scholarly journals Safety for psychiatrists – from trainee to consultant

2008 ◽  
Vol 32 (3) ◽  
pp. 85-87 ◽  
Author(s):  
Claire Dibben ◽  
Rory O'Shea ◽  
Ricci Chang ◽  
Joanna Woodger
Keyword(s):  
General Hospital ◽  
Old Age ◽  
Royal College ◽  
Response Rate ◽  
District General Hospital ◽  
Clinical Implications ◽  
East Anglia ◽  
Self Perceptions ◽  
The Past ◽  
Perceptions Of Safety

Aims and MethodsTo assess safe practice in psychiatry and self-perceptions of safety among trainees (Senior House Officers (SHOs) and Specialist Registrars (SpRs)) and consultants, a questionnaire was sent out to all general adult and old age psychiatrists, including trainees, in a teaching hospital and a district general hospital in East Anglia.ResultsA total of 29 SHOs, 11 SpRs and 27 consultants were approached (response rate 92%). In the past year 69% SHOs, 45% SpRs and 11% consultants attended breakaway training. Interview rooms were frequently below the Royal College of Psychiatrists' standards; 87% of the rooms did not have a panic button and 62% were isolated. Most doctors had felt threatened over the past 6 months but only 31% carried a personal alarm. Despite similar frequencies of assaults, consultants felt safer at work than trainees.Clinical ImplicationsSafety is important for doctors throughout their careers and should be regularly reviewed by individuals as well as audited by hospital trusts.

scholarly journals Guidelines on antipsychotics for dementia: are we losing our minds?

2009 ◽  
Vol 33 (2) ◽  
pp. 57-60 ◽  
Author(s):  
Camilla Haw ◽  
Graeme Yorston ◽  
Jean Stubbs
Keyword(s):  
Old Age ◽  
Royal College ◽  
Response Rate ◽  
Psychiatric Symptoms ◽  
Clinical Excellence ◽  
Clinical Judgement ◽  
Clinical Implications ◽  
Anonymous Questionnaire

Aims and MethodThe National Institute for Health and Clinical Excellence (NICE) and the Royal College of Psychiatrists have each issued guidance on the use of antipsychotics for behavioural and psychiatric symptoms of dementia (BPSD). We sent all old age psychiatrists an anonymous questionnaire asking for their opinions on these documents and for details of their use of antipsychotics for BPSD.ResultsThe response rate was 202 out of 648 (31.2%). the two documents, though similar in content provoked very different responses, with the College guidance being much more favourably received. All respondents prescribed antipsychotics for BPSD, most commonly quetiapine.Clinical ImplicationsWhen prescribing antipsychotics for behavioural and psychiatric symptoms of dementia, psychiatrists should take both NICE and College guidelines into account and use their clinical judgement.

scholarly journals A national survey of old age psychiatry services in Wales

2002 ◽  
Vol 26 (1) ◽  
pp. 18-20
Author(s):  
Alison Napier
Keyword(s):  
Service Quality ◽  
Old Age ◽  
National Survey ◽  
Royal College ◽  
Response Rate ◽  
Postal Questionnaire ◽  
Clinical Implications ◽  
Service Levels ◽  
Provision Of Services ◽  
Old Age Psychiatry

Aims and MethodA postal questionnaire was circulated to all consultants in old age psychiatry in Wales, examining provision of services with reference to the indicative service levels defined by the Royal College of Psychiatrists and Royal College of Physicians.ResultsThe response rate was 100%. Levels of staffing and resources overall fell well below recommendations and varied widely between services. The average population over 65 served by a whole time consultant was 22 995; more than twice that recommended. No association was found between morale or how well population needs were perceived as being met, and the size of the population served.Clinical ImplicationsConsiderable investment in staff and other resources is needed for the recommendations made by the royal Colleges concerning service levels and, by implication, service quality to be met.

Risk Factor Of Substitution ARV First Line People Living With HIV/AIDS In General Hospital Buleleng Bali

2020 ◽  
Vol 9 (1) ◽  
pp. 190-197
Author(s):  
Luh Putu Desy Puspaningrat ◽  
Gusti Putu Candra ◽  
Putu Dian Prima Kusuma Dewi ◽  
I Made Sundayana ◽  
Indrie Lutfiana
Keyword(s):  
Risk Factor ◽  
General Hospital ◽  
Medical Records ◽  
Secondary Data ◽  
District General Hospital ◽  
People Living With Hiv ◽  
First Line ◽  
The Past ◽  
Factor Substitution ◽  
Living With Hiv

Substitution is still a threat to the failure of ARV therapy so that no matter how small it must be noted and monitored in ARV therapy. The aims  was analysis risk factor substitution ARV first line in therapy ARV. This study was an analytic longitudinal study with retrospective secondary data analysis in a cohort of patients receiving ARV therapy at the District General Hospital of Buleleng District for the period of 2006-2015 and secondary data from medical records of PLHA patients receiving ART.  Result in this study that the percentage of first-line ARV substitution events is 9.88% (119/1204) who received ARV therapy for the past 11 years. Risk factors that increase the risk of substitution in ARV therapy patients are zidovudine (aOR 4.29 CI 1.31 -2.65 p 0.01), nevirapine (aOR1.86 CI 2.15 - 8.59 p 0.01) and functional working status (aOR 1.46 CI 1.13 - 1.98 p 0.01). 

scholarly journals Establishing a District Psychiatric Service without Psychiatric Trainees

