The Operating Theatre Journal April 2022

THE THE

THE

SEPTEMBER APRIL 2020 2022 2020 ISSUE NO. NO. NO. 360 360 379 ISSN 0000-000X 1747-728X

SEPTEMBER 2020 ISSUE NO. 360 ISSN 0000-000X

The The Operating Theatre Theatre Journal

Journal

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Multiple long-term conditions should not be a

barrier to hip replacement surgery

Having multiple long-term

conditions should not prevent

people with osteoarthritis

having hip replacements. New

research found that the surgery

improved their quality of life and

complication rates were generally

low. Despite this, the study found

that fewer than half of those

with hip osteoarthritis had hip

replacement surgery.

Osteoarthritis is a common

type of arthritis that causes

pain and stiffness. In severe

cases, hip replacement surgery

is recommended. However,

surgery might be delayed, or

even ruled out, if the person has

other existing health conditions.

Such decisions are not based on

evidence; the researchers say no

previous research has explored

whether people with multiple

long-term conditions have worse

outcomes than others after this

procedure.

This study analysed the health

records of 27,560 people aged 65

and over, who all had a diagnosis

of hip osteoarthritis. Decisions on

surgery were influenced by longterm

conditions, the study found;

the more long-term conditions

people had, the less likely they

were to have a hip replacement.

Yet these people generally had

good outcomes and benefitted

from surgery.

The research highlights the

importance of an evidencebased

approach. The researchers

hope their work will help inform

doctors and patients about the

relative risks and benefits of hip


What’s the issue?

People with osteoarthritis have

joints that are painful, stiff, and

sometimes swollen. This happens

when the protective cartilage on

the ends of bones breaks down.

It most often affects the knees,

hips and small joints of the hands

and is the most common type of

arthritis in the UK.

When symptoms are mild, they

can be managed with regular

exercise, weight management or

with special devices to reduce the

strain on joints during everyday

activities. If symptoms get worse,

people may need painkillers or a

structured exercise plan with a

physiotherapist.

In severe osteoarthritis, people

can have surgery to completely

replace the hip or other affected

joint. Hip replacement surgery

generally gives people a greater

range of movement and reduces

their pain.

People having hip replacements

are 70 years old, on average. By

this age, many have other longterm

conditions, such as high

blood pressure or diabetes, which

might increase the risk of any

surgery. Doctors may therefore be

concerned about recommending

hip replacement surgery for older

people who have such conditions.

Researchers explored how

multiple long-term conditions

influence the likelihood and timing

of hip-replacement surgery. They

also looked at the impact of

multiple long-term conditions on

the outcomes of hip replacement

surgery.

What’s new?

The researchers analysed GP

health records from across the UK.

They included data from 27,560

people aged 65 years and older.

Participants had an average age

of 75 years and most (62%) were

women. All had a diagnosis of hip

osteoarthritis in their records.

The team assessed participants’

general health through the

number of other conditions,

and medications mentioned in

their records, and the number

of primary care consultations in

the preceding 12 months. There

is no single way to measure

other conditions; the researchers

assessed conditions using

different approaches, including a

measure of frailty.

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Hospital records showed that

fewer than half (40%) the

participants underwent hip


In the whole group, which

included people with and without

multiple long-term conditions,

the study found:

People with more long-term

conditions were less likely to have

hip replacement surgery, even if

they had moderate poor health,

and the benefits of surgery

outweighed the risks

Neither age nor gender affected

the rate of surgery, which

suggested that surgery was

withheld because of the longterm

conditions the people had,

and not these other factors

Even people who were ‘mildly

frail’ were less likely to have the

surgery

Most surgery took place 10 months

after a diagnosis was added to GP

records, but the more pre-existing

long-term conditions a person

had, the longer they waited.

In a group of 6682 people with hip

osteoarthritis and multiple longterm

conditions, the researchers

looked at the outcomes of hip


They found that:

Regardless of pre-existing

conditions, patients reported

improved quality of life 6 months

after surgery

Other conditions weakly predicted

risk of complications (such as a

heart attack or wound infection)

but the increases in risk were

small

People with worse health before

surgery were more likely to have

complications afterwards, though

the complication rates (3%) and

death rates (1%) were low

People’s health before surgery

did not influence how long they

stayed in hospital; but those with

worse health before surgery were

twice as likely to be readmitted

to hospital afterwards than the

healthiest people in the study

group.

The researchers concluded that,

for most people, having multiple

long-term conditions should

not be a barrier to having hipreplacement

surgery.

Why is this important?

Professionals and patients

both raise concerns about hipreplacement

surgery when people

have other long-term conditions.

This research provides evidence

about the risks and benefits of

hip-replacement surgery for this

group of people.

It found that hip-replacement

surgery improves quality of life

regardless of someone’s other

conditions. The surgery could

improve some other conditions,

such as depression, because of

the improvement in pain. The

team would like to follow people

up for longer, to understand the

longer-term impact of surgery in

people with multiple long-term

conditions.

The findings from this study show

that healthcare professionals and

patients should decide together

on the benefits of surgery to

them. They should discuss the

risks, including of anaesthesia,

and jointly come to a decision

based on evidence.

The researchers say that, as long

as the risk of having a general

anaesthetic is not too high, having

multiple long-term conditions

should not be a barrier to hip

surgery.

What’s next?

These results depend on the

accuracy of primary care

health records. If a diagnosis

was included in the medical

records some time after the first

symptoms appeared, people may

have been suffering with pain for

longer than the records suggest.

People with multiple long-term

conditions did not stay in hospital

any longer than other people after

surgery. It is possible that the

length of stay could be influenced

more by type of procedure.

Surgery carried out under local

anaesthetic might have shorter

hospital stays than those carried

out under general anaesthetic.

You may be interested to read

One of the papers this NIHR Alert

is based on: Ferguson R, and

others. Influence of pre-existing

multimorbidity on receiving a hip

arthroplasty: cohort study of 28 025

elderly subjects from UK primary

care. BMJ Open 2021;11:e046713

Another paper this NIHR Alert is

based on: Ferguson R, and others.

Does pre-existing morbidity

influences risks and benefits of total

hip replacement for osteoarthritis:

a prospective study of 6682 patients

from linked national datasets in

England. BMJ Open 2021;11:e046712

Published on 11 March 2022doi:

10.3310/alert_49302

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THE THE

THE

SEPTEMBER APRIL 2020 2022 2020 ISSUE NO. NO. NO. 360 360 379 ISSN 0000-000X 1747-728X


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RCEM responds to public’s dissatisfaction with A&E services and wider NHS

The British Social Attitudes Survey by Nuffield Trust and The King’s Fund found that overall satisfaction with

the NHS fell to 36 per cent “an unprecedented 17 percentage point decrease on 2020” and “the lowest level

of satisfaction recorded since 1997, when satisfaction fell to 34 per cent.”

The reasons for the fall in satisfaction are given as:

- Waiting times for GP and hospital appointments (65%)

- Staff shortages (46%)

Royal College of

Emergency Medicine

- A view that the government does not spend enough money on the NHS (40%)

Satisfaction with Accident and Emergency Services fell by 15 percentage points, from 54% to 39%. Responding

to this fall Dr Katherine Henderson, President of The Royal College of Emergency Medicine, said:

“It is disheartening to see that satisfaction with Accident and Emergency services has fallen to its lowest

since a question on A&E was introduced in 1999, a fall of 15 percentage points from 54% to 39%. Sadly,

though, it is not surprising. For months we have been highlighting the crisis that Urgent and Emergency

Care services are facing, the significant threats to patient safety, the moral injury facing staff, the crowded

Emergency Departments and long waiting times and the danger these pose.”

“This has been met with little to no action by the UK Government. We have called for an Urgent and

Emergency Care recovery plan to tackle the crisis and improve the situation, what we have been given are

tents in carparks outside Emergency Departments.

“The dissatisfaction that the public feel with A&E services is understandable, Emergency Medicine staff are

also wholly dissatisfied and tired of being unable to deliver the high-quality effective care they are trained

to provide because of the lack of beds and staff in Emergency Departments, and the indifference shown by

the UK Government.

“I commend all Emergency Medicine staff and all of The Royal College’s membership for their resilience and

tireless efforts to do their best to keep patients safe and minimize harm in Emergency Departments in these

extremely challenging and trying circumstances. The present state of Urgent and Emergency Care is dire, but

their efforts are preventing the system from tipping completely.”

RCEM welcomes the publication of three reports

into clinical negligence published by NHS Resolution

Dr Katherine Henderson, President of the Royal College of Emergency Medicine, said:

“We welcome these reports as learning opportunities to reduce the tragedy of preventable harm to individuals

and their families as well as the staff involved. As specialty leaders and standard setters, we must use the

stories and themes identified in these reports to focus our guidance and teaching and sharpen our advocacy

for a better system of care modelled to deliver patient needs.

“Reports like these highlight the gap between what should be the standard of care and the operational

pressures the urgent and emergency care system is working under. While the responsibility for both ensuring

Emergency Departments are adequately staffed with staff trained and qualified in Emergency Medicine and

have the equipment needed and access to relevant inpatient specialties lies with those who plan healthcare

services, every clinician must look through reports like these.

“We must all think how we can eliminate patient harm by improving our knowledge and skills, teach others,

advocate for better diagnostic pathways and safety net systems. We must also get better at communicating

risk and uncertainty realities to patients, so they feel involved and confident to return for review if things do

not seem to be following the expected plan.

“The Royal College is committed to doing everything it can to improve patient safety and reduce the use of

resources needed to manage patient harm.”

