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Causby B, Jakimowicz S, Levett-Jones T. Upskill training and preparedness of non-critical-care registered nurses deployed to intensive care units during the COVID-19 pandemic: A scoping review. Aust Crit Care 2024; 37:790-804. [PMID: 38582624 DOI: 10.1016/j.aucc.2024.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Revised: 01/16/2024] [Accepted: 02/06/2024] [Indexed: 04/08/2024] Open
Abstract
BACKGROUND The increase in intensive care unit (ICU) capacity compelled by the COVID-19 pandemic required the rapid deployment of non-critical-care registered nurses to the ICU setting. The upskill training needed to prepare these registered nurses for deployment was rapidly assembled due to the limited timeframe associated with the escalating pandemic. Scoping the literature to identify the content, structure, and effectiveness of the upskill education provided is necessary to identify lessons learnt during the COVID-19 pandemic response so that they may guide workforce preparation for future surge planning. AIM The aim of this scoping review was to map the literature to identify the available information regarding upskill training and preparedness of non-critical-care registered nurses deployed to the ICU during the COVID-19 pandemic. METHODS This scoping review was conducted in accordance with JBI methodology. A protocol outlined the review questions and used the participants, concept, and context framework to define the inclusion and exclusion criteria. A search of healthcare databases MEDLINE (Ovid), Embase (Ovid), CINAHL (EBSCO), Cochrane, and Scopus was supplemented with a grey literature search via Google. RESULTS Screening and review found 32 manuscripts that met the inclusion criterion for examination. Analysis revealed variation in duration of programs, theoretical versus practical content, face-to-face or online mode of delivery, and duration of preparation time at the bedside in the ICU setting. Data on contributors to preparedness for deployment were sparse but included training, support, peer education, buddy time, and clarity around responsibilities and communication. DISCUSSION Evaluation of upskill education was mostly limited to post-training surveys. Few studies explored the preparedness of deployed registered nurses as an outcome of their upskill training or described measures of effectiveness of ICU deployment. CONCLUSION There is limited evidence describing preparedness of non-critical-care registered nurses on deployment to the ICU. Further research is needed to identify what elements of upskill education led to preparedness and effective deployment to the ICU setting.
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Affiliation(s)
- Belinda Causby
- Faculty of Health, University of Technology Sydney, NSW, Australia; Intensive Care Unit, St Vincent's Hospital, Sydney, NSW, Australia.
| | - Samantha Jakimowicz
- Faculty of Health, University of Technology Sydney, NSW, Australia; Faculty of Science and Health, Charles Sturt University, NSW, Australia.
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Carter D, Rosen A, Applebaum JR, Southern WN, Crossman DJ, Shelton RC, Auerbach A, Schnipper JL, Adelman JS. National Survey of Patient Safety Experiences in Hospital Medicine During the COVID-19 Pandemic. Jt Comm J Qual Patient Saf 2024; 50:260-268. [PMID: 38087723 DOI: 10.1016/j.jcjq.2023.10.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 10/21/2023] [Accepted: 10/23/2023] [Indexed: 05/07/2024]
Abstract
BACKGROUND During the COVID-19 pandemic, hospitals were caring for increasing numbers of patients with a novel and highly contagious respiratory illness, forcing adaptations in care delivery. The objective of this study was to understand the impact of these adaptations on patient safety in hospital medicine. METHODS The authors conducted a nationwide survey to understand patient safety challenges experienced by hospital medicine clinicians during the COVID-19 pandemic. The survey was distributed to members of the Society of Hospital Medicine via an e-mail listserv. It consisted of closed- and open-ended questions to elicit respondents' experience in five domains: error reporting and communication, staffing, equipment, personal protective equipment (PPE) and isolation practices, and infrastructure. Quantitative questions were reported as counts and percentages; qualitative responses were coded and analyzed for relevant themes. RESULTS Of 196 total responses, 167 respondents (85.2%) were attending physicians and 85 (43.8%) practiced at teaching hospitals. Safety concerns commonly identified included nursing shortages (71.0%), limiting patient interactions to conserve PPE (61.9%), and feeling that one was practicing in a more hazardous environment (61.4%). In free-text responses, clinicians described poor outcomes and patient decompensation due to provider and equipment shortages, as well as communication lapses and diagnostic errors resulting from decreased patient contact and the need to follow isolation protocols. CONCLUSION Efforts made to accommodate shortages in staff and equipment, adapt to limited PPE, and enforce isolation policies had unintended consequences that affected patient safety and created a more hazardous environment characterized by less efficient care, respiratory decompensations, diagnostic errors, and poor communication with patients.
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Alismail A, Esteitie R, Leon-Astudillo C, Pantaleón García J, Sangli S, Kumar Sunil S. Twelve Tips to Succeed as Health Profession Clinical Educator in Resource-Limited Settings. ADVANCES IN MEDICAL EDUCATION AND PRACTICE 2024; 15:201-206. [PMID: 38505497 PMCID: PMC10949165 DOI: 10.2147/amep.s453993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Accepted: 03/06/2024] [Indexed: 03/21/2024]
Abstract
Health professions education is one of the pillars of academic medicine; however, clinical educators often lack the appropriate resources to succeed in this field. Examples of these challenges include: lack of support for faculty development, mentorship, and high cost of resources, when available. In addition, challenges such as the Coronavirus disease (COVID-19) pandemic can affect healthcare personnel who are already struggling to provide adequate patient care while attempting to succeed in the role of educator and supervisor of trainees. Clinical educators face more challenges particularly in low-middle income countries as the limitations are more prominent and become key barriers to success. Similarly, due to COVID-19, these challenges can be far more evident in disadvantaged geographical, economic, and academic environments even in the United States. Herein, in this perspective paper, we define resource-limited settings in medical education, provide an overview of the most common barriers to career development as a clinical educator, and offer practical strategies to overcome some of these shortcomings.
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Affiliation(s)
- Abdullah Alismail
- Department of Cardiopulmonary Sciences, School of Allied Health Professions, Loma Linda University Health, Loma Linda, CA, USA
- Department of Medicine, School of Medicine, Loma Linda University Health, Loma Linda, CA, USA
| | - Rania Esteitie
- Department of Pulmonary and Critical Care Medicine, Covenant HealthCare, Saginaw, MI, USA
| | | | - Jezreel Pantaleón García
- Department of Pulmonary Medicine, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Swathi Sangli
- Department of Pulmonary and Critical Care, Kaiser Permanente, San Leandro, CA, USA
| | - Sriram Kumar Sunil
- Department of Internal Medicine, Jacobi Medical Center, Bronx, New York City, NY, USA
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Soklaridis S, Chowdhury M, Turco MG, Tremblay M, Mazmanian P, Williams B, Besa R, Sockalingam S. Pivoting Continuing Professional Development During the COVID-19 Pandemic: A Narrative Scoping Review of Adaptations and Innovations. THE JOURNAL OF CONTINUING EDUCATION IN THE HEALTH PROFESSIONS 2024:00005141-990000000-00104. [PMID: 38205969 DOI: 10.1097/ceh.0000000000000539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/12/2024]
Abstract
INTRODUCTION Most formal continuing professional development (CPD) opportunities were offered in person until March 2020 when the COVID-19 pandemic disrupted traditional structures of CPD offerings. The authors explored the adaptations and innovations in CPD that were strengthened or newly created during the first 16 months of the pandemic. METHODS The objectives of the narrative review were to answer the following questions: (1) what types of adaptations to CPD innovations are described? and (2) what may shape future innovations in CPD? The following databases were searched: Medline, Embase, CINAHL, and ERIC to identify the literature published between March 2020 to July 2021. The authors conducted a comprehensive search by including all study types that described adaptations and/or innovations in CPD during the stated pandemic period. RESULTS Of the 8295 citations retrieved from databases, 191 satisfied the inclusion criteria. The authors found three categories to describe adaptations to CPD innovations: (1) creation of new online resources, (2) increased use of the existing online platforms/software to deliver CPD, and (3) use of simulation for teaching and learning. Reported advantages and disadvantages associated with these adaptations included logistical, interactional, and capacity building elements. The review identified five potential future CPD innovations: (1) empirical research on the effectiveness of virtual learning; (2) novel roles and ways of thinking; (3) learning from other disciplines beyond medicine; (4) formation of a global perspective; and (5) emerging wellness initiatives. DISCUSSION This review provided an overview of the adaptations and innovations that may shape the future of CPD beyond the pandemic.
