Developing effective educational approaches for Liaison Old Age Psychiatry teams: a literature review of the learning needs of hospital staff in relation to managing the confused older patient

2009 ◽  
Vol 22 (6) ◽  
pp. 874-885 ◽  
Author(s):  
Andrew Teodorczuk ◽  
Mark Welfare ◽  
Sally Corbett ◽  
Elizabeta Mukaetova-Ladinska
Keyword(s):  
General Hospital ◽  
Old Age ◽  
Intervention Studies ◽  
Healthcare Professionals ◽  
Hospital Setting ◽  
Educational Interventions ◽  
Learning Needs ◽  
Older Patient ◽  
Old Age Psychiatry ◽  
The Impact

ABSTRACTBackground:Deficiencies in the knowledge, skills and attitudes of all healthcare professionals working within the general hospital contribute towards the suboptimal care of older hospitalized patients with confusion. In the U.K., policy dictates that Liaison Old Age Psychiatry teams deliver effective education to general hospital clinical staff. The purpose of this paper is to review the literature concerning the learning needs of healthcare professionals in relation to managing confusion in the older patient in order to inform effective educational approaches for Liaison Old Age Psychiatry teams.Methods:A broad range of medical and educational databases were searched. Identified English language studies were selected for further analysis if they had a specific educational focus in the hospital setting and then further subdivided into intervention and naturalistic studies. The impact of intervention studies was evaluated by Kirkpatrick's system. Learning needs, as determined from the naturalistic studies, were mapped to identify themes.Results:13 intervention studies were identified. Despite a high level of effectiveness for educational interventions, it was unclear what the active components were. A further 23 naturalistic studies were identified; their findings focused on knowledge gaps, diagnostic behaviors and experiences, attitudes and training issues. Few studies specifically researched learning needs or the educational role of liaison teams. Conspicuous by its absence was reference to relevant educational theories.Conclusions:The findings of this review can be incorporated in the planning of local curricula by Liaison Teams in order to design educational strategies. There is a need for further research, especially studies exploring the learning needs ofallhealthcare professionals.

661 Improving Antibiotic Prescribing in a District General Hospital: A Closed Loop Audit

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
Z H Ng ◽  
T Kamran
Keyword(s):  
General Hospital ◽  
District General Hospital ◽  
Educational Interventions ◽  
Correct Choice ◽  
Antibiotic Prescribing ◽  
Surgical Team ◽  
Abdominal Abscesses ◽  
Antibiotic Efficacy ◽  
The Impact ◽  
Local Antibiotic

Abstract Aim Broad-spectrum antibiotics are effective in decreasing wound infection and postoperative intra-abdominal abscesses for patients undergoing appendicectomy. Compliance with local hospital antibiotic guidelines is important in ensuring antibiotic efficacy and reducing potential for toxicity and antibiotic resistance. The aim was to assess the impact of educational interventions on the adherence to local antibiotic guidelines in patients undergoing appendicectomy at a Scottish district general hospital. Method Preoperative antibiotic prescribing in consecutive adult patients aged ≥ 16 years undergoing appendicectomy were audited against hospital guidelines over a four-month period between March 2019 and July 2019. We implemented change through antibiotic prescribing teaching for doctors in the surgical team and anaesthetic team. This change was subsequently evaluated through a re-audit over a three-month period between December 2019 and February 2020. Results The baseline audit demonstrated 68.8% (n = 11/16) compliance to local antibiotic guidelines among patients undergoing appendicectomy. The remaining patients had the correct choice of antibiotics, but gentamicin was prescribed in different doses. Gaps in prescriber awareness of antibiotic guidelines were identified. Following departmental teaching sessions regarding antibiotic prescribing and use of the gentamicin dosing calculator, the re-audit showed 93.8% (n = 15/16) compliance with local antibiotic guidelines among prescribers in the surgical team and anaesthesic team. Conclusions Education interventions were instrumental in improving adherence to antibiotic prescribing guidelines. This highlights the importance of regular audit and prescriber education in the promotion of antibiotic stewardship in hospitals.

