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Showing results for tags 'Monitoring'.
Found 136 results
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Content ArticlePatients, clinicians and managers all want to be reassured that their healthcare organisation is safe. But there is no consensus about what we mean when we ask whether a healthcare organisation is safe or how this is achieved. In the UK, the measurement of harm, so important in the evolution of patient safety, has been neglected in favour of incident reporting. The use of softer intelligence for monitoring and anticipation of problems receives little mention in official policy. This paper from Vincent et al. proposes a framework which can guide clinical teams and healthcare organisations in the measurement and monitoring of safety and in reviewing progress against safety objectives. The framework has been used so far to promote self-reflection at both board and clinical team level, to stimulate an organisational check or analysis in the gaps of information and to promote discussion of ‘what could we do differently’.
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Content ArticleThe aim of this systematic review in the Journal of Patient Safety was to determine the impact of automated patient monitoring systems (PMSs) on sepsis recognition and outcomes. Authors Gale and Hall found that automated sepsis PMSs have the potential to improve sepsis recognition and outcomes, but current evidence is mixed on their effectiveness. More high-quality studies are needed to understand the effects of PMSs on important sepsis-related process and outcome measures in different hospital units.
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Content ArticleCare Quality Commission (CQC) Chief Executive, Ian Trenholm, discusses the immediate priorities for CQC, what’s coming next with their Transitional Regulatory Approach, and further ahead to CQC's future strategy.
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Content ArticleThis alert, from the National Institute for Health Research, provides a synopsis of a new study which suggests that many early warning scores are based on flawed research. It looks at the issue and the next steps in terms of patient safety.
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Content ArticleThis investigation, published in Anesthesiology, was specifically designed to determine whether errors at low saturation correlate with skin colour.
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Content ArticleThis report, from the Healthcare Safety Investigation Branch (HSIB), provides insight into a current safety risk that was identified on a referral. The referral was about difficulties in identifying clinical deterioration in patients with COVID-19 on general wards. The Royal College of Physicians (RCP) highlighted the issue of rapid deterioration in oxygenation in patients with COVID-19 and how this might relate to the use of early warning scores.
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Content Article
NHS leaflet: Illness in newborn babies
PatientSafetyLearning Team posted an article in Maternity
After babies are born they have to breathe, suck, feed, wee, poo and stay warm. This NHS leaflet (April 2020) will tell you how to keep your baby safe and healthy. Do not delay seeking help if you have any concerns. Content includes: What is jaundice? Breathing, colour and movement. Feeding. -
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Risks of CTG monitoring
PatientSafetyLearning Team posted an article in Maternity
This is a series of three articles written by Kirsten Small, a specialist obstetrician and gynaecologist in Australia, exploring the risks that flow from the use of intrapartum monitoring. Part 1 Examines evidence of short and long-term physical harms to birthing women relating to higher rates of surgical birth when intrapartum Cardiotocography (CTG) monitoring is used. Part 2 Focuses on possible psychological harms which have been reported relating to CTG use. Part 3 Looks at the possibility that CTG use might cause harm to the baby, while the two previous posts have examined the risk to birthing women. -
Content ArticleThe UKONS Telephone Triage Tool Kit outlines a clear symptom based, RAG rated ( RED, AMBER, GREEN) risk assessment process. It is used for telephone triage of patients who: have received or are receiving systemic anticancer therapy have received any other type of anticancer treatment, including radiotherapy and bone marrow graft/transplant may be suffering from disease-/treatment-related immunosuppression. The UKONS tool is evidence based and has been piloted and evaluated positively. It can be used by almost all, regardless of skill level or experience, and identifies patients at risk and advises action according to the level of risk.
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Commissioning for Quality and Innovation (CQUIN)
Claire Cox posted an article in CQUIN
CQUIN stands for Commissioning for Quality and Innovation. This is a system introduced in 2009 to make a proportion of healthcare providers’ income conditional on demonstrating improvements in quality and innovation in specified areas of care. This means that a proportion of a Trusts income depends on achieving quality improvement and innovation goals, agreed between the Trust and its commissioners. The sum attached to the CQUINs is variable each year based on a percentage of the contract value and depends on achieving quality improvement and goals. -
Content ArticleThe Summary Hospital-level Mortality Indicator (SHMI) reports on mortality at trust level across the NHS in England using a standard and transparent methodology. It is produced and published monthly as a National Statistic by NHS Digital. The SHMI is the ratio between the actual number of patients who die following hospitalisation at the trust and the number that would be expected to die on the basis of average England figures, given the characteristics of the patients treated there.
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Content ArticleIn this presentation on improving patient safety and reducing alarm fatigue, the panellists discuss the right and wrong way to use continuous surveillance monitoring.