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Affiliation(s)
- Sophie Soklaridis
- Dr. Soklaridis: Senior Scientist, Centre for Addiction and Mental Health, Toronto, Ontario, Canada, Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada, Department of Family and Community Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada, and The Wilson Centre, University Health Network/University of Toronto, Toronto, Ontario, Canada. Ms. Chowdhury: PhD (cand.), Centre for Addiction and Mental Health, Toronto, Ontario, Canada. Dr. Turco: Associate Professor of Medicine, Department of Medicine, Dartmouth-Hitchcock Medical Centre/Geisel School of Medicine at Dartmouth, Lebanon, NH. Dr. Tremblay: Senior Research and Innovation Advisor, Fédération des médecins spécialistes du Québec, Montréal, Québec, Canada. Dr. Mazmanian: Professor Emeritus, Department of Preventive Medicine and Community Health, Virginia Commonwealth University, Richmond, VA. Dr. Williams: Clinical Program Director, Professional Renewal Centre, Lawrence, KS, and Department of Psychiatry, School of Medicine, University of Kansas, Kansas City, KS. Ms. Besa: Information Specialist, Centre for Addiction and Mental Health, Toronto, Ontario, Canada. Dr. Sockalingam: Vice-President Education, Centre for Addiction and Mental Health, Toronto, Ontario, Canada, Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada, and The Wilson Centre, University Health Network/University of Toronto, Toronto, Ontario, Canada
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Pogorzelska-Maziarz M, de Cordova PB, Manning ML, Johansen ML, Grafova I, Gerolamo A. Voices from frontline nurses on care quality and patient safety during COVID-19: An application of the Donabedian model. Am J Infect Control 2023; 51:1295-1301. [PMID: 37625547 DOI: 10.1016/j.ajic.2023.08.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 08/18/2023] [Accepted: 08/19/2023] [Indexed: 08/27/2023]
Abstract
BACKGROUND The COVID-19 pandemic has adversely impacted quality of care and patient safety. This study aimed to describe registered nurses' (RNs) perceptions on the impact of the COVID-19 pandemic on their ability to adhere to patient safety protocols using Donabedian's Health Care Quality model. METHODS In October 2020, a survey was conducted among all actively licensed RNs in New Jersey who provided direct patient care during the first peak of COVID-19. RESULTS Of 3,027 participants, 68% reported that the number of patients assigned impacted their ability to adhere to protocols. RNs identified a variety of organizational structures impacting adherence, including inadequate staffing, staff qualifications, and inadequate resources. Impacted processes included the inability to adhere to patient safety protocols and conduct comprehensive assessments and surveillance, the need for additional time spent on personal protective equipment and isolation policies, and difficulty maintaining isolation integrity; the need to prioritize and cluster care; and guidelines limiting personnel who could enter the room. Nurses attributed both adverse patient and staff outcomes to inadequate staffing and high patient acuity. CONCLUSIONS These findings highlight the need for health care organizations to support frontline nursing staff in adhering to patient safety and infection prevention and control protocols during times of crises. Infection preventionists have substantial contact with bedside nurses and should leverage their collegial relationships to promote patient safety.
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Affiliation(s)
| | | | - Mary Lou Manning
- Thomas Jefferson University College of Nursing, Philadelphia, PA
| | - Mary L Johansen
- Rutgers University, Biomedical and Health Sciences, Newark, NJ
| | - Irina Grafova
- Rutgers University, Edward J. Bloustein School of Planning & Public Policy, New Brunswick, NJ
| | - Angela Gerolamo
- Thomas Jefferson University College of Nursing, Philadelphia, PA
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Zimbudzi E, Fraginal D. Experiences of redeployment by haemodialysis nurses during the COVID-19 pandemic: a hermeneutic phenomenological approach. Contemp Nurse 2023; 59:377-391. [PMID: 37756418 DOI: 10.1080/10376178.2023.2262064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 09/17/2023] [Indexed: 09/29/2023]
Abstract
BACKGROUND Redeployment of healthcare workers is one of the strategies that has been successfully used to manage increased workload and shortage of staff during the COVID-19 pandemic. However, little is known about how best to do this in the pandemic and beyond. The purpose of this study was to explore the lived experiences of haemodialysis nurses who were redeployed across five haemodialysis units affiliated with a large metropolitan teaching hospital in Australia during the COVID-19 pandemic. DESIGN Qualitative design utilizing a hermeneutic (interpretive) phenomenology approach. METHODS Interviews were conducted in March 2022 among nurses who had been redeployed to other haemodialysis units during the COVID-19 pandemic (N = 16). Audiotaped interviews were transcribed verbatim and analysed independently by two researchers following specific steps of hermeneutic phenomenological analysis. RESULTS Five themes were derived from the analyses. These were: (1) Nurses' immediate reaction; (2) Barriers to redeployment; (3) Benefits of redeployment; (4) Local and organisational support and (5) Opportunities for improvement. CONCLUSIONS Redeployment of nurses across different haemodialysis units is associated with personal and organisational benefits and number of barriers that need to be addressed. Future studies should explore the long-term effects of redeployment due to the COVID-19 pandemic on haemodialysis nurses and other healthcare workers.
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Affiliation(s)
- Edward Zimbudzi
- School of Nursing and Midwifery, Monash University, Melbourne, Australia
- Department of Nephrology, Monash Health, Melbourne, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Denise Fraginal
- Department of Nephrology, Monash Health, Melbourne, Australia
- Chronic and Complex Care-Renal, Western Health, Melbourne, Australia
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Changes to teaching and learning about medication administration within a diploma of nursing course due to the Covid-19 pandemic: A staff and student multi-method evaluation. Nurse Educ Pract 2023; 67:103547. [PMID: 36669295 PMCID: PMC9844256 DOI: 10.1016/j.nepr.2023.103547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Revised: 12/13/2022] [Accepted: 01/03/2023] [Indexed: 01/19/2023]
Abstract
AIM This project aimed to evaluate student and staff satisfaction with, and perspectives on, changes to delivery and format of the Medication Unit of Competency within a Diploma of Nursing Program. BACKGROUND Medication safety is an integral component of learning for pre-registration nursing students. The COVID-19 pandemic required rapid changes to be made to the medication competency unit being taught to students within a Diploma of Nursing, pre-registration course. Changes to sequencing of theory, mode of education delivery, class sizes, available resources and learning support were required. DESIGN A multi-method evaluation process was conducted. The project is reported as per SQUIRE-EDU guidelines. METHODS Focus groups and survey data were obtained from staff and students in December 2020, to evaluate responses to the changes. Student exam results and the number of learning support consultations accessed were also assessed to identify impact of changes. RESULTS Staff and student evaluation identified mixed responses but overall, the change in sequence of theory and mode of delivery was positively received. Crude comparisons of final assessment results revealed improved marks compared to the previous cohort. The addition of an online medication resource was utilised by most students. The agility of staff in responding to the challenges was highlighted in the staff focus group and additional, flexible learning support was favourably received by students. CONCLUSIONS Despite the need for rapid changes being made to the course, positive responses were received from both staff and students. Some students preferred the traditional sequencing of learning as they felt it matched their learning style. An added online resource and extra learning support supported student self-efficacy development of medication competency; however further research is needed to ascertain any associations. The online resource is still being utilised within course curriculum.
