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Found 206 results
  1. Content Article
    Following the publication of Donna Ockenden’s first report: Emerging Findings and Recommendations from the Independent Review of Maternity Services at the Shrewsbury and Telford Hospitals NHS Trust on 11 December 2020, the NHS has issued this latest update. Read previous letter update
  2. Content Article
    This survey tool from the Australian Commission on Safety and Quality in Health Care provides Australian health service organisations with a set of 14 principles supported by a variety of risk reduction strategies. The tool is intended for use in hospitals by all clinicians involved in the medication management pathway, including those with governance responsibilities within the health service. The survey tool is also intended to be applied within pharmacy and ward storage environments.
  3. Content Article
    The Health Index is a new tool to measure a broad variety of health outcomes and risk factors over time, and for different geographic areas. This methodology article explains how the Health Index has been constructed.
  4. Content Article
    Some patients die after major surgery. Risk prediction tools can help shared decision making with the patient, aiding decisions on whether to operate, how to prepare and use of critical care. An international multi-centre prospective observational cohort study in 274 sites with 22,631 patients compared risk prediction with 30-day mortality. In 88.7% of cases clinicians exclusively used subjective assessment. The best predictions were from the SORT tool combined with clinical assessment. P-POSSUM Surgical Risk Scale, SRS and SORT all over-predicted risk, with SORT performing best. This 10-question SORT model has been updated including clinician assessment and provides an accurate means of predicting perioperative risk.
  5. Content Article
    Patient advocate Vonda Vaden Bates interviews Brandyn Lau, Assistant Professor of Radiology and Health Sciences Informatics, Johns Hopkins School of Medicine, around the importance of venous thromboembolism (VTE) prophylaxis for hospitalised patients.
  6. Content Article
    Staff safety is fundamental to running an effective health service and delivering quality care. This year has highlighted how important risk assessments are in protecting the NHS workforce, as it continues to respond to the COVID-19 pandemic. We know that frontline healthcare staff are more at risk of becoming infected with COVID-19. We also know the virus has a disproportionate impact on staff from minority ethnic communities, and that many NHS workers are considered “clinically vulnerable” to COVID-19. There are also risk factors that relate to gender, age, weight and many more. This can understandably leave staff feeling confused about what they should and shouldn’t be doing to look after themselves and their colleagues.  On 24 June, it became mandatory for all trusts to complete occupational risk assessments of vulnerable NHS workers. In this interview, Patient Safety Learning speaks to James Duez, CEO of Rainbird. James tells us how his company developed an automated decision-making tool, able to produce individualised risk assessments so that appropriate measures can be put in place quickly. 
  7. Content Article
    Around 1 in 12 people are exposed to domestic violence and abuse (DVA) during pregnancy. Health appointments during this time are a good opportunity for maternity staff and other health professionals to ask people about DVA and offer support. Maternity staff routinely screen for DVA, yet disclosure and referral rates remain low. This course is designed for midwives and maternity staff caring for people giving birth and their families. It may also offer useful guidance for any professional providing care for pregnant people and in the postpartum period. Participants will discover the research, guidelines and techniques for screening for DVA more effectively. They will have the opportunity to enhance their ability to support victims and contribute to creating change in DVA rates during pregnancy. Follow the link below to register for free.
  8. Content Article
    Harm reviews give assurance to patients, patient groups, commissioners and the public as to whether patients have been harmed, or are at risk of harm, as well as helping to avoid future harm to patient. Patients may be harmed not only by clinical treatment, but also as a result of the need to be on a waiting list for clinical treatment, as this may result in deterioration of their physical or mental condition.  Royal Cornwall Hospitals standard operating procedure (SOP) identifies a standardised approach to harm reviews for all specialities at the Trust that support the Trusts' governance and assurance processes and maintains practice in line with national expectations.
  9. Content Article
    In this Anaesthesia editorial, Simoes and Bhangu, on behalf of the CovidSurg Collaborative, outline why and how elective surgery must restart. "COVID‐19‐free pathways will be crucial for patient safety during the COVID‐19 pandemic, as they seem to lead to low rates of SARS‐CoV‐2 infection rates and complications. Further preventive measures and patient level risk assessment will allow surgery to safely restart and continue during this, and future, crises." This editorial accompanies an article by Kane et al. Anaesthesia 2020; 75: 1596–1604.
  10. Content Article
    Prostate cancer is the most common cancer in men, but most men with early prostate cancer don’t have symptoms. So what should you do? Click the link below and and answer three quick questions to find out.
  11. Content Article
    Our understanding of race and human genetics has advanced considerably, yet these insights have not led to clear guidelines on the use of race in medicine. The result is ongoing conflict between the latest insights from population genetics and the clinical implementation of race. For example, despite mounting evidence that race is not a reliable proxy for genetic difference, the belief that it is has become embedded, sometimes insidiously, within medical practice. One subtle insertion of race into medicine involves diagnostic algorithms and practice guidelines that adjust or “correct” their outputs on the basis of a patient’s race or ethnicity. Physicians use these algorithms to individualise risk assessment and guide clinical decisions. By embedding race into the basic data and decisions of health care, these algorithms propagate race-based medicine. Many of these race-adjusted algorithms guide decisions in ways that may direct more attention or resources to white patients than to members of racial and ethnic minorities. To illustrate the potential dangers of such practices, Vyas et al. have compiled a partial list of race-adjusted algorithms.
