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Patient Safety Learning

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Everything posted by Patient Safety Learning

  1. News Article
    Senior doctors fear that thousands of routine vaccination appointments may be missed or delayed because of the coronavirus lockdown, raising the risk of sudden and potentially fatal outbreaks of other diseases when restrictions on movement are finally eased. GPs and accident and emergency departments have witnessed unprecedented falls in the numbers of people seeking medical care in recent weeks, prompting concerns that vital routine immunisations for infections such as measles, mumps, rubella, tetanus and whooping cough are falling by the wayside. “We are very concerned. There are no data yet because we have only been in lockdown for a month, but there are plenty of anecdotes from practice nurses and others saying they have noticed a decline in vaccine uptake,” said Helen Bedford, a professor of children’s health at the UCL Great Ormond Street Institute of Child Health and member of the Royal College of Paediatrics and Child Health’s health promotion committee. Read full story Source: The Guardian, 26 April 2020
  2. News Article
    Care homes looking after thousands of vulnerable residents have said none of their staff has been tested for coronavirus. Out of 210 care providers spoken to by the BBC, 159 said none of their workers had had a test. BBC England spoke to care homes and companies across the country, who between them employ nearly 18,000 staff and have almost 13,000 residents. Many said they had seen no testing at all, while others have spoken of struggles to access official test centres after reporting online that they have symptoms. Some have told how staff face long journeys to test centres, with one reporting a three-hour round trip. On Sunday it was announced that the military will begin testing essential workers in mobile units operating at sites in "hard to reach" areas, including care homes. Anna Knight runs Harbour House Care Home on the Dorset coast and said getting enough personal protective equipment (PPE) and testing for coronavirus were her biggest challenges. Read full story Source: BBC News, 26 April 2020
  3. News Article
    Shop workers and other essential staff should be provided with face masks to control the spread of coronavirus, according to the British Medical Association (BMA). The doctors’ union is also calling on the government to ask all members of the public to cover their mouths and noses while outside their homes. “Common sense tells you that a barrier between people must offer a level of protection, however small,” said Dr Chaand Nagpaul, BMA council chairman. “The government must pursue all avenues of reducing the spread of infection. “This includes asking the public to wear face coverings to cover mouths and noses when people leave home for essential reasons.” Read full story Source: The Independent, 26 April 2020
  4. Content Article
    Establishing a culture of zero harm is critical for organizations that strive to deliver safe, high quality, patient-centered care. This video features insights from leading organisations—Advocate Health Care, Cancer Treatment Centers of America, Boston Children’s Hospital, Novant Health, and MedStar Health—that have embraced a commitment to making safety a core value. Watch now to learn how they overcame the challenges of building a highly reliable safety culture and benefited from making safety and high reliability a top priority within their organisations.
  5. Content Article
    Unknown to its hypertension specialists, a major teaching hospital changed the cuffs on its sphygmomanometers from manufacturer-validated to a uniform washable alternative, in line with ‘Health and Safety’ concerns surrounding potential cross-contamination between patients. When clinic doctors suspected serious under-reading with the new cuffs, a systematic comparison was undertaken in 54 patients using two UM-101 sphygmomanometers: one using the original, manufacturer-supplied cuff and the other with the washable replacement. The study confirmed an average under-reading of 8±10/5±5 mm Hg using the washable cuff, and a third of patients with poorly controlled hypertension were considered normotensive, after using this cuff. The UM-101 sphygmomanometers have now been re-fitted with the original cuffs. Sphygmomanometer cuffs are not interchangeable between devices and a modicum of common sense should be shown to prevent changes made in the name of Health and Safety from having the opposite effect to that intended.
  6. Content Article
    Blood pressure (BP) has been measured with a cuff for over a 100 years. Recently, ‘tricorders’ and smartwatches that measure BP without a cuff using pulse transit time (PTT) have become available. These BP measurements are based on the inverse relationship between BP and PTT. PTT can be measured as the timing delay in a QRS complex on an EKG and the onset of a photoplethysmography wave, for example measured from a finger. Since these measurements are relatively more user‐friendly than conventional cuff‐based measurements they may aid in more frequent BP monitoring. Using a guidelines‐based protocol, Bard et al. investigated the accuracy and precision of two popular PTT‐based BP measuring devices: the Everlast TR10 fitness watch (Everlast, New York City, NY) and the BodiMetrics tricorder (BodiMetrics, Manhattan Beach, CA).
