scholarly journals Hot beds of general psychiatry

1997 ◽  
Vol 21 (3) ◽  
pp. 142-144 ◽  
Author(s):  
M. Dominic Beer ◽  
Carol Paton ◽  
Stephen Pereira
Keyword(s):  
Intensive Care ◽  
Multidisciplinary Team ◽  
Special Interest ◽  
Postal Survey ◽  
Support Network ◽  
General Psychiatry ◽  
Team Working ◽  
Local Support ◽  
The Uk ◽  
Very High

Little is known of the facilities available nationally to treat the most disturbed patients. A postal survey sent to all pharmacists in the UK known to have a special interest in psychiatry identified 110 psychiatric intensive care units. They varied in size from four to 30 beds, with the small units having low and the larger units very high occupancy levels. Many units accepted a mixture of informal patients directly from the community, detained patients and referrals from the prison service. Medical cover was variable, multidisciplinary team-working poor, and the existence of written policies unsatisfactory. Staff often felt undervalued with little control over admissions and discharges. There is currently no national or local support network for these units.

Multidisciplinary team working: is it both holistic and effective?

2004 ◽  
Vol 14 (2) ◽  
pp. 210-211 ◽  
Author(s):  
H. Jefferies ◽  
K. K. Chan
Keyword(s):  
Multidisciplinary Team ◽  
Clinical Management ◽  
Tertiary Care ◽  
Medical Model ◽  
Holistic Care ◽  
Disease Trajectory ◽  
Team Working ◽  
Cancer Services ◽  
The Uk ◽  
Seamless Service

Multidisciplinary team (MDT) working has been endorsed as the main mechanism to ensure truly holistic care for patients and a seamless service for patients throughout their disease trajectory and across the boundaries of primary, secondary, and tertiary care. However the effectiveness of each team needs to be continually evaluated to ensure that all the relevant disciplines are able to participate in the clinical management of patients. This article describes the work of the Cancer Services Collaborative at the Birmingham Women's hospital in the UK in promoting the development of a holistic MDT in parallel with the medical model.

scholarly journals Multidisciplinary team working in an adult male prison establishment in the UK

BDJ ◽  
2014 ◽  
Vol 217 (3) ◽  
pp. 117-121 ◽  
Author(s):  
E. Heidari ◽  
C. Dickinson ◽  
T. Newton
Keyword(s):  
Adult Male ◽  
Multidisciplinary Team ◽  
Team Working ◽  
The Uk

scholarly journals Trainee doctors’ experiences of learning and well-being while working in intensive care during the COVID-19 pandemic: a qualitative study using appreciative inquiry

BMJ Open ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. e049437
Author(s):  
Jennifer Warren ◽  
Emma Plunkett ◽  
James Rudge ◽  
Christina Stamoulis ◽  
Tomasz Torlinski ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Qualitative Study ◽  
Appreciative Inquiry ◽  
Personal Development ◽  
Well Being ◽  
Work Related ◽  
Team Working ◽  
Analysis Technique ◽  
The Uk

ObjectivesConcern about trainee work-related well-being has been raised in recent years and is the subject of several reviews, reports and research studies. This study aimed to understand the experiences of trainees working in a large intensive care unit during the first surge of the COVID-19 pandemic from an educational and operational perspective in order to highlight what worked and what could be improved.DesignA qualitative study using peer-to-peer semistructured interviews, developed using appreciative inquiry methodology, was conducted during July 2020. Responses were analysed using a thematic analysis technique.SettingA large, tertiary intensive care unit in the UK.ParticipantsAll trainees in anaesthesia and intensive care working on the intensive care unit during the first surge were invited to participate.ResultsForty interviews were conducted and four over-arching themes were identified. These were: feeling safe and supported; physical demands; the emotional burden of caring; and a sense of fulfilment, value and personal development. Positive aspects of the organisational response to the pandemic included communication, personal protective equipment supply, team working and well-being support. Suggestions for improvement focused on rest facilities, rota patterns and hierarchies, creating opportunities for reflection and ensuring continued educational and training opportunities despite operational demands.ConclusionsTrainees described opportunities for learning and fulfilment, as well as challenges, in working through a pandemic. Trainees described their needs and how well these were met during the pandemic. Ideas for improvement most frequently related to basic needs including safety and fatigue, but suggestions also related to supporting learning and development. The appreciative inquiry methodology of the project facilitated effective reflection on positive aspects of trainee experiences.

scholarly journals 17 Interprofessional mentoring: the key towards a better multidisciplinary team working model?

