Nurses' disaster core competencies and resilience during the COVID-19 pandemic: A cross-sectional study from Turkey.

AIM: The aim of this study is to determine nurses' disaster core competency levels, compare them based on characteristics and examine the relationships with psychological resilience. BACKGROUND: Since nurses constitute a critical part in the health care services, it is important to understand the competencies and effective factors in their disaster preparedness. METHODS: The data were collected from 489 nurses between January and February 2021 with an introductory information form, the Nurses' Perceptions of Disaster Core Competencies Scale and the Connor-Davidson Resilience Scale. RESULTS: The nurses' level of disaster core competencies was above the average, and it was positively correlated with their psychological resilience. The nurses' disaster experiences made higher differences on their disaster core competencies when compared to their personal and professional characteristics. CONCLUSIONS: It is important to provide disaster training and drills to all nurses on a regular basis. However, under disaster conditions, resilience should also be considered and included in the preparation plans for nurses to support their professional competencies and qualifications. IMPLICATIONS FOR NURSING MANAGEMENT: Nurse managers should play a leadership role in planning disaster preparedness training for nurses, and these trainings should be addressed to cover both professional competencies and resilience for nurses to respond effectively to disasters.

The role of safety leadership in nursing management during the pandemic: A qualitative study in Indonesia

The article discusses a qualitative study on the role of safety leadership in nursing management during the pandemic in Indonesia. The study assessed safety leadership behavior of head nurses in inpatient facilities, expectations and obstacles to leadership and safety in the ward setting based on the human caring theory. Findings revealed the significance of caring values, risk perception, trust-based relationship, sharing knowledge and experience on patient safety, coaching and role modeling.

Nursing Management Challenges in the Face of the COVID-19 Pandemic in Military Hospitals: A Qualitative Study

Background and Aim: The COVID-19 pandemic led public health systems to encounter major challenges. Nurses in hospitals are serving on the frontline in encountering disasters and military hospitals have a vital role in the health response to disasters. The aim of this study was to explore the nursing management challenges in the face of the COVID-19 pandemic in military hospitals. Methods: This qualitative study with a conventional content analysis approach was conducted in 2021. Fourteen nursing administrators from seven military hospitals in Tehran were enrolled using purposive sampling. In-depth and semi-structured interviews were used for data collection and continued until reaching data saturation. Results: Four main categories emerged from the data analysis: "Human barriers” (Support, Commitment, Culture, Staff management, Volunteers Management), "Financial barriers” (Budget, Equipment), "Organizational barriers” (Organizing, Rules and Regulations, Planning, Training, Drill), and "Communicational barriers” (Communications and Coordination, Information management). Conclusion: The complex crisis of the Covid-19 pandemic can lead to instability and numerous challenges in the nursing management process, especially related to rules and regulations, volunteer management, extra-organizational coordination, and information management in military hospitals. With correct and accurate planning, scientific and, decisive management, and unity of command, these challenges can be prevented from affecting the disaster risk management process in military hospitals. © 2022 Baqiyatallah University of Medical Sciences. All rights reserved.

A blueprint for the continuation of comprehensive cardiac rehabilitation during the COVID-19 pandemic. An Australian single hospital experience

Background: The COVID-19 pandemic has disrupted cardiac rehabilitation (CR) around the world with an estimated 50-75% of CR programmes discontinuing or reducing services. Alternative models such as TeleHealth have been encouraged and adopted in place of face to face (F2F) CR. There is a paucity of published data on the continuation of F2F CR during the pandemic. Method(s): A retrospective database audit examined the CR participation rates at an Australian quaternary public hospital during the pre-COVID (2018/2019) and in-COVID (2020/2021) periods. Socio-demographic status, diagnosis at CR entry, CR modalities, and outcome measures (wait times, completion rates) were analysed. Result(s): There were no COVID-19 cases or cross infections occurring in CR during the in-COVID period. An audit of 1623 consecutive patients who attended our CR programme (pre-COVID n=760: In-COVID n=863) were included in this study. No significant differences were observed in age, male sex, CR wait times and completion rates between the two groups. Participation rates of patients diagnosed with heart failure (CCF) increased (p=0.02) and those who entered CR after elective PCI decreased (p=0.03) during the in-Covid period in comparison with the pre-COVID period. Total F2F CR was maintained in the in-COVID period compared to the pre- COVID period (85%: 89%, p=not significant (NS)). A significant increase in F2F utilising home walking (p<0.0001) and a decrease in F2F utilising supervised exercise (p<0.0001) was seen. TeleHealth, introduced during the in-COVID period, only contributed to 6% of the total CR participation. More detailed results of this study are presented in Table 1 below. Conclusion(s): During the COVID-19 pandemic our CR programme adhered to state health orders, recorded zero transmissions, maintained face to face services, and increased CR uptake only partially due to the introduction of TeleHealth. Our blueprint for the successful continuation of CR during COVID involves having expert nursing management, medical CR champions, dedicated CR gym, and well-established, flexible patientcentric programme modalities. (Table Presented).

