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Patient-Safety-Learning

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Everything posted by Patient-Safety-Learning

  1. Content Article
    Sepsis is an emergency medical condition where the immune system overreacts to an infection. It affects people of all ages and, without urgent treatment, can lead to organ failure and death. This leaflet by the Sepsis Trust outlines the symptoms of sepsis in children and aims to help parents and carers identify when to seek medical help.
  2. Content Article
    This cohort study examined whether sociodemographic characteristics affected patient access to and use of patient health care portals during the Covid-19 pandemic. The authors found significant disparities in portal use by sex, age, multimorbidity and health literacy were found. While disparities by sex and age decreased and were no longer statistically significant by 2021, disparities by multimorbidity remained consistent throughout the pandemic and disparities by health literacy were exacerbated.
  3. Content Article
    This study in BMJ Open aimed to describe the experiences and opinions of GPs in England about patients having access to their full online GP health records. 400 registered GPs in England completed an online survey. The results revealed some key findings: 91% GPs believed a majority of patients would worry more. 85% said they though patients would find their GP records more confusing than helpful. 60% believed a majority of patients would find significant errors in their records. 70% believed patients would better remember their care plan. 60% said patients would feel more in control of their care. 89% believed they will/already spend more time addressing patients’ questions outside of consultations. 81% said that consultations will/already take significantly longer. 72% said they will be/already are less candid in their documentation after online records access. 62% believed patients having access to their records would increase their litigation.
  4. Content Article
    Antibiotic underdosing is a widespread issue in the healthcare system. The use of modern infusion pumps to deliver intravenous (IV) medications has resulted in the practice of flushing IV lines being lost in some specialties. Failure to give full doses of IV antibiotics poses significant risks to individual patients as well as adding to the problem of antimicrobial resistance (AMR). In this interview, Ruth Dando, Head of Nursing, Theatres, Critical Care and Anaesthetics at Barking, Havering and Redbridge University Hospitals Trust (BHRUHT) explains why antibiotic underdosing is a risk to patient safety and describes how she has implemented a change in practice to tackle the issue across BHRUHT. A transcript is available below the video.
  5. Content Article
    Ashleigh Hughes is a Senior Sister at an NHS chemotherapy day unit. In this interview she shares her personal story about the impact of antibiotic underdosing on her Mum’s end of life care. Antibiotic underdosing is a medication safety issue that has profound implications for the health service as well as individual patients, but there is currently a lack of understanding and recognition of the issue.
  6. Content Article
    This paper provides a summary of a webinar entitled “Long Covid and return to work support - what works?” held in March 2022. The webinar was organised because of the multiple different approaches being taken to the management of Long Covid across the UK and elsewhere. The paper aims to provide guidance to occupational health providers, employers, workers, people with Long Covid, HR personnel, managers, healthcare professionals and unions about the identification and management of Long Covid, particularly relating to return to work. It argues that a multi-disciplinary approach is essential to help retain and support people affected by Long Covid to return to work. It includes information on: Universal first-line screening assessment in Long Covid Red flags and specialist referral Treatment which can help function and recovery Rehabilitation Specific Fitness for Work considerations after Covid-19 infection Examples of workplace adjustments for Long Covid Prevention of infection: risk management in the workplace Workplace public health messages
  7. Content Article
    This consensus statement co-ordinated by the British In Vitro Diagnostics Association (BIVDA) outlines the role of point of care testing in reducing the amount of antibiotics prescribed in primary care. It highlights the issue of antimicrobial resistance (AMR) and outlines evidence for the effectiveness of the rapid point-of-care C-Reactive Protein (POC CRP) test to assist clinical decision making as to whether an individual presenting with symptoms of respiratory tract infection needs an antibiotic. It makes a series of recommendations for the Department of Health and Social Care (DHSC) and NHS England around the use of POC CRP testing in primary care.
  8. Content Article
    The Patients Association has been working with the Health and Care Professions Council (HCPC) to understand the impact the English language proficiency of health and care professionals has on patient and carer experiences. The HPCP is proposing changes to its English language proficiency requirements for applicants and this blog outlines key issues that were raised in an online focus group with patients, including: The impact of English language proficiency on patient experience Creating a fair system Partnering with patients and carers
  9. Content Article
    The authors of this JAMA article describe the experience of a family member who was in critical care, and who is deaf. They outline a lack of awareness amongst healthcare professionals about their relative's deafness and highlight the lack of understanding in how to communicate with her. They go on to outline a number of approaches to communicating with patients who are deaf or hard of hearing.
