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News ArticleA leading NHS doctor has warned frontline medical staff dealing with Britain’s coronavirus outbreak feel like “cannon fodder” and "lambs to the slaughter". Dr Rinesh Parmar, chairman of the Doctor's Association UK, is battling the disease on an intensive care ward at a city hospital in Birmingham. The Anaesthetic Registrar begged Boris Johnson to provide better Personal Protective Equipment (PPE), describing the current crisis the "calm before the storm" Doctors and nurses fear a lack of masks, gloves, aprons and protective suits is putting them at risk as they care for patients diagnosed with Covid-19. Speaking after a night shift on the ward, Dr Parmar told The BBC's Andrew Marr Show: "We have had doctors tell us they feel like lambs to the slaughter, that they feel like cannon fodder. GPs tell us that they feel absolutely abandoned." Read full story Source: The Sun, 23 March 2020
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News Article
Intensive care staffing ratios dramatically diluted
Patient Safety Learning posted a news article in News
The staff-to-patient ratios for intensive care are being dramatically reduced as the NHS seeks to rapidly expand its capacity to treat severely ill covid-19 patients, HSJ has learned. Acute trusts in London have been told to base their staffing models for ICU on having one critical care nurse for every six patients, supported by two non-specialist nurses and two healthcare assistants. Trusts have also been told by NHS England and NHS Improvement’s regional directorate to plan for one critical care consultant per 30 patients, supported by two middle grade doctors. The normal guidance is the consultant-to-patient ratio “should not exceed a range between 1:8-1:15”. Nicki Credland, chair of the British Association of Critical Care Nurses, confirmed the plans had been agreed today nationally. She told HSJ: “There will absolutely be a lot of concern about this in the profession, but it’s the only option we’ve got available. We simply don’t have the capacity to increase our staffing levels quickly enough." “It will dilute the standard of care but that’s absolutely better than not having enough critical care staff. There’s also a massive issue around the ability of critical care nurses not only to care for their patients but also monitor what the non-specialists in their teams are doing.” Read full story (paywalled) Source: HSJ, 24 March 2020 -
News Article
Cancer treatment delayed as patient priority lists drawn up
Patient Safety Learning posted a news article in News
Delays have begun to cancer treatments, as patients are reprioritised ahead of capacity becoming overwhelmed by the coronavirus crisis. In three separate developments: A London trust announced it was cancelling chemotherapy and routine cancer operations for a fortnight due to coronavirus pressure; An NHS England covid-19 guidance document indicated palliative care cancer patients will be less likely to receive appropriate treatment; and Cancer waiting times guidance has been changed to provide for some urgent referrals for suspected cancer to be sent back to GPs without diagnosis. Read full story (paywalled) Source: HSJ, 23 March 2020 -
News Article
Coronavirus: The new inventions inspired by a pandemic
Patient Safety Learning posted a news article in News
A new ventilator, a virus-killing snood and a hands-free door pull are just some of the innovations coming out of Wales to tackle coronavirus. Since the outbreak, doctors, scientists and designers have been working on ideas to stop the virus spreading. The ventilator has already successfully treated a Covid-19 patient and has been backed by the Welsh Government. Mass production of the snood-type mask is under way while a 3D design of the handle has been widely circulated. Plaid Cymru leader Adam Price, who was part of the impetus to get the ventilator into mass production, said the innovations put Wales "on the front foot" in the battle against the pandemic. "It shows that Wales, as a small nation, can get things done quickly as we face the biggest challenge of our generation," he said. Read full story Source: BBC News, 24 March 2020 -
News ArticleThe NHS must ensure that doctors have proper protective equipment, Jeremy Hunt, the former health secretary, has urged. NHS chiefs say that there are no problems with national stock levels of items including masks, gowns and gloves and that local supply issues should have been resolved over the weekend. However, hospital staff say that they are still experiencing shortages, with nurses going to DIY shops to stock up or even refusing to work without the right equipment. One London doctor said: “Every time the government is asked they say the equipment is there, and it is just not true.” Read full story (paywalled) Source: The Times, 23 March 2020
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News Article
FDA approves first bedside COVID-19 test by Danaher’s Cepheid
Patient Safety Learning posted a news article in News
A Covid-19 test can deliver results in less than an hour has been approved under an FDA emergency authorization, marking the first test that clinicians can use at the bedside. Cepheid, a Silicon Valley molecular diagnostics company that’s a unit of Danaher Corp., announced Saturday it received an emergency authorisation from the U.S. Food and Drug Administration to use the test, making it the 13th Covid-19 test the agency has allowed on the market as long as the public health emergency exists. But it’s the first one that can be used at the point of care, meaning providers don’t have to send patient samples to a separate lab to be processed and then come back to the hospital or provider’s office. Cepheid said it expects to start shipping tests next week. “An accurate test delivered close to the patient can be transformative — and help alleviate the pressure that the emergence of the 2019-nCoV outbreak has put on healthcare facilities that need to properly allocate their respiratory isolation resources,” said David Persing, Cepheid Chief Medical and Technology Officer. Read full story Source: Bloomberg, 21 March 2020 -
News Article
WHO Health Alert brings COVID-19 facts to billions via WhatsApp
Patient Safety Learning posted a news article in News
