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Found 263 results
  1. Content Article
    Decisions to admit older, frail patients to critical care must pay particular attention to quality of life and the potential burden of care on patients. This burden may extend beyond surviving a critical illness. These decisions are not easy and require careful thought, clinical judgment, and communication write Daniele Bryden and colleagues in this BMJ opinion piece. 
  2. Content Article
    In my 15 years focusing on developing drink thickening solutions for dysphagia patients, the intersection of dysphagia management and patient safety has become increasingly apparent. Dysphagia, or difficulty swallowing, presents not only as a significant health challenge but also as a critical patient safety issue. The condition's underdiagnosis, particularly in vulnerable populations, heightens the risk of severe complications, including choking, aspiration pneumonia, dehydration and the profound fear of choking that can lead to malnutrition.
  3. Content Article
    This article outlines a recent improvement put in place by a ward at Sir Robert Peel Community Hospital, part of University Hospitals of Derby and Burton NHS Foundation Trust. The team won an award for implementing learning following a patient fall to help drastically reduce the frequency of incidents and improving patient safety.
  4. Content Article
    Set up in January 2023, the Times Health Commission was a year-long projected established to consider the future of health and social care in England in the light of the pandemic, the growing pressure on budgets, the A&E crisis, rising waiting lists, health inequalities, obesity and the ageing population. Its recommendations are intended to be pragmatic, practical, deliverable and able to be potentially taken up by any political party or government, present or future. 
  5. Content Article
    The first UK geriatric oncology service at a tertiary cancer centre was established at the Royal Marsden Hospital in London. Its purpose is to conduct comprehensive geriatric assessments of patients with cancer on order to make referrals to multidisciplinary care. This descriptive study aimed to track its progress. It found that the service made a median of three referrals for each patient, most commonly to physiotherapy and occupational therapy. The frequency of referrals indicates that there is a high level of unmet need in older patients with cancer.
  6. Content Article
    In 2021 in New South Wales (NSW) there were 41,619 people over 65 who were hospitalised due to a fall at home or in the community. This number increased by 60% in a decade from 25,982 in 2010 and the incidence of falls is set to increase further as the population ages. In 2021 the cost to the NSW health system from falls by older people in the community was around $752 million. These costs are projected to grow to $1.09 billion by 2041 – the result of around 60,300 hospitalised falls projected for that year. There is robust evidence that falls can be prevented. Fall prevention is a complex area as there are multiple risk factors that may contribute as to why a person may fall. A systems thinking approach acknowledges the complexity of fall prevention, seeks to understand the interactions between components, and identifies what interventions work best.
  7. Content Article
    This cross-sectional study in JAMIA Open aimed to identify concerns, barriers and facilitators impacting the use of patient portals by older patients, as well as desired features in future updates. The authors held two focus group discussions culminating in an anonymous survey completed by women who were 65 years and older receiving urogynaecology care in Northwest Ohio. The authors concluded that the lack of age-aligned medical access software and products may lead to worsening digital exclusion and disparities in healthcare. Portal application developers and healthcare systems must advance efforts that consider the needs of those who are older when designing patient portals.
  8. News Article
    Thousands more elderly people will be stuck in hospital over Christmas because of junior doctors’ strikes, Age UK has warned. The charity is among several who have said the timing of the strikes, which begin at 7am on Wednesday means it will be “extremely difficult to ensure safe and effective care” during them. Age UK is one of five organisations raising fears over patient safety and making a plea to the British Medical Association (BMA) and Victoria Atkins, the Health Secretary, for a resolution to the dispute. Junior doctors’ walkouts are due to last until Saturday, with their longest strike to come early in the new year, while flu, norovirus and Covid hospitalisations are rising. In a joint letter with the NHS Confederation, Patients Association, National Voices and Healthwatch , Age UK said strike action in the days ahead could leave thousands of patients stranded in hospital for want of staff to get them discharged. The latest figures show 13,000 such cases in hospitals despite being medically fit for discharge. The charities said the withdrawal of almost half the medical workforce in England would mean the most vulnerable are left “bearing the brunt” of the pay dispute. “Our concern is that, despite the best efforts of hard-working NHS staff, it will be extremely difficult to ensure safe and effective care during this period for all patients that need it.” Read full story (paywalled) Source: The Telegraph, 20 December 2023
  9. Content Article
    As part of the Care Quality Commission's (CQC's) commitment to person-centric care, they have worked with the University of Bedfordshire to produce guidance for care home managers and members of the public on the availability and management of alcohol in care homes.   This guidance focuses on both the benefits of having alcohol available to care home residents who want it, as well as how to mitigate potential risks.   The University of Bedfordshire spoke to residents, their family members, care home managers and CQC inspectors, and captured their expectations and requirements on how alcohol is managed in care settings.  
