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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. -
Content ArticleNon-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.
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Content ArticleWhen 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.
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Laurence Goldberg, an independent pharmaceutical consultant, discusses the effectiveness and also the potential for harm of unit-dose medicines distribution. -
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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Content ArticlePatient 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.
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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. -
Content ArticleDavid 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.
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Content ArticlePeripherally inserted central catheters (PICCs) are medical devices often used for medium-to-long-term intravenous therapy, but they are often associated with morbid and potentially lethal complications. This multi-centre study in the journal Plos One aimed to identify barriers and facilitators to implementing evidence-based appropriateness criteria to improve PICC safety and patient outcomes in a pay-for-performance model. The authors found that structured quality improvement (QI) efforts led to sustained PICC appropriateness and improved patient safety. These interventions included a multidisciplinary vascular access committee, clear targets, local champions and support from an online education toolkit.
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Content ArticleThis standard operating procedure (SOP) for Leicester Royal Infirmary Children's Hospital outlines the process to be followed at times of increased pressure on services caused by increased acuity or activity in the pathway for non-elective care.
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Content ArticleWith emergency departments beyond capacity throughout the country, some hospitals have been trialling an approach of moving a set number of patients into inpatient wards each hour, regardless of bed availability. Is this a viable solution to the problems faced throughout the system? Dr Louella Vaughan assesses the evidence and argues for further caution before rolling out such a model.
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Content ArticleThe Covid-19 pandemic has, in many ways, been healthcare’s finest hour. Clinicians performed miracles as they battled to understand a new disease, learning as they went along the techniques and approaches that gave patients the best chance of survival. But, for all this quiet heroism, the crisis also turned a harsh spotlight on the deficiencies of health systems, writes Sarah Neville in this Financial Times article.
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Content ArticleThis guidance from the Irish Health Services Executive (HSE) aims to help healthcare staff improve venous thromboembolism (VTE) prevention in hospitals. Hospital-acquired blood clots, or VTE, are the most common preventable cause of in-hospital death. Assessing patients’ risk of VTE and bleeding and choosing the appropriate thromboprophylaxis such as medicines or compression stockings early in their hospital admission reduces their risk of developing a blood clot.
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Content ArticleThis Nuffield Trust Quality Watch blog from Sophie Flinders and Sarah Scobie takes a closer look at the rising number of patients facing delays in leaving hospital – and explores the reasons for why it’s happening.
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Content ArticleThe 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.
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Content Article'The state of care in NHS acute hospitals 2014 to 2016' presents findings from the Care Quality Commission (CQC's) programme of NHS acute comprehensive inspections. The report captures what has been learned from three years’ worth of inspections. It gives a baseline on quality that is unique in the world – and also shows that it is possible, even in challenging times, to deliver the transformational change that is needed if the NHS is to continue delivering high-quality care into the future.
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Content ArticleBariatrics is the branch of medicine that deals with the causes, prevention and treatment of obesity and its associated diseases. This pathway written by East Kent Hospitals University Foundation NHS Trust (EKHUFT) provides guidance for multidisciplinary teams to allow them to provide appropriate care for each bariatric patient according to their unique shape, size and body dynamics.
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Content ArticleSonia Sparkles is a senior manager in healthcare who is using her artistic skills to improve the way healthcare services communicate with patients. Her goal is to empower patients to feel at ease in healthcare settings and able to fully engage in their care. In this blog, Sonia describes how her own experience of being in hospital helped her see healthcare from a patient's perspective. While an inpatient, she felt disempowered, frightened and unable to ask the questions she wanted to. Having reviewed some NHS patient literature, Sonia realised that there was a need to find a way to communicate clearly with patients and invite them to share their concerns with healthcare staff. She produced a series of 23 posters as a starting point to get people thinking about how to communicate with patients in a simple, visual and empowering way.
