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Found 119 results
  1. Content Article
    Evidence shows that nurse staffing affects patient safety events (PSEs), but the role of an appropriate nursing care delivery system remains unclear. This Japanese study aimed to investigate whether nursing care delivery systems could prevent PSEs. The findings suggest that in an emergency intensive care unit, a collaborative nursing care delivery system was associated with a decrease in PSEs.
  2. Content Article
    In this 6 minute video, Laurence describes his experiences of post-ICU delirium.
  3. Content Article
    The authors of this JAMA article describe the experience of a family member who was in critical care, and who is deaf. They outline a lack of awareness amongst healthcare professionals about their relative's deafness and highlight the lack of understanding in how to communicate with her. They go on to outline a number of approaches to communicating with patients who are deaf or hard of hearing.
  4. News Article
    Whistleblower Dr Chris Day has won the right to appeal when a a Deputy High Court Judge Andrew Burns of the Employment Appeal Tribunal granted permission to appeal the November 2022 decision of the London South Employment Tribunal on six out of ten grounds at a hearing in London. The saga which has now being going on for almost ten years began when Dr Day raised patient safety issues in intensive care unit at Woolwich Hospital in London. The Judge said today this was of the “utmost seriousness” and were linked to two avoidable deaths but their status as reasonable beliefs were contested by the NHS for 4 years using public money. In a series of twists and turns at various tribunals investigating his claims Dr Day has been vilified by the trust not only in court but in a press release sent out by the trust and correspondence with four neighbouring trust chief executives and the head of NHS England, Dr Amanda Pritchard and local MPs. This specific hearing followed a judgement in favour of the trust by employment judge Anne Martin at a hearing which revealed that David Cocke, a director of communications at the trust, who was due to be a witness but never turned up, destroyed 90,000 emails overnight during the hearing. A huge amount of evidence and correspondence that should have been released to Dr Day was suddenly discovered. The new evidence showed that the trust’s chief executive, Ben Travis, had misled the tribunal when he said that a board meeting which discussed Dr Day’s case did not exist and that he had not informed any other chief executive about the case other than the documents that were eventually disclosed to the court. Read full story Source: Westminster Confidential, 26 February 2024
  5. Content Article
    During the first wave of Covid-19, the drug hydroxychloroquine was used off-label despite the absence of evidence documenting its clinical benefits. Since then, a meta-analysis of randomised trials showed that the drug's use was associated with an 11% increase in the mortality rate. This study in the journal Biomedicine & Pharmacotherapy aimed to estimate the number of hydroxychloroquine-related deaths worldwide.
  6. Content Article
    This article in Anaesthesia Critical Care & Pain Medicine aims to provide guidelines to define the place of human factors in the management of critical situations in anaesthesia and critical care. The authors aimed to formulate recommendations according to the GRADE® (Grading of Recommendations Assessment, Development and Evaluation) methodology for four different fields:communicationorganisationworking environmenttrainingThe guidelines produced include a set of recommendations to guide human factors in critical situations.
  7. Content Article
    This study published in JAMA Internal Medicine looked at how often diagnostic errors happened in adult patients who are transferred to the intensive care unit (ICU) or die in the hospital, what causes the errors, and what are the associated harms. In this cohort study of 2428 patient records, a missed or delayed diagnosis took place in 23%, with 17% of these errors causing temporary or permanent harm to patients. The underlying diagnostic process problems with greatest effect sizes associated with diagnostic errors, and which might be an initial focus for safety improvement efforts, were faults in testing and clinical assessment.
  8. Content Article
    Through a data sharing agreement, the Faculty of Intensive Care Medicine can access a record of incidents reported to the National Reporting and Learning System (NRLS). Available information is limited and from a single source; all that is know about these incidents is presented in this report. The safety bulletin aims to highlight incidents that are rare or important, and those where the risk is perhaps something we just accept in our usual practice. It is hoped that the reader will approach these incidents by asking whether they could occur in their own practice or on their unit. If so, is there anything that can be done to reduce the risk?
  9. Content Article
    Inconsistent and poorly coordinated systems of tracheostomy care commonly result in frustrations, delays, and harm. The Safer Tracheostomy Care in Adults bundle was a programme of 18 interventions implemented across 20 hospitals in England between August 2016 and January 2018. These interventions were designed to improve the quality and safety of care for patients who have had tracheostomies. This evaluation report outlines why the interventions were needed and assesses their impact, including an estimated reduction in total hospital length of stay per tracheostomy admission of 33.02 days, corresponding to a potential reduction of over £27,000 per admission.
