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Found 224 results
  1. Content Article
    This month, we’ve been looking back over 2020 and highlighting some of the key areas of health and care that Patient Safety Learning has worked in this year. First, Chief Executive, Helen Hughes, gave an overview, detailing some of the main ways we’ve been achieving our aims as an organisation. Following that, we looked at the impact of the COVID-19 pandemic on patient safety, and, earlier this week, we focused on advice and support for people living with Long COVID. In this blog, Patient Safety Learning reflect on the work we’ve been doing to highlight serious patient safety concerns relating to hysteroscopy procedures in the NHS and how we’ve been making the case for change.
  2. Content Article
    In this wonderfully personal reflection, Junior Doctor and Clinical Fellow, Lisa Rampersad, argues that women are taught to apologise for their pain from an early age. Lisa draws on her own experiences, including those as a patient herself, to highlight a need for a better understanding of the female anatomy. She concludes by sharing her own approach as a clinician, encouraging others to listen and believe their patients when they talk about pain. 
  3. Event
    until
    The institution of medicine has always excluded women. From ancient beliefs that the womb wandered through the body causing 'humours' to 19th century Freudian hysteria, female bodies have been marked as unruly, defective, and lesser. We are still feeling the effects of these beliefs today. In 2008, a study of over 16,000 images in anatomy textbooks found that the white, heterosexual male was presented as the ‘universal model’ of a human being. We see this play out in medical research, when it isn't considered necessary to include women's experiences: approximately 70% of people who experience chronic pain are women, and yet 80% of pain study participants are men or male rats. We also see these beliefs inform clinical decisions. When experiencing pain, women are more likely to be given sedatives than painkillers, in a nod to the stereotype that women are more emotional and are therefore probably exaggerating the nature of their pain. This phenomenon is known as the gender pain gap, which describes the disparities in medical care that men and women receive purely due to their gender. But while awareness has risen over the last few years, how close are we to really closing the gender pain gap? Join The Femedic and Hysterical Women in discussion with Dr Omon Imohi, Dr Hannah Short, and research charity Wellbeing of Women as we consider how far medicine has come and how far we still have to go. Register
  4. Content Article
    In this short video produced by Endometriosis Explained, retired gynaecologist, MJ Quinn, talks about the neuropathic causes of painful hysteroscopy. This includes seven recommendations for how to avoid severe pain outpatient hysteroscopy. 
  5. Content Article
    Pain is spoken about often within health and social care. Patients might be asked to locate our pain during examinations, to rate our level of pain or to describe the type of pain we are feeling. They may be forewarned of the possibilities of pain occurring during or after procedures or operations. Medical consent forms often include reference to the risk of pain and require a signature to confirm they have been appropriately ‘informed’. Pain can be acute (lasting less than 12 weeks) or chronic (lasting more than 12 weeks), and the way we experience it, our thresholds, can also vary. It can be our body’s way of warning us of potential damage, yet it can also occur when no actual harm is happening to the body.[1] It can cause trauma, physiological reactions, mental health difficulties and chronic fatigue, and can have a huge impact on someone’s quality of life and ability to perform daily tasks.[2] Pain is undoubtedly complex, but is it a patient safety issue?[3]
  6. Content Article
    Hysteroscopy is a diagnostic gynaecological procedure traditionally requiring administration of general anaesthesia, but more frequently completed using local anaesthesia within a day-case (ambulatory) setting. Advantages associated with this transition include decreased completion times, fewer risks, and lower clinical costs. Numerous services advertise the procedure as being either pain free or low pain; however, it is estimated that 25% of patients report experiencing intense or intolerable pain. For severe pain, local anaesthetic can be administered, but this does not guarantee effective pain management. This research, published in the British Journal of Anaesthesia, found that very few patients feel no pain and a significant number felt pain of greater than 7/10. It also found a disconnect between the patient's experience of pain and the clinician's perception of it. This research paper is paywalled, but can be purchased via the link below.
  7. Content Article
    In this blog, Stephanie O'Donohue, Content and Engagement Manger for Patient Safety Learning, discusses some of the patient safety issues that specifically impact on women. Drawing on recent inquiries, patient testimonials and research, Stephanie focuses on three main issues; consent, patient engagement and bias. She highlights the need for people to work in partnership to understand the barriers to safe care for women and to prevent future harm. 
