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1.
Int J Nurs Stud ; 131: 104256, 2022 Jul.
Article in English | MEDLINE | ID: covidwho-1838890

ABSTRACT

BACKGROUND: The COVID-19 pandemic had its first peak in the United States between April and July of 2020, with incidence and prevalence rates of the virus the greatest in the northeastern coast of the country. At the time of study implementation, there were few studies capturing the perspectives of nurses working the frontlines of the pandemic in any setting as research output in the United States focused largely on treating the disease. OBJECTIVE: The purpose of this study was to capture the perspectives of nurses in the United States working the frontlines of the COVID-19 pandemic's first wave. We were specifically interested in examining the impact of the pandemic on nurses' roles, professional relationships, and the organizational cultures of their employers. DESIGN: We conducted an online qualitative study with a pragmatic design to capture the perspectives of nurses working during the first wave of the United States COVID-19 pandemic. Through social networking recruitment, frontline nurses from across the country were invited to participate. Participants provided long form, text-based responses to four questions designed to capture their experiences. A combination of Latent Dirichlet Allocation--a natural language processing technique--along with traditional summative content analysis techniques were used to analyze the data. SETTING: The United States during the COVID-19 pandemic's first wave between May and July of 2020. RESULTS: A total of 318 nurses participated from 29 out of 50 states, with 242 fully completing all questions. Findings suggested that the place of work mattered significantly in terms of the frontline working experience. It influenced role changes, risk assumption, interprofessional teamwork experiences, and ultimately, likelihood to leave their jobs or the profession altogether. Organizational culture and its influence on pandemic response implementation was a critical feature of their experiences. CONCLUSIONS: Findings suggest that organizational performance during the pandemic may be reflected in nursing workforce retention as the risk for workforce attrition appears high. It was also clear from the reports that nurses appear to have assumed higher occupational risks during the pandemic when compared to other providers. The 2020 data from this study also offered a number of signals about potential threats to the stability and sustainability of the US nursing workforce that are now manifesting. The findings underscore the importance of conducting health workforce research during a crisis in order to discern the signals of future problems or for long-term crisis response. TWEETABLE ABSTRACT: Healthcare leaders made the difference for nurses during the pandemic. How many nurses leave their employer in the next year will tell you who was good, who wasn't.


Subject(s)
COVID-19 , Nurses , Nursing Staff , Humans , Nurse's Role , Pandemics , United States
2.
Int J Environ Res Public Health ; 19(8)2022 04 07.
Article in English | MEDLINE | ID: covidwho-1809850

ABSTRACT

The current physician-centric model of care is not sustainable for the rising tide of atrial fibrillation. The integrated model of care has been recommended for managing atrial fibrillation. This study aims to provide a preliminary evaluation of the effectiveness of a Nurse-led Integrated Chronic care E-enhanced Atrial Fibrillation (NICE-AF) clinic in the community. The NICE-AF clinic was led by an advanced practice nurse (APN) who collaborated with a family physician. The clinic embodied integrated care and shifted from hospital-based, physician-centric care. Regular patient education, supplemented by a specially curated webpage, fast-tracked appointments for hospital-based specialised investigations, and teleconsultation with a hospital-based cardiologist were the highlights of the clinic. Forty-three participants were included in the six-month preliminary evaluation. No significant differences were observed in cardiovascular hospitalisations (p-value = 0.102) and stroke incidence (p-value = 1.00) after attending the NICE-AF clinic. However, significant improvements were noted for AF-specific QoL (p = 0.001), AF knowledge (p < 0.001), medication adherence (p = 0.008), patient satisfaction (p = 0.020), and depression (p = 0004). The preliminary evaluation of the NICE-AF clinic demonstrated the clinical utility of this new model of integrated care in providing safe and effective community-based AF care. Although a full evaluation is pending, the preliminary results highlighted its promising potential to be expanded into a permanent, larger-scale service.


