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Content ArticleMidwives, public health nurses and practice nurses are in an ideal position to address mental health and emotional well-being with women in the perinatal period. However, research involving midwives, public health nurses and practice nurses in Ireland indicates that there is considerable variation in perinatal mental health assessment and care. All three groups identify the following issues as barriers to addressing perinatal mental health issues: Lack of knowledge on the range of perinatal mental health problems Lack of skill in opening a discussion and developing a plan of care with women Organisational issues, such as lack of policies, guidelines and care pathways This document produced by the Irish Health Service Executive, aims to provide an evidence-based guidance document for midwives, public health nurses and practice nurses in the area of perinatal mental health care.
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News ArticleAt least 12,000 people were treated for sepsis in hospitals in Ireland last year, with one in five of those dying from the life-threatening condition. However, the HSE said the total number of cases is likely to be much higher. Marking World Sepsis Day, it said the condition kills more people each year than heart attacks, stroke or almost any cancer. The illness usually starts as a simple infection which leads to an “abnormal immune response” that can “overwhelm the patient and impair or destroy the function of any of the organs in the body”. Dr Michael O’Dwyer, the HSE’s sepsis clinical lead, said: “The most effective way to reduce deaths from sepsis is by prevention. “A healthy lifestyle with moderate exercise, good personal hygiene, good sanitation, breastfeeding when possible, avoiding unnecessary antibiotics and being vaccinated for preventable infections all play a role in preventing sepsis. “Early recognition and then seeking prompt treatment is key to survival. Recognising sepsis is notoriously difficult and the condition can progress rapidly over hours or sometimes evolve slowly over days.” Read full story Source: Independent Ireland, 13 September 2022 hub resources on sepsis RCNi: Sepsis resource collection NSW Clinical Excellence Commission - Sepsis toolkit Dr Ron Daniels video: Recognising sepsis Introducing the Suspicion of Sepsis Insights Dashboard
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Content ArticleThe Irish Health Service Executive (HSE) has produced a selection of resources and guidance to help people use medicines safely. It offers information about the Know, Check, Ask campaign, encouraging members of the public to: Know your medicines and keep a list Check that you're using the right medicine the right way Ask your health professional if you're unsure The page also includes videos about: how to use the My medicines list tool designed to ensure patients and healthcare professionals know which medications and doses the patient should be taking. 5 moments for medication safety, a campaign linked to the World Health Organizations' WHO Medsafe app.
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News Article
Unfilled consultant posts pose key risk to patient safety - Irish Medical Council
Patient Safety Learning posted a news article in News
Unfilled specialised medical consultant roles and an over-reliance on overworked, internationally trained graduates for non-consultant hospital doctors are among key risks to patient safety identified by the Irish Medical Council. The council, which is the regulatory body for the medical profession, sets out the risks to healthcare for the first time in its workforce intelligence report that breaks down the make-up of the medical register and explains why doctors are leaving the health system. More than a third of all clinically active doctors are on the general register, which is a key risk to patient safety because consultant and specialist roles are not being filled and “a considerable proportion” of non-consultant hospital doctors are required to perform the duties of consultants. The report found that the majority of non-consultant hospital doctors are trained overseas and that the health system overly relied on these doctors who reported being “overworked, undervalued, experiencing discrimination and unable to access specialist training.” “Aside from the individual impact on the doctors, the treatment of international medical graduates has serious implications for patient safety,” the council said. In another risk identified by the regulatory body, more than a quarter of doctors reported working more than 48 hours a week, in breach of the European Working Time Directive. This has further serious implications for patient safety,” the council said. Read full story Source: Irish Times, 1 September 2022 -
News ArticleMajor concerns are being raised about the Irish State’s failure to set up an inquiry into a drug that caused serious birth defects and developmental delays in at least 1,200 Irish babies. Sodium valproate, a drug used to treat epilepsy and bipolar disorder, has been estimated to have caused major malformations in up to 341 Irish children between 1975 and 2015 after it was taken by their mothers during pregnancy. The drug, which is sold in Ireland as Epilim, is also believed to have caused neuro-developmental delays in 1,250 children. Many women were never warned of the risks that taking the drug during pregnancy would pose to their babies. Read full story Source: The Irish Independent
