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Content ArticleThere is evidence that certain subgroups of the population have a higher risk of developing dementia than others. Aside from the most important risk factor—age,—other risk factors include ethnicity, sex, learning disability and socio-economic status. This report by the UK Dementia Research Institute (UK DRI) details the impact of scientific research on health inequalities for people affected by dementia. In order to make sure dementia diagnosis and treatments are effective for everyone, we need to understand how and why different groups are affected differently, so that we can target interventions where they are most needed and maximise their benefit. The report was produced by leading dementia scientists from the UK DRI who are taking action to reduce health inequalities through their own research. This includes: Researching “blood biomarkers” to pave the way for a blood test to diagnose Alzheimer’s disease. Ensuring both male and female mice are used equally in animal research so that findings can be applied to the whole population. This is policy across the UK DRI. Broadening understanding of the implications of ethnicity on risk of Alzheimer’s disease through genetic studies. Working to make clinical trials more accessible to all. Pioneering accessible, scalable, and affordable new therapies. Investigating rarer forms of dementia to plug the knowledge gap and support people living with these diseases. Addressing the environmental and lifestyle factors that impact brain health to better understand the link between socio-economic status and dementia risk.
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Content Article
This year, the World Health Organisation’s annual World Patient Safety Day on 17 September 2022 will focus on medication safety, promoting safe medication practices to prevent medication errors and reducing medication-related harm. Patient Safety Learning has pulled together some useful resources from the hub about different aspects of medication safety - here we list six top Learn articles about medication safety in social care. -
Content ArticleThese resource lists compiled by US insurance company MedPro Group, highlight a number of expert and evidence-based sources that can be used to increase awareness of safety issues, identify areas of risk and determine mitigation strategies. They cover a wide range of healthcare safety topics: Advanced practice providers Anaesthesia and surgery Artificial Intelligence Bed safety and entrapment in senior care Behavioural health Behavioural health in senior care Burnout in healthcare Culture of safety Cybersecurity Disclosure of unanticipated outcomes Disruptive behaviour Elder abuse Electronic Health Records Emergency medical Treatment and Labour Act Emergency preparedness and response Emergency preparedness and response in senior care organisations Ergonomics and safe patient handling Falls and fall risk in older adults Handoffs and care transitions Health equity and social determinants of health Health literacy and cultural competence Healthcare-associated infections Healthcare compliance HIPAA Human trafficking and trauma-informed care Infection prevention and control in ambulatory care settings Infection prevention and control in dentistry Infection prevention and control in senior care organisations Informed consent LGBT+-inclusive care Maternal morbidity and mortality Medical marijuana Medication safety during care transitions Obstetrics and gynaecology Opioid prescribing and pain management Patient engagement Pressure injuries in older adults Sepsis Social media in healthcare Staff shortages and workforce issues Suicide screening in primary care Telehealth/telemedicine Violence prevention in home healthcare Violence prevention in the Emergency Department Wrong-site procedures
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Content ArticleIssues with medication management and errors in medication administration are major threats to patient safety. This article for the US Agency for Healthcare Research and Quality (AHRQ) Patient Safety Network takes a look at the AHRQ's current areas of focus for medication safety. The authors look at evidence-based solutions to improve medication safety in three areas: High-risk medication use and polypharmacy in older adults Reducing opioid overprescribing, increasing naloxone access and use and other interventions for opioid medication safety Nursing-sensitive medication safety The article also explores future research directions in medication safety and highlights that these will advance patient safety overall.
