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Content ArticleThe primary objective of this multicenter, observational, retrospective study from Giacobbe et al. was to assess the incidence rate of ventilator-associated pneumonia (VAP) in coronavirus disease 2019 (COVID-19) patients in intensive care units (ICU). The secondary objective was to assess predictors of 30-day case-fatality of VAP.
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Content ArticleDuncan L Wyncoll and Peter J Young discuss 'Treating the symptom not the cause' of ventilator associated pneumonia.
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Content ArticleThe PneuX System is a novel endotracheal tube and tracheal seal monitor, which has been designed to minimise the aspiration of oropharyngeal secretions. Doyle et al. aimed to determine the incidence of ventilator-associated pneumonia (VAP) in patients who were intubated with the PneuX System and to establish whether intermittent subglottic secretion drainage could be performed reliably and safely using the PneuX System.
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Content ArticleThis document highlights practical recommendations in a concise format to assist acute care hospitals in implementing and prioritising strategies to prevent ventilator-associated pneumonia (VAP) and other ventilator-associated events (VAEs) and to improve outcomes for mechanically ventilated adults, children, and neonates.
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Content ArticleThe Centers for Disease Control and Prevention (CDC) provide answers to FAQs about ventilator-associated pneumonia.
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Content ArticleVentilator-associated pneumonia (VAP) continues to be a clinically important hospital-acquired infection. In this paper, Marin H. Kollef discusses the financial impact.
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Content ArticleHealthcare associated infections (HAI), such as ventilator-associated pneumonia (VAP), are the most common and most preventable complication of a patient’s hospital stay. Their frequency and potential adverse effects increase in critically ill patients because of impaired physiology, including a blunted immune response and multi-organ dysfunction. Traditionally, VAP rates have been measured as an indicator of quality of care. Despite recent initiatives to measure complications of mechanical ventilation and a decrease in incidence over the past few years, VAP remains an issue for critically ill adults, with mortality estimated as high as 10%. This article from Boltey et al. reviews the top five evidence-based nursing practices for reducing VAP risk in critically ill adults.
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Content ArticleVentilator-associated pneumonia is an important healthcare-associated infection. Interventions for the prevention of ventilator-associated pneumonia are often used within bundles of care. Recent evidence has challenged widespread practices mandating a review of subject. This article outlines guidance for ventilator-associated pneumonia prevention.
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Content ArticleVentilator-associated pneumonia (VAP) is an important cause of morbidity and mortality in ventilated critically ill patients. Muscedere et al. systematically searched for all relevant randomised, controlled trials and systematic reviews on the topic of prevention of VAP in adults that were published from 1980 to 1 October 2006. in order to develop evidence-based guidelines for the prevention of VAP.
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Content ArticleKishorkumar Patel and Kofi Aning were both treated at the Nightingale Hospital in London in April 2021. In both cases there was a serious incident in which the wrong filter was found to have been used within the breathing systems of their intensive care ventilator.
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Content ArticleA recording of the recent webinar, moderated by Dr Charlotte Tai, discussing the lessons learnt and advances in practice in diagnosis, treatment, and prevention of ventilator-associated pneumonia. This is available for everyone to watch but you will need to provide an email address to request access.
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Content ArticleThis article looks at the issue of oxygen hoses becoming disconnected from transport ventilators when patients are moved between hospitals, which led to a patient death. Following the incident, the National Patient Safety team worked with national partners involved in transfer of patients to ensure a ‘tug test’ is incorporated into local practice.
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Content ArticleCase study looking at how a Covid patient on a ventilator deteriorated due to their heat and moisture exchanger filter (HMEF) being flooded with secretions. The identified incident highlighted a possible under-recognised patient safety risk of the need to replace such filters.
