PDF(Pubmed)
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.
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.
摘要：
背景：患者护理体验与安全性相关，护理质量，治疗结果，成本和服务使用。有效的护理包括满足患者的基本身体，关系和心理社会需求，这可能会受到SARS-CoV-2的挑战。对于SARS-CoV-2患者，尚无循证护理指南。我们报告制定这样一个指导方针的工作。我们的目的是确定护理人员对SARS-CoV-2（非侵入性通气）住院患者的必要护理的观点和经验，这些患者被遗漏或延迟（错过护理）以及任何障碍。
方法：我们根据《护理基础框架》进行了在线混合方法调查。我们招募了英国护理人员的便利样本，这些护理人员对SARS-CoV-2住院患者进行了非侵入性通气护理。我们要求受访者评估他们能够满足SARS-CoV-2患者的需求，与非SARS-CoV-2患者相比，在15个护理类别中；从护理障碍列表中进行选择；并描述错过护理和护理障碍的示例。我们使用框架分析对定量数据进行了描述性和定性数据的分析，在并排比较表中集成数据。
结果：在1062名受访者中，大多数评级的流动性，说话和倾听，非语言交流，与重要的其他人沟通，SARS-CoV-2患者的情绪状况更糟。在三个护理领域中的至少一个中，有八个障碍排在前五名之内。这些是（按等级顺序）：穿戴个人防护装备，患者病情的严重程度，无法在不穿戴和脱下个人防护设备的情况下将物品进出隔离室，没有时间和病人在一起，缺乏专业服务的存在，例如物理治疗师，缺乏关于SARS-CoV-2的知识，库存不足，由于害怕感染SARS-CoV-2而不愿与患者在一起。
结论：我们的受访者确定了SARS-CoV-2患者可能错过的护理领域，以及提供护理的障碍。我们目前正在评估解决这些障碍的护理策略指南，这不太可能是这场大流行或我们的受访者所代表的环境所独有的。我们的结果应该是,因此,纳入全球大流行规划。
方法：我们根据《护理基础框架》进行了在线混合方法调查。我们招募了英国护理人员的便利样本，这些护理人员对SARS-CoV-2住院患者进行了非侵入性通气护理。我们要求受访者评估他们能够满足SARS-CoV-2患者的需求，与非SARS-CoV-2患者相比，在15个护理类别中；从护理障碍列表中进行选择；并描述错过护理和护理障碍的示例。我们使用框架分析对定量数据进行了描述性和定性数据的分析，在并排比较表中集成数据。
结果：在1062名受访者中，大多数评级的流动性，说话和倾听，非语言交流，与重要的其他人沟通，SARS-CoV-2患者的情绪状况更糟。在三个护理领域中的至少一个中，有八个障碍排在前五名之内。这些是（按等级顺序）：穿戴个人防护装备，患者病情的严重程度，无法在不穿戴和脱下个人防护设备的情况下将物品进出隔离室，没有时间和病人在一起，缺乏专业服务的存在，例如物理治疗师，缺乏关于SARS-CoV-2的知识，库存不足，由于害怕感染SARS-CoV-2而不愿与患者在一起。
结论：我们的受访者确定了SARS-CoV-2患者可能错过的护理领域，以及提供护理的障碍。我们目前正在评估解决这些障碍的护理策略指南，这不太可能是这场大流行或我们的受访者所代表的环境所独有的。我们的结果应该是,因此,纳入全球大流行规划。
