Are nurses prepared to respond to next infectious disease outbreak: A narrative synthesis

Development and psychometric testing of the nurses' core competencies for public health emergencies scale: A multicenter cross-sectional study

BACKGROUND

The significance of addressing public health emergencies (PHEs) emphasizes the pivotal role of a skilled nursing workforce in effective preparedness and response. However, there's a lack of comprehensive assessments tailored to nurses' core competencies, serving as a standard for ongoing education in preparedness.

OBJECTIVE

This study aimed to develop a psychometrically sound scale for identifying and measuring essential core competencies crucial for nurses during public health emergencies.

DESIGN

A multicenter cross-sectional study was conducted.

SETTINGS

Twelve tertiary hospitals in Shanghai.

PARTICIPANTS

Affiliated nurses with prior experience and significant exposure to public health emergencies were recruited.

METHODS

The study underwent development and validation in two stages, utilizing qualitative data analysis, a Delphi expert panel, and an empirical quantitative cross-sectional survey. The Nurses' Core Competencies for Public Health Emergencies (NCC-PHEs) scale and a demographic questionnaire were distributed between January 2023 and March 2023. Exploratory factor analysis, confirmatory factor analysis, Pearson correlations, and Cronbach's alpha analyses were employed to identify theoretical constructs, assess scale reliability, and establish validity.

RESULTS

Analysis was conducted on valid data collected from 1481 nurses. Factor analysis identified 47 professional nursing competencies arranged within a four-factor high-order model: prevention competencies (9 items), preparation competencies (7 items), response competencies (comprising basic and advanced levels) (26 items), and recovery competencies (5 items). Structural equation modelling confirmed satisfactory factor loadings and a good model fit, validating construct integrity. The reliability of the total scale was confirmed.

CONCLUSION

This study presents a valid scale that empirically measures nurses' core competencies crucial for preparedness and response during public health emergencies. The findings offer instrumental support for guiding the development of future courses and training programs in nursing research and practice.

General nurse competencies in disaster: A delphi study

AIM

The aim of this study is to understand the significance of a disaster-related competence framework for Portuguese general nurses and identify from ICN - Core Competencies in Disaster Nursing version 2.0 core competencies description, those that are considered crucial for a competent preparedness and response in disaster scenarios.

BACKGROUND

Research suggests that the occurrence of disasters will be more recurrent, requiring that nurses, pillars of any health system, have knowledge, skills and preparedness to face these events.

DESIGN

An exploratory, cross-sectional qualitative study was carried out. Delphi method was used for data collection.

METHODS

The study group consisted of technical-scientific council's presidents or coordinators/directors of nursing courses, nurses integrated in the Portuguese Council of Nurses and National Nursing Specialty Colleges and nurses with experience in the field of disasters.

RESULTS

Findings revealed that there is consensus on sixteen competencies, considered relevant for developing general nurse knowledge and competence, both at a national or international level, in the field of disasters.

CONCLUSIONS

The development of these competencies which establishes practice standards, building nurses skills and knowledge and ultimately, influencing nursing level-entry curricula's, conferring professional autonomy and self-regulation, in the field of disaster are fundamental. Furthermore, this study may serve as a reference for future alignment of competency frameworks between European Union countries or others.

Competency in responding to infectious disease outbreaks among nurses in primary healthcare institutions: a quantitative, cross-sectional multicentre study

Background

Nurses' competencies are crucial for infectious disease prevention and control. We aimed to investigate competencies in responding to infectious disease outbreaks of nurses in primary healthcare institutions and identify their training needs.

Methods

A cross-sectional study was conducted from June to September 2022, recruiting nurses from primary healthcare institutions across Sichuan Province. Their competencies and training needs were assessed using a modified Emergency Response Competency Scale for Infectious Diseases. Additionally, their sociodemographic characteristics and experience in infectious disease outbreak trainings were collected. Univariate analyses were used to compare competencies and training needs by participant characteristics. Multiple linear regression was conducted to identify determinants of their competencies.

