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Showing results for tags 'Research'.
Found 955 results
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Content ArticlePatient views on ladders of engagement, including a review of Arnstein's ladder of participation, the IAP2 Public Participation Spectrum, and an exploration of patient views on meaningfulness, professionalisation, and representativeness in the context of patient engagement in research.
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Content ArticleWhile individual countries have gained considerable knowledge and experience of COVID-19 management, an international, comparative perspective is lacking, particularly regarding the measures taken by different countries to tackle the pandemic. This paper from Tartaglia et al. elicits the views of health system staff, tapping into their personal expertise on how the pandemic was initially handled.
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News ArticleAn experimental treatment involving stem cells from umbilical cords could significantly reduce deaths and quicken recovery time for patients suffering the most severe form of COVID-19, a study suggests. US researchers reported a 91% survival rate in seriously ill patients given the stem cell infusion, compared to 42% in a second group who did not receive the treatment. Researchers said the treatment also appeared to be safe, with no serious adverse reactions reported. Read full story Source: The Independent, 5 January 2021
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Content ArticleTransparent collaborations between patient organisations and clinical research sponsors can identify and address the unmet needs of patients and caregivers. These insights can improve clinical trial participant experience and delivery of medical innovations necessary to advance health outcomes and standards of care. Roennow et al. share their experiences from such a collaboration undertaken surrounding the SENSCIS® clinical trial and discuss its impact during, and legacy beyond, the trial.
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Content ArticleA network of endometriosis experts from 16 Italian academic departments and teaching hospitals distributed all over the country made a critical appraisal of the available evidence and definition of 10 suggestions regarding measures to be de-implemented. Strong suggestions were made only when high-quality evidence was available. The aim was to select 10 low-value medical interventions, characterized by an unfavorable balance between potential benefits, potential harms, and costs, which should be discouraged in women with endometriosis.
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Content ArticleThis review in the Journal of Clinical and Diagnostic Research explains the basics of audit and describes in detail how a clinical audit should be performed and monitored. It includes information on the 'Audit Cycle' and 'Ten Tips for Successful Audits'.
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Content ArticleUnderstanding how and why programmes work—not simply whether they work—is crucial. Good theory is indispensable to advancing the science of improvement. Mary Dixon-Woods and colleagues argue for the ex post theorisation programmes.
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Content ArticleTelemetry monitoring of heart rates and rhythms was introduced in intensive care units in the 1960s, and since then it has expanded into patient rooms and units in noncritical care settings. It allows healthcare workers to watch the condition of many patients all at once and intervene quickly when their condition changes; however, if the technology is not used appropriately or the equipment malfunctions, relying on telemetry monitoring also risks patient harm. This study from Kukielka et al. looked at real-life cases of breakdowns in the processes and procedures regarding telemetry monitoring, such as user errors and miscommunication, and equipment failures, including broken transmitters and dead batteries. The lessons learned can help improve training and best practices to improve the safety of patients being monitored.
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Content ArticleWrong-site surgery (WSS) is a well-known type of medical error that may cause a high degree of patient harm. In Pennsylvania, healthcare facilities are mandated to report WSS events, among other patient safety concerns, to the Pennsylvania Patient Safety Reporting System (PA-PSRS) database.
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Content ArticleThe National Institute for Health Research (NIHR)-supported RECOVERY trial has found no clinical benefit from the antibiotic azithromycin for hospitalised patients with severe COVID-19.
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Content ArticleA deep learning algorithm accurately identified allergic reactions in hospital patient safety reports, which could help providers avoid medical errors and improve event surveillance, according to a study from Yang et al. published in JAMA Network Open. Allergic reactions – to medications, foods, and healthcare products – are becoming increasingly common in the US. Researchers noted that up to 36% of patients report drug allergies, and 4-10% report food allergies. Patients in healthcare settings are at particularly high risk of developing an allergic reaction, and it’s critical that providers are able to quickly detect and monitor these events. Results of this study suggest that deep learning can improve the accuracy and efficiency of the allergic reaction identification process, which may facilitate future real-time patient safety surveillance and guidance for medical errors and system improvement.
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Content Article
COVID-19: COGER Study (30 November 2020)
Patient Safety Learning posted an article in Data, research and statistics
The COGER study is collecting data to gain insight into the course of functional and medical recovery in older people affected by COVID-19 participating in rehabilitation across Europe. -
Content ArticleHealthcare professionals are experiencing unprecedented levels of occupational stress and burnout. Higher stress and burnout in health professionals is linked with the delivery of poorer quality, less safe patient care across healthcare settings. In order to understand how we can better support healthcare professionals in the workplace, this study from Johnson et al. evaluated a tailored resilience coaching intervention comprising a workshop and one-to-one coaching session addressing the intrinsic challenges of healthcare work in health professionals and students. The authors found preliminary evidence that the intervention was well received and effective, but further research using a randomised controlled design will be necessary to confirm this.
