scholarly journals Audit of documentation of observations on mental health services for older people (MHSOP) wards following implementation of nervecentre

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S215-S215
Author(s):  
Nitya Rathi
Keyword(s):  
Original Data ◽  
Early Warning Score ◽  
Inclusion Criteria ◽  
Electronic Documentation ◽  
Desktop Computers ◽  
National Guidance ◽  
National Early Warning Score ◽  
Paper Documentation ◽  
Almost All

AimsNervecentre is an application that can be used on mobile devices and desktop computers to record and view physical observations amongst other tools. An audit had been done previously assessing the practice of recording observations using paper documentation. That audit had recommended the use of Nervecentre to improve the recording of observations. This audit was undertaken following the introduction of Nervecentre for documentation of physical observations. The aims were to evaluate if the transition to electronic documentation of NEWS (National Early Warning Score) observations on Nervecentre has improved practice in comparison to paper documentation and to evaluate if our practice could be improved by implementing electronic observations for psychiatric observations in addition.MethodData were collected over a 10-day period looking at all the documented observations from all inpatients on the MHSOP wards that met the inclusion criteria. Data were collected on the recording of psychiatric observations (recorded on paper charts) and physical observations (recorded on Nervecentre). The data were collated and analysed. The new data were compared to the original data from prior to the introduction of NerveCentre and the findings were presented at a local meeting.ResultThis audit has highlighted that the documentation of physical observations on MHSOP wards has greatly improved since Nervecentre was introduced. There was an improvement in recording of physical observations in almost all domains measured. NEWS scores were correctly documented 100% of the time compared to 87% previously. Raised NEWS scores were correctly escalated to a senior and reviewed 80% of the time compared to 0% previously. It has also highlighted that the quality of documentation regarding psychiatric observations could be improved as we are not currently meeting local or national guidance.ConclusionThe most likely cause for the improvement in the recording of the physical observations is the implementation of Nervecentre. Nervecentre prompts users when observations are due, removes the risk of calculation errors and allows for observations to be directly escalated. Implementing Nervecentre for psychiatric observations may similarly improve the quality of these observations therefore improving patient safety.

Physicochemical and bacteriological characterization of hospital effluents and their impact on the environment

2019 ◽  
Author(s):  
Chem Int
Keyword(s):  
Human Health ◽  
Fecal Coliforms ◽  
Chemical Pollution ◽  
Hospital Effluents ◽  
Biological Contaminants ◽  
Almost All ◽  
Direct Discharge ◽  
Significant Chemical

Liquid effluents discharged by hospitals may contain chemical and biological contaminants whose main source is the different substances used for the treatment of patients. This type of rejection can present a sanitary potentially dangerous risk for human health and can provoke a strong degradation of diverse environmental compartments mainly water and soils. The present study focuses on the quality of the liquid effluents of Hassani Abdelkader’s hospital of Sidi Bel-Abbes (West of Algeria). The results reveal a significant chemical pollution (COD: 879 mgO2/L, BOD5: 850 mgO2/L, NH4+ : 47.9 mg/l, NO2- : 4.2 mg/l, NO3- : 56.8 mg/l with respect to WHO standard of 90 mgO2/L, 30 mgO2/L, 0.5 mg/l, 1 mg/l and 1 mg/l respectively). However, these effluents are biodegradable since the ratio COD/BOD5 do not exceeded the value of 2 in almost all samples. The presence of pathogen germs is put into evidence such as pseudomonas, the clostridium, the staphylococcus, the fecal coliforms and fecal streptococcus. These results show that the direct discharge of these effluents constitutes a major threat to human health and the environment.

