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Moreno-Jiménez JE, Romero M, Blanco-Donoso LM, Hernández-Hurtado M, Garrosa E. Studying daily fluctuations of emotional effort among nurses of intensive care units: the establishment of latent profiles and its relationship with daily secondary traumatic stress and vitality. Front Psychol 2024; 15:1340740. [PMID: 38558776 PMCID: PMC10978758 DOI: 10.3389/fpsyg.2024.1340740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Accepted: 02/27/2024] [Indexed: 04/04/2024] Open
Abstract
Introduction Nursing professionals working in Intensive Care Units (ICU) face significant challenges that can result in secondary traumatic stress (STS). These challenges stem from witnessing patients' suffering and managing difficult tasks (i.e. communication with patients' relatives). Furthermore, these professionals encounter emotional demands, such as emotional effort, which is the dissonance between the emotion felt and the emotion that should be expressed to meet work expectations. Consequently, we aimed to investigate whether different profiles exist concerning nurses' levels of emotional effort over a five-day period and whether these profiles are related to daily STS and vitality. Methods The sample comprised 44 nursing professionals from ICUs in Spanish hospitals. They were assessed daily, using a package of questionnaires twice per day for five working days: a) immediately after their shift and b) at a later time after working. Results The findings revealed three distinct profiles based on emotional effort levels: high (Profile 1), moderate (Profile 2), and low (Profile 3). These profiles were found to be negative predictors for both daily shattered assumptions and symptomatology. Discussion This study underscores the importance of assessing daily emotional demands in an ICU setting. Such assessments are crucial for establishing preventive measures to help nursing professionals manage lower-level emotional demands.
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Affiliation(s)
| | - Miriam Romero
- Department of Biological and Health Sciences, European University of Madrid, Madrid, Spain
| | | | | | - Eva Garrosa
- Faculty of Psychology, Autonomous University of Madrid, Madrid, Spain
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de Vries N, Maniscalco L, Matranga D, Bouman J, de Winter JP. Determinants of intention to leave among nurses and physicians in a hospital setting during the COVID-19 pandemic: A systematic review and meta-analysis. PLoS One 2024; 19:e0300377. [PMID: 38484008 PMCID: PMC10939201 DOI: 10.1371/journal.pone.0300377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Accepted: 02/26/2024] [Indexed: 03/17/2024] Open
Abstract
BACKGROUND The global outbreak of COVID-19 has brought to light the profound impact that large-scale disease outbreaks can have on healthcare systems and the dedicated professionals who serve within them. It becomes increasingly important to explore strategies for retaining nurses and physicians within hospital settings during such challenging times. This paper aims to investigate the determinants of retention among nurses and physicians during the COVID-19 pandemic. METHOD A systematic review of other potential determinants impacting retention rates during the pandemic was carried out. Secondly, a meta-analysis on the prevalence of intention to leave for nurses and physicians during the COVID-19 pandemic. FINDINGS A comprehensive search was performed within four electronic databases on March 17 2023. Fifty-five papers were included in the systematic review, whereas thirty-three papers fulfilled the eligibility criteria for the meta-analysis. The systematic review resulted in six themes of determinants impacting intention to leave: personal characteristics, job demands, employment services, working conditions, work relationships, and organisational culture. The main determinants impacting the intention to leave are the fear of COVID-19, age, experience, burnout symptoms and support. Meta-analysis showed a prevalence of intent to leave the current job of 38% for nurses (95% CI: 26%-51%) and 29% for physicians (95% CI: 21%-39%), whereas intention to leave the profession for nurses 28% (95% CI: 21%-34%) and 24% for physicians (95% CI: 23%-25%). CONCLUSION The findings of this paper showed the critical need for hospital managers to address the concerning increase in nurses' and physicians' intentions to leave during the COVID-19 pandemic. This intention to leave is affected by a complex conjunction of multiple determinants, including the fear of COVID-19 and the confidence in and availability of personal protective equipment. Moreover, individual factors like age, experience, burnout symptoms, and support are maintained in this review. Understanding the influence of determinants on retention during the COVID-19 pandemic offers an opportunity to formulate prospective strategies for retaining nurses and physicians within hospital settings.
