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• No continuous suction required

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October 2014 Issue No. 289 ISSN 1747-728XThe Leading Independent Journal For ALL Operating Theatre Staff

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The next issue copy deadline, Friday 24th October 2014All enquiries: To the editorial team, The OTJ Lawrand Ltd, PO Box 51, Pontyclun, CF72 9YY Tel: 02921 680068 Email: admin@lawrand.com Website: www.lawrand.comThe Operating Theatre Journal is published twelve times per year. Available in electronic format from the website, www.otjonline.comand in hard copy to hospitals throughout the United Kingdom. Personal copies are available by nominal subscription.Neither the Editor or Directors of Lawrand Ltd are in any way responsible for the statements made or views expressed by the contributors. All communications in respect of advertising quotations, obtaining a rate card and supplying all editorial communications and pictures to the Editor at the PO Box address above. No part of this journal may be reproduced without prior permission from Lawrand Ltd. © 2014

Operating Theatre Journal is printed on paper sourced from Forest Stewardship Council (FSC) approved paper mills and is printed with vegetable based inks. All paper and ink waste is recycled.

Journal Printers: The Warwick Printing Co Ltd, Caswell Road, Leamington Spa, Warwickshire. CV31 1QD

NHS pay statistics publishedNHS staff in England working full time are paid an estimated average basic annual wage of £29,754, a rise of 0.7 per cent on last year and 9.4 per cent on fi ve years ago, new fi gures show.Th e report from the Health and Social Care Information Centre (HSCIC) covering the 12 months to June 2014 looks at the earnings of 1.16 million staff working in NHS hospital and community health services in England (excluding GP surgeries).Looking at mean full-time equivalent (FTE) salaries, the most appropriate measure for comparing earnings between staff groups, over the last year the largest annual increase of 4.4 per cent per cent went to locum hospital practitioners and clinical assistant doctors taking their pay up to £62,895. Th e largest decrease of 0.7 per cent went to health visitors, taking their pay to £34,038.

Variations over time in the average pay of a staff group can be caused by a change in the composition of that group (for example a greater proportion of lower-paid, junior staff joining a group would bring down average pay) as well as changes in pay for staff who have remained within a staff group from one year to the next.Today’s report also includes for the fi rst time fi gures on bonuses and performance related pay. It shows that over the 12 months to the end of February 2014, 87 managers and senior managers across the NHS in England are recorded as having received such a payment and the total paid was £399,131. Th ere were 37,049 such managers in February 2014.NHS Staff Earnings Estimates to June 2014, Provisional statistics show that looking at average basic pay per FTE member of staff :

Doctors (including consultants and registrars, but excluding locums and GPs), earned on average £59,051, a 0.4 per cent increase on 2013. Within this staff group, ‘other medical and dental staff ’ saw the largest percentage increase on 2013 at 1.6 per cent (to £64,161) while ‘other doctors in training’ saw a drop of 0.2 per cent (to £26,007).Qualifi ed nurses including midwives and health visitors earned on average £30,761, a 0.5 per cent increase on 2013. Within this staff group school nurses saw the largest percentage increase on 2013 at 1.2 per cent (to £33,004) while health visitors saw the largest reduction at 0.7 per cent (to £34,038)Infrastructure support staff earned on average £27,969, a 1.5 per cent increase on 2013. Within this group, senior managers saw the largest percentage increase on 2013 at 3.0 per cent (to £78,064) while hotel,

property and estates staff saw the smallest increase at 0.5 per cent (to £17,266).

Qualifi ed ambulance staff earned on average £26,885, a 0.8 per cent increase on 2013.

Clinical support staff earned on average £18,598, a 0.5 per cent increase on 2013.

Qualifi ed scientifi c, therapeutic and technical staff , a group which includes speech therapists, radiographers and others, earned on average £34,509, a 0.2 per cent increase on 2013. Within this group the largest increase went to qualifi ed healthcare scientists at 0.9 per cent (to £35,568) and the largest reduction of 0.4 per cent to speech therapists (to £34,688).

You can fi nd the full report at http://www.hscic.gov.uk/pubs/staff earntojun14

Source: HSCIC

Public Health England and NHS prepare for unpredictable fl u seasonAt-risk audiences urged to take up free fl u vaccinationPHE’s national seasonal fl u campaign launches from today, encouraging uptake of the infl uenza (fl u) vaccine among the most at-risk groups. Th e campaign – across press, radio and online channels – targets people of all ages with a health condition, pregnant women and parents of children aged 2 to 4.

Each winter hundreds of thousands of people see their GP and tens of thousands are hospitalised because of fl u. Last winter, PHE received reports of 904 people admitted to intensive care or high dependency units with laboratory confi rmed fl u and, of them, 11% (98 people) died.[i]

Th is does not account for the many deaths where fl u is not recognised or reported - estimates of the annual number of deaths attributable to fl u range from 4 to 14,000[ii] per year, with an average of around 8,000 per year.

For most healthy people, fl u is an unpleasant but usually self-limiting disease with recovery taking up to a week. However, older people, the very young, pregnant women and those with a health condition, particularly chronic respiratory conditions such as asthma, diabetes or heart disease, or those with a weakened immune system are at particular risk from the more serious eff ects of fl u.

People with fl u are approximately 11 times more likely to die if they have an underlying health condition than if they don’t.[iii] Despite this, only 52% of people aged 6 months to 65 years living with an underlying condition putting them at risk of severe infection took up the off er of the free fl u vaccine during 2013/14.

Pregnant women are encouraged not to put off the free fl u vaccination this winter. Pregnancy naturally weakens the body’s immune system and as a result, increases the risk of a mother and unborn baby becoming seriously ill from fl u.

Since 2013, 2 and 3 year olds have been eligible for fl u vaccination with a newly available nasal spray, and this year the spray is also being off ered to 4 year olds. However, nearly half (48%) of mums are not aware of this quick, eff ective and painless way to protect children from fl u[iv] with uptake only around 40% in 2-3 year olds in 2013/14.

Last year’s fl u season was less severe than some we have seen but fl u is an unpredictable virus and it is impossible to predict the impact of the disease and how many serious cases there might be as new strains might circulate each year with varying intensity. Th is reinforces the need for annual fl u vaccination among these key groups – including those aged 65 and over who have historically good uptake rates at around 75%.Th e national campaign is being launched to encourage those eligible for the vaccine free on the NHS to contact their GP or pharmacist.Dr Carol Cooper, leading media medic, said: “Flu is often underestimated and can sometimes be very serious. Th is campaign is about raising awareness among those eligible for the free vaccine - including engaging parents of children aged 2-4. I am often surprised by the low uptake of the fl u vaccination within certain groups, and there is a great need for more awareness to ensure those eligible take up the off er. For example, mums of children aged 2-4 may not know about the nasal spray vaccine, a quick, eff ective and painless option, which eliminates the need for needles. Immunisation is an important way to stay healthy and that’s why campaigns to raise awareness of fl u vaccination, such as this PHE activity, are so essential. I urge anyone at risk of fl u to speak with their GP about protecting themselves and their families this season.” Th e campaign includes:• National press adverts aimed at adults with long-term conditions and pregnant

women• Radio adverts aimed at adults with long-term conditions and pregnant women• Search marketing aimed at all at risk groups

References

[i] Surveillance of infl uenza and other respiratory viruses in the UK: Winter 2013 to 2014 report. Page 13.[ii] Green et al (2013). Mortality Attributable to Infl uenza in England and Wales Prior to, during and after

the 2009 Pandemic. PLoS ONE 8(12): e79360. doi:10.1371/journal.pone.0079360[iii] Surveillance of infl uenza and other respiratory viruses in the UK. Winter 2010 to 2011 report Page

50, table 9[iv] TNS Seasonal Flu survey (pre) - Mums of 2-4 year olds

4 THE OPERATING THEATRE JOURNAL www.otjonline.com

Patients may bene t from operating room team simulations

Shorter hospital stays and reduced complication rates may be the result of new team-orientated simulation-based training being pioneered by the University of Auckland.

