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April/May 2009 Issue No. 223 ISSN 1747-728X

2 THE OPERATING THEATRE JOURNAL www.otjonline.com

In 2010 every NHS surgeon will be using a safety checklist to help save more lives on the operating table, but as MedilinkWM’s CEO Tony Davis explains, there are already home-grown solutions to prevent avoidable casualties, right now.

Safety First

The publication of a pilot study by the World Health Organisation, in The New England Journal of Medicine (NEJM), which reveals that millions of lives can be saved on the operating table using the Surgical Safety Checklist, has sparked a direct response from the National Patient Safety Agency (NPSA).

Its decision to issue an alert that requires healthcare organisations in England and Wales to implement the Surgical Safety Checklist for every surgical patient by February 2010, demands that hospitals invest in patient safety. But within industry, we know that many leading hospitals have already recognised this and are already putting safety fi rst, by incorporating technology that helps prevent the mistakes and human errors that can cost lives.

It’s diffi cult to recognise that people make mistakes – but they do, and mistakes in healthcare can lead to the death of a patient. The World Health Organisation’s pilot study ran in eight hospitals around the world from Tanzania to Toronto and collected data from noncardiac patients, concluding that a checklist can cut the death rate from surgery from 1.5 per cent to 0.8 per cent (a 47 per cent reduction) and the complication rate from 11 per cent to 7 per cent (a 36 per cent reduction). Based on these fi gures, with an estimated 8 million operations performed every year in England and Wales, the checklist could save up to 56,000 lives a year.

From discovering that the wrong limb has been removed, to incorrectly administering medication, or even fi nding that equipment has been left in the body after surgery, the complications and potential fatalities because of human error are startling. But how do we prevent mistakes?

One way has to be the checklist, which is simply 19 steps that should be completed before, during and after surgery. It’s a similar system to that used in aircraft cockpits before take off, ensuring that the whole team checks everything, every time.

At the moment, it’s just a piece of paper, another piece of administration for our overworked NHS teams. But by using technology to prompt and record the process, keeping patients safe from error can become a transparent, fast and monitored process.

With so many lives at risk because of individuals’ mistakes, it’s essential that hospitals across the UK follow the lead of those surgeons and staff who have already introduced checking systems into their operating theatres and wards, with similar reductions in fatalities and complications. In the UK’s medical technology hub, the West Midlands, companies have been working with hospitals to develop world-leading devices to help the NHS implement the checklist quickly, effectively and actually make life easier for staff and surgeons.

Birmingham’s Heartlands Hospital has been a pioneer in the fi eld, piloting an effective and error-proof way of replicating the paper process using technology. The Safe Patient System includes an electronic wristband using passive radio frequency identifi cation (RFID) to improve the identifi cation processes, patient safety and staff effi ciency, saving money and reducing the risk of litigation. The company is already in discussions with the NPSA to combine the technology with the Surgical Safety Checklist, making it easier for surgeons and staff to adopt and use.

New mobile technology called Near Field Communication allows a user to merely touch their mobile phone against an electronic tag to initiate a task or receive information. Specialists Sero Solutions are already looking at ways in which this technology could help all members of a team record their feedback or patient interactions. By touching a tag with a mobile device, a URL of a Mobile Internet session on a PDA device could be sent. Each user could contribute their own feedback on the checklist, and it could be viewed for completeness before each stage of the surgical procedure.

Such innovative technology ensures the checklist approach and ethos can be applied across all areas of the hospital, not just within the operating theatre. A patient’s entire journey through the hospital, including every interaction, can be checked and recorded. A specifi c risk to patient safety has been identifi ed by the award-winning Metrasens Ltd, a spin-out from the world’s leading defence technology and security company, QinetiQ, in MRI scanning units.

The central magnet in an MRI scanner has such a powerful attraction to ferrous metals, that it can hurl a porter’s trolley through a room, or rip a device from the body of a patient. According to a recent US study, incidents occur once in every 1000 scans, so Metrasens developed a system that immediately alerts clinicians to any trace of ferrous metal entering the MRI scanning suite.

With the wider patient safety issues in mind, investment in the Institute for Digital Healthcare at Warwick University’s £12.5million digital lab, brings together technology experts from the Warwick Manufacturing Group, researchers from Warwick Medical School and key NHS staff to translate scientifi c advances into improved public health and patient care. And the Heart of England NHS Foundation Trust is developing The Hollier Simulation Centre at Good Hope Hospital as a facility to train doctors, dentists, nurses, allied health professionals and multi-disciplinary teams across the region – with a focus on safety.

By using technology as a safety net, the NHS can ensure that the Surgery Safety Checklist works, that patient safety improves, while enhancing the effi ciency of NHS staff and communication. It will also make the effects of the checklist easier to measure. So why look to the US or Europe for inspiration, when the answers are right here, in the West Midlands?

The Author - Tony Davis

Tony Davis is CEO of MedilinkWM, a leading authority in the medical and healthcare industry.

Email: Tony@MedilinkWM.co.uk

When responding please quote ‘OTJ’

fi nd out more 020 7100 2867 • e-mail admin@lawrand.com Issue 223 APRIL/MAY 2009 3 l

The Operating Theatre Journal is published twelve times per year.

Available in electronic format from the pages of www.otjonline.com

and in hard copy to hospitals throughout the UK.

Personal copies are available by nominal subscription.

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Guidance for hospitals to reduce risks for

patients undergoing hip replacement for

fractures of the hip joint

NHS and private hospitals are being alerted to ways of reducing risk for patients undergoing hip replacement surgery after a fracture at the hip joint.

Approximately 60,000 total hip replacements and 60,000 repairs of hip fractures are carried out each year in the UK. The death rate following partial hip replacement for fracture treatment is ten times higher than following a planned hip replacement mainly because the patients undergoing surgery after fracture are older, ill and are in need of an emergency operation. The death rate is also signifi cantly higher when surgery is delayed more than 48 hours.

The most common cause of sudden intra-operative death during this surgery is the occurrence of venous embolisation of fat and bone marrow contents. This occurs during the instrumentation and reaming of any long bone or any manoeuvre that raises the pressure within that bone.

Twenty-six patient deaths and 6 cases of severe harm were reported to the National Patient Safety Agency (NPSA) between October 2003 and October 2008 in patients having a partial or total hip replacement where bone cement was used. The majority related to older patients undergoing emergency hip fracture.

The NPSA is therefore advising local organisations to report all deaths and incidents in such cases and to adopt best practice techniques in surgery and anaesthesia.

This includes identifying patients most at risk and stabilizing their medical condition before surgery. Skilled anaesthetic input and communication between surgeon and anaesthetist at critical points during the surgery is vital. Best surgical technique should be used, including methods to reduce the pressure in the intramedullary canal. Bone cement, if used, should be introduced from below upwards.

Dr Kevin Cleary, Medical Director of the NPSA said: All clinicians want to do the best thing for their patients. For certain patients the short term risks of using cement in orthopaedic surgery need to be balanced against the long term benefi ts. This NPSA report shares evidence of harm from hospitals across the country and indicates certain practical steps which can be taken by surgical and anaesthetic staff to reduce risks to patients. By asking staff to report all serious incidents to the NPSA, we hope to improve learning and make this common procedure even safer for patients.

Miss Clare Marx, President of the British Orthopaedic Association stated. “Hip surgery is a very common procedure and when performed following hip fracture enhances the lives of many elderly patients. It is generally considered safe and effective. However there are rare examples where patients have experienced severe harm or death immediately following these replacement operations.

We welcome and support all actions to reduce risks for these often frail and elderly patients and to maximise learning from incident reports and audit.”

