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Content Article
Nursing notes on a scandal (31 March 2023)
Patient-Safety-Learning posted an article in Nursing
The tenth anniversary this year of the publication of the Francis Report in 20131 is marked by the largest scale of industrial action ever taken by nurses in the UK for better pay and conditions and, especially, safe staffing. In this article in the Future Healthcare Journal Alison Leary and Anne Marie Rafferty reflect on opportunities missed in the last decade in the attempt to secure safe staffing in nursing. They consider the aftermath of the public inquiry into Mid Staffordshire NHS Foundation Trust and its consequences for nursing, and how policymakers have consistently ignored a growing body of evidence outlining the benefits of safe staffing. -
Content ArticleThis article explains Quality and Safety Education in Nursing (QSEN), a US initiative to align nursing education and nursing best practices in quality and safety standards. The six focus areas of QSEN are: Patient-centred care Evidence-based practice Teamwork and collaboration Safety Quality improvement Informatics
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Content ArticleIn the UK today, nearly 40% of the population are living in poverty because of low income. This means that nurses and midwives are likely to meet people experiencing poverty and deprivation as part of their everyday work and should be ready and able to help them access the assistance they need to overcome the associated challenges. This article in the British Journal of Nursing examines the link between financial status and people's health and wellbeing. The article includes a case study and suggestions as to how nurses and midwives can promote financial wellbeing.
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Content ArticleA shortage of nurses across the world, including in countries that provide nurses for international recruitment, has created a global health emergency, according to the latest report from the International Council of Nurses. The report, Recover to Rebuild: Investing in the Nursing Workforce for Health System Effectiveness, lays out the devastating impact that the Covid-19 pandemic has had on nurses around the world. It urges that investment in a well-supported global nursing workforce is needed if health systems around the world are to recover and be rebuilt effectively. It also warned against reliance on the “quick fix” of international recruitment instead of investing in nursing education, as this was contributing to staff shortages even in countries with a long tradition of educating nurses to work in higher income countries. The report, co-authored by the organisation's chief executive, Howard Catton, and nursing workforce policy expert Professor James Buchan, includes the findings of workforce surveys from more than 25 countries, including the UK, as well as other research.
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Content ArticleThis paper, published in the International Journal of Health Governance, discusses and analyses the need and benefits of a patient safety definition within the context of nursing. The predominant role of nurses due to the proportionate size and significant role along with the need for clarification of patient safety in nursing terms is recognised. Research evidence of nursing areas with safety issues and relevant nursing interventions are presented. Based on all findings, a research-based nursing specific patient safety definition is proposed. This definition includes three axes: What is patient harm? How this harm can be eliminated or reduced? Which are the areas of nursing practice that are identified to provide opportunity for patient harm? These axes include nursing specifications of the patient safety definition.
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Content ArticleHealthcare IT News interviewed Wendy Deibert, senior vice president of clinical solutions at Caregility, a telehealth technology and services company, to talk about virtual nursing's role in helping tackle the nursing shortage.
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Content ArticleThis article by Katherine Virkstis, Managing Director of the US health thinktank Advisory Board, looks at the growing problem of a nursing 'skills gap' in the US. She argues that this area is often overlooked, but needs to be tackled to ensure patients are safe. A recent boom in new nurses graduating means that the balance of the nursing workforce is now less experienced than it has previously been. The growing complexity of patients and care approaches in healthcare systems also means that the demand for highly-trained nurses with specific skills has increased. The author explains this as a widening 'experience-complexity gap' and suggests four strategies to close the gap: Bolster emotional support and show staff your own vulnerability as a leader Dramatically scope the first year of practise Differentiate practice for experienced nurses Reinforce experienced nurses' identity as system citizens
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Content ArticleThe aim of this article is to enable nurses to understand the powerful role of organisational culture in influencing the effectiveness of healthcare delivery, primarily within the NHS.
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Content ArticleWatch Professor Alison Leary discuss the huge value of specialist nursing at the hFRenDs event in July 2022.
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Content ArticleThis article in Nurse Leader examines mounting evidence for nurse and patient safety associated with registered nurse (RN) fatigue. What changes driven by strong evidence are nursing leaders enacting to reduce the impact of RN fatigue on patient and nurse safety?
