Publications by authors named "Nick Woodier"

2 Publications

  • Page 1 of 1

A 6-Year Thematic Review of Reported Incidents Associated With Cardiopulmonary Resuscitation Calls in a United Kingdom Hospital.

J Patient Saf 2022 Jan 12. Epub 2022 Jan 12.

From the University of Nottingham Nottingham University Hospitals, Nottingham, United Kingdom University of Alberta Hospital, Edmonton, Canada.

Background: Critical incident reporting can be applied to cardiopulmonary resuscitation (CPR) events as a means of reducing further occurrences. We hypothesized that local CPR-related events might follow patterns only seen after a long period of analysis.

Design: We reviewed 6 years of local incidents associated with cardiac arrest calls. The following search terms were used to identify actual or potential resuscitation events: "resuscitation," "cardio-pulmonary," "CPR," "arrest," "heart attack," "DNR," "DNAR," "DNACPR," "Crash," "2222." All identified incidents were independently reviewed and categorized, looking for identifiable patterns.

Setting: Nottingham University Hospitals is a large UK tertiary referral teaching hospital.

Results: A total of 1017 reports were identified, relating to 1069 categorizable incidents. During the same time, there were approximately 1350 cardiac arrest calls, although it should be noted that many arrest-related incidents were not associated with cardiac arrest call (e.g., failure to have the correct equipment available in the event of a cardiac arrest). Incidents could be broadly classified into 10 thematic areas: no identifiable incident (n = 189; 18%), failure to rescue (n = 133; 12%), staffing concerns (n = 134; 13%), equipment/drug concerns (n = 133; 12%), communication issues (n = 122; 10%), do-not-attempt-CPR decisions (n = 101; 9%), appropriateness of patient location or transfer (n = 96; 9%), concerns that the arrest may have been iatrogenic (n = 76; 7%), patient or staff injury (n = 43; 4%), and miscellaneous (n = 52; 5%). Specific patterns of events were seen within each category.

Conclusions: By reviewing incidents, we were able to identify patterns only noticeable over a long time frame, which may be amenable to intervention. Our findings may be generalizable to other centers or encourage others to undertake this exercise themselves.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1097/PTS.0000000000000912DOI Listing
January 2022

Plurality of governance - plurality of systems.

J R Coll Physicians Edinb 2021 Dec;51(4):424-3427

Healthcare Safety Investigation Branch, Farnborough, UK.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4997/JRCPE.2021.431DOI Listing
December 2021
-->