To view the NPSAs latest guidance, a Rapid Response Report on Mitigating surgical risk in patients undergoing hip arthroplasty for fractures of the proximal femur, visit: http://www.npsa.nhs.uk/nrls/

alerts-and-directives/rapidrr/mitigating-risks-when-using-bone-

cement-in-hip-surgery/.

As well as the incidents reported to the NPSA, the Medicines and Healthcare Products Regulatory Authority (MHRA) has received reports of 19 patient deaths. Between 2000 and 2008 in NHS and independent facilities in the UK where cement was used during hip surgery and 6 cases of severe harm.

Bone cement implantation syndrome can occur after an internal

prosthesis is implanted using bone cement. Cardiac arrest and death

have been reported. It was originally thought that problems related

to toxic effects if the cement itself, but now it appears that harm is

caused by fat embolism as the prosthesis is inserted under pressure and

this can also occur when cement is not used. The Chief Medical Offi cers

Annual Report (2007) highlighted the need to fi nd ways of reducing the

incidence of sudden death during Hip fracture surgery.

SonoSite announces powerful new

technology for M-Turbo systemSonoSite, the world leader and specialist in hand-carried ultrasound for point-of-care medicine, has developed SonoGT Global Targeted technology, which capitalises on the power of the M-Turbo platform to provide point-of-care ultrasound with targeted solutions. SonoGT offers a new level of colour fl ow imaging, wireless connectivity and workfl ow integration for acute point-of-care ultrasound, such as anaesthesia, emergency medicine and critical care.

The SonoGT platform offers ColorHD technology, a proprietary, colour Doppler algorithm, to increase colour performance, sensitivity and frame rates, for increased diagnostic information and better visualisation of colour fl ow. Wireless solutions include SonoRemote control, which untethers the clinician from the ultrasound system during procedures to increase ergonomic comfort, and is expected to be very useful in sterile fi eld procedures. SonoRoam technology allows wireless image transfer from the M-Turbo system to a PACS system or to a personal computer so that clinicians can quickly retrieve the information from any location. For improved workfl ow integration, new features facilitate seamless clinical integration of ordering, scheduling, image acquisition, storage, viewing and billing of patient procedures. Patient demographics can be entered before, during or after the examination, allowing fl exibility in time-critical situations.

New M-Turbo systems are available with SonoGT technology, and existing M-Turbo systems can be upgraded with SonoGT technology via an easy software download from a USB thumb drive.

For more information about SonoSite products, please contact:

SonoSite, Alexander House, 40A Wilbury Way, Hitchin SG4 0APT +44 (0)1462 444 800, F +44 (0)1462 444 801Email: europe@sonosite.com Website: www.sonosite.com Quote ‘OTJ’

4 THE OPERATING THEATRE JOURNAL www.otjonline.com

EORNA Launches First

European Accreditation

System for Continuous

Medical Education of

Nursing and Healthcare

Professionals

EORNA - the European Operating Room Nurses Organisation - has launched its Accreditation Council for Education (ACE). With ACE, EORNA wants to improve and harmonize the quality of surgical care in Europe. The new ACE is the fi rst European accreditation system for operating room nurses. ACE represents a unique initiative for the professional development of nursing and care in general.

The new ACE will improve the quality and accessibility of continuing education and professional development for nursing and healthcare professionals in Europe. EORNA ACE sets quality standards for distance learning courses and educational events as scientifi c meetings, conferences, workshops or symposia. Teaching institutes will be able to rely on the ACE quality label and integrate approved courses in their learning plans, thus guaranteeing the latest and accurate information. ACE will also be available to national nursing associations throughout Europe.

After receiving the stamp “EORNA ACE APPROVED”, educational courses or events will be able to advertise the label on all materials associated with the course or event. Participating nurses will be able to collect credits points and build their personal continued education program. The review process by the EORNA ACE Board will assure the quality standards of all courses or events.

The system also allows easy exchange of credits between European countries and comparable systems outside Europe, thus improving mobility in the healthcare sector.

EORNA’s new ACE will be implemented at its upcoming international Congress “Professional Development - Bridging Perioperative Care”, taking place in Copenhagen, Denmark, from 17 - 19 April 2009.

“Educational and training programmes in the nursing sector need alignment and development on a European level. EORNA achieved 1997 to present a curriculum of a minimum of education in Operating room and anaesthetic nursing and care. ACE represents a major step towards achieving a harmonized high-level perioperative patient care in Europe,” confi rms EORNA President Irini Antoniadou.

Next to evaluating Operating Theatre related initiatives, the ACE will also act as accreditation committee for other healthcare associations and associations representing expert areas including emergency, critical, paediatric, and neonatal care nursing.

The new ACE has been created with the support of Ansell Healthcare, infection prevention specialist and global leader in hand protection solutions for healthcare practitioner and patients.

http://www.eorna.eu

Yeovil Patients

Benefi t From New

Operating Techniques

Yeovil District Hospitals patients who require abdominal aortic aneurysm repairs can now benefi t from state-of-the-art surgery which results in safer care, shorter hospital stays and a quicker recovery.

Previously patients needing Endo Vascular Aneurysm Repair (EVAR) had to have major surgery in Somerset or travel to Bath for the new technique. Now, in a bid to bring services closer to patients homes, vascular surgeons provide initial consultations at Yeovil District Hospital with those suitable for EVAR undergoing the new treatment at Musgrove in Taunton.

Consultant Vascular Surgeon Paul Eyers said: An abdominal aortic aneurysm is a swelling of the main artery in the abdomen. If left untreated it can burst, usually with fatal consequences. Traditionally, aneurysms have been treated by a major operation involving a large cut in the abdomen, one to two days in intensive care, a hospital stay of seven days and a total recovery time of up to several months.

The new technique involves two cuts in the groin with patients going home one to two days later. Now, thanks to close working between our surgeons, and X-ray teams, and excellent support from colleagues at the Royal United Hospital in Bath, these cases can be done locally.

Yeovil patient Trevor Cousins, 63, from Yeovil, was the fi rst patient to undergo EVAR at Musgrove. He said: I was rather frightened when the open surgery procedure was explained to me and was very pleased when the consultant told me about EVAR. He sent photos of my aneurysm to Bath for the team there to look at and I got the go-ahead.

Some of the Bath team then came down to help as it was the fi rst of its kind in this area. The procedure was perfect and now I feel so good! I have seen a photo of the repair and it is unbelievable. If other patients fi nd that they are suitable for EVAR they should jump at the chance. I was home within three or four days and feeling fi ne after six weeks with no side effects or any other problems.

Consultant Andrew Stewart says: This is a very exciting development in the treatment of this life-threatening condition. We are delighted to be able to provide this minimally invasive surgery to patients in Somerset.

PATIENTS’ LIVES AT

RISK DURING NHS

TRANSFERS

Patients’ lives are being put at by the

inadequacy of NHS transfers, according to

the Association of Anaesthetists.

A combination of NHS and private ambulances are responsible for ferrying people around sites in the UK.

But the Association said the HS and private ambulances used for the transfers are poorly equipped and its members have called for a national transfer service to be established.

Dr David Goldhill, the chairman of the working group, which drew up the report, said it was an issue that needed to be taken more seriously.

“There is no doubt that the situation we have at the moment in most areas is entirely unsatisfactory. The patients are in a vulnerable position,” he said.

The warning comes in advance of hospital services re-organisation across England, aimed to create centres of excellence. This restructure will mean more patients are gong to be transferred for specialist care – placing extra pressure on the transfer system.

The Association also highlighted the EU working time directive, which is being phased in gradually across the NHS. It pointed to the move later this year (2009), to reduce the hours of junior doctors, leading to a smaller pool of staff to transfer patients.

This could lead to key hospital staff being taken off wards to transfer patients, putting even more patients at risk.

The report also criticised the facilities available on some ambulances with insuffi cient power supplies for medical equipment identifi ed as one of the key areas of concern.

