A whole healthcare system mortality review of the second wave COVID-19 pandemic response, were lessons learned?

We previously reported a study of features of emergency healthcare response to COVID-19 that could be modified to mitigate against future excess deaths. Here we determined what themes persisted in later waves. This was an expert panel review of all components of care delivered to COVID-19 patients who died (primary and secondary care, community services, NHS 111 and 999, COVID oximetry at home, virtual wards).

Service development of a nurse-led community-based PICC insertion service.

Patients receiving intravenous therapy require reliable venous access. Typically patients with poor peripheral access or requiring long-term treatment from an outpatient antibiotic therapy (OPAT) service need to receive secondary care input for safe central line placement, and radiological confirmation of the correct line tip placement where necessary, if treatment is to proceed as planned. Technological developments that enable accurate ultrasound-guided vein selection and electrocardiograph (ECG)-guided central line tip placement have eliminated the need for radiological or fluoroscopic confirmation of correct tip placement for peripherally placed central catheters (PICCs).

How a central venous catheter surveillance tool was developed for use with all ethnic groups.

High rates of central venous catheter related infections in a renal unit highlighted a need to address catheter site care in these patients. However, a literature review found no surveillance tools that were designed to identify infections in all ethnic groups. Since the trust served an ethnically diverse population, the nursing team devised the multiracial visual inspection catheter tool observation record (MR VICTOR).