scholarly journals Substance misuse teaching: a patient safety issue

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S190-S191
Author(s):  
Lucy Harborow ◽  
Mary Thornton ◽  
Nicola J. Kalk ◽  
Mike Kelleher
Keyword(s):  
Patient Safety ◽  
Substance Misuse ◽  
Readiness To Change ◽  
Safety Issue ◽  
Psychiatric Morbidity ◽  
Cross Sectional Survey ◽  
Opioid Substitution Therapy ◽  
Harm Minimisation ◽  
Cross Sectional ◽  
Clinical Concern

AimsClinical substance misuse presentations are commonly managed by Psychiatry Core Trainees (CTs) out of hours. However, specialist teaching is not included in the Maudsley Training Program (MTP) induction. We aimed to investigate whether this was of clinical concern and, if so identify interventions to address it.BackgroundThe association of substance misuse disorder and mental illness is widely recognised. The Adult Psychiatric Morbidity Survey 2014 reported that half of people dependent on drugs other than cannabis were receiving mental health treatment. Substance use substantially impacts clinical risk; 57% of patient suicides in 2017 had a history of substance misuse. It also effects emergency psychiatric services: 55-80% of patients detained under S136 are intoxicated. Therefore, it is imperative for patient safety that CTs can assess and manage these patients appropriately.The Royal College of Psychiatrists recognises the need for specialist substance misuse knowledge and skills, and lists this as a key ‘Intended Learning Outcome’ for CTs. Unfortunately, the availability of specialist drug and alcohol service placements for CTs has significantly declined. Only one placement is available per MTP rotation. Teaching is therefore relied upon to gain these competencies.MethodUsing a cross-sectional survey we explored CTs confidence in recognising and managing substance misuse presentations, knowledge of where to seek guidance and asked for teaching suggestions. We surveyed two CT1 cohorts in 2017 and 2019.ResultFifty-one CTs took the survey. Of these 92% did not feel prepared to manage acute substance intoxication or withdrawal and 96% would like relevant teaching at the start of CT1. Furthermore, 67% did not know where they could seek guidance.CTs felt confident at recognising and managing alcohol related presentations. However, they were less confident in recognising opioid withdrawal, how to safely prescribe opioid substitution therapy (OST), and the usual doses of OST (65%, 94%, 94% rated ‘neither confident nor not confident’ or below, respectively). CTs were not confident at recognising GBL and cannabinoid withdrawal, principles of harm minimisation, assessing readiness to change, delivering Brief Interventions and teaching patients to use Naloxone.ConclusionThe results were exceptionally similar between cohorts, demonstrating reliability of our findings and that CTs lack of substance misuse knowledge is a significant clinical concern.To address this deficit of knowledge, we are writing an introductory lecture with supporting guidance in the induction pack, developing an online video resource, and moving key substance misuse lectures to earlier in the MTP taught programme.

scholarly journals Exploring Safety Aspects in Dental School Clinics Including Droplet Infection Prevention

2020 ◽  
Vol 8 (E) ◽  
pp. 509-515
Author(s):  
Asmaa Abdelnaby ◽  
Laila Mahmoud Kamel ◽  
Jylan Elguindy ◽  
Reham Yousri Elamir ◽  
Eman Elfar
Keyword(s):  
Health Care ◽  
Patient Safety ◽  
Infection Control ◽  
Dental Health ◽  
Survey Study ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Safety Practices ◽  
Preparedness Plan ◽  
Dental Schools

BACKGROUND: Health-care safety focuses on improving patient’s and worker’s safety in a safe working clinics’ environment and prevent infection transmission including droplet infections as seasonal influenza and novel coronavirus (COVID-19). Dental health-care personnel (DHCP) are the target of safety measures and are themselves responsible for elimination of preventable harm. Dental schools are expected to demonstrate the model for quality safe care. AIM: This study aims to achieve high-quality safe dental care at dental clinics, Faculty of Dentistry, Cairo University. METHODS: A cross-sectional survey study was conducted at two Dental Outpatient Clinics, Cairo University. Disk review of policies, observation checklists for practices and awareness questionnaires of DHCP were used. RESULTS: DHCP showed good awareness for most of infection control (IC) and X-ray safety items. However, there are no policies or procedures to control droplet infections in the clinics. The clinics were closed in the current COVID-19 pandemic. There were poor patient safety practices, hand hygiene compliance, and personal protective equipment (PPE) use except for protecting clothes and disposable gloves. Students showed better compliance for patient safety guidelines. Other safety policies were poorly communicated. CONCLUSION: There should be preparedness plan to deal with any droplet infection outbreak, epidemic or pandemic as COVID-19 in all dental settings. There is a need to initiate dental safety unit in dental schools to implement, communicate, train, and supervise all dental safety practices including infection control.