  12. Content Article
    Tim Stephens is a researcher at Queen Mary University of London and Barts Health NHS Trust and a qualified intensive care nurse. He is currently working with a large team of clinicians, patients and scientists to investigate how older people make decisions about having major surgery.  In this blog, Tim talks about shared decision-making, individual impact and the need for better data to help clinicians quantify risk. 
  13. Content Article
    Clift et al. have developed a new risk prediction tool that estimates a person’s chance of hospitalisation and death from COVID-19. The algorithm, which was constructed using data from more than eight million people across England, uses key factors such as age, ethnicity and body mass index to help identify individuals in the UK at risk of developing severe illness.
  14. Content Article
    This cross-sectional survey in the British Journal of General Practice looks at the availability and use of emergency admission risk stratification (EARS) tools across the UK and aims to identify factors that influence their implementation. The authors identified 39 different EARS tools in use. They found that the most important factors in encouraging general practices to use EARS tools were: promotion by NHS commissioners involvement of clinical leaders engagement of practice managers. High workloads and information governance were significant barriers to their use. The authors highlight the need to align policy and practice with research evidence.
  15. Content Article
    On 24 June, NHS E&I mandated that all trusts perform occupational risk assessments of vulnerable NHS workers. Public Health England has also called for “accelerated development of culturally competent occupational risk assessment tools”. Rainbird Technologies has developed a tool with a SEQOHS-accredited NHS occupational health service. It is approved by a clinical safety review panel and being used by multiple NHS trusts. Follow the link below if you would like to request access to the tool for your trust.
  16. News Article
    Almost half of NHS Trusts in England have reported risks classified as “significant” or “extreme”, with issues facing funding, buildings and failing equipment, according to an analysis by Labour. Highlighting warnings of staff shortages and patient safety, the party demanded urgent action from the government to prepare the health service for the winter months as cases of COVID-19 accelerate across the country. Labour said its study of 114 NHS Trusts’ risks registers showed that over three quarters of trusts logged a workforce risk. The analysis also revealed that 66% reported a financial risk, 82% highlighted risks directly related to COVID-19 and 84% recorded a risk to patient safety. Almost half of Trusts (54), the party said, had outlined risks described as “significant” or “extreme”. One hospital trust reported it was “not financially stable” beyond the current financial year while another recorded a potential risk to patient safety due to “structural deficiencies” in roof structure. NHS hospitals are expected to consider risks to their operations and processes and when risks are identified, it is likely they will have been considered at board level and mitigations put in place. Describing the registers – compiled between March and August - as “worrying” in a normal winter, Jonathan Ashworth, the shadow health secretary, said: “In the coming winter, with the incompetent handling of the test and trace system leaving the NHS wide open and poorly supported, they take on a whole new meaning." "We urgently need a commitment from ministers to fix the problems with test and trace and a timetable by which these issues will finally be sorted. On top of this it is vital that ministers confirm that the NHS will get the additional support it needs to address these risks." Read full story Source: The Independent, 6 October 2020
  17. Content Article
    The aim of this study from Jardine et al. was to determine the rate of complicated birth at term in women classified at low risk according to the National Institute for Health and Care Excellence guideline for intrapartum care (no pre-existing medical conditions, important obstetric history, or complications during pregnancy) and to assess if the risk classification can be improved by considering parity and the number of risk factors. The authors found nulliparous women without risk factors have substantially higher rates of complicated birth than multiparous women without a previous caesarean section even if the latter have multiple risk factors. Grouping women first according to parity and previous mode of birth, and then within these groups according to presence of specific risk factors would provide greater and more informed choice to women, better targeting of interventions, and fewer transfers during labour than according to the presence of risk factors alone.
  18. Content Article
    Although airway safety is known to be one of the key components in safe care, thousands of patients lose their lives each year to poor airway management and unplanned extubations. In this Patient Safety Movement webinar, the team discusses starting an unplanned extubation project without buy-in from others, multi-institutional collaboration, pushback from leaders, colleagues, or other organisations, the future of interventions, clinicians who have experience with unplanned extubations as key advocates, and cross-checking pediatric and adult safety efforts. The panel ends with Drew Hughes’ story and the team emphasises taking a moment to ground yourself in your practice and the importance of speaking up when you think the patient is at risk.
  19. Content Article
    The OSIRIS programme is a major project of research, to understand and improve the shared decision making process for patients at high risk of medical complications as they contemplate major surgery. Led by Barts Health NHS Trust & Queen Mary University London and funded by the National Institute for Health Research (NIHR), research will be conducted with patients, doctors and carers to understand the surgical decision making process. The OSIRIS team aim to understand the values and beliefs about long-term outcomes amongst high-risk patients contemplating major surgery, how these differ from doctors’ opinions, how these affect decisions about surgical treatments, and whether patients’ opinions change once they experience surgery. They will co-design with patients and doctors, a decision support intervention, to provide an accurate and individualised forecast of the risks and benefits of surgery for each high-risk patient. You can find out more about the research methodology and the aims of the project through the link below. 
