Optimizing Access to the COVID-19 Vaccination for People Experiencing Homelessness.

The success of the Australian COVID-19 vaccination strategy rested on access to primary healthcare. People experiencing or at risk of homelessness are less likely to access primary healthcare services. Therefore, leaders in homeless health service delivery in Sydney identified the need to develop a vaccine hub specifically for this vulnerable population. The aim of this study was to develop an evidenced based model of care to underpin the Vaccine Hub and optimize access to vaccination for people experiencing or at risk of homelessness. A mixed methods study was conducted that included interviews with key stakeholders involved in establishing and delivering the Inner City COVID-19 Vaccine Hub, and a survey with people receiving COVID-19 vaccination. Over the 6-month period of this study, 4305 COVID-19 vaccinations were administered. Participants receiving vaccination reported feeling safe in the Vaccine Hub and would recommend it to others. Stakeholders paid tribute to the collective teamwork of the Vaccine Hub, the collaboration between services, the 'no wrong door' approach to increasing access and the joy of being able to support such a vulnerable population in challenging times. The study findings have been populated into a Vaccination Hub Blueprint document that can be used as a template for others to improve access to vaccinations for vulnerable populations.

Coping with COVID-19. Work life experiences of nursing, midwifery and paramedic academics: An international interview study.

BACKGROUND: The COVID-19 global pandemic was declared in March 2020. By June 2022, the total deaths worldwide attributed to COVID-19 numbered over 6.3 million. Health professionals have been significantly impacted worldwide primarily those working on the frontline but also those working in other areas including nursing, midwifery, and paramedic higher education. Studies of occupational stress have focused on the clinical health professional roles but scant attention has been drawn to the pressures on university-based academic staff supporting and preparing professionals for frontline health work. DESIGN AND OBJECTIVES: This qualitative study sought to explore the challenges experienced by health academics (nurses, midwives and paramedics), during COVID-19 and identify strategies enlisted. SETTING AND PARTICIPANTS: Six Australian and two United Kingdom universities collaborated, from which 34 health academics were individually interviewed via video or teleconference, using six broad questions. Ethical approval was obtained from the lead site and each participating University. DATA ANALYSIS: Thematic analysis of the data was employed collaboratively across institutions, using Braun and Clarke's method. RESULTS: Data analysis generated four major themes describing academics': Experiences of change; perceptions of organisational responses; professional and personal impacts; and strategies to support wellbeing. Stress, anxiety and uncertainty of working from home and teaching in a different way were reported. Strategies included setting workday routine, establishing physical boundaries for home-working and regular online contact with colleagues. CONCLUSIONS: The ability of nursing, midwifery and, paramedic academic staff to adapt to a sudden increase in workload, change in teaching practices and technology, while being removed from their work environment, and collegial, academic and technological supports is highlighted. It was recognised that these changes will continue post-COVID and that the way academics deliver education is forever altered.

A scoping review of the healthcare provided by nurses to people experiencing domestic violence in primary health care settings

Background Domestic and family violence is a significant and growing public health concern in many communities around the world. Nurses are often the first and sometimes only point of contact for people seeking healthcare following DFV incidents and are therefore well placed to identify and support these vulnerable people. The aim of this scoping review is to examine the English language studies of healthcare provided by nurses in primary healthcare settings to people experiencing domestic and family violence. Methods A scoping review of the following databases was undertaken between March-June 2021: CINAHL, Medline, and PubMed. Primary studies were included if written in English, published from 2000 onwards, and focused on the care provided by primary healthcare nurses to people experiencing DFV. A critical appraisal of included studies was conducted using the Mixed Methods Appraisal Tool (MMAT). Results were synthesised narratively. Results Six studies were included, from the United States (n=2), United Kingdom (n=1), Sweden (n=2), and Brazil (n=1). Five studies were quantitative and one qualitative. A fundamental aspect of the healthcare provided by nurses, reported by all studies, was the screening of DFV. Other healthcare provided includes physical and mental health assessment and referral to other services, including sexual assault clinics, social supports, and law enforcement agencies. Findings suggest the level of DFV screening conducted by nurses is limited. Nurses’ knowledge of how to support people experiencing DFV was also reportedly limited. Two studies reported that nurses were unfamiliar with DFV practice guidelines and the existence and availability of support networks for people experiencing DFV. Conclusion Findings suggest inconsistency in primary healthcare nurses’ level of education, skill and knowledge, and detection of people experiencing DFV. As the largest healthcare professional discipline, nurses have frequent contact with people experiencing DFV. There is an urgent need for nurses to be better educationally prepared and more organisationally supported in order to adequately respond and provide healthcare to people experiencing DFV. Given that the number of people experiencing DFV has increased due to the COVID-19 pandemic, it is ever more important for nurses to be well equipped to identify and respond appropriately.