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Found 86 results
  1. Content Article
    This Standard Operating Procedure for ICU/HDU handover has been produced by the anaesthetic team at Brighton and Sussex Universoty Hospitals to aid a safe handover of care to the receiving team on the Intensive Care Unit/High Dependency Unit (ICU/HDU).  This double sided document is used to prepare the patient for transfer and collate all necessary information ready for the receiving team. It also includes the process and a handy check list. The form can then be placed in the patient notes as documentation of the handover. Also attached is the South East Coast Critical Care Network Critical Care Intrahospital Transfer form.
  2. News Article
    The next few months will be full of grim updates about the spread of the new coronavirus, but they will also be full of homecomings. Patients hospitalised with severe COVID-19, some having spent weeks breathing with the help of a mechanical ventilator, will set about resuming their lives. Many will likely deal with lingering effects of the virus — and of the emergency treatments that allowed them to survive it. “The issue we’re all going to be faced with the most in the coming months is how we’re going to help these people recover,” says Lauren Ferrante, a pulmonary and critical care physician at the Yale School of Medicine. Hospital practices that keep patients as lucid and mobile as possible, even in the throes of their illness, could improve their long-term odds. But many intensive care unit doctors say the pandemic’s strain on hospitals and the infectious nature of the virus are making it hard to stick to some of those practices. Read full story Source: Science, 8 April 2020
  3. News Article
    A major new model of post-acute care is needed for the discharge and rehabilitation of patients following COVID-19 infection, say Alice Murray, Clare Gerada, and Jackie Morris. A comprehensive plan must be made for the 50% of COVID-19 patients who will require some form of ongoing care following admission to intensive care, with the goal of improving their long-term outcomes and freeing-up much-needed acute hospital capacity. While the current focus is quite rightly on emergent cases, planning should be set in place to create post-acute care resources and facilities for the surge in numbers of people with the physical, psychological and functional consequences of prolonged ITU stays and or hospital admission following COVID-19 infection. One potential solution is to provide mass facilities, on a scale to match the Nightingale Hospitals in so-called “Centres of Excellence”, requisitioned for those who survive but need care and cannot return to their own homes, with both residential and day care units available. Read full story Source: HSJ, 9 April 2020
  4. Content Article
    A National Patient Safety Alert has been issued on the risk of harm from interruption of high flow nasal oxygen (HFNO) during transfer.
  5. Content Article
    Medication reconciliation (‘med rec’, as it is often called) refers to the ‘process of identifying the most accurate list of all medications a patient is taking … and using this list to provide correct medications for patients anywhere within the health system’. Two recent systematic reviews summarised the evidence for med rec interventions, finding that several med rec interventions reduced medication history errors and errors in patients’ admission and discharge medication regimens.
  6. News Article
    From July, hospitals will be able to refer patients who would benefit from extra guidance around new prescribed medicines to their community pharmacy. Patients will be digitally referred to their pharmacy after discharge from hospital. The NHS Discharge Medicines Service will help patients get the maximum benefits from new medicines they’ve been prescribed by giving them the opportunity to ask questions to pharmacists and ensuring any concerns are identified as early as possible. This is part of the Health Secretary’s ‘Pharmacy First’ approach to ease wider pressures on A&Es and general practice. Read full story Source: Department of Health and Social Care, 23 February 2020
  7. Content Article
    The database of people with diabetes who are eligible for diabetic eye screening (DES) in England is available on GP registration systems. Local screening services can access it electronically through the GP2DRS IT system, or by requesting a copy from the GP practice. Eligible individuals remain on the local service register until they are no longer part of the local service cohort – for example if they have moved away from the area or died. These individuals then become ‘off register’ and should be managed in accordance with the consent and cohort management guidance. People with diabetes may not need to attend routine digital screening while under the care of ophthalmology or being seen in surveillance clinics, but they remain eligible unless they meet the ‘off register’ criteria. Each year, local screening services will recall many individuals for screening who are no longer registered with a GP in England and are ‘untraceable’. Many of these individuals may no longer live in England. Providers should use this guidance to manage untraceable individuals. It’s only applicable in cases where an individual is no longer registered with a GP in England.  
