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Content ArticleQuestions have been raised as to whether medical masks offer similar protection against Covid-19 compared with N95 respirators. This study in The Annals of Internal Medicine aimed to determine whether medical masks are noninferior to N95 respirators in preventing Covid-19 in healthcare workers providing routine care. The authors of the study conducted a multicentre, randomised, noninferiority trial at 29 healthcare facilities in Canada, Israel, Pakistan and Egypt. The study found that among healthcare workers who provided routine care to patients with Covid-19, the overall estimates rule out a doubling in hazard of PCR–confirmed Covid-19 for medical masks when compared with N95 respirators.
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Content ArticleThe third leading cause of death in the US is its own healthcare system—medical errors lead to as many as 440,000 preventable deaths every year. To Err Is Human is an in-depth documentary about this silent epidemic and those working quietly behind the scenes to create a new age of patient safety. Through interviews with leaders in healthcare, footage of real-world efforts leading to safer care, and one family’s compelling journey from being victims of medical error to empowerment, the film provides a unique look at the US healthcare system’s ongoing fight against preventable harm.
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News Article
Covid: Boris Johnson WhatsApp messages requested by inquiry
Patient Safety Learning posted a news article in News
The Covid public inquiry has asked to see Boris Johnson's WhatsApp messages during his time as prime minister as part of its probe into decision-making. Counsel for the inquiry, Hugo Keith KC, said the messages had been requested alongside thousands of other documents. He said a major focus of this part of the inquiry was understanding how the "momentous" decisions to impose lockdowns and restrictions were taken. The revelations came as he set out the details of how this module will work. The inquiry is being broken down into different sections - or modules as they are being called. The preliminary hearing for module one, looking at how well prepared the UK was, took place last month. Monday marked the start of the preliminary hearing for module two, which is looking at the political decision-making. Mr Keith said this allowed the inquiry to take a "targeted approach". He said it would look at whether lives could have been saved by introducing an earlier lockdown at the start of 2020. Read full story Source: BBC News, 31 October 2022 -
News Article
MRSA reported at Manston in migrant who tested positive for diphtheria
Patient Safety Learning posted a news article in News
A case of MRSA has been reported at the congested asylum processing centre at Manston in Kent, the Guardian has learned, after it emerged that Suella Braverman ignored advice that people were being kept at the centre unlawfully. The antibiotic-resistant bacteria was identified in an asylum seeker who initially tested positive for diphtheria. But the asylum seeker was moved out of the site in Ramsgate to a hotel hundreds of miles away before the positive test result was received, raising concerns about the spread of the infection. The Manston site is understood to now have at least eight confirmed cases of diphtheria, a highly contagious and potentially serious bacterial infection. Migrants are meant to be held at the short-term holding facility, which opened in January, for 24 hours while they undergo checks before being moved into immigration detention centres or asylum accommodation such as a hotel. But giving evidence to a committee of MPs last week, David Neal, the independent chief inspector of borders and immigration, said he had spoken to a family from Afghanistan living in a marquee for 32 days, and two families from Iraq and Syria sleeping on mats with blankets for two weeks. Conditions at the site left him “speechless”, he said. On a visit to the site on 24 October, Neal was told there were four confirmed cases of diphtheria. Protective medical equipment for staff has now been brought on to the site. Although diphtheria is a notifiable disease, meaning cases must be reported to authorities, those at Manston have not appeared on weekly public health reports. A Home Office spokesperson said it was “aware of a very small number of cases of diphtheria reported at Manston”, and that proper medical guidance and protocols were being followed. Read full story Source: The Guardian, 30 October 2022 -
News Article
Eighteen deaths following Tees health trusts' safety lapses
Patient Safety Learning posted a news article in News
Eighteen people died at two Teesside hospital trusts following patient safety lapses over a 12-month period. Sixteen such deaths were recorded at the South Tees Hospitals NHS Foundation Trust, with two at the North Tees and Hartlepool NHS Foundation Trust. Examples of patient safety lapses include a failure to provide or monitor care, a breakdown in communication, an out-of-control infection in a hospital, insufficient staffing or a missed diagnosis. NHS England figures show that, between April 2021 and March this year, there were 16,557 incidents at the South Tees Trust, which operates James Cook University Hospital in Middlesbrough, and Northallerton's Friarage Hospital. Thirty-four resulted in "severe" harm. Middlesbrough MP Andy McDonald told the Local Democracy Reporting Service the figures were a concern and that he planned to take them up with the South Tees Trust's chief executive. He said NHS staff worked under "the most demanding of conditions" but added: "Every person going into hospital rightly expects to receive the best treatment. Patient safety is paramount and no family wants to see a loved one suffer." Dr Mike Stewart, the trust's chief medical officer, said: "We encourage an open and transparent culture and promote the reporting of all patient safety incidents, even when there is uncertainty over a direct link between any problems in care and incidents of severe harm or death. "In the last year there were no deaths graded as definitely preventable due to a problem in the care delivered by the trust. "While our reporting has increased consistently over the last three years, the number of serious incidents has not risen, which is strong evidence of a positive safety culture." Read full story Source: BBC News, 30 October 2022 -
