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News Article
After coronavirus, we may not recognise changed NHS
Patient Safety Learning posted a news article in News
In many ways it is wrong to talk about the NHS restarting non-coronavirus care. A lot of it never stopped — births, for instance, cannot be delayed because of a pandemic. However, exactly what that care looks like is likely to be very different from what came before. There are more video and telephone consultations and staff treat patients from behind masks and visors. That is likely to be the case for some time, experts have told The Times. Read full story (paywalled) Source: The Times, 6 June 2020 -
News Article
Prime Minister urged to give NHS 100 new hospitals plus an extra £7bn a year
Patient Safety Learning posted a news article in News
NHS leaders have urged Boris Johnson’s government to build 100 new hospitals and give the service an extra £7bn a year for new facilities and equipment. They want the Prime Minister to commit to far more than the 40 new hospitals over the next decade that the Conservatives pledged during the general election. So many hospitals, clinics and mental health units are dilapidated after years of underinvestment in the NHS’s capital budget that a spending splurge on new buildings is needed, bosses say. Too many facilities are cramped and growing numbers are unsafe for patients and staff, they claim. Johnson has promised £2.7bn to rebuild six existing hospitals and pledged to build 40 in total and upgrade 20 others, although has been criticised for a lack of detail on the latter two pledges. The call has come from NHS Providers, which represents the bosses of the 240 NHS trusts in England that provide acute, mental health, ambulance and community-based services. Read full story Source: The Guardian, 3 February 2020 -
News ArticleDoctors and nurses must adapt their routines and improvise their actions to ensure continued patient safety, and for their roles to be effective and to matter as new technology disrupts their working practices. Research from Lancaster University Management School, published in the Journal of Information Technology, found electronic patient records brought in to streamline and improve work caused changes in the division of labour and the expected roles of both physicians and nursing staff. These changes saw disrupted working practices, professional boundaries and professional identities, often requiring complex renegotiations to re-establish these, in order to deliver safe patient care. Managers implementing these systems are often quite unaware of the unintended consequences in their drive for efficiency. Read full story Source: EurekAlert, 25 November 2019
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News Article
Hospital alarms prove a noisy misery for patients
Patient Safety Learning posted a news article in News
When Kea Turner’s 74-year-old grandmother checked into Virginia’s Sentara Virginia Beach General Hospital in the US, with advanced lung cancer, she landed in the oncology unit where every patient was monitored by a bed alarm. “Even if she would slightly roll over, it would go off,” Turner said. Small movements — such as reaching for a tissue — would set off the alarm, as well. The beeping would go on for up to 10 minutes, Turner said, until a nurse arrived to shut it off. Tens of thousands of alarms shriek, beep and buzz every day in every US hospital. All sound urgent, but few require immediate attention or get it. Intended to keep patients safe by alerting nurses to potential problems, they also create a riot of disturbances for patients trying to heal and get some rest. Alarms have ranked as one of the top 10 health technological hazards every year since 2007, according to the research firm ECRI Institute. That could mean staffs were too swamped with alarms to notice a patient in distress, or that the alarms were misconfigured. The Joint Commission, which accredits hospitals, warned the nation about the “frequent and persistent” problem of alarm safety in 2013. It now requires hospitals to create formal processes to tackle alarm system safety, but there is no national data on whether progress has been made in reducing the prevalence of false and unnecessary alarms. The commission has estimated that of the thousands of alarms going off throughout a hospital every day, an estimated 85-99% do not require clinical intervention. Staff, facing widespread “alarm fatigue,” can miss critical alerts, leading to patient deaths. Patients may get anxious about fluctuations in heart rate or blood pressure that are perfectly normal, the commission said. Read full story Source: The Washington Post, 24 November 2019 -
Content ArticleThe article in the Journal of Global Health examines the unique patient safety risks that can arise in fragile, conflict-affected and vulnerable settings (FCV), including humanitarian crises, conflict, extreme adversity, services disruption and immediate or protracted emergencies. Recent estimates suggest a large proportion of the total number of preventable deaths take place in FCV settings, including 60% of preventable maternal deaths, 53% of deaths in children under five years, and 45% of neonatal deaths. The authors highlight a gap in knowledge and research about healthcare in FCV settings, which prevents researchers from being able to effectively assess interventions for quality, safety and sustainability. They suggest that more academic research is urgently needed in order to make policy and practice more effective in improving patient safety in these settings.