Teams of senior clinicians were gathered together to work as they normally would without risk to patients in an attempt to change the culture of teamwork, communication and patient safety in the operating theatre.

“Death and disability from unintended avoidable adverse events is high around the world and results in a huge global burden”, says study lead Associate Professor Jennifer Weller, who is an anaesthetist and director of the University of Auckland’s Centre for Medical and Health Science Education. “If we can help solve this problem, we can make a big impact on patient health and safety,” says Dr Weller.

“Research has shown that communication is a contributing factor to more than 60% of avoidable patient harm. Training together is one way to improve this and simulation is an ideal method.”

Th e multi-disciplinary team training that included surgeons, nurses, anaesthetists, and anaesthetic technicians, was carried out for the Multidisciplinary Operating Room Simulation (MORSim) study at the University of Auckland’s Patient Safety Simulation Centre in Tamaki. Worldwide, this is one of the fi rst simulation-based training opportunities for all team members to engage in together.

Most simulation training is conducted for individual specialties.

“Th e main reasons that this sort of work is not done worldwide is the cost, the need for realism, and the challenge of getting all the disciplines together and engaged”, says Dr David Cumin, a lecturer in anaesthesiology. “We were able to achieve this with the support of our funders; a special eff ects company; and a large, multidisciplinary team.”

Th e Auckland study was a pilot and involved 120 staff in total (20 teams of six).

Th e MORSim study was set up to improve eff ective team communication with a focus on sharing information among the whole operating room team. Th e course was designed to give participants a better understanding of the need for information sharing, expose their assumptions, identify stressors and barriers to eff ective teamwork, and provide a setting in which participants could refl ect on their practice and come up with ideas for improved communication.

To highlight these objectives, before each simulation every team member was given a brief of the case with a critical piece of information that no one else got.

Discussion after the scenario could then be around why these clinically important pieces of information were or were not shared.

Th e simulations included realistic patient manikins with novel surgical models all within a realistic environment and with real equipment. Th e scenarios were based on real patient cases that members of the large research team had experienced before.

“All the scenarios were based on real-life cases that require strong clinical coordination among all team members” says study co-author, Dr Cumin. “We used a special eff ects company to increase the realism by creating models for surgeons to actively engage with as this has been a barrier to previous attempts at this work.”

“Each scenario included a handover, the initial crisis period, and on-going treatment,” he says. “Often the participants were so deeply involved in treating the ‘patient’ they were reluctant to leave when we tried to stop the simulation.”

Communication tools presented to the participants over the day included briefi ngs (including the WHO checklist), closed loop communication, and structured call-outs. Debriefs after each scenario, didactic lectures, and time together in breaks are all thought to be contributing factors to the success of the pilot.

Th e study design included observations of 437 real clinical cases and rating the team performance for information sharing, inquiry, vigilance and awareness, and inter-team information sharing. Th is is a modifi ed version of a tool that was developed in the USA and has been related to adverse events, called the behavioural marker of risk index (BMRI). Results show a signifi cant improvement in team performance and work is being done to identify any change in patient outcome.

Th ere were many positive participation evaluations from the day’s training with many saying they would go back into the clinical environment and do things diff erently,

“Th e debriefs produced ideas on how to improve things in the clinical environment. We certainly challenged participants’ assumptions about working together as diff erent disciplines and the need for an atmosphere of trust and collaboration,” says Dr Cumin. “Th e challenge is to transfer these new communications skills into clinical practice. More than 60 percent of participants said they now feel more confi dent to speak up in the operating room setting, after this one day course.”

“Th ere are still barriers to change and more work to be done, but this is a good start,” says Dr Cumin. “Better communication in the operating room should result in fewer adverse events and improved patient safety.”

In future it is hoped the team will be able to pilot the simulations outside of the simulation centre and into the hospital setting and eventually roll it out into New Zealand hospitals so that it becomes normal practice training for multi-disciplinary operating teams

Source: Auckland Universitywww.facebook.com/TheOTJ

NHS CHIEF SIMON STEVENS LAUNCHES £650,000 PRIZE FUND FOR INNOVATION

Simon Stevens, NHS Chief Executive, recently launched a £650,000 prize pot to reward innovation in the NHS.

Th e NHS Innovation Challenge Prize encourages, celebrates and rewards innovation driven by the frontline doctors, nurses and NHS staff who deliver care every day.

Th e 2014/15 NHS Innovation Challenge Prizes, worth £650,000, will be announced at the Queen’s Nursing Institute conference in London.

Ahead of the announcement, Mr Stevens said: “We have a strong track record in developing and using new medical technologies to revolutionise the way we care for and treat patients – diagnostic ultrasound, the MRI scan, the ophthalmoscope used to examine our eyes – to name but a few.

All developed or invented by British innovators and used across the world to deliver healthcare to millions of people every day.”

“We need to fi nd new ways of working if our health service is going to be fi t to face the challenges ahead and we know that those ideas come from the brilliant people working in frontline caring and research roles.”

Now in its fourth year, this year’s programme will off er prizes across seven categories including for recognising innovations that support patient safety, enhance care for those with diabetes and prevent people from dying prematurely through the innovative use of technology to speed up diagnosis or improve care.

Previous winners include Dr Neil Guha and Professor Guruprasad Aithal from Nottingham University Hospitals NHS Trust who were awarded £100,000 after developing a new way of detecting early stage liver disease in the community.

Th e pathway uses a test fi rst developed to detect the ripeness of cheese, to identify early stage liver disease, and has proven its potential to save lives and increase detection rates for cirrhosis.

If rolled out nationally, this project could save the NHS as much £74.6 million in the fi rst year.

Th e NHS Innovation Challenge Prize is open to all NHS organisations in England and deadline for entry is 7 November. For more information, visit www.england.nhs.uk/challengeprizes.

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Fukuda Denshi patient monitoring solutions on display at the ACTA 31st Autumn Meeting

Fukuda Denshi is a leading supplier of advanced patient monitoring and user-confi gurable clinical information management systems, as well as cardiac monitoring and imaging technology. Th e company will be displaying their latest range of patient monitoring solutions at the Association of Cardiothoracic Anaesthetists (ACTA) 31st Autumn Meeting, being held on the 13th & 14th November 2014.

