Australian critical care nurses' knowledge, preparedness, and experiences of managing SARS-COV-2 and COVID-19 pandemic

Abstract

Background COVID-19 has again highlighted the crucial role of healthcare workers in case management, disease surveillance, policy development, and healthcare education and training. The ongoing pandemic demonstrates the importance of having an emergency response plan that accounts for the safety of frontline healthcare workers, including those working in critical care settings. Objectives To explore Australian critical care nurses’ knowledge, preparedness and experiences of managing patients diagnosed with SARS-CoV-2 and COVID-19. Methods An exploratory cross-sectional study of Australian critical care nurses was conducted between June and September 2020. An anonymous online survey was sent to Australian College of Critical Care Nurses (ACCCN) members to collect information about their knowledge, preparedness and experiences during the COVID-19 pandemic. Descriptive statistics were used to summarise and report data. Results A total of 157 critical care nurses participated, with 138 fully complete surveys analysed. Most respondents reported ‘good’ to ‘very good’ level of knowledge about COVID-19, and obtained up-to-date COVID-19 information from international and local sources. To manage patients with COVID-19, 82.3% felt sufficiently prepared at the time of data collection, and 93.4% had received specific education, training or instruction. Most participants were involved in assessing (89.3%) and treating (92.4%) COVID-19 patients. Varying levels of concerns about contracting SARS-CoV-2 were expressed by respondents, and 55.7% thought the pandemic had increased their workload. The most frequent concerns expressed by participants were a lack of appropriate PPE and fear of the PPE shortage. Conclusions While most nurses expressed sufficient preparedness for managing COVID-19 patients, specific education had been undertaken and experiential learning was evident. Fears of insufficient or appropriate PPE made the response more difficult for nurses and the community. Preparedness and responsiveness are critical to successful management of the COVID-19 pandemic and future outbreaks of emerging infectious diseases.

A Glance at the Barriers and Enablers of the Nursing Role in Pandemics: An Integrative Review

“…Regarding the evidence found, the results of this review coincide with other reviews retrieved (53,54) regarding the barriers to the performance of their professional role; some of the relevant factors, which have been developed by several authors, are "fear" (3,14,46), uncertainty (55), psychological stress and the reluctance of healthcare professionals -especially nurses and nursing assistants (56)to work with patients infected with emerging infectious diseases in an environment of scarce personal protective equipment (46,48) and, therefore, the fear of bringing the infection to their homes and families (48,57,58). This situation has not been addressed by governmental and health agencies, nor by the ICN (International Council of Nurses); the aforementioned institution, although it has recently published the 12 main priorities for the COVID-19 pandemic (59), did not consider in any of the points of the declaration the protection of the fundamental pillar of every human being, and of course, of a healthcare professional, namely, their families.…”

“…The search strategy used achieved an initial retrieval of 11,031 potential articles for the study, out of which 32 articles were finally included in the final sample (Table 1 Once the 32 selected studies had been evaluated (Table 1), it was observed that more than half of the articles stemmed from the Americas: Canada (3,35), The USA (1, 23-30, 34, 37, 45), Brazil (47) and one article that refers to the American continent in general (3); the rest of the evidence is distributed across studies from Asia (10, 14,32,38,40,40,42,43,43,44,49), Europe (39,41,46), Oceania (6,31,48), and Africa (33); therefore, all the articles are written in English. Regarding the journals where these articles were published, it was noted that all were published in journals indexed in the Proquest, Scopus, and Pubmed databases.…”

“…On the other hand, the evidence also reports that there are enabling factors for the performance of the role, firstly, when it is considered that these professionals provide "constructive" support with their work (38); in addition, they are resilient, capable of self-care and adaptability towards the continuous changes in protocol and scarcity of resources (42), as well as their capacity for planning, support, information, active participation in research and adequate use of resources (39), relevant aspects that should be considered by the employers of healthcare services, since they must ensure clear practices in the care to be provided, control measures for infections and personal protection equipment that is adequate for the use of healthcare providers, which are all indispensable variables to en-sure the health of healthcare providers and their families (28); in addition, the need for psychological support for these professionals is also evident (48), as well as the need for their continuing education. This need should not only satisfy nurses but also other healthcare providers who are for the implementation of programs and protocols with the objective of minimizing cross-infection for patient and staff safety in the face of a pandemic (10, 33,48), strengthening interdisciplinary work (46). One strategy reported in this review that will undoubtedly support their performance in improving communication with isolated populations is telehealth.…”

“…Among the factors that hinder the performance of their role were the fear of working with patients with infectious diseases experienced by nursing professionals (32) -and therefore, the need for support in case of contracting the disease (48) -, the insecurity of not having adequate personal protective equipment (46,48), the fear of contaminating members of their family, the social isolation that these professionals must face (3,46), as well as the limited infrastructure and the deficit of nursing professionals (33), the feeling of ignorance and underestimation of the efforts of nurses compared to physicians (38), and the lack of social recognition (46), all of which undoubtedly affect their willingness to work with and provide care for patients with infectious diseases (28); in addition, the crucial contribution and work of immigrant nurses in support of the existing workforce is often overlooked, since despite the different nature and environment of their jobs, they can play a key role during times of crisis such as what has been witnessed in the COVID-19 pandemic (35).…”

Measuring COVID-19 Related Health Literacy in Healthcare Professionals—Psychometric Evaluation of the HL-COV-HP Instrument

“…While there is a growing body of research on aspects of COVID-19 related health literacy of the general population [4,15,16,22] or specific populations, e.g., migrants, children, students, or patients [8][9][10][11]13,[19][20][21]23], little is known about the COVID-19 related health literacy of healthcare professionals, such as physicians, nurses, or psychologists. Since 2020, many studies have investigated the knowledge, attitude, and behavior of healthcare professionals worldwide [24][25][26][27][28][29][30][31][32][33][34]. The results indicate a lack of adequate knowledge about COVID-19 in many cases (6-42%) [24,25,27,32].…”