bluuebunny/crossref_metadata_2025 huggingface dataset:
Trans: A Response
Authors: Brubaker Rogers
Published: December 2017

Rogers Brubaker on Ivan Szelenyi’s review of his book, Trans.
Hurricane Party
Authors: Kimbro Rachel Tolbert
Published: December 2017

rachel tolbert kimbro on life and community in a flood zone.
Comparison of open surgery and endovascular procedures as a therapeutic choice for visceral artery aneurysms
Authors: Song Chao , Dong Jian , Yu Guanyu , Zhou Jian , Xiang Feng , Pei Yifei , Lu Qingsheng , Jing Zaiping
Published: December 2017

Objectives

Visceral arterial aneurysms may be treated using open surgery or endovascular repair, but the best approach remains controversial. This was a retrospective study aiming to compare open surgery and endovascular treatment strategies for visceral arterial aneurysms.

Methods

The study included all 93 patients who were admitted with visceral artery aneurysms between January 2001 and January 2011 at the Department of Vascular Surgery, Changhai Hospital, Shanghai, China. All cases underwent either open or endovascular procedures. Overall survival and adverse events were compared between the groups. Success rate, blood loss, length of surgery, and length of hospital stay were also compared. The patients were followed up at three, six, and 12 months then every year until April 2014.

Results

Open surgery was performed on 34 patients and endovascular procedures on 59. There were no differences in characteristics of the patients between the open surgery and endovascular groups. The perioperative complication rate was 52.9 and 13.6% in the open surgery and endovascular groups, respectively. Mean follow-up was 36.8 months (range: 11 months to 10 years). The one- and five-year survival rates were 100 and 60.6%, respectively, in the open surgery group, compared to 100 and 84.5% in the endovascular group. Multivariate analysis for factors related to overall survival showed that there was a significant relationship with the treatment approach (HR = 0.479, 95%CI: 0.278–0.825; P = 0.008) and the presence of false aneurysm (HR = 2.929, 95%CI: 1.388–6.180, P = 0.005).

Conclusions

Endovascular repair could be considered as an effective method for visceral artery aneurysm. Endovascular repair showed lower perioperative complication rates and better long-term survival.
Enhancing the Effectiveness of Work Groups and Teams: A Reflection
Authors: Kozlowski Steve W. J.
Published: December 2017

Teamwork has been at the core of human accomplishment across the millennia, and it was a focus of social psychological inquiry on small group behavior for nearly half a century. However, as organizations world-wide reorganized work around teams over the past two decades, the nature of teamwork and factors influencing it became a central focus of research in organizational psychology and management. In this article, I reflect on the impetus, strategy, key features, and scientific contribution of “Enhancing the Effectiveness of Work Groups and Teams,” by Kozlowski and Ilgen, a review monograph published in Psychological Science in the Public Interest in 2006.
Why Interventions to Influence Adolescent Behavior Often Fail but Could Succeed
Authors: Yeager David S. , Dahl Ronald E. , Dweck Carol S.
Published: December 2017

We provide a developmental perspective on two related issues: (a) why traditional preventative school-based interventions work reasonably well for children but less so for middle adolescents and (b) why some alternative approaches to interventions show promise for middle adolescents. We propose the hypothesis that traditional interventions fail when they do not align with adolescents’ enhanced desire to feel respected and be accorded status; however, interventions that do align with this desire can motivate internalized, positive behavior change. We review examples of promising interventions that (a) directly harness the desire for status and respect, (b) provide adolescents with more respectful treatment from adults, or (c) lessen the negative influence of threats to status and respect. These examples are in the domains of unhealthy snacking, middle school discipline, and high school aggression. Discussion centers on implications for basic developmental science and for improvements to youth policy and practice.
The UK’s corporate killing law: Un/fit for purpose?
Authors: Tombs Steve
Published: December 2017

The annual total of occupational deaths in the UK is measured in the tens of thousands, yet the overwhelming majority attract no criminal justice attention. More recently, a very small number of deaths have generated attempts to prosecute companies for manslaughter. In 1996, following a series of multiple fatality ‘disasters’, the Law Commission proposed for a new law on corporate manslaughter; in 2008, the Corporate Manslaughter and Corporate Homicide Act 2007 came into force. It is with the implementation and effects of this Act that this article is concerned. It begins by setting out the dimensions of the new law before analysing the key themes that have emerged from its use to date. In conclusion, I consider whether the law has proven to be unfit for purpose—which begs the question of what that purpose might have been.
Is more law the answer? Seeking justice for victims of intimate partner violence through the reform of legal categories
Authors: Walklate Sandra , Fitz-Gibbon Kate , McCulloch Jude
Published: December 2017

