PIR HEALTHCARE MANAGEMENT the home of product information Issue Stylish

PIR HEALTHCARE MANAGEMENT ...the home of product information! Issue 18 Stylish Healthcare Furniture See Page 7 Specialist Steam Cleaning Equipment See Page 9 FEATURES INSIDE: Dry Mouth Page 3 The Care Show 25th & 26th October Page 2 Specialist Bathrooms Page 6 Relieving Pressure Ulcers Page 10 VISTAMATIC Vision Panels Discreet two-way monitoring Tel: 0208 5002 200 www.vistamatic.com See page 7 for more details www.pirnet.co.uk - for thousands of products, services and links Optimal Renal Care UK Ltd Positive Results for CKD Patients Introduction: The Disease Management Programme The burden of chronic kidney disease (CKD) is rising globally with epidemiological studies pointing to an increasing prevalence of early stage CKD among the population. The adverse outcomes of CKD such as kidney failure, cardio-vascular morbidity and premature death are major public health problems, which are rising referrals from all three PCTs of between two and three-fold Emergency Presentation: 2004/5 32% of patients presented within one month of dialysis; 2005/6 fell to 25% presenting within three months; in UK, 30-50% of patients present with less than three months of pre dialysis care Preservation of Renal Function: in 69% of patients, renal function either improved or there was a reduction in the rate of decline after five months in programme Resource Utilisation: substantially lower than historic controls at same stage of illness: outpatient attendances (-44%), inpatient stays (-58%), inpatient days (-63%) Human Touch: specialist nurses have provided patients with a very important contact available 24 hours a day, seven days a week for help, support, advice and to allay any fears and calm nerves. This service would not otherwise be available • • • • rapidly and which have the potential to become major drivers of cost in Primary Care Trusts in terms of unplanned emergency admissions to hospital. Optimal Renal Care UK, in partnership with West Lincolnshire Primary Care Trust, has implemented a nurse led, primary care based, multidisciplinary disease management programme for patients with chronic kidney disease.The programme is designed to facilitate the early detection of kidney disease and to offer rigorous systematic approaches to the treatment in response to clinical indicators. The pilot started in April 2005 and will run for 18 months prior to independent assessment by the School of Health and Related Research of Sheffield University (ScHARR). An interim report after 9 months has been examined by ScHARR and the data looks encouraging. How the Programme Works • Patients with CKD identified automatically through screening of laboratory tests on routine blood samples from patients in PCT • The basis: an abnormal GFR, estimate of kidney function • Results returned to referring clinician (usually GP) with a copy and patient details sent to Optimal, who confirms with GP that referral is appropriate • Patients receive a package of care depending on their risk stratification, which includes input from a dietitian, social worker and renal nurses where appropriate • Heart of the programme is computer based information management system, conforming to NHS net codes of connectivity Key Results to Date • Case Detection: in a 9 month period, 33,492 people received an eGFR calculated from blood test originating in primary care. Of the above figure the number of patients identified by the programme from primary care as having some form of CKD is approximately 11,915 • Referrals: of 454 patients identified from primary care, 353 have been enrolled into Optimal disease programme; roll-out of eGFR reporting to all of Lincolnshire has led to increase in nephrology Conclusion The programme will be completed in October 2006, followed by a full, robust analysis of the data. However, the trends seen to date are very positive and would suggest that they will continue in a similar vein for the remaining eight months. About Optimal Renal Care UK Optimal Renal Care UK is a member of the Fresenius Medical Care group of Companies, along with Fresenius Medical Care UK (the leading provider to the NHS of dialysis products) and Fresenius Medical Care Renal Services UK. Contact Details Optimal Renal Care UK Ltd PO Box 8422 Sutton-in-Ashfield, Nottinghamshire NG17 2WW Tel: 01623 445 184 Email:info@optimalrenalcareuk.com References EKNOYAN G, LEVEY AS, LEVIN NW, KEANE WF, 2001. The national epidemic of chronic kidney disease: what we know and what we can do. Post Rad Med, 110, 23-29. NIDD (National Institute of Diabetes & Digestive & Kidney Diseases), 2001. US Renal Data System (USRDS) annual report. Bethesda, Maryland, USA: NIDD. HSU C, CHERTOW G, CURHAN G, 2002. Methodological issues in studying the epidemiology of mild to moderate chronic renal insufficiency. Kidney International, 61, 1567-1576. COUCHOUD C, 1999. Screening early renal failure: cut off values for serum creatinine as an indicator of renal impairment. Kidney International, 55, 1878-1884. DEPARTMENT OF HEALTH, 2004. The National Service Framework for Renal Services, Part One: Dialysis and Transplantation. London: DH. http://www.dh.gov.uk/PublicationsAndStatistics/Publications/Publications PolicyAndGuidance/PublicationsPolicyAndGuidanceAr ticle/fs/en? CONTENT_ID=4070359&chk=ZX5LF3 DEPARTMENT OF HEALTH, 2005, The National Service Framework for Renal Services, Part Two: Chronic kidney disease, acute renal failure and end of life care. London: DH. http://www.dh.gov.uk/PublicationsAndStatistics/Publications/Publications PolicyAndGuidance/PublicationsPAmpGBrowsableDocument/fs/en?CO NTENT_ID=4102941&chk=aKHxDl RODERICK P, JONES C,TOMSON C, MASON J, 2002. Late referral for dialysis: improving the management of chronic renal disease. Q J Med, 95, 363-370. LEVIN A, 2001. Identification of patients and risk factors in chronic kidney disease - evaluating risk factors and therapeutic strategies. Nephrology Dialysis Transplantation, 16[Suppl 7], 57-60. MENDELSSOHN DC, 2005. Coping with the CKD epidemic: the promise ofmultidisciplinary team-based care. Nephrology Dialysis Transplantation, 20, 10-12. JUNGERS P, 2002. Late referral: loss of chance for the patient, loss of money for society. Nephrology Dialysis Transplantation, 17, 371-375. ST PETER WL, KHAN SS, EBBEN JP, PEREIRA BJG, COLLINS AJ, 2004. Chronic kidney disease: the distribution of health care dollars. Kidney International, 66, 313-321. NIDD (National Institute of Diabetes & Digestive & Kidney Diseases; also National Heart, Lung & Blood Institute), 2003. Workshop on cardiovascular disease in chronic kidney disease: options for intervention. Report of the Planning Committee. Bethesda, Maryland, USA: NIDD. BARRETT BJ, 2003. Applying multiple interventions in chronic kidney disease. Seminars in Dialysis, 16 (2), 157-164. MITKA M, 2004. Attacking host of risk factors is key to treating, preventing diabetic kidney disease. (Reprinted) JAMA, 291 (24), 2931-2. YEOH HH, TIQUIA HS, ABCAR AC, RASGON SA, IDROOS ML, DANESHVARI SF, 2003. Impact of predialysis care on clinical outcomes. Hemodialysis International, 7 (4), 338-341. Page 1 Care Show Comes To Birmingham Wave Exhibitions is in preparation for its fifth Care Show event, which will take place for the first time at the Birmingham National Exhibition Centre on 25-26th October 2006. 