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Showing results for tags 'Paediatrics'.
Found 157 results
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Content ArticleThis National Paediatric Diabetes Audit (NPDA) report on care and outcomes 2022/23 found that the prevalence of children and young people cared for in Paediatric Diabetes Units (PDUs) in England and Wales has increased from 33,251 in 2021/22 to 34,371 in 2022/23, despite a fall in the incidence of new cases. It also found that the percentages of children and young people with Type 1 and Type 2 diabetes receiving all six key annual healthcare checks have increased, but there remains much variability between PDUs (and completion rates for those with Type 2 remain lower than for those with Type 1). Other findings include: Percentages of young people with early signs of micro and macrovascular complications for both Type 1 and Type 2 diabetes show very little change in 2022/23 compared to the previous audit year Use of diabetes related technology has increased in 2022/23, with around half of children and young people with Type 1 diabetes using insulin pumps and half using a real time continuous glucose monitor (rtCGM) Around a quarter of all new cases of Type 1 diabetes had diabetic ketoacidosis (DKA) at diagnosis, compared to 25.6% in 2021/22. The report also states that, despite improvements in outcomes and use of technologies across different ethnicities and areas of deprivation, inequalities remain evident. In terms of rtCGM use, the inequality gap by deprivation has reduced, however the difference in use between Black and White children with Type 1 diabetes has widened from 8.6% in 2021/22 to 14% in 2022/23.
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News Article
Thousands of children unsure of gender identity ‘let down by NHS’, report finds
Patient Safety Learning posted a news article in News
Thousands of vulnerable children questioning their gender identity have been let down by the NHS providing unproven treatments and by the “toxicity” of the trans debate, a landmark report has found. The UK’s only NHS gender identity development service used puberty blockers and cross-sex hormones, which masculinise or feminise people’s appearances, despite “remarkably weak evidence” that they improve the wellbeing of young people and concern they may harm health, Dr Hilary Cass said. Cass, a leading consultant paediatrician, stressed that her findings were not intended to undermine the validity of trans identities or challenge people’s right to transition, but rather to improve the care of the fast-growing number of children and young people with gender-related distress. But she said this care was made even more difficult to provide by the polarised public debate, and the way in which opposing sides had “pointed to research to justify a position, regardless of the quality of the studies”. “There are few other areas of healthcare where professionals are so afraid to openly discuss their views, where people are vilified on social media, and where name-calling echoes the worst bullying behaviour. This must stop.” Read full story Source: The Guardian, 10 April 2024 -
Content ArticleDr Hilary Cass has submitted her final report and recommendations to NHS England in her role as Chair of the Independent Review of gender identity services for children and young people. The Review was commissioned by NHS England to make recommendations on how to improve NHS gender identity services, and ensure that children and young people who are questioning their gender identity or experiencing gender dysphoria receive a high standard of care, that meets their needs, is safe, holistic and effective. The report describes what is known about the young people who are seeking NHS support around their gender identity and sets out the recommended clinical approach to care and support they should expect, the interventions that should be available, and how services should be organised across the country. It also makes recommendations on the quality improvement and research infrastructure required to ensure that the evidence base underpinning care is strengthened.
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Content ArticleThis improvement initiative featured in the Journal of Patient Safety aimed to examine whether the independent double check (IDC) during administration of high alert medications resulted in improved patient safety when compared with a single check process. The authors found that IDC had no impact on reported medication events compared with single checking.
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Content ArticleOfficial data on whooping cough show that reports of suspected cases are at a 15-year high in the first three months of 2024. This article in the Pharmaceutical Journal looks at why cases are increasing, including falling rates of children receiving the childhood 6-in-1 vaccine and maternal vaccination. It outlines the symptoms of whooping cough, describes how it can be treated and includes a map identifying infection 'hot spots' in England and Wales. This article is free to read but you will need to sign up for a free Pharmaceutical Journal online account.
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Content ArticleSevere myalgic encephalomyelitis or chronic fatigue syndrome (ME/CFS) in children and young people is a little-understood condition which significantly impacts education, development and quality of life. This study in BMJ Paediatrics Open used data from a population-wide surveillance study to explore the screening investigation, referral and management of suspected cases of paediatric severe ME/CFS. The authors found that full investigation is frequently incomplete in children and young people with suspected severe ME/CFS. Recommendations for referral and management are poorly implemented—in particular the needs of children and young people who are unable to leave their home might be poorly met.
