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News ArticlePatients who receive good perioperative care can have fewer complications after surgery, shorter hospital stays, and quicker recovery times, shows a large review of research. The Centre for Perioperative Care, a partnership between the Royal College of Anaesthetists, other medical and nursing royal colleges, and NHS England, reviewed 27 382 articles published between 2000 and 2020 to understand the evidence about perioperative care, eventually focusing on 348 suitable studies. An estimated 10 million or so people have surgery in the NHS in the UK each year, with elective surgery costing £16bn a year. A perioperative approach can increase how prepared and empowered people feel before and after surgery. This can reduce complications and the amount of time that people stay in hospital after surgery, meaning that people feel better sooner and are able to resume their day-to-day life. Read full story (paywalled) Source: BMJ, 17 September 2020
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Content ArticleThis report from the Centre for Perioperative Care provides evidence to justify the case for perioperative care, the integrated multidisciplinary care of patients from the moment surgery is contemplated through to full recovery. This report has brought together a wide range of research about the effectiveness of perioperative care. It considered over 27,000 studies in preparing this review. The results show that perioperative care is associated with high quality clinical outcomes, reduced financial cost and better patient satisfaction. A perioperative approach can increase how prepared and empowered people feel before and after surgery. This can reduce complications and the amount of time that people stay in hospital after surgery, meaning that people feel better sooner and are able to resume their day-to-day life. The review highlights the effectiveness of clear perioperative pathways, with an average two-day reduction in hospital stay across multiple types of surgery. Different interventions, including prehabilitation, exercise and smoking cessation can significantly reduce complications by 30% to 80%. This scale of benefits is far greater than many new drugs or treatments launched.
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Content ArticlePrevious research suggests that surgical safety checklists (SSCs) are associated with reductions in postoperative morbidity and mortality as well as improvement in teamwork and communication. These findings stem from evaluations of individual or small groups of hospitals. Studies with more hospitals have assessed the relationship of checklists with teamwork at a single point in time. The objective of this study from Molina et al. was to evaluate the impact of a large-scale implementation of SSCs on staff perceptions of perioperative safety in the operating room. They concluded that a large-scale initiative to implement SSCs is associated with improved staff perceptions of mutual respect, clinical leadership, assertiveness on behalf of safety, team coordination and communication, safe practice, and perceived checklist outcomes.
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Centre for Perioperative Care: What is perioperative care?
Patient Safety Learning posted an article in Surgery
Perioperative care is the Integrated care across the full patient pathway before, during and after surgery. Perioperative care, also referred to as perioperative medicine, is the practice of patient-centered, multidisciplinary, and integrated medical care of patients from the moment of contemplation of surgery until full recovery. The Centre for Perioperative Care has produced a video on what good perioperative care looks like and a number or resources and advice on the perioperative journey.- Posted
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Content ArticleThis report, by the National Confidential Enquiry into Patient Outcome and Death (NCEPOD) looks at the peri-operative mortality rate in the UK and argues that people die because we do not give them the level of care they are entitled to expect. In this report less than half of the high-risk patients received care that the expert advisors thought they would accept from themselves or their own institutions. Th reasons for this are examined within the report.
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Content ArticleThe Perioperative Warming Quality Improvement Resource summarises the evidence for temperature monitoring, pre, intra and post-operative warming, plus intravenous and irrigation fluids. See also the Perioperative Warming Decision Guide to help support what pre, intra and post-op actions need to be taken to prevent inadvertant perioperative hypothermia.
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Content ArticleThe Surgical Skin Preparation Quality Improvement Resource summarises the evidence for patient washing, hair removal, skin disinfection and the use of incise drapes.
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WHO: What you need to know before and after surgery
Patient Safety Learning posted an article in Surgery
If you or your child is undergoing a surgical procedure, be sure to communicate the following to your healthcare provider. Your active participation in health care is important for your safety. This information from the World Health Organization (WHO) will help your discussion with your care-provider. Be a well-informed partner in your own care.- Posted
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National Safety Standards for Invasive Procedures
Annie Hunningher posted a topic in Surgery
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How are people getting on with the NatSSIPs? PDF version to share NatSSIPs headline booklet.pdf- Posted
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Content ArticlePostoperative delirium is common and has multiple adverse consequences. Guidelines recommend routine screening for postoperative delirium beginning in the post-anaesthesia care unit. The 4 A’s test (4AT) is a widely used assessment tool for delirium; however, there are no studies evaluating its use in the post-anaesthesia care unit. Saller et al. evaluated the performance of the 4AT in the post-anaesthesia care unit in a tertiary German medical centre. The findings published in Anaesthesia suggest that the 4AT is an effective and robust instrument for delirium detection in the post-anaesthesia care unit. suggest that the 4AT is an effective and robust instrument for delirium detection in the post-anaesthesia care unit.
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Content ArticlePete Smith is nothing without the energy and commitment of the amazing people who surround him. Increasing the technical skill of a healthcare clinician makes for incremental change. Improve the culture within which they work, think and communicate and suddenly quantum change is possible. Two perioperative nurses from a regional hospital in Victoria, Australia, innovated a simple, elegant solution to the problem of noise and distraction in the operating room. Pete Smith was one of them.
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Content ArticleThe Care Quality Commission (CGC) is the independent regulator of health and adult social care in England. They make sure that health and social care services provide people with safe, effective, compassionate, high-quality care and encourage care services to improve. Independent acute hospitals play an important role in delivering healthcare services in England, providing a range of services, including surgery, diagnostics and medical care. As the independent regulator, the CQC, hold all providers of healthcare to the same standards, regardless of how they are funded.
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Content Article
Patient information for surgical safety: WHO leaflet (2015)
Claire Cox posted an article in Keeping patients safe
This leaflet produced by the World Health Organization (WHO) is aimed at patients who are undergoing a surgical procedure. It aims to enable communication between you and your surgical team, including you in safety checks.- Posted
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- Operating theatre / recovery
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