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Found 117 results
  1. News Article
    A fifth of UK hospitals were forced to cancel operations during the three days in July last year when temperatures soared, research suggests. The findings, published in a letter to the British Journal of Surgery, are based on surveys from surgeons, anaesthetists and critical care doctors working during the heatwave from July 16-19 2022, when temperatures reached as high as 40C in some parts of the country. The researchers received 271 responses from 140 UK hospitals – with one in five (18.5%) reporting elective surgeries being cancelled due to the heatwave. The respondents also said surgical services were poorly prepared for heatwaves, with 41% of operating theatres having no means to control ambient temperature, while more than a third (35.4%) reported making changes to maintain routine surgical activity during the period. These include delayed discharge of high-risk patients, changes to surgical teams, selecting lower-risk patients to have surgery, and restricting surgical activity to day cases. Other measures included longer staff breaks, extra fluids to patients, and surgeries earlier in the morning when temperatures were lower. Read full story Source: The Independent, 23 March 2023
  2. Event
    The provision of safe and quality care is the most fundamental principle to consider for patients in perioperative practice. Alongside this commitment, is the safety and welfare of all staff and visitors within the setting. Risk assessment, staffing ratios, competency and skill are crucial to ensuring that the intended outcome for patients is achieved as far as is reasonably practicable. The discussion will outline how this can be achieved utilising the recommendations by the Association for Perioperative Practice (AfPP). Learning outcomes: Understanding risk and the process of risk assessment in perioperative practice. The components of a safe perioperative environment. How to calculate a safe staffing model for your environment based on the AfPP standard. Register
  3. News Article
    Pradeep Gill can see very little of the intense activity around him. He is leaning back in a reclining chair inside one of Heatherwood Hospital's operating theatres. Buzzing around him is the operating team, led by consultant orthopaedic surgeon Jeremy Granville-Chapman. For the surgeon and his team, this procedure is the very definition of routine. They have carried out more than 1,000 joint operations in the past 10 months. Heatherwood Hospital, part of the Frimley Health NHS Foundation Trust, is a specialist elective hub where patients can come in for routine but life-changing surgery at a super-charged pace with theatres working at full tilt, six days a week. It is busy. But it is a good-busy, not the bad-busy we have come to associate with the NHS during this winter crisis. The site opened in March last year and Frimley's hospital executives are keen to stress the impact it has made. "As a specialist planned care facility, Heatherwood has been able to perform surgery six days a week with four out of its six state-of-the-art theatres dedicated to orthopaedic procedures," it said in a press release. "The hospital has also successfully reduced the length of time patients stay in hospital, with 40% of patients safely discharged within 24 hours." This is the practice the NHS wants to adopt as it battles a record seven-million-strong waiting list. Heatherwood can do that because the hospital is ring-fenced from acute pressures that affect other hospitals, as one its most senior orthopaedic surgeons, Mr Rakesh Kucheira, explained. "We have now realised that winter pressures are 12 months not just three months, which means the acute sites are not going to be able to do planned activity that they planned for, so we've got to create more space," he said. Read full story Source: Sky News, 9 March 2023
  4. Event
    Understanding human factors will allow surgical teams to enhance performance, culture and organisation of operating theatres. This one day masterclass will concentrate on human factors within the operating room. This is aimed at all theatre staff. It will look at why things go wrong and how to implement change to prevent it from happening again or mitigate the risks. This Masterclass will focus on systems to improve patient safety as well as looking at never events and how to learn from them using a human factors approach. Key learning objectives: Safety culture Human factors Leadership Never events This masterclass is aimed at all theatre staff. Register
  5. News Article
    High levels of microplastics have been found in operating theatres by researchers who highlighted the “astoundingly high” amounts of single-use plastic used in modern surgical procedures. A team from the University of Hull found the amount of microplastics in a cardiothoracic operating theatre was almost three times that found in homes, and said this identifies another route through which the tiny particles can enter the human body, with unknown consequences. The study, published in the journal Environment International, is the first to examine the prevalence of microplastics in surgical environments. The team analysed levels in the operating theatre and the anaesthetic room in cardiothoracic surgeries and discovered an average of 5,000 microplastics per metre squared when the theatre was in use. Jeanette Rotchell, professor of environmental toxicology at the university, said the types of microplastic particles identified relate to common plastic wrapping materials and could also come from blister packs, surgical gowns, hairnets and drapes for patients. Prof Rotchell said: “Although we know microplastics are in the air in a variety of settings, we can’t yet say what the consequences are or whether microplastics are harmful to health. Researchers have yet to establish this. Read full story Source: The Independent, 27 January 2023
