The impact of COVID-19 on primary health care delivery in Australia.
COVID-19
care delivery
community
nursing
pandemic
primary health care
quality
safety
support
workforce
Journal
Journal of advanced nursing
ISSN: 1365-2648
Titre abrégé: J Adv Nurs
Pays: England
ID NLM: 7609811
Informations de publication
Date de publication:
May 2022
May 2022
Historique:
revised:
23
08
2021
received:
20
06
2021
accepted:
05
09
2021
pubmed:
24
9
2021
medline:
27
4
2022
entrez:
23
9
2021
Statut:
ppublish
Résumé
To validate the 'safe and effective staffing tool' and explore the impact of COVID-19 on the quality of Australian primary health care (PHC). A national survey was conducted from October to December 2020. The online survey was distributed via social media and professional organisations to PHC nurses. Three-hundred fifty-nine PHC nurses participated. A two-factor solution was found with factors named; 'Perception of quality of care provided' and 'Personal satisfaction with care delivered'. Cronbach's alpha demonstrated good internal consistency for the total scale (α = .915) and each subscale (α = .879/α = .864). Nearly three-quarters of participants (71.3%) were satisfied with the quality of care they delivered. Participants working in general practice, and those with more nursing experience had significantly higher scores in the factor 'perceptions of quality of care provided' and the total 'quality and satisfaction with care'. A lack of time, inadequate supervision and support, and performing non-nursing duties were reported to be impacting care quality. Most participants (80.5%) reported that COVID-19 had impacted negatively on the detection and management of non-COVID related health conditions. The 'safe and effective staffing tool' is a valid and reliable measure of perceived quality of care and satisfaction with care delivered. Many PHC nurses perceive that there has been an overall reduction in the quality of care delivered due to COVID-19 and feel that there is a lack of adequate supervision and workplace support. Given the limited baseline data, further research is required to understand the extent that COVID-19 impacts these findings. However, this study demonstrates that strategies need to be implemented to support PHC nurses to provide high-quality care to optimise health outcomes and maintain nurse satisfaction. This is the first attempt to evaluate care quality in Australian PHC. Policymaking requires this evidence to drive changes to better support PHC nurses.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1327-1336Subventions
Organisme : Australian College of Nursing
Organisme : University of Wollongong
Informations de copyright
© 2021 John Wiley & Sons Ltd.
Références
Aitken, L., Cerón, C., Simonetti, M., Lake, E., Galiano, A., Garbarini, A., Soto, P., Bravo, D., & Smith, H. (2018). Hospital nurse staffing and patient outcomes. Revista Médica Clínica Las Condes, 29(3), 322-327. https://doi.org/10.1016/j.rmclc.2018.04.011
Anzai, E., Douglas, C., & Bonner, A. (2014). Nursing practice environment, quality of care, and morale of hospital nurses in Japan. Nursing and Health Sciences, 16(2), 171-178. https://doi.org/10.1111/nhs.12081
Ashley, C., James, S., Stephen, C., Mursa, R., McInnes, S., Williams, A., Calma, K. R. B., & Halcomb, E. (in press). Primary health care nurses’ perceptions of risk during COVID-19: A qualitative study. Journal of Nursing Scholarship. https://doi.org/10.1111/jnu.12698
Ashley, C., James, S., Williams, A., Calma, K., McInnes, S., Mursa, R., Stephen, C., & Halcomb, E. (2021). The psychological well-being of primary health care nurses’ during COVID-19: A qualitative study. Journal of Advanced Nursing, 77(9), 3820-3828. https://doi.org/10.1111/jan.14937
Ashley, C., Peters, K., Brown, A., & Halcomb, E. (2018). Work satisfaction and future career intentions of experienced nurses transitioning to primary health care employment. Journal of Nursing Management, 26(6), 663-670. https://doi.org/10.1111/jonm.12597
Australian Institute of Health and Welfare. (2020). Cancer screening and COVID-19 in Australia. Cat. no: CAN 136. AIHW. Retrieved May 10, 2021, from https://www.aihw.gov.au/reports/cancer-screening/cancer-screening-and-covid-19-in-australia/contents/how-has-covid-19-affected-australias-cancer-screening-programs
Borneo, A., Helm, C., & Russell, J. (2017). Safe and effective staffing: Nursing against the odds. Royal College of Nursing.
