Journal of perioperative practice
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Comparative Study
Patient controlled analgesia: The impact of an 8 versus 10 minute lockout interval in postoperative patients.
The purpose of this study was to compare the level of pain control achieved with 8 versus 10 minute lockout intervals in adult patients who received patient controlled analgesia (PCA) within 24 hours of surgery. There was no difference in pain in the first 72 hours between the 8 minute and 10 minutes group. Additionally, there was no difference in time to first PCA regimen change or a composite outcome of adverse events.
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Multicenter Study
Growing our own theatre staff: Practice development and education.
Royal Bournemouth & Christchurch Hospitals NHS Foundation Trust engaged in a quality improvement project aimed at improving quality and safety in theatres. The improvements delivered were recruitment to full staffing template, reduction in agency staffing to zero, and creating a theatre coordinator role to ensure safe staffing. The Practice Education Team was increased fivefold with no extra investment as a result of these improvements. Student satisfaction results amongst ODPs and nurses have increased alongside staff morale and productivity.
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Hemidiaphragmatic paralysis is initially recognised as postoperative respiratory distress. The subsequent sequential management of the patient following arthroscopic shoulder surgery under interscalene block is described. ⋯ Reducing the volume of anaesthetic used reduces its spread to the phrenic nerve and thus reduces the incidence of hemidiaphragmatic paralysis. Furthermore, a reduction in anaesthetic volume has equivalent analgesic efficacy.
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Although videolaryngoscopy plays a major role in the 2015 Difficult Airway Society guidelines, the impact on anaesthetic assistant working practices and training has not previously been reported. We surveyed anaesthetic assistants in our hospital to document their experience with using the C-MAC© videolaryngoscope (48 practitioners, 100% response rate). ⋯ Ninety percent reported that the clinical benefit outweighed any additional workload. In conclusion, the C-MAC© videolaryngoscope is judged by anaesthetic assistants to confer numerous advantages for their working practice and training.
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The aim of this study was to improve emergency theatre efficiency via the introduction of a theatre booking form and morning briefing meeting. Process mapping was used to engage staff and consider if the emergency theatre may benefit from the application of a structured process of communication. A theatre booking form and morning briefing meeting were implemented to promote change. ⋯ The results demonstrated a 12.9% increase in efficient time, 3.3% fall in inefficient time and 9.6% fall in neutral time post-implementation, during the high volume work period of 08:00 to 17:59 on weekdays. No improvement in efficiency was demonstrated outside these hours or on weekends during lower volume workloads. Utilisation of a theatre booking form and morning briefing meeting improved emergency theatre efficiency during high volume work periods by the application of a structured process of communication.