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Showing results for tags 'Infection control'.
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Content ArticleThis article in the Journal of Global Health aimed to consider which patient safety interventions are the most effective and appropriate in fragile, conflict-affected, and vulnerable (FCV) settings. The authors examined available literature published between 2003 and 2020, using an evidence-scanning approach. They found that the existing literature is dominated by infection prevention and control interventions for multiple reasons, including strength of evidence, acceptability, feasibility and impact on patient and healthcare worker wellbeing. They identified an urgent need to further develop the evidence base, specialist knowledge and field guidance on a range of other patient safety interventions such as education and training, patient identification, subject specific safety actions and risk management.
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Content ArticleThis guidance from the Department of Health and Social Care (DHSC) should be used to help reduce the spread of Covid-19 in adult social care settings. It applies from 4 April 2022 and should be read in conjunction with: the infection prevention and control (IPC) resource for adult social care, which should be used as a basis for any infection prevention and control response the adult social care testing guidance, which details the testing regimes for all staff, as well as any resident and outbreak testing where applicable.
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News Article
Covid threat being ignored in England for ideological reasons, say NHS leaders
Patient Safety Learning posted a news article in News
Ministers should reconsider England’s “living with Covid” plans, health leaders have said, while accusing the government of ignoring the ongoing threat for ideological reasons. The NHS Confederation, which represents organisations across the healthcare sector, has accused No 10 of having “abandoned any interest” in the pandemic, despite a new Omicron surge putting pressure on an already overstretched NHS. “The brutal reality for staff and patients is that this Easter in the NHS is as bad as any winter,” said Matthew Taylor, the chief executive of the NHS Confederation. "We do not have a living-with-Covid plan, we have a living-without-restrictions ideology. “But instead of the understanding and support NHS staff received during 2020 and 2021, we have a government that seems to want to wash its hands of responsibility for what is occurring in plain sight in local services up and down the country. No 10 has seemingly abandoned any interest in Covid whatsoever. “NHS leaders and their teams feel abandoned by the government and they deserve better.” Taylor later told BBC Breakfast: “In our view, we do not have a ‘living with Covid’ plan, we have a ‘living without restrictions’ ideology, which is different. We need to put in place the measures that are necessary to try to alleviate the pressures on our health service while this virus continues to affect [it].” Read full story Source: BBC News, 11 April 2022 -
News Article
Trusts to stop routine Covid tests for new patients amid ‘brutal’ NHS pressures
Patient Safety Learning posted a news article in News
Overstretched hospitals are stopping routine Covid tests for new patients as “brutal” pressures mount on doctors and nurses, The Independent understands. On Monday there were 1,702 new Covid admissions to hospitals in England as of 9 April – with 16,442 positive patients occupying beds – the NHS leaders warn their ability to tackle the backlog in planned care is at risk. Despite pleas from NHS chiefs to measures such as mask-wearing back into force, ministers said there were no plans to change guidance. The Independent understands at least two major hospitals, in Newcastle and York, have dropped testing of all patients without symptoms in order to alleviate pressure on beds – raising fears that Covid could spread on unchecked wards. Other hospitals are also likely to do the same as bed pressures worsen. Sources have told The Independent some trusts have begun to drop “red” Covid only wards, while some are considering not separating patients in A&E. One expert, critical care doctor Tom Lawton, who analyses hospital-acquired infection data, said that stopping patient testing in hospitals was “worrying” and that the NHS would be putting “blinkers on” just as in-hospital infections were “as high as they’ve ever been”. Read full story Source: The Independent, 11 April 2022 -
EventECRI has released its newest list of the Top 10 patient safety concerns confronting healthcare organisations. Healthcare providers, regardless of their practice setting, can start with our Top 10 list and use it to guide their own discussions about patient safety and improvement initiatives. This top 10 report highlights patient safety concerns across the continuum of care because patient safety strategies increasingly focus on collaborating with other provider organizations, community agencies, patients or residents, and family members. Each patient safety concern on this list may affect more than one setting. Join ECRI to learn more about the identified concerns and how your organisation can begin to address them. Register
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News Article
This Easter will be worse than any winter for the NHS
Patient Safety Learning posted a news article in News
