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Found 185 results
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Content ArticleWhen Covid-19 first struck the UK, the disease was described as 'a great leveller'. But it soon became clear that Covid's impacts were not evenly distributed—we may have been in the same storm, but we were in different boats. In this episode of All in it together, guests Charlotte Augst, Halima Begum, Beth Kamunge-Kpodo, Professor Sir Michael Marmot and Pastor Mick Fleming discuss unequal outcomes during the Covid-19 pandemic.
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Content ArticleThis study by a team at the University of Derby in the British Journal of Anaesthesia used experimental psychology methods to explore the potential benefits of colour-coded compartmentalised trays compared with conventional trays in a visual search task. The authors found that errors were detected faster when presented in the colour-coded compartmentalised trays than in conventional trays, a finding that was replicated for correct responses for error-absent trays. Overall, colour-coded compartmentalised trays were associated with significant performance improvements when compared with conventional trays.
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Content ArticleThis investigation by the Healthcare Safety Investigation Branch (HSIB) explored the detection and diagnosis of jaundice in newborn babies, in particular babies born prematurely (before 37 weeks of pregnancy). Specifically, it explored delayed diagnosis due to there being no obvious visual signs of jaundice apparent to clinical staff. Jaundice is a condition caused by too much bilirubin in a person’s blood. Bilirubin is a yellow substance produced when red blood cells are broken down. If left undiagnosed and untreated, high bilirubin levels in newborn babies can lead to significant harm. Newborn babies have a higher number of red blood cells in their blood which increases their risk of jaundice. Jaundice can cause yellowing of the skin and whites of the eyes; however, sometimes the visual signs of jaundice are not obvious, particularly for premature or newborn babies with brown or black skin. The reference event for this investigation was the case of baby Elliana, who was born at 32 weeks and 1 day via a forceps delivery and then transferred to the Trust’s special care baby unit (SCBU). Elliana was assessed on admission to the SCBU by staff as a clinically stable premature baby and a routine blood sample was taken from around two hours after her birth to establish a baseline. Analysis of the blood sample indicated bilirubin was present and so the level was measured. This result was uploaded onto the Trust’s computer system alongside the results of the blood tests that had been requested by the clinical team. The bilirubin result was seen by a SCBU member of staff who recognised that the level was high, indicating the possible need for treatment. However, this member of staff was then required to attend an emergency and the bilirubin result was not acted upon. Another blood sample was taken when Elliana was two days old and was uploaded to the Trust’s computer system. It is unclear if this bilirubin result was seen by staff; it was not documented in clinical records and was not acted upon. Over the next two days, Elliana continued to show no visible signs of jaundice that were detected by staff and she was documented to be developing well. When Elliana was five days old, a change in her skin colour was observed and visible signs of jaundice were detected. A further blood sample was taken which showed she had a high level of bilirubin in her blood and treatment was started accordingly. Elliana’s bilirubin levels returned to within acceptable levels over the next three days and she was subsequently discharged home.
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Content ArticleThis article in iNews looks at a major new study in The BMJ by researchers in Israel which suggests that symptoms of Long Covid end within a year in most people with the condition. The study looked at information on a number of symptoms linked to Long Covid, including loss of taste and smell, breathing problems, concentration and memory issues, weakness, palpitations and dizziness. The research also demonstrated the role of Covid vaccines in improving outcomes for people with Long Covid. However, the article also highlights cautions from experts who note that people who got Long Covid after a more serious case of the virus were not included in the study, and their symptoms typically last longer than for those who got the condition after a mild infection. The authors also highlight that these results do not match up with the latest data from the Office for National Statistics (ONS). According to the ONS, 57% people reporting symptoms in December 2022 said that they had had long Covid symptoms for at least one year, with 30 per cent reporting that symptoms had lasted for at least two years.
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Content ArticleThis paper in the journal RSC Advances aimed to track changes in chemical bonding taking place in PP meshes on the nanoscale via mechano–chemical processes. The authors used the novel and advanced spectroscopic characterisation technique secondary electron hyperspectral imaging (SEHI) to build high resolution chemical maps. Polypropylene (PP) surgical mesh is associated with serious clinical complications when used in the pelvic floor for repair of stress urinary incontinence or support of pelvic organ prolapse. While manufacturers claim that the material is inert and non-degradable, there is a growing body of evidence that asserts PP fibres are subject to oxidative damage. Material surgically removed from patients suffering with clinical complications has shown some evidence of fibre cracking and oxidation. It has been proposed that a pathological cellular response to the surgical mesh contributes to medical complications, but the mechanisms that trigger the specific host response against the material are not well understood. The study presented key insights into the mechano–chemistry reaction of PP which can cause polymer oxidation, changes in molecular structure, crack/craze formation and the release of etched oxidised insoluble particles. SEHI, provided a new route to link the effect of localised stresses to reactions of mechano–chemistry within PP. The method of mechanical distension testing during hydrogen peroxide exposure followed SEHI image analysis could form the basis of an “early warning” system which has the ability to identify materials which are not appropriate for use as medical implants.
