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Found 25 results
  1. Content Article
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    This document aims to achieve the following: ➤ Outline the data received, the severity of reported patient harm and the timing and source of reports ➤ Provide feedback to reporters and encourage further reports ➤ Provide vignettes for clinicians to use to support learning in their own Trusts and Boards ➤ Provide expert comments on reported issues ➤ Encourage staff to contact SALG in order to share their own learning.
  3. News Article
    Lego could be used as a practical tool to train doctors in anesthetic skills according to new research that has shown a simple task using the building bricks can help improve technical skills—a finding that could improve medical training and patient safety. Scientists from the University of Nottingham's School of Psychology and School of Medicine developed a task where people copied shapes using bricks that they could see in a mirror. They found this simple training improved student performance in an ultrasound-guided regional anesthesia task. The results of the study have been published in British Journal of Anesthesia Read the full article here
  4. Content Article
    Key findings: 44% of respondents are not confident in their hospital’s ability to provide planned surgery safely while managing COVID-19 demand during future surges. Nearly two-thirds of respondents (64%) have, to some extent during the last month, suffered mental distress because of additional work related stress due to COVID-19. Nearly nine in ten trainees (89%) strongly agree that the pandemic is affecting their training opportunities, career and professional development. Key recommendations: NHS Improvement should publish a new People Plan, with the investment and teeth needed to support staff welfare and wellbeing, build resilience and address inequality. NHS Improvement should identify, train and maintain the skills of cross-specialty ‘reservists’ who can support COVID-19 surges, and escalation plans should rapidly be made, with the support of the Medical Royal Colleges. The Government should make a commitment to additional, and sustainable, investment in the resources, facilities and staff needed to support a return to pre-COVID-19 activity. Hospitals and trusts may need to cohort specialist surgery on a regional basis; and there is merit in a ‘clean hospital’ approach. Other locations for managing planned surgery or COVID-19 care should be considered, with sufficient resources that are separate from those within the NHS. Efforts should be made to support hospitals in ensuring that sufficient numbers of anaesthetic, theatre, perioperative care and ward staff are free to return to their routine work activities. A transparent, flexible, approach to re-scheduling assessments and teaching should be developed, with clear guidance on how missed learning opportunities will be delivered.
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    Pain affects all of us on occasion, but thankfully can be controlled or abates over a short period of time. For some, pain is ongoing to the degree of becoming persistent and for many is it significant. An estimated 14 million people in the UK live with chronic pain. Pain therefore is a frequently presenting complaint across a wide range of health care settings. It presents to primary and community care and specialist (secondary) and specialised (tertiary). For most, their pain is treated, managed or resolved within the primary care and community setting. The pain management of those for whom this does not happen must be scaled up, which means referral to more specialised care. This referral should be timely; persistent pain does not go away but develops and accelerates over time through well recognised neurophysiological processes. The principle driving these standards is to have an acceptable level of care in pain management which is consistent, both geographically and from initial to escalating levels of care. These standards are multidisciplinary, that is to say they apply to all clinical professions to include nursing, physiotherapy, clinical psychology, occupational therapy and medicine. It is intended however that this work is not only a clinical guideline for those working to deliver pain management but that it is a reference and framework for those planning or negotiating pain services in the wider sense, particularly commissioners.
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    This article is about accepting that our working lives are difficult, that this is a big part of the attraction of our work and that it is wise to look at ways in which both team and personal resilience can be improved.