  10. News Article
    Three intensive care units for children are not meeting standards for co-located services, a national report has found. Royal Stoke University Hospital, Royal Brompton Hospital in London and Freeman Hospital in Newcastle, which all have “level three” paediatric intensive care beds for the most seriously ill patients, do not offer specialised paediatric surgery, according to a report from NHS England’s Getting it Right First Time (GIRFT) programme. The report, released in April, said specialised paediatric surgery “should be co-located on the same site” as a paediatric intensive care unit with level three beds and be “immediately available” to meet quality standards set by the Paediatric Intensive Care Society. The report also found the units do not offer services such as trauma, neurosurgery and bone marrow transplantation, which it says is a reflection of the variability and “the poor alignment” of specialised paediatric services at PICUs. Read full story (paywalled) Source: HSJ, 23 May 2022
  11. News Article
    Relatives of intensive care Covid patients were left traumatised by being banned from visiting their seriously ill loved ones during the pandemic, a study has found. Researchers found two-thirds of family members of patients in intensive care were still suffering high levels of symptoms of post traumatic stress disorder (PTSD) three months after their relative was admitted. Symptoms of PTSD include flashbacks, nightmares and physical sensations such as pain, sweating, feeling sick or trembling. Before the Covid pandemic, symptoms of PTSD in family members of intensive care patients were between 15 and 30 per cent, depending on the condition. The team from the University of Colorado School of Medicine said visitation restrictions may have inadvertently generated a secondary public health crisis of stress-related disorders in family members of Covid patients. At the height of the pandemic, hospitals across Britain restricted access to patients, with many people forced to say goodbye to dying loved ones over Skype, or behind screens or windows. Even as late as last winter, a Telegraph investigation showed that a quarter of trusts were still imposing restrictions on visitors. The findings suggest that the rates of PTSD may be higher in relatives than in patients. A previous study by Imperial College and the University of Southampton found that only one-third of patients on ventilators suffer symptoms. Read full story (paywalled) Source: The Telegraph, 25 April 2022
  12. News Article
    While most babies born more than two months prematurely now survive thanks to medical advances, little progress has been made in the past two decades in preventing associated developmental problems, an expert review has found. The review also found that very preterm babies can have their brain development disrupted by environmental factors in the neonatal intensive care unit (NICU), including nutrition, pain, stress and parenting behaviours. A review conducted by experts from the Children’s Hospital of Orange County in the US and the Turner Institute for Brain and Mental Health at Monash University in Australia found that while these neurodevelopmental problems can be related to brain injury during gestation or due to cardiac and respiratory issues in the first week of life, the environment of the NICU is also critical. To improve outcomes for very preterm babies, the review recommended family based interventions that reduce parental stress during gestation, more research into rehabilitation in intensive care and in the early months of life, and greater understanding of the role of environment and parenting after birth. Read full story Source: The Guardian, 3 August 2023
  13. News Article
    Six wards in a busy London Hospital, added at a cost of £24 billion during the pandemic, are lying empty because the builders did not install sprinklers. With the NHS in crisis, the Royal London Hospital in east London, has had to mothball the space, which is large enough to take 155 intensive care beds, while officials work out what to do with it. They have no patients in it since last May. Source: The Sunday Times, 29 January 2023 Shared by Shaun Lintern on Twitter
  14. News Article
    There were more than 3,700 patients a day in hospital with flu last week - up from 520 a day the month before, the latest data from NHS England shows. Of these, 267 people needed specialised care in critical care beds last week. NHS England warns pressures on the health service continue to grow as viruses like flu re-circulate after a hiatus during the pandemic. Prof Sir Stephen Powis, NHS national medical director, said: "Sadly, these latest flu numbers show our fears of a 'twindemic' have been realised, with cases up seven-fold in just a month and the continued impact of Covid hitting staff hard, with related absences up almost 50% on the end of November." He warned this was "no time to be complacent" with the risk of serious illness being "very real" and encouraged those eligible to take up their flu and Covid jabs as soon as possible. Admissions among children under 5 have been high this flu season, as well as among older people. Read full story Source: BBC News, 30 December 2022
  15. News Article
