1
|
Wyer M, Hor SY, Ferguson PE, Morath A, Barratt R, Priestley CM, Polak A, Gilbert GL. Using Video-Reflexive Methods to Develop a Provider Down Protocol for the New South Wales Biocontainment Center. Health Secur 2024; 22:S34-S44. [PMID: 39134067 DOI: 10.1089/hs.2023.0165] [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] [Indexed: 09/13/2024] Open
Abstract
The New South Wales Biocontainment Centre is a statewide referral facility for patients with high-consequence infectious disease (HCID). The facility collaborates with researchers to adapt existing HCID procedures such as donning and doffing of personal protective equipment (PPE). However, information on how to respond safely to collapse of a healthcare provider in full PPE within a contaminated zone is scarce. To address this gap, we adapted Nebraska Medicine's "provider down" protocol on paper and then simulated and video recorded the process, iteratively, in the facility. Clinicians analyzed the recordings collaboratively in researcher-facilitated reflexive discussions. Our primary aim was to ascertain how to maintain optimal infection prevention and control while providing urgent care for the healthcare provider. We tested participants' suggested modifications, in repeated video recorded simulations, until consensus on optimal practice was achieved. Our secondary aim was to assess the utility of video-reflexive methods to enhance clinicians' awareness and understanding of infection prevention and control in a rare and complex scenario. Six adaptations and simulations were discussed in video-reflexive sessions before consensus was reached; the final version of the protocol differed considerably from the first. Viewing footage of simulations in situ enabled participants to (1) identify infection and occupational risks not identified on paper or during verbal postsimulation debriefs and (2) test alternative perspectives on safe procedure. Video-reflexivity enables context-sensitive and consensus-building codesign of policies and procedures, critical to protocol development in a new unit. It contributes to a culture of teamwork, preparedness, and confidence before, rather than in the heat of, a crisis.
Collapse
Affiliation(s)
- Mary Wyer
- Mary Wyer, PhD, RN, is a Nurse Educator, New South Wales Biocontainment Centre (NBC) at Westmead Hospital, Westmead, New South Wales (NSW), Australia; Mary Wyer is also a Postdoctoral Researcher at the Sydney Infectious Diseases Institute, The University of Sydney, Westmead, NSW, Australia
| | - Su-Yin Hor
- Su-Yin Hor, PhD, MEd, is a Senior Lecturer, School of Public Health, Faculty of Health, University of Technology Sydney, Ultimo, NSW, Australia
| | - Patricia E Ferguson
- Patricia E. Ferguson, PhD, FRACP, is Associate Director, NBC, and an Infectious Diseases Physician, Infectious Diseases at Westmead Hospital, Westmead, New South Wales (NSW), Australia
| | - Arwen Morath
- Arwen Morath, MBBS, FACEM, is a Visiting Medical Officer, Emergency Department at Westmead Hospital, Westmead, New South Wales (NSW), Australia; Arwen Morath is also an Emergency Department Staff Specialist, Auburn Hospital, Auburn, NSW, Australia
| | - Ruth Barratt
- Ruth Barratt, PhD, NZRN, MAdvPrac, is an Infection Prevention and Control Specialist, Health Quality and Safety Commission New Zealand, Wellington, New Zealand
| | - Catherine M Priestley
- Catherine M. Priestley, BN, MPHTM, is a Nurse Educator, NBC at Westmead Hospital, Westmead, New South Wales (NSW), Australia
| | - Alice Polak
- Alice Polak, BSN, GradCertNP, MANP, is a Nurse Educator and Clinical Nurse Consultant, NBC at Westmead Hospital, Westmead, New South Wales (NSW), Australia
| | - Gwendolyn L Gilbert
- Gwendolyn L. Gilbert, MD, FRACP, FRCPA, M. Bioethics, FASM, is a Senior Researcher at the Sydney Infectious Diseases Institute, The University of Sydney, Westmead, NSW, Australia
| |
Collapse
|
2
|
Robinson R, Madge S. Rapid nursing redeployment from a specialist ward to a COVID-19 high-dependency setting. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2024; 33:132-138. [PMID: 38335100 DOI: 10.12968/bjon.2024.33.3.132] [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: 02/12/2024]
Abstract
BACKGROUND Redeployment in health care can have a negative impact on the mental wellbeing of staff. Advanced planning and provisions for wellbeing support for health professionals has been recommended following previous pandemics. At the authors' institution nurses were redeployed overnight from a specialist cystic fibrosis ward to a COVID-19 high-dependency unit. AIM To evaluate nurses' wellbeing following this redeployment during the first wave of the COVID-19 pandemic. METHOD A mixed online survey, consisting of both open and closed questions, based on literature, preliminary results of the Impact of COVID-19 on the Nursing and Midwifery Workforce (ICON) study and staff feedback. This was sent to 28 nurses to explore their feelings and experiences of redeployment to a COVID-19 environment. Purposive sampling was used to select study participants while thematic analysis and descriptive statistics were used to analyse the data. FINDINGS The survey had an 86% response rate. Using thematic analysis three key themes emerged: redeployment anxiety, lack of organisational preparedness and newfound teamworking. More than half (57%) of respondents expressed anxiety and concern when told of their redeployment; 52% reported that they did not receive adequate support from senior staff and management. However, 74% reported that they felt their nursing was positively influenced by support and teamwork from those in patient-facing roles. Twenty-five percent reported that they were looking for a new job or leaving their current role. CONCLUSION This study examines the effects that redeployment to a COVID-19 environment has had on nurses. It highlights the need for further improvement to ensure redeployed staff are supported to safeguard their mental wellbeing.
