The Operating Theatre Journal

Saturday, 27 July 2013

24% of Surgical Errors Can Be Blamed on the Machine

If you’re worried about the robot apocalypse and how our metallic creations are going to take over all of our jobs, this is going to sound like some good news. If you enjoy living and would like to survive your next visit to the hospital, then this is going to sound pretty grim.

A new study was recently published in the BMJ Quality & Safety journal and it indicated that a technological “glitch” was the root cause of 1 in 4 surgical errors. That’s a lot, especially when you consider how much these surgeons rely on the technology around them to monitor their patients and to perform the actual surgeries. There’s still human error, but if the human is operating based on what the machine says or does, this kind of statistic stacks the odds against us.

It’s annoying when your home computer or your smartphone glitches out in one way or another, but this is very expensive surgical equipment that could literally mean the difference between life and death. You would hope that the error rate would be so miniscule that it could largely be ignored. To be fair, they do say that having proper briefing and training could cut that error rate in half.

Of the technological “glitches” that caused problems in surgery, 37% were due to equipment failure, 44% were related to equipment configuraton and 33% were because of device malfunctions.






http://www.mobilemag.com/2013/07/26/surgical-errors-machine/

Wednesday, 24 July 2013

Operating Department Practitioner Scrub/Anaesthetics/Recovery

As a Operating Department Practitioner we can offer you a varied surgical caseload, which will broaden your skills and experience. You will play a full part in our close knit multi-disciplinary operating theatre team, ensuring high quality, evidence-based and safe patient care is delivered.

An excellent communicator and team worker, you must be flexible, motivated and committed to the highest standards of patient care.

You'll get to enjoy the real respect, rapport and effective working in an innovative, clean, modern working environment. You will also benefit from support and training opportunities, as well as the time and nurse-patient ratio that ensure quality of care.

More ...

Operating Theatre Practitioner Anaesthetics and Recovery

We're taking Healthcare to new heights in Bristol. Nuffield Health has been part of Bristol's healthcare sector for 50 years and we are beginning a new exciting phase with the development of our Chesterfield Hospital, which is due to open in September 2013. The Chesterfield will be a new £20m state-of-the-art hospital, built alongside our Grade II listed property in the heart of Clifton. It will be one of the most technologically advanced private hospitals in the UK, offering a 5-star patient environment with an intimate and personal customer experience, Facilities will include 3 of the most up to date digital operating theatres, a 3-bed Intensive Care Unit and excellent day-case facilities including 12 Consulting rooms and some of the most advanced MRI and CT scanning equipment in the UK.

Working for Nuffield in Bristol will provide the opportunity to work alongside some of the best medical talent in the area on a varied surgical caseload, covering all specialties. What's more, the opening of the Chesterfield will provide the opportunity for us to further expand our case-mix into more specialised areas such as neurosurgery and more minimally invasive surgery. While the development of the Chesterfield is being completed, you'll be based at our St Mary's Hospital, just a mile from Bristol City Centre.

We're looking for experienced Operating Theatre Practitioners to join our Anaesthetics and Recovery team.

More ...

Operating Theatre Practitioner (Scrub) x 3 in Cambridge

As a registered Operating Theatre Practitioner (Scrub), we require someone who enjoys variety of working. As an excellent communicator and team player, you will need to be flexible, motivated and committed to the highest standards of patient care.

We are interested in hearing from registered Operating Theatre Practitioners with post-registration experience and proven scrub skills. We can offer you a varied surgical caseload that will help you develop your capabilities and experience and youll enjoy the real respect, rapport and effective working of a close-knit, highly skilled, multidisciplinary team.

The Operating Theatre department offers flexible working patterns and supports continuing education and development with both in house and external training programmes. We have recently purchased state of the art wireless technology and video scopes for our Endoscopy suite.

More ...

