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Showing results for tags 'Systematic review'.
Found 100 results
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Content ArticleThis systematic review in the Western Journal of Nursing Research examined the relationship between hospital nurse fatigue and outcomes. The authors found that fatigue was consistently associated with mental health problems, decreased nursing performance and sickness absence. Many studies confirmed that nurse fatigue is negatively associated with nurse, patient-safety and organisational outcomes. The review also highlighted gaps in current knowledge and the need for future research using a longitudinal design and measuring additional outcomes to better understand the consequences of nurse fatigue.
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Content ArticleA prolonged stay in the emergency department before moving on to an in-hospital bed, another facility or departing home, is believed to have a negative effect on clinical outcomes for patients. This international systematic review and meta-analysis in the Journal of Clinical Medicine aimed to investigate the link between emergency department length of stay (EDLOS) and in-hospital mortality. The study's findings suggest two key associations with increased in-hospital mortality: low EDLOS EDLOS exceeding 24 hours The authors suggest that: long stays in the emergency department should not be allowed. special attention should be given to patients admitted after a short stay in the emergency department.
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Content ArticleIn this document, Charles Vincent and colleagues from Imperial College London, propose a new framework to help find the elusive answer to the question – how safe is care today?
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News Article
ER doctors in the US misdiagnose patients with unusual symptoms
Patient Safety Learning posted a news article in News
As many as 250,000 people die every year because they are misdiagnosed in the emergency room, with doctors failing to identify serious medical conditions like stroke, sepsis and pneumonia, according to a new analysis from the US federal government. The study by the Agency for Healthcare Research and Quality estimates roughly 7.4 million people are inaccurately diagnosed of the 130 million annual visits to hospital emergency departments in the United States. Some 370,000 patients may suffer serious harm as a result. Researchers from Johns Hopkins University analysed data from two decades’ worth of studies to quantify the rate of diagnostic errors in the emergency room and identify serious conditions where doctors are most likely to make a mistake. While these errors remain relatively rare, they are most likely to occur when someone presents with symptoms that are not typical. “This is the elephant in the room no one is paying attention to,” said Dr. David E. Newman-Toker, a neurologist at Johns Hopkins University and director of its Armstrong Institute Center for Diagnostic Excellence, and one of the study’s authors. The findings underscore the need to look harder at where errors are being made and the medical training, technology and support that could help doctors avoid them, Dr. Newman-Toker said. “It’s not about laying the blame on the feet of emergency room physicians,” he said. Read full story Source: New York Times, 15 December 2022 -
Content ArticleDiagnostic errors are a known patient safety concern across all clinical settings, including the emergency department (ED). The authors from the John Hopkins University conducted a systematic review to determine the most frequent diseases and clinical presentations associated with diagnostic errors (and resulting harms) in the ED, measured error and harm frequency, as well as assessing causal factors.
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Content ArticleThis study in eClinicalMedicine aimed to bring together the global evidence on the prevalence of persistent symptoms in people who had experienced Covid-19 infection. The authors found, across the 194 studies included in the systematic review, that 45% of Covid-19 survivors, regardless of hospitalisation status, were experiencing a range of unresolved symptoms at around four months after infection. The authors state that current understanding is limited by heterogeneous study design, follow-up durations and measurement methods, and highlight that definition of subtypes of Long Covid is unclear, which hampers effective treatment and management strategies.
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Content ArticleThis systematic review in the International Journal of Health Planning and Management aimed to examine and analyse the existing literature that examines the impact of strike action on patient morbidity—all patient outcomes apart from death. 15 studies were included in the review. and articles included a variety of outcomes from hypertension control to rates of chlamydia. Strikes ranged from 13 to 118 days, with a mean strike length of 56 days. The authors found that the majority of studies reported that strike action had a neutral or mixed impact on patient morbidity. One study reported positive outcomes and three studies reported negative outcomes, however in both cases, the impact that the strike had was marginal.
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Content ArticleThis report by the US non-profit organisation the Emergency Care Research Institute (ECRI) was commissioned by the US Food and Drug Administration (FDA) to determine the safety profile of polypropylene (PP) mesh used in a variety of surgical procedures. ECRI performed a comprehensive literature search and systematic review to identify the current state of knowledge about how patients' bodies respond to PP mesh.
