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.

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.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.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.

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.

178 Suspected Cauda Equina Syndrome in a District General Hospital

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
L Ellerton ◽  
H Benjamin-Laing ◽  
W J Harrison
Keyword(s):  
General Hospital ◽  
Cauda Equina Syndrome ◽  
Cauda Equina ◽  
District General Hospital ◽  
Bladder Function ◽  
Mri Scan ◽  
Eligibility Criteria ◽  
Joint Project ◽  
Tertiary Centre ◽  
Patient Morbidity

Abstract Introduction Cauda Equina Syndrome (CES) is rare but when the diagnosis is delayed patient morbidity is significant. Recently, NICE Clinical Knowledge Summaries have updated their red flags on CES to be more explicit enabling earlier referral and diagnosis. A joint project between Orthopaedics and Radiology departments aimed to assess the current pathway of Cauda Equina Investigation at a District General Hospital. Method Data was collected from the local Radiology database for requests between July 2017 and August 2018. This included both direct requests to assess for CES and implied. Raw data revealed a potential of 600 patients, of which we have analysed 332 patients met the eligibility criteria. Results Only 58 patients had a documented complete bladder function assessment, of those 33% had incomplete or partial bladder emptying. Time to MRI scan ranged from 50mins – 23 hours & 52 mins. 47% had negative scans with CES or Cord compromise on MRI scan was demonstrated on 9%. 23 patients were transferred urgently to the receiving tertiary centre. Conclusions We found that nearly 90% of patients were being incompletely assessed and time to scan ranged significantly. We are producing a trust wide suspected CES pathway to improve patient assessment.

scholarly journals GAMBARAN KEPUASAN KELUARGA PASIEN STROKE PADA PEMENUHAN PERSONAL HYGIENE OLEH PERAWAT DI RUANG MAWAR RUMAH SAKIT UMUM DAERAH KABUPATEN CIAMIS TAHUN 2018

2019 ◽  
Vol 1 (2) ◽  
Author(s):  
DIta Permatasari ◽  
Siti Rohimah ◽  
Romlah Romlah
Keyword(s):  
General Hospital ◽  
Basic Needs ◽  
Sampling Technique ◽  
District General Hospital ◽  
Well Being ◽  
Family Satisfaction ◽  
Personal Hygiene ◽  
Stroke Patients ◽  
The Family ◽  
The Rose

Background Family and patient satisfaction is the first indicator of a hospital's standard and is a measure of service quality. Meeting basic needs is an important action that nurses must take to hospitalized clients, including those in stroke clients. Personal hygiene action is one of the basic needs that nurses must do to clients. Personal hygiene is an action to maintain one's hygiene and health for physical and psychological well-being. The purpose of this study was to describe the family satisfaction of stroke patients in the fulfillment of personal hygiene by nurses in the Rose Room of the Ciamis District General Hospital in 2018. This type of research uses descriptive, namely a research method with the main purpose of making a description or description of an object. The population in this study were all families of stroke patients who were undergoing treatment in the Rose Room of the Ciamis District General Hospital in December 2018 as many as 30 people. Sampling in this study used a total sampling technique, namely the entire population as a sample of the study as many as 30 families of stroke patients. The results showed that the family satisfaction of stroke patients in fulfilling personal hygiene by nurses in the Rose Room of the Ciamis District General Hospital, the highest frequency was quite satisfied category of 11 people (36.7%), satisfied categories were 8 people (26.7%) ), the category of dissatisfaction was 7 people (23.3%) and the lowest frequency was in the very satisfied category of 4 people (13.3%). Suggestions are expected that in nursing services nursing staff should be active in getting new information and knowledge about nursing science, especially regarding the fulfillment of personal hygiene, more intensively conducting socialization and health education about personal hygiene so as to reduce the risk of complications which can ultimately increase their role as professional nurses and satisfaction with family and patients.

EVALUATION OF THE SHORT-TERM IMPACT OF COVID-19 IN A LARGE DISTRICT GENERAL HOSPITAL

2021 ◽  
pp. 14-15
Author(s):  
Natalie Hamer ◽  
Ashley Brown ◽  
Trisha Jha ◽  
Oladiran Olatunbode ◽  
Madan Jha
Keyword(s):  
Intensive Care ◽  
General Hospital ◽  
Service Provision ◽  
District General Hospital ◽  
Healthcare Services ◽  
Healthcare Systems ◽  
Surgical Service ◽  
Short Term ◽  
Tertiary Centre ◽  
Additional Strain