In 2015 in England and Wales a new offence of controlling or coercive behaviour was introduced with the aim of improving legal responses to intimate partner violence. Recognizing the historical limits of legal interventions in this area, this article examines the efficacy of coercive control as a conceptual device for improving access to law and justice outcomes for women victims. To do so, it considers the problems and possibilities of translating a concept generated from clinical practice into legal practice alongside an exploration of the potential unintended consequences of this new offence. The gendered analysis undertaken here reveals the limitations of framing women’s experiences as ‘coercive control’ in law and concludes that, in the case of coercive control, more law is not the answer to improving responses to intimate partner violence.
Lives and spaces: Photovoice and offender supervision in Ireland and England
Authors: Fitzgibbon Wendy , Healy Deirdre
Published: December 2017

The lives and experiences of those on probation supervision are often invisible and dismissed as unimportant or worse as ‘an easy option’. This article reviews two different studies in England and Ireland which utilized an innovative technique, Photovoice, to foreground the experiences of probationers on their journey towards desistance. The difficulties they face such as stigma, social judgement and exclusion are explored as well as their need for emotional calm, and support and understanding from their supervisors and the wider community. Photovoice as a methodological and creative tool is revealed as a novel and expressive means to develop insight into probation supervision and an effective technique for undertaking cross-national research which can communicate across cultural boundaries.
Theorizing hit-and-run: A study of driver decision-making processes after a road traffic collision
Authors: Hopkins Matt , Chivers Sally
Published: December 2017

Explanations for driver decisions to hit-and-run have largely been based around a rational choice perspective that suggests drivers consider the expected costs of reporting a collision against the benefits of leaving the scene. Although such an explanation appears plausible, previous research has largely focused upon identifying contributory or contextual factors through analysis of quantitative datasets rather than engaging with drivers in order to understand how they make the decision to ‘run’. This article explores the application of the rational choice perspective to hit-and-run driving. First, it develops an analytical framework based upon the rational choice decision-making process put forward by Tay et al. in 2008. Second, through analysis of 52 interviews with offenders, it examines how drivers structure the decision to leave the scene. Third, a typology of drivers is developed that illustrates that hit-and-run is not always based upon rational decision making. Finally, the article concludes with some implications for further research and the prevention of hit-and-run collisions.
The impact of the Great Recession on the Irish drug market
Authors: Windle James
Published: December 2017

This article analyses 10 years (2004–2014) of An Garda Síochána controlled drug data to investigate the impact of economic recession and globalization on the Irish illicit drug market. The limited international literature on recessions and drug markets suggests that economic downturns can increase both drug consumption and dealing. Gardaí data may, however, suggest that the 2008 Great Recession reduced drug use and dealing, yet increased the cultivation and manufacture of drugs: trends which largely conflict with the international literature. Two testable hypotheses are drawn from the data: (1) net consumption and trade of illicit drugs were reduced by emigration triggered by the Great Recession; (2) the Great Recession forced an adaptation in the market which sped up the process towards import substitution of cannabis cultivation. The article concludes by investigating how recent changes highlight the globalized nature of Irish drug markets before proposing avenues for further research.
Coercive control: To criminalize or not to criminalize?
Authors: Tolmie Julia R
Published: December 2017

Criminalizing coercive or controlling behaviour in an intimate relationship, as has been done in England and Wales and is proposed in Scotland, has the advantage of offering an offence structure to match the operation and wrong of intimate partner violence. This article raises the question as to whether other jurisdictions should follow suit. It argues that the successful implementation of such an offence may require a complexity of analysis that the criminal justice system is not currently equipped to provide and will require significant reforms in practice and thinking. If it is not successful such an offence could conceivably operate to minimize the criminal justice response to intimate partner violence and be used to charge primary victims.
Lifeskills Training: You've Read the Books… Now it's Time to Apply it to Life!
Authors: Brown Helen
Published: December 2017

In this article I would like to introduce you to lifeskills and lifeskills training. Lifeskills are about unlocking potential, your potential. That may have put you off already! But for those of you who are still with me, let us begin the journey.
The Support Worker in Theatres
Authors: Sketchley-Kaye Jansci
Published: December 2017

This article will consider various aspects of the use of the support worker in theatre and will propose that the support worker can undertake the scrubbed role. The position of NATN is that it ‘does not recommend that the role of the support worker encompasses the scrub role’ (NATN 1996); it will be argued here that this stance is based on arguments which are fundamentally flawed.
Manual Handling: In the Perioperative Environment
Authors: Wicker Paul
Published: December 2017

Problems with manual handling create a significant impact on: • patients - through affecting patient safety, comfort and quality of care • nurses - through injury and adverse career prospects • Trusts - through risk assessment and litigation.

