An unprecedented global software outage brought major industries to a standstill recently – including healthcare facilities. Nurses across the U.S. found themselves unable to access certain hospital computer systems on July 19, creating unexpected chaos.
An update from cybersecurity company CrowdStrike for Microsoft Windows machines caused the technological issues. A bug prevented users from logging into Microsoft Windows systems, prompting a “blue screen of death” for hospitals, banks, airlines, and other major businesses.
This digital catastrophe left some nurses scrambling as electronic health records (EHRs), and critical communication systems went dark, plunging them back into an era of manual processes. Ripple effects included delayed patient care, canceled surgeries, and rerouted ambulances.
With technology becoming increasingly intertwined in healthcare, nurses may experience more outages like this one. Let’s go over vital tips on how to prepare for and handle similar crises in the future.
The impact on hospitals and healthcare centers
The recent software issues led to widespread disruptions, including:
- Charting by hand: Many nurses had to revert to manual documentation methods, a time-consuming and less efficient process compared to using EHRs. The sudden switch to paper charting slowed patient care workflows and increased the risk of errors.
- Ambulance rerouting: With hospital systems down, many facilities could not accept new patients, leading to ambulances being rerouted to other hospitals. This delayed critical care and strained the resources of neighboring healthcare facilities.
- Surgery cancellations: Elective and non-emergency surgeries were postponed or canceled altogether at some hospitals, like Mass General Hospital. The inability to access patient records and ensure the availability of necessary resources made it unsafe to proceed with scheduled surgeries.
Nurses' response: pivoting processes
In the early hours of Friday, July 19, calls started to flood in at the University of Vermont Health Network service center. Nurses and staff across the system’s six hospitals and numerous clinics were reporting trouble accessing EHR systems, according to Julie Jones, MS, RN, NI-BC.
“At approximately 1:00 a.m., an incident command center was activated in response to these reports, prompted by what we colloquially refer to as the ‘blue screen of death’ appearing on our computers,” she said.
Downtime procedures were promptly initiated, including transition to paper documentation protocols. But additional challenges persisted.
“Even our downtime computers, intended to facilitate essential functions such as tracking patient admissions, were impacted by the technical malfunction,” Jones said. “This situation underscored the severity and urgency of the disruption, requiring coordinated efforts to maintain continuity of care for our patients.”
Challenges faced during the Microsoft outage
According to reports from Healthcare IT News, the outage also revealed several critical vulnerabilities in hospital operations:
- Limited access to diagnostic tools: The inability to access digital diagnostic tools meant that nurses and doctors had to rely on less efficient manual methods, which delayed patient diagnoses and treatment.
- Difficulty in tracking patient locations: With EHR systems down, keeping track of patient locations within the hospital became challenging, complicating care coordination.
- Increased workload: The transition to manual processes increased the workload for nurses, who had to manage their usual patient care responsibilities and additional documentation tasks.
How nurses can prepare for future software outages
Preparing for situations like the CrowdStrike and Microsoft outage is crucial for healthcare facilities and systems to ensure that patient care continues uninterrupted — no matter what. A key way to do that is through drills and practice scenarios.
“Conducting downtime drills is crucial. These simulations simulate real-world scenarios, allowing nurses to practice using paper-based documentation and familiarize themselves with alternative workflows,” Jones said.
The American Nursing Informatics Association, where Jones serves as a regional director, offers a toolkit designed specifically for such situations. This resource equips nurses with guidelines and templates to effectively manage patient care during downtimes, ensuring they can quickly adapt and maintain high standards of care, she said.
Nurses can also attend webinars hosted by the association for insights and updates on best practices to stay informed and prepared to handle technological interruptions effectively.
“By embracing these resources and practices, nurses can enhance their readiness and resilience when faced with unexpected system failures, ultimately safeguarding patient safety and continuity of care,” Jones said.
Other strategies and tips to help nurses navigate such situations more effectively include:
Maintaining a stock of supplies
Ensuring that adequate supplies of paper charts, forms, and other necessary materials are always available is crucial.
- Paper forms: Stocking various patient care forms, including MARs, vital signs sheets, and assessment forms
- Writing supplies: Keeping a sufficient supply of pens, clipboards, and other writing tools
- Backup power sources: Having backup power sources for essential equipment, such as battery-operated blood pressure monitors
Strengthening teamwork and support
Strong teamwork and support systems can help mitigate the impact of outages. Nurses should:
- Foster a collaborative environment: Encouraging open communication and teamwork among staff members
- Provide support and mentorship: Offering guidance and support to colleagues who may be less experienced with manual processes
- Share experiences and lessons learned: Discussing past outages and sharing effective strategies and tips to improve preparedness
Investing in robust IT infrastructure
Hospitals should also invest in healthcare cybersecurity to minimize the impact of future outages. This includes:
- Redundant systems: Implementing backup systems and redundancies to ensure that critical functions can continue even if primary systems fail
- Regular updates and maintenance: Keeping software and hardware up to date and conducting regular maintenance to prevent outages
- Cybersecurity measures: Strengthening cybersecurity measures to protect against cyberattacks that could cause system outages
The recent software outages served as a stark reminder of the vulnerabilities in our increasingly digital healthcare systems. For nurses, the ability to adapt quickly and effectively is essential.
By understanding the challenges faced during these outages and implementing proactive measures, nurses can better prepare for future disruptions, ensuring that patient care remains uninterrupted and of the highest quality.
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