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Patient Safety Learning

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Everything posted by Patient Safety Learning

  1. News Article
    Staff working in care homes are to be tested every week starting on Monday, with residents tested every month, the government has said. The expansion of testing comes as a whistleblower at one of the testing laboratories revealed dozens of shifts had been cancelled throughout May and June because of a lack of test samples. Ministers hope that the expansion of testing will help to prevent the spread of infection to vulnerable residents. Read full story Source: The Independent, 3 July 2020
  2. Content Article
    Since the rise of COVID-19 in the UK, many consultations between surgeons and patients take place remotely, via phone or video. These consultations include pre-operative assessments, discussions between surgeons and patients about the benefits and risks of their surgery, and gaining the patient’s consent to proceed with treatment.  This transition to remote consultations has been central in the healthcare system’s effort to prevent transmission of COVID-19, and has required a series of adjustments by patients, hospitals and members of the surgical team. However, when it comes to the consent process, the same principles and requirements should apply as set out by the GMC and The Royal College of Surgeons of England, regardless of whether the conversation takes place face-to-face or via phone or video. In addition, during the COVID-19 period, the consent discussion should include further considerations to ensure that patients have the necessary information to make an informed decision about their treatment. This guide sets out the main principles of the consent process and provides advice on what additional information should be included in conversations with patients while COVID-19 is still prevalent in society.
  3. Content Article
    Virtual consultations, involving a telephone or video call between surgeon and patient, have been used in several surgical specialties prior to COVID-19. It has, however, played a particularly significant role during the current pandemic which is likely to continue in the post COVID-19 era and in future pandemic planning. This guide provides practical advice for surgeons and managers for delivering virtual consultations with surgical patients.
  4. News Article
    There has been a significant rise during lockdown in the UK in the number of LGBT people seeking suicide-prevention support. Support group LGBT Hero reports 11,000 people have accessed its suicide-prevention web pages - up over 44% on the first three months of the year. The government considers LGBT people to be at higher risk of suicide but no national data on LGBT suicides is kept. In total, eight charities told BBC News they had seen an increase in LGBT people accessing their support for suicide prevention. The LGBT Foundation has received more calls about suicide "than ever before". Gavin Boyd, of The Rainbow Project, based in Northern Ireland, said: "In just the last three weeks, we know of three LGBT people who have ended their lives." And another chief executive of a charity, in the south of England, who did not want to be named in case it affected its funding, said: "We know of two young LGBT people in the past two weeks. We're under more pressure to deliver than ever before. The government has done absolutely nothing to help regional LGBT charities cope with the demand from our already struggling service users." Read full story Source: BBC News, 2 July 2020
  5. News Article
    Parents of babies who died at a hospital trust at the centre of a maternity inquiry say a police investigation has come "too late". West Mercia Police said it was looking at whether there was "evidence to support a criminal case" at Shrewsbury and Telford NHS Hospital Trust. An independent review, contacted by more than 1,000 families, said it was working with police to identify relevant cases. "It's bittersweet," one mother said. "It's come too late for my daughter, she should still be here," said Tasha Turner, whose baby, Esmai, died four days after she was born at Royal Shrewsbury Hospital in 2013. Ms Turner's case is part of the Ockenden Review, an independent investigation into avoidable baby deaths at the trust, which runs Royal Shrewsbury Hospital and Telford's Princess Royal. LaKamaljit Uppal, 50, from Telford, who is also part of the review following the death of her son Manpreet in April 2003 at Royal Shrewsbury Hospital, said she hoped the police inquiry would bring some closure. "The trust put me through hell, someone should be held accountable," she said. Read full story Source: BBC News, 1 July 2020
  6. News Article
