Journal articles on the topic 'Non-consultant hospital doctors'
To see the other types of publications on this topic, follow the link: Non-consultant hospital doctors.
Create a spot-on reference in APA, MLA, Chicago, Harvard, and other styles
Consult the top 50 journal articles for your research on the topic 'Non-consultant hospital doctors.'
Next to every source in the list of references, there is an 'Add to bibliography' button. Press on it, and we will generate automatically the bibliographic reference to the chosen work in the citation style you need: APA, MLA, Harvard, Chicago, Vancouver, etc.
You can also download the full text of the academic publication as pdf and read online its abstract whenever available in the metadata.
Browse journal articles on a wide variety of disciplines and organise your bibliography correctly.
1
Naji, N., H. McLoughlin, F. O. Connell, and L. Clancy. "Smoking profile of non-consultant hospital doctors." Irish Journal of Medical Science 175, no. 1 (March 2006): 29–31. http://dx.doi.org/10.1007/bf03168996.
Full text
2
Osuafor, C., J. Molloy, and S. Murphy. "Dysphagia screening in acute stroke care among non-consultant hospital doctors." Irish Journal of Medical Science (1971 -) 186, no. 3 (February 21, 2017): 773–74. http://dx.doi.org/10.1007/s11845-017-1584-1.
Full text
3
Smith, J., K. Ryan, D. Phelan, and M. McCarroll. "Cardiopulmonary resuscitation skills in non consultant hospital doctors-the Irish experience." Irish Journal of Medical Science 162, no. 10 (October 1993): 405–7. http://dx.doi.org/10.1007/bf02996318.
Full text
4
Gillen, Peter, Sue Faye Sharifuddin, Muireann O’Sullivan, Alison Gordon, and Eva M. Doherty. "How good are doctors at introducing themselves? #hellomynameis." Postgraduate Medical Journal 94, no. 1110 (January 13, 2018): 204–6. http://dx.doi.org/10.1136/postgradmedj-2017-135402.
Full textAbstract:
BackgroundThis explorative study was triggered by the ‘#hellomynameis’ campaign initiated by Dr Kate Granger in the UK. Our objectives were twofold: first, to measure rates of introduction in an Irish hospital setting by both consultant and non-consultant hospital doctors. Second to establish whether such practices were associated with patient perceptions of the doctor/patient interaction.MethodA patient ‘exit’ survey was undertaken following doctor–patient consultations in both acute (surgical and medical assessment units) and elective settings (outpatient clinics). The survey was carried out over a 5-month period by three trained clinical observers.ResultsA total of 353 patients were surveyed. There were 253 outpatients and 100 inpatients surveyed. There were 121 outpatients (47.8%) who attended a surgeon, 73 were medical (28.8%), while 59 (23.3%) were divided between obstetrics, gynaecology and ophthalmology. One hundred acute presentations were surveyed: 52% in the emergency department, 20% to the acute medical assessment unit, 21% attended the acute surgical assessment unit and 7% attended other specialties/departments.ConclusionAccording to the returned forms, 79% of doctors (n=279) introduced themselves to patients. Eleven per cent (39) of doctors did not introduce themselves, and 8.5% of patients (30) were unsure whether the doctor had introduced themselves. Five patients left their response blank.Consultants were significantly more likely (P=0.02) to introduce themselves or shake hands than non-consultant hospital doctors. Gender had no bearing (P=0.43) on introductions or handshakes regardless of grade of doctor.Three hundred and seventeen patients (89.7%) felt that an introduction had made a positive difference to their healthcare visit. Thirty patients (8.5%) felt it did not make a difference and 8 patients (2.2%) were unsure or failed to answer.This study has highlighted the importance of introductions to patients. Definite evidence of an introduction was documented in 79% of patients with 14.5% either not receiving or could not recall whether an introduction had been made on repeat visits. 6.5% stated that they did not receive an introduction.