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News Article
Covid: Lack of ventilator supplies 'hit' disabled people
Patient Safety Learning posted a news article in News
Some disabled people in the UK have been struggling to obtain essentials such as medication and breathing equipment during the Covid pandemic, research for the BBC suggests. Some 60% of those who rely on social care told a YouGov survey they were finding it hard to obtain at least one of their necessities. Charity WellChild said people felt more "forgotten than they ever have been". But ministers say the needs of disabled people were being considered. The Department of Health and Social Care says it has sufficient stocks and patients should contact their local care provider. Like one in 20 of those survey respondents who receive social care, Fi Anderson, a mother of two with muscular dystrophy from Bolton in Greater Manchester, said she has faced problems obtaining breathing apparatus. Her local hospital told her to re-use the filter for her portable ventilator, recommending she boil it, because supplies were so short. Disabled people who rely on social care - which funds equipment and other support to allow them to live independent lives - also said they had struggled to obtain personal protective equipment (PPE) such as face masks. Many of them receive funding directly to employ carers in their home, so they also need to provide them with PPE during the coronavirus crisis. The survey, which the BBC commissioned to mark the 25th anniversary of the Disability Discrimination Act, asked more than 1,000 people about life in the UK with a disability and how it has changed in the shadow of a pandemic. More than 65% felt their rights had regressed, and 71% said disabled people's needs had been overlooked. The Coronavirus Act, which granted the government emergency powers, gave local councils the ability to reduce care, education and mental health provision for disabled people if it became necessary during the pandemic. According to the latest figures from the Office for National Statistics, nearly six out of 10 deaths from COVID-19 were of disabled people. Read full story Source: BBC News, -
News ArticleThe most comprehensive picture so far of how covid’s second wave has hit the NHS in the north of England is revealed in new figures obtained by HSJ. The latest data confirms that parts of the North West region now have more coronavirus patients in hospital beds than they did in the spring. It comes amid intense public debate about the best way to fight covid, and whether or not it is close to swamping the NHS. Collected from local NHS sources in a joint HSJ and Independent investigation, the information shows for example that: Lancashire and South Cumbria had 544 confirmed covid hospital patients yesterday (around 15-18% of the bed base), about 20 more than during the April peak. Liverpool University Hospitals – which remains the most severely affected trust – had 408 confirmed covid patients yesterday (20-25% of bed base), whereas it never topped 400 in the spring. The data is sent routinely by trusts to NHS England but most of it is not published – something some politicians are now calling for. As of yesterday, there were nearly 6,100 confirmed-covid patients across England, about 650 of whom were in critical care, and 560 receiving mechanical ventilation, according to information shared with HSJ. The number of “unoccupied” hospital beds is much lower now than in the spring, when they were cleared out in anticipation of a major hit. In the North West, up to 5,500 acute beds were reported as “unoccupied” in the spring, whereas the figure now is about 2,500 (around 14-18% of the bed base). However, critical care is the major pinch point in the most affected areas, with nearly half of the mechanical ventilation beds open at Liverpool’s hospitals (29 of 62) occupied by confirmed covid patients; and a third of those across the North West (178 of 556). However, hospitals in the area have opened very few extra critical care “surge” beds so far. The total numbers of mechanical ventilation (a subset of critical care) beds open in LUH and the rest of the region has not increased much in recent weeks, and falls well short of what they have declared they could open as potential surge capacity, if they cancelled large amounts of non-urgent care and reorganised staffing and wards. Read full story Source: HSJ, 23 October 2020
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News Article
Covid ICU survivor: 'I have come out the other end'
Patient Safety Learning posted a news article in News
Covid survivor Tam McCue is one of the lucky ones. Earlier in the year he was in intensive care in the Royal Alexandra Hospital in Paisley where he had been on a ventilator for nearly two weeks. At one point Mr McCue, who could barely speak, didn't think he would live. Fast forward five months and Mr McCue, of Barrhead, East Renfrewshire, is back from the brink. He became desperately ill but, thankfully, it only went as far as his lungs. With coronavirus some patients have have suffered multiple organ failure which also affected their heart, kidneys, brain and gut. Mr McCue describes his recovery as a "rollercoaster". He added: "It's a slow process. You think you can do things then the tiredness and fatigue sets in." He said: "It lies in the back of your mind. As years go on, how are you going to be? Is it going to get you again? It does play on you. It definitely does." As part of his recovery Mr McCue is attending the Ins:pire clinic online. It is normally a face-to-face rehabilitation clinic which involves multiple specialties, including pharmacists, physiotherapists and psychologists. Mr McCue is one of the first Covid survivors to take part in the five-week programme, which started earlier this month. Read full story Source: BBC Scotland News, 29 September 2020 -
News ArticleHospitals have been warned hundreds of ventilators used to keep sedated patients alive are at risk of suddenly shutting down because of a fault, in some cases without warning. The Medicines and Healthcare products Regulatory Agency, which said there were approximately 303 Philips Respironics V60 ventilators used in the UK, has warned hospitals over a delay in replacement parts arriving in the UK to fix the problem. It has issued a safety alert to hospitals to make them aware of the increased risk. The regulator said it had received one report of a ventilator suddenly shutting down but said there was no report of any injury to patients. Read full story Source: The Independent, 23 September 2020