Subject(s)
Atrial Fibrillation , Stroke , Ambulatory Care Facilities , Atrial Fibrillation/drug therapy , Humans , Nurse's Role , Quality of Life , Stroke/epidemiology
3.
J Nurs Adm ; 52(5): 251-252, 2022 May 01.
Article in English | MEDLINE | ID: covidwho-1806725

ABSTRACT

ABSTRACT: It is imperative that we listen to our nation's nurses, who have a unique vantage point from their clinical environments. Clinical research nurses have greatly contributed to studying the delivery of care over the years; however, since 2020, COVID-19 has brought unprecedented changes within the nursing profession. Each wave of the pandemic has created a worrisome landscape where nurse researchers face multiple challenges in implementing and funding practice-based nursing-led research projects. To raise nurses' voices and promote nurse-led research, the American Nurses Credentialing Center (ANCC) Research Council 2022 Research Priorities include the dissemination of a research agenda for practice-based research, promoting interprofessional research, and encouraging equitable and inclusive participation on research teams.


Subject(s)
COVID-19 , Nurses , Credentialing , Humans , Nurse's Role , United States
4.
Nurs Stand ; 37(6): 45-49, 2022 Jun 01.
Article in English | MEDLINE | ID: covidwho-1786258

ABSTRACT

Reflection is an essential element in every nurse's practice and is embedded in the Nursing and Midwifery Council's code of conduct - the UK nursing regulatory body's code of professional standards of practice and behaviour. The application of reflection to practice has clear advantages, for example it enables nurses to learn from clinical events and adapt and enhance their skills. This article explores the role of reflection in nursing practice, considers the use of reflective models and explores how nurses can overcome barriers to reflection in their everyday practice. These barriers include psychological stress or discomfort when revisiting challenging clinical experiences, which may have been exacerbated during the coronavirus disease 2019 (COVID-19) pandemic.


Subject(s)
COVID-19 , Education, Nursing , Midwifery , COVID-19/epidemiology , Curriculum , Female , Humans , Nurse's Role , Pregnancy
5.
Int J Environ Res Public Health ; 19(7)2022 04 06.
Article in English | MEDLINE | ID: covidwho-1785666

ABSTRACT

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.


Subject(s)
Problem-Based Learning , Thinking , Adult , Clinical Competence , Female , Hospitals , Humans , Male , Nurse's Role , Program Evaluation , Prospective Studies
6.
Front Public Health ; 9: 726647, 2021.
Article in English | MEDLINE | ID: covidwho-1775849

ABSTRACT

Cardiothoracic intensive care unit (CICU) nurses have shared the role and responsibility for ventilator-weaning to expedite decision-making in patient care. However, the actions taken are based on individual's unstructured training experience as there is no clinical practice guideline (CPG) for nurses in Malaysia. Hence, this study aims to design a CPG for the process of weaning from mechanical ventilation (MV) for a structured nursing training in a CICU at the National Heart Institute (Institut Jantung Negara, IJN) Malaysia. The Fuzzy Delphi Method (FDM) was employed to seek consensus among a panel of 30 experts in cardiac clinical practice on the guidelines. First, five experts were interviewed and their responses were transcribed and analyzed to develop the items for a FDM questionnaire. The questionnaire, comprising of 73 items, was distributed to the panel and their responses were analyzed for consensus on the design of the CPG. The findings suggested that the requirements expected for the nurses include: (a) the ability to interpret arterial blood gases, (b) knowledge and skills on the basics of mechanical ventilation, and (c) having a minimum 1-year working experience in the ICU. On the other hand, the CPG should mainly focus on developing an ability to identify criteria of patient eligible for weaning from MV. The learning content should focus on: (a) developing the understanding and reasoning for weaning and extubating and (b) technique/algorithm for extubating and weaning. Also, the experts agreed that the log book/competency book should be used for evaluation of the program. The CPG for structured nursing training at IJN in the context of the study is important for developing the professionalism of CICU nurses in IJN and could be used for training nurses in other CICUs, so that decision for ventilator-weaning from postcardiac surgery could be expedited.