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Gundo B, Beyamu J, Singo A, Chipeta D, Gundo R, Kazembe A. Healthcare workers' experiences in caring for critically ill COVID-19 patients at a tertiary hospital in Malawi. Malawi Med J 2022; 34:267-272. [PMID: 38125779 PMCID: PMC10645831 DOI: 10.4314/mmj.v34i4.7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2023] Open
Abstract
Introduction The coronavirus pandemic overwhelmed the healthcare landscape, placing a strain on healthcare workers worldwide. In addition to directly causing the deaths of people, the COVID-19 pandemic disrupted critical health services in developing countries. The study aimed to explore the experiences of healthcare workers who cared for critically ill COVID-19 patients at a tertiary hospital in Malawi. Methods A qualitative descriptive design was used. Data were gathered through in-depth interviews with doctors, clinical officers, nurses, and allied staff (n=25) who were involved in the care of critically ill COVID-19 patients at the hospital's COVID-19 treatment centres during the first and second waves of the pandemic in Malawi. The interviews were conducted in English, audiotaped, and later transcribed verbatim. Conventional content analysis was used to analyse the data following the steps proposed by Hsieh and Shannon1. Results The overall experience of the health workers was negative. However, delivering care to critically ill COVID-19 patients was associated with positive and negative experiences. The positive experience was a result of teamwork among staff and support from hospital authorities and the community. Negative experiences, on the other hand, were attributed to a lack of knowledge and skills in managing critically ill COVID-19 patients, a lack of resources, and abuse by some patients and members of the community. Furthermore, there was fear of contracting the virus from patients and fellow health workers while providing care. Conclusion The findings point to the need for adequate preparedness within the health sector to support and protect the healthcare workers and individuals they look after. There is a need for disease awareness strategies for health workers and the general public for future pandemics.
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Affiliation(s)
| | | | | | - Deliwe Chipeta
- Malawi Ministry of Health, COVID-19 Secretariat, Lilongwe, Malawi
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Krauss DM, Molefe A, Hung L, Hayes K, Gorman C, Latterner M, Henderson S, Miller M. Emergent themes from a quality improvement programme for CLABSI/CAUTI prevention in ICUs amid the COVID-19 pandemic. BMJ Open Qual 2022; 11:bmjoq-2022-001926. [DOI: 10.1136/bmjoq-2022-001926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 11/01/2022] [Indexed: 11/23/2022] Open
Abstract
ObjectivesHealthcare-associated infection (HAI) prevention has been difficult for healthcare providers to maintain during the COVID-19 pandemic. This study summarises themes for maintaining infection prevention activities learnt from the implementation of a quality improvement (QI) programme during the pandemic.MethodsWe conducted qualitative analysis of participants’ semistructured exit interviews, self-assessments on HAI prevention activities, participant-created action plans, chat-box discussions during webinars and informal correspondence.SettingIntensive care units (ICUs) with elevated rates of central line-associated bloodstream infections (CLABSI) and/or catheter-associated urinary tract infections (CAUTI) participating in the Agency for Healthcare Research and Quality Safety Programme for ICUs: Preventing CLABSI and CAUTI.ResultsForty-nine ICU teams who participated in the programme between December 2019 and April 2021 found ways to maintain activities such as daily huddles, multidisciplinary rounds, and central line and indwelling urinary catheter monitoring despite barriers, including staff turnover, a lack of time, staff fatigue and pandemic-related guidelines limiting providers’ time around patients. We use four themes to summarise the ICU teams’ adaptations that allowed them to sustain infection prevention activities: (1) Units had CLABSI and CAUTI prevention teams, policies and practices established prior to the pandemic; (2) Units were flexible in their implementation of those policies and practices; (3) Units maintained consistent buy-in for and engagement in HAI prevention activities among both leadership and care teams throughout the pandemic and (4) Units looked to learn from other units in their facility and beyond.ConclusionsFuture shocks such as the pandemic must be anticipated, and the healthcare system must be resilient to the resulting disruptions to HAI prevention activities. This study encountered four themes for successful maintenance of infection prevention activities during the current pandemic: the value of a pre-existing infection prevention infrastructure; a flexibility in approach; broad buy-in for maintaining QI programmes and the facilitation of idea-sharing.
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Scott PA, Orton H, Daw R. ACP-supported redeployment in response to the COVID-19 pandemic: a service evaluation of staff experience. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2022; 31:940-946. [PMID: 36227788 DOI: 10.12968/bjon.2022.31.18.940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
BACKGROUND During the COVID-19 pandemic, healthcare organisations around the world had to optimise resources and redeploy staff to meet unprecedented demands on services. This service evaluation aims to establish the experiences of nurses redeployed to a COVID-negative Nightingale ward during the first wave of the pandemic in the UK. METHODS Purposive sampling using a survey was used to capture nurses' experiences. Data were extrapolated to meet the aims of the thematic line of enquiry and descriptive statistics used to analyse the data set. RESULTS The response rate was 34.0% (n=30). The majority of redeployees (76.7%; n=23) strongly agreed or agreed the trust induction had been beneficial. Informal learning, including from colleagues, was said to be very helpful by 50.0% (n=15) and helpful by 36.7% (n=10) of participants. Most (90.0%; n=27) agreed they were able to maintain safety, with 93.3% (n=28) satisfied with the quality of their care. Regarding giving the care they aspired to, 46.7% (n=14) strongly agreed and 40.0% (n=12) agreed they had been able to do this. CONCLUSION The advanced clinical practitioner role was central to successful redeployment, in preparing redeployees through induction and education. These practitioners facilitated the acquisition of the knowledge and skills to deliver competent care, ensuring staff had the capacity and capability to undertake their job. Patient safety was not compromised by redeployment.
