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Found 137 results
  1. Content Article
    This article highlights three questions tabled in the House of Commons relating to the Yellow Card Scheme, the system for recording adverse incidents with medicines and medical devices in the UK.
  2. Content Article
    In March 2019, NHS England published Saving Babies Lives version 2, which included information for providers and commissioners of maternity care on how to reduce perinatal mortality across England. One element of this recommends the appointment of a fetal monitoring lead with the responsibility of improving the standard of fetal monitoring. The aim of the fetal monitoring lead is to support staff working on the labour ward to provide high quality intrapartum risk assessments and accurate CTG interpretation and should contribute to building and sustaining a safety culture on the labour ward with all staff committed to continuous improvement. The importance of fetal monitoring was highlighted again in the Ockenden Report, published December 2020. The report recommended, as an essential action, that all maternity services must appoint a dedicated lead midwife and lead obstetrician, both with demonstrated expertise, to focus on and champion best practice in fetal monitoring. Monitoring May is a month long learning event based around fetal monitoring, human factors, maternity safety and shared learning. The East Midlands Academic Health Sciences Network has shared the recording of Monitoring May’s discussions and presentations.
  3. Content Article
    Remote digital postoperative wound monitoring provides an opportunity to strengthen postoperative community care and minimise the burden of surgical-site infection (SSI). This study aimed to pilot a remote digital postoperative wound monitoring service and evaluate the readiness for implementation in routine clinical practice. It concluded that remote digital postoperative wound monitoring successfully demonstrated readiness for implementation with regards to the technology, usability, and healthcare process improvement.
  4. News Article
    NHS trusts are facing calls to suspend the use of a monitoring system that continuously records video of mental health patients in their bedrooms amid concerns that it breaches their human rights. Mental health charities said the Oxevision system, used by 23 NHS trusts in some psychiatric wards to monitor patients’ vital signs, could breach their right to privacy and exacerbate their distress. The call comes after Camden and Islington NHS foundation trust (C&I) suspended its use of Oxevision after a formal complaint by a female patient who said the system amounted to “covert surveillance”. The Oxevision system allows staff to monitor a patient’s pulse and breathing rate via an optical sensor, which consists of a camera and an infrared illuminator to allow night-time observation. It includes a live video feed of the patient, which is recorded and kept for 24-72 hours, depending on the NHS trust, before being deleted. Oxehealth, which created the system, said it was not like CCTV because staff could only view the video feed for about 10-15 seconds during a vital signs check or in response to a safety incident. The system, which is also installed at Exeter police station custody suite and an Oxfordshire care home, can alert staff if someone else has unexpectedly entered a patient’s room or if they are in a blindspot, such as the bathroom, for too long. Alexa Knight, associate director of policy and practice at Rethink Mental Illness, said: “While we appreciate that the motivation for putting surveillance cameras in people’s bedrooms stems from the need to protect them, to do so without clear consent is unjustifiable and this pilot should be suspended immediately.” Read full story Source: The Guardian, 13 December 2021
  5. News Article
    A major GP group in Plymouth covering tens of thousands of patients could have its licence removed after failing to make ‘substantial improvements’ ordered by the Care Quality Commission (CQC). In August, the CQC rated the Mayflower Medical Group “inadequate” and last month the regulator said it had served a “letter of intent” on the group after another inspection. Such a letter is the last step the CQC takes before a provider’s licence is suspended. Licence suspension would affect around 40,000 people (a sixth of Plymouth’s population), who live in one of the highest areas of deprivation in the country – according to Public Health England (now the UK Health Security Agency). Among the CQC’s concerns were safety fears about the way medicines were prescribed, poor management of high-risk patients, coding issues, limited monitoring of the outcomes of care and treatment, and patients experiencing difficulties accessing care and treatment. Read full story (paywalled) Source: HSJ, 2 December 2021
  6. News Article
    Ministers may allow GPs in England to halt regular monitoring of millions of patients with underlying health problems as part of the urgent new blitz on delivering Covid booster jabs. Sajid Javid and NHS bosses are locked in talks with GP representatives at the British Medical Association (BMA) about relaxing rules which mean family doctors undertake checks on people with diabetes, high blood pressure and other conditions that mean they are at higher risk of having a heart attack or stroke. It came as the health secretary announced the government has secured contracts to buy 114m more vaccine doses for next year and 2023. The deals, accelerated in the wake of the Omicron variant, will see the UK purchase 54m more Pfizer/BioNTech jabs and 60m from Moderna to “future-proof” the inoculation programme, Javid said. The BMA, the doctors’ union, has been lobbying Javid for months to suspend or scrap the Quality Outcomes Framework (QOF), which it says is “bureaucratic” and interferes with GPs’ right to judge how they care for patients. Officials with knowledge of the talks told the Guardian that those involved spent much of Tuesday discussing the suspension of part or all of the requirements under QOF. “They’re talking about a partial suspension of QOF. But they may well just bin it,” one said. However, sources stressed that ministers are nervous about approving a move that could lead to claims that vulnerable patients could see any deterioration in their condition go undetected by GPs. Read full story Source: The Guardian, 1 December 2021
