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Found 153 results
  1. Content Article
    The transition from hospital to home is a vulnerable time as patients may have changes in medications or care needs, or difficulties accessing follow up with an outpatient provider. Authors conducted a prospective intervention study of children with medical complexity discharged at a children’s hospital from April 2018 to March 2020. To reduce adverse events (AE), rehospitalizations, and emergency department visits, this hospital developed a structured discharge bundle based on the I-PASS tool used for inpatient handoffs. AE, rehospitalisations, and emergency department visits were all reduced following implementation of the I-PASS bundle.
  2. Content Article
    These charts have been collaboratively developed by clinical teams across England to standardise how the deterioration of children in hospital is tracked. There are four charts for children of different ages, designed to be used on general children’s wards. PEWS observation and escalation chart: 0 to 11 months PEWS observation and escalation chart: 1-4 years PEWS observation and escalation chart: 5-12 years PEWS observation and escalation chart: ≥13 years
  3. News Article
    Sick children’s health problems are getting worse as record numbers wait up to 18 months for NHS care, doctors treating them have warned. The number of under-18s on the waiting list for paediatric care in England has soared to 423,500, the highest on record. Of those, 23,396 have been forced to wait over a year for their appointment. Delays facing children and young people are now so common that Dr Jeanette Dickson, the chair of the Academy of Medical Royal Colleges, the body representing all UK doctors professionally, warned that children are “the forgotten casualties of the NHS’s waiting list crisis”. “As a paediatrician, I’ve seen first hand the damaging impact that long waiting times have on children, on their education and overall wellbeing, and of course on their families,” said Dr Camilla Kingdon, the president of the Royal College of Paediatrics and Child Health (RCPCH). The figures came from the RCPCH’s analysis of official performance data recently published by NHS England. The health of some children was deteriorating while they languished on the waiting list because their illness and age meant they needed to have their treatment fast, Kingdon added. “Many treatments and interventions must be administered within specific age or developmental stages. No one wants to wait for treatment, but children’s care is frequently time-critical.” Read full story Source: The Guardian, 17 September 2023
  4. News Article
    Children have suffered severe harm at two further hospital trusts as a result of failures in paediatric audiology, HSJ has revealed. HSJ reported in July that three children at Croydon Health Service Trust may have come to “severe harm” – meaning they may have suffered permanent damage – following failures in the trust’s processes in audiology. Now East and North Hertfordshire Trust and North West Anglia Foundation Trust have also confirmed a small number of cases of severe or serious harm; while some trusts have yet to confirm findings from case reviews they have carried out. Major problems emerged earlier this year, initially in Scotland, of poor quality checks missing children with hearing problems who should have received support, and of a failure to inspect the services. NHS England ordered a review of data from the national newborn screening programme which, alongside other review work, identified six English trusts as having likely failures in their service: Croydon, East and North Herts, North West Anglia, Warrington and Halton Hospitals, North Lincolnshire and Goole, and Worcestershire Acute Hospitals. Read full story (paywalled) Source: HSJ, 14 September 2023
  5. Content Article
    A new issue brief from the Agency for Healthcare Research and Quality (AHRQ) examines the unique challenges of studying and improving diagnostic safety for children in respect to their overall health, access to care and unique aspects of diagnostic testing limitations for multiple paediatric conditions. The issue brief features approaches to address these challenges cross the care-delivery spectrum, including in primary care offices, emergency departments, inpatient wards and intensive care units. It also provides recommendations for building capacity to advance paediatric diagnostic safety. 
  6. News Article
    A hospital trust has apologised to families after dozens of children suffered hearing loss following failures in their care. Croydon Health Services Trust had already revealed three children “may have been at risk of serious hearing loss or a delay to their speech development”, but it has now confirmed to HSJ that a further 49 “incurred mild to moderate hearing loss or impairment”. The south London trust would not disclose the results of its internal review that begun after it declared a serious incident in March 2021, saying it was “ongoing”, but said it had acted on all the “immediate recommendations”. The incident was declared after more than 1,400 children were found not to have been followed up by the trust. There was also an external review carried out by an audiologist from Guy’s and St Thomas’ Foundation Trust. It is unclear which review uncovered the incidents of harm. Read full story Source: HSJ 1 August 2023
  7. Content Article
    Tests that indicate the health of newborns, moments after birth, are limited and not fit-for-purpose for Black, Asian and ethnic minority babies, and need immediate revision according to the NHS Race and Health Observatory.
