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Found 324 results
  1. Content Article
    The National Institute for Health and Care Excellence (NICE) is developing an update to the guideline on assessment and prevention of falls in older people and people 50 and over at higher risk. It has published the final scope for the update alongside consultation comments and responses, an equality impact assessment and the stakeholder list. The final guidance is expected to be published on 13 June 2024.
  2. Content Article
    European Union Directive 2010/32/EU legally enforces a set of strategies aimed at preventing sharps injuries and determining the risk of bloodborne infections and psychological distress in healthcare workers. This article in the International Journal of Environmental Research and Public Health looks at the results of a national survey conducted in Italy in 2017 and repeated in 2021 to evaluate the progress of the Directive's implementation. The authors assessed the impact of the Covid-19 pandemic on implementation.
  3. Content Article
    This year, the World Health Organisation’s annual World Patient Safety Day on 17 September 2022 will focus on medication safety, promoting safe medication practices to prevent medication errors and reducing medication-related harm. Patient Safety Learning has pulled together some useful resources from the hub about different aspects of medication safety - here we list six helpful reads related to medication safety in hospital settings.
  4. News Article
    NHS trusts across London are set to start moving patients from A&E onto wards “irrespective” of whether there are beds available, The Independent has learned. The new model, which involves moving patients every two hours out of A&E and onto wards called acute medical units, has prompted concerns that patients could be “double lodged” on hospital wards. The move follows the trial of a new system by North Bristol NHS Trust last month, which said it would be moving three patients every hour from A&E onto wards in a bid to address severe ambulance handover delays. On Thursday, health secretary Steve Barclay said that the “number one” priority for the NHS currently is tackling ambulance handover delays, with a “small” number of trusts accounting for half of all delays. In a memo seen by The Independent, NHS clinicians in one hospital were told that London trusts would be rolling out the North Bristol model at “pace” ahead of winter. The system involves moving one patient from A&E onto a ward every two hours “irrespective of bed availability”. Speaking to The Independent, one NHS director said the move would lead to “double lodging” patients, which means squeezing more patients into wards, and that this could be “dangerous” for patients. However, A&E doctors told The Independent that the move should be welcomed, as it spreads the crowding and risk for patients across hospital departments rather than confining it to A&E. Read full story Source: The Independent, 4 September 2022
  5. News Article
    When the new Royal Liverpool Hospital opens its doors in October, every patient will have a single room with an en-suite bathroom. That set-up is unusual for acute hospitals in England, but many feel it is the future for all new buildings. "There's the privacy and dignity from the patient's point of view," says Jacqui Stamper, the hospital's associate chief nurse. "If they're in the room and talking to the doctors or the nurses, there isn't somebody just the other side of a curtain listening." "And then there's the infection prevention side of it as well. "It's absolutely the state of the art way of hospital care really." The new system will require staff to work differently, so patients can be properly monitored. Each ward has been broken up into smaller zones of between six and eight beds, and each zone has its own base where the nurses will sit. The trust which runs the hospital is currently running workshops to get staff used to the layout. "Nursing staff will be used to working in a bigger team than a couple of people, so it is a different way of working," Ms Stamper says. "We're listening to our staff and their concerns and answering those to see how we can address them going forward." Read full story Source: BBC News, 2 September 2022
  6. Content Article
    Non-ventilator-associated hospital-acquired pneumonia (NVHAP) is one of the most common and deadly healthcare-associated infections, but it is not tracked, reported or actively prevented by most hospitals. This article in the journal Infection Control & Hospital Epidemiology highlights a national call to action to address NVHAP in the US. This national call to action includes: launching a national healthcare conversation about NVHAP prevention. adding NVHAP prevention measures to education for patients, healthcare professionals, and students. challenging healthcare systems and insurers to implement and support NVHAP prevention. encouraging researchers to develop new strategies for NVHAP surveillance and prevention.
  7. Content Article
    When hospital patients do not have their teeth brushed it can lead to them developing pneumonia—poor dental hygiene in hospital is believed to be a leading cause of hundreds of thousands of cases of pneumonia a year. In this blog for Medscape, reporter Brett Kelman looks at the link between dental hygiene and hospital-acquired pneumonia, which kills up to 30% of patients who are infected with it. He highlights a lack of understanding of the impact of failing to brush inpatients' teeth, in spite of a growing body of research evidence that links lack of adequate toothbrushing to pneumonia infection.