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Content Article
HSE Ireland - My Medicines List leaflet (January 2020)
Patient-Safety-Learning posted an article in Medication
This leaflet produced by the Irish Health Services Executive (HSE) provides a central place for patients to record information about their medications. It acts as a reference point for patients to use when discussing their medications with a healthcare professional and includes a reminder of the Know, Check, Ask campaign, aimed at reducing medication errors in the community. -
News Article
Covid-19 'unmasked' existing problems in Irish healthcare
Patient Safety Learning posted a news article in News
The Irish health services did “relatively well” during Covid-19 but, as in other countries, the pandemic unmasked existing problems, a renowned patient safety expert has said. Peter Lachman of the Royal College of Physicians of Ireland (RCPI), was one of nine international experts who consulted on a new World Health Organization (WHO) report on the implications of the Covid-19 pandemic for patient safety. Dr Lachman said the impact is only starting to be understood. “Ireland did very well early on [in the pandemic], then opened up over Christmas [2020] which led to our numbers going sky-high, then we clamped down again,” he said. "We did well on some things and not so well on others. We have done relatively well when compared with other countries." “Covid-19 was an event which around the world unmasked problems which were there already rather than creating them necessarily,” he said. “The findings start with safety problems — we’ve had safety problems in Ireland but things are getting better. There is a good strategy coming on. I’ve worked with hospitals around the country on this. It’s no worse than other countries.” Read full story Source: The Irish Examiner, 12 August 2022 -
EventuntilBringing together a community of human factors in patient safety advocates across Ireland and abroad, the annual Human Factors in Patient Safety Conference will offer the opportunity to gain valuable knowledge and insights from human factors experts. The conference will include contributions from: Martin Bromiley OBE, Founder of Clinical Human Factors Group UK – Listening Down to Develop your Safety Behaviours Mr Peter Duffy, Consultant Urologist – Whistle in the Wind: a Personal Exploration of the Consequences of Whistleblowing in Healthcare Professor Eva Doherty (Chair), Director of Human Factors in Patient Safety – The Irish Context, panel discussion Healthcare professionals can register for the event here. For more information, please email mschumanfactors@rcsi.ie.
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News ArticleMore than one fifth of complaints about Irish hospitals were deemed ‘high severity' including one from a person who claimed their mother should not have died and another who alleged a patient was turned away from an A&E even though she was at risk of self-harming. An analysis of 641 complaints about HSE hospitals between October and December 2019 by NUI Galway and the HSE separated them into high severity (22%), medium severity (56%) and low severity (also 22%). Among those complaints highlighted as potentially linked to ‘catastrophic harm’ was this: “My mother would still be alive if this had not happened." However the largest number were about hospital systems at 392 — including complaints about waiting lists. “I was left on a waiting list for surgery for years,” at least one person wrote. The analysis also found 322 complaints centred around patients’ arrival into hospitals including emergency departments (ED). “She was turned away instead of admitted even though she was at risk of self-harming,” one person wrote. Some 92 complaints related to staff not listening to patients, including new parents who said: "While our newborn son was on the ward they took too long to notice his difficulty breathing and transfer him to the NICU (neonatal intensive care unit)." Read full story Source: Irish Examiner, 11 July 2022
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Content ArticleRepresentatives from Mesh Ireland and Mesh Survivors have this week appeared before the Oireachtas Health Committee, where questions were raised about access to vital diagnostic machines and treament for women who have had vaginal mesh implants put in. Vaginal mesh devices were used to treat issues in women after childbirth, or in their later years, and while it’s not known how many procedures were carried out, it’s believed there were more than 10,000 on the public system alone. Women have experienced painful complications as a result of the procedure and Founder of the Mesh Survivors Ireland Campaign, Melanie Power, who’s a solicitor from Meelick, says many women are unable to work and can’t afford the cost of ongoing treatment. She believes questions need to be answered on why women affected by a post-natal procedure which can cause chronic pain are being means tested for the medical card. Listen to the full interview on Clare FM below.
