A Qualitative Analysis of the Functions of Primary Care Nurses in COVID-19 Vaccination.
COVID‐19
nurse roles
nursing
pandemic response
primary care
qualitative research
vaccination
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 Sep 2024
20 Sep 2024
Historique:
revised:
23
08
2024
received:
17
04
2024
accepted:
04
09
2024
medline:
21
9
2024
pubmed:
21
9
2024
entrez:
20
9
2024
Statut:
aheadofprint
Résumé
To describe vaccination roles of primary care nurses during the COVID-19 pandemic in Canada. This analysis was part of a larger mixed-methods case study. We conducted semi-structured qualitative interviews from May 2022 to January 2023 with primary care nurses across four provinces: British Columbia, Ontario, Newfoundland and Labrador, and Nova Scotia. We asked participants to describe their roles during various stages of the pandemic, facilitators and challenges encountered and possible roles that nurses could have played. We used thematic analysis and analysed codes relevant to vaccination. We interviewed a total of 76 nurses and identified four key functions of primary care nurses' roles in COVID-19 vaccination: (1) education, (2) vaccine administration, (3) outreach and (4) advocacy. Themes outlined nurses' roles with respect to patient education, addressing vaccine hesitancy, partaking in vaccination roles outside of regular primary care practice and supporting accessibility in COVID-19 vaccination. Specific tasks varied by nursing professions. Primary care nurses fostered trust through existing patient-provider relationships to enhance roles and activities related to education, outreach and advocacy in COVID-19 vaccination. Some COVID-19 vaccine-related roles were more easily integrated into primary care, whereas others competed with routine primary care roles. Findings highlight the vital contributions of primary care nurses towards COVID-19 vaccination efforts in Canada. Leveraging nursing expertise can enhance future pandemic response efforts and improve patient care by addressing barriers to vaccination and promoting equitable access to vaccination services. This study addresses a knowledge gap by describing the vaccination-related roles of primary care nurses during the pandemic. Findings illustrate that nurses demonstrated adaptability through their engagement in vaccine education, administration, outreach and advocacy. This research informs resource allocation, policy development and workforce planning for future vaccination efforts during a pandemic response. The authors have adhered to the Standards for Reporting Qualitative Research (SRQR) guidelines included in the Empirical Research Qualitative reporting method. No patient or public contribution. WHAT DOES THIS PAPER CONTRIBUTE TO THE WIDER GLOBAL CLINICAL COMMUNITY?: Provides insight into the pivotal roles of primary care nurses during the COVID-19 vaccination efforts in Canada, highlighting their diverse contributions towards education, vaccine administration, outreach and advocacy. Offers implications for future pandemic planning by informing resource allocation, policy development and workforce planning for vaccination efforts.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Subventions
Organisme : CIHR
ID : 477227
Pays : Canada
Informations de copyright
© 2024 The Author(s). Journal of Advanced Nursing published by John Wiley & Sons Ltd.
Références
Aggarwal, M., K. M. Kokorelias, R. H. Glazier, A. Katz, J. E. Shiers‐Hanley, and R. E. G. Upshur. 2023. “What Is the Role of Primary Care in the COVID‐19 Vaccine Roll‐Out and the Barriers and Facilitators to an Equitable Vaccine Roll‐Out? A Rapid Scoping Review of Nine Jurisdictions.” BMJ Open 13, no. 4: e065306. https://doi.org/10.1136/bmjopen‐2022‐065306.
Ali, F., A. Kaura, C. Russell, et al. 2023. “Identifying Barriers and Facilitators to COVID‐19 Vaccination Uptake Among People who Use Drugs in Canada: A National Qualitative Study.” Harm Reduction Journal 20, no. 1: 99. https://doi.org/10.1186/s12954‐023‐00826‐6.
American Nurses Association. 2020. “American Nurses Association Underscores nurses' Role in Successful Mass Vaccination Campaigns: ‘Most Trusted’ Profession Key to Building Public Confidence.” ANA https://www.nursingworld.org/news/news‐releases/2020/american‐nurses‐association‐underscores‐nurses‐role‐‐‐in‐successful‐mass‐vaccination‐campaigns‐‐‐most‐trusted‐‐profession‐key‐to‐building‐public‐confidence/.