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Content ArticleSocial prescribing is a way of linking people with complex needs to non-medical supports in the community. There are different models of social prescribing, ranging from online signposting services to individual support from a link worker to access community resource. The aim of this study from Kiely et al. was to establish the evidence base for the effects on health outcomes and costs of social prescribing link workers (non-health or social care professionals who connect people to community resources) for people in community settings focusing on people experiencing multimorbidity and social deprivation. The study found that there is an absence of evidence for social prescribing link workers. Policymakers should note this and support evaluation of current programmes before mainstreaming.
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Content ArticleA systematic review and meta-analysis from Hodkinson et al. examines the association of physician burnout with the career engagement and the quality of patient care globally. A joint team of British and Greek researchers analysed 170 previous observational studies of the links between burnout among doctors, their career engagement and quality of patient care. Those papers were based on the views and experience of 239,246 doctors in countries including the US, UK and others in Africa, Asia and elsewhere globally. This meta-analysis provides compelling evidence that physician burnout is associated with poor function and sustainability of healthcare organisations primarily by contributing to the career disengagement and turnover of physicians and secondarily by reducing the quality of patient care. Healthcare organisations should invest more time and effort in implementing evidence-based strategies to mitigate physician burnout across specialties, and particularly in emergency medicine and for physicians in training or residency. Read accompanying BMJ editorial here.
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Content ArticleImproving health care quality and ensuring patient safety is impossible without addressing medical errors, so it is important to accurately estimate incidence rates and implement the most appropriate solutions to reduce medical errors. This systematic review in the journal Frontiers in Medicine aimed to identify interventions that have the potential to decrease medical errors. The authors concluded that although many interventions have been suggested and tried, patient safety has not significantly improved. They call on policymakers to focus more on implementing selected interventions effectively.
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Content Article
Communication in the operating theatre (14 November 2013)
Patient-Safety-Learning posted an article in Surgery
Communication is extremely important to ensure safe and effective clinical practice. This systematic literature review of observational studies addressing communication in the operating theatre aimed to gain an understanding of actual communication practices, rather than what was reported through recollections and interviews. In all of the studies reviewed, communication was found to affect operating theatre practices. Further detailed observational research is needed to gain a better understanding of how to improve the working environment and patient safety in theatre. -
Content ArticleNursing workforce shortages are an issue of international concern, with the gap between demand for services and the limited numbers of nurses widening. Recruiting nurses internationally is one solution that is helping to bridge this gap in some health systems. This systematic review in the International Journal of Nursing Studies Advances aimed to explore the lived experiences of international nurses working and living in different countries globally. The authors identified factors that can help nurses from other countries to adapt culturally to the UK health system, and that may support retention of international staff. The authors found that in order to improve the long term retention of international nurses, cultural integration and language barriers should be sensitively managed to enable effective acculturation. Culturally sensitive leadership should also be promoted to ensure zero tolerance of inappropriate racist and discriminatory behaviours.
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Content ArticlePatients recovering from an episode in an intensive care unit (ICU) frequently experience medication errors on transition to the hospital ward. This systematic review in BMJ Quality & Safety aimed to examine the impact of medication-related interventions on medication and patient outcomes on transition from adult ICU settings and identify barriers and facilitators to implementation.
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Content ArticleThis article in The Milbank Quarterly summarises an extensive literature review addressing the question, "How can we spread and sustain innovations in health service delivery and organisation?" The authors identify three key outputs of the systematic review: A parsimonious and evidence-based model for considering the diffusion of innovations in health service organisations Clear knowledge gaps on which further research on the diffusion of innovations in service organisations should be focused A robust and transferable methodology for systematically reviewing complex research evidence
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Content ArticleBullying, discrimination and harassment between healthcare workers can have an impact on how well individuals do their job, and may therefore lead to an increase in medical errors, adverse events and medical complications. This systematic review in BMJ Quality & Safety aimed to summarise current evidence about the impact on clinical performance and patient outcomes of unacceptable behaviour between healthcare workers.
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Content ArticleSafety voice is the act of speaking up about safety in order to prevent accidents and physical harm. This systematic review in the journal Safety Science aimed to determine how safety voice differs conceptually from employee voice, is described across levels of analysis and could be best investigated. The authors found that there are important challenges for safety voice in terms of developing methodologies and interventions.
