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Patient Safety Learning

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  1. Content Article
    Too little, too late, says Scally, Jacobson and Abbasi in this BMJ Editorial on the government's response to COVID-19. The UK government and its advisers were confident that they were “well prepared” when COVID-19 swept East Asia. The four-pronged plan of 3 March to contain, delay, research, and mitigate was supported by all UK countries and backed, they claimed, by science. With over 30 000 hospital and community deaths by 12 May, where did the plan go wrong? What was the role of public health in the biggest public health crisis since the Spanish flu of 1918? And what now needs to be done?
  2. Content Article
    Pennsylvania is the only state that requires acute healthcare facilities to report all events of harm or potential for harm. With over 3.6 million acute care event reports, the Pennsylvania Patient Safety Reporting System (PA-PSRS) is the largest repository of patient safety data in the United States and one of the largest in the world. This report analyses the serious events and incidents from the database.
  3. Event
    Due to the current COVID-19 pandemic, the 73rd World Health Assembly will be virtual. The agenda has been reduced to fit into two days, starting on Monday 18 May and concluding no later on Tuesday 19 May. The programme will cover: Opening of the Health Assembly by WHA 72 President. Election of the President and five Vice-Presidents. Presidential address. Statements by invited speakers. Address by the Director-General (on COVID-19 pandemic response). Statements by Heads of delegation on COVID-19 pandemic. Watch live
  4. News Article
    More than half a million people have accessed online training that aims to prevent suicide in the last three weeks alone, a charity has said. The Zero Suicide Alliance said 503,000 users completed its online course during lockdown. It aims to help spot the signs that a person may need help. It comes as health leaders warned front-line workers tackling coronavirus could suffer from mental ill health. NHS England launched a mental health hotline to support staff last month. The alliance's Joe Rafferty said the true impact of the coronavirus on mental health will not be known until the pandemic ends, but he said "the stress and worry of the coronavirus is bound to have impacted people's mental health". Read full story Source: BBC News, 18 May 2020
  5. News Article
    The leader of the NHS’ pandemic testing programme has highlighted concerns about the rate of COVID-19 transmissions in hospitals, HSJ can reveal. NHS England’s patient safety director Dr Aidan Fowler told an industry webinar that he and his team “are concerned about the rates of nosocomial spread within our hospitals”. Dr Fowler leads the NHS and Public Heath England testing programme (know as “pillar one”). He said the concerns had led to a focus on discovering where transmissions of covid-19 are occurring in hospitals, and how the NHS can reduce the rate of staff and patients becoming infected while on the NHS estate. His comments come as the NHS attempts to restart the provision of routine elective care and prepares for a significant increase in emergency admissions. The NHS has been told to create separate areas for covid positive and negative patients where possible, regardless of what they are being treated for. Patients are being to self-isolate at home for two weeks before attending hospital for treatment. Read full story Source: HSJ, 18 March 2020
  6. News Article
    Hospitals have been refusing requests for caesarean sections during the COVID-19 outbreak despite official guidance and NHS England advice that they should go ahead. Multiple NHS trusts have told women preparing to give birth since March that requests for a caesarean section will not be granted due to the viral pandemic. It has led to accusations from the charity Birthrights that the coronavirus outbreak is being used as an excuse to promote an ideology that more women should have a natural birth. Maria Booker, from Birthrights, told The Independent: “We continue to be contacted by women being told they cannot have a maternal request caesarean and we are concerned that in some places coronavirus is being used as an excuse to dictate to women how they should give birth, which contravenes NICE (National Institute for Health and Care Excellence) guidance. Official guidance from NICE says women should be offered a caesarean section where they insist it is what they want. NHS England has warned hospitals they need to “make every effort” to avoid cancelling caesarean sections and work with neighbouring trusts to transfer women if necessary. It said surgery should only be suspended in “extreme circumstances” where there is a shortage of obstetricians or anaesthetists. Read full story Source: The Independent, 17 May 2020
  7. News Article
    The government needs to make sure its coronavirus testing strategy is fit for purpose instead of focusing on hitting targets, says the Royal College of GPs (RCGP). In a letter to Health Secretary Matt Hancock, chairman Prof Martin Marshall said long wait times were "undermining confidence" in the results. Health professionals were also concerned about the accuracy of some test results, he said. The government said "95% of tests" were processed "in less than 48 hours". Ensuring there are enough tests to meet demand is part of the government's five tests it says must be met before easing lockdown restrictions. However, the absence of a clear strategy had left patients vulnerable, according to Prof Marshall. He said the RCGP did not currently believe the testing strategy was capable of working to prevent a second wave of infections and "secure the overall health of the population". Read full story Source: BBC News, 16 May 2020
  8. Content Article
    A film about why Schwartz Rounds are needed.
