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Showing results for tags 'Nutrition'.
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News Article
Cancer patients 'may starve' without vital drug
Patient Safety Learning posted a news article in News
Cancer patients and others with debilitating conditions have highlighted shortages of a vital drug they say have had a "devastating" impact on their lives. Creon, a pancreatic enzyme replacement therapy (Pert), helps digestion, but has been hard to obtain for the last year and shortages are predicted to last until 2026. It is thought more than 61,000 patients in the UK need it, including those with pancreatic cancer, cystic fibrosis and chronic pancreatitis. Some patients said through Your Voice, Your BBC News that they have had to cover long distances to find a pharmacist with supplies. The Department of Health and Social care says it is working closely with the NHS, manufacturers and others in the supply chain to try to resolve the issues. Without the drug, patients lose weight and strength, which means their ability to cope with treatment such as chemotherapy is reduced. Diana Gibb, who is 74, and her husband Mick, 78, live in Tonbridge, Kent. Mick had a major operation to treat pancreatic cancer in 2023. Diana wrote to BBC News explaining that it is impossible for Mick to digest food without creon. She says he was prescribed a high dose to enable him to regain weight after losing four stone in hospital, but it became increasingly difficult to get hold of the medicine. "We started to have trouble getting them in the higher dosage, involving me traipsing round pharmacies to find one who could get them. Pharmacies cannot get hold of that dosage. He now has to take a lower dose doubling up on the number of tablets taken, one box now lasts less than a week. "Pharmacies cannot get hold of lower dosage either and there is no alternative medication. I was worried that my husband would starve to death without them." Read full story Source: BBC News, 28 February 2025 Related reading on the hub: Medicines shortages: minimising the impact on patients Medication supply issues: A pharmacist’s perspective Medication supply issues: Mast cell activation syndrome (MCAS) -
News Article
The father of a seven-week-old boy who died after being breastfed in a baby carrier is calling for increased safety standards around baby slings. James Alderman, who was known as Jimmy, was being breastfed "hands-free" within a baby carrier worn by his mother while she moved around their home. Jimmy's father, George Alderman, told Sky News: "Baby slings are sold as being a lifesaver, allowing you to get on with your business while your baby's safe and close to you, but in this instance, we had our baby close, but not safe." The inquest into his death heard Jimmy was in an unsafe position too far down the sling. Mr Alderman said that while much of the available advice around slings focused on them not being too tight, few people were aware of the danger of the sling not being tight enough, and so allowing the baby to slump. Explaining what medical experts think happened to Jimmy, he said: "After he'd been feeding, he fell asleep and then he slumped forwards. Then, because his head was covered and he had his chin against his chest, he was facing downwards. "Nothing was covering his face, but because of the position he was in, that meant that not enough oxygen was going into his lungs because he was small and not fully developed, and that's why he stopped breathing." Mr Alderman said that while many brands of baby carriers said they were safe for breastfeeding, the lack of advice around how to safely do it meant that parents were "left to work it out by themselves". Read full story Source: Sky News, 30 December 2024- Posted
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Content Article
Baby Jimmy was being breastfed within a baby carrier worn by his mother. After 5 minutes she found that he was collapsed and although immediate resuscitation was commenced he died 3 days later on 11 October 2023 in St George’s Hospital. Jimmy died because his airway was occluded as he was not held in a safe position while within the sling. There is insufficient information available from any source to inform parents of safe positioning of young babies within carriers and in particular in relation to breastfeeding. It was accepted that the sling was being worn snugly, not tightly, and although she could see his face when she looked down, the TICKS acronym was not met by his position within the sling as Jimmy was too far down. The TICKS acronym was prepared by the (now disbanded) UK consortium of sling retailers and manufacturers tight in view at all times close enough to kiss keep chin off the chest supported back. There appeared to be no advice in the literature regarding the risk of baby slumping and the risk therefore of suffocation, particularly if baby is under the age of 4 months, and