Search the hub
Showing results for tags 'HDU / ICU'.
Found 105 results
-
Content ArticleDecisions to admit older, frail patients to critical care must pay particular attention to quality of life and the potential burden of care on patients. This burden may extend beyond surviving a critical illness. These decisions are not easy and require careful thought, clinical judgment, and communication write Daniele Bryden and colleagues in this BMJ opinion piece.
-
Content Article
Studies from medical and surgical intensive care units (ICU) suggest that long-term outcomes are poor for patients who have spent significant time in an ICU. This study in the American Journal of Surgery aimed to identify determinants of post-intensive care physical and mental health outcomes 6–12 months after injury. The authors found that: Delirium during an intensive care unit (ICU) stay is linked with long-term physical impairment in injury survivors who spent three or more days in the ICU. The use of ventilators in the ICU is another factor associated with long-term physical impairment and mental health symptoms in these patients. Delirium and ventilator use are potentially modifiable, suggesting opportunities for improving patient outcomes. They suggest that that this knowledge can inform the development of interventions that specifically target delirium and ventilator use to mitigate long-term impairments. -
Content ArticleDiagnostic errors contribute to patient harm, though few data exist to describe their prevalence or underlying causes among medical inpatients. The aim of this study published by Jama Internal Medicine was to determine the prevalence, underlying cause, and harms of diagnostic errors among hospitalised adults transferred to an intensive care unit (ICU) or who died. The results showed that diagnostic errors were common and associated with patient harm. Problems with choosing and interpreting tests and the processes involved with clinician assessment are high-priority areas for improvement efforts.
-
Content ArticleThe Paediatric Intensive Care Audit Network (PICANet) has published the National Paediatric Critical Care Audit State Nation Report 2023. Based on a data collection period from January 2020 to December 2022, it describes paediatric critical care activity which occurred within Level 3 paediatric intensive care units and Specialist Paediatric Critical Care Transport Services in the United Kingdom (UK) and Republic of Ireland (ROI). This report contains key information on referral, transport and admission events collected by the National Paediatric Critical Care Audit to monitor the delivery and quality of care in relation to agreed standards and evaluate clinical outcomes to inform national policy in paediatric critical care. It reports on the following five key metrics relevant to Paediatric Intensive Care services: case ascertainment including timeliness of data submission retrieval mobilisation times emergency readmissions within 48 hours of discharge unplanned extubation in PICU mortality in PICU.
-
Content ArticlePatient safety incidents, including medical errors and adverse events, frequently occur in intensive care units, leading to a significant psychological burden on healthcare professionals. This burden results in second victim syndrome, which impacts the psychological and psychosomatic wellbeing of these staff members. This systematic review and meta-analysis aimed to examine the occurrence of second victim syndrome among intensive care unit healthcare workers, including the types, prevalence, risk factors and recovery time associated with the condition.
-
Content ArticleBetween 2009 and 2010, 48 year-old David Richards was admitted to intensive care during the ‘swine flu pandemic’. He spent six weeks in an intensive care unit (ICU), first on mechanical ventilation and later receiving extra-corporeal membrane oxygenation (ECMO) treatment. He recovered and became a survivor of severe acute respiratory distress syndrome (ARDS). During his 50 days in intensive care, David's former partner Rose kept an ‘ICU diary’. Rose recorded clinical updates as well as conversations with relatives and staff who were by David's bedside. In this article, David describes how important this diary has been to him understanding and processing his experience. It forms a record not just of procedures, treatments and clinical signs but of how he reacted, how he appeared to feel and how he tried to communicate during a time that were permeated by delirium.
-
Content ArticleSussex Community NHS Foundation Trust share their patient safety newsletters with the hub.
-
Content ArticleIn anticipation of an increase in patients requiring a temporary tracheostomy due to the huge surge in patients placed on ICU ventilation at the peak of the COVID-19 pandemic, the NHS England National Patient Safety Team launched a National Patient Safety Improvement programme to rapidly support the NHS to provide safe tracheostomy care.
