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January 2014 Edition 280TRANSCRIPT
01943 878647 [email protected], Guiseley, West Yorkshire LS20 9JE
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January 2014 Issue No. 280 ISSN 1747-728XThe Leading Independent Journal For ALL Operating Theatre Staff
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Find out more 02921 680068 • e-mail [email protected] Issue 280 January 2014 3
The next issue copy deadline, Friday 24th January 2014All enquiries: To the editorial team, The OTJ Lawrand Ltd, PO Box 51, Pontyclun, CF72 9YY Tel: 02921 680068 Email: [email protected] Website: www.lawrand.comThe Operating Theatre Journal is published twelve times per year. Available in electronic format from the website, www.otjonline.comand in hard copy to hospitals throughout the United Kingdom. Personal copies are available by nominal subscription.Neither the Editor or Directors of Lawrand Ltd are in any way responsible for the statements made or views expressed by the contributors. All communications in respect of advertising quotations, obtaining a rate card and supplying all editorial communications and pictures to the Editor at the PO Box address above. No part of this journal may be reproduced without prior permission from Lawrand Ltd. © 2014
Operating Theatre Journal is printed on paper sourced from Forest Stewardship Council (FSC) approved paper mills and is printed with vegetable based inks. All paper and ink waste is recycled.
Journal Printers: The Warwick Printing Co Ltd, Caswell Road, Leamington Spa, Warwickshire. CV31 1QD
Secretary Of State For Health To Speak On Th e Francis Inquiry
Th e report of the Public Inquiry led by Robert Francis QC looking into the alarming events that led to needless patient harm at Mid Staff ordshire NHS Foundation Trust was published on the 6th February 2013. Th e government issued an initial response and their full response and recommendations were released in November 2013 through the publication of Hard Truths the Journey to Putting Patients First. Jeremy Hunt MP Secretary of State for Health will give a keynote address at a national conference refl ecting on the Francis Inquiry one year on.
My recommendations represent not the end but the beginning of a journey towards a healthier culture in the NHS in which good practice in one place is not considered to be a reason for ignoring poor practice somewhere else; where personal responsibility is not thought to be satisfi ed by a belief that someone else is taking care of it; where protecting and serving patients is the conscious purpose of everything everyone thinks about day in day out.Robert Francis QC
With a full line up of national speakers this conference will focus on what has changed a year after Francis and how the NHS can move forward in implementing the recommendations from the Inquiry and the full government response to Francis.
Confi rmed national speakers include:Jeremy Hunt MP Secretary of State for HealthAnn Clywd MP for Cynon Valley & Joint Lead for the National Review into Complaints Handling in the NHSJackie Smith Chief Executive Nursing and Midwifery CouncilSir Richard Th ompson President Th e Royal College of PhysiciansJulie Bailey Founder Cure the NHSMark Easton BBC Home EditorDr Nick Bishop Senior Medical Advisor Care Quality CommissionJan Sobieraj Managing Director NHS Leadership Academy
Th e conference is due to take place on 5th February 2014 at the ICO Conference Centre, London.Visit: http://www.healthcareconferencesuk.co.uk/francis-inquiry-a-year-on.
Drug testing without the painMicroneedles on a sticking-plaster-like patch may be the painless and safe way doctors will test for drugs and some infections in the future, thanks to work supported by the Engineering and Physical Sciences Research Council (EPSRC).
Samples of the rough, absorbent patches are being tested in the Queens University Belfast laboratories of Dr Ryan Donnelly, an award-winning researcher in the School of Pharmacy. Th e experiments are showing that the forest of tiny polymer needles on the underside of the patch, when pressed into the skin, can absorb the fl uid in the surface tissue, taking up at the same time the salts, fatty acids and other biological molecules found there as well.
Th e important thing is that we typically fi nd the same compounds in this interstitial fl uid as you would fi nd in the blood, Dr Donnelly explains. But, compared with drawing blood, our patches can get their samples in a minimally invasive way. And its far safer than using a conventional needle. Th ese microneedles, once they have been used, become softened, so that theres no danger of dirty needles transferring infection to another patient, or one of the healthcare workers. Two million healthcare workers are infected by needlestick injuries every year.
Th e microneedle sampling technique is a development of earlier and ongoing experiments using similar patches to deliver drugs and vaccines painlessly the sensation when they are pressed onto the skin is a bit like the roughness of Velcro, Dr Donnelly reports.
Th e microneedles are made of polymer gel similar to the material used in superabsorbent nappies. For their original, injecting function, they are pre-loaded with vaccine or drug compounds that will be released into the skin on contact with the interstitial fl uid.
But the fl ow can go both ways. So that for the sampling variants, the backing material can be made chemically attractive to target compounds, encouraging them to diff use into the gel with interstitial fl uid drawn out of the skin and locking them in place for later analysis.
Dr Aaron Brady, a clinical pharmacist in Dr Donnellys group, is currently conducting the fi rst clinical evaluation of the technology using caff eine as a model drug (though he admits that fi nding caff eine-free volunteers for the control group can be hard). Eyman Eltayib, a PhD student with the group, is also trialling the technique for blood-free glucose sampling at her home university in Khartoum, Sudan. Future targets for sampling could include, for example, therapeutic drugs where monitoring the correct dose can be important.
Th eophylline, the asthma drug, is one compound doctors might want to track this way, says Dr Donnelly. It has a very narrow therapeutic range too much and you can harm the patient, too little and it wont do the job. During our EPSRC project, my PhD student Ester Caff arel-Salvador has shown theophylline in the blood of rats can be indirectly detected using our microneedles. In the future, patches could also be designed for medics treating TB, particularly in sub-Saharan Africa. Patients are very bad at completing their long courses of antibiotic treatment, the main cause of drug-resistant TB. A simple, cheap technique like this would let healthcare workers monitor compliance, even with a minimum of training.
Real-time monitoring could be a realistic option in the future and might involve combining the microneedle technology with simple laser-based detection (SERS) of drug compounds inside the gel. Th e group already has proof-of-concept for this idea and are now looking to extend the range of drug concentrations that can be detected in this manner. Electrochemical detection is another attractive possibility that might allow patients to use the technology in their own homes.
If connected wirelessly to their healthcare provider, they could then have their medicines or doses changed based on the microneedle readings, both enhancing patient care and saving NHS resources.
Childrens charity Action Medical Research, through a generous donation from Th e Henry Smith Charity, is now funding Dr Donnelly to develop the minimally-invasive microneedle sampling technology for monitoring therapeutic drug levels in babies.
Premature babies have very limited blood volumes and are prone to bruising and scarring when blood samples are taken, Dr Caroline Johnston, Research Evaluation Manager at Action Medical Research for children explains. Th ere is a real need for a safe, reliable and painless way to monitor these babies drug levels, and these microneedles are so far proving to have all the right characteristics.
Th e group is currently in discussions with a major medical manufacturer with a view to producing prototype commercial devices, the fi rst stage ahead of full clinical trials.
4 THE OPERATING THEATRE JOURNAL www.otjonline.com
U-turn on simple test to prevent death and disability in newborn babiesTh e Department of Health has made a last minute, catastrophic U-turn on a policy decision to give pregnant women and health professionals access to an improved Group B Streptococcus test within Public Health England just days ahead of the scheduled start date of 1 January 2014.
