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Showing results for tags 'Paediatrics'.
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News Article
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 -
News Article
Logan Mwangi murder: Injuries seen as accident by doctor
Patient Safety Learning posted a news article in News
Hospital doctors failed to share with child protection services a list of "significant" injuries a five-year-old boy suffered 11 months before he was murdered, a case review has found. Logan Mwangi had a broken arm and multiple bruises across his body when he was taken to A&E in August 2020. But a paediatric consultant said these injuries were accidental and did not make a child protection referral. Logan, from Bridgend, was murdered by his mother, stepfather and a teenager. A Child Practice Review (CPR) has looked at how different agencies were involved with Logan's family in the 17 months before his death. Cwm Taf Morgannwg health board said it welcomed the commissioning of an independent review into how it identifies and investigates non-accidental injuries. The report said that if the injuries had been shared with social services, appropriate action could have been taken to safeguard Logan. Jan Pickles, the independent chair of the review panel, said it was a "a significant missed opportunity". She added: "Had further information from health been shared it most likely, though we cannot say for sure because of hindsight bias, would have triggered a child protection assessment in line with the joint agreed guidelines, as the nature of those injuries clearly met the threshold." Read full story Source: BBC News, 24 November 2022 -
News Article
'My baby died of sepsis - we can stop more deaths'
Patient Safety Learning posted a news article in News
New monitors that can detect the deadly blood condition sepsis are being fitted at a Scottish children's hospital. The equipment will be installed at the Royal Hospital for Children in Glasgow. Charlotte Cooper, who lost her nine-month-old daughter Heidi to sepsis last year, said she had "no doubt" the monitors would help save babies' lives. She told BBC Scotland: "You don't have time to come to terms with the fact that someone you love is dying from sepsis because it happens so quickly." Ms Cooper now wants to see the monitors installed in every paediatric ward in Scotland. "We need to do whatever we can to stop preventable deaths from sepsis in Scotland," she said. The monitors record and track changes in heart rate, temperature and blood pressure, and can pick up early sepsis symptoms. The machines, which have been installed in a critical care area, use the Paediatric Early Warning Scores to monitor the children for any signs of deterioration in their condition. Sepsis Research said early warning of the changes would mean sepsis being diagnosed and treated faster. The monitors were accepted on behalf of the hospital by senior staff nurse Sharon Pate, who said: "In a very busy paediatric word it is vital all our patients are monitored regularly and closely for signs of deterioration. The addition of these new monitors will greatly improve our ability to monitor patients and provide vital care." Read full story Source: BBC News, 4 February 2020 -
News Article
Safety fears for hundreds of ‘hidden’ children on ventilators
Patient Safety Learning posted a news article in News
Experts have warned hundreds of “hidden” children who rely on machines to help them breathe at home are at significant risk of harm due to staff shortages, poor equipment and a lack of training. The number of children who rely on long-term ventilation is rising but new research has shown the dangers they face with more than 220 safety incidents reported to the NHS between 2013 and 2017. In more than 40% of incidents the child came to harm, with two needing CPR after their hearts stopped. Other children had to have emergency treatment or were rushed back to hospital. Many parents reported concerns with the skills of staff looking after their children or reported paid carers falling asleep while caring for their child. Families reported having to cover multiple night shifts due to staff shortages, while also having to care for their child during the day. Other patient safety incidents including broken or faulty equipment or information on packaging that did not match the item or incorrect equipment being delivered. Consultant Emily Harrop, who led the study, said it was “easy for the plight of individual complex children to slip down the agenda”. She warned: “This is a very hidden group of very vulnerable children who are at risk without investment in staffing, access to training and good communication." Read full story Source: The Independent, 18 December 2019 -
Content ArticleThe National Paediatric Diabetes Audit (NPDA) is performed annually in England and Wales and aims to provide information that leads to improved quality care for children and young people affected by diabetes. The audit is funded by the Department of Health through the Healthcare Quality Improvement Partnership (HQIP). Key messages in this 2020-21 annual report on care processes and outcomes include: There was an increase of an increase of 20.7% in the number of children aged 0-15 diagnosed with type 1 diabetes compared with 2019-20. Completion rates on recommended health checks were lower than in previous years due to the impact of the Covid-19 pandemic. There was wide variation between paediatric diabetes units in the completion rates of all key annual health checks. A smaller percentage of newly-diagnosed children and young people started insulin pump therapy compared to previous years. The national median HbA1c (a measure of blood glucose control) reduced from 61.5 mmol/mol to 61.0mmol/mol between 2019/20 and 2020/21, following several years of year on year decreases (improvement) in the national median. Children from ethnic minorities were less likely to be using insulin pumps and continuous glucose monitors (CGMs) than white children. However, the highest percentage increase between audit years in the use of CGMs was seen in black children and young people with type 1 diabetes.
