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1.
Saúde Soc ; 30(4): e201011, 2021. tab
Article in Portuguese | WHO COVID, LILACS (Americas) | ID: covidwho-1817569

ABSTRACT

Resumo Diante da importância do trabalho de Enfermagem no combate a epidemias e dos desafios impostos pela covid-19 ao exercício da profissão, o objetivo deste artigo é analisar as condições de trabalho e as percepções das profissionais de Enfermagem sobre sua atuação no contexto da pandemia de covid-19 no Brasil. Para tanto, realizamos uma pesquisa de caráter exploratório, a partir de um questionário online, aplicado entre 15 de junho e 1º de julho de 2020, respondido por 445 profissionais. Realizamos análise qualitativa, fundamentada na análise de conteúdo proposta por Bardin e Saldaña. No campo das sensações, os relatos das profissionais evidenciam medo, aumento da irritabilidade, sobrecarga de trabalho, tristeza e solidão. A pandemia da covid-19 alterou os processos de trabalho e a organização dos serviços, influenciando no dimensionamento do quantitativo de profissionais, na jornada de trabalho e na modalidade de execução, além de demandar maior vigilância quanto às medidas de prevenção e contágio. As mudanças impactaram no tempo disponibilizado para atendimento, na interação entre profissionais e usuários, e prejudicou a comunicação. A relevância do trabalho de Enfermagem junto às equipes de saúde no enfrentamento à covid-19 no Brasil reforça a necessidade de adoção de medidas eficazes de proteção e preservação da saúde física e mental dessas profissionais.


Abstract Before the importance of nursing in fighting epidemics and the challenges imposed on the exercise of the profession by COVID-19, this paper aims to analyze the working conditions and perceptions of nursing professionals regarding their performance in the context of the COVID-19 pandemic in Brazil. This exploratory research consisted of data collected through an online survey answered by 445 nursing professionals between June 15th and July 1st, 2020. Data underwent a qualitative content analysis in the light of the propositions of Bardin and Saldaña. In the field of sensations, the professionals' reports show fear, increased irritability, work overload, sadness, and loneliness. Besides demanding greater vigilance regarding preventive measures to reduce contagion, the COVID-19 pandemic changed the work processes and services organization, influencing the quantitative dimensioning of professionals, working hours, and execution mode. Moreover, these changes impacted the time available for care and the interaction between professionals and users. The relevance of nursing work and health teams in confronting COVID-19 in Brazil reinforces the need for effective measures aimed at protecting and preserving these professionals' physical and mental health.


Subject(s)
Humans , Male , Female , Perception , Working Conditions , Nursing , COVID-19 , Nurse Practitioners
2.
Rev. latinoam. enferm. (Online) ; 30: e3518, 2022. tab
Article in Portuguese | WHO COVID, LILACS (Americas) | ID: covidwho-1760026

ABSTRACT

Resumo Objetivo avaliar a relação entre sintomas psicopatológicos e a situação laboral de profissionais de enfermagem da Região Sudeste do Brasil, no contexto da pandemia da COVID-19. Método estudo observacional e transversal com coleta de dados virtual e por meio de snowball nos meses de abril a julho de 2020. Aplicou-se um questionário contendo dados sociodemográficos, laborais e a escala de avaliação de sintomas psicopatológicos (psicoticismo, obsessividade/compulsividade, somatização e ansiedade). Foram utilizadas estatísticas descritivas e inferenciais para a análise dos dados. Resultados entre os 532 participantes, verificou-se relação entre carga horária de trabalho semanal e psicoticismo. Todos os domínios da escala associaram-se ao constrangimento e/ou violência no percurso de trabalho e recebimento de suporte psicológico/emocional da instituição onde o indivíduo trabalha/estuda. Conclusão a faixa etária, carga horária elevada, violência vivenciada e falta de suporte psicológico durante a pandemia associaram-se com o aumento dos sintomas psicopatológicos entre os profissionais de enfermagem. Sugere-se a criação de diretrizes institucionais voltadas ao acolhimento e acompanhamento dessas demandas.