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EventuntilThe number one focus in the world right now is health care and the critical need to bring greater efficiency to treating patients. During the COVID-19 pandemic, vast amounts of information are rapidly cross-crossing the globe. Governments, health systems, and research communities in the European region are looking to learn as much as possible from each other, as quickly as possible, about the nature of COVID-19 and the most effective interventions for preventing and treating it. We cannot afford to ignore the clear signs pointing to a new future of increased care needs, labour shortages, and operational strain. From COVID-19 to general routine care, we must act now to ensure that no patient waits for the care they need. For health care professionals looking to structure their leadership plans around lessons learned in the field comes the 'Hospital Flow in the UK: During and Beyond COVID-19'. In this online course from the Institute for Healthcare Improvement (IHI), health care leaders address challenges and share successes, best practices, and strategies to effectively advance the long-term goal of improving community health in a post-COVID world. Experts will discuss noteworthy global challenges and responses to COVID-19, specifically focusing on efforts in the United Kingdom (UK) to monitor and quickly improve treatment for patients across the care continuum. Further information and registration
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Content ArticleMany risks faced by patients in acute mental health settings are similar to those that occur in other areas of healthcare, for example medication errors and cross-infection. In addition, however, there are unsafe behaviours associated with serious mental health problems, including violence and self-harm; the measures taken to address these, such as restraint or seclusion, may result in further risks to patient safety. This article by Catherine Gilliver in the Nursing Times discusses the need for a physical and psychosocial environment in which staff, patients and visitors feel recognised and valued.
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Content ArticleOn 23 September, Improvement Cymru, the all-Wales Improvement service for NHS Wales, hosted an online session with colleagues from Holland to talk about patient flow in hospital.
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First, Do No Harm — But in a Pandemic, How? (25 September 2020)
Patient Safety Learning posted an article in Blogs
As hospitals in the US braced for the onslaught of coronavirus cases this past spring, they radically restructured and reorganised to help ease the burden on staff and minimise transmission within the hospital. Along with ceasing elective surgeries and transforming floors to allow for care of intubated patients, visitors were forbidden from entering hospitals with few exceptions. Now, several months removed from the peak of the pandemic, a limited number of visitors are allowed at a time. While limiting visitors allows some additional element of physical distancing, how much does a ban actually help our patients, and how much does it hurt them — especially mothers-to-be in the vulnerable perinatal period? Is it possible to limit visitor-spread virus while allowing our patients the dignity and the peace of companionship during one of the most stressful periods of their lives? In this blog, Byrne and Goldfarb look at the consequences of limiting visitors during the pandemic and considers the negative effect this may have on the health of the patient. -
Content ArticleRaymond Cipollini, a long-time employee (recently retired) of the maintenance department at Einstein Medical Center Montgomery in East Norriton, Pennsylvania, used to visit patients during his shifts. His fellow staff noted that he would respond to call lights, asking how he could help, with a cheerful demeanor. Raymond often intervened if a patient was restless and pulling at IV lines or needed nurse assistance to get out of bed—potentially preventing falls. The Patient Safety Authority (PSA) named him the winner of its 2017 I AM Patient Safety Award in the category Individual Impact; he was nominated by his colleagues, who had frequently noted lively conversations coming from patient rooms, where he bonded with his “friends” over sports or other shared interests. It is lonely sometimes in those rooms, especially for patients who do not have visitors. “When I stop in, I hope I take their mind off their troubles and make them smile,” he said. These connections attend to patient’s physical safety and emotional well-being. Raymond brought his own perspective to his job and felt empowered to act for the benefit of patients and strengthened the fabric of the organisational culture.
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Based on the experiences of hospital trusts that performed well during the early phase of the pandemic, the guidance shares successful innovations and practices which others can utilise and adopt. Drawing on the Getting It Right First Time (GIRFT) programme’s data-driven methodology and the wealth of experience of its national clinical leads, the advice covers infection prevention and control, emergency medicine, critical care, anaesthesia, acute and general medicine, respiratory medicine, diabetes care, and geriatric medicine and community care, as well as looking at cross-cutting themes such as trust leadership and management, research and clinical coding. The guide, Clinical practice guide for improving the management of adult COVID-19 patients in secondary care, is reviewed and endorsed by 12 key professional societies. -
Content ArticleWard rounds are the focal point for a hospital’s multidisciplinary teams to undertake assessments and care planning with their patients. Coordination of assessments, plans and communication is essential for effective and efficient care. However, the delivery of ward rounds is consistently constrained by the competing priorities of clinical staff. A number of factors contribute to this, including workforce gaps, inadequate planning, unwarranted variation in practice and an absence of training in the skills required to deliver complex multidisciplinary team care. This leads to frustration for staff and patients, and can lead to errors in care, longer stays in hospital and readmissions. A new report from UK healthcare professional leaders including the Royal College of Physicians, and developed along with patients, sets out best practice for modern ward rounds.
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