Investigating the FAIR Equivalency in National Guidance in Health in Kenya

Antimicrobial resistance continues to be a considerable threat to global public health due to the persistent inappropriate use of antibiotics. Antimicrobial stewardship (AMS) programs are essential in reducing the growth and spread of antibiotic resistance, in an environment which lacks incentives for the development of new antibiotics. Over the years, a variety of resources have been developed to strengthen antimicrobial stewardship. However, the differences in resources available present a challenge for organisations/teams to establish the best resources to utilise for service provision. A peer review tool was formulated using four national documents on AMS and tested through three phases with feedback. A survey method was used to collect feedback on the validity, feasibility, and impact of the AMS peer review tool. Feedback received was positive from the earlier pilots. The tool was found to be useful at identifying areas of good practice and gaps in antimicrobial stewardship across various pilot sites. Feedback suggests the tool is useful for promoting improvements to AMS programs and highlights that the content and features of the tool are appropriate for evaluating stewardship.

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964 Telemedicine: Speedy Triage Tool or Clinical Record?

British Journal of Surgery ◽

10.1093/bjs/znab134.515 ◽

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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Managing patients on bisphosphonates: The practice of primary care dentists before and after the publication of national guidance

BDJ ◽

10.1038/sj.bdj.2014.1121 ◽

2014 ◽

Vol 217 (12) ◽

pp. E25-E25 ◽

Cited By ~ 2

Author(s):

D. L. Bonetti ◽

J. E. Clarkson ◽

P. Elouafkaoui ◽

D. A. Stirling ◽

L. Young ◽

...

Keyword(s):

Primary Care ◽

National Guidance ◽

Before And After

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Influence of adherence to the national guidance on nutrition screening and dietitian referral on clinical outcomes of those requiring parenteral nutrition

Journal of Human Nutrition and Dietetics ◽

10.1111/j.1365-277x.2010.01041.x ◽

2010 ◽

Vol 23 (2) ◽

pp. 190-193 ◽

Cited By ~ 3

Author(s):

R. P. Vincent ◽

C. H. Goo ◽

P. F. Wu ◽

H. L. Delaney ◽

C. W. le Roux

Keyword(s):

Parenteral Nutrition ◽

Clinical Outcomes ◽

Nutrition Screening ◽

National Guidance

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A multicenter review of epidemiology and management of varicose veins for national guidance

Annals of Medicine and Surgery ◽

10.1016/j.amsu.2016.04.024 ◽

2016 ◽

Vol 8 ◽

pp. 21-27 ◽

Cited By ~ 8

Author(s):

Nitin Joseph ◽

Abhishai B ◽

Mohamed Faizan Thouseef ◽

Uma Devi M ◽

Ayesha Abna ◽

...

Keyword(s):

Varicose Veins ◽

National Guidance

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National guidance for adapting to coastal hazards and sea-level rise: Anticipating change, when and how to change pathway

Environmental Science & Policy ◽

10.1016/j.envsci.2018.01.012 ◽

2018 ◽

Vol 82 ◽

pp. 100-107 ◽

Cited By ~ 21

Author(s):

Judy Lawrence ◽

Rob Bell ◽

Paula Blackett ◽

Scott Stephens ◽

Sylvia Allan

Keyword(s):

Sea Level Rise ◽

Sea Level ◽

Coastal Hazards ◽

National Guidance ◽

And Sea Level

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

BJPsych Open ◽

10.1192/bjo.2021.573 ◽

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.

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1018 Did COVID Compromise the Care of Closed Paediatric Hand Fractures?

