Aggression and violence continue to be common occurrences in inpatient settings for people with mental health problems, and resolving aggressive incidents is a key task of staff within those settings.
Our DASA (Dynamic appraisal of Situational Aggression) study team provide an update on how they are developing and testing their research within new settings. As well as publicising their findings to help improve and support other mental health/wellbeing services and teams.
Open access. Quality and safety in healthcare, as an academic discipline, has made significant progress over recent decades, and there is now an active and established community of researchers and practitioners. However, work has predominantly focused on physical health, despite broader controversy regarding the attention paid to, and significance attributed to, mental health. Work from both communities is required in order to ensure that quality and safety is actively embedded within mental health research and practice and that the academic discipline of quality and safety accurately represents the scientific knowledge that has been accumulated within the mental health community.
A safety organisation drawing on lessons from the airline industry will have new legal powers to investigate serious patient safety incidents in the NHS in England, under plans laid before parliament today (14 September 2017).
Despite concerns about the degree of compassion in contemporary healthcare, there is a dearth of evidence for health service managers about how to promote compassionate healthcare. This paper reports on the implementation of the Creating Learning Environments for Compassionate Care (CLECC) intervention by four hospital ward nursing teams. CLECC is a workplace educational intervention focused on developing sustainable leadership and work-team practices designed to support team relational capacity and compassionate care delivery. To read the full article, log in using your NHS OpenAthens details.
Editorial. Alongside concern about avoidable mortality, one of the key findings of the public enquiry into failings at Mid Staffordshire NHS Foundation Trust,1 which ran Stafford Hospital in England, was the lack of compassion in care delivery. Sir Robert Francis, who led the enquiry, laid the blame for the compassion deficit at the door nursing and support staff. He recommended, among other things, that people should work as care assistants prior to nurse training and that values-based recruitment should be used to ensure that the ‘right’ people are recruited to be nurses. However, there has been little evidence to support these propositions. For example Snowden et al2 found that nursing students who had previous care jobs scored no higher for emotional intelligence than those without prior experience. To read the full article, log in using your NHS OpenAthens details.
[Mersey Care] Trust joined a group of UK and USA healthcare organisations taking part in a unique programme with researchers from The Risk Authority Stanford to reduce clinical risk in selected areas.
A mixture of technology and talking, it uses leading edge software (to analyse data and identify the risks) and a new approach known as Design Thinking – gaining an understanding of the issue by talking at the design stage to people who may use the service.
The approach is then tailored to what the software and patients tell.
The plan is to monitor impact over six to twelve months, compare and contrast and roll out the most effective interventions.
The colour of the wristband is based on a personalised risk assessment and care plan and lets staff know how mobile each patient is at a glance. If a patient has a green wristband they are safe to walk alone, amber means they need help from a nurse, red means the patient is at a high risk of falling, while a blue one means they need support from two staff. The bands are given to patients as soon as they are admitted and assessed – and the colours can change as the patient engages in physiotherapy and occupational therapy during their stay.
Physical restraint involves “any direct physical contact where the intervener's intention is to prevent, restrict, or subdue movement of the body, or part of the body of another person” (Dept. of Health, 2014 p.26). Such restrictive interventions are used to take control of situations deemed to be dangerous, where there is a real possibility of harm being caused, if no action were to be taken. The actions are designed to end, or significantly reduce, the danger presented to the patient or others including staff (Dept. of Health, 2015). To read the full article, log in using your SSSFT NHS OpenAthens details.
Depression independently increases the risk of falls in older people, but the mechanism for this relationship, as well as the specific falls type involved, remains unclear. To read the full article, log in using your SSSFT NHS OpenAthens details.
Safety is an issue for older adults with dementia because they are at risk for various incidents. Intelligent assistive technology (IAT) may mitigate risks while promoting independence and reducing the impact on the caregiver of supporting a relative with dementia. The aim of this scoping review was to describe IATs and to identify factors to consider when selecting one. A systematic search was performed of the scientific and gray literature published between 2000 and 2015. A total of 31 sources were included. Four types of IATs were identified as addressing safety issues in dementia: monitoring technologies, tracking and tagging technologies, smart homes, and cognitive orthoses. Characteristics of the device and ethical considerations emerged as key factors to consider when selecting one. IATs yield promising results but pose various challenges, such as adapting to the evolution of dementia. Further research on their actual impact is needed. You can request a copy of this article by replying to this email. Please ensure you are clear which article you are requesting.
A ‘Trigger Tool’ is used around the world to identify case-notes that warrant further search for adverse events. This paper shows we can get rid of Trigger Tools and just review random notes – we will find just as many adverse events. If we want a ‘canary in the mineshaft’ then we should examine adverse events in case-notes of patients who have died – they have a much higher than random adverse event rate.
Memory, and remembering the past, are fundamental to patient safety. One of the core objectives of safety improvement is to learn from the past in order to improve the future. This commitment to remember and to learn is central to the strategies that have shaped the evolution of patient safety such as ‘An organisation with a memory’,1 and underpins definitive academic research such as Bosk's ‘Forgive and Remember’.2 Remembering the past to improve the future is institutionalised across healthcare in a variety of activities such as safety incident reporting, morbidity and mortality meetings, coroner investigations and public inquiries. Despite this, healthcare systems still suffer striking and acute episodes of forgetfulness3 that are deeply consequential: when harmful events are forgotten, they are likely to be repeated. To read the full article, log in using your NHS OpenAthens details.