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Content ArticleThis Newsnight report looks at the case of Rebecca Wight, an advanced nurse practitioner who raised concerns about a colleague at at Manchester’s Christie cancer hospital and felt her treatment by Trust management as a whistleblower was poor. She is now taking The Christie to an employment tribunal for constructive dismissal. The video also features an interview with Helené Donnelly, a nurse who tried to raise the alarm more than 100 times at Mid Staffs and went on to be a key witness in the subsequent Francis inquiry. She calls for failing NHS managers to be struck off, highlighting that a decade on from one of the worst failings in NHS history, those raising concerns were still not being listened to.
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Content ArticleThe nurse-to-patient ratio represents the number of patients a registered nurse cares for during a shift. Most hospitals have guidelines to ensure safe staffing ratios, but staffing shortages have led to heavier nursing workloads. This article outlines which US states have laws and regulations in place for safe staffing ratios.
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Content ArticleThe Patient Safety Network (PSNet) produces primers which provide guidance on key topics in patient safety through context, epidemiology and relevant PSNet content. This primer focuses on nurse-related medication administration errors and highlights that despite error reduction efforts through implementing new technologies and streamlining processes, medication administration errors remain prevalent. It covers the background to the issue, low-tech and high-tech prevention strategies and the current context.
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Content ArticleMost US healthcare organisations use staffing guidelines to decide a nurse's patient load on a given shift, but current staffing shortages are pushing nurse-to-patient ratios to the limit. In this article for Nurse Journal, registered nurse Alexa Davidson asks whether laws and regulations could prevent nursing workloads from getting out of control. She argues that mandated staffing ratios are a proven way to ensure patient safety. She describes the situation in Massachusetts and California, the two US states where laws have been passed mandating nurse-to-patient ratios, and outlines the implications of introducing ratios for nurses and patients.
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News Article
Steve Barclay names Lucy Letby inquiry lead amid patient safety address
Patient Safety Learning posted a news article in News
Health secretary, Steve Barclay, has named Lady Justice Thirlwall as the chair of the independent inquiry into the crimes committed by former Countess of Chester Hospital nurse, Lucy Letby. The inquiry was given statutory powers last week and will be led by one of the country’s most senior judges, who currently sits on the Court of Appeal. The announcement came during Barclay’s speech in the House of Commons, where he also announced that the chair of the Essex mental health inquiry will be Baroness Lampard, who investigated the crimes of Jimmy Saville in a similar inquiry led by the Department of Health and Social Care (DHSC). The rest of the health secretary’s address centred around patient safety and what the government has done, is doing and will do. Barclay drew attention to the appointment of Dr Aidan Fowler as NHS England’s first ever national director of patient safety in 2018, and thus the following patient safety strategy in 2019. Read full story Source: National Health Executive, 4 September 2023 -
Content ArticleThis is an oral statement given to the House of Commons by the Secretary of State for Health and Social Care, Steve Barclay MP, to update on the Lucy Letby statutory inquiry.
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News ArticleThe inquiry into how nurse Lucy Letby was able to murder seven babies will now have greater powers to compel witnesses to give evidence. In a significant move, ministers upgraded the independent inquiry after criticism from families of the victims that it did not go far enough. The inquiry, ordered after Letby was found guilty this month, was not initially given full statutory powers. Health Secretary Steve Barclay said he had listened to the families. He said he had decided a statutory inquiry led by a judge was the best way forward and "respects the wishes" of the families. Mr Barclay said the key advantage was the power of compulsion. "My priority is to ensure the families get the answers they deserve and people are held to account where they need to be," he added. He said an announcement about who would chair the inquiry would be made in the coming days - ministers have already said it will be a judge. Richard Scorer, a lawyer who is representing two of the families, welcomed the government's announcement. "It is essential that the chair has the powers to compel witnesses to give evidence under oath, and to force disclosure of documents. Without these powers, the inquiry would have been ineffectual and our clients would have been deprived of the answers they need and deserve," he said. Read full story Source: BBC News, 30 August 2023
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News Article
Nurses caring ‘for too many patients’ as vacancy rates rise again
Patient Safety Learning posted a news article in News
Around one in ten NHS nursing jobs remain unfilled leaving already stretched service struggling to cope. The number of unfilled NHS nursing jobs in England has risen again after falling slightly earlier this year. Between March and June of this year, the number of vacant nursing positions across the NHS in England increased by 3,243 taking the total to a staggering 43,339. With the number of applications to study nursing also falling by a massive 13,380 in just two years, experts admit they are concerned about how the NHS is going to cope. In real terms, the figures mean around one in ten NHS nursing jobs remain unfilled. The Royal College of Nursing (RCN) has warned the high vacancy rate will leave the health service “underprepared” for winter. Read full story Source: Nursing Notes, 25 August 2023 -
Content ArticleIn this letter, Rob Behrens, the Parliamentary and Health Service Ombudsman, calls on the Secretary of State for Health and Social Care, Steve Barclay MP, to prioritise improving patient safety in the wake of the Lucy Letby trial.
