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A qualitative descriptive study of the COVID-19 pandemic: Impacts on nursing care delivery in the critical care work system.

ABSTRACT: The COVID-19 pandemic drastically changed the delivery of nursing care in U.S. critical care settings. The purpose of this study was to describe nurses' perceptions of the critical care work system during the COVID-19 pandemic in the U.S. We conducted interviews with experienced critical care nurses who worked during the pandemic and analyzed these data using deductive content analysis framed by the Systems Engineering Initiative for Patient Safety (SEIPS) 2.0 model. Concepts include the critical care work system structures, nursing care processes, outcomes, and adaptations during the pandemic. Our findings revealed a description of the critical care work system framed by the SEIPS 2.0 model. We suggest how human factors engineers can utilize a human factors and engineering approach to maximize the adaptations critical care nurses made to their work system during the pandemic.

SUBMITTER: Bethel C

PROVIDER: S-EPMC8882402 | biostudies-literature | 2022 Jul

REPOSITORIES: biostudies-literature

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A qualitative descriptive study of the COVID-19 pandemic: Impacts on nursing care delivery in the critical care work system.

Bethel Claire C Rainbow Jessica G JG Johnson Karen K

Applied ergonomics 20220228

The COVID-19 pandemic drastically changed the delivery of nursing care in U.S. critical care settings. The purpose of this study was to describe nurses' perceptions of the critical care work system during the COVID-19 pandemic in the U.S. We conducted interviews with experienced critical care nurses who worked during the pandemic and analyzed these data using deductive content analysis framed by the Systems Engineering Initiative for Patient Safety (SEIPS) 2.0 model. Concepts include the critica ...[more]

PMID: 35278827

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Project description:BackgroundResearch examining RNs' experiences during the COVID-19 pandemic is lacking, thus inhibiting efforts to optimize nursing care delivery and patient outcomes during the current pandemic and future public health emergencies.ObjectiveTo explore the experience of being a registered nurse caring for patients with COVID-19 at an urban academic medical center during the early stages of the pandemic.DesignQualitative descriptive study, guided by Donabedian's Quality Framework for Evaluation of Healthcare Delivery which focuses on structures, processes, and outcomes of care delivery.SettingUrban academic medical center in the northeast United States.ParticipantsRegistered nurses cared for or caring for patients with COVID-19, age ≥18 years old, and English-speaking.MethodsParticipants were recruited for individual in-person semi-structured interviews. Interviews occurred during March and April 2020 and were recorded and transcribed. Transcripts were analyzed by two researchers using emergent qualitative content analysis to identify themes.ResultsTwenty-one registered nurses participated in the study. Three themes emerged from the data, included one relevant to structures and two relevant to processes of care during the pandemic. Registered nurses perceived the clinical context as highly dynamic, but quickly adapted to pandemic-related care delivery. They felt a "sense of duty" to care for patients with COVID-19, despite being fearful of acquiring or spreading infection. Compared to clinical colleagues, registered nurses reported increased patient exposure and performed tasks previously assigned to other clinical team members.ConclusionRoles and nursing practice processes evolved to meet the demand for care despite challenges. Registered nurses require adequate protection for their frontline role which may consist of increased patient exposure compared to clinical colleagues, emotional support, and clear clinical guidance. A deeper understanding of how a public health emergency, such as the COVID-19 pandemic, affects nursing practice can guide future efforts to optimize healthcare structures, nursing care processes, and patient outcomes. Our study can inform strategies for providing registered nurses with adequate communication, protection, and resources during the COVID-19 pandemic and future similar public health emergencies.

Project description:AimsThe goal of this study was to gain insight into the views and experiences of an intensive care team working in a new nursing-care delivery model during the COVID-19 waves. A new model of care was implemented to augment nursing capacity and provide sufficient intensive care beds.DesignA qualitative monocentric study using rapid qualitative descriptive methods was reported in line with the COREQ checklist.MethodsNurse, ward manager and physician participants were purposively recruited between January and March 2021 in a tertiary university-affiliated hospital in the Flemish-speaking part of Belgium. Semistructured interviews were conducted and analysed using thematic analysis methods.ResultsThe participants were seventeen expert nurses, twelve supporting nurses, seven ward managers and four physicians. A central theme of ensuring safe, high-quality care emerged from the findings. There was a sense of losing one's grip on clinical practice when working in the mixed nursing-care teams. Different underlying experiences played a part in this sense of losing control: dealing with unknown elements, experiencing role ambiguity, struggling with responsibility and the absence of trust. Several coping mechanisms were developed by the nursing-care team to deal with those experiences, including attempts to create stability, to strike a balance between delegating and educating, to build in control and to communicate openly.ConclusionIn this rapid qualitative descriptive study, the implementation of a new nursing-care delivery model during a pandemic was seen to lead to several challenges for all members of the care team. Coping mechanisms were developed by the team to deal with these experienced challenges.ImpactWhen rethinking nursing-care delivery models, the findings of this study may help guide the process of implementing mixed nursing-care teams. Special attention needs to be paid to clarifying roles, sharing responsibility and clinical leadership. Other significant influences (such as moral distress) should also be taken into account.

Dataset Information

A qualitative descriptive study of the COVID-19 pandemic: Impacts on nursing care delivery in the critical care work system.

Publications

A qualitative descriptive study of the COVID-19 pandemic: Impacts on nursing care delivery in the critical care work system.

Similar Datasets

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