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Found 92 results
  1. Content Article
    Postoperative surgical site infection is a serious problem. Coverage of sterile goods may be important to protect the goods from bacterial air contamination while awaiting surgery. This study from Wistrand and colleagues, evaluated the effectiveness of this practice in a systematic review covering five databases using search terms related to bacterial contamination in the operating room and on surgical instruments. No negative effects regarding bacterial contamination were found and the authors conclude that protection with a sterile cover decreases bacterial air contamination of sterile goods while waiting for surgery to start.
  2. Content Article
    'Failure to rescue' is the rate of death amongst patients with postoperative complications and has been proposed as a perioperative quality indicator. However, there may be significant variation in its definition between research studies. This study in the journal Surgery systematically reviewed all surgical literature reporting failure to rescue rates and examined variations in the definition of the ‘numerator,’ ‘denominator’ and timing of failure to rescue measurement. The authors found that failure to rescue is an important concept in the study of postoperative outcomes, but its definition is highly variable and poorly reported. They highlight that researchers should be aware of the advantages and disadvantages of different approaches to defining failure to rescue.
  3. Content Article
    This study published in BMJ Quality & Safety identified factors acting as barriers or enablers to the process of healthcare consent for people with intellectual disability and to understand how to make this process equitable and accessible. The study found that multiple reasons contribute to poor consent practices for people with intellectual disability in current health systems. Recommendations include addressing health professionals’ attitudes and lack of education in informed consent with clinician training, the co-production of accessible information resources and further inclusive research into informed consent for people with intellectual disability. Related reading on the hub: Accessible patient information: a key element of informed consent
  4. Content Article
    Health and social care standards have been widely adopted as a quality improvement intervention. Standards are typically made up of evidence-based statements that describe safe, high-quality, person-centred care as an outcome or process of care delivery. They involve stakeholders at multiple levels and multiple activities across diverse services. As such, challenges exist with their implementation. Existing literature relating to standards has focused on accreditation and regulation programmes and there is limited evidence to inform implementation strategies specifically tailored to support the implementation of standards. This systematic review aimed to identify and describe the most frequently reported enablers and barriers to implementing (inter)nationally endorsed standards, in order to inform the selection of strategies that can optimise their implementation.
  5. Content Article
    Leadership walkarounds (LWs) have been promoted in practice as means to drive operational, cultural and safety outcomes. This systematic review in BMJ Open Quality aimed to evaluate the impact of LWs on these outcomes in the US healthcare industry. The authors found only positive association of LWs with operational and perception of cultural outcomes.
  6. Content Article
    Patient safety incidents, including medical errors and adverse events, frequently occur in intensive care units, leading to a significant psychological burden on healthcare professionals. This burden results in second victim syndrome, which impacts the psychological and psychosomatic wellbeing of these staff members. This systematic review and meta-analysis aimed to examine the occurrence of second victim syndrome among intensive care unit healthcare workers, including the types, prevalence, risk factors and recovery time associated with the condition.
  7. Content Article
    This is the protocol for a Campbell systematic review. The main aim of this systematic review was to identify whether hospital leadership styles predict patient safety as measured through several indicators over time. The second aim was to assess the extent to which the prediction of hospital leadership styles on patient safety indicators varies as a function of the leader's hierarchy level in the organisation.
  8. Content Article
    The adoption of virtual consultations, catalysed by the COVID-19 pandemic, has transformed the delivery of primary care services. Owing to their rapid global proliferation, there is a need to comprehensively evaluate the impact of virtual consultations on all aspects of care quality. This study aims to evaluate the impact of virtual consultations on the quality of primary care. It found that virtual consultations may be as effective as face-to-face care and have a potentially positive impact on the efficiency and timeliness of care; however, there is a considerable lack of evidence on the impacts on patient safety, equity, and patient-centeredness, highlighting areas where future research efforts should be devoted. Capitalising on real-world data, as well as clinical trials, is crucial to ensure that the use of virtual consultations is tailored according to patient needs and is inclusive of the intended end users. Data collection methods that are bespoke to the primary care context and account for patient characteristics are necessary to generate a stronger evidence base to inform future virtual care policies.
  9. Content Article
    Private equity takeovers of health services worldwide are associated with worse quality of care and higher costs, according to this study from Borsa et al. In the past decade, private equity firms have increasingly invested in, acquired and consolidated healthcare facilities. Globally, healthcare buyouts have exceeded £157bn since 2021 alone. Despite much speculation, evidence about the impact of this rapidly growing global trend has been lacking. Now a systematic review of private equity healthcare service takeovers across eight countries including the US, UK, Sweden and the Netherlands provides it. Private equity (PE) ownership of healthcare services including hospitals and nursing homes is linked to a harmful effect on cost and quality of care, suggests the review published in the BMJ. The authors of the review, which was led by the University of Chicago, said: “The most unequivocal evidence points to PE being associated with an increase in healthcare costs. Evidence across studies also suggests mixed impacts of PE ownership on healthcare quality, with greater evidence that PE ownership might degrade quality in some capacity rather than improve it.”
