ICN Call to Action
COVID-19

1

Urgently prioritise ready access to sufficient quantity of highquality and appropriate personal protective equipment (PPE) fornurses and other healthcare workers

Governments must ensure that production of such equipment is rapidly expanded to meet thedemands of this pandemic and optimise supply chains for the rapid distribution of such materials.
Manufacturers and businesses that are capable of assisting should step forward and rapidly scale
up production or re-tool manufacturing lines to develop medical products (such as PPE).
Using their professional judgement, within the context of national/international evidence-based
guidelines, nurses are best placed to select the appropriate PPE required, based on their assessmentof the situation in which they are providing care. The application of practices and precautions should
include a point of care risk assessment by the healthcare worker.

2Ensure all nurses have appropriate evidence-based infection
prevention and control training and the latest COVID-19-specificguidance and training

All healthcare workers must have access to infection prevention and control (IPC) training whichshould include application of the systematic, comprehensive approach of the hierarchy of controls.
This includes the use of engineering controls, which remove or reduce hazards or place a barrier
between the worker and the hazard; administrative controls, which include protocols and policies;
and PPE.
Nurses must be kept informed of new and emerging COVID-19 specific guidance and advances/changes in policy/procedures as new information emerges on this virus. This must be communicatedto nurses in an appropriate and timely manner.
Working in a pandemic may pose ethical challenges and nurses should be provided with ethicalguidelines and procedural values frameworks to help guide decision-making.

3

Protect the health and wellbeing of nurses and other healthcare
workers

Nurses are the largest group of frontline health professionals in the battle against COVID-19: theirsafety and wellbeing should be a priority for governments and healthcare organisations. Strategies
must be developed and implemented to reduce the physical and psychosocial burden on nurses.
Governments should provide access to mental health and counselling resources.
Employers must monitor and mitigate fatigue by ensuring appropriate respite between shifts andmaintaining scheduled breaks while on shift.

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Nurses who fall into the high-risk category, because of their age and/or any pre-existing conditions(i.e. pregnancy, immunocompromised) should be deployed to areas of lower risk of infection.
COVID-19 exposure in the workplace is considered occupational exposure by WHO and the resulting
illness would be considered an occupational disease. Governments should ensure compensation,curative services and rehabilitation are provided for infected health workers.

4

Rapidly implement/scale-up comprehensive surveillancesystems to track and investigate healthcare worker infection

Early detection of COVID-19 in healthcare workers is an important protective mechanism for
populations that may come into contact with them. Testing for COVID-19 should be prioritised for
health workers who provide direct patient care. Health workers should be tested if they demonstrate
any symptoms or have been exposed to patients who have tested positive to COVID-19 (orsuspected) whilst not wearing appropriate protective equipment. As best practices evolve withincreased evidence and resources, testing of healthcare workers should be in line with these.
It is essential that governments create comprehensive surveillance and data collection systems toprovide up-to-date information about infection rates among the nursing and the healthcare workforce
during the pandemic.

5

Ensure the financial protection and compensation of nurses

Nurses who work casually, including agency, temporary, and part-time workers, makeup a sizable proportion of many nations’ nursing workforces. These staff are particularly importantwhen the permanent and fulltime nursing workforce is unable to meet demand. These nurses mustreceive adequate sickness benefits.
Nurses are working beyond normal working hours to address the demand for care: they must be
appropriately remunerated for all of the hours they work.
Financial support should be considered to support frontline health workers who are at an increased
risk of contact with COVID-19.
Governments need to provide emergency funding to assist nurses with childcare needs and coverwage losses as a result of illness or having to be quarantined.

6

Provide a safe and effective Registration and Regulatory
response when rapidly expanding the nursing workforce

In many countries, there has been a call for the rapid expansion of the number of Registered Nurses
and other practitioners, including expediting nursing student graduation or recalling retired nurses.
These strategies must continue to ensure that public safety is of paramount importance. This can beeffectively supported by National Nurses Associations, which have the expertise to ensure that anyexpansion of the workforce is robust and approached strategically. They will be able to support theprocess to maintain a competent and capable workforce.

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7

Ensure a safe and effective deployment of nursing staff to areasof high demand and high complexity as the need arises

Where there are a shortages of specialist nurses due to high demand and highly complex environments,
careful planning must be considered regarding the deployment of nurses working outside of theirtraditional roles to take into consideration patient safety and professional competence. These nurses
require physical, emotional and legal protections. In addition, deployed nurses must be supportedwith education, training, mentorship and supervision.
Senior nursing leadership is best placed to develop, guide and implement such policies or protocols.

8

Encourage, develop and support new models of care andinnovation

Innovative approaches to the way care is delivered must be rapidly developed to meet the needs ofpopulations. Nurse-led models of care can facilitate increased access to high-quality care and have
proven to improve health outcomes.
The funding and use of digital health and virtual care is strongly encouraged. Telehealth, for example,
has been shown to improve access to care and reduce the risk of infection transmission.

9Demonstrate public support and recognise the value of nurses
to society

This pandemic has shone a spotlight on nursing that none of us could have anticipated. Nurses are
the largest group of healthcare professionals and are critical to the COVID-19 response, to keeping
health systems functioning and to the health of populations.
The public has an important role to play in keeping nurses and other healthcare workers safe. They
can support nurses and show they value them by continuing to strictly adhere to the latest publichealth advice such as physical distancing and self-isolation.

10Capitalise on nursing leadership

It is imperative that the world’s nurse leaders are involved in policy and planning decision making at
the highest level to ensure that overstretched healthcare systems can provide the best possible careto the greatest number of patients.
ICN’s 130-plus National Nurses’ Associations (NNAs) represent the world’s 20 million nurses in every
region of the globe and are the repository of decades of knowledge and experience. Governments
should see NNAs as key partners in policymaking, alongside their Chief Nursing Officers and othersenior officials. Countries without a government-level Chief Nursing Officer should immediately
engage nursing leaders to provide expertise and advice at the highest level of policymaking.
Health systems and policy makers must leverage the expertise of and support nurse leaders inclinical settings who are effectively managing several aspects of the COVID-19 response.
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3

11Develop and implement a comprehensive, coordinated COVID-19
public health strategy with active engagement of nurses

A strategy to control and mitigate the impact of COVID-19 on the health of populations and on healthsystems should include testing every suspected case, isolating and caring for the people confirmed
to have the infection, and positive case contact tracing and quarantining.
It is vital to keep members of the public informed with regular, transparent briefings on the sciencebehind government measures to control the pandemic. This will help people to take appropriate
measures to control the spread of COVID-19 as well as increase trust and reduce potential stressand anxiety.
Nurses are at the frontline of any outbreak response. Their experience and views must be consideredin the planning, organisation and provision of responses to public health emergencies. Governments
must also actively engage nurses and fully mobilise the expertise of nurses in the development ofhealth policies, public health measures and strategies.

12

Learn from the COVID-19 pandemic to be prepared for thefuture

The health, social and economic impact of COVID-19 is unprecedented. We must use lessons
learned from this pandemic to strengthen the global pandemic preparedness and response system
for future outbreaks. Strengthening health systems, particularly in countries with the most fragile
health systems, should be prioritised. This should include the ability to rapidly mobilise healthcare
workers, while ensuring their safety and wellbeing. This response should be a coordinated one
between global stakeholders and the public, bringing together healthcare, business, security andgovernment. This will require a long-term political commitment by leaders and sustained resources
to strengthen the health system and build the capacity and capability of the health workforce.

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