bluuebunny/crossref_metadata_2025_split huggingface dataset:
P94 Pre-Operative Fasting in Surgical Patients at Good Hope Hospital – Reducing incidents of unnecessary prolonged fasting periods in patients undergoing surgery
Authors: Kamath Anjali 
Published: April 2021

Abstract
Patients are often fasted from food and liquid for unnecessarily long periods of time prior to surgery. There is often misunderstanding amongst patients and even members of staff as to what exactly is meant by the pre-operative fasting rules, specifically the meaning of ‘clear fluids’. Prolonged fluid fasting can result in significant distress to adult and children patients through feelings of thirst, hunger and anxiety. Prolonged fasting can also negatively affect insulin resistance and severe cases of hypoglycaemia and hypovolaemia.
A questionnaire was handed out to elective surgical patients over a month period between September and October 2019. Data was then collated and compared to the 2011 ESA Guidelines standard where 100% of patients should be fasted appropriately. Results were presented and a poster was created which will be distributed at pre-operative assessment clinic and displayed in clinical areas and the day-case unit.
68 responses to the questionnaire were collected. The results showed that 58% of patients received both written and verbal advice about pre-operative fasting. However, 42% of patients stated they received no information about being able to drink clear fluids until 2 hours prior to their operation and therefore fasted from fluids for longer than required.
In conclusion there was still disparity between what exactly was meant by ‘clear fluids’ and many did not realise the list included coffee and tea without added milk. The next steps would be to implement clear posters outlining correct fasting rules and reinforce education to healthcare staff about this matter. Patients are often fasted from food and liquid for unnecessarily long periods of time prior to surgery. There is often misunderstanding amongst patients and even members of staff as to what exactly is meant by the pre-operative fasting rules, specifically the meaning of ‘clear fluids’. Prolonged fluid fasting can result in significant distress to adult and children patients through feelings of thirst, hunger and anxiety. Prolonged fasting can also negatively affect insulin resistance and severe cases of hypoglycaemia and hypovolaemia.
P104 Orion xTask: Improving neurosurgical workflow using an electronic tasks system
Authors: Koh Chan Hee , Nathan Arjun , Goacher Edward , Fernandez-Mendez Rocio , Owen Nicola , Martin Michael , Davies Benjamin Marshall , Joannides Alexis 
Published: April 2021

Abstract

Introduction
The dominant form of communication within hospitals remains the antiquated paging system. Pitfalls to pagers include: overwhelming volume of non-urgent bleeps; inability to prioritise at the point-of-bleep; no written record of communication - potentially compromising patient safety.
Orion xTask, an electronic tasks system, was implemented at Cambridge neurosurgery in April 2019 to mitigate some of these pitfalls.

Methods
Bleep logs, covering 2-months before and 4-months after xTask implementation with total 3181 bleeps, were obtained. xTask data for the same period (total 4195 electronic requests) was exported. Bleep response times for neurosurgery and for other specialties without xTask were collected. Questionnaires were distributed to nursing and medical staff.

Results
Daily averages of 14.4 in-hours and 23.7-out-of-hours electronic requests were made. The exception to greater out-of-hours utilisation was the ward without a dedicated doctor, where requests peaked in the morning. Prescription was most commonly requested (49%), followed by clinical review (17%).
There were daily averages of 13.0 in-hours and 8.3 out-of-hours bleeps. Changes in bleep volume with xTask implementation were inconsistent: Calls to ward bleeps decreased (p = 0.044), but increased to the on-call (p = 0.042).
Bleep response times, and (bleeped-)job completion times were significantly quicker for neurosurgery than for other specialties (p &lt; 0.001).
Nursing and doctors’ feedback was overwhelmingly positive, with agreement that xTask improves patient safety. xTask scored particularly highly on “Improves Communication”, “Improves Record Keeping” and “Useful Out-of-Hours”. Doctors indicated that xTask also “Helps Prioritisation” and “Facilitates Educational Opportunities”.