no advice that breastfeeding “hands free” a young baby is unsafe, due to the risk of suffocation and not being able to meet every aspect of TICKS. There appeared to be no helpful visual images of “safe” versus “unsafe” sling/carrier postures. Evidence was given by the witnesses assisting the inquest that public information, readily available, not too complex but consistent in message would be welcomed to advise and instruct. Matters of concern There is very little information available to inform parents of safety and positioning advice of young babies in carriers/slings and in particular nothing in relation to breastfeeding in carriers/slings This is notwithstanding a significant increase over recent years in the use of such equipment. The question of whether it is safe to breastfeed “hands free” is not addressed or referred to in the public domain or manufacturers literature. The NHS available literature provides no guidance or advice. The only current “tips” are provided on the National Childbirth Trust (NCT) website but these are in fact unhelpful Young babies are at risk of suffocation. Consideration should be given to industry standards to promote the safe use of slings/carriers, to warn users of the risks and whether any such standards should be voluntary or mandatory.- Posted
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News Article
A senior coroner has warned that more babies could die unless "action is taken", following the deaths of three infants who had received contaminated feed while being cared for in hospital. Three-month-old Aviva Otte died in January 2014 after being given contaminated feed at St Thomas' Hospital, south London. In June that year, one-month-old Oscar Barker and nine-day-old Yousef Al-Kharboush died after a similar, but separate contamination incident. Following an inquest, Dr Julian Morris said he was concerned that St Thomas' Hospital was not legally required to report the first incident and called for a change in the law. All three babies, who had been born prematurely, were fed through an intravenous drip, a method known as "total parenteral nutrition" (TPN). Aviva, the first child to die, was given TPN that was made by NHS pharmacists at St Thomas' Hospital. Oscar, who died at Addenbrooke's Hospital, Cambridge and Yousef, who also died at St Thomas' Hospital, received feed manufactured by private company ITH Pharma which supplied to several trusts. The bacteria Bacillus cereus was found to be the contaminant in the cause of all three deaths. In his conclusion, the senior coroner for Inner South London said he was worried that a lack of regulation around medicines such as Aviva's feed might lead to future deaths. Read full story Source: BBC News, 19 November 2024- Posted
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News Article
Unlicensed medicines may lead to more baby deaths in England, coroner warns
Patient_Safety_Learning posted a news article in News
More babies in England could die from issues caused by unlicensed medicines if providers are not required to report problems, a coroner has warned. The conclusions were reached at the end of an inquest held after three infants died due to receiving contaminated feed. The babies were all receiving hospital care after being born prematurely and died after receiving total parenteral nutrition (TPN) feed contaminated with Bacillus cereus, Southwark coroners court heard. Read full story Source: Guardian, 18 November 2024- Posted
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Content Article
Healthcare professionals are reminded to inform patients about the common and serious side effects associated with glucagon-like peptide-1 receptor agonists (GLP-1RAs). Advice for healthcare professionals: Inform patients upon initial prescription and when increasing the dose about the common risk of gastrointestinal side effects which may affect more than 1 in 10 patients. These are usually non-serious, however can sometimes lead to more serious complications such as severe dehydration, resulting in hospitalisation. Be aware that hypoglycaemia can occur in non-diabetic patients using some GLP-1RAs for weight management; ensure patients are aware of the symptoms and signs of hypoglycaemia and know to urgently seek medical advice should they occur. Patients should also be warned of the risk of falsified GLP-1RA medicines for weight loss if not prescribed by a registered healthcare professional, and be aware that some falsified medicines have been found to contain insulin. Be aware there have been reports of potential misuse of GLP-1RAs for unauthorised indications such as aesthetic weight loss report suspected adverse drug reactions to the Yellow Card scheme.- Posted
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News Article
Mother repeatedly ‘kept in dark’ about reason for baby’s death, inquest told
Patient Safety Learning posted a news article in News