Further reading:

https://resolution.nhs.uk/2022/03/28/learning-from-emergency-medicine-compensation-claims/

Inside this issue

New research shows Surgical

Site Infection prevention,

and achieving First-Pass

Recanalization in Mechanical

Thrombectomy could lead to

environmental benefits for the

NHS

P4

University gets government

backing for multi-million-pound

healthcare skills hub refurb

P7

NAO Investigation into the

management of PPE contracts

P8

New BAOMS Council members

bring diversity and strong skills

P9

First of a kind study evidences

effectiveness of MFAT on pain

and improved joint function

P10

Novel nuclear microRNA is being

developed for the treatment of

cardiovascular disease

P12

Saintonge becomes first hospital

in France to install the Dexter®

surgical robot

P14

Nurse saves man’s life

P16

ODP Andrew Verrecchia wins

the Keir Hardie Award

P16

Liquid biopsy offers new tools

for detecting recurrent breast

cancer

P17

Cleveland Clinic Expands its

Global Footprint with Opening

of London Hospital

P18

Detecting possible signs of

stroke quickly and reliably

P20

More Than AI: What Other

Technological Develoments

Have Improved Surgery

P20

BAOMS New Model Hospital

clinical OMFS performance

data goes live

P21

Jobs boost for Cork as private

hospital group announces

national expansion

P21

WHO Risk of medication

errors with tranexamic acid

P22

Find out more 02921 680068 • e-mail admin@lawrand.com Issue 379 April 2022 3

New research shows Surgical Site Infection prevention, and

achieving First-Pass Recanalization in Mechanical Thrombectomy

could lead to environmental benefits for the NHS

The NHS faces a new challenge – it needs to continue providing worldclass

healthcare whilst striving to meet its net zero carbon goal 1 . New

research has demonstrated that it is possible to reduce environmental

impact by improving patient outcomes in two areas: reducing surgical

site infections across the NHS 2 and achieving first pass recanalization in

mechanical thrombectomy 3 .

The research was presented at The International Society of

Pharmaeconomic and Outcomes Research (ISPOR) European conference

in December by Mesut Kocaman, EMEA Health & Economics Market

Access Manager for Johnson & Johnson Medical Devices. Environmental

impact models were used to analyse the influence treatment options

can have on sustainability, keeping in mind the NHS’s objective to reach

net zero carbon emissions by 2040 1 .

The first study explored the impact of surgical site infections (SSIs)

across NHS England – demonstrating SSIs were associated with 10

additional days in hospital, 4.1 additional outpatient appointments, and

22% more A&E visits compared with patients without SSIs 2 . Due to the

additional resources required, the analysis demonstrated reducing one

SSI could save 0.58 tonnes of CO2e (equivalent to two return flights from

London to Rome), 5m³ of direct water use and 0.06 tonnes of waste 2 .

The annual cost to NHS England of SSI-associated environmental impact

was estimated to be £2.67million 2 .

Jennifer Nagy, UK General Manager for Ethicon, part of Johnson &

Johnson Medical Devices Companies, says:

“Supporting our NHS to continue improving patient outcomes is our

organization’s number one priority, but we also have a responsibility

to promote a sustainable healthcare system. Our Plus Sutures were

recognized by NICE in June 2021, the report highlighted their potential

environmental benefits by preventing surgical site infections 4 , and it’s

great that this study shows what the potential environmental impact

of reducing SSIs could be.”

The second study focused on mechanical thrombectomy – a procedure

which uses a mechanical thrombectomy device to remove a clot

from the brain during acute ischemic stroke. Previous studies have

demonstrated that achieving complete or near complete reperfusion

(modified Thrombolysis in Cerebral Infarction (mTICI) grade 2c-3) after a

single pass can result in improved clinical outcomes 5 ; the new research

was to explore if there was also an environmental benefit. The study

showed that the decrease in resource utilisation by achieving mTICI

2c-3 after a single pass (first pass recanalization) led to a 134 kg drop

in CO2e and a reduction of 13 kg of waste compared to the patients

who achieved the same result after multiple passes 3 . In the UK, it is

estimated that there are approximately 10,000 patients eligible for

mechanical thrombectomy due to acute ischemic stroke 6 . Achieving a

40% rate of first pass recanalization could save as much as 51 tonnes

of waste each year and 536 tonnes of CO2e - equivalent to 2,500 round

trip flights from London to Milan 3 .

Andrew Cleworth, who leads Cerenovus stroke solutions, part of the

Johnson & Johnson Family of Companies, which makes products and

technologies used during mechanical thrombectomy procedures, says:

“The NHS long term plan includes expanding access to mechanical

thrombectomy from 1% to 10% of stroke patients 7 . At Cerenovus we

want to change the trajectory of stroke together with the NHS and

reach as many patients as possible. This research demonstrates that

by removing clots from the brain successfully at the first pass, not only

can we improve patient outcomes, we can also help the NHS meet its

net zero goal.”

The full results can be found here for surgical site infections and here

for mechanical thrombectomy - https://bit.ly/OTJ422

References:

1. NHS (2020). Delivering a ‘Net-Zero’ National Health Service. Available at:

https://www.england.nhs.uk/greenernhs/a-net-zero-nhs/. Accessed: January

2022.

2. Kocaman M, Galvain T. The Cost Analysis of the Environmental Impacts of

Surgical Site Infection from the Perspective of NHS England. Value in Health,

Volume 24, Issue 12, S2 (December 2021)

3. Kocaman M, Taylor H. The Environmental Impact of the First Pass Effect in

Mechanical Thrombectomy in the NHS. Value in Health, Volume 24, Issue 12,

S2 (December 2021)

4. © NICE 2021. MEDICAL TECHNOLOGY GUIDANCE: PLUS SUTURES FOR

PREVENTING SURGICAL SITE INFECTION. Available from: nice.org.uk/

guidance/MTG59. Accessed: January 2022. All rights reserved. Subject to

Notice of rights. NICE guidance is prepared for the National Health Service in

England. All NICE guidance is subject to regular review and may be updated

or withdrawn. NICE accepts no responsibility for the use of its content in this

product/publication.

5. ZaidatOO, RiboM, MattleHP, SaverJL, Bozorgchami H et al. (2020) Health

economic impact of first-pass success among patients with acute ischemic

stroke treated with mechanical thrombectomy: a United States and European

perspective. Journal of Neurointerventional Surgery.

6. McMeekin P, White P, James MA, Price CI, Flynn D et al. (2017) Estimating

the number of UK stroke patients eligible for mechanical thrombectomy.

European Stroke Journal 2(4): 319-326.

7. NHS. The NHS Long Term plan. Available from: https://www.longtermplan.

nhs.uk/wp-content/uploads/2019/08/nhs-long-term-plan-version-1.2.pdf

Accessed: January 2022.

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The next issue copy deadline, Tuesday 26th April 2022

All 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.com

The Operating Theatre Journal is published twelve times per year. Available in electronic format from the website, www.otjonline.com

and 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.

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A newly installed operating theatre at the Elective Orthopaedic Centre

(SWLEOC) in Epsom Hospital, South West London is equipped with

the latest state-of the art integrated digital theatre technology from

Bender UK and Merivaara.

SWLEOC is ranked as one of the best facilities in the country for high

quality, efficient, elective orthopaedic services, including inpatient,

day-case and outpatient. Performing around 5,200 procedures a year -

SWLEOC is one of the largest orthopaedic centres in the UK and Europe.

It is also a shoulder surgery specialist centre, with sub specialities in

soft tissue, spine, foot and ankle procedures.

New Integrated Operating Theatre

delivered at Epsom Hospital

The new operating theatre adds a sixth facility to the five theatres

already in place within SWLEOC. A key requirement for the teaching

hospital was integrated theatre communication, enabling clinical teams

to interact and share video with staff and students in an observation

area (referred to as ‘the fishbowl’).

At the heart of the theatre is the high capacity Merivaara OpenOR

open architecture management system, which integrates operating

theatre devices, data and image management for rapid display of

surgical imagery. OpenOR is connected with surgical lights, monitors

and cameras within the theatre. Any media related to the patient

can be stored and managed through the system including footage and

snapshots from surgery.

OpenOR is a scalable solution tailored to fit the requirements of any

hospital. It integrates PACS and hospital systems for patient worklists

and data integration, and the system is vendor-neutral, so it does not

limit the connection of image sources from specific manufacturers.

Video is connected via a simple plug and play function. The over IPbased

audio and video management capability provides flexible video

routing between sources and displays, allowing live procedures to

be viewed and streamed outside the operating theatre to any given

location.

Bender UK Managing Director Gareth Brunton explains: “With our

background in hospital critical care power, turnkey theatre projects

and more recently a full clinical product capability in partnership with

Merivaara, the OpenOR technology has been a natural progression for

our hospital business unit team.”

Bender UK supplied theatre equipment including the new CP924 glass

touchscreen theatre control panel, 24-inch DICOM compliant Bender

PACS with glass fascia membrane keyboard, and two 55-inch 4K in-wall

glass fascia viewing panels.

Merivaara Q-Flow LED operating lights with a wireless HD camera

were selected due to the best-in-class colour-rendering and optimised

airflow, with unique dynamic obstacle compensation to deliver optimum

illumination to the surgical site. The ring-within-a-ring design of the

Merivaara lights ensures uninterrupted clean air flow from the canopy

- an important requirement for orthopaedic surgery to help minimise

the risk of infection.

Bender UK has an excellent aftersales capability with full training and

familiarisation service provided by consultant Steve Coleman who took

the Epsom theatre team through a step-by-step introduction, so they

were fully conversant with the technology.

Epsom Hospital is managed by the Epsom and St Helier University

Hospitals NHS Trust along with the nearby St Helier Hospital. Both

teaching hospitals play key roles in the education and training of future

doctors, nurses and health professionals. The two hospitals work in

partnership with St George’s Hospital and St George’s Medical School in

South London to deliver high quality education and research.

Ken Macdonald, Electrical Design Engineer for the Trust commented:

“ We now have a fantastic theatre that I know the client is more than

happy with, all the surgeons and the clinical staff too, and that goes

right down to us as the Trust engineers.

