Читать книгу Quality and Safety in Nursing - Группа авторов - Страница 40

The COVID‐19 pandemic that consumed much of health care and society as well over 2020 and 2021 led to rapid and substantial changes in all types of delivery systems (Fitzsimons, 2021). Anecdotally, many systems report unintended consequences from changes to operating procedures. For example, to try to limit the spread of the virus, many systems eliminated visitors. With no family member to stay with patients who may have confusion or need mobility assistance, the incidence of falls escalated. Nurses and other providers became family surrogates, scheduling daily video calls with anxious family members or providing comfort in the absence of loved ones. These additional expectations on the health care workforce have taken an extreme toll, with many reporting burnout, physical and emotional exhaustion, and stress from constant vigilance to not contract the virus or take it home to their families (Ross, 2020). Effective leadership was a moderator for stress and psychological safety (Zhao et al., 2020).

Still, there were many reports of the satisfaction of being able to meet the challenge and the opportunity to shift roles within the hierarchy. Nurses were on the front lines using skills developed as leaders in quality safety: taking charge of setting up COVID units, monitoring quality and safety data, sifting evidence as it became available to maintain current standards and procedures, leading daily safety briefings and rounds, and joining in countless other contributions that helped to keep patients and environments safe (Staines et al, 2020). Competency in teamwork and collaboration was evident as nurses were included in interprofessional briefings and updates at the center of the action (Carenzo et al., 2020; Tannenbaum xi., 2020).

All areas of health care delivery were impacted, as noted in Textbox 1.6. Staines et al. (2020), however, point out that competencies built over the past decade to advance quality and safety are key ways to maintain quality safe care during COVID. Still, nursing homes were particularly vulnerable, in part because of the nature of the work. It may yet prove that lessons learned can leave lasting improvements in care (Scopetti et al., 2020). Many developments are being measured, such as: What is the impact of increasing use of telehealth on patient care quality and safety? What will be the lasting impact of the multiple stressors on the workforce? How will systems adapt as COVID‐19 abates to apply lessons learned? Like the past 20 years, the next 20 will be equally impactful as all join in making patient care safe, reliable and free from harm.