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News Article
We need to find alternatives to 999 for care homes and falls
Patient Safety Learning posted a news article in News
The NHS needs to do more to support care homes and people who have fallen with alternatives to ambulance calls and hospital admissions, the NHS England chief executive has said. Speaking at the Ambulance Leadership Forum, Amanda Pritchard acknowledged this winter would be a difficult one for the health service, saying: “The scale of the current and potential challenge mean that we do need to continue to look further for what else we can do… We need to pull out all the stops to make sure that they [patients] get that treatment as safely as possible and as quickly as possible.” She added one area of focus should be making sure certain patient groups can access other – more appropriate – forms of care, rather than calling an ambulance by default and often resulting in hospital admission. On care homes, she said: “Can we wrap around even more care for these care homes so they get to the point where they don’t need to call for help at all or, if they do, there are alternatives pathways [to the emergency department]?” She suggested another area where responses could be made more consistent was for patients who had fallen but without serious injuries, which she said made up a “really significant part of activity”. These patients took a long time to reach and, if admitted to hospital, risked long admissions, she said. Some areas were working to find other ways of responding to non-injury falls patients and trying to keep them away from hospital, she said. Read full story (paywalled) Source: HSJ, 6 September 2022 -
News ArticleMillions of people will be invited for their autumn Covid booster jab in England and Scotland, with care home residents the first to receive them. Although infections are falling, health bosses are predicting a resurgence of Covid and flu this autumn and winter. They are urging those eligible to protect themselves from serious illness by getting vaccines against both. A recently approved vaccine against the Omicron variant will be used first. However, there is not enough of Moderna's "bivalent" vaccine to protect everyone aged over 50 so health officials say people should take whichever booster they are offered. These will be the vaccines used in the spring. The UK's Medicines and Healthcare products Regulatory Agency (MHRA) announced on Saturday that it had approved a second "bivalent" coronavirus vaccine from Pfizer/BioNTech for people aged 12 and over. Read full story Source: BBC News, 4 September 2022
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Content ArticleThis guide by the Royal College of Physicians explains what a hip fracture is and answers questions about how patients will be cared for before and after a hip operation. It is written for patients and their families and carers. The guide covers aspects of hip fracture care such as: pain relief memory problems who should be involved in your care how soon an operation should take place eating and drinking bladder problems rehabilitation and physiotherapy following surgery when you will be able to go home future falls prevention bone strengthening medication
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News Article
Hip fracture care too slow in some hospitals, study says
Patient-Safety-Learning posted a news article in News
There are big differences in how well patients with hip fractures are cared for by hospitals in England and Wales, a Bristol University study says. In some hospitals one in 10 people died within a month of surgery - more than three times worse than in the best. Getting patients into theatre quickly and out of bed the next day for physio are key ways to improve care. People should receive the same, high-quality care wherever they live, the researchers said. "If you get it right for older people with hip fractures, you're probably getting it right for older people in general," says Professor Celia Gregson, who led the study of more than 170,700 patients in 172 hospitals between 2016 and 2019. An NHS spokesperson said hip fracture care in the UK had "seen dramatic improvements in recent years". Read full story Source: BBC News (31 August 2022) -
Content ArticleThese reports by the Pharmaceutical Society of Australia look at different aspects of medication safety. Medicine safety: Take care This report details the extent of harms in Australia as a result of medicine use. It highlights that 250,000 Australians are hospitalised each year, with another 400,000 presenting to emergency departments, as a result of medication errors, inappropriate use, misadventure and interactions. At least half of these incidents could have been prevented. Medicine safety: Aged care This report provides data about the real and current medication safety problems affecting older care residents across Australia. Medicine safety: Rural and remote care This report highlights the extreme challenges patients in rural and remote Australia have in accessing health care and the impact that this has on the safe and appropriate use of medicines. Medicine safety: Disability care This report focuses on the challenges that people with disability face in using medicines safely and effectively. The report found that people with disability face challenges at all stages of medicine use–prescribing, dispensing, administration and adherence and monitoring. Medicine safety forum: Informing Australia’s 10th National Health priority area This report presents a summary of views and experiences shared at a stakeholder workshop in December 2019.
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Content Article
Medication safety in nursing home patients (5 July 2022)
Patient-Safety-Learning posted an article in Social care
Medication safety has long been a major issue in long-term social care due to the number of medications taken by many older people. This editorial in BMJ Quality & Safety looks at why managing medications in care homes is so complex and highlights potential interventions to improve medication safety in long-term care settings. -
News Article
Injured 90-year-old, in 40-hour ambulance wait
Patient Safety Learning posted a news article in News
A 90-year-old woman waited 40 hours for an ambulance after a serious fall. Stephen Syms said his mother, from Cornwall, fell on Sunday evening and an ambulance arrived on Tuesday afternoon. She was then in the vehicle for 20 hours at the Royal Cornwall Hospital. It comes as an ambulance trust warns lives are at risk because of delays in patient handovers. It was also reported a man, 87, who fell, was left under a makeshift shelter waiting for an ambulance. South Western Ambulance Service said it was "sorry and upset" at the woman's wait for an ambulance. Mr Syms, from St Stephen, told BBC Radio Cornwall: "We are literally heartbroken to see a 90-year-old woman in such distress, waiting and not knowing if she had broken anything. "The system is totally broken." He said it took nine minutes before his 999 call was answered. "If that was a cardiac arrest, nine minutes is much too long, it's the end of somebody's life," he said. Mr Syms said paramedics were "absolutely incredible people". He added: "The system is not deteriorating, it's totally broken and needs to be urgently reviewed." Read full story Source: BBC News, 19 August 2022 -
Content ArticleAdverse incident research within residential aged care facilities (RACFs) is increasing and there is growing awareness of safety and quality issues. However, large-scale evidence identifying specific areas of need and at-risk residents is lacking. This study from St Clair et al. used routinely collected incident management system data to quantify the types and rates of adverse incidents experienced by residents of RACFs.