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Content ArticleThis article presents data on how deprivation affects life expectancy and health life expectancy at birth. It highlights a difference in life expectancy of around 9 years for males and 8 years for females between the most and least deprived deciles of society.
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Content ArticleThis article in The Lancet aimed to review published work about the efficacy and safety of electroconvulsive therapy (ECT) with simulated ECT, ECT versus pharmacotherapy and different forms of ECT for patients with depressive illness. The authors designed a systematic overview and meta-analysis of randomised controlled trials and observational studies. They concluded that: ECT is an effective short-term treatment for depression, and is probably more effective than drug therapy. bilateral ECT is moderately more effective than unilateral ECT. high dose ECT is more effective than low dose.
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Content ArticleUp to 30% of healthcare spending is considered unnecessary and represents systematic waste. While much attention has been given to low-value clinical tests and treatments, much less has focused on identifying low-value safety practices in healthcare settings. This study in the Journal of Patient Safety surveyed healthcare staff in the UK and Australia to identify safety practices perceived to be of low value. Staff who took part in a survey as part of the study frequently identified the following categories of practices as being low-value: paperwork, duplication and intentional rounding. Five cross-cutting themes (for example, 'covering ourselves') offered an underpinning rationale for why staff perceived these practices to be of low value. The authors conclude that in healthcare systems under strain, removing existing low-value practices should be a priority.
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Content ArticleThe Royal College of Anaesthetists set up PatientsVoices@RCoA to help the College improve the delivery of safe, more effective, patient-centred care to enhance patients’ experience of anaesthesia and perioperative care. This plan by PatientsVoices@RCoA aims to set out a clear direction for our future work which ensures patients’ voices are clearly heard across all relevant activities, as the College delivers its strategic aims over the next five years.
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Content ArticleThe Patients Association's Patient Partnership Week brought together patients, carers and healthcare professionals to talk about patient partnership.
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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.
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Content ArticleIn this editorial. Peter Walsh reflects on 20 years as Chief Executive of Action against Medical Accidents (AVMA) as he retires from the role. AvMA also marks its 40th anniversary this year, and Peter examines the organisation's unique role in focusing on patient safety and justice for patients. He highlights that healthcare systems and patient safety practice still have a long way to go in offering fairness and support to families affected by avoidable harm in healthcare, and argues that focusing on patients and their families must be a top priority when looking at system safety. He highlights the vital role that AvMA has played in bringing Duty of Candour into law in the countries of the UK, and argues that legal action is an important right that must be retained for patients and families who have come to harm as a result of medical error. He also talks about AvMA's recent development of a Harmed Care Pathway in collaboration with the Harmed Patients Alliance, which outlines the specific set of needs that should form part of a package of care for harmed patients and families.
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Content ArticleThis short report from the National Vascular Registry (NVR) provides information on medical devices implanted during primary and revision abdominal aortic aneurysm (AAA) repair procedures during the past three years. In response to the Cumberlege review in 2020, the NVR has enabled information on implantable devices used in aortic aneurysm repairs to be entered in its datasets from July 2020. This was accompanied by the launch of the revision aortic datasets, which capture revision procedures both after open repair and endovascular stent grafting for abdominal aortic aneurysm (AAA). In total, there were 10,678 AAA procedures in the NVR performed from 1st January 2020 to 31st July 2022 and 5,383 (50%) contained information on implanted devices. This report also contains information on the: patterns for elective and non-elective procedures. type of repair for elective and non-elective surgery, for example, open procedures. type of device and components used during the procedures.
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Content ArticleThis study in Plos One used a prospective error analysis method—the Systematic Human Error Reduction and Prediction Approach (SHERPA)—to examine the process of dispensing medication in community pharmacy settings and identify solutions to avoid potential errors. These solutions were categorised as strong, intermediate or weak based on an established patient safety action hierarchy tool. The authors identified 88 potential errors with a total of 35 remedial solutions proposed to avoid these errors in practice. Sixteen (46%) of these remedial measures were categorised as weak, 14 (40%) as intermediate and 5 (14%) as strong according to the Veteran Affairs National Centre for Patient Safety action hierarchy. The authors suggest that future research should examine the effectiveness of the proposed remedial solutions to improve patient safety.
