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News Article
USA: Top 10 patient safety concerns for 2023
Patient Safety Learning posted a news article in News
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- Posted
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- Mental health
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Content ArticleThere is little longitudinal information about the type and frequency of harm resulting from medication errors among outpatient children with cancer. This study aimed to characterise rates and types of medication errors and harm to outpatient children with leukaemia and lymphoma over 7 months of treatment.
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- Children and Young People
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Content ArticleIn this video, Leah Coufal’s mother, Lenore Alexander, recounts the tragic story of her 12-year-old daughter’s preventable death in hospital in December 2002. Leah died from opioid-induced respiratory depression due to a lack of continuous postoperative monitoring which could have saved her life. Lenore now campaigns for the legal requirement to monitor patients on opioids after surgery.
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- Medication
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Content ArticleInstitute of Health Visiting executive director Alison Morton warns national policy has developed a “baby blind spot” amid the NHS crisis, with many young children missing out on government’s promise of the “best start in life”, and calls for a shift towards prevention and early intervention.
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- Children and Young People
- Baby
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Content ArticleThis video from the Irish Health Services Executive (HSE) tells the story of Barry, a paediatric nurse who made a medication error when treating a critically ill baby. Barry describes how the incident and the management response to it affected his mental health and confidence over a long period of time. He also describes how he had to fight to ensure the family were told the full story of what had happened, and the positive relationship he developed with the baby's mother as a result. The baby received the treatment they needed and recovered well.
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- Paediatrics
- Staff safety
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Content ArticleGlobally, the under-five mortality rate (U5MR) fell to 38 deaths per 1,000 live births in 2021, while under-five deaths dropped to 5.0 million. Although this demonstrates a decrease, this immense, intolerable and mostly preventable loss of life was carried unequally around the world , and children continue to face widely differing chances of survival based on where they are born. In contrast to the global rate, children born in sub-Saharan Africa are subject to the highest risk of childhood death in the world with a 2021 U5MR of 74 deaths per 1,000 live births – 15 times higher than the risk for children in Europe and Northern America and 19 times higher than in the region of Australia and New Zealand This report outlines and analyses figures from The United Nations Inter-Agency Group for Child Mortality Estimation (UN IGME) to examine levels and trends in child mortality around the world during 2022.
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Content ArticleThis case study published by the Healthcare Quality Improvement Partnership (HQIP) highlights the Epilepsy12 Audit’s approach to working with children and young people to improve paediatric epilepsy care. Epilepsy12 Youth Advocates are epilepsy experienced or interested children, young people, families and an epilepsy specialist nurse. They volunteer together to shape Epilepsy12 and to lead improvement activities with families and epilepsy services. The audit won the Richard Driscoll Memorial Award (RDMA) 2022. The RDMA asks HQIP commissioned programmes to describe how patients and carers influence the production of the patient-focused outputs of the programme.
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- Children and Young People
- Paediatrics
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Content ArticleGomes et al. report the utilisation and impact of a novel triage-based electronic screening tool (eST) combined with clinical assessment to recognise sepsis in paediatric emergency department. An electronic sepsis screening tool was implemented in the paediatric emergency departments of two large UK secondary care hospitals between June 2018 and January 2019. Patients eligible for screening were children < 16 years of ages excluding those with minor injuries or who were brought directly to resuscitation. Utilisation of a novel triage-based eST allowed sepsis screening in over 99% of eligible patients. The screening tool showed good accuracy to recognise sepsis at triage in the ED, which was augmented further by combining it with clinician assessment. The screening tool requires further refinement through multicentre evaluation to avoid missing sepsis cases.
