scholarly journals 1062 Are CT-KUB Requests Adequately Completed by Urologists in Emergency Settings?

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
M Mubarak ◽  
N Awad

Abstract Aim Imaging requests are an essential communication tool between urologists and radiologists. Poorly completed request forms, especially in acute settings, directly translates to substandard patient care. We aimed to evaluate and improve our request completion practice in emergency settings. Method 40 randomly selected CT-KUB images were reviewed to assess the completion of clinical background, question, patient data, location, and requester data. A multiple cycle audit followed by minor intra-departmental interventions were carried out over ten months to evaluate compliance. In December 2019, 55% and 52.5% of the requests lacked a good clinical history and question, respectively. The remaining three domains achieved the target of 100%. Subsequently, the literature and the audit data were shared and discussed, and a verbal agreement was made to improve practice. Result A re-audit revealed a 22.5% and 2.5% improvement in providing sufficient clinical background and questions. Findings were presented at an informal setting, and feedback was obtained on improving compliance. Simple posters or notices and occasional reminders were found as acceptable approaches. Following the implementation of feedback and orientation for joining junior doctors, a third audit cycle showed a significant improvement in compliance with 90% and 82.5%. A final cycle to assess the maintenance improvements in background and question provision was at a high of 97.5% and 90%. Conclusions CT-KUB request completion is essential in emergency settings to ensure optimal patient care. Improving compliance can be achieved using small interventions catered to the department, such as peer-to-peer discussions, reminder posters, and orientations.

2020 ◽  
Vol 37 (12) ◽  
pp. 839.1-839
Author(s):  
Dominic Craver ◽  
Aminah Ahmad ◽  
Anna Colclough

Aims/Objectives/BackgroundRapid risk stratification of patients is vital for Emergency Department (ED) streaming during the COVID-19 pandemic. Ideally, patients should be split into red (suspected/confirmed COVID-19) and green (non COVID-19) zones in order to minimise the risk of patient-to-patient and patient-to-staff transmission. A robust yet rapid streaming system combining clinician impression with point-of-care diagnostics is therefore necessary.Point of care ultrasound (POCUS) findings in COVID-19 have been shown to correlate well with computed tomography (CT) findings, and it therefore has value as a front-door diagnostic tool. At University Hospital Lewisham (a district general hospital in south London), we recognised the value of early POCUS and its potential for use in patient streaming.Methods/DesignWe developed a training programme, ‘POCUS for COVID’ and subsequently integrated POCUS into streaming of our ED patients. The training involved Zoom lectures, a face to face practical, a 10 scan sign off process followed by a final triggered assessment. Patient outcomes were reviewed in conjunction with their scan reports.Results/ConclusionsCurrently, we have 21 ED junior doctors performing ultrasound scans independently, and all patients presenting to our department are scanned either in triage or in the ambulance. A combination of clinical judgement and scan findings are used to stream the patient to an appropriate area.Service evaluation with analysis of audit data has found our streaming to be 94% sensitive and 79% specific as an indicator of COVID 19. Further analysis is ongoing.Here we present both the structure of our training programme and our integrated streaming pathway along with preliminary analysis results.


2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
A Gowda ◽  
Z Chia ◽  
T Fonseka ◽  
K Smith ◽  
S Williams

Abstract Introduction Every day in our surgical department; prior to our quality improvement project, Junior Doctors spent on average 3.26 clinical hours maintaining 5 surgical inpatient lists of different specialities with accessibility of lists rated as “neutral” based on a 5-point scale from difficult to easy. Our hospital previously had lists stored locally on designated computers causing recurrent difficulties in accessing and editing these lists. Method We used surveys sent to clinicians to collect data. Cycle 1: Surgical Assessment Units list on Microsoft Teams Cycle 2: Addition of surgical specialities and wards lists onto Microsoft Teams. Cycle 3 (current): expand the use of Microsoft Teams to other specialities. Results Utilising technology led to a 25% reduction in time spent on maintaining inpatient lists, to 2.46 hours a day, and an improvement in the accessibility of lists to “easy”. Across a year, this saves over 220 hours clinician hours which can be used towards patient care and training. Furthermore, use of Microsoft Teams has improved communication and patient care, in the form of virtual regional Multi-Disciplinary Team meetings and research projects. Conclusions Microsoft Teams is currently free to all NHS organisations in England so there is potential for these efficiency savings to be replicated nationwide.


