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Found 53 results
  1. Content Article
    The virtual service was implemented initially as a work-based project by the Hospital Liaison Nurse (HLN) over an 18-month period between 2017 and 2019. It was designed to keep the patient very much in the centre of their care with regular patient/carer remote contact, ongoing assessment, monitoring, clinical decision making and person-centred care planning. In a consultative capacity, the HLN was enabled to work remotely and maintain ongoing close patient/carer contact, effective case management and improved communication across multiagency professionals. This included ongoing virtual collaborative working across care providers and professionals working within primary, secondary and tertiary health and social care services. Overtime, by embedding person centred care and coordination into clinical practice; it became clear that the approach of the HLN’s role shifted from reactive to proactive care provision. This was likely due to early recognition and earlier response to the subtle signs of deterioration in the patient condition. The initial findings highlight the potential of virtual care coordination, to essentially respond to the ongoing changing health needs of adults diagnosed with an ID and comorbidities and enable timely planning for the individual’s future longer term needs. This shared learning example relates to NICE guidance and quality standards: (QS153) on Multimorbidity (Statement 3 on coordination of care and (NG56) Multi-morbidity: clinical assessment and management. In particular this project takes into account NICE recommendations in relation to equality and diversity considerations and making reasonable adjustments as follows: healthcare professionals should take into account the needs of adults who may find it difficult to fully participate in a review of medicines and other treatments (i.e. those with learning disabilities, cognitive impairment or language barriers.
  2. Content Article
    7 golden rules for Vision Zero Take leadership – demonstrate commitment. Identify hazards – control risks. Define targets – develop programmes. Ensure a safe and healthy system – be well-organised. Ensure safety and health in machines, equipment and workplaces. Improve qualifications – develop competence. Invest in people – motivate by participation.
  3. News Article
    Almost half of NHS Trusts in England have reported risks classified as “significant” or “extreme”, with issues facing funding, buildings and failing equipment, according to an analysis by Labour. Highlighting warnings of staff shortages and patient safety, the party demanded urgent action from the government to prepare the health service for the winter months as cases of COVID-19 accelerate across the country. Labour said its study of 114 NHS Trusts’ risks registers showed that over three quarters of trusts logged a workforce risk. The analysis also revealed that 66% reported a financial risk, 82% highlighted risks directly related to COVID-19 and 84% recorded a risk to patient safety. Almost half of Trusts (54), the party said, had outlined risks described as “significant” or “extreme”. One hospital trust reported it was “not financially stable” beyond the current financial year while another recorded a potential risk to patient safety due to “structural deficiencies” in roof structure. NHS hospitals are expected to consider risks to their operations and processes and when risks are identified, it is likely they will have been considered at board level and mitigations put in place. Describing the registers – compiled between March and August - as “worrying” in a normal winter, Jonathan Ashworth, the shadow health secretary, said: “In the coming winter, with the incompetent handling of the test and trace system leaving the NHS wide open and poorly supported, they take on a whole new meaning." "We urgently need a commitment from ministers to fix the problems with test and trace and a timetable by which these issues will finally be sorted. On top of this it is vital that ministers confirm that the NHS will get the additional support it needs to address these risks." Read full story Source: The Independent, 6 October 2020
  4. Content Article
    Key findings The survey results point to conclusions that seem to be equally applicable across different regions. Health workers in all countries need sufficient education and awareness to recognise and report workplace hazards. Workplace cultures must be improved to mandate appropriate reporting of hazards and to improve safety practices and especially to eliminate preventable bullying and harassment that can be intensified during an organisationally destabilising pandemic experience. The global health worker job market is very mobile like COVID-19, so lessons learned in one country or region must be translated to others. Economic classification, region, occupation and sex all play key roles in health worker’s perception of health and safety risk and mitigation measures in the workplace. Despite significant results across different demographic measures, the overall consensus of participants was clear. In spite of calls to action by the international community, risks to healthcare workers remain and mitigation measures are insufficient or in some cases nonexistent. These issues will continue to haunt the healthcare sector and will continue to exacerbate staff shortages globally. In the face of COVID-19 and its impacts on workplaces, it is also another reminder to the global health community to help those countries in need.
