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Showing results for tags 'Research'.
Found 949 results
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Content ArticleBureaucratic organisational culture is less favourable to quality improvement, whereas organisations with group (teamwork) culture are better aligned for quality improvement. In this study, Speroff et al. determine whether an organisational group culture shows better alignment with patient safety climate.
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Content ArticleWould you like to help our healthcare professionals understand how they can continue to use a new approach for prescribing safety in general practices? This research is looking at making prescribing safer in general practices in England and is jointly conducted by the Universities of Nottingham, Manchester, Edinburgh & Dundee. GP surgeries are working with pharmacists to use a computer programme to help find patients who may need their medicines reviewing. People from patient and public groups are invited to say what they think about continuing this service across the country in the longer term. If you choose to take part, this will involve being part of a group discussion on issues relating to continuing the service for medicines safety. You do not need to know about the service before taking part as this will be explained to you. If interested, please contact: azwa.shamsuddin@ed.ac.uk
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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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Content ArticleThis article from Peden et al. reviews of some of the key topics and challenges in quality, safety, and the measurement and improvement of outcomes in anaesthesia. Topics covered include medication safety, changes in approaches to patient safety, payment reform, longer term measurement of outcomes, large-scale improvement programmes, the ageing population, and burnout. The article begins with a section on the success of the specialty of anaesthesia in improving the quality, safety, and outcomes for our patients, and ends with a look to future developments, including greater use of technology and patient engagement.
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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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Content ArticleOn 30 May 2020, NHS England and the NHS Confederation launched the NHS Race and Health Observatory, a new centre to investigate the impact of race and ethnicity on people’s health and to identify and tackle the specific health challenges facing people of black and ethnic minority origin.
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Content ArticleWhile there is growing awareness of the risk of harm in ambulatory health care, most patient safety efforts have focused on the inpatient setting. The Comprehensive Unit-based Safety Program (CUSP) has been an integral part of highly successful safety efforts in inpatient settings. In 2014 CUSP was implemented in an academic primary care practice. As part of CUSP implementation, staff and clinicians underwent training on the science of safety and completed a two-question safety assessment survey to identify safety concerns in the practice. The concerns identified by team members were used to select two initial safety priorities. The impact of CUSP on safety climate and teamwork was assessed through a pre-post comparison of results on the validated Safety Attitudes Questionnaire. CUSP is a promising tool to improve safety climate and to identify and address safety concerns within ambulatory health care.
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Content ArticleA culture of teamwork and learning from mistakes are universally acknowledged as essential factors to improve patient safety. Both are part of the Comprehensive Unit-based Safety Program (CUSP), which improved safety in intensive care units but had not been evaluated in other inpatient settings.
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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 ArticleUsing a dextrose-containing solution, instead of normal saline, to maintain the patency of an arterial cannula results in the admixture of glucose in line samples. This can misguide the clinician down an inappropriate treatment pathway for hyperglycaemia. Patel et al., following a near-miss and subsequent educational and training efforts at their institution, they conducted two simulations: (1) to observe whether 20 staff would identify a 5% dextrose/0.9% saline flush solution as the cause for a patient’s refractory hyperglycaemia, and (2) to compare different arterial line sampling techniques for glucose contamination. They found only 2/20 participants identified the incorrect dextrose-containing flush solution, with the remainder choosing to escalate insulin therapy to levels likely to risk fatality, and (2) glucose contamination occurred regardless of sampling technique. Despite national guidance and local educational efforts, this is still an under-recognised error. Operator-focussed preventative strategies have not been effective and an engineered solution is needed.
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Content ArticleIn 2008, the UK National Patient Safety Agency (NPSA) made recommendations for safe arterial line management. Following a patient safety incident in their intensive care unit (ICU), Leslie et al. surveyed current practice in arterial line management and determined whether these recommendations had been adopted. They contacted all 241 adult ICUs in the UK; 228 (94.6%) completed the survey. Some NPSA recommendations have been widely implemented – use of sodium chloride 0.9% as flush fluid, two‐person checking of fluids before use – and their practice was consistent. Others have been incompletely implemented and many areas of practice (prescription of fluids, two‐person checking at shift changes, use of opaque pressure bags, arterial sampling technique) were highly variable. More importantly, the use of the wrong fluid as an arterial flush was reported by 30% of respondents for ICU practice, and a further 30% for practice elsewhere in the hospital. This survey provides evidence of continuing risk to patients.
