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Showing results for tags 'HDU / ICU'.
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News Article
Third of region’s ICUs exceed ‘maximum safe capacity’
Patient Safety Learning posted a news article in News
More than a third of critical care units in the East of England are either at or have exceeded their maximum surge capacity, information leaked to HSJ reveals, and all but one are above their normal capacity. Data from the region’s critical care network shows that as of 11 January, seven of the region’s 19 critical care units were either at 100% of, or had exceeded, what is known as ”maximum safe surge” capacity. This represents the limit of safe care, mostly based on available staffing levels. The units have opened more beds, but they require dilution of normal staffing levels. Across the East of England, 482 of the region’s current 491 intensive care beds, after the opening of surge capacity, were occupied. This included 390 patients in intensive care with confirmed covid-19, six with suspected covid and 86 non-covid patients. It gives a regional occupancy rate of 91 per cent against total “safe surge” capacity. Published government figures show the rapid increase in demand for intensive care in the East of England in the last two weeks — the number of patients with covid in mechanical ventilation beds is more than double what it was just after Christmas. Read full story (paywalled) Source: HSJ, 11 January 2021 -
Event
The NHS ICU Virtual Summit: Future-proofing critical care
Sam posted an event in Community Calendar
The countries focus on critical care services in England has increased because of COVID-19. A significant proportion of hospitalised patients with COVID-19 require help with breathing, including mechanical ventilation and other services critical care staff and units provide. Delivering sufficient critical care capacity goes beyond physical infrastructures – such as having more beds and equipment – and requires sufficient numbers of trained and available staff. The NHS ICU Virtual Summit: Future-Proofing Critical Care conference aims to celebrate the current efforts of ICU staff, in this time of unprecedented strain, via best practice and practical insight. We will also take a look at some key areas of potential improvement including: Understanding intensive care staffing, occupancy and capacity. Infection control. Crisis management and emergency preparedness. Clinical Information Systems. NHS staff and services will continue to be tested to their limits over the coming months, this short but high-value session aims to bring peers together from across the UK to share best practice and outcomes. Register -
EventA Westminster Health Forum policy conference with: Dr Clifford Mann, National Clinical Director, Urgent and Emergency Care, NHS England and NHS Improvement Dr Katherine Henderson, President, Royal College of Emergency Medicine Jessica Morris, Nuffield Trust; Dr Nick Scriven, The Society of Acute Medicine; Sandie Smith, Healthwatch Cambridgeshire and Peterborough; and Deborah Thompson, NHS Acute Frailty and Ambulatory Emergency Care Networks and NHS Elect Delegates will discuss key developments and challenges in the context of service changes in response to the COVID-19 pandemic, and the ongoing implementation of the NHS Long Term Plan. Register
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Content ArticlePatients recovering from an episode in an intensive care unit (ICU) frequently experience medication errors on transition to the hospital ward. This systematic review in BMJ Quality & Safety aimed to examine the impact of medication-related interventions on medication and patient outcomes on transition from adult ICU settings and identify barriers and facilitators to implementation.
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- Medication
- Systematic review
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Content ArticleAn HSJ roundtable, supported by Edwards Lifesciences, looked at how trusts can find solutions to the complex challenges of improving patient safety in operating theatres and intensive care units.
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- HDU / ICU
- Surgery - General
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Content ArticleAre you applying Safety-II principles to improve safety in maternity, A&E, ICU or anaesthetics? If so, Dr Ruth Baxter would love to interview you!
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Content ArticleThis Healthcare Safety Investigation Branch (HSIB) investigation aims to help improve patient safety in relation to the use of a flush fluid and blood sampling from an arterial line in people who are critically ill in hospital. As its ‘reference case’, the investigation uses the experience of Keith, a 66 year old man who during a stay in a clinical care unit had blood samples taken from an arterial line which were contaminated with the flush fluid containing glucose. As a result he received incorrect treatment which led to his blood glucose levels being reduced to below the recommended limit.
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- Investigation
- More staff training
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Content ArticleThese Quality Standards have been developed by the Resuscitation Council UK. They enable healthcare organisations provide a high-quality resuscitation service, with guidance tailored for different settings including acute care, primary care, dental care, mental health units, community hospitals and in the community.
