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Temporary ER staff poses increased safety risk to patients
Date:8/25/2011

Temporary staff members working in a hospital's fast-paced emergency department are twice as likely as permanent employees to be involved in medication errors that harm patients, new Johns Hopkins research suggests.

Results of the research raise serious issues related to temporary nursing staff in particular because they already are a substantial and growing part of the health care workforce owing to the national nursing shortage. These fill-ins are used to plug holes in both short-term and long-term work schedules, and are seen as a cheaper alternative to permanent hires. They tend to earn more per hour, but don't receive benefits.

The Hopkins team cautions that while it may be easy to blame the temps themselves for the errors, the problem is probably more diffuse and complex. "A place that uses a lot of temporary staff may have more quality of care issues in general," says Julius Cuong Pham, M.D., Ph.D, an assistant professor of anesthesiology and critical care medicine and emergency medicine at the Johns Hopkins University School of Medicine and the study's leader. "It may not be the temporary staff that causes those errors but a function of the whole system."

The Hopkins team says its findings do suggest however that the temp strategy in hospital staffing may be exacting a price in patient harm and that temp staff's unfamiliarity with the practices and systems of a new hospital could be more costly in the long run in terms of patient safety. "Our work suggests that if you can, you probably want to avoid hiring temporary staff because they are associated with more severe medical errors," Pham says.

Pham and his colleagues did their study by examining a national Internet-based voluntary medication error reporting system and data from 2000 and 2005, encompassing nearly 24,000 emergency department medication errors among 592 hospitals. Medication errors made by temporary workers were more likely to reach the patient, resu
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Contact: Stephanie Desmon
sdesmon1@jhmi.edu
410-955-8665
Johns Hopkins Medical Institutions
Source:Eurekalert

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