A5072303555- Sepsis Diagnosis and Treatment
- Respiratory Support and Mechanisms
- Emergency and Acute Care Studies
- COVID-19 Clinical Research Studies
- COVID-19 and healthcare impacts
- Chronic Obstructive Pulmonary Disease (COPD) Research
- Clinical Reasoning and Diagnostic Skills
- Hospital Admissions and Outcomes
- Long-Term Effects of COVID-19
- Healthcare Policy and Management
- Trauma and Emergency Care Studies
- Hemodynamic Monitoring and Therapy
- Cardiac, Anesthesia and Surgical Outcomes
- Intensive Care Unit Cognitive Disorders
- Nosocomial Infections in ICU
- COVID-19 and Mental Health
- Climate Change and Health Impacts
- Respiratory viral infections research
- Cardiac Arrest and Resuscitation
- Renal function and acid-base balance
- Telemedicine and Telehealth Implementation
- Patient Safety and Medication Errors
- Family and Patient Care in Intensive Care Units
- Influenza Virus Research Studies
- Healthcare Technology and Patient Monitoring
Hampshire Hospitals NHS Foundation Trust
2014-2025
Royal Hampshire County Hospital
2009-2024
University of Southampton
2022-2024
NHS England
2019-2024
Wessex Academic Health Science Network (United Kingdom)
2015-2023
University Hospital Southampton NHS Foundation Trust
2023
Pennine Acute Hospitals NHS Trust
2022
University of Oxford
2020-2021
University of California, San Francisco
2020-2021
Public Health England
2021
What you need to know• Pulse oximeters used at home can detect hypoxia associated with acute covid-19 • Home oximetry requires clinical support, such as regular phone contact from a health professional in virtual ward setting More research is needed understand the safety and effectiveness of optimise service models referral pathways Oxygen levels covid-19Low blood oxygen-technically, hypoxaemia but usually referred hypoxia-can be defined measured oxygen saturation below 94% absence (or 88%...
Backgroundthe aim of this review was to analyze the implementation and impact remote home monitoring models (virtual wards) for confirmed or suspected COVID-19 patients, identifying their main components, processes implementation, target patient populations, on outcomes, costs lessons learnt.Methodswe carried out a rapid systematic led by primary secondary care across seven countries (US, Australia, Canada, The Netherlands, Ireland, China, UK). outcomes included in were: virtual length stay,...
RATIONALE: Clinical deterioration of patients hospitalized outside the ICU is a source potentially reversible morbidity and mortality. To address this, some acute care hospitals have implemented systems aimed at detecting responding to such patients. OBJECTIVES: provide evidence-based recommendations for hospital clinicians administrators optimize recognition response clinical in non-ICU PANEL DESIGN: The 25-member panel included representatives from medicine, nursing, respiratory therapy,...
'Failure to rescue' in patients with documented signs of deterioration results an estimated five potentially avoidable deaths at each acute trust England month. One common cause is inattention concerns or their families about deterioration. Martha's Rule requires reliable methods for (1) escalate worries and (2) routinely input understanding illness/wellness trajectory into the health record. This paper sets out rationale these approaches. Following review staff from first wave British units...
Objectives: The Sepsis-3 task force recommended the quick Sequential (Sepsis-Related) Organ Failure Assessment score for identifying patients with suspected infection who are at greater risk of poor outcomes, but many hospitals already use National Early Warning Score to identify high-risk patients, irrespective diagnosis. We sought compare performance and in hospitalized, non-ICU without an infection. Design: Retrospective cohort study. Setting: Large U.K. General Hospital. Patients: Adults...
Background The National Early Warning Score (NEWS) was introduced to standardise early warning scores (EWS) in England. It has been recommended that NEWS should be used pre-hospital care but there is no published evidence this improves outcomes. In 2015, the West of England Academic Health Science Network region standardised across all healthcare settings. Calculation for acutely unwell patients at referral into secondary care. Aim To evaluate whether implementation a system affects...
To evaluate oxygen saturation and vital signs measured in the community by emergency medical services (EMS) as clinical markers of COVID-19-positive patient deterioration.
Background Prepandemic sentinel surveillance focused on improved management of winter pressures, with influenza-like illness (ILI) being the key clinical indicator. The World Health Organization (WHO) global standards for influenza include monitoring acute respiratory infection (ARI) and ILI. WHO’s mosaic framework recommends that strategies countries virological viruses pandemic potential such as influenza. Oxford-Royal College General Practitioner Research Surveillance Centre (RSC) in...
