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Found 145 results
  1. Content Article
    Strategies to reduce medication dosing errors are crucial for improving outcomes. The Medication Education for Dosing Safety (MEDS) intervention, consisting of a simplified handout, dosing syringe, dose demonstration and teach-back, was shown to be effective in the emergency department (ED), but optimal intervention strategies to move it into clinical practice remain to be described. This study aimed tov describe implementation of MEDS in routine clinical practice and associated outcomes. The study was conducted in five stages (baseline, intervention 1, washout, intervention 2, and sustainability phases). The 2 intervention phases taught clinical staff the MEDS intervention using different implementation strategies. The study found that both MEDS intervention phases were associated with decreased risk of error and that some improvement was sustained without active intervention. These findings suggest that attempts to develop simplified, brief interventions may be associated with improved medication safety for children after discharge from the ED
  2. Content Article
    This US study in the journal Pediatrics analysed a national sample of paediatric hospitalisations to identify disparities in safety events. The authors used data from the 2019 Kids’ Inpatient Database and looked at the independent variables of race, ethnicity and the organisation paying for care (for example, private insurance company or Medicaid). The results showed disparities in safety events for Black and Hispanic children, indicating a need for targeted interventions to improve patient safety in hospitals.
  3. Content Article
    Incorporating parental values in complex medical decisions for young children is important but challenging. This review in The Lancet Child & Adolescent Health explores what it means to incorporate parental values in complex paediatric and perinatal decisions. It provides a narrative overview of the paediatric, ethics and medical decision-making literature, focusing on value-based and ethically complex decisions for children who are too young to express their own preferences. 
  4. Content Article
    The relationship between the fields of human factors and patient safety is relatively nascent but represents a powerful interaction that has developed in only the last twenty years. Application of human factors principles, techniques, and science can facilitate the development of healthcare systems, protocols, and technology that leverage the enormous and adaptable capacity of human performance while acknowledging human vulnerability and decreasing the risk of error during patient care. This chapter will review these concepts and employ case studies from neonatal care to demonstrate how an understanding of human factors can be applied to improve patient safety.
  5. Content Article
    The aim of this study was to investigate the incident reporting process (IR1s), to calculate the costs of reporting incidents in this context and to gain an indication of how economic the process was and whether it could be improved to yield better outcomes.
  6. Content Article
    As health care specialists, we spend a huge amount of time considering, empathising with, and addressing the needs of the people we want to help. We intimately understand the challenges children and young people face, and how these may impact their health and development long term. Exposed daily to this kind of emotional and physical distress, it can be easy for compassion fatigue to creep in. Our brains work automatically to protect our own mental health, almost desensitising us to the trauma experienced by others. It’s much easier to think of people as statistics, especially when it comes to children and young people. But the more we think in terms of statistics, the more immune to them we become, the more empathy we lose and the less potential there is for an effective, caring health care system that works well for everyone. We need to put the care back into health care.
  7. Content Article
    This safety article aims to outline the actions taken by the patient safety team at NHS Improvement in response to a reported incident and to highlight potential for harm to babies from knitted items. Related reading on the hub: Finger injuries from infant mittens; a continuing but preventable hazard (April 1996) Notes from a Patient Safety Education Network discussion on a similar incident. (This is a group for UK hub members involved in patient safety education/training in their organisations and members of the hub can join by emailing support@PSLhub.org.)
  8. Content Article
    During the last 4 years, three infants have presented with finger-tip injuries secondary to entrapment in woollen/synthetic mittens. The accident happened at home in one case but the other two occurred in different neonatal units. Spontaneous amputation of the terminal phalanx of the index finger occurred in two patients but in the other there was complete healing. This problem may be avoided by restricting the use of mittens, by changing their design, and by a greater awareness of this hazard. Related reading on the hub: Knitted items – potential for harm to babies? (2018) Notes from a Patient Safety Education Network discussion on a similar incident. (This is a group for UK hub members involved in patient safety education/training in their organisations and members of the hub can join by emailing support@PSLhub.org.)
