OPEN Research Support
head

Postdoc
Kirsten Specht
Department of Orthopedic Surgery, Hospital of Southern Jutland


Projekt styring
Projekt status    Sampling ongoing
 
Data indsamlingsdatoer
Start 21.04.2020  
Slut 01.05.2021  
 



Healthcare professionals experiences of comprehensive organisational changes in three South Jutland hospitals during Covid-19 outbreak in Denmark

Short summary

During the COVID-19 pandemi the Danish healthcare system had to prepare for a substantial amount of COVID-19 patients who would be in need for hospital admission. Consequently, there was a need for fast and comprehensive organizational changes within the health care system in Denmark. The managers and the staff needed to cope with a totally new and unpredictable situation and make decisions that were to be implemented immediately. Therfore the overall aim of this study is to explore how these changes are experienced among nurses and other health professionals and to learn about what the organisation needs to provide of training, information and on going support in future similar scenarios. 


Rationale

In December 2019, the novel coronavirus or COVID-19 (Corona Virus Disease 2019) caused the first cluster of patients with severe pneumonia of unknown cause. Coronaviruses belong to a large respiratory virus family that causes diseases ranging from a common cold to the Middle East respiratory syndrome (MERS) and severe acute respiratory syndrome (SARS). The newly identified COVID-19 infection is a highly contagious disease with symptoms such as fever, tiredness, fatigue, dry cough, dyspnea, lymphopenia and pneumonia. Currently no effective therapy or vaccination has been developed to treat or prevent this new infection. 

In March 2020, WHO characterized COVID-19 as a pandemic as it caused infections among people in all parts of the world. As of April 5, 2020, COVID-19 has become a global health problem with more than 1,1 million confirmed cases in 208 countries and with almost 63,000 deaths in total. In the middle of March 2020, the Danish Health Authority and the Danish government took a series of difficult precautionary measures in an effort to contain the spread of COVID-19. Health authorities advised people to clean all touch-surfaces in the home daily, wash or disinfect their hands frequently, maintain social distance, avoid touching eyes, nose and mouth and if they had fever, cough and difficulty breathing they should seek medical care. Based on experiences from China and Italy, the Danish healthcare system had to prepare for a substantial amount of COVID-19 patients who will be in need for hospital admission and hereof approximately 25% needing mechanical ventilation in intensive care facilities. Consequently, there was a need for fast and comprehensive organizational changes within the health care system in Denmark. The managers and the staff needed to cope with a totally new and unpredictable situation and make decisions that were to be implemented immediately. 

Health care professionals are on the frontline caring for patients with this new emerging infectious disease and patients who are potentially infected. The International Council of Nursing (ICN) has emphasized the importance of nurses to keep themselves as safe as possible through their actions as well as their use of personal protective equipment. Providing care during the COVID-19 outbreak is associated with occupational risks and nurses and other healthcare professionals are putting their lives at risk in their duties.

A qualitative study showed that during the MERS outbreak, nurses experienced burnout because of a heavy workload, and they were concerned about their safety and to become infected. The same study revealed that unclear and frequently changed guidelines resulted in confusion and there was a need to create a supportive environment while caring for suspected or infected patients.

Healthcare professionals working with COVID-19 patients are facing new work routines, new colleagues, new managers and a new disease they have never heard about just three months earlier. To handle these demands, the healthcare professionals need to adjust their work to the new demands - they need to act resiliently, which means they need to adjust their performance to the conditions. An organisation's performance is resilient if it can function as required under expected and unexpected conditions. However, limited studies have been performed to explore the nurses' and other healthcare professionals' experiences when working with COVID-19 infected patients during the COVID-19 outbreak. It is relevant to investigate how and if the organization made it possible for them to handle the situation. 

Aim

The overall aim of the study is to learn about what the organisation needs to provide of training, information and on going support in future similar scenarios. 

Objectives

The study has three objectives: 

1a) to explore how nurses experience to work in a newly organized COVID-19 department with high risk patients, after a short training and work under a new management together with nurses from different specialties. 

1b) To explore how nurses experience to cope with the fast and comprehensive organizational changes at their workplace and how the organization can ensure the best possible conditions for nurses to handle these changes. 

2) To explore how different healthcare professionals involved in Covid-19 treatment at three hospitals (Sonderjylland, Lillebaelt, Esbjerg) experience the organizational changes during the pandemic with focus on identification of learning points for future alike scenarios. 


Description of the cohort

Nurses and other health professionals who work in a newly organized COVID-19 department after a short training. 


Data and biological material

Qualitative data from telephone interviews.

Questionnaires


Collaborating researchers and departments

Emergency Department, University Hospital of Southern Denmark, Aabenraa and Department of Regional Health Research, University of Southern Denmark 

  • Lilian Keene Boye, PhD Fellow
  • Mette Elkjær, PhD Fellow

University Hospital of Southern Denmark, Sonderborg 

  • Bettina Ravnborg Thude, PhD, Researcher

Department of Anaesthesiology and Intensive Care, University Hospital of Southern Denmark, Lillebaelt Hospital and Department of Regional Health Research, University of Southern Denmark 

  • Hanne Irene Jensen, Associate professor 

Research Unit of Health Sciences, University Hospital of Southern Denmark, Esbjerg and Department of Regional Health Research, University of Southern Denmark 

  • Bibi Valgerdur Gram, Associate professor

University Hospital of Southern Denmark, Sonderborg and Department of Regional Health Research, University of Southern Denmark 

Danish Hospital for Rheumatic Diseases, University Hospital of Southern Denmark, Sonderborg

  • Jette Primdahl, Professor