Healthcare Inspection: Emergency Department Staffing and Patient Safety Issues, VA San Diego Healthcare System, San Diego, California.

摘要

The VA Office of Inspector General Office of Healthcare Inspections conducted an inspection in response to allegations concerning critically low registered nurse (RN) staffing levels and patient safety issues in the Emergency Department (ED) at the VA San Diego Healthcare System (system), San Diego, CA. We reviewed the following allegations: (1) there are usually three RNs after midnight, and if one RN does not come to work, RN staffing is at a dangerous level; (2) the system has no emergency plan or policy in place that addresses critically low RN staffing levels; (3) RNs who float to the ED are not oriented to the floor and will not take a patient assignment; (4) numerous Patient Event Reports (PERs) have been submitted regarding critically low RN staffing levels on the night shift, but no action has been taken; and (5) two ED patients waited over 9 hours for emergency care.