ABSTRACT
The availability of sufficient, efficient nursing staff and the development of nursing services are crucial in the provision of high-quality care to healthcare services users. Provision of adequate nursing staff is of vital importance as it affects patient outcomes and safety. Limited nursing staff and a low ratio of nurses per patient are associated with an increased risk of patient death. Understaffing affects the staff members themselves, the patients and the health-care organizations, and, internationally, measures focusing on setting a safe nurse-to-patient ratio have been developed. Factors that increase the need for nursing staff are the increasingly demanding nursing care of patients in hospitals following advances in technology, the ageing of the population, and the increasing numbers of patients and their comorbidities. The COVID-19 pandemic constitutes a new significant determinant of increase in the need for qualified nursing staff. The COVID-19 pandemic has caused major organizational issues in healthcare systems world-wide, even in the developed countries with their reasonably well-organized primary and secondary healthcare systems. Staffing plans during the COVID-19 pandemic should focus on the care needs of patients with COVID-19, and should include the deployment and allocation of skilled clinical staff. Healthcare systems internationally need to take immediate and effective action regarding the availability of qualified nursing staff, to be better prepared for future public health threats.
ABSTRACT
BACKGROUND: Healthcare workers (HCWs) represent a high-risk population for infection with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). AIM: To determine the seroprevalence of SARS-CoV-2 antibodies among HCWs, and identify the factors associated with this seroprevalence. METHODS: The Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines were applied for this systematic review and meta-analysis. Databases including PubMed/MEDLINE and preprint services (medRχiv and bioRχiv) were searched from inception to 24th August 2020. FINDINGS: Forty-nine studies including 127,480 HCWs met the inclusion criteria. The estimated overall seroprevalence of SARS-CoV-2 antibodies among HCWs was 8.7% (95% confidence interval 6.7-10.9%). Seroprevalence was higher in studies conducted in North America (12.7%) compared with those conducted in Europe (8.5%), Africa (8.2) and Asia (4%). Meta-regression showed that increased sensitivity of antibody tests was associated with increased seroprevalence. The following factors were associated with seropositivity: male gender; Black, Asian and Hispanic HCWs; work in a coronavirus disease 2019 (COVID-19) unit; patient-related work; front-line HCWs; healthcare assistants; shortage of personal protective equipment; self-reported belief of previous SARS-CoV-2 infection; previous positive polymerase chain reaction test; and household contact with suspected or confirmed cases of COVID-19. CONCLUSION: The seroprevalence of SARS-CoV-2 antibodies among HCWs is high. Excellent adherence to infection prevention and control measures; sufficient and adequate personal protective equipment; and early recognition, identification and isolation of HCWs infected with SARS-CoV-2 are imperative to decrease the risk of SARS-CoV-2 infection.