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Weiner-Lastinger LM, Pattabiraman V, Konnor RY, et al. Infect Control Hosp Epidemiol. 2021;Epub Sept 13.
Using data reported to the National Healthcare Safety Network, this study identified significant increases in the incidence of healthcare-associated infections from 2019 to 2020. The authors conclude that these findings suggest a need to return to conventional infection control and prevention practices and prepare for future pandemics.
Wang X, Wilson C, Holmes K. J Gerontol Soc Work. 2021:1-17.
Nursing home residents are especially vulnerable to COVID-19 due to their age and communal living conditions. Using publicly available data for nursing homes in Florida, this study explored the association between nursing home characteristics and COVID-19 cases and deaths. Findings suggest that the likelihood of COVID-19 cases in nursing homes is related to ownership status, facility size and average occupancy rate, rather than quality (as measured by infection prevention and control deficiencies).
Pilosof NP, Barrett M, Oborn E, et al. Int J Environ Res Public Health. 2021;18(16):8391.
The COVID-19 pandemic has led to dramatic changes in healthcare delivery. Based on semi-structured interviews and direct observations, researchers evaluated the impact of a new model of remote inpatient care using telemedicine technologies in response to the pandemic. Intensive care and internal medicine units were divided into contaminated and clean zones and an integrated control room with audio-visual technologies allowed for remote supervision, communication, and support. The authors conclude that this model can increase flexibility in staffing via remote consultations and allow staff to supervise and monitor more patients without compromising patient and staff safety.
Preston-Suni K, Celedon MA, Cordasco’s KM. Jt Comm J Qual Patient Saf. 2021;47(10):673-676.
Presenteeism among healthcare workers – continuing to work while sick – has been attributed to various cultural and system factors, such as fear of failing colleagues or patients. This commentary discusses the patient safety and ethical considerations of presenteeism during the COVID-19 pandemic

Ellis NT, Broaddus A. CNN. August 25, 2021. 

Maternal safety is an ongoing challenge worldwide. This news feature examines how the COVID pandemic has revealed disparities and implicit biases that impact the maternal care of black women. The stories shared highlight experiences of mothers with preventable pregnancy-related complications.
Pring ET, Malietzis G, Kendall SWH, et al. Int J Surg. 2021;91:105987.
This literature review summarizes approaches to crisis management used by non-healthcare institutions (e.g., private businesses, large military organizations) in response to the COVID-19 pandemic and how healthcare organizations – particularly the surgical community – can leverage these approaches in operational planning and crisis management.
Neprash HT, Sheridan B, Jena AB, et al. Health Aff (Millwood). 2021;40(8):1321-1327.
The COVID-19 pandemic led to an increase in the use of telehealth in order to limit patient exposure to the virus. Findings from this study highlight the value of telehealth visits for patients with suspected respiratory infections to prevent further transmission. Researchers found that patients exposed to influenza-like illness in primary care office settings were more likely than nonexposed patients to return with a similar illness within two weeks.
Taylor M, Reynolds C, Jones RM. Patient Safety. 2021;3(2):45-62.
Isolation for infection prevention and control – albeit necessary – may result in unintended consequences and adverse events. Drawing from data submitted to the Pennsylvania Patient Safety Reporting System (PA-PSRS), researchers explored safety events that impacted COVID-19-positive or rule-out status patients in insolation. The most common safety events included pressure injuries or other skin integrity events, falls, and medication-related events.
Dhahri AA, Refson J. BMJ Leader. 2021;Epub Aug 12.
Hierarchy and professional silos can disrupt collaboration. This commentary describes one hospital’s approach to shifting the surgical leadership role to facilitate communication and cross-organizational influence to affect quality and safety performance.
Fatemi Y, Coffin SE. Diagnosis (Berl). 2021;Epub Aug 5.
Using case studies, this commentary describes how availability bias, diagnostic momentum, and premature closure resulted in delayed diagnosis for three pediatric patients first diagnosed with COVID-19. The authors highlight cognitive and systems factors that influenced this diagnostic error.
Marziliano A, Burns E, Chauhan L, et al. J Gerontol A Biol Sci Med Sci. 2021;Epub Jul 19.
Many COVID-19 patients present with atypical symptoms, such as delirium, smell and taste dysfunction, or cardiovascular features. Based on inpatient electronic health record data between March 1 and April 20 of 2020, this cohort study examined the frequency of atypical presentation of COVID-19 among older adults. Analyses suggest that atypical presentation was often characterized by functional decline or altered mental status.
Geerts JM, Kinnair D, Taheri P, et al. JAMA Netw Open. 2021;4(7):e2120295.
The COVID-19 pandemic has disrupted many aspects of health care delivery and has placed unprecedented pressure on health care workers. This consensus statement, based on input from an international panel of individuals with expertise in health leadership, health care, and public health, outlines 10 imperatives to guide health and public leaders during the post emergency stage of the pandemic. Imperatives addressed in the framework include supporting staff well-being and psychological health, preparing for future emergencies, managing the backlog of delayed care, and the importance of sustaining learning, innovations and collaborations that arose during the pandemic.

