COVID-19 and Inpatient Rehabilitation Nursing Care: Lessons Learned and Implications for the Future

Camicia, Michelle; Cournan, Michele; Rye, Jill

doi:10.1097/rnj.0000000000000337

Cited by 20 publications

(18 citation statements)

References 12 publications

(18 reference statements)

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“…The stress in the family members of ICU patients may increase during a global pandemic and strict visitation limitations [ 30 ]. They are exposed to many of these stressors, and the stress also increases due to COVID-related restrictions for family and friends in visiting the patient [ 38 ]. In Iran, no appropriate support system exists for the patients discharged from the ICU and their family caregivers even under normal circumstances, much less during the COVID-19 pandemic, which puts extra stress on both patients and their families and health care providers.…”

Section: Discussionmentioning

confidence: 99%

The role of the ICU liaison nurse services on anxiety in family caregivers of patients after ICU discharge during COVID-19 pandemic: a randomized controlled trial

et al. 2022

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Background With the onset of the COVID-19 pandemic and the need to maintain social distancing and changes in wards' structure, families no longer access the routine support they received during the hospitalization of their patients in the ICU. This study aimed to determine the effects of ICU liaison nurse services on the anxiety in patients’ family caregivers after ICU discharge during the COVID-19 pandemic. Methods This randomized controlled trial was performed in western Iran from February 2020, to March 2021. Sixty subjects were selected from the family caregivers of the patients transferred from the ICU and were randomly assigned to the control (n = 30) and the intervention groups (n = 30). The control group received routine transfer care. In the intervention group, liaison nurse services were offered in 4 dimensions: patient support, family support, training, support of the ward’s staff, and the evaluation of the destination ward. The participants’ anxiety was measured using the Spielberger State Anxiety Inventory immediately after the patient transfer and 6 h after admission to the general ward. Data analyzed with SPSS V16, descriptive and inferential statistics, including Chi-square test, Mann–Whitney test, Wilcoxon test, and Generalized Linear Model with cumulative logit link function. Results were reported at a 0.05 significance level. Results A statistically significant difference was observed in baseline anxiety levels (P = 0.035) and age group (P < 0.001) between the intervention and control groups. After moderating baseline anxiety levels, the age group, and marital status, the impact of the intervention was significant (X2 = 10.273, df = 1, P < 0.001), meaning that the intervention could reduce the relative chances of developing higher levels of anxiety by 92.1% (OR: 0.08, 95%CI: 0.017–0.373, P < 0.001). Conclusions This study confirmed the positive impact of nursing services on reducing anxiety in family caregivers during the COVID-19 pandemic. It is recommended to use these services, especially during the COVID-19 condition, to facilitate the patient transfer, support the patient's family, and reduce the health care gap between the ICU and the ward.

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Section: Discussionmentioning

confidence: 99%

The role of the ICU liaison nurse services on anxiety in family caregivers of patients after ICU discharge during COVID-19 pandemic: a randomized controlled trial

et al. 2022

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“…Thus, our findings may not reflect the diversity of patients nationwide. Furthermore, our study was conducted prior to the start of the COVID-19 pandemic, and the pandemic has resulted in significant changes to healthcare delivery and perceptions of care (Camicia et al, 2021; Sutter-Leve et al, 2021).…”

Section: Discussionmentioning

confidence: 99%

Quality Measure Concepts for Inpatient Rehabilitation That Are Best Understood From the Patient’s Perspective

Deutsch

Neumann

Goldsmith

et al. 2022

Rehabilitation Nursing

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Purpose: The aim of this study was to identify inpatient rehabilitation quality-of-care concepts that are best understood from the patient perspective. Design: We conducted 12 focus groups with 95 former patients, caregivers, and rehabilitation clinicians and asked them to describe high-quality inpatient rehabilitation care. Methods: We independently reviewed the focus group transcripts and then used an iterative process to identify the quality measure concepts identified by participants. Results: Based on participants' comments, we identified 18 quality measure concepts: respect and dignity, clinician communication with patient, clinician communication with family, organizational culture, clinician engagement with patient, clinician engagement with family, rehabilitation goals, staff expertise, responsiveness, patient safety, physical environment, care coordination, discharge planning, patient and family education, peer support, symptom management (pain, anxiety, fatigue, sadness), sleep, and functioning. Clinical Relevance to the Practice of Rehabilitation Nursing: Rehabilitation nurses should be aware of the quality-of-care issues that are important to patients and their caregivers. Conclusion: Important patient-reported domains of quality of care include interpersonal relationships, patient and family engagement, care planning and delivery, access to support, and quality of life.