The Association put forward a series of recommendations to improve the system. The most radical was the creation of a centrally managed transfer system to replace the current arrangements which are run by individual NHS trusts.

Other recommendations include better training standards and a reduction in transfer for non-clinical reasons – patients can fi nd themselves transferred because of a lack of beds. Source: Legal & Medical

Japanese surgical robot can perform a bypass on still-beating hearts

When doctors need to perform a coronary bypass, it typically involves cracking open the patient’s chest and stopping all functions of the heart. From Waseda University in Japan comes a robot that could end the need for that second step, at least.

The surgical robot is so precise that it can actually account for the motions of a beating heart and still proceed with surgery — no small feat, considering the operations being performed require millimeters-long accuracy.

Despite how handy a robot can be, though, the biggest barrier right now is the price of one of these ‘bots, as well as the gross maintenance costs.

On the other hand, robotic surgical assistance and advancements in nanotechnology could result in surgeries where you don’t have to get your chest cracked open ever again — instead leaving you with the tiniest of scars.

Via Engadget

fi nd out more 020 7100 2867 • e-mail admin@lawrand.com Issue 223 APRIL/MAY 2009 5 l

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Chair of the Health Professions Council appointed

The Health Professions Council (HPC) is pleased to announce the appointment of Anna Van der Gaag as Chair. Anna was appointed in principle as Chair by the Health and Social Care Appointments Committee of the Appointments Commission subject to legislative approval.

Anna has served as President of the Council since July 2006. After an initial two years she was unanimously re-elected by Council on the 11 September 2008.

Chief Executive of the HPC, Marc Seale, commented;

“I am looking forward to working with Anna as part of the newly restructured Council which will be smaller and more board like. It is a particularly exciting time for us at the HPC with new professions such as practitioner psychologists, hearing aid dispensers, psychotherapists and counsellors set to join our Register over the coming years.”

“Council Members play a vital role in the strategic direction of the HPC and therefore fulfi lling our primary function of protecting the public. It is a rewarding and fulfi lling position to hold that has great impact.”

Anna van der Gaag is a speech and language therapist and Honorary Research Fellow in the Faculty of Medicine, University of Glasgow. She has been actively involved in research and development initiatives in standard setting, clinical guidance, quality assurance, skills mix and service evaluation for more than two decades. Her recent research work includes user involvement in decision making, e-learning in post graduate education and improving communication between primary care practitioners and people with communication disabilities. Anna has been a member of various advisory groups for the Medical Research Council, Department of Health, Kings Fund and the Royal College of Speech and Language Therapists.

HPC President, Anna van der Gaag commented: “I am very honoured to have been independently appointed as Chair of HPC. The HPC continues to welcome new challenges and I look forward to working with colleagues on the Council to continually improve our services and work with the professions to maintain high standards of good professional practice.”

“I believe the HPC is set to make a signifi cant contribution to public protection in the coming years as we take on new professions and help to build the evidence base of robust regulation. If we are to continue to be an effective regulator, good governance must be at the heart of what we do and I intend to ensure that this commitment is upheld.”

In 2007 a Government white paper, entitled Trust, Assurance

and Safety – The Regulation

of Health Professionals in the

21st Century, made a number of proposals regarding the governance arrangements for the nine UK healthcare regulators.

One proposal was that the Council’s of regulators should be smaller and more ‘board-like’. The white paper also proposed that all Council members should be independently appointed rather than elected.

In February 2008 the HPC recommended to the Department of Health (DH) that the number of members on the HPC Council should be 20 (including the President), and that there should be an equal representation of registrant and lay members. On 3 July 2008, the Council agreed the criteria which will be used to appoint the Chair and members of the restructured Council.

HPC’s newly appointed Council will play a key role in setting strategy and policy and ensuring the HPC fulfi ls its statutory duties. The aim is to create a diverse Council, with a balanced mix of skills and experience refl ecting the professions we regulate and public that we serve. The restructured Council will be comprised of a Chair and 19 Council members and will commence on 1 July 2009.

6 THE OPERATING THEATRE JOURNAL www.otjonline.com

Increasing customer

base heralds Fukuda

Denshi growth at

She eldFukuda Denshi is a leading supplier of advanced patient monitoring and user-confi gurable clinical information management systems. As a result of a growth in customers, the company has decided to expand its service operation and training facilities, focused on its Northern offi ces in Sheffi eld.

To accommodate this expansion, Fukuda Denshi is investing in a 50% growth to its fl oor space (sq foot) during the fi rst quarter of 2009, in order to cater for the rising volumes of its DS 7100/7200/7300 bedside monitors, DS 7600 central station monitors and various telemetry options.

The expanded facility will provide:

A new training room, housing up to around 14 delegates, where networking resources allow practical sessions on the monitors.The opportunity to promote the partnership approach to customers more widely, which in past entails more ‘hands-on’ training workshops, which are practical, comprehensive, customer-oriented and free of charge.Additional space for servicing of equipment and maintenance, including troubleshooting, verifi cation testing and calibration.

Managing Director of Fukuda Denshi UK, Terry Rickwood said: “This timely investment in extra training and service back-up will keep pace with our increasing number of customers countrywide. Sheffi eld is an expanding city with a population of over ½ million, and excellent local motorways, rail connections to London, plus a good central situation to reach hospitals quickly.”

For more information on the exciting facility expansion in Sheffi eld, please telephone Fukuda Denshi on 01483 728065.

Fukuda Denshi:Healthcare bound by technology.

When responding to articles please quote ‘OTJ’

CSA Standard helps clear toxic smoke from operating rooms

Surgical lasers and advanced operating techniques may create occupational hazard for healthcare workers

Canadian Standards Association (CSA), a leading developer of standards and codes, announces Canada’s fi rst standard to help protect healthcare workers in surgical, diagnostic, therapeutic and aesthetic settings exposed to noxious airborne contaminants, collectively called”plume.”

Procedures that require instruments such as surgical lasers to treat a patient can generate toxic smoke and other vapours that may create an occupational health risk for healthcare workers and other professionals.

The use of surgical lasers, electrosurgical generators, broadband light sources, ultrasonic instruments, and bone saws create plume as human tissue is cut, ablated or coagulated. This plume can contain a variety of contaminants,including viable bacteria, viruses, cellular debris, particulates, noxious and toxic aerosols, gases, vapours, and fumes.

Research into the long-terms effects of plume has only recently begun, but numerous studies indicate that health risk-factors are present. Studies have shown that one puff of plume can be the same as three puffs from an unfi ltered cigarette(1) and that plume may contain serious and even deadly bacteria or viruses that can infect others in the operating room.(2) As recently as April 2008, the Association of Perioperative Registered Nurses (AORN) ratifi ed a Statement on Surgical Smoke and Bioaerosols. In it, the association stated that exposure to these substances poses a hazard to perioperative professionals in healthcare settings.(3)

“CSA’s Plume Standard is the fi rst of its kind in North America, one of the fi rst in the world, and provides solutions to help ensure the safety of dedicated professionals who work to keep us healthy,” says Suzanne Kiraly, President, Standards, CSA. “Organizations that choose to implement this standard will be on the forefront of occupational health and safety management in terms of providing a safer work environment and reducing exposure to the potentially damaging effects of plume.”

Plume Scavenging Standard is a voluntary standard designed to enhance the safety of individuals in surgical, diagnostic, therapeutic, and aesthetic settings. The Standard provides guidance on the purchasing, installation, testing, use, servicing, and regular maintenance of systems that collect and fi lter contaminants that might otherwise enter the atmosphere.

Plume occurs in a variety of settings in addition to operating rooms and may also pose a danger to workers in dental clinics, laboratories, R&D, veterinary, cosmetic, teaching and manufacturing facilities. Generally, patients are not at risk from plume. As a precaution, procedures are outlined in the standard to protect both patients and clients.

