CRN National Coordinating Centre (CRNCC), National Institute for Health Research (NIHR), London, UK.
School of Nursing & Midwifery, University of Plymouth, Plymouth, UK.
J Adv Nurs. 2022 Apr;78(4):1075-1088. doi: 10.1111/jan.15081. Epub 2021 Nov 15.
To understand how COVID-19 affected nurse staffing in intensive care units (ICUs) in England, and to identify factors that influenced, and were influenced by, pandemic staffing models.
Exploratory qualitative study.
Semi-structured, online interviews conducted July-September 2020 with regional critical care leaders including policy leads (n = 4) and directors/lead nurses (n = 10) across critical care networks in England.
The six themes emerging from the framework analysis illustrate how the pre-pandemic ICU culture influenced ICU staffing models during the pandemic. Changes in staffing impacted on the workforce and the care delivered, whilst it was necessary to learn from, and adjust to, a rapidly changing situation. Variation across and between networks necessitated variation in responses. The overwhelming outcome was that the pandemic has challenged the central tenets of ICU nurse staffing.
Pandemic nurse staffing models resulted in changes to ICU skill-mix and staffing numbers. Factors such as the impact of nurse staffing on care practices and on the workforce need to be taken into account when developing and testing future nurse staffing models for ICU. The extent to which ICUs will return to former staffing models is not yet known but there seems to be an appetite for change.
In common with many countries, nurse staffing in English ICUs was adapted to address surge requirements during the COVID-19 pandemic. Findings highlight the challenge COVID-19 presented to pre-pandemic ICU nurse staffing guidelines, the impact on patient and staff well-being and the potential legacy for future staffing models. Study findings have implications for ICU nurse managers, researchers and policy makers: nurse staffing models need to be adaptable to the local context of care and future research should investigate the impact of different models on patients, staff and health service outcomes.
了解 COVID-19 如何影响英格兰重症监护病房（ICU）的护士人员配置，并确定影响和受大流行人员配备模式影响的因素。
探索性定性研究。
2020 年 7 月至 9 月，通过在线半结构化访谈，对英格兰重症监护网络中的政策负责人（n=4）和主任/护士长（n=10）等区域重症护理领导人进行了访谈。
框架分析中出现的六个主题说明了大流行前 ICU 文化如何影响大流行期间的 ICU 人员配备模式。人员配备的变化影响了劳动力和提供的护理，而有必要从快速变化的情况中吸取教训并进行调整。网络内部和之间的差异需要做出不同的反应。压倒性的结果是，大流行挑战了 ICU 护士人员配备的核心原则。
大流行期间的护士人员配备模式导致 ICU 技能组合和人员配备数量发生变化。在为 ICU 开发和测试未来的护士人员配备模型时，需要考虑护士人员配备对护理实践和劳动力的影响等因素。ICU 是否会恢复到以前的人员配备模式尚不清楚，但似乎有变革的意愿。
与许多国家一样，英格兰 ICU 的护士人员配备已适应大流行期间的激增需求。研究结果强调了 COVID-19 对大流行前 ICU 护士人员配备指南的挑战、对患者和员工福祉的影响以及对未来人员配备模式的潜在影响。研究结果对 ICU 护士管理人员、研究人员和政策制定者具有启示意义：护士人员配备模式需要适应护理的当地情况，未来的研究应调查不同模式对患者、员工和卫生服务结果的影响。