-
Content ArticleA new issue brief from the Agency for Healthcare Research and Quality (AHRQ) examines the unique challenges of studying and improving diagnostic safety for children in respect to their overall health, access to care and unique aspects of diagnostic testing limitations for multiple paediatric conditions. The issue brief features approaches to address these challenges cross the care-delivery spectrum, including in primary care offices, emergency departments, inpatient wards and intensive care units. It also provides recommendations for building capacity to advance paediatric diagnostic safety.
-
Content ArticleThe extent to which postintensive care unit (ICU) clinics may improve patient safety for those discharged after receiving intensive care remains unclear. This observational cohort study from Karlick et al., conducted at an academic, tertiary care medical centre, used qualitative survey data analysed via conventional content analysis to describe patient safety threats encountered in the post-ICU clinic. For 83 included patients, safety threats were identified for 60 patients resulting in 96 separate safety threats. These were categorised into 7 themes: medication errors (27%); inadequate medical follow-up (25%); inadequate patient support (16%); high-risk behaviours (5%); medical complications (5%); equipment/supplies failures (4%); and other (18%). Of the 96 safety threats, 41% were preventable, 27% ameliorable, and 32% were neither preventable nor ameliorable. Nearly 3 out of 4 patients within a post-ICU clinic had an identifiable safety threat. Medication errors and delayed medical follow-up were the most common safety threats identified; most were either preventable or ameliorable.
-
Content ArticleBased on data from January 2019 to December 2021, this report by the Paediatric Intensive Care Audit Network (PICANet) catalogues comprehensive information on referral, transport and admission events. This enables the monitoring of delivery and quality of care in relation to agreed standards, and the evaluation of clinical outcomes to inform national policy in paediatric critical care. It reports on five key metrics relevant to Paediatric Intensive Care services: case ascertainment including timeliness of data submission retrieval mobilisation times emergency readmissions within 48 hours of discharge unplanned extubation in PICU mortality in PICU
-
Content ArticleIn November 2021, 15-year old Alice Tapper nearly died due to a missed diagnoses of a perforated appendix. In this opinion piece, Alice shares her experience of being admitted to hospital with intense abdominal pain and other serious symptoms. In spite of her parents' requests for imaging to rule out appendicitis, doctors diagnosed that Alice had a viral infection and refused to prescribe antibiotics. Alice's condition severely deteriorated, leading her father to call the hospital and beg a gastroenterologist for further investigation. Fortunately, the hospital granted his request and after an x-ray and ultrasound, Alice was found to have a perforated appendix. She was going into hypovolemic shock, when severe blood or other fluid loss makes the heart unable to pump enough blood to the body. Thankfully, emergency surgery and antibiotics saved Alice's life, but she reflects on the fact that without her father's intervention, she would probably have died. She describes how her doctors failed to take the concerns she and her parents repeatedly expressed seriously, and that this lack of responsiveness could have been fatal. She highlights research that shows that appendicitis is missed in up to 15% of paediatric patients, and that missed diagnosis is most common in children under five, and is more common in girls than boys.
-
Content ArticleIn this blog, journalist David Hencke shares his views on the ruling of Judge Anne Martin in the case of NHS whistleblower Dr Chris Day. He argues that Judge Martin was determined to find in favour of Lewisham and Greenwich NHS Trust, glossing over the disclosure of the deliberate destruction of 90,000 emails and the use of false evidence by the Trust. She discredited the evidence of Dr Day’s witnesses, including the present Chancellor of the Exchequer, Jeremy Hunt and two senior medical experts, on the basis that they were biased.
-
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!
-
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.
-
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.
-
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.
-
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.