70 percent of all stand space has already been sold for the biannual business to business event, which is the only standalone exhibition for the care industry. The Birmingham Care Show will meet growing demand from businesses in the Midlands and surrounding regions for a forum that offers the latest industry knowledge and advice, whilst displaying the best innovations from across the sector. This demand is set to increase as the care sector expands, with official population projections suggesting an increase in demand for care home places of around 10,000 per annum across the UK over the next 15 years (source: Laing & Buisson 2005). Lorne Cheetham, director of Wave Exhibitions said, “The sector is a huge growth area and the Care Show reflects this with an average 11 percent increase in visitor numbers year on year. “The exhibition has now been established for three years and has become the place for thousands of healthcare professionals and care home operators to be inspired, to learn, to network and gain new business contacts. The event is also thought to have an 89 percent share of the annual care home exhibition stand revenue for the sector.” The event, sponsored by The Royal Bank of Scotland, will return with The Care Show Conference featuring a panel of leading experts tackling the industry’s most prominent and critical issues. The event will also feature free seminars, workshops, and the Innovations Stage which will provide free demonstrations of cutting edge devices for the sector. For more information about The Care Show and to pre-register for a free ticket visit www.careshow.co.uk or call 01425 470 666 or email emma@waveexhibitions.co.uk TV Chef Paul Rankin to Highlight Cookery Excellence at the Care Show Celebrity chef, Paul Rankin will be sharing his culinary expertise as part of a new Cookery Demonstration Theatre being introduced at the Care Show at the Birmingham NEC on 25-26th October 2006. Paul, who has made regular appearances on BBC’s Ready Steady Cook and Saturday Kitchen, will provide guidance and inspiration for the UK’s care homes in the provision of delicious and nutritious cuisine for the elderly. The new Theatre will feature a series of live cookery demonstrations with Paul and other celebrity chefs providing top tips for increasing variety, nutritional content, and fresh local produce within care home menus. The cookery demonstrations will run throughout the two days of The Care Show and are free to attend. Celebrity chef Paul Rankin is campaigning for improvements in the quality of food in care homes. He is calling for an increase in money spent on food from an average of £18 to £28 a week, allowing care homes to achieve healthier menus. He was recently appointed by Care Circle’s Kingsway Nursing Home in Belfast, Northern Ireland to develop a new menu, much to the delight of its residents. He is now working alongside Barchester Healthcare, which has 160 care homes throughout the UK. He said, “I’m looking forward to presenting a fresh range of ideas to industry professionals at the Care Show, which will help them to devise menus that are realistic, highly nutritious and extremely tasty.” The Care Show, sponsored by The Royal Bank of Scotland, will offer visitors the latest advice, information, free seminars, workshops, and demonstrations of new products and services for the sector. It will also feature the Care Show Conference with a panel of industry experts addressing the sector’s most pertinent issues. For more information about The Care Show and to pre-register for a free ticket visit www.careshow.co.uk or call 01425 470 666 or email emma@waveexhibitions.co.uk Dry Mouth - Is it really that much of an issue? Well, yes it is! Saliva is hugely important in maintaining a healthy mouth. Reduced salivary flow is a major contributing factor in progressive oral diseases, difficulties with mouth function and to a variety of painful and distressing symptoms which severely affect the sufferer’s quality of life. Complaints of a dry mouth (xerostomia) and diminished salivary output (salivary hypofunction) are common conditions, particularly in older people. They can result in impaired intake of food and fluids, a host of oral disorders and diminished host defence and communication (See table on right). Global estimates of xerostomia and salivary gland hypofunction are difficult to establish due to differences in study populations, diagnostic criteria, and limited sample sizes. Overall the prevalence increases with age and affects ~30% of the population aged 65 and over.1 There are multiple causes of xerostomia and salivary hypofunction, the most common of which is drug-induced xerostomia with research suggesting that as many as 1 in 5 of the adult population suffer the symptoms and effects of Dry Mouth due to medication. Over 400 commonly used over-the-counter and prescription medicines can restrict or stop the flow of saliva to an extent where oral health may be compromised.The longer such medication is taken, the more important it becomes to treat the symptoms of Dry Mouth in order to try and avoid the damaging effect on the oral mucosa and the teeth. In addition to its lubricating function, saliva acts as an essential protective mechanism protecting oral tissues and helping control orally transmitted pathogens2. It is the activity of the non-immune factors such as lysozyme, lactoferrin and lactoperoxidase in conjunction with other immune system components such as immunoglobulins3 which help maintain a healthy balance in the mouth. Salivary Replacements and Stimulants Artificial saliva and lubricants can help to ameliorate some Dry Mouth symptoms in patients who have remaining salivary tissue as well as those who have no remaining salivary gland