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Content ArticleThis study, published in Risk Management and Healthcare Policy, analyses staffs perception of a safety culture and their knowledge of safety measures in the hospitals of Saudi Arabia.
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News Article
Half of unexpected deaths in Belgian hospitals are due to shortage of staff
Patient Safety Learning posted a news article in News
Half of the unexpected deaths in Belgian hospitals are due to a shortage of nurses, according to a study by the University of Antwerp. Researchers from the University of Antwerp show the link between the number of nurses in hospitals and the death of the patients they care for, based on data from 34,567 patients’ medical records in four Flemish, one Walloon and two Brussels hospitals. The records showed that, on average, three out of every thousand patients in the hospital died ‘unexpectedly’. A death is considered as unexpected when a patient suddenly dies during active treatment, with no care plan for the end of their life having been started. “We know from previous research that part of these unexpected deaths can be avoided, which is always heartbreaking for the family as well as the staff,” said Filip Haegdorens, a researcher at the university. “As a sector, we must do everything we can to prevent this,” he added. The average nurse in Belgium is responsible for 9.7 patients at a time. For 89% of all departments, the number of nurses per hospital department was too low to be able to ensure good quality care. “Compared to, for example, Australian hospitals, where legal minimums exist, our Belgian figures could be improved,” said Haegdorens. The study also shows a link between the training level of nurses and the number of unexpected deaths in the hospital. “In some hospital services, we found that more nurses with a high level of education would reduce the risk of unexpected deaths,” Haegdorens added. Read research paper Read full story Source: The Brussels Times, 4 December 2019- Posted
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Content Article
How do you initiate change within a pressure cooker?
Anonymous posted an article in Florence in the Machine
Frontline staff are being told to work harder, discharge more patients, be quicker, be more efficient, but are also expected to innovate and give safer care. Where can we find the time to innovate? The time to discuss and implement new ideas? One nurse gives her thoughts in this insightful blog.- Posted
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News Article
Health strike: Nurses start industrial action on pay and staffing
Patient Safety Learning posted a news article in News
Industrial action by healthcare workers is intensifying as Northern Ireland's nurses take part in 24 hours of action. Health workers are staging industrial action in protest at pay and staffing levels which they claim are "unsafe". In an unprecedented joint statement, the five health trusts said the action was likely to result in "a significant risk to patient safety". Last week, the Royal College of Surgeons warned NI's healthcare system was "at the point of collapse". On Tuesday, members of the Royal College of Nursing (RCN) are refusing to do any work that is not directly related to patient care. Full details and advice on current health care services can be found on the Health and Social Care Board website. Read full story Source: BBC News, 3 December 2019- Posted
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Content ArticleClinician burnout has been well-documented and is at record highs. The same issues that drive burnout also diminish joy in work for the healthcare workforce. Healthcare leaders need to understand what factors are diminishing joy in work, nurture their workforce, and address the issues that drive burnout and sap joy in work. The most joyful, productive, engaged staff feel both physically and psychologically safe, appreciate the meaning and purpose of their work, have some choice and control over their time, experience camaraderie with others at work, and perceive their work life to be fair and equitable. There are proven methods for creating a positive work environment that creates these conditions and ensures the commitment to deliver high-quality care to patients, even in stressful times.
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News Article
'We try our best as nurses, but it's not enough'
Patient Safety Learning posted a news article in News
Georgina Day works as an A&E nurse in a London hospital. Every shift, her team of just over 20 starts four nurses short because there are posts it cannot fill. "It can be worse - if people are sick or agency staff don't turn up. It makes providing good patient care difficult." She says the demands are huge - her department sees more than 400 patients a day. But the shortages mean patients face delays or have to be given care, such as intravenous antibiotics, in corridors instead of in cubicles. She says that can make patients angry, recounting the experience of one father shouting at her and saying she didn't care about his sick son. "I care massively," she says. "When patients are angry it makes me really sad. I want more for them." Georgina's experience is not unique. A survey by the Royal College of Nursing found six in 10 nurses felt they could not provide the level of care they wanted to. Read full story Source: BBC News, 2 December 2019 -
Content ArticleGrowing evidence indicates that improved nurse staffing in acute hospitals is associated with lower hospital mortality. Current research is limited to studies using hospital level data or without proper adjustment for confounders which makes the translation to practice difficult. In this observational study published in BMC Health Services Research, Haegdorens et al. analysed retrospectively the control group of a stepped wedge randomised controlled trial of 14 medical and 14 surgical wards in seven Belgian hospitals. All patients admitted to these wards during the control period were included in this study. Pregnant patients or children below 17 years of age were excluded. The records showed that, on average, three out of every thousand patients in the hospital died ‘unexpectedly’. A death is considered as unexpected when a patient suddenly dies during active treatment, with no care plan for the end of their life having been started. Their results are in accordance with previous research and confirm the association between higher nurse staffing levels and lower patient mortality. Furthermore, they also found that a higher proportion of bachelor’s degree nurses is related to a reduction in patient mortality. They proposed a new method to estimate optimal staffing levels using ward level data.