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Content ArticleFracture liaison services (FLSs) check if people who have recently broken a bone after falling from a standing height or less (a fragility fracture) might also have osteoporosis – a disease that weakens bones. They then advise on treatments to reduce the risk of another fracture, helping to improve patient outcomes. The Royal College of Physicians (RCP) estimates that at least 90,000 patients in England and Wales who should have anti-osteoporosis therapy are not receiving it. This guide by the RCP's Fracture Liaison Service Database (FLS-DB) aims to help patients and their families and carers understand what to expect following a fragility fracture. It outlines three key findings and the actions that individuals can take to ensure they receive the care and treatment they need from health services.
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Content ArticleThis article discusses how medication safety can be improved in Canada. It explores the complexities of aging, what can go wrong with medication, 'Best Possible Medication Histories', the role of pharmacists and paramedics, engaging with patients and their families, and improving communication across the healthcare system.
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Content ArticleFrail older adults are often at increased risk of patient safety incidents including rehospitalisation and overtreatment. In this study, published in BMC Geriatrics, researchers in the United States assessed the association of care coordination and preventable adverse events in frail older adults. Compared with non-frail older adults, they found that frail older adults reported experiencing more adverse events they believed could have been prevented with better care coordination.
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Content ArticleMedication errors are a common issue within the care home sector, impacting on the health and wellbeing of residents as well as creating challenges for care home staff and managers. This report addresses the issue of medication safety in care homes in England. Through intense engagement with a representative sample of care homes and stakeholders involving an electronic survey, workshops and conversations, Patient Safety Collaboratives have sought to understand the reasons for medication errors and how these could be avoided in the future.
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News Article
Boots criticised over pill boxes for the elderly
Patient Safety Learning posted a news article in News
Some pharmacies run by the High Street chain Boots have been criticised for telling some patients on multiple drugs that they can no longer have blister pack boxes, known as dosette boxes or multi-compartment compliance aids (MCCAs). Weekly pill organisers can help users keep track of their daily medication and stay safe. Pharmacists put the tablets into individual boxes in the trays, each one indicating when they should be taken. The NHS says boxes are not always available for free on the NHS and they're not suitable for every type of medicine. Tracey Hobbs' mother, Pat Garner, lives at home with care visits. For several years, she has had her MCCAs provided by her local Boots pharmacy. She takes more than 15 pills each day. Tracey says she was phoned by Boots and told that from one month later her mother would receive all the drugs in the original packaging, rather than organised into morning and night doses for each day of the week. Tracey told the BBC: "I pointed out that the blister packs were the only way we could know she had taken her medication at the right time. Handing seven individual boxes with different instructions on each one was totally unworkable and - quite frankly - dangerous". A Boots spokesperson said: "The latest Royal Pharmaceutical Society guidance indicates that the use of multi-compartment compliance aids is not always the most appropriate option for patients that need support to take their medicines at the right dose and time." "Pharmacists are speaking with patients who we provide with MCCAs to discuss whether it is the right way to support them, depending on their individual circumstances and clinical needs." Prof Gill Livingston, an expert in elderly medicine at University College London, said she was concerned to hear that some patients and their families were being told the boxes were being scrapped. She said: "Blister packs enable people with mild dementia or some memory problems to take their own medication and remain independent. They can check that they have taken it and they know they have taken the right thing, as it is already sorted out. "Later on in dementia or with other disabilities, it enables paid carers and families to help them take their medication and remain in the community and remain as well as possible." Read full story Source: BBC News, 21 June 2022 -
News Article
Dementia patients not allowed to use toilet
Patient Safety Learning posted a news article in News
Heather Lawrence was shocked at the state she found her 90-year-old mother, Violet, in when she visited her in hospital. "The bed was soaked in urine. The continence pad between her legs was also soaked in urine, the door wide open, no underwear on. It was a mixed ward as well," Heather says. "I mean there were other people in there that could have been walking up and down seeing her, with the door wide open as well. My mum, she was a very proud woman, she wouldn't have been wanted to be seen like that at all." Violet, who had dementia, was taken to Tameside General Hospital, in Greater Manchester, in May 2021, after a fall. Her health deteriorated in hospital and she developed an inflamed groin with a nasty rash stretching to her stomach - due to prolonged exposure to urine. She died a few weeks later. Heather tells BBC News: "I don't really know how to put it into words about the dignity of care. I just feel like she wasn't allowed to be given that dignity. And that's with a lot of dementia patients. I think they just fade away and appear to be insignificant, when they're not." New research, shown exclusively to BBC Radio 4's File on 4 programme, has found other dementia patients have had to endure similar indignity. Dr Katie Featherstone, from the Geller Institute of Ageing and Memory, at the University of West London, observed the continence care of dementia patients in three hospitals in England and Wales over the course a year for a study funded by the National Institute for Health and Care Research. She found patients who were not helped to go to the toilet and instead left to wet and soil themselves. "We identified what we call pad cultures - the everyday use of continence pads in the care of all people with dementia, regardless of their continence but also regardless of their independence, as a standard practice," Dr Featherstone says. Read full story Source: BBC News, 21 June 2022 -
Content ArticleThe NHS Confederation has published a new report, 'The unequal impact of COVID-19: investigating the effect on people with certain protected characteristics', which maps existing research into COVID-19 inequalities onto some of these protected characteristics, showing how the pandemic has interacted with them. The report then showcases four case studies of how different health and care systems have put in place interventions to respond to these inequalities when designing their COVID-19 response. It focuses on a number of key areas including the impact of COVID-19 on: BAME communities people with disabilities older and younger people. The report concludes with a series of recommendations for health and care systems across the UK.