“At Women’s College Hospital we are committed to providing a safe and healthy work environment for all our staff and patients,” said Dr. John Semple, Chief of Surgery, Women’s College Hospital. “Protecting health-care workers from the effects of plume is critically important, and we are pleasedthat the CSA is taking this issue seriously.”

Scavenging and evacuating plume is crucial as particulates may contain living pathogens that can remain viable for up to 72 hours. Researchers have so far identifi ed more than 600 organic compounds in plume generated by vaporized tissue.(4) Harmful health effects can include irritation to the eyes, nose and respiratory tract, live and kidney damage, carcinogenic cellchanges, headaches, dizziness, drowsiness, stomach pains, vomiting and nausea and rapid breathing.

Most plume scavenging systems are either portable, and can be carried or placed on a shelf, or mobile, free-standing fl oor models, which often have wheels or are incorporated into a cart. The system’s evacuation source captures plume through tubing positioned in accordance with the manufacturer’s operating instructions. Some plume scavenging systems are designed to be used with electrosurgical devices and have small capture devices that attach to the electrosurgical hand piece. Others have wands, nozzles, or hoses that need to be held for laparoscopic procedures. The captured plume then passes through a series of fi lters that remove harmful elements. The fi ltered air is released through the system’s exhaust port back into the room.

CSA Z305.13-09 Plume Scavenging Standard is priced at $110 CAD. It is available for purchase online at www.shopcsa.ca, by calling CSA Standards Sales at 800-463-6727, or by e-mail at sales@csa.ca.

About CSACanadian Standards Association (CSA) is a membership association serving industry, government, consumers and other interested parties in Canada and the global marketplace. As a leading solutions-based standards organization providing standards and codes development, application products, training and advisory services, CSA aims to enhance public safety, improve quality of life, preserve the environment and facilitate trade. The Canadian Standards Association is a division of CSA Group, which also consists of CSA International, which provides testing and certifi cation services for electrical, mechanical, plumbing, gas and a variety of other products; and OnSpeX, a provider of consumer product evaluation, inspection and advisory services for retailers and manufacturers. For more information visit www.csa.ca

(1) “K W Gracie, “Hazards of vaporized tissue plume” The Surgical Technologist 33 (January 2001) pp 22.

(2) “Nurses keep surgical smoke a burning issue”. Hospital Employee Health. Feb., 2001. pp 19-20

(3) “Surgical smoke raises safety alarms: procedures may expose 500,000 healthcare workers annually”.

Medical Environment Update 18.7. July, 2008. pp 1-2.

(4) Source: K W Gracie, “Hazards of vaporized tissue plume” The Surgical Technologist 33 (January

2001) pp 20-25.

fi nd out more 020 7100 2867 • e-mail admin@lawrand.com Issue 223 APRIL/MAY 2009 7 l

HIFU hope on Horizon - Non-invasive technology for women’s health

A revolutionary, non-invasive High-intensity focused ultrasound (HIFU) treatment from China could be an alternative to Tamoxifen and o ther aftercare treatments such as chemotherapy and radiotherapy, which may alleviate side effects such as nausea, exhaustion, vomiting, weight gain, mood swings, depression, and loss of energy, as well as higher risk of deep-vein thrombosis and pulmonary embolism.

HIFU is totally non-invasive and may minimise th e recurrence rate of tumours and therefore shows considerable promise. The clinical and cost-effectiveness evidence was reviewed by The National Institute for Health and Clinical excellence (NICE) requesting more long term data. Meanwhile, over 20,000 patients have been treated worldwide with around fi fty HIFU centres established across the Republic of China along with Rome, Moscow, Korea and an extremely successful unit in Milan specializing in breast cancer treatment.

Recent headlines highlighting the story on Jade Goody fi ghting cancer focuses our awareness how quickly and dramatically a person’s life can change with a primary disease. Cancer does not discriminate. Famous or not, it is traumatic enough having a life threatening disease, but worse still is the endurance of unpleasant treatments to hopefully regain quality of life and possible cure. It is a poignant time therefore, following International Women’s Day to consider the options women have in these health matters.

‘Wonder drugs’ such as Tamoxifen received extensive news coverage promising huge success but often the side effects were not quite so exposed such as pa inful conditions like endometriosis which often necessitates the regular taking of pain-killers that might also pose a health risk with long term use. Research also considered a possible link to increased risk with endometrial cancer in the lining of the uterus. Could HIFU be the hopeful alternative on the horizon?

In Britain, clinicians in the Midlands are currently exploring the demand for HIFU and aim to pioneer a new clinical service by capitalising on a unique funding plan. The fi nancial scheme has been organised by UK HIFU Medical Marketing Limited for both NHS and independent health groups matching investment with savings, providing at worst a cost-neutral solution. At the Churchill Hospital, Oxford clinical trials in kidney and liver cancer specifi cally utilize HIFU technology.

Anecdotal evidence suggests the treatment stimulates an immune response to tumour cells. HIFU also appears to reduce cancer pain, an immeasurable benefi t in palliative care where quality of life is as important as curative strategies.

Alan Walton, Managing Director of UK HIFU Medical Marketing Limited said, We are very excited about the opportunity to enhance the prospects of hospitals having HIFU to explore treatments for fi broids as well as clinical trials for cancer. Oncologists are keen to explore HIFU because of indications that cancer cells secrete factors which immobilise the immune system. After one week or even a single treatment patients20show signs of renewed immune response to the necrosed cancer cells. High temperatures over 80-90 degrees Celsius achieved within seconds cause the coagulated necrosis, (break down of tumour cells). This enhancement of immune stimulation is an important topic deserving further studies.. We feel it is now time for Brita in to consider the HIFU treatment more seriously and demand is the key to moving things forward.

To fi nd out more fax:HIFU Medical Marketing Ltd on: +44 (0) 1524 854853 or contact Alan Walton, Managing Director at email:

alanwalton@haifuhifumarketing.co.uk

Web address:

www.theraputicultrasound.vpweb.co.uk

When responding to articles please quote ‘OTJ’

Free patient warming kits help

hospitals to meet budget

Patient-warming blankets are being offered free-of-charge to 50 hospitals in East Anglia by the high-tech warming company Hot Dog International.

The company says that the full body blankets are being made available as part of a £500,000 investment in supporting the NHS towards the end of the fi nancial year. Hospitals can apply to have as many as fi ve blankets.

“Some hospitals had told us that they were running out of patient-warming budget towards the end of the fi nancial year”, said Hot Dog International’s UK President Robin Humble.

“This is a controlled exercise which will enable some hospitals to continue to warm patients despite budget constraints and also to try out a more affordable and environmentally-friendly patient warming technology”.

The company is also including in the kit information on how the new technology enables hospitals to save substantial amounts from their warming budgets.

“Using this new form of patient warming will successfully keep their patients warm and make substantial savings”, said Mr Humble.

Further information: Robin Humble, President, Hot Dog International, Email: rhumble@augbiomed.com Tel: 07802 662727

Quote ‘OTJ’

8 THE OPERATING THEATRE JOURNAL www.otjonline.com

Erik Lovquist, a researcher with Limerick’s Interaction Design Centre (IDC), concurs: “Many means of assessing doctors and surgeons in training environments has, in the past, been subjective. “This tool offers trainers a chance to objectively test students in the fi eld.”

‘Feedback’

The “haptic simulator” recreates the skin tension felt by the practitioner at the point the needle is inserted. If the injection is not carried out correctly, the trainee receives immediate audio and visual feedback.

The developers questioned doctors extensively about the precise tactile responses involved in inserting a needle between two vertebrae of the human back.

The result is an advance that incorporates visual feedback - allowing the operator to view a 3-D map of the area while simultaneously positioning the needle.

