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Found 949 results
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Content ArticleInterruptions and multitasking are implicated as a major cause of clinical inefficiency and error. The aim of this study by Westbrook et al. was to measure the association between emergency doctors' rates of interruption and task completion times and rates.
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Content ArticleStephanie Longe first arrived in the UK from Switzerland in 2019 to work at the High Consequence Emerging Viruses Group at what is now the UK Health Security Agency. At the time, her project was focused on Ebola virus disease survivors. But Covid quickly changed plans. Stephanie and her colleagues had to use their skills to develop Covid treatments and new antivirals. Stephanie was involved in early research to study the Sars-CoV-2 infection, and test vaccine candidates. Then in June 2022, Stephanie had Covid and she is now one of the 2 million people who experience self-reported Long Covid symptoms in the UK. She shares her experience of Long Covid and the research she is doing in this Guardian article.
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Content ArticleSentinel Event Alerts from the Joint Commission identify specific types of sentinel event (a patient safety event that results in death, permanent harm or severe temporary harm), describe their common underlying causes and suggest steps to prevent them occurring in the future. This Sentinel Event Alert looks at the well-documented link between health care worker fatigue and adverse events. It looks at: The impact of fatigue Contributing factors to fatigue and risks to patients Actions suggested by The Joint Commission for healthcare organisations
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Content ArticleThis systematic review in BMJ Open synthesised evidence on the impacts of insufficient sleep and fatigue on health and performance of physicians in independent practice, as well as on patient safety. The authors also assessed the effectiveness of interventions targeting insufficient sleep and fatigue. The authors found that fatigue and insufficient sleep may be associated with negative physician health outcomes, but concluded that current evidence is inadequate to inform practice recommendations.
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Content ArticleElectronic prescribing (ePrescribing) systems allow healthcare professionals to enter prescriptions and manage medicines using a computer. Sheikh and colleagues set out to find out how these ePrescribing systems are chosen, set up and used in English hospitals. Given that these systems are designed to improve medication safety, we looked at whether or not these systems affected the number of prescribing errors made (mistakes such as ordering the wrong dose of medication). They also tried to see whether or not the systems were good value for money (or more cost-effective). Finally, they made recommendations to help hospitals choose, set up and use ePrescribing systems.
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Content ArticlePain and trauma experienced as a preterm baby in the NICU have been linked to lasting psychological injury, altered brain development and individuals' ability to regulate emotions later in life. In this blog, Vox's Science and Health Editor Brian Resnick looks at how scientists are investigating how to treat pain in babies who can’t tell you when it hurts.
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Content ArticleThis study in the journal Acta Neuropathologica Communications examined neuropathological findings of patients who died following hospitalisation in an intensive care unit with Covid-19. The researchers conducted brain autopsy on 20 people who had died, followed by ex-vivo imaging and dissection. They found that acute tissue injuries and microglial activation were the most common abnormalities discovered in Covid-19 brains. They also found evidence of encephalitis-like changes despite the lack of detectable virus. The majority of older subjects showed age-related brain conditions even in the absence of known neurologic disease. The findings of this study suggest that acute brain injury alongside common pre-existing brain disease may put older subjects at higher risk of post-Covid neurological issues.
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Content Article
The haunting brain science of Long Covid (Stat,16 February 2023)
Patient-Safety-Learning posted an article in Blogs
In this article for Stat, E. Wesley Ely, Professor of Medicine and Critical Care at Vanderbilt University Medical Center, looks at the impact Covid-19 and Long Covid can have on people's brains. He speaks to people with Long Covid who have experienced a sharp decline in brain function, leading to them losing their jobs, struggling to hold a conversation and in some cases developing early-onset dementia. He also highlights biomedical research that has shown changes to the brain in people with confirmed Covid-19 infections, including a reduction in grey matter, problems in the cells lining the blood vessels and impaired cellular metabolism in the frontal lobe six months following acute Covid. -
Content ArticleWaiting for procedures delayed by COVID-19 may cause anxiety and related adverse consequences. This study from Gagliardi et al. looked at the research on the mental health impact of waiting and patient-centred mitigation strategies that could be applied in the COVID-19 context. Findings revealed patient-centred strategies to alleviate the mental health impact of waiting for procedures. Ongoing research should explore how to optimize the impact of those strategies for diverse patients and caregivers, particularly in the COVID-19 context.
