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Found 287 results
  1. Content Article
    This blog for the British Medical Association (BMA) by Tim Tomkin looks at growing frustration among doctors that the national guidelines concerning the use of respirators in Covid-19 infection control are still not robust enough, and do not fulfil legal health and safety obligations. He highlights examples of trusts that have led the way in implementing robust personal protective equipment (PPE) policies to protect staff, and research that demonstrates that the use of FFP3 masks reduces infection rates in staff on Covid-19 wards. He calls for more to be done to provide adequate PPE for staff across the health service, including GPs.
  2. Content Article
    An author turned junior doctor’s account of the chaos at work and anguish at home as Covid-19 arrived in the UK.
  3. News Article
    As surges of COVID-19 cases driven by the highly infectious Omicron variant recede, parts of the United States, Canada, and Europe are moving swiftly to lift constraints on a pandemic-fatigued public. Sweden, Denmark, and Norway have abolished nearly all ­COVID-19–related restrictions in recent weeks, and the United Kingdom announced it would do the same this month, dropping even the legal requirement that people quarantine after testing positive for SARS-CoV-2. In the United States, despite persistently high numbers of COVID-19–related deaths and busy hospitals, 10 governors, many known for being cautious in their pandemic response, last week announced immediate or impending ends to their states’ indoor or school mask mandates. Some of those moves came with assertions that it’s time to “live with the disease” and treat the coronavirus as endemic—a stable, enduring figure in the panoply of human pathogens, alongside cold viruses and influenza. That suggestion troubles many scientists, who warn it is eroding governments’ commitment to tracking and responding to the pandemic—which could leave countries flying blind and unprepared for any new variant. “Endemic delusion is probably what captures it the best,” says Kristian Andersen, an infectious disease researcher at Scripps Research who has been especially critical of recent moves by his home country of Denmark, which include an announcement that as of this month COVID-19 would no longer be categorised as a “socially critical disease” even though related death and hospitalisation rates were still climbing there. In the United States, governors cited various metrics to justify recent decisions to lift or let expire indoor mask mandates. California Governor Gavin Newsom noted stable hospitalisation rates and a 65% reduction in cases since Omicron’s peak in announcing the state’s mandate would end this week. But leaders also face political and economic pressures. States’ moves may be driven largely by the public’s impatience with restrictions, says epidemiologist Dustin Duncan of Columbia University. “Even people who recognize the importance of masking, social distancing, all that stuff, may be more amenable to take more risk,” he says. “At the same time, to me, going maskless just seems egregious.” Read full story Source: Science, 15 February 2022
  4. Content Article
    On the 15 May 2020, John Skinner was admitted to Watford Hospltal suffering from a tonic clonlc seizure. He had a background of cannabis usage and a subdural empyema in 2020 that had left him with epilepsy. On arrival at hospital he again had another tonic clonlc seizure and focal seizures. The Junior doctor Instructed to administer the drug sought advice from a more senior doctor as to the dose to be administered. As a result of a failure In verbal communication between the doctors, aggravated as both were masked, a dose of 15 mg/kg was heard as 50 mg/kg and an overdose was administered. He was given 3600 mg of phenytoln. He arrested within 16 minutes and died and could not be revived. 
  5. News Article
    Masks worn by doctors "aggravated" a miscommunication over the dose of an anti-epileptic drug that resulted in a man's death, a coroner has warned. John Skinner died at Watford General Hospital in May 2020. A coroner has written a Prevention of Future Deaths Report (PFDR) saying he feared the same could happen at other hospitals if action was not taken. Assistant Coroner for Hertfordshire, Graham Danbury, said in the report: "As a result of failure in verbal communication between the doctors, aggravated as both were masked, a dose of 15mg/kg was heard as 50mg/kg and an overdose was administered." Mr Danbury, writing to NHS England, said: "This is a readily foreseeable confusion which could apply in any hospital and could be avoided by use of clearer and less confusable means of communication and expression of number." A spokesperson for West Hertfordshire Hospitals NHS Trust said: "A comprehensive action plan is in place to ensure that lessons are learned from this incident." Read full story Source: 15 February 2022
  6. Content Article
    This qualitative study in Antimicrobial Resistance & Infection Control aimed to identify institutional actions, strategies and policies related to healthcare workers’ safety perception during the early phase of the Covid-19 pandemic at a tertiary care centre in Switzerland. The authors interviewed healthcare workers from different clinics, professions, and positions. The study identified transparent communication as the most important factor affecting healthcare worker's safety perceptions during the first wave. This knowledge can be used to help hospitals better prepare for future infectious disease threats and outbreaks.
