To develop a Zambian context specific short and long term model for managing COVID-19 pandemic and future infectious disease outbreaks.

Pandemics such as COVID-19 bring significant challenges for all health services, especially those in low-middle income countries. This trauma, emergency and critical care nursing project was developed with our established partners in Zambia, Ministry of Health, Nursing and Midwifery Council, Lusaka College of Nursing and Ndola College of Nursing, in recognition that the COVID-19 pandemic will have a short, medium and long-term impact on healthcare delivery and workforce. While funding streams may focus on the current COVID-19 pandemic itself, the likelihood of future outbreaks of COVID-19, new or known infectious diseases, cannot be discounted. Therefore, solutions must be sought to address the effects of diverting resources from an already over stretched workforce with limited resources. In Zambia, nurses are the only professional group who are present at every stage of the patient pathway, from initial contact in a rural health clinic or emergency and trauma services through inpatient services to discharge and rehabilitation. Individually they have more patient contact than all other professional groups combined. These nurses need to have increased capacity in leadership, management and clinical decision-making. These attributes, essential to prevent healthcare systems becoming overwhelmed enable nurses to identify and respond appropriately to the rapidly changing health needs that arise during outbreaks of infectious diseases and pandemics. They include the ability to develop and implement strategies for containing infected cohorts and preventing the disease spreading. Our shared needs assessment early in the pandemic. identified the urgent need to up-skill their healthcare workers for what is likely to be rapidly increasing need. These will enable them to be both proactive and reactive in their responses to the COVID-19 pandemic and other infectious diseases. This project will be conducted in three phases. Phase 1: Communities engagement examines how the 73 tribes, with their own language, cultural beliefs and traditions engage with the limited community healthcare services. The nurses live alongside and with the communities they serve, and have a very wide remit, being expected to treat whoever seeks their assistance. This includes communicable and non-communicable diseases (for all age groups), public health and prevention. Consequently, the COVID-19, with its rapid onset and high, unprecedented incidence inevitably impacts adversely on services that the community relies on. Phase 2: Documentary Data Analysis will be used to analyse, interpret and national documentation, health statistics and information, to complete a gap analysis regarding COVID-19. Much of the information, guidance, education and training that the MoH have been able to access was developed in High-Income Countries, and may not be apposite for the Zambian context. Therefore, this project will identify strategies that can build on (and not adversely impact on), current Zambian health systems and structures. Phase 3: Development of processes for practice and enhanced nursing response to COVID-19, combining results from phases one and two to develop educational and clinical processes and procedures for practice; and make recommendations for policy for dealing with COVID-19. This includes planning for a possible second wave, and future infectious disease outbreaks. Deliverables from this research include recommendations for national and international policy makers. A national curriculum and competency assessment document for Bachelor of Science in Trauma and Emergency Nursing and critical care specialist practice. The sharing of outputs via webinars and virtual conference/actual conferences, and peer-reviewed journal papers. It will facilitate knowledge exchange and transfer between healthcare professionals Zambia and UK and support the establishment of an international community of practitioners with expertise in COVID-19 management.