Nurse Practitioners and COVID-19: Early Challenges and Future Strategies
Bibliographic record
Abstract
Aim: To discuss the challenges experienced by nurse practitioners (NPs) caring for individuals with chronic diseases during the early years of COVID-19 pandemic in Newfoundland and Labrador (NL) and to recommend potential strategies that can be utilized in the current practice environment and when planning for future pandemics. Background: Chronic diseases may not have been adequately managed during the early years of the COVID-19 pandemic, even with the increased use of virtual care services. Most literature has focused on identifying the challenges faced by healthcare providers, rather than options for strategies to improve collaboration with individuals and enhance team management of chronic conditions. Methods: In this sequential exploratory mixed methods study, 14 NPs were interviewed in the qualitative phase to identify challenges. Results informed the development of a contextually- relevant survey questionnaire (first integration step). In the quantitative phase, 32 NPs completed the questionnaire. Data collected during the quantitative survey were compared with the qualitative data, the second integration step, to assess how widespread challenges were and to gain further insights for potential strategies to implement in the current practice environment. Findings: In addition to identifying stress and changes to the NP practice environment, key themes related to chronic disease management were identified by the interviewed NPs (qualitative phase) and supported by the surveyed NPs (quantitative phase). These related to reduced access to care (e.g. due to closures or lack of cell service), difficulty diagnosing and managing patients even with virtual care availability (e.g. due to inability to conduct a physical assessments), and inadequacies in patient self-management of their chronic diseases. The NPs agreed with the recommended strategies, at the individual, team, and organizational levels, to address the identified challenges. Conclusion: Numerous strategies, relevant to the identified challenges and the local practice context, are recommended to be used by NPs and other HCPs in caring for individuals with chronic diseases, in the current practice environment and when planning for future pandemics.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.007 | 0.001 |
| Scholarly communication | 0.001 | 0.005 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.005 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".