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Showing results for tags 'Operating theatre / recovery'.
Found 150 results
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Content ArticleDr Liz O’Riordan is a breast cancer surgeon who has battled against social, physical and mental challenges to practise at the top of her field. Under the Knife charts Liz’s incredible highs: performing like a couture dressmaker as she moulded and reshaped women’s breasts, while saving their lives; to the heart-breaking lows of telling ten women a day that they had cancer. But this memoir is more than just an eye-opening look at the realities of training to be a female surgeon in a man’s world. In addition to this high-powered, high-pressured role, Liz faced her own breast cancer diagnosis, severe depression and suicidal thoughts, in tandem with commonplace sexual harassment and bullying. And by revealing how she coped when her life crashed around her, she demonstrates there is always hope.
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EventThis session will focus on blood and bodily fluids exposure, including sharps injuries as well as their risk factors and prevention strategies. This webinar will present the 2020 RCN study and the 2022 UK NHS Trust study of sharps injury (SI) among UK HCW and, by comparing these results with other countries, question whether UK 2013 Sharps Regulations went far enough, and whether increased emphasis may be required on reporting, recording and implementation of effective prevention strategies. Learning outcomes: Define sharps injuries (SI); the four steps in sharps usage that place staff at risk; and the top two staff groups at risk of SI. Discuss the incidence of SI in the UK and UK HCW staff groups compared with international incidences. Appraise whether facility’s reporting and recording of SI enables benchmarking of the efficacy of their preventive strategies. Define three prevention strategies proven to reduce SI. Register
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Content ArticleIntrahospital transport is a common occurrence for many hospitalised patients. Critically ill children are an especially vulnerable population who experience preventable adverse events at least once a week, on average. Transporting these patients throughout the hospital introduces additional hazards and increases the risk of adverse events. The transport process can be decomposed into a series of steps, each incurring specific risk. These risks are numerous and few of these risks are specific to the transport process. There is a paucity of literature available on paediatric intrahospital transport and related adverse events. Elliot et al. recently reviewed the Wake Up Safe database, a paediatric anesthesia quality improvement initiative across member institutions to disseminate information on best practices, for paediatric perioperative adverse events associated with anaesthesia-directed transport. The authors present several examples of airway and respiratory events taken from the database and discuss the complexity of the transport process.
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Content Article
PIT stop (prosthesis/implant timeout) checklist
Nigel Roberts posted an article in Surgery
The PIT stop (prosthesis/implant timeout) checklist is Birmingham Women's and Children's NHS Trust's visual and aid memoir. It was launched to limit 'human error' and thus preventing never events (wrong implant/prosthesis). The four steps cover the intra-operative stages when implants are required. It works by recording what is requested on a small, hand held white board, and works in harness with the NatSSIPs 8, specifically step 5 of the infographic that has been previously developed. -
Content ArticleTony Clarke suffered from a chronic inflammatory skin disease, hidradenitis suppurativa. In September 2020, Tony underwent surgery to remove infected tissue on one side of his body. When he entered the operating theatre, Tony’s surgical team first covered part of his body with an alcohol-based solution, to keep the area clean. Then, when the operation began, the surgeons began cutting off the infected tissue using a diathermy pen, a device that targets electrically-induced heat to stop wounds from bleeding. However, shortly into the surgery, disaster struck: heat from the surgical pen had ignited the alcohol on Tony’s body. “But because alcohol burns so hot, no fire was seen,” says Tony, recalling an explanation he later received from the hospital. “The surgeons were concentrating on the right side of my body. The left side was left burning for about 20 minutes.” For the next four months, Tony travelled back to the hospital every three days, to get his injuries checked and bandages changed. During that time, Tony describes himself as ‘totally disabled.’ In September this year, Tony, as a patient ambassador for prevention of surgical fires, spoke at a conference held in York by the Association for Perioperative Practice (AFPP). There, perioperative practitioners from across the country gathered to listen to Tony’s experience. “I was speaking to lots and lots of different professionals in the medical service and they'd never heard of it [being set on fire during surgery]. It was a rarity for them,” Tony says. Tony’s now working with different health agencies, with the aim of stopping preventable surgical burns entirely.
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Content ArticleThis paper from Roberts et al. examines the application of the Surgical Safety Checklist (SSC) within NHS hospital operating theatres England. The aim of the study, through a combination of open-ended questions, was to solicit specific information including views and opinions from operating theatre experts to establish from how the World Health Organisations (WHO) SSC is being applied, and therefore and why intraoperative ‘Never Events’ continue to occur more than a decade after the SSC was introduced. Participants were from the seven regions identified by NHS England. The intention of this paper is not to establish definitively whether the quantitatively identified themes; including a lack of training and engagement with human factors explains the increased presence of intraoperative ‘Never Events’. However, these themes, when subjected to methodological triangulation with the current literature, do appear consistent, and therefore provide an exploratory approach to inform research intended to improve safety in the operating theatre by informing policy and its application to safe practice ultimately towards quality improvements.
