Reflexology session and ex-patient interview

Just a quick note today.  This morning I had my first reflexology session whilst hooked up to a machine.  I was able to take a video of myself being hooked up to the ecg machine, so I will be posting this soon.  I also have the follow up session this friday.

In the afternoon I interviewed an ex-patient who recently underwent  a Minimally Invasive Mitravalve Repair Procedure.  She was originally diagnosed with her heart condition five years ago, so she has had a lot of experience over the past few years with tests involving ecg machines.  We talked about a variety of variables and drew some sketches to get an idea for improving the condition of the wires belonging to the ecg machine.  I will be posting the interview soon in video or transcript format, with highlights of the conversation, very soon.

Endoscopy department

I have been in contact with an endoscopy department and will be discussing with their endoscopy/day surgery manager how I can begin my research into this department, how much access I can achieve etc.

I will have an update for this on or after the 26th October as the day surgery manager is currently on holiday.

Participation in Reflexology Study

I have been asked to participate in a study into the possible effects of reflexology on a patient admitted to the cardio respiratory department of a hospital.  As a participant I will be hooked up to an ECG machine, giving me invaluable first hand experience of what it is like to be connected to one of these machines.

Reflexology is a complimentary treatment where a therapist will apply pressure to my feet.  The ECG machine will measure any and all physiological responses during the treatment.

This is phase one of a much larger investigation and it will be interesting to find out what these initial results yield.

I am told that a large number of doctors have dismissed reflexology with little to no scientific evidence.  Even if through this study reflexology is scientifically proven not to have any actual effect upon the condition of the patient, the possible placebo effect that could be derived from this study could prove invaluable to the condition of the patient.

A large number of people have described the reflexology treatment as a very relaxing experience.  That experience alone could prove very useful during the treatment of a patient.  It could among other things relax feelings of anxiety during what could be a particularly troubling time for a patient. 

This will be happening in the following week.

Cardio Respiratory Department visit

Yesterday was my first introduction to an ecg department.  Before the tour of the department I signed a disclosure agreement from the NHS Code of Practice on Protecting Patient Confidentiality.  Basically if I wish to involve patients with this research I have to gain their consent. On the tour I was introduced to a number of interesting areas from the waiting area to the preparation room and even the 'brew' room where members of staff (maybe even patients, I'll have to ask) can enjoy a cup of tea.

The waiting area was interesting from a patient point of view as I had to sit and wait to be seen.  As with most waiting areas that I have visited from dentists to doctors, the atmosphere was very quiet.  There was a number of basic chairs in an L shape around the room.  The ecg department recently moved to a newly furnished part of the building, so the chairs and carpets appeared to be in good condition.  As mentioned before the atmosphere appeared to be a little stifled, with whispered conversations.  For children there was only a couple of toys to play with and for adults there was information on procedures and pace makers. The information I collected was presented in what appeared to be a white grill.  I will be reading what I collected in order to gain an insight into how information is presented to the patient, both adults and children.

I was then invited into the office of one of the senior members of staff which is shared between two.  Although not the focus of this project, it may be interesting to investigate how they feel about sharing an office what are it's pros and cons?

We then moved onto one of the preparation rooms where the problem of tangled cables I had previously discussed with my guide was brought up.

When my guide detangled the cables it was clear how frustrating and time consuming the process of detangling these cables can be.  In the top image you can see there is a small space where cables should be ideally stored, however it is a very cramped space.  I can imagine, as you do with anything new and electrical that you buy for your house that the cables were neatly packed when it first arrived from the factory, but unfortunately you are left with no real practical storing options.  I was told that these machines sometimes don't even come with a storage compartment, and they are unfortunately left to dangle.  They are cleansed before and after each use.

This is one of the main complaints from the majority of the Cardio Respiratory department, where to and how to store the ecg cables.

More information from this tour will be added in the following days.

