The Cambridge Mental Health Film Club: lessons to learn, feedback, expansion and development of a standard operating protocol

AimsTo report on our progress and feedback running the Cambridge Mental Health Film Club. To share the recent development of a Standard Operating Protocol to help others organise Mental Health Film Screenings in order to foster discussion, engage the public, reduce stigma about mental health and build understanding.BackgroundCinema lends itself to exploring social and mental health issues such as stigma in an enjoyable way within a limited time and budget. Viewing a film with those from different backgrounds and having a chance to discuss perspectives on meaning and significance is an effective way to promote a collaborative stance and expand perspectives. We have been running a Mental Health Film Club in Cambridge for the past 3 years and have recently celebrated our 10th screening.MethodWe give details of our screenings and feedback. We also share our Standard Operating Protocol which covers important topics such as resources to find suitable films, obtaining copyright permission, finding suitable venues, supporting open discussions, use of social media and promoting inclusivity.ResultOur Mental Health Film club shows three films a year and over time has opened up to both professionals and members of the public who are interested in discussing mental health through movies and supporting recovery. We have screened many challenging and interesting films: from the impact of religious control on emergent adolescent sexuality (‘The Miseducation of Cameron Post’) to a classic film on Alcohol Dependency (‘Days of Wine and Roses’). We also support local festivals with a similar mental health theme (e.g. MEDFEST) and have recently run a very successful screening with the University of Cambridge Psychiatry Society which was introduced by a student offering subjective experience of growing up with a sibling with an Autism Spectrum Disorder (‘Life, Animated’). We promote screenings and publish all film discussions on our website (www.tinyurl.com/psychfilmclub) and Twitter in order to contribute to resources for educational use within Psychiatry training and to further involve the wider public. Feedback shows that our sessions are highly rated at helping audiences see mental health in a new way with post film discussion especially valued.ConclusionOur experience and practical advice can inspire others to start a Mental Health Film Club and promote cohesion, resilience and collaborative thinking within their locality. For future events we plan to expand into more public engagement via local Film Festivals. We welcome delegates ideas, experiences and film recommendations.

Nation-wide vector surveillance did not indicate transmission of the “American lineage pandemic ZIKA virus” in India

Background In wake of the global health emergency declared by the World Health Organization (WHO) during 2016, on the outbreak of ZIKA pandemic, Indian Council of Medical Research (ICMR) carried out countrywide vector surveillance for ZIKA and DENGUE viruses (ZIKV & DENV) in India, as a preparedness measure. Methods The study incorporated high-risk zones distributed to 49 Districts in 14 states/ Union Territories (UT) of India during 2016-2019. Seven ICMR Institutions undertook the study, following a uniform Standard Operating Protocol. Aedes specimens sampled on weekly intervals were processed by multiplex Reverse transcriptase PCR for ZIKV/DENV and Real time RT-PCR of ZIKV, among few samples distributed to all the Districts. Results Altogether, 79492 specimens of Aedes mosquitoes in 6492 pools were processed for both ZIKV and DENV infections. Among these, three and 63 pools respectively were found positive for ZIKV and DENV. ZIKV infections were recorded from Aedes aegypti sampled during 2018 sporadic ZIKA outbreak in Jaipur, Rajasthan, which belonged to the Asian lineage, already circulating in the Country. Both Ae. aegypti and Aedes albopictus were found infected with DENV and were distributed to ten states/ UTs. Both male and female specimens of Ae. albopictus recorded DENV infections indicating trans-ovarial transmission of DENV in the species. Conclusion This national vector surveillance study evinced no active transmission of the “American lineage - pandemic ZIKA virus” in India during 2016-2019, although Asian lineage of the virus already circulating in the Country was detected from Ae. aegypti from Jaipur, Rajasthan.

49 A Quality Improvement Project to Assess and Refine the Handover Process at Morning Trauma Meetings

Introduction Poor handover between shifts can result in patient harm. This study was designed to evaluate the impact of implementing a handover protocol on the quality of information exchanged in the trauma handover meetings in a UK hospital. Method A prospective single-centre observational study was performed at an NHS Trust. Ten consecutive weekday trauma meetings, involving 43 patients, were observed to identify poor practices in handover. This data was used in conjunction with the Royal College of Surgeons’ recommendations for effective handover (2007) to create and implement a standard operating protocol (SOP). Following its implementation, a further 8 consecutive meetings, involving a further 47 patients, were observed. The data was analysed using t-test for quantitative variables and chi-square or Fisher’s exact tests for categorical variables. Results An improvement was demonstrated in multiple aspects of trauma handover including past medical history, injury date, results, diagnosis, consent, mark, and starvation status (all p < 0.001). Subgroup analyses showed that handover of neck-of-femur fracture patients including information on baseline mobility (p = 0.04), Nottingham-Hip-Fracture Score (p = 0.01), next-of-kin discussion (p = 0.075) and resuscitation status (p = 0.001) all improved following the intervention. Conclusions These results demonstrate that the implementation of a well-structured handover protocol can improve the transmission of critical information in trauma meetings.

