Becker's Clinical Quality & Infection Control

36 QUALITY IMPROVEMENT & MEASUREMENT New Jersey to offer free at-home wellness checks in attempt to cut maternal deaths By Gabrielle Masson N ew Jersey — which has one of the highest maternal mortality rates in the U.S. — will establish a program letting new parents receive free at-home wellness checks from nurses, e New York Times reported July 29. For every 100,000 live births in 2020, more than 26 New Jersey women died of pregnan- cy complications, according to CDC data cited by the Times. Black women in New Jersey were seven times more likely to die from pregnancy-related complications than white women, the data showed. e new bill, which Democratic Gov. Phil Murphy is set to sign July 29, will create a universal, voluntary home nurse visitation program for parents of newborns aimed at reducing the state's maternal mortality rate, which is the fourth highest in the nation, according to the Times. e plan, called Nurture New Jersey, aims to cut state mater- nal mortality rates in half in five years. e free wellness check — provided regard- less of income or insurance status — will consist of a registered nurse coming to the homes of families with newborns and assessing mother and baby for physical problems, breastfeeding issues, postpartum mood disorders and any potential social factors. Research has found that the more support mothers have aer they give birth, the better the outlook for both mother and baby, reported the Times. Oregon has a similar program, but New Jersey will be the first state to offer home visits within the first two weeks of birth. Adoptive parents and those who experience stillbirths will also be eligible for the program. Families are allotted up to three free home visits within three months, with services anticipated to become available within the year. "We know that oentimes when moms and fami- lies are experiencing some kind of life-threatening complication that they've had the symptoms for hours or days before they present to care," Suzanne Spernal, DNP, vice president of women's services at RWJBarnabas Health, told the Times. "is is an opportunity to intervene earlier so that we're able to possibly circumvent some of these catastrophic adverse events for mom and baby." n Fitbit, Apple Watch can identify COVID-19's long-term effects, Scripps study finds By Jackie Drees W earable health-tracking devices like Fitbit and Ap- ple Watch may help detect early signs of COVID-19 infections, as well as provide better insights into patients' long-term recovery from the disease, according to a paper published July 7 in JAMA Network Open. The paper examines study results from the Digital En- gagement and Tracking for Early Control and Treatment trial, spearheaded by researchers at the Scripps Research Translational Institute in La Jolla, Calif. More than 37,000 people enrolled in the study, which collected wearables data from March 25, 2020, to Jan. 24, 2021. Participants downloaded the MyDataHelps research app and consented to share health data from their Fitbit, Ap- ple Watch or other wearable device as well as report any illness symptoms to the app and results of any COVID-19 tests. The researchers found that when they combined wearable data with self-reported symptoms, they could detect COVID-19 cases more accurately than when they only analyzed symptoms. After the results of the first trial, the Scripps researchers launched a new study focusing on a subset of 875 Fitbit wearers who reported having a fever, cough, body aches or other symptoms of respiratory illness and were tested for COVID-19, according to a July 7 New York Times re- port. Of the group, 234 tested positive for the virus, while the rest were believed to have other kinds of infections. The study found that individuals from both groups slept more and walked less after getting sick while their resting heart rates were higher, according to the report. These changes were more pronounced in people with COVID-19, Jennifer Radin, MD, a Scripps epidemiologist leading the DETECT trial, told the Times. The researchers also found that about nine days after par- ticipants with COVID-19 first began reporting symptoms, their heart rates dropped. After the drop, which was not observed in participants with other illnesses, their heart rates rose again and remained heightened for months. On average, it took 79 days for their resting heart rates to return to normal, compared to four days for those in the non-COVID-19 group. The prolonged heart-rate elevation may be a sign that COVID-19 disrupts the autonomic nervous system, which manifests in symptoms such as heart palpitations and dizzi- ness, according to the report. Participants' sleep and activity levels also returned to their baselines more slowly in individu- als with COVID-19, compared to those with other ailments. A limitation of the study, according to the researchers, was that they did not ask the participants to continue reporting their symptoms in the weeks and months after they first felt ill; however, the team plans to ask volunteers to do that in future research, according to the Times. n

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