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Patient Safety Learning

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Everything posted by Patient Safety Learning

  1. Content Article
    Blog published in the Guardian from an NHS respiratory consultant.
  2. News Article
    When Victoria Gianopoulos-Johnson got a call from her midwife to say her home birth would be cancelled, panic took hold. She says she “lost it” for two days, crying constantly, gripped by uncertainty and then anger. Now she has reached the decision to have a free birth, also known as unassisted childbirth. Maternity rights groups say there has been a rise in the number of women seeking advice about freebirthing owing to pressures on hospitals and new restrictions around birth partners. More than a fifth of birthing centres and more than a third of homebirth services have closed due to a shortage of midwives and concerns about ambulance response times. Alison Edwards, of Doula UK, whose 700 members advocate for expectant mothers, says she has seen a threefold increase in calls about freebirthing in the last fortnight. “Initially women were concerned about staff shortages,” says Edwards. “Now they don’t want to go to hospital at all, it’s about infection. It is inevitable that some who should not be freebirthing because they are in a high-risk category will give birth at home because they fear the alternative – infection from [coronavirus] or spending time in hospital without their partner’s support.” Read full story Source: Guardian, 5 April 2020
  3. News Article
    Almost 400 care companies which provide home support across the UK have told the BBC they still do not have enough personal protective equipment (PPE). Without protection, providers say they may not be able to care for people awaiting hospital discharge. Of 481 providers, 381 (80%) said they did not have enough PPE to be able to support older and vulnerable people. The government said it was working "around the clock" to give the sector the equipment it needs. The BBC sent questions to the nearly 3,000 members of the UK Homecare Association. About a quarter of respondents said they have either run out of masks or have less than a week's supply left. Read full story Source: BBC News, 6 April 2020
  4. News Article
    People who may be having a stroke should still call 999 for emergency medical care, even during the coronavirus pandemic, say UK experts. They are concerned that many are not seeking urgent help when they most need it, possibly due to fear of the virus or not wanting to burden the NHS. Any delay in seeking help can lead to disability or even death, warns the Stroke Association. Prompt assessment and treatment saves lives, it says. Data suggest people are currently staying away from hospitals, which is fine unless you really need care. Latest figures for England and Scotland suggest attendance to Emergency Departments has dropped by over a third on the same week last year. Those who need urgent medical help should still attend, say experts. Read full story Source: BBC News, 6 April 2020
  5. News Article
    Singapore plans to open source a smartphone app its digital government team has developed to track citizens' encounters with coronavirus carriers. The app, named TraceTogether, and its government is urging citizens to run so that if they encounter a Coronavirus carrier, it’s easier to trace who else may have been exposed to the virus. With that info in hand, health authorities are better-informed about who needs to go into quarantine and can focus their resources on those who most need assistance. The app is opt-in and doesn’t track users through space, instead recording who you have encountered. To do so, it requires Bluetooth and location services to be turned on when another phone running the app comes into range exchanges four nuggets of information - a timestamp, Bluetooth signal strength, the phone’s model, and a temporary identifier or device nickname. While location services are required, the app doesn't track users, instead helping to calculate distances between them. Read full story Source: The Register, 26 March 2020
  6. News Article
    City and Hackney Clinical Commissioning Group might have the fifth highest prevalence of serious mental illness in England, but last year it achieved the highest physical health check coverage in the country. This was down to a collaborative approach by the CCG, local trust, GPs, heath informatics, a voluntary sector exercise and diet specialist organisation, and service users themselves. This alliance model for primary care SMI physical health was named mental health innovation of the year at the HSJ awards. Find out more Source: HSJ, 20 March 2020
  7. Content Article
    How safe is the laundering of uniforms by staff at home? What can be done to reduce the risk of bacterial survival and contamination? This article was first published in the Nursing Times in 2018 but is relevant to the current coronavirus pandemic.
