scholarly journals EP.TU.160Does a foundation interim year one post improve confidence in the care of the dying of general surgical patients in a tertiary centre?

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Jayan George ◽  
Alok Mathew ◽  
Edward Botsford ◽  
Ahmed Al-Mukhtar
Keyword(s):  
Palliative Care ◽  
Pain Control ◽  
Social Issues ◽  
Spiritual Health ◽  
Surgical Patients ◽  
Microsoft Excel ◽  
Likert Scales ◽  
Google Docs ◽  
Confidence Levels ◽  
Tertiary Centre

Abstract Aims 1. Understand the confidence levels of current foundation year one (FY1) doctors. 2. Understand whether an interim foundation year one (FiY1) post improves confidence. Methods FY1s were surveyed throughout August – December 2020. Six questions used Likert scales (1 to 5: not at all confident to very confident) over some common palliative care themes. Data was initially inputted using Google Docs and analysed in Microsoft Excel. Results 26.7% (28/105) of FY1s completed the survey. 28.6% (8/28) did not undertake a FiY1 post and 71.4% (20/28) did. Confidence levels were higher for FY1s who did have a FiY1 post compared to those that did not in managing pain control, psychological distress, spiritual health, speaking to family and the patient in the last days of life. Confidence levels were similar for all FY1s for dealing with social issues. Conclusions FY1s who have had a FiY1 post in a tertiary centre have more confidence in most areas but not all. This data shows the value of the FiY1 post however work needs to be done to improve the experience to the role.

scholarly journals EP.TU.524Does a foundation interim year one post improve confidence in the care of the dying of general surgical patients in a district general hospital?

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Jayan George ◽  
Alok Mathew ◽  
Edward Robinson ◽  
Rohan Ardley
Keyword(s):  
General Hospital ◽  
Pain Control ◽  
Social Issues ◽  
District General Hospital ◽  
Spiritual Health ◽  
Surgical Patients ◽  
Microsoft Excel ◽  
Likert Scales ◽  
Google Docs ◽  
Confidence Levels

Abstract Aims 1. Understand the confidence levels of current foundation year one (FY1) doctors. 2. Understand whether an interim foundation year one (FiY1) post improves confidence. Methods FY1s were surveyed throughout August – December 2020. Six questions used Likert scales (1 to 5: not at all confident to very confident) over some common palliative themes. Data was initially inputted using Google Docs and analysed in Microsoft Excel. Results 28.6% (8/28) of FY1s completed the survey. 50% (4/8) did not undertake a FiY1 50% (4/8). Confidence levels were higher for FY1s who did have a FiY1 post compared to those that did not in managing pain control, psychological distress, spiritual health, social issues, speaking to family and the patient in the last days of life. Conclusions FY1s who had a FiY1 post had greater confidence levels than those that did not in a district general hospital. This data suggest the value of the FiY1 post however work needs to be done to improve the experience to the role.

scholarly journals EP.TU.517Is a foundation interim year one post better for improving confidence in the care of the dying in general surgery in a tertiary centre or a district general hospital?

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Jayan George ◽  
Alok Mathew ◽  
Edward Robinson ◽  
Edward Botsford ◽  
Rohan Ardley ◽  
...  
Keyword(s):  
General Hospital ◽  
Social Issues ◽  
District General Hospital ◽  
Spiritual Health ◽  
Microsoft Excel ◽  
Likert Scales ◽  
Google Docs ◽  
Confidence Levels ◽  
Tertiary Centre ◽  
The Family