5
Smith, Jeremy, Kate Ryan, Dermot Phelan, and Maire McCarroll. "Basic cardiopulmonary resuscitation skills in non consultant hospital doctors — the Irish experience." Resuscitation 24, no. 2 (November 1992): 193. http://dx.doi.org/10.1016/0300-9572(92)90112-p.
Full text
6
Fahmy, W., W. Tawfick, H. Khokhar, R. Kumar, and B. Azeem. "Non-consultant hospital doctors in Ireland; A survey of satisfaction in training." International Journal of Surgery 23 (November 2015): S106. http://dx.doi.org/10.1016/j.ijsu.2015.07.494.
Full text
7
Floyd Jr, MS, DM Gulur, M. Lyttle, B. Hickerton, J. Philip, MVP Fordham, and PA Cornford. "is it good to talk? Analysing the out-of-hours telephone workload of urology registrars in a university teaching hospital." Bulletin of the Royal College of Surgeons of England 95, no. 3 (March 1, 2013): 97–101. http://dx.doi.org/10.1308/147363513x13500508917413.
Full textAbstract:
The European WorkingTime Regulations have curtailed the hours that non-consultant hospital doctors work. Specialties with significant emergency operative workloads such as general surgery mandate senior non-consultant cover in hospital on a shift basis to satisfy service provision. As a surgical specialty, urology enjoys a lower emergency operative rate and hence service demands are dealt with via the traditional non-resident system. However, emergency admissions remain frequent and advice is often sought by telephone from junior colleagues on acute clinical presentations. Additionally, professions allied to medicine working in the hospital environment such as laboratory personnel may require advice from registrars to aid in result interpretation.
8
Feeney, Sinéad, Kevin O’Brien, Neasa O’Keeffe, Anna Nic Con Iomaire, Maureen E. Kelly, John McCormack, Genevieve McGuire, and David S. Evans. "Practise what you preach: health behaviours and stress among non-consultant hospital doctors." Clinical Medicine 16, no. 1 (February 2016): 12–18. http://dx.doi.org/10.7861/clinmedicine.16-1-12.
Full text
9
De Souza, Valerie, Anne MacFarlane, Andrew W. Murphy, Belinda Hanahoe, Andrew Barber, and Martin Cormican. "A qualitative study of factors influencing antimicrobial prescribing by non-consultant hospital doctors." Journal of Antimicrobial Chemotherapy 58, no. 4 (August 2, 2006): 840–43. http://dx.doi.org/10.1093/jac/dkl323.
Full text
10
O’Connor, M. B., M. J. Hannon, D. Cagney, U. Harrington, F. O’Brien, N. Hardiman, R. O’Connor, K. Courtney, and C. O’Connor. "A study of needle stick injuries among non-consultant hospital doctors in Ireland." Irish Journal of Medical Science 180, no. 2 (December 29, 2010): 445–49. http://dx.doi.org/10.1007/s11845-010-0667-z.
Full text
11
Gaffney, Aoife, Lylas Aljohmani, and Roisin Dolan. "AB118. SOH22ABS199. Radiation exposure and safe practices among surgical non-consultant hospital doctors (NCHDs)." Mesentery and Peritoneum 6 (May 2022): AB118. http://dx.doi.org/10.21037/map-22-ab118.
Full text
12
Rooney, Siobhan, and Gabrielle Kelly. "Psychotherapy experience in Ireland." Psychiatric Bulletin 23, no. 2 (February 1999): 89–94. http://dx.doi.org/10.1192/pb.23.2.89.
Full textAbstract:
Aims and methodA questionnaire was sent to members of the Psychotherapy Section of the Irish Division of the Royal College of Psychiatrists to assess psychotherapy training.ResultsMembers from Northern Ireland, compared with those from the Republic, had more mandatory psychotherapy experience in a variety of psychotherapies, had attended more lectures on the theories of the psychotherapies, had cases longer in analysis and were more satisfied with their level of supervision. Few non-consultant hospital doctors had obtained mandatory psychotherapy training as outlined by the College guidelines and they were also generally dissatisfied with their basic training in psychotherapy.ImplicationsAlthough there were clear qualitative differences in psychotherapy training between Northern Ireland and the Republic, 100% of members believed there should be improvements in the training of psychotherapy in Ireland. If the Royal College guidelines are to be adhered to, these results would imply that changes in the structure of psychotherapy training in Ireland particularly for non-consultant hospital doctors are required.