2018 ◽  
Vol 02 (02) ◽  
pp. 106-115
Author(s):  
Joshua Cornman-Homonoff ◽  
David Madoff

AbstractThe peritoneum, omenta, and mesenteries can be affected by a myriad of disease processes, but many common pathologies cannot be definitively distinguished based on clinical history and imaging characteristics alone. Percutaneous image-guided biopsy is a safe, well-tolerated procedure with high diagnostic accuracy, which has supplanted more invasive means of obtaining tissue and is increasingly essential in directing patient care. An understanding of the indications, pre-procedural evaluation, technical considerations, and potential complications is essential for the radiologist who performs these procedures, and more broadly for any clinician who may request them.


BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S196-S196
Author(s):  
Qutub Jamali ◽  
Tarun Khanna ◽  
Gareth Thomas

AimsTo explore the level of supervision between training and non-training posts at LSCFT.Background•Supervision is defined as ‘provision of guidance and feedback on matters of personal, professional and educational development in the context of a trainees' experience of providing safe and appropriate patient care’.•Along with the trainees, doctors working in non-training posts such as staff grade, specialty doctors, trust grade doctors (TJD)and MTI (Medical training initiative) doctors form an integral part of patient care in the NHS.Method•A mixed method approach was adopted with both qualitative and quantitative data collected simultaneously in the form of an online questionnaire.•An anonymous online questionnaire was sent to junior doctors currently in training and non-training posts at LSCFT in 2019 using Meridian software.Result1- Quantitative Data: - Participants included were doctors in training post such as Foundation Doctors (5), Psychiatry Core Trainees (6), GP STs (2) and doctors in non-training post such as TJD (4), Specialty Doctors (2) and MTI doctors (4). Based on the Meridian score, 84% of doctors were satisfied with the supervision. It was found that 72% of doctors received weekly supervisions, 10% monthly (1 TJD, 1 Foundation trainee) and16% bi-monthly (1 MTI, 1 SAS, 2 CTs). The data suggested that there was no difference in the frequency of supervisions between training and non-training posts at LSCFT.2- Qualitative Data: - The feedback was common as there was no major difference between training and non-training doctors. •Positives – WPBAs, discussion on reflections, management of complex cases and medication, personal issues affecting work.•Negatives – Limited discussion on QI, Audit, Research and Psychotherapy.- More specific help, need more support at times.Conclusion1.To prepare a checklist of contents to be discussed during supervision.2.To prepare a timeline chart of supervision.3.Preparing a ‘menu’ of QI projects that junior doctors can sign up to at the start of each post.4.To formulate training packages available to support junior doctors with QI/Audits.


2006 ◽  
Vol 88 (9) ◽  
pp. 318-319
Author(s):  
MBS Brewster ◽  
R Potter ◽  
D Power ◽  
V Rajaratnam ◽  
PB Pynsent

For the last few years all the hospitals in the UK have been changing junior doctors' rotas to become compliant with the European Working Time Directive (EWTD). The first stage, requiring a junior doctor to work a maximum of 58 hours per week averaged over a 6-month period, became law in August 2004. In addition to new posts for junior doctors there have been schemes to facilitate the transition, such as the Hospital at Night programme. This was designed to use the minimum safe number of doctors from appropriate specialties with supporting medical staff to cover the hospital out of hours. It was required to make the most efficient use of this team and allow the junior doctor rotas to be compliant with the appointment of as few new posts as possible.


