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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

Research output: Contribution to journalReview articlepeer-review

Rebecca Whear, Rebecca A. Abbott, Alison Bethel, David A. Richards, Ruth Garside, Emma Cockcroft, Heather Iles-Smith, Pip A. Logan, Ann Marie Rafferty, Maggie Shepherd, Holly V.R. Sugg, Anne Marie Russell, Susanne Cruickshank, Susannah Tooze, G. J. Melendez-Torres, Jo Thompson Coon

Original languageEnglish
Pages (from-to)78-108
Number of pages31
JournalJournal of Advanced Nursing
Issue number1
Accepted/In press2021
PublishedJan 2022

Bibliographical note

Funding Information: This work is funded by the National Institute for Health Research and UK Research and Innovation, administered by the MRC: grant number MR/V02776X/1 and is also independent research supported by the National Institute for Health Research Applied Research Collaboration South West Peninsula. The funder has had no role in design, conduct, interpretation or writing of the review. The views expressed in this publication are those of the author(s) and not necessarily those of the National Institute for Health Research or the Department of Health and Social Care. Publisher Copyright: © 2021 The Authors. Journal of Advanced Nursing published by John Wiley & Sons Ltd. Copyright: Copyright 2021 Elsevier B.V., All rights reserved.

King's Authors


Aim: This systematic review identifies, appraises and synthesizes the evidence on the provision of fundamental nursing care to hospitalized patients with a highly infectious virus and the effectiveness of adaptations to overcome barriers to care. Design: Systematic review. Data Sources: In July 2020, we searched Medline, PsycINFO (OvidSP), CINAHL (EBSCOhost), BNI (ProQuest), WHO COVID-19 Database ( MedRxiv (, bioRxiv ( and also Google Scholar, TRIP database and NICE Evidence, forwards citation searching and reference checking of included papers, from 2016 onwards. Review Methods: We included quantitative and qualitative research reporting (i) the views, perceptions and experiences of patients who have received fundamental nursing care whilst in hospital with COVID-19, MERS, SARS, H1N1 or EVD or (ii) the views, perceptions and experiences of professional nurses and non-professionally registered care workers who have provided that care. We included review articles, commentaries, protocols and guidance documents. One reviewer performed data extraction and quality appraisal and was checked by another person. Results: Of 3086 references, we included 64 articles; 19 empirical research and 45 review articles, commentaries, protocols and guidance documents spanning five pandemics. Four main themes (and 11 sub-themes) were identified. Barriers to delivering fundamental care were wearing personal protective equipment, adequate staffing, infection control procedures and emotional challenges of care. These barriers were addressed by multiple adaptations to communication, organization of care, staff support and leadership. Conclusion: To prepare for continuation of the COVID-19 pandemic and future pandemics, evaluative studies of adaptations to fundamental healthcare delivery must be prioritized to enable evidence-based care to be provided in future. Impact: Our review identifies the barriers nurses experience in providing fundamental care during a pandemic, highlights potential adaptations that address barriers and ensure positive healthcare experiences and draws attention to the need for evaluative research on fundamental care practices during pandemics.

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