  8. Content Article
    These 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.
  9. Content Article
    Defining whether a diagnostic error has occurred can be difficult, but in order to reduce harms from diagnostic errors, hospitalists must first understand how these errors occur and then develop practical strategies to avoid them. This article in the journal Annals of Internal Medicine explores these issues and highlights new opportunities for reducing diagnostic error in hospitals.
  10. News Article
    Specialist nurses at an NHS hospital have been told they may be taken off clinical shifts to help clean wards, it has emerged. Bedfordshire Hospitals NHS Foundation Trust has said it asked nursing staff to help clean wards as the hospital faced the “most challenging circumstances” it has ever faced. Clinical specialist nurses, who are advanced nurses and can usually have hundreds of patients under their care, were among those asked to spend entire shifts helping other wards “cleaning”, “tidying” and “decluttering”. The news has prompted criticism from unions, however, multiple nurses have reported that the requests happen “often” during winter. Alison Leary professor of healthcare and workforce at South Bank University warned that asking specialist nurses to drop their work was “very risky”. She said: “This problem keeps cropping up-as soon as there is pressure on wards they are expected to abandon their patients. It usually happens in winter and so it’s concerning that it has now started to happen in summer. “This also shows very little respect for nursing generally and will not help retention. Trusts need to plan workforces accordingly and should ensure they have the right amount of cleaning, administrative and housekeeping staff-all staff groups which contribute to patient safety and care quality." Read full story Source: The Independent, 8 August 2022
  11. Content Article
    Laurence Goldberg, an independent pharmaceutical consultant, discusses the effectiveness and also the potential for harm of unit-dose medicines distribution.
  12. Content Article
    Patient safety culture is the foundation of patient safety and refers to a healthcare organisation’s shared values, norms and beliefs that influence staff’s behaviour and actions. This study in BMJ Open Quality aimed to assess nurses’ reporting on the predictors and outcomes of patient safety culture and the differences between patient safety grades and the number of events reported. It aimed to fill a gap in research by looking at patient safety culture in terms of both predictors and outcomes. The author developed a cross-sectional comparative research design and recruited 300 registered nurses to take part in a survey on patient safety culture. The author found that nurses generally perceived patient safety culture as 'moderate', and identified areas that should be prioritised to improve patient safety culture. They concluded that assessing patient safety culture is the first step in improving hospitals’ overall performance and quality of services, and that improving patient safety practices is essential to improving culture and clinical outcomes.
  13. News Article
    People who go to hospital for non-covid treatment are at higher risk of the virus compared with the general public, which is why high levels of hospital-acquired Covid-19 in England are worrying some doctors. They fear that the coronavirus is becoming a potential hazard of a hospital stay for older or vulnerable people, in a similar way to “superbugs” such as methicillin-resistant Staphylococcus aureus (MRSA). People who go to hospital for non-covid-19 treatment are at higher risk from the virus compared with the general public, says Tom Lawton, an intensive care doctor in Bradford, UK. Read full story (paywalled) Source: The New Scientist, 21 July 2022
  14. Content Article
    In this blog, Lotty Tizzard, Patient Safety Learning’s Content and Engagement Manager, looks at the safety issues faced by people with diabetes in hospital settings. Reflecting on feedback from Twitter users with diabetes, she looks at why so many people with diabetes fear having to stay in hospital, and asks what the NHS and its staff can do to make it a safer, less stressful environment.