  20. Content Article
    With evidence of the impact of COVID-19 on BAME communities, on 15 April 2020 NHS England CEO Simon Stevens convened a meeting of leaders in healthcare and representative bodies such as the British Medical Association and Royal College of Nursing to agree a plan of action to support staff. The NHS response has since been underpinned by three principles of protecting, supporting, and engaging staff.
  21. Content Article
    This prospective study aimed to determine the surgical site infection (SSI) rate and associated risk factors was carried in a general surgical ward at Liaquat University Hospital Jamshoro. A total of 460 patients requiring elective general surgery from July 2005 to June 2006 were included in this study. All four surgical wound categories were included. Primary closure was employed in all cases. Patients were followed up to 30th day postoperatively. All cases were evaluated for postoperative fever, redness, swelling of wound margins and collection of pus. Cultures were taken from all the cases with any of the above finding. The overall rate of surgical site infection was 13·0%. The rate of wound infection was 5·3% in clean operations, 12·4% in clean‐contaminated, 36·3% in contaminated and 40% in dirt‐infected cases. Age, use of surgical drain, duration of operation and wound class were significant risk factors for increased surgical site infection.. Postoperative hospital stay was double in cases who had surgical site infection. Sex, haemoglobin level and diabetes were not statistically significant risk factors. In conclusion, surgical site infection causes considerable morbidity and economic burden. The routine reporting of SSI rates stratified by potential risk factors associated with increased risk of infection is highly recommended.
  22. News Article
    Guidance to protect at-risk healthcare workers in Wales from coronavirus infection has been relaxed, the BBC has learned. A risk assessment tool initially recommended high-risk workers should not work in the parts of a hospital where infection was most likely. But it now says their personal protective equipment (PPE) should be reviewed or duties changed. The Welsh government says this reflects latest data and low infection rates. However, healthcare professionals say the change to the all-Wales COVID-19 workforce risk assessment tool was made without consultation, and are concerned it was done to prevent hospitals from losing frontline staff ahead of a potential second wave of the virus. Mr Amol Pandit, a urologist who helped to design the tool, has written to the Welsh government four times seeking clarity on the basis for the changes, and why no one was made aware of them before the tool was rolled out. "The changes could have been made in order to keep as many healthcare workers on the frontline as possible, which is why I sent a specific list of questions to the Welsh government, so that I could have assurances that it wasn't done for that reason, but for clinical, evidence-based reasons," Mr Pandit said. Mr Pandit believes healthcare workers who fall into the high-risk category and work in environments where aerosol-generating procedures are performed - considered to carry a high risk of transmission of the virus - may not be fully protected by the current version of the tool if PPE supplies fall short and additional safeguarding measures aren't put into place. "The government needs to be absolutely sure that there is adequate PPE and that it is going to be available to everybody - we have to trust them on that," he said Read full story Source: BBC News, 27 August 2020
  23. Event
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    The Flight Safety Foundation goal with this Seminar is to promote further globally the practical implementation of the concepts of system safety thinking, resilience and Safety II. There will be two sessions, one for each day, that will consist of briefings and a Q&A panel afterwards. The following themes are suggested for briefings and discussions for the Seminar 1.The limits of only learning from unwanted events. 2. Individuals’ natural versus organisations’ consciously pursued resilience. 3. How the ancient evolutionary individual instincts for psychological safety affect individual and team learning and how these can be positively managed? 4. The slow- and fast-moving sands of operations and environment change over time and their significance for safety. 5. How to pay as much attention to why work usually goes well as to why it occasionally goes wrong? 6. Understanding performance adjustments of individuals to get the job done. 7. The blessings and perils of performance variability. 8. Learning from data versus learning from observing. 9. Learning from differences in operations versus learning from monitoring for excrescences. 10. Can risk- and resilience-based concepts work together? 11. Does just culture matter for learning from success? 12. How to document explicitly, maintain current and use the information about success factors and safety barriers and shall this be a part of organisational SMS? Further information
  24. Content Article
    Research has shown that frontline staff understand the dangers of pressure sores but experience significant challenges in their attempts to prevent them. The research, undertaken by NHS Midlands and East and downloadable below, showed that staff feel they do not have the time to treat patients and need improved communication between the patients, their carers and the homes from which they might have come. In response to this, NHS Midlands and East has created the Pressure Ulcer Path, a tool to support staff in preventing pressure ulcers and treating them, alongside a number of useful resources.
  25. Content Article
    In this article, published by The Justice Gap, Theo Huckle QC discusses the issue of people not receiving treatment because of diversion of pre-existing NHS resources to the fight against the COVID-19 pandemic. There are legal issues which arise about the rights of citizens to receive – and continue to receive – treatment from their health service. What are those rights and what right do Governments in the UK or the health Trusts have to reduce services and not treat existing patients because of the current global health crisis?
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