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Content ArticleYou can now watch the recording of the Nuffield Trust event: 'Does the rush for new types NHS staff have a dark side?'
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News Article
Harlow hospital suspends gas and air over nitrous oxide levels
Patient Safety Learning posted a news article in News
A hospital has stopped using gas and air in its maternity unit to "protect our midwifery and medical team". The Princess Alexandra Hospital in Harlow, Essex, said the decision followed tests on nitrous oxide levels. It said it would temporarily suspend the use of Entonox while additional safety equipment was installed. Giuseppe Labriola, director of midwifery, said: "There is no risk to mothers, birthing people, their partners and babies." Other hospitals have previously temporarily suspended the use of gas and air in recent months including Basildon and Ipswich. Read full story Source: BBC News, 22 January 2023 -
Content ArticleIn this interview for The Guardian, Pat Cullen, General Secretary of Royal College of Nursing (RCN), talks about how RCN members are being forced to use food banks, her frustration with the government and how she learned to be a tough negotiator. She discusses the issues that led to nurses balloting to strike—violence, sexual assault, unsafe staffing levels and pay that has not kept up with inflation—and outlines the difficult realities of being a nurse in the NHS. She also describes the negotiations with the Government, who according to Cullen, refused to discuss nurses' pay.
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News ArticlePatients and staff are in danger as regulators are accused of poor handling of sexual assault allegations made against doctors and nurses, The Independent has been told. Campaigners and frontline staff who spoke to The Independent warned that professional regulators are not dealing adequately with allegations of sexual assault, harassment and domestic violence. A study of rulings by the Nursing and Midwifery Council (NMC) has also revealed that male nurses account for 80% of striking-off orders relating to sexual assault allegations, despite only making up 11% of the register. The warning comes after horrific details of rape and abuse by police officer David Carrick were uncovered this week. Dr Rebecca Cox, who helped sparked a major #MeToo movement in medicine and is co-founder of the Surviving in Scrubs campaign group, told The Independent: “There are great similarities, in the recent cases of prolific sexual harassment and assault, between the Met Police and the NHS. “As an organisation, we have had multiple healthcare professionals contacting us desperate to seek support after facing repeated barriers when trying to report harassment and assault to their employing NHS organisation and regulators such as the GMC. “Victims find their cases ignored or dropped without good reason, and perpetrators being able to continue working without repercussions. We need a public inquiry into sexism, sexual harassment and sexual assault in healthcare.” Read full story Source: The Independent, 22 January 2023 You may also be interested in: Calling out the sexist and misogynist culture within healthcare: a blog by Dr Chelcie Jewitt, co-founder of the Surviving in Scrubs campaign
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Content ArticleThis video from the Irish Health Services Executive (HSE) tells the story of Barry, a paediatric nurse who made a medication error when treating a critically ill baby. Barry describes how the incident and the management response to it affected his mental health and confidence over a long period of time. He also describes how he had to fight to ensure the family were told the full story of what had happened, and the positive relationship he developed with the baby's mother as a result. The baby received the treatment they needed and recovered well.
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News Article
Poll shows 2 in 5 GPs face verbal abuse on a daily basis
Patient Safety Learning posted a news article in News
Two in five GPs are facing verbal abuse every single day, a new poll suggests. Some 74% of family doctors have claimed they or their staff have experienced verbal abuse on a weekly basis, including almost 40% who say it occurs daily, according to the survey conducted by GP publication Pulse. And 45% said practice staff experience physical abuse every year, according to the poll of 1000 GPs. As well as facing abuse in GP surgeries, a third reported practice staff have faced abuse on social media on a weekly basis. The Royal College of GPs described the survey findings as deeply disturbing. One GP told the journal: "Last week a patient, without any mitigating circumstances, was desperately abusive to one of my receptionists bemoaning the fact it wasn’t the US where she could buy a gun and 'sort us all out'. "Primary care seems to be bearing the brunt and blamed by all and sundry for the current issues and the public are picking up on this." Read full story Source: Medscape, 19 January 2023 -
Content ArticleIn this blog, Paul E Sax, Contributing Editor at NEJM Journal Watch looks at a recent study into the effectiveness of medical masks compared to N95 respirators for preventing Covid-19 infection among healthcare workers. The author aims to help readers understand how to appraise research studies and decide how and whether to apply their findings. He defines some of the complex terminology used in the study and looks at its methods and findings from both a critical and supportive viewpoint.