  7. Event
    until
    This webinar from the Institute of Global Health Innovation explores the safety, effectiveness and global relevance of pulse oximetry for at-home monitoring of Covid-19. Pulse oximeters are being explored as a tool for people with COVID-19 to keep an eye on their health at home, away from healthcare settings. These are widely available, low-cost devices that shine light through a person’s finger to assess their blood oxygen saturation. Evidence has shown that a fall in blood oxygen levels is a critical indicator that a COVID-19 patient’s health is deteriorating and they may need closer monitoring and urgent treatment. But what is the evidence surrounding their effectiveness, and are they a safe way for people to monitor themselves at home? Join our webinar as we explore these important questions while discussing their applications in the UK health system and globally, with particular attention to their relevance in low- and middle-income countries. We will also discuss findings of the ongoing NHS COVID Oximetry at Home (CO@H) programme, which supports people at home who have been diagnosed with coronavirus and are most at risk of becoming seriously unwell. This virtual event will consist of a series of short talks by experts from IGHI followed by a live audience Q&A, giving you the chance to ask any questions you may have. Speakers Professor the Lord Ara Darzi, IGHI co-director Dr Ana Luisa Neves, IGHI Advanced Research Fellow and Associate Director, NIHR Imperial Patient Safety Translational Research Centre, IGHI Dr Jonny Clarke, Sir Henry Wellcome Postdoctoral Research Fellow, IGHI, Imperial College London Dr Ahmed Alboksmaty, IGHI Research Associate Professor Paul Aylin, Professor of Epidemiology and Public Health, IGHI Dr Thomas Beaney, IGHI Clinical Research Fellow Register for the webinar
  8. Event
    This conference focuses on reducing medication errors and the level of severe, avoidable harm related to medications. The conference focuses on prioritising high risk medications and high risk patient groups to enable your interventions to have the highest impact on patient care and reduction in patient harm. The conference which aims to bring together clinicians and pharmacists, managers, and medication safety officers and leads will reflect on medication safety issues that have arisen as a result of the Covid-19 pandemic, help you to understand current national developments, and allow you to debate and discuss key issues and areas in improving and monitoring medication safety, reducing medication errors and harm in hospitals. For further information and to book your place visit https://www.healthcareconferencesuk.co.uk/conferences-masterclasses/reducing-medication-errors or email kate@hc-uk.org.uk hub members receive a 20% discount. Email infor@pslhub.org for discount code. Follow on Twitter @HCUK_Clare #MedicationErrors
  9. Event
    until
    This Westminister Forum conference will discuss the priorities for NICE within health and social care following the publication of the NICE Strategy 2021 to 2026: Dynamic, Collaborative, Excellent earlier this year, which sets out NICE’s vision and priorities for transformation over the next five years, including: rapid and responsive evaluation of technology, and increasing uptake and access to new treatments flexible and up-to-date guideline recommendations which integrate the latest evidence and innovative practices improving the effective uptake of guidance through collaboration and monitoring providing scientific leadership through driving research and data use to address gaps in the evidence base. It will be an opportunity to discuss the role of NICE in a changing health and social care landscape following the pandemic, as well as the opportunities presented for guidance to keep pace with the development of integrated care, innovative treatments, and data-driven research and technology. Sessions in the agenda include: key priorities for delivering the future vision and transformation of NICE going forward developing evidence-based guidelines in a changing health and social care landscape: flexibility, patient engagement, collaboration, and effective implementation lessons learned from the use of rapid guidelines in response to COVID-19 the opportunities presented for improving the utilisation of data and the future for data-driven evidence and guidelines taking forward new approaches to evaluating health technology - speed, cost-effectiveness, and engagement priorities for industry engagement and improving value and access to innovative health technology supporting the development and adoption of innovative medicines the role of managed access and funding in delivering improved patient access to innovation opportunities for using research and data analytics to meet gaps in the evidence base. Register
  10. Content Article
    There was a national roll out of ‘COVID Virtual Wards’ (CVW) during England's second COVID-19 wave (Autumn 2020 – Spring 2021). These services used remote pulse oximetry monitoring for COVID-19 patients following discharge from hospital. A key aim was to enable rapid detection of patient deterioration. It was anticipated that the services would support early discharge, reducing pressure on beds. This study from Georghiou et al. evaluated the impact of the CVW services on hospital activity. The study found no evidence of early discharges or changes in readmissions associated with the roll out of COVID Virtual Wards across England.