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EventuntilThe aim of this webinar is to share, engage and discuss with clinicians, patient safety managers, patients and leaders the latest standards. There will be 2 sessions: 17.30: Session 1 – NatSSIPs 2: what it is and why it matters Welcome and introduction The CPOC perspective The Patient Safety Learning perspective Photo review of why NatSIPPs matters The patient perspective What is new in NatSIPPs 2? Resources to support Implementation: Checklists, infographics Q&A 18.30: Session 2 – NatSSIPs 2: implementation, practical insights and tips Our NatSIPPs 2 Workshop and how to consider a NatSSIPs gap analysis Team training for NatSIPPs 2 Q&A Register
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Content ArticleAccording to the World Health Organization, humanity faces its greatest ever threat: the climate and ecological crisis. Healthcare services globally have a large carbon footprint, accounting for 4-5% of total carbon emissions. Surgery is particularly carbon intensive, with a typical single operation estimated to generate between 150-170kgCO2e, equivalent to driving 450 miles in an average petrol car. The UK and Ireland surgical colleges have recognised that it is imperative for us to act collectively and urgently to address this issue. The Royal College of Surgeons of Edinburgh have collated a compendium of peer-reviewed evidence, guidelines and policies that inform the interventions included in the Intercollegiate Green Theatre Checklist. This compendium should support members of the surgical team to introduce changes in their own operating departments. The recommendations apply the principles of sustainable quality improvement in healthcare, which aim to achieve the “triple bottom line” of environmental, social and economic impacts.
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Content ArticleStandard operating procedures (SOPs) should improve safety in the operating theatre, but controlled studies evaluating the effect of staff-led implementation are needed. Morgan et al. evaluated three team process measures (compliance with WHO surgical safety checklist, non-technical skills and technical performance) and three clinical outcome measures (length of hospital stay, complications and readmissions) before and after a 3-month staff-led development of SOPs. They found that SOPs when developed and introduced by frontline staff do not necessarily improve operative processes or outcomes. The inherent tension in improvement work between giving staff ownership of improvement and maintaining control of direction needs to be managed, to ensure staff are engaged but invest energy in appropriate change.
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Content ArticleTraditional approaches to patient safety and handoffs need redesigning to acknowledge the different constraints, goals, and requirements necessary for each individual patient. There is no “one size fits all” approach to patient safety, handoffs or a perfect checklist. Despite the inherit complexity present in healthcare systems, we tend to reduce our thinking about handoffs into simple solutions of checklists and cognitive aids. In studies of these tools, their association with patient outcomes is unclear with mixed results in large studies. Incorporating general resilience engineering principles of visibility, understanding, anticipation, and learning provides new opportunities for increased patient safety. This involves situating the handoff in the context of the system - understanding the process of summarising pre-handoff and of developing understanding post-handoff, tracing flows of information and patients, and considering the role of feedback and control loops in the system. Direct observations, analysis of multiple outcomes, focus on patient evolving specific exceptions, reducing the number of handoffs, taking time for two-way discussions, and user-centred design and redesign may promote acceptability and sustainability of a new view of handoffs for improved patient safety.
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News Article
‘Fifth of UK hospitals cancelled operations’ during three days of 2022 heatwave
Patient Safety Learning posted a news article in News
A fifth of UK hospitals were forced to cancel operations during the three days in July last year when temperatures soared, research suggests. The findings, published in a letter to the British Journal of Surgery, are based on surveys from surgeons, anaesthetists and critical care doctors working during the heatwave from July 16-19 2022, when temperatures reached as high as 40C in some parts of the country. The researchers received 271 responses from 140 UK hospitals – with one in five (18.5%) reporting elective surgeries being cancelled due to the heatwave. The respondents also said surgical services were poorly prepared for heatwaves, with 41% of operating theatres having no means to control ambient temperature, while more than a third (35.4%) reported making changes to maintain routine surgical activity during the period. These include delayed discharge of high-risk patients, changes to surgical teams, selecting lower-risk patients to have surgery, and restricting surgical activity to day cases. Other measures included longer staff breaks, extra fluids to patients, and surgeries earlier in the morning when temperatures were lower. Read full story Source: The Independent, 23 March 2023 -
Content ArticleMaria Koijck's goal for this film was to create a movement within the pharmaceutical industry considering the waste it produces. In this film you see Maria lay in the middle of an incredible amount of waste from just one surgery, her surgery. In August 2019 Maria was diagnosed with breast cancer. Surgeons had to remove her entire left breast. After a successful recovery, she went to to have a deep lap surgery where they gave her an entire new breast of her own bodily materials. During this process she discovered that 60% of the surgery materials used for this operation is disposable. For example: the stainless steal scissors that are flown in from Japan, are used for one cut before they end up in the bin. Maria asked the doctors to collect all of the surgery materials used for her operation, to get a clear idea of how much it really was. She was shocked to see six bags full of plastic waste.
