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Patient-Safety-Learning

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Everything posted by Patient-Safety-Learning

  1. News Article
    According to public health reports, there has been a sharp rise in drug overdoses, particularly heroin, over the past 10-14 days with the synthetic opioid isotonitazene implicated in some cases. In several areas of the country including five London boroughs, Hampshire, Essex, West Sussex, Dorset and Thames Valley, there has been 46 poisonings, resulting in 16 deaths, although currently, investigations are still ongoing. In a National Patient Safety alert issued on 18 August 2021, Public Health England (PHE) have instructed all NHS organisations to ensure staff are made aware of the risk of severe toxicity resulting from the synthetic opioid, and that all organisations that treat emergency cases should ensure staff are able to treat suspected cases “using naloxone and appropriate supportive care”. Roz Gittins, director of pharmacy at the charity Humankind, said "People also need to know where they can get hold of naloxone, as well as being reminded to carry it with them and to let people know where they keep it. If advice and support is required then the local substance misuse service should be contacted for specialist support. We hope that the current consultation to widen naloxone provision will be successful and that improved funding will lead to naloxone being distributed more widely to help reduce the risk of accidental opioid overdoses." Read full story. Source: The Pharmaceutical Journal, 18 August 2021
  2. News Article
    After three Covid-19 patients died at the make-shift Nightingale Hospital in London following a breathing tube mix-up, NHS trusts in England could be issued tougher ventilation guidance. In each of the cases, filters which prevent the build-up of fluid were not attached to the machines, resulting in dangerous blockages, but it has not yet been determined if these incidents contributed to their deaths. Coroner Nadia Persaud has said the way the machines vary from model to model can be "confusing" and may lead to future deaths, also ruling that the classification and colour coding was "worthy of review, simplification, and standardisation". The original coroners report, carrying advice from an independent expert said "In my opinion, the non-standardised colour coding used by manufacturers of these filters, the number of different types of filters with different names, the variable optimal position of the filters, and whether a wet or a dry breathing system is being used, results in an extremely confusing situation. One of the leading manufacturers of these filters produces HMEs that are blue, which is the same colour as the non-HME filters supplied by another company. In my experience, few doctors and nurses working in ICU are knowledgeable about all these different filters and which ones should be used for any given breathing system." Inquests into the deaths are scheduled for October. Read full story. Source: The Daily Mail, 17 August 2021
  3. News Article
    According to reports, the number of children being treated by the NHS has soared, with waiting times tripling in a year, and experts warning the pandemic may have set back treatment for young people "by years". The Royal College of Psychiatrists have also said services are struggling to provide timely treatment due to an "overwhelming" demand. Dr Agnes Ayton, the chair of the Royal College of Psychiatrists Faculty of Eating Disorders Psychiatry, said: “The pandemic has had a huge impact on children and young people with disruption to their schooling, social lives and home lives. Many young people have not received support early enough, causing their eating disorders to become much worse and harder to treat. Delays to treatment can put lives at risk. Services are struggling with soaring demand, fewer beds because of social distancing and an ongoing shortage of specialist doctors.” Read full story. Source: The Independent, 19 August 2021
  4. Content Article
    This article discusses the prevalence and cost of hospital-acquired conditions (HACs) and patient safety events (PSIs) associated with procedures that may below value, and reports on the prevalence of adverse events associated with potential low-value procedures and the additional hospital length of stay (LOS) and costs. 
  5. Content Article
    This article examines the challenges in regulating patient safety during hospital discharges in England through the lens of liminality. In addition, this article proposes that by positioning the new role of Patient Safety Commissioner (PSC) as that of a ‘Representative of Order’, it could be a means by which this poorly regulated space could be navigated more successfully.
  6. Content Article
    This article by Tanya Albert Henry discusses poor “cognitive ergonomics” and how the American Medical Association has studied burnout among doctors and is currently addressing issues causing and fuelling physician burnout—including time constraints, technology and regulations—to better understand and reduce the challenges physicians face. 
