Patient Safety in the Time of COVID-19
Our health system is experiencing a crisis unlike any in modern times. Since late 2019, the COVID-19 pandemic has been creating unprecedented stress on the system. In early May 2020, there were 3.8 million confirmed cases and 270,000 deaths worldwide. The United States has had over 1.2 million confirmed cases and 76,000 deaths.1 This crisis has been overwhelming. Things that were unimaginable were and are now deemed necessary. Patient and provider safety issues fill the news media. Transmission of the virus and high fatality rates in nursing homes has been well documented. Healthcare providers have had to work with inadequate personal protective equipment. Patients have died without family support or consolation.
The pandemic has forced those responsible for healthcare to reorder priorities, and in doing so the standard of care has been lowered. The CDC’s [Centers for Disease Control and Prevention] face mask strategy is an example of lowered standard of care: It is based on levels of “surge” in patient volume and severity, yet there are no specific qualifications or trigger points for application. The CDC admits that in crisis capacity, “strategies that are not commensurate with U.S. standards of care (would and have been implemented). These measures, or a combination of these measures, may need to be considered during periods of known face mask shortages.”2 The CDC did advise that these strategies should not be implemented until other (strategies) have been found overwhelmed, including such unheard-of policies of reducing face-to-face HCP [healthcare personnel] encounters with patients and excluding visitors to patients with confirmed or suspected COVID-19.
Data from: CDC · WHO · ECDC · Wikipedia. https://www.bing.com/search?q=corona+update&form=EDGSPH&mkt=en-us&httpsmsn=1&msnews=1&rec_search=1&plvar=0&refig=c20ae2139d5948cb94f02e1ca980109b&sp=-1&ghc=1&pq=corona+update&sc=8-13&qs=n&sk=&cvid=c20ae2139d5948cb94f02e1ca980109b.
CDC. Strategies for Optimizing the Supply of Facemasks. https://www.cdc.gov/coronavirus/2019-ncov/hcp/ppe-strategy/face-masks.html. 4/15/2020.
Trump Says 100,000 Americans Could Die of COVID-19, Revising His Earlier Predictions. Thomson Reuters · Posted: May 03, 2020 11:46 PM ET. https://www.cbc.ca/news/trump-fox-covid-19-coronavirus-1.5554216. 5/7/20 accessed.
Fauci Estimates That 100,000 To 200,000 Americans Could Die From The Coronavirus. NPR. March 29, 20202:17 PM ET. https://www.npr.org/sections/coronavirus-live-updates/2020/03/29/823517467/fauci-estimates-that-100-000-to-200-000-americans-could-die-from-coronavirus. Accessed 05/07/2020.
Lyons, M. Should Patients Have a Role in Patient Safety? A Safety Engineering View. Qual Saf Health Care 2007;16:140–142. doi: 10.1136/qshc.2006.018861.
Joint Commission Extends Suspension of Regular Surveys Until End of May. https://www.jointcommission.org/resources/news-and-multimedia/newsletters/newsletters/joint-commission-online/april-8-2020/joint-commission-extends-suspension-of-regular-surveys-until-end-of-may/
Center for Clinical Standards and Quality/Quality, Safety & Oversight Group Ref: QSO-20-20-All: March 23, 2020 State Survey Agency Directors Director Quality, Safety & Oversight Group file:///C:/Users/William/Documents/Patient%20Safety/Corona%20and%20Safety/References/CMS%20direction%20for%20oversight.pdf
State and CMS Survey Activity Guidance for Health Care Facilities during the COVID-19 Pandemic.PA Dept of Health. March 31, 2020 https://www.health.pa.gov/topics/Documents/Diseases%20and%20Conditions/COVID19%20State_CMS%20Survey%20Activity%20Guidance.pdf
Order of the Governor of the Commonwealth of Pennsylvania to Enhance Protections for Health Care Professionals. https://www.governor.pa.gov/wp-content/uploads/2020/05/20200506-GOV-health-care-professionals-protection-order-COVID-19.pdf Accessed 5/7/2020.
Murphy Grants Health Workers Legal Immunity as the Coronavirus Swamps N.J. Hospitals. Updated Apr 01, 2020; Posted Apr 01, 2020. https://www.nj.com/coronavirus/2020/04/murphy-grants-health-workers-legal-immunity-as-the-coronavirus-swamps-nj-hospitals.html