News ArticleA surge in Covid cases over winter could lead to harsh visiting restrictions being reimposed in care homes and hospitals, MPs and campaigners have warned. Families are still facing a “postcode lottery” of Covid restrictions in care homes, with visiting times restricted and personal protective equipment (PPE) obligatory. However MPs are worried that some will reimpose even harsher measures if Covid cases rise this winter. Daily global Covid infections are projected to rise slowly to around 18.7 million by February, up from the current 16.7 million average daily cases this October. MPs are calling for the government to enact legislation that would enshrine the right for an essential care giver to be present with their loved ones in care settings. Liberal Democrat MP Daisy Cooper said that one of her constituents, Lynn, was not allowed into a hospital A&E ward to see her husband Andy when his dementia deteriorated over Christmas last year. The hospital refused to let Andy have any visitors for two weeks until Ms Cooper intervened. When she was allowed in, Lynn was distraught to find that Andy had lost a significant amount of weight in the weeks he was isolated. Ms Cooper continued: “We have come a long way since last Christmas, and since the start of the pandemic, but as winter approaches the NHS and care settings are once again expected to struggle with a surge in Covid cases. “It is not inconceivable that what happened to Lynn and Andy could happen again to them and to many others.” Read full story Source: Independent, 30 October 2022 Further hub reading Visiting restrictions and the impact on patients and their families: a relative's perspective It’s time to rename the ‘visitor’: reflections from a relative Mother knows best – a blog by Dr Abha Agrawal
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News ArticleA Harley Street doctor suspended for working while testing positive for Covid at the height of the pandemic has said that his patient’s cancer treatment took priority. Dr Andrew Gaya was found to have “blatantly disregarded” the rules by going to work at a centre for patients with brain tumours after he tested positive for the disease. The “highly regarded” consultant oncologist “dishonestly” misled colleagues that he was safe to work by keeping his positive test secret, a tribunal found. Dr Gaya, whose work is at the forefront of tumour care and has been described as “world class”, said he defied Covid-19 rules because he believed “the risk of harm to his patient” in delaying treatment was “greater than the risk he posed”. Now, the doctor of 27 years has been suspended for three months at a Medical Practitioners’ Tribunal. Read full story (paywalled) Source: The Times, 20 Ocotober 2022
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News ArticleDoctors have criticised new health secretary Therese Coffey over reports that pharmacists will be allowed to prescribe antibiotics without the approval of a doctor. According to The Times, Ms Coffey’s “Plan for Patients” will give pharmacists the power to prescribe certain drugs, such as contraception, without a prescription in an effort to reduce the need for GP appointments and tackle waiting lists. Responding to reports of the plans, Rachel Clarke, an NHS palliative care doctor and writer, wrote on Twitter: “This is staggeringly irresponsible of Therese Coffey and will cause so much more harm than good. “Doctors do not – unlike Coffey – dish out spare antibiotics to our family and friends because we’re painfully aware of the harms of antibiotic resistance. Utter recklessness.” Stephen Baker, a professor at Cambridge University and an expert in molecular microbiology and antimicrobial resistance, branded the health secretary’s plans “moronic”. He told the newspaper that the more antibiotics were used “the more likely we are to get drug-resistant organisms”. He added that it was “nuts” to consider widening access to drugs, adding that resistance against antibiotics is “clearly one of the biggest problems humanity is facing in respect of infectious disease at the moment”. Read full story Source: The Independent, 17 October 2022
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News ArticleNHS trusts may be forced to cancel appointments and limit visiting times in a Covid and flu “twindemic” this winter, health leaders have warned. Fears have been raised the viruses could strip back the workforce and further increase demand for services during an already busy period. It comes amid rising Covid infections in the UK. Around 1.3 million tested positive in late September, according to the latest figures, which was a 25% increase on the week before. The UK is also concerned there could be a bad flu season this year, with lower immunity across the population due to reduced exposure in the Covid pandemic. NHS leaders have warned that this background could make winter even more difficult for the health service. “I make no bones about this: we know it’s going to be a pressurised time for trusts over the next four months if not longer,” Saffron Cordery from NHS Providers, which represents trusts in England, told The Independent. The interim chief executive added: “We’re worried about Covid and we’re worried about flu.” Ms Cordery said these joint pressures – which could increase demand, strip back workforces and introduce the need for greater infection control measures – could have a knock-on effect on services. “We need to anticipate that there may well be cancellations for either outpatient appointments or routine procedures or operations, because there could be staff shortages or rising demand in emergency care – that means that those routine appointments cannot take place as quickly as we’d like,” she said. Read full story Source: The Independent, 8 October 2022
