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Content ArticleThis 15-minute training video by the Parkinson's Excellence Network pulls together the key symptoms and issues that can impact on a person with Parkinson's and their care when admitted to a hospital ward. it aims to help ward staff understand the key issues when caring for people with Parkinson's.
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Content ArticleNHS chiefs and regulators have written to hospital bosses admitting winter could be so bad NHS staff may have to "depart from established procedures" to care for patients. Letter says regulators will take the challenging situations into context...
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Content ArticleTeamwork is critical in delivering quality medical care, and failures in team communication and coordination are substantial contributors to medical errors. This study in JAMA Internal Medicine aimed to determine the effectiveness of increased familiarity between medical resident doctors and nurses on team performance, psychological safety and communication. The authors found that increased familiarity between nurses and residents promoted rapid improvement of nursing perception of team relationships and, over time, led to higher team performance on complex cognitive tasks in medical simulations. They argue that medical systems should consider increasing team familiarity as a way to improve doctor-nursing teamwork and patient care.
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News Article
US nurse who called emergency services on own hospital speaks out
Patient Safety Learning posted a news article in News
A nurse in the USA who called emergency services in response to staffing issues at Silverdale, Washington-based St. Michael Medical Center spoke out about her decision and the events leading up to the call. Kelsay Irby has been an emergency department charge nurse at the hospital for less than a year. On the 8 October, the night Ms Irby called emergency services for help, the ED was operating at less than 50% of its ideal staffing grid. Among the nearly 50 people in the hospital's waiting room were patients with cardiac or respiratory issues and children with high fevers — "all patients that made us very nervous to have in the lobby, unmonitored for extended periods of time," Ms. Irby said. The ED had one first-look nurse on the clock who was trying to keep up with patients checking in and could not supervise those waiting for care. After exhausting all other available options, Ms. Irby said she called emergency services' nonemergent line and asked the dispatcher if any crews were available to help ED staff. Ms. Irby was connected with a local fire chief who sent an emergency services crew to the hospital to monitor patients in the lobby, retake their vitals and do roll calls to ensure the ED team's patient list was accurate. Ms. Irby's actions made national headlines in the US as a dramatic example of the staffing issues hospitals nationwide are facing. "I didn’t recognize the impact of what I was doing that night," Ms. Irby wrote. "I was simply working my way down the list of possible sources of help for my coworkers and ultimately our patients." Read full story Source: Becker's Hospital Review, 8 November 2022 -
Content ArticleDisruptive behaviours have been shown to have a significant negative impact on staff collaboration and clinical outcomes of patient care. Disruptive episodes are more likely to occur in high stress areas such as the Emergency Department (ED). Having the structure, process, and skills in place to effectively address this issue will lower the likelihood of preventable adverse events. This study assessed the status of disruptive behaviours and staff relationships in the ED setting. It concluded that disruptive behaviours in the ED have a significant impact on team dynamics, communication efficiency, information flow, and task accountability, all of which can adversely impact patient care. EDs need to recognise the significance of disruptive behaviours and implement appropriate policies and protocols to address this issue.
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News Article
Nurses’ strike: what’s at stake and how will it affect patients?
Patient Safety Learning posted a news article in News
Ministers have offered about 1 million NHS staff in England – everyone bar doctors and dentists – a pay rise of at least £1,400 for 2022-23. That represents a rise of between 4% and 5% for staff covered by the longstanding Agenda for Change negotiating framework. Health unions have rejected the £1,400. They want a rise that would at least match inflation – which is currently 10.1% – while the Royal College of Nursing (RCN) is seeking inflation plus 5%. Without inflation-proof rises, staff will suffer a real-terms cut in their take-home pay, unions say. “Our members will no longer tolerate a financial knife-edge at home and a raw deal at work”, said the RCN general secretary, Pat Cullen. Sara Gorton, head of health at Unison, added: “Inflation has already wiped out this year’s 72p-an-hour increase. The government must put pay right to spare the NHS, its staff and all those relying on its care from a dispute no one wants to see.” The RCN has balloted its members across the UK. The results, published on Wednesday, show that a majority of nurses in most but not all hospitals and other NHS services across the four home nations have rejected the government’s offer and decided to strike in pursuit of better pay. Wes Streeting, the shadow health secretary, has condemned as “unacceptable” the fact that strikes will disrupt services and affect patients’ care. While he has not criticised nurses or any health union, he has blamed ministers for not negotiating with the RCN to try to avert strike action. “I’m concerned, I think lots of people are concerned about the impact of disruption”, he told LBC’s Tonight with Andrew Marr on Monday. “That’s still a disruption to patients, which I think is unacceptable.” If he were the health secretary he would see patients as his “first and foremost” responsibility, he said. “That’s why I think the government have to get a grip on this and get the unions around the table because there is a deal there to be done.” Read full story Source: The Guardian, 9 November 2022 -
Content ArticleRacism is unacceptable and it has no place in health and care. But we know that it exists and that the impact on staff can be devastating. All registered professionals have responsibility under the Nursing and Midwifery Council (NMC) Code to challenge discriminatory behaviour, creating an environment where people are treated as individuals and with dignity and respect. This resource is firmly rooted in our professional Code and it is designed to support nurses, midwives and nursing associates, providing advice on the action you can take if you witness or experience racism. It also supports those in leadership roles to be inclusive leaders. This document provides practical examples of how, as nursing and midwifery professionals, you can recognise, and challenge racial discrimination, harassment, and abuse. It also highlights other useful resources and training materials that will support you to care with confidence. This document is a resource for individuals at all levels. This resource does not replace existing NHS England policies and procedures for speaking up and managing racism. It is a resource to support best practice in line with organisational policies and procedures.
