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Nurses are at the forefront of health and social care delivery. Often they are also leading, championing and driving change for patient safety. In this edition of our ‘Top picks’ series we celebrate some of the amazing work nurses are doing to prevent avoidable harm and improve patient and staff experience. The examples below include blogs, interviews and practical improvement projects. They have been shared with us by members of the hub, a global community of people passionate about patient safety. You can sign up to the hub here, it’s free and easy to do.  Safety tools, approaches and insights Implementing the aSSKINg pressure ulcer care bundle – a blog by Susan Martins Nurse-led use of technology to enable better care - Homerton University Hospital Action Card App Yellow kits - an innovation to reduce the risk of falls in Accident and Emergency departments Friends of African Nursing: Training perioperative nurses across Africa Measuring standards of care, not negative outcomes Nobody left behind: Improving the health of people with learning disabilities and reducing inequalities across primary care Tackling antibiotic underdosing: Interview with Ruth Dando, Head of Nursing for Theatres, Critical Care and Anaesthetics at BHRUHT Insights from a reducing falls project at the University Hospital Southampton How a catheter removal project improved care for patients while saving money and carbon emissions Safety culture How a simple newsletter can improve culture and communication within teams It’s time to look beyond perceived barriers to Family Integrated Care in the NICU and create a culture for change Safety Incident Supporting Our Staff (SISOS) Safety Chats Interviews with nurses In our series of Patient Safety Spotlight interviews, we talk to different people about their role and what motivates them to make health and social care safer. Martin Hogan, Lead Professional Nurse Advocate at Central London Community Healthcare NHS Trust Kathy Nabbie, Theatre Scrub Nurse Practitioner and Non-medical Surgical First Assistant Angela Hayes and Caroline Morris, Palliative Care Nurse Specialists at The Christie NHS Foundation Trust In an episode of our Speaking up for patient safety interview series, we spoke to Rebecca Wight, a nurse consultant practitioner. Rebecca talks about what happened to her when she tried to raise patient safety concerns about a colleague. Speaking up for patient safety: Rebecca Wight in conversation with Peter Duffy and Helen Hughes Could you share for safety? Are you a nurse with a passion for patient safety? Do you have insights, projects or practical tools and resources that could be shared for wider benefit? Perhaps you’d like to feature in one of our Spotlight interviews? You can get in touch with our hub editorial team by emailing us at [email protected]

Nursing is central to patient safety, quality of care and the sustainability of health systems, yet its contribution is frequently undervalued in policy and practice). This seminar will present an overview of the existing international and UK evidence on the association between safe nurse staffing and patient and staff outcomes, including mortality, failure‑to‑rescue and quality of care. It will examine how inadequate staffing is linked to missed care, preventable harm, staff burnout and attrition, contributing to the widening workforce crisis across health and care systems. Attention will be paid to the gendered nature of the nursing workforce, with women comprising nearly nine in ten registrants in the UK, and how structural inequities, misrecognition and limited professional agency shape decision‑making about safety and workforce investment. Positioning nursing as a critical yet often invisible ‘safety net’, this session demonstrates that patient safety cannot be meaningfully addressed without nursing workforce evidence at its core. Speaker: Dr Kate Kirk, Associate Director of Nursing Workforce Academy, Royal College of Nursing and Prof Amanda Adegboye, Head of Workforce Research, Royal College of Nursing Register

At Patient Safety Learning we believe that sharing insights and learning is vital to improving outcomes and reducing harm. That's why we created the hub; providing a space for people to come together and share their experiences, resources and good practice examples.  To support. WHO's World Immunisation Week, we have picked 14 resources full of practical advice about vaccination in a range of settings. 1 WHO: Vaccines explained "Vaccines Explained" is a series of illustrated articles from the World Health Organization that describe how vaccines work, how they’re developed and distributed and how their safety is carefully monitored. 2 EDUCATE KS3 lesson pack: HPV vaccination Co-produced by young people and researchers from the University of Bristol and London School of Hygiene and Tropical Medicine, ‘EDUCATE’ helps teach students about the human papillomavirus (HPV) vaccine and provide reassurance about receiving the vaccine, which is usually offered to teenagers at school as part of the national vaccination programme. 3 The Green Book: Immunisation against infectious diseases The Green Book is published by the UK Health Security Agency and contains the latest information on vaccination procedures for vaccine-preventable infectious diseases in the UK. It offers guidance on general safety considerations and clinical procedures relating to immunisation, as well as specific information on a wide range of diseases and vaccinations. 4 Vaccination awareness toolkit for children and young people The School And Public Health Nurses Association (SAPHNA) has coproduced this vaccination toolkit with children and young people. It aims to increase young people's awareness of what vaccines are, why they are important and what to expect from different types of vaccines. 