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Affiliation(s)
- Paul Anthony Scott
- Advanced Clinical Practitioner: Acute Medicine, Liverpool University Hospitals NHS Foundation Trust
| | - Helen Orton
- Academic Lead for Continuing Professional Development, University of Liverpool School of Health Sciences
| | - Rachael Daw
- Postgraduate Lecturer, University of Liverpool School of Health Sciences
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Spencer SA, Gumley JS, Pachucki M. Paediatric admissions to a district general hospital adult intensive care unit over a six year period: A single centre retrospective case series, with review of practitioner confidence and competence in paediatric critical care. J Intensive Care Soc 2022; 23:297-304. [PMID: 36033240 PMCID: PMC9411777 DOI: 10.1177/17511437211012151] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2024] Open
Abstract
BACKGROUND Critically ill children presenting to district general hospitals (DGH) are admitted to adult intensive care units (AICUs) for stabilisation prior to transfer to paediatric intensive care units (PICUs). Current training in PICU for adult intensive care physicians is only three months. This single centre retrospective case series examines the case mix of children presenting to a DGH AICU and a multidisciplinary survey assesses confidence and previous experience, highlighting continued training needs for DGH AICU staff. METHODS all paediatric admissions to AICU and paediatric retrievals were reviewed over a 6-year period (2014-2019). Cases were identified from the Electronic Patient Record (EPR) and from data provided by the regional paediatric retrieval service. A questionnaire survey was sent to AICU doctors and nurses to assess confidence and competence in paediatric critical care. RESULTS Between 2014-2019, 284 children were managed by AICU. In total 35% of cases were <1 y, 48% of cases were <2 y and 64% of cases were <5 y, and 166/284 (58%) children were retrieved. Retrieval reduced with increasing age (OR 0.49 [0.40-0.60], p < 0.0001). The survey had an 82% response rate, and highlighted that only 13% of AICU nurses and 50% of doctors had received prior PICU training. CONCLUSION At least one critically unwell child presents to the AICU each week. Assessment, stabilisation and management of critically unwell children are vital skills for DGH AICU staff, but confidence and competence are lacking. Formalised strategies are required to develop and maintain paediatric competencies for AICU doctors and nurses.
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Affiliation(s)
- Stephen A Spencer
- Gloucestershire Hospitals NHS Foundation Trust, Gloucester, UK
- Severn Deanery, Health Education South West, Bristol, UK
| | - Joanna S Gumley
- Gloucestershire Hospitals NHS Foundation Trust, Gloucester, UK
- Severn Deanery, Health Education South West, Bristol, UK
| | - Marcin Pachucki
- Gloucestershire Hospitals NHS Foundation Trust, Gloucester, UK
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Santana-Padilla YG, Bernat-Adell MD, Santana-Cabrera L. Nurses’ perception on competency requirement and training demand for intensive care nurses. Int J Nurs Sci 2022; 9:350-356. [PMID: 35891902 PMCID: PMC9305005 DOI: 10.1016/j.ijnss.2022.06.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 05/29/2022] [Accepted: 06/13/2022] [Indexed: 11/19/2022] Open
Affiliation(s)
- Yeray Gabriel Santana-Padilla
- Complejo Hospitalario Universitario Insular Materno Infantil, Las Palmas de Gran Canaria, Canary Islands, Spain
- Corresponding author.
| | | | - Luciano Santana-Cabrera
- Complejo Hospitalario Universitario Insular Materno Infantil, Las Palmas de Gran Canaria, Canary Islands, Spain
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Carter C, Aedy H, Osborn M, Rooney M, Notter J. Service evaluation of a COVID-19 critical care orientation programme. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2022; 31:452-458. [PMID: 35439073 DOI: 10.12968/bjon.2022.31.8.452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
BACKGROUND During the first wave of the COVID-19 pandemic in the UK, south London had the highest number of COVID-19 patients admitted to critical care. At one hospital, staff being redeployed to critical care were invited to attend an orientation to critical care workshop. AIM To carry out a service evaluation of the training outcomes from rapidly redeployed staff who completed the workshop during the first wave of the COVID-19 pandemic (March-July 2020). METHODS Two stages were used, the first was a post-workshop evaluation questionnaire completed immediately after the training, with the second involving a single centre e-survey questionnaire two months later. FINDINGS In total 131 health professionals attended the workshop, and 124 (95%) post-course evaluations were completed. Some 116 staff were contacted for the e-survey, with a response rate of 34% (n=40). Overall, the training was well evaluated. Of the 40 respondents, 70% (n=28) had volunteered, but only just over half (n=21, 52%) went on to work in critical care. CONCLUSION This article describes the organisational response of one NHS acute hospital to the unprecedented challenges that arose from the COVID-19 pandemic. The service evaluation identified the importance of a pedagogical approach, which not only delivered clinical content, but also allayed anxiety for health professionals preparing to work in a new environment.
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Affiliation(s)
- Chris Carter
- Senior Lecturer, Birmingham City University, Birmingham
| | - Helen Aedy
- Critical Care Outreach Sister, University Hospital Lewisham, London
| | | | - Martine Rooney
- Matron Critical Care, University Hospital Lewisham, London
| | - Joy Notter
- Professor of Community Healthcare Studies, Birmingham City University, Birmingham
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He L, Ren H, Chen F, Chen Z, Wang C, Zhang R, Jiang Y. Perspectives of nursing directors on emergency nurse deployment during the pandemic of COVID‐19: A nationwide cross‐sectional survey in mainland China. J Nurs Manag 2022; 30:1147-1156. [PMID: 35403305 PMCID: PMC9115130 DOI: 10.1111/jonm.13627] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 03/31/2022] [Accepted: 04/04/2022] [Indexed: 02/05/2023]
Abstract
Aims The aim of this study is to investigate the situation and perceptions of nursing directors about emergency nursing staff deployment in designated hospitals during the pandemic of COVID‐19 in mainland China. Background The pandemic of COVID‐19 has significantly depleted health care resources, leading to increased burden of nursing care and staffing and exacerbating the crisis in health care facilities. Currently, how to effectively plan and schedule nursing staffing in the pandemic still remains unknown. Methods From 14 July 2020 to 8 September 2020, 62 nursing directors of designated hospitals in mainland China were invited to participate in a cross‐sectional online survey for their perceptions of nursing human‐resource allocation during the pandemic of COVID‐19. Results A total of 55 valid questionnaires were collected, showing that 96.36% of the hospitals had emergency nursing organizations and management systems during the pandemic, 96.36% had well‐established scheduling principles for nursing human resources and 54.55% of hospitals had human‐resource scheduling platforms. All the hospitals had trained emergency nursing staff in infection control (55, 100%), work process (51, 92.73%) and emergency skills (50, 90.91%). Most of the participants were satisfied with the nursing staffing deployments at their institutions (52, 94.55%). However, more than two thirds of them believed that their human‐resource deployment plans need further improvements (39, 70.91%). Conclusions Most of the designated hospitals investigated had established emergency nursing organizations, and management systems, and related regulations for the epidemic. However, the contents mentioned above still need to be further standardized. Implications for nursing management The surge of patients in the epidemic was considerable challenge for the emergency capacity of hospitals. In the future, we should pay more attention to the following aspects: building emergency nursing staffing platforms, increasing emergency human‐resource reserves, establishing reliable communication channels for emergency response teams, improving the rules and regulations of emergency human‐resource management, offering more training and drills for emergency‐related knowledge and skills and giving more focus on bio‐psycho‐social wellbeing of nurses.