  5. Content Article
    5 steps to improve health worker safety and patient safety Establish synergies between health worker safety and patient safety policies and strategies: Develop linkages between occupational health and safety, patient safety, quality improvement, and infection prevention and control programmes. Incorporate requirements for health worker and patient safety in health care licensing and accreditation standards. Integrate staff safety and patient safety incident reporting and learning systems. Develop and implement national programmes for occupational health and safety of health workers: Develop and implement national programmes for occupational health for health workers in line with national occupational health and safety policies. Review and upgrade, where necessary, national regulations and laws for occupational health and safety to ensure that all health workers have regulatory protection of their health and safety at work. Appoint responsible officers with authority for occupational health and safety for health workers at both the national and facility levels. Develop standards, guidelines, and codes of practice on occupational health and safety. Strengthen intersectoral collaboration on health worker and patient safety, with appropriate worker and management representation, including gender, diversity and all occupational groups. Protect health workers from violence in the workplace Adopt and implement in accordance with national law, relevant policies and mechanisms to prevent and eliminate violence in the health sector. Promote a culture of zero tolerance to violence against health workers Review labour laws and other legislation, and where appropriate the introduction of specific legislation, to prevent violence against health workers. Ensure that policies and regulations are implemented effectively to prevent violence and protect health workers. Establish relevant implementation mechanisms, such ombudspersons and helplines to enable free and confidential reporting and support for any health worker facing violence. Improve mental health and psychological well-being: Establish policies to ensure appropriate and fair duration of deployments, working hours, rest break and minimizing the administrative burden on health workers. Define and maintain appropriate safe staffing levels within health care facilities. Provide indemnity and insurance coverage for work-related risk, especially those working in high-risk areas. Establish a ‘blame-free’ and just working culture through open communication and including legal and administrative protection from punitive action on reporting adverse safety events. Provide access to mental well-being and social support services for health workers, including advice on work-life balance and risk assessment and mitigation. Protect health workers from physical and biological hazards Ensure the implementation of minimum patient safety, infection prevention and control, and occupational safety standards in all health care facilities across the health system. Ensure availability of personal protective equipment (PPE) at all times, as relevant to the roles and tasks performed, in adequate quantity and appropriate fit and of acceptable quality. Ensure an adequate, locally held, buffer stock of PPE. Ensure adequate training on the appropriate use of PPE and safety precautions. Ensure adequate environmental services such as water, sanitation and hygiene, disinfection and adequate ventilation at all health care facilities. Ensure vaccination of all health workers at risk against all vaccine-preventable infections, including Hepatitis B and seasonal influenza, in accordance with the national immunization policy, and in the context of emergency response, priority access for health workers to newly licenced and available vaccines. Provide adequate resources to prevent health workers from injuries, and harmful exposure to chemicals and radiations; provide functioning and ergonomically designed equipment and work stations to minimize musculoskeletal injuries and falls.
  6. News Article
    The Health Information and Quality Authority (HIQA) has today published an overview report on the lessons learned from notifications of significant incident events in Ireland arising from accidental or unintended medical exposures in 2019. In 2019, HIQA received 68 notifications of significant events of accidental or unintended medical exposures to patients in public and private facilities, which is a small percentage of significant incidents relative to the total number of procedures taking place which can be conservatively estimated at over three million exposures a year.The most common errors reported were patient identification failures, resulting in an incorrect patient receiving an exposure. These errors happened at various points in the patient pathway which, while in line with previous reporting nationally and international data, highlights an area for improvement.John Tuffy, Regional Manager for Ionising Radiation, said “The overall findings of our report indicate that the use of radiation in medicine in Ireland is generally quite safe for patients. The incidents which were reported to HIQA during 2019 involved relatively low radiation doses which posed limited risk to service users. However, there have been radiation incidents reported internationally which resulted in severe detrimental effects to patients so ongoing vigilance and attention is required." John Tuffy, continued “As the regulator of medical exposures, HIQA has a key role in the receipt and evaluation of notifications received. While a significant event is unwanted, reporting is a key demonstrator of a positive patient safety culture. A lack of reporting does not necessarily demonstrate an absence of risk. Reporting is important, not only to ensure an undertaking is compliant but because it improves general patient safety in a service and can minimise the probability of future preventative events occurring.” Read full story Source: HIQA, 9 September 2020
