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Showing results for tags 'Research'.
Found 957 results
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Content ArticleA gap analysis identified the need for process improvement surrounding the identification and reporting of adverse drug reactions related to moderate sedation. A change to documentation was selected to address this gap. The challenge was disseminating the change in a meaningful way during a time of high census and limited staffing due to the COVID-19 pandemic. Complex adaptive systems theory was used to plan interventions in these conditions.
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Content ArticleAdherence to best practices for sepsis management at a small community hospital was below system, state and national benchmarks and affected vital indicators, including mortality. This study carried out by Megan Kiser aimed to improve sepsis best practice compliance by implementing human factors–influenced interventions.
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Content ArticleStudy into patient attitudes and perspectives related to viewing immediately released test results through an online patient portal. In this survey study of 8139 respondents at four US academic medical centres, 96% of patients preferred receiving immediately released test results online even if their healthcare practitioner had not yet reviewed the result. However a subset of respondents experienced increased worry after receiving abnormal results.
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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. Beverley talks to us about setting up Thrombosis UK and how it has grown to have a national impact on patient safety in hospitals. She also describes the value of combining policy work with seeing patients face-to-face, and explores the need to find new ways of working to deal with the pressures facing the healthcare system. -
Content ArticleStandard operating procedures (SOPs) should improve safety in the operating theatre, but controlled studies evaluating the effect of staff-led implementation are needed. Morgan et al. evaluated three team process measures (compliance with WHO surgical safety checklist, non-technical skills and technical performance) and three clinical outcome measures (length of hospital stay, complications and readmissions) before and after a 3-month staff-led development of SOPs. They found that SOPs when developed and introduced by frontline staff do not necessarily improve operative processes or outcomes. The inherent tension in improvement work between giving staff ownership of improvement and maintaining control of direction needs to be managed, to ensure staff are engaged but invest energy in appropriate change.
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Content ArticleThe African Surgical Outcomes Study (ASOS) showed that surgical patients in Africa have a mortality rate twice the global average. Existing risk assessment tools are not valid for use in this population because the pattern of risk for poor outcomes differs from high-income countries. This aim of this study in The British Journal of Anaesthesia was to derive and validate a simple, preoperative risk stratification tool to identify African surgical patients at risk for in-hospital postoperative mortality and severe complications. ASOS was a 7-day prospective cohort study of adult patients undergoing surgery in Africa. The ASOS Surgical Risk Calculator was developed using data from 8799 patients in 168 African hospitals. It includes the following risk factors: age, ASA physical status, indication for surgery, urgency, severity, and type of surgery. The authors concluded that the ASOS Surgical Risk Calculator could be used to identify high-risk surgical patients in African hospitals and facilitate increased postoperative surveillance.
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Content ArticleThe objective of this study from Sharma et al. was to evaluate the accuracy of a new elective surgery clinical decision support system, the ‘Patient Tacking List’ (PTL) tool (C2-Ai(c)) through receiver operating characteristic (ROC) analysis. They found that the PTL tool was successfully integrated into existing data infrastructures, allowing real-time clinical decision support and a low barrier to implementation. ROC analysis demonstrated a high level of accuracy to predict the risk of mortality and complications after elective surgery. As such, it may be a valuable adjunct in prioritising patients on surgical waiting lists. Health systems, such as the NHS in England, must look at innovative methods to prioritise patients awaiting surgery in order to best use limited resources. Clinical decision support tools, such as the PTL tool, can improve prioritisation and thus positively impact clinical care and patient outcomes.
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Content ArticleCancer patients and their carers face a multitude of challenges in the treatment journey; the full scope of how they are involved in promoting safety and supporting resilient healthcare is not known. This study from Tillbrook et al. aimed to undertake a scoping review to explore, document, and understand existing research, which explores what cancer patients and their carers do to support the safety of their treatment and care.
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Content ArticleMeasures exist to improve early recognition of and response to deteriorating patients in hospital. However, management of critical illness remains a problem globally; in the United Kingdom, 7% of the deaths reported to National Reporting and Learning System from acute hospitals in 2015 related to failure to recognise or respond to deterioration. The current study from Albutt et al. explored whether routinely recording patient-reported wellness is associated with objective measures of physiology to support early recognition of hospitalised deteriorating patients. The preliminary findings suggest that patient-reported wellness may predict subsequent improvement or decline in their condition as indicated by objective measurements of physiology (NEWS). Routinely recording patient-reported wellness during observation shows promise for supporting the early recognition of clinical deterioration in practice, although confirmation in larger-scale studies is required.