Establishment of infection prevention and control strategy in nursing managements during surgical operations in COVID-19 patients based on Delphi method.

AIM: The aim of this study was to establish an infection prevention and control strategy for nursing managements during surgical operations in coronavirus disease 2019 (COVID-19) patients. DESIGN: A Delphi method. METHODS: Between November 2021 and March 2022, we first formulated a preliminary infection prevention and control strategy based on the literature review and institutional experience. Then, we applied Delphi method and performed expert surveys to reach a final strategy for nursing managements during surgical operations in COVID-19 patients. RESULTS: The strategy included seven dimensions with 34 items. The positive coefficients of Delphi experts in both surveys were 100%, indicating a high coordination among experts. The degree of authority and expert coordination coefficient were 0.91 and 0.097-0.213. After the second expert survey, value assignments for importance of each dimension and item were 4.21-5.00 and 4.21-4.76 points, respectively. The coefficients of variation for dimension and item were 0.09-0.19 and 0.05-0.19, respectively. PATIENT OR PUBLIC CONTRIBUTION: Except the medical experts and research personnel, there was no other patient or public contribution involved in the study.

Nursing management for temporary lodging facilities in Japan in the early stages of the COVID-19 pandemic: A multiple-case study.

AIM: Temporary lodging facilities which were non-medical facilities were established to secure beds for severely and moderately ill patients with COVID-19, as well as for isolation, non-contact observation, and care of mildly ill and asymptomatic patients in Japan. This study aims to understand nursing management practices adopted in these facilities by examining cases of their establishment and operation. METHODS: A multiple-case study design was used. Interviews for qualitative data collection were conducted from August to October 2020. After analyzing the nursing management practices in four temporary lodging facilities, common points were collated and integrated. RESULTS: For the establishment and operation of temporary lodging facilities, a three-layer structure based on disaster management methods was adopted: headquarters at the helm as overseers, field supervisors in the middle, and frontline nursing staff at the base. The structure had clear roles, facilitated information exchange, and provided efficient and effective nursing care. Field supervisors mainly provided psychological and clinical support for staff and served as information and interprofessional hubs. CONCLUSION: It is recommended that temporary lodging facilities should be organized based on principles of the division of labor. The workforce should comprise nursing staff, and experienced nursing professionals should be recruited to the higher echelons.

Working as a nurse in community health services during Covid-19: a qualitative study.

BACKGROUND: During the Covid-19 pandemic, new roles, increased workload, lack of staffing and infection control equipment, unclear infection control guidelines and conflicting information have led to uncertainty and unpredictability for health workers. Although community home-care nurses have been exposed to a range of personal and professional stressors during the pandemic, few studies have focused on their experiences. The aim of this study was to explore how Norwegian home-care nurses experienced the first wave of the Covid-19 pandemic. This knowledge may contribute to preparations for meetings with patients in future pandemics, how management can support its employees and how to structure a successful organization. METHODS: This study was a qualitative descriptive design comprising 12 semi-structured individual interviews with home-care nurses. A thematic analysis was carried out. RESULTS: Four main themes and 11 subthemes were constructed. The results revealed challenges related both to the organization and to management, experiences of unclear information, lack of available equipment, redeployment of staff and increased workload. Furthermore, it was challenging to provide high qualitative care. The nurses missed collegial togetherness and had feelings of uncertainty with a great fear of infecting others. Positive consequences were feelings of being valued and a greater awareness of infection control. CONCLUSION: This study highlighted the importance of unambiguous information and clear delegation of responsibility, and that enough infection control equipment will likely minimize the fear of infecting each other. Being visible and admired for their work was important for the nurses' psychological well-being. Nurses, nursing managers and policymakers in community health care can use these results to develop strategies for future pandemic planning.