13
French, Fiona, Divine Ikenwilo, and Anthony Scott. "What influences the job satisfaction of staff and associate specialist hospital doctors?" Health Services Management Research 20, no. 3 (August 1, 2007): 153–61. http://dx.doi.org/10.1258/095148407781395982.
Full textAbstract:
Despite their rising numbers in the National Health Service (NHS), the recruitment, retention, morale and educational needs of staff and associate specialist hospital doctors have traditionally not been the focus of attention. A postal survey of all staff grades and associate specialists in NHS Scotland was conducted to investigate the determinants of their job satisfaction. Doctors in both grades were least satisfied with their pay. They were more satisfied if they were treated as equal members of the clinical team, but less satisfied if their workload adversely affected the quality of patient care. With the exception of female associate specialists, respondents who wished to become a consultant were less satisfied with all aspects of their jobs. Associate specialists who worked more sessions also had lower job satisfaction. Non-white staff grades were less satisfied with their job compared with their white counterparts. It is important that associate specialists and staff grades are promoted to consultant posts, where this is desired. It is also important that job satisfaction is enhanced for doctors who do not desire promotion, thereby improving retention. This could be achieved through improved pay, additional clinical training, more flexible working hours and improved status.
14
Sulaiman, Che Fatehah Che, Patrick Henn, Simon Smith, and Colm M. P. O'Tuathaigh. "Burnout syndrome among non-consultant hospital doctors in Ireland: relationship with self-reported patient care." International Journal for Quality in Health Care 29, no. 5 (July 18, 2017): 679–84. http://dx.doi.org/10.1093/intqhc/mzx087.
Full text
15
Humphreys, Martin S. "Non-consultant psychiatrists' knowledge of emergency detention procedures in Scotland." Psychiatric Bulletin 21, no. 10 (October 1997): 631–35. http://dx.doi.org/10.1192/pb.21.10.631.
Full textAbstract:
There is growing concern with psychiatrists' knowledge of mental health law, in particular with the introduction of new legislation and more complex statutory arrangements for after care. Despite this, little systematic research has been undertaken in the UK. This study was designed to determine the knowledge of a sample of doctors in psychiatry in Scotland, of part of the Mental Health (Scotland) Act 1984 which provides for urgent involuntary admission to hospital. A one in three sample of all non-consultant grade psychiatrists throughout Scotland was interviewed on the aspects of the Act considered essential to lawful detention. Knowledge of even this restricted part of the Act was poor regardless of experience. Evidence emerged which suggested that at times civil liberties might be compromised or the right to treatment denied. The findings clearly point to the need for increased emphasis on training in mental health law.
16
Azhar, Jawad, Peter Thomas, Karen McCarthy, Tanzeem Raza, and Michael Vassallo. "Improving the experience of hospital doctors who are not in training programmes." British Journal of Healthcare Management 26, no. 12 (December 2, 2020): 1–8. http://dx.doi.org/10.12968/bjhc.2019.0052.
Full textAbstract:
Background/Aims Doctors in non-consultant, non-training (NCNT) trust grade posts are an important part of the medical workforce across the UK, but their needs are often neglected. It is important to explore their work-related experience to support their welfare. This study aimed to explore the issues that were most important to the positive work experience of this group of doctors. Method Work-related themes were identified through meetings with NCNT trust grade doctors. A questionnaire was then compiled asking such doctors to rate statements based on these themes using a 5-point Likert scale. Correlations between scores on these statements and the scores on the key statement ‘I will recommend coming to this hospital for training to my friends’ were explored. Results The questionnaire was completed by 25 doctors. Statements reflecting organisational culture, such as ‘I never felt bullied’ (r=0.698) or ‘I feel well supported in my work’ (r=0.796) demonstrated strong correlations with whether respondents would recommend the trust to a friend, while process-based statements, such as ‘I have been allocated a clinical supervisor’ (r=0.12), did not. Conclusions Focusing on the needs and opinions of NCNT trust grade doctors is important to support recruitment and retention. When evaluating the impact of processes on job satisfaction for this group, it may be more useful to focus on the outcomes of the processes and the general organisational culture, rather than simply checking off whether the processes exist.