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Affiliation(s)
- Neeltje de Vries
- Department of Internal Medicine, Spaarne Gasthuis, Haarlem and Hoofddorp, the Netherlands
- Spaarne Gasthuis Academy, Spaarne Gasthuis, Haarlem and Hoofddorp, the Netherlands
| | - Laura Maniscalco
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, “G. D’Alessandro” (PROMISE), University of Palermo, Palermo, Italy
| | - Domenica Matranga
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, “G. D’Alessandro” (PROMISE), University of Palermo, Palermo, Italy
| | - José Bouman
- Spaarne Gasthuis Academy, Spaarne Gasthuis, Haarlem and Hoofddorp, the Netherlands
| | - J Peter de Winter
- Spaarne Gasthuis Academy, Spaarne Gasthuis, Haarlem and Hoofddorp, the Netherlands
- Department of Paediatrics, Spaarne Gasthuis, Haarlem and Hoofddorp, the Netherlands
- Leuven Child and Health Institute, KU Leuven, Leuven, Belgium
- Department of Development and Regeneration, KU Leuven, Leuven, Belgium
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Camenzind E, Vetter L, Exl MT, Jeitziner MM. [Lessons from the COVID-19-Pandemic : Experiences of critical care nurses during the COVID-19 pandemic: a qualitative explorative study]. Med Klin Intensivmed Notfmed 2024:10.1007/s00063-024-01120-4. [PMID: 38459360 DOI: 10.1007/s00063-024-01120-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 12/08/2023] [Accepted: 02/02/2024] [Indexed: 03/10/2024]
Abstract
BACKGROUND When the workload for critical care nurses becomes too high, this can have consequences for both personal health as well as patient care. During the COVID-19 pandemic, critical care nurses were confronted with new and dynamic changes. OBJECTIVE The aim of this study was to describe the experiences of critical care nurses regarding the ad hoc measures taken and the perceived physical and psychological burden experienced during the coronavirus disease 2019 (COVID-19) pandemic. METHODS This was a cross-sectional study conducted at two hospitals using an online survey. The open questions addressing the challenges faced during the COVID-19 pandemic were subjected to content analysis according to Mayring. RESULTS A total of 179 critical care nurses participated in the online survey. From the results, the following four categories were developed: "not meeting one's own quality of care requirements," "uncertainties in everyday professional and private life," "increased responsibility with lack of relief," and "insufficient coping strategies for physical and psychological burden." CONCLUSION Critical care nurses require structures and processes which support them in situations of high workload. The focus should be on the self-imposed requirements of quality of care as well as potentially relieving measures.
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Affiliation(s)
- Elena Camenzind
- Universitätsklinik für Anästhesiologie und Schmerzmedizin, Universitätsspital Bern (Inselspital), Bern, Schweiz
| | - Luzia Vetter
- Pflegeentwicklung und -qualität, Luzerner Kantonsspital, Luzern, Schweiz
| | - Matthias Thomas Exl
- Universitätsklinik für Intensivmedizin, Universitätsspital Bern (Inselspital), Bern, Schweiz.
| | - Marie-Madlen Jeitziner
- Universitätsklinik für Intensivmedizin, Universitätsspital Bern (Inselspital), Bern, Schweiz
- Departement Public Health (DPH), Pflegewissenschaft - Nursing Science (INS), Universität Basel, Basel, Schweiz
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Scott M, Wade R, Tucker G, Unsworth J. Redeployment to critical care during the COVID-19 pandemic: A phenomenological study. Nurs Crit Care 2024; 29:385-396. [PMID: 37715624 DOI: 10.1111/nicc.12962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Revised: 07/10/2023] [Accepted: 07/24/2023] [Indexed: 09/17/2023]
Abstract
BACKGROUND The redeployment of staff which involves moving staff from one clinical setting to another is a key feature of health care management. Rising demand associated with chronic disease and seasonal variation makes redeployment increasingly commonplace. During the COVID-19 pandemic preparation for the influx of patients included sourcing equipment and resources and the redeployment of staff to respiratory wards and critical care. AIM The aim of this study was to explore the lived experience of redeployment to critical care during the COVID-19 pandemic from the perspective of those individuals who were moved to help and critical care core staff. STUDY DESIGN A transcendental phenomenological study involving semi-structured interviews with staff redeployed and critical care core staff was conducted. Data were collected from staff in one critical care department of a large NHS Trust in England between the second and third pandemic wave (April-June 2021). RESULTS Analysis of the data led to the identification of seven meaning units: intention, apprehension, expectations, familiarity, preparation, support, and own work. Intention related to the decisions made by managers regarding whom to redeploy and the reasons why people were chosen. Apprehension and expectations were closely linked and related to critical care skills and knowledge as well as anxiety about infection risk. Familiarity was a key element of people feeling comfortable and the confidence core staff had in colleagues who had come to help. Support and preparation helped but staff were anxious about their own work and concerned about the open-ended nature of redeployment. CONCLUSION Familiarity and recency of critical care experience played a significant role in how useful redeployed staff were. Redeployed staff were concerned about assumptions being made and expectations of themselves as well as detachment from their usual support network. RELEVANCE TO CLINICAL PRACTICE Continued shortages of registered nurses globally combined with the need to create additional critical care capacity during emergencies such as infection outbreaks means that redeployment of staff will continue for some time. Identifying the impact of redeployment on staff will enable services to better prepare and support registered nurses who are redeployed to critical care.
