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Covid Nurse

The development, testing and evaluation of a COVID-19 fundamental nursing care protocol: a randomised controlled trial.

At the outset of the SARS-CoV-2 pandemic, UK nurses and other healthcare professionals reported not feeling fully confident in delivering care to COVID-19 patients (who were not invasively ventilated). The requirement to wear PPE during care delivery and frequent re-deployment to unfamiliar clinical environments all contributed to staff uncertainties. 

The aim of the COVID-NURSE study is to co-create and evaluate the impact on patient experience, care quality, functional ability, treatment outcomes and costs of a nursing care protocol specifically addressing the fundamental care requirements of hospitalised patients with COVID-19 (not invasively ventilated). 

Methods 

This is a cluster randomised trial of a nursing guideline compared to usual care for inpatients with COVID-19 who are not invasively ventilated. 

The experimental intervention (nursing guideline) has been co-created by nurses and patients to help overcome the barriers to care experienced by nurses in the pandemic and to minimize missed care. Co-creation was complete via an on-line survey of 1700 nurses, a rapid systematic review and consensus groups of patients and nurses. 

The intervention consists of multiple examples of practice innovations and learning from nurses who cared for patients with COVID-19 during the first wave of the pandemic.  

It includes a guideline, trigger posters, management support and some online support materials that include:  

  • Step by step online learning 
  • Short expert videos from scientists, patients, nurses and carers  
  • Masses of useful information for nursing COVID-19 patients  
  • Can be revisited whenever nurses want to, again and again  
  • Quick quizzes to help nurses remember what they’ve learnt  
  • Help nurses feel supported and appreciated and know they’re doing well  
  • Shared findings and feedback from nurses locally and nationally  

The intervention is being tested in practice through the cluster randomised trial, which involves the entire hospital being allocated to the intervention or usual care arm rather than individual patients.  

At least 18 participating sites across the UK will recruit 60 patient participants who will complete on-line questionnaire related to the quality and effectiveness of care during their admission. Nurses caring for these patients will be invited to participate in interviews to better understand the fidelity of the care guideline (intervention).  

Results from the trial are expected during summer 2022. 

Publications

Richards, DA, Sugg, HVR, Cockcroft, E, Cooper, J, Cruickshank, S, Doris, F, Hulme, C, Logan, P, Iles-Smith, HM , Melendez-Torres, GJ, Rafferty, AM, Reed, N, Russell, AM, Shepherd, M, Singh, SJ, Thompson Coon, J, Tooze, S, Wotton, S, Abbott, R, Bethel, A, Creanor, S, Quinn, L, Tripp, H, Warren, FC, Whear, R, Bollen, J, Hunt, HA, Kent, M, Morgan, L, Morley, N and Romanczuk, L (2021) ‘COVID-NURSE : evaluation of a fundamental nursing care protocol compared to care as usual on experience of care for non-invasively ventilated patients in hospital with the SARS-CoV-2 virus : protocol for a cluster randomised controlled trial’ , BMJ Open, 11 (5) , e046436. 

Royal Berkshire NHS – Research & Development @BerksResearch- Jul 2, 2021- “Research goes beyond the Research and Development department at our Trust. Multi-disciplinary working is an essential part of offering our patients the chance to take part in research. #ThankYou #HealthResearch #MultiDisciplinery @jessicaemilybea @COVIDNURSEProj1  

Heather Rostron, @RostronHeather “So proud too! Fantastic to have a St Nurse actively delivering a nurse-led RCT” @julesaevans1 @wadsy76 @LeedsHealthcare @HChristodoulide @JanetHirst1 @LisaChiefNurse @crf_leeds @covid19leeds @UoLStudents #nihr70at70 

Research Group: KHP, Long term Conditions 

Project Funder

Medical Research Council (MRC)

National Institute for Health Research (NIHR) 

Project Team

Professor Dave Richards, Professor of Mental Health Services Research and Head of Nursing, NIHR Senior Investigator Emeritu

Professor Heather Iles-Smith, Professor of Nursing, SHS, UoS/Northern Care Alliance

Professor Joanne Cooper, Nottingham University Hospitals NHS Trust, Nottingham

Dr Susanne Cruickshank, Royal Marsden NHS Foundation Trust, London

Professor Anne Marie Rafferty, King’s College London

Dr Holly V. R. Sugg, University of Exeter

Emma Cockcroft, University of Exeter

Faye Doris, University of Exeter

Dr Claire Hulme, University of Exeter

Phillipa Logan, University of Nottingham

Dr G.J. Melendez-Torres, University of Exeter

Nigel Reed, University of Exeter

Dr Anne-Marie Russell, University of Exeter

Dr Maggie Shepherd, University of Exeter

Sally J. Singh, University Hospitals of Leicester NHS Trust

Jo Thompson Coon, University of Exeter

Susannah Tooze, University of Exeter

Stephen Wotton, University of Southampton

Rebecca Abbott, University of Exeter

Alison Bethel, University of Exeter

Dr Siobhan Creanor, University of Exeter

Lynne Quinn, University of Exeter

Harry Tripp, University of Exeter

Fiona C. Warren, University of Exeter

Rebecca Whear, University of Exeter

Jessica Bollen, University of Exeter

Harriet A. Hunt, University of Exeter

Merryn Kent, University of Exeter

Leila Morgan, Royal Devon and Exeter NHS Foundation Trust

Naomi Morley, University of Exeter

Lidia Romanczuk, University of Exeter. 

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