  10. News Article
    Patients needing emergency treatment are becoming sicker in A&E as hospitals struggle to free up enough beds, top doctors have warned. Dr Adrian Boyle, president of the Royal College of Emergency Medicine (RCEM), told The Independent that elderly patients are waiting so long for treatment in A&E that they’re developing bed sores and delirium. Another senior NHS doctor, Dr Vicky Price, who is president-elect of the Society for Acute Medicine, warned that corridor care is now “routine practice” with the situation only set to worsen as A&E departments come under increasing pressure. Their comments highlight the ongoing chaos in emergency medicine, as strikes take place during the most difficult time of the year. The chief executive of the NHS, Amanda Pritchard, said on Thursday that last winter was the worst she’d ever seen for the health service, warning that strikes by junior doctors will only make the situation harder for hospitals this year The warnings come as the latest NHS data shows that the prime minister, Rishi Sunak, could fail in his promise to deliver 5,000 more acute hospital beds to the NHS this month. Current data shows that the NHS is falling short of the target by just under 1,200 beds, with 97,818 against a target of 99,000. Read full story Source: The Independent, 10 November 2023
  11. Content Article
    This report published by the National Audit of Inpatient Falls (NAIF) includes information on multi-factorial risk assessments and post fall management, and contains five recommendations as well as resources to support improvement.
  12. Content Article
    This blog calls for action on the careful review of established pain medication when a patient is admitted to hospital. Richard describes the experience of two elderly patients who suffered pain due to their long term medication being stopped when they were admitted to hospital. Pain control needs must not be ignored or undermined, there needs to be carer and patient involvement and their consent, and alternative pain control must be considered.
  13. Content Article
    The Greater Manchester Major Trauma Network recognise that many older patients self-present to emergency departments and the ‘Meet Harry’ infographic was produced as an aide memoire to triage nurses and clinicians to assist in assessment. You can view the ‘Meet Harry’ infographic by clicking on the image or download it from the attachment below.
  14. News Article
    The UK faces an ageing crisis and healthcare must step in, England's chief medical officer, Prof Sir Chris Whitty, warns in his annual report. People are living longer but some spend many of their later years in bad health - and that has to change, he said. Based on projections, the elderly boom will be in rural, largely coastal, areas and these places are often poor cousins when it comes to provision. In deprived regions, age-related issues emerge 10 years earlier, on average. "We've really got to get serious about the areas of the country where ageing is happening very fast, and we've got to do it now. "It's possible to compress the period of time that people spend in ill health...because otherwise we will end up with large numbers of people leading much more dependent lives." Providing services and environments suitable for older adults in these areas is an absolute priority, the report says. Read full story Source: BBC News, 10 November 2023
  15. Content Article
    Chief Medical Officer Professor Chris Whitty's annual report recommends actions to improve quality of life for older adults and prioritise areas with the fastest growth in older people.
  16. News Article
    A rise in hip fractures last year could be a symptom of a wider increase in general physical deconditioning in older and vulnerable people following the pandemic, senior clinicians have warned. Around 72,000 hip fractures were recorded in 2022 compared to 66,000 in 2020 and 67,000 in 2021, according to the 2023 National Hip Fracture Database report, published this month. The report, published by the Royal College of Physicians, said: “These additional hip fractures happened despite a fall in the size of the ‘at risk’ older population over the preceding three years, as a result of Covid-19-related mortality among older people and those living in care homes.” “Our casemix run chart shows a slight increase in the proportion of hip fractures occurring in people aged under 80. “This is perhaps an early indication of Public Health England’s [now the UK Health Security Agency] predictions that physical deconditioning and increased risk of falling due to the pandemic may lead to an increase in the number of people who are at risk of fragility fracture.” Read full story (paywalled) Source: HSJ. 25 September 2023
  17. Content Article
    The number of older people having surgery is increasing. However, older patients are more likely to have complications after surgery than younger patients as they often have multiple health conditions and age-related problems such as frailty and a decline in mental ability. These factors increase the risk of surgery and can hinder recovery. Surgical pre-assessment usually focuses on the patient’s physical fitness for surgery, not the broader range of health-related factors that are important to consider in older patients. The Perioperative care for Older People undergoing Surgery (POPS) model was developed to provide a holistic assessment of an older person’s medical, physiological and functional condition prior to surgery. The assessment is then used to inform interventions that can reduce the risk of complications. The POPS model is increasingly being implemented across the English and Welsh NHS, but there are often challenges in introducing these new ways of providing care that need to be better understood. This independent study, led by THIS Institute Fellow Professor Justin Waring, outlines the key activities and strategies that are needed for the POPS model to be successfully implemented and become part of routine practice in a hospital.
  18. Content Article
    Monitoring and responding to deterioration in social care settings is critical to providing safe, effective and responsive care. Front-line staff are pivotal for highlighting change to wider teams and managing low to medium risk individuals in their place of residence. However, there is a core set of principles that most systems use which may not be used by non-clinical staff in residential settings. This case study explores an intervention to empower non-clinical staff to take observations. The Whzan blue box contains a digital tablet and equipment to take temperature, pulse, oxygen saturation levels and blood pressure measurements. Staff were trained and supported on site to use the system and set up a digital platform to share measurements with wider teams. Staff fed back that they felt empowered and able to better engage in conversation with health care professionals, highlighting the importance of having a common language. This case study was submitted to the Care Quality Commission (CQC) by North East and North Cumbria ICB.
