The direction, by a senior clinician, of the requesting of blood tests by junior doctors to ensure that requests were based on clinical need, reduced the number of inappropriate blood tests and resulted in some reduction in laboratory costs.

Background: Tracheostomies are common procedures in head and neck surgery and critical care practice. Fifty percent of airway-related deaths on intensive care units are attributed to tracheostomy complications. The National Confidential Enquiry into Patient Outcome and Death (NCEPOD) advocated the implementation of mandatory training for health care staff involved in the management of neck stoma patients. Despite these recommendations, effective training in emergency management of neck stoma patients remains substandard. Methods: We present the evaluation of a pilot 1day workshop consisting of interactive lectures and high-fidelity simulation scenarios in a purpose-built clinical simulation centre. The simulation recreated commonly encountered clinical scenarios aimed at increasing participants' knowledge and confidence in assessing and managing common neck stoma emergencies. The workshop was an optional interprofessional training session for postgraduate nurses and doctors. Participants completed a multiple-choice question (MCQ) questionnaire before and after the workshop, and a 16-point post-workshop evaluation questionnaire. Results: A total of 14 participants attended the pilot workshop. The MCQ mean score improved from 53% (range, 50-70%) to 63.8% (range, 60-80%) following the workshop. All participants reported increased confidence in assessing and managing patients with neck stomas. They all felt the workshop was a valuable learning experience, and that training on neck stoma emergencies should be provided regularly in the postgraduate curriculum. Conclusions: The simulation workshop provided postgraduate clinical staff with safe and effective interprofessional training. The participants gained knowledge and increased confidence in the early recognition, practical assessment and management of tracheostomy and laryngectomy emergencies.

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