Collapse
Affiliation(s)
- Rachel Robinson
- Clinical Nurse Specialist, Department of Adult Cystic Fibrosis, Royal Brompton Hospital, London
| | - Susan Madge
- Consultant Nurse, Department of Adult Cystic Fibrosis, Royal Brompton Hospital, London
| |
Collapse
|
3
|
Lukewich J, Bulman D, Mathews M, Hedden L, Marshall E, Vaughan C, Ryan D, Dufour E, Meredith L, Spencer S, Renaud LR, Asghari S, Cusack C, Elliott Rose A, Marchuk S, Young G, Wong E. Redeployment Among Primary Care Nurses During the COVID-19 Pandemic: A Qualitative Study. SAGE Open Nurs 2024; 10:23779608241262143. [PMID: 38881679 PMCID: PMC11179460 DOI: 10.1177/23779608241262143] [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: 12/13/2023] [Revised: 05/13/2024] [Accepted: 05/20/2024] [Indexed: 06/18/2024] Open
Abstract
Introduction: Throughout the COVID-19 pandemic, primary care nurses were often redeployed to areas outside of primary care to mitigate staffing shortages. Despite this, there is a scarcity of literature describing their perceptions of and experiences with redeployment during the pandemic. Objectives: This paper aims to: 1) describe the perspectives of primary care nurses with respect to redeployment, 2) discuss the opportunities/challenges associated with redeployment of primary care nurses, and 3) examine the nature (e.g., settings, activities) of redeployment by primary care nurses during the COVID-19 pandemic. Methods: In this qualitative study, semi-structured interviews were conducted with primary care nurses (i.e., Nurse Practitioners, Registered Nurses, and Licensed/Registered Practical Nurses), from four regions in Canada. These include the Interior, Island, and Vancouver Coastal Health regions in British Columbia; Ontario Health West region in Ontario; the province of Nova Scotia; and the province of Newfoundland and Labrador. Data related to redeployment were analyzed thematically. Results: Three overarching themes related to redeployment during the COVID-19 pandemic were identified: (1) Call to redeployment, (2) Redeployment as an opportunity/challenge, and (3) Scope of practice during redeployment. Primary care nurses across all regulatory designations reported variation in the process of redeployment within their jurisdiction (e.g., communication, policies/legislation), different opportunities and challenges that resulted from redeployment (e.g., scheduling flexibility, workload implications), and scope of practice implications (e.g., perceived threat to nursing license). The majority of nurses discussed experiences with redeployment being voluntary in nature, rather than mandated. Conclusions: Redeployment is a useful workforce strategy during public health emergencies; however, it requires a structured process and a decision-making approach that explicitly involves healthcare providers affected by redeployment. Primary care nurses ought only to be redeployed after other options are considered and arrangements made for the care of patients in their original practice area.