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News Article
Nurses set to hold biggest-ever strike
Patient Safety Learning posted a news article in News
The biggest ever strike by nurses looks set to go ahead. The Royal College of Nursing is due to unveil the results of its ballot, which ended last week, in the next few days. The final results are being counted but RCN sources say a large majority of nurses have voted in favour of action in a dispute over pay. The RCN had recommended to its 300,000 members that they walk out. If strikes take place, they would affect non-urgent but not emergency care. The vote has involved a series of individual workplace-based ballots across the UK and if nurses do not back action at a local level it is possible some hospitals and services will not be involved. The government had appealed to nurses to "carefully consider" the impact on patients. But Pat Cullen, RCN general secretary and chief executive, said: "Huge numbers of staff - both experienced and newer recruits - are deciding they cannot see a future in a nursing profession that is not valued nor treated fairly. She added: "Our strike action will be as much for patients as it is for nurses. We have their support in doing this." Cabinet minister Oliver Dowden said the government had "well-oiled contingencies in place" for dealing with any strike action by nurses. Speaking on Sky News, Mr Dowden said essential services would be prioritised, "but of course there would be an impact as a result of a strike like that". Read full story Source: BBC News, 6 November 2022 -
Content ArticleIn 1999, the pivotal report “To Err is Human” by the Institute of Medicine led to sweeping changes in healthcare. This report outlined how blaming individuals does not change the underlying factors that contribute to medical errors. It also stated that blaming an individual does little to make the system safer – or prevent someone else from similar errors. It is unusual for a nurse to be charged criminally, when there is no intent to harm a patient. However, the recent trial in America of nurse RaDonda Vaught could set a precedent for future medical errors to be treated as criminal cases. The case may ensure that for every step that has been taken forward in patient safety, we have now taken two steps backwards. This article from Human Factors 101 looks at the case of RaDonda Vaught, the criminal trial and conviction, and discusses the impact this will have on healthcare.
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Content Article
Blog - Long Covid: A catalogue of shame (2 November 2022)
Patient-Safety-Learning posted an article in Blogs
In this blog, Roger Kline, Research Fellow at Middlesex University Business School, highlights the lack of support from the Government and NHS that healthcare staff with Long Covid face. He looks at the impact of the Government’s decision to scrap extended sick pay for NHS staff with Long Covid and argues that healthcare workers deserve better support. The blog includes accounts from 31 NHS nurses and midwives with Long Covid; some are having to use annual leave as they cannot work their full hours and some have been threatened with redundancy. Others describe their experiences of phased return to work and applying for the NHS Injury Allowance or ill health early retirement. -
Content Article
Blog - Is human error a crime? (2 November 2022)
Patient-Safety-Learning posted an article in Legal matters
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. -
Content ArticleThis webinar hosted by GovConnect features three presentations about digital wound management:Digital data and information (National Wound Care Strategy Programme)York Community Services approach to engagement of staff in digital changeDigitising wound care in the community: The challenges and successes (Livewell Southwest)
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Content ArticleThis analysis by The Health Foundation looks at NHS staff pay over the ten years to 2021. During those 10 years, there was very little change in overall average basic pay for NHS staff, after accounting for inflation. However, the analysis found considerable variation in how pay has changed across different NHS staff groups over the same period. After accounting for inflation, pay declines are particularly visible for nurses and health visitors, midwives, and scientific, therapeutic and technical staff.
