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Lego builds anaesthesia skills according to new study

Lego could be used as a practical tool to train doctors in anesthetic skills according to new research that has shown a simple task using the building bricks can help improve technical skills—a finding that could improve medical training and patient safety.

Scientists from the University of Nottingham's School of Psychology and School of Medicine developed a task where people copied shapes using bricks that they could see in a mirror. They found this simple training improved student performance in an ultrasound-guided regional anesthesia task. The results of the study have been published in British Journal of Anesthesia

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Largest Independent Randomized Controlled Trial of a Digital Therapy against Chronic Pain

In the largest independent randomized controlled trial (RCT) of its type, a multimodal digital therapy program for patients with non-specific chronic low back pain has outperformed standard-of-care treatment across all medical outcomes.

Results of the study, published in the Journal of Pain Research, show that patients using Kaia, the back pain management app developed by leading digital therapeutics company Kaia Health, reduced pain levels, anxiety, depression, stress, and improved wellbeing and body functionality significantly more compared to standard-of-care treatments, e.g. pain killers, surgeries, physical therapy.

“This large-scale study demonstrates the significant benefits for people managing low back pain when using Kaia to deliver a multimodal treatment through a digital device, such as a smartphone,” says Thomas R. Toelle, M.D., Ph.D., Head of the Pain Center of the Technical University Munich, Germany. “These results add to the growing body of medical evidence that supports the use of digital multimodal treatments for chronic conditions, such as back pain.”

Low back pain is one of the leading causes of global disability, with an enormous cost for healthcare systems worldwide. 1,2 According to a 2018 report on the impact of musculoskeletal pain on employers, chronic pain, including back pain, accounts for 188.7 million lost work days, and $62,4 billion in lost productivity cost.3

Kaia is an app-based, multimodal digital therapy program for chronic back pain, which focuses on Physical therapy, Relaxation exercises, and Medical education.

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'We will live with this for years': virus expert on debilitating after-effects of Covid-19

One of the world’s foremost virus experts has said survivors will be living with the effects of Covid-19 for “years to come” after he was struck down by a severe infection, and called for added support for those who have recovered from the disease. 

Professor Peter Piot, who as director of the London School of Hygiene and Tropical Medicine has been at the forefront of the academic response to the pandemic, has spent his entire career studying viruses such as Ebola and HIV. 

Prof Piot spent a week at the Royal Free Hospital in London in early April after contracting the disease. “I spent a week in isolation on a ward with three other men. I couldn’t leave the room. When I came out the thing I remember most is seeing the sky. London was deserted - it was in acute lockdown,” he said.

The fever and splitting headache he had felt before being admitted were gone and apart from chronic exhaustion he was feeling better, he said. Getting out of bed was a struggle and he had to take rests when going up the many flights of stairs of his tall Georgian townhouse. But a week later he took a turn for the worse - he became breathless and his heart rate shot up to over 100. 

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Improving patient safety in the NHS with point-of-care scanning

A new report has highlighted how point-of-care scanning in the NHS can help to improve patient safety, saving the NHS millions of pounds.

Six NHS hospital trusts which implemented regular point-of-care scanning have ensured complete traceability of healthcare items to help improve patient safety while securing millions of pounds of savings and releasing thousands of hours of clinical time, a new report reveals.

‘A scan of the benefits: the Scan4Safety evidence report’ details the results at hospital trusts that took part in a national two-year programme, known as Scan4Safety, to investigate the benefits of point-of-care barcode scanning in the NHS.

Full article here

We wonder if @Richard Price might like to post more about what the impact of Scan4safety has been at University Hospitals Plymouth. Perhaps here:
https://www.pslhub.org/learn/commissioning-service-provision-and-innovation-in-health-and-care/digital-health-and-care-service-provision/other-health-and-care-software/ 

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Investigation launched into safety of maternity equipment used in NHS

A national investigation has been launched into the equipment used by NHS staff to monitor babies heart rates during labour because of concerns they could be contributing to deaths and disabilities.

The independent Healthcare Safety Investigation Branch (HSIB), which investigates systemic safety risks in the NHS, has opened an inquiry after reviewing hundreds of maternity incidents.

