ProNurse

Patients could find themselves face-to-face with a robot in hospital

By John Duckers

Patients could find themselves face-to-face with a robot in hospital, Lord Bhattacharyya suggested yesterday. 

The peer, head of the Warwick Manufacturing Group and adviser to the Government, said it could allow more people to concentrate on treatment and care. 

He outlined how new energy sources, improved energy efficiency and a revolution in car technology could help prevent conflict. 

The effects of increased energy demand were not just being reflected in higher oil prices, but in the war in Georgia, the debate over Iran's nuclear programme, and in the politics of the Middle East, he told his audience. 

Lord Bhattacharyya stated: "At WMG we are developing plans for a major technology demonstrator project that will bring together global automotive leaders with research scientists and parts suppliers to look at every aspect of low carbon automotive design. 

"This project will become more important as demand for energy becomes one of the defining features of our global environment. 

"Many of these social conflicts are ripples caused by the need for economies to secure their energy future. 

"So if we can find ways of managing demand more effectively the long term consequences will not just be less polluting cars or more efficient factories, but a less dangerous world. 

"The more scientific solutions we apply, the less pressure on resources there will be, and the lower the risk of human conflict." 

Lord Bhattacharyya gave details of how WMG was looking to revolutionise healthcare - an area it has only moved in to recently. He said: "The fundamental challenge for hospital managers is to maximise the effective utilisation of costly healthcare equipment and optimise the throughput of patients. 

"Consider the problem of ensuring patients are in the right place in hospital for their treatment at the right time, a logistical issue that currently consumes the time of nurses, doctors and hospital porters. 

"We are researching systems where patients manage their own movement around a hospital with robotic guidance. This frees up human resources to focus on treatment and care." 

Factory processes, he said, could be adapted for hospitals. 

"In one application we found that a typical blood test sample was looked at by 21 different people, each time introducing a risk of error and time and cost spent. In another we applied the type of simulation modelling used in laying out new factories to look at the flow of patients in an emergency department. 

"Applying these principles meant we were able to provide exactly the right number of doctors and nurses to meet patient demand." 

The peer said global partnerships were needed between institutions if such advances were to be made, adding: "India can be a test bed for some of the things we are doing." 

He highlighted the pressures on manufacturers as they sought to balance the need for economic growth with impact on the environment. "We know we will need more energy to ensure economies grow. We also know the energy we produce has an unacceptable impact. 

"That tension creates a double role for scientists. First we need to develop ways of maximising energy efficiency. Second, we need to find new sources of energy." 

New emission standards for the likes of carbon, particulates and nitrous oxide were placing tough challenges on car makers. 

He sa id WMG was looking at low carbon vehicles "from the bottom up" which included the total redesign of cars and said WMG had been able to demonstrate how a wide range of natural origin plant-based materials could replace oil-based plastics, using, for example, cashew nut shells and starch from potatoes. 

Lord Bhattacharyya said: "These have been brought together in a racing car platform. 

"This year we will be racing a Formula 3 car built from natural origin materials and running on biofuels."

(c) 2008 Birmingham Post; Birmingham (UK). Provided by ProQuest LLC. All rights Reserved.

Call for Ban on Superbug Gels in Hospitals

By Jeremy Watson; Kate Foster

ONE of Scotland's most senior doctors has called for alcohol gel hand-rubs to be removed from hospitals because they are ineffective against the deadly C diff superbug. 

Alcohol hand-rub dispensers have been placed in wards and clinical areas throughout the country at a cost of more than GBP 1m, largely to combat another superbug, MRSA. However, they do not provide a defence against C diff, which has killed hundreds of patients in Scotland in recent years. 

But Dr Charles Saunders, head of the British Medical Association's Consultants' Committee in Scotland, said most doctors, nurses and other healthcare professionals are unaware that the gels were ineffective and they must wash their hands with soap and water between dealing with each patient. 

He said the dispensers should be scrapped because they are causing confusion about the best method of infection control. 

However, the Scottish Government has insisted that the dispensers - introduced to most hospital bedsides over the past three years - will remain on wards as part of the strategy against hospital- acquired infections. 