Th e ACTA 31st Autumn Meeting is being held in the City Suite of the St Paul’s Hotel in Sheffi eld, and will be hosted by the South Yorkshire Cardiothoracic Centre. Th e event opens with leading International and National experts covering a number of core cardiothoracic topics on day one, followed by open discussion forums on day two.

Fukuda Denshi will be attending the meeting and exhibiting their range of patient monitoring solutions, including their state-of-the-art DS-8500, and their new DS-8100 and DS-8200 patient monitors.

Th e DS-8500 is highly versatile and can be mounted as a standalone system or attached to any anaesthesia machine. All patient data can be collected and viewed at the bedside or central station with its seamless patient record transfer from monitor to monitor via an HS 8000 super module.

Fukuda Denshi’s new transportable and powerful DS-8200 patient monitor with a 10” wide colour TFT monitor is a modular monitor that uses the same GUI as Fukuda Denshi’s high-end DS-8500. It also off ers continuous monitoring during transportation using the DS-8500 super module and has a battery operation of up to 5 hours.

Fukuda Denshi’s new DS-8100 compact, lightweight integrated monitor with 10” colour display and touch screen will also be on display, along with their MetaVision Clinical Information System, the MVICU, which is specifi cally designed for critical care use.

Visitors will receive a warm welcome from the Fukuda Denshi team, who will be on hand to demonstrate their products as well as provide full product information and answer any questions.

Fukuda Denshi: Healthcare bound by technology.

For more information visit www.fukuda.co.uk.

When responding to articles please quote ‘OTJ’

HCPC launches consultation on Rules change

Th e Health and Care Professions Council (HCPC) has recently launched a fi ve-week consultation to seek the views of stakeholders on proposed changes to the Health and Care Professions Council (Registration and Fees) Rules 2003 (the “Rules”), which will allow the regulator to implement checks for the new professional indemnity arrangement requirements. Th e professional indemnity arrangement requirements were introduced by legislation on 17 July 2014. Th e proposed amendments to the Rules, if implemented, would allow the HCPC to ask registrants and applicants to complete declarations about their professional indemnity arrangements, as well as take appropriate action where a registrant did not have an appropriate professional indemnity arrangement in place, or where a professional indemnity arrangement did not provide appropriate cover. Th e proposed changes to the HCPC Rules will not apply to social workers in England, who are outside the scope of the legislation. Director of Policy and Standards Michael Guthrie commented: “Th ese amendments are in line with our guidance ‘Professional indemnity and your registration’, which we consulted on in 2013. Th e proposed changes to our Rules are about implementing the policy approach outlined in that guidance, rather than adding any additional requirements.” Th e consultation will run from Friday 26 September to Friday 31 October 2014. It will be of particular interest to registrants, employers and professional bodies. Th e HCPC will analyse the responses once the consultation closes and publish the comments received and explain the decisions made as a result. Subject to the outcomes of the consultation and the parliamentary process, the HCPC anticipates that the Rules will be in place from early 2015-16. www.research.net/s/consultationonprofessionalindemnityrules

6 THE OPERATING THEATRE JOURNAL www.otjonline.com

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New EEG electrode set for fast and easy measurement of brain function abnormalitiesA new, easy-to-use EEG electrode set for the measurement of the electrical activity of the brain was developed in a recent study completed at the University of Eastern Finland. Th e solutions developed in the PhD study of Pasi Lepola, MSc, make it possible to attach the electrode set on the patient quickly, resulting in reliable results without any special treatment of the skin. As EEG measurements in emergency care are often performed in challenging conditions, the design of the electrode set pays particular attention to the reduction of electromagnetic interference from external sources.

EEG measurements can be used to detect such abnormalities in the electrical activity of the brain that require immediate treatment. Th ese abnormalities are often indications of severe brain damage, cerebral infarction, cerebral haemorrhage, poisoning, or unspecifi ed disturbed levels of consciousness. One of the most serious brain function abnormalities is a prolonged epileptic seizure, status epilepticus,

which is impossible to diagnose without an EEG measurement. In many cases, a rapidly performed EEG measurement and the start of a proper treatment signifi cantly reduces the need for aftercare and rehabilitation. Th is, in turn, drastically improves the cost-eff ectiveness of the treatment chain.

Although the benefi ts of EEG measurements are indisputable, they remain underused in acute and emergency care. A signifi cant reason for this is the fact that the electrode sets available on the markets are diffi cult to attach on the patient, and their use requires special skills and constant training. Th is new type of an electrode set is expected to provide solutions for making EEG measurements feasible at as an early stage as possible.

Th e EEG electrode set was produced using screen printing technology, in which silver ink was used to print the conductors and measurement electrodes on a fl exible polyester fi lm. Th e EEG electrode set consists of 16 hydrogel-coated electrodes which,

unlike in the traditional method, are placed on the hair-free areas of the patient’s head, making it easy to attach. Th e new EEG electrode set signifi cantly speeds up the measurement process because there is no need to scrape the patient’s skin or to use any separate gels. As the electrode set is fl exible and solid, the electrodes get automatically placed in their correct places. Furthermore, there is no need to move the patient’s head when putting on the EEG electrode set, which is especially important in patients possibly suff ering from a neck or skull injury. Due to the fact that the disposable electrode set is easy and fast to use, it is particularly well-suited to be used in emergency care, in ambulances and even in fi eld conditions. Th anks to the materials used, the electrode set does not interfere with any magnetic resonance or computed tomography imaging the patient may undergo.Th e performance of the electrode set was tested by using various electrical tests, on several volunteers, and in real patient cases.

Th e results were compared to those obtained by traditional EEG methods.

Th e PhD study also focused on the use of screen printing technology solutions to protect electrodes against electromagnetic interference. Th e silver or graphite shielding layer printed to the outer edge of the electrode set was discovered to signifi cantly reduce external interference on the EEG signal. Th is shielding layer can be easily and cost-effi ciently introduced to all measurement electrodes produced with similar methods. Protecting the electrode with a shielding layer is benefi cial when measuring weak signals in conditions that contain external interference.

Th e original articles were published in Journal of Neuroscience Methods, Sensors and Actuators A: Physical, and IEEE Sensors Journal.

Th e doctoral dissertation, entitled Novel EEG Electrode Set for Emergency Use, is available for download at: http://urn.fi /URN:ISBN:978-952-61-1551-1

Unexpected increase in adult appendicitis

in the UKRodney Jones Statistical Advisor at Healthcare Analysis & Forecasting

Trends in appendicitis over the past 14 years show an unexpected increase in adult appendicitis which increases with age and especially female gender. Since appendicitis does not depend on access to a GP or other measures of health service ‘effi ciency’ it is a clear marker that the long-standing increase in medical admissions may have greater etiological complexity than is currently acknowledged.

ht t p : //w w w.hc a f .b i z /2014 /CMV_Appendix.pdf

Th is is part of wider research into emergency admissions which can be found at www.hcaf.biz

Source: Linkedin

Implementation Learning Laboratories Launch Event

Wednesday 10 December 2014, Th inktank, Birmingham Science Museum

Many patients do not receive optimal quality care; the failure to eff ectively implement guidelines contributes to the challenges of clinical and fi nancial stability and poor patient outcomes in healthcare. To support organisations in meeting this challenge the Infection Prevention Society (IPS), supported by the Health Foundation, is launching Implementation Learning Laboratories across the UK and Ireland.