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“…Visitation restrictions, in particular, proved to be especially challenging, as large‐scale disasters—such as the COVID pandemic—intensify stress and basic human needs to feel safe and connected 7 . Balancing high‐quality care and human connection with the safety of patients, families and HCPs during a pandemic proved extremely challenging 8 .…”

Section: Introductionmentioning

confidence: 99%

“…[4][5][6] Visitation restrictions, in particular, proved to be especially challenging, as large-scale disasters-such as the COVID pandemicintensify stress and basic human needs to feel safe and connected. 7 Balancing high-quality care and human connection with the safety of patients, families and HCPs during a pandemic proved extremely challenging. 8 HCPs were in an especially difficult position as they attempted to fulfil their own needs for human connection while simultaneously meeting those needs for their patients.…”

Section: Introductionmentioning

confidence: 99%

Infection prevention and control across the continuum of COVID‐19 care: A qualitative study of patients', caregivers' and providers' experiences

Wasilewski

Szigeti

Sheppard

et al. 2022

Health Expectations

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Introduction Healthcare facilities adopted restrictive visitor policies as a result of the COVID‐19 (COVID) pandemic. Though these measures were necessary to promote the safety of patients, families and healthcare providers, it led to isolation and loneliness amongst acute care inpatients that can undermine patient rehabilitation and recovery. The study objectives were to (1) explore how infection prevention and control (IP&C) measures impacted stakeholders' perceptions of care quality and interactions with others and (2) investigate how these experiences and perceptions varied across stakeholder groups and care settings. Methods A qualitative descriptive study was conducted. Patients and their families from an inpatient COVID rehabilitation hospital and healthcare providers from an acute or rehabilitation COVID hospital were interviewed between August 2020 and February 2021. Results A total of 10 patients, 5 family members and 12 healthcare providers were interviewed. Four major themes were identified: (1) IP&C measures challenged the psychosocial health of all stakeholders across care settings; (2): IP&C measures precipitated a need for greater relational care from HCPs; (3) infection prevention tenets perpetuated COVID‐related stigma that stakeholders experienced across care settings; and (4) technology was used to facilitate human connection when IP&C limited physical presence. Conclusion IP&C measures challenged psychosocial health and maintenance of vital human connections. Loneliness and isolation were felt by all stakeholders due to physical distancing and COVID‐related stigma. Some isolation was mitigated by the relational care provided by HCPs and technological innovations used. The findings of the study underscore the need to balance safety with psychosocial well‐being across care settings and beyond the patient–provider dyad. Patient and Public Contribution This study was informed by the Patient‐Oriented Research Agenda and developed through consultations with patients and family caregivers to identify priority areas for rehabilitation research. Priority areas identified that informed the current study were (1) the need to focus on the psychosocial aspects of recovery from illness and injury and (2) the importance of exploring patients' recovery experiences and needs across the continuum of care. The study protocol, ethics submission, analysis and manuscript preparation were all informed by healthcare providers with lived experience of working in COVID care settings.

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COVID-19 and Inpatient Rehabilitation Nursing Care: Lessons Learned and Implications for the Future

Cited by 20 publications

References 12 publications

The role of the ICU liaison nurse services on anxiety in family caregivers of patients after ICU discharge during COVID-19 pandemic: a randomized controlled trial

The role of the ICU liaison nurse services on anxiety in family caregivers of patients after ICU discharge during COVID-19 pandemic: a randomized controlled trial

Quality Measure Concepts for Inpatient Rehabilitation That Are Best Understood From the Patient’s Perspective

Infection prevention and control across the continuum of COVID‐19 care: A qualitative study of patients', caregivers' and providers' experiences

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