1986 ◽  
Vol 10 (12) ◽  
pp. 338-340 ◽  
Author(s):  
D. G. Kingdon ◽  
T. K. Szulecka
Keyword(s):  
General Hospital ◽  
Social Services ◽  
Early Development ◽  
Royal College ◽  
Medical Staff ◽  
Psychiatric Service ◽  
District General Hospital ◽  
Short Report ◽  
House Of Commons ◽  
The Social

The Report of the Social Services Committee of the House of Commons in 1981 (the ‘Short Report’) recommended the establishment of consultant posts without the support of trainee medical staff as part of a strategy to correct the situation where too many doctors occupied training posts for the number of consultant posts available.1 The Royal College of Psychiatrists has endorsed this policy,2 and the withdrawal of approval for training from an increasing number of hospitals around the country is leading rapidly to a situation where a large number of them need to look at alternative arrangements for providing medical cover. We would like to report the establishment and early development of such an arrangement based in a district general hospital.

scholarly journals Stress in psychiatrists: coping with a decade of rapid change

2011 ◽  
Vol 35 (4) ◽  
pp. 130-134 ◽  
Author(s):  
Shanaya Rathod ◽  
Minal Mistry ◽  
Ben Ibbotson ◽  
David Kingdon
Keyword(s):  
National Health Service ◽  
Early Retirement ◽  
Response Rate ◽  
Rapid Change ◽  
Clinical Implications ◽  
Personal Lives ◽  
The Past ◽  
Working Lives ◽  
Adverse Impacts ◽  
The Impact

Aims and methodThe study explored the impact of National Health Service changes on the working and personal lives of psychiatrists. A questionnaire survey was carried out with psychiatrists working in the South Eastern Division of the Royal College of Psychiatrists.ResultsThe response rate was 44.9%. Changes to services have reduced stress in some areas, but increased stress in others. Over the past decade early retirement has become less popular, but psychiatrists have been more likely to self-prescribe and have suicidal thoughts.Clinical implicationsThe increasing involvement of psychiatrists in leadership may be a way to reduce adverse impacts of future changes on their working lives.

scholarly journals P219 Evaluating medical thoracoscopy services at a District General Hospital over the past 13 years

Thorax ◽  
2013 ◽  
Vol 68 (Suppl 3) ◽  
pp. A175.1-A175
Author(s):  
LM George ◽  
HJ Roberts ◽  
NJ Downer ◽  
GM Cox ◽  
NJ Ali ◽  
...  
Keyword(s):  
General Hospital ◽  
District General Hospital ◽  
The Past ◽  
Medical Thoracoscopy

scholarly journals 684 The Standard of Emergency Operation Note Documentation at A District General Hospital Compared Against The Royal College of Surgeons of England (RCSEng) Standard

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
S Zuberi ◽  
Y Mushtaq ◽  
K Patel ◽  
J Joseph ◽  
R Gurprashad
Keyword(s):  
General Hospital ◽  
Royal College ◽  
Emergency Operation ◽  
District General Hospital ◽  
National Standard ◽  
Average Score ◽  
Estimated Blood Loss ◽  
Operation Note ◽  
The Impact ◽  
Current Guidelines

Abstract Introduction Meticulous operation note documentation is essential for seamless, safe continuity of care in postoperative surgical patients. This study evaluated the standard of emergency operation note documentation at a district general hospital, when compared to the Royal College of Surgeons of England (RCSEng) guidelines and assessed the impact of a new operation note proforma. Method A retrospective review of 50 emergency operation notes was conducted between December 2019 and March 2020 and compared to RCSEng guidelines. Initial findings were presented at a local clinical governance meeting and a new electronic operation note was introduced. A further 50 emergency operation notes using the new proforma were analysed between August 2020 and December 2020. Results RCSEng mentions 19 main points that all operation notes must include. A total of 100 operation notes were reviewed and each given a score out of 19. Intervention of the new proforma showed significant improvement to the average score (15.64 vs 17.94; p < 0.0001) when compared to RCSEng guidelines. In particular, there was significant improvement in the documentation of assistants involved in the procedure (58% vs 98%; p < 0.0001), estimated blood loss (2% vs 63%; p < 0.0001) and specific mention whether the operation was emergency or elective (20% vs 86%; p < 0.0001). Conclusions Implementation of the new proforma showed significant improvement in operation note documentation when compared to the RCSEng standard. Therefore, this study emphasises the need for surgeons to familiarise themselves with the current guidelines and highlights the importance of tailoring local operation note proformas to match this national standard closely.

scholarly journals Delays in discharging elderly psychiatric in-patients

2008 ◽  
Vol 32 (6) ◽  
pp. 211-213 ◽  
Author(s):  
Irfan Hanif ◽  
Bhupendra Rathod
Keyword(s):  
General Hospital ◽  
Nosocomial Infections ◽  
Psychiatric Patients ◽  
District General Hospital ◽  
Clinical Implications ◽  
Primary Concern ◽  
Hospital Managers ◽  
The Cost

Aims and MethodThe issue of elderly psychiatric patients remaining in hospitals after being declared medically fit is of concern to doctors, hospital managers and politicians alike. This article sets out the findings from a study involving elderly psychiatric patients at a district general hospital, undertaken to establish the actual lengths, reasons for and financial implications of delays in discharge. The study involved 50 in-patients, all of whom had been discharged over the 3-month study period.ResultsMore than half of the patients in the sample were subject to some delay in discharge and for patients waiting for Elderly Mentally Infirm (EMI) placements this averaged 50 days. Collectively, nearly 25% of the time spent in hospital was due to delay. The cost to the hospital was estimated at more than £700 000 in 1 year.Clinical ImplicationsPatients are being put at extra risk in terms of their health by being delayed in hospital. Issues of institutionalisation, nosocomial infections and falls are of primary concern.

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