Care Of COVID-19 Patients Research Articles

A Hungarian Centrum Hospital’s COVID-19 Response Strategy in Light of International Management Experiences

The COVID-19 pandemic has placed enormous pressure on healthcare systems. In the first line of the “war” against the virus, hospitals tried to maintain their general operations, while supplementing their services with COVID-19 patient care. To tackle the new difficulties, hospitals had to develop strategic response plans, and were in need of finding the most effective management structure for their institution. The focus of this paper is the aforementioned management structures. After overviewing the international literature, we identified three different approaches and we named them the Horizontal, Vertical, and Intermedier Approach. The separation is based on the following features: decision making, information distribution, command forwarding, intra-hospital communication channels, hierarchy, and control. After summarizing the international experiences, we introduce a Hungarian centrum hospital’s approach, as the institution was assigned to fulfil COVID-19 centrum hospital duties in the middle of the first wave. The North-Buda Szent János Central hospital was in need of restructuring their management structure, and the leadership decided to transform it into a hierarchical, vertical structure, operating with centralized decision making and personal control. This control–command system idea came from the hospital’s Internist Head Coordinator Physician, who is the first author of our article, and had serious military medicine experiences (in Afghanistan).

Evaluation of Healthcare Workers Attitudes Toward Handling and Treating COVID-19 Patients in Diyala Governorate, Iraq

Background: In 2019, the World Health Organization (WHO) declared a global state of emergency due to the spread of the COVID-19 pandemic. Objective: This study aimed to determine the attitudes of healthcare workers in various Iraqi health institutions towards treating patients with COVID-19. Additionally, it aimed to identify the most important reasons behind preventing them from doing their job. Methods: Between Nov. 2021 to Dec. 2022, we conducted a self-administered cross-sectional survey of 207 healthcare worker participants. The data were collected using a questionnaire that included three parts. The first part included sociodemographic data, the second part aimed to assess the participants’ information concerning how they dealt with this pandemic, and the third part was designed to identify the participants’ attitudes. The statistic data were analysed by using (SPSS), 25.0/ IBM Crop., Armonk, NY. The scientific content of the questionnaire items was taken from the online literature as well as updated information on the WHO website. Results: The results study revealed that 135 (65.22\%) of the participants were willing to receive and treat COVID-19 patients in hospitals and private clinics. While 72 (34.78\%) of the study participants showed their unwillingness to treat infected patients. The most crucial reasons behind their reluctance were the fear of transmission of infection and the lack of protective equipment. Conclusion: The study concluded that the participants' willingness was good. This was indicated by their positive attitudes toward carrying out their medical duties and commitment to providing health care and treatment for COVID-19 patients. There is an urgent need to reduce psychological and physical stress as well as the pressures that health workers suffer from because they are facing large numbers of daily infections. This reduction is achieved via training, continuous education and equipping hospitals with the latest protective supplies to confront epidemics and pandemics.

Cell free DNA as a new prognostic biomarker for COVID-19, A prospective cohort study

Predicting the need of hospitalization and intensive care in COVID-19 patients has been challenging with current diagnostic tests since the beginning of the pandemic. We aimed to test cell free DNA (cfDNA) as a novel biomarker for COVID-19 disease severity and mortality. cfDNA concentration was quantified by RT-PCR based test. One hundred and sixty-eight patients(85 outpatients, 61 inpatients,22 ICU) included the study. Mean initial plasma cfDNA levels were significantly different (p < 0.01) in outpatients (1.190,66 ng/ml), inpatients (8.258,10 ng/ml) and ICU patients (84.806,87 ng/ml). ROC analysis showed with 95 % specificity that patients with initial cfDNA concentrations ≥6.389 ng/ml need to be hospitalized and those ≥26.104 ng/ml require ICU referral. cfDNA concentration was correlated with neutrophil/lymphocyte ratio, lymphocyte level, CRP, AST, LDH, CK, fibrinogen, ferritin and D-dimer. Plasma cfDNA levels on admission, well correlating with disease severity and mortality in COVID-19 that found as a useful biomarker.

