- Email: [email protected]
Determining the frequency of repeat chest radiographs to establish NG tube position when no aspirate is obtainable – A retrospective study
Free poster abstracts numbered P1 - P255 / British Journal of Oral and Maxillofacial Surgery 54 (2016) e66–e153
Although there are very few official sanctioned links between Universities where trainees undertake their second degree and local units, there is a trend towards second-degree students covering the night on-call rota. This does have financial benefits - a normal (unbanded) hourly wage for a night shift maxillofacial SHO is between £15-18 an hour, with locum hourly rates varying between £30-45 and a theoretical cap of £67.43 per hour. However, much could be improved with regard to assessments and appraisal. There may even be an economic benefit to the NHS by undertaking parts of the curriculum during the second degree elective stage, particularly those areas where exposure rather than competence is required. This would further demonstrate commitment to the specialty. We will present the results of a survey to 6 Maxillofacial units regarding how many trainees undertaking their second degree cover the night on-call rota, and whether there are systems in place to offer training benefit as well as financial. Depending upon statistical requirements we may access further second-degree students through the junior training group. The aim of this project is to help guide the future training and recruitment in OMFS. http://dx.doi.org/10.1016/j.bjoms.2016.11.157 RP164 Oral and Maxillofacial Regional Specialty Professional Advisors (RSPA): a review of the collaboration between BAOMS and the Royal College of Surgeons of England Bhavin Visavadia ∗ , Robert Banks, Patrick Magennis British Association of Oral and Maxillofacial Surgeons Introduction: The Regional Specialty Professional Advisor role was an initiative between the Royal College of Surgeons of England and Specialty Associations. They were created to bridge a growing gap between the RCS and Consultants and Specialists with the existing structure in place. ? The Consultants and Specialists Group of BAOMS examine the role of RSPAs and their establishment within Oral and Maxillofacial Surgery across England, Wales and Northern Ireland. Methods: A survey of OMFS Regional Specialty Professional Advisors across the UK was performed. We examined the RSPA roles and their evolution and the range of duties undertaken across the board. We assessed the processes of job planning, achieving accurate job descriptions and attending Consultant Appointment panels in the regions. The group were particularly interested in the engagement of RSPAs in the changing NHS including the development of consultant posts within NHS Foundation Trusts. Results: The results of our survey will be presented examining the role of RSPAs in the development and appointment of New OMFS Consultants.
e121
We examined Job Planning variations and support for new consultants. We discussed seniority at appointment, support for sub-specialty interests and variations in PA/SPAs in the job plan. RSPA Support from Trusts and allocation of time and duties in job plans were analysed. Conclusions: The RSPA role is a key collaboration between the Specialty Associations and Royal College of Surgeons. With effective training, induction and support, the role could continue to be of greater local and regional importance for Consultants at all levels of their career. http://dx.doi.org/10.1016/j.bjoms.2016.11.158 P165 Determining the frequency of repeat chest radiographs to establish NG tube position when no aspirate is obtainable – A retrospective study Sally Al-Ali ∗ , Nicola Mahon, Gary Walton University Hospital Coventry and Warwickshire Introduction: Nasogastric tubes (NGT) are commonly used in head and neck surgery for the provision of nutritional requirements, fluids and medication. Following reported complications associated with incorrect placement, current practice advises the use of chest radiographs (CXR’s) to confirm correct tube positioning. However prior to each drug/feed administration if no acidic aspirate is obtained, repeat CXR’s are performed. This results in delays in the provision of medication/nutrition, increased radiation exposure and increased costs. The aim of this study was to determine the frequency of repeat CXR’s taken to confirm NGT position when no aspirate was obtained. Method: Patients who had NG tubes placed following head and neck surgery over 12 months were included in this study (n = 35). The frequency of repeat CXR’s, NGT position, and radiologist report availability were recorded. Results: 37% of patients had repeat CXR’s to confirm NGT position and 20% required >2 CXR’s. The highest number of radiographs per patient was 6 and only 7% were formally reported by a Radiologist. All radiographs confirmed the NGT had been in the correct position despite no aspirate. Conclusions: This study shows that 100% of NGT’s remained in the correct position regardless of aspirate production, and patients were unnecessarily subjected to repeat CXR’s. Currently, there is no nationally agreed hospital protocol on CXR indication after initial placement confirmation. Therefore, a national ethically approved multi-centre study may be indicated to evaluate the safety of proceeding with treatment when no aspirate is obtained, and create new national guidelines with a unified protocol. http://dx.doi.org/10.1016/j.bjoms.2016.11.159