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News ArticleA paediatric nurse who called in to LBC news during a discussion on Lucy Letby, says she can see how Letby was able to get away with her crimes as she herself was 'blacklisted' when she reported a colleague. Watch the video Source: LBC News, 19 August 2023
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Content Article
On 18 August 2023, Lucy Letby was found guilty of murdering seven babies and convicted of trying to kill six other infants at the Countess of Chester Hospital. Looking ahead to the forthcoming independent inquiry into this case, Patient Safety Learning, reflecting on the inquiries of the past, sets out some key patient safety themes and issues that should be considered as part of this.- Posted
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Content ArticleWe now know that Lucy Letby is a murderer, responsible for the deaths of seven babies and the attempted murders of six more. But as unimaginable as her crimes were, this verdict raises as many questions as it answers. Letby was not working in a vacuum. Could the killings at the Countess of Chester Hospital NHS Foundation Trust have been stopped sooner? Did organisational failures cost the lives of babies who could have been protected? The timeline gives us a clue, writes Minh Alexander, a retired consultant psychiatrist and NHS whistleblower, in this Guardian opinion piece. In June 2016, Letby’s hospital trust commissioned a review of neonatal care by the Royal College of Paediatrics and Child Health after “concerns about increasing neonatal mortality”, which oddly did not feature a case-note review. This prevented detailed examination of the deaths, which should have been the prime objective. The college reported “extremely positive relationships” among staff but “remote” relationships with executives. Astonishingly, the college’s report seemingly did not explicitly acknowledge a possibility of deliberate harm. Nevertheless, the college raised concern that not all deaths were followed by postmortem investigations – as they should have been, according to guidelines – and that where postmortems did take place, they did not include systematic blood tests and toxicology. It noted concerns from obstetrics staff about four unexpected deaths. In the coming days, there will be many questions. Why did it take so long for the hospital to refer matters to the police? Were doctors pressured not to persist with their concerns about Letby? How many trust board members knew there was a possibility of deliberate harm but failed to act?
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News Article
Revealed: the files that show how Lucy Letby was treated as a victim
Patient Safety Learning posted a news article in News
Lucy Letby sat with her parents in a meeting with senior managers at the Countess of Chester Hospital, where she worked, waiting patiently for an apology. She had prepared a statement that was read out by her parents to Tony Chambers, the hospital’s chief executive, about being bullied and victimised on the neonatal unit. It was December 22, 2016, and for the previous 18 months, two doctors on the unit had been trying to find an answer for a series of mysterious deaths of babies. Their detective work had led them to a single common denominator: Letby. The neonatal nurse had been on shift for each of the incidents. Rumours of a killer on the ward had spread and Letby had complained about the doctors and their finger-pointing, claiming she was being wrongly blamed. Chambers, who had trained as a nurse, was convinced by Letby’s account, and in front of her parents, John and Susan, offered sincere apologies on behalf of the hospital trust. The doctors in question would be “dealt with’’. Except the doctors were right. By that point Letby had secretly murdered seven babies and tried to kill six more, one of them twice. An investigation by The Sunday Times, based on a cache of internal documents, reveals in detail how the hospital delayed calling the police for months and that senior management, including the board, sided with Letby against doctors after commissioning perfunctory investigations. Read full story (paywalled) Source: The Times, 19 August 2023 -
Content ArticleBabies would have survived if hospital executives had acted earlier on concerns about the nurse Lucy Letby, a senior doctor who raised the alarm has said. In an exclusive Guardian interview, Dr Stephen Brearey accused the Countess of Chester hospital trust of being “negligent” and failing to properly address concerns he and other doctors raised about Letby as she carried out her killings. Brearey was the first to alert a hospital executive to the fact that Letby was present at unusual deaths and collapses of babies in June 2015. The paediatrician and his consultant colleagues raised concerns multiple times over months before Letby, then 26, was finally removed from the neonatal unit in July 2016. The police were contacted almost a year later, in May 2017. Speaking publicly for the first time, Brearey told the Guardian that executives should have contacted the police in February 2016 when he escalated concerns about Letby and asked for an urgent meeting.