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News Article
Former vaccines chief sounds warning about UK pandemic readiness
Patient Safety Learning posted a news article in News
The UK is not in a significantly better place to deal with a new pandemic, the former vaccine taskforce chief has said, as a leading public health expert suggested Covid infections may be on the rise again. Dame Kate Bingham, the managing partner at the life sciences venture capital firm SV Health Investors, headed the UK’s vaccine taskforce between May and December 2020. Speaking to a joint session of the Commons health and social care committee and the science and technology committee, about lessons learned during the pandemic, Bingham said many of the initiatives set up by the taskforce had been dismantled, while key recommendations it had provided had not been acted upon. “To begin with, I thought it was lack of experience of officials since we don’t have a lot of people within Whitehall who understand vaccines, relationships with industry, all of that, but actually, I’m beginning to think this is deliberate government policy, just not to invest or not to support the sector,” she said. Among her concerns, Bingham cited the failure to create bulk antibody-manufacturing capabilities in the UK and the proposed termination of the NHS Covid vaccine research registry through which the public could indicate their willingness to participate in clinical trials for Covid vaccines. The decision by the National Institute for Health and Care Research to close the registry was eventually reversed after Robert Jenrick, then a health minister, stepped in. “I am baffled as to the decisions that are being made,” she said. Bingham also raised concerns about the length of time it is taking to agree a contract with Moderna – a US-based company that produces mRNA Covid vaccines – to create a research and development, and manufacturing, facility in the UK. Read full story Source: The Guardian, 30 November 2022 -
News Article
Poorer women in UK have sixth-highest cancer death rates in Europe, WHO finds
Patient Safety Learning posted a news article in News
Poorer women in Britain have some of the highest death rates from cancer in Europe, an in-depth new World Health Organization study has found. They are much more likely to die from the disease compared with better-off women in the UK and women in poverty in many other European countries. Women in the UK from deprived backgrounds are particularly at risk of dying from cancer of the lungs, liver, bladder and oesophagus (foodpipe), according to the research by the International Agency for Research on Cancer (IARC), the WHO’s specialist cancer body. IARC experts led by Dr Salvatore Vaccarella analysed data from 17 European countries, looking for socioeconomic inequalities in mortality rates for 17 different types of cancer between 1990 and 2015. Out of the 17 countries studied, Britain had the sixth-worst record for the number of poor women dying of cancer. It had the worst record for oesophageal cancer, fourth worst for lung and liver cancer and seventh worst for breast and kidney cancer. However, the UK has a better record on poor men dying of cancer compared with their counterparts in many of the other 16 countries. It ranked fifth overall, second for cancer of the larynx and pharynx, and third for lung, stomach and colon cancer. That stark gender divide is most likely because women in the UK began smoking in large numbers some years after men did so, the researchers believe. They pointed to the fact that while cases of lung cancer have fallen among men overall in Britain, they have remained stable or increased among women, and gone up among women from deprived backgrounds. Read full story Source: The Guardian, 28 November 2022 -
News Article
Patient harm versus medical malpractice: What US clinicians fear more
Patient Safety Learning posted a news article in News
Attending physicians and advanced practice clinicians in US emergency departments are more concerned about medical errors resulting in patient harm than in malpractice litigation, according to a study published JAMA Network Open. The findings are based on an online survey of 1,222 ED clinicians across acute care hospitals in Massachusetts from January to September 2020. Respondents used a Likert scale of 1 (strongly disagree) to 6 (strongly agree) to indicate their degree of agreement with statements on how fearful they are of making a mistake that leads to a patient harm in their day-to-day practice, and how fearful they are of an error that results in being sued. The mean score was greater for fear of harm (4.40) than fear of being sued (3.40), the findings showed. Researchers said the mean scores for both fear of harm and fear of suit were similar regardless of whether the survey was completed before or after onset of the COVID-19 pandemic. Although previous studies have associated clinicians' fear of legal concerns with "excessive healthcare use through defensive medicine," the role fear of patient harm may play in clinical decision-making is less documented, researchers said. "Although the study did not delineate the association between this concern and potential overuse of testing, it suggested that fear of harm should be considered with, and may be more consequential, than fear of suit in medical decision-making," researchers said. Read full story Source: Becker's Hospital Review, 21 November 2022 -
News Article
Pregnancy soon after miscarriage no more risky - study finds
Patient Safety Learning posted a news article in News