WHO has launched a messaging service with partners WhatsApp and Facebook to keep people safe from coronavirus. This easy-to-use messaging service has the potential to reach 2 billion people and enables WHO to get information directly into the hands of the people that need it. From government leaders to health workers and family and friends, this messaging service will provide the latest news and information on coronavirus including details on symptoms and how people can protect themselves and others. It also provides the latest situation reports and numbers in real time to help government decision-makers protect the health of their populations. The service can be accessed through a link that opens a conversation on WhatsApp. Users can simply type “hi” to activate the conversation, prompting a menu of options that can help answer their questions about COVID-19. The WHO Health Alert was developed in collaboration with Praekelt.Org, using Turn machine learning technology. Read full story Source: World Health Organization, 20 March 2020 -
News Article
Mental health charity slams Government's ‘irresponsible’ coronavirus bill
Patient Safety Learning posted a news article in News
A mental health charity has branded as “irresponsible” the Government’s coronavirus bill which would grant single doctors the power to detain the mentally ill. The Government wants to relax legal safeguards in the Mental Health Act in order to free up medical staff to deal with the COVID-19 pandemic. If passed, the bill would reduce the number of doctors needed to approve detaining individuals from the current minimum of two, to just one. In addition, it would temporarily allow time limits in the Mental Health Act to be extended or removed altogether. This would mean patients currently detained in mental health facilities could be released into the community early, or be detained for longer. Akiko Hart, Chief of National Survivor User Network (NSUN), a UK mental health charity, said: “Whilst we understand that these are unprecedented times, any legislative change must be proportionate and thought through, and should protect all of us. Minimising some of the safeguards in the Mental Health Act and extending its powers, is a step in the wrong direction.” Read full story Source: The London Economic, 19 March 2020 -
News ArticleNew guidelines have been published to help doctors and nurses decide how to prioritise patients during the coronavirus pandemic. The advice from the National Institute for Health and Care Excellence (NICE) was produced amid concerns that the NHS would be overwhelmed by the demand for intensive care beds and ventilators. The three new NICE guidelines, which have been drawn up within a week rather than the usual timescale of up to two years, cover patients needing critical care, kidney dialysis and cancer treatment. They say all patients admitted to hospital should still be assessed as usual for frailty “irrespective of Covid-19 status”. Decisions about admitting patients to critical care should consider how likely they are to recover, taking into account the likelihood of recovery “to an outcome that is acceptable to them”. Doctors are advised to discuss possible “do not resuscitate” decisions with adults who are assessed as having increased frailty, such as those who need help with outside activities or are dependent for personal care. Read full story Source: Independent, 22 March 2020
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News Article
Coronavirus: Hancock admits ‘challenges’ over NHS equipment
Patient Safety Learning posted a news article in News
The health secretary has acknowledged there have been "challenges" with the supply of personal protective equipment to NHS staff in England - but added he is determined to rise to them. Last week, NHS staff said the lack of protective gear was putting them at risk during the coronavirus outbreak. Matt Hancock said a million face masks had been bought over the weekend and he was taking the issue "very seriously". From this week, the Army will play a part in helping to distribute supplies. "I am determined to ensure that the right kit gets to the right hospital, the right ambulance service, the right doctors' surgery, right across the country," said Mr Hancock. "There have been challenges and I can see that. We're on it and trying to solve all the problems." Read full story Source: BBC News, 23 March 2020 -
Content Article
HSJ Primer: Breaking point (25 April 2022)
Patient Safety Learning posted an article in Workforce and resources
Recently the Financial Times health and data reports produced an incisive piece showing the world what is all too readily apparent to people in the NHS: bed capacity has been stretched to breaking point. The report said this “calls into question [the NHS’s] ability to meet a commitment to increase non-urgent hospital treatment by 30 per cent above pre-pandemic levels over the next three years”. It also demonstrates the dangerous congestion that is causing ambulances to stack up outside emergency departments and medically fit patients to languish in vital beds past their due time for discharge. This congestion is causing dangerous delays, leading to a rising number of serious incidents in ambulances queuing to get to the front door of the ED. There is doubtless much that can be done inside hospitals to improve efficiency, alleviate bottlenecks and improve patient flow. -
Content ArticleDr Roberta Heale, Associate Editor of Evidence-Based Nursing, speaks to Dr Elaine Maxwell, Nurse and author of two National Institute for Health Research reviews on evidence on Long COVID in this BMJ Talk Medicine podcast. They discuss the variance in reported Long COVID statistics, the impact of vaccinations, symptoms, and research efforts.
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Content ArticleChen et al. examined the worldwide prevalence of post COVID-19 condition, through a systematic review and meta-analysis. The research, published in the Journal of Infectious Disease, assessed 23 symptoms reported across 36 of the studies and found that shortness of breath, sleep problems, and joint pain was widely reported by those who had recovered from the novel coronavirus infection. They analysed the prevalence of this condition globally and regionally, estimating the proportion of individuals facing long Covid in Asia, Europe and North America. They found that the global prevalence for post-Covid conditions at 30, 60, 90 and 120 days after infection was about 37, 25, 32, and 49%, respectively. The authors concluded that post COVID-19 condition prevalence is substantial; the health effects of COVID-19 appear to be prolonged and can exert stress on the healthcare system.