Lack of knowledge among healthcare staff about the ineffectiveness of the gels may be one of the reasons for Scotland's appalling C diff figures. It was cited this month as being among the factors behind the outbreak which killed 18 patients at the Vale of Leven hospital in West Dunbartonshire earlier this year. 

Saunders said: "In terms of preventing the spread of infection, the most important and effective method is hand-washing, whatever the organism. People should be washing their hands after touching each patient. The problem is that some hospitals do not have adequate facilities for handwashing, which is one of the issues highlighted in the report into Vale of Leven." 

The gels, designed to remove potentially harmful bugs from the skin surface, had become a substitute. "Staff have been told that they could use alcohol gel instead of washing their hands," said Saunders. "That is not a good message to give people. They should be told they should wash their hands, but a lot of wards have dispensers when they should have more hand-basins. 

"What would make sense would be for hospitals to remove the dispensers and replace them with adequate hand-washing facilities in wards and clinical areas." 

Studies have shown that the gels are effective against MRSA but cannot tackle C diff, which forms tough spores highly resistant to damage. 

Asked if staff were aware that the gels were ineffective against C diff, Saunders replied: "By and large, no. I suspect it's because staff have been told that they can use alcohol gel rather than washing their hands and they have come to the conclusion that they are being told that because it is effective." 

The previous Labour-Lib Dem Executive allocated more than GBP 1m to the NHS in Scotland in 2005 to help hospital managers install alcohol gel dispensers beside each bed. 

A spokeswoman for the Scottish Government said studies have proved that alcohol hand gels were "very effective at disinfecting hands and killing a whole host of bugs and germs". 

She added: "Hand gel provides healthcare workers with a quick method of decontaminating their hands between healthcare interventions and facilitates higher levels of compliance with hand hygiene." 

She acknowledged that the gels were less effective against C diff. However, the Government had no intention of removing the dispensers. "It is important that staff, patients and visitors not only wash their hands with soap and water but combine this practice with the use of alcohol-based hand gels," she said. 

Labour's health spokesman, Richard Simpson, said he would not support the removal of the dispensers because of their role in tackling MRSA. However, he said ministers must make sure that staff comply with targets that stipulate that they must hand-wash at least 90 per cent of the time when moving from patient to patient. 

The investigation into the Vale of Leven outbreak fou nd staff did not know that soap and water, rather than alcohol gel, were required to prevent the spread of C diff. Although there were plans to upgrade hand-washing facilities, investigators heard the work was expected to take 20 weeks to complete. 

On the internet www.cdiff-support.co.uk

(c) 2008 Scotland on Sunday. Provided by ProQuest LLC. All rights Reserved. −

Home Olympians are risking their Health by Going for Gold

A gadget helpline firm has reported a big increase in calls from people who want to use their home gym equipment to keep up with the Olympic athletes they are watching on the TV.

The BBC reports that the Gadget Helpline, that is designed to help people who are having problems with their phones or ipods, has received around 50 calls from the start of the Olympics from people wanting to know how to set their home gym equipment to Olympic levels. One man claimed that he had broken his rowing machine while trying to keep up with the British rowers.

Ben Titchmarsh from Gadget Helpine is quoted as saying:

"One woman said she really wanted to set her rowing machine so she could do the same number of strokes per minute as the Olympic athletes.”

"Another caller wanted to adjust his exercise bike so he was cycling at the same number of miles per hour as the Olympians.

"And even though the track and field events hadn't yet started, people were also asking about settings for their jogging machines.

"With rowing and cycling machines, if you can't keep up you'll just go slowly. But with jogging machines, if you set them to the pinnacle of what it's capable of doing and you can't keep up, it could be dangerous."

Home Olympians are being reminded that the athletes have been training for many years to reach their level of fitness and ability and that anyone who is interested in boosting their sporting performance should set themselves reasonable short term goals instead of aiming to emulate their heroes.

NHS 24 Monkey Business

A woman who was bitten by a monkey in Thailand was among a record 1.5million callers to NHS 24 last year.

