scholarly journals Burnout, well-being and defensive medical practice among obstetricians and gynaecologists in the UK: cross-sectional survey study

BMJ Open ◽  
2019 ◽  
Vol 9 (11) ◽  
pp. e030968 ◽  
Author(s):  
Tom Bourne ◽  
Harsha Shah ◽  
Nora Falconieri ◽  
Dirk Timmerman ◽  
Christoph Lees ◽  
...  
Keyword(s):  
Medical Practice ◽  
Maslach Burnout Inventory ◽  
Well Being ◽  
Survey Study ◽  
Secondary Outcome ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Obstetrics And Gynaecology ◽  
Quality Of Patient Care ◽  
The Uk

ObjectivesTo determine the prevalence of burnout in doctors practising obstetrics and gynaecology, and assess the association with defensive medical practice and self-reported well-being.DesignNationwide online cross-sectional survey study; December 2017–March 2018.SettingHospitals in the UK.Participants5661 practising obstetrics and gynaecology consultants, specialty and associate specialist doctors and trainees registered with the Royal College of Obstetricians and Gynaecologists.Primary and secondary outcome measuresPrevalence of burnout using the Maslach Burnout Inventory and defensive medical practice (avoiding cases or procedures, overprescribing, over-referral) using a 12-item questionnaire. The odds ratios (OR) of burnout with defensive medical practice and self-reported well-being.Results3102/5661 doctors (55%) completed the survey. 3073/3102 (99%) met the inclusion criteria (1462 consultants, 1357 trainees and 254 specialty and associate specialist doctors). 1116/3073 (36%) doctors met the burnout criteria, with levels highest amongst trainees (580/1357 (43%)). 258/1116 (23%) doctors with burnout reported increased defensive practice compared with 142/1957 (7%) without (adjusted OR 4.35, 95% CI 3.46 to 5.49). ORs of burnout with well-being items varied between 1.38 and 6.37, and were highest for anxiety (3.59, 95% CI 3.07 to 4.21), depression (4.05, 95% CI 3.26 to 5.04) and suicidal thoughts (6.37, 95% CI 95% CI 3.95 to 10.7). In multivariable logistic regression, being of younger age, white or ‘other’ ethnicity, and graduating with a medical degree from the UK or Ireland had the strongest associations with burnout.ConclusionsHigh levels of burnout were observed in obstetricians and gynaecologists and particularly among trainees. Burnout was associated with both increased defensive medical practice and worse doctor well-being. These findings have implications for the well-being and retention of doctors as well as the quality of patient care, and may help to inform the content of future interventions aimed at preventing burnout and improving patient safety.

scholarly journals Doctors’ perception of support and the processes involved in complaints investigations and how these relate to welfare and defensive practice: a cross-sectional survey of the UK physicians

BMJ Open ◽  
2017 ◽  
Vol 7 (11) ◽  
pp. e017856 ◽  
Author(s):  
Tom Bourne ◽  
Bavo De Cock ◽  
Laure Wynants ◽  
Mike Peters ◽  
Chantal Van Audenhove ◽  
...  
Keyword(s):  
Online Survey ◽  
Well Being ◽  
Adverse Outcomes ◽  
Perceived Support ◽  
Survey Study ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Final Sample ◽  
Perception Of Support ◽  
The Uk

