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Found 118 results
  1. Content Article
    This customisable, educational toolkit published by the Agency for Healthcare Research and Quality (AHRQ) aims to help ICUs reduce rates of central line-associated bloodstream infection (CLABSI) and catheter-associated urinary tract infection (CAUTI). The materials can be used to assess current safety practice, implement new approaches and overcome particular challenges related to CLABSI and CAUTI in ICUs.
  2. Content Article
    This webpage provides an overview of how human factors affect outcomes in surgical emergencies. It includes: An introduction to human factors Video exploring the case of Elaine Bromiley Explanation of human error and the Swiss Cheese Model Table of factors that reduce human error 'What if?' video showing how simple changes could have resulted in a different outcome in Elaine Bromiley's case Practical tips for managing the paediatric airway in a critically ill child
  3. Content Article
    Out-of-hours discharge from the intensive care unit (ICU) to the ward is associated with increased in-hospital mortality and ICU readmission. This study in the journal Critical Care Medicine was part of the REcovery FoLlowing intensive CarE Treatment mixed methods study. It aimed to map the discharge process and describe the consequences of out-of-hours discharge to inform practice changes to reduce the impact of discharge at night. The study identified significant limitations in out-of-hours care provision following overnight discharge from ICU. The authors recommend changes to help make daytime discharge more likely, and new systems to ensure patient safety where night time discharge is unavoidable.
  4. Content Article
    Where a new or under-recognised risk identified through the NHS England's review of patient safety events doesn’t meet the criteria for a National Patient Safety Alert, NHS England look to work with partner organisations, who may be better placed to take action to address the issue. To highlight this work and show the importance of recording patient safety events, they publish regular case studies. These case studies show the direct action taken in response to patient safety events recorded by organisations, staff and the public, and how their actions support the NHS to protect patients from harm.
  5. Content Article
    The 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.
  6. Content Article
    This study from Harris et al. estimated the effect of prompt admission to critical care on mortality for deteriorating ward patients. They found that prompt admission to critical care leads to lower 90-day mortality for patients assessed and recommended to critical care.
  7. Content Article
    This case study looks at how implementing a daily emergency call safety huddle at Surrey and Sussex Healthcare NHS Trust has increased efficiency in team working and improved patient safety. A safety huddle is a short multidisciplinary briefing, held at a predictable time and place, and focused on the patients most at risk. By implementing the ten-minute daily safety huddle, the medical emergency and cardiac arrest teams improved patient outcomes and staff experience, and were able to make better use of resources.
  8. Content Article
    Getting 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.
  9. Content Article
    This is the first in a series of thematic reports which will be published by the Independent Maternity Services Oversight Panel in the coming year. The purpose of the report is to summarise the learning which is emerging from the ongoing programme of independent clinical reviews of the maternity and neonatal care previously provided by the former Cwm Taf University Health Board. This particular report summarises the key themes and issues which emerged from the clinical review of 28 individual episodes of care1 which were provided by the Health Board between 01 January 2016 and 30 September 20182. It focuses on the care of mothers who needed unplanned emergency treatment during childbirth, including some who required admission to an Intensive Care Unit.
  10. Content Article
    In this article in the Anesthesia Patient Safety Foundation Newsletter, Katsuyuki Miyasaka talks about the history of the pulse oximeter in Japan and celebrates one of it's earliest developers, Takuo Aoyagi. The author recognises the life-saving impact of pulse oximeters, but talks about the need for more education and regulation around the use of this readily available device. Miyasaka highlights that the quality of devices is variable and that when patients attempt to interpret the numbers they see, it may lead to harm.
  11. Content Article
    In conditions of intensive therapy, where the patients treated are in a critical condition, alarms are omnipresent. Nurses, as they spend most of their time with patients, monitoring their condition 24 h, are particularly exposed to so-called alarm fatigue. The purpose of this study from Lewandowska et al. is to review the literature available on the perception of clinical alarms by nursing personnel and its impact on work in the ICU environment.
  12. Content Article
    The surge in the need for invasive ventilation during the covid pandemic has required the provision of intensive care beds in London to be reallocated. NHS England have proposed the formation of a Pan‐London Emergency Cardiac surgery (PLECS) service to provide urgent and emergency cardiac surgery for the whole of London. In this initial report, the Department of Cardiac Surgery, St Bartholomew's Hospital, outline their experience of setting up and delivering a pan‐regional service for the delivery of urgent and emergency cardiac surgery with a focus on maintaining a COVID‐free in‐hospital environment. In doing so, they hope that other regions can use this as a starting point in developing their own region‐specific pathways if the spread of coronavirus necessitates similar measures be put in place across the United Kingdom
  13. Content Article
    This research was conducted with the aim to reduce the number of poor outcomes for surgical patients with a National Early Warning Score (NEWS) score ≥7 in the author's institution by 50%. Results found that the introduction of the surgical safety huddle supported by the deteriorating patient response team reduced the number of cardiac arrests and poor outcomes in a surgical inpatient cohort.
