Nursing workload in the COVID-19 era

Lucchini, Alberto; Iozzo, Pasquale; Bambi, Stefano

doi:10.1016/j.iccn.2020.102929

Cited by 74 publications

(78 citation statements)

References 15 publications

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“…Dyrbye et al reported 3%‐9% increased odds of physician burnout for each additional night or weekend on call 89 . SARS‐CoV‐2 has brought a surplus of patients with complex management needs, placing an even greater strain on healthcare systems and HCW workload 90 . A recent survey by Zhang et al identified that frontline HCWs were working longer hours than preferred during the SARS‐CoV‐2 pandemic 91 .…”

Section: Discussionmentioning

confidence: 99%

“…89 SARS-CoV-2 has brought a surplus of patients with complex management needs, placing an even greater strain on healthcare systems and HCW workload. 90 A recent survey by Zhang et al identified that frontline HCWs were working longer hours than preferred during the SARS-CoV-2 pandemic. 91 This was particularly the case in fever clinics and isolation wards.…”

Section: Working Hoursmentioning

confidence: 99%

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The impact of SARS-CoV-2 on the mental health of healthcare workers in a hospital setting—A Systematic Review

Sanghera

Pattani

Hashmi

et al. 2020

Journal of Occupational Health

186

194

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Objectives The SARS‐CoV‐2 global pandemic has subjected healthcare workers (HCWs) to high risk of infection through direct workplace exposure, coupled with increased workload and psychological stress. This review aims to determine the impact of SARS‐CoV‐2 on mental health outcomes of hospital‐based HCWs and formulate recommendations for future action. Methods A systematic review was performed between 31st December 2019 and 17th June 2020 through Ovid Medline and Embase databases (PROSPERO ID CRD42020181204). Studies were included for review if they investigated the impact of SARS‐CoV‐2 on mental health outcomes of hospital‐based HCWs and used validated psychiatric scoring tools. Prevalence of ICD‐10 classified psychiatric disorders was the primary outcome measure. Results The initial search returned 436 articles. Forty‐four studies were included in final analysis, with a total of 69,499 subjects. Prevalence ranges of six mental health outcomes were identified: depression 13.5%‐44.7%; anxiety 12.3%‐35.6%; acute stress reaction 5.2%‐32.9%; post‐traumatic stress disorder 7.4%‐37.4%; insomnia 33.8%‐36.1%; and occupational burnout 3.1%‐43.0%. Direct exposure to SARS‐CoV‐2 patients was the most common risk factor identified for all mental health outcomes except occupational burnout. Nurses, frontline HCWs, and HCWs with low social support and fewer years of working experience reported the worst outcomes. Conclusion The SARS‐CoV‐2 pandemic has significantly impacted the mental health of HCWs. Frontline staff demonstrate worse mental health outcomes. Hospitals should be staffed to meet service provision requirements and to mitigate the impact onmental health. This can be improved with access to rapid‐response psychiatric teams and should be continually monitored throughout the pandemic and beyond its conclusion.

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Section: Discussionmentioning

confidence: 99%

Section: Working Hoursmentioning

confidence: 99%

The impact of SARS-CoV-2 on the mental health of healthcare workers in a hospital setting—A Systematic Review

Sanghera

Pattani

Hashmi

et al. 2020

Journal of Occupational Health

186

194

View full text Add to dashboard Cite

show abstract

“…In comparison with “classical” pressure support, the use of free flow helmet CPAP has the main advantages of not requiring a ventilator (whose shortage represented a major issue during pandemics) and not presenting any issue of patient–ventilator synchrony, even in the presence of leaks, elevated respiratory rate, patient movement and so forth. Taking advantage of a nurse-managed optimization bundle, helmet CPAP was well tolerated for many hours a day (almost continuously during the first days) [ 14 ], without relevant pressure ulcers [ 22 ].…”

Section: Discussionmentioning

confidence: 99%

“…In fact, it is generally well tolerated, air leaks are rarely an issue and it is associated with low pressure ulcer complications, particularly for prolonged therapy [ 12 ]. When treating COVID-19 affected patients, the use of helmets might bear the additional advantage of reducing virus environment contamination [ 13 , 14 ]. Recent reports suggest that helmet CPAP can be effective for COVID-19 treatment [ 15 – 17 ], possibly combined with prone or lateral position [ 18 – 20 ].…”

Section: Introductionmentioning

confidence: 99%

Helmet CPAP to treat hypoxic pneumonia outside the ICU: an observational study during the COVID-19 outbreak

et al. 2021

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Background Respiratory failure due to COVID-19 pneumonia is associated with high mortality and may overwhelm health care systems, due to the surge of patients requiring advanced respiratory support. Shortage of intensive care unit (ICU) beds required many patients to be treated outside the ICU despite severe gas exchange impairment. Helmet is an effective interface to provide continuous positive airway pressure (CPAP) noninvasively. We report data about the usefulness of helmet CPAP during pandemic, either as treatment, a bridge to intubation or a rescue therapy for patients with care limitations (DNI). Methods In this observational study we collected data regarding patients failing standard oxygen therapy (i.e., non-rebreathing mask) due to COVID-19 pneumonia treated with a free flow helmet CPAP system. Patients’ data were recorded before, at initiation of CPAP treatment and once a day, thereafter. CPAP failure was defined as a composite outcome of intubation or death. Results A total of 306 patients were included; 42% were deemed as DNI. Helmet CPAP treatment was successful in 69% of the full treatment and 28% of the DNI patients (P < 0.001). With helmet CPAP, PaO2/FiO2 ratio doubled from about 100 to 200 mmHg (P < 0.001); respiratory rate decreased from 28 [22–32] to 24 [20–29] breaths per minute, P < 0.001). C-reactive protein, time to oxygen mask failure, age, PaO2/FiO2 during CPAP, number of comorbidities were independently associated with CPAP failure. Helmet CPAP was maintained for 6 [3–9] days, almost continuously during the first two days. None of the full treatment patients died before intubation in the wards. Conclusions Helmet CPAP treatment is feasible for several days outside the ICU, despite persistent impairment in gas exchange. It was used, without escalating to intubation, in the majority of full treatment patients after standard oxygen therapy failed. DNI patients could benefit from helmet CPAP as rescue therapy to improve survival. Trial Registration: NCT04424992

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“…This system will allow identifying high-risk patients at an early stage, possibly leading to optimized management, and overcoming the shortage of medical and material resources ( Gao et al, 2020 , Li et al, 2020 , Shi et al, 2020 , Zhou et al, 2020 ). At the same time, this system will provide a more adequate screening of patients eligible to be transferred to specialized intensive care units, thus avoiding the overload of care and the medical errors that may arise ( Garcia-Alamino, 2020 , Janssonet al, 2020 , Lucchini et al, 2020 ).…”

Section: Introductionmentioning

confidence: 99%

Development and validation of a laboratory risk score for the early prediction of COVID-19 severity and in-hospital mortality

Bennouar

Cherif

Kessira

et al. 2021

Intensive and Critical Care Nursing

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Nursing workload in the COVID-19 era

Cited by 74 publications

References 15 publications

The impact of SARS-CoV-2 on the mental health of healthcare workers in a hospital setting—A Systematic Review

The impact of SARS-CoV-2 on the mental health of healthcare workers in a hospital setting—A Systematic Review

Helmet CPAP to treat hypoxic pneumonia outside the ICU: an observational study during the COVID-19 outbreak

Development and validation of a laboratory risk score for the early prediction of COVID-19 severity and in-hospital mortality

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