Healthcare professionals in COVID-19-intensive care units in Norway: preparedness and working conditions: a cohort study

Irene Lie; Siv Stafseth; Laila Skogstad; Ingvild Strand Hovland; Haakon Hovde; Øivind Ekeberg; Johan Ræder

doi:10.1136/bmjopen-2021-049135

Healthcare professionals in COVID-19-intensive care units in Norway: preparedness and working conditions: a cohort study

BMJ Open. 2021 Oct 11;11(10):e049135. doi: 10.1136/bmjopen-2021-049135.

Authors

Irene Lie¹, Siv Stafseth^{2

3}, Laila Skogstad^{4

5}, Ingvild Strand Hovland⁶, Haakon Hovde⁷, Øivind Ekeberg⁸, Johan Ræder^{9

10}

Affiliations

¹ Centre for Patient Centered Heart and Lung Research, Department of Cardiothoracic Surgery, Oslo University Hospital, Oslo, Norway irene.lie@ous-hf.no.
² Department of Postoperative and Intensive Care, Administrative Section, Oslo University Hospital, Oslo, Norway.
³ Department of MEVU, Lovisenberg Diaconal University College, Oslo, Norway.
⁴ Department of Research, Sunnaas Sykehus HF, Nesoddtangen, Norway.
⁵ Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway.
⁶ Department of Acute Medicine, Oslo University Hospital, Oslo, Norway.
⁷ Critical Care Nurses, Norwegian Nurses Association, Oslo, Norway.
⁸ Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway.
⁹ Department of Anaesthesiology, Oslo University Hospital, Oslo, Norway.
¹⁰ Institute of Clinical Medicine, University of Oslo, Oslo, Norway.

Abstract

Objective: To survey the healthcare professionals' background and experiences from work with patients with COVID-19 in intensive care units (ICUs) during the first wave of the COVID-19 pandemic in Norway.

Design: Observational cohort study.

Setting: COVID-ICUs in 27 hospitals across Norway.

Participants: Healthcare professionals (n=484): nurses (81%), medical doctors (9%) and leaders (10%), who responded to a secured, web-based questionnaire from 6 May 2020 to 15 July 2020.

Primary and secondary measures: Healthcare professionals': (1) professional and psychological preparedness to start working in COVID-ICUs, (2) factors associated with high degree of preparedness and (3) experience of working conditions.

Results: The age of the respondents was 44.8±10 year (mean±SD), 78% were females, 92% had previous ICU working experience. A majority of the respondents reported professional (81%) and psychological (74%) preparedness for working in COVID-ICU. Factors significantly associated with high professional preparedness for working in COVID-19-ICU in a multivariate logistic model were previous ICU work experience (p<0.001) and participation in COVID-ICU simulation team training (p<0.001). High psychological preparedness was associated with higher age (p=0.003), living with spouse or partner (p=0.013), previous ICU work experience (p=0.042) and participation in COVID-ICU simulation team training (p=0.001). Working with new colleagues and new professional challenges were perceived as positive in a majority of the respondents, whereas 84% felt communication with coworkers to be challenging, 46% were afraid of being infected and 82% felt discomfort in denying access for patient relatives to the unit. Symptoms of sweating, tiredness, dehydration, headache, hunger, insecurity, mask irritation and delayed toilet visits were each reported by more than 50%.

Conclusions: Healthcare professionals working during the first wave of COVID-ICU patients in Norway were qualified and prepared, but challenges and potential targets for future improvements were present.

Trial registration number: NCT04372056.

Keywords: COVID-19; adult intensive & critical care; intensive & critical care.

Publication types

Observational Study
Research Support, Non-U.S. Gov't

MeSH terms

COVID-19*
Cohort Studies
Delivery of Health Care
Female
Humans
Intensive Care Units
Pandemics*
SARS-CoV-2

Associated data

ClinicalTrials.gov/NCT04372056