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

lt in at least temporary harm and also be life-threatening, they found. The findings appear in the July/August issue of the Journal for Healthcare Quality.

Pham says temporary personnel are often not familiar with local staff, care management systems, protocols or procedures. This may hamper communication and teamwork that causes them difficulty in retrieving important medical information and leave them unsure of which procedures to follow. Temporary help may be less likely to speak up if they see problems and also lag behind the latest knowledge because, unlike permanent employees, temps typically manage their own continuing education.

"You may know the medicine," Pham says, "but you still may get tripped up by the policies and procedures of an unfamiliar system. This can lead to more serious errors."

The emergency department is a unique environment with a high risk for medication errors, likely due to the increased severity of injury or disease, the rapidity with which lifesaving decisions must be made, the medical complexities encountered and overcrowding. Many medications are ordered, dispensed and administered in the ED without the standard pharmacy check that occurs in nonemergency situations elsewhere in a hospital. There is a higher prevalence of verbal orders and they are often given urgently.

Pham says it isn't known whether the correlation between temporary workers and more serious medication errors exists in other hospital service areas. Further research is needed to determine that, he says.

Hospital administrators may not want to use temporary staff, but may have no choice but to hire temporary help or be understaffed depending on the situation. Some temporary nurses and doctors spend a month or a couple of months in a city and then move to the next, not because they can't hold down a permanent job but because they like to travel to new places, Pham says. While some temporary are used in a single dep
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Contact: Stephanie Desmon
sdesmon1@jhmi.edu
410-955-8665
Johns Hopkins Medical Institutions
Source:Eurekalert

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