2020 ◽  
Vol 11 (2.ESP) ◽  
Author(s):  
Tercia Soares Sharpe

Objetivo: Mostrar como o uso da tecnologia na comunicação, tem contribuído para promover o diálogo e a compaixão no atendimento ao paciente, minimizando o isolamento e facilitando a comunicação com entes queridos no fim da vida. Método: Estudo baseado num artigo de opinião. Resultados: Estudo aponta o uso do Face Time como importante ferramenta de comunicação, durante o cuidado aos pacientes internados em Unidade de Tratamento Intensivo e seus familiares. Considerações Finais: Os cuidados de Enfermagem em Unidade de Tratamento Intensivo com o uso de tecnologias de comunicação favorecem a afetividade entre cliente-família-enfermeira, além de estimular a compaixão e a empatia.Descritores: Enfermagem; Cuidados Paliativos na Terminalidade da Vida; Enfermagem de Cuidados Paliativos na Terminalidade da Vida; Empatia; Infeção por Coronavírus. YOU WON'T DIE ALONE: TECHNOLOGY AND COMPASSION IN THE COVID-19 PANDEMICObjective: to describe how the use of technology in communication has contributed to promote dialogue and compassion in patient care, minimizing isolation and facilitating communication with loved ones at the end of life. Method: Study based on an opinion article. Results: A study points to the use of Face Time as an important communication tool, during the care of patients admitted to the Intensive Care Unit and their families. Final Considerations: Nursing care in the Intensive Care Unit with the use of communication technologies favors affection between client-family-nurse, in addition to stimulating compassion and empathy.Descriptors: Nursing; Hospice Care; Hospice and Palliative Nursing Care; Empathy; Coronavirus Infections.NO MORIRÁS SOLO: TECNOLOGÍA Y COMPASIÓN EN LA PANDEMIA DE COVID-19Objetivo: mostrar cómo el uso de la tecnología en la comunicación ha contribuido a promover el diálogo y la compasión en la atención al paciente, minimizando el aislamiento y facilitando la comunicación con los seres queridos al final de la vida. Método: Estudio basado en un artículo de opinión. Resultados: Un estudio señala el uso de Face Time como una herramienta de comunicación importante, durante la atención de pacientes ingresados en la Unidad de Cuidados Intensivos y sus familias. Consideraciones finales: La atención de enfermería en la Unidad de Cuidados Intensivos con el uso de tecnologías de comunicación favorece el afecto entre el cliente-familia-enfermera, además de estimular la compasión y la empatía.Descriptores: Enfermería; Cuidados Paliativos al Final de la Vida; Enfermería de Cuidados Paliativos al Final de la Vida; Empatía; Infecciones por Coronavirus.


2021 ◽  
Author(s):  
Natsuko Nishida ◽  
Tomoko Hikita ◽  
Megumi Iida ◽  
Goshiro Yamamoto ◽  
Tomohiro Kuroda

Shortening hospital stays increases communication needs between nurses in inpatient and outpatient wards. Smooth information sharing is required to reduce the workload of nurses and improve the quality of patient care. However, electronic medical records (EMR) system does not have sufficient functions to support information sharing between wards, because EMR has been developed mainly for recording. This study led to three improvements; unified communication tool, common patient list linked to EMR, and outpatient nursing diagnosis.


1970 ◽  
Vol 3 (1) ◽  
pp. 21-23
Author(s):  
Abdul Latif Bhuiya

The rate of Caesarean delivery in Bangladesh is not known but thought to have increased markedly in recent years. This observational study addressed the prevalence of various types of deliveries conducted on 2714 subjects attending the postnatal ward of a referral hospital in Dhaka from August 1994 to March 1995. During this period data were collected retrospectively from their registries and clinical history sheets. Of these participants 1509 (55.6%) had a history of normal delivery and 1150 (42.4%) underwent Caesarean sections. Very few (1.7%) had other means of delivery and only 0.7% were reported to have forceps delivery. The Caesarian delivery for the first baby was 14.1%, which gradually decreased in subsequent deliveries. Most of the deliveries, be it normal or Caesarean, were conducted by the trainee doctors (43.6%) and Medical Officers (25.7%). Professors and Assistant Professors performed less than 1%. The normal or Caesarean deliveries were assisted mostly by trainee doctors (54.4%), interns (19.0%) and nurses (15.8%); and very few were conducted by Medical Officers (8.3%) and Assistant Registrars (2.1%). The study observes that the rate of Caesarean delivery is much higher than that observed in western countries. Most of the deliveries in this hospital, whether normal or Caesarean, were found to be conducted by the trainee or junior doctors. Ibrahim Med. Coll. J. 2009; 3(1): 21-23 Keywords: Pregnancy, normal delivery, Caesarean delivery, delivery practices, tertiary hospital.   doi: 10.3329/imcj.v3i1.2915


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