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Showing results for tags 'Research'.
Found 982 results
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Content ArticleThis report by the US non-profit organisation the Emergency Care Research Institute (ECRI) was commissioned by the US Food and Drug Administration (FDA) to determine the safety profile of polypropylene (PP) mesh used in a variety of surgical procedures. ECRI performed a comprehensive literature search and systematic review to identify the current state of knowledge about how patients' bodies respond to PP mesh.
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Content Article
In this blog, Kath Sansom, founder of the Sling the Mesh campaign, unpacks the findings of a medical device performance study into polypropylene mesh published by the Emergency Care Research Institute (ECRI) in the US. The document highlights significant gaps in evidence about the risk of complications associated with polypropylene (PP) surgical mesh. -
Content ArticleAppreciative Inquiry (AI) is a research approach that aims to create practical and collaborative change by taking participants through an in-depth exploration of their organisation, team or role. This article in the European Journal of Midwifery reflects on the process of using AI in a study that explored staff wellbeing in a UK maternity unit. The authors share key lessons to help others decide whether AI will fit their research aims, and highlight issues in its design and application.
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Content ArticleEvidence suggests that full implementation of the WHO surgical safety checklist across NHS operating theatres is still proving a challenge for many surgical teams. The aim of the current study from Charles Vincent and colleagues was to assess patients’ views of the checklist, which have yet to be considered and could inform its appropriate use, and influence clinical buy-in.
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Content ArticleSocial prescribing is a way of linking people with complex needs to non-medical supports in the community. There are different models of social prescribing, ranging from online signposting services to individual support from a link worker to access community resource. The aim of this study from Kiely et al. was to establish the evidence base for the effects on health outcomes and costs of social prescribing link workers (non-health or social care professionals who connect people to community resources) for people in community settings focusing on people experiencing multimorbidity and social deprivation. The study found that there is an absence of evidence for social prescribing link workers. Policymakers should note this and support evaluation of current programmes before mainstreaming.
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Content ArticleThis joint position statement from The Royal College of Physicians (RCP) and National Institute for Health and Care Research (NIHR) sets out a series of recommendations for making research part of everyday practice for all clinicians. Its recommendations are aimed at stakeholders across the health and care system, with the overall aim of embedding research in clinical practice: Trusts, health boards and integrated care systems (ICSs) Health Education England and NHS England and statutory education bodies and the departments of health in the other UK nations Regulators Funders
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Content ArticleThis German study in the Journal of Patient Safety aimed to analyse the strength of safety measures described in incident reports in outpatient care. 184 medical practices were invited to submit anonymous incident reports to the project team three times in 17 months. The authors coded the incident reports and safety measures, classifying them as as “strong” (likely to be effective and sustainable), “intermediate” (possibly effective and sustainable) or “weak” (less likely to be effective and sustainable). The study found that the proportion of weak measures was high, which indicates that practices need more support in identifying strong patient safety measures.
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Content ArticleIn this blog, Eve Namisango, Programs and Research Manager at the African Palliative Care Association, looks at the importance of patient and public involvement and engagement (PPIE) in palliative care research. She highlights recent work with the Uganda Cancer Society to explore best practices for engaging patients and caregivers and looks at key issues to consider when structuring PPIE in research.
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Content ArticlePatient lead users can be defined as patients or relatives who use their knowledge and experience to improve their own or a relative’s care situation and/or the healthcare system, and who are active beyond what is usually expected. This study in the BMJ Open aimed to explore patient lead users’ experiences and engagement during the early Covid-19 pandemic in Sweden, from 1 June to 14 September 2020. The authors recruited 10 patient lead users living with different long-term conditions and undertook qualitative in-depth interviews with each of them. They found that health systems were not able to fully acknowledge and engage with the resource of patient lead users during the pandemic, event though they could be a valuable resource as a complementary communication channel.
