The College has recently reviewed and refreshed our patient safety bulletins, to improve the layout and content and bring a consistent format to all future bulletins.

Reflection is a valuable learning tool and constitutes high-quality CPD. The new bulletins are intended to provide you with opportunities to reflect on your own practices, as well as experiences of others, to draw out learning and development opportunities.

You can download the patient safety bulletins from our publications pages. You can also submit your own experiences as case studies.  

Share your knowledge and experiences and earn CPD

Help the College's patient safety work by sharing your knowledge and experiences with colleagues via a case study, the best of which will be published as patient safety bulletins. If you send us your case studies, you may claim 1 CPD credit per case study and enter them in your online CPD portfolio.

We're looking for case study contributions from authors that reflect on something that has made an impact on patient safety. Your case study should describe patient care that went well or not so well, and why. We would also like to hear about:

• how this was approached and resolved, either on an individual or team basis and/or by the wider system
• what was learned 
• how this was shared.

‘SHOT’ is a submitted case study which may be viewed by clicking the image to the top right.

Clear, timely and effective communication is critical in ensuring patient safety, not just for safe transfusions but in all aspects of patient care. Errors/gaps in communications are often cited as the cause of patient safety incidents. Effective communication in healthcare starts with recognising the importance of listening to one another with timely actions as appropriate. It is vital to ensure that relevant information is available to all teams involved in the patient care including laboratory staff. 

Transfusions save lives and improve health of patients. Transfusion delays are preventable, and patients should not die or suffer harm from avoidable delays in transfusion. A rapid, focused approach to ensure timely provision of blood components is required as delays can result in preventable death or end-organ damage. Delays in provision and transfusion of blood during major haemorrhage have been identified repeatedly in Annual SHOT Reports and communication failures are often contributory. One such case that was reported to SHOT, the UK haemovigilance scheme has been used in this Safety Bulletin to illustrate the importance of effective, timely communication and escalation in ensuring patient safety.
 

Download the template

We have provided a template for you to complete with details of your case study. You can submit your case study to the Professional Standards team via [email protected], and also enter it in your online CPD portfolio.

Please ensure that your employing organisation is aware of the incident.