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Content Article
Staff safety and wellbeing
Becky T posted an article in Staff safety
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An original article that explores the significance of both staff physical safety in the workplace as well as their psychological safety and wellbeing. In particular, I highlight the impact the COVID-19 pandemic has had on both these areas, and discuss the importance of ensuring all aspects of staff safety. -
Content ArticlePeople in England’s most deprived neighbourhoods work longer hours than those in the rest of the country but live shorter lives with more years in ill health costing an estimated £29.8bn a year to the economy in lost productivity. People living in these communities were also 46% more likely to die from COVID-19 than those in the rest of England. The findings, revealed in a joint report released today by the All-Parliamentary Party Group for ‘left behind’ neighbourhoods and Northern Health Science Alliance, shows the devastating impact of poor health for those living in deprived areas and left behind neighbourhoods (LBNs) and makes a number of recommendations to overcome the health inequalities faced by people living in these places. Those living in local authorities that contain ‘left behind’ neighbourhoods have a further £2bn gap in lost productivity compared to those areas with a similar rate of deprivation but with more civic assets, connectedness and an active and engaged community. Across most measures people in these areas fair even worse than those in deprived neighbourhoods.
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Content ArticleLong dreary corridors, impersonal waiting rooms, the smell of disinfectant — hospitals tend to be anonymous and depressing places. Even if you’re just there as a visitor, you’re bound to wonder, “How can my friend recover in such an awful place? Will I get out of here without catching an infection?” But the transformation of the Rotterdam Eye Hospital suggests that it doesn’t have to be this way. Over the past 10 years, the hospital’s managers have transformed their institution from the usual, grim, human-repair shop into a bright and comforting place. By incorporating design thinking and design principles into their planning process, the hospital’s executives, supported by external designers, have turned the hospital into a showplace that has won a number of safety, quality, and design awards.
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Content Article
Responding to patient alarms in single patient rooms
katepym posted an article in Equipment and facilities
This survey for health and care staff looks at how quickly staff are aware of alarms emitted by bedside monitoring equipment in single patient rooms, and their ability to respond. Doors to single patient rooms are often kept shut for long periods of time for reasons of privacy, dignity and (at the moment especially) infection control. With the UK Government targeting a growth in the proportion of NHS hospital rooms which have a single bed, is this a risk to the health and wellbeing of patients? This is not a specific issue where data is collected, so an online survey has been created to gather feedback and opinions. -
EventEnergy-based devices, lasers and diathermy are some of the most commonly used pieces of equipment in operating theatres today. Dangerous emissions can be produced that affect the respiratory systems of everyone in the operating theatre. This study day will look at the occupational hazards of exposure to surgical plume in the operating theatre, as well as the associated risks to the surgical team, patients and visitors. It will also highlight how to assess risk and mitigate against the dangers of surgical plume and how to implement changes. Topics Include: Electrosurgery/diathermy/laser. Anaesthetic airway fires. Laparoscopic surgery aerosolisation. Health and Safety and risk assessment. Surgical plume. Register
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Content ArticleTheatres are a high risk area. This poster from the Association for Perioperative Practice and BD illustrates how to plan and practise to manage a surgical fire. Download a pdf of the poster from the attachment below.
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Content ArticleTony Clarke suffered from a chronic inflammatory skin disease, hidradenitis suppurativa. In September 2020, Tony underwent surgery to remove infected tissue on one side of his body. When he entered the operating theatre, Tony’s surgical team first covered part of his body with an alcohol-based solution, to keep the area clean. Then, when the operation began, the surgeons began cutting off the infected tissue using a diathermy pen, a device that targets electrically-induced heat to stop wounds from bleeding. However, shortly into the surgery, disaster struck: heat from the surgical pen had ignited the alcohol on Tony’s body. “But because alcohol burns so hot, no fire was seen,” says Tony, recalling an explanation he later received from the hospital. “The surgeons were concentrating on the right side of my body. The left side was left burning for about 20 minutes.” For the next four months, Tony travelled back to the hospital every three days, to get his injuries checked and bandages changed. During that time, Tony describes himself as ‘totally disabled.’ In September this year, Tony, as a patient ambassador for prevention of surgical fires, spoke at a conference held in York by the Association for Perioperative Practice (AFPP). There, perioperative practitioners from across the country gathered to listen to Tony’s experience. “I was speaking to lots and lots of different professionals in the medical service and they'd never heard of it [being set on fire during surgery]. It was a rarity for them,” Tony says. Tony’s now working with different health agencies, with the aim of stopping preventable surgical burns entirely.
