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Found 26 results
  1. Content Article
    Implementation challenges The investigation highlighted the main implementation challenges. This includes: National consistency in drug libraries – smart infusion pumps have an inbuilt dose error reduction system (DERS) which requires the use of a drug library. The investigation found that drug libraries were developed ‘locally’ and that there is no agreed national drug library for use in NHS. They also found that there is no national guidelines or standards on how to implement the libraries. Significant changes in processes – introducing the technology requires significant changes to prescribing and administration processes in trusts. The investigation found that procedure and guidance documents often needed updating, and variations in medication practice were ‘locally managed’ and were rarely shared within and between hospitals. Provision of specialist IT support and infrastructure – substantial IT infrastructure is needed to support the integration of smart pump technology. Software is needed to upload the drug library to smart pumps, download data logs (including any errors detected) and monitor the status of each smart pump. The investigation highlighted that maintaining the required IT infrastructure required specialist staff roles and often a new skill set. The investigation found that the implementation of smart pump functionality would benefit from the use of risk management practices, as requirements are complex and similar to the introduction of a new IT system. Existing NHS Clinical risk standards could provide a basis for both manufacturers and trusts to work together to manage risks.
  2. Content Article
    Written Questions are a parliamentary mechanism by which Members of the Senedd can table questions specifically for a written answer by the Welsh Government or the Senedd Commission. Laura Anne Jones MS asked what progress had been made in Wales in implementing the findings of the Cumberlege Review (The Independent Medicines and Medical Devices Review). This review examined how the healthcare system in England responds to reports about the harmful side effects from medicines and medical devices and consider how it could respond to them more quickly and effectively in the future. Vaughan Gething MS, Minister for Health and Social Services, responded as follows: The Cumberlege recommendations are primarily focused on England but they have implications for Wales. I issued a written statement on 15 July about the Cumberlege review: https://gov.wales/written-statement-baroness-cumberleges-announcement-use-surgical-mesh In that statement, I said the principle of high vigilance to ensure mesh use is restricted until the same conditions Baroness Cumberlege identified in her report are met should also apply in Wales. Her recommendations were consistent with those made by the review panel, which I set up at the end of 2019. It is my expectation that sufficient levels of clinical governance, including consent, audit and research are in place in health boards in Wales to ensure all women can be confident that all possible safeguards are in place. The evidence we have already of a significant reduction in the use of vaginal mesh procedures in Wales suggests a “pause” is already largely in place, driven by a change in clinical decision making during recent years. However, it is my expectation that these additional restrictions will be the case until the requirements for increased safeguards can be met. Action has already been taken on some of the recommendations. Specialist mesh centres have been identified in Swansea and Cardiff and work is underway in establishing a UK-wide medical device information system. In addition, the Women’s Health Implementation Group will be tasked with considering many of the recommendations of the Cumberlege review as they pertain to mesh, as this is consistent with work the group is already doing in this area. My officials are examining the other recommendations which relate to Wales and are working with the other UK governments to look at those recommendations with a UK remit. The Medicines and Medical Devices Bill, currently before the House of Lords, will also impact in relevant areas. I will issue a further statement when officials have completed their assessment of the options available and their implications for the future effectiveness of Wales’ healthcare service.
  3. Community Post
    We should all strive to keep antibiotics working for our NHS surgeons and future generations, by decreasing antibiotic use in medicine. It is mums themselves who could dramatically decrease antibiotic use, in the only medical specialty where this is possible - in obstetrics - by keeping skin intact; by being informed of the 10cm diameter that 'Aniball' and 'Epi-no Delphine Plus' birth facilitating devices, the mechanical version of Antenatal Perineal Massage, achieve by skin expansion (much like by 'earlobe skin expanders') prior to birth, for back of baby's head. This enables a normal birth for many more babies by shortening birth, with no cutting (episiotomies) or tearing, and much fewer Caesarean sections, as each Caesarean section requires antibiotics to be injected into mum, to kill any bacteria, which might have invaded a skin cell, from being implanted with that skin cell, deep into the wall of the uterus, by the surgeon's knife. There are around 750,000 births in the UK alone and three-quarters of mums are damaged during birth and at risk of developing infection; so a dramatic decrease in antibiotic use is possible. Empowering mums with knowledge; that both the skin and the coats of the pelvic floor muscles, which form the floor of the lower tummy, can be stretched painlessly, in preparation of birth, from the 26th week of pregnancy, so a gentler, kinder birth for both baby and mum becomes possible by decreasing risky obstetric interventions. Muscle can be stretched to 3 times its original length, if stretched painlessly over 6 or more occasions, and still retains its ability to recoil back, contracting to its original length. So there is no damage to mum. Baby's delicate head is not used to achieve this 'birth canal widening', because Antenatal Perineal Massage or Aniball or Epi-no Delphine Plus have already achieved this prior to the start of birth. In birth this stretching is rushed within the last 2 hours of birth, with risk of avulsion of pelvic floor muscle fibres from the pubic bone and risk of skin tearing or the need for episiotomy. The overlying skin will likewise stretch without tearing if done over 6 or more occasions. The maximal opening in the outlet or lower part of the pelvis is 10cm diameter, so 10cm diameter is the goal of the birth aiding devices and 'Antenatal Perineal Massage' or 'Birth Canal Widening' - opening doors for baby maximally. The mother reviews on 'Aniball' and 'Epi-no Delphine Plus' are impressive: Wanda Klaman, a first time mum, gives birth at nearly 42 weeks to a 4.4kg baby, with no need for episiotomy or forceps; Sophie of London, avoids episiotomy, when forceps are used to aid delivery for her baby who lays across her tummy - transverse lay, because the skin at this opening is so stretchy thanks to the birth facilitating devices. Cochrane Collaborate Report on Antenatal Massage https://pubmed.ncbi.nlm.nih.gov/23633325/ https://www.dailymail.co.uk/news/article-7450045/Fears-infections-pandemic-grow-NINETEEN-new-superbugs-discovered-UK.html https://www.mirror.co.uk/news/uk-news/mistakes-maternity-wards-setting-nhs-22702909