“Healthcare-associated infections are still a very real threat to patients, their families and carers and staff ” said Professor Gillian Leng from the National Institute for Health and Care Excellence (NICE) in April 2014.

Julie Storr, IPS President describes this launch event: “it will focus on Implementation Science, Leadership, Human Factors and Behaviour Change and how we can integrate these to overcome the barriers to successful implementation of infection prevention guidelines and protect patients now and in the future.

Without eff ective and reliable implementation of clinical and practice guidelines, patient safety is compromised, especially in light of the global challenge posed by antimicrobial resistance.”

Th is inaugural interactive event invites senior managers, leaders, policy makers, strategists and academics to share, learn and debate how together we can ensure guidelines are implemented into practice to optimise patient care. It will draw on evidence from within and beyond the specialty of infection prevention to ensure learning for the broader health community and enhancement of quality, eff ectiveness and effi ciency of care.

Th e programme brings together national policy leads as well as thought leaders and academics, including

• Dr Suzette Woodward Campaign Director, Sign up to Safety, formerly lead Patient Safety First Campaign.

• Julie Storr President, Infection Prevention Society.

• Professor Tricia Hart CEO, South Tees NHS Foundation Trust and Patron, Infection Prevention Society.

• Professor Alison Holmes Director of Infection Prevention and Control, Imperial College Healthcare NHS Trust and Co-Director, National Centre for Infection Prevention and Management.

• Expert analysts representing national quality, safety and infection prevention across the UK and Ireland.

A unique event, the outcome of which will be a vital consensus on the way forward for implementation of quality, evidence based care. With an option to join virtually, this event also leads the way in engaging all those with a remit and interest in quality of care wherever they may be around the country.

To further support organisations, IPS will run a series of 12 days across the UK and Ireland, designed as practical, front line focused guideline implementation ‘Spoke’ events. Th e ‘Spoke’ events will become Implementation Learning Laboratories “in action” focusing on the reality of implementing infection prevention and control guidelines into practice, sharing examples of success in overcoming common barriers.

For full event information visit: www.eventsforce.net/IPSLearningLabs

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Find out more 02921 680068 • e-mail admin@lawrand.com Issue 289 OCTOBER 2014 7

Th e Uni-Th erm, the easiest way to test all leading electrosurgical devices, the compact UNI-PULSE defi brillator analyser and UNI-SIM, which is capable of undertaking six synchronised vital signs parameter tests simultaneously form part of a comprehensive range of specialist biomedical test equipment from Rigel Medical, part of the Seaward Group. Th e company is based at Bracken Hill, South West Industrial Estate, Peterlee, County Durham, SR8 2SW.

Rigel Medical testers improve testing at medical devices company

Th e 288 and Uni-Sim are among the advanced Rigel Medical analysers which help BCAS Biomed improve compliance testing for customers

Rigel Medical’s range of advanced testers has been specifi ed by one of the UK’s leading independent medical device sales and service companies for improved compliance testing.Th e move by High Wycombe-based BCAS Bio-medical Services Ltd (BCAS Biomed) has simplifi ed testing procedures as part of its in-service preventative maintenance programme for NHS, emergency and rescue and private healthcare sector customers in the UK and Middle East.Th is has seen improvements in the speed and ease by which electrosurgical units (ESU), vital signs monitors, infusion devices and defi brillators among other items of medical equipment are maintained and checked for electrical safety and performance accuracy.BCAS Biomed, established in 2005, has grown to become a leader in medical device maintenance and currently has a national team of 26 biomed engineers completing more than 1,000 compliance safety tests a week using Rigel instruments.Th e 288 automated safety analyser, electrosurgical generator calibrator Uni-Th erm, Uni-Pulse defi brillator analyser, Multi-Flo infusion pump analyser and combination vital sign simulator Uni-Sim are among the Rigel products used by

BCAS to ensure compliance with manufacturer’s recommendations to the appropriate standards including IEC/EN 62353 and IEC/EN 60601.

Managing director of BCAS Biomed Ian Roberts said Rigel Medical met the requirement for high quality, robust and mobile test solutions that were easy-to-carry and use by the engineers.

“Rigel supplies us with a range of high performance, high quality instruments, which provide the engineers with convenient, versatile and accurate on-site testing solutions,” he said.

“Our engineers appreciate the fact that they are compact enough to carry from site-to-site, off ering full automation of test procedures and leading to more effi cient testing schedules and, ultimately, better standards of customer service and care.

“Th ey incorporate an excellent range of features, while the added value benefi ts, such as increased connectivity and easy-to-follow instructions, are particularly impressive.

“Th e fact that they are supplied by a British company is also important. It means that quality is assured and good after sales maintenance and support is always available.”

Th e Rigel 288 reduces downtime between tests, making the instrument practical and highly portable for multi-site use while the Multi-Flo heads a range of advanced performance analysers, electrical safety analysers and vital signs simulators. Meeting all the requirements of IEC 60601-2-24, Multi-Flo leads the way in high and low fl ow, occlusion, back pressure and bolus measurement and features variants of one, two and four independent channels.

More at www.rigelmedical.com When responding to articles please quote ‘OTJ’

The ECG Workbook 3/eISBN: 9781905539864 October 2014 • M&K Publishing • 118pp • £28.00Angela Rowlands, Senior Lecturer at Barts and the London School of Medicine and Dentistry, Queen Mary University of London, UKAndrew Sargent, Tutor in Critical Care Nursing, Florence Nightingale School of Nursing and Midwifery, King’s College London, UKMany books on ECG interpretation use simulated ECG tracings. Most of the traces that you fi nd in this book are from real people and of the quality that you will be expected to interpret from in practice.Th ere are two new chapters in this third edition that add greatly to the usefulness of the book.Th ere is now a chapter on Hemiblocks, Bi Fascicular and Tri Fascicular Blocks. Here the reader will see how what seems a complex diagnosis from an ECG is easily mastered by simply putting together two concepts learned in earlier chapters. Th e other new chapter is on Paced Rhythms to help those looking after patients who have pacemakers fi tted as it is recognised that pacemakers may cause confusion when trying to interpret the ECG.Both these new chapters adhere to the principles followed set out the fi rst edition: that the text should be accessible and relevant to all practitioners, regardless of their experience and that the text should always be supported with relevant exercises to reinforce learning.

