Evaluation of a COVID-19 fundamental nursing care guideline versus usual care: The COVID-NURSE cluster randomized controlled trial.

COVID-19 SARS-COV-2 cluster randomized controlled trial fundamental nursing care patient experience

Journal

Journal of advanced nursing
ISSN: 1365-2648
Titre abrégé: J Adv Nurs
Pays: England
ID NLM: 7609811

Informations de publication

Date de publication:
20 Nov 2023
Historique:
revised: 01 11 2023
received: 14 06 2023
accepted: 01 11 2023
medline: 21 11 2023
pubmed: 21 11 2023
entrez: 21 11 2023
Statut: aheadofprint

Résumé

To evaluate the impact of usual care plus a fundamental nursing care guideline compared to usual care only for patients in hospital with COVID-19 on patient experience, care quality, functional ability, treatment outcomes, nurses' moral distress, patient health-related quality of life and cost-effectiveness. Parallel two-arm, cluster-level randomized controlled trial. Between 18th January and 20th December 2021, we recruited (i) adults aged 18 years and over with COVID-19, excluding those invasively ventilated, admitted for at least three days or nights in UK Hospital Trusts; (ii) nurses caring for them. We randomly assigned hospitals to use a fundamental nursing care guideline and usual care or usual care only. Our patient-reported co-primary outcomes were the Relational Aspects of Care Questionnaire and four scales from the Quality from the Patient Perspective Questionnaire. We undertook intention-to-treat analyses. We randomized 15 clusters and recruited 581 patient and 418 nurse participants. Primary outcome data were available for 570-572 (98.1%-98.5%) patient participants in 14 clusters. We found no evidence of between-group differences on any patient, nurse or economic outcomes. We found between-group differences over time, in favour of the intervention, for three of our five co-primary outcomes, and a significant interaction on one primary patient outcome for ethnicity (white British vs. other) and allocated group in favour of the intervention for the 'other' ethnicity subgroup. We did not detect an overall difference in patient experience for a fundamental nursing care guideline compared to usual care. We have indications the guideline may have aided sustaining good practice over time and had a more positive impact on non-white British patients' experience of care. We cannot recommend the wholescale implementation of our guideline into routine nursing practice. Further intervention development, feasibility, pilot and evaluation studies are required. Fundamental nursing care drives patient experience but is severely impacted in pandemics. Our guideline was not superior to usual care, albeit it may sustain good practice and have a positive impact on non-white British patients' experience of care. CONSORT and CONSERVE. Patients with experience of hospitalization with COVID-19 were involved in guideline development and writing, trial management and interpretation of findings.

Identifiants

pubmed: 37986547
doi: 10.1111/jan.15959
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Subventions

Organisme : Medical Research Council
ID : MR/V02776X/1
Pays : United Kingdom

Informations de copyright

© 2023 The Authors. Journal of Advanced Nursing published by John Wiley & Sons Ltd.