    A Scottish Government committee has found that the “profound failings” of IT systems are the biggest problem facing a medicine-prescribing service that does not sufficiently focus on patients. A report from the members of Scottish Parliament on the Health and Sport Committee describes a medicines system “burdened by market forces, public sector administrative bureaucracy and under resourcing, inconsistent leadership and a lack of comprehensive, strategic thinking and imagination, allied to an almost complete absence of useable data”. The committee particularly criticised the failure of the NHS to introduce appropriate IT systems. “We are extremely disappointed that once again all roads lead to the dismal failure of the NHS in Scotland to implement comprehensive IT systems which maximise the use of patient data to provide a better service,” the report says. Committee members are calling for an overhaul of the system to allow for collection and analysis of data that would ensure the best possible outcomes for patients and cost savings for the NHS. MSPs found a “lack of care” to understand patients’ experience of taking medicines and a lack of follow up to ensure that medicines were effective or even being used. Prescribers were “instinctively reaching for the prescription pad” and not taking the time to discuss medicines with patients, nor were the principals of realistic medicine, in which patients and clinicians share decision making about their care, being followed. Read full story Source: Public Technology.net, 1 July 2020
  7. News Article
    NHS England and NHS Improvement have ordered urgent reviews into the deaths of people with a learning disability and autism during the pandemic, HSJ has learned. In May, the regulators said the COVID-19 death rates among this population were broadly in line with the rest of the population. But in early June, the Care Quality Commission published data which suggested death rates of people with learning disabilities and/or autism had doubled during the pandemic. In an announcement posted on a social media group for Royal College of Nursing members last week, NHSE/I said they were “urgently seeking clinical reviewers with experience in learning disability”. The message to the private Facebook group, seen by HSJ, added: “The effects of coronavirus are having a far-reaching impact on all our lives. As we learn more about the virus, we are taking steps to make changes to safeguard our well-being. “For people with a learning disability, the number of deaths has doubled during the covid pandemic. (compared to data on the number of deaths recorded during the same period last year). As a result, we have a large number of deaths of people with a learning disability who have died during the pandemic whose deaths we want to review.” Read full story (paywalled) Source: HSJ, 1 July 2020
  8. Content Article
    The COVID-19 pandemic has suddenly challenged many healthcare systems. To respond to the crisis, these systems have had to reorganise instantly, with little time to reflect on the roles to assign to their patient safety (PS) and quality improvement (QI) experts. In many cases, staff who had a background in clinical care was called to support wards and critical care. Others were deemed “non-essential” and sent back to work from home, while their programmes were placed in hibernation mode. This has meant that many QI and PS experts with skills to offer in their field have ended up carrying out tasks unrelated to the current crisis.
  9. Content Article
    Analysis of wrong-site surgery events in Pennsylvania suggests opportunities for prevention. Many steps of preparing the patient for an operation and performing an operation can lead down the path of wrong-site surgery. Preventing wrong-site surgery may require attention at every step of the process. The Patient Safety Authority has provided resources, guidelines and education tools.
  10. Content Article
    This ‘Erice Call for Change’ is a report from a group of experts, patients and patient representatives who met in Erice in September 2019 following previous similar meetings after the original Erice Declaration (1996). The aim of the meeting was to discuss the challenge of causal complexity and individual variation in modern healthcare. The group’s concern was the impact that new clinical decision-making tools, based on statistical correlations in large databases, could have on individual patient care if they replace other types of clinical investigation and knowledge. The group calls for a change in the approach to the care of the individual patient, and indicates some specific challenges to overcome for such changes to happen.
  11. Event
    This free four-week online course from the King's Fund will provide you with a broad understanding of the NHS – its inner workings, how it all fits together and the challenges it typically faces. You will build your knowledge of the health system in England through articles, quizzes and videos with experts from The King’s Fund. Plus you can study each week at a time that suits you. Sign up
  12. Content Article
    Motivated by the COVID-19 pandemic, Perla et al. developed a novel Shewhart chart to visualise and learn from variation in reported deaths in an epidemic.
