scholarly journals TP9.1.5Optimizing Patient Outcomes and Improving Organization Efficiency through Enhanced Management of Low Back Ache and Sciatica

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Harish Peri ◽  
Rafique Umer Harvitkar ◽  
Khursheed Ansari
Keyword(s):  
Patient Outcomes ◽  
Clinical Audit ◽  
Treatment Modalities ◽  
Risk Category ◽  
Work Output ◽  
Low Back ◽  
Psychological Counselling ◽  
Pdsa Cycle ◽  
Management Protocol ◽  
Back Ache

Abstract Aim This study was undertaken to tackle the rising incidence of Low Back Ache and Sciatica in a primary care government setup, which had contributed to a disabled and diminished workforce. The aim being improving patient outcomes by implementing changes in the current management protocol (measured against the standard NICE guidelines by an initial clinical audit) Method Two Plan-Do-Study-Act (PDSA) cycles were implemented post an initial clinical audit among 59 patients of the institution. Data was collected using self-made questionnaires and then analyzed. Re-audits were done to measure the outcome against a set standard. Results 20-30% (n = 12-18) of patients were aware of their risk category, understood various treatment modalities and use of orthotics in the initial clinical audit. 56% (n = 33), 73% (n = 43), 88% (n = 51) of the patients were absent from work or had diminished work output, were offered imaging and were put on medication respectively. 10% of the patients were offered psychological counselling. Post implementation of changes from the first PDSA cycle, the set target of 90% was achieved in most of the categories. Further, 24% (n = 14) of patients reported that they were still apprehensive about their condition. A second PDSA cycle was undertaken and post implementation of changes, the set standard of 10% or less patients being apprehensive was noted. Conclusions Increased awareness among patients through means of regular educational sessions, psychological counselling, updated management protocols have led to healthier patients, less absence from duty and improved work output thereby increasing the organizational efficiency as a whole.

EP.TU.854Happy Patients and Updated Open Wound Management Protocols

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Harish Peri ◽  
Rafique Umer Harvitkar
Keyword(s):  
Chronic Wound ◽  
Clinical Audit ◽  
Wound Dressings ◽  
Wound Management ◽  
Open Wound ◽  
Current Management ◽  
Pdsa Cycle ◽  
Management Protocol ◽  
Open Injuries

Abstract Introduction Open injuries have a potential for serious bacterial wound infections and may lead to long term disabilities, chronic wound or bone infection, and even death. This QI study was undertaken to ring in changes to the current management protocol and align them as per WHO guidelines. Method Implementing changes through a Plan-Do-Study-Act (PDSA) cycle post an initial clinical audit among 38 patients of the organization. Re-audits were done to measure the outcome against the standard and establish a new protocol. Results Initial audit showed only a dismal 37% (n = 14) of patients being managed as per WHO protocol. Patient satisfaction percentage (as measured by a questionnaire) was also low with only 54% of patients satisfied with the treatment. Significant variations were noted post implementation of changes after the first PDSA cycle where >90% (n = 35) of patients reported that they noticed better wound healing, transition to optimal performance and were satisfied with treatment outcomes. Conclusions Timely wound dressings, appropriate antibiotic prophylaxis and increased patient’s awareness on wound hygiene through means of regular educational sessions and updated management protocols have led to healthier patients, lesser long term disabilities and happy patients.

scholarly journals Pharmacological approach in the Management of Katishula (Low back ache) - A case study

2020 ◽  
Vol 11 (1) ◽  
pp. 124-129
Author(s):  
Narahari B R
Keyword(s):  
Treatment Modalities ◽  
Daily Routine ◽  
Low Back ◽  
Major Health ◽  
Oral Medications ◽  
Appropriate Treatment ◽  
Back Ache ◽  
History Of ◽  
The Right

Katishula (low back ache) is one of the major health problems now a days which affects approximately 60 – 85% of adults during some point of their life causing trouble to their daily routine. It is shosha (degeneration), sthamba (stiffness), and shula (pain) predominant vyadhi (disease). It is clearly stated in the classics that the pain is produced due to stiffness which is produced by sama or nirama vayu movement in the kati (low back) region. Ayurvedic classics have mentioned appropriate treatment modalities for kati shula. A 24 year old female patient with katishula was treated conservatively with internal medicine and panchakarma (treatment procedure). Patient presented with low back ache for 1 year with aggravated symptoms like shooting pain, pain while standing and pain in the left leg. SLR was positive being 20 degree on the left leg and was negative in the right leg. There was no history of any kind of trauma. Management was done in 2 rounds where the first part included  matra basti and oral medications, through which the symptoms got reduced around 40 – 50% and in the second part of the treatment patient was managed only with the oral medications which gave very good results where the patient was almost completely relieved.

