Blog spotlight: Patient safety and agency nurses

Nurse Leader Insider, September 5, 2011

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Medication errors are twice as likely to occur with agency and temporary emergency room (ER) nurses than with permanent staff, according to a new study from Johns Hopkins University School of Medicine.

There are many reasons for such findings, including the fact that temporary nurses are unfamiliar with their surroundings. They do not know the nurses, physicians, and multidisciplinary personnel they are working with, which can lead to communication problems and poor teamwork. They may be less comfortable speaking up if they have questions or concerns.

Bringing in agency staff is often the only way to ensure adequate staffing and they are a valuable resource for most organizations. So what should nurse managers do to mitigate the effects and improve patient safety?

1. Advocate for thorough orientation for new agency staff. Organizations should have competency-based orientation programs designed for temporary staff so they can quickly and easily learn what you need them to know.

2. When on the unit, assess for competency. Once the agency staff are on the unit, don't just assume they can handle anything. Charge nurses should be involved in assessing them for competency and how they deal with situations. Don't give them more than they can handle right off the bat. Assign more challenging situations to experienced staff until you know the agency staff member can handle more and you are confident in his or her decisions.

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