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Patient-Safety-Learning

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Everything posted by Patient-Safety-Learning

  1. Content Article
    This paper in the journal RSC Advances aimed to track changes in chemical bonding taking place in PP meshes on the nanoscale via mechano–chemical processes. The authors used the novel and advanced spectroscopic characterisation technique secondary electron hyperspectral imaging (SEHI) to build high resolution chemical maps. Polypropylene (PP) surgical mesh is associated with serious clinical complications when used in the pelvic floor for repair of stress urinary incontinence or support of pelvic organ prolapse. While manufacturers claim that the material is inert and non-degradable, there is a growing body of evidence that asserts PP fibres are subject to oxidative damage. Material surgically removed from patients suffering with clinical complications has shown some evidence of fibre cracking and oxidation. It has been proposed that a pathological cellular response to the surgical mesh contributes to medical complications, but the mechanisms that trigger the specific host response against the material are not well understood.  The study presented key insights into the mechano–chemistry reaction of PP which can cause polymer oxidation, changes in molecular structure, crack/craze formation and the release of etched oxidised insoluble particles. SEHI, provided a new route to link the effect of localised stresses to reactions of mechano–chemistry within PP. The method of mechanical distension testing during hydrogen peroxide exposure followed SEHI image analysis could form the basis of an “early warning” system which has the ability to identify materials which are not appropriate for use as medical implants.
  2. News Article
    A “most accomplished fraudster” was paid between £1m and £1.3m by the NHS during the nearly two decades she posed as a qualified doctor after forging a degree certificate, a court has heard. Zholia Alemi, believed to be 60 years old, worked as a psychiatrist in the UK for 19 years after claiming to have qualified at the University of Auckland in New Zealand, a trial at Manchester crown court heard. The defendant is accused of 20 offences, including forgery and fraud, which she denies. The jury heard Alemi’s case was that she was appropriately qualified and documents demonstrating her qualifications were genuine. She denies 13 counts of fraud, three counts of obtaining a pecuniary advantage by deception, two counts of forgery and two counts of using a false instrument. Read full story Source: The Guardian (paywalled)
  3. News Article
    Patients have suffered cardiac and respiratory arrests because of errors using oxygen cylinders, NHS England has warned, citing more people being cared for in “areas without access to medical gas pipeline systems” such as corridors and ambulances queuing outside A&E. A patient safety alert issued by NHS England today identifies 120 incidents in the past year related to oxygen cylinder use, including cylinders either being empty at point of use, not switched on, inappropriately transported, or inappropriately secured. Some of the incidents involved “compromised oxygen delivery to the patient, leading to serious deterioration and cardiac or respiratory arrest” the alert said, and at least 43 caused harm. Read full story (paywalled) Source: HSJ, 10 January 2023
  4. Content Article
    This blog for Refinery 29 by journalist Sarah Graham examines the gender health gap, a term used to describe the inequalities in treatment and health outcomes that men and women experience. She talks about the stories relating to sexism and institutional bias she has come across during her time as a health journalist, that result in poor care experiences and outcomes for women. While acknowledging that women should not have to make extra effort to be heard by the health system, Sarah offers tips for women to help them voice their concerns and improve their chances of being listened to by medical professionals.
  5. Content Article
    Appreciative Inquiry (AI) is a transformational change methodology grounded in theories from the disciplines of human sciences and philosophy. It invites people to see themselves and the world through an appreciative or valuing eye. This article by AI strategist Robyn Stratton-Berkessel aims to provide an overview of AI for beginners, and covers: What is Appreciative Inquiry How it is a strengths-based, positive framework What it can achieve through collaborative conversations The 4-D process of Appreciative Inquiry – known as the Appreciative Inquiry Model How it can be applied personally and professionally The guiding principles (Including the new addition of the five emerging principles) The importance of Appreciative Inquiry questions – affirmatively-framed questions The value of story-telling in Appreciative Inquiry
  6. Content Article
    Even before the Covid-19 pandemic, rural and remote health services in England faced long-standing workforce, financial and capacity issues. This report by the Nuffield Trust explores the impact the pandemic has had on the delivery of rural and remote health services, highlighting the underlying challenges faced by these services. It outlines how the challenges faced are different for rural areas when compared to more urban areas. The authors also discuss how performance could be monitored to signal the risk of any significant service pressures over the coming months.
  7. Content Article
    In this article for The Guardian, an anonymous hospital consultant describes the situation in many NHS emergency departments in January 2023—patients ready for medical admission waiting in ambulances in the hospital car park, patients receiving IV antibiotics in chairs in the corridor and staff completely overwhelmed by the workload. The author highlights that accident and emergency departments are now being used for a purpose for which they were not designed—looking after patients who need to be admitted to hospital wards. They describe the implications of this on patient safety and staff wellbeing and argue that the NHS and Government need to call the situation what it is—a crisis—or we will come to accept poor quality care and low patient safety standards as the norm.
