http://www.nic.nhs.uk Recent Needs Copyright 2009 NHS. Need to purchase new fans that create less dirt and reduce infection http://clinicalneed.nic.nhs.uk/ClinicalNeedView.aspx?need=248 Wed, 23 Nov 2011 12:18:00 GMT Patients with Parkinson's exhibit a forward leaning posture and a gait whereby they lean forward on their toes without balancing their weight over both the toes and the heels. This leads to a lrage number of falls. A device is require to correct this gait and minimise the number of falls For full details please access 'Austin's Wedge' previously submitted under the Scorecard http://clinicalneed.nic.nhs.uk/ClinicalNeedView.aspx?need=229 Mon, 27 Jun 2011 22:50:00 GMT There is a need for the development of a self-injecting device for Hydrocortisone. It is often needed in emergencies, and patients and their families find the current provision scary and too difficult. Breaking an ampoule, loading a syringe, changing needles and then injecting yourself - almost impossible if you are feeling unwell and dizzy. And the packaging is a challenge in itself. Having an Addisonian Crisis is still quite rare, so patients often find themselves put at risk by ambulance staff, junior doctors and A&E personnel who refuse to administer the life-saving hydrocortisone. This is similar to refusing a diabetic his emergency injection. Without treatment, the patient goes into Hypovolemic shock. Patients lose their quality of life, because they are too frightened to travel far from their local hospital or ambulance service. Some patients need to be no more than 10 minutes from a family member in case they need help - and this impacts their ability to work and socialise. There is increased cost to the NHS, because timely administration of hydrocortisone means no hospital admissions, quicker recoveries. All liquid hydrocortisone will be administered by injection, so an easy solution would be to deliver the drug in a standardised pre-filled syringe. Then one can pair up with a company producing devices, who can turn it into a self-injecting device. Please see the Petition from the Pituitary Foundation for more details: http://www.gopetition.com/petition/41065.html http://clinicalneed.nic.nhs.uk/ClinicalNeedView.aspx?need=227 Thu, 17 Feb 2011 14:23:00 GMT If the patient is shutting down around the peripheries, as exemplified by cold nose, it means they are getting 'dry' because as you know, in dialysis you are taking off fluid. The fluid is in various fluid compartments, interstitial mostly, to 'get it' you have to draw water off the circulatory system, its a bit of a hit and miss thing because how do you assess how much fluid the patient actually has on board....... E.g. Iif patient weighs 70kgs and comes in for treatment at a weight of 73 kgs, and assuming theyI have 3 kgs of excess water on board.so programme machine to remove (filter off) 3 litres (I litre water weighs I KG) , then at 71 kgs they crash because they are now hypovolaemic.. Also imagine they been feeling well and eating well so actually their weight has changed from 70 to 71.5 kgs, OR maybe they are very constipated and I have a kilos worth of waste stuck in their gut or even more. OR perhaps took anti-hypertensive's before treatment so their BP collapses because they can't cope with fluid removal ON TOP of the antihypertensive effect of the medicine? Or maybe they weighed myself with their car keys, purse, dairy, loose coins and a can of coke in their pocket, so wern't 73 kgs after all , and were only 71kgs? A useful working practice tip is to touch the patients nose - if cold its an excellent tip at giving the game away that patient is shutting down.........but of course thats TOO LATE.. So, if an external sensor that was out of the way of fans, heaters, away from machines that generate a lot of heat, open windows could predict this that would be great. http://clinicalneed.nic.nhs.uk/ClinicalNeedView.aspx?need=226 Wed, 16 Feb 2011 20:38:00 GMT Dialysis needles able to locate flow of blood through fistulae (so helpful at locating awkward vessels), better still if able to estimate depth/length/shape of vessel under skin.......... http://clinicalneed.nic.nhs.uk/ClinicalNeedView.aspx?need=225 Wed, 16 Feb 2011 20:27:00 GMT Clotting is a more common problem for PTFE grafts than for Cimino fistulae. (Blood is stimulated to clot by artificial substances; blood vessel walls contain substances that help to prevent clotting.) It is usually possible to tell by examining