ObjectiveHow adverse outcomes and complaints are managed may significantly impact on physician well-being and practice. We aimed to investigate how depression, anxiety and defensive medical practice are associated with doctors actual and perceived support, behaviour of colleagues and process issues regarding how complaints investigations are carried out.DesignA survey study. Respondents were classified into three groups: no complaint, recent/current complaint (within 6 months) or past complaint. Each group completed specific surveys.SettingBritish Medical Association (BMA) members were invited to complete an online survey.Participants95 636 members of the BMA were asked to participate. 7926 (8.3%) completed the survey, of whom 1780 (22.5%) had no complaint, 3889 (49.1%) had a past complaint and 2257 (28.5%) had a recent/current complaint. We excluded those with no complaints leaving 6144 in the final sample.Primary outcomes measuresWe measured anxiety and depression using the Generalised Anxiety Disorder Scale 7 and Physical Health Questionnaire 9. Defensive practice was assessed using a new measure for avoidance and hedging.ResultsMost felt supported by colleagues (61%), only 31% felt supported by management. Not following process (56%), protracted timescales (78%), vexatious complaints (49%), feeling bullied (39%) or victimised for whistleblowing (20%), and using complaints to undermine (31%) were reported. Perceived support by management (relative risk (RR) depression: 0.77, 95% CI 0.71 to 0.83; RR anxiety: 0.80, 95% CI 0.74 to 0.87), speaking to colleagues (RR depression: 0.64, 95% CI 0.48 to 0.84 and RR anxiety: 0.69, 95% CI 0.51 to 0.94, respectively), fair/accurate documentation (RR depression: 0.80, 95% CI 0.75 to 0.86; RR anxiety: 0.81, 95% CI 0.75 to 0.87), and being informed about rights (RR depression 0.96 (0.89 to 1.03) and anxiety 0.94 (0.87 to 1.02), correlated positively with well-being and reduced defensive practice. Doctors worried most about professional humiliation following a complaint investigation (80%).ConclusionPoor process, prolonged timescales and vexatious use of complaints systems are associated with decreased psychological welfare and increased defensive practice. In contrast, perceived support from colleagues and management is associated with a reduction in these effects.

scholarly journals Burnout of Healthcare Workers amid the COVID-19 Pandemic: A Japanese Cross-Sectional Survey

2021 ◽  
Vol 18 (5) ◽  
pp. 2434
Author(s):  
Yoshito Nishimura ◽  
Tomoko Miyoshi ◽  
Hideharu Hagiya ◽  
Yoshinori Kosaki ◽  
Fumio Otsuka
Keyword(s):  
Healthcare Workers ◽  
Healthcare Professionals ◽  
Healthcare Delivery ◽  
General Medicine ◽  
Maslach Burnout Inventory ◽  
University Hospital ◽  
Survey Study ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
The Past

The coronavirus disease 2019 (COVID-19) global pandemic has drastically changed how we live and work. Amid the prolonged pandemic, burnout of the frontline healthcare professionals has become a significant concern. We conducted a cross-sectional survey study to provide data about the relationship between the COVID-19 pandemic and the prevalence of burnout in healthcare professionals in Japan. Healthcare workers in a single Japanese national university hospital participated in the survey, including basic demographics, whether a participant engaged in care of COVID-19 patients in the past 2 weeks and the Maslach Burnout Inventory. Of those, 25.4% fully answered the survey; 33.3% were doctors and 63.6% were nurses, and 36.3% engaged in care of COVID-19 patients in the past 2 weeks. Compared to those belonging to General Medicine, those in Emergency Intensive Care Unit were at higher risk of burnout (odds ratio (OR), 6.7; 95% CI, 1.1–42.1; p = 0.031). Of those who engaged in care of COVID-19 patients, 50% reported burnout while 6.1% did not (OR 8.5, 95% CI; 1.3–54.1; p = 0.014). The burnout of healthcare workers is a significant concern amid the pandemic, which needs to be addressed for sustainable healthcare delivery.

scholarly journals Development of the Psychological Insight Questionnaire among a sample of people who have consumed psilocybin or LSD

2021 ◽  
pp. 026988112096787
Author(s):  
Alan K Davis ◽  
Frederick S Barrett ◽  
Sara So ◽  
Natalie Gukasyan ◽  
Thomas C Swift ◽  
...  
Keyword(s):  
Life Satisfaction ◽  
Longitudinal Research ◽  
Psychological Flexibility ◽  
Well Being ◽  
Survey Study ◽  
Strongly Correlated ◽  
Strong Correlations ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Therapeutic Outcomes