It found equipment used to record cardiotocographic (CTG) traces were linked to 138 maternity investigations since 2018 with more than 238 separate findings referencing the use of CTG as a factor in the error.

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CDC: One-third of COVID-19 patients who aren't hospitalized have long-term illness

The Centers for Disease Control and Prevention acknowledged last week that a significant number of COVID-19 patients do not recover quickly, and instead experience ongoing symptoms, such as fatigue and cough.

As many as a third of patients who were never sick enough to be hospitalized are not back to their usual health up to three weeks after their diagnosis, the report found.

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NHS maternity safety to come under investigation after scandals involving mother and baby deaths

The safety of maternity services in the NHS are to be investigated by MPs after a string of scandals involving the deaths of mothers and babies highlighted by The Independent.

The Commons health select committee, chaired by former health secretary Jeremy Hunt, has announced it will hold an inquiry looking at why maternity incidents keep re-occurring and what needs to be done to improve safety.

The committee will also examine whether the clinical negligence process needs to change and the wider aspects of a “blame culture” in the health service and its affects on medical advice and decision making.

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New patient safety research by Northumbria University achieves global accolades

Looking to improve practice through learning

Errors, mishaps and misunderstandings are surprisingly common in medicine and around one in 10 patients suffer avoidable harm, impacting on patients, their families, health care organisations, staff and students. However a research project seeking to improve patient safety across Europe, led by Newcastle-based Northumbria University, has received international acclaim as it looks to improve practice through learning.

The SLIPPS (Shared Learning from Practice to improve Patient Safety) project is Co-funded by the Erasmus+ Programme of the European Union, and is led by Professor Alison Steven, a Reader in Health Professions Education at Northumbria University.  Professor Steven has a longstanding interest in the use of education to raise standards of care and ensure patient safety. Considering the rapid spread of Covid 19, she says improving patient safety and standards of care across Europe and beyond, has never been more important.

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Most people in England to be offered flu vaccine

Most people in England, about 30 million, are to be offered a free flu vaccine this year, the government says.

It is to prepare for a winter that could see the annual flu season coincide with a surge in coronavirus.

The traditional flu programme will include all over-50s for the first time, as well anyone on the shielding list and the people they live with.

Also for the first time, children in their first year of secondary school will all be offered the vaccine.

Plans for Scotland, Wales and Northern Ireland have not yet been announced.

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How to support loved ones in hospital during the coronavirus pandemic

To help stop the spread of the coronavirus that causes COVID-19, the majority of hospitals have stopped or severely restricted visits. This article explains how you can still help a loved one even when you can't see them face to face.

During the coronavirus crisis, most hospitals and care homes in the UK have stopped visits. If you have a loved one in a healthcare setting, not being able to go to see them will be incredibly difficult. But these temporary measures have not been taken lightly. Restricting visits to hospitals and care homes is important to reduce the spread of the virus that causes COVID-19 as much as possible. This way hospital and care home residents, and healthcare staff, can be better protected during the pandemic.

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A third of GP practices may take year or longer to return to pre-Covid capacity

A third of GPs believe it will take up to a year or longer for their practice to return to pre-Covid levels of capacity, even with ‘no future spikes’ of the virus.

The data comes from the BMA’s latest COVID-19 tracker survey, which polled almost 2,000 GPs in England and Wales.

GPs have previously warned that they are battling a backlog of referrals and patients who have been ‘overlooked’ during the coronavirus crisis.

Around 26% of the 1,770 GP respondents said consultations would take between three and 12 months to return to normal when asked how quickly their practice will ‘return to full pre-Covid levels of capacity... assuming there are no future Covid spikes’.

And a further 7% of GPs believed it could take ‘longer’ than a year or that consultations would ‘never’ return to pre-Covid levels.

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Source: Pulse, 23 July 2020

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Covid-19: Government failed to protect staff during height of pandemic, experts tell MPs

Healthcare staff working at the height of the covid-19 pandemic in England were not properly protected and were forced to work in an unsafe environment, MPs have been told.

Appealing before the health and social care committee on 21 July, experts criticised the government and NHS management for their failure to provide staff with sufficient testing and personal protective equipment (PPE). The committee was gathering evidence for its inquiry into the management of the COVID-19 outbreak.