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News ArticleNurse Lucy Letby has been found guilty of murdering seven babies on a neonatal unit, making her the UK's most prolific child serial killer in modern times. The 33-year-old has also been convicted of trying to kill six other infants at the Countess of Chester Hospital between June 2015 and June 2016. Letby deliberately injected babies with air, force fed others milk and poisoned two of the infants with insulin. Commenting on the verdict, Parliamentary and Health Service Ombudsman Rob Behrens said: “We know that, in general, people work in the health service because they want to help and that when things go wrong it is not intentional. At the same time, and too often we see the commitment to public safety in the NHS undone by a defensive leadership culture across the NHS. “The Lucy Letby story is different and almost without parallel, because it reveals an intent to harm by one individual. As such, it is one of the darkest crimes ever committed in our health service. Our first thoughts are with the families of the children who died. “However, we also heard throughout the trial, evidence from clinicians that they repeatedly raised concerns and called for action. It seems that nobody listened and nothing happened. More babies were harmed and more babies were killed. Those who lost their children deserve to know whether Letby could have been stopped and how it was that doctors were not listened to and their concerns not addressed for so long. Patients and staff alike deserve an NHS that values accountability, transparency, and a willingness to learn. “Good leadership always listens, especially when it’s about patient safety. Poor leadership makes it difficult for people to raise concerns when things go wrong, even though complaints are vital for patient safety and to stop mistakes being repeated. We need to see significant improvements to culture and leadership across the NHS so that the voices of staff and patients can be heard, both with regard to everyday pressures and mistakes and, very exceptionally, when there are warnings of real evil.”
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News ArticleThe exodus of healthcare workers from Nigeria, Ghana and Zimbabwe continues, despite the WHO red list and a range of laws to keep them at home. It took nearly three hours of queueing in Ikorodu general hospital in Lagos state, Nigeria, before Hadijat Hassan, a retired civil servant, could see a nurse. The 66-year-old has attended the clinic for health checks since being diagnosed with diabetes nearly 10 years ago. But since May, she says, the delays, often while suffering from excruciating pain in her legs, are worse than ever. “You can get there [the hospital] and meet about 50 people waiting to be attended to,” Hassan says. “They said all of their nurses and doctors have been leaving for abroad. Just a few are left.” In Nigeria, there is one doctor for every 5,000 patients, whereas the average in developed countries is one doctor for about every 254 people. A hospital official said the Ikorodu management get resignation notices from nurses and doctors almost every month. “Many leave for the US, Canada, UK and, most recently, Australia,” says the official, who asked to remain anonymous. The National Association of Nigeria Nurses and Midwives has reported there is now a ratio of one nurse to 1,160 patients. Its president, Michael Nnachi, said that more than 75,000 nurses had left Nigeria since 2017. “If you look at the conditions of service of health workers generally, you’ll see the difficult challenges complicated by the current economic realities,” he said, adding that rising inflation has compounded the problems. The World Health Organization predicts a worldwide shortage of 10 million health and care workers by 2030 – mostly in low-income countries, where people are leaving for opportunities abroad. This is despite the WHO’s introduction of a safeguard list to stop rich countries poaching from poorer countries with staff shortages. The “red list”, launched in 2020 with plans to update it every three years, includes Nigeria, Ghana, Zimbabwe and 34 other African countries. Yet the UK’s nursing regulator, the Nursing and Midwifery Council, says more than 7,000 Nigerian nurses relocated to the UK between 2021 and 2022. Data from the Ghana Registered Nurses and Midwives Association shows that nearly 4,000 nurses left the country in 2022. In Zimbabwe, more than 4,000 health workers, including 2,600 nurses, left in 2021 and 2022, the government said. The WHO has no powers to prohibit recruitment of doctors from countries on the list, but recommends “government-to-government health worker migration agreements be informed by health labour market analysis and the adoption of measures to ensure adequate supply of health workers in the source countries”. Read the full article here
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Content Article
Friends of African Nursing
Patient_Safety_Learning posted an article in International patient safety
Friends of African Nursing (FoAN) was started as an organisation by Lesley and Kate, who had family contacts in Africa and due to their professional nursing backgrounds, had taken an interest in the health systems in African countries which they had visited whilst on holiday. It was apparent to them both separately, that the privilege of the healthcare environment in which they both worked in the UK - which offered continuing education, ready access to journals, speciality (perioperative) education and a professional association (in which they were closely involved, at home) as a ready made network was indeed a huge privilege which should be shared. Their primary interest is in supporting nurses and nursing in Africa. FOAN specialises in supporting nurses who work in Operating Theatres particularly and work with the surgical teams. Surgery is often high risk in Africa and their key interest is to update practice, educate on risk management and patient safety as well as infection prevention measures. They have also delivered programmes for ward leaders and other bespoke courses. Visit the FoAN website to find out more via the link below. -
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. Judi talks to us about her experience of managing patient safety for a large healthcare provider, the importance of ensuring implemented safety standards are sustained and how crucial it is to professionalise patient safety. -
Content ArticleThe UK government’s long-awaited NHS workforce plan for England outlines a vision to increase the number of nursing staff in England over the next 15 years, with a promise of 170,000 more nurses by 2036/37. This article from the Royal College of Nursing (RCN) outlines how the detail of the plan will affect nurses. It argues that the plan fails to acknowledge the financial investment needed if its objectives are to be fulfilled, and expresses the RCN's concern that it does not address financial support for student nurses.