  11. Content Article
    The investigation identified: There is an opportunity to clarify the consent requirements for diagnostic imaging facilitated by a general anaesthetic. There is variation in the information given to patients regarding anaesthesia at the point of referral for an MRI scan under general anaesthetic. The observations and examinations to be routinely performed in pre-anaesthetic assessment are not defined nationally. The investigation found variation in the hospitals it visited. Children coming into hospital for an MRI scan who had been assessed as fit for anaesthetic were perceived as “well” by ward staff. Children with autism, learning disabilities and/or learning difficulties often find clinical environments distressing, which may be reflected in their physiological observations. This may result in diagnostic overshadowing, where problems such as autism (or a medical condition) are attributed as the cause of other new problems, rather than considering other underlying causes, thereby leaving other co-existing conditions potentially undiagnosed. Children with autism, learning disabilities or learning difficulties may benefit from reasonable adjustments being made when attending hospital. Electronic flagging systems can help staff identify patients who may benefit from reasonable adjustments. Hospital passports provide valuable information to assist with implementation of these adjustments. The model of care for learning disability nursing teams is not standardised nationally. There is an opportunity to enhance the existing published guidance available to assist clinicians involved in general anaesthetics to prepare for adverse events in the MRI scanning environment. Professional networks for anaesthetists provide the opportunity for shared learning and consensus regarding best practice. It is challenging to comply fully with the existing published standards for anaesthetic equipment used in MRI environments.
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    These guidelines by the Association of Anaesthetists are a concise document designed to help peri-operative physicians and allied health professionals provide multidisciplinary, peri-operative care for people with dementia and mild cognitive impairment. They include information on: involving carers and relatives in all stages of the peri-operative process administering anaesthesia with the aim of minimising peri-operative cognitive changes training in the assessment and treatment of pain in people with cognitive impairment.
  15. Content Article
    Key recommendations All patients should be informed of the risks of general anaesthesia, including the possibility of AAGA, before their surgery. When consenting patients, practitioners should use a form of words that proportionately conveys the risks of AAGA. Consent for sedation should emphasise that the patient will be awake and therefore may have recall for at least parts of the procedure. Practitioners should identify certain situations or certain patient factors as constituting a higher risk for AAGA (including organisational factors such as overbooked or reorganised surgical lists) and highlight these at the WHO premeet/team brief. During induction of anaesthesia, practitioners should adhere to suitable dosing of intravenous agent, check anaesthetic effect before paralysis or instrumentation of the airway and maintain anaesthetic administration, including during transfer of patients (which is facilitated by a simple ABCDE checklist). If AAGA is suspected during maintenance (e.g., by patient movement), prompt attention should be paid to giving verbal reassurance to the patient, increasing analgesia, and deepening the level of anaesthesia. For cases requiring paralysis, the minimum dose of neuromuscular blocking drugs (NMBDs) that achieves sufficient neuromuscular blockade for surgery should be used, and the nerve stimulator is an essential monitor to titrate the dosing of NMBDs to this minimum. Where total intravenous anaesthesia (TIVA) is used, practitioners should adhere to the relevant recently published guidelines. At emergence, practitioners should first confirm that surgery is complete, then ensure NMBDs are adequately reversed before allowing the patient to regain consciousness. Practitioners should then manage the patient experience, particularly during awake extubation, by speaking to the patient. Cases of AAGA should be managed using the NAP5 pathway as a guide.
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    This course, is for all members of the multidisciplinary team who provide airway support to patients, or care for patients with a compromised airway. This includes anaesthetists, anaesthesia associates, operating department practitioners, nurses, physiotherapists, adult and paediatric intensivists, prehospital and emergency medicine physicians, paramedics, head and neck surgeons and members of the cardiac arrest team. By the end of the course, you'll be able to: improve your strategies to deal with the unexpected difficult airway and explore guidelines to use in special circumstances. identify the key learning points and recommendations from the 4th National Audit Project (NAP4) on major complications of airway management in the UK. apply the principles of multidisciplinary planning, communication and teamwork in shared airways interventions. describe the technical and non-technical aspects of safe airway management for patients undergoing elective or emergency surgery, and the critically ill. engage in a global discussion on airway matters with health professionals from around the world.
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    This short video, by Abertawe Bro Morgannwg University Health Board, demonstrates the Soothing Patient Anxiety (SPA), a unique approach to co-production in meeting the needs of complex patients requiring a surgical intervention.
  25. Content Article
    The aims of this study were to: eradicate accidental administration of medication into the arterial line and improve arterial line safety estimate the prevalence of wrong route arterial line drug errors conduct primary research implement the NIC in the East of England assess cost effectiveness and the uptake of the NIC in the East of England understand the reasons for barriers to adoption.
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