News
Coaching trainees just before a procedure could improve safety
Giving inexperienced clinicians “just-in-time” training with an expert, just before they carry out a procedure, boosts their success rate and could improve patient safety, finds a study in The BMJ. Athletes and musicians often rehearse, warm up, or practice just before they are about to perform. Yet in medicine, where performing a procedure can have life-altering consequences, warm-up, or “just-in-time” training is rare to non-existent. To fill this knowledge gap, a team of US researchers conducted a randomised clinical trial to assess whether coaching inexperienced clinicians just before intubating an infant could improve the quality of care.
Intubating an infant can be challenging for
trainees who may need several attempts to insert the tube correctly. This creates time pressure, increases mental stress, and is linked to complications including hypoxia, bradycardia, and cardiac arrest. The trial took place at Boston Children’s Hospital and involved 153 anaesthesiology trainees (residents, fellows, or student resident nurses) from 10 regional training programmes who completed a questionnaire about their knowledge and previous experience of intubating infants. Participants were then randomly assigned to either a 10-minute training session on an infant mannequin with an expert airway coach (treatment group) or usual on-the-job training (control group) within one hour of intubating an infant. Each trainee performed up to five infant intubations. Immediately after each intubation, the trainee filled out a survey developed by NASA to measure
Sponsored by
Mölnlycke announces major investment in Siren
Mölnlycke Health Care, a world-leading MedTech company specialising in wound care solutions, announced an investment of USD 8 million in Siren. The healthcare tech company Siren is on a mission to help reduce the risk of diabetic foot ulcers by early detection of potential injuries through temperature-sensing textile technology. About 830 million people around the world suffer from diabetes,1
living with the risk of
cognitive workload while performing a task. Higher scores indicate a high cognitive load, linked to increased task specific error. Between 1 August 2020 and 30 April 2022, the trainees (83 control, 70 treatment) did a total of 515 intubations (283 control, 232 treatment). First attempt success was 91.4% (212 out of 232) in the treatment group and 81.6% (231 out of 283) in the control group, a clinically meaningful 10 percentage point improvement. Just-in-time training was associated with significant improvements in quality of care, including less time to intubation, improved views of the airway while intubating, fewer manoeuvres by the trainee in trying to place the breathing tube in the airway, and fewer technical difficulties. Just-in-time training was also associated with significantly lower cognitive load scores and improved competency. Visit:
www.bmj.com/content/387/bmj-2024-
080924 Bacterial biofilms have ‘natural enemy’
Biofilms make infections harder to treat when they form protective shields for bacteria on devices like catheters and implants. However, scientists have now discovered a chemical that plants produce when they’re stressed prevents biofilm from forming. The breakthrough offers potential advances in healthcare, as well as preventing equipment corrosion in industrial settings. The study, published in the journal Nature Communications, highlights the importance of a molecule produced during life-sustaining chemical reactions inside plants, as well as bacteria and even some parasites, like the one that causes malaria. When a plant is damaged and too much oxygen enters its cells, it accumulates MEcPP. This molecule then triggers protective responses within the plant. The researchers discovered that this same molecule has a surprising effect on bacteria
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www.clinicalservicesjournal.com I February 2025
like E. coli: it disrupts biofilm development by interfering with its ability to attach to surfaces. Bacteria rely on hair-like structures called fimbriae to anchor themselves to surfaces, a critical step in biofilm initiation. Fimbriae can help bacteria latch onto medical implants, for example, where they secrete a protective matrix that shields them from antibiotics. The research team identified a key gene called fimE, which acts as an “off switch” for fimbriae production. MEcPP enhances the activity of this gene and increases the expression of fimE. This, in turn, prevents the bacteria from producing fimbriae and forming biofilms. “Our discovery could inspire biofilm prevention
strategies across a wide range of industries,” said Jingzhe Guo, first author of the paper. “From cleaner water systems to better dental care products, the possibilities are immense.”
diabetic foot ulcers (DFU) and amputation. Siren has developed “the Siren sock” as well as remote patient monitoring clinical teams, creating a service ecosystem for patients at risk of DFU. The system has been clinically proven to reduce the risk of ulcers by up to 68%2 by 83%.2
and amputations This means less suffering for patients
and is estimated to lower the cost of care by approximately USD 10,000 per patient annually. In addition, the workload for physicians is reduced, which is increasingly important in the pressurised healthcare environment. “Our strategic investment in Siren reflects our commitment to integrating into digital ecosystems and pioneering innovative digital solutions that revolutionise healthcare delivery,” said Zlatko Rihter, CEO of Mölnlycke adding: “Helping to prevent wounds from occurring is also in line with Mölnlycke’s Wound Care mission to ‘help free patients from the burden of wounds’ and our ambition to further support healthcare in the post-acute segment.” “We’re excited to team up with Mölnlycke
to tackle diabetic foot ulcers at their earliest stages”, said Ran Ma, co-founder and CEO of Siren. “By investing in preventive technologies like ours, Mölnlycke is demonstrating real vision and leadership in helping patients avoid the debilitating consequences of diabetic foot ulcers. Their investment sends a clear message that prevention matters. By catching issues before they escalate, we can help patients stay healthy and independent, reduce unnecessary procedures, and ultimately make a real difference in their lives.”
References 1 WHO,
https://www.who.int/health-topics/ diabetes
2 Shih et al., Effectiveness of a Continuous Remote Temperature Monitoring Program to Reduce Foot Ulcers and Amputations: Multicenter Postmarket Registry Study, JMIR Diabetes, 2024
Paul -
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