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- Resuscitation
- Standards
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Event
ICS Workforce Wellbeing Webinar Series
Patient Safety Learning posted an event in Community Calendar
untilFrom debrief to safe story sharing. The word “debrief” is throughout our language in healthcare settings, yet it is considered controversial and potentially unsafe if in the wrong hand. However we know in the providing the critical care that our ICU workforce needs, the chance to make sense of experience and share stories is important. This webinar explores the different methodologies for doing this safely in your unit. This webinar from the Intensive Care Society will consist of presentations and then a panel discussion with questions from the audience. Further information and registration -
Content ArticleHealthcare is in the midst of significant change, with substantial shifts in emphasis and priorities. Patient-centered care has become central to the core goals of better health, better quality, and lower costs while highlighting the necessity of incorporating patients’ efforts, needs, and perspectives into healthcare at all levels. Patient and family engagement (PFE) is critical to patient-centered care, and important theoretical and empirical work has identified key elements and implications of PFE, especially for management of chronic illnesses and preference-sensitive clinical decision making. Brown et al. believe that the ultimate goal of active, mutually respectful partnership among clinicians and patients/families is urgent and important. However, consistent terminology and definitions of PFE are still lacking. This deficit is particularly striking in intensive care units (ICUs), which pose special challenges to outpatient models of PFE: the emotional stakes are high, time is greatly compressed, surrogates play a central role, and the specter of death often dominates decision making.
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- Patient engagement
- Patient / family involvement
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Content ArticleECRI position paper looking at post-intensive care syndrome (PICS) after covid. PICS, a nonspecific syndrome that results from physical, mental, and emotional stresses associated with critical illness and treatment in intensive care units.
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- Virus
- Secondary impact
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Content ArticleThis toolkit has been produced by the National Tracheostomy Safety Project in collaboration with the Academic Health Science Networks in response to the COVID-19 pandemic, to support healthcare staff who are looking after this very vulnerable group of patients. Primarily it is for those working in hospitals. However, much of the material is also applicable to primary and community care settings. Wherever it is used, the toolkit’s key objective is the same: to ensure that healthcare staff caring for patients with tracheostomies in these challenging circumstances are able to do so safely.
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- Ventilators
- HDU / ICU
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Content ArticleEach quarter, the Patient Safety Movement Foundation hosts a free webinar on a variety of central patient safety topics aligned with their Actionable Patient Safety Solutions (APSS). This session addressed airway safety. It's focus was on how existing, high-impact solutions can be planned to reduce unplanned extubation. The presentation was given by Dr. Art Kanowitz.
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- protocols and procedures
- HDU / ICU
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Content ArticleIn the autumn of 2020, the Care Quality Commission (CQC) looked at how providers were working together in urgent and emergency care (UEC). Winter and the pandemic now place UEC services under exceptional pressure. It's against this context CQC are publishing examples of the innovation and creative approaches they've found so far.
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- Collaboration
- Virus
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Content ArticleJones et al. hypothesised that antimicrobial stewardship (AMS) could be enhanced through positive feedback for the behaviors of healthcare professionals. This project aimed to reduce antimicrobial consumption in a Pediatric Intensive Care Unit (PICU) by >5%, with secondary aims to reduce broad-spectrum antimicrobial consumption, and processes related to AMS.
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- Paediatrics
- HDU / ICU
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Content ArticleFrontline clinicians working with the National CLEAR Programme for ICU have published ten recommendations that can be adopted in ICU in 48 hours, to help manage the COVID surge. Click on the image or download the attachment as a PDF.
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Content ArticleUsing a dextrose-containing solution, instead of normal saline, to maintain the patency of an arterial cannula results in the admixture of glucose in line samples. This can misguide the clinician down an inappropriate treatment pathway for hyperglycaemia. Patel et al., following a near-miss and subsequent educational and training efforts at their institution, they conducted two simulations: (1) to observe whether 20 staff would identify a 5% dextrose/0.9% saline flush solution as the cause for a patient’s refractory hyperglycaemia, and (2) to compare different arterial line sampling techniques for glucose contamination. They found only 2/20 participants identified the incorrect dextrose-containing flush solution, with the remainder choosing to escalate insulin therapy to levels likely to risk fatality, and (2) glucose contamination occurred regardless of sampling technique. Despite national guidance and local educational efforts, this is still an under-recognised error. Operator-focussed preventative strategies have not been effective and an engineered solution is needed.