  8. News Article
    More than 650,000 deaths were registered in the UK in 2022 - 9% more than 2019. This represents one of the largest excess death levels outside the pandemic in 50 years. Though far below peak pandemic levels, it has prompted questions about why more people are still dying than normal. Data indicates pandemic effects on health and NHS pressures are among the leading explanations. Although the ongoing impact of the pandemic is a contributing factor, a number of doctors are blaming the wider crisis in the NHS. On 1 January 2023, the president of the Royal College of Emergency Medicine suggested the crisis in urgent care could be causing "300-500 deaths a week". Read full story Source: BBC News, 10 January 2023
  9. News Article
    More than 7,000 nurses at two major New York City hospitals walked off the job Monday, arguing immense staffing shortages are causing widespread burnout and hindering their ability to properly care for their patients. The nurses say they are working long hours in unsafe conditions without enough pay – a refrain echoed by several other nurses strikes across the country over the past year. The union representing the nurses said an offer of 19% pay hikes isn’t enough to solve staffing shortages. This is the latest in a series of strikes in the health care industry in recent years. Those union members who were on the front lines during the three-year battle with the Covid pandemic say the system is no longer able to function with the widespread shortages that arose during those years. “We’ve been fighting for working under safer conditions,” Warren Urquhart, a transplant nurse at Mount Sinai, told CNN Monday while on the picket line. “We do the best we can every day. There’s something wrong inside the hospital. That’s why we’re outside the hospital.” Read full story Source: CNN, 9 January 2023
  10. Content Article
    This document outlines NHS England's approach to learning from safety culture best practice. It covers: Safety culture context within the NHS patient safety strategy Leadership Continuous learning and improvement Measurement and systems Teamwork and communication Psychological safety Inclusion, diversity and narrowing healthcare inequalities Case studies
  11. News Article
    Ambulance staff will take part in their second day of strike action this winter on Wednesday 11 January. Alongside paramedics, call-centre staff will walk out across England and Wales in the dispute over pay. These workers play a vital role, taking calls from the public and assigning ambulance crews. An ambulance dispatcher at the North West Ambulance Service, who wishes to stay anonymous, has described working amid the extreme pressures of this winter. They said, "The thought of going in and having to manage those calls just fills me with absolute dread. I have seen people leave the ambulance service - they have had enough. We are physically and mentally exhausted." Most frustrating, the dispatcher says, is the number of crews stuck outside hospital waiting to hand patients over to accident-and-emergency staff. In the last week of 2022, more than 40% of crews in England had waits of more than 30 minutes - it should take 15. Read full story Source: BBC News, 10 January 2023
  12. Content Article
    The Cambridge Elements series offers a comprehensive and authoritative set of overviews of different improvement approaches that can be applied to healthcare. Each publication explores the thinking behind them, examines evidence for each approach and identifies areas of debate. Publications available include: Design creativity Values and ethics Statistical process control Approaches to spread, scale-up, and sustainability Health economics Governance and leadership Workplace conditions Reducing overuse Simulation as an improvement technique Implementation science Operational research approaches Making culture change happen Co-producing and co-designing Collaboration-based approaches The positive deviance approach
  13. News Article
    Nigel Edwards is the Chief Executive of the think tank the Nuffield Trust. In this interview, he outlines the discharge problems currently faced by NHS hospitals, highlighting lack of staff and resources in the social care sector as major causes of hospital capacity issues. Source: Channel 4 News
  14. Content Article
    A joint paper by Public Health Wales and Cardiff University has identified a worrying trend of depreciating health inequalities between Wales’ most and least deprived areas. This blog outlines the key findings of the paper, including how the gap in life expectancy increased amongst both men and women between 2002 and 2020. This was primarily caused by large drops in life expectancy in Wales’ most deprived areas, including a sharp decline for women between 2018 and 2020.
  15. News Article
    The FDA is greenlighting the drug Leqembi after it appeared to slow cognitive decline in some early stage Alzheimer’s patients in spite of some potential risks. In this video, Kristen Dahlgren has more details about findings from the clinical trial. Watch full story Source: NBC News, 7 January 2023
  16. News Article
    TV presenter Dr Hilary Jones has blasted the Prime Minister over his handling of the NHS, warning it is at risk of collapse. Speaking on ITV’s Good Morning Britain, the GP shared the experiences of “heartbroken” frontline doctors and said if the situation “doesn’t change very quickly, the NHS is finished”. Dr Jones referred to a group chat between 13,000 doctors who work on the front line and in primary care, where members are sharing stories that show patients experiencing very long delays in receiving treatment. He described how staff are in tears at the end of their shift “and when they return to the next shift, the same patient is still waiting to be seen after 24 hours”. He added: “For Rishi Sunak and the Government to pretend that this is not a crisis when more than a dozen trusts have announced critical incidents is not only delusional, as the BMA say, I would say at the very best it’s ill-informed misjudgment, at the very worst it’s total irresponsibility and incompetence. I have never known anything like this.” Read full story Source: Independent, 5 January 2023
  17. News Article
    More than 100,000 people with type 1 diabetes in England are to be offered an artificial pancreas, which experts believe could become the “holy grail” for managing the disease. The groundbreaking device uses an algorithm to determine the amount of insulin that should be administered and reads blood sugar levels to keep them steady. A world-first trial on the NHS found it was more effective at managing diabetes than current devices and required far less input from patients. The device is now set to be rolled out across the NHS in England after it won approval from the National Institute for Health and Care Excellence (NICE). Prof Partha Kar, national specialty adviser for diabetes at NHS England, said: “This technology has been proven to give the best control for managing type 1 diabetes and should make things like amputations, blindness, and kidney problems possibly a thing of the past.” Read full story Source: The Guardian, 10 January 2023
  18. News Article
    The government has ‘a week to 10 days’ to distribute the £200m it is committing to speed up hospital discharge if the initiative is to have a meaningful impact on reducing the 13,000 patients who are medically fit to leave hospital, national healthcare leaders have told HSJ. Health and social care secretary Steve Barclay announced this morning that the government was effectively reintroducing the national discharge scheme used to fund “short-term care placements” earlier in the covid pandemic, which was scrapped in April last year. NHS Confederation chief executive Matthew Taylor said: “We await the full details of the proposed hospital discharge fund with interest. Given the ongoing delay in distributing the delayed discharge fund announced last autumn any funds will need to be rapidly deployed.” Read full story (paywalled) Source: HSJ, 9 January 2023
  19. Content Article
    This is part of our series of Patient Safety Spotlight interviews, where we talk to people working for patient safety about their role and what motivates them. Ian talks to us about rebuilding patient trust in the healthcare system, how the Private Healthcare Information Network (PHIN) is helping to improve decision making for patients in the private sector, and why recognising the link between physical and mental health is vital to patient safety.