British Journal of Surgery ◽

10.1093/bjs/znab259.116 ◽

2021 ◽

Vol 108 (Supplement_6) ◽

Author(s):

R Dbeis ◽

G Yim ◽

A Watts

Keyword(s):

Health Informatics ◽

Operative Management ◽

National Standards ◽

Post Injury ◽

Rapid Access ◽

Hand Fractures ◽

National Guidance ◽

A Prospective Study ◽

Surgery Department ◽

Mean Time

Abstract Aim To assess the effect of a ‘rapid-access’ musculoskeletal unit, established in March 2020, as part of the Royal Devon & Exeter hospital COVID response, with direct assessment of hand trauma by the Plastic Surgery department staff, on treatment timelines and national guidance compliance for closed paediatric hand fractures. Method This was a retrospective review from 1st January to 31st December 2019 and a prospective study from the 1st April to 15th June 2020. The retrospective cases were collated by health informatics. The prospective data was recorded on the department’s database. Exclusion criteria: nail bed injuries with tuft fractures, ligament injuries only, open fractures and patients aged 18 at time of surgery. Results In 2019 the majority (73%) of patients (n = 26) were referred within 48hrs but waited a median of 5 days to be seen in clinic by a hand surgeon resulting in significant delays in treatment. After service reconfiguration in 2020, all patients (n = 6) were operated on within 72 hours of the decision to operate - mean time to surgery 1.5 days (range 0-3 days). The mean time from referral to clinic was 1.33 days (range 0-6 days). 4 patients were operated on within 7 days of injury. Of the 2 patients operated on > 7 days, 1 was referred 32 days post injury and 1 failed conservative management. Conclusions The introduction of a ‘rapid-access’ musculoskeletal unit with early senior review and a dedicated theatre has created ‘gold-standard’ compliance with national standards for the operative management of closed paediatric fractures.

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NHS Hospital ‘Learning from Deaths’ reports: A qualitative and quantitative analysis of the first year of a countrywide patient safety programme

10.1101/2020.10.15.20213132 ◽

2020 ◽

Author(s):

Zoe Brummell ◽

Cecilia Vindrola-Padros ◽

Dorit Braun ◽

S. Ramani Moonesinghe

Keyword(s):

Patient Safety ◽

Secondary Care ◽

Secondary Data ◽

Patient Safety Culture ◽

Organisational Learning ◽

First Year ◽

Qualitative And Quantitative ◽

Safety Programme ◽

National Guidance ◽

Common Learning

ABSTRACTIntroductionPotentially preventable deaths occur worldwide within healthcare organisations. Organisational learning from incidents is essential to improve quality of care. In England, inconsistencies in how NHS secondary care trusts reviewed, investigated and shared learning from deaths, resulted in the introduction of national guidance on ‘Learning from Deaths’ (LfDs) in 2017. This guidance provides a ‘framework for identifying, reporting, investigating and learning from deaths’. Amendments to NHS Quality Account regulations, legally require NHS trusts in England to report quantitative and qualitative information relating to patient deaths annually. The programme intended trusts would share this learning and take measurable action to prevent future deaths.MethodWe undertook qualitative and quantitative secondary data analysis of all NHS secondary care trust LfDs reports within their 2017/18 Quality Accounts, to review how organisations are using the LfDs programme to learn from and prevent, potentially preventable deaths.ResultsAll statutory elements of LfDs reporting were reported by 98 out of 222 (44%) trusts. The percentage of deaths judged more likely than not due to problems in healthcare was between 0% and 13%. The majority of trusts (89%) reported lessons learnt; the most common learning theme was poor communication. 106 out of 222 trusts (48%) have shared or plan to share the learning within their own organisation. The majority of trusts (86%) reported actions taken and 47% discussed or had a plan for assessment of impact. 37 out of 222 trusts (17%) mentioned involvement of bereaved families.ConclusionsThe wide variation in reporting demonstrates that some trusts have engaged fully with LfDs, while other trusts appear to have disengaged with the programme. This may reveal a disparity in organisational learning and patient safety culture which could result in inequity for bereaved families. Many themes identified from the LfD reports have previously been identified in national and international reports and inquiries. Further work is needed to strengthen the LfDs programme.

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