Contents include:Recording a readable electrocardiogram (ECG)Th e electrical conducting system of the heartA systematic approach to rhythm strip analysisHeart blocksCommon ArrhythmiasEctopics and ExtrasystolesTh e 12 lead ECGAxis deviationIschaemia, injury and necrosisSites of infarctionBundle branch blocksChamber enlargementHemiblocks, bifascicular blocks and trifascicular blocksPaced rhythmsA systematic approach to ECG interpretation

M&K PUBLISHING • an imprint of M&K Update Ltd • Keswick • CA12 5ASwww.mkupdate.co.uk • Tel: 01768 773030 • Fax: 01768 781099 • publishing@mkupdate.co.uk When responding to articles please quote ‘OTJ’

8 THE OPERATING THEATRE JOURNAL www.otjonline.com

“Safety of Private Hospitals Questioned as Report Reveals Hundreds Die Unexpectedly” - AIHO response

Th e Centre for Health and the Public Interest has today published a report entitled ‘Patient Safety in Private Hospitals – the known and unknown risks’. Th e report makes several questionable claims concerning the quality of healthcare in private hospitals.

Commenting on the report, Fiona Booth, AIHO Chief Executive, said: “We’re disappointed that the CHPI has chosen to publish what appear to be questionable claims about the quality of healthcare off ered in independent hospitals.

“Th e reality is that these institutions off er very high levels of care to NHS, insured and self-paying patients, a fact that has been and continues to be independently verifi ed by the CQC.

“Th e independent sector acknowledges that we need to publish more data, and we have been working with the NHS to do so in a way that enables patients, clinicians, regulators and other interested parties to make direct and meaningful comparisons. Th e sector has established an independent body, the Private Healthcare Information Network, to go further than this to help patients make informed choices about their care.”

Th e main claims in the report are:“Patients undergoing operations in private hospitals may be put at risk from inadequate equipment, lack of intensive care beds, unsafe staffi ng arrangements, and poor medical record-keeping”

Th e CQC regulates both NHS and independent hospitals, and conducts regular inspections of institutions in both systems. If the CQC found any serious care failing in an independent hospital, it would apply the appropriate enforcement measures in the same way that it does for NHS hospitals.

Th e CQC publishes an annual ‘State of Care’ report, covering care delivered by NHS and independent hospitals. Th e most recent ‘State of Care’ report found that “independent services generally perform better than NHS locations in terms of safety and quality of care” 1. Th e report also found that:* Independent hospitals met safeguarding and safety standards in 92% of

inspections* Independent hospitals met care and welfare standards in 98% of

inspections* Independent hospitals met respect and dignity standards in 99% of

inspections* Independent hospitals met staffi ng suitability standards in 93% of

inspections

Independent sector hospitals do not claim to be perfect, and there is no room for complacency in these fi gures – but they do throw into doubt the position taken by the CHPI.

We acknowledge that the sector needs to do more on information availability, which is why, in 2008, private hospitals established a data sharing and reporting project. Th is subsequently became the Private Healthcare Information Network (PHIN). Th e sector has also been working with the NHS to publish directly comparable data (see below for detail).

“Between October 2010 and April 2014 802 patients died unexpectedly in private hospitals, and there were 921 serious injuries. Because of the limited reporting requirements for private hospitals we are unable to state whether these deaths and injuries should be cause for concern.”

Like NHS hospitals, independent hospitals are places visited by people who are either unwell or in need of medical treatment. Some of those will have complex healthcare needs and some will have underlying medical conditions.

Th e report states that, unlike NHS hospitals, private hospitals are not required to report such incidents to the National Reporting and Learning System (NRLS). In fact, the independent sector has been working with the NHS to enable it to report incidents in the same way that NHS hospitals do and would like to move this project forward more quickly than is currently possible. Furthermore, the NHS itself uses a variety of diff erent reporting system to input this data.

Th e report states, correctly, that private hospitals are required to report all serious incidents to the CQC and Monitor – and of course they fulfi l those obligations.

“Th e majority of private hospitals have no intensive care beds, some have no dedicated resuscitation teams, and surgeons and anaesthetists usually work in isolation - without assistant surgeons and anaesthetists in training present.”

Whether junior staff are present in training has no bearing on the safety of clinical procedures – it is the presence of adequately qualifi ed and experienced consultants which assures patient safety and high-quality care.

Staffi ng arrangements in private hospitals are indeed often diff erent from those in the NHS but there is no valid basis for suggesting that they are defi cient. It is relatively common for trainee surgeons to assist in private theatres but the consultant will always be personally present and responsible.

Furthermore, the NHS operates a large variety of hospitals, from large district generals to small community hospitals. Not all of these institutions will off er the same breadth of services, indeed it is quite usual for smaller hospitals not to have an A&E department, and some do not have intensive care facilities – so it seems odd to single out private hospitals for this criticism.

“Although the private hospital sector now gets over a quarter of its income from treating NHS-funded patients, there is signifi cantly less information available to patients about the performance of private hospitals than about the NHS.”

Th e report suggests, correctly, that more needs to be done on information availability. Th at is why the independent sector established the Private Healthcare Information Network (PHIN) in 2012. PHIN is an independent institution which publishes a range of healthcare data for staff and patients, and was set up specifi cally to open up data from the independent healthcare sector in order to increase transparency. Th e information sharing project from private hospitals predated the Competition Markets Authority inquiry into the private healthcare market, and, as a result of the CMA fi ndings on information availability, will continue to publish relevant data.

“It is not possible to establish whether all private hospitals providing NHS care are fulfi lling their legal obligation to publish Quality Accounts letting the public know how they are performing”

We acknowledge that not all providers post their quality accounts on the NHS Choices website. However, the major independent hospital groups providing NHS care do post their quality accounts online, some at an individual hospital level.

Concluding comments

Th ere are a number of other questionable claims in the report, such as that private hospitals rely on the NHS if patients in their care develop complications, and that ‘around’ 6,000 patients have transferred to NHS hospitals from independent institutions. Th ere is no evidence to suggest that readmission rates or the need for critical care support are higher following treatment in independent hospitals than in NHS hospitals; actually such information as is available tends to suggest the opposite.

Th e report also asserts that there is a ‘moral hazard’ in which private hospitals know that there is a ‘safety net’ of the NHS underneath them if things go wrong. Th is is false and unsubstantiated. Independent institutions strive at every opportunity to assure patients’ safety and comfort, as evidenced by the CQC. Of course, in small private and public hospitals, if a patient suff ers a major trauma which is best dealt with in a larger centre, that patient will be moved there. But that does not imply that there is a lackadaisical approach to quality or safety.

Th e report suggests that patients in the independent sector lack a means of redress if things go wrong, which is also factually incorrect. Private patients can put in a formal complaint to their provider and, in isolated incidents where the problem is not addressed, can also contact the Chair or other senior board member of the provider. Finally, if they still feel that their complaint is unresolved, they can take it to the Independent Sector Complaints Adjudication Service (ISCAS). For NHS patients, the Parliamentary and Health Service Ombudsman is available.

For all questions, please contact:Mark Detreinfo@aiho.org.uk020 7227 16441http://www.cqc.org.uk/sites/default/fi les/documents/cqc_soc_report_2013_lores2.pdf, page 54

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10 THE OPERATING THEATRE JOURNAL www.otjonline.com

Drug Trolley Alarm To Increase Patient Safety Wins Award In Innovation Competition

An award for an outstanding innovation in healthcare – the Limpet Drug Trolley Alarm - has been presented to a team of NHS staff at a prestigious event organised by Health Enterprise East, a leading NHS Innovation Hub.