  11. Content Article
    Adverse drug reactions (known as ADRs) can occur both in the home, and within the healthcare setting, when combinations of medications produce unexpected side effects. Unfortunately this means that in the most serious cases fatalities can occur. However ADRe has helped all service users by addressing life-threatening problems, reducing pain or improving quality of life. With preventable ADRs responsible for 5-8% unplanned hospital admissions in the UK, and costing the NHS up to £2.5bn pa, it is crucial that healthcare organisations take advantage of tools which can help improve how medicines are managed. ADRe has been developed with the aid of nursing professionals to help nursing staff take a structured approach to the monitoring of medicines, identifying any ADRs service users may be experiencing, and then making changes to improve a patients' health and wellbeing.
  12. Content Article
    In a series of blogs, Gina Winter-Bates, Associate Nurse Director Quality and Safety at Solent NHS Trust, shares her experience of implementing Safety Chats. In her first blog, Gina explained what motivated her to introduce Safety Chats into her Trust. In part 2, Gina reflects on how we know we are safe and the safety measures her Trust has put in place.
  13. Content Article
    This guideline covers preventing and managing inadvertent hypothermia in people aged 18 and over having surgery. It offers advice on assessing patients’ risk of hypothermia, measuring and monitoring temperature, and devices for keeping patients warm before, during and after surgery.
  14. Content Article
    On 3 September 2021 assistant coroner Jonathan Stevens commenced an investigation into the death of Martha Mills, aged 13 years. Martha sustained a handlebar injury whilst cycling on a family holiday in Wales. She was transferred to King’s College Hospital London and died approximately one month later. Her medical cause of death was: 1a refractory shock 1b sepsis 1c pancreatic transection (operated) 1d abdominal trauma.
  15. Content Article
    The purpose of this investigation by the Healthcare Safety Investigation Branch (HSIB) was to consider the management and care of preterm labour and birth of twins. Preterm birth—defined as babies born alive before the completion of 37 weeks of pregnancy—is one of the main causes of death, long-term conditions and disability in under-fives worldwide, and 60% of twin pregnancies result in premature birth. The reference event for this investigation was the case of Sarah, who was pregnant with twins and was overseen by an obstetrician during her pregnancy. Sarah was assessed as having a higher-risk pregnancy as she had had previous medical intervention on her cervix and was pregnant with twins. Shortly after having been discharged from a hospital with a specialist neonatal unit following suspected early labour, she went to her local maternity unit at 29+2 weeks with further episodes of abdominal tightening. Her labour did not progress as expected and a caesarean section was required to deliver the babies at 29+6 weeks. The twin girls were born well, but 23 days after their birth a scan revealed brain injury in both babies. The investigation identified several findings to explain the experience of the mother in the reference event, including the lack of scientific evidence or specific guidelines and the uncertainty associated with the clinical decision making in this scenario. This highlighted the need for further research into preterm labour as a recognised risk factor for twin pregnancies. As part of the investigation, HSIB identified that since 2019 a large volume of national work and research in the area of twin pregnancy and preterm birth has been undertaken. The investigation report sets out the work currently in progress and seeks to understand if it will address gaps in knowledge.
  16. Content Article
    NHS Resolution received 172 claims relating to anti-infective medications between 1 April 2015 until 31 March 2020. Anti-infective medications include antibiotics, antivirals and antifungals. The analysis in this leaflet focuses on closed claims that have been settled with damages paid and concern an element of the prescribing process: prescribing, transcribing, dispensing, administering and monitoring. Claims concerning a failure to recognise that an anti-infective was indicated have not been included within the analysis.
  17. Content Article
    Successful adoption of novel noncontact physiological measurement and physical monitoring requires analysis of how they support patient care. Lloyd-Jukes et al. review available technologies and present their vision-based patient monitoring and management system, supported by a framework enabling its integration within clinical workflows. The framework links tasks such as assessing patients to elements of the patient journey (eg, risk factors and early warning signs). The system enabled insights from patient activity reports and noncontact vital sign measurements. It supports staff in ensuring patients' health follows desired trajectories, avoiding adverse events, making observations without disrupting patients' rest, intervening proactively, and learning from incidents.
