A stage one alert has been issued to raise awareness of the risk of severe dehydration and death caused by an omission or delay of desmopressin in patients with cranial diabetes insipidus. Risk of severe harm or death when desmopressin is omitted or delayed in patients with cranial diabetes insipidus Cranial diabetes insipidus is a […]
A warning alert has been issued on the risk of harm from inappropriate placement of pulse oximeter probes. Patient Safety Alert – Risk of harm from inappropriate placement of pulse oximeter probes Measurement of oxygen saturation, using a pulse oximeter probe, is routinely undertaken as part of patients’ vital signs during diagnosis and ongoing monitoring. Oximeter probes […]
ECGs are routinely performed to diagnose cardiac problems and there are no risks associated with the test itself, however, there is a risk of associating ECG records with wrong patients leading to misdiagnosis and incorrect treatment. Risk of associating ECG records with wrong patients Patient safety alerts are shared rapidly with healthcare providers via the […]
Prevent the spread of carbapenemase-producing Enterobacteriaceae. Rising trends and outbreaks in carbapenemase-producing Enterobacteriaceae Enterobacteriaceae are a large family of bacteria that usually live harmlessly in the gut of all humans and animals, but, in the wrong place, can cause serious infections. Worldwide, a small but increasing number of strains of Enterobacteriaceae have become resistant to […]
A resource Patient Safety Alert has been issued to help organisations ensure any injuries to an accidentally dropped baby are detected and treated as quickly as possible. Patient Safety Alert – Assessment and management of babies who are accidentally dropped in hospital The risks of accidentally dropping a baby are well known, particularly when a parent […]
A patient safety alert has been issued today (5 December 2013) by NHS England on the use of placement devices for inserting nasogastric tubes. This alert has been issued via the Central Alerting System (CAS) to ensure all hospitals and community services that use nasogastric tubes continue to follow previous guidance issued by the National […]
A resource alert has been issued to support NHS providers to reduce harm leading to avoidable admissions of full-term babies. Resources to support safer care for full-term babies We’ve produced a resource to support staff in preventing avoidable admissions of full-term babies. It is a priority for the NHS to reduce avoidable harm that can lead to […]
A resource alert has been issued to eliminate use of the imprecise term ‘soft diet’ and assist providers with safe transition to the International Dysphagia Diet Standardisation Initiative (IDDSI) framework, which introduces standard terminology to describe texture modification for food and drink. Resources to support safer modification of food and drink Food texture modification is […]
A resource Patient Safety Alert has been issued to support the management of life threatening bleeds from arteriovenous fistulae and grafts. Patient Safety Alert – Life threatening bleeds from arteriovenous fistulae and grafts Haemodialysis removes the waste products and extra fluid that build up in the blood of those whose kidneys no longer function properly and relies […]
A stage one warning has been issued to further raise awareness of the risk of harm or death from inappropriate doses of naloxone in patients on long-term opioid or opiate treatment, where these drugs are used to provide relief from both chronic and acute pain, such as following surgery. Risk of distress and death from […]