1396 Improving Documentation During A General Surgical Ward Round

Introduction Clear documentation at ward rounds is essential to patient safety. The purpose of this audit was to identify areas that could be improved in the documentation at surgical ward round. Method A retrospective audit of the most recent ward round entry, in two surgical wards, was carried out against the Royal College of Physicians ‘Generic Medical Record Keeping Standards’. Patient name, Health & Care number (HCN), date, time(24hr), senior doctor present, signature, printed name, GMC/contact details of the scribe were analysed. After data collection, the standards were circulated to all doctors during departmental teaching and displayed on note trollies. A re-audit was then undertaken. Chi-square test was used to compare the two audit cycles and p value of < 0.05 was considered significant. Results 21 patient notes were analysed in the initial audit. Patient name and HCN was noted in 86%(18/21) and 67%(14/21) respectively. 100% of notes included date and senior doctor. Time of entry, signature and printed name/Bleep/GMC number were noted in 81%(17/21), 90.5%(19/21) and 57%(12/21) respectively. 24 patients were included in the re-audit. Results revealed improvement in all parameters as follows: patient name (95.8% 21/24;p=0.23); HCN (91.6%; 22/24;p=0.036),; date and senior doctor (100% as before); time (87.5%; 21/24;p=0.55); signature (100%; 24/24), and printed name/GMC/bleep (87.5%; 21/24;p=0.022). Conclusions This closed loop audit demonstrates an overall improvement in the quality of surgical documentation at ward rounds with a very simple intervention. Additionally, a statistically significant improvement was noted in recording HCN and printed name/GMC/bleep.

Does the age difference between the doctor and the patient matter - communication between the doctor and the young patient

Introduction and purpose of work: The contact between doctor and patient is an element that builds mutual trust, which translates into the quality and effectiveness of treatment. This is especially important for adolescent patients, who expect attention and understanding of their problems. In addition, they start visiting the doctor themselves, so it is very important that they do not become discouraged by the lack of understanding of the doctors and that they do not avoid visits in the future. Currently, the average age of a doctor in Poland is over 50 years. The aim of the study is to investigate the influence of a doctor's age on his contact with a teenage patient.Material and method: The results of the study were obtained on the basis of the questionnaire survey.Results: 54 respondents aged 16-19 participated in the study. The vast majority (64.8%) consider a person under 30 years of age to be a young doctor, 29.6% under 40 years of age. Almost 67% declare that it is more likely to visit a young doctor. 87% of respondents find it easier to establish contact with a younger medic. For 68.5% of respondents, a visit to a senior doctor is more embarrassing. 88.9% of teenagers find it easier to admit embarrassing matters to younger medics. 66.7% declare that for them being more practiced is more important than easier contact with doctor. Two out of three teenagers are more stressed about visiting older doctor.Conclusions: Teen patients definitely prefer visits to younger doctors. Despite the greater stress and resistance to visiting older, more experienced doctors, young patients choose them. Training for senior physicians on contact with young people should be considered to reduce the proportion of people avoiding medical appointments due to difficulties in making contact in the future.

Reports (continued)

Meeting on January 8th. At the suggestion of Dr. P.I. Dobrynin, prof. G.E. Rein, and his comrade, senior doctor of the Ryazan regional hospital, D.S. Shchetkin. Prof. G.E. Rein turned to the section with a speech, in which he thanked for the honorary election. I read the report of Dr. A. I. Zamshin (St. Petersburg). "Bacteriological and experimental research on antiseptic during childbirth and on self-infection."

Reports (continued)

Meeting on January 8th. At the suggestion of Dr. P.I. Dobrynin, prof. G.E. Rein, and his comrade, senior doctor of the Ryazan regional hospital, D.S. Shchetkin. Prof. G.E. Rein turned to the section with a speech, in which he thanked for the honorary election. I read the report of Dr. A. I. Zamshin (St. Petersburg). "Bacteriological and experimental research on antiseptic during childbirth and on self-infection."

