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Showing results for tags 'Surgery - General'.
Found 485 results
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Content ArticleThis project aims to develop peer consensus centred on specific themes defined by the steering group covering topics relevant to the optimal, universal and evidence-based care bundle to reduce surgical site infections (SSIs). It will support building expert consensus around best practices when selecting the care bundle to reduce surgical site infections in practice. It is hoped that the output will support best practice patient management in Europe. The survey takes under 10 minutes to complete. Please review each statement and indicate your level of agreement with it (tick one box only per statement). Please only complete this questionnaire once. Your anonymous responses will be a source of data for the development of a consensus publication. This project has been initiated and funded by Becton Dickinson and is being managed and delivered by Triducive.
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Content ArticleThis study examines the prevalence of advanced care planning (ACP) for patients undergoing endoscopic, fluoroscopic, laparoscopic or open surgical gastrostomy tube procedures at an academic hospital in the USA. The authors found that only 10.6% of included patients had accessible ACP documents available within their electronic medical record (EMR) and that Black patients had lower rates of ACP documentation. They also highlight an association between ACP documentation and decreased hospital length of stay, with no difference in mortality. The authors recommend the expansion of ACP in perioperative settings.
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Content ArticleIn the fast-evolving realm of contemporary healthcare, surgical techniques have attained unprecedented levels of advancement, leading to substantial enhancements in patient care. However, the journey towards complete recovery extends far beyond the operating room, emphasising the importance of effective postoperative care. In this critical phase, patient partnerships play a pivotal role, ensuring a holistic and personalised approach to recovery.
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Content ArticleAlthough disparities in surgical outcomes are well-documented, understanding of how socioecological factors drive these disparities remains limited. This US study’s objective was to develop and assess the acceptability and feasibility of a comprehensive tool to evaluate socioecological determinants of health in patients requiring colorectal surgery. The authors developed an 88-item assessment tool measuring 31 socioecological determinants of health. It was assessed as having high acceptability and feasibility for patients who required colorectal surgery. The authors concluded that this work will help to identify what research is needed to understand and address surgical disparities.
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EventThis event gives trainees at all levels the opportunity to attend, present and gain feedback on their Audit and QI work. Further lectures will include the McKeown Medal Lecture, a keynote on patient safety and discussion from a Trainee Committee member. Trainees are invited to submit their abstracts for consideration for presentation at this event. Topics for submission: General Surgery, Trauma & Orthopaedic Surgery, Specialties & Common Interest and Patient Safety. Register
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Content ArticleThe Royal College of Surgeons of Edinburgh 'Let's remove it' hub is a platform to tackle bullying and undermining across the surgical workforce.
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Content Article
Surgeon News: Truth and compassion (December 2023)
Patient Safety Learning posted an article in Patient engagement
Surgeons' News is a magazine for surgical, dental and allied healthcare professionals. Published quarterly by the Royal College of Surgeons of Edinburgh, it features comment and opinion from leading professionals, plus reviews and reports on subjects relevant to all career levels. In the article 'Truth and compassion' (page 20-21), David Alderson considers the patient’s perspective on mistakes. -
Content ArticlePostoperative surgical site infection is a serious problem. Coverage of sterile goods may be important to protect the goods from bacterial air contamination while awaiting surgery. This study from Wistrand and colleagues, evaluated the effectiveness of this practice in a systematic review covering five databases using search terms related to bacterial contamination in the operating room and on surgical instruments. No negative effects regarding bacterial contamination were found and the authors conclude that protection with a sterile cover decreases bacterial air contamination of sterile goods while waiting for surgery to start.
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Content ArticleThe Patient Safety Indicators (PSIs) are a set of quality indicators developed by the Agency for Healthcare Research and Quality (AHRQ) providing information on potential hospital complications and adverse events after surgeries, procedures, and childbirth. They have been used for the past two decades in the USA for monitoring potentially preventable patient safety events in the inpatient setting through the automated screening of readily available administrative data. However, these indicators are also used for hospital benchmarking and cross-country comparisons in other nations with different health-care settings and coding systems as well as missing present on admission (POA) flags in the administrative data. This study sought to comprehensively assess and compare the validity of 16 PSIs in Switzerland, where they have not been previously applied.