Although there are very few official sanctioned links between Universities where trainees undertake their second degree and local units, there is a trend towards second-degree students covering the night on-call rota. This does have financial benefits - a normal (unbanded) hourly wage for a night shift maxillofacial SHO is between £15-18 an hour, with locum hourly rates varying between £30-45 and a theoretical cap of £67.43 per hour. However, much could be improved with regard to assessments and appraisal. There may even be an economic benefit to the NHS by undertaking parts of the curriculum during the second degree elective stage, particularly those areas where exposure rather than competence is required. This would further demonstrate commitment to the specialty. We will present the results of a survey to 6 Maxillofacial units regarding how many trainees undertaking their second degree cover the night on-call rota, and whether there are systems in place to offer training benefit as well as financial. Depending upon statistical requirements we may access further second-degree students through the junior training group. The aim of this project is to help guide the future training and recruitment in OMFS. http://dx.doi.org/10.1016/j.bjoms.2016.11.157 RP164 Oral and Maxillofacial Regional Specialty Professional Advisors (RSPA): a review of the collaboration between BAOMS and the Royal College of Surgeons of England Bhavin Visavadia ∗ , Robert Banks, Patrick Magennis British Association of Oral and Maxillofacial Surgeons Introduction: The Regional Specialty Professional Advisor role was an initiative between the Royal College of Surgeons of England and Specialty Associations. They were created to bridge a growing gap between the RCS and Consultants and Specialists with the existing structure in place. ? The Consultants and Specialists Group of BAOMS examine the role of RSPAs and their establishment within Oral and Maxillofacial Surgery across England, Wales and Northern Ireland. Methods: A survey of OMFS Regional Specialty Professional Advisors across the UK was performed. We examined the RSPA roles and their evolution and the range of duties undertaken across the board. We assessed the processes of job planning, achieving accurate job descriptions and attending Consultant Appointment panels in the regions. The group were particularly interested in the engagement of RSPAs in the changing NHS including the development of consultant posts within NHS Foundation Trusts. Results: The results of our survey will be presented examining the role of RSPAs in the development and appointment of New OMFS Consultants.
e121
We examined Job Planning variations and support for new consultants. We discussed seniority at appointment, support for sub-specialty interests and variations in PA/SPAs in the job plan. RSPA Support from Trusts and allocation of time and duties in job plans were analysed. Conclusions: The RSPA role is a key collaboration between the Specialty Associations and Royal College of Surgeons. With effective training, induction and support, the role could continue to be of greater local and regional importance for Consultants at all levels of their career. http://dx.doi.org/10.1016/j.bjoms.2016.11.158 P165 Determining the frequency of repeat chest radiographs to establish NG tube position when no aspirate is obtainable – A retrospective study Sally Al-Ali ∗ , Nicola Mahon, Gary Walton University Hospital Coventry and Warwickshire Introduction: Nasogastric tubes (NGT) are commonly used in head and neck surgery for the provision of nutritional requirements, fluids and medication. Following reported complications associated with incorrect placement, current practice advises the use of chest radiographs (CXR’s) to confirm correct tube positioning. However prior to each drug/feed administration if no acidic aspirate is obtained, repeat CXR’s are performed. This results in delays in the provision of medication/nutrition, increased radiation exposure and increased costs. The aim of this study was to determine the frequency of repeat CXR’s taken to confirm NGT position when no aspirate was obtained. Method: Patients who had NG tubes placed following head and neck surgery over 12 months were included in this study (n = 35). The frequency of repeat CXR’s, NGT position, and radiologist report availability were recorded. Results: 37% of patients had repeat CXR’s to confirm NGT position and 20% required >2 CXR’s. The highest number of radiographs per patient was 6 and only 7% were formally reported by a Radiologist. All radiographs confirmed the NGT had been in the correct position despite no aspirate. Conclusions: This study shows that 100% of NGT’s remained in the correct position regardless of aspirate production, and patients were unnecessarily subjected to repeat CXR’s. Currently, there is no nationally agreed hospital protocol on CXR indication after initial placement confirmation. Therefore, a national ethically approved multi-centre study may be indicated to evaluate the safety of proceeding with treatment when no aspirate is obtained, and create new national guidelines with a unified protocol. http://dx.doi.org/10.1016/j.bjoms.2016.11.159