5 Improving communication about the human papillomavirus (HPV) vaccination programme among families In England, young people aged 12 to 13 years are offered immunisation against HPV as part of the NHS vaccination programme. However, research by the National Institute for Health and Care Research (NIHR) Health Protection Research Unit in Behavioural Science and Evaluation at the University of Bristol has identified sustained inequalities in uptake by area and minority ethnic groups. They have produced a number of information videos to address information needs about HPV among young people. They were coproduced with young people from disadvantaged backgrounds and diverse ethnic groups. 6 A visual guide to vaccines for the UK routine vaccination programme This guide by the UK Health Security Agency is designed to help ensure healthcare workers administer the right vaccines at the right time. It provides photos of all vaccines used in the UK routine immunisation programme, as well as information on when each vaccine should be given and its different trade names and abbreviations. 7 Pain management in infant immunisation: A cross-sectional survey of UK primary care nurses Childhood immunisation is a critically important public health initiative. However, since most vaccines are administered by injection, it is associated with considerable pain and distress. Despite evidence demonstrating the efficacy of various pain management strategies, the frequency with which these are used during routine infant vaccinations in UK practice is unknown. This study aimed to explore primary care practice nurses’ use of evidence-based pain management strategies during infant immunisation, as well as barriers to evidence-based practice. 8 Shingles Vaccination Programme: GP toolkit for improving uptake About 1 in 5 people who have had chickenpox develop shingles, predominantly those who are over 70. However, uptake rates of the shingles vaccine are falling in London and across England. The purpose of this toolkit is to help GPs better protect their patients by suggesting ways to improve uptake of the shingles vaccine. These suggestions are based on best practice and evidence and have been shown to work with little or no cost to practices. 9 Interview with Charlet Crichton, founder of UKCVFamily UKCVFamily was set up in November 2021 to support patients in the UK who have had an adverse reaction to a Covid-19 vaccination. The group provides help and advocacy as well as raising awareness amongst healthcare professionals, the media and the Government. In this video for the hub, founder of UKCVFamily Charlet Crichton talks about why she established the group and describes the support it offers to patients. 10 Measles and rubella vaccine microneedle patch: new hope to reach the unreached children This Lancet article looks at how microneedle patches (MNPs) could potentially improve coverage of childhood vaccinations by providing a more thermostable, individual-dose, injection-free vaccine delivery device suitable for administration by local, non-medical personnel. MNPs could also reduce wasted vaccine doses, needle-stick injuries and breaks in the cold chain, as well as making waste management easier. 11 Whooping cough resurgence as vaccination rates slump Official data on whooping cough show that reports of suspected cases are at a 15-year high in the first three months of 2024. This article in the Pharmaceutical Journal looks at why cases are increasing, including falling rates of children receiving the childhood 6-in-1 vaccine and maternal vaccination. It outlines the symptoms of whooping cough, describes how it can be treated and includes a map identifying infection 'hot spots' in England and Wales. 12 Enhancing vaccine confidence across ethnic minority communities The Collaboration for Change is a group of two UK universities, nine community organisations and two small and medium size enterprises, who have conducted research on how to improve vaccine uptake among ethnic minority groups. The report highlights the factors influencing vaccine uptake. 13 Vaccination in the UK: Access, uptake and equity Over the last decade, the uptake of vaccines in the UK has stalled and is in many cases falling. Declining rates of routine childhood vaccination in a country with a well-established universal healthcare system are extremely concerning and pose a significant public health risk, with outbreaks of preventable diseases such as measles and whooping cough already being seen. The Royal College of Paediatrics and Child Health (RCPCH)'s Commission on Immunisation policy report assesses how and why vaccine uptake has stalled or declined. It outlines the evidence and our recommendations to increase uptake of routine childhood vaccinations across three broad themes: access to services, improved data systems and strengthening public information, education and communication. 14 UK Covid-19 Inquiry: Module 4 -Vaccines and therapeutics The UK Covid-19 Inquiry has published its fourth report and recommendations following its investigation into ‘Vaccines and therapeutics of the United Kingdom’. It considers and makes recommendations on a range of issues relating to the development of Covid-19 vaccines and the implementation of the vaccine rollout programme in England, Wales, Scotland and Northern Ireland. Issues relating to the treatment of Covid-19 through both existing and new medications were examined in parallel. Do you have a resource or story to share about immunisation safety? We’d love to hear about it - leave a comment below or join the hub to share your own post.

