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Showing results for tags 'Accident and Emergency'.
Found 434 results
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Content ArticleThe aorta is the largest artery in the body. Acute dissection occurs when a spontaneous tear allows blood to flow between the layers of the wall of the aorta, which may then rupture with catastrophic consequences. There are about 2,500 cases per year in England, with around 50% of patients dying before they reach a specialist centre for care and 20-30% of patients dying before they reach any hospital. This Healthcare Safety Investigation Branch (HSIB) report highlights the difficulty which can face hospital staff in recognising acute aortic dissection. Although sudden severe chest or back pain is the most common symptom, the picture can vary or mimic other conditions, which may lead to an incorrect diagnosis or delays in recognising a life-threatening condition which needs urgent treatment.
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News Article
Plan to scrap A&E target sparks furious backlash from medics
Patient Safety Learning posted a news article in News
Plans to scrap the four-hour A&E target have sparked a furious backlash from doctors and nurses, with some claiming it is driven by ministers’ desire to avoid negative publicity about patients facing increasingly long delays. A&E consultants led a chorus of medical opposition to the move. They pointedly urged NHS leaders and ministers to concentrate on delivering the long-established maximum waiting time for emergency care rather than finding “ways around” it. Under the target, 95% of people arriving at A&E in England are meant to be treated and then discharged, admitted or transferred within four hours. But performance against the target plunged to a new record low of just 68.6% last month in hospital-based A&E units as a result of staffing problems, the decade-long squeeze on the NHS budget and the dramatic growth in the number of patients seeking care. The Royal College of Emergency Medicine (RCEM), which represents A&E doctors, was responding to Wednesday’s apparent confirmation by the health secretary, Matt Hancock, that the target is set to be axed because it is no longer deemed to be “clinically appropriate”. “So far we’ve seen nothing to indicate that a viable replacement for the four-hour target exists and believe that testing [of alternatives to the target] should soon draw to a close,” said Dr Katherine Henderson, the President of the RCEM. “Rather than focus on ways around the target, we need to get back to the business of delivering on it.” The Emergency Care Association, to which 8,000 A&E nurses belong, said ministers should exercise “extreme caution” in decisions about the target because “it could cause significant detriment to patient safety within our emergency departments if the four-hour target was abolished”. There are fears that patients thought to have only minor ailments could come to harm by having to wait a lot longer than four hours because they also have a more serious condition. Read full story Source: The Guardian, 15 January 2020 -
Content ArticleThe reference event in this HSIB investigation is the case of a 58-year-old woman who deteriorated and died within 24-hours of presenting at hospital, two weeks after having surgery. The national investigation reviewed relevant research and safety literature relating to recognition and response to deteriorating patients, engaged with national subject matter advisors and consulted with professional bodies.
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Content Article
Ambulance handover to emergency care standard V1.0
Claire Cox posted an article in Handover
Emergency care needs fast, effective sharing of information. When clinicians have access to the information they need, they can better ensure safe and high-quality care for patients. To facilitate this, the Professional Record Standards Body (PRSB) has developed a standard for the information that is shared when care is transferred from ambulances to emergency departments. Once implemented, the standard for handover will improve continuity of care, as emergency care will have the information they need available to them on a timely basis. Whichever ambulance service brings the patient to the hospital, there will be a consistent set of information available to the emergency department. It means that patient safety will be improved, because emergency care professionals will know what medications have been administered, what diagnostic tests have been done, whether the patient has any allergies and other important information. Sharing clinical information with emergency care will also support professionals in arranging patient discharge and preventing unnecessary admissions. -
Content ArticleThis is a story of a patient in whom the emergency department missed the same diagnosis twice, four years apart. The first occasion (prior to his diagnosis of ankylosing spondylitis) was understandable. The second was not. As a result of this case, the hospital have changed their x-ray policy for non-traumatic back pain. They also want to share key learning points (the majority of which were due to lack of awareness about a relatively rare condition and its complications) as widely as possible, to help others avoid the same errors. This reflective learning features guest educator, Mr Gareth Dwyer (the patient).
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Content ArticleIn January 2016, a high-profile local inquest examined the death of Jasmine Lapsley, a six year old child who sadly died after choking on a grape. One of Bangors post-ACCS Clinical Fellows (not involved with the case) attended the inquest with the intention of sharing any learning points at a CPD Day for Emergency Medical Service (EMS) colleagues we were due to hold six weeks later. Upon releasing the CPD Day programme, organisers realised some EMS colleagues were profoundly uncomfortable about this talk, stating concerns such as 'talking publicly about lessons learned might upset the bereaved family'. They decided to ask all delegates at the CPD day what they thought of the inclusion of this item on the conference programme before and after the talk. This poster shows the results.
