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Found 660 results
  1. News Article
    CVS Health confirmed last year it was closing half its Coram home infusion branches and firing about 2,000 nurses, dietitians and pharmacists. Their patients with life-threatening digestive disorders depend on parenteral nutrition, or PN — in which amino acids, sugars, fats, vitamins and electrolytes typically are pumped through a catheter into a large vein near the heart. A day later Optum Rx, another big supplier, announced its own consolidation. Suddenly, thousands were scrambling for their complex essential drugs and nutrients. “With this kind of disruption, patients can’t get through on the phones. They panic,” said Cynthia Reddick, a senior nutritionist laid off last summer in the CVS restructuring. “It was very difficult. Many emails, many phone calls, acting as a liaison between my doctor and the company,” said Elizabeth Fisher Smith, a 32-year-old public health instructor in New York, whose Coram branch closed. A rare medical disorder has forced her to rely on PN for survival since 2017. “It added to my mental burden,” she said Home and outpatient infusions in the USA are a growing business, as new drugs for chronic illness expand treatment options and enable patients, providers and insurers to avoid hospitalisation. But while reimbursement for expensive new drugs has attracted corporations and private equity, the industry is constrained by a lack of nurses and pharmacists. The less profitable parts of the business — and the vulnerable patients they serve — are at risk. This includes the 30,000-plus Americans who rely on parenteral nutrition — including premature infants, post-surgery patients and those with damaged bowels because of genetic defects. Read full story (paywalled) Source: The Washington Post, 6 February 2023
  2. Content Article
    For years, it has been known that pulse oximeters may present racial biases, with studies dating back as far as the late 1980s suggesting a flaw in how the device measures oxygen in people with darker skin tones. This article looks at how the Covid-19 pandemic finally brought the problem to the forefront of medicine. Ashraf Fawzy, Assistant Professor of Medicine at the Johns Hopkins University School of Medicine, talks about how he and other doctors noticed a trend in pulse oximeter readings not matching up to patient symptoms, and how they went on to research the issue, publishing their results in a study in May 2022. Their study found that Black and Hispanic patients were 29% and 23% less likely than white patients, respectively, to have pulse oximeters recognise their eligibility for more aggressive Covid-19 treatment. The resulting delay in care for patients with darker skin tones is likely to have a significant impact on patient outcomes.
  3. Content Article
    Nurses work long hours and play a critical role in keeping patients healthy. Many nurses feel that fatigue “comes with the territory” of such a high-stress, high-impact job. But what’s really at risk when a nurse is fatigued? This blog by US insurance company Nurses Service Organization (NSO) looks at the impact of nurse fatigue on patient and staff safety. It suggests several strategies to address the issue: Designing schedules and organising work to reduce nurse fatigue Developing a fatigue management plan Educating staff on sleep hygiene and the effects of fatigue on nurse health and patient safety Providing opportunities for staff to express concerns about fatigue and taking action to address those concerns Making sure extended shifts have adequate staff support and rest periods
  4. Content Article
    The National Institute for Clinical Excellence (NICE) updated their guidance for continuous glucose monitoring (CGM) in 2022, recommending that CGM be available to all people living with type 1 diabetes. This review in the journal Diabetes, Obesity and Metabolism aimed to compare regulatory standards for CGM in the UK and Europe, with those applied in the USA by the Food and Drug Administration (FDA) and in Australia by the Australian Therapeutic Goods Administration (TGA). It describes the processes in place and highlights that the criteria applied in the UK for assessing accuracy do not translate into real-life performance. The authors offer a framework to evaluate CGM accuracy studies critically and conclude that FDA- and TGA-approved indications match the available clinical data, whereas CE marking indications applied in the EU can have discrepancies. They argue that the UK can bolster regulation, but that this need to be balanced to ensure that innovation and timely access to technology for people with type 1 diabetes are not hindered.
  5. Content Article
    This Patient Safety Advisory from the Pennsylvania Patient Safety Authority provides an overview of the issues associated with healthcare worker fatigue. It outlines fatigue risk mitigation practices that are being used in healthcare and other industries, including comprehensive fatigue risk management programs.
