A microscopic view of the coronavirus. They appear as blue spheres with spikes sticking out of them.

Learning from HSIB COVID-19 reports

by Communications team

Since the beginning of the coronavirus (COVID-19) pandemic we have worked to conduct investigations that help healthcare staff combat the virus.

Since April 2020 HSIB has launched more than 13 investigations as a direct response to COVID-19 and the impact it has been having on the healthcare system.

These reports provide useful assistance in responding to all variants of the disease, including Omicron, and it will be beneficial for NHS colleagues to review again the safety recommendations and guidance given.

The reports can be found in the investigations and reports section of our website and a few are highlighted below with short summaries.

COVID-19 transmission in hospitals: management of the risk – a prospective safety investigation

HSIB’s nosocomial transmission report reviewed the evidence for the initial variant of the virus as it emerged in 2020. The report highlights how the transmission of coronavirus can be minimised and includes a series of infographics prompting questions for organisations to consider how they can reduce the risk of COVID-19 transmission.

Early warning scores to detect deterioration in COVID-19 inpatients

This HSIB report highlights the use of early warning scores to detect deterioration in patients with coronavirus on general hospital wards. While the scores are extremely valuable, any increase in oxygen requirements should be an indicator of clinical deterioration as the early warning score itself might not significantly increase. Early warning scores should be used alongside clinical judgement to help identify the severity of a patient’s illness and the risk of their condition deteriorating.

Oxygen issues during the COVID-19 pandemic

This investigation highlights factors that can impact COVID-19 patients receiving adequate oxygen when the gas supply system in hospitals is put under extreme demand.

Treating COVID-19 patients using continuous positive airway pressure (CPAP)

This HSIB report was published in November 2021 and is highly relevant at this current time, particularly given growing issues with staffing resource and the potential volume of patients requiring non-invasive respiratory support outside of critical care units.

The investigation explored the risks of caring for acutely unwell patients requiring CPAP in the side rooms of general wards, and the challenges of delivering such treatment outside of respiratory high dependency units or critical care areas.

Patients with COVID-19 who are treated with CPAP in side rooms require close monitoring and observation, and there can be a safety risk unless there is a clinician in the side room or staff monitoring centrally.

We encourage organisations to review the safety questions highlighted on pages 10 and 11 of the summary report (PDF).

Personal protective equipment (PPE): care workers delivering homecare during the COVID-19 response

Each care sector requires specific PPE guidelines due to the wide range of scenarios in which PPE is used. As evidence emerges, it is important that any new considerations are incorporated into guidance that has already been issued. There is a risk that service providers will operate on the basis of older guidelines and might be unaware of newer considerations. Read the PPE report.

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