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Content ArticleThe communication between nurses and patients' families impacts patient well-being as well as the quality and outcome of nursing care, this study aimed to demonstrate the facilitators and barriers which influence the role of communication among Iranian nurses and families member in ICU.
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Content ArticleThe objective of this systematic review, published by JBI database of systematic reviews and implementation reports, is to synthesise the eligible evidence of patients' experience of engaging and interacting with nurses, in the medical-surgical ward setting.
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Content ArticleThe ‘Productive Ward: Releasing Time to Care’ programme is a quality improvement (QI) intervention introduced in English acute hospitals a decade ago to: increase time nurses spend in direct patient care improve safety and reliability of care improve experience for staff and patients make changes to physical environments to improve efficiency. The objective of this paper, published in BMJ Quality & Safety, was to explore how timing of adoption, local implementation strategies and processes of assimilation into day-to-day practice relate to one another and shape any sustained impact and wider legacies of a large-scale quality improvement intervention.
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News Article
Nursing shortages forcing NHS to rely on less qualified staff
Patient Safety Learning posted a news article in News
The NHS is relying on less qualified staff to plug workforce gaps because of a huge shortage of nurses, according to a new report. Support staff, such as healthcare assistants and nursing associates, have been used to shore up staffing numbers, said the Health Foundation charity. The NHS has relied upon overseas recruitment, but a lack of EU nurses because of Brexit means it is now taking more nurses from countries such as India and the Philippines. At present, there are almost 44,000 nursing vacancies across the NHS (12% of the nursing workforce), but this could hit 100,000 in a decade, the report said. The report said most changes to the skill mix – meaning the ratio of fully qualified to less qualified staff – are implemented well and led by evidence, but added: “It is important that quality and safety are at the forefront of any skill mix change.” Read full story Source: The Guardian, 28 November 2019- Posted
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Content ArticleThe Buurtzorg model of care, developed by a social enterprise in the Netherlands in 2006, involves small teams of nursing staff providing a range of personal, social and clinical care to people in their own homes in a particular neighbourhood. There’s an emphasis on one or two staff working with each individual and their informal carers to access all the resources available in their social networks and neighbourhood to support them to be more independent. The nursing teams have a flat management structure, working in ‘non-hierarchical self-managed' teams. This means they make all the clinical and operational decisions themselves. They can access support from a coach, whose focus is on enabling the team to learn to work constructively together, and a central back office.