  6. Content Article
    Sentinel Event Alerts from the Joint Commission identify specific types of sentinel event (a patient safety event that results in death, permanent harm or severe temporary harm), describe their common underlying causes and suggest steps to prevent them occurring in the future. This Sentinel Event Alert looks at the well-documented link between health care worker fatigue and adverse events. It looks at: The impact of fatigue Contributing factors to fatigue and risks to patients Actions suggested by The Joint Commission for healthcare organisations
  7. Content Article
    This study in The Journal of Nursing Administration aimed to investigate the relationship between sleep deprivation and occupational and patient care errors among staff nurses who work the night shift. A cross-sectional correlational design was used to evaluate relationships between sleep deprivation and occupational and patient care errors in 289 hospital night shift nurses. The study found that more than half (56%) of the sample reported being sleep deprived. Sleep-deprived nurses made more patient care errors. Testing for associations with occupational errors was not feasible because of the low number of occupational errors reported.
  8. News Article
    Plans to prevent one of the deadliest cancers for women in Jamaica have been significantly set back by the Covid pandemic, new figures reveal. The scheme to vaccinate schoolgirls against cervical cancer in Jamaica – which is the cancer with the second highest death rate in the Americas – began in 2018, but the Pan American Health Organization says inoculation rates fell to just 2.71% in 2021. This represents a drastic drop from the 2019 rate of 32%, and far from the WHO target of 90% by 2030. The cancer, which is curable if caught early, kills 22 in every 100,000 women in Jamaica. By comparison, in the UK the rate is 2.4 in every 100,000, and in Canada it is 2. Prevention of cervical cancer in Jamaica is also hindered by low rates of cervical screenings. “Women are afraid of the screening process and potential pain, but there is also a fear of a cancer diagnosis itself,” said Nicola Skyers of Jamaica’s Ministry of Health. “Some people just prefer not to know. But I also think that healthcare providers don’t offer screenings often enough. If a healthcare provider is really ‘selling’ the pap smear, more often than not the woman will choose to have it.” Health workers are forced to focus on cures rather than preventions amid staffing shortages and an overburdened healthcare system, said Skyers. “As a doctor, you won’t be encouraging every women you see to do a pap smear if you have 40 patients waiting outside.” Read full story Source: The Guardian, 2 February 2023
  9. News Article
    President Joe Biden has announced to the US Congress that he will end the country’s Covid-19 public health emergency on 11 May, although about 500 Americans are currently dying every day from Covid-19. He also plans to end the related national Covid-19 emergency. In contrast, the World Health Organization said on 27 January that the Covid-19 pandemic was still a public health emergency. The US administration’s statement said that extending the emergencies until May would provide time for an orderly transition. Ending the emergencies will mean that many Americans will lose the health insurance provided through the Medicaid programme, which helps people on low incomes and was extended during the pandemic. Many others will find that they no longer get free tests, treatments, or vaccines. Read full story Source: BMJ, 1 February 2023
  10. Content Article
    In this YouTube video, Jerika T. Lam, Associate Professor at Chapman University, School of Pharmacy, offers insights on patient safety from a pharmacist’s perspective. As someone who works in a clinic that serves marginalised and underserved communities, she describes the important role pharmacists can play on a healthcare team alongside doctors and nurses to ensure patients get the appropriate medications with minimal drug interactions.
  11. News Article
    Community health workers are stepping in to provide critical services and information in rural areas in Texas, USA, with few hospitals or doctors. When Claudia Salazar and her family migrated to San Elizario, Texas, a small city in El Paso county, they settled into a colonia – informal, low-income housing often found in rural parts along the US-Mexico border. But the remoteness of their new home soon presented problems – Salazar suddenly found herself in a medical desert. The nearest hospital is a 35-minute drive away. Even that is challenging to get to – the community’s mostly farm worker population works 10- to 12-hour days, and often lacks adequate time to travel for medical attention between workdays. The lack of consistent medical access is just one of the many public health issues that colonias face, and a group of women familiar with the dynamics in this region thought of a relatively simple solution: bringing medical care to the people who need it most in these borderland communities. “Familias Triunfadoras has been really helpful since they provide a mobile unit clinic,” Salazar said. “That’s when we get a chance to visit a doctor or get a doctor’s appointment.” Familias Triunfadoras is a San Elizario-based non-profit that is composed of women who step in as community organizers to connect residents like Salazar to resources they may not know exist. Their efforts to make healthcare more accessible in medical deserts like San Elizario has proven invaluable to residents. Read full story Source: The Guardian, 2 February 2023
  12. Content Article
    This study in JAMA Health Forum aimed to assess the costs of inpatient falls and cost benefits associated with the Fall TIPS (Tailoring Interventions for Patient Safety) Program. The authors carried out an economic evaluation across a large cohort of 900,635 patients. The average total cost of a fall was $62 521 ($35 365 direct costs), and injury was not significantly associated with increased costs. The Fall TIPS Program was associated with $22 million in savings at study sites across the five year study period. The findings of this study indicate that implementation of cost-effective, evidence-based safety programs was associated with lower cost and care burdens associated with inpatient falls and are a step toward safer, more affordable patient care.
