Basic mistakes made by nurses using paper monitoring charts could be causing the deaths of thousands of patients every year, according to new research.
The Quality and Safety section of the British Medical Journal (BMJ) demonstrated that death rates fell by more than 15% in two large hospitals when instead of using traditional methods, nurses monitored their patients’ vital signs using handheld terminals.
Across the two sites concerned, more than 750 lives were saved during a single year, and if the system is rolled out across the NHS, tens of thousands of lives could potentially be saved.
Keeping paper records – it simply not good enough
Most hospitals use paper charts for nurses to record a patient’s blood pressure, temperature, pulse or oxygen levels. Paper records can lead to mistakes being made in calculations, and difficulty in reading handwriting.
The handheld computers have now been rolled out to around 40 hospitals across England, and are pre-loaded with special software which calculates whether a patient is deteriorating. If deterioration is detected, the unit alerts a doctor or reponse team, or prompts the nurse to monitor the patient more regularly.
Success in Portsmouth and Coventry hospitals
When the new system was introduced at the Queen Alexandra Hospital in Portsmouth, almost 400 fewer deaths were recorded in the following year. During the same period, University Hospital in Coventry reported 370 fewer deaths.
The editorial in the BMJ was extremely positive about the research and described it as a “milestone” in terms of patient safety and hailed the decrease in deaths in the pilot hospitals as a “dramatic improvement”.
The handheld system was developed as a joint project between a health improvement company called The Learning Clinic and medical staff at the Portsmouth hospital.
Further benefits expected
There could potentially be a number of other benefits from introducing this type of system, such as providing a safety net for patients as there are more safeguards against a deteriorating condition, recognition that old-fashioned paper charts are just not up to the job of monitoring patients, and as using the handheld device is quicker, this frees up nurses to spend more time on caring for their patients.
The software, called VitalPAC, takes the numbers entered by the nurse and then calculates an Early Warning Score, which is an estimate on how severe the condition may be. These scores are also calculated from paper records, but using pencil and paper can mean arithmetical mistakes, or errors from misreading handwriting.
In addition, all information which is recorded onto the handheld computer automatically uploads onto the hospital network, which allows doctors, nurses and managers to monitor the health of all patients throughout the hospital.
During ward rounds, staff who are connected to the network can access information about patients instantly.
This system has been in use in Portsmouth since 2005, and was introduced in Coventry in 2007. The total number of deaths in each hospital after the computer terminals were introduced was compared with the numbers of deaths before the scheme was introduced.
The good news [ and to be frank I’m an optimist] is that the rapid introduction of these computerised systems will save thousands of lives every year. That’s really something to cheer about. The bad news is that it seems to have taken so long for a decision to have been made – the system appears to have worked in Portsmouth since 2005. What’s more there is no indication of how soon the remaining hospitals in England and Wales will have a new system. Let’s hope that the new system is introduced quickly – because every day it’s delayed means more lives will be lost unnecessarily.
If you have lost a loved one due to medical negligence [as I have] then nothing can replace them. However you could be entitled to claim compensation for a medical error, which apart from the help you could give you, also puts more pressure on the NHS to make sure that best practice is consistently adopted by the medical profession throughout England and Wales.
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