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).
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.
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. https://bmjopen.bmj.com/content/11/5/e046436.abstract
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
Project Team: Professor Dave Richards, Professor of Mental Health Services Research and Head of Nursing, NIHR Senior Investigator Emeritus; 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.
Research Group: KHP, Long term Conditions
Project Funder: Medical Research Council (MRC)/National Institute for Health Research (NIHR)