    Staff were suspended by their trust after they were found to have been sleeping in a patient’s bed, a Care Quality Commission (CQC) report has revealed. The regulator inspected acute wards for adults and psychiatric intensive care units at Black Country Healthcare Foundation Trust in February, after safeguarding concerns were raised. As HSJ revealed earlier this year, inspectors investigated a series of incidents, while a referral was also made to the police. As well as reports of staff using a mental health inpatient’s bed, there were complaints involving alleged inappropriate sexual behaviour and a governance breach. The concerns were said to relate to Hallam Street hospital in West Bromwich and Penn Hospital in Wolverhampton. The CQC inspection report said it inspected the service following allegations that “abuse had occurred” and a “multi-agency safeguarding meeting was convened to discuss the investigations of these”. Read full story (paywalled) Source: HSJ, 18 May 2023
  16. News Article
    Critically ill patients “will inevitably die” because hospitals are having to cancel surgery as a direct result of next week’s junior doctors’ strike in England, leading heart experts have warned. There were bound to be fatalities among people with serious heart problems whose precarious health meant they were “a ticking timebomb” and needed surgery as soon as possible, they said. They added that patients would face an even greater risk than usual of being harmed or dying if their time-sensitive operation was delayed because NHS heart units would have too few medics available during the four-day stoppage by junior doctors to run normal operating lists. The trio of cardiac experts are senior doctors at the Royal Brompton and Harefield specialist heart and lung hospitals in London. Those facilities, plus the cardiac unit at St Thomas’ hospital in the capital, have between them postponed between 30 and 40 operations they were due to conduct next week on “P2” patients, whose fragile health means they need surgery within 28 days. “It is no exaggeration to say that delaying surgery for this group [P2s] will result in harm. For some, this may be life-changing. For others, it may mean premature death,” said Dr Richard Grocott-Mason, a cardiologist who is also the chief executive of the Royal Brompton and Harefield hospitals. Read full story Source: The Guardian, 4 April 2023
  17. Content Article
    This survey undertaken by SCATA and supported by the FightFatigue group is looking at rest facilities and culture in anaesthesia and intensive care. Aims: To describe the current situation regarding availability and quality of rest facilities in anaesthetic and intensive care departments in the UK and ROI, compared with current standards. To describe the current situation regarding rest culture in anaesthetic and intensive care departments in the UK and ROI, compared with current standards. To feedback to departments and provide a benchmarking of their practice as compared to current standards and peers nationally. If you would like to take part, please follow the link and enter the data into the data collection tool for each rota, in consultation with colleagues as you feel necessary. The data collected will be shared with partners in the FightFatigue group and used in line with the aims of the project as above and to produce a summary report. In this report, each Trust/Board will be able to identify their own data but not others. Please direct queries to fatigue@scata.org.uk.
  18. News Article
    University College London Hospitals (UCLH) is to host to a new collaboration researching patient safety, after being awarded £3 million in funding from the National Institute for Health and Care Research. The NIHR Central London Patient Safety Research Collaboration (PSRC) aims to improve safety in Surgical, Perioperative, Acute and Critical care (SPACE) services, which treat more than 25 million NHS patients annually. Perioperative care is care given at and around the time of surgery. Amongst the highest risk clinical settings are SPACE services because of the seriousness of the patients’ conditions and the complex nature of clinical decision making. Further risks arise at the transitions of care between SPACE services and other parts of the health and social care system. The research team led by UCLH and UCL will develop and evaluate new treatments and care pathways for SPACE services. This will include new interventions such as surgical and anaesthetic techniques, and new approaches to predicting and detecting patient deterioration. They will also help the NHS become safer for patients through the development of innovative approaches to organisational learning, and to how clinical evidence is generated. The PSRC’s learning academy will support the next generation of patient safety researchers through a comprehensive programme of funding, mentoring and peer support. The team includes frontline clinicians, policy makers and world-leading academics across a range of scientific disciplines including social and data science, mechanical and software engineering. Patients and the public representing diverse backgrounds are key partners in the collaboration. Professor Moonesinghe said: “We have a great multidisciplinary, multiprofessional team ready to deliver a truly innovative programme to improve patient safety in these high-risk clinical areas. As a uniquely rich research environment, UCLH and UCL are well placed to lead this work, and we are looking forward to collaborating with clinicians and patients across the country to ensure impact for the whole population which the NHS serves.”