Senior Staff Nurse / ODP Scrub Practitioner - Cardiac

Nuffield Health The Manor Hospital are seeking a motivated Cardiac Staff Nurse to join the team in their six-theatre suite. This centre of excellence offers a high standard of acute and critical nursing care, within Oxford. The Manor is proud of their ability to offer complex procedures; supported by a Critical Care Department, which includes fully ventilated intensive care and high dependency beds. Successful applicants will enjoy career development and support from a strong management team, the opportunity to work alongside recognised expert Consultants and a multi-disciplinary team of other healthcare specialists, access to a dedicated professional and personal development program and experience within a highly professional working environment. This role is a development role for a qualified Staff Nurse, we will support and provide full training to enable the right candidate to develop into a Senior Cardiac Nurse position.

More ...

Operating Theatre Manager in Cambridge

Nuffield Health has been part of Cambridges healthcare for 10 years and we are about to embark on an incredibly exciting journey with the development of our new hospital.

Due to open in 2015, the new hospital will offer the latest in 21st-century medical care and will continue and enhance the Nuffield Health focus on best practice, care and equipment. The hospital will offer an exceptional patient environment including 46 beds, 2 high dependency beds, 3 of the most up to date digital operating theatres and an endoscopy suite, as well as excellent day-case facilities and an award-winning oncology day centre.

This is a unique opportunity to play a key role in the development of the hospital and to lead the Operating Theatre team as they prepare for the transition to the new site.

More ...

ODP / Operating Theatre Nurses in Liverpool/Cheshire

Due to an expansion we are looking to appoint into post a variation of ODP / Operating Theatre Nurses at varying levels

If you are newly qualified and you are looking to embark upon a career in operating theatres or you have worked within general surgery and orthopaedics then we want to hear from you!

You will work in what is already an established team and will contribute to the continued growth and further expansion which in turn will create further development for you within your operating theatre career.

More details ....

Friday, 19 July 2013

'Is there no limit to what this Government will privatise?': UK Plasma Supplier Sold to US Private Equity Firm Bain Capital

The Government was accused of gambling with the UK's blood supply by selling the state-owned NHS plasma supplier to a US private equity firm.

Full Story ...

Consultation on HCPC registration fees

We are the Health and Care Professions Council, a statutory regulator of 16 different health and care professions. I am writing to invite you to respond to the consultation we have launched on our registration fees.
 
Our existing registration fees were introduced in April 2009. We are proposing an increase in our fees in order to ensure that we can continue to function effectively as a regulator.

Full Story ...

Chief Inspector of Hospitals Announces Inspection Plans

CQC's new Chief Inspector of Hospitals, Professor Sir Mike Richards is introducing radical changes to the way hospitals in England are inspected. Following on from the review carried out by Bruce Keogh, the changes will be introduced by the end of next month

Full Story ...

Thursday, 18 July 2013

"Intelligent Knife" Tells Surgeon if Tissue is Cancerous

Scientists have developed an "intelligent knife" that can tell surgeons immediately whether the tissue they are cutting is cancerous or not.
 
In the first study to test the invention in the operating theatre, the "iKnife" diagnosed tissue samples from 91 patients with 100 per cent accuracy, instantly providing information that normally takes up to half an hour to reveal using laboratory tests.

Full Story ....

Respond to NMC Information about Professional Indemnity Insurance

From October this year, it will be a legal requirement for nurses and midwives to have an indemnity arrangement in order to be registered with [the NMC].

When you renew your registration, you will be required to self declare that you either have an indemnity arrangement in place that is appropriate for your practice, or will have one in place when you start practising. Most nurses and midwives will be covered through their employer, but it is your responsibility to check what is covered by your employers indemnity insurance.

Full Story ....

Wednesday, 17 July 2013

Better Management of Hospitals Could See an Extra 20,000 Operations Each Year

NSW hospitals could perform an extra 20,000 operations a year if they were better managed, according to the State's Auditor-General.

Full Story ...

Nurses Who Don't Show Compassion May Be Struck Off

A review of nurses' code of conduct could mean staff may face formal disciplinary action if they display an uncaring attitude.
 
Nursing Standard reports this week that the Nursing and Midwifery Council (NMC) is to discuss adding the word 'compassion' to the nurses' code.

Full Story ...

