Mounting evidence indicates a concerning trend in patient harm across Canadian hospitals. From March 2022 through March 2023, an estimated one in 17 hospital admissions involved a sufferer enduring unintentional harm, according to a comprehensive analysis by the Canadian Institute for Health Information (CIHI). This implies that approximately 145,000 patients seeking treatment during this period may have been inadvertently afflicted with complications such as infection, pneumonia, medication miscalculations, or pressure ulcers.
These disturbing figures mark a three-year consecutive rise in patient harm, an escalation Kate Parson from CIHI describes as “an increase in the wrong direction.” The CIHI’s intention is to leverage these alarming statistics to incite change and elevate the quality of hospital care.
In retrospect, the year-over-year numbers reveal further unsettling details: a 20% surge in hospital-acquired urinary tract infections, a 25% uptick in aspiration pneumonia, and an astonishing 50% spike in bedsores. The rapid rise in the prevalence of pressure ulcers is also partially attributed to more comprehensive data recording.
For the first time, the CIHI report disclosed that hospitals had become excessively dependent on overtime and agency staff to provide patient care. The resulting patient harm was found to correlate strongly with staffing levels. Sick time amongst the nursing staff had surged by 17%, equating to a staggering equivalent of 6,500 nurses removed from the healthcare system. This was complemented by a 50% rise in recorded nurse overtime hours.
Forced overtime has become a grim reality for many nurses such as Deb Lefebvre, a registered nurse from Kingston, Ontario. Amidst escalating nurse shortages, Lefebvre and her colleagues constantly struggle to provide quality patient care, a situation she describes as feeling ‘trapped’. These untenable conditions have catalyzed a mass departure of nursing staff from the profession, citing exhaustion and burnout.
The scant nursing workforce left behind grapples with the crushing daily pressures and openly acknowledges the risks this poses to patient care. A pseudonymous nurse from an Ontario hospital, ‘Miryam’, shared her harrowing experiences with these increasing harms, claiming the adverse effects on her personal mental health. Management, when confronted with the issues, often dismiss these concerns, she lamented.
‘Miryam’s’ accounts resonated with Linda Silas, president of the Canadian Federation of Nurses Unions, who scorned the healthcare system for its negligence towards these increasing disasters. The report further showed an alarming 80% increase in agency nurse and health worker billable hours for the year 2022-23. However, this influx could not curtail the rates of patient harm, instead, it underscored the lack of cohesion and skill mismatch amongst the ranks.
The CIHI report emphatically suggests permanent staff retention and work flexibility as keys to reducing patient harm. Adequate staffing with nurses familiar with hospital systems could greatly enhance patient care. Echoing similar enactments in the U.S., advocates propose mandated nurse-to-patient ratio legislation to curb patient harm and improve satisfaction rates. The initial costs associated with increased staff retention could be offset by the future reduction in patient harms and extended hospital stays.
Lefebvre highlights the critical importance of Canadians to be cognizant of these alarming figures, imploring, “If we do not ensure that there are adequate nurse professionals at the bedside, these numbers will only worsen.”
