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Found 949 results
  1. Content Article
    Traditional approaches to patient safety and handoffs need redesigning to acknowledge the different constraints, goals, and requirements necessary for each individual patient. There is no “one size fits all” approach to patient safety, handoffs or a perfect checklist. Despite the inherit complexity present in healthcare systems, we tend to reduce our thinking about handoffs into simple solutions of checklists and cognitive aids. In studies of these tools, their association with patient outcomes is unclear with mixed results in large studies. Incorporating general resilience engineering principles of visibility, understanding, anticipation, and learning provides new opportunities for increased patient safety. This involves situating the handoff in the context of the system - understanding the process of summarising pre-handoff and of developing understanding post-handoff, tracing flows of information and patients, and considering the role of feedback and control loops in the system. Direct observations, analysis of multiple outcomes, focus on patient evolving specific exceptions, reducing the number of handoffs, taking time for two-way discussions, and user-centred design and redesign may promote acceptability and sustainability of a new view of handoffs for improved patient safety.
  2. Content Article
    Calculating nurse staffing in the acute hospital has become a key issue but solutions appear distant. Community, mental health and areas such as learning disability nursing have attracted less attention and remain intractable. This review from Leary and Punshon aimed to examine current approaches to the issue across many disciplines.
  3. Content Article
    New study from Farr et al. into the effect of implanting polypropylene (PP) surgical mesh into patients. More evidence is needed to show the harmful effect to patients by implanting a foreign body into them, especially into the pelvic floor.
  4. Content Article
    Improving medication safety during transitions of care is an international healthcare priority. While existing research reveals that medication-related incidents and associated harms may be common following hospital discharge, there is limited information about their nature and contributory factors at a national level which is crucial to inform improvement strategy. This study in the journal Therapeutic Advances in Drug Safety aimed to characterise the nature and contributory factors of medication-related incidents during transitions of care from secondary to primary care. The authors found several themes for future research that could support the development of interventions, including: commonly observed medication classes older adults increase patient engagements improve shared care agreements for medication monitoring post hospital discharge.
  5. Content Article
    The Learning Together Evaluation framework for Patient and Public Engagement (PPE) in research is an adaptable tool which can be used to plan and to evaluate patient engagement before, during and at the end of a project. The Learning Together Framework can be used in multiple ways with the purpose of mutual learning and understanding by all partners. It is rooted in seven guiding principles of patient engagement defined by the patient-oriented research community: Relationship building Co-building Equity, diversity and inclusion Support and barrier removal Transparency Sustainability Transformation
  6. Content Article
    To receive and participate in medical care, patients need high quality information about treatments, tests, and services—including information about the benefits of and risks from prescription drugs. Provision of information can support ethical principles of patient autonomy and informed consent, facilitate shared decision making, and help to ensure that treatment is sensitive to, and meets the needs and priorities of, individuals. Patients value high quality, written information to supplement and reinforce the verbal information given by clinicians. This is the case even for those who do not want to participate in shared decision making. The aim of this study was to evaluate the frequency with which relevant and accurate information about the benefits and related uncertainties of anticancer drugs are communicated to patients and clinicians in regulated information sources in Europe. The findings of this study highlight the need to improve the communication of the benefits and related uncertainties of anticancer drugs in regulated information sources in Europe to support evidence informed decision making by patients and their clinicians.
  7. Content Article
    The NHS Knowledge and Library Hub connects NHS staff and learners to high quality knowledge and evidence resources in one place, using a single search.  includes all journal articles, e-books, guidelines and evidence summary tools provided nationally and by your local NHS library team provides seamless access to full text, as an immediate download or on request from an NHS library avoids the less-reliable sources you might find in a general web search. Full access is free to all NHS staff and learners using your NHS OpenAthens account. 
  8. Content Article
    The ‘McNamara fallacy’ (also known as quantitative fallacy) is named after the US Secretary of Defense during the Vietnam War. The fallacy consists of over-reliance on metrics, and may be summarised as: ‘if it cannot be measured, it is not important’. This paper describes the McNamara fallacy as it applies to medicine and healthcare, taking as examples hospital mortality data, NHS targets and quality assurance.