Two years ago the first wave of the covid pandemic reached its peak. The NHS had reacted with impressive speed to prepare for an influx of patients with an infectious disease that few knew much about, had no cure for, and for which there was no known vaccine. However, now the NHS goes into the Easter break in a more fragile state than in any previous winter since, at least, the 1990s. This is not just the direct result of covid hospitalisation, of course – although the distracting narrative of ‘with rather than because of covid’ has obscured how hugely damaging any kind of infectious disease that is as widespread in the community as covid is now can be to effective hospital care. For someone who has just undergone an operation, for example, the greatest threat is not from catching covid itself, but from the impact the virus may have on how quickly their wound may heal. Perhaps covid’s greatest continuing impact is on growing staff absences and the pernicious impact it is having on the long-term health of those who had the disease – even in some cases where it has been relatively mild. For the tens of thousands who have been hospitalised with covid, the consequences for their long-term health look more serious every day. Much of this new workload is ending up at the doors of primary and community care – and displacing other needs and services just when they are most required after two years of coping with the pandemic. There is usually one thing you can confidently say about the NHS, which is that in any crisis it will make sure the life-saving decisions are made on time. However, in the South West, and probably other regions too, that is not happening. People are dying because the NHS cannot – despite its best efforts – save them. Read full story (paywalled) Source: HSJ, 8 April 2022 -
Content ArticleEarly in the pandemic, the World Health Organization (WHO) stated that SARS-CoV-2 was not transmitted through the air. That mistake and the prolonged process of correcting it sowed confusion and raises questions about what will happen in the next pandemic. This Nature feature looks at the changing views of how Covid is spread.
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News Article
Public health ‘at risk’ as leading Covid surveillance programme ends
Patient Safety Learning posted a news article in News
Ministers will be left in the dark on Covid spikes just as case numbers reach unprecedented levels if a “world-beating” surveillance programme is scrapped, scientists have warned. The React-1 study, which played a crucial role in detecting and tracking the spread of the Alpha variant in December 2020 ahead of the second lockdown, has been stopped as part of the government's plan to cut its Covid costs. But in its last report, the study found 6.37% of the population was infected between 8 and 31 March – the highest figure since it began in May 2020. More worryingly, the scientists behind the research said the prevalence rate has also reached new highs for people aged 55 and over, at 8.31 per cent. The Royal Statistical Society (RSS) said dismantling the project while cases were at record levels damaged preparedness and put public health at risk. The spread of Covid within hospitals is also fuelling staff shortages, bed closures and delayed discharges in multiple regions of the country. This is coinciding with delays in ambulance handovers and response times, NHS sources say. Information seen by The Independent revealed hundreds of beds are currently out of use at Newcastle upon Tyne Hospitals trust due to Covid outbreaks. A senior clinician said the “hospital is coming apart at the seams” and that, across the northeast, even “high” performing emergency departments were “crashing” and “stacking ambulances outside of hospital”. Read full story Source: The Independent, 6 April 2022 -
News Article
Overcrowding, delays, cross infection: Review reveals emergency department issues
Patient Safety Learning posted a news article in News
Patients in nine hospitals in Ireland were often treated in the wrong places, sometimes corridors, in situations where it was “unclear” who was supposed to be providing their care, a clinical review has found. It warned of the potential for people to receive inappropriate specialist input and recommended specific wards be used to avoid so-called “safari rounds” where consultants must seek out scattered patients. The independent review team consisted of clinical and management experts from Scotland and England who undertook a programme of visits between August and November, 2019. “The review team witnessed widespread boarding and outliers – any bed, anytime, anywhere and including mixed gender,” the document said. “This does not create extra capacity, leads to safari rounds, increases length of stay, introduces harm by non-specialist care and increases staff absenteeism.” Although acknowledging often excellent work by staff, the report was commissioned to examine non-scheduled care at nine hospitals found to be “under the greatest pressures” during the winter season of 2018/2019. These had “significant numbers” of patients waiting for long periods on trolleys. Read full story Source: The Irish Times, 4 April 2022 -
Content ArticleThis guidance from the Department of Health and Social Care (DHSC) outlines infection prevention and control (IPC) principles for adult social care settings in England, to be used with guidance on managing specific infections. It applies from 4 April 2022. This should be read in conjunction with DHSC's Covid-19 supplement to the infection prevention and control resource for adult social care.