Contrary to current advice, getting pregnant within a few months of an abortion or a miscarriage does not appear to be extra risky for the mum and baby, say researchers who have looked at recent real-life data. The World Health Organization (WHO) recommends at least a six-month gap to give the woman time to recover. However, a study in PLoS Medicine, analysing 72,000 conceptions, suggests couples might safely try sooner for a baby. The baby loss support charity Tommy's says women who feel ready to try again immediately after a miscarriage should do so if there is no medical reason against it. The WHO says more research into pregnancy spacing is already under way and would inform any future updates to the advice. The research from Norway, spanning eight years from 2008 to 2016, found no major differences in outcomes when a new pregnancy happened sooner than a six-month delay. That is a different finding to earlier work in Latin America that - along with other studies - informed the WHO recommendations on pregnancy spacing. The authors of the latest Norwegian analysis say the advice needs reviewing so that couples can make an informed decision about when to try for a baby. Read full story Source: BBC News, 23 November 2022 -
News Article
New mothers more likely to die in UK than Scandinavia
Patient Safety Learning posted a news article in News
Women are four times as likely to die after childbirth in Britain as in Scandinavian countries, a study published in the BMJ has found. Researchers analysed data on the number of women who die because of complications during pregnancy in eight high-income European countries. They found that Britain had the second-highest death rate, with one in 10,000 mothers dying within six weeks of giving birth, only slightly less than in Slovakia, the worst performing. The study found that rates of “late” maternal death — when women die between six weeks and a year after giving birth — were nearly twice as high in Britain as in France, the only other country for which data was available. Heart problems and suicide were the main causes of death. Professor Andrew Shennan, an obstetrician at King’s College London, said: “Any death relating to pregnancy is devastating. Equally shocking are the avoidable discrepancies in worldwide maternal mortality. “Causes of [maternal] death are relatively consistent across the world, and largely avoidable. Most deaths are due to haemorrhage, sepsis and hypertensive disorders of pregnancy. “In Europe, non-obstetric causes of death have become proportionately more common than obstetric causes, including deaths from cardiovascular disease (23%) and suicide (13%); these should be prioritised.” Read full story (paywalled) Source: The Times. 17 November 2022 -
News Article
Europe faces ‘cancer epidemic’ after estimated 1m cases missed during Covid
Patient Safety Learning posted a news article in News
Experts have warned that Europe faces a “cancer epidemic” unless urgent action is taken to boost treatment and research, after an estimated 1m diagnoses were missed during the pandemic. The impact of Covid-19 and the focus on it has exposed “weaknesses” in cancer health systems and in the cancer research landscape across the continent, which, if not addressed as a matter of urgency, will set back cancer outcomes by almost a decade, leading healthcare and scientific experts say. A report, European Groundshot – Addressing Europe’s Cancer Research Challenges: a Lancet Oncology Commission, brought together a wide range of patient, scientific, and healthcare experts with detailed knowledge of cancer across Europe. One unintended consequence of the pandemic was the adverse effects that the rapid repurposing of health services and national lockdowns, and their continuing legacy, have had on cancer services, on cancer research, and on patients with cancer, the experts said. “To emphasise the scale of this problem, we estimate that about 1m cancer diagnoses might have been missed across Europe during the Covid-19 pandemic,” they wrote in The Lancet Oncology. “There is emerging evidence that a higher proportion of patients are diagnosed with later cancer stages compared with pre-pandemic rates as a result of substantial delays in cancer diagnosis and treatment. This cancer stage shift will continue to stress European cancer systems for years to come. “These issues will ultimately compromise survival and contribute to inferior quality of life for many European patients with cancer.” Read full story Source: The Guardian, 15 November 2022 -
News ArticleVoices offer lots of information. Turns out, they can even help diagnose an illness — and researchers in the USA are working on an app for that. The National Institutes of Health is funding a massive research project to collect voice data and develop an AI that could diagnose people based on their speech. Everything from your vocal cord vibrations to breathing patterns when you speak offers potential information about your health, says laryngologist Dr. Yael Bensoussan, the director of the University of South Florida's Health Voice Center and a leader on the study. "We asked experts: Well, if you close your eyes when a patient comes in, just by listening to their voice, can you have an idea of the diagnosis they have?" Bensoussan says. "And that's where we got all our information." Someone who speaks low and slowly might have Parkinson's disease. Slurring is a sign of a stroke. Scientists could even diagnose depression or cancer. The team will start by collecting the voices of people with conditions in five areas: neurological disorders, voice disorders, mood disorders, respiratory disorders and pediatric disorders like autism and speech delays. This isn't the first time researchers have used AI to study human voices, but it's the first time data will be collected on this level — the project is a collaboration between USF, Cornell and 10 other institutions. The ultimate goal is an app that could help bridge access to rural or underserved communities, by helping general practitioners refer patients to specialists. Long term, iPhones or Alexa could detect changes in your voice, such as a cough, and advise you to seek medical attention. Read full story Source: NPR, 10 October 2022