  9. Content Article
    In this guest post, Michael A. Osborne, Professor of Machine Learning at Oxford's Department of Engineering Science looks at how the medical community is failing to explore the links between Long Covid and ME/Chronic Fatigue Syndrome (ME/CFS). He describes the symptoms common to both conditions and highlights the historic lack of funding and attention ME/CFS research and treatment has received.
  10. Content Article
    This article by Till Bruckner of Transparimed outlines how a new UK law will affect how clinical trial results are reported. The UK Government will introduce a legal requirement to make the results of all clinical trials public within 12 months of trial completion. Any company or university breaking the law will be refused permission to start new trials.
  11. Content Article
    In this study, Tsampasian et al. looked at what the risk factors were for developing post−COVID-19 condition (also known as Long Covid). The systematic review and meta-analysis of 41 studies, including 860 783 patients, found that female sex, older age, higher body mass index, smoking, preexisting comorbidities, and previous hospitalisation or ICU admission were risk factors significantly associated with developing Long Covid, and that SARS-CoV-2 vaccination with two doses was associated with lower risk of Long Covid. The findings of this systematic review and meta-analysis provide a profile of the characteristics associated with increased risk of developing Long Covid and suggest that vaccination may be protective against Long Covid.
  12. Content Article
    This innovative, practical guide introduces researchers to the use of the video reflexive ethnography in health and health services research. This methodology has enjoyed increasing popularity among researchers internationally and has been inspired by developments across a range of disciplines: ethnography, visual and applied anthropology, medical sociology, health services research, medical and nursing education, adult education, community development, and qualitative research ethics.
  13. Content Article
    Research on maternity care often focuses on factors that prevent good communication and collaboration and rarely includes important stakeholders – parents – as co-researchers. To understand how professionals and parents in Dutch maternity care accomplish constructive communication and collaboration, Korstjens et al. examined their interactions in the clinic, looking for “good practice”.
  14. Content Article
     Researchers writing in the Journal of the Royal Society of Medicine say that while UK life expectancy has increased in absolute terms over recent decades, other, similar countries are experiencing larger increases. In 1952, when Queen Elizabeth II came to the throne, the UK had one of the longest life expectancies in the world, ranking seventh globally behind countries such as Norway, Sweden and Denmark. In 2021 the UK was ranked 29th. The researchers show the rankings of the G7 countries at each decade from 1950 to 2020. The G7 is a collection of countries with advanced economies (UK, Canada, France, Germany, Italy, Japan and the U.S.) that represent about half of global economic output.
  15. Content Article
    This study in Brain, Behaviour & Immunity - Health aimed to examine associations between symptomatic Covid-19 history, neurocognitive function and psychiatric symptoms. The authors used cognitive task performance, functional brain imaging and a prospective population survey to conduct the study. Converging findings from laboratory and population survey data support the conclusion that symptomatic Covid-19 infection is associated with task-related, functional imaging and self-reported indices of cognitive dysfunction as well as psychiatric symptoms. In some cases, these findings appear to be more amplified among women than men, and among older women than younger.
  16. Content Article
    This article in BBC Science Focus looks at the factors driving an increase in testosterone prescribing for women in the UK. The author, Dr Michelle Griffin, highlights the need to ensure that there is a strong evidence base for prescribing testosterone to women. While there have been some clinical trials and studies around testosterone as a treatment for low libido, there is concern that patients, doctors and pharma companies are relying on anecdotal accounts of its effectiveness to treat symptoms such as low mood, poor concentration and tiredness. She also highlights that testosterone prescribing is just one example of the lack of research going into women's health issues and treatments, and argues that this is contributing to health inequity.