  13. News Article
    Waiting times for tests and treatment not related to COVID-19 are likely to increase significantly in the second half of 2020 because of the fallout from the pandemic, the head of NHS England has acknowledged. Giving evidence to the Commons health select committee on 30 June, NHS England’s chief executive Simon Stevens said that contrary to some commentary, the NHS’s overall waiting list actually dropped by over half a million people between February and April 2020 because fewer people were coming forward for treatment. But, he added, “As referrals return we expect that will go up significantly over the second half of the year.” Stevens said that there were 725 000 fewer elective admissions to NHS hospitals during March and April, but that number has begun to recover significantly. “As we speak, we think we’re now somewhere north of 55% of pre-covid-19 elective activity levels,” he said. He added that he hoped the NHS would return to around three quarters of normal activity levels by July or August. Stevens told MPs that the NHS would pursue a range of measures to increase capacity over the coming months, including extending the deal with the private sector to use its facilities, and repurposing some of the Nightingale hospitals for diagnostic testing. Read full story Source: BMJ, 1 July 2020
  14. News Article
    Inspectors have raised “new and ongoing” patient safety concerns at Shrewsbury and Telford Hospitals Trust, it has emerged. The Care Quality Commission has issued a new warning notice to the Midlands trust after an inspection of the hospital earlier this month sparked concerns for the welfare of patients on its medical wards. These concerns are separate from the trust’s maternity service, which, it was revealed on Tuesday, is now facing a police investigation alongside an NHS inquiry into more than 1,200 allegations of poor maternity care dating back to the 1970s. In October, a patient at the hospital bled to death after a device used to access his bloodstream became inexplicably disconnected while he was receiving care on the renal unit. The Health Service Journal reported the latest concerns related to the inappropriate use of bed rails and risks of patients falling from beds after several incidents. The CQC is also concerned about the trust’s use of powers to detain elderly or vulnerable patients on wards. The concerns also include patients being at risk of abuse and learning from past incidents not being shared with staff. Read full story Source: The Independent, 1 July 2020
  15. News Article
    The government must set out plans for an inquiry into its handling of the coronavirus pandemic, the health service ombudsman has said. This was not about blaming staff but about "learning lessons", he said. Ombudsman Rob Behrens said patients were reporting concerns about cancelled cancer treatment and incorrect COVID-19 test results. Ministers have not committed to holding an inquiry, but have accepted there are lessons to be learned. The Parliamentary and Health Service Ombudsman (PHSO) stopped investigating complaints against the NHS on 26 March, to allow it to focus on tackling the COVID-19 outbreak. But people had continued to phone in with these concerns, Mr Behrens said. "Complaining when something has gone wrong should not be about criticising doctors, nurses or other front-line public servants, who have often been under extraordinary pressure dealing with the Covid-19 crisis," he said. "It is about identifying where things have gone wrong systematically and making sure lessons are learned so mistakes are not repeated." Read full story Source: BBC News, 1 July 2020
  16. News Article
    Police in Bristol have launched investigations into the circumstances that led to the death of a teenager with autism and learning disabilities. Avon and Somerset Police told HSJ they are investigating the circumstances behind the death of Oliver McGowan in 2016, at North Bristol Trust. They said: “As part of the enquiry [officers] will interview a number of individuals as they seek to establish the circumstances around Oliver’s death before seeking advice from the Crown Prosecution Service.” Oliver died in 2016 at Bristol’s Southmead Hospital after being admitted following a seizure. He had mild autism, epilepsy and learning difficulties. During previous hospital spells he experienced very bad reactions to antipsychotic medications, prompting warnings in his medical records that he had an intolerance to these drugs. Despite this Oliver was given anti-psychotic medication by doctors at Southmead against his own and his parents’ wishes. This led him to suffer a severe brain swelling which led to his death. His death has since prompted a national training programme for NHS staff on the care of people with autism and learning disabilities. Read full story (paywalled) Source: HSJ, 1 July 2020
  17. Content Article
    Research has found that variations in cardiometabolic factors, vitamin D levels and socioeconomic or behavioural factors do not adequately explain why COVID-19 disproportionately affects black, Asian and minority ethnic populations. In this study published in the Journal of Public Health, Raisi-Estabragh et al. examined whether the greater severity of coronavirus disease 2019 (COVID-19) amongst men and Black, Asian and Minority Ethnic (BAME) individuals is explained by cardiometabolic, socio-economic or behavioural factors. They found ethnicity differential pattern of COVID-19 was not adequately explained by variations in cardiometabolic factors, vitamin D levels, or socioeconomic or behavioural factors. This, the researchers said, suggests that alternative biological pathways or genetic susceptibilities may have importance in driving the higher rates of severe COVID-19 in BAME populations and should be investigated.
  18. News Article
    The Professional Record Standards Body would like you to take part in two surveys about the information that should be shared between health and social care. The project aims to improve connections between different services, to allow people better access to the personalised care and wellbeing support they need. They’ve also produced an easy read version for anyone who has difficulty reading, which can be found here.
  19. Content Article
    The COVID Trauma Response Working Group has been formed to help coordinate trauma-informed responses to the COVID outbreak. It is made up of psychological trauma specialists, coordinators of the psychosocial response to trauma, wellbeing leads at NHS Trusts and people with lived experience of psychological trauma. The working group is being coordinated by staff at University College London and the Traumatic Stress Clinic at Camden and Islington NHS Trust. On their website you will find many resources and information on the work they are doing.