A grieving mother has told an inquest how secretive, evasive and “patronising” behaviour by NHS staff was “traumatic” and led to her spending years seeking the truth about her daughter’s death. Jedidajah Otte told how she encountered a “stubborn refusal” by doctors and nurses at St Thomas’ hospital in London to tell her what was happening with three-month-old Aviva’s health. The hospital insisted for 10 years that Aviva died of natural causes. However, last month it admitted that her death in January 2014 occurred as a result of contaminated feed given to her by staff, which led to her developing a deadly infection. Otte, who is a Guardian journalist, also accused Guy’s and St Thomas’ NHS trust (GSTT), which runs the hospital, of “dishonesty”, a “lack of transparency” and “misleading” her about the outbreak of Bacillus cereus, a food-borne bacteria in the baby feed, which caused Aviva’s death. Otte also alleged that she was “repeatedly kept in the dark” about why her daughter’s health suddenly collapsed, “discouraged” from making inquiries and “told off” for looking at Aviva’s medical notes in her desire to understand her condition. GSTT has denied being “dishonest” towards Otte. Two senior doctors from St Thomas’ who treated Aviva have told the inquest there was no “cover-up” of the reasons why she lost her life. Read full story Source: The Guardian, 5 October 2024- Posted
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News Article
Hospital where baby died from infected feed had ‘entirely unsafe system’
Patient Safety Learning posted a news article in News
An NHS trust that gave four newborn babies contaminated feed has admitted that it was operating “an entirely unsafe system” at the time they became infected. The admission came during evidence by a senior doctor at Guy’s and St Thomas’ trust (GSTT), who led its investigation into the outbreak, during an inquest into how one of the very premature babies died. Dr William Newsholme was answering questions last week at the inquest at Southwark coroner’s court in London into the death of Aviva Otte at St Thomas’ hospital on 2 January 2014. Newsholme was questioned about why the results of tests carried out on samples of the baby feed on 26 December 2013 did not come back until 6 January, by which time the baby had died and three others were ill. He was asked if he would agree that the long delay meant that “that this is an entirely unsafe system within which to be preparing parenteral nutrition for the most vulnerable cohort of patients in your hospital”. Newsholme, a consultant in infectious diseases and the trust’s clinical lead for infection prevention and control, answered: “Yes, I would.” The inquest is examining events surrounding the deaths of Aviva and of two other babies, nine day-old Yousef Al-Kharboush and one-month-old Oscar Barker, in an outbreak of Bacillus cereus five months later which also involved contaminated feed. Nineteen babies at nine hospitals were infected in that outbreak, three of whom died. Read full story Source: The Guardian, 24 September 2024 -
News Article
Coeliac patient died after being fed Weetabix in hospital, inquiry hears
Patient Safety Learning posted a news article in News
An 80-year-old woman with coeliac disease died within days of being fed Weetabix in hospital, an inquest has heard. Hazel Pearson, from Connah’s Quay in Flintshire, was being treated at Wrexham Maelor hospital and died four days later on 30 November from aspiration pneumonia. Although her condition was recorded on her admission documents, there was no sign beside her bed to alert healthcare assistants to her dietary requirements. Coeliac disease is a condition where the immune system attacks the body’s own tissues after consuming gluten, a type of protein found in wheat, rye and barley, causing damage to the small intestine. The hospital’s action plan to avoid similar fatal incidents lacked detail and had “narrow vision”, the coroner said. The hospital’s matron, Jackie Evans, told the inquest that changes, including placing signs above the beds of patients with special dietary requirements, had been implemented since Pearson’s death. But Sutherland raised concerns that the hospital had yet to carry out a formal investigation into what went wrong. She said: “The action plan lacks detail. What has happened locally is commendable, but it lacks detail and it has narrow vision.” She added that the plan that had been put in place was “amateurish with no strategic vision”. The assistant coroner said she would be unable to make a decision on a prevention of future deaths report until the Betsi Cadwaladr University Health Board (BCUHB) provided a witness to answer further questions about changes. Read full story Source: The Guardian, 17 June 2022- Posted
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Content Article
