2024

Trial of lateral flow devices for COVID/Flu A+B ±RS (2024)

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Type of publication:

Service evaluation

Author(s):

*Rebecca Kerrigan

Citation:

SaTH Service Evaluation

Abstract:

We attempted to evaluate the use of dual/triple lateral flow devices to screen patients for winter viruses (COVID, Flu A and B, RSV). Lateral flow kits were sent to Ward 17 at Princess Royal Hospital and Ward 24 at Royal Shrewsbury Hospital. Instructions were given to staff on how to take the samples and complete the paperwork, and how to return samples and paperwork.

No samples or paperwork were returned to the Microbiology department during the trial period, therefore no analysis can be performed, and no conclusions on the effectiveness of either lateral flow device can be drawn.

The Microbiology department recommends that the Trust contacts the POCT team if a repeat trial is required.

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Improving In-Hospital Falls Management Through In-situ Simulation (2024)

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Type of publication:

Conference abstract

Author(s):

*Claire Swindell, *Omar Hassouba

Citation:

Journal of Healthcare Simulation 2024;4(Suppl 1):A1–A102

Abstract:

Introduction: This quality improvement initiative focuses on utilising in-situ simulation techniques to promote active participation from the multidisciplinary healthcare team to improve in-patient falls management. The project focused on a simulated patient that had sustained a fractured neck of Femur after experiencing a fall on the ward. Safe transfer of the fallen patient and identification of equipment needed was central to the project’s objectives. In doing so, learner centred engagement assisted in the identification of organisational and systematic barriers that impinge on best practice. As in-situ simulation can proactively identify latent system issues that may be acting as barriers in achieving best practice, how effective can it be in improving staff management, in response to a fallen in-patient that has sustained a Fractured neck of Femur? Methods: A collaborative approach was initiated and fostered to allow key stakeholders to identify fall-related issues and areas most in need of improvement within the Trust relating to falls. Using in-situ simulation, a standardised patient was utilised to recreate a realistic scenario, where a patient falls on the way to the toilet. The standardised patient ‘role plays’ that they have sustained a hip injury which presents as a fractured neck of femur, hence unable to get up from the floor. The multidisciplinary ward team were then observed to see how they collectively managed the fallen patient and how they safely transfer the patient from the floor. A protected, inclusive debrief was then carried out to enhance understanding of the scenario undertaken and to highlight barriers encountered. Results: Although the multidisciplinary team appeared to have a good awareness of Trust policy and procedure pertaining to post-fall care, accessibility to essential equipment needed was lacking. A need for staff training in the safe use of this essential equipment was apparent. Discussion: By carrying out this immersive in-situ simulation, specific ward issues that required attention were identified, problems that may have gone unnoticed if not presented in a realistic scenario, recreating real-time patient care needs. Therefore, in-situ simulation is an ideal and effective modality in capturing authentic latent issues that may occur during the management of a fallen patient that has sustained a fractured neck of femur. The need for improvements were identified and cascaded to the relevant teams to remove barriers for best practice.

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An evaluation of autonomic and gastrointestinal symptoms, and gastric emptying, in patients with systemic sclerosis (2024)

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Type of publication:

Journal article

Author(s):

Hughes M.; *Harrison E.; Herrick A.L.; Lal S.; McLaughlin J.T.

Citation:

Journal of Scleroderma and Related Disorders. (no pagination), 2024. Date of Publication: 2024.

Abstract:

Objective: Assessment of gastrointestinal and autonomic symptoms in patients with systemic sclerosis, and possible associations with gastric emptying rate. Method(s): Participant and patient disease-related characteristics were collected. Gastrointestinal and autonomic symptoms were assessed by the UCLA-SCTC GIT 2.0 and COMPASS-31 questionnaires, respectively. Potentially confounding gastrointestinal medications were discontinued where possible. Gastric emptying was assessed using a non-radioactive <sup>13</sup>C sodium acetate isotope, end-expiratory breath samples collected at baseline and then serial timepoints up to 120 min. Result(s): In total, 49 participants were studied: 17 with systemic sclerosis with variable gastrointestinal involvement, and healthy matched (n = 17) and non-matched controls (n = 15), the last to control for the impact of age rather than disease on gastric emptying and autonomic function. The total mean (range) UCLA GIT 2.0 questionnaire for patients with systemic sclerosis was 0.63 (0.0-1.5) and for both healthy matched and non-matched controls was 0.04 (0.0-0.2), and was higher in patients with systemic sclerosis across all domains. The total mean (range) COMPASS-31 score for patients with systemic sclerosis patients was 32.2 (0.0-54.9) and for healthy matched- and non-matched controls: 7.45 (0.0-24.9) and 4.25 (0.0-2.1), respectively, again higher for patients with systemic sclerosis across all domains. No association was observed between patients' UCLA GIT 2.0 total score (s = -0.039, p = 0.38), total COMPASS 31 score (s = -0.108, p = 0.68), or COMPASS-31 GI domain (s = -0.051, p = 0.85) and gastric emptying rates. Conclusion(s): Gastrointestinal and autonomic symptoms are overrepresented in patients with systemic sclerosis but did not associate with gastric emptying rates.

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Fear of reinjury after acute Achilles tendon rupture is related to poorer recovery and lower physical activity postinjury (2024)

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Type of publication:

Journal article

Author(s):

Larsson, Elin; LeGreves, Agnes; Brorsson, Annelie; Eliasson, Pernilla; Johansson, Christer; *Carmont, Michael R; Nilsson Helander, Katarina.

Citation:

Journal of Experimental Orthopaedics. 11(4):e70077, 2024 Oct.

Abstract:

Purpose: The aim of this study was to investigate how fear of reinjury to the Achilles tendon affects return to previous levels of physical activity and self-reported Achilles tendon Total Rupture Score (ATRS) outcomes.

Methods: Data were collected from a large cohort of patients treated for an acute Achilles tendon rupture at Sahlgrenska University Hospital Molndal between 2015 and 2020. The ATRS and additional questions concerning fear of reinjury, treatment modality, satisfaction of treatment and recovery were analyzed 1-6 years postinjury. Analysis was performed to determine the impact of fear of reinjury on patient-reported recovery and physical activity.

Results: Of a total of 856 eligible patients, 550 (64%) answered the self-reported questionnaire and participated in the follow-up. Of the participants, 425 (77%) were men and 125 (23%) were women. ATRS, recovery in percentage, satisfaction of treatment, recovery on a 5-point scale and physical activity level post- versus preinjury were significantly related to fear of reinjury (p < 0.001). Of the nonsurgically treated patients, 59% reported fear of reinjury compared to 48% of the surgically treated patients (p = 0.024) Patients that reported fear of reinjury had a 15-point lower median ATRS score than those who did not (p < 0.001).

Conclusion: More than half of patients who have suffered an Achilles tendon rupture are afraid of reinjuring their tendon. Patients who reported fear of reinjury exhibited a significantly lower ATRS score. This indicates the importance of addressing psychological aspects in the treatment after this injury.

Level of Evidence: Level II.

Link to full-text [open access - no password required]

Percivall Pott (1713-1788): Father of Orthopaedics and Pioneer of Occupational Medicine (2024)

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Type of publication:

Journal article

Author(s):

*Forster, Seth.

Citation:

Cureus. 16(10):e70608, 2024 Oct.

Abstract:

Percivall Pott was an eighteenth-century English surgeon best known for three eponymous diseases: Pott's fracture, Pott's puffy tumour and Pott's disease of the spine. He wrote extensively, with treatises covering a wide range of surgical subjects, including cataracts, cranial trauma, hernias
and neurology. Pott's practice came at a time when surgery was being transformed from the work of barbers into a scientific study. His publications had a wide-reaching impact, influencing contemporary practice and setting out building blocks for the work of those who came after him. This article aims to explore the life and career of Percivall Pott, looking in particular at his influence on the subjects of orthopaedics and occupational medicine.