  14. Content Article
    This article, published in the BMJ, looks at the declining mental health of staff in ICU during the height of the Covid-19 pandemic, based on research by King's College London in 2020.
  15. Content Article
    This research focuses on patient advocacy from a nursing perspective. In this qualitative study,15 clinical nurses working in intensive care units (ICUs), coronary care units (CCUs), and emergency units were interviewed regarding patient advocacy with data analysed using content analysis. After data analysis was performed, results showed that patient advocacy consisted of the two themes of empathy with the patient and protecting the patients.
  16. Content Article
    The Chartered Institute of Ergonomics and Human Factors (CIEHF) has launched an oxygen safety campaign aimed at people working at patient bedsides within hospitals. They have consulted with clinicians, fire safety experts and a wide range of allied professional bodies to design the campaign, which has been launched in response to the anticipated national surge in hospital patients as a result of the Omicron variant. Inevitably, the use of oxygen will be very high and issues such as oxygen leakage can cause major fire risks.
  17. Content Article
    A shared lingo can create cohesion in “the unit,” but James M Hodgetts and colleagues ask whether this is exclusionary and puts patient safety at risk. They collected the slang terms used by others and ourselves in the intensive care unit (ICU) over six months and collated these terms and expressions (those that can be committed to print) in a mini-dictionary of ICU slang, and some are used in UK medicine more broadly. They hope that the dictionary may be of use and possibly a source of amusement—and that it causes ICU staff and other healthcare workers to reflect on the suitability and inclusivity of the language they use with colleagues.
  18. Event
    until
    The Safe Anaesthesia Liaison Group Patient Safety Conference will be held in collaboration with RA-UK. The first session will include engaging lectures around the current work of SALG, and the second session will focus on topical issues in relation to regional anaesthesia safety. There will be a prize session for accepted abstracts, with a poster section and oral presentations. This online conference is being organised by SALG co-chairs, Dr Peter Young from the Association of Anaesthetists, Dr Felicity Platt, Royal College of Anaesthetists and Nat Haslam, Regional Anaesthesia UK The day will provide valuable knowledge for doctors engaged in clinical anaesthesia, pain management and intensive care medicine, and who have an interest in improving patient safety. Register
  19. Community Post
    During the COVID pandemic, it was clear that Emergency Departments across the UK needed to adapt and quickly, with my trust not exempt from this. We have increased capacity, increased our nursing and doctors on the shop floor, obviously with nurse in charge being responsible for all areas. We have different admission wards in terms of symptoms that the patient has, but also have a different type of flow, which i am getting my head around to be able to share I have seen departments split into 2 and various other ideas coming out from various trusts. Which got me thinking about patient safety and how well this is managed. So.... How is your department responding to the pandemic? Do you have any patient safety initiatives as a result of the response? Is there a long term plan? The reason why i am asking this, is so we can share practice and identify individual trust responses.
  20. Content Article
    NHS urgent and emergency care is under intolerable strain. This strain is increasingly causing harm to patients. Timely and high quality patient care is often not being delivered due to overcrowding driven by workforce and capacity constraints. While the covid-19 pandemic has accentuated and arguably expedited the crisis; the spiral of decline in urgent and emergency care has been decades long and unless urgent action is taken, we may not yet have reached its nadir, writes Tim Cooksley and colleagues in this BMJ opinion article.