  8. News Article
    Tens of thousands of children will be treated in “virtual wards” to free hospital beds for more critically ill patients under new NHS plans. The Hospital at Home service will be expanded to include paediatric care in every region of England this month, the health service announced. As part of the service, clinical teams review patients daily and can provide treatments including blood tests, prescribe medicines or administer fluids through a drip. Ward rounds can include home visits or a video call, and many services use technology such as apps and wearable devices to monitor recovery. Professor Simon Kenny, the NHS’s national clinical director for children and young people, said: “The introduction of paediatric virtual wards means children can receive clinical care from home, surrounded by family and an environment they and their parents would rather they be — with nurses and doctors just a call away.” Read full story (paywalled) Source: The Times. 5 July 2023
  9. News Article
    U.S. News & World Report's Best Children's Hospital list for 2023-2024, released 21 June, said 11 children's hospitals are at the top of their game when it comes to 10 pediatric specialties. This year, 11 children's hospitals are included on this list due to a tie in the diabetes and endocrinology category. U.S. News gathered subjective data from more than 15,000 pediatric specialists and clinical data from close to 200 children's hospitals to develop its Best Children's Hospitals 2023-2024 listings. For the first time, Cincinnati Children's Hospital Medical Center took the top spot on the list. The hospital has the only level 4 neonatal intensive care unit, which offers care to infants at all level 3 NICUs in the area. The hospital discovered a "super antibody" it believes will inform new vaccines and offered a specialized approach to reduce stays in the NICU for opioid-exposed newborns. Steve Davis, MD, president and CEO: "This distinction only confirms what we have always known — that we have outstanding, talented team members who are unmatched in their dedication to ensuring that all children have access to exceptional care." Read full story Source: Becker's Hospital Review, 23 June 2023
  10. News Article
    NHS trusts across England are scrambling to trace thousands of children for urgent hearing tests amid fears that cases of infant deafness may have been missed for years. An internal NHS report has exposed poor-quality testing within paediatric audiology departments at five hospitals and warned of systemic failings. At another NHS trust, almost 1,500 children were found to have missed out on appointments dating back to 2012. Vital quality inspections of departments checking infants for hearing loss were stopped ten years ago. Whistleblowers who previously worked for the NHS’s newborn hearing screening programme have revealed that concerns were raised shortly before they were told to stop carrying out checks. They say that thousands of children may have been mistreated for deafness and hearing loss in the past decade. Read full story (paywalled) Source: The Times, 25 June 2023
  11. Content Article
    Intrahospital transport is a common occurrence for many hospitalised patients. Critically ill children are an especially vulnerable population who experience preventable adverse events at least once a week, on average. Transporting these patients throughout the hospital introduces additional hazards and increases the risk of adverse events. The transport process can be decomposed into a series of steps, each incurring specific risk. These risks are numerous and few of these risks are specific to the transport process. There is a paucity of literature available on paediatric intrahospital transport and related adverse events. Elliot et al. recently reviewed the Wake Up Safe database, a paediatric anesthesia quality improvement initiative across member institutions to disseminate information on best practices, for paediatric perioperative adverse events associated with anaesthesia-directed transport. The authors present several examples of airway and respiratory events taken from the database and discuss the complexity of the transport process.
  12. News Article
    Forty children were hospitalised for vaping last year, prompting NHS bosses to warn we risk “sleep-walking into a crisis”. Amanda Pritchard, NHS England boss, said it was "right" for paediatricians to call for action on vaping among young people, as the Royal College of Paediatrics and Child Health called for an outright ban on disposable vapes. She said the 40 children admitted to hospital in England in 2022 due to “vaping-related disorders” was up from 11 two years before. The RCPCH’s call for action comes as NHS data revealed one in five 15-year-olds said they used e-cigarettes in 2021, while charity Action on Smoking (ASH) reported the experimental use of e-cigarettes among 11 to 17-year-olds had risen by 50 per cent compared to last year. The college warned: “Youth vaping is fast becoming an epidemic among children, and I fear that if action is not taken, we will find ourselves sleep-walking into a crisis.” Read full story Source: The Independent, 16 June 2023
  13. Content Article
    The Child Health Clinical Outcome Review Programme has produced this review of the barriers and facilitators in transitioning children and young people with complex chronic health conditions into adult health services. Based on data on children and young people with one of 12 complex conditions identified from a sample period between 1st October 2019 and 31st March 2021, the report concludes that there is no clear pathway for the transition from healthcare services for children and young people to adult healthcare services. The report finds that the process of transition and subsequent transfer is often fragmented, both within and across specialties, and that adult services often sit only with primary care. It argues that developmentally appropriate healthcare should be everyone’s responsibility, with adequate resources needed to allow this to happen. The Inbetweeners also calls for services to: involve young people and parent/carers in transition planning and transition to adult services improve communication and coordination between all specialties be organised to enable young people to transfer to adult services effectively, and provide strong leadership at Board and specialty level at all stages of transition and transfer. The report’s recommendations highlight areas that are suitable for regular local clinical audit and quality improvement initiatives by those providing care to this group of patients. It suggests that the results of such work should be presented at quality or governance meetings, and action plans to improve care should be shared with executive boards.
