The Impact of COVID-19 from the Perspectives of Dutch District Nurses: A Mixed-Methods Study

Little is known about how COVID-19 affects older patients living at home or how it affects district nursing teams providing care to these patients. This study aims to (1) explore, from the perspectives of Dutch district nurses, COVID-19′s impact on patients receiving district nursing care, district nursing teams, and their organisations during the first outbreak in March 2020 as well as one year later; and (2) identify the needs of district nurses regarding future outbreaks. A mixed-methods, two-phase, sequential exploratory design was followed. In total, 36 district nurses were interviewed during the first outbreak (March 2020), of which 18 participated in the follow-up questionnaire in April 2021. Thirteen themes emerged, which showed that the COVID pandemic has substantially impacted patient care and district nursing teams. During the first outbreak, nurses played a crucial role in organising care differently and worked under high pressure, leading to exhaustion, tiredness, and psychosocial problems, including fear of infection. A year later, nurses were better prepared to provide COVID care, but problems regarding work pressure and mental complaints remained. The identified needs focus on a sustainable implementation of leadership roles for district nurses. At the organisational and national levels, more support and appreciation are needed in terms of trust and appropriate policies.

Dressings and dignity in community nursing

Although dignity has been widely explored in the context of healthcare, it has rarely been the subject of empirical exploration when care is delivered by community district nursing teams. This paper demonstrates how a commonplace community nursing task (changing dressings) can constitute a clinical lens through which to explore the ways in which community nurses can influence patients' dignity. This ethnographic study involved two research methods: interviews with patients and nurses (n=22) and observations of clinical interactions (n=62). Dignity can manifest during routine interactions between community nurses and patients. Patient-participants identified malodour from their ill-bodies as a particular threat to dignity. Nurses can reinforce the dignity of their patients through relational aspects of care and the successful concealment of ‘leaky’ bodies.

How Can Nursing Teams Respond to Large-Scale COVID-19 Screening?

The COVID-19 virus has devastated lives and economies worldwide. The responses of nursing teams to large-scale COVID-19 screening have rarely been addressed or described. The aim of this study is to introduce an efficient response strategy for nurses in large-scale COVID-19 screening. A new COVID-19 case was confirmed on Jan 14, 2021 in Nanning, China. Immediately, a large-scale COVID-19 screening was launched and ran from Jan 14 to Jan 17, 2021. Our nurse team responding to the screening included three major components: (1) establishing a leadership group and a nucleic acid sampling emergency team; (2) defining, conducting, and evaluating nurse training; (3) implementing efficient sampling schemes (10 in 1 mixed sample technique). A total of 500 nurse volunteers were recruited and divided into three echelons. A total of 353 trained nurses were sent to 65 sampling stand stations. In cooperation with nurses from other health institutions, samples were collected from a total of 854,215 people in only 4 days for 2019-nCOV nucleic acid screening. The preparation and efficient response strategies used to conduct this screening may provide a baseline reference for future large-scale COVID-19 screening worldwide.

Factors related to job burnout among older nurses in Guizhou province, China

Background The nursing workforce shortage has long been a global concern, and with the aging of nurses, this problem has become more prominent. Nursing is recognized as a high-stress occupation, and nurses experience high levels of job burnout, which reduces their professional identity. Older nurses are an indispensable talent force for nursing teams and are extremely important for the stability of nursing teams and improvement in nursing quality. Exploring the mental health and influencing factors of older nurses is very beneficial for the stability and development of nurse teams and patients’ clinical outcomes. Purpose This study aimed to investigate the level of job burnout and its influencing factors among older nurses in Guizhou Province, China and confirm the correlations among job burnout, professional identity and stress level. Methods From July to August 2019, 520 registered nurses aged over 40 years in Guizhou Province, China were surveyed through the Questionnaire Star platform. The questionnaire contained the following four parts: a general information questionnaire, the Maslach Burnout Inventory (MBI), a professional identity scale, and a job stressors scale. Results The results showed that the job burnout score of the 520 older nurses was 55.44 ± 18.62, which was moderate. The level of job burnout was positively correlated with the level of nurse stress and negatively correlated with the level of professional identity, which was influenced by various personal and social factors. Conclusions This study not only revealed that job burnout was still at a moderate level, but also revealed its current status and influencing factors among older nurses in China.