  10. Content Article
    This report describes the findings of a study that collected stories of the working lives of Black and Brown healthcare staff during the Covid-19 pandemic. The study asked them to reflect on their experiences and highlight the changes they would like to see. It highlights a number of issues around victimisation, access to PPE, speaking up and risk assessments. The authors argue that the report confirms previous studies that identify the entrenched nature of racism in healthcare systems and highlights how systemic cultures of racism contributed to the disproportionate impact of Covid-19 on health and care workers from minority ethnic backgrounds.
  11. Content Article
    This US study looked at how critical care doctors approach shared decision-making with Black compared with White caregivers of critically ill patients. The authors found that racial disparities exist in critical care clinicians' approaches to shared decision-making and suggest potential areas for future interventions aimed at promoting equity.
  12. Content Article
    The epidemic of workplace violence has prompted the use of harsh responses that include “behaviour contracts” (sometimes called “behavioural agreements”) by US healthcare organisations. The authors of this JAMA article look at how this approach can undermine a hospital’s commitment to providing evidence-based, patient-centred care and highlight other approaches to dealing with patient aggression and violence in healthcare settings.
  13. Content Article
    This systematic review of qualitative evidence aimed to improve understanding of the processes and outcomes of redress and reconciliation following a life-changing event, from the perspectives of individuals experiencing the event and their families. The authors searched six bibliographic databases for primary qualitative evidence exploring the views of individuals who have experienced a life-changing event, and/or their family or carers, of redress or reconciliation processes. This was supplemented with targeted database searches, forward and backward citation chasing and searches of Google Scholar and relevant websites. The review identified three themes identified by patients and families that represent procedural elements required to support a fair and objective process: transparency, person-centred and trustworthy. A further theme identified—restorative justice—is about how a fair process feels to those who have experienced a life-changing event. It highlights the importance of an empathic relationship between the different parties involved in the process and the significance of being able to engage in meaningful action. Theses findings provide insights on how to conduct a fair review into instances of medical harm.
  14. Content Article
    This US study in the journal Pediatrics analysed a national sample of paediatric hospitalisations to identify disparities in safety events. The authors used data from the 2019 Kids’ Inpatient Database and looked at the independent variables of race, ethnicity and the organisation paying for care (for example, private insurance company or Medicaid). The results showed disparities in safety events for Black and Hispanic children, indicating a need for targeted interventions to improve patient safety in hospitals.
  15. Content Article
    This cohort study in the Lancet aimed to evaluate the overall effect of vaccination to prevent Long Covid symptoms and assess comparative effectiveness of the most used vaccines (ChAdOx1 and BNT162b2). The results showed that vaccination against Covid-19 consistently reduced the risk of Long Covid symptoms, which highlights the importance of vaccination to prevent persistent Covid-19 symptoms, particularly in adults.
  16. Content Article
    This ethnographic study looked at five local Healthwatch organisations to determine the extent to which they have fulfilled their intended role of fostering co-creation in health and social care in England. The study results demonstrate clear activity and some tangible impacts that have been achieved towards the aim of cocreation. However, the authors also highlight that the positioning of these organisations as 'collaborative insiders' in local governance systems has limited the issues that have been prioritised in co-creative activities. This analysis suggests that the increasing promotion of ideas of co-production in English health and social care has resulted in fertile grounds for localised co-creation. However, the authors highlight that the areas Healthwatch focused on were ones where other agencies in the system recognised their limitations, and where they knew they needed help to avoid socially undesirable outcomes. As a result, the approaches taken to co-creation by Healthwatch were largely conservative and constrained. The authors state that, "Even though they were not explicitly ruled out-of-bounds, Healthwatch officers knew that to be considered legitimate and serious players in the governance of health and social care, they needed to be selective about which issues they brought to the table."
  17. Content Article
    When Emma Powell experienced psychosis this year, she was told to go to A&E by the mental health crisis team. But she was left waiting for a bed for three and a half days, in conditions that only made her distress worse. In this article, Emma describes several experiences of trying to access crisis care for her schizoaffective disorder. She explains the impact of long waits at A&E and how they make her condition worse, with the overcrowded and busy environment causing overstimulation, and changing staff carrying out repetitive consultations causing confusion and exhaustion.
  18. Content Article
    This month marks two years of the hub's Patient Safety Spotlight interview series. Patient Safety Learning's Content and Engagement Manager Lotty Tizzard reflects on the value of sharing personal insights and identifies the key patient safety themes that interviewees have highlighted over the past two years.