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Affiliation(s)
- Ling‐xiao He
- Trauma Center of West China Hospital Sichuan University/West China School of Nursing, Sichuan University Chengdu China
| | - Hong‐fei Ren
- Department of Gastroenterology, West China Hospital Sichuan University/West China School of Nursing, Sichuan University Chengdu China
| | - Feng‐jiao Chen
- Department of Hematology, West China Hospital Sichuan University/West China School of Nursing, Sichuan University Chengdu China
| | - Zhong‐lan Chen
- Department of Cardiology, West China Hospital Sichuan University/West China School of Nursing, Sichuan University Chengdu China
| | - Cong Wang
- Evidence‐based Nursing Center, West China Hospital Sichuan University/West China School of Nursing, Sichuan University Chengdu China
| | - Rui‐xue Zhang
- Nursing Department of West China Hospital Sichuan University/West China School of Nursing, Sichuan University Chengdu China
| | - Yan Jiang
- Nursing Department of West China Hospital Sichuan University/West China School of Nursing, Sichuan University Chengdu China
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15
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Molina Ruiz JC, Guerrero Orriach JL, Bravo Arcas ML, Montilla Sans A, Escano Gonzalez R. COVID-19 pandemic and nurse teaching: Our experience. World J Clin Cases 2022; 10:2657-2659. [PMID: 35434074 PMCID: PMC8968598 DOI: 10.12998/wjcc.v10.i8.2657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 01/11/2022] [Accepted: 02/10/2022] [Indexed: 02/06/2023] Open
Abstract
In this letter to the editor, we would like to show in our hospital how our nurse team manage formation during coronavirus disease 2019 pandemic.
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16
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A scoping review of barriers, facilitators and tools to escalation of care processes in the emergency department. CAN J EMERG MED 2022; 24:300-312. [DOI: 10.1007/s43678-022-00268-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 01/14/2022] [Indexed: 11/02/2022]
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17
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Lee H, Lee SE, Sang S, Morse B. The Lived Experience of Nurses Who Volunteered to Combat the COVID-19 Pandemic in South Korea: A Qualitative Phenomenological Study. J Nurs Manag 2022; 30:864-871. [PMID: 35229395 PMCID: PMC9115118 DOI: 10.1111/jonm.13571] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 02/16/2022] [Accepted: 02/23/2022] [Indexed: 11/29/2022]
Abstract
Aim To explore the motivation and lived experience of nurses responding to the COVID‐19 pandemic in South Korea. Background Identifying motivation, barriers and facilitators to nurses' willingness to work during a pandemic is necessary to prepare for future pandemic responses. Methods Ten individual interviews were conducted. Interviews were analysed and synthesized following Colaizzi's method. Results Six major themes identified: Decision to participate in the COVID‐19 response; Facing hardship; Distress due to the nature of COVID‐19; Overcoming hardship; Growing through the COVID‐19 response; and The need for reciprocity. Conclusion The increased demands for nursing care during the pandemic highlight the need for strong organisational support and effective workforce strategies. Our study results can inform the development of programmes and policies that are proactive, rather than reactive, to prepare for future pandemic situations. Implications for Nursing Management To recruit and manage nurses during a pandemic effectively, a safe work environment with proper resources should be established. Additionally, adequate education, training and compensation are needed.
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Affiliation(s)
- Hyunjie Lee
- Yonsei University College of Nursing, Seoul, South Korea
| | - Seung Eun Lee
- Mo-Im Kim Nursing Research Institute, Yonsei University College of Nursing, Seoul, South Korea
| | - Somin Sang
- Yonsei University College of Nursing, Seoul, South Korea
| | - Brenna Morse
- Solomont School of Nursing, University of Massachusetts Lowell, Lowell, MA, USA
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18
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Jafree SR, Zakar R, Rafiq N, Javed A, Durrani RR, Burhan SK, Hasnain Nadir SM, Ali F, Shahid A, Momina AU, Wrona KJ, Mahmood QK, Fischer F. WhatsApp-Delivered Intervention for Continued Learning for Nurses in Pakistan During the COVID-19 Pandemic: Results of a Randomized-Controlled Trial. Front Public Health 2022; 10:739761. [PMID: 35242728 PMCID: PMC8885589 DOI: 10.3389/fpubh.2022.739761] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Accepted: 01/13/2022] [Indexed: 12/18/2022] Open
Abstract
The COVID-19 pandemic has necessitated support for continued learning in frontline practitioners through online digital mediums that are convenient and fast to maintain physical distancing. Nurses are already neglected professionals for support in training for infection control, leadership, and communication in Pakistan and other developing countries. For that reason, we aimed to deliver a WhatsApp-based intervention for continued learning in nurses who are currently working in both private and public sector. A 12-week intervention was delivered to 208 nurses (102 in the control group and 106 in the intervention group) who had been employed in the clinical setting during data collection. The analysis reveals that nurses in the intervention group show significantly better results for learning in “infection prevention and control” and “leadership and communication.” Results of a content analysis based on participant's feedback also confirm that the WhatsApp-based intervention is a valuable tool for education. This study highlights the effectiveness of online-based digital interventions as a convenient training tool for awareness and management of infectious diseases, leadership, and communication during COVID-19 and beyond. Furthermore, this study emphasizes that group interventions with other healthcare practitioners and the role of on-going longer WhatsApp-based interventions can become integral tools to support continued learning and patient safety practices.
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Affiliation(s)
- Sara Rizvi Jafree
- Department of Sociology, Forman Christian College University, Lahore, Pakistan
| | - Rubeena Zakar
- Department of Public Health, Institute of Social and Cultural Studies, University of the Punjab, Lahore, Pakistan
| | | | - Ambreen Javed
- Department of English, Forman Christian College University, Lahore, Pakistan
| | - Rana Rubab Durrani
- Language Development Center, Forman Christian College University, Lahore, Pakistan
| | | | | | - Fatima Ali
- CMH Lahore Medical College, Lahore, Pakistan
| | | | - Ain ul Momina
- Institute of Public Health, King Edward Medical University, Lahore, Pakistan
| | - Kamil J. Wrona
- School of Public Health, Bielefeld University, Bielefeld, Germany
- *Correspondence: Kamil J. Wrona
| | | | - Florian Fischer
- Institute of Public Health, Charité – Universitätsmedizin Berlin, Berlin, Germany
- Institute of Gerontological Health Services and Nursing Research, Ravensburg-Weingarten University of Applied Sciences, Weingarten, Germany
- Bavarian Research Center for Digital Health and Social Care, Kempten University of Applied Sciences, Kempten, Germany
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19
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Conti A, Clari M, Luciani M, Sciannameo V, Berchialla P, Dimonte V, Campagna S. Exploring the Use and Usefulness of Educational Resources Among Nurses During the First Wave of the COVID-19 Pandemic: A Cross-Sectional Study. J Contin Educ Nurs 2022; 53:63-69. [PMID: 35103502 DOI: 10.3928/00220124-20220104-06] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Nurses needed to learn rapidly how to care for patients with coronavirus disease 2019 (COVID-19). This cross-sectional study identified the educational resources RNs used to learn how to care for these patients, measured the perceived usefulness of the content of these resources, and explored the most relevant educational content sought during the first wave of the pandemic. A total of 799 RNs completed an online survey. Significant differences were found in the educational resources used between RNs who cared for patients with COVID-19 and RNs who did not, as well as for RNs who changed units following the pandemic. The educational resources most often used were also ranked as most useful. The most relevant educational content sought was related to respiratory care techniques and infection containment. These findings provide insight into the educational resources available during the first wave of the COVID-19 pandemic. They could help in developing educational programs relevant to nurses' needs during future pandemics. [J Contin Educ Nurs. 2022;53(2):63-69.].