Th is devastating U-turn will leave future families grieving the loss of their baby when a simple test could have saved his life and will bring no relief from the pain and suff ering caused by Group B Streptococcus, the UK’s most common cause of life-threatening infection in newborn babies.
Th e safe and specifi c ECM (enriched culture medium) test for group B Strep (GBS) carriage has been available for more than a decade in other countries and is recognised by Public Health England in their UK Standard ‘B 58’ as the ‘gold standard’ for the purpose. Th is U-turn means that health professionals will remain unable to request a GBS-specifi c test when in their professional judgement it is appropriate for a pregnant woman in their care. Th e ‘general purpose’ test currently used within the NHS is poor at detecting GBS – it fails to identify GBS in approximately 2 out of every 5 women carrying GBS.
National charity Group B Strep Support (GBSS), which campaigns for information and routine antenatal testing for GBS to be made freely available on the NHS, is shocked by this inexplicable U-turn. In December 2012, GBSS met with the Chief Medical Offi cer, Prof Dame Sally Davies and the Parliamentary Under Secretary of State, Dr Dan Poulter, to discuss preventing GBS infection in newborn babies.
GBSS’ Chief Executive Jane Plumb MBE says: “We were assured that measures would be put in place to improve the testing of swabs for the presence of GBS, both by educating staff as to correct procedures and by making sure that the UK Standard
for Microbiology Investigations B 58 test (ECM) for GBS was universally available. Th ese assurances were repeated in letters from the Minister and in his responses to parliamentary questions. We urge the Minister to stick to his commitment and ensure this simple, safe and eff ective test for GBS carriage is made available.”
On the same day GBSS heard the decision, a baby boy was born in the north of England. His mother carried GBS in her previous pregnancy but wasn’t off ered testing to fi nd out whether she was carrying GBS this time, nor off ered antibiotics in labour as preventative medicine. Within hours of his birth, her son was fi ghting for his life from GBS infection, too ill to be transferred to a hospital with facilities to cope with the severity of his illness.
Prof Philip Steer, Emeritus professor at Imperial College and consultant obstetrician at the Chelsea and Westminster Hospital in London says,“I regularly meet women who wish to fi nd out if they are carriers for good clinical reasons (such as a GBS urinary tract infection in a previous pregnancy, or a sister with a baby who suff ered from early onset GBS disease). It is bizarre that we cannot get a reliable test for carrier status within the NHS. I fi nd it distressing that a sudden U-turn in policy can be announced while people we met a year ago and whose assurances we believed, fail to reply to our urgent requests for an explanation.”
On hearing the news of the U-turn, Dr Alison Bedford Russell, West Midlands Strategic Clinical Network Director for Maternity and Children in Birmingham, comments,
“In an era where the Patient and Public Voice is given so much profi le in the new NHS, I am astonished that the DH has such blatant and cruel disregard for what women are asking for. What happened to the “No decision about me without me” agenda? Is the DH exempt from the agendas that they set?”
Jane Plumb MBE says:“Th is decision fl ies in the face of the Government’s drive for cost effi ciency through early intervention and prevention and totally ignores patient choice. Th ere are a handful of infl uential individuals who for a number of years have advised the national policy on preventing group B Strep infections in babies and have personally opposed better testing for GBS carriage. It seems they have now been successful in blocking the Health Minister’s desire for making an improved test for GBS available in England.
“All we, at GBSS want, what women and their health professionals want – and what the Chief Medical Offi cer and the Minister told us they wanted – is that, when a swab for GBS is taken, health professionals should be able to access a good quality test that’s fi t for purpose. Th is was to be introduced from 1 January 2014, but now, under the cover of Christmas, it has been cancelled. Th is decision leaves us way behind other developed countries, with hard-pressed health professionals unable to access the ‘gold standard’ test.”
Th e simple, safe, GBS-specifi c test could help prevent death and disability in vulnerable newborn babies; it would improve decision making, thereby reducing mothers’ anxiety.
It is essential if mothers are to be given “clear, accessible and high-quality information and advice to inform” their choices, as set out in the Choice Charter.
Group B Strep – the factsGroup B Streptococcus (group B Strep/GBS) is recognised as the most frequent cause of life-threatening infection in newborn infants. GBS colonises the intestines of many men and women and usually cause no harm. Up to 1 in 4 women carry GBS in the vagina or rectum. As a result, many babies come into contact, and are colonised with GBS, at the time of labour and birth and some will become seriously ill with GBS infection.• GBS infection is the most frequent cause of meningitis and sepsis in newborn babies and the incidence of early-onset (EOGBS aged 0-6 days) in the UK in 2000 was 0.5/1000 live births, with reports showing an increase in the number of babies being aff ected of approximately 50% over the last decade (2013, Lamagni). • Almost one newborn baby a day in England, Wales and Northern Ireland suff ers GBS infection• One in ten of these sick babies will die and a further one in twenty will suff er long-term physical or mental disabilities• GBS infection in babies is up to 90% preventable when antibiotics are given in labour to women found to be carrying GBS by sensitive testing at 35 to 37 weeks of pregnancy
For further information:Group B Strep Support, P O Box 203, Haywards Heath, West Sussex RH16 1GF Tel: 01444 416176 www. gbss.org.uk Registered Charity No 1112065. Company Registration No 5587535
OBE FOR CONSULTANT AT EAST SURREY HOSPITALA pioneering surgeon at Redhills East Surrey Hospital has been made an OBE.
Professor Abhay Rane performed the fi rst keyhole surgery through the belly button in Europe when he pioneered the keyhole procedure on a patient at East Surrey Hospital in 2007. Since then, he has taught and mentored other specialists to perform the practice across the world.
Mr Rane, a consultant urological surgeon who has worked at the hospital for the past 13 years, has praised Surrey and Sussex Healthcare NHS Trust for supporting his innovation that has proved to be very successful and is now widely adopted in many countries.
Th e specialist has been given the honour for services to laparoscopic surgery, otherwise known as keyhole surgery. He is praised for both the innovation and the dissemination of the practice.
He has mentored other consultants, written more than 100 publications and given many presentations at medical seminars internationally.As a result of his eff orts more than a dozen hospitals in the UK now have a local laparoscopic urology programme.Professor Rane was nominated in the New Year Honours by a former patient and fellow specialist Urologist, Peter Rimmington. Th e two colluded and gathered citations from nearly 25 respected urologists from around the world. Abhay Rane said: I am overwhelmed by the honour. I have had the privilege to read the citations written by the people I know and respect and I am extremely humbled by what they say about me and my work.
You cant do it alone though, and I am very fortunate to have support from the Trusts executive team and a fantastic team around me.
Th anks to hospital trusts like Surrey and Sussex Healthcare NHS Trust that support progression and forward thinking, surgery for many patients has become less immobilising.
First, incisions were made smaller, then keyhole surgery through several ports was introduced, and then Professor Ranes developed his technique to perform key-hole surgery through the belly button resulting in no visible scaring.
Find out more 02921 680068 • e-mail [email protected] Issue 280 January 2014 5
Rediscover space and movementDiscovery IGS 730
GE Healthcare
The Discovery* IGS 730 angiography system brings both extremely high-quality imaging and complete workspace freedom to the hybrid operating room. Its unique mobile platform brings all the power of a fixed imaging system to the table, yet it can be moved aside, so multi-disciplinary teams can complete procedures comfortably, with unobstructed access to patients. High-end fluoroscopy image guidance, advanced applications, 3D image fusion – it all comes on a sophisticated gantry that travels on predefined paths with laser-guided precision. Now one room accommodates a wide range of endovascular, cardiac, hybrid and open surgical procedures, free of interference from fixed floor or ceiling system structures.
