Catherine Weeks Laparoscopic Colorectal Practitioner Nottingham University Hospital NHS Trust 2010

LAPAROSCOPICCOLORECTAL PRACTITIONER

ALTS CONFERENCE 25TH NOVEMBER

•Career History

•Education/courses

•LAPCO/ Nottingham training centre

•Feedback from course

•How the role evolved

•Challenges

•Research projects

Summary

•2004 Diploma in adult nursing

•2004 rotated around different specialities at QMC.

•2006 Royal Prince Alfred Hospital, Sydney Australia.

•2007 Royal Infirmary, Derby, Orthopaedics.

•2008 returned QMC.

•June 2009 laparoscopic colorectal specialist.

Career History

Education/Courses• General Courses

Degree modules – 2006 Contemporary

practice operative surgical care

– 2008 Evidence based practice

– 2010 Advanced Scrub Practitioner

– 2010 Patient safety in theatre teams, Royal College of Surgeons of England.

– 2011 completed post grad certificate in medical education, presently continuing for Masters in medical education

• Laparoscopic courses– 2005 Endosurgery

harmonic and stapler workshop, Ethicon.

– 2005 Basic laparoscopic workshop, Tyco.

– 2009 Laparoscopic colorectal course, European Surgical Institute, Hamburg.

– 2009 Advanced laparoscopic procedures, MATTU.

• National Programme to train colorectal consultant surgeons, branching out to trainees.

• NTP funded by the Cancer Action Team at DoH.

• Devised 2007 to implement 2006 NICE guidelines – ‘laparoscopic colorectal resection is recommended as an alternative to open resection for individuals with colorectal cancer in whom both laparoscopic and open surgery are considered suitable.’

•40 active trainers delivering training across 11 centres.

•130 trainees are currently registered with Lapco, which along with pending registrations will take total numbers in training to 150.

Nottingham• One of the largest national

training centres.

• NTP places strong emphasis on team training.

• 1st day – live operating, team working and skills stations.

• 2nd day – Cadaveric course.

• Support consultants and their teams within their own hospitals.– 8 outreach hospitals– 16 consultant surgeons

• Ethicon sponsored courses for Scottish delegates

When theatre practitioners asked (pilot questionnaires), what would they say was the most important factor when developing laparoscopic colorectal work?

• Prior planning

• Communication

• Information • Teamwork

• Patient Safety

• Standardisation

• Experience/Practice

Feedback from course

• ‘Useful that the whole team learns together and is aware of each professionals role’.

• ‘Really like the fact that the whole team involved in one course’

• ‘I really enjoyed the course because you actually do the real life thing (cadaveric day) which helps to be more confident to scrub in theatre’.

• ‘Good to share ideas on practice with other hospitals’.

How the role evolved• Education/Training

– Education materials.– Co-ordinate two day

Lapco course.– Support theatre staff

for consultants of site visits.

– Theatre practitioners course.

– Teach new recruits/students.

• Service– Lead role in the co-

ordination and management of colorectal laparoscopic surgical equipment.

Challenges•Create new role.

•Time management – balance training and service need.

•Steep learning curve.

•New hospitals/new staff.

•Changing old ways.

•Learning from mistakes.

•Developing laparoscopic colorectal emergency surgery.

Research Projects

• Questionnaire attitudes towards IPL.

• Pre and post evaluation of the course.

• Focus groups or semi-structured interviews.

• Involved in other research projects – TAP trial, – Single port surgery, – OTAS observation theatre teams (Imperial).

THANK YOU FOR YOUR TIME

Questions?

catherine.weeks@nuh.nhs.uk