Insufficient milk intake in breastfed neonates is common, frequently missed, and causes preventable hospitalisations for jaundice/hyperbilirubinaemia, hypernatraemia/dehydration, and hypoglycaemia - accounting for most U.S. neonatal readmissions. These and other consequences of neonatal starvation and deprivation may substantially contribute to fully preventable morbidity and mortality in previously healthy neonates worldwide.This article argues that modern misconception of exclusive breastfeeding as natural and thus safe causes common and preventable harm to neonates. This review shows that the evidence regarding common and preventable harm to neonates associated with breastfeeding insufficiencies is sufficient to warrant fundamental changes to early infant feeding policies and practices. -
News Article
Most health claims on formula milk ‘not backed by evidence’
Patient Safety Learning posted a news article in News
Most health claims on formula milk products have little or no supporting evidence, researchers have said, prompting calls for stricter marketing rules to be introduced worldwide. Millions of parents use formula milk in what has become a multibillion-dollar global industry. But a study published in the BMJ has found most health and nutritional claims about the products appear to be backed by little or no high-quality scientific evidence. “The wide range of health and nutrition claims made by infant formula products are often not backed by scientific references,” said Dr Ka Yan Cheung and Loukia Petrou, the joint first co-authors of the study. “When they are, the evidence is often weak and biased.” Dr Daniel Munblit and Dr Robert Boyle, senior co-authors for the study, added: “There is a clear need for greater regulation and oversight to ensure that these claims are supported by sound scientific evidence and to protect the health and wellbeing of our youngest and most vulnerable populations.” Read full story Source: The Guardian, 15 February 2023 -
News Article
USA: Patients needing home IV nutrition fear dangerous shortages
Patient Safety Learning posted a news article in News
CVS Health confirmed last year it was closing half its Coram home infusion branches and firing about 2,000 nurses, dietitians and pharmacists. Their patients with life-threatening digestive disorders depend on parenteral nutrition, or PN — in which amino acids, sugars, fats, vitamins and electrolytes typically are pumped through a catheter into a large vein near the heart. A day later Optum Rx, another big supplier, announced its own consolidation. Suddenly, thousands were scrambling for their complex essential drugs and nutrients. “With this kind of disruption, patients can’t get through on the phones. They panic,” said Cynthia Reddick, a senior nutritionist laid off last summer in the CVS restructuring. “It was very difficult. Many emails, many phone calls, acting as a liaison between my doctor and the company,” said Elizabeth Fisher Smith, a 32-year-old public health instructor in New York, whose Coram branch closed. A rare medical disorder has forced her to rely on PN for survival since 2017. “It added to my mental burden,” she said Home and outpatient infusions in the USA are a growing business, as new drugs for chronic illness expand treatment options and enable patients, providers and insurers to avoid hospitalisation. But while reimbursement for expensive new drugs has attracted corporations and private equity, the industry is constrained by a lack of nurses and pharmacists. The less profitable parts of the business — and the vulnerable patients they serve — are at risk. This includes the 30,000-plus Americans who rely on parenteral nutrition — including premature infants, post-surgery patients and those with damaged bowels because of genetic defects. Read full story (paywalled) Source: The Washington Post, 6 February 2023 -
News Article
‘Underhand’ formula milk ads stop millions from breastfeeding, experts say
Patient Safety Learning posted a news article in News
Exploitative and “underhand” marketing of formula milk is preventing millions of women from breastfeeding, according to a series of reports published in the Lancet. The reports, by 25 experts from 12 countries, including paediatricians, public health specialists, scientists, economists and midwives, finds that the commercial milk formula companies “exploit parents’ emotions and manipulate scientific information to generate sales at the expense of the health and rights of families, women and children”. Breastfeeding promotes brain development, protects infants against malnutrition, infectious diseases and death, while also reducing risks of obesity and chronic diseases in later life. It also helps protect mothers against breast and ovarian cancers. The World Health Organization (WHO) recommends exclusively breastfeeding babies for the first six months and giving breast milk alongside solid food until the age of two or beyond. Over three reports, the series reveals how, more than 40 years since the World Health Assembly developed a voluntary international code prohibiting the marketing of infant formula, widespread violation of the code persists, with promotion of infant formula milk continuing in about 100 countries in every region of the world since the code was adopted. Read full story Source: The Guardian, 7 February 2023- Posted