Trainees can operate in either “trial” or “practise” mode, and safely locate the optimal point for a spinal injection – called the “intrathecal space”.

In trial mode, the audio and visual clues can be turned off. Correct placement of the needle is registered by the sight of fl uid draining from the needle, which is what happens during the real procedure.

This could be used to train surgeons to carry out operations on elderly people, epidurals on expectant mothers and lumbar punctures to obtain biopsy samples of the cerebro-spinal fl uid (CSF) that circulates around the spinal cord.

Currently, the IDC team led by Professor Liam Bannon are half way through the development phase and have embarked on trials in Hungary and Ireland.

By John Rainsford Science reporter BBC

It uses computer graphics and a virtual needle to realistically recreate contact with the spine. The tool was developed by scientists at the University of Limerick, Ireland.

In the past, the procedure was fraught with danger, and medical staff learning the technique had to take extreme care not to damage patients’ spinal columns.

According to the scientists, this is a major breakthrough in the process of teaching spinal anaesthesia, and could be used widely in hospitals within three years.

Recreating surgery

Human vertebrae are protected by a delicate gel like substance that is less than one inch thick. Safely injecting the spine is very diffi cult; anaesthetists run the risk of damaging a patient’s spinal column or the blood vessels that serve it.

Developed in conjunction with Dr George Shorten of Cork University Hospital, the new simulator exploits state of the art ‘haptic toolkits’. These are multi-disciplinary technologies that can accurately recreate the touch and feel of real-time surgery.

Dr Mikael Fernstrom, head of Limerick University’s masters degree in interactive media, says the project has tremendous potential. The advance comes at a time of growing concern over patient safety, and new EU legislation limiting working hours in hospitals. In addition, some patients cannot be completely anaesthetised during spinal procedures, for fear of postoperative complications. Such problems make the use of surgical simulators all the more vital.

Inserting a needle between two vertebrae is a delicate operation

The simulator recreates the sensation of injecting the skin and gives visual

feedback

1 - Injection site between the third and fourth lumbar vertebrae2 - Local anaesthetic is injected into the cerebrospinal fl uid (CSF)3 - Needle must penetrate muscle but not touch spinal cord4 - The procedure numbs the lower body

Risk-free virtual anaesthetics

Medical staff can learn the delicate procedure of spinal anaesthesia without practising on live patients, thanks to a new training device.

SPINAL ANAESTHESIA

SonoSites MicroMaxx® system is the right choice for regional nerve blocksRussells Hall Hospital in Dudley has recently acquired a MicroMaxx® system, and will soon add a new M-Turbo® system, to its portfolio of SonoSite point-of-care ultrasound units, specifi cally for the administration of regional nerve blocks in theatre.

Dr Wilson Thomas is a consultant anaesthetist at Russells Hall, and explained the benefi ts of the MicroMaxx system: I have been working with SonoSite for over four years, since I fi rst trained in using ultrasound needle guidance for nerve blocks.

I also regularly use the MicroMaxx system in theatre for orthopaedic patients undergoing limb surgery, to administer cervical plexus blocks for carotid endarterectomy and in guiding the needle during tranverse abdominus plane (TAP) blocks. Using ultrasound guidance is a safer technique, as you can visualise exactly where the needle is with respect to the nerve, and avoid vital tissue structures.

We chose the MicroMaxx system because of the excellent resolution, which makes it very good for nerve blocks. We use a 13 MHz probe, and the image quality is very clear. It is a very robust system, and easy to manoeuvre, even mounted on a trolley; it has a quick start up and is easy to use - all important features in theatre.

For more information about SonoSite products, please contact:Tel +44 (0)1462 444 800, Fax +44 (0)1462 444 801Email: europe@sonosite.comWebsite: www.sonosite.com

When responding to articles please quote ‘OTJ’

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SonoSite ultrasound systems increasingly the choice for

vascular surgeonsThe portability and user-friendly operation of SonoSites point-of-care ultrasound systems are helping to promote portable ultrasound as a versatile tool for vascular surgeons. Hamish Hamilton, a vascular surgeon at Chase Farm Hospital in Middlesex, uses SonoSite ultrasound systems as a diagnostic aid as well as for ultrasound guidance for endovenous laser ablation.

Mr Hamilton explained: I have only been using portable ultrasound for a few years, and I wish I had started earlier. Im not primarily a diagnostician, but the SonoSite ultrasound systems have highlighted the benefi ts of point-of-care scanning. Although it is not our primary scanning option, features like the colour Doppler modality mean we can get a lot of information very quickly, and I think this makes clinicians more aware of the options available during diagnosis. It is ideal for taking around the wards and in theatre, and is useful as a teaching aid.

Mr Hamilton added: There are more and more vascular surgeons routinely using these systems in their clinical work largely because their convenience and ease of use makes them very helpful in managing vascular patients.

About SonoSite

SonoSite, Inc. (www.sonosite.com) is the innovator and world leader in hand-carried ultrasound. Headquartered near Seattle, Washington, USA, the company is represented by ten subsidiaries and a global distribution network in over 100 countries. SonoSite’s small, lightweight systems are expanding the use of ultrasound across the clinical spectrum by cost-effectively bringing high performance ultrasound to the point of patient care. The company employs over 600 people worldwide.

SonoSite, Ltd., a wholly owned subsidiary of SonoSite, Inc. based in Hitchin, Hertfordshire, oversees a direct sales distribution network in the UK and provides sales and marketing support for SonoSite’s European offi ces.

For more information about SonoSite products, please contact:

Tel +44 (0)1462 444 800, Fax +44 (0)1462 444 801Email: europe@sonosite.com Website: www.sonosite.com

When responding to articles please quote ‘OTJ’

First case of haemophiliac vCJDThe Health Protection Agency has confi rmed the fi rst case of the human form of “mad cow disease” in a patient with haemophilia.

A post-mortem showed the man, who was “over 70” and had received plasma products before rules were introduced to limit contagion, died infected.

However he died of other causes and had not shown any symptoms, the HPA said.

Up to 4,000 haemophilia sufferers have been warned they could be at risk of variant Creutzfeldt-Jakob disease.

The HPA says it is still unclear how the man became infected with the prion protein that causes vCJD, but it is known that he was treated with several batches of UK blood plasma products before 1999, when the risk of transmission was not known.

Specifi cally, he was treated with a batch that was manufactured from the plasma of a donor who went on to develop symptoms of vCJD.

Risk confi rmed

It is the fi rst time that vCJD has been found in one of the thousands of haemophiliac patients who received blood plasma transfusions between 1980 and 2001. They have been told they all run a low risk of developing the disease.

While this is the fi rst case involving plasma products, three people have died after being infected with vCJD linked to blood transfusions.

“This new fi nding may indicate that what was until now a theoretical risk may be an actual risk to certain individuals who have received blood plasma products, although the risk could still be quite low,” said Professor Mike Catchpole of the agency’s Centre for Infections.

“We recognise that this fi nding will be of concern for persons with haemophilia who will be awaiting the completion of the ongoing investigations and their interpretation.”

There is no test that can screen for vCJD, although development work is underway. However, even if an effective test were available, there is no means of treating the brain-wasting disease.

Professor Catchpole added: “This fi nding does not change our understanding of the risk from vCJD for other people in any specifi c way. But it does reinforce the importance of the precautionary measures that have been taken over the years.”

UK plasma is no longer used for the production of the clotting treatment haemophiliacs require, and when suitable, synthetic products are used.

Chris James, the chief executive of the Haemophilia Society, said the Department of Health needed to now act “swiftly to give people the full details and offer them the appropriate support.

“Detailed information about recent developments must be made available immediately to all those who have been treated with potentially-infected plasma products.”

David Allsop, professor of neuroscience at Lancaster University, said there was no need for widespread concern among haemophilia sufferers.

