Using Serenity Rooms and Similar Tools to Improve the Workplace during COVID-19: A Rapid Review

Round 1

Reviewer 1 Report

Comments and Suggestions for Authors

Thank you for giving me the opportunity to review this manuscript. The paper is well-written and has no issues. I only have one comment:

in the objectives section "including from January 2020 to the present"

please revise this line and specify the date of the search date. 

Author Response

Thank you for the review of our manuscript, and your comments below. I have addressed any areas below the comment specifically after the >>> provided to show the areas of my response. We appreciate your expertise and interest in reviewing our work.

Thank you for giving me the opportunity to review this manuscript. The paper is well-written and has no issues. I only have one comment:

in the objectives section "including from January 2020 to the present"

please revise this line and specify the date of the search date. 

>>>This line was initially revised to state “…including from January 202 to September 2023.” However, the line has been entirely deleted based on other reviewer comments after “...COVID-19 pandemic.”

Reviewer 2 Report

Comments and Suggestions for Authors

Thank you for the opportunity to review this manuscript. Very interesting and well thought through. The following are my comments:

Line 29 and 30 please support these statements with references

Line 43 please define moral distress at the onset.

Good luck

Author Response

Thank you for the review of our manuscript, and your comments below. I have addressed any areas below the comment specifically after the >>> provided to show the areas of my response. We appreciate your expertise and interest in reviewing our work.

Thank you for the opportunity to review this manuscript. Very interesting and well thought through. The following are my comments:

Line 29 and 30 please support these statements with references

>>>The line beginning at 29, “The advent of COVID-19 compounded the effects of these stressors,” is a transition sentence not requiring citations. The next two sentences (lines 29-33) are supported with citations already.

Line 43 please define moral distress at the onset.

>>>This has been defined in parenthesis after the term moral distress (situations in which individuals professional ethics are situationally constrained)

Good luck

Reviewer 3 Report

Comments and Suggestions for Authors

Thank you for the opportunity to review the article titled - The use of serenity rooms and similar tools to improve the workplace during COVID-19: A rapid review.   It is a well-written article addressing a very important issue.

Even though the study was conducted in the context of COVID-19, it is still pertinent today because it examines the well-being of a group of professionals who operate in extremely demanding environments, like hospitals.  Barrier themes and facilitator themes were extracted and presented in an appropriate manner.  The importance of having compassionate leaders who care about the welfare of their staff is emphasized in the study. Therefore, the discussion and conclusion can be centred around the attitude and value priority of the leaders rather than explaining the various strategies they adopt to ensure the well-being of their staff.
Thank you for this very important piece of work. 

Author Response

Thank you for the review of our manuscript, and your comments below. I have addressed any areas below the comment specifically after the >>> provided to show the areas of my response. We appreciate your expertise and interest in reviewing our work.

Thank you for the opportunity to review the article titled – The use of serenity rooms and similar tools to improve the workplace during COVID-19: A rapid review.   It is a well-written article addressing a very important issue.

Even though the study was conducted in the context of COVID-19, it is still pertinent today because it examines the well-being of a group of professionals who operate in extremely demanding environments, like hospitals.  Barrier themes and facilitator themes were extracted and presented in an appropriate manner.  The importance of having compassionate leaders who care about the welfare of their staff is emphasized in the study. Therefore, the discussion and conclusion can be centred around the attitude and value priority of the leaders rather than explaining the various strategies they adopt to ensure the well-being of their staff.
Thank you for this very important piece of work. 

>>>NO comments to address here.

Reviewer 4 Report

Comments and Suggestions for Authors

Dear authors

I think it is a good study that can be useful in clinical departments. I present some comments that I hope will be of interest to you:

- The title should be written more concisely and attractively.

-Keywords are better to be selected from mesh.

- In the introduction, the existing chat and the necessity of conducting the study should be explained.

-In the method section, the exact date of the study should be mentioned (not yet). Also, please explain the reason why the Scopus database was not used?

- In the findings section, table number one is not well designed, it should be more concise and understandable.

- The clinical applications of the study should be explained in the discussion and conclusion section.

- The number of references does not seem sufficient for a review study. The number of references should be increased. I recommend that you also use the following article in the references section:

DOI: 10.2174/1874944502114010519

Comments on the Quality of English Language

It needs some minor edits.

Author Response

Thank you for the review of our manuscript, and your comments below. I have addressed any areas below the comment specifically after the >>> provided to show the areas of my response. We appreciate your expertise and interest in reviewing our work.

Dear authors

I think it is a good study that can be useful in clinical departments. I present some comments that I hope will be of interest to you:

- The title should be written more concisely and attractively.

>>>The title has been changed to “Using serenity rooms and similar tools to improve the workplace during COVID-19: A rapid review”

-Keywords are better to be selected from mesh.