Abstract Objective to evaluate the relationship between psychopathological symptoms and the work situation of nursing professionals in the Southeast Region, Brazil, in the context of the COVID-19 pandemic. Method an observational and cross-sectional study with virtual and snowball data collection from April to July 2020. A questionnaire containing socio-demographic and labor data and the psychopathological symptoms assessment scale (psychoticism, obsessiveness/compulsivity, somatization, and anxiety) were applied. Descriptive and inferential statistics were used to analyze the data. Results among the 532 participants, there was a relationship between weekly workload and psychoticism. All domains of the scale were associated with embarrassment and/or violence in the course of work and receiving psychological/emotional support from the institution where the individual works/studies. Conclusion the age group, heavy workload, experienced violence and lack of psychological support during the pandemic were associated with increased psychopathological symptoms among nursing professionals. It is suggested the creation of institutional guidelines aimed at the reception and follow-up of these demands.


Resumen Objetivo evaluar la relación entre síntomas psicopatológicos y la situación laboral de profesionales de enfermería de la Región Sureste de Brasil, en el contexto de la pandemia de la COVID-19. Método estudio observacional y transversal con recolección de datos virtual y por medio de snowball en los meses de abril a julio de 2020. Se aplicó un cuestionario que contenía datos sociodemográficos, laborales y la escala de evaluación de síntomas psicopatológicos (psicoticismo, obsesión/compulsión, somatización y ansiedad). Fueron utilizadas estadísticas descriptivas y de inferencia para el análisis de los datos. Resultados entre los 532 participantes, se verificó una relación entre la carga horaria de trabajo semanal y el psicoticismo. Todos los dominios de la escala se asociaron con incomodidad y/o violencia, en el transcurso del trabajo y el recibimiento de soporte psicológico/emocional de la institución, en donde el individuo trabaja/estudia. Conclusión el intervalo etario, la carga horaria elevada, la violencia experimentada y la falta de soporte psicológico, durante la pandemia se asociaron con el aumento de los síntomas psicopatológicos entre los profesionales de enfermería. Se sugiere la creación de directrices institucionales dirigidas al acogimiento y acompañamiento de esas demandas.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Psychopathology , COVID-19 , Mental Disorders , Nurse Practitioners , Occupational Diseases
3.
Nurs Adm Q ; 46(2): 137-143, 2022.
Article in English | MEDLINE | ID: covidwho-1746180

ABSTRACT

Advanced practice registered nurses (APRNs) significantly contribute to health promotion, disease prevention, and disease management. Yet, barriers to APRN practice exist, including regulatory, state, and institutional barriers, that hinder their ability to practice to the full extent of their education, licensure, and certification. Nurse leaders can play an important role in helping reduce unnecessary institutional barriers to APRN practice.


Subject(s)
Advanced Practice Nursing , Licensure, Nursing , Nurse Practitioners , Advanced Practice Nursing/education , Certification , Humans , Leadership
4.
J Nurs Educ ; 61(3): 153-155, 2022 Mar.
Article in English | MEDLINE | ID: covidwho-1732317

ABSTRACT

BACKGROUND: The coronavirus disease 2019 pandemic resulted in the abrupt withdrawal of clinical sites for nurse practitioner (NP) students during the Spring semester of 2020. This situation necessitated the identification of innovative clinical opportunities to ensure advanced practice nursing students met course objectives and program requirements. METHOD: This article describes innovative clinical opportunities that met the needs of the community, including those impacted by the pandemic, and enabled NP students' progression toward completing clinical requirements. RESULTS: Participation in these unique opportunities provided more than 130 NP students with meaningful clinical experiences to increase competence in the care of vulnerable populations and communities during a public health crisis. CONCLUSION: Experiences supported competency development in the areas of leadership, clinical management, population health and infection control, policy and advocacy, informatics, telehealth, and ethical considerations while providing essential services to the community. These innovative clinical opportunities may be useful for graduate clinical programs worldwide. [J Nurs Educ. 2022;61(3):153-155.].