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20
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Vera San Juan N, Clark SE, Camilleri M, Jeans JP, Monkhouse A, Chisnall G, Vindrola-Padros C. Training and redeployment of healthcare workers to intensive care units (ICUs) during the COVID-19 pandemic: a systematic review. BMJ Open 2022; 12:e050038. [PMID: 34996785 PMCID: PMC8753114 DOI: 10.1136/bmjopen-2021-050038] [Citation(s) in RCA: 35] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 12/09/2021] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVES The rapid influx of patients with COVID-19 to intensive care at a rate that exceeds pre-existing staff capacity has required the rapid development of innovative redeployment and training strategies, which considered patient care and infection control. The aim of this study was to provide a detailed understanding of redeployment and training during the first year of the COVID-19 pandemic by capturing and considering the merit of the strategies enlisted and the experiences and needs of redeployed healthcare workers (HCWs). DESIGN The review involved a systematic search of key terms related to intensive care AND training AND redeployment AND healthcare workers within nine databases (Medline, CINAHL, PsychINFO, MedRxiv, Web of Science, The Health Management Consortium database, Social Science Research Network, OpenGrey and TRIP), which took place on 16 July 2021. Analysis consisted of a synthesis of quantitative study outputs and framework-based thematic analysis of qualitative study outputs and grey literature. These results were then combined applying an interpretative synthesis. We followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses, and the review protocol was available online. RESULTS Forty papers were analysed. These took place primarily in the UK (n=15, 37.5%) and USA (n=17, 42.5%). Themes presented in the results are redeployment: implementation strategies and learning; redeployed HCWs' experience and strategies to address their needs; redeployed HCWs' learning needs; training formats offered and training evaluations; and future redeployment and training delivery. Based on this, key principles for successful redeployment and training were proposed. CONCLUSIONS The COVID-19 pandemic presents unique challenges to develop flexible redeployment strategies and deliver training promptly while following infection control recommendations. This review synthesises original approaches to tackle these challenges, which are relevant to inform the development of targeted and adaptative training and redeployment plans considering the needs of HCWs.
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Affiliation(s)
- Norha Vera San Juan
- Rapid Research Evaluation and Appraisal Lab (RREAL), University College London, London, UK
- Health Service and Population Research, King's College London Institute of Psychiatry Psychology and Neuroscience, London, UK
| | | | - Matthew Camilleri
- 33N Ltd, London, UK
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - John Paul Jeans
- 33N Ltd, London, UK
- London North West University Healthcare NHS Trust, London, UK
| | - Alexandra Monkhouse
- 33N Ltd, London, UK
- Anaesthetics Department, St Bartholomew's Hospital, London, UK
| | - Georgia Chisnall
- Rapid Research Evaluation and Appraisal Lab (RREAL), University College London, London, UK
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21
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Fernandez DFD, Phoon YL, Soon MML, Tiow Shen C. Exploration of Factors Influencing Nurses’ Preparedness and Response to the COVID-19 Outbreak. SAGE Open Nurs 2022; 8:23779608221142159. [DOI: 10.1177/23779608221142159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 10/15/2022] [Accepted: 11/12/2022] [Indexed: 12/15/2022] Open
Abstract
Introduction and Objective Nurses as the core of the health care workforce affect an organization's preparedness and response. This study explores the factors and unique determinants influencing nurses’ preparedness and response to the coronavirus disease 2019 (COVID-19) outbreak in Singapore. Methods This qualitative phenomenological study utilized purposive sampling and in-depth interviews with 10 registered nurses and two enrolled nurses who had worked or were still working in an infectious disease (ID) hospital during the COVID-19 outbreak at the point of recruitment. The data were collected from September 2020 to December 2020. Results (1) Before the outbreak: Factors such as knowledge, skills, and experiences that enhanced nurses’ adaptability and response through training and exposure prior to the outbreak influenced preparedness. In addition, the importance of nurses’ knowing their purpose and the role of their institute during the outbreak also influenced preparedness. (2) The COVID-19 phase: Factors such as the novelty of the disease, communication, load and demand, and coping mechanisms affected participants’ working response to the outbreak. (3) Learning and looking forth: Lessons learnt to enhance preparedness and response to future outbreaks, and positive sentiments as part of the nation's effort to combat the disease. Conclusion Ground nurses should be actively involved in outbreak planning to gain a better view of their responsibilities and unpredictable events that may occur. A transparent and bidirectional communication among management and nurses is crucial amidst rapid changes in an outbreak to strike a balance between the needs of nurses and leadership and to enhance nurses’ resilience throughout this challenging journey.
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Affiliation(s)
| | - Yan Ling Phoon
- Department of Nursing, National Centre for Infectious Diseases, Singapore
| | | | - Chua Tiow Shen
- Department of Nursing, National Centre for Infectious Diseases, Singapore
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22
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Bruyneel A, Lucchini A, Hoogendoorn M. Impact of COVID-19 on nursing workload as measured with the Nursing Activities Score in intensive care. Intensive Crit Care Nurs 2021; 69:103170. [PMID: 34893395 PMCID: PMC8580832 DOI: 10.1016/j.iccn.2021.103170] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Affiliation(s)
- Arnaud Bruyneel
- Health Economics, Hospital Management and Nursing Research Dept, School of Public Health, Université Libre de Bruxelles, Belgium.