Impacts of online learning: Evaluation of the graduating nursing students

Introduction: The COVID-19 pandemic declared in March 2020 has disrupted education at all levels, forcing it to switch to online learning. Prompt actions were taken by the Faculty of Medicine, UniKL RCMP, to change the physical classroom teaching to online learning in ensuring that medical and nursing education can be carried out during the pandemic and students were able to graduate on time. Objective(s): To explore the final year of graduating Nursing students' experiences in online learning and the effects of the pandemic on their education. Material(s) and Method(s): A total of 52 students from the graduating cohort of January Semester 2022 were invited to provide feedback on the Nursing education conducted in the 'new normal' after they have sat for the Malaysian Nursing Board Examination. Evaluation forms were given and explained to students, areas evaluated include factors that support or hinder online learning, their experiences, and effects on their education. A total of 47 completed evaluation forms were received. Result(s) and Conclusion(s): Over 95% of students perceived online learning as less effective and preferred to learn in the conventional method of face-to-face classes. The impact of the pandemic has caused multiple stressors in lives including financial concerns, lack of family and peer support, feeling alone and isolated, role confusion, and conflicts between home and college environments when studying online. They have difficulty understanding the diseases' pathophysiology and nursing management when learning in the virtual environment, which leads to a loss of interest or failure to stay focused in their study. Technical challenges, intermittent or poor internet connectivity, lack of student engagement, and camera usage remains the main limitations of online learning. Nursing education was interrupted by the COVID-19 pandemic. The evaluation showed some negative impacts of online learning among the students who preferred to learn in traditional face-to-face classes. However, students' and lecturers' experiences, their readiness for online teaching and learning, their effectiveness, technical support, and resources needed in this new learning platform need further evaluation.

Moral distress and moral injury and their interplay as a challenge for leadership and management: The case of Croatia.

AIM: We aim to investigate the interplay between moral distress and moral injury among nurses working in palliative and oncology wards and to assess its impact on nursing leadership. BACKGROUND: The past 2 years have been particularly challenging for nurses and nursing leaders in Croatia. The coronavirus disease pandemic and the subsequent earthquakes in the country significantly impacted the work of nurses. Moral distress has been well-known to nursing professionals, but recent studies warn about cofounding it with moral injury and their possible intercorrelation, deserving more attention from an empirical perspective. METHODS: We conducted quantitative cross-sectional research in palliative and oncology wards in 11 Croatian health care facilities on 162 nurses, using a questionnaire and paper/pencil method over 6 months (1 January 2021 to 1 July 2021). The questionnaire consisted of three parts: sociodemographic data, a Measure of moral distress for health care professionals and Moral injury symptoms scale for health care professionals. The research protocol was approved by the Ethics committee of the Catholic University of Croatia under no. 1-21-04. RESULTS: The findings of our study demonstrated that the current average levels of moral distress might be characterized as low, but the moral injury symptoms are severe. The results of our study bring interesting novel insights, such as the strong correlation between moral distress and moral injury, but also in terms of nurses' decision to leave or consider leaving their position. The nurses who experience higher levels of moral distress experience severe symptoms of moral injury, while nurses who score higher in moral distress and moral injury have left, considered or consider leaving their positions. CONCLUSIONS: This study highlighted the need to pay attention to the emerging phenomenon of moral injury that has been unaddressed and overshadowed by moral distress, their intercorrelation, and the importance of addressing them timely and adequately within health care organizations with their leadership and management. IMPLICATIONS FOR NURSING MANAGEMENT: These findings provide a significant insight that may assist nursing managers and leaders to act and respond in time to develop various prevention and mitigation measures and help resolve situations leading to moral distress or moral injury.