scholarly journals A new opportunity: three tales of training in liaison psychiatry of old age

2002 ◽  
Vol 26 (11) ◽  
pp. 433-435 ◽  
Author(s):  
John Holmes ◽  
Jon Millard ◽  
Susie Waddingham
Keyword(s):  
General Hospital ◽  
Old Age ◽  
Psychiatric Comorbidity ◽  
Psychiatric Symptoms ◽  
Specialist Training ◽  
Liaison Psychiatry ◽  
Adult Psychiatry ◽  
Old Age Psychiatry ◽  
Hospital Wards ◽  
And Training

Liaison psychiatry has emerged as a sub-speciality within general adult psychiatry, with specific experience and training being required to develop the skills and knowledge to address comorbid physical and psychiatric symptoms and illness (House & Creed, 1993; Lloyd, 2001). Older people often present with significant physical and psychiatric comorbidity (Ames et al, 1994; Holmes & House, 2000) and most old age psychiatry services receive one-quarter to one-third of referrals from general hospital wards (Anderson & Philpott, 1991). Despite this, there are no specific requirements for training in liaison psychiatry for old age psychiatrists at any level. The experience gained in assessing and treating general hospital referrals during basic and higher specialist training is felt to be adequate (Royal College of Psychiatrists, 1998).

scholarly journals An audit: fitness to drive assessment in inpatients of general adult and old age psychiatry

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S200-S201
Author(s):  
Ismail Khan ◽  
Nneamaka Asiodu ◽  
Dr Divyanish ◽  
Anum Yaqoob ◽  
Hasanain Qureshi
Keyword(s):  
Old Age ◽  
Social Withdrawal ◽  
Data Collection Tool ◽  
Fitness To Drive ◽  
Good Medical Practice ◽  
Adult Psychiatry ◽  
Old Age Psychiatry ◽  
Duty To Inform ◽  
The Impact ◽  
Physical Health Screening

AimsTo determine if fitness to drive is assessed on admission and discharge, if applicable, and for this to be documented during clerking and on discharge notifications.To determine if patients are being educated about the impact of their condition on the ability to safely drive.To ascertain if patients are aware of the duty to inform the DVLA if they for any reason are not fit to drive.BackgroundRisk factors include social, behavior and iatrogenic factors such as social withdrawal, increased likelihood of substance abuse and side effects of anti-psychotic medication.MethodThis trust wide audit involved the random sampling of a total of 71 case notes, 4 case notes per Consultant team in general adult psychiatry and old age psychiatry across Dudley and Walsall sites (total of 3 sites). A data collection tool was developed and included relevant questions regarding fitness to drive. Data were collected between October and December 2019.Result18/49 patients had physical health screening prior to medication initiation.ConclusionAn important aspect of good medical practice is to educate patients about their condition, this includes their fitness to drive as this can be affected both by their diagnosis and medication. It is clear that clinicians also need to be educated about this responsibility to ensure assessment is performed especially on inpatient discharge.

scholarly journals The impact of healthcare workers job environment on their mental-emotional health. Coping strategies: the case of a local general hospital

2015 ◽  
Vol 3 (1) ◽  
Author(s):  
Aristotelis Koinis ◽  
Vasiliki Giannou ◽  
Vasiliki Drantaki ◽  
Sophia Angelaina ◽  
Elpida Stratou ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Social Support ◽  
General Hospital ◽  
Healthcare Professionals ◽  
Emotional Health ◽  
Predisposing Factors ◽  
Workplace Stress ◽  
Stressful Events ◽  
The Impact

