Preventable Adverse Events Are a System Failure

31 Jan

Linda-Hamilton_1by MNA President Linda Hamilton, RN, BSN

After nine years, hospitals are still reporting 314 adverse events that could have been prevented.

Patients are suffering; families are grieving because systems did not adequately protect them from preventable mistakes, such as falls and the development of pressure ulcers.

Beyond the sobering revelations of Wednesday’s 2013 Adverse Health Event report, nurses at the bedside are deeply concerned that other troubling instances are not reported.   We catch our breath with every “near miss,” every late medication, every discharge with hasty instruction.  We provide a safety net through our continual monitoring, but we see the foundation of that net eroding more each day.

Our frustration mounts when we warn our managers that in our professional judgment that patients are at risk as a result of  not enough time to provide adequate care for the amount of patients at the level of acuity we are assigned.  Sadly our notice is sometimes met with no response at all or, more often, a hollow “make do.”

To prevent further suffering of patients and families in our hospitals, and to reduce overall health care costs, nurses have a solution.

Learn more about the Standards of Care Act on Feb. 5 when members of the Minnesota Nurses Association sponsor “Nurses Day on the Hill.”  Every nurse in the state is invited to help advance this proposed measure that will:

1)     Require patient-to-nurse standards that could be further adjusted based on the patient’s acuity and nursing intensity.

2)     Establish legislated committees to address patient care units where a nationally accepted standard does not exist.

3)     Ensure that mandatory overtime does not become the solution for meeting the staffing standards set forth.

4)     Provide protection for nurses who report employers that are not in compliance with the law.

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