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Growing evidence indicates that improved nurse staffing in acute hospitals is associated with lower hospital mortality. Current research is limited to studies using hospital level data or without proper adjustment for confounders which makes the translation to practice difficult. In this observational study published in BMC Health Services Research, Haegdorens et al. analysed retrospectively the control group of a stepped wedge randomised controlled trial of 14 medical and 14 surgical wards in seven Belgian hospitals. All patients admitted to these wards during the control period were included in this study. Pregnant patients or children below 17 years of age were excluded. The records showed that, on average, three out of every thousand patients in the hospital died ‘unexpectedly’. A death is considered as unexpected when a patient suddenly dies during active treatment, with no care plan for the end of their life having been started. Their results are in accordance with previous research and confirm the association between higher nurse staffing levels and lower patient mortality. Furthermore, they also found that a higher proportion of bachelor’s degree nurses is related to a reduction in patient mortality. They proposed a new method to estimate optimal staffing levels using ward level data.- Posted
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The number of doctors entering GP training is higher than ever, yet the overall number of full-time equivalent GPs keeps decreasing. This is one of the reasons that patients report increasing dissatisfaction with their ability to access general practice, although they are satisfied with their care once they are seen. In this blog for the King's Fund, Abigail Heller, a current GP trainee discusses the results of a recent survey of 840 trainees about their career intentions. Abigail and many of the respondents hope to pursue other clinical or non-clinical interests alongside general practice, with interests ranging from expedition medicine to medico-legal work to give them the opportunity to broaden their skills However, despite this desire for a more flexible career, the trainees have concerns about an unmanageable workload. The intensity of the working day remains the leading factor in not wishing to undertake full-time GP work.- Posted
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Learning from deaths of people in their care can help providers improve the quality of the care they provide to patients and their families, and identify where they could do more. A CQC review in December 2016, 'Learning, candour and accountability: a review of the way trusts review and investigate the deaths of patients in England' found some providers were not giving learning from deaths sufficient priority and so were missing valuable opportunities to identify and make improvements in quality of care. This video from the NHS Improvement national patient safety team is a guide for NHS trusts in England on developing and implementing learning from deaths policies within their organisations.- Posted
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Making schools safer project
Claire Cox posted an article in Allergies
The Anaphylaxis Campaign is the only UK wide charity solely focused on supporting people at risk of severe allergic reactions.- Posted
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- Training
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Physicians, particularly trainees and those in surgical subspecialties, are at risk for burnout. Mistreatment (i.e., discrimination, verbal or physical abuse, and sexual harassment) may contribute to burnout and suicidal thoughts. In a study published in NEJM, Hu et al. carried out a cross-sectional national survey of general surgery residents administered with the 2018 American Board of Surgery In-Training Examination assessed mistreatment, burnout (evaluated with the use of the modified Maslach Burnout Inventory), and suicidal thoughts during the past year. They found mistreatment occurs frequently among general surgery residents, especially women, and is associated with burnout and suicidal thoughts.- Posted
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Remove central lines supine - animation (2017)
Claire Cox posted an article in Implementation of improvements
The PatientSafe Network is a registered non for profit charity in Australia. It has been developed by front line healthcare staff and is for anyone who wants to improve patient safety. Their combined commitment is to improve patient safety through the transparent review of medical mistakes and the generation of transparent networked projects. Hundreds of patients die every year from avoidable central line related air emboli. This animation explains what air emboli are and how they may be avoided.- Posted
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- Hospital ward
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Health Education England: Human Factors Toolkit
Patient Safety Learning posted an article in Techniques
Health Education England have produced a toolkit on human factors in healthcare looking at example of training, simulation and speaking up. -
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East Kent Hospitals University NHS Foundation Trust is delighted to have been the recipients of the Patient Safety Learning Award 2019 for ‘Professionalising Patient Safety’ for our FallStop programme.- Posted
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This is the fourth annual NHS workforce trends report published by the Health Foundation. In it, they analyse the changes in the size and composition of the NHS workforce in England in the context of long-term trends, policy priorities and future projected need. -
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Designed for faculty, medical education curricula developers, residents, medical school administration, Designated Institutional Officials (DIOs), clinical leaders at teaching hospitals, and others interested in undergraduate, graduate and continuing medical education. There have been many advancements in medical education over the past 20 years, including how outcomes such as competencies are defined and used to guide teaching and learning. To support this positive change, the Association of American Medical Colleges (AAMC) has launched the New and Emerging Areas in Medicine series. This first report in the series focuses on quality improvement and patient safety competencies across the continuum of medical education. It presents a roadmap for curricular and professional development, performance assessment, and improvement of health care services and outcomes. The competencies can help educators design and deliver curricula and help learners develop professionally.- Posted