Tuesday, 16 July 2013

Jeremy Hunt Sets Out Plans to Tackle Mediocrity and Inadequate Leadership in the NHS - Sir Bruce Keoghs Review into 14 Hospital Trusts in England Published

All 14 Trusts investigated by Professor Sir Bruce Keogh's review team will have to undertake strict improvement plans and 11 will be placed into special measures to ensure that Sir Bruce's recommendations are fully implemented and patient care improves, Health Secretary Jeremy Hunt announced today.


Full Story ...

Doctors Who Abused Liverpool Care Pathway Face Disciplinary Action

Hospitals will today be told to review the treatment of every patient who has been on the controversial Liverpool Care Pathway after an independent review found examples of abuse across the NHS.

Full Story ...

Hospital chaos looms as junior doctors vote on strike action (Eire)

http://www.independent.ie/irish-news/hospital-chaos-looms-as-junior-doctors-vote-on-strike-action-29419838.html

Wales Audit Office finds NHS ops postponed to cut costs

http://aggbot.com/UK-News/article/19990731?utm_content=bufferd8707&utm_source=buffer&utm_medium=linkedin&utm_campaign=Buffer

Monday, 15 July 2013

Operating Theatre Practitioner in Warwickshire

We are looking for a registered practitioner to join our busy Operating Theatre team and deliver high quality, effective, clinical patient care.

The successful candidate will assess, plan, implement and evaluate care as part of a collaborative patient care programme. You will possess the ability to remain calm and work efficiently under pressure and you must maintain a keen eye for detail and accuracy. You will be well organised, a good communicator and an enthusiastic, flexible and adaptable team worker. Ideally, you should have experience in Anaesthetics and Recovery gained through the formal training required to meet registration needs.

More Detail ....

Overhaul of End of Life Care System

The Government is to replace the Liverpool Care Pathway (LCP) and will ask senior clinicians to sign off all end of life care plans, as part of its response to the findings of an Independent Review, Care and Support Minister Norman Lamb announced today.

 

The standards of proficiency are the threshold standards for safe and effective practice in the UK and play a key role in public protection. They are divided into generic standards (which apply to all of the 16 professions we regulate) and standards specific to each of the professions regulated. They are used when an individual professional applies for or renews their registration, or when concerns are raised about their competence. They are also used to approve education and training programmes.

Full Story ...

HCPC Launches Consultation on Standards of Proficiency for Operating Department Practitioners

The Health and Care Professions Council (HCPC) has today launched a consultation to invite stakeholders for their views on proposed changes to the profession-specific standards of proficiency for operating department practitioners.
 
The standards of proficiency are the threshold standards for safe and effective practice in the UK and play a key role in public protection. They are divided into generic standards (which apply to all of the 16 professions we regulate) and standards specific to each of the professions regulated. They are used when an individual professional applies for or renews their registration, or when concerns are raised about their competence. They are also used to approve education and training programmes.

Full Story ...

Saturday, 13 July 2013

'Dead' woman wakes up on operating table as organs about to be removed

A woman in New York state was pronounced dead and about to have her organs removed for transplant when she awoke and opened her eyes.



http://www.telegraph.co.uk/news/worldnews/northamerica/usa/10168712/Dead-woman-wakes-up-on-operating-table-as-organs-about-to-be-removed.html

5 high-touch objects to clean better

Environmental cleaning in the OR has become an important strategy in preventing infection.

Perioperative leaEnvironmental cleaning in the OR has become an important strategy in preventing infection.

Perioperative leaders are increasingly working with environmental services and infection prevention colleagues to discuss cleaning strategies. One reason for this increased collaboration is consideration of research recognizing the role environment can play in the development of health care associated infections and transmission of multi drug-resistant organisms.

However, research also shows that ORs may not be as clean as they could or should be, explains AORN Perioperative Nursing Specialist Amber Wood, MSN, RN, CNOR, CIC, CPN. Wood is developing an update to AORN’s practice recommendations for environmental cleaning.

Wood cites a 2011 study in which researchers observed a mean cleaning rate of 25% for objects monitored in the operating room setting in 6 acute care hospitals. “It’s studies like this that show us the concept of clean is still evolving in the perioperative setting,” she says.

Taking a closer look at your high-touch objects
High touch objects—objects that are frequently touched during patient care—may create a higher risk for transmitting infectious pathogens to patients. 