Références

Aiken, L. H., Sloane, D., Griffiths, P., Rafferty, A. M., Bruyneel, L., Mchugh, M., Maier, C. B., Moreno-Casbas, T., Ball, J. E., Ausserhofer, D., Sermeus, W., & Consortium, R. C. (2017). Nursing skill mix in European hospitals: Cross-sectional study of the association with mortality, patient ratings, and quality of care. BMJ Quality & Safety, 26, 559-568.
Bagnasco, A., Zanini, M., Hayter, M., Catania, G., & Sasso, L. (2020). COVID 19-A message from Italy to the global nursing community. Journal of Advanced Nursing, 76, 2212-2214.
Black, N., Varaganum, M., & Hutchings, A. (2014). Relationship between patient reported experience (PREMs) and patient reported outcomes (PROMs) in elective surgery. BMJ Quality and Safety, 23, 534-542.
Canadian Nurses Association. (2003). CNA brief to the National Advisory Committee on SARS and Public Health: Lessons learned and recommendations. Canadian Nurses Association.
Corley, M. C., Elswick, R. K., Gorman, M., & Clor, T. (2001). Development and evaluation of a moral distress scale. Journal of Advanced Nursing, 33, 250-256.
Doyle, C., Lennox, L., & Bell, D. (2013). A systematic review of evidence on the links between patient experience and clinical safety and effectiveness. BMJ Open, 3, e001570.
Euroqol Research Foundation. (2019). EQ-5D-5L user guide. https://euroqol.org/publications/user-guides
Gammon, J., & Hunt, J. (2018). A review of isolation practices and procedures in healthcare settings. The British Journal of Nursing, 27, 137-140.
Goodrich, D. E., Lowery, J. C., Burns, J. A., & Richardson, C. R. (2018). The phased implementation of a national telehealth weight management program for veterans: Mixed-methods program evaluation. JMIR Diabetes, 3, e14.
Graham, C., Käsbauer, S., Cooper, R., King, J., Sizmur, S., Jenkinson, C., & Kelly, L. (2018). Health services and delivery research. In An evaluation of a near real-time survey for improving patients' experiences of the relational aspects of care: A mixed-methods evaluation. NIHR Journals Library.
Graham, J. W. (2012). Missing data: Analysis and design, statistics for social and behavioural sciences. Springer.
Huis, A., Hulscher, M., Adang, E., Grol, R., Van Achterberg, T., & Schoonhoven, L. (2013). Cost-effectiveness of a team and leaders-directed strategy to improve nurses' adherence to hand hygiene guidelines: A cluster randomised trial. International Journal of Nursing Studies, 50, 518-526.
Johnson, K., Gustafson, D., Ewigman, B., Provost, L., & Roper, R. (2015). Using rapid-cycle research to reach goals: Awareness, assessment, adaptation, acceleration. AHRQ publication No. 15-0036. Agency for Healthcare Research and Quality.
Kelly, L., Sizmur, S., Kasbauer, S., King, J., Cooper, R., Jenkinson, C., & Graham, C. (2018). The relational aspects of care questionnaire: Item reduction and scoring using inpatient and accident and emergency data in England. Patient Related Outcome Measures, 9, 173-181.
Kenward, M. G., & Roger, J. H. (1997). Small sample inference for fixed effects from restricted maximum likelihood. Biometrics, 53, 983-997.
Kitson, A. (2010). Reclaiming nursing care. Collegian, 17, 1-2.
Kitson, A., Carr, D., Conroy, T., Feo, R., Gronkjaer, M., Huisman-De Waal, G., Jackson, D., Jeffs, L., Merkley, J., Muntlin Athlin, A., Parr, J., Richards, D. A., Sorensen, E. E., & Wengstrom, Y. (2019). Speaking up for fundamental care: The ILC Aalborg statement. BMJ Open, 9, e033077.
Kroenke, K., Spitzer, R. L., & Williams, J. B. (2003). The patient health Questionnaire-2: Validity of a two-item depression screener. Medical Care, 41, 1284-1292.
Kroenke, K., Spitzer, R. L., Williams, J. B., Monahan, P. O., & Lowe, B. (2007). Anxiety disorders in primary care: Prevalence, impairment, comorbidity, and detection. Annals of Internal Medicine, 146, 317-325.
Larsson, B., Larsson, G., Chantereau, M., & Von Holstein, K. (2005). International comparisons of patients' views on quality of care. International Journal of Health Care Quality Assurance Incorporating Leadership in Health Services, 18, 62-73.
Mahoney, F. I., & Barthel, D. W. (1965). Functional evaluation: The Barthel index. Maryland State Medical Journal, 14, 61-65.
Marshall, J., & On behalf of the WHO working group on the clinical characteristics of COVID-19 infection. (2020). A core outcome measure set for studies of SARS-CoV2/COVID-19 infection [online]. University of Toronto http://www.comet-initiative.org/Studies/Details/1528
