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Showing results for tags 'Pre-op period'.
Found 36 results
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Let’s Move for Surgery: Surgery toolkit
Patient Safety Learning posted an article in Surgery
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Content ArticleTo make the best of this approach we need to make sure patients and all health care professionals including GPs and multidisciplinary hospital teams work together to: Identify anaemia early in the pathway. Make the patient aware of this and all actions going forward. Find the cause of the anaemia. Use tried and tested treatments for anaemia before surgery. This could include advice on changes in diet, oral treatments such as iron supplements and the use intravenous iron when necessary. Make sure the patient has a personalised treatment programme including providing appropriate information about the pros and cons of the different approaches suggested to the patient and how long these should be continued. Communicate clearly between different members of the team so that operations are not cancelled unnecessarily and improve the interface between primary care and hospitals. Talk openly to the patient about the benefits and risks of managing anaemia and the surgery.
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Content ArticleThis guideline includes recommendations on: information for patients measuring temperature warming patients before their operation, including transfer to the operating theatre keeping patients warm during their operation, including ambient temperature in the operating theatre and temperature of intravenous fluids keeping patients warm after their operation
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PRSB: Shared decision making workshop in March
Patient Safety Learning posted a calendar event in Community Calendar
The Professional Records Standard Body (PRSB) are holding a workshop on 4 March to help us develop a shared decision-making standard, so that individuals can be more involved in the decisions that affect their health, care and wellbeing. The online workshop will bring together health and care professionals, patients and system vendors to focus on different topics including diabetes and other long-term conditions, mental health, child health, gynaecology, colorectal cancer, genetic conditions, multi-medications and orthopaedics. We will be asking questions about the way information about treatment and care options are discussed and decisions recorded. This would include consent for treatment, when it is agreed, and any pre-operative assessments and requirements. By standardising the process, it will ensure that information can be shared consistently using any digital systems. If you’re interested in getting involved in the project, please contact info@theprsb.org -
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How I raised awareness of fires in the operating theatre
Kathy Nabbie posted an article in Surgery
Here is the FRAS tool I implemented: Fire risk assessment tool.pdf Other useful resources I found: Scoring_Fire_Risk-2.pdf Surgical Site Fire Triangle.pdf Surgical_Fire_Poster (1).pdf Video: Fire hazard demo by Zaamin Hussain and Mike Reed Demonstration: "Burning Bruce" drives home the reality of surgical fires - article in Outpatient Surgery- Posted
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Patient information for surgical safety: WHO leaflet (2015)
Claire Cox posted an article in Keeping patients safe
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Content ArticleNHS England and NHS Improvement have worked with a number of partners to identify five key principles which can help ensure that patients are discharged in a safe, appropriate and timely way. The five principles relate to different stages of a patient’s stay: some to the moment of admission, some to their time on a ward and some to the end of their stay. Plan for discharge from the start Involve patients and their families in discharge decisions Establish systems and processes for frail people Embed multidisciplinary team reviews Encourage a supported ‘Home First’ approach The 'Where Best Next?' website lists specific actions for each principle and provides links to useful resources.
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Community Post
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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News ArticleRoy Cairns, 58, was diagnosed with liver cancer in 2019. Twelve months later a tumour was found on his lung. Mr Cairns said taking part in the cancer prehab programme piloted by the Northern Ireland's South Eastern Health Trust after his second diagnosis was a "win-win", not only for himself but also his surgeons. "I think when you get that diagnosis you are left floundering and with prehab the support you get gives you focus and a little bit of control back in your life," he said. Prehabilitation (prehab) means getting ready for cancer treatment in whatever time you have before it starts. Mr Cairns is one of 175 patients referred to the programme which involves the Belfast City Council and Macmillan Cancer Support. Dr Cherith Semple said the point of the programme is to " improve people's physical well-being as much as possible before treatment and to offer emotional support at a time that can be traumatic". Dr Semple, who is a leader in clinical cancer nursing, said this new approach to getting patients fit prior to their surgery was proving a success, both in the short and long-term. She said: "We know that it can reduce a patient's hospital stay post-surgery and it can reduce your return to hospital with complications directly afterwards." Read full story Source: BBC News, 20 July 2022
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Content ArticleThe investigation explored: Safety issues associated with the establishment of surgical services in independent hospitals to support the NHS and in particular the specialist services that are in place to deliver patient care. The assessment of patients prior to surgery to identify their risk and suitability for an operation and where it was to be undertaken; this included identification of patients with frail physical states. Key findings included: National and local NHS organisations had limited understanding of independent hospitals’ capabilities. This resulted in variation in how independent hospitals were used during Covid-19. Some independent hospitals saw patients with increasingly complex conditions and undertook more complex operations during Covid-19. The increasing complexity was well managed where capability of the independent hospitals had been evaluated and addressed prior to implementation of new services. Where pathways between NHS and independent hospitals were effective, it was often found that relationships between the hospitals had been longstanding and direct. There was variation in how preoperative assessments were undertaken across NHS and independent hospitals. This included what tests were ordered and risk assessments undertaken. Preoperative nutrition screening was inconsistent across NHS and independent hospitals. Examples were identified where it was not undertaken, or undertaken too late to allow any preoperative optimisation – that is, to make sure the patient was in the best possible nutritional state before their operation. Remote preoperative assessment became the norm during Covid-19, but created risks when staff were not able to see the patient. Lack of video call facilities and staff preference meant assessments were commonly done by telephone. Safety recommendations HSIB recommends that NHS England and NHS Improvement ensures that effective processes have been implemented in integrated care systems to identify local capability and capacity of their independent acute hospitals. HSIB recommends that NHSX expands its work programme addressing the challenges associated with interoperability of information systems used in healthcare to include transfer of information between the NHS and independent sector in support of safe care delivery. HSIB recommends that the Care Quality Commission reviews and appropriately develops its methodology for regulatory assurance of arrangements between NHS and independent providers for the provision of care across care pathways. This is to include any screening and risk management processes used to ensure the safe transfer of care between providers. HSIB recommends that NHS England and NHS Improvement reviews models of perioperative care for their value and impact. This should inform future work to support implementation of a standardised approach, based on evidence, across all healthcare providers that deliver surgical services. HSIB recommends that NHS England and NHS Improvement establishes a process to ensure that findings of the National Institute for Health Research’s policy research programme into frailty in younger patient groups are reviewed and acted upon.