  8. News Article
    The number of patients stuck in hospitals because they could not be transferred is at its highest quarterly level since 2017, reversing years of progress amid ongoing crises in health and care services. “Delayed transfers of care” – often known as “bed blocking” – rose in the mid-2010s as austerity hit council-run adult-care services, meaning hospitals were unable to discharge patients into the community. The number of “delayed days” in the NHS increased from an average of 114,000 a month in 2012 to more than 200,000 in October 2016, before extra funding and higher council taxes brought the numbers back down. But the latest NHS figures show the problem is returning. December 2019 saw 148,000 delayed days across England, 15% higher than the same month a year earlier. The combined figures for the last quarter of 2019 were the highest in two years. Read full story Source: The Guardian, 23 February 2020
  9. Content Article
    The location of care for many brain-injured patients has changed since 2012, following the development of major trauma centres. Advances in management of ischaemic stroke have led to the urgent transfer of many more patients. The basis of care has remained largely unchanged, however, with emphasis on maintaining adequate cerebral perfusion as the key to preventing secondary injury. Organisational aspects and training for transfers are highlighted, the Association of Anaesthetists have included an expanded section on paediatric transfers.  This guideline has also provided a table with suggested blood pressure parameters for the common types of brain injury but acknowledge that there is little evidence for many of the recommendations. These guidelines remain a mix of evidence-based and consensus-based statements.
  10. Content Article
    Referrals to hospital are increasing as more people continue to live longer with a range of complex conditions. The Professional Records Standards Body (PRSB) recognise that good information sharing is integral to ensuring that patients can receive the ongoing care that they need. Currently there are differences between GP systems and GP practices in the clinical content of referrals, with multiple templates in use. The clinical referral information standard is designed to improve the exchange of referral information from GPs to hospital consultants and other health care professionals providing outpatient services.
  11. Content Article
    This article, published by the University of Hertfordshire, addresses the need for reasonable adjustments, and other issues, by using examples of: a hospital passport assessing the mental capacity of a person how to improve care provided how to reduce clinical risks for people with intellectual disability.
  12. Content Article
    People with a learning disability are more likely to experience major illnesses that will require acute care (Disability Rights Commission, 2006) and more people with learning disability are living longer, and are therefore more likely to use health services as they get older. As a group, they experience more admissions to hospital (26%) compared to the general population (14%) (Mencap, 2004).
  13. Content Article
    People with mental health problems need good, joined up physical and mental health care, both in hospital and the community. Successful joined up care depends on GPs, community and acute mental health care teams and social care professionals all having access to timely information about a persons care and treatment. The Professional Records Standards Body (PRSB) has developed the mental health discharge summary standard to ensure that relevant information is shared, so professionals can provide continuity of care when an adult is discharged from mental health services. It includes information on patient history and social context, medications, the details of their hospital admission, as well as current and previous diagnoses. The mental health discharge summary will improve professional communication between the patient's secondary care providers to their GP. It is very important to recognise the different nature of mental illness to physical illness and disease including the different methods of treatments and imperative follow-up care after discharge. The language used in the headings and in the clinical descriptions has been modified, where necessary, to be more inclusive and sympathetic to the nature of mental illness and processes of care. This project supports the NHS Digital and NHS England interoperability work
  14. News Article
    Hospitals across England are using 21 separate electronic systems to record patient health care – risking patient safety, researchers suggest. A team at Imperial College say the systems cannot "talk" to each other, making cross-referencing difficult and potentially leading to "errors". Of 121 million patient interactions, there were 11 million where information from a previous visit was inaccessible. The team from London's Imperial College's Institute of Global Health Innovation (IGHI) looked at data from 152 acute hospital trusts in England, focusing on the use of electronic medical records on the ward. Around a quarter were still using paper records. Half of trusts using electronic medical records were using one of three systems: researchers say at least these three should be able to share information. 10% were using multiple systems within the same hospital. Writing in the journal BMJ Open, the researchers say: "We have shown that millions of patients transition between different acute NHS hospitals each year. These hospitals use several different health record systems and there is minimal coordination of health record systems between the hospitals that most commonly share the care of patients." Lord Ara Darzi, lead author and co-director of the IGHI, said: "It is vital that policy-makers act with urgency to unify fragmented systems and promote better data-sharing in areas where it is needed most – or risk the safety of patients." A spokesperson for NHSX, which looks after digital services in the NHS, said: "NHSX is setting standards, so hospital and general practioner IT systems talk to each other and quickly share information, like X-ray results, to improve patient care." Read research article Read full story Souce: BBC News, 5 December 2019
  15. Content Article
    Warren et al. from London's Imperial College's Institute of Global Health Innovation (IGHI) looked at data from 152 acute hospital trusts in England, focusing on the use of electronic medical records on the ward. They found 117 (77.0%) hospital trusts were using electronic health records (EHR), but there was limited regional alignment of EHR systems. On 11,017,767 (9.1%) occasions, patients attended a hospital using a different health record system to their previous hospital attendance. Most of the pairs of trusts that commonly share patients do not use the same record systems. This research published in BMJ Open highlights significant barriers to inter-hospital data sharing and interoperability. Findings from this study can be used to improve EHR system coordination and develop targeted approaches to improve interoperability. The methods used in this study could be used in other healthcare systems that face the same interoperability challenges.
