ObjectiveThis study sought to explore the experiences of Australian primary healthcare (PHC) nurses in the use of telehealth during COVID-19. Telehealth was defined as the use of any telecommunications mode (eg, telephone and videoconferencing) to deliver healthcare.Design and settingThematic analysis of qualitative interviews undertaken in Australian PHC.ParticipantsTwenty-five PHC nurses who had participated in a national survey about their experiences during COVID-19 were recruited using purposive sampling.MethodsSemistructured telephone interviews were conducted from June to August 2020. Interviews lasted a mean of 38.5 min. They were audio-recorded and transcribed before thematic analysis was undertaken. The consolidated criteria for reporting qualitative research were followed.ResultsFour overarching themes were identified: preparedness, accessibility of telehealth, care experience and impacts on the PHC nurses’ role. Some nurses were experienced in the use of telehealth, while others indicated a lack of preparation and limited appropriate technology to support its use. Telehealth enabled patients to access care but did not support complex clinical assessment. Participants indicated that patient engagement in telehealth was dependent on access and confidence using technology, perceived safety when physically attending the practice and the value they placed on care via telehealth. Many participants expressed frustration about telehealth funding and its impact on facilitating nurses to practise to their full scope.ConclusionTelehealth has provided a means to continue PHC service delivery during COVID-19. While there are advantages to adopting this technology, considerations of the challenges and lessons from this experience are important to inform the future implementation of telehealth initiatives.

Aim To explore primary healthcare nurses' psychological well‐being related to the COVID‐19 pandemic. Design Qualitative descriptive study. Methods Semi‐structured interviews were conducted with 25 participants between June and August 2020 who indicated their willingness to participate in an interview following a national survey. Interviews were audio‐recorded and transcribed verbatim by professional transcribers. Data were analysed using thematic analysis. Results The importance of professional and public support and acknowledgement of the nurses' role during the pandemic positively influenced feelings of being valued. The psychological impact of negative experiences increased anxiety and stress levels. Participants reported a range of self‐care strategies, including increased vigilance with infection control at home and work and attention to physical exercise and diet. Most participants remained positive about their roles and career decisions, although some indicated that the negative psychological impacts prompted re‐evaluation of their career. Conclusions Primary healthcare nurses have been exposed to a range of personal and professional stressors during the pandemic that have impacted their psychological well‐being. Awareness of stressors and an understanding of what has helped and what has impacted well‐being are important in guiding future workplace support systems. Further work to explore the long‐term impact of these stressors and the effectiveness of coping strategies employed by primary healthcare nurses is warranted. Impact Managers and professional organisations need to consider the personal and professional stressors that have impacted on primary healthcare nurses' psychological well‐being to promote health and well‐being among nurses following COVID‐19.

COVID-19 has placed global health systems, and the nurses who work in them, under significant strain. High global infection and mortality rates in both the general population and healthcare professionals (Koh, 2020) highlight the far reaching pandemic impact. As reported during previous respiratory pandemics (Koh et al., 2012;Person et al., 2004), nurses hold real fears of heightened risk (Ho et al., 2005;Sperling, 2021) in terms of contracting disease, spreading the infection to others and fear of stigmatization by the community (Koh, 2020;Taylor et al., 2020). Exposure to infectious disease is a real risk for nurses which is heightened during a pandemic (Cawcutt et al., 2020).There is a demonstrated relationship between perceived risks and mental health issues such as anxiety and depression in nurses (Gorini et al., 2020;Labrague & De Los Santos, 2020;Lam et al., 2020;Sperling, 2021), as well as attrition from nursing (Halcomb et al., 2020a(Halcomb et al., , 2020b. During COVID-19, mass media and its spreading of misinformation about transmission and symptom management have contributed to what has been termed an "infodemic," heightening risk perceptions (Cinelli et al., 2020;Pickles et al., 2021).Despite evidence-based infection control strategies informing clinical practice, reports of insufficient or inappropriate personal protection equipment (PPE)

Aims To validate the ‘safe and effective staffing tool’ and explore the impact of COVID‐19 on the quality of Australian primary health care (PHC). Design A national survey was conducted from October to December 2020. Methods The online survey was distributed via social media and professional organisations to PHC nurses. Results Three‐hundred fifty‐nine PHC nurses participated. A two‐factor solution was found with factors named; ‘Perception of quality of care provided’ and ‘Personal satisfaction with care delivered’. Cronbach's alpha demonstrated good internal consistency for the total scale (α = .915) and each subscale (α = .879/α = .864). Nearly three‐quarters of participants (71.3%) were satisfied with the quality of care they delivered. Participants working in general practice, and those with more nursing experience had significantly higher scores in the factor ‘perceptions of quality of care provided’ and the total ‘quality and satisfaction with care’. A lack of time, inadequate supervision and support, and performing non‐nursing duties were reported to be impacting care quality. Most participants (80.5%) reported that COVID‐19 had impacted negatively on the detection and management of non‐COVID related health conditions. Conclusion The ‘safe and effective staffing tool’ is a valid and reliable measure of perceived quality of care and satisfaction with care delivered. Many PHC nurses perceive that there has been an overall reduction in the quality of care delivered due to COVID‐19 and feel that there is a lack of adequate supervision and workplace support. Given the limited baseline data, further research is required to understand the extent that COVID‐19 impacts these findings. However, this study demonstrates that strategies need to be implemented to support PHC nurses to provide high‐quality care to optimise health outcomes and maintain nurse satisfaction. Impact This is the first attempt to evaluate care quality in Australian PHC. Policymaking requires this evidence to drive changes to better support PHC nurses.