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CPOC: Perioperative care of people living with frailty
Patient Safety Learning posted an article in Surgery
Download frailty pathway infographic Download the guidelines -
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Centre for Perioperative Care newsletter
Patient Safety Learning posted an article in Health care
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Content ArticleAnaesthesia is the largest hospital speciality in the UK, involved in a third of all hospital admissions, while perioperative care covers a patient's care from when they first contemplate surgery to their full recovery. The GIRFT national report for anaesthesia and perioperative medicine contains 18 recommendations based on information gathered from the 134 trusts in England with an anaesthesia and perioperative medicine service. It seeks to improve outcomes for patients having surgery in the new COVID-19 environment, including reducing the amount of time they spend in hospital. You will need a FutureNHS account to view this report, or you can watch a short video summary summarising key recommendations.
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Content ArticleThe latest expert guidance on routine operations recommends: Within 10 days of your planned surgery date If you have a positive test, or COVID-19 symptoms, elective surgery should not take place because you may be infectious to others (as well as risks to you). Between 10 days and 7 weeks before your planned operation date Reduce your risks of catching COVID-19. If meeting people, consider social distancing, wearing a facemask, opening windows or meeting outdoors. If you test positive or have COVID-19 symptoms: You MUST inform your surgical team. Elective surgery may need to be delayed. Your health professional may undertake a risk assessment with you to decide whether the risks of delaying are worse than the risks of problems with surgery and COVID-19. At any time before surgery Please ensure you stay healthy and prepare for surgery: Ensure you have had a full course of vaccinations including a 3rd dose/booster. Vaccination reduces the chance of getting COVID-19 and of spreading it as well as reducing the severity of the illness if you get it. Regular exercise, nutrition and stopping smoking reduce complications from surgery by 30–80%. There is more information here: www.cpoc.org.uk/patients
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Content ArticleKey recommendations For Commissioners 1. Investment should be provided to: (a) establish prehabilitation services; (b) enable integrated Care Systems (England), Health Boards (Wales), Regional Health Boards (Scotland) and Health and Social Care Trusts (NI); and (c) expand perioperative services For NHS X 2. Ongoing work to bridge the Primary - secondary care interface should be accelerated. For primary care providers, surgeons, anaesthetists and multidisciplinary teams 3. Shared Decision Making (SDM) should be embedded throughout perioperative pathways. beginning at the earliest point where surgery is contemplated, and involving discussion between patient, surgeon, and the broader multidisciplinary team. 4. At the earliest possible point in the surgical pathway (e.g. at the point of referral from primary care, or at the first review in surgical clinic) patients should complete a screening self-assessment health questionnaire, to help shared decision making, risk prediction and optimisation. 5. Referrals from primary care to surgeons and from surgeons to Preoperative Assessment (POA) Services should detail significant medical comorbidities using a “fitness for surgery” process to enable early optimisation and review. For preoperative assessment services 6. Every patient requiring surgery and/or anaesthesia/anaesthesia-led sedation should undergo formal preoperative assessment before the day of admission. 7. Patients should be assessed for impact of comorbid conditions on functional capacity, perioperative pathways and surgical outcome. 8. Patients should be screened for cognitive impairment, psychological distress and risk of malnutrition using validated tools. For surgeons, anaesthetists and perioperative multidisciplinary teams 9. All patients being considered for surgical intervention should have their individualised risk assessed using objective measures, combined with senior, experienced clinical judgement. 10. Where possible, surgery should be avoided for 7 weeks after COVID-19 infection, or until symptoms have resolved, to avoid the higher risk of postoperative complications and death associated with earlier surgery. 11. All patients who are being considered for a surgical intervention should be screened for reduced functional capacity/physical fitness using a validated tool such as the Duke Activity Status Index (DASI). 12. All patients should be advised that improving fitness before surgery reduces risk of complications after surgery, and improves length of hospital stay, speed of recovery and quality of life. All healthcare professionals should be competent to deliver universal exercise advice to all patients following UK CMO (WHO) guidance. 13. All patients considered for a major or inpatient elective surgical intervention should be invited to attend a group ‘surgery school’, which may be in-person, via remote access or hybrid. 14. All surgical / perioperative services should have a system for active clinical surveillance of patients on waiting lists, particularly those who have been waiting for longer than 3 months. 15. Prompt preoperative assessment and optimisation, supported by agreed local pathways based on national recommendations, should be prioritised in emergency surgery. This will ensure efficient and safe care which will benefit best use of hospital resources, creating more capacity for both emergency and elective work.
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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