  21. News Article
    Britain’s sickest children are being treated in intensive care units that are struggling with severe shortages of the specialist nurses needed to look after them, a report says. The shortages in the UK’s 30 paediatric intensive care units (PICUs) are so severe that healthcare assistants are covering the work of nurses in an attempt to ensure that staffing levels are maintained. Only one of the PICUs – at the James Cook University hospital in Middlesbrough – was found to have enough nurses to guarantee the standards of care expected. About 15,000 children and young people a year, often with life-threatening conditions, are cared for in PICUs. Clinical standards that prevail in PICUs require them to ensure that seven nurses are on duty for each bed in a 24-hour cycle. However, the report by the Paediatric Intensive Care Audit Network (PICANet), a group of experts from Leicester and Leeds universities, found that 29 of the 30 had too few nurses to do that, and that all 30 had vacancies, sometimes large numbers of them. “Parents will find this extremely alarming”, said Patricia Marquis, the Royal College of Nursing’s England director. “Most people wouldn’t believe that only one paediatric intensive care unit across the whole UK has enough staff to function properly, but this is the reality of the workforce crisis. Key roles in specialist nursing teams are lying vacant for years.” Read full story Source: The Guardian, 23 January 2022
  22. News Article
    A specialist service to transport critically ill and injured patients is being copied around England after the success of a trial in the South West. More than 700 patients have been transported since the pilot scheme began a year ago. Retrieve was set-up to transport the most seriously ill patients between intensive care units to take pressure off ambulance and hospital staff. Six other regions around England are now developing a similar service. "Everyone will have a service that looks similar to Retrieve by the end of next year which is amazing in the short period of time that we've been talking about it," said Dr Scott Grier, lead consultant for Retrieve. Dr Grier said critically unwell patients need to be transported between hospitals for various reasons, though frequently to be treated in a hospital specialising in the care they require. The service, which operates in Bristol, Gloucestershire, Wiltshire, Somerset, Devon and Cornwall, is funded by NHS England and Improvement South West and costs £3.2m a year. "It sounds expensive but it's an efficient service and every time we make a transfer we save the hospital and staff time and those hospitals can care for other people while we care for their patients on the move. "It's incredibly exciting because we have changed this area of critical care forever," added Dr Grier. Read full story Source: BBC News, 5 January 2021
  23. News Article
    Eight highly skilled intensive care (ICU) nurses have resigned from one trust in the past two weeks and more could follow, a leading nurse has warned. More resignations expected as working conditions remain unsustainable Belfast Health and Social Care Trust in Northern Ireland has confirmed it is redeploying non-specialist nursing staff to fill the gaps in staffing on ICU wards, with experienced ICU nurses expected to provide supervision. RCN Northern Ireland director Rita Devlin said the college has heard others at the trust are ‘considering their position’. "These are highly skilled nurses who are difficult to replace and this is a very worrying situation," she said. "Nursing staff are doing everything they can to keep services going, but it is not sustainable to work under such pressure for long periods of time without a break." The resignations come just months after it was revealed that 182 nurses and 50 healthcare assistants had quit their jobs at the trust between January and July. Read full story Source: Nursing Standard, 23 November 2021
  24. News Article
    A senior doctor has warned that paediatric intensive care units (PICUs) are ‘as pressured as I can ever recall’ – despite the absence of cold weather, which typically leads to higher demand levels. James Fraser, president of the Paediatric Critical Care Society, said national bed occupancy in PICUs has “often been greater than 95 per cent” over recent weeks, while several units have reported 100 per cent occupancy. He said some children have had to be transferred between regions in order to admit them to a bed. PICUs are often under more pressure during winter, due to seasonal RSV and other viral infections. But high demand levels have started earlier this year, which has meant severely ill children have occasionally waited longer in local hospitals before being admitted to PICUs, and have sometimes had to be transferred to another site. Mr Fraser told HSJ: “[PICUs] are really busy, as pressured as I can ever recall them. “Every winter PICUs are under huge pressure due to seasonal RSV bronchiolitis. This usually happens between November and February. This year we always anticipated it would be a much longer season. It’s putting a lot of pressure on our national bed base. “What is different is we have been under this pressure earlier in the year with RSV and other viral chest infections. We have been under this pressure for a month. The pressure is both the number of patients and there are a lot of staff off having to self-isolate." Read full story (paywalled) Source: HSJ, 29 October 2021
  25. News Article
    On Tuesday, there were 356 COVID-19 patients being treated in intensive care wards throughout Australia. Of those, 25 were fully vaccinated. While the data points to the extraordinary efficacy of COVID-19 vaccines in preventing people from becoming severely unwell, being hospitalised and dying, it does raise the question: why do a small number of people become seriously ill and, in rare cases, die, despite being fully vaccinated? An intensive care unit staff specialist at Nepean hospital in Sydney, Dr Nhi Nguyen, said those who are fully vaccinated and die tend to have significant underlying health conditions. Being treated in intensive care, where people may be on a ventilator and unable to move, added to any existing frailty, especially in elderly people, she said. “If we think about intensive care patients in general, whether they are there due to COVID-19, pneumonia or any other infection, we know that those who have underlying disorders, those who are frail, and those with co-morbidities will have a higher risk of dying from whatever the cause of being in intensive care is,” she said. “Being fully vaccinated against Covid protects you from getting severe disease, yes, but it doesn’t completely protect you from getting Covid. So if you are someone with chronic health conditions, what might be a mild disease or mild infection in a young person or a person who is in good health, will have a greater impact on you.” She said this was why the Australian Technical Advisory Group for Immunisation (Atagi) had recommended boosters for those people who are severely immunocompromised. On Wednesday the government said it intended booster shots to be rolled out to the aged care sector within weeks, and to be available to the whole population by the end of the year. Read full story Source: The Guardian, 20 October 2021
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