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Found 654 results
  1. Content Article
    This paper from Claire Su-Yeon Park aims to propose Park's sweet spot theory-driven implementation strategy, which makes optimal safe staffing policy really work in nursing practice.
  2. News Article
    A large private provider says it is finding it harder than ever to fill its staffing vacancies, but is optimistic that its investment in nursing apprenticeships and overseas recruitment can help expand NHS-commissioned capacity. In an interview with HSJ, Shelley Thomas, group HR director for Spire Healthcare, said the company is facing the same staffing difficulties as NHS providers. She said: “We’re all feeling the same things at the moment… high sickness absence, high holidays, teams that are worn out. We’re all… experiencing the same from a workforce perspective.” However, she said Spire is “working harder than ever” to fill vacancies, and now has a “really robust pipeline” of apprentices and oversees recruits. Despite the waiting list backlogs which have ballooned since the pandemic began, and a £10bn framework in place for the NHS to utilise private sector capacity, analysis suggests NHS activity undertaken by private hospitals has been below pre-covid levels in almost all specialities. Ms Thomas suggested the staffing difficulties had been a factor in that, but acknowledged there were more conversations to be had locally about how the private sector could undertake more activity. She said the pandemic was a “huge catalyst for stronger working partnerships” between the NHS and the private sector and that relationships are “stronger than they’ve ever been”. Read full story (paywalled) Source: HSJ, 4 August 2022
  3. Content Article
    Patient safety culture is the foundation of patient safety and refers to a healthcare organisation’s shared values, norms and beliefs that influence staff’s behaviour and actions. This study in BMJ Open Quality aimed to assess nurses’ reporting on the predictors and outcomes of patient safety culture and the differences between patient safety grades and the number of events reported. It aimed to fill a gap in research by looking at patient safety culture in terms of both predictors and outcomes. The author developed a cross-sectional comparative research design and recruited 300 registered nurses to take part in a survey on patient safety culture. The author found that nurses generally perceived patient safety culture as 'moderate', and identified areas that should be prioritised to improve patient safety culture. They concluded that assessing patient safety culture is the first step in improving hospitals’ overall performance and quality of services, and that improving patient safety practices is essential to improving culture and clinical outcomes.
  4. Community Post
    In unit-dose dispensing, medication is dispensed in single doses in packages that are ready to administer to the patient. It can be used for medicines administered by any route, but oral, parenteral, and respiratory routes are especially common. The system provides a fully closed loop process where the patient, the drug and the healthcare professional are identified by machine readable codes and the drug administration process is linked directly to the electronic prescription. and is fully recorded There are many variations of unit-dose dispensing. As just one example, when physicians write orders for inpatients, these orders are sent to the central pharmacy . Pharmacists verify these orders and technicians place drugs in unit-dose carts. The carts have drawers in which each patient's medications are placed by pharmacy technicians—one drawer for each patient. The drawers are labelled with the patient's name, ward, room, and bed number. Sections of each cart containing all medication drawers for an entire nursing unit often slide out and can be inserted into wheeled medication carts used by nurses during their medication administration cycles. Alternatively, electronic medicine storage cabinets can be located on wards and these are attached to medicine carts which are then filled from the cabinets. Studies often compare unit-dose dispensing to a ward stock system. In this system, bulk supplies are issued from the pharmacy; the drugs are stored in a medication room on the ward. The correct number of doses must be taken out of the correct medication container for each cycle and taken to the patient for administration. Liquids must be poured by the nurse from the appropriate bottle and each dose carefully measured. Evidence for Effectiveness of the Practice Though the practice of unit-dose dispensing is generally well accepted and has been widely implemented, the evidence for its effectiveness is modest. Most of the published studies reported reductions in medication errors of omission and commission with unit-dose dispensing compared with alternative dispensing systems such as ward stock systems. Potential for Harm Unit-dosing shifts the effort and distraction of medication processing, with its potential for harm, from the ward to central pharmacy. It increases the amount of time nurses have to do other tasks but increases the volume of work within the pharmacy. Like the nursing units, central pharmacies have their own distractions that are often heightened by the unit-dose dispensing process itself, and errors do occur. Overall, unit-dose appears to have little potential for harm. The results of most of the observational studies seem to indicate that it is safer than other forms of institutional dispensing. However, the definitive study to determine the extent of harm has not yet been conducted. A major advantage of unit-dose dispensing is that it brings pharmacists into the medication use process at another point to reduce error. Yet about half of the hospitals in a national survey indicated that they bypass pharmacy involvement by using floor stock, borrowing patients' medications, and hiding medication supplies. Unit dose drug distribution is being introduced across Europe. In Germany, a recent study showed a saving of 2.61 WTE nurses per 100 beds. There is now growing interest in UK hospitals and pilot sites to develop the system are being established.