  15. Community Post
    These comments were made by people with diabetes in response to a Twitter thread asking "Why is a hospital stay scary if you have diabetes?" If you have diabetes, or care for someone who does, please share your experience with us by adding a comment to this community thread, “I was in ICU after a car accident—none of the staff knew how to work my CGM and/or my insulin pump. I had to manage my own care” “For me it was when I went into hospital for surgery and the nurse said 'Type 1... so do you take insulin for that?'... that's not a reassuring thing to hear minutes before you're taken into the theatre!” “Lucky to get out alive.” “DKA 10 years ago, once back in normal range the consultant insisted I didn't need anymore insulin & refused to let me have any. Obvs within 3 hours I was back in DKA, he wouldn't come see me but had a convo with my husband on the ward phone where hubs explained how T1 works.” “I've been given a full day's bolus, through my iv and then told I was wrong when I said that I only bolused when I ate. Massive hypo followed quickly. I was then told it was my fault and I should have said something.” “After being admitted as an emergency, my own insulin ran out. I was given 2 (2!) of the wrong types of insulin and told that 'it would be okay'.” “They were often confused about T2 versus T1 - lots of emphasis about low fat foods and only being allowed a low fat yoghurt for puddings even though I was on a pump! I had a bag of snacks though as it was a planned hospital stay” “After a major medical issue I was denied insulin in the ICU for over 24 hours but was told I could have some pills to treat my type 1 diabetes” “Last time I went to the hospital, they took my pump (forcefully) and refused to give it back. When I protested, they sedated me. I was in and out of sedation having a panic attack bc I couldn’t breathe. They sedated me again and put me on DKA protocol, even tho I wasn’t in DKA.” “it’s so scary right like you know that you’re the expert on your condition and your needs but that power gets totally taken away” “Handing over your care over to a group of nurses who have no idea what they are doing. It’s super scary. I hate it when they lock it all away and you can’t get to it.” “I didn’t feel safe either. Told them on a few occasions I felt ‘low’. Finally Lucozade got wheeled out but it was almost an inconvenience” “Totally understand why they don’t know much about it if it’s not their specialism BUT some are so arrogant that what they were told one afternoon 10yrs ago is the absolutely way to deal with, and that the person living with it doesn’t know what they’re talking about!” Sarcastic responses “You seem to know a lot about it!” “The neurologist told me I am a terrible diabetic.” “I never feel safe because they don’t allow me to dose my own insulin and last time dropped me from 600 to 40 in three hours and then shot me back up so fast when i specifically told them that i would go low and high from that much insulin” Report of being diagnosed with type 1 diabetes while in hospital, despite telling every healthcare professional she had T1. “I smuggled in my own tester and meds and took care of myself.” “I think the biggest thing for me is them not understanding insulin dose when they’re writing up your chart and how you don’t really have a “typical” insulin dose that fits neatly into their charts because of carb counting or correction doses/reduction dose. It’s strange, when I’ve had DKA admissions and I’m on the sliding scale IV it’s fine because there’s clear guidelines but for just day to day injection management it’s soooo difficult.” "Daughter had food and insulin withheld in a mental hospital." “the ward nurses didn’t even know I had T1 until the more mobile lady opposite me went and fetched a nurse who had been ignoring my call button. I was hypo and couldn’t reach my treatment.” "Taken off insulin for two days as no doctor to prescribe." “Particularly bad experience when a nurse left the glucose drip on but turned off the insulin. It terrifies me to think how bad this could have been.”
  16. Content Article
    David Oliver is a consultant in geriatrics and acute general medicine who has worked in the NHS for 33 years. In this blog, he talks about his personal experience of running covid 'hot' wards during the different waves of the pandemic, describing the toll working in these conditions has taken on the health of him and many of his colleagues. He highlights the impact of looking after dying patients without adequate PPE, informing family members of patients' death over the phone, being responsible for many more patients than usual and witnessing colleagues die from Covid-19. The result has been burnout, mental health issues and low morale for a workforce that was already stretched before the pandemic hit the UK. David finally caught Covid-19 himself in March 2022 and he talks about how the virus—plus the cumulative effect of working under such strain for over two years—has meant he is not able to work and has been signed-off sick since mid-May.
  17. Content Article
    People with a learning disability and autistic people should have the right support in place to live an ordinary life and fulfil their aspirations, in their own home. This action plan from the Department of Health and Social Care (DHSC) aims to strengthen community support for people with a learning disability and autistic people, and reduce reliance on mental health inpatient care. This action plan outlines the government's policy to achieve this by: strengthening community support. reducing the overall reliance on specialist inpatient care in mental health hospitals. improving the experiences of people with a learning disability and autistic people across public services such as health, social care, education, employment, housing and justice. It brings together the commitments that have been made by different organisations to realise these aims, and aims to drive long-term change for people with a learning disability and autistic people.
  18. Content Article
    This study in the journal Infection Control & Hospital Epidemiology aimed to determine the extent to which asymptomatic individuals infected with Covid-19 transmitted the disease to other patients and staff on a hospital ward. The authors found that a comprehensive symptoms and signs assessment, in combination with adequate follow-up, allows for a more precise determination of Covid-19 symptoms. The results of the study revealed that asymptomatic infection was quite uncommon amongst adults in this setting.
