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Showing results for tags 'Paediatrics'.
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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 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 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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News Article
Autistic girl, 14, unlawfully detained in hospital, high court judge finds
Patient Safety Learning posted a news article in News
A 14-year-old autistic girl was unlawfully detained in hospital and restrained in front of scared young patients, a high court judge has found. On one occasion last month the teenager managed to break into a treatment room where a dying infant was receiving palliative care. She was restrained there by three security guards, Mr Justice MacDonald said in a judgment in the family court that ordered Manchester city council (MCC) to find the girl a suitable community care placement instead of what he described as the “brutal and abusive” and “manifestly unsuitable” hospital environment. Nurses witnessed the girl screaming “very loudly” and sounding “very scared” when repeatedly held down on her hospital bed so that she could not move her legs, arms or head, before being tranquillised. Other children on the ward were frightened to witness the frequent battles between the girl and security guards, the judge said. The judge noted that the teenager made “regular and determined” efforts to run away, sometimes using screwdrivers to try to unlock doors and windows, and running away from her family on walks. He described the teenager as having an autistic spectrum disorder and a learning disability. She demonstrated “complex and extreme behaviour” that could not be controlled even within a school environment involving six adults to one child supervision, he added. Despite this, the council and NHS trust decided to have the girl be detained in hospital on a general paediatric ward “solely as a place of safety”, without applying for the necessary court order to do so, the judge found. She did not require any medical treatment, the judge said. Read full story Source: The Guardian, 5 April 2022 -
News Article
Doctor accused of failings following Claire Roberts' death
Patient Safety Learning posted a news article in News
A paediatrician who was at the centre of one of Northern Ireland's longest running public inquiries will appear before a professional misconduct panel. Dr Heather Steen is accused of several failings following the death of Claire Roberts at the Royal Belfast Hospital for Sick Children in October 1996. The nine-year-old's death was examined by the hyponatraemia inquiry, which lasted 14 years. It examined the role of several doctors. Among his findings, the inquiry's chairman Mr Justice O'Hara said there had been a "cover-up" to "avoid scrutiny." Monday's tribunal will inquire into allegations that, between 23 October 1996 and 4 May 2006, Dr Steen "knowingly and dishonestly carried out several actions to conceal the true circumstances" of the child's death. Also that the doctor provided inappropriate, incomplete and inaccurate information to the child's parents and GP regarding the treatment, diagnosis, clinical management and cause of her death. The tribunal website adds: "It is also alleged that Dr Steen inappropriately recommended a brain-only post-mortem for Patient A (Claire Roberts) when a full post-mortem was necessary. "In addition, it is alleged that Dr Steen failed to refer Patient A's death to the coroner, inappropriately completed the medical certificate of cause of death and inaccurately completed the autopsy request form for Patient A. "Furthermore, it is alleged that during a review of Patient A's notes, Dr Steen failed to consult with the necessary colleagues and medical teams and provided a statement and gave evidence to the coroner's inquest into Patient A's death which omitted key information." Read full story Source: BBC News, 21 March 2022 -
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 ArticleAn examination of how humans interact with their environments and each other led this team to question one of its long-standing medication safety practices and change how they work.
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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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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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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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EventuntilInfection is a leading cause of childhood deaths, but many of these deaths are avoidable with timely treatment. The national Before Arrival at Hospital Project (BeArH), funded by the National Institute for Health Research (NIHR), explored what happens to children under five years of age with serious infections before they are admitted to hospital. The aim of this research was to explore what helps children get help quickly and what might slow this process down, so that lessons could be learned for the care of this group of children in the future. This forum will be led by Professor Sarah Neill, Dr Damian Roland and Natasha Bayes. To join the research forum and hear the findings of this important research project from the study team, email lpt.research@nhs.net for the Microsoft Teams link.
