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Content ArticleHealthcare students are at high risk of sharps injuries, which can negatively impact their confidence and wellbeing. This study audited three clinical skills simulation wards at a UK university to determine the incidence of sharps injuries in this educational setting. The authors found that sharps injuries were the most common type of incident in clinical skills simulation wards, with student nurses being at highest risk. They suggest that intervention is needed to improve safety in this educational setting, including sharps handling training, with greater focus on existing regulations.
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Content ArticlePreventable conditions are costing the NHS and wider society hundreds of billions of pounds and leading to reduced quality of life for large numbers of people. This paper from the Tony Blair Institute for Global Change proposes ways in which the NHS can use existing tools for screening and preventing ill health, to make the UK healthier and more productive and reduce pressure on the health system. It suggests a prevention programme that uses AI to highlight risk factors and screen individuals most likely to develop chronic health conditions.
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Content ArticleStudies have reported evidence on sharps injuries among nursing, medical and dental students but little is known about the amount, type and causes of sharps injuries affecting other healthcare students. This narrative review aimed to identify the extent, type and causes of sharps injuries sustained by healthcare students, especially those not in nursing, medicine or dentistry. The review highlights that some groups of healthcare students, including those studying pharmacy, physiotherapy and radiography, sustain sharps injuries from similar devices as reported in research on such injuries in nursing, medical and nursing students. Sharps injuries happen in a range of healthcare environments, and many were not reported by students. The main cause of a sharps injury identified was a lack of knowledge.
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Content ArticleThe National Institute for Health and Care Excellence (NICE) pioneered the Health Technology Assessment (HTA) processes and methodologies. Technology appraisals (TAs) focus on pharmaceutical products and clinical and economic data, which are presented by the product manufacturers to the NICE appraisal committee for decision-making. Uncertainty in data reduces the chance of a positive outcome from the HTA process or requires a higher discount. This study in the BMJ Open aimed to investigate the quality of clinical data submitted by product manufacturers to NICE. The authors found that the primary components of clinical evidence influencing NICE’s decision-making framework were of poor quality. They argue that there is a need to generate robust clinical data for premarket and postmarket introduction of medicines into clinical practice, to ensure they deliver benefits to patients.
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Content ArticleNontechnical skills (NTS) are the behaviours and thought processes used by surgeons to make decisions, maintain awareness of the operating environment, communicate with and lead team members with the view to producing reliably safe outcomes. This qualitative research explored how surgeons deploy NTS to facilitate safe and effective outcomes from surgical interventions. The authors conclude that successfully understanding and engaging NTS is potentially more proactively useful to surgeons than feedback from more invasive techniques used by some approaches to safe operator assurance.
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Content ArticleThe adrenal glands are found in the fatty tissue at the back of the abdomen above each kidney, and produce steroid and adrenaline hormones. Surgery on tumours of the adrenal gland is uncommon compared with surgery for other tumours such as those of the breast, bowel, kidney and lung. Research has shown that the more adrenal operations a surgeon undertakes per year, the better the overall outcomes for patients undergoing that type of surgery. In this study, the outcomes from adrenal operations recorded over 18 years in the national adrenal surgical registry were analysed. The results confirmed previous findings showing that postoperative complications and length of hospital stay were reduced for patients operated by surgeons who did more adrenal operations per year. Operations done by keyhole surgery had better outcomes. Operations done either in older patients, or for the rare adrenal cancer tumours had worse outcomes, as did operations in which both adrenal glands were removed. The authors recommended that all surgeons performing adrenal surgery should monitor the outcomes of their operations, ideally in a national registry, and discuss these with patients before surgery; and undertake a minimum of six adrenal operations per year, but a minimum of 12 per year if doing surgery for adrenal cancer or surgery to remove both adrenal glands.
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Content ArticleConcerns have been voiced about the possibility of health risks to operating room staff from exposure to surgical smoke generated from electrocautery. This study reviewed available literature to try and assess this risk. The authors concluded that: Regulations on Surgical Smoke that supersede the best judgement of the surgeon are not warranted. The extent of particulate pollution from surgical smoke has been overstated and drawing parallels between exposure to surgical smoke and cigarette smoking is not justified. Numerous studies consistently report negligible levels of pollutants associated with surgical smoke within the operating room's breathable air. While transmission of HPV through surgical smoke is a theoretical concern, conclusive evidence supporting the claim is yet to be established.
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Content ArticleThis study assessed for disparities in the presentation and management of medullary thyroid cancer (MTC). The authors identified patients with MTC from the National Cancer Database and assessed differences in disease presentation and likelihood of guideline-concordant surgical management by sex and race/ethnicity. The results showed that male and non-White patients with MTC more frequently present with advanced disease, and Black patients are less likely to undergo guideline-concordant surgery.