| | - Alberto Lucchini
- General Intensive Care Unit, Emergency Department - ASST Monza - San Gerardo Hospital, Via Pergolesi 33, Monza (MB), Italy - University of Milano-Bicocca, Italy
| | - Marga Hoogendoorn
- Department Anesthesiology and Intensive Care, Isala, Zwolle, The Netherlands
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23
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Noorland SA, Hoekstra T, Kok MO. The experiences and needs of re-entering nurses during the COVID-19 pandemic: A qualitative study. INTERNATIONAL JOURNAL OF NURSING STUDIES ADVANCES 2021; 3:100043. [PMID: 34661169 PMCID: PMC8501512 DOI: 10.1016/j.ijnsa.2021.100043] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Accepted: 09/24/2021] [Indexed: 11/30/2022] Open
Abstract
Background: During the COVID-19 outbreak in the Netherlands, thousands of former nurses have returned to nursing to support healthcare staff. After a period of absence and with little time to prepare, these former nurses re-entered during a challenging, uncertain and rapidly evolving pandemic. Little is known about the experiences and needs of these re-entering nurses. Objectives: Assessing the needs and experiences of re-entering nurses during the COVID-19 pandemic. Design: Qualitative study using a pragmatist approach within the interpretative paradigm. Settings: This study took place in the following settings within the Dutch healthcare system: Intensive care units, COVID and regular departments within hospitals, nursing home settings, a rehabilitation centre and newly established COVID-19 departments within nursing home settings. Participants: We purposively selected 20 nurses who had re-entered nursing during the first wave of the COVID-19 pandemic between March 2020 and June 2020 in the Netherlands. The first interview was conducted on the eighth of May 2020. Methods: We conducted 20 semi-structured interviews in Dutch. Interviews were transcribed verbatim and analysed via thematic content analysis in the coding program of MAXQDA2020. This study followed the SRQR and COREQ guidelines. Results: Seven main themes were identified. Clear job description: Participants mentioned that a lack of a clear job description led to lack of clarity about the kind of tasks that re-entering nurses were expected and allowed to perform. Training: the majority of the participants had received none or little training prior to their return. Training content: Re-entering nurses mentioned to wish for an easily accessible mentorship structure and an individualised and practical training program. Positive team dynamic: Re-entering nurses felt supported by a positive team dynamic, which was shaped by the sense of urgency and relevance of their work and helped them deal with stressful experiences. Mental health: Nearly all participants mentioned that re-entering during a pandemic did not lead to impairment of their mental health. mental health support: Most participants mentioned being able to cope with their mental health independently, sharing experiences with family and colleagues Conclusion: The results indicate that a rapid and safe return to nursing during a pandemic could be facilitated by: a clear description of roles and responsibilities; an individualised assessment determining the competences and knowledge disparities of re-entering nurses; practical training focussing on competencies needed during a pandemic; and a collaborative mentorship structure to guide re-entering nurses. Tweetable abstract: In-depth interviews with former nurses who returned to #nursing during the first wave of the #COVID19 #pandemic in the Netherlands
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Affiliation(s)
- Sofie A Noorland
- Erasmus School of Health Policy and Management, Erasmus University Rotterdam, Burgemeester Oudlaan 50, Rotterdam 3062 PA, the Netherlands.,Department of Health Sciences and Amsterdam Public Health research institute, Vrije Universiteit Amsterdam, van der Boechorststraat 7, Amsterdam 1081 HV, the Netherlands
| | - Trynke Hoekstra
- Department of Health Sciences and Amsterdam Public Health research institute, Vrije Universiteit Amsterdam, van der Boechorststraat 7, Amsterdam 1081 HV, the Netherlands
| | - Maarten O Kok
- Erasmus School of Health Policy and Management, Erasmus University Rotterdam, Burgemeester Oudlaan 50, Rotterdam 3062 PA, the Netherlands.,Department of Health Sciences and Amsterdam Public Health research institute, Vrije Universiteit Amsterdam, van der Boechorststraat 7, Amsterdam 1081 HV, the Netherlands
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24
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Han JW, Kang JS, Park JH. Educational Needs of Nurses for Respiratory Communicable Infectious Disease Care: A Cross-Sectional Descriptive Study. Healthcare (Basel) 2021; 9:healthcare9081043. [PMID: 34442179 PMCID: PMC8393325 DOI: 10.3390/healthcare9081043] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Revised: 08/08/2021] [Accepted: 08/09/2021] [Indexed: 11/16/2022] Open
Abstract
Clinical nurses have training needs related to the strategies for infection spread prevention. This study aimed to investigate the levels of importance of and performance in the various areas of care for communicable respiratory infections among clinical nurses and to determine the priority of educational needs. Hospitals in which a baseline survey could be conducted were considered, and nurses working in six hospitals that were designated as COVID-19 care centers in Korea were enrolled. The training needs for the care of patients with communicable respiratory infections were analyzed using Borich’s needs equation, and the locus for focus model. Among participants with prior COVID-19 patient care experience, according to Borich’s equation, the need score was the highest for “initial response to communicable respiratory infection”, followed by “management of aerosol-generating procedures in patients with communicable respiratory infection” and “reporting of patients with communicable respiratory infection and death of patient”. An item rated highly in both Borich’s equation and the locus for focus model among the participants with prior experience was “initial response to communicable respiratory infection”. Among participants without prior relevant experience, according to Borich’s equation, the need score was highest for “management of aerosol-generating procedures in patients with a communicable respiratory infection”, followed by “initial response to communicable respiratory infection” and “reporting of patients with communicable respiratory infection and death of patient”. None of the items were rated high in both Borich’s equation and the locus for focus model among participants without relevant prior experience.
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Affiliation(s)
- Jeong-Won Han
- College of Nursing Science, Kyung Hee University, 26 Kyunghee-daero, Dongdaemun-gu, Seoul 02447, Korea;
| | - Ji-Soon Kang
- Department of Nursing, Hansei University, 30 Hansei-ro, Gunpo-si 43742, Korea;
| | - Jun-Hee Park
- Department of Nursing, Dongnam Health University, 50 Cheoncheon-ro 74 gil, Jangan-gu, Suwon-si 16328, Korea
- Correspondence:
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25
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Unoki T, Kawai Y, Hamamoto M, Tamoto M, Miyamoto T, Sakuramoto H, Ito Y, Moro E, Tatsuno J, Nishida O. Workforce and Task Sharing of Nurses in the Japanese Intensive Care Unit-Cross-Sectional Postal Survey. Healthcare (Basel) 2021; 9:healthcare9081017. [PMID: 34442154 PMCID: PMC8394815 DOI: 10.3390/healthcare9081017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 08/03/2021] [Accepted: 08/05/2021] [Indexed: 11/22/2022] Open
Abstract
This study aimed to estimate the number of nurses who independently care for patients with severe respiratory failure receiving mechanical ventilation (MV) or veno-venous extracorporeal membrane oxygenation (VV-ECMO). Additionally, the study analyzed the actual role of nurses in the treatment of patients with MV and VV-ECMO. We performed a cross-sectional study using postal questionnaire surveys. The study included 725 Japanese intensive care units (ICUs). Data were analyzed using descriptive statistics. Among the 725 ICUs, we obtained 302 responses (41.7%) and analyzed 282 responses. The median number of nurses per bed was 3.25. The median proportion of nurses who independently cared for patients with MV was 60% (IQR: 42.3–77.3). The median proportion of nurses who independently cared for patients with VV-ECMO was 46.9 (35.7–63.3%) in the ICUs that had experience with VV-ECMO use. With regard to task-sharing, 33.8% of ICUs and nurses did not facilitate weaning from MV. Nurses always titrated sedative dosage in 44.5% of ICUs. Nurse staffing might be inadequate in all ICUs, especially for the management of patients with severe respiratory failure. The proportion of competent nurses to care for severe respiratory failure in ICUs should be considered when determining the workforce of nurses.