Background: Several measures have been developed to examine acute psychedelic effects (e.g. mystical-type and challenging experiences), but no measure assesses acute psychologically insightful experiences that may occur during psychedelic experiences. Aim: The purpose of this study was to develop and examine the psychometric properties of the Psychological Insight Questionnaire. Method: A cross-sectional survey study among psilocybin and LSD users. Respondents ( n=1661; Mage=22.9, standard deviation=8.5; Caucasian/White=83%; non-Hispanic=91%; men=72%; United States resident=66%) completed an Internet-based survey. Results: The Psychological Insight Questionnaire consists of 23 items with two subscales: (a) Avoidance and Maladaptive Patterns Insights and (b) Goals and Adaptive Patterns Insights. Construct validity of the Psychological Insight Questionnaire was supported by strong correlations of the Psychological Insight Questionnaire (and Avoidance and Maladaptive Patterns Insights and Goals and Adaptive Patterns Insights subscales) scores with the insight subscale of the Session Impacts Scale, and weak-to-moderate correlations with the Mystical Experiences and Challenging Experiences Questionnaires. Furthermore, Psychological Insight Questionnaire (and Avoidance and Maladaptive Patterns Insights and Goals and Adaptive Patterns Insights subscales) scores were moderately-to-strongly correlated with retrospectively reported increases in psychological flexibility, and well-being/life satisfaction that were attributed to a memorable psychedelic experience. Lastly, incremental validity was established showing that the Psychological Insight Questionnaire (and Avoidance and Maladaptive Patterns Insights subscale) scores predict unique variance in changes in psychological flexibility, and Psychological Insight Questionnaire (and Avoidance and Maladaptive Patterns Insights and Goals and Adaptive Patterns Insights subscales) scores predict changes in well-being and life satisfaction, beyond measures of acute mystical-type and challenging effects. Conclusions: The Psychological Insight Questionnaire has the potential to extend the understanding of the acute and enduring effects of psychedelics. Further longitudinal research is necessary to determine the long-term predictive validity of the Psychological Insight Questionnaire and to examine the role of psychological insight in predicting therapeutic outcomes.

Prevalence and Workplace Drivers of Burnout in Cancer Care Physicians in Ontario, Canada

2021 ◽  
pp. OP.21.00170
Author(s):  
Simron Singh ◽  
Ashley Farrelly ◽  
Catherine Chan ◽  
Brett Nicholls ◽  
Narges Nazeri-Rad ◽  
...  
Keyword(s):  
Health Care ◽  
Cancer Care ◽  
Gynecologic Oncology ◽  
Maslach Burnout Inventory ◽  
Well Being ◽  
System Level ◽  
Survey Study ◽  
Cross Sectional Survey ◽  
Questionnaire Response ◽  
Mental Health Patient

PURPOSE: Provider well-being has become the fourth pillar of the quadruple aim for providing quality care. Exacerbated by the global COVID-19 pandemic, provider well-being has become a critical issue for health care systems worldwide. We describe the prevalence and key system-level drivers of burnout in oncologists in Ontario, Canada. METHODS: This is a cross-sectional survey study conducted in November-December 2019 of practicing cancer care physicians (surgical, medical, radiation, gynecologic oncology, and hematology) in Ontario, Canada. Ontario is Canada's largest province (with a population of 14.5 million), and has a single-payer publicly funded cancer system. The primary outcome was burnout experience assessed through the Maslach Burnout Inventory. RESULTS: A total of 418 physicians completed the questionnaire (response rate was 44% among confirmed oncologists). Seventy-three percent (n = 264 of 362) of oncologists had symptoms of burnout (high emotional exhaustion and/or depersonalization scores). Significant drivers of burnout identified in multivariable regression modeling included working in a hectic or chaotic atmosphere (odds ratio [OR] = 15.5; 95% CI, 3.4 to 71.5; P < .001), feeling unappreciated on the job (OR = 7.9; 95% CI, 2.9 to 21.3; P < .001), reporting poor or marginal control over workload (OR = 7.9; 95% CI, 2.9 to 21.3; P < .001), and not being comfortable talking to peers about workplace stress (OR = 3.0; 95% CI, 1.1 to 7.9; P < .001). Older age (≥ 56 years) was associated with lower odds of burnout (OR = 0.16; 95% CI, 0.1 to 0.4; P < .001). CONCLUSION: Nearly three quarters of participants met predefined standardized criteria for burnout. This number is striking, given the known impact of burnout on provider mental health, patient safety, and quality of care, and suggests Oncologists in Ontario may be a vulnerable group that warrants attention. Health care changes being driven by the COVID-19 pandemic provide an opportunity to rebuild new systems that address drivers of burnout. Creating richer peer-to-peer and leadership engagement opportunities among early- to mid-career individuals may be a worthwhile organizational strategy.

scholarly journals Use of online cultural content for mental health and well-being during COVID-19 restrictions: cross-sectional survey