  7. Content Article
    Hazardous Hospitals: Cultures of Safety in NHS General Hospitals, c.1960-Present is a three-year research project at the University of Warwick, funded by the Wellcome Trust. It is being conducted by Dr Christopher Sirrs. The publication of the Francis Report into healthcare failures at Mid Staffordshire NHS Foundation Trust in 2013 dramatically refocused public and political attention on issues of ‘safety’ in the National Health Service. ‘Safety’ has increasingly occupied the attention of policy makers in recent decades, with hospital managers establishing various systems and processes to protect patients and staff from harm. These include learning and reporting systems, policies about patient consultation, and campaigns for preventing harms such as falls and healthcare-associated infections. However, little is understood about how and why these ideas and practices around ‘safety’ in the NHS evolved. This three-year project explores the history of safety in the NHS, highlighting how hospitals have promoted ‘safety cultures’: ideas, values and behaviours which support safety. Drawing upon a rich seam of archival material, as well as a distinctive methodology, it makes timely contribution to historical understandings of the NHS. The project asks the following key questions: 1. What defines the ‘safety culture’ of NHS hospitals? How can these ‘safety cultures’ vary? 2. How was safety in hospitals assessed, and in what ways did it come to the attention of NHS managers and policymakers after 1960? 3. How did NHS managers promote safety among their staff? 4. What role did groups such as patient organisations, safety campaigners and the press play in depicting, challenging and promoting reform of hospital ‘safety cultures’? The project will directly engage individuals and organisations involved in promoting or campaigning for safety in the NHS. Interviews will also be conducted with a wide range of individuals. If you are interested in participating in the project, please see the ‘Participate‘ page for more information. You can follow the project via @hazardhospitals or, for more information follow the link below.
  8. Content Article
    Complaints from staff are not being heeded. Why is it that healthcare staff's opinions and pleas for their safety and the safety of patients do not matter? Here are just some examples of where safety has been compromised: Disposable gowns are being reused by keeping them in a room and then reusing after 3 days. There were no fit tests. Staff were informed by management that "one size fits all, no testers or kits available and no other trusts are doing it anyway". Only when the Health and Safety Executive (HSE) announced recently that fit tests were a legal requirement, then fit tests were given. I queried about fit checks only to discover that it was not part of the training and, therefore, staff were wearing masks without seals for three months before fit tests were introduced and even after fit tests! I taught my colleagues how to do fit checks via telephone. There was no processes in place at the hospital to aid staff navigation through the pandemic (no red or green areas, no donning or doffing stations, no system for ordering PPE if it ran out); it was very much carry on as normal. A hospital pathway was made one week ago, unsigned and not referenced by governance, and with no instructions on how to don and doff. Guidelines from the Association for Perioperative Practice (AFPP) and Public Health England (PHE) for induction and extubation are not being followed – only 5 minutes instead of 20 minutes. Guidelines state 5 minutes is only for laminar flow theatres. None of the theatres in this hospital have laminar flow. One of my colleagues said she was not happy to cover an ENT list because she is BAME and at moderate/high risk with underlying conditions. She had not been risk assessed and she felt that someone with lower or no risk could do the list. She was removed from the ENT list, told she would be reprimanded on return to work and asked to write a report on her unwillingness to help in treating patients. The list had delays and she was told if she had done the list it would not have suffered from delays. Just goes to show, management only care about the work and not the staff. It was only after the list, she was then risk assessed. Diathermy smoke evacuation is not being used as recommended. Diathermy is a surgical technique which uses heat from an electric current to cut tissue or seal bleeding vessels. Diathermy emissions can contain numerous toxic gases, particles and vapours and are usually invisible to the naked eye. Inhalation can adversely affect surgeons’ and theatre staff’s respiratory system. If staff get COVID-19 and die, they become a statistic and work goes on as usual. The examples listed above are all safety issues for patients and staff but, like me, my colleagues are being ignored and informed "it's a business!" when these safety concerns are raised at the hospital. The only difference is they are permanent staff and their shifts cannot be blocked whereas I was a locum nurse who found my shifts blocked after I spoke up. Why has it been allowed to carry on? Why is there no Freedom To Speak Up Guardian at the hospital? Why has nothing been done? We can all learn from each other and we all have a voice. Sir Francis said we need to "Speak Up For Change", but management continues to be reactive when we try to be proactive and initiate change. This has to stop! Actions needed We need unannounced inspections from the Care Quality Commission (CQC) and HSE when we make reports to them. Every private hospital must have an infection control team and Freedom To Speak Up Guardian in post.