“The system is probably the most up to date and cutting edge. It

provides the team with such a better facility, with the ability to record

for training purposes, allowing the consultants to talk to ‘the fishbowl’

during operations.

“It was delivered with confidence for us as the client. Questions that

were asked of Bender during the commission received answers that

were exemplary.”

Epsom Hospital is one of eight OpenOR projects completed by Bender

UK in 2021. The theatre was officially handed over for use in July 2021.

For more information on Bender UK integrated theatre capabilities

and products and service for the healthcare sector, visit https://www.

bender-uk.com/solutions/healthcare.

When responding to articles please quote ‘OTJ’

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University gets government backing for multi-million-pound

healthcare skills hub refurb

Birmingham City University has secured new

government funding as part of a more than

£3.5million redevelopment of a skills and

training hub for healthcare workers of the

future.

The University is investing £1.57 million of

its own money on the refurbishment and

has landed a further £2million from the

government’s Office for Students following a

successful capital funding bid last year.

The money will be spent on a revamping the

skills hub at the University’s Seacole Building

at its Edgbaston-based City South Campus,

which is used to provide hands-on, practical

training for those studying on health courses

such as nursing and midwifery.

It will provide even better facilities for

students by introducing a high-tech and highspec

suite of resources fitted with state-ofthe-art

equipment including 5G technology

to allow for advice, diagnoses and procedures

to be supported by real-time mobile network

connections.

Professor Ian Blair, Pro-Vice Chancellor of the

University and Executive Dean of its Faculty of

Health, Education and Life Sciences, believes

the refurbishment will strengthen its position

as a leading healthcare education provider and

considers the investment from the Office for

Students an endorsement of the University’s

commitment to developing a workforce wellequipped

to meet future needs.

Professor Blair said:

We’re really pleased to have secured funding

from the Office for Students, and I think the

success of our bid is testament to the strong

case we made to meet employer demands

around the recruitment and retention

of nurses, midwives and allied health

professionals.

We work closely with hospitals and trusts

to ensure training of new recruits is fully

up to date with the latest standards and

is tailored towards employers’ particular

needs. But as well as meeting future

workforce requirements, we’re also focused

on knowledge enhancement and upskilling

of current staff members through continuing

professional development.

Professor Ian Blair, Executive Dean

Teaching facilities already housed within the

Seacole Building include a simulated operating

theatre and hospital wards, a fully equipped

birthing room, a simulated home environment

and a fully functional radiography suite and 3D

imaging diagnostic suite.

The £3.57million pound upgrade will see

the refurbishment of the building’s existing

skills hub, where students receive handson

healthcare training to complement their

learning. Two new hubs will also be created,

alongside a new resuscitation room, the

redesign and renovation of a theatre suite,

and installation of new specialist simulation

equipment for midwifery, nursing and

healthcare teaching.

In addition to the physical improvements being

made, the building’s digital infrastructure will

be revamped – with increased capacity for 5G

connectivity – reflecting the increasing use of

virtual reality, simulation and other method

of remote communication technologies in

healthcare treatment and teaching.

The installation of the 5G capabilities will be

supported by researchers in the University’s

Faculty of Computing, Engineering and the

Built Environment, who specialise in the

study and promotion of the latest advances in

telecommunications.

Professor Blair added:

“The use of digital technologies forms a

key part of the NHS long-term plan and are

increasingly prevalent in modern healthcare.

“The pandemic has accelerated their use

with things like virtual consultations and

intelligent, remote care becoming more

commonplace now. But teaching has also been

impacted and major bodies like the Nursing

and Midwifery Council are now incorporating

additional simulated learning hours into their

training standards.

“We’ve likewise been trialling virtual learning

and with this latest investment we’ll be

able to expand our provision and continue

to develop new, innovative ways of learning

through simulation.”

The redevelopment work at the Seacole

Building is starting this month with the newly

revamped facilities open for use in May.


Investigation into the

management of PPE contracts

The Department of Health & Social Care (DHSC) continues to deal with the contract management issues caused by the need to purchase

unprecedented volumes of PPE in 2020 due to COVID-19, with billions of pounds of taxpayers’ money still at risk, according to the National Audit

Office (NAO).

Since February 2020 DHSC and its NHS procurement partner, NHS Supply Chain Co-ordination Limited (SCCL), have awarded almost 10,000 contracts

for personal protective equipment (PPE). DHSC has so far spent £12.6 billion of the total £13.1 billion it expects to spend on almost 38 billion items

of PPE.

In the spring of 2020, DHSC was operating in an extremely over-heated global market with desperate customers competing against each other,

pushing up prices and buying huge volumes of PPE. To secure the unprecedented amount of PPE estimated to be needed at the start of the

COVID-19 pandemic, DHSC established two new procurement routes: the Parallel Supply Chain1, established in late March 2020; and a new UK

Make route2, established in April 2020 to purchase PPE specifically from UK-based manufacturers.3 Some 394 contracts worth £7.9 billion were

awarded through these two new procurement routes, largely to new or unknown suppliers to the NHS. Of these 394 contracts,115 were awarded to

51 ‘VIP lane’ suppliers: suppliers suggested by government officials, ministers’ offices, members of Parliament, senior NHS staff and other health

professionals.

To date, DHSC has taken receipt of 31.5 billion items of PPE, with a further 1.4 billion items stored in China and 5.0 billion still to be received.

Of the 31.5 billion items received, some 17.3 billion items have been delivered to frontline services and 14.2 billion items remain in UK storage.

Between March 2020 and October 2021, it had cost the Department £737 million to store PPE, including penalty charges of £436 million because it

had to store PPE in containers for longer than expected.

Assessing the total demand for PPE at the start of the pandemic was challenging due to the unprecedented nature of COVID-19 and the precise

technical specifications for the PPE necessary to respond to it. DHSC estimates it now has 3.9 billion more PPE items than it needs; around 10% of

the total PPE it purchased. The Department is trying to reduce excess stock by selling, repurposing, donating to other parts of the public sector

or recycling. It is currently spending an estimated £7 million a month storing these items.

DHSC is also storing 3.6 billion PPE items that it considers are not currently suitable for frontline services, accounting for 11% of all PPE it has

received. Some 64% of all items assessed as not currently suitable for frontline services were procured through the Parallel Supply Chain and UK

Make. Over half (53%) of 51 VIP suppliers provided some PPE that DHSC considers is not currently suitable for frontline services. In addition, some

1.5 billion items of PPE currently in storage are estimated by DHSC to have passed their expiry date and therefore unable to be distributed.

The Department does not have a single end-to-end stock management system and the management data it holds contains inconsistencies between

the volume of PPE ordered and quantities received. In data provided to the NAO, in 21 of 36 contracts there were differences of more than 1%

between the number of PPE items contracted for and the number actually received. For 14 of these contracts, DHSC received a total of 107 million

fewer items than it had contracted for. In the remaining 7 contracts it received 13 million items more than it had contracted for. Discrepancies

arise for several reasons including the double counting of PPE as it is moved between locations, and some stock being missed from the count in

cases where it is held in storage by the supplier.

DHSC has so far concluded discussions about contract disputes on 76 contracts with suppliers, worth £1.9 billion. Through contract cancellations

and variations, DHSC has reported that it has reduced costs by £572 million. DHSC continues to manage 176 contracts where it is in dispute, where

it believes it may not achieve full value for money, putting an estimated £2.7 billion at risk. DHSC assesses that 35% of these cases will not be

resolved until 2023. The primary cause of contractual dispute is the quality of PPE that has been delivered.

The Department is continuing to assess potential fraud across the programmes and its current estimate is that this will be between 0.5% and 5.0%

of expenditure.

Read the full report here: https://bit.ly/OTJNAO422


New BAOMS Council members bring

diversity and strong skills

The British Association of Oral and Maxillofacial Surgeons (BAOMS)

Council has confirmed the members’ decision to elect three new

members to Council for a three-year term:

Carrie Newlands; Nabeela Ahmed; and Elizabeth Gruber. This also

included the re-election of Anne Begley for a further three years.

Consultant OMFS Anne Begley, who is based at Liverpool’s Aintree

University Hospital Regional Maxillofacial Unit, has already served

three years on BAOMS Council: “I am honoured my contribution to

the association and to the specialty has been recognised by the wider

membership and have been entrusted to serve on Council for a further

three years.”

Carrie Newlands is a Consultant OMFS at the Royal Surrey County

Hospital, and Nabeela Ahmed recently returned from two years

working in Australia and New Zealand and is now a Consultant OMFS

at Nottingham’s Queens Medical Centre. While Elizabeth Gruber is now

based at University Hospitals of Northamptonshire NHS Group.

Some of the latest representatives gather after a successful BAOMS Council

meeting at the new Royal College of Surgeon of England offices. The photo

shows L to R: Danielle Britton, Deputy Junior Trainee and Members’ Rep

; Anne Begley, Consultant OMFS and Council member; Elizabeth Gruber,

Consultant OMFS and Council member; Nabeela Ahmed, Consultant OMFS and

Council member; Carrie Newlands, Consultant OMFS and Council member;

and Sirisha Duggineni, Fellow in Training Deputy Representative.

Operating Department Practitioner

– New Zealand

Do you want to work at the largest tertiary centre in the South Island?

You will get work-life balance and with adventure never far away from

your doorstep, if you are considering a move, this could well be your

best one yet!

This is your chance to join a health system that truly cares. Our client

is a world leader in the delivery of integrated healthcare, and right now

they have the opportunity for you!

As a highly skilled Anaesthetic Technician, you will be eager to play

a key role in continuing their drive of constant improvement, provide

exceptional care and delivery of service, and enjoy a varied and fast

paced environment.