  20. News Article
    Junior doctors across England will walk out for 72 hours in March if a ballot for industrial action is successful, the British Medical Association has told ministers. The BMA confirmed the move ahead of the opening of its ballot on Monday (9 January). The union is calling for real terms pay cuts over the past decade to be reversed, claiming the last 15 years have led to a 26 per cent decline in the value of junior doctors’ pay. Robert Laurenson and Vivek Trivedi, co-chairs of the BMA’s junior doctors committee, said: “Pay erosion, exhaustion and despair are forcing junior doctors out of the NHS, pushing waiting lists even higher as patients suffer needlessly.” Read full story (paywalled) Source: HSJ, 8 January 2023
  21. Content Article
    A prolonged stay in the emergency department before moving on to an in-hospital bed, another facility or departing home, is believed to have a negative effect on clinical outcomes for patients. This international systematic review and meta-analysis in the Journal of Clinical Medicine aimed to investigate the link between emergency department length of stay (EDLOS) and in-hospital mortality. The study's findings suggest two key associations with increased in-hospital mortality: low EDLOS EDLOS exceeding 24 hours The authors suggest that: long stays in the emergency department should not be allowed. special attention should be given to patients admitted after a short stay in the emergency department.
  22. News Article
    Thousands of NHS patients in England will be moved into care homes as part of the government's plan to ease unprecedented pressure on hospitals. The NHS is being given £250m to buy thousands of beds in care homes and upgrade hospitals amid a winter crisis. The move aims to free up hospital beds so patients can be admitted more quickly from A&E to hospital wards. The plans will be included in an emergency package to be unveiled by Health Secretary Steve Barclay. Helen Whately, minister for care, said, "Getting people out of hospital on time is more important than ever. It's good for patients and it helps hospitals make space for those who need urgent care." Read full story Source: BBC News
  23. Content Article
    Electroconvulsive therapy (ECT) is a technique that has been used since 1938 to treat several psychiatric disorders as a replacement for chemically induced seizures. Despite its history of stigma, controversy and low accessibility, ECT is found to be beneficial and efficient in severe cases of depression where medication fails to bring results. This article in Experimental and Therapeutic Medicine aimed to summarise the research conducted on the efficacy of ECT on major depressive disorder and variables studied such as technique, comorbidities and medication as well as the effects and outcomes of this procedure.
  24. Content Article
    In this blog for the Citizens Commission on Human Rights, Jane London shares her account of how electroconvulsive therapy (ECT) has affected her life since early adulthood, resulting in severe memory loss and heart problems. Jane shares how her physical medical problems including appendicitis and a severe heart attack were put down to depression, and how she was nearly forced to have ECT against her will in England in 1966. When her abusive marriage ended in 1968 and Jane returned to Australia her mother insisted she have ECT, despite her depression being temporary and related to her marriage ending. After 14 treatments, Jane left the treatment facility and received talking therapy to help her recover. Jane talks about the dramatic adverse effect ECT has had on the rest of her adult life.
  25. Content Article
    In this article for The Guardian, psychiatrist Rebecca Thomas talks about the benefits and problems related to electroconvulsive therapy (ECT) treatments, which are used in cases of severe depression. Having had 70 individual ECT treatments for depression herself, Rebecca highlights that although the therapy can be very effective, doctors need to acknowledge the issues it can cause for patients. She talks about the memory issues ECT can cause, and highlights that as a therapy it has been stigmatised, which spreads fear about a treatment that can be necessary and life-saving. Concluding that decisions around ECT therapy should be clinical and not moral, she urges doctors not to be complacent about the risks, and patients to be careful about stigmatising an effective treatment.
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