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Found 77 results
  1. News Article
    Death rates for a major emergency abdominal surgery are almost eight times higher at some outlier hospitals compared with top performers, a national report has found. A review of emergency laparotomies in England and Wales has identified six hospitals as having much higher-than-average 30-day mortality rates for the surgery between December 2018 and November 2019. Hospitals identified by the annual National Emergency Laparotomy Audit as having the best outcomes, such as Stepping Hill Hospital and Salford Royal Hospital, had mortality rates of around 2.5%. But the review, published this month, found some hospitals, such as George Eliot Hospital, had 30-day mortality rates for emergency laparotomies as high as 19.6% The national 30-day mortality rate for emergency laparotomies in England and Wales was 9.3% last year and has fallen consistently since the review started in 2013. Some trusts told HSJ that data collection issues were partly to blame for the high mortality rates recorded in the review. Read full story (paywalled) Source: HSJ, 20 November 2020 .
  2. Content Article
    C-Diff Dentures in the healthcare setting Discharge instructions Drug allergies End of life care Falls at home Getting the right diagnosis Handwashing Hospital ratings Influenza (the flu) Latex allergies Medical records Medication safety at home Medication safety: Hospital and doctor's office Metric-based patient weights MRI safety MRSA Neonatal abstinence syndrome (NAS) Norovirus (stomach flu) Obstructive sleep apneoa Pneumonia Pressure injuries (bed sores) Sepsis What is an MRI? Wrong-site surgery
  3. Content Article
    Let’s imagine that you’re in your early 70s and you have a few chronic health problems. Your mobility has been getting worse due to arthritis in your hip. You’ve tried pain killers, had some physiotherapy and now use a stick but the pain and restriction in your function is getting you down. Your GP refers you to your local hospital to see an orthopaedic surgeon to discuss surgery. How do you know if having surgery is the right decision for you? On the face of it the decision may seem easy; have the surgery to cure the problem. Indeed many, or even most of us, would choose this option to be rid of the pain. What, however, about the short- and long-term risks of surgery? We know that with increasing age, and in particular with increasing number of chronic health problems, the medical risks associated with surgery increase. That is to say, the surgical procedure, the hip replacement itself, may go smoothly but the overall process of surgery, anaesthesia and hospitalisation may make existing medical problems worse or create new ones. This is a situation that hundreds of older people face each week in the UK, and as the population ages and advances in medicine and surgery increase, will become even more common. However, quantifying these risks has been a major challenge for researchers to date. The Optimising Shared Decision Making In high RIsk Surgery (OSIRIS) research programme is funded by the National Institute of Health Research (NIHR). We’re focussing on the group of older patients who often have significant chronic health issues and are at greater risk of complications around and after surgery. We’re asking some big questions about how these patients and their doctors currently make decisions about major surgery and how we could improve that process. We are also looking at the data on over 5 million patients to truly understand what happens to older patients in the year after surgery. This will then allow us to develop a tool to forecast and present risks associated with surgery. This will be tested in a trial across UK hospitals, to see if it improves the decisions people make. Presenting a more detailed risk forecast to patients will help them to understand how the choice about surgery may specifically impact them and their lives and so support genuine shared decision-making. Surgery improves the lives of millions of people a year around the world, but it is not without risks and patients and doctors need to be more aware of these and be able to discuss them openly. The outputs of the OSIRIS research programme will help increase that awareness and allow people to make informed decisions where all the risks can be weighed up against all the benefits. Shared decision making and informed consent are hot topics right now in the health care professions and in the media. We’re 2 years into our 6-year research programme and we already know so much more about the decision-making process and how we might improve this. Ultimately, doctors need access to better, more individualised information and patients need to be presented this information in a way that is clear and comprehensible. We are very hopeful that OSIRIS will provide a model to empower patients to make a major decision that is right for them. Watch this space! You can find out more about the research by visiting the OSIRIS Programme website or following @osirisprogramme on Twitter. If you'd like to share your thoughts on any of the issues raised in the blog or another patient safety topic, please get in touch with Patient Safety Learning by emailing content@pslhub.org or leave a comment below.
  4. Content Article
    In 2012, the Pennsylvania Patient Safety Authority published an analysis of surgical fires reported through its database for the primary purpose of determining whether surgical fires continued to be a problem. In 2018, the Authority published an update, including analysis of events reported from 1 July 2011 through to 30 June 2016. The model suggests a 71% decrease in the patient risk of surgical fires from 2005 to 2016. The analysts noted that in 2005, there was about one surgical fire per month in Pennsylvania, and, if the downward trend continues, the rate will be only one surgical fire per year in 2032.
  5. Content Article
    Detailed results from the report show: - The regions that have seen the sharpest decline in the number of people referred for routine elective care during the first 8 months of the year are London (37% reduction as compared to 2019), North West (35% reduction) and South East (35% reduction). The South West saw the smallest reduction in the number of people referred for elective care compared to 2019 (29%). The North East and Yorkshire saw a 34% reduction and Midlands and East of England both had a 33% reduction. - Those regions that experienced the lowest rates of COVID-19 during the first wave, namely the South West and East of England, are also those that have made the most progress in reopening elective care services. While there are currently only limited signs that more treatment is being postponed in the regions hardest hit by COVID-19, this may change in the future. - Referrals to clinical areas have declined as follows: oral surgery (43% lower than in 2019, representing 177,591 fewer people) trauma and orthopaedics (42% lower, representing 622,593 fewer people). This includes surgery for hip and knee replacements ophthalmology (41% lower, representing 531,660 fewer people). This includes cataract operations thoracic medicine (29%, or 98,546 fewer people) cardiothoracic surgery (29%, or 7,889 fewer people) neurosurgery (29% lower, or 23,872 fewer people); urology (28% lower, representing 186,119 fewer people).