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Content ArticleThis systematic review in the Western Journal of Nursing Research examined the relationship between hospital nurse fatigue and outcomes. The authors found that fatigue was consistently associated with mental health problems, decreased nursing performance and sickness absence. Many studies confirmed that nurse fatigue is negatively associated with nurse, patient-safety and organisational outcomes. The review also highlighted gaps in current knowledge and the need for future research using a longitudinal design and measuring additional outcomes to better understand the consequences of nurse fatigue.
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Content ArticleNurses work long hours and play a critical role in keeping patients healthy. Many nurses feel that fatigue “comes with the territory” of such a high-stress, high-impact job. But what’s really at risk when a nurse is fatigued? This blog by US insurance company Nurses Service Organization (NSO) looks at the impact of nurse fatigue on patient and staff safety. It suggests several strategies to address the issue: Designing schedules and organising work to reduce nurse fatigue Developing a fatigue management plan Educating staff on sleep hygiene and the effects of fatigue on nurse health and patient safety Providing opportunities for staff to express concerns about fatigue and taking action to address those concerns Making sure extended shifts have adequate staff support and rest periods
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Content ArticleFatigue in anaesthesia practice is often ignored or accepted as the norm due to persistent, high-intensity work demands and expectations. This document produced by the American Association of Nurse Anesthesiology (AANA) aims to provide guidance to healthcare professionals, healthcare facilities and nurse anaesthesia programs regarding sleep deprivation and fatigue. It provides evidence-based information that promotes fatigue management and work-life balance.
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Content ArticleFatigue is a workplace hazard that affects the health and safety of patients, health care providers and the community. This blog from health tech company Cerner looks at the importance of managing fatigue in healthcare staff. The author suggests a three-step approach to lessen fatigue: Shift the culture of safety to include recognising and dealing with fatigue. Operationalise fatigue reduction measures within the organisation. Promote fatigue self-management through preventative strategies.
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News Article
Our job is to keep people out of A&E
Patient Safety Learning posted a news article in News
As the pressures of winter and the Covid treatment backlog grow, the NHS is struggling. In Manchester, one organisation is pioneering a new way to care for people that tries to reduce the burden on the health service. It's the first call-out of the day for nurse Manju and pharmacist Kara in north Manchester. They are on their way to see Steven, who has been diagnosed with Parkinson's disease and had a fall the previous night. This might have led to a call-out for an ambulance crew and a visit to A&E. But instead the Manchester Local Care Organisation (LCO) stepped in. Once at Steven's house, Manju makes sure he hasn't been harmed by his fall, while Kara checks his medication. Manju notes that Steven's tablets could have contributed to his fall. Manju asks Steven how he copes going up and down the stairs. "I'm OK, just about," he says. But when he has a go at coming down the stairs, Manju spots he could use an extra grab rail and says she will sort one out. This intervention by the team has not only avoided Steven ending up in A&E, but also ensures he can continue to live independently in his own home. That's a key part of the LCO mission, according to Lana McEwan, one of the team leaders in north Manchester. "We would consider ourselves to be an admission-avoidance service, so we're trying to prevent ambulances being called in the first instance. "When an ambulance has been called, we're taking referrals directly from the ambulance service and responding within a one or two-hour response depending on need, and that's an alternative to A&E." Local neighbourhood teams are made up of nurses, social workers, pharmacists and doctors, all working together to keep people out of hospital. Read full story Source: BBC News, 9 December 2022 -
News Article
Parents of man left to die in prison say care failures will haunt them for ever
Patient Safety Learning posted a news article in News
