Insufficiencies in U.S. health system exposed by pandemic, study finds

Insufficiencies in U.S. health system exposed by pandemic, study finds

The rapid spread of COVID-19 has revealed serious shortcomings in the U.S. healthcare system's preparedness to respond to a public health emergency, a report from the Johns Hopkins Center for Health Security finds.

The report, Recommendations for Improving National Nurse Preparedness for Pandemic Response: Early Lessons From COVID-19 (34 pages, PDF), found that while nurses have played a critical role in the response to the pandemic, evidence from the field suggests the nursing workforce does not have reliable access to personal protective equipment (PPE); lacks adequate knowledge and skills related to pandemic response; is hampered by a lack of decision-making authority as it relates to workflow redesign, staffing decisions, and allocation of scarce resources; and is disconnected from nurse executives and hospital administrators. A recent survey conducted by the American Nurses Association found that 87 percent of nurses fear going to work, 36 percent have cared for an infectious patient without having adequate PPE, and only 11 percent said they felt well prepared to care for a COVID-19 patient.

The report offers several recommendations aimed at addressing the readiness, safety, and support of the national nursing workforce for COVID-19 and future pandemics. They include calls for the U.S. Department of Health and Human Services to identify the roles and responsibilities of nurses during a pandemic and to work with experts to develop a plan to train nurses to execute those roles; for key stakeholders to identify the capacity of various federal agencies to advance emergency preparedness among the nursing workforce and integrate that information into strategic plans going forward; and for healthcare accreditors to develop and implement metrics to determine whether a facility is adequately prepared to surge its nursing workforce during a pandemic and include education and training for nurses on pandemic preparedness as a specific requirement beyond the all-hazards approach currently required to evaluate an organization's preparedness.

"Recommendations for improving national nurse preparedness for pandemic response: early lessons from COVID-19." Johns Hopkins Center for Health Security press release 06/10/2020.