WEBVTT 00:00:00.967 --> 00:00:05.092 position:50% align:middle - [Woman] Nicole Ozturk is a research scientist at NCSBN. 00:00:05.092 --> 00:00:11.390 position:50% align:middle Dr. Ozturk received her Ph.D. in education psychology in 2018 focusing on Bayesian 00:00:11.390 --> 00:00:14.309 position:50% align:middle applications to psychometric data. 00:00:14.630 --> 00:00:19.429 position:50% align:middle In addition, she has five years experience drawing upon quantitative analytical 00:00:19.429 --> 00:00:25.050 position:50% align:middle techniques to deliver actionable data products in an education setting. 00:00:25.050 --> 00:00:29.244 position:50% align:middle Dr. Ozturk's previous projects include developing a Bayesian augmented 00:00:29.244 --> 00:00:34.150 position:50% align:middle testing algorithm, evaluating student competencies, and learning outcomes 00:00:34.150 --> 00:00:36.135 position:50% align:middle in healthcare curricula. 00:00:42.669 --> 00:00:47.558 position:50% align:middle - [Dr. Ozturk] Good afternoon. I'm Nicole Ozturk and my talk is titled Global 00:00:47.558 --> 00:00:52.210 position:50% align:middle Regulatory Response to the COVID-19 Pandemic: A Descriptive Study. 00:00:52.210 --> 00:00:55.500 position:50% align:middle We'll do a live Q&A at the end of the session. 00:00:55.500 --> 00:01:01.289 position:50% align:middle So throughout the presentation, feel free to enter questions you have in the Q&A box. 00:01:01.289 --> 00:01:05.529 position:50% align:middle To begin, I will outline the general structure of my talk today. 00:01:05.529 --> 00:01:10.017 position:50% align:middle I will start out with some limited background information, my primary research question, 00:01:10.017 --> 00:01:16.697 position:50% align:middle research design and methodology, analysis plan, respond in distribution, the results 00:01:16.697 --> 00:01:21.439 position:50% align:middle of my study, and finally, a summary of key findings. 00:01:21.439 --> 00:01:26.359 position:50% align:middle As of February 2021, the World Health Organization reports cumulatively 00:01:26.359 --> 00:01:32.434 position:50% align:middle there have been 103 million confirmed cases of COVID-19 and 2.2 million 00:01:32.434 --> 00:01:37.245 position:50% align:middle resulting deaths. The monumental swell of the COVID-19 pandemic has strained 00:01:37.245 --> 00:01:42.513 position:50% align:middle healthcare systems and personnel worldwide. With nurses serving on the frontlines of 00:01:42.513 --> 00:01:47.436 position:50% align:middle hospitals, there are increasing concerns that nurses' capacity to provide care will 00:01:47.436 --> 00:01:52.405 position:50% align:middle be stretched to the breaking point by rising need. Nursing regulatory bodies have 00:01:52.405 --> 00:01:59.134 position:50% align:middle taken a variety of actions to safeguard the nursing profession. The primary goal of 00:01:59.134 --> 00:02:03.335 position:50% align:middle this study is to examine what changes have been made and if these changes are 00:02:03.335 --> 00:02:08.096 position:50% align:middle permanent, temporary, or somewhere in between. In particular, we were interested 00:02:08.096 --> 00:02:13.008 position:50% align:middle in identifying changes in telehealth, nursing mobility, education, and the disciplinary 00:02:13.008 --> 00:02:19.010 position:50% align:middle process. To address this question, a web survey was developed in collaboration with 00:02:19.010 --> 00:02:26.719 position:50% align:middle NCSBN staff and sent to about 150 individuals representing non-U.S. nursing jurisdictions. 00:02:26.719 --> 00:02:32.077 position:50% align:middle The survey was sent on January 2021 and closed in February. 00:02:32.077 --> 00:02:36.008 position:50% align:middle The survey was developed to better understand what changes jurisdictions had 00:02:36.008 --> 00:02:41.206 position:50% align:middle made during the COVID-19 pandemic. The web survey was developed in and administered with 00:02:41.206 --> 00:02:46.771 position:50% align:middle Qualtrics. The Global Regulatory Atlas: COVID-19 Pandemic Response Survey 00:02:46.771 --> 00:02:52.335 position:50% align:middle consisted of 41 items with branching logic across governance, practice and workforce, 00:02:52.335 --> 00:02:55.897 position:50% align:middle education, telehealth, and discipline domains. 00:02:55.897 --> 00:03:00.578 position:50% align:middle The web survey was then translated into 11 languages to increase the diversity of 00:03:00.578 --> 00:03:05.709 position:50% align:middle responses. Our final sample consisted of 30 jurisdictions. 00:03:05.709 --> 00:03:10.573 position:50% align:middle Frequencies and counts were drawn upon to evaluate jurisdiction changes as a result 00:03:10.573 --> 00:03:16.049 position:50% align:middle of the COVID-19 pandemic. All analyses were conducted in SAS and Tableau. 