As the largest tertiary centre in the South Island their service also

encompasses several other sites across Christchurch and houses

state of the art equipment while offering a varied case mix.

The Role: Where you fit in

In this role, you will be responsible for:

• Providing professional, technical, and clinical assistance to

Anaesthetists.

• Preparing equipment within operating theatres or areas where

anaesthesia is provided.

• Anticipate problems and exceptional patient care.

• Mentoring trainee Anaesthetic Technicians.

You must:

• Have a recognised qualification within New Zealand or international

equivalent.

• Have registration with the Medical Sciences Council (or eligibility to

obtain) and an Annual Practising Certificate

• Having a minimum of 2 years’ experience is preferable but not

essential.

• Have strong interpersonal skills.

• Be motivated to embrace challenges and change as well as being

able to work in challenging environments.

We can provide the successful applicants with:

• Assistance with registration, immigration, and relocation processes

• Reimbursement of registration fees with MSCNZ and APC

• Contribution towards relocation costs

• Payment for accommodation and flights

For interviews or for any questions you may have regarding this

fantastic opportunity please contact info@accent.net.nz

Free call from the UK 0808 23 444 68 or WhatsApp 006421 403143

Email or call Prudence to enquire NOW:

prue@accent.net.nz or UK Freephone 0808 23 444 68

Commenting on the Council election, Carrie Newlands said it was a real

honour to have been elected: “The results reflect the blossoming of

inclusivity in surgery.”

Colleague Nabeela Ahmed was moved by the monumental support from

her peers, and that she felt empowered by the appointment: “I am

committed to promoting our specialty and demonstrating how diversity

is compatible with being a surgeon.”

Elizabeth Gruber is looking forward to serving on BAOMS Council

“representing my peers and our trainees, building on the great work

already achieved and working for the future of OMFS”.

BAOMS President Designate 2024-25 and Council media lead Professor

Kathy Fan commented: “These are strong candidates with a broad

range of experience and skills that will add to the strength of BAOMS

Council. I look forward to an exceptional future for our specialty.”

www.facebook.com/TheOTJ


60% OSTEOARTHRITIS SUFFERERS SHOW IMPROVEMENT IN PAIN

First of a kind study evidences effectiveness of MFAT on pain and improved joint function 2 years after treatment

In a significant discovery for the management of osteoarthritis, a team of

surgeons led by experts in London has found that 60% hip osteoarthritis

patients experienced an improvement in pain over a 2-year period as a

result of micro-fragmented adipose tissue (MFAT) injections.

The study is the largest of its type to be recorded and measures the

effectiveness of micro-fragmented adipose tissue (MFAT) injections,

and separately the combination treatment of MFAT with platelet-rich

plasma (PRP).

The research is a joint project between experts at The Regenerative

Clinic, London, The George Emil Palade University, Romania, Manchester

Metropolitan University, Manchester and University of Ferrara, Italy.

147 patients suffering from grade 1–4 hip osteoarthritis took part in

the study. Hip osteoarthritis (OA) is a major contributor to reduced

quality of life and concomitant disability associated with lost working

life months.

The peer reviewed research has been published in The Journal of

Clinical Medicine in February 2022 and is available as a downloadable

pdf. Key findings are:

• Over 60% patients report an improvement in pain

• This is using both visual analogue score for pain (VAS) and Oxford hip

score (OHS)

• It shows that an intra-articular injection of MFAT + PRP suggest

a positive role for patients with a lower BMI where there may be

difficulty in obtaining sufficient MFAT

• In each of the MFAT and MFAT + PRP groups, only 10 patients went

on to have a total hip replacement as they did not respond to the

treatment. Of these 20, most had higher grades of osteoarthritis (KL

3 and 4)

• No infections or thromboembolic events were observed

• In this first of its kind clinical study, researchers have shown the

efficacy of MFAT and combinational preparation in successful

amelioration of hip pain together with improved joint function in

patients treated with osteoarthritis

• A larger clinical trial is warranted to determine long-term benefits

over 2–5 years, and any gender-related differences in response

Professor Nima Heidari, Consultant Orthopaedic and Trauma Surgeon,

said; “In this first of its kind clinical study, we have shown the efficacy

of MFAT and combinational preparation in successful amelioration of

hip pain together with improved joint function in patients treated with

osteoarthritis. Both types of intra-articular injections were equally

effective in improving pain scores over 6–12 months. We look forward to

a larger clinical trial characterize in detail the effectiveness in patients

with different grades of osteoarthritis, to determine long-term benefits

over 2–5 years, and any osteoarthritis gender-related differences in

response.”

He continues; “This work has provided an insight into the optimal time

period for MFAT treatments to be effective. Some participants went

on to have hip replacement because the hip had deteriorated too far

before MFAT treatment commenced. When hip osteoarthritis is very

advanced, and the femoral head loses its natural spherical shape then

it is unlikely that these kinds of treatments can provide long term

effective pain relief.”

Osteoarthritis (OA) is the most common joint disease, affecting more

than 250 million people worldwide and being the fourth leading cause

of disability in men. Over 95,000 hip replacements are conducted in

the United Kingdom each year, while worldwide the number is over 1

million.

Intra-articular injection of various biological materials has shown

promise in alleviating symptoms and potentially slowing down the

degenerative process. MFAT treatments may offer alternative treatment

pathways for the rejuvenation of osteoarthritic joints, pain reduction,

aiding recovery from surgery or trauma, and as an alternative to joint

replacement or to delay the need for joint replacement.

Micro-fragmented adipose tissue (MFAT) possesses unique biological

properties. The adipose tissue has an innate anti-inflammatory quality

and contains the highest concentration of MSCs of any tissue in the body

(up to 2% of cells sited in the MFAT tissue are MSC compared to a 0.02%

in the bone marrow), being derived from the micro vessel pericytes,

these multipotent cells maintain the capacity to differentiate into

chondrocytes with adequate stimuli.

Patients

The mean patient age at the time of the treatment for the MFAT group

was 60 and for MFAT+ PRP was 60 (Table 1). Both groups had a range

in grade of hip OA of between 1–4 (median 3) on the KL scale and ASA

1–3 (median of 2; Table 2)). The mean BMI for the MFAT group was

29 and for the MFAT+ PRP was 27. Patients were not separated into

different groups for grade of arthritis for the statistical analysis and

power calculations due to the overall small numbers of patients in the

study. A significant number of patients had severe grade 4 OA at the

time of treatment (61/147).

Academic Editors: Diego Delgado and Mikel Sánchez

J. Clin. Med. 2022, 11(4), 1056; https://doi.org/10.3390/jcm11041056

Received: 15 December 2021 / Revised: 14 February 2022 / Accepted:

16 February 2022 / Published: 17 February 2022

Coming Soon – Cambridge University Press

Where Are You Now?

Did YOU train as a Technician, ODA or ODP? City & Guilds, NVQ ?

Where has you career path taken you?

Are you still in theatres or have you moved to pastures new?

We’d love to hear from you regards your career path, which we

hope can inspire others.

Please send us your career path in around 500 words which we’ll

publish in a future issue of The OTJ. We won’t use your name when

publishing your career summary, just let us know your initials or

even a pseudonym (unless you give us permission to use your name).

We look forward to sharing you progression since qualifying with

our readers.

Please send your summary in an email with ‘Career’ in the subject

heading to: admin@otjonline.com

Fundamentals of Operating Department Practice

2nd Edition

• EDITORS:

• Daniel Rodger, London South Bank University

• Kevin Henshaw, Edge Hill University, Birmingham

• Paul Rawling, Edge Hill University, Birmingham

• Scott Miller, St Helens and Knowsley Hospitals NHS Trust

• PUBLICATION PLANNED FOR: August 2022

• AVAILABILITY: Not yet published - available from August 2022

• FORMAT: Paperback

• ISBN: 9781108819800


Theatre staff vacancies

Practice Plus Group Hospital, Southampton

Competitive salary up to £39,250 dependent on experience

Are you looking to join an energetic and vibrant organisation that truly makes a

difference to people’s lives on a daily basis?

Are you looking to join an energetic and vibrant organisation that truly makes a difference to people’s lives on

a daily basis? if you’re a motivated and dedicated theatre nurse we have some exciting opportunities to join

our theatre team at our highly rated Hospital in the following areas:

• Scrub practitioners • Operating department practitioners

You’ll be working as part of our professional, friendly and compassionate expert multidisciplinary theatre team

supported by our experienced theatre manager, speciality team leads and the senior management team.

Staff are supported to challenge our practices and we actively encourage them to innovate and suggest new

ways of working.

If you are a part 1 registered NMC nurse with experience of being a scrub practitioner in

a theatre, or a HCPC registered operating department practitioner we would like to hear

from you. We offer favourable working conditions giving you more time to do the things

you love doing, with our full-time team working 37.5 hours over four days and part-time

options available. Our focus at all times is on ensuring that our patients receive high

quality treatment quickly, in clean & comfortable surroundings.

When you’re part of the southampton hospital team, you don’t just have a job. You have

a career. We are committed to developing and training our team and support staff to

attend courses and provide appropriate study days. We are keen to offer development

opportunities to our teams such as access to the surgical first assistant course, if not

already obtained. We also have an extensive e-learning portal accessible to all staff. If

you want to move up the ladder, we’ll support you. If you just want to stay in your role,

that’s fine too. We’ll help you be the best you can be.

About Us

Practice Plus Group Hospital, Southampton creates an exceptional experience for all

NHS and private patients, with real dedication to delivering the highest standards of

quality and safety. Our team delivers a broad range of elective surgery procedures,

consultations and appointments in our departments including five operating theatres,

an endoscopy suite, an oral surgery suite, physiotherapy, diagnostic imaging and

outpatients’ departments. We even have our own sterile services facility.

To apply or find out more about the roles email

rebecca.stevens@practiceplusgroup.com or call 01189 521 902 and quote OTJ.

