Medical errors are common in healthcare -- too common. Such errors can result in patient harm, and unfortunately, the picture hasn't improved much over the past decade-plus, according to a new study published in Health Affairs.
Nurses in particular aren't impressed. Over 80 percent of nurses rated the clinical work environments in their hospitals as less than excellent. Close to 30 percent of nurses gave their hospital an unfavorable grade on infection prevention, and more than 30 percent scored in the high burnout range on standardized tests.
Despite substantial investment by government and private institutions to increase patient safety, progress has been slow and uneven. Researchers investigated whether hospitals have implemented a key National Academy of Medicine recommendation -- to improve nurse work environments and assure adequate nurse staffing -- and whether these changes corresponded to improved patient safety, as reported by patients and nurses.
Between 2005 and 2016, only 21 percent of hospitals substantially improved their clinical work environments; 71 percent made no improvements and 7 percent experienced deteriorating work environments.
Hospitals that improved their work environments saw their patient safety indicators improve as well, with favorable nurse and patient appraisals of patient safety increasing by 11-15 percent.
Grades on patient safety remained the same for hospitals in which work environments remained the same, and favorable grades on patient safety fell by 19 percent in hospitals with worsening care environments.
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Hospitals in which the work environment worsened exhibited a 25 percent decrease in the percentage of nurses saying that patient safety is a top priority of management.
Patients also expressed concern about quality and safety, with 30 percent reporting that they would definitely not recommend their hospital. Nearly 40 percent of patients said that they did not always receive help quickly from hospital staff, and nearly 40 percent reported that medications were not always explained before given.
Physicians and nurses have been struggling with burnout for a while now, driven largely by worsening shortages in both fields. But multiple factors can contribute to burnout -- stagnant or declining clinical quality, certainly, but also overwork, emotional exhaustion, and burdensome electronic medical record and documentation requirements.
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