The primate sank its teeth into the honeymooner as she posed for a photograph.

Instead of going to hospital, she rang the helpline for advice on what to do.

Nurses advised her to get a rabies shot as a precaution.

NHS 24's annual review in Glasgow yesterday revealed that 99 per cent of urgent calls received a response within 20 minutes last year.

Health secretary Nicola Sturgeon ordered a progress report by November on efforts to cut staff absence levels.

Last December, helpline bosses were told to come up with plans to reduce sick days to six per cent by March 2009.

Levels ran above the target rate last year - 8.59 per cent in November and December.

But recent levels showed an improvement - 6.12 per cent in May, 5.97 per cent in June and 5.79 per cent in July.

Sturgeon said: "There is evidence of progress but much work still needs to be done."

(c) 2008 Daily Record; Glasgow (UK). Provided by ProQuest LLC. All rights Reserved. 

Hour and a Half Workout 'is Only Way to Beat Flab'

Scotland on Sunday

10 August 2008

By Kate Foster

IT has been revered as the perfect way to keep healthy and stay in shape. 

But the traditional 30-minute-a-day exercise target is insufficient and overweight Scots will need a daily 90-minute workout to stand any chance of fighting the flab, according to new public health guidance. 

The advice, which GPs and nurses are to pass on to NHS patients, also warns that light housework such as cleaning or dusting, or strolling round the supermarket, must not be counted in the daily exercise regime. 

Instead, only "moderate" or "vigorous" activity such as brisk walking, running, swimming and heavy domestic chores like vacuuming, mowing the lawn or painting and decorating count. 

And as part of their weekly regime all adults should perform two sessions of weight training exercises. 

The updated guidance on exercise targets has been published by the Scottish Government's public health advisory body NHS Health Scotland. The recommended levels of physical activity have been renewed with ambitious new targets following a recent change in international guidelines. 

The guidance is being sent out to GPs, practice nurses, health visitors and pharmacists so they can advise members of the public on how to incorporate exercise into their daily lives as part of the NHS drive to reduce the nation's soaring obesity problem. 

But though it has been welcomed by some experts, others have dismissed it as "dictatorial and inappropriate", and unrealistic for many busy professionals. The guidance document, 'Energising Lives', states that NHS staff must make physical activity a "higher priority", with 60 per cent of men and 70 per cent of women not thought to be taking enough exercise. 

It sets out a number of tips that staff can offer to patients. It adds: "You should do at least 30 minutes of moderate-intensity physical activity, above usual activity at work or home, on at least five days of the week. If you are already overweight or obese, then you should aim to do between 60 and 90 minutes on five days of the week." 

Approved activities according to the guidance include brisk walking, running, badminton and cycling as well as heavier household and gardening chores such as mowing the lawn and vacuuming. 

However, many ordinary activities of "light intensity" such as office work, shopping or cooking do not count towards the daily target. Nor does anything that takes less than 10 minutes, such as taking out the rubbish. 

It adds that weight training or stair climbing should be included twice a week and that a range of activities should be aimed for to improve stamina, strength, flexibility and balance. 

Last night a spokeswoman for NHS Health Scotland said the document was based on recently updated, internationally recognised guidelines produced by the American College of Sports Medicine in Indianapolis. 

She added: "NHS primary care staff felt there was a need for a guide that had appropriate advice for patients. This really spells out what type of exercise to do and making it relate to people's lives. People can interpret it in different ways so this gives examples of what staff can tell patients to do. This is about how to put it into practice. 

"It's up to the discretion of the GP or nurse how they use this information. It's not about going to the gym but doing things like gardening to benefit health." 

A spokeswoman for the British Medical Association said: "This has to operate in tandem with advice, support and education on healthy eating and making sensible lifestyle choices. In order to make a significant impact on the weight of individuals there has to be a commitment to do as much exercise as possible. 

"If somebody is suffering from the medical consequences of being obese or overweight, they may be at risk of chronic heart disease, stroke or have high blood pressure but if they lose weight they are more likely to reduce their health risks. So it may be appropriate to raise the potential for exercise with the patient. That's a discussion that has to take plac e between the GP and the patient." 