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News Article
Patient care and safety put at risk in A&E at brand new £350m hospital
Patient Safety Learning posted a news article in News
Patients visiting Wales' newest emergency department were likely to have been put at risk of harm due to the lack of processes and systems in place, inspectors found. Healthcare Inspectorate Wales (HIW) carried out an unannounced inspection of The Grange University Hospital in Cwmbran between 1 and 3 November last year and published its findings on 29 March. On the day of their arrival inspectors said The Grange was at full capacity with no empty beds in A&E or in the hospital in general. Despite the best efforts of staff who were "working hard under pressure" the report stated the emergency department had several issues which could have compromised the privacy and dignity of patients. This included problems with the physical environment of the waiting room, which was described as a "major cause of anxiety" for visitors, as well as with the flow of patients through the hospital in general. It found that patients were not triaged and medically managed in A&E in a timely fashion with many being placed on uncomfortable chairs or in corridors for hours on end. Between 1 April 2021 and 1 November 2021, the average waiting time in the department was six hours and seven minutes. The report said some issues required immediate action including the fact patients in the waiting area were often left to "deteriorate without being overseen". There were also infection control failures which could have led to the cross-contamination of Covid-19. "We were not assured that all the processes and systems in place were sufficient to ensure that patients consistently received an acceptable standard of safe and effective care," the report stated. Read full story Source: Wales Online, 1 April 2022 -
Content ArticleMore and more people have been asking for a return to normal, and with omicron waning, governments are starting to act. The UK is removing its remaining public health measures, including mandatory self-isolation of COVID cases and free testing. However, the inescapable truth is that – unless the virus mutates to a milder form – the “normal” life we are returning to will be shorter and sicker on average than before. This article in The Conversation looks at how we need to live post-Covid.
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Content ArticleSweden was well equipped to prevent the pandemic of COVID-19 from becoming serious. Over 280 years of collaboration between political bodies, authorities, and the scientific community had yielded many successes in preventive medicine. Sweden’s population is literate and has a high level of trust in authorities and those in power. During 2020, however, Sweden had ten times higher COVID-19 death rates compared with neighbouring Norway. In this report, Nele Brusselaers et al. try to understand why, using a narrative approach to evaluate the Swedish COVID-19 policy and the role of scientific evidence and integrity. We argue that that scientific methodology was not followed by the major figures in the acting authorities—or the responsible politicians—with alternative narratives being considered as valid, resulting in arbitrary policy decisions.
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Content ArticleBetween 2006 and 2009, WHO elaborated and issued the concept of ‘My Five Moments for Hand Hygiene’ in healthcare in collaboration with the pioneering infection prevention and control (IPC) research group at the University of Geneva. The primary objective of this approach is to facilitate behavioural change and prioritise hand hygiene action at the exact times needed to prevent the transmission of pathogens and avoid harm to patients and health workers during care delivery. Importantly, the Five Moments approach overcomes some relevant barriers to hand hygiene practices identified before its launch, such as long lists for hand hygiene action without any consideration of the dynamics of patient, health worker and environmental interactions The Five Moments approach is being constantly tailored to meet the challenges of care locations outside the traditional hospital setting, as well as across all countries and resource levels. The main thrust of the approach remains targeted at patient and health worker safety at the point of care where the risk of acquiring infection can be at its highest. Further work to help meet the Five Moments objectives through its adaptation and adoption worldwide is to be welcomed. WHO committed to further action and research on lessons learnt from field implementation, as well as the active dissemination of available tools to support countries to further understand and accept this proven approach.
