THE MANAGEMENT OF SUSPECTED ENCEPHALITIS AT A REGIONAL DISTRICT GENERAL HOSPITAL

2015 ◽  
Vol 86 (11) ◽  
pp. e4.183-e4
Author(s):  
Dafydd Llewelyn ◽  
Mark Fish
Keyword(s):  
Hiv Testing ◽  
General Hospital ◽  
District General Hospital ◽  
Serum Glucose ◽  
Retrospective Audit ◽  
Average Latency ◽  
Ct Head ◽  
Paired Serum ◽  
Medical Teams ◽  
Time Of Admission

AimTo determine how suspected encephalitis is managed in a regional DGH against standard of ABN/BIA (Association of British Neurologists/British Infection Association) Guidelines (2012).MethodologyA retrospective audit of notes for 21 cases with suspected encephalitis (June to December 2013). Sampling utilised case coding, records of referrals to neurology and CSF analyses. Latency from time of admission to suspicion of encephalitis, CT, LP, MRI, aciclovir administration and neurological input were determined.Results12/21 patients received aciclovir within 6 hours (average 11.5h), 18/21 patients had a CT head scan before LP and in 14/21 cases aciclovir was started before LP.  18/21 cases underwent LP (6 on MAU, 11 by medical teams and 1 by neurology), 17/18 had CSF constituents requested, 9/18 had a paired serum glucose. 5 cases had repeat HSV PCR, 5 had HIV testing and 12/21 had an EEG. The average latency to MRI was 2.34 days and time to be seen by a neurologist was 2 days. Treatment was discontinued in 7 cases after negative HSV PCR and 5 after alternative diagnosis were made.ConclusionsManagement of suspected encephalitis varied, we need to increase awareness ABN/BIA guidance and address the delay in neurology services seeing these patients.

Management of diabetic ketoacidosis in a district general hospital: a 3 years retrospective audit

2013 ◽  
pp. 1-1
Author(s):  
Mohamed Ahmed ◽  
Juaidy Zakaria ◽  
Caitriona Doyle ◽  
Ciana McCarthy ◽  
Cathrine McHugh
Keyword(s):  
Diabetic Ketoacidosis ◽  
General Hospital ◽  
District General Hospital ◽  
Retrospective Audit

Reducing the number of unnecessary laboratory tests within hospital through the use of educational interventions

2021 ◽  
pp. 000456322110406
Author(s):  
Michael Thurm ◽  
Helen Craggs ◽  
Merlin Watts ◽  
Anthony Brooks
Keyword(s):  
Cohort Study ◽  
Cost Saving ◽  
General Hospital ◽  
Laboratory Tests ◽  
Patient Management ◽  
District General Hospital ◽  
Educational Interventions ◽  
Blood Tests ◽  
Medical Teams ◽  
The Impact

Background The growing number of laboratory investigation requests is placing an increased burden upon NHS resources. Around a quarter of all tests are unnecessary repeats, and almost a third have no impact on patient management. Doctors recognise that tests should only be performed when clinically indicated, but a culture persists of undertaking unnecessary repeat investigations. Methods A cohort study was undertaken at a district general hospital to observe the impact of introducing educational interventions in the form of a poster and a series of educational lectures, encouraging clinicians to consider whether an investigation was clinically indicated. Data was collected from nine different sites across the hospital run by different medical teams regarding the number of tests undertaken and the impact on patient care. Results Data from over 13,000 tests and over 2000 patients was analysed from nine different sites across the hospital. There was a significant reduction (33%, p = 0.0001) in the number of blood tests performed. This reduction in testing saved £7006 over the course of 1 month, in addition to other benefits. There was a reduction in testing in eight out of the nine sites in which the study was undertaken, demonstrating good generalisability of results. There was no significant increase in length of admission or mortality. Conclusion Educational interventions to doctors have a significant and safe impact in reducing the number of unnecessary investigations, providing cost saving benefits to the NHS.

scholarly journals EP.TH.640Outcomes in Elective and Emergency Laparoscopic Cholecystectomies in a District General Hospital

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Ahmed Nur ◽  
Aditya Agrawal
Keyword(s):  
General Hospital ◽  
Bile Leak ◽  
District General Hospital ◽  
Perioperative Outcomes ◽  
Electronic Patient Records ◽  
Incision And Drainage ◽  
Retrospective Audit ◽  
Operative Findings ◽  
Time Of Operation ◽  
Base Data

Abstract Aims To evaluate early perioperative outcomes following emergency and elective laparoscopic cholecystectomies in a district general hospital against the national average. Methods A retrospective audit was carried out on consecutive Laparoscopic Cholecystectomies performed between January 2020 and June 2018. All indications were included. Demographics and base data included; age, gender, ASA grade, type of surgery (Emergency/Elective), number of symptomatic days preoperatively, preoperative bloods, preoperative ERCP, operative findings, postoperative complications and length of stay. Data was gathered from physical and electronic patient records. Results 166 laparoscopic cholecystectomies were included in the audit. Of the 166 included patients, 48 were male and 118 were female. Mean age at time of operation was 53.4 years. 106 of the laparoscopic cholecystectomies were carried out as Elective cases and 60 were performed as Emergencies. 100% of cases were performed laparoscopically, with 3 cases requiring conversion to open intraoperatively. Postoperatively, 5 patients had post-op pneumonia. There were 3 documented cases of bile leak with 1 patient requiring ERCP as a result. There were 2 cases of wound infection requiring re-admission. Other documented complications included; umbilical port sit abscess requiring incision and drainage, collection in the gallbladder fossa, small bowel injury and a post-op drop in Haemoglobin requiring transfusion. Conclusions Outcomes in this cohort of patients undergoing laparoscopic cholecystectomies are comparable to national data. The focus of further evaluation from this cohort should be to compare outcomes between Emergency and Elective Laparoscopic Cholecystectomies, with Emergency cases further stratified according to the number of symptomatic days preoperatively.

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