Can intersectional innovations reduce hospital infection?

Saint, S. The Journal of Hospital Infection. Published online: November 28, 2016

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Preventing healthcare-associated infection remains an international priority given the clinical and economic consequences of this largely preventable patient safety harm. While important strides have been made in preventing hospital infections over the past several decades, thorny issues remain, including how to consistently improve hand hygiene rates and further reduce device-related complications such as catheter-associated urinary tract infection.

Rather than relying solely on directional innovations – incremental changes that continue to serve as the bedrock of scientific advancement – perhaps we should also search for “intersectional innovations,” which represent breakthrough discoveries that emanate from the intersection of often widely divergent disciplines. Several intersectional innovations that have the potential to greatly impact infection prevention efforts include human factors engineering, sociology, and engaging the senses. Indeed, Professor Edward Joseph Lister Lowbury, the namesake of this lecture, exemplified intersectional thinking in his own life having been both an accomplished bacteriologist and poet. By incorporating approaches outside of traditional biomedical science we will hopefully provide patients with the safe care they expect and deserve.

Read the full article here

Ethical Use of Telemedicine in Emergency Care

American College of Emergency Physicians(2016) Annals of Emergency Medicine68(6) p. 791

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  • The American College of Emergency Physicians (ACEP) believes that EDs using telemedicine should make this form of care accessible regardless of race, religion, sexual orientation, location, or ability to pay.

  • ACEP believes that EDs and hospitals should ensure that their telemedicine systems and practices provide patients with at least the privacy and confidentiality required under HIPAA. This includes ensuring that their equipment and technology are up-to-date and secure.

  • ACEP believes that telemedicine decisions relating to patient care, referrals, and transfers should be based on the patient’s health care needs.

  • ACEP supports the establishment of standards for telemedicine practitioners and development of related quality assurance and educational programs to develop the discipline.

  • ACEP supports legislative efforts that would allow single-state licensing to be sufficient for telemedical practice throughout the United States.

  • ACEP believes that all aspects of the telemedical consultations between advance medical practitioners (ie, physicians, nurse practitioners, and physician assistants) are subject to the same informed consent and refusal standards as face-to-face medical encounters.

Read the full abstract here

Plymouth Hospitals NHS Trust: gaining Workplace Wellbeing Charter accreditation

NHS Employers, November 2016

This case study shares Plymouth Hospitals NHS Trust experience of gaining the Workplace Wellbeing Charter accreditation. The charter helped the trust identify if their wellbeing offer had any gaps and also make improvements. It also provided an opportunity to celebrate the success of initiatives that were working well.

The trust used the WWC resources along with supporting guidance, and worked closely with their assessor to create a portfolio of evidence against the eight criteria of the charter, which are:

leadership
absence management
health and safety
mental health
smoking and tobacco
physical activity
healthy eating
alcohol and substance misuse.

Interventions for preventing elder abuse: applying findings of a new Cochrane review

Baker, P.R. et al. Age & Ageing. Published online: October 13 2016

There is evidence that elder abuse is a significant public health problem that is destined to grow as population age. Countries are considering how best to act and this requires an understanding of the complex causal mechanisms contributing to its occurrence and the identification of effective interventions which can potentially make a difference.

Previously, a high quality synthesis of evidence for policy and practice has been missing. In this paper, we describe a new Cochrane review of interventions to prevent the occurrence or reoccurrence of elder abuse. Overall, the quality of the evidence available for decision making is very low and there is little to guide practice. Amongst the interventions, there is some evidence that teaching coping skills to family carers of persons with dementia might make the situation better. We argue that poor quality and wasteful research needs to be avoided, and front-line agencies be supported in undertaking comparative evaluation of their services.

Read the full Cochrane Review here

Read the full article here

New perioperative QI e-learning resource

The Royal College of Anaesthetists has launched a new online anaesthesia quality improvement (QI) e-learning resource – the Perioperative Improvement Science and Management (PRISM-ed) module

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The PRISM-ed module has been developed by anaesthetists Dr Maria Chazapis, Dr Carolyn Johnston and Dr Ramani Moonesinghe, and written by experts in the field. It builds on the QI web resource funded by UCLH/NIHR Surgical Outcomes and Research Centre (SOuRCe) and the London Academy of Anaesthesia.

The PRISM-ed e-learning module outlines key knowledge and training resources required to deliver quality improvement within healthcare. PRISM-ed is designed to assist with practical implementation through downloadable project toolkits and data templates. Although it is designed for doctors in anaesthetics training, the content is relevant and accessible to anyone in the perioperative multi-disciplinary team or wider health services, who wish to improve the quality of care they provide.

PRISM-ed is being hosted on the e-Learning for Healthcare (e-LfH) online learning hub and can be accessed by all healthcare professionals with an e-LfH account. Completing the PRISM-ed module via the e-LfH online learning platform allows clinicians to record their scores and print a certificate of completion for CPD purposes.

The e-learning module is available here

Reducing infections in the NHS

Department of Health | Published online:  10 November 2016

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Image source: David Gregory & Debbie Marshall – Wellcome Images // CC BY-NC-ND 4.0

Image shows electron micrograph of Escherichia coli close-up

Plans to prevent hospital infections include more money for hospitals who reduce infection rates and publishing E. coli rates by local area.

Health Secretary Jeremy Hunt has launched new plans to reduce infections in the NHS. He announced government plans to halve the number of gram-negative bloodstream infections by 2020 at an infection control summit.

E. coli infections – which represent 65% of what are called gram-negative infections – killed more than 5,500 NHS patients last year and are set to cost the NHS £2.3 billion by 2018. There is also large variation in hospital infection rates, with the worst performers having more than 5 times the number of cases than the best performing hospitals.

Infection rates can be cut with better hygiene and improved patient care in hospitals, surgeries and care homes, such as ensuring staff, patients and visitors regularly wash their hands. People using insertion devices such as catheters, which are often used following surgery, can develop infections like E. coli if they are not inserted properly, left in too long or if patients are not properly hydrated and going to the toilet regularly.

Read the full news story here

Improving health through the home

Resources to inform local action to ensure that everyone has a home in which to start, live and work, and age well.

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This guide produced by Public Health England describes why investing in improving the home or housing circumstances may be an effective means to:

  • improving health and wellbeing
  • reducing health inequalities
  • preventing, delaying and reducing demand for health care and social care

To support and inform local action, links are provided to the main sources of data, evidence and guidance. A checklist suggests the questions that should be asked locally of commissioning plans to ensure that home, health and wellbeing are considered in all policies.