Nurses’ Lived Experiences of Caring for Patients with COVID-19 in Nigeria

Introduction Since the beginning of the COVID-19 pandemic, nurses have been on the frontline providing care for patients with COVID-19. Caring for patients with COVID-19 can be a rewarding experience for nurses, but research also suggests that nurses experience numerous challenges on the frontline. Objectives This study aims to explore the experiences of frontline nurses caring for patients with COVID-19 in Nigeria Methods Ten nurse volunteers working in a COVID-19 isolation center were purposively recruited. Data were collected with a semi-structured interview guide, and a template analysis approach was used to analyze the transcribed interviews. Results The participants volunteered at the isolation center for safety reasons, professional gain, and concern for humanity. Working at the isolation center was accompanied by changes in working hours, work dynamics, care context and care tools. These changes resulted in personal, professional, and work-related challenges for nurses. However, team spirit, positive patient outcomes, gratitude and family support helped the nurses cope with the challenges. Conclusions This research highlighted that working on the frontline of COVID-19 is associated with multiple and complex challenges that can impact nurses’ personal and professional life. Thus, a tailored approach to support is needed to address the challenges faced by frontline nurses.

Self-Fetal Wellbeing Monitoring and Ante-Natal Care during the COVID-19 Pandemic: A Qualitative Descriptive Study among Pregnant Women in Indonesia.

Pregnant women are expected to have a high level of awareness when it comes to checking their fetal health and ensuring their welfare. This study explored the experiences of pregnant women in Indonesia who were monitoring their fetal wellbeing during the COVID-19 pandemic. A qualitativedescriptive study design with a constructivist paradigm was used. Twenty-two pregnant women were recruited and participated in a semi-structured interview. Analysis of the transcribed interviews used a content, thematic and comparative process. Three themes emerged from the analysis: feelingsand responses, changes to the ante natal care service during the COVID-19 pandemic, and the fetal wellbeing monitoring, tools, and methods used. Advice on how pregnant women should conduct fetal wellbeing monitoring during COVID-19 is urgently needed. The results of this study indicate there is a need for interventions to help pregnant women carry out self-fetal wellbeing monitoring in times where they have fewer contacts with health professionals such as during the COVID-19 pandemic.

Impacts of COVID-19 on Mental Health Safety Net Services for Youths: A National Survey of Agency Officials.

OBJECTIVE: Mental health agencies provide critical safety net services for youths. No research has assessed impacts of the COVID-19 pandemic on services these agencies provide or youths they serve. This study sought to characterize agency officials' perceptions of the pandemic's impacts on youths and challenges to providing youth services during the pandemic and to examine associations between these challenges and impacts. METHODS: Surveys were completed in September-October 2020 by 159 state or county mental health agency officials from 46 states. Respondents used 7-point scales (higher rating indicated more severe impact or challenge) to rate the pandemic's impact on youth mental health issues, general service challenges, and telepsychiatry service challenges across patient, provider, and financing domains. Multiple linear regression models estimated associations between service challenges (independent variables) and pandemic impacts (dependent variables). RESULTS: Most agency officials perceived the pandemic as having disproportionately negative mental health impacts on socially disadvantaged youths (serious impact, 72%; mean rating=5.85). Only 15% (mean=4.29) perceived the pandemic as having a seriously negative impact on receipt of needed youth services. Serious service challenges were related to youths' lack of reliable equipment or Internet access for telepsychiatry services (serious challenge, 59%; mean=5.47) and the inability to provide some services remotely (serious challenge, 42%, mean=4.72). In regression models, the inability to provide some services remotely was significantly (p≤0.01) associated with three of five pandemic impacts. CONCLUSIONS: Officials perceived the COVID-19 pandemic as exacerbating youth mental health disparities but as not having a dramatic impact on receipt of needed services.

Pre COVID-19 emergency department nurses' perspectives of the preparedness to safely manage influenza pandemics: A descriptive exploratory qualitative study.

