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Patient Safety Learning

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Everything posted by Patient Safety Learning

  1. Content Article
    This report from the Skills for Health reveals the extensive mental and physical health impact on the NHS, and health and care professionals across the UK, as a result of working and living through COVID-19. It also identifies organisational priorities for recovery, both as the country enters the next phase of the pandemic and for the longer term.
  2. Content Article
    In a project led by the Race Equality Foundation, the Men’s Health Forum teamed up with Faith Action and Clinks to develop a community-centred programme to offer blood pressure testing and raise awareness amongst black African and Caribbean males. The programme was piloted in barbershops, a bus depot and a local church in three London boroughs. It demonstrated that offering blood pressure checks in community settings could help overcome the reluctance amongst black African and Caribbean men to have their blood pressure checked. The report, following evaluation between February-March 2020 in the London boroughs of Southwark, Hackney and Brent, concluded: 'The community blood pressure programme was welcomed in all community settings. The pilots engaged a considerable number of men in an accessible environment that they were comfortable in. There was a willingness from community stakeholders for the programme to be implemented over a longer period of time, and healthcare providers may wish to consider the practicalities of delivering blood pressure testing in similar settings for specific target groups.'
  3. Content Article
    Organisational learning requires that teams continuously assess their performance to identify and learn from successes and failures. The After Action Review (AAR) is a simple but powerful tool to help you do this. Conducting an AAR at the end of a project, program or event can help you and your team learn from your efforts. Furthermore, sharing the results from your AAR can help future teams learn your successful strategies and avoid pitfalls you have worked to overcome.
  4. Content Article
    Developed to support healthcare professionals at the front line of prostate cancer diagnosis and care, Prostate Cancer UK's Best Practice Pathway uses easy to follow flowcharts to guide healthcare professionals deliver best practice diagnosis, treatment and support. It sets out how to achieve an early diagnosis in men at higher than average risk of the disease. It also supports use of the most up-to-date, cutting-edge research-led innovations - so that healthcare professionals are equipped and supported to provide the very latest evidence-based best practice to their patients.
  5. Content Article
    Join a new study to help us understand why black men are at higher risk of prostate cancer. Prostate Cancer UK are funding the PROFILE study to help find out why black men are at higher risk of prostate cancer than other ethnic groups. The researchers are looking at the genes of healthy men at higher risk of prostate cancer, including men of African or Caribbean descent. Over five years, they’ll monitor the men for signs of developing prostate cancer, using blood tests and scans and biopsies. At the end of the study, the researchers hope to understand why certain men are more likely to get prostate cancer, and whether one day they could create tests to help spot these men earlier, based on their genes. By working towards catching prostate cancer sooner in high risk men, we can increase the chances of curing their prostate cancer. And by understanding more about why and how they develop prostate cancer, we could work towards treatments that stop this from happening. If you are a man of African or Caribbean descent aged 40-69 and haven’t had prostate cancer, you may be suitable to take part in a study that can help us understand more about the genetics of prostate cancer. Follow the link below for further information.