March 2022 (0293)

Novel nuclear microRNA

is being developed

for the treatment of

cardiovascular disease

A novel angiogenic microRNA

drug can be a new option for

the treatment of ischemic

cardiovascular disease, according

to a new study published in PLOS

ONE by researchers from the

University of Eastern Finland

together with international

collaborators. In the study, the

researchers describe a novel

nuclear acting microRNA.

MicroRNAs are small RNA

molecules, which regulate gene

expression. Their canonical

role is gene silencing by

targeting messenger RNAs in

cell cytoplasm. However, this

novel microRNA, miR-466c, has

a different mechanism of action.

It upregulates the vascular

endothelial growth factor A

(VEGFA) by targeting the gene

promoter in the cell nucleus.

In addition to expanding the

academic understanding of

microRNA biology, these findings

have commercial relevance for

the development of novel RNA

drugs. Increasing the expression of

VEGFA by using small RNAs offers

novel options for the treatment of

ischemic cardiovascular disease,

where the blood supply in the

tissue is compromised.

“RNA activation as a phenomenon

has been known for 16 years

already, but its commercial

potential has been recognised only

recently,” says Adjunct Professor

Mikko Turunen, Chair of the newly

founded RNatives company,

which will be commercialising the

patented microRNA drug.

“Our patented microRNA drug

has several advantages over

traditional means of increasing

gene expression. First of all,

by activating the cell’s own

therapeutic gene (e.g., VEGFA),

all the different spliceforms of

the gene are correctly produced.

Also, being a small RNA, it is much

less immunogenic and more stable

than longer RNAs, such as mRNA

based drugs,” Turunen says.

In addition to RNA drugs, RNatives

is developing engineered

exosomes for the delivery of

these RNAs into the patients.

For further information, please

contact: RNatives Chairman,

Adjunct Professor Mikko Turunen,

tel. +358 44 5537 414, email:

mikko.turunen@rnatives.com

Article:

Laitinen P, Väänänen M-A, Kolari I-L,

Mäkinen PI, Kaikkonen MU, Weinberg

MS, et al. (2022) Nuclear microRNA-

466c regulates Vegfa expression in

response to hypoxia. PLoS ONE 17(3):

e0265948. https://doi.org/10.1371/

journal.pone.0265948 31.3.2022

Full Conference: £95

One Day: £60

Supported by:

The Second Annual

Operating Theatres Show

THE KIA OVAL, LONDON

11TH OCTOBER 2022

Save 20% with code OTJ20

www.igpp.org.uk/otj

View the agenda today

www.infection360.co.uk

27-28 September 2022

Edgbaston Stadium, Birmingham

INFECTI

Infection 360

360

N

What's trending in Infection

Prevention & Control

Day 1: SSI, Sepsis, COVID-19 &

other emerging pathogens

Day 2: Healthcare buildings as

a source of air & water borne

infection

CALL FOR ABSTRACTS: OPEN

Submission date: 2 August 2022

Join us from 27 to 28 September 2022 at Edgbaston Stadium in Birmingham for the inaugural Infection

360 Conference, where renowned speakers within infection prevention discuss technology and its part in

combatting new and existing pathogens.

The programme is designed to appeal to all those working within infection prevention and control and

public health across clinical and non-clinical areas.

Day 1: SSI, Sepsis, COVID-19 and other emerging pathogens

Day 2: Healthcare buildings as a source of air and water borne infection

The programme has been awarded 8 CPD credits by the Royal College of Pathologists and The Water

Management Society

Featuring a large exhibition where companies will be showcasing new products and technologies within

infection prevention.

Full conference: £95 / One day £60

Registration, Programme and abstract submission at: www.infection360.co.uk

Supported by The Operating Theatre Journal, Global Sepsis Alliance, BSI, The UK Sepsis Trust, Central

Sterilising Club, Health Services Journal, Water Management Society, Global Sepsis Alliance, and BICSc

Organised by Fitwise Management Ltd.


THE


THE

THE


The Operating SEPTEMBER 2020 ISSUE NO. Theatre 360 ISSN 0000-000X

Journal

The TheOperating OperatingTheatre WWW.OTJONLINE.COM

TheatreJournal

Get Your Personal copy from

OTJONLINE.COM


ODPs, Theatre, Anaesthetic & Recovery Nurses

Your Favourite Journal is available ONLINE

OTJONLINE.COM

OTJONLINE.COM



Jobs, News, Study Days, Books,

Clinical Articles £2.00

Register Today at:

www.otjonline.com

£2.00

£2.00

Jobsite:

www.operatingtheatrejobs.com

View the journal online @ www.otjonline.com

OTJ Back issues are also available to view

Registration is Free !

www.otjonline.com

Why not recommend The OTJ to your librarian

Operating Room

Nursing jobs

Auckland DHB

Nau mai, haere mai ki Te Toka Tumai (Auckland DHB)

At Te Toka Tumai | Auckland DHB we are committed to upholding

Te Tiriti o Waitangi and providing culturally safe care. We value

role modelling manaakitanga as demonstrated by Ngāti Whātua

in the gifting of their whenua on which our hospitals stand. We

aspire to having a workforce reflective of the communities we serve

and achieving equitable outcomes for all.

We are looking for experienced OR nurses to join our dynamic

team of Perioperative service. We invite you to bring your expertise,

knowledge, clinical and cultural skills and join us in making a

difference to the way we approach our mahi to better deliver

optimal and equitable health care to Te Toka Tumai’s diverse

communities. You will already have at least 1 year of recent OR

experience within a large tertiary hospital and are ready to further

develop your practice within the Perioperative environment.

For more information on what we offer, please visit our careers

website to see staff benefits.

Please submit your application online, outlining your experience

and motivation to apply to this role.

If you have any queries about this opportunity or accessibility

or technical issues with the online process, please contact

Aqeela Razvi, Recruitment Consultant on aqeelar@adhb.govt.nz

to discuss how we can best support your application.

careers.adhb.govt.nz


INTS2022

BERLIN

GERMANY

© Marco2811 - Fotolia.com

15 th International

Neurotrauma Symposium

Improving lives after neurotrauma through research

17–20 July 2022

Pre-symposium-courses scheduled for 17 July

www.neurotrauma2022.com

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Professor Helen Stokes-Lampard, Chair of the Royal College GPs, said:

“Sepsis is a huge worry for GPs as initial symptoms can be similar

to other common illnesses, and the College is putting a lot of effort

into helping family doctors recognise potential sepsis and ensure that

patients rapidly receive appropriate assessment and treatment.

“We have produced a toolkit, in partnership with NHS England, which

brings 28th–29th together June existing 2022 | Coventry guidance, Building training Society materials Arena, Coventry and patient

information to encourage us all to ‘think sepsis, talk sepsis and treat

The EBME Expo is an independent educational event bringing together

sepsis’.

healthcare professionals who are responsible for the management of

medical “We are equipment. pleased to be These working healthcare with NHS professionals England to raise are involved awareness in

areas and improve such as outcomes procurement, for patients. maintenance, It really user could training, save lives.” and managing

inventories.

Anna Crossley, Professional Lead for Acute, Emergency & Critical

Thanks Care at the to the RCN, sponsorship said: “Sepsis of is our a life-threatening 110+ exhibitors, condition this independent and early

exhibition identication is offered is the key free to of survival, charge to but all it visitors. can be difcult Furthermore, to diagnose there

are and three often workshops symptoms in can the be break mistaken out areas for a and u-like many illness. of our This exhibitors is why

provide raising awareness technical demonstrations.

among carers, health care professionals and the

public is so vital. Even though there has been good progress to improve

For our 2022 event on the 28th & 29th June, we are excited to

diagnosis, a cohesive national plan is needed to ensure that healthcare

announce that we will be moving to the Coventry Building Society

professionals are supported and equipped to identify and treat sepsis

Arena (Formerly the Ricoh Arena), Coventry, UK. This larger venue

early.

has been chosen so that we can expand to host a second conference

focusing “If sepsis on is not ‘The recognised Operating quickly, Theatre’, it can and lead to to keep shock, up multiple with demand organ

from failure both and exhibitors death, which and delegates. is why early Operating detection theatre is critical staff to are start the

largest treatment group within of medical the hour. equipment Nurses and users health in hospitals, care support and this workers, is why

we who believe see their they patients will complement on a regular our current basis, audience. and are often the rst

healthcare worker to see them, are well placed to recognise the signs

We are delighted to welcome Rob Brothwood, Senior Operating

of sepsis early and raise the alarm. If a person has signs or symptoms

Department Practitioner at the Royal Liverpool and Broadgreen

that indicate possible infection, think ‘could this be sepsis?’ and act

University Hospital, as the Chairman for the additional conference

fast to raise the alarm, wherever you are.

area, to which we will be welcoming Specialist EBME Technicians,

Operating https://www.england.nhs.uk/wp-content/uploads/2015/08/Sepsis-

Department Practitioners (ODP’s), Theatre & Recovery

Nurses, Action-Plan-23.12.15-v1.pdf

Anaesthetists, Surgeons, plus others…

twitter.com/OTJOnline

Saintonge becomes first hospital in France

to install the Dexter® surgical robot

Saintonge Hospital is the first healthcare institution in France to

purchase and install the novel Dexter® surgical system. Dexter’s clinical

versatility will provide on-demand robotic aid to help improve patient

outcomes in general surgery, gynecology and urology.

Saintonge Hospital has purchased and installed its first surgical robot:

Distalmotion’s Dexter®, a Swiss solution. This marks the first Dexter

installation in France. With its new Dexter system Saintonge Hospital

is pioneering a new approach to best-in-class minimally invasive care

called “on-demand robotics”.

