[Medication safety during the COVID-19 pandemic in primary care nurses]. / Seguridad de medicamentos durante la pandemia COVID-19 en las enfermeras de atención primaria.

OBJECTIVE: To know the perception of nurses about the factors that influence the safe administration of medications during the COVID-19 period, in the work context in a primary care health department of the Spanish national health system. DESIGN: This is a qualitative phenomenological study. SITE: Carried out in the Department of Health 21 (Alicante, Spain) between the months of September 2021 and November 2021. PARTICIPANTS: Fifteen nurses chosen by intentional sampling. METHODS: A semi-structured interview lasting between 30 and 60min was used, recorded and transcribed verbatim by the research team. A main category called "know" is established, which encompasses all the reflections about the nurse's performance during the medication administration process. RESULTS: The participants expressed concern about the performance of medication administration procedures, which made it possible to perceive safety as the greatest concern in the study unit. From this main category, the following subcategories are developed: work overload, insufficient training, distractions and communication and information failures. CONCLUSION: Knowing the perception of nurses about the factors that influence the safe administration of medications could facilitate the use of instruments to standardize and reduce variability in the safe administration of medications. As well as improving conditions in work environments at the community level, and not favoring social, personal and professional stigmatization due to care error.

What can general practice learn from primary care nurses' and healthcare assistants' experiences of the COVID-19 pandemic? A qualitative study.

OBJECTIVES: UK general practice has radically altered in response to COVID-19. The general practice nursing team has been central to these changes. To help learn from COVID-19 and maintain a sustainable nursing workforce, general practice should reflect on their support needs and perceptions of organisational strategies. This study aimed to explore primary care nurses' and healthcare assistants' experiences and perceptions of general practice, and the changes made to it, during the pandemic. DESIGN: Exploratory qualitative study using semistructured interviews. Interview data were analysed using Braun and Clarke's 'codebook' thematic analysis. SETTING: General practices in the Midlands, South East and South West England. Interviews were conducted in February and March 2021, as England began to unlock from its third national lockdown. PARTICIPANTS: Practice nurses (n=12), healthcare assistants (n=7), advanced nurse practitioners (n=4) and nursing associates (n=1) recruited using convenience and snowball sampling. RESULTS: Three themes were identified. Difficult changes describes dramatic changes made to general practice at the onset of the pandemic, creating confusion and anxiety. Dealing with change characterises how negative emotions were intensified by fear of infection, problematic government guidance, personal protective equipment (PPE) shortages and friction with doctors; but could be mitigated through effective practice communication, peer support and individual coping strategies. An opportunity for improvement highlights certain changes (eg, the increased use of telehealth) that participants believed could be adopted long term to improve efficiency. CONCLUSION: General practice should learn from the COVID-19 pandemic to nurture the clinical role and resilience of nurses and healthcare assistants in the postpandemic 'new normal'. Robust PPE provision could enable them to undertake their patient-facing duties safely and confidently. Judicious implementation of telehealth could help preserve the practical and caring nature of nursing. Improving channels of communication and interprofessional collaboration could help realise their potential within the primary care team.

COVID-19 Telehealth Fair Partnership for Capacity Building in Primary Care Nursing.

Telehealth in health care delivery grew exponentially throughout the COVID-19 pandemic. This growth occurred because of necessity, yet requires capacity building to maximize the technology's use. In this article, we discuss the development, implementation, and evaluation of a telehealth fair to build capacity in the use of telehealth technology within primary care nursing. The telehealth fair consisted of didactic and simulation components. Undergraduate and graduate nursing students completed the telehealth fair supported by a team of 12 nursing faculty and 6 clinical partner sites. Findings suggest statistically significant increases in student self-assessment of knowledge in telehealth, self-confidence in the use of telehealth, and readiness in the use of telehealth technology. Participant satisfaction following completion of the telehealth fair was high, with average scores of 4.2 to 4.58 (out of 5) for the didactic and 4.57 to 4.86 for the simulation components. The telehealth fair provided an invaluable opportunity for participants to enhance their learning relative to telehealth within primary care nursing. The experience also provided an opportunity for students to gain clinical hours during a pandemic when clinical placements in the community were limited. The experience also enhanced telehealth practice readiness of nursing students entering the workforce.

Reorganisation of primary care services during COVID-19 in the Western Cape, South Africa: Perspectives of primary care nurses.

BACKGROUND: Primary care nurses play a pivotal role in the response to disasters and pandemics. The coronavirus diseases 2019 (COVID-19) pandemic required preventative, diagnostic, and curative measures for persons presenting with symptoms of COVID-19 by healthcare providers, whilst continuing other essential services. We aimed to investigate the reorganisation of primary care services during COVID-19 from the perspectives of primary care nurses in the Western Cape province of South Africa. METHODS: We administered an online survey with closed and open-ended questions to professional nurses enrolled for a Postgraduate Diploma in Primary Care Nursing at Stellenbosch University (2020) and alumni (2017-2019) working in the Western Cape. Eighty-three participants completed the questionnaire. RESULTS: The majority of the participants (74.4%) reported that they were reorganising services using a multitude of initiatives in response to the diverse infrastructure, logistics and services of the various healthcare facilities. Despite this, 48.2% of the participants expressed concerns, which mainly related to possible non-adherence of patients with chronic conditions, the lack of promotive and preventative services, challenges with facility infrastructure, and staff time devoted to triage and screening. More than half of the participants (57.8%) indicated that other services were affected by COVID-19, whilst 44.6% indicated that these services were worse than before. CONCLUSION: Our findings suggest that the very necessary reorganisation of services that took place at the start of the COVID-19 pandemic in South Africa enabled effective management of patients infected with COVID-19. However, the reorganisation of services may have longer-term consequences for primary care services in terms of lack of care for patients with other conditions, as well as preventive and promotive care.