  6. News Article
    The NHS is ready to start providing the new coronavirus vaccine "as fast as safely possible", Health Secretary Matt Hancock has said. Asked whether it could be available by Christmas, he said that was "absolutely a possibility" - but he expected the mass roll-out "in the first part of next year". He said vaccination clinics would be open seven days a week, and he was giving GPs an extra £150m. On Monday, early results from the world's first effective coronavirus vaccine showed it could prevent more than 90% of people from getting Covid. The vaccine has been developed by pharmaceutical companies Pfizer and BioNTech and is one of 11 vaccines that are currently in the final stages of testing. The UK has already ordered 40 million doses - enough to vaccinate up to 20 million people as each person will need two doses for it to work effectively. Asked how many people would need to be vaccinated before life can return to normal, Matt Hancock said: "Well the answer to that is we just don't know." "So the trials can tell you if a vaccine is clinically safe and if it's effective at protecting an individual from the disease. What we can't know, until we've vaccinated a significant proportion of the population, is how much it stops the transmission of the disease." Mr Hancock told BBC Radio 4's Today programme it would be "a mammoth logistical operation" and highlighted some of the challenges, including getting it from Belgium to the UK while not removing from a temperature of -70C more than four times. Older care home residents and care home staff are at the top of a list from government scientific advisers of who would get immunised first, followed by health workers. Mr Hancock said NHS staff would go into care homes to vaccinate residents, as well as setting up vaccination venues. Children would not be vaccinated, he said. However, Prof Sir John Bell from Oxford University said: "I would worry about not giving this to as wide a percentage of the population as we can." "I'm more of the view that we need to vaccinate further into the population and vaccinate younger people as well, partly because we don't really know what the long term effects of this disease are." The vaccine will not be released for use until it passes final safety tests and gets the go-ahead from the Medicines and Healthcare products Regulatory Agency. Read full story Source: BBC News, 10 November 2020
  7. News Article
    In small room in the Royal Derby Hospital, there's a table bearing a laminated sign. "You are not alone," it says. It continues: "Kindness will get you through. Embrace the challenge. Look after each other. You are stronger than you think." This is the "wobble room", set aside not for patients but for front-line staff to get them away - briefly - from the intense pressure and strain experienced in the first wave of COVID-19. "We made a wobble room because that's what we needed," Kelly-Ann Gurney, an intensive-care nurse, told the BBC. "It's a room where staff could just go and sit and cry if they needed to and get it all out and then come back and 'put their face on' and get back into it again." Now the second wave is hitting the hospital, and the need for the room is just as great. Concerns are growing about the physical and mental health of front-line NHS staff. There has been no lull since the April peak of the virus as normal treatments and operations, postponed during the crisis, have returned to hospitals. Caroline Swan, a senior sister and manager of the intensive care unit at the Royal Derby, says she is ready to face what is ahead but feels very tired. "I am also very concerned. My staff are very tired and stressed out. We have a lot of sickness either due to burnout or they are unwell," she says. "A lot of staff have to self-isolate at home - and that puts a lot of strain on staffing here." Dr Magnus Harrison, medical director of the University Hospitals of Derby and Burton NHS Trust, says managing rotas is getting harder due to staff sickness and the need for some to self-isolate if family members are infected. "It is worth acknowledging what staff did in the first wave. They behaved tremendously and worked incredibly hard, and we're expecting them to do it again in winter - and Covid numbers could be higher than in the first wave. People are tired out." Read full story Source: BBC News, 10 November 2020
  8. News Article
    One in five COVId-19 patients were diagnosed with a mental illness for the first time within three months of their infection, a study has shown. Mental health experts said the findings, which were based on an analysis of the electronic medical records of 69 million people in the US, suggest that coronavirus survivors could have an increased risk of developing psychiatric disorders. Of the almost 70 million people whose records were examined in the study, 62,354 individuals had confirmed COVID-19 cases. Researchers at the University of Oxford and the NIHR Oxford Health Biomedical Research Centre found that one in five of these patients went on to receive a first time diagnosis of anxiety, depression or insomnia within 90 days of testing positive for the virus. This was roughly twice as high as the figure for other individuals over the same time frame, according to the researchers. People with a history of mental health disorders who contracted the virus were also discovered to be more likely to have new psychiatric diagnoses. Paul Harrison, a psychiatry professor at the University of Oxford who led the research, said: "People have been worried that COVID-19 survivors will be at greater risk of mental health problems, and our findings in a large and detailed study show this to be likely. Read full story Source: The Independent, 10 November 2020
  9. News Article
    The NHS will rollout twice-weekly asymptomatic testing for all patient-facing staff by the end of next week, according to a letter from NHS medical director Stephen Powis. Government said only last week that universal asymptomatic staff testing would start in December, but government has now agreed it will bring this forward to this week for a first tranche of 34 trusts; and all others next week. The tests at 34 trusts this week will cover “over 250,000 staff,” Professor Powis said. He set out plans for the new testing regime in a letter to Commons health and social care committee chair Jeremy Hunt who has been pressing the government for routine staff testing since the summer. “Staff will be asked to test themselves at home twice a week with results available before coming into work,” Professor Powis said. The new testing regime can start following “further scientific validation of the lateral flow testing modality last week, and confirmation over the weekend from Test and Trace that they can now supply the NHS with sufficient test kits”. Read full story Source: HSJ, 9 November 2020
  10. Event Comment

    Hi Sharon. I'll pass your question on to the organisers of the event and let you know.
