Nurses' experience of an Extracorporeal Membrane Oxygentation (ECMO) clinical support team during the COVID-19 pandemic: A service evaluation.

ABSTRACT

BACKGROUND: The COVID-19 pandemic placed unprecedented stress on the National Health Service and critical care units including those with Extracorporeal Membrane Oxygenation (ECMO) facility as this intervention had proved successful with H1N1 patients in 2009. To successfully care for the influx of ECMO patients, an ECMO clinical support team (ECST) formed by redeployed staff was created to assist critical care nurses. AIM: This service evaluation aims to review the experience of critical care nursing staff working with an ECST during the period of increased provision of ECMO care. DESIGN: A UK-based single-site qualitative service evaluation was followed. METHOD: Critical care nursing staff's feedback was anonymously collected using a paper questionnaire designed for this project. Data were analysed using inductive content analysis. FINDINGS: Approximately 40 critical care nurses were invited to complete a questionnaire, 19 (48%) of whom completed it within the available timeframe. A variety of themes were identified including 'Prior knowledge of ECST', 'Management matters', 'ECST in action', 'ECST response', 'Emotions' and 'Overall experience of the ECST'. Staff initially reported apprehension regarding a new team and training responsibilities. Following the rollout of the ECST, nurses' accounts described the utilization of the ECST and subsequent stress relief. Feedback commented on the ECST's positive attitude, effective team working with the critical care team and provision of moral support. Nurses' gratitude was strongly conveyed throughout, with many expressing the positive effect of the ECST on staff emotional well-being. CONCLUSION: The implementation of the ECST provided clinical and emotional support to nurses. The ECST demonstrated the effective use of redeployed health care staff to support the critical care unit at a time of a significant increase in patients requiring ECMO. This could be used as a model to enhance staffing levels in the event of future viral outbreaks.