2020 ◽  
Author(s):  
Baguiasri Mandane ◽  
Shivanee Nakum ◽  
Jagraj Thandi ◽  
Jekaterina Jasina
Keyword(s):  
Multidisciplinary Team ◽  
Working Model ◽  
Team Working

scholarly journals Prevalence and Carbapenem Resistance of Acinetobacter baumannii and Other Than A. baumannii Isolates From Intensive Care Units (ICUs) and non-ICUs

2020 ◽  
Vol 41 (S1) ◽  
pp. s356-s357
Author(s):  
Tomasz Kasperski ◽  
Biophage Pharma S.A. Kraków ◽  
Agnieszka Chmielarczyk ◽  
Monika Pomorska-Wesolowska ◽  
Dorota Romaniszyn ◽  
...  
Keyword(s):  
Intensive Care ◽  
Inhibitory Concentration ◽  
Carbapenem Resistance ◽  
Diagnostic Methods ◽  
Clinical Settings ◽  
Gram Negative Bacteria ◽  
Carbapenem Resistant ◽  
Therapeutic Problem ◽  
Hospital Associated Infections ◽  
Very High

Background:Acinetobacter spp are gram-negative bacteria that have emerged as a leading cause of hospital-associated infections, most often in the intensive care unit (ICU) setting. This is particularly important in Poland, where the prevalence of A. baumannii in various types of infections, including bloodstream infection (BSI), pneumonia, skin and soft-tissue infection (SSTI), and urinary tract infection (UTI) is higher than in neighboring countries. Recently, other Acinetobacter spp, including A. lwoffii or A. ursingii, have been found to be clinically relevant. In Poland, we have also observed a very rapid increase in antimicrobial resistance, significantly faster for A. baumannii than for other nosocomial pathogens. Methods: A study was conducted in 12 southern Polish hospitals, including 3 ICUs, from January 1 to December 31, 2018. Only adult hospitalized patients were included. Strains were identified using the MALDI-TOF method. Carbapenem resistance was determined using the minimum inhibitory concentration (MIC). Results: During the study, 194 strains belonging to the Acinetobacter genus were isolated. A. baumannii was the dominant species, 88.1% (n = 171), and 23 isolates (11.9%) were other Acinetobacter spp: A. ursingii (n = 5), A. lwofii (n = 4), A. haemolyticus (n = 4), A. junii (n = 3), A. radioresistens (n = 2), A. bereziniae (n = 2), and A. johnsonii (n = 2). Moreover, 15 Acinetobacter strains were collected from ICUs. The most Acinetobacter strains were isolated from SSTIs (n = 115) from non-ICU settings. Non–A. baumannii strains were also most frequently isolated from SSTIs; they constituted 11.3% of all Acinetobacter strains from this type of infection (n = 13). The total Acinetobacter prevalence was 2.6%, whereas the prevalence in the ICU setting was 7%. Acinetobacter prevalence in SSTIs was 10.4%. In pneumonia, Acinetobacter prevalence was 18.6% for ICUs (n = 13) and 2.7% for non-ICUs (n = 46). Strains from UTIs were isolated only with the non-ICU setting, and their prevalence was 0.7% (n = 14). More than half of the tested strains (52.1%) were resistant to carbapenems, but all non–A. baumannii strains were susceptible. The highest resistance to carbapenems was among strains from pneumonia cases in ICUs (58.3%) and resistance among all strains isolated from ICU was 50%. However, even higher resistance was noted among SSTI strains from non-ICUs (61.7%). Conclusions: Increasingly, more than A. baumannii, other species among Acinetobacter strains are isolated from patients hospitalized in Polish hospitals. To assess the significance of non–A. baumannii spp in clinical settings, precise species identification is needed. Therefore, the diagnostic methods used must be improved. Carbapenem-resistant A. baumannii infections are the biggest problem in pneumonia patients in ICUs and in SSTI patients in other hospital departments. Carbapenem resistance occurs in a very high percentage of A. baumannii strains; among non–A. baumannii strains it is not yet a therapeutic problem.Funding: NoneDisclosures: None