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Content ArticlePeople with COVID-19 often have symptoms in the long term (ie, long COVID), including fatigue, breathlessness, and neurocognitive difficulties. The disease mechanisms causing long COVID are unknown, and there are no evidence-based treatment options. Clinical guidelines focus on symptom management, and various treatment options are being evaluated. The scarcity of advice has often left people with long COVID feeling isolated and frustrated in their search for therapies. Research is needed to understand the self-management practices that are being used to manage long COVID symptoms; factors influencing their uptake; and the benefits, harms, and costs. There is also a need to assess the potential harmful effects of polypharmacy and drug–drug interactions in these individuals. The Therapies for Long COVID (TLC) Study (ISRCTN15674970) will begin to explore self-management practices through a survey of people with long COVID. This study aims to be a first step towards understanding this important and under-researched public health issue.
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Content ArticleAfter two years under siege from COVID, many nurses in the United States are reconsidering the profession.
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Content ArticleAnnegret Hannawa investigated communication during Covid-19. She asked the questions: to what extent did communication by the Swiss traditional news media and by the Swiss Government, communication in the social media, and interpersonal communication affect Swiss residents' (1) trust, (2) willingness to vaccinate, (3) engagement in conspiracy theories, and (4) mental health? This video gives a short summary of the first results.
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Content ArticleThe world’s third biggest economy seems to have emerged from the pandemic comparatively unscathed. Priyanka Borpujari speaks to health workers who survived the frontlines about how, and at what cost.
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Content ArticleEarly in the pandemic, the World Health Organization (WHO) stated that SARS-CoV-2 was not transmitted through the air. That mistake and the prolonged process of correcting it sowed confusion and raises questions about what will happen in the next pandemic. This Nature feature looks at the changing views of how Covid is spread.
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Content ArticleDr Tejal Gandhi, has been a leader in patient and workforce safety for more than 20 years. Dr. Gandhi talked with Patient Safety Beat following publication of her essay, “Don’t Go to the Hospital Alone: Ensuring Safe, Highly Reliable Patient Visitation,” in the Joint Commission Journal on Quality and Patient Safey.
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Content ArticleInfluenza, polio and more have shown that infections can change lives even decades later. So why the complacency over possible long-term effects of COVID-19 writes Laura Spinney in this Nature article.
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Content ArticleGovernment must take a cautious and evidence-based approach to exiting the pandemic, factoring in six key elements for a fail-safe exit strategy.
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Content ArticleThe theme of this Issue of Hindsight is ‘Wellbeing’, which has an undeniable link to safe operations, though this is not often spoken about. This Issue coincides with the COVID-19 pandemic. The authors of the articles in this Issue were considering wellbeing in the context of aviation, and other industries. But the articles touch on topics that are deeply relevant to the pandemic. The spread of the virus and its effect on our everyday lives has brought the biological, psychological, social, environmental, and economic aspects of wellbeing into clear view in a way we have never seen before.
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Content ArticleMore and more people have been asking for a return to normal, and with omicron waning, governments are starting to act. The UK is removing its remaining public health measures, including mandatory self-isolation of COVID cases and free testing. However, the inescapable truth is that – unless the virus mutates to a milder form – the “normal” life we are returning to will be shorter and sicker on average than before. This article in The Conversation looks at how we need to live post-Covid.
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Content ArticleThis book interrogates the assumption that evidence means the same thing to different constituencies and in different contexts by outlining a more nuanced and socially responsive approach to medical expertise that incorporates scientific and lay processes of making sense of the world and deciding how to act in it. In so doing, it provides a point of orientation for clinicians working at the coalface, whose experience is sometimes at odds with the type of rationality that underpins evidence-based medicine and that guides researchers conducting randomised controlled trials. The argument elaborated also has implications for policy makers in the healthcare system, who have to navigate similar pressures and contradictions between scientific and lay rationality to produce meaningful guidelines in the midst of a runaway pandemic. Debates within and beyond the medical establishment on the efficacy of measures such as mandatory face masks and lockdowns are examined in detail, as are various degrees of hesitancy towards vaccines and other pharmaceutical interventions. The authors demonstrate that it is ultimately through narratives that knowledge about medical and other phenomena is communicated to others, enters the public space, and provokes discussion and disagreements. Importantly, effective narratives can enhance the reception of that knowledge and reduce some of the sources of resistance and misunderstanding that continue to plague public communication about important medical issues such as pandemics. Access the introduction and excerpts from each chapter from the link below.
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Content ArticleWhat have we learned about the symptoms of Long COVID or Post COVID-19 condition so far? How long does it last, when should you worry, and what treatments are recommended? WHO’s Dr Janet Diaz explains in this video. Part of WHO's Science in 5 series.
