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Found 19 results
  1. Content Article
    This study examines the prevalence of advanced care planning (ACP) for patients undergoing endoscopic, fluoroscopic, laparoscopic or open surgical gastrostomy tube procedures at an academic hospital in the USA. The authors found that only 10.6% of included patients had accessible ACP documents available within their electronic medical record (EMR) and that Black patients had lower rates of ACP documentation. They also highlight an association between ACP documentation and decreased hospital length of stay, with no difference in mortality. The authors recommend the expansion of ACP in perioperative settings.
  2. News Article
    A man died after A&E doctors sent him home from hospital and “told him to drink Lucozade” despite him vomiting 100 times in 24 hours. Nick Rousseau died from an undiagnosed blocked bowel in 2019 after doctors at Milton Keynes Hospital failed to spot that he had the life-threatening condition. The 47-year-old was sent home twice in three days and reassured he “would be alright” as doctors believed he had gastroenteritis, his “devastated” wife Kimberly White said. But Mr Rousseau was actually suffering from an ischaemic bowel, a condition which blocks the arteries to the bowel. He had been to see his doctors several times and had lost three stones in weight over two years due to vomiting and diarrhoea but was never diagnosed. His family, represented by Osbornes Law, received a six-figure payout in June from Milton Keynes University Hospital NHS Foundation Trust. While it did not admit negligence, it accepted that there were features of Mr Rousseau’s illness which could have justified admission, inpatient observation, and further tests, which could have given a definitive diagnosis. Read full story Source: The Independent, 4 August 2023
  3. News Article
    NHS England was aware of concerns about upper gastrointestinal surgery at a hospital nearly three years before the Care Quality Commission intervened to stop it being carried out, HSJ can reveal. NHSE in the South East commissioned a report into upper GI cancer services in parts of the region in January 2020. In particular, HSJ understands the review was prompted by concerns the small number of surgeries carried out at the Royal Sussex County Hospital in Brighton meant it may be unable to comply with parts of the service specification and face difficulties maintaining an adequate surgical workforce rota. Despite these concerns, Brighton continued to carry out upper GI surgery until the CQC suspended planned oesophagic-gastric resections last August. Read full story (paywalled) Source: HSJ, 14 March 2023
  4. Content Article
    Based on data from 22,132 patients who had emergency bowel surgery in England and Wales between December 2020 and November 2021, this report from the National Emergency Laparotomy Audit (NELA) found that improvements in in-hospital mortality have levelled off. As such, it calls for hospitals to continue to engage with NELA data collection and, in particular, to make use of real-time data and resources available to drive clinical and service quality improvement.
  5. Content Article
    This report from the National Oesophago-Gastric Cancer Audit (NOGCA) focuses on the care received by patients diagnosed with invasive epithelial cancer of the oesophagus, gastro-oesophageal junction (GOJ) or stomach, or high-grade dysplasia (HGD) of the oesophagus between April 2019 and March 2021. For outcomes of curative surgery among people with OG cancer, data are reported for a three year period (April 2018 to March 2021).