Epidural Steroid In Low Back Ache

2011 ◽  
Vol 1 (5) ◽  
pp. 166-167
Author(s):  
Dr. B. L. Khajotia Dr. B. L. Khajotia ◽  
◽  
Dr. Neelam meena
Keyword(s):  
Low Back ◽  
Back Ache ◽  
Epidural Steroid

Role of Panchakarma in management of Gridhrasi

2016 ◽  
Vol 1 (2) ◽  
Author(s):  
Imlikumba . ◽  
Parappagoudra Mahesh ◽  
BA Lohith ◽  
K Singha ◽  
S Lalravi
Keyword(s):  
Modern Science ◽  
Stressful Life ◽  
Low Back ◽  
Lateral Aspect ◽  
Effective Measure ◽  
Main Complaint ◽  
Different Types ◽  
Back Ache ◽  
Different Dimensions

Panchakarma is a fruitful measure and its extensive efficacies are classified in different dimensions to cure different types of complicated diseases. Vamana, Virechana, Niruha, Anuvasana and Nasya are the five procedures and subsequently even Vamana, Virechana, Basti, Nasya and Rakta Mokshana are broadly termed as Panchakarma in day to day practices.The new diseases are evolving with intense gravity and therefore to combat those, Panchakarma is a very effective measure. In present era competition and advancement have led to hectic and stressful life, man has eventually forgotten the absolute enjoyment and solitary affection of nature and as a result is facing many health problems. Gridhrasi is no exception, it is correlated to sciatica in modern science where low back ache radiating to toes in the lateral aspect of the thigh associated with stiffness is the main complaint.

67 The Evolution of A Frailty Service

2021 ◽  
Vol 50 (Supplement_1) ◽  
pp. i12-i42
Author(s):  
C Abbott ◽  
K Bishop ◽  
F Hill ◽  
C Finlow ◽  
R Maraj
Keyword(s):  
Cost Effectiveness ◽  
Patient Outcomes ◽  
Local Population ◽  
Management Team ◽  
Pdsa Cycle ◽  
North Wales ◽  
Number Of Patients ◽  
Constant State ◽  
Clinical Resource ◽  
Improve Patient

Abstract Introduction In September 2017 our frailty service was started within our medium sized DGH in North Wales. Working with our management team we secured a significant clinical resource including: We describe how resources, setting and staffing develop over a 2 year period in order to create a service which meets the needs of the local population. Method The service has been in a constant state of development since it has been in operation, utilising a PDSA model with regular meetings of clinical and managerial staff to analyse performance. Results With each new PDSA cycle the amount of patients reviewed has increased. With the move to AMU we increased the monthly number of patients reviewed from 29 to 172 patients reviewed, 97 of which were discharged directly from the unit. Conclusion Using QI methodology our Frailty Service has improved dramatically since its inception. We will continue to analyse how we work to improve patient outcomes and cost effectiveness.

scholarly journals Implementation of Clinical Guidelines on Physical Therapy for Patients With Low Back Pain: Randomized Trial Comparing Patient Outcomes After a Standard and Active Implementation Strategy

2005 ◽  
Vol 85 (6) ◽  
pp. 544-555 ◽  
Author(s):  
Geertruida E Bekkering ◽  
Maurits W van Tulder ◽  
Erik JM Hendriks ◽  
Marc A Koopmanschap ◽  
Dirk L Knol ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Physical Therapy ◽  
Patient Outcomes ◽  
Physical Functioning ◽  
Clinical Guidelines ◽  
Physical Therapists ◽  
Low Back ◽  
Active Strategy ◽  
Active Implementation

Abstract Background and Purpose. An active strategy was developed for the implementation of the clinical guidelines on physical therapy for patients with low back pain. The effect of this strategy on patients' physical functioning, coping strategy, and beliefs regarding their low back pain was studied. Subjects. One hundred thirteen primary care physical therapists treated a total of 500 patients. Methods. The physical therapists were randomly assigned to 1 of 2 groups. The control group received the guidelines by mail (standard passive method of dissemination). The intervention group, in contrast, received an additional active training strategy consisting of 2 sessions with education, group discussion, role playing, feedback, and reminders. Patients with low back pain, treated by the participating therapists, completed questionnaires on physical functioning, pain, sick leave, coping, and beliefs. Results. Physical functioning and pain in the 2 groups improved substantially in the first 12 weeks. Multilevel longitudinal analysis showed no differences between the 2 groups on any outcome measure during follow-up. Discussion and Conclusion. The authors found no additional benefit to applying an active strategy to implement the physical therapy guidelines for patients with low back pain. Active implementation strategies are not recommended if patient outcomes are to be improved.

scholarly journals Adverse events associated with COVID-19 vaccination among health care professionals of Himachal Pradesh- a Rapid Survey.