The parents of a 25-year-old man left to die in a cell by a negligent prison nurse given responsibility for 800 inmates have told how the conditions in which their son died will haunt them for ever. The case – the 27th death in just five years at HMP Nottingham – was said to illustrate the desperate state of Britain’s understaffed and increasingly dangerous prison system. Alex Braund was being held on remand awaiting trial when he fell ill in his cell with the first signs of pneumonia on 6 March 2020. Four days later, on the morning of 10 March, after a series of ill-fated attempts by Braund’s cellmate to get prison staff to take the situation seriously, the young man collapsed. Prison staff responded to an emergency bell rung by Braund’s cellmate at 6.55am, but they initially only looked through the cell hatch, taking five minutes to enter the cell in order to give CPR. Braund was subsequently taken to Queen’s medical centre in Nottingham, where he was pronounced dead at 11.44am of cardiac arrest caused by pneumonia. The jury at an inquest at Nottinghamshire coroner’s court found there had been a “continuous failure to provide adequate healthcare”, with a prison officer told by a nurse a few hours before Braund’s death that there was “nothing to be done at this time of night”. Questioning during the hearing revealed that the nurse, who has since lost her job and been reported to the nursing and midwifery council, had amended her records on the morning of Braund’s death. Read full story Source: The Guardian, 6 December 2022 -
News Article
Wales ‘displaying a dangerous and growing reliance’ on agency nurses
Patient-Safety-Learning posted a news article in News
The NHS in Wales could move to a model in which most or all nursing care is outsourced to private companies, if its increasing reliance on agency staff continues, a union report has claimed. According to the Royal College of Nursing, the Welsh health service risks moving to a situation where it no longer directly employs staff to provide patient care. NHS Wales spent between £133m and £140m on agency nursing during 2021-22, based on different freedom of information (FOI) requests and official figures, the RCN’s report suggested. RCN Wales said, “If this trend continues, Wales will move to a situation where NHS Wales no longer directly employs staff to provide patient care and instead moves to a model in which most or all nursing care is outsourced to private companies.” Read more Source: Nursing Times, 4 December 2022 -
News Article
Urgent surgery ‘may be postponed’ by nurses’ strikes, say NHS bosses
Patient Safety Learning posted a news article in News
Hospitals may not be able to provide key elements of healthcare such as urgent surgery, chemotherapy and kidney dialysis during the forthcoming strikes by nurses, NHS bosses have said. Trusts may also have to stop discharging patients, postpone urgent diagnostic tests and temporarily withdraw services to people undergoing a mental health crisis. Executives have been warned that industrial action by nurses in their pay dispute with the government could mean that a range of important, and in some cases time-critical, services to seriously ill patients may have to be scaled back or suspended altogether. NHS England bosses have raised that possibility in a letter sent on Monday to hospitals and other care providers ahead of crunch talks with the Royal College of Nursing later this week. At that meeting they will try to agree what areas of care will be hit on Thursday 15 and Tuesday 20 December, and which will continue as normal because they are covered by “derogations” – agreed exemptions to the action. The letter sets out a list of 12 areas of care and some non-clinical activity in hospitals, such as food supply, which could be affected if agreement is not reached with the nurses’ union. Eight of those involve direct patient care, three involve support services in NHS trusts and the other involves “system leadership and management to oversee safe care” on strike days. NHS England’s letter sets out 10 other types of vital care, mainly involving life or death scenarios, headed “derogations not needed”, which they hope to agree with the RCN to go ahead as normal. These include A&E care, services in intensive care units and emergency operating theatres as well as maternity services, including the delivery of babies, psychiatric intensive care, time-critical organ transplants and palliative and end of life care. Meanwhile, the chief executive of NHS England has insisted patients will not have procedures cancelled at the last minute due to the nurses’ strikes, but warned some care would have to be delayed. Read full story Source: The Guardian, 28 November 2022 -
News Article
Nurses across UK to strike for first time on 15 and 20 December
Patient Safety Learning posted a news article in News