International Collaboration for Thoracic Oncology Education

Introduction: The International Thoracic Oncology Nursing Forum (ITONF) is an international lung cancer nursing organization with a mission to educate nurses around the world about caring for patients with thoracic cancers. The mission of ITONF is accomplished through educational workshops, online educational modules and networking opportunities. Methods: During 2020-2021 ITONF had been collaborating with the Mersal Cancer Center in Egypt to provide an educational program to educate Egyptian oncology nurses on the latest treatments in thoracic cancers as well as nursing management strategies. This was based on a regional need’s assessment. Due to the COVID pandemic, as well as practical needs, a hybrid delivery was required. ITONF developed 5 learning modules to meet identified needs. Educational modules with detailed slides were pre-recorded and presented to the Egyptian nurses during an educational conference. Results: A total of 18 Egyptian nurses and social workers attended the conference. Participants viewed the 5 educational modules, each covering a different topic about lung cancer. On the final day of the conference, 3 ITONF presenters joined the conference via Zoom for a live question and answer session. One Egyptian nurse was present to translate questions and facilitate an interactive discussion. During the question and answer session, expert international thoracic oncology nurses from the United States and Australia were able to provide valuable nursing education and answer questions. The Egyptian nurses submitted feedback after the completion of the conference with positive results and constructive feedback. Also, several nurses joined the ITONF organization and have since attended ITONF virtual webinars. Conclusions: ITONF serves as a unified source of international thoracic oncology nurses eager to provide education to any country or organization using a robust educational program. The collaboration with the Mersal Cancer Center in Egypt was the first customized educational program to fit the needs of the Egyptian nurses. During the pandemic, when in person educational opportunities were limited, ITONF collaborated internationally to meet the needs of thoracic oncology nurses. Based on the positive feedback, ITONF feels that this effort can be replicated for other countries and cancer centers. A hybrid educational model of live meetings, recordings, and live-streaming education is a practical model for international oncology nursing education. [Formula presented] Keywords: ITONF, Mersal Cancer Center, Collaboration

EFFECTS OF COVID-19 ON MINERAL AND BONE DISEASE OUTCOMES IN HEMODIALYSIS PATIENTS: A RETROSPECTIVE STUDY FROM QATAR

BACKGROUND AND AIMS: Management of end-stage renal disease (ESRD) on dialysis has been challenging during the COVID19 epidemic. Staff illness led to a shortage of manpower that affected patient care. We established a specialty nursing management for mineral and bone disease (MBD) in the ambulatory dialysis service in Qatar in 2016. We are presenting a retrospective study about the effects of the COVID-19 epidemic on MBD outcomes in ambulatory dialysis patients in the State of Qatar. METHOD: A retrospective cohort study in all adult patients with ESRD on chronic hemodialysis therapy (>1 month) in ambulatory dialysis clinics in the State of Qatar. Data collected were patient's characteristics, laboratory and diagnostic investigations for each patient through our electronic data system (nationwide). We focused on parathyroid hormone (PTH), calcium and phosphorus levels done routinely on monthly basis. The study duration was 31 months (January 2019-September 2021). RESULTS: We included 623 patients. Age was 56 ± 11 years old and 61% were male. The main comorbidities were diabetes mellitus (63%), hypertension (92%) and cardiovascular disease (22%). The percentage of patients with PTH levels within targets ranged from 63 to 74%. It was stable before and during the first wave of COVID-19 in Qatar (March-June 2020) then dropped afterward briefly for 3 months (October-December 2020) (74% versus 63% respectively P = 0.0003). PTH level in target improved afterward and also during the second wave of COVID-19 (February- May 2021) but then dropped again for 3 months (July-September 2021) [72% versus 66% respectively P = 0.02 (graph below with details)]. Patients with phosphorus and calcium in the target were mostly stable [79% (77-83%) and 76% (74-79%), respectively]. CONCLUSION: Our retrospective study regarding the effect of the COVID-19 epidemic on MBD outcomes in hemodialysis (HD) showed a temporary drop in PTH level in the target without affecting calcium and phosphorus targets. The delayed drop after COVID-19 waves in PTH in target could be related to the routine quarterly measurement of PTH. We think that establishing a solid management system for MBD led to reasonably stable outcomes despite all challenges during the COVID-19 epidemic. (Figure Presented).