Winners of the Kiss Communications Award for Software/ICT/Assistive Technology were Maryanne Mariyaselvam, Dr Peter Young and Dr John Gibson from Th e Queen Elizabeth Hospital King’s Lynn NHS Foundation Trust.

Th e Limpet Drug Trolley Alarm is used on drug trolleys to prevent the risk of drug theft and tampering, increasing patient safety. It has a motion detector, alarm and camera and if the drug trolley is left open and unattended, the alarm starts to bleep and alerts the nurse to re-attend. It is an integral piece of equipment for patient safety that protects nurses and staff in charge of drug rounds.

Winners were presented with a specially engraved glass trophy and received £2,000 to help progress their idea.

Hosting the 2014 Innovation Awards, held on Wednesday 24th September at Girton College, Cambridge, was BBC Look East presenter Susie Fowler-Watt.

Th e 2014 competition was open to staff working in Member Trusts across all branches of the NHS to put forward their ideas for products and services which will benefi t patients. Th is year it comprised fi ve categories: Long Term Conditions Management, Patient Safety, Software/ICT/Assistive Technology, Patient Dignity and Experience and Medical Technology.

Dr Anne Blackwood, Health Enterprise East Chief Executive said: “Th is is our ninth Annual Innovation Competition Awards and as with all our previous competitions, we have received a fantastic response from our Member Trusts across our fi ve categories. Th e judges had a diffi cult task to select the winners but I would personally like to congratulate all the applicants for their creative ideas to improve patient care in the future.

“As Health Enterprise East approaches its tenth anniversary next month, it remains our great privilege to work in a region with such a world-renowned reputation for research and innovation. Alongside our strategic partner, the Eastern Academic Health Science Network, we are determined to continue acting as a catalyst to bring forward new medical innovation for many years to come.

“I would like to thank everyone who has taken part in this year’s competition and also our sponsors: Birketts, Th e Eastern Academic Health Science Network, JA Kemp, Kiss Communications and Mathys & Squire LLP - whose generosity and support is very much appreciated.”

Health Enterprise East Limited is a leading NHS Innovation Hub. It is committed to improving healthcare through supporting the development of innovative new products and services which meet the needs of the NHS. Health Enterprise East delivers a broad range of services to NHS organisations, providing expert advice, funding and support to NHS innovators to translate their ideas into practice.

Operating within the NHS, Health Enterprise East also provides consultancy services to technology-based companies looking to access the UK market. Health Enterprise East works with clinical key opinion leaders and senior NHS managerial, commissioning and procurement staff on a daily basis. Its NHS market assessments provide vital information for companies to ensure that their products are well targeted to the technical and business needs of the NHS, speeding up adoption of new technology by the NHS.

For further information please visit www.hee.co.uk.

Staff at Th e Queen Elizabeth Hospital King’s Lynn NHS Foundation Trust are celebrating winning a First Prize in the Health Enterprise East 2014 Innovation Competition, left to right: Look East presenter Susie Fowler-Watt, Dr John Gibson, Dr Peter Young, Maryanne Mariyaselvam and Simon Fryer, Kiss Communications.

When responding please quote ‘OTJ’

New guidance on reporting suspected

adverse drug reactions in children and neonates

Th e Medicines and Healthcare products Regulatory Agency (MHRA) has announced new simplifi ed guidance for healthcare professionals reporting suspected adverse drug reactions (ADRs) in children to its Yellow Card Scheme.

Changes to the guidelines follow a recent workshop with paediatric specialists, healthcare professionals and patient organisations who concluded that reporting all suspected ADRs in children was considered impractical for busy healthcare professionals and potentially acted as a barrier to reporting.

Th e new guidance is simpler and aligned with the reporting guidelines for adults. It asks that healthcare professionals report all suspected ADRs that are serious, medically signifi cant or result in harm, and all those that are associated with newer drugs and vaccines identifi ed by the black triangle symbol .

Th is guidance applies to medicines, vaccines, herbal or complementary products, whether self-medicated or prescribed, and includes suspected ADRs associated with misuse and unlicensed medicines.

It also places greater importance on the reporting of medication errors in children resulting in suspected ADRs, and provides information on why reporting these reactions in children and neonates is particularly important.

Director of Vigilance and Risk Management of Medicines, Dr June Raine said:

“We strongly encourage healthcare professionals to help improve adverse drug reaction data by reporting suspected adverse drug reactions in children and neonates using the new simplifi ed guidance.

“Th e eff ects of medicines in children can be diff erent to adults and in order to widen our knowledge on any possible side eff ects in this young age group for existing and new drugs, it is vital that we receive reports.

“Th e quickest way to send a Yellow Card is online at mhra.gov.uk/yellowcard. Healthcare professional should inform patients about the Scheme and encourage them to also report themselves.”

Dr Hilary Cass, President of the Royal College of Paediatrics and Child Health, said:

“Reporting adverse reactions quickly and accurately is key to ensuring medicines are safe and eff ective for children and young people. Th ese new guidelines should help speed up the process and mean that healthcare professionals are not put off by complex forms and unclear processes Th e key message is – if you suspect a serious adverse drug reaction in a child – it must be reported and the best way of doing so it via the online Yellow Card.”

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www.Opera ngpera ngTheatreheatreJobs.comobs.comA one-stop resource for ALL your theatre related Career opportuni es

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‘Hard Truths’ – preparing for one year onTh e Department of Health is preparing the fi rst annual progress report on ‘Hard Truths: the journey to putting patients fi rst’, to be published later this autumn.As part of this, we want to make sure this progress update is about more than what’s happening at the top of Government. We want to hear the voices of a range of staff , patients and carers on what they think the eff ects of the Francis inquiries and subsequent government commitments in ‘Hard Truths’ have been.To do this, we’ve been holding conversations with staff and groups across England.In addition, and to reach beyond the ‘usual voices’ we held a Twitter chat with the @WeNurses community on Tuesday this week. You can read more about the discussion, and our blog from the chat.We’re also holding discussion forums with MumsNet and GransNet to hear the experiences and views of patients, carers and family members.If you would like to get in touch with your views and experiences on what’s changed since Francis and Hard Truths, we’d love to hear from you.

