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Found 900 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
    Hospitals with high mortality and readmission rates for patients with heart failure (HF) might also perform poorly in other quality concepts. Wang et al. sought to evaluate the association between hospital performance on mortality and readmission with hospital performance rates of safety adverse events. They found that patients admitted with HF to hospitals with high 30-day all-cause mortality and readmission rates had a higher risk of in-hospital adverse events. There may be common quality issues among these 3 measure concepts in these hospitals that produce poor performance for patients with HF.
  3. Content Article
    Patient harm, patient safety and their governance have been ongoing concerns for policymakers, care providers and the public. In response to high rates of adverse events/medical errors, the World Health Organization (WHO) advocated the use of surgical safety checklists (SSC) to improve safety in surgical care. Canadian health authorities subsequently made SSC use a mandatory organisational practice, with public reporting of safety indicators for compliance tied to pre-existing legislation and to reimbursements for surgical procedures. Perceived as the antidote for socio-technical issues in operating rooms (ORs), much of the SSC-related research has focused on assessing clinical and economic effectiveness, worker perceptions, attitudes and barriers to implementation. Suboptimal outcomes are attributed to implementations that ignored contexts. Using ethnographic data from a study of SSC at an urban teaching hospital (C&C), a critical lens and the concepts of ritual and ceremony, this paper examinse how it is used, and theorise the nature and implications of that use. Two rituals, one improvised and one scripted, comprised C&C’s SSC ceremony. Improvised performances produced dislocations that were ameliorated by scripted verification practices. This ceremony produced causally opaque links to patient safety goals and reproduced OR/medical culture. We discuss the theoretical contributions of the study and the implications for patient safety.
  4. 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.
  5. Content Article
    This cohort study in the Lancet aimed to evaluate the overall effect of vaccination to prevent Long Covid symptoms and assess comparative effectiveness of the most used vaccines (ChAdOx1 and BNT162b2). The results showed that vaccination against Covid-19 consistently reduced the risk of Long Covid symptoms, which highlights the importance of vaccination to prevent persistent Covid-19 symptoms, particularly in adults.
  6. News Article
    People experiencing Long Covid have measurable memory and cognitive deficits equivalent to a difference of about six IQ points, a study suggests. The study, which assessed more than 140,000 people in summer 2022, revealed that Covid-19 may have an impact on cognitive and memory abilities that lasts a year or more after infection. People with unresolved symptoms that had persisted for more than 12 weeks had more significant deficits in performance on tasks involving memory, reasoning and executive function. Scientist said this showed that “brain fog” had a quantifiable impact. Prof Adam Hampshire, a cognitive neuroscientist at Imperial College London and first author of the study, said: “It’s not been at all clear what brain fog actually is. As a symptom it’s been reported on quite extensively, but what our study shows is that brain fog can correlate with objectively measurable deficits. That is quite an important finding.” Read full story Source: The Guardian, 29 February 2024
  7. Content Article
    Poor memory and difficulty thinking or concentrating (commonly referred to as “brain fog”) have been implicated in syndromes occurring after Covid-19 — a situation that has led to suggestions that Covid-19 may have lasting cognitive consequences. However, objective data on cognitive performance are largely lacking, and how long such deficits may persist and which cognitive functions are most vulnerable are unclear. In this observational study, Hampshire et al. invited 800,000 adults in a study in England to complete an online assessment of cognitive function. The authors estimated a global cognitive score across eight tasks. They hypothesised that participants with persistent symptoms (lasting ≥12 weeks) after infection onset would have objectively measurable global cognitive deficits and that impairments in executive functioning and memory would be observed in such participants, especially in those who reported recent poor memory or difficulty thinking or concentrating (“brain fog”). They found that participants with resolved persistent symptoms after Covid-19 had objectively measured cognitive function similar to that in participants with shorter-duration symptoms, although short-duration Covid-19 was still associated with small cognitive deficits after recovery. Longer-term persistence of cognitive deficits and any clinical implications remain uncertain.