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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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Content ArticleThere has been little applied learning from organisations engaged in making evidence useful for decision makers. More focus has been given either to the work of individuals as knowledge brokers or to theoretical frameworks on embedding evidence. More intelligence is needed on the practice of knowledge intermediation. This paper from Tara Lamont and Elaine Maxwell describes the evolution of approaches by one UK Centre to promote and embed evidence in health and care services.
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Content ArticleEssure (TM, Bayer; Leverkusen, Germany) may act as a potential cause of autoimmune/inflammatory syndrome by adjuvants (ASIA). Essure is a device hysteroscopically inserted into the fallopian tubes to elicit a local inflammatory response for permanent sterilisation. Patients with ASIA present with a constellation of symptoms including fatigue, cognitive impairment, and arthralgias. It is well known that ASIA is triggered by implantation of foreign material such as breast implants and mesh for hernia repair. In the current study, Chauhan et al. present a retrospective cohort of 33 patients electing to remove Essure due to pelvic pain and systemic symptoms consistent with an ASIA diagnosis, and detail a case report of an Essure patient. Furthermore, the authors reviewed the existing literature on adverse events associated with Essure and studies assessing outcomes following explantation. The concept that Essure may trigger ASIA is further supported by both in vivo and in vitro studies demonstrating immunostimulatory effects of the material components of the device. We conclude that the existing evidence is sufficient to recommend screening of Essure recipients for ASIA symptoms, and where indicated, discussion of the risks and potential benefits of surgical removal.
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Content ArticleA study from Jackson et al. looked at how the prevalence of psychological distress in the adult population of England has changed since 2020. The study found that the proportion reporting any psychological distress was similar in December 2022 to that in April 2020 (an extremely difficult and uncertain moment of the COVID-19 pandemic), but the proportion reporting severe distress was 46% higher. These findings provide evidence of a growing mental health crisis in England and underscore an urgent need to address its cause and to adequately fund mental health services.
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Content ArticleThis article in The Lancet aimed to review published work about the efficacy and safety of electroconvulsive therapy (ECT) with simulated ECT, ECT versus pharmacotherapy and different forms of ECT for patients with depressive illness. The authors designed a systematic overview and meta-analysis of randomised controlled trials and observational studies. They concluded that: ECT is an effective short-term treatment for depression, and is probably more effective than drug therapy. bilateral ECT is moderately more effective than unilateral ECT. high dose ECT is more effective than low dose.
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Content ArticleFor some time now I've been looking to find out more about mental health services in Trieste, Italy. Then I met Vincenzo Passante Spaccapietra, co-host of the Place of Safety? podcast series. This has enabled me to learn more about the closure of the mental institutions in Trieste, Italy, and the work of Franco Basaglia. I was keen to find out what really took place, what this really means in practice and how we can adopt this model in the UK. We were delighted to have become involved and to have recorded a couple of podcasts. I recommend this resource to everyone interested in safe, compassionate, patient led mental health care.
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Content ArticleThis survey, published by the Parliamentary and Health Service Ombudsman, found that one in five people did not feel safe while in the care of the NHS mental health service that treated them.
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Content ArticleThis study in JAMA Network Open aimed to investigate whether attention-deficit/hyperactivity disorder (ADHD) is over diagnosed in children and adolescents. The authors reviewed 334 published studies and found convincing evidence that ADHD is over diagnosed. They highlight that the harms associated with ADHD diagnosis may outweigh the benefits, particularly in children and young people with milder symptoms.
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Content ArticlePeople with developmental disability have higher healthcare needs and lower life expectancy compared with the general population. Poor quality of care resulting from interpersonal and systemic discrimination may further entrench existing inequalities.
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Content ArticleThe mortality rates for people with autism spectrum disorder (ASD) are double those of the general population and researchers believe unmet mental health needs may be a factor. The researchers’ results were derived from an Australian-first University of New South Wales (UNSW) study, which analysed linked data sets on death rates, risk factors and cause of death for 36,000 people on the autism spectrum. While cancer and circulatory diseases are the leading cause of deaths in the general population, injury and poisoning – including accidents, suicide and deaths related to self-harm – were the most common causes for people with ASD. GP and autism advocate Dr James Best told newsGP he was not surprised by the results, but that they did confirm people with ASD have a different set of health risk factors.