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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. Kathy tells us about the importance of breaking down barriers to share patient safety tools, and talks about changes she has implemented to make surgery safer. -
News Article
Nurses are working the equivalent of one day a week for nothing, research says
Patient Safety Learning posted a news article in News
Nurses are working the equivalent of one day a week for nothing, according to a study. Researchers from London Economics were commissioned by the Royal College of Nursing (RCN) to look at pay in England, Wales, Scotland and Northern Ireland since 2010. They found that the salary of an experienced nurse had fallen by 20% in real terms, based on a five-day week. Experienced nurses in England, Wales, and Northern Ireland would need a nominal pay rise of 45% by 2024-25 just to return their salaries to levels seen in 2010-11 in real terms, the research said. And such a pay rise would actually help the NHS save money in the long term, as it would be cheaper than hiring staff from overseas, according to the study. Dr Gavan Conlon, who oversaw the research, said that bringing staff in from overseas costs approximately £16,900 more annually than retaining a nurse, while using agency workers costs around £21,300 more per year. He said that about 32,000 nurses leave the NHS every year, many due to the failure of their pay to keep up with the rising cost of living. The RCN is balloting its 300,000 members for strike action, calling for higher pay and an effort by government to fill the hundreds of thousands of nursing vacancies across the country. Read full story Source: Sky News, 28 October 2022 -
News ArticleThe NHS is launching an effort to recruit tens of thousands of nurses to help fill the record number of vacancies that low pay, Covid and heavy workloads have created across the service. A multimedia blitz will try to raise nursing’s profile as a worthwhile career by featuring patients who benefited from nurses’ skills and dedication. NHS England’s “We are the NHS” campaign will use radio, social media and cinema advertisements to portray nursing as a varied and fulfilling role that can change people’s lives. It comes soon after NHS figures showed that the number of empty posts in nursing across hospitals, mental health, community care and other services had reached 46,828 – the largest number ever. That means that more than one in 10 nursing roles (11.8%) are unfilled across the service overall. While the NHS is short of almost every type of staff, service chiefs say the acute lack of nurses is a key reason why so many patients are waiting so long for A&E, cancer treatment and other care. Read full story Source: The Guardian, 24 October 2022
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Content Article
SAPHNA - Eating disorder toolkit (October 2022)
Patient-Safety-Learning posted an article in Eating disorders
This toolkit has been co-produced by the School and Public Health Nurses Association (SAPHNA) with school nursing services, mental health campaigners, eating disorder experts, education colleagues and young people with lived-experience of eating disorders. It is aimed at qualified, trained and skilled nurses who have access to robust supervision. The toolkit is free of charge, but you will need to enter your details in order to receive a PDF copy by email. -
Content ArticleDespite the constant pressures and chronic shortages, the number of nurses leaving the NHS had flatlined over recent years. Now our analysis of new data shows there has been a large increase in nurses leaving the NHS, and that this trend is being driven by younger workers. The last year's data (June 2021 - June 2022) saw a 25% increase in the number of NHS nurses leaving their role, with an additional 7,000 leaving compared to the previous year. The largest increase in numbers leaving was seen among the younger nurses, two thirds of leavers were under 45 years of age. In this article, Jonathon Holmes explores why there is a sudden increase in vacancies.
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News Article
Lucy Letby was ‘constant malevolent’ presence on neonatal ward, court hears
Patient Safety Learning posted a news article in News
A nurse murdered seven babies and attempted to kill 10 others by poisoning them on a hospital neonatal unit where she was a “constant malevolent presence”, a court has heard. Lucy Letby, 32, fatally injected newborns with insulin, air or milk during night shifts when she knew their parents would not be present, a jury was told. One of the babies was just 24 hours old when Letby allegedly injected him with air, killing him just 90 minutes after she came on shift. The nurse tried to kill his twin sister the next day, it is alleged. The court was told that Letby, who was trained to care for the most seriously ill babies, developed an “unusual interest” in the parents of some of her 17 alleged victims and in some cases tracked them on Facebook. Jurors were told that she was the only “common denominator” that connected the deaths of seven infants and the “catastrophic” collapses of 10 others at the Countess of Chester hospital between June 2015 and June 2016. She allegedly tried to kill some babies more than once – in one case, three times – using various methods. Nick Johnson KC, prosecuting, told the jury: “We say the collapses and deaths of the 17 children named on the indictment were not normally occurring tragedies. They were all the work, we say, of the woman in the dock who we say was a constant malevolent presence when things took a turn for the worse for these children.” Read full story Source: The Guardian, 10 October 2022 -
News Article
Bullying, misogyny and sexual culture at Royal College of Nursing, inquiry finds
Patient Safety Learning posted a news article in News