  8. Content Article
    Hysteroscopy is a procedure used as a diagnostic tool, to identify the cause of common problems such as abnormal bleeding, unexplained pain or unusually heavy periods in women. It involves a long, thin tube being passed into the womb, often with little or no anaesthesia. In recent years, there has been an increased focus on these procedures being performed within outpatient services. The availability of pain relief is much reduced in these settings. There are financial incentives in place to support this move to day surgery.[1] Reflecting on activity to date, Patient Safety Learning discusses the important role that consent, patient engagement and collaborative action is playing in highlighting a serious patient safety concern and in driving the change needed for safe hysteroscopy.
  9. Content Article
    The Campaign Against Painful Hysteroscopy is a campaign group raising awareness of the safety flaws that exist within the processes surrounding hysteroscopy procedures for women.  On 20 October 2020, they wrote to Matt Hancock MP, Secretary of State for Health and Social Care and Nadine Dorries MP, Minister for Patient Safety, Suicide Prevention and Mental Health. In their letter they used both empirical data and the personal stories of women to illustrate the prevalence and seriousness of the issue. 
  10. Content Article
    Dr Richard Harrison is a pain researcher employed at the University of Reading and affiliated with the School of Psychology and Clinical Language Sciences (SPCLS) and Centre for Integrative Neuroscience and Neurodynamics (CINN). His research focuses predominately on pain, examining psychological processes underlying how pain is processed, as well as individual differences in the ability to modulate (or control) the experience of pain. In this blog, Richard reflects on his recent research on pain experience and assessment during hysteroscopy procedures, published recently in the British Journal of Anaesthesia. "The dangers of advertising hysteroscopy as a mildly painful procedure are many. Firstly, this stands to put women off engaging with a very useful diagnostic test for the identification of serious medical conditions, such as ovarian cancer or endometriosis. But secondly, it is highly plausible that the resulting prediction error stands to make the experience even more painful than if patients were appropriately warned."
  11. Content Article
    Authors of this commentary published in the Canadian Medical Association journal argue that many patients suffer from a specific adverse event on a daily basis: pain. It is never reported as an adverse event and corrective action is often not taken.
  12. Content Article
    This blog, published in the BMJ, sets the context for an Evidence Based Nursing (EBN) Twitter Chat that took place on 18 March 2015. The chat focused on whether mismanaged (undertreated) pain should be considered an adverse event. The Twitter Chat was hosted by Dr Alison Twycross who is editor of EBN and has also done lots of work in the area of paediatric pain management. This blog provides some context for the chat. The examples given relate to paediatric pain but the principles apply to pain in patients of all ages.
  13. News Article
    In ‘Invisible Women: Exposing Data Bias in a World Designed For Men’ author Caroline Criado Perez writes about Rachael, a woman who suffered years of severe and incapacitating pain during her period. It takes, on average, eight years for women in the UK to obtain a diagnoses of endometriosis. In fact, for over a decade, there has been no improvement in diagnostic times for women living with the debilitating condition. You might think, given the difficulty so many women experience in having their symptoms translated into a diagnosis, that endometriosis is a rare condition that doctors perhaps don’t encounter all that often. Yet it is something that affects one in ten women – so what is going wrong? Read the full article here in The Scotsman
  14. Content Article
    The World Health Organization (WHO) is actively exploring the role of compassion in quality health care. This Global Health Compassion Rounds (GHCR) highlighted the compelling evidence around compassion and quality care—not only for patients, but also for providers and health care organisations. Respondents offered their views of the implications of this evidence at national, district, and community levels of care. 
  15. Content Article
    Restorative practices involve inclusive democratic dialogue between all those affected by healthcare harm. They are guided by concern to address harms, meet needs, restore trust, and promote repair or healing for all involved. In this webinar recording from the Canadian Patient Safety Institute, participants explore New Zealand's approach to healing after healthcare harm from surgical mesh and ask: What was the impetus for a restorative approach?  What inspired the choice of a relationship-centric and reconciliatory model?  How did restorative practices support the co-design process between consumer advocates and Ministry of Health representatives? How do restorative approaches support New Zealand's commitment to Te Tiriti o Waitangi- The treaty that determines the partnership between the Crown and indigenous peoples?