  7. Content Article
    This resource by The Health Foundation provides a timeline of national policy and health system responses to Covid-19 in the UK. Themes include: Policy narrative Measures to limit spread Health and social care response Research and development Broader policy Policy history
  8. News Article
    The government has written off £8.7bn it spent on protective equipment bought during the pandemic, accounts show. The Department for Health and Social Care documents show items costing £673m were unusable, while £750m of equipment was not used before its expiry date. The largest write-off - £4.7bn - was because the government paid more for it than it is currently worth, now that global supplies have recovered. No 10 said the purchases were justified - with 97% of items suitable for use. A further £2.6bn of equipment was judged to be unsuitable for use in the NHS, the 2020/21 accounts show, but the Department of Health and Social Care (DHSC) believes it could still be sold or given to charities. At the start of the pandemic, countries around the world were clamouring for personal protective equipment (PPE), sending prices soaring. No 10 said "we stand by the decision to purchase the items that we did", saying the approach was "justified" to get PPE to the front line. And the government was now able to "mitigate" similar problems in the future by "massively increasing our onshore-based PPE production". Read full story Source: BBC News, 1 February 2022
  9. News Article
    The self-isolation period for positive cases is being cut and the limit on visitors lifted from next week. Residents who test positive will have to self-isolate for up to 10 days, with a minimum isolation period of five full days followed by two sequential negative lateral flow tests – as is already the case for the rest of the population. Isolation periods for those having care after an emergency hospital visit will also be reduced to a maximum of 10 days, while a requirement for residents to test or self-isolate after normal visits out will be removed. Care homes will have to follow outbreak management rules for 14 rather than 28 days, and by 16 February care workers will need to use lateral flow tests before work rather than taking a weekly PCR test. The limit on visitors to care homes will be lifted. Visitors should still obtain a negative lateral flow test result earlier in the day of their visit, and guidance on the use by visitors of PPE such as face masks remains unchanged. Read full story Source: The Guardian, 27 January 2022
  10. News Article
    Over 30 trusts are now mandating FFP3 masks are used beyond settings stipulated in national rules, amid calls for system leaders to clarify the national position on the key staff and patient safety issue. Fresh Air NHS, a group of frontline staff who campaign for better protection against Covid-19, said it now knows of 32 trusts which have already introduced enhanced infection prevention control policies that mandate FFP3 use beyond national guidance. News that a growing number of trusts are mandating more stringent PPE use comes amid fresh confusion around the national guidance after small but potentially significant alterations were made last week. A new line has been added to guidance which says:: “FFP3 respirator or equivalent must be worn by staff when caring for patients with a suspected or confirmed infection spread by the airborne route.” David Tomlinson, consultant cardiologist and also a member of Fresh Air NHS, said NHS trusts were “in fear of going beyond the guidance and allowing non-ICU staff to wear FFP3 respirators”. “The guidance doesn’t mandate respirators for staff in highest risk of transmission areas, for example, medical wards housing symptomatic patients at a time in their disease when they are releasing greatest amounts of infectious aerosols,” Dr Tomlinson said. “Real world data has consistently shown far greater rates of SARS2 infection comparing non-ICU healthcare workers to those on ICU.” Alison Leary, chair of healthcare and workforce modelling at London Southbank University, said: “Trusts choosing to implement evidence based safety interventions is a positive move towards workforce safety.” Read full story Source: HSJ, 27 January 2022
  11. Content Article
    In this article for the Patient Safety Network, the authors highlight ways in which the Covid-19 pandemic initiated drastic modifications to the way in which health services are delivered across care settings, in particular in hospital emergency departments and inpatient units. They examine particular challenges highlighted by patient safety organisations (PSOs), including increases in safety incidents relating to pressure sores, sepsis, infections and communication issues. The article also highlights innovations to support safety that have been developed during the pandemic.
