Nurses’ strategies for overcoming barriers to fundamental nursing care in patients with COVID-19 caused by infection with the SARS-COV-2 virus: Results from the ‘COVID-NURSE’ survey

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

doi:10.1111/jan.15261

Nurses’ strategies for overcoming barriers to fundamental nursing care in patients with COVID-19 caused by infection with the SARS-COV-2 virus: Results from the ‘COVID-NURSE’ survey

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

Aims: To identify strategies used by registered nurses and non-registered nursing care staff in overcoming barriers when providing fundamental nursing care for non-invasively ventilated inpatients with COVID-19.

Design: Online survey with open-ended questions to collect qualitative data.

Methods: In August 2020, we asked UK-based nursing staff to describe any strategies they employed to overcome barriers to delivering care in 15 fundamental nursing care categories when providing care to non-invasively ventilated patients with COVID-19. We analysed data using Framework Analysis.

Results: A total of 1062 nurses consented to participate in our survey. We derived four themes. 1) Communication behaviours included adapting verbal and non-verbal communication with patients, using information technology to enable patients’ significant others to communicate with staff and patients, and establishing clear information-sharing methods with other staff. 2) Organizing care required clustering interventions, carefully managing supplies, encouraging patient self-care and using ‘runners’ and interdisciplinary input. 3) Addressing patients’ well-being and values required spending time with patients, acting in loco familiae, providing access to psychological and spiritual support, obtaining information about patients’ wishes early on and providing privacy and comforting/meaningful items. 4) Management and leadership behaviours included training, timely provision of pandemic information, psychological support, team huddles and facilitating regular breaks.

Conclusions: Our respondents identified multiple strategies in four main areas of clinical practice. Management and leadership are crucial to both fundamental care delivery and the well-being of nurses during pandemics. Grouping strategies into these areas of action may assist nurses and leaders to prepare for pandemic nursing. Impact: As these strategies are unlikely to be exclusive to the COVID-19 pandemic, their global dissemination may improve patient experience and help nurses deliver fundamental care when planning pandemic nursing. However, their effectiveness is unknown. Therefore, we are currently evaluating these strategies in a cluster randomized controlled trial.

Original language	English
Pages (from-to)	1003-1017
Number of pages	15
Journal	Journal of Advanced Nursing
Volume	79
Issue number	3
Early online date	25 Apr 2022
DOIs	https://doi.org/10.1111/jan.15261
Publication status	Published - Mar 2023

Bibliographical note

Funding Information:
This work is funded by the National Institute for Health and Research (NIHR) and United Kingdom Research and Innovation (UKRI), administered by the Medical Research Council (grant no. MR/V02776X/1). 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 NIHR or the United Kingdom 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 and nor in writing this manuscript or in the decision to submit the manuscript for publication.

Publisher Copyright:
© 2022 The Authors. Journal of Advanced Nursing published by John Wiley & Sons Ltd.

Keywords

COVID-19
fundamental nursing care
nurses
nursing interventions
qualitative
SARS-CoV-2
survey

ASJC Scopus subject areas

General Nursing

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Cite this

Sugg, H. V. R., Richards, D. A., Russell, A. M., Burnett, S., Cockcroft, E. J., Thompson Coon, J., Cruickshank, S., Doris, F. E., Hunt, H. A., Iles-Smith, H., Kent, M., Logan, P. A., Morgan, LM., Morley, N., Rafferty, A. M., Shepherd, M. H., Singh, S. J., Tooze, S. J., & Whear, R. (2023). Nurses’ strategies for overcoming barriers to fundamental nursing care in patients with COVID-19 caused by infection with the SARS-COV-2 virus: Results from the ‘COVID-NURSE’ survey. Journal of Advanced Nursing, 79(3), 1003-1017. https://doi.org/10.1111/jan.15261