Subject(s)
COVID-19 , Nurse Practitioners , Students, Nursing , COVID-19/epidemiology , Curriculum , Humans , Nurse Practitioners/education , Pandemics , SARS-CoV-2
5.
JAAPA ; 34(6): 1-4, 2021 Jun 01.
Article in English | MEDLINE | ID: covidwho-1684812

ABSTRACT

ABSTRACT: Preliminary data suggest that opioid-related overdose deaths have increased subsequent to COVID-19. Despite national support for expanding the role of physician assistants (PAs) and NPs in serving patients with opioid use disorder, these clinicians are held to complex and stringent regulatory barriers. COVID-19 triggered significant changes from regulatory and federal agencies, yet disparate policies and regulations persist between physicians and PAs and NPs. The dual epidemics of COVID-19 and opioid use disorder highlight the inadequate infrastructure required to support patients, communities, and clinicians, and may serve as the catalyst for eliminating barriers to care.


Subject(s)
COVID-19/epidemiology , Health Services Accessibility/legislation & jurisprudence , Opioid-Related Disorders/drug therapy , Opioid-Related Disorders/epidemiology , Buprenorphine/therapeutic use , COVID-19/prevention & control , Drug Prescriptions , Health Policy/legislation & jurisprudence , Humans , Legislation, Drug , Narcotic Antagonists/therapeutic use , Nurse Practitioners/legislation & jurisprudence , Opioid Epidemic , Physician Assistants/legislation & jurisprudence , Physicians/legislation & jurisprudence , SARS-CoV-2 , Telemedicine , United States/epidemiology
6.
Anon.
Acta Paul. Enferm. (Online) ; 34: e, 2021.
Article in Portuguese | WHO COVID, LILACS (Americas) | ID: covidwho-1675683
7.
J Contin Educ Nurs ; 53(2): 83-89, 2022 Feb.
Article in English | MEDLINE | ID: covidwho-1662731

ABSTRACT

The purpose of this project was to evaluate student outcomes before and during the coronavirus disease 2019 (COVID-19) pandemic in an advanced health assessment course that was offered in the summer semesters to nurse practitioner (NP) students as a hybrid course with online didactic and in-person lab components. Due to COVID-19, the summer 2020 course offering transitioned to being 100% online and innovative strategies replaced the in-person labs. Student outcomes from summer 2019, when the course was hybrid, were compared to summer 2020, when the course was changed to being 100% online. The findings of this project showed somewhat similar learning outcomes on both knowledge and skill acquisition in the 100% online course despite the change to 100% online during COVID-19. In teaching advanced health assessment to NP students, use of videography for skills demonstration, the virtual classroom, and unfolding case studies provided a robust and flexible pedagogy approach for 100% online teaching during a pandemic. [J Contin Educ Nurs. 2022;53(2):83-89.].


Subject(s)
COVID-19 , Nurse Practitioners , Humans , Learning , SARS-CoV-2 , Students
8.
Int J Nurs Stud ; 126: 104141, 2022 Feb.
Article in English | MEDLINE | ID: covidwho-1636068