>>>Agreed, however there are no MESH terms which are available for our study parameters. We did change the keywords to the following, as we were able to more clearly define nurse to nurses and burnout, per MESH terms.

Keywords: serenity room; tranquility room; nurses; burnout, professional; burnout, psychological; retention; stress relief; well-being

- In the introduction, the existing chat

>>>We are uncertain what you mean by the “existing chat” and are unable to address this comment

and the necessity of conducting the study should be explained.

>>>We believe that the necessity of conducting the study was fully explained in the introduction. The bulk of the rationale discusses the reasons behind the study.

-In the method section, the exact date of the study should be mentioned (not yet).

>>>The timeframe for the study was mentioned in Section 1.2 Objectives. We clarified the states of the articles published from 1 January 2020 and September 2023. Further dates were discussed stating that the analysis was completed in September 2023 in 2.2 Inclusion Criteria.

 Also, please explain the reason why the Scopus database was not used?

>>>We chose not to use Scopus. Pubmed, CINAHL, Academic Search Complete, and Science Direct were used in our search parameters. Anything in Scopus should have been found in any of these four search engines already.

- In the findings section, table number one is not well designed, it should be more concise and understandable.

>>>Table One is designed per protocols mentioned in 2.1 Overview. This particular way of making the table was specifically chosen to allow readers to download and plug the table into Excel and use the information in a pivot table for quick access and utilization. This is the same table design we have used with many different published systematic reviews and meta-analyses published by the authors of this manuscript, including MDPI journals.

- The clinical applications of the study should be explained in the discussion and conclusion section.

>>>This paper does not focus on clinical applications. This paper focuses on employees and staff. Adding a section for clinical applications is not applicable.

- The number of references does not seem sufficient for a review study. The number of references should be increased.

>>>We agree that the number of references is problematic. This is why a rapid review was utilized instead of a full systematic review. There is simply too little information on the topic, showing the need for further research. Unfortunately, we cannot add papers that do not exist.

I recommend that you also use the following article in the references section:

DOI: 10.2174/1874944502114010519

>>>We respectfully decline the addition of this article. The article is titled “Adherence to Personal Protective Equipment Against Infectious Diseases Among Healthcare Workers in Arak-Iran” and is entirely irrelevant to our topic. Our work is not focused on personal protective equipment at all.

Reviewer 5 Report

Comments and Suggestions for Authors

The use of serenity rooms and similar tools to improve the workplace during COVID-19: A rapid review 

This is an excellent paper, well written and interesting, and will be a great addition to the journal. Below I have made some minor comments and suggestions that I believe will improve the manuscript. 

1. I think it would be good to have an additional table (or expand Table 2) to include more characteristics of the studies including the population, concept, and context mentioned in section 1.3. As a reader I would also be interested to know (if available), the country of origin of the study (US, UK, Canada…), the size of the facility (how many beds? residents?), size of the study population, and study design. I would make this Table 1, and make the current Table 1 as Table 2. 

2. Table 1. I like the contents of the table; however, there’s a lot of empty space and I think the layout can be improved to reduce its size and therefore, readability. (1) Combine the author and year into one column. (2) Combine the facilitators and themes into 1 column, with the theme in bold or in parenthesis before or after each Facilitator. (3) Combine the Barriers and Theme columns in the same way. (4) You could even stack the Facilitators and Barriers under the same column, which will save a lot of space.

Something like this:

3. Line 40: Please write “RN” in full as “registered nurse” at first mention in the text.

4. Lines 65-66: The use of “identify” and “identifying” in this one sentence makes it rather awkward sounding to the reader. 

5. Line 67: For clarity, please add “of serenity rooms” after “utilization” in this sentence.

6. Line 68: “including from” sounds a bit strange. How about just having “…during the OVID-19 pandemic (January 2020 to present).” 

7. Line 68: “This manuscript hopes to…” A manuscript cannot hope, the authors can. How about something like: “It is hoped that this study will provide…”

8. Line 109: Having “limited” and “limiting” in this sentence sounds a bit strange to the reader. 

9. Lines 112-114: I don’t think you need the sentence beginning “However the lack of germane…” You address this fully in lines 129 to 135.

10. Lines 144-146: This part of the sentence is a bit confusing: “due to the lack of available knowledge in the sphere.” I think you could delete this whole sentence or clarify what you mean for the reader.

11. Line 179: “APRNs (advanced practice registered nurses) …” Please put the abbreviation in parentheses:“Advanced practice registered nurses (APRNs)…”

12. Line 261: “Three additional facilitator themes…” Should this be “barrier themes”?

13. Line 273: Remove “these” from before serenity rooms.

Comments on the Quality of English Language

I detected a few issues, all of which I have mentioned in my comments above. An excellently written paper!