Collapse
Affiliation(s)
- Julia Lukewich
- Faculty of Nursing, Memorial University, St. John's, NL, Canada
| | - Donna Bulman
- Faculty of Nursing, Memorial University, St. John's, NL, Canada
| | - Maria Mathews
- Department of Family Medicine, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada
| | - Lindsay Hedden
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
| | - Emily Marshall
- Department of Family Medicine, Dalhousie University, Halifax, NS, Canada
| | - Crystal Vaughan
- Faculty of Nursing, Memorial University, St. John's, NL, Canada
| | - Dana Ryan
- Faculty of Nursing, Memorial University, St. John's, NL, Canada
| | - Emilie Dufour
- Department of Family Medicine, Dalhousie University, Halifax, NS, Canada
| | - Leslie Meredith
- Department of Family Medicine, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada
| | - Sarah Spencer
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
| | - Lauren R Renaud
- Department of Family Medicine, Dalhousie University, Halifax, NS, Canada
| | - Shabnam Asghari
- Faculty of Medicine, Memorial University, St. John's, NL, Canada
| | - Cheryl Cusack
- College of Nursing, University of Manitoba, Winnipeg, MB, Canada
| | | | | | - Gillian Young
- Department of Family Medicine, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada
| | - Eric Wong
- Department of Family Medicine, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada
| |
Collapse
|
4
|
Arbour S, Paul S, Rice M. Reduction of adverse events in a psychiatric inpatient eating disorder unit during the COVID-19 pandemic. JOURNAL OF CHILD AND ADOLESCENT PSYCHIATRIC NURSING 2023; 36:293-298. [PMID: 37350241 DOI: 10.1111/jcap.12430] [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: 03/06/2023] [Revised: 05/09/2023] [Accepted: 06/11/2023] [Indexed: 06/24/2023]
Abstract
TOPIC Globally, the COVID-19 pandemic had impacted the health care delivery including inpatient psychiatric facilities. Within psychiatric settings, life of inpatients was profoundly altered. PURPOSE This paper aimed to understand if pandemic-related changes within an inpatient Eating Disorder Unit in a specialized psychiatric hospital in Ontario, Canada impacted incidence of aggression and use of coercive methods among adolescents. SOURCE USED An exploratory study design was used to examine incidence of aggression, self-harm, code whites, staff assist, restraints and seclusion, and nasogastric feeding (NGF) among adolescents with eating disorders before and after the modified service delivery within the inpatient unit. Descriptive analyses were conducted. RESULTS Analyses revealed a complete reduction in episodes of self-harm, aggression, staff assists, use of restraint and seclusion as well as an 80.14% reduction on average use of NGF. CONCLUSION Authors speculate that the change in environment and program delivery method, peer influence, and shift in power relations between patient and staff may have resulted in improved experiences. This report provides insights to adopt a recovery-oriented service delivery for adolescents with eating disorders in inpatient settings.
Collapse
Affiliation(s)
- Simone Arbour
- Ontario Shores Centre for Mental Health Sciences, Whitby, Ontario, Canada
| | - Sayani Paul
- Ontario Shores Centre for Mental Health Sciences, Whitby, Ontario, Canada
| | - Mark Rice
- Clinical Services, Ontario Shores Centre for Mental Health Sciences, Whitby, Ontario, Canada
| |
Collapse
|
5
|
McGill N, Weller-Newton J, Lees C. A new survey tool for evaluating pandemic preparedness in health services. BMC Health Serv Res 2022; 22:708. [PMID: 35624506 PMCID: PMC9136193 DOI: 10.1186/s12913-022-08067-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 04/28/2022] [Indexed: 02/06/2023] Open
Abstract
Background Rapid decision-making with limited resources and prior research to draw upon posed challenges for health service leaders globally when preparing for COVID-19. How do health services prepare for a pandemic and evaluate if the preparation has been effective? This study aimed to explore health workers’ perceptions and knowledge regarding preparedness for COVID-19 at a regional health service in Australia. Methods A 32-item online survey was developed to evaluate preparedness across five scales: 1) Clinical, 2) Communication, 3) Environment, 4) Human Resources, and 5) General Preparedness. Data were analyzed using parametric and non-parametric statistics and qualitative content analysis. Results Ninety-three employees completed the survey, with most working in clinical roles (58.1%). Respondents largely felt the health service was well-prepared (84.0%) and they were personally prepared (74.4%) to respond to COVID-19. Clinical and communication scale scores varied by role type. Respondents faced personal risk and resource shortages impacted their sense of safety; others felt adequately supported. Conclusions A coordinated “whole hospital response”, accessible and inclusive communication, education, adequate resourcing, and employee wellbeing supports are necessary when preparing health services for sentinel events. This survey tool offers health services an approach to evaluating pandemic preparation. Continued advocacy for resources and wellbeing needs of health workers is paramount in future preparations.
