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Found 949 results
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Content ArticleThere is concern among patients, surgeons and health authorities regarding reported adverse patient outcomes following use of mesh in certain urogynaecological surgical procedures. The European Society of Coloproctology (ESCP) has conducted an extensive review of the surgical literature on the outcome of use of mesh in the pelvis of patients who have undergone bowel surgery and will shortly publish its recommendations. ESCP would like to hear from patients who have had both good and not so good experiences with colorectal surgery using mesh such as operations for rectal prolapse (rectopexy), or operations for advanced rectal cancer/inflammatory bowel disease who had mesh inserted to assist in skin closure of the back passage area. The survey is designed to capture the experience of patients who have had an operation that involved using mesh in the pelvis as a part of a colorectal (bowel) surgical operation. The survey is NOT designed to cover outcomes following urogynaecological operations for prolapse or urinary incontinence. The use of mesh as part of abdominal wall hernia repair is also not included.
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Content ArticleThe Patient Safety Authority are inviting PharmD students and faculty to submit their manuscripts by 30 June. A panel of guest editors—pharmacy experts from across the United States—will select their favourites.
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Content ArticleDespite widespread recognition and known harms, serious surgical errors, known as surgical never events, endure. The California Department of Public Health (CDPH) has developed an oversight system to capture never events and a platform for process improvement that has not yet been critically appraised. This study examined surgical never events occurring in hospitals in California and summarize recommendations to prevent future events.
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Content ArticleImproving the design of technology relies in part, on the reporting of performance failures in existing devices. Healthcare has low levels of formal reporting of performance and failure of medical equipment. This paper from Tase et al. examines methods of reporting in the car industry and healthcare and aims to understand differences and identify opportunities for improvement within healthcare.
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Content ArticleMesh-related complications resulting from pelvic organ prolapse (POP) reconstruction operations may be a devastating experience leading to multiple and complex interventions. The aim of the study from Paulo Rodrigues and Shlomo Raz was to describe the experience and time frame of management of mesh-related complications in women treated for POP or stress urinary incontinence in a tertiary centre.
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Content ArticleIn April 2009 a 'considerative checklist' was developed to ensure that all important aspects of care on a team's routine and post-take general internal medicine ward rounds had been addressed and in order to answer the question: How long should a ward round take, when conducted to high standards of quality and safety at the point of care? The checklist has been used on 120 ward rounds: 90 routine ward rounds and 30 post-take ward rounds. Overall, the average time per patient was 12 minutes (10 minutes on routine rounds and 14 minutes on post-take rounds). The considerative checklist has encouraged and enabled documented evidence of high quality and safe medical care, and anecdotally improved team working, communication with patients, and team and patient satisfaction.
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Content ArticleThe COVID-19 pandemic has imposed extraordinary strains on healthcare workers. But, in contrast with acute settings, relatively little attention has been given to those who work in mental health settings. Liberati et al. aimed to characterise the experiences of those working in English NHS secondary mental health services during the first wave of the pandemic.
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Content ArticleAlthough most current medication error prevention systems are rule-based, these systems may result in alert fatigue because of poor accuracy. Previously, we had developed a machine learning (ML) model based on Taiwan’s local databases (TLD) to address this issue. However, the international transferability of this model is unclear. This study examines the international transferability of a machine learning model for detecting medication errors and whether the federated learning approach could further improve the accuracy of the model. It found that the ML model has good international transferability among US hospital data. Using the federated learning approach with local hospital data could further improve the accuracy of the model.
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Content ArticleIn March 2021 the advocacy group LongCovidSOS launched a survey in partnership with the University of Exeter and University of Kent to find out how people with Long Covid respond to COVID-19 vaccines. The analysis, which is yet to be peer reviewed showed that 56.7% of respondents experienced an overall improvement in symptoms, with 24.6% remaining unchanged and 18.7% reporting a deterioration in their symptoms. In general, those who received mRNA vaccines (Pfizer/BioNTech or Moderna) reported more improvements in symptoms, compared with those who got an adenovirus vaccine (Oxford/AstraZeneca). In particular, those who received the Moderna vaccine were more likely to see improvements in symptoms such as fatigue, brain fog and muscle pain, and less likely to report a deterioration, the analysis found.