Impact of the COVID-19 pandemic on the life habits of the nursing staff working in intensive care units of hospitals in the city of Campos dos Goytacazes-RJ

The COVID-19 pandemic remains a major public health challenge. Most patients infected with the SARS-CoV2 virus are critical patients requiring admission to intensive care units (ICU) and qualified nursing care. However, the experiences of nurses from China and Italy showed that one of the biggest obstacles in the care of patients with the disease occurred within the scope of the organization of trained and qualified teams, staff dimensioning, management of supplies and equipment, and attention to the mental health of these professionals. Faced with this pandemic scenario, professional nurses face important challenges concerning care and the quality of nursing services in intensive care. The objective of this research will be to identify the impact caused by the COVID-19 pandemic on the life habits of professionals from the Nursing teams who work in the Intensive Care Units in the municipality of Campos dos Goytacazes-RJ. This is a cross-sectional study to be carried out between October and December 2021. Data collection will be carried out through an online questionnaire (Google Forms®) whose sample will consistof professionals from the Nursing teams (nurses and nursing technicians), working in the Intensive Care Units of Private and Public Hospitals in the city of Campos dos Goytacazes-RJ. Subsequently, the data obtained will be analyzed using descriptive statistics in the SPSS® software. This study aims to contribute to improving the quality of life and health of nursing professionals working in ICUs and, consequently, the quality of care and patient safety. Furthermore, it is expected that the results corroborate the need to implement health protection strategies for these professionals in the context of the pandemic.

Features of medical support of physical training and mass sports events in the Armed Forces of the Russian Federation

Introduction. Physical training is the most important element of the combat readiness of the troops, its goals and objectives are defined by the Manual on Physical Training in the Armed Forces of the Russian Federation. The solution of these tasks should contribute to the formation of military personnel's readiness to endure extreme physical and mental stress during the preparation and conduct of combat operations. Comprehensive provision of physical training in the troops requires the hard work of various services, including the medical service.The purpose of the study. Identify problematic issues of medical support for physical training and sports events in the Armed Forces of the Russian Federation and identify ways to solve them.Materials and methods. The article uses the materials of the work of medical and nursing teams in the medical provision of physical training of units of the Southern Military District from 2016 to 2019. Additionally, the data of an in-depth medical examination of the personnel of some units of the district subordination for 2018 were used.Results and discussion. When analyzing the work of visiting medical and nursing teams during the medical support of passing the standards for physical training, a number of problematic issues were identified. First, there are always military personnel who regularly do not engage in physical training and during the delivery of standards make excessive efforts and work at the limit of their capabilities. Secondly, some exercises are very dangerous, either in terms of injuries or the likelihood of developing complications from the cardiovascular system. All this applies to the medical support of the competition. As an example, the championship of the Armed Forces of the Russian Federation in fire and rescue sports, held from 3 to 6 September 2019 in Rostov-on-Don on the territory of the garrison fire brigade, is given. The program of the competition included passing the obstacle course, climbing the training tower, extinguishing the fire, etc., all very traumatic. Therefore, for the medical support of these competitions, a medical and nursing team of the resuscitation profile was allocated on a reanimobile with specialized stowage, respiratory and oxygen equipment.Conclusion. It is necessary to strictly monitor the correctness of the definition of the group of physical training and the gradual increase in physical activity in order to avoid complications and further progression of diseases or even deaths in military personnel. It is impossible to approach formally the conduct of an in-depth medical examination of military personnel.

The Slippery Slope Syndrome

For more than 20 years I have practiced nursing, first in oncology services, then in palliative care. As a teacher and psychotherapist for the past 10 years, I have had the opportunity to continue working with nursing students in palliative care and psychiatric services, as well as to supervise nursing teams. An ethicist by training, I belong to an ethics committee in a neuropsychiatric hospital. Wearing these different hats gives me the great privilege of encountering patients at the end of life or who suffer from mental illnesses as well as nurses and students who face difficult situations, and to review in the ethics committee clinical situations involving great suffering.The question of euthanasia comes up very regularly and occasions numerous discussions that are both emotional and engaging.

