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Content ArticleThere are limited prospective long-term real-world safety data after faecal microbiota transplantation (FMT). This study reported long-term outcomes of FMT from a population-based FMT registry in Hong Kong. The results demonstrate that FMT has an excellent long-term safety profile and the risk of developing new medical conditions beyond 12 months after FMT is low.
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Content ArticleThe objective of this systematic review from Benhamou et al. was to assess the clinical, economic, and health resource utilisation outcomes associated with the use of prefilled syringes in medication administration compared with traditional preparation methods. The findings provide new insights into clinical and economic benefits of prefilled syringe adoption. These benefits include improved medication delivery and safety, which can lead to time and cost reductions for health care departments, hospitals, and health systems. However, further real-world research on clinical and economic outcomes, especially in contamination, is needed to better understand the benefits of prefilled syringes.
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Content ArticleChildhood immunisation is a critically important public health initiative. However, since most vaccines are administered by injection, it is associated with considerable pain and distress. Despite evidence demonstrating the efficacy of various pain management strategies, the frequency with which these are used during routine infant vaccinations in UK practice is unknown. This study aimed to explore primary care practice nurses’ use of evidence-based pain management strategies during infant immunisation, as well as barriers to evidence-based practice.
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Content ArticleIn this article for The Lancet, Professor Gagandeep Kang from the Bill & Melinda Gates Foundation examines what the story of rotavirus vaccine development in India can tell us about the opportunities, the necessary enabling environment and the challenges of creating products to improve global health. He highlights that although multiple successful vaccines were developed during the Covid-19 pandemic—in quantities that were inconceivable at the start of the pandemic—vaccine nationalism trumped the efforts of WHO, which established a prioritisation framework for vaccination of clinically vulnerable populations. The COVAX scheme was not successful in its aim to ensure that vaccines could be financed and distributed equitably around the world. This experience of delayed and low access to vaccines has led to calls for reparative justice and for moving away from short-term fixes of product donations to support local or regional vaccine manufacturing. Sharing intellectual property and enhancing regional capacity are now framed as moral imperatives against colonialism, and the development of the rotavirus vaccine provides lessons on how this can be achieved.
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Content ArticleDespite their widespread use, the evidence base for the effectiveness of quality improvement collaboratives remains mixed. Lack of clarity about ‘what good looks like’ in collaboratives remains a persistent problem. This qualitative study in BMJ Open aimed to identify the distinctive features of a state-wide collaboratives programme that has demonstrated sustained improvements in quality of care in a range of clinical specialties over a long period. The authors identified five features that characterised success in the collaboratives programme: learning from positive deviance high-quality coordination high-quality measurement and comparative performance feedback careful use of motivational levers mobilising professional leadership and building community.
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Content ArticleThe maternal mortality rate (MMR) in the United States continues to increase despite medical advances and is exacerbated by stark racial disparities. Black women are disproportionately affected and are three times more likely to experience a pregnancy-related death (PRD) compared to Non-Hispanic White (NHW) women. Keisha E. Montalmant and Anna K. Ettinger carried out a literature review to examine the racial disparities in the United States' MMR, specifically among pregnant Black women. The review highlights that maternal health disparities for Black women are further impacted by both structural racism and racial implicit biases. Cultural competence and educational courses targeting racial disparities among maternal healthcare providers (MHCP) are essential for the reduction of PRDs and pregnancy-related complications among this target population. Additionally, quality and proper continuity of care require an increased awareness surrounding the risk of cardiovascular diseases for pregnant Black women.