Experiences of nursing staff caring for COVID-19 patients. Exploratory study

Introduction: Nursing staff are responsible for providing care to people in public health crises such as the COVID-19 pandemic. In previous epidemics, studies were carried out in developed countries with a quantitative approach in which it was observed that this group suffered from conditions in their mental health, although it was not possible to delve into their experiences or explore them in the Latin American context, so the aim of this study was to explore the experiences of nursing staff while caring for COVID-19 patients.Methodology: Qualitative phenomenological study that allows identifying the experiences and feelings of the informants during the care they provided to people with COVID-19.Outcomes: Two large categories were identified: 1) Emotions with three subcategories: a) Emotions at the beginning of the pandemic, b) Emotions during the pandemic and c) Emotions at the end of the pandemic; and 2) Qualities of nurses during the COVID-19 pandemic with three subcategories: a) Commitment to humanity, b) Companionship and c) Nurse-patient moments.Conclusion: The experiences of the Mexican nursing staff who cared for people with COVID-19 focus on the emotions they experienced in three moments, at the beginning: fear and uncertainty; during the pandemic: fear, anxiety, stress and depression, and at the end of the pandemic: self-confidence and satisfaction when facing the pandemic with commitment to humanity, camaraderie, satisfaction and pride in having provided care to infected people despite various obstacles.

Compassionate leaders influence nurses’ emotional healing during the COVID-19 crisis in hospitals

Background: The crisis situation during the pandemic has placed an additional burden on nurses regarding the care of COVID-19 patients. This is due to several factors, including the emergence of new disease variants, a rising number of cases, limited access to information, and nurses’ psychological well-being. Therefore, it is crucial for nurses to receive support from their leadership to effectively fulfill their roles Objective: To determine the key dimensions of compassionate leadership that have the greatest impact on the emotional well-being of nurses working in COVID-19 treatment rooms. Methods: The research design employs a cross-sectional approach, with the independent variable being compassionate leadership, encompassing dimensions such as presence, understanding, empathy, and assistance. The dependent variable under examination is emotional healing. The sampling technique applied is purposive sampling, resulting in a sample size of 200 respondents across eight treatment rooms. Results: Nurses, on the whole, perceived their leaders’ implementation of compassionate leadership during the pandemic crisis as fairly adequate, scoring it at 66.4%. As for emotional healing among nurses, it was, on average, fulfilled to a level of 68.3%. Importantly, there exists a significant relationship between compassionate leadership and emotional healing. Specifically, among the dimensions of compassionate leadership, the one that had the most substantial influence on nurses’ emotional healing was “helping”. Conclusion: Amidst the COVID-19 pandemic crisis in hospitals, nurses required assistance and support from leadership to navigate the challenges encountered while actively providing care. These interventions could be effectively incorporated by nurses to complement ongoing tuberculosis treatment therapies.

Correlations among family functions, lifestyles and resilience of nurses working in COVID-19 intensive care units in post-corona era

ABSTRACT Background: Despite the passing of time since the outbreak of Covid-19, the virus still impacts individuals and families. Hence, the present study investigated the effect of corona pandemic on correlations among nurses’ family functions, lifestyles, and resilience. Method: The present descriptive-correlational study examined 205 nurses working in Covid-19 Intensive Care Units (ICUs) in 2021–2022. The subjects were selected by convenience sampling and three questionnaires on family functioning, lifestyle and resilience were used to collect data, which were then analyzed by the Pearson correlation coefficient and Fisher’s test. Results: A negative correlation was observed between the FAD Total score and the Lifestyle Scale during COVID-19 (r = −0.15, 95% CI: −0.28 to −0.01, P = 0.031) and Resilience Scale Total Score (r = −0.16, 95% CI: −0.29 to −0.03, P = 0.020). We found a positive correlation between the Lifestyle Scale during COVID-19 Total score and the Resilience Scale Total score (r = 0.59, 95% CI: 0.49–0.67, P < 0.001). Conclusion: The results of the study revealed moderate resilience, lifestyle, and family functioning of nurses. Also, family functioning negatively correlated with lifestyle and resilience, i.e. nurses with family dysfunctions manifested weaker lifestyle and resilience, mostly due to Civid-19 complications. Thus, nurse-supporting programs dealing with the unpredictable care and treatment process of Covid-19 patients must be presented.