ABSTRACT

BACKGROUND: At the beginning of the COVID-19 pandemic in the United States, 22 state governors temporarily waived physician supervision of nurse practitioners to expand access to health care during the state of emergency. OBJECTIVE: We examined the nurse practitioner perception of the simultaneous scope of practice changes and the exigent pandemic demands during the initial COVID-19 surge in Massachusetts. METHODS: Qualitative descriptive design using content analysis of open-ended responses to a web-based survey of Massachusetts nurse practitioners conducted in May & June 2020. RESULTS: Survey response rate was 40.6 percent (N = 389). Content analysis identified four themes including: 1) State waivers enabled more control over practice and more expedited care, 2) State waiver did not change practice either because of pre-established independence or employers not changing policy, 3) Perception of nurse practitioner role as both versatile and disposable and 4) Telehealth increased access to care and created an autonomous setting. CONCLUSIONS: Although findings suggest fewer barriers in some areas, the temporary removal of state-level restrictions alone is not sufficient to achieve immediate full scope of practice for nurse practitioners. There is a need for regulatory frameworks that optimize the capacity of the advanced practice nursing workforce to respond to global health emergencies. US-based policymakers and healthcare organizations should revise outdated scope of practice policies and capitalize on telehealth technology to utilize the full extent of nurse practitioners. Likewise, nursing leaders should be a voice for nurse practitioners to more effectively and safely maximize the nurse practitioner contribution during emergency responses. In countries where the role is under development, regulators can leverage these findings to establish modernized nurse practitioner scope of practice policies from the outset.


Subject(s)
COVID-19 , Nurse Practitioners , Humans , Nurse's Role , Pandemics , Perception , SARS-CoV-2 , United States
9.
Prehosp Disaster Med ; 37(1): 1-3, 2022 Feb.
Article in English | MEDLINE | ID: covidwho-1632135

ABSTRACT

This article outlines a disaster medicine team response to the Texas-Mexico border during a coronavirus disease 2019 (COVID-19) surge. The team consisted of emergency medicine attending providers, as well as a nurse practitioner and a physician assistant, who were asked to work in the intensive care unit (ICU) under the guidance of an intensivist. The article highlights the medicolegal and ethical implications of providers working outside of their designated scope of practice. A framework for future staff augmentation during a disaster is explained.


Subject(s)
COVID-19 , Disasters , Nurse Practitioners , Critical Care , Humans , Intensive Care Units , SARS-CoV-2
10.
Nurs Leadersh (Tor Ont) ; 34(4): 79-85, 2021 Dec.
Article in English | MEDLINE | ID: covidwho-1629389

ABSTRACT

Advanced practice nurses' (APNs') role definition, education, regulation, scope of practice, working conditions and integration vary worldwide. Clarity and alignment of foundational APN tenets can strengthen future workforce harmonization, innovation and models of care and data reliability for discussions and decision making. This global clarity and consistency can inform the design, delivery and leadership aspiring for health, education and socio-economic systems. Healthcare demands related to the COVID-19 pandemic, opioid crisis, aging population, non-communicable diseases, natural disasters and climate change have exposed glaring health needs and taxed workforces' and service capacity locally and globally. A fulsome deployment of nurse practitioners is one strategy that could help mitigate the impacts of these forces.


Subject(s)
Advanced Practice Nursing , COVID-19 , Nurse Practitioners , Aged , Canada , Humans , Pandemics , Reproducibility of Results , SARS-CoV-2
11.
J Am Assoc Nurse Pract ; 34(1): 3-4, 2022 Jan 01.
Article in English | MEDLINE | ID: covidwho-1631668

ABSTRACT

ABSTRACT: Firearm injuries are considered among the five leading causes of death for people ages 1-64 years. The issue is of concern for nurse practitioners (NPs) and NP educators as the need for gun violence-related health care increases. This essay focuses on several local and national efforts to address the short- and long-term consequences of gun violence.


Subject(s)
Firearms , Gun Violence , Nurse Practitioners , Wounds, Gunshot , Adolescent , Adult , Child , Child, Preschool , Gun Violence/prevention & control , Humans , Infant , Middle Aged , Violence/prevention & control , Wounds, Gunshot/prevention & control , Young Adult
12.
Am J Crit Care ; 31(1): 4-6, 2022 01 01.
Article in English | MEDLINE | ID: covidwho-1614084
13.
J Nurses Prof Dev ; 37(6): 365-367, 2021.
Article in English | MEDLINE | ID: covidwho-1604477

ABSTRACT

The unexpected challenges of COVID-19 forced our nation to "rework" normal practices and routines. Kathy Chappell states that nurse professional development practitioners must be problem focused and solution oriented. Led by a nurse professional development specialist, planners employed innovation and creativity to address the problems found in one professional development program. This article assures readers that remote day-long conferences are well accepted and useful in today's fast-paced learning environment.