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News Article
Children at similar risk for Long Covid as adults, study suggests
Patient Safety Learning posted a news article in News
A large study today from Germany shows that children and adolescents are at the same relative risk of experiencing COVID-19 symptoms 90 days or more after acute infection as adults are, according to findings in PLOS Medicine. Though kids and adolescents have far fewer deaths or severe outcomes from COVID-19 infections compared to adults, little is known about Long or post-Covid symptoms in this age-group, or symptoms that persist for more than 12 weeks after acute infection. Researchers from the Technical University of Dresden, Germany, used data from half of the German population to determine that kids and adults have the same relative risk of experiencing post-Covid symptoms at 90 days following infection. Martin Roessler, the lead author of the study, said there were significant symptom overlap among kids and adults who experienced symptoms 90 days or more after acute infection. "We found 5 identical outcomes among the 10 outcomes with the highest relative risk among children/adolescents and adults. These symptoms are cough, fever, headache, malaise/fatigue/exhaustion, throat or chest pain," he told CIDRAP News. Other symptoms were more commonly seen in adults, but not kids. Those included a loss of taste or smell, fever, and shortness of breath. Daniel Blatt, MD, a pediatric infectious disease physician at the post-COVID clinic at Norton Children's Hospital in Louisville, Kentucky, said he was not surprised by the study's findings. "It's unclear if Long Covid is the same in children and adults, in terms of pathophysiology, but it's just as real," he said. Blatt, who was not involved in the study, said his clinic also collects data on children and Long Covid. He said the most common symptoms reported in his patients are fatigue, anxiety, and "brain fog," followed by some shortness of breath or muscle pain. "The good news is kids tend to get better, regardless of what intervention is needed," Blatt said. As in adult Long Covid, there's no one-size-fits-all approach for pediatric Long Covid patients. "Some need reassurance; some need a graduated exercise program." Read full story Source: CIDRAP, 10 November 2022 -
News Article
Children to be screened for diabetes risk in UK early detection trial
Patient Safety Learning posted a news article in News
Scientists are launching a trial screening programme for type 1 diabetes in the UK to detect the disease earlier and reduce the risk of life-changing complications. About 20,000 children aged between 3 and 13 are being invited to take part in the Early Surveillance for Autoimmune Diabetes (Elsa) study, with recruitment opening on Monday. The aim is to assess children’s risk of developing type 1 diabetes at the earliest stage possible to ensure a quick and safe diagnosis, and reduce the number being diagnosed when they are already seriously ill. Parth Narendran, a professor of diabetes medicine at the University of Birmingham, said: “As general population screening programmes for type 1 diabetes emerge around the world, we need to explore how best to screen children here in the UK.” Dr Elizabeth Robertson, the director of research at Diabetes UK, which is co-funding the study with the not-for-profit organisation JDRF, said: “Identifying children at high risk of type 1 diabetes could put them and their families on the front foot, helping ensure a safe and soft landing into an eventual diagnosis, avoiding DKA and reducing the risk of life-altering complications.” Read full story Source: The Guardian, 14 November 2022 -
News Article
Antibody jab approved for common winter virus RSV
Patient Safety Learning posted a news article in News
A new treatment to protect babies against a common and potentially dangerous winter virus has been approved by the Medicines and Healthcare products Regulatory Agency (MHRA). Respiratory syncytial virus (RSV) is the main reason children under five end up in hospital. In a normal winter, RSV mostly causes coughs and colds which clear up in a couple of weeks - but it can be particularly serious in infants under the age of two, causing severe lung problems such as bronchiolitis and pneumonia. Every year, about 29,000 babies need hospital care for RSV and most have no other health issues beforehand. The new antibody treatment, called nirsevimab, from Sanofi and AstraZeneca, has already been shown to reduce lower respiratory tract infections caused by RSV by 74.5% in trials involving 4,000 babies. It works by preventing RSV from fusing to cells in the respiratory tract and causing infections. But it still needs more research in larger numbers of babies before it can be used on the NHS. Researchers now plan to investigate whether it can cut the number of babies needing hospital care for RSV, and are urging parents to sign up to their study. The study is open to newborn babies and those up to 12 months old. Only one visit for the antibody injection is needed, and follow-up sessions happen via an app. Co-study leader Dr Simon Drysdale, consultant paediatrician in infectious diseases at London's St George's Hospital, said the treatment could eventually be given at birth to offer protection for the first months of life, or during routine immunisations at two months old. Read full story Source: 10 November 2022 -
News Article
Covid-19: Evusheld protects the most vulnerable patients, analysis shows