-
Content ArticleThis article in the journal Patient Safety describes a state-wide, population-based study into tracheostomy- and laryngectomy-related airway safety events. The Pennsylvania-based study aimed to assess the relationship of these events with associated factors, interventions and outcomes, to identify potential areas for improvement. The authors queried the Pennsylvania Patient Safety Reporting System (PA-PSRS) to find tracheostomy- and laryngectomy-related airway safety event reports involving adults age 18 years and older that occurred between 1 January 2018, and 31 December 2020.
-
Content ArticleThis study in Patient Education and Counseling aimed to systematically review parental perceptions of shared decision-making (SDM) in neonatology, and identify barriers and facilitators to implementing SDM. The study identified the following key barriers to SDM: Emotional crises experienced in the NICU setting Lack of medical information provided to parents to inform decision-making Inadequate communication of information Poor relationships with caregivers Lack of continuity in care Perceived power imbalances between HCPs and parents. It also identified the following key facilitators for SDM: Clear, honest and compassionate communication of medical information Caring and empathetic caregivers Continuity in care Tailored approaches that reflected parent’s desired level of involvement.
-
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.
-
News Article
HEE’s new £10m critical care workforce training package set for autumn roll-out
Clive Flashman posted a news article in News
Health Education England (HEE) has announced that its new £10 million training programme, intended to ‘boost’ the critical care workforce, will be rolled out this autumn. According to HEE, the funds it secured earlier this year will provide nurses and Allied Health Professionals with a ‘nationally recognised pathway’ to further their careers in Adult Intensive Care Units (ICUs). Specialist training, delivered through a ‘blended learning package’ could help to strengthen the ICU workforce across England and will offer around 10,500 nursing staff the chance to undertake courses and ‘further their careers’. There will be a focus on flexible training – enabling participants to balance family and caring commitments, as well as taking into account those who are unable to travel, when the roll-out of the programme begins. The learning will be delivered by higher education institutions, Critical Care Skills Networks and acute trusts, and it is expected to take participants up to 12 months to receive the standardised qualification. It’s hoped that the programme could lead staff to career opportunities such as becoming a shift leader or clinical educator, or to lead on research. Read full article here Original source: Leading Healthcare News -
Content ArticleHospitals across the US are grappling with nurse shortages as the pandemic continues to change the healthcare system as we know it. Two intensive care unit nurses who left their jobs shared their experiences in Becker's Hospital Review.
-
Content ArticleThe primary objective of this study, published in Intensive Care Medicine, was to investigate the risk of ICU bloodstream infection (BSI) in critically ill COVID-19 patients compared to non-COVID-19 patients. Authors conclude: "The ICU-BSI risk was higher for COVID-19 than non-COVID-19 critically ill patients after seven days of ICU stay. Clinicians should be particularly careful on late ICU-BSIs in COVID-19 patients. Tocilizumab or anakinra may increase the ICU-BSI risk."
-
News Article
Critical care beds shortage prompts calls for review
Patient Safety Learning posted a news article in News
The NHS's "insufficient" critical care capacity has been laid bare by the pandemic, with the UK having one of the lowest number of beds per head in Europe, NHS Providers has said. The group, which represents trusts in England, is calling for a review of the health service's capacity. The UK has 7.3 critical care beds per 100,000 people, compared to Germany's 33.8 and the US's 34.3, analysis found. The government said it was investing £72bn in the next two years in the NHS. "The UK is towards the bottom of the European League table for critical care beds per head of population," NHS Providers said. The group added that the UK had comparatively fewer critical care beds than France, Italy, Australia and Spain. "It's neither safe nor sensible to rely on NHS hospital trusts being able to double or triple their capacity at the drop of a hat as they've had to over the last two months, with all the disruption to other care and impossible burdens on staff that involves." Seeking a review into critical care capacity in England, the organisation said it wanted the government to commit to providing additional finances in areas where it was needed. "There have been too many reviews of NHS capacity in the past where huge amounts of time have been wasted because the government has not been willing to fund the results of what's been found," the group said. Read full story Source: BBC News, 1 March 2021