* Trademark of General Electric Company
For further information please contact David Britton at GE Healthcare.e-mail : [email protected] 07831697463
DEPUY SYNTHES CMF LAUNCHES NEW MATRIXRIBTM MIPO INSTRUMENTATION FOR LESS INVASIVE SURGICAL FIXATION OF RIB FRACTURES
DePuy Synthes CMF, a leader in skeletal and soft tissue repair and reconstruction, announce the launch of new instrumentation that enable less invasive surgical fi xation and stabilization of rib fractures with the company’s MatrixRIB™ System of precontoured, low-profi le titanium plates, locking screws and intramedullary splints.
MatrixRIBTM Minimally Invasive Plate Osteosynthesis (MIPO) instrumentation was designed to provide surgeons with less invasive access, through small incisions, to rib fractures including diffi cult to reach sub-scapula rib fractures. Th e new instruments include a Trocar, Th readed Reduction Tool (TRT) with self-drilling tip, and 90o screwdriver with drilling capability.
“Surgical fi xation and stabilization of painful rib fractures is a growing procedure and the introduction of new MIPO instrumentation should help make it an even more attractive option for both surgeons and patients,” said Karl Zerderfeldt, Group Marketing Manager, DePuy Synthes CMF. Rib fractures are associated with respiratory complications, prolonged hospitalization, prolonged pain, long-term disability and mortality.1
Th e potential benefi ts of surgical stabilization (osteosynthesis) of severe rib fractures over non-surgical treatments include reduced duration of mechanical ventilation support, shortened ICU stays and hospitalization, better secretion management through effi cient cough, and minimized chest wall deformities resulting from trauma.2,3
More than 5,000 patients worldwide have received MatrixRIB implants since the System was launched in 2009. Th e MatrixRIB System is indicated for the fi xation and stabilization of rib fractures, fusions and osteotomies of normal and osteoporotic bone.*
MatrixRIBTM is the only rib fi xation system that is approved by the AO Foundation, an independent medically guided nonprofi t organization led by an international group of surgeons specialized in the treatment of trauma and disorders of the musculoskeletal system. For more information, visit www.aofoundation.org.
About DePuy Synthes CMFDePuy Synthes CMF is a global leader in medical devices, off ering a comprehensive portfolio of implant systems for surgeons to treat patients who have sustained conditions aff ecting the face, head, neck and thorax, including solutions for craniomaxillofacial, sternum and rib fi xation. DePuy Synthes CMF is part of the DePuy Synthes Companies of Johnson & Johnson, the largest provider of orthopaedic and neurological solutions in the world. For more information, visit www.depuysynthes.com.
* Please refer to the MatrixRIB technique guide and package insert for full indications, contraindications, instructions for use, warnings and/or precautions.1 Nirula R, Mayberry JC.:”Rib fracture fi xation: controversies and technical challenges.” Th e American Surgeon. 2010 Aug;76(8):793-802.2 Ahmed Z, Mohyuddin Z: “Management of fl ail chest injury: internal fi xation versus endotracheal intubation and ventilation.”, J Th orac Cardiovasc Surg. 1995 Dec;110(6):1676-80 3 Tanaka H, Yukioka T, Yamaguti Y, Shimizu S, Goto H, Matsuda H, Shimazaki S: “Surgical stabilization of internal pneumatic stabilization. A prospective randomized study of management
of severe fl ail chest patients.”, J Trauma. 2002;52(4):727-32; discussion 32 When responding to articles please quote ‘OTJ’
6 THE OPERATING THEATRE JOURNAL www.otjonline.com
New Software Speeds Up Staging Of Tumours
A Consultant Radiologist at Th e Queen Elizabeth Hospital King’s Lynn NHS Foundation Trust has devised new software to enable faster and more consistent staging of cancerous tumours.
Dr Martin Crowe has created StageCRAFT, which is already in use and helping radiologists to speed up the process of determining the ‘stage’ of a malignancy.
Dr Crowe received help during the development process from Health Enterprise East (HEE), the NHS Innovation Hub for the East Midlands, East of England and North London.
StageCRAFT uses the internationally recognised (TNM) system. Th e TNM classifi cation of malignant tumours is a cancer staging system that describes the extent of a person’s cancer: T describes the size of the primary tumour, N describes nearby lymph nodes involved and M describes the distant metastasis (the spread of cancer from one part of the body to another).
Th e software works by the Radiologist answering some key questions about the tumour which enables a TNM stage to be produced, removing the need for the Radiologist to look up the appropriate staging category in books or rely on memory with the chance of error or inconsistency. Th e software also includes rapid ‘calculators’ to assess bone metastases or tumour response to therapy.
Currently StageCRAFT supports the staging of nine diff erent types of cancer: Lung, Rectum, Renal, Oesophagus, Cervix, Bladder, Endometrium, Lymphoma and Prostate. Th ere are plans to increase this in the future.
Commercial partner for StageCRAFT is Healthcare Software Solutions (HSS), supplier of CRIS, the UK’s most widely utilised radiology information system. HSS is taking StageCRAFT through the MHRA CE marking process, which will enable the solution to be off ered as an accredited medical device, thus approved for use in a clinical context.
Dr Martin Crowe said: “In devising StageCRAFT I was keen to increase the use of the TNM staging system in Radiological reports whilst at the same time making it a simpler process for the Radiologist. Th is is also a fi rst - interactive software such as this has not been used in this process before.”
Robert Donald, HEE’s Intellectual Property Manager added: “StageCRAFT won the Software category in one of our Innovation Competitions for delivering a measurable improvement to the way tumour staging is carried out. It’s extremely rewarding to see this technology now being commercialised and widely available”.
Chris Yeowart, Director of HSS said: “We are delighted to be working in collaboration with HEE in support of Dr Crowe and QEH to enable the commercialisation of StageCRAFT. Th is is a fabulous innovation, developed at the ‘coalface’ which will be of real value to Dr Crowe’s fellow clinicians in terms of time effi ciency and clinical consistency”.
For further information please visit www.hee.org.uk.
Award-winning software speeds staging of tumours, left to right: Robert Donald, IP Manager HEE, Dr Martin Crowe, Consultant Radiologist QEH and Matt Wardlow, Client Manager HSS Ltd.
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New Classifi cation System to Improve Scheduling of Emergency Surgery Highlighted
in Special BJS (British Journal of Surgery) IssueResearchers in Finland have implemented a classifi cation system for emergency operations that allows for a fair and effi cient way to manage a large volume of such surgery. Th e system is described in a special issue of the BJS (British Journal of Surgery) that focuses on emergency surgery. Other studies in the issue focus on topics ranging from advances in the use of surgery performed through natural orifi ces to the global burden of conditions requiring emergency surgery.
Among hospitals, there is growing interest in centralizing emergency surgery into specialized centres that have suffi cient resources and available expertise to improve patient care and save more lives. Increasing the volume of emergency operations in such regional centres which also perform elective, or planned, surgery requires new structural and organizational elements that allow patients needing emergency surgery to be operated on without unnecessary delay, but also ensure that elective operations are not negatively aff ected.