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News Article
Inhaled steroids to be tested as a possible treatment for COVID-19
Patient Safety Learning posted a news article in News
The NIHR-supported PRINCIPLE trial is to start investigating the inhaled corticosteroid budesonide to find out if it can help treat COVID-19 in patients who aren’t in hospital. Led by the University of Oxford, the PRINCIPLE is the UK’s national platform trial for COVID-19 treatments that can be taken at home. It is evaluating treatments that can help people aged over 50 recover quickly from COVID-19 illness and prevent the need for hospital admission. The study, funded by NIHR and UK Research and Innovation (UKRI) has so far recruited more than 2100 volunteers from across the UK with support from NIHR’s Clinical Research Network. Inhaled budesonide is often used to treat asthma and chronic obstructive pulmonary disease, with no serious side-effects associated with short-term use. In some patients with COVID-19, the body’s immune response to the virus can cause high levels of inflammation that can damage cells in the airways and lungs. Inhaling budesonide into the airways targets anti-inflammatory treatment where it is needed most, and can potentially minimise any lung damage that might otherwise be caused by the virus. Patients taking part in the study will be randomly assigned to receive an inhaler in the post, alongside the usual care from their clinician. They will be asked to inhale two puffs twice a day for 14 days with each puff providing a 400 microgram dose of budesonide. They will be followed up for 28 days and will be compared with participants who have been assigned to receive the usual standard-of-care only. Read full story Source: National Institute for Health Research, 27 November 2020 -
News Article
COVID-19: Lung damage 'identified' in study
Patient Safety Learning posted a news article in News
COVID-19 could be causing lung abnormalities still detectable more than three months after patients are infected, researchers suggest. A study of 10 patients at Oxford University used a novel scanning technique to identify damage not picked up by conventional scans. It uses a gas called xenon during MRI scans to create images of lung damage. Lung experts said a test that could spot long-term damage would make a huge difference to Covid patients. The xenon technique sees patients inhale the gas during a magnetic resonance imaging (MRI) scan. Prof Fergus Gleeson, who is leading the work, tried out his scanning technique on 10 patients aged between 19 and 69. Eight of them had persistent shortness of breath and tiredness three months after being ill with coronavirus, even though none of them had been admitted to intensive care or required ventilation, and conventional scans had found no problems in their lungs. The scans showed signs of lung damage - by highlighting areas where air is not flowing easily into the blood - in the eight who reported breathlessness. The results have prompted Prof Gleeson to plan a trial of up to 100 people to see if the same is true of people who had not been admitted to hospital and had not suffered from such serious symptoms. He is planning to work with GPs to scan people who have tested positive for COVID-19 across a range of age groups. The aim is to discover whether lung damage occurs and if so whether it is permanent, or resolves over time. Read full story Source: BBC News, 1 December 2020 -
Content ArticleIn response to the rapid spread of COVID-19, this paper from Tamar Wildwing and Nicole Holt provides health professionals with better accessibility to available evidence, summarising findings from a systematic overview of systematic reviews of the neurological symptoms seen in patients with COVID-19. Implications of so-called Long Covid on neurological services and primary care and similarities with other neurological disorders are discussed. Note: This article is a preprint and has not yet been peer-reviewed.
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Content ArticleDespite it being 20 years since the Institute of Medicine reported poor quality and high variability in healthcare delivery, there are still significant opportunities for clinical quality improvement (QI). As frontline clinicians and future healthcare leaders tasked with driving these changes, resident physicians are an important cohort to equip with knowledge, skills, and experience in QI and patient safety. In this article, Mitchel and Li review the barriers to resident engagement, leadership and success with QI initiatives and propose potential solutions. Several barriers are unique to psychiatric training. The barriers described are broadly categorised as either structural or process-related, a distinction derived from Donabedian who described a framework for understanding the causal relationship between structures, processes, and outcomes in QI. In addition, the authors provide an example of a resident-led QI initiative to illustrate the proposed solutions.
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Event
Long COVID Joint Research Forum
Patient Safety Learning posted an event in Community Calendar
untilCurrently very little is known about the clinical, biological, psychological and socio-environmental impact of COVID-19. While most people may have uncomplicated recoveries, some experience prolonged or new symptoms and complications. The wide range of Long Covid symptoms documented indicates that multiple body systems are involved. Some of the more commonly reported symptoms include fatigue, breathing difficulties, joint pain, chest pain, as well as muscle weakness and neurological symptoms. These are common among both people who were hospitalised in the early phase of COVID-19 and those who were not. Systematic reviews show that people worldwide are experiencing prolonged symptoms of COVID-19. There are implications at an individual level for people’s quality of life and their ability to work, as well as at a socioeconomic level due to the risk of widening health inequalities. As well as breadth of the physical, psychological and social complications, there is a need to understand the causes (aetiology) of the symptoms and complications experienced. It is also vital to be able to identify people at higher risk of Long Covid, as well as interventions that might reduce that risk, and support rehabilitation and recovery. There is an urgent need for robust scientific studies into the long-term impact of COVID-19 in both adults and children, and for healthcare providers to be informed to support prevention, assessment, rehabilitation and interventions to improve recovery and patient outcomes. With this need in mind, ISARIC and GloPID-R are organising the Long Covid Forum on December 9 and 10, 2020 in collaboration with the Long Covid Support. The objectives of the forum will be: to gain a better understanding of Long Covid; the science and the personal impact to define research gaps for funders and researchers to take forward. Register -
Content ArticleThe use of healthcare complaints to improve quality and safety has been limited by a lack of reliable analysis tools and uncertainty about the insights that can be obtained. The Healthcare Complaints Analysis Tool, developed by Alex Gillespie and Tom W. Reader was used to analyse a benchmark national data set, conceptualise a systematic analysis, and identify the added value of complaint data.