Abstract Aims 1. Understand the confidence levels of current foundation year one (FY1) doctors who have had foundation interim year one (FiY1) post in a tertiary centre (TC) and a district general hospital (DGH). 2. Determine whether there is a difference in the experience of the FiY1 post in a TC or DGH. Methods FY1s were surveyed throughout August – December 2020. Six questions used Likert scales (1 to 5: not at all confident to very confident) over some common palliative themes. Data was initially inputted using Google Docs and analysed in Microsoft Excel. Results 16.7% (4/24) from a DGH and 83.3% (20/24) from a TC had a FiY1 post. Confidence levels were higher for FY1s who had a FiY1 post in a TC than a DGH in managing pain control, psychological distress, spiritual health. Confidence levels were higher for FY1s who had a FiY1 post in a DGH than a TC in dealing with social issues, speaking to the family of a patient in the last days of life. Conclusions FY1s who had a FiY1 post in a TC had better confidence in three areas as opposed to a DGH in two areas. The experience of the FiY1 should be more standardised to ensure the growth of confidence across all areas identified in the survey.

EP.TU.505Does a foundation interim year one post improve confidence in general surgery in a tertiary centre?

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Jayan George ◽  
Alok Mathew ◽  
Edward Botsford ◽  
Ahmed Al-Mukhtar
Keyword(s):  
Abdominal Pain ◽  
General Surgery ◽  
Hepatobiliary Disease ◽  
Surgical Patients ◽  
Microsoft Excel ◽  
Likert Scales ◽  
Google Docs ◽  
Confidence Levels ◽  
Tertiary Centre

Abstract Aims 1. Understand the confidence levels of current foundation year one (FY1) doctors. 2. Understand whether a foundation interim year one (FiY1) post improves confidence. Methods FY1s were surveyed throughout August – December 2020. Nine questions used Likert scales (1 to 5: not at all confident to very confident) over some common general surgical themes. Data was initially inputted using Google Docs and analysed in Microsoft Excel. Results 28.6% (30/105) of FY1s completed the survey. 20% (6/30) did not undertake a FiY1 post but 80% (24/30) did. Confidence levels were similar between FY1s who had a FiY1 post and those that did not for: dealing with acute general surgical patients, non-specific abdominal pain, appendicitis and prescribing fluids for maintenance as well as resuscitation. Confidence levels were higher for FY1s who did not have a FiY1 post compared to those that did in managing those with hepatobiliary disease. Confidence levels were lower for FY1s who did not have a FiY1 post compared to those that did in scrubbing for theatre, speaking to a family when a patient is dying and speaking to a patient when their diagnosis is unknown. Conclusions FY1s who have had a FiY1 post in a tertiary centre have more confidence in most areas but not all. This data shows the value of the FiY1 post however work needs to be done to improve the experience to the role.

scholarly journals EP.TU.526Is a foundation interim year one post better for improving confidence in general surgery in a tertiary centre or a district general hospital?

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Jayan George ◽  
Alok Mathew ◽  
Edward Robinson ◽  
Edward Botsford ◽  
Rohan Ardley ◽  
...  
Keyword(s):  
General Hospital ◽  
General Surgery ◽  
District General Hospital ◽  
Hepatobiliary Disease ◽  
Surgical Patients ◽  
Microsoft Excel ◽  
Likert Scales ◽  
Google Docs ◽  
Confidence Levels ◽  
Tertiary Centre

Abstract Aims 1. Understand the confidence levels in caring for general surgical patients of current foundation year one (FY1) doctors in who have had foundation interim year one (FiY1) post in a tertiary centre (TC) and a district general hospital (DGH). 2. Determine whether there is a difference in the experience of the FiY1 post in a TC or DGH. Methods FY1s doctors were surveyed throughout August – December 2020. Nine questions used Likert scales (1 to 5: not at all confident to very confident) over some common general surgical themes. Data was initially inputted using Google Docs and analysed in Microsoft Excel. Results 20% (6/30) from a DGH and 80% (24/30) from a TC Confidence levels were higher for FY1s who had a FiY1 post in a TC as opposed to a DGH in dealing with acute general surgical patients, appendicitis and scrubbing in theatre. Confidence levels were the same in both a TC and DGH for FY1s in managing those with hepatobiliary disease, prescribing fluids for resuscitation and maintenance as well as speaking to a family when a patient is dying and speaking to a patient when their diagnosis is unknown. Conclusions FY1s who had a FiY1 post in a TC had better confidence levels in more areas as opposed to a DGH. The experience of the FiY1 post should be more standardised to ensure the growth of confidence across all areas identified in the survey.

scholarly journals EP.TU.521Does a foundation interim year one post improve confidence in general surgery in a district general hospital?

