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Patient Safety Learning

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  1. Content Article
    NHS Education for Scotland has developed a TURAS Learn page to support student pharmacists in Scotland.
  2. Content Article
    This is a joint letter from The Health Foundation, The King's Fund and the Nuffield Trust to the Health and Social Care Select Committee for the evidence session on delivering core NHS and care services during the pandemic and beyond.
  3. Content Article
    This document “Resumption of hospital services after lockdown” provides a comprehensive set of action plans and key guidelines to be followed in the context of continuous hospital preparedness. It specifically addresses the action plan in India for resuming of services, in the safest and most effective manner to safeguard both patients and healthcare worker. 
  4. Event
    until
    A Weekly series of Clinical Practice Webinars with SAMLondon 2020 Abstract Presentations Wednesday 20 May – Wednesday 17 June 2020, 1900-2100 The current COVID-19 pandemic is the greatest public health challenge of our time and has significant implications for acute medicine. The Society for Acute Medicine wants to support the acute medicine community and provide resources that will help you understand and manage this crisis. We plan to do this virtually by launching a weekly series of clinical practice webinars and abstract presentations running for 5 weeks, starting on Wednesday 20 May 2020. These virtual webinars are open to all members of the multidisciplinary team who work in acute and general medicine. They give us the opportunity to discuss and debate current COVID-19 challenges for acute medicine. They also offer a platform to the authors who successfully submitted abstracts for the postponed SAMLondon conference due to take place in May 2020, enabling them to share their work with colleagues. Further information
  5. Content Article
    The coronavirus pandemic has sparked reports of NHS workers being warned, threatened or disciplined for speaking up about the lack of personal protective equipment (PPE) and testing for coronavirus and similar worries raised in the care sector. It underlines the need for a shift in attitudes in UK workplaces to whistleblowers, underpinned by an overhaul of the law to afford them greater protection, according to Elizabeth Gardiner, the new chief executive of the whistleblowing charity, Protect, in this blog in the Guardian. "We’ve heard direct from some care sector workers who have been threatened with disciplinary aciton if they persist in raising concerns," says Elizabeth. "Whistleblowers are a safety valve – it’s everyone’s business to reveal dangerous working practices." “What we would like to see is a proactive duty on employers to protect whistleblowers from being victimised,” she says. “That would be the sort of cultural shift that we’re looking for.”
  6. Content Article
    The government needs to set out a contingent exit plan, involving carefully specified levels of lockdown, and the thresholds at which they would be triggered. This will allow businesses and people to plan, and begin to look to the future. This report from the Institute of Global Changes puts forward suggestions for a lockdown exit plan.
  7. News Article
    NHS staff are at risk of high rates of post-traumatic stress disorder (PTSD) if they don't get the right support as the coronavirus outbreak subsides, health service adviser Prof Neil Greenberg has said. For now there's a national focus on health and care workers. Public billboards praise them, millions turn out on the street for a weekly round of applause and volunteers have been rushing to help in any way they can. But the height of the crisis is when many staff will be in coping mode. It's when things slow down - and the clapping stops - that, psychologists believe, the real risk of difficulties will arise. People may need months or even years of "active monitoring" of their mental health after things return to some semblance of normality, according to Prof Greenberg, a world-leading expert in trauma at King's College London. The NHS in England is providing crisis support to its staff. But it hasn't produced a formal long-term plan to offer extra psychological services in the aftermath of the pandemic. It's what happens after the trauma that is "most predictive of what people will be like in terms of their mental health", according to Prof Greenberg. How well people are supported and how much stress they're put under as they try to recover can make or break whether someone manages well or develops far more serious difficulties including PTSD. "If we muck it up then that's going to make the trauma they've already had much more difficult to deal with," he says. Read full story Source: BBC News, 15 May 2020
  8. News Article
    More than 22,000 care home residents in England and Wales may have died as a direct or indirect result of COVID-19, academics have calculated – more than double the number stated as passing away from the disease in official figures. Academics at the London School of Economics (LSE) found that data on deaths in care homes directly attributed to the virus published by the Office for National Statistics significantly underestimated the impact of the pandemic on care home residents and accounted for only about 4 out of 10 of the excess deaths in care settings recorded in recent weeks in England and Wales. The figures suggest the impact of the virus in care homes is finally reducing. They are based on reports filed directly from care home operators to the regulator, the Care Quality Commission. Care Inspectorate Wales has said Covid was confirmed or suspected in a further 504 cases in homes up to the 8 May in Wales. But academics at the care policy and evaluation centre at the LSE found that when excess deaths of other care residents and the deaths of care home residents from Covid-19 in hospitals are taken into account, the toll that can be directly and indirectly linked to the virus pandemic is likely to be more than double the current official count. Read full story Source: The Guardian, 13 May 2020
  9. News Article
