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Showing results for tags 'Emergency medicine'.
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Content Article
Spotting the sick child - online learning tool (2020)
Patient-Safety-Learning posted an article in Paediatrics
This online interactive tool was commissioned by the Department of Health and Health Education England to support health professionals in assessing acutely sick children. It includes footage of real patients, guidance on assessing common symptoms and real test cases. -
Content ArticleThe need to evacuate an intensive care unit (ICU) or operating theatre complex during a fire or other emergency is a rare event but one potentially fraught with difficulty: not only is there a risk that patients may come to significant harm but also that staff may be injured and unable to work. The Intensive Care Society and the Association of Anaesthetists have published new 2021 guidelines regarding fire safety and emergency evacuation of ICUs and operating theatres. These guidelines have been drawn up by a multi-professional group including frontline clinicians, healthcare fire experts, human factors experts, clinical psychologists and representatives from the National Fire Chiefs Council, Health and Safety Executive (HSE), NHS Improvement, Medicines and Healthcare Products Regulatory Authority (MHRA), and representatives from relevant industries.
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Content Article
The House of Commons Science and Technology Committee and Health and Social Care Committee have published their Report following a joint inquiry, which began in October 2020, examining six key areas of the UK's response to COVID-19: the country's preparedness for a pandemic; the use of non-pharmaceutical interventions such as border controls, social distancing and lockdowns to control the pandemic; the use of test, trace and isolate strategies; the impact of the pandemic on social care; the impact of the pandemic on specific communities; and the procurement and roll-out of COVID-19 vaccines. The 150-page Report contains 38 recommendations to the Government and public bodies, and draws on evidence from over 50 witnesses as well as over 400 written submissions. The inquiry concluded that some initiatives were examples of global best practice but others represented mistakes. Both must be reflected on to ensure that lessons are applied to better inform future responses to emergencies. -
Event
ECIST Keynote Lecture Series
Patient Safety Learning posted an event in Community Calendar
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Content Article
NHS Emergency Department Safer Nursing Care Tool
Patient Safety Learning posted an article in Safe staffing levels
The Emergency Department Safer Nursing Care Tool is now available to use in NHS emergency departments in England. Developed by the Shelford Group chief nurses, licenced by Imperial College London and supported by the NHS England Chief Nursing Officer, the Emergency Department Safer Nursing Care Tool (ED SNCT) calculates nurse staffing requirements for emergency departments based on patients’ needs (acuity and dependency). Together with professional judgement, the tool supports emergency department managers and chief nurses in their safe staffing decisions. The Safer Nursing Care Tools (SNCT), including the Mental Health Optimal Staffing Tool (MHOST), are free to use by NHS trusts in England. -
News Article
Hospital admits patient care is being compromised as cancer operations delayed
Patient Safety Learning posted a news article in News
Cancer operations at one of England’s largest hospital trusts are being delayed as bosses admit patient care on wards is being compromised. Nottingham University Hospitals Trust has been forced to convert one of its few remaining wards for cancer surgery patients into an emergency medical ward to cope with an influx of patients. The Independent understands the trust’s A&E department is regularly overcrowded with 40 or more patients waiting for a bed at the start of most days. In a leaked message to staff sent on Friday and shared with The Independent, bosses at the hospital said the trust was facing an “exceptionally difficult time” which was “probably the most challenging position we have been in since the pandemic began”. It added: “There is no doubt that we are having to compromise the quality of care we are providing to some patients to ensure that we are able to maintain a service for the whole population.” “Our emergency department is over capacity continuously, which means that patients are waiting for extended periods on trolleys with little privacy and dignity because they do not have a bed to go to. We are having to make difficult decisions every day as to whether we can proceed with cancer and urgent operations and we are not able to tell some patients when they will get their operation." Read full story Source: The Independent, 13 September 2021 -
Content ArticleGetting It Right First Time (GIRFT) is designed to improve the quality of care within the NHS by reducing unwarranted variations. By tackling variations in the way services are delivered across the NHS, and by sharing best practice between trusts, GIRFT identifies changes that will help improve care and patient outcomes, as well as delivering efficiencies such as the reduction of unnecessary procedures and cost savings.
