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INTRODUCTION: The COVID-19 pandemic has opened a dialogue regarding advocacy and policy changes that need to occur at the federal, state, and local levels to ensure provisions for the financial and healthcare well-being of nurses. Often nurses struggle as the "breadwinners" in their families caring for multiple generations, thus leading them to live paycheck to paycheck. DESIGN: A review of current and proposed policy changes. The pandemic demonstrated clearly through governmental executive orders that laws and regulations could be changed more rapidly than the traditional routes, illustrating an ability to enact change in nursing practice. At the federal level, provisions are not made to ensure that nurses who risk their lives during pandemic times are adequately compensated monetarily and through extended healthcare benefits, often provided for police, fire, and other emergency personnel. RESULTS/CONCLUSIONS: Suggestions for new policy and advocacy agendas are proposed based on the gap in coverage noted during and after this pandemic. CLINICAL RELEVANCE: COVID-19 has brought to the forefront gaps in the financial and healthcare safety nets for nurses in the United States. Opportunities exist to inform via advocacy and policy reform at the federal, state, and local governmental agencies regarding the need for extended financial and healthcare provisions for nurses.
ABSTRACT
OBJECTIVE: To use evidence-based practice and an interprofessional approach to improve outcomes for adult patients with tracheostomies and enhance staff knowledge during the COVID-19 pandemic. METHODS: The core interprofessional Tracheostomy Thursday team included staff nurses, respiratory therapists, and nursing leadership who collaborated with surgeons and materials management staff at an urban academic medical center in New York, the epicenter of the COVID-19 pandemic in the US. The team implemented hospital-wide bedside rounds on all adults with tracheostomies. Skin and safety assessments were performed with peer-to-peer coaching. Data were collected and analyzed to understand areas of improvement. RESULTS: After 6 months of hospital-wide rounding, implementation of a bedside tracheostomy safety checklist, and a continued interprofessional approach, safety measures increased by 48%, and preventive dressing use increased by 24% with improvement in preventing tracheostomy-related medical device-related pressure injuries. The team's work was professionally recognized through institutional policy change, conference poster presentations, and Sigma's international excellence award. CONCLUSION: Bundling an interprofessional approach, staff education, bedside rounds, and standard preventive measures was key to the team's success. A bedside safety checklist fostered team communication and supported direct care nurses in managing individuals with a new tracheostomy.
Subject(s)
COVID-19 , Teaching Rounds , Adult , COVID-19/epidemiology , COVID-19/prevention & control , Humans , Pandemics/prevention & control , Patient Care Team , TracheostomyABSTRACT
[...]caring science connects nurses, patients, families, and all healthcare professionals in authentic human caring relationships (Ackerman. 20191. [...]we determined that development of a helping-trusting human caring relationship (Factor #4) resulting in an authentic caring relationship was pertinent. [...]we identified Factor #9 as germane, specifically assistance with gratification of human needs explained as assisting with basic needs, with an intentional, caring consciousness of touching and working with embodied spirit of individual, honoring unity of Being (Gallagher-Lepak & Kubsch. 2009). To identify the most serious health and financial problems encountered in the country, National Public Radio (NPR), the Robert Wood Johnson Foundation (RWJF) and the Harvard T.H. Chan School of Public Health (20201 conducted a survey from July 1 to August 3, 2020 in the four largest urban areas in the United States.