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News ArticlePatients who feel fortunate to get a doctor's appointment then find they are in and out of the GP surgery in less than five minutes. A fifth of the consultations in England last year were done within that time. Dennis Reed, of the Silver Voices campaign group for over-60s, said: "It is hard enough to get a face-to-face appointment with a GP these days, without being shown the door before you have had a chance to take your coat off. "The public wants the family doctor back, who knows your family history and has the time to chat about your general health and wellbeing. "A revolving door policy, with the patient exiting after a couple of minutes clutching a prescription, is not the way to run a primary care service." Research from the House of Commons Library, commissioned by the Lib Dems, found 22% of GP appointments between January to October 2023 lasted five minutes or less. Lib Dem MP Wera Hobhouse said: "Seeing a GP is the most vital contact for people to address their health concerns, seek help and start treatment. "Not having quick and easy access to a GP and not having sufficient time for patients during an appointment leads to huge problems later on, let alone the anxiety and additional pain people suffer because of delays." Read full story Source: The Express, 31 December 2023
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News Article
Jab for winter virus could cut baby hospitalisations by 80%, study says
Patient Safety Learning posted a news article in News
Hospital admissions from a winter virus could be reduced by more than 80% if babies are given a single dose of a new antibody treatment, a study says. Respiratory syncytial virus (RSV) usually causes mild, cold-like symptoms, but can lead to bronchiolitis and pneumonia. More than 30,000 under fives are hospitalised with RSV in the UK annually, resulting in 20 to 30 deaths. One British parent said her son getting RSV was "very scary" as a first-time mother. Lorna and Russell Smith's eldest son, Caolan, got the virus when he was eight months old and was admitted to hospital twice - each time requiring oxygen. Now aged two, he has made a full recovery. "I hadn't heard of RSV and wasn't sure what to do. He had laboured breathing due to high temperature and was quite lethargic. It brought a lot of anxiety and stress," Lorna said. The Harmonie study involved 8,000 children up to the age of 12 months, with half receiving a single dose of the monoclonal antibody treatment nirsevimab. The results, published in the New England Journal of Medicine, showed that RSV-related hospitalisation was reduced by 83% in those receiving the jab and admissions for all chest infections were cut by 58%. Side effects were similar in both groups and mostly mild. Read full story Source: BBC News, 27 December 2023 -
Content Article
This is a guide, published by Shaping Our Lives, to help you get involved with organisations and researchers and share your views to help shape services, research and policy. -
Content ArticleLarge language models such as OpenAI's GPT-4 have the potential to transform medicine by enabling automation of a range of tasks, including writing discharge summaries, answering patient questions, and supporting clinical treatment planning. These models are so useful that their adoption has been immediate, and efforts are already well underway to integrate them with ubiquitous clinical information systems. However, the unchecked use of the technology has the potential to cause harm. In this article for The Lancet, Janna Hastings looks at the need to mitigate racial and gender bias in language models that may be used in healthcare settings.
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Content ArticleThe Belmont Report was written by the National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research. The Commission, created as a result of the National Research Act of 1974, was charged with identifying the basic ethical principles that should underlie the conduct of biomedical and behavioral research involving human subjects and developing guidelines to assure that such research is conducted in accordance with those principles. Informed by monthly discussions that spanned nearly four years and an intensive four days of deliberation in 1976, the Commission published the Belmont Report, which identifies basic ethical principles and guidelines that address ethical issues arising from the conduct of research with human subjects.
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Content ArticleEfforts to increase physician engagement in quality and safety are most often approached from an organisational or administrative perspective. Given hospital-based physicians’ strong professional identification, physician-led strategies may offer a novel strategic approach to enhancing physician engagement. It remains unclear what role medical leadership can play in leading programmes to enhance physician engagement. In this study, Rotteau et al. explore physicians’ experience of participating in a Medical Safety Huddle initiative and how participation influences engagement with organisational quality and safety efforts. They found that The Medical Safety Huddle initiative supports physician engagement in quality and safety through intrinsic motivation. However, the huddles’ implementation must align with the organisation’s multipronged patient safety agenda to support multidisciplinary collaborative quality and safety efforts and leaders must ensure mechanisms to consistently address reported safety concerns for sustained physician engagement.
