Background: Studies suggest that nursing staff during pandemics such as H1N1 Influenza and COVID-19 exhibit higher than usual stress levels due to an increasingly overburdened healthcare system and increasing infection rates. This study aims to investigate the major stressors and coping strategies reported by nurses working directly with potentially infectious patients in Alabama, United States, during the COVID-19 pandemic. Materials and Methods: A cross-sectional questionnaire study was conducted with nursing staff working in hospital settings in the state. The questionnaire was completed by 109 nurses working in hospitals that treated COVID-19 patients. Results: Around 71% of the nursing staff were concerned about receiving more COVID-19 patients and exhibited heightened workload-related stress resulting from taking care of infected patients. The study found that most nurses (82%) are stressed about getting their friends and family infected. Overall, younger, less experienced nurses reported more stress levels compared to older, senior-level nurses. Findings suggest that many nurses fail to perceive protective measures as an effective coping strategy, with only 75% reporting problem-solving strategies such as hand washing and wearing a face mask, and only 60% avoiding public transportation and crowded spaces. Findings also suggest a lack of organizational support including psychiatric assistance, with no nurses reportedly seeking psychological therapy. Conclusion:The COVID-19 pandemic increased the stress level of the nursing staff in Alabama. The study finds that the cases in the state of AL are still increasing dramatically, which can overwhelme the healthcare system and escalate nurse stress levels.

Introduction: Current research about frontline nurse stress and turnover intention lacks context related to rural communities' plight in providing organizational resources during the current COVID-19 pandemic. These implications have been particularly underexamined in the United States, whose regional differences may influence how frontline nurses perceive the access and utility of organizational resources. This study investigates if anxiety and stress while working during the current COVID-19 pandemic contribute to frontline nurses' desire to leave their current position in Alabama hospital settings. Material and Methods: A cross-sectional survey was developed and distributed as a Qualtrics survey to frontline nurses using social media and professional contacts. A total of 111 frontline nurse respondents within May 19-June 12, 2020 were included in this study. Results: A significant correlation was found between gender (p= 0.002), marital status (p= 0.000) and seniority (p= 0.049) on turnover intention. A nurse's perceived anxiety and stress related to their patients' acuity (r= 0.257, p= 0.004), their personal health as a risk factor (r= 0.507, p= 0.000), their patient assignments (r= 0.239, p= 0.01), their personal protective equipment (r= 0.412, p= 0.000), and their psychological support (r= 0.316, p= 0.001) correspond to higher turnover intention among nurses working with patients infected with COVID-19. Conclusion: Perceived resource loss in task autonomy, PPE, and psychosocial support increased turnover intention among frontline nurses in Alabama. Research is needed to understand how intrinsic motivations and social support influence individual nurse staff's perceptions of resource loss and job demands. Further, more research is necessary to examine the implications of rurality and place in discussing turnover intention and organizational resources across multiple health systems.

Little research has been conducted to capture the perceptions of nursing home staff when using the call light system. There is also a lack of information regarding the effects that these perceptions of the call light system have on their workload, safety, quality of care, or overall satisfaction. In response to the high volume of complaints from residents and their families regarding long response times to call light alarms, we developed this exploratory cross-sectional survey study. This study aims to capture nursing home staff experiences while using a call light system; to investigate the challenges the staff face when using the system; and to determine how these challenges contribute to their workload, performance, and satisfaction. A survey instrument was developed and distributed to all 153 of the nursing staff, certified nursing assistants, and licensed practical nurses in a nursing home in upstate New York. A total of 105 completed surveys were retrieved for an overall response rate of 68.63%. Descriptive analysis, Pearson correlation, and the Kruskal-Wallis test were used to analyze the collected data. The results showed a significant correlation between the processes of being notified and locating call light alarms and workload. The staff reported many usability challenges that may contribute to longer response time such as lack of prioritization, low/no discriminability, noise, and overwrite previous alarm. In addition, 78% of the staff agreed that responding to a call light can prevent serious harm; however, 56% of the staff agreed that call light system is not meaningful; and around 78% think that call light system is disruptive in the environment and source for constant noise. The study finds that incorporating the insights provided by nursing home staff may improve the acceptance of new and existing technology, which ultimately improves the delivery of care through greater usability.

Most child-patients do not provide their own account of their healthcare experiences and are instead represented by their parents/legal guardians. A common belief is that children lack the perceptiveness, knowledge, experience, or maturity needed to answer questions on a complex subject such as their health and the care received while hospitalized. However, the literature suggests that children can provide valuable feedback about their experiences, which can differ from the perspective of their parent/guardian. The overall goal of this project is to 1. Determine whether child-patients perceive their healthcare experiences differently than their parents. 2. Identify the key domains whereby they differ. 3. Evaluate and explain the differences in perceived healthcare quality between child-patient and parent. 4. Develop innovative and engaging tools/instruments to obtain hospitalized children’s experience and meaningful feedback. This paper will describe the methodology, insights, and challenges of developing the tools and instruments aimed at understanding how children define their quality of care. A semi-structured, 10 question interview and multiple versions of a 45-question survey instrument was prepared to test recently hospitalized children (ages 4-17) and their parent/guardian along eight key domains. While the goal of the interview is to identify the key domains that reflect a child’s measures of quality, the survey seeks to provide a comprehensive outlook at a pediatric patient’s experience from start to finish. Pilot testing showed that Cronbach alpha values were within the acceptable range (> 0.7), and younger children were consistently able to complete the interview and survey within 45-minute time. It was observed through the study that children have a unique awareness of their own experiences and can convey their thoughts if given the opportunity and were able to provide specific ideas for improvement.

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