  9. News Article
    Up to a fifth of patients with COVID-19 in several hospitals contracted the disease over the course of the pandemic while already being treated there for another illness, NHS bosses have told senior doctors and nurses. Some of the infections were passed on by hospital staff who were unaware they had the virus and were displaying no symptoms, while patients with coronavirus were responsible for the others. The figures represent NHS England’s first estimate of the size of the problem of hospital-acquired COVID-19, which Boris Johnson last week said was causing an “epidemic” of deaths. In a national briefing last month on infection control and COVID-19, NHS England told the medical directors and chief nurses of all acute hospitals in England that it had found that 10%-20% of people in hospital with the disease had got it while they were inpatients. Senior doctors and hospital managers say that doctors, nurses and other staff have inadvertently passed on the virus to patients because they did not have adequate personal protective equipment (PPE) or could not get tested for the virus. Doctors say that hospital-acquired COVID-19 is a significant problem and that patients have died after becoming infected that way. One surgeon, who did not want to be named, said: “Multiple patients my department treated who were inpatients pre lockdown got the bug and died. Obviously the timeline supports that they acquired it from staff and other patients.” Read full story Source: The Guardian, 17 May 2020
  10. Content Article
    This leaflet explains what sedation is, how it works and when you may need it. It also explains the benefits and risks of using sedation and what it might feel like. Importantly, it tells you what you will need to plan for your care after sedation. It has been written by patients, patient representatives and anaesthetists, working together.
  11. Content Article
    This guidance from the British Dental Association provides information to help support dental practitioners and the wider dental team in the safe use of conscious sedation techniques.
  12. Content Article
    The report defines the standards for the provision of conscious sedation in the delivery of dental care.
  13. Content Article
    This Scottish Dental Clinical Effectiveness Programme guidance aims to promote good clinical practice through recommendations for the safe and effective provision of conscious sedation for dental care. 
  14. Content Article
    Conscious sedation can help a patient undergo dental treatment. There are several reasons why they may need sedation – anxiety, medical needs or complex treatment. The Care Quality Commission (CQC) outlines the regulations and standards of conscious sedation.
  15. Content Article
    Conscious sedation helps reduce anxiety, discomfort, and pain during certain procedures. This is accomplished with medications and (sometimes) local anesthesia to induce relaxation. Conscious sedation is commonly used in dentistry for people who feel anxious or panicked during complex procedures like fillings, root canals, or routine cleanings. It’s also often used during endoscopies and minor surgical procedures to relax patients and minimise discomfort. Find out more about the procedure, the drugs used and the side effects.
  16. Content Article
    The biopsychosocial model outlined in Engel’s classic Science paper four decades ago emerged from dissatisfaction with the biomedical model of illness, which remains the dominant healthcare model. Engel’s call to arms for a biopsychosocial model has been taken up in several healthcare fields, but it has not been accepted in the more economically dominant and politically powerful acute medical and surgical domains.  This editorial from Wade and Haligan reviews the historical context, achievements and recent developments of the biopsychosocial model, with a view to explaining how the model could be better employed to help (re-)organise and improve both the efficiency and the effectiveness of healthcare systems. This could improve patient outcome while also controlling costs.
  17. Content Article
    Around 6.5 million carers in the UK are propping up the NHS by keeping loved ones safe at home. Where is their recognition? For the past eight years, Sheena and her brother have been caring for their mother, who has early onset dementia, diabetes and other health issues. In her blog to the Guardian, Sheena discusses why she wants to see affirmative action for carers, why government needs to take responsibility and why the carers themselves need to be involved in these discussions.
  18. Content Article
    Information on the Collaborating Centres and NGOs in official and working relations with WHO for Patient Safety.
  19. Content Article
    Previous research suggests that surgical safety checklists (SSCs) are associated with reductions in postoperative morbidity and mortality as well as improvement in teamwork and communication. These findings stem from evaluations of individual or small groups of hospitals. Studies with more hospitals have assessed the relationship of checklists with teamwork at a single point in time. The objective of this study from Molina et al. was to evaluate the impact of a large-scale implementation of SSCs on staff perceptions of perioperative safety in the operating room. They concluded that a large-scale initiative to implement SSCs is associated with improved staff perceptions of mutual respect, clinical leadership, assertiveness on behalf of safety, team coordination and communication, safe practice, and perceived checklist outcomes.