Nurses’ experiences of caring for COVID-19 patients: A systematic review of qualitative studies

Background &amp; Aim: Nurses are considered one of the most important members of the healthcare system in facing pandemics, including COVID-19. This study was conducted to explain the nurses' experiences in caring for patients diagnosed with COVID-19. Methods &amp; Materials: This study was a qualitative systematic review. A structured search was conducted using CINAHL, MEDLINE, EMBASE, Pub Med, Google Scholar, Cochrane Library, MedNar, and ProQuest. All qualitative studies describing nurses’ experiences of caring for patients with Covid-19 were included. This review was conducted using the Joanna Briggs Institute methodology for systematic reviews. Themes and narrative statements were extracted from included papers using the JBI SUMARI data extraction tool. Results: The findings of 46 qualitative studies were included in this systematic review. From the data analysis, four themes "Professional Development", "Psychological exhaustion", "Care Challenges" and "Work-family conflict" were extracted. Conclusion: Nurses have experienced conflicts between their work and family and challenges when caring for patients with COVID-19. Hence, they were psychologically under pressure but professionally developed. To ensure the survival of nurses in critical situations, all their needs must be carefully monitored and the necessary support provided to them.

Impact of the COVID-19 Pandemic on Head and Neck Cancer Management: The Experience of the Maxillo-Facial Surgery Department of a French Regional Referral Center in a High-Incidence Area.

Background: Cancer patients are at a high risk of complications in cases of infection, and head and neck cancers (HNC) are no exception. Since late 2019, SARS-CoV-2 has caused a global health crisis, with high rates and severe forms of the disease in cancer patients. Hospitalization, surgery and radiotherapy were rapidly described as increasing the risk of infection. Since March 2020, the Amiens University Hospital (France) has been taking care of COVID-19 patients while its maxillofacial surgery department managed HNC patients without interruption, even during lockdown periods. However, many questions concerning the impact on patient care were still pending. The aim of this study is to describe HNC management in our center during the first epidemic peak and to evaluate the impact of containment measures on patient treatment. Methods: We retrospectively included 44 HNC patients treated in our department between 1 March and 31 August 2020. Two groups were defined according to the period of care: lockdown (March to May) and lighter restrictions (June to August). Results: The results show typical epidemiological characteristics, maintained management times and non-downgraded procedures. Conclusions: Thus, during the first epidemic peak, continuity of care and patients' safety could be ensured thanks to adequate means, adapted procedures and an experienced surgical team.

Effect of Positive Thinking Skills on Optimism and Death Anxiety of COVID-19 Nurses: A quasi-experimental study

BACKGROUND: The COVID-19 pandemic has placed nurses on the front lines, facing challenging conditions and increased stress levels. The aim of this study was to examine the effect of positive thinking skills training on nurses' optimism and death anxiety while caring for COVID-19 patients. METHODS: In a quasi-experimental, two-group, pre- and post-test study, a total of 52 eligible nurses working at Amir al-Momenin Hospital in Zabol, Iran, between October and December 2022, were divided into intervention and control groups. The intervention group received positive thinking skills training via email or WhatsApp, with eight, 60-minutes sessions over two months. Data were collected using a demographic questionnaire, the Templer Death Anxiety Scale (DAS), and the Scheier and Carver Life Orientation Test, both before and one month after the intervention. RESULTS: There were no significant differences in optimism and death anxiety scores between the two groups before the intervention. However, the intervention group showed a statistically significant increase in optimism (from 13.11±3.78 to 19.03±2.58) and decrease in death anxiety (from 55.15±7.06 to 41.76±4.48) after the intervention (P &lt;0.001). CONCLUSION: Considering the stressful nature of COVID-19 disease, positive thinking skills training can be recommended as an effective method to reduce death anxiety and improve nurses' optimism, thus enhancing their willingness to continue caring for patients.

