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News Article
USA: Rise in infant deaths hits Black families hardest, study finds
Patient Safety Learning posted a news article in News
A new US study highlights a striking racial disparity in infant deaths: Black babies experienced the highest rate of sudden unexpected deaths (SIDS) in 2020, dying at almost three times the rate of White infants. The findings were part of research by the Centers for Disease Control and Prevention, which also found a 15% increase in sudden infant deaths among babies of all races from 2019 to 2020, making SIDS the third leading cause of infant death in the United States after congenital abnormalities and the complications of premature birth. “In minority communities, the rates are going in the wrong direction,” said Scott Krugman, vice chair of the department of pediatrics and an expert on SIDS at Sinai Hospital in Baltimore. The study found that rising SIDS rates in 2020 was likely attributable to diagnostic shifting — or reclassifying the cause of death. The causes of the rise in sleep-related deaths of Black infants remain unclear but it coincided with the arrival of the coronavirus pandemic, which disproportionately affected the health and wealth of Black communities. Read full story (paywalled) Source: The Washington Post, 13 March 2023 -
Content ArticleThis summary of how a National Patient Safety Board (NPSB) will benefit patients and families was coproduced by the NPSB Advocacy Board with Patients for Patient Safety US. It outlines how the NPSB would ensure more comprehensive learning from patient safety incidents, ensure patients and families have a core role in governance and priority setting and that data is used to better understand patient safety in the US.
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Content ArticleIn this blog, US family doctor Lisa Baron highlights the role that social media has played in exposing how patients, particularly women, are dismissed and gaslighted by healthcare professionals, resulting in delayed diagnosis, deterioration and trauma. She talks about her own experience of having her symptoms and concerns dismissed by her GP, which led to a two-year delay in being diagnosed with coeliac disease, rheumatoid arthritis and Sjogren's syndrome. She goes on to talk about her experience of Long Covid and how her symptoms were dismissed and not taken seriously in spite of the life-limiting nature of her condition. She raises concerns that Long Covid patients are turning to unqualified practitioners offering untested, ineffective and expensive treatments as they are not being taken seriously by mainstream healthcare systems.
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Content ArticleFor 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.
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Content ArticleThis 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.
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Content ArticleThis 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.
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Content ArticleThe 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.
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Content ArticleThis 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.
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Content ArticleIn 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.
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Content ArticleIn 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.
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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 Article
University of Maine Patient Safety Petition
US Patient Safety posted an article in Whistle blowing
An examination of our local community hospital (2nd largest in the state of Maine) and a petition to hopefully spark discussion and change. -
Content ArticleIt 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.
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Content ArticleIn this post, Amber Clour, author of the Diabetes Daily Grind blog, talks about her experience of managing her type 1 diabetes while attending the emergency room for suspected appendicitis. She describes the steps she took to make sure her blood sugar levels were managed safely and with her consent, including communicating clearly with all healthcare professionals, ensuring her continuous glucose monitor (CGM) was not removed and bringing her own supply of glucose tablets to manage hypoglycaemia. Further reading Blog - “I felt lucky to get out alive”: why we must improve hospital safety for people with diabetes
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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 ArticleThis blog by Brita Lundberg of Lundberg Health Advocates looks at how healthcare providers can sometimes blame the patient for their condition, errors in treatment and communication issues. She looks at the role that language used in medical settings and historical views of the medical profession have on the tendency to blame patients, and highlights how the issue is also present in wider society. She offers three potential steps to help tackle patient-blaming: Recognise the problem, as it is difficult if not impossible to solve a problem until one recognises that it exists. Families, friends and clinicians should start with the assumption that the patient is correct and question others, particularly any in authority. All of us can be much too quick to dismiss patients’ concerns and to reassure them. It’s a bad habit. Instead–it is prudent never to eliminate any diagnosis, particularly one suggested by the patient, until all the supporting and contradictory evidence for each is carefully considered. Listen–that terribly overused and so little practiced—word. Listening instead of interrupting right away not only helps preserve the flow of the narrative but also gives us time to think about what is being said, and time to formulate a more considered response.
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Content ArticleThis study, published in The New England Journal of Medicine, looks at the frequency, preventability and severity of patient harm in a random sample of admissions from 11 Massachusetts hospitals during 2018. From this sample, it identified adverse events in nearly one in four admissions, approximately a quarter of which were deemed as preventable.