Arya, N., V. J. Redditt, R. Talavlikar, et al. 2021. “Caring for Refugees and Newcomers in the Post–COVID‐19 Era: Evidence Review and Guidance for FPs and Health Providers.” Canadian family physician Medecin de famille canadien 67, no. 8: 575–581. https://doi.org/10.46747/cfp.6708575.
Ashcroft, R., C. Donnelly, S. Lam, et al. 2024. “A Qualitative Examination of Primary Care Team's Participation in the Distribution of the COVID‐19 Vaccination. BMC.” Primary Care 25, no. 85: e1–e10. https://doi.org/10.1186/s12875‐024‐02327‐2.
Aylsworth, L., T. Manca, È. Dubé, et al. 2022. “A Qualitative Investigation of Facilitators and Barriers to Accessing COVID‐19 Vaccines Among Racialized and Indigenous Peoples in Canada.” Human Vaccines & Immunotherapeutics 18, no. 6: 2129827. https://doi.org/10.1080/21645515.2022.2129827.
Bajnok, I., H. Catton, T.Skinner, J. Shamian, and T. Pavlovic. 2018. “The Role of Nurses in Immunisation: A Snapshot From OECD Countries.” International Council of Nurses, 1–37. https://www.icn.ch/sites/default/files/inline‐files/IMMUNISATION_Report%20%28002%29.pdf.
Bardosh, K., A. D. Figueiredo, R. Gur‐Arie, et al. 2022. “The Unintended Consequences of COVID‐19 Vaccine Policy: Why Mandates, Passports and Restrictions May Cause More Harm Than Good.” BMJ Global Health 7, no. 5: e008684. https://doi.org/10.1136/bmjgh‐2022‐008684.
BBC. “Why Canada Is Falling Behind in Covid Vaccinations.” BBC https://www.bbc.com/news/world‐us‐canada‐56035306.
Berg, B. L. 1995. Qualitative Research Methods for the Social Sciences. 2nd ed. Boston: Allyn and Bacon.
Bergen, N., and R. Labonté. 2020. ““Everything Is Perfect, and We Have No Problems”: Detecting and Limiting Social Desirability Bias in Qualitative Research.” Qualitative Health Research 30, no. 5: 783–792. https://doi.org/10.1177/1049732319889354.
Burden, S., C. Henshall, and R. Oshikanlu. 2021. “Harnessing the Nursing Contribution to COVID‐19 Mass Vaccination Programmes: Addressing Hesitancy and Promoting Confidence.” Journal of Advanced Nursing 77: e16–e20.
Canadian Council for Practical Nurse Regulators. 2019. “Entry‐Level Competencies for Licensed Practical Nurses.” CCPNR. https://www.clpna.com/wp‐content/uploads/2019/08/doc_CCPNR_Entry‐Level_Competencies_LPNs_2019E.pdf.
Canadian Council of Registered Nurse Regulators. 2019. “Entry‐Level Competencies (ELCs) for the Practice of Registered Nurses.” 2018. CCRNR. https://www.ccrnr.ca/assets/ccrnr‐rn‐entry‐level‐competencies‐‐‐2019.pdf.
Canadian Council of Registered Nurse Regulators. 2023. “Nurse Practitioner Entry‐Level Competencies Development Report.”
Canadian Family Practice Nurses Association. 2019. “National Competencies for Registered Nurses in Primary Care.” https://www.cfpna.ca/copy‐of‐resources‐1.
Canadian Institute for Health Information. 2022. “Canadian COVID‐19 Intervention Timeline.” CIHI. https://www.cihi.ca/en/canadian‐covid‐19‐intervention‐timeline.