function. These products diminish the sensation of oral dryness and improve oral functioning. The choice of product depends very much on effect duration, lubrication, taste, delivery system and cost. Several products currently available without prescription include BioXtra (mouthwash, toothpaste, gel, spraygel, chewing gum and sucking tablets), Saliva Orthana (a porcine mucin-based artificial saliva) and Freedent (low-tack, sugar-free gum). A new concept and generation of dry mouth care systems are now available which mimic not only the saliva peroxidase system, but also introduce other naturally occurring salivary components to help supplement the mouth’s natural antibacterial and immune mechanisms. These systems can help promote a healthy, balanced oral environment as well as helping maintain a feeling of comfort, moisture and freshness. No one product suits all and so it is very much a process of ‘try it and see’ for most patients. However, ensuring that all oral health products that Dry Mouth sufferers use do not exacerbate their symptoms is an essential part of the oral care plan. The presence of sodium laural sulphate (SLS) in toothpaste can irritate the mucosa and Dry Mouth patients should be advised on SLS free toothpastes. Alcohol containing mouthwashes are also not very well tolerated in Dry Mouth patients. Alcohol not only dries the mucosa but intensifies the flavour of the mouthwash which are often too strong for many patients already suffering with dygeusia (taste alteration). Just the acknowledgement of the misery of living with a dry mouth can go a long way to help patients suffering with this largely undiagnosed, sometimes debilitating condition. Simple changes to their oral hygiene regimen, like applying a flavour and fragrant free moisturiser to the lips and a moisturising gel to the oral mucosa before brushing can greatly improve comfort and oral hygiene. For those times when Dry Mouth sufferers cannot tolerate a standard toothbrush specialist toothbrushes with incredibly soft filaments such as TePe Special Care brush may make the difference between being able to brush or choosing (for comforts sake) not too. The ageing population, coupled with longer life expectancy will mean that we will routinely be required to help patients manage the symptoms of Dry Mouth and so ‘an issue’ it most definitely is! Tel: 01934 710022 for more information. Oral effects of salivary hypofunction Dental Caries Dry lips Dry Mouth Dysgeusia Dysphasia Gingivitis Halitosis Mucositis Mastication problems Oral-pharyngeal candidiasis Poorly fitting prostheses Sleeping difficulty Speech difficulty Traumatic oral lesions Sources: 1 J A Ship. Saliva and Oral Health- 3rd Edition: Xerostomia: aetiology, diagnosis, management and clinical implications. 2004.BDJ Books 2 Screebny LM .Saliva in health and disease: an appraisal and update. Int Dent J 2000:50(3):140-61 3 Tenovuo J et al. Antimicrobial factors in saliva. Ontogeny and relation to oral health. J Dent Res 1987:66(2):475-9 About Paul Rankin Paul has appeared on numerous TV shows, including Saturday Kitchen, Ready Steady Cook, Gourmet Ireland, Masterchef, Who’ll do the Pudding?, The Good Food Show and more recently X-Factor Battle of the Stars. He, together with his wife Jeanne have written five books, including New Irish Cookery. He also runs a successful restaurant business, the Rankin Group, in his native Belfast. Page 2 Page 3 Signature becomes Master Distributor for UK THE CARE SHOW - NEC - 25 & 26 OCTOBER 2006 STAND NUMBER: 126 Signature Aromas Ltd, one of the UK’s leading manufacturers of air treatment products, has this year been appointed the UK’s sole distributor by international manufacturers Vaportek. Signature, which is based in the West Midlands, continues to develop a number of innovative products with natural ingredients aimed at purifying and fragrancing various retail, educational, medical and industry environments. The company has been working alongside Vaportek who have been manufacturing odour-neutralising systems in the USA since 1979. One of Signature Aromas best selling systems is the Restaroma, which provides a superior alternative to ozone cleaning renewing and neutralising air malodour. The unit uses patented essential oil membranes to release a non-toxic odour neutralising dry vapour into the air, which quickly eliminate any smoke, food and biological odours. Available in nearly 50 distinctive aromas the most popular being Orchard, Winter Spice, Spring Meadow, Berry, Vanilla and Relaxing. All oils come with a C.O.H.S.E sheet. Released earlier in 2006 was Purazone, a portable unit which kills in excess of 99% of all air borne bacteria and viruses and shows no growth or mutation after 5 days. These amazing results illustrate that Signature’s unique British made system; incorporating UVC light and natural oils helps to eliminate hazardous air-borne bacteria and is especially useful on hospital wards and in nursing homes. For further details of the Signature Aromas range of air-treatment products please contact 01902 678822 or email enquiries@signaturearomas.co.uk Altro to Exhibit New Product at Care Show Interior surfaces specialist Altro is set to wow visitors to this year’s Care Show with a revolutionary new flooring product, due to launch at the Birmingham event. Altro’s latest product will challenge perceptions of safety flooring and is sure to appeal to those care home managers and healthcare professionals who want to combine great aesthetics with the reassurance of slip resistance. Recognised as the inventors of safety flooring, Altro’s new product comes after extensive research within the care home industry. Tel: 01462 707600 Email: enquiries@altro.com Web: www.altro.com Take the strain away when turning in bed! Turning in bed is a problem when people are cared for at home or in institutions. Being turned with ease or being able to turn in bed independently eliminate pressure sores which cost the NHS over £750m per year. Swedish Company ‘Romedic AB’ has developed a solution. The Ross ‘TurnSheet’ consists of a mattress cover, fixed with Velcro straps which are smooth in the middle with an anti-slip surface on the sides.The second part of the system is a ‘Turnsheet’ which is quilted and made of soft microfiber.The TurnSheet ‘Maxi’ covers all pressure points of the body and enables the patient to be turned easily.This model is used in ICU units where people may be in much pain. ‘Romedic’ has also developed the Ross ‘Topsheet’ which is used in combination with the ‘Turnsheet’. ‘Topsheet’ is