  11. Content Article
    Social prescribing, also sometimes known as community referral, is a means of enabling health professionals to refer people to a range of local, non-clinical services. The referrals generally, but not exclusively, come from professionals working in primary care settings, for example, GPs or practice nurses.  Recognising that people’s health and wellbeing are determined mostly by a range of social, economic and environmental factors, social prescribing seeks to address people’s needs in a holistic way. It also aims to support individuals to take greater control of their own health.  Social prescribing enables GPs, nurses and other primary care professionals to refer people to a range of local, non-clinical services to support their health and wellbeing. But does it work? And how does it fit in with wider health and care policy?
  12. Content Article
    As we seek to develop a national healthcare system that delivers true 21st century care, we are confronted by a COVID-19 pandemic that has identified numerous challenges. Among the most important: the need to provide correct diagnoses. Definitive answers about diagnosis are critical not only for patients, but also for their families and others around them. Consequential questions gnaw at us: Are we diagnosing COVID-19 correctly? Are we missing cases? How do we know? How can we improve? Gopal Khanna and Jeff Brady are hopeful that some of the changes that have resulted from the US's battle against the pandemic will spark the long-term improvements in diagnostic safety that will strengthen the system’s ability to address COVID-19 and other challenges we face.
  13. Content Article
    Healthcare providers around the world are engaged in actions intended to enhance health, yet they regularly put themselves at risk in order to care for their patients. Working in stressful health care environments can make this burden worse. The COVID-19 pandemic brought these dangers to an entirely new level, revealing how risks to health workers risk patient health and safety in turn. Creating a safe space for health-care workers has never been more important. Today, health workers worry about being infected with the novel coronavirus themselves and contributing to the spread of the virus at work, at home, or in their communities.Health workers have also had to work with limited access or adherence to personal protective equipment (PPE) and other infection prevention and control measures. They’ve had to be flexible and resilient in the face of ever-changing and evolving work policies and practices. Such stressors take a toll on the well-being and safety of our health providers. And that’s not good for patients, as Ivy Bourgeault and Chris Power explores in this article.
  14. News Article
    Pfizer and BioNTech have said that their coronavirus vaccine may be more than 90% effective, after the two pharmaceutical firms released interim data from their ongoing large-scale trial. Preliminary analysis, conducted by an independent data monitoring board, looked at 94 infections recorded so far in the vaccine’s phase 3 study, which has enrolled nearly 44,000 people in the US and five other countries. Of those participants who were infected with COVID-19, it is currently unclear how many had received the vaccine versus those who had been given a placebo. The current efficacy rate, which is much better than most experts expected, implies that no more than eight volunteers will have been inoculated. The data have yet to be peer-reviewed, and Pfizer said the initial protection rate might change by the time the study ends. The longevity of the immune response provoked by the mRNA-based vaccine also remains unknown. However, the findings are the most promising indication to date that a vaccine will be effective in preventing disease among infected individuals, handing humanity a crucial tool in tackling the pandemic. Pfizer and its German partner BioTech will continue with the phase 3 trial until 164 infections have been reported among volunteers - a figure that will give regulatory authorities a clearer idea of the vaccine’s efficacy. This number is expected to be reached by early December in light of the rising US infection rates, Pfizer said. The two companies said they have so far found no serious safety concerns and expect to seek US emergency use authorisation later this month. Read full story Source: The Independent, 9 November 2020
  15. Content Article
    In this Anaesthesia editorial, Simoes and Bhangu, on behalf of the CovidSurg Collaborative, outline why and how elective surgery must restart. "COVID‐19‐free pathways will be crucial for patient safety during the COVID‐19 pandemic, as they seem to lead to low rates of SARS‐CoV‐2 infection rates and complications. Further preventive measures and patient level risk assessment will allow surgery to safely restart and continue during this, and future, crises." This editorial accompanies an article by Kane et al. Anaesthesia 2020; 75: 1596–1604.