Conclusion
The feedback and pattern-of-use indicates that Orion xTask successfully mitigates some of the pitfalls of pagers, thereby improving patient safety.
P108 Service Evaluation - the impact and lessons learnt from the COVID-19 pandemic on a UK burns centre
Authors: Phillips Georgina , Talwar Cyrus , Makaranka Stanislau , Collins Declan 
Published: April 2021

Abstract
The COVID-19 pandemic has dramaticallyimpacted healthcare provision in the UK and burns services have had to adapt to ensure the continuityof a safe care. As we return to " normalit y" we reflect on lessons learnt from our response to this pandemic.
A service evaluation was performed from patient notes between March 23rd and May8th 2020 and an anonymoussurveygiven to patients attending outpatient appointments.
258 patients were referred to our burns service and 148 patients completed the survey. Eleven burns were caused bytreatment or prevention of COVID-19. Patients delayed seeking medical attention due to concern of catching COVID-19 (36% adults, 8% children). There was a delayin referral of 17 patients despite them fulfilling the referral criteria. Infection rates were higher following delayed presentation (21% vs 6%). The majorityof burns were managed conservatively (237/258). Dressing changes were performed at home by32% of patients. The outreach team treated 22 patients.
During the pandemic telemedicine has improved the efficiencyof outpatient burn care and outreach nurses have enabled treatment of vulnerable patients. More must be done to raise public awareness of preventable causes of burn injuryand to reassure them to seek help when burns occur.
P117 Surgical management of Ureteropelvic Junction Obstruction (UPJO) in Neonates amid COVID-19 pandemic; Review of Literature and a Cohort Study in Iran
Authors: Sherafat Alireza , Ashraf Mohammad Ali , Ahmadian Sarina , Sarian Arni , Ramezannezhad Elham , Foroutan Hamid Reza , Hiradfar Mehran 
Published: April 2021

Abstract

Introduction
The current study presents a systematic review of literature on surgical management of ureteropelvic junction obstruction (UPJO) alongside an ongoing cohort study of neonates presenting with high grades of hydronephrosis due to UPJO requiring urgent treatment in a developing country amid the COVID-19 pandemic. The aim of this study is to investigate the efficacy and cost effectiveness of laparoscopic-assisted pyeloplasty.

Methods
Patients’ demographics, clinical presentations and treatment outcomes are recorded. The cohort is classified into 3 groups based on type of surgical treatment offered including open, laparoscopic and laparoscopic-assisted pyeloplasty. All patients admitted with grade 3-4 hydronephrosis due to UPJO are included. Patients with UPJO as part of a complex multisystemic syndrome are excluded. Literature review was conducted from 2000/1/1 to 2020/1/1 to include all original research papers on surgical management of UPJO. The age group was limited to neonates (under 1 year-old).

Results
32 articles were included in the review. 20 papers (62.5%) recommended open pyeloplasty, 10 papers (31.3%) recommended laparoscopic pyeloplasty and 2 papers (6.25%) recommended laparoscopic-assisted pyeloplasty. The cohort study is currently recruiting patients treated by the 3 surgical approaches.

Conclusion
The majority of studies are focusing on open pyeloplasty. However, as more surgeons are going through the learning curve of laparoscopic pyeloplasty, the trend is towards more laparoscopic management in the future. It is important to discover the advantages of laparoscopic-assisted approach as a new technique to improve the outcome and shorten the hospital stay amid the COVID-19 pandemic.
P119 The association of hand and wrist injuries with other skeletal injuries in multiple trauma patients in a UK Major Trauma Centre
Authors: Tsinaslanidis Prodromos , Smith Toby O , Brown Oliver S , Tsinaslanidis George , Umarji Shamim , Hing Caroline B 
Published: April 2021

Abstract

Background
There are 20,000 major trauma cases in England annually yet the association with concomitant upper limb injuries is unknown. Injuries of the hand and wrist can cause serious functional impairment, decreased quality of life and confer a significant economic burden to healthcare systems. The aim of this study was to determine the incidence, injury pattern and association of hand/wrist injuries with other injuries and the ISS score in multiple trauma patients in the UK.

Methods
A single centre retrospective cohort study was performed at a level one trauma centre. Trauma Association & Research Network (TARN) eligible patients during a 5-year period were included.