An Evaluation of Cognitive Behavioral Therapy for Insomnia: A Systematic Review and Application of Tolin’s Criteria for Empirically Supported Treatments

2019 ◽  
Author(s):  
Cassandra L. Boness ◽  
Rachel Hershenberg ◽  
Joanna Kaye ◽  
Margaret-Anne Mackintosh ◽  
Damion Grasso ◽  
...  
Keyword(s):  
Cognitive Behavioral Therapy ◽  
Behavioral Therapy ◽  
Cognitive Behavioral ◽  
Empirically Supported Treatments ◽  
Inclusion Criteria ◽  
American Psychological ◽  
Strong Recommendation ◽  
Empirically Supported ◽  
High Quality Evidence

The American Psychological Association’s Society of Clinical Psychology recently adopted the “Tolin Criteria” to evaluate empirically supported treatments. These criteria better account for strength and quality of rapidly accumulating evidence bases for various treatments. Here we apply this framework to Cognitive Behavioral Therapy for Insomnia (CBT-I). Following procedures outlined by Tolin and colleagues (2015), Step 1 included an examination of quantitative systematic reviews; nine met inclusion criteria. Step 2 evaluated review quality and effect size data. We found high-quality evidence that CBT-I produces clinically and statistically significant effects on insomnia and other sleep-related outcomes. Based on the Tolin Criteria, the literature merits a “strong” recommendation for CBT-I. This report is a working model for subsequent applications of the Tolin Criteria.

Sustainability Failure in the Antimicrobial Stewardship Program in a Secondary Care Hospital from Cuba: A Historical Review of 30 Years and 3 Shots

2020 ◽  
Vol 18 ◽  
Author(s):  
Humberto Guanche Garcell ◽  
Juan José Pisonero Socias ◽  
Gilberto Pardo Gómez
Keyword(s):  
Antimicrobial Stewardship ◽  
Historical Review ◽  
Original Data ◽  
Care Hospital ◽  
Antimicrobial Stewardship Program ◽  
Continuous Quality ◽  
Stewardship Program ◽  
History Of ◽  
Health Organization

Background: During the last 30 years an antimicrobial stewardship program (ASP) was implemented in a facility with periods of weakness. We aim to describe the history of the sustainability failure in the local ASP. Methods: A historical review was conducted using original data from the facility library and papers published. An analysis of factors related to the failure was conducted based on the Doyle approach. Results: The first ASP was implemented from 1989 to 1996 based on the international experiences and contributes to the improvement in the quality of prescription, reduction of 52% in cost and in the incidence of nosocomial infection. The second program restarts in 2008 and decline in 2015, while the third program was guided by the Pan-American Health Organization from 2019. This program, in progress, is more comprehensive than previous ones and introduced as a novel measure the monitoring of antibiotic prophylaxis in surgery. The factors related to the sustainability were considered including the availability of antimicrobials, the leader´s support, safety culture, and infrastructure. Conclusions: The history behind thirty years of experiences in antimicrobial stewardship programs has allowed us to identify the gaps that require proactive strategies and actions to achieve sustainability and continuous quality improvement.

Transformative Learning in Mastery-Oriented CS0 Course

2021 ◽  
pp. 234763112110072
Author(s):  
Srinivasan Lakshminarayanan ◽  
N. J. Rao ◽  
G. K. Meghana
Keyword(s):  
Transformative Learning ◽  
First Year ◽  
Guided Discovery ◽  
Engineering Programs ◽  
Transformative Experiences ◽  
Significant Difference ◽  
Cognitive Levels ◽  
Almost All ◽  
Core Course

The introductory programming course, commonly known as CS1 and offered as a core course in the first year in all engineering programs in India, is unique because it can address higher cognitive levels, metacognition and some aspects of the affective domain. It can provide much needed transformative experiences to students coming from a system of school education that is dominantly performance-driven. Unfortunately, the CS1 course, as practiced in almost all engineering programs, is also performance-driven because of a variety of compulsions. This paper suggests that the inclusion of a course CS0 can bring about transformative learning that can potentially make a significant difference in the quality of learning in all subsequent engineering courses. The suggested instruction design of this course takes the advantage of the unique features of a course in programming. The proposed CS0 course uses “extreme apprenticeship” and “guided discovery” methods of instruction. The effectiveness of these instruction methods was established through the use of the thematic analysis, a well-known qualitative research method, and the associated coding of transformative learning experiences and instruction components.

scholarly journals Experiences of a National Early Warning Score (NEWS) intervention in care homes during the COVID-19 pandemic: a qualitative interview study