@article{d8fabd37251f4777af7f8ec33b344f38,

title = "Nurses{\textquoteright} strategies for overcoming barriers to fundamental nursing care in patients with COVID-19 caused by infection with the SARS-COV-2 virus: Results from the {\textquoteleft}COVID-NURSE{\textquoteright} survey",

abstract = "Aims: To identify strategies used by registered nurses and non-registered nursing care staff in overcoming barriers when providing fundamental nursing care for non-invasively ventilated inpatients with COVID-19. Design: Online survey with open-ended questions to collect qualitative data. Methods: In August 2020, we asked UK-based nursing staff to describe any strategies they employed to overcome barriers to delivering care in 15 fundamental nursing care categories when providing care to non-invasively ventilated patients with COVID-19. We analysed data using Framework Analysis. Results: A total of 1062 nurses consented to participate in our survey. We derived four themes. 1) Communication behaviours included adapting verbal and non-verbal communication with patients, using information technology to enable patients{\textquoteright} significant others to communicate with staff and patients, and establishing clear information-sharing methods with other staff. 2) Organizing care required clustering interventions, carefully managing supplies, encouraging patient self-care and using {\textquoteleft}runners{\textquoteright} and interdisciplinary input. 3) Addressing patients{\textquoteright} well-being and values required spending time with patients, acting in loco familiae, providing access to psychological and spiritual support, obtaining information about patients{\textquoteright} wishes early on and providing privacy and comforting/meaningful items. 4) Management and leadership behaviours included training, timely provision of pandemic information, psychological support, team huddles and facilitating regular breaks. Conclusions: Our respondents identified multiple strategies in four main areas of clinical practice. Management and leadership are crucial to both fundamental care delivery and the well-being of nurses during pandemics. Grouping strategies into these areas of action may assist nurses and leaders to prepare for pandemic nursing. Impact: As these strategies are unlikely to be exclusive to the COVID-19 pandemic, their global dissemination may improve patient experience and help nurses deliver fundamental care when planning pandemic nursing. However, their effectiveness is unknown. Therefore, we are currently evaluating these strategies in a cluster randomized controlled trial.",

keywords = "COVID-19, fundamental nursing care, nurses, nursing interventions, qualitative, SARS-CoV-2, survey",

author = "Sugg, {Holly V. R.} and Richards, {David A.} and Russell, {Anne Marie} and Sarah Burnett and Cockcroft, {Emma J} and {Thompson Coon}, Jo and Susanne Cruickshank and Doris, {Faye E.} and Hunt, {Harriet A.} and Heather Iles-Smith and Merryn Kent and Logan, {Philippa A.} and Leila M Morgan and Naomi Morley 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 funded by the National Institute for Health and Research (NIHR) and United Kingdom Research and Innovation (UKRI), administered by the Medical Research Council (grant no. MR/V02776X/1). 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 NIHR or the United Kingdom 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 and nor in writing this manuscript or in the decision to submit the manuscript for publication. Publisher Copyright: {\textcopyright} 2022 The Authors. Journal of Advanced Nursing published by John Wiley & Sons Ltd.",

year = "2023",

month = mar,

doi = "10.1111/jan.15261",

language = "English",

volume = "79",

pages = "1003--1017",

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Sugg, HVR, Richards, DA, Russell, AM, Burnett, S, Cockcroft, EJ, Thompson Coon, J, Cruickshank, S, Doris, FE, Hunt, HA, Iles-Smith, H, Kent, M, Logan, PA, Morgan, LM, Morley, N, Rafferty, AM, Shepherd, MH, Singh, SJ, Tooze, SJ & Whear, R 2023, 'Nurses’ strategies for overcoming barriers to fundamental nursing care in patients with COVID-19 caused by infection with the SARS-COV-2 virus: Results from the ‘COVID-NURSE’ survey', Journal of Advanced Nursing, vol. 79, no. 3, pp. 1003-1017. https://doi.org/10.1111/jan.15261

Nurses’ strategies for overcoming barriers to fundamental nursing care in patients with COVID-19 caused by infection with the SARS-COV-2 virus: Results from the ‘COVID-NURSE’ survey. / Sugg, Holly V. R.; Richards, David A.; Russell, Anne Marie et al.
In: Journal of Advanced Nursing, Vol. 79, No. 3, 03.2023, p. 1003-1017.

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

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T2 - Results from the ‘COVID-NURSE’ survey

AU - Sugg, Holly V. R.

AU - Richards, David A.

AU - Russell, Anne Marie

AU - Burnett, Sarah

AU - Cockcroft, Emma J

AU - Thompson Coon, Jo

AU - Cruickshank, Susanne

AU - Doris, Faye E.