  7. Content Article
    After her infant son suffered due to a succession of medical errors, Sue worked tirelessly to prevent this from happening to others, starting by writing letters to the health care regulatory bodies until she and a group of mothers had formed a nonprofit and put out guidelines for the regulatory bodies to follow. In the midst of all of this, Sue’s husband was misdiagnosed as having a benign tumor, when it was later discovered to be a malignant sarcoma. With this she redoubled her efforts to lead us to a safer health system.
  8. News Article
    “I am really angry about this,” said Dr Anna Down, scanning her computer for figures to show how coronavirus has ravaged her patients living in nursing homes. “One home had 23 deaths, another lost 19, and another 13,” the Ealing GP said. “In two units 50% of residents died in the space of 10 days.” Down is the clinical lead at a practice with 1,000 residents on its books in 15 privately run nursing homes in the area of west London hit harder than anywhere in Britain by COVID-19 deaths in the first weeks of the outbreak. In a normal month, she might expect to lose around 28 people. In the last month she has lost 125. Down has a warning to the rest of the country informed by her practice’s experience: reform how social care handles Covid-19 or face rising deaths and a second devastating wave of infection. Read full story Source: The Guardian, 22 April 2020
  9. Content Article
    Cumulative stress, compassion fatigue and trauma due to experiences with patient safety incidents impact the mental wellness of our healthcare providers. These factors contribute to inadvertent patient care errors, mental health issues and attrition which compromise patient safety. A peer support programme not only simply helps healthcare workers with their experiences with patient safety incidents but also improves the system and help make patient care safe. The Creating a Safe Space: Addressing the Psychological Safety of Healthcare Workers manuscript and the Canadian Peer Support Network are intended to assist healthcare organisations create peer-to-peer support programmes (PSPs) to improve the emotional well-being of healthcare workers and allow them to provide the best and safest care to their patients.
  10. News Article
    Several acute trust chief executives have told HSJ they are keen to resume more planned operations, as the peak of new coronavirus cases has passed and many hospital beds remain empty. Some trust leaders said they believed routine elective surgery could be restarted as early as next week. There is also tension between NHS hospitals — some of which are keen to resume their own planned care, especially the more urgent operations — and a desire to use private hospitals, which have been booked out by NHS England. The government said yesterday the number of people in hospitals with COVID-19 has fallen by 10% over the last week. Around 42% of acute beds are now unoccupied, according to figures seen by HSJ. The peak of new infection cases in hospitals was at about 3,000 on 1 April — the number is now about half that figure. However, there will be fears nationally about the NHS seeking to return to normal and being caught out by ongoing COVID-19 pressures, or by a second peak of infections. Read full story Source: HSJ, 24 April 2020
  11. News Article
    The coronavirus can linger in patients’ eyes for several weeks and could act as a way of spreading the COVID-19 disease, according new study from Italy. Scientists at Italy’s National Institute for Infectious Diseases hospital in Rome studied the symptoms of an unnamed 65-year-old woman who developed the virus after travelling from the Chinese city of from Wuhan. When the woman developed conjunctivitis – an eye infection causing redness and itchiness – doctors decided to take regular swabs from her eye. They discovered the virus remained present in “ocular samples” up to 21 days after she was admitted to hospital. The team said the findings, published in the Annals of Internal Medicine, indicated that eye fluids from coronavirus patients “may be a potential source of infection”. The study authors said: “These findings highlight the importance of control measures, such as avoiding touching the nose, mouth, and eyes and frequent hand washing.” Read full story Source: The Independent, 24 April 2020
  12. News Article
    Women say the uncertainty surrounding maternity services during the coronavirus outbreak is "making a stressful situation harder". The Royal College of Midwives says services may need to be reduced due to COVID-19. Like many areas in the health sector, staff shortages caused by sickness and workers self-isolating are impacting resources, the college adds. The BBC asked a group of NHS trusts and boards across the UK about the services they are able to provide during the coronavirus pandemic. Nine trusts in England, five boards in Scotland and one trust in both Wales and Northern Ireland responded. All 16 bodies said one birth partner could be present during labour, but just over a quarter of those asked are allowing partners on the postnatal ward following the birth. Around a third of trusts and boards that spoke to the BBC are now allowing home births. In the weeks after a birth, midwives and health visitors are now heavily relying on virtual communication to provide families with postnatal support. Home visits are mostly still happening, but one trust in London said it only allows face-to-face contact when it is "absolutely essential". Read full story Source: BBC News, 24 April 2020 Read Patient Safety Learning's latest blog: Home births, fears and patient safety amid COVID-19
