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Implementing NICE guidance

CardioQ-ODM oesophageal doppler monitor. Implementing NICE guidance. March 2011. NICE medical technology guidance 3. What this presentation covers. Background Guidance Costs and savings Discussion Accessing the guidance and implementation tools.

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Implementing NICE guidance

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  1. CardioQ-ODM oesophageal doppler monitor Implementing NICE guidance March 2011 NICE medical technology guidance 3

  2. What this presentation covers • Background • Guidance • Costs and savings • Discussion • Accessing the guidance and implementation tools

  3. Background: medical technologies guidance • NICE medical technology guidance addresses specific technologies notified to NICE by manufacturers. • If the case for adopting the technology is supported, then the technology has been found to offer advantages to patients and the NHS. • The specific recommendations on individual technologies are not intended to limit use of other relevant technologies that may offer similar advantages.

  4. Background: current clinical practice • To ensure adequate organ perfusion during surgery it is essential to optimise intravascular volume and cardiac output • Methods for measuring this include: • conventional clinical assessment of heart rate and blood pressure • central venous catheter monitoring • pulse contour analysis • dye dilution • measurement of thoracic electrical impedance • transoesophageal echocardiography • pulmonary artery catheters

  5. Background: CardioQ-ODM • An oesophageal doppler monitor that assesses cardiac output and intravascular fluid status • A single-use probe is placed in the oesophagus • Ultrasound signal is reflected by red blood cells in the aorta; stroke volume and cardiac output can be measured from the reflected signal • Fluid management during surgery is guided by using the CardioQ-ODM to monitor changes in stroke volume

  6. Guidance (1) • Compared with conventional clinical assessment (with or without invasive cardiovascular monitoring) the CardioQ-OMD is associated with reduced: • postoperative complications • use of central venous catheters • in-hospital stay • The case for adopting it in the NHS is supported by the evidence Image reproduced with kind permission of Deltex Medical Group plc.

  7. Guidance (2) • Consider the CardioQ-ODM for patients having major or high-risk surgery or other surgical patients in whom invasive cardiovascular monitoring would be considered Image reproduced with kind permission of Deltex Medical Group plc.

  8. Costs and savings for the NHS

  9. Costs and savings: the equipment • If the CardioQ-ODM is used in 50% of eligible patients, the initial outlay for the monitors could be repaid by savings made after 10 days

  10. Costs and savings: length of stay

  11. Costs and savings: central venous pressure monitoring

  12. Discussion • Clinicians • How can we prepare a case for the organisation to invest in this technology? • How can we encourage our colleagues to use this technology? • Management • What needs to be done to facilitate the purchase of the CardioQ-ODM device in our organisation? • What can we do to facilitate implementation of the device within our organisation?

  13. ‘How to why to’ guide

  14. Accessing the guidance and implementation tools online • Guidance • Costing tools • Podcast • available from: www.nice.org.uk/MTG3 Image reproduced with kind permission of Deltex Medical Group plc.

  15. What do you think? • Did the implementation tool you accessed today meet your requirements, and will it help you to put the NICE guidance into practice? • We value your opinion and are looking for ways to improve our tools. Please complete a short evaluation form. • If you have problems accessing or using this tool, please email implementation@nice.org.uk To open the links in this slide set right click over the link and choose ‘open link’

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