Our thanks to Ciaran Friel of Liverpool Community Health NHS Trust for this news.
The Centre for Pharmacy Postgraduate Education (CPPE) has launched the Medicines Safety app. This is free and funded by Health Education North West. It offers short quizzes for any healthcare professional to test their knowledge on high-risk areas for medicines safety incidents. The topics so far include: Insulin, Allergies, Opioids, Anticoagulation and Medicines safety.
It stimulates further learning so it can be used to generate ideas for CPD portfolios and to improve practice. You can also use it in group learning situations as a starting point for discussion on key safety issues.
Download the app free of charge from the App Store for iPhone/iPad users and from Google Play Store for Android devices. More topics will be released soon.
KR Aryal, J Pereira – Indian Journal of Surgery, 2014
M White, JSG Wells, T Butterworth – International Journal of Nursing Studies, May 2014
Safety of short, in-hospital delays before surgery for acute appendicitis: Multicentre cohort study, systematic review, and meta-analysis
Citation: Annals of Surgery, May 2014, vol./is. 259/5(894-903), 0003-4932;1528-1140 (May 2014)
Author(s): Bhangu A.; Panagiotopoulou I.G.; Chatzizacharias N.; Rana M.; Rollins K.; Ejtehadi F.; Jha B.; Tan Y.W.; Fanous N.; Markides G.; Tan A.; Marshal C.; Akhtar S.; Mullassery D.; P. Szatmary (East Cheshire NHS Trust, Macclesfield);
OBJECTIVE: To determine safety of short in-hospital delays before appendicectomy. BACKGROUND: Short organizational delays before appendicectomy may safely improve provision of acute surgical services.
METHODS: The primary endpoint was the rate of complex appendicitis (perforation, gangrene, and/or abscess). The main explanatory variable was timing of surgery, using less than 12 hours from admission as the reference. The first part of this study analyzed primary data from a multicentre study on appendicectomy from 95 centers. The second part combined this data with a systematic review and meta-analysis of published data.
RESULTS: The cohort study included 2510 patients with acute appendicitis, of whom 812 (32.4%) had complex findings. Adjusted multivariable binary regression modelling showed that timing of operation was not related to risk of complex appendicitis [12-24 hours odds ratio (OR) 0.98 (P = 0.869); 24-48 hours OR 0.88 (P = 0.329); 48+ hours OR 0.82 (P = 0.317)]. However, after 48 hours, the risk of surgical site infection and 30-day adverse events both increased [adjusted ORs 2.24 (P = 0.039) and 1.71 (P = 0.024), respectively]. Meta-analysis of 11 nonrandomized studies (8858 patients) revealed that delay of 12 to 24 hours after admission did not increase the risk of complex appendicitis (OR 0.97, P = 0.750).
CONCLUSIONS: Short delays of less than 24 hours before appendicectomy were not associated with increased rates of complex pathology in selected patients. These organizational delays may aid service provision, but planned delay beyond this should be avoided. However, where optimal surgical systems allow for expeditious surgery, prompt appendicectomy will still aid fastest resolution of pain for the individual patient.
Copyright 2014 by Lippincott Williams & Wilkins.
Publication Type: Journal: Article
Full Text: Available from Ovid in Annals of Surgery