  19. News Article
    New data has shown the number of coronavirus patients being admitted to hospital and intensive care units across the country has risen as lockdown rules are set to be eased further on Monday. The Public Health England (PHE) data, published on Friday, covers 134 NHS trusts across the country and shows the daily rate of new patients admitted to hospital and critical care with COVID-19 has risen compared to recent weeks, with London experiencing a sharp spike in new admissions in the past week. The south east region also saw an increase. The surveillance data on the spread of COVID-19 throughout England has also revealed an increase in the number of people testing positive at their GP. Read full story Source: Independent, 31 May 2020
  20. News Article
    Delirium and confusion may be common among some seriously-ill hospital patients with COVID-19, a study in The Lancet suggests. Long stays in intensive care and being ventilated are thought to increase the risk, the researchers say. Doctors should look out for depression, anxiety and post-traumatic stress disorder (PTSD) after recovery, although most patients, particularly those with mild symptoms, will not be affected by mental health problems. The evidence is based on studies of patients with severe acute respiratory syndrome (Sars) and Middle-East respiratory syndrome (Mers), as well early data on COVID-19 patients. Read full story Source: BBC News, 19 May 2020
  21. News Article
    Restarting NHS services will be an even greater challenge than coping with the first coronavirus infections, health think tanks and hospital chiefs have warned. Since March, the NHS has freed up more than 33,000 beds to prepare for an influx of COVID-19 patients needing intensive care, but since the peak of infection health chiefs have worried that delays to care were harming patients. Around 46,000 so-called excess deaths have been recorded during the pandemic, as compared against a five-year average. Around a quarter of these are believed to be unrelated to COVID-19. In a joint statement, the Health Foundation, Nuffield Trust and King’s Fund think tanks have said it could take months before the NHS and social care are able to fully restart. All three bodies will be giving evidence to the Commons health committee on Thursday, where they will warn about the impact on the health service’s “exhausted staff” and demand action to help care homes – which are now at the frontline in the fight against coronavirus. The experts will stress the need for the NHS to begin planning for a second peak of infections, especially if it comes in winter – when the service is usually overwhelmed by seasonal flu. They will warn about concerns over how the NHS manages the risk of infection, with the need for more protective equipment, social distancing and increased testing. This will “severely limit capacity for many months”, they said. Read full story Soruce: The Independent, 14 May 2020
  22. News Article
    Doctors, nurses and paramedics have been given conflicting advice about when to start resuscitation for coronavirus patients, amid fears the procedure could put them at risk of infection. While Public Health England has said it does not believe CPR creates a risk, the UK’s Resuscitation Council – which is responsible for setting standards for resuscitation in the NHS – has said it believes there is a risk and staff should wear full equipment. The Independent has seen several examples of different messages being sent out to hospital staff and ambulance workers, and some NHS trusts were forced to change their guidance within a matter of days after PHE changed its stance. One set of guidance could mean a delay in starting CPR for patients while staff put on protective equipment, while the other means staff could be at risk of being infected with coronavirus. Ken Spearpoint, a former consultant nurse and resuscitation officer at Imperial College Healthcare Trust, said the situation had led to confusion and created an “ethical dilemma” for some staff who were being forced to choose between the Resus UK’s position and their trust’s guidance. Read full story Source: The Independent, 6 April 2020
  23. News Article
    Details of a massive ramp-up in intensive care beds have been circulated to NHS bosses in London, amid concerns from national leaders that they are four days away from full capacity. In a call with local leaders, the NHS’ national director for mental health, Claire Murdoch, spoke about the intense pressures facing the acute system due to the coronavirus outbreak. According to several people on the call, she said London “runs out of [ICU] beds in four days” if urgent action is not taken. She also warned the need for intensive care beds will now double every three days, the sources said. The capital’s hospitals are frantically planning to try to quadruple their “surge capacity” in intensive care over the next fortnight, from around 1,000 surge beds over the weekend just passed, to more than 4,000 in two weeks’ time. Read full story Source: HSJ, 24 March 2020
  24. News Article
    New 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
  25. Content Article
    This customisable, educational toolkit published by the Agency for Healthcare Research and Quality (AHRQ) aims to help ICUs reduce rates of central line-associated bloodstream infection (CLABSI) and catheter-associated urinary tract infection (CAUTI). The materials can be used to assess current safety practice, implement new approaches and overcome particular challenges related to CLABSI and CAUTI in ICUs.
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