2021 ◽  
pp. 1-10
Author(s):  
Rebecca J. Syed Sheriff ◽  
Helen Adams ◽  
Evgenia Riga ◽  
Andrew K. Przybylski ◽  
Laura Bonsaver ◽  
...  
Keyword(s):  
Mental Health ◽  
Well Being ◽  
Vulnerable Groups ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Online Culture ◽  
Reported Data ◽  
June July ◽  
The Uk ◽  
Health And Well Being

Aims and method To gain a deeper understanding of the use of online culture and its potential benefits to mental health and well-being, sociodemographic characteristics and self-reported data on usage, perceived mental health benefits and health status were collected in an online cross-sectional survey during COVID-19 restrictions in the UK in June–July 2020. Results In total, 1056 people completed the survey. A high proportion of participants reported finding online culture helpful for mental health; all but one of the benefits were associated with regular use and some with age. Reported benefits were wide-ranging and interconnected. Those aged under 25 years were less likely to be regular users of online culture or to have increased their use during lockdown. Clinical implications There may be benefits in targeting cultural resources for mental health to vulnerable groups such as young adults.

scholarly journals Areas of Work Life as Predictors of Occupational Burnout of Nurses and Doctors in Operating Theaters in Poland—Multicenter Studies

Healthcare ◽  
2021 ◽  
Vol 10 (1) ◽  
pp. 26
Author(s):  
Piotr Jarzynkowski ◽  
Renata Piotrkowska ◽  
Wioletta Mędrzycka-Dąbrowska ◽  
Janina Książek
Keyword(s):  
Emotional Exhaustion ◽  
Maslach Burnout Inventory ◽  
Work Life ◽  
Personal Accomplishment ◽  
Survey Study ◽  
Cross Sectional Survey ◽  
Occupational Burnout ◽  
Multicenter Studies ◽  
Cross Sectional ◽  
Mean Values

Introduction: Researchers’ interest in occupational burnout results primarily from the dangerous and extensive consequences of this phenomenon. The aim of the study was to analyze the level of occupational burnout among nurses and doctors in operating theaters. Materials and Methods: A cross-sectional survey study conducted on 325 nurses and doctors of seven hospitals in Poland. The Maslach Burnout Inventory (MBI) and the Areas of Worklife Survey (AWS) by Michael Leiter and Christina Maslach. Results: The mean values for the level of occupational burnout for the entire sample according to the scale from the Maslach Burnout Inventory by C. Maslach amounted to 14.35 for emotional exhaustion, 8.56 for depersonalization, and 11.90 for personal accomplishment; when compared to reference levels, they classified emotional exhaustion at a low level, depersonalization at an average level, and personal accomplishment at a high level of burnout. Areas of work life are predictors of occupational burnout. The analysis showed a relationship between three of the six variables. As the workload increased, so did the level of burnout among participants, and the categories of honesty and values. Conclusions: The conducted research has shown that occupational burnout among nurses and doctors in operating theaters occurs in all dimensions of this phenomenon (emotional exhaustion, depersonalization, job satisfaction). It was also shown that the areas of work life (workload, control, community, rewards, fairness, values) are predictors of occupational burnout among the respondents. This article shows how important the problem of burnout among operating theater medical staff is. Perhaps it will allow nurses and doctors to recognize this syndrome and encourage them make changes to their work to prevent burnout.

scholarly journals The Relation Between Official WhatsApp-Distributed COVID-19 News Exposure and Psychological Symptoms: Cross-Sectional Survey Study (Preprint)

2020 ◽  
Author(s):  
Jean C J Liu ◽  
Eddie M W Tong
Keyword(s):  
Protective Factor ◽  
Psychological Symptoms ◽  
Well Being ◽  
Primary Outcome Measure ◽  
World Health ◽  
Survey Study ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Global Pandemic ◽  
Health Organization

