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Showing results for tags 'Care plan'.
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News Article
Blanket 'do not resuscitate' orders imposed on English care homes, finds CQC
Patient Safety Learning posted a news article in News
Blanket orders not to resuscitate some care home residents at the start of the Covid pandemic have been identified in a report by England’s care regulator. A report published by the Care Quality Commission (CQC) found disturbing variations in people’s experiences of do not attempt cardiopulmonary resuscitation (DNACPR) decisions during the pandemic. Best practice is for proper discussions to be held with the person involved and/or their relatives. While examples of good practice were identified, some people were not properly involved in decisions or were unaware that such an important decision about their care had been made. Poor record-keeping, and a lack of oversight and scrutiny of the decisions being made, was identified. The report, 'Protect, respect, connect – decisions about living and dying well during Covid-19', calls for a ministerial oversight group – working with partners in health and social care, local government and the voluntary sector – to take responsibility for delivering improvements in this area. The report surveyed a range of individuals and organisations, including care providers and members of the public, and identified: Serious concerns about breaches of some individuals’ human rights. Significant increase in DNACPRs put in place in care homes at the beginning of the pandemic, from 16,876 to 26,555. 119 adult social care providers felt they had been subjected to blanket DNACPR decisions since the start of the pandemic. A GP sent DNACPR letters to care homes asking them to put blanket DNACPRs in place. In one care home a blanket DNACPR was applied to everyone over 80 with dementia. Read full story Source: The Guardian. 18 March 2021 -
Content ArticleCQC review of ‘do not attempt cardiopulmonary resuscitation’ decisions during the coronavirus (COVID-19) pandemic.
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Content ArticleNHSX's Innovation Team has released its latest digital playbook which focuses on eye care and directs clinicians and organisations to digital tools that can support patient pathways. The resource, which is extensive and features numerous case studies, can be used by eye care specialists looking to digitally enhance their ophthalmology pathways, remote monitoring and sharing of diagnostics.
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Content Article'Covid Oximetry @home' describes an enhanced package of care for individuals with confirmed (or suspected) COVID-19 who are at risk for future deterioration. NHS England and Improvement wrote to all CCGs and trusts to encourage the development of local CO@H projects. The 'CO@h' package of care involves the remote monitoring of the patient's condition through providing regular contact with a local health care team who will reassess the individuals symptoms (including oxygen saturation levels). This close monitoring enables the individual to remain at their usual place of residence whilst allowing early signs of deterioration to be identified and escalated quickly and appropriately. This material has been designed primarily for use across the South East AHSN network by colleagues within the Wessex AHSN, Kent Surrey Sussex AHSN and Oxford AHSN regions. Colleagues from regions beyond the South East are also very welcome to make use of this toolkit in setting up their own local approaches to remote monitoring.
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News ArticleOne of the mysteries of COVID-19 is why oxygen levels in the blood can drop to dangerously low levels without the patient noticing. It is known as "silent hypoxia" and as a result, patients have been arriving in hospital in far worse health than they realised and, in some cases, too late to treat effectively. But a potentially life-saving solution, in the form of a pulse oximeter, allows patients to monitor their oxygen levels at home, and costs about £20. They are being rolled out for high-risk Covid patients in the UK, and the doctor leading the scheme thinks everyone should consider buying one. A normal oxygen level in the blood is between 95% and 100%. "With Covid, we were admitting patients with oxygen levels in the 70s or low-or-middle 80s," said Dr Matt Inada-Kim, a consultant in acute medicine at Hampshire Hospitals. He told BBC Radio 4's Inside Health: "It was a really curious and scary presentation and really made us rethink what we were doing." Read full story Source: BBC News, 21 January 2021 See hub resource on the 'Covid Oximetry @home' project
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Content ArticleWard rounds are the focal point for a hospital’s multidisciplinary teams to undertake assessments and care planning with their patients. Coordination of assessments, plans and communication is essential for effective and efficient care. However, the delivery of ward rounds is consistently constrained by the competing priorities of clinical staff. A number of factors contribute to this, including workforce gaps, inadequate planning, unwarranted variation in practice and an absence of training in the skills required to deliver complex multidisciplinary team care. This leads to frustration for staff and patients, and can lead to errors in care, longer stays in hospital and readmissions. A new report from UK healthcare professional leaders including the Royal College of Physicians, and developed along with patients, sets out best practice for modern ward rounds.
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News Article
Global health insurance card to replace EHIC under new rules
Patient Safety Learning posted a news article in News
UK residents can apply for a Global Health Insurance Card (GHIC) to access emergency medical care in the EU when their current EHIC card runs out. Under a new agreement with the EU, both cards will offer equivalent healthcare protection when people are on holiday, studying or travelling for business. This includes emergency treatment as well as treatment needed for a pre-existing condition. The new GHIC card is free and can be obtained via the official GHIC website. Current European Health Insurance Cards (EHIC) are valid as long as they are in date, and can continue to be used when travelling to the EU. You don't need to apply for a GHIC until your current EHIC expires. People should apply at least two weeks before they plan to travel to ensure their card arrives on time. Read full story Source: BBC News, 11 January 2021 -
Content ArticleThis guide will support healthcare professionals to integrate prehabilitation services into the cancer pathway.