Cultural Diversity in Nursing Teams: Triggers, Team Process and Contingencies / Kulturelle Vielfalt in Pflegeteams: Triggers, Teamprozesse und Kontext

IntroductionThe study explored cultural diversity in nursing teams and the internal and external conditions under which cultural differences represent an asset or a liability for these teams.MethodsA qualitative design with content analysis was employed. In total, 18 interviews were conducted with nurses and assistant nurses with experience of working in culturally diverse teams in three distinct clinical settings.ResultsThree domains emerged in the study analysis: triggers, team process and contingencies. Each one encompassed a number of themes related to culturally diverse nursing team processes, triggers of team processes and context-specific contingencies, which represent the complexity of culturally diverse nursing team functioning.Discussion/implicationsThe study suggests how cultural differences in nursing teams can be managed and further explored from within the team and by individuals leading those teams, taking into account the disablers and enablers of their functioning.

Handover de enfermagem em clínicas cirúrgicas: a interface entre a comunicação e a segurança do paciente [Nursing shift handover in surgical clinics: the interface between communication and patient safety] [Traspaso de turnos de enfermería en clínicas quirúrgicas: la interfaz entre la comunicación y la seguridad del paciente]

Objetivo: identificar os fatores que interferem na comunicação entre as equipes de enfermagem durante o handover de troca de turno em clínicas cirúrgicas, e sua interface com a segurança do paciente. Método: estudo quantitativo, observacional, com análise descritiva, realizado de abril a julho de 2019, por meio de um roteiro de observação e um formulário, em nove clínicas cirúrgicas de um hospital universitário. Resultados: observou-se 54 handovers e participaram 123 profissionais de enfermagem. Dentre os fatores analisados, destaca-se, a ausência de instrumento padronizado de handover (85,19%) e presença de ruídos sonoros (77,78%). A maioria dos participantes (86,93%) apontaram a omissão de informações, na transferência de cuidados, como o fator mais prejudicial para assistência. Conclusão: os fatores que interferiram na comunicação durante o handover foram: ruídos sonoros, omissão de informações, ausência de instrumento padronizado e atrasos dos profissionais. Acredita-se que a identificação desses fatores contribua para o desenvolvimento de melhores estratégias.ABSTRACTObjective: to identify factors affecting communication between nursing teams during shift handover on surgical wards, and how it interfaces with patient safety. Method: this quantitative, observational study, with descriptive analysis, was conducted on nine surgical wards of a university hospital from April to July 2019, using an observation script and record form. Results: 54 nursing shift handovers were observed, and 123 nursing personnel participated. Of particular note among the factors analyzed were absence of a standardized handover instrument (85.19%) and the presence of noise (77.78%). Most of the participants (86.93%) pointed to missing information at handover as the factor most prejudicial to care. Conclusion: the factors that interfered with communication during handover were: noise, omission of information, absence of a standardized instrument, and staff lateness. It is believed that identifying these factors will help develop better strategies.RESUMENObjetivo: identificar los factores que afectan la comunicación entre los equipos de enfermería durante la transferencia de turno en las salas quirúrgicas y cómo interactúa con la seguridad del paciente. Método: este estudio cuantitativo, observacional, con análisis descriptivo, se realizó en nueve salas quirúrgicas de un hospital universitario de abril a julio de 2019, utilizando un guión de observación y formulario de registro. Resultados: se observaron 54 traspasos de turno de enfermería y participaron 123 personal de enfermería. Entre los factores analizados destacan la ausencia de un instrumento de traspaso estandarizado (85,19%) y la presencia de ruido (77,78%). La mayoría de los participantes (86,93%) señaló la falta de información en la entrega como el factor más perjudicial para la atención. Conclusión: los factores que interfirieron en la comunicación durante el traspaso fueron: ruido, omisión de información, ausencia de instrumento estandarizado y tardanza del personal. Se cree que identificar estos factores ayudará a desarrollar mejores estrategias.

Desirable Features of an Interdisciplinary Handoff

Failure of communication of critical information during handoffs is one of the leading causes of medical errors, resulting in serious, yet preventable, adverse events in hospitals across the United States. Recent studies have shown that a majority of these errors occur during patient handoffs, with notable communication gaps in interdisciplinary handoffs. We suggest some features that would improve the handoff usability and effectiveness for interdisciplinary medical and nursing teams while potentially improving patient safety.