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News ArticleThe Royal College of Paediatrics and Child Health has called on the UK government not to wait until after the upcoming general election to approve an infant immunisation programme against respiratory syncytial virus (RSV), so that babies can be protected next winter. In June 2023 the Joint Committee on Vaccinations and Immunisations (JCVI) recommended developing an RSV immunisation programme for infants and for older adults.1 It issued a fuller statement reiterating the advice in September 2023.2 But the government has yet to make a final decision on rolling out an RSV immunisation programme. A letter signed by more than 2000 paediatricians and healthcare professionals says that the sooner a full RSV vaccination programme is implemented the more effective it will be and that it “could save child health services reaching breaking point.” Read full story (paywalled) Source: BMJ, 20 March 2024
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Content ArticleDiagnostic delays in the emergency department (ED) are a serious patient safety concern. This retrospective cohort study included children treated at 954 EDs across 8 states, and examined the association between ED volume and delayed diagnosis of first-time diagnosis of an acute, serious conditions (e.g., bacterial meningitis, compartment syndrome, stroke). The researchers found that EDs with lower pediatric volume had higher rates of delayed diagnosis across 23 serious conditions.
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Content ArticleNurses play a significant role during transitions of care, such as discharge from inpatient care to the home. Findings from this systematic review of 15 studies confirm the role of nurses in ensuring high-quality care and patient safety in pediatric inpatient care. The review identified five essential elements that could be used in a checklist to ensure safe discharge to home – emergency management, physiological needs, medical device and medications management, and short-term and long-term management.
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Content ArticleAdverse safety events (ASE) are common in paediatric out-of-hospital cardiac arrests (OHCA). This retrospective chart review study sought to estimate the prevalence of adverse safety events in children under age 18 experiencing OHCA. The researchers found that 60% of those children experienced at least one severe ASE, with the highest odds of ASE occurring when the OHCA was birth-related.
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Content ArticleThis study aimed to determine whether the use of video telemedicine for paediatric consultations to referring hospital emergency departments (EDs) results in less frequent medication errors than the current standard of care—telephone consultations. The authors found no statistically significant differences in physician-related medication errors between children assigned to receive telephone consultations vs video telemedicine consultations.
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Content ArticleSepsis is an emergency medical condition where the immune system overreacts to an infection. It affects people of all ages and, without urgent treatment, can lead to organ failure and death. This leaflet by the Sepsis Trust outlines the symptoms of sepsis in children and aims to help parents and carers identify when to seek medical help.
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Content ArticleStrategies to reduce medication dosing errors are crucial for improving outcomes. The Medication Education for Dosing Safety (MEDS) intervention, consisting of a simplified handout, dosing syringe, dose demonstration and teach-back, was shown to be effective in the emergency department (ED), but optimal intervention strategies to move it into clinical practice remain to be described. This study aimed tov describe implementation of MEDS in routine clinical practice and associated outcomes. The study was conducted in five stages (baseline, intervention 1, washout, intervention 2, and sustainability phases). The 2 intervention phases taught clinical staff the MEDS intervention using different implementation strategies. The study found that both MEDS intervention phases were associated with decreased risk of error and that some improvement was sustained without active intervention. These findings suggest that attempts to develop simplified, brief interventions may be associated with improved medication safety for children after discharge from the ED
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Content ArticleThis US study in the journal Pediatrics analysed a national sample of paediatric hospitalisations to identify disparities in safety events. The authors used data from the 2019 Kids’ Inpatient Database and looked at the independent variables of race, ethnicity and the organisation paying for care (for example, private insurance company or Medicaid). The results showed disparities in safety events for Black and Hispanic children, indicating a need for targeted interventions to improve patient safety in hospitals.
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Content ArticleIncorporating parental values in complex medical decisions for young children is important but challenging. This review in The Lancet Child & Adolescent Health explores what it means to incorporate parental values in complex paediatric and perinatal decisions. It provides a narrative overview of the paediatric, ethics and medical decision-making literature, focusing on value-based and ethically complex decisions for children who are too young to express their own preferences.
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Content ArticleThe relationship between the fields of human factors and patient safety is relatively nascent but represents a powerful interaction that has developed in only the last twenty years. Application of human factors principles, techniques, and science can facilitate the development of healthcare systems, protocols, and technology that leverage the enormous and adaptable capacity of human performance while acknowledging human vulnerability and decreasing the risk of error during patient care. This chapter will review these concepts and employ case studies from neonatal care to demonstrate how an understanding of human factors can be applied to improve patient safety.
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Content ArticleThe aim of this study was to investigate the incident reporting process (IR1s), to calculate the costs of reporting incidents in this context and to gain an indication of how economic the process was and whether it could be improved to yield better outcomes.
