Anita Nilsen

• Nilsen, Anita; Lichtwarck, Bjørn; Eriksen, Siren & Rokstad, Anne Marie Mork (2026). What have nursing home staff learned from the COVID-19 pandemic about managing pandemic infectious diseases? A qualitative study. Geriatric Nursing. ISSN 0197-4572. 68(March ). doi: 10.1016/j.gerinurse.2026.103850. Full text in Research Archive Show summary

  Aim: The aim of this study is to explore the lessons that nursing home staff learned from the COVID-19 pandemic related to the management of pandemic infectious diseases. Methods: Four focus groups were conducted with nursing home staff who had experienced COVID-19 infections at the nursing home where they were employed. The focus groups, conducted during September and October 2023 at the respective nursing homes, were audio recorded and transcribed verbatim. Data were analyzed using reflexive thematic analysis as described by Braun and Clarke (2022). Findings: The analysis resulted in three themes: 1) organization of infection control measures, 2) framework for training in infection control routines, and 3) clinical assessments and measures when suspecting infection. The participants experienced challenges regarding access to personal protective equipment, a lack of knowledge about infection control routines, and the difficulty of limiting infection given the building layout. Using clinical tools or assessments to detect signs of infection in nursing home residents improved nursing home staff’s ability to detect symptoms of contagious infections. Conclusion: For nursing homes to be more prepared and resilient in the event of a new pandemic, overall planning of nursing homes’ needs should take place at both the national and municipal levels, as well as at the management level within each nursing home. This planning must ensure sufficient staffing, access to infection control equipment, and the updating of employees’ professional and clinical knowledge. Keywords: COVID-19; Infection prevention and control; Nursing homes.

• Nilsen, Anita; Eriksen, Siren; Lichtwarck, Bjørn; Hillestad, Adelheid Hummelvoll; Julnes, Signe Gunn & Tretteteig, Signe [Show all 7 contributors for this article] (2024). Treatment and Care for nursing home residents with COVID-19: a qualitative study. Journal of Multidisciplinary Healthcare. 17, p. 2935–2946. doi: 10.2147/JMDH.S467459. Full text in Research Archive Show summary

  Purpose: Coronavirus disease 2019 (COVID-19) placed a significant strain on nursing homes, leading to numerous outbreaks and high mortality rates. This situation created considerable stress and challenges for residents, their physicians and nurses, as well as family caregivers. By understanding these challenges, we can gain new insights and learn valuable lessons. Thus, the purpose of this study is to examine the treatment and care provided to nursing home residents with COVID-19, as experienced by physicians, nurses, and family caregivers. Participants and Methods: This study is a secondary analysis of 35 interviews with physicians, nurses, and family caregivers, each with personal experience caring for nursing home residents diagnosed with COVID-19. The interviews took place from December 2020 to April 2021. We analyzed the transcriptions based on Braun and Clarke’s reflexive thematic analysis model and followed a qualitative descriptive design as outlined by Sandelowski. Findings: The analysis produced three themes: 1) Balancing medical treatment, 2) The need for increased systematic monitoring of vital functions, and 3) Determining the treatment level for nursing home residents. These themes were explored through the unique perspectives of the three participant groups: physicians, nurses, and family caregivers. The findings revealed several challenges related to treatment and care for nursing home residents diagnosed with COVID-19. This applied both to relief of symptoms, monitoring of vital functions, assessment of treatment level and use of advance care planning. Conclusion: Drawing from the experiences of physicians, nurses, and family caregivers, there should be a unified plan at the municipal or national level for competency development in nursing homes to prepare for future crises like pandemics or epidemics. Additionally, the safe engagement of family caregivers and relatives should be given priority.

• Nilsen, Anita; Lichtwarck, Bjørn; Eriksen, Siren & Rokstad, Anne Marie Mork (2023). Clinical expressions, characteristics and treatments of confirmed COVID-19 in nursing home residents: a systematic review. BMC Geriatrics. 23, p. 1–25. doi: 10.1186/s12877-023-03826-0. Full text in Research Archive Show summary