Collapse
Affiliation(s)
- Nicole McGill
- Department of Rural Health; Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, 49 Graham St, Shepparton, Victoria, Australia. .,Department of Education, Training and Research, Echuca Regional Health, 226 Service St, Echuca, Victoria, Australia.
| | - Jennifer Weller-Newton
- Department of Rural Health; Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, 49 Graham St, Shepparton, Victoria, Australia
| | - Catherine Lees
- Department of Education, Training and Research, Echuca Regional Health, 226 Service St, Echuca, Victoria, Australia
| |
Collapse
|
6
|
Martin K, Arbour S, McGregor C, Rice M. Silver linings: Observed reductions in aggression and use of restraints and seclusion in psychiatric inpatient care during COVID-19. J Psychiatr Ment Health Nurs 2022; 29:381-385. [PMID: 33704877 PMCID: PMC8242738 DOI: 10.1111/jpm.12752] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 01/25/2021] [Accepted: 03/03/2021] [Indexed: 01/09/2023]
Abstract
WHAT IS KNOWN ABOUT THE SUBJECT?: In a survey conducted by the World Health Organization (WHO) in the summer of 2020, 93% of countries worldwide acknowledged negative impacts on their mental health services. Previous research during the H1N1 pandemic in 2009 established an increase of patient aggression in psychiatric facilities. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: Despite expected worsening of mental health, our hospital observed reductions in aggressive behaviour among inpatients and subsequent use of coercive interventions by staff in the months following Covid-19 pandemic restrictions being implemented. The downward trend in incidents observed during the pandemic has suggested that aggression in mental health hospitals may be more situation-specific and less so a factor of mental illness. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: We believe that the reduction in aggressive behaviour observed during the pandemic is related to changes in our organization that occurred in response to concerns about patient well-being; our co-design approach shifted trust, choice and power. Therefore, practices that support these constructs are needed to maintain the outcomes we experienced. Rather than return to normal in the wake of the pandemic, we are strongly encouraged to sustain the changes we made and continue to find better ways to support and work with the individuals who rely on or use our services. ABSTRACT: The global COVID-19 pandemic has dramatically changed the operation of health care such that many services were put on hold as patients were triaged differently, people delayed seeking care, and transition to virtual care was enacted, including in psychiatric facilities. Most of the media dialogue has been negative; however, there have been some silver linings observed. Coinciding with the pandemic has been a reduction in aggressive incidents at our psychiatric hospital, along with the decreased need to use restraints and seclusion to manage behaviour. In this paper, we are taking stock of the changes that have occurred in response to the pandemic in an attempt to share our learnings and offer suggestions so that health care does not necessarily return to "normal".
Collapse
Affiliation(s)
- Krystle Martin
- Ontario Shores Centre for Mental Health Sciences, Whitby, ON, Canada.,Ontario Tech University, Oshawa, ON, Canada
| | - Simone Arbour
- Ontario Shores Centre for Mental Health Sciences, Whitby, ON, Canada
| | - Carolyn McGregor
- Ontario Shores Centre for Mental Health Sciences, Whitby, ON, Canada.,Ontario Tech University, Oshawa, ON, Canada
| | - Mark Rice
- Ontario Shores Centre for Mental Health Sciences, Whitby, ON, Canada
| |
Collapse
|
7
|
Barnes A, Crilly J. Review article: Impact of pandemics on rural emergency departments: A scoping review. Emerg Med Australas 2022; 34:312-321. [PMID: 35231959 DOI: 10.1111/1742-6723.13938] [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: 06/30/2021] [Revised: 12/04/2021] [Accepted: 01/10/2022] [Indexed: 11/27/2022]
Abstract
Pandemics can cause much distress to communities and present a major burden to the resources and functioning of hospitals. This scoping review aimed to identify, evaluate and summarise current literature regarding how pandemics impact rural EDs in terms of staff wellbeing, structure, function and resources. A systematic search of six databases using search terms including pandemic, ED and rural and remote was undertaken. Articles were included if they were peer-reviewed, written in English, original research, published between January 2010 and October 2021 and discussed the impact of pandemics on rural EDs. Articles were critically appraised using the Mixed Methods Appraisal Tool (MMAT). Three articles, one from Canada and two from the United States, met the inclusion criteria. The articles included were quantitative in design and fulfilled most of the MMAT critical analysis criteria. Pandemics reported on included H1N1 and COVID-19. These pandemics impacted rural EDs in terms of functioning and resourcing; no description of staff wellbeing or structure was identified. Rural ED functioning was affected in terms of input; with an increase in patient presentations and time to physician assessment during H1N1, but a decrease in patient presentations and transfers during COVID-19. Rural ED resources were impacted in regard to staffing, difficulty in obtaining stocks of personal protective equipment and medication, and community response. Further research to understand and address the short- and long-term impacts pandemics may have on rural EDs is required.