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A whole-system approach to nasogastric tubes led by nurses is improving patient safety at Lancashire Teaching Hospitals NHS Foundation Trust. This initiative won the patient safety improvement category in the 2018 Nursing Times Awards.- Posted
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Dr Helen Higham, Co-Director of the Patient Safety Academy, presented at the 'A New Strategy for Patient Safety - Insight, Involvement, Improvement' conference on how we can effectively learn from serious incidents.- Posted
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Royal Pharmaceutical Society: Antimicrobial stewardship portal
Claire Cox posted an article in Medicine management
The AMS Portal signposts resources and information to promote learning about antimicrobial stewardship (AMS) and antibiotic resistance. The Portal focuses on resources in the UK for pharmacists and pharmacy teams and within each section they have identified key resources to support pharmacy practice within the UK. They recognise, however, the need to signpost worldwide information and resources from outside the UK and these are also included as additional links. The aim is to continuously develop the AMS Portal to be accessible across all healthcare professions, encouraging a multidisciplinary and collaborative approach for improvement of antimicrobial use. The AMS Portal is intended as a dynamic ‘living’ resource which is constantly revised and updated.- Posted
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Maternity care continues to be associated with avoidable harm that can result in serious disability and profound anguish for women, their children, and their families, and in high costs for healthcare systems. To understand how to make maternity care safer, we must first understand what makes a maternity unit safe. Rather than focus on what goes wrong, this study from THIS.Institute focuses on what needs to go right by studying one high-performing maternity unit, located in Southmead Hospital in Bristol, UK.- Posted
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Antibiotic resistance is increasing worldwide due to overuse and misuse of antibiotics. Newborn baby Amala has a life-threatening infection called septicemia. Will her antibiotic treatment work? This video from the World Health Organization (WHO) explains what people can do to prevent the spread of antibiotic resistance.- Posted
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Antibiotic awareness: quizzes and crosswords (updated 2017)
Claire Cox posted an article in Medicine management
The Antibiotic Guardian has produced a range of quizzes and crosswords about antibiotic resistance for the public, healthcare prescribers and pharmacists.- Posted
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TARGET stands for: Treat Antibiotics Responsibly, Guidance, Education, Tools. The toolkit helps influence prescribers’ and patients’ personal attitudes, social norms and perceived barriers to optimal antibiotic prescribing. It includes a range of resources that can each be used to support prescribers’ and patients’ responsible antibiotic use, helping to fulfil continued professional development (CPD) and revalidation requirements.- Posted
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Antibiotic resistance is an increasingly serious threat to global health and human development. It is rising to dangerously high levels in all parts of the world, compromising our ability to treat infectious diseases and putting people everywhere at risk.- Posted
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The National Guidance on Learning from Deaths was published by the National Quality Board in March 2017 to initiate a standardised approach, ensuring that learning from a review of the care provided to patients who die should be integral to a provider’s clinical governance and quality improvement work. To fulfil the standards and new reporting, this policy identifies and highlights: The Trust’s governance arrangements. The Trust’s processes on reporting, reviewing and investigation of deaths, including those deaths that are determined more likely than not to have resulted from problems in care. The Trust’s processes, to share and act upon any learning derived from these processes.- Posted
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- Patient death
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The National Mortality Case Record Review Programme (NMCRR) aims to develop and implement a standardised methodology for reviewing the case records of adults who have died in acute hospitals across England and Scotland. As well as improve understanding and learning about problems and processes in healthcare that are associated with mortality.- Posted
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Jenny Slayton, Executive Director of Quality Improvement for Vanderbilt University Medical Center, explains how the Vanderbilt University Medical Center has created a safety culture. Starting small, by deciding to improve handwashing, they applied what they learned from this to a range of other safety improvement opportunities.- Posted
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- Safety behaviour
- Safety culture
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Presentation from Ben Tipney and Vikki Howarth at the 'A New Strategy for Patient Safety - Insight, Involvement, Improvement' conference held in Manchester on the 16 October 2019.- Posted
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Presentation from Dr Devina Halsall, NHS England & NHS Improvement Northwest Region, at the 'A New Strategy for Patient Safety - Insight, Involvement, Improvement' conference held in Manchester on the 16 October 2019.- Posted
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Operative vaginal birth is a common procedure used to expedite birth after full cervical dilatation where there is a clinical need to do so (15% of births in the UK in 2016). The acquisition of skills for operative vaginal birth is dependent on the exposure of junior obstetricians to situations in which they can undertake directly supervised learning.- Posted
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- Obstetrics and gynaecology/ Maternity
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This report is a practical guide to developing an organisation-wide approach to improvement. It summarises the benefits of such an approach and outlines the key elements and steps that NHS trust leaders should adopt when pursuing this agenda.- Posted
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- Leadership
- Organisational learning
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