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News Article
Big surge in the most serious ambulance calls
Patient-Safety-Learning posted a news article in News
Performance data published by NHS England has revealed a big surge in the number of immediately life-threatening incidents ambulance services have responded to. The data also showed average response times have increased and a large number of patients are attending emergency departments. So far, the reason for the increase remains unclear, however, a potential factor could be the return of respiratory illnesses, particularly in children, as the lockdown has eased. In a statement Association of Ambulance Chief Executives said, ”The reasons for the demand increases are complex and will include some patients who have not accessed care as early as they might have done normally and therefore present to the ambulance service as a high acuity patient and many patients who are contacting us for lower acuity issues which in some cases could have been managed by accessing other parts of the UEC system. We continue to work closely with NHS England to mitigate the demand as much as possible and encourage sign-posting of patients to other parts of the UEC system when that is a safe and more appropriate solution to their problem.” Read full story (paywalled). Source: HSJ, 12 August 2021 -
News Article
Record 1 million 999 calls made to NHS in July
Patient-Safety-Learning posted a news article in News
Latest data has revealed more than one million 999 calls were placed in July, showing paramedics were sent out to 82,000 emergencies last month and 8,000 more than the record set in June. This comes after A&E departments became overwhelmed with an influx of new patients over the summer, with many hospitals having to cancel operations due to being dangerously understaffed. Dr Katherine Henderson, president of the Royal College of Emergency Medicine has said, "The NHS has been running hot for months now and these figures show we are nearly at boiling point. We are worried that the public think things are getting back to normal on the virtual eve of a further reduction in restrictions, and messages from the centre that say things are OK are disingenuous – the reality is that the health service is really struggling." Read full story. Source: The Independent, 12 August 2021 -
News Article
NHS’ promotion of 111 First ‘not strong enough’, watchdog warns
Patient-Safety-Learning posted a news article in News
Not enough people know about the NHS 111 First A&E booking service as the messaging hasn't been strong enough, says Healthwatch England. The service can be used for patient who need urgent care but are not in an emergency situation, and patients can call 111 to "book" into urgent care. However, not enough people know about it, or what it's used for. “There’s a real gap in high quality communication to the public,” she said. “They [the NHS leadership] expect the public just to catch up with the changes they have made. 111 First [or] online booking services come along and we’re all supposed just to know how to use it. That’s caused a lot of frustration for people. Our evidence shows that when people understand and use [111 First], they like it. But not enough people know about it and the comms have not been strong enough.” Says Imelda Redmond, the outgoing national director for Healthwatch England. Read full story (paywalled). Source: HSJ, 2 August 2021 -
News Article
Paramedics left in tears from ‘unsustainable demand’, warns union
Patient-Safety-Learning posted a news article in News
In a letter seen by The Independent to ambulance trust chief executives, union officials have warned the health of paramedics is being put at risk due to "unsustainable demand". Union bosses have also warned paramedics are being left in tears at the end of their 12 hour shifts and often working overtime in order to meet demand, warning this increased amount of pressure is taking its toll on the health of ambulance workers. “Ambulance workers have faced exceptional pressures over the past 17 months. It’s not surprising many have reached burnout. They cannot be left to just carry on doing excessive hours without proper breaks and rest between shifts. Employers must act swiftly by doing all they can to limit the unprecedented pressures on staff. Additional welfare support is needed, and the government should make this a top priority.” Says Deputy head of health Helga Pile. Read full story. Source: The Independent, 02 August 2021 -
Content ArticleIn this indicator update, Nuffield Trust look at trends in the quality of urgent and emergency care both before and during the pandemic. This includes measures of other parts of the health system which affect urgent care services.