  9. Content Article
    Racial and ethnic disparities in health are substantial and persistent in the USA. They occur from the earliest years of life, are perpetuated by societal structures and systems, and profoundly affect children’s health throughout their lives. This series of articles in The Lancet Child & Adolescent Health summarises evidence on racial and ethnic inequities in the quality of paediatric care, outlines priorities for future research to better understand and address these inequities and discusses policy solutions to advance child health equity in the USA. Racial and ethnic inequities in the quality of paediatric care in the USA: a review of quantitative evidence Policy solutions to eliminate racial and ethnic child health disparities in the USA
  10. Content Article
    Medication is a common cause of preventable medical harm in paediatric inpatients. This study aimed to examine the sociotechnical system surrounding paediatric medicines management and to identify potential gaps in this system and how these might contribute to adverse drug events (ADEs). The authors advocate the following actions as a result of the insights gained about contributing factors to ADEs: processes to involve parents in the care of their children in hospital. development of skill-mix interventions to ensure appropriate expertise is available where it is needed. modified checking procedures to permit staff to use their skills and judgment effectively and efficiently.
  11. Content Article
    The Situation Awareness for Everyone (S.A.F.E.) programme has been used at 50 sites over four years to help reduce 50 sites over four years. This toolkit has been produced by the Royal College of Paediatrics and Child Health (RCPCH) to support child health professionals to use S.A.F.E. principles at their sites. The toolkit contains four modules: Translating quality improvement into action Theories of patient safety and application to the S.A.F.E programme The S.A.F.E programme: from reaction to anticipation Team perspectives
  12. Content Article
    The Paediatric Intensive Care Audit Network (PICANet) has published the National Paediatric Critical Care Audit State Nation Report 2023. Based on a data collection period from January 2020 to December 2022, it describes paediatric critical care activity which occurred within Level 3 paediatric intensive care units and Specialist Paediatric Critical Care Transport Services in the United Kingdom (UK) and Republic of Ireland (ROI). This report contains key information on referral, transport and admission events collected by the National Paediatric Critical Care Audit to monitor the delivery and quality of care in relation to agreed standards and evaluate clinical outcomes to inform national policy in paediatric critical care. It reports on the following five key metrics relevant to Paediatric Intensive Care services: case ascertainment including timeliness of data submission retrieval mobilisation times emergency readmissions within 48 hours of discharge unplanned extubation in PICU mortality in PICU.
  13. Content Article
    Paediatric drug optimization (PADO) exercises aim to identify key priority products and their preferred product characteristics for research and development. These have been successfully undertaken for HIV, hepatitis C, tuberculosis and antibiotics, demonstrating their potential and impact to accelerate access to optimal formulations in the context of fragmented, small markets for medicines for children. WHO convened and facilitated a paediatric exercise for neglected tropical diseases to ensure that more targeted research and development efforts can address the specific needs of infants and children. These are schistosomiasis, human African trypanosomiasis (HAT), scabies, onchocerciasis and visceral leishmaniasis (VL).