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Content ArticleInfection prevention and control (IPC) programmes and practices play a vital role to ensure outbreak preparedness and control, including patient safety and quality of care, which remain essential components of universal health coverage across health systems worldwide. However, detailed IPC evaluations using standardised validated tools, such as the WHO IPC self-assessment framework (IPCAF), are limited. Tomczyk et al. have conducted the first WHO global survey to assess implementation of these programmes in healthcare facilities. IPC professionals were invited through global outreach and national coordinated efforts to complete the online WHO IPC assessment framework (IPCAF). The study found that despite an overall high IPCAF score globally, important gaps in IPC facility implementation and core components across income levels hinder IPC progress. Increased support for more effective and sustainable IPC programmes is crucial to reduce risks posed by outbreaks to global health security and to ensure patient and health worker safety.
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Content ArticleChen et al. examined the worldwide prevalence of post COVID-19 condition, through a systematic review and meta-analysis. The research, published in the Journal of Infectious Disease, assessed 23 symptoms reported across 36 of the studies and found that shortness of breath, sleep problems, and joint pain was widely reported by those who had recovered from the novel coronavirus infection. They analysed the prevalence of this condition globally and regionally, estimating the proportion of individuals facing long Covid in Asia, Europe and North America. They found that the global prevalence for post-Covid conditions at 30, 60, 90 and 120 days after infection was about 37, 25, 32, and 49%, respectively. The authors concluded that post COVID-19 condition prevalence is substantial; the health effects of COVID-19 appear to be prolonged and can exert stress on the healthcare system.
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Content ArticleThis article, published in BMC Health Services Research, reviews the effectiveness of hospital accreditation. It found no evidence to suggest accreditation and certification of hospitals leads to improved quality of care.
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Content ArticlePrehospital care is the care received by a patient from an emergency medical service before arriving at a hospital. This systematic review in the International Journal for Quality in Health and Care aimed to identify: how the prevalence and level of harm associated with patient safety incidents (PSIs) in prehospital care are assessed. the frequency of PSIs in prehospital care. the harm associated with PSIs in prehospital care.
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Content Article
Artificial intelligence (AI) is increasingly being used in medicine to help with the diagnosis of diseases such as skin cancer. To be able to assist with this, AI needs to be ‘trained’ by looking at data and images from a large number of patients where the diagnosis has already been established, so an AI programme depends heavily upon the information it is trained on. This review, published in The Lancet Digital Health, looked at all freely accessible sets of data on skin lesions around the world. -
Content ArticleWhile it is now apparent that Long Covid may persist after acute COVID-19, its nature, frequency and aetiology are poorly characterised. This study from MicHelen et al. aimed to regularly synthesise evidence on long COVID characteristics, to help inform clinical management, rehabilitation strategies and interventional studies to improve long-term outcomes. The authors conclude that Long Covid is a complex condition with prolonged heterogeneous symptoms. The nature of studies precludes a precise case definition or risk evaluation. There is an urgent need for prospective, robust, standardised, controlled studies into aetiology, risk factors and biomarkers to characterise long COVID in different at-risk populations and settings.
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Content ArticleEmergency Department *ED) crowding has potential detrimental consequences for both patient care and staff. Advancing disposition can reduce crowding. This may be achieved by using prediction models for admission. This systematic review from Brink et al. aims to present an overview of prediction models for admission at the ED. Furthermore, we aimed to identify the best prediction tool based on its performance, validation, calibration and clinical usability.
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Content ArticleThis systematic review published in BMJ Global Health looks to identify the nature, frequency and causes of long-COVID symptoms by reviewing data from existing research studies into long-COVID. It aims to regularly synthesise evidence on long-COVID characteristics to help improve long-term outcomes. From the data provided by 39 studies, the review found that: long-COVID affects both patients who were hospitalised and those managed in the community patients with long-COVID display a wide range of symptoms including weakness, general malaise, fatigue, concentration impairment and breathlessness research currently available on long-COVID is vulnerable to bias, so caution should be used when interpreting data. The authors also identify areas where further research is needed to help define long-COVID symptoms, identify risk factors for different populations and assess the impact of variants of concern and vaccination on long-term outcomes.