  14. News Article
    The mayor of London is independently reviewing NHS England plans to reconfigure children’s cancer services in the capital, which were triggered when the commissioner finally accepted the current arrangements are unsafe. In a letter to NHSE London director Caroline Clarke, Sadiq Khan’s health adviser said the mayor would apply his six tests for major reconfigurations to both the options proposed for the “principal treatment centre” for paediatric cancer in south London. NHSE London is currently running a process to decide the principal treatment centre's location. An earlier assessment put the bid from the Evelina Hospital, part of Guy’s and St Thomas’ Foundation Trust, ahead of the other bidder, St George’s University Hospitals FT. Read full story (paywalled) Source: HSJ, 5 June 2023
  15. News Article
    Children presenting with 'high-risk' behaviours are being cared for in NHS paediatric wards that may put them and others at risk of harm, according to a new report from the Healthcare Safety Investigation Branch (HSIB). HSIB's interim report warns that the placement of children and young people with complex mental health issues on NHS paediatric wards can impact on the wellbeing of these patients and their families, and pose a risk to other patients and staff. The report emphasises that paediatric wards are designed to care for patients who only have physical health needs and not for those who are exhibiting high-risk behaviours, which include attempts to die by suicide, self-harm, attempts to leave the hospital without permission, and episodes of violence and aggression. Examples of children and young people being restrained or sedated in front of other sick and vulnerable patients, families feeling concerned for their and their children's safety during incidents, rooms being stripped down to remove any risk of self-harm or death by suicide, and paediatric staff being physically assaulted are cited in the report. Saskia Fursland, HSIB national Investigator, said,"We know that NHS staff are trying to provide a safe environment for their patients, but they are facing difficult choices in wards that are not designed to support children and young people displaying high-risk behaviours. Our ongoing investigation will take a longer-term look at effective design, adaptations and risk management in the wards. A whole system response is now needed to ensure we can keep children and young people safe." Read full story Source: Medscape, 25 May 2023
  16. News Article
    A safety investigation has warned that young people with complex mental health needs are being put at significant risk, by being placed on general children's wards in England. The findings come from the Healthcare Safety Investigation Branch (HSIB). BBC News recently highlighted the plight of a 16-year-old autistic girl, who spent several months in a children's ward. Other families have since contacted the BBC describing similar situations. The majority had faced similar difficulties getting appropriate support. HSIB says that paediatric wards are designed to care for patients who only have physical health needs and not for those with mental health needs. It describes the situation in 18 hospitals it visited as "challenging", and 13 were described as "not safe" for children who were suicidal or at risk of harming themselves to be on their paediatric wards. Read full story Source: BBC News, 25 May 2023
  17. Content Article
    Paediatric wards in acute hospitals are increasingly caring for children and young people (CYP) who have mental health needs. Paediatric wards are primarily designed to accommodate children with physical health needs and are not specifically designed to help keep children and young people with mental health needs safe. This national investigation looks at the risk factors associated with the design of paediatric wards in acute hospitals for children and young people with mental health needs.
  18. Content Article
    This report by the National Paediatric Diabetes Audit (NPDA) is based on data from 33,251 children and young people receiving care from a paediatric diabetes unit (PDU) in 2021/22 in England and Wales. It found that the increase in incidence of Type 1 diabetes observed in the first year of the Covid-19 pandemic was followed by a continuing increase in the numbers of children newly diagnosed with the condition in 2021/22. Other key findings include: Almost all of those with Type 2 diabetes were overweight or obese, and almost half had a diastolic or systolic blood pressure in the hypertensive range. Despite reductions in the percentages recorded as requiring additional support between 2020/21 and 2021/22, over a third of children and young people were assessed as requiring additional psychological support outside of multidisciplinary meetings. Inequalities persist in terms of the use of diabetes related technologies in relation to ethnicity and deprivation.