  16. Content Article
    Undertreated, unrecognised, or poorly managed pain in young people can have long-lasting negative consequences in later life, including continued chronic pain, disability and distress. This Lancet Child & Adolescent Health Commission presents four transformative goals – to make pain matter, understood, visible, and better. It sets out priorities for clinicians, researchers, funders, and policy makers, and calls for cross-sector collaboration to deliver the action needed to improve the lives of children and adolescents with pain.
  17. News Article
    Patients who saw a pain medicine specialist via telemedicine saved time and money and were highly satisfied with their experience, even before the COVID-19 pandemic, according to a study presented at the ANESTHESIOLOGY® 2020 annual meeting. Results of the study confirm many chronic pain patients are confident they will receive good care via telemedicine, while avoiding lengthy commutes and time spent in traffic. "This era of contactless interactions and social distancing has really accelerated the adoption of telemedicine, but even before the pandemic, patient satisfaction was consistently high," said Laleh Jalilian, M.D., lead author of the study and clinical assistant professor at the University of California, Los Angeles (UCLA). "Patients who are being evaluated for new conditions may be better off having office visits initially. But once patients establish a relationship with providers, follow-up visits can occur efficiently with telemedicine, while maintaining patient rapport and quality outcomes. We believe 50% of our visits could be conducted via telemedicine." "Now that telemedicine is more widespread, it may become a valued part of care delivery in chronic pain practices," said Dr. Jalilian. "Clearly many patients benefitted from remote consultations and follow-up appointments using telemedicine. We hope it will encourage policymakers and insurance providers to continue to support these platforms and inspire more innovation in this developing field of research and patient care." Read full story Source: EurekAlert, 5 October 2020
  18. Content Article
    This guidance from the British Dental Association provides information to help support dental practitioners and the wider dental team in the safe use of conscious sedation techniques.
  19. Content Article
    The report defines the standards for the provision of conscious sedation in the delivery of dental care.
  20. Content Article
    This Scottish Dental Clinical Effectiveness Programme guidance aims to promote good clinical practice through recommendations for the safe and effective provision of conscious sedation for dental care. 
  21. Content Article
    Conscious sedation helps reduce anxiety, discomfort, and pain during certain procedures. This is accomplished with medications and (sometimes) local anesthesia to induce relaxation. Conscious sedation is commonly used in dentistry for people who feel anxious or panicked during complex procedures like fillings, root canals, or routine cleanings. It’s also often used during endoscopies and minor surgical procedures to relax patients and minimise discomfort. Find out more about the procedure, the drugs used and the side effects.
  22. Content Article
    Acute and chronic pain place a huge burden on our society. Approximately 10% of the population in Western countries report suffering from chronic pain, and both chronic and acute pain are responsible for high absenteeism in the workplace. It is therefore crucial that we have effective ways of treating pain. Unfortunately though, we have no objective measures of pain - no blood tests, no urine dipsticks. We have to rely on what the patient tells us. So how then do we know what are and what are not effective pain treatments? It is here that the principles of evidence-based medicine have been of great value - helping us to understand the most effective forms of pain treatment. Bandolier's Little Book of Pain is a unique portable guide to evidence-based pain treatments. For each possible treatment, the book provides the evidence supporting the efficacy of the treatment, along with a clinical bottom line, for those requiring immediate information. Written by world leaders in the field of evidenced-based pain treatments, the book will be indispensable for the multi-disciplinary professionals managing acute and chronic pain in primary and secondary care.
  23. Content Article
    In this article, Berlanda et al. discuss the safety of different medical treatments for endometriosis to relieve pain.
  24. Community Post
    *Trigger warning. This post includes personal gynaecological experiences of a traumatic nature. What is your experience of having a hysteroscopy? We would like to hear - good or bad so that we can help campaign for safer, harm free care. You can read Patient Safety Learning's blog about improving hysteroscopy safety here. You'll need to be a hub member to comment below, it's quick and easy to do. You can sign up here.
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