Risk factors for converting traditional wards to temporary intensive care units during the COVID‐19 pandemic: Insights from nurses' perspectives

• Published in: Nursing in critical care 2024-11, Vol.29 (6), p.1412-1420
• Main Authors: Li, Wenyu, Lin, Xiuli, Fang, Zhenhong, Fang, Xufei, Zheng, Xiuyun, Tu, Wenyu, Feng, Xiaofang
• Format: Article
• Language: English
• Subjects: Clinical medicine; COVID-19; Critical care; Intensive care; nurse perspectives; Nurses; Pandemics; Patient safety; Risk factors; Skills; temporary ICU
• ISSN: 1362-1017; 1478-5153; 1478-5153
• DOI: 10.1111/nicc.13106

Background The surge in critically ill COVID‐19 patients caused a shortage of intensive care unit (ICU) beds. Some hospitals temporarily transformed general wards into ICUs to meet this pressing health care demand. Aim This study aims to evaluate and analyse the risk factors in temporary ICU from the perspective of nurses. By identifying these factors, the goal is to provide actionable insights and recommendations for effectively establishing and managing temporary ICUs in similar crisis scenarios in the future. Study Design The study was conducted in China within a public hospital. Specifically, it focused on examining 62 nurses working in a temporary ICU that was converted from an infectious disease ward. The research utilized the Hazard Vulnerability Analysis (HVA) scoring method to identify potential threats, evaluate their probability, estimate their impact on specific organizations or regions and calculate the relative risk associated with such occurrences. Results Staff demonstrated the highest risk percentage (32.74%), with Stuff (16.11%), Space (15.19%) and System (11.30%) following suit. The most critical risk factors included insufficient knowledge and decision‐making competence in critical care (56.14%), lacking decision‐making abilities and skills in renal replacement therapy care (55.37%), inadequate decision‐making capacity and relevant skills in respiratory support care (50.64%), limited decision‐making capability in circulatory support care (45.73%) and unfamiliarity with work procedures or systems (42.09%). Conclusions Urgent implementation of tailored training and support for temporary ICU nurses is paramount. Addressing capability and skill‐related issues among these nurses supersedes resource availability, infrastructure, equipment and system considerations. Essential interventions must target challenges encompassing nurses' inability to perform critical treatment techniques autonomously and ensure standardized care. These measures are designed to heighten patient safety and elevate care quality during emergencies. These findings offer a viable avenue to mitigate potential moral distress, anxiety and depression among nurses, particularly those transitioning from non‐critical care backgrounds. These nurses swiftly assimilate into temporary ICUs, and the study's insights offer practical guidance to alleviate their specific challenges. Relevance to Clinical Practice The study on risk factors for converting traditional wards into temporary