No one is perfect, so it is inevitable that medical errors will occur. Although most errors are minor and result in little long-term harm, some are serious. In the U.S. alone it has been estimated that medical errors are responsible for tens of thousands of patient deaths annually. There are many factors involved in medical errors including lack of training, poor safeguards, and human error. Some are easily preventable if hospitals are willing to invest in proper staffing. A new study by Stephanie Andel, Archana Tedone, Winny Shen, and Maryana Arvan, published in the peer reviewed Journal of Advanced Nursing shows that nurse understaffing can cause medical errors.
What Is Understaffing?
Understaffing occurs when there are inadequate human resources to get a job done. When understaffing exists in the workplace, it can put employees under stress in coping with excessive workloads. There are two types.
- Personnel Understaffing. This form of understaffing occurs when there are too few people to comfortably cover all tasks to be done. In a hospital setting this means too few nurses to cover each shift. This puts undue strain on nurses as they struggle to cover everything needed. When that happens, nurses might have to take shortcuts to provide care to each patient. This can be especially difficult when caseloads are high, and units are full.
- Expertise Understaffing. This occurs when nurses do not have the needed expertise to perform their tasks. It is possible to have expertise understaffing even though there are enough nurses to cover each shift. However, having personnel understaffing can make expertise understaffing worse if not everyone has the same expertise and there are not enough people with certain skills to cover every shift.
How Nurse Understaffing Can Cause Medical Errors
Andel and her team surveyed more than 100 nurses during the COVID-19 pandemic in spring 2020. Nursing is a tough occupation under normal circumstances, but the pandemic made it even tougher. They asked about their experiences working under the heavy workloads created by the pandemic. They included measures of both forms of understaffing to see the potential impact on behaviors and errors. These were:
- Safety Workarounds: Ignoring safety rules and taking shortcuts in order to get the job done.
- Cognitive Failures: Errors in making decisions and lapses due to difficulty concentrating.
- Near Misses: A medical error that might have harmed a patient but did not, or an accident (e.g., slip on a wet floor) that might have injured a nurse but did not. Often the difference between a near miss and injury is a matter of luck, or a quick recovery so that the error can be rectified. Near misses are a concern because they represent a unit that is prone to patient or staff injury.
The results of the study showed that understaffing was related to safety workarounds and cognitive failures both of which were related to near misses. These results show that understaffing not only puts nurses under stress, it increases the chances that they will accidentally harm a patient through a medical error, or be injured on the job. This study sounds an alarm that nurse shortage is a serious problem can likely contributes to medical errors and serious harm to patients and nurses themselves.
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