Paul Nurse, director of the Francis Crick Institute, said he believed that the failure to implement better testing systems in the early days of the pandemic had contributed significantly to the problems.

He said, “At the height of the pandemic, our own research—which backs up what’s been done elsewhere—found that up to 45% of healthcare workers were infected and they were infecting their colleagues and infecting patients, yet they weren’t being tested systematically.

“In the healthcare environment we weren’t providing proper protection, and it’s important because it protects the most vulnerable in our society and it protects our healthcare workers. They deserve to work in a safe environment, and some of them are dying because of what they do. They deserve better.”

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Source: BMJ, 22 July 2020

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Regulator launches independent review into care of vulnerable man

NHS England and Improvement have launched an independent review into the care and death of a man with learning disabilities, following concerns raised by HSJ. 

The regulator has appointed Beverley Dawkins to carry out an independent review of the case of Clive Treacy, as part of the learning disability mortality review programme.

Clive, who died in 2017, had previously been denied a review under LeDer and, according to emails seen by HSJ, his death was never officially recorded by the programme, which is meant to record all deaths of people with a learning disability.

NHS England and Improvement overturned the decision earlier this year after HSJ presented evidence of a series of failures in his care between 2012 and 2017.

Today, it was confirmed to us that Ms Dawkins has been commissioned to carry out the review, and that it would review his care throughout his life, as well as his death.  

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Source: HSJ, 23 July 2020

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Mental health leave for paramedics in England nearly triples since 2011

The number of paramedics taking time off with mental health conditions has almost tripled over the last decade, a Guardian analysis has found.

In 2019, paramedics took 52,040 days off due to anxiety, stress, depression and other psychiatric illnesses, up from 18,184 in 2011 – an increase of 186%.

While the overall number of paramedics has increased slightly over the period, the rate of mental health leave has increased more, resulting in the average number of days taken off per paramedic in a year rising from 2.8 to 5.8.

Unison’s head of health, Sara Gorton, said: “Crisis-level staffing has increasingly become the norm within the NHS in recent years, even before the pandemic. Working long hours without breaks, in demanding conditions, it’s no wonder it’s taken a toll on the mental health of workers across the health service. And the coronavirus challenges have piled on more pressure.”

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Source: The Guardian, 23 July 2020

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All patients' Covid test results to become visible to GPs

GP systems will now be updated in 'near-real time' to reveal the result of Covid-19 tests taken by all of their patients.

GPs will not need to act on the information, which will be visible on systems whether the patient tested positive or negative. This will apply to all patients where it has been possible to identify the patient's NHS number, NHS Digital said.

EMIS Health chief medical officer Shaun O’Hanlon said: "Technology has played a pivotal role in the response to COVID-19 across the board and keeping the medical record up to date with COVID-19 test results means everyone who can share that record has a full picture of the patient’s health, including the patient themselves via Patient Access."

"This will not only help day to day patient care, and it will also help on a wider population health level, as data-led insight relies on full and complete medical records as analysts continue to research COVID-19 and its short- and long-term impact on the nation."

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Source: Pulse, 20 July 2020

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SECAmb introduces new spinal care guidelines

South East Coast Ambulance Service NHS Foundation Trust (SECAmb) is the first ambulance service in the country to introduce new pioneering guidance aimed at improving the treatment of spinal injury patients.

The guidance includes the ending of the use of neck braces or semi-rigid collars on spinal injury patients. The ground-breaking approach is only currently in place in three other countries – Australia, Norway and Denmark. While collars are often seen as synonymous with spinal care, there is growing evidence that they could cause further harm, while providing little or no benefit.

Instead, for ‘standard patients’, spinal precautions will be undertaken with manual in-line stabilisation followed by head blocks, tape and placement on a scoop stretcher secured in a non-rigid vacuum mattress.

For a group of ‘non-standard’ patients – which may include older patients, those who are frail or have pre-existing spinal conditions, those with communication difficulties, pregnant patients, young children, bariatric patients or agitated and uncooperative patients – transport on a scoop stretcher is not beneficial. In these cases, a position of comfort approach will be used to minimise spinal motion and a special lanyard will be applied to the patient in order to alert the receiving emergency department of the patient’s status.