  Background: The coronavirus 2019 (COVID-19) pandemic has led to a high rate of infections, frequent outbreaks, and high mortality rates in nursing homes (NH) worldwide. To protect and improve the treatment and care of the vulnerable NH population, it is pivotal to systematise and synthesise data from cases of COVID-19 among NH residents. In our systematic review, we therefore aimed to describe the clinical expressions, characteristics, and treatments of NH residents confirmed to have COVID-19. Methods: We conducted two comprehensive literature searches in several electronic databases: (1) PubMed, (2) CINAHL, (3) AgeLine, (4) Embase, and (5) PsycINFO in April and July 2021. Of the 438 articles screened, 19 were included in our sample, and we used the Newcastle–Ottawa Assessment Scale to assess the quality of the reported studies. A weighted mean (Mweighted), was calculated to account for the large variation in sample sizes of the studies, and due to heterogeneity among the studies, we report our findings in a narrative synthesis. Results: According to the mean weights (Mweighted), common symptoms and signs in NH residents confirmed to have COVID-19 were fever (53.7%), cough (56.5%), hypoxia (32.3%), and delirium or confusion (31.2%). Common comorbidities were hypertension (78.6%), dementia or cognitive impairment (55.3%), and cardiovascular diseases (52.0%). Six studies presented data concerning medical and pharmacological treatments, such as inhalers, oxygen supplementation, anticoagulation, and parenteral/enteral fluids or nutrition. The treatments were used to improve outcomes, as part of palliative care, or as end-of-life treatment. Transfers to hospital for NH residents with confirmed COVID-19 were reported in six of the included studies, and the rate of hospital transfers ranged from 6.9% to 50% in this population. In the 17 studies reporting mortality, 40.2% of the NH residents died during the studies’ observation periods. Conclusions: Our systematic review allowed us to summarise important clinical findings about COVID-19 among NH residents and to identify the population’s risk factors for serious illness and death caused by the disease. However, the treatment and care of NH residents with severe COVID-19 warrant further investigation.

• Julnes, Signe Gunn; Lichtwarck, Bjørn; Eriksen, Siren; Hillestad, Adelheid Hummelvoll; Nilsen, Anita & Tretteteig, Signe [Show all 7 contributors for this article] (2022). Sykehjemslegers erfaringer med covid-19 : en kvalitativ intervjustudie. Tidsskrift for omsorgsforskning. ISSN 2387-5976. 8(3), p. 1–14. doi: 10.18261/tfo.8.3.12. Full text in Research Archive Show summary

  Beboere med covid-19-sykdom på norske sykehjem hadde høy risiko for alvorlig forløp og død. Hensikten med denne studien var å utforske sykehjemslegers erfaringer med å ivareta behandlingsansvaret for beboere med covid-19 og hvordan de samarbeidet med pårørende og sykepleiere. Denne intervjustudien inkluderte ti sykehjemsleger med erfaring fra covid-19 i sykehjem fra tre av de fire helseregionene i Norge. Vi gjorde en kvalitativ innholdsanalyse av de transkriberte intervjuene. Analysen identifiserte følgende tre hovedfunn: 1) Krevende ansvar for medisinskfaglige vurderinger og avgjørelser, 2) Kommunikasjon og samarbeid med pårørende – viktig og tidkrevende, og 3) Sykepleierne – en viktig samarbeidspartner. Sykehjemslegene opplevde et krevende ansvar og utfordringer med å ivareta multimorbide og skrøpelige beboere under pandemien. Dette illustrerer behovet for gode rutiner samt lokale og nasjonale retningslinjer. Samarbeidet med erfarne og rutinerte sykepleiere ga trygghet. Sykehjemslegenes beskrivelse av følelsesmessige utfordringer under covid-19-pandemien understreker behovet for faste, kollegiale og faglige nettverk. Nøkkelord: kommunehelsetjeneste, pandemi, multisyke, eldre, samarbeid

• Tretteteig, Signe; Eriksen, Siren; Hillestad, Adelheid H.; Julnes, Signe Gunn; Lichtwarck, Bjørn & Nilsen, Anita [Show all 7 contributors for this article] (2022). The experience of relatives of nursing home residents with COVID-19 : a qualitative study. Nursing: Research and Reviews. 12, p. 17–27. doi: 10.2147/NRR.S328336. Full text in Research Archive Show summary

  Background: The coronavirus disease 2019 (COVID-19) pandemic had significant consequences for relatives’ opportunities to communicate with and offer care to seriously ill and dying nursing home residents with COVID-19. Residents in nursing homes were urged to protect themselves through social distancing, and visits have been permanently regulated and limited. These restrictions have been challenging, and the limitations have raised many questions and led to difficult choices. The aim of this study was to explore the experiences of relatives of nursing home residents with COVID-19. We investigated the following two research questions: How did relatives of COVID-19 patients in Norwegian nursing homes experience the situation and how did the physical distancing and precepts of infection control affect the relationship between the long-term residents and the relatives?. Methods: The study has a qualitative explorative design with a phenomenological-hermeneutic approach, with individual in-depth interviews used for data collection. The study included ten relatives of nursing home residents with COVID-19. Results: Three main perspectives were identified from the participants’ experiences: (1) the difficult choices; (2) maintaining the relationship; and (3) experiencing support. The relatives experienced ethical dilemmas when weighing the risk of getting COVID-19 if they visited the patient versus the consequences of not visiting their loved one. In this situation, they needed good information and support from health care professionals. Conclusion: To enable relatives of COVID-19 patients to make choices in line with their goals and intrinsic motivations, it is important that staff members possess competence in infection control, updated knowledge about the residents’ situations, and the skills to facilitate a safe and confident dialogue. Trust in the care staff and a feeling of safety are essential for relatives in a stressful situation with difficult choices, while a lack of confidence, routines, and/or dialogue might increase relatives’ feelings of insecurity and stress and make their caring role difficult.

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