Author Response

Thank you for the review of our manuscript, and your comments below. I have addressed any areas below the comment specifically after the >>> provided to show the areas of my response. We appreciate your expertise and interest in reviewing our work.

This is an excellent paper, well written and interesting, and will be a great addition to the journal. Below I have made some minor comments and suggestions that I believe will improve the manuscript. 

1. I think it would be good to have an additional table (or expand Table 2) to include more characteristics of the studies including the population, concept, and context mentioned in section 1.3. As a reader I would also be interested to know (if available), the country of origin of the study (US, UK, Canada…), the size of the facility (how many beds? residents?), size of the study population, and study design. I would make this Table 1, and make the current Table 1 as Table 2.

>>>Thank you for your comments. This paper is a rapid review, not a systematic review, where this information would potentially be included. The information provided in this paper is focused specifically on interventions, facilitators, and barriers. Whereas adding some of this information suggested here might provide a matter of interest to some readers, it would not clarify our findings or add to them. Further, reasons why some of this information was not included was discussed in the paper. We respectfully disagree with the addition of the table. 

2. Table 1. I like the contents of the table; however, there’s a lot of empty space and I think the layout can be improved to reduce its size and therefore, readability. (1) Combine the author and year into one column. (2) Combine the facilitators and themes into 1 column, with the theme in bold or in parenthesis before or after each Facilitator. (3) Combine the Barriers and Theme columns in the same way. (4) You could even stack the Facilitators and Barriers under the same column, which will save a lot of space.

Something like this:

>>>Thank you for your comments. Table One is designed per protocols mentioned in 2.1 Overview. This particular way of making the table was specifically chosen to allow readers to download and plug the table into Excel and use the information in a pivot table for quick access and analysis. This is the same table design we have used with many different published systematic reviews and meta-analyses published by the authors of this manuscript, including MDPI journals. Changing the table to the format you suggest here would not allow for quick utilization by readers, as they would have to extract all the information that you suggest we condense. As such, we respectfully decline your suggestion.

2. Line 40: Please write “RN” in full as “registered nurse” at first mention in the text.

>>>Correction made.

3. Lines 65-66: The use of “identify” and “identifying” in this one sentence makes it rather awkward sounding to the reader. 

>>>The first instance of identify was changed to recognize.

4. Line 67: For clarity, please add “of serenity rooms” after “utilization” in this sentence.

>>>The addition of “…of serenity rooms and similar tools” was placed in the sentence for clarification purposes.

5. Line 68: “including from” sounds a bit strange. How about just having “…during the OVID-19 pandemic (January 2020 to present).” 

>>>Another reviewer made a comment in this particular area. We chose to delete all words after COVID-19 pandemic in the sentence.

6. Line 68: “This manuscript hopes to…” A manuscript cannot hope, the authors can. How about something like: “It is hoped that this study will provide…”

>>>Line was changed to “It is hoped that this study will provide…”

7. Line 109: Having “limited” and “limiting” in this sentence sounds a bit strange to the reader. 

>>>The first limited was changed to “germane”

8. Lines 112-114: I don’t think you need the sentence beginning “However the lack of germane…” You address this fully in lines 129 to 135.

>>>The sentence was deleted.

9. Lines 144-146: This part of the sentence is a bit confusing: “due to the lack of available knowledge in the sphere.” I think you could delete this whole sentence or clarify what you mean for the reader.

>>>Sentence clarified.

10. Line 179: “APRNs (advanced practice registered nurses) …” Please put the abbreviation in parentheses:“Advanced practice registered nurses (APRNs)…”

>>>Correction made.

11. Line 261: “Three additional facilitator themes…” Should this be “barrier themes”?

>>>An excellent catch! Thank you!

12. Line 273: Remove “these” from before serenity rooms.

>>>Deleted.

Round 2

Reviewer 2 Report

Comments and Suggestions for Authors

Accept revised manuscript 

Author Response

Accept revised manuscript 

>>>Thank you for your second review of our manuscript.

Reviewer 4 Report

Comments and Suggestions for Authors

Dear authors

Thank you for the edits you have made. However, I don't think all the comments are fully addressed. Therefore, I cannot approve this manuscript for publication.

With respect

Author Response

Thank you for the edits you have made. However, I don't think all the comments are fully addressed. Therefore, I cannot approve this manuscript for publication.

With respect

>>>Respectfully, we have addressed each area of concern which this reviewer provided. We see no areas of concern from the first review that were not adequately addressed in the corrections or our comments to the reviewer. Should there be some specific comments that the reviewer would like addressed here, we would be happy to consider them.

Reviewer 5 Report

Comments and Suggestions for Authors

The authors have responded well to my comments and suggestions. The manuscript is really interesting. Congratulations. 

Author Response

The authors have responded well to my comments and suggestions. The manuscript is really interesting. Congratulations. 

>>>Thank you for your thoughts and well wishes.