Impact of COVID-19 and other infectious conditions requiring isolation on the provision of and adaptations to fundamental nursing care in hospital in terms of overall patient experience, care quality, functional ability, and treatment outcomes: systematic review.
Rebecca Whear, Rebecca A Abbott, Alison Bethel and 13 others
PMID 34554585WHAT IT FOUND
Isolation and PPE disrupted fundamental nursing care by blocking communication, limiting bedside tasks, reducing visits and increasing staff burden.
Nurses described many adaptations, but no studies tested whether they improved patient experience, quality, function or outcomes.
Key findings
01PPE reduced non-verbal communication and made bedside nursing tasks harder.
02Visitor restrictions and isolation had a negative impact on patient and family experience, including dignity, end-of-life care and family-centred care for children.
03The review found no studies testing whether adaptations improved patient experience, care quality, functional ability or treatment outcomes.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Only 19 empirical studies were found, and all seven quantitative studies were rated weak, so effectiveness claims are very limited. Most included papers were commentaries, protocols or guidance rather than patient outcome studies. No studies tested whether adaptations improved patient experience, care quality, function or treatment outcomes. English-only searches and exclusion of invasively ventilated patients mean the findings may not cover all hospital isolation settings. The search was in July 2020, so it may not reflect later pandemic practice.
Declared interests
The authors declared no conflicts of interest. The work was funded by the Medical Research Council and the National Institute for Health Research.
The easy way to misread this
Do not conclude that photos on PPE, tablets, modular care or staff support improve patient experience, quality, function or outcomes. This review found no studies testing these adaptations on those outcomes.