  12. Content Article
    There is no longer any scientific doubt about how Covid spreads through the air. Covid spreads like any other airborne respiratory disease. The virus is carried in tiny particles called aerosols, which we breathe out constantly — especially when speaking loudly or singing. The particles stay in the room air like smoke, and if someone has Covid, their exhaled aerosols contain the virus and can infect someone who breathes them in. We stop the disease spreading by stopping people inhaling infected aerosol. In this article for the Guardian, Dr Adam Squires and Prof Christina Pagel detail what we can do to protect ourselves from the airborne spread of Covid. “Filtering facepiece respirator” masks, social distancing and opening windows are short term solutions. Additionally, much can be done by cleaning the air in the room, removing infectious aerosol before it can be inhaled through ventilation and supplement the clean air by filtering out the respiratory aerosol particles using small portable HEPA (“High Efficiency Particle Air”) filter unit.. Longer term, new developments in ultraviolet (UV) technology can safely and efficiently kill airborne pathogens in large spaces such as canteens, gyms or theatre. Infrastructure upgrades and new builds, necessary for zero carbon targets, can combine more energy-efficient ventilation with filtration to lower pollution. In the classroom and the workplace, clean fresh air has wider benefits on health and wellbeing far beyond our current airborne pandemic.
  13. Content Article
    In this article for The Conversation, the authors discuss their latest research findings regarding Covid-19 transmission, outlining the likelihood of catching Covid-19 in different indoor and outdoor scenarios. They demonstrate that speaking, shouting, singing and heavy exercise all increase the likelihood of transmission, and illustrate the impact of ventilation, face coverings and number of people on the risk of catching the virus. The article includes an table summarising their findings and a link to the Covid-19 Aerosol Transmission Estimator developed by the authors. View the full research paper
  14. Content Article
    Healthcare workers (HCWs), particularly those from ethnic minority groups, have been shown to be at disproportionately higher risk of infection with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) compared to the general population. However, there is insufficient evidence on how demographic and occupational factors influence infection risk among ethnic minority HCWs. Researchers analysed data from 10,772 HCWs who worked during the pandemic to identify demographic and household factors that contributed to infection risk. Results from the UK-REACH study, co-funded by the NIHR and UK Research and Innovation, showed that healthcare workers' risk of catching coronavirus increased in correlation with the level of exposure to COVID-19 patients. Other risk factors included a lack of PPE access and sharing living or working environments with other key workers. Geographical differences were also seen, with healthcare workers in Scotland and South West England at lower risk of infection compared with those in the West Midlands. Intensive care unit staff were also at lower risk than those in other hospital settings.
  15. Content Article
    This poster from the Royal College of Midwives (RCM) provides information for midwives and midwife support workers on appropriate PPE for different scenarios in maternity care. It covers what to wear in different stages of care in both hospital and community settings if a patient has, or does not have, confirmed or suspected Covid-19.
  16. News Article
    NHS staff treating Covid patients should be given much more protective facewear than thin surgical masks to help them avoid getting infected during the Omicron rise, doctors say. The British Medical Association (BMA), Hospital Consultants and Specialists Association (HCSA) and Doctors’ Association UK are calling for frontline personnel to be given FFP3 masks. Making the much higher-quality face masks standard issue would save the lives of health workers who fall ill as a result of treating Covid patients, the BMA said. “At this critical point in the pandemic this is extremely urgent – a matter of life and death,” said Prof Raymond Agius, the acting chair of the doctors’ union’s occupational health committee. FFP3 masks, also known as filtering facepiece respirators, have been shown in a trial in Addenbrooke’s hospital in Cambridge to reduce the number of healthcare staff who become infected. However, the Department of Health and Social Care’s (DHSC) guidance on personal protective equipment, updated last week, only recommends their use in limited circumstances. “With a high transmissible new strain now circulating, and clear evidence that Covid-19 spreads in small airborne particles, healthcare workers must be given the best possible protection against the virus. Surgical masks don’t give the necessary protection against airborne transmission of Covid,” Agius said. The BMA has written to every hospital trust in England demanding that any health professional treating patients who are or may be Covid-positive should be routinely issued with FFP3s, which are much more expensive than the surgical masks usually provided. Surgical masks are “unsuitable” given the threat Covid poses, the BMA believes. Read full story Source: The Guardian, 27 December 2021
  17. Content Article
    When the pandemic began, many nations’ emergency stockpiles came into the spotlight—and were found wanting. Twenty months later, Jane Feinmann asks what happened, and if procurement has got any better.