  16. News Article
    As many as 2,000 people could die because of Covid-related delays in the Welsh NHS, a cancer expert has said. With virus cases rising, Prof Tom Crosby, of the Wales Cancer Network, fears cancer cases missed in the first lockdown may now be harder to treat. Health Secretary Vaughan Gething said it would be "foolish" to have a plan for backlogs before the pandemic is over. But he said work was under way to address the issue with health boards. Alongside the spread of the virus, medical professionals are very worried about deaths that could occur not because of Covid, but due to the backlog of appointments and surgery it is causing. BBC Wales Investigates has been uncovering the full extent of the looming problem facing the NHS. Delays caused by the pandemic are a serious concern to Prof Crosby, who is medical director at the Wales Cancer Network. He said when the pandemic first hit, acute COVID-19 cases became the focus in hospitals at the expense of cancer, cardiac and orthopaedic appointments. "Some of the conversations we've had with patients in the clinic have been really, really challenging," he said. "Then there are thousands of patients who have not come through to the system that usually would have. Some of those are going to have had cancer, and they will not have been diagnosed now." Prof Crosby has been looking at possible outcomes for cancer patients because of delays in diagnosis and treatment. "We have done some modelling work with England, and it has suggested that between 200 and 2,000 excess deaths will occur as a result of undiagnosed or untreated cancer in Wales," he said. "I think the effects on cancer services are going to be here for two to three years." Read full story Source: BBC News, 9 November 2020
  17. News Article
    Some disabled people in the UK have been struggling to obtain essentials such as medication and breathing equipment during the Covid pandemic, research for the BBC suggests. Some 60% of those who rely on social care told a YouGov survey they were finding it hard to obtain at least one of their necessities. Charity WellChild said people felt more "forgotten than they ever have been". But ministers say the needs of disabled people were being considered. The Department of Health and Social Care says it has sufficient stocks and patients should contact their local care provider. Like one in 20 of those survey respondents who receive social care, Fi Anderson, a mother of two with muscular dystrophy from Bolton in Greater Manchester, said she has faced problems obtaining breathing apparatus. Her local hospital told her to re-use the filter for her portable ventilator, recommending she boil it, because supplies were so short. Disabled people who rely on social care - which funds equipment and other support to allow them to live independent lives - also said they had struggled to obtain personal protective equipment (PPE) such as face masks. Many of them receive funding directly to employ carers in their home, so they also need to provide them with PPE during the coronavirus crisis. The survey, which the BBC commissioned to mark the 25th anniversary of the Disability Discrimination Act, asked more than 1,000 people about life in the UK with a disability and how it has changed in the shadow of a pandemic. More than 65% felt their rights had regressed, and 71% said disabled people's needs had been overlooked. The Coronavirus Act, which granted the government emergency powers, gave local councils the ability to reduce care, education and mental health provision for disabled people if it became necessary during the pandemic. According to the latest figures from the Office for National Statistics, nearly six out of 10 deaths from COVID-19 were of disabled people. Read full story Source: BBC News,
  18. News Article
    Nurses will be allowed to look after two critically ill COVID-19 patients at the same time after NHS bosses relaxed the rule requiring one-to-one treatment in intensive care as hospitals come under intense strain. NHS England has decided to temporarily suspend the 1:1 rule as the number of people who are in hospital very sick with Covid has soared to 11,514, of whom 986 are on a ventilator. The move comes amid concern that intensive care units, which went into the pandemic already short of nurses, are being hit by staff being off sick or isolating as a result of Covid. It follows a warning last week by Prof Chris Whitty, England’s chief medical officer, that the Covid resurgence could overwhelm the NHS. Dr Alison Pittard, the dean of the Faculty of Intensive Care, which represents doctors in ICUs, welcomed the shift to a more “flexible” nurse/patient staffing ratio in critical care. But she said it must be used only for as long as the second wave is putting units under serious pressure. “Covid has placed the NHS, and critical care in particular, in an unenviable position and we must admit everyone for whom the benefits of critical care outweigh the burdens. This means relaxing the normal staffing ratios to meet this demand in such a way that delivers safe care, but also takes account of the impact this may have on staff health and wellbeing." “The 1:2 ratio is a maximum ratio, to be used only to support Covid activity, [and] not for planned care, and is not sustainable in the long term. This protects staff and patients”, she said. Read full story Source: The Guardian, 8 November 2020
  19. Content Article
    When SynergyHealth, St. Joseph’s Hospital of West Bend, Wisconsin, USA, decided to relocate and build an 82-bed acute care facility, there was an opportunity to design a hospital that focused on patient safety. Hospital leaders believed if a facility design process was “engineered properly,” it would enhance patient safety and create a patient safe culture; however, they found little information to give the direction. To help plan the new facility, a national learning lab was conducted, drawing from patient safety in the available literature; inviting experts from the healthcare profession and other fields, including transportation, spacecraft design, and systems engineering; and involving the hospital's board members, staff, physicians, and facility design team. In this case study, John G. Reiling describes the process used by St. Joseph to design a new hospital around patient safety, and identify and discuss safety design principles, providing examples of their application at St. Joseph’s new facility. Finally, recommendations are made for the design of all health care systems, including new facilities, remodeling, and additions.
