FEATURE ARTICLES

Consultant anaesthetists, Dr HOWARD WAKELING and Dr CAROLINE JENKINS, from the Western Sussex Hospitals NHS Trust, provide an update on the latest research on the use of oesophageal Doppler monitoring (ODM) to guide fluid management during surgery.

Despite the high prevalence of diabetes in the western world and the significant increase in hospital admissions, it remains poorly understood by non-diabetic specialist hospital staff. M S KAMARUDDIN,* R QUINTON,† N LEECH,§ examine the question: is inpatient diabetes care adhering to the principle of “first do no harm”?

The MHRA recently hosted a programme of workshops aimed at improving compliance with the Blood Safety and Quality Regulations.

KATE WOODHEAD RGN, DMS examines how healthcare organisations can retain and capitalise on the experience of older workers.

Graft infection rates following vascular surgery have been significantly improved at the Leicester Royal Infirmary through a raft of changes at the Trust. As an unexpected consequence, antibiotic costs have been halved. LOUISE FRAMPTON reports.

The NHS has been criticised for “not doing enough to promote innovation”. However, health minister Lord Darzi has announced major plans to transform health service performance – including a £220 million fund for innovation, prizes for inventions, and a requirement for SHAs to produce annual innovation reports.

Based on 8.6 million surgical procedures performed in the UK each year, an infection rate of 4.2% and treatment costs of approximately £2,100 per infection, the total cost of surgical site infection (SSI) is estimated to total £758 million per annum.

The health service is faced with the challenge of managing a multi-generational workforce – each with different cultural values and career aspirations. Achieving a better understanding of each generation, their differences, and how to motivate them, could have an important contribution to the development of successful teams. KATE WOODHEAD RGN, DMS reports.

In cases of acute, severe colitis, is it preferable to perform prompt surgery or should a policy of conservative management be adopted? Leading experts recently debated this issue at the British Society of Gastroenterology’s annual meeting, in Glasgow. LOUISE FRAMPTON reports.

At a recent training course on legal issues, Kate Hill, a medical law specialist, explained that giving evidence in court cases is “all about confidence and preparation”. Understanding the tricks that lawyers may use to discredit you, staying in control in the witness box, and ensuring good documentation are key to performing well. LOUISE FRAMPTON reports.

The Association for Perioperative Practice (AfPP) is a registered charity developing and promoting high standards in perioperative practice. The new president, DIANE GILMOUR, and new chief executive, ALISON TAIT, are introducing significant changes, including radical plans to boost the skills and education of perioperative practitioners, involve the organisation in new areas and influence political thinking on perioperative care. They offer an insight into the AfPP and the future role of the organisation.

It is the responsibility of the whole of the healthcare community to strive for reduced levels of healthcare-acquired infections – but the direction, support and resources must first be in place to ensure frontline clinicians have the right tools for the job, argues RICHARD O’BRIEN.

Trainee surgeons say they are under pressure to lie about the hours they are working and are struggling to gain sufficient theatre experience, due to restrictions imposed by the European Working Time Directive. Concerns were raised that limiting the working week could lead to inferior training and ultimately affect patient safety. The Clinical Services Journal reports.

Optimum tuberculosis management requires rapid detection, prevention and treatment – but current technology is inadequate, says Dr DAVID PERSING. He explains why a new test could prove to be one of the most important diagnostic developments to have occurred in many years

The demand to provide more oral anticoagulation outpatient clinics beyond the boundaries of the traditional hospital environment is increasing, as biomedical scientist, BARRY HILL points out.

MIKE PALIN argues that important aspects have not been included in NICE guidance on SSIs in relation to surgical clothing and drapes.

Experts at the Healthcare-acquired Infections Conference, in Crewe, highlighted the need to monitor and take action on all healthcare-associated infections.

While adherence to basic infection control practices is essential, novel technologies for prevention of vascular access-related infection are urgently needed, experts stated at a recent symposium.

At its last Annual Scientific Meeting, the British Society of Gastroenterology highlighted some serious issues in the delivery of services and has been campaigning hard to improve the quality of care.

Dr ROLAND ENGLAND, MB BCh BSc (Hon), FRCS (Urol), consultant urologist at Kettering General Hospital, looks at how medical device innovation is contributing to significant advances in treating kidney stones.