  19. Content Article
    Based on data from January 2019 to December 2021, this report by the Paediatric Intensive Care Audit Network (PICANet) catalogues comprehensive information on referral, transport and admission events. This enables the monitoring of delivery and quality of care in relation to agreed standards, and the evaluation of clinical outcomes to inform national policy in paediatric critical care. It reports on five key metrics relevant to Paediatric Intensive Care services: case ascertainment including timeliness of data submission retrieval mobilisation times emergency readmissions within 48 hours of discharge unplanned extubation in PICU mortality in PICU
  20. Content Article
    ERIC is the national charity dedicated to improving children’s bowel and bladder health. Their mission is to reduce the impact of continence problems on children and their families. The ERIC website includes: advice and resources for professionals advice and resources for parents and young people training and events information about bowel and bladder health for children with additional needs. To speak to an ERIC advisor you can call 0808 1699 949. The Helpline is open Monday - Thursday, 10am to 2pm and is free to call from landline and mobile numbers. To visit the ERIC website, click on the link below.
  21. News Article
    The pressure to tackle long waiting lists in children’s community services is impacting care quality, clinical leaders have warned. It comes after community health services waiting list figures were published for the first time by NHS England last week. They revealed more than 200,000 children were waiting, of whom 12,000 had been waiting more than a year, and 65,000 more than 18 weeks. While adult community services lists have been coming down fairly steadily since the autumn, children’s services are failing to make progress. The children’s services with the longest lists are community paediatrics (which mostly deals with neurological development issues such as autism and ADHD), speech and language therapy, and children’s occupational therapy. Specialists in those areas told HSJ it was the result of staffing gaps, rising and more complex demand, Covid backlog, and years of underfunding. Read full story (paywalled) Source: HSJ, 20 March 2023
  22. News Article
    The US Emergency Care Research Institute (ECRI) has said the paediatric mental health crisis is the most pressing patient safety concern in 2023. ECRI, which conducts independent medical device evaluations, annually compiles scientific literature and patient safety events, concerns reported to or investigated by the organization, and other data sources to create its top 10 list. Here are the 10 patient safety concerns for 2023, according to the report: 1. The pediatric mental health crisis 2. Physical and verbal violence against healthcare staff 3. Clinician needs in times of uncertainty surrounding maternal-fetal medicine 4. Impact on clinicians expected to work outside their scope of practice and competencies 5. Delayed identification and treatment of sepsis 6. Consequences of poor care coordination for patients with complex medical conditions 7. Risks of not looking beyond the "five rights" to achieve medication safety 8. Medication errors resulting from inaccurate patient medication lists 9. Accidental administration of neuromuscular blocking agents 10. Preventable harm due to omitted care or treatment For the number one spot, ECRI said the COVID-19 pandemic raised the situation, which includes high rates of depression and anxiety among children, to crisis levels. ECRI President and CEO Marcus Schabacker, MD, PhD, said social media, gun violence and other socioeconomic factors were fueling the issue, but COVID-19 pushed it into a crisis. "We're approaching a national public health emergency," Dr. Schabacker said in a statement. Read full story Source: Becker's Hospital Review, 13 March 2023
  23. Content Article
    ECRI’s Top 10 Patient Safety Concerns 2023 list identifies potential sources of danger for patients and staff. ECRI believe these risks require the greatest focus for the coming year and offer actionable recommendations for reducing these risks. ECRI conducts independent medical device evaluations, annually compiles scientific literature and patient safety events, concerns reported to or investigated by the organization, and other data sources to create its top 10 list.
  24. Content Article
    This report by the National Paediatric Diabetes Audit (NPDA) looks at diabetes care for children in England and Wales in 2021-22. The effectiveness of diabetes care is measured against NICE guidelines and includes treatment targets, health checks, patient education, psychological wellbeing, and assessment of diabetes-related complications including acute hospital admissions, all of which are vital for monitoring and improving the long-term health and wellbeing of children and young people with diabetes. In 2021/22, 100% of paediatric diabetes teams participated in the NPDA.
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