INNOVATIONS IN FERTILITY NURSING: THE IMPACT OF COVID-19 ON THE DELIVERY OF PATIENT CARE

OBJECTIVE: The WHO declared a global pandemic on 11th March 2020 for Coronavirus (COVID-19). During this time, fertility clinics around the world had to adapt very quickly in order to care for patients in a changing landscape with many clinics reducing or halting in-person clinical care during national lockdowns. This provided a unique opportunity for fertility nurses to increase engagement with patients via digital approaches. The purpose of this study was to examine the shift in fertility nursing clinical care pathways from face to face to virtual including the use of electronic patient information/ education delivery, electronic consenting platforms, and telehealth visits. understand the experience of fertility nursing care during the pandemic from a cohort of nursing professionals based in the UK and US. MATERIALSANDMETHODS: Baseline data was collected from the EngagedMD electronic patient information and consenting platform taken (March 2019 to March 2020), and then during the first year of the pandemic (March 11th 2020 [the declaration from the WHO] to April 11th 2021), and via a survey about virtual patient engagement conducted via interviews with nursing staff currently based in fertility clinics in both the US and UK. Descriptive statistics were analysed for all the data. RESULTS: There was an increase from baseline of 105.32% in the use of electronic consent forms during the pandemic, an increase of 60.016% of patients who had been educated with electronic patient information modules and an increase of 102.33% of fertility nurses implementing an electronic consenting or electronic patient education tool into their clinical patient pathway. All respondents (n=28) reported that the use of electronic consenting, electronic patient information and telehealth services changed the way in which they care for fertility patients. 62% (n=17) reported that as a direct result of implementing virtual care pathways, they had saved nursing time. CONCLUSIONS: Evidence collected from both data sources shows that there has been a significant shift in the way that fertility nurses are caring for their patients during the pandemic. There has been a change in the way that fertility nurses provide patient care due to the need to adapt during this global pandemic. The use of electronic and virtual platforms to educate, consult and consent fertility patients has increased at a much higher level than previous years. The results suggest that the role of the fertility nurse practitioner has changed to include the implementation of virtual care pathways and that care may continue to be provided this way in the future. IMPACT STATEMENT: Patient care can be delivered at a high level in a virtual way and the use of electronic platforms should be considered to save nursing administration time and to provide patients with better access to resources and information.

Application of refined management in prevention and control of the coronavirus disease 2019 epidemic in non-isolated areas of a general hospital.

OBJECTIVE: This article summarizes the experience in the prevention and control of coronavirus disease 2019(COVID-19) epidemic in non-isolated areas in a general hospital. METHODS: Based on refined management theory, we professionally developed the standards for prevention and control of COVID-19 in non-isolated areas, systematically implemented various prevention and control measures, performed gridding audits, effectively communicated among teams and between medical staff and patients assisted by information techniques, and reported results for quality improvement. RESULTS: There was no hospital-acquired COVID-19 infections among staff in the hospital. The rates of mask-wearing, epidemiological history screening, and the medical supplies disinfection were all 100% in the hospital. The accuracy rate of mask-wearing of patients and their families was 73.79% and the compliance rate of their hand hygiene was 40.78%. CONCLUSION: Refined management strategies for the prevention and control of COVID-19 infection in non-isolated areas of the general hospital are effective. The accuracy rate of mask-wearing and hand hygiene compliance of patients and their families need to be further improved.

Experience and views of nurses on nursing services and personal protective equipment in Covid-19 pandemic the case of Turkey: A cross-sectional study.

BACKGROUND: During the COVID-19 pandemic, there were difficulties in planning the nursing workforce and personal protective equipment. AIM: The purpose of this study was to identify the experiences and views of nurses on personal protective equipment use and nursing workforce planning in Turkey. METHODS: This descriptive and cross-sectional study was conducted between 23 December 2020 and 3 May 2021, among 362 nurses who agreed to participate in this study voluntarily. RESULTS: The findings showed that the satisfaction scores were significantly higher for those nurses who worked in 8-h shifts, were not assigned to different clinics, were notified by an official letter and 1 week or month in advance before assignment compared with nurses in other categories. CONCLUSIONS: The problems that have arisen in the COVID-19 pandemic process have made it clear that there is a need for a nursing services management model in the event of an epidemic. IMPLICATIONS FOR NURSING MANAGEMENT: This study reveals the need for the 'Nursing Services Management Model in the Event of an Epidemic' by discussing the problems of nurse workforce planning and protective personal equipment management from the perspective of nurses who experienced these problems at first hand.

Development and Evaluation of the "High-Up" Program for Enhancing the Nursing-Management Competency of Mid-Career Hospital Nurses: A Quasi-Experimental Study.