17
Parvathaiah, H., C. Daly, S. Macsuibhne, A. Ni chorcorain, A. Guerandel, and K. Malone. "Development of E-learning Module On Delirium for Non-consultant Hospital Doctors Using the Delphi Method." European Psychiatry 30 (March 2015): 997. http://dx.doi.org/10.1016/s0924-9338(15)30782-3.
Full text
18
Garvey, Ruth. "Review of on-call duties of non-consultant hospital doctors in a rural Irish psychiatric unit." Psychiatric Bulletin 29, no. 8 (August 2005): 315. http://dx.doi.org/10.1192/pb.29.8.315.
Full text
19
Hally, Odile, and Colm Cooney. "Delirium in the hospitalised elderly: An audit of NCHD prescribing practice." Irish Journal of Psychological Medicine 22, no. 4 (December 2005): 133–36. http://dx.doi.org/10.1017/s0790966700009241.
Full textAbstract:
AbstractObjectives: This study was carried out to determine the prescribing of psychotropic medication of non-consultant hospital doctors in the management of delirium and to compare this with best practice guidelines.Method: A structured questionnaire was forwarded to all non-consultant hospital doctors (n = 95) working at St Vincent's University Hospital and data was collected over a six month period. The questionnaire addressed type, dose and route of psychotropic medication use in delirium as well as adjunctive measures used to manage delirium.Results: There was a 55% response rate (n = 52). Haloperidol and lorazepam were the two most frequently prescribed psychotropic agents used and over one third of respondents (n = 20) reported the use of risperidone. There was wide variation in doses used and a substantial proportion of NCHDs used higher than recommended starting doses for elderly patients with delirium. In addition, the intramuscular route was reported as the commonest route of administration with a majority of respondents reporting infrequent intravenous route of administration.Conclusions: The drug choice reported by respondents followed best practice guidelines. However, the wide variation in drug doses used and frequency of parenteral route of administration (particularly intramuscular) indicate the need for increasing awareness of best practice international guidelines. Guidance and clarification regarding the use of atypical antipsychotic medication is required following concerns about their use in dementia.
20
Rice, Darragh, Lucy Chapman, Mel Corbett, Grainne Courtney, and Brian Lawlor. "252 Physicians’ Perceptions to Electronic Alerts for Delirium and Dementia Screening - Qualitative Analysis of Bypass Reasons in an Electronic Patient Record." Age and Ageing 48, Supplement_3 (September 2019): iii1—iii16. http://dx.doi.org/10.1093/ageing/afz102.57.
Full textAbstract:
Abstract Background Delirium and dementia are common cognitive disorders within an inpatient hospital population (Mukadam & Sampson 2010) Efforts were made to improve detection by embedding the 4As Test (4AT) cognitive screening tool within the hospital electronic patient record (EPR). Non consultant hospital doctors (NCHDs) and consultants were prompted to complete the electronic 4AT on all inpatients aged 65 years and over at 24 hours into admission. Doctors could opt to bypass completion of the screening assessment but a reason for bypassing was required. Methods Reasons for bypassing the 4AT electronic alert were analysed using mixed methods during a seven week time period between June 28th and August 16th 2018. Free text entries were grouped into 15 qualitative categories. Quantitative methods using descriptive statistics were subsequently applied to qualitative categorisation. Results During seven weeks of analysis, hospital doctors bypassed electronic 4AT screening on 2473 occasions equating to a mean of 50.5 bypasses per day. Overall 40% of free text reasons documented were unintelligible. Examples of unintelligible bypass reasons documented in the EPR included “2321” and “dghj”. Amongst the qualitative categories analysed, the most common reasons for bypass observed were “Accessing EPR Remotely from Patient” (33%), “Specific Clinical Reason for Override” (12%) and “Not Patient’s Primary Team” (11%). Twenty-five entries (2%) were deemed to be angry or inappropriate. Examples included “Stop sending me delirium assessment”, “this is irrelevant, restrict this message to intern log-ins” and “I am consultant and I have to prioritise”. Conclusion Bypass of cognitive screening alerts within the EPR by doctors is common. Qualitative analysis of reasons for bypassing electronic alerts may provide insights on physicians’ perceptions to computer-generated prompts as well as informing future customisation and optimisation of alerts. Education and awareness amongst physicians regarding the nature and quality of documentation within electronic records is required.