AU - Hunt, Harriet A.

AU - Iles-Smith, Heather

AU - Kent, Merryn

AU - Logan, Philippa A.

AU - Morgan, Leila M

AU - Morley, Naomi

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 funded by the National Institute for Health and Research (NIHR) and United Kingdom Research and Innovation (UKRI), administered by the Medical Research Council (grant no. MR/V02776X/1). 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 NIHR or the United Kingdom 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 and nor in writing this manuscript or in the decision to submit the manuscript for publication. Publisher Copyright: © 2022 The Authors. Journal of Advanced Nursing published by John Wiley & Sons Ltd.

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N2 - Aims: To identify strategies used by registered nurses and non-registered nursing care staff in overcoming barriers when providing fundamental nursing care for non-invasively ventilated inpatients with COVID-19. Design: Online survey with open-ended questions to collect qualitative data. Methods: In August 2020, we asked UK-based nursing staff to describe any strategies they employed to overcome barriers to delivering care in 15 fundamental nursing care categories when providing care to non-invasively ventilated patients with COVID-19. We analysed data using Framework Analysis. Results: A total of 1062 nurses consented to participate in our survey. We derived four themes. 1) Communication behaviours included adapting verbal and non-verbal communication with patients, using information technology to enable patients’ significant others to communicate with staff and patients, and establishing clear information-sharing methods with other staff. 2) Organizing care required clustering interventions, carefully managing supplies, encouraging patient self-care and using ‘runners’ and interdisciplinary input. 3) Addressing patients’ well-being and values required spending time with patients, acting in loco familiae, providing access to psychological and spiritual support, obtaining information about patients’ wishes early on and providing privacy and comforting/meaningful items. 4) Management and leadership behaviours included training, timely provision of pandemic information, psychological support, team huddles and facilitating regular breaks. Conclusions: Our respondents identified multiple strategies in four main areas of clinical practice. Management and leadership are crucial to both fundamental care delivery and the well-being of nurses during pandemics. Grouping strategies into these areas of action may assist nurses and leaders to prepare for pandemic nursing. Impact: As these strategies are unlikely to be exclusive to the COVID-19 pandemic, their global dissemination may improve patient experience and help nurses deliver fundamental care when planning pandemic nursing. However, their effectiveness is unknown. Therefore, we are currently evaluating these strategies in a cluster randomized controlled trial.

AB - Aims: To identify strategies used by registered nurses and non-registered nursing care staff in overcoming barriers when providing fundamental nursing care for non-invasively ventilated inpatients with COVID-19. Design: Online survey with open-ended questions to collect qualitative data. Methods: In August 2020, we asked UK-based nursing staff to describe any strategies they employed to overcome barriers to delivering care in 15 fundamental nursing care categories when providing care to non-invasively ventilated patients with COVID-19. We analysed data using Framework Analysis. Results: A total of 1062 nurses consented to participate in our survey. We derived four themes. 1) Communication behaviours included adapting verbal and non-verbal communication with patients, using information technology to enable patients’ significant others to communicate with staff and patients, and establishing clear information-sharing methods with other staff. 2) Organizing care required clustering interventions, carefully managing supplies, encouraging patient self-care and using ‘runners’ and interdisciplinary input. 3) Addressing patients’ well-being and values required spending time with patients, acting in loco familiae, providing access to psychological and spiritual support, obtaining information about patients’ wishes early on and providing privacy and comforting/meaningful items. 4) Management and leadership behaviours included training, timely provision of pandemic information, psychological support, team huddles and facilitating regular breaks. Conclusions: Our respondents identified multiple strategies in four main areas of clinical practice. Management and leadership are crucial to both fundamental care delivery and the well-being of nurses during pandemics. Grouping strategies into these areas of action may assist nurses and leaders to prepare for pandemic nursing. Impact: As these strategies are unlikely to be exclusive to the COVID-19 pandemic, their global dissemination may improve patient experience and help nurses deliver fundamental care when planning pandemic nursing. However, their effectiveness is unknown. Therefore, we are currently evaluating these strategies in a cluster randomized controlled trial.

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