Focusing on fundamentals of care in an ICU setting during a pandemic

Abstract

Aims This manuscript aims to describe one acute care hospital's ICU journey during the COVID‐19 pandemic and how fundamental care was central to the implementation of team‐based models of care. Background Over the course of the COVID‐19 pandemic, team‐based and alternative models of care are being employed to manage and address global shortages and surge capacity. Employing these alternate models of care required attention to ensure fundamental care needs of patients were being met. Design/Method The following paper describes an ICU's journey of focusing on the delivery of the fundamentals of care through the implementation of team‐based models of care to address the surge in patient care demands experienced in response to our global pandemic. Conclusions The implementation of an evidence‐informed approach to optimizing models of care and staffing in the ICU amid the evolving COVID‐19 waves in one acute‐care hospital is provided. This local approach focused on meeting patients' fundamental care needs throughout the necessary introduction of team‐based care models and staffing changes and drew from evolving evidence, the ILC Fundamentals of Care Framework, and regulatory guidance.

‘No more heroes’: The ILC Oxford Statement on fundamental care in times of crises

“…There were some excellent examples from health system nursing leaders who had been given or took control of the whole system response to COVID. Colleagues from Sinai Health in Toronto, Canada shared their experiences of managing an Ontario‐wide response as well as how they changed models of care in the ICU to safely accommodate the fast‐changing scenarios of staff shortages and the need to quickly skill up nursing staff and continue to provide safe care (Amaral et al, 2022). They also shared how the Fundamentals of Care Framework (see Figure 1; Feo et al, 2018; Kitson et al, 2013; Kitson & Muntlin Athlin, 2013) guided policy guidance documents on provisions of care through the conventional, contingency and crisis phases of the pandemic.…”

“…At the same time, nurses were trying to respond to patient fundamental care needs and safety issues. Teams experimented with team-based models of care in ICUs and nurses moved around hospital, education, aged care and community care systems to fill in gaps (Amaral et al, 2022).…”

Leadership for fundamental care: The whole is greater than the sum of the parts

“…Healthcare and nursing leaders cannot ignore the impact of the COVID pandemic. Several papers have described how this was undertaken (Amaral et al, 2022; Sugg et al, 2022; Schroberer et al, 2022) and how leadership interventions shaped patients' experiences of fundamental care during the pandemic. Contributions from around the globe have ranged from discursive pieces to descriptive and empirical work.…”

Leadership for Fundamental Care: The whole is greater than the sum of the parts

“…Healthcare and nursing leaders cannot ignore the impact of the COVID pandemic. Several papers have described how this was undertaken (Amaral et al, 2022; Schroberer et al, 2022; Sugg et al, 2022) and how leadership interventions shaped patients' experiences of fundamental care during the pandemic. Contributions from around the globe have ranged from discursive pieces to descriptive and empirical work.…”