It is essential that manual handling problems be addressed. This article seeks to explore these issues in the perioperative environment.
Waste Anaesthetic Gases
Authors: Pressly Vanessa
Published: December 2017

Occupational exposure to inhalation anaesthetics is a controversial subject and an topic for ongoing debate. In this article, Vanessa Pressly reviews the significant research on the subject and details current regulations and guidelines for perioperative practice.
Nursing at the Forefront
Authors: Hunt Lord Philip , Williams Marilyn
Published: December 2017

The Government sees nurses at the forefront of the drive for improvement in healthcare delivery. In this article, Lord Hunt, the Government spokesperson on nursing, spells out the role that nurses are expected to play in this process. Clincal governance has undoubtedly already been mentioned if not enacted in your Trust, and maybe some of you have applied for the discretionary points now on offer. Whatever the outcome of these and other strategies, the future is going to be different for perioperative nurses, whether we like it or not. Your views, as ever, are welcome…
Laser Safety Management
Authors: Champion June
Published: December 2017

LASER is an acronym for Light Amplification by Stimulated Emission of Radiation. Since the first working laser was demonstrated in 1960 the laser has evolved from being viewed as a weapon, courtesy of the film industry, to its current position as a commonplace medical device within the healthcare industry. As perioperative staff we have become very familiar with the therapeutic use of this device. It is my experience however that, just occasionally, we are guilty of the old adage ‘familiarity breeds contempt’. We must remember that the very same features which make lasers so useful in healthcare may also represent major health hazards to patients, staff and others.
Hand Washing: Simple, Cost Effective, Evidence Based … Lip Service!
Authors: Fell Chris
Published: December 2017

Hand washing is so simple that we teach our toddlers to do it. It's so important in our every day lives that facilities for hand washing can be found in every conceivable environment. Scientists, literature and the media give evidence on the benefits and in the art of good techniques. So why, in an environment where the management of infection is a matter of health and safety for all, is hand washing so low on our ever-growing list of priorities? This article examines the legal and moral issues of hand washing in relation to health and safety, concentrating on possible reasons for non-compliance and how these can be addressed.
Of Vision, Virtue, Valour and Victory
Authors: Montgomery Adrienne
Published: December 2017

The year 2000, as either the beginning or the end of a millennium, signals a time for reflection. It is 30 years this month since I first landed on these shores; I was a member of the London Branch of NATN in the 70s. My first NATN congress was in 1977 and my first world congress was in Hawaii in 1983. My most recent NATN congress was in 1997 and I'm about to transfer my membership from overseas to the host branch. Outcome of my reflection - I'm getting old!
Don'T Blame the Iceberg
Authors: Campbell Libby , Miller Jim
Published: December 2017

At a workshop on risk management at one of the Association's Management Study Days in London in November 1999, a number of good ideas emerged. One was the need for the Association to review the current Risk Assessment Guide (RAG) published by NATN. That review is presently underway. It was also suggested that we might have a page in the Journal for risk management issues. As a result, a series of articles has been commissioned, with this opening article on the principles of risk management using the Titanic experience as a model.
First Assistant Activities
Authors: Williams Marilyn , County Bernadette , Tanner Judith
Published: December 2017

In this article, Judith Tanner proposes that it is time to address the premise that first assistant activities constitute an extended role and to explore whether the tasks undertaken are extended skills requiring additional training and separate contracts. This article is particularly timely, as the two NATN documents Role of the Nurse as First Assistant (1993) and Nurse as Surgeon's Assistant (1994) are being reviewed and updated this year.
Career Breaks
Authors: Campbell Claire
Published: December 2017

A career break scheme is one way of retaining an individual's valuable skills and experience if an employee wishes to take a break from their working life, after which they intend to return to work. The article that follows outlines some of the possibilities for career breaks within the NHS.
The Physiology of Wound Healing and Wound Assessment
Authors: Clancy John , McVicar Andrew , Muncaster Damian
Published: December 2017

Wound healing is a complex and remarkable process that occurs when the body responds to trauma. It requires the interaction of several intricate processes with the ultimate aim being to maintain homeostasis. With advances in surgery and increases in the amount of surgery being undertaken, research into wound healing has become of great importance. Providing the optimum conditions for wounds to heal is of great significance as pressures on nursing and hospital resources become ever greater.
Deep Vein Thrombosis Incidence and Physiology
Authors: Williams Marilyn , Quantrill Shelley
Published: December 2017

Deep vein thrombosis (DVT) has become a matter for public concern because of its alleged links to long haul air travel. But DVT has been recognised for many years as a threat to the wellbeing of patients. Shelley Quantrill looks at the incidence and physiology of the disorder in the hospital setting, and at the options available for dealing with it.
Expanding the Perioperative Role the Surgeon's Assistant
Authors: Boss Suzanne
Published: December 2017

The role of Surgeon's Assistant continues to be a contentious issue within the perioperative environment. Questions arise as to whether theatre nurses both want to and ought to extend their role into the medical margins. Suzanne Boss surveys the literature and draws preliminary conclusions on this development in nursing practice. This article was submitted in entry for the Alison Bell Writer's Competition 2001.
Lung Volume Reduction with Video Assisted Thoracic Surgery
Authors: Clark Margaret
Published: December 2017

This article aims to describe lung volume reduction (LVR) and some aspects of perioperative care. LVR is a surgical treatment for emphysema. An understanding of the operation and the patient's pre-existing medical condition is important for skilled and appropriate care, particularly in anaesthetic and recovery rooms.
Informed Consent the Global Picture
Authors: Blain Colin , Mackay Margaret , Tanner Judith
Published: December 2017