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Content ArticleAccording to the National Institutes of Health (January 2019), more than 130 people in the United States die after overdosing on opioids every day. Among these deaths are patients in the hospital setting, recovering from surgical procedures or undergoing sedation, who are often prescribed opioids such as morphine and oxycodone to manage pain – a necessity for healthy and comfortable recovery. But at certain doses, these drugs can also cause respiratory failure, and, because each patient is different, there is no one dose that is 'right' or 'wrong'. Hospitals must take action to ensure their staff are aware of these risks, and put protocols in place to prevent patient deaths. The authors of this US article, published by Medium, offer recommendations for improving patient safety in this area.
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Content ArticleIn this article published in the British Columbia Medical Journal, Drs Richard Merchant and Matt Kurrek encourage the use of capnographic monitoring to improve the safety of patients undergoing procedural sedation.
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Content Article
RCPCH: Young Epilepsy app
Claire Cox posted an article in Apps for health and care
The Young Epilepsy app is a free information and support tool designed primarily for young people with epilepsy, their parents and carers. The app includes a seizure video function, symptom log and diary to help keep track of seizures and aid diagnosis. It also features key emergency and contact details, an information library tailored for either adults or young people, and provides data in both email and chart format that can be easily shared with a school, carer or medical professional. -
Content ArticleDrawing together academic evidence and practical experience to produce a framework for safety measurement and monitoring.
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Content ArticleThis was one of Q Exhange's 2018 winning ideas. Testing the use of a tool to support domiciliary care staff in recognising the softer signs of deterioration. Improving response and communication to colleagues/health professionals (incorporating SBAR). The aim of this work is to reduce avoidable harm, enhance clinical outcomes and improve the experience of deteriorating individuals in the community.To achieve this, focus will be placed on improving recognition (softer signs and NEWS where appropriate), response and communication by domiciliary carers.
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Content ArticleThe Care Quality Commission (CGC) is the independent regulator of health and adult social care in England. They make sure that health and social care services provide people with safe, effective, compassionate, high-quality care and encourage care services to improve. Independent acute hospitals play an important role in delivering healthcare services in England, providing a range of services, including surgery, diagnostics and medical care. As the independent regulator, the CQC, hold all providers of healthcare to the same standards, regardless of how they are funded.
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Content Article
MHRA: The Yellow Card Scheme
Claire Cox posted an article in Adverse interactions
The Yellow Card Scheme helps the Medicines and Healthcare products Regulatory Agency (MHRA) monitor the safety of all healthcare products in the UK to ensure they are acceptably safe for patients and those who use them. On the Yellow Card Scheme website you can report a suspected incident or problem. -
Content ArticleThe Care Quality Commission (CQC) is the independent regulator of health and adult social care in England. We make sure that health and social care services provide people with safe, effective, compassionate, high-quality care and we encourage care services to improve. When CQC inspects health and care services they assess how well these services meet people’s needs. As part of this, they look at how people’s medicines are optimised. Medicines optimisation is the safe and effective use of medicines to enable the best possible outcomes for people. It also looks at the value that medicines deliver, making sure that they are both clinically and cost effective, and that people get the right choice of medicines, at the right time, with clinicians engaging them in the process.
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Content ArticleThis case story highlights the missed opportunities that could have prevented a cardiac arrest and subsequent severe hypoxic brain injury in an intensive care patient.
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Content ArticleThe purpose of this study was to describe patient engagement as a safety strategy from the perspective of hospitalised surgical patients with cancer.
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Content ArticleThe assessment of acute-illness severity in adult non-pregnant patients in the UK is based on early warning score (EWS) values that determine the urgency and nature of the response to patient deterioration. This study from Freathy et al., published in the journal Resuscitation, aimed to describe, and identify variations in, the expected clinical response outlined in ‘deteriorating patient’ policies/guidelines in acute NHS hospitals.
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Content ArticlePatients with delirium have changes in their thinking and are often confused and cannot pay attention. About half of patients in an intensive care unit (ICU) have delirium during their stay. Research has shown that patients with delirium are more likely to die or to have long-term brain problems, including posttraumatic stress disorder, depression and other mental health issues, than those without delirium. Although nurses and doctors have tools to measure delirium in the ICU, it can be hard to identify and, in some cases, may be missed. Family members may be the first to notice that their loved ones have changes in their thinking or cannot pay attention. There are tools called the Family Confusion Assessment Method (FAM-CAM) and Sour Seven questionnaire that can be used by family members to detect delirium. However, neither of these tools has been used in an ICU. This study from Krewulak et al., published in CmajOPEN, shows that these tools can be used by family members to measure delirium in the ICU. The results from this study could lead to a change in policy that would involve partnering with family members to improve the diagnosis of delirium in the ICU. In turn, this would improve patient and family care and outcomes in the ICU.
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Content ArticleEarly warning scores were developed to improve recognition of clinical deterioration in acute hospital settings. In 2015, the West of England Academic Health Science Network supported the roll-out of the National Early Warning Scores (NEWS) across a range of non-acute-hospital healthcare sectors. The objective of this study from Brangan et al., published in BMJ Open, was to explore staff experiences of using NEWS in these new settings. This study demonstrated that while NEWS can work for staff outside acute hospital settings, the potential for routine clinical practice to accommodate NEWS in such settings varied.
