Becker's Clinical Quality & Infection Control

17 PATIENT SAFETY & OUTCOMES A threat to care quality Magnified levels of burnout and decreased psychological safety among clinicians can pose serious consequences to care quality and patient safety. A 2021 study published in the Journal of Research in Nursing found workplace violence and verbal abuse increased nurses' emotional exhaustion, and nurses who reported higher levels of emotional exhaustion also had lower perceptions of patient safety in their organizations. e Joint Commission has routinely warned of the effect disrespectful behaviors can have on healthcare teams' performance, with consequences including medical errors and preventable adverse outcomes. Several physicians told Becker's their real- world experiences echo these findings. "It's difficult for nurses and doctors and other clinical staff to provide high-quality patient care when they're constantly worried about their personal safety, or they're distracted by disruptive patients or family members, or even have been traumatized from fire [or] violent interactions," Dr. Davidoff said. Leah Alexander, MD, a pediatrician at PediatricCare Associates in Fair Lawn, N.J., said she's encountered several situations in her 16 years in private practice that required law enforcement intervention. "One occasion that elicited the most fear was a father who told me, 'I wish I had a bomb,' and threatened gun violence toward one of my nurses," Dr. Alexander said. In these circumstances, the nurse or physician's top priority is to de-escalate the situation, which means the patient's needs may not be fully addressed, she added. Fear for staff safety could also lead to increased use of physical restraints on patients, which could be problematic, as research shows Black patients are more likely to be restrained than other patients, according to Dr. Miller. "So, there is also an equity component that we need to face," he said. Healthcare workers are only human As state and federal lawmakers propose legislation to better protect healthcare workers, hospitals weigh enhanced security measures and healthcare leaders call for gun safety reform, business as usual continues for healthcare workers. But "the concept of being superheroes has to be debunked," Ochsner's Dr. Girgrah said. "e community has to understand that physicians, nurses, [advanced practice providers and] healthcare workers are human. e superhero concept sort of propagates this sort of uneasiness about self-compassion and self-care." n Has smell, taste returned for COVID-19 survivors? 2 findings By Mackenzie Bean T emporary loss of smell emerged as a common indicator of COVID-19 early in the pandemic. Research into the cause and treatment of the condition, known as anosmia, is ongoing, though studies have brought us one step closer to answers. Two findings on COVID-19-related anosmia: 1. Loss of smell and taste is becoming less common as the virus evolves, according to researchers. The Monell Chemical Senses Center in Philadelphia received a flood of inquiries from patients during the pandemic's first two years, according to Valentina Parma, PhD, a psychologist at the center. "Our inboxes are not as flooded as they used to be," she told Nature in early June. A study published May 3 in Otolaryngology-Head and Neck Surgery may help explain why. Researchers analyzed the outcomes of more than 616,000 U.S. COVID-19 survivors and found those infected with the alpha variant were half as likely to experience loss of smell or taste compared to those infected with the original coronavirus strain. This figure dropped to 44 percent for the delta variant and just 17 percent for omicron. 2. Smell and taste hasn't fully returned for many people who contracted COVID-19 early in the pandemic, research shows. In a separate study published in the journal Rhinology, researchers tracked the outcomes of 100 people who had mild cases of COVID-19 between March and April of 2020. More than a year after their recovery, 46 percent of study participants still had smell issues, compared to 10 percent of people in a control group who lost their sense of smell for other reasons. Another 7 percent of COVID-19 survivors still had total smell loss a year after contracting the virus. Based on these findings — and considering that more than 500,000 million COVID-19 cases have been confirmed globally — Nature suggests that tens of millions of people may be grappling with long-term smell issues. Scientists are still working to understand the cause and potential treatment for these issues via ongoing clinical trials. For now, most researchers point to smell training as a potentially effective treatment for patients with partial smell loss. The treatment entails having patients try to identify strong scents to restore olfactory signaling, according to Danielle Reed, PhD, a geneticist at Monell Chemical Senses Center. n

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