Subject(s)
COVID-19 , Nurse Practitioners , Creativity , Humans , Learning , SARS-CoV-2
14.
JAAPA ; 35(1): 53-57, 2022 Jan 01.
Article in English | MEDLINE | ID: covidwho-1584037

ABSTRACT

ABSTRACT: The rapid spread of COVID-19 brought forth a rapid increase in hospitalization rates, requiring changes in hospital use and medical personnel structure. Physician assistants (PAs) and NPs in pediatric critical care were cross-trained and redeployed to our pediatric biocontainment unit to address the clinician strain in providing high-quality patient care during these unprecedented times. This manuscript discusses the effectiveness of using these clinicians while recognizing the challenges of managing a novel virus in a new unit.


Subject(s)
COVID-19 , Nurse Practitioners , Physician Assistants , Child , Critical Care , Humans , SARS-CoV-2
15.
Adv Emerg Nurs J ; 43(4): 279-292, 2021.
Article in English | MEDLINE | ID: covidwho-1574416

ABSTRACT

Since the introduction of ultrasonography, clinicians have discovered different uses for embedding this technology in the clinical setting. The use of point-of-care ultrasonography has gained a lot of interest in the emergency department. It is a procedure that a clinician can rapidly utilize to triage, risk stratify, evaluate, and monitor the patient's condition. The COVID-19 pandemic has highlighted the significance and application of ultrasonography in identifying and managing patients presenting with lung pathology in the emergency setting.


Subject(s)
COVID-19 , Nurse Practitioners , Emergency Service, Hospital , Humans , Lung/diagnostic imaging , Pandemics , Point-of-Care Systems , SARS-CoV-2 , Ultrasonography
16.
Acad Med ; 97(3S): S61-S65, 2022 Mar 01.
Article in English | MEDLINE | ID: covidwho-1532561

ABSTRACT

Graduate nursing students are both nurses and adult learners. During the COVID-19 pandemic, many found themselves working on the frontlines while maintaining their studies and confronting challenges in their professional, educational, and personal lives. Changes in work environments, including redeployments, increased hours, and furloughs, challenged their work-study balance. The rapid pivot to virtual instruction allowed graduate nursing students to continue their coursework, but asynchronous delivery of course content increased their isolation and stress. Academic institutions supported graduate nursing students through innovations such as regular town hall meetings and flexible attendance policies, while the widespread closure of clinical learning sites became one of their biggest challenges. A minimum of 500 hours of supervised direct patient care is required to prepare a student to practice as a nurse practitioner, but there is no formal, financed clinical placement system for nurse practitioner students-leaving this clinical learning requirement particularly vulnerable to disruption during the pandemic. Some of the clinical learning alternatives employed included occupational health work, tele-precepting, and simulation. Since telehealth will be a part of the future of health care delivery, tele-precepting practices should be further developed, but simulation was underused and not an acceptable replacement for supervised direct patient care. A postpandemic future needs to limit gaps in the development of safe, competent health care providers by viewing graduate nursing students as essential workers and ensuring their access to the robust didactic and clinical learning opportunities that will best position them as leaders in health care.


