Nursing Surge Capacity Strategies for Management of Critically Ill Adults with COVID-19

Abstract

Background: There is a vital need to develop strategies to improve nursing surge capacity for caring of patients with coronavirus (COVID-19) in critical care settings. COVID-19 has spread rapidly, affecting thousands of patients and hundreds of territories. Hospitals, through anticipation and planning, can serve patients and staff by developing strategies to cope with the complications that a surge of COVID-19 places on the provision of adequate intensive care unit (ICU) nursing staff—both in numbers and in training. Aims: The aim is to provide an evidence-based starting point from which to build expanding staffing models dealing with these additional demands. Design/Method: In order to address and develop nursing surge capacity strategies, a five-member expert panel was formed. Multiple questions directed towards nursing surge capacity strategies were posed by the assembled expert panel. Literature review was conducted through accessing various databases including MEDLINE, CINAHL, Cochrane Central, and EMBASE. All studies were appraised by at least two reviewers independently using the Joanna Briggs Institute JBI Critical Appraisal Tools. Results: The expert panel has issued strategies and recommendation statements. These proposals, supported by evidence-based resources in regard to nursing staff augmentation strategies, have had prior success when implemented during the COVID-19 pandemic. Conclusion: The proposed guidelines are intended to provide a basis for the provision of best practice nursing care during times of diminished intensive care unit (ICU) nursing staff capacity and resources due to a surge in critically ill patients. The recommendations and strategies issued are intended to specifically support critical care nurses incorporating COVID-19 patients. As new knowledge evidence becomes available, updates can be issued and strategies, guidelines and/or policies revised. Relevance to Clinical Practice: Through discussion and condensing research, healthcare professionals can create a starting point from which to synergistically develop strategies to combat crises that a pandemic like COVID-19 produces.

WITHDRAWN: Examining and Investigating the Impact of Demographic Characteristics and Chronic Disease with Mortality of COVID-19: Retrospective Study

“…The binary logistic regression analysis used in our study quantitatively suggests that the COVID-19 patients who have age > 50 years, who are males, or who have history of HTN and/or DM may have up to 9-fold increased chances of mortality than those patients who are young, who are females and are nondiabetic and normotensive. This is in line with the previous reports that suggest similar correlation between mortality and these factors(2,3,4,5,6,7).…”

Examining and investigating the impact of demographic characteristics and chronic diseases on mortality of COVID-19: Retrospective study

“…The binary logistic regression analysis used in our study quantitatively suggests that the COVID-19 patients who have age > 50 years, who are males, or who have history of HTN and/or DM may have up to 9-fold increased chances of mortality than those patients who are young, who are females and are non-diabetic and normotensive. This is in line with the previous reports that suggest similar correlation between mortality and these factors [11][12][13][14][15][16][17][18]. In a previously reported study conducted in Saudi Arabia HTN and type 2 Diabetes mellitus were the most comorbidities in both genders of all included patients accounting for 45.7% and 28.5% retrospectively [9] and this was expected as the present study deals with moderate to severe COVID-19 hospitalized patients.…”

Transparent teamwork: The practice of supervision and delegation within the multi‐tiered nursing team

“…As part of these strategies, skill mix and nurse staffing are manipulated to reduce costs and provide quality care to patients (Aiken et al, 2013; Jacob et al, 2015; NHHRC, 2009). Adding to this, the COVID 19 pandemic has placed further strain on the healthcare system resulting in the need to build surge workforce capacity to meet the needs of patients (Al Mutair et al, 2020; Marshall et al, 2020). Healthcare organisations have been required to reframe the delivery of patient care examining options to augment and extend the nursing and healthcare workforce.…”

“…Healthcare organisations have been required to reframe the delivery of patient care examining options to augment and extend the nursing and healthcare workforce. A common strategy is a tiered healthcare team approach to patient care delivery based on the idea of experienced staff supervising less experienced or lower trained staff members working together to meet the patients’ needs (Al Mutair et al, 2020; Marshall et al, 2020). This may occur in situations where tasks traditionally performed by one worker are shifted to another worker (APPG, 2016).…”

“…Prior to the pandemic, pressures on healthcare systems internationally had increased the reliance on the use of unregulated nursing assistant (NA) roles in the acute hospital setting (Aiken et al, 2016; Blay & Roche, 2020; Duffield et al, 2014; Kalisch, 2011). To meet pandemic surge workforce demands, healthcare teams may be additionally augmented with reassigned or redeployed staff with transferable skills, healthcare staff re‐entering the hospital workforce, final year students in nursing, medical and allied health courses and NA roles (Al Mutair et al, 2020). It is imperative when working in the multi‐skilled/ multi‐tiered nursing workforce environment that each team member is cognisant of their roles, responsibilities and capabilities and that appropriate delegation and supervision practices are in place to ensure the quality and safety of patient care.…”