Innovative Partnership Between Intensive Care Unit Nurses and Therapists to Care for Patients With COVID-19

Abstract

Background When patients with COVID-19 began presenting to hospitals in early 2020, medical professionals were unprepared to handle the severity of disease and the number of severely ill patients. Local Problem In response to critical needs of patients with COVID-19 and the threat of nurse burnout, a special operations team comprising physical and occupational therapists was convened to (1) provide help to intensive care unit nurses, (2) help therapists be productive, and (3) use therapists’ specialties for critical patients. Methods Two therapists teamed up each shift to work with every critical patient with COVID-19, performing numerous nursing and therapy activities. Activity frequency was documented by the therapists daily, and duration was estimated and data were summarized by nursing leadership. Results During the 9-week program, 35 critical patients with COVID-19 were included in the special operations program. During the program, the teams performed 10 activities, including prone positioning, turning, and mobilization, 1937 times with the patients with COVID-19. The partnership saved between 5 and 40 minutes of intensive care nurse time per activity, which resulted in a total of 677.2 hours of nursing time saved. Discussion Implementation of the special operations program had a positive impact on patients, nurses, and therapists. Patients benefited both clinically and socially from additional time with special operations teams. Nurses benefited from having help caring for critical patients, and therapists benefited from increased productivity during redeployment. Conclusion Deployment of nonnursing clinical staff could be an effective strategy to leverage available resources while maintaining clinical standards of care and reducing nursing burden during a pandemic or crisis surge.

The use of outcome measures and factors affecting use in adult social care occupational therapy services in the UK

“…The data collection phase (July 2021) occurred during the Covid-19 pandemic, but this was not cited by participants as a factor in reducing or supporting use of outcome measures. However, their use may have decreased during the acute response phases to the pandemic, as practice priorities by NHS and social care staff shifted from gathering data to supporting hospital colleagues in intensive care work (Reese et al , 2021), or moving medically well in-patients back into their community settings at pace. Increased use of outcome measures may now be evident as the pandemic no longer constitutes a global health emergency (World Health Organisation, 2023), but this topic would need further study.…”

“…Bowman (2006) found lack of knowledge was a barrier to outcome measure use in Australian hospital and community settings. Additionally, a multi-disciplinary frailty team in England (Coker et al, 2019) found barriers to use of the Clinical Frailty Scale (Rockwood et al, 2005), which included lack of knowledge, lack of consistency in scoring and a dislike of "pigeon holing" clients. Therapists need to balance time constraints to build knowledge and use outcome measures demonstrate the effectiveness of occupational therapy.…”

Implementation of Early Rehabilitation in Severe COVID-19 Respiratory Failure

“…SARS-CoV-2, the virus responsible for the syndrome COVID-19, has caused many paradigm shifts in health care and rehabilitation 1–3. The strains on the health care system during a pandemic characterized by an increased incidence of severe respiratory failure have meant that paradigm shifts are especially profound in the intensive care unit (ICU) 4,5. Patients with COVID-19 often experience respiratory failure but may have additional symptoms including anorexia, nausea and diarrhea, myocarditis, skeletal muscle myopathy, and generalized debility 6–14.…”

“…[1][2][3] The strains on the health care system during a pandemic characterized by an increased incidence of severe respiratory failure have meant that paradigm shifts are especially profound in the intensive care unit (ICU). 4,5 Patients with COVID-19 often experience respiratory failure but may have additional symptoms including anorexia, nausea and diarrhea, myocarditis, skeletal muscle myopathy, and generalized debility. [6][7][8][9][10][11][12][13][14] These patients are at risk of substantial deconditioning as they are confined to bed from systemic symptoms as well as profound hypoxemia.…”