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News Article
Families of people with dementia have said there is a national crisis in care safety as it emerged that more than half of residential homes reported on by inspectors this year were rated “inadequate” or requiring improvement – up from less than a third pre-pandemic. Serious and often shocking failings uncovered in previously “good” homes in recent months include people left in bed “for months”, pain medicine not being administered, violence between residents and malnutrition – including one person who didn’t eat for a month. In homes in England where standards have slumped from “good” to “inadequate”, residents’ dressings went unchanged for 20 days, there were “revolting” filthy carpets, “unexplained and unwitnessed wounds” and equipment was ”encrusted with dirt”, inspectors’ reports showed. Nearly one in 10 care homes in England that offer dementia support reported on by Care Quality Commission inspectors in 2022 were given the very worst rating – more than three times the ratio in 2019, according to Guardian analysis. Read full story Source: 29 December 2022- Posted
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News Article
High cost of infant formula putting babies in danger, UK charities warn
Patient Safety Learning posted a news article in News
Vulnerable parents may be forced to resort to unsafe practices to feed their babies because of sharp increase in the cost of infant formula, charities have warned. The price of the cheapest brand of baby formula has leapt by 22%, according to analysis by the British Pregnancy Advisory Service (BPAS). BPAS said the cost of infant formula needed to safely feed a baby in the first six months of their life was no longer covered by Healthy Start vouchers, which are worth £8.50 a week and provided to women in England, Wales and Northern Ireland who are pregnant or have young children. The charity Feed said families that were unable to afford enough infant formula had resorted to watering down the product or feeding their babies unsuitable food such as porridge. BPAS’s chief executive, Clare Murphy, said: “We know that families experiencing food poverty resort to unsafe feeding methods, such as stretching out time between feeds and watering down formula. The government cannot stand by as babies are placed at risk of malnutrition and serious illness due to the cost of living crisis and the soaring price of infant formula. “The government must increase the value of Healthy Start vouchers to protect the health of the youngest and most vulnerable members of our society.” Read full story Source: The Guardian, 6 December 2022 -
Content Article
The number of children and young people admitted to children’s wards with an eating disorder has increased significantly since the start of the Covid-19 pandemic. In the most extreme cases, those with severe malnutrition may need to be fed via a nasogastric tube without their consent. Children’s nurses working on hospital wards may therefore care for children and young people who need to receive nasogastric tube feeding under physical restraint. This article offers an overview of eating disorders and their detrimental effects as well as practical advice for children’s nurses, supporting them to provide safe, compassionate and person-centred care to their patients.- Posted
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Event
Everywoman festival
Patient Safety Learning posted an event in Community Calendar
untilThe Everywoman festival is a one day event aimed at all women over the age of 16 and aims to empower women to understand what is normal and when to seek help for issues that can affect 90% of women at some point in their life. The festival combines more than 40 workshops and 6 themed seminar sessions with a fun, relaxed environment with art workshops, food and drink, music and charity stands. Themes are wide ranging and include periods and endometriosis, pelvis pain and bladder, childbirth injury, menopause and sexual wellbeing. Additional drop in sessions to meet the consultant experts as well as book readings and signings will be available on the day. The Everywoman Festival will be held in the heart of Cardiff in the beautiful venue of Insole Court. It will feature a range of interactive workshops and talks from leading health experts. Attendees will have the opportunity to learn about everything from nutrition and fitness to mindfulness through art. For those who are looking for something a little more active, there will be a variety of fitness classes and workshops taking place throughout the day. From seated yoga, Pilates to Belly dancing and dancing lessons from Heels empowerment, there's