    More than a quarter of all NHS patients who have died after being infected with COVID-19 had diabetes, according to new statistics from NHS England. Between 31 March and 12 May, a total of 5,873 patients with diabetes died in hospital from COVID-19, 26% of all coronavirus deaths. It is the first time data on hospital deaths and underlying health conditions has been revealed by the NHS. People with diabetes have previously been described as being at moderate risk from the virus and were not part of the groups told to shield themselves in their homes due to fears they were at extreme risk. The NHS England data does not specifically say whether type 1 or type 2 was more prevalent among deaths. It said work was underway to understand the deaths data to include examining the type of diabetes, ethnicity and weight of those who died. NHS England said it was working with Diabetes UK to provide support and advice to patients via its helpline which will include volunteer clinical advisers. Read full story Source: Independent, 15 May 2020
  10. News Article
    Rapid testing and an adequate supply of protective equipment must be in place when the NHS reopens services cancelled during the peak of the coronavirus oubreak, health unions have said. The unions have put forward a nine-point plan for the NHS to reopen safely as lockdown restrictions ease. NHS England has told hospitals to restart routine and non-urgent operations and procedures which were put on hold to create more capacity for COVID-19 patients. But 16 unions, including Unison, the Royal College of Nursing, Unite and GMB, said they wanted the NHS to continue to operate a "safety-first" approach as outpatient clinics and operations resume. They said they wanted to avoid a repeat of the PPE supply problems which "sapped" staff confidence and "caused widespread and unnecessary anxiety". Unison's Sara Gorton, who also chairs the NHS group of unions, said the health sector faced another "crucial test" after handling the outbreak. She added: "As hospitals get busier, and clinics and other services begin to reopen, the safety of staff and patients is paramount. But this can't happen without plentiful and constant PPE supplies." Read full story Source: BBC News, 15 May 2020
  11. Community Post
    Following the recent Patient Safety Learning webinar, ‘Patient safety: Time for questions? Non Covid-19 care and treatment’, we’ve gained a deeper understanding of the key issues frontline staff and patients are facing and have heard many more great ideas around how to address these issues and improve staff and patient safety. Due to its success, and the clear need to spend more time addressing the issues raised and identifying further issues, we plan to hold more webinars. So that we can determine what issues need to be addressed urgently, can you spare a few minutes to tell us about the issue/s related to patient safety and staff safety you are most concerned about? Please add your comments below.
  12. Content Article
    European governments hope that contact tracing apps can allow them to ease lockdowns. But much work must be done at both national and EU level before restrictions can be eased. There are growing calls for lifting lockdowns across European countries. Austria and Denmark have already announced plans to open schools. But ending lockdowns without mass testing and contact tracing firmly in place will be very dangerous, as COVID-19 is far more infectious than its predecessors, like SARS. Even with rigorous testing and contact tracing, some curbs on social contact will be needed, and lockdown measures will need to be eased step by step. Once it has been shown that restrictions can be eased while containing the spread of the disease, there will still need to be co-ordination at the EU level to allow travel between member-states. Without trust in each other’s exit strategies, countries will be wary of opening up. In this article, John Springford, Deputy Director of the Centre for European Reform, stresses that mass testing and contact tracing apps must be in place before lockdowns can be eased in Europe - and that the EU has an important role to play.
  13. Content Article
    Freedom to Speak Up Guardians are required to record all cases of speaking up that are raised to them.These guidelines are for Speak Up Guardians on what data they need to collect and the range of information that could be recorded for each case that you deal with. 
  14. News Article
    A&E admissions in the UK have fallen to the lowest on record, with a 57% year-on-year drop in attendances in England, new NHS data shows. The latest figures show a dramatic fall in demand for emergency treatment, falling below one million attendances per month for the first time since records began in 2010. The coronavirus crisis has placed additional strain on NHS resources, but is thought to have had the opposite effect on A&E, with the public staying at home and avoiding hospitals where possible. Read full story (paywalled) Source: The Telegraph, 14 May 2020
  15. News Article
    With all care home staff and residents now eligible for testing, with a priority given to those in homes looking after residents over 65 years of age, a new online portal has been launched to streamline the process of arranging coronavirus test kit deliveries. As national testing capacity continues to increase, the government is prioritising testing for care homes and other areas identified as having the greatest need. As such, across England, all symptomatic and asymptomatic care home staff and residents can be tested for coronavirus. The Department of Health and Social Care (DHSC) is working alongside local authority Directors of Public Health, Directors of Adult Social Services and local NHS providers to deliver this testing programme for care homes. Tens of thousands of care home workers and residents have already been tested, either by Public Health England or at drive through testing sites, mobile testing units and via satellite testing kits – packages of tests sent to care homes for staff to use on residents. Secretary of State for Health and Social Care Matt Hancock said: “The additional testing capacity we have achieved delivers many thousands of tests a day for residents and staff in care homes. This new portal allows those who book tests for staff and residents to do so even more easily, and it also offers a route for the prioritisation of care homes with the greatest need." Read full story Source: National Health Executive, 12 May 2020
