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News Article
Covid aftercare piles pressure on ‘understaffed’ community services
Patient Safety Learning posted a news article in News
The aftercare of COVID-19 patients will have significant financial implications for ‘understaffed’ community services, NHS England has been warned. This month the national commissioner released guidance for the care of patients once they have recovered from an immediate covid infection and been discharged from hospital. It said community health services will need to provide “ongoing health support that rehabilitates [covid patients] both physically and mentally”. The document said this would result in increased demand for home oxygen services, pulmonary rehabilitation, diagnostics and for many therapies such as speech and language, occupational, physio, dieticians and mental health support. One GP heavily involved in community rehab told HSJ: “There is a lot detailed information about what people might experience in recovery, but it doesn’t say what should actually happen. “We have seen people discharged from hospital that don’t know anything about their follow-up and the community [health sector] hasn’t got any instructions of what they should be doing or what services have even reopened. This guidance needs to go a step further and rapidly say what is expected so local commissioners can put that in place.” Read full story Source: HSJ, 10 June 2020 -
Content Article
'Storm in a Checklist'
Kathy Nabbie posted an article in Surgery
Recently Dr Peter Brennan tweeted a video of a plane landing at Heathrow airport during Storm Dennis. I looked at this with emotion, and with hundreds of in-flight safety information, human factors, communication and interpersonal skills running through my head. I thought of the pilot and his crew, the cabin crew attendants and the passengers, and how scared and worried they would have felt. On a flight, the attendants will take us through the safety procedures before take off. We are all guilty, I am sure, of partly listening because it is routine and we have heard it all before. Then suddenly we are in the midst of a violent storm and we need to utilise that information! We ardently listen to the attendants instructions and pray for the captain to land the plane safely, which he does with great skill! I now want to link this scenario to the care of our patients in the operating theatre. They are also on a journey to a destination of a safe recovery and they depend on the consultants and the team to get them there safely. Despite being routine, we need to do all the safety checks for each patient and follow the WHO Surgical Safety Checklist as it is written: ask all the questions, involve all members of the surgical team, even do the fire risk assessment score if it is implemented in your theatre. The pilot of that flight during Storm Dennis certainly did not think he was on a routine flight. He had a huge responsibility for the lives of his crew and many passengers! We can only operate on one patient at a time. Always remember, even though the operation may be routine for us, it may be the first time for the patient – so let's make it a safe journey for each patient. Do it right all the time! -
Content Article
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Content ArticleIn this report the CQC have seen much good and outstanding care, in particular around: responsiveness staff interactions with patients effective treatment leadership and engagement with staff and patients. However, there were a number of areas where services needed to make substantial improvements: governance clinical audit safety culture.
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Content ArticleThis document explains how patients are informed, involved and consulted in the development, improvement and delivery of health and care services.
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Content ArticleMandy Odell, Nurse Consultant, Critical Care, Royal Berkshire NHS Foundation Trust, Reading, has implemented this initiative in her hospital and beyond. Five years following the introduction of a whole-hospital, 24-hour critical care outreach (CCO) service, an additional service was introduced that enabled patients and their families to directly call the CCO team if they had concerns that were not being acknowledged by the patient’s clinical team. The aim of this review, published in the Journal of Nursing, was to report on 7 years of patient and family referrals using quantitative and free text data extracted from the CCO referral database.