TRANSMISSION DYNAMICS OF COVID-19 WITH DIABETES IN INDIA: A COST-EFFECTIVE AND OPTIMAL CONTROL ANALYSIS

In this study, we develop a mathematical model to examine the dynamics of COVID-19 with diabetes. Recognizing the increased vulnerability of diabetic patients, we proposed separate isolation classes for COVID-19 cases with and without diabetes. The model is parameterized using real data from India for the period March 2021 to September 2021. Sensitivity analysis for the basic reproduction number shows that isolation (for COVID-19 with diabetes) plays a significant role in lessening COVID-19 cases. Through numerical evaluations, we demonstrate that timely and focused care, including hospitalization/isolation, and treatment for COVID-19 patients with diabetes, can substantially reduce the disease burden by nearly three-fold. The optimal control problem with different strategies has also been discussed. We obtain that vaccination (with the least Average Cost-Effectiveness Ratio (ACER) and a combined strategy (with the highest Infection-Averted Ratio (IAR) are the most cost-saving and effective interventions to eradicate the disease.

Experience of nurses using the COVID-19 Early Warning Score in the care of COVID-19 patients: A qualitative study

Experience of nurses using the COVID-19 Early Warning Score in the care of COVID-19 patients: A qualitative study Abstract: Background: In all phases of the COVID-19 disease, patients are at risk of acute deterioration. In order to identify patients at risk at an early stage, the COVID-19-EWS Salzburg was implemented in April 2020 at the University Hospital Salzburg. So far, the applicability, practicability and relevance of the EWS for acute inpatient COVID-19 care are unknown. Aim: The aim of this qualitative study was to describe the relevance and practicability of the COVID-19-EWS Salzburg as a risk assessment tool for acute inpatient COVID-19 care, based on the experiences of the nursing staff. Methods: Nine semi-structured expert interviews were conducted with the nursing staff of the COVID-19 acute care unit. The data were analysed by qualitative content analysis. Results: Nurses described the EWS as relevant to practice because the score facilitates decision-making, increases patient safety, and enhances interprofessional communication. Both the Early Warning Score (EWS) and experience in caring for COVID-19 patients were found to be relevant for decision-making in the context of managing clinical deterioration. The score provided a sense of security in the care of COVID-19 patients, particularly to new and inexperienced nurses. Conclusion: The participating nurses describe the COVID-19-EWS Salzburg as a useful and practical risk assessment instrument, complementing clinical judgment. A need for adaptation concerning the parameters oxygen saturation and oxygen requirement was identified.

Depression and anxiety between nurses and nursing assistants working in long-term care facilities during the COVID-19 pandemic.

This study investigated the levels of depression and anxiety in nurses and nursing assistants working in long-term care facilities during the COVID-19 pandemic. We also explored the potential causes of depression and anxiety in nurses and nursing assistants working in long-term care facilities during the pandemic. The COVID-19 pandemic has had a considerable impact on long-term care facilities. The high infection and mortality rates for COVID-19 have resulted in an increased workload for caregivers. The COVID-19 pandemic exposedcaregivers working in long-term care facilities to higher risks of anxiety and depression. Additionally, the high risk of infection in the work environment and concerns about spreading COVID-19 to family members and long-term care facility residents led to various forms of stress among caregivers. The present study was a cross-sectional study. Questionnaires were used to investigate depression and anxiety among regarding nurses and nursing assistants working in long-term care facilities during the pandemic. The depression and anxiety levels of the nurses were higher than nursing assistants, but had no statistically significant difference (p=0.551). The factors influencing levels of depression and anxiety in nurses contained facility affiliation and experience working. In terms of nursing assistants, age, marital status, and facility affiliation were correlated with the levels of depression and anxiety. The pandemic has severely impacted caregivers. In the process of implementing pandemic prevention measures and providing care for COVID-19 patients, safeguarding the psychological health of caregivers is also essential. The levels of depression and anxiety in nurses were higher than in nursing assistants working in long-term care facilities during the pandemic. Long-term care facilities managers are recommended to enhance the education and training process for caregivers. Managers are also recommended to ensure provision of sufficient amounts of pandemic prevention equipment and resources.