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News Article
‘Twindemic’ warning as health chiefs launch Covid and flu vaccination drive
Patient Safety Learning posted a news article in News
Health chiefs have warned of a Covid and flu “twindemic” this winter as they launched a renewed vaccination drive. Around 33 million people in England will be eligible for a free flu vaccination this year, while 26 million are also eligible for an autumn Covid-19 booster. Officials at the UK Health Security Agency (UKHSA) warned there will be lower levels of natural immunity to flu this year after the past few winters saw the public socialising less during restrictions. The UKHSA warned of a possible "difficult winter" ahead as respiratory viruses, including flu and Covid, circulate widely as the public return to pre-pandemic levels of mixing. One expert said they were more worried about flu than they had been for several years because of the reduction in population immunity. There are also concerns patients may have vaccine fatigue and may choose to have one vaccine but not the other. Read full story (paywalled) Source: The Telegraph, 28 September 2022 -
News Article
Doctors in Ebola zone strike over safety fears
Patient Safety Learning posted a news article in News
Trainee medics battling Ebola in Uganda's virus epicentre accuse the government of putting their lives at risk. "Most times you come into contact with a patient and you use your bare hands," one worker told the BBC anonymously. All trainees at Mubende's regional hospital say they are on strike and are demanding to be moved somewhere safer. But Ugandan health ministry spokesman Emmanuel Ainebyoona told the BBC there was "no strike at the hospital". Yet all 34 of the hospital's interns - including doctors, pharmacists and nurses - have announced their decision to strike in a joint statement. They say they are being put at undue risk because they lack appropriate safety kit, risk allowances and health insurance. Six interns at the hospital have already been exposed to the virus, and are awaiting their test results in isolation. Read full story Source: BBC News, 26 September 2022 -
News Article
Flu poses 'significant threat' in Wales this winter, officials warn
Patient Safety Learning posted a news article in News
Flu could pose a "significant" threat this winter for the first time since the Covid pandemic, public health expert have warned. There are concerns the flu season may start earlier and affect more people, as other respiratory viruses re-emerge following Covid restrictions. Public Health Wales is urging adults and children who are eligible for a free flu jab to take up the offer. The announcement comes as cases of flu have already been detected in Wales. All children between two and 16 are eligible for a free flu vaccine - although only certain groups of children over five are eligible for Covid-19 boosters. The warning comes after Australia experienced its highest number of flu cases in five years, with its season starting early. Experts fear Wales and the UK could see similar levels this winter. Read full story Source: BBC News, 27 September 2022 -
News Article
‘Out of control’: rise in STDs, including 26% syphilis spike, sparks US alarm
Patient Safety Learning posted a news article in News
Sharply rising cases of some sexually transmitted diseases (STDs), including a 26% rise in new syphilis infections reported last year, are prompting US health officials to call for new prevention and treatment efforts. “It is imperative that we ... work to rebuild, innovate, and expand (STD) prevention in the US,” said Leandro Mena of the US Centers for Disease Control and Prevention in a speech on Monday at a medical conference on sexually transmitted diseases. Infections rates for some STDs, including gonorrhoea and syphilis, have been rising for years in the US. Last year the rate of syphilis cases reached its highest since 1991 and the total number of cases hit its highest since 1948. HIV cases are also on the rise, up 16% last year. An international outbreak of monkeypox has further highlighted the nation’s worsening problem with diseases spread mostly through sex. David Harvey, executive director of the National Coalition of STD Directors, called the situation “out of control”. Officials are working on new approaches to the problem, such as home-test kits for some STDs that will make it easier for people to learn they are infected and to take steps to prevent spreading it to others, Mena said. Read full story Source: The Guardian, 20 September 2022 -
