HospitalInspections.org

Based on document review and interview it was determined that, the Hospital failed to ensure adequate number of registered nurses were available in the emergency department (ED).

Findings include:

1. The Hospital's policy titled, "Mission and Scope of Services of the Department of Emergency Medicine" dated 04/2019 was reviewed. The policy included, " ...Nursing staff: ...staffing levels will be based on our facilities staffing matrix ...Day and evening: Minimum of 5 RN's with additional support staff ...Nights: Minimum 4 RN's with additional support staff ..."

2. The Hospital's document titled, "Emergency Department of Nursing Staffing Schedule" dated 02/16/2020 - 07/27/2020 was reviewed. The schedule included staffing shortages during the morning shift (7:00 - 7:00 PM) on the following dates: 02/19/2020 - 3 RNs; 02/20/2020 - 3RNs; 03/01/2020 - 3 RNs; 03/14/2020 - 3 RNs; 03/15/2020 - 3 RNs; 05/05/2020 - 3 RNs; and on 07/09/2020 - 2 RNs.

3. On 07/28/2020 at approximately 2:20 PM, the ED Manager (E #6) was interviewed. E #6 stated, "Normally, we need to have five (5) RNs from 7:00 AM to 7:00 PM and four (4) RNs from 7:00 PM to 7:00 AM ...It is absolutely not safe to have only three (3) RNs during day shift in the ED. Now that, we have our census going high from the pandemic and the closure of a nearby Hospital, it is essential to have enough staffing in the ED. On 07/09/2020 for the morning shift we had only two (2) RNs in the ED. But, I was on the unit helping them with the nursing care."

4. On 07/28/2020 at approximately 3:30 PM, the Chief Nursing Officer (E #7) was interviewed. E #7 stated, "Definitely, patient safety is affected if we have only three (3) RNs in the ED."