Bridging the gap between guidelines and practice in the management of emerging infectious diseases: a qualitative study of emergency nurses

International Journal of Qualitative Studies on Health and Well

et al. 2020

2020) Emergency nurses' perceptions regarding the risks appraisal of the threat of the emerging infectious disease situation in emergency departments, ABSTRACT Purpose: Emerging infectious diseases are considered as a pressing challenge to global public health. Throughout public health response to emerging infectious diseases, emergency nurses are situated at the forefront of the healthcare system. The present study has explored emergency nurses' perceptions regarding the risks appraisal of the threat of the emerging infectious disease situation in emergency department context. Methods: The present study used a qualitative descriptive approach. A purposive sampling method was employed to recruit emergency nurses who worked in public hospitals in Hong Kong. Semi-structured interviews were conducted to 24 emergency nurses. The data were interpreted using a thematic analysis strategy. Results: Five overarching themes emerged from the data: (1) the novelty of an emerging infectious disease, (2) the severity of an emerging infectious disease, (3) the proximity to an emerging infectious disease, (4) the complexity of an emerging infectious disease situation, and (5) the response levels towards an emerging infectious disease situation. Conclusion: It is anticipated that the information may help to predict the attitudes and behaviours of emergency nurses in future impending epidemic events, enhancing emergency nurses' preparedness towards in such situations.

Section: Introductionmentioning

confidence: 99%

Emergency nurses’ perceptions regarding the risks appraisal of the threat of the emerging infectious disease situation in emergency departments

International Journal of Qualitative Studies on Health and Well

et al. 2020

“…They have been shown to be non-compliant with guidelines and protocols intended to prevent the spread of EIDs, such as adherence to hand hygiene practices (Muller, Carter, Siddiqui, & Larson, 2015) and personal protective equipment (PPE) usage (Baduge, Moss, & Morphet, 2017). Studies have revealed that limitations in time and resources were the major cause of non-compliance with recommended practices (Lam, Kwong, Hung, & Pang, 2016;Muller et al, 2015). Interestingly, it has also been reported that the issue of emergency nurses' non-compliance with guidelines could still occur, regardless of the availability of sufficient resources (Lam & Hung, 2013).…”

Section: Introductionmentioning

confidence: 99%

“…Understanding emergency nurses' experiences and perceptions of disease management during epidemic events might help identify and address the barriers to their involvement in EID management. The goal of this study was to identify and explore the contextual factors that inhibited the ability of emergency nurses to perform outbreak-response-related duties according to established protocols (Lam, Kwong, Hung, & Pang, 2016;Muller et al, 2015).…”

Section: Introductionmentioning

confidence: 99%

A qualitative descriptive study of the contextual factors influencing the practice of emergency nurses in managing emerging infectious diseases

International Journal of Qualitative Studies on Health and Well

et al. 2019

Purpose : Emergency nurses are engaged in the management of epidemic events that unfold along with the evolution of diseases. The goal of this study was to explore the contextual factors that inhibited the ability of emergency nurses to perform their duties in response to an outbreak. Methods : A qualitative descriptive design was used to explore the experiences and perceptions of emergency nurses. Participants were purposively recruited from 12 emergency departments in Hong Kong. Semi-structured face-to-face individual interviews were conducted with 26 emergency nurses. The audio-recorded interviews were transcribed verbatim and interpreted with a thematic analysis approach. Results : Four intertwined themes emerged from the analysis: resource constraints, threats of infection, ubiquitous changes and lingering uncertainties. These themes portrayed the constraints and challenges surrounding the work environment of emergency nurses. Conclusion : This study described the instabilities and vulnerabilities of the circumstances in which the emergency nurses were situated in during epidemic events. The findings shed light on the importance of hospitals and emergency departments in addressing both the technical problems and adaptive challenges that face emergency nurses during epidemic events.

“…This uncertainty increases the risk of exposure to frontline emergency nurses compared with that of other healthcare professionals during an epidemic event [7]. In addition to the occupational risks associated with EIDs, a well-reported challenge encountered by emergency nurses is adapting to the changes in the existing guidelines and recommendations for addressing a particular EID [8][9][10]. Studies have highlighted that emergency nurses are required to frequently and rapidly adjust their practice in accordance with amendments to infection control guidelines, even if such amendments are subtle and/or implicit [8,9].…”

Section: Introductionmentioning

confidence: 99%

“…In addition to the occupational risks associated with EIDs, a well-reported challenge encountered by emergency nurses is adapting to the changes in the existing guidelines and recommendations for addressing a particular EID [8][9][10]. Studies have highlighted that emergency nurses are required to frequently and rapidly adjust their practice in accordance with amendments to infection control guidelines, even if such amendments are subtle and/or implicit [8,9]. The literature suggests that the antecedents of these challenges could be consequential to the uncertainty and changes experienced by emergency nurses in the workplace during an outbreak: changes and uncertainty within the work environment thus seem to be major and primary barriers to the emergency nursing practice [10].…”

Section: Introductionmentioning

confidence: 99%

Investigating the Strategies Adopted by Emergency Nurses to Address Uncertainty and Change in the Event of Emerging Infectious Diseases: A Grounded Theory Study

et al. 2020

IJERPH

Emergency nurses frequently encounter uncertainty and changes during the management of emerging infectious diseases, which challenge their capability to perform their duties in a well-planned and systematic manner. To date, little is known about the coping strategies adopted by emergency nurses in addressing uncertainty and changes during an epidemic event. The present study explored emergency nurses' behaviours and strategies in handling uncertainty and practice changes during an epidemic event. A qualitative study based on the Straussian grounded theory approach was established. Semi-structured, face-to-face, individual interviews were conducted with 26 emergency nurses for data collection. Adapting protocol to the evolving context of practice was revealed as the core category. Four interplaying subcategories were identified: (1) Completing a comprehensive assessment, (2) continuing education for emerging infectious disease management, (3) incorporating guideline updates and (4) navigating new duties and competencies. The nurses demonstrated the prudence to orientate themselves to an ambiguous work situation and displayed the ability to adapt and embrace changes in their practice and duties. These findings offer insights into the need for education and training schemes that allow emergency nurses to acquire and develop the necessary decision-making and problem-solving skills to handle a public health emergency.