Ari Leppäniemi, MD, PhD, and Irma Jousela, MD, PhD, of the University of Helsinki, in Finland, now describe a system that has been in use at their hospital for several years that addresses these issues. Th e system introduces elements such as having a signifi cant number of operating tables designated specifi cally for emergency surgery during the daytime. Also, because not all emergency operations need to be done immediately but can be safely postponed until the next day, only operations that are truly urgent can be performed in the evenings and a night time. A colour-coding system categorizes emergency operations by urgency and helps to optimize the timing of emergency operations in a rational and fair way. Th e computerized system also enables the investigators to monitor how eff ective their system is and whether there are systematic errors or problems that need to be solved.
Our study documents some of the objectively measurable benefi ts of the system. For example, the proportion of nighttime emergency operations has clearly decreased without causing disturbances in elective surgery or delaying surgery for those patients who need it urgentlythe red code patients, explained Dr Leppäniemi. Another benefi t of the system was demonstrated in the improved effi ciency of operating room use during the day.
In another article published in the BJSs special issue, investigators reviewed the history and eff ectiveness of surgery performed through natural orifi ces called natural orifi ce transluminal endoscopic surgery, or NOTES revealing that selected techniques off er reduced invasiveness for patients with intra-abdominal emergencies and may improve outcomes. Steady future development and adoption of NOTES are likely to follow as technology improves and surgeons become comfortable with the approaches, they wrote.
Also in the special issue is a review of the global burden of conditions requiring emergency surgery (excluding trauma and obstetrics). Th e researchers found that in 2010, there were 896,000 deaths, 20 million years of life lost, and 25 million disability-adjusted life-years from 11 emergency general surgical conditions. Th e most common cause of death was complicated peptic ulcer disease, followed by aortic aneurysm, bowel obstruction, biliary disease, mesenteric ischemia, peripheral vascular disease, abscess and soft tissue infections, and appendicitis. Th e majority of deaths occurred in low- and middle-income countries, which have inadequate capacity to deal with the problem. Th e data presented in this study will be useful for both the surgical and public health communities to plan a more adequate response, the authors wrote.
Full citation:A traffi c-light coding system to organize emergency surgery across surgical disciplines. A. Leppäniemi and I. Jousela. British Journal of Surgery 2013 (DOI: 10.1002/bjs.9325)URL: http://doi.wiley.com/10.1002/bjs.9325
Full citation:Natural orifi ce transluminal endoscopic surgery for intra-abdominal emergency conditions. J. Bingener and I. Ibrahim-zada. British Journal of Surgery 2013 (DOI: 10.1002/bjs.9352)URL: http://doi.wiley.com/10.1002/bjs.9352
Full citation:Global disease burden of conditions requiring emergency surgery. B. Stewart, P. Khanduri, C. McCord, M. Ohene-Yeboah, S. Uranues, F. Vega Rivera, and C. Mock. British Journal of Surgery 2013 (DOI: 10.1002/bjs.9329)URL: http://doi.wiley.com/10.1002/bjs.9329
About the Authors: Ari Leppäniemi, MD, PhD, and Irma Jousela, MD, PhD, are affi liated with the University of Helsinki, in Finland.
Visit: www.bjs.co.uk for more information. http://www.wiley.comwww.facebook.com/TheOTJ
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SonoSite X-Porte boost for regional anaesthesia in SwindonTh e Great Western Hospitals NHS Foundation Trust has recently purchased an X-Porte point-of-care ultrasound system from FUJIFILM SonoSite to extend its ultrasound-guided regional anaesthesia capabilities for orthopaedic surgery.
Dr Anthony Allan, a consultant anaesthetist with a special interest in regional anaesthesia, explained: We already had two SonoSite point-of-care instruments an M-Turbo® and an S-Nerve for use in our theatre suite, but these are much in demand and we needed another system to deal with our workload. Our previous experience with SonoSites instruments and service made the newly launched X-Porte system the obvious choice.
Th e X-Porte has a very elegant, functional design, and the touchpad is both intuitive to operate and straightforward to clean, which is a signifi cant advantage for infection control. As with all SonoSite systems, it is a fairly robust piece of kit which is vital in a busy theatre environment and boots up very quickly, which again is an important consideration. In terms of image quality, the X-Porte is a step ahead, with a large screen and very good resolution, and we are only just beginning to discover its potential for regional anaesthesia.
For more information about FUJIFILM SonoSite products, please contact:FUJIFILM SonoSite Ltd T +44 (0)1462 444 800 [email protected] www.sonosite.com Dr Anthony Allan alongside the new X-Porte system
www.OOpera ngpera ngTTheatreheatreJJobs.comobs.comA one-stop resource for ALL your theatre related Career opportuni es
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8 THE OPERATING THEATRE JOURNAL www.otjonline.com
NEW DRUG TREATMENTS FOR TREATING ABNORMAL HEART
RHYTHM
Patients with life-threatening abnormal heart rhythm are being given renewed hope of future treatments thanks to the work of a London research team and a grant from national charity Heart Research UK.
Th e team at the National Heart and Lung Institute at Imperial College London, have been awarded a grant of £125,000 to look into new drug treatments that can target cells that aff ect heart rhythm and help protect the heart against this problem.
Abnormal heart rhythms in some patients can cause fainting, seizures, heart attacks and even sudden death and are believed to aff ect more than 700,000 people in England.
Th e heart is made up of many diff erent cell types, and in some disorders, including the aftermath of a heart attack, new cells called myofi broblasts appear, which are usually only seen in the foetus. If too many myofi broblasts are present in the heart it can cause disturbances to its electrical rhythm - called arrhythmias which can spoil the normal contraction of the heart muscle.
Th e two year Imperial College project will study how myofi broblasts interact with heart muscle cells and how they aff ect normal contractions.
It is expected that this project will help to show that myofi broblasts represent an important new target for anti-arrhythmia drugs. Th e fi ndings will help explain how myofi broblasts aff ect heart rhythm, helping to pave the way for the development of new and better drugs to restore a normal heart rhythm. Th e work will also focus on whether the drug UCDA can protect the heart against abnormal heart rhythms.
Dr Julia Gorelik, who is leading the team at Imperial College, said: Th e heart as an organ is composed of fi broblasts and myocytes in equal measure. However for a long time the attention in heart science was focussed on myocytes. Now the time of fi broblasts has come.
We aim to shed light on the function of fi broblasts and their pathological counterparts, myofi broblasts, in heart disease. We hope we can fi nd drugs that specifi cally target myofi broblasts and help to prevent negative outcomes for people with arrhythmias and other adverse conditions of the heart.
Barbara Harpham, National Director of Heart Research UK, said: Abnormal heart rhythm can have serious consequences for those who suff er with this condition, and were hopeful that this important work by the team at Imperial College will help fi nd new ways to treat this problem and improve the situation for patients.