  20. Content Article
    Contrary to popular belief, people rarely panic in dangerous situations. Withholding information is patronising and counter-productive says Stephen Reicher, a member of the Sage subcommittee advising the government on behavioural science. He suggests in his blog in the the Guardian that there needs to be a broader shift in the relationship between the state and its citizens. The government must abandon a psychology that infantilises people. It must recognise and respect the ability of the public to acknowledge and deal with harsh realities. It must engage us as full partners in every stage of the strategy against Covid-19: from formulating a response, to implementing and evaluating policy. And, as in any constructive relationship, none of this can happen without putting openness at the very heart of what government does.
  21. Content Article
    Tips, advice and guidance on where you can get support for your mental health during the coronavirus (COVID-19) pandemic. If you’re worried about the impact of coronavirus on your mental health, you are not alone. The COVID-19 pandemic is a new and uncertain time for all of us and will affect our mental health in different ways. However you are feeling right now is valid. With the right help and support, we can get through this. Here is you will find advice from Young Minds on things you can do to keep mentally healthy during this time.  
  22. Content Article
    Presenteeism is linked to negative outcomes for patients, nurses, and healthcare organisations; however, we lack understanding of the relationships between nurse fatigue, burnout, psychological well-being, team vitality, presenteeism, and patient safety in nursing. In this study from Rainbow et al., the two aims were: (a) to examine the fit of a literature-derived model of the relationships between presenteeism, psychological health and well-being, fatigue, burnout, team vitality, and patient safety; and (b) to examine the role of presenteeism as a mediator between patient safety and the other model variables. The findings indicate that focusing on job-stress presenteeism may be relevant for this population and may offer additional insight into factors contributing to decreased nurse performance and the resulting risks to patient safety.
  23. Content Article
    Force Field Analysis was created by Kurt Lewin in the 1940s. He used it in his work as a social Psychologist. In the modern world, it is used for making and communicating decisions about whether to go ahead with a change or not. It frames problems in terms of factors or pressures that support the status quo (restraining forces) and those pressures that support change in the desired direction (driving forces). The driving forces must be strengthened or the resisting forces weakened for the change to take effect. A factor can be people, resources, attitudes, traditions, regulations, values, needs, desires, etc. As a tool for managing change, Force Field Analysis helps identify those factors that must be addressed and monitored if change is to be successful. It can be difficult for teams to make decisions about testing new ideas especially when there are a variety of opinions. Force Field Analysis provides a structured approach to decision making which helps teams to consider the forces that are driving the change and those that resist the change.
  24. Content Article
    Siobhan Brammeld is a care worker at Massereene Manor care home in County Antrim and leads the social care team. She has sat with several residents as they passed away having contracted COVID-19. In this interview with BBC News NI she says she was convinced some residents had "died before their time". "I feel as though I am on autopilot - it never leaves my head. Sometimes I worry that I could have done more," she said. "These are sad times, scary times too," she added. Siobhan told BBC News that staff felt not enough was done to prepare them for the pandemic and that workers like her were left to the side. "I feel we were left on our own. We as workers were forgotten about as well as the wee residents," she said. "At the start of all this I just wanted to scream at somebody - could someone please come and help these wee residents? I just didn't want them to die before their time." "I watched what was happening in other countries and you knew it was coming, but there didn't seem to be an awful lot happening to prepare us."
  25. News Article
    A joint letter from the Health Foundation, The King’s Fund and Nuffield Trust has been delivered to the Health and Social Care Select Committee identifying five key aspects which need addressed ahead of their evidence session on delivering core NHS and care services during and beyond the coronavirus pandemic. Health and Social Care Secretary Matt Hancock told the House of Commons on 22 April 2020 that the pandemic had reached its peak and talked of his intention to ‘gradually reopen’ the NHS as soon as it was safe to do so. For the joint authors of the letter, before any services look to begin being restarted key areas need addressed including a reliable supply of PPE to protect staff and a clear understanding within the system of the full extent of unmet need – particularly important as at present, from a big picture view, it is not clear how many services have been suspended. The joint letter puts five key questions to the Select Committee to address: How and when will appropriate infection prevention and control measures be available for all settings delivering care, and what impact will these have on capacity to reopen? How will the system understand the full extent of unmet need? How will the public’s fear of using NHS and social care services be reduced? What is the strategy for looking after and growing the workforce? Can the system improve as it recovers? Read full story Source: National Health Executive, 14 May 2020
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