Andel SA, Tedone AM, Shen W, et al. J Adv Nurs. Epub 2021 Jul 10.

During the first weeks of the COVID-19 pandemic, 120 nurses were surveyed about nurse-to-patient staffing ratios, skill mix, and near misses in their hospitals. Personnel understaffing led to increased use of workarounds, and expertise understaffing led to increased cognitive failures, both of which shaped near misses. Hospital leaders should recognize both forms of understaffing when making staffing decisions, particularly during times of crisis.

Fournier JP, Amélineau JB, Hild S, et al. Eur J Gen Pract. 2021;27(1):142-151.

The COVID-19 pandemic has raised new patient safety concerns. This study examined patient safety incidents in primary care settings in France during the early months of the COVID-19 pandemic. Of the 132 reported incidents, 44% related to delayed diagnosis, assessments and referrals. Reported incidents less commonly related to cancellation of care, home confinement-related incidents, and inappropriate medication discontinuation.
von Vogelsang A‐C, Göransson KE, Falk A‐C, et al. J Nurs Manag. 2021;Epub Jun 8.
Incomplete nursing care can be detrimental to care quality and patient safety. This cross-sectional survey of nurses in Sweden at one acute care hospital did not identify significant differences in missed nursing care before and during the COVID-19 pandemic. The authors posit that these results may be attributed to maintaining nurse-patient ratios, sufficient nursing skill mix, and patient mix.
Silvera GA, Wolf JA, Stanowski A, et al. Patient Exp J. 2021;8(1):30-39.
Research has found that families and caregivers play a key role in identifying and preventing patient safety events.  Based on a national sample of hospitals, this study explored the impact of hospital visitation restrictions during the COVID-19 pandemic on patient experience and safety outcomes. Results indicate that hospitals with closed visitations experienced larger performance deficits across measures of medical staff responsiveness, fall rates, and sepsis rates.

Washington, DC: Department of Veterans Affairs, Office of Inspector General. June 24, 2021. Report No. 19-09808-171.

This report examined veterans' health clinic use of telemental health to identify safety challenges inherent in this approach before the expansion of telemedine during the COVID-19 crisis. The authors note the complexities in managing emergent mental health situations in virtual consultations. Recommendations for improvement included emergency preparedness planning, specific reporting of telemental health incidents and organized access to experts.

Rockville, MD: Agency for Healthcare Research and Quality; June 2021.

The use of antibiotics should be monitored to reduce the potential for infection in care facilities. This toolkit outlines offers a methodology for launching or invigorating an antibiotic stewardship program. Designed to align with four time elements of antibiotic therapy, its supports processes that enable safety for nursing home residents.
Dickinson KL, Roberts JD, Banacos N, et al. Health Secur. 2021;19(S1):S14-S26.
The COVID-19 pandemic highlighted the continued existence of structural racism and its disproportionate impact on the health of communities of color. This study examines the experiences of non-White and White communities and the negative impact of structural racism on the non-White communities. The authors call for bold action emphasizing the need for structural changes.