Critical Care Units, Ghent University Hospital, Ghent, Belgium.
Nursing Department, Ghent University Hospital, Ghent, Belgium.
J Adv Nurs. 2022 Oct;78(10):3345-3357. doi: 10.1111/jan.15334. Epub 2022 Jun 28.
The goal of this study was to gain insight into the views and experiences of an intensive care team working in a new nursing-care delivery model during the COVID-19 waves. A new model of care was implemented to augment nursing capacity and provide sufficient intensive care beds.
A qualitative monocentric study using rapid qualitative descriptive methods was reported in line with the COREQ checklist.
Nurse, ward manager and physician participants were purposively recruited between January and March 2021 in a tertiary university-affiliated hospital in the Flemish-speaking part of Belgium. Semistructured interviews were conducted and analysed using thematic analysis methods.
The participants were seventeen expert nurses, twelve supporting nurses, seven ward managers and four physicians. A central theme of ensuring safe, high-quality care emerged from the findings. There was a sense of losing one's grip on clinical practice when working in the mixed nursing-care teams. Different underlying experiences played a part in this sense of losing control: dealing with unknown elements, experiencing role ambiguity, struggling with responsibility and the absence of trust. Several coping mechanisms were developed by the nursing-care team to deal with those experiences, including attempts to create stability, to strike a balance between delegating and educating, to build in control and to communicate openly.
In this rapid qualitative descriptive study, the implementation of a new nursing-care delivery model during a pandemic was seen to lead to several challenges for all members of the care team. Coping mechanisms were developed by the team to deal with these experienced challenges.
When rethinking nursing-care delivery models, the findings of this study may help guide the process of implementing mixed nursing-care teams. Special attention needs to be paid to clarifying roles, sharing responsibility and clinical leadership. Other significant influences (such as moral distress) should also be taken into account.
本研究旨在深入了解在 COVID-19 浪潮期间，在新的护理提供模式下工作的重症监护团队的观点和经验。实施了一种新的护理模式来增加护理能力并提供足够的重症监护床位。
一项定性单中心研究，使用快速定性描述方法，根据 COREQ 清单进行报告。
在 2021 年 1 月至 3 月期间，在比利时佛兰芒语区的一家三级大学附属医院，有目的地招募了护士、病房经理和医生参与者。进行了半结构化访谈，并使用主题分析方法进行分析。
参与者包括 17 名专家护士、12 名支持护士、7 名病房经理和 4 名医生。研究结果中出现了一个确保安全、高质量护理的核心主题。在混合护理团队中工作时，有一种失去对临床实践的控制感。不同的潜在经验在这种失控感中起到了一定的作用：处理未知因素、体验角色模糊、努力承担责任和缺乏信任。护理团队制定了几种应对这些经验的应对机制，包括尝试创造稳定性、在授权和教育之间取得平衡、建立控制和进行开放沟通。
在这项快速定性描述研究中，在大流行期间实施新的护理提供模式被认为给护理团队的所有成员带来了一些挑战。团队制定了应对这些经验挑战的应对机制。
在重新思考护理提供模式时，本研究的结果可能有助于指导实施混合护理团队的过程。需要特别注意明确角色、分担责任和临床领导。还应考虑其他重大影响因素（如道德困境）。