“The only real cause for concern is for other haemophilia patients who received clotting factors from the same infected human donor, at around the same period of time; and they can presumably be traced and given specialist advice.”

VCJD was fi rst detected in the mid-1990s but remains rare. The vast majority of the 164 deaths in the UK are believed to be linked to eating meat infected with bovine spongiform encephalopathy (BSE).

Source: BBC

fi nd out more 020 7100 2867 • e-mail admin@lawrand.com Issue 223 APRIL/MAY 2009 11 l

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Improvements To The Regulation Of

Healthcare Professionals 20 Mar 09

Measurements to improve the regulation and governance of healthcare professionals, providing greater reassurances for the public and professionals, were set out in two reports published on the 20th of March by the Department of Health.

The Tackling Concerns Nationally and Tackling Concerns Locally reports are part of the wider Government reforms on professional regulation to raise professional standards and ensure patient safety. These two reports are the result of external working groups taking forward the implementation of the reforms announced in the White Paper Trust, Assurance, Safety: the Regulation of Health Professionals in the 21st Century over the last 18 months.

Tackling Concerns Nationally (TCN) makes recommendations on professional regulation and assuring patient safety at a national level. It sets out recommendations for the establishment of the Offi ce of the Health Professions Adjudicator (OHPA) which will look at cases brought forward assessing fi tness to practise for healthcare professionals.

This separate body would be independent from existing professional regulators, the Government and the healthcare profession to ensure absolute fairness and transparency. The board will initially take on cases concerning doctors and will expand to other professions. A consultation has also been launched today which sets out proposals for the principles and governance of this new body.

Tackling Concerns Locally (TCL) sets out recommendations and principles of best practice to strengthen local NHS arrangements for identifying poor performance among healthcare workers and taking effective action. Local implementation will be supported by more detailed operational guidance and by regulations which the Department of Health will introduce later this year, after consultation with interested parties.

Health Minister, Ben Bradshaw said:

Our overriding priority is to ensure that patients and the public are protected. The recommendations outlined in Tackling Concerns Nationally and Tackling Concerns Locally will put in place the best systems, both locally and nationally, to identify and address concerns about individual professional conduct and competence.

These reports go a long way to further ensure healthcare standards in the NHS are high, and to reassure both public and professionals that the systems and processes put the safety of patients at their heart, while being fair to staff.

Professor Jenny Simpson OBE, Chief Executive of the British Association of Medical Managers and chair of the overarching Tackling Concerns Locally working group said:

Every patient, professional and healthcare organisation has the right to expect that robust systems are in place ensuring that colleagues delivering care are up to date and fi t to practice.

I am delighted to see the launch of this important document. It details a range of practical measures, specifi cally designed to bridge any gaps between structures and processes within local organisations and national -level regulatory mechanisms.

Both Tackling Concerns reports are a critical component of the Governments drive to improve NHS services, as set out in the 2008 Next Stage Review, High Quality Care for All. As part of the professional standards programme, the Department of Health is looking at how to implement the recommendations in Tackling Concerns to help deliver the high quality workforce needed to ensure the safe, respectful and effective care that patients expect.

The Tackling Concerns Nationally and Tackling Concerns Locally reports

can be found at: Tackling Concerns Nationally: establishing the Offi ce

of the Health Professions Adjudicator (report)

http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/Publi

cationsPolicyAndGuidance/DH_096502

Tackling Concerns Locally: report of the Working Group

http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/Publi

cationsPolicyAndGuidance/DH_096492

12 THE OPERATING THEATRE JOURNAL www.otjonline.com

New NVQ team at Eastwood Park

Angela Palmer (pictured above right) is the new NVQ Manager at Eastwood Park. Working with her is Claire Mitchell (left) who has recently joined as NVQ Co-ordinator.

Both have been instrumental in developing the new department and promoting the Level 3 NVQ in Health (Decontamination) qualifi cation among those working in Sterile Services Departments throughout the health sector. Between them they work with a large group of external verifi ers and assessors across the country and over 350 candidates are in the process of attaining the award since Eastwood Park started to offer the courses. More than 100 have already qualifi ed.

Angela is passionate about promoting the NVQ qualifi cation opportunities among those working in hospitals and trusts: “The beauty of the NVQ system is that candidate’s skills are assessed through work-based evidence, observations, professional discussions and witness testimony. This is practical; competence based training which is helping to raise the standards of cleanliness and infection control at the heart of the health sector. It is making a real difference.”

A number of learners have also been eligible for funding, or even part funding which allows more accessibility to those wanting to develop their skills, as well as having an opportunity to train to become assessors for the Decontamination programme through Eastwood Park.

The team are looking forward to developing new programmes this year that will include apprenticeships and courses focused on infection control and decontamination in different environments.

Eastwood Park is the only third-party provider in the UK delivering NVQs in Decontamination. To fi nd out more contact:sales@eastwoodpark.co.uk or call: 01454 262777 and visit: www.eastwoodpark.co.uk. When responding please quote ‘OTJ’

Productive Theatre Strategies & Lean ThinkingIn 2006 the director of the NHS Institute for Innovation and Improvement announced that Lean Thinking and Six Sigma were to be adopted as the methodologies of choice for implementing improvement in the English NHS.

Through the introduction of the ‘productive operating theatre’ scheme which uses the principles of Lean Thinking and Six Sigma the programme aims to remove waste activities from processes and therefore enable staff to focus more time on patient care.

In several recent studies it has been demonstrated that by introducing custom procedure packs into the theatre setting, savings can be made in terms of both cost and time, and it is estimated that 60% of all surgeries performed involve some type of procedure pack because of the many benefi ts they provide.

As a leading provider of Custom Procedure Packs Pennine Healthcare also ‘practice what they preach’ by the adoption of a company-wide approach to Six Sigma and development of a ‘lean culture’. This is now one of Pennine’s core manufacturing principles, and is fundamental to the company’s commitment to continuous improvement.

By managing theatres more effectively through the adoption of lean strategies, staff will be given the knowledge and tools they need to improve theatre performance, increase patient throughput, enhance reliability and safety of patient care, develop effective team working and leadership, and improve effi ciency by reducing waste and driving down waiting times.

By embracing teamwork, training, skills development, communication and motivation Pennine Healthcare has become a point of reference for other companies looking to embark upon lean manufacturing.

Pennine is happy to organise pre-arranged visits from any business that would like to see mature lean principles and practices in action. For further information or to arrange a visit please contact:Annette Dunne, Sales & Marketing Manager,

on Tel: +44 (0)1332 794880.

Features Advantages Benefits

Faster pick and lay-up times More efficient use of theatre time

Increases patient throughput and faster response times foremergency procedures

Eliminates picking errors All required products to hand when needed

Reduced theatre time waiting for correct products to arrive

Management of staffresources

Allows more time to be spent with the patient in the clinical setting

Allow clinical staff to do what they are trained to do and so improves staff morale

Reduced inventory andnumber of order points

Continuity of consumables supplied

Reduction in waste and order administration

Costs per procedure easily identifiable

Greater cost control More efficient allocation of budgets

Single patient use instruments Reduced risk of cross contamination

Reducing post-operative infection and hospital stay

Reliable, regular and ‘just in time’ deliveries of packs to hospitals

Only stocking what isrequired when required

Reduce the amount ofredundant stock held

Are you reading someone else’s

copy of the OTJ?

Then why not “download” your own

from the Links Page of

www.otjonline.com

Sick children at risk from poor trainingCritically ill children are having their life put at risk by inadequate

medical training in London hospitals

A recent report says that many health trusts in the capital are failing to give doctors, nurses and surgeons the specifi c skills needed to treat patients under 16.

Medical watchdog, the Healthcare Commission, found that nine out of 10 London trusts are not providing basic training on how to resuscitate children or provide emergency life support and only one in 10 has anaesthetists who have performed the recommended number of consultations on children.