Menezes, P., Miller, W. C., Wohl, D. A., Adimora, A. A., Leone, P. A., Miller, W. C., & Eron, J. J., Jr. (2011). Does HAART efficacy translate to effectiveness? Evidence for a trial effect. PLoS ONE, 6, e21824.
National Institute for Health Care Excellence. (2013). Guide to the methods of technology appraisal. National Institute for Health and Care Excellence.
Orkin, A. M., Gill, P. J., Ghersi, D., Campbell, L., Sugarman, J., Emsley, R., Steg, P. G., Weijer, C., Simes, J., Rombey, T., Williams, H. C., Wittes, J., Moher, D., Richards, D. P., Kasamon, Y., Getz, K., Hopewell, S., Dickersin, K., Wu, T., … Group, C. (2021). Guidelines for reporting trial protocols and completed trials modified due to the COVID-19 pandemic and other extenuating circumstances: The CONSERVE 2021 statement. JAMA, 326, 257-265.
Pentecost, C., Frost, J., Sugg, H. V. R., Hilli, A., Goodwin, V. A., & Richards, D. A. (2019). Patients' and nurses' experiences of fundamental nursing care: A systematic review and qualitative synthesis. Journal of Clinical Nursing, 29, 1858-1882.
Registered Nurses Association of Ontario. (2003). SARS unmasked: Celebrating resilience, exposing vulnerability. A report on the nursing experience with SARS in Ontario. Registered Nurses Association of Ontario.
Richards, D. A., Sugg, H. V., Cockcroft, E., Cooper, J., Cruickshank, S., Doris, F., Hulme, C., Logan, P., Iles-Smith, H., Melendez-Torres, G. J., Rafferty, A. M., Reed, N., Russell, A. M., Shepherd, M., Singh, S. J., Thompson Coon, J., Tooze, S., Wootton, S., Abbott, R., … Romanczuk, L. (2021). Covid-nurse: Evaluation of a fundamental nursing care protocol compared with care as usual on experience of care for noninvasively ventilated patients in hospital with the SARS-CoV-2 virus-protocol for a cluster randomised controlled trial. BMJ Open, 11, e046436.
Schulz, K. F., Altman, D. G., Moher, D., & Group, C. (2010). CONSORT 2010 statement: Updated guidelines for reporting parallel group randomised trials. BMJ, 340, c332.
Sugg, H. V. R., Richards, D. A., Russell, A. M., Burnett, S., Cockcroft, E. J., Thompson Coon, J., Cruickshank, S., Doris, F. E., Hunt, H. A., Iles-Smith, H., Kent, M., Logan, P. A., Morgan, L. M., Morley, N., Rafferty, A. M., Shepherd, M. H., Singh, S. J., Tooze, S. J., & Whear, R. (2022). Nurses' strategies for overcoming barriers to fundamental nursing care in patients with COVID-19 caused by infection with the SARS-COV-2 virus: Results from the ‘COVID-NURSE’ survey. Journal of Advanced Nursing79, 1003-1017.
Sugg, H. V. R., Russell, A. M., Morgan, L. M., Iles-Smith, H., Richards, D. A., Morley, N., Burnett, S., Cockcroft, E. J., Thompson Coon, J., Cruickshank, S., Doris, F. E., Hunt, H. A., Kent, M., Logan, P. A., Rafferty, A. M., Shepherd, M. H., Singh, S. J., Tooze, S. J., & Whear, R. (2021). Fundamental nursing care in patients with the SARS-CoV-2 virus: Results from the ‘COVID-NURSE’ mixed methods survey into nurses' experiences of missed care and barriers to care. BMC Nursing, 20, 215.
Van Hout, B., Janssen, M. F., Feng, Y. S., Kohlmann, T., Busschbach, J., Golicki, D., Lloyd, A., Scalone, L., Kind, P., & Pickard, A. S. (2012). Interim scoring for the Eq-5D-5L: Mapping the Eq-5D-5L to Eq-5D-3L value sets. Value in Health, 15, 708-715.
Verbeek, J. H., Rajamaki, B., Ijaz, S., Sauni, R., Toomey, E., Blackwood, B., Tikka, C., Ruotsalainen, J. H., & Kilinc Balci, F. S. (2020). Personal protective equipment for preventing highly infectious diseases due to exposure to contaminated body fluids in healthcare staff. Cochrane Database of Systematic Reviews, 5, CD011621.
Whear, R., Abbott, R. A., Bethel, A., Richards, D. A., Garside, R., Cockcroft, E., Iles-Smith, H., Logan, P. A., Rafferty, A. M., Shepherd, M., Sugg, H. V. R., Russell, A. M., Cruickshank, S., Tooze, S., Melendez-Torres, G. J., & Thompson Coon, J. (2022). Impact of COVID-19 and other infectious conditions requiring isolation on the provision of and adaptations to fundamental nursing care in hospital in terms of overall patient experience, care quality, functional ability, and treatment outcomes: Systematic review. Journal of Advanced Nursing, 78, 78-108.
Wilde Larsson, B., & Larsson, G. (2002). Development of a short form of the Quality from the Patient's Perspective (QPP) questionnaire. Journal of Clinical Nursing, 11, 681-687.
World Health Organization. (2016). Guidelines on core components of infection prevention and control programmes at the national and acute health care facility level. World Health Organization.

