Key strategies for managing nursing care under the COVID-19 pandemic: A multiple-case study of nursing directors

Aim: We aim to identify measures implemented by hospital nursing directors early in the COVID-19 pandemic and enabling factors. Background: Managerial factors affect nurses' physical and mental health and willingness to work, especially early in a pandemic. Method: We used multiple-case study of 15 hospitals, comparing management approaches by interviewing 28 nursing directors and their assistants from August to December 2020. Results: Hospitals that accepted COVID-19 patients and hospitals that unexpectedly experienced clusters underwent a nursing provision system organization phase, followed by an adjustment phase to maintain nursing organization function. Two factors aided measure implementation: an emergency system and staff protection policies. Conclusion: Early epidemic management strategies apply across contexts. The hospital's basic attitude is key to effective implementation of the strategies. Implications for Nursing Management: The results suggest that hospitals, nursing directors and nurses can each prepare for future emerging infectious disease epidemics.