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News Article
Women tell committee of being 'maimed' by mesh implant surgery
Patient Safety Learning posted a news article in News
Women who underwent damaging surgery in Irish hospitals have accused health authorities of dragging them into a "nightmare" of "gaslighting, ignorance and disrespect". Having had vaginal mesh implants, the women told an Oireachtas committee that they were "maimed" and then led on "a fool's errand" when they sought support from the HSE. The Health Committee heard from members of Mesh Ireland and Mesh Survivors Ireland who represent around 750 women. While the HSE said that it would be "extremely difficult" to provide accurate figures, it estimates that around 10,000 women had this surgery in Ireland. More than one in ten have suffered complications, Dr Cliona Murphy, Clinical Lead for the National Women and Infants Health Programme, revealed. Mary McLaughlin, Mesh Ireland, said that at one point, "I lay in bed 16 hours a day", because of the pain she was in. She demanded dignity and respect for survivors in the face of this "global scandal". The women are calling for access to a US-based expert in complete mesh removal, to mirror schemes in Scotland and the Canadian state of Quebec. Read full story Source: RTE, 29 March 2022 -
News ArticleThe number of notified “extreme” and “major” incidents involving serious harm to patients and others in hospital has risen significantly in the Republic of Ireland in recent years, new figures reveal. Reported “extreme” incidents, which can involve death or permanent incapacity, rose from 373 in 2017 to 579 last year. The number of cases classified as “major”, where there is long-term disability or incapacity, climbed from 46 to 82 in the same period. “Moderate” incidents, when there is a patient injury involving medical treatment, also increased from 9,219 in 2017 to 13,563 last year. Minor incidents, involving injury or illness needing first aid, also increased over the same time from 9,210 to 15,483. The figures, involving patients, staff, visitors, contractors and the public, were released by the HSE in response to a parliamentary question from Aontú leader Peadar Tóibín. A spokewoman for the HSE said: “It is HSE policy that all incidents are identified, reported and reviewed so that learning from events can be shared to improve the quality and safety of services.” “The number of reported incidents has increased year on year since 2004 with a significant increase noted since 2015, with the introduction of the National Incident Management System.” Read full story Source: Independent.ie, 3 May 2022
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News ArticleAt least 200,000 people missed out on essential surgery as a result of the Covid-19 pandemic, with many enduring “misery and daily pain” as a result, a conference has heard. Both scheduled and emergency surgery levels dropped by 20% during the pandemic, suggesting there is now significant pent-up demand for treatment, according to the national clinical lead in surgery, Prof Deborah McNamara. Almost 343,000 people are waiting to see a surgeon for the first time, 100,000 of whom have been on a waiting list for more than 18 months, she told the conference on outcomes from the pandemic at the Royal College of Surgeons in Ireland (RCSI). This was only the start of delays for patients, she pointed out, as they have to wait again for their procedure to be carried out. Currently, more than 71,000 patients are waiting for surgery, a fifth of whom have been on the list for more than a year. Long-waiting patients needing complex surgery have been disproportionately affected, she said, as the system focused on treating “quick-win” procedures such as endoscopies. The amount of day-case work carried out by hospitals is back to 84 per cent of 2017 levels, yet complex care remains at only 67 per cent, she pointed out. Patients waiting for surgery were enduring a “huge amount of misery” that remains unquantified, according to Prof McNamara. The pandemic resulted in some positive changes, she said, including shorter hospital stays, a greater role for physician associates and a generational change in the use of IT. However, it also led to greater constriction in the capacity for scheduled surgery, and greater seasonal variations in demand. Read full story Source: The Irish Times, 26 April 2022
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News Article
GP telephone first system 'here to stay' in Northern Ireland
Patient Safety Learning posted a news article in News
A phone first system adopted by most GP surgeries at the start of the pandemic is "here to stay", the Royal College of GPs (RCGPs) in Northern Ireland has said. However, the RCGP has also accepted patient access needs to improve. The system was introduced in spring 2020. According to GPs, the move, which came without either consultation or prior information, was necessary to minimise the risk of infection of Covid-19. Two years on, there is concern among some members of the public that the system is not working. Speaking to BBC News NI, Dr Ursula Mason accepted that the system wasn't working but said there were not enough GPs to see people. She added that the telephone system, which was being "refined" and "improved" was the best way to manage "growing demand" and to "prioritise the sickest patients to be seen first". "The telephone system allows us to see many more patients, to deal with demand in a better way so I think the telephone system is here to stay," added Dr Mason. "There will be some changes to upgrade it, but it will form a significant part of how we manage demand." -
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 is the first Women's Health Action Plan published but the Government of Ireland, and it sets out women's priorities for their health. Women, their representatives and women's health professionals have influenced the development of the Action Plan by sharing their insights and experiences through listening projects and participation opportunities carried out by the Women's Health Task Force 2020-2021. The Action Plan responds to key issues that women raised, including faster access to specialist services, reputable sources of health information and enhanced healthcare experiences. Supporting documents and related reading are provided alongside the Action Plan, including information about the Women's Health Taskforce.