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Content Article
Our son's final days: "It was like he didn't matter"
Patient Safety Learning posted an article in Patient stories
Mark Stuart spent five days in agony and died following a catalogue of failings by NHS staff. His parents say they have been battling for answers for four years. They tell their story to BBC News. -
Content Article
My experience in a coroner’s court – a nurse perspective
Anonymous posted an article in Florence in the Machine
This is the story of a nurse's experience when attending a coroner's court and how the Trust supported them through this difficult time.- Posted
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Nine in 10 NHS bosses say staffing crisis endangering patients
Patient Safety Learning posted a news article in News
Hospitals are so short of doctors and nurses that patients’ safety and quality of care are under threat, senior NHS leaders have warned in a dramatic intervention in the general election campaign Nine out of 10 hospital bosses in England fear understaffing across the service has become so severe that patients’ health could be damaged. In addition, almost six in 10 (58%) believe this winter will be the toughest yet for the service. The 131 chief executives, chairs and directors of NHS trusts in England expressed their serious concern about the deteriorating state of the service in a survey conducted by the NHS Confederation. The findings came days after the latest official figures showed that hospitals’ performance against key waiting times for A&E care, cancer treatment and planned operations had fallen to its worst ever level. However, many service chiefs told the confederation that delays will get even longer when the cold weather creates extra demand for care. “There is real concern among NHS leaders as winter approaches and this year looks particularly challenging,” said Niall Dickson, the chief executive of the confederation, which represents most NHS bodies, including hospital trusts, in England." “Health leaders are deeply concerned about its ability to cope with demand, despite frontline staff treating more patients than ever." Read full story Source: 19 November 2019 -
Content Article
Re-ACT Talks – child deterioration: human factors (March 2015)
Claire Cox posted an article in Paediatrics
Child deterioration: human factors is a presentation by Peter-Marc Fortune, Consultant Paediatric Intensivist, Associate Clinical Head, Royal Manchester Children’s Hospital.- Posted
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Content ArticleIn recent years, there has been an increasing focus on the role of safety culture in preventing incidents such as medication errors and falls. However, research and developments in safety culture has predominantly taken place in hospital settings, with relatively less attention given to establishing a safety culture in care homes. Despite safety culture being accepted as an important quality indicator across all health and social care settings, the understanding of culture within social care settings remains far less developed than within hospitals. It is therefore important that the existing evidence base is gathered and reviewed in order to understand safety culture in care homes.
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Content Article
A dropped instrument, washed in theatre and immediately reused: a story from a theatre nurse
Anonymous posted an article in By health and care staff
What happens if a surgeon accidentally drops an instrument on the floor, picks it up and reuses, without it going through a steriliser? Should this be allowed to happen? Well it did!- Posted
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Nurses' role in communication and patient safety
Swoo posted an article in Professionalising patient safety
In this paper published in the Journal of Nursing Care Quality, Nadzam discusses why effective communication is critical during the countless interactions that occur among healthcare workers on a daily basis.- Posted
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Content Article
A reflective account of the culture of fear
Anonymous posted an article in Bullying and fear
This is my story of how one bad experience can lead to another. We talk a lot about patients and their safety (quite rightly so) but very rarely do we hear about the healthcare professional who is going through turmoil and their mental health. This is my story. -
Content ArticleActive surveillance (AS) is an option in the management of men with low-stage, low-risk prostate cancer. These patients, who often require prolonged follow-up, can put a strain on outpatient resources. Nurses are ideally placed to develop advanced roles to help meet this increased demand—a model Martin et al. have utilised since 2014. The authors set about to comprehensively evaluate their nurse-led AS (NLAS) programme. The study found that nurse-led active surveillance is safe and effective. Patients and stakeholders alike held positive views of the programme.
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Content ArticleA 24/7 clinical tele-triage service for care homes in Wirral has resulted in an average 66% decrease in the number of NHS 111 calls and a 10% decrease in ambulance conveyances to A&E for care home residents. The service is delivered by all the area’s health and social care partners with funding support from the Innovation Agency. Care homes have been provided with iPads and secure nhs.net email addresses, and staff have been trained to take basic observations and equipped with blood pressure monitors, thermometers, urine dipsticks and oximeters.
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Content ArticleSam Goodhand is a Anaesthetic Registrar who I had the great pleasure in working with in Brighton University Hospitals NHS Trust. He produced these action/prompt cards for health professionals who attend and take part in RSI's. These are great to attach to your ID badge. This ensures you always have one at hand in those tricky situations.
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How NHS staff handle acute pressure in A&Es (June 2018)
Claire Cox posted an article in Stories from the front line
In Wales, like in England, the government has come under pressure over the poor performance of parts of the service. The Betsi Cadwaladr Health Board is the largest in Wales. It also has the worst A&E waiting times and has been in special measures for three years. Its hospital in Bangor, Ysbyty Gwynedd, serves 193,000 people, from tourists visting Snowdonia to the many retirees who live in North Wales. In this film, Saleyha Ahsan, looks at how the department tries to cope with unrelenting demand for patient space.- Posted
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