ABSTRACT
Background: The nurse manager is one of the nurses who has authority to implement a nursing management system in a nursing organization to achieve goals based on the input, process and output stages, whether the Covid-19 pandemic has positive and negative impacts on the implementation of the nursing management system. Nursing management is a form of coordination and integration in achieving nursing care and nursing services. Purpose: The purpose of this study is to explore the experience of nurse managers in implementing nursing management system in the COVID-19 wards. Methods: This study used a phenomenological descriptive design and in-depth interview data collection methods. Furthermore, the implementation of this research was carried out in 10 hospitals in North Sumatera, especially Medan City, Deli Serdang Regency and Serdang Bedagai Regency. The participants involved in this study were 20 participants and used the Collaizzi data analysis method. Results: This study revealed 7 themes related to the experience of nurse managers running a nursing management system in the COVID-19 treatment room;(1) Requires extra high discipline to carry out nursing management functions, (2) There is a psychological disorder for nurse manager to carry out nursing management, (3) Requires moral and material support in carrying out their duties, (4) Performs various efforts to disseminate information on nursing care management systems, (5) Experiences more benefits in implementing nursing management in the COVID-19 ward, (6) Faces complicated obstacles in carrying out nursing management, and (7) Has high expectations in carrying out increasingly complex management functions. Conclusion: From the themes above, the researcher concludes that the nursing management system in the COVID-19 treatment room involves psychological feelings, requires extra self-preparation, requires support from all parties in providing nursing care, improving nursing services to the fullest and can develop the concept of nursing management system during a pandemic. © The Author(s) 2022.
ABSTRACT
Background: Indonesia is one of the Southeast Asian countries with high case numbers of COVID-19 with up to 4.2 million confirmed cases by 29 October 2021. Understanding the genome of SARS-CoV-2 is crucial for delivering public health intervention as certain variants may have different attributes that can potentially affect their transmissibility, as well as the performance of diagnostics, vaccines, and therapeutics. Objectives: We aimed to investigate the dynamics of circulating SARS-CoV-2 variants over a 15-month period in Bogor and its surrounding areas in correlation with the first and second wave of COVID-19 in Indonesia. Methods: Nasopharyngeal and oropharyngeal swab samples collected from suspected patients from Bogor, Jakarta and Tangerang were confirmed for SARS-CoV-2 infection with RT-PCR. RNA samples of those confirmed patients were subjected to whole genome sequencing using the ARTIC Network protocol and sequencer platform from Oxford Nanopore Technologies (ONT). Results: We successfully identified 16 lineages and six clades out of 202 samples (male n = 116, female n = 86). Genome analysis revealed that Indonesian lineage B.1.466.2 dominated during the first wave (n = 48, 23.8%) while Delta variants (AY.23, AY.24, AY.39, AY.42, AY.43 dan AY.79) were dominant during the second wave (n = 53, 26.2%) following the highest number of confirmed cases in Indonesia. In the spike protein gene, S_D614G and S_P681R changes were dominant in both B.1.466.2 and Delta variants, while N439K was only observed in B.1.466.2 (n = 44) and B.1.470 (n = 1). Additionally, the S_T19R, S_E156G, S_F157del, S_R158del, S_L452R, S_T478K, S_D950N and S_V1264L changes were only detected in Delta variants, consistent with those changes being characteristic of Delta variants in general. Conclusions: We demonstrated a shift in SARS-CoV-2 variants from the first wave of COVID-19 to Delta variants in the second wave, during which the number of confirmed cases surpassed those in the first wave of COVID-19 pandemic. Higher proportion of unique mutations detected in Delta variants compared to the first wave variants indicated potential mutational effects on viral transmissibility that correlated with a higher incidence of confirmed cases. Genomic surveillance of circulating variants, especially those with higher transmissibility, should be continuously conducted to rapidly inform decision making and support outbreak preparedness, prevention, and public health response.