2021 ◽  
Vol 33 (3) ◽  
pp. 531-533
Author(s):  
Harshvardhan Singh ◽  
Shailja Sharma
Keyword(s):  
Health Care ◽  
Adverse Events ◽  
Health Care Professionals ◽  
Himachal Pradesh ◽  
Low Grade ◽  
High Grade ◽  
Low Back ◽  
High Grade Fever ◽  
Cross Sectional ◽  
Back Ache

Background: The rolling out of the COVID -19 vaccination programme was accompanied by several doubts including the safety and occurrence of adverse effects after the vaccination. Methodology: A cross sectional study was conducted amongst the health care professionals working in the state of Himachal Pradesh to assess the frequency and types of side effects associated with the administration of Covid-19 vaccines using a semi structured questionnaire floated through a Google form. Result: Of the 187 responses received, after the 1st dose, 37.5% participants reported malaise, 31% myalgia, 36.4% low-grade fever, while 18.5% high-grade fever. Mild reactions at the injection site were reported by 37.5%, headache was reported by 3%, low back ache, drowsiness, giddiness and diarrhea were reported by about 3%. No reactions were reported by 18.5% of the participants. After the second dose, 51.8% did not report any adverse event, 17.1% reported malaise,15.2% reported low grade fever, 3% reported high grade fever, 20.1% reported mild reactions at the site of injection while 4.2% reported drowsiness, breathlessness on exertion, nausea, low back ache and diarrhea. Conclusion: The frequency of adverse events with COVID -19 vaccines is not higher than those observed with other commonly used vaccines.

scholarly journals Radiofrequency Denervation of the Lumbar Zygapophysial Joints: 10-Year Prospective Clinical Audit

2007 ◽  
Vol 2;10 (3;2) ◽  
pp. 291-299
Author(s):  
Michael Gofeld
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Pain Relief ◽  
Patient Selection ◽  
Clinical Audit ◽  
Low Back ◽  
Zygapophysial Joint ◽  
Radiofrequency Neurotomy ◽  
Radiofrequency Denervation

Background: Evidence for the efficacy of zygapophysial joint nerve radiofrequency neurotomy has remained controversial. Two randomized controlled trials showed positive results, but two others demonstrated no benefit. One carefully performed prospective trial confirmed high efficacy and lasting pain relief after the procedure; however, selection criteria for this study were superfluous, which resulted in a small number of patients available for follow up. Objectives: A large clinical audit with routine patient selection and use of appropriate technique was undertaken to determine the effect of radiofrequency neurotomy of the lumbar facet joints for relief of chronic low back pain. Design: Prospective clinical audit for quality was conducted in the pain clinic affiliated with a tertiary care teaching hospital. Setting: An interventional pain management setting in Canada. Methods: All patients with low back pain of more than 6 months’ duration, with or without non-radicular radiation to the buttock, hip, and leg were included. From January 1991 to December 2000, eligible patients underwent standardized diagnostic work-up, which included a self-reported pain questionnaire, physical examination, review of imaging studies, and diagnostic blockades. Those with an appropriate response to comparative double diagnostic blocks underwent standardized radiofrequency denervation of the lumbar zygapophysial joints. Patients were asked to estimate total perceived pain reduction (on a scale from 0% to 100%) at 6 weeks and at 6, 12, and 24 months after the procedure. Results: Of the 209 patients, 174 completed the study, and 35 were lost to follow-up or did not provide complete data for assessment. Of the 174 patients with complete data, 55 (31.6%) experienced no benefit from the procedure. One hundred and nineteen patients (68.4%) had good (> 50%) to excellent (> 80%) pain relief lasting from 6 to 24 months. Conclusion: This large, prospective clinical audit indicates that proper patient selection and anatomically correct radiofrequency denervation of the lumbar zygapophysial joints provide long-term pain relief in a routine clinical setting. Key words: low back pain, lumbar zygapophysial joint, radiofrequency denervation, clinical audit

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