scholarly journals Review of HIV testing at a district general hospital in an area of high HIV prevalence following the introduction of new national guidelines

2010 ◽  
Vol 13 (Suppl 4) ◽  
pp. P218
Author(s):  
ID Page ◽  
M Phillips ◽  
P Flegg ◽  
R Palmer
2015 ◽  
Vol 91 (Suppl 1) ◽  
pp. A48.1-A48
Author(s):  
Matthew James ◽  
Eleanor Draeger ◽  
Charles Mazhude ◽  
Ruhin Das ◽  
Melanie Rosenvinge

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
D Bernstein ◽  
A West ◽  
E Preston ◽  
P Premakumaran ◽  
N Suleyman ◽  
...  

Abstract Aim Consent is a core component of interaction between patients and healthcare professionals. Prior to surgery, forms are completed to record patient consent. As well as containing risks and benefits of the procedure, the consent form, as per guidelines1,2, must be legible and suitable to a patient’s capacity. To evaluate compliance with local and national guidelines, a quality improvement project was undertaken at a district general hospital. Method Over a three-week period 30 urology consent forms were selected to assess adherence to local and national guidelines. The appropriateness of consent form, patient signature, legibility, acronym use and whether the patient was offered a carbon copy were assessed. After initial data collection, all urology staff consenting patients were notified of the findings and how best to improve guideline adherence. A further three-week data collection was undertaken, though the sample set was small due to Coronavirus and Christmas. Results The results confirmed that patients had appropriate consent forms filled out and were signed appropriately. After intervention, there was clear improvement in legibility, with no low legibility consent forms, and 100% vs 83% high or moderate legibility between data sets. Intervention also resulted in significant reduction of acronym use; 33% vs 60%. More patients were also offered to retain a carbon copy; 89% vs 40%. Conclusions Through this intervention of highlighting local and national guidance as compared to current practice, compliance drastically improved. As the pandemic subsides, we hope regular emails to surgical teams will improve consent form completion to better patient care.


2008 ◽  
Vol 18 (2) ◽  
pp. 56-59 ◽  
Author(s):  
Soni Putnis ◽  
Joe Nanuck ◽  
Dugal Heath

Purpose Audit of the use of preoperative blood tests in elective general surgery in a district general hospital. Comparison is made with the National Institute for Health and Clinical Excellence (NICE) guidelines and recommendations. Methodology Retrospective audit of preoperative blood tests performed for elective general surgical patients in a district general hospital over a one month period. Findings Patients attending preoperative assessment for general surgery have blood tests performed in excess of the NICE guidelines. The most frequently requested test that is performed against NICE guidelines is a coagulation screen. This was requested in excess of the national guidelines in 17.8% of cases. Practical implications This audit highlights the overuse of preoperative blood tests and provides suggestions for improving efficiency and economics in the preoperative setting. Originality/value of paper There have been no published audits assessing the current practice against the 2003 NICE guidelines for the use of routine preoperative tests for elective surgery.


2015 ◽  
Vol 86 (11) ◽  
pp. e4.183-e4
Author(s):  
Dafydd Llewelyn ◽  
Mark Fish

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.


2021 ◽  
Vol 108 (Supplement_5) ◽  
Author(s):  
W Luo ◽  
R Limb ◽  
A Aslam ◽  
R Kattimani ◽  
D Karthikappallil ◽  
...  

Abstract Introduction This study aimed to assess the impact of the COVID-19 pandemic on emergency operations during the first phase of lockdown in the United Kingdom, compared to the equivalent population in the same calendar period in 2019. Method We retrospectively reviewed patients undergoing surgery in emergency theatres at our district general hospital between March 23rd and May 11th in 2019 and 2020. Data collected included demographics, National Confidential Enquiry into Patient Outcome and Death (NCEPOD) category and procedure. The primary outcome was 90-day post-operative mortality; secondary outcomes included time to intervention and length of inpatient stay. Result 132 patients (2020) versus 141 (2019) patients were included with no significant difference in age (P = 0.676), sex (P = 0.230), or overall 90-day postoperative mortality (P = 0.196). Notably, time to intervention was faster for NCEPOD code 3 patients in 2020 than 2019 (P = 0.027). Time to intervention in 2020 was longer for those dying within 90 days post-operatively compared to survivors (P = 0.02). There was no difference in length of stay between years, both overall and when comparing subgroups by NCEPOD category or procedures (fractured neck of femur (P = 0.776), laparoscopies (P = 0.866), laparotomies (P = 0.252)), except for upper limb trauma (P = 0.007). Conclusion This study is amongst the first describing the general case mix in emergency theatres in the UK. Patient pre-operative characteristics and demographics did not change. Our data confirms patient prioritisation according to NCEPOD recommendations and streamlining of surgical services, with no difference in overall mortality, time to intervention or length of stay compared to 2019. Take-home Message At this district general hospital, patients were appropriately prioritised, and our results show adaptation of hospital practice to emerging national guidelines during the first phase of lockdown. A national validation audit assessing morbidity and mortality outcomes for all NCEPOD patients may be facilitate further understanding of risks posed to patients requiring urgent surgery during these unprecedented times.


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