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Content Article
Double checking: a second look (16 November 2015)
Patient Safety Learning posted an article in Process improvement
Double checking is a standard practice intended to improve patient safety. It is used in different areas of health care, such as medication administration, radiotherapy and blood transfusion. Some studies have found double checking to be a useful practice, which has been endorsed by agencies and individuals. The confidence in double checking exists in spite of the lack of evidence substantiating its effectiveness. In this study, Hewitt et al. asks: ‘How do front line practitioners conceptualise double checking? What are the weaknesses of double checking? What alternate views of double checking could render it a more robust process?’ The authors conclude that double checking deserves more questioning, as there are limitations to the process. Practitioners could view double checking through alternate lenses, and thus help strengthen this ubiquitous practice that is rarely challenged. -
Content ArticleDelays to timely admission from emergency departments (EDs) are known to harm patients. In this study, Jones et al. assessed and quantified the increased risk of death resulting from delays to inpatient admission from EDs, using Hospital Episode Statistics and Office of National Statistics data in England.
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Content ArticleIn response to growing pressures on healthcare systems, the advanced clinical practice (ACP) role has been implemented widely in the UK and internationally. In England, ACP is a level of practice applicable across various healthcare professions, who exercise a level of autonomy across four domains, referred to as the four pillars of practice (education, leadership, research and clinical practice). A national framework for ACP was established in 2017 to ensure consistency across the ACP role, however current ACP governance, education and support is yet to be evaluated. This study aimed to analyse data from a national survey of the ACP role to inform the development and improvement of policies relating to ACP in the National Health Service (NHS) in England.
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Content ArticleThere is a prevailing popular belief that expenditure on management by healthcare providers is wasteful, diverts resources from patient care, and distracts medical and nursing staff from getting on with their jobs. There is little existing evidence to support either this narrative or counter-claims. Asaria et al. explore the relationship between management and public sector hospital performance. They found no evidence of association either between quantity of management and management quality or directly between quantity of management and any of the measures of hospital performance. However, there is some evidence that higher-quality management is associated with better performance. NHS managers have limited discretion in performing their managerial functions, being tightly circumscribed by official guidance, targets, and other factors outside their control.
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Content ArticleMultiple sclerosis (MS) is a chronic inflammatory demyelinating disease of the central nervous system of unknown etiology. Bjornevik et al. tested the hypothesis that MS is caused by Epstein-Barr virus (EBV) in a cohort comprising more than 10 million young adults on active duty in the US military, 955 of whom were diagnosed with MS during their period of service. Risk of MS increased 32-fold after infection with EBV but was not increased after infection with other viruses. These findings cannot be explained by any known risk factor for MS and suggest EBV as the leading cause of MS.
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Content ArticlePopulation-level data on COVID-19 vaccine uptake in pregnancy and SARS-CoV-2 infection outcomes are lacking. Stock et al. describe COVID-19 vaccine uptake and SARS-CoV-2 infection in pregnant women in Scotland, using whole-population data from a national, prospective cohort. They found that vaccine coverage was substantially lower in pregnant women than in the general female population of 18−44 years. Overall, 77.4% of SARS-CoV-2 infections, 90.9% of SARS-CoV-2 associated with hospital admission and 98% SARS-CoV-2 associated with critical care admission, as well as all baby deaths, occurred in pregnant women who were unvaccinated at the time of COVID-19 diagnosis. Addressing low vaccine uptake rates in pregnant women is imperative to protect the health of women and babies in the ongoing pandemic.
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Content Article
Post-COVID syndrome symptoms, functional disability, and clinical severity phenotypes in hospitalized and nonhospitalized individuals: A cross-sectional evaluation from a community COVID rehabilitation service (15 November 2021)
Patient Safety Learning posted an article in Data, research and statistics
There is currently limited information on clinical severity phenotypes of symptoms and functional disability in post-coronavirus disease 2019 (COVID) Syndrome (PCS). A370 PCS patients from a dedicated community COVID-19 rehabilitation service was assessed using the COVID-19 Yorkshire Rehabilitation Scale where each symptom or functional difficulty was scored on a 0–10 Likert scale and also compared with before infection. Phenotypes based on symptom severity were extracted to identify any noticeable patterns. The correlation between symptom severity, functional disability, and overall health was explored. -
Content ArticleBurnout is a serious problem for clinicians as well as the patients who rely on them for safe care, and the challenge has only been compounded by the stresses and trauma of the pandemic. A recent study by Pearl et al. showed that healthcare administrators could use a single survey item to see how their clinicians are doing. The question it asked was, “Are there individuals at your work location who are so burned out that the quality or safety of research, clinical care, or other important work product is impacted?” The respondents’ perception of the impact of burnout on quality safety of healthcare was self-reported using a 5-point system, ranging from 1 (“no burnout or it doesn’t impact safety and quality”) to 5 (“a serious impact on quality and safety”). This nonproprietary, single-item burnout-impacting safety scale showed a sensitivity of 82% using 4 on the scale as a cutoff (“there is quite a bit of impact of burnout on safety and quality”), indicating this tool may be effective in helping determine what healthcare providers may be at high risk for safety events affecting patients.
