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Claire Cox

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Everything posted by Claire Cox

  1. Content Article
    The Patient Safety Management Network (PSMN), created in June 2021, is an innovative voluntary network for patient safety managers and everyone working in patient safety. Claire Cox, Quality Patient Safety Lead, King's College Hospital NHS Foundation Trust, looks at how the Network has evolved over the last two years, its achievements and its aims going forward. 
  2. Content Article Comment
    Hi Tom, thank you. I would like to know more about what you are doing - sounds right up my street!
  3. Content Article
    Claire Cox, Patient Safety Lead at Kings College Hospital NHS Foundation Trust, shares a recent technique she used to explain the difference between 'work as imagined' and 'work as done'. Claire's example (a pathway for a patient coming to A&E, who also has a mental health issue) highlights the safety risks of competing guidance and the importance of co-production moving forward.
  4. Content Article
    The latest issue of the Patient Safety Journal is now out.  US patient safety journal brought to you by the Patient Safety Authority, an independent agency of the Commonwealth of Pennsylvania. Each issue publishes original, peer-reviewed research and data analyses and also gives patients a voice. It's mission is to give clinicians, administrators and patients the information they need to prevent harm and improve safety. 
  5. Content Article
    In this blog, Claire Cox, Quality Improvement and Patient Safety Manager at Guys and St Thomas' Hospital NHS Foundation Trust, explains why and how she developed the Patient Safety Management Network. She looks at why the network is needed, what it has achieved so far, its aims for the future and how patient safety managers can get involved.
  6. Community Post
    Years ago I remember never being allowed a drink at the desk. It was against infection control is what I was told. however I do remember breaking the rules and then promptly spilling the drink across the keyboard 🤦🏼‍♀️ As an outreach nurse , we are travellers around the hospital. I know where all the water stations are in each department - the trouble is that there are sometimes a lack of cups. Disposable cups are not environmentally friendly , however if you are a HCP that moves around wards you can’t always take a bottle with you - especially if you are running to an emergency. If you are based on the wards , the culture where I work is that you are able to have a bottle at the desk. working on COVID wards , regular breaks were taken as hydration was much more focussed on than ever before. Not sure who controls the heating in all hospitals, but turning that off in the summer would help!!
  7. Content Article
    Since her last blog for the hub, Claire has moved away from clinical practice as a critical care outreach nurse and has entered the world of patient safety management in a new Trust. Coming out of a second lockdown, Claire reflects on how her experiences working in the NHS are very different from the first lockdown back in March 2020 and the difficulties she's facing doing quality improvement from home.
  8. Content Article
    A concept called “psychological safety” is especially crucial to a team’s success, according to Amy Edmondson, professor of leadership and management at the Harvard Business School.  Psychological safety describes “a workplace where one feels that one’s voice is welcome with bad news, questions, concerns, half-baked ideas and even mistakes,” Edmondson tells CNBC Make It. People should feel like they can ask questions, raise concerns and pitch ideas without undue repercussions.  This article gives a good introduction to what psychological safety is and how to achieve it in the work place.
  9. Content Article
    Many of us are aware of school campaigns against bullying, protecting school aged children from harmful experiences that pose life-long lasting effects. Phrases such as “don’t be a bystander” and “stand up” are used to remind us of our obligation to help those who need it. Yet, these efforts rarely continue into our adult lives, and have mainly ignored the devastating effects of bullying on people from all walks of life, including in the patient community.
  10. Content Article
    This interactive orientation of an Intensive Care Unit (ICU) bed space, created by the London Transformation and Learning Collaborative, is ideal for healthcare professionals new to the ICU environment. It allows you to explore the risks and demonstrated the safety check required to keep patients safe in the ICU. This application is best used with a smart phone, but can be used on a computer.
  11. Content Article
    Humility, transparency and urgency are the keys to successfully steering an organization – big or small – through the challenges that come your way. In this TED Talk, leadership expert, Amy Edmondson, provides clear advice and examples to help any leader rise to the occasion.