a combined turning device and incontinence protection. ‘This sheet is specifically designed for people who must be turned frequently.The straps of the ‘Topsheet’ are attached to the spreader bar of the hoist to enable a turning action. The load is spread over a wide area which makes it very gentle for people in pain, and heavy people (up to 24st) can be turned by a single carer without compromising safety. Tel: 01227 479 293 for more information. Page 4 Page 5 Specialist Bathrooms Can Look Great Without Costing The Earth In the past, people used to accept that if you needed special adaptations or access in a bathroom, then that meant unsightly products, utility design – and still a major struggle to get washed. step into showers is no longer necessary. Preformed shower bases can be quickly and economically installed to create a step free and unrestricted shower area. Level deck showers come in all sorts of shapes and sizes, wide enough for wheel chairs or small enough to be fitted into recesses adjoining bedrooms. Level deck showers can also be installed pretty well anywhere and on any floor base. Ben Grave, marketing director of Impey, Britain’s leader in specialist wet rooms, says thanks to the new design and materials available today, these flat floor showers can now be installed on timber, solid or floating floors; they can be put into basements or lofts; and because they are preformed, they are quick and straightforward to install. “This ease of installation is a big plus,” says Ben. “Thanks to the pre-formed decks, the usual difficulties faced by an installer are eliminated. Our Impey Level-Decs come with an installation video to make it even more straightforward to install. Then the floor can be covered with non-slip flooring or tiled to provide an attractive and safe finish.” How things have changed! Today there is a wide range of innovative new bathroom products that are available for nursing and care homes and for anyone needing adapted bathroom facilities; products that are affordable, easy to install, work well for people with disabilities and with carers and, so important today, can make a specialist bathroom look modern, fresh and attractive. The biggest breakthrough of all must be level access showering. Modern technology and design means the need for a high entry Another big change is the fixtures that are now available for specialist bathrooms. A generation ago, who would have thought grip handles, specially strong with a carefully textured finish, would be available in a range of rainbow bright colours. Seats too have changed beyond recognition; thanks to the exceptional strength that can now be built into modern materials, a modern shower seat can be neat and attractive and still take the heaviest weight. Doors and screens for showers have also changed dramatically. Some level floor showers don’t need doors at all, but if you do want doors, then the range is remarkable, including doors that lift, fold or slide open, half height doors to allow carer assistance and lots of easy to use technology such as touch button opening. In the past, screens of course would have been made of glass, so dangerous and also difficult to keep clean. Now with modern materials and coatings, screens are safer, easier to keep sparkling – and also come in a range of designs and colours. Colour is a big breakthrough in special care bathrooms. The new step free shower floors are suitable for most brands of non-slip Page 6 Stylish Healthcare Furniture... environments for life Deanestor is Britain’s leading range of healthcare furniture specifically designed for medical environments. Deanestor furniture is made from quality materials, built to last and withstand the demanding ‘wear and tear’ of working environments. Specifiers and users can rely on our knowledge and experience in providing you products and services to satisfy all your requirements. Our CD-ROM containing our entire range of AutoCAD drawings and this product Specifications, is now available. Please contact us for more details. vinyl flooring which is now available in wide range of great colours and patterns. Add to this some bright grip handles and a patterned screen door, and today you can have a special access bathroom that is as good as any bathroom in a modern designer home. Deanestor Healthcare,Warren Way, Crown Farm Business Park, Mansfield, NG19 0FL Tel: 01623 420041 Fax: 01623 420061 www.deanestor.co.uk Email: sales@deanestor.co.uk NHS Foundation Trust serves up new catering system The Royal Bournemouth and Christchurch Hospitals NHS Foundation Trust has improved efficiency, reduced wastage and saved costs with a state of the art catering solution from Toshiba and Datasym (UK). An innovative and forward thinking Trust,The Royal Bournemouth and Christchurch hospitals have recently introduced several enhancement to its catering solution. May 2006 saw the introduction of hand held units for stock control, which has enabled the hospital to carry out weekly stock checks for all areas, including vending machines. Prior to this, the hospital had relied on monthly stock checks which had to be manually recorded and fed into the system. With the new hand held units, stock in all areas can now be electronically read and automatically updated into the Datasym “Menumark” back office system, allowing stock to be checked on an ongoing basis, saving a great deal of time and resulting in even greater efficiencies. A further initiative implemented in the Spring of 2006 was the introduction of swipe cards to all staff, enabling all staff meals to be recorded through the Toshiba tills, which means an impressive 98% of all catering sales are now centrally controlled. Most recently in August 2006 The Royal Bournemouth and Christchurch hospitals to trial Palm Top devices, utilising wireless technology, for collating patient meal choices using Datasym UK’s latest development, Menumate. Commenting on this planned development, Terry Reeves said: “It has long been the aim of every hospital catering department to collect meal orders as close to serving time as possible. This will make us far more efficient and have a dramatic affect on wastage which in a multi million pound operation can equal a significant amount.” Telephone 0870 890 7200 Fax 0870 890 7350 for more information. Grab rails today come in all sorts of bright colours. The Answer to your Specialist Flush Door Requirements Noberne doors offer solutions to the problems faced by today’s specifier. • • • • • • Third Party Quality Assured through BM TRADA “Q” Mark fire