Staff Publication

Oxygen Prescriptions for Gynaecology Inpatients (2025)

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Type of publication:

Service improvement case study

Author(s):

*William Roberts

Citation:

SaTH Improvement Hub, December 2025

SMART Aim:

Trust policy for all inpatients to have a target oxygen saturation identified on admission. Widespread issue with poor oxygen prescription compliance across the country. 47% (n = 15) of gynae inpatients had no oxygen prescribed. Incorrect/absent prescriptions have the potential to cause harm. Target compliance 80%

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Next-of-Kin (NOK) Communication Bundle – Second Cycle (2025)

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Type of publication:

Service improvement case study

Author(s):

*Yasmin Ahmadi, *Giulia Abdel Latif

Citation:

SaTH Improvement Hub, December 2025

SMART Aim:

To evaluate the awareness, use, and perceived helpfulness of the NOK communication sticker among ward staff following its implementation in Cycle 1 by 31st October 2025 as evidenced by staff feedback survey results.

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The robotic platform is the minimally invasive tool of choice- Improving techniques and outcomes (2024)

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Type of publication:

Conference abstract

Author(s):

Mohamedahmed A.; Abdalla H.E.; *Ismail A.; Yassin N.A.

Citation:

Colorectal Disease. Conference: 19th Scientific and Annual Conference of the European Society of Coloproctology, ESCP 2024. Thessaloniki Greece. 26(Supplement 2) (pp 239), 2024. Date of Publication: 01 Sep 2024.

Abstract:

Aim: This study aimed to assess the clinical outcomes of robotic compared with laparoscopic surgery within a transformation of minimally invasive total surgical practice. Method(s): A series of 201 consecutive patients relating to a single surgeon's experience when transforming total minimal invasive practice from laparoscopic to robotic surgery were included. Patients underwent laparoscopic and robotic surgery between 2018 and 2023. Short-term and long-term outcomes were evaluated and compared between the Laparoscopy (LG) and robotic (RG) with subgroup analyses according to procedure. Result(s): The median age and length of hospital stay (LOS) were 64 years and 6 days, respectively. Indications for surgery were CRC (62.2%), IBD (27.4%) and other general surgery conditions (hernia, appendicectomy, de-functioning loop colostomy, complex diverticular disease and rectal prolapse) (10.4%). The surgical approach was laparoscopic in 62 patients (30.8%) and Robotic in 139 patients (69.2%). Conversion to open was 12.9% in the LG versus 0% in the RG (p = 0.001). Regarding postoperative complications, the RG showed lower rate of overall complications [CD>=2 complications 14.3% in RG versus 16.1% in LG, p = 0.02], paralytic ileus [p = 0.03] and shorter LOS (p = 0.001) in comparison to LG. Moreover, both groups showed no difference in anastomosis leak [RG 1.3% vs LG 0%, p = 0.3], abdominal collection [RG 2.8% vs LG 2.5%, p = 0.5], re-operation [RG 1.4% vs LG 1.6%, p = 0.9], 30-day re-admission [RG 7.9% vs LG 8%, p = 0.9] and 30-day mortality [RG 0.7% vs LG 0%, p = 0.5]. Moreover, the RG remained superior when subgroup analyses were applied for anterior resection (39.3%), Right hemicolectomy (28.4%) and subtotal colectomy (13.4%). Conclusion(s): Robotic colorectal surgery improves clinical and surgical outcomes. This minimally invasive approach is the choice in a total transformation of practice from laparoscopic to robotic surgery, leading to significant reductions in LOS, rapid postoperative recovery, and an earlier return of gut function.

DOI: 10.1111/codi.17125

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Intravenous fluid mismanagement: time for national stewardship and quality improvement (2025)

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Type of publication:

Journal article

Author(s):

Breen, Andrew; *Miller, Ashley; Timmins, Alan; Barton, Greg; Kirk-Bayley, Justin; Peck, Marcus John Edwards; Davis, Huw John; Wilkinson, Jonathan.