Live surgery beams patient images around the world in seconds … What did your patient consent to? The incidence of misuse of medical images taken without patient consent has challenged existing hospital standards and policies. Based on responses from senior theatre nurses, practitioners and medical industry personnel, this article explores the misuse of medical images taken without patient consent.
The Scrub Practitioner and the First Assistant Role
Authors: Robinson Rosanne , McIntosh Steven
Published: December 2017

An audit of the activities undertaken by scrub nurses was performed at Ninewells Hospital, Dundee during November 1999. The results showed that a high percentage of scrub practitioners are undertaking first assistant activities. In order to prepare staff for their role within specialised areas of practice, an ongoing program of Fitness for Practice modules is being developed collaboratively between Tayside University Hospitals Trust and the University of Dundee. This article describes their experiences.
Psychosurgery
Authors: Williams Marilyn
Published: December 2017

The use of surgical procedures to alter mental states raises many issues. Surgery on the brain has been known for thousands of years, but procedures developed in the 1930s, ‘40s and ‘50s, and the reasons for them, raised many ethical issues that remain with us today. The following article touches on the history of psychosurgery, the conditions treated, the literature on the subject, and the ethical and legal issues.
Creutzfeldt-Jakob Disease the Perioperative Connection
Authors: Beesley John
Published: December 2017

The recent adverse incident at Middlesbrough General Hospital where neurosurgical instruments were used on a patient later diagnosed with sporadic CJD, and then reused on further patients, has major implications for us all as perioperative practitioners. This article looks at what happened and explores what can be done to prevent it in the future.
Healthcare Assistants to Scrub or Not to Scrub?
Authors: Smith Hazel
Published: December 2017

The appropriateness of healthcare assistants expanding their role into the domain of scrubbing has been a contentious issue for a long time. Whenever the shortage of theatre staff becomes a major concern, expanding the role of the healthcare assistant into scrubbing is discussed and decided against. Although allowing healthcare assistants to scrub is not the sole answer for all theatre's problems, Hazel Smith argues that it would ease a difficult situation.
Managing Competency within a Perioperative Setting
Authors: Beesley John
Published: December 2017

In the second article of the PEPDN series, John Beesley introduces practitioners who are involved in training and practice development to the key contemporary drivers which are encouraging competency frameworks to be established within a perioperative setting. The article outlines established benchmarked competency frameworks and provides guidance for those involved in practice development who are anticipating the formulation and introduction of a competency framework within their own operating departments.
Of Human Bondage Dealing with Vulnerable Patients in Theatre
Authors: Keenan Bernie , Tanner Judith
Published: December 2017

The ethical dilemmas surrounding the use of physical and chemical restraint in the acute care arena are highlighted in project work currently in progress within the University Hospital Birmingham NHS Trust. The impetus for this work has emerged from a multidisciplinary group of trust colleagues who are attempting to develop guidelines for good practice in this area. Their work relating to the theatre setting has been presented at the RCN Critical Care Conference and is outlined in this article.
Managers’ Workshop 2003 a Follow-Up
Authors: McKay Margaret
Published: December 2017

Monday 6 October in Harrogate during NATN Congress was a wonderfully sunny day, pleasantly warm for the time of year, with a clear blue sky. Despite the obvious attractions outside the Majestic Hotel many delegates took the time to come and listen to the talk which was to be delivered at the managers’ workshop.
Learning Intimate Examination Skills An Ethical Challenge
Authors: Reid Jane
Published: December 2017

Learning how to perform intimate examinations poses ethical challenges for those needing to develop clinical competence and for those responsible for the supervision of learners. Perioperative practitioners need to challenge unethical behaviour and promote ethical caring.
Targeted Haemostasis Monitoring Using the Teg® Whole Blood Analyser System
Authors: Von Kier Stephen , Parker Rachel , Cox Falicia
Published: December 2017

Conventional tests of coagulation, performed by designated technical personnel within central laboratories, can be laborious and rely on transport of the sample to the laboratory. These logistical problems impact on the relevance of the results to the clinician and, with current staffing shortages affecting the laboratory groups and porters, the situation is likely to intensify. This article describes an alternative approach which enables coagulation testing to be a simple ‘on site’ activity.
Agenda for Change Questions and Answers
Authors: Beesley John
Published: December 2017

Dear NATN

I am a theatre manager in an area where recruiting and retaining operating theatre staff is proving to be increasingly difficult. The high cost of living within this geographical area and competition for staff from other hospitals and agencies complicates this. How will Agenda for Change assist me to improve this situation within my operating department? Worried of Wimbledon
Haemophilia
Authors: Vidler Vicky , Cox Falicia
Published: December 2017

This is the third article in a series that aims to refresh readers’ knowledge of blood. This article describes haemophilia which is a congenital disorder of coagulation. Vicky Vidler describes the aetiology of Haemophilia A and B, their clinical manifestations and the treatment options available to manage these patients in the perioperative period.
Career and Pay Progression
Authors: Pirie Susan
Published: December 2017