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Content ArticleA blog from Dr Linda Dykes. "Bryn was my patient. He died. He may have stood a better chance of survival had I been aware of the risk of small bowel volvulus in an adult. I produced this reflective learning resource with some colleagues - and with Bryn's widow, whom we call Fiona. Please read it... it may help you save a life one day."
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News ArticleThe first publication of data from the Royal College of Emergency Medicine’s 2019-20 Winter Flow Project shows that existing data does not reflect the true scale of the problem of 12 hour stays in A&E. RCEM data shows that in the first week of December over 5,000 patients waited for longer than 12 hours in the Emergency Departments of 50 Trusts and Boards across the UK. The sample of trusts and boards from across the UK is the equivalent to a third of the acute bed base in England. From the beginning of October 2019 over 38,000 patients have waited longer than 12 hours for a bed at the sampled sites across the UK – yet data from NHS England reports that in England alone a total of only 13,025 patients experienced waits over 12 hours since 2011-12. President of the Royal College of Emergency Medicine, Dr Katherine Henderson said: “In a nine-week period, at only a third of trusts across the UK, we’ve seen nearly three times the number of 12 hour waits than has been officially reported in eight years in England. This must be fixed." Read full story Source: Royal College of Emergency Medicine, 9 December 2019
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News Article
Mental health: North Wales A&E support scheme extended
Patient Safety Learning posted a news article in News
A "life-changing" mental health service at three hospitals in north Wales is to be expanded to GP surgeries. More than 2,500 people have used 'I Can' centres at Glan Clwyd, Gwynedd and Wrexham Maelor hospitals since the trial was launched earlier this year. The centres offer support to patients at A&E departments who may not require medical treatment or a bed. They employ both volunteers and paid staff, many of whom have experienced mental health issues themselves. Betsi Cadwaladr University Health Board said the service allowed people to talk about mental health issues away from wards. It hopes extending the scheme to GP surgeries and community hubs will allow people to get support close to home if they do not need medical treatment. Read full story Source: 9 December 2019 -
Content ArticleHomerton University Hospital describes how they have embedded the Redthread Youth Violence Intervention Programme into their A&E department.
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News Article
War veteran, 99, left 'crying out in pain' on A&E trolley for 10 hours
Patient Safety Learning posted a news article in News
A 99-war-old war veteran was left in agony on an A&E trolley in a hospital for almost 10 hours. Brian Fish, a former captain in the Royal Engineers, was left “crying out in pain” as he endured the long wait at Margate’s Queen Elizabeth Queen Mother Hospital, his daughter said. Mr Fish had been urgently admitted to hospital with gall bladder problems. Details of his ordeal emerged as figures showed the queues at NHS emergency departments are now the longest on record, with one in four patients at major A&Es waiting longer than four hours to be seen or treated in October. His daughter Hilary Casement, who witnessed her father’s hospital ordeal, said: “It was traumatic for him. He lay for hours crying out in pain on a hard trolley. Eventually, with much pleading from me, he was transferred, actually tipped, on to a slightly more comfortable hospital bed and eventually seen by the kind, but overworked, medical team". Read full story Source: The Independent, 19 November 2019 -
Content ArticleA 24/7 clinical tele-triage service for care homes in Wirral has resulted in an average 66% decrease in the number of NHS 111 calls and a 10% decrease in ambulance conveyances to A&E for care home residents. The service is delivered by all the area’s health and social care partners with funding support from the Innovation Agency. Care homes have been provided with iPads and secure nhs.net email addresses, and staff have been trained to take basic observations and equipped with blood pressure monitors, thermometers, urine dipsticks and oximeters.