  8. Content Article
    To decrease surgical site infections after appendectomy for acute appendicitis, preoperative broad-spectrum antibiotics are often used in clinical practice. However, this treatment strategy has come under scrutiny because of increasing rates of antibiotic-resistant infections. This multisite quality improvement project aimed to decrease the treatment of uncomplicated acute appendicitis with piperacillin-tazobactam without increasing the rate of surgical site infections. The intervention had two distinct components: Updating electronic health record orders to encourage preoperative administration of narrow-spectrum antibiotics. Educating surgeons and emergency department clinicians about selecting appropriate antibiotic therapy for acute appendicitis. Patient demographics, clinical characteristics and outcomes were compared six months before and after implementation of the quality improvement intervention. The intervention successfully decreased piperacillin-tazobactam administration without increasing the rate of surgical site infections in patients with acute appendicitis.
  9. Content Article
    Brain fog is one of the most common, persistent complaints in patients with Long Covid, affecting up to 46% of patients, many of whom also deal with other cognitive concerns like memory loss and difficulty concentrating.  This Medscape article looks at new research suggesting these symptoms may be the result of a viral-borne brain injury that causes cognitive and mental health issues that persist for years. This may offer new options for treating brain fog and other cognitive symptoms associated with Long Covid.
  10. Content Article
    Continuity of care, defined as an ongoing therapeutic relationship between a patient and a physician, is a defining characteristic of primary care. However, arranging a consultation with one’s regular doctor is increasingly difficult as practices face physician shortages. Kajaria-Montag et al. studied the effect of declining care continuity on the productivity of physicians by analysing data of over 10 million consultations in 381 English primary care practices over a period of 11 years. Specifically, they examined whether a consultation with the patient’s regular doctor is more productive than with another doctor in the practice. The authors found that the time to a patient’s next visit is on average 18.1% longer when the patient sees the doctor they have seen most frequently over the past two years, while there is no operationally meaningful difference in consultation duration. The data show that the productivity benefit of care continuity is larger for older patients, patients with multiple chronic conditions, and patients with mental health conditions. The authors estimate that the total consultation demand in their sample could have fallen by up to 5.2% had all practices offered continuity of care at the level of the top decile of practices while prioritising patients expected to yield the largest productivity benefits.
  11. News Article
    Seeing the same GP improves patients’ health, reduces doctors’ workloads and could free up millions of appointments, according to the largest study of its kind. Research has previously suggested there may be benefits to seeing the same family doctor. But studies have mostly been small or covered a short period of time. Now University of Cambridge and Insead business school researchers have analysed data from 10m consultations over more than a decade in the most authoritative study on the issue yet. They found that if all GP practices moved to a model where patients saw the same doctor at each visit, it would significantly reduce doctors’ workloads while improving patient health. Multiple benefits emerged when patients had a long-term relationship with their doctor, researchers found. Seeing the same GP – known as continuity of care – meant people waited on average 18% longer between visits, compared with patients who saw different doctors. People did not take up more GP time in each consultation and the findings were particularly strong for older patients, those with multiple chronic illnesses, and people with mental health conditions. Although it will not always be possible for people to see their regular GP, researchers said the findings would translate to an estimated 5% reduction in consultations if all practices provided the level of continuity of care of the best 10% of practices. That suggests millions of appointments could be freed up. The researchers added: “Importantly, if patients receiving care from their regular doctors have longer intervals between consultations without requiring longer consultations, then continuity of care can potentially allow physicians to expand their patient list without increasing their time commitment.” Read full story Source: The Guardian, 23 February 2024
  12. News Article
