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Keep up to date with the latest news, research and activity in patient safety.

US nurses to hold informational picket for patient safety at West Anaheim Medical Center

Registered nurses (RNs) at US Prime Healthcare’s West Anaheim Medical Center (WAMC) will hold an informational picket today to protest chronic short staffing and its impact on safe patient care.
Nurses say that the hospital should cancel elective surgeries because those beds and nurses are needed for other emergent patients. RNs in all medical departments are short-staffed, putting patient safety in jeopardy.
“Nurses are under incredible pressure to care for patients beyond the state’s mandated safe staffing ratios due to the staffing crisis in our hospital,” said John Olarte, RN at WAMC. “The employer should be making beds available by canceling elective surgeries for the foreseeable future. Save those beds for the patients who most need them and at the same time give the RNs a chance to truly care for these patients by not forcing nurses to take patients that don’t need to be in the hospital right now. The public needs to know that the hospital is not doing everything they can to help the nurses care for patients.”
“There is a staffing crisis because RNs are leaving,” said Sofia Rivera, RN in the emergency department at WAMC, “To attract and retain quality nurses — just staff the floors so the RNs do not have to pick up multiple extra shifts due to the revolving door of RNs in this hospital.”
Nurses say they want a strong contract so they can recruit and retain RNs and they want to establish a health and safety committee to ensure they have a voice on issues of nurse safety and patient care. They have been in contract negotiations since May 2021. Their contract expired in June 2021.
“We are getting slaughtered in the ER,” said Rasha Tran, RN. “Ambulances are just leaving their patients in the ER instead of waiting for an available bed because they are waiting too long. I don’t even know how we can sustain this demand to care for so many patients. It means less care for each patient. Continuing elective surgeries means that a regular bed is not available for a patient in the ER who is now is being held for hours or days before they are admitted. Even before this most recent Covid surge, nurses have been picking up extra 12-hour shifts to help our coworkers, often without a break for meals or rest periods.”
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Source: National Nurses United, 11 February 2022
Patient Safety Learning

Masks 'aggravated' fatal dosage miscommunication at Watford Hospital

Masks worn by doctors "aggravated" a miscommunication over the dose of an anti-epileptic drug that resulted in a man's death, a coroner has warned.
John Skinner died at Watford General Hospital in May 2020.
A coroner has written a Prevention of Future Deaths Report (PFDR) saying he feared the same could happen at other hospitals if action was not taken.
Assistant Coroner for Hertfordshire, Graham Danbury, said in the report: "As a result of failure in verbal communication between the doctors, aggravated as both were masked, a dose of 15mg/kg was heard as 50mg/kg and an overdose was administered."
Mr Danbury, writing to NHS England, said: "This is a readily foreseeable confusion which could apply in any hospital and could be avoided by use of clearer and less confusable means of communication and expression of number."
A spokesperson for West Hertfordshire Hospitals NHS Trust said: "A comprehensive action plan is in place to ensure that lessons are learned from this incident."
Read full story
Source: 15 February 2022
Patient Safety Learning

Doctors call for action not words from NHS in response to racial inequality report

Health officials have “paid lip service” to racism in the NHS for years, leading black, Asian and minority ethnic doctors have warned as they called for “concrete” action to tackle inequalities exposed by a landmark review.
The damning study – the largest of its kind – had found “vast” and “widespread” inequity in every aspect of healthcare it reviewed, and warned that this was harming the health of minority ethnic patients in England.
In response, an NHS spokesperson said the health service was “already taking action” to improve the experiences of patients and access to services and was working “to drive forward” the recommendations made in the report.
However, Dr JS Bamrah, a consultant psychiatrist in Greater Manchester and national chairman of the British Association of Physicians of Indian Origin, said he was unsatisfied with the response.
“This 166-page review … is a terrible indictment of the current state of the NHS,” he told the Guardian. “As many of us have often said and reported, we don’t need any further reports. It’s action we need, as there are scores of patients who are not getting optimal treatment, and many are being neglected.
“It really isn’t good enough for NHS bosses to say that action is being taken and it’s even more disappointing to then not see any concrete proposals on dealing with glaring disparities despite all that we have learnt during the pandemic.”
Dr Rajesh Mohan, presidential lead for race and equality at the Royal College of Psychiatrists, said it was “time for warm words to end” as he urged NHS leaders to “do everything they can to ensure patients from ethnic minority backgrounds get the care they need”.
Read full story
Source: The Guardian, 15 February 2022
Patient Safety Learning