A damning inquiry into the Royal College of Nursing, the world’s biggest nurses’ union, has exposed bullying, misogyny and a sexual culture where women are at risk of “alcohol and power-related exploitation”. A 77-page internal report by Bruce Carr KC, leaked to the Guardian, lays bare how the RCN’s senior leadership has been “riddled with division, dysfunction and distrust” and condemns the male-dominated governing body, known as council, as “not fit for purpose”. Grave concerns are also raised about the RCN’s annual conference, known as congress, where Carr says an “inappropriate sexual culture” warrants further urgent investigation “to identify the extent to which [it] has actually resulted in exploitation of the vulnerable”. The eminent barrister reports that there is evidence to support the “impression” that senior individuals have been seeking to take sexual advantage of subordinates and “engaging in unwanted sexual behaviours”. He calls on those whose conduct is cited in the report, whom he does not name, to consider their positions in the light of testimony of groping, humiliation of female staff members and a refusal of those in positions of responsibility to reflect on the letters of resignation from women on the council, who have complained of “gaslighting and microaggressions”. Read full story Source: The Guardian, 10 October 2022- Posted
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Content ArticleThis article published by the Royal College of Nursing (RCN) aims to explain how health services in the UK protect patient safety during industrial action by nurses. It describes the principle of derogations, an exemption from taking part in strike action given to particular RCN members or services. Any RCN industrial action must follow the life-preserving care model. This exempts: emergency intervention for the preservation of life or the prevention of permanent disability. care required for therapeutic services without which life would be jeopardised or permanent disability would occur. urgent diagnostic procedures and assessment required to obtain information on potentially life-threatening conditions or conditions that could potentially lead to permanent disability. The article goes on to explain the process by which derogations are granted, and talks about balancing the need to maximise the impact of the strike while keeping patients safe.
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News Article
Four of UK’s top countries for nurse recruitment on WHO ‘red list’
Patient Safety Learning posted a news article in News
Three of the top seven countries from which the UK recruits overseas nurses are on the World Health Organization’s (WHO) ‘red list’ where active recruitment should not be used. Nigeria, Ghana and Nepal are the third, fifth and seventh highest respectively in the list of countries that provided the largest number of overseas staff joining the Nursing and Midwifery Council (NMC) register between April 2021 and March 2022. All three were on the red list during this period, which is derived by the WHO and identifies countries facing the most pressing health workforce shortages, meaning they should not be targeted for systematic recruitment by international employers. Nepal has since moved off the red list following of a government-to-government agreement between the Department of Health and Social Care (DHSC) and the Government of Nepal in the summer. But the agreement has raised concerns among health leaders, including those reported in The Observer which suggested Nepali recruitment agencies carried out abusive practices, such as charging illegal fees. Royal College of Nursing general secretary and chief executive Pat Cullen said the “overreliance” on international recruitment showed that the government had “no grip on the nursing workforce crisis”. “It’s deeply concerning that four ‘red list’ countries appear amongst the top 20 most recruited from countries,” she said. “This approach is unsustainable. Ministers must invest in growing the domestic nursing workforce. “They need to give nursing staff the pay rise they deserve to retain experienced nurses and attract new people to the profession.” Read full story Source: Nursing Times, 4 October 2022 -
News ArticleNurses will start voting on Thursday on whether to strike over pay amid warnings that record numbers are leaving the profession. Around 300,000 members of the Royal College of Nursing (RCN) are being asked if they want to mount a campaign of industrial action in the union’s first UK-wide ballot. The RCN said new analysis by London Economics to coincide with the ballot launch showed that pay for nurses has declined at twice the rate of the private sector in the last decade. It is the first time in its 106-year history that the RCN has balloted members across the UK on strike action and it is urging them to vote in favour. RCN general secretary Pat Cullen said in a message to those being balloted: “This is a once-in-a-generation chance to improve your pay and combat the staff shortages that put patients at risk. “Governments have repeatedly neglected the NHS and the value of nursing. We can change this if together we say ‘enough is enough’. “Record numbers are feeling no alternative but to quit and patients pay a heavy price. We are doing this for them too." Read full story Source: The Independent, 6 October 2022
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Content Article
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In this blog, Lotty Tizzard, Patient Safety Learning's Content and Engagement Manager, writes about a recent experience taking her son to a local walk-in centre. She describes the negative response she received when asking questions about her son's treatment, and considers the potentially dangerous consequences of patients and parents being disempowered to fully understand and contribute to their own, or their children's, care. -
Content ArticleThis longitudinal study in BMJ Quality & Safety aimed to examine the impact of nursing team size and composition on inpatient hospital mortality. The authors found that registered nurse staffing and seniority levels were associated with patient mortality. The lack of association for healthcare support workers and agency nurses indicates they are not effective substitutes for registered nurses who regularly work on the ward.
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