  19. Content Article
    This infographic by artist Sonia Sparkles highlights ways to prevent patient falls in hospital. A wide range of graphics relating to patient safety, healthcare and quality improvement is available on the Sonia Sparkles website.
  20. Content Article
    Falls have a significant negative impact on the health and well-being of people with dementia and increase service costs related to staff time, paramedic visits, and accident and emergency (A&E) admissions. The author of this study, published in the Journal of Patient Safety, examined whether a remote digital vision-based monitoring and management system had an impact on the prevention of falls.
  21. Content Article
    The National Early Warning Score (NEWS2) is calculated using routine vital sign measures of temperature, pulse and so on. It is used by ambulance staff and emergency departments to identify sick adults whose condition is likely to deteriorate.  NEWS2 has been shown to work among the general population. However, it has been unclear if it could monitor the condition of care home residents because of their age, frailty, and multiple long-term conditions. New research from the National Institute for Health and Care Research (NIHR) shows that, among care home residents admitted to hospital as an emergency, NEWS2 can effectively identify people whose condition is likely to get worse.
  22. Content Article
    Harold Pedley, known as Derek, attended his GP surgery during the late afternoon on 21.12.22 and after spending most of that day feeling unwell with symptoms including abdominal pain and vomiting. He was appropriately referred to the hospital and travelled there with his friend after his GP had discussed his case with doctors. Due to a lack of available beds in the assessment unit, Derek needed to remain in the emergency department. Following his arrival at 20.07 hours, doctors were not notified of his attendance. He remained in the emergency department waiting area for almost two hours during which time due to significant pressures faced by the department he was not assessed or spoken to by a medical professional. At 21.59 hours a triage nurse called for him. By then, Derek had been unresponsive for some time and had died, his death confirmed at 22.26 hours. A subsequent post mortem examination revealed he died from the effects of non-survivable extensive small bowel ischaemia caused by a significantly narrowed mesenteric artery. His death was contributed to by heart disease.
  23. Content Article
    This state-of-the-nation report from the National Hip Fracture Database (NHFD) focuses on the period from 1 January to 31 December 2022. It shows that the number of people who died in the month following a hip fracture now stands at 6.2%; down from 10.9% in 2007, when the NHFD was set up. However, the report also finds that it took longer for patients to reach a ward where a hip fracture team can work together (where there is the best chance of recovery) in 2022. It also states that fewer patients received prompt surgery to repair their broken hip by the day after they presented to hospital. There was an improvement in how many people with hip fracture received bone strengthening medicines to avoid future fractures in 2022, but some hospitals continue to report that none of their patients receive such treatment.
  24. Content Article
    The Acute Frailty Network (AFN) was a scheme run in England by NHS Elect, using an approach called Quality Improvement Collaboratives (QICs), to help trusts implement principles of Comprehensive Geriatric Assessment (CGA) as part of their acute pathway. In July 2023, Street et al published a paper in BMJ Quality and Safety analysing the impact of the AFN which concluded that there was no difference in length of hospital stay, in-hospital mortality, institutionalisation and hospital readmission between organisations that took part in AFN and those that did not. This article outlines the position of the British Geriatrics Society (BGS) on the paper, addressing why it thinks that focusing on older people’s healthcare is more important than ever. It highlights the importance of ensuring that the paper's findings are not used as a reason to abandon efforts to improve acute frailty care. Rather, they should be seen as a call to redouble efforts to identify and overcome the barriers to delivering CGA in acute settings.
  25. News Article
    Hospitals are sending frail, vulnerable patients home before they are better and without vital medical care, leaving them unable to fend for themselves. Over the past fortnight, The Mail on Sunday has received an alarming number of letters from readers who have told of their anger, frustration and sheer desperation at being denied support they were promised. Many have been left bed-bound and unable to wash, dress or use the bathroom for weeks on end. The daughter of an 87-year-old stroke survivor had to put a hospital bed in her living room and provide 24/7 care for her mother after the local health team failed to provide adequate support. Within a year, the woman was dead, having been treated with little more than paracetamol. In another case, a 70-year-old woman had to take her immobile 84-year-old husband to the hospital in a taxi every day for several weeks to have vital injections, because carers refused to come to their home. And the disabled wife of one 74-year-old man, who fell off a roof and broke his pelvis and ribs, told of the heartbreak at not being able to look after her husband due to her own poor health. Campaigners say a Government scheme designed address the ‘problem’ of bed-blockers – the somewhat derogatory term used to describe patients, most of them elderly, who are occupying a hospital bed that they don’t strictly need – is to blame. The protocol, called Discharge To Assess, launched eight years ago, aims to get patients home as quickly as possible amid reports that some elderly patients ended up stuck in wards for months on end – usually because the NHS hasn’t been able to organise the next stage of their care, so it’s not safe discharge them. Read full story Source: Mail Online, 2 September 2023
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