In addition to her previous articles on Agenda for Change and early implementer (EI) sites in England and Scotland, Susan Pirie explores the proposed systems that salary reviews will be administered under. Looking at the link between pay progression and the Knowledge and Skills Framework, she addresses how and when this will be applied.
Nurse Practitioners in Theatre An Investigation
Authors: Bladon Heather
Published: December 2017

A small qualitative study was conducted to identify in-depth views of three nurse practitioners who work in one unit – two are part-time ‘F’ grades and one is a full-time ‘H’ grade. Data was collected by three semi-structured interviews based on three themes highlighted in the literature. By introducing nurse practitioners, the continuity and quality of patient care will be enhanced, and flexible working will be facilitated from a reduction in doctor's hours.
Treating Jehovah's Witnesses
Authors: Wade Paul , Cox Felacia
Published: December 2017

This article explores the beliefs of Jehovah's Witnesses, related to allogeneic blood transfusions. Paul Wade also describes how Witnesses contribute to healthcare planning through the completion of individual Advance Medical Directive/Release documents and by shared learning. The article addresses the reasons why Jehovah's Witnesses refuse allogeneic blood, and what resources are available.
Acid Aspiration Syndrome
Authors: Farman Jean
Published: December 2017

All patients undergoing general anaesthetic are at risk of acid aspiration particularly in emergency situations when they have not been starved preoperatively. To minimise the risk of acid aspiration, anaesthetists and anaesthetic nurses employ Rapid Sequence Induction of anaesthesia, cricoid pressure and endotracheal intubation. Knowledge of airway anatomy, airway management techniques, anaesthetic agents, muscle relaxant drugs, and Sellick's Manoeuvre help the anaesthetic nurse ensure the safety of the high risk patient.
The Perioperative Practitioner the Way Perioperative Roles Fulfil Our Patients Needs
Authors: Couzens Sally
Published: December 2017

This article demonstrates how patient care can be compromised when vital patient information is not communicated to the team in the operating theatre. It challenges practitioners to consider the information required to properly care for our patients. Several members of NATN were asked to comment on this article and these are reproduced at the end.
Intraoperative Red Cell Salvage
Authors: Fisher Tony , Cox Felicia
Published: December 2017

In this article, Tony Fisher explores the background to autotransfusion and how recent advances in equipment and techniques have facilitated intraoperative cell salvage, thus reducing the need for homologous transfusion.
The Hazards of Diathermy Plume: Part 2 Producing Quantified Data
Authors: Scott Eve , Beswick Alan , Wakefield Kathy
Published: December 2017

Laser and electrocautery devices used during surgery produce smoky emissions that may contain vapours and particulate aerosols, which can have a chemical and biological impact on those exposed. A group of theatre staff and specialist nurses at Rotherham District General Hospital got together to draw up a risk assessment into the possible occupational exposure of theatre staff, with a view to eliminating or controlling these hazards as far as possible.
The Role of the Link Lecturer in the Perioperative Environment
Authors: Hughes Suzanne J
Published: December 2017

As a result of the demise of the two-tier system of clinical teacher and lecturer, all teachers were assigned to clinical areas in which they facilitate the development of an educational milieu to support student learning in practice. This article highlights the role of the link lecturer within the perioperative environment. It focuses on how this multi-faceted position can assist students to link theory and practice, and addresses key issues relating to mentorship, clinical credibility and educational audit.
An Evaluation of Preoperative Skin Antiseptics
Authors: Lipp Allyson
Published: December 2017

An underpinning tenet of evidence-based practice is that all routine practices should be open to scrutiny. Questioning practice should not be limited to new, experimental procedures, but should also include examination of ‘tried and trusted’ techniques. Taking this perspective, the author recently contributed to a systematic review evaluating the use of antiseptics preoperatively.
Patient Autonomy Legal and Ethical Issues in the Post-Anaesthetic Care Unit
Authors: Humphreys Sally
Published: December 2017

The need for patient autonomy, empowerment and choice has become central to health reforms. Confronted with the prospects of such perpetual changes, respect for patient autonomy has to be tempered with paternalistic beneficence. This article discusses the difficulties encountered when applying patient autonomy within the post-anaesthetic care unit (PACU), evaluating ethical, legal and professional issues.
The Duty of Care: An Update Current Legal Principles
Authors: Fullbrook Suzanne
Published: December 2017

The author had a twofold purpose in writing this article: firstly to inform readers of the current legal principles that inform the duty of care, and secondly to discuss these principles with reference to two recent cases. Practitioners giving consideration to these issues will be assisted in their professional decision-making processes.
Theatre Nursing in Post-SARS Hong Kong
Authors: Lipp Allyson
Published: December 2017

On a recent visit to Hong Kong the author visited an operating theatre in an effort to explore the differences and similarities with the UK. She found that SARS has had a profound influence upon both public behaviour and the healthcare system. The author found the visit interesting and educational and she encourages others to make similar visits as a way of exchanging ideas and maintaining optimal practice.
Surgical Equipment and Materials Left in Patients
Authors: Brown James , Feather Donald
Published: December 2017