Collapse
Affiliation(s)
- Amber Barnes
- School of Nursing and Midwifery, Griffith University, Gold Coast, Queensland, Australia
| | - Julia Crilly
- School of Nursing and Midwifery, Griffith University, Gold Coast, Queensland, Australia.,Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia.,Department of Emergency Medicine, Gold Coast Health, Gold Coast, Queensland, Australia
| |
Collapse
|
8
|
Ryder M, Gallagher P, Coughlan B, Halligan P, Guerin S, Connolly M. Nursing and midwifery workforce readiness during a global pandemic: A survey of the experience of one hospital group in the Republic of Ireland. J Nurs Manag 2021; 30:25-32. [PMID: 34473868 PMCID: PMC8646494 DOI: 10.1111/jonm.13461] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Revised: 07/08/2021] [Accepted: 08/23/2021] [Indexed: 12/23/2022]
Abstract
AIM To explore the mobilization of nurses/midwives in a designated hospital group in Ireland during a global pandemic. BACKGROUND The recent global pandemic has resulted in the large-scale worldwide mobilization of registered nurses and midwives working in the acute care sector. There is a dearth of literature reporting the mobilization of this professional workforce. METHOD Mixed-methods design using an electronic survey and facilitated discussion across one Irish hospital group. RESULTS Eight of 11 hospitals responded to the survey. There was a 2% vacancy rate prior to the pandemic. Mobilization included reconfiguration of clinical areas and redeployment of 9% of the nursing/midwifery workforce within 2 weeks of the pandemic. A total of 11% (n = 343) of nurses/midwives were redeployed in 3 months. Nurses/midwives required re-skilling in infection prevention control, enhancement of critical care skills and documentation. CONCLUSIONS Three key areas were identified to enable the nursing workforce readiness. These are referred to as the three 'R's': Reconfiguration of specific resources, Redeployment of nurses to dedicated specialist areas and Re-skilling of nurses to safely care for the patients during the pandemic. IMPLICATIONS FOR NURSING MANAGEMENT A centralized approach to reconfiguration of clinical areas. Redeployment is enabled by closing non-essential departments. Hands-on re-skilling and reorientating staff are essential.
Collapse
Affiliation(s)
- Mary Ryder
- School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland.,Department of Nursing, St. Vincent's University Hospital, Dublin, Ireland
| | | | - Barbara Coughlan
- School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland
| | - Phil Halligan
- School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland
| | - Suzanne Guerin
- School of Psychology, University College Dublin, Dublin, Ireland
| | - Michael Connolly
- School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland
| |
Collapse
|
9
|
Zhang Y, Wang C, Pan W, Zheng J, Gao J, Huang X, Cai S, Zhai Y, Latour JM, Zhu C. Stress, Burnout, and Coping Strategies of Frontline Nurses During the COVID-19 Epidemic in Wuhan and Shanghai, China. Front Psychiatry 2020; 11:565520. [PMID: 33192686 PMCID: PMC7649755 DOI: 10.3389/fpsyt.2020.565520] [Citation(s) in RCA: 112] [Impact Index Per Article: 28.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Accepted: 10/02/2020] [Indexed: 12/12/2022] Open
Abstract
Background: Nurses at the frontline of caring for COVID-19 patients might experience mental health challenges and supportive coping strategies are needed to reduce their stress and burnout. The aim of this study was to identify stressors and burnout among frontline nurses caring for COVID-19 patients in Wuhan and Shanghai and to explore perceived effective morale support strategies. Method: A cross-sectional survey was conducted in March 2020 among 110 nurses from Zhongshan Hospital, Shanghai, who were deployed at COVID-19 units in Wuhan and Shanghai. A COVID-19 questionnaire was adapted from the previous developed "psychological impacts of SARS" questionnaire and included stressors (31 items), coping strategies (17 items), and effective support measures (16 items). Burnout was measured with the Maslach Burnout Inventory. Results: Totally, 107 (97%) nurses responded. Participants mean age was 30.28 years and 90.7% were females. Homesickness was most frequently reported as a stressor (96.3%). Seven of the 17 items related to coping strategies were undertaken by all participants. Burnout was observed in the emotional exhaustion and depersonalization subscales, with 78.5 and 92.5% of participants presenting mild levels of burnout, respectively. However, 52 (48.6%) participants experienced a severe lack of personal accomplishment. Participants with longer working hours in COVID-19 quarantine units presented higher emotional exhaustion (OR = 2.72, 95% CI 0.02-5.42; p = 0.049) and depersonalization (OR = 1.14, 95% CI 0.10-2.19; p = 0.033). Participants with younger age experienced higher emotional exhaustion (OR = 2.96, 95% CI 0.11-5.82; p = 0.042) and less personal accomplishment (OR = 3.80, 95% CI 0.47-7.13; p = 0.033). Conclusions: Nurses in this study experienced considerable stress and the most frequently reported stressors were related to families. Nurses who were younger and those working longer shift-time tended to present higher burnout levels. Psychological support strategies need to be organized and implemented to improve mental health among nurses during the COVID-19 pandemic.