UK Foot and Ankle Thromboembolism (UK-FATE) (2024)

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Type of publication:

Journal article

Author(s):

Mangwani, Jitendra; Houchen-Wolloff, Linzy; Malhotra, Karan; Booth, Sarah; Smith, Aiden; Teece, Lucy; Mason, Lyndon W; Shaikh, Rabia; Alfred, Wilam; Okhifun, Imobhio; Cinar, Ece; Bua, Nelson; Vemulapalli, Krishna; Acharya, Ashok; Gadd, Richard; Money-Taylor, John; Kantharaju, Rohit; Bhosale, Abhijit; Bahri, Suchita; Broadbent, Rosie; Drummond, Isabella; Jones, Neil; Shah, Savan; Ravindrarjah, Thuwarahan; Yasen, Zaid; Singh, Kunjshri; Al-Habs, Ruqaiya; Jeyaseelan, Lucky; Habbiba, Abdullah; Walker, Thomas; Dewhurst, Maximilian; Glasgow, Nisha; Eze, Dominic; Carter, Gary; Rajan, Praveen; Patil, Vijay; Amer, Omer; Malik, Kalim; Pavanerathan, Pranavan; Mallick, Arijit; Seferiadis, Ilias; Currall, Verity; Sadasivan, Preetha; Kumar, Sunil; Sanjani, Shahrukh R; Ciaccio, Maria; Ayyaswamy, Brijesh; Prasad, Pradeepsyam; Anand, Mr; Sunilraj, Dr; Lane, Suzanne; Prathap, Swetha; Kankate, Raghubir; Aktselis, Ioannis; Davda, Kinner; Vijapur, Arvind; Tayyem, Mohammed; Chau, Jackie; Azhar, Muhammad S; Sturdee, Simon; Hussain, Halima; Sonde, Sarah; Luqman, Muhammad Q; Farooq, Rahy; Wells, Gareth; Shenolikar, Aneil; Simons, Michiel; Hodgson, Paul; Thomas, Rhys; Stevens, Sam; Elhassan, Yahya; Adeniyi, Adebowale; Aspinall, Will; Joseph, Vinay; Day, Miriam; Tong, Aureola; Joyner, Claire; Alzaranky, Muhammed; Elhassan, Osman; Chhantyal, Kishor; Arora, Abhishek; Abiddin, Zain; Kucharski, Robert; Ahmad, Irfan; Zeb, Junaid; Ishaq, Usman; Thomas, Jija; Jain, Kowshik; Deol, Rupinderbir; Faroug, Rad; Johal, Karan; Mordecai, Simon; Argyropouos, Miltiadis; Chawla, Amit; Ibrahim, Mohamed; Pereira, Marta; Barr, Lynne; Julies, Elda; Hill, Francesca; Kapoor, Smriti; Bailey, James; Mukhopadhyay, Ishani; Rana, Sarina; Tarig, Hamza; Qualaghassi, Mahdi; Seewoonarian, Sheena; Rose, Barry; Crate, Georgina; Abbott, Sarah; Fenner, Christopher; Geleit, Ryan; Yousaf, Sohail; Akram, Nimra; Al-Hubeshy, Zahra; Patel, Bhavi; Hussein, Mohamed; Clark, Callum; Giddie, Jasdeep; Dega, Raman; Dasari, Kishore; Nandhara, Gurbinder; Kumar, Pritesh; Gupta, Prateek; Poole, Hope; Zace, Pamela; Alvi, Farhan; Jacob, Jagan; Reddy, Raji; Sateesh, Vaishnav; Gledhill, Andrea; Craven, James; Cichero, Matt; Yates, Ben; Newton, Ayla; Grice, John; Fawcett, Nicholas; Fraig, Hossam; Hamad, Farouk; Marsland, Daniel; Elliot, Robin; Ghani, Yaser; Chandrashekhar, Suresh; Millan, Ravi K; Clark, Andrew; Rahman, Kashed; Sykes, Mark; Little, Zoe; Saleem, Jawaad; Jolly, Lewis; Jain, Aman; Qadri, Ansar; Rymaruk, Sophy; Kulkarni, Avadhut; Garabadi, Mohanrao; Akhtar, Meraj; Hossain, Munier; Yunus, Shamael; Saleem, Maleeha; Fong, Joanna; Islam, Amirul; Nusir, Ben; Chapman, James; Holmes, David; Mamoowala, Neville; Almond, Kieran; Wright, Claire; Caruana, Ethan; Watson, Thomas; Allison, Georgia; Pillai, Anand; Madhi, Imad; Alsalihy, Mazin; Elamin, Khadija; Yip, Chee