Soon to be adopted nationally by the Joint Royal Colleges Ambulance Liaison Committee, (JRCALC), SECAmb has been assigned as an ‘early adopter’ while the national guidelines are formalised.

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Source: South East Coast Ambulance Service, 15 July 2020

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Four in ten anaesthetists fear for safety of their hospitals, poll finds

More than 4 in 10 anaesthetists are not convinced their hospitals would be able to provide safe services should there be a second wave of COVID-19, a new survey has indicated.

A survey of members of the Royal College of Anaesthetists (RCOA) showed 44% of respondents were not confident their hospitals would be able to provide safe covid and non-covid services should there be a second surge of infections.

The survey also showed levels of mental distress and morale were worsening among anaesthetists – many of whom were drafted into intensive care units during the first wave. Almost two-thirds of respondents (64%) said they had suffered mental distress in the last month due to the pressures faced during the COVID-19 pandemic.

Now the college is calling on the NHS to plan intensively for a second covid wave and to identify, train and maintain the skills of cross-specialty “reservists” – including current clinicians, recent retirees and senior trainees — who can support the health service in the event of future surges. 

One anaesthetist told the RCOA they were “exhausted with constantly having to think about covid and protecting yourself” and “struggling with the realisation that PPE is here to stay for some time.” Another said: “We have burned out our human resource. We need a period of rebuilding or patient harm will result.”

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Source: HSJ, 22 July 2020

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Coronavirus: NHS nurses told 'lives would be made hell'

Hospital nurses were told their "lives would be made hell" if they complained over conditions on a coronavirus ward, a union has claimed.

Unison has raised a group grievance for 36 employees, most of them nurses, at Nottingham University Hospitals Trust. It said staff on the Queen's Medical Centre ward were not trained properly, faced bullying for raising concerns and denied PPE "as punishment".

The trust said the allegations were "very troubling".

The union said the staff, which included nurses, senior nurses and healthcare assistants, volunteered to work on the hospital's only ward dealing with end-of-life coronavirus patients. It claimed they were not given any specialist training or counselling for dealing with dying patients and their grieving relatives.

An anonymous member of staff described it as "incredibly stressful".

Another worker said a board with everyone's record of sickness was put on display in a break room to intimidate staff.

Dave Ratchford from Unison said: "This is absolutely shocking stuff. We're talking about a very high-performing team who fell foul of a culture that permits bullying and fails to address it"

"Staff were told their lives would be made hell for complaining."

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Source: BBC News, 21 July 2020

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Shrewsbury maternity scandal: Hospital bosses ‘softened’ damning safety report

Hospital bosses at scandal-hit Shrewsbury and Telford Hospital Trust were more concerned with reputation management than addressing patient safety concerns in its maternity department, according to a new NHS investigation.

Families harmed by poor care at the trust have called for chairman Ben Reid to resign after the report by NHS England revealed how senior figures in the trust, including the former chief executive, tried to soften a report into maternity services that raised serious concerns over safety.

The Royal College of Obstetricians and Gynaecologists (RCOG) report was not published until after the college had agreed to an “unprecedented” addendum report 12 months after its inspection in 2017, that presented the trust in a more positive light.

When the final report was made public in July 2018 the addendum was placed at the front of the report.

The original RCOG report warned: “Neonatal and perinatal mortality rates will not improve until areas of poor / substandard care are addressed.”

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Source: The Independent, 22 July 2020

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Global accolades for patient safety research

Research into patient safety across Europe, led by Northumbria University, has received international acclaim.

The SLIPPS (Shared Learning from Practice to improve Patient Safety) project is a major EU-funded project led by Professor Alison Steven, a Reader in Health Professions Education at Northumbria University. It seeks to improve European patient safety and education across a range of clinical settings.

Errors, mishaps and misunderstandings are common and around one in 10 patients suffer avoidable harm. These incidents impact upon patients, their families, health care organisations, staff and students. SLIPPS is responding to the challenge to improve patient safety education.

Professor Steven has a longstanding interest in the use of education to raise standards of care and ensure patient safety. Considering the rapid spread of COVID-19, she says improving patient safety and standards of care across Europe and beyond, has never been more important.