The report also showed that more than a third are not training surgeons to recognise signs of child abuse, despite criticisms in the Baby P scandal that doctors failed to spot signs of life-threatening injuries.

Anna Walker, the commission’s chief executive, demanded “refresher” training each year and said: “’We are particularly concerned about training in child protection.

“It is absolutely vital that NHS staff working with children know how to recognise signs of child abuse.

“Children are not ‘mini adults’. They can’t always articulate their symptoms or level of pain and some illnesses in children are rarely seen in adults.

“That’s why it is so important that staff are equipped with the skills and training they need to assess and treat children.”

Source: Evening Standard

fi nd out more 020 7100 2867 • e-mail admin@lawrand.com Issue 223 APRIL/MAY 2009 13 l

FITkit® tests show undetectable NRL allergen

levels in Ansells Gammex® PF surgical glove range

The Association for Perioperative Practice

strengthens support for Patient Safety FirstThe Association for Perioperative Practice has spoken out to show its continued support of Patient Safety First, the innovative patient safety improvement campaign for England. Representing between 30 and 40 per cent of all nurses and 10 per cent of Operating Department Practitioners, the Association for Perioperative Practice is encouraging Trusts and individual Perioperative staff from around the country to show their commitment to putting Patient Safety First by signing up to the Campaign at www.patientsafetyfi rst.nhs.uk.

The pioneering Campaign has been created to promote a strong patient safety culture in Trusts, helping to eliminate avoidable death and harm in the healthcare environment. So far, 86% of acute Trusts have signed up to the Campaign and are actively changing the way they work to put Patient Safety First.

Patient Safety First welcomes the continued support of the Association for Perioperative Practice which has the power to strengthen the message of Patient Safety and to encourage more staff to join the Campaign.

Diane Gilmour, President of the Association for Perioperative Practice says: “Patient Safety First is a banner around which all Perioperative staff can rally. By getting involved and actively seeking ways to support the Campaign, you will be part of the driving force that is changing behaviour and attitudes towards patient safety in theatres across the country. Perioperative staff don’t want their patients to be harmed by surgery. Patient Safety First can empower each of us to make the small changes that make a big difference.”

The Association for Perioperative Practice is just one of the vital health organisations that have pledged their support for Patient Safety First,

along with the Royal College of Nursing, Royal College of Anaesthetists, and the British Association of Medical Managers.

Mark Emerton, Consultant Orthopaedic Surgeon at Leeds Teaching Hospitals NHS Trust and Core Team Member of Patient Safety First

says: “Patient Safety First is calling for all those working with patients to commit to the Campaign. We are working to actively change hearts and minds and to enhance strong and supportive patient safety cultures in Trusts throughout England. The support of the Association for Perioperative Practice is very important to us as it has power to infl uence hundreds of operating theatre staff across the country – it is, after all, the front line staff that have the power to make the greatest difference to patients.”

Patient Safety First is part of an international move to make hospitals safer. It is a voluntary Campaign which supports Trusts in making recommended changes to practice that are proven to reduce the level of avoidable harm. These include:

• Leadership for safety – getting Trust Board s to clearly demonstrate that patient safety is their the highest priority

• Care of deteriorating patients in acute care – to reduce in-hospital cardiac arrest and mortality rate through earlier recognition and treatment of the deteriorating patient

• Reducing harm in critical care – Improving the care of patients receiving critical care through the reliable application of care bundles.

• Reducing harm in Perioperative care – Preventing surgical site infection and implementing the World Health Organisation’s Safe Surgery Checklist

• Reduction of harm from high-risk medication – includes anticoagulants, opiates, injectable sedatives and insulin.

For further information about the Patient Safety First Campaign,

please contact:

Catherine Chapman Kat Adams Press Relations Press RelationsE, Catherine@pr4.com E, kat@pr4.comT, 0207 637 1237 T, 0207 637 3845M, 07872 921599 M, 07852 185967

Who is behind Patient Safety First?

Patient Safety First is not Government-led. It is sponsored by three organizations who are leading the agenda for quality and safety improvement in the NHS sponsors: the National Patient Safety Agency (NPSA), the NHS Institute for Innovation and Improvement and The Health Foundation. It is shaped and delivered by a Core Team of activists whose specialization stretches across a broad spectrum of clinical and managerial experience in the NHS.

Why was Patient Safety First developed?

The Chief Medical Offi cer’s report, Safety First (Department of Health, 2006), set out a number of actions to improve patient safety and increase healthcare quality across England. A key recommendation was to develop and implement a high-profi le initiative to ensure that all staff responsible for patient care understand that patient safety must become their fi rst priority.

When was Patient Safety First launched?

• Patient Safety First was launched at the NHS Confederation Annual Conference (18th-19th

June 2008) and the development of a dedicated website, www.patientsafetyfi rst.nhs.uk, followed shortly after.

• Since the Campaign has launched a total of 260 organisations have signed up. This includes 86% of all acute trusts, engagement through all 10 SHAs as well as 13 national organizations.

Ansell Healthcare, a global leader in hand protection solutions, announced that new tests using the unique FITkit® methodology have demonstrated undetectable allergen levels in Ansells bestselling Gammex® PF range of surgical gloves. These tests confi rm Ansells continuous research efforts to minimize the onset of type I allergic reactions to Natural Rubber latex (NRL) gloves.. Developed by leading scientists working in the area of NRL allergy, FITkit® is unanimously recognised as the fi rst specifi c test method for identifying and quantifying individual NRL allergens.Thanks to their seamless combination of superior barrier protection with tactile sensitivity and comfort, NRL gloves have been widely used by surgeons all of the world. With the growing awareness about latex allergy, however, some resistance occurs to choose NRL. But not justifi ed, says Ansell Healthcare, as ongoing switch of powdered gloves into powder free ones has a confi rmed effect on the reduction of the allergy rate amongst healthcare practitioners. Moreover many NRL gloves today contain very low allergy levels. The company has always invested heavily, to reduce the allergen levels in their gloves. The resulting manufacturing process, including intensive post-washing and leaching procedures, ensures the lowest levels of allergenic potential in latex gloves.

FITkit®: a breakthrough allergen detector

The effectiveness of this approach has recently been proven through tests that utilize the unique FITkit® methodology. Developed by leading Finnish NRL experts, in cooperation with glove manufacturers like Ansell, FITkit® is a breakthrough methodology that stands out from all other tests on the market on account of its sensitivity, accuracy and

reliability. As a pioneer in latex allergy, Ansell has welcomed the FITkit® as additional procedure to measure the allergen levels in its NRL gloves. FITkit® is marketed by Quattromed (www.quattromed.com).

Gammex® PF ensures undetectable allergenicity

The result of such recent measurements was highly favourable for Ansells Gammex® PF range of surgical gloves. All tested Gammex® PF gloves showed undetectable levels of allergens. This success demonstrates that Gammex®, which has set the standard in many hospitals for its unbeatable combination of protection and comfort levels, is the answer for the most demanding surgical requirements.

About Ansell:Ansell Limited is a global leader in barrier protective products. With operations in the Americas, Europe, and Asia, Ansell employs more than 11, 000 people worldwide and holds leading positions in the natural latex and synthetic polymer glove and condom markets. Ansell operates in three main business segments: Occupational Healthcare, supplying hand protection to the industrial market; Professional Healthcare, supplying surgical and examination gloves to healthcare professionals; and Consumer Healthcare, supplying condoms and consumer hand protection. Information on Ansell and its products can be found at http://www.ansell.eu

For more information, please contact:

Wouter Piepers, Director Communications, Ansell Healthcare,Tel: + 32(0)2 528 75 68, Cell. +32 (0) 478 33 56 32email: wpiepers@eu.ansell.com Please quote ‘OTJ’

14 THE OPERATING THEATRE JOURNAL www.otjonline.com

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Benefi ts of Subtilis® shown in new DVD

from The Electrode Company

The Electrode Company Ltd (TEC) specialises in non-invasive monitoring, optical sensors and high performance pulse oximetry. TEC has

now developed Subtilis, a truly diagnostic pulse oximetry system, that calibrates itself

both to the sensor and to the patients variables. As a result, a new, brief DVD is now available on this unique non invasive

blood spectrometry device.

