COLUMBIA, Mo. – The University of Missouri is helping to lead a statewide effort to retrain and deploy retired nurses and other health care providers to alternative care sites (ACSs) for recovering COVID-19 patients. The coordinated response ensures that staff would be immediately available to assist whenever the need may arise.

The state has designated a site in Florissant and, if needed another possible site in the St. Louis area, Kansas City or Springfield to handle recovering COVID-19 patients and those with chronic conditions such as cardiac and pulmonary problems and diabetes. These sites ensure more hospital beds are available for patients who need higher levels of medical intervention and care.

Staffing these alternative care sites was an urgent challenge. About 800 retired nurses and other health care professionals, with and without active licenses, immediately answered the statewide call to volunteer. The varied group — from those long gone from nursing to those who had recently left the field — all required some level of vetting and retraining to prepare them to care for patients at these sites, said Shirley Farrah, assistant dean for Nursing Outreach at the MU Sinclair School of Nursing.

The Missouri governor’s office turned to the University of Missouri to provide that high-quality training — and to do so in record time.

Within days, MU Health Care, the MU School of Medicine and MU Extension Nursing Outreach, along with Missouri Disaster Medical Assistance Team (DMAT) leaders, coordinated a response.

The training needed to be online and streamlined, with additional on-site training by DMAT clinical staff once at the ACS. The curriculum had to cover essentials such as vital signs, oxygen administration, EKG testing and early recognition of declining patient status. Most important, all trainees have to be drilled in meticulous handling and wearing of personal protective equipment.

Clinical nursing educators from MU Health Care’s Center for Education and Development had recently developed their own mostly online training program for clinic nurses in inpatient medical-surgical settings. The clinic nurses were among 800 MU Health Care staff members receiving specialized training, including front office staff, unit clerks and others who were also trained for performing nonclinical COVID-19-related duties such as helping with meal delivery, transport and other needs.

With input from DMAT, MU educators swiftly adapted this program to alternative care site needs. MU Health Care reached out to Elsevier/Mosby, a publisher of nursing education materials, and arranged complimentary access to these resources for the ACS nurses. Should sicker patients need to be assigned to these sites, nurses would also have access to online training that covers more complex nursing skills.

Dena Higbee, executive director of simulation at the School of Medicine and School of Nursing, identified other training resources around competencies such as detecting early warning signs of a patient’s deteriorating condition. The MU Mobile Simulation Van, approved as a mass casualties training unit, would also be available for on-site training, if needed.

Since the initial request from the state, nearly 300 nurses have been or will be vetted by DMAT and assigned to the appropriate level of training based on licensing status and nursing experience, Farrah said.

“The situation remains very fluid regarding statewide need,” she said. No additional staff has been called to the Florissant site at this time.

“And we are ready,” Farrah added. “The level of rapid response, coordination and collaboration among state, university, health care and extension leaders was heartening. It demonstrates that we have the will, desire and capacity to bring the right experts and resources together to help our state and fellow Missourians in this and any crisis if we face it together.”

The MU training response was coordinated by the Sinclair School of Nursing (Shirley Farrah), School of Medicine (Kathleen Quinn, Dena Higbee) and MU Health Care (Stephanie Hunt, James Parsons), with MU Extension Nursing Outreach and Community Health assistance.

Writer: Katherine Foran