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Content ArticleBibliometric analysis is a research technique that allows a macroscopic study of the literature surrounding a subject, enabling a prediction of themes that will arise in future research on the subject. In this book chapter, Hülya Saray Kiliç, Assistant Professor at the Bilecik Şeyh Edebali University in Turkey outlines the approach taken in his bibliometric analysis of patient safety in the operating room. His analysis anticipates that the following subjects will be explored in the coming years in relation to patient safety in the operating room. Technology integration and digital solutions Communication and team collaboration Patient education and information Staff training and skill development Risk management and error analysis
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News Article
‘Culture of fear’ at Sussex hospitals trust, Royal College of Surgeons reports
Patient Safety Learning posted a news article in News
Bosses at hospitals where police are investigating dozens of deaths have been criticised for “bullying” and fostering a “culture of fear” among staff in a damning review by the Royal College of Surgeons in England. The review focused on concerns about patient safety and dysfunctional working practices in the general surgery departments at the Royal Sussex County hospital in Brighton and the Princess Royal hospital in nearby Haywards Heath. But the reviewers were so alarmed by reports of harassment, intimidation and mistreatment of whistleblowers that they suggested executives at the University Hospitals Sussex trust may have to be replaced. They concluded: “Consideration should be given to the suitability, professionalism and effectiveness of the current executive leadership team, given the concerning reports of bullying.” The report comes as Sussex police continue to investigate allegations of medical negligence and cover-up in the general surgery department and neurosurgery department, involving more than 100 patients, including at least 40 deaths, from 2015 to 2021. The investigation was prompted by concerns from a general surgeon, Krishna Singh, and a neurosurgeon, Mansoor Foroughi, who lost their jobs at the trust after blowing the whistle over patient safety. Read full story Source: The Guardian, 6 February 2024 -
Content ArticleOn 26 January 2023, University Hospitals Sussex NHS Foundation Trust contacted the Royal College of Surgeons of England to request an invited service review of the Trust’s general surgery department, with a specific focus on upper gastrointestinal surgery, lower GI surgery and emergency general surgery. The request highlighted that the general surgery department was a service which had been under scrutiny for many years, with a history of internal reviews, and concerns being raised by consultant surgeons as well as other members of staff within the department. This report sets out the findings of this review.
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Content Article
An innovative approach to managing behaviour in the operating room (OR) using posters with eye symbols has seen positive results. A team of Australian researchers conducted a successful trial to address offensive and impolite remarks within ORs by implementing ‘eye’ signage in surgical rooms. These posters, placed on the walls of an Adelaide orthopaedic hospital’s operating theatre without explanation, effectively reduced poor behaviour among surgical teams. The lead researcher, Professor Cheri Ostroff from the University of South Australia, attributed this outcome to a sense of being ‘watched’, even though the eyes are not real. The three-month experiment targeted a prevalent culture of bullying and misconduct in surgical settings, a problem pervasive not only in healthcare but across various high-stress industries. Professor Ostroff emphasised that besides affecting staff morale and productivity, rude behaviour also has a detrimental impact on patients, particularly in compromising teamwork and communication during surgery, potentially leading to poorer outcomes. -
Content ArticleAn otherwise healthy patient is taken to the operating room for the removal of a neck mole under monitored sedation. After the patient is given two litres of oxygen through nasal cannula and administered intravenous sedation, an alcohol-based skin preparation is applied to the surgical field. As the surgeon uses electrocautery to coagulate bleeding, a flash occurs, and the surgical drapes ignite. After extinguishing the fire by pouring water on the surgical field, assessment of the patient reveals second-degree burns on the patient’s face. Oxygen from the nasal canula had accelerated the fire and caused the nasal cannula to melt and adhere to the patient’s face. The patient was transferred to the burn unit for care, and ultimately required reconstructive plastic surgery. This case illustrates one type of injury that can be sustained during a surgical fire. The Joint Commission issues this alert to help healthcare organizations recommit to surgical fire prevention.
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Content ArticleEmergency surgical patients are at high risk for harm because of errors in care. Quality improvement methods that involve process redesign, such as “Lean,” appear to improve service reliability and efficiency in healthcare. This study found that lean can substantially and simultaneously improve compliance with a bundle of safety related processes. Given the interconnected nature of hospital care, this strategy might not translate into improvements in safety outcomes unless a system-wide approach is adopted to remove barriers to change.
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Content Article'Failure to rescue' is the rate of death amongst patients with postoperative complications and has been proposed as a perioperative quality indicator. However, there may be significant variation in its definition between research studies. This study in the journal Surgery systematically reviewed all surgical literature reporting failure to rescue rates and examined variations in the definition of the ‘numerator,’ ‘denominator’ and timing of failure to rescue measurement. The authors found that failure to rescue is an important concept in the study of postoperative outcomes, but its definition is highly variable and poorly reported. They highlight that researchers should be aware of the advantages and disadvantages of different approaches to defining failure to rescue.
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Content ArticleIn 2023, the Royal College of Surgeons of England surveyed the UK surgical workforce to identify the key challenges facing surgical teams and to inform workforce planning. Respondents included consultants, surgeons in training, Specialist, Associate Specialist and Specialty (SAS) surgeons, Locally Employed Doctors in surgery (LEDs) and members of the extended surgical team (EST). Advancing the Surgical Workforce reveals a number of interesting insights and paints a picture of a surgical workforce working long hours and in stressful environments. Too many staff are trying to navigate a system which frustrates the delivery of surgical services rather than enabling them. Surgical trainees in particular are increasingly being affected by these pressures.
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Content ArticleEmergence delirium is a temporary but potentially dangerous condition that can occur when a patient awakens after a procedure. In this video, staff at the VA Pittsburgh Healthcare System (VAPHS) share how they implemented a perioperative intervention to reduce the risk of patient and staff harm.