  7. News Article
    This interview with April Kapu, DNP, APRN, ACNP-BC, FAANP, FCCM, FAAN, a critical care nurse, discusses how Nurse Practitioners are changing healthcare, the likelihood of all states granting full practice authority to NPs, and what the American Association of Nurse Practitioner members can expect from her for the next two years. Read full story. Source: American Medical Association, 16 August 2021
  8. News Article
    Vaccinated nurses will now be expected to return to work instead of isolating as new rules are set to relax. In a letter on the latest rule change from NHS England chief nursing officer Ruth May, chief people officer Prerana Issar, and medical director for primary care Dr Nikita Kanani said “Fully vaccinated staff and students who are identified as a contact of a positive Covid-19 case will no longer be expected to isolate and will be expected to return to work.” Staff returning to work are required to have been double jabbed, have no Covid-19 symptoms and receive a negative PCR test. This latest change in rules go in line with changes for the wider population. Read full story. Source: Nursing Times, 16 August 2021
  9. News Article
    With just hours left to go, a health watchdog has paused a final update to ME treatment guidance due to disagreement on some of it's contents. Charities have expressed their anger over this decision as NICE says it needs more discussions with patient groups and professionals so that the advice is supported. Although it is not yet clear when the guidance will be published, the advice on CBT (cognitive behavioural therapy) has been changed as it was only helping with anxiety around the condition rather than the illness itself, with NICE acknowledging the controversy over the best treatment has served only to alienate many people with the condition. "We were extremely concerned that the final guidelines proposed by NICE may not have taken into consideration the extensive comments we made to the draft version, particularly in relation to treatments we know to have significantly benefited many patients." Andrew Goddard, president of the Royal College of Physicians, has said. Read full story. Source: BBC News, 17 August 2021
  10. Content Article
    This article describes what to be expect when coming off of antidepressants, withdrawal problems, the importance of safely tapering off medication and the need for extreme care and support for patients coming off prescribed antidepressants and benzodiazepines.
  11. Content Article
    This research focused on the Clinical pharmacist (CP) interventions from the PROTECTED-UK cohort. Data was collected from 21 adult critical care units over 14 days and interventions were catergorised as an error, optimisation or consults, with pharmacy service demographics also being collected by investigator survey.
  12. Content Article
    The present research conducted a prospective observational study in 21 UK critical care units (CCU's) from 5-18 November 2012 with the aim to describe clinical pharmacist interventions. Data was collected via a web portal where specialist critical care pharmacists could make their reports, with each intervention classified as medication error, optimization or consult. A total of 20, 517 prescriptions were reviewed with 3294 interventions recorded during the weekdays. Results demonstrated that both medication error resolution and pharmacist-led optimisation rates were substantial.
  13. News Article
    A new study has found night shifts are "significantly associated" with health issues related to the heart, particularly atrial fibrillation, finding that women may be at a greater risk. The research, published in the European Heart Journal also found working night shifts is linked to an increased risk of coronary heart disease (CHD). “Night shift exposure also increased the risk of CHD (coronary heart disease) but not stroke or HF (heart failure). Whether decreasing night shift work frequency and duration might represent another avenue to improve heart health during working life and beyond warrants further study,” the paper said. Read full story. Source: The Independent, 16 August 2021
  14. News Article
    1,500 safety recommendations have been made to NHS trusts a year after hundreds of babies were left brain damaged and dozens of mothers and infants died. Safety watchdog Healthcare Safety Investigation Branch (HSIB) has outlined key themes from 760 investigations of maternity incidents, taking over investigations for NHS trusts in 2018 after concerns were raised over the poor quality of investigation by trusts and a lack of involvement in families. Sandy Lewis, associate director of maternity said: “The publication of the HSIB maternity programme year review provides crucial details of the work that has been undertaken in the last year. We would like to thank all of those who have worked with us in the past year, sharing their experiences, insights and expertise. Many families have not only told us their stories but have also trusted our investigators to reflect their perspectives and share their experience. Trusts have responded promptly to this insight, this has contributed to improving safer care of mothers, babies and families across the country.” Read full story. Source: The Independent, 16 August 2021
  15. News Article
    Providers fear 'fragmentation' of specialised services as NHS England begins delegating specialised services budgets to integrated care systems under reform plans. One leader of a specialist trust told HSJ: “There is a real risk of fragmentation. You can already see some of the conversations around various services around how people want to keep patients within their own ICS. There is the potential there for systems to buck the trend of centralising specialist services. Rather than bringing expertise and quality together, systems looking after budgets will look to set up their own specialist services.” Read full story (paywalled). Source: HSJ, 17 August 2021
  16. News Article
    Plasma from blood donations in England will be used to make a life-saving drug whilst also helping to secure NHS plasma stocks to make the antibody-based medicines, called immunoglobulins. The service will begin roll-out in the coming months, with other parts of the UK potentially following suit. Gerry Gogarty, from NHS Blood and Transplant, welcomed the decision, calling it a huge step forward. "By recovering plasma from blood donations, we can improve long-term supplies of immunoglobulin medicine, and each generous blood donation will go even further in helping to save the lives." Read full story. Source: BBC News, 17 August 2021
  17. Content Article
    This article discusses what advocacy actually entails and what values it ought to embody. The paper considers whether advocates are necessary since not only can they be dangerously paternalistic, but the salutary values advocacy embodies are already part of good professional health care.
