Clinical Epidemiology and Medical Technology Assessment, Maastricht UMC+, Maastricht, The Netherlands
Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands.
BMJ Open. 2023 Apr 5;13(4):e065931. doi: 10.1136/bmjopen-2022-065931.
During the COVID-19 pandemic, the staff in the intensive care unit (ICU) was materially, physically and emotionally challenged. This qualitative study investigated the effects that ICU staff experienced and were considered of value to be permanently implemented.
ICU in an university medical centre during the first wave of the COVID-19 pandemic.
An opportunity-centric approach was applied in individual semi-structured interviews to optimise the achieved results and was guided by the theoretical model of appreciative inquiry (AI).
Fifteen ICU staff members (8 nurses and 7 intensivists) participated.
Working during the COVID-19 pandemic catalysed interprofessional collaboration and team learning in the ICU on an individual and team level, centred around a common goal: taking care of critically ill patients with COVID-19. The effect of interprofessional collaboration was that provisions were taken care of quicker than usual, without bureaucratic delays. However, this effect was experienced to be transient. Also, ICU staff perceived limited possibilities to help patients and families around the palliative phase, and they perceived a lack of appreciation from higher management. This is a point of future attention: how to make this perceived lack of appreciation more visible to all (ICU) staff.
Regarding our primary question, the ICU staff voiced that the direct communication and collaboration are the most important elements of the COVID-19 peak they would like to preserve. Furthermore, it was learnt that consolation and support for family members should not be forgotten. Considering the results, we believe that further research concerning team reflexivity might contribute to (or enhance) our knowledge about working together during and after a crisis.
在 COVID-19 大流行期间，重症监护病房（ICU）的工作人员在物质、身体和情感方面都面临着巨大的挑战。本定性研究调查了 ICU 工作人员所经历的影响，并认为这些影响有价值，可以永久实施。
COVID-19 大流行期间的一所大学医学中心的 ICU。
采用以机会为中心的方法，在个别半结构化访谈中进行，以优化所取得的结果，并以欣赏式探询（AI）的理论模型为指导。
15 名 ICU 工作人员（8 名护士和 7 名重症监护医生）参加。
在 COVID-19 大流行期间工作，在个人和团队层面上促进了 ICU 内的跨专业合作和团队学习，以一个共同的目标为中心：照顾患有 COVID-19 的重症患者。跨专业合作的效果是，与往常相比，规定的照顾更快得到落实，没有官僚主义的拖延。然而，这种效果是暂时的。此外，ICU 工作人员认为在临终关怀阶段，他们帮助患者和家属的可能性有限，并且他们感到上级管理层的赞赏不够。这是未来需要关注的一个问题：如何让所有（ICU）工作人员都更清楚地看到这种被认为的缺乏赞赏。
关于我们的主要问题，ICU 工作人员表示，他们希望保留在 COVID-19 高峰期最直接的沟通和合作是最重要的元素。此外，还了解到，不应该忘记对家属的安慰和支持。考虑到这些结果，我们认为，关于团队反思的进一步研究可能有助于（或增强）我们对危机期间和之后共同工作的知识。