Auteurs

David A Richards (DA)

Faculty of Health and Life Sciences, University of Exeter, Exeter, UK.
Department of Health and Caring Sciences, Western Norway University of Applied Sciences, Bergen, Norway.

Jess Bollen (J)

Faculty of Health and Life Sciences, University of Exeter, Exeter, UK.

Ben Jones (B)

Faculty of Health and Life Sciences, University of Exeter, Exeter, UK.

G J Melendez-Torres (GJ)

Faculty of Health and Life Sciences, University of Exeter, Exeter, UK.

Claire Hulme (C)

Faculty of Health and Life Sciences, University of Exeter, Exeter, UK.

Emma Cockcroft (E)

Faculty of Health and Life Sciences, University of Exeter, Exeter, UK.

Heather Cook (H)

Faculty of Health and Life Sciences, University of Exeter, Exeter, UK.

Joanne Cooper (J)

Nottingham University Hospitals NHS Trust, Nottingham, UK.

Siobhan Creanor (S)

Faculty of Health and Life Sciences, University of Exeter, Exeter, UK.

Susanne Cruickshank (S)

Royal Marsden NHS Foundation Trust, London, UK.

Phoebe Dawe (P)

Faculty of Health and Life Sciences, University of Exeter, Exeter, UK.

Faye Doris (F)

Faculty of Health and Life Sciences, University of Exeter, Exeter, UK.

Heather Iles-Smith (H)

School of Health and Society, University of Salford, Salford, UK.

Merryn Kent (M)

Faculty of Health and Life Sciences, University of Exeter, Exeter, UK.

Pip Logan (P)

Community Health Sciences, University of Nottingham, Nottingham, UK.

Abby O'Connell (A)

Faculty of Health and Life Sciences, University of Exeter, Exeter, UK.

Jakub Onysk (J)

Faculty of Health and Life Sciences, University of Exeter, Exeter, UK.

Rosie Owens (R)

Faculty of Health and Life Sciences, University of Exeter, Exeter, UK.

Lynne Quinn (L)

Faculty of Health and Life Sciences, University of Exeter, Exeter, UK.

Anne Marie Rafferty (AM)

Florence Nightingale School of Nursing and Midwifery, Kings College University London, London, UK.

Lidia Romanczuk (L)

Royal Devon and Exeter Foundation Trust, Exeter, UK.

Anne Marie Russell (AM)

Faculty of Health and Life Sciences, University of Exeter, Exeter, UK.

Maggie Shepherd (M)

Faculty of Health and Life Sciences, University of Exeter, Exeter, UK.

Sally J Singh (SJ)

Department of Respiratory Science, University of Leicester, Leicester, UK.
University Hospitals of Leicester NHS Trust, Biomedical Research Centre - Respiratory, Glenfield Hospital, Leicester, UK.

Holly V R Sugg (HVR)

Faculty of Health and Life Sciences, University of Exeter, Exeter, UK.

Jo Thompson Coon (JT)

Faculty of Health and Life Sciences, University of Exeter, Exeter, UK.
The National Institute for Health Research (NIHR) Applied Research Collaboration (ARC) South West Peninsula (PenARC), Exeter, UK.

Susannah Tooze (S)

Faculty of Health and Life Sciences, University of Exeter, Exeter, UK.

Fiona C Warren (FC)

Faculty of Health and Life Sciences, University of Exeter, Exeter, UK.

Bethany Whale (B)

Faculty of Health and Life Sciences, University of Exeter, Exeter, UK.

Stephen Wootton (S)

Institute of Human Nutrition, University of Southampton, Southampton, UK.

Classifications MeSH