Hospital Fire Outbreaks Before and During the COVID-19 Pandemic in Low- and Middle-Income Settings.

OBJECTIVE: The aim of the study is to identify and synthesize existing published and gray literature reporting on hospital fire outbreaks before and during the coronavirus disease 2019 (COVID-19) pandemic. METHODS: A 2-phase narrative review approach was used. The search covered peer-reviewed, gray literature sources, and news outlets. The pre-COVID-19 hospital fire outbreak search period was January 2000-December 2019 while that for during COVID-19 was December 2019-July 2021 (repeated in December 2021). RESULTS: Thirteen and 24 media reports were identified for the pre-COVID-19 and during COVID-19 periods, respectively. Although varied fire risks existed before the emergence of the COVID-19, this article demonstrates that the incidence of hospital fires has increased more than two-folds in recent times in COVID-19 wards and intensive care units causing death, injuries, and extensive damage to properties. The main risk in the pre-COVID-19 era was identified as electrical faults. During the pandemic, other issues such as oxygen explosions, inefficient cooling systems, and lack of fire control measures in makeshift pre-COVID-19 centers were identified as additional risks/causes of the hospital fire outbreaks. CONCLUSIONS: Additional risks have emerged during the COVID-19 era, which increased the occurrence of hospital fire outbreaks. Guidelines, protocols, and policies regarding the prevention of hospital fire outbreaks and strategies for attenuating its effects need to be highlighted across settings and adhered to. Existing policies need to evolve to help resolve these risks. Beyond the preventive strategies, context-specific psychosocial support is also required for healthcare staff, families, and patients who survive episodes of hospital fire outbreaks.

A meta-synthesis of the transitioning experiences and career progression of migrant African nurses.

INTRODUCTION: With the rise in global migration, hospitals and health systems in developed countries are looking to supplement their workforces with migrant nurses who have been reported to feel devalued, underutilized with experience of deskilling and unmet expectations as they transitioned. Despite the plethora of literature reporting on the experiences of internationally trained nurses, only limited work has been done regarding understanding the experiences of Migrant African nurses. Thus, this study sought to synthesize existing qualitative studies to develop in-depth understanding of the transitioning experiences of migrant African nurses, their career progression and to highlight existing gaps to guide future studies as well as inform policies. METHOD: A meta-synthesis was performed and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses and the Enhancing transparency in reporting the synthesis of qualitative research statement. A pre-planned search strategy was developed guided by the SPIDER tool for qualitative synthesis searching EMBASE via OVID, CINAHL via EBSCO, PubMed, Web of Science, and PsychINFO databases. We included published studies that 1) focused on migrant African nurses, 2) employed a qualitative design and 3) reported in English. RESULTS: The search yielded 139 studies of which nine studies met the inclusion criteria and included in final synthesis. Three themes with corresponding subthemes emerged from data synthesis: 1) Navigating reality shock (a. Navigating a new culture, b. Survival strategies and support amidst the shock); 2) Discrimination and limited opportunities for promotion (a. Prejudices and preference for White over Black, b. Lack of recognition and limited opportunities for a workplace promotion); and 3) Finding one's feet (a. Standing up for oneself and looking beyond discrimination, b. Experiencing growth). CONCLUSION: Transitioning to a new setting can be a challenging experience for migrant African nurses warranting the availability of a tailor-made adaptation or orientation programme. Though African nurses may experience discrimination and prejudices as part of their transition, they consider their situation to be better off compared to back home. Therefore, clear transitioning policies which focus on career pathways are required by hiring institutions, and migrant nurses should be proactive in taking active roles in pushing their career ahead, instead of maintaining a culture of silence.