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Content Article
Communication in the operating theatre (14 November 2013)
Patient-Safety-Learning posted an article in Surgery
Communication is extremely important to ensure safe and effective clinical practice. This systematic literature review of observational studies addressing communication in the operating theatre aimed to gain an understanding of actual communication practices, rather than what was reported through recollections and interviews. In all of the studies reviewed, communication was found to affect operating theatre practices. Further detailed observational research is needed to gain a better understanding of how to improve the working environment and patient safety in theatre. -
Content ArticleVideo recording technologies offer a powerful way to document what happens in clinical areas. Cameras, and to a lesser extent, microphones, can be found in a growing number of modern operating rooms in the USA, UK and other parts of the world. While they could be used to create a detailed record of what happens in and around the operating table, this is still rarely being done; the vast majority of operations are still only documented in written operation notes. In this paper, Bezemer et al. discuss using microanalysis of videos from the operating room.
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Content ArticleThe variety of alarms from all types of medical devices has increased from 6 to 40 in the last three decades, with today’s most critically ill patients experiencing as many as 45 alarms per hour. Alarm fatigue has been identified as a critical safety issue for clinical staff that can lead to potentially dangerous delays or non-response to actionable alarms, resulting in serious patient injury and death. To date, most research on medical device alarms has focused on the nonactionable alarms of physiological monitoring devices. While there have been some reports in the literature related to drug library alerts during the infusion pump programming sequence, research related to the types and frequencies of actionable infusion pump alarms remains largely unexplored.
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Content ArticleThis qualitative study in BMC Medicine aimed to improve understanding of the reality of making and sustaining improvements in complex healthcare systems. It focused on understanding the implications of complexity theory, introducing a framework known as Successful Healthcare Improvement From Translating Evidence in complex systems (SHIFT-Evidence). This approach is accompanied by a series of ‘simple rules’ that aim to make complexity navigable (whilst recognising that it will never be simple), providing actionable guidance to both practice and research. The authors concluded that the SHIFT-Evidence framework provides a tool to guide practice and research. The ‘simple rules’ have potential to provide a common platform for academics, practitioners, patients and policymakers to collaborate when intervening to achieve improvements in healthcare.
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Content ArticleThis paper by Professor Paul Bate, Emeritus Professor of Health Services Management at University College London, looks at the importance of considering context in healthcare initiatives. It introduces various frameworks for viewing context and looks at key themes in existing research. It concludes by looking at key questions for future research on context.
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Content ArticleThe paradox of representation in public involvement in research is well recognised, whereby public contributors are seen as either too naïve to meaningfully contribute or too knowledgeable to represent ‘the average patient’. Given the underlying assumption that expertise undermines contributions made, more expert contributors who have significant experience in research can be a primary target of criticism. Knowles SE et al. conducted a secondary analysis of a case of expert involvement and a case of lived experience, to examine how representation was discussed in each.
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Content ArticleHospital-acquired venous thromboembolism (VTE) continues to be a significant source of preventable patient harm. This study from Richie et al. retrospectively examined patients admitted with VTE and found that only 15% received correct risk stratification and appropriate management and treatment. The case review found that patients were commonly incorrectly stratified, received incorrect pharmaceutical treatment, or inadequate application of mechanical prophylaxis (e.g., intermittent compression).
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Content ArticlePatient safety in ambulatory care settings is receiving increased attention. Based on interviews and focus groups with patients, providers, and staff at ten patient-centered medical homes, this qualitative study explored perceived facilitators and barriers to improving safety in ambulatory care. Participants identified several safety issues, including communication failures and challenges with medication reconciliation, and noted the importance of health information systems and dedicated resources to advance patient safety. Patients also emphasised the importance of engagement in developing safety solutions.