Citation:

BMJ Open Quality. 14(4), 2025 Dec 14.

DOI: 10.1136/bmjoq-2025-003503

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The Impact of Smoking on Outcomes Following Anterior Cruciate Ligament Reconstruction: A Systematic Review and Meta-Analysis (2025)

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Type of publication:

Systematic Review

Author(s):

*Ibrahim, Abdelrahman; Al-Musabi, Musab; Kabariti, Rakan; Kempe-Gowda, Swarna; Wade, Roger.

Citation:

Cureus. 17(11):e96765, 2025 Nov.

Abstract:

The influence of smoking on postoperative outcomes following anterior cruciate ligament (ACL) reconstruction is a topic of ongoing scientific discussion and uncertainty. We aimed to conduct a systematic review and meta-analysis to compare the outcomes between smokers and non-smokers undergoing this procedure. We conducted a systematic search of electronic information sources, including MEDLINE, EMBASE, CINAHL, CENTRAL, ClinicalTrials.gov, and bibliographic reference lists. We applied a combination of free-text search and controlled vocabulary search adapted to thesaurus headings, search operators, and limits in each of the above-mentioned databases. Primary outcome parameters included surgical site infections, ACL graft rupture, revision rates, and patient-reported outcome measures (PROMs). We identified 24 comparative studies, including a total of 672,241 patients, of whom 69,113 were in the smoker group and 603,128 were in the non-smoker group. The analysis revealed that smoking was associated with a significantly higher risk of surgical site infections (OR 1.40, P=0.01). Smokers also reported significantly worse PROMs on the International Knee Documentation Committee (IKDC) score (MD -5.38, P<0.00001) and multiple Knee Injury and Osteoarthritis Outcome
Score (KOOS) subscales. There was no statistically significant difference between the two cohorts for ACL graft rupture or all-cause revision rates. Smoking appears to be associated with a higher risk of surgical site infections following ACL reconstruction and is linked to significantly poorer functional PROMs.

DOI: 10.7759/cureus.96765

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Factors associated with conversion from day-case to in-patient elective laparoscopic cholecystectomy surgery across England: an observational study using administrative data (2025)

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Type of publication:

Journal article

Author(s):

*Olagunju, Naomi; *Cheetham, Mark; Savage, Katrein; Briggs, Tim W R; Gray, William K.

Citation:

Surgical Endoscopy.  2025 Dec 18. [epub ahead of print]

Abstract:

PURPOSE: Elective laparoscopic cholecystectomy is increasingly being conducted as a day-case procedure. However, some patients planned for day-case surgery stay in hospital for at least one night. The aim of this study was to identify factors associated with conversion from planned day-case to in-patient management for elective laparoscopic cholecystectomy.

METHODS: This was an exploratory retrospective analysis of observational data from the Hospital Episode Statistics dataset for England. All patients aged >= 17 years undergoing a planned elective day-case laparoscopic cholecystectomy between 1st April 2017 and 31st March 2024 were identified. The exposure of interest was discharge on the day of admission (day-case) or requiring overnight stay. For reporting, providers were aggregated to an Integrated Care Board (ICB) level.

RESULTS: A total of 286,754 elective LCs planned as day-case were identified over the seven-year study period. Of these, 74,957 (26.1%) stayed in hospital for at least one night and were classed as day-case to in-patient stay conversions. In multilevel, multivariable modelling, conversion to in-patient stay was associated with great age (odds ratio (OR) 2.54 for 17-29 vs >= 70 years, p < 0.001), male sex (OR = 1.11, p < 0.001), deprivation (OR 1.14, first vs fifth quintile, p < 0.001), open surgery (46.93, p < 0.001), and low annual surgeon volume (OR 1.73, < 10 vs >= 80 LCs per year, p < 0.001). Comorbidities and post-procedural complications were also strongly associated with conversion. Across the 42 ICBs in England, model-adjusted conversion rates varied from 14.5% to 39.0%, 18 (42.9%) ICBs had conversion rates above the 99.8% control limit.