Margaret Watt, chairwoman of the Scotland Patients' Association, described the move as "a step in the right direction". However, she warned it would not work unless people were sufficiently motivated. She added: "It's a personal responsibility and people will not be helped unless they want to help themselves." 

But Edinburgh-based personal trainer Tracy Griffen said most members of the public would find it far too difficult to meet the targets. She said: "Most people who have not exercised before would struggle even to walk for 90 minutes a day, let alone do weight training. 

"What I generally recommend to my clients is 30minutes three times a week. That's based on what's practical for them. A lot of people work from 8am to 6pm. To tell them that they need to do an extra hour and a half of exercising will put people off. I think if I was an obese person I would be quite disheartened." 

Scottish Conservative health spokeswoman Mary Scanlon said: "It is somewhat dictatorial and inappropriate for many people. It would be far better to make small changes to your lifestyle."

(c) 2008 Scotland on Sunday. Provided by ProQuest Information and Learning. All rights Reserved.

Medical Accronyms that may be useful for nurses: V-Z

VF  ventricular fibrillation
VQ  ventilation quotient
VFM  value for money
VT  ventricular tachycardia

WBC  white blood cells
WCH  Wales Centre for Health
WDC  workforce development confederation
WHO  World Health Organisation
WIsH  Welsh Innovations in Healthcare
WTD  working-time directive

Medical Accronyms that may be useful for nurses: T-U

Tachy  tachycardia
TB  tuberculosis
TDS  three times a day
THR  total hip replacement
TIA  trans ischaemic attack
TKR  total knee replacement
TPN  total parietal nutrition
TV  tissue viability

U&E  urea & electrolysis
URTI  upper respiratory track infection
US  ultra sound
UTI  urinary track infection

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Medical Accronyms that may be useful for nurses: S

SACDA  Scottish Advisory Committee on Distinction Awards
SARS  severe acute respiratory syndrome
SAS  Scottish Ambulance Service
SASM  Scottish Audit of Surgical Mortality
SB  sinus bradycardia
SC  subcutaneous
SCBU  special care baby unit
SCVO  Scottish Council for Voluntary Organisations
SEHD  Scottish Executive Health Department
SEU  Social Exclusion Unit
SFA  statement of fees and allowances
SHA  strategic health authority; special health authority
SHARE  Scottish health authorities revenue equalisation
SHO  senior house officer
SHRINE  Strategic Human Resources Information Network
SIGN  Scottish Intercollegiate Guidelines Network
SL  sublingual
SLA  service level agreement
SMAC  Standing Medical Advisory Committee
SMR  standardised mortality ratio
SN  stall nurse
SNMAC  Standing Nursing and Midwifery Advisory Committee
SNOMED  systematised nomenclature of medicine
SOB  short of breath
SRB  single regeneration budget
SSA  standard spending assessment
SSC  shared service centre
SSI  Social Services Inspectorate
SR  Sister
SR  sinus rhythm
ST  sinus tachycardia
ST  speech therapist
STN student nurse
STAT  immediately
SURG surgical
SVT  supra ventricular tachycardia
SW  social worker

Medical Accronyms that may be useful for nurses: Q-R

QA  quality assurance
QALY  quality-adjusted life year
QDS four times a day
QMAS  quality management and analysis system

RA  rheumatoid arthritis
RAWP  resource allocation working party
RBBB  right bundle branch block
RBC  red blood cells
RCM Royal College of Midwives
RCN  Royal College of Nursing
RCP  Royal College of Physicians
RCPE  Royal College of Physicians of Edinburgh
RCPSG  Royal College of Physicians and Surgeons of Glasgow
RCS  Royal College of Surgeons
RCSE  Royal College of Surgeons of Edinburgh
RCT  randomised controlled trial
REG  Registrar
RIF  right iliac fossa
RGN  registered general nurse
RN  registered nurse
RTA  road traffic accident
RVF  right ventricular failure