21
Scott-Jupp, Robert, Emily Carter, and Nick Brown. "Effects of consultant residence out-of-hours on acute paediatric admissions." Archives of Disease in Childhood 105, no. 7 (January 14, 2020): 661–63. http://dx.doi.org/10.1136/archdischild-2019-317553.
Full textAbstract:
Acute paediatric units require round-the-clock skilled resident medical cover. Fully trained doctors remaining resident on-site at night and weekends may improve care at these times, but costs are higher. In compensation, more senior doctors may be less likely to admit children.MethodsIn a unit providing 24-hour, 7-day acute services, out-of-hours resident cover has been divided between level 2/3 trainees and consultants. Between 2007 and 2017, night and weekend day shifts were identified as resident consultant or non-resident consultant. Admission numbers (duration of stay of ≥4 hours) were obtained from hospital activity databases. Analyses were undertaken on total admissions and stratified by time of day and duration of stay of >12 or < 12 hours. Incidence rate ratios (IRRs) were derived using negative binomial regression .ResultsFor all out-of-hours and short-stay patients, children were significantly more likely to be admitted when there was no resident consultant: IRRs 1.07 (95% CI 1.04 to 1.09) and 1.09 (95% CI 1.02 to 1.18), respectively. There was no difference between rates stratified into long stay at night or weekend days: IRRs 1.01 (95% CI 0.96 to 1.07) and 1.03 (95% CI 0.99 to 1.18) respectively .ConclusionA resident consultant presence was associated with reduced total, night-time and short-stay admissions.
22
Hartnett, Yvonne, Clive Drakeford, Lisa Dunne, Declan M. McLoughlin, and Noel Kennedy. "Physician, heal thyself: a cross-sectional survey of doctors’ personal prescribing habits." Journal of Medical Ethics 46, no. 4 (December 3, 2019): 231–35. http://dx.doi.org/10.1136/medethics-2018-105064.
Full textAbstract:
BackgroundSelf-prescribing and prescribing to personal contacts is explicitly discouraged by General Medical Council guidelines.AimsThis study examines how widespread the practice of self-prescribing and prescribing to personal contacts is.MethodsA 16-item questionnaire was distributed via an online forum comprising 4445 young medical doctors (representing 20% of all Irish registered doctors), which asked respondents about previous prescribing to themselves, their families, friends and colleagues, including the class of medication prescribed. Demographic details were collected including medical grade and specialty.ResultsA total of 729 responses were obtained, the majority of which were from young non-consultant hospital doctors from a range of specialties. Two-thirds of respondents had self-prescribed, over 70% had prescribed to family, and nearly 60% had prescribed to a friend or colleague. Older doctors were more likely to self-prescribe (χ2=17.51, p<0.001). Interns being less likely to self-prescribe was not unexpected (χ2=69.55, p<0.001), while general practitioners (GPs) and paediatricians were more likely to self-prescribe (χ2=13.33, p<0.001; χ2=11.35, p<0.001). GPs, paediatricians and hospital medicine specialties were more likely to prescribe to family (χ2=5.19, p<0.05; χ2=8.38, p<0.05; χ2=6.17, p<0.05) and surgeons were more likely to prescribe to friends (χ2=15.87, p<0.001). Some 3% to 7% who had self-prescribed had prescribed an opiate, benzodiazepine or psychotropic medication. Male doctors, anaesthetists and surgeons were more likely to self-prescribe opioids (χ2=7.82, p<0.01; χ2=7.31, p<0.01; χ2=4.91, p<0.05), while those in hospital medicine were more likely to self-prescribe psychotropic medications (χ2=5.47, p<0.05).ConclusionPrescribing outside the traditional doctor-patient relationship is widespread despite clear professional guidance advising against it.