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News Article
Overcrowded A&Es ‘much more dangerous now because of covid’
Patient Safety Learning posted a news article in News
Emergency departments across England are reporting ‘dangerous’ overcrowding similar to levels seen pre-covid, and struggling to maintain social distancing, A&E leaders have warned. The Royal College of Emergency Medicine said it was concerned about covid spreading among the most vulnerable patients, as overall transmission rates continue to rise sharply across the UK. It was always anticipated that A&E activity would return to pre-covid levels this winter, following a significant drop-off in A&E activity during the spring and early summer, and that service transformation would be needed to help maintain social distancing. But the emergence of widespread overcrowding so far ahead of winter is of serious concern to system leaders. A&E staff were already being forced to make difficult trade-offs over which patients to isolate, the college’s vice president told HSJ. He also urged NHS leaders not to place unrealistic expectations on the impact a new model involving walk-in patients booking slots by phone could make on addressing overcrowding in emergency departments. RCEM vice president Adrian Boyle said the NHS was “largely back to the pre-covid levels of crowding” but it was “much more dangerous now because of covid”. He said: “We are hearing that most emergency departments can’t maintain social distancing safely and staff are having to make fairly difficult trade-offs about which people need to be isolated. No one can be safely social distanced in a corridor.” Read full story (paywalled) Source: HSJ, 21 September 2020 -
Content ArticleThe Quality Network for Inpatient Working Age Mental Health Services (QNWA) based within the Royal College of Psychiatrists' Centre for Quality Improvement are pleased to announce the publication of their 8th edition standards. Since the publication of the first edition standards in 2006, the Network has grown to include over 140 members from the NHS and private sector. This new edition of standards aims to reflect the changes in working practices and legislation over the last two years in addition to placing greater emphasis on equality, diversity and inclusion as well as sustainability in inpatient mental health services. The eighth edition standards have been drawn from key documents and expert consensus and have been subject to extensive consultation with professional groups involved in the provision of inpatient mental health services, and with people and carers who have used services in the past.
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Content ArticleAn investigation started on 9 October 2020 into the death of Matthew Alexander Caseby. Following his admission and subsequent absconsion from the Priory Hospital in Edgbaston, Matthew stepped in front of a train on the 8 September 2020 and was fatally injured. At the time, Matthew was suffering from disorder thinking and did not have the capacity to form any intention to end his life. Matthew absconded from Beech ward over a fence in the courtyard area and at the time of his absconsion Matthew was unattended. It was inappropriate for Matthew to be left unattended in the courtyard. There were concerns regarding Matthew absconding but the recording processes on Beech ward were inadequate which resulted in the communication to staff involved in Matthew's care being lacking. As a result of risks not being fully recorded, Matthew's risk assessment was not adequate as it was not based on all of the available information. Overall, the inadequate risk assessment for Matthew, the inadequate documentation records, the lack of a risk assessment for the courtyard area and the absence of a policy regarding observations levels in the courtyard means that the courtyard was not safe for Matthew to use unattended. His death was contributed to by neglect on the part of the treating hospital.
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Content ArticleISO 45001 is an international standard for health and safety at work developed by national and international standards committees independent of government. Introduced in March 2018, it replaces the current standard (BS OHSAS 18001) which will be withdrawn. Businesses have a three-year period to move from the old standard to the new one. You're not required by law to implement ISO 45001 or other similar management standards, but they can help provide a structured framework for ensuring a safe and healthy workplace.
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Content ArticleIn March 2018, the Secretary-General of the United Nations launched a global call to action for WASH in all healthcare facilities, noting that healthcare facilities are essential tools in reducing disease, and that without basic WASH services, healthcare facilities can instead contribute to more infections, prolonged hospital stays and preventable deaths, including of mothers and babies. This call was answered in a May 2019 World Health Assembly resolution calling on countries to conduct comprehensive assessments of WASH and IPC in health care facilities, and to take steps to improve WASH and IPC conditions where necessary. In May 2022, the World Health Assembly passed a resolution calling for WHO to draft a global strategy on infection prevention and control. The World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF), through the WHO/ UNICEF Joint Monitoring Programme for Water Supply, Sanitation and Hygiene (JMP) release progress updates on WASH in households, WASH in schools and WASH in health care facilities every two years. This 2022 update presents national, regional and global estimates for WASH in healthcare facilities up to the year 2021, with a special focus on the linkages between WASH and infection prevention and control (IPC). Achieving universal access to WASH in health care facilities requires political will and strong leadership at both national and facility levels, but is highly cost-effective, and would yield substantial health benefits.
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Content ArticleSuccessful adoption of novel noncontact physiological measurement and physical monitoring requires analysis of how they support patient care. Lloyd-Jukes et al. review available technologies and present their vision-based patient monitoring and management system, supported by a framework enabling its integration within clinical workflows. The framework links tasks such as assessing patients to elements of the patient journey (eg, risk factors and early warning signs). The system enabled insights from patient activity reports and noncontact vital sign measurements. It supports staff in ensuring patients' health follows desired trajectories, avoiding adverse events, making observations without disrupting patients' rest, intervening proactively, and learning from incidents.