Cardiorespiratory tness is often misdiagnosed

A recent study by the University of Eastern Finland shows that scaling maximal oxygen uptake and maximal workload by body weight confounds measures of cardiorespiratory fi tness. It has been a common practice in exercise testing to scale the results by body weight and, according to researchers, this practice should be abandoned. More reliable data on cardiorespiratory fi tness can be observed by using lean mass proportional measures. Th e results were published recently in Clinical Physiology and Functional Imaging.Exercise tests, such as the maximal cycle ergometer exercise test, are used to evaluate cardiorespiratory fi tness. Maximal performance refers to an individual’s metabolic capacity. While the size of an individual is an important determinant of the maximal workload and maximal oxygen uptake, the absolute values should be scaled by body size or composition to enable comparison between individuals. Body weight has traditionally been used to perform body size related scaling in exercise testing.Scaling methods, when measuring the function of the human body, have been causing scientifi c debate since the mid-1600s. Scaling by body weight has been criticized, because body fat, per se, does not increase metabolism during exercise.University of Eastern Finland researchers were the fi rst to publish a methodological analysis of the relationship between capacity variables and body composition in healthy 7-8 year-old children, all children having similar maturity status. Measurements were done as part of Th e Physical Activity and Nutrition in Children Study. Children performed a maximal exercise test with a respiratory gas analysis. Th e children’s body composition was determined by dual-energy X-ray absorptiometry (DXA) and a high quality impedance method. Th e agreement of the methods to defi ne body composition has been demonstrated in an earlier study.Th e present study shows that exercise test results scaled by lean mass were the best to measure cardiorespiratory fi tness. For this purpose, both DXA and a more easily accessible impedance method can be used to assess lean mass. Scaling by body weight introduces confounding by body adiposity. Fat mass determines more strongly by body weight scaled measures than the performance in the exercise test. Furthermore, scaling by body weight did not fulfi l the statistical criteria set for scaling purposes.However, scaling by body weight is reasonable when assessing an individual’s functional capacity, which refers to a composite measure of the adiposity and cardiorespiratory fi tness. Weight proportional measures are also valuable indicators of the composite health risk of the adiposity and cardiorespiratory fi tness. By using body height proportional measures, it was also possible to avoid confounding by adiposity. However, height is not as precise an indicator of individual muscle tissue as lean mass.It is a too common practice to scale exercise test results by body weight. According to researchers, this represents a historical burden, and scaling by lean mass should rather be done to avoid confounded interpretations of cardiorespiratory fi tness. “In practice, adipose subjects may be diagnosed too easily to have poor cardiorespiratory fi tness, although this might not be the case,” says Specialising Physician Tuomo Tompuri, the fi rst author of the article.“It is paramount to note that confounded methodology can be refl ected in the scientifi c conclusions. Exercise physiologists are aware of the problem, but in clinical practice or in biomedical scientifi c research, the problem has been taken into account too rarely.”“It is vital to understand what is being measured. While measuring cardiorespiratory fi tness, it is important to take diff erences in body size correctly into account in order to enable correct scientifi c conclusions about the signifi cance of cardiorespiratory fi tness on human health.”

Research article:Tuomo Tompuri, Niina Lintu, Kai Savonen, Tomi Laitinen, David Laaksonen, Jarmo Jääskeläinen & Timo A. Lakka. Measures of cardiorespiratory fi tness in relation to measures of body size and composition among children. Clinical Physiology and Functional Imaging: early view 27.8.2014. DOI: 10.1111/cpf.12185. Link to the publication: http://onlinelibrary.wiley.com/doi/10.1111/cpf.12185/abstractLink to the earlier publication on body composition measurement: http://onlinelibrary.wiley.com/doi/10.1111/cpf.12118/abstractTh e Physical Activity and Nutrition in Children Study website: http://www.lastenliikuntajaravitsemus.fi /

Authors: Nigel Conway, Paul Ong, Mark Bowers, Nikki GrimmettDescription: Following the success of the fi rst edition, this comprehensive update will assist practitioners in refreshing their knowledge. At the same time, the student ODP will fi nd the thoughtful structure and careful choice of content is an ideal basis for learning. Th is book and its updates will provide an invaluable reference throughout the ODP’s career.Publication details: ISBN 978-1-908725-01-1; 60 pp; 160 x 84mm; 2 colour throughout; spiral bound pad; printed on laminated board; £10.99; 2nd edition published 2014.www.clinicalpocketreference.comPublisher:

Clinical Pocket Reference, Oxford / www.clinicalpocketreference.comOrder from:

Marston Book Services Ltd, 160 Eastern Avenue, Milton Park, Abingdon, OXON OX14 4SB, UK, Tel: +44 1235 465500 Fax: +44 1235 465555 Email: direct.orders@marston.co.uk

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Visit www.clinicalpockereference.com and enter the code OTJ2014 at checkout to receive 15% discount.

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Operating Department Practice

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12 THE OPERATING THEATRE JOURNAL www.otjonline.com

www.Opera ngpera ngTheatreheatreJobs.comobs.comA one-stop resource for ALL your theatre related Career opportuni es

View the latest vacancies online !

Theatre Practitioners Recovery Nurses Anaesthetic Nurses ODPs Scrub Practitioners Nurse Practitioners Medical Representatives

and Clinical Advisers

Find out more 02921 680068 • e-mail admin@lawrand.com Issue 289 OCTOBER 2014 13

Theatre / ODP / Scrub Nurses / Theatre Manager / Deputy Manager

London and North West England

Full Time & Part Time

Salaries negotiable for the right candidates.

We have a variation of exciting opportunities for a number of Theatre / ODP / Scrub Nurse / Theatre Manager & Deputy Manager Posts to join our client’s prestigious hospitals based in London and North West England to work in multiple theatres and within multiple disciplines such as Recovery, Scrub and Anaesthetics. The right candidates will have worked in a Theatre setting within diverse general hospitals.

Do you actively participate in and maintain the highest standard of care and safety for patients, visitors and staff in the operating theatre suite and PACU, and are competent in all aspects of clinical practice within the Operating Department / PACU.

Do you accurately record data within the theatre / Anaesthetic / Recovery multi disciplinary team and update or revise the care required as appropriate;

Can you identify and discuss the nursing situations or needs with the patient, relatives and other staff as deemed necessary.

Can you provide evidence of ability to work collaboratively in a small multidisciplinary team, and have excellent written and verbal communication skills, and computer literacy are essential.

NMC Registered / HCPC registered.

“Are you going through a re-banding – are you currently at the pinnacle of your career where you are, do you want to continue to develop your skills or simply want to join the private sector”.

For a con dential discussion please contact Martine Cohen at JS3 Recruitment on 0161 212 7313 or by email martinecohen@js3recruitment.com

If you are responding directly to this position please attach your current CV and inform us of your current remuneration.

Should you know anyone who may be seeking an opportunity then JS3 offer a referral scheme?

Please refer to our website www.js3recruitment.com for more details.

Tel: 01303 840 882 Fax: 01303 840 969 enquiries@sophiebellandassociates.co.uk

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LONDONTRAUMA & ORTHOPAEDIC TEAM LEADER – BAND 7

This role requires a motivated & focused individual. You will have comprehensive scrub skills in this area & will naturally lead the team by your example. You will currently be working as an established RGN or ODP Band 6 or above & will have further post registration quali cations which support your

development.

MAIN THEATRES - THEATRE PRACTITIONERS – BAND 6 You will have current UK Theatre experience in Anaesthetic, Scrub or Recovery. RGN or ODPs are welcome to apply. This is a busy & highly professional department which can enhance your career

development with exposure to a mixture of surgical specialities including Cardiac.