  6. Content Article
    Before surgery 1. Tell them about your previous surgeries, anesthesia and current medications, including herbal remedies. 2. Tell them if you are pregnant or breast-feeding. 3. Tell them about your health conditions (allergies, diabetes, breathing problems, high blood pressure, anxiety, etc.). 4. Ask about the expected length of your hospital stay. 5. Ask for personal hygiene instructions. 6. Ask them how your pain will be treated. 7. Ask about fluid or food restrictions. 8. Ask what you should avoid doing before surgery. 9. Make sure that the correct site of your surgery is clearly marked on your body. After surgery 1. Tell them about any bleeding, difficulty breathing, pain, fever, dizziness, vomiting or unexpected reactions. 2. Ask them how you can minimise infections. 3. Ask them when you can eat food and drink fluids. 4. Ask when you can resume normal activity (e.g. walking, bathing, lifting heavy objects, driving, sexual activity, etc.). 5. Ask what, if anything, you should avoid doing after surgery. 6. Ask about the removal of stitches and plasters. 7. Ask about any potential side effects of prescribed medications. 8. Ask when you should come back for a check-up.
  7. Content Article
    The Optimising Shared decision-makIng for high RIsk Surgery (OSIRIS) programme is funded by the National Institute for Health Research and investigates different aspects of the decision making process for major surgery. Improving our knowledge of how patients and doctors make decisions about major surgery is an important step in designing and trialling ways of improving this process for patients. We know that a lot of surgery has been cancelled due to COVID-19 and this is a cause of great concern for both patients and healthcare professionals. However, looking to the future, this research it is important to ensure that we optimise decision making process once normal elective surgical services are resumed. We would like to invite you to take part in a research study run as part of OSIRIS Programme. We are looking for volunteers who are 50+ years old, live in the UK and are currently not contemplating undergoing surgery. This study involves an online questionnaire, where you will be presented with a hypothetical medical situation and asked to imagine how you would make decisions in that particular situation. The study will take approximately 25 min to complete. More information is available about the study before you commit to participating. If you are interested in taking part please follow the link below.
  8. Content Article
    This paper from ABHI details the role of surgical instruments and how they bring value to the NHS. It highlights the vast range and number of instruments that are needed in the NHS at any one time and, to ensure that these instruments continue to be safe and fit for purpose, makes the following recommendations: Investment in the replacement of aged surgical instrument inventory should be considered as a priority for NHS spending. The procurement of surgical instruments should be based on overall quality and value, with the demonstration of strong ethical and resilient supply chains recognised and rewarded in purchasing decisions. There should be a focused, sustained and appropriately accredited programme of education into the management and maintenance of surgical instruments. Such a programme could be delivered in conjunction with industry.
  9. Content Article
    Key points Communication between members of the surgical team is an integral component of the prevention of surgical fires. Open delivery of 100% oxygen should be avoided if at all possible for surgery above the xiphoid process. Surgeons usually control the ignition sources, such as electrosurgical units and lasers. Operating theatre nurses or practitioners usually control the fuel sources, such as alcohol-based preparations and surgical drapes. The use of an ignition source in close proximity of an oxidiser-enriched environment creates a high risk for surgical fires.
  10. Content Article
    The authors found that fire occurs when the three elements of the fire triad, fuel, oxidiser and ignition, coincide. Surgical fires are unusual in the absence of an oxygen-enriched atmosphere. The ignition source is most commonly diathermy but lasers carry a relatively greater risk. The majority of fires occur during head and neck surgery. This is due to the presence of oxygen and the extensive use of lasers. The risk of fire can be reduced with an awareness of the risk and good communication. Surgery will always carry a risk of fire. Reducing this risk requires a concerted effort from all team members.
  11. Event
    until
    Driven by advances in digital technology, precision medicine and the need for improved patient safety the future of surgery is changing, and fast. Future Surgery Virtual brings experts and innovators virtually together to explore these changes and how they will transform the profession. Future Surgery Virtual is a two-day online conference and networking event dedicated to all that is new in surgery. The event explores the evolving world of surgery with expert speakers delivering CPD accredited education. Further information and registration
  12. Content Article
    Based on an analysis of surgical data received through the Patient Safety Organization, plus detailed research and expert evaluation, this Deep Dive identifies and provides actionable recommendations and tools on six key risk categories of adverse event reports related to operative procedures: complications patient and OR readiness retained surgical instruments contamination equipment failures wrong surgery. There are common themes echoed through each of the six event types examined in this Deep Dive. These include the following: Communication problems are an underlying issue. Problems with communication—whether between the scheduler and the OR team, between clinical staff and the patient, or among the OR team—can lead to adverse events or near misses. Organisations should promote a team approach. Taking a team approach to surgical procedures can help avoid many of the adverse events reported in this Deep Dive. Such an approach is an element of a culture of safety and should be emphasised through team-building exercises. Organisations should focus on addressing preventable events. Some events are not preventable, meaning that no matter how well the team prepares, the event would likely have happened anyway. For example, the patient could have an allergic reaction resulting from an unknown anesthesia allergy, or a rare but known risk of surgery occurring. Focusing on preventable events can help focus the surgical team’s attention, however, thereby reducing the risk of unpreventable events as well. Quality improvement should be emphasized to reduce risk. Clinical staff should apply a quality improvement mentality to any problems that emerge, and focus on actions that can be taken to prevent such problems in the future.
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