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Content ArticleCovid-19 infection may lead to acute and chronic sequelae. Emerging evidence suggests a higher risk of diabetes after infection, but population-based evidence is still sparse. In this study, Naveed et al. evaluated the association between COVID-19 infection, including severity of infection, and risk of diabetes. They concluded that Covid-19 was associated with a higher risk of diabetes and may have contributed to a 3% to 5% excess burden of diabetes at a population level.
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Content ArticleWe often hear the mesh scandal blamed on poor surgeon skill. We also hear the argument that high use mesh implanting surgeons are likely to have fewer patients suffering mesh complications, than a less experienced surgeon. However, this study published in JAMA in October 2018, based on NHS data, shows that high mesh implanting surgeons produce the same or even more mesh complications compared to low volume implanters.
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Content Article
A ‘Just Culture’ aims to improve patient safety by looking at the organisational and individual factors that contribute to incidents. It encourages people to speak up about their errors and mistakes so that action can be taken to prevent those errors from being repeated. Adam Tasker and Julia Jones are graduate medical students at Warwick Medical School. They wanted to explore doctors’ perceptions of culture and identify ways to foster a Just Culture, so they conducted a qualitative research study at one of the hospitals where they were doing their medical training. We asked them about why Just Culture is important in the health and care system, and what they discovered from their research. -
Content ArticleOutpatient and daycase hysteroscopy and polypectomy (OPHP) are widely recognised methods for the treatment of endometrial polyps. There have been concerns regarding pain affecting satisfaction and tolerability of the outpatient procedure. Dr Bhawana Purwar and colleagues from the Royal Wolverhampton Hospitals NHS Trust conducted a service evaluation of their outpatient hysteroscopy and polypectomy (OPHP) and compared it with their daycase procedures. They concluded that the OPHP is cost-effective and efficient method with reasonable acceptability. It is well tolerated with remarkable success rates and excellent patient satisfaction. As compared to daycase group, it requires less time for recovery and sooner returns to work.
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Content ArticleTechnologies abstract intelligence and provide predictor and precision insight in workflows that manage disorders, similar to cardiology and hematological disease. Positive perceptions of Artificial Intelligence (AI) that support Machine Learning (ML) and Deep Learning (DL) manage transformations with a safe system that improves wellbeing. In sections, workflow introduces an eXamination (X = AI) as an end-to-end structure to culture workstreams in a step-by-step design to manage populace health in a governed system. The author undertook structure and practice reviews and appraised perspectives that impact the management of AI in public health and medicine.
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Content ArticlePatients benefit from guideline-based preventive, chronic disease, and acute care, but many do not receive it. A limitation to providing high-quality care is insufficient time for primary care providers (PCPs). The aim of this study was to quantify the time needed to provide preventive care, chronic disease care, and acute care for a nationally representative adult patient panel by a PCP alone, and by a PCP as part of a team-based care model. The authors concluded that PCPs do not have enough time to provide the guideline-recommended primary care. With team-based care the time requirements would decrease by over half, but still be excessive.
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Content ArticleTraditional approaches to patient safety and handoffs need redesigning to acknowledge the different constraints, goals, and requirements necessary for each individual patient. There is no “one size fits all” approach to patient safety, handoffs or a perfect checklist. Despite the inherit complexity present in healthcare systems, we tend to reduce our thinking about handoffs into simple solutions of checklists and cognitive aids. In studies of these tools, their association with patient outcomes is unclear with mixed results in large studies. Incorporating general resilience engineering principles of visibility, understanding, anticipation, and learning provides new opportunities for increased patient safety. This involves situating the handoff in the context of the system - understanding the process of summarising pre-handoff and of developing understanding post-handoff, tracing flows of information and patients, and considering the role of feedback and control loops in the system. Direct observations, analysis of multiple outcomes, focus on patient evolving specific exceptions, reducing the number of handoffs, taking time for two-way discussions, and user-centred design and redesign may promote acceptability and sustainability of a new view of handoffs for improved patient safety.
