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

Holly V.R. Sugg; Anne Marie Russell; Leila M. Morgan; Heather Iles-Smith; David A. Richards; Naomi Morley; Sarah Burnett; Emma J. Cockcroft; Jo Thompson Coon; Susanne Cruickshank; Faye E. Doris; Harriet A. Hunt; Merryn Kent; Philippa A. Logan; Anne Marie Rafferty; Maggie H. Shepherd; Sally J. Singh; Susannah J. Tooze; Rebecca Whear

doi:10.1186/s12912-021-00746-5

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

Holly V.R. Sugg^*, Anne Marie Russell, Leila M. Morgan, Heather Iles-Smith, David A. Richards, Naomi Morley, Sarah Burnett, Emma J. Cockcroft, Jo Thompson Coon, Susanne Cruickshank, Faye E. Doris, Harriet A. Hunt, Merryn Kent, Philippa A. Logan, Anne Marie Rafferty, Maggie H. Shepherd, Sally J. Singh, Susannah J. Tooze, Rebecca Whear

^*Corresponding author for this work

Nursing and Midwifery

Research output: Contribution to journal › Article › peer-review

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Abstract

Background: Patient 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.

Methods: We 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.

Results: Of 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.

Conclusions: Our 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.

Original language	English
Article number	215
Number of pages	17
Journal	BMC Nursing
Volume	20
Issue number	1
Early online date	1 Nov 2021
DOIs	https://doi.org/10.1186/s12912-021-00746-5
Publication status	Published - Dec 2021

Bibliographical note

Funding Information:
This work is supported by the NIHR and UK Research and Innovation, administered by the MRC: grant number MR/V02776X/1. The Trial Sponsor is the University of Exeter, ref.: 1920/ Research Ethics and Governance Office, Lafrowda House, St Germans Road, Exeter, Devon, EX4 6TL. The work is also supported by the NIHR Applied Research Collaboration South West Peninsula. The views expressed in this publication are those of the authors and not necessarily those of the National Institute for Health Research or the Department of Health and Social Care. The sponsor and funding sources have had no role in the design of this study, nor during the collection, analysis, and interpretation of data, nor in writing this manuscript.

Publisher Copyright:
© 2021, The Author(s).

Keywords

COVID-19
Fundamental nursing care
Missed care
Mixed methods
SARS-CoV-2
Survey

ASJC Scopus subject areas

General Nursing

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Cite this

Sugg, H. V. R., Russell, A. M., Morgan, L. M., Iles-Smith, H., Richards, D. A., Morley, N., Burnett, S., Cockcroft, E. J., Thompson Coon, J., Cruickshank, S., Doris, F. E., Hunt, H. A., Kent, M., Logan, P. A., Rafferty, A. M., Shepherd, M. H., Singh, S. J., Tooze, S. J., & Whear, R. (2021). 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, 20(1), Article 215. https://doi.org/10.1186/s12912-021-00746-5

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title = "Fundamental nursing care in patients with the SARS-CoV-2 virus: results from the {\textquoteleft}COVID-NURSE{\textquoteright} mixed methods survey into nurses{\textquoteright} experiences of missed care and barriers to care",

abstract = "Background: Patient experience of nursing care is associated with safety, care quality, treatment outcomes, costs and service use. Effective nursing care includes meeting patients{\textquoteright} 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. Methods: We 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. Results: Of 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{\textquoteright} 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. Conclusions: Our 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.",

keywords = "COVID-19, Fundamental nursing care, Missed care, Mixed methods, SARS-CoV-2, Survey",

author = "Sugg, {Holly V.R.} and Russell, {Anne Marie} and Morgan, {Leila M.} and Heather Iles-Smith and Richards, {David A.} and Naomi Morley and Sarah Burnett and Cockcroft, {Emma J.} and {Thompson Coon}, Jo and Susanne Cruickshank and Doris, {Faye E.} and Hunt, {Harriet A.} and Merryn Kent and Logan, {Philippa A.} and Rafferty, {Anne Marie} and Shepherd, {Maggie H.} and Singh, {Sally J.} and Tooze, {Susannah J.} and Rebecca Whear",

note = "Funding Information: This work is supported by the NIHR and UK Research and Innovation, administered by the MRC: grant number MR/V02776X/1. The Trial Sponsor is the University of Exeter, ref.: 1920/ Research Ethics and Governance Office, Lafrowda House, St Germans Road, Exeter, Devon, EX4 6TL. The work is also supported by the NIHR Applied Research Collaboration South West Peninsula. The views expressed in this publication are those of the authors and not necessarily those of the National Institute for Health Research or the Department of Health and Social Care. The sponsor and funding sources have had no role in the design of this study, nor during the collection, analysis, and interpretation of data, nor in writing this manuscript. Publisher Copyright: {\textcopyright} 2021, The Author(s).",

year = "2021",

month = dec,

doi = "10.1186/s12912-021-00746-5",

language = "English",

volume = "20",

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Sugg, HVR, Russell, AM, Morgan, LM, Iles-Smith, H, Richards, DA, Morley, N, Burnett, S, Cockcroft, EJ, Thompson Coon, J, Cruickshank, S, Doris, FE, Hunt, HA, Kent, M, Logan, PA, Rafferty, AM, Shepherd, MH, Singh, SJ, Tooze, SJ & Whear, R 2021, '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, vol. 20, no. 1, 215. https://doi.org/10.1186/s12912-021-00746-5

TY - JOUR

T1 - Fundamental nursing care in patients with the SARS-CoV-2 virus

T2 - results from the ‘COVID-NURSE’ mixed methods survey into nurses’ experiences of missed care and barriers to care

AU - Sugg, Holly V.R.

AU - Russell, Anne Marie

AU - Morgan, Leila M.

AU - Iles-Smith, Heather

AU - Richards, David A.

AU - Morley, Naomi

AU - Burnett, Sarah

AU - Cockcroft, Emma J.

AU - Thompson Coon, Jo

AU - Cruickshank, Susanne

AU - Doris, Faye E.

AU - Hunt, Harriet A.

AU - Kent, Merryn

AU - Logan, Philippa A.

AU - Rafferty, Anne Marie

AU - Shepherd, Maggie H.

AU - Singh, Sally J.

AU - Tooze, Susannah J.

AU - Whear, Rebecca

N1 - Funding Information: This work is supported by the NIHR and UK Research and Innovation, administered by the MRC: grant number MR/V02776X/1. The Trial Sponsor is the University of Exeter, ref.: 1920/ Research Ethics and Governance Office, Lafrowda House, St Germans Road, Exeter, Devon, EX4 6TL. The work is also supported by the NIHR Applied Research Collaboration South West Peninsula. The views expressed in this publication are those of the authors and not necessarily those of the National Institute for Health Research or the Department of Health and Social Care. The sponsor and funding sources have had no role in the design of this study, nor during the collection, analysis, and interpretation of data, nor in writing this manuscript. Publisher Copyright: © 2021, The Author(s).

PY - 2021/12

Y1 - 2021/12

N2 - Background: Patient 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. Methods: We 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. Results: Of 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. Conclusions: Our 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.

AB - Background: Patient 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. Methods: We 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. Results: Of 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. Conclusions: Our 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.

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KW - Missed care

KW - Mixed methods

KW - SARS-CoV-2

KW - Survey

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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

Abstract

Bibliographical note

Keywords

ASJC Scopus subject areas

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