    Black children in the UK are four times more likely to experience complications after appendicitis surgery than their white counterparts, a study has found. The study, funded by the Association of Paediatric Anaesthetists of Great Britain and Ireland, looked at 2,799 children from 80 hospitals across the UK aged under 16 who had surgery for suspected appendicitis between November 2019 and January 2022. Of these, 185 children (7%) developed postoperative complications within 30 days of the surgery. Three-quarters of these complications were related to the wound, while a quarter were respiratory, urinary or catheter-related or of unknown origin. The study found that black children had a four times greater risk of experiencing complications after the operation, and that this risk was independent of the child’s socioeconomic status and health history. Appendicitis is one of the most common paediatric surgical emergency with 10,000 performed every year. The authors said that this was the first study to look at the demographic differences of postoperative complication rates in regards to appendicitis. The researchers said they could not draw firm conclusions regarding why black children had worse outcomes after this type of emergency surgery, and that this apparent health inequality “requires urgent further investigation and development of interventions aimed at resolution”. Read full story Source: The Guardian, 22 February 2024
  13. News Article
    From forgetfulness to difficulties concentrating, many people who have Long Covid experience “brain fog”. Now researchers say the symptom could be down to the blood-brain barrier becoming leaky. The barrier controls which substances or materials enter and exit the brain. “It’s all about regulating a balance of material in blood compared to brain,” said Prof Matthew Campbell, co-author of the research at Trinity College Dublin. “If that is off balance then it can drive changes in neural function and if this happens in brain regions that allow for memory consolidation/storage then it can wreak havoc.” Writing in the journal Nature Neuroscience, Campbell and colleagues report how they analysed serum and plasma samples from 76 patients who were hospitalised with Covid in March or April 2020, as well 25 people before the pandemic. Among other findings, the team discovered that samples from the 14 Covid patients who self-reported brain fog contained higher levels of a protein called S100β than those from Covid patients without this symptom, or people who had not had Covid. This protein is produced by cells within the brain, and is not normally found in the blood, suggesting these patients had a breakdown of the blood-brain barrier. Read full story Source: The Guardian, 22 February 2024
  14. Content Article
    This video, was produced by Long Covid Support to show why effective Long Covid research is urgently needed.
  15. Content Article
    This is part of our series of Patient Safety Spotlight interviews, where we talk to people working for patient safety about their role and what motivates them. Kevin talks to us about the role research plays in improving staff and patient safety. He explains how his own research has uncovered the extent of violence experienced by student nurses and the underreporting of sharps injuries among healthcare students. He also highlights how research can help universities improve awareness of issues facing students across all healthcare courses and provide more effective support.
  16. Content Article
    The National Institute for Health and Care Excellence (NICE) pioneered the Health Technology Assessment (HTA) processes and methodologies. Technology appraisals (TAs) focus on pharmaceutical products and clinical and economic data, which are presented by the product manufacturers to the NICE appraisal committee for decision-making. Uncertainty in data reduces the chance of a positive outcome from the HTA process or requires a higher discount. This study in the BMJ Open aimed to investigate the quality of clinical data submitted by product manufacturers to NICE. The authors found that the primary components of clinical evidence influencing NICE’s decision-making framework were of poor quality. They argue that there is a need to generate robust clinical data for premarket and postmarket introduction of medicines into clinical practice, to ensure they deliver benefits to patients.
  17. Content Article
    Effective teamwork is critical to the provision of safe, effective healthcare. High functioning teams adapt to rapidly changing patient and environmental factors, preventing diagnostic and treatment errors. While the emphasis on teamwork and patient safety is relatively new, significant team-related foundational and implementation research exists in disciplines outside of healthcare. Social scientists, including, organizational psychologists, have expertise in the study of teams, multi-team units, and organizations. This article highlights guiding team science principles from the organisational psychology literature that can be applied to the study of teams in healthcare. The authorsʼ goal is to provide some common language and understanding around teams and teamwork. Additionally, they hope to impart an appreciation for the potential synergy present within clinician-social scientist collaborations.
  18. Content Article
    This study aimed to explore the experience and psychological impact on nursing students of sustaining a sharps injury. A qualitative approach was taken, using two methods to gather data, namely a Twitter chat and interviews. Some nursing students reported psychological impacts after sustaining the sharps injury, which affected both their professional and personal life. The qualitative findings were synthesised into eight themes.
