COVID-19 healthcare policies in Ireland: A rapid review of the initial pandemic response

Abstract

Aims: Healthcare systems urgently required policies to guide the response to the COVID-19 pandemic. The aim of this review was to document the healthcare policies developed during the initial wave of widespread COVID-19 transmission in Ireland. We further sought to determine the key focus and impact of these policies. Methods: We conducted a rapid review of COVID-19 healthcare policies published from 28 January to 31 May 2020. Key information including the focus of the policy, target population and impact on service delivery was extracted from included policies. During analysis, data was grouped under descriptive categories and narrative summaries were developed for each category. Results: We identified 61 healthcare policies relating to COVID-19. We developed six category headings to describe the focus and impact of these policies: infection prevention and control ( n = 19), residential care settings ( n = 12), maintaining non-COVID-19 healthcare services and supports ( n = 12), testing and contact tracing ( n = 7), guidance for healthcare workers concerning COVID-19 ( n = 6), and treating COVID-19 ( n = 5). Conclusions: This review has identified lessons for policy development and implementation to help prepare for future healthcare emergencies. Factors to consider include support of vulnerable groups during and in the aftermath of the pandemic, providing psychological supports for healthcare workers and investment in public healthcare services such as contact tracing for future emergencies. While pandemic conditions necessitate the speedy development of policies, effective communication and adequate resourcing is required to ensure policy implementation.

The Impact of the COVID-19 Pandemic on the Working Lives and Retirement Timing of Older Nurses in Ireland

“…It confirms previous findings that nurses are at high risk of personal exposure to the disease, and that some nurses contracted the COVID-19 virus at work, particularly those working in high-risk areas [10]. The likelihood of contracting the virus was compounded by the initial shortage of PPE in Ireland and the guidelines that directed some nurses not to wear masks during the early stages of the pandemic [17][18][19]21]. Nurses made recommendations for infrastructural changes to improve facilities both for nurses and for patients.…”

“…Redeployment was one of the policies adopted by the HSE to deal with the pandemic. In some cases, this poses problems for nurses; in acute hospital settings, they typically had to move to work in intensive care units in hospitals, or from the community to nursing homes where there was an outbreak of COVID-19, or to testing or vaccinating facilities [19]. While many nurses were willing to be redeployed, their accounts support previous international studies that emphasise difficulties experienced by redeployed nurses in having to upskill very quickly, join a new team and learn new procedures while simultaneously trying to control infection [20].…”

“…Both internationally and in Ireland, there were initially shortages of personal protective equipment (PPE) [2,17,18]. In Ireland, to preserve supply, PPE was initially limited to staff working directly with diagnosed COVID-19 patients [19]. This adversely affected the working conditions and health of nurses.…”

“…When the pandemic struck, healthcare workers in Ireland had to adapt to the stresses of responding to sudden and significant changes to their daily work practices [9]. Prior to COVID-19, there were no identifiable policies in Ireland on the delivery and staffing of healthcare services during pandemics [19]. During the first wave, policies for the reorganisation and redeployment of staff were prioritised.…”

“…Resulting regressive social policies and public spending cuts included cuts in health and social care, leading to embargoes on nurse recruitment. Furthermore, public spending cuts in the health system in recent years have seen reduced staff numbers as well as pay cuts for the nursing workforce, so that a higher workload and reduced pay places them under increasing pressure, with weakened social protection [3,12,19]. This study considers how these dynamics of gender and age, shaped by State and employer policies, and economic market forces, inform the subjective experiences and perceptions of working life for nurses in Ireland during COVID-19.…”