00:03:16.049 --> 00:03:19.880 position:50% align:middle Google Translate was used to interpret free-response items. 00:03:21.379 --> 00:03:26.459 position:50% align:middle As mentioned on the previous slide, we had 30 jurisdictions participate in our COVID 00:03:26.459 --> 00:03:31.038 position:50% align:middle Response Survey resulting in a 21% response rate. 00:03:31.038 --> 00:03:36.668 position:50% align:middle In the map above, countries are represented in teal while provinces are colored in blue. 00:03:36.668 --> 00:03:42.088 position:50% align:middle To begin, we asked jurisdictions about changes to nursing regulatory governance. 00:03:42.088 --> 00:03:47.236 position:50% align:middle More specifically, we asked about any sort of regulatory actions taken to facilitate the 00:03:47.236 --> 00:03:51.648 position:50% align:middle movement of nurses in or out of their jurisdiction. 00:03:51.648 --> 00:03:55.783 position:50% align:middle Interestingly enough, roughly one-third or about 10 jurisdictions 00:03:55.783 --> 00:04:01.497 position:50% align:middle of our sample, colored green on this map, indicated legislative action was taken to 00:04:01.497 --> 00:04:05.936 position:50% align:middle support the movement of nurses in and out of the jurisdiction. 00:04:05.936 --> 00:04:08.228 position:50% align:middle Those that have not are colored red. 00:04:08.407 --> 00:04:13.736 position:50% align:middle Next, we asked respondents about their jurisdiction practice and workforce changes. 00:04:13.736 --> 00:04:18.506 position:50% align:middle In terms of nursing practice, only Poland and Sweden along with Honduras and El 00:04:18.506 --> 00:04:23.456 position:50% align:middle Salvador expanded the role of the nurse generalists during the pandemic. 00:04:23.456 --> 00:04:28.141 position:50% align:middle Sweden, for example, had expanded the role of nurse generalists and pediatric 00:04:28.141 --> 00:04:33.426 position:50% align:middle nurses to prescribe the COVID-19 vaccine, provided they can demonstrate knowledge 00:04:33.426 --> 00:04:38.981 position:50% align:middle related to vaccinations. We found five other jurisdictions also indicated they 00:04:38.981 --> 00:04:44.172 position:50% align:middle temporarily altered the process of accepting internationally educated nurses into their 00:04:44.172 --> 00:04:50.130 position:50% align:middle respective jurisdictions. For example, El Salvador temporarily accepted to nurses 00:04:50.130 --> 00:04:55.833 position:50% align:middle educated in Spain as part of an international team to treat COVID-19 patients. 00:04:55.833 --> 00:05:00.997 position:50% align:middle One-third of our sample altered their continued competency requirements for generalist nursing, 00:05:00.997 --> 00:05:05.508 position:50% align:middle moving courses to online and distance learning platforms, and offering courses 00:05:05.508 --> 00:05:10.678 position:50% align:middle in infectious diseases as was the case in Taiwan, personal protective equipment and 00:05:10.678 --> 00:05:15.846 position:50% align:middle ethics as is the case in Seychelles, and emergency care as was the case in the 00:05:15.846 --> 00:05:21.160 position:50% align:middle Solomon Islands. And one last element, 16 jurisdictions in our sample allowed 00:05:21.160 --> 00:05:24.087 position:50% align:middle retired nurses to reenter the workforce. 00:05:24.930 --> 00:05:29.095 position:50% align:middle We then moved on to changes made to nursing education during the COVID-19 00:05:29.095 --> 00:05:32.566 position:50% align:middle pandemic. Similar to what we have seen in our U.S. 00:05:32.566 --> 00:05:37.570 position:50% align:middle pre-licensure study in which we examined the shift from in-person lectures to online 00:05:37.570 --> 00:05:42.938 position:50% align:middle learning environments, two-thirds of our sample or about 20 jurisdictions moved a 00:05:42.938 --> 00:05:47.932 position:50% align:middle portion of their lecture-based curriculum to online learning environments. 00:05:47.932 --> 00:05:54.382 position:50% align:middle Further, most indicated such changes were a mix of both temporary and permanent. 00:05:54.382 --> 00:05:58.032 position:50% align:middle We then asked about disruptions to the clinical curriculum. 00:05:58.032 --> 00:06:02.200 position:50% align:middle Slightly fewer jurisdictions, 18 in our sample, indicated that their clinical 00:06:02.200 --> 00:06:05.800 position:50% align:middle curriculum was disrupted due to the pandemic. 00:06:05.800 --> 00:06:10.489 position:50% align:middle The most often identified solutions were offering clinicals through simulation, 00:06:10.489 --> 00:06:14.540 position:50% align:middle virtual simulation, and waivers to clinicals entirely. 00:06:14.540 --> 00:06:19.064 position:50% align:middle All others indicated there was a general delay or the pandemic did not influence 00:06:19.064 --> 00:06:21.960 position:50% align:middle their clinical offerings to a great degree. 