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Evaluation of a COVID‐19 fundamental nursing care guideline versus usual care: The COVID‐NURSE cluster randomized controlled trial

Richards, David A.; Bollen, Jess; Jones, Ben; Melendez-Torres, G. J.; Hulme, Claire; Cockcroft, Emma; Cook, Heather; Cooper, Joanne; Creanor, Siobhan; Cruickshank, Susanne; Dawe, Phoebe; Doris, Faye; Iles-Smith, Heather; Kent, Merryn; Logan, Pip; O'Connell, Abby; Onysk, Jakub; Owens, Rosie; Quinn, Lynne; Rafferty, Anne Marie; Romanczuk, Lidia; Russell, Anne Marie; Shepherd, Maggie; Singh, Sally J.; Sugg, Holly V.R.; Coon, Jo Thompson; Tooze, Susannah; Warren, Fiona C.; Whale, Bethany; Wootton, Stephen

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Authors

David A. Richards

Jess Bollen

Ben Jones

G. J. Melendez-Torres

Claire Hulme

Emma Cockcroft

Heather Cook

Joanne Cooper

Siobhan Creanor

Susanne Cruickshank

Phoebe Dawe

Faye Doris

Heather Iles-Smith

Merryn Kent

PIP LOGAN pip.logan@nottingham.ac.uk
Professor of Rehabilitation Research

Abby O'Connell

Jakub Onysk

Rosie Owens

Lynne Quinn

Anne Marie Rafferty

Lidia Romanczuk

Anne Marie Russell

Maggie Shepherd

Sally J. Singh

Holly V.R. Sugg

Jo Thompson Coon

Susannah Tooze

Fiona C. Warren

Bethany Whale

Stephen Wootton



Abstract

Aim: To evaluate the impact of usual care plus a fundamental nursing care guideline compared to usual care only for patients in hospital with COVID‐19 on patient experience, care quality, functional ability, treatment outcomes, nurses' moral distress, patient health‐related quality of life and cost‐effectiveness. Design: Parallel two‐arm, cluster‐level randomized controlled trial. Methods: Between 18th January and 20th December 2021, we recruited (i) adults aged 18 years and over with COVID‐19, excluding those invasively ventilated, admitted for at least three days or nights in UK Hospital Trusts; (ii) nurses caring for them. We randomly assigned hospitals to use a fundamental nursing care guideline and usual care or usual care only. Our patient‐reported co‐primary outcomes were the Relational Aspects of Care Questionnaire and four scales from the Quality from the Patient Perspective Questionnaire. We undertook intention‐to‐treat analyses. Results: We randomized 15 clusters and recruited 581 patient and 418 nurse participants. Primary outcome data were available for 570–572 (98.1%–98.5%) patient participants in 14 clusters. We found no evidence of between‐group differences on any patient, nurse or economic outcomes. We found between‐group differences over time, in favour of the intervention, for three of our five co‐primary outcomes, and a significant interaction on one primary patient outcome for ethnicity (white British vs. other) and allocated group in favour of the intervention for the ‘other’ ethnicity subgroup. Conclusion: We did not detect an overall difference in patient experience for a fundamental nursing care guideline compared to usual care. We have indications the guideline may have aided sustaining good practice over time and had a more positive impact on non‐white British patients' experience of care. Implications for the Profession and/or Patient Care: We cannot recommend the wholescale implementation of our guideline into routine nursing practice. Further intervention development, feasibility, pilot and evaluation studies are required. Impact: Fundamental nursing care drives patient experience but is severely impacted in pandemics. Our guideline was not superior to usual care, albeit it may sustain good practice and have a positive impact on non‐white British patients' experience of care. Reporting Method: CONSORT and CONSERVE. Patient or Public Contribution: Patients with experience of hospitalization with COVID‐19 were involved in guideline development and writing, trial management and interpretation of findings.

Citation

Richards, D. A., Bollen, J., Jones, B., Melendez-Torres, G. J., Hulme, C., Cockcroft, E., …Wootton, S. (2024). Evaluation of a COVID‐19 fundamental nursing care guideline versus usual care: The COVID‐NURSE cluster randomized controlled trial. Journal of Advanced Nursing, 80(5), 2137-2152. https://doi.org/10.1111/jan.15959

Journal Article Type Article
Acceptance Date Nov 1, 2023
Online Publication Date Nov 20, 2023
Publication Date 2024-05
Deposit Date Jan 18, 2024
Publicly Available Date Jan 19, 2024
Journal Journal of Advanced Nursing
Print ISSN 0309-2402
Electronic ISSN 1365-2648
Publisher Wiley
Peer Reviewed Peer Reviewed
Volume 80
Issue 5
Pages 2137-2152
DOI https://doi.org/10.1111/jan.15959
Keywords fundamental nursing care, cluster randomized controlled trial, SARS‐COV‐2, COVID‐19, patient experience
Public URL https://nottingham-repository.worktribe.com/output/27855428
Publisher URL https://onlinelibrary.wiley.com/doi/10.1111/jan.15959

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