Reports highlight a youth mental health crisis and the lingering effects of COVID-19.
ECRI Institute, the nonprofit health care quality and safety watchdog, recently released the Top 10 Patient Safety Concerns 2023 Special Report, which lists as the number one concern: finding the resources to meet the escalating mental health needs of children and adolescents.
According to the report, "Concern for pediatric mental health was already high during the 2010s due to the growing use of social media, limited access to pediatric behavioral health providers, drug and alcohol use, gun violence, and socioeconomic impact, among other stressors." But it notes that children's mental health issues have been exacerbated by the COVID-19 pandemic, "with a 29% increase in children ages 3 to 17 experiencing anxiety and a 27% increase in depression in 2020 compared with 2016."
Several other items on the list reflect the pressures health care workers experienced during the pandemic. Among the concerns are physical and verbal violence against health care staff (number two on the list), clinical uncertainty surrounding maternal-fetal medicine (number three), and the impact on clinicians expected to work outside their scope of practice and competencies (number 4).
"Nurses play a central role in the systems designed to deliver safe and effective care, and when we see breakdowns in those systems, often the impact on nurse safety, both physical and psychological, is a leading indicator that something is wrong," said Shannon Davila, director, total systems approach to safety, at ECRI, in an email to AJN. "Many concerns on our list this year illustrate that. Workforce safety, one of the foundations of total systems safety, means more than needlesticks and back injuries. It is about providing nurses with tools they need to be successful in navigating the complex health care system that they work within."
To download the full executive report, which details the rationale for each safety concern and offers practical recommendations, go to http://www.ecri.org/top-10-patient-safety-concerns-2023-special-report.
The Joint Commission has released its Sentinel Event Data 2022 Annual Review. The commission's Office of Quality and Patient Safety aids health care organizations in conducting analyses to identify sentinel events-defined as patient safety events unrelated to the patient's illness or underlying condition that result in death, permanent harm, or severe harm-and develop mitigating strategies.
In 2022, patient falls were the most reported sentinel events (42%). Although falls have topped the sentinel event list since 2019, they increased significantly in 2022, with 611 sentinel events classified as patient falls compared to 483 in 2021-a 27% increase. Of these patient falls, 5% resulted in death and 70% in severe patient harm. Other leading categories included delay in treatment (6%), unintended retention of foreign object (6%), wrong surgery (6%), and suicide (5%).
The report cites failures in communication and teamwork and inconsistent adherence to policy as leading causes of reported sentinel events. To read the report, go to: http://www.jointcommission.org/-/media/tjc/documents/resources/patient-safety-to.-Amy M. Collins, managing editor