Call 999 over early heart attack symptoms, urges new NHS campaign

A life-saving campaign is being launched by the NHS to urge people to learn how to spot signs of a heart attack.
The survival rate for heart attack sufferers is seven in 10, rising to nine in 10 for those who have early hospital treatment.
The most common sign of a heart attack is chest pain, but other symptoms to look out for include chest, arm, jaw, neck, back and stomach pain, lightheadedness or dizziness, sweating, shortness of breath, nausea, vomiting, anxiety, coughing and wheezing.
The health service are encouraging anyone experiencing these indicators to call 999.
It comes after a poll found found that fewer than half of people knew to dial 999 if they or a loved one experienced the more vague signs of a heart attack.
Another priority of the campaign is to teach people how to differentiate between a heart attack and cardiac arrest.
According to the health service, there is often no warning and the person quickly loses consciousness when they suffer cardiac arrest.
Those experiencing a cardiac arrest will usually die within minutes if they do not receive treatment.
It also points out that a heart attack can lead to a cardiac arrest.
NHS medical director Professor Stephen Powis said: “Sadly, cardiovascular disease causes a quarter of all deaths across the country and we have identified this as the single biggest area where we can save lives over the next decade.
Read full story
Source: 13 February 2022
Patient Safety Learning

Surgery delays: Man feels forgotten after six-year wait

A County Tyrone man who has been waiting six years for a gall bladder operation has said he feels forgotten about by the health service.
John Doherty, 55, said he could not understand why he was unable to get updates on his operation.
BBC News NI can reveal almost 475,000 people are waiting for surgery or to see a consultant for the first time.
The Royal College of Surgeons wants patients to be told how long they will have to wait for treatment.
Mr Doherty said he felt anxious and depressed waiting for a telephone call from his local hospital and blamed the government for "letting him down".
"I feel forgotten about, they don't even get in touch with you, not even a letter to say it could happen three months down the line... they say they'll phone back but never do," he added.
"I feel neglected."
Mark Taylor, a consultant surgeon, people who had been languishing for years on lists deserved to know when to expect their surgery so they could attempt to get in shape for it.
He said about a one third of operations had to be cancelled daily as a result of people not being ready, either their blood pressure was too high, they were overweight or their diabetic control was not right.
"Pre-habilitation schemes can help to get patients ready for their operation as much as possible, a more personalised pre operation plan is required," he said.
Mr Taylor called on the government to have a proper conversation with the public about how hospitals might look in the future.
"This is not about closure, this is about the redesign and re-profiling of hospitals to get maximum gain," he said.
Read full story
Source: BBC News, 15 February 2022
Patient Safety Learning

GPs each seeing 15% more patients, BMA says

The average number of patients each individual GP is responsible for has increased by 15%, or around 300 people, since 2015, the BMA has said.
This is due to the ‘slow but steady haemorrhaging’ of GPs over the last few years, which has led to pressures on services growing ‘even more acute’, it suggested.
The Association’s statement comes in response to the latest GP workforce data – published by NHS Digital (10 February) – which showed that 188 FTE GPs left between December 2020 and December 2021.
Dr Farah Jameel, chair of the BMA’s GP committee, said the figures are the direct result of an ‘over-stretched’ and ‘under-resourced’ NHS.
She said: ‘Family doctors, exhausted and disenchanted, feel as though they have no choice but to leave a profession they love because of chronic pressures now made worse by the pandemic. Workload has dramatically increased, there are fewer staff in practices to meet patient needs.’
Insufficient staffing is particularly concerning as the backlog for care continues to grow, she suggested, with many GPs believing ‘the day job is just no longer safe, sustainable or possible anymore’.
The NHS and the Government must work to retain current staff as its ‘immediate priority’ and must urgently refocus on retention strategies as a key enabler for the NHS’ recovery.
She said: ‘The Government has repeatedly argued that the number of doctors is growing, but this isn’t the reality for general practice, and it begs the question: how many more have to go before something is finally done about it? Our NHS is the people who work in it, and without them, the entire system and provision of patient care is under threat.’
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Source: Management in Practice, 11 February 2022
Patient Safety Learning