BACKGROUND: Pandemics pose significant challenges to healthcare systems worldwide and emergency departments are a crucial component in any pandemic response. This study was designed to explore what New Zealand emergency nurses perceive as the major challenges to nursing care and staff safety during a pandemic, and to identify strategies nurses feel are important in mitigating these challenges. METHODS: A descriptive exploratory qualitative design using semi-structured interviews was conducted in March 2019. Participants were 16 triage nurses from two New Zealand emergency departments. Qualitative content and thematic data analysis techniques were used. RESULTS: Emergency nurses highlighted existing safety issues in their practice, and their concerns about how a pandemic might exacerbate these issues. These themes were identified as: safety of self and family, safety of patients, and safety of organisational systems. Nurses also shared their perspectives on how to mitigate these safety issues. CONCLUSIONS: This study provides a detailed understanding of the concerns emergency nurses hold about working during pandemics. Similar fears for staff and patient safety have been voiced globally during the current COVID-19 pandemic, and it is crucial that emergency departments worldwide develop pandemic plans that address the safety concerns to which fear was attributed.

Mask Reuse in the COVID-19 Pandemic: Creating an Inexpensive and Scalable Ultraviolet System for Filtering Facepiece Respirator Decontamination.

As the current COVID-19 pandemic illustrates, not all hospitals and other patient care facilities are equipped with enough personal protective equipment to meet the demand in a crisis. Health care workers around the world use filtering facepiece respirators to protect themselves and their patients, yet during this global pandemic they are forced to reuse what are intended to be single-use masks. This poses a significant risk to these health care workers along with the people they are trying to protect. Ultraviolet germicidal irradiation (UVGI) has been validated previously as a method to effectively decontaminate these masks between use. However, not all facilities have access to the expensive commercial ultraviolet type C (UV-C) lamp decontamination equipment required for UVGI. UV-C bulbs are sitting idle in biosafety cabinets at universities and research facilities around the world that have been shuttered to slow the spread of COVID-19. These bulbs may also be available in existing medical centers where infectious diseases are commonly treated. We developed a method to modify existing light fixtures or create custom light fixtures that are compatible with new or existing UV-C bulbs. This system is scalable; can be created for less than US$50, on site and at the point of need; and leverages resources that are currently untapped and sitting unused in public and private research facilities during the pandemic. The freely accessible design can be easily modified for use around the world. Health care facilities can obtain this potentially lifesaving UVGI resource with minimal funds by collaborating with research facilities to obtain the UV-C meters and UV-C bulbs if they are unavailable from other sources. Although mask reuse is not ideal, we must do what we can in emergency situations to protect our health care workers responding to the pandemic and the communities they serve.

Significant Unresolved Questions and Opportunities for Bioengineering in Understanding and Treating COVID-19 Disease Progression.

COVID-19 is a disease that manifests itself in a multitude of ways across a wide range of tissues. Many factors are involved, and though impressive strides have been made in studying this novel disease in a very short time, there is still a great deal that is unknown about how the virus functions. Clinical data has been crucial for providing information on COVID-19 progression and determining risk factors. However, the mechanisms leading to the multi-tissue pathology are yet to be fully established. Although insights from SARS-CoV-1 and MERS-CoV have been valuable, it is clear that SARS-CoV-2 is different and merits its own extensive studies. In this review, we highlight unresolved questions surrounding this virus including the temporal immune dynamics, infection of non-pulmonary tissue, early life exposure, and the role of circadian rhythms. Risk factors such as sex and exposure to pollutants are also explored followed by a discussion of ways in which bioengineering approaches can be employed to help understand COVID-19. The use of sophisticated in vitro models can be employed to interrogate intercellular interactions and also to tease apart effects of the virus itself from the resulting immune response. Additionally, spatiotemporal information can be gleaned from these models to learn more about the dynamics of the virus and COVID-19 progression. Application of advanced tissue and organ system models into COVID-19 research can result in more nuanced insight into the mechanisms underlying this condition and elucidate strategies to combat its effects.