  9. Content Article
    Key benefits of tool Raises the profile of Health & Safety – engages the workforce to talk about health and safety issues. Captures sensitive information – participants respond anonymously. Enables active management of health and safety - allows companies to highlight both areas of concern and good practice. Provides a baseline measure - can help you evaluate whether health and safety initiatives have had the desired effects on performance. Key features Generates paper and HTML versions of the questionnaire. Quick wizard guides the user through easy set up to produce the survey. The survey can be tailored towards the organisation, for example by incorporating the company logo and supporting Management statement and by tailoring terminology within the SCT statements. Allows for up to 9 demographic questions and an additional 6 open questions. The software automatically analyses the data to produce a series of charts and also allows detailed filtering to further interrogate your findings
  10. News Article
    People carrying Emerade 500 microgram adrenaline auto-injector pens should return them and get hold of a prescription for a different brand. A fault has been detected in the pens, meaning the dose of adrenaline may not be delivered when needed for people with severe allergies. The official advice comes from the Medicines and Healthcare products Regulatory Agency (MHRA). Alternative brands - EpiPen and Jext - are available up to 300 micrograms. "Action has been taken to protect patients, following detection of a fault in one component of the Emerade adrenaline auto-injector pens," an MHRA spokesperson said. "Patients should return all Emerade 500 microgram pens to their local pharmacy once they have a new prescription and have been supplied with pens of an alternative brand." If an Emerade pen does need to be used before a patient can get hold an alternative pen, the advice is that it should be pressed very firmly against the thigh. If this does not work, the patient should immediately use their second pen. Read full story Source: BBC News, 19 May 2020
  11. Content Article
    Actions for healthcare professionals All healthcare professionals in primary, secondary or specialist healthcare services who prescribe, supply or administer adrenaline auto-injectors, or who advise patients and their carers, should ensure that they: identify patients who have been supplied with Emerade 500 micrograms auto-injectors and ensure they are reviewed to determine whether their adrenaline auto-injector prescription is still appropriate and in line with existing guidance immediately inform patients and carers to request a new prescription to replace each Emerade 500 microgram auto-injector with one new 300 microgram adrenaline pen in an alternative brand. Healthcare professionals should be aware that the licensed dosing recommendations for each brand of pen are not identical. inform patients to return Emerade 500 microgram auto-injectors to the pharmacy, when they have obtained a total of two adrenaline 300 microgram auto-injectors in a different brand; although pens should be returned to a pharmacy once a replacement is obtained, this should not require someone who is self-isolating to leave their home during COVID-19. Pharmacies that receive Emerade 500 microgram auto-injectors from patients should quarantine the pens and return them to the supplier using the supplier’s approved process. Inform patients: that they should always carry two in-date auto-injectors with them at all times in case they need to administer a second dose of adrenaline before the arrival of the emergency services that they need to receive training, so they are confident in being able to use any new devices so that they know the signs of anaphylaxis and the actions they should immediately take and are aware that this recall also applies to Emerade 500 microgram auto-injectors that are in emergency anaphylaxis kits held by healthcare professionals, such as dental surgery kits etc. adrenaline ampoules, as opposed to auto-injectors, should be stocked when renewing the adrenaline in anaphylaxis kits (ensuring dosing charts, needles and syringes are included) are aware that this recall also applies to Emerade 500 microgram auto-injectors that are currently held by schools. Prescribers should issue no more than two adrenaline auto-injectors per patient (of any brand or strength) unless: schools require separate pens to be kept on the school premises (e.g. in a medical room) in which case prescribers may need to consider issuing more than two but no more than four pens per child (of any brand or strength). for the rare scenario where patients might need more than two adrenaline pens prescribed (for example, a prior severe reaction resistant to treatment with adrenaline), where the prescriber may issue additional pens. General Practitioners (GPs) should send the letter “Advice for patients who have been prescribed an Emerade 500 microgram auto-injector” on page 6 of the alert, to all patients and carers, as appropriate, who have been prescribed Emerade 500 micrograms auto-injectors.
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