BACKGROUND In a global pandemic, digital technology offers innovative methods to disseminate public health messages. As an example, the messenger app WhatsApp was adopted by both the World Health Organization and government agencies to provide updates on the coronavirus disease (COVID-19). During a time when rumors and excessive news threaten psychological well-being, these services allow for rapid transmission of information and may boost resilience. OBJECTIVE In this study, we sought to accomplish the following: (1) assess well-being during the pandemic; (2) replicate prior findings linking exposure to COVID-19 news with psychological distress; and (3) examine whether subscription to an official WhatsApp channel can mitigate this risk. METHODS Across 8 weeks of the COVID-19 outbreak (March 7 to April 21, 2020), we conducted a survey of 1145 adults in Singapore. As the primary outcome measure, participants completed the Depression, Anxiety, and Stress Scale (DASS-21). As predictor variables, participants also answered questions pertaining to the following: (1) their exposure to COVID-19 news; (2) their use of the Singapore government’s WhatsApp channel; and (3) their demographics. RESULTS Within the sample, 7.9% of participants had severe or extremely severe symptoms on at least one DASS-21 subscale. Depression scores were associated with increased time spent receiving COVID-19 updates, whereas use of the official WhatsApp channel emerged as a protective factor (<i>b</i>=–0.07, <i>t</i>[863]=–2.04, <i>P</i>=.04). Similarly, increased anxiety scores were associated with increased exposure to both updates and rumors, but this risk was mitigated by trust in the government’s WhatsApp messages (<i>b</i>=–0.05, <i>t</i>[863]=–2.13, <i>P</i>=.03). Finally, although stress symptoms increased with the amount of time spent receiving updates, these symptoms were not significantly related to WhatsApp use. CONCLUSIONS Our findings suggest that messenger apps may be an effective medium for disseminating pandemic-related information, allowing official agencies to reach a broad sector of the population rapidly. In turn, this use may promote public well-being amid an “infodemic.” CLINICALTRIAL ClinicalTrials.gov NCT04305574; https://clinicaltrials.gov/ct2/show/NCT04305574

scholarly journals Exploring the therapeutic alliance in Belgian family medicine and its association with doctor–patient characteristics: a cross-sectional survey study

BMJ Open ◽  
2020 ◽  
Vol 10 (2) ◽  
pp. e033710 ◽  
Author(s):  
Pauline Boeckxstaens ◽  
Annelou Meskens ◽  
Aline Van der Poorten ◽  
Anne-Catherine Verpoort ◽  
Elizabeth Ann Sturgiss
Keyword(s):  
Therapeutic Alliance ◽  
Quality Of Healthcare ◽  
Survey Study ◽  
Secondary Outcome ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Family Doctors ◽  
Patient Centred Care ◽  
Clinical Method ◽  
Age Range

ObjectivesPatient-centred care is related to better health outcomes, greater patient satisfaction and reduced healthcare costs. One of the core components of patient-centred care, defined in the patient-centred clinical method, is enhancing the patient–doctor relationship. In this study, we aim to measure the therapeutic alliance in consultations between patients and family doctors in Belgium, and explore which patient, provider and practice characteristics are associated with the strength of the therapeutic alliance.DesignCross-sectional cohort study using the Working Alliance Inventory for General Practice (WAI-GP). The patients and family doctors completed a survey after the consultation. The survey consisted of the WAI-GP, demographics, consultation characteristics and variables related to the patient–doctor relationship.SettingBelgian primary care.ParticipantsEvery third patient (both practice and house call visits) was invited to participate. 170 patient–doctor dyads from four practices were included. Total of 10 doctors (30% men, age range 24–63 years) and 170 patients (35.9% men, age range 18–92 years).Primary and secondary outcome measuresPrimary outcome was the WAI-GP score and its correlations with characteristics of the doctor (gender, age) and patients (gender, age, chronic disease, number of annual consultations).ResultsThe median WAI-GP score reported after these consultations was 4.5±0.62. Higher WAI-GP scores were reported for consultations with male doctors and by older patients. In the subsample of patients with a chronic illness, higher WAI-GP scores were reported by patients who had more than 10 follow-up consultations per year.ConclusionsConsultation quality is an important aspect of healthcare, but attention is needed to understand how the WAI-GP performs in relation to variables that are beyond control, such as gender of the physician, age of the patient and variables related to building continuity of care. This has implications for the measurement of quality of healthcare.

scholarly journals A cross-sectional survey of awareness of human papillomavirus-associated oropharyngeal cancers among general practitioners in the UK

BMJ Open ◽  
2018 ◽  
Vol 8 (7) ◽  
pp. e023339 ◽  
Author(s):  
Matt Lechner ◽  
Claire Vassie ◽  
Cemal Kavasogullari ◽  
Oliver Jones ◽  
James Howard ◽  
...  
Keyword(s):  
Risk Factor ◽  
Human Papillomavirus ◽  
General Practitioners ◽  
Further Education ◽  
Secondary Outcome ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Chewing Tobacco ◽  
The Uk ◽  
Epidemiological Trends

