Implementation of COVID-19 measures for Dutch nursing home staff and their insights

BACKGROUND: Measures against COVID-19 in nursing homes impacted both clients and staff, yet the importance of measures from the staff's perspective remain underexplored. This study examined measures related to staff during the COVID-19 pandemic, staff perspectives of their importance and the involvement of staff in deciding these measures. METHODS: In this qualitative study, the minutes of 41 nursing home outbreak teams in the period March to November 2020 were analyzed and 4 group meetings were conducted between June-November 2020. Qualitative content analysis was used for the minutes data, whereas reflexive thematic analysis was used for the group meeting data. RESULTS: Measures implemented for staff focused on prevention of COVID-19 transmission, (suspension of) educational activities, testing, additional tasks and staffing capacity, promoting well-being, and other means of support. The results showed overlap between the implemented measures and the measures considered important by staff, except for measures on decision-making support and communication, which were considered important by staff but not listed among the implemented measures. Measures were prioritized by staff because they affected their well-being, workforce scheduling, decision making, or preventing infections. Furthermore, the group meetings revealed that decision making shifted from mainly implementing national guidelines to more context -adjusted decision making in the staff's or clients’ situation. CONCLUSIONS: Although there was overlap regarding measures taken, our findings suggest that organizations should be encouraged to explore ways of timely involvement of staff in decision making when implementing measures in future pandemics. During the COVID-19 pandemic, information about the pandemic response strategies and policies were shared with policymakers and nursing home organizations to learn from each other and make more informed decisions about how to respond to the pandemic. KEY MESSAGES: • The information gained through the group meetings can lead to an improved fit between implemented measures and staffs’ working procedures during future pandemics. • Decision making support and communication should receive more attention according to staff during future pandemics.