News ArticleA coroner has said she does not understand why frontline workers were not required to wear a mask during lockdown after hearing a paramedic had died with Covid. A two-day inquest into the death of Peter Hart, who died on his 52nd birthday, concluded on Tuesday (September 13) with assistant coroner Dr Karen Henderson ruling the father-of-three died of natural causes caused by Covid. She said on the balance of probabilities he caught the disease while working at East Surrey Hospital, where he died on May 12, 2020. During the onset of the pandemic only healthcare workers tending to those suspected of having Covid-19 were required to wear personal protective equipment (PPE). In accordance with national guidelines, Mr Hart, who was treating patients not suspected of having the virus, did not need to. “Retrospectively it is difficult to comprehend why the national guidance said PPE did not need to be used for all patients and healthcare workers at the earliest opportunity,” Dr Henderson said. “Although there appears a lost opportunity to ensure maximum protection I make no finding of fact whether this contributed to Mr Hart’s death. “Patients not suspected to have Covid were not expected to wear face masks. This is in effect a perfect storm and given evidence of Mrs Hart I am satisfied Mr Hart contracted Covid during his work at East Surrey Hospital,” she added. Read full story Source: Surrey Live, 13 September 2022
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News Article
Covid-19: Commission describes “massive global failures” of pandemic response
Patient Safety Learning posted a news article in News
The global response to the first two years of the Covid-19 outbreak failed to control a pandemic that has led to an estimated 17.7 million deaths to date, a major review has concluded. The Lancet Commission on lessons for the future from the Covid-19 pandemic, produced by 28 world leading experts and 100 contributors, cites widespread failures regarding prevention, transparency, rationality, standard public health practice, operational coordination, and global solidarity. It concludes that multilateral cooperation must improve to end the pandemic and manage future global health threats effectively. The commission’s chair, Jeffrey Sachs, who is a professor at Columbia University and president of the Sustainable Development Solutions Network, said, “The staggering human toll of the first two years of the Covid-19 pandemic is a profound tragedy and a massive societal failure at multiple levels.”In its report, which used data from the first two years of the pandemic and new epidemiological and financial analyses, the commission concludes that government responses lacked preparedness, were too slow, paid too little attention to vulnerable groups, and were hampered by misinformation.Read full story Source: BMJ, 14 September 2022 -
Content ArticlePhysicians raised a concern to the Quality Department about patients who were diagnosed in the emergency department (ED) with a urinary tract infection (UTI) but who later were clinically reviewed and found to be without disease. These patients were often admitted and treated with potentially unnecessary antibiotics.
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Content Article
I guess that a common feature linking most visitors to Patient Safety Learning is that they have a profound interest in two things. First, recognising and applauding innovations and ‘best practice’ in healthcare. Second, recognising, exposing and denouncing bad practice. The thing they have in common is the desire to learn from the mistakes in the past to do better in the future. When it comes to ‘bad practice’ in healthcare it is usually in connection with some adverse and damaging impact on patients. Our thoughts turn perhaps to certain medical failures, such as the ‘Mid‑Staffs scandal’. Seldom do we find the need to consider the adverse and damaging impacts on the doctors, nurses and all the other staff who work in the health and social care sector. However, those of you who watched the recent BBC Panorama programme, 'Forgotten heroes of the Covid frontline' will have been appalled at the scandal that now confronts so many frontline staff for whom we stood outside our front doors and clapped for so enthusiastically back in those dark days at the height of the pandemic. This blog is dedicated to those 'forgotten heroes'. I hope that it demonstrates that they are not, in fact, forgotten I hope that the resources linked to this blog may be of help to them. -
Content Article
The Hand Hygiene Acceleration Framework Tool (HHAFT) tracks the process that a government has undergone to develop and implement a plan of action for hand hygiene improvement, and assesses the quality of that plan. It helps identify barriers, opportunities and priority actions for accelerating progress towards hand hygiene and drive investment to these plans. This webpage includes a dashboard that captures data from different countries. Use of this common framework allows for cross-country learning and exchange, and helps direct and coordinate global action. -
Content ArticleThe Global Taskforce on WASH in healthcare facilities aims to provide global strategic direction and coordination to the World Health Organization (WHO) and UNICEF and to allow for information exchange and dialogue. The latest World Health Organization (WHO) data show that there are major global gaps in water, sanitation and hygiene (WASH) services in health care facilities: half of health care facilities do not have basic hand hygiene services one in five facilities have no water services one in ten have no sanitation services. WHO and UNICEF convened a series of stakeholder ‘think-tanks’ to discuss barriers to progress, coinciding with the launch of the Global Report on WASH in health care facilities. The Global Taskforce on WASH evolved from these think-tanks, and this webpage includes a link to a synthesis of their work in 2022-23. The purpose of the task force is to: encourage and hold accountable national governments to achieve the objectives established by WHA 72/7 and SDG 3 and SDG 6 reinforce calls for strong health leadership (e.g. mobilising political leaders at global events including G7, G20, UNGA) work at country level to increase demand, financing and integration of WASH in health programming and reporting support greater collaboration with other initiatives (e.g. UHC, Child/maternal health, AMR, climate smart health systems, Hand Hygiene for All).