  5. News Article
    Five wards at Scotland's largest hospital had to operate with one registered nurse on duty each. Staff at the Queen Elizabeth University Hospital in Glasgow experienced the shortage on Monday night. It is an example of the severe pressure affecting health services across the country, which has intensified due to the Covid-19 pandemic. Greater Glasgow and Clyde health board said nurses were supported by a number of other staff. Originally reported in the Daily Record, the shortage was described to staff in an email sent on Monday afternoon. The email said nurse staffing levels across medicine were critical, despite attempts to seek support from bank or agency workers. It said admin staff had been asked to stay on to offer support including answering phones and door buzzers for the rest of the week. As well as staffing problems, the pandemic has caused more bed blocking in Scotland's hospitals and longer waits for both emergency and outpatient treatment. Norman Provan, associate director at the Royal College of Nursing Scotland said the shortage had an impact on patient safety as well as staff wellbeing - concerns that had been raised with the health board and the Scottish government. He added: "We're in this situation largely because of the failure of Scottish government to address the nursing workforce crisis, which has seen registered nurse vacancies reach a record high. "Urgent action is needed to protect patient safety, address staff shortages and demonstrate that the nursing workforce is valued as a safety critical profession." Read full story Source: BBC News, 24 July 2022
  6. Content Article
    The National Infusion and Vascular Access Society (NIVAS) is a multidisciplinary organisation made up of healthcare professionals with a special interest in vascular access and IV therapy.  This white paper by NIVAS lays out evidence that having a nursing-led vascular access team in every hospital in the UK will improve patient safety, reduce workload pressures for other staff, and save the NHS money. Vascular access involves the use of devices such as catheters to deliver or remove fluids, blood or medication from a patient’s bloodstream. The paper examines the arguments advocating for Vascular Access Services Team (VAST) across the NHS, acknowledging the current pressures of restarting the NHS following the pandemic and the roadmap to reduce the elective waiting lists. It also outlines how integrating a standardised model of VAST into the healthcare systems of the NHS will benefit patients, the new Integrated Care Systems (ICS) and the wider objectives of the NHS.
  7. News Article
    A nurse who recorded she had given medication to care home residents when in fact she had delegated the task to unqualified staff has been struck off. Adelaide Maloane was working a night shift at Somerleigh Court in Dorchester, Dorset, in August 2019 when the incident took place. Ms Maloane delegated giving 16 medicines to residents to an unqualified healthcare assistant at the home. The Nursing and Midwifery Council said Ms Maloane had "failed to acknowledge the seriousness of her misconduct and dishonesty and the implications of her actions for residents, colleagues and the reputation of the nursing profession". Read full story Source: BBC News, 21 July 2022
  8. Content Article
    Nursing workforce shortages are an issue of international concern, with the gap between demand for services and the limited numbers of nurses widening. Recruiting nurses internationally is one solution that is helping to bridge this gap in some health systems. This systematic review in the International Journal of Nursing Studies Advances aimed to explore the lived experiences of international nurses working and living in different countries globally. The authors identified factors that can help nurses from other countries to adapt culturally to the UK health system, and that may support retention of international staff. The authors found that in order to improve the long term retention of international nurses, cultural integration and language barriers should be sensitively managed to enable effective acculturation. Culturally sensitive leadership should also be promoted to ensure zero tolerance of inappropriate racist and discriminatory behaviours.