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News Article
Demand for public inquiry into NHS mental health deaths to be debated by MPs
Patient Safety Learning posted a news article in News
A mother fighting for a public inquiry into the death of her son and more than 20 other patients at an NHS mental health hospital in Essex has won a debate in parliament after more than 100,000 people backed her campaign. On Monday, MPs in the House of Commons will debate Melanie Leahy’s petition calling for a public inquiry into the death of her son Matthew in 2012, as well as 24 other patients who died at The Linden Centre, a secure mental health unit in Chelmsford, Essex, since 2000. The centre is run by Essex Partnership University NHS Trust which has been heavily criticised by regulators over the case. A review by the health service ombudsman found 19 serious failings in his care and the NHS response to his mother’s concerns. This included staff changing records after his death to suggest he had a full care plan in place when he didn’t. Matthew was detained under the Mental Health Act but was found hanged in his room seven days later. He had made allegations of being raped at the centre, but this was not taken seriously by staff nor properly investigated by the NHS. The trust has admitted Matthew’s care fell below acceptable standards. In November, it pleaded guilty to health and safety failings linked to 11 deaths of patients in 11 years. Read full story Source: The Independent, 29 November 2020 -
Content ArticleA report on the investigation into the death of Elizabeth Dixon and a series of recommendations in respect of the failures in the care she received from the NHS.
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Content Article
Wirral University Teaching Hospital's SSKIN bundle
Patient Safety Learning posted an article in Pressure ulcers
SSKIN is a five step approach to preventing and treating pressure ulcers. Wirral University Teaching Hospital is sharing their version of the SSKIN bundle as part of Stop The Pressure Day. They have worked with their Allied Health Professional colleagues on refreshing the bundle for local use. -
Content Article
Prostate Cancer UK: Personalised stratified follow-up
Patient Safety Learning posted an article in Men's health
This cost-effective programme for personalised stratified follow-up delivers better outcomes for prostate cancer patients and has been shown to free up capacity in the follow-up pathway. The programme moves follow-up care from outpatient clinics to remote monitoring. Men who are eligible for remote follow up therefore don't need to attend routine appointments unless an issue arises. This web page gives advice, guidance and tools, and examples of hospital trusts that took part in the pilot. -
Content ArticleMaintaining safe elective surgical activity during the global coronavirus disease 2019 (COVID‐19) pandemic is challenging and it is not clear how COVID‐19 may impact peri‐operative morbidity and mortality in this population. Therefore, adaptations to normal care pathways are required. Here, Kane et al. establish if implementation of a bespoke peri‐operative care bundle for urgent elective surgery during a pandemic surge period can deliver a low COVID‐19‐associated complication profile. Kane et al. present a single‐centre retrospective cohort study from a tertiary care hospital of patients planned for urgent elective surgery during the initial COVID‐19 surge in the UK between 29 March and 12 June 2020.
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Content Article
Patient Safety Authority: Pressure injuries
Patient Safety Learning posted an article in Patient management
Pressure injuries are a recognized patient safety concern and meet the definition of a reportable event under the Pennsylvania Medical Care Availability and Reduction of Error (MCARE) Act. The Patient Safety Authority has collated guidelines, tools and resources on pressure injuries. -
Content ArticleA fundamental shift is underway in care provision for older populations, with long-term care (LTC) increasingly taking on care provision that was traditionally delivered in hospitals. As OECD populations are rapidly aging, there has been increasing demand on the LTC sector to provide care for more, and older people, with complex conditions and heightened needs for expert care. Currently, 58% of adults aged 65 or over report living with two or more chronic diseases, with this figure rising over 70% in many OECD countries. Simultaneously, trends in LTC focus on substitution of care settings from nursing homes and residential care towards home care and supporting older persons to live on their own or with family as long as possible. The total cost of avoidable admissions to hospitals from LTC facilities in 2016 was almost USD 18 Billion, equivalent to 2.5% of all spending on hospital inpatient care or 4.4% of all spending on LTC. Research shows that over half of the harm that occurs in LTC is preventable, and over 40% of admissions to hospitals from LTC are avoidable. The root causes of these events can be addressed through improved prevention and safety practices and workforce development—including skill-mix and education. Targeted investments in a number of key areas can have a significant impact by mitigating the main cost drivers of adverse events in LTC.
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Content ArticleThis report from the Centre for Perioperative Care provides evidence to justify the case for perioperative care, the integrated multidisciplinary care of patients from the moment surgery is contemplated through to full recovery. This report has brought together a wide range of research about the effectiveness of perioperative care. It considered over 27,000 studies in preparing this review. The results show that perioperative care is associated with high quality clinical outcomes, reduced financial cost and better patient satisfaction. A perioperative approach can increase how prepared and empowered people feel before and after surgery. This can reduce complications and the amount of time that people stay in hospital after surgery, meaning that people feel better sooner and are able to resume their day-to-day life. The review highlights the effectiveness of clear perioperative pathways, with an average two-day reduction in hospital stay across multiple types of surgery. Different interventions, including prehabilitation, exercise and smoking cessation can significantly reduce complications by 30% to 80%. This scale of benefits is far greater than many new drugs or treatments launched.
