2021 Annual Conference

Role of CNS in COVID-19 Pandemic

Background/Significance: In March of 2020, the Novel Corona Virus swept our nation and impacted healthcare around the world.  Overnight, organizations were forced to rapidly interpret the evidence and make decisions for COVID-19 patients and healthcare works.  Frontline caregivers struggled to interpret the fast-paced changes in regulations and guidance from around the world on a day to day, sometimes, hour to hour basis.  The organization’s culture of safety was at risk with the abundance of new and changing information, differing expert opinions, and an overflow of stakeholders.

Methods: Using the CNS framework, a CNS team was able to establish a structure for communication, infection prevention, patient care expectations and best practice sharing among 6 hospitals in an organization.  Sharp HealthCare instituted a disaster command center in which the role of the CNS was vital in communicating to the frontline by continuous rounding on the COVID-19 units to answer questions, guide patient care, problem solve, develop education, and facilitate training.  Through collaboration with experts including physicians, infection prevention specialists and other disciplines, a multidisciplinary, system-wide COVID-19 patient care guideline was established to promote quality and safety of patient care.

Outcomes: In a global pandemic, a system-wide CNS team was able to unify an organization by identifying key stakeholders, gain consensus, stabilize fears, and create a guideline for frontline empowerment. The team impacted structure, data collection, infection prevention strategies and promoted PPE conservation. Once established the team was able to track quality metrics through the quality variance reporting system and impact the Culture of Safety.  COVID-19 communication scored 77% favorable, and the COVID-19 care units maintained non-significant differences in their individual culture of safety metrics.  There was an initial increase in quality variance reporting, with a steady decrease since May 2020.

Implications: Standardization of patient care and creating a structure for communication is vital to an organization’s culture of safety and continuous improvement in the quality of patient care.  Healthcare organizations need commitment to the evidence to guide patient care while being adaptable and collaborative among all disciplines to deliver the highest quality of patient care.