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- Sepsis
- Deterioration
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News Article
RSV, other viruses making it hard to find a bed in children’s hospitals
Patient-Safety-Learning posted a news article in News
Children’s hospitals are under strain in the United States as they care for unusually high numbers of kids infected with RSV and other respiratory viruses. Respiratory syncytial virus, a common cause of cold-like illness in young children known as RSV, started surging in late summer, months before its typical season from November to early spring. This month, the United States has been recording about 5,000 cases per week, according to federal data, which is on par with last year but far higher than October 2020, when more coronavirus restrictions were in effect and very few people were getting RSV. Jesse Hackell, a doctor who chairs the committee on practice and ambulatory medicine for the American Academy of Pediatrics, said, "It’s very hard to find a bed in a children’s hospital — specifically an intensive care unit bed for a kid with bad pneumonia or bad RSV because they are so full.” Read full story Source: The Washington Post, 21 October 2022- Posted
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News ArticleChildren’s doctors plan to help poor families cope with the cost of living crisis and its feared impact on health, amid concern that cold homes this winter will lead to serious ill health. In an unusual move, the Royal College of Paediatrics and Child Health (RCPCH) is issuing the UK’s paediatricians with detailed advice on how they can help households in poverty. It has drawn up a series of resources, including advice for doctors treating children to use appointments to talk sensitively to their parents about issues that can have a big impact on their offspring’s health. These include diet, local pollution levels, socio-economic circumstances and difficulties at home or school, which are closely linked to children’s risk of being overweight, asthmatic or stressed. “Don’t shy away from it,” the RCPCH’s 17-page manual says. “If we aren’t asking families about things which may impact on their children’s health, we are short-changing the children themselves.” However, it adds that paediatricians should “pick your timing carefully [as] parents can feel alienated if we are perceived as jumping in with two feet to ask about smoking when they are stressed about an acutely unwell child with pneumonia.” Read full story Source: The Guardian, 22 September 2022
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Content ArticleThis 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.
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Content ArticleBased 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
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- Paediatrics
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Content ArticlePoster presentation from Dr Felicity Brokke and Ken Spearpoint at the recent GOSH Patient Safety and Human Factors Conference.
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- Human factors
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Content ArticleThis national NHS primary care clinical pathway for constipation in children guidance supports clinicians in the prevention and management of constipation in children and young people by providing a clear and standardised approach, based on guidelines from the National Institute for Health and Care Excellence (NICE), the British National Formulary for Children (BNFc) and clinical expert groups. The pathway promotes available resources for clinicians, families and other care providers and ensures they are easily accessible, as well as raises the profile of constipation in children and young people with a learning disability as a factor in adult mortality rates.
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Content Article
ERIC: The children's bowel and bladder charity
Patient_Safety_Learning posted an article in Paediatrics
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. -
Content ArticleECRI’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.
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- USA
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Content ArticleThis 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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- Diabetes
- Paediatrics
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Content ArticlePatient engagement is a key component of quality improvement in health. Patient activation is defined as the patient's willingness to manage their health based on understanding their role in the care process and having the knowledge and skills to do so. For children parents have this role. The Parent Patient Activation Measure (Parent-PAM) is adapted from Patient Activation Measure(PAM), a 13-point questionnaire designed to measure healthcare activation. PAM scores are stratified into "levels of activation": Level 1-does not believe the caregiver role is important (score ≤47.0) through to Level 4-takes action, may have difficulty maintaining behaviours (score ≥71). This study, published in the European Respiratory Journal, aimed to evaluate caregiver activation using Parent-PAM in a paediatric difficult asthma(DA)clinic.
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- Patient engagement
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Content ArticleThe purpose of this study, published in Archives of Disease in Childhood, was to determine the incidence and nature of prescribing and medication administration errors in paediatric inpatients. Authors conclude that prescribing and medication administration errors are not uncommon in paediatrics, partly as a result of the extra challenges in prescribing and administering medication to this patient group. The causes and extent of these errors need to be explored locally and improvement strategies pursued.
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Content ArticleThe purpose of this study, published in Intensive Care Medicine, was to establish the baseline prescribing error rate in a tertiary paediatric intensive care unit (PICU) and to determine the impact of a zero tolerance prescribing (ZTP) policy incorporating a dedicated prescribing area and daily feedback of prescribing errors.
