FEATURE ARTICLES

A number of speakers at this year’s Association for Perioperative Practice (AfPP) Congress pointed out that high-risk industries have made significant advances towards cultural improvements, focusing on systems change, human factors and team building. The lessons learned can be applied to everyday medical practices, according to ALLAN GOLDMAN, the lead consultant in cardiac critical care and head of ECMO, at Great Ormond Street Hospital.

At this year’s Association for Perioperative Practice (AfPP) Congress, only 10% of an audience of perioperative practitioners said they believed safety was the highest priority at their Trust, while surgery was described by one speaker as being “as risky as bungee jumping”. Changing the culture of organisations will no doubt prove challenging, but efforts to improve safety are now gaining momentum LOUISE FRAMPTON reports.

This year’s Association for Perioperative Practice (AfPP) Congress and Exhibition took place at Harrogate, last month, attracting top leaders in healthcare – including the Chief Medical Officer, Sir Liam Donaldson, as well as champions of patient safety such as entrepreneur Sir Richard Branson. KATE WOODHEAD RGN DMS gives a flavour of what the event had to offer.

MARK HALL, a consultant cardiologist at the Liverpool Heart and Chest Hospital, describes his experience of using a new generation of implantable cardioverter defibrillators – reporting advantages in device safety, size and longevity.

In the past, there have been concerns over the standards of decontamination within hospitals, yet funding for training has often been considered a low priority. The Clinical Services Journal speaks to specialist managers at Eastwood Park and in the NHS about the need to provide structured training to address the skills gap.

Despite significant improvements in the delivery of emergency care, the Healthcare Commission has found that the public often does not know which services to use. The needs of those with disabilities in A&E are being ignored, while the planning of services and the monitoring of performance was poorly managed in 40% of PCTs. The Clinical Services Journal reports.

Seven hospitals have been chosen to assess a number of infection prevention and control technologies, under a programme aimed at obtaining evidence on their efficacy. LOUISE FRAMPTON reports.

More than 3,000 experts from around the world gathered at the 6th World Stroke Congress, in Vienna, to discuss current trends and strategies in the field of stroke prevention and treatment. Subjects ranged from the effectiveness and safety of decompressive hemicraniectomy, to a possible new thrombolysis agent in acute ischaemic stroke. The Clinical Services Journal reports.

KATE WOODHEAD RGN, DMS, technical editor of The Clinical Services Journal, and chairman of Friends of African Nursing, provides an insight into one of the ways in which she spends her spare time.

A coroner’s inquest into the death of a patient poses complex challenges for any NHS organisation. These are likely to intensify with the advent of the Corporate Manslaughter and Homicide Act 2007 which came into force in April this year. JOANNA TREWIN, a partner at legal firm Hill Dickinson LLP, provides guidance for those who may become involved in an inquest as a witness or as a manager liaising with the coroner’s office.

BERYL DE SOUZA and KAUSHIK CHAKRABARTY provide an insight into the many sub-specialties within the pioneering field of plastic surgery and discuss its origins and development.

A hands-free, wireless system is improving communications, and ultimately patient care, at the Belfast Health and Social Care Trust. At the Royal Victoria Hospital, an estimated 4,000 hours of wasted time are being saved annually within the emergency department alone. LOUISE FRAMPTON reports.

When MEDICA – the 40th world forum for medicine – takes place in Düsseldorf (19-22 November 2008), procedures for improved diagnostics and therapy for cancer patients will be among the topics. High on the agenda will be significant advances in the field of hyperthermia, which are showing promising results in European studies.

The National Institute for Health and Clinical Excellence (NICE), in collaboration with the National Patient Safety Agency (NPSA), has issued guidance to reduce the risk of pneumonia in patients who are on a ventilator. The Clinical Services Journal reports.

Cisco’s Internet Business Solutions Group (IBSG) is piloting a remote teleconsultation system that combines video, audio and medical technology with IP telephony to create a “consulting room” environment in a medical setting, home, office or shopping mall. Two key goals are to enable patients many miles from their nearest doctor to receive remote consultations, and to reduce pressure in hospital emergency departments. JONATHAN BAILLIE reports.

Dr FERDINAND SERRACINO-INGLOTT looks at why a growing number of vascular surgeons are offering a minimally invasive alternative to open surgery, known as endovascular aneurysm repair (EVAR).

MARTIN KIERNAN, nurse consultant, infection prevention and control, Southport and Ormskirk NHS Trust, and vice-president of the Infection Prevention Society (IPS) discusses best practice when using drapes and gowns.

The concept of transfusing patients in a non-hospital environment is growing in popularity and has many benefits. Transfusion scientist BARRY HILL examines the background behind this development and the implications for healthcare providers.

DANIEL STEINES and JONG LEE discuss the issue of revision surgery in patients receiving knee implants and argue that a patient-specific approach to implant design could have significant value.

The Health Protection Agency (HPA) recently published its third annual report on surveillance of healthcare-associated infections in England. The results showed that significant progress has been achieved, but the agency warned that vigilance is required in relation to changes in epidemiology and new strains of pathogen. The Clinical Services Journal reports.