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News Article
Persistent cough may be tuberculosis not Covid, doctor warns
Patient Safety Learning posted a news article in News
The UK's top public health doctor says anyone with a persistent cough and fever should not dismiss it as Covid - and should consider other infectious illnesses like tuberculosis (TB). Dr Jenny Harries' warning comes as provisional data shows there were 4,430 cases recorded in England in 2021, despite sharp declines in recent years. Charities are calling for more funding to tackle the disease around the world. They say the pandemic and conflicts have set back progress worldwide. In 2020, global deaths because of tuberculosis ranked second to Covid for any infectious disease. The charity Stop TB Partnership warns the war in Ukraine could have "devastating impacts on health services", including the country's strong national TB treatment programme. The charity is urging all countries to put facilities in place urgently so refugees can be given the care they need. In the UK a requirement for Ukrainians to take a TB test before arrival has been waived for those who are coming to the country on the family scheme visa. Refugees arriving on the scheme will get medical care and testing via GPs. Meanwhile Dr Jenny Harries, chief executive of the UK Health Security Agency, said delayed diagnosis and treatment, particularly during the pandemic, will have increased the number of undetected cases in England. Read full story Source: BBC News, 24 March 2022 -
News ArticleCovid hospitalisations will continue to rise for at least two weeks, England’s government’s chief medical officer warned on Wednesday as Britain’s daily cases breached 100,000 for the second time this month. Professor Sir Chris Whitty said the country’s Covid crisis “is not over” and that new variants of the disease could arise at any time. He pointed to the latest data showing that the number of people with Covid in hospitals has been rising, and said this would likely continue for at least two weeks. The current rise in cases is “currently being driven by Omicron rather than new variants”, he told an audience at a Local Government Association conference, but added: “We need to keep a very close eye on this, because at any point new variants could emerge anywhere in the world, including the UK, obviously, as what happened with the Alpha variant.” Another 194 Covid deaths were reported on Wednesday, up 27% on last week. Prof Whitty said that death rates were fortunately still low but that hospitalisations meant there was still pressure on the NHS. Asked about the end of free testing for the public on 1 April, Sir Chris said it was a “trade-off between disparities, because the effects of free testing are probably going to be differential across society, and [there are] very substantial sums that are going into it, which otherwise would be going into other public health issues." However, he said that testing for staff within health and social care was “slightly different” as the risks are greater, and those who are in hospital or care homes are more vulnerable. His comments come on the second anniversary of the day the UK announced a national lockdown. Read full story Source: The Independent, 23 March 2022
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Content ArticleAll big experiences in our lives have two realities. There is what really happened. And there is the narrative, the story we tell ourselves and each other about what happened. Of the two, psychologists say it’s the narrative that matters most. Creating coherent stories about events allows us to make sense of them. It is the narrative that determines our reactions, and what we do next. Two years after the World Health Organization (WHO) finally used the word “pandemic” in its own story about the deadly new virus from Wuhan, narratives have multiplied and changed around the big questions. How bad is it? What should we do about it? When will it be over? The stories we embraced have sometimes been correct, but others have sown division, even caused needless deaths. Those stories aren’t finished – and neither is the pandemic. As we navigate what could be – if we are lucky – Covid’s transition to a present but manageable disease, it is these narratives we most need to understand and reconcile. What has really happened since 2020? And how does it still affect us now?