Rong; Tew, Lucy; Dahiya, Rohan; Goff, Thomas; Bagshaw, Oliver; Slade, Henry; Andrzejowski, Paul; Gomati, Ayoub; Drake, Chris; Hind, Jamie; Morgan, Rebecca; Khalaf, Ahmed; Ditta, Adeel; Ramasamy, Arul; McIntyre, Joshua; Blacklock, Calum; Middleton, Scott; Clayton, Robert; Hrycaiczuk, Alex; Thornhill, Christopher; Jeyakumar, Gowsikan; Vaithilingam, Delani; Potter, Kate; Jamal/Pete Chan, Bilal; Mohamed, Muyed; Fraser, Debbie; Elhalawany, Ahmed; Beastall, James; Cousins, Gerard; Nunag, Perrico; Loveday, David; Bawa, Akshdeep; Gilmore, Rebecca; Schankat, Kerstin; Walls, Andrew; Corin, Nicole; Robinson, Peter; Hepple, Steve; Harries, William; Riddick, Andrew; Winson, Ian; Marsh, Luke; Bashir, Muhammad A; Saini, Jigyasa; Atkinson, Henry; Limaye, Rajiv; Johnson-Lynn, Sarah; Sethi, Mohit; Flanagan, George; Uddin, Akram; Reilly, Ian; Martin, Rebecca; Pujol-Nichol, Andrea; Carroll, Natalie; Boucher, Alexander; Alward, Mustafa; Myint, Yuland; Butler, Katherine; Kendal, Adrian; Bugeja, Mark; Mooteeram, Justin; Saedi, Farid; Koc, Togay; Morcos, Zeid; Robertson, Gregory; Holmes, Natal; Tribe, Howard; Pearkes, Tim; Soliman, Ahmed; Prasanna, Anil; Teoh, Kar; Kamat, Sanil; Bajracharya, Abhijit; Reeves, James; Ngwayi, Mbori; Imtiaz, Galal; Blackmore, Noah; Lau, Benjamin; Naik, Arjun; Tung, Eleanor; Murhekar, Siddhartha; Ray, Robbie; Lyle, Shirley; Makwana, Nilesh; Kaisi, Kahlan A; Al-Musabi, Musab; Dean, Mike; Hughes, Adrian; Shuttlewood, Kimberley; Welck, Matthew; Patel, Shelain; Sykes, Adam; Thibbaiah, Mahesh M; Hadi, Hosain; Haldar, Anil; Ardakani, Amir G; Jani, Priyanka; Kutuzov, Vladislav; Gibbons, James; Trussler, Daniel; Hawley, Eve; Akhtar, Sabeen; Rajgor, Harshadkumar D; Budair, Basil; Prem, Hari; Mckenzie, James; Thurston, Daniel; O'Sullivan, Michael; Elmajee, Mohammed; Pond, Erika; *Zahra, Wajiha; *Heaver, Catriona; Igbagiri, Kueni; Gaukroger, Andrew; Solan, Matthew; Peacock, Christian; Fan, Ka S; Barton, Tristan; Robinson, Derek; Graham, Selina; Zeolla, Julian; Everett, Samuel; Iqbal, Mohammad; Gourbault, Lysander; Singh, Shashwat; Tang, Cary; Tarhini, Mariam; Khan, Shahrukh; Balasubramanian, Satishkumar; Lever, Caroline; Bansod, Vaibhav; Iyengar, Kartik; Wadood, Abdul; McMillan, Lara; Toh, Eugene; Masunda, Stanley; Federer, Simon; Ahmad, Faheem; Lashin, Ahmed; Kaddah, Ahmed; Oladeji, Emmanuel; Dawe, Ed; Nolan, Ciaran; El-Bayouk, Khalil; Dhukaram, Vivek; Chapman, Anna; Beddard, Laura; Thomas, Alex; Garg, Vipul; Taylor, Heath; Kelsall, Nikki; Roslee, Charline; Akram, Nimra; Lowdon, Hamish; Kamel-Sherif, Ahmed; Jones, Anette; Best, Alistair; Zabaglo, Mate; Sayani, Junaid; Kyaw, Olive; Khin, Chan; Ali, Ramla; Shaik, Yousufuddin; Hossain, Natasha; Valente, Lucia; Ajis, Adam; Guha, Abhijit; Pereira, Melwyn; Ayoub, Atif; Paraoan, Vlad; Hali, Nayeem; Baird, Charles; Kugan, Raj; Abdallatif, Ahmad; Blomfield, Mark; Jackson, Gillian; Craven, James; Malhotra, Anubhav; Toner, Aileen; Render, Luke; Ashley, Connor; Limb, Richard; Smith, Robert; Hughes, Luke; Matthews, Hannah; Shiers-Gelalis, Fleur; Ting, Jason; Place, Stuart; Budgen, Adam; Stanley, James; Jowett, Charlie.