  6. Content Article
    NatSSIPs2 consists of two inter-related sets of standards: The organisational standards are clear expectations of what Trusts and external bodies should do to support teams to deliver safe invasive care. The sequential standards are the procedural steps that should be taken where appropriate by individuals and teams, for every patient undergoing an invasive procedure. The NatSSIPs2 have evolved to have less emphasis on tick boxes or rare ‘Never Events’ and now include cautions, priorities and a clear concept of proportionate checks based on risk. We recognise that ‘teams’ change or may be newly formed on the day of a procedure, and therefore require clear processes. NatSSIPs2 should form the basis of improvement work, inspections and curricula. Key principles in NatSSIPs2 include: The concept that NatSSIPs2 will help achieve of the triple goals of improved patient safety, better team-working and enhanced efficiency. The categorisation of invasive procedures into major or minor procedures, each requiring different checks which are proportionate to the risk of harm. The benefit of ‘Standardisation, Harmonisation, and Education’ across invasive specialty processes. The need to consider human factors with systems thinking, culture, psychological safety and team-work to underpin NatSSIPs2 implementation. An update of the WHO Five steps to safer surgery of Team Brief, Sign In, Time Out, Sign Out and Handover/Debrief to include three more steps to make the Sequential Standards (Steps): Consent and Procedural verification; Safe use of implants; and Reconciliation of items (to prevent retained foreign objects). ‘The NatSSIPs Eight’ should be in place for every relevant patient. That checks performed by an engaged team enable communication and save misunderstandings, reduce risk, provide clarity and set expectations The central role of the patient as a participant in safety checks. The need for a learning safety system supported by insight, involvement and improvement. A structure of People, Processes and Performance within the organisational standards The requirement for adequately resourced organisational leadership and support for safety. The NatSSIPs2 have been written by practising clinicians, from across the four UK nations, across disciplines, professions and organisations, with patient and organisational input and published by the Centre for Perioperative Care. They incorporate safety science and learning from all UK nations’ patient safety strategies and major reports and investigations. Are you a healthcare professional interested in learning more about NatSIPPs? On the hub we host the National NatSIPPs Network, a voluntary group of healthcare professionals aiming to reduce the number of patient safety incidents related to invasive procedures. You can join by signing up to the hub today. When putting in your details, please tick ‘National NatSIPPs Network’ in the ‘Join a private group’ section’. If you are already a member of the hub, please email hello@patientsafetylearning.org.
  7. Content Article
    Prevention of surgical site infection (SSI) remains a main priority in operating theatres. This has previously led to the introduction of practices, often referred to as rituals and behaviours and sometimes labelled as ‘myths’. Some of them are not underpinned by sound scientific evidence, but they are established in everyday practice, and considered by many as traditional to help ensure discipline and professionalism in the operating theatre. Previous Healthcare Infection Society guidelines were published 20 years ago, and they aimed to debunk some of the practices. Since then, new technologies have emerged, and an update was required. These new updated guidelines, produced in collaboration between Healthcare Infection Society and The European Society of Clinical Microbiology and Infectious Diseases, used NICE-accredited methodology to provide further advice on which practices are unnecessary. Specifically, they discuss the current available evidence for 40 different rituals which are commonplace in the operating theatre and highlight the gaps in knowledge with recommendations for future research. As part of the consultation, we will be hosting a webinar on Wednesday 25 January, 17:00 - 18:00. During the webinar, the attendees will have an opportunity to ask questions to a panel who were involved in the guideline development, and give their feedback.
  8. Content Article
    The authors conducted a literature search to identify quality improvement initiatives that aimed to decrease the environmental impact of the operating room while reducing costs. Data were included from 23 unique quality improvement initiatives that described 28 interventions. Eleven (39.3%), eight (28.6%), three (10.7%), and six (21.4%) interventions, respectively, were categorised as refuse, reduce, reuse and recycle. The researchers found that the potential annual cost savings varied from $2,233 (intervention: transition to a waterless surgical scrub; environmental impact: 2.7 million litre of water saved annually) to $694,141 (intervention: education to reduce regulated medical waste; environmental impact: 30% reduction in regulated medical waste), although the methods of measuring environmental impact and cost savings varied considerably among studies. "The opportunity to reduce our carbon footprint falls squarely on us, and I see surgeons taking a prominent role in leading efforts, not just locally with their green implementation teams, but in setting national standards and policies that will move this effort forward for an overall sustainable way of approaching health care delivery," a coauthor said in a statement.