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Content ArticlePeople who have already been infected by some common cold viruses are less likely to get COVID, according to new results from a study by Kundu et al. funded by the NIHR.
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Content ArticleThe importance of employee voice—speaking up and out about concerns—is widely recognised as fundamental to patient safety and quality of care. However, failures of voice continue to occur, often with disastrous consequences.
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Content ArticleThis study from Cho et al. examined the association of nurse staffing and education with the length of stay of surgical patients in acute care hospitals in South Korea. They found that nurse staffing and nurses’ education levels were significantly associated with the length of stay of surgical patients in South Korean hospitals. The findings from this study suggest that the South Korea healthcare system should develop appropriate strategies to improve the nurse staffing and education levels to ensure high-quality patient care in hospitals.
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Content ArticleClinician burnout in healthcare is a growing area of concern, especially as the COVID-19 pandemic stretches on. Research from the U.S. Department of Veterans Affairs and Regenstrief Institute looked at ways organisations can address burnout.
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Content ArticleCOVID-19 is known to cause multi-organ dysfunction in acute infection, with prolonged symptoms experienced by some patients, termed Post-Acute Sequelae of SARSCoV-2 (PASC). However, the burden of infection outside the respiratory tract and time to viral clearance is not well characterised, particularly in the brain. Chertow et al. performed complete autopsies on 44 patients with COVID-19 to map and quantify SARS-CoV-2 distribution, replication, and cell-type specificity across the human body, including brain, from acute infection through over seven months following symptom onset. The study showed that SARS-CoV-2 is widely distributed, even among patients who died with asymptomatic to mild COVID-19, and that virus replication is present in multiple pulmonary and extrapulmonary tissues early in infection. The authors detected persistent SARS-CoV-2 RNA in multiple anatomic sites, including regions throughout the brain, for up to 230 days following symptom onset. Despite extensive distribution of SARS-CoV-2 in the body, the authors observed a paucity of inflammation or direct viral cytopathology outside of the lungs. The data prove that SARS-CoV-2 causes systemic infection and can persist in the body months. * Note: This is a pre-print and has not been peer-reviewed yet.
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Content ArticleWhen Addenbrooke’s Hospital in Cambridge upgraded its face masks for staff working on COVID-19 wards to filtering face piece 3 (FFP3) respirators, it saw a dramatic fall – up to 100% – in hospital-acquired SARS-CoV-2 infections among these staff. Healthcare workers – particularly those working on COVID-19 wards – are much more likely to be exposed to coronavirus, so it’s important we understand the best ways of keeping them safe The findings are reported by a team at the University of Cambridge and Cambridge University Hospitals (CUH) NHS Foundation Trust. The research has not yet been peer-reviewed, but is being released early because of the urgent need to share information relating to the pandemic.
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Content ArticleThe COVID-19 pandemic continues to be a source of stress and have important mental health implications for all persons but may have unique implications for men. In addition to the risk of contracting and dying from COVID-19, the rising COVID-19 death toll, ongoing economic uncertainty, loneliness from social distancing, and other changes to our lifestyles make up the perfect recipe for a decline in mental health. In June 2020, men reported slightly lower rates of anxiety than women, but had higher rates of depressive symptoms and suicidal ideation. As of September 2020, men sought mental health care at a higher rate than women for family and relationships, with year-over-year visits up 5.5 times and total virtual mental health care visits monthly growth in 2020 was up 79% since January. Because men are not a homogeneous group, it is important to implement strategies for groups of men that may have particularly unique needs. In this paper, Ellison et al. discuss considerations for intervening in men’s mental health during and in response to the COVID-19 pandemic, including current technology-based cyberpsychology options.
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Content ArticleAnticoagulants are used hospital wide throughout the patient trajectory involving many healthcare providers. Given their widespread use and risk profile, they are classified as high risk. Despite the many precautions and vast experience with these drugs, errors often occur in daily practice. The aim of this study was to investigate which factors currently negatively affect patient safety in Az Sint-Lucas hospital in Belgium. The authors performed a retrospective data analysis based on incident reports and registered usage (2018–2019) as well as on pharmaceutical recommendations (3 months period in 2019) related to anticoagulants and antiaggregants. The data were obtained from the hospital information systems. A number of risk factors were identified, such as education of all healthcare professionals, communication, the IT systems used, the opening of temporary wards and transfer of patients within the hospital. It is our opinion that a multidisciplinary, centralised approach with a focus on monitoring is imperative. The use of a clinical pharmacist could play an important role.