  16. Content Article
    Children presenting to district general hospitals with critical illness may need transfer to a Paediatric Intensive Care Unit (PICU) by a specialist retrieval team.  Learning from these PICU transfers would help local hospitals identify areas for improvement to enhance patient safety and clinical care. Local hospital paediatricians often rely on updates from their retrieval service for information about their patients transferred to PICU.
  17. Content Article
    Examples and recommendations around how to implement some aspects from the Royal Pharmaceutical Society's report: Getting the medicines right.
  18. Content Article
    Transport of patients from the intensive care unit (ICU) to another area of the hospital can pose serious risks if the patient has not been assessed prior to transport. The Department of Critical Care Medicine, Calgary Health Region, experienced two adverse events during transport. A subgroup of the Department's Patient Safety and Adverse Events team developed an ICU patient transport decision scorecard. This tool was tested through Plan-Do-Study-Act cycles and further revised using human factors principles. Staff, especially novice nurses, found the tool extremely useful in determining patient preparedness for transport.
  19. Content Article
    The Healthcare and Safety Investigation Branch (HSIB) identified a significant safety risk posed by the communication and transfer of information between secondary care, primary care and community pharmacy relating to medicines at the time of hospital discharge. A reference event was identified that resulted in a patient inadvertently receiving two anticoagulant medications at the same time, possibly causing an episode of gastrointestinal (digestive tract) bleeding. Increasingly, healthcare facilities in primary and secondary care are introducing digital solutions (electronic prescribing and medicines administration (ePMA) systems) to improve medicines safety. However, analysis of the reference event identified how ePMA systems can create their own risks – risks that will need to be addressed as these systems become more widespread. Other risk factors relating to prescribing and the discharge of the patient, including medicines reconciliation, availability of pharmacy services and weekend working, were identified during the investigation.
  20. Content Article
    The Healthcare Safety Investigation Branch (HSIB) investigated the case study of Martin, a 43-year old inmate, who suffered multiple seizures after his epilepsy medication wasn’t transferred with him to a new prison. Each day around 120 prisoners with ongoing medication needs are moved between jails. Martin’s case is just one example of a serious outcome when medication was missed. Prisoners may also need to be treated in the community at local hospitals, with prison security staff being taken away from planned duties to accompany them.
  21. Content Article
    How offender healthcare is managed in prisons and in the community.
  22. Community Post
    Hi everybody This is Jaione from Spain (we are in the North, Basque Region) and i am a nurse working in collaboration with the Patient Safety Team in our local NHS (Basque Health Service). First of all, I would like to congratulate the team for this hub which i think is a wonderful idea. Secondly, i would like to apologize for the language, since, although i lived in England many years ago, that is not the case anymore and I'm afraid i don't speak as well as I used to. I would like to comment a problem that we encounter very often in our organization which is related to patient's regular medications when they are admitted to hospital. We do have online prescriptions for both acute and community settings but the programs don't really speak to each other so, for example, if I take a blood pressure pill everyday and i get admitted into hospital, chances are that my blood pressure tablet won't get prescribed during my in-hospital stay. The logical thing to do would be to change both online systems so they communicate to each other, but that's not possible at the moment. I wanted to ask whether other systems have the same problem and, if so, if there is any strategy implemented to alleviate this issue. I hope i have expressed myself as clearly as possible. Thanks very much once more for this hub! Kind regards Jaione
  23. Content Article
    Guidance from the National Institute for Health and Care Excellence (NICE) cites evidence that when people move from one care setting to another, between 30% and 70% of patients have an error or unintentional change to their medicines. This presents a significant risk to their safety. Maintaining safe care as patients move across health and care services is a national priority for the NHS.
  24. Content Article
    The Care Quality Commission (CQC) is the independent regulator of health and adult social care in England. We make sure that health and social care services provide people with safe, effective, compassionate, high-quality care and we encourage care services to improve.  When CQC inspects health and care services they assess how well these services meet people’s needs. As part of this, they look at how people’s medicines are optimised. Medicines optimisation is the safe and effective use of medicines to enable the best possible outcomes for people. It also looks at the value that medicines deliver, making sure that they are both clinically and cost effective, and that people get the right choice of medicines, at the right time, with clinicians engaging them in the process. 
  25. Content Article
    The Care 24/7 team at Oxford University Hospitals NHS Foundation Trust has been investigating ways of providing integrated, seamless care to patients across all their hospital sites. One of the priorities identified by the team has been the formalisation of the clinical handover process between teams and shifts, but what does this formalisation process involve? How can it make care more consistent and safe? What does it involve for staff? Central to the successful change to clinical handover is the use of a standardised clinical communication tool (SBAR) but how does it work, what benefits can a standardised clinical communication tool bring to staff and the handover process? Formalising the handover process, using clinical communication tools, seems to bring benefit to both staff and patients, but what are the changes like and what impact do they have on staff? Can formalisation empower staff and ensure that their concerns are heard?
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