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Content ArticleDigital healthcare knowledge and tools can enhance the efforts of patients, clinicians, and health systems working to improve healthcare quality and safety. AHRQ’s digital healthcare research (DHR) programme funds research to create actionable findings on what and how digital healthcare works best for these critical stakeholders in healthcare. Now more than ever, the DHR programme is focused on supporting crucial research that identifies how the various components of the ever evolving digital healthcare ecosystem can best come together to positively influence healthcare delivery and create value for its key stakeholders: patients, clinicians, and health systems. This ecosystem includes clinical, contextual, and patient-generated health data as well as the tools used to manage and apply these data, such as advanced analytics and data visualisations. The application of these data can result in new knowledge, which can take the form of computable clinical guidelines and decision support. The DHR program continues to fund research on how these ecosystem elements and the actors who create and use them can best support the quality and safety of healthcare.
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Content ArticleA broken hip or ‘hip fracture’ is a serious injury, which each year in the UK leads to around 75,000 people needing hospital admission, surgery and anaesthesia, followed by weeks of rehabilitation in hospital and the community. The National Hip Fracture Database (NHFD) is an online platform that uses real-time data to drive Quality Improvement (QI) across all 163 hospitals that look after patients with hip fractures in England and Wales. This report highlights key research carried out using data from the NHFD in 2021, and makes a number of recommendations to improve treatment and outcomes for patients with hip fractures.
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Content Article
Risk of suicide after dementia diagnosis (3 October 2022)
Patient Safety Learning posted an article in Dementia
Patients with dementia may be at an increased suicide risk. Identifying groups at greatest risk of suicide would support targeted risk reduction efforts by clinical dementia services. In this study, Alothman et al. examine the association between a dementia diagnosis and suicide risk in the general population and to identify high-risk subgroups. They found that dementia was associated with increased risk of suicide in specific patient subgroups: those diagnosed before age 65 years (particularly in the 3-month postdiagnostic period), those in the first 3 months after diagnosis, and those with known psychiatric comorbidities. Given the current efforts to improve rates of dementia diagnosis, these findings emphasise the importance of concurrent implementation of suicide risk assessment for the identified high-risk groups. -
Content ArticleHealthcare simulation is an established technique for improving patient safety, through training individual skills, teamwork behaviours, and by testing healthcare systems for latent safety threats. However, healthcare simulation may present risks to safety, especially when delivered ‘in situ’—in real clinical environments—when lines between simulated and real practice may be blurred. Brazil et al. developed a simulation safety policy (SSP) after reading reports of adverse events in the healthcare simulation literature, editorials highlighting these safety risks, and reflecting on our own experience as a busy translational simulation service in a large healthcare institution. The process for development of a comprehensive SSP for translational simulation programs is unclear. Personal correspondence with leaders of simulation programs like our own revealed a piecemeal approach in most institutions. In this article, the authors describe the process we used to develop the simulation safety policy at our health service, and crystalize principles that may provide guidance to simulation programs with similar challenges.
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Content ArticleWhen the COVID-19 pandemic began, initial descriptions of the symptomology focused on the clinical presentations of patients in the acute, inpatient setting. In the months since, information on how patients with mild disease present has become available along with information on the fairly common occurrence of asymptomatic disease. More recently, data have emerged that some patients continue to experience symptoms related to COVID-19 after the acute phase of infection. There is currently no clearly delineated consensus definition for the condition: terminology has included “long COVID,” “post-COVID syndrome” and “post-acute COVID-19 syndrome". Among the lay public, the phrase “long haulers” is also being used. Here the COVID-19 Real-Time Learning Network review the current literature on post-acute symptoms in patients with COVID-19, using the term “post-acute COVID-19 syndrome".
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Content ArticleRisk assessments are a central component of mental health care. Few national studies have been done in the UK on risk assessment tools used in mental health services. In this study, Graney et al. aimed to examine which suicide risk assessment tools are in use in the UK; establish the views of clinicians, carers, and service users on the use of these tools; and identify how risk assessment tools have been used with mental health patients before suicide.
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Content ArticleCOVID-NMA is an international research initiative supported by the WHO and Cochrane. It provides a living mapping of COVID-19 trials available through interactive data visualisations. COVID-NMA also conductis living evidence synthesis on preventive interventions, treatments and vaccines for COVID-19 to assist decision makers.