Tel: 01303 840 882 Fax: 01303 840 969 enquiries@sophiebellandassociates.co.uk

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LONDONDAY SURGERY MATRON - BAND 8A

This full time role requires a committed Matron (RGN or ODP) to lead change in a stand-alone 5 theatre day case unit, where they are increasing utilisation & ef ciency to bene t patients & give

their staff a good work life balance. Being one of ve 8a’s in theatres, this Matron role will give you the opportunity to exercise your leadership & management skills within an enthusiastic team striving

to achieve excellence. To succeed in this role you will use your knowledge, skills & experience to negotiate with & in uence others as you further develop & review the theatre services. You will be expected to be highly visible in the theatre areas & are required to work regular late shifts & undertake on-calls 1:6. A wide range of opportunities for personal & professional development,

including access to Masters Courses is available.

Prevention of Occupational Infection,

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14 THE OPERATING THEATRE JOURNAL www.otjonline.com

Th e Gynaecology theatre nursing team at the Royal Wolverhampton NHS Trust (RWH) would like inform you that Wolverhampton will be hosting the British and Irish Association of Robotic Gynaecological Surgeons (BIARGS) annual gynaecology robotic surgery conference. Th e conference will be held on Th ursday 6th November and Friday 7th November, it is a great programme that will be held at the Wolverhampton science park with two full days of education on robotic surgery, nurse’s sessions on both days and a gala dinner on the fi rst night at Wolverhampton Race course. As well as a comprehensive surgical programme we also have a nurse’s session on both days which will cover topics such as:Th e nursing role in robotic surgeryIntegrating robotic surgery into routine practiceTeam leading in robotic practice Care of the anaesthetised patient Improving effi ciency in robotic surgeryRole of the robotic fi rst assistantStandards and guidelines in robotic surgeryEnhanced RecoveryRobotic theatre tour at the RWH, with an overview of the surgical robot, tips, tricks and trouble shootingWe are inviting all robotic surgery theatre staff from all over, whether you are part of a robotic surgery team or if you are interested in this fi eld of surgery to come and join us. We have been mindful to include topics which are specifi c to robotic practice as we want theatre practitioners to get the most from this conference. Th ey are also relevant to robotic teams/team members at every level whether you are new to robotic surgery, have a new interest in robotic surgery or if you are part of an established robotic team.Th e links below will forward you to the conference website where there is access to the full conference programme, registration details, details on nearby hotels and a list of the speakers. If you know of anyone that would be interested in attending the conference could you forward the information so that they can gain access to the websites.http://www.biargs.org.uk/index.htmhttp://wolverhamptonbiargs2014.comSharing knowledge at events such as this enables us to create a robotic network of knowledge, this will ensure that new robotic teams can start off on the right path, that established robotic teams can review their practices whilst also keeping up to date with developments, to promote awareness of robotic surgery and the great things our teams are doing on a daily basis and fi nally to promote an open safety culture amongst robotic surgery teams.Conference price: £195.00 for nursing staff to register, this includes registration for the two day conference and entrance to the gala meal on the Th ursday evening at the Wolverhampton racecourse.We are looking forward to hearing from you, for further information please contact:Dezita TaylorSenior ODP/Team leaderTh e Royal Wolverhampton NHS Trustdezita.taylor@nhs.netTel: 01902 307999 EXT 5192

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Protecting Rights with Employment LawEmployment law allows staff to take action if they feel that they have been unfairly treated. If workers feel that their rights have been violated, they can fi le a legal claim against their employer. Th ere are many reasons why they might decide to do this. Th ey may decide to take action if they have suff ered from harassment from another employee or have been the victim of a workplace injury. Th ey may also press forward with legal action if they feel that they have been unfairly dismissed or have been bullied, perhaps due to their race, sex or religious beliefs.

Claims for Discrimination

Discrimination is one of the most common reasons for action being taken against an employer. Action may be taken whether the employer acted in a discriminate manner or if they permitted others to. Staff may fi le a claim if they were the victim of discrimination and their employer failed to do anything about it. Many people with disabilities have taken legal action after being treated poorly due to their condition.

Injury Payouts

Harrassment is also a common factor behind a claim being fi led. Harrassment can be sexual in nature and may come in the form of inappropriate comments or unwanted touching. Again, if a complaint is made to an employer and they fail to take action, a claim can be made. Workplace injuries are also a common reason behind lawsuits being failed, especially if they are the result of negligence. Many employers have been sued after blocking or challenging a claim.

Unfair Dismissal

Wrongful termination can lead to lawsuits and cases can be won when employment lawyers prove that employers had no legitimate reason to sack a member of staff . Th e compensation arising from a wrongful termination claim can be used to off set lost wages, the pain and suff ering and any other fi nancial costs resulting from the dismissal. Many employees have been compensated after being the victims of constructive dismissal, in which life is made so unbearable for an employee that they are left with no realistic option other than to resign. Constructive dismissal usually involves an employer failing to adhere to what is expected of them legally, with the poor treatment from the employer represent a breach of contract.

Breach of Contract

Th e Employment Tribunal statistics 2012-13 showed a 3% rise in claims compared to 2011/12. It has been predicted that there will be a decrease in case numbers over the next few years due to the fees that are being attached to claims. 30% of claims were related to the Working Time Regulations being breached. Th ese regulations protect employees from being forced to work more than 48 hours if they do not wish to, but the stats seem to show that many employers chose to ignore the legislation. 15% of all cases were unfair dismissal claims in 2012/13, and there was a 74% rise in gender discrimination claims. Th ere are many factors that can infl uence the payout awarded in an employment law claim, including length of service and age. It’s wise to get in touch with employment lawyers at the earliest opportunity if you have a case.

If you think you might have a claim on a previous or current employer then you should speak to an employment law specialist. Someone like Th omson Snell & Passmore who are solicitors in Tonbridge Wells in Kent could be a good place to start and a lot of useful information can be found on their website. http://www.ts-p.co.uk

Life to the full

Theatre RN & ODP Opportunities

Our focus is on building healthier futures for everyone. Bringing together clinical, prevention and cure with fitness and wellbeing into one pioneering service. We are committed to delivering expert care and support, and as a not for profit organisation, we continually reinvest every penny we make to benefit the health of the UK.

Here, you’ll be a vital part of a close-knit team with a shared clarity of purpose. You can enjoy the variety offered by our multi-specialty hospitals and grow your breadth of experience working with Consultants at the forefront of medical care, who respect your skills and knowledge. Every day will bring a fresh challenge. You’ll have the opportunity to make use of every aspect of your skills and experience and with support, training and development opportunities we’ll help you be the best you can be.

Above all is our approach to Nursing. We don’t see patients; we see people. So everything we do is focussed on their needs, both clinical and emotional. As an advocate for people at their most vulnerable, your empathy will work in tandem with your expertise to provide the high level of trust and reassurance your patients and colleagues need. In return we offer a total reward package that enhances your wellbeing and lets you make the most out of life.

We have opportunities available now for a theatre team lead and theatre practitioners with post qualification experience in the following areas:

• Anaesthetics • Endoscopy • Ophthalmic • Orthopaedic • Recovery • General Scrub

Join us in one of the following locations and help improve lives across the UK.

• Bournemouth • Brentwood • Chester • Chichester • Exeter • Hereford • Guildford • Leicester • Oxford • Shrewsbury • Taunton • Wolverhampton • York

Discover much more and apply at www.nuffieldhealth.com/recruitment/theatre or call Daniella on 0771 781 5253 for an informal chat.

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