Canadian Institutes of Health Research, Sciences and Engineering Research Council of Canada, and Social Sciences and Humanities Research Council of Canada. 2022. “Tri‐Council Policy Statement: Ethical Conduct for Research Involving Humans.” https://ethics.gc.ca/eng/documents/tcps2‐2022‐en.pdf.
Canadian Nurses Association. 2015. “Framework for the Practice of Registered Nurses in Canada 2015.” CNA. https://hl‐prod‐ca‐oc‐download.s3‐ca‐central‐1.amazonaws.com/CNA/2f975e7e‐4a40‐45ca‐863c‐5ebf0a138d5e/UploadedImages/Framework_for_the_Pracice_of_Registered_Nurses_in_Canada__1_.pdf.
Canadian Nurses Association. n.d. “Advanced Nursing Practice. CNA.” Accessed July 22, 2024. https://www.cna‐aiic.ca/en/nursing/advanced‐nursing‐practice.
Canadian Nurses Association, and Nurse practitioners. n.d. “What Are Nurse Practitioners? CNA.” Accessed March 11, 2024. https://www.cna‐aiic.ca/en/nursing/advanced‐nursing‐practice/nurse‐practitioners.
Carcary, M. 2009. “The Research Audit Trial–Enhancing Trustworthiness in Qualitative Inquiry.” Electronic Journal of Business Research Methods 7, no. 1: 11–24.
Coughlin, S. S. 1990. “Recall Bias in Epidemiologic Studies.” Journal of Clinical Epidemiology 43, no. 1: 87–91. https://doi.org/10.1016/0895‐4356(90)90060‐3.
Creswell, J. W. 2014. Research Design–Qualitative, Quantitative and Mixed Methods Approaches. 4th ed. Thousand Oaks: SAGE Publications Ltd.
Dubé, E., J. Bettinger, W. Fisher, M. Naus, S. Mahmud, and T. Hilderman. 2016. “Vaccine Acceptance, Hesitancy and Refusal in Canada: Challenges and Potential Approaches.” Canada Communicable Disease Report 42, no. 12: 246–251. https://doi.org/10.14745/ccdr.v42i12a02.
Fiske, A., F. Schönweitz, J. Eichinger, et al. 2022. “The COVID‐19 Vaccine: Trust, Doubt, and Hope for a Future Beyond the Pandemic in Germany.” PLoS One 17, no. 4: e0266659. https://doi.org/10.1371/journal.pone.0266659.
Gonnella, K., and D. Mankikar. 2023. “Instilling Confidence in the COVID‐19 Vaccine.” Nursing Clinics of North America 58: 77–85. https://doi.org/10.1016/j.cnur.2022.11.001.
GOV.UK. 2021. “Policy Paper: UK COVID‐19 Vaccine Uptake Plan.” Department of Health & Social Care. https://www.gov.uk/government/publications/covid‐19‐vaccination‐uptake‐plan/uk‐covid‐19‐vaccine‐uptake‐plan.
Government of Nova Scotia. 2021. “Update on Nova Scotia's Immunization Plan.” Government of Nova Scotia. https://news.novascotia.ca/en/2021/03/23/update‐nova‐scotias‐immunization‐plan
Government of Ontario. 2021a. “Ontario Pharmacies and Primary Care Settings to Begin Offering COVID‐19 Vaccinations.” King's Printer for Ontario. https://news.ontario.ca/en/release/60628/ontario‐pharmacies‐and‐primary‐care‐settings‐to‐begin‐offering‐covid‐19‐vaccinations.
Government of Ontario. 2021b. “Ontario Expanding Pharmacy and Primary Care Locations for COVID‐19 Vaccinations.” https://news.ontario.ca/en/release/60976/ontario‐expanding‐pharmacy‐and‐primary‐care‐locations‐for‐covid‐19‐vaccinations.King's Printer for Ontario.
Guay, M., A. Maquiling, R. Chen, et al. 2023. “Racial Disparities in COVID‐19 Vaccination in Canada: Results From the Cross‐Sectional Canadian Community Health Survey.” CMAJ Open 11, no. 6: e1075–e1082. https://doi.org/10.9778/cmajo.20230026.