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- Human factors
- Human error
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Content ArticleIn 2008, the UK National Patient Safety Agency (NPSA) made recommendations for safe arterial line management. Following a patient safety incident in their intensive care unit (ICU), Leslie et al. surveyed current practice in arterial line management and determined whether these recommendations had been adopted. They contacted all 241 adult ICUs in the UK; 228 (94.6%) completed the survey. Some NPSA recommendations have been widely implemented – use of sodium chloride 0.9% as flush fluid, two‐person checking of fluids before use – and their practice was consistent. Others have been incompletely implemented and many areas of practice (prescription of fluids, two‐person checking at shift changes, use of opaque pressure bags, arterial sampling technique) were highly variable. More importantly, the use of the wrong fluid as an arterial flush was reported by 30% of respondents for ICU practice, and a further 30% for practice elsewhere in the hospital. This survey provides evidence of continuing risk to patients.
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- Medical device / equipment
- Blood / blood products
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Content ArticleWe all have to deal with pressure. Sometimes it's minor like "do I go left or right at the roundabout?". Sometimes it's the difference between life and death. But how can we manage and work with that pressure, rather than against it? Dr Stephen Hearns is a critical care doctor and search and rescue specialist in Scotland, who has spent his career understanding what pressure is and how he can try to handle it in stressful times. His new book 'Peak performance under pressure' goes into detail about the tools and techniques we can all use to manage stress when the going gets tough. In this podcast, produced by eeast (East of England Ambulance Service) General Broadcast, Stephen talks about why pressure is sometimes good for us, how to recognise stress in other and what to do when you're maxed out.
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- Stress
- Staff factors
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Content Article
NIHR: COVID-19 research voices
Patient Safety Learning posted an article in Blogs
Thomas Walters, a Senior Research Nurse from London, describes his experience of going back to ICU and how that’s renewed his appreciation for research. Part of the National Institute for Health Research (NIHR) COVID-19 Research Voices series. -
Content Article
Why I ‘walk on by’
Anonymous posted an article in Florence in the Machine
I recently read the blog on the hub ‘Walk on by...’ by a junior doctor. What a fantastic doctor, if only we had more of these people in our healthcare service. I wanted to respond to this blog by writing about my own experiences in ‘walking on by’. It’s been a difficult write as it has questioned my integrity, my motivation and my career.- Posted
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- HDU / ICU
- Distractions/ interruptions
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Content ArticleChildren admitted to paediatric and neonatal intensive care units may be at high risk from medication errors (MEs) and preventable adverse drug events. In this systematic review published in Drug Safety, Alghamdi et al., reviewed empirical studies examining the prevalence and nature of MEs and preventable adverse drug events in paediatric and neonatal intensive care units. They found that medication errors occur frequently in critically ill children admitted to paediatric and neonatal intensive care units and may lead to patient harm. Important targets such as dosing errors and anti-infective medications were identified to guide the development of remedial interventions.
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- HDU / ICU
- Paediatrics
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Content ArticleA candid account from a healthcare professional on how it feels to have to tell a patient in intensive care that their treatment is to be delayed. Part of the Guardian newspaper's Blood, sweat and tears series.
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Content ArticleThe hospital environment is both unique and unusual in that electrical equipment is directly applied to the human body. From this contact either capacitive or resistive coupling may lead to current flow and harm. Surgical diathermy, patient monitoring and imaging, although universal, are often misunderstood, and many clinicians are ignorant of their principles and hazards. Electrical equipment in hospital therefore has the potential to lead to serious injury or death. This article published in Anaesthesia and Intensive Care Medicine outlines the basic physics of electricity, in particular the principles behind diathermy, the hazards posed by it and by other devices and the various measures available to reduce the risk of these.
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- Operating theatre / recovery
- HDU / ICU
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Content ArticleClinician burnout has been well-documented and is at record highs. The same issues that drive burnout also diminish joy in work for the healthcare workforce. Healthcare leaders need to understand what factors are diminishing joy in work, nurture their workforce, and address the issues that drive burnout and sap joy in work. The most joyful, productive, engaged staff feel both physically and psychologically safe, appreciate the meaning and purpose of their work, have some choice and control over their time, experience camaraderie with others at work, and perceive their work life to be fair and equitable. There are proven methods for creating a positive work environment that creates these conditions and ensures the commitment to deliver high-quality care to patients, even in stressful times.