BMJ Open ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. e045469
Author(s):  
Rachel Stocker ◽  
Siân Russell ◽  
Jennifer Liddle ◽  
Robert O Barker ◽  
Adam Remmer ◽  
...  
Keyword(s):  
Early Warning ◽  
Healthcare Professionals ◽  
Care Home ◽  
Qualitative Interview ◽  
Interview Study ◽  
Care Homes ◽  
Early Warning Score ◽  
Service Utilisation ◽  
Qualitative Interview Study ◽  
National Early Warning Score

BackgroundThe COVID-19 pandemic has taken a heavy toll on the care home sector, with residents accounting for up to half of all deaths in Europe. The response to acute illness in care homes plays a particularly important role in the care of residents during a pandemic. Digital recording of a National Early Warning Score (NEWS), which involves the measurement of physical observations, started in care homes in one area of England in 2016. Implementation of a NEWS intervention (including equipment, training and support) was accelerated early in the pandemic, despite limited evidence for its use in the care home setting.ObjectivesTo understand how a NEWS intervention has been used in care homes in one area of North-East England during the COVID-19 pandemic, and how it has influenced resident care, from the perspective of stakeholders involved in care delivery and commissioning.MethodsA qualitative interview study with care home (n=10) and National Health Service (n=7) staff. Data were analysed using thematic analysis.ResultsUse of the NEWS intervention in care homes in this area accelerated during the COVID-19 pandemic. Stakeholders felt that NEWS, and its associated education and support package, improved the response of care homes and healthcare professionals to deterioration in residents’ health during the pandemic. Healthcare professionals valued the ability to remotely monitor resident observations, which facilitated triage and treatment decisions. Care home staff felt empowered by NEWS, providing a common clinical language to communicate concerns with external services, acting as an adjunct to staff intuition of resident deterioration.ConclusionsThe NEWS intervention formed an important part of the care home response to COVID-19 in the study area. Positive staff perceptions now need to be supplemented with data on the impact on resident health and well-being, workload, and service utilisation, during the pandemic and beyond.

scholarly journals Physical activity in patients with rheumatoid arthritis - an agile lifelong behaviour: a qualitative meta-synthesis

RMD Open ◽  
2021 ◽  
Vol 7 (2) ◽  
pp. e001635
Author(s):  
Emma Swärdh ◽  
Christina Opava ◽  
Nina Brodin
Keyword(s):  
Rheumatoid Arthritis ◽  
Physical Activity ◽  
Web Of Science ◽  
Body Awareness ◽  
Main Theme ◽  
Inclusion Criteria ◽  
Online Databases ◽  
Taking Action ◽  
The Impact

BackgroundPhysical activity (PA) in rheumatoid arthritis (RA) is considered a cornerstone in the treatment. To highlight aspects involved in supporting a positive PA behaviour, it is important to understand the patients’ perceptions of the phenomenon.ObjectiveThe aim of this qualitative meta-synthesis was to explore and synthesise patient perceptions of PA in RA.MethodsA purposeful search was conducted across three online databases (PubMed, CINAHL and Web of Science). The methodological quality of the included studies was appraised, and data were extracted and analysed using an interpretive inductive thematic synthesis.ResultsFifteen studies met the inclusion criteria and were included. PA was identified as an agile lifelong behaviour, with one main theme: The disease as a persistent catalyst for or against PA illustrating how the constant presence of the disease itself underlies the entire process of a life with or without regular PA. Seven subthemes: ‘considering aggravated symptoms’, ‘acknowledging the impact on health’, ‘becoming empowered and taking action’, ‘keeping informed to increase awareness’, ‘creating body awareness’, ‘dealing with social support’ and ‘feeling satisfied with circumstances and achievements’ were interpreted as facilitators and/or challenges.ConclusionThis synthesis has identified PA as an agile lifelong behaviour in which the disease pervades all aspects of an individuals’ perception of PA. Placed in a theoretical context, our findings outline a model for tailoring PA support to the drivers and determinants of a certain individual, which will improve clinical practice for the benefit of both health professionals and patients with RA.