  13. News Article
    "I have never seen my A&E department so still, so well-staffed and so uncannily calm," says Steven Fabes, an A&E doctor. Attendances in A&E departments across the country are down, in some cases by up to 80%. There is an obvious reason for the calm: people are not out and about. Pedestrians are not walking out in front of cyclists. Cyclists are not diving over car bonnets. Asthmatics are not wheezing through the fumes of Oxford Street. But there is something more worrying at play, too – people who need us are not coming in. "I am worried that people who need us are not coming in, scared that hospitals are vectors for infection rather than cure," says Steven. Read full story Source: The Guardian, 23 April 2020
  14. News Article
    Half of health workers are suffering mental health problems such as stress and trauma as a result of dealing with COVID-19, new research reveals. The pandemic is having a “severe impact” on the mental wellbeing of NHS personnel as well as agency staff, GPs and dentists, with rates of anxiety and burnout also running far higher than usual. New YouGov polling for the IPPR thinktank found that 50% of 996 healthcare workers questioned across the UK said their mental health had deteriorated since the virus began taking its toll. That emerged as the biggest impact on staff, just ahead of worries about their family’s safety because of a lack of testing and protective equipment for NHS workers (49%) and concern about their ability to ensure that patients receive high-quality care when the NHS is so busy (43%). As many as 71% of younger health professionals, who are likely to be inexperienced and early in their careers, said their mental health had deteriorated. More women were affected than men. Read full story Source: The Guardian, 23 April 2020
  15. News Article
    Guy's and St Thomas' has received its first delivery of face shields created in a specially developed "3D printing farm", in collaboration with 3D printing companies and enthusiasts. The face shields will be worn by frontline medical staff tending to patients during the ongoing coronavirus pandemic. Several 3D printing manufacturers have been brought together at Guy's and St Thomas' supply chain hub in Dartford, with over 200 printers working 24 hours a day to make the face shields. This 3D printing farm can produce roughly 1,500 face shields a day. The face shields are paired with a visor, assembled by a team of volunteers made up of 3D printing enthusiasts, as well as students and staff from King's College London and Brunel University. Read full story Source: Guy's and St Thomas NHS Foundation Trust, 21 April 2020
  16. Content Article
    We are all in lockdown, but COVID-19 seems to have been the spur to all sorts of imaginative behaviours on the ground. For example, NHS care delivery has been redesigned at a pace unimaginable in more stable times. Everywhere, volunteering is showing what it can do in the age of social media. However, in contrast those in and around Whitehall are responding poorly, says Mike Gill, former Regional Director of Public Health, South East England, in this BMJ blog. Effective crisis management demands flexibility and collaboration. We are seeing neither.
  17. News Article
    Some seriously ill COVID-19 patients in London may not have been taken to hospital by ambulance because of a system temporarily used to assess people, a BBC investigation suggests. Patients could have "become very sick or died at home" instead, a paramedic claimed. One family said they had to plead to get hospital care. Medical professionals use 'NEWS2', as one way of identifying patients at risk of deteriorating, a check normally used for sepsis patients. Under normal circumstances, ambulance teams would blue-light anyone with a score of five or above to hospital. But on 18 March, LAS workers were told to apply the NEWS2 check to suspected Covid patients and that many of those with a score up to seven could be "suitable for community care", even if there were issues with breathing rate, oxygen supply and consciousness. But one paramedic, who wanted to remain anonymous because she did not have permission to speak to the media, said she believed that as a result of the NEWS2 advice, crews went to patients "who may have been seen by ambulance before and then suddenly became very sick or even just dropped dead." Read full story Source: BBC News, 23 April 2020
  18. News Article
    The availability of dialysis equipment used to treat more than a quarter of ventilated COVID-19 patients has reached “critical” levels, HSJ has learned. Concerns are growing over an “exceptional shortage” of specialist dialysis machines used to treat intensive care patients with acute kidney failure. Although hospitals are able to deploy alternative machines which are not typically used in intensive care, this is logistically challenging and can carry increased risks for patients. Read full story Source: HSJ, 22 April 2020
  19. Content Article
    This blog published in the Intelligencer explores the impact COVID-19 will have on frontline staffs' mental health.