You can also follow Heart Research UK on Twitter: @heartresearchuk or become a fan of our Facebook page: http://www.facebook.com/pages/Heart-Research-UK/10733061906
Healthcare company brings international expertise to UK marketA Sheffi eld healthcare company is using its international expertise to bring to the UK market a portfolio of innovative and cost-eff ective products aimed at treating and preventing abdominal wall related complications.Th e dedicated B. Braun Medical Ltd products have been developed by the companys Spanish Centre of Excellence, based in Rubi near Barcelona, and are helping the organisation position itself as an expert in abdominal wall health. Now the VasTech team is bringing the range of innovative products to the UK market with the aims of preventing future complications and improving patient outcomes.Liam Huson, VasTech National Sales Manager at B. Braun Medical, said: Within the UK healthcare sector, more than 100,000 hernia operations are performed every year at a signifi cant cost to the NHS. Th e healthcare industry is operating in a drastically changed environment with reduced government funding. But this also presents companies like Braun with opportunities to provide more innovative and cost-eff ective services, products and solutions.Working in partnership with our overseas colleagues, we are keen to promote the message that Braun is not just concerned with the repair of the abdominal wall, but ensuring its future functionality and health for the patients, too.Th e products include the Optilene Mesh which features large pores and a light weight concept to ease integration, minimising recurrence and maximising patient comfort. Th e Omyra mesh is made of materials which help prevent bacterial growth and bowel adhesion, Th e latest innovation is the Histoacryl tissue adhesive for Mesh Fixation, a non-invasive method helping to prevent chronic pain for hernia patients.Said Liam: As well as being cost-eff ective, the products have signifi cant and substantial benefi ts for patients and the NHS.Th is very comprehensive portfolio of solutions allows B. Braun to position itself as an expert in abdominal wall health.We aim to develop our presence in this sector and are also looking to become a preferred partner to surgeons in the prevention of abdominal wall complications, promoting health through clinical treatment pathways. VasTech is part of the B. Braun group of companies, which has its headquarters at Th orncliff e Park, Sheffi eld, and is the UK arm of the global healthcare company B. Braun. Please quote ‘OTJ’
See the latest range of products from Fukuda Denshi at the 34th ISICEM in Brussels
Fukuda Denshi is a leading supplier of advanced patient monitoring and user-confi gurable clinical information management systems, as well as cardiac monitoring and imaging technology. Th e company will be attending the 34th International Symposium on Intensive Care and Emergency Medicine, being held from 18th to 21st March in Brussels.
Th e four day symposium is designed to provide participants with an up to date review of the most recent clinically relevant developments in research, therapy, and management of the critically ill. It’s open to all physicians, nurses and other health professionals with an interest in critical care or emergency medicine.
Fukuda Denshi will be attending the event with their DS-8500 high end anaesthesia/critical care monitor incorporating Fukuda Denshi’s most intelligent user interface. It allows users to tailor the monitor to meet their specifi c requirements by off ering a full suite of modules as well as a full 5 agent gas bench.
Th e DS-8500 is highly versatile and can be mounted as a standalone system or networked. In addition, all patient data can be collected and viewed at the bedside or central station with its seamless patient record transfer from monitor to monitor via an HS 8000 super module.
Also on show will be Fukuda Denshi’s MetaVision Clinical Information System, the MVICU, which is specifi cally designed for critical care use.
Visitors will receive a warm welcome from the Fukuda Denshi team, who will be on hand to demonstrate their state-of-the-art products as well as provide full product information and answer any questions.
Fukuda Denshi: Healthcare bound by technology.For more information visit www.fukuda.co.uk. Please quote ‘OTJ’
ISO 9001 ACCREDITED
TELEPHONE 01652 657200 FAX 01652 657009 WEB www.oakmedicalservices.co.uk EMAIL [email protected]
Oak Medical Services Ltd Unit 5A, Albert Street, Brigg, North Lincolnshire DN20 8HQ
OAK MEDICALSERVICES LTD
Oak Medical Services Limited are a leadingmanufacturer of Tourniquet machines and accessories.
Over the last 30 years our team of engineers and designers have developed a range of Tourniquet machinery and accessories that are in popular demand throughout Europe and The Middle East.
As a valued customer you can expect a level of comfort and security in dealing with us that is driven by ongoing processes which include IS09001 status.
Please take a minute to browse through our product list. Machines are available on a 10 day delivery basis with accessories dispatched by overnight courier.
In the event that you cannot nd what you are looking for please do not hesitate to call our team.
All our products are manufactured in England.
We look forward to being of service to you,
DenD nis Ecuyer Director
All new TQ electronic tourniquetfrom Oak Medical Services Ltd* A gimmick free electronic tourniquet - Quick, Quiet & Easy to use!
* The TQ is manufactured by Oak Medical Services Ltd in the UK.
* Dual channel supply for bilateral procedures.
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* Height Adjustable utility cart.
* Antistatic castors.* Utility baskets.
* Display rotary tilt function.
* Push click cuff pressure Rotary knobs for easy preset pressure selection, adjustment and de ation.
* Digital display: Pre-set pressure, cuff pressure, in ation time.
* Range of safety features to maintain cuff in ation pressure.
* Dual channel audio & visual alarms: Cuff check, low battery, service due.
* Procedure time tracking - alerts 1hr after in ation and every 15 minutes thereafter.
We pride ourselves on quality..Our commitment to quality is an ongoing process con rmed by our ISO13485:2003 status. Even after the product is delivered our aftercare service ensures the machine is kept in good condition.
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10 THE OPERATING THEATRE JOURNAL www.otjonline.com
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Clinical Examination Skills for Clinical Examination Skills for Healthcare ProfessionalsHealthcare Professionals
ISBN: 9781905539710eBook ISBN: 9781907830716January 2014 M&K Publishing 216pp £29.00
EDITED BY:Mark Ranson (Editor) MA, FHEA, PGCIHE, BSc (Hons), Specialist Practitioner (NMC), DipHE, RGN; Senior Lecturer (Acute and Critical Care), University Campus Suff olkHannah Abbott (Editor), MSc (Science)(Open), PGCE, QTLS Status, BSc (Hons), RODP, FCODP; Head of Department (ODP & Paramedic Science), Birmingham City UniversityWendy Braithwaite (Editor), MEd, PGCE, BSc (Hons), Dip HE, RGN; Senior Lecturer (Acute and Critical Care), University Campus Suff olk
Today, an increasing number of healthcare professionals (including nurses, midwives and members of many allied professions) have to conduct the vital fi rst stage in a patients journey taking a clinical history and conducting an eff ective physical examination. Th is book off ers clear, practical guidance on the fundamentals of clinical examination for any practitioner who wishes to understand their patients specifi c needs and to plan appropriate care.Recognising that readers will come from a diverse range of clinical backgrounds and roles, the opening chapter (on consultation and the skills needed to take an accurate clinical history) underpins the systems-based approach. Th is, combined with the use of case study examples, allows healthcare professionals to focus on the principles of examining the system or systems that are most relevant to their specifi c area of practice. Th e book also includes a helpful glossary and list of abbreviations.
Th e authors come from the same diverse range of professions for whom the book has been written, and their wealth of knowledge and experience enables them to understand the challenges facing todays healthcare professionals.
Contents include:Consultation and clinical history-taking skillsRespiratory assessmentCardiovascular assessmentGastrointestinal assessmentNeurological assessmentGenitourinary assessmentMusculoskeletal assessmentObstetric assessmentMental health assessmentPerioperative assessment
M&K Update Ltd | Th e Old Bakery | St. John’s Street | Keswick | Cumbria | CA12 5ASt: 01768 773030 | f: 01768 781099 | www.mkupdate.co.uk
f i l (i l di
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Trials to begin on new degradable surgical implant
Researchers in Oxford have developed a degradable implant which they say has huge potential to improve surgical success rates.