  19. Content Article
    Eating Disorders Awareness Week takes place 26 February - 3 March 2024 Eating disorders are complex mental health conditions that affect an estimated 1.25 million people in the UK. There are many unhelpful myths about who eating disorders affect, what the symptoms are and how to support people in recovery. Alongside a current lack of appropriately trained staff and capacity in mental health services, this can make it challenging for people with eating disorders to access the help and support they need. Patient Safety Learning has pulled together ten useful resources shared on the hub to help healthcare professionals, friends and family support people with eating disorders. They include awareness-raising articles, practical tips for patients and their loved ones, and clinical guidance for primary, secondary and mental health providers.
  20. Content Article
    To decrease surgical site infections after appendectomy for acute appendicitis, preoperative broad-spectrum antibiotics are often used in clinical practice. However, this treatment strategy has come under scrutiny because of increasing rates of antibiotic-resistant infections. This multisite quality improvement project aimed to decrease the treatment of uncomplicated acute appendicitis with piperacillin-tazobactam without increasing the rate of surgical site infections. The intervention had two distinct components: Updating electronic health record orders to encourage preoperative administration of narrow-spectrum antibiotics. Educating surgeons and emergency department clinicians about selecting appropriate antibiotic therapy for acute appendicitis. Patient demographics, clinical characteristics and outcomes were compared six months before and after implementation of the quality improvement intervention. The intervention successfully decreased piperacillin-tazobactam administration without increasing the rate of surgical site infections in patients with acute appendicitis.
  21. Content Article
    To tackle the serious harms, up to and including death, associated with eating disorders it is crucial that more is done to identify them at the earliest stage possible so that the appropriate care and treatment can be provided. This new guidance by the Royal College of Psychiatrists is based on the advice and recommendations of an Expert Working Group. It provides a comprehensive overview of the latest evidence associated with eating disorders, including highlighting the importance and role of healthcare professionals from right across the spectrum recognising their responsibilities in this area.
  22. Content Article
    In this article, investigative journalist Scilla Alecci reports on a court case brought against medical tech company Medtronic by a US whistleblower. Former Medtronic sales representative Leanne Houston alleges that between 2016 and 2018 she witnessed the company engaging in “unlawful conduct” by offering several US hospitals free equipment in exchange for the exclusive use of Medtronic products. She also claims that the company failed to acknowledge and deal with reports from surgeons that one of its surgical staple devices was causing harm to patients.
  23. Content Article
    This manifesto draws on the views of NHS Confederation members—health and care leaders across England, Wales and Northern Ireland. It suggests five changes that the next government will need to make in order to place the health and care system on a sustainable footing: Put the NHS on a more sustainable footing, with no top-down structural reform in England for the next parliament. Commit to a short-term stabilisation plan during the first 12 months of parliament to help get performance in the English NHS back on track. Increase NHS capital spending across the UK and reform how the capital regime operates. Specifically in England, capital funding needs to increase to at least £14.1 billion annually, a £6.4 billion increase from the current level of £7.7 billion. This is vital if we are to increase productivity and reduce waiting lists. Commit to fund and deliver the NHS Long Term Workforce Plan for England, alongside an equivalent plan for social care. Provide more care closer to home by enabling local health systems to proportionately increase investment upstream into primary care and community-based services, mental health and social care. Deliver a strategy for national health given that most policy that impacts people’s health is made outside the NHS. The Prime Minister should lead a cross-government national mission for health improvement to shift the focus from simply treating illness to promoting health and wellbeing, reducing inequalities and tackling the wider determinants of health, and supporting the public to be active partners in their own health.
  24. Content Article
    Leadership in a safety culture environment is essential in avoiding patient harm. However, leadership in surgery is not routinely taught or assessed. This study aimed to identify a framework, metrics and tools to improve surgical leadership and safety outcomes. It identified three areas of leadership needed to build a culture of safety in surgery: Control risk (risk management) Drive progress (opportunity management) Rally support for the mission (people management) A leadership assessment tool (SLAM) was developed to provide objective metrics of surgical leadership behaviours based on nine key performance indicators.
  25. Content Article
    Over the past decade, the implementation of simulation education in health care has increased exponentially. Simulation-based education allows learners to practice patient care in a controlled, psychologically safe environment without the risk of harming a patient. Facilitators may identify medical errors during instruction, aiding in developing targeted education programs leading to improved patient safety. However, medical errors that occur during simulated health care may not be reported broadly in the simulation literature. This study in the Journal of Patient Safety aimed to identify and categorise the type and frequency of reported medical errors in healthcare simulation.
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