  19. Content Article
    This is the annual report of the National Diabetes Inpatient Audit–Harms (NaDIA-Harms) programme, which aims to monitor and reduce instances of key life-threatening diabetes specific inpatient events. The programme covers hypoglycaemic rescue, diabetic ketoacidosis (DKA), hyperosmolar hyperglycaemic state (HHS) and diabetic foot ulcer. Overall 4,605 inpatient harms were submitted to the NaDIA-Harms audit between May 2018 and October 2020; the majority of which related to hypoglycaemic rescue (69%). This report also covers: the number of submissions of each inpatient harm. the impact of the Covid-19 pandemic on inpatient harms. patient profiles of people that experience each inpatient harm. These include demographics, diabetes characteristics, treatment targets, care processes, admission characteristics and comorbidities.
  20. Content Article
    Patients 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.
  21. Content Article
    This study in BMC Health Services Research aimed to evaluate the impact of an Internet of Things intervention in a hospital unit. The Internet of Things refers to a network of physical objects that are connected by sensors, software and other technologies in order to transfer data and interact with one another. This study demonstrates the effects of smart technologies on patient falls, hand hygiene compliance rate and staff experiences. The authors reported some positive changes that were also reflected in interviews with staff. They identified behavioural and environmental issues as being particularly important to ensure the success of Internet of Things innovations in a hospital setting.
  22. Content Article
    Cheshire and Merseyside Health and Care Partnership has published this consensus document on the interface between primary and secondary care. It aims to ensure healthcare providers ensure access to the right care to give patients the best outcomes. It contains a set of clinically-led principles to ensure pathways have a common structure of good quality, patient-centred communication. It includes a number of guiding principles that encourage staff to ensure: the patient is at the centre of decision making actions taken are completed in a timely way actions are undertaken by the most appropriate individual or team decisions and actions are understood by all.
  23. News Article
    Admissions of people to hospital with Covid in England have begun to grow again, new data from the NHS shows, as fears were raised over a new wave. Analysis by John Roberts of the Covid Actuaries group, set up in response to the pandemic, showed hospital admissions had stopped falling after a period of decline. Figures on Tuesday showed weekly admissions increased by 4% across England as of 5 June and were up by 33% in the North East and Yorkshire. When asked if the UK was heading into another wave, Mr Roberts told The Independent: “Yes we could be but...how big that wave and how serious it will be in terms of admissions and deaths is very, very difficult to judge at this stage.” His comments come after experts in Europe warned there will be a new wave driven by the growth of the BA.5 and BA.4 Covid variants. The figures, which cover hospitals in England only, show the weekly average of admissions for patients in hospital with Covid stood at 531 as of 5 June. Read full story Source: The Independent, 9 June 2022
  24. News Article
    The number of patients stuck in hospitals despite being ‘medically fit’ to leave has continued to increase in recent months, leading to warnings from NHS Confederation that trusts are finding it ‘impossible’ to make progress on reducing the numbers. Official statistics for April suggest an average of 12,589 patients per day in NHS hospitals in England – 13% of all occupied beds – did not meet the “criteria to reside”. At 31 trusts, the proportion was 20% or more. NHS England has since told local leaders to make reducing the numbers of delayed discharges an operational priority. The issue is a key factor behind the long waits in emergency care, as ward beds are taking longer to become available to accident and emergency patients. Rory Deighton, acute lead at NHS Confederation, said targets to reduce delayed discharges “will not be met” unless the government “invests in domiciliary care wages,” amid high numbers of vacancies in the social care sector. Read full story (paywalled) Source: HSJ, 1 June 2022
  25. Content Article
    Since 2010/11, the NHS has lost almost 25,000 beds across the UK. The evolving nature of healthcare provision means that the role of hospital admission has changed, but hospital beds still represent an essential part of healthcare, and the number available to the NHS should be carefully considered. A broad consensus has developed in recent years that the reduction in beds has happened too quickly. The outcome is that the NHS is now under-bedded. This has important consequences; patients must now endure long waits to be admitted with emergency department staff providing care normally provided in wards even as they continue to care for new arrivals; ambulance handover delays increase and there are delays to calls for an ambulance; planned operations are cancelled. Reducing long stays in emergency departments requires adequate staffing, space, efficient processes, and sufficient inpatient bed capacity. This report from the Royal College of Emergency Medicine (RCEM) focuses on inpatient bed capacity. While the unit of measurement is a bed, it must be remembered that a bed requires medical, nursing and other staff to safely function.
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