Cancino, R. S., Su, Z., Mesa, R., Tomlinson, G. E., & Wang, J. (2020). The impact of COVID-19 on cancer screening: Challenges and opportunities. JMIR Cancer, 6(2), e21697. https://doi.org/10.2196/21697
Carver, C. S. (1997). You want to measure coping but your protocol’too long: Consider the brief cope. International Journal of Behavioral Medicine, 4(1), 92-100. https://doi.org/10.1207/s15327558ijbm0401_6
Chudasama, Y. V., Gillies, C. L., Zaccardi, F., Coles, B., Davies, M. J., Seidu, S., & Khunti, K. (2020). Impact of COVID-19 on routine care for chronic diseases: A global survey of views from healthcare professionals. Diabetes & Metabolic Syndrome: Clinical Research & Reviews, 14(5), 965-967. https://doi.org/10.1016/j.dsx.2020.06.042
Duckett, S. (2020). What should primary care look like after the COVID-19 pandemic? Australian Journal of Primary Health, 26(3), 207. https://doi.org/10.1071/PY20095
Griffiths, P., Maben, J., & Murrells, T. (2011). Organisational quality, nurse staffing and the quality of chronic disease management in primary care: Observational study using routinely collected data. International Journal of Nursing Studies, 48(10), 1199-1210. https://doi.org/10.1016/j.ijnurstu.2011.03.011
Griffiths, P., Recio-Saucedo, A., Dall'Ora, C., Briggs, J., Maruotti, A., Meredith, P., Smith, G. B., & Ball, J. (2018). The association between nurse staffing and omissions in nursing care: A systematic review. Journal of Advanced Nursing, 74(7), 1474-1487. https://doi.org/10.1111/jan.13564
Halcomb, E., McInnes, S., Williams, A., Ashley, C., James, S., Fernandez, R., Stephen, C., & Calma, K. (2020). The experiences of primary healthcare nurses during the COVID-19 pandemic in Australia. Journal of Nursing Scholarship, 52(2), 553-563. https://doi.org/10.1111/jnu.12589
Halcomb, E. J., Salamonson, Y., Davidson, P. M., Kaur, R., & Young, S. A. M. (2014). The evolution of nursing in Australian general practice: A comparative analysis of workforce surveys ten years on. BMC Family Practice, 15(52). http://www.biomedcentral.com/1471-2296/1415/1452
Halcomb, E., Smyth, E., & McInnes, S. (2018). Job satisfaction and career intentions of registered nurses in primary health care: An integrative review. BMC Family Practice, 19(136), https://doi.org/10.1186/s12875-12018-10819-12871
Halcomb, E. J., Stephens, M., Bryce, J., Foley, E., & Ashley, C. (2017). The development of national professional practice standards for nurses working in Australian general practice. Journal of Advanced Nursing, 73(8), 1958-1969.
Halcomb, E., Williams, A., Ashley, C., McInnes, S., Stephen, C., Calma, K., & James, S. (2020). The support needs of Australian primary health care nurses during the COVID-19 pandemic. Journal of Nursing Management, 28, 1553-1560. https://doi.org/10.1111/jonm.13108
Henry, J. D., & Crawford, J. R. (2005). The short-form version of the Depression Anxiety Stress Scales (DASS-21): Construct validity and normative data in a large non-clinical sample. British Journal of Clinical Psychology, 44(Pt. 2), 227-239. https://doi.org/10.1348/014466505X29657
IBM Corp. (2017). IBM SPSS Statistics for Windows, Version 25.0. IBM Corp.