Th e protective patch, which wraps round soft tissue repairs, will be trialled in patients with shoulder injuries.
It is hoped in time this approach could help patients with other conditions including arthritis, hernias and heart defects.
Th e implant has been developed using a mix of modern and ancient technology.
Kevin Senior experiences pain every time he lifts his right arm. He has torn the tendons in his shoulder. Mr Senior, who is 59, is a plumbing engineer, so this gives him serious diffi culties in his work.
Even combing his hair or shaving causes him problems. He is looking forward to having an operation next year at Nuffi eld Orthopaedic Hospital in Oxford.
“It’s very frustrating but obviously you’ve got to do the best you can. Hopefully when it’s repaired I’ll be able to do everything, but as it stands now, you just struggle on.”
Th ere are 10,000 of these shoulder repair operations carried out each year in England and Wales. Th e fi gure has risen by 500% in the last decade. But one in four procedures is not successful, because the tendon tears again.
Th e surgeon who will operate on Kevin Senior’s shoulder, Professor Andrew Carr, has led a research project to improve the success rate and ensure a quicker recovery. Th is collaboration between the university and the hospital trust helps move ideas quickly from the lab to the clinic.
Professor Carr’s team have developed a protective patch - an implant which wraps around the surgical repair, like a splint.
One side is made of resilient woven material, to help it withstand the stresses of movement after surgery.
Th e other side is made of thread spun a hundred times fi ner than human hair.
Its surface encourages cells to grip and bond, as they would naturally in a much younger patient.
Ancient technology Professor Carr says the results in laboratory tests have been encouraging, and they hope to start clinical trials in patients soon. “We’ve used modern technology to produce very fi ne fi bres which have the extraordinary ability to direct the way cells behave, and “wake up” tired and ageing cells, and make them want to heal, whereas previously they weren’t being made to want to heal.Th e material in the patch is degradable, and disappears after a few months. Professor Carr says this is important for patients in their 40s, 50s and 60s who want to get back to work and may well live for several decades.“Once the repair process has taken place we would rather not have a piece of foreign material sitting in someone’s body for the rest of their lives, because experience has shown us that ultimately the body will respond and reject that tissue.”Th e project uses the best in modern and ancient technology. Alongside the humming, whirring and beeping of the latest laboratory gadgetry, is the click and snap of a manually operated wooden handloom - perfect for producing the patch’s protective cover. One of the team, Osnat Hakimi, says the loom enabled them to use small quantities of expensive fi bre and investigate its properties. “Scientists may look very technological, but they are very fond of simplicity and crafts. Using our hands is something we do a lot in the lab. So actually working with a handloom is something that went down quite well.”Less than 5% of government funding for medical research goes on surgery, but Professor Carr says this approach is relatively inexpensive, and has huge potential to benefi t patients.“We might be able to use it for other applications such as early arthritis management where we want to regenerate cartilage, repair of hernias, repair of bladder walls, repair of heart defects.”
Source: BBC News Adam Brimelow Health Correspondent
in TM
Find out more 02921 680068 • e-mail [email protected] Issue 280 January 2014 11
www.karlstorz.com
KARL STORZ Endoscopy (UK) Ltd • HR Department415 Perth Avenue, Slough, Berkshire, SL1 4TQ Telephone 01753 503603
We see
what’s
inside you
Medical Sales Account Manager for Airway Management Products
Duties and responsibilities will include:
• Sell KARL STORZ airway management and medical imaging equipment across Scotland
• Maintain and develop existing and prospective customers
• Optimise business growth, customer satisfaction and quality of service
• Plan and prioritise personal sales activities and customer/prospect contact
• Plan and manage territory according to an agreed market development strategy
•
• Thorough working knowledge of an operating theatre environment
• Sales experience not essential
• Well organised
• Flexible approach
KARL STORZ offers an excellent remuneration package including Private Healthcare, Pension Scheme, Critical Illness and Life Assurance.
To apply:
If you are interested in this opportunity, you will need to submit a CV and covering letter demonstrating how you meet each key attribute to [email protected]. For further enquiries, please telephone 01753 503603. Company information is available at www.karlstorz.com
Perspective in the international environment
KARL STORZ is one of the world’s leading suppliers of medical equipment for minimally invasive surgery. Since its beginnings in 1945, KARL STORZ has established itself worldwide as an international and highly regarded company in the production and sale of medical instruments and devices.
The family-owned company KARL STORZ applies tradition and experience to think about tomorrow, today. The company caters for future trends with sophisticated products, services and processes that systematically support our global activities. Our commitment to performance and professionalism means we can guarantee both user and patient the ideal solution.
To strengthen our team in Scotland, KARL STORZ Endoscopy (UK) Ltd have a vacancy for a:
Off-the-shelf multibranched stents
show promise for aneurysm patients
Journal of Endovascular Therapy Early results are promising for use of the rst off-the-shelf multibranched stent in aneurysm patients. Five months after receiving this treatment, a small group of patients has survived and remained free of rupture. Although custom-made devices have been available for more than a decade, these readily available t-Branch stents offer greater resources for treatment of thoracoabdominal aortic aneurysm.The current issue of the Journal of Endovascular Therapy presents a retrospective review of 15 patients who were implanted with the Zenith t-Branch stent. The stent has four downward facing branches and can be combined with a number of individual components, such as tapered thoracic endografts and universal distal bodies. Previous study has shown that a standardized endograft would be suitable for nearly 88 percent of patients with thoracoabdominal aortic aneurysms.The aorta delivers blood from the heart to the rest of the body. A thoracoabdominal aortic aneurysm, a weakness in the wall of the aorta can rupture, causing uncontrolled bleeding that can be fatal if not treated immediately. A complex surgical procedure, open repair of thoracoabdominal aortic aneurysms, has been associated with high mortality and morbidity.Since their introduction 13 years ago, custom-made multibranched endografts have been proven to reduce mortality and morbidity among aneurysm patients. However, these customized stents require manufacturing times of at least 8 weeks, making them unavailable when a patient needs urgent treatment. One year ago, the rst commercially made off-the-shelf thoracoabdominal t-Branch became available in Europe.Among the 15 patients treated with this t-Branch stent between November 2012 and May 2013, none have died, and no branch occlusion or type I or III endoleaks have occurred. Type II endoleaks were observed in ve patients, one patient suffered paraplegia, and four patients experienced transient paraparesis that was resolved. These short-term results indicate that use of an off-the-shelf t-Branch endograft is practicable and safe.An accompanying commentary suggests some improvements or alternate versions of a standardized t-Branch stent that may help resolve certain issues. The author notes that the design is still evolving, and time will tell which stent approach best meets treatment needs.Full text of the article, Early Experience With the First Commercially Available Off-the-Shelf Multibranched Endograft (t-Branch) in the Treatment of Thoracoabdominal Aortic Aneurysms and commentary article, Journal of Endovascular Therapy, Vol. 20, No. 6, 2013, are now available.
The Orange Guide - new edition available now!The Medicines and Healthcare products Regulatory Agency (MHRA) today announced that the eighth edition of Rules and Guidance for Pharmaceutical Manufacturers and Distributors, known as the Orange Guide, is now available to buy.