something for everyone, regardless of their fitness level. Charities attending with stalls and information include Coppa feel, Endometriosis UK, Womens Aid, the Menstrual project and Fair Treatment for Women of Wales. Health stalls from Muslim Doctors Cymru, Medtronic, Mcgregor, THD will be on hand to provide information and signpost for everything from your bladder and bowels, childbirth to high blood pressure. Some of the highlights of the festival are the wellness market, where attendees can shop for a wide variety of health and wellness products and in the creative market products from artists such as Black and Beech, Melin Trygwynt and Eliza Eliza. Further tickets and information Follow on instagram @Theeverywomanfestival A5leaflet Everywoman (2).pdf- Posted
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This conference focuses on improving nutrition and hydration on the wards. Through expert guidance and practical case studies and advice the conference aims to support and equip you to improve practice on your ward and reduce the risk of malnutrition in patients. For further information and to book your place visit https://www.healthcareconferencesuk.co.uk/conferences-masterclasses/improving-nutrition-hydration-ward or email [email protected]. hub members receive a 20% discount. Email [email protected] for discount code. Follow the conference on Twitter @HCUK_Clare #NHSNutrition- Posted
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Content Article
Total parenteral nutrition (TPN, also known as PN) is a method of providing nutrition directly into the bloodstream to those unable to absorb nutrients from the food they eat. TPN is used in all age groups, but in babies its use is often as part of a temporary planned programme of nutrition to supplement milk feeds in those too immature to suckle or too sick to receive milk feeds as a result of intestinal conditions. TPN consists of both aqueous and lipid components, which are infused separately into the baby via specific administration sets and infusion pumps. The rate at which TPN is administered to a baby is crucial: if infused too fast there is a risk of fluid overload, potentially leading to coagulopathy, liver damage and impaired pulmonary function as a result of fat overload syndrome. In a recent three and a half year period 10 incidents were identified where infusion of the aqueous and/or lipid component of TPN at the incorrect rate resulted in severe harm to babies through pulmonary collapse, intraventricular haemorrhage or organ damage, and where intensive intervention and treatment were needed. Most of these incidents involved too rapid a rate of infusion.- Posted
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News Article
A man with Down’s Syndrome and dementia died in hospital after not being fed for nine days. The 56-year-old was admitted to Poole hospital with a hip fracture after falling over at a Bournemouth care home, where he had been receiving care. On admittance, he was taken to the trauma and orthopaedics ward, where he was listed as ‘nil by mouth’, as he had trouble swallowing. Nine days later, he died of pneumonia after a ‘series of errors’ at the hospital. Now, the man’s father has been given £22,500 in compensation, after an incident investigation at the hospital. Allegations made against the hospital included a failure to feed the patient for nine days, causing "his subsequent severe deterioration and death". The hospital failed to adequately monitor and investigate his condition, while failing to provide senior doctors, it was alleged. This left unsupervised junior doctors who did not have access to senior staff or any way to escalate their concerns, allegations said. This, it was claimed, was not done when the patient was still nil by mouth after nine days, despite the fact he was suffering from pneumonia. Read full story Source: Yahoo News, 9 February 2024- Posted
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News Article
Woman died after begging GP for help - inquest
Patient_Safety_Learning posted a news article in News
A young woman died months after begging her GP for help with her chronic fatigue syndrome, an inquest heard. Maeve Boothby-O’Neill, 27, had written to her doctor asking for help with feeding as she was hungry. Ms Boothby-O’Neill had been diagnosed with myalgic encephalomyelitis (ME). She died at home in Exeter, Devon, in October 2021. The inquest, which is scheduled to last two weeks, continues. Read full article Source: BBC News, 22 July 2024- Posted
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Event
Patient safety in hospices
Patient Safety Learning posted an event in Community Calendar