  9. Content Article
    December issue Delphi Study Round One – A study across NHS England Hospital Trust operating theatres. Managing NHS backlogs and waiting times in England. Steroid injections worsen knee arthritis, according to two new studies. First robotic hysterectomy completed in Wales. World’s first algae-based local anaesthetic another step closer to reality. How new bacterial species siscovered in Asian soil could help battle against antibiotic resistance November issue New research calls for all health and care staff to be trained in AI Reducing noise in operating theatre improves children’s behaviour after surgery, study finds Brain tumour patient operated on awake while playing saxophone No difference between spinal versus general anaesthesia in patients having hip fracture surgery finds study October issue Why are intra-operative surgical Never Events still occurring in NHS operating theatres? Radical rethink needed to improve safety in health and social care. World Anaesthesia Day 2022: History, significance, celebrations and theme. £4 million “space-age” operating theatre will help bring down eye surgery backlog. Two thirds of nurses choosing between food and fuel as cost of living bites and one in five turn to food banks. ‘An inspirational story’: Hartlepool cleaner changes career to become hospital nurse. September issue Service evaluation of the current World Health Organisation’s Surgical Safety Checklist in spine surgery at the University Hospitals of Derby & Burton. Could this lead to a change in NHS Improvement? The Anaesthetic Gas Scavenging System Project. Cancelled operations could be prevented by an earlier anaemia test and time to prepare. The top 10 things experts need you to know about screening during Gynaecological Cancer Awareness Month September 2022 £35.5m for New Friarage Hospital Operating Theatres. New robotic surgical system revolutionises patient care at UHCW. Insourcing: Giving NHS operating theatre teams a helping hand. Arterial stiffness raises blood pressure in adolescents via insulin resistance. Birmingham’s Public Health Chief is among sector leaders to receive university honours,
  10. Content Article
    Delphi study participants Participants were from the seven regions identified by NHS England. The study revisited several questions from round one to gather further knowledge and understanding of the responses received. The debrief was not undertaken due to all team members not being present, staff wanting to go home, current culture and list overruns. Key initial findings of Delphi study round two The second round facilitated a broader engagement in the literature, as well highlighting a number of reasons why full compliance has not yet been universally achieved. The Delphi study is intended to be an exploratory approach to inform a more in-depth doctoral research study intended to improve patient safety in the operating theatre, inform policy making and quality improvement. Participants felt that training on the checklist should be mandated and take place annually. They also felt that learning from other organisations was key, and that the NHS needs to revise how the checklist is currently being delivered by being more proactive and by providing the foundations of an electronic checklist to all NHS trusts. Participants felt that a lack of direction from senior NHS leaders and multidisciplinary team working may impact on why the checklist is not always completed. With regard to Local Safety Standard for Invasive Procedures (LocSSIPs) and their introduction, participants either strongly agreed or agreed that NHS trusts must be held accountable for ensuring they are implemented. Participants overwhelmingly felt that surgical fires (non-airway) should be classed as a Never Event. To ensure cyclical learning occurs, details of each and every Never Event should be provided to all NHS Trusts Context of the Delphi study The literature to support a greater understanding of the impact on the implementation of checklist is still emerging. The review to date is not intended to be exhaustive, but begins to frame further questions, identify some of the contextual issues and plan for the third and final Delphi round. The use of a Delphi study was born out of curiosity to see to what the theatre safety experts (matrons, managers and clinical educators) think of the current checklist since its introduction across England thirteen years ago. Contextually it can be anticipated that invasive procedures in the NHS and indeed in healthcare globally will continue to rise, in part as a result of the advancement of new supportive technologies, such as robotics and enhanced minimally invasive approaches. Furthermore, access to these treatments is more readily available to different patient groups whose needs and longer-term rehabilitation can be more complex and demanding. While in this regard clinical outcomes, quality of life, and indeed life expectancy can be improved and extended, this is only the case if surgery takes place within optimum conditions. Taking all other factors into consideration, the number of Never Events continues to remain a constant yet stubborn patient safety concern. Future work - Delphi study round three The author is not yet in a position to draw further conclusions as the final Delphi study round is aiming to draw together the results from the first and second rounds, as well as asking further research questions. In acknowledging that the participant rate was 16%, the study cannot claim to know how other Trusts are utilising the SSC. Given the timing and context in which the Delphi study was carried out, it is appreciated that other priorities could have had an impact on trusts' ability and willingness to participate. Nevertheless, it was perhaps surprising to discover over a decade after the initial launch, that there is a lack of direction/leadership and that lack of multidisciplinary team engagement is still an issue. LocSSIPs 2 are due to launch early in 2023 and in order for this to be successful, training must take place, but most importantly NHS England need to hold trusts to account for not introducing them. A long-standing debate around whether surgical (non-airway) fires should be classified as a Never Event was asked to the theatre safety experts, with an overwhelming response agreeing that this type of event should be added to the reportable Never Event list. The study has also raised questions that will be answered in the third Delphi round.