  20. Content Article
    In 2002 the UK Department of Health and the Design Council jointly commissioned a scoping study to deliver ideas and practical recommendations for a design approach to reduce the risk of medical error and improve patient safety across the National Health Service (NHS). The research was undertaken by the Engineering Design Centre at the University of Cambridge, the Robens Institute for Health Ergonomics at the University of Surrey and the Helen Hamlyn Research Centre at the Royal College of Art. The research team employed diverse methods to gather evidence from literature, key stakeholders, and experts from within healthcare and other safety-critical industries in order to ascertain how the design of systems—equipment and other physical artefacts, working practices and information—could contribute to patient safety. Despite the multiplicity of activities and methodologies employed, what emerged from the research was a very consistent picture. This convergence pointed to the need to better understand the healthcare system, including the users of that system, as the context into which specific design solutions must be delivered. Without that broader understanding there can be no certainty that any single design will contribute to reducing medical error and the consequential cost thereof.
  21. Content Article
    There is a lack of awareness regarding the pervasive influence of the built environment on caregiving activities, and how its design could reduce risks for patients and providers. This article from Joseph et al. presents a narrative review summarising key findings that link health care facility design to key targeted safety outcomes: health care–associated infections, falls, and medication errors. It describes how facility design should be considered in conjunction with quality improvement legislation; projects under way in health systems; and the work of guideline-setting organizations, funding agencies, industry, and educational institutions. The article also charts a path forward that consolidates existing challenges and suggests what can be done about them to create safe and high-quality healthcare environments.
  22. Content Article
    There are large numbers of patients with olfactory disturbance in the UK and shortfalls in assessment and support amongst mainstream practice in both primary and secondary care leading to significant quality‐of‐life impairment and potential missed diagnoses. The aim of this study from Erskine and Philpott was to determine the key themes which can be identified from the accounts of anosmia sufferers and to identify important areas to target for future research or service development.
  23. Content Article
    The NHS Knowledge Mobilisation Framework is designed to help individuals to develop and use skills to mobilise knowledge effectively in their organisations – to help them to learn before, during and after everything that they do so that pitfalls can be avoided and best practice replicated. It is a re-working of an original concept devised by what was the Department of Health Connecting for Health Knowledge Management Team and the Kent, Surrey and Sussex Library and Knowledge Services Team. The modules introduce eleven techniques to help plan, co-ordinate and implement knowledge mobilisation activities in your organisation. Accompanying the framework are a set of quick reference cards.
  24. Content Article
    The need for radical investment and reform of diagnostic services was recognised at the time the NHS Long Term Plan was published in 2019. This report, commissioned by NHS England at that time, alongside a review of adult screening services, was nearing publication before the COVID-19 pandemic struck. However, while the recommendations made pre-pandemic still stand, additional actions will be needed to deliver safe, high quality diagnostic services in an endemic phase of the disease and to support the recovery of diagnostic services.
  25. Content Article
    This cost-effective programme for personalised stratified follow-up delivers better outcomes for prostate cancer patients and has been shown to free up capacity in the follow-up pathway.  The programme moves follow-up care from outpatient clinics to remote monitoring. Men who are eligible for remote follow up therefore don't need to attend routine appointments unless an issue arises. This web page gives advice, guidance and tools, and examples of hospital trusts that took part in the pilot.
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