Exploring the perceptual experiences of nurses regarding the care of patients with COVID-19: A mixed methodological approach

Abstract Background: The COVID-19 pandemic, with its rapid spread and subsequent lockdown measures, has brought about unprecedented changes in our lives. Terms like lockdown, social distancing, and quarantine have become part of our daily vocabulary. Amid this crisis, frontline workers, including nurses, have emerged as the unsung heroes, bravely battling the effects of the pandemic. This study delves into the perceptual encounters of nurses regarding patient care during this critical period, providing valuable insights into their experiences. Materials and Methods: This study employed a unique mixed-methods sequential explanatory design. Quantitative data was gathered from 202 registered nurses attending to COVID-19 patients in designated hospitals in Navi Mumbai. Following quantitative analysis, samples of qualitative data were collected until data saturation, focusing on experiences categorized as fair or adverse. Quantitative data collection relied on self-reporting, while qualitative data collection involved in-depth telephone interviews and audio recording techniques. The study’s scope was confined to hospitals in Navi Mumbai and specifically targeted staff nurses providing care for COVID-19 patients. Results: 39% of respondents reported experiencing fair situations, while 69% of nurses expressed encountering negative experiences related to COVID-19. The study identified various themes, including encountered challenges, physical hardships, emotional conflicts, provided facilities, and most importantly, the robust support systems. Challenges included caring for immobile patients, insufficient staffing, and extended work hours. Mental concerns comprised fear of contracting the virus, stress, familial tensions, separation anxiety, and disrupted communication with loved ones. The provided facilities encompassed meals, transportation, lodging, personal protective equipment, and amenities such as air conditioning and hot water. Support was observed from colleagues, friends, family, and senior staff members, highlighting the strength of the healthcare community in times of crisis. Social resistance included pressure to resign, lack of familial support, and societal stigma. Coping mechanisms involved communicating with loved ones, receiving support from colleagues, and engaging in activities such as listening to music, meditation, prayer, exercise, and yoga. The study found no significant association between nurses’ perceptual experiences and selected demographic variables. Conclusion: The study examined the perspectives of staff nurses regarding their duties during the COVID-19 pandemic, capturing their experiences through quantitative and qualitative analyses that addressed notable challenges, including physical, mental, and social obstacles.

COVID-19 pandemic: maker or breaker for families having children with autism spectrum disorder-case series of maternal experiences, strategies and suggestions

The COVID-19 pandemic due to prioritization of emergency and COVID-19 patient care at hospitals and disruption of daily routines and finances, impacted significantly families having people with special needs. This case series highlights the problems faced and strategies used by mothers of children having autism spectrum disorder (ASD). It summarizes the experiences of nine families of ASD children (2 to 9 years), selected consecutively from pediatric developmental/disability outpatient department (OPD) of a tertiary care center during i.e. April 2021 to May 2021 (2nd wave of COVID-19 pandemic) using a pre-designed proforma. Socio-demographic details, maternal experiences about challenges faced in child’s home care, special therapies, managing child’s behaviour, family support system, adaptations and their suggestions were recorded. The age group was 2 to 9 years and 8 were males. 7 out of 9 mothers reported that their child’s interaction with father and other family members improved. Institutional therapy was discontinued by all mothers. Two mothers reported increased aggression in the child. Mothers from joint family and having supportive families reported less stress. Children who had company of parents/grandparents/sibling and availability of indoor games, art and craft and storytelling, reported less screen time and less behavioural disturbances though all the mothers reported increased screen time compared to pre COVID times. Mother’s empowerment is key to success. Indoor physical games, unstructured play, increasing social awareness, supportive families, tele-rehabilitation services can improve overall progress in ASD children. Health care practices need to be revised from time to time for special needs/situations.