Workplace violence is an everyday reality for too many nurses. Recent surveys show that more than six in ten nurses and midwives in the UK have been attacked in the past year, with incidents ranging from verbal abuse to serious physical assault. The impact on personal wellbeing, morale, and the ability to provide safe patient care cannot be overstated. This webinar will shine a light on the lived experiences of nurses who have faced violence, explore the latest evidence on prevalence and risk factors, and share practical tools to improve safety and resilience in practice. Through expert insight, case studies, and open discussion, you will gain a deeper understanding of how violence can be addressed at both individual and organisational levels. Join colleagues from across the profession to hear real stories and take away strategies to support yourself, your team & your patients. Register

Continence care is a cornerstone of person-centred nursing, yet it remains one of the most sensitive and often overlooked aspects of practice. Bladder and bowel problems affect millions across the UK, leading to discomfort, loss of independence, and reduced quality of life, while also carrying emotional consequences such as embarrassment and social isolation. Nurses are uniquely placed to make a real difference. Early recognition, accurate assessment, and timely intervention can prevent complications, protect dignity, and promote recovery. Skilled continence care also reduces infection risk, skin damage, and unnecessary catheter use — all essential to improving safety and outcomes. This webinar highlights continence as a fundamental element of safe, compassionate care. Through expert discussion, case studies and practical examples, nurses will explore structured assessment, first-line interventions, and communication techniques that empower patients and enhance quality of life. Register

The Green Nursing Challenge Showcase was held on 20 October 2025 celebrating the outstanding work of teams from hospital and social care settings—an award-winning leadership and engagement programme dedicated to transforming healthcare. One of the teams that competed in the Green Nursing Challenge was the Bladder, Bowel and Pelvic Health community team in Lewisham, London, with their project: ‘Trial without catheter (TWOC) using a structured approach’. The team have shared their project with the hub. The Centre for Sustainable Healthcare supported the Bladder, Bowel and Pelvic Health community team in Lewisham by undertaking a sustainable quality improvement project: a ‘Trial without catheter (TWOC) using a structured approach’. The team (consisting of the clinical lead, catheter lead nurse and a graduate management trainee) worked with the district nursing teams and urgent care service as part of the Green Nursing Challenge to improve care for patients, whilst saving money and carbon emissions. The challenge Indwelling urinary catheters are among the most used invasive medical devices in the UK, and an estimated 90,000 people in community settings require long-term catheter use. Evidence suggests that the longer a catheter remains in place, the higher the risk of infection, and around 2,100 deaths per year are directly attributed to catheter-related infections. The financial burden of catheter-associated urinary tract infections (CaUTIs) is approximately £2,000 per episode and the total annual cost of Foley catheter use estimated between £1 billion and £2.5 billion. A TWOC is conducted when a catheter, which is a tube inserted into the bladder to drain urine, is removed to determine if the patient can urinate normally without it. This procedure is essential for evaluating bladder function and ensuring that the patient can manage without ongoing catheterisation The team found that there was a lack of knowledge around standardised TWOC protocol, and a lack of clear evidence on how to manage the process. They identified problems with repeated catheter use, unnecessary district nurse visits, ambulance callouts and avoidable hospital stays. These inefficiencies not only compromise patient care, comfort and quality of life, but also generate considerable plastic waste from catheters, gloves, aprons and maintenance solutions. Removing catheters as soon as possible has many advantages, but it is vital that removals are planned and effective to prevent adverse events, unnecessary emergency call outs or attendances to the emergency department. Avoiding the cycle of failed TWOC and repeated catheter insertion is key. The Green Nursing Challenge helped the team in the successful implementation and evaluation of a project to develop a structured TWOC process, and measure the impact from a social, financial and environmental perspective. They implemented a