doors Scheme. Established over 30 years with a wealth of technical expertise. Extensive Primary fire test evidence. Non standard and higher fire rated products upto FD120, our speciality. Fully framed up construction to provide superior screw fixing. UK manufactured. Perhaps the best change of all is the affordability. If you choose a preformed level deck shower base, the cost becomes really affordable because they are so quick and easy to install, saving builders and installers a lot of time and worry. With their in-built gradient, you can be sure of a quick and efficient disposal of water and they can be used in either gravity or pumped waste situations. Really, today there is no excuse for anyone to put up with tired looking or difficult to use bathrooms. Thanks to the work of thoughtful designers and to the evolution of new materials, a modern special access bathroom should look fantastic and be available for all. Information for the article was provided by Ben Grave, Marketing Director Impey UK, manufacturers of the leading Level-Dec shower base for special access bathrooms. More information on Level-Dec is available on 01460 256080. Web: www.impey-uk.com or email info@impey-uk.com Recent Clients include Gateshead Music Centre, BAA, Halifax Bank, Homebase, Marks & Spencer, Morgan Stanley Bank, Runnymede Hotels, Leeds General Infirmary and Barnsley District Hospital. Our latest brochure is now available on request. Noberne Doors Ltd, Lupton Street, Hunslet, Leeds, West Yorkshire LS10 2QP Tel 0113 2778577 Fax 0113 2772049 Web: www.nobernedoors.co.uk Instant Hospitals - Manufactured To Go Highly technical modular buildings designed, manufactured and supplied by Cadolto Fertiggebäude are incorporating VISTAMATIC Vision Panels due to their extremely high quality within areas where hospital safety, security and patient welfare are of paramount importance. Designed to allow medical personnel to safely observe areas sensitive to any potential security, safety and health concerns,VISTAMATIC Vision Panels allow discreet two-way monitoring before entering or leaving a room. Consisting of clear and opaque sheets of glass in a single frame, the panel is opened or closed via a simple lever or knob mechanism, revealing or obscuring the view. Amidst a present day revival of interest in ‘volumetric’ modular buildings, Cadolto is emerging as the European market leader in the conception and execution of prefabricated healthcare buildings. In an economically demanding climate where consumers have become accustomed to everything at the touch of a button, Cadolto with the expertise in security of VISTAMATIC, provides an instant and complete solution to hospital construction needs. Based on the Post-World War II idea of prefabricated buildings, modular construction is set to overtake conventional construction methods with all weather production and fixed costs offering an efficient alternative. A standard prefabricated building, with simple mod cons and panel style windows effectively used as a quick fix, now takes the form of a technically advanced medical unit incorporating VISTAMATIC Vision Panels, mass produced in factories worldwide and then rapidly installed in hospitals ready for use. As part of its prefabricated product philosophy, Cadolto constructs self-supporting room modules and installs all electrical, mechanical and medical equipment under the controlled conditions of its production facilities and transports them to be connected on site. The range of units includes fully functional operating theatres, ICU’s, pathology labs, renal and diagnostic imaging facilities to complete clinics for primary care providers. An innovation in security, the installation of the genuinely unique vision panels is an integral process on the assembly line for the production of Cadolto clinics, blending unobtrusively into the interior design of the units. VISTAMATIC products are designed and manufactured in the UK and distributed worldwide.The vision panels meet BS EN ISO 9002: 1994, as well as BS 6206 for Tempered Safety Glass Class ‘A’.VISTAMATIC can also work with architects and designers to create bespoke sizes and specifications. Tel: 0208 5002 200 Fax: 0208 5598 584 Email: sales@vistamatic.com Web: www.vistamatic.com Page 7 Magnifiers & Lighting for New Re-writable Visual Professional & Personal Use Card Printer From minor surgery & chiropody to sewing, reading or fly-making, this Fluorescent Magnifier from Daylight has a 190mm x 160mm lens with a 1.75x magnification and requires two 9watt tubes. It comes complete with table clamp, although floor stands, wall brackets and table bases are available making this enormously versatile. Of course this is only one piece in our comprehensive range of magnifiers and portable lighting including headlights for hands free operation/examination. Contact Cathy McMain at C-Clearly on 01924 882402 or visit the web site www.c-clearly.co.uk for guidance and on-line shopping. The TCP400 is the latest visual card reader/writer system from DED Limited.This new printer can take plastic cards of 0.76mm in thickness and erase and re-write the information on them in as little as 3 seconds, up to a maximum of 500 times. Printing high contrast text at up to 203 dpi on any colour background, the TCP400 is ideal for environments where cards need to be reused again and again, such as temporary access control and visitor management applications as well as loyalty, membership and appointment cards. The TCP400 has a choice of USB or RS232C Serial interface options and comes with Windows 2000 and XP drivers – with a footprint of just 119mm wide x 270mm deep x 132.5mm height, this re-writable card printer even has a maintenance indicator to warn the operator of the optimum time to run a head cleaning cycle in order to obtain the highest resolution card printouts. Supplied as standard with a magnetic stripe encoder, the TCP400 is also available with an optional a Mifare encoder. Tel: 01797 320636 Fax: 01797 320273 Pulse Fitness Pulse provides a concise, uncomplicated range of affordable innovative, leading edge fitness equipment and bespoke leisure solutions If you are looking to create: Modern hotel & fitness facilities Increased customer & guest retention Investment return Unique amenities that standout from the competition Pulse supply expertise in the following areas: Designing and building leisure facilities Fully furnishing facilities with innovative fitness equipment Training and development of staff Flexible financial options Contact: Pulse Fitness Limited,The