‘Who Ya Gonna Call …?’ Ethical and legal dilemmas in specialist children centres and district general hospitals

2021 ◽  
pp. 147775092110366
Author(s):  
Harika Avula ◽  
Mariana Dittborn ◽  
Joe Brierley
Keyword(s):  
Intensive Care ◽  
Clinical Ethics ◽  
Ethical Issues ◽  
General Setting ◽  
Daily Practice ◽  
Paediatric Intensive Care ◽  
Ethical Challenges ◽  
Legal Cases ◽  
Ethics Support ◽  
The Uk

The field of Paediatric Bioethics, or ethical issues applied to children's healthcare, is relatively new but has recently gained an increased professional and public profile. Clinical ethics support to health professionals and patients who face ethical challenges in clinical practice varies between and within institutions. Literature regarding services available to paediatricians is sparse in specialist tertiary centres and almost absent in general paediatrics. We performed a mixed-methods study using online surveys and focus groups to explore the experiences of ethical and legal dilemmas and the support structures available to (i) paediatric intensive care teams as a proxy for specialist children's centres and (ii) paediatricians working in the general setting in the UK. Our main findings illustrate the broad range of ethical and legal challenges experienced by both groups in daily practice. Ethics training and the availability of ethics support were variable in structure, processes, funding and availability, e.g., 70% of paediatric intensive care consultants reported access to formal ethics advice versus 20% general paediatricians. Overall, our findings suggest a need for ethics support and training in both settings. The broad experience reported of ethics support, where it existed, was good – though improvements were suggested. Many clinicians were concerned about their relationship with children and families experiencing a challenging ethical situation, partly as a result of high-profile recent legal cases in the media. Further research in this area would help collect a broader range of views to inform clinical ethics support's development to better support paediatric teams, children and their families.

ICU admissions: Consequences after discharge

2020 ◽  
Vol 13 (9) ◽  
pp. 550-556
Author(s):  
Minal Karavadra ◽  
Ricky Bell
Keyword(s):  
Intensive Care ◽  
Cognitive Decline ◽  
Intensive Care Units ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Psychiatric Disturbance ◽  
Intensive Care Department ◽  
Previous Level ◽  
The Uk

The intensive care department may seem a long way from the GP's consulting room, but every year tens of thousands of critically ill patients are admitted to intensive care units (ICUs) across the UK. Patients are often left with long term sequelae that may require GP input. Physical weakness, psychiatric disturbance and cognitive decline are not uncommon after an illness that requires a stay in an ICU. These hinder a patient’s return to their previous level of function and impact caregivers after discharge. This article aims to highlight the chronic symptoms patients can acquire during ICU admission that may come to the attention of GPs for their advice and treatment.

scholarly journals An audit of UK audiological practice in specialist paediatric oncology centres regarding hearing assessment of children at risk of ototoxicity due to chemotherapy

2021 ◽  
Vol 135 (1) ◽  
pp. 14-20
Author(s):  
E C M Brown ◽  
C Caimino ◽  
C L Benton ◽  
D M Baguley
Keyword(s):  
High Frequency ◽  
Good Practice ◽  
Paediatric Oncology ◽  
Chemotherapy Drugs ◽  
Team Working ◽  
Platinum Based Chemotherapy ◽  
Hearing Assessment ◽  
Self Test ◽  
The Uk ◽  
Monitoring Service

AbstractObjectivePlatinum-based chemotherapy drugs are associated with substantial ototoxicity. The hearing of children treated with these drugs should be closely monitored.MethodA questionnaire was sent out to the 19 audiology departments associated with national paediatric cancer specialist centres in the UK looking at current practice in ototoxicity monitoring.ResultsResponses were received from 17 of 19 centres (89 per cent). All offered some form of audiometric monitoring service. Extended high-frequency testing (9–20 kHz) was only utilised by 7 services (29 per cent). A majority of respondents were reluctant to consider self-test devices in paediatric ototoxicity monitoring (n = 9; 53 per cent). Provision of long-term audiological follow up is sporadic with only 4 (23 per cent) respondents keeping all children with normal hearing under review once treatment is completed.ConclusionWhile some good practice in paediatric ototoxicity was identified, opportunities exist to improve clinical practice and protocols, promote multidisciplinary team working and to utilise technologies such as extended high frequency and self-test audiometry.

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