Workplace stress can influence healthcare professionals’ physical and emotional well-being by curbing their efficiency and having a negative impact on their overall quality of life. The aim of the present study was to investigate the impact that work environment in a local public general hospital can have on the health workers’ mental-emotional health and find strategies in order to cope with negative consequences. The study took place from July 2010 to October 2010. Our sample consisted of 200 healthcare professionals aged 21-58 years working in a 240-bed general hospital and the response rate was 91.36%). Our research protocol was first approved by the hospital’s review board. A standardized questionnaire that investigates strategies for coping with stressful conditions was used. A standardized questionnaire was used in the present study Coping Strategies for Stressful Events, evaluating the strategies that persons employ in order to overcome a stressful situation or event. The questionnaire was first tested for validity and reliability which were found satisfactory (Cronbach’s α=0.862). Strict anonymity of the participants was guaranteed. The SPSS 16.0 software was used for the statistical analysis. Regression analysis showed that health professionals’ emotional health can be influenced by strategies for dealing with stressful events, since positive re-assessment, quitting and seeking social support are predisposing factors regarding the three first quality of life factors of the World Health Organization Quality of Life -BREF. More specifically, for the physical health factor, positive re-assessment (t=3.370, P=0.001) and quitting (t=−2.564, P=0.011) are predisposing factors. For the ‘mental health and spirituality’ regression model, positive re-assessment (t=5.528, P=0.000) and seeking social support (t=−1.991, P=0.048) are also predisposing factors, while regarding social relationships positive re-assessment (t=4.289, P=0.000) is a predisposing factor. According to our findings, there was a notable lack of workplace stress management strategies, which the participants usually perceive as a lack of interest on behalf of the management regarding their emotional state. Some significant factors for lowering workplace stress were found to be the need to encourage and morally reward the staff and also to provide them with opportunities for further or continuous education.

Reducing the number of unnecessary laboratory tests within hospital through the use of educational interventions

2021 ◽  
pp. 000456322110406
Author(s):  
Michael Thurm ◽  
Helen Craggs ◽  
Merlin Watts ◽  
Anthony Brooks
Keyword(s):  
Cohort Study ◽  
Cost Saving ◽  
General Hospital ◽  
Laboratory Tests ◽  
Patient Management ◽  
District General Hospital ◽  
Educational Interventions ◽  
Blood Tests ◽  
Medical Teams ◽  
The Impact

Background The growing number of laboratory investigation requests is placing an increased burden upon NHS resources. Around a quarter of all tests are unnecessary repeats, and almost a third have no impact on patient management. Doctors recognise that tests should only be performed when clinically indicated, but a culture persists of undertaking unnecessary repeat investigations. Methods A cohort study was undertaken at a district general hospital to observe the impact of introducing educational interventions in the form of a poster and a series of educational lectures, encouraging clinicians to consider whether an investigation was clinically indicated. Data was collected from nine different sites across the hospital run by different medical teams regarding the number of tests undertaken and the impact on patient care. Results Data from over 13,000 tests and over 2000 patients was analysed from nine different sites across the hospital. There was a significant reduction (33%, p = 0.0001) in the number of blood tests performed. This reduction in testing saved £7006 over the course of 1 month, in addition to other benefits. There was a reduction in testing in eight out of the nine sites in which the study was undertaken, demonstrating good generalisability of results. There was no significant increase in length of admission or mortality. Conclusion Educational interventions to doctors have a significant and safe impact in reducing the number of unnecessary investigations, providing cost saving benefits to the NHS.

The experience of depression

2020 ◽  
pp. 591-594
Author(s):  
Dening et
Keyword(s):  
Old Age ◽  
Healthcare Professionals ◽  
Clinical Aspects ◽  
First Person ◽  
Diagnosis And Management ◽  
Old Age Psychiatry ◽  
Person Account

The majority of chapters in this book demonstrate clinical aspects of various aspects of old age psychiatry. These accounts tend to focus only on the viewpoints of the healthcare professionals involved in the investigation, diagnosis, and management of the condition. This chapter is different, and provides a first-person account of an anonymous author and his experience of having episodes of depression. The author describes the course of the condition at various times in his life and the various ways in which it has affected him at various stages. This chapter also describes his experiences of treatment and contact with professionals.