  20. Content Article
    AI health chatbots around the world have been racing to add coronavirus detection into algorithms or put up helpful information to demonstrate they are part of the response to coronavirus (COVID-19). But to be honest, it’s pointless. A symptom checker can’t diagnose you with COVID-19. That can only be done through testing. The symptoms are too close to cold and flu. However, Prof Dr. Maureen Baker, Chief Medical Officer at Your.MD and former Chair of the UK’s Royal College of General Practitioners, has been involved at the highest level of pandemic preparation planning in the UK for decades and she is clear that AI chatbots, like Your.MD, can play a vital role in reducing the number of people who unnecessarily seek medical treatment and the deaths of individuals who are endangered by symptoms unrelated to COVID-19. So, if AI health chatbots can’t reliably detect COVID-19 and should only advise you to stay at home, what else can they do? “They can work in tandem with governments and health services to stop the worried well not at risk from the virus from seeking treatment, and also support people to self-care where that is appropriate,” says Prof Baker. She thinks that with collaboration, there is enormous potential for chatbots to act as reliable companions providing guidance and tracking symptoms.
  21. News Article
    A third of pharmacists cannot obtain continuous supplies of personal protective equipment (PPE), according to a survey conducted by the Royal Pharmaceutical Society (RPS). The survey found that 34% of respondents said they were not able to source continued supplies of PPE as they work in the face of COVID-19. The poll of 445 pharmacists also revealed that 94% were unable to maintain social distancing of two metres from other staff in their pharmacy, mainly because the pharmacies — and the dispensaries in particular — were too small. A further 40% of respondents said they were unable to maintain social distancing of two metres from patients. The results of the survey, which ran between 14 and 20 April 2020, have come after Public Health England (PHE) updated its PPE guidance on 10 April 2020, which recommends that pharmacy staff only wear fluid-resistant (type IIR) surgical masks (FRSMs) when in “contact with possible or confirmed cases of COVID-19” and not around other pharmacy staff. Read full story Source: The Pharmaceutical Journal, 22 April 2020
  22. Community Post
    A great way to know which member of staff has contacted the patients family and when - thought of by a Matron at Sussex and Surrey Hospitals Trust.
  23. News Article
    Military personnel have criticised the NHS for its “appalling” handling of distributing personal protective equipment. The armed forces are helping with the distribution of equipment and staff have been seconded to help planning across seven hubs. A senior army source lambasted the health service for its logistics for PPE, alleging that masks, aprons, gloves and other items were being assigned to hospitals without regard to relative need, leading to oversupply in some areas and shortages in others. Read full story (paywalled) Source: The Times, 22 April 2020
  24. Community Post
    NHS Blood and Transplant are calling for people to donate plasma to help treat coronavirus. They need people who’ve recovered from coronavirus (COVID-19) to donate blood plasma, as part of a potential clinical trial to help with the national effort against the virus. The trial, if approved, will tell us how effective convalescent plasma (plasma from people who’ve had coronavirus) is for treating coronavirus patients. Visit their website to see how you could help: https://www.nhsbt.nhs.uk/how-you-can-help/convalescent-plasma-clinical-trial/
  25. News Article
    The coronavirus pandemic has already caused as many as 41,000 deaths in the UK, according to a Financial Times analysis of the latest data from the Office for National Statistics. The estimate is more than double the official figure of 17,337 released by ministers on Tuesday, which is updated daily and only counts those who have died in hospitals after testing positive for the virus. The FT extrapolation, based on figures from the ONS that were also published on Tuesday, includes deaths that occurred outside hospitals updated to reflect recent mortality trends. The ONS data also showed that deaths at home and in care homes had also jumped sharply during the pandemic. In the week ending 10 April, deaths in care homes reached 4,927, almost double the figure of 2,471 a month earlier. The ONS said on Tuesday it had asked Public Health England to investigate why care home deaths were rising so sharply. Read full story Source: The Financial Times, 22 April 2020
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