FEATURE ARTICLES

Efforts to reduce rates of MRSA and Clostridium difficile have had a significant impact, but progress has not been reported for all Trusts or for other healthcare-associated infections.

CATHERINE CLEGG reviews the present position on “end of life” care and assisted suicide in light of recent legal developments and proposed guidance

Many patients requiring end of life care experience unnecessary pain and find themselves in hospital when they have no clinical need to be admitted. Front line staff often lack training in delivering basic end of life care, and patients’ wishes, in many cases, are not recorded or respected. The Clinical Services Journal reports.

Hospitals are now providing feedback on a range of infection prevention technologies, selected by the NHS Purchasing and Supply Agency for evaluation. Promising innovations include a system for decontamination, a test device for monitoring the cleanliness of equipment and wards, and a catheter that could help reduce the number of CAUTIs. The Clinical Services Journal reports.

Service redesign and transformation processes are helping Birmingham Children’s Hospital to understand how it can influence and improve the experience of patients, carers and staff. AMANDA BAUGH RGN MBA describes the early stages of the journey for improvement.

NICE guidelines state that laparoscopic resection is recommended as an alternative to open resection for individuals with colorectal cancer in whom both laparoscopic and open surgery are considered suitable.

A two-year pilot project, the Stockport Early Intervention Service (EIS) was developed out of a desire to reduce the frequency and cost of short stay hospital admissions for “ambulatory care sensitive” conditions. Dr ASH PATEL and BRIDGET SMITH provide an insight into this innovative model of care, which could potentially ease pressure on the acute sector.

RICK GEOFFRION and ANDREA VENTURELLI address the question: “Can drug eluting balloons (DEBs) become the next successful and sustainable device platform for treatment of atherosclerosis?”

Dr FRANK PRIOR describes the development of a new method for rapidly and efficiently removing prion protein from stainless steel surgical instruments, which could potentially reduce the infection risk associated with vCJD and other TSEs.

By many accounts, the introduction of digital imaging and PACS in the NHS has been a great success – with PACS now being used in every hospital Trust in England. But what progress has been achieved towards enabling image studies to be shared “seamlessly” across clinical networks? DEWINDER S. BHACHU provides an insight into the challenges ahead.

The Serious Hazards of Transfusion scheme report for 2008 was published recently. The summary of the full report, which is available on the SHOT website or as a hard copy from the SHOT office, is reproduced below.

A national enquiry into inpatient deaths due to acute kidney injury found that a fifth were predictable and avoidable. In many cases, the “very essentials of medical care” were omitted, patients received inadequate investigations and recognition of acute illness, hypovolaemia and sepsis was poor.

Although anaesthetic anaphylaxis is still relatively rare, the numbers of adverse reactions that receive specialist treatment appear to be on the increase. New guidance has been published to help avoid serious consequences. The Clinical Services Journal reports.

A wide range of speakers will educate, motivate and inspire an audience of perioperative practitioners at the AfPP Congress. There will be much to learn from – whether it is the moving account of a family tragedy caused by errors in surgery; a warning of the dangers of smoke inhalation in the operating theatre; or an emotive insight into the work of Mercy Ships in Africa, which is saving lives though the kindness of volunteers.

The Government refusal to offer compensation to all recipients of contaminated blood and blood products has raised deep concerns. Transfusion scientist BARRY HILL examines the background behind this and looks at potential problems ahead for UK blood services.

The Heart of England NHS Foundation Trust (HEFT) recently won first prize in the Oxoid Infection Control Team of the Year Awards for its sustained commitment to reducing healthcare-associated infections.

STEFANO DI LULLO argues that intelligent remote monitoring systems could enable healthcare professionals to predict the course of chronic diseases and therefore take pre-emptive action. Arrhythmia is one example where significant cost benefits could be realised through this approach.

Vanguard Healthcare, a provider of mobile surgery and endoscopy services to the NHS, became an independent company in April 2009, following a management buy out from Nuffield Health. LOUISE FRAMPTON speaks to chief executive Ian Gillespie about the company’s role in providing extra capacity for the NHS, its plans for growth and his views on waiting list targets.

In three years’ time, hospital radiology departments will be “running to stand still” according to the latest market intelligence. In order to meet the increase in demand, the off-site reading market is predicted to grow from £7 m to £74 m in just five years. LOUISE FRAMPTON looks at how one independent sector provider is striving to address this need.

Since committing to the national campaign Patient Safety First, Trusts are reporting significant improvements. One Trust has reduced incidence of cardiac arrest outside critical care by almost a third, while another is making progress in implementing steps to prevent cases of ventilator-associated pneumonia (VAP).