“The concern is that organisms such as MRSA (Methicillin-resistant Staphylococcus aureus) and CRE (carbapenem-resistant Enterobacteriaceae) are colonized on the patient and health care providers are touching a patient and then touching the environment … creating reservoirs harboring these pathogens,” Wood explains.

She advises, “Identifying high-touch objects in each procedural setting and thoroughly cleaning these areas in collaboration with environmental services can help decrease contamination and transmission.”

Wood identifies five high-touch objects common in all procedural settings:

1. Anesthesia cart and equipment (including IV pole)
2. Anesthesia machine
3. Patient monitors
4. OR bed
5. Table strap

High-touch objects are unique to the procedural setting and MUST be identified by a multidisciplinary team that includes perioperative nursing, infection prevention and environmental services, Wood stresses. This team should work together to:
  • Identify ALL high-touch objects
  • Develop a detailed action plan for cleaning these objects
  • Consider enhanced cleaning 
  • Consider implementing advanced technologies for measuring cleanliness
Enhanced environmental cleaning—cleaning that is more in-depth than routine cleaning—was introduced in AORN’s recently updated “Recommended Practices for Prevention of Transmissible Infections” as a method of cleaning when care involves patients in isolation.

“Enhanced cleaning of high-touch objects may be a helpful strategy for lowering the risk of infection transmission and reducing the risk of creating reservoirs for infection in the OR with all patients, not only those in isolation,” Wood suggests. “This approach, which must be a shared decision with infection prevention, may be especially useful when there is concern about an outbreak.”

Considering the human factor
Evaluation of thorough cleaning practices across the health care setting shows the importance of cleaning accountability.

Wood notes an example of this: it may be assumed that environmental services personnel are cleaning the knobs and handles on a piece of technical equipment, but these team members may be too nervous to touch expensive, sensitive OR equipment, posing a risk for the next patient that the perioperative nurse in the room is unaware of.

“With the push for rapid turnover, cleaning corners may also be cut,” Wood adds. “A manufacturer’s recommended drying time for a cleaning agent may not be followed, or worse, cleaning may begin before the patient leaves the room—a problem because the team may be distracted from care of the patient.”

Making it a team approach
This is why team collaboration is absolutely essential, Wood emphasizes, noting “You need shared input from infection prevention, environmental services and perioperative nursing to develop a comprehensive plan for environmental cleaning that includes careful evaluation of the OR environment.”

This evaluation may include newer methods for measuring cleanliness, such as with Adenosine triphosphate (ATP) monitoring and fluorescence marking.
All team members must be held accountable for cleaning high-touch objects and following cleaning protocols developed collectively, Wood says. “Perioperative nurses are ultimately responsible for making sure the OR environment is clean. This focus must include cleaning competence and recognition of reservoirs for infectious pathogens lurking in places we might not be catching with current cleaning practices.”ders are increasingly working with environmental services and infection prevention colleagues to discuss cleaning strategies. One reason for this increased collaboration is consideration of research recognizing the role environment can play in the development of health care associated infections and transmission of multi drug-resistant organisms.

However, research also shows that ORs may not be as clean as they could or should be, explains AORN Perioperative Nursing Specialist Amber Wood, MSN, RN, CNOR, CIC, CPN. Wood is developing an update to AORN’s practice recommendations for environmental cleaning.

Wood cites a 2011 study in which researchers observed a mean cleaning rate of 25% for objects monitored in the operating room setting in 6 acute care hospitals. “It’s studies like this that show us the concept of clean is still evolving in the perioperative setting,” she says.

Taking a closer look at your high-touch objects
High touch objects—objects that are frequently touched during patient care—may create a higher risk for transmitting infectious pathogens to patients. 

“The concern is that organisms such as MRSA (Methicillin-resistant Staphylococcus aureus) and CRE (carbapenem-resistant Enterobacteriaceae) are colonized on the patient and health care providers are touching a patient and then touching the environment … creating reservoirs harboring these pathogens,” Wood explains.

She advises, “Identifying high-touch objects in each procedural setting and thoroughly cleaning these areas in collaboration with environmental services can help decrease contamination and transmission.”