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Content Article
How NHS staff handle acute pressure in A&Es (June 2018)
Claire Cox posted an article in Stories from the front line
In Wales, like in England, the government has come under pressure over the poor performance of parts of the service. The Betsi Cadwaladr Health Board is the largest in Wales. It also has the worst A&E waiting times and has been in special measures for three years. Its hospital in Bangor, Ysbyty Gwynedd, serves 193,000 people, from tourists visting Snowdonia to the many retirees who live in North Wales. In this film, Saleyha Ahsan, looks at how the department tries to cope with unrelenting demand for patient space. -
Content Article
Safer outcomes for people with psychosis
Dorit posted an article in By patients and public
Dorit describes the assessment and subsequent death of her much loved daughter-in-law who died during a psychotic episode having been discharged the previous evening. Her story raises a number of questions: How should families be included in making judgements and assessments about the patient and their well-being? What support do they need to care for a very distressed loved one? Why aren't written care and contingency plans provided to the patient and their family? What more needs to be done to ensure standard practices are in place to protect patients with psychosis? -
EventWhat do we miss? What do we do about it? An exploration of safety themes and the impact of harm leading to litigation. Promoting an awareness and understanding of Emergency Department claims as well as the cost of claims, both financial and human, to patients and the staff involved. This free training conference is only aimed at Emergency Department (ED) clinical staff and safety, quality and governance leads. Key topics: Reducing claims in ED – What can we do? What do we miss, what do we do about it? Claims relating to nursing care Shared learning – spreading the word Understanding the patient pathway Further information and tickets
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Content Article
Remove central lines supine - animation (2017)
Claire Cox posted an article in Implementation of improvements
The PatientSafe Network is a registered non for profit charity in Australia. It has been developed by front line healthcare staff and is for anyone who wants to improve patient safety. Their combined commitment is to improve patient safety through the transparent review of medical mistakes and the generation of transparent networked projects. Hundreds of patients die every year from avoidable central line related air emboli. This animation explains what air emboli are and how they may be avoided. -
Content Article
Hitting the target, missing the point
Anonymous posted an article in Florence in the Machine
A thought-provoking blog about what it's like nursing in the emergency department (ED) when there are no beds.- Posted
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Content ArticleHigh numbers of non-urgent attendances at paediatric emergency departments (i.e. attendances for illness that could have safely been treated elsewhere) increases waiting times, inconveniences families, incurs significant costs to the NHS, and reduces the time hospital staff can spend treating severely ill children. This report, produced by the Behavioural Insights Team (BIT) in collaboration with the Connecting Care for Children (CC4C) programme, addresses this issue.
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Content Article
Leicester Royal Infirmary NHS Trust: SBAR in action!
Claire Cox posted an article in Handover
Pro Mukherjee, Emergency Department Consultant at Leicester Royal Infirmary, briefly defines the SBAR terms and explains how healthcare practitioners can use it to communicate effectively within the emergency department. -
Content ArticleMany studies have investigated the presence of a ‘weekend effect’ in mortality following hospital admission, and these frequently use diagnostic codes from administrative data for information on co-morbidities for risk adjustment. However, it is possible that coding practice differs between week and weekend. This paper assess patients with a confirmed history of certain long-term health conditions and investigate how well these are recorded in subsequent week and weekend admissions.
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Content ArticleReducing emergency admissions from care homes has the potential to reduce pressure on hospitals. This is a significant national policy focus, as demonstrated by a strong commitment to improve support in care homes in the NHS Long Term Plan.
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Content ArticleBrighton and Sussex University Hospitals NHS Trust found a key challenge in tackling emergency department (ED) doctors' low levels of satisfaction, high rates of burnout and high turnover was because of the way shifts were organised. They found that while ED could be a highly pressurised environment that could contribute to these issues, another key challenge was the way shifts were organised and the lack of flexibility that had become a standard part of being an ED doctor.
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Content Article"It’s time to halt, take a break, and redraw the relationship between patient care and self-care. Self-care isn’t an optional luxury. It must sit at the heart of what we do, to ensure our teams can continue to rise to the challenges of working in the 21st century NHS, to give our patients the best of both ourselves, and the organisation so many of us are proud to be a part of."
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Content Article
Greater Manchester Trauma Network: Elderly trauma infographic
Claire Cox posted an article in Emergency medicine
Treating the elderly and frail within the speciality of trauma emergency medicine is complex. This poster infographic from the Greater Manchester Trauma Network gives a great basic overview on what to look out for in this patient group. -
Content ArticleThis seven-minute video from the US Suicide Prevention Resource Center describes the first part of the Patient Safety Screener, the Patient Safety Screener (PSS-3), a tool for identifying patients in the acute care setting who may be at risk of suicide. The PSS-3 can be administered to all patients who come to the acute care setting, not just those presenting with psychiatric issues. For those who are positive, the second part of the Patient Safety Screener, referred to as the ED-SAFE Secondary Screener, can be administered to guide suicide risk stratification.