  4. Content Article
    During the debate there were contributions from a range of parliamentarians reflecting on the First Do No Harm report and the implementation of its recommendations in Scotland. Some points of interest from the debate included: Jeane Freeman MSP indicated the intention of the Scottish Government to implement the recommendations of the First Do No Harm report which fall within its remit and powers. Their discussion about the report's recommendation that specialist centres should be set up to provide comprehensive treatment, care and advice for those affected by implanted mesh. While Jeane Freeman noted that a National Mesh Removal Service had been established in Glasgow last year, Neil Findlay MSP expressed concerns that the levels of coproduction involved in the design and delivery of this service were inadequate. Alison Johnstone MSP highlighted the particular impact of these issues on women and noted nthat the findings reflected the ways in which women are disadvantaged in accessed health and social care services. In her closing remarks Clare Haughey MSP, Minister for Mental Health, noted the intention to begin a consultation on the Scottish Government's proposal to introduce a Patient Safety Commissioner. Follow the link below for the full transcript.
  5. News Article
    A new report has highlighted how point-of-care scanning in the NHS can help to improve patient safety, saving the NHS millions of pounds. Six NHS hospital trusts which implemented regular point-of-care scanning have ensured complete traceability of healthcare items to help improve patient safety while securing millions of pounds of savings and releasing thousands of hours of clinical time, a new report reveals. ‘A scan of the benefits: the Scan4Safety evidence report’ details the results at hospital trusts that took part in a national two-year programme, known as Scan4Safety, to investigate the benefits of point-of-care barcode scanning in the NHS. Full article here We wonder if @Richard Price might like to post more about what the impact of Scan4safety has been at University Hospitals Plymouth. Perhaps here: https://www.pslhub.org/learn/commissioning-service-provision-and-innovation-in-health-and-care/digital-health-and-care-service-provision/other-health-and-care-software/
  6. Content Article
    Recommendations The Government should immediately issue a fulsome apology on behalf of the healthcare system to the families affected by Primodos, sodium valproate and pelvic mesh. The appointment of a Patient Safety Commissioner who would be an independent public leader with a statutory responsibility. The Commissioner would champion the value of listening to patients and promoting users’ perspectives in seeking improvements to patient safety around the use of medicines and medical devices. A new independent Redress Agency for those harmed by medicines and medical devices should be created based on models operating effectively in other countries. The Redress Agency will administer decisions using a non-adversarial process with determinations based on avoidable harm looking at systemic failings, rather than blaming individuals Separate schemes should be set up for each intervention – HPTs, valproate and pelvic mesh – to meet the cost of providing additional care and support to those who have experienced avoidable harm and are eligible to claim. Networks of specialist centres should be set up to provide comprehensive treatment, care and advice for those affected by implanted mesh; and separately for those adversely affected by medications taken during pregnancy. The Medicines and Healthcare products Regulatory Agency (MHRA) needs substantial revision particularly in relation to adverse event reporting and medical device regulation. It needs to ensure that it engages more with patients and their outcomes. It needs to raise awareness of its public protection roles and to ensure that patients have an integral role in its work. A central patient-identifiable database should be created by collecting key details of the implantation of all devices at the time of the operation. This can then be linked to specifically created registers to research and audit the outcomes both in terms of the device safety and patient reported outcomes measures. Transparency of payments made to clinicians needs to improve. The register of the General Medical Council (GMC) should be expanded to include a list of financial and non-pecuniary interests for all doctors, as well as doctors’ particular clinical interests and their recognised and accredited specialisms. In addition, there should be mandatory reporting for pharmaceutical and medical device industries of payments made to teaching hospitals, research institutions and individual clinicians. The Government should immediately set up a task force to implement this Review’s recommendations. Its first task should be to set out a timeline for their implementation. Response from Patient Safety Learning Patient Safety Learning welcomes the publication of the First Do No Harm report today from the Independent Medicines and Medical Devices Safety Review. The Chair of the review, Baroness Julia Cumberlege, highlighted in this that they found the healthcare system to be "disjointed, siloed, unresponsive and defensive" to the patients effected by these issues. She also noted that: ‘The system is not good enough at spotting trends in practice and outcomes that give rise to safety concerns. Listening to patients is pivotal to that’ The report highlighted some key themes consistent with other major patient safety failures: Patients not being engaged in their care: Lacking the information required to make informed choices, awareness of how to report problems and their experiences not being recognised. Ineffective reporting: Data not being utilised to identify and address patient safety issues. Existing reporting systems not being effective enough to capture this information and share learning widely. Blame culture: Persistent failure to acknowledge when things go wrong for fear of blame, reducing the ability to address threats to patient safety. Patient Safety Learning considers that patient safety is currently treated as one of many priorities to be weighed against each other. We think it is wrong that safety is negotiable. Patient safety must be core to the purpose of healthcare, reflected in everything that it does.