Results

A total of 1,439 nurses from 44 primary healthcare institutions participated in this study. The overall competency and training needs had a median of 3.6 (IQR [3.1, 4.0]) and 4.0 (IQR [3.9, 4.7]), respectively. Age (β = -0.074, p = 0.005), experience in higher authority hospitals (β = 0.057, p = 0.035), infectious disease outbreak trainings attended within the last 5 years (β = 0.212, p < 0.001), and regions where the institutions located were determinants of the competencies.

Conclusion

The competencies in responding to infectious disease outbreaks among nurses in primary healthcare institutions were at a moderate level, influenced by varied factors.

COVID-19 and nurses' ethical issues: Comparisons between two European countries

BACKGROUND

The global pandemic raised ethical issues for nurses about caring for all patients, not just those with COVID-19. Italy was the first European country to be seriously affected by the first wave, while Estonia's infection and death rates were among the lowest in Europe. Did this raise different ethical issues for nurses in these two countries as well?

AIM

The aim was to describe and compare ethical issues between nurses working during the first wave of the COVID-19 pandemic in Estonia and Italy.

RESEARCH DESIGN

A cross-sectional survey study with a self-administered questionnaire. The impact of COVID-19 emergency on nursing care questionnaire was used.

PARTICIPANTS AND RESEARCH CONTEXT

Convenience sampling was used to recruit 1098 nurses working during the first wave of the pandemic in 2020: 162 from Estonia and 936 from Italy.

ETHICAL CONSIDERATIONS

Research ethics approvals were obtained, and the nurses provided informed consent.

RESULTS

The most frequent ethical issues for Estonian nurses were professional communication and ensuring access to care for patients without COVID-19, and for Italian nurses, the end-of-life care and the risk of them getting the virus and transmitting it to their loved ones. There were no statistically significant differences in the frequency of ethical issues between Estonian nurses working with patients with and without COVID-19. Italian nurses caring for COVID-19 patients faced statistically significantly more (both p < .001) issues around prioritising patients and end-of-life. Nurses working with patients without COVID-19 in Italy faced more issues about access to care (p < .001).

CONCLUSIONS

Estonian and Italian nurses, working in different clinical contexts during the first wave of the pandemic, faced different ethical issues. Local contextual aspects need to be considered to support nurses' ethical decision-making in providing care during future crises and to ensure ethical care for patients.

Nursing Graduates' Preparedness for Practice: Substantiating the Call for Competency-Evaluated Nursing Education

Practice readiness continues to be a challenge in healthcare. This was especially evident during the COVID-19 pandemic. This focused descriptive-correlational study examined nurses' perceived preparedness for practice during the pandemic. One hundred and eighty-four registered nurses (RN) responded to Qualtrics survey questions addressing the competencies they perceived they had and the competencies they felt they needed that would have better prepared them to care for patients during the COVID-19 pandemic. The results demonstrated that although these nurses felt competent in certain areas, they perceived that they needed more education in those same areas to feel better prepared. Bivariate correlations and linear regression analysis indicated that institutional competency development, education, and work experience influenced perceived competency.

Middle Eastern nurses' views/experiences of work and well-being with the support measures during past disease outbreaks and COVID-19: a qualitative systematic review

BACKGROUND

The potential psychological health impact of pandemics on nurses has been increasingly widely recognised, as have recommendations to establish support measures for nurses' well-being. Despite the availability of support measures significant number of nurses still experienced burnout and mental distress during Covid-19. Few efforts have been made in the wider literature to understand how nurses experience well-being support or how they perceive it affects their well-being during pandemics. In the Middle East, understanding and exploring well-being support measures during pandemics from nurses' perspectives has not received significant attention.

OBJECTIVE

To investigate nurses' perspectives and experiences of well-being support measures during prior pandemics and the Covid-19 pandemic in the Middle East.

METHODS

A systematic qualitative review was undertaken utilising the JBI model as a framework. Searches were carried out in databases comprised CINAHL, MEDLINE, NUsearch Library of Nottingham University and Google Scholar. Moreover, a manual search through reference lists for relevant studies were carried out.