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Content ArticleThis study compared two quality improvement (QI) interventions to improve antenatal magnesium sulphate (MgSO4) uptake in preterm births for the prevention of cerebral palsy. It found that PReCePT improved MgSO4 uptake in all maternity units. Enhanced support did not further improve uptake but may improve teamwork, and more accurately represented the time needed for implementation. Targeted enhanced support, sustainability of improvements and the possible indirect benefits of stronger teamwork associated with enhanced support should be explored further.
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Content ArticleResearch funded by the NIHR has found that air cleaning technologies designed to make social interactions safer in indoor spaces are not effective. The research was funded by the NIHR Health Protection Research Unit (HPRU) in Emergency Preparedness and Response. The researchers looked at technologies including: air filtration germicidal lights ionisers. They studied evidence about whether the technologies reduce the risk of catching airborne respiratory or gastrointestinal infections. The researchers found the technologies do not stop the spread of infections in buildings.
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Content ArticleElective recovery plans in part rely on the strengths of Surgical Hubs (SH) and Community Diagnostic Centres (CDC) to provide additional support. This report by the Medical Technology Group (MTG) considers how well these new tools are working for the NHS. It raises questions about how SHs and CDCs have been established and the decision making processes within these services.
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Content ArticleIn a study published in Rheumatology, researchers used the example of neuropsychiatric lupus, an incurable autoimmune disease that is particularly challenging to diagnose, to examine the different value given by clinicians to 13 different types of evidence used in diagnoses. This included evidence such as brain scans, patient views, and the observations of family and friends.
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News Article
Sepsis breakthrough as blood test trial for killer condition underway
Patient Safety Learning posted a news article in News
Scientists are hoping a new 45-minute blood test can quickly identify sepsis before it kills. Sepsis is a life-threatening reaction to an infection. It occurs when the body overreacts and starts attacking its own tissues and organs. The hard-to-diagnose condition kills nearly 50,000 Brits a year more than breast, prostate and bowel cancer combined - with severe cases taking just hours to prove fatal. Dr Andrew Retter, an intensive care consultant at Guy’s and St Thomas’ NHS Foundation Trust, who is trialling the test told The Times: “If someone comes into A&E and they’re sick, we can spot that early and start treatment early. “For every hour antibiotics are delayed, people’s mortality goes up by about 7 or 8 per cent if they’ve got sepsis.” Melissa Mead’s one-year-old son William died after weeks of a lingering cough and concerns were dismissed by doctors and 111 operators. The campaigner told The Times: “A test like this at the point of care in A&E, for example, could remove the uncertainty about sepsis, which presents differently in different people. “This could give people a chance at life that my son never had.” Read full story Source: The Independent, 17 December 2023 -
Content ArticleThis article in the International Journal of Environmental Research and Public Health proposes a new approach to hospital bed planning and international benchmarking. The number of hospital beds per 1000 people is commonly used to compare international bed numbers. The author, Rodney Jones, suggests that this method is flawed because it doesn't consider population age structure or the effect of nearness-to-death on hospital use. To remedy this problem, Jones suggests a new approach to bed modelling that plots beds per 1000 deaths against deaths per 1000 population. Lines of equivalence can be drawn on the plot to delineate countries with a higher or lower bed supply. This method is extended to attempt to define the optimum region for bed supply in an effective health care system. England is used as an example of a health system descending into operational chaos due to too few beds and manpower. The former Soviet bloc countries represent a health system overly dependent on hospital beds. Several countries also show evidence of overuse of hospital beds. The new method is used to define a potential range for bed supply and manpower where the most effective health systems currently reside. The role of poor policy in NHS England is used to show how the NHS has been led into a bed crisis. The method is also extended beyond international benchmarking to illustrate how it can be applied at a local or regional level in the process of long-term bed planning.
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Content ArticleIncreasing diversity amongst surgeons results in a wide range of sizes and strengths. There are many types of biases affecting women surgeons. This study evaluates what challenges women surgeons may have with surgical equipment. Key findings include: 89% of women surgeons report difficulty with surgical instruments due to size. 71% of women surgeons report difficulty with surgical instruments due to grip strength. The study highlights a potential source of gender bias which could be addressed to improve equity for women surgeons.