The aim of this study was to develop an educational program to strengthen the nursing management competency of experienced nurses who are prospective nurse managers and then determine the effectiveness of the program. This quasi-experimental study was conducted from January to April 2021. A total of 22 nurses were assigned to the experiment group (mean age: 26.55 ± 1.30 years; 2 males, 20 females), and 20 were assigned to the control group (mean age: 27.55 ± 2.04 years; 20 females). The program, known as the "High-Up" program, comprised problem-based learning (PBL) and video lectures. In the experiment group, nurses discussed PBL cases through video conferences and applied problem-solving methods. The collected data were analyzed using the Friedman test and Wilcoxon rank-sum test (administered through SPSS). At four weeks after the intervention, the experiment group showed higher critical thinking tendency scores than the control group (pre-intervention score: 3.48 ± 0.36; post-intervention score: 3.71 ± 0.49; Z = -1.99, p = 0.046). The findings indicate that the "High-Up" program can enhance the nurse management competency of experienced nurses who need to prepare for nurse manager roles, and that it can also positively influence the performance of nursing organizations. However, it can be difficult to comprehensively enhance nursing management competency in a short period of time, meaning continuous education is required.

Observed Time Burden with Nursing Practices in an Emergency Room COVID-19 Isolation Zone at a University Affiliated Hospital in Korea

Background. The coronavirus disease 2019 (COVID-19) has caused great burdens on emergency room (ER) and front-line ER healthcare personnel faced with great challenges, including threats to their safety. This study aimed to provide a basis for additional workload of ER nurses who are charged with providing care for COVID-19 confirmed or suspicious cases. Methods. With institutional review board approval, we recruited ER nurses who were assigned to COVID-19 isolation zone with more than 6 months' ER work experience. After their demographic information were collected through a questionnaire, their nursing practices and practice time during their 1 shift (day or evening) were recorded by one researcher using a stopwatch and an observation form. For each observation shift, unit-related information was collected, including the numbers of hospitalized patients, admission, discharge, and transfer of patients. For each nursing practice, frequency and total time spent were analyzed using descriptive statistics with SPSS 26.0 program. Results. From January 4 to February 22, 2021, a total 18 nurses (27.4 years old on average with 25.2 months of ER experience) were observed from 20 different shifts. During the observation period, the average number of nurses' working hours was 8.27 ± 0.39 hours. A total of 6,567 tasks were monitored with 337,703 seconds (93.81 hours) of the total time spent. Infection control practices were most frequent (33.88%) followed by nursing management (27.80%), assessment and observation (11.07%), medication (10.35%), pre and post examination care(4.86%), education (4.37%), communication (4.10%), safety care (1.10%), and others (0.03;Table 1). Nursing management (e.g., nursing recording) was most time-consuming (49.29%) followed by assessment and observation (15.03%), medication (12.94%), patient education (6.10%), infection control (5.30%), and safety care (1.64%). Conclusion. This study showed that infection control practices were most frequent while time spent was relatively insignificant among ER nurses in charge of COVID-19 isolation zones. Further studies for more observations or with different study designs at other ER settings are necessary to understand nurse's burdens with COVID-19 emergency care.

Business acumen for nursing leaders: A scoping review.

AIM: The aim of this study is to explore the current evidence on business acumen of nurse leaders. BACKGROUND: Health systems across the world are under immense pressure to stay solvent, maintaining services within a defined budget as we recover from the COVID-19 pandemic. Effective nurse leaders not only need to have strong leadership and management skills but also strong business acumen to navigate the complexity of the system. EVALUATION: A scoping review of research was undertaken, using preferred reporting items for systematic reviews and meta-analyses (PRISMA) scoping extension checklist, with 571 studies found across multiple databases, 17 meeting final review eligibility. KEY ISSUES: Findings were noted surrounding three themes: the value of business acumen in nursing, the gaining of business acumen in health care as a nursing leader and the utilizing business acumen as a nurse leader in the health care industry. CONCLUSION: While nursing leadership and management were well researched, limited studies covered the specific focus of business acumen in health care for nurses or broader clinicians. IMPLICATIONS FOR NURSING MANAGEMENT: While evidence points towards business acumen being important for health care leaders in balancing care and cost, inadequate research limits the recognition of these professional capabilities of nurse leaders. Further understanding could inform future policy and curriculum, as well as empower our next generation of clinicians.