  20. News Article
    Delays in going to the emergency department because of the coronavirus pandemic lockdown may have been a contributory factor in the deaths of nine children, a snapshot survey of consultant paediatricians in the UK and Ireland has shown. Three of the reported deaths associated with delayed presentation were due to sepsis, three were due to a new diagnosis of malignancy, in two the cause was not reported, and one was a new diagnosis of metabolic disease. Read full story (paywalled) Source: BMJ, 30 June 2020
  21. News Article
    A quarter of people who sought help for mental health problems during lockdown were unable to access NHS services, a new survey shows. A survey by the mental health charity Mind found that 25% of respondents who contacted primary care services could not get support. More than a fifth (22%) of adults with no previous experience of poor mental health now say that their mental health has deteriorated, according to the survey. Many people who were previously well will develop mental health problems as a “direct consequence of the pandemic and all that follows”, according to Mind. Two out of three (65%) adults aged 25 and over and three-quarters of young people aged 13-24 with an existing mental health problem reported worse mental health during the lockdown. Mind predicts that prolonged worsening of wellbeing and “continued inadequate access” to NHS mental health services will lead to a marked increase in people experiencing longer-term mental health problems. Read full story Source: The Independent, 30 June 2020
  22. Content Article
    The COVID-19 pandemic is emerging as the defining health crisis of our generation. Healthcare organisations were already a high-risk environment for workers, who are exposed on a daily basis to the suffering of their patients, tragedy, and the potential for failure. Now, healthcare staff of all kinds are straining to meet the demands of caring for patients with the novel coronavirus. Caring for patients with COVID-19 places them at personal risk for infection, and also poses a threat to their emotional well-being. If workers are not provided with sufficient emotional support, the distress can be disabling. It may render them less able to work to their full ability. This in turn can threaten the integrity of the health care workforce to deliver the volumes of care required by the pandemic. In the longer term individual workers are at risk for accelerated burnout, and for mental health problems like post traumatic stress disorder (PTSD). The Journal of Patient Safety and Risk Management asked their international editorial board to provide advice for healthcare leaders and managers and frontline clinicians for meeting the emotional needs of healthcare workers and supporting one another. They identified several priority areas central to maintaining and promoting the well-being of the workforce during the pandemic. These included meeting basic needs, improving crisis leadership and communication, promoting well-being, and providing mental and emotional support.
  23. Content Article
    Face coverings have become a flashpoint in the US, particularly now as COVID-19 cases continue to surge in Texas, Florida, and Arizona, among other states. Misinformation and mixed signals about masking have spread almost as quickly as the virus. And political debates pitting civil liberties vs. civic responsibilities have drowned out the growing body of evidence that shows wearing masks significantly reduce infection risk. Sonja Bartolome is a specialist in lung disorders and pulmonary disease, treating respiratory infections every day and has seen firsthand the aggressive nature in which they can spread. She lists the most common myths surrounding masks and separate them from the medical and scientific realities of the current situation.
  24. News Article
    A new report by Research Australia details more than 200 ongoing COVID-19 studies that extend far beyond the search for a vaccine. Almost every COVID-19 research project being led by Australians has been in the new report, including studies of breastfeeding guidelines for parents with COVID-19, filter systems to remove the virus via air-conditioning systems, monitoring of sewage to detect the prevalence of COVID-19, and repurposing technology normally used to identify explosives to see if it can detect the presence of COVID-19. The report was compiled by Research Australia, the national peak body for health and medical research. It’s chief executive, Nadia Levin, said the report was not a complete catalogue of COVID-19 related research in Australia, but provided a useful insight into the scale of the response from the health and innovation sectors. “All of this Australian research kept popping up and we were blown away by the scale and scope of it, so we asked all of our members to share what they are working on,” Levin told the Guardian Australia. Read full story Source: The Guardian, 27 June 2020
  25. News Article
    The NHS will not be able to get back to providing its full range of services for as long as four years because of the huge disruption caused by COVID-19, hospital bosses have warned. Patients will face much longer waits than usual for operations and diagnostic tests because hospitals’ drive to remain infection-free means they are closing beds, and surgeons’ need to wear protective clothing means they are carrying out fewer procedures than before the pandemic. In a stark admission of the complexity of reopening the NHS, a key health service leader has predicted that some hospitals will be able to provide only 40% of the care they previously delivered. Hospitals are under pressure from ministers and health charities to restart services as soon as possible for patients with conditions such as cancer, obesity and joint problems. But the chief executives of three NHS trusts in England have told the Observer that the “sheer complexity” of getting back to normal amid the lingering effects of COVID-19 means progress will be very slow. “It could be four years before waiting times get back to pre-Covid levels. We could see that. It’s certainly years, not months,” said Glen Burley, the group chief executive of Warwick hospital, George Eliot hospital in Nuneaton and County hospital in Hereford. Read full story Source: The Guardian, 27 June 2020
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