KITE, Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada.
Lawrence S. Bloomberg, Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada.
Gerontologist. 2021 Jun 2;61(4):615-623. doi: 10.1093/geront/gnab030.
There is an urgency to respond to the longstanding deficiencies in health human resources in the long-term care (LTC) home sector, which have been laid bare by the coronavirus disease 2019 (COVID-19) pandemic. Nurse practitioners (NPs) represent an efficient solution to human resource challenges. During the current pandemic, many Medical Directors in LTC homes worked virtually to reduce the risk of transmission. In contrast, NPs were present for in-person care. This study aims to understand the NPs' roles in optimizing resident care and supporting LTC staff during the pandemic.
This exploratory qualitative study employed a phenomenological approach. A purposive sample of 14 NPs working in LTC homes in Ontario, Canada, was recruited. Data were generated using semistructured interviews and examined using thematic analysis.
Four categories relating to the NPs' practices and experiences during the pandemic were identified: (a) containing the spread of COVID-19, (b) stepping in where needed, (c) supporting staff and families, and (d) establishing links between fragmented systems of care by acting as a liaison.
The findings suggest that innovative models of care that include NPs in LTC homes are required moving forward. NPs embraced a multitude of roles in LTC homes, but the need to mitigate the spread of COVID-19 was central to how they prioritized their days. The pandemic clearly accentuated that NPs have a unique scope of practice, which positions them well to act as leaders and build capacity in LTC homes.
长期护理(LTC)院长期存在卫生人力资源不足的问题,在 2019 年冠状病毒病(COVID-19)大流行期间暴露无遗。护士从业者(NPs)是解决人力资源挑战的有效方法。在当前的大流行期间,许多 LTC 院的医疗主任都远程工作以降低传播风险。相比之下,NPs 则提供现场护理。本研究旨在了解 NPs 在优化居民护理和在大流行期间支持 LTC 工作人员方面的作用。
本探索性定性研究采用现象学方法。在加拿大安大略省的 LTC 院招募了 14 名从事 LTC 工作的 NPs 作为目的抽样。使用半结构式访谈生成数据,并使用主题分析进行检查。
确定了与 NPs 在大流行期间的实践和经验相关的四个类别:(a)控制 COVID-19 的传播,(b)在需要时介入,(c)支持员工和家庭,以及(d)通过充当联络人在零碎的护理系统之间建立联系。
研究结果表明,需要在 LTC 院中采用包括 NPs 在内的创新护理模式。NPs 在 LTC 院中承担了多种角色,但减轻 COVID-19 的传播是他们确定日常工作重点的核心。大流行清楚地表明,NPs 具有独特的实践范围,使他们能够在 LTC 院担任领导并建立能力。