THE COVID-19 PANDEMIC IN THE PLEVEN REGION FOR A THREE-YEAR PERIOD (MARCH 2020 – MARCH 2023)

The COVID-19 pandemic had a major impact on the capacity of health systems to continue the delivery of essential health services. While health systems were being challenged by increasing demand for care of COVID-19 patients, it was critical to maintain preventive and curative services, especially for vulnerable populations. Materials and methods: A retrospective analysis was conducted on epidemiological and demographic characteristics of the COVID-19 pandemic in the Pleven region (March 2020 – March 29 2023). Data were obtained from annual reports of the National Statistical Institute and annual epidemiological analyses of Regional Health Inspectorate–Pleven and were analyzed using statistical software (IВМ SPSS Statistics 19.0). Results: There were 36,308 confirmed cases of COVID-19 (medical workers – 2,176 confirmed cases), with 1,895 deaths. The cases during the years were 5,646 (2020), 16,258 (2021), 15,225 (2022). The incidence of COVID-19 in the region was 2,389; 6,964, and 6,668 at 100,000 populations in 2020, 2021 and 2022, respectively. The prevalence of the disease was 93%, 98% and 94% of all registered respiratory transmitted cases (p&lt;0.0005). There were four waves with the highest incidence (November 2020, March 2021, October 2021, and January 2022, in concordance with registered for Bulgaria). The highest mortality of COVID-19 (15% of deaths) was registered during 2021 – 456 and 368 at 100,000 population for males and females, respectively (16% and 15% of deaths, respectively; 81% – at ages 65+). Conclusion: The global implementation of different interventions had a significant impact on slowing down the community transmission of SARS-CoV-2. Health care and resources must be focused on the vulnerable populations.

Impact of overburden due COVID-19 pandemic on psychological health and work efficacy of doctors in Mangalore city, Dakshina Kannada district -A cross-sectional study

Introduction and Aim: One of the greatest pandemics faced by the world was COVID-19 which has added increased strain and psychological impacts on healthcare workers. This study was conducted to find out the impact of overburden due to COVID-19 on the psychological health of doctors and further to know whether it has affected the services provided by them. Materials and Methods: An information sheet which contained the details regarding purpose and nature of the study, questionnaire and consent form were given to each participant. Data was collected through email, WhatsApp, and physical forms. Depression, anxiety, stress, self-efficacy, and perceived social support were assessed using standard questionnaires. Results: Out of the 205 participants, 9 (4%) had a mild depression, 6(3%) had mild anxiety and 6(3%) had mild stress. Female doctors, those involved in fever clinics and inpatient care of COVID patients had significantly higher scores for depression, anxiety and stress when compared to others. Those involved in ICU care of COVID patients had higher General Self Efficacy (GSE) scores. General Self Efficacy (GSE) and Multidimensional Scale of Perceived Social Support (MSPSS) scores showed a positive correlation. Conclusion: Doctors involved in care of COVID-19 patients at fever clinic and inpatient care had several mental health problems. Hence, they along with female doctors need to be periodically screened for these conditions periodically.

A Journey of Uncertainty: Learned Lessons From the Lived Experiences of Nurses in Kuwait Taking Care of COVID-19 Patients in the Early Pandemic.

Purpose of the Study: This study explored the experiences of nurses in Kuwait who worked with COVID-19 patients during the first wave of the disease. Study Design: This was a qualitative descriptive study. Methods Used: In-depth interviews were conducted with seven (7) nurses who worked in intensive care units between September 2020 and March 2021. Findings: The experiences of Kuwait nurses in COVID-19 care showed an evolving journey of dealing with a strange and complex disease. With little known about the disease, the nurses approached COVID-19 care with uncertainty and ambivalence, unsure of where this journey would look like. Four themes emerged from the data and they included (1) from challenges to coping, (2) focusing on good health throughout the pandemic, (3) navigating through scarce resources and power dynamics, and (4) a multi-dimensional burden. Conclusions: Despite the difficulties encountered, supportive systems such as the availability of medical supplies, and support from superiors, colleagues, the community, and families, helped Kuwait nurses to cope with the stresses of an early COVID-19 pandemic while providing care. This approach takes a holistic stance to care for both patients and the nurses working in an epidemic setting.