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Content Article
Left-handedness—A handicap for training in surgery? (2010)
Patient-Safety-Learning posted an article in Surgery
Left-handedness was historically considered a disability and a social stigma, and teachers would make efforts to suppress it in their students. Little data are available on the impact of left-handedness on surgical training and this report aimed to review available data on this subject. The review revealed 19 studies on the subject of left-handedness and surgical training. Key findings include: Left-handedness produced anxiety in residents and their trainers. There was a lack of mentoring on laterality. Surgical instruments, both conventional and laparoscopic, are not adapted to left-handed use and require ambilaterality training from the resident. There is significant pressure to change hand laterality during training. Left-handedness might present an advantage in operations involving situs inversus or left lower limb operations. -
Event
Operating Theatres Conference 2024
Sam posted an event in Community Calendar
NHS England have set out an ambitious three-year plan back in February 2022, aimed at tackling the surgical backlog that has reached a record high following the pandemic. With a major milestone on the horizon to reduce wait times over a year by March 2025, we take a look at the progress being made and how trusts around the country are collaborating in order to drive down waiting times. Join Salford Professional Development for their 9th annual conference where industry leading speakers from all corners of the healthcare sector will come together to dive into captivating discussions on the key issues operating theatres are currently facing, alongside how they are driving innovation and utilising technology to support their practices. Hear unravelling insights on how to enhance sustainability, boost surgery productivity, amplify effectiveness, and work together in order to drive down the surgical backlog, ensuring a person-centred approach. This isn't just theory – it's practical wisdom you can immediately apply to your own surgical team. Case study examples and our panel of experts will illustrate how teams have transformed their practice and brought innovative solutions into play such as the HVLC delivery, GIRFT, Robotics and Sustainability action plans, and how they are tackling challenges facing the trusts theatres and beyond. Register -
Content ArticleThe rise of the #TheatreCapChallenge in 2017, which saw participants donning surgical caps labelled with their names and roles, promises to be a seemingly simple intervention aimed at improving operating theatre communication and patient safety. This narrative review strives to expand upon the perceived and studied benefits of this intervention and address potential concerns that have arisen with the use of these name and role-labelled surgical caps.
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News Article
Bariatric tourism care costs NHS more than actual surgery
Patient Safety Learning posted a news article in News
People who go abroad for weight-loss surgery, and then need urgent medical care back in the UK, cost the NHS more than it costs to carry out the operation itself, according to new research. A study featuring five London hospitals recorded the details of 35 people who had suffered complications after travelling abroad for gastric surgery during 2022. The data, shared with the BBC's Disclosure programme, shows the patients suffered from a range of symptoms including severe malnutrition, vomiting, sepsis, hernias and haemorrhaging. Five of them needed feeding tubes inserted, while the average stay in hospital was 22 days. The interventions at the five hospitals for the 35 patients cost the NHS a total of £560,234, or £16,006 per patient, in 2022. The equivalent amount would have covered the cost of about 110 bariatric surgeries in UK hospitals. Consultant bariatric surgeon Omar Khan, one of the lead authors of the study, said the paper was intended "to try and quantify" the effect on the NHS of increasing numbers of people going abroad for weight-loss surgery - sometimes known as bariatric tourism. "We know that the waiting lists in the NHS are unfortunately long. We also know that there are new units, particularly in Turkey, which have been set up to cater for an international market," he explained. "We focused on patients with major complications, patients who were severely ill. They had leaks from the stomach, they had bleeding, they had infections. A significant portion required further surgery and some required revisional surgery." Read full story Source: BBC News, 15 January 2024 -
Content ArticleAntonio Gonzalez speaks to Susan Standford for the Yale Anesthesiology podcast on intraoperative pain. Susanna is a patient who experienced intraoperative pain, and knowing she was not alone, she has actively raised awareness of this issue. In her own words, “Being able to feel major abdominal surgery is every bit as horrific as it sounds.” They discuss neuraxial anaesthesia for CS, guidance on testing and managing blocks, women being labelled ‘anxious’, outcome measures and targets.
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Content ArticleIleostomy is a common treatment option for various gastrointestinal conditions. This study in Surgery aimed to examine how receiving care at different facilities might increase the risk of post-discharge complications and readmission following ileostomy. The authors used a national cohort to explore the associations of care fragmentation among ileostomy patients experiencing adverse outcomes and increased hospitalisation.
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Content ArticleThe opioid epidemic has been declared a public health emergency in the US, with major news outlets calling operating rooms “unintended gateways.” In response to this emergency, a team from Thomas Jefferson University sought to decrease their organisation's contribution to the potential diversion pool—the opioids surgeons prescribe to patients which go unused. This article in the journal Patient Safety looks at the research and improvement work undertaken by the team, who concluded that surgical departments can develop opioid reduction toolkits aimed at reducing the potential diversion pool of opioids in communities.