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News ArticleMore than 200 women were affected by failures in Ireland’s CervicalCheck screening system. It emerged in 2018 that 221 women and families were not told about misreported smear tests. The Minister for Health said that non-disclosure issues which arose in the cervical check screening controversy will be legislated for to prevent it from happening again. Stephen Donnelly said new legislation will address the negligence issues and ensure that the failure to inform the women of the clinical audit of their screening will “never happen again”. Mr Donnelly was discussing a number of amendments at the committee stage of Ireland's Patient Safety Bill. The new legislation will require the mandatory open disclosure of serious patient safety incidents, and sets out a list of incidents which must be reported to the health watchdog, Health Information and Quality Authority (HIQA). Mr Donnelly said that he will introduce an amendment at the report stage of the Bill that will provide for non-disclosure and will deal with issues around delayed diagnosis and delayed screening. Mr Donnelly said: “I’ve had lengthy discussions with the department on this and it doesn’t fit neatly with this Bill because the serious patient safety issues which result in death or serious harm, they are very clear and binary. “Legislating around delayed diagnosis and delayed screening, it is really complex and doesn’t fit neatly in this Bill, however my view is that the non-disclosure that happened in cervical check, even though it doesn’t neatly fit here, should still be legislated for." Read full story Source: The Independent, 11 March 2022
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News Article
'Urgent action' needed on hospital waiting times in Ireland
Patient Safety Learning posted a news article in News
Urgent action is required to tackle hospital waiting times on both sides of the Irish border, according to the Economic and Social Research Institute (ESRI). A report into the primary healthcare systems of Ireland and Northern Ireland found that both jurisdictions are experiencing similar problems. These include workforce shortages and increasing expenditure. On hospital waiting times the problem is worse in Northern Ireland. The proportion of people on the waiting list in Northern Ireland for more than one year increased from 20% to 60%. In the Republic of Ireland, during the same period between 2017 and 2021, the figure increased from 12% to 20%. A key distinction between the healthcare systems is the absence of a universal healthcare system in Ireland, write the authors. That means in Northern Ireland, all residents are entitled to a wide range of free health care services, while in Ireland, the majority pay to see their GP and for other services. But despite this key difference, both systems are currently facing similar challenges, including shortages in key areas of the workforce and long waits for a range of healthcare services. Cross-border collaboration in healthcare across the island is an interesting but contentious issue. At present, according to the ESRI report, that work is relatively limited. It points to a 2011 report which identified the potential benefits to be gained from increased co-operation in healthcare including collaboration in cystic fibrosis, ear, nose and throat surgery, paediatric cardiac surgery and acute mental health services. However, this 2022 report concludes that despite some notable exceptions such as the Congenital Heart Disease Network and the North West Cancer Centre at Altnagelvin Hospital in Londonderry, "collaboration has been relatively limited". Read full story Source: BBC News, 10 March 2022 -
Content ArticleThis study in the Journal of Patient Safety aimed to assess the impact of a pro forma that standardises medical record-keeping on ward rounds. The pro forma was developed by analysing notes entered in patient charts and comparing them with standards set out by the Royal College of Surgeons of Ireland and England, as well as Medical Council guidelines from the two countries. The authors found that the pro forma improved compliance of ward round notes when compared with internationally recognised guidelines, with no additional time required during ward rounds.