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News Article
Paramedics abused and assaulted while on duty, survey reveals
Patient-Safety-Learning posted a news article in News
New data has revealed hundreds of paramedics experience physical assault and verbal abuse whilst serving the public. According to NHS, there has been a 32 per cent rise in assault against paramedics over the past 5 years, with more than 1,600 saying they had been threatened while on duty or feared for their own lives. Now, ambulance trusts are aiming to fit paramedics with body cameras while the West Midlands have CCTV inside their ambulances. "After years of lobbying, the legislation is now in place to ensure that the worst offenders are severely and appropriately dealt with. The problem is that the law is not being used to full effect and sentences are still far too lenient. We are calling today on the courts to step up and impose the harshest penalties available to them." Said Tracy Nicholls, chief executive of the College of Paramedics. Read full story. Source: The Independent, 28 July 2021 -
News Article
Hospitals experiencing "perfect storm"
Patient-Safety-Learning posted a news article in News
NHS bosses have warned as Covid-19 infections rise, the demand for A&E ha surged, colliding with holiday season. According to reports, hospitals are being told to brace themselves as admissions to hospital for patients with Covid have risen by more than 30 per cent over the past week. Newcastle upon Tyne Hospitals, chief executive Dame Jackie Daniel has said, “We are going through the ‘perfect storm’ of high numbers of Covid patients in hospital, high Covid infections in the community, which is affecting staff and our families, unprecedented levels of urgent and emergency demand and peak holiday season, all of which comes after 18 months of exhausting work.” Read full story. Source: The Independent, 25 July 2021 -
News Article
Patients waiting 10 minutes for 999 calls to be answered
Patient-Safety-Learning posted a news article in News
Some people calling 999 are having to wait up to 10 minutes before their call is answered. Staff have warned patients may be coming to harm, and may be even dying as a result of the delays and with paramedics also reporting it's taking as long as 24 hours for some ambulances to reach patients. One paramedic has told The Independent, “We are stacking over 500 jobs, with patients waiting hours for an ambulance response. That includes elderly vulnerable people who have fallen but only merit a category three, so their calls are routinely pushed further and further down the queue. In the last few days, I've been to patients waiting 11 or 13 hours. And just to be clear: this is not the hospitals’ fault. The system is profoundly broken.” Read full story. Source: The Independent, 22 July 2021 -
News Article
London Ambulance Service declares incident as 999 calls surge
Patient-Safety-Learning posted a news article in News
The London Ambulance service declared a 'business continuity incident' on Monday after a surge in 999 calls. Paramedics were told the ambulance service was under extreme demand after the calls threatened to overwhelm the service. The announcement was made after more than 400 calls were made in a single hour during Monday afternoon. “Yesterday we saw high levels of demand for our services and used tested processes to care for our patients – this allowed some people with the least urgent care needs to be treated through alternative routes" said a London Ambulance Service spokesperson. Read full story. Source: The Independent, 20 July 2021 -
News Article
Greater Manchester hospitals ‘forced to provide extra critical care beds’
Patient-Safety-Learning posted a news article in News
Hospital waiting lists across the country could hit 13 million in the months to come. Reports have found Manchester Hospitals are having to provide extra beds for critical care patients as the number of people coming in has surged. Hospitals are struggling to cope due to increase in patients attending hospitals in the city a reports the Manchester Evening News. The “number of people attending emergency departments across Greater Manchester has seen a significant increase in recent weeks” and that assistance from hospitals in other parts of the country was “part of our usual processes”, a spokesperson for the Greater Manchester Health and Social Care Partnership has said. Read full story. Source: The Independent, 15 July 2021 -
News Article
'We feel bullied' say emergency department staff
Patient-Safety-Learning posted a news article in News
In November last year, Unison and RCN raised concerns with NHS Forth Valley chief executive Cathie Cowan amid bullying claims made by emergency department staff at Forth Valley Royal Hospital. In light of the reports of bullying, a review was commissioned and leaked details revealed junior doctors were left unsupervised on shifts, nurses and doctors had said they are 'battle-weary', and many senior staff members have resigned their posts. Karren Morrison, Unison Forth Valley health branch secretary has said: ‘Last year, concerns were being raised by our members who worked in, or who had previously worked in the ED. Staff talked to us about feeling bullied and intimidated, being frightened to speak up, concerns about the delivery of safe patient care, high staff turnover and other issues.’ Read full story (paywalled). Source: Nursing Standard, 12 July 2021 -
Content ArticleEvery day we use tools and resources to manage our lives, both personally and professionally. As a healthcare professional, you are committed to providing safe quality healthcare to all individuals. The checklists in this book are designed to help you succeed in that effort. You may be a first-time reader who has not had the opportunity to put these tools to the test, or you could be a returning reader interested in what new checklists you can use. In either instance, if you’re reading this book, then you are searching for tools to help your healthcare organisation navigate the increasing complexities of providing quality health care and maintaining the physical environment where healthcare is delivered.