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News ArticleShortages of oxygen are endangering the lives of more than half a million COVID-19 patients every day in the world’s poorest nations, new research has shown. Despite being vital for the effective treatment of people admitted to hospital with coronavirus, sustained access to oxygen has proven difficult in low- and middle-income countries (LMICs) due to cost, infrastructure and logistical barriers. According to Unitaid, a global health agency, more than half a million people in LMICs currently need 1.1 million cylinders of oxygen per day, with 25 countries currently reporting surges in demand, the majority in Africa. Supplies of oxygen were already constrained prior to COVID-19 and have been exacerbated by the pandemic, Unitaid says. Read full story Source: The Independent, 25 February 2021
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Inquest hears evidence of mistakes in Nightingale patients’ care
Patient Safety Learning posted a news article in News
An inquest into the death of a London bus driver at London’s Nightingale Hospital during the first wave of coronavirus has heard evidence about equipment mistakes which may have harmed patients. Kishorkumar Patel, aged 58, was one of the first patients to be admitted to the field hospital at London’s Excel Conference Centre in April last year. An inquest at East London Coroner’s Court was told doctors and nurses were forced to work “leanly” because of limited staff and ventilators to help patients breathe. Mr Patel is one of 10 patients who had the wrong filter used on the ventilator machines which it is thought triggered a cardiac arrest in Mr Patel, a father of six. A serious incident report identified 10 patients were affected by the use of the wrong filter, with three said to have been harmed as a result. Read coroner's report Read full story Source: The Independent, 6 October 2021- Posted
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News ArticleAfter three Covid-19 patients died at the make-shift Nightingale Hospital in London following a breathing tube mix-up, NHS trusts in England could be issued tougher ventilation guidance. In each of the cases, filters which prevent the build-up of fluid were not attached to the machines, resulting in dangerous blockages, but it has not yet been determined if these incidents contributed to their deaths. Coroner Nadia Persaud has said the way the machines vary from model to model can be "confusing" and may lead to future deaths, also ruling that the classification and colour coding was "worthy of review, simplification, and standardisation". The original coroners report, carrying advice from an independent expert said "In my opinion, the non-standardised colour coding used by manufacturers of these filters, the number of different types of filters with different names, the variable optimal position of the filters, and whether a wet or a dry breathing system is being used, results in an extremely confusing situation. One of the leading manufacturers of these filters produces HMEs that are blue, which is the same colour as the non-HME filters supplied by another company. In my experience, few doctors and nurses working in ICU are knowledgeable about all these different filters and which ones should be used for any given breathing system." Inquests into the deaths are scheduled for October. Read full story. Source: The Daily Mail, 17 August 2021
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Covid: Pressured oxygen reduces ventilator need
Patient-Safety-Learning posted a news article in News
New research has found oxygen therapy may help reduce the number of patients needing a ventilator. The research trial, conducted across 48 hospitals in the UK, found that out of the three methods of oxygen delivery, continuous positive airway pressure (CPAP) could be the most beneficial in reducing the need for a patient to go on a ventilator. "The routine use of high-flow nasal oxygenation, which can consume large amounts of oxygen, should be reconsidered, as it did not improve outcomes. By giving patients the most effective treatment to begin with, we can help prevent resource shortages in our NHS and make sure the right type of ventilation is available to patients when it is required." Says Prof Gavin Perkins, from the Warwick Medical School. Read full story. Source: BBC News, 05 August 2021 -
News Article
‘Ventilator challenge’ to equip NHS for Covid lost £143m of public money
Patient-Safety-Learning posted a news article in News
£140m that was spent on developing ventilators has been written off by ministers. According to the Observer, the ventilators were never put to use in the NHS in the months after the pandemic began. The 'ventilator challenge' was launched to help provide more machines where needed, however problems began early last year when companies complained their expertise was not being used, while others who had no relevant experience of building ventilators, were asked to do so. A government spokesperson has said: “Throughout the pandemic, we have done whatever it takes to protect the NHS and save lives. This included launching the ventilator challenge, which saw more than 15,000 new machines delivered to the NHS, meaning every patient who needs a ventilator has been able to access one". Read full story. Source: The Guardian, 18 July 2021 -
News ArticleA new leaked report has found almost half of hospital isolation rooms did not meet ventilation guidelines after an audit was commissioned after healthcare staff and patients were found to be infected with COVID-19. The audit revealed nearly 40 per cent of hospital wards failed air filtration guidelines and though 99 percent of wards had enough outside air, problems begin to occur when it gets into the hospitals. The ABC has contacted the Victorian Health Department for comment. Read full story. Source: The ABC News, 1 July 2021
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EventuntilThis Webinar hosted by Hamilton Medical, will focus on the clinical use of intelligent ventilation software. Agenda Intro from Chair Luigi Camporata Presentation from Prof. Giorgio A. Iotti : “ The birth and growth of the visionary idea” Presentation from Laura Buiteman-Kruizinga: “Lung protective ventilation in the time of COVID-19” Followed by a Q&A Register for the webinar
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EventuntilThis webinar, moderated by Dr Charlotte Tai, will discuss the lessons learnt and advances in practice in diagnosis, treatment, and prevention of Ventilator-associated Pneumonia. Speakers: The role of the oral cavity and the endotracheal tube in the aetiology of VAP Dr Matt Wise, Consultant Adult Critical Care, University Hospital of Wales Relationship between VAP and mortality Professor Saad Nseir, Professor of Critical Care at the Medical School of Lille, France Ventilator-associated pneumonia in critically ill patients with COVID-19 Dr Andrew Conway Morris, Honorary Consultant in Intensive Care Medicine, Cambridge University Hospitals NHS Foundation Trust Panellists: Dr Mark Blunt, Lead Critical Care Consultant, Queen Elizabeth Hospital, Kings Lynn Helen Hughes, Chief Executive, Patient Safety Learning Register