Venous leg symptoms, ecchymosis, and coldness in patients with peripheral varicose vein: A multicenter assessment and validation study (VEIN-VIOLET study)

Vascular ◽  
2020 ◽  
pp. 170853812098020
Author(s):  
Ertan Yetkin ◽  
Makbule Kutlu Karadag ◽  
Mehmet Ileri ◽  
Ramazan Atak ◽  
Nevzat Erdil ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Regression Analysis ◽  
Varicose Vein ◽  
Odds Ratio ◽  
Venous Insufficiency ◽  
Study Quality ◽  
Inclusion Criteria ◽  
Economic Study ◽  
Independent Association

Objectives We aimed to evaluate peripheral varicose vein symptoms including ecchymosis and coldness by using the Venous Insufficiency Epidemiological and Economic Study-Quality of Life/Symptoms (VEINES-QoL/Sym) questionnaire. Methods A total of 1120 patients were enrolled to the analysis after the exclusion of 199 patients who did not match the inclusion criteria. Patients were asked to answer the VEINES-Sym questionnaire and questions about ecchymosis and coldness. Scores of ecchymosis and coldness were calculated similar to VEINES-Sym questionnaire. Classifications of peripheral varicose vein were made according to the clinical part of clinical, etiological, anatomical, and pathophysiological classification system and patients with grade 2 or higher were considered as positive for peripheral varicose vein. Results Frequency of symptoms present in the VEINES-Sym instrument, ecchymosis and coldness were significantly higher in patients with peripheral varicose vein. Mean score of each symptom was significantly lower in peripheral varicose vein patients including scores of ecchymosis and coldness. Logistic regression analysis revealed that presence of hemorrhoids and all symptoms in VEINES-Sym questionnaire except restless leg were significantly and independently associated with peripheral varicose vein. Besides, ecchymosis (odds ratio: 2.04, 95% confidence interval: 1.34–3.08, p = 0.008) but not coldness was significantly and independently associated with peripheral varicose vein. There was also significant correlation of VEINES-Sym score with ecchymosis ( r = 0.43, p < 0.001) and coldness ( r = 0.47, p < 0.001). Conclusions Venous leg symptoms present in VEINES-Sym questionnaire except restless legs, presence of hemorrhoids and ecchymosis are significantly and independently associated with peripheral varicose vein. Not only ecchymosis but also coldness has shown an independent association with total VEINES-Sym score.

scholarly journals 964 Telemedicine: Speedy Triage Tool or Clinical Record?

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
A Ghareib ◽  
Z Vinnicombe ◽  
G Visser ◽  
A Ra ◽  
M Mantella ◽  
...  
Keyword(s):  
Plastic Surgery ◽  
Compliance Rate ◽  
Clinical Record ◽  
Portal System ◽  
Clinical Documentation ◽  
University Hospitals ◽  
Record Keeping ◽  
Clinical Document ◽  
National Guidance

Abstract Introduction St. George’s University Hospitals NHS Foundation Trust is a tertiary plastic surgery centre serving a population of 3.5 million in and around South West London. Telemedicine Referral Image Portal System (TRIPS) is integral to our service, allowing triage of patients in remote locations. During Covid, TRIPS helped in reducing footfall and streamlining out of hospital referrals to reduce unnecessary transfer. The aim of this project was to assess the quality of clinical documentation for emergency referrals to plastic surgery via TRIPS. Method We performed a retrospective review of all patients referred to plastic surgery via TRIPS during April 2020. Documentation standards were determined from national guidance. After introduction of a condensed guide, a second review was performed four months later. Results In April, 131 referrals were recorded on TRIPS. Only 22.9% of records met the standard. The most common omission was treatment advice. Following introduction of guidance, 215 TRIPS records were reviewed. The quality of clinical documentation improved in all aspects with a compliance rate of 89%. Conclusions Although TRIPS remains a useful tool for triage, it is a clinical document and must meet the standards of clinical record keeping. Introduction of clear guidelines improves overall compliance.

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