  19. Content Article
    This systematic review and meta-analysis in JAMA Internal Medicine aimed to explore whether there is an association between daily toothbrushing among hospitalised patients and prevention of hospital-acquired pneumonia. The authors found that hospital-acquired pneumonia rates were lower among patients randomised to daily toothbrushing, particularly among patients receiving invasive mechanical ventilation. Toothbrushing was also associated with shorter duration of mechanical ventilation, shorter intensive care unit (ICU) length of stay and lower ICU mortality, whereas hospital length of stay and use of antibiotics showed no differences.
  20. Content Article
    The National Institute for Health Research (NIHR) awarded researchers from The Open University (OU), Manchester Metropolitan University, the Universities of Oxford, Glasgow and Edinburgh more than £141,000 to expand their world-first study of witnesses’ experience of giving evidence during health and social care workers’ professional conduct hearings. The project, Witness to harm, holding to account: Improving patient, family and colleague witnesses’ experiences of Fitness to Practise proceedings, mainly focuses on cases where there are allegations of harm. This focus should help regulators and employers identify potential improvements to support witnesses whose role in giving evidence is crucial to a fair hearing.
  21. Event
    Speaker: Professor Ian Leistikow; Adviser at the Dutch Health & Youth Care Inspectorate and Professor at Erasmus School of Health Policy & Management, Erasmus University Rotterdam, the Netherlands Challenges that health and care faces, translate to challenges for the regulatory authorities. Classic regulatory strategies aimed at compliance increasingly fall short in contributing to quality of (health)care. In this webinar Ian will use the model of ‘value driven regulation’ to show how the Dutch Inspectorate strives to keep up with the dynamics of the sectors it regulates, by keeping its eye on creating societal value. Ian will also give an overview of the broad range of scientific research projects within the Inspectorate aimed at improving the positive impact of its regulation. Find out more
  22. Content Article
    The aim of this study, published in the BMJ, was to evaluate whether a structured online supervised group physical and mental health rehabilitation programme can improve health related quality of life compared with usual care in adults with Long Covid.  Best practice usual care was a single online session of advice and support with a trained practitioner. The REGAIN intervention was delivered online over eight weeks and consisted of weekly home based, live, supervised, group exercise and psychological support sessions. The authors concluded that in adults with Long Covid, an online, home based, supervised, group physical and mental health rehabilitation programme was clinically effective at improving health related quality of life at 3 and 12 months compared with usual care.
  23. Content Article
    Despite progress on patient safety since the publication of the Institute of Medicine’s 1999 report, To Err Is Human, significant problems remain. Human factors and systems engineering (HF/SE) has been increasingly recognized and advocated for its value in understanding, improving, and redesigning processes for safer care, especially for complex interacting sociotechnical systems. However, broad awareness of HF/SE and its adoption into safety improvement work have been frustratingly slow. We provide an overview of HF/SE, its demonstrated value to a wide range of patient safety problems (in particular, medication safety), and challenges to its broader implementation across health care. We make a variety of recommendations to maximise the spread of HF/SE, including formal and informal education programmes, greater adoption of HF/SE by health care organisations, expanded funding to foster more clinician-engineer partnerships, and coordinated national efforts to design and operationalise a system for spreading HF/SE into health care nationally.
  24. Content Article
    Prolonged length of stay (LOS) in emergency departments (ED) is a widespread problem in every hospital around the globe. Multiple factors cause it and can have a negative impact on the quality of care provided to the patients and the patient satisfaction rates. This project aimed to ensure that the average LOS of patients in a tertiary care cancer hospital stays below 3 hours. 
  25. Content Article
    Although disparities in surgical outcomes are well-documented, understanding of how socioecological factors drive these disparities remains limited. This US study’s objective was to develop and assess the acceptability and feasibility of a comprehensive tool to evaluate socioecological determinants of health in patients requiring colorectal surgery. The authors developed an 88-item assessment tool measuring 31 socioecological determinants of health. It was assessed as having high acceptability and feasibility for patients who required colorectal surgery. The authors concluded that this work will help to identify what research is needed to understand and address surgical disparities.
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