  14. News Article
    Two young people facing mental health crises were left on paediatric wards for months while different agencies across a health system struggled to find appropriate placements. The patients – who were both autistic and had learning disabilities, with special educational needs – were admitted to Maidstone and Tunbridge Wells Trust (MTW) last year after attending emergency departments more than 10 times within a two-month period. They were left on a paediatric ward – one of the patients for four months – as this was the “only available place of safety as opposed to the optimum setting to meet their needs,” according to Kent and Medway Integrated Care Board’s “learning review” of children and young people with complex needs, which the two cases prompted. The review, which HSJ obtained under a Freedom of Information request, revealed several problems with joint working, despite a multidisciplinary team meeting regularly to discuss the young patients’ needs. Since the review, a new escalation process has been introduced, urgent mental health risk assessments in the community have been enhanced and a three-month pilot of a self-harm service has been implemented at Tunbridge Wells Hospital, part of MTW. Read full story (paywalled) Source: HSJ, 17 November 2023
  15. News Article
    The number of child deaths has hit record levels, with hundreds more children dying since the pandemic, shocking new figures show. More than 3,700 children died in England between April 2022 and March 2023, including those who died as a result of abuse and neglect, suicide, perinatal and neonatal events and surgery, new data from the National Child Mortality Database has revealed – with more than a third of the deaths considered avoidable. Children in poorer areas were twice as likely to die as those in the richest, while 15 per cent of those who died were known to social services. The UK’s top children’s doctor, Dr Camilla Kingdon, president of the Royal College of Paediatrics and Child Health, hit out at the government for failing to act to tackle child poverty, which she said was driving the “unforgivable” and “avoidable” deaths. The report said: “Whilst the death rate in the least deprived neighbourhoods decreased slightly from the previous year, the death rate for the most deprived areas continued to rise, demonstrating widening inequalities.” Read full story Source: The Independent, 11 November 2023
  16. Content Article
    The National Child Mortality Database (NCMD) was launched on 1 April 2019 and collates data collected by Child Death Overview Panels (CDOPs) in England from reviews of all children who die at any time after birth and before their 18th birthday. There is a statutory requirement for CDOPs to collect this data and to provide it to NCMD, as outlined in the Child Death Review statutory and operational guidance. The guidance requires all Child Death Review (CDR) Partners to gather information from every agency that has had contact with the child, during their life and after their death, including health and social care services, law enforcement, and education services. This is done using a set of statutory CDR forms and the information is then submitted to NCMD. The data in this report summarise the number of child deaths up to 31 March 2023 and the number of reviews of children whose death was reviewed by a CDOP before 31 March 2023.
  17. Event
    On the NHS75 anniversary, NHSE announced that paediatrics will be the next priority pathway for the rollout of virtual wards. With over 350,000 children in the queue for treatment, capacity pressures continue to mount for paediatric teams. The stage is set for paediatric virtual wards to address these pressures head-on, and emerging evidence is promising. Pilot sites have demonstrated paediatric virtual wards can: Reduce a child’s length of stay in hospital by an average of 3 days Decrease hospital readmission by 38% for children with chronic conditions. So what is needed to build paediatric virtual wards that work for both children and their caregivers? This webinar will dive into the nuanced approach required when caring for children at home, bringing in insights and learnings from leading UK paediatric clinicians and experts working in the field. In this webinar you will learn: The need for a fresh approach: the huge potential for paediatric virtual wards to reduce pressure in paediatric departments and why these pathways require teams to think differently Lessons from the front-line: the key take-aways from one of the first NHS sites to trial paediatric virtual wards How to build a successful paediatric virtual ward: what is needed to set up a paediatric virtual ward pathway and team for success Speakers: Zoe Tribble, Children's Nurse Jim McDonald, Black Country ICB Juliana Faleti, Paediatric Nurse Register for the webinar
  18. Content Article
    The transition from hospital to home is a vulnerable time as patients may have changes in medications or care needs, or difficulties accessing follow up with an outpatient provider. Authors conducted a prospective intervention study of children with medical complexity discharged at a children’s hospital from April 2018 to March 2020. To reduce adverse events (AE), rehospitalizations, and emergency department visits, this hospital developed a structured discharge bundle based on the I-PASS tool used for inpatient handoffs. AE, rehospitalisations, and emergency department visits were all reduced following implementation of the I-PASS bundle.