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News Article
Updated PPE guidance puts NHS staff at risk of infection, say medics
Patient Safety Learning posted a news article in News
NHS staff face unacceptable health risks as a result of “retrograde” changes to the government’s guidance on preventing spread of Covid-19, doctors’ leaders have warned. The BMA said on 16 March it was concerned over updated guidance issued by the UK Health Security Agency covering use of personal protective equipment. It said the guidance failed to properly acknowledge that SARS-CoV-2 infection can spread in the air during the routine care of patients as they cough or sneeze and not just when specific processes known as aerosol generating procedures (AGPs) are being undertaken. “This is a retrograde step as it once again means that healthcare workers will not be routinely provided the right level of protective masks and equipment they need to be safe at work when looking after covid patients,” said Chaand Nagpaul, the BMA’s chair of council. The BMA said it was crucial that any staff looking after patients with confirmed or suspected Covid-19, or in other situations where a local risk assessment required it, had access to respiratory protective equipment such as filtering face piece (FFP3) masks. Nagpaul said, “All healthcare workers who are caring for Covid-19 patients are putting themselves at risk, each and every day, and the very least the government should do is to provide surety that staff will be given the best protection possible.” Respirators such as FFP3 masks are designed to protect the wearer from ingress of contaminated air and are fitted to ensure no gaps. They offer higher protection than surgical masks, which block the outward escape of droplets from the wearer. The BMA’s concern follows a supposed clarification of the main messages regarding airborne transmission in the latest infection and prevention and control guidance issued on 15 March 2022. The guidance said that respiratory protective equipment (FFP3 masks) are recommended when caring for patients with a suspected or confirmed infection spread “predominantly” by the airborne route (during the infectious period). The word “predominantly” has been added to the previous guidance update, which was issued on 17 January 2022, and is the crux of doctors’ concern, one leading scientist said. Read full story Source: BMJ, 18 March 2022 -
Content Article
This is part of our new series of Patient Safety Spotlight interviews, where we talk to people about their role and what motivates them to make health and social care safer. Julie talks to us about how attitudes to patient safety have evolved since the 1990s, the role of the World Health Organization in improving quality and safety, and the need to learn lessons from infection prevention and control approaches that were adopted during the Covid-19 pandemic. -
News Article
‘Disproportionate’ infection control holding back electives, say NHS bosses
Patient Safety Learning posted a news article in News
Infection control rules in hospitals are ‘now disproportionate to the risks’ posed by covid and should be relaxed, some of the NHS’s most senior leaders have warned. The government rules – such as not allowing covid-positive staff to work, and separating out services for covid, non-covid and covid-contact patients – make a big dent in hospital capacity and slows down services. Glen Burley, who is chief executive of three Midlands trusts and involved in national-level discussions on elective matters, told HSJ: “Pretty much every pathway has a covid and non-covid route, which slows down flow and staff productivity. “There is a growing argument that these rules are now disproportionate to the risks. With covid cases in the community also rising now, we may have to question again the relative risks of continuing to isolate staff.” NHS Confederation director of policy Layla McCay told HSJ: “Healthcare leaders are concerned the current [IPC] measures are having a serious knock-on effect on capacity and that the measures in their current form are reducing efficiency and capacity within healthcare settings. “We need more clarity on if and how current measures can be safely adjusted so [the NHS] can further increase bed capacity and patient throughput, as well as the ability to transport patients more quickly and efficiently.” But NHS Providers, which has previously said relaxing the IPC guidance would not enable a “rapid” increase in the NHS’ capacity to tackle the elective care backlog and could pose significant “risks”, remains more cautious. Read full story (paywalled) Source: HSJ, 21 March 2022 -
Content ArticleThis article by the US Centers for Disease Control and Prevention (CDC) provides advice for patients about steps they can take to help avoid catching healthcare-associated infections, which can ultimately lead to sepsis and even death. It outlines ten things patients and their families can do to protect themselves or their loved ones while receiving medical care. Speak up Keep hands clean Ask each day if your central line catheter or urinary catheter is necessary Prepare for surgery Ask your healthcare provider, “Will there be a new needle, new syringe, and a new vial for this procedure or injection?” Be antibiotics aware Watch out for deadly diarrhoea (aka Clostridium difficile) Know the signs and symptoms of infection Get vaccinated Cover your mouth and nose
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Content ArticleLast month, Boris Johnson argued that the downward trends in Covid cases and hospitalisations meant that it was time to scrap restrictions. Now both are rising. But the government is ending testing and most surveillance studies. Sajid Javid, the health secretary, said that the rise was “to be expected” – though this foresight did not extend to having a plan to deal with the increase in infections. Instead, he dismissed the concern about the new Deltacron variant. The health secretary seemed nonchalant about the threat the virus now posed. Sajid Javid may be right that the country has weathered the worst of the pandemic, but Covid is not yet in retreat. It makes no sense to withdraw funding from a series of studies that allow the spread of the virus to be mapped in detail. Without the data, experts won’t be able to effectively monitor the disease. The country will be less effective in responding and adjusting to future waves of infection. Individuals will be less able to make informed choices about the risks involved. The clinically vulnerable face being cut off from everyday life. “It is like turning off the headlights at the first sign of dawn,” Stephen Reicher, a psychologist at the University of St Andrews, told the Guardian. “You can’t see what’s coming and you don’t know when it makes sense to turn them on again.”
