Documenting Response To COVID-Individual and Systems Successes and Challenges: A Longitudinal Qualitative Study

Abstract

Background This feasibility study aimed to assess the use of WhatsApp for qualitative data collection to document the evolution of perceptions of frontline healthcare workers (FHCW) regarding their wellbeing and the quality of health systems' response to the COVID-19 pandemic over four months. Methods This was a prospective longitudinal qualitative study conducted during the four months coinciding with the peak and trough of the first wave of the COVID-19 pandemic (June-September 2020). We approached frontline healthcare workers (physicians and nurses working in emergency departments) in two hospitals using the WhatsApp group of the Pakistan Society of Emergency Physicians (PSEM). We introduced the study and obtained consent using a google consent form. Each participant was asked to self-record their perception of their personal wellness and their level of satisfaction with the quality of their hospitals' response to the pandemic. Each participant sent their voice notes/audio-recording to a central WhatsApp number. We transcribed and analysed the recordings and identified themes and sub-themes, and the changes to these themes over six months. Results We invited approximately 200 FHCWs associated with PSEM to participate in the study. Of the 61 who agreed to participate, 27 completed the study. A total of 149 audio recordings were received and transcribed. Three themes and eight sub-themes have emerged from the data. The themes were individual-level challenges, health system-level challenges, and hope for the future. Sub-themes for individual-level challenges were: fear of getting or transmitting infection, financial stressors, stress due to turning away those patients who need care, anxiety due to the general public's lack of compliance with preventive measures, physical exhaustion, and fatigue. For the healthcare system, sub-themes were: issues with logistics and management of the hospital/healthcare system and lack of focus on providing air conditioning to address heat due to PPEs and sub-themes under hope for the future were the improved disease knowledge and vaccine development. Conclusion Despite a lower level of completion, our study identified possible use of a ubiquitously available mobile app to collect longitudinal real-time data from FHCWs during the initial period of the pandemic. The overall perceptions and experiences of FHCWs evolved from negative to positive as the curve of COVID-19 went down.

The construction and practice of a standardized nursing service system based on the designated hospital for the treatment of COVID-19 in China

“…The public health safety of China is facing a great challenge [3]. To address the problems caused by COVID-19, according to the disease characteristics of the new coronavirus pneumonia, setting up the local hospital as a designated hospital for centralized isolation and treatment has become an important and effective initiative [4,5]. However, at this stage, it is not possible to set up a hospital for the national COVID control program (NCCP), and there is no specific standard for the care service system of the designated hospital for NCCP, which cannot meet the current status of epidemic regularity.…”

“…The public health safety of China is facing a great challenge [3]. To address the problems caused by COVID-19, according to the disease characteristics of the new coronavirus pneumonia, setting up the local hospital as a designated hospital for centralized isolation and treatment has become an important and effective initiative [4,5]. However, at this stage, it is not possible to set up a hospital for the national COVID control program (NCCP), and there is no specific standard for the care service system of the designated hospital for NCCP, which cannot meet the current status of epidemic regularity.Therefore, this study aims to construct a standardized nursing service system in the designated hospitals for NCCP, to provide nursing standards and a theoretical basis for the designated hospitals.After reviewing the literature and consulting with experts from January to March 2021, the research team was established in April 2021, consisting of 12 members, including one expert in the field of standardization research, 2 chief nursing officers, one deputy chief nursing officer, 7 competent nursing officers, and one nurse practitioner.…”