Healthcare Hygiene magazine September 2020 September 2020 | Page 6

from the editor COVID-19 Reveals the Danger of Chronic Nurse Understaffing Nursing may be one of the most trusted professions, but it continues to suffer chronic understaffing, brought to light once more by the COVID-19 pandemic. A new study documents staffing ratios that varied from 3 to 10 patients for each nurse on general adult medical and surgical units – with ICU nurse staffing faring only slightly better. The study points out that New York City, the early epicenter of the COVID-19 surge in the U.S., had the poorest average hospital nurse staffing on the eve of this public health emergency. Researchers at the University of Pennsylvania found that the workload had adverse consequences on nurses and on patient care, with serious repercussions for the future. “Half of nurses right before the COVID-19 emergency scored in the high burnout range due to high workloads, and 1 in 5 nurses said they planned to leave their jobs within a year,” says lead author Karen Lasater, PhD, RN, an assistant professor and researcher at the Center for Health Outcomes and Policy Research (CHOPR) at the University of Pennsylvania School of Nursing. “It is an immense credit to nurses that in such an exhausted and depleted state before the pandemic they were able to reach deep within themselves to stay at the hospital bedside very long hours and save lives during the emergency.” Researcher and CHOPR director Linda Aiken, PhD, RN, notes that half of nurses in the study gave their hospitals unfavorable grades on patient safety, and two-thirds would not recommend their hospital to family and friends. The researchers surveyed all RNs holding active licenses to practice in New York and Illinois from Dec. 16, 2019 to Feb. 24, 2020. Hospital nurses reported on the number of patients assigned to them to care for at one time. These nurse reports were linked to Medicare patient-reported outcomes for the same hospitals. They studied 254 hospitals throughout New York and Illinois. Notably, these two states have pending legislation requiring hospitals to meet minimum safe nurse staffing standards – no more than four patients per nurse on adult general medical and surgical units. The study found that most hospitals in both states currently do not meet these proposed standards, nor do they even meet the safe nurse staffing standard of five patients per nurse set by legislation in California 20 years ago. The study found that each additional patient per nurse significantly increased the proportion of both patients and nurses giving unfavorable hospital quality and safety ratings, after differences in hospital characteristics such as teaching status, size and technology availability were taken into account. Half of the nurses were burned out, 31 percent were dissatisfied with their jobs, and 22 percent intended to leave their jobs within a year. Half of the nurses also gave their hospitals an unfavorable grade on patient safety, one-third gave unfavorable ratings on prevention of infections, and 70 percent would not definitely recommend the hospital where they worked to a family member or friend. A majority of nurses reported that delays in care were common because of insufficient staff, and many reported frequent delays in care due to missing supplies including medications and missing or broken equipment. Nurses are the backbone of healthcare delivery. Like our lackluster readiness for the pandemic, our inability to support these frontline warriors is shameful. Let’s hope that in hindsight, as the pandemic continues to be dissected and analyzed for gaps in response, the hero status of nurses becomes more than just lip service. Until next month, bust those bugs! Kelly M. Pyrek Editor & Publisher [email protected] healthcarehygienemagazine Kelly M. Pyrek editor & publisher [email protected] A.G. Hettinger, CPA president & CFO Patti Valdez art director Linda Lybert business development consultant J. Christine Phillips customer service manager Send inquiries to: [email protected] Healthcare Hygiene magazine is published monthly by Keystone Media Inc. 8925 Ridgeline Boulevard, suite 106, Highlands Ranch, CO 80129. Free digital subscriptions available at www.healthcarehygienemagazine.com for U.S., Canada and other foreign subscribers. Copyright © 2019 Keystone Media Inc. All rights reserved. The publisher reserves the right to accept or reject any advertising or editorial material. Advertisers, and/or their agents, assume the responsibility for all content of published advertisements and assume responsibility for any claims against the publisher based on the advertisement. Editorial contributors assume responsibility for their published works and assume responsibility for any claims against the publisher based on the published work. All items submitted to Healthcare Hygiene magazine become the sole property of Keystone Media Inc. Editorial content may not necessarily reflect the views of the publisher. No part of this publication may be reproduced in any form or by any electronic or mechanical means, including information storage and retrieval systems, without permission in writing from the publisher. Reference: Lasater KB, Aiken LH, et al. Chronic Hospital Nurse Understaffing Meets COVID-19: An Observational Study. BMJ Q&S. 2020. DOI: 10.1136/bmjqs-2020-011512 6 september 2020 • www.healthcarehygienemagazine.com