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Showing results for tags 'Deterioration'.
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Content Article“Failure to rescue” (FTR) is the failure to prevent a death resulting from a complication of medical care or from a complication of underlying illness or surgery. There is a growing body of evidence that identifies causes and interventions that may improve institutional FTR rates. Why do patients “fail to rescue” after complications in hospital? What clinically relevant interventions have been shown to improve organisational fail to rescue rates? Can successful rescue methods be classified into a simple strategy?
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Content ArticleThis article from Perlin et al. discusses how a 173-hospital system used technology as a strategy to reduce sepsis-related mortality system-wide by real-time dissemination of basic laboratory and clinical data to alert teams to patients exhibiting signs of sepsis risk.
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- Sepsis
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Content ArticleRESTORE2 TM is a physical deterioration and escalation tool for care/nursing homes. It is designed to support homes and health professionals to: recognise when a resident may be deteriorating or at risk of physical deterioration act appropriately according to the resident’s care plan to protect and manage the resident obtain a complete set of physical observations to inform escalation and conversations with health professionals speak with the most appropriate health professional in a timely way to get the right support provide a concise escalation history to health professionals to support their professional decision making. Here you can find all the official resources to accompany the initiative.
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Content ArticleEarly warning scores are widely used prediction models that are often mandated in daily clinical practice to identify early clinical deterioration in hospital patients. In this paper published in the BMJ, Gerry et al. carried out a systematic review and critical appraisal of early warning scores for adult hospital patients. The results found that many early warning scores in clinical use had methodological weaknesses.The study's authors concluded that the early warning scores might not perform as well as expected and therefore they could have a detrimental effect on patient care. “Future work should focus on following recommended approaches for developing and evaluating early warning scores, and investigating the impact and safety of using these scores in clinical practice.”
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News ArticleEarly warning scores are used in the NHS to identify patients in acute care whose health is deteriorating, but medics say it could actually be putting people in danger. The rollout of an early warning system used in hospitals to identify patients at the greatest risk of dying is based on flawed evidence, according to a study published in the BMJ which suggests that much of the research supporting the rollout of NEWS was biased and overly reliant on scores that could put patients at greater risk.. Medical researchers said problems with NHS England's National Early Warning Scores (NEWS) system had emerged "frequently" in reports on avoidable deaths. The system sees each patient given an overall score based on a number of vital signs such as heart rate, oxygen levels, blood pressure and level of consciousness. Doctors and nurses can then prioritise patients with the most urgent NEWS scores. But some professionals have argued that the system has reduced nursing duties to a checklist of tasks rather than a process of providing overall clinical assessment. Professor Alison Leary, a fellow of the Royal College of Nursing and chair of healthcare and workforce modelling at London South Bank University, told The Independent: “In our analysis of prevention of future death reports from coroners, early warning scores and misunderstanding around their use feature frequently". “It's clear that some organisations use scoring systems and a more tick box approach to care as they lack the right amount of appropriately skilled staff, mostly registered nurses.” “Early warning scores might not perform as well as expected and therefore they could have a detrimental effect on patient care,” the authors of the research conclude. “Future work should focus on following recommended approaches for developing and evaluating early warning scores, and investigating the impact and safety of using these scores in clinical practice.” Read full story Source: The Independent, 21 May 2020
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Content ArticleFamily members are a vital part of the healthcare team and are often best positioned to recognize the sometimes subtle, yet very important changes in their loved one's condition that may indicate deterioration. You may not know WHAT is wrong, but you know something just isn't right. Empower yourself and your loved ones with the following information and resources from the Canadian Patient Safety Institute (CPSI). They will both help you recognize the signs of deteriorating patient condition, and effectively discuss your concerns with the healthcare provider.
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Wessex AHSN: RESTORE2
Claire Cox posted an article in Health Innovation Networks (formerly AHSNs)
RESTORE2 is a physical deterioration and escalation tool for care/nursing homes based on NEWS2 and has been a key element of the process of implementing NEWS2 within care Homes, initially across Wessex and subsequently nationally via the AHSN network. In July 2019 RESTORE2 won a Parliamentary Award for Excellence.- Posted
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CQUIN for deteriorating patients: proforma (February 2020)
PatientSafetyLearning Team posted an article in CQUIN
Dr Matt-Inada-Kim, National Clinical Lead for Sepsis and Deterioration, shares the proforma he has developed to document management and treatment for the deteriorating patient for the new CQUIN, coming soon. This proforma ensures that all the CQUIN data is captured when it comes to audit. He has shared his accompanying slide set explaining about the CQUIN.- Posted
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Content ArticleDr Hein Le Roux is Primary Care Patient Safety GP Lead at the West of England Academic Health Science Network. Here Hein interviews Dr Emma Redfern on their programme to encourage the use of the National Early Warning Score (NEWS), followed by a conversation with Dr Sheena Yerburgh on a standardised admission sheet they have helped to develop, which is being used by GPs in the Gloucestershire area when referring patients to emergency departments.
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Content ArticleThe West of England Academic Health Science Network has produced this webpage on caring for the deteriorating patient. One of the priorities identified by their Patient Safety Collaborative was the emergency management of the deteriorating patient, in particular identifying patients at risk and avoiding patient deterioration. This webpage includes examples and resources to help others implement similar changes and initiatives.
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Content ArticleThe objective of this study, published in the Journal of Clinical Nursing, was to determine the predictive value of individual and combined dutch-early-nurse-worry-indicator-score indicators at various Early Warning Score levels, differentiating between Early Warning Scores reaching the trigger threshold to call a rapid response team and Early Warning Score levels not reaching this point.
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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 ArticleThis article, published by the University of Hertfordshire, addresses the need for reasonable adjustments, and other issues, by using examples of: a hospital passport assessing the mental capacity of a person how to improve care provided how to reduce clinical risks for people with intellectual disability.
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Content Article
Commissioning for Quality and Innovation (CQUIN)
Claire Cox posted an article in CQUIN
CQUIN stands for Commissioning for Quality and Innovation. This is a system introduced in 2009 to make a proportion of healthcare providers’ income conditional on demonstrating improvements in quality and innovation in specified areas of care. This means that a proportion of a Trusts income depends on achieving quality improvement and innovation goals, agreed between the Trust and its commissioners. The sum attached to the CQUINs is variable each year based on a percentage of the contract value and depends on achieving quality improvement and goals.- Posted
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Content ArticleThe aim of this qualitative service evaluation, published by Nursing in Critical Care, was to map the barriers and facilitators to the escalation of care in the acute ward setting and identify those that are modifiable. This service evaluation identified barriers and facilitators to the escalation of care in the acute ward setting. Unlike other studies, we found that re‐escalation or tracking of deterioration was problematic. Patients identified as being at a higher risk of escalation failure included complex patients, outliers, and patients with multiple care teams.
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Content Article
Re-ACT Talks – child deterioration: human factors (March 2015)
Claire Cox posted an article in Paediatrics
Child deterioration: human factors is a presentation by Peter-Marc Fortune, Consultant Paediatric Intensivist, Associate Clinical Head, Royal Manchester Children’s Hospital.- Posted
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- Work / environment factors
- Deterioration
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