  19. Content Article
    These charts have been collaboratively developed by clinical teams across England to standardise how the deterioration of children in hospital is tracked. There are four charts for children of different ages, designed to be used on general children’s wards. PEWS observation and escalation chart: 0 to 11 months PEWS observation and escalation chart: 1-4 years PEWS observation and escalation chart: 5-12 years PEWS observation and escalation chart: ≥13 years
  20. News Article
    Sick children’s health problems are getting worse as record numbers wait up to 18 months for NHS care, doctors treating them have warned. The number of under-18s on the waiting list for paediatric care in England has soared to 423,500, the highest on record. Of those, 23,396 have been forced to wait over a year for their appointment. Delays facing children and young people are now so common that Dr Jeanette Dickson, the chair of the Academy of Medical Royal Colleges, the body representing all UK doctors professionally, warned that children are “the forgotten casualties of the NHS’s waiting list crisis”. “As a paediatrician, I’ve seen first hand the damaging impact that long waiting times have on children, on their education and overall wellbeing, and of course on their families,” said Dr Camilla Kingdon, the president of the Royal College of Paediatrics and Child Health (RCPCH). The figures came from the RCPCH’s analysis of official performance data recently published by NHS England. The health of some children was deteriorating while they languished on the waiting list because their illness and age meant they needed to have their treatment fast, Kingdon added. “Many treatments and interventions must be administered within specific age or developmental stages. No one wants to wait for treatment, but children’s care is frequently time-critical.” Read full story Source: The Guardian, 17 September 2023
  21. News Article
    Children have suffered severe harm at two further hospital trusts as a result of failures in paediatric audiology, HSJ has revealed. HSJ reported in July that three children at Croydon Health Service Trust may have come to “severe harm” – meaning they may have suffered permanent damage – following failures in the trust’s processes in audiology. Now East and North Hertfordshire Trust and North West Anglia Foundation Trust have also confirmed a small number of cases of severe or serious harm; while some trusts have yet to confirm findings from case reviews they have carried out. Major problems emerged earlier this year, initially in Scotland, of poor quality checks missing children with hearing problems who should have received support, and of a failure to inspect the services. NHS England ordered a review of data from the national newborn screening programme which, alongside other review work, identified six English trusts as having likely failures in their service: Croydon, East and North Herts, North West Anglia, Warrington and Halton Hospitals, North Lincolnshire and Goole, and Worcestershire Acute Hospitals. Read full story (paywalled) Source: HSJ, 14 September 2023
  22. Content Article
    A new issue brief from the Agency for Healthcare Research and Quality (AHRQ) examines the unique challenges of studying and improving diagnostic safety for children in respect to their overall health, access to care and unique aspects of diagnostic testing limitations for multiple paediatric conditions. The issue brief features approaches to address these challenges cross the care-delivery spectrum, including in primary care offices, emergency departments, inpatient wards and intensive care units. It also provides recommendations for building capacity to advance paediatric diagnostic safety. 
  23. News Article
    A hospital trust has apologised to families after dozens of children suffered hearing loss following failures in their care. Croydon Health Services Trust had already revealed three children “may have been at risk of serious hearing loss or a delay to their speech development”, but it has now confirmed to HSJ that a further 49 “incurred mild to moderate hearing loss or impairment”. The south London trust would not disclose the results of its internal review that begun after it declared a serious incident in March 2021, saying it was “ongoing”, but said it had acted on all the “immediate recommendations”. The incident was declared after more than 1,400 children were found not to have been followed up by the trust. There was also an external review carried out by an audiologist from Guy’s and St Thomas’ Foundation Trust. It is unclear which review uncovered the incidents of harm. Read full story Source: HSJ 1 August 2023
  24. Content Article
    Tests that indicate the health of newborns, moments after birth, are limited and not fit-for-purpose for Black, Asian and ethnic minority babies, and need immediate revision according to the NHS Race and Health Observatory.
  25. News Article
    Tens of thousands of children will be treated in “virtual wards” to free hospital beds for more critically ill patients under new NHS plans. The Hospital at Home service will be expanded to include paediatric care in every region of England this month, the health service announced. As part of the service, clinical teams review patients daily and can provide treatments including blood tests, prescribe medicines or administer fluids through a drip. Ward rounds can include home visits or a video call, and many services use technology such as apps and wearable devices to monitor recovery. Professor Simon Kenny, the NHS’s national clinical director for children and young people, said: “The introduction of paediatric virtual wards means children can receive clinical care from home, surrounded by family and an environment they and their parents would rather they be — with nurses and doctors just a call away.” Read full story (paywalled) Source: The Times. 5 July 2023
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