  13. Content Article
    Fatigue is a workplace hazard that affects the health and safety of patients, health care providers and the community. This blog from health tech company Cerner looks at the importance of managing fatigue in healthcare staff. The author suggests a three-step approach to lessen fatigue: Shift the culture of safety to include recognising and dealing with fatigue. Operationalise fatigue reduction measures within the organisation. Promote fatigue self-management through preventative strategies.
  14. Content Article
    This primer article by the Agency for Healthcare Quality and Research (AHQR) looks at the impact of fatigue and sleep deprivation on patient safety. Fatigue is the feeling of tiredness and decreased energy that results from inadequate sleep time or poor quality of sleep. Fatigue can also result from increased work intensity or long work hours. The article outlines the current context for discussions in the US around mitigating the potential risks of sleep deprivation among healthcare workers, highlighting measures that can be put in place by healthcare organisations including employing optimal practices for scheduling, planned napping and ensuring appropriate spaces are available for rest breaks.
  15. Content Article
    Fatigue in anaesthesia practice is often ignored or accepted as the norm due to persistent, high-intensity work demands and expectations. This document produced by the American Association of Nurse Anesthesiology (AANA) aims to provide guidance to healthcare professionals, healthcare facilities and nurse anaesthesia programs regarding sleep deprivation and fatigue. It provides evidence-based information that promotes fatigue management and work-life balance.
  16. News Article
    Erik, a 26-year-old Seattle grocery clerk, who also has attention-deficit hyperactivity disorder (ADHD), has been unable to get his medications filled for months now – and he’s worried he’ll lose the first full-time job he’s ever had. For people like Erik, ADHD medication is a prerequisite for basic functioning – and over the last year it’s become dramatically harder for patients like them to access care. Last October, the Food and Drug Administration (FDA) announced a shortage of Adderall, one of the most common stimulant medications for ADHD. In recent months, patients have reported problems filling nearly every type of ADHD medication. What’s stranger is that no one seems to know why. Is it some kind of supply chain issue? A pandemic-era surge in demand? A government crackdown? Official explanations have offered little clarity. The FDA’s announcement mentioned “intermittent manufacturing delays” at Teva, the producer of the branded version of Adderall, but few other details. The American Society of Health Pharmacists reports shortages of multiple ADHD drugs but says manufacturers have given no explanation. The situation has left patients in turmoil. Read full story Source: The Guardian, 30 January 2023
  17. Content Article
    This brief paper reviews the available published literature on shiftwork and safety that allows the estimation of the relative risk of “accidents” or injuries associated with specific features of shift systems. It discusses three main trends in risk: Risk is higher on the night shift, and to a lesser extent the afternoon shift, than on the morning shift Risk increases over a span of shifts, especially so if they are night shifts Risk increases with increasing shift length over eight hours The authors discuss the fact that some of these trends are not entirely consistent with predictions made based on considerations of the circadian variations in sleep propensity or rated sleepiness, and consider factors relating to sleep that may underlie the observed trends in risk. They also discuss the practical implications of the trends in risk for the design of safer shift systems.
  18. Content Article
    This 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.
  19. Content Article
    In this video, Leah Coufal’s mother, Lenore Alexander, recounts the tragic story of her 12-year-old daughter’s preventable death in hospital in December 2002. Leah died from opioid-induced respiratory depression due to a lack of continuous postoperative monitoring which could have saved her life. Lenore now campaigns for the legal requirement to monitor patients on opioids after surgery.