classification system for TWOC suitability, together with corresponding TWOC strategies. The project saw the team training staff and evaluating their results across the community of Lewisham and the wider Trust. Results Monthly figures were collected before and after the project and showed clear improvements in the following: Reductions in: Catheter-related ambulance call outs by 25%, suggesting more timely community interventions. Catheter-related hospital stays (bed days) by 32%. Catheter-related hospital admissions by 12.5%, indicating fewer acute deterioration events. No catheter associated urinary tract infections were reported. Environmental sustainability The projected annual saving is 42,156.40 CO2e, equivalent to driving 124,026 miles in an average car. Economic sustainability On average, the initiative contributed to projected net annual savings of £441,708. Social sustainability The reduction in bed days meant that patients spent less time in hospital and more time at home which linked to improved emotional wellbeing. Reduction in staff pressures due to TWOC attempts and urgent visits for catheter-related complications. Increased staff confidence in catheter management contributing to a working environment that was less reactive and more focused on delivering high quality, consistent care. Improved integration, communication and patient pathways helped to ensure accurate referrals, faster and more effective communication. Next steps The team are continuing to develop their project hoping to see further improvements in emergency attendance, hospital stays, CaUTI rates, use of catheter materials and speed of catheter removals. They hope developing more comprehensive guidelines will lead to faster assessment and TWOC, or referral elsewhere, with the net result being a significant reduction in catheter usage overall. For more information please see Green Nursing Challenge Trial without catheter - a structured approach. Do you have a project you would like to share on the hub? We'd love to hear from you. Please email [email protected].

The Green Nursing Challenge Showcase was held on 20 October 2025 celebrating the outstanding work of six teams from hospital and social care settings—an award-winning leadership and engagement programme dedicated to transforming healthcare. The six clinical teams presented their Sustainable Quality Improvement (SusQI) projects to a judging panel, focusing on key priorities identified through carbon footprint measurements, partner collaboration and input from people with lived experience. Themes included valuing people’s time, supporting informed choices, improving access and experience for underserved groups, and addressing complex care, pelvic health and continence—all aimed at reducing environmental harm and tackling health inequalities in nursing care. Winning team Winner: Norfolk and Norwich University Hospitals NHS Foundation Trust recognised for their close collaboration between professionals across both maternity and inflammatory bowel disease (IBD) services, working together to deliver more efficient, person-centred and environmentally sustainable care. Highly commended: Oxfordshire Health NHS Foundation Trust for their joint District Nurse & Diabetic Nurse Specialist reviews, optimising care for patients in the community, reducing harms and the need for hospital admissions. Showcase outcomes and learning The Green Nursing Showcase celebrated the inspiring work of the six project teams who took part in the Green Nursing Challenge 2025. Together, these teams are helping to shape more sustainable and equitable nursing care. During the event, each clinical team presented their Sustainable Quality Improvement (SusQI) projects, focussing on priority areas identified through collaboration with challenge partners, carbon footprinting analysis, and discussions with patient and staff groups. The event’s keynote speaker was Charlotte McCardle, Global nurse consultant and former CNO for Northern Ireland and DCNO at NHS England, who spoke of nurses and midwives being the “…holders of hope, the voice of the vulnerable, and the champions of change. I believe you are very well placed to lead. Don’t undersell in any way your work… You can use what you’ve created in your projects to break down barriers for others.” The Challenge demonstrates how nurses and midwives can play a crucial role in achieving the NHS’ Net-Zero targets. By making changes in working practices, nurses can lead action to minimise the environmental harm created from healthcare services, and can help address health inequalities, improve outcomes and experiences, and contribute to a more sustainable healthcare system. To hear more about the individual projects follow the link: Green Nursing Showcase 2025 — Sustainable Healthcare