  18. Content Article
    This report, published by the Agency for Healthcare Research and Quality (AHRQ) in the United States, presents findings from a review of 5,500 patient safety records in which the Covid-19 public health emergency was included as part of the description of the event or unsafe condition. It forms part of a series of Network of Patient Safety Databases Data Spotlight reports.
  19. Content Article
    In this HSJ article, workforce correspondent Annabelle Collins looks at the workforce issues facing the NHS as the Omicron variant of Covid-19 spreads rapidly across the UK. She highlights that staff absences are at their highest since March 2020, with the situation particularly worrying in London, where 1 in 13 doctors are currently off sick. The author discusses the role of PPE in protecting staff and reducing absences and quotes Patient Safety Learning's Chief Executive Helen Hughes, who highlights "inconsistencies" in the UK approach, saying the IPC guidance needs to be “urgently updated” so HEPA/FPP3 masks are provided for NHS staff, in line with World Health Organization recommendations: “Today the World Health Organisation is issuing updated guidance for health workers, recommending the use of either a respirator or a medical mask, in addition to other personal protective equipment, when entering a room where there is a patient with suspected or confirmed covid.” The article also examines the government's lack of workforce plans and the Treasury’s unwillingness to publish workforce predictions, despite repeated calls for them over the past few years.
  20. Content Article
    This toolkit published by the Royal College of Nursing (RCN) aims to support healthcare professionals to consider and manage risks associated with the transmission of respiratory infections, specifically Covid-19. It is designed to aid local decision making about the level of personal protective equipment (PPE) required to protect healthcare professionals while at work.
  21. News Article
    David Oliver, NHS consultant physician and a columnist for the BMJ makes a plea on behalf of his colleagues as they face a surge of admissions due to the spread of the omicron variant of COVID-19 this Christmas. "Pandemic health protection measures are not all about you and your own personal risk or appetite for it, your own ‘natural immunity’ or fitness, your own liberty or freedom. They are about protecting everyone else. It might be your own parent, grandparent or sibling that dies from COVID-19 or from lack of access to overwhelmed services. It might be your neighbour’s or someone in another town or from another social class or ethnic group, This isn’t a game and we need to take it seriously and stop posturing and point-scoring, before, once again, we have left it too late to act" Read full story Source: Byline Times, 21 December 2021
  22. Content Article
    A post on Doctors in Unite website argue that COVID-19 guidelines are fundamentally flawed and not fit for purpose, putting health care workers and patients at serious risk. IPC authorities are increasingly isolated in their view that COVID-19 is spread by droplets and not through the air, a position which is directly contradicted now by official government policy. This article takes a more detailed look at the issues, which demonstrates how unscientific, out of touch and indeed hazardous the guidelines are for health workers and patients.
  23. Content Article
    This is the second of a short series of blogs in which we take a look back at our work in five areas of patient safety during 2021. In this blog, we look at our work to highlight key patient and staff safety issues resulting from the ongoing Covid-19 pandemic. Through our work, Patient Safety Learning seeks to harness the knowledge, insights, enthusiasm and commitment of health and social care organisations, professionals and patients for system-wide change and the reduction of avoidable harm. We believe patient safety is not just another priority; it is a core purpose of health and social care. Patient safety should not be negotiable.
  24. Content Article
    The emergence of the omicron variant has raised concerns that the pandemic is not yet over. In this BMJ opinion piece, William et al. outline four key lessons that governments need to learn from to protect against future pandemics
  25. Content Article
    Wearing face masks and maintaining social distance are familiar to many people around the world during the ongoing COVID-19 pandemic. Evidence suggests that these are effective ways to reduce the risk of COVID-19 infection. However, it is not clear how exactly the risk of infection is affected by wearing a mask during close personal encounters or by social distancing without a mask. Results from a study by Bagheri et al. show that face masks significantly reduce the risk of COVID-19 infection compared to social distancing. We find a very low risk of infection when everyone wears a face mask, even if it doesn’t fit perfectly on the face.
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