  9. Content Article
    In this blog, nurse Carol Menashy describes her experience making an error in theatre fifteen years ago, and the personal blame she faced in the way the incident was dealt with at the time. She talks about how a SEIPS (Systems Engineering Initiative for Patient Safety) framework can transform how adverse incidents are dealt with, allowing healthcare teams to learn together and use incidents to help make positive changes towards patient safety. She describes the progress that has been made towards organisational accountability and systems thinking over the past fifteen years, and talks about the importance of staff support to allow for healing from adverse events.
  10. Content Article
    Even before the pandemic struck, there was a shortage of nurses in the UK. In January 2020, a survey by the Royal College of Nursing (RCN) found that almost three-quarters of nurses said the staffing level on their last shift was not sufficient to meet the needs of patients safely and effectively. Yet this month NHS England predicted that the government will not meet its manifesto pledge to boost the NHS’s nursing workforce by 50,000 by March 2024. The key reason? NHS workers are quitting in droves, citing burnout, fatigue and pay as factors. Filling these gaps are nurses from overseas. Recently released figures for 2021 and 2022 from the Nursing and Midwifery Council (NMC) show that record numbers of nurses trained overseas are coming to work in the UK – almost half of new registrations. The Guardian spoke to four of them about their experience working in the UK.
  11. Content Article
    One of the reasons why patient safety may be put at risk during healthcare interventions is a lack of staff adherence to patient safety guidelines. There could be a relationship between staff’s adherence to patient safety guidelines and their perceived level of reward for their work and/or motivation. This study from Asmoro et al. examined the relationship between reward and adherence to patient safety guidelines, and between motivation and adherence to patient safety guidelines, among nurses working in emergency departments (EDs) in Indonesia. They found that ensuring ED nurses are motivated for their work by offering rewards – such as a decent salary, a supportive workplace environment and career progression opportunities – is important to enhance their adherence to patient safety guidelines.
  12. Content Article
    This document summarises the findings of The Health Foundation's analysis on workforce supply and demand in general practice in England up to 2030/31. It focuses on patient care staff including GPs and general practice nurses. The Health Foundation developed three scenarios of potential workforce supply through a mix of in-house modelling and publicly available data: a scenario based on current policy, a more optimistic scenario and a pessimistic scenario. The analysis demonstrates that in all three scenarios, the supply of GPs and general practice nurses is projected to fall short of demand. Under current policy, the NHS faces a shortfall of over 1 in 4 GP and general practice nurse posts by 2030/31. In the pessimistic scenario this increases to around 1 in 2 GP and nurse posts, raising concerns about patient safety, quality of care and equity of access. In the optimistic scenario, the GP shortfall can be substantially mitigated by 2030/31, but this would require sustained and concerted policy action to boost GP retention and integrate newer roles within multidisciplinary practice teams.
  13. Content Article
    The consultancy firm McKinsey & Company explored the effects of the Covid-19 pandemic on the nursing workforce in a global survey that included nurses from United States, the United Kingdom, Singapore, Japan, Brazil and France. The survey findings show a consistency around how nurses feel in their roles today, despite the different healthcare systems and delivery networks in each of the six countries. A substantial population of nurses are expressing a desire to leave direct patient care, with between 28% and 38% of nurse respondents in the United States, the United Kingdom, Singapore, Japan and France indicating that they were likely to leave their current role in direct patient care in the next year. This article explores in detail some of the reasons why nurses are choosing to leave direct patient care, and highlights approaches that might encourage retention, including positive leadership initiatives.
  14. Content Article
    This is part of our series of Patient Safety Spotlight interviews, where we talk to people working for patient safety about their role and what motivates them. Claire talks to us about her role as a Patient Safety Lead and why she thinks the new Patient Safety Incident Response Framework will make her work more practical and patient-centred. She also describes why she set up the Patient Safety Management Network and highlights why patient safety roles would benefit from more standardisation across trusts.