This article seeks to examine the issue of lost equipment and materials left in patients and the assumptions that registered theatre practitioners make. The assumptions are highlighted using a tragic case study that relates to a young lady who died and what the subsequent post mortem revealed: five pieces of gauze in her abdominal cavity which were proved to be five surgical swabs. The problem of retained swabs and other surgical equipment is far greater than many would believe. It is said ‘to err is human’, but maybe to err is negligent.
Preoperative Visiting: Landmarks of the Journey
Authors: Holmes Jill
Published: December 2017

Our fifteen bed, five day recovery unit accepts adult and paediatric patients and serves seven theatres dedicated to eye and ENT surgery. The aim of this article is to provide an insight into the practicalities involved in introducing a preoperative visiting programme and associated leaflet. These initiatives aim to give continuity of care, reduce stress and anxiety, and promote patients' coping strategies, by increasing the patients' knowledge and understanding of their perioperative journey (Malin & Teasdale 1991).
Razors versus Clippers: A Randomised Controlled Trial
Authors: Taylor Tracy , Tanner Judith
Published: December 2017

The purpose of this randomised controlled trial was to determine if patients showed a preference for preoperative hair removal with razors or clippers and to identify if one method was associated with more trauma or postoperative infections. The trial took place in a day surgery unit with patients who were having a range of surgical procedures including hernias and varicose veins. This study was sponsored by an award from the NATN/3M Clinical Fellowship.
Dealing with the Media
Authors: Pirie Susan
Published: December 2017

Dear AfPP

We have recently had an incident where members of the press contacted theatres directly requesting information relating to a high profile patient who was undergoing emergency surgery. As the incident happened at night when there was minimal staff throughout the whole hospital, we were unable to access the usual resources for dealing with press enquiries. The incident has created discussion among staff as to how a similar incident should be dealt with in future, and also in relation to professional codes of conduct and patient confidentiality. We are also aware that one of our consultant surgeons wishes to involve the media in filming an operative procedure and we are concerned about this proposal. Can AfPP advise on these issues?

Anxious from Aberdeen
Achieving Level Three of the Clinical Negligence Scheme
Authors: Impey Penny
Published: December 2017

This article discusses my experience, from a theatre nurse's perspective, of meeting Level Three of the Clinical Negligence Scheme for Trusts (CNST). As the practice development sister for Theatres, Day Unit and Endoscopy and as a member of the CNST group, it is my responsibility to gather evidence for my areas.
The Sims’ Speculum
Authors: Ellis Harold
Published: December 2017

An instrument that is taken for granted in gynaecological clinics, operating theatres and GP surgeries all over the world is the humble Sims’ speculum. How would we manage without it? In the fourth article of this biographical series, Professor Ellis looks at the work of James Marion Sims.
Assistant Theatre Practitioners: ‘Must Have’ Or ‘Needs Must’?
Authors: Huddleston Mark , Scoins Hoagy
Published: December 2017

Assistant theatre practitioners (ATPs) are healthcare assistants (HCAs) with additional training, extending their practice to include limited, supervised roles in scrub and recovery support. They have the potential to increase the flexibility of the theatre team and aid retention of critical staff. Will they become an essential member of your perioperative team? What are the risks and issues associated with the role? How can they be implemented safely? Theatre teams around the country are addressing these, and many other questions. This article will tackle some of the concerns and report progress so far.
Reflection on Action: Communication is the Key
Authors: Seed Julie
Published: December 2017

This article will explore, by reflection, a critical incident by considering the positive and negative aspects. This will encourage me as a trainee surgical care practitioner to look at how and why the incident occurred and it will support me in exploring my emotions. Having experienced this incident, on reflection I can look back at my mixture of emotions – ranging from fear and annoyance to accomplishment – because no matter how able we are as practitioners there will always be new and challenging experiences. When we value our work we value ourselves as practitioners who can make important contributions to the care of patients (Taylor 2000).
Checking the Anaesthetic Machine
Authors: Wicker Paul , Smith Brian
Published: December 2017

Making sure that anaesthetic equipment is working correctly is an essential part of the anaesthetic practitioner's role. During induction of anaesthesia the patient is at one of the most vulnerable points in his or her perioperative care. This is the point at which equipment error may put the patient at high risk of harm, for example, through compromising the airway, causing circulatory problems, preventing satisfactory oxygenation or even causing death. Many writers have drawn comparisons between anaesthesia and aviation, with the suggestion that practitioners should check the anaesthetic machines using a ‘cockpit drill’ (Ranasinghe 2000). The purpose of this detailed check is to ensure the machine is safe to use. The careful attention to the check is a reflection of good practice which the practitioner's codes of professional practice demand (HPC 2004, NMC 2004). This article discusses the importance of following the anaesthetic checklist to the recommended standards for both the practitioner and the patient.
Charnley's Hip Prosthesis
Authors: Ellis Harold
Published: December 2017