The Mental Health Toll: Medical Trainees Living with Disabilities during the COVID-19 Pandemic

Objectives. Throughout the world, medical trainees have experienced psychological distress during the COVID-19 pandemic due to substantial changes in their educational programs and COVID-19 patient care. When medical trainees live with a disability, their psychological distress may be exacerbated. This study aimed to explore how having a disability may be associated with an additional emotional toll for medical trainees during the COVID-19 pandemic. Methods. Participants in the study were 201 medical trainees (62 interns and 138 residents) and 147 medical attending physicians in various fields of medicine. Participants completed an online survey including the Fear of COVID-19 scale, the Depression Anxiety and Stress Scale, and the Mental Health Continuum Scale measuring aspects of wellbeing, including emotional wellbeing, belonging, and sense of psychological meaning. Results. Disabled participants experienced higher levels of fear of COVID-19, depression, anxiety, stress, and lower levels of emotional wellbeing, sense of belonging, and psychological meaning compared to participants with no disabilities. Residents generally experienced higher stress levels and lower wellbeing levels than attendings. Residents living with disabilities were more prone to experience stress and fear of COVID-19, and residents and interns living with disabilities experienced higher levels of depression, anxiety, and stress compared to their peers who live without disabilities and compared to attendings living with disabilities. Conclusions. Medical trainees living with disabilities were more prone to experience high levels of psychological distress and lower levels of wellbeing during the COVID-19 pandemic compared to their peers without disabilities. Therefore, there is a need to address this emotional toll and provide support in medical education programs promoting trainees’ wellbeing, sense of belonging, and psychological meaning.

Work-related flow and its correlates among frontline nurses during the COVID-19 pandemic.

Ample evidence across non-healthcare fields highlights the role of work-related flow in enhancing resilience against work stress and work engagement. Understanding flow and its factors can support staff development and management. This study aimed to investigate the level of work-related flow and its associated factors among frontline nurses during the COVID-19 pandemic. A cross-sectional multicenter study included 336 nurses caring for COVID-19 patients between March and April 2022. Cluster random sampling was used to select 9 nurse groups from 29 Taiwanese hospitals specialized in COVID-19 care. A web survey link was shared on the selected nurses' social media. Hierarchical regression analyses examined predictor-outcome relationships, following the STROBE checklist for reporting findings. Among demographic characteristics, sex (β=-0.11; p=0.016) and living arrangement (β=-0.12; p=0.017) reached statistical significance in model 3. Social support from family, friends, and significant others, managerial position, and sufficiency of personal protective equipment showed significant associations with work-related flow (all β>0.12; p<0.05). The variables included in the final model accounted for 35% of the variance in work-related flow for COVID-19 patient care tasks. Flow experience is influenced by factors associated with demographics, work conditions, and social support. Nurse administrators should consider these factors when evaluating nurses' flow at work. Allocating care tasks to nurses based on their flow levels can be beneficial, particularly during healthcare crises. Ensuring a sufficient supply of personal protective equipment and offering social support to nurses are vital strategies for facilitating their flow experience in the workplace.

Rapid Critical Care Training for Nurses Deployed to Intensive Care Units During the COVID-19 Surge.

During the first COVID-19 pandemic wave, non-intensive care unit (non-ICU) nurses were deployed to temporary ICUs to provide critical care for the patient surge. A rapid critical care training program was designed to prepare them to care for patients in either temporary or permanent ICUs. To evaluate the effectiveness of this training program in preparing non-ICU nurses to provide critical care for COVID-19 patients in temporary ICUs. A survey was used to evaluate the impact of rapid critical care training on nurses' critical care skills and compare the experiences of nurses deployed to temporary versus permanent ICUs. Data were analyzed with χ2 and Spearman ρ tests with α = .05. Compared with nurses in other locations, nurses deployed to temporary ICUs were less likely to report improved capability in managing mechanical ventilation; infusions of sedative, vasoactive, and paralytic agents; and continuous renal replacement therapy. Nurses in temporary ICUs also reported being less prepared to care for critically ill patients (all P < .05). The rapid training program provided basic critical care knowledge for nurses in temporary ICUs, but experiences differed significantly between those deployed to temporary versus permanent ICUs. Although participants believed they provided safe care, nurses with no critical care experience cannot be expected to learn comprehensive critical care from expedited instruction; more formal clinical support is needed for nurses in temporary ICUs. Rapid critical care training can meet emergency needs for nurses capable of providing critical care.