Results
A total of 107 patients were included in this study. Seventy patients had an ISS&lt;15 and 37: had an ISS&gt;15. The majority were male (70.1%) and the mean age was 45 Years. Hand and wrist injuries were the second most common injury found in 26.2% of patients.
There was a significant association between hand/wrist injuries and lower limb injuries (p = 0.04) and pelvic injuries (p = 0.02). The association between hand and wrist injuries with ISS score was found to be not significant (p = 0.82).

Conclusion
Hand and wrist injuries should be screened for in multiply injured patients with a pelvic or lower limb injury.
P121 The development of Core Outcome Sets and Common Data Elements in clinical neurosciences: a scoping review
Authors: Bandyopadhyay Soham , Horsfall Hugo Layard , Chari Aswin , Kolias Angelos G 
Published: April 2021

Abstract

Background
Core Outcome Sets (COS) are a consensus-based agreed minimum set of outcomes that should be measured and reported in all studies within a research field. Common Data Elements (CDEs) are the minimum data points that should be collected regarding the characteristics of population, condition and intervention. The use of COS and CDEs minimises research wastage by increasing the cross-comparison and meta-analysis of study findings.

Objective
The primary objective was to collate and describe the current process of developing core outcome sets and common data elements in published research pertaining to clinical neurosciences. The secondary objective was to identify the clinical neuroscience subspecialties that have developed COS and CDEs, the countries of origin of authors, and the process through which COS and CDEs were developed.

Design
A search between 2000-2020 of the top 40 Impact Factor neurosurgical and neurological journals was conducted. A scoping review was performed in accordance with the PRISMA-ScR Checklist.

Results
Our search returned 169 papers, of which 35 were eligible for inclusion in the present study. The USA published the majority of papers (20/35). The papers mostly related to neurosurgery (30/35), with the most common neurosurgical sub-specialty being traumatic brain injury (14/35) and subarachnoid haemorrhage (10/35). There is an increasing publication trend over time, with 12 papers published in 2019. COS and CDE development is an international collaborative process, with authors from a number of different countries. Five papers were systematic reviews conducting with the intention of COS/CDE development. 27 papers reported CDE development and 2 papers reported COS development (aphasia and non-specific low back pain). The COS development papers utilised international consensus meetings and adhered to international development statements.

Conclusions
COS and CDEs are an essential research tool to reduce research wastage and ultimately improve patient outcomes through homogenous outcome reporting, aligned with patient-derived outcomes. COS and CDEs are increasingly being developed within clinical neurosciences.
P123 The effect of having volunteers and face masks present at hospital entrances on the wearing of face masks and hand washing
Authors: Stanier Paul B , Lochab Savneet K , Grice John E , Stanier Paul B 
Published: April 2021

Abstract

Background
The spread of COVID-19 has put inpatients lives at risk and increased stress on hospital. Simple, cost effective measures such as mask wearing and hand hygiene have been shown to reduce the spread of droplet borne viruses. Compliance with these measures is variable and when performed improperly, reduce efficacy.

Objective
In this paper we aim to determine whether the provision of masks at hospital entrances and the use of volunteers to ensure correct mask wearing and hand hygiene can improve compliance with infection prevention measures for COVID-19.

Method
Visitor and staff compliance with mask wearing and hand hygiene measures were observed with and without the presence of masks and volunteers at hospital entrances at a District General Hospital.

Results
A total of 519 people were observed entering the hospital. Mask wearing went from 71% to 99% (P = &lt;0.001) with the addition of volunteers. Provision of masks increased mask wearing from 56% to 97% (P = &lt;0.001). Hand hygiene was improved from 9% to 84% (P = &lt;0.001) with the presence of volunteers.

Discussion
A statistically significant improvement in hand hygiene and correct mask wearing was seen with both the presence of volunteers at hospital entrances and with the provision of masks. This is a relatively small study with heterogenous cohorts of staff and visitors. However, these results appear to indicate that use of volunteers and provision of masks at entrances may improve the compliance with the measures that been shown to reduce the in-hospital transmission of COVID-19.
P130 Timing of nasogastric tube insertion and risk of postoperative pneumonia: international, prospective cohort study
Authors:   EuroSurg Collaborative,   EuroSurg Collaborative
Published: April 2021

Abstract

Introduction
This study aims to assess whether Prophylactic NGT insertion was associated with reduced rates of pneumonia, in comparison to Reactive NGT after colorectal surgery.