  6. News Article
    A consultant surgeon refused to attend hospital to carry out urgent surgery at a trust which later had upper gastrointestinal surgery suspended after an unannounced Care Quality Commission visit. The CQC report into upper GI surgery at the Royal Sussex County Hospital in Brighton – based on an inspection in August – said incident reports revealed occasions when upper GI surgeons could not be contacted or refused to come into hospital to treat patients. In one case, a consultant would not come in to carry out urgent surgery, it added. Low numbers of surgeons meant the on-call rota for upper GI was shared with the lower GI surgeons. This meant an upper GI specialist was not always available immediately, despite guidance from a professional body that 24/7 subspecialty cover was needed at centres which carry out major resectional surgery. This surgery was suspended at the RSCH after the August inspection and has yet to be reinstated. Mortality at both 30 and 90 days for patients with oesophago-gastric cancer was twice the national average between 2017 and 2020 – though the trust was not an outlier – and there was an increasing number of emergency readmissions for patients who had undergone upper GI surgery, the report said. Read full story (paywalled) Source: HSJ, 1 December 2022
  7. News Article
    COVID-19 patients have active and prolonged gut viral infection, even in the absence of gastrointestinal symptoms, scientists in Hong Kong showed. The coronavirus may continue to infect and replicate in the digestive tract after clearing in the airways, researchers at the Chinese University of Hong Kong said in a statement Monday. The findings, published in the medical journal GUT, have implications for identifying and treating cases, they said. SARS-CoV-2 spreads mainly through respiratory droplets -- spatters of virus-laden discharge from the mouth and nose, according to the World Health Organization. Since the first weeks of the pandemic, however, scientists in China have said infectious virus in the stool of patients may also play a role in transmission. The finding “highlights the importance of long-term coronavirus and health surveillance and the threat of potential fecal-oral viral transmissions,” Siew Chien Ng, associate director of the university’s Centre for Gut Microbiota Research, said in the statement. Read full story Source: Bloomberg, 7 September 2020
  8. Content Article
    Getting It Right First Time (GIRFT) is designed to improve the quality of care within the NHS by reducing unwarranted variations. By tackling variations in the way services are delivered across the NHS, and by sharing best practice between trusts, GIRFT identifies changes that will help improve care and patient outcomes, as well as delivering efficiencies such as the reduction of unnecessary procedures and cost savings.
  9. Content Article
    Misplacement of nasogastric tubes can have disastrous consequences for patients and is listed as a “never event” by NHS England. When Lancashire Teaching Hospitals NHS Foundation Trust had two of these never events, the nutrition nursing team carried out a system-wide evaluation to identify problems and develop plans to address them. An e-learning package, robust standardisation in staff’s approach to patient care, re-setting “red lines” to support and empower staff, and the introduction of monitoring and reporting systems have contributed to improving patient safety.
  10. Content Article
    This position paper was prepared by the Nasogastric Tube Special Interest Group of BAPEN. Dr Trevor Smith, BAPEN President commented:  “It is essential that patient safety is at the top of the agenda of every NHS Trust and Health Board. Nobody in need of artificial nutrition should be at risk of a Never Event, so we endorse the special NGT placement training for a select group of staff in every hospital. Our mission is to ensure everybody receives optimal nutritional care, but it is also important to us to protect frontline healthcare professionals from the risk of avoidable and incredibly distressing mistakes. We hope this paper goes some way to encouraging Trusts and Health Boards to move towards far safer practices.”
  11. Content Article
    These coroner reports relate to two patients, Stephen and Peter, who both died as a result of complications from use of a nasogastric tube. The coroner notes concerns that this issue may be more widespread and has therefore highlighted the report to several relevant bodies who she advises to take action.
  12. Content Article
    Since 2015 Quomodus has developed the digital course 'Diathermy – a practical guide to electrosurgery' for surgeons and other professional users of electrosurgery. The 30-minute course covers the history of electrosurgery, indication and proper use, adverse effects and complications associated with the use of diathermy. The course has been tested and quality assured by health professionals in Scandinavia. The course is flexible, user friendly and applies to all models of diathermy equipment currently on the market.