a fistula or graft if there is good flow through it. Good flow is turbulent and often produces a rhythmic buzz or thrill. If a previously appreciated thrill is gone, it usually means that flow has diminished significantly. The access should be checked three times a day, especially in the morning, to insure that there is still flow.. Clotting occurs more frequently in the summer months when patients are more likely to become dehydrated and flow through the access device decreases. If there was a way of making audible the rhythmic buzz so that an alarm or alert could be heard then that would reduce the risk of clotting. Also if there was a way of cooling down the flow by using intelligent materials that would be great. http://clinicalneed.nic.nhs.uk/ClinicalNeedView.aspx?need=224 Thu, 10 Feb 2011 18:56:00 GMT Mental well-being in the workplace interventions are challenged by a myriad of issues including delivering within the changing and complex organisational environment, insufficient attention paid to the individual characteristic of the audience, the influence of individual difference, the need for proactive versus reactive interventions as well as providing interventions which are time sensitive and measureable. A recent systematic review of the literature on art therapy and mental well-being in the workplace interventions suggests that art therapy based interventions could respond effectively to these issues. The clinical need therefore is to launch a field trial to assess the effectiveness of art therapy as a potential ‘one-size-fits-all ‘mental well-being in the workplace intervention on both individual and tertiary levels. http://clinicalneed.nic.nhs.uk/ClinicalNeedView.aspx?need=222 Thu, 03 Feb 2011 13:14:00 GMT Better information management is not just a matter of more pictures, video and graphs, though that is very important. Much medical data is in the form of text and current text manipulation systems are very basic. The Hyperwords Company makes all the words on the web richly, and usefully interactive - we take the position that the written word is A fundamental unit of knowledge and therefore how we interact with words is of crucial importance. Please have a look at exactly what we mean on our website: www.hyperwords.net and do not hesitate to get in touch via email or you can phone me directly on 0787 517 3378. The application of interactive words for the medical community - both for professionals and patients, is an increase in the ability to deal with the large amount of information. Terms can be looked up at the click of the mouse without a web designer needing to pre-link anything. Units can be converted on the fly and text translated and shared at the touch of a button. The Hyperwords Company was initially a research project at UCLIC (UCL Interaction Center) and is now a UK company collaborating with Doug Engelbart (inventor of personal computing, including word processing and the computer mouse), Ted Nelson (hypertext innovator) and Vint Cerf (co inventor of the internet). Thank you for reading our Statement of clinical need, I very much look forward to hearing from you. http://clinicalneed.nic.nhs.uk/ClinicalNeedView.aspx?need=220 Fri, 07 Jan 2011 13:42:00 GMT Although the NHS National Programme for IT has been shelved, and the Conservatives are pushing for a private/competitive market so that Trusts can choose the desired EHR system, I still think that the most important step is to address the need of a standardised platform for medical health data (ie. notes, images, diagrams, etc), similar to how JPEG, mp3/mp4, H.264, 802.1, PACS are all platform standards. Once the platform standard has been built, software applications regardless of OS or device should seamlessly interface with the data very much like how sophisticated social networking websites (Facebook, Flickr, Engadget, etc) do so with APIs. This would build a robust platform which would lasts years and would also be up-to-date with the fast moving pace of IT technology, rather than playing catch-up for ever. http://clinicalneed.nic.nhs.uk/ClinicalNeedView.aspx?need=211 Fri, 04 Jun 2010 11:12:00 GMT Every flu season but more so in the current swine flu season all GP's want to have a simple and quick diagnostic test to know if patients have or have not got infection with Influenza A. This would aid greatly diagnostic certainty and management. http://clinicalneed.nic.nhs.uk/ClinicalNeedView.aspx?need=210 Tue, 11 May 2010 17:05:00 GMT