A survey from the Institute for Safe Medication Practices (ISMP) has found that the recession may be compromising medication safety—at least according to hospital workers surveyed nationwide.
In an ISMP survey of healthcare professionals made in fall 2009, the economy appears to be putting various pressure on a number of hospitals—particularly through staff cuts—causing them to take steps in response to the economic downturn that could put patients at greater risk.
The 848 respondents to ISMP's survey were largely nurses and pharmacists working at a staff or managerial/director level in hospitals. About one-fifth (20%) of respondents reported that the economic downturn has been a contributing factor to medication errors in the past year.
Among the areas cited were:
Staff reductions. Survey respondents reported staff cuts have had the biggest negative impact. More than two thirds reported that the economy has affected their staffing. About the same percentage reported that the economy was causing low morale—often citing unsafe workloads and inability to provide quality and safe healthcare as the key contributing factors.
Working conditions/technology. Nearly half of the respondents felt the economy had negatively impacted equipment purchases, technology implementation and updating, and facility remodeling. About half also reported that the economy was affecting their ability to participate in education and certification programs.
Culture of safety. According to respondents, organizational culture, staff willingness to report errors, and leadership support for safety had been the least impacted by the economy. However, one-third reported the economy has negatively affected the safety culture with "no time to report near misses" given as the most common example given.
Medication safety officer cutbacks. About 42% of respondents reported that the economy had forced a reduction in dedicated time or total elimination of medication safety officers or quality/risk staff dedicated to medication safety.
Drug purchasing. About a third of respondents reported that current economic conditions have resulted in less safe drug purchasing decisions, such as switching to multiple dose vials instead of using single use vials and prefilled syringes. One-third also reported reduced availability of medications as organizations tried to maintain smaller inventories.
Reduction in pharmacist interaction. More than a third of respondents said the economy had impacted the clinical presence of pharmacists on patient care units.
Missed safety steps. About 33% of respondents reported a reduction in available staff for patient education, and 31% said that staffing changes had led to missed independent double checks of high alert medications before dispensing or administration.
Drug administration shortcuts. About a quarter of nurse respondents reported that staff reductions—due to the weakened economy—has led to hurried drug administration practices during which shortcuts are sometimes taken.