This conference focuses on improving safety for hospice patients. The day will highlight best practice in improving safety in hospices, highlight new developments such as the implications of the new Patient Safety Incident Response Framework (PSIRF), and the new CQC Inspection Framework, and will focus on key clinical safety areas such as falls prevention, medication safety, reduction and management of pressure ulcers, nutrition and hydration, improving the response and investigation of incidents, preparing for onsite inspections and developing a compassionate culture in hospices. Register at https://www.healthcareconferencesuk.co.uk/virtual-online-courses/patient-safety-hospices or email [email protected] hub members receive a 20% discount. Email [email protected] for discount code. Follow the conference on Twitter @HCUK_Clare #PSHospices- Posted
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This conference focuses on Prehabilitation – Principles and Practice, and will provide a practical guide to delivering an effective prehabilitation programme, ensuring patients are fit and optimised for surgery/treatment. This is even more important in light of the Covid-19 pandemic and lockdowns which have had a negative effect on many individual’s health and fitness levels, and currently high waiting lists could be used as preparation time to ensure the best outcomes. The conference will look at preoperative/pre treatment optimisation of patients fitness and wellbeing through exercise, nutrition and psychological support. This conference will enable you to: Network with colleagues who are working to deliver effective prehabilitation for surgery/treatment Reflect on a patient lived experience to understand how to engage patients in prehab programmes Learn from outstanding practice in implementing a prehabilitation programme Embed virtual prehabilitation into your programme during and beyond Covid-19 Demonstrate a business case for prehabilitation and ensure prehab services continue through and beyond the pandemic Reflect on national developments and learning Improve the way we support patients to prepare themselves, physically and emotionally for surgery/treatment Develop your skills in Behaviour Change and Motivational Interviewing Embed virtual prehabilitation into your programme during and beyond Covid-19 Learn from case studies Understand how you can improve emotional and psychological support Explore the role of prehabilitation in older people Work with patients to improve nutrition Ensure you are up to date with the latest evidence Self assess and reflect on your own practice Supports CPD professional development and acts as revalidation evidence. This course provides 5 Hrs training for CPD subject to peer group approval for revalidation purposes. Register- Posted
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A review of government policies tackling smoking, poor diet, physical inactivity and harmful alcohol use in England. Key points Smoking, poor diet, physical inactivity and harmful alcohol use are leading risk factors driving the UK’s high burden of preventable ill health and premature mortality. All are socioeconomically patterned and contribute significantly to widening health inequalities. This report summarises recent trends for each of these risk factors and reviews national-level policies for England introduced or proposed by the UK government in England between 2016 and 2021 to address them. Based on our review, it assesses the government’s recent policy position and point towards policy priorities for the future. Population-level interventions that impact everyone and rely on non-conscious processes are most likely to be both effective and equitable in tackling major risk factors for ill health. Yet recent government policies implemented in England have largely focused on providing information and services designed to change individual behaviour. As well as relying heavily on policies that promote individual behaviour change, the strength of the government’s approach has been uneven for the leading risk factors, and decision making across departments has been disjointed. Action to tackle harmful alcohol use in England has been particularly weak. To reduce exposure to risk factors and tackle inequalities, government will need to deploy multiple policy approaches that address the complex system of influences shaping people’s behaviour. Population-level interventions that are less reliant on individual agency and aim to alter the environments in which people live should form the backbone of strategies to address smoking, alcohol use, poor diet and physical inactivity. These interventions need to be implemented alongside individual-level policies supporting those most in need. The strong role played by corporations in shaping environments and influencing individual behaviour must also be recognised and addressed in a consistent way through government policy. The costs of government inaction on the leading risk factors driving ill health are clear. As the country recovers from the COVID-19 pandemic and seeks to build greater resilience against future shocks, now is the time to act. -
Content Article