“Patient safety is paramount in these extreme circumstances,” said Professor Steven. “The SLIPPS project is unique in that it taps into students’ experiences. These students on practice placements have the potential to offer fresh perspectives on clinical practices, and with so many final-year students treating patients on the front line during this global pandemic, their current views on patient safety are more important than ever.”

The project utilises real-life experiences and students’ reflections on them as the basis for a range of educational resources which feed into an open access virtual learning centre for international, multi-professional learning about patient safety.

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Source: Northumbria University Newcastle, 20 July 2020

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Hundreds more potentially avoidable baby deaths found at Shropshire NHS trust

Hundreds more cases of potentially avoidable baby deaths, stillbirths and brain damage have emerged at an NHS trust, raising concerns about a possible cover-up of the true extent of one the biggest scandals in the health service’s history.

The additional 496 cases raise further serious concerns about maternity care at Shrewsbury and Telford hospital NHS trust since 2000.

The cases involving stillbirths, neonatal deaths or baby brain damage, as well as a small number of maternal deaths, have been passed to an independent maternity review, led by the midwifery expert Donna Ockenden. They bring the total number of cases being examined to 1,862.

They will also be passed to West Mercia police, which last month launched a criminal investigation into the trust’s maternity services. Detectives are trying to establish whether there is enough evidence to bring charges of corporate manslaughter against the trust or individual manslaughter charges against staff involved.

The extra 496 cases had not emerged until now because an “open book” initiative led by the NHS in 2018 asked only for digital records of cases identified as a cause for serious concerns. The vast majority of the 496 further cases were recorded only in paper documents.

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Source: The Guardian, 21 July 2020

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Kent and Medway: Dermatology patients 'exposed to risk of harm'

A private company carrying out dermatology services has had its contract suspended by the NHS over concerns about patients safety.

DMC Healthcare ran the service which oversaw the care of almost 2,000 patients in north Kent and Medway for more than a year. NHS bosses says those patients may have been harmed and the contract was suspended in June.

A helpline has been set up to ensure affected patients are seen by GPs and follow-up treatment can be arranged.

Paula Wilkins, Chief Nurse at Kent and Medway Clinical Commissioning Group, said: "In mid-June we suspended most of DMC's dermatology service when we became concerned about patient safety."

"I'm very sorry to say, we now know there have been delays in appointments, including for the diagnosis and treatment of cancers, and that has exposed people to the risk of harm."

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Source: BBC News, 21 July 2020

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‘Almost half of healthcare workers had covid-19’ at some hospitals

Almost half of healthcare workers at some hospitals were infected with COVID-19 during the height of the first wave, the director of a biomedical research centre has told MPs.

Sir Paul Nurse, director of the Francis Crick Institute, told MPs today that COVID-19 had infected up to 45% of healthcare workers during ”the height of the pandemic” at some hospitals, according to the centre’s research.

Chief medical officer Chris Whitty also told the Health and Social Care Committee that there was more evidence that COVID-19 was transmitted between staff, rather than from patients to staff, and there was “just as much risk as people being in their break rooms than on wards”.

Sir Paul told MPs the Francis Crick Institute contacted Downing Street in March and wrote to health secretary Matt Hancock in April to emphasise the importance of regular systematic testing for all healthcare workers as it was “quite clear” that those without symptoms were likely to be transmitting the disease.

He said hospital staff “were infecting their colleagues, they were infecting their patients, yet they were not being tested systematically.”

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Source: HSJ, 21 July 2020

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Culture of bullying, harassment and discrimination in medicine still widespread in Australia

One in three trainee doctors in Australia have experienced or witnessed bullying, harassment or discrimination in the past 12 months, but just a third have reported it.

That's according to a national survey of almost 10,000 trainee doctors released today by the Australian Health Practitioner Regulation Agency (AHPRA).

The results of the survey, co-developed by the Medical Board of Australia (MBA), send a "loud message" about bullying and harassment to those in the medical profession, said MBA chair Anne Tonkin.

"It is incumbent on all of us to heed it," Dr Tonkin said. "We must do this if we are serious about improving the culture of medicine."

"Bullying, harassment and discrimination are not good for patient safety, constructive learning or the culture of medicine," Dr Tonkin continued. "We must all redouble our efforts to strengthen professional behaviour and deal effectively with unacceptable behaviour."

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Source: ABC News, 10 February 2020

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