  17. Content Article
    Concerns about Covid-19 related mental health are substantial, but the sheer volume of low quality evidence has posed a barrier to evidence synthesis and decision making. In this systematic review,  Thombs et al. synthesised results of mental health outcomes in cohorts before and during the Covid-19 pandemic. The authors compared general mental health, anxiety symptoms, and depression symptoms in the general population and other groups during covid-19 with outcomes from the same cohorts before Covid-19. The study found high risk of bias in many studies and substantial heterogeneity suggest caution in interpreting results. Nonetheless, most symptom change estimates for general mental health, anxiety symptoms, and depression symptoms were close to zero and not statistically significant, and significant changes were of minimal to small magnitudes. Small negative changes occurred for women or female participants in all domains. The authors will update the results of this systematic review as more evidence accrues.
  18. Content Article
    Medication errors are an important cause of preventable morbidity, especially in children in emergency department (ED) settings. Internal use of voluntary incident reporting (IR) is common within hospitals, with little external reporting or sharing of this information across institutions. In this paper published Emergency Medicine Journal, authors describe the analysis of paediatric medication events (ME) reported in 18 EDs in a paediatric research network in 2007–2008.
  19. Content Article
    The ‘improvement’ of healthcare is now established and growing as a field of research and practice. This article by Cribb et al., based on qualitative data from interviews with 21 senior leaders in this field, analyses the growth of improvement expertise as not simply an expansion but also a multiplication of ‘ways of knowing’. It illustrates how healthcare improvement is an area where contests about relevant kinds of knowledge, approaches and purposes proliferate and intersect. One dimension of this story relates to the increasing relevance of sociological expertise—both as a disciplinary contributor to this arena of research and practice and as a spur to reflexive critique. The analysis highlights the threat of persistent hierarchies within improvement expertise reproducing and amplifying restricted conceptions of both improvement and ‘better’ healthcare.
  20. Content Article
    The Bulletin of the World Health Organization is a fully open-access monthly journal of public health with a special focus on low and middle-income countries.
  21. Content Article
    Healthcare is a $4 trillion component of the US economy, and the well-being of the clinician workforce is a major factor determining its effectiveness. Extensive evidence indicates that inefficiency, poorly designed workflows and processes, suboptimal teamwork, work overload, isolation, problems with work-life integration, and a professional culture that expects perfection and discourages help-seeking are currently contributing to high levels of occupational distress among clinicians. Although the problem and its impact on the health care delivery system are well defined, there is minimal evidence regarding effective interventions to drive progress. This knowledge gap is, in large part, due to the near-complete absence of federal funding for research to address one of the critical challenges facing the US health care delivery system.
  22. Content Article
    This study from Jones et al. identified wide variability in the implementation of the Guardian role and concluded that optimal implementation has six components.
  23. Content Article
    This article in Nurse Leader examines mounting evidence for nurse and patient safety associated with registered nurse (RN) fatigue. What changes driven by strong evidence are nursing leaders enacting to reduce the impact of RN fatigue on patient and nurse safety?
  24. Content Article
    This cross-sectional study, published in Workplace Health & Safety, used secondary survey data sent to approximately 7,100 health care workers at a large academic medical centre in the United States. Instruments included: the Hospital Survey on Patient Safety Culture a WPV scale measuring physical and verbal violence perpetrated by patients or visitors the Emotional Exhaustion scale from the Maslach Burnout Inventory. Findings suggest that improvements in hospital strategies aimed at patient safety culture, including team cohesion with handoffs and transitions, could positively influence a reduction in physical and verbal violence perpetrated by patients or visitors, and burnout among health care workers.
  25. Content Article
    The OptiBreech project is a research study exploring the feasibility of evaluating a new care pathway for women with a breech pregnancy. About 1 in 25 babies are born bottom-down (breech) after 37 weeks of pregnancy. Women who wish to plan a vaginal breech birth have asked for more reliable support from an experienced professional. This aligns with national policy to enable maternal choice. In this video, Dr Shawn Walker explains why the combination of meconium and tachycardia, particularly in the first stage of labour, indicates increased risk in breech births.
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