  10. Content Article
    There are reports of increasing incidence of paediatric diabetes since the onset of the COVID-19 pandemic. This study by D'Souza et al. compares the incidence rates of paediatric diabetes during and before the COVID-19 pandemic. The study found that incidence rates of type 1 diabetes and diabetic ketoacidosis at diabetes onset in children and adolescents were higher after the start of the COVID-19 pandemic than before the pandemic. Increased resources and support may be needed for the growing number of children and adolescents with diabetes. Future studies are needed to assess whether this trend persists and may help elucidate possible underlying mechanisms to explain temporal changes.
  11. News Article
    As many as 250,000 people die every year because they are misdiagnosed in the emergency room, with doctors failing to identify serious medical conditions like stroke, sepsis and pneumonia, according to a new analysis from the US federal government. The study by the Agency for Healthcare Research and Quality estimates roughly 7.4 million people are inaccurately diagnosed of the 130 million annual visits to hospital emergency departments in the United States. Some 370,000 patients may suffer serious harm as a result. Researchers from Johns Hopkins University analysed data from two decades’ worth of studies to quantify the rate of diagnostic errors in the emergency room and identify serious conditions where doctors are most likely to make a mistake. While these errors remain relatively rare, they are most likely to occur when someone presents with symptoms that are not typical. “This is the elephant in the room no one is paying attention to,” said Dr. David E. Newman-Toker, a neurologist at Johns Hopkins University and director of its Armstrong Institute Center for Diagnostic Excellence, and one of the study’s authors. The findings underscore the need to look harder at where errors are being made and the medical training, technology and support that could help doctors avoid them, Dr. Newman-Toker said. “It’s not about laying the blame on the feet of emergency room physicians,” he said. Read full story Source: New York Times, 15 December 2022
  12. Content Article
    Chronic pain is common and debilitating, affecting about one in five people globally. However, chronic pain can be difficult to treat, and management is often suboptimal. The 2021 National Institute for Health and Care Excellence guideline for chronic primary pain explicitly recommends against the use of pain medicines, with the exception of antidepressants. To provide patients and clinicians with an updated and comprehensive resource on the efficacy, safety, and tolerability of antidepressants to treat pain, Ferreira et al. conducted an overview of relevant systematic reviews.  The study found no review could provide high certainty evidence on the effectiveness of antidepressants for pain for any condition. Nine reviews did provide evidence that some antidepressants were effective, such as moderate evidence suggesting serotonin-norepinephrine reuptake inhibitors (SNRIs), such as duloxetine, were effective for back pain, post-operative pain, fibromyalgia and nerve pain. However, the study only found low certainty evidence that selective serotonin reuptake inhibitors (SSRIs) were effective for people with depression and pain related to other conditions, and that tricyclic antidepressants (TCAs) were effective for irritable bowel syndrome, nerve pain and chronic tension-type headaches. The findings suggest that a more nuanced approach is needed when prescribing antidepressants for pain conditions.
  13. Content Article
    A prolonged stay in the emergency department before moving on to an in-hospital bed, another facility or departing home, is believed to have a negative effect on clinical outcomes for patients. This international systematic review and meta-analysis in the Journal of Clinical Medicine aimed to investigate the link between emergency department length of stay (EDLOS) and in-hospital mortality. The study's findings suggest two key associations with increased in-hospital mortality: low EDLOS EDLOS exceeding 24 hours The authors suggest that: long stays in the emergency department should not be allowed. special attention should be given to patients admitted after a short stay in the emergency department.
  14. Content Article
    In this document, Charles Vincent and colleagues from Imperial College London, propose a new framework to help find the elusive answer to the question – how safe is care today?
  15. Content Article
    Diagnostic errors are a known patient safety concern across all clinical settings, including the emergency department (ED). The authors from the John Hopkins University conducted a systematic review to determine the most frequent diseases and clinical presentations associated with diagnostic errors (and resulting harms) in the ED, measured error and harm frequency, as well as assessing causal factors.
  16. Content Article
    This systematic review in the International Journal of Health Planning and Management aimed to examine and analyse the existing literature that examines the impact of strike action on patient morbidity—all patient outcomes apart from death. 15 studies were included in the review. and articles included a variety of outcomes from hypertension control to rates of chlamydia. Strikes ranged from 13 to 118 days, with a mean strike length of 56 days. The authors found that the majority of studies reported that strike action had a neutral or mixed impact on patient morbidity. One study reported positive outcomes and three studies reported negative outcomes, however in both cases, the impact that the strike had was marginal.