USA: Alhambra Hospital nurses ratify a new contract with improvements for patient safety and nurse retention

Registered nurses at Alhambra Hospital Medical Center in Los Angeles, California, voted overwhelmingly in favor of ratifying a new three-year contract yesterday, winning protections to improve patient safety and nurse retention.. The collective bargaining agreement was the result of an almost six-month fight, which included an informational picket for patient safety and multiple other actions.
So Hee Park, an ICU nurse at Alhambra, said, “We are so thrilled that after months of negotiations, we have ratified an agreement that provides substantial measures to ensure nurses feel supported and can continue to provide optimal patient care, as well as numerous provisions that will improve recruitment and retention of experienced nurses.”
The contract includes several highlights that will help nurses create better outcomes for their patients, such as provisions for ensuring hospital compliance with existing registered nurse-to-patient safe staffing laws. The agreement also establishes a new Infectious Disease Task Force that will offer new protections against communicable diseases and guarantee levels of PPE supplies. The contract also expands workplace violence prevention plans for all hospital units, as well as stating that quality care be provided to all patients regardless of their immigration status.
Under the contract, nurses will also receive proper orientation when they’re floated to new hospital units, improving care for patients. And, rather than being sent home at management's whims, RNs will be able to remain at work to provide meal and break relief to other nurses, bolstering safe staffing. These measures will ensure nurses are prepared to provide patients with the highest and safest levels of care possible, resulting in improved nurse retention at Alhambra, which will benefit the entire community long term.
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Source: National Nurses United, 10 November 2022
Patient Safety Learning

Waits for diagnosis and decision rise to over 38 weeks

Waiting times to diagnosis and decision rose by more than a week in December, reaching 38.6 weeks at month end. This matters because many urgent conditions are only detected when the patient reaches diagnosis, including nearly a quarter of all cancers, and such very long waits put those patients at risk.
Looking at the whole referral-to-treatment waiting list, which includes patients who have a diagnosis and decision, waiting times remained roughly steady at 43.4 weeks, compared with the standard of 18 weeks that is still required by legislation. Waiting times are a function of both the size and shape of the waiting list, and in December the former got worse and the latter improved.
There were 6,067,326 patients on the waiting list as December ended, which is the first time the official figures have topped six million. As many as 310,813 of them had waited over a year (strictly, 52 weeks), and 20,065 over two years (104 weeks). The NHS’s backlog recovery plan has committed that “By July 2022, no one will wait longer than two years for an elective treatment”.
Read full story (paywalled)
Source: HSJ, 10 February 2022
Patient Safety Learning

Majority of ‘last resort’ ambulance diverts reported by only two trusts

Two acute trusts account for almost two-thirds of emergency department ‘diverts’ reported over the last two months.
Between the start of December and the start of February, Worcestershire Acute Hospitals Trust and University Hospitals Sussex Foundation Trust implemented 122 temporary “diverts” between them – representing around 60% of the national total.
The measure is taken when a particular site, such as Worcestershire Royal or Royal Sussex County Hospital, comes under significant pressure and ambulances are temporarily directed to an alternative hospital, usually within the same trust.
NHS England guidance says diverts of emergency patients due to lack of physical or staff capacity to deal with attendances or admissions “should be an action of last resort” and that this “should only need to happen in exceptional circumstances, where internal measures have not succeeded in tackling the underlying problem”.
Helen Hughes, chief executive of Patient Safety Learning, said: “For ambulance services, the impact of A&E diverts is two-fold. It both increases the length of journeys that crews have to make once a divert is implemented, and increases the travel time required to get back to subsequent emergency calls."
“This has the potential to increase waiting times for patients, increasing the risk of avoidable harm, particularly for those who are seriously ill, frail or elderly.”
Read full story (paywalled)
Source: HSJ, 15 February 2022
Patient Safety Learning

