Rapid development of COVID Resources, USA

29 June 2021

Contributor: Terri Hinkley, CEO, Academy of Medical-Surgical Nurses

In the United States, as in many countries, there has never been a pandemic on the scale of COVID-19. The impact on the public has been devastating, with over 32 million cases of COVID-19 in the US at the end of May 2021 - the largest outbreak in the world. The COVID-19 pandemic has resulted in a significant volume of acutely or critically ill patients in many cities around the US and globally.

Many hospitals around the country were hit with overwhelming volume and many made calls for contingent or temporary staff to support their existing staff. Some of these staff are retired healthcare providers, others are students currently in medical or nursing school. In addition, hospitals cancelled elective surgeries or other outpatient activities and those staff were redeployed or 'floated' to medical-surgical units, intensive care units, emergency departments and special COVID-19 units designed and identified to care for these patients. The stress on healthcare facilities to find, hire, prepare and deploy these staff was significant at best, overwhelming at worst.

There are approximately 5,725 hospitals in the United States and four million nurses. Based on data from national nursing surveys, the Academy of Medical-Surgical Nurses (AMSN) estimates that there are approximately 600,000 medical-surgical nurses in the US.

In late 2019, AMSN began to work on an innovate and comprehensive competency model for medical-surgical nurses. While all hospitals assess staff competencies, usually on an annual basis, the majority of these are independently created and not supported by evidence. In addition, the very fact that the pandemic has been straining the resources for hospitals, limiting their ability to easily assess nurse competencies, makes this model, which is backed by science and psychometrically developed, to be both innovative and necessary for the quality and safety of the patients we serve.

The reach of this programme is significant and potentially impacts upwards of one million nurses in the US when we consider all medical-surgical nurses, the contingent workforce and employers.

AMSN recognised very quickly that registered nurse staffing was going to be an issue during the COVID-19 pandemic, especially in 'hot spots' seeing significant volume of cases. Recognising its ability to assist with the staffing challenges many institutions would face, AMSN quickly identified an opportunity to leverage some related work it was doing to make three tools available to facilities and organisations to help them through the staffing crisis. All these products are provided free of charge.

AMSN’s self-assessment tool assists facilities in assessing the competence of this new workforce to assist employers with placing these staff in the right clinical area and assigning them appropriately based on their individual levels of practice.

AMSN also developed a staffing model and template to assist facilities in ensuring patient care can safely be provided while also balancing the staffing needs of individual units and hospitals. The staffing model includes instructions for use, implementation strategies and a staffing template that organisations could modify according to their own facility.

The last resource AMSN developed was a set of educational flash cards that contingent and float staff could use to familiarize themselves with common medical issues in medical-surgical nursing to ensure they had access to concise electronic references for the types of patients they will care for. It is mobile-friendly and accessible from any device.

AMSN, in partnership with Assessment, Education, and Research Partners, and Naughton Consulting, quickly worked with volunteers to evaluate, modify and prepare the current competency model to meet the needs of healthcare facilities, contingent staff and float staff. The self-assessment tool was ready for deployment within three weeks. Volunteers from AMSN, board members and staff worked closely together to develop and launch the staffing model and educational product. Prior to launch, AMSN was able to pilot the instrument with one of its corporate member organisations to test the product and make any necessary refinements. The self-assessment launched first on 6 April 2020, the staffing model launched on 17 April 2020 and the educational resources launched on 20 April 2020.

AMSN volunteers, made up of registered nurses around the country, were critical to the ability to quickly develop these critical resources. While volunteers are the lifeblood of every association, AMSN volunteers truly went above and beyond at a time they were extremely stressed and overwhelmed within their workplaces to support their fellow med-surg colleagues. The ability of AMSN staff to leverage their subject matter expertise and work with them to develop and deploy these products is truly commendable. Staff and volunteers partnered to work long hours and in some cases into the evenings and weekends because they understood the urgent need for these products. AMSN is entirely grateful for the work of many committed partners in developing these products.

The AMSN COVID resources can be accessed here: https://www.amsn.org/business-solutions/workforce-solutions/covid-19-staffing-resources.