NEWS
Life threatening risk posed by delay in group B strep treatment
Delay or failure to give preventative antibiotics to mothers can leave newborn babies at risk of death or severe injury from group B strep infection, a national safety report has revealed.
The Healthcare Safety Investigation Branch compiled the national learning report after identifying the risk associated with group B streptococcus (GBS) from maternity investigations they have carried out across the country.
GBS is a naturally occurring bacterium which can found in the vagina and poses a danger to babies most commonly during labour and shortly after birth. Giving antibiotics during labour (intrapartum antibiotic prophylaxis) is the most effective way to reduce the infection being passed onto the baby. In the reports the HSIB analysed, GBS was considered to have contributed to six neonatal deaths, six intrapartum stillbirths and three severe brain injuries. This was because either GBS would not have been known about or antibiotic treatment was delayed or not given.
The learning from investigations highlighted that delays in identifying GBS risk as well as delays to treatment could occur during pregnancy or after the baby was born. The common themes emerging from the reports were categorised into key areas which related to: Women not receiving information on GBS during pregnancy in line with the Royal College of Obstetricians and Gynaecologists (RCOG) national guidance. In eight cases HSIB looked at, the information shared with mothers during pregnancy was insufficient. The advice given to women in early labour is variable and teams observed
Diabetes deaths increase by 50%
mothers being encouraged to stay at home as long as possible when they call maternity triage services. In HSIB’s GBS cases, four mothers were advised to stay at home even though they were GBS positive and reporting regular contractions.
Competing demands means that
intrapartum antibiotic prophylaxis is not always given in a timely manner. HSIB referenced lack of resource and staff completing other tasks at the time IAP needed to be given in four of their reports. Even once the mother was in hospital, several HSIB investigations found issues with information sharing. Positive tests for GBS were not being communicated to the mother or noted clearly in case records meaning antibiotic treatment was not given in labour. HSIB found that there were missed
opportunities to detect when a newborn was unwell. The learning report highlights that the use of an early warning score chart for babies may prompt staff to recognise deterioration. However, currently, there is no universal newborn early warning score chart in use in England.
during lockdown National statistics show that almost 50% more people died per week with diabetes as the underlying cause or mentioned on their death certificate, in care homes, private homes and in hospital, during lockdown – excluding those categorised as ‘COVID deaths’. Diabetes UK is urging Government to keep people with diabetes safe by implementing additional measures and safeguards. A large proportion of the excess deaths which occurred were in private homes, with a staggering increase of 106%. Diabetes UK said the figures support charity’s concerns that people with diabetes are not receiving the support and consideration needed from Government to keep them safe, as lockdown continues to ease. Helen Kirrane, from Diabetes UK, commented: “These harrowing statistics hammer home the devastating impact the COVID-19 pandemic has had – and continues to have – on thousands of families affected by diabetes. As lockdown measures ease further day by day, it’s important the seriousness of diabetes – in light of the disproportionate impact COVID-19 has on people with diabetes – is recognised by Government.” People diagnosed with diabetes are on the list of clinically vulnerable groups, but the Charity warns there is little acknowledgement of the impact that the current easing of lockdown will have or detail on the support and protections they can expect specifically if their workplace is not COVID-secure and they are unable to work from home.
Technology helps predict PPE numbers during Covid-19
Data analysis requested by The Royal Wolverhampton NHS Trust (RWT) has allowed the Trust to measure the amount of Personal Protective Equipment (PPE) that is likely to be needed day-by-day and week-by-week by front-line staff caring for possible and confirmed COVID-19 patients. Using the Trust’s TeleTracking patient and staff tracking solution in combination with Real-time Location System (RTLS) sensors, TeleTracking UK’s data analysts have been able to audit the number of interactions between staff and possible and confirmed COVID-19 patients over each 24-hour period since 10th March.
Mapped against NHS guidance on the use
of PPE and modelled in line with the predicted trends of the COVID-19 virus, RWT has been able to measure and predict in advance the number of PPE it is likely to require. The data from 10 March-9 April shows that across five wards, there are on average 21 staff interactions per COVID-19 patient each day. The data also showed a trend which suggested that the requirement for PPE would increase by a factor of 1.5 every 7 days, so the requirement on any day will be 50% higher than was needed 7 days prior.
Clare Nash, senior nurse for clinical procurement, commented: “Given the demands on the NHS overall, we need to
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be able to more reliably predict PPE use based on staff contacts with patients. We knew that we had the capability to do this within our existing reporting, but no time. The TeleTracking team have been able to run the initial analysis across our affected wards which gave us an indication of PPE usage. We have then been able to map this and look at predicted required numbers to keep staff and patients safe. “This analysis has both local and potentially wider importance; because not only is it vital in ensuring the safety of our staff locally, but it can help ensure we do not over-order PPE that is much needed across the NHS.”
AUGUST 2020
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