CONCLUSIONS: Conversion from day-case to in-patient stay was associated with increasing age, male sex, deprivation, open surgery, low surgeon volume, comorbidity and post-procedural complication. Our findings will help surgical team identify patients suitable for day-case laparoscopic cholecystectomy.

DOI: 10.1007/s00464-025-12480-z

Facing the isles: Maxillofacial emergencies unveiled - A tale of two realms (2024)

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Type of publication:

Conference abstract

Author(s):

*Kichenaradjou A.; Reddy M.; *Shah N.

Citation:

Craniomaxillofacial Trauma and Reconstruction. Conference: FACE AHEAD 2024. Prague Czechia. 17(1 Supplement) (pp 80S-81S), 2024. Date of Publication: 01 Jun 2024.

Abstract:

The Noble hospital on the Isle of Man likely experiences a lower volume of maxillofacial emergencies compared to district general hospitals in mainland UK. The Island's smaller population and relative tranquillity contributes to this. Common maxillofacial emergencies include facial trauma, dental infections and oral abscesses. In contrast, district general hospitals in mainland UK, like those in Shrewsbury and Telford hospitals, likely to handle a higher volume and variety of maxillofacial emergencies due to their larger catchment areas and higher population density. We audit and present the emergency work undertaken during the year 2023 between Noble hospital and the district general hospital(s) of the Shrewsbury and Telford hospitals NHS.

DOI: 10.1177/19433875241232784

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Utilising research management technology to streamline and integrate pharmacy clinical trial processes within a multi-disciplinary research team: a service evaluation (2025)

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Type of publication:

Conference abstract

Author(s):

*Essra Y.; *Angela Y.; *Rachel R.;

Citation:

International Journal of Pharmacy Practice. Conference: Royal Pharmaceutical Society Annual Conference, RPS 2025. London United Kingdom. 33(Supplement 1) (pp i17), 2025. Date of Publication: 01 Nov 2025

Abstract:

Introduction: Clinical trials are the gold standard for testing pharmacological, behavioural and policy interventions [1]. In hospital settings, trial setup can be complex, requiring coordination across multiple teams, specialties, and environments. For trials involving InvestigationalMedicinal Products (IMPs), pharmacy departments must align their processes with other research teams in a transparent, efficient, and standardised manner [2]. One approach to achieving this is using a research management system. Aim(s): To evaluate the implementation of a digital research management system (EDGE) in streamlining and standardising the setup of clinical trials involving pharmacy and other departments. Methodology: As this was a service evaluation, ethical approval was not required. Retrospective quantitative data from between 01 May 2022- 28 May 2025 were extracted from the research management system at a single NHS hospital trust. Data were analysed to assess the number of pharmacy workflows set up, turnaround times and the range of clinical trials supported. Qualitative stakeholder feedback on experiences of implementation were also sought from research nurse colleagues and the trust governance and quality assurance lead. Result(s): Between 2022-2025, four pharmacy-specific workflows were developed and implemented. These were: Expression of interest/feasibility; Amendment implementation; Pharmacy site file audit and Trial closure and archiving. A total of 161 workflows were completed across 62 different clinical trials. Notably 67% of pharmacy workflows were completed ahead of their target timelines. Feedback from research nurses and the trust research and governance lead was positive. The implementation of the pharmacy workflows provided greater transparency for pharmacy set-up and management of clinical trials facilitating better collaborative relationships between the team. Use of the workflows also lead to reduction in e-mail correspondence with better ability to track progress with different tasks and provide visibility to obstacles and blockers. Discussion(s): The implementation of a research management system significantly improved the efficiency, transparency, and coordination of pharmacy workflows in clinical trial setup and management. Positive stakeholder feedback and early completion of most workflows suggest that digital tools can enhance interdisciplinary collaboration in research settings. A key limitation is this evaluation was limited to a single NHS trust and relied on retrospective data and informal stakeholder feedback, which may not fully capture the broader impact or generalisability of the findings.

DOI: 10.1093/ijpp/riaf093.092

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