Subject(s)
Nurse's Role , Ventilator Weaning , Humans , Practice Guidelines as Topic , Ventilator Weaning/nursing
7.
8.
Emerg Med J ; 39(7): 554-558, 2022 Jul.
Article in English | MEDLINE | ID: covidwho-1759386

ABSTRACT

BACKGROUND: To accommodate and separate the large numbers of patients going to hospital with COVID-19, many EDs had to create new pathways for patients. We describe the outcomes of patients treated in a nurse-led alternate care site (ACS) at our hospital. METHODS: This was a retrospective study of outcomes of patients managed at the ACS of 'San Bassiano' Hospital ED, Bassano del Grappa, Italy between 9 March and 16 April 2020. Self-presenting patients aged 5 years and older, suspected of having COVID-19, were initially diverted to the ACS. Patients with a National Early Warning Score ≥5 or with a desaturation ≥4% after the walking test were sent back to the main ED COVID-19 path for further evaluation and medical attention and were not further followed up. In the ACS, patients received a CXR, blood samples and a nasopharyngeal swab to test for SARS-CoV-2, and were sent home. An emergency physician reviewed the results later and called the patient back 5-6 hours later with instructions to return for medical evaluation of abnormal findings, or to seek their general practitioner's attention. Patients received a follow-up phone call 15 days later to learn of their course. RESULTS: A total of 487 patients were fully managed in the ACS and discharged home. Of the 392 (80.5%) patients with no abnormalities after the workup and instructed to stay at home, 29 reattended the ED in the next 15 days, and 13 were admitted. Among the 95 patients asked to return and receive medical attention, 20 were admitted and of those discharged, 3 reattended the ED within 15 days. At 15 days, no patient was deceased or received invasive ventilation; one admitted patient received non-invasive ventilation. CONCLUSIONS: A nurse-led ACS diverted a substantial proportion of patients from main ED resources without associated negative clinical outcomes.


Subject(s)
COVID-19 , COVID-19/therapy , Emergency Service, Hospital , Humans , Nurse's Role , Retrospective Studies , SARS-CoV-2
9.
J Med Internet Res ; 24(3): e31912, 2022 03 21.
Article in English | MEDLINE | ID: covidwho-1753283

ABSTRACT

BACKGROUND: In recent years, telehealth has become a common channel for health care professionals to use to promote health and provide distance care. COVID-19 has further fostered the widespread use of this new technology, which can improve access to care while protecting the community from exposure to infection by direct personal contact, and reduce the time and cost of traveling for both health care users and providers. This is especially true for community-dwelling older adults who have multiple chronic diseases and require frequent hospital visits. Nurses are globally recognized as health care professionals who provide effective community-based care to older adults, facilitating their desire to age in place. However, to date, it is unclear whether the use of telehealth can facilitate their work of promoting self-care to community-dwelling older adults. OBJECTIVE: This review aims to summarize findings from randomized controlled trials on the effect of nurse-led telehealth self-care promotion programs compared with the usual on-site or face-to-face services on the quality of life (QoL), self-efficacy, depression, and hospital admissions among community-dwelling older adults. METHODS: A search of 6 major databases was undertaken of relevant studies published from May 2011 to April 2021. Standardized mean differences (SMDs) and their 95% CIs were calculated from postintervention outcomes for continuous data, while the odds ratio was obtained for dichotomous data using the Mantel-Haenszel test. RESULTS: From 1173 possible publications, 13 trials involving a total of 4097 participants were included in this meta-analysis. Compared with the control groups, the intervention groups of community-dwelling older adults significantly improved in overall QoL (SMD 0.12; 95% CI 0.03 to 0.20; P=.006; I2=21%), self-efficacy (SMD 0.19; 95% CI 0.08 to 0.30; P<.001; I2=0%), and depression level (SMD -0.22; 95% CI -0.36 to -0.08; P=.003; I2=89%). CONCLUSIONS: This meta-analysis suggests that employing telehealth in nurse-led self-care promotion programs may have a positive impact on older adults, although more studies are needed to strengthen the evidence base, particularly regarding organization and delivery. TRIAL REGISTRATION: PROSPERO (Prospective International Register of Systematic Reviews) CRD42021257299; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=257299.