23
Ramasubbu, B., M. Heron, R. Ramasubbu, and P. Murphy. "A study to investigate the factors that influence the prescribing habits of non-consultant hospital doctors in Ireland." Irish Journal of Medical Science (1971 -) 186, no. 2 (July 30, 2016): 363–67. http://dx.doi.org/10.1007/s11845-016-1486-7.
Full text
24
Brady, Anne-Marie, Gobnait Byrne, Mary Brigid Quirke, Aine Lynch, Shauna Ennis, Jaspreet Bhangu, and Meabh Prendergast. "Barriers to effective, safe communication and workflow between nurses and non-consultant hospital doctors during out-of-hours." International Journal for Quality in Health Care 29, no. 7 (October 26, 2017): 929–34. http://dx.doi.org/10.1093/intqhc/mzx133.
Full text
25
Douglas, L., and L. Feeney. "An established practice in new surroundings: concepts, challenges, pitfalls and guidelines for NCHD Balint Groups." Irish Journal of Psychological Medicine 34, no. 1 (February 1, 2016): 1–5. http://dx.doi.org/10.1017/ipm.2015.63.
Full textAbstract:
Balint groups are now mandatory for psychiatry trainees. Balint groups have been in existence in General Practice for several decades. Providing Balint groups for Psychiatry Non Consultant Hospital Doctors brings with it challenges for the group leader and participants. Many of these challenges are common place in any form of group work, while others are unique to this cohort. This article describes these challenges. Guidelines which offer the the group the best chance of success, in the face of these common challenges, are discussed.
26
Haroon, Muhammad, Faiza Yasin, Rachael Eckel, and Frank Walker. "Perceptions and attitudes of hospital staff toward paging system and the use of mobile phones." International Journal of Technology Assessment in Health Care 26, no. 4 (October 2010): 377–81. http://dx.doi.org/10.1017/s0266462310001054.
Full textAbstract:
Objectives:Our objective was to document the pattern of mobile phone usage by medical staff in a hospital setting, and to explore any perceived benefits (such as improved communications) associated with mobile phones.Methods:This cross-sectional survey was conducted in Waterford Regional Hospital, Ireland, where bleep is the official system of communication. All non-consultant hospital doctors, of medical disciplines only, were asked to participate. The questionnaire was designed to explore the pattern and different aspects of mobile phone usage.Results:At the time of study, there were sixty medical junior doctors, and the response rate was 100 percent. All participants used mobile phones while at work, and also for hospital-related work. For 98.3 percent the mobile phone was their main mode of communication while in the hospital. Sixty-two percent (n= 37) made 6–10 calls daily purely for work-related business, and this comprised of ≥80 percent of their daily usage of mobile phones. For 98 percent of participants, most phone calls were work-related. Regarding reasons for using mobile phones, all reported that using mobile phone is quicker for communication.Conclusions:Mobile phone usage is very common among the medical personnel, and this is regarded as a more efficient means of communication for mobile staff than the hospital paging system.
27
Morgan, Kate. "P37 A model for reducing paediatric prescribing errors in secondary care." Archives of Disease in Childhood 105, no. 9 (August 19, 2020): e26.1-e26. http://dx.doi.org/10.1136/archdischild-2020-nppg.46.
