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Found 154 results
  1. Content Article
    This book brings together all aspects of perioperative practice in one easy-to-read book: Moves through the patient journey, providing support to perioperative practitioners in all aspects of their role. Covers key information on perioperative emergencies. Includes material on advanced skills to support Advanced Practitioners. Each topic is covered in two pages, allowing for easy revision and reference. This is a must-have resource for operating department practitioners and students, theatre nurses and nursing students, and trainee surgeons and anaesthetists.
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    I was once working in a private operating theatre where, to my horror, the surgeon accidentally dropped an instrument on the floor, picked it up and reused it without it going through a steriliser. In my 30 years of working as a theatre nurse, I had never seen anything like this. I felt sick to my stomach! Is this what happens in private hospitals? I reported it immediately to the senior staff on duty and also the theatre manager. I also sent through a report at the end of the case. Nothing happened, except my shifts were blocked for reporting the incident . I no longer work in that hospital. I feel hurt. My mental health has also suffered as I feel tortured. I question myself. Did I do the right thing by reporting it? Because now I do not have a job and I am using my savings to survive. If I was a permanent member of staff, I would still be working. Is this why staff do not report incidents? For fear of losing their jobs? What about the safety of the patient? I tried calling to speak to anyone who would listen. I did not have any luck – I found all avenues were blocked. There was no Speak Up Guardians in post. I feel I did the right thing by reporting it, but I was not supported by management. Where is the system in private hospitals to protect locum theatre staff? Why is this allowed to go on? In theatres, we are the patient's advocate. We are only there to ensure the patient is safe at all times. Would I do things differently if it happens again, now that I know the consequences? Yes! Absolutely 100%. I will continue to speak up and send through a report. What will you do?
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    The operating theatre works daily by the premise of ‘surgical precision’. Every opportunity to work as a holistic team is embraced, not only as an effective way to get things done, but also as a way to maximise patient safety and reduce risk. Given the intensity of the work and the mandatory desire for a good outcome, surgeons, anaesthetists, nurses and theatre technicians are embracing a new concept in operating theatre team dynamics. The concept has been developed by nurses at Geelong Hospital. John Gibbs, a Clinical Nurse Specialist in Anaesthetics, studied Crew Resource Management strategies common in the airline industry and found that some dimensions of aeronautical crew resource engineering could solve dilemmas in his operating theatre environment, in particular, the reduction of ambient noise and distractions at sentinel times of anaesthesia. In collaboration with other staff, he has worked on and improved upon the idea, finally arriving at the prototype concept of ‘Below Ten Thousand’ for the surgical and clinical setting.
  8. Content Article
    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
  9. Content Article
    This editorial by Dr Michael Farquhar, published in Anaesthesia, explains the importance of taking breaks while on shift and ensuring a good sleep between shifts and the inextricable link between sleep and patient safety.
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    The report argues that better engaged staff have higher morale, make fewer errors and deliver better patient experience. It demonstrates that patients receive more appropriate care and better outcomes when they are actively engaged in their care and highlights how leaders must be increasingly effective at integrating healthcare activities across healthcare systems. It sets out recommendations and outlines the argument for engagement, looking at what engagement means and why it matters. It looks at engaging across the system as well as with specific groups: Staff Patients Doctors Nurses and allied health professionals Boards
  15. Content Article
    This web page includes videos and facts on the evidence behind the theatre cap challenge.
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    This report sets out 17 recommendations to improve the way vascular surgery – surgery to repair and restore blood supply to organs and areas of the body – is delivered in the NHS in England. The recommendations focus primarily on the way vascular surgery is organised and delivered, with the central goal of enabling patients to receive urgent surgery sooner. Taken together, they could not only deliver better surgical outcomes for seriously ill patients but also reduce length of stay, cut readmission's and make better use of surgical resources. The report also recommends steps to improve the quality of data gathered around vascular surgery, as a precursor to further long-term change, and identifies opportunities to deliver substantial cost savings on procurement of devices and consumables.
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    Contrary to existing work, this study distinguishes error from complication, includes a measure of event severity and explores the impact of adverse events across a range of outcomes. The extent to which surgeons feel negative following adverse events is striking: nearly half of participants reported becoming more anxious, 40% sleeping worse, a third struggling to cope with anger or irritability, and over 10% reporting depression. The frequency of post-traumatic stress symptomatology illustrates the profound impact of adverse events. The study suggests surgeons do not feel prepared for the impact of adverse event. It also indicates failings in how surgeons are supported after an adverse event. Talking about the impact of an event is helpful, yet over 40% of participants talked to no-one about it. Despite high levels of mental health symptomology, participants reported very little engagement with formal support services. This may be because surgeons perceive barriers to talking about adverse events and surgeon-specific support programmes are lacking.
