Quality management in the COVID-19 pandemic: nursing action plan

to describe the implementation of a nursing action plan to face the pandemic of COVID 19 in a University Hospital in the state of Rio de Janeiro. Methods: this is an experience report, in which two management tools were used: the Ishikawa Diagram to identify problems and the 5W2H spreadsheet to outline the actions according to the situations presented.

Results:

four categories were listed in two groups: 1- Actions of the Nurse Manager in the Organization of Logistics, Infrastructure and Care: materials and environment; and 2- Nursing Human Resources Management and Continuing Education: method and human resources.

Final Considerations:

the plan developed showed the role of nursing management, with the search for best care practices, development of protocols, carrying out multi-professional training and management of supplies.

Descriptors:
Quality Management; Nursing; COVID-19; Pandemic; Tertiary Health Care.

What	Why	Where	When	Who	How	How much
ORGANIZATION OF LOGISTICS, INFRASTRUCTURE AND ASSISTANCE
Control of medical supplies and medications	Market shortage and inflated prices	In the whole hospital	During the first year of the pandemic, especially the first six months	Assistance Coordinators	Through evidence-based contingency plan of utilization	Unestimated Expense
Availability of a nurse to monitor the materials (standardization of PPE^* * PPE - personal protection equipment; )	To keep track of the quality and quantity required for material assistance	Warehouse and Purchasing Sector	In the acquisition of materials for assistance use	Nurse in partnership with the administrative sector	Through the assessment of the real needs for usage in the sectors and the product’s quality opinion	Unestimated Expense
Adequacy of the number of beds to the necessary distance and quantity of nursing professionals	Mandatory distance of 2 meters between beds	In all locations with inpatients	During the entire period	Assistance Coordinators	Reducing the number of beds	Unestimated Expense
CONTINUING EDUCATION AND HUMAN RESOURCES
Organization with the University rectory of transportation for the hospital’s personnel and hotel accommodations	Allow transport of the health teams for care and accommodate the professionals	Several daily routes were established for the professionals’ attendance	During the lockdown period at some locations	University Drivers and Nursing Division	Routes established by necessity demands, due to transportation restriction	Unestimated Expense
Request for emergency professionals to attend COVID-19 to the competent body	Adequate the COVID dimensioning, established by COFEN† and compensate for the exit of vulnerable professionals	In all sectors intended for COVID-19 service	During the pandemic	Nursing Division and Hospital Superintendent	Reports demonstrating the need for personnel	Unestimated Expense
Provide effective communication between the nursing teams	Spreading the knowledge of the elaborated processes and the changes in the assistance protocols	Inside the hospital	After each decision making with changes in routine and care processes	Team managers and nurse coordinators	Through registrations in order books and sectoral occurrences, electronic mail, and social networks	Unestimated Expense
Organization of incoming and outgoing flows of professionals and patients	Avoid cross flow between suspected and contaminated patients, with professionals and other patients	In the COVID-19 service sectors and outpatient areas	During the pandemic	Risk Management Team, HICC‡ and Nursing Division	Signs on the floor with green and red stripes and seats inside the hospital	Unestimated Expense

Associação Brasileira de Enfermagem SGA Norte Quadra 603 Conj. "B" - Av. L2 Norte 70830-102 Brasília, DF, Brasil, Tel.: (55 61) 3226-0653, Fax: (55 61) 3225-4473 - Brasília - DF - Brazil
E-mail: reben@abennacional.org.br

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[1] Corresponding author: Fabiana Aparecida Corrêa de Oliveira Braga, E-mail: fabiana.correa@ebserh.gov.br