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Jayan George ◽  
Alok Mathew ◽  
Edward Robinson ◽  
Rohan Ardley
Keyword(s):  
Abdominal Pain ◽  
General Hospital ◽  
General Surgery ◽  
District General Hospital ◽  
Hepatobiliary Disease ◽  
Microsoft Excel ◽  
Likert Scales ◽  
Google Docs ◽  
Confidence Levels ◽  
Deteriorating Patient

Abstract Aims 1. Understand the confidence levels of current foundation year one (FY1) doctors. 2. Understand whether an interim foundation year one (FiY1) post improves confidence. Methods FY1s were surveyed throughout August – December 2020. Nine questions used Likert scales (1 to 5: not at all confident to very confident) over some common general surgical themes. Data was initially inputted using google docs and analysed in Microsoft Excel. Results 32.1% (9/28) of FY1s completed the survey. 33.3% (3/9) did not undertake a FiY1 post where 66.7% (7/9) did. Confidence levels were mostly the same between FY1s who had a FiY1 post and those that did not for dealing with patients with hepatobiliary disease, non-specific abdominal pain, appendicitis, speaking to a family when a patient is dying prescribing fluids for maintenance as well as resuscitation. Confidence levels were higher for FY1s who did not have a FiY1 post compared to those that did in managing the deteriorating patient. Confidence levels were lower for FY1s who did not have a FiY1 post compared to those that did in speaking to a patient when their diagnosis is unknown. Conclusions FY1s who have had a FiY1 post in a district general hospital have more confidence in most areas but not all. This data shows the value of the FiY1 post however work needs to be done to improve the experience to the role.

Application of People Capability Maturity Model in I.T Industry

2014 ◽  
Vol 4 (1) ◽  
Author(s):  
Padma Tripathi
Keyword(s):  
Workforce Development ◽  
Maturity Model ◽  
It Industry ◽  
Microsoft Excel ◽  
Google Docs ◽  
Capability Maturity ◽  
Important Benefit ◽  
Managerial Positions ◽  
People Capability Maturity Model ◽  
Level 2

The present study was conducted to examine the implementation of PCMM in the Indian IT Industry by analyzing the perceptions of managers regarding the reasons for PCMM implementation, people related issues and benefits of PCMM. The objectives of the study were to gain a conceptual understanding of PCMM, to examine the methods and application of PCMM in IT industry and to gain an overview of the dissemination of PCMM on organizational field by focusing on the implementation of PCMM in organizations, and its impact on the effectiveness of people management and the overall business. Based on the findings of literature review a questionnaire was developed using Google Docs. Subjects of this study were managers belonging to middle and higher managerial positions of various IT companies with PCMM certification ranging from Level 2 to Level 5. The data collected was then analyzed using statistical tools like SPSS and Microsoft Excel. The survey brought out that the reasons for PCMM certification do not vary significantly across IT companies. The Level of PCMM to which an employee’s organization belonged had a significant impact on his/her perception of factors leading to success of IT projects. Reducing turnover was rated as the most prevalent issue followed by overcoming low morale and burnout, and identifying competencies. Integrating workforce development with process improvement was ranked as the most important benefit of PCMM implementation.

