EP.TU.79Assessed and Discharged - An Audit of Discharge Summaries Completion During On-Calls

Aim Effective health care provision is heavily dependent on timely, reliable transfer of patient information. Failure of this communication between professionals could result in redundancy of tests, delay in treatment, which may in turn endanger patient safety. The NHS Standard Contract requirements state discharge summaries should be completed within 24 hours of hospital assessment and discharge. Discharge summaries for patients who were reviewed but not admitted have been observed to be poorly completed during on-calls and this audit aims to clarify this. Method On-Call Patient Lists between 1 December to 14 December 2020 were studied retrospectively. Patients who were assessed by the on-call surgical team but not admitted were included in the audit. Patients referred to other specialties were excluded. Hospital electronic system was reviewed for electronic records from the encounter including clinical note or discharge summary. Results In total, 47 patients were identified during the 2 week- period. 40/47 patients were referred from AE and 9 of these patients were discharged from AE directly. 3 of the patients had a clinical note or discharge summary completed on the hospital electronic system. Overall, 18 of the 47 (38.3%) patients had a clinical note or discharge summary on the electronic system, with 6 (12.8%) of them being recorded as discharge summaries. Conclusion The overall completion of discharge summaries for this group of patients was poor. Awareness of this failing and the importance of professional communication should be highlighted with the juniors during surgical meeting to improve compliance.

ASSESSMENT OF SKILLS AND COMPETENCIES OF NURSE STUDENTS

Purpose: The training process in the specialty of Nurse from the regulated occupations in the Republic of Bulgaria is in accordance with both national and European normative documents. The mission of the program Nurse for a bachelor degree is to provide highly-qualified professionals for giving effective health care in terms of a changing social, economic and health environment. Material and methods: study and analysis of legal documents and modeling (model presentation). Results: The philosophy of learning provides the opportunity to form personal qualities, communication skills, teamwork skills, competencies, as well as developing skills and adaptability and mobility in terms of free movement of professionals in the European Union. This paper presents an author's model of protocol for assessing practical skills and competencies as well as the benefits of applying it. Conclusions: The evaluation of the results of the training process is emphasized as a particular element of the lecturer's work.

Syncing Our Global Thinking: A Framework for Contextualized Clinical Reasoning

Purpose Globally, health care practitioners (HCPs) practice in a variety of settings. To account for the diversity of these contexts, HCPs should utilize dynamic clinical reasoning skills to provide contextually responsive services that account for the complexities of patients, clinicians, and their surroundings. However, traditional models of clinical reasoning approach this skill in a reductionistic and segmented manner that ignores the impact of these diverse factors in health care provision. This makes it very difficult to reconcile these models with the realities of practice. Method By repositioning clinical reasoning as a unique and dynamic skill and identifying the shortcomings of traditional clinical reasoning models, we suggest a novel theoretical framework: contextualized clinical reasoning , which centralizes factors related to context and individual within its approach. Conclusions In order to practice clinical reasoning in an authentic manner that recognizes the impact of contextual and personal realities, we put forward the contextualized clinical reasoning framework. This framework gives HCPs the tools needed to change the rhetoric on best practice and provide effective health care services that account for complexity and diversity of health care contexts globally.

402 Assessed and Discharged - An Audit of Discharge Summaries Completion During On-Calls

Aim Effective health care provision is heavily dependent on timely, reliable transfer of patient information. Failure of this communication between professionals could result in redundancy of tests, delay in treatment, which may in turn endanger patient safety. The NHS Standard Contract requirements state discharge summaries should be completed within 24 hours of hospital assessment and discharge. Discharge summaries for patients who were reviewed but not admitted have been observed to be poorly completed and this audit aims to clarify this. Method On-Call Patient Lists between 1 December to 14 December 2020 were studied retrospectively. Patients who were assessed by the on-call surgical team but not admitted were included in the audit. Patients referred to other specialties were excluded. Hospital electronic system was reviewed for electronic records frim the encounter including clinical note or discharge summary. Results In total, 47 patients were identified during the 2 week- period. 40/47 patients were referred from AE and 9 of these patients were discharged from AE directly. 3 of the patients had a clinical note or discharge summary completed on the hospital electronic system. Overall, 18 of the 47 (38.3%) patients had a clinical note or discharge summary on the electronic system, with 6 (12.8%) of them being recorded as discharge summaries. Conclusions The overall completion of discharge summaries for this group of patients was poor. Awareness of this failing and the importance of professional communication should be highlighted with the juniors during surgical meeting to improve compliance before re-audit.

Protocol for assessing feasibility, acceptability and fidelity of screening for antenatal depression (FAFSAD) by midwives in Blantyre District, Malawi

Background Depression is often underdiagnosed by treating health professionals. This is a situation in Malawi where there is no routine screening of depression at antenatal clinics. Recently, a Screening Protocol for Antenatal Depression (SPADe) that can be used by midwives to screen for antenatal depression was developed in Blantyre District. SPADe proposes multistage screening of antenatal depression by midwives which may enable early detection and treatment of pregnant women with depression. Proper treatment of antenatal depression can assist in achieving Sustainable Development Goals (SDGs). However, utilisation of SPADe in clinical practice to screening for depression in antenatal clinics has not been established yet. Therefore, the primary aim of this study is to assess feasibility of screening for depression by midwives using SPADe in antenatal clinics in Blantyre District. The secondary aim was to assess acceptability and fidelity of screening for depression by midwives using SPADe in antenatal clinics in Blantyre District. Methods This will be a feasibility study which will consist of scientific investigations that will support movement of evidence-based, effective health care approach, SPADe, from the clinical knowledge base into routine use. This study will consist three phases: phase 1 will introduce SPADe in antenatal clinics in Blantyre District where screening of depression is almost none existent; phase 2 will implement screening of depression using SPADe in antenatal clinics in Blantyre District; and phase 3 will evaluate the screening of antenatal depression using SPADe to establish its feasibility, acceptability and fidelity in antenatal clinics in Blantyre District. Discussion This study will establish and document feasibility, acceptability and fidelity of screening for depression by midwives using SPADe in antenatal clinics in Blantyre District. It is expected that midwives will develop more confidence in detecting and dealing with antenatal depression. Consequently, there will be increased numbers of pregnant women detected with depression by midwives and increased accessibility to mental health care by pregnant women in antenatal clinics.

Oral Care that Supports Healthy Lives as a Case Study of the Kumamoto Earthquake

Immediately after the Great Hanshin-Awaji Earthquake in 1995 and the Great East Japan Earthquake in 2011, pneumonia outbreak among the elderly increased the rate of fatalities. What caused this? To use lessons learned during the large-scale disaster, specialists concerned with the field of dentistry began to take action using new perspectives. Consequently, they noticed the importance of giving care to the entire oral cavity as well as the teeth. Based on reports from a dentist and a dental hygienist who tackled the oral care of the Kumamoto Earthquake victims in 2016, their methods of effective health care following a disaster is presented in this paper. We also propose a preventative medical activity that can be conducted sustainably for anyone, not just medical personnel.