Hospital standards in relation to colonoscopy throughout Scotland

http://living.scotsman.com/health/Poor-hospital-standards-39putting-thousands.6550821.jp?articlepage=2

Discovered this recent article in the Scotsman online which mentions the level of dignity the patient maintains waiting for and during the colonoscopy procedure.  I am currently organising a research trip to a day case unit (as well as the ECG department) and will hopefully receive word from them at the beginning of next week.

Poor hospital standards 'putting thousands at risk

Published Date: 26 September 2010

By Kate Foster

THOUSANDS of patients undergoing hospital tests are at risk from poor hygiene and understaffed wards, a damning investigation has revealed.

A report by Scotland's hospital watchdog has found "breaches" in the adequate decontamination of equipment and patients being treated on understaffed, overcrowded units.

The inspection examined hospital units across the country carrying out endoscopies, diagnostic tests which tens of thousands of Scots undergo every year.

The tests help diagnose conditions including cancer, stomach ulcers and bowel disease. But services at a number of hospitals in Aberdeen, Inverness, Glasgow and Kirkcaldy have been heavily criticised by NHS Quality Improvement Scotland. In categories including clinical safety and patient dignity, some of the hospitals were found to be operating "minimum acceptable standards."

Inspectors found a catalogue of problems, including staff failing to sterilise equipment properly and follow infection control standards. Patients were being treated on understaffed and "cluttered" mixed-sex units, with some forced to wait in corridors.

Patients' groups condemned the findings and warned that pressure on officials to meet government waiting time targets meant patients were being treated "like cattle."

Doctors carry out endoscopies using a flexible tube with a camera which is passed into the gut or bowel to help diagnose or even treat a number of health problems. Patients are either sedated or given a local anaesthetic for the procedure, which is usually treated as a day case in hospital.

Health boards must now ensure patients wait no longer than six weeks for the tests. But at Aberdeen Royal Infirmary, inspectors found "inadequate staffing" with patients who had been sedated left without supervision. Staff were so scarce, their report said, it "raised concerns for patient safety."

They also found "multiple deficiencies" in the way staff at Aberdeen were decontaminating equipment, raising safety concerns about infection risk.

Patients who had been undressed for the procedure were kept in mixed sex areas, which was also criticised.

The unit at Ninewells, Dundee had "excellent" decontamination facilities, a report said, but staff failed to follow basic procedures such as handwashing. Patients were put into mixed-sex recovery areas and the unit was understaffed.

Inspectors said the endoscopy unit at Raigmore Hospital in Inverness was meeting waiting time targets but warned that staff "posed an infection control risk" by failing to wear scrubs (sterilised clothing) during procedures. Their report also found a lack of trained staff and sedatives being prepared by junior staff.

Victoria Hospital, Kirkcaldy, was described by inspectors as "well performing" but noted "significant breaches" in decontamination practice.

It warned that some of the facilities were not up to scratch, "posing an infection control risk."

Stobhill Hospital in Glasgow was praised for its "superb" new facility and decontamination procedures but said the dignity and privacy of patients c

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ould be improved to make it a better experience for patients.

Although the endoscopy service at the Western Isles Hospital, Stornoway, was of a "high quality, " patient dignity and privacy was being compromised by long journeys through the hospital and by patients having to wait in main corridors.

Jan Warner, director of patient safety and performance assessment for NHS Quality Improvement Scotland, said: "We found staff to be hard-working and motivated to provide a good quality of endoscopy service within the hospitals we reviewed.

"We also found areas of concern, largely surrounding decontamination, training and the use of equipment. We have highlighted what we believe the NHS boards concerned need to do to improve their services, and we are satisfied that the hospitals are taking appropriate steps to make the necessary improvements."

But Dr Jean Turner, executive director of the Scotland Patients' Association said last night: "This is dreadful. People are being treated like cattle. This points to people being processed and that's what happens when you have waiting time targets."

Dr Alan Robertson, Scottish council member of the British Medical Association said: "Decontamination standards are set for a reason. Waiting targets will put pressure on hospitals because there is a limited number of staff and rooms but you have to get the balance right."

Health boards said that following the inspections action plans were in place to improve areas which had come in for criticism.