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Temp ER Nurses a Safety Threat to Patients, Study Shows

John Commins, for HealthLeaders Media, August 30, 2011

Temporary emergency room nurses who are unfamiliar with their surroundings may inadvertently be a threat to the patients they serve, according to new research from Johns Hopkins University School of Medicine.

The study found that the temporary help was twice as likely as permanent staff to be involved in medication errors in the hectic and fast-paced environs of the ER. However, the study's authors stressed that temporary nurses should not necessarily be blamed for those shortcomings, which the researchers said are complex and diffuse.

"A place that uses a lot of temporary staff may have more quality of care issues in general," study leader Julius Cuong Pham, MD, an assistant professor of anesthesiology and critical care medicine and emergency medicine at the Johns Hopkins University School of Medicine, said in a media release. "It may not be the temporary staff that causes those errors but a function of the whole system."

The nation's hospitals have become more reliant on temporary nurses and other temporary clinical staff because of widespread shortages of healthcare professionals. Temporary nurses generally earn higher wages than their permanent coworkers, but they don't receive benefits, and could be cheaper in the long run.

"It's one of those necessary evil sorts of things," Ann Marie Papa, RN, president of the Emergency Nurses Association, tells HealthLeaders Media. "Temporary help can be tremendous when you are struggling with nursing shortages but the key is that these temporary nurses are properly trained and they have proper orientation, mentoring, and supervision."

The Johns Hopkins study examined a national Internet-based voluntary medication error reporting system and data from 2000 and 2005, encompassing nearly 24,000 emergency department medication errors among 592 hospitals.

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