The guide, compiled by the MHRA, is the leading source of of cial EU guidance on good practice in manufacturing and distribution. It is now updated with the latest pharmaceutical regulations, directives and guidance for anyone involved in the manufacture and distribution of medicines in Europe.
This new edition contains all the signi cant changes and additions to the detailed European Community guidelines on Good Manufacturing Practice (GMP) since the last edition in 2007.
It includes substantial amendments to the Community code relating to medicinal products for human use, along with:• changes to the EU Guide on GMP, including the addition of
Part III • revised EU Guide for good distribution practice • revisions to the EU Directive on medicines for human use
• new chapters for brokers of nished medicines and manufacturers, importers and distributors of active substances as a result of Falsi ed Medicines Directive 2011/62/EU
• extracts from the UK’s consolidated human medicines legislation
• a new appendix of names and addresses of other EU medicines regulators.
With its restructured contents, index and a fresh design, its easier than ever for manufacturers and distributors to nd the answers they need.
Mark Birse, MHRA Group Manager, GMDP Inspections said:
The new edition of the Orange Guide will help you follow good practice and stay compliant with the law. It not only contains more information than ever before, but it has been redesigned to maximise the ease of nding key details and will no doubt become the primary reference source for many professionals working in all aspects of the pharmaceutical supply chain.
Also available is the Green Guide, providing a single source of guidance to and legislation for the distribution of medicines in the UK and Europe.
12 THE OPERATING THEATRE JOURNAL www.otjonline.com
Smiths Medical: Infusing Con dence With CADD®-Solis
Smiths Medical, a world leader in the development, design and manufacture of medical devices, is committed to patient safety and minimising medication errors.
Patient safety is a priority for all
healthcare organisations and the importance of reducing
medication errors is crucial to improving patient safety. Studies show up to nine per
cent of all patients staying in hospital experience medication related harm and many of these incidents are preventable.
Th e National Patient Safety Agency (NPSA) estimates that preventable harm from medicines could cost more than £750 million each year in England.1 A recent study found 47 per cent of adverse events involved medications, and wrong dosages were among the most common errors.2
Smiths Medical, continuously invests in the development of new technologies and incremental product safety features with the aim of reducing medication errors. Th e CADD®-Solis Medication Safety Software, available with the CADD®-Solis Ambulatory Infusion System, allows hospitals to input their own standardised pain management protocols for their patients; helping clinicians deliver the correct dosages of medication and promote patient safety. Clinicians may only select the standard protocol information that has been predetermined by the hospital pain management team, helping reduce the risk of pump programming errors.
Th e CADD®-Solis is the fi rst infusion pump to off er Programmed Intermittent Bolus (PIB) delivery, which has been designed to meet industry-recognised standards for advanced error reduction features in pain management. Error-reducing features of the system include: Dose limits, initial programming, indication of overridden limit, drug name displayed at all times and the ability to track limit overrides and programming changes. It has a large PDA-style colour graphic display screen, which helps clinicians view and verify pump programs, identify and respond to alarms and interpret therapy trends and patient activity.
Th e CADD®-Solis is designed to be easy to use and its hardware and software security options help to maximise effi ciency, ensure compliance and improve patient safety. Th e on screen reporting facility enables clinicians to review and, if required, make immediate changes to the patient therapy.
Glen Johnson, Marketing Manager, Smiths Medical says: “Patient safety is really important to Smiths Medical. We use statistics, such as those from the NPSA, and feedback from our work with clinical experts, to help focus our product and technological developments. We are very proud of our extensive range of safety products, which also includes intravenous catheters and catheter securement devices through to a whole host of blood collection and hypodermic safety devices.”
For over 25 years, Smiths Medical has been supplying products for use during surgery, critical and intensive care and post-operative care. Smiths Medical works closely with clinical experts, healthcare agencies and regulatory bodies worldwide to deliver meaningful safety advancements through technological improvements whenever possible.
For more information on the Smiths Medical safety devices, contact Glen Johnson, UK Marketing Manager at Smiths Medical, on 01303 260 551 or log on to www.smiths-medical.com
References:1. Safety in doses: medication safety incidents in the NHS, NPSA, 2007 2. Rothschild, J.M., Keohane, C.A., Cook, E.F. et al. A controlled trial of smart infusion pumps to improve medication safety in critically ill patients. Critical Care Magazine, (2005) 33 (3), 533-540, 679
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GOOD MANNERS CATCH A COLD IN THE WORKPLACE
Sick workers sniff at cold and fl u etiquette… With Britain facing one of its worst winter cold and fl u outbreaks for years – and more workers than ever battling into the offi ce even when ill – it looks like we’re in for a rude winter.
For the latest fi ndings in the annual Cold & Flu Survey from Fisherman’s Friend show many cold and fl u-stricken workers consistently ignore basic etiquette such as covering their mouth when they cough or sneeze, while some even boast about coming into work when ill – despite concerns from colleagues that they are needlessly spreading their cold or virus.
Two out of fi ve people surveyed in a poll of 2,000 UK adults for Fisherman’s Friend said sick co-workers often refused to cover their mouth when they coughed or sneezed – even when challenged about their rude behaviour – while the same number said colleagues often sniff ed, snorted, coughed and spluttered their way through the day, rather than reaching for a tissue or handkerchief.
One in six workers said sick colleagues always refused to take anything to alleviate symptoms, even though it would make life more bearable for those around them. And it also seems that many sick workers refuse to battle on in silence – with more than a third of those surveyed saying that ill colleagues seemed to enjoy moaning about how terrible they felt, while one in six complained that sick colleagues bragged about battling into work.
Despite this, the nation is clearly divided over the rights and wrongs of going to work ill.
Two out of fi ve Brits said they didn’t mind co-workers coming in ill – so long as they gave them a wide birth – while one in four said they felt that sick colleagues should stay at home. One in fi ve said it was ‘bad manners’ to go into work ill, one in 10 said it was selfi sh, while one in 20 went so far as to say they thought it should be a disciplinary off ence.
Conversely, one in 10 said that suff ering from a cold or mild fl u was never a valid reason for calling in sick.
Perhaps hardest to swallow is that of all the professions surveyed, chefs and kitchen staff were found to be most guilty of poor cold and fl u etiquette in the workplace. More than half of all chefs surveyed had noticed their colleagues coughing, spluttering and sneezing noisily without covering their mouths.
Public-facing professionals weren’t far behind, with sport and leisure centre workers, builders, bankers, fi refi ghters, police offi cers and charity workers all falling short when it comes to cold and fl u decorum, while teachers and nurses didn’t fare much better – with one in four saying they often noticed colleagues coughing and spluttering their way around the classroom or hospital ward.
Adding fuel to the fi re is the fact that two in three Britons aren’t planning to have the annual jab that could give them immunity to the potentially killer fl u virus.
Fisherman’s Friend spokesman Rob Metcalfe says: “Despite warnings of one of the worst fl u epidemics we’ve seen for some years – and constant advice from health professionals on how to protect ourselves – it seems very few of us are taking heed, particularly in the workplace.
“Th e fact that this is happening while record numbers of us are struggling into work ill, and while many of us choose to duck the fl u jab, is particularly worrying.”