Supporting the Mental Health of Primary Care Nurses and Staff through the Pandemic and Beyond.

As a clinical nurse specialist, I provide leadership and strategy for our primary care program where I lead clinical initiatives and develop practice tools and guidelines across our clinics. My portfolio encompasses five clinics, one perinatal program, an opioid agonist therapy (OAT) clinic and an intensive case management team, and in the past year I supported several teams that focus on COVID-19 testing and isolation support. Our clinics specialize in serving people who experience significant economic and social marginalization and those who are not well served by traditional health services. Our nurses, in particular, juggle many roles: providing both outreach- and clinic-based care and supporting our injectable OAT program, youth clinic and our transgender specialty care program. Our work has become increasingly complex as our clients navigate survival with competing syndemics - the opioid crisis, COVID-19, a Shigella outbreak and an ongoing housing crisis - among the many significant structural factors that impact our clients' health.

Primary care nurses' preparedness for COVID-19 in the Western Cape province, South Africa.

INTRODUCTION: The novel coronavirus 2019 or COVID-19 pandemic has brought about a global public health crisis. Primary care (PC) nurses render first line care, or refer for more specialised services. AIM: To investigate the preparedness of PC nurses for COVID-19 in the Western Cape. SETTING: The Western Cape province of South Africa. METHODS: We administered an online survey, with closed and open-ended questions, to 83 Stellenbosch University postgraduate PC nursing students and alumni working in the Western Cape, between 03 July and 01 September 2020. RESULTS: The results indicated that 43.3% of participants were confident about the infection, prevention, and control (IPC) training they received and 56.7% felt prepared to provide direct care to suspected cases of COVID-19. Primary care nurses were more comfortable to triage (78.3%) than to manage persons with COVID-19 (42.2%), indicating that they may not be functioning to the full capacity of their education and training. Adequate infrastructure was reported by less than a third of the participants (30.1%) and 59.1% reported that personal protective equipment (PPE) was always available. Primary care nurses needed support in coping with stress (57.8%) although few (14.5%) reported access to mental health services. CONCLUSION: Primary care nurses were not prepared optimally for the COVID-19 pandemic. Challenges included adequate training, infrastructure, the availability of personal protective equipment, COVID-19 testing of health care workers and management support. Primary care nurses need comprehensive support to manage stress and anxiety.

The Experiences of Primary Healthcare Nurses During the COVID-19 Pandemic in Australia.

PURPOSE: The COVID-19 pandemic has presented an international health crisis of a scope not seen in our lifetime. While much attention has been paid to health workers in critical care and acute areas, nurses working outside of hospitals are also significantly affected. This study sought to investigate the experience of nurses working in Australian primary healthcare during the COVID-19 pandemic. In particular, it sought to understand the implications on their employment status, role, and access to personal protective equipment. DESIGN AND METHODS: Nurses employed in primary healthcare across Australia were invited to participate in a cross-sectional online survey through social media and professional organizations. The survey tool was composed of demographics, and of questions about the nurses' employment, work role, and access to personal protective equipment. FINDINGS: Of the 637 responses received, nearly half (43.7%) reported a decrease in hours and threatened or actual loss of employment. While most respondents felt that they had sufficient knowledge about COVID-19, they expressed concern about work-related risks to themselves and their family. Most respondents described never or only sometimes having sufficient personal protective equipment in their workplace. Just over half of respondents (54.8%) felt well supported by their employer. A third of respondents (34%) perceived that care provided in their workplace was significantly or slightly worse than before the pandemic. CONCLUSIONS: This is the first study of primary healthcare nurses' experiences during the COVID-19 pandemic. The study findings highlighted a concerning level of insecurity around primary healthcare nursing employment, as well as issues with the availability of personal protective equipment for these nurses. The perception that the pandemic has resulted in reduced quality of care needs further exploration to ensure that those with chronic conditions are supported to maintain and promote health. CLINICAL RELEVANCE: Understanding the implications of COVID-19 on the primary healthcare nursing workforce is vital to ensure staff retention and care quality. Ensuring that the community remains healthy and supported at home is vital to both reduce the burden on the health system and reduce secondary mortality.

The support needs of Australian primary health care nurses during the COVID-19 pandemic.

AIM: To identify Australian primary health care nurses' immediate support needs during the COVID-19 pandemic. BACKGROUND: COVID-19 has had widespread implications for primary health care nurses. Supporting these nurses' capacity to deliver quality care ensures that ongoing health needs can be met. METHODS: Primary health care nurses were recruited to an online survey via social media and professional organisations in April 2020. RESULTS: Six-hundred and thirty-seven responses were included in the analysis. Participants provided 1,213 statements about perceived supports required to provide quality clinical care. From these, seven key categories emerged, namely personal protective equipment, communication, funding, industrial issues, self-care, workplace factors and valuing nurses. CONCLUSION: A number of key issues relating to personal health and safety, care quality and job security need to be addressed to support primary health care nurses during the COVID-19 pandemic. Addressing these support issues can assist in retaining nurses and optimizing the role of primary health care nurses during a pandemic. IMPLICATIONS FOR NURSING MANAGEMENT: Responding to the needs of primary health care nurses has the potential to facilitate their role in providing community-based health care. This knowledge can guide the provision of support for primary health care nurses during the current pandemic, as well as informing planning for future health crises across the health service.