Fundamental nursing care in patients with the SARS-CoV-2 virus: results from the ‘COVID-NURSE’ mixed methods survey into nurses’ experiences of missed care and barriers to care

BMC Nursing

Emma J. Cockcroft¹  Rebecca Whear¹  Naomi Morley¹  Susannah J. Tooze¹  Holly V. R. Sugg¹  Harriet A. Hunt¹  Merryn Kent¹  Sarah Burnett¹  Anne-Marie Russell¹  Faye E. Doris¹  Leila M. Morgan¹  David A. Richards²  Jo Thompson Coon³  Sally J. Singh⁴  Anne Marie Rafferty⁵  Maggie H. Shepherd⁶  Heather Iles-Smith⁷  Philippa A. Logan⁸  Susanne Cruickshank⁹ 

[1] College of Medicine and Health, University of Exeter, St Luke’s Campus, Heavitree Road, EX1 2LU, Exeter, UK;College of Medicine and Health, University of Exeter, St Luke’s Campus, Heavitree Road, EX1 2LU, Exeter, UK;Department of Health and Caring Sciences, Western Norway University of Applied Sciences, Inndalsveien 28, 5063, Bergen, Norway;College of Medicine and Health, University of Exeter, St Luke’s Campus, Heavitree Road, EX1 2LU, Exeter, UK;The National Institute for Health Research (NIHR) Applied Research Collaboration (ARC) South West Peninsula (PenARC), Exeter, UK;Department of Respiratory Science, University of Leicester, University Road, LE1 7RH, Leicester, UK;University Hospitals of Leicester NHS Trust, Biomedical Research Centre – Respiratory, Glenfield Hospital, Groby Road, LE3 9QP, Leicester, UK;Faculty of Nursing, Midwifery and Palliative Care, King’s College London, SE1 8WA, London, UK;NIHR Exeter Clinical Research Facility, Royal Devon and Exeter NHS Foundation Trust, Barrack Road, EX2 5DW, Exeter, UK;Institute of Biomedical and Clinical Science, College of Medicine and Health, University of Exeter, St Luke’s Campus, Heavitree Road, EX1 2LU, Exeter, UK;School of Health and Society, University of Salford, Allerton Building, Frederick Rd, M6 6PU, Salford, UK;Northern Care Alliance NHS Group, Stott Lane, M6 8HD, Salford, UK;School of Medicine, University of Nottingham, Queens Medical Centre, NG7 2UH, Nottingham, UK;The Royal Marsden NHS Foundation Trust, Fulham Road, SW3 6JJ, London, UK;

关键词: Fundamental nursing care;    COVID-19;    SARS-CoV-2;    Missed care;    Survey;    Mixed methods;   

DOI  :  10.1186/s12912-021-00746-5

来源: Springer

【 摘 要 】

BackgroundPatient experience of nursing care is associated with safety, care quality, treatment outcomes, costs and service use. Effective nursing care includes meeting patients’ fundamental physical, relational and psychosocial needs, which may be compromised by the challenges of SARS-CoV-2. No evidence-based nursing guidelines exist for patients with SARS-CoV-2. We report work to develop such a guideline. Our aim was to identify views and experiences of nursing staff on necessary nursing care for inpatients with SARS-CoV-2 (not invasively ventilated) that is omitted or delayed (missed care) and any barriers to this care.MethodsWe conducted an online mixed methods survey structured according to the Fundamentals of Care Framework. We recruited a convenience sample of UK-based nursing staff who had nursed inpatients with SARS-CoV-2 not invasively ventilated. We asked respondents to rate how well they were able to meet the needs of SARS-CoV-2 patients, compared to non-SARS-CoV-2 patients, in 15 care categories; select from a list of barriers to care; and describe examples of missed care and barriers to care. We analysed quantitative data descriptively and qualitative data using Framework Analysis, integrating data in side-by-side comparison tables.ResultsOf 1062 respondents, the majority rated mobility, talking and listening, non-verbal communication, communicating with significant others, and emotional wellbeing as worse for patients with SARS-CoV-2. Eight barriers were ranked within the top five in at least one of the three care areas. These were (in rank order): wearing Personal Protective Equipment, the severity of patients’ conditions, inability to take items in and out of isolation rooms without donning and doffing Personal Protective Equipment, lack of time to spend with patients, lack of presence from specialised services e.g. physiotherapists, lack of knowledge about SARS-CoV-2, insufficient stock, and reluctance to spend time with patients for fear of catching SARS-CoV-2.ConclusionsOur respondents identified nursing care areas likely to be missed for patients with SARS-CoV-2, and barriers to delivering care. We are currently evaluating a guideline of nursing strategies to address these barriers, which are unlikely to be exclusive to this pandemic or the environments represented by our respondents. Our results should, therefore, be incorporated into global pandemic planning.

【 授权许可】

CC BY