Methods
Pre-planned secondary analysis of a multicentre, prospective cohort study. Patients undergoing elective colorectal surgery between January and April 2018 were included. Those receiving NGT were divided into three groups, based on the timing of the placement: Routine (at the time of surgery); Prophylactic (after surgery, before vomiting); and Reactive (after surgery, after vomiting).
Pneumonia within 30 postoperative days was considered as primary outcome measure and it was compared between the three groups using multivariable regression analysis.

Results
4,715 patients were included in the analysis. 1,536 (32.6%) received an NGT corresponding to 926 (60.3%) Routine, 461 (30%) Reactive and 149 (9.7%) Prophylactic. 200 patients (4.2%) developed pneumonia (No NGT: 2.7%; Routine NGT: 5.2%; Reactive NGT: 10.6%; Prophylactic NGT: 11.4%). After adjustment for confounding factors, no significant difference in pneumonia rates was detected between the Prophylactic and Reactive NGT groups (OR: 1.03, 95% CI: 0.56 – 1.87, p = 0.932).

Conclusion
In patients who required NGT insertion after surgery, prophylactic insertion was not associated with fewer cases of pneumonia within 30 days of surgery in comparison to reactive insertion.
P137 Virtual support for the newly formed stoma
Authors: Wright Francesca , Alford Natasha , McDonald Sophie , Okocha Michael 
Published: April 2021

Abstract

Background
214 stomas were created between January 2019 and January 2020 at our Tertiary Colorectal Centre. We surveyed patients to identify desirable features for a mobile stoma support application to mitigate potential challenges of limited in-person review.

Objective
The aim is three-fold: To survey stoma patients, identify literature on mobile applications supporting stoma patients and evaluate available stoma support applications.

Methods
A survey of 60 newly formed stoma patients focused on mobile application support. A systematic search, following the PRISMA checklist, determined the use of mobile applications in supporting stoma patients. A comprehensive search of mobile applications on IOS and Android stores was performed.

Results
79% of patients under 70 years old, and 58% of patients over 70, were interested in using a mobile application. 45 patients wanted an application that could photograph their output. Output and soft tissue management were the most cited reasons for contacting the stoma care nurse. The literature search yielded 196 publications; 4 studies met the eligibility criteria. One study found self-efficacy of stoma care improved after the app-based intervention. One stoma mobile application met the inclusion criteria: ‘Ostobuddy osto companion’; features include measurement of output volume, photography and diary keeping. 21 fluid intake applications included features to customise water input and record fluid history.

Conclusion
Mobile applications can ease strain on services whilst improving care. This study indicates, a mobile application including a stoma output diary and photography would be well received by patients and could improve self-efficacy and care of the stoma.
P138 What are medical students’ perceptions of human factors in simulated learning events: a thematic analysis
Authors: Tebbett Alex , Jennings Jo , Bannon Chris , Brown Mike , Khan Qasim , Shuker Ben , Shanmugam Rathinavel , Ranganathan Mohan 
Published: April 2021

Abstract

Introduction
Human factors, such as communication skills, are imperative to good patient care. In post-simulation debriefs we discuss these non-technical skills with medical students regularly, but do we have a good appreciation of what the terms mean to them, or what aspects of behaviour, good or bad, they focus on?

Method
Six human-factor sheets were developed to guide the students in their analysis of events in simulated scenarios. The sheets focused on one of: communication, teamwork, decision making, task management, situational awareness, or a final overview. A brief introduction to each factor was given as well as examples of good practice. The students were encouraged to record in writing what aspects of the scenario went well, and what could be improved, for a chosen skill. These sheets were then collected at the end of the session, with the students’ consent, for anonymous analysis. Data collection commenced last month and will run until December, with an estimated inclusion of about 100 students from two universities. The data will be analysed using thematic analysis performed by multiple researchers.