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Affiliation(s)
- Margaret Scott
- Human Factors and Patient Safety Lead, Northumbria Healthcare NHS Foundation Trust, Newcastle-upon-Tyne, UK
| | - Rachel Wade
- Northumbria Healthcare NHS Foundation Trust, Newcastle-upon-Tyne, UK
| | - Guy Tucker
- Midwifery and Allied Health Professions Education, South Tyneside and Sunderland NHS Foundation Trust, Sunderland, UK
| | - John Unsworth
- Department of Nursing, Midwifery and Health, Northumbria University, Newcastle-upon-Tyne, UK
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Li M, Zhao R, Wei J, Zhou L, Yang S, Tian Y, Wang L, Zhang W, Xiong X, Huang C, Pan Z, Song R. Nurses' perspectives on workplace environment needs associated to resilience: a qualitative descriptive study. Front Psychiatry 2024; 15:1345713. [PMID: 38404475 PMCID: PMC10884228 DOI: 10.3389/fpsyt.2024.1345713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 01/24/2024] [Indexed: 02/27/2024] Open
Abstract
Objective The purpose of this study was to explore the demands of nurses on the workplace environment related to psychological resilience. Methods A qualitative descriptive design was employed for this study. Purposeful sampling was chosen from a tertiary hospital in Henan Province, China. Semi-structured in-depth interviews were conducted with 20 nurses. The interview data was analyzed using the Colaizzi's method and results were reported following the COREQ standards. Results Analysis of the interview data revealed three main themes: (1) Career Support and Development, (2) Practical Support & Development, and (3) Personal Support and Development. Conclusion The perspectives of nurses for a workplace environment demands needs to be appreciated, and in addition, it is worth noting that the key role of building a good workplace environment in strengthening the resilience of nurses emphasizes the need for careful consideration. Nursing administrators should formulate policies and measures from multiple perspectives based on the real needs of nurses in terms of professional, practical, and personal dimensions.
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Affiliation(s)
- Meng Li
- Nursing Department, The Third People’s Hospital of Henan Province, Zhengzhou, China
| | - Runze Zhao
- School of Medicine, Zhengzhou University of Industrial Technology, Zhengzhou, China
| | - Junfan Wei
- The Seventh Clinical Medicine College of Guangzhou University of Chinese Medicine, Shenzhen, China
| | - Linghan Zhou
- Nursing Department, The Third People’s Hospital of Henan Province, Zhengzhou, China
| | - Shuhua Yang
- Nursing Department, The Third People’s Hospital of Henan Province, Zhengzhou, China
| | - Yuan Tian
- Nursing Department, The Third People’s Hospital of Henan Province, Zhengzhou, China
| | - Lingning Wang
- School of Medicine, Maanshan University, Maanshan, China
| | - Wenling Zhang
- Operating Room, Henan Provincial People’s Hospital, Zhengzhou, China
| | - Xiaoyun Xiong
- Nursing Department, The Third People’s Hospital of Henan Province, Zhengzhou, China
| | - Chuzhen Huang
- The Seventh Clinical Medicine College of Guangzhou University of Chinese Medicine, Shenzhen, China
| | - Zhongjie Pan
- School of Medicine, Zhengzhou University of Industrial Technology, Zhengzhou, China
| | - Ruipeng Song
- Nursing Department, The Third People’s Hospital of Henan Province, Zhengzhou, China
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Abbasi S, Maleki M, Imanipour M, Mardani A. Nursing students' experiences of teaching and learning during the COVID-19 pandemic: a systematic review and meta-synthesis of qualitative studies. Int J Nurs Educ Scholarsh 2024; 21:ijnes-2023-0094. [PMID: 38407250 DOI: 10.1515/ijnes-2023-0094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 01/31/2024] [Indexed: 02/27/2024]
Abstract