  12. Content Article
    The current COVID-19 pandemic has necessitated the redeployment of NHS staff to acute-facing specialties, meaning that care of dying people is being provided by those who may not have much experience in this area. This report, published in Future Healthcare Journal, details how a plan, do, study, act (PDSA) approach was taken to implementing improved, standardised multidisciplinary documentation of individualised care and review for people who are in the last hours or days of life, both before and during the COVID-19 pandemic. The documentation and training produced is subject to ongoing review via the specialist palliative care team's continuously updated hospital deaths dashboard, which evaluates the care of patients who have died in the trust. It is hoped that sharing the experiences and outcomes of this process will help other trusts to develop their own pathways and improve the care of dying people through this difficult time and beyond.
  13. Content Article
    The COVID-19 pandemic has put the UK health and care workforce under unprecedented pressure. The workforce had been struggling to cope even before the pandemic took hold. Staff stress, absenteeism, turnover and intentions to quit had reached alarmingly high levels in 2019, with large numbers of nurse and midwife vacancies across the health and care system.  The impact of the pandemic on the nursing and midwifery workforce has been unprecedented and will be felt for a long time to come. The crisis has also laid bare and exacerbated longstanding problems faced by nurses and midwives, including inequalities, inadequate working conditions and chronic excessive work pressures. The health and wellbeing of nurses and midwives are essential to the quality of care they can provide for people and communities, affecting their compassion, professionalism and effectiveness.  This review, from the Kings Fund, investigated how to transform nurses’ and midwives’ workplaces so that they can thrive and flourish and are better able to provide the compassionate, high-quality care that they wish to offer.  Nurse and midwives have three core work needs that must be met to ensure wellbeing and motivation at work, and to minimise workplace stress: autonomy, belonging and contribution. This report sets out eight key recommendations designed to meet these three core work needs. These recommendations focus on: authority, empowerment and influence; justice and fairness; work conditions and working schedules; teamworking; culture and leadership; workload; management and supervision; and learning, education and development.
  14. Content Article
    Falls and fractures in older people are often preventable. Reducing falls and fractures is important for maintaining the health, wellbeing and independence of older people. A fall is defined as an event which causes a person to, unintentionally, rest on the ground or lower level, and is not a result of a major intrinsic event (such as a stroke) or overwhelming hazard. Having a fall can happen to anyone; it is an unfortunate but normal result of human anatomy. However, as people get older, they are more likely to fall over. Falls can become recurrent and result in injuries including head injuries and hip fractures.
  15. Content Article
    The Falls and Fragility Fractures Pathway defines the core components of an optimal service for people who have suffered a fall or are at risk of falls and fragility fractures.The Falls and Fragility Fractures Pathway has been developed in collaboration with the National Clinical Director for Musculoskeletal Services, Peter Kay, Public Health England (PHE), the National Osteoporosis Society (NOS) and a range of other stakeholders from across the health and care system. The pathway defines the key interlocking components for an optimal system for prevention and management and the priority higher value interventions that systems should focus on to address variation, improve outcomes, reduce cost and contribute toward a sustainable NHS.
  16. Content Article
    The coronavirus that causes COVID-19 attacks the lungs and respiratory system, sometimes resulting in significant damage. COVID-19 often leads to pneumonia and even acute respiratory distress syndrome (ARDS), a severe lung injury. Recovering lung function is possible but can require therapy and exercises for months after the infection is treated.
  17. Content Article
    The early identification of deterioration in suspected COVID-19 patients managed at home enables a more timely clinical intervention, which is likely to translate into improved outcomes. Dr Matt Inada Kim and team undertook an analysis of COVID-19 patients conveyed by ambulance to hospital to investigate how oxygen saturation and measurements of other vital signs correlate to patient outcomes, to ascertain if clinical deterioration can be predicted with simple community physiological monitoring.
  18. Content Article
    This resource, written by the Royal College of Nursing, is intended for any registered nurse working with medicines as part of their role. The principles of medicines management however, apply across all health care settings and for non-registered staff.