Full textAbstract:
BackgroundA prescribing error is a preventable error that may lead to inappropriate medication use and patient harm(1). Prescribing errors are particularly important in paediatrics where dose calculations are complicated and small errors can result in significant morbidity and mortality.1 In 2017 pharmacy data showed that paediatric prescribing errors were an issue at our Hospital regarding the severity and high numbers of errors, especially for antibiotics and analgesia.ObjectivesTo achieve a zero prescribing error rate for paediatric within the hospital.MethodForm the Paediatric Medication Errors Prevention (PMEP) group consisting of the Paediatric Consultant, Paediatric Pharmacist, Children’s Assessment Unit Sister and Practice Education Senior Nurse.Paediatric Pharmacist to record and feedback all paediatric prescribing errors weekly at Doctors’ handover.Paediatric Pharmacist/Nurses to DATIX report all significant medication prescribing errorsPaediatric Pharmacist to produce and communicate monthly pharmacy prescribing newsletter.Paediatric Pharmacist to produce quick reference charts for the drugs with the most common prescribing errors e.g. antibiotics and analgesiaPaediatric Doctors to request a second check from another Doctor or Ward Sister when prescribing any medication on the drug chart of take home prescription.Paediatric Pharmacist to target Doctors’ induction to improve prescribing and implement a prescribing test.Doctors to complete reflections for errors with their educationsal supervisors.This study did not require ethics approval.ResultsFollowing implementation of the above strategies, there was a 33% reduction in the number of prescribing errors recorded by the Paediatric Pharmacist daily intervention log from 2017/2018 to 2018/2019. There were 163 prescribing errors for 2017/2018 compared to 110 for 2018/2019.ConclusionThe formation of the PMEP group and implementation of strategies to reduce paediatric prescribing errors has positively impacted on reducing the error rate at the hospital. It has also raised awareness of the necessity to report all errors and actively find ways to prevent these from re-occurring. Further work is required to reduce these errors to zero including targeting non paediatric teams prescribing on paediatrics and implementing Pharmacists prescribing on consultant ward rounds. Future work would also include replicating this model in other specialities e.g. neonatal intensive care to achieve the same success rate in reducing medication errors.ReferenceDavis T. Paediatric prescribing errors. Arch Dis Child. 2011;96:489–91. Accessed via http://adc.bmj.com on 2/4/19.
28
Comber, Ruth. "132 A Survey of Non-consultant Hospital Doctors’ Knowledge and Understanding of the Legal Status of Advance Care Directives in Ireland." Age and Ageing 48, Supplement_3 (September 2019): iii17—iii65. http://dx.doi.org/10.1093/ageing/afz103.77.
Full textAbstract:
Abstract Background The legal status of advance care directives (ACDs) in Irish law, as they pertain to current clinical practice, is a relatively new topic to healthcare staff. This project aimed to assess current understanding in non-consultant hospital doctors (NCHDs). Methods An online survey was conducted with NCHDs across a range of disciplines to ascertain current knowledge of the legal parameters of ACDs. Descriptive analysis of data was conducted in Excel. Results The survey was completed by 183 NCHDs. Of respondents 93.99% (n=172) were familiar with the term advance care directive and 41.53% (n=76) had encountered one in clinical practice. Their current legal status in Ireland was not known to 58.47% (n=107). That to be considered legally binding an ACD must be in writing was understood by 63.39%, but 58.47% (n=107) were unsure if a solicitor is required to draft one. Refusal of medical treatment as an application for ACDs was appreciated by 79.78% (n=146), however 38.89% (n=73) erroneously believed medical intervention could be requested in an ACD, with a further 30.6% (n=56) unsure. Current guidance sets out that only specific situations may be contained within an ACD, however 77.6% (n=142) of respondents believed a general stipulation could be documented, 25.14% (n=46) did not know if cognitive function affected the legality of an ACD, 95.08% (n=174) of respondents would attend formal training on ACDs if provided by their place of work. Conclusion Despite being enshrined in current legislation the legal status of advance care directives, their definition and criteria to be considered legally binding are very poorly understood by NCHDs. Guidance and education are crucial to the future protection of both patients and doctors with regards the execution of advanced care directives as prescribed by law.