INTRODUCTION During the COVID-19 pandemic, the sudden transition to virtual learning led to several challenges for nursing students. This study aimed to synthesis nursing students' experiences of teaching and learning during the COVID-19 pandemic. CONTENT A meta-synthesis of qualitative articles were conducted. Three online databases were searched from December 2019 to December 2022. Qualitative studies and qualitative sections of mixed method studies were included. SUMMARY Twenty-four qualitative studies and seven mixed-method studies were included in the review. The findings consisted of one main theme "educational transformation", and three categories "challenging face-to-face clinical training", "transition from face-to-face to virtual education", and "support continua". The evidence indicated that during this health-related crisis, most of the training was provided as distance learning in various forms. According to the findings, distance education alone cannot replace face-to-face education and is suggested to be considered as a supplementary learning method. OUTLOOK This study provides a comprehensive understanding of nursing students' experiences during the COVID-19 pandemic, offering practical implications for educators and institutions globally. The lessons learned can inform strategic decisions, policies, and practices to enhance the resilience and adaptability of nursing education in the face of unforeseen challenges.
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Affiliation(s)
- Soheila Abbasi
- Department of Pediatric and Neonatal Intensive Care Nursing Education, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Maleki
- Department of Pediatric and Neonatal Intensive Care Nursing Education, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Masoomeh Imanipour
- Nursing and Midwifery Care Research Center, Department of Critical Care Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Abbas Mardani
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Zanjan University of Medical Sciences, Zanjan, Iran
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Alrjoub W, Alarjeh G, Ammar K, Shamieh A, Harding R, Booth C, Sullivan R, Al-ruzzieh M, Mansour A, Shamieh O. Stress, resilience, and moral distress among health care providers in oncology during the COVID-19 pandemic. Front Public Health 2023; 11:1288483. [PMID: 38192554 PMCID: PMC10773806 DOI: 10.3389/fpubh.2023.1288483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 11/02/2023] [Indexed: 01/10/2024] Open
Abstract
Background The coronavirus pandemic has potential implications for stress levels and resilience among oncology healthcare professionals (HCPs). This study aims to assess perceived stress, resilience, and moral distress levels among oncology HCPs in Jordan during the pandemic and identify associated risk factors. Methods An online cross-sectional survey was conducted among oncology HCPs in Jordan using three validated tools: Perceived Stress Scale (PSS), Connor-Davidson Resilience Scale (CD-RSIC), and Moral Distress Thermometer (MDT). Seven items were used to assess sources of stress. Results A total of 965 participants enrolled with a 74% response rate. The participants' ages ranged from 20 to 74 (mean = 32.74, SD = 5.197), with 79.1% males, 45.1% were physicians, 32.6% were public hospital workers, 57.1% were married, and 56.6% had children below 18 years. Findings indicated moderate perceived stress (Mean = 15.87, SD = 5.861), low resilience (Mean = 29.18, SD = 5.197), and high moral distress (Mean = 4.72, SD = 2.564). Females, unmarried individuals, and younger age groups exhibited higher PSS (p = 0.009, p < 0.001, and P<0.001) and lower resilience (p = 0.024, p = 0.034, and p = 0.001). Not having children below 18 years correlated with higher perceived stress (P < 0.001). In linear regression analysis, age and gender emerged as significant predictors of both perceived stress and resilience. Female participants reported stress related to the risk of contracting COVID-19 (p = 0.001), transmitting it to others (p = 0.017), social isolation (P < 0.001), and having children at home due to school closures (p = 0.000). A cohort of 239 participants repeated the survey within a two-month interval, revealed a statistically significant decrease in the CD-RISC scores (p < 0.001). Conclusion Oncology HCPs in Jordan experienced moderate stress, high moral distress, and poor resilience during the COVID-19 pandemic. These factors may negatively affect the quality of oncology care. Urgent measures are necessary to support HCPs in coping with unforeseen circumstances in the future.