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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 report by LCP Health Analytics, looks at how inequalities across the medicine life cycle impact patients and populations. It paints a vision of what success could look like, and proposes specific, feasible calls to action across industry, health technology assessment (HTA) bodies and players that could transform the role of the life science sector in reducing inequalities and fostering healthy populations. The report identifies two key challenges in addressing health inequalities that are tractable, and where the life science sector is most likely to make commitments and contributions: Multimorbidity is increasing and embedding inequalities in health Financial incentives across health systems are not aligned with patient and population health
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Content ArticleThis cross-sectional study in BMJ Evidence-Based Medicine aimed to understand the relationship between financial conflicts of interest and recommendations for atrial fibrillation (AF) screening in the UK. The authors looked at whether the UK media recommend for or against screening for AF and the financial conflicts of interests of AF screening commentators. The authors found that the vast majority of UK media promotes screening for AF, in contrast to the position of the independent UK National Screening Committee, which recommends against screening. Most commentators, internal NHS organisations and UK charities promoting screening had a direct or indirect financial conflict of interest. Independent information was rare and the reasons for this are unknown. They recommend readers consider the potential impact of financial conflicts on recommendations to screen.
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Content ArticleThe Health Equity Network will launch in January 2023 and aims to build momentum for health equity across the UK. It will provide an opportunity for public and private sector organisations, community and voluntary groups and individuals to share their work on health equity and to engage across the country with others with the same interests. This article describes how the Network will work and offers the opportunity to register interest in joining.
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Content ArticleThis article from Reuters highlights the results of a survey of 1,002 people which was conducted in October 2022 by market research company Censuswide on behalf of recruitment website Indeed. The survey showed that more than three quarters of British people who have suffered persistent ill health following a Covid-19 infection have had to cut back or change the work they do.
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Content ArticleAdam Tasker spent over a decade in the Royal Navy before starting medical training at the University of Warwick. In this article for BMJ Leader, he reflects on a near miss incident that he was involved in while working as a Helicopter Warfare Officer, examining his attitudes and those of his colleagues, and the practices and behaviours of the squadron’s leaders. He compares his experience in the Royal Navy to that of his experience as a medical student, and identifies lessons that are relevant to medical training, professional expectations and the management of clinical incidents. These lessons aim to support the implementation of a Just Culture within the NHS.
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Content ArticleIn this article, Kamran Abbasi, editor in chief of the BMJ outlines the need for reform to the General Medical Council (GMC), which is responsible for regulating doctors in the United Kingdom. He talks about how the GMC received a significant backlash from doctors after its handling of the case of Manjula Arora, a GP who was disciplined for a word she used when asking her employer for a laptop. However, he highlights that the GMC's issues started long before this case, with racial bias, discrimination and an adversarial culture present over the last 30 years. Kamran also outlines measures that should be taken to ensure organisational change and accountability for the GMC.
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Content ArticleIn this BMJ opinion piece, Iona Heath reviews a new book by Penelope Campling, who worked as an NHS psychiatrist and psychotherapist for 40 years. Don't Turn Away tells the story of "an increasingly brutal turning away from the most abused and damaged people who struggle to survive within our complacent society." The article argues that over the past few decades, our society has failed to listen to and support the most vulnerable people, with mental health systems focusing on exclusion criteria and keeping people out of the system.
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Content ArticleThe Industrial Injuries Advisory Council (IIAC) is an independent scientific advisory body that looks at industrial injuries benefit and how it is administered. Since the start of the Covid-19 pandemic in 2020, the IIAC has been reviewing and assessing the increasing scientific evidence on the occupational risks of Covid-19. This report builds on an IIAC interim Position Paper published in February 2021 and considers more recent data on the occupational impacts of Covid-19, particularly around the longer term health problems and disability caused by the virus. IIAC found the most convincing and consistent evidence was for health and social care workers in certain occupational settings, who present with five serious pathological complications following Covid-19 that have been shown to cause persistent impairment and loss of function in some workers.
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Content Article
Survey - Keeping up to date with NICE guidance (November 2022)
Patient-Safety-Learning posted an article in NICE
The National Institute for Health and Care Excellence (NICE) is looking for feedback on how people currently keep up to date with NICE guidance and what they do when an update has been made to NICE guidance. NICE will use your feedback to help shape the future of its guidelines. The survey takes around 10 minutes to complete. The closing date of the survey is 28th November 2022. -
Content ArticleThis analysis from the Health Foundation examines how healthcare spending in the UK compares with EU countries in the decade preceding the pandemic. Taking a longer-term view enables us to see how trends in spending may have impacted healthcare resilience today.