When he sat the FRCS examination in 1951 Harold Ellis was advised that, if asked by the examiner, ‘ What is the best treatment for osteoarthritis of the hip?‘, to reply, ‘ Provide the patient with a walking stick and prescribe aspirin‘. The results of surgery for this condition at that time were pretty discouraging. Here, Professor Ellis outlines the development of this surgical technique.
The Thomas Splint
Authors: Ellis Harold
Published: December 2017

Surely the best known appliance in orthopaedics and trauma surgery is the Thomas splint, and the story of its evolution is interesting. Hugh Owen Thomas (1834–1891) came from a family of Welsh bone-setters. His father was determined that Hugh should become a ‘proper doctor' so he studied at Edinburgh and University College, London and qualified MRCS in 1857. He spent the whole of his life in general practice in the slums of Liverpool among the dock workers and the numerous seafarers, many with severe injuries sustained weeks or even months before, while at sea, where their only care had been from their shipmates and captain.
A Reflective Case Study in the Obstetric Theatre: Focusing on the Principles of Care Involved
Authors: Steevenson Grania
Published: December 2017

This article focuses on the principles of care involved in a reflective case study of a patient undergoing a caesarean section. Unplanned caesarean sections are often emotionally charged procedures. Often a mother has had no warning of a surgical intervention for the birth of her child and is understandably both distressed and frightened.
Discharge Criteria in Recovery: ‘Just in Case’
Authors: Smith Brian , Hardy Dawn
Published: December 2017

According to the Association of Anaesthetists of Great Britain and Ireland (AAGBI 2002) the increasing complexity of surgical procedures has increased the need for improved monitoring of the postoperative patient. ‘Recovery’ of a patient has moved from a brief period of observation towards one of assessment and evaluation during the immediate postoperative phase. The purpose of this article is to explore current practice with a focus on the application and importance of discharge criteria. Critical analysis will highlight the responsibilities and accountability of the recovery practitioner (a registered nurse (RN) or operating department practitioner (ODP)) when discharging the patient. Conversely, the article will also explore the tensions in relation to effective application of the discharge criteria and the recovery practitioner's professional accountability. The term ‘recovery practitioner’ will be used throughout this paper to refer to those who are chiefly employed to care for patients in the recovery room, or more contemporarily referred to as the post anaesthetic care unit (PACU).
The Hopkins Rod-Lens System
Authors: Ellis Harold
Published: December 2017

Surgeons have always been ready to adapt advances in technology into their practice. The discovery by Wilhelm Roentgen of X-rays in 1885 was applied within weeks of its publication to the diagnosis of fractures and the location of foreign bodies. The development of the electric light bulb by Edison enabled Max Nitze, Professor of Urology in Berlin, to develop the electrically illuminated cystoscope, which he patented in 1877. By 1911, Hugh Young used a cystoscope with a punch device to perform transurethral prostatectomy. Rapidly other electrically lit ‘scopes’ were introduced – the gastroscope, bronchoscope, thoracoscope and so on. All had two problems: they were rigid instruments and lacked really brilliant illumination.
Anaesthesia for Day Surgery
Authors: Russon Kim , Thomas Anthony
Published: December 2017

The Department of Health (DH) proposes that 75% of elective surgery should be performed as a day case procedure (NHS Plan 2000). To achieve this some modification of the traditional selection criteria may be required and careful thought given to the patient pathway, including the anaesthetic technique. Successful anaesthesia for day case surgery requires a balanced anaesthetic technique and multidisciplinary input which commences at booking, runs through preoperative assessment and continues to a nurse-led discharge. Suitable patients need to be selected (Digner 2007), prepared both physically and psychologically, undergo minimally invasive surgery with a suitable anaesthetic technique encompassing good pain relief and the avoidance of postoperative nausea and vomiting (PONV). Pain and PONV are the most common causes for a patient to require unplanned admission (Junger 2001).
The Impact of Multi-Skilled Staff Availability on Day Surgery Cancellations
Authors: Lloyd Helen
Published: December 2017

This paper outlines a study undertaken by Helen Lloyd to assess the impact of multi-skilled theatre practitioners on reducing cancellations in stand alone day surgery units in England and Wales. The author provides the background to the study together with an overview of the results. The literature review undertaken before the study is published in full. It identifies what factors influence the efficiency of day surgery and operating theatre facilities, traditional staffing of operating theatres and day surgery facilities, together with other influencing factors for theatre utilisation. The author recieved partial funding from ERFF to complete her MBA in Health Service Management at Greenwich School of Management (accredited to University of Hull) in 2007.
Inadvertent Hypothermia: A Literature Review
Authors: Nunney Robert
Published: December 2017