Background and objectives Handover communication failures are a recognised threat to patient safety. in emergency care is particularly vulnerable activity owing the high-risk context overcrowded conditions. In addition, handover frequently takes place across boundaries of organisations that have different goals motivations, exhibit local cultures behaviours. This study aimed explore risks associated with failure pathway, identify organisational factors impact on quality handover. Methods...
Objectives Handover across care boundaries poses additional challenges due to the different professional, organizational and cultural backgrounds of participants involved. This paper provides a qualitative account how practitioners in emergency attempt align their individual priorities when handing over patients (ambulance service department (ED), ED acute medicine). Methods A total 270 clinical handovers were observed three pathways involving five participating NHS organizations (two...
Objectives To define the target population of patients who have suspicion sepsis (SOS) and to provide a basis for assessing burden SOS, evaluation guidelines improvement programmes. Design Retrospective analysis routinely collected hospital administrative data. Setting Secondary care, eight National Health Service (NHS) Acute Trusts. Participants Hospital Episode Statistics data 2013–2014 was used identify all admissions with primary diagnosis listed in ‘suspicion sepsis’ coding set. The SOS...
Background Inadequate handover in emergency care is a threat to patient safety. Handover across boundaries poses particular problems due different professional, organisational and cultural backgrounds. While there have been many suggestions for standardisation of content, relatively little known about the verbal behaviours that shape conversations. This paper explores both what communicated (content) how this (verbal behaviours) during types conversations care. Methods Three...
Background The National Early Warning Score (NEWS) calculated from physiological observations provides a simple away to identify and respond the deteriorating patient. There is increasing interest in application of NEWS facilitate referrals community. Aim To establish whether elevated are associated with adverse outcomes at 5 30 days when obtained community setting time transfer an acute setting. Design & A retrospective service evaluation was undertaken using database emergency...
Background COVID-19 has placed unprecedented demands on hospitals. A clinical service, Oximetry @home (CO@h) was launched in November 2020 to support remote monitoring of patients the community. Remote through CO@h aims identify early patient deterioration and provide timely escalation for cases silent hypoxia, while reducing burden secondary care. Methods We conducted a retrospective service evaluation onboarded from March 2021 North Hampshire (UK) community led (a collaboration 15 General...
Introduction Sepsis is a common, potentially life-threatening complication of infection. The optimal treatment for sepsis includes prompt antibiotics and intravenous fluids, facilitated by its early accurate recognition. Currently, clinicians identify assess severity suspected using validated clinical scoring systems. In England, the National Early Warning Score 2 (NEWS2) has been mandated across all Health Service (NHS) trusts ambulance organisations. Like many systems, NEWS2 should not be...
RATIONALE: Clinical deterioration of patients hospitalized outside the ICU is a source potentially reversible morbidity and mortality. To address this, some acute care facilities have implemented systems aimed at detecting responding to such patients. OBJECTIVES: provide evidence-based recommendations for hospital clinicians administrators optimize recognition response clinical in non-ICU PANEL DESIGN: The 25-member panel included representatives from medicine, nursing, respiratory therapy,...
The cause of deterioration is often unclear, so it vitally important that we spot the sick and deteriorating patient from all causes. As a result, warning scores must cater for conditions, - where possible be standardised across healthcare settings. This article summarises importance an 'unblinkered' approach to acute illness assessment, comparing examining evidence different historical scoring systems looking at early impact national alignment NEWS2 in patients admitted hospital with...
The "Bow-tie" optimal pathway discovery analysis uses large clinical event datasets to map pathways and visualize risks (improvement opportunities) before, outcomes after, a specific event. This proof-of-concept study assesses the use of NHS Hospital Episode Statistics (HES) in England as potential dataset for this approach.A metaheuristic optimization algorithm was used perform "bow-tie" on HES log data sepsis (ICD-10 A40/A41) 2016. Analysis hospital episodes across inpatient outpatient...
ABSTRACT Background The early identification of deterioration in suspected COVID-19 patients managed at home enables a more timely clinical intervention, which is likely to translate into improved outcomes. We undertook an analysis conveyed by ambulance hospital investigate how oxygen saturation and measurements other vital signs correlate patient outcomes, ascertain if can be predicted with simple community physiological monitoring. Methods A retrospective routinely collected data relating...