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News ArticleThe Irish Cabinet has approved general indemnity cover and product liability cover for claims to two public sector bodies relating to transvaginal mesh products and the Gardasil HPV vaccine. The Health Minister Stephen Donnelly brought forward a proposal to Cabinet Wednesday for the provision of this cover to the Irish Blood Transfusion Service (IBTS) and the Mental Health Commission (MHC) for claims relating to the mesh products or Gardasil. Gardasil is a type of vaccine used to protect against HPV. Vaginal mesh devices have been used in operations to treat stress urinary incontinence and pelvic organ prolapse; two conditions that can impact women after natural childbirth or in their later years. Including the bodies in the State’s general indemnity scheme for these claims will eliminate the requirement for them to carry private insurance. The State Claims Agency was consulted and indicated that it supports the inclusion of both bodies under the scheme. The clinical indemnity scheme indemnifies hospitals but is confined to clinical acts and/or omissions and doesn’t cover product liability matters. Current legal cases around transvaginal mesh products involve allegations in relation to the product itself and allegations of clinical negligence. It has now been proposed to delegate the product liability claims for mesh products to the State Claims Agency to ensure hospitals aren’t exposed to uninsured liability. Thousands of women across the world have suffered complications after having a vaginal mesh device implanted. These complications include chronic pain and recurrent urinary tract infections and have been life-changing in many cases. Read full story Source: thejournal.ie, 19 January 2022
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News Article
Republic of Ireland: Most HSE staff felt negative change at work during pandemic
Patient Safety Learning posted a news article in News
The vast majority of HSE staff in the Republic of Ireland felt supported during the COVID-19 pandemic but more than half felt there has been a negative change in their working environment, a new survey has found. Staff across the health service were asked about their work, and responses from almost 13,000 staff showed a mixed impact since the pandemic with staff saying they were more enthusiastic about their job than in 2018 but were less optimistic about their future in the health service. Three in 10 said they had been subject to assault from the public in the past two years. One in three felt more positively towards the HSE since before the pandemic began. The survey found there had been an increase in the satisfaction with the level of care delivered since 2018 but almost 4 in 10 felt the service delivered was deteriorating. There was a strong sense of job security among staff, but satisfaction levels have fallen back on the previous survey three years ago. A third said they were dissatisfied at present. Despite the fact that an anti-bullying taskforce was set up after the previous survey, the same number of staff reported experiences of being bullied by a colleague as in 2018. Three in 10 said they had experienced bullying or harassment at work from a manager, team leader or other colleagues. Read full story Source: The Irish Times, 6 December 2021 -
Content ArticlePrehospital care is the care received by a patient from an emergency medical service before arriving at a hospital. This systematic review in the International Journal for Quality in Health and Care aimed to identify: how the prevalence and level of harm associated with patient safety incidents (PSIs) in prehospital care are assessed. the frequency of PSIs in prehospital care. the harm associated with PSIs in prehospital care.
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News Article76 people were unintentionally exposed to ionising radiation in Irish hospitals in 2020, according to the Health and Information Quality Authority (HIQA). This figure represents an 11% increase on the total reported in 2019. HIQA today published an overview report on the 'increase in accidental and unintended exposure to ionising radiation events notified to HIQA in 2020. Under the European Union (Basic Safety Standards for Protection against dangers arising from Medical Exposure to Ionising Radiation) Regulations 2018 and 2019, HIQA is the competent authority for patient protection in relation to medical exposure to ionising radiation in Ireland. In its 2019 report — its first such publication — HIQA expressed hope that the areas of improvement it identified "would help reduce the likelihood of such events and drive quality improvements in safety mechanisms for medical exposures in Ireland." Despite this, eight more accidental exposure incidents were recorded in 2020 than in the previous year. Human error was identified as the main cause of accidental exposure in 58% of the incidents, however, HIQA determined that other factors likely contributed to these. Some 34% of the incidents involved the wrong patient being exposed to ionising radiation. HIQA said these exposures occurred at varying points along the medical exposure pathway. It stressed that the number of unintended exposure to ionising radiation incidents last year was small compared with the total number of procedures carried out, estimated to be in the region of three million. Read full story Source: Irish Examiner, 15 September 2021
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Content ArticleThe Health Information and Quality Authority (HIQA) has published its annual overview report of lessons learned from receipt of statutory notifications of accidental and unintended exposures to ionising radiation in 2020. This report provides an overview of the findings from these notifications and shares learnings from the investigations of these incidents.
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News Article
Northern Ireland health system "one step from chaos"
Patient Safety Learning posted a news article in News
"Bodies would have been piling up" if the Covid vaccine had not been available, the director of intensive care at Belfast City Hospital has said. Dr George Gardiner, a consultant, also said his biggest fear would be having to stop routine cancer surgery. He has called for an end to "tribal politics" in Northern Ireland to allow transformation of the health service, so that cancer and coronavirus can be tackled in tandem. He said the system was currently "one step from chaos" and warned hospitals will not cope with winter if Covid numbers continue to rise. "We need to get everyone who can take a vaccine to take it now before the winter pressures are on us," Dr Gardiner added. "The cancer surgery that we are doing at the minute is life saving. A few more Covid admissions, which could be prevented, will cause us to stop operating because we simply haven't got the capacity to do both." Read full story Source: BBC News, 7 September 2021
