As hospitals and health systems struggle with staffing shortages, industry experts warn that these shortages may be threatening patient safety and care.
Hard truths on the current and future state of the nursing workforce
Hospital staffing shortages hamper patient safety
Staffing shortages have strained both the health care workforce and hospitals' resources, and many experts warn that they may negatively impact patient safety and quality of care. In fact, ECRI last month chose staffing shortages as the top patient safety concern for 2022.
"Adverse events that we found were happening because the staff they did have were exhausted, and that contributes to contributes to human error" said Sheila Rossi, director of ECRI's Institute for Safe Medication Practices. "You can't think clearly you have too many tasks to do, and that's a common theme that we were seeing."
During the pandemic, many hospitals have also grown increasingly reliant on travel nurses, who often have a steep learning curve when they join new organizations. Because of increased workloads due to Covid-19 surges and delayed treatments, many travel nurses have been thrown immediately into bedside care instead of going through weeks-long training courses first.
According to Kert Anzilotti, CMO at Christiana Care, when nurses are unaware or unsure of all the individual steps an organization takes to prevent different infections, adverse outcomes may increase. "The traveling nurses and the people that we've redeployed have done an outstanding job for us, but it was tough learning a new environment and quite honestly doing it while you were scared and worried about your own health and the health of your family," he said.
In addition, a recent study published in the American Journal of Infection Control found a correlation between increased infection rates and the use of travel nurses and overtime hours during the pandemic. For the study, researchers from Northwestern Medicine charted hospital-acquired infections (HAIs) at two Illinois hospitals with a combined 1,000 beds over a three-year period ending December 2020. For every 1% in premium pay hours towards travel nurses or overtime, there were 0.13 more HAIs after adjusting for both state- and county-level Covid-19 cases and deaths.
"The increase in [HAI] rates has been a real wake-up call across the United States and internationally," said Linda Dickey, the 2022 president of the Association for Professionals in Infection Control and Epidemiology.
How to improve patient safety
To help improve patient safety, Angela Zuick, director of clinical services at Medline, recommends hospital leaders provide clear instructions for specific procedures that all nurses can access. This can be through short how-to videos that nurses can watch on their phones or signs next to medical supplies.
"We need to be more proactive and think about what our needs will be when we have to use travelers, and put together some solutions, almost like a first aid kit," Zuick said. "This just-in-time education is something we should continue to focus on to prepare ourselves to provide success for our travelers or outside staff."
In addition, Dickey recommended hospitals prioritize their day-to-day infection control practices again. "It doesn't have to be a miracle to turn the ship," she said. "It's amazing how much those nudges add up." (Gillespie, Modern Healthcare, 4/1; Reed, Axios, 3/28)