Bromley Centre, Bromley Road, Congleton, Cheshire. CW12 1PT T: +44 (0)1260 294600 E: info@pulsefitness.com www.pulsefitness.com Intelligent Megapixel Cameras ClearView Communications has combined the increased resolution of megapixel video cameras with the latest in video analytics to enhance their “Videsearch” range of intelligent video systems. Live and recorded pictures can be recorded and displayed in 1024x968 pixel resolution (2.7 times that available from analog PAL cameras). The intelligent video software can identify different behaviour or object types (person, vehicle, bag etc.) and create an alarm on user-defined rule. Examples of rules could include “person moving from vehicle to vehicle in a car park” or “large vehicle parked in a controlled zone”. VideSearch can improve the efficiency of control room operators, automate alarms for non-monitored systems, zoom dome cameras to objects creating alarms, and save time when searching CCTV recordings. The system is suited to applications where precise picture detail is important, coupled with automated alarm response. Examples include the recognition or identification of people, objects or vehicles for perimeter surveillance, town centre monitoring, education, health or commercial security. Tel: 01245 214 104 Fax: 01245 214 101 E-mail: marie.brown@clearview-cctv.com Web: www.clearview-cctv.co.uk Munters and Troy See Things Clearly By controlling relative humidity at the Troy (CL) UK site in St Helens - which produces contact lenses environmental control specialist Munters have been able to maintain consistent conditions for optimum production. As pharmaceutical products are more ‘moisture-sensitive’ than most it is imperative that the relative humidity and temperature in the production area remain constant. In 1984 a Munters dehumidifier was installed to do just this.This system has worked well and in 2005 they finally decided it was time for a replacement. A new system was installed which should give another 23 years reliable service. The principle of Munters desiccant dehumidifiers is very simple. Moisture is absorbed onto a slowly-revolving desiccant wheel as the air passes through. A small heater reactivates the wheel in another air-stream and drives off the moisture which has collected on the drying side of the dehumidifier. This is vented outside the building or collected as condensation and discharged. As all the moisture is removed as water vapour by the desiccant wheel, the dehumidifier can operate effectively even at very low temperatures and still maintain desired humidity conditions. Tel: 08708 505202 Fax: 01480 413147 Email: dryair@munters.co.uk Web: www.munters.co.uk RFID Tag Solutions TOSHIBA TEC launches world’s first direct print-on-tag RFID solution SPRINT(tm) TOSHIBA TEC, a global manufacturer of retail and industrial information systems, has announced the world’s first operational Print-on-Tag RFID solution. Until now, RFID tags have had to be inserted behind selfadhesive labels to meet the traceability requirements set by major government organisations, retail chains and logistics-related enterprises. This new engineering process from TOSHIBA TEC known as SPRINT(tm) (Short Pitch RFID Encoding Technology) enables TOSHIBA TEC’s SX-series of barcode label printers to able to successfully print label information straight onto RFID tags. This major technology breakthrough for RFID tag vendors brings a practical solution to market that combines TOSHIBA quality and innovation with cost-effective, high-volume RFID tag production. Tel: 0870 890 7200 Fax: 0870 890 7339 E-mail: bviccars@toshibatec-eu.co.uk Web: www.toshibatec-eu.co.uk SPACE SAVING CYCLE RACKS 3G Food Service - new corporate Leading Supplier of IT identity for Billy Boy Frozen Food Billy Boy Frozen Foods, distributor of chilled and frozen foods, has a new name and corporate identity. From May 2006, the company will be known as 3G Food Service. “The Billy Boy Frozen Foods name has served us well and helped establish our core business,” said Ben Smales, Managing Director. “New opportunities and developments such as the introduction of our Seafood Solutions range of chilled and frozen fish and seafood highlighted the need for a new, cohesive corporate name and identity.” The re-branding exercise began with painstaking research into customer perceptions of the existing Billy Boy Frozen Foods brand. Key strengths were identified including strong associations with quality, service and value.The name and logo led others to think that Billy Boy was simply a frozen fish company, or that it might be a regional rather than national player.The use of the words ‘frozen foods’ were inappropriate for a company which has added chilled fish and seafood to its products. From May 2006 the new 3G Food Service branding will be rolled out to the company’s distribution centres and delivery vehicles. It will be used on signage, stationery and own brand products. The website will be re-designed to reflect the strong new corporate image. Tel: 01482 593700 Fax: 01482 593701 Gopak Serving The Future Gopak, the UK’s market leader in the design, manufacture and supply of lightweight aluminium furniture, is launching an innovative new addition to its range of folding tables, the Premier Servery table. Based on Gopak’s Premier range of tables, the new serving table has all the features of the standard Premier table but with a food grade ABS plastic top. There are 3 holes conveniently designed to house standard Gastronorm Containers to facilitate the serving of hot or cold food and there is room in front of the food containers to place flight trays or plates, enabling pupils to serve themselves. Once dining is completed, the containers can be lifted out and the table folded neatly away, requiring minimal storage space.The Premier Servery table comes in three heights: buffet (76omm), adult (698mm) and junior (635mm) with a standard length of 1830mm by 760mm.The new table has been on trial with the London Borough of Ealing and has proved a real success in ensuring children eat healthier. The table is a great method of encouraging schools to participate in the Healthy Food initiative and empower school kids to make healthier choices. Gopak offers a five year guarantee on all its own designed and manufactured products. Gopak has recently launched its new website where orders can be placed, purchased and tracked online. Visit www.gopak.co.uk to find out more. Delivery is free on all orders. Products and Services XMA has been in the business of supplying IT products and