Becker's Hospital Review

11 INFECTION CONTROL & PATIENT SAFETY Mount Sinai's ED is a 'war zone,' nurse says By Mackenzie Bean C urrent and former Mount Sinai Hospital employees said staffing shortages and high patient volumes are creating serious patient safety issues in its emergency department, which one nurse called "a war zone," reported the New York Post. Six things to know: 1. In April 2016, outside medical consultants said the conditions at Mount Sinai's ED were "among the worst we have ever seen," according to an internal report obtained by the New York Post. ey urged New York City-based Mount Sinai to revamp the department, citing concerns with staffing ratios, infection control and patient safety. 2. e New York Post spoke with several former physicians and nurses at the ED, who said high patient volumes and care lapses are still issues. A former nurse who quit in September 2019 claims she was typically assigned nine patients on a normal shi, although this figure could be as high as 18. Other staff members described instances in which patients experienced a heart attack without clinicians noticing or were not admitted to critical care units due to a lack of space. "Every day I go to work, I feel like I am going to a war zone," one nurse, who wished to remain anonymous, told the New York Post. 3. A spokesperson for Mount Sinai disputed claims that nurses have ever had as many as 18 patients on a shi, saying the hospital aims for staffing ratios of 6:1 or 8:1. e spokesperson said leaders have been receptive to past concerns staff members raised about workloads. In response, the hospital added 20 nurses in 2019, along with a second nurse manager and four assistant nurse managers. 4. Employees told the New York Post they believe the issues stem from Mount Sinai's switch to "split flow" ED operations in 2016. e process seeks to expedite care and lower wait times, but employees say the system creates a dangerous overload of patients due to staffing and bed shortages. 5. In a direct statement to Becker's, Mount Sinai said the New York Post's report "in no way reflects the current status of our emergency department," adding that patients admitted through Mount Sinai's ED with heart attacks, heart failure, severe lung conditions and stroke have among the best survival rates in the nation. e hospital has made major investments in its ED since completing a strategic review in 2016, including the addition of more than 130 employees. "We have also opened the Mount Sinai Express Care facility on the same block to alleviate emergency department crowding by taking care of patients with less serious conditions in a separate location," the hospital said. "Now, we have plans for a complete renovation of both our emergency department and our observation unit to more than double the number of treatment locations and further improve patient care." 6. On Dec. 9, 2019, Democratic New York Gov. Andrew Cuomo ordered state health officials to investigate the allegations against Mount Sinai aer learning of the New York Post's exposé, according to a separate report from the publication. n Asymptomatic C. diff carriers pose infection risk in hospitals By Mackenzie Bean C lostridium difficile infections may originate outside of hospital settings more often than previously thought, according to a study published in Infection Control & Hospital Epidemiology. For the study, researchers at New York City-based Monte- fiore Medical Center tested 220 patients with no symptoms of a C. difficile infection who were admitted between July 2017 and March 2018. Researchers also followed up with patients after six months. They identified 9.6 percent of patients as C. difficile carriers upon admission. After six months, 38 percent of carriers developed symptomatic C. difficile infections. In contrast, only 2 percent of noncarriers developed infections. The results contradict the notion that patients usually contract the bacteria during a hospital stay, researchers said. Identify- ing C. difficile carriers upon admission could be a useful new infection prevention strategy for hospitals, they added. n New Jersey hospital performs kidney transplant on wrong patient By Mackenzie Bean C amden, N.J.-based Virtua Our Lady of Lourdes Hospital performed a kidney transplant on the wrong patient Nov. 18, 2019, hospital officials confirmed to CBS 3 Philly. The mix-up involved two patients who have the same name and are close in age. The 51-year-old patient who received the kidney was also on the transplant list, although ranked lower in priority. A staff member recognized the mistake a day after the surgery. Marlton, N.J.-based Virtua Health, which acquired Lourdes Health System last summer, voluntarily reported the error to New Jersey health officials. "This is an unprecedented event in our respected 40-plus- year transplant program," Reginald Blaber, MD, executive vice president and chief clinical officer of Virtua Health, said in a statement to CBS 3 Philly. "As an organization committed to safety and process, we immediately institut- ed additional measures and educational reinforcement to help ensure this does not happen again." The higher-priority patient underwent a kidney transplant Nov. 24. Both patients' transplant surgeries were successful. n

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