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Content ArticleCalculating nurse staffing in the acute hospital has become a key issue but solutions appear distant. Community, mental health and areas such as learning disability nursing have attracted less attention and remain intractable. This review from Leary and Punshon aimed to examine current approaches to the issue across many disciplines.
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Content ArticleNew study from Farr et al. into the effect of implanting polypropylene (PP) surgical mesh into patients. More evidence is needed to show the harmful effect to patients by implanting a foreign body into them, especially into the pelvic floor.
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Content Article
Analysis of the nature and contributory factors of medication safety incidents following hospital discharge using National Reporting and Learning System (NRLS) data from England and Wales: a multi-method study (16 March 2023)
Patient-Safety-Learning posted an article in Medication including labelling
Improving medication safety during transitions of care is an international healthcare priority. While existing research reveals that medication-related incidents and associated harms may be common following hospital discharge, there is limited information about their nature and contributory factors at a national level which is crucial to inform improvement strategy. This study in the journal Therapeutic Advances in Drug Safety aimed to characterise the nature and contributory factors of medication-related incidents during transitions of care from secondary to primary care. The authors found several themes for future research that could support the development of interventions, including: commonly observed medication classes older adults increase patient engagements improve shared care agreements for medication monitoring post hospital discharge. -
Content ArticleThe Learning Together Evaluation framework for Patient and Public Engagement (PPE) in research is an adaptable tool which can be used to plan and to evaluate patient engagement before, during and at the end of a project. The Learning Together Framework can be used in multiple ways with the purpose of mutual learning and understanding by all partners. It is rooted in seven guiding principles of patient engagement defined by the patient-oriented research community: Relationship building Co-building Equity, diversity and inclusion Support and barrier removal Transparency Sustainability Transformation
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Content ArticleTo receive and participate in medical care, patients need high quality information about treatments, tests, and services—including information about the benefits of and risks from prescription drugs. Provision of information can support ethical principles of patient autonomy and informed consent, facilitate shared decision making, and help to ensure that treatment is sensitive to, and meets the needs and priorities of, individuals. Patients value high quality, written information to supplement and reinforce the verbal information given by clinicians. This is the case even for those who do not want to participate in shared decision making. The aim of this study was to evaluate the frequency with which relevant and accurate information about the benefits and related uncertainties of anticancer drugs are communicated to patients and clinicians in regulated information sources in Europe. The findings of this study highlight the need to improve the communication of the benefits and related uncertainties of anticancer drugs in regulated information sources in Europe to support evidence informed decision making by patients and their clinicians.
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Content Article
NHS Knowledge and Library Hub
Patient Safety Learning posted an article in Suggest a useful website
The NHS Knowledge and Library Hub connects NHS staff and learners to high quality knowledge and evidence resources in one place, using a single search. includes all journal articles, e-books, guidelines and evidence summary tools provided nationally and by your local NHS library team provides seamless access to full text, as an immediate download or on request from an NHS library avoids the less-reliable sources you might find in a general web search. Full access is free to all NHS staff and learners using your NHS OpenAthens account. -
Content Article
Medicine and the McNamara fallacy (2017)
Patient Safety Learning posted an article in Research, data and insight
The ‘McNamara fallacy’ (also known as quantitative fallacy) is named after the US Secretary of Defense during the Vietnam War. The fallacy consists of over-reliance on metrics, and may be summarised as: ‘if it cannot be measured, it is not important’. This paper describes the McNamara fallacy as it applies to medicine and healthcare, taking as examples hospital mortality data, NHS targets and quality assurance. -
Content ArticleIn this guest post, Michael A. Osborne, Professor of Machine Learning at Oxford's Department of Engineering Science looks at how the medical community is failing to explore the links between Long Covid and ME/Chronic Fatigue Syndrome (ME/CFS). He describes the symptoms common to both conditions and highlights the historic lack of funding and attention ME/CFS research and treatment has received.
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Content ArticleThis article by Till Bruckner of Transparimed outlines how a new UK law will affect how clinical trial results are reported. The UK Government will introduce a legal requirement to make the results of all clinical trials public within 12 months of trial completion. Any company or university breaking the law will be refused permission to start new trials.