Subject(s)
COVID-19 , Telemedicine , Aged , Health Promotion , Humans , Independent Living , Nurse's Role , Prospective Studies , Quality of Life , Self Care
10.
J Nurs Manag ; 30(2): 367-374, 2022 Mar.
Article in English | MEDLINE | ID: covidwho-1714244

ABSTRACT

BACKGROUND: The COVID-19 frontline nurses' stress-reduction programme by the cooperation of manager with the nurses is not-well developed. AIM: This study aimed to examine the effect of an emergency nurse-led stress-reduction project on reducing stress levels during the COVID-19 pandemic. METHODS: The action research was conducted using online and person-to-person group brainstorming strategies. The online survey was used to evaluate emergency nurses' stress levels, causes of stress and needs at the 50th, 80th and 110th days of the pandemic from March to May 2020. RESULTS: The numbers of nurses participating in three-time survey were 160, 166 and 160, respectively. There was a decrease in the nurses' work-related stress after implementing the improvement strategies. Stress from personal protective equipment (PPE), information about infection control and family's worry about being infected reduced across 2 months. Needs regarding PPE, COVID-19 information and a forum for sharing experiences of COVID-19 care decreased whereas needs of allowing more days off increased. CONCLUSIONS: The stress-reduction project targeting at nurses' views of their needs can reduce their stress during the COVID-19 pandemic. IMPLICATIONS FOR NURSING MANAGEMENT: The online and person-to-person group brainstorming building a good partnership between nurses and managers can be an effective nursing management.


Subject(s)
COVID-19 , COVID-19/epidemiology , Cross-Sectional Studies , Humans , Nurse's Role , Pandemics , SARS-CoV-2 , Taiwan/epidemiology
11.
J Addict Nurs ; 33(1): 51-55, 2022.
Article in English | MEDLINE | ID: covidwho-1713769

ABSTRACT

ABSTRACT: The North Carolina Board of Nursing (NCBON) implemented an alternative-to-discipline program (AP) in 1995 for nurses experiencing a substance use disorder. There have been programmatic changes since the inception of the AP. However, COVID-19 posed significant challenges related to balancing the NCBON's public protection mandate against COVID-19 impacts on the nurse's ability to comply with the AP conditions. The changes to the AP structure in response to COVID-19 included transition from in-person orientation interviews to virtual, drug screening process modifications, acceptance of virtual treatment and 12-step meeting attendance, and specific employment condition waiver accommodations. The NCBON identified modifications facilitated opportunities for nurses to remain compliant with the conditions of the AP while meeting the mandate of public protection.


Subject(s)
COVID-19 , Humans , North Carolina , Nurse's Role , SARS-CoV-2
12.
Nurs Open ; 9(2): 996-1004, 2022 03.
Article in English | MEDLINE | ID: covidwho-1709339

ABSTRACT

AIM: This study aimed to explore the perception of other healthcare professionals, including the doctors, physiotherapists and perfusionists, about the nurses' role and competencies in veno-venous extracorporeal membrane oxygenation. BACKGROUND: Extracorporeal membrane oxygenation is considered as a challenging clinical activity that requires critical decision and rapid response from nurses, particularly in emergencies. It was observed that nurses are primarily responsible for bedside management of these patients, and teamwork was found helping the nurses to manage this high-acuity care. However, little is known on the perception of other healthcare professionals about the nurses' roles and competencies, which would contribute to further improvements in quality extracorporeal membrane oxygenation care. DESIGN: This was a qualitative descriptive study. METHODS: One-to-one in-depth interviews were conducted with nine healthcare professionals working in extracorporeal membrane oxygenation care in an adult intensive care unit of a general hospital in Kuwait. RESULTS: Participants reported that nurses play critical and multiple roles and responsibilities in the insertion, maintenance, weaning, and retrieval of extracorporeal membrane oxygenation, plus providing general nursing care, and performed their roles competently. Heavy workload, less recognition and support, and individual differences in competence were reported as possible barriers to the nurses' performance. CONCLUSION: Other healthcare professionals recognize continuous training, having experience, teamwork, and increased staffing as measures that can promote the nurses' role in extracorporeal membrane oxygenation.