  11. News Article
    Thousands of hospital surgeries are likely to be cancelled as NHS leaders prepare for unprecedented strike action, The Independent has been told. Most operations apart from cancer care are likely to be called off when nurses take to the picket line, with NHS trusts planning for staffing levels to be similar to bank holidays. Multiple sources say they are almost certain that the upcoming Royal College of Nursing ballot will result in strike action. Results are expected to be finalised on Wednesday. “Trusts are looking at the totality of it. It’s the waiting list that is going to be hit, massive questions over waiting lists, and we’re going to lose days of activity in terms of addressing that growing pressure. “The more we see strike action the harder it is, the risk is [that] the rate of recovery [of waiting list] slows.” They added: “The unions normally provide bank holiday cover and maintain emergency service basically.” Read full story Source: The Independent, 7 November 2022
  12. News Article
    Surgeons in a London hospital have performed a week’s worth of operations in a single day, pioneering a technique that could be used to help reduce the NHS backlog. The team at Guy’s and St Thomas’ hospital performed eight robot assisted radical prostatectomy operations in under ten hours, the highest number performed in a single day in the UK in one hospital. High Intensity Theatre lists (HIT) focus on one procedure at a time and seek to minimise the turnaround time between operations. Using two theatres, the surgeon can go between cases without having to wait for a patient to come in. This helps to cut the significant amount of time it takes for medics to anaesthetise a patient, set up equipment in the theatre and help them to recover – a process which sometimes takes longer than the operation itself. The team at Guy’s assembled a large team for the HIT list, which took place on 8 October. Each theatre had a team of around 1.5 times its usual size and staff were given very specific roles. By the time the list had reached the third patient, the turnaround time between operations had dropped as low as 32 seconds. Behind the scenes, staff in the control room used Proximie software to monitor activity in the theatre in real time. Dr Ben Challacombe, a consultant urological surgeon who performed the operations with his surgical consultant colleagues Paul Cathcart, Christian Brown, and Prokar Dasgupta, told the Standard that the success of the HIT list had given staff a “huge” morale boost. “Everyone pulled together to do the job, it really helped to energise the team. Morale has been hit by Covid and other issues, but people feel galvanised by doing something different.” Read full story Source: Evening Standard, 29 October 2022
  13. News Article
    The push to tackle the hospital backlog is being undermined by the struggle to get services back to full strength. A BBC analysis shows the expected surge in new patients has not yet happened. Instead, the waiting list in England is growing because the NHS is carrying out fewer operations and treatments than it was before Covid, despite a government push to boost capacity. Surgeons said it was really frustrating as operating theatres were not being used due to a lack of beds and staff. They say it is not unusual to find surgery cancelled at the last minute as staff are unavailable or intensive care and ward beds are full with other patients. "It's tough on patients and tough on staff who want to get on and treat patients," said Tim Mitchell, vice-president of the Royal College of Surgeons of England. "Without treatment, the health of patients can deteriorate. Not only do we need to get back to where we were before the pandemic, we need to do more if we are going to tackle the backlog." Read full story Source: BBC News, 13 October 2022
  14. Content Article
    To 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.