Collapse
Affiliation(s)
- Yuxia Zhang
- Department of Nursing, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Chunling Wang
- Department of Nursing, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Wenyan Pan
- Department of Nursing, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Jili Zheng
- Department of Nursing, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Jian Gao
- Department of Biostatistics, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Xiao Huang
- Department of Psychology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Shining Cai
- Department of Nursing, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Yue Zhai
- School of Nursing, Fudan University, Shanghai, China
| | - Jos M. Latour
- School of Nursing and Midwifery, Faculty of Health: Medicine, Dentistry and Human Sciences, University of Plymouth, Plymouth, United Kingdom
| | - Chouwen Zhu
- Department of Hospital Administration, Zhongshan Hospital, Fudan University, Shanghai, China
- Department of Gastroenterology, Zhongshan Hospital, Fudan University, Shanghai, China
| |
Collapse
|
10
|
Shi P, Yan J, Keskinocak P, Shane AL, Swann JL. The impact of opening dedicated clinics on disease transmission during an influenza pandemic. PLoS One 2020; 15:e0236455. [PMID: 32760086 PMCID: PMC7410326 DOI: 10.1371/journal.pone.0236455] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Accepted: 07/05/2020] [Indexed: 11/19/2022] Open
Abstract
Dedicated clinics can be established in an influenza pandemic to isolate people and potentially reduce opportunities for influenza transmission. However, their operation requires resources and their existence may attract the worried-well. In this study, we quantify the impact of opening dedicated influenza clinics during a pandemic based on an agent-based simulation model across a time-varying social network of households, workplaces, schools, community locations, and health facilities in the state of Georgia. We calculate performance measures, including peak prevalence and total attack rate, while accounting for clinic operations, including timing and location. We find that opening clinics can reduce disease spread and hospitalizations even when visited by the worried-well, open for limited weeks, or open in limited locations, and especially when the clinics are in operation during times of highest prevalence. Specifically, peak prevalence, total attack rate, and hospitalization reduced 0.07–0.32%, 0.40–1.51%, 0.02–0.09%, respectively, by operating clinics for the pandemic duration.
Collapse
Affiliation(s)
- Pengyi Shi
- Krannert School of Management, Purdue University, West Lafayette, Indiana, United States of America
| | - Jia Yan
- School of Industrial and Systems Engineering, Georgia Institute of Technology, Atlanta, Georgia, United States of America
| | - Pinar Keskinocak
- School of Industrial and Systems Engineering, Georgia Institute of Technology, Atlanta, Georgia, United States of America
| | - Andi L. Shane
- Division of Infectious Diseases, Department of Pediatrics, Emory University and Children’s Healthcare of Atlanta, Atlanta, Georgia, United States of America
| | - Julie L. Swann
- Department of Industrial and Systems Engineering, North Carolina State University, Raleigh, North Carolina, United States of America
- * E-mail:
| |
Collapse
|
11
|
Adelaja I, Sayma M, Walton H, McLachlan G, de Boisanger J, Bartlett-Pestell S, Roche E, Gandhi V, Wilson GJ, Brookes Z, Yeen Fung C, Macfarlane H, Navaratnam A, James C, Scolding P, Sara H. A comprehensive hospital agile preparedness (CHAPs) tool for pandemic preparedness, based on the COVID-19 experience. Future Healthc J 2020; 7:165-168. [PMID: 32550286 DOI: 10.7861/fhj.2020-0030] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
COVID-19 presents an unprecedented challenge to hospitals and the systems in which they operate. The primary exponential surge of COVID-19 cases is arguably the most devastating event a hospital will face. In some countries, these surges during the initial outbreak of the disease have resulted in hospitals suffering from significant resource strain, leading to excess patient mortality and negatively impacting staff wellbeing. As experience builds in managing these surges, it has become evident that agile, tailored planning tools are required. The comprehensive hospital agile preparedness (CHAPs) tool provides clinical planners with six key domains to consider that frequently create resource strain during COVID-19; it also allows local planners to identify issues unique to their hospital, system or region. Although this tool has been developed from COVID-19 experiences, it has potential to be modified for a variety of pandemic scenarios according to transmission modes, rates and critical care resource requirements.