Subject(s)
Extracorporeal Membrane Oxygenation , Nurse's Role , Adult , Humans , Intensive Care Units , Perception , Qualitative Research
13.
Aquichan ; 22(1): e2211, ene. 26, 2022.
Article in English, Spanish | WHO COVID, LILACS (Americas) | ID: covidwho-1706483

ABSTRACT

The transformation of health systems to meet the needs of chronic and multi-pathological patients has turned continuity of care into one of the mainstays of care programs and the design of new resources to care for these patients and their families. In this context, nurses' professional practice poses challenges for the three dimensions of continuity of care: relational, informational, and managerial. Faced with these challenges, nursing research is essential for the profession and necessary to promote innovative quality care.


La transformación de los sistemas sanitarios para dar respuesta a las necesidades del paciente crónico y pluripatológico ha situado la continuidad de cuidados como uno de los pilares en los que se basan los programas de atención y el diseño de nuevos recursos para atender a estos pacientes y a sus familias. En este contexto, la práctica profesional de las enfermeras presenta retos y desafíos en las tres dimensiones de la continuidad de cuidados: relacional, informativa y de gestión. Ante estos desafíos, la investigación en enfermería es fundamental para la profesión y necesaria para promover unos cuidados innovadores y de calidad.


A transformação dos sistemas sanitários para atender às necessidades do paciente crônico e pluripatológico situa a continuidade de cuidados como um dos pilares nos quais os programas de atenção e a criação de recursos para assistir esses pacientes e suas famílias estão baseados. Nesse contexto, a prática profissional dos enfermeiros apresenta desafios e obstáculos nas três dimensões da continuidade de cuidados: relacional, informativa e de gestão. Diante desses desafios, a pesquisa em enfermagem é fundamental para a profissão e necessária para promover cuidados inovadores e de qualidade.


Subject(s)
Creativity , Nurse's Role , Shared Governance, Nursing , Leadership , Nursing Care
14.
Nurs Open ; 9(2): 1486-1496, 2022 03.
Article in English | MEDLINE | ID: covidwho-1706642

ABSTRACT

AIMS: The aims of the Asthma Academy study were to (1) evaluate the telehealth performance of DNP students, (2) evaluate the perceived learning experience of DNP students and (3) investigate whether an association exists related to student performance and family caregiver outcomes. DESIGN: A descriptive study was conducted with doctor of nursing practice students. METHODS: Students conducted telehealth visits to help family caregivers of children with asthma and were rated on their performance by two faculty members using a rubric. Student perception data were gathered via survey. RESULTS: Out of a total possible score of 15 points, the mean telehealth performance score of students was 13.38 points. Students indicated the telehealth experience was valuable and that they were satisfied with their learning. This model of leveraging telehealth to bridge nursing students to the community may be adapted to help family caregivers of children with various disease foci.


Subject(s)
Asthma , Students, Nursing , Telemedicine , Caregivers , Child , Humans , Nurse's Role
15.
J Adv Nurs ; 78(4): 1154-1165, 2022 Apr.
Article in English | MEDLINE | ID: covidwho-1691540