485 Optimisation of The Evening Surgical Handover Process in A Large Tertiary Surgical Department - A Quality Improvement Project

Introduction The aim of the project was to improve the quality and effectiveness of the evening surgical handover in a large tertiary surgical department, incorporating up to 150 patients. Method Audit standards were derived from GMC and RCSEng guidelines. An initial audit of the evening handover was conducted over a period of two weeks. Following this, a standard operating protocol (SOP) was introduced, with re-audit 4-weeks following implementation. Results The initial audit identified an inconsistent format and significant variability. Few handovers commenced with all team members present (11%) and were uninterrupted (33%). A laminated handover SOP checklist was produced and a new proforma was introduced to document tasks or reviews required overnight. A mandatory evening surgical HDU round was invoked and a “watchers” system was introduced to identify patients at highest risk of deterioration. Re-audit demonstrated significant improvements in all domains to > 85%. ICU referrals overnight decreased from 6% to 2%. Further improvements measures were implemented in the form of a dynamic virtual handover document. Conclusions A structured SOP improved the consistency of the handover process. A night review of all HDU patients reduced the rate of ICU referrals. Implementation of virtual handover processes may be required in the COVID-era.

Prevalence of needle stick injuries among health care workers of various hospitals: a cross sectional study in an urban district of North India

Background: Needle stick injuries (NSI) are one of the dreaded but preventable occupational hazard posed to health care worker in various clinical settings. The causes of NSI includes injuries caused by use of hypodermic needles, blood collection needles, needles in intravenous delivery systems, needles in diagnostic aspiration procedures and needle in interventional or surgical procedures. In developing countries, needle stick injuries prevalence is also related to lack of standard operating protocol in various institution.Methods: A cross sectional observational study was carried out in 384 paramedical, technical, auxiliary and sanitary staff of three government and three private hospitals of Meerut from November 2015 to October 2016.Results: In our study, Overall prevalence of NSI was 77/384 (20.1%). Among sub-groups, needle stick injury was 26.6% and 31.3% in nurses, 37.5% and 16.7% in technicians, 15% and 12.5% in wardboys/aaya and 15.6% and 9.4% in sweepers of public and private hospitals respectively.Conclusions: Standard operating protocol is the need of the hour at every medical institution and hospitals for NSI. Regular training regarding NSI, promoting early reporting and availability of immediate Post exposure prophylaxis should be ensured.

Standard operating Protocol (SOP) of Haematopoietic Stem Cells Enumeration

Human hematopoietic stem cells (HSCs) are obtained either from the bone marrow (BM), cord blood (CB) or peripheral blood (PB). Transplantation of HSCs occurs following various conditions like high doses of chemotherapy, diseases like; leukaemia, lymphoma, congenital metabolic defects, immunedeficiency illnesses and myeloblastic syndromes.

Parental acceptability of coloured compomer as a restorative material in primary teeth of children - A randomized split mouth clinical trial

Coloured compomer materials have been introduced in Pediatric Dentistry and gained popularity as it develops a positive behaviour in the child and makes further treatment stress-free. However, parental satisfaction regarding the appearance of coloured compomer is questionable. This study aimed to compare the parental acceptability of coloured compomer compared to conventional compomer for the restoration of primary teeth in children. A total of sixty sites, divided into two groups, with thirty subjects in each group using split-mouth design were chosen amongst patients aged between 5 to 10 years reporting to the Department of Pedodontics and Preventive Dentistry. In the control group, conventional compomer(Material A) were placed, similarly coloured compomers(Material B) were placed in the experimental group under the standard operating protocol. Parental preference was noted by asking them to tick or point to the appropriate box labelled Material A and Material B, and the results were evaluated by statistical analysis using SPSS version 21.0. A statistically significant difference was found in parents in preference of conventional tooth coloured compomer as the restorative material. (p<0.05)Thus, the preference of parents regarding the placement of coloured compomer in primary teeth is comparatively low. Though the coloured compomer material positively influences the behaviour and treatment outcome in children, the parental satisfaction is found to be comparatively low as parents feel that it lacks the aesthetic appeal when compared to the conventional tooth-coloured restorations.