ObjectivesTo examine the level of awareness of the link between human papillomavirus (HPV) and oropharyngeal cancer (OPC) and epidemiological trends in HPV-related OPC among general practitioners (GPs) in the UK.DesignCross-sectional survey.Participants384 GPs from England, Scotland, Wales and Northern Ireland.SettingThe survey was administered at GP training courses and via email to lists of training course attendees.Primary and secondary outcome measuresProportion of respondents aware of the link between HPV and OPC; respondents’ self-rated knowledge of OPC; proportion of participants aware of the epidemiological trends in HPV-associated OPC.Results384 questionnaires were completed with an overall response rate of 72.9%. 74.0% of participants recognised HPV as a risk factor for OPC, which was lower than knowledge about the role of smoking, chewing tobacco and alcohol consumption (all >90% recognition). Overall, 19.4% rated their knowledge of OPC as very good or good, 62.7% as average and 17.7% as poor or very poor. The majority (71.9%) were aware that rates of HPV-associated OPC have increased over the last two decades. Fewer than half (41.5%) of the participants correctly identified being male as a risk factor of HPV-associated OPC, while 58.8% were aware that patients with HPV-associated OPC tend to be younger than those with non-HPV-associated disease.ConclusionsThe association of HPV infection with OPC is a relatively recent discovery. Although the level of awareness of HPV and OPC among GPs was high, the characteristics of HPV-associated OPC were less well recognised, indicating the need for further education.

A NATIONAL SURVEY TO IDENTIFY HOW DISPLACEMENT VALUE INFORMATION IS USED AND PRESENTED TO CLINICAL STAFF IN NHS HOSPITALS

2016 ◽  
Vol 101 (9) ◽  
pp. e2.75-e2
Author(s):  
Nanna Christiansen ◽  
Zinab Kehk ◽  
Susan Keeling ◽  
Bryony Dean
Keyword(s):  
Hospital Setting ◽  
Visual Presentation ◽  
National Standard ◽  
Survey Study ◽  
Easy Access ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Paediatric Hospital ◽  
Method Of Calculation ◽  
The Uk

AimThe use of displacement values (DVs) when preparing intravenous (IV) medication for children enables accurate doses to be given1 and is assumed to be common paediatric practice. This survey aimed to assess views of UK paediatric pharmacists on DVs in practice to explore:▸ How prevalent is DV use in the paediatric hospital setting▸ Which type of IV administration guidelines were being used▸ Which form of DV presentation is perceived to be most practical▸ Which method of calculation is preferredMethodA national cross-sectional survey study was undertaken. The questionnaire comprised of 13 closed and open questions as well as samples of how DVs are currently displayed on the Medusa Injectable Medicines Guide2. After piloting the questionnaire the survey was sent to 365 paediatric pharmacists across 120 UK hospitals utilising Qualtrics Survey Software.ResultsFifty-five completed questionnaires covering 52 (43%) United Kingdom (UK) hospital trusts were received. Of 55 respondents, 52 (95%) reported the clinical significance of DVs in paediatric care. This was reflected in the fact that all local guides provided information on DVs. The majority (32;59%) used locally produced guides, while 15 (27%) of respondents used Medusa as a resource. All respondents commented on methods of presentation and calculation of DV information. Of four methods presented, the method involving presentation of reconstitution information in a brand-specific table was ranked as most practical (46;84% respondents). This method was viewed as being clear and concise. Respondents also expressed the importance of having this tabulated method visually embedded in the monograph to allow easy access to information on the wards. This concurs with suggested information presentation to aid error reduction in the literature.3 National standardisation of DV information was viewed as ‘very useful' or ‘preferred' by 52 (95%) of respondents; reasons for this preference were risk reduction due to errors or misinterpretation.ConclusionThe use of DVs in paediatrics is commonplace in the UK; this is reflected in local IV guides used by the majority of centres. Improving visual presentation of DVs is important and tabulated expression of DVs is preferred by pharmacists and a national standard presentation of DVs is encouraged. The results from the survey will inform the monograph layout for the Medusa. Prior to implementation nurse feedback should also be sought.

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