Nurses across the UK will go on strike for the first time over two days in the fortnight before Christmas after ministers rejected their pleas for formal talks over NHS pay. The Royal College of Nursing (RCN) said its members would stage national strikes – the first in its 106-year history – on 15 and 20 December. Senior sources said the industrial action was expected to last for 12 hours on both days – most likely between 8am and 8pm. The unprecedented national industrial action will seriously disrupt care and is likely to be the first in a series of strikes over the winter and into the spring by other NHS staff, including junior doctors and ambulance workers. On Friday, RCN general secretary, Pat Cullen, said the UK government had chosen strikes over listening to nursing staff, adding: “If you turn your back on nurses, you turn your back on patients.” The RCN said that despite a pay rise of about £1,400 awarded in the summer, experienced nurses were worse off by 20% in real terms due to successive below-inflation awards since 2010. It said the economic argument for paying nursing staff fairly was clear when billions of pounds were being spent on agency staff to plug workforce gaps. It added that in the last year, 25,000 nursing staff around the UK had left the Nursing and Midwifery Council register, with poor pay contributing to staff shortages across the country, which it warned were affecting patient safety. There are 47,000 unfilled NHS registered nurse posts in England alone. Read full story Source: The Guardian, 25 November 2022 -
News Article
Plea to blur line between doctors and nurses amid NHS staff crisis
Patient Safety Learning posted a news article in News
The NHS staffing crisis will be solved only if doctors and nurses get more flexible about their job descriptions and break down barriers between roles, according to Rishi Sunak’s health adviser. Bill Morgan argues that training times for doctors and nurses may have to be reduced, and suggests developing “sub-consultants” and entirely new medical professions, He wants ministers to create an Office for Budget Responsibility-style body to predict future workforce needs. The Treasury has held down the numbers of doctors and nurses Britain trains to prevent “supply-induced demand”, which encourages people to seek appointments that are not needed, Morgan argues. Chronic shortages of qualified staff are the biggest problem facing the health service, which has more than 130,000 vacancies. Morgan acknowledges that this means “some of the government’s key manifesto commitments will not be met”, citing the promise of 6,000 extra GPs. Sunak said this week that the government was “thinking creatively about what new roles and capabilities we need in the healthcare workforce of the future”. He urged the NHS to shed “conventional wisdom”. Read full story (paywalled) Source: The Times, 24 November 2022 -
News Article
US nurse who called emergency services on own hospital speaks out
Patient Safety Learning posted a news article in News
A nurse in the USA who called emergency services in response to staffing issues at Silverdale, Washington-based St. Michael Medical Center spoke out about her decision and the events leading up to the call. Kelsay Irby has been an emergency department charge nurse at the hospital for less than a year. On the 8 October, the night Ms Irby called emergency services for help, the ED was operating at less than 50% of its ideal staffing grid. Among the nearly 50 people in the hospital's waiting room were patients with cardiac or respiratory issues and children with high fevers — "all patients that made us very nervous to have in the lobby, unmonitored for extended periods of time," Ms. Irby said. The ED had one first-look nurse on the clock who was trying to keep up with patients checking in and could not supervise those waiting for care. After exhausting all other available options, Ms. Irby said she called emergency services' nonemergent line and asked the dispatcher if any crews were available to help ED staff. Ms. Irby was connected with a local fire chief who sent an emergency services crew to the hospital to monitor patients in the lobby, retake their vitals and do roll calls to ensure the ED team's patient list was accurate. Ms. Irby's actions made national headlines in the US as a dramatic example of the staffing issues hospitals nationwide are facing. "I didn’t recognize the impact of what I was doing that night," Ms. Irby wrote. "I was simply working my way down the list of possible sources of help for my coworkers and ultimately our patients." Read full story Source: Becker's Hospital Review, 8 November 2022 -
News Article
Nurses’ strike: what’s at stake and how will it affect patients?