James, S., Ashley, C., Williams, A., Desborough, J., McInnes, S., Calma, K. R. B., Mursa, R., Stephen, C., & Halcomb, E. (2021). Experiences of primary health care nurses in using telehealth during COVID-19: A qualitative study. British Medical Journal Open. https://bmjopen.bmj.com/content/11/18/e049095
Kaiser, H. F. (1960). The application of electronic computers to factor analysis. Educational and Psychological Measurement, 20(1), 141-151. https://doi.org/10.1177/001316446002000116
Kidd, M. (2020). Australia's primary care COVID-19 response. Australian Journal of General Practice, 49. https://doi.org/10.31128/AJGP-COVID-02
Lee, S. E., Vincent, C., Dahinten, V. S., Scott, L. D., Park, C. G., & Dunn Lopez, K. (2018). Effects of individual nurse and hospital characteristics on patient adverse events and quality of care: A multilevel analysis. Journal of Nursing Scholarship, 50(4), 432-440. https://doi.org/10.1111/jnu.12396
Martin, P., & Snowdon, D. (2020). Can clinical supervision bolster clinical skills and well-being through challenging times? Journal of Advanced Nursing, 76(11), 2781-2782. https://doi.org/10.1111/jan.14483
McInnes, S., Peters, K., Bonney, A., & Halcomb, E. (2015). An integrative review of facilitators and barriers influencing collaboration and teamwork between general practitioners and nurses working in general practice. Journal of Advanced Nursing, 71(9), 1973-1985. https://doi.org/10.1111/jan.12647
McInnes, S., Peters, K., Bonney, A., & Halcomb, E. J. (2017). A qualitative study of collaboration in general practice: Understanding the general practice nurse’s role. Journal of Clinical Nursing, 26(13-14), 1960-1968. https://doi.org/10.1111/jocn.13598
Mesa Vieira, C., Franco, O. H., Gómez Restrepo, C., & Abel, T. (2020). COVID-19: The forgotten priorities of the pandemic. Maturitas, 136, 38-41. https://doi.org/10.1016/j.maturitas.2020.04.004
Milne, D., & Martin, P. (2019). Supportive clinical supervision: Supported at last. Journal of Advanced Nursing, 75(2), 264-265. https://doi.org/10.1111/jan.13816
Park, S., Hanchett, M., & Ma, C. (2018). Practice environment characteristics associated with missed nursing care. Journal of Nursing Scholarship, 50(6), 722-730. https://doi.org/10.1111/jnu.12434
Recio-Saucedo, A., Dall'Ora, C., Maruotti, A., Ball, J., Briggs, J., Meredith, P., Redfern, O. C., Kovacs, C., Prytherch, D., Smith, G. B., & Griffiths, P. (2018). What impact does nursing care left undone have on patient outcomes? Review of the literature. Journal of Clinical Nursing, 27(11-12), 2248-2259. https://doi.org/10.1111/jocn.14058
Roehr, B. (2020). COVID-19 is threatening the survival of US primary care. British Medical Journal, 369, m2333. https://doi.org/10.1136/bmj.m2333
Semachew, A., Belachew, T., Tesfaye, T., & Adinew, Y. M. (2017). Predictors of job satisfaction among nurses working in Ethiopian public hospitals, 2014: Institution-based cross-sectional study. Human Resources for Health, 15(1), 31-31. https://doi.org/10.1186/s12960-017-0204-5
Senek, M., Robertson, S., Ryan, T., King, R., Wood, E., Taylor, B., & Tod, A. (2020). Determinants of nurse job dissatisfaction-Findings from a cross-sectional survey analysis in the UK. BMC Nursing, 19(1), 88. https://doi.org/10.1186/s12912-020-00481-3
Senek, M., Robertson, S., Ryan, T., Sworn, K., King, R., Wood, E., & Tod, A. (2020). Nursing care left undone in community settings: Results from a UK cross-sectional survey. Journal of Nursing Management, 28(8), 1968-1974. https://doi.org/10.1111/jonm.12995
Tabachnick, B. G., & Fidell, L. S. (2014). Using multivariate statistics (6th ed.). Pearson Education Limited.
Tsirtsakis, A. (2020). Pandemic results in nearly 100,000 fewer GP visits, MBS data reveals. The Royal Australian College of General Practitioners (RACGP). Retrieved April 22, 2021, from https://www1.racgp.org.au/newsgp/clinical/pandemic-results-in-nearly-100-000-fewer-gp-visits
Williams, B., Brown, T., & Onsman, A. (2012). Exploratory factor analysis: A five-step guide for novices. Australasian Journal of Paramedicine, 8(3), 1-13.
World Health Organization. (2018). A vision for primary health care in the 21st century: Towards universal health coverage and sustainable development goals. WHO. Retrieved April 26, 2021, from https://apps.who.int/iris/bitstream/handle/10665/328065/WHO-HIS-SDS-2018.15-eng.pdf?sequence=1&isAllowed=y
World Health Organization. (2020). COVID-19 AND NCDs-Rapid assessment of service delivery for NCDs during the COVID-19 pandemic. WHO. Retrieved April 22, 2021, from https://www.who.int/publications/m/item/rapid-assessment-of-service-delivery-for-ncds-during-the-covid-19-pandemic
Wright, A., Salazar, A., Mirica, M., Volk, L. A., & Schiff, G. D. (2020). The invisible epidemic: Neglected chronic disease management during COVID-19. Journal of General Internal Medicine, 35(9), 2816-2817. https://doi.org/10.1007/s11606-020-06025-4
Wright, M., Versteeg, R., & Hall, J. (2020). General practice's early response to the COVID-19 pandemic. Australian Health Review, 44(5), 733-736. https://doi.org/10.1071/AH20157