Abstract
We aim to identify measures implemented by hospital nursing directors early in the COVID-19 pandemic and enabling factors. Managerial factors affect nurses' physical and mental health and willingness to work, especially early in a pandemic. We used multiple-case study of 15 hospitals, comparing management approaches by interviewing 28 nursing directors and their assistants from August to December 2020. Hospitals that accepted COVID-19 patients and hospitals that unexpectedly experienced clusters underwent a nursing provision system organization phase, followed by an adjustment phase to maintain nursing organization function. Two factors aided measure implementation: an emergency system and staff protection policies. Early epidemic management strategies apply across contexts. The hospital's basic attitude is key to effective implementation of the strategies. The results suggest that hospitals, nursing directors and nurses can each prepare for future emerging infectious disease epidemics.
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