DATA EXTRACTION AND SYNTHESIS

Eleven studies were included in the review. The findings from the included qualitative studies were extracted using the JBI-QARI data extraction tool for qualitative research. The results were synthesised using a meta-synthesis in line with the JBI approach.

RESULTS

The included studies yielded an aggregate of 111 findings and were categorised into 14 categories, followed by four synthesised findings. These were: [1] nurses experienced challenges during MERS, yet different strategies were implemented by leaders and nurses to manage these challenges; [2] some well-being support measures were unfulfilled during Covid-19; [3] additional aspects compounded negatively on nurses' well- being; and [4] nurses showed maturity during Covid-19.

CONCLUSION

In comparison to prior health emergencies, well-being support measures during Covid-19 were not sufficiently adopted. Nurse policymakers and managers should consider these support measures to correspond with nurses' needs and explore the contextual factors that affect their implementation.

TRIAL REGISTRATION

PROSPERO (CRD42022344005).

A practice-based nursing emergency management system model for public health emergencies: A descriptive qualitative study

AIM

This study aims to explore nursing emergency management system under public health emergencies.

DESIGN

A descriptive qualitative study.

METHOD

Semi-structured interviews were conducted during March-November 2020 with 11 nursing emergency management administrators from 11 COVID-19 designated hospitals and infectious disease hospitals under four administrative divisions in China, who were recruited through convenience and purposive sampling. Interviews were audio-recorded and transcribed. Data were analysed with Braun and Clarke's inductive thematic analysis. The study adhered to the Consolidated Criteria for Reporting Qualitative Research.

RESULTS

Three main themes emerged from data analysis: (1) Five core elements of nursing emergency management system: Structure, Staff, System, Setting, and Supply (5S); (2) Four phases of nursing emergency management system: Reduction, Readiness, Response and Recovery (4R); and (3) operational process of nursing emergency management system (5S*4R). The findings generated a conceptual model of a nursing emergency management system.

PUBLIC CONTRIBUTION

This study provides a theoretical basis for nursing emergency management system for public health emergencies in the future. Nurse administrators could refer to this model to either review or develop their system and develop viable interventions to prepare for future public health emergencies.

Do Contextual and Demographic Factors Help Malaysian Nurses Prepare in Dealing with the COVID-19 Pandemic?

As of 11 October 2020, Sabah comprised a quarter of all COVID19 cases reported in Malaysia since the start of the pandemic last January 2020. In this pandemic, nurses serve in vital roles to mitigate the effects of COVID-19. This study aims to explore the nurses’ preparedness in managing the COVID-19 outbreak situation in Sabah, Malaysia, examining the contextual (e.g., participated in an actual major disaster event) and demographic factors (e.g., age and working experience that may influence nurses’ preparedness for managing the COVID-19 pandemic). A total of 317 nurses in Sabah, Malaysia were involved in this study. The Emergency Preparedness Information Questionnaire (EPIQ) contained 41 items and was used to assess civilian nurses’ perceived familiarity with 9 competency dimensions of preparedness. The mean scores of nurses’ preparedness indicated a moderate level of nurses’ preparedness in managing the COVID-19 pandemic (mean ranging from 2.89 to 3.79). The results indicated that there was a significant difference between the nurses who actively participate in an actual major disaster event and who were not active in a total of preparedness and all dimensions (t = 2.79, df = 285, p = 0.006) (except in familiarity with decontamination and familiarity with special populations), across working experience (F(2,291) = 5.09, p = 0.007) (except familiarity with Incident Command System and role), and age among nurses ((F(3,290) = 2.68, p = 0.047)) (total of preparedness, familiarity with ethical issues in triage, epidemiology, and surveillance, and psychological issues). Overall, this study has made a significant theoretical contribution, as well as in clinical implications in the field of nursing practice, by addressing the impact of contextual and demographic factors on nurses’ preparedness in managing the COVID-19 outbreak situation. This study will help nurses to understand the skills, abilities, knowledge, and actions needed to respond, mitigate, and prepare for emergencies during pandemics and disasters.