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SAN ANTONIO
MEDICINE

Patient Safety, Systemic inconsistencies

Along with the challenges of working in the
Burnout and hospital with an increased volume of patients
during the pandemic, there were rapid changes
in protocols and policies varied by specialty
and hospital.7 This caused confusion and frus-
tration within healthcare teams. The differ-
COVID-19 By Prachi Shah and Desiree “Dez” Ojo
ences in local and national responses along
with inadequate planning for equipment avail-
This article will examine how COVID-19 34.1% of the participants experienced emo- ability, emergency management and triage
contributes to burnout, the impact of tional exhaustion, 12.6% experienced deper- also contributed to this frustration as the bur-
COVID-19 on patient safety and changes sonalization and 15.2% felt a lack of personal den falls on healthcare workers. The pandemic
that can take place in hospitals to help miti- accomplishment.³ The AMA Coping with put a pause on many parts of the US economy,
gate burnout and increase patient safety. COVID-19 survey administered to assess which increased rates of unemployment and
stress among healthcare workers in the United consequently added stress and anxiety on the
What do patient safety, burnout and States found that 25% of physicians experi- population.²
COVID-19 have to do with each other? enced anxiety, 37.3% experienced work over- Exacerbated by the pandemic, the need for
They are intertwined. The pandemic in- load and 47.73% experienced symptoms of healthcare workers has increased while the
creased the prevalence of burnout among burnout.4 In a survey by Medscape, 47% of supply is decreasing.8 Stress, burnout and
healthcare professionals. Exhaustion and stress physicians said they were burned out − a 5% more difficult working conditions from the
impact how patients are cared for in our hos- increase from the year before.5 pandemic have led many healthcare workers
pitals and clinics. Recent studies have shown wanting to leave healthcare partially or com-
concerning increases in Methicillin Resistant Occupational hazards pletely.9 Hospitals and clinics had a decrease
Stahylococcus Aureus (MRSA), Central Line In the early stages of the pandemic, there in staffing, more overtime work and decreased
Associated Blood Stream Infections was a lack of personal protective equipment time spent during patient visits. Among the
(CLABSI), Catheter Associated Urinary (PPE) availability in many parts of the coun- healthcare workers that kept their job, it was
Tract Infection (CAUTI), and Skilled Nurs- try and inconsistent data about the reliability found that 31% have considered leaving, and
ing Facility (SNF) major injury fall rates and of PPE. Healthcare workers were fearful of 19% said they thought about completely leav-
decubitis ulcers since the COVID pandemic contracting the disease from work and spread- ing the healthcare field¹¹. Another study found
began.¹ This area of research is especially im- ing it to their families.² The AMA Coping that 55% of frontline doctors have reduced in-
portant because it is likely that we will have to with COVID-19 survey found that 61% of terest or ability to continue working in the
learn to live with COVID-19, new strains and the healthcare workers felt fear of exposing the field.8 By 2050, the predicted shortage of
periodic surges for the rest of our lives. Hos- disease to their families.4 This led to many nurses will exceed 500,000, while the shortfall
pital administrators and hospital systems will healthcare workers isolating themselves from of physicians will top 139,000.9
need to figure out a way to take better care of their loved ones. The toll of having to see pa-
their healthcare workers while also making our tients die from COVID-19 while not being How COVID-19 impacts patient safety
patients feel safe, happy and cared for in their able to have loved ones around contributed to To us at the Texas Patient Safety Initiative
hospitals. the stress of working on the frontlines during (TPSI), there are four big contributors to the
the pandemic. There was also inadequate lack of patient safety in the era of COVID-19:
How is COVID contributing to COVID-19 testing availability, uncertainty human error, misdiagnosis, delayed patient
burnout? about whether healthcare workers would be care and fear of transmission.
Burnout is increasing among healthcare supported if they contracted the infection and
workers due to occupational hazards, systemic whether there would be access to childcare Human error
inconsistencies, financial instability and an in- from the increased work hours. Increased As human beings practicing the art of med-
crease in the volume of patients due to the work hours, decreased sleep and disrupted icine, physicians are going to mess up. It’s a
pandemic.² A study that examined burnout work-life balance led to fatigue and mental given. No one is perfect, not even a physician.
among nurses during the pandemic found that distress, which can lead to burnout.6 Medicine has been historically known as a

28 SAN ANTONIO MEDICINE • June 2022