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Content ArticleNHS England’s Worry and Concern Collaborative is looking into how hospitals can make sure the worries and concerns of patients, their family and friends about a patient in hospital are taken into account by doctors, nurses and other health professionals. This webinar, hosted by the Patients Association explored: The role of the National Worry and Concern Collaborative and its seven pilot sites the experiences of both clinicians and patients how these services need to be designed and delivered.
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Content ArticleThis systematic review and meta-analysis in JAMA Internal Medicine aimed to explore whether there is an association between daily toothbrushing among hospitalised patients and prevention of hospital-acquired pneumonia. The authors found that hospital-acquired pneumonia rates were lower among patients randomised to daily toothbrushing, particularly among patients receiving invasive mechanical ventilation. Toothbrushing was also associated with shorter duration of mechanical ventilation, shorter intensive care unit (ICU) length of stay and lower ICU mortality, whereas hospital length of stay and use of antibiotics showed no differences.
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Content ArticleThis study aimed to assess whether the risk of 90-day mortality is comparable for individuals who switch early to oral antibiotics and those who continue intravenous (IV) antibiotics in the treatment of uncomplicated gram-negative bacteremia. The results suggest that transition to oral antibiotics within four days after initial blood culture may be an effective alternative to prolonged IV antibiotic treatment for uncomplicated gram-negative bacteremia.
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Content Article
Studies from medical and surgical intensive care units (ICU) suggest that long-term outcomes are poor for patients who have spent significant time in an ICU. This study in the American Journal of Surgery aimed to identify determinants of post-intensive care physical and mental health outcomes 6–12 months after injury. The authors found that: Delirium during an intensive care unit (ICU) stay is linked with long-term physical impairment in injury survivors who spent three or more days in the ICU. The use of ventilators in the ICU is another factor associated with long-term physical impairment and mental health symptoms in these patients. Delirium and ventilator use are potentially modifiable, suggesting opportunities for improving patient outcomes. They suggest that that this knowledge can inform the development of interventions that specifically target delirium and ventilator use to mitigate long-term impairments. -
Content ArticleThe use of AI in medical devices, patient screening and other areas of healthcare is increasing. This Medscape article looks at some of the risks associated with the use of AI in healthcare. It outlines the difficulties regulators face in monitoring adaptive systems, the inbuilt bias that can exist in algorithms and cybersecurity and liability issues.
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Content ArticleThis study aimed to explore the experience and psychological impact on nursing students of sustaining a sharps injury. A qualitative approach was taken, using two methods to gather data, namely a Twitter chat and interviews. Some nursing students reported psychological impacts after sustaining the sharps injury, which affected both their professional and personal life. The qualitative findings were synthesised into eight themes.
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Content ArticleEmergency general surgery (EGS) involves care and treatment of a patient's often previously unknown disease in an unplanned interaction with the healthcare system. This leads to challenges in collecting and interpreting patient reported outcome measures (PROMs). This study in the American Journal of Surgery aimed to capture the peri-operative experiences of 30 patients at 6 to 12 months after their treatment. The authors found that: two-thirds reported feeling no choice but to pursue emergency surgery with many reporting exclusion from decision-making. Females reported these themes more commonly. patients with minor complications less frequently reported trust in their team and discussed communication issues and delays in care. patients with major complications more frequently reported confidence in their team and gratefulness, but also communication limitations. patients not admitted to the ICU more frequently discussed good communication and expeditious treatment.
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Content Article
Doctors in Distress website
Patient-Safety-Learning posted an article in Suggest a useful website
Doctors in Distress is a UK-based independent charity that promotes and protects the mental health of all healthcare workers and prevents suicides in the medical profession. It was set up in 2018 by Amandip Sidhu following the suicide of his brother Jagdip, a consultant cardiologist, with the aim of providing support for healthcare staff facing burnout and mental health difficulties. The charity runs free online support groups and webinars for healthcare professionals and students. Previous webinars can be viewed on the Doctors in Distress YouTube channel. -
Content ArticleThis Lancet article highlights new evidence from analysis of population-based electronic health records for almost the entire population of the UK. The analysis showed that, as of 1 June 2022, a high proportion of the population had received fewer than the recommended number of Covid-19 vaccinations: 45·8% in England, 49·8% in Northern Ireland, 34·2% in Scotland and 32·8% in Wales. Combining the results across countries suggests that a substantial number of severe Covid-19 outcomes, including hospital admissions or deaths from Covid-19, might be prevented if recommended vaccination schedules were fully implemented. These findings reinforce the message that the role of vaccination in Covid-19 is to mitigate the severity of the illness, reducing the risk of complications and mortality, rather than avoiding all Covid-19 infections.