  8. Event
    Healthcare professionals are deeply impacted by this crisis as are the citizens and patients who have been exposed to or contracted the virus. Patients and families who have navigated illness and our healthcare system for decades have insights that can support us as we move from the crisis to the rebuild. What is the role of partnership as we witness our providers in great need of emotional support? How are patients without COVID-19 coping with the interruptions in care and how do they balance their needs with that of the overall COVID response? How does the patient community support the healthcare community today? How do we begin to think ahead to rebuilding together? A panel of patients, family members and patient advocates will provide insights into these questions and more. Further information and registration
  9. News Article
    Children may have died from non-coronavirus illnesses because they are not coming to hospital quickly enough, amid concerns NHS 111 may be giving flawed advice to stay away, according to senior paediatricians. HSJ understands the concern about 111 giving the wrong advice to parents who should travel to hospital had been “escalated” to national leaders. Several senior paediatric leaders in London raised serious concerns to HSJ. They said several children in the past week had been admitted to intensive care in London, and had been harmed — and, in some cases, died — because of the issue, though they did not want to identify particular hospitals or cases. The sources said it was a national problem. Read full story Source: HSJ, 3 April 2020
  10. News Article
    Royal Wolverhampton Trust (RWT) has become the first provider to sign a deal with Babylon Health for citywide coverage of a new COVID-19 app, HSJ has learned. Digital health provider Babylon announced earlier this month the creation of a “covid-19 care assistant” app, which provides patients with digital triage, a live chat service, a symptom tracker and video consultation. RWT’s deal covers around 300,000 patients registered to a Wolverhampton GP, and all trust staff regardless of where they live. Earlier this year, RWT announced a 10-year deal with Babylon to develop a “digital-first integrated care” model. The new COVID-19 app will be made available to staff today and will then be rolled out to the general public next week. Read full story Source: HSJ, 3 April 2020
  11. News Article
    Elderly care home residents have been categorised “en masse” as not requiring resuscitation, in a strategy branded unacceptable by the healthcare regulator. People in care homes in Hove, East Sussex and south Wales are among those who have had “do not attempt resuscitation” (DNAR) notices applied to their care plans during the coronavirus outbreak without proper consultation with them or their families, MPs and medical unions fear. Care homes in Leeds have reported that district nurses have been asking them to “revisit do not resuscitate conversations with people who said they didn’t want them” and a care worker in Wales told the Guardian that after a visit from a GP, all 20 of their residents had DNAR notices attached to their plans. DNAR notices are a common part of care plans and many people wish to have them in place because, in the event of cardiac arrest, attempts to resuscitate can cause serious trauma, including broken bones. But the Care Quality Commission and other medical bodies are so concerned about the blanket application of the notices that it has issued a warning to stop. “It is unacceptable for advance care plans, with or without DNAR form completion, to be applied to groups of people of any description,” the notice states. “These decisions must continue to be made on an individual basis according to need.” Read full story Source: The Guardian, 1 April 2020
  12. News Article
    Major transplant centres have stopped performing many of their procedures due to the coronavirus pandemic, while the national coordinating body says a complete cessation “may only be days away”. Read full story (paywalled) Source: HSJ, 2 April 2020
  13. News Article
    On any normal day the Oak Springs Care home in Liverpool is a hive of activity, laughter ringing out as its elderly residents enjoy dancing, creative crafts and bingo. Yesterday it was quiet, the inhabitants confined to their bedrooms and stark notices on the door warning visitors against entering, as word spread that a third resident had died in hospital that morning after a corona-virus diagnosis. Of the 66 remaining residents, 52 are exhibiting symptoms. Four were put on end-of-life care plans this week, a situation described by Andrea Lyons, the general manager, as “our absolute worst nightmare”. She said: “These are people who we love, who we spend more time with than our families. It has been difficult beyond the worst you can imagine”. Read full story Source: The Times, 2 April 2020
  14. News Article
    Boris Johnson has been forced to shift strategy on the government’s testing regime for coronavirus after criticism of the slow pace of checks being carried out on frontline NHS staff. Private laboratories are now being drafted in to do the tests where before these were being performed through a centralised process. The prime minister accepted last night that mass testing was the way out of the crisis and said in a tweet that it would “eventually unlock the puzzle of coronavirus”. Read full story (paywalled) Source: The Times, 2 April 2020
  15. News Article
    A father has described the "huge impact" of losing respite care for his young daughter who has complex special needs. Tim Clarke and his wife Ana look after their six-year-old daughter Molly at home in Worcester. The family normally receives a few hours of outside care and educational help a week, but that ended with the coronavirus pandemic. Molly has been diagnosed with autism and also has medical issues including a cyst on her brain. One charity worker from the Pathological Demand Avoidance (PDA) Society, a condition which is on the autism spectrum, described parents of children with special needs as being in "survival mode". Watch video Source: BBC News, 1 April 2020
  16. News Article
    The procurement of digital tools to support online primary care services during the coronavirus outbreak are to be fast-tracked for providers who don’t have the resources. In a letter sent to primary care providers and commissioners, GP surgeries were told to move to a triage-first model of care as soon as possible as the NHS bolsters its response to COVID-19. The letter, sent by medical director for primary care, Nikita Kanani, and director of primary care strategy and NHS contracts, Ed Waller, states practices and commissioners should promote online consultation services where they are in place or “rapidly procure” them. “Rapid procurement for those practices that do not currently have an online consultation solution will be supported through a national bundled procurement,” wrote in the letter. Read full story Source: Digital Health, 30 March 2020
  17. News Article
    Doctors have been reminded not to prioritise coronavirus patients at the expense of others in new ethical guidance backed by royal colleges. There are increasing concerns that patients are not getting treatment for serious problems, including strokes or heart attacks, because they are afraid to go to hospitals. The guidelines were drawn up by the Royal College of Physicians (RCP) amid worries that a shortage of ventilators and beds could force doctors to make difficult decisions on which patients get lifesaving treatment. Read full story (paywalled) Source: The Times, 2 April 2020
  18. Content Article
    The Royal College of Physicians has published ethical guidance for frontline staff dealing with the COVID-19 pandemic, supported by more than a dozen other health organisations. Members of the RCP’s Committee on Ethical Issues in Medicine, chaired by Dr Alexis Paton, developed the guidance, which is supported by nine other Royal Colleges and five medical faculties. It takes into consideration recent joint statements from the General Medical Council (GMC), the NHS and the UK’s four Chief Medical Officers. The guidance reminds frontline staff that while so much has changed during the pandemic, they still need to ensure that care is provided in a fair and equitable way.