  15. News Article
    Vulnerable patients cared for in secure mental health units across England could miss out on vital medications due to a shortage of learning disability nurses, the Healthcare Safety Investigation Branch (HSIB) has warned. The report into medication omissions in learning disability secure units across the country highlights problems with retaining learning disability nurses, with the number recruited each year matching those leaving. Figures quoted in the report suggest the number of learning disability nurses in the NHS nearly halved from 5,500 in 2016 to 3,000 in 2020. The HSIB launched a national investigation after being alerted to the case of Luke, who spent time in NHS secure learning disability units but was not administered prescribed medication for diabetes and high cholesterol on several occasions. At Luke’s facility, which included low and medium secure wards, HSIB investigators considered that the quality and style of care provided to patients had been directly impacted by a lack of nurses with required skill sets. Findings from HSIB’s wider national investigation link a shortfall of learning disability nurses to instances of patients missing their medication, with the report’s authors describing a “system in which medicines omissions were too common and prevention, identification and escalation processes were not robust”. Read full story (paywalled) Source: HSJ, 23 June 2022
  16. Content Article
    This Healthcare Safety Investigation Branch (HSIB) investigation explores medicines omission among patients with learning disabilities who are cared for in medium and low secure wards in mental health hospitals. A medicine omission is when a patient doesn't receive medicines that have been prescribed to them, and the investigation focused on a number of factors that could contribute to omission: the environment in which medicines administration takes place the availability and use of learning disability nurses in these environments the skills required for nurses to help patients with learning disabilities be involved in choices about their medicines. For it's reference event, the investigation looked at the case of Luke, who was detained in a medium secure ward of a mental health hospital. He spent 21 months on the ward before moving into a low secure ward at the same hospital, where he stayed for a further 11 months. Both wards were specifically designated for patients with learning disabilities. While at the hospital, there were a number of periods when Luke was not given the physical health medication he had been prescribed for his diabetes and high cholesterol. Although Luke’s medication record regularly noted that Luke refused the medication, Luke and his Mother disagreed with this version of events, stating that other factors led to Luke’s medicine omissions.
  17. Content Article
    Since the Covid-19 pandemic, staff shortages have worsened in health systems around the world, with an increasing number of healthcare workers leaving the workforce coinciding with increased patient demand. In this blog, Jens Hooiveld, International Marketing Manager at the Patient Safety Company, examines the patient safety issues caused by staffing shortages. He highlights tools that can help nurses manage patient safety in this pressured climate by decreasing the burden of admin associated with reporting adverse incidents.
  18. Content Article
    Family Integrated Care (FICare) is an approach to neonatal care which aims to involve parents as equal partners in the care of their babies while in the Neonatal Intensive Care Unit (NICU). FICare aims to minimise separation, support parent-child bonding and promote parental decision-making. In this blog, Katie Cullum, Lead Nurse for Innovation and Quality Improvement at East of England Neonatal Operational Delivery Network, talks about the proven benefits of Family Integrated Care and why all NICUs should be implementing the model to improve outcomes.