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EventuntilProfessor Sir Chris Whitty will deliver a live-streamed lecture on health inequalities to launch Talk 200, the University's bicentenary lecture and podcast series. ‘Health inequalities past, present and future’ will consider the main drivers of inequalities and disparities in health, how these have changed over time and why addressing them remains a major public health priority. As a society we face the hard truth that the more socio-economically disadvantaged someone is, the higher their risk of poor health. The world’s greatest killer is not any one individual disease, but the unequal way in which people are born, grow, live, work and age. In Greater Manchester, our unique health and social care ecosystem means we can rapidly drive innovation and translate breakthroughs into real-world solutions – which can be scaled-up and replicated across the globe. Professor Whitty is Chief Medical Officer for England, the UK government’s Chief Medical Adviser, and head of the public health profession. His lecture is the first in our Talk 200 series: a mix of in-person and live-streamed lectures and recorded podcast episodes to be released throughout 2024, our bicentenary year. This event will also include a panel discussion and Q&A, with those joining online able to submit questions using Slido and the code Talk200ChrisWhitty (page not active until 13 February). Watch the lecture live
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Content ArticleThis population-based cohort study from Sweden and Norway aimed to explore whether exposure to mRNA Covid-19 vaccination during pregnancy increases the risk of adverse events in newborn infants. The cohort included 94,303 infants exposed to Covid-19 vaccination during pregnancy and 102,167 control infants born between June 2021 and January 2023. The authors found that vaccination during pregnancy was associated with lower odds of neonatal intracranial haemorrhage, cerebral ischemia and hypoxic-ischemic encephalopathy, and neonatal mortality.
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Content ArticleThis study examines the prevalence of advanced care planning (ACP) for patients undergoing endoscopic, fluoroscopic, laparoscopic or open surgical gastrostomy tube procedures at an academic hospital in the USA. The authors found that only 10.6% of included patients had accessible ACP documents available within their electronic medical record (EMR) and that Black patients had lower rates of ACP documentation. They also highlight an association between ACP documentation and decreased hospital length of stay, with no difference in mortality. The authors recommend the expansion of ACP in perioperative settings.
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Content ArticleThis blog by Healthwatch outlines research conducted by the organisation that shows the issues homeless people face accessing the health and social care they need. The research demonstrates that homeless people: have particular problems accessing GPs and other services. experience serious problems accessing NHS dentistry. may forgo care because of the costs of travelling to appointments. often feel judged by healthcare professionals and not well cared for. The blog also discusses the impact that integrated care systems could have in improving accessibility and quality of care for homeless people.
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Content ArticleAlthough disparities in surgical outcomes are well-documented, understanding of how socioecological factors drive these disparities remains limited. This US study’s objective was to develop and assess the acceptability and feasibility of a comprehensive tool to evaluate socioecological determinants of health in patients requiring colorectal surgery. The authors developed an 88-item assessment tool measuring 31 socioecological determinants of health. It was assessed as having high acceptability and feasibility for patients who required colorectal surgery. The authors concluded that this work will help to identify what research is needed to understand and address surgical disparities.
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Content ArticleBibliometric analysis is a research technique that allows a macroscopic study of the literature surrounding a subject, enabling a prediction of themes that will arise in future research on the subject. In this book chapter, Hülya Saray Kiliç, Assistant Professor at the Bilecik Şeyh Edebali University in Turkey outlines the approach taken in his bibliometric analysis of patient safety in the operating room. His analysis anticipates that the following subjects will be explored in the coming years in relation to patient safety in the operating room. Technology integration and digital solutions Communication and team collaboration Patient education and information Staff training and skill development Risk management and error analysis
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Content ArticleThis paper aims to explore the insights provided by Safety-I and Safety-II approaches by examining the practical application of two frequently used methods: Systematic Human Error Reduction and Prediction Approach (SHERPA) and Functional Resonance Analysis Method (FRAM). Neither method should be uniquely labelled as a Safety-I or Safety-II approach, however, SHERPA is traditionally used within a Safety-I context, and FRAM is frequently used within a Safety-II context. By examining the application of these two methods to the management of post-surgical deterioration, the authors critically reflect on the analysis logic embedded in each method and their potential contribution to improving patient safety.
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Content ArticleParticipants are vital to the success of any clinical trial. Without the data they provide, our research system would collapse. But being a clinical trial participant is not easy. Financial barriers, transport challenges, and a lack of engagement and support can leave patients feeling marginalised and disconnected. This article looks at what needs to be done to ensure diverse patients from around the world can engage with studies and remain engaged from screening until study completion, regardless of their personal circumstances.