  13. News Article
    An acute trust is reviewing thousands of gastroenterology cases for possible patient harm, after details emerged of an ‘extremely concerning’ list of patients who have not had follow-up appointments for up to six years since being treated. HSJ understands major concerns have been raised internally at Liverpool University Hospital Foundation Trust, over 9,500 patients who received treatment at Aintree University Hospital as far back as 2015, but have not had a follow-up appointment. Whistleblowers have also contacted the Care Quality Commission, which has confirmed it is looking into the issues. Well-placed sources said around 7,000 of the cases have “target dates” for an outpatient follow-up that are in the past. Around 20 of these cases were supposed to be seen in 2015 or 2016, with around 400 dating back to 2017, and around 900 to 2018, the sources said. The remaining 2,500 cases either have no target date or have not yet had a follow-up appointment booked. Read full story (paywalled) Source: HSJ, 8 April 2021
  14. News Article
    A trust’s gastroenterology service was ‘in a very poor state with significant risks to patient safety’ and had poor teamworking which “blighted” the service, an external review found. The problems in the service at Salisbury Foundation Trust, Wiltshire, were so severe that the Royal College of Physicians suggested it should consider transferring key services such as management of GI bleeds and the care of hepatology patients to other hospitals. The service was struggling with poor staffing which had led to increased reliance on a partnership with University Hospital Southampton Foundation Trust, outsourcing and the daily use of locum consultants, according to the report. The trust board had identified “inability to provide a full gastroenterology service due to lack of medical staff capacity” as an extreme risk. The report said: “This review was complex and necessary as the gastroenterology service is in a very poor state with significant risks to patient safety and the reputation of the trust. We found a wide range of problems which now need timely action to ensure patients are safe.” Read full story (paywalled) Source: HSJ, 7 June 2021
  15. Content Article
    Alexander James Davidson was aged 17 years and 6 months when he died at the Queens Medical Centre on 26 February 2018. Alex was previously fit and well before suddenly taking ill with abdominal pain on 17 January 2018. Between that date and his admission to the Queens Medical Centre on 8 February 2018, Alex made contact with his GP on three occasions, had four telephone triage assessments undertaken by the NHS 111 service and two admissions to his local Accident & Emergency Department at the Kingsmill Hospital. Alex’s symptoms of sudden onset acute abdominal pain, tachycardia, and vomiting and diarrhoea were attributed either to stress or to a bout of gastroenteritis. At no stage prior to 8 February 2018 was gallstones or pancreatitis considered as a differential diagnosis. When Alex was eventually admitted to the Queens Medical Centre Emergency Department on 8 February 2018, he was found to be septic as a result of an infected and necrotic pancreatic pseudocyst, which had evolved as a complication of gallstone pancreatitis, a rare condition in someone of Alex’s age. Despite medical intervention, Alex did not survive. The inquest explored the medical treatment and intervention that Alex received in the six weeks prior to his death. The medical evidence concluded that the pancreatic pseudocyst had likely formed by the time Alex began vomiting on 18 January 2018, and from that point onwards, it was unlikely he would survive even with treatment on account of the high mortality rate associated with this condition
  16. Content Article
    Hospital Watchdog is a nonprofit patient advocacy organisation in the US that champions safe hospital care for patients. They are a diverse group that includes nurses, physicians, pharmacists, healthcare experts, attorneys and members of the public. Some of them have experienced or witnessed medical errors that led to an extremely serious or tragic outcome. They are committed to improving unsafe conditions in hospitals. In February 2019, Hospital Watchdog conducted an in-depth interview with Ms. Dena Royal, a former paramedic, and respiratory therapist. Dena’s mother, Martha Wright, bled to death following a colonoscopy and a series of tragic nursing mistakes at Cass Regional Medical Center in Harrisonville Missouri.
  17. Content Article
    A blog from Dr Linda Dykes. "Bryn was my patient. He died. He may have stood a better chance of survival had I been aware of the risk of small bowel volvulus in an adult.  I produced this reflective learning resource with some colleagues - and with Bryn's widow, whom we call Fiona.  Please read it... it may help you save a life one day."
  18. Content Article
    Michael Seres was a husband, a father, a successful entrepreneur and many more things. Most importantly in some ways, he was a lifelong Chrohn's patient who finally succumbed to an associated cancer last weekend. His loss has hit hard those who knew and admired him and the tributes have been numerous and from both clinicians and other patients. His death is a real loss for anyone interested in promoting patient engagement, and the involvement of patients in safer medical practise.
  19. Content Article
    Emergency abdominal surgery (EAS) refers to high-risk intra-abdominal surgical procedures undertaken for acute gastrointestinal pathology. The relationship between hospital or surgeon volume and mortality of patients undergoing EAS is poorly understood. This study, published in BMJ Open, examined this relationship at the national level.
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