  18. Content Article
    This article by Dean K Wright describes the definition of 'advocate' and discusses how a doctor can best support their patient, particularly in regards to advocating for their patients rights and/or needs and in cases of child abuse and barriers to effective patient care.
  19. News Article
    According to reports, Barts Health Trust and most other providers in the north east London health system may run out of blood tube collection products by the end of August. Though, according to notes seen by HSJ, a “mitigation plan with demand management in place this may extend into September”. After warning colleagues in north east London that the shortage of blood collection tubes made by Becton Dickinson affects “all NEL areas” except acute trust Barking, Havering and Redbridge University Hospitals Trust, Diane Jones, chief nurse of the NEL integrated care system has said “NHSE are looking at mitigations, but nothing confirmed as yet, and [they] may take a few weeks to come on stream. The mitigation may get us up to 50 per cent of usual supply in the short term.” Read full story (paywalled). Source: HSJ, 13 August 2021
  20. News Article
    Coroners have raised multiple concerns that visiting restrictions are having a damaging effect on patient care and wellbeing, also raising the issue that families of vulnerable patients may be unable to pass on information to clinicians which would be relevant to their care. NHS Providers chief executive Chris Hopson said: “No trust makes the decision to suspend or restrict visiting lightly. Trust leaders understand the importance of allowing visitors, in a safe and manageable way, or finding alternative ways to enable particularly vulnerable patients to stay in touch with their families and carers. They are also aware of the important information that families and carers can provide about patients.” Read full story (paywalled). Source: HSJ, 16 August 2021
  21. News Article
    A hospital in Yorkshire has suspended all routine inpatient surgeries amid overcrowding in A&E caused by a lack of beds. Staff at the Mid Yorkshire Hospitals NHS Trust were told in an email that this had been a "critical issue for too long." “It is with regret that this decision has had to be made given that it will result in less patients receiving surgical treatment, slowing down our progress on reducing waiting times. However, the extreme pressure on beds has to be reduced and quickly. The trust consistently has between 25 and 50 patients waiting for a bed at any one time at Pinderfields emergency department, causing serious overcrowding and long delays [and] contributing to an unacceptable patient and staff experience.” Martin Barkley, chief executive of the trust, told staff. Read full story. Source: The Independent, 14 August 2021
  22. News Article
    The new head of NHS England has urged people not to ignore the signs of cancer and encourages people to get checked out if symptoms emerge, such a cough or stomach pain that won't go away. Experts believe certain cancers such as abdominal cancers - throat, stomach, bowel, pancreatic, ovarian - and urological cancers - prostate, kidney and bladder - are the most likely to go unrecognised and suggest anyone with symptoms to tell their GP. "People should not feel like they cannot trouble the NHS, which is open and ready to treat people." NHS England chief executive Amanda Pritchard has said. Read full story. Source: BBC News, 15 August 2021
  23. Content Article
    The efficacy of injection therapy in diabetes depends on correct injection technique. The aim of the Insulin Injection Technique Questionnaire was to understand how people with diabetes inject, so that guidance can be tailored towards improving injection technique. This article in the Journal of Diabetes analyses the results of the 2008-2009 survey and identifies areas where improvements have been made since the last survey, and areas where there is still progress to be made.
  24. Content Article
    This research article aimed to provide Registered Nurses with a description of patient advocacy in the clinical setting. Through a series of semi-structured interviews with 25 participants, the results of this study found the nurses had an adequate understanding of patient advocacy and were willing to advocate for patients, describing patient advocacy as promoting patient safety and quality care.
  25. Content Article
    This article by Angira Patel discusses the importance of health advocacy and a clinicians professional responsibility towards their patients. Angira also describes current attitudes and practices surrounding advocacy, particularly within the political and social sphere.
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