  15. Event
    Treating trauma can be traumatic. The UK now has over 30 major trauma centres which treat more than 40,000 patients with traumatic injuries each year. For people under the age of 40, trauma remains a leading cause of death, and trauma survivors often experience life-changing injury and long-term disability. This study day examines the impact of various traumatic injuries on patients and the teams who care for them. Exploring burns, orthopaedic and battlefield trauma, as well as how to manage mass casualty events, you’ll learn about a wide range of trauma care scenarios. The speakers will outline how battlefield experience can be adapted for frontline work in within the NHS, with a key focus on the mental, physical and practical skills required to manage trauma to achieve the best outcomes for both patient and practitioner. The goal is to provide you with theory and practical skills to help you manage the mental and physical aspects of trauma in different settings. The sessions will also support you with understanding how skills learnt in one area can be transferred to another. Topics include: Treatment of acute burn injuries. The role of the Orthopaedic Trauma Coordinator. Introduction to AO Trauma Principles. Mass Casualty Events and the Citizen Aid App – with practical demo. Trauma and resilience in the armed forces: A Captain’s perspective. Trauma management on the battlefield. Register
  16. Content Article
    Ian Lindsley, Secretary of the SHBN, began by welcoming those on the call and talking through the speakers and the presentations. The first presentation was given by Martin McMahon of the Health and Safety Executive on the Post Implementation Review (PIR) of the Sharps Regulations 2013 by the HSE. The PIR will assess post implementation effectiveness of these legislative regulations against the objectives as laid out in the original impact assessment and must be concluded, submitted and agreed by Minister by 10 May 2023. The HSE are currently engaged in the evidence and analysis process to inform the final report to Parliament and asked those on the webinar and others to complete the questionnaire. The next presentation was given by Terry Grimmond, Consultant Microbiologist, and provided attendees with an update on the progress of the new national Blood and Body Fluid Exposures (BBFE), or sharps injuries, survey and database. Attendees were informed of the importance of the creation of a national database for sharps injuries. To date, thirty trusts have responded to the survey which has now been shortened to three key questions in order to encourage further responses. Trusts informed the BBFE working group that workloads are currently incredibly high so it was agreed a shorter survey could increase response rates by taking significantly less time than the original 20+ question survey. The data so far indicates a lower rate of sharps injuries than perhaps expected, especially when compared with the RCN survey published in 2021. Terry called for more trusts to complete the survey and encouraged attendees to reach out with any questions or queries. The third presentation continued with the theme of sharps injuries and healthcare worker safety and was given by Rose Gallagher, Professional Lead Infection Prevention and Control and Leona Cameron, Head of Health, Safety and Wellbeing, Royal College of Nursing. The presentation explained, in terms of sharps injuries, it is not just healthcare staff who are at risk; ancillary staff who work in healthcare environments or handle healthcare waste or equipment are also at risk. The RCN Survey published in 2021, with responses from more than 7,000 members, found that 63% have had a sharps injury in their career. Employers have a legal duty to carry out a suitable and sufficient sharps risk assessment in order to identify and implement adequate control measures to reduce the risk of harm. Controls in practice aim to change the behaviour of workers to reduce exposure to occupational hazards and should be implemented widely. The presentation concluded with a note on sustainability – healthcare is the 5th largest greenhouse gas producer globally and therefore action to reduce its climate warming emissions through procurement, transport, waste management and energy consumption are key. The fourth presentation was given by Lindsay Keeley, Patient Safety & Quality Lead of the Association for Perioperative Practice (AfPP) and covered the topic of theatre safety. The presentation explained the current legislation in place around theatre safety and focussed on risk management and safety in the perioperative environment. The point was made that risk management and patient safety is one of the most fundamental principles of service delivery in healthcare today especially in the operating theatre. There is a minimum benchmark standard of five staff for each operating theatre depending on skill mix, speciality, complexity, and patient care and those staff have a duty to take reasonable care of their own health and safety and that of others who may be affected by their actions. The presentation concluded by setting out the six key elements of effective safety programmes: hazard assessment, training, policies & procedure, accident investigations, measurement and management commitment. Lindsay informed attendees that the AfPP provides evidence-based guidance, standards and recommendations on risk management to enhance perioperative practitioners’ knowledge on safe handling and positioning of patients in the perioperative environment. The final presentation was a case study on surgical smoke and creating a smoke free environment in theatres by Lisa Nealen, from the Queen Elizabeth Foundation Trust, Newcastle. Lisa spoke about her own personal experiences of not only the hazards of surgical smoke but also the health hazards posed by surgical fluid waste and explained why it is so important that we create safer theatre environments for patients and staff. The presentation detailed how to create a smoke free operating theatre and the guidelines which have been adopted which help to deliver a safer working environment.
  17. News Article
    Surgical blunders have soared 60% in five years – and extreme mistakes are now a daily occurrence in the NHS. Some 13,921 people were treated for damage caused by botched operations in the year to March 31 – up from 8,695 in England in 2016/17. Cases involved an “unintentional cut, puncture, perforation or haemorrhage”. Separately, a report from NHS England shows 134 patients fell victim to so-called Never Events from April 1 to July 31. Extreme errors included two women left infertile after their ovaries were wrongly removed. Injections and invasive tests were given to the wrong patients and in 39 cases foreign objects, such as drill bits and wires, were left inside bodies. There were 57 cases of surgery on the wrong body part and 12 instances of patients being given the wrong implant or prosthesis. The Royal College of Surgeons in England said: “If the system is overstretched, there is a risk that mistakes will happen.” Rachel Power, chief executive of the Patients Association, said: “When Never Events occur, the physical and psychological effects can stay with a patient for life.” Read full story Source: The Mirror, 1 October 2022