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Affiliation(s)
- Waleed Alrjoub
- Centre for Palliative and Cancer Care in Conflict (CPCCC), King Hussein Cancer Centre (KHCC), Amman, Jordan
| | - Ghadeer Alarjeh
- Centre for Palliative and Cancer Care in Conflict (CPCCC), King Hussein Cancer Centre (KHCC), Amman, Jordan
| | - Khawlah Ammar
- Centre of Research Shared Resources, King Hussein Cancer Centre (KHCC), Amman, Jordan
| | | | - Richard Harding
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King’s College London, Cicely Saunders Institute, London, United Kingdom
| | - Christopher Booth
- Faculty of Health Sciences, Cancer Care and Epidemiology, Queen's University, Kingston, ON, Canada
| | - Richard Sullivan
- Institute of Cancer Policy, King’s College London, London, United Kingdom
| | | | - Asem Mansour
- Director General’s Office, King Hussein Cancer Center, Amman, Jordan
| | - Omar Shamieh
- Centre for Palliative and Cancer Care in Conflict (CPCCC), King Hussein Cancer Centre (KHCC), Amman, Jordan
- Faculty of Medicine, The University of Jordan, Amman, Jordan
- Department of Palliative Care, King Hussein Cancer Centre (KHCC), Amman, Jordan
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Andersson M, Nordin A, Fredholm A, Engström Å. The four domains of the person-centred practice framework from the perspective of critical care nurses in intensive care units during a pandemic. Intensive Crit Care Nurs 2023; 78:103449. [PMID: 37169630 DOI: 10.1016/j.iccn.2023.103449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 04/25/2023] [Accepted: 04/29/2023] [Indexed: 05/13/2023]
Abstract
OBJECTIVES The aim was to describe the Person-Centred Practice Framework's four domains (prerequisites, care environment, person-centred processes, and person-centred outcomes) through the perspectives of critical care nurses working in intensive care units during the second year of the COVID-19 pandemic. Furthermore, the aim was to investigate the relationships between prerequisites, care environment, person-centred processes, and person-centred outcomes. DESIGN/METHODS A cross-sectional study involving questionnaires. Prerequisites were measured using person-related conditions, the care environment by using the Person-Centred Climate Questionnaire-Staff version, the person-centred processes by using the Person-Centred Care Assessment Tool and person-centred outcomes were measured with one question about present health and well-being and by using Self-rated Exhaustion Disorder. Descriptive and analytic statistics were used. Data was collected from July 2021 to November 2021. SETTING Critical care nurses (n = 217) working in 15 Swedish adult intensive care units. RESULTS Participants' average length of experience in intensive care units was 14 years, and most participants experienced increased nursing care responsibilities. They perceived the climate as safe but had limitations in terms of its everydayness and community. Participants perceived the organisations both supported and hindered personalized care. Most participants experienced a variety of exhaustion symptoms, and their health had positive relationship with community. CONCLUSION By showing how prerequisites, care environment, person-centred process influences critical care nurses' health and well-being, organisations might identify aspects in the work environment that require targeted interventions to reach healthy workplaces. IMPLICATIONS FOR CLINICAL PRACTICE To preserve the health and well-being of critical care nurses and to flourish as humans in their professional roles, they need to interact with and form relationships with their colleagues, patients, and relatives. Organisations should have a person-centred approach for every individual in the workforce to harness each critical care nurses' knowledge and skills for individuals to growth in their roles.
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Affiliation(s)
- Maria Andersson
- Swedish Red Cross University College, SE-141 21 Huddinge, Sweden.
