RESUMEN
OBJECTIVES: The objective was to compare specific data from the 2020 National Confidential Enquiry into Patient Outcome and Death (NCEPOD) report "Balancing the Pressures" with two previous U.K. studies and to examine changes in the pediatric population requiring long-term ventilation (LTV) as well as the types delivered. We believe that the new data presented will facilitate future service planning. DESIGN: A subset of confidential enquiry data derived from a study by a nationally funded quality improvement organization (NCEPOD: www.ncepod.org.uk ) was compared with two previous U.K. datasets. SETTING: Healthcare providers across England, Wales, and Northern Ireland-inpatient and community settings. PATIENTS: Children and young people (CAYP) 0-16 years old receiving LTV between April 1, 2016, and March 31, 2018. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: When comparing the NCEPOD data with that last published in the United Kingdom, the number of CAYP requiring LTV more than doubled between 2008 and 2018 (933-2,093). There has also been a particular increase in the proportion of children that were under two when they were commenced on LTV (26-39.2%). Children are now more likely than previously to be receiving LTV to manage upper airway obstruction and CNS conditions. There has also been an approximate doubling of those receiving LTV over the whole 24-hour period (9.4-18.4%). CONCLUSIONS: The increased numbers and changing characteristics of babies and children requiring LTV over the last 3 decades in the United Kingdom have implications for all healthcare sectors but particularly for providers of critical care services.
Asunto(s)
Cuidados Críticos , Respiración Artificial , Humanos , Niño , Adolescente , Recién Nacido , Lactante , Preescolar , Reino Unido/epidemiologíaRESUMEN
The National Confidential Enquiry into Patient Outcome and Death reviewed the barriers and facilitators in the process of the transition of children and young people with chronic health conditions into adult health services. The report focuses on five issues - developmentally appropriate healthcare, the involvement of children and young people and their parents or carers in transition planning, communication and coordination of care, the organisation of transition services and leadership - and makes recommendations for practice.
Asunto(s)
Comunicación , Liderazgo , Adolescente , Adulto , Niño , Humanos , Enfermedad CrónicaRESUMEN
The National Confidential Enquiry into Patient Outcome and Death reviewed the quality of dysphagia care provided to patients with Parkinson's disease admitted to hospital when acutely unwell. It highlights both clinical and organisational changes that should be made to improve patient care and outcomes.
Asunto(s)
Trastornos de Deglución , Enfermedad de Parkinson , Humanos , Enfermedad de Parkinson/complicaciones , Enfermedad de Parkinson/terapia , Trastornos de Deglución/etiología , Trastornos de Deglución/terapia , Hospitalización , HospitalesRESUMEN
The National Confidential Enquiry into Patient Outcome and Death undertook a detailed analysis of data from 1269 patients aged 11-25 years, admitted to hospital with intentional injury, affective disorder, or eating disorders, to assess the quality of physical and mental healthcare provided. This article summarises the findings and associated recommendations relevant for the general hospital setting.
Asunto(s)
Hospitalización , Trastornos Mentales/epidemiología , Trastornos Mentales/terapia , Servicios de Salud Mental/organización & administración , Adolescente , Adulto , Niño , Comunicación , Trastornos de Alimentación y de la Ingestión de Alimentos/epidemiología , Trastornos de Alimentación y de la Ingestión de Alimentos/terapia , Humanos , Trastornos del Humor/epidemiología , Trastornos del Humor/terapia , Seguridad del Paciente , Medición de Riesgo , Conducta Autodestructiva/epidemiología , Conducta Autodestructiva/terapia , Transición a la Atención de Adultos/organización & administración , Adulto JovenRESUMEN
Assessing the quality of care for patients receiving long-term ventilation is complex given the diversity of this population (0-24 years in this case) and their differing requirements for treatment. This article details how and why such reviews are necessary.
Asunto(s)
Vías Clínicas , Cuidados a Largo Plazo , Calidad de la Atención de Salud/normas , Respiración Artificial , Niño , Vías Clínicas/organización & administración , Vías Clínicas/normas , Necesidades y Demandas de Servicios de Salud , Humanos , Recién Nacido , Cuidados a Largo Plazo/métodos , Cuidados a Largo Plazo/normas , Admisión del Paciente , Mejoramiento de la Calidad , Respiración Artificial/efectos adversos , Respiración Artificial/métodos , Reino Unido , Adulto JovenRESUMEN
We are writing to draw senior nurses' attention to the latest report published by the National Confidential Enquiry into Patient Outcome and Death.
RESUMEN
OBJECTIVES: To survey clinical practice and opinions of consultant surgeons and anaesthetists caring for children to inform the needs for training, commissioning and management of children's surgery in the UK. DESIGN: The National Confidential Enquiry into Patient Outcome and Death (NCEPOD) hosted an online survey to gather data on current clinical practice of UK consultant surgeons and anaesthetists caring for children. SETTING: The questionnaire was circulated to all hospitals and to Anaesthetic and Surgical Royal Colleges, and relevant specialist societies covering the UK and the Channel Islands and was mainly completed by consultants in District General Hospitals. PARTICIPANTS: 555 surgeons and 1561 anaesthetists completed the questionnaire. RESULTS: 32.6% of surgeons and 43.5% of anaesthetists considered that there were deficiencies in their hospital's facilities that potentially compromised delivery of a safe children's surgical service. Almost 10% of all consultants considered that their postgraduate training was insufficient for current paediatric practice and 20% felt that recent Continued Professional Development failed to maintain paediatric expertise. 45.4% of surgeons and 39.2% of anaesthetists considered that the current specialty curriculum should have a larger paediatric component. Consultants in non-specialist paediatric centres were prepared to care for younger children admitted for surgery as emergencies than those admitted electively. Many of the surgeons and anaesthetists had <4 h/week in paediatric practice. Only 55.3% of surgeons and 42.8% of anaesthetists participated in any form of regular multidisciplinary review of children undergoing surgery. CONCLUSIONS: There are significant obstacles to consultant surgeons and anaesthetists providing a competent surgical service for children. Postgraduate curricula must meet the needs of trainees who will be expected to include children in their caseload as consultants. Trusts must ensure appropriate support for consultants to maintain paediatric skills and provide the necessary facilities for a high-quality local surgical service.