Patient Safety Learning posted a news article in News
The antibody drug Evusheld is effective for protecting clinically extremely vulnerable people from Covid-19, including its omicron variants, a preprint study has reported. The prophylactic treatment, manufactured by AstraZeneca, is a combination of two long acting antibodies (tixagevimab and cilgavimab). It is given as two separate, sequential intramuscular injections in the same session and can be administered in the community. A research team, led by the University of Birmingham alongside academics from King’s College London and the UK Health Security Agency, carried out a systematic review and meta-analysis to examine its effectiveness in immunocompromised patients. The paper examined the outcomes among 24 773 immunocompromised participants across 17 international studies, 10 775 of whom received Evusheld. Overall, it reported that the treatment was 86% effective for preventing covid specific death, 88% effective in preventing intensive care admission, effective in preventing hospital admission, and 40% effective in preventing Covid-19 infection. The study’s senior investigator, Lennard Lee, senior research fellow at the University of Birmingham and academic medical oncologist at the University of Oxford, said, “There is strong evidence emerging across the world that this approach of using prophylactic antibody therapies in combination with vaccination is a revolutionary approach to safeguard the most vulnerable patients this winter. The science and data suggest that it would be a successful approach for many cancer and immunocompromised patients at the highest level of risk.” Evusheld is already being given to immunocompromised patients in countries including the United States, France, and Israel, but the UK government is waiting for more data on the duration of protection it provides against omicron and its subvariants before deciding whether it should be used. Read full story Source: BMJ, 8 November 2022 -
News Article
More than two-fifths of people in Britain have chronic pain by mid-40s
Patient Safety Learning posted a news article in News
More than two-fifths of people in Britain suffer from some form of chronic pain by the time they are in their mid-40s, research suggests. Scientists have found that persistent bodily pain at this age is also associated with poor health outcomes in later life – such as being more vulnerable to Covid-19 infection and experiencing depression. The findings, published in the journal Plos One, suggest chronic pain at age 44 is linked to very severe pain at age 51 and joblessness in later life. Study co-author Professor Alex Bryson, of University College London’s Social Research Institute, said: “Chronic pain is a very serious problem affecting a large number of people. “Tracking a birth cohort across their life course, we find chronic pain is highly persistent and is associated with poor mental health outcomes later in life including depression, as well as leading to poorer general health and joblessness. “We hope that our research sheds light on this issue and its wide-ranging impacts, and that it is taken more seriously by policymakers.” Read full story Source: The Independent, 2 November 2022 -
Content Article
Survey - Asthma is worse for women (27 April 2022)
Patient-Safety-Learning posted an article in Women's health
Women often have worse asthma than men, and female sex hormones can affect the condition. Asthma and Lung UK are conducting a survey to find out more about women's experience of asthma - women with asthma and those that care for them are invited to take the survey, which takes about five minutes to complete and is completely anonymous. Asthma and Lung UK have also published a report, Asthma is Worse for Women, outlining the need for more research into asthma and female sex hormones. -
Content ArticleGlobally, there are 136 million women with asthma. Asthma is more common among women, women experience more severe symptoms and they are more likely to die from their asthma. Many women experience a significant worsening of symptoms around menstruation and are at risk of potentially fatal asthma attacks every month. However, there has been very little research to understand why. Asthma and Lung UK has published this report following a roundtable meeting with scientists, funders and pharmaceutical companies to discuss how to transform outcomes for women with asthma. The report covers information on sex bias in asthma and looks at recent developments in understanding about the condition, highlighting areas for further research. The report also makes the case for increasing funding to deliver better outcomes for women with asthma, strengthening leadership and infrastructure in asthma treatment, and increasing innovation in drug trials. Alongside the report, Asthma and Lung UK has made a short video where one woman talks about her experience of severe asthma, how it has affected her life and why we need more research into the link between asthma, periods and female hormones. Asthma and Lung UK has also released a survey to find out more about women's experience of living with asthma.
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Content ArticleThis paper ranks the performance of the UK health care system with that of 18 similar, wealthy countries since 2000 or the earliest year for which data is available. It covers the level of health spending, overall life expectancy, the health care outcomes of the major diseases and the outcomes for treatable mortality and childbirth.
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Content ArticleOperations can have cognitive side-effects, particularly in the over-65s but also in the very young. How can science minimise the danger?