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Content Article
This is part of our series of Patient Safety Spotlight interviews, where we talk to different people about their role and what motivates them to make health and social care safer. Martin talks to us about the role of Professional Nurse Advocates (PNAs) in improving patient safety through restorative clinical supervision for nurses. He also talks about the need to recognise the close relationship between staff safety and patient safety, and the impact that long waiting lists and limited NHS capacity are currently having. -
News ArticleA nurse-led trial has found that a new electronic tool could reduce the number of preventable injuries and deaths caused by wrongly inserting nasogastric tubes. The study, led by Tracy Earley, a consultant nutrition nurse at Royal Preston Hospital, tested a new fibre-optic device which can tell clinicians definitively if a nasogastric tube – which is inserted through the nose and delivers food, hydration and medicine into the stomach – has been placed correctly. Currently, to check if nasogastric tubes – also referred to as NG tubes – are in the right place, nurses have to extract bodily fluid from the patient through the tube. Clinicians then test this fluid on a pH strip to judge whether the placement is correct. Studies show that interpreting the pH level results in mistakes 12-30% of the time, and that in 46% of cases nurses are unable to draw aspirate at all. This means patients have to undergo x-rays, leaving them without nutrition or treatment for longer. The study tested a device called NGPod, which uses a fibre-optic sensor to retrieve the pH reading from the tip of the NG tube leading to a definitive 'yes' or 'no' result in terms of whether it has been placed correctly – removing the need for aspirate or interpretation from the health professional. It found that the device was as accurate as pH strip testing, and removed all of the risks associated with making subjective pH strip judgements. Read full story Source: Nursing Times, 18 July 2023
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Content ArticleThe presentation was held following the inaugural William Rathbone X Lecture, given by Professor Alison Leary, who spoke on the highly topical subject, ‘Thinking differently about nursing workforce challenges.’ The presentation can be watched from The Queen's Nursing Institute website.
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Content Article
Mandy Anderton is a Clinical Nurse specialising in learning disability and a hub Topic Leader. In this new blog, Mandy explains how they are using shared decision making and reasonable adjustments to implement a new care pathway, where patients with a learning disability needing to undergo a medical investigation can receive deep sedation within their own home. Working with patients, carers, relatives, anaesthetists and others, the aim is to improve access to important medical investigations with minimal distress, where other avenues have been exhausted. -
Event
Nursing Live
Patient Safety Learning posted an event in Community Calendar
The first event of its kind in the UK, Nursing Live will bring thousands of nurses together to enjoy a packed day of high quality professional development, peer-to-peer collaboration, interactive activities, and much more. Featuring over 100 presentations, demonstrations and masterclasses – together with special zones focused on the very latest clinical and technological advances in all aspects of healthcare – Nursing Live will support your CPD progression, develop your skills, and inform your practice. The event will also give you access to a wide range of self-care guidance and lifestyle resources designed specifically for nurses. This means you’ll get the chance to enhance your career, and boost your personal well-being, all under one roof. Register -
Content ArticleThis study looked at nursing within the UK and The Netherlands' health sectors, which are both highly regulated with policies to increase inclusiveness. It aimed to investigate the interplay between employment conditions and policy measures at sectoral level, in order to identify how these both facilitate and limit employment participation for disabled workers.