services for almost 20 years. Today, with a turnover over £200 million, we are supplying more products to more customers than ever before. Our basic philosophy of supplying quality products and services cost effectively, combined with knowledgeable friendly staff ensure that our customers obtain the best possible value for money. There are many reasons why the biggest names in the country deal with XMA. Here are just a few: • Over 400 dedicated sales and support staff • £18 million average stockholding • 160,000 sq ft purpose built distribution facility • Superb nation-wide service from a central location • 50 direct agreements with industry leading brands ensure you buy at the right price • Extensive range of supplies, equipment and spares For more information: Contact XMA on 0115 846 4889 or visit our website at www.xmaonline.co.uk • Horizontal, galvanised cycle rack (above) • Semi-vertical, galvanised cycle rack (right) • Cycles stored at 305mm centres • Infinate capacity available • Supplied flat packed for simple assembly Elwell Buildings Limited - Odoni Cycle Storage Equipment Unit 5, Excelsior Industrial Estate, Cakemore Road, Blackheath B65 0QT Tel: 0121 561 5656 Fax: 0121 559 0505 Web: www.odoni.co.uk Page 9 Page 8 Relieving the Pressure: managing pressure ulcers in primary and secondary care What are pressure ulcers and how are they caused? Pressure ulcers, commonly referred to as pressure sores, bed sores, pressure damage, pressure injuries and decubitus ulcers, are areas of localised damage to the skin, which can extend to underlying structures such as muscle and bone Damage is believed to be caused by a combination of factors including pressure, shear forces (where the layers of the skin are forced to slide over one another or over deeper tissues, for example when patients slide down, or are pulled up, a bed or chair), friction and moisture. Pressure ulcers can develop in any area of the body. In adults damage usually occurs over bony prominences, such as the sacrum (base of spine). Presentation in infants and children is more likely to occur on the back of the head or ears. The first sign that a pressure ulcer may be forming is usually discoloured skin, which may get progressively worse and eventually lead to an open wound. Pressure ulcers can develop very quickly in some people if they are unable to move for even a very short time - sometimes within an hour. Without proper treatment, pressure ulcers can be very serious, damaging or destroying not just the skin, but also the underlying tissues or bone. In extreme cases, pressure ulcers can become life threatening, as they can become infected, and sometimes cause blood poisoning or bone infections. Pressure ulcers are more likely to occur in those who are seriously ill, are neurologically compromised (i.e. individuals with spinal cord injuries), have impaired mobility or who are immobile, suffer from impaired nutrition, obesity, poor posture, or use equipment such as seating or beds which do not provide appropriate pressure relief. Pressure ulcers have been associated with an increased incidence of infection including osteomyelitis (inflammation/infection of the bone) and research indicates that pressure ulcers represent a major burden of sickness and reduced quality of life for patients, their carers and their families. Often patients require prolonged and frequent contact with the health care system, and suffer much pain, discomfort and inconvenience. The presence of pressure ulcers has been associated with a two to four-fold increase of risk of death in older people in intensive care units. Estimates on pressure ulcer incidence and prevalence from hospital-based studies vary widely according to the definition and grade of ulcer, the patient population and care setting. However, new pressure ulcers are estimated to occur in 4-10% of patients admitted to acute hospitals in the UK. The financial costs to the NHS are considered to be substantial. In 1993, the estimated cost of preventing and treating pressure ulcers in a 600-bed general hospital was between £600,000 and £3 million a year. The cost of treating a grade 4 pressure ulcer - the most severe - was calculated in 1999 to be £40,000 a year. More recent cost data suggest that treating ulcers varies from £1,064 for a grade 1 ulcer to £10,551 for a grade 4 ulcer with total costs in the UK estimated as being £1.4-£2.1 billion annually, equivalent to 4% of the total NHS Expenditure. The presence of a pressure ulcer creates a number of significant difficulties - psychologically, physically and clinically - to patients, carers and their families. Clinicians working in a variety of clinical and non-clinical settings, including primary care and acute trusts, also face challenges when providing holistic, person-centred services for the assessment and treatment of pressure ulcers. These challenges include clinical decisions on methods of assessment and treatments to be used for individuals with an existing pressure ulcer. Box 1: European Ulcer Advisory Panel classification system of pressure ulcer grades. Graded 1 - 4 according to their severity: Grade 1: non-blanchable erythema of intact skin (redness of the skin that does not whiten when light pressure is applied to the skin). Discolouration of the skin, warmth, oedema (localised accumulation of fluid under the skin), induration or hardness may also be used as indicators, particularly on individuals with darker skin. Grade 2: partial thickness skin loss involving epidermis (outermost layer of skin) or dermis, or both. The ulcer is superficial and presents clinically as an abrasion or blister. Grade 3: full thickness skin loss (ie epidermis and dermis) involving damage or necrosis of tissue below the skin that may extend down to, but not through, underlying fascia. Grade 4: extensive destruction, tissue necrosis, or damage to muscle, bone or supporting structures with or without full thickness skin loss. NICE clinical guidelines In September 2005 NICE issued its clinical guideline on pressure ulcer management1. The new guideline was developed in conjunction with the Royal College of Nursing (RCN) and incorporates the main recommendations from the RCN guideline on the management of pressure ulcers in primary and secondary care2. It also summarises the existing NICE guideline on pressure ulcer prevention3. The guideline aims to reduce the occurrence of pressure ulcers by providing guidance on the early identification of at risk patients and the provision of preventive interventions. The guideline also makes