ABSTRACT

AIM: To evaluate the effectiveness of a nurse-led smartphone-based self-management programme (NSSMP) on improving self-efficacy, promoting diabetes self-care, increasing health-related quality of life (HRQoL) and decreasing HbA1c, acute complications and unplanned medical consultation for people with poorly controlled type 2 diabetes compared with a nurse-led diabetic service (NDS). DESIGN: A two-arm randomized controlled trial with repeated measures was conducted. METHODS: Participants were recruited from June 2018 to September 2020. Eligible participants were assigned to either the intervention or control group randomly. Participants assigned to intervention group received the 6-month NSSMP, while those in the control group received existing NDS provided by the study hospital. Outcomes were measured at baseline, and at 3 and 6 months from baseline. RESULTS: A total of 114 participants were recruited. There were no significant interactions between group and time for all the outcomes except for blood glucose testing activities (F = 4.742, p = .015). Both groups had reduced HbA1c over 6 months. The intervention group had a lower HbA1c than the control group at follow-ups, but the differences were not statistically significant. None of the participants had acute diabetes complications at follow-up. Similarly, the differences in the number of unplanned medical consultation at 6-month follow-up between two groups were statistically insignificant. CONCLUSION: The NSSMP is as effective as existing NDS provided by the study hospital in improving most of the outcomes. NSSMP can liberate valuable time for nurses to provide care to critically ill patients and supports healthcare resource constraints in the current COVID-19 pandemic. IMPACT: The existing diabetes service is labour intensive as nurses are required to deliver education, follow-up telephone calls to trace blood sugar monitoring and provide therapeutic consultations and necessary referrals. The outbreak of COVID-19 pandemic has added further strain on the overworked professionals. NSSMP provides an alternative programme that is just as effective, to reduce nurses' workload by delegating them back to the individuals through self-management strategies. This enables nurses to increase contact time with patients, and individuals to take onus of their disease through increased self-efficacy, facilitated by technology. CLINICAL TRIAL: This study is registered under clinical registration number NCT03088475.


Subject(s)
COVID-19 , Diabetes Mellitus, Type 2 , Self-Management , Diabetes Mellitus, Type 2/therapy , Humans , Nurse's Role , Pandemics , Quality of Life , SARS-CoV-2 , Smartphone
16.
Disaster Med Public Health Prep ; 15(6): 671-672, 2021 12.
Article in English | MEDLINE | ID: covidwho-1683818
17.
Am J Nurs ; 122(2): 60-61, 2022 02 01.
Article in English | MEDLINE | ID: covidwho-1672279

ABSTRACT

Updated several times a week with posts by a wide variety of authors, AJN's blog Off the Charts allows us to provide more timely-and often more personal-perspectives on professional, policy, and clinical issues. Best of the Blog is a regular column to draw the attention of AJN readers to posts we think deserve a wider audience. To read more, please visit: www.ajnoffthecharts.com.


Subject(s)
COVID-19 , Critical Care Nursing , Nurse's Role , Organizational Innovation , Work Schedule Tolerance , Burnout, Professional/prevention & control , Humans
18.
Air Med J ; 41(2): 177-189, 2022.
Article in English | MEDLINE | ID: covidwho-1664622

ABSTRACT

Registered nurses are core members of critical care ground transport teams because of their education, experience, and scope of practice. Advances in medicine, technology, and equipment, combined with regionalization of specialized care and, most recently, the coronavirus disease 2019 pandemic, necessitate that transport nurses possess specialized knowledge, skills, and abilities. National specialty certification in ground transport nursing via the Certified Transport Registered Nurse (CTRN) offers registered nurses a process to validate their expertise. The most recent transport nursing role delineation study, which was conducted by the Board of Certification for Emergency Nursingin 2019, provided the foundation for the revised CTRN examination content outline, which is now separate from the Certified Flight Registered Nurse (CFRN) content outline. In this article, we provide a brief history of the specialty of ground transport nursing; details on the CTRN examination blueprint; and a composite patient case report to illustrate the ground-specific role, expertise, and contributions of the CTRN in delivering the highest level of patient care during ground transport.