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Content ArticleModern healthcare is burgeoning with patient centred rhetoric where physicians “share power” equally in their interactions with patients. However, how physicians actually conceptualise and manage their power when interacting with patients remains unexamined in the literature. This study from Laura Nimmon and Terese Stenfors-Hayes explored how power is perceived and exerted in the physician-patient encounter from the perspective of experienced physicians. Although the “sharing of power” is an overarching goal of modern patient-centred healthcare, this study highlighted how this concept does not fully capture the complex ways experienced physicians perceive, invoke, and redress power in the clinical encounter. Based on the insights, the authors suggest that physicians learn to enact ethical patient-centered therapeutic communication through reflective, effective, and professional use of power in clinical encounters.
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News ArticleUp to £20 million is available for new research projects which aim to understand and address the longer-term physical and mental health effects of COVID-19 in non-hospitalised individuals. Increasing medical evidence and patient testimony has shown that some people who contract and survive COVID-19 may develop longer-lasting symptoms. Symptoms can range from breathlessness, chronic fatigue, ‘brain fog’, anxiety and stress and can last for months after initially falling ill. These ongoing problems, commonly termed ‘Long-COVID’, may be experienced by patients regardless of how severe their COVID-19 infection was and irrespective of whether they were hospitalised. UK Research and Innovation (UKRI) and the National Institute for Health Research (NIHR) are launching a call to fund two or three ambitious and comprehensive proposals and a small number of study extensions that will address ‘Long-COVID’ in the community. This work will complement other major studies already funded by UKRI and NIHR which focus on long covid in hospitalised patients. Projects are expected to start early in the new year and may be funded for up to three years in the first instance. The call will open on 12 November and close on 9 December 2020. Further information
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News Article
Covid antibodies 'last at least six months'
Patient Safety Learning posted a news article in News
Coronavirus antibodies last at least six months and offer protection against a second infection, a study of healthcare workers suggests. Staff at Oxford University Hospitals were regularly tested both for COVID-19 infections and for antibodies revealing a past infection. The more antibodies people had, the lower their chances of re-infection. A separate study found pre-existing immunity from other coronaviruses also protected against Covid. Infection consultant Dr Katie Jeffery described the Oxford findings as "encouraging news" ahead of forthcoming Covid vaccines. They indicated that having the virus once "provides at least short-term protection" from getting it again, she said. Read full story Source: BBC News, 21 November 2020 -
Content ArticleDebriefs (or After Action Reviews) are increasingly used in training and work environments as a means of learning from experience. Tannenbaum and Cerasoli assessed the efficacy of debriefs with a quantitative review and found organisations can improve individual and team performance by approximately 20% to 25% by using properly conducted debriefs.
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Content ArticleFalls represent a leading cause of preventable injury in hospitals and a frequently reported serious adverse event. Hospitalisation is associated with an increased risk for falls and serious injuries including hip fractures, subdural hematomas, or even death. Multifactorial strategies have been shown to reduce falls in acute care hospitals, but evidence for fall-related injury prevention in hospitals is lacking. Dykes et al. assessed whether a fall-prevention tool kit that engages patients and families in the fall-prevention process throughout hospitalisation is associated with reduced falls and injurious falls. The study found that implementation of a fall-prevention tool kit was associated with a significant reduction in falls and related injuries. A patient–care team partnership appears to be beneficial for prevention of falls and fall-related injuries.
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News Article
Rheumatoid arthritis drug appears to help Covid patients in ICU
Patient Safety Learning posted a news article in News
A drug used to treat rheumatoid arthritis appears to help patients who are admitted to intensive care with the most severe coronavirus infections, researchers say. Tocilizumab, a medicine that dampens down inflammation, improved outcomes for critically ill patients, according to early results from an international trial investigating whether the drug and others like it boost survival rates and reduce the amount of time patients spend in intensive care. The findings have not been peer-reviewed or published in a journal, but if confirmed by more trial data, the drug will be on track to become only the second effective therapy for the sickest Covid patients, following positive results for the steroid dexamethasone earlier this year. “We think these are very exciting results, we are encouraged by them,” said Prof Anthony Gordon, of Imperial College London, the UK’s chief investigator on the REMAP-CAP trial. “It could become the standard of care once we have all the data reviewed by guidelines groups, and also drug regulators.” Read full story Source: The Guardian, 20 November 2020