Top 10 workplace faux pas during cold and fl u season (all responses):Colleagues coughing and splutteringColleagues not covering their mouth when they cough or sneezeColleagues sniffi ng and snorting when they should blow their noseColleagues moaning about how ill they feelColleagues coughing and spluttering unnecessarily noisilyColleagues showing no awareness of how not to spread their germsColleagues refusing to take anything to help them feel better/alleviate symptomsColleagues boasting how wonderful they are for coming to work illColleagues insisting on still shaking hands with others even though they’re illColleagues insisting on still kissing in salutation even when they’re ill
Source: All statistics taken from a OnePoll survey of 2,000 UK adults – 52 w/e 8th November 2013
Prediction by virologist Professor John Oxford, of Queen Mary University in London, October 2013
OnePoll survey of 2,000 UK adults, which shows that the average British worker now takes just 1.3 days off work each year for minor ailments such as colds, compared with almost fi ve days in 2008 – 52 w/e 8th November 2013
Find out more 02921 680068 • e-mail [email protected] Issue 280 January 2014 13
ODPs make a lifestylechoice – choose New Zealand
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Operating Department Practitioners – this is yourchance to work at one of New Zealand’s premierprivate surgical hospitals.
MercyAscot is one of New Zealand’s premier private surgical hospital groups,with 22 theatres on various sites in Auckland. The hospitals carry out morethan 21,500 elective procedures annually, across the full range of specialties.
No nights or weekends and time off over Christmas.Work in a friendly, supportive team where your skillswill be valued.Enjoy the lifestyle in this wonderful part of the world.
FAR AND AWAY THE BEST
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Anaesthetic Technicians From its sub-tropical far north to its dramatic southern alpine landscapes New Zealand is one beautiful country. Cities abuzz with cultural and urban lifestyle activity rub shoulders with the great outdoors – there is something here for everyone. For you and your family the dream of living and working in New Zealand need not be a dream anymore – let us make it a reality for you!
There are employment opportunities for Anaesthetic Technicians from the metropolitan hub of Auckland to the deep south of Invercargill and places in between.
But don’t just take it from us – a recent immigrant Melanie tells us what she thinks:“The bene ts I’ve found, as an ODP moving to New Zealand from the UK are numerous for both myself and my family. The work/life balance is just right. I can afford to work a normal shift week and spend a lot more time with my family. The relaxed atmosphere and working relations, provide an almost stress free working environment. You feel valued and a part of the team. My kids are kids again. They play outdoors a lot more, enjoy biking, camping and tramping through the breath-taking, scenic countryside and attend schools that cater to this newfound outdoor lifestyle. We get to spend weekends in the most unbelievable areas; I’ve discovered why a lot of scenic lms are made here.”
Melanie McKinnon-Peel, Anaesthetic Technician So come on – what are you waiting for?
To nd out more go to: http://www.kiwihealthjobs.com or email us at: [email protected] for more information or to apply.
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14 THE OPERATING THEATRE JOURNAL www.otjonline.com
My university project gave me the opportunity to blend the theory and practice to put in place a new system that would improve the overall patient experience and access to services.
Th anks to Christines project South Tees Hospitals NHS Foundation Trust decided to put in place a new centralised decontamination unit, with a dedicated team of staff for endoscope reprocessing. Th e new unit has been operating since April of this year and has already proved to be a success.
Christine said: What we have now is a central point for decontamination which, from a service point of view, means we clean, decontaminate and package up endoscopes in a more effi cient way.
We were already delivering best practice, however we’ve gone further than that, we have future-proofed the service.
From a savings point of view by centralising the system were eliminating waste and there is no delay for a patient coming in for a procedure.
From a personal point of view the project has allowed me to improve my analytical and project management skills. Plus it has also strengthened my leadership and management skills to combine with how I work on a day-to-day basis.
Yasmin Scott, Acute Medicine Divisional Manager of South Tees Hospitals NHS Foundation Trust, said: Th e development of a centralised decontamination unit which is streamlined and purpose built, with a dedicated team of staff , has further enhanced quality of care and patient safety
Laura Woods, Director of Academic Enterprise at Teesside University, said: Christine Williams project for her work-based learning degree is already making a considerable diff erence to the lives of people in the region.
Bringing together academic research and the knowledge gained through professional experience can result in massive benefi ts for both organisations and individuals.
In Christines case a new process has been put in place making a positive diff erence to healthcare practices in the region showing the value of this collaborative process.
For more information on Teesside Universitys work with and opportunities for business visit www.tees.ac.uk/business
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Student project results in new £2m facility for hospitalA COMBINATION of professional knowledge and university research has led to a cutting-edge health facility being installed at a North East hospital.
Christine Williams, Business Performance Manager for the Division of Acute Medicine at South Tees Hospitals NHS Foundation Trust, looked at processes for decontaminating fl exible endoscopes, used to examine patients stomachs, as part of her work-based degree in Leadership and Management at Teesside University.
Her project has led to the installation of a new £2m centralised decontamination unit at James Cook Hospital in Middlesbrough which carries out more than 900 endoscopies each month.
Christine said: A pivotal part of my degree, a work-based programme, is to undertake a work-based project.
Working with support and contribution of Trust colleagues, I looked at the decontamination of endoscopes in the Endoscopy and Th eatre setting. It is crucial to make sure endoscopes are decontaminated eff ectively and I looked at ways of making this even more effi cient and eff ective.
Christine Williams and Yasmin Scott
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NHS Graduate Management Training Scheme shortlisted for top social media awardTh e graduate management training scheme, which is run by the NHS Leadership Academy, has once again been recognised as one of the best schemes for the use of social media in the public sector. Having won the award last year, it has now made this years shortlist.More than 4,000 students completed an online survey during November 2013. Th ey were asked to nominate those organisations who eff ectively utilise social media in the sectors they would most like to work in. Th e graduate scheme is up against stiff competition from other public sector organisations including the Civil Service Fast Stream, British Army, Teach First and the European Commission.Th e scheme uses the Career Inspiration Facebook page to enhance its pre and post application experience for candidates. Th is feature also provides useful information about NHS career paths and lets candidates engage with specially-appointed current trainees to fi nd out what its like to work in the NHS. Th e scheme has now built up a following of over 5,000 on Twitter and 10,322 likes on Facebook. Other social media activity includes live question and answer sessions online and live tweeting from the schemes events. Th eir most recent general management Q and A saw over 600 people take part.Rob Farace, programme lead at the NHS Leadership Academy, said: We are delighted to be shortlisted for the award. Th ere is some really great competition out there and its an honour to be included in the same category as them. Th e fact that we have been nominated on the back of student feedback makes it that extra bit special.Th e multi-award winning scheme, which has been running for more than 50 years, is a comprehensive training programme that aims to equip graduates with the expertise needed to become successful leaders in the NHS. Challenging work placements and educational components enable graduates to learn about the NHS and develop the competence required to lead the ongoing transformation of the service. Applications are currently open for the graduate scheme and will soon close on 9 December, 2013.Now in their third year, the social media graduate recruitment conference and awards, which are sponsored by graduate careers website Milkround aim to showcase and celebrate best practice in social media by graduate recruiters. Th e award ceremony will take place on 23 January, 2014 in London.You can follow the NHS Graduate Management Training Scheme on Twitter at @NHSGradScheme and join the Facebook page.For general information about the NHS Graduate Management Training Scheme, visit www.nhsgraduates.co.uk.
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