Guay, M., A. Maquiling, R. Chen, et al. 2022a. “Sociodemographic Disparities in COVID‐19 Vaccine Uptake and Vaccination Intent in Canada.” Health Reports 33, no. 12: 37–54. https://doi.org/10.25318/82‐003‐x202201200004‐eng.
Guay, M., A. Maquiling, R. Chen, et al. 2022b. “Measuring Inequalities in COVID‐19 Vaccination Uptake and Intent: Results From the Canadian Community Health Survey 2021.” BMC Public Health 22, no. 1: 1708. https://doi.org/10.1186/s12889‐022‐14090‐z.
Guest, G., K. M. MacQueen, and E. E. Namey. 2012. Applied Thematic Analysis. Los Angeles: SAGE Publications Ltd.
Heck, L. O., B. S. Carrara, I. A. C. Mendes, and C. A. Arena Ventura. 2022. “Nursing and Advocacy in Health: An Integrative Review.” Nursing Ethics 29, no. 4: 1014–1034. https://doi.org/10.1177/09697330211062981.
Hill, M. C., D. Salmon, J. Chudleigh, and L. M. Aitken. 2021. “Practice Nurses' Perceptions of Their Immunization Role and Strategies Used to Promote Measles, Mumps, and Rubella Vaccine Uptake in 2014–2018: A Qualitative Study.” Journal of Advanced Nursing 77, no. 2: 948–956. https://doi.org/10.1111/jan.14652.
International Council of Nurses. 2020. “Success of Mass COVID‐19 Vaccination Programmes Will Depend on Frontline Nurses and Nurse Leaders at the Highest Level of Government.” ICN. https://www.icn.ch/news/success‐mass‐covid‐19‐vaccination‐programmes‐will‐depend‐frontline‐nurses‐and‐nurse‐leaders.
International Council of Nurses. 2021. “Report on the Role of Nurses in COVID19 Pandemic.”
Kholina, K., S. H. E. Harmon, and J. E. Graham. 2022. “An Equitable Vaccine Delivery System: Lessons From the COVID‐19 Vaccine Rollout in Canada.” PLoS One 17, no. 12: e0279929. https://doi.org/10.1371/journal.pone.0279929.
Kiran, T., A. Eissa, D. Mangin, et al. 2022. “Brief on Primary Care Part 1: The Roles of Primary Care Clinicians and Practices in the First Two Years of the COVID‐19 Pandemic in Ontario.” Science Briefs of the Ontario COVID‐19 Science Advisory Table 3, no. 67: e1–e31. https://doi.org/10.47326/ocsat.2022.03.67.1.0.
Kirchherr, J., and K. Charles. 2018. “Enhancing the Sample Diversity of Snowball Samples: Recommendations From a Research Project on Anti‐Dam Movements in Southeast Asia.” PLoS One 13, no. 8: e0201710. https://doi.org/10.1371/journal.pone.0201710.
Lessard, D., D. Ortiz‐Paredes, H. Park, et al. 2022. “Barriers and Facilitators to COVID‐19 Vaccine Acceptability Among People Incarcerated in Canadian Federal Prisons: A Qualitative Study.” Vaccine: X 10: 100150. https://doi.org/10.1016/j.jvacx.2022.100150.
Lukewich, J., M. Allard, L. Ashley, et al. 2020. “National Competencies for Registered Nurses in Primary Care: A Delphi Study.” Western Journal of Nursing Research 42, no. 12: 1078–1087. https://doi.org/10.1177/0193945920935590.
Lukewich, J., D. S. Edge, E. VanDenKerkhof, T. Williamson, and J. Tranmer. 2018. “Team Composition and Chronic Disease Management Within Primary Healthcare Practices in Eastern Ontario: An Application of the Measuring Organizational Attributes of Primary Health Care Survey.” Primary Health Care Research & Development 19, no. 6: 622–628. https://doi.org/10.1017/S1463423618000257.