00:06:21.960 --> 00:06:26.347 position:50% align:middle No jurisdiction indicated these changes were permanent, rather most indicated 00:06:26.347 --> 00:06:30.087 position:50% align:middle the changes were a mix of temporary and permanent. 00:06:30.087 --> 00:06:34.699 position:50% align:middle Lastly, with the exception of El Salvador, all jurisdictions reported students would 00:06:34.699 --> 00:06:37.945 position:50% align:middle not be allowed to graduate early to enter the workforce. 00:06:38.537 --> 00:06:43.207 position:50% align:middle As for discipline during the pandemic, most jurisdictions observed about the 00:06:43.207 --> 00:06:46.647 position:50% align:middle same number of complaints relative to pre-pandemic times. 00:06:46.647 --> 00:06:51.897 position:50% align:middle In addition, an even larger majority indicated that they did not alter their 00:06:51.897 --> 00:06:57.615 position:50% align:middle disciplinary process. Of those that adjusted their disciplinary process, the jurisdiction 00:06:57.615 --> 00:07:02.942 position:50% align:middle of Newfoundland and Labrador simply indicated hearings were just held online. 00:07:02.942 --> 00:07:08.532 position:50% align:middle In terms of telehealth changes, about 30% of the jurisdictions in our sample made 00:07:08.532 --> 00:07:10.822 position:50% align:middle changes to their telehealth policies. 00:07:10.822 --> 00:07:15.521 position:50% align:middle This included clarifying telehealth scope of practice and developing guidelines for 00:07:15.521 --> 00:07:21.018 position:50% align:middle virtual care. Again, a little over a third of the jurisdictions addressing this 00:07:21.018 --> 00:07:25.472 position:50% align:middle question reported their population received care via telehealth. 00:07:25.472 --> 00:07:30.858 position:50% align:middle However, only 15% of our sample reported that nurses based in their own jurisdictions 00:07:30.858 --> 00:07:34.604 position:50% align:middle were providing care outside of their borders. 00:07:34.604 --> 00:07:40.108 position:50% align:middle In summary, the COVID-19 pandemic has strained nurses' capacity to provide care 00:07:40.108 --> 00:07:45.354 position:50% align:middle and as a result, nursing regulatory bodies had taken a variety of actions to support 00:07:45.354 --> 00:07:50.686 position:50% align:middle the nursing workforce. The most significant changes appear to have been nursing 00:07:50.686 --> 00:07:55.835 position:50% align:middle education as clinicals have been shifted to simulation and lecture-based courses 00:07:55.835 --> 00:08:01.822 position:50% align:middle to online learning environments. Additionally, jurisdictions in our sample have brought 00:08:01.822 --> 00:08:06.727 position:50% align:middle retired nurses back into the workforce to supplement the current group and offered 00:08:06.727 --> 00:08:13.072 position:50% align:middle virtual continued competency courses on COVID-19 preparedness. Residents within 00:08:13.072 --> 00:08:19.190 position:50% align:middle these jurisdictions are also receiving cross-jurisdictional care. It's unclear if 00:08:19.190 --> 00:08:24.861 position:50% align:middle these changes will remain temporary or permanent. As our study found, jurisdictions 00:08:24.861 --> 00:08:29.168 position:50% align:middle made numerous changes during the COVID-19 pandemic which invites the 00:08:29.168 --> 00:08:33.923 position:50% align:middle question of how all these changes will impact the future of nursing. Thank you 00:08:33.923 --> 00:08:37.608 position:50% align:middle for listening to my talk. I'd like to open the floor for any questions. 00:08:54.782 --> 00:08:59.290 position:50% align:middle All right. One of the questions we received from Allison was, "Can you repeat if 00:08:59.290 --> 00:09:02.676 position:50% align:middle telehealth changes were temporary or permanent?" 00:09:02.676 --> 00:09:08.840 position:50% align:middle So we did ask our sample countries or jurisdictions if these changes were 00:09:08.840 --> 00:09:13.146 position:50% align:middle temporary or permanent, and we received a middle ground answer. 00:09:13.146 --> 00:09:17.746 position:50% align:middle So some said that they were temporary and some said that they would remain permanent. 00:09:17.746 --> 00:09:21.782 position:50% align:middle It doesn't seem there was a lot of clarity yet if they will remain permanent at this 00:09:21.782 --> 00:09:29.016 position:50% align:middle time. All right. It doesn't appear we have any other questions. 00:09:29.016 --> 00:09:34.705 position:50% align:middle Again, if you have any additional questions that pop up a little bit later, you're certainly 00:09:34.705 --> 00:09:43.371 position:50% align:middle welcome to email me at nkaminski-ozturk@ncsbn.org. 00:09:43.371 --> 00:09:45.715 position:50% align:middle Thank you and have a lovely afternoon.