Aims To examine the nurses' burnout and associated risk factors during the COVID‐19 pandemic. Design We followed the Cochrane criteria and the Preferred Reporting Items for Systematic Reviews and Meta‐Analysis guidelines for this systematic review and meta‐analysis. Data Sources PubMed, Scopus, ProQuest, Cochrane COVID‐19 registry, CINAHL and pre‐print services (medRχiv and PsyArXiv) were searched from January 1 to November 15, 2020 and we removed duplicates. Review Methods We applied a random effect model to estimate pooled effects since the heterogeneity between results was very high. Results Sixteen studies, including 18,935 nurses met the inclusion criteria. The overall prevalence of emotional exhaustion was 34.1%, of depersonalization was 12.6% and of lack of personal accomplishment was 15.2%. The main risk factors that increased nurses' burnout were the following: younger age, decreased social support, low family and colleagues readiness to cope with COVID‐19 outbreak, increased perceived threat of Covid‐19, longer working time in quarantine areas, working in a high‐risk environment, working in hospitals with inadequate and insufficient material and human resources, increased workload and lower level of specialized training regarding COVID‐19. Conclusion Nurses experience high levels of burnout during the COVID‐19 pandemic, while several sociodemographic, social and occupational factors affect this burnout. Impact We found that burnout among nurses is a crucial issue during the COVID‐19 pandemic. There is an urgent need to prepare nurses to cope better with COVID‐19 pandemic. Identification of risk factors for burnout could be a significant weapon giving nurses and health care systems the ability to response in a better way against the following COVID‐19 waves in the near future.

BackgroundDuring the COVID-19 pandemic, physical and mental health of the nurses is greatly challenged since they work under unprecedented pressure and they are more vulnerable to the harmful effects of the disease.AimTo examine the impact of the COVID-19 pandemic on nurses’ burnout and to identify associated risk factors.MethodsWe followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines for this systematic review and meta-analysis. PubMed, Scopus, ProQuest and pre-print services (medRχiv and PsyArXiv) were searched from January 1, 2020 to November 15, 2020 and we removed duplicates. We applied a random effect model to estimate pooled effects since the heterogeneity between results was very high.FindingsFourteen studies, including 17,390 nurses met the inclusion criteria. Five standardized and valid questionnaires were used to measure burnout among nurses; Maslach Burnout Inventory, Copenhagen Burnout Inventory, Professional Quality of Life Scale version 5, Mini-Z, and Spanish Burnout Inventory. The overall prevalence of emotional exhaustion was 34.1% (95% confidence interval [CI]: 22.5-46.6%), of depersonalization was 12.6% (95% CI: 6.9-19.7%), and of lack of personal accomplishment was 15.2% (95% CI: 1.4-39.8%). The following factors were associated with increased nurses’ burnout: younger age, higher educational level, higher degree, decreased social support, having a relative/friend diagnosed with COVID-19, low family and colleagues readiness to cope with COVID-19 outbreak, increased perceived threat of Covid-19, longer working time in quarantine areas, working in a high-risk environment (a COVID-19 designated hospital, a COVID-19 unit, etc.), working in hospitals with inadequate and insufficient material and human resources, decreased working safety while caring for COVID-19 patients, increased workload, decreased self-confidence in self-protection, and lower levels of specialized training regarding COVID-19, job experience, and self-confidence in caring for COVID-19.ConclusionNurses experience high levels of burnout during the COVID-19 pandemic, while several sociodemographic, social and occupational factors affect this burnout. Several interventions need to be implemented to mitigate mental health impact of the COVID-19 pandemic on nurses, e.g. screening for mental health illness and early supportive interventions for high-risk nurses, immediate access to mental health care services, social support to reduce feelings of isolation, sufficient personal protective equipment for all nurses to provide security etc. Governments, health care organizations and policy makers should act in this direction to prepare health care systems, individuals and nurses for a better response against the COVID-19 pandemic.

In 2010, the Greek economy entered a deep, structural and multi-faceted crisis, the main futures of which are a large fiscal deficit and huge public debt. The negative effects can also be observed at the societal level, as all social indicators have deteriorated. The present paper discusses the impact of economic crisis on access to healthcare services especially for the vulnerable groups. Uninsured, unemployed, older people, migrants, children and those suffering from chronic disease and mental disorders are among the groups most affected by the crisis in Greece. High costs, low proximity and long waiting lists are among the main barriers in accessing health care services.

Aim: The purpose of this study was to identify and measure managerial competencies, skills and knowledge necessary for a competent Operating Room (OR) nurse manager so to provide quality care. Methods:The Nurse Manager Questionnaire was used in General and Army Hospitals with at least 5 operating suites. 153 Operating Room nurses and Operating Room nurse managers rated the 53 skills of the Questionnaire depending on how essential those skills are for OR nurse manager (RR=81%). The 53 skills were separated in two columns one for knowledge and understanding and one for ability to implement and/or use. Reliability of the questionnaire was Cronbach (a) = 0.987. Results:The decision-making, ethical principles and effective communication were identified as the most necessary competencies for OR nurse manager when in contrast financial competencies were identified as the least necessary. The nurse's educational preparation effected technical, human and leadership competencies in proportional way (p≤0.05) when nurse's age seemed to affect inversely leadership (p≤0.027) and financial competencies (p≤0.034). Conclusions:As the Operating Room is an extremely stressful place, staffed with qualified personnel with multiple and even conflicting interests, OR nurse manager must be equipped with multiple competencies such as technical and human, in order to be able to promote safety and quality of perioperative nursing care to the patient.

No abstract