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Content ArticleAs health care specialists, we spend a huge amount of time considering, empathising with, and addressing the needs of the people we want to help. We intimately understand the challenges children and young people face, and how these may impact their health and development long term. Exposed daily to this kind of emotional and physical distress, it can be easy for compassion fatigue to creep in. Our brains work automatically to protect our own mental health, almost desensitising us to the trauma experienced by others. It’s much easier to think of people as statistics, especially when it comes to children and young people. But the more we think in terms of statistics, the more immune to them we become, the more empathy we lose and the less potential there is for an effective, caring health care system that works well for everyone. We need to put the care back into health care.
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Content Article
Knitted items – potential for harm to babies? (2018)
Patient Safety Learning posted an article in Paediatrics
This safety article aims to outline the actions taken by the patient safety team at NHS Improvement in response to a reported incident and to highlight potential for harm to babies from knitted items. Related reading on the hub: Finger injuries from infant mittens; a continuing but preventable hazard (April 1996) Notes from a Patient Safety Education Network discussion on a similar incident. (This is a group for UK hub members involved in patient safety education/training in their organisations and members of the hub can join by emailing support@PSLhub.org.) -
Content ArticleDuring the last 4 years, three infants have presented with finger-tip injuries secondary to entrapment in woollen/synthetic mittens. The accident happened at home in one case but the other two occurred in different neonatal units. Spontaneous amputation of the terminal phalanx of the index finger occurred in two patients but in the other there was complete healing. This problem may be avoided by restricting the use of mittens, by changing their design, and by a greater awareness of this hazard. Related reading on the hub: Knitted items – potential for harm to babies? (2018) Notes from a Patient Safety Education Network discussion on a similar incident. (This is a group for UK hub members involved in patient safety education/training in their organisations and members of the hub can join by emailing support@PSLhub.org.)
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Content ArticleRacial and ethnic disparities in health are substantial and persistent in the USA. They occur from the earliest years of life, are perpetuated by societal structures and systems, and profoundly affect children’s health throughout their lives. This series of articles in The Lancet Child & Adolescent Health summarises evidence on racial and ethnic inequities in the quality of paediatric care, outlines priorities for future research to better understand and address these inequities and discusses policy solutions to advance child health equity in the USA. Racial and ethnic inequities in the quality of paediatric care in the USA: a review of quantitative evidence Policy solutions to eliminate racial and ethnic child health disparities in the USA
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Content ArticleMedication is a common cause of preventable medical harm in paediatric inpatients. This study aimed to examine the sociotechnical system surrounding paediatric medicines management and to identify potential gaps in this system and how these might contribute to adverse drug events (ADEs). The authors advocate the following actions as a result of the insights gained about contributing factors to ADEs: processes to involve parents in the care of their children in hospital. development of skill-mix interventions to ensure appropriate expertise is available where it is needed. modified checking procedures to permit staff to use their skills and judgment effectively and efficiently.
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Content ArticleThe Situation Awareness for Everyone (S.A.F.E.) programme has been used at 50 sites over four years to help reduce 50 sites over four years. This toolkit has been produced by the Royal College of Paediatrics and Child Health (RCPCH) to support child health professionals to use S.A.F.E. principles at their sites. The toolkit contains four modules: Translating quality improvement into action Theories of patient safety and application to the S.A.F.E programme The S.A.F.E programme: from reaction to anticipation Team perspectives
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Content ArticleThe Paediatric Intensive Care Audit Network (PICANet) has published the National Paediatric Critical Care Audit State Nation Report 2023. Based on a data collection period from January 2020 to December 2022, it describes paediatric critical care activity which occurred within Level 3 paediatric intensive care units and Specialist Paediatric Critical Care Transport Services in the United Kingdom (UK) and Republic of Ireland (ROI). This report contains key information on referral, transport and admission events collected by the National Paediatric Critical Care Audit to monitor the delivery and quality of care in relation to agreed standards and evaluate clinical outcomes to inform national policy in paediatric critical care. It reports on the following 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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Content ArticlePaediatric drug optimization (PADO) exercises aim to identify key priority products and their preferred product characteristics for research and development. These have been successfully undertaken for HIV, hepatitis C, tuberculosis and antibiotics, demonstrating their potential and impact to accelerate access to optimal formulations in the context of fragmented, small markets for medicines for children. WHO convened and facilitated a paediatric exercise for neglected tropical diseases to ensure that more targeted research and development efforts can address the specific needs of infants and children. These are schistosomiasis, human African trypanosomiasis (HAT), scabies, onchocerciasis and visceral leishmaniasis (VL).
