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Showing results for tags 'Care plan'.
Found 65 results
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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 -
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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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 -
EventThis conference will provide a practical guide to delivering an effective prehabilitation programme, ensuring patients are fit for cancer surgery or treatment. This is even more important in light of the COVID-19 pandemic and lockdowns which have had a negative effect on many individual’s health and fitness levels. The conference will look at optimisation of patients fitness and wellbeing through exercise, nutrition and psychological support. Register
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Content ArticleThe Quality Network for Inpatient Working Age Mental Health Services (QNWA) based within the Royal College of Psychiatrists' Centre for Quality Improvement are pleased to announce the publication of their 8th edition standards. Since the publication of the first edition standards in 2006, the Network has grown to include over 140 members from the NHS and private sector. This new edition of standards aims to reflect the changes in working practices and legislation over the last two years in addition to placing greater emphasis on equality, diversity and inclusion as well as sustainability in inpatient mental health services. The eighth edition standards have been drawn from key documents and expert consensus and have been subject to extensive consultation with professional groups involved in the provision of inpatient mental health services, and with people and carers who have used services in the past.
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Content ArticleThe impact of COVID-19 on mortality can be broadly split into three categories: direct impacts; indirect impacts; and wider social and economic impacts. Indirect impacts represent excess deaths due to stresses on the health system or changes in the health-seeking behaviour of individuals. These are the focus of this bulletin from the COVID-19 Actuaries Response Group. At this stage of the pandemic, the mortality impacts are shifting from direct to indirect. Analysing emerging data can help to identify the magnitude of these impacts and the extent to which they are asymmetric across the population. If care pathways do not rapidly return to pre-pandemic levels, then the COVID-19 pandemic will affect the standard of healthcare, morbidity and mortality across the UK for years to come.
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Content ArticleOn 23 April 2020 Jaqueline Lake commenced an investigation into the death of Eliot Harris aged 48. Eliot had schizophrenia and diabetes. Eliot had not been taking medication for several days and his condition deteriorated. He was admitted to Northgate under the Mental Health Act after assessment on 5 April. He was initially in seclusion then on the ward from 6 April, he spent a lot of time in his room and only ate cheese sandwiches. He only accepted medication in intramuscular form and on 9 April by depot injection. His physical observations were recorded as being normal, and a blood test on 7 April showed he did not have diabetes. His intake of food and fluid remained minimal but he was not put on a chart to monitor this. Staff last entered his room at 17:46 on 9 April. He was last seen conscious at 18:10 on 9 April. He was found unresponsive at 01:33 and declared dead at 02:00. The investigation concluded at the end of the inquest on 8 August 2022. Medical cause of death: 1a) Unascertained Conclusion: Open – the evidence does not reveal the means by which Eliot Harris came by his death.
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Content ArticleOn 24 October 2019 coroner Lydia Brown commenced an investigation into the death of Asher William Robert Sinclair, age 3. The investigation concluded at the end of the inquest on 24 January 2022. The conclusion of the inquest was: His medical cause of death was: 1a Hypoxic ischaemic brain injury 1b out of hospital cardiac arrest 1c displaced tracheal tube (trachael tube dependant) II Neonatal enterviral myocarditis and encephalitis (trachael ventilator dependant and cardiac pacemaker). Asher died on 8th October 2019 in Great Ormond Street hospital when his life support mechanisms were withdrawn.
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Content ArticlePoor and ambiguous medication recording is a common issue identified by the Care Inspectorate during inspections or complaints activity. This guidance aims to support care staff working in residential care services who record medication administration and develop personal plans, by giving common sense guidance on medication recording and personal plans.
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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'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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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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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 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 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 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 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 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 Article
Royal Pharmaceutical Society: Ward round checklist example
Claire Cox posted an article in Handover
Ward rounds happen each day with your clinical team. In order for them to standardise the way they are conducted East Lancashire Hospital NHS Trust has designed a ward round check list, this is to ensure that everyone gets the same safety checks and important discussions are had for every patient. -
Content ArticleAdverse events and poor health outcomes are continuing challenges for nursing home residents and staff. Research has shown that many resident harms are avoidable and may be caused by situations in which residents do not receive needed care, often called omissions of care. Omissions of care research in nursing home settings is limited and definitions of omissions of care vary. Therefore, the US Agency of Healthcare Research and Quality (AHRQ) has developed a definition of omissions of care for nursing homes intended to be meaningful to stakeholders, including residents and caregivers, and actionable for research or improving quality of care. They developed the definition through a literature review and feedback from subject matter experts and stakeholders in the US. To develop and describe the definition, project staff produced an environmental scan and final report, including resources to help nursing homes operationalise and apply the definition of omissions of care.
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Content ArticleIn this Editorial published in BMJ Quality & Safety, Major and Aphinyanaphongs discuss the challenges in translating mortality risk to the point of care. Despite advances in medicine, prognostication remains inaccurate for many patients. Physicians tend to overestimate survival, even in advanced cancer and terminal illness groups. Over half of terminally ill patients express they do not want prolonging of life if their quality of life would decline. End-of-life interventions such as advanced care planning have shown improved adherence to patient’s wishes, improvement in satisfaction and reductions in stress, anxiety and depression, but clinicians remain reluctant to initiate end-of-life discussions with terminal patients if they are currently asymptomatic. Automated systems can complement clinician judgement to prompt earlier end-of-life discussions.
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Content ArticleThe Care Quality Commission (CGC) is the independent regulator of health and adult social care in England. They make sure that health and social care services provide people with safe, effective, compassionate, high-quality care and encourage care services to improve. Independent acute hospitals play an important role in delivering healthcare services in England, providing a range of services, including surgery, diagnostics and medical care. As the independent regulator, the CQC, hold all providers of healthcare to the same standards, regardless of how they are funded.