MacDonald NE, SAGE Working Group on Vaccine Hesitancy. 2015. “Vaccine Hesitancy: Definition, Scope and Determinants.” Vaccine 33, no. 34: 4161–4164. https://doi.org/10.1016/j.vaccine.2015.04.036.
Mathews, M., L. Meredith, D. Ryan, et al. 2023a. “The Roles of Family Physicians During a Pandemic.” Healthcare Management Forum 36, no. 1: 30–35. https://doi.org/10.1177/08404704221112311.
Mathews, M., L. Meredith, D. Ryan, et al. 2023b. “An Analysis of Policies Supporting the Roles of Family Physicians in Four Regions in Canada During the COVID‐19 Pandemic.” Healthcare Management Forum 36, no. 5: 333–339. https://doi.org/10.1177/08404704231183174.
Mathews, M., D. Ryan, R. Buote, S. Parsons, and J. Lukewich. 2021. “Family Practice Nursing in Newfoundland and Labrador: Are Reported Roles Reflective of Professional Competencies for Registered Nurses in Primary Care?” SAGE Open Nursing 7: 237796082110534. https://doi.org/10.1177/23779608211053496.
Mathews, M., S. Spencer, H. Hedden, et al. 2021. “Development of a Primary Care Pandemic Plan Informed by in‐Depth Policy Analysis and Qualitative Case Studies With Family Physicians Across Canada During COVID‐19: A Qualitative Case Study Protocol.” BMJ Open 11: e048209. https://doi.org/10.1136/bmjopen‐2020‐048209.
Mizumoto, J., T. Mitsuyama, S. Kumagaya, M. Eto, M. Izumiya, and S. Horita. 2022. “Primary Care Nurses During the Coronavirus Disaster and Their Struggle: Qualitative Research.” Journal of General and Family Medicine 23, no. 5: 343–350. https://doi.org/10.1002/jgf2.566.
Ontario College of Family Physicians. 2021. “With Vaccines Coming, Family Doctors Could Jab Millions More if Fully Involved.” OCFP. https://www.newswire.ca/news‐releases/with‐vaccines‐coming‐family‐doctors‐could‐jab‐millions‐more‐if‐fully‐involved‐851073212.html.
Ontario Medical Association. 2021. “Ontario's Doctors Thank the Premier, Ready to Expand Vaccine Role.” OMA. https://www.oma.org/newsroom/news/2021/mar/ontarios‐doctors‐thank‐the‐premier‐ready‐to‐expand‐vaccine‐role/
Palinkas, L. A., S. M. Horwitz, C. A. Green, J. P. Wisdom, N. Duan, and K. Hoagwood. 2015. “Purposeful Sampling for Qualitative Data Collection and Analysis in Mixed Method Implementation Research.” Administration and Policy in Mental Health 42, no. 5: 533–544. https://doi.org/10.1007/s10488‐013‐0528‐y.
Petracek, H., and L. Kaiser. 2021. “First Primary Care Clinic in Nova Scotia Administers COVID‐19 Vaccines Saturday.” Atlantica. https://atlantic.ctvnews.ca/first‐primary‐care‐clinic‐in‐nova‐scotia‐administers‐covid‐19‐vaccines‐saturday‐1.5355660?cache=gdyzofsh%3FclipId%3D89578.
Ponterotto, J. 2006. “Brief Note on the Origins, Evolution, and Meaning of the Qualitative Research Concept Thick Description.” Qualitative Report 11, no. 3: 538–549. https://doi.org/10.46743/2160‐3715/2006.1666.
Public Health Agency of Canada. 2020. “Canada's COVID‐19 Immunization Plan: Saving Lives and Livelihoods.” https://www.canada.ca/en/public‐health/services/diseases/2019‐novel‐coronavirus‐infection/canadas‐reponse/canadas‐covid‐19‐immunization‐plan.html.Government of Canada.
Public Health Agency of Canada. 2022. “Canada's COVID‐19 Vaccine Supply and Donation Strategy.” Government of Canada. https://www.canada.ca/en/public‐health/services/diseases/coronavirus‐disease‐covid‐19/vaccines/supply‐donation.html.