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Content ArticleDrawing on a 2010 analysis of the reform and costs of adult social care commissioned by Downing Street and the UK Department of Health, this paper from Glasby et al., published in the Journal of Social Policy, sets out projected future costs under different reform scenarios, reviews what happened in practice from 2010-19, explores the impact of the growing gap between need and funding, and explores the relationship between future spending and economic growth. It identifies a ‘lost decade’ in which policy makers failed to act on the warnings which they received in 2010, draws attention to the disproportionate impact of cuts on older people (compared to services for people of working age) and calls for urgent action before the current system becomes unsustainable.
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Content ArticleThis resource, from NHS Education for Scotland, has been designed for acute general hospital staff to help them develop their abilities in supporting people with dementia, their families and carers. It will help you develop the knowledge and skills set out at the ‘Dementia Skilled Practice Level’ of Promoting Excellence: a framework for all health and social services staff working with people with dementia, their families and carers.
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Content ArticleIn this Episode of the 'This Is Nursing' podcast series, Gavin Portier speaks to with Alison Schofield, Tissue Viability Clinical Nurse Specialist from North Lincolnshire & Goole NHS Trust. Alison has worked in Tissue Viability since 2012 and during this time she has studied extensively in leading change in tissue viability, tissue viability management and leg ulcers. Alison discusses her role of a Tissue Viability Clinical Nurse Specialist and the challenges facing the role in this current world of nursing, the impact of COVID-19 has had on the delivery of community tissue viability services and on people in receipt of the services in care homes and in their own homes.
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Content ArticleHealthcare Improvement Scotland is currently working with the Scottish Government to develop COVID-19 specific Anticipatory Care Planning (ACP) templates and guidance. ACP is a person-centred approach to help people to plan for their future. The essence of ACP is to encourage individuals to think ahead to help ensure that in the event of a change in their health or care needs, including loss of capacity, the right thing is done at the right time by the right person with the right outcome. ACP can benefit many individuals, from those with early onset of long-term conditions to people with chronic and complex illnesses, to plan ahead for care needs. ACP can be beneficial to individuals towards the end of their life, however the process can be more effective if started earlier in their journey. The link below takes you to an online resource that is designed to be used in conjunction with practitioner judgement, and is not for sole use by individuals and their families without guidance.
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News ArticleNHS England has said disabled and vulnerable patients must not be denied personalised care during the coronavirus pandemic and repeated its warning that blanket do not resuscitate orders should not be happening. In a joint statement with disabled rights campaigner and member of the House of Lords, Baroness Jane Campbell, NHS England said the COVID-19 virus and its impact on the NHS did not change the position for vulnerable patients that decisions must be made on an individualised basis. It said: “This means people making active and informed judgements about their own care and treatment, at all stages of their life, and recognises people’s autonomy, as well as their preferences, aspirations, needs and abilities. This also means ensuring reasonable adjustments are supported where necessary and reinforces that the blanket application of do not attempt resuscitation orders is totally unacceptable and must not happen.” Read full story Source: The Independent, 26 May 2020
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News Article
Coronavirus: Doctors urge conversations about dying
Patient Safety Learning posted a news article in News
Palliative care doctors are urging people to have a conversation about what they would want if they, or their loved ones, became seriously unwell with coronavirus. We should discuss all possible scenarios - even those we are not "comfortable to talk about", they said. Medics said the virus underlined the importance of these conversations. New guidelines are being produced for palliative care for Covid-19 patients, the BBC understands. Read full story Source: BBC News, 21 March 2020 -
Content ArticleDr James Reed, CCIO, Birmingham & Solihull Mental Health NHS Foundation Trust, presented at the recent Bevan Brittan Patient Safety Seminar. As one of the Mental Health & Global Digital Exemplars, James discussed how his trust has implemented innovative digital technology to improve patient observations on the ward. His presentation slides are attached.
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Content ArticleThis is the second part of Irene Tuffrey-Wijne's (Professor of Intellectual Disability and Palliative Care at St Georges NHS Trust) blogs on end of life care for people with learning disabilities. This time focusing on why it is important. 'End of life care planning is not so much a question of where and how do you want to die? But where and how do you want to live until you die?'
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Content ArticleThis is part 1 of a series of blogs on end of life care planning and people with learning disabilities. This is a tricky subject as there seems to be confusion on the language. What's the difference between an end of life plan and a funeral plan? Should these plans be for young and old - well and unwell? What does the CQC say? This blog, by Irene Tuffrey-Wijne, Professor of Intellectual Disability and Palliative Care at St Georges NHS Foundation Trust, should give you some of these answers.
