Alfred Health, PO Box 315, Prahran, Melbourne, VIC, 3181, Australia.
Deakin University, Faculty of Health, School of Nursing and Midwifery, Centre for Quality and Patient Safety Research - Alfred Health Partnership, Melbourne, Victoria, Australia.
BMC Health Serv Res. 2023 Mar 1;23(1):208. doi: 10.1186/s12913-022-09000-3.
Strict isolation of COVID-19 patients to prevent cross infection may inadvertently cause serious adverse outcomes including psychological harm, limitations to care, increased incidence of delirium, deconditioning and reduced quality of life. Previous research exploring the staff perspective of the effect of isolation on patients is limited. The aim of this study is to understand staff perceptions and interpretations of their experiences of the care and treatment of isolated patients and the impact of isolation on patients, families, and staff.
This qualitative, exploratory study is set in a major metropolitan, quaternary hospital in Melbourne, Australia. Data was collected in focus groups with clinical and non-clinical staff and analysed using content analysis. The hospital ethics committee granted approval. Each participant gave informed verbal consent.
Participants included 58 nursing, medical, allied health, and non-clinical staff. Six main themes were identified: 1) Communication challenges during COVID-19; 2) Impact of isolation on family; 3) Challenges to patients' health and safety; 4) Impact on staff; 5) Challenging standards of care; 6) Contextual influences: policy, decision-makers and the environment.
Isolating patients and restricting visitors resulted in good pandemic management, but staff perceived it came at considerable cost to staff and consumers. Innovative communication technology may facilitate improved connection between all parties. Mental health support is needed for patients, families, and staff. Further research using a co-design model with input from patients, families and staff is recommended to determine appropriate interventions to improve care. Preventing the spread of infection is essential for good pandemic management, but the cost to consumers and staff must be mitigated. Preparation for future pandemics must consider workforce preparedness, adapted models of care and workflow.
为防止交叉感染，对 COVID-19 患者进行严格隔离，可能会无意中导致严重的不良后果，包括心理伤害、护理受限、谵妄发生率增加、身体机能下降和生活质量下降。之前的研究探索了隔离对患者的影响，主要集中在医护人员的角度，而对隔离对患者、家属和医护人员的影响的研究则有限。本研究旨在了解医护人员对隔离患者护理和治疗的体验以及隔离对患者、家属和医护人员的影响的看法和解释。
这是一项在澳大利亚墨尔本一家主要大都市的四级医院进行的定性、探索性研究。在焦点小组中收集了临床和非临床医护人员的数据，并使用内容分析法进行分析。医院伦理委员会批准了该研究。每位参与者均给予了口头知情同意。
参与者包括 58 名护理、医疗、联合健康和非临床人员。确定了六个主要主题：1）COVID-19 期间的沟通挑战；2）隔离对家庭的影响；3）对患者健康和安全的挑战；4）对员工的影响；5）有挑战的护理标准；6）背景影响：政策、决策者和环境。
隔离患者并限制访客的做法对大流行管理有好处，但工作人员认为这给工作人员和消费者带来了相当大的代价。创新的沟通技术可能有助于各方更好地联系。需要为患者、家属和工作人员提供心理健康支持。建议使用患者、家属和工作人员共同设计的模型进行进一步研究，以确定改善护理的适当干预措施。预防感染的传播对于良好的大流行管理至关重要，但必须减轻对消费者和工作人员的影响。为未来的大流行做准备必须考虑劳动力准备、适应的护理模式和工作流程。