Dangers and Benefits of Social Media on E-Professionalism of Healthcare Professionals: Rapid Evidence-Based Review (Preprint)

2020 ◽  
Author(s):  
Tea Vukusic Rukavina ◽  
Josko Viskic ◽  
Lovela Machala Poplasen ◽  
Danko Relic ◽  
Marko Marelic ◽  
...  
Keyword(s):  
Social Media ◽  
Systematic Reviews ◽  
Professional Education ◽  
Healthcare Professionals ◽  
Educational Interventions ◽  
Rapid Review ◽  
Future Research ◽  
Measurement Tool ◽  
The Impact

BACKGROUND As we are witnessing the evolution of social media (SM) use globally among the general population, popularity of SM has also been embraced by healthcare professionals. In the context of SM evolution and exponential growth of users, this rapid review summarizes recent findings about e-professionalism of healthcare professionals (HCPs). OBJECTIVE The objective of our study was to review and characterize the original peer-reviewed research studies published from November 1, 2014 to November 31,, 2018 on e-professionalism of healthcare professionals, to assess the quality of methodologies and approaches used, to explore the impact of social media on e-professionalism of healthcare professionals recognizing benefits and dangers of social media and to provide insights to guide future research in this area. METHODS A search of the literature was performed in December 2018 using 3 databases (PubMed, CINAHL and Scopus). The searches were conducted using the following defined search terms: 'professionalism’ AND 'social media' OR 'Internet' OR ‘Facebook’ OR ‘Twitter’ OR ‘Instagram’. The search strategy was limited to studies published in English. This rapid review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses and the Measurement Tool to Assess Systematic Reviews guidelines. RESULTS Of the 709 retrieved papers, a total of 58 studies were finally included in this review. Overall, the quality of the studies was satisfactory. Participants in the reviewed studies were from diverse healthcare professions. Medical health professionals were involved in about three-quarters of the studies. Three key benefits of SM on e-professionalism of HCPs were identified: 1) professional networking and collaboration, 2) professional education and training and 3) effectiveness of educational interventions about e-professionalism or impact of existing SM policies. For the selected studies, there are five recognized dangers of SM on e-professionalism of HCPs: 1) loosening accountability, 2) compromising confidentiality, 3) blurred professional boundaries, 4) depiction of unprofessional behavior, and 5) legal issues. This rapid review also recognizes recommendations for changes in educational curricula regarding e-professionalism or adopting novel approaches to existing SM policies as opportunities for improvement and barriers that influence HCPs use of SM in the context of e-professionalism. CONCLUSIONS Findings in reviewed studies indicate existence of both benefits and dangers of SM on e-professionalism of HCPs. Even though there are some barriers recognized, this review has highlighted existing recommendations for including e-professionalism in educational curricula of HCPs. Based on all evidence provided, this review provided new insights and guides for future research on this area. There is a clear need for robust research to investigate new emerging SM platforms, the efficiency of guidelines and educational interventions, and the specifics of each profession regarding their SM potential and usage. CLINICALTRIAL PROSPERO CRD42019131532; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42019131532

Psycho-educational interventions designed to prevent deployment-related psychological ill-health in Armed Forces personnel: a review

2010 ◽  
Vol 41 (4) ◽  
pp. 673-686 ◽  
Author(s):  
K. Mulligan ◽  
N. T. Fear ◽  
N. Jones ◽  
S. Wessely ◽  
N. Greenberg
Keyword(s):  
Intervention Studies ◽  
Emergency Services ◽  
Armed Forces ◽  
Educational Interventions ◽  
Beneficial Effects ◽  
Potentially Traumatic Events ◽  
Randomized Controlled ◽  
Process And Outcome ◽  
The Military ◽  
The Impact

