Impact of COVID‐19 and other infectious conditions requiring isolation on the provision of and adaptations to fundamental nursing care in hospital in terms of overall patient experience, care quality, functional ability, and treatment outcomes: systematic review

Whear, Rebecca; Abbott, Rebecca A.; Bethel, Alison; Richards, David A.; Logan, Pip A.; Garside, Ruth; Cockcroft, Emma; Iles‐Smith, Heather; Rafferty, Ann Marie; Shepherd, Maggie; Sugg, Holly V. R.; Russell, Anne Marie; Cruickshank, Susanne; Tooze, Susannah; Melendez‐Torres, G.J.; Thompson Coon, Jo

Abstract

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 (https://search.bvsalud.org/) MedRxiv (https://www.medrxiv.org/), bioRxiv (https://www.biorxiv.org/) 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.

Citation

Whear, R., Abbott, R. A., Bethel, A., Richards, D. A., Logan, P. A., Garside, R., Cockcroft, E., Iles‐Smith, H., Rafferty, A. M., Shepherd, M., Sugg, H. V. R., Russell, A. M., Cruickshank, S., Tooze, S., Melendez‐Torres, G., & Thompson Coon, J. (2022). Impact of COVID‐19 and other infectious conditions requiring isolation on the provision of and adaptations to fundamental nursing care in hospital in terms of overall patient experience, care quality, functional ability, and treatment outcomes: systematic review. Journal of Advanced Nursing, 78(1), 78-108. https://doi.org/10.1111/jan.15047

• Journal Article Type: Article
• Acceptance Date: Sep 5, 2021
• Online Publication Date: Sep 23, 2021
• Publication Date: 2022-01
• Deposit Date: Sep 30, 2021
• Publicly Available Date: Oct 5, 2021
• Journal: Journal of Advanced Nursing
• Print ISSN: 0309-2402
• Electronic ISSN: 1365-2648
• Publisher: Wiley
• Peer Reviewed: Peer Reviewed
• Volume: 78
• Issue: 1
• Pages: 78-108
• DOI: https://doi.org/10.1111/jan.15047
• Keywords: adaptation, barrier, experience, fundamental, care nurses, nursing support, systematic review
• Public URL: https://nottingham-repository.worktribe.com/output/6347976
• Publisher URL: https://onlinelibrary.wiley.com/doi/10.1111/jan.15047