Pain and Symptom Management in Palliative Care

1996 ◽  
Vol 3 (3) ◽  
pp. 204-213 ◽  
Author(s):  
Carla Ripamonti ◽  
Eduardo Bruera
Keyword(s):  
Palliative Care ◽  
Cancer Pain ◽  
Control Strategy ◽  
Symptom Management ◽  
Pain Control ◽  
Advanced Disease ◽  
Patients With Cancer ◽  
Pharmacologic Management

Background Pain, dyspnea, and anorexia are common symptoms experienced by patients with cancer and often are poorly managed. Methods The incidence and causes of these symptoms are described, as well as factors that exacerbate or ameliorate their impact. Results Pharmacologic management of cancer pain is based on the use of a sequential “ladder” that incorporates nonopioid, opioid, and adjuvant drugs, depending on the severity of the pain. This approach usually is effective. Other symptoms of advanced disease may be more difficult to control. Conclusions Adherence to an adequate pain-control strategy will significantly enhance palliation of pain in patients with cancer.

The Hospice Companion

2021 ◽  
Keyword(s):  
Emergency Medicine ◽  
Palliative Care ◽  
Time Use ◽  
Pain Control ◽  
Review Literature ◽  
Evidence Based ◽  
Advanced Illness ◽  
Control Techniques ◽  
Team Meetings ◽  
Common Problems

The Hospice Companion is an evidence-based handbook meant to guide hospice teams in the assessment and management of common problems, situations, conditions, and symptoms encountered in the care of advanced illness patients and their families. It addresses and integrates the practical, biomedical, social, and spiritual issues typically experienced in day-to-day management. It also includes guidance on conducting team meetings, how to structure care, and proper documentation. Chapters conclude with listings of contemporary references from peer-review literature sources for additional reading. Appendices provide more detailed information on several topics, such as advanced pain control techniques, including ketamine and lidocaine infusion protocols. This book is meant for real-time use, both during team meetings and “at the bedside.” The material in this book will also be helpful to those in other related disciplines, including palliative care, hospitalist practice, geriatrics, emergency medicine, and intensive care.

scholarly journals Continuous subcutaneous infusion for pain control in dying patients: experiences from a tertiary palliative care center

2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Per Fürst ◽  
Staffan Lundström ◽  
Pål Klepstad ◽  
Peter Strang
Keyword(s):  
Palliative Care ◽  
Adverse Effects ◽  
Pain Control ◽  
Performance Status ◽  
Infusion Pump ◽  
Eastern Cooperative Oncology Group ◽  
Moderate Increase ◽  
Subcutaneous Infusion ◽  
Dying Patients ◽  
Continuous Subcutaneous Infusion

Abstract Background Continuous subcutaneous infusion (CSCI) via ambulatory infusion pump (AIP) is a valuable method of pain control in palliative care. When using CSCI, low-dose methadone as add-on to other opioids might be an option in complex pain situations. This study aimed to investigate the effects, and adverse effects, of CSCI for pain control in dying patients, with particular interest in methadone use. Methods This was an observational cohort study. Imminently dying patients with pain, admitted to specialized palliative inpatient wards and introduced on CSCI, were monitored daily by staff for symptoms (Integrated Palliative Care Outcome Scale - IPOS), sedation (Richmond Agitation and Sedation Scale – RASS), performance status (Eastern Cooperative Oncology Group - ECOG) and delirium (Confusion Assessment Method - CAM). Results Ninety-three patients with a median survival of 4 days were included. Of the 47 patients who survived ≥3 days, the proportion of patients with severe/overwhelming pain decreased from 45 to 19% (p < 0.001) after starting CSCI, with only a moderate increase in morphine equivalent daily dose of opioids (MEDD). Alertness was marginally decreased (1 point on the 10-point RASS scale, p = 0.001), whereas performance status and prevalence of delirium, regardless of age, remained unchanged. Both patients with methadone as add-on (MET, n = 13) and patients with only other opioids (NMET, n = 34), improved in pain control (p < 0.05 and 0.001, respectively), despite that MET patients had higher pain scores at baseline (p < 0.05) and were on a higher MEDD (240 mg vs.133 mg). No serious adverse effects demanding treatment stop were reported. Conclusions CSCI via AIP is an effective way to reduce pain in dying patients without increased adverse effects. Add-on methadone may be beneficial in patients with severe complex pain.

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