Expedited upskilling of intermediate care nurses to provide critical care during the COVID‐19 pandemic

Abstract

Aim Describe the strategy, efficacy and preferred mechanisms of training used to rapidly upskill intermediate care nursing staff to provide critical care during the COVID‐19 pandemic. Design Descriptive study. Methods The strategy used from March through December 2020 to upskill nurses in an intermediate care unit to administer critical care upon rapid conversion of the intermediate care unit to an intensive care unit for coronavirus disease 2019 is described. Training and education included paired staffing models, interdisciplinary education, skills days and self‐directed learning. Nurses engaged in this upskilling process were surveyed to evaluate their confidence in new critical care competencies and educational preferences. Results Of 38 intermediate care nurses, 35 completed training and began independent intensive care practice. Nursing confidence in critical care competencies increased steadily. Nurses demonstrated the greatest preference for peer education models, particularly those incorporating the hospital's pre‐existing medical intensive care nurses. Patient and Public Contributions No patient or public contributions were made to this manuscript.

Lung Protective Ventilation Adherence and Outcomes for Patients With COVID-19 Acute Respiratory Distress Syndrome Treated in an Intermediate Care Unit Repurposed to ICU Level of Care

“…Although there was debate among the larger critical care community about the best LPV strategies (14), this center was likely biased toward an approach of limiting Vt and Pplat (15). Additionally, there was an intensive effort to upskill the nursing staff to provide critical care (7), to then support the multidisciplinary teamwork that is necessary for highquality ICU care (29)(30)(31). This was complemented by a closed physician staffing model comprising first-call physicians who were managing COVID-19 ARDS almost exclusively during this period (32).…”

“…Nursing and physician staffing characteristics across the three study units are shown in Figure 1 . When the IMCU/ICU was opened, most IMCU nurses were not critical care trained, and this required a training program that has previously been reported ( 7 ). Briefly, training included self-directed learning, skills days targeting critical care competencies, and on-the-job training supervised by experienced critical care nurses.…”

“…To meet demand, many hospitals repurposed non-ICU spaces into critical care units ( 3 ). Intermediate care units (IMCUs), which typically provide treatments and monitoring not feasible on a general medical ward (e.g., noninvasive ventilation and some continuous titratable infusions) ( 4 – 6 ), were retrofitted by some hospitals to serve this purpose ( 3 , 7 ).…”

A Review of Upskilling in The Healthcare Sector With Special Emphasis On Nurses

“…The study further highlighted the importance of incorporating technology-based training methods, such as simulation and e-learning, to enhance the effectiveness of upskilling programs. A study by Duffield et al 202026 emphasized the importance of upskilling nurses in leadership and management. The study found that leadership development programs can improve nurses' confidence, communication, and decision-making skills, ultimately improving patient outcomes.…”