This new concept allows laparoscopic surgeons to choose their preferred

tools for every step of a surgical procedure. Sometimes these will

be handheld tools, manipulated manually at bedside. At other times

– particularly for steps that require the highest degree of precision -

robotic instruments, manipulated from a robotic console will be the

preferred option. The leading surgeons at Saintonge Hospital now have

the ultimate freedom of choice between the two surgical techniques.

This unlocks new benefits for the surgical teams in Saintes and helps

them deliver optimal care for patients.

Unlocking new possibilities in the OR

Fabrice Leburgue, Director of Saintonge Hospital, explains why the

adoption of Dexter represents a key milestone for his institution: “We

are proud to be the first hospital in France to offer our patients this

innovative surgical solution. This investment addresses our objective

to continuously modernize our equipment and to support our surgical

team in delivering the best possible care for every patient at Saintonge

Hospital.”

Delivering best-in-class care in high volumes and across numerous

indications at Saintonge Hospital speaks to the vision that drives

Distalmotion, the company that designed and developed the Dexter

robot. Michael Friedrich, CEO of Lausanne, Switzerland based

Distalmotion affirms: “We want to establish a new standard of care,

where all patients in urology, gynecology and general surgery have

access to the best possible treatment – also when that treatment

requires or strongly benefits from robotic assistance. That is why we

are now rolling-out Dexter across Europe.”

http://www.distalmotion.com/

Theatre staff vacancies

Practice Plus Group Hospital, S

wrand.com Issue 316 January 2017

14

7

THE OPERATING THEATRE JOURNAL www.otjonline.com

Competitive salary up to £39,250 dependent on expe

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Nurse saves man’s life after he suffers heart attack

during Doncaster Parkrun

A nurse leapt into action to save the life of a

55-year-old man who collapsed after suffering

a heart attack at a Doncaster Parkrun.

Nicola Wilkinson, a research nurse at Doncaster

Royal Infirmary, was on hand to save the man

after he collapsed in Sandall Park.

Nicola, who had also been taking part in the

race, stepped in after noticing a group of

people gathered around him.

“I could tell he wasn’t fine. He had no output

pulse at all.” she explained.

Despite muscle spasms and jerking movements,

something that led onlookers to believe the

man was okay, Nicola knew the situation was

potentially fatal and immediately began CPR.

“I said to the people around me I need a

defibrillator, scissors and I need anyone else

who can do CPR.”

The avid runner, who has worked in the

NHS in Doncaster for just over 22 years, was

joined by a fellow colleague, David Langford,

an Operating Department Practitioner at

DRI, who leapt in to lend a hand after also

completing the run.

The pair shocked the man with the defibrillator

and another round of CPR before finally

getting an output pulse. The man had suffered

a cardiac arrest.

Paramedics were called by the director of the

run.

“The park runners were amazing. They had

made a curtain of respect around the man for

his dignity.” Nicola explained.

Once the paramedics arrived, the man was

taken to the Coronary Care Unit at DRI.

Following the ordeal, Nicola, who has been

running every day for three and a half years,

took herself to Dunkin’ Donuts for a needed

sugar rush, only to be messaged by a colleague

in A&E who received the patient, praising her

for saving the man’s life.

This was shortly followed by messages of

heartfelt gratitude from the man’s family and

friends.

Being trained as a nurse to deal with lifethreatening

and time-pressured scenarios

means situations like this trigger a knee-jerk

reaction, Nicola explained.

“I just snapped into action,” she said.

“I was just relieved more than anything that

the patient got back to A&E,”

“I don’t feel like I’ve done anything

extraordinary, as a nurse I’ve been trained to

do that. If I see someone in distress I can’t just

walk away. I’ll always try to help and fix the

situation,”

The incident has sparked discussions amongst

local joggers of the importance of having a

defibrillator nearby for events such as park

runs.

With a less than 10% survival rate of cardiac

arrest outside of hospitals, this important

piece of equipment is an essential to safely

conducting running events, Nicola explained.

“We may never need the defibrillator, or use

it, but wouldn’t you rather have it in that

moment when they are needed?”

In April 2019, Nicola created the Facebook

group ‘Runners United!!’ , a forum for runners

to share their running progress, advice and

experiences. The group now has approx. 1,200

members.

Nicola, who has recently qualified as an English

athletics running coach, regularly fundraises

when completing running events.

The man, an avid jogger and marathon-runner,

made a full recovery with no long-term

injuries. He even suggested a run together

with Nicola.

“I said I’m not sure I want to do another park

run with you - you need time to recover!” she

said.

Source: Doncaster FreePress Darren Burke

Rosyth: Councillor Andrew Verrecchia

wins the Keir Hardie Award

By Chloe Goodall - Reporter

WANTED

ODPs / Anaesthetic Technicians wanted for

NEW ZEALAND?

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* Relocation Advice - From overseas to New Zealand

Rosyth councillor Andrew Verrecchia, right, receiving the Keir Hardie Award

from Scottish Labour leader Anas Sarwar.

A ROSYTH councillor has been awarded the Keir Hardie Award for

community engagement.

Cllr Andrew Verrecchia was recognised for his work representing his

ward but also as an operating department practitioner for NHS Fife

and a COVID-19 vaccinator.

Scottish Labour leader Anas Sarwar made the presentation at the

recent party conference.

Cllr Verrecchia said: “I’m incredibly humbled by this award, there

are literally thousands of people within our public sector who are

more deserving of recognition than me, but I am very honoured and

flattered that someone thought enough of me to nominate me.”

He will continue to work with NHS Fife and is standing for re-election

to Fife Council in May.

Source: Dunfermline Press, Chloe Goodall

We can assist in getting your job offer you will need for your work

visa to be processed and will support you through the isolation

time if required in New Zealand.

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Freephone 0808 23 444 68


Congratulations, you are now reading, the extended OTJ


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Liquid biopsy offers new tools for detecting recurrent

breast cancer and monitoring its progression

Liquid biopsy performed on serum samples taken from breast cancer

patients can provide increasingly accurate information on cancer

progression and enable earlier detection of cancer recurrence, a new

study from the University of Eastern Finland and Kuopio University

Hospital shows. The findings were published in Cancers.

Intratumoural heterogeneity is a major challenge for cancer treatment

Breast cancer tumour cells are known to differ in both genetic and

biological properties. This phenomenon is known as intratumoural

heterogeneity. From the perspective of cancer treatment, intratumoural

heterogeneity is a major challenge because cancer cells with different

biological properties may have a different response to treatment.

It is possible that some cancer cells tolerate treatment well enough to

survive, which can lead to recurrent breast cancer later on.

“Time is a key factor in intratumoural heterogeneity. Over time, the

spectrum and properties of cancer cells tend to change and develop in a

direction that is more therapeutically challenging,” Doctoral Researcher

Jouni Kujala from the University of Eastern Finland says.

“In addition, tumour samples are representative at the time of sampling

only, and intratumoural heterogeneity cannot really be monitored much

after sampling.”

Liquid biopsy opens up new possibilities for detecting cancer mutations

Liquid biopsy that utilises biomarkers released by cancer cells has been

proposed as a possible method for the early detection of recurrent

breast cancer, and for the monitoring of cancer progression. A major

advantage of liquid biopsy over traditional tumour biopsy is the ease,

safety and repeatability of sampling.

In particular, liquid biopsy focuses on cell-free DNA released by cancer

cells, which is known to carry mutations characteristic of the cancer

tumour. This has enabled a new way of detecting cancer mutations

without having to do a biopsy of the cancer tumour itself.

“Our results show that liquid biopsy can be used to detect cancer

mutations both from breast cancer tumours and their metastases. This

provides further support for our hypothesis that liquid biopsy can, at

least to some extent, be used to overcome the limitations of traditional

biopsy.”

Towards earlier diagnosis and more accurate clinical picture

The researchers observed mutations characteristic of recurrent breast

cancer in cell-free DNA months before the recurrent cancer was

detected during a medical examination. With the mutations observed,

the researchers were also able to assess changes in intratumoural

heterogeneity, and to establish a more accurate understanding of the

clinical picture.

“By monitoring the cancer mutations detectable from cell-free DNA,

it is possible not only to detect recurrent breast cancer but also to

identify mutations that are relevant to treatment planning and thus

to support medical professionals’ decision-making,” Professor Arto

Mannermaa from the University of Eastern Finland explains.

“Based on our results, liquid biopsy is a promising method that can

supplement the information obtained using traditional diagnostic

methods, and it can provide increasingly accurate information on the

development and recurrence of breast cancer.”

For further information, please contact:

Doctoral Researcher Jouni Kujala, Institute of Clinical Medicine,

Pathology and Forensic Medicine, jouni.kujala@uef.fi

Research article:

Jouni Kujala, Jaana M. Hartikainen, Maria Tengström, Reijo Sironen,

Päivi Auvinen, Veli-Matti Kosma and Arto Mannermaa. Circulating

Cell-Free DNA Reflects the Clonal Evolution of Breast Cancer Tumors.

Cancers 2022.

Available as an open access article at:

https://doi.org/10.3390/cancers14051332

www.facebook.com/TheOTJ


Cleveland Clinic Expands its Global Footprint

with Opening of London Hospital

First Cleveland Clinic hospital in Europe provides access to a global network of physicians and specialists

Cleveland Clinic London is one of the first private hospitals in the

U.K. that can conduct intraoperative imaging for brain and spinal cord

disorders, a leading tool in preventing reoperations. The hospital is also

equipped with a 41-bed neuro-rehabilitation suite with technologically

advanced robotic equipment.

Cleveland Clinic London is also the first U.K. hospital to use advanced

technology such as pharmacy barcoding and robot-powered medicine

administration tracking, offering an additional level of safety in the

delivery of medicine. Patients and caregivers will have access to the

most advanced electronic medical records, allowing caregivers to make

faster and more effective decisions about patient care, and giving the

patient easier access to information about their treatment.

