Becker's Clinical Quality & Infection Control

20 PATIENT SAFETY & OUTCOMES Black patients face worse safety outcomes than white patients at same hospitals, study finds By Erica Carbajal B lack patients are more likely to experience hospital-acquired illnesses or injuries than white patients within the same hos- pitals, according to a large analysis from the Urban Research Institute published July 20. While the group's earlier research found Black patients are less likely to be admitted to high-quality hospitals and thus experience worse patient safety outcomes, this analysis found the disparities persist even within the same hospitals. e report assessed racial disparities in the quality of inpatient care across 11 patient safety indicators. Four of the measures center on general patient safety, while seven are related to surgical procedures. Researchers used discharge records from 2,347 hospitals across 26 states in 2017 to conduct the analysis. Black patients experienced significantly worse patient safety outcomes compared to white patients for six of the 11 indicators, including four of the seven surgery-related indicators. Overall, Black adults faced higher rates of press ulcers, catheter-re- lated infections, perioperative hemorrhage or hematoma, postop- erative respiratory failure, perioperative pulmonary embolism and postoperative sepsis. For example, the rate of sepsis infections aer surgery were 1.3 times higher (per 1,000) among Black patients compared to white patients of the same gender and age group. at translates to about a 27 percent difference. For pulmonary embolism or deep vein thrombosis, Black patients experienced a 30 percent higher rate. ese trends largely persisted when adjusting for patients' insurance coverage type, and when separating hospitals by those where more than 25 percent of patients were Black. At the same time, white patients experienced worse quality of care relative to Black patients on two general patient safety indicators: iatrogenic pneumothorax and an in-hospital fall with a hip fracture. "Our previous work suggested increasing the racial diversity of patients that high-quality hospitals serve or concentrating resourc- es to improve quality of care at low-performing hospitals would narrow racial inequities in care," Anuj Gangopadhyaya, PhD, senior research associate at the Urban Institute, said in a news release sent to Becker's. "is study's findings show that achieving racial equity in patient safety requires transforming the way care is delivered within hospitals as well." e report outlines several approaches that may mitigate these dis- parities, including expanding Medicare penalties for hospitals with higher rates of racial care gaps. n HCA hospital nurses claim inadequate staffing is hindering care of pregnant patients By Kelly Gooch L abor and delivery nurses at HCA Healthcare's MountainView Hospital in Las Vegas have alleged there are not enough nurses to provide safe care for pregnant patients and their unborn children, accord- ing to the Las Vegas Review-Journal. The nurses, members of National Nurses Organizing Committee-Nevada/National Nurses United, expressed their concerns Aug. 10 during an informational picket. Because of staffing issues, labor and delivery nurses say they at times have to decide which laboring patients and babies to care for first, according to the union. The union also contended that staffing is often inadequate, according to nurses, for patients who need one-on-one critical care, and for those being triaged when arriving at MountainView. "No new mother, no family should have to worry wheth- er they will receive the focused care they need when they come to the hospital to bring a child into the world. We are appalled that we cannot guarantee they will have safe staffing at all times for the intensive process of delivering a baby," Nicole Taylor, RN, and chief nurse representative for the union, said in a news release. Jennifer McDonnell, director of public relations and communications for the hospital, told Becker's the hospital respects the right of unions to hold an informa- tional picket. "Patient care is of the utmost importance, and we are always looking ahead to make sure our staffing is at appropriate levels. We will continue to work tirelessly to care for our patients, support our care teams and continually improve," Ms. McDonnell said. "Unfortunately, the national nurse staffing shortage is a difficult challenge for hospitals throughout the U.S. and is at critical levels for certain parts of the country. We are doing everything in our power to retain and recruit new nurses to our community, from shift bonuses to new grad programs," she said. The safety concerns came as nurses at MountainView Hospital were in contract negotiations. Bargaining began in May, and the last contract expired June 30. On Sept. 7, nurses signed a new three-year contract that includes more health and safety protections. MountainView is part of HCA Healthcare, a for-profit hospital operator based in Nashville, Tenn. n

• Cover