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Content ArticleWe have a new app within Homerton which is featured on the hub. The Homerton University Hospital (HUH) Action Card App is an initiative that aims to bridge the gap between information/processes with clinical members of staff without the need to log into a computer, access the intranet, and finding the long black and white document which is never ending. The Action Card App has easy to read, 1-page coloured documents relating to local and national/local incident trends and Never Events. We entered the Patient Safety Learning Awards on the back of seeing the hub and finding content on there that was incredibly useful on a day to day basis. We genuinely weren't expecting to hear anything back from the Patient Safety Learning team as we are a small trust that not a lot of people know about, and we thought the standard of patient safety initiatives would be high, with many trusts miles ahead of us. I have to say, the team at Patient Safety Learning were nothing but lovely, from the moment the conversation started about the prospect of entering the awards. They all took the time for correspondence and they treated you as a person, as oppose to an entry. When we got the information that we had won the overall prize, we were gobsmacked and elated. The app team were overjoyed with the sense that our hard work had paid off and someone had taken the time to appreciate the work we have been doing at Homerton. We were asked to prepare a presentation prior to the awards, which showcased our work and to share with the attendees of the conference. The day arrived, with so much great work, inspiring talks and a general atmosphere of wanting to do more to keep our patients safe. I would like to thank everyone who heard our presentation (some may say performance) and thank everyone in the Patient Safety Learning team for their help with this process.
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Content Article
Swab safe management to prevent retained swabs
Kathy Nabbie posted an article in Improving systems of care
It happened on a Saturday, 19.30pm, in April 2012. I was the theatre coordinator. We had a 'never event' of a retained swab in a breast wound. The following week, I changed practice following audits for four weeks in eight theatres. We never looked back. Attached is the poster presented in November 2016 at the Patient First Excel conference. Until recently no one ever asked me how I felt. I knew what to do. But I felt for the surgeon. As theatre scrub practitioners we complete counts and inform the surgeon. He acknowledges the count. If later on a swab is retained, it's the surgeon who has to inform the patient and remove it. By using a system especially designed for counting swabs (see video below), we can stop never events of retained swabs and maintain safety for the patient, the consultants, perioperative staff and also the hospital. We have the technology – let's use it! Kathy showcasing the Swabsafe Management poster at the Patient First Event, Excel London. -
Content Article
Staff safety in the mental healthcare setting
Sarahjane Jones posted an article in Mental health
Our recent observational study, published in the Health Informatics Journal, focussed on staff safety in the mental healthcare setting. We worked with a mental healthcare provider to extract and analyse incidents of adverse events. In one aspect of the work, we looked specifically at the incidents that were reported that had recorded a member of staff as a ‘victim’ of the adverse event. From the 1 September 2014 to the 31 March 2017, 19,693 members of staff were reported as victims across 10,119 adverse events. For context, this was the equivalent of around 25 incidents per week, but it is important to keep in mind that this was for both harmful and non-harmful incidents and near misses. The most common incident was ‘aggression by patient on staff or other’. We were interested in exploring whether nurse staffing levels affected adverse events on staff. To investigate this we made use of nurse staffing data for each inpatient area. We were able to obtain data that quantified the planned, the clinically required and the actual, staffing level of nurses. We found that, in many cases, registered nurse staffing affected staff safety. Where there were more registered nurses, there tended to be less adverse events on staff. We also found that, although there was also a relationship with unregistered nurses, staff harm was more resilient to understaffing of unregistered nurses. This leads us to hypothesise that the role of the registered nurse provides additional benefits to risk mitigation and that it’s not simply about head count but rather the type of skills and care provision that the healthcare team provides. However, it is important to note that these relationships were not consistent across all locations and all shifts. On the night shift, for example, we found that as the clinically required level of unregistered nurses decreased, the number of adverse events to staff increased. This suggested that where the perceived clinical demand was low, the risk to staff was highest. This has important implications. This implies that the perceived clinical demand for nursing staff doesn’t appropriately consider the risk of harm to staff, particularly during the night shift when the clinically required levels of unregistered nurses is insufficient to project staff from harm. The use of these data in this way is novel and as researchers, we are very excited about the promise of utilising routinely collected data to predict both patient harm and staff harm. We hope that this will provide significant opportunities to improve healthcare safety. In order to provide effective and sustained high levels of mental health care, we need to understand the challenges presented by the mental healthcare environment, and the need to staff these environments in such a way that keeps the workforce safe. We are doing a long term study to explore the environment and workforce retention in secondary and mental healthcare. You can find out more here.