  20. Content Article
    When healthcare workers are fatigued, the safety of both patients and staff is compromised. This short article in the American Journal of Nursing reports on a recent webinar in which the Joint Commission distilled current research on fatigue, discussing its causes and symptoms and the various means of addressing the issue. Ann Scott Blouin, a nurse and Executive Vice President of Customer Relations at the Joint Commission, led the discussion and highlighted that factors contributing to staff fatigue fall into three categories: organisation and management issues, the nature of the work and personal challenges. Fatigue has emotional, physical, and behavioural consequences, including lapses in attention, diminished reaction time, and reduced motivation.
  21. News Article
    Physicians' happiness fell amid the pandemic and is not rebounding easily, according to Medscape's 2023 Physician Lifestyle and Happiness Report. The report is based on survey responses from 9,175 U.S.-based physicians in 29 specialties polled last year between 28 June and 3 October. The report found: 1. 59% of physicians said they were "somewhat" or "very happy," down from 84% before the pandemic. These figures mirror percentages seen in Medscape's same report conducted last year. 2. The percentage of physicians who are happy at work, specifically, fell from 75% before the pandemic to 48% today. 3. Four in 10 physicians said they regularly look after their own health and wellness, up from 33% who said the same in Medscape's 2022 report. 4. 53% said they would take a pay decrease in return for better work-life balance. Read full story Source: Becker's Hospital Review, 20 January 2023
  22. Content Article
    It is difficult to monitor compliance to surgical checklists, which is associated with improved patient outcomes. This research study in The Annals of Surgery reported for the first time on the use of the Operating Room Black Box (ORBB) to track checklist compliance, engagement, and quality. The authors took a retrospective review of prospectively collected ORBB data and measures of checklist compliance, engagement and quality were assessed. ORBB provides the unprecedented ability to assess not only compliance with surgical safety checklists but also engagement and quality. This technology allows the assessment of compliance in near real time and to accurately address safety threats that may arise from noncompliance.
  23. Content Article
    An examination of our local community hospital (2nd largest in the state of Maine) and a petition to hopefully spark discussion and change.
  24. News Article
    A hernia mesh lawsuit recently filed by a Washington woman alleges that a Strattice “pig skin” mesh product used during her hernia repair was defective and failed, resulting in the need for two additional revision surgeries. The Strattice Reconstructive Tissue Matrix is a hernia repair mesh introduced in 2008, which is constructed from porcine, or pig skin. The mesh is then preserved in a phosphate buffered aqueous solution. It is marketed as a cross-linked graft device, which is intended to chemically link the proteins in the tissue together. However, a growing number of lawsuits allege that the design actually increases the risk of foreign body responses, infections and other complications. Hundreds of injuries and several deaths have been linked to the Strattice hernia mesh made from pig skin, according to the lawsuit. Read full story Source: About Lawsuits.com, 20 January 2023
  25. News Article
    The percentage of Americans reporting they or a family member postponed medical treatment in 2022 due to cost rose 12 points in one year, to 38%, the highest in Gallup’s 22-year trend. The latest double-digit increase in delaying medical treatment came on the heels of two consecutive 26% readings during the COVID-19 pandemic that were the lowest since 2004. The previous high point in the trend was 33% in 2014 and 2019. An average 29% of U.S. adults reported putting off medical treatment because of cost between 2001 and 2021. Americans were more than twice as likely to report the delayed treatment in their family was for a serious rather than a nonserious condition in 2022. In all, 27% said the treatment was for a “very” or “somewhat” serious condition or illness, while 11% said it was “not very” or “not at all” serious. Lower-income adults, younger adults and women in the U.S. have consistently been more likely than their counterparts to say they or a family member have delayed care for a serious medical condition. In 2022, Americans with an annual household income under $40,000 were nearly twice as likely as those with an income of $100,000 or more to say someone in their family delayed medical care for a serious condition (34% vs. 18%, respectively). Those with an income between $40,000 and less than $100,000 were similar to those in the lowest income group when it comes to postponing care, with 29% doing so. Read full story Source: Gallup News, 17 January 2023
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