The hospital has failed to develop a consistent process to examine, respond and determine if a specific nurse staffing complaint was resolved. There is not a fair process in place for staff nurse representatives and management representatives to vote or agree upon disposition of complaints. Additionally, there is not an efficient tracking system is in place to document workflow and record disposition of complaints.

The hospital failed to follow shift to shift adjustment in nurse staffing levels as evidenced by a pattern of more than 60 days unresolved staffing complaints. The hospital has failed to post staffing plans in a public area on each patient care unit and the nurse staffing schedule for that shift on that unit, as well as the relevant clinical staffing for that shift.

Please continue tofill out ADOs! We consider all missed meals, missed rest breaks, and inadequate staffing to be patient safety concerns because they interfere with your ability to provide the best care. Be sure to give enough details on the ADO’s so that we can determine how the assignment presented risk, or real harm, to your patient. Examples of risk or harm to patient safety include:

• Staff not available to provide care.
• Failure to provide care.
• Providing the wrong care
• Medication errors or mistakes
• Unsafe, unclean or dangerous areas in the facility
• Patient injuries or falls.
• Not following medical orders
• Improperly prepared food
• Not responding to a patient complaint
• Patient abuse or neglect

At this time, we do not know when the DOH investigator will be on your campus. If you find yourself being questioned, be open and honest. You are allowed to have your WSNA Rep present.

Thank you for of you hard work and consideration. If you have any questions, please contact lrobinson@wsna.org or one of your Officers.