scholarly journals Readiness to change towards accredited public health centres (PHCs) in West Lombok

2018 ◽  
Vol 6 (1) ◽  
pp. 42
Author(s):  
I Made Santiana ◽  
Ni Made Sri Nopiyani ◽  
Dyah Pradnyaparamita Duarsa
Keyword(s):  
Public Health ◽  
Readiness To Change ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Managerial Support ◽  
Promotional Strategy ◽  
Performance Accountability ◽  
Health Centres ◽  
Administrative Systems ◽  
Working Procedure

AbstractBackground and purpose: The 2016 Report of Performance Accountability of Government Agencies, Ministry of Health of Indonesia showed only a small proportion of public health centres (PHCs) are accredited. In West Lombok District, some PHCs are not accredited. This study aims to examine factors associated with PHC’s staff readiness for accreditation.Methods: A cross-sectional survey was employed involving seven non-accredited PHCs. A total of 165 out of 310 PHC’s staff were recruited using a systematic random sampling. Data was collected from February to March 2017. Self-administered questionnaire was used to collect data on socio-demographic characteristics, duration of service, content, process, and context changes, individual attributes, and readiness to change. Logistic regression was applied to examine the association between readiness to change with independent variables.Results: As many as 72.1% of respondents are ready to change. From the change efficacy and appropriateness dimensions, as many as 46.1% and 97.0% of respondents are ready to change. Multivariate analysis shows an association between readiness to change with administrative systems (AOR=4.47; 95%CI: 2.05-9.74) and working procedure (AOR=2.95; 95%CI: 1.19-7.30). There is no significant association between readiness to change with technological improvement, promotional strategy, staff engagement, organisational commitment and managerial support from health offices.Conclusions: The readiness to change among PHC’s staff is high. The availability of working procedure and administrative systems improves PHC’s staff readiness for the accreditation. These findings suggest the importance of inclusion of all PHC’s staff during the accreditation processes.

Patient safety in practical nurses' education: A cross-sectional survey of newly registered practical nurses in Canada

2017 ◽  
Vol 51 ◽  
pp. 48-56 ◽  
Author(s):  
Elizabeth VanDenKerkhof ◽  
Nancy Sears ◽  
Dana S. Edge ◽  
Deborah Tregunno ◽  
Liane Ginsburg
Keyword(s):  
Patient Safety ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Practical Nurses

scholarly journals Patient safety content and delivery in pre-registration nursing curricula: A national cross-sectional survey study

2018 ◽  
Vol 66 ◽  
pp. 82-89 ◽  
Author(s):  
Kim Usher ◽  
Cindy Woods ◽  
Jane Conway ◽  
Jackie Lea ◽  
Vicki Parker ◽  
...  
Keyword(s):  
Patient Safety ◽  
Survey Study ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Nursing Curricula

scholarly journals Childhood sexual abuse and psychosis: data from a cross-sectional national psychiatric survey in England

2011 ◽  
Vol 199 (1) ◽  
pp. 29-37 ◽  
Author(s):  
Paul Bebbington ◽  
Sarah Jonas ◽  
Elizabeth Kuipers ◽  
Michael King ◽  
Claudia Cooper ◽  
...  
Keyword(s):  
Sexual Abuse ◽  
Childhood Sexual Abuse ◽  
Psychiatric Morbidity ◽  
Population Attributable Risk ◽  
Population Sample ◽  
Cannabis Use ◽  
Anxiety And Depression ◽  
Computer Assisted ◽  
Cross Sectional Survey ◽  
Cross Sectional

BackgroundA number of studies in a range of samples attest a link between childhood sexual abuse and psychosis.AimsTo use data from a large representative general population sample (Adult Psychiatric Morbidity Survey 2007) to test hypotheses that childhood sexual abuse is linked to psychosis, and that the relationship is consistent with mediation by revictimisation experiences, heavy cannabis use, anxiety and depression.MethodThe prevalence of psychosis was established operationally in a representative cross-sectional survey of the adult household population of England (n = 7353). Using computer-assisted self-interview, a history of various forms of sexual abuse was established, along with the date of first abuse.ResultsSexual abuse before the age of 16 was strongly associated with psychosis, particularly if it involved non-consensual sexual intercourse (odds ratio (OR) = 10.14, 95% CI 4.8–21.3, population attributable risk fraction 14%). There was evidence of partial mediation by anxiety and depression, but not by heavy cannabis use nor revictimisation in adulthood.ConclusionsThe association between childhood sexual abuse and psychosis was large, and may be causal. These results have important implications for the nature and aetiology of psychosis, for its treatment and for primary prevention.

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