  18. Content Article
    This article in DIA Global Forum examines a new collaboration between the European Commission, the European Medicines Agency (EMA) EU Member States Belgium, France, and Germany, the Bill & Melinda Gates Foundation and the recently established African Medicines Agency (AMA). The group will mobilise more than €100 million over the next five years to support the AMA and other African medicines regulatory initiatives at regional and national levels. The initiative will foster collaboration and sharing of technical expertise by European regulators with AMA. It also aims to assist African national regulatory authorities (NRAs) in achieving the minimum World Health Organization (WHO) requirements for effective regulatory oversight of quality-assured, safe, local production of medicines and vaccines.
  19. Content Article
    Martin Anderson, author of the Human Factors 101 blog, looks at the case of US nurse RaDonda Vaught, who was found guilty of criminally negligent homicide and abuse of an impaired adult following a medication error that led to a patient death in 2017. He provides a timeline of the events that occurred in the run up to the criminal trial and highlights concerns that the case will set a precedent in bringing criminal charges against nurses when there is no intent to harm a patient. He then looks at the system factors that may have contributed to the medication error, asking a number of questions about the circumstances under which Vaught made the error. The blog goes on to outline the serious impact the case could have on healthcare professionals' willingness to report errors, take on complex cases and use innovative treatments—it may even put people off taking on a career in the healthcare sector in the first place.
  20. Content Article
    This article tells the story of Baby E, who died two hours after delivery following issues with the management of her labour. The maternity unit was short-staffed on the night of Baby E's birth and there were delays in getting her mother to theatre for a caesarean section. Baby E's parents felt that the hospital withheld information from them, failing to inform them of internal investigations that had taken place following Baby E's death. At the inquest, the coroner concluded that errors had been made, including the fact that Baby E's low heart rate had been missed. She also criticised the decision-making process in the management of labour, but concluded that she was unable to say whether this had made a difference to whether or not Baby E lived.
  21. Content Article
    This case study summarises the story of Evadney Dawkins, a 77 year-old living in East London who died on 23 August 2018 as a result of treatment errors and poor care received at Newham University Hospital. Following a fall at home, Evadney was taken to the hospital on 22nd July 2018, where she was initially treated for a chest infection and fast atrial fibrillation (an irregular and abnormally fast heart rate). As she had other co-morbidities that included chronic renal failure, a treatment plan including renal monitoring was agreed, but the hospital failed to monitor her renal function and she sustained a profound acute kidney injury. Following intensive treatment, the acute kidney injury resolved but she sustained a cardiac arrest on 23rd August 2018 and died later that day. This case study outlines how Action Against Medical Accidents (AvMA) helped Evadney's family convince the Coroner to open an inquest. The inquest found that there were ‘gross failures’ in the care provided to Evadney which led to her renal deterioration, including a failure in the frequency of blood tests, a failure in fluid monitoring and a failure to carry out renal ultrasound. The Coroner also criticised Bart's Health NHS Trust's systems of governance for not identifying for two years that Evadney’s case was a serious incident which required investigation.
  22. Content Article
    The variety of alarms from all types of medical devices has increased from 6 to 40 in the last three decades, with today’s most critically ill patients experiencing as many as 45 alarms per hour. Alarm fatigue has been identified as a critical safety issue for clinical staff that can lead to potentially dangerous delays or non-response to actionable alarms, resulting in serious patient injury and death. To date, most research on medical device alarms has focused on the nonactionable alarms of physiological monitoring devices. While there have been some reports in the literature related to drug library alerts during the infusion pump programming sequence, research related to the types and frequencies of actionable infusion pump alarms remains largely unexplored.
  23. Content Article
    Hospital-acquired venous thromboembolism (VTE) continues to be a significant source of preventable patient harm. This study from Richie et al. retrospectively examined patients admitted with VTE and found that only 15% received correct risk stratification and appropriate management and treatment. The case review found that patients were commonly incorrectly stratified, received incorrect pharmaceutical treatment, or inadequate application of mechanical prophylaxis (e.g., intermittent compression).
  24. Content Article
    Identifying improvements in maternity care to help reduce the risk of delays in crucial interventions during labour when a baby is suspected to be unwell is the focus of this latest Healthcare Safety Investigation Branch (HSIB) report. The report was compiled after a review of 289 of our maternity investigations into intrapartum stillbirths, neonatal deaths and potential severe brain injuries. In 14.9% of the cases the delay was a contributory factor. The review identified issues such as inadequate staffing, poor infrastructure and high workload as contributory factors to the delays. Evidence from national reports confirms that such delays are a recognised patient safety risk. 
  25. Content Article
    The Resident Assessment Instrument-Minimum Data Set (RAI-MDS) 2.0 is designed to collect the minimum amount of data to guide care planning and monitoring for residents in long-term care settings. These data have been used to compute indicators of care quality. Use of the quality indicators to inform quality improvement initiatives is contingent upon the validity and reliability of the indicators.
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