Voices from frontline nurses on care quality and patient safety during COVID-19: An application of the Donabedian model.

Covid-19 pandemic Health care–associated infections Infection prevention and control Nurse staffing Resources

Journal

American journal of infection control
ISSN: 1527-3296
Titre abrégé: Am J Infect Control
Pays: United States
ID NLM: 8004854

Informations de publication

Date de publication:
Dec 2023
Historique:
received: 15 03 2023
revised: 18 08 2023
accepted: 19 08 2023
pubmed: 26 8 2023
medline: 26 8 2023
entrez: 25 8 2023
Statut: ppublish

Résumé

The COVID-19 pandemic has adversely impacted quality of care and patient safety. This study aimed to describe registered nurses' (RNs) perceptions on the impact of the COVID-19 pandemic on their ability to adhere to patient safety protocols using Donabedian's Health Care Quality model. In October 2020, a survey was conducted among all actively licensed RNs in New Jersey who provided direct patient care during the first peak of COVID-19. Of 3,027 participants, 68% reported that the number of patients assigned impacted their ability to adhere to protocols. RNs identified a variety of organizational structures impacting adherence, including inadequate staffing, staff qualifications, and inadequate resources. Impacted processes included the inability to adhere to patient safety protocols and conduct comprehensive assessments and surveillance, the need for additional time spent on personal protective equipment and isolation policies, and difficulty maintaining isolation integrity; the need to prioritize and cluster care; and guidelines limiting personnel who could enter the room. Nurses attributed both adverse patient and staff outcomes to inadequate staffing and high patient acuity. These findings highlight the need for health care organizations to support frontline nursing staff in adhering to patient safety and infection prevention and control protocols during times of crises. Infection preventionists have substantial contact with bedside nurses and should leverage their collegial relationships to promote patient safety.

Sections du résumé

BACKGROUND BACKGROUND
The COVID-19 pandemic has adversely impacted quality of care and patient safety. This study aimed to describe registered nurses' (RNs) perceptions on the impact of the COVID-19 pandemic on their ability to adhere to patient safety protocols using Donabedian's Health Care Quality model.
METHODS METHODS
In October 2020, a survey was conducted among all actively licensed RNs in New Jersey who provided direct patient care during the first peak of COVID-19.
RESULTS RESULTS
Of 3,027 participants, 68% reported that the number of patients assigned impacted their ability to adhere to protocols. RNs identified a variety of organizational structures impacting adherence, including inadequate staffing, staff qualifications, and inadequate resources. Impacted processes included the inability to adhere to patient safety protocols and conduct comprehensive assessments and surveillance, the need for additional time spent on personal protective equipment and isolation policies, and difficulty maintaining isolation integrity; the need to prioritize and cluster care; and guidelines limiting personnel who could enter the room. Nurses attributed both adverse patient and staff outcomes to inadequate staffing and high patient acuity.
CONCLUSIONS CONCLUSIONS
These findings highlight the need for health care organizations to support frontline nursing staff in adhering to patient safety and infection prevention and control protocols during times of crises. Infection preventionists have substantial contact with bedside nurses and should leverage their collegial relationships to promote patient safety.

Identifiants

pubmed: 37625547
pii: S0196-6553(23)00577-1
doi: 10.1016/j.ajic.2023.08.014
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

1295-1301

Informations de copyright

Copyright © 2023 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Auteurs

Monika Pogorzelska-Maziarz (M)

Thomas Jefferson University College of Nursing, Philadelphia, PA. Electronic address: Monika.Pogorzelska-Maziarz@jefferson.edu.

Pamela B de Cordova (PB)

Rutgers University, Biomedical and Health Sciences, Newark, NJ.

Mary Lou Manning (ML)

Thomas Jefferson University College of Nursing, Philadelphia, PA.

Mary L Johansen (ML)

Rutgers University, Biomedical and Health Sciences, Newark, NJ.

Irina Grafova (I)

Rutgers University, Edward J. Bloustein School of Planning & Public Policy, New Brunswick, NJ.

Angela Gerolamo (A)

Thomas Jefferson University College of Nursing, Philadelphia, PA.

Classifications MeSH