| | - Anna Nordin
- Karlstad University, Department of Health Science, Faculty of Health, Science, and Technology, Sweden; Lulea University of Technology, Department of Health, Education and Technology, Division of Nursing and Medical Technology, SE-97187 Luleå, Sweden
| | - Angelica Fredholm
- Karlstad University, Department of Health Science, Faculty of Health, Science, and Technology, Sweden; Centre for Clinical Research, County Council of Värmland, Karlstad, Sweden
| | - Åsa Engström
- Lulea University of Technology, Department of Health, Education and Technology, Division of Nursing and Medical Technology, SE-97187 Luleå, Sweden
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Excess mortality among non-COVID-19 surgical patients attributable to the exposure of French intensive and intermediate care units to the pandemic. Intensive Care Med 2023; 49:313-323. [PMID: 36840798 PMCID: PMC9959950 DOI: 10.1007/s00134-023-07000-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 02/03/2023] [Indexed: 02/26/2023]
Abstract
PURPOSE The mobilization of most available hospital resources to manage coronavirus disease 2019 (COVID-19) may have affected the safety of care for non-COVID-19 surgical patients due to restricted access to intensive or intermediate care units (ICU/IMCUs). We estimated excess surgical mortality potentially attributable to ICU/IMCUs overwhelmed by COVID-19, and any hospital learning effects between two successive pandemic waves. METHODS This nationwide observational study included all patients without COVID-19 who underwent surgery in France from 01/01/2019 to 31/12/2020. We determined pandemic exposure of each operated patient based on the daily proportion of COVID-19 patients among all patients treated within the ICU/IMCU beds of the same hospital during his/her stay. Multilevel models, with an embedded triple-difference analysis, estimated standardized in-hospital mortality and compared mortality between years, pandemic exposure groups, and semesters, distinguishing deaths inside or outside the ICU/IMCUs. RESULTS Of 1,870,515 non-COVID-19 patients admitted for surgery in 655 hospitals, 2% died. Compared to 2019, standardized mortality increased by 1% (95% CI 0.6-1.4%) and 0.4% (0-1%) during the first and second semesters of 2020, among patients operated in hospitals highly exposed to pandemic. Compared to the low-or-no exposure group, this corresponded to a higher risk of death during the first semester (adjusted ratio of odds-ratios 1.56, 95% CI 1.34-1.81) both inside (1.27, 1.02-1.58) and outside the ICU/IMCU (1.98, 1.57-2.5), with a significant learning effect during the second semester compared to the first (0.76, 0.58-0.99). CONCLUSION Significant excess mortality essentially occurred outside of the ICU/IMCU, suggesting that access of surgical patients to critical care was limited.
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Ageel M, Shbeer A. Assessment of the Critical Care Work Environment of Intensive Care Unit Nurses in Saudi Arabia. Risk Manag Healthc Policy 2022; 15:2413-2420. [PMID: 36582743 PMCID: PMC9793786 DOI: 10.2147/rmhp.s391698] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Accepted: 12/16/2022] [Indexed: 12/24/2022] Open
Abstract
Background Nurses play a major role in the delivery of complex and challenging critical care in intensive care units (ICUs). Assessment of work environment is essential indicators of hospital management and can be applied to workforce planning and identifying nursing profession needs. The American Association of Critical-Care Nurses (AACN) recognized six standards for a healthy work environment and developed the Healthy Work Environment Assessment Tool (HWEAT). The aim of this study was to assess the work environment of ICU nurses in Jazan, Saudi Arabia. Methods This cross-sectional study was conducted at public and private hospitals. Data were collected using a self-administered questionnaire that included the sociodemographic characteristics and the AACN HWEAT. Data were analyzed to obtain descriptive and inferential statistics. The Mann-Whitney U and Kruskal-Wallis tests were employed to compare demographic data, on the basis of the overall mean HWEAT score. Results The study participants were 238 ICU nurses, who were predominantly female (83%). The mean overall HWEAT score was 3.55±1.03, which is within the "good" range, and was higher for male nurses (3.66), nurses aged ≥41 years (3.76), and nurses with postgraduate education (4.04), work experiences of >10 years (3.63), and alternate work shifts (3.6). Nurses in private hospitals had significantly higher overall scores than nurses in public hospitals (3.83 vs 3.19, P<0.001). All HWEAT standards ("effective decision-making", "authentic leadership", "appropriate staffing", "true collaboration", "skilled communication", and "meaningful recognition") were rated as good (mean range, 3.43-3.63). Conclusion The study results could assist hospitals in prioritizing the adoption of AACN HWE standards. A target benchmark of "good" was established for both the overall score and each standard, which indicates a good work environment as perceived by ICU nurses. In Addition, interpersonal differences should be considered when developing improvement initiatives.
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Affiliation(s)
- Mohammed Ageel
- College of Medicine, Jazan University, Jazan, Saudi Arabia,Correspondence: Mohammed Ageel, College of Medicine, Jazan University, Jazan, Saudi Arabia, Tel +966505769570, Email
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