recommendations on what types of pressure relieving devices (beds, mattresses and overlays) are the most appropriate for a given situation, based on an overall assessment of the patient. Box 2: Key priorities for implementation highlighted in the NICE guideline include: • Patients should receive an initial and ongoing risk assessment in the first episode of care (within 6 hours). • The pressure ulcer grade should be recorded using the European Pressure Ulcer Advisory Panel Classification System (see Box 1 above) • Patients should receive an initial and ongoing pressure ulcer assessment. This should be supported by photography and/or tracings (ruler for calibration). • All those who are vulnerable to pressure ulcers should as a minimum be placed on a high specification foam mattress. • For patients undergoing surgery, as a minimum provision a high specification foam theatre mattress or other pressure redistributing surface should be used. • All pressure ulcers graded 2 and above should be documented as a local clinical incident. • Patients with a grade 1-2 pressure ulcer should: - As a minimum provision be placed on a high specification foam mattress/cushion with pressure-reducing properties - Be closely observed for skin changes * Patients with a grade 3-4 pressure ulcer should as a minimum be placed on: - A high specification foam mattress with an alternating pressure overlay or, - A sophisticated continuous low pressure system (for example, low air loss, air flotation, viscous fluid) Keeping moving One of the best ways of preventing a pressure ulcer is to reduce or relieve pressure on areas that are vulnerable to pressure ulcers (for example, bony parts of the body). This is done by moving around and changing position as much as possible. If a pressure ulcer is already present, lying or sitting on the ulcer should be avoided as it will make the ulcer worse. The guideline recommends that healthcare professionals should advise patients and their carers on how pressure is best reduced or relieved on areas of skin that are vulnerable to pressure ulcers. This advice should include: * Correct sitting and lying positions * How to adjust the patient’s sitting and lying position * How often patients need to move or be moved * Supporting the patient’s feet * Keeping good posture * Which equipment patients should use and how to use it. Skin assessment The guideline recommends that a patient’s skin should be assessed regularly to check for signs of pressure ulcer development. The most common signs are: * red patches of skin on light skinned people that don’t go away * bluish/purplish patches of skin on dark skinned people that don’t go away * blisters, or damage to the skin * patches of hot skin * swelling * patches of hard skin * patches of cool skin Mattresses and cushions There are many different types of mattress and cushion that can help reduce the pressure on bony parts of the body and help prevent pressure ulcers. The guideline recommends that healthcare professionals should work with patients and their carers to decide which types of pressure relieving supports are most appropriate, considering all surfaces that the patient comes into contact with, and how their needs may change over time. For patients who are at risk of developing a pressure ulcer, or who already have a grade 1 or grade 2 pressure ulcer, the minimum provision they should receive is a high specification foam mattress. Patients with a grade 3 or 4 pressure ulcer should receive a more sophisticated foam mattress with an alternating pressure overlay, or a sophisticated continuous low pressure system (for example, low air loss, air flotation or viscous fluid). Nutrition Proper nutrition is particularly important for people at risk of developing a pressure ulcer or those with a pressure ulcer as without it their condition can worsen, or fail to improve. The NICE guideline recommends that healthcare professionals should provide nutritional support to patients with an identified deficiency, based on a nutritional assessment using a recognised tool (for example, the Malnutrition Universal Screening Tool - see www.bapen.co.uk), taking into account patient preference and, where appropriate, the views of a dietitian /specialist. Further information - The following documents are available from www.nice.org.uk/CG029 * A quick reference guide * Information for the public - a lay version produced for people at risk of pressure ulcers and those with pressure ulcers, their families and carers, and the public. * The full guideline (developed by the RCN) - all the recommendations, details of how they were developed, and summaries of the evidence on which they were based. 1. Pressure ulcers: The management of pressure ulcers in primary and secondary care (NICE clinical guideline No.29) 2. Pressure ulcers: The management of pressure ulcers in primary and secondary care - A clinical practice guideline (Royal College of Nursing) 3. Pressure ulcer risk assessment and prevention, including the use of pressure-relieving devices (beds, mattresses and overlays) for the prevention of pressure ulcers in primary and secondary care (NICE clinical guideline No.7). Page 10 Page 11 The CONC∑PT™ INFO By AD∑PTIAS™ The launch of The CONC∑PT™ INFO by Adeptias Limited is scheduled for May 2006. The CONC∑PT™ INFO is a computer integrated desk that is designed to be the information point for Doctor’s surgeries, clinics, hospitals and dental practices. It is ideal for public areas where information needs to be input or accessed or for check-in. The desk needs only a single lead for connection to a power point and integrates all wires and connections internally. It can be wireless or used with network connection. The CONC∑PT™ INFO integrates a slim line computer within the lockable desktop where it is secure from accidental damage, tampering and theft. It is out of sight and accessible only to authorised personnel. The computer is housed within a removable case for ease of maintenance and upgrade and is built using standard components. Additionally, existing CPU’s or named brand computers can also be integrated into the INFO. The monitor is mounted on an arm above the desktop leaving the desk surface clear and completely usable. The flat screen monitor can be ordered with a traditional surface or with hardened glass for use with a keyboard and mouse or with a Touch screen, alleviating the need for any IT equipment on the desktop. For additional information, contact Adeptias Limited at info@adeptias.com or Telephone: 01926 888 550. Page 12