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EventuntilThe provision of safe and quality care is the most fundamental principle to consider for patients in perioperative practice. Alongside this commitment, is the safety and welfare of all staff and visitors within the setting. Risk assessment, staffing ratios, competency and skill are crucial to ensuring that the intended outcome for patients is achieved as far as is reasonably practicable. The discussion will outline how this can be achieved utilising the recommendations by the Association for Perioperative Practice (AfPP). Learning outcomes: Understanding risk and the process of risk assessment in perioperative practice. The components of a safe perioperative environment. How to calculate a safe staffing model for your environment based on the AfPP standard. Register
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Content ArticleIn this blog, the Healthcare Safety Investigation Branch (HSIB) reflects on the recent publication of the new National Safety Standards for Invasive Procedures (NatSSIPs 2) by the Centre for Perioperative Care. It outlines how these standards can help NHS organisations provide safer care and reduce the number of patient safety incidents, including a comment on this from Deinniol Owens, Associate Director of National Investigations at HSIB.
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Content ArticleThe Centre for Perioperative Care (CPOC) has published new safety standards (NatSSIPs2) to enable all hospitals in the UK to improve patient safety by applying a consistent and proportionate set of safety checks for all invasive procedures. Listen to the podcast from the Royal College of Anaesthetists on the new standards.
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News Article
Is Heatherwood Hospital a model for the future of the NHS?
Patient Safety Learning posted a news article in News
Pradeep Gill can see very little of the intense activity around him. He is leaning back in a reclining chair inside one of Heatherwood Hospital's operating theatres. Buzzing around him is the operating team, led by consultant orthopaedic surgeon Jeremy Granville-Chapman. For the surgeon and his team, this procedure is the very definition of routine. They have carried out more than 1,000 joint operations in the past 10 months. Heatherwood Hospital, part of the Frimley Health NHS Foundation Trust, is a specialist elective hub where patients can come in for routine but life-changing surgery at a super-charged pace with theatres working at full tilt, six days a week. It is busy. But it is a good-busy, not the bad-busy we have come to associate with the NHS during this winter crisis. The site opened in March last year and Frimley's hospital executives are keen to stress the impact it has made. "As a specialist planned care facility, Heatherwood has been able to perform surgery six days a week with four out of its six state-of-the-art theatres dedicated to orthopaedic procedures," it said in a press release. "The hospital has also successfully reduced the length of time patients stay in hospital, with 40% of patients safely discharged within 24 hours." This is the practice the NHS wants to adopt as it battles a record seven-million-strong waiting list. Heatherwood can do that because the hospital is ring-fenced from acute pressures that affect other hospitals, as one its most senior orthopaedic surgeons, Mr Rakesh Kucheira, explained. "We have now realised that winter pressures are 12 months not just three months, which means the acute sites are not going to be able to do planned activity that they planned for, so we've got to create more space," he said. Read full story Source: Sky News, 9 March 2023 -
Event
Human factors in operating theatres
Patient Safety Learning posted an event in Community Calendar
Understanding human factors will allow surgical teams to enhance performance, culture and organisation of operating theatres. This one day masterclass will concentrate on human factors within the operating room. This is aimed at all theatre staff. It will look at why things go wrong and how to implement change to prevent it from happening again or mitigate the risks. This Masterclass will focus on systems to improve patient safety as well as looking at never events and how to learn from them using a human factors approach. Key learning objectives: Safety culture Human factors Leadership Never events This masterclass is aimed at all theatre staff. Register hub members receive 20% discount using code hcuk20kh. -
Content ArticleThe original National Safety Standards for Invasive Procedures (NatSSIPs) were published in 2015. Understanding of how to deliver safe care in a complex and pressurised system is evolving. These revised standards (NatSSIPs2) are intended to share the learning and best practice to support multidisciplinary teams and organisations to deliver safer care. The Centre for Perioperative Care shares their slideset on the revised standards.