  19. Content Article
    This guidance is intended for doctors, nurses and allied healthcare professionals looking after children. It is therefore written in a manner to be accessible to all groups. It is intended to improve the care of children at risk of, or with, Acute Kidney Injury (AKI).
  20. Content Article
    Human factors affect paramedic practice and training. However, although there are frequent references to human factors in the literature, little evidence on this is available on those that influence student paramedic development. In this article, published by the Journal of Paramedic Practice, looks at a case study which highlighted certain human factors unique to the role, most notably how interactions between students and mentors can affect a student's practice. Following this, the awareness and effect of human factors within the student paramedic role were investigated.  
  21. Community Post
    Oh Alice, I bet you feel scared stiff. I know there are many women on this forum who may be able to offer some words of advice/comfort to you. @Katharine Tylko I am glad you have found our site as this will put you in touch with women around the UK who understand your anxieties and are battling for a safer hysteroscopy.
  22. Content Article Comment
    Thanks Jonathan! The narrative of a datix is so important. I am new to the patient safety manager role, so I have limited experience in dealing with the 'back end' of datix. From the small amount that I have seen - you get many (tonnes actually) that are no harm, and you can tell that 'I am going to datix you' type reports. Datix may not be the best place to report these type of incidents - but where else can you log them? When reading the narrative you can get a sense of what is going on and the theme of it - communication, frustration with current systems/processes. These reports should not be ignored as, if looked at and themed with others, tell a powerful story about what is happening in that area. It may highlight risk hot spots or a poor culture of speaking up in certain areas, it may be an indicator of a deeper problem at play. Reporting systems are process driven. What you do with that information is not always process driven. The serious incidents are a process - but the no harm incidents often don't follow a process, so are often left aside. These small, seemingly insignificant events with a narrative are important. I am not sure what other patient safety managers do , but I am collecting the themes of all no harm events that happen in my directorates and will be looking at them on a monthly basis to spot trends and hotspots. We have a process to capture incidents. This is not the problem. The problem is with what we are doing with the information captured. How we interpret the data, who we involve, how we feed back and how we share actions and how we change practice - this is the hard work. It is easy to complain about Datix or any other incident reporting system and its functionality - its not so easy to act on the information it is giving us. As I mention, I am new to this area - 1 month in. Naive? Possibly, wanting the best for patients and staff? Definitely
  23. Community Post
    Hi , I am new to patient safety management, after 25 years working clinically it has been a learning curve. I have seen RCA reports, some poor reports that need to be re written and many good ones too. This takes up a huge amount of time by many different people of differing roles. Co-ordinating meeting, feedback and discussion can take time and hold up actions for dissemination. There is much effort put into severe and moderate harm, internal RCAs where it is not a serious incident but it doesn't warrant a serious incident investigation. However, the very low/no harm incidents don't get much of a look in (there are tonnes of them!) If you take a look at the 'accident triangle ' (which I am sure you will be aware of ) - near misses and no harm happen the most frequent and may often lead to the more serious incidents if left. I would suggest much more emphasis, effort needs to be directed into the no harm/near miss incidents. They may seem petty and not sexy, like an SI - but they are great indicators of when the next SI may appear. An over sight of all no/low harm incidents with thematic problems highlighted and then fed into either a local (ward, department) or Trust wide QI project would be a fantastic way of changing practice from the 'ground up'. Capability of ALL staff trained in QI is happening in Trusts but not all Trusts. It would be a fabulous question for the CQC lines of enquiry 'how many staff are trained in QI?' This can be linked to well led and safety, but thats a whole other subject! As I mentioned, I am new to this role, but these are my observations so far. Claire
  24. Content Article

    Faded rainbows

    Claire Cox
    As the colourful rainbows in people's windows are beginning to fade, is the public support for our frontline workers also fading? Has gratitude and thank you's been replaced with frustration and anger from the public? In her latest blog, critical care outreach nurse Claire reflects on the impact this is having on the wellbeing of already exhausted frontline staff.
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