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Content ArticleWhen something goes wrong in health and social care, the people affected and staff often say, "I don’t want this to happen to anyone else." These 'Learning from safety incidents' resources are designed to do just that. Each one briefly describes a critical issue - what happened, what the Care Quality Commission (CQC) and the provider have done about it, and the steps you can take to avoid it happening in your service.
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Content ArticleThe Regulation and Quality Improvement Authority (RQIA) has published its independent 'Review of the implementation of recommendations to prevent choking incidents in Northern Ireland'. The Review examined the measures and governance arrangements in place to prevent choking, in line with current guidance, focusing on the work undertaken in high-risk areas across health and social care, including stroke care, care of the elderly and services for those with physical and/or mental health and learning disabilities. The Review found that there was a clear and urgent need to improve the quality and safety of care provided to people at risk of choking. The key recommendations in the Review include: training for staff including clinicians, catering and domestic teams; shorter waiting times for assessment by Speech and Language Therapy; better systems for communication between staff, and safer systems for ordering and storing food.
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Content ArticleThis first report in National Voices' ‘Behind the Headlines’ series gathers insight and intelligence from member organisations on what the cost of living crisis means for people living with ill health. It examines the close link between poverty and health, highlighting that people living in poverty are more likely to be living in poor health. Equally, lack of support for people living with ill health and disability can make people poor. The report gathers case studies and data on topics including include cancer, kidney conditions, older people and homelessness. It makes a set of recommendations based on this insight.
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Content ArticleNext Steps is a tool created by the Dementia Change Action Network to help patients find the right support, at the right time, while waiting for their memory assessment appointment. Some patients are facing longer waits as a result of the Covid-19 pandemic, and it can be an uncertain time. Next Steps provides information about what to expect from the memory assessment process and about organisations who can help.
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News Article
GPs won’t see us unless it’s ‘life or death’, complain pensioners
Patient Safety Learning posted a news article in News
A 94-year-old man has said his GP refuses to see him “unless it’s life or death”. Dennis Baker, from North Hampshire, said he felt “put off” by his doctor's surgery, which is a three-minute walk from his house. The pensioner, who lives with his wife who has advanced dementia and is bed-bound, said he found it “quite difficult to carry on a conversation with a doctor” and cannot get one to visit him at home. “The chances are [the receptionist] will say… ‘you're not dying, a doctor will phone you at some stage today’, that’s the usual response,” he told BBC Radio 4’s World at One. It comes as the president of the Royal College of GPs (RCGP) said family doctors should start “saying no” to extra work to tackle the crisis in primary care. Speaking at Pulse Live last week, Professor Dame Clare Gerada said the workload crisis was not the fault of GPs and they “cannot innovate [their] way out”. “When you’re in debates and people are saying to you 'you’ve got to work harder and smarter' - no, the rest of the system has to adapt,” she told the conference. “You have to start saying no.” Read full story (paywalled) Source: The Telegraph, 3 May 2022 -
Content ArticleIn 2020, over 2,000 people over the age of 60 fell and fractured their hip while staying in hospital in England and Wales. This graphic has been produced by the National Audit of Inpatient Falls (NAIF), which audits the delivery and quality of care for patients over 60 who fall and fracture their hip or thigh bone across England and Wales. It features the three most important findings of the 2021 NAIF Report, chosen by the patient and carer panel. The infographic covers the following questions: How can falls be prevented? What should happen after a fall? How can I help to improve care in hospital?