Patient Safety Learning posted a news article in News
Ministers have offered about 1 million NHS staff in England – everyone bar doctors and dentists – a pay rise of at least £1,400 for 2022-23. That represents a rise of between 4% and 5% for staff covered by the longstanding Agenda for Change negotiating framework. Health unions have rejected the £1,400. They want a rise that would at least match inflation – which is currently 10.1% – while the Royal College of Nursing (RCN) is seeking inflation plus 5%. Without inflation-proof rises, staff will suffer a real-terms cut in their take-home pay, unions say. “Our members will no longer tolerate a financial knife-edge at home and a raw deal at work”, said the RCN general secretary, Pat Cullen. Sara Gorton, head of health at Unison, added: “Inflation has already wiped out this year’s 72p-an-hour increase. The government must put pay right to spare the NHS, its staff and all those relying on its care from a dispute no one wants to see.” The RCN has balloted its members across the UK. The results, published on Wednesday, show that a majority of nurses in most but not all hospitals and other NHS services across the four home nations have rejected the government’s offer and decided to strike in pursuit of better pay. Wes Streeting, the shadow health secretary, has condemned as “unacceptable” the fact that strikes will disrupt services and affect patients’ care. While he has not criticised nurses or any health union, he has blamed ministers for not negotiating with the RCN to try to avert strike action. “I’m concerned, I think lots of people are concerned about the impact of disruption”, he told LBC’s Tonight with Andrew Marr on Monday. “That’s still a disruption to patients, which I think is unacceptable.” If he were the health secretary he would see patients as his “first and foremost” responsibility, he said. “That’s why I think the government have to get a grip on this and get the unions around the table because there is a deal there to be done.” Read full story Source: The Guardian, 9 November 2022 -
News Article
Nurses set to hold biggest-ever strike
Patient Safety Learning posted a news article in News
The biggest ever strike by nurses looks set to go ahead. The Royal College of Nursing is due to unveil the results of its ballot, which ended last week, in the next few days. The final results are being counted but RCN sources say a large majority of nurses have voted in favour of action in a dispute over pay. The RCN had recommended to its 300,000 members that they walk out. If strikes take place, they would affect non-urgent but not emergency care. The vote has involved a series of individual workplace-based ballots across the UK and if nurses do not back action at a local level it is possible some hospitals and services will not be involved. The government had appealed to nurses to "carefully consider" the impact on patients. But Pat Cullen, RCN general secretary and chief executive, said: "Huge numbers of staff - both experienced and newer recruits - are deciding they cannot see a future in a nursing profession that is not valued nor treated fairly. She added: "Our strike action will be as much for patients as it is for nurses. We have their support in doing this." Cabinet minister Oliver Dowden said the government had "well-oiled contingencies in place" for dealing with any strike action by nurses. Speaking on Sky News, Mr Dowden said essential services would be prioritised, "but of course there would be an impact as a result of a strike like that". Read full story Source: BBC News, 6 November 2022 -
News ArticleNurses and essential healthcare staff could be left redundant in the middle of the pandemic as local authorities look to make changes to healthcare contracts that would leave patients facing major disruption, NHS bosses have warned. NHS Providers, which represents all NHS trusts, and NHS Confederation, which represents health and care organisations, said that the decision to put contracts for public health services out to tender as workers battle coronavirus in the community is “completely inappropriate” and a “damaging distraction”, creating uncertainty for those who have spent the past six months on the COVID-19 frontline. Shadow health minister Jonathan Ashworth told The Independent: “This process is disruptive and wasteful at the best of times, but to be doing this mid-pandemic is risky, unnecessary and undermines the ability of frontline health workers to focus not only on preparations for a potential second wave, but a whole host of other health issues, such as Covid rehabilitation, community mental health services and children’s health, all of which are now urgent priorities.” Read full story Source: The Independent, 1 September 2020
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News Article
Midwives and paramedics to deliver flu and Covid vaccines, proposes DHSC
Patient Safety Learning posted a news article in News
An 'expanded workforce' will be delivering flu and a potential COVID-19 vaccine, under proposals unveiled by the Government today. The three-week consultation also focuses on a proposal of mass vaccinations against COVID-19 using a yet-to-be-licensed vaccine, if one becomes available this year. The Department of Health and Social Care (DHSC) is hoping new legislation could come into effect by October, ahead of the winter season. The consultation proposes to amend the Human Medicine Regulations 2012 to "expand the workforce legally allowed to administer vaccines under NHS and local authority occupational health schemes, so that additional healthcare professionals in the occupational health workforce will be able to administer vaccines". It said this would include 'midwives, nursing associates, operating department practitioners, paramedics, physiotherapists and pharmacists'. The consultation said: "This will help ensure we have the workforce needed to deliver a mass COVID-19 vaccination programme, in addition to delivery of an upscaled influenza programme, in the autumn." The consultation also said that "there is a possibility that both the flu vaccine and the COVID-19 vaccine will be delivered at the same time, and we need to make sure that in this scenario there is sufficient workforce to allow for this". Read full story Source: Pulse, 28 August 2020