Discussion
If we can understand what aspects of these non-technical skills are considered important to our students early on in their career we can better tailor our teaching, both in simulation and in the clinical environment, to foster better performance throughout their training. By understanding what our students perceive, analyse, and internalise we can also reflect on our own practice and interactions to consider how we project as role models to our future colleagues.
P139 Women's Health Care during COVID-19
Authors: Rimmer Michael P , Al Wattar Bassel A , Barlow Catriona , Black Naomi , Carpenter Ciara , Conti-Ramsden Frances , Dalton John A W , Davies Rhianna , Davies Rebecca , Dunlop Cheryl , Guyett Elvena , Jamison Laura , Karavadra Babu , Kasaven Lorraine , Lattey Katherine , Long Emma , Macmahon Caroline , Navaratnam Kate , Nijjar Simrit , O’Brien Stephen , Ojukwu Obi , Parnell Laura , Raglan Olivia , Ramcharn Meera , Riches Jenny , Stocker Linden Jane , Wong Siew Chee , Wyeth Charlotte 
Published: April 2021

Abstract

Introduction
The coronavirus disease 2019 (COVID-19) pandemic is disrupting health services worldwide. Women's health care is often acute and in continual demand, with poor health outcomes seen in women's health in particular in the recent Ebola and Swine flu epidemics. Regrettably, early reports globally and in the UK have shown a rise in the stillbirth rate. We aimed to evaluate the provision of obstetrics and gynaecology services in the UK during the acute phase of the COVID-19 pandemic.

Methods
We undertook an interview-based national survey of junior doctors in obstetrics and gynaecology in women’s healthcare units in the National Health Service using the network of the UK Audit and Research Collaborative in Obstetrics and Gynaecology. We sought responses on general training, labour ward care, antenatal and postnatal care, benign gynaecology and gynaecology oncology services.

Results
We received responses from 148/155 units (95%) contacted. Most completed speciﬁc training drills for managing obstetric and gynaecological emergencies (89/148, 60.1%) and two-person donning and dofﬁng of personal protective Equipment (PPE) (96/148, 64.9%). The majority of surveyed units implemented COVID-19-speciﬁc protocols (130/148, 87.8%), offered adequate PPE (135/148, 91.2%) and operated dedicated COVID-19 emergency theatres (105/148,70.8%). Most units suspended elective gynaecology services (131/148, 88.5%). The 2-week referral pathway for oncological gynaecology was not affected in half of the units (76/148,51.4%), but half reported a planned reduction in oncology surgery (82/148, 55.4%)

Discussion
Women's health care services have responded well to the acute phase of the COVID-19 pandemic, however further planning is required for the long term.
V12 VIRTUAL: Virtual InteRacTive sUrgicAl skiLls classroom – A Randomized Controlled Trial Proposal
Authors: Nathan Arjun , Fricker Monty , Hanna Nancy , Asif Aqua , Patel Sonam , Georgi Maria , Hang Kien , Sinha Amil , Mullins Will , Lamb Benjamin , Sridhar Ashwin , Kelly John , Collins Justin 
Published: April 2021

Abstract

Introduction
High costs and inaccessibility are significant barriers to face-to-face basic surgical skills (BSS) training. Virtual classrooms enable the combination of computer-based learning with interactive expert instruction and feedback. They may optimise resources and increase accessibility, facilitating larger-scale training whilst producing a similar educational benefit. We aim to evaluate the efficacy of virtual BSS classroom training compared to both non-interactive video and face-to-face teaching.

Method
72 medical students will be randomly assigned to three equal intervention groups based on year group and surgical skill confidence. Interventions will be implemented following an instructional video. Group A will practice independently, Group B will receive face-to-face training, and Group C will receive virtual classroom training. The assessed task will be to place three interrupted sutures with hand tied knots. Pre- and post-intervention Objective Structured Assessment of Technical Skills (OSATS) will be blind marked by two experts. Change in confidence, time to completion and a granular performance score will be measured. Feasibility and accessibility will also be assessed.

Results
Significant improvement in OSATS within groups will be indicative of intervention quality. Difference in improvement between groups will determine relative performance.

Conclusion
To our knowledge, this will be the largest randomised control trial investigating virtual BSS classroom training. It will serve as a comprehensive appraisal of the suitability of virtual BSS classroom training as an alternative to face-to-face training. The findings will assist the development and implementation of further resource-efficient virtual BSS training programs during the COVID-19 pandemic and in the future.