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Content Article'Cautious Tortoise' is an easy to follow flow chart that aims to guide parents and caregivers through the early steps of their child's recovery from Covid-19 and Long Covid, while supporting them to preserve energy to aid ongoing recovery. Alongside an infographic flow-chart, this webpage contains frequently asked questions about Covid-19 and Long Covid in children, including: What does the government advise? Long Covid Kids urge families to proceed cautiously When can a child be referred to a Long Covid Paediatric Hub? How many children get Long Covid? Long Covid Symptoms In Children What is post exertional malaise/post exertional symptom exacerbation? When is the right time to return to school?
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Content ArticleThis webpage provides an overview of how human factors affect outcomes in surgical emergencies. It includes: An introduction to human factors Video exploring the case of Elaine Bromiley Explanation of human error and the Swiss Cheese Model Table of factors that reduce human error 'What if?' video showing how simple changes could have resulted in a different outcome in Elaine Bromiley's case Practical tips for managing the paediatric airway in a critically ill child
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Content ArticleThis article in the journal Archives of Disease in Childhood examines patient safety theories and suggests principles to tackle safety challenges specific to paediatric care. The authors provide an overview of the evolution of patient safety theories and tools such as huddles and electronic prescribing. They look at the example of Paediatric Early Warning Systems (PEWS), highlighting that the organisational context and culture in which PEWS is used will dramatically affect its effectiveness as a tool. They conclude that approaches to patient safety must see it as a complex interconnected whole, rooted in the culture and environment in which safety interventions act. They also argue that paediatricians must take a lead in improving the safety of the care they deliver on a systems basis.
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Content ArticleWhere a new or under-recognised risk identified through the NHS England's review of patient safety events doesn’t meet the criteria for a National Patient Safety Alert, NHS England look to work with partner organisations, who may be better placed to take action to address the issue. To highlight this work and show the importance of recording patient safety events, they publish regular case studies. These case studies show the direct action taken in response to patient safety events recorded by organisations, staff and the public, and how their actions support the NHS to protect patients from harm.
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Content Article
Spotting the sick child - online learning tool (2020)
Patient-Safety-Learning posted an article in Paediatrics
This online interactive tool was commissioned by the Department of Health and Health Education England to support health professionals in assessing acutely sick children. It includes footage of real patients, guidance on assessing common symptoms and real test cases. -
Content ArticleQuotes from US doctors on the impact the pandemic has had on their hospitals and the care they are providing.
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Content ArticleDouble-checking the administration of medications has been standard practice in paediatric hospitals around the world for decades, but there is little evidence of its effectiveness in reducing errors or harm. This study in BMJ Quality & Safety measures the association between double-checking and the occurrence and potential severity of medication administration errors. The authors found that: most nurses complied with mandated double-checking, but the process was rarely independent when not carried out independently, double-checking resulted in little difference to the occurrence and severity of errors compared with single-checking where double-checking was not mandated, but was performed, errors were less likely to occur and were less serious. They raise a question about whether the current approach to double-checking is a good use of time and resources, given the limited impact it has on medication administration errors.
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Content ArticleThe purpose of this study from Roberts et al. was to explore anxiety, worry, and posttraumatic stress symptoms (PTSS) in parents of children with food allergies, and to evaluate whether these three psychological outcomes could be predicted by allergy severity, intolerance of uncertainty, and food allergy self-efficacy. The study highlights the need for greater awareness of mental health in parents of children with food allergy.