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Affiliation(s)
- Takeshi Unoki
- Department of Acute and Critical Care Nursing, School of Nursing, Sapporo City University, Kita 11 Nishi 13, Chuo-ku, Sapporo 060-0011, Japan
- Correspondence:
| | - Yusuke Kawai
- Department of Nursing, Fujita Health University Hospital, 1-98 Dengakugakubo, Kutsukake, Toyoake 470-1192, Japan;
| | - Miya Hamamoto
- Intensive Care Unit, Tosei General Hospital, 160 Nishioiwake, Seto 489-8642, Japan;
| | - Mitsuhiro Tamoto
- Intensive Care Unit, Kyoto University Hospital, 54 Kawaharacho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan;
| | - Takeharu Miyamoto
- Department of Nursing, Faculty of Health Sciences, Junshin Gakuen University, 1-1-1 Chikushigaoka, Minami-ku, Fukuoka 815-1510, Japan;
| | - Hideaki Sakuramoto
- Department of Adult Health Nursing, College of Nursing, Ibaraki Christian University, 6-11 Omika, Hitachi 319-1295, Japan;
| | - Yumi Ito
- Department of Nursing, Faculty of Health Sciences, Kyorin University, 6-20-2 Shinkawa, Mitaka 181-8611, Japan;
| | - Etsuko Moro
- Intensive Care Unit, Jichi Medical University Hospital, 3311-1 Yakushiji, Shimotsuke 329-0498, Japan;
| | - Junko Tatsuno
- Department of Nursing, Kokura Memorial Hospital, 3-2-1 Asano, Kokurakita-ku, Kitakyushu 802-8555, Japan;
| | - Osamu Nishida
- Department of Anesthesiology and Critical Care Medicine, School of Medicine, Fujita Health University, 1-98 Dengakugakubo, Kutsukake, Toyoake 470-1192, Japan;
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26
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Sarnkhaowkhom C, Promkanya A, Pomisrikeaw S, Ritthapanya N. "Novice nurse and novel coronavirus"-experiences of novice nurses caring for patients diagnosed with COVID-19 in Thailand. Nurs Open 2021; 9:2887-2898. [PMID: 34289235 PMCID: PMC8441826 DOI: 10.1002/nop2.996] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 06/19/2021] [Accepted: 07/10/2021] [Indexed: 12/23/2022] Open
Abstract
Aims To explore the experiences of novice nurses caring for patients diagnosed with COVID‐19 in Thailand. Design A qualitative descriptive research. Methods The experiences of twelve novice nurses were explored through in‐depth interviews, telephone and video conferencing interviews. All interviews were recorded, verbatim transcribed and analysed by thematic content analysis. Results The findings fell into five main themes as follows: from novice nurses to nurse who care for COVID‐19 patients; various learning methods focused on providing care to COVID‐19 patients; work experiences and confrontations with COVID‐19; various feelings that arise when being a nurse caring for patients with COVID‐19; the power of novice nurse to bring along positive changes. Conclusions The study provides an understanding of novice nurses’ experiences when caring for COVID‐19 patients. It also highlights the stress, fear and anxiety of novice nurses during the pandemic and suggests novice nursing practice training systems to enhance their familiarity and confidence when dealing with situations during the pandemic. The novice nurses were found to demonstrate a large amount of self‐determination and possess several technological skills and innovative abilities to improve the nursing practice and quality of care.
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Affiliation(s)
- Chawapon Sarnkhaowkhom
- School of Nursing Study, Srisavarindhira Thai Red Cross Institute of Nursing, Bangkok, Thailand
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27
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Williams MS, Zakaria S, D'Alessandro M, Kraeuter S, Hicks H. Alternative cardiac intensive care unit locations during the COVID-19 pandemic at an academic medical center. Heart Lung 2021; 50:296-297. [PMID: 33450594 PMCID: PMC7836218 DOI: 10.1016/j.hrtlng.2021.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Accepted: 01/04/2021] [Indexed: 11/24/2022]
Affiliation(s)
- Marlene S Williams
- Departments of Medicine and Nursing, Johns Hopkins Bayview Medical Center Johns Hopkins Medical Institutions, 301 Building Suite 2400, Baltimore, MD 21224, United States.
| | - Sammy Zakaria
- Departments of Medicine and Nursing, Johns Hopkins Bayview Medical Center Johns Hopkins Medical Institutions, 301 Building Suite 2400, Baltimore, MD 21224, United States
| | - Michelle D'Alessandro
- Departments of Medicine and Nursing, Johns Hopkins Bayview Medical Center Johns Hopkins Medical Institutions, 301 Building Suite 2400, Baltimore, MD 21224, United States
| | - Susan Kraeuter
- Departments of Medicine and Nursing, Johns Hopkins Bayview Medical Center Johns Hopkins Medical Institutions, 301 Building Suite 2400, Baltimore, MD 21224, United States
| | - Heather Hicks
- Departments of Medicine and Nursing, Johns Hopkins Bayview Medical Center Johns Hopkins Medical Institutions, 301 Building Suite 2400, Baltimore, MD 21224, United States
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Vindrola-Padros C, Andrews L, Dowrick A, Djellouli N, Fillmore H, Bautista Gonzalez E, Javadi D, Lewis-Jackson S, Manby L, Mitchinson L, Mulcahy Symmons S, Martin S, Regenold N, Robinson H, Sumray K, Singleton G, Syversen A, Vanderslott S, Johnson G. Perceptions and experiences of healthcare workers during the COVID-19 pandemic in the UK. BMJ Open 2020; 10:e040503. [PMID: 33154060 PMCID: PMC7646318 DOI: 10.1136/bmjopen-2020-040503] [Citation(s) in RCA: 153] [Impact Index Per Article: 38.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 10/07/2020] [Accepted: 10/18/2020] [Indexed: 01/03/2023] Open
Abstract
OBJECTIVE The COVID-19 pandemic has set unprecedented demand on the healthcare workforce around the world. The UK has been one of the most affected countries in Europe. The aim of this study was to explore the perceptions and experiences of healthcare workers (HCWs) in relation to COVID-19 and care delivery models implemented to deal with the pandemic in the UK. METHODS The study was designed as a rapid appraisal combining: (1) a review of UK healthcare policies (n=35 policies), (2) mass media and social media analysis of front-line staff experiences and perceptions (n=101 newspaper articles, n=1 46 000 posts) and (3) in-depth (telephone) interviews with front-line staff (n=30 interviews). The findings from all streams were analysed using framework analysis. RESULTS Limited personal protective equipment (PPE) and lack of routine testing created anxiety and distress and had a tangible impact on the workforce. When PPE was available, incorrect size and overheating complicated routine work. Lack of training for redeployed staff and the failure to consider the skills of redeployed staff for new areas were identified as problems. Positive aspects of daily work reported by HCWs included solidarity between colleagues, the establishment of well-being support structures and feeling valued by society. CONCLUSION Our study highlighted the importance of taking into consideration the experiences and concerns of front-line staff during a pandemic. Staff working in the UK during the COVID-19 pandemic advocated clear and consistent guidelines, streamlined testing of HCWs, administration of PPE and acknowledgement of the effects of PPE on routine practice.
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Affiliation(s)
| | - Lily Andrews
- Institute of Epidemiology and Healthcare, University College London, London, UK
| | - Anna Dowrick
- Institute of Population Health Sciences, Queen Mary University of London, London, UK
| | - Nehla Djellouli
- Institute of Global Health, University College London, London, UK
| | | | | | - Dena Javadi
- Harvard TH Chan School of Public Health, Department of Social and Behavioral Sciences, Harvard University, Cambridge, Massachusetts, USA
| | | | - Louisa Manby
- Institute of Epidemiology and Healthcare, University College London, London, UK
| | - Lucy Mitchinson
- Marie Curie Palliative Care Research Department, Division of Psychiatry, University College London, London, United Kingdom
| | | | - Sam Martin
- Oxford Vaccine Group, Centre for Clinical Vaccinology and Tropical Medicine (CCVTM), Oxford University, Oxford, Oxfordshire, UK
| | - Nina Regenold
- Department of Anthropology, University College London, London, UK
| | - Hannah Robinson
- School for Policy Studies, Bristol University, Bristol, United Kingdom
| | - Kirsi Sumray
- Institute of Epidemiology and Healthcare, University College London, London, UK
| | - Georgina Singleton
- Department of Targeted Intervention, University College London, London, UK
| | - Aron Syversen
- Institute of Epidemiology and Healthcare, University College London, London, UK
| | - Samantha Vanderslott
- Oxford Vaccine Group, Centre for Clinical Vaccinology and Tropical Medicine (CCVTM), Oxford University, Oxford, Oxfordshire, UK
| | - Ginger Johnson
- Department of Targeted Intervention, University College London, London, UK
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