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Content ArticlePerioperative practitioners in the UK are universally concerned about the risk surgical smoke plume poses to their health. Yet less than a fifth are aware of any policy being in place to manage this risk within their organisation. The majority of hospitals have plume evacuation equipment in place, but it is only used in the minority of surgical procedures. Almost three-quarters of theatre staff have experienced symptoms associated with exposure to surgical smoke plume. But these symptoms are rarely reported and, when they are, no action is generally taken. These are the findings of a new report published by the Surgical Plume Alliance (SPA), a joint advocacy initiative between the Association for Perioperative Practice (AfPP) and the International Council on Surgical Plume (ICSP). They aimed to gain a greater understanding of the awareness levels, training, management and policy surrounding surgical smoke plume in the UK.
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Content ArticleKaren Lesley Starling died on 7 February 2020 aged 54 and Anne Edith Martinez died on 17 December 2020 aged 65. Both deceased underwent successful lung transplant procedures at the new Royal Papworth Hospital. However, both women became infected with a hospital acquired infection, namely Mycobacteria abscessus (M. abscessus), and died. M. abscessus is an environmental non-tuberculous mycobacterium (NTM). It can sometimes be found in soil, dust and water, including municipal water supplies. It is usually harmless for healthy people but may cause opportunistic infection in vulnerable individuals. Lung transplant patients and lung defence patients such as Mrs Starling and Mrs Martinez were at particular risk of infection from mycobacteria, including M. abscessus.
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Content ArticleAt the beginning of the pandemic, there was an important question to resolve: is coronavirus “airborne”? If it was, then this meant that the virus could transmit through the air from person to person, even over long distances, in indoor environments. We now know the answer is yes. In the 19th century diseases such as cholera and typhoid taught us the importance of water quality – coronavirus in the 21st century should provide that same realisation on the importance of air quality. Ideally, all indoor environments where people congregate should be fitted with modern, efficient ventilation systems that flush out potentially contaminated air and replace it with fresh, clean air continually. This would prevent the build-up of virus-containing aerosols and reduce the likelihood of transmission of covid-19 and other diseases such as influenza. With energy costs rising, it is vitally important to find methods of preventing virus transmission that are safe, quick to implement and affordable, writes Dr Alice Bunn in this HSJ article.
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Content ArticleLucy is a world-leading authority on recovering from disaster. She has been at the centre of the most seismic events of the last few decades, advising on everything from the 2004 Boxing Day tsunami to the 7/7 bombings, the Christchurch earthquake in New Zealand, the Grenfell fire and the Covid-19 pandemic. In every catastrophe, Lucy is there to pick up the pieces and prepare for the next one. She holds governments to account, helps communities rally together, returns personal possessions to families, and holds the hands of the survivors. In her moving memoir she reveals what happens in the aftermath and explores how we pick up and rebuild with strength and perseverance. She takes us behind the police tape to scenes of destruction and chaos, introducing us to victims and their families, but also to the government briefing rooms and bunkers, where confusion and stale biscuits can reign supreme. Telling her own personal story, Lucy looks back at a life spent on the edges of disaster, from a Liverpudlian childhood steeped in the Hillsborough tragedy to the many losses and loves of her career.
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Content ArticleCommunity Diagnostic Centres (CDCs) can relieve pressure on NHS acute services and bring diagnostic services closer to patients. This resource by the Chartered Institute of Ergonomics & Human Factors (CIEHF) explores ten principles for including systems thinking in the design of the diagnostic workforce and CDC services.
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Event
Human Factors for Patient Safety Course
Patient Safety Learning posted an event in Community Calendar
Patient Safety is an essential part of health and social care that aims to reduce avoidable errors and prevent unintended harm. Human Factors looks at the things that can affect the way people work safely and effectively, such as the optimisation of systems and processes, the design of equipment and devices used and the surrounding environment and culture, all of which are key to providing safer, high quality care. New for September 2020, this part-time, three year, distance learning course, from the Centre of Excellence Stafford, focuses specifically on Human Factors within the Health and Social Care sectors with the aim of helping health and social care professionals to improve performance in this area. The PgCert provides you with the skills to apply Human Factors to reduce the risk of incidents occurring, as well as to respond appropriately to health, safety or wellbeing incidents. Through the study of Human Factors, you will be able to demonstrate benefit to everyone involved, including patients, service users, staff, contractors, carers, families and friends. Further information -
Content Article
COVID-19: voices from the front line
Claire Cox posted an article in Stories from the front line
The COVID-19 pandemic has changed most lives internationally. Households have shifted, balancing financial concerns and anxieties about the health of family and friends with the trials and responsibilities of childcare. During this pandemic it became clear that while many were struggling with the same issues, a series of shared stories could help the wellbeing of frontline NHS staff who might feel isolated and alone. The following voices are not unique to Guy’s and St Thomas’ NHS Foundation Trust, anaesthesia or healthcare in the UK, but they were selected from the department to represent some of many healthcare workers who have taken on new professional roles as well as radically different ways of working and living.
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