  19. News Article
    Stable coronavirus patients could be taken off ventilators in favour of those more likely to survive, it emerged on Wednesday, as another sharp rise in deaths left the UK braced for the outbreak to reach up to 1,000 deaths a day by the end of the week. In a stark new document issued by the British Medical Association (BMA), doctors set out guidelines to ration care if the NHS becomes overwhelmed with new cases as the outbreak moves towards its peak. Under the proposals, designed to provide doctors with ethical guidance on how to decide who should get life-saving care when resources are overstretched, hospitals would have to impose severe limits on who is put on a ventilator. Large numbers of patients could be denied care, with those facing a poor prognosis losing the potentially life-saving equipment even if their condition is improving. The BMA suggested that younger, healthier people could be given priority over older people and that those with an underlying illness may not get treatment that could save them, with healthier patients given priority instead. Read full story Source: The Guardian, 1 April 2020
  20. News Article
    A major hospital trust has told staff they should attend work even if a household member is showing covid-19 symptoms, contrary to national guidance. Newcastle Upon Tyne Hospitals Foundation Trust’s occupational health department has told staff who had reported having family members with covid-19 symptoms they were still expected to attend work. In the email exchanges seen by HSJ, some as recently as a couple of days ago, the trust’s occupational health department was clear there was an NUTH policy agreement with Public Health England. Read full story Source: HSJ, 1 April 2020
  21. News Article
    Healthcare professionals have been told to consider not treating patients with the COVID-19 coronavirus if they themselves would be put at risk, part of new ethical guidance that calls on doctors to prioritise some ailments over the pandemic. The new recommendations for healthcare professionals over 70 years, or with pre-existing conditions, to put themselves first when tackling the pandemic comes following the death of a doctor who returned to the frontlines as a volunteer following a call to arms from the government. The guidance from the Royal College of Physicians (RCP) makes up part of a sweeping list of ethical considerations faced by healthcare workers in the face of the global pandemic. Read full story Source: The Independent, 2 April 2020
  22. News Article
    Hospitals should allow parents to be with children who are being treated for the coronavirus, NHS England has confirmed, after a 13-year-old boy died without any family members beside him. Under its national guidance to hospitals, parents are considered essential visitors, but hospitals do have discretion to suspend visitors if it is “considered appropriate”. Anyone who has symptoms of COVID-19 should not be allowed to visit a hospital. NHS England confirmed the position after 13-year-old Ismail Mohamed Abdulwahab died at King’s College Hospital in south London in the early hours of Monday without any family members present. A statement by his family suggested he was alone because of the risk of infection. On its website the hospital repeated the guidance sent to trusts by NHS England that states children are allowed one parent or carer as a visitor, but declined to explain why his family were not with him. The end-of-life charity Marie Curie has also called on doctors to allow families to be with their loved ones, describing it as an “important part of their duty of care”. Read full story Source: The Independent, 2 April 2020
  23. Event
    ORCHA are hosting a free #COVID19 webinar today. ⁦‪@LizAshallPayne⁩ and ⁦‪@AndyJeans5⁩ will be showing how you can find the best apps to support remote care. Follow the link to register
  24. Content Article
    A number of associations and societies across the UK have come together to provide guidance on the safe switching of warfarin to direct oral anticoagulants (DOACs). This needs to be undertaken in a phased manner over the 12 week cycle of INR monitoring to protect the supply chain for ALL patients. As highlighted in the guidelines, many patients are not suitable for a switch from warfarin to DOACs and further guidance will be available shortly to support services providing care for these patients.
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