BackgroundEmployers such as the Armed Forces (AF) and emergency services, who predictably expose their staff to potentially traumatic events (PTEs), often provide psycho-educational briefings in an attempt to mitigate possible adverse psychological sequelae. Within the military, psycho-educational briefings are widely used, particularly following exposure to PTEs on operations. The aim of this review was to evaluate the efficacy of these interventions and make appropriate recommendations.MethodA search of Medline, PsycINFO and EMBASE was conducted, bibliographies of retrieved articles were searched and experts in the field were consulted.ResultsTwo surveys and seven intervention studies were identified for inclusion in the review. Only three studies were randomized controlled trials (RCTs). Overall, the review found some evidence of benefit of psycho-educational interventions but it was not consistent across studies or outcomes and effects were small. However, there was also little evidence to suggest that they caused harm. There was some evidence that the beneficial effects may be greater for those who have been exposed to a higher number of PTEs.ConclusionsGiven the high operational tempo currently faced by coalition forces personnel, there remains a pressing need to identify the most effective way of minimizing the impact of exposure to potentially traumatic deployment incidents. To date, few psycho-educational interventions designed to prevent deployment-related psychological ill-health have been evaluated systematically in methodologically robust studies. The review recommends that future interventions are theoretically based and evaluated in cluster RCTs that examine both process and outcome variables.

scholarly journals The impact of interventions to improve compliance in hand hygiene – a prospective study from Sangre Grande Hospital

2018 ◽  
Author(s):  
Rajeev Nagassar ◽  
Roma Bridgelal-Nagassar ◽  
Keston Daniel ◽  
Lima Harper
Keyword(s):  
Hand Hygiene ◽  
Prospective Study ◽  
Compliance Rate ◽  
Hospital Setting ◽  
Educational Interventions ◽  
World Health ◽  
Post Intervention ◽  
Improve Hand Hygiene ◽  
A Prospective Study ◽  
The Impact

Objectives To assess the compliance of hand hygiene (HH) practices of staff and determine the impact of multimodal interventions to improve hand hygiene practices. Methods A prospective study was conducted to determine the hand hygiene (HH) practices of staff according to the World Health Organization’s “5 moments of HH”. During random visits to the general wards, HH practices of staff were observed for 41 weeks during 2014-15. During the first 8 weeks, the basic compliance rate (BCR) was calculated. A BCR of 50% or more was considered compliant. Data were provided to the staff via email. Toolbox talks, posters, and other educational interventions were instituted in a multimodal manner. Wards were visited by infection control staff to reinforce HH practices. During the post-intervention phase, the HH practices were reassessed for 33 weeks to compare the impact of interventions. Results A total of 13,120 observations were made. Participants ranged from ages 18 to 65. The overall average BCR before intervention was 34.1%, for the first 8 weeks, while it increased to 62.3%, over the next 33 weeks, after the multimodal interventions (p =0.007). The wards which showed significant improvement include Paediatrics (p <0.0001), Male Surgical (p = 0.001), Female Surgical (p = 0.005), Male Medical (p < 0.0001), Haemodialysis Unit (p < 0.0001), ICU, (p = 0.038), and Accident and Emergency (p = 0.007). Obstetric, Female Medical, and Oncology wards did not show statistically significant improvement. Conclusion Hand Hygiene compliance rate of staff can be improved by multimodal interventions in a General Hospital setting.

Patient and carer participation in old age psychiatry in England. Part I: a systemic perspective of the historical and policy context

2011 ◽  
Vol 24 (2) ◽  
pp. 175-184 ◽  
Author(s):  
Susan Mary Benbow
Keyword(s):  
Mental Health ◽  
Old Age ◽  
Healthcare Professionals ◽  
Historical Context ◽  
Service Development ◽  
Healthcare Staff ◽  
Policy Context ◽  
Systemic Theory ◽  
Service Evolution ◽  
Old Age Psychiatry

ABSTRACTBackground: Patient and carer participation in old age psychiatry is less developed than in other areas of mental health. What can we learn from the historical context about increasing participation and how can it be conceptualized?Methods: The historical and policy context of patient and carer participation in the National Health Service is reviewed and related to the development of old age psychiatry in England and the parallel development of the mental health user movement.Results: Systemic theory is offered as a way of understanding how partnership between healthcare professionals, patients and carers might lead to service evolution by bringing a range of perspectives together in order to co-construct a mutually influenced outcome. It is further suggested that this might empower not only patients and carers but also healthcare staff at a time when they are under increasing pressures.Conclusions: Old age psychiatry patients and carers struggle to be heard but have much to offer to services in partnership with healthcare professionals as partners and allies in service development.

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