patient safety Archives - Page 2 of 17

ER Nurse Who Called 911 for Backup: ‘What Are We Afraid Of?’

Making the call.

As I got home this morning after a hectic 12-hour shift as charge RN in a 50-bed ER, I sat in my silent car for a moment to ponder how much has changed in the last three weeks.

Three weeks ago, overwhelmed by walk-in patients and ambulance traffic and severely short-staffed, I called the emergency services non-emergent line and asked for help in our crowded lobby. I wasn’t thinking about the repercussions, about the uproar or the giant target I sometimes feel I’ve installed on my back with my outspokenness. I was thinking about my coworkers, spread too thin, exhausted and afraid for their licenses, and the patients that I knew had been sitting in the lobby for hours, sick and in pain and mostly unmonitored. I had no idea of the attention that call would receive.

Did speaking out change anything?

Someone recently asked, “What changes have you seen in the month since you made that call?”

For myself, I’ve been learning to navigate in a more public arena, to […]

Guest Author2022-12-01T09:51:43-05:00December 1st, 2022|Ethics, Nursing, nursing perspective, patient safety, safe staffing|5 Comments

Staffing Tops ECRI 2022 Top 10 Patient Safety Concerns List for First Time

Staffing: the problem has ‘grown exponentially.’

Each year, ECRI Institute creates a list of top 10 patient safety concerns in order “to support organizations in their efforts to proactively identify and respond to threats to patient safety.” Over the years, some repeat offenders have made the cut, for example managing behavioral health, patient falls, and issues related to infection control.

Some of these concerns again appear on the 2022 top 10 patient safety concerns list, but the list also has some notable first-time offenders—a fact that reflects the conditions in which we’ve been living over the past two years during this global pandemic: These include COVID-19’s effect on clinicians’ mental health, vaccine coverage gaps, and supply chain disruptions, to name a few.

However, the number one concern this year is one that has been a central and unrelenting issue for nurses, even before the pandemic—staffing shortages.

According to the ECRI:

“The number one topic on this year’s list has been steadily growing throughout the COVID-19 pandemic and impacts patients and staff on all levels: staffing shortages…Prior to 2021, there was a growing shortage of both clinical and non-clinical staff, but the problem has grown exponentially. In early January 2022, it was estimated that 24% of US hospitals were critically […]

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Amy M. Collins, managing editor2022-03-24T10:04:38-04:00March 24th, 2022|Nursing|0 Comments

A Proposal to Ensure Patients Don’t Fall Through the Cracks

As a retired RN who was certified in medical-surgical nursing, I remember the goals of the hourly rounding policy. Our patients were reassured to find out that staff would check on them every hour at a minimum for any needs they might have, and families could rest easy knowing their loved ones would not be ignored. Hourly rounding also helped prevent a patient from falling through the cracks on a busy shift—always my biggest fear, and one that would keep me up at night.

Obstacles to hourly rounding in acute care.

I also remember the challenges to this policy. Because in hospitals we are dealing with humans and not machines, unlike in factories, there are countless variables to sabotage our best efforts. Everyone has heard the line from the Robert Burns poem, “The best-laid plans of mice and men often go awry.”

The patient variables are unique to each primary nurse and her patient care technician (PCT) who have a plan to alternate rounding on those in their care: the patient who codes, the hemorrhaging post-op patient, the incontinent patient, and the cancer patient with intractable pain. The list is endless—situations that keep the primary nurse or PCT tied up in a room during their turn to do hourly rounds.

Some hospitals may have instituted tracking systems […]

Guest Author2021-07-15T10:28:41-04:00July 15th, 2021|Nursing|0 Comments

No Country for Old People

In my editorial in the March issue, I ask, “Where do we go from here?’” in thinking about what’s next for nursing. In particular, I wonder if we’re going to make any strides in improving the quality of how we care for older adults who need long-term care.

Disasters give rise to assessments of what went wrong.

After prior disasters like hurricanes, heat waves, and flooding, there has often been a flurry of initial concern, with many committees convened to look at the deaths that occurred.

More recently, the New York Times has reported on the fate of nursing home residents during the Covid-19 pandemic in relation to the deterioration of quality in nursing homes once they are owned by for-profit entities—as 70% of nursing homes now are. So here we are once again, this time decrying the conditions revealed by Covid-19. Will things change this time?

In answer to this question, I’m especially pleased with the article in our March issue by 22 nurse gerontology experts. They issue a call (a challenge?) for the Centers for Medicare and Medicaid Services (CMS) Coronavirus Commission for Safety and Quality in Nursing Homes to rewrite standards to finally address under-resourcing and ensure residents get the care they […]

Shawn Kennedy, MA, RN, FAAN, editor-in-chief (emerita)2021-03-15T15:33:48-04:00March 15th, 2021|COVID-19, nursing roles, patient safety, Patients|1 Comment

Building Back Better: Constructive Nursing Regulation

As governor of the first COVID-19 epicenter in the country, Andrew Cuomo challenged New Yorkers to think about how the state could “build back better” after the crisis. As registered nurses with experience in health law and policy, we have recommendations for transforming the boards of nursing. The manner in which nurses are regulated must be reformed, not just in New York, but throughout the country. It must begin by understanding the dangerous environments in which nurses are working.

Staffing, safety issues affect both nurses and patients.

In May, for example, Governor Cuomo reported that 12.2% of health care workers in New York city had been diagnosed with COVID-19. Nationwide, more than 164 nurses have died, often because they lacked adequate personal protective equipment. But COVID-19 is not the only dangerous situation. Long-term and psychiatric care facilities, as well as hospitals, are often dangerously understaffed, exposing nurses to violence. Nurses and other workers have been attacked and sometimes killed because they lack necessary resources and protections. Workplace violence is a growing threat which has not been adequately addressed by health care managers and administrators. Danger to patients occurs when nurses are expected to accept assignments outside of their areas of expertise. Nurses cannot care for more […]

Guest Author2020-07-27T07:08:18-04:00July 27th, 2020|Nursing, nursing career, nursing perspective, patient safety|2 Comments