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Content ArticleThis preprint study (not yet peer reviewed) provides further evidence on Long COVID in children. An anonymous, online survey was developed by an organisation of parents of children suffering from persisting symptoms since initial infection. Parents were asked to report signs and symptoms, physical activity and mental health issues. Only children with symptoms persisting for more than four weeks were included. Symptoms like fatigue, headache, muscle and joint pain, rashes and heart palpitations, and mental health issues like lack of concentration and short memory problems, were particularly frequent and confirm previous observations, suggesting that they may characterise this condition. Authors conclude that a better comprehension of Long COVID is urgently needed.
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Content ArticleHow do we know how a patient is coping with their medicines once they have left our care? How do we know that they are using their medicines safely at home? Surprisingly few medicine errors in children in the home setting are reported, yet evidence suggests that parents sometimes struggle here. We can tackle this hidden medicines safety issue by putting families’ insight at the heart of our interventions. We have to ask. And not least for our infant, children and young adult patients, and their families. Medicines use in this patient group has long been known to be challenging, and many families continue to struggle to use medicines safely at home. But a collaborative approach between healthcare professionals and families can remedy this.
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Content ArticleThis article by Angira Patel discusses the importance of health advocacy and a clinicians professional responsibility towards their patients. Angira also describes current attitudes and practices surrounding advocacy, particularly within the political and social sphere.
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Content ArticleThis is a study evaluating the implementation of a patient safety programme across a paediatric department at the largest public hospital in Guatemala. In their conclusion, the authors note that implementing such programmes in low-resource settings requires recognition of facilitators such as staff receptivity and patient-centredness as well as barriers such as lack of training in patient safety and poor organisational incentives.
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Content ArticleThis study in Clinical Child Psychology and Psychiatry assessed feedback from paediatric diabetes patients and their parents or carers regarding virtual consultations, using a solution focused approach, in a hospital setting. Patients completed an electronic survey following their virtual consultation, and of those surveyed, 86% recommended video consultations to be part of their diabetes care. Qualitative data showed reduced travel time, comfort, reduced need for parking and convenience as the major benefits to patients. The results demonstrated that clinical care was shown to be positive and addressed patients concerns, the majority of respondents (84%) reported that the appointment was about what they wanted it to be about. Using the solution focused model helped overcome the challenges faced with virtual consultations particularly with concerns surrounding safeguarding issues, confidentiality, audio/video difficulties and also helped to support the patient journey.
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Content ArticleThis presentation was given to the Colab Partnership virtual conference in July 2021. Gill Phillips, creator of the Whose Shoes? approach to coproduction and Dr Mary Salama, Consultant Paediatrician at Birmingham Children's Hospital, speak about genuine coproduction and why is it needed for children with medical complexity, giving practical examples from their work. A mother of a child with complex needs shares her lived experience, and paediatric surgeon Joanne Minford shares her experience of coproduction using Whose Shoes?
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Content ArticleUniversity Hospitals Leicester NHS Trust has published a guide to help parents and carers know what to do when young children fall ill. It gives advice on when and where to seek treatment for children suffering from common illnesses or injuries. The guidance, written by doctors, focuses on coughs, minor head injuries, vomiting and fever. The trust said it hoped to help families avoid long waits in A&E departments. Advice in the guide aims to help people decide whether to seek help from their GP, call 111, visit A&E or treat children at home.
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EventuntilEvent overview: Attend the first Paediatric Patient Safety & Human Factors Conference hosted by Great Ormond Street Hospital for Children. Taking a patient-centred approach, this event will bring together experts to consider the challenges of patient safety in paediatrics. It will explore human behaviours that influence safety in healthcare as well as ways to improve safety for children and young people. It will also discuss ways to support patients, families and colleagues when things go wrong and how we can learn from these events. This event is open to all paediatric healthcare professionals including medical, nursing, AHP, administrative and support staff. Event objectives: To share knowledge and develop a better understanding of the impact of compassion on patient safety in paediatrics. To discuss the challenges in patient safety, ways to support families and colleagues when challenges persist and how to learn from events to reduce the likelihood of harm. To explore innovations in paediatric patient safety and share this knowledge. To foster and expand paediatric patient safety networks, to collectively improve care for children and their families. Register
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Content ArticleTests 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.
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Content ArticleIntrahospital 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.
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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. -
Content ArticlePaediatric 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.
