Becker's Hospital Review

81 CMO / CARE DELIVERY 7 ways to immediately reduce nurse strain By Mackenzie Bean and Erica Carbajal H ospitals and health systems are in- creasingly partnering with nursing schools or offering academic finan- cial assistance to bolster the nursing pipeline. While an influx of nursing students will even- tually help address workforce issues, there will be at least a two-year lag before these in- vestments pay off, and with a growing nurs- ing shortage, hospitals can't afford to wait. A more immediate solution to reducing nurse strain is to perform an "audit" of nurses' jobs to assess which duties could be shied to other staffers or done virtually. Becker's asked four chief nursing officers what immediate strategies come to mind if they were to do such an audit to optimize nurses' workflow. e following leaders weighed in: • Denise Mihal, BSN, RN, executive vice president and chief nursing and clinical operations officer at Winston-Salem, N.C.- based Novant Health • Kathleen Sanford, BSN, RN, executive vice president and CNO of Chicago-based CommonSpirit Health • Annette Sy, DNP, RN, CNO of Keck Hospi- tal of USC and USC Norris Cancer Hospital, both in Los Angeles • Janet Tomcavage, MSN, RN, executive vice president and chief nurse executive at Dan- ville, Pa.-based Geisinger Here's what they shared: 1. Consider how other employees in the organization can support nurses to ensure they're practicing at the top of their license. For example, pharmacy technicians could be tapped to pull medications, cutting the time nurses spend hunting and gathering neces- sary drugs. is could also include leveraging nonlicensed employees to reduce some of the side work nurses typically do, such as stock- ing supplies. Another example is tapping ad- mission-discharge-transfer nurses to assist primary nurses with necessary tasks. 2. Don't forget about nurse managers and nurse leaders when looking at ways to reduce strain. e responsibilities of nurse managers have grown over time, and it's worth consider- ing what sorts of tasks another team member may be able to do so leaders can spend more time with their front-line staff to directly man- age and support them. 3. Tap technology for patient monitoring. Hospitals can adopt a tele-intensive care unit program with video monitoring capabilities for patients who need closer observation. Another option is to use remote patient care monitoring for high-risk fall patients, so that one staff member can watch numerous pa- tients at once to reduce falls and consolidate nurses' workloads. 4. Replace call centers with smartphones to create a more flexible approach that enables nurses to answer calls from anywhere, in- stead of tying them to the nursing desk. 5. Address alarm fatigue. By implementing an integrated alarm management solution, hospitals can improve clinical processes and efficiency alongside patient experience. 6. Streamline documentation for nurses. Hospitals should assess how much time nurs- es are spending on charting and reporting in- formation about their patients. Eliminating unnecessary documentation and improving existing processes is another way to protect nurses' time and reduce strain. Smartphones can also be used as one-stop, universally used electronic hubs to house patient vitals, health records and internal communications 7. Offer options to near-retirement or other experienced nurses who may be considering leaving the field. For example, hospitals can offer nurses the opportunity to be more in- volved in virtual care services. n Don't let the term fool you — 'Endemic' can be dangerous By Mackenzie Bean and Gabrielle Masson T he word "endemic" is one of the most misused of the pandemic, contributing to a dangerous compla- cency about COVID-19's potential future toll, Aris Katzourakis, PhD, professor of evolution and genomics at St. Hilda's College Oxford in the U.K., wrote in a Jan. 24 op- ed published in Nature. The CDC defines a pandemic as "an event in which a dis- ease spreads across several countries and affects a large number of people." In contrast, an endemic is the "constant presence and/or usual prevalence of a disease or infectious agent within a geographic area." An endemic can be wide-reaching and deadly, Dr. Katzourakis wrote, citing examples such as malaria and tuberculosis. He added that the "endemic" classification doesn't mean a return to "normal." "There is a widespread, rosy misconception that viruses evolve over time to become more benign," Dr. Katzourakis wrote. "This is not the case: there is no predestined evolu- tionary outcome for a virus to become more benign, espe- cially ones, such as SARS-CoV-2, in which most transmission happens before the virus causes severe disease." An "endemic" classification gives no indication of duration, case rate, severity, vulnerability or death rates, according to the professor, who added that health policies and behavior determine what form endemic COVID-19 takes. The "lazy optimism" about endemic COVID-19 must be replaced with more realistic projections on future levels of death, disability and illness, according to Dr. Katzourakis. The world must recognize the risk for new variants to emerge when considering reduction targets and invest in vaccines to protect against a broader range of variants, among other actions, he said. "Thinking that endemicity is both mild and inevitable is more than wrong — it is dangerous. It sets humanity up for many more years of disease, including unpredictable waves of outbreaks," he concluded. "It is more productive to con- sider how bad things could get if we keep giving the virus opportunities to outwit us. Then we might do more to en- sure that this does not happen." n

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