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Content ArticlePsychological safety is the belief that you won’t be punished or humiliated for speaking up with ideas, questions, concerns, or mistakes. This article by the Center for Creative Leadership explores why psychological safety is so important to foster in workplaces. It suggests eight steps toward creating more psychological safety at work and describes the four stages of psychological safety.
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Content ArticleThis research by the Nuffield Trust looked at how smaller hospitals have fared over the pandemic. Smaller hospitals are sometimes overlooked when system planning gets done, so this report focuses on the operational responses and management approaches taken by staff from 10 smaller hospitals over the course of the first and second waves of the pandemic. It aims to tell the stories of those working in small hospitals in order to understand what happened to acute and emergency care in these institutions during the pandemic. The authors interviewed staff in smaller hospitals around the country during 2021 to understand their key concerns. The report makes a set of recommendations for future crisis planning and response.
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News Article
Wales coroner rules nurses’ Covid deaths as industrial disease
Patient Safety Learning posted a news article in News
The deaths of two nurses from Covid-19 in the early days of the pandemic have been ruled as industrial disease. Gareth Roberts, 65, of Aberdare, and Domingo David, 63, of Penarth, were found to have been most likely to have contracted the virus from colleagues or patients while working for hospitals under the Cardiff and Vale University Health Board. The senior coroner Graeme Hughes concluded on Friday that although they were given appropriate personal protective equipment (PPE), Roberts and David were “exposed to Covid-19 infection at work, became infected and that infection caused” their deaths. He made a finding of industrial disease. Roberts’ family had argued for a conclusion of industrial disease, while the health board had made the case for ruling that both deaths were from natural causes. Unions are campaigning for Covid-19 to be considered an industrial disease by the UK government so workers affected by it would receive greater financial support. Read full story Source: The Guardian, 13 January 2023 -
Content ArticleIn this letter to Steve Barclay MP, Secretary of State for Health and Social Care, the chair and chief executive of the Patients Association, Sir Robert Francis and Rachel Power, raised their concerns about how the Government is dealing with the growing crisis in health and social care. The letter asked him to declare a national incident in the NHS and to publish solutions to the current crisis, developed with patients and carers. The letter also asked the Minister to publish the long-term workforce plan and includes an offer from the Patients Association to work with the Department for Health and Social Care (DHSC).
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News Article
Basildon Hospital maternity staff exposed to 30 times legal gas limit
Patient Safety Learning posted a news article in News
Staff at a maternity unit were exposed to almost 30 times the legal workplace exposure limit for nitrous oxide, documents have shown. Testing at Basildon Hospital revealed the levels more than 16 months before colleagues were informed. The Royal College of Midwives said its members there were considering legal action. Routine testing of the maternity suite in June 2021 revealed nine staff members had been exposed to excess nitrous oxide levels during the course of their shifts. Three had readings of more than 1,000 parts per million (ppm) of the gas, while a fourth recorded almost 3,000. The Workplace Exposure Limit is set at 100ppm. Trust management apologised after failing to notify staff at the unit until October 2022. A briefing seen by the BBC stated the issue was logged on the risk register, but "there has not been proper oversight of the problem and staff have not been informed". One person familiar with the situation, who did not want to be identified, said: "We had an email sent out that said 'emergency maternity staff briefing' and there was a Teams meeting. "The Teams meeting was very, very difficult to listen to. It was very emotive. People were angry understandably, but I feel like the executive who were on the call didn't handle it very well." Read full story Source: BBC News, 16 January 2023 -
Content ArticleThis blog by Robert Otto Valdez, Director of the US Agency for Healthcare Research and Quality (AHRQ), outlines the setbacks to patient safety and the healthcare workforce caused by the Covid-19 pandemic. He highlights areas of concern including workforce burnout and an increase in healthcare associated infections (HAIs) since 2020. The issues faced by the US healthcare system are not felt equally, and Valdez draws attention to a report that demonstrates worsening health inequalities. The blog includes links to evidence-based research and initiatives developed by AHRQ aimed at improving current patient safety priorities. Toolkits to improve antibiotic use. These resources are based on a “Four Moments of Antibiotic Decision Making” model that has shown success in hospitals, long-term care facilities, and ambulatory care practices. Tools to engage patients and families in making healthcare safer. Patients and families are powerful partners in improving quality and safety in hospital settings, during primary care visits, or whenever a diagnosis is made. These resources help ensure that patients’ voices are heard. Surveys on patient safety culture. This family of surveys asks healthcare providers and staff about the extent to which their organisational culture supports patient safety. Each survey is designed to assess patient safety culture in a specific setting. Diagnostic Centers of Excellence. These grants establishing 10 centres of excellence are aimed at developing systems, measures, and new technology solutions to improve diagnostic safety and quality.