Cleveland Clinic London Hospital, 33 Grosvenor Place (Exterior)

Photo courtesy of Cleveland Clinic

Cleveland and London: Cleveland Clinic announced on the 29th of

March 2022 the opening of Cleveland Clinic London Hospital, a 184-bed

state-of-the-art hospital, at 33 Grosvenor Place in central London. The

facility is the newest location in Cleveland Clinic’s expanding global

footprint and the second in London, following the opening of Cleveland

Clinic Portland Place Outpatient Centre in September 2021.

As part of one of the world’s top hospital systems – as determined

in Newsweek’s World’s Best Hospitals 2022 list – Cleveland Clinic

London provides patients access to a global network of physicians and

specialists to provide the highest quality care, as well as world-class

patient experience built around the best practices and core values

of Cleveland Clinic. It will offer a doctor-led model of care that is

innovative, empathetic and based on research and education.

The Cleveland Clinic health system, which employs more than 72,000

caregivers worldwide, has pioneered many medical breakthroughs,

including coronary artery bypass surgery, the first face transplant in

the United States, and most recently the first uterus transplant in the

United States.

The eight-story facility will treat a wide range of complex conditions,

with a focus on heart & vascular, digestive disease, neurosciences and

orthopaedics. The hospital has 184 inpatient beds, including 29 ICU

beds and eight operating theatres, a 41-bed neurological rehabilitation

ward and a staff of approximately 1,150 caregivers.

Equipped with the latest technology, Cleveland Clinic London has the

ability to care for a complex patient population, supported by an acute

admissions unit and 24/7 intensive care specialists in the ICU, a model

that enhances patient safety and experience. Alongside its core focus

areas, the hospital also offers a full range of medical sub-specialties and

comprehensive services for imaging, labs and interventional radiology.

“For more than 100 years, Cleveland Clinic has been at the forefront of

medical innovation and specialized health care,” said Cleveland Clinic

CEO and President Tom Mihaljevic, M.D. “We believe that touching

more lives is our ethical imperative. With the opening of Cleveland

Clinic London, we are extending our unique model of care to more

patients than ever.”

Brian Donley, M.D., CEO of Cleveland Clinic London, said, “This is an

eventful moment for the entire Cleveland Clinic family. We are excited

to be bringing our unique model of care to the U.K., combining London’s

world-renowned physicians and research with Cleveland Clinic’s 100-

year history of technological advances and clinical expertise. We will

provide patients with an unparalleled experience and the highest

quality care.”

Cleveland Clinic’s latest facility combines the health system’s integrated

care approach with its leadership in medical innovation to meet the

unique needs of each patient. The hospital is equipped with the most

advanced medical and surgical technologies, including innovative

laser and robotic surgery capabilities. It will offer the most advanced

minimally invasive procedures, such as transcatheter aortic valve

implantations (TAVI); Cleveland Clinic was one of the early pioneering

centers of TAVI and has since become a world leader in this specialized

treatment.

Cleveland Clinic London Hospital hybrid Operating Room

Photo courtesy of Cleveland Clinic

Cleveland Clinic is among the first hospitals in the United States to

publish outcomes. Since 2004, it has required all clinical specialties to

collect and publish comprehensive data every year. In 2008, the health

system was the first to disclose industry relationships of our clinicians

and again, in 2015, Cleveland Clinic was the first medical center to

display patients’ ratings and comments about the care they receive.

Cleveland Clinic London will report data and outcomes to key U.K.

national registries. The hospital will publish detailed information on

its treatment outcomes, with the goal of helping existing and future

patients make informed decisions about their care options.

Originally built in the 1950’s as the headquarters for an energy company,

33 Grosvenor Place has been extensively renovated and redesigned to

create a hospital environment that reflects the needs of Cleveland

Clinic London patients and the future of healthcare in the U.K. The

building – with the latest in design and innovation – alongside the

organization’s top-quality talent and world-leading clinical excellence

will offer an unparalleled patient experience that leverages state-ofthe-art

equipment and technology.

Cleveland Clinic places great importance on growing responsibly and

modelling sustainable practices in healthcare and the communities in

which it operates. Throughout the renovation process, the organization

prioritized reducing the facility’s environmental impact, with 98% of

the original building’s materials recycled. As a result, 33 Grosvenor

Place will produce some of its own heat and power through a combined

heat and power plant to significantly reduce carbon emissions. This

highly energy-efficient solution is unusual in a building with a retained

façade, such as 33 Grosvenor Place.

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Operating Room

Nursing jobs

Auckland DHB

Nau mai, haere mai ki Te Toka Tumai (Auckland DHB)

At Te Toka Tumai | Auckland DHB we are committed to upholding

Te Tiriti o Waitangi and providing culturally safe care. We value

role modelling manaakitanga as demonstrated by Ngāti Whātua

in the gifting of their whenua on which our hospitals stand. We

aspire to having a workforce reflective of the communities we serve

and achieving equitable outcomes for all.

We are looking for experienced OR nurses to join our dynamic

team of Perioperative service. We invite you to bring your expertise,

knowledge, clinical and cultural skills and join us in making a

difference to the way we approach our mahi to better deliver

optimal and equitable health care to Te Toka Tumai’s diverse

communities. You will already have at least 1 year of recent OR

experience within a large tertiary hospital and are ready to further

develop your practice within the Perioperative environment.

For more information on what we offer, please visit our careers

Theatre Practitioners website Recovery to see staff Nurses benefits. Anaesthetic Nurses ODPs

Scrub Practitioners Nurse

Please submit

Practitioners

your application

Medical

online, outlining

Representatives

your experience

and motivation to apply to this role.

and Clinical Advisers

If you have any queries about this opportunity or accessibility

or technical issues with the online process, please contact

Aqeela Razvi, Recruitment Consultant on aqeelar@adhb.govt.nz

to discuss how we can best support your application.

careers.adhb.govt.nz

83 AUDIT REPORT Waitematā District Health Board Annual Report 2018/19

outhampton

ience


Detecting possible signs of stroke

quickly and reliably

- The use of SRA quickly and reliably reveals atrial fibrillation as

the main trigger after a TIA (transient ischaemic attack)

- A study from England underlines the paramount importance of TIA

detection for the prevention of further TIA and strokes

Numbness or paralysis in the hand, arm, leg or even one half of the

body, speech and visual disorders and dizziness or difficulty

walking: The impairments set in quickly, last only for a short time

and then disappear again. The transitory ischaemic attack (TIA)

generally has the same characteristics and causes as a stroke and

should definitely be taken as a warning. After the symptoms have

subsided, usually within an hour, the triggers remain and not only

further TIAs but also a stroke could therefore soon follow.

That’s why, on the occasion of the Germany-wide Action Day against

Stroke (May 10), apoplex medical technologies GmbH is pointing out

the urgent need to look for the causes of TIAs in order to eliminate

them. With its stroke risk analysis SRA, the Germany-based medical

technology company offers a software-based solution that helps to

quickly and reliably identify atrial fibrillation (A-fib), which is

difficult to detect, as the most important risk factor for TIA and

strokes, so that countermeasures can be initiated.

The “ministroke” announcing the serious one

About one in three strokes is announced in advance by a TIA; this is

why it is commonly referred to as a “ministroke”. After such an

event, the trigger needs to be determined as quickly and reliably as

possible in order to be able to initiate measures against another TIA

or stroke in time. This particularly applies to A-fib as a major

driver of cardioembolism, i.e. the obstruction of blood vessels by

clots that have passed from the heart via the artery into the

bloodstream. For example, the risk

of stroke in TIA patients with A-fib can be reduced by up to two

thirds by administering anticoagulants.

For such cases, apoplex medical technologies offers SRA, a

telemedical procedure based on conventional ECG recordings. The

procedure detects A-fib with the help of an algorithm, even if it

occurs only irregularly, suddenly and without the patient noticing.

As part of secondary prevention, i.e. the avoidance of a second

stroke after a first stroke, SRA is already being successfully used

in the stroke units of more than 200 hospitals throughout Europe.

A recent study from England now confirms the high importance of the

immediate use of automatic continuous ECG monitoring in TIA patients

through procedures such as SRA, both in terms of the A-fib detection

rate and the risk of suffering a TIA or stroke again within six

months.

The results of the study, conducted at the renowned Charing Cross

Hospital - Imperial College Healthcare NHS Trust, can be found

here[1]: https://pubmed.ncbi.nlm.nih.gov/35110330/

Further information is available at https://apoplexmedical.com .

[1] D’Anna L, Sikdar O, Lim S, Kalladka D, Banerjee S. Atrial

fibrillation detection using a automated electrocardiographic

monitoring in a transient ischaemic attack service. BMJ Open Qual.

2022 Feb;11(1):e001433. doi: 10.1136/bmjoq-2021-001433. PMID:

35110330; PMCID: PMC8811557

We are pleased to accept

clinical articles for publication

within the pages of


Please send for the attention of the

Editor at:

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More Than AI: What Other

Technological Develoments

Have Improved Surgery

Hospitals and wider healthcare settings utilise AI in ways that have

revolutionised the healthcare system. In theatres, rigorous research

and case studies have led to the advancement of heavily relied upon

technology and equipment - and the introduction of innovative new

technologies that are transforming the operating room by bringing it

into the 21st century.

Below, we’ll look at some of the most innovative and transformative

technologies to reach theatres.

The Simplicity Of Single-Use Tools

Sometimes, it’s the smaller developments that seem somewhat

insignificant that have the most impact on day-to-day theatre duties.

Take the humble retractor, for example. A commonly utilised tool

that holds open an incision to give surgeons access to the operating

site. An operating department practitioner would have had the job

of keeping the retractor open until June Medical developed their

medical retractors that are self-retaining.

Simple advancements like a self-retaining retractor have saved

hospitals money, operating staff time and reduced infection rates in

theatres.

