Over 100 ‘Risk to Patient Safety’ Forms to be Filed by UW Nurses

• Tensions between UW Health Hospital administration and nurses have risen due to critical understaffing and a lack of veteran nurses.
• These tensions have resulted in nurses submitting over 100 risk to patient safety forms to Wisconsin’s Department of Health Services.
• Risk to patient safety reports are handled by the Divison of Quality Assurance in cases of abuse, understanding, neglect, or other unsafe conditions. 

At the start of this month, nurses at UW Health have filed over 100 risk to patient safety forms detailing critical staffing failures, rampant burnout, and unsafe working conditions. The hospital has rebuffed these formal complaints, claiming that patient safety is being “utilized as a tactic in a union organizing drive.”

Tensions between the hospital and nurses have continued to rise as UW Health’s nurses have sought union representation since 2019. Amidst the conversation of these safety complaints are conflicting statistics on nurse turnover rates as well as disagreements over the best way to protect nurses and their patients.

This article will detail the scope of patient safety, the grounds UW Nurses have with Wisconsin’s Department of Health Services, and the ongoing conversation between hospital administration and the nurses.

Risk to Patient Safety Forms

At the core of the complaints from UW Health’s nurses is fear and frustration at the continued risk to patient safety. But what contributes to a patient’s safety and risk to patient safety forms?

Patient Safety Definition

The World Health Organization (WHO) defines patient safety as “the absence of preventable harm to a patient and reduction of risk of unnecessary harm associated with health care to an acceptable minimum.”

WHO also recognizes several common sources of patient harm:

• Medication Errors
• Surgical Errors
• Health Care-Associated Infections
• Sepsis
• Diagnostic Errors
• Patient Falls
• Venous Thromboembolism
• Pressure Ulcers
• Unsafe Transfusion Practices
• Patient Misidentification
• Unsafe Injection Practices

Wisconsin Department of Health Services

Wisconsin’s Department of Health Services provides multiple resources through its Division of Quality Assurance (DQA) Safety in Health Care. Complaints filed with the DQA may pertain to any issue regarding quality care, including:

• Abuse
• Caregiver Misconduct
• Discharges
• Lack of Staffing
• Mistreatment
• Neglect
• Poor Care Transfers
• Unsafe Conditions

UW Health Complaints

Nurses at UW Health have collected over 100 incident reports of events that compromise patient safety. Alongside these reports, the nurses also submitted a five-page cover letter detailing the overarching issues represented in their complaints.

On September 25th, UW Health’s CEO emailed a statement to all hospital employees stating that these complaints “were explicitly tied to demands for compensation” and that nurses “have so far refused to share” the cited patient safety issues. He also stated that the use of the hospital’s internal reporting system had increased by 24% compared to the previous year, showcasing a shared commitment to patient safety.

Not all nurses agreed with this sentiment. Mary Jorgensen, a UW Nurses United Leader, said, “The internal reporting system in the hospital doesn’t do anything.”

Additionally, a 14-page summary was emailed to UW Hospital’s employees 21 minutes prior to the CEO’s statement. This summary included dozens of anecdotes and descriptions related to the risk to patient safety forms collected by UW Health’s chief compliance officer.

Turnover

This disagreement between hospital administration and nurses extends to nurse turnover rates. The hospital claims that its operating room sees a turnover rate of 9.9%, against union nurses reporting a 23% turnover rate.

Nurses also describe an overall loss in experienced nurses, with one Rose Askevold stating she was assigned to train a brand-new nurse immediately after her own orientation in the surgical department. Askevold also describes “nurses with just a year or so of experience being assigned the role of charge nurse, meaning they’re responsible for the entire surgical department for a Level 1 Trauma Center.”

Charge nurses are typically strong leaders able to manage entire teams in stressful environments. These nurses need experience to create patient assignments accurately and coordinate care for the entire unit.

Sara Booth, an OR nurse at UW Health, describes the stress of having to work both inside and outside the sterile field during surgery with two inexperienced nurses. “The surgeons are very aware. They direct their attention (and requests) to the nurse they are most familiar with. Even though the surgeon asks a nurse outside the sterile field to perform a task, she is really telling me to tell her to do it right now.”

It was after this surgery that prompted Nurse Booth to file a risk to patient safety form. She shouldn’t be made to split her attention away from a patient and surgeon to prompt other nurses.

Save Our Shift Nurses (SOS)

At UW Health, a group of emergency response nurses are able to float between any unit in the hospital to fill staffing gaps. This team is known as the SOS nurses and is considered crucial to the overall patient outcomes at the hospital.

The union is hoping to expand this program but fears the hospital’s new groups of critical care nurses will replace the SOS nurses, “taking a giant step backwards on patient safety and quality of care.”

The Bottom Line

Despite these conflicts, UW Health and its nurses both claim to be working in the best interests of their patients. However, inflammatory language that claims nurses are “resorting to threats” does a disservice to the stress these nurses are under every day while providing care to patients.

The DQA has stated that the department “cannot comment on complaints” already submitted by the nurses. Hopefully, this escalation will lead to real action to protect patients at UW Health and the nurses who serve them.

Cover Image sources from SEIU Wiscon’s Facebook Page.

Read More