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News Article
‘Tearful’ staff raise patient safety concerns to CQC
Patient-Safety-Learning posted a news article in News
An inspection of a hospital has found all wards were understaffed, while ‘tearful [and] exhausted’ clinicians raised patient safety concerns to the Care Quality Commission (CQC). The CQC’s visit to Colchester hospital, run by East Suffolk and North East Essex Foundation Trust, also found patients going unfed because of low staffing ratios and patient confidentiality concerns. The concerns were raised in a letter sent by the CQC to the trust, which also runs Ipswich hospital, ahead of publication of an inspection report for older people’s medical services, which is due later this month. The CQC’s letter, published in board papers for a meeting on Thursday, said: “All wards’ actual staffing levels and skill mix meant staff were often overstretched. All staff we spoke with expressed concern about the impact on patient care and personal wellbeing. Some staff we spoke with were tearful, reported feeling exhausted and concerned that they were unable to care for patients well enough to keep them safe.” The letter also said significant positives were found. Inspectors “found staff to be welcoming, hardworking and supportive of each other… We found staff at all levels working together with the aim of putting the patients first and providing a safe and effective service”. Read full story (paywalled) Source: HSJ, 11 January 2023 -
News Article
7,000 ‘exhausted and burnt out’ NYC nurses walk out
Patient-Safety-Learning posted a news article in News
More than 7,000 nurses at two major New York City hospitals walked off the job Monday, arguing immense staffing shortages are causing widespread burnout and hindering their ability to properly care for their patients. The nurses say they are working long hours in unsafe conditions without enough pay – a refrain echoed by several other nurses strikes across the country over the past year. The union representing the nurses said an offer of 19% pay hikes isn’t enough to solve staffing shortages. This is the latest in a series of strikes in the health care industry in recent years. Those union members who were on the front lines during the three-year battle with the Covid pandemic say the system is no longer able to function with the widespread shortages that arose during those years. “We’ve been fighting for working under safer conditions,” Warren Urquhart, a transplant nurse at Mount Sinai, told CNN Monday while on the picket line. “We do the best we can every day. There’s something wrong inside the hospital. That’s why we’re outside the hospital.” Read full story Source: CNN, 9 January 2023 -
Content ArticleThe Cambridge Elements series offers a comprehensive and authoritative set of overviews of different improvement approaches that can be applied to healthcare. Each publication explores the thinking behind them, examines evidence for each approach and identifies areas of debate. Publications available include: Design creativity Values and ethics Statistical process control Approaches to spread, scale-up, and sustainability Health economics Governance and leadership Workplace conditions Reducing overuse Simulation as an improvement technique Implementation science Operational research approaches Making culture change happen Co-producing and co-designing Collaboration-based approaches The positive deviance approach
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Content ArticleThe NHS and social care system in the UK are under immense strain, and this is increasingly causing harm to patients. This is seen in the current crisis in urgent and emergency care, but is present throughout the system. This BMJ article looks at a collaborative document produced by the Royal College of Physicians (RCP), Royal College of Emergency Medicine (RCEM), Royal College of General Practitioners (RCGP), Royal College of Psychiatrists (RCPsych) and the Society for Acute Medicine (SAM). The document highlights key actions and priorities that may help mitigate part of the crisis facing the NHS. As part of these recommendations, the authors call on the UK governments to increase and prioritise investment in primary care, social care, mental health and ambulance services.
