Patients arriving for knee surgery at a Glasgow hospital are being asked if they want to watch a movie while they are having their operation. The technique is being used to divert their attention so they need less anaesthetic. A DVD instead of general anaesthetic relaxes James McLaren during his knee surgery at Gartnavel Hospital, Glasgow.
The idea was the brainchild of Gartnavel Hospital anaesthetist Dr Nick Pace. He had been trying to reduce the number of people opting for a general anaesthetic and being put to sleep for the entire operation. Most people recover faster when they are only numbed from the waist down, but too many patients found the sights and sounds of the surgery unnerving.
"We tried music, but after about an hour a lot of patients got distracted and fidgety, and we ended up having to give them a general anaesthetic anyway," said Dr Pace. "Then I happened to be speaking to a friend of mine who was taking two young kids on a long journey down to London and she told me she'd distract them with two DVDs strapped to the back of the seats. It got me thinking."
Dr Pace asked Gartnavel Hospital's engineering department to make a mount to hold a DVD player over the operating table. He brought in some DVDs from home and found that offering his patients the option of watching a movie during their surgery has proved a huge success. He said: "Most of them are desperate to phone relatives and say - 'Guess what? I've just been watching Only Fools and Horses in the middle of my operation!'"
If the patient becomes uncomfortable Dr Pace will quickly put them to sleep, but that has never happened so far in the 18 months he's been using DVDs. James McLaren, 69, is very relaxed about the idea of staying awake during his knee operation. He picks The Blue Planet from Dr Pace's extensive collection. "The Blue Planet is very relaxing," he said. "I like the fish and the oceans. I don't mind being awake at all."
'Some noise'
During the operation he seems engrossed in David Attenborough and hardly seems to notice the sights and sounds of the theatre. After his leg is swabbed down with iodine, a blue sheet is positioned below his neck so he can't see the surgery itself. After about an hour it's all over and he's wheeled into recovery. "It went very well," he reflects. "There are various movements and maybe some noise, like that grinder, but it was fine."
Now, 50% of Dr Pace's patients opt for a movie and a spinal anaesthetic, although he still has a long way to go to match Scandinavia, where about 95% of operations are carried out using this kind of 'regional' anaesthetic. "It's a really good way, I think, of undertaking these kinds of operations," he said. "Some patients are quite disappointed because the operation is finished before the end of the film!"
However, the biggest surprise for Dr Pace has been his patients' taste in DVDs. "I picked up this one: The Guide to Successful Pole Fishing," he explains. "My wife said - 'Who on Earth is going to want to watch that?' but it's by far the most popular male choice!"
A project to improve the effectiveness of tests into cancer treatments could limit the need for animal testing, researchers have claimed. Scientists at the University of Dundee, who will lead the £10m Europe-wide project, said it may also boost safety for those involved in clinical trials.
They want to isolate at an earlier stage those drugs most likely to produce cancerous effects themselves. Doing so could cut the amount of time and money spent on ineffective drugs. Researchers said that one of the key drivers behind the plan was the "3 R" issue - the reduction, refinement and replacement of experimental animal use.
The study, known as the MARCAR project and involving 12 organisations from business and academia, will explore the use of non-invasive imaging techniques such as MRI scanning to study the effects of developmental treatments. As such techniques are non-invasive, long-term studies can be carried out on the same animal over weeks or months.
The method also has the potential to detect pre-cancerous lesions and tumours sooner without sacrificing the animals, meaning smaller numbers of subjects could be used. Prof Roland Wolf, from the university's biomedical research institute, said: "This would potentially markedly reduce the numbers of animals needed for this kind of research and provide a much more reliable prediction of the rates of toxicity of drugs in development in man."
'Improved safety'
The researchers will focus on a group of drugs known as non-genotoxic carcinogens (NGCs). These are drugs which when tested are shown to promote biochemical processes which lead to cancer. At present such potential cancer-causing compounds only tend to be identified following prolonged biological trials.
Prof Wolf said the research would also improve safety for those taking part in drug trials. He added: "The development of new drugs is a very costly process, partly because of the large number of drugs which never make it to market due to the discovery of cancerous effects during drug development. "Predictions regarding safety of drug compounds can be imprecise and sometimes incorrect.