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Content Article
Clean hands count for safe healthcare (CDC, 2020)
Patient-Safety-Learning posted an article in Infection control
Ensuring everyone has clean hands can protect patients from serious infections in healthcare facilities. However, studies show that on average, healthcare workers wash their hands less than half as many times as they should. This contributes to the spread of healthcare-associated infections, which affect 1 in 31 hospital patients in the US. This campaign by the US Centers for Disease Control and Prevention (CDC) aims to improve healthcare provider adherence to hand hygiene recommendations, address myths and misperceptions about hand hygiene, and empower patients to play a role in their care by asking or reminding healthcare providers to clean their hands. -
Content ArticleIn this video published by Patient Safety Movement, Kimberly Cripe, CEO of the Children's Hospital of Orange County (CHOC), discusses how her hospital has incorporated Actionable Evidence-Based Practices to improve patient safety culture in a paediatric setting. She describes the many benefits of the approach including for staff morale and making financial savings.
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Content ArticleThis book is an urgent call to action centring on David Mayer's thirty-five-year mission to raise awareness of the 250,000 lives that are lost each year to preventable medical harm. It also looks at the harm faced by healthcare professionals in the form of workplace violence, depression, and burnout resulting in suicide rates higher than almost every other industry. The book's narrative-driven timeline follows the author's 2,452-mile walk to thirty-seven Major League Ballparks using his love of baseball as a way to garner media attention for his mission and indulge in the welcome relief of baseball nostalgia. Written for both medical professional and lay readers, the book pulls in stories of patients and caregivers harmed as a catalyst for change in our healthcare system, and as a way for the public to connect with the issues faced by healthcare professionals. Also included are pivotal anecdotes and stories from Mayer's medical career that propelled him to become an internationally recognized patient safety leader.
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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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Content ArticleThe Leapfrog Group is a non-profit watchdog organisation that serves as a voice for healthcare consumers in the US, using their collective influence to foster positive change in healthcare. It provides patient safety ratings for hospitals, grading them from A to E. This article in Becker's Hospital Review highlights the patient safety priorities for 2023 of eleven US hospitals that have consistently been awarded 'A' grades by Leapfrog. Key themes include a focus on reducing healthcare associated infections, increasing psychological safety for staff and improving communication between staff and patients.
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Content ArticleIn November 2021, 15-year old Alice Tapper nearly died due to a missed diagnoses of a perforated appendix. In this opinion piece, Alice shares her experience of being admitted to hospital with intense abdominal pain and other serious symptoms. In spite of her parents' requests for imaging to rule out appendicitis, doctors diagnosed that Alice had a viral infection and refused to prescribe antibiotics. Alice's condition severely deteriorated, leading her father to call the hospital and beg a gastroenterologist for further investigation. Fortunately, the hospital granted his request and after an x-ray and ultrasound, Alice was found to have a perforated appendix. She was going into hypovolemic shock, when severe blood or other fluid loss makes the heart unable to pump enough blood to the body. Thankfully, emergency surgery and antibiotics saved Alice's life, but she reflects on the fact that without her father's intervention, she would probably have died. She describes how her doctors failed to take the concerns she and her parents repeatedly expressed seriously, and that this lack of responsiveness could have been fatal. She highlights research that shows that appendicitis is missed in up to 15% of paediatric patients, and that missed diagnosis is most common in children under five, and is more common in girls than boys.
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Content ArticleIn this blog for Medpage Today, US doctor Diane Solomon talks about the power of apologising to patients. Outlining the tendency of healthcare professionals to defend their practice, she describes how being honest and open with patients about errors demonstrates humanity and compassion. She talks about the importance of being sincere when apologising and outlines how taking responsibility builds trust and can positively change future outcomes.
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Content ArticleRoughly 16 million Americans are living with Long Covid, but many are not getting the right medical care. In this article in Popular Science, Miles Griffis argues that one way to improve the system is by letting patients lead. He describes his own disabling case of Long Covid, the issues he has faced in gaining access to Long Covid clinics and the lack of treatment options available to him. He argues that at some point, the demand from patients for treatment will force progress in Long Covid research.