  16. News Article
    Ministers faced fresh allegations on Wednesday of failing to prepare care homes for a pandemic, as it emerged that COVID-19 may have killed 22,000 residents in England and Wales – more than twice the official toll. Council social care directors in England warned the government two years ago, in a series of detailed reports, about care homes’ exposure to a pandemic, the Guardian has learned. They called for better supply plans for personal protective equipment (PPE) – warning that “demand for PPE could rapidly outstrip supply” – plus improved infection control and a system to enlist volunteers to help services expected to be stretched to breaking point. The Association of Directors of Adult Social Services (Adass), which represents directors of adult social services in England, told the Guardian it carried out the work to improve government planning for a flu pandemic at the request of the Department of Health and Social Care. But it said: “We are not aware of whether government departments picked up on any of the recommendations set out.” A Department for Health and Social Care spokesperson said: “As the public would expect, we regularly test our pandemic plans – allowing us to rapidly respond to this unprecedented crisis. Our planning helped prevent the NHS being overwhelmed and means we are past the peak of the virus.” Read full story Source: Guardian, 13 May 2020
  17. News Article
    NHS England has set up an advisory group to look at how physical and mental health services can be delivered to patients who are most vulnerable to COVID-19 and have been asked to shield themselves from the pandemic. There are now around 2.5 million patients on the list of people considered to be at the highest clinical risk, including solid organ transplant recipients and patients on chemotherapy, who have been told to cut themselves off from society as far as possible. They are going to have to stay that way beyond the end of June, with suggestions that their isolation could continue for many more months hence, and there is significant concern about the impact of this on their ongoing physical and mental health. The NHS has therefore set up an advisory group to examine how care can be provided to these patients. Read full story Source: HSJ, 13 May 2020
  18. News Article
    Restarting NHS services will be an even greater challenge than coping with the first coronavirus infections, health think tanks and hospital chiefs have warned. Since March, the NHS has freed up more than 33,000 beds to prepare for an influx of COVID-19 patients needing intensive care, but since the peak of infection health chiefs have worried that delays to care were harming patients. Around 46,000 so-called excess deaths have been recorded during the pandemic, as compared against a five-year average. Around a quarter of these are believed to be unrelated to COVID-19. In a joint statement, the Health Foundation, Nuffield Trust and King’s Fund think tanks have said it could take months before the NHS and social care are able to fully restart. All three bodies will be giving evidence to the Commons health committee on Thursday, where they will warn about the impact on the health service’s “exhausted staff” and demand action to help care homes – which are now at the frontline in the fight against coronavirus. The experts will stress the need for the NHS to begin planning for a second peak of infections, especially if it comes in winter – when the service is usually overwhelmed by seasonal flu. They will warn about concerns over how the NHS manages the risk of infection, with the need for more protective equipment, social distancing and increased testing. This will “severely limit capacity for many months”, they said. Read full story Soruce: The Independent, 14 May 2020
  19. Content Article
    Stress urinary incontinence (SUI) is the loss of urine when coughing, laughing, sneezing or exercising. It is a common and distressing condition, with negative impact on quality of life. If conservative treatment, e.g. pelvic floor muscle training, is not successful, the most successful surgical procedures are mid-urethral mesh tape, colposuspension, autologous fascial sling and urethral bulking agent injections.
  20. Content Article
    Duncan L Wyncoll and Peter J Young discuss 'Treating the symptom not the cause' of ventilator associated pneumonia.
  21. Content Article
    The PneuX System is a novel endotracheal tube and tracheal seal monitor, which has been designed to minimise the aspiration of oropharyngeal secretions. Doyle et al. aimed to determine the incidence of ventilator-associated pneumonia (VAP) in patients who were intubated with the PneuX System and to establish whether intermittent subglottic secretion drainage could be performed reliably and safely using the PneuX System.
  22. Content Article
    This document highlights practical recommendations in a concise format to assist acute care hospitals in implementing and prioritising strategies to prevent ventilator-associated pneumonia (VAP) and other ventilator-associated events (VAEs) and to improve outcomes for mechanically ventilated adults, children, and neonates.
  23. Content Article
    Ventilator-associated pneumonia (VAP) continues to be a clinically important hospital-acquired infection. In this paper, Marin H. Kollef discusses the financial impact.
  24. Content Article
    Ventilator-associated pneumonia is an important healthcare-associated infection. Interventions for the prevention of ventilator-associated pneumonia are often used within bundles of care. Recent evidence has challenged widespread practices mandating a review of subject. This article outlines guidance for ventilator-associated pneumonia prevention.
  25. Content Article
    Ventilator-associated pneumonia (VAP) is an important cause of morbidity and mortality in ventilated critically ill patients. Muscedere et al. systematically searched for all relevant randomised, controlled trials and systematic reviews on the topic of prevention of VAP in adults that were published from 1980 to 1 October 2006. in order to develop evidence-based guidelines for the prevention of VAP.
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