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Content ArticleIatrogenic injuries, including medication errors, are an important problem in all hospitalized populations. However, few epidemiological data are available regarding medication errors in the paediatric inpatient setting. The objectives of this paper, published in JAMA, were to assess the rates of medication errors, adverse drug events (ADEs), and potential ADEs; to compare paediatric rates with previously reported adult rates; to analyse the major types of errors; and to evaluate the potential impact of prevention strategies.
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Content ArticleMedication errors are an important cause of preventable morbidity, especially in children in emergency department (ED) settings. Internal use of voluntary incident reporting (IR) is common within hospitals, with little external reporting or sharing of this information across institutions. In this paper published Emergency Medicine Journal, authors describe the analysis of paediatric medication events (ME) reported in 18 EDs in a paediatric research network in 2007–2008.
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Content ArticleThe Scottish Patient Safety Programme (SPSP) is a national quality improvement programme that aims to improve the safety and reliability of care and reduce harm. Since the launch of SPSP in 2008, the programme has expanded to support improvements in safety across a wide range of care settings including Acute and Primary Care, Mental Health, Maternity, Neonatal, Paediatric services and medicines safety. Underpinned by the robust application of quality improvement methodology SPSP has brought about significant change in outcomes for people across Scotland.
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- Scotland
- Patient safety strategy
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News Article
Scarlet fever cases rise tenfold as parents struggle to find Strep A antibiotics
Patient-Safety-Learning posted a news article in News
Scarlet fever cases have surged by tenfold in a year, official data shows, as pharmacists grapple with a shortage of antibiotics during a Strep A outbreak. Strep A bacteria usually only causes mild illness, including scarlet fever and strep throat, which is treated with antibiotics. But in rare cases, it can progress into a potentially life-threatening disease if it gets into the bloodstream. Infections are higher than normal for this time of year, and at least nine children have died after contracting the bacteria in recent weeks. Pharmacists say they are struggling to get their hands on antibiotics to treat Strep A infections – despite the government insisting there is no shortage. “We are worried because we are having to turn patients away,” said Dr Leyla Hannbeck, the head of the Association of Multiple Pharmacies (AIMP). Read more Source: The Independent, 8 December 2022- Posted
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- Virus
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Germany faces ‘catastrophic’ paediatric bed shortage as RSV cases soar
Patient Safety Learning posted a news article in News
Intensive care doctors in Germany have warned that hospital paediatric units in the country are stretched to breaking point in part due to rising cases of respiratory infections among infants. The intensive care association DIVI said the seasonal rise in respiratory syncytial virus (RSV) cases and a shortage of nurses was causing a “catastrophic situation” in hospitals. RSV is a common, highly contagious virus that infects nearly all babies and toddlers by the age of two, some of whom can fall seriously ill. Experts say the easing of coronavirus pandemic restrictions means RSV is affecting a larger number of babies and children, whose immune systems aren’t primed to fend it off. Cases of RSV and other respiratory illnesses have also increased in the UK and in the US, which is also suffering from a shortages of antivirals and antibiotics. In Germany, hospital doctors are having to make difficult decisions about which children to assign to limited intensive care beds. In some cases, children with RSV or other serious conditions are getting transferred to hospitals elsewhere in Germany with spare capacity. “If the forecasts are right, then things will get significantly more acute in the coming days and week,” Sebastian Brenner, head of the paediatric intensive care unit at University Hospital Dresden, told German news channel n-tv. “We see this in France, for example, and in Switzerland. If that happens, then there will be bottlenecks when it comes to treatment.” Others warned that, in certain cases, doctors already were unable to provide the urgent care some children need. “The situation is so precarious that we genuinely have to say children are dying because we can’t treat them any more,” Dr. Michael Sasse, head of paediatric intensive care at Hanover’s MHH University hospital, said. Read full story Source: The Guardian, 1 December 2022- Posted
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- Germany
- Paediatrics
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