Reports (continued)

Meeting on January 8th. At the suggestion of Dr. P.I. Dobrynin, prof. G.E. Rein, and his comrade, senior doctor of the Ryazan regional hospital, D.S. Shchetkin. Prof. G.E. Rein turned to the section with a speech, in which he thanked for the honorary election. I read the report of Dr. A. I. Zamshin (St. Petersburg). "Bacteriological and experimental research on antiseptic during childbirth and on self-infection."

Report on the appointment of the gynecological section of the IV-th congress of Russian doctors in Moscow from the 3rd to the 10th of January 1891 (Ending)

Meeting on January 8th. At the suggestion of Dr. P.I. Dobrynin, prof. G.E. Rein, and his comrade, senior doctor of the Ryazan regional hospital, D.S. Shchetkin. Prof. G.E. Rein turned to the section with a speech, in which he thanked for the honorary election. I read the report of Dr. A. I. Zamshin (St. Petersburg). "Bacteriological and experimental research on antiseptic during childbirth and on self-infection."

COVID-19 & The Art of Unclenching Your Fist

Dr. AP, a senior doctor of a large teaching hospital, retired. A happy go lucky person with a large group of admirers consisting largely of fellow doctors, both young & old. He is a great party man, drinks & smoke on the house with his devoted fanfare partaking his lavish offerings. And then, one fine day, he contacts COVID-19 & is admitted in the very hospital where he had spent 30 years of his life. He develops respiratory distress… As I rush to attend the call, I am appalled by the look of the deserted corridors & waiting areas. I don’t see any known faces, none of his fanfare for sure. He lies struggling for breath on non invasive ventilation, confused & hypoxic. As he is intubated & put on ventilatory support at the insistence of his son, I reflect back on those days when he used to be surrounded by his friends, treating them to drinks. But today, when he needs their support the most, he is left alone, in his suffering, to fend for himself. Truly, we are indeed a death denying society. ‘O death, where is your victory? O death, where is your sting?’ (St.Paul, I Corinthians, 15:55) When it began, people thought, ‘It can’t affect me’. However, with time, they were increasingly confronted with the looming threat which threatened to disrupt the ‘web of illusion’ that they had created for themselves…an illusion, for the very world of existence is actually akin to an illusion, characterised by its transient nature. No wonder, our ancient sages called the world of existence ‘maya’. Then came the period of ‘lockdowns’ & the web of uncertainity surrounding it. People were in a fix, for in today’s tech-savvy existence, fostered by science & reasoning, they were now unprepared to spend time with ‘themselves’! The very Self was now seen as an alien being & was avoided. But as the lockdown prolonged, the monkey nature of the mind grew increasingly restless, demanding for more stimuli from the outgoing senses…and as the stimuli gradually dwindled amidst the lockdown, most c

Nikolai Alexandrovich VELYAMINOV – leib-medic, academician of medicine, Professor of the Imperial Military medical Academy (to the 165th of birthday)