Reiss‐Brennan, B., R. Hayes, and L. McCauley. 2022. “An Overlooked Strategic Powerhouse: How Nurses can Rise to the Challenge of Integrating Public Health and Primary Care.” American Journal of Public Health 112, no. S3: 253–255. https://doi.org/10.2105/AJPH.2022.306861.
Schober, M., D. Lehwaldt, M. Rogers, et al. 2020. “Guidelines on Advanced Practical Nursing.” International Council of Nurses, 1–44. Accessed March 11, 2024. https://www.icn.ch/system/files/documents/2020‐04/ICN_APN%20Report_EN_WEB.pdf.
Sebring, J. C. H., G. Capurro, C. Kelly, C. G. Jardine, J. Tustin, and S. M. Driedger. 2022. ““None of It Was Especially Easy”: Improving COVID‐19 Vaccine Equity for People With Disabilities.” Canadian Journal of Public Health. Revue Canadienne de Sante Publique 113, no. 6: 887–897. https://doi.org/10.17269/s41997‐022‐00621‐z.
Shakory, S., A. Eissa, T. Kiran, and A. D. Pinto. 2022. “Best Practices for COVID‐19 Mass Vaccination Clinics.” Annals of Family Medicine 20, no. 2: 149–156. https://doi.org/10.1370/afm.2773.
Shariff, S. Z., L. Richard, S. W. Hwang, et al. 2022. “COVID‐19 Vaccine Coverage and Factors Associated With Vaccine Uptake Among 23,247 Adults With a Recent History of Homelessness in Ontario, Canada: A Population‐Based Cohort Study.” Lancet Public Health 7, no. 4: e366–e377. https://doi.org/10.1016/S2468‐2667(22)00037‐8.
Shen, S., and V. Dubey. 2019. “(2019). Addressing Vaccine Hesitancy.” Canadian Family Physician 65, no. 3: 175–181.
Stratoberdha, D., B. Gobis, A. Ziemczonek, J. Yuen, A. Giang, and P. J. Zed. 2022. “Barriers to Adult Vaccination in Canada: A Qualitative Systematic Review.” Canadian Pharmaceutical Journal 155, no. 4: 206–218. https://doi.org/10.1177/17151635221090212.
Swanson, M., S. Wong, R. Martin‐Misener, and A. J. Browne. 2020. “The Role of Registered Nurses in Primary Care and Public Health: A Scoping Review.” Nursing Open 7, no. 4: 1197–1207. https://doi.org/10.1002/nop2.496.
Treble, P. 2021. “Pfizer's COVID Vaccines Are Delayed in Canada. What Exactly Is the Hold‐Up? Maclean's.”
Vernon‐Wilson, E., M. Tetui, A. Nanyonjo, et al. 2023. “Unintended Consequences of Communicating Rapid COVID‐19 Vaccine Policy Changes – A Qualitative Study of Health Policy Communication in Ontario, Canada.” BMC Public Health 23, no. 1: 932. https://doi.org/10.1186/s12889‐023‐15861‐y.
Weis, K. L., K. K. Trout, J. P. Cimiotti, et al. 2024. “The nurse's Role in a Patient‐Centered Approach for Reducing COVID‐19 Vaccine Hesitancy During Pregnancy: An American Academy of Nursing Consensus Paper.” Nursing Outlook 72, no. 5: 102196. https://doi.org/10.1016/j.outlook.2024.102196.
Wilkinson, E., A. Jetty, S. Petterson, Y. Jabbarpour, and J. M. Westfall. 2021. “Primary care's Historic Role in Vaccination and Potential Role in COVID‐19 Immunization Programs.” Annals of Family Medicine 19, no. 4: 351–355. https://doi.org/10.1370/afm.2679.
World Health Organization. n.d. “A Brief History of Vaccination.” Accessed March 31, 2024. https://www.who.int/news‐room/spotlight/history‐of‐vaccination/a‐brief‐history‐of‐vaccination.