  7. Content Article
    Michael was diagnosed with Crohn's disease at the age of 12 and had his first operation at 14. He died last weekend and was the same age as me. Our daughters were in the same year at secondary school together, and we got to know each other that way at first and then through our mutual interest in health care. When he awoke from an operation to discover he had a stoma bag, he didn't wallow. He bought items online to make it a 'smart' stoma bag to be able to get an alert when it was near full and provide useful data to his medical consultants. This was the type of person he was. Whenever I needed help in anything and asked him, he would unconditionally do everything he could to help, and never failed to deliver – I wish I had been able to do more for him. When he realised that thousands of other patients would be able to benefit from his smart ostomy bag, he tried to get innovation funding to develop and manufacture it at scale for the NHS. He tried over 40 times and received over 40 rejections. People on the other side of the Atlantic were able to see what the NHS couldn't, and 11 Health (he was the 11th person to have a bowel transplant) moved to the West Coast of the USA and grew quickly. He was 'patient in residence' at Stanford Medical school, one of the first such roles in the world. With the clinicians at Stanford, they created the Everyone Included programme, a joint initiative between clinicians and patients which as he described it is "a framework for healthcare innovation, implementation and transformation based on principles of mutual respect and inclusivity". He mentioned this and his journey as a patient in his Ted X talk in 2018. In that talk, he calls for a Chief Patient Officer to work with healthcare execs in co-designing new services for patients or improving existing services. Involving patients in this sort of work is a key foundation for safer healthcare systems. This is not a non-exec role, it is not an arms length committee tick box role. It is a role that can have a profound effect on the ways that services are delivered to patients. It is hugely important and no UK care providers has anyone like this on their exec teams. If you know different, please comment on it below. I think it is about time that a movement to appoint Chief Patient Officers into Trusts was started, don't you? See here for a detailed interview with Michael in 2018: https://www.highland-marketing.com/interviews/hm-interview-michael-seres/
  8. Content Article
    What can I learn? Practical guidance and examples of best practice in the design of infusion devices How design can be used to change and make safer the use of infusion devices in practice. Principles that can be widely applied to the design of other technologies
  9. Content Article
    The aims of this study were to: eradicate accidental administration of medication into the arterial line and improve arterial line safety estimate the prevalence of wrong route arterial line drug errors conduct primary research implement the NIC in the East of England assess cost effectiveness and the uptake of the NIC in the East of England understand the reasons for barriers to adoption.
  10. Content Article
    Key points Medication errors are the most common type of error affecting patient safety and the most common single, preventable cause of adverse events. Medicines calculations can assist in preventing an inaccurate medicines dose from being administered to the patient, which could result in suboptimal therapeutic benefit and/or possible harm to the patient. It is crucial for IV infusion calculations to be accurate, because these medicines directly enter the venous system and generally have a prompt action. Therefore, there is limited possibility of removing the medicine if an error is made. Individual nurses and healthcare organisations must ensure that medicines calculation skills are developed and maintained in practice.
  11. Community Post
    We are looking into introducing a new device to deliver CPAP at ward level into our trust. Currently we use NIPPY machines which can deliver some PEEP when in a selected mode, however the downfall to this is, it can only produce an oxygen concentration of around 50%. Often, the patient groups that require this intervention are on high oxygen requirements and so particularly in the early stages would benefit from a device that could deliver both. I have previously worked with Pulmodyne 02-Max trio which allows up to 90% oxygen and PEEP up to 7.5cmH20. Majority of patients responded very well to this treatment. I wondered whether any other trusts/ team have any other experiences/ devices that they may use and recommend? @Danielle Haupt@Claire Cox@Emma Richardson@Mandy Odell@PatientSafetyLearning Team@Patient Safety Learning@Patient safety Hub@CCOT_Southend
  12. Content Article
    The webinar covers: human factors pitfall of hospital procurement usability testing task efficiency examples of good and not so good design.
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