![]() ![]() One nurse cannot care for more than five patients at a time. Just one state, California, has legal criteria regarding the minimum number of staff members needed for safety in hospitals. The pandemic exasperated already stressed nursing staff, leading to strikes. Sixty percent reported that there weren’t enough nurses at their hospitals to provide safe care. In a 2018 study published in the journal Health Affairs, Aiken and her team interviewed nurses at 535 hospitals in the U.S. “Having a sufficient number of nurses is a building block for safety.” “Since we’ve been doing research on patient safety, we consistently find that one of the major explanations for poor patient outcomes is insufficient numbers of nurses at the bedside,” she said. ![]() However, the study looked for a smaller range of adverse events than the current research, and hospitals have become much better at reporting harm when it does occur. Using data from patients hospitalized in New York state in 1984, it found that only about 4% of hospitalized patients experienced harm. The 1991 study, called the Harvard Medical Practice Study I, is considered landmark research. One bright spot, experts said, was that infections acquired in the hospital accounted for only about 12% of the adverse events - a significant decrease from a 1991 study that found infections were the second-most-common adverse event. They include falls and bedsores, both of which are considered preventable. Surgery and other procedures accounted for just over 30%, followed by what the study authors called “patient-care events,” at 15%. The most common adverse events overall (nearly 40%) were related to medications given in the hospital. They can include known side effects from certain medications or known risks associated with surgery. The majority of the bad outcomes, however, were deemed unpreventable. Twenty-nine people, or 1% of the total of those admitted, experienced serious preventable adverse events that resulted in serious harm. That translates to about 7% of the total admissions the researchers analyzed. Hospital data showed that 663 of the patients - about 24% - experienced at least one event during their stays that negatively affected their health, even temporarily.Ī total of 222 adverse events were considered preventable, meaning errors resulted in patient harm. ![]() The study excluded people who were admitted for observation only or for hospice, rehabilitation, addiction treatment or psychiatric care. The research looked at the medical records of 2,809 patients who were hospitalized in 11 Boston-area hospitals in 2018. “They do show we still have lots of work to do.” David Bates, the chief of general medicine at Brigham and Women’s Hospital and the medical director of clinical and quality analysis for Mass General Brigham in Boston. “These numbers are disappointing, but not shocking,” said lead study author Dr. ![]()
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