Investigation of a complaint against the Belfast Health and Social Care Trust A Trust’s failure to perform an examination of a patient on admission to hospital meant he was not assessed by medical staff against this baseline during his time on the ward. The investigation found a significant number of failures in the care and treatment of the patient overall and in the following areas: Nutrition and Feeding the patient – contrary to guidance which highlights the importance of high quality nutritional care based on individual assessment of needs with appropriate planning and monitoring, this investigation found the following failings: The feeding of porridge contrary to Speech and Language Therapy advice on 3 and 4 December 2016 and offering other foods contrary to advice. The recording who fed the patient porridge. The identification that the recommended diet was not provided and the taking of appropriate action. The recording of foodstuffs in a consistent manner. The reporting and recording of adverse incidents in relation to the feeding of porridge on 3 and 4 December 2016. Communication & Reasonable Adjustments – safe, person centred care is underpinned by effective communication. When caring for a patient with a learning disability communication must be timely and sensitive to the needs of the person and involve the family when appropriate. This is particularly essential in relation to pain management and when a patient is non-verbal. This investigation found the following significant failures: Failure to use any kind of pain tool to assess and record the patient’s possible pain or distress. This issue is of particular importance as the patient was unable to verbalise his pain levels. Failure to ensure the care of the patient was consistently tailored for a person with dementia and learning disabilities in accordance with GAIN Guidelines. The investigation also established further failings in relation to: A failure to ensure there was a coordinated approach between the Palliative Care and Care of the Elderly teams. A lack of coordinated communication between the family, Palliative Care and Care of the Elderly teams. The over prescribing of paracetamol to the patient on Ward 3 South due to the inaccurate estimation of the patient’s weight. The investigation established maladministration in relation to: The failure of the Trust to show regard for the patient’s human rights by failing to appropriately support or record the assessment of the patient's possible pain or distress; and to ensure the care of the patient was not consistently tailored for a person with dementia and earning disabilities. The failure to report overprescribing of paracetamol in line with the Trust’s ‘Adverse Incident Reporting and Management Policy’, April 2014 and Guidelines for the administration of intravenous (IV) Paracetamol’, December 2014. The failure to inform the complainant and her family of the overprescribing of paracetamol in line with the Trust’s ‘Being Open Policy’, February 2015 and it’s ‘Guidelines for the administration of intravenous (IV) Paracetamol’, December 2014. The failure to inform the complainant and her family of the overprescribing of paracetamol in line with the Trust’s ‘Being Open Policy’, February 2015. The poor management of complaints has been highlighted in many of the reports and inquiries that have examined the care of people with a learning disability in hospitals. Opportunities were missed in this complaints handling process to provide the family with empathetic and timely responses which may have helped resolve their concerns locally and prevented them having to use time and energy in approaching the Public Services Ombudsman. The investigation established failings in the Trust’s handling of the complaint namely: The failure to meet with the family prior to completing any investigation. The failure to share minutes of the meeting, held on 21 September 2018, with the complainant for comment. The delay in issuing minutes of the meeting, held on 21 September 2018, to the complainant. The delay in providing a final response to the complainant. The failure to provide regular and informative updates to the complainant. The failure to ensure coordination between the complaints team and the service area. The failure to recognise the sensitivities around arranging a venue for the meeting with the complainant on 21 September 2018. The investigation did not establish failings in the patient’s care and treatment in relation to: The decision to carry out the procedure of oral suctioning on the patient on the night before he died. The vitamin drip being administered after the patient was deemed End of Life on 6 December 2016. The reducing pain relief without consen. The anaesthetics care of the patient on 10 November 2016. The investigation was unable to make a determination as to whether the vitamin drip was administered prior to the administration of paracetamol on 9 December 2016- Posted
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