Wood identifies five high-touch objects common in all procedural settings:

1. Anesthesia cart and equipment (including IV pole)
2. Anesthesia machine
3. Patient monitors
4. OR bed
5. Table strap

High-touch objects are unique to the procedural setting and MUST be identified by a multidisciplinary team that includes perioperative nursing, infection prevention and environmental services, Wood stresses. This team should work together to:
  • Identify ALL high-touch objects
  • Develop a detailed action plan for cleaning these objects
  • Consider enhanced cleaning 
  • Consider implementing advanced technologies for measuring cleanliness
Enhanced environmental cleaning—cleaning that is more in-depth than routine cleaning—was introduced in AORN’s recently updated “Recommended Practices for Prevention of Transmissible Infections” as a method of cleaning when care involves patients in isolation.

“Enhanced cleaning of high-touch objects may be a helpful strategy for lowering the risk of infection transmission and reducing the risk of creating reservoirs for infection in the OR with all patients, not only those in isolation,” Wood suggests. “This approach, which must be a shared decision with infection prevention, may be especially useful when there is concern about an outbreak.”

Considering the human factor
Evaluation of thorough cleaning practices across the health care setting shows the importance of cleaning accountability.

Wood notes an example of this: it may be assumed that environmental services personnel are cleaning the knobs and handles on a piece of technical equipment, but these team members may be too nervous to touch expensive, sensitive OR equipment, posing a risk for the next patient that the perioperative nurse in the room is unaware of.

“With the push for rapid turnover, cleaning corners may also be cut,” Wood adds. “A manufacturer’s recommended drying time for a cleaning agent may not be followed, or worse, cleaning may begin before the patient leaves the room—a problem because the team may be distracted from care of the patient.”

Making it a team approach
This is why team collaboration is absolutely essential, Wood emphasizes, noting “You need shared input from infection prevention, environmental services and perioperative nursing to develop a comprehensive plan for environmental cleaning that includes careful evaluation of the OR environment.”

This evaluation may include newer methods for measuring cleanliness, such as with Adenosine triphosphate (ATP) monitoring and fluorescence marking.

All team members must be held accountable for cleaning high-touch objects and following cleaning protocols developed collectively, Wood says. “Perioperative nurses are ultimately responsible for making sure the OR environment is clean. This focus must include cleaning competence and recognition of reservoirs for infectious pathogens lurking in places we might not be catching with current cleaning practices.”

Ondansetron for intravenous use: dose-dependent QT interval prolongation—new posology

http://www.mhra.gov.uk/Safetyinformation/DrugSafetyUpdate/CON296402

Wednesday, 10 July 2013

Call over Healthcare Assistants

Some healthcare assistants are doing jobs which should be done by doctors or nurses but do not have to undergo compulsory formal training, a review into the profession has found.

Full Story ...

Monday, 8 July 2013

Tameside Hospital: 'Urgent steps' Needed at Hospital under Probe

The government must take urgent action to improve care at a Greater Manchester hospital being probed for high death rates, a patients' association has said.

Full Story ....

Friday, 5 July 2013

Health Service to Move from Treating Patients as Numbers to Providing Personal and Integrated Care

Celebrating the 65th anniversary of the founding of the NHS, Health Secretary Jeremy Hunt has set out proposals to improve care for vulnerable older people and create a more personalised health service for every single patient [in England].

Too often, the people the NHS fails are its heaviest users older people with multiple long-term conditions and there is frequently confusion and fragmentation over how care is provided.

The proposals outlined by the Health Secretary today include every vulnerable older person having a named clinician responsible for their care outside of hospital.  This will mean that accountability is clear and care packages can be personalised and tailored around individual needs.

Full Story ...

Tuesday, 2 July 2013

The Operating Theatre Journal July 2013

This month's top stories:

HCPC Launches Consulatation on Guidance for Professional Indemnity Cover and Registration

Expansion of Groundbreaking Plan to Support NHS Staff

Heroic Operating Theatre Practitioners

Diabetic Patients Developing Preventable Life-threatening Complications in Hospital

eVersions now available on OTJONLINE