Nikolai Alexandrovich Velyaminov was born in 1855 in St. Petersburg. He studied at the gymnasiums of Wiesbaden and Warsaw. In 1872 he entered the Moscow University in physics and mathematics, and in 1873 transferred to the faculty of medicine. In 1877 he was sent to the army in the Caucasus. In 1878-1879, Nikolai Alexandrovich became ill with typhus, developing a chronic process in the lungs, which requires long-term treatment abroad. After recovery in the years 1880-1881 N. And. Velyaminov works in Central Asia as a surgeon of the Akhal-Teke expedition, develops a system of medical sorting and evacuation of the wounded, writes "Memories of the surgeon from the Akhal-Teke expedition." In 1883 he received the degree of doctor of medicine and worked as an assistant to Professor K. K. Reyer, lectured on operative surgery in Women's medical courses. In 1884 N. Ah. Velyaminov becomes an assistant to the chief physician and surgeon of the Holy cross community of sisters of mercy. In 1885 he founded the first in Russia authoritative scientific surgical journal "Surgical Bulletin". Since 1887 N. Ah. Velyaminov as a Junior doctor of the life guards of the Preobrazhensky regiment heads the surgical Department in Krasnoselsky hospital, since 1893 works as the Director of the Maximilian hospital in St. Petersburg, since 1894 the senior doctor of the Semenovsky regiment, is appointed the life-physician and honorary surgeon of the Highest Court, and then the senior doctor of the Imperial headquarters. In 1889 he defended his doctoral thesis. In 1894 N. Ah. Velyaminov is elected Professor of the Military medical Academy. In 1896 he designs the device for the first time in St. Petersburg service of "Ambulance", organizing children's sanatoriums. In 1900, Velyaminov was elected an honorary member of the Royal medical College in London, the Chief Commissioner of the Russian red cross society for assistance to the sick and wounded in the far East. In 1905 N. Ah. Velyaminov was awarded the rank of privy Councilor, and in 1907 was awarded the order of St. Anne of the 1st degree. In the same years N. Ah. Velyaminov was the first in Russia to study occupational injuries, insurance of workers and organized the "Bureau of medical examination for workers" (1907). In 1910 1912 N. Ah. Velyaminova works as the head of the Imperial Military medical Academy in St. Petersburg. In 1913, the conference of the Military medical Academy elected him academician of medicine. At the beginning of World war I. Ah. Velyaminov took part in the work of the Main Directorate of the red cross, and from the end of August he was a surgeon-consultant at the Headquarters of the commander-in-Chief to inspect the surgical case in the army. By the beginning of 1917 N. Ah. Velyaminov held many positions: Director of the Mariinsky hospital for the poor, Alexandrinsky women's hospital and Maximilian hospital; Chairman of the Medical Commission for reception in the sanatorium "khalila", the Russian Society for the protection of public health, the Interdepartmental Commission for the revision of medical legislation; Vice-Chairman of the Committee of the Community of the Seaside sanatorium for chronically ill children; editor of the magazines "Surgical archive" and "Hygiene and sanitary Affairs"; inspector of the court medical unit; honorary consultant of the Alexander-Mariinsky hospital and hospital for incoming patients; consultant of the Royal office for the institutions of the Empress Maria Feodorovna, member of the Board of the Community. Kaufman red cross and the Medical Council of the interior Ministry. In 1919-1920 he headed the Department of surgical pathology with desmurgy at the Women's medical Institute. In March 1920, he was offered the post of Chairman of the Commission for the reform of medical education, from which N. Ah. Velyaminov refused. By this time the new government took away the Professor's apartment, and he found refuge in the utility room of the Petrograd hospital named after Peter the Great. N. And. Velyaminov author of over 100 scientific medical works, including 8 monographs. He described thyrotoxic polyarthritis, gave the classification of diseases of the joints and thyroid gland, one of the first pointed to the importance of the endocrine glands in the development of surgical diseases, used phototherapy; opened the first Russian light therapy room. A lot of new N. And. Velyaminov contributed to the doctrine of surgical treatment of bone tuberculosis and abdominal surgery. April 9, 1920 N. Ah. Velyaminov died and was buried at the Volkov cemetery.

Same day cancellations of elective operations in a tertiary hospital in south-east England: a review of 11 000 patients in 1 year

Cancellations of elective operations have negative consequences, both for patients and the NHS. For the latter, reducing waiting times for surgical procedures remains a pressing concern, as does maintenance of adequate staffing. This study aimed to identify factors contributing to the cancellation of elective operations on the day of the procedure in order to suggest measures that could be taken to reduce these incidents. The retrospective details of just over 11 000 patients awaiting theatre admission for elective operations over a period of 1 year were obtained. The reasons behind last-minute operation cancellations were categorised as either patient factors or hospital factors. Data analysis suggested that the number of cancellations could be reduced by scheduling appointments with a senior doctor closer to the operation date.