Collapse
Affiliation(s)
| | | | - Henry Walton
- NHS England and NHS Improvement, London, UK, and A&E registrar, Barts Health NHS Trust, London, UK
| | | | | | | | - Emma Roche
- NHS England and NHS Improvement, London, UK
| | | | | | | | | | | | | | | | | | - Hurley Sara
- England, and deputy strategic incident commander COVID-19, NHS England and NHS Improvement, London, UK
| |
Collapse
|
12
|
Barratt R, Shaban RZ, Gilbert GL. Clinician perceptions of respiratory infection risk; a rationale for research into mask use in routine practice. Infect Dis Health 2019; 24:169-176. [PMID: 30799181 PMCID: PMC7129171 DOI: 10.1016/j.idh.2019.01.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Revised: 01/29/2019] [Accepted: 01/30/2019] [Indexed: 11/18/2022]
Abstract
Outbreaks of emerging and re-emerging infectious diseases are global threats to society. Planning for, and responses to, such events must include healthcare and other measures based on current evidence. An important area of infection prevention and control (IPC) is the optimal use of personal protective equipment (PPE) by healthcare workers (HCWs), including masks for protection against respiratory pathogens. Appropriate mask use during routine care is a forerunner to best practice in the event of an outbreak. However, little is known about the influences on decisions and behaviours of HCWs with respect to protective mask use when providing routine care. In this paper we argue that there is a need for more research to provide a better understanding of the decision-making and risk-taking behaviours of HCWs in respect of their use of masks for infectious disease prevention. Our argument is based on the ongoing threat of emerging infectious diseases; a need to strengthen workforce capability, capacity and education; the financial costs of healthcare and outbreaks; and the importance of social responsibility and supportive legislation in planning for global security. Future research should examine HCWs' practices and constructs of risk to provide new information to inform policy and pandemic planning.
Collapse
Affiliation(s)
- Ruth Barratt
- Centre for Infectious Diseases and Microbiology, Westmead Institute for Medical Research, 176 Hawkesbury Rd, Westmead, NSW 2145, Australia; Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney, Camperdown, NSW 2050, Australia; The Westmead Clinical School, University of Sydney, NSW 2145, Australia.
| | - Ramon Z Shaban
- Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney, Camperdown, NSW 2050, Australia; Faculty of Medicine and Health, Susan Wakil School of Nursing and Midwifery, University of Sydney, Camperdown, NSW 2050, Australia; Directorate of Nursing, Midwifery and Clinical Governance, Western Sydney Local Health District, Westmead, NSW 2145, Australia.
| | - Gwendoline L Gilbert
- Centre for Infectious Diseases and Microbiology, Westmead Institute for Medical Research, 176 Hawkesbury Rd, Westmead, NSW 2145, Australia; Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney, Camperdown, NSW 2050, Australia.
| |
Collapse
|
13
|
Goode N, Salmon PM, Spencer C, McArdle D, Archer F. Defining disaster resilience: comparisons from key stakeholders involved in emergency management in Victoria, Australia. DISASTERS 2017; 41:171-193. [PMID: 26987455 DOI: 10.1111/disa.12189] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Three years after the introduction of the National Strategy for Disaster Resilience there remains no unanimously adopted definition of disaster resilience within Australia's emergency management sector. The aim of this study is to determine what the concept means to key stakeholders in the emergency management sector in the Australian State of Victoria, and how these conceptualisations overlap and diverge. Via an online survey, 113 people were asked how they define disaster resilience in their work in the emergency management sector. A data mining software tool, Leximancer, was employed to uncover the relationships between the definitions provided. The findings show that stakeholders see resilience as an 'ability' that encompasses emergency management activities and personal responsibility. However, the findings also highlight some possible points of conflict between stakeholders. In addition, the paper outlines and discusses a number of potential consequences for the implementation and the success of the resilience-based approach in Australia.