"If we could make better predictions at an early stage of drug development it would save a lot of time and money and make the whole process more efficient. To achieve that we need to identify early biological indicators, known as 'biomarkers' that can be used to predict the effects of drugs and reliably and robustly predict later cancer developments."
Just five minutes of exercise in a "green space" such as a park can boost mental health, researchers claim. There is growing evidence that combining activities such as walking or cycling with nature boosts well-being. In the latest analysis, UK researchers looked at evidence from 1,250 people in 10 studies and found fast improvements in mood and self-esteem.
The study in the Environmental Science and Technology journal suggested the strongest impact was on young people. The research looked at many different outdoor activities including walking, gardening, cycling, fishing, boating, horse-riding and farming in locations such as a park, garden or nature trail. The biggest effect was seen within just five minutes.
With longer periods of time exercising in a green environment, the positive effects were clearly apparent but were of a smaller magnitude, the study found. Looking at men and women of different ages, the researchers found the health changes - physical and mental - were particularly strong in the young and the mentally-ill.
Green and blue
A bigger effect was seen with exercise in an area that also contained water - such as a lake or river. Study leader Jules Pretty, a researcher at the University of Essex, said those who were generally inactive, or stressed, or with mental illness would probably benefit the most from "green exercise".
"Employers, for example, could encourage staff in stressful workplaces to take a short walk at lunchtime in the nearest park to improve mental health." He also said exercise programmes outdoors could benefit youth offenders. "A challenge for policy makers is that policy recommendations on physical activity are easily stated but rarely adopted widely."
Paul Farmer, chief executive of mental health charity Mind, said the research is yet further evidence that even a short period of green exercise can provide a low cost and drug-free therapy to help improve mental wellbeing. "It's important that people experiencing depression can be given the option of a range of treatments, and we would like to see all doctors considering exercise as a treatment where appropriate."
Mind runs a grant scheme for local environmental projects to help people with mental illness get involved in outdoor activities.
OES Healthcare Recruitment hereby serves notice we are voluntarily withdrawing our registration from the registry of the Care Quality Commission. This, due to the fact that we do not fall within the scope of the current legislation neither do we fall within the scope of the Health and Social Care Act 2008 legislation, which comes into force 1st October 2010.
OES is an Employment Agency as described within the Conduct of Employment Agencies and Employment Business Regulations 2003. We are not a direct employer of nurses and do not provide care services requiring the regulation of the Care Quality Commission. OES Healthcare Recruitment has been pleased to be registered with the Care Quality Commission and formerly CSCI, since 2005.
We continue to be committed to quality services and remain registered with The Employers Agents Movement (TEAM) in ensuring our quality of services to both candidates and clients alike is at it's highest at all times.
A Northamptonshire hospital believes it could be the first in the country to simultaneously create a barcoded wristband for newborn babies and a sticky label for heel prick tests. Kettering General Hospital will produce barcoded bloodspots rather than handwritten bands within an hour of birth, in the hope of making them clearer and more detailed. These are attached to the child’s ankle or wrist and the heel prick labels are added to the baby record book for parents to keep.
According to the hospital, the National Patient Safety Agency asked for standardised wristbands to be used throughout the NHS, while the UK Newborn Screening Programme asked all maternity units to produce barcoded blood spot cards by April 1 this year. A spokesman said the new system means Kettering General has introduced both methods for its labour ward. He said the hospital was not the first to use barcoded bands for babies, but may be one of the first to combine this with heel prick testing labels. The new method allows hospital staff to have a lot of information about the baby, including name, NHS number, date of birth, sex and mother’s name - whereas previously basic information would have been hand-written on the wrist band, which could be less reliable.
IT project manager at Kettering General Hospital, Paula Lilburn, said: “The main reason for the introduction of barcoded wristbands and barcoded heel prick blood spot labels is to improve safety in hospitals. “The new system is quicker and safer because if the barcoded information can be quickly read by the computers
Copyright Nursing Times, Friday 23rd April 2010 12:27