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Content ArticleTension pneumothorax can occur following chest trauma, respiratory disease and infection, or during resuscitation requiring invasive or non-invasive ventilation. It is a life-threatening condition resulting from a collapsed lung when air trapped in the pleural cavity compromises cardiopulmonary function. Immediate temporary decompression is required to prevent cardiac arrest. This is commonly done by inserting a needle and cannula, usually used for intravenous access, through the chest wall into the pleural cavity (needle thoracostomy). The needle is withdrawn, and the cannula left in place to allow the trapped air to flow out. New blood control (closed system) intravenous cannulas are increasingly used in the NHS; at least 130 trusts bought a total of three million of them in the last year. They look very similar to both traditional and standard safety cannula (with needle guard or shield) but have an extra integral septum which closes when the needle is withdrawn and stops free flow in or out of the cannula. Flow is only possible once an intravenous line or Luer-lock syringe is attached to the hub, which opens the septum. Blood control (closed system) cannulas help prevent blood spillage, exposure and contamination, when used for their intended intravenous purpose, but they cannot be used to decompress a pneumothorax without additional equipment. The main patient safety risks are: staff may select a blood control (closed system) cannula not realising its limitations for this procedure a blood control (closed system) cannula may wrongly be assumed to be functioning in a patient who is deteriorating rapidly a second needle might be introduced risking very significant damage to the lung as it reinflates.
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Content ArticleThis guide, developed by Parkinson's UK, tells you how to manage someone with Parkinson's in an emergency situation. It will be particularly useful for professionals who don’t see people with Parkinson's day-to-day.
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News Article
'Major changes needed' at Northern Ireland emergency departments
Patient Safety Learning posted a news article in News
Major change is required if Northern Ireland's emergency departments are to avoid another "exceptionally difficult" winter, a senior consultant has warned. Dr Brendan Lavery, who works for the Western Health Trust, said "standing still is not an option". He described the system as currently operating on a "knife edge". The Department of Health said it was "a very challenging time" for staff "with COVID-19 restrictions impacting on an already fragile system". Speaking to BBC News NI, Dr Lavery likened the situation to "Groundhog Day" with decade-long problems like capacity and staffing exacerbated by the lingering effect of the COVID-19 pandemic on other healthcare services. The department responded: "Well before COVID-19, there was clear evidence that our urgent and emergency care services were under increasing pressure. This is an unsustainable position that requires sustained investment and reform, including, of course, long-term investment in staffing. There is no quick or easy solution to these problems." Read full story Source: BBC News, 12 May 2021 -
Content ArticleFrequent external interruptions and lack of collaboration among team members are known to be common barriers in end-of-shift handoffs between physicians in the emergency department. In spite of being the primary location for this crucial and cognitively demanding task, workstations are not designed to limit barriers and support handoffs. The purpose of this study from Joshi et al. was to examine handoff characteristics, actual and perceived interruptions, and perceived collaboration among emergency physicians performing end-of-shift handoffs in physician workstations with varying levels of enclosures—(a) open-plan workstation, (b) enclosed workstation, and (c) semi-open workstation. The study showed positive outcomes experienced by physician working in the enclosed workstation as compared to the open and semi-open workstations.
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Content Article
Manchester Triage System (updated 24 February 2021)
Patient Safety Learning posted an article in Emergency medicine
The Royal College of Emergency Medicine has raised a concern to NHS England and Improvement Patient Safety, following several reported incidents noting that organisations may not be using the latest version of The Manchester Triage System clinical risk management triage tool. Old versions of the system have outdated treatment/priority parameters for adult and paediatric sepsis that could affect patient outcome. The updated Manchester Triage System can be accessed from the link below. -
Content ArticleThis Healthcare Safety Investigation Branch (HSIB) investigation explores the impact of ambulance delays on the emergency treatment of heart attack. The current preferred model of care in the NHS in England is for patients to receive primary percutaneous coronary intervention (PPCI), a procedure which involves widening a blocked artery and inserting a stent to keep the artery open. The effectiveness of PPCI is dependent on the timescale in which it can be carried out. National figures have identified increasing delays in ambulances taking people with a type of heart attack known as ST-elevation myocardial infarction (STEMI) to hospital so that PPCI can be provided within target timescales. This may lead to worse outcomes for these patients. Alternative treatment using thrombolytic medicine (medicines used to dissolve blood clots) is advised where specific timescales for providing PPCI may not be met. This investigation started after a patient notified HSIB of a delay in an ambulance attending him after suffering a heart attack (STEMI).