Collapse
Affiliation(s)
- Natassia Goode
- PhD is Deputy Director of the Centre for Human Factors and Sociotechnical Systems at the University of the Sunshine Coast, Australia
| | - Paul M Salmon
- PhD is the Director of the Centre for Human Factors and Sociotechnical Systems at the University of the Sunshine Coast, Australia
| | - Caroline Spencer
- PhD is a Research Fellow at the Monash Injury Research Institute, Monash University, Australia
| | - Dudley McArdle
- Emergency Management Consultant at the Monash Injury Research Institute, Monash University, Australia
| | - Frank Archer
- Emeritus Professor at the Monash Injury Research Institute, Monash University, Australia
| |
Collapse
|
14
|
Dewar B, Barr I, Robinson P. Hospital capacity and management preparedness for pandemic influenza in Victoria. Aust N Z J Public Health 2015; 38:184-90. [PMID: 24690058 DOI: 10.1111/1753-6405.12170] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2013] [Revised: 08/01/2013] [Accepted: 10/01/2013] [Indexed: 01/01/2023] Open
Abstract
OBJECTIVE This study was designed to investigate acute hospital pandemic influenza preparedness in Victoria, Australia, particularly focussing on planning and management efforts. METHODS A prospective study was conducted by questionnaire and semi-structured interview of health managers across the Victorian hospital system from July to October 2011. Participants with responsibility for emergency management, planning and operations were selected from every hospital in Victoria with an emergency department to complete a questionnaire (response rate 22/43 = 51%). Each respondent was invited to participate in a phone-based semi-structured interview (response rate 11/22 = 50%). RESULTS Rural/regional hospitals demonstrated higher levels of clinical (86%) and non-clinical (86%) staff contingency planning than metropolitan hospitals (60% and 40% respectively). Pandemic plans were not being sufficiently tested in exercises or drills, which is likely to undermine their effectiveness. All respondents reported hand hygiene and standard precautions programs in place, although only one-third (33%) of metropolitan respondents and no rural/regional respondents reported being able to meet patient needs with high levels of staff absenteeism. Almost half Victoria's healthcare workers were unvaccinated against influenza. CONCLUSIONS AND IMPLICATIONS Hospitals across Victoria demonstrated different levels of influenza pandemic preparedness and planning. If a more severe influenza pandemic than that of 2009 arose, Victorian hospitals would struggle with workforce and infrastructure problems, particularly in rural/regional areas. Staff absenteeism threatens to undermine hospital pandemic responses. Various strategies, including education and communication, should be included with in-service training to provide staff with confidence in their ability to work safely during a future pandemic.
Collapse
Affiliation(s)
- Ben Dewar
- School of Public Health and Human Biosciences, La Trobe University, Victoria
| | | | | |
Collapse
|
15
|
van Dijk CE, Hooiveld M, Jentink A, Isken LD, Timen A, Yzermans CJ. Experiences of General Practitioners and Practice Assistants during the Influenza A(H1N1) Pandemic in the Netherlands: A Cross-Sectional Survey. PLoS One 2015; 10:e0135666. [PMID: 26313147 PMCID: PMC4551952 DOI: 10.1371/journal.pone.0135666] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2014] [Accepted: 07/26/2015] [Indexed: 11/24/2022] Open
Abstract
Objectives Since few pandemics have occurred since the Spanish influenza pandemic, we should learn from every (mild) pandemic that occurs. The objective of this study was to report on general practitioners’ and practice assistants’ acceptance of the chosen national policy, and experiences in the Netherlands during the influenza A(H1N1)pdm09 pandemic. Methods Data on experience and acceptance of the chosen national policy were obtained by structured questionnaires for general practitioners (n = 372) and practice assistants (n = 503) in April 2010. Results The primary policy chosen for general practice was not always accepted and complied with by general practitioners, although the communication (of changes) and collaboration with involved organisations were rated as positive. In particular, the advised personal protective measures were difficult to implement in daily work and thus not executed by 44% of general practitioners. Half of the general practitioners were not satisfied with the patient information provided by the government. The influenza A(H1N1) pandemic highly impacted on general practitioners’ and practice assistants’ workloads, which was not always deemed to be adequately compensated. Discussion Involvement of general practitioners in future infectious disease outbreaks is essential. This study addresses issues in the pandemic policy which might be critical in a more severe pandemic.
Collapse
Affiliation(s)
- Christel E. van Dijk
- NIVEL, Netherlands Institute for Health Services Research, Utrecht, The Netherlands
- * E-mail:
| | - Mariette Hooiveld
- NIVEL, Netherlands Institute for Health Services Research, Utrecht, The Netherlands
| | - Anne Jentink
- NIVEL, Netherlands Institute for Health Services Research, Utrecht, The Netherlands
| | - Leslie D. Isken
- Preparedness and Response Unit, Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Aura Timen
- Preparedness and Response Unit, Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - C. Joris Yzermans
- NIVEL, Netherlands Institute for Health Services Research, Utrecht, The Netherlands
| |
Collapse
|