  19. Event
    until
    This online study day from the East of England Neonatal Operational Delivery Network will be led by Sara Davis, Neonatal Practice Development Lead. Using a blend of theory and guided workshops, you will have the opportunity to see worked examples, ask questions, share ideas and receive support in the first stages of planning your own project. It will include: Action planning for learning and improvement using human factor science and QI methodologies, Audit as a tool for assurance and improvement and team effectiveness. The cost of this study day is: £10.00 per person for delegates attending from within the East of England Network £20.00 per person for delegates attending from outside of the East of England Network. Book a place
  20. News Article
    A whistleblower nurse who was sacked after warning that the workload on NHS staff had led to a patient’s death has been awarded hundreds of thousands of pounds. Linda Fairhall, who had an “unblemished” career as a nurse for almost 40 years, was suspended and then sacked in 2016 after raising concerns about patient safety. The 62-year-old nurse, from Billingham, has now been awarded a payout in excess of £462,000, her lawyers have said. It is thought to be a record for lost salary and remedies. Ms Fairhall had been a nurse at North Tees and Hartlepool NHS Trust. She started working with the NHS in 1979 and had been overseeing a team of about 50 district nurses in Hartlepool when she was suspended. In 2020, Ms Fairhall successfully challenged her employer's decision to dismiss her. Though the trust tried to appeal the decision last year, the appeal court found in her favour again – saying the tribunal had reached “an unimpeachable decision” that she was dismissed for whistleblowing. The trust says it is continuing to learn lessons and implement positive change. She said: "If it changes things for others then it will be worthwhile. I'm relieved it's over. Read full story Source: The Northern Echo, 14 June 2022
  21. Content Article
    This report outlines the results of a survey of 10,000 nursing staff in the UK carried out by the Royal College of Nursing (RCN). The survey highlighted stark differences in career progression and treatment in the workplace between White nurses and those from a mixed ethnic background, and Black and Asian nurses. In the 35-44 age group, 66% of White and 64% of respondents from mixed ethnic backgrounds said they’d been promoted. This dropped to just 38% of Asian and 35% of Black respondents. Black respondents working in both hospital (39%) and community (32%) settings are more likely to report having experienced physical abuse than respondents of other ethnic backgrounds. In response to these findings, the RCN is calling on the UK Government to reform human rights law to help tackle workplace racism, including introducing a legal requirement to eliminate disparities in recruitment, retention and career progression. They also want employers to have greater responsibility to protect minority ethnic groups from racism in all its forms.
  22. Content Article
    Krista Haugen is National Director of Patient Safety for US-based emergency and patient relocation services provider Global Medical Response. In this interview, she describes how her 25-year career as an emergency medicine nurse has influenced her approach to safety and patient care. She discusses her personal experience of being involved in an accident as an air-ambulance flight nurse, and how this caused her to look at safety and risk management from a systems perspective, focussing on building a just culture where safety is optimised through organisational reflection and learning.
  23. News Article
    Most nurses warn that staffing levels on their last shift were not sufficient to meet the needs of patients, with some now quitting their jobs, new research reveals. A survey of more than 20,000 frontline staff by the Royal College of Nursing (RCN) suggested that only a quarter of shifts had the planned number of registered nurses on duty. The RCN said the findings shone a light on the impact of the UK’s nursing staff shortage, warning that nurses were being “driven out” of their profession. In her keynote address to the RCN’s annual congress in Glasgow, general secretary Pat Cullen will warn of nurses’ growing concerns over patient safety. Four out of five respondents said staffing levels on their last shift were not enough to meet all the needs and dependency of their patients. The findings also indicated that only a quarter of shifts had the planned number of registered nurses, a sharp fall from 42% in 2020 and 45% five years ago, said the RCN. Ms Cullen will say: “Our new report lays bare the state of health and care services across the UK. “It shows the shortages that force you to go even more than the extra mile and that, when the shortages are greatest, you are forced to leave patient care undone. Read full story Source: The Independent, 6 June 2022
  24. Content Article
    This report from the Royal College of Nursing (RCN) reveals the full extent of the UK nursing workforce crisis. In March 2022, nursing and midwifery staff from across the UK were invited to tell the RCN about their experiences of the last time they were at work. The survey report provides valuable insight into the realities of staffing levels across the UK, and the impact on our members and the people they are caring for.
  25. Content Article
    Returning to work as a nurse with Long Covid is thwart with difficulties in part due to its relapsing-remitting nature. Many nurses with Long Covid experience post-exertional malaise and symptom exacerbation if they push themselves and this may trigger a major relapse. This means that a return to work needs to be planned carefully. Dr Alison Twycross, Editor in Chief of Evidence-Based Nursing, speaks to two freelance consultants from Long Covid Work: Dr Clare Rayner, a consultant occupational physician, and Kirsty Stanley, Director, Occupational Therapist & Writer at Occupation4Life Ltd, about best practice in this context. They provide guidance for both employers and employees. Alison, Clare and Kirsty are also members of the Long Covid Support Employment Group. 
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