The DVD is all about receiving something which is measurably different and better than conventional pulse oximetry, namely blood spectrometry. This is the next generation of blood oxygenation monitoring technology.

The DVD covers a number of areas, including:

• How pulse omimetry has become well established, resulting in clinicians reliance on it for vital medical decisions.

• How 36 UK hospitals have been surveyed, and reveal that up to one third of pulse oximeters could impact adversely on clinical decisions.

• How in a patient undertaking breathe down exercises to deoxygenise his blood, a ‘high’ reading pulse oximeter can become even less reliable as SpO2 falls.

• How blood levels of melanin interfere with the absorption of light, thereby causing pulse oximetres to read ‘high’. Subtilis adjusts to varying levels of melanin, thus providing precise and personalised blood oxygen monitoring.

The DVD details a number of benefi ts from the use of Subtilis, which result in improved patient outcomes and potential cost savings. For your copy of the DVD, or for more information on Subtilis, please visit The Electrode Company Website on www.electo.co.uk, telephone the company on 01291 650279.

The Electrode Company: Ensuring accurate data for better clinical outcomes. Please quote ‘OTJ’

Safety in numbers - NPSA publishes new local patient safety incident data

NHS staff are more likely than ever to raise a patient safety concern as new data, released recently by the National Patient Safety Agency (NPSA), demonstrates an upward trend in safety reporting.

From the 6th of March the NPSA began publishing Organisation Patient Safety Incident Reports from each NHS trust or local health board in England and Wales.

The NPSAs Reporting and Learning database began recording patient safety incident reports in 2003. Since then the NPSA has encouraged all healthcare staff to report to the database to help the NHS understand why things go wrong, and how to prevent them happening in the future.

The latest data show that over 65% of all patient safety incidents result in no harm to the patient. The most common problems are patient accidents, followed by treatments and procedures and medication related incidents.

Speaking about the release of the Organisation Patient Safety Incident Reports, Martin Fletcher, Chief Executive, NPSA, said: If we dont know where the problems are, then we cant fi x them. That is why we are so pleased that more and more staff are reporting safety concerns. This shows that there is a much greater awareness of patient safety amongst NHS staff. We believe that an organisation with a high reporting rate is much more likely to have a strong commitment to patient safety and high safety standards.

We will never be able to stop human beings making mistakes, but we can try and ensure that such errors do not translate into patient harm. This is why reporting of incidents even when there is no harm to patients is important. These incidents represent the best opportunity for learning because NHS staff are raising a safety concern before anyone gets hurt.

The publication of Organisation Patient Safety Incident Reports aims to encourage greater awareness of patient safety and to improve the quality of local and national reporting from all healthcare staff, as part of embedding strong patient safety standards in all NHS organisations.

Welcoming the publication, Professor Sir Bruce Keogh, NHS Medical Director, said: Whilst there is obvious value in reporting incidents where patients have suffered harm, it is just as important that we encourage people to report even more incidents that highlight potential risk to patients so that they can be analysed and corrected well before anyone comes to harm.

Sir Robert Naylor, Chief Executive, University College Hospital NHS Foundation Trust, said: Publishing this data will help to improve patient safety. The sharing of reports will enable trusts to learn from one another to ensure similar incidents do not occur in the future. At UCH we are continually introducing initiatives designed to improve the quality of care for patients such as our recent Safety Improvement Project which aims to minimise the risk of falls.

Cynthia Bower, Chief Executive of the Care Quality Commission said: Ensuring that services are safe is at the heart of the work of the Care Quality Commission. Knowing about when things go wrong helps us to understand the reasons for failings in patient safety and helps everyone to improve standards. It is particularly good to see that more staff are reporting safety concerns, demonstrating their commitment to patient safety.

Dr William Moyes, Executive Chairman of Monitor said: Monitor welcomes the increased transparency that publication of trust-level data on incident reporting will offer. For the fi rst time the Boards of trusts will be able to examine closely the levels and patterns of reporting in their own hospitals and how this compares with other hospitals. This will add to their understanding of its performance and will enable boards to take action to remedy areas where there might appear to be problems. This is an important step towards developing the rounded understanding of the quality of services that a board needs if it is to discharge properly its responsibility for the performance of the hospital.

Katherine Murphy of the Patients Association commented: “This is long overdue. Patients need local information on which to base their treatment choices. It needs to be in an easily understandable and accessible form or patients cannot give truly informed consent and make comparisons.”

The Organisation Patient Safety Incident Reports are based on reports by NHS organisations in England and Wales for the period April 2008 to September 2008 will be available from Friday 06 March on www.npsa.nhs.uk

find out more 020 7100 2867 • e-mail admin@lawrand.com Issue 223 APRIL/MAY 2009 15

‘ Make A New Start!-HIFU-Theraputic Ultrasound

for Tumours’Exciting commission only opportunities for several areas in

the UK in the rapidly emerging area of non-invasive HIFU

theraputic ultrasound.

It is unique! It could also be part-time but you would have to

have exceptional contacts to do this.

This is a unique range of cancer-treating systems and already

over 20,000 patients have been treated world-wide.

We have to be extremely selective in this and a ‘can do’ attitude

on your part is absolutely vital to make this work.

If you think you have what it takes then simply e-mail your CV

to: alanwalton@haifuhifumedicalmarketing.co.uk

or fax to: 01524 854853

*The largest HIFU Centre in the world has been given the

green light in the East Midlands*

find out more 020 7100 2867 • e-mail admin@lawrand.com Issue 223 APRIL/MAY 2009 15

Datascope Patient Monitoring & Mindray

Earlier this year Mindray acquired Datascope's Patient Monitoring business with the stated intent of using Datascope sales operations and infrastructures as routes to market for both Mindray and Datascope branded patient monitoring products. This strategy will allow us to build a strong and sustainable business, structured to lend the best long term support to our products for the benefit of our customers and patients.

From 1 April 2009 Mindray UK Ltd will become responsible for the future sale and total support of both Mindray and Datascope brand patient monitoring products. We will ensure continuity of support for all Mindray and Datascope brand patient monitoring products previously purchased through authorised channels.

The people involved in the UK operation are primarily those people you will have known previously as Datascope people.

In the recent past Mindray patient monitoring products have been sold on a distribution basis by Artemis Medical Ltd to whom we are grateful. Until 31 March 2009 we strongly encourage all customers to continue to place their Mindray patient monitoring product orders with Artemis who will have undertaken sales effort during the year. Artemis will process, deliver and invoice your Mindray patient monitoring product order and Mindray UK Ltd willprovide future support for your purchase. This will include the standard Mindray manufacturer warranty.

We strongly believe that from 1 April 2009 our new direct structure will have us much closer to our customers and better able to serve them with locally located sales people, service technicians and application specialists. Our team will be focused on satisfying customer needs and you can be assured ofcloser, faster after sales support from Mindray UK Ltd.

If you have any questions or would like any further information we would be very pleased to hear from you. As you can see below both businesses have now come together as one.

Mindray UK Ltd 3 Percy Road St. John’s Park Huntingdon PE29 6SZ

Tel: 01480 416840 Fax: 01480 436588 Email: uksales@dat,ascopemonitors.,eu ukservice@datascopemonitors.euWeb: www.datascopemonitors.us

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