While working on my first placement in the operating department recovery room, I was surprised by the frequency of patients coming into recovery with mild hypothermia, having taken their temperature on arrival. In many cases the patient did not arrive with a forced-air warming blanket, or any device other than a cotton blanket. It seemed to me that it would be more efficient, kinder and possibly more cost-effective to take steps to prevent perioperative hypothermia rather than to treat the consequences.
Infection Prevention and Control in the Operating Theatre: Reducing the Risk of Surgical Site Infections (Ssis)
Authors: Weaving Paul , Cox Felicia , Milton Sherran
Published: December 2017

Continuing advances in surgical techniques, asepsis, operating theatre protocols and ventilation systems that ensure an uninterrupted supply of clean air, should allow all patients to undergo both invasive and minimally-invasive procedures with reduced risk. Patients having surgery in the United Kingdom are probably less vulnerable to surgical site infections (SSIs) than ever before - despite persisting concerns about meticillin-resistant Staphylococcus aureus (MRSA) and increasing antibiotic resistance in other organisms such as vancomycin-resistant Enterococci (VRE).
Evolving Perioperative Roles: Nicety or Necessity?
Authors: Reid Jane
Published: December 2017

In recent years we have experienced considerable interest in new roles but since the demise of the National Practitioner Programme (England) in 2007, much has gone quiet. NHS Education Scotland (NES) continues with the Physician Assistant pilots and there is evidence of developments at individual SHA level, but nothing like the activity we observed through 2005–2007. However the commitment to secure significant service transformation is predicated on the future workforce engaging differently and in new ways.
The First Ligation of the Abdominal Aorta
Authors: Ellis Harold
Published: December 2017

To operate on the abdominal aorta is difficult enough today, even with all the appurtenances of the modern operating theatre. Yet the first time this was performed, as an emergency by Astley Cooper of Guy's Hospital in 1817, it was carried out without any form of anaesthetic, in the patient's bed, at night and therefore, presumably, by lamp light.
Young People: Their Insights into the Roles of Healthcare Professionals
Authors: Hewkin Kimberley
Published: December 2017

This article is the result of discussions with groups of young people about my job as an Operating Department Practitioner (ODP) and about general health-related issues. Study days had been arranged for these young people so they could be given an insight into various healthcare-based careers. As well as to inform, my role was also to listen to their views and opinions and to also broaden their understanding. There were a total of 10 study days arranged for the various age groups. The ages ranged from 12–18.
Pacemakers: Some of the Risks and Complications you are Not Warned About
Authors: Marsh Ann
Published: December 2017

Pacemaker technology has advanced rapidly over the last decade. A lot of everyday interference can be regarded as transient. The media tend to cover stories of relatively insignificant transient interference incurred by pacemaker wearers while many manuals gloss over the high risks, some potentially life-threatening. These include the reliability of pacemakers and the use of monopolar diathermy which can generate electromagnetic interference, potentially causing a pacemaker to malfunction.
Surgical Management of Fractured Neck of Femur
Authors: Malik Atif A. , Kell Peter , Khan Wasim S. , Ihsan Khan M. H. , Dunkow Paul
Published: December 2017

The fractured neck of femur is the classically described fracture in osteoporotic elderly patients. Further, the fracture has a strong predominance in post-menopausal women and, although relatively uncommon in both children and young adults, where present in this age group it is usually the result of significant trauma.

In elderly patients, with an already weakened bone, even minimal trauma may be sufficient to cause fracture and as such a fractured neck of femur is often referred to as a fragility fracture.
Dame Cicely Saunders Om DBE: Founder of the Hospice System
Authors: Ellis Harold
Published: December 2017

Sixty years ago, when I was a young house-surgeon at the old Radcliffe Infirmary in Oxford, we were not at all expert at dealing with our dying patients. Of course, we had every pity and sympathy with them and their families, but we were often constrained by the family members themselves from talking frankly to the patient, and our use of pain-relieving drugs: morphine, heroin and the Brompton mixture, was not very scientific. We were warned of the danger of the patient becoming rapidly tolerant to increasing doses of narcotic drugs. Although devoted general practitioners and district nurses would make frequent home visits to their terminal patients, designated hospices hardly existed and much of the care fell onto the shoulders of the family. Often, a dying patient, carefully hidden behind the screens, would be found at the far end of the surgical or medical ward. The revolution in palliative care that we see today owes itself to one remarkable person - Cicely Mary Saunders.
Clippers or The Knife? The Reform of Surgical Practice and the Difficulty of Early Wound Closure
Authors: Stephens-Borg Keith
Published: December 2017

Salt, vinegar and wine sounds more like a recipe from the Saturday kitchen, but in 1667 it was all a surgeon could use to close wounds, along with silk and linen strips. In providing this service, barbers and surgeons found themselves confused and intertwined, struggling for professional recognition that was about to experience reform. Allegations of neglect in the aftermath of a major seafaring battle on the very shores of our capital city required the court of King Charles II to search for a solution of supreme magnitude to accommodate the hundreds of maimed sailors who were littering the streets of London. A campaign to conceal the horrors of warfare began which lead to the implementation of the Greenwich charter and the construction of a hospital which the architect Christopher Wren helped to design.