  17. Content Article
    This study in eClinicalMedicine aimed to bring together the global evidence on the prevalence of persistent symptoms in people who had experienced Covid-19 infection. The authors found, across the 194 studies included in the systematic review, that 45% of Covid-19 survivors, regardless of hospitalisation status, were experiencing a range of unresolved symptoms at around four months after infection. The authors state that current understanding is limited by heterogeneous study design, follow-up durations and measurement methods, and highlight that definition of subtypes of Long Covid is unclear, which hampers effective treatment and management strategies.
  18. Content Article
    In this study, Tsampasian et al. looked at what the risk factors were for developing post−COVID-19 condition (also known as Long Covid). The systematic review and meta-analysis of 41 studies, including 860 783 patients, found that female sex, older age, higher body mass index, smoking, preexisting comorbidities, and previous hospitalisation or ICU admission were risk factors significantly associated with developing Long Covid, and that SARS-CoV-2 vaccination with two doses was associated with lower risk of Long Covid. The findings of this systematic review and meta-analysis provide a profile of the characteristics associated with increased risk of developing Long Covid and suggest that vaccination may be protective against Long Covid.
  19. Content Article
    Concerns about Covid-19 related mental health are substantial, but the sheer volume of low quality evidence has posed a barrier to evidence synthesis and decision making. In this systematic review,  Thombs et al. synthesised results of mental health outcomes in cohorts before and during the Covid-19 pandemic. The authors compared general mental health, anxiety symptoms, and depression symptoms in the general population and other groups during covid-19 with outcomes from the same cohorts before Covid-19. The study found high risk of bias in many studies and substantial heterogeneity suggest caution in interpreting results. Nonetheless, most symptom change estimates for general mental health, anxiety symptoms, and depression symptoms were close to zero and not statistically significant, and significant changes were of minimal to small magnitudes. Small negative changes occurred for women or female participants in all domains. The authors will update the results of this systematic review as more evidence accrues.
  20. Content Article
    This systematic review in the British Journal of Surgery aimed to describe types of cognitive bias in surgery, their impact on surgical performance and patient outcomes, their source, and the mitigation strategies used to reduce their effect. The authors concluded that cognitive biases have a negative impact on surgical performance and patient outcomes across all points of surgical care. This review highlights the scarcity of research investigating the sources that give rise to cognitive biases in surgery and the mitigation strategies that target these factors.
  21. Content Article
    This systematic review in the Western Journal of Nursing Research examined the relationship between hospital nurse fatigue and outcomes. The authors found that fatigue was consistently associated with mental health problems, decreased nursing performance and sickness absence. Many studies confirmed that nurse fatigue is negatively associated with nurse, patient-safety and organisational outcomes. The review also highlighted gaps in current knowledge and the need for future research using a longitudinal design and measuring additional outcomes to better understand the consequences of nurse fatigue.
  22. Content Article
    This systematic review in BMJ Open synthesised evidence on the impacts of insufficient sleep and fatigue on health and performance of physicians in independent practice, as well as on patient safety. The authors also assessed the effectiveness of interventions targeting insufficient sleep and fatigue. The authors found that fatigue and insufficient sleep may be associated with negative physician health outcomes, but concluded that current evidence is inadequate to inform practice recommendations.
  23. Content Article
    Chen et al. examined the worldwide prevalence of post COVID-19 condition, through a systematic review and meta-analysis. The research, published in the Journal of Infectious Disease, assessed 23 symptoms reported across 36 of the studies and found that shortness of breath, sleep problems, and joint pain was widely reported by those who had recovered from the novel coronavirus infection. They analysed the prevalence of this condition globally and regionally, estimating the proportion of individuals facing long Covid in Asia, Europe and North America. They found that the global prevalence for post-Covid conditions at 30, 60, 90 and 120 days after infection was about 37, 25, 32, and 49%, respectively. The authors concluded that post COVID-19 condition prevalence is substantial; the health effects of COVID-19 appear to be prolonged and can exert stress on the healthcare system.
  24. Content Article
    Prehospital care is the care received by a patient from an emergency medical service before arriving at a hospital. This systematic review in the International Journal for Quality in Health and Care aimed to identify: how the prevalence and level of harm associated with patient safety incidents (PSIs) in prehospital care are assessed. the frequency of PSIs in prehospital care. the harm associated with PSIs in prehospital care.
  25. Content Article
    Artificial intelligence (AI) is increasingly being used in medicine to help with the diagnosis of diseases such as skin cancer. To be able to assist with this, AI needs to be ‘trained’ by looking at data and images from a large number of patients where the diagnosis has already been established, so an AI programme depends heavily upon the information it is trained on. This review, published in The Lancet Digital Health, looked at all freely accessible sets of data on skin lesions around the world.
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