Subject(s)
COVID-19 , Nurses , Certification , Critical Care , Humans , Nurse's Role
19.
Aquichan ; 22(1): e2214, ene. 26, 2022.
Article in English, Spanish | WHO COVID, LILACS (Americas) | ID: covidwho-1662774

ABSTRACT

Objetivo: analizar los factores facilitadores y las barreras para el cumplimiento del rol profesional de las enfermeras y enfermeros en tiempos de pandemia y desastres. Material y método: revisión integrativa según método analítico SALSA, realizada en ocho bases de datos: Medline, Proquest, CINAHL, Web of Science, BVS, SpringerLink, Scopus y Pubmed. Los descriptores utilizados fueron: 'rol de la enfermera' AND 'pandemia' AND 'paciente' AND 'infección por coronavirus', en idiomas inglés, español y portugués. A los 11.031 artículos encontrados se aplicaron filtros y criterios de inclusión y exclusión; después de ello un total de 32 artículos conformaron la muestra final. Resultados: considerando los objetivos planteados y los resultados obtenidos, se advierte que todas las acciones se enfocaban en tres instancias principales: a) formación y actualización para el desempeño del rol; b) factores predictores, facilitadores y barreras para ejercer el rol frente a una pandemia; y c) evidencia el rol frente a pandemias. Conclusión: este estudio hizo posible conocer, tanto las barreras, como los aspectos facilitadores que permiten el cumplimiento del rol profesional de enfermería frente a pandemias o catástrofes. Además, dejo claro que las enfermedades infecciosas emergentes deben abordarse en forma inmediata, colaborativa y multidisciplinaria. La experiencia, el liderazgo y la formación profesional de enfermeras y enfermeros son atributos claves que estos profesionales poseen, para permitir que su rol sea más proactivo durante una situación de emergencia.


Objective: to analyze the enablers and barriers to nurses' professional role fulfillment during pandemics and disasters. Materials and methods: this was an integrative review based on the SALSA analytical method, carried out in eight databases, namely: Medline, Proquest, CINAHL, Web of Science, BVS, SpringerLink, Scopus, and Pubmed. The descriptors used were the following: 'nurse's role' AND 'pandemic' AND 'patient' AND 'coronavirus infection', in English, Spanish and Portuguese. Filters along with inclusion and exclusion criteria were applied to the 11,031 articles found, after which the final sample consisted of a total of 32 articles. Results: considering the objectives set and the results obtained, it is noted that all actions focused on three main instances, namely: a) training and updating for role performance; b) predictors, enablers, and barriers for exercising the role in the face of a pandemic; and c) evidence of the role in the face of pandemics. Conclusion: this study allowed understanding both the barriers and the enablers that allow the fulfillment of nurses' professional role in the face of pandemics or catastrophes. It also clarified that emerging infectious diseases must be addressed in an immediate, collaborative, and multidisciplinary way. Nurses' experience, leadership, and professional training are key attributes that these professionals possess to enable their role to be more proactive during an emergency situation.


Objetivo: analisar os fatores facilitadores e as barreiras para o cumprimento do papel profissional de enfermeiros e enfermeiras em tempos de pandemia e desastres. Materiais e método: revisão integrativa segundo método analítico SALSA, realizada em oito bases de dados: Medline, Proquest, CINAHL, Web of Science, BVS, SpringerLink, Scopus e PubMed. Os descritores utilizados foram: "papel da enfermeira" AND "pandemia" AND "paciente" AND "infecção por coronavírus", em inglês, espanhol e português. Aos 11 031 artigos encontrados, foram aplicados filtros e critérios de inclusão e exclusão. Depois disso, 32 artigos conformaram a amostra final. Resultados: considerando os objetivos propostos e os resultados, constata-se que todas as ações se enfocavam em três instâncias principais: a) formação e atualização para o desempenho do papel; b) fatores preditores, facilitadores e barreiras para exercer o papel ante uma pandemia e c) evidência do papel profissional ante pandemias. Conclusões: este estudo torna possível conhecer tanto as barreiras quanto os aspectos facilitadores que permitem o cumprimento do papel do profissional de enfermagem ante pandemias e catástrofes. Além disso, deixa claro que as doenças infecciosas emergentes devem ser abordadas de forma imediata, colaborativa e multidisciplinar. A experiência, a liderança e a formação profissional de enfermeiras e enfermeiros são atributos-chave desses profissionais para permitir que seu papel seja mais proativo durante uma emergência.


Subject(s)
Coronavirus Infections , Community Health Nursing , Nurse's Role , Pandemics , Nurse Clinicians
20.
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
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