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News Article
Staff mental health support faces axe after national funding cut
Patient Safety Learning posted a news article in News
Mental health and wellbeing hubs for NHS and social care staff could be axed within months, as national funding for them is likely to be cut, HSJ has learned. NHS England and the Department of Health and Social Care are understood to be close to ending ring-fenced national funding for the 41 hubs, which were set up in February 2021, at the peak of acute covid pressures and concern about the impact on staff. Sources told HSJ discussions were ongoing, but that it is likely integrated care systems would need to find funding themselves if they are to continue. Amid tight local finances, it is expected many will be wound down or closed. This is despite problems with low staff morale, high absence rates and with large numbers of experienced staff thought to be leaving the service. Read full story (paywalled) Source: HSJ, 4 January 2022 -
Content ArticleFatigue and sleep deprivation may affect healthcare professionals' skills and communication style and also may affect clinical outcomes. However, there are no current guidelines limiting the volume of deliveries and procedures performed by a single individual, or on the length of time that they can be on call. This Committee Opinion from the American College of Obstetricians and Gynecologists (ACOG) analyses research relating to fatigue and performance in healthcare professionals in order to make recommendations to doctors and managers to improve staff and patient safety.
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Content ArticleMusculoskeletal disorders (MSDs) are one of the main causes of ill health in the workplace, leaving many employees with painful long-term injuries. Health and social care are industries with a particularly high incidence of MSDs among staff. This infographic by the Chartered Institute for Ergonomics and Human Factors (CIEHF) lists the warning signs to be aware of and gives lots of easy-to-follow practical advice on how to prevent or reduce the risk of developing symptoms. There’s also a link to find exercises that could help prevent injuries occurring.
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Content ArticleCrammed wards, burned-out GPs, patients waiting hours for ambulances – the health service is at breaking point. The Guardian journalists, Andrew Gregory and Denis Campbell, take a look at the current NHS situation.
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Content ArticleDr Mike Farquhar talks and writes a lot about the importance of healthcare professionals being able to look after themselves, both for their own wellbeing but also to improve the care we give to our patients. He has collated a Twitter thread of resources on the theme.
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Content ArticleThis survey undertaken by SCATA and supported by the FightFatigue group is looking at rest facilities and culture in anaesthesia and intensive care. Aims: To describe the current situation regarding availability and quality of rest facilities in anaesthetic and intensive care departments in the UK and ROI, compared with current standards. To describe the current situation regarding rest culture in anaesthetic and intensive care departments in the UK and ROI, compared with current standards. To feedback to departments and provide a benchmarking of their practice as compared to current standards and peers nationally. If you would like to take part, please follow the link and enter the data into the data collection tool for each rota, in consultation with colleagues as you feel necessary. The data collected will be shared with partners in the FightFatigue group and used in line with the aims of the project as above and to produce a summary report. In this report, each Trust/Board will be able to identify their own data but not others. Please direct queries to fatigue@scata.org.uk.
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Content ArticleThis report commissioned by the NHS Confederation and written by the Centre for Mental Health sets out a vision for what mental health, autism and learning disability services in England should look like in ten years’ time. It brings together research and engagement with a wide range of stakeholders including people who bring personal and professional experience. The report identifies ten interconnecting themes that underpin the vision and three key requirements that would turn the vision into reality.
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Content ArticleThis article for ABC News looks at a study conducted by researchers from the Bond University and other Australian universities about the impact of the 'hero' and 'angel' narratives applied to nurses during the Covid-19 pandemic. They interviewed critical care nurses in the UK, Australia and North America about their perceptions of these terms. The study found that nurses felt the labels devalued their professionalism, created unreasonable expectations, contributed to gender stereotypes and increased burn-out by putting emphasis on showing up for work even when nurses are unwell. The study also highlighted that nurses responded more positively to the terms 'hero' and 'angel' when used by patients, as opposed to governments and the media.