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News ArticleLondon’s fragmented children’s cancer services will finally be reformed following a decade of delays and allegations of cover-up by senior officials. NHS England has said it will adopt recommendations that will see the capital’s services brought up to standards already common across the rest of the country, with children’s cancer centres needing to be based in hospitals with full paediatric intensive care units. The changes will be imposed “with no exceptions or special arrangements permitted,” it said in a letter yesterday. This means the Royal Marsden’s children’s service at its base in Sutton, south London, will have to move to a new hospital. Currently sick children who deteriorate at the Marsden’s site have to be rushed by ambulance to St George’s Hospital 40 minutes away. More than 330 children were transferred from the Marsden to other hospitals between 2000 and 2015 and in one year 22 children were transferred for intensive care a total of 31 times, with some experiencing at least three transfers individually. The changes will also affect cancer care at University College London Hospital which links with Great Ormond Street Children’s Hospital. The world-renowned Royal Marsden trust, whose chief executive Dame Cally Palmer is also NHS England’s national cancer director, was at the centre of a cover-up scandal before the COVID-19 pandemic. In 2019, the Health Service Journal revealed a major report, commissioned by NHS bosses in London following the deaths of several children, had been “buried” by NHS England. Read full story Source: The Independent, 12 November 2021
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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 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. -
News Article
Children’s intensive care at near full national occupancy amid rising RSV
Patient Safety Learning posted a news article in News
A senior doctor has warned that paediatric intensive care units (PICUs) are ‘as pressured as I can ever recall’ – despite the absence of cold weather, which typically leads to higher demand levels. James Fraser, president of the Paediatric Critical Care Society, said national bed occupancy in PICUs has “often been greater than 95 per cent” over recent weeks, while several units have reported 100 per cent occupancy. He said some children have had to be transferred between regions in order to admit them to a bed. PICUs are often under more pressure during winter, due to seasonal RSV and other viral infections. But high demand levels have started earlier this year, which has meant severely ill children have occasionally waited longer in local hospitals before being admitted to PICUs, and have sometimes had to be transferred to another site. Mr Fraser told HSJ: “[PICUs] are really busy, as pressured as I can ever recall them. “Every winter PICUs are under huge pressure due to seasonal RSV bronchiolitis. This usually happens between November and February. This year we always anticipated it would be a much longer season. It’s putting a lot of pressure on our national bed base. “What is different is we have been under this pressure earlier in the year with RSV and other viral chest infections. We have been under this pressure for a month. The pressure is both the number of patients and there are a lot of staff off having to self-isolate." Read full story (paywalled) Source: HSJ, 29 October 2021 -
News Article
Deaths of two children spark ‘urgent’ investigations at leading trust
Clive Flashman posted a news article in News
Five serious incidents, including the deaths of two children, spark “urgent” investigations at specialist trust Great Ormond Street Hospital FT has linked the incidents partly to what it described as a “faulty” batch of a type of glue used to close wounds during surgery Supplier says it followed the correct recall processes for the product Five serious incidents, including the deaths of two children, have sparked ‘urgent’ investigations into the processes through which clinicians are alerted to potential safety concerns over medical products used on patients. Great Ormond Street Hospital Foundation Trust has been investigating the incidents which happened between December 2020 and April 2021. The trust has linked the incidents partly to what it described as a “faulty” batch of a type of glue used to close wounds during surgery. The glue, called Histoacryl, is produced by B. Braun Medical Ltd, and the company issued three separate “field safety notices”, relating to different batches of the product, in March and April this year. The company has stressed that it followed the correct recall processes throughout. According to a report to GOSH’s public board meeting on 29 September, Histoacryl has been used for the endovascular treatment of brain arteriovenous malformations for more than 30 years, but earlier this year batches of the product were identified as hardening less rapidly than expected. The trust told HSJ in a statement: “A comprehensive serious incident investigation has been carried out to determine the impact of the faulty glue on all patients treated with it. “The investigation found that whilst the passage of glue through the intended vessel may have been contributory in some instances of harm, it was unlikely to be the sole or main factor. “Both patients who died had serious and complex medical conditions and the procedure to correct these always carries a high degree of risk which is discussed extensively with the families before any treatment takes place.” Read full article here (paywalled) Original source: Health Service Journal -
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 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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News Article
New NHS long COVID service for children
Patient-Safety-Learning posted a news article in News
NHS England are set to launch a new service for children suffering from long COVID. Although data has suggested that children are less likely to suffer from severe disease, there have been an increasing number of reports of continued symptoms. The new service will consist of 15 new paediatric hubs with experts to treat young people and advise their families and carers or refer them to specialist services. The NHS has invested £100m in specialist services to help meet the needs of the possible hundreds of thousands who are expected to experience long COVID with symptoms ranging from breathing difficulties to fatigue. Read full story. Source: Sky News, 15 June 2021 -
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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News Article
Trusts team up for weekend surgery drive to cut paediatric waiting times
Patient Safety Learning posted a news article in News
Three acute trusts have teamed up to carry out surgical procedures on hundreds of children over several weekends as part of plans to tackle waiting lists in the region. Trusts across the Bath and North East Somerset, Swindon and Wiltshire Integrated Care System are pooling resources to tackle long waits in paediatric oral and ear, nose and throat services. The initiative began on the April bank holiday weekend. Thirty-eight of the longest waiters from Royal United Hospitals Bath Foundation Trust, who had been waiting up to 74 weeks for oral surgery, were treated by Salisbury FT. The other trust involved in the plans is Great Western Hospitals FT. More than 400 children are expected to be treated over a series of joint surgery weekends. The next, which will also focus on both oral and ENT surgery, will take place over the early May bank holiday. RUH’s chief executive Cara Charles-Barks told HSJ the joint surgery plans will have a “huge impact” on the region’s elective waiting lists. Read full story (paywalled) Source: HSJ, 21 April 2021 -
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.