Experiences of residents, family members and staff in residential care settings for older people during COVID-19: A mixed methods study.

AIM: The aim of this study was to explore the COVID-19 pandemic as it was experienced by people on the front line in residential care settings for older people in the Republic of Ireland (ROI). BACKGROUND: The COVID-19 pandemic had a disproportionate effect in residential care settings for older people in Ireland. METHODS: A two-phased mixed methods study was conducted, consisting of an online survey administered shortly after the first wave of the virus to staff, residents and family members and one-to-one interviews with family members shortly after wave 2 of the virus. RESULTS: Isolation, loss of connectedness as well as a reduction in the level/quality of care provision led to significant adverse impacts for both residents and their families. Staff reported high levels of stress, trauma and burnout. Family input to care was suspended, with adverse consequences. CONCLUSION: The pandemic had an extremely adverse impact on residents, family members and staff in care settings for older people. IMPLICATIONS FOR NURSING MANAGEMENT: Strategies to ensure that residents' physical, emotional and social needs and staffs' professional and personal needs are appropriately supported during future waves of the pandemic should now be implemented.

Nursing Management of Frail Patients with Hematologic Malignancies during COVID-19 Pandemia in the Viterbo Domiciliary Care Unit: Data Analysis from March 2020 to March 2021

Introduction In the Viterbo province (3612 Km 2 divided into 60 municipalities) is operative a Domiciliary Hematologic Care Unit (DHCU) for clinical assistance to frail patients (pts) with hemopathies: DHCU nursing activity is done by 4 units who were employed during Covid-19 pandemia to avoid as possible risks of viral contagium due to hospital admissions of our pts. Aims To evaluate the entity and type of nursing management for frail pts followed by DHCU during the first year of Covid-19 pandemia. Methods All nursing activities from 3/2020 to 3/2021 in the lockdown framework were analysed. On the whole, 107 pts in 43 municipalities of Viterbo province were followed by DHCU nurses in the study period. Results Main features of the pts at baseline of domiciliary assistance are reported in the Table. At beginning of the study period (08/03/2020), 37 pts (34.5%) were already followed by DHCU, while 70 pts (65.5%) entered domiciliary assistance during the year of study. Median distance from DHCU central site to pts house was 25 Km [Interquartile range (IQR) 16 - 34]: distance from DHCU was < 20 Km in 32 cases (29.9%), ≥ 20 < 40 Km in 57 (53.2%) and ≥ 40 Km in 18 (16.9%). A total number of 2609 nursing accesses was done in the whole period. According to different procedures, 1152 blood samples were performed, with a median number of 7 (IQR 3 - 15) for each pts: in addition, there were 1040 accesses for chemotherapy (CHT) administration (108 cycles of azacytidine in 15 pts, 87 bortezomib-based cycles in 30 pts, 16 administrations of other CHTs in 2 pts) and 417 accesses for other procedures (260 venous catheter medications, 125 therapy other than CHT, 32 nursing assistances of transfusions or marrow aspirates). Finally, 20 pts were vaccinated at home with respective caregivers. During the entire study period, 2 pts (1.8%) developed Covid-19 infection while in home care. At the last follow-up (31/03/2021), 59 pts (55.1%) were alive and still followed by DHCU, 20 pts (18.6%) were alive and returned to sDay-Hospital (DH) setting due to improvement of clinical conditions and 28 pts (26.3%) died while in domiciliary assistance. Conclusions Domiciliary nurse assistance during Covid-19 pandemia allowed to follow in a safer way compared to standard DH/ordinary admission settings > 100 frail pts with hemopathies, most of them in 1 st or subsequent active lines of therapy, in a wide geographic area. In our opinion, this approach should represent the best type of assistance for a high rate of hematologic pts even beyond Covid-19 period of pandemia. [Formula presented] Disclosures: Stagno: Novartis: Consultancy, Honoraria, Other: Support for attending meetings and/or travel, Research Funding;Pfizer: Consultancy, Honoraria, Other: Support for attending meetings and/or travel;InCyte: Consultancy, Honoraria. Latagliata: BMS Cellgene: Honoraria;Pfizer: Honoraria;Novartis: Honoraria.