Providence Health Care, University of British Columbia, Vancouver, Canada.
Providence Health Care, Vancouver, Canada.
Aust Crit Care. 2022 Jan;35(1):13-21. doi: 10.1016/j.aucc.2021.02.009. Epub 2021 May 27.
The current coronavirus disease 2019 (COVID-19) pandemic is creating unprecedented and unchartered demands on critical care units to meet patient needs and adapt the delivery of health services. Critical care nurses play a pivotal role in developing models of care that are effective, flexible, and safe.
We report on the accelerated development of a critical care nursing surge model responsive to escalating needs for intensive care capacity.
We conducted an exploratory prospective observational cohort study that included (i) a self-assessment and survey of learning needs of noncritical care nurses identified as candidate groups for redeployment in the intensive care unit and (ii) a pilot implementation of a team nursing model evaluated by individual questionnaires and the conduct of focus groups. We used descriptive statistics and qualitative content analysis to analyse the exploratory findings.
We surveyed 147 noncritical care nurses; 99 (67.3%) self-assessed at the lowest level of critical care competency, whereas 33 (24.3%) reported feeling able to help care for a critically ill patient under the direction of a critical care nurse. Identified learning needs included appropriate use of personal protective equipment in the intensive care unit (n = 123, 83.7%), use of specialised equipment (n = 103, 85.1%), basic mechanical ventilation, and vasoactive medication. We completed 11 team nursing pilot assignments with dyads of critical care and noncritical care nurses categorised in tiers of competencies. Nurses reported high levels of perceived support and provision of safe care; multiple recommendations were identified to improve the model of care delivery and communication.
The complexity, acuity, and unpredictability of the COVID-19 pandemic is placing new demands on critical care nurses to modify existing processes for care delivery while ensuring excellent outcomes and professional satisfaction. The study findings provide a road map to support nursing engagement in meeting patient needs.
当前的 2019 年冠状病毒病（COVID-19）大流行对重症监护病房提出了前所未有的、未经探索的需求，以满足患者的需求并调整医疗服务的提供。重症监护护士在制定有效、灵活和安全的护理模式方面发挥着关键作用。
我们报告了一种重症监护护理激增模型的快速发展，该模型对加强重症监护能力的需求做出了响应。
我们进行了一项探索性前瞻性观察队列研究，包括（i）对被确定为重症监护病房重新部署候选群体的非重症监护护士进行自我评估和学习需求调查，以及（ii）通过个人问卷和焦点小组评估实施团队护理模式的试点。我们使用描述性统计和定性内容分析来分析探索性发现。
我们调查了 147 名非重症监护护士；99 名（67.3%）自我评估为最低水平的重症监护能力，而 33 名（24.3%）报告说在重症监护护士的指导下能够帮助护理重症患者。确定的学习需求包括在重症监护病房正确使用个人防护设备（n=123，83.7%）、使用专业设备（n=103，85.1%）、基本机械通气和血管活性药物。我们完成了 11 个团队护理试点任务，将重症监护和非重症监护护士组成的小组分为能力层次。护士报告说他们感受到了高度的支持和安全的护理；提出了多项建议来改进护理服务提供和沟通模式。
COVID-19 大流行的复杂性、严重性和不可预测性要求重症监护护士修改现有的护理提供流程，同时确保卓越的结果和专业满意度。研究结果为支持护理人员满足患者需求提供了路线图。