Concerns over 'enormous' backlog for NHS dentistry

Scotland's dental leaders say the backlog for patients getting NHS treatment is "enormous".
Official data shows people in more affluent areas of Scotland were much more likely to be seen by a dentist in the last two years compared to poorer communities.
Meanwhile, patients on long waiting lists are resorting to costly private treatment in order to be seen sooner.
The Scottish government said it was committed to tackling the pandemic-related backlog in routine dental care.
The shutdown of dental services in the early days of Covid, and then severe restrictions on working practices meant emergency care was prioritised in Scotland.
Denise Hesketh is one of thousands of Scots who couldn't see a dentist during the start of the pandemic.
The 58-year-old from Edinburgh has battled dental problems for years, but being unable to see a dentist during Covid meant her oral health has taken a turn for the worse.
She told BBC Scotland: "It was over a year before I was able to see a dentist and by then it just got too bad. Everything was unstable. It needn't have happened - it could have been repaired."
She now faces a bill of £20,000 for private care, with her NHS dentist unable to offer any help.
Some patients have raised fears that those who pay for private dental treatment are being prioritised.
BBC Scotland has seen an email to patients from one practice in Lanarkshire. It states "Due to NHS restrictions and waiting lists on routine care… there are other options for check-ups for adults and children to pay privately".
Read full story
Source: BBC News, 16 February 2022
Patient Safety Learning

‘Don’t overwork staff’, says trust with just one 52-week waiter

Allowing staff enough rest has been ‘the key’ to elective recovery for an acute trust which has the lowest number of 52-week waiters in England, it has said.
Maidstone and Tunbridge Wells (MTW) Trust currently has just one patient who has waited 52 weeks or more on its lists, compared with a high of 976 at one point in April 2021.
MTW is one of a handful of trusts with very few long waiters. All are relatively small trusts – and are not regional centres for specialist/tertiary patients – but their 52-week-waiters also represent less than 1% of their total list.
MTW chief of service for the surgery division Greg Lawton told HSJ its success in tackling long waiters was down to “attention to detail” in tracking each patient, and not expecting staff to run too many extra sessions.
“Any problems patients are having getting through their pathways are identified early and addressed,” he said. "Treatment had been prioritised on the grounds of clinical need, he added, with cancer treatments still going ahead and cancer targets being met."
The trust, in the South East, has put on extra operating sessions to clear some of its backlog of patients but these had been limited in number, Dr Lawton said.
“What we have never done is try to run too many and I think that may be the key. If you try to do too much you will burn staff out,” he said. The trust had “been mindful that staff need a break,” he added. “Morale is very important.”
Read full story (paywalled)
Source: HSJ, 16 February 2022
Patient Safety Learning

Lassa fever: Patient who died in UK ‘was newborn baby’

A patient who died from Lassa fever last week was a newborn baby, according to reports.
The UK Health Security Agency (UKHSA) confirmed on Friday that an individual with the Ebola-like disease had died in Bedfordshire, and that two other people  were infected.
All three cases were linked to recent travel in West Africa.
The BBC said the fatality had been an infant at Luton and Dunstable Hospital, quoting an email sent to staff by Cambridge University Hospitals NHS Trust.
Hundreds of frontline workers at the hospital, as well as at Addenbrooke’s Hospital in Cambridge, were reportedly told to isolate after being identified as potential contacts.
Lassa fever is an acute viral infection endemic in parts of Africa, and the UKHSA has assured the public that the risk of further infections in the UK remains “very low”.
Read full story
Source: The Independent, 15 February 2022
Patient Safety Learning

Vaccinated less likely to develop Long Covid

People who are vaccinated are less likely to develop Long Covid even if they catch the virus, a rapid review by the UK Health Security Agency reveals.
It looked at the available evidence to date from 15 studies around the world.
The findings suggest that while some who are jabbed catch Covid, vaccines reduce infection risk and illness, including symptoms like fatigue.
And unvaccinated people who catch Covid and get symptoms of Long Covid, do better if they then get vaccinated.
Vaccine effectiveness against most Long-Covid symptoms was highest in people aged 60 years and over
In people who already had Long Covid symptoms, it found that vaccines may improve rather than worsen Covid symptoms, either immediately or over several weeks
According to the UK Health Security Agency (UKHSA), around 2% of the UK population have reported symptoms of Long Covid, such as fatigue, shortness of breath and muscle or joint pain.
Symptoms like these can last for more than four weeks after the infection.
Read full story
Source: 15 February 2022
Patient Safety Learning

Sanction against 150 doctors for sexual misconduct are ‘tip of the iceberg’, medics warn

