Journal
JOURNAL OF ADVANCED NURSING
Volume 78, Issue 1, Pages 78-108Publisher
WILEY
DOI: 10.1111/jan.15047
Keywords
adaptation; barrier; experience; fundamental care; nurses; nursing; support; systematic review
Categories
Funding
- National Institute for Health Research
- UK Research and Innovation [MR/V02776X/1]
- National Institute for Health Research Applied Research Collaboration South West Peninsula
- MRC [MR/V02776X/1] Funding Source: UKRI
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This systematic review examines the provision of fundamental nursing care to patients with highly infectious viruses during hospitalization and the effectiveness of adaptations to overcome barriers to care. The review identifies barriers nurses face, such as wearing personal protective equipment and emotional challenges, and highlights the importance of evaluative research on fundamental care practices during pandemics to ensure evidence-based care provision in the future.
Aim This systematic review identifies, appraises and synthesizes the evidence on the provision of fundamental nursing care to hospitalized patients with a highly infectious virus and the effectiveness of adaptations to overcome barriers to care. Design Systematic review. Data Sources In July 2020, we searched Medline, PsycINFO (OvidSP), CINAHL (EBSCOhost), BNI (ProQuest), WHO COVID-19 Database () MedRxiv (), bioRxiv () and also Google Scholar, TRIP database and NICE Evidence, forwards citation searching and reference checking of included papers, from 2016 onwards. Review Methods We included quantitative and qualitative research reporting (i) the views, perceptions and experiences of patients who have received fundamental nursing care whilst in hospital with COVID-19, MERS, SARS, H1N1 or EVD or (ii) the views, perceptions and experiences of professional nurses and non-professionally registered care workers who have provided that care. We included review articles, commentaries, protocols and guidance documents. One reviewer performed data extraction and quality appraisal and was checked by another person. Results Of 3086 references, we included 64 articles; 19 empirical research and 45 review articles, commentaries, protocols and guidance documents spanning five pandemics. Four main themes (and 11 sub-themes) were identified. Barriers to delivering fundamental care were wearing personal protective equipment, adequate staffing, infection control procedures and emotional challenges of care. These barriers were addressed by multiple adaptations to communication, organization of care, staff support and leadership. Conclusion To prepare for continuation of the COVID-19 pandemic and future pandemics, evaluative studies of adaptations to fundamental healthcare delivery must be prioritized to enable evidence-based care to be provided in future. Impact Our review identifies the barriers nurses experience in providing fundamental care during a pandemic, highlights potential adaptations that address barriers and ensure positive healthcare experiences and draws attention to the need for evaluative research on fundamental care practices during pandemics.
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