Abstract
Little is known about how COVID-19 affects older patients living at home or how it affects district nursing teams providing care to these patients. This study aims to (1) explore, from the perspectives of Dutch district nurses, COVID-19′s impact on patients receiving district nursing care, district nursing teams, and their organisations during the first outbreak in March 2020 as well as one year later; and (2) identify the needs of district nurses regarding future outbreaks. A mixed-methods, two-phase, sequential exploratory design was followed. In total, 36 district nurses were interviewed during the first outbreak (March 2020), of which 18 participated in the follow-up questionnaire in April 2021. Thirteen themes emerged, which showed that the COVID pandemic has substantially impacted patient care and district nursing teams. During the first outbreak, nurses played a crucial role in organising care differently and worked under high pressure, leading to exhaustion, tiredness, and psychosocial problems, including fear of infection. A year later, nurses were better prepared to provide COVID care, but problems regarding work pressure and mental complaints remained. The identified needs focus on a sustainable implementation of leadership roles for district nurses. At the organisational and national levels, more support and appreciation are needed in terms of trust and appropriate policies.
Highlights
COVID-19 has had a significant impact on healthcare systems worldwide [1]
Our study shows that the pandemic has had a deep impact on patients, informal caregivers, and district nursing teams
The study identified multiple needs for the future, where more focus should be placed on the role of nurses, necessary changes at the organisational and national levels, and how district nursing teams can be better prepared for the future
Summary
COVID-19 has had a significant impact on healthcare systems worldwide [1]. World Health Organization (WHO) declared COVID-19 to be a pandemic [2]. Much attention has been given to the infection rates of COVID-19 patients in intensive care units (ICUs), hospitals in general, and long-term care facilities [3,4]. Relatively little attention has been paid to how COVID-19 affects older patients living at home and to the homecare professionals who care for these patients in their own home [3]. Professional care assistance at home is provided through district nursing care and other healthcare professionals, such as general practitioners and (paramedic) professionals in primary care [5,6]. The organisation, delivery, and funding of district nursing care varies around the world [7–9]. District nursing teams provide rehabilitative, Int. J.
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