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News Article
High levels of microplastics found in operating theatres
Patient Safety Learning posted a news article in News
High levels of microplastics have been found in operating theatres by researchers who highlighted the “astoundingly high” amounts of single-use plastic used in modern surgical procedures. A team from the University of Hull found the amount of microplastics in a cardiothoracic operating theatre was almost three times that found in homes, and said this identifies another route through which the tiny particles can enter the human body, with unknown consequences. The study, published in the journal Environment International, is the first to examine the prevalence of microplastics in surgical environments. The team analysed levels in the operating theatre and the anaesthetic room in cardiothoracic surgeries and discovered an average of 5,000 microplastics per metre squared when the theatre was in use. Jeanette Rotchell, professor of environmental toxicology at the university, said the types of microplastic particles identified relate to common plastic wrapping materials and could also come from blister packs, surgical gowns, hairnets and drapes for patients. Prof Rotchell said: “Although we know microplastics are in the air in a variety of settings, we can’t yet say what the consequences are or whether microplastics are harmful to health. Researchers have yet to establish this. Read full story Source: The Independent, 27 January 2023 -
Content ArticleThe original National Safety Standards for Invasive Procedures (NatSSIPs) were published in 2015. Understanding of how to deliver safe care in a complex and pressurised system is evolving. These revised standards (NatSSIPs2) are intended to share the learning and best practice to support multidisciplinary teams and organisations to deliver safer care.
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Content ArticleOperating rooms are major contributors to a hospital’s carbon footprint due to the large volumes of resources consumed and waste produced. The objective of this study from Sullivan et al., published in the Journal of the American College of Surgeons, was to identify quality improvement initiatives that aimed to reduce environmental impact of the operating room while decreasing costs.
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Content ArticleThis paper asked healthcare workers who are considered to be theatre safety experts—theatre managers, matrons and clinical educators—to take part in the second round of a Delphi study. These individuals work at the coalface in operating theatres and deliver the surgical safety checklist daily. It addresses information raised as part of a Delphi study of NHS hospital operating theatres in England. The aim of the second Delphi study round was to establish the views of theatre users on the theatre checklist and local safety standards for invasive procedures. Likert scale responses and a combination of closed and open-ended questions solicited specific information about current practice and researched literature that generated ideas and allowed participants freedom in their responses of how the World Health Organisation’s (WHO's) Surgical Safety Checklist (SSC) is currently being used in the peri-operative setting as part of a strategy to reduce surgical ‘never events’. The paper is part of a literature review undertaken by the author towards a Doctor of Philosophy (PhD). Read the findings of round one of the Delphi study
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Content ArticleThis paper addresses information raised as part of a Delphi study of NHS hospital operating theatres in England. The aim of the first Delphi study round was to establish how the World Health Organisation’s Surgical Safety Checklist (SSC) is currently being used in the peri-operative setting as part of a strategy to reduce surgical ‘never events’. It used a combination of closed and open-ended questions that solicited specific information about current practice and research literature, that generated ideas and allowed participants freedom in their responses. The study asked theatre managers, matrons and clinical educators that work in operating theatres and deliver the surgical safety checklist daily, and who are therefore considered to be theatre safety experts. Participants were from the seven regions identified by NHS England. The study revealed that the majority of trusts don’t receive formal training on how to deliver the SSC, checklist champions are not always identified, feedback following a ‘never event’ is not usually given and that the debrief is the most common step missed. While the intention of the study was not to establish whether the lack of training, cyclical learning and missing steps has led to the increased presence of never events, it has facilitated a broader engagement in the literature, as well highlighting some possible reasons why compliance has not yet been universally achieved. Furthermore, the Delphi study is intended to be an exploratory approach that will inform a more in-depth doctoral research study aimed at improving patient safety in the operating theatre and informing policy making and quality improvement.
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News ArticleThousands of hospital surgeries are likely to be cancelled as NHS leaders prepare for unprecedented strike action, The Independent has been told. Most operations apart from cancer care are likely to be called off when nurses take to the picket line, with NHS trusts planning for staffing levels to be similar to bank holidays. Multiple sources say they are almost certain that the upcoming Royal College of Nursing ballot will result in strike action. Results are expected to be finalised on Wednesday. “Trusts are looking at the totality of it. It’s the waiting list that is going to be hit, massive questions over waiting lists, and we’re going to lose days of activity in terms of addressing that growing pressure. “The more we see strike action the harder it is, the risk is [that] the rate of recovery [of waiting list] slows.” They added: “The unions normally provide bank holiday cover and maintain emergency service basically.” Read full story Source: The Independent, 7 November 2022
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Content Article
This is part of our series of Patient Safety Spotlight interviews, where we talk to people working for patient safety about their role and what motivates them. Kathy tells us about the importance of breaking down barriers to share patient safety tools, and talks about changes she has implemented to make surgery safer.
