A very interesting paper by Lee et al regarding the trial of a simple risk management process in Bristol’s Southmead NICU was published in August 2008 (Archives of Disease in Childhood - Fetal and Neonatal Edition 2009;94:F116-F119).
To quote the deputy editor’s comments;
“Over recent years, we have carried a number of papers examining rates of adverse [...]
One of the important features of our baby’s death was something called a sub-aponeurotic haemorrhage. On the face of it, this is a relatively rare complication of vacuum assisted delivery - an invaluable technique in difficult births for delivering babies. As far as the hospital where our baby was born is concerned, this [...]
This is an extract from a report on healthcare professionals’ views about safety in maternity services, published in 2008. The report identifies, along with various staffing and management issues, that learning lessons from mistakes and near-misses is one of the key problems in maternity.
Learning from adverse incidents is one of the key components of [...]
A Serious Untoward Incident (SUI) is the term used in the NHS where loss of life or serious injury has been unexpectedly sustained during care. It kicks off an investigation into what occurred, with the emphasis on learning from mistakes, rather than on apportioning blame. The SUI process is probably your best chance [...]
Group B Strep (GBS) is a bacterial infection that results in significant mortality and morbidity in newborns. While a significant proportion of mothers (25 to 30 %) carry GBS at the time of delivery, only a relatively small fraction of them will pass it on to their baby during birth (~ 1 in 200). [...]
Group B Strep (GBS) is a common, asymptomatic bacteria in adults, which occasionally seriously affects newborns because their immune systems are not well developed. It is the most common cause of life-threatening infection in newborns in the developed world.
We were told, following the death of our baby in which early onset GBS had been [...]