Technology That Enables Minimally Invasive Surgery

Minimally invasive surgeries performed through keyhole procedures

are more commonplace in the operating room. The advancement in

technology allows surgeons to make small, more precise cuts that

provide almost direct access to the intended site. Typically, three

incisions will be needed - one for an intraoperative camera and two

for rods that allow the surgeons to operate as if they were extensions

of their hands.

Further advancements in laparoscopic and endoscopic will enable

surgeons to carry out investigative diagnostic procedures and

therapeutic treatments with as little impact on the patient as

possible. It may seem obvious, but one of the outstanding advantages

of minimally invasive procedures is aesthetics. Patients have two or

three small incisions rather than a large scar.

Other advantages include a reduction in the potential for infections,

easy access to operating sites, and better precision.

The Early Developments of 3D Printing

3D printing is nothing new in theatres - the technology has

transformed the operating room by giving surgeons and professionals

the chance to create tools and equipment specific to the needs of

the procedure in question. But it’s the early developments of a new

generation of 3D printing set to improve surgeries further.

Advancements in 3D printing focus on the future of bioprinting.

Biogenetics is a focal point in medicine, with huge strides towards

replicating human organs and tissues using 3D printing already

happening. Research scientists and surgeons have already replicated

skin and connective tissues that have successfully transformed the

lives of awaiting patients.

The future, however, lies with 3D bioprinting and replicating organs

that could save the lives of thousands of patients waiting on the

transplant list. It’s still in its early development, but the theory and

potential are exciting.

The medical world is constantly advancing - there will never be a

time when developing new technology, procedures, and medicines

will stop. There’s a constant race to find the next best solution -

especially in theatres where ground-breaking operations continue to

push the boundaries of medicine and science, helping to change the

lives of millions.

Source: Youth Health



Discovering the many more pages available online @ www.otjonline.com

New Model Hospital clinical OMFS

performance data goes live

The British Association of Oral and Maxillofacial Surgeons (BAOMS) is

calling on members to interrogate the new clinical OMFS performance

data from the Getting It Right First Time

(GIRFT) team, which is now live on the Model Health System.

Maire Morton, a past BAOMS President, Consultant Oral and Maxillofacial

Surgeon and GIRFT clinical lead for OMFS, explains: “Sign up and log on

so you can see your trust’s Hospital Episode Statistics (HES) and your

department’s data. Take this opportunity to assess your hospital and

the OMFS team’s performance, and benchmark against peers.”

She said that once logged in, users can interrogate data for more than

50 clinical areas for emergency readmissions, day case rates, outpatient

rates and average length of stay.

For example, it is possible to measure outpatient procedure rates for

wisdom tooth surgery or the number of emergency readmissions in 30

days following major head and neck cancer surgery.

“This is our specialty’s opportunity to examine the system to check that

the data is representative of our activity. If the data seems incorrect,

speak to your coding team and check the coding used - and feed back

to me at Maire.Morton@elht.nhs.uk ”

All NHS staff in England can access the Model Health System. Staff in

NHS trusts and commissioning organisations can view and download

their own organisation’s data, compare it to other trusts, national

England averages and peer groups.

Use this link to register and access the Model Hospital: NHS Improvement

- Model Hospital: https://model.nhs.uk/

Maire Morton also says that the National Clinical Information Programme

(NICP) is going live shortly: “I will be visiting trusts across the country

to support the implementation of the new programme. There’ll be

more information about NCIP as it rolls out.”

Jobs boost for Cork as private

hospital group announces

national expansion

Bon Secours are hiring 450 people nationally and setting up

a new hospital in Limerick

Bon Secours Health System have announced that they are recruiting

people for 450 new positions across Ireland, with 80 roles being based

in Cork.

The private hospital group are expanding nationally and they will be

hiring in Cork, Dublin, Tralee and Galway.

They are recruiting 250 people for their new hospital in Limerick which

is to be a huge part of their growing operation.

New staff will include doctors, nurses, and allied health professionals

as they aim to continue their “investment in world-class facilities and

technologically advanced medical care across Ireland.”

Minister Micheal McGrath, who attended the conference where the

recruitment drive was announced, said that “as we move into a period

now tinged with optimism and hope, it is extremely encouraging to

see Bon Secours Health System’s ambition for its healthcare services

in Ireland at a time when the demand for innovative healthcare in our

population continues to grow.”

“Its expanding services will greatly benefit patients across Bon Secours

Health system’s growing national catchment, and I welcome these

new jobs as part of its bold new strategy and ongoing commitment to

technologically-advanced medical care in Ireland,” he added.

The chief executive of the hospital group, Bill Maher, said that the last

few years have seen a “significant growth” in the services that Bon

Secours offers, and that their strategy to 2025 features a “€300 million

investment built on the foundation of the excellence of our healthcare

professionals.”

He also noted that a lot of the group’s recent growth has been

concentrated in Cork, with a new operating theatre having been

opened this year, and the Cork Cancer Centre having been established

here in 2019

Source: CorkBeo Eimer McAuley


Risk of medication errors with

tranexamic acid injection resulting

in inadvertent intrathecal injection

WHO is alerting health care professionals about the risk of administration

errors that can potentially occur with Tranexamic Acid injection. There

have been reports of Tranexamic Acid being mistaken for obstetric

spinal anaesthesia used for caesarean deliveries resulting in inadvertent

intrathecal administration.

Intrathecal TXA is a potent neurotoxin and neurological sequelae are

manifested, with refractory seizures and 50% mortality. The profound

toxicity of intrathecal TXA was described in 1980. A 2019 review

identified 21 reported cases of inadvertent intrathecal injection of TXA

since 1988, of which 20 were life-threatening and 10 fatal. Sixteen were

reported between 2009 and 2018.

WHO recommends early use of intravenous TXA within 3 hours of

birth in addition to standard care for women with clinically diagnosed

postpartum haemorrhage (PPH) following vaginal births or caesarean

section. TXA should be administered at a fixed dose of 1g in 10 ml (100

mg/ml) IV at 1 ml per minute, with a second dose of 1g IV if bleeding

continues after 30 minutes.

TXA is frequently stored in close proximity with other medicines,

including injectable local anesthetics indicated for spinal analgesia

(e.g., for caesarean section). The presentation of some of the local

anesthetics is similar to the TXA presentation (transparent ampoule

containing transparent solution), which can erroneously be administer

instead of the intended intrathecal anesthetic resulting in serious

undesirable adverse effects.

Endo Begins Shipment of

Premixed Ephedrine Sulfate

Injection in Ready-to-Use Vials

Endo International plc announced recently that its Par Sterile Products

business has begun shipping premixed Ephedrine Sulfate Injection in a

ready-to-use 50 mg/10 ml single-use vial.

“We are pleased to launch this new ready-to-use product as part of our

agreement with Nevakar,” said Scott Sims, Senior Vice President and

General Manager, Sterile Products at Endo. “This is a demonstration

of our commitment to deliver quality, life-enhancing therapies to

healthcare providers—when and how they need them.”

Ready-to-use, or RTU, products help streamline operations for hospitals

by eliminating the need to prepare or transfer the product before

patient administration. This may reduce waste and costs, optimize

convenience and workflow, and heighten accuracy and compliance by

reducing the chance for preparation error—all of which support quality

patient care.

This is the first product launch under the previously announced exclusive

licensing agreement between Nevakar Injectables, Inc., a privately

held biopharmaceutical company, and Endo’s subsidiary, Endo Ventures

Limited (EVL). Under the agreement, the companies are collaborating

on five differentiated sterile injectable products in the U.S. Nevakar is

responsible for developing the drugs and obtaining approval from the

U.S. Food and Drug Administration, and EVL is responsible for product

launch and distribution through Endo’s Par Sterile Products business.

SOURCE Endo International plc

Recently, obstetricians from several countries have reported

inadvertent intrathecal TXA administration and related serious

neurological injuries.

TXA is a lifesaving medicine, however, this potential clinical risk should

be considered and addressed by all operating theatre staff. Reviewing

of existing operating theatre drug handling practice is required in order

to decrease this risk, such as storage of TXA away from the anaesthetic

drug trolley, preferably outside the theatre.

References:

South African Medical Journal 2019;109(11):841-844. DOI:10.7196/

SAMJ.2019.v109i11.14242

Yamaura A, Nakamura T, Makino H, Hagihara Y. Cerebral complication

of antifibrinolytic therapy in the treatment of ruptured intracranial

aneurysm. Animal experiment and a review of literature. Eur Neurol.

1980;19(2):77-84. doi: 10.1159/000115131. PMID: 6893025.

Patel S, Robertson B, McConachie I. Catastrophic drug errors involving

tranexamic acid administered during spinal anaesthesia. Anaesthesia.

2019 Jul;74(7):904-914. doi: 10.1111/anae.14662. Epub 2019 Apr 15.

PMID: 30985928.

https://www.fda.gov/drugs/drug-safety-and-availability/fda-alertshealthcare-professionals-about-risk-medication-errors-tranexamicacid-injection-resulting

Join the South West Infection Control Network on 7-8 June 2022

for Infection Prevention & Control Conference: From Introduction

to Directors at Sandy Park Stadium in Exeter where renowned

speakers within infection prevention & control will come together

to deliver an exciting and informative programme.

Find out more and register for FREE: https://fitwise.eventsair.

com/ipc-conference-exeter

• DAY 1: 7 June 2022 New to Infection Prevention & Control

Day: For those new to the field of infection control link

practitioners

• DAY 2: 8 June 2022 Directors of Infection Control (DIPC) Day:

For senior infection prevention practitioners

The event will draw upon some of the latest research and findings

nationally, which to date have not been shared or discussed due to

the constraints of the pandemic. Also featuring a large infection

prevention and control exhibition.


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