Nearly 150 doctors have been disciplined for sexual misconduct in the last five years, as surgeons call for action on the “systemic” and “cultural” problem of sexual assault within healthcare, The Independent can reveal.
Doctors campaigning for the UK’s healthcare services to address widespread problems with sexual harassment and assault in medicine have warned that people do not feel safe to come forward with allegations amid deep-seated “hierarchies” within healthcare.
The Royal College of Surgeons’ Women in Surgery chair has said the issues are “widespread” across the health services and improvements to protecting whistleblowers needed to be made nationally.
Last year, surgeons Becky Fisher and Simon Fleming wrote an academic paper exposing the problem of sexual assault, harassment and rape in surgery and surgical training.
In interviews with The Independent, both have warned the “institutional” problem goes beyond surgery and across all of the healthcare services.
Mr Fleming said the figures from the GMC were the “the very tip of the iceberg” in terms of actual levels of sexual assault within healthcare.
Talking about the role of the GMC, Mr Fleming said he’d been told “by more than one person” that when they’ve reached out to the GMC over sexual assault or misconduct they were “failed” by the regulator and were “either not helped, abandoned or told to deal with it locally”.
Read full story
Source: The Independent, 15 February 2022
Patient Safety Learning

Is it time to live with COVID-19? Some scientists warn of ‘endemic delusion’

As surges of COVID-19 cases driven by the highly infectious Omicron variant recede, parts of the United States, Canada, and Europe are moving swiftly to lift constraints on a pandemic-fatigued public. Sweden, Denmark, and Norway have abolished nearly all ­COVID-19–related restrictions in recent weeks, and the United Kingdom announced it would do the same this month, dropping even the legal requirement that people quarantine after testing positive for SARS-CoV-2. In the United States, despite persistently high numbers of COVID-19–related deaths and busy hospitals, 10 governors, many known for being cautious in their pandemic response, last week announced immediate or impending ends to their states’ indoor or school mask mandates.
Some of those moves came with assertions that it’s time to “live with the disease” and treat the coronavirus as endemic—a stable, enduring figure in the panoply of human pathogens, alongside cold viruses and influenza. That suggestion troubles many scientists, who warn it is eroding governments’ commitment to tracking and responding to the pandemic—which could leave countries flying blind and unprepared for any new variant.
“Endemic delusion is probably what captures it the best,” says Kristian Andersen, an infectious disease researcher at Scripps Research who has been especially critical of recent moves by his home country of Denmark, which include an announcement that as of this month COVID-19 would no longer be categorised as a “socially critical disease” even though related death and hospitalisation rates were still climbing there.
In the United States, governors cited various metrics to justify recent decisions to lift or let expire indoor mask mandates. California Governor Gavin Newsom noted stable hospitalisation rates and a 65% reduction in cases since Omicron’s peak in announcing the state’s mandate would end this week. But leaders also face political and economic pressures. States’ moves may be driven largely by the public’s impatience with restrictions, says epidemiologist Dustin Duncan of Columbia University.
“Even people who recognize the importance of masking, social distancing, all that stuff, may be more amenable to take more risk,” he says. “At the same time, to me, going maskless just seems egregious.” 
Read full story
Source: Science, 15 February 2022
Patient Safety Learning

England to offer Covid jab to five to 11-year-olds

Children aged between five and 11 in England will be offered a low-dose Covid vaccine, the government says.
Official scientific advice concludes the move would help protect the "very small" number of children who become seriously ill with Covid.
Health Secretary Sajid Javid says the rollout will be "non-urgent", with an emphasis on parental choice.
Northern Ireland also said on Wednesday it will be following Wales and Scotland in offering young children the vaccine.
Children are at a much lower risk of becoming severely ill from a Covid infection, so the health benefits of vaccinating them are smaller than in other age-groups. Also, many will have some protection from already having caught the virus.
So the scientists on the Joint Committee on Vaccination and Immunisation (JCVI), which advises governments across the UK, have been weighing up the evidence for immunising five to 11-year-olds.
It concluded vaccination should go ahead to prevent a "very small number of children from serious illness and hospitalisation" in a future wave of Covid.
Prof Wei Shen Lim, from the JCVI, said: "We're offering this to five to 11-year-olds now in order to future-proof their defences against a future wave of infection."
He suggested parents consider getting their children vaccinated during school holidays to minimise disruption to their education from any flu-like side effects of the jab.
Read full story
Source: BBC News, 16 February 2022
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