Issue link: https://beckershealthcare.uberflip.com/i/1337263
16 PATIENT SAFETY 10 top patient safety issues for 2021 By Erica Carbajal, Gabrielle Masson and Mackenzie Bean T he Becker's Clinical Leadership & Infection Control editorial team chose the following 10 patient safety issues for health- care leaders to prioritize in 2021, presented below in no particular order, based on news, study findings and trends reported in the past year. COVID-19. First referred to as a "mysterious pneumonia" in December 2019, the SARS-CoV-2 virus quickly spread across the globe, posing unprecedented challenges for hospitals. e first known COVID-19 death in the U.S. was documented Feb. 6. Since then, more than 330,000 additional Americans have died from the virus, according to data from Baltimore-based Johns Hopkins University. In early 2020, scientists worldwide raced to understand the virus, learning more about symptoms, transmission and antibodies every day. While clinicians now have a better understanding of how to treat the virus and the nation is in the early stages of vaccination, hospitals continue to grapple with capacity issues and supply short- ages. Many health systems are also facing staffing shortages amid rising COVID-19 hospitalizations, making it increasingly difficult to provide quality care for all patients. Many routine care visits, elective procedures and routine childhood vaccinations have been delayed amid COVID-19 surges and shut- downs, leaving some patients without care for prolonged periods of time. Data has revealed continuing racial disparities linked to the virus, with a higher number of people of color exposed to, infected with and dying from COVID-19. e pandemic has also exacerbat- ed other health inequities, underscoring the role social determinants of health play in patient outcomes. While the pandemic's full effect on patient care is still unknown, it is certain that the American healthcare system will be profoundly changed. Healthcare staffing shortages. e COVID-19 pandemic has exacerbated healthcare staffing shortages nationwide, as the virus sidelines thousands of employees who either contracted the virus or were exposed and must isolate. In mid-November, more than 1,000 hospitals nationwide reported serious staffing shortages, according to HHS data obtained by e Atlantic. In some parts of the U.S., staffing shortages have been so dire, some health systems have asked exposed employees to continue working if they are asymptomatic. ese staffing shortages, combined with a surge in COVID-19 hospitalizations, has led to increased nurse-patient ratios at many facilities, spurring many conflicts between nursing unions and hos- pitals in 2020. A 2017 study published in the International Journal of Nursing Studies showed every extra patient on a nurse's caseload increased mortality rates by 7 percent. Another study published in the Annals of Intensive Care found intensive care unit patients exposed to a high workload-to-nurse ratio for one or more days had lower risk-adjusted odds of survival to hospital discharge compared to patients exposed to normal ratios. Missed and delayed diagnoses. Fear of contracting COVID-19 led to many people delaying both routine and emergency care in 2020. Across the oncology field, many people skipped out on screenings. Mammograms, for example, fell by 95 percent during the second week of April compared to the same period in 2019. Additionally, many oncologists have reported diagnosing higher proportions of advanced-stage disease compared to 2019. is leads to more difficult treatment plans and higher death risks. e pandemic has also had a profound effect on cardiac care, with a June study showing 50 percent of heart attack patients delayed care. Many patients have delayed seeking emergency care for health issues such as inflamed appendices, chest pain or bowel obstructions and oen show up past optimal treatment window times. is has led to increased risks for complications and in some cases, unneces- sary death. For instance, researchers believe a 20 percent jump in pediatric appendix rupture cases and increased mortality are linked to COVID-19-related fears. To combat this issue, many healthcare systems are emphasizing their COVID-19 safety measures and advancing their telehealth services. Drug and medical supply shortages. Hospitals and health systems experienced remarkable supply shortages in 2020, which pose safety risks for patients and healthcare workers. e U.S. relies heavily on international suppliers like China for personal protective equipment, and imports significantly declined during the pandemic. Across the U.S., healthcare facilities have struggled to obtain enough PPE for staff members treating COVID-19 patients. Many clinicians have been forced to reuse masks or bring in their own PPE to pro- tect themselves and patients. Amid this spring's COVID-19 surge, some nurses in New York recorded themselves working in plastic garbage bags because systems ran out of gowns. Scammers selling counterfeit PPE also created numerous obstacles for health systems attempting to protect employees and prevent transmission of the virus within their facilities. As of June, the U.S. was facing shortages of more than 200 gener- ic drugs and supplies due to international shutdowns linked to the pandemic. In November, the American Medical Association declared drug shortages an urgent public health crisis and updated its approach to mitigating the shortages. Many drugs in shortage are commonly required for routine patient care and ventilator support, threatening basic care quality and patient safety. Low vaccination coverage and disease resurgence. e pandemic has significantly disrupted routine vaccinations, with millions of U.S. children missing out on immunizations for preventable diseases such as measles, mumps, rubella and polio, among others. Public health officials are worried that if current trends continue, diseases that have nearly been eradicated could once again become a threat. More than 100 million children may miss out on measles vaccina- tions worldwide, estimates show. In 2019, global measles cases hit a 23-year peak with 869,770 cases and 207,500 deaths. UNICEF and the World Health Organization also warned of a potential polio re- surgence within 10 years, and called for emergency funds to address immunity gaps and ramp up global vaccination campaigns. With so many testing supplies dedicated to COVID-19, U.S. labs are also facing a shortage of supplies needed to test for sexually trans- mitted infections and other common diseases like strep throat and pneumonia. Public health experts said inadequate testing could lead to skyrocketing infection rates, since many undiagnosed people may unknowingly spread STIs.