Citation:

Bone & Joint Journal. 106-B(11):1249-1256, 2024 Nov 01.

Abstract:
Aims: Venous thromboembolism (VTE) is a potential complication of foot and ankle surgery. There is a lack of agreement on contributing risk factors and chemical prophylaxis requirements. The primary outcome of this study was to analyze the 90-day incidence of symptomatic VTE and VTE-related mortality in patients undergoing foot and ankle surgery and Achilles tendon (TA) rupture. Secondary aims were to assess the variation in the provision of chemical prophylaxis and risk factors for VTE. Methods: This was a multicentre, prospective national collaborative audit with data collection over nine months for all patients undergoing foot and ankle surgery in an operating theatre or TA rupture treatment, within participating UK hospitals. The association between VTE and thromboprophylaxis was assessed with a univariable logistic regression model. A multivariable logistic regression model was used to identify key predictors for the risk of VTE. Results: A total of 13,569 patients were included from 68 sites. Overall, 11,363 patients were available for analysis: 44.79% were elective (n = 5,090), 42.16% were trauma excluding TA ruptures (n = 4,791), 3.50% were acute diabetic procedures (n = 398), 2.44% were TA ruptures undergoing surgery (n = 277), and 7.10% were TA ruptures treated nonoperatively (n = 807). In total, 11 chemical anticoagulants were recorded, with the most common agent being low-molecular-weight heparin (n = 6,303; 56.79%). A total of 32.71% received no chemical prophylaxis. There were 99 cases of VTE (incidence 0.87% (95% CI 0.71 to 1.06)). VTE-related mortality was 0.03% (95% CI 0.005 to 0.080). Univariable analysis showed that increased age and American Society of Anesthesiologists (ASA) grade had higher odds of VTE, as did having previous cancer, stroke, or history of VTE. On multivariable analysis, the strongest predictors for VTE were the type of foot and ankle procedure and ASA grade. Conclusion: The 90-day incidence of symptomatic VTE and mortality related to VTE is low in foot and ankle surgery and TA management. There was notable variability in the chemical prophylaxis used. The significant risk factors associated with 90-day symptomatic VTE were TA rupture and high ASA grade.

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A Standardised approach to Theatre training (2024)

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Type of publication:

Service improvement case study

Author(s):

*Nicola Bell, *Andrew Hutchinson

Citation:

SaTH Improvement Hub, June 2024

Abstract:

To ensure a consistent approach to training for all non-medical clinical staff, (including Nurses, Nursing Associates, Assistant practitioners and HCA’s ) that are new to Theatres, that results in them being competent & effectively developed to safely work as a non-supernumery member of the team, within six
months of starting their new role.

Link to PDF poster