Intro: Since December 2019, SARS-CoV-2 has had a dramatic impact on the global landscape. One of the biggest challenges has been the additional strain that the virus has put on healthcare systems. Although there has been much data on the direct affects of COVID-19 on intensive care beds and ventilator availability, there has been little exploration into the wider impacts that the restrictions brought about by COVID-19 have had on the provision of other healthcare services. We designed this study to explore how Aim: COVID-19 has impacted surgical service provision at a tertiary centre. We Methods: compared the number and types of general surgeries carried out at a single hospital in the six months prior to the initial UK COVID-19 outbreak (September 2019 - February 2020) and the six months after (March 2020 - August 2020). We found that since March 2020 there has been a 70% decrease i Results: n the number of operations being carried out, with numbers dropping from a pre-COVID surgery number of 1761 to a post-COVID number of 529. This mainly affected elective procedures however, with emergency surgeries remaining relatively constant (48 pre-COVID vs 44 post-COVID). COVID-19 has Conclusion: caused a signicant decrease in the number of surgeries being undertaken. This is due to a combination of factors including stafng issues, reduced investigation, and national mandates requesting the cessation of non-urgent procedures. Although this has mainly affected elective operations, it is likely to have a larger impact in the future as surgical waiting lists continue to grow

scholarly journals AB0817 CAN RHEUMATIC CONDITIONS ASSOCIATED INTERSTITIAL LUNG DISEASES BE MANAGED IN A DISTRICT GENERAL HOSPITAL – RESULTS FROM A LONGITUDINAL OUTCOMES SURVEY

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1432.1-1433
Author(s):  
A. Francioni ◽  
J. Gnanapragasam ◽  
N. Ramsundar ◽  
V. Joshi ◽  
M. K. Nisar
Keyword(s):  
General Hospital ◽  
Rheumatic Diseases ◽  
Care Pathway ◽  
Treatment Options ◽  
Tertiary Care ◽  
District General Hospital ◽  
Interstitial Lung Diseases ◽  
Specialist Service ◽  
Hub And Spoke ◽  
Tertiary Centre

Background:Interstitial lung disease is a well described extra-articular manifestation in a range of rheumatic diseases. It carries significant morbidity and mortality. Management of rheumatic diseases associated ILD (r-ILD) requires expertise as the needs of such patients are complex and treatment options limited. Historically, such complex ILD has been managed in tertiary referral centres. We set up a combined service incorporating both rheumatology and respiratory domains in a district general hospital (DGH) to help patients avoid long journeys and improve their experience whilst focusing on an integrated care pathway.Objectives:We evaluated the outcomes of all patients managed over three years in this pilot service model.Methods:Referrals were accepted from any hospital specialist involved in the management r-ILD. They were triaged by lead ILD pulmonologist to monthly ILD MDT comprising a rheumatologist, respiratory physician, a radiologist and ILD specialist nurse. Appropriate patients were booked into combined clinic, run by the respective rheumatology and chest specialists with ILD interest, attracting a multi-speciality tariff. All the data was recorded electronically with full access to demographics, disease parameters, investigations and drug management.Results:111 consecutive patients were included in this evaluation. Mean age was 66.4 yrs (19-92 yrs) and 36% (n=40) were male. 34 (30%) had RA, 31 (28%) had CTD, 20 (18%) had IPAF and 26 others. Most predominant HRCT pattern was NSIP (n=40,36%) followed by UIP (n=31, 28%). Mean FVC was 2.59 L/min (1.93-4.13) with DLCOc of 52.7% (28.9-90.1%) predicted. Only two patients had all antibodies negative whilst 109 had at least one antibody positive with ANA being the most common (n=38).Most (83%) patients were treated with immunomodulators including 11 with rituximab. 49 (44.1%) patients had significant improvement in clinical, imaging and pulmonary parameters with DLCOc improving to 56.57% and FVC to 2.70 L/min. There were similar improvements in six minute walk test. 21 patients died and 23 patients required long term oxygen therapy.Conclusion:This pilot real world study confirms the utility of a combined specialist service in a district general hospital. Nearly half of this complex and resource intensive patient cohort had good clinical outcomes and derived benefit from the expertise in one room. Feedback from both patients and referrers was unanimously positive. No patient required tertiary centre referral and all could be managed adequately in the clinical setting.Our report confirms that r-ILD can be managed in a DGH setting with a stream-lined service offering clear benefits to patients. We would argue that r-ILD service, congruent to satellite pulmonary hypertension clinics in secondary care with hub-and-spoke model liaison with tertiary centre, can be established on similar principles and could help over-stretched tertiary care with repatriation of services whilst helping develop local expertise in the management of chronic ILD.Disclosure of Interests:None declared

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