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Content ArticleThis report by the World Health Organization (WHO) identifies major global gaps in water, sanitation and hygiene (WASH) services. It outlines that: one third of health care facilities do not have what is needed to clean hands where care is provided one in four facilities have no water services 10% have no sanitation services. This means that 1.8 billion people use facilities that lack basic water services and 800 million use facilities with no toilets. Across the world’s 47 least-developed countries, the problem is even greater, with half of health care facilities lacking basic water services. In addition, the extent of the problem remains hidden because major gaps in data persist, especially on environmental cleaning. The report describes the global and national responses to the 2019 World Health Assembly resolution on WASH in health care facilities. More than 70% of countries have conducted related situation analyses, 86% have updated and are implementing standards and 60% are working to incrementally improve infrastructure and operation and maintenance of WASH services. Case studies from 30 countries demonstrate that progress is being propelled by strong national leadership and coordination, use of data to direct resources and action, and the mutual benefits of empowering health workers and communities to develop solutions together. The report includes four recommendations to all countries and partners to accelerate investments and improvements in WASH services in health care facilities: Implement costed national roadmaps with appropriate financing. Monitor and regularly review progress in improving WASH services, practices and the enabling environment. Develop capacities of the health workforce to sustain WASH services and promote and practice good hygiene. Integrate WASH into regular health sector planning, budgeting and programming to deliver quality services, including Covid-19 response and recovery efforts.
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Content ArticleWound care is rarely considered a strategic objective within health and care, but it has considerable impact on patients and on health service resources. In this blog, Ameneh Saatchi, Senior Partnerships and Policy Manager at Public Policy Projects looks at the growing burden of wound care on the health service and what can be done to tackle the problem.
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Content ArticleNHS Wales has published a new report detailing the good progress being made to investigate and learn from hospital-acquired COVID-19 in Wales. Established in April 2022, the National Nosocomial COVID-19 Programme is supporting NHS Wales organisations to carry out a review of nosocomial (hospital acquired) COVID-19 patient safety incidents that occurred between March 2020 and April 2022. The programme has prioritised the investigation of the most complex cases, with an aim to provide as many answers as possible for service users, families, carers and staff impacted by nosocomial COVID-19. The programme also aims to maximise learning opportunities across NHS Wales, to drive quality and safety improvements.
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Content Article
An understanding of the social sciences within infection prevention and control (IPC) is important for those working in health and social care. This new book positions the specialty of IPC as more than a technical discipline concerned with microbes. It is about people and their behaviour in context and the book therefore explores a number of relevant social sciences and their relationship to IPC across different contexts and cultures. IPC is relevant to every person who works in, and accesses health care and it remains a global challenge. Exploring novel approaches and perspectives that expand our collective horizons in an ever changing and evolving IPC landscape therefore makes sense. -
Content ArticleThis practice recommendation offers practical recommendations to assist acute-care hospitals in prioritising and implementing strategies to prevent healthcare-associated infections (HAIs) through hand hygiene. It updates Strategies to Prevent Healthcare-Associated Infections in Acute Care Hospitals through Hand Hygiene, published in 2014. This expert guidance document is sponsored by the Society for Healthcare Epidemiology (SHEA) and is the product of a collaborative effort led by SHEA, the Infectious Diseases Society of America, the Association for Professionals in Infection Control and Epidemiology, the American Hospital Association and The Joint Commission.
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News ArticleAntibiotics could be given to children at schools affected by Strep A to stop the spread of the infection, schools minister Nick Gibb has said. Mr Gibb told Sky News that the UK Health and Security Agency (UKHSA) is "working closely with the schools involved and giving very specific advice to those schools which may involve the use of penicillin". He added that health officials will "have more to say about that". "They're providing more general advice to parents, which is to look out for the symptoms - so, sore throat, fever, high temperature and also a red or raised rash on the skin are symptoms of this invasive Strep A outbreak." His comments came after the ninth death of a child from the infection. Read full story Source: Sky News, 6 December 2022