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    In 2005, while in a consultation about an unrelated problem, my gynaecologist asked me whether I ever experienced incontinence. When I said that occasionally I did, very slightly, while exercising, he suggested I have a transvaginal mesh inserted while I was having a coil fitted. It would “future proof” me against incontinence and I would be in and out of hospital in a day. So without thinking much of it, I agreed to the surgery. That was a mistake that I have bitterly regretted for the past 17 years; I have never been well since I had that surgery. Straight afterwards, I had a UTI, the first of a continuous string that sent me back and forth to the GP for antibiotics. I developed severe pain in my pelvic area and incontinence, and my symptoms changed so many parts of my life. I could no longer take part in the exercise I loved, sex was very painful and I had to retire early because I felt I couldn’t do my job well anymore. The medications I was taking for the pain and incontinence made me so spaced out, and led to an incident where I fell and broke my foot. After that, I decided to stop taking them, leaving me without relief from the awful pain. It took me a while to link my symptoms to the mesh. The surgeon that originally carried out the surgery told me “the mesh is all intact” and dismissed my issues as being psychological. It was only when I googled “transvaginal tape” that I came across Sling the Mesh, a support group for women with complications from mesh surgery. I discovered that thousands of people were in a similar boat - this small piece of mesh was destroying people’s health and lives. I visited my GP and asked whether she thought my symptoms could stem from the mesh, and she referred me to a gynaecologist. When the doctor examined me, I could tell something was wrong, but she didn’t say much, referring me on to a specialist mesh clinic. It was a relief to be referred, but after seeing the mesh specialist surgeon I didn’t feel very reassured. I felt he, like so many doctors before him, dismissed the amount of pain I was in, telling me there were “no significant abnormalities.” He did offer to remove the mesh, but I just didn’t feel confident in his care. He had only done 15 mesh removals before, and not on a regular basis. So I went back to my GP and she referred me to a different mesh centre hundreds of miles away to get a second opinion. I initially had a private consultation with the surgeon, and he immediately identified that the tape had become twisted in my pelvic floor, which was the source of my issues. He gave me a full explanation of the surgery and its risks, and I felt much more confident to undergo the procedure at this centre. Privately, the wait was two months, but I don’t have the money to fund such an expensive operation, plus all the associated costs. On the NHS, I was told to expect to wait six months. We’re now at that six-month mark and I have been chasing the hospital to find out what’s going on. I recently found out I am not on the waiting list yet but will need to have my case assessed by a multidisciplinary team that meets once a month. Before me in the queue for discussion are 24 other women, so I don’t know when my case will be reviewed and whether I’ll need any further investigations before I can have surgery. It’s not knowing that’s really hard - if the hospital communicated what was going on, it would reduce my stress and make the wait much easier to bear. I understand the pressures the NHS is under at the moment, but this lack of information and clarity is really unhelpful for everyone. The hospital told me that they have appointed a Mesh Coordinator who is due to start soon - I hope that improves communication with patients. The variance between mesh centres concerns me. I know it will take time for surgeons to gain the skills they need to carry out mesh removal effectively, but I experienced very different responses and attitudes from the surgeons I saw at the two centres. Although I’m desperate to have the mesh removed, I’m also worried about aftercare. There doesn’t seem to be much information out there about recovery, or what to expect. It is a complex procedure that involves picking the mesh away from your flesh. Having been damaged once, I feel very nervous about what the outcome of the removal surgery might be, but I don’t feel that I have any choice other than to get it done and try to get some of my life back. Further reading ‘Mesh removal surgery is a postcode lottery’ - patients harmed by surgical mesh need accessible, consistent treatment A year on from the Cumberlege Review: Initial reflections on the Government’s response (Patient Safety Learning, 23 July 2021) Regulatory flaws: Women were catastrophically failed in the mesh, Primodos and Sodium Valproate tragedies
  24. Community Post
    I’ve just been listening to the 10 o’clock news tonight and it has been covering the report into Paterson, the breast surgeon who may have needlessly operated on thousands on women. One of the recommendations is that patient safety should be a ‘top priority’ across the NHS (again!!). Another interesting recommendation is that the NHS (and private healthcare providers) need to be better at sharing information about medical staff. Currently, medical staff seem to be able to be investigated in one hospital, and then move to another without any of their history following them. Maybe we need some sort of central system, like Doctify for employers? What do you think?
  25. News Article
    Barts Health NHS Trust has been told to take action to prevent future deaths after an elderly woman was unlawfully killed at one of its hospitals. East London acting senior coroner Graeme Irvine sent a report to the trust in which he raised concerns over the death of 78-year-old Surekha Shivalkar in 2018. The report follows an inquest into Mrs Shivalkar's death, which reached a narrative conclusion incorporating a finding of unlawful killing. A Barts spokesperson said the trust had made a number of changes after carrying out an investigation. Mrs Shivalkar underwent hip replacement revision surgery at Newham Hospital on September 28, 2018 in a procedure estimated to last between four and five hours, the coroner wrote. She had a number of serious conditions, including ischaemic heart disease, osteoporosis and chronic obstructive pulmonary disorder. But Mr Irvine said an inaccurate risk of death of less than 5% was given, as no formal risk assessment tool was used. The surgery took longer than seven and a half hours, during which time Mr Irvine said Mrs Shivalkar sustained a "prolonged and dangerous" period of hypotension, or low blood pressure. He said the anaesthetist failed to communicate this to the surgical team and agreed to prolong surgery at the six hour point. Mr Irvine said: "Poor communication between the orthopaedic surgical team and the anaesthetist during surgery led to a collective failure to identify a critically ill patient." Read full story Source: Newham Recorder, 17 January 2022
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