Subject(s)
COVID-19 , Education, Distance , Education, Nursing, Graduate , Nurse Practitioners/education , SARS-CoV-2 , Humans , Pandemics , United States
17.
Policy Polit Nurs Pract ; 23(1): 41-47, 2022 Feb.
Article in English | MEDLINE | ID: covidwho-1523245

ABSTRACT

Nurses in advanced practice roles have existed in Canada for over 100 years, yet only in the last two decades, have nurse practitioners (NPs) been recognized as advanced practice nurses (APNs). During this time, NP educational programs have increased and transitioned from post-baccalaureate level to graduate level. Legislation and national NP regulatory approval processes have contributed to existing barriers to NP role implementation and full scope of practice. While regulation is mandatory and focused on public safety, an emphasis towards quality has led to the introduction of a national voluntary NP program accreditation process. The purpose of this paper is to initiate a discussion between Canadian NP regulators and educators related to proposed regulatory approaches and accreditation processes that balance public safety while promoting quality and excellence in NP education. Having two separate and costly processes has led to tension during a time of provincial fiscal restraint on university budgets coupled with the COVID-19 pandemic and its impact on nursing education. An integrated pan-Canadian approach of regulation and accreditation may ensure public safety, continuity, and consistency in quality NP education, enhance mobility of the NP workforce, and systematic planning to guide successful future NP role development and practice.


Subject(s)
COVID-19 , Nurse Practitioners , Canada , Humans , Pandemics , SARS-CoV-2
18.
Surgery ; 171(2): 437-446, 2022 02.
Article in English | MEDLINE | ID: covidwho-1500272

ABSTRACT

BACKGROUND: In March 2020, in response to the COVID-19 pandemic, the New Zealand government instituted a 4-level alert system, which resulted in the rapid dissolution of nonurgent surgical services to minimize occupational exposure to both patients and staff, with the primary health sector bearing most of the diverted caseload. Consequently, the study authors sought to collate information around the establishment of a supportive nonacute surgical liaison role in a public hospital surgical department, with an interest in establishing this role in New Zealand. METHODS: The narrative review conducted systematically in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Databases searched included Pubmed, MEDLINE, Embase, and Cochrane Controlled Register of Trials. A deductive analysis was applied using a demand management model developed by the Institute for Innovation and Improvement at Waitemata District Health Board. All included studies were rated using the Oxford Centre for Evidence-Based Medicine Levels of Evidence tool. RESULTS: Collation of 19 studies resulted in 3 key findings: first, that a surgical liaison could be utilized at the primary care to specialist interface to improve communication and workflow between services. Second, a liaison could be utilized directly communicating with patients as a means of increasing engagement and self-management. Finally, this service can be offered through multiple modalities including a noncontact telehealth service. CONCLUSION: Evidence of nonacute surgical liaisons both internationally and specifically within New Zealand has been collated to provide evidence for its application.


Subject(s)
COVID-19/prevention & control , Elective Surgical Procedures , Nurse's Role , Physician's Role , Primary Health Care/organization & administration , Referral and Consultation/organization & administration , Secondary Care/organization & administration , Delivery of Health Care/organization & administration , Global Health , Humans , Nurse Practitioners/organization & administration , Surgeons/organization & administration , Workflow
20.
J Nurs Educ ; 60(11): 651-654, 2021 Nov.
Article in English | MEDLINE | ID: covidwho-1497423

ABSTRACT

BACKGROUND: This educational innovation describes the implementation of a telehealth supportive counseling center for psychiatric/mental health nurse practitioner (PMHNP) students at a small graduate school. The free, nurse-run, health care center was at risk due to the coronavirus disease 2019 (COVID-19) in-person care restrictions. METHOD: Due to COVID-19, PMHNP faculty and students pivoted to offer services via telehealth for the summer 2020 semester. Planning and implementation strategies regarding this pivot are presented. RESULTS: PMHNP students conducted a total of 82 visits, recording a 150% increase in clients served during the telehealth implementation. On average, students accrued between 39 and 73 supervised clinical hours. CONCLUSION: Given the COVID-19 pandemic, clinical placements as well as access to health care services were jeopardized. Through innovation and flexibility, PMHNP students were able to continue accruing supervised clinical hours, and an identified need in the community was continued to be met. [J Nurs Educ. 2021;60(11):651-654.].


Subject(s)
COVID-19 , Nurse Practitioners , Telemedicine , Counseling , Humans , Pandemics , SARS-CoV-2 , Students
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