Missed or incomplete nursing care can adversely affect care quality and safety. Based on survey responses from 295 frontline nurses in the Philippines, this study explored factors contributing to missed nursing care during the COVID-19 pandemic. Findings suggest that nurses most frequently missed tasks such as patient surveillance, comforting patients, skin care, ambulation, and oral hygiene. The authors suggest that increasing nurse staffing, adequate use of personal protective equipment, and improved safety culture may reduce instances of missed care.
Murata M, Nakagawa N, Kawasaki T, et al. Am J Emerg Med. 2022;52:13-19.
Transporting critically ill patients within a hospital (e.g., to radiology for diagnostic procedures) is necessary but also poses safety threats. The authors conducted a systematic review and meta-analysis of all types of adverse events, critical or life-threatening adverse events, and death occurring during intra-hospital transport. Results indicate that adverse events can occur in intra-hospital transport, and that frequency of critical adverse events and death are low.
Pilosof NP, Barrett M, Oborn E, et al. Int J Environ Res Public Health. 2021;18:8391.
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.
Amit Aharon A, Fariba M, Shoshana F, et al. J Clin Nurs. 2021;30:3290-3300.
Patient suicide attempts or completions can have negative psychological impacts on the nurses involved. This mixed-methods study found a significant association between emotional distress and feeling alone with absenteeism and higher staff turnover. Healthcare organizations should develop support programs for second victims to increase resiliency and potentially decrease absenteeism and turnover.
Kakemam E, Chegini Z, Rouhi A, et al. J Nurs Manag. 2021;29:1974-1982.
Clinician burnout, characterized by emotional exhaustion, depersonalization, and decreased sense of accomplishment, can result in worse patient safety outcomes. This study explores the association of nurse burnout and self-reported occurrence of adverse events during COVID-19. Results indicate higher levels of nurse burnout were correlated with increased perception of adverse events, such as patient and family verbal abuse, medication errors, and patient and family complaints. Recommendations for decreasing burnout include access to psychosocial support and human factors approaches.
Kim J-sung, Bae H-J, Sohn CH, et al. Crit Care. 2020;24:305.
Overcrowding in the emergency department (ED) can adversely impact patient safety. This study conducted at a single ED found that maximum ED occupancy rates were positively correlated with in-hospital cardiac arrest over a 3.5-year period, but occupancy rates were not correlated with ED mortality.
Wee LE, Fua T‐P, Chua YY, et al. Acad Emerg Med. 2020;27:379-387.
This article describes the use of a broad suspect case criteria for detecting COVID-19 in the emergency department of one large, hospital in Singapore. Both the initial official case criteria and the broadened case definition, which included patients presenting with acute respiratory disease with no alternative etiology and a history of travel or residence in a country with ongoing local transmission were used with the broadened criteria having higher sensitivity. The broader criterion may increase the numbers of suspected positive cases but can help minimize nosocomial ED transmission.
Tartari E, Saris K, Kenters N, et al. PLoS One. 2020;15.
Presenteeism among healthcare workers can lead to burnout and healthcare-associated infections, but prior research has found that significant numbers of healthcare workers continue to work despite having influenza-like illness. This study surveyed 249 healthcare workers and 284 non-healthcare workers from 49 countries about their behaviors when experiencing influenza-like illness between October 2018 and January 2019. Overall, 59% of workers would continue to work when experiencing influenza-like illness, and the majority of healthcare workers (89.2-99.2%) and non-healthcare workers (80-96.5%) would continue to work with mild symptoms, such as a mild cough, fatigue or sinus cold. Fewer non-healthcare workers (16.2%) than healthcare workers (26.9%) would continue working with fever alone.
This article describes the use of strong matrix management and the plan-do-check-act cycle in the management of severe COVID-19 patients in one hospital in China. These tools were used to ensure efficient task delegation in healthcare teams and quality care for COVID-19 patients.
Cai H, Tu B, Ma J, et al. Med Sci Monit. 2020;26:e924171.
Production pressure – the pressure to continue to work at maximum capacity – presents risks to patient safety. This study reported on a survey of 534 healthcare providers and hospital staff in the Hunan province of China about the psychological impact of COVID-19. Respondents cited moral and social responsibility as being the strongest driver to continue working long hours during the outbreak and expressed anxiety and concerns regarding their safety, the safety of their families, and high mortality among their patients. Recognition of healthcare staff by hospital management and government, strong infection control guidelines, and specialized equipment and facilities for the management of COVID‑19 were reported as factors that mitigated psychological burnout.
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