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Content Article
Latest issue of the Operating Theatre Journal
Patient Safety Learning posted an article in Surgery
A monthly journal for all operating theatre staff covering surgical and anaesthesia news. -
Content Article
D-Coded is an online resource that presents easy-to-understand summaries of diabetes research studies. It aims to make the latest knowledge and developments accessible to people who don't have a medical or scientific background. In this blog, Jazz Sethi, Founder and Director of the Diabesties Foundation and part of the global team that developed D-Coded, discusses the need for the resource and outlines how it will help people living with diabetes to better understand and manage their condition. -
Content ArticlePaediatric health research is fraught with both ethical and practical challenges that can prevent the successful completion of research studies. Listening to, and acting on, the voices of children and young people in the design and delivery of paediatric health research (otherwise known as Patient and Public Involvement) is one way to overcome these challenges. This paper describes the authors' experiences of working directly with children and young people in various health research initiatives. They outline the journey of involving children and young people as partners and give examples to demonstrate the unique knowledge and insights gained in the production of high-quality research.
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News Article
Public confused over physician associates working in NHS, research finds
Patient Safety Learning posted a news article in News
Many people are deeply confused about the growing number of “physician associates” in the NHS and wrongly assume they are doctors, research suggests. Around 4,000 physician associates work in the NHS in England. Ministers and health chiefs plan to increase the figure to 10,000 to help plug widespread gaps in the NHS workforce. However, there is widespread confusion among the public about their role and relationship with fully trained medics, according to a survey commissioned by the British Medical Association (BMA). A quarter of the representative sample of 2,009 people erroneously believed that a physician associate was a doctor, while a fifth made the same mistake about “physician assistants”. Many respondents thought that a physician associate was more senior than a junior doctor, even though only the latter have a medical degree. The expansion of physician associates has prompted a backlash by grassroots medics. They fear patients will be misled into thinking they have seen a doctor despite physician associates not having the same skills and training. The government has moved to try to quell criticism of physician associates by legislating to ensure they are regulated by the General Medical Council (GMC). Read full story Source: The Guardian, 13 December 2023 -
News ArticleThe risk of dying from cancer in England “varies massively” depending on where a person lives, according to a study that experts say exposes “astounding” health inequalities. Researchers who analysed data spanning two decades found staggering geographical differences. In the poorest areas, the risk of dying from cancer was more than 70% higher than the wealthiest areas. Overall, the likelihood of dying from cancer has fallen significantly over the last 20 years thanks to greater awareness of signs and symptoms, and better access to treatment and care. The proportion dying from cancer before the age of 80 between 2002 and 2019 fell from one in six women to one in eight, and from one in five men to one in six. However, some regions enjoyed a much larger decline in risk than others, and the new analysis has revealed that alarming gaps in outcomes remain. “Although our study brings the good news that the overall risk of dying from cancer has decreased across all English districts in the last 20 years, it also highlights the astounding inequality in cancer deaths in different districts around England,” said Prof Majid Ezzati, from Imperial College London, who is a senior author of the study. Read full story Source: The Guardian, 11 December 2023
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Content ArticleCancers are the leading cause of death in England. This study from Rashid et al. published in Lancet Oncology aimed to estimate trends in mortality from leading cancers from 2002 to 2019 for the 314 districts in England. The study found that declines in overall cancer mortality have been unequal both geographically and among different groups of cancers. The greatest geographical inequality was observed for cancers with modifiable risk factors and potential for screening for precancerous lesions. Addressing risk factors such as smoking and alcohol use, expanding access to and utilisation of screening for prevention and early detection, and improving the quality of care should be used to reduce deaths in areas where they remain highest. High-resolution spatiotemporal data can help identify where intervention is required and track progress.