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News Article
Somerset care home staff continue working with Covid
Patient Safety Learning posted a news article in News
Some care homes have "no choice" but to allow workers who have Covid to deliver care, a public health official said. According to Public Health England cases are rising the fastest in Somerset. As a result, care homes in the county are struggling to safely staff their services and schools are seeing a rise in staff sickness. Somerset Council said ensuring vulnerable residents received care was "lower risk" than them being infected. Health officials advised care workers to continue working only if they wore PPE and felt well enough. Council public health consultant Alison Bell said: "In some cases, we have no choice but to have people who are testing positive delivering care to people in Somerset. "That risk is actually less than that person not receiving care." She said the Omicron variant was more transmissible and people were getting re-infected with it, some within a matter of weeks. Read full story Source: BBC News, 16 March 2022 -
News Article
Lateral flow tests could cost care home visitors £73 a month
Patient Safety Learning posted a news article in News
Lateral flow tests could cost care home visitors £73 a month, a leading UK charity has said, as it renewed calls to keep the devices free in such settings. The government has previously announced that free testing for the general public will end from 1 April, and that this will include care home visitors. However, charities have warned the shift away from free tests could place a heavy financial burden on those visiting care homes, where testing is still advised. James White, the head of public affairs and campaigns at the Alzheimer’s Society, said the proposed charge on lateral flow tests for visitors to care homes was a cruel tax on care. “Over the past two years, we’ve consistently heard many tragic stories from families struggling to visit their loved ones in care homes. For many people with dementia, this isolation has led to a significant deterioration in their condition and mental health,” he said. “With infection rates rising once again, the government must provide free lateral flow tests for all visitors to care homes so that families are not put in an agonising position where they are forced to ration visits, leaving people with dementia once again isolated and alone.” Caroline Abrahams, Age UK’s charity director, said: “No one should have to pay out of their own pocket for tests in circumstances where the expert advice is clear that testing remains an important safeguard against Covid,” she said. “If care home visitors are going to continue to be asked to keep testing to protect their loved ones, it would be completely unacceptable to expect them to pay.” Read full story Source: The Guardian, 15 March 2022 Further reading Visiting restrictions and the impact on patients and their families: a relative's perspective -
News Article
Covid-19: Countries in the Americas are warned not to lower their guard
Patient Safety Learning posted a news article in News
Covid-19 is on the retreat across the American continents but it is too early for the region to let its guard down, warned the Pan American Health Organisation, the World Health Organization’s regional office for the Americas, on 9 March. Reported cases of Covid-19 fell by 26% in the past week and deaths by nearly 19%, as the omicron wave of infections tailed off. But ongoing transmission and future variants could expose the region’s public health priorities once more, said PAHO’s director, Carissa Etienne. A total of 2.6 million people have died from Covid-19 in the Americas, the highest number of any region of the world and almost half of the global total, despite being home to only 13% of its population. “This is a tragedy of enormous proportions, and its effects will be felt for years to come,” said Etienne on the second anniversary of the pandemic. Patchy vaccination coverage has left countries vulnerable to current and future variants of SARS-CoV-2. Around 248 million people in Latin America and the Caribbean are yet to receive a single dose of a covid vaccine, with vaccination rates particularly low in hard-to-reach rural areas. In the first two months of 2022 the Americas accounted for 63% of the world’s new cases. Despite a general fall in incidence across the region, new cases rose by 2.2% in the Caribbean, while Bolivia and Puerto Rico reported an increase in deaths in the past week. Michael Touchton, head of the University of Miami’s Covid-19 policy observatory for Latin America, said, “Latin America is perhaps the most vulnerable region in the world to the emergence of a new variant. Vaccine delays have a greater impact in Latin America due to concentrated urban populations, chronic disease burden, and low capacity health systems. Taken together, Latin America is likelier to fare worse than other similarly low and middle income regions.” Read full story Source: BMJ, 14 March 2022