29
Li, Lily, Sam Nahas, Rajan Jandoo, Sarah Williams, Haddon Paul Lionel Ganippa, Rajarshi Bhattacharya, and Dinesh Nathwani. "The Mass Knee Clinic: a new NHS outpatient care model showing clinically led transformation in practice." BMJ Innovations 7, no. 1 (October 27, 2020): 117–22. http://dx.doi.org/10.1136/bmjinnov-2019-000419.
Full textAbstract:
BackgroundThe Mass Knee Clinic is an innovative, patient-focused and efficient clinic introduced into our hospital in April 2017. The UK Government has mandated referral-to-treatment (RTT) time for patients to be within 18 weeks to improve patient care. The new clinic involves seeing high numbers of patients by amalgamating all new non-traumatic knee disorders (up to 200) from primary care into one clinic day every 6 weeks. The premise and success of the clinic is multifactorial and involves focused multidisciplinary consultant-led care in every case, training opportunities for junior doctors, a ‘one-stop shop’ for patients allowing them to be seen by a consultant, physiotherapist and receive a date for surgery all in 1 day, and subspeciality consultant presence, preventing multiple reattendances.MethodsWe present the results of prospectively collected data on wait times to clinic, time-to-treatment and outsourcing of new referrals, 1 year after the initiation of the new clinic model (n=56). This data was compared with data 1 year prior to the Mass Clinic being introduced (n=56).ResultsTime from primary care referral to first Orthopaedic review was reduced from median 13.5 weeks to 11 weeks (statistically significant (p=0.00512)). RTT was reduced from median 30.5 weeks to 15.5 weeks (p<0.01), allowing a significant reduction in waiting times for the patient. Outsourcing was eliminated, and the number of appointments per patient also halved.ConclusionsThe new Mass Clinic with focused consultant-led care and multidisciplinary approach has led to significant reductions in patient wait times and cost savings for the hospital.
30
Leahy, Niall, Michael Devine, Waqar Khan, Ronan Waldron, Iqbal Zaman Khan, and Kevin Barry. "AB181. SOH21AS205. Venous thromboembolism prophylaxis in general surgical patients undergoing elective and emergency procedures in a model 3 hospital: outcomes and non-consultant hospital doctors’ perspectives." Mesentery and Peritoneum 5 (April 2021): AB181. http://dx.doi.org/10.21037/map-21-ab181.
Full text
31
Felmingham, Claire, Samantha MacNamara, William Cranwell, Narelle Williams, Miki Wada, Nikki R. Adler, Zongyuan Ge, et al. "Improving Skin cancer Management with ARTificial Intelligence (SMARTI): protocol for a preintervention/postintervention trial of an artificial intelligence system used as a diagnostic aid for skin cancer management in a specialist dermatology setting." BMJ Open 12, no. 1 (January 2022): e050203. http://dx.doi.org/10.1136/bmjopen-2021-050203.
Full textAbstract:
IntroductionConvolutional neural networks (CNNs) can diagnose skin cancers with impressive accuracy in experimental settings, however, their performance in the real-world clinical setting, including comparison to teledermatology services, has not been validated in prospective clinical studies.Methods and analysisParticipants will be recruited from dermatology clinics at the Alfred Hospital and Skin Health Institute, Melbourne. Skin lesions will be imaged using a proprietary dermoscopic camera. The artificial intelligence (AI) algorithm, a CNN developed by MoleMap Ltd and Monash eResearch, classifies lesions as benign, malignant or uncertain. This is a preintervention/postintervention study. In the preintervention period, treating doctors are blinded to AI lesion assessment. In the postintervention period, treating doctors review the AI lesion assessment in real time, and have the opportunity to then change their diagnosis and management. Any skin lesions of concern and at least two benign lesions will be selected for imaging. Each participant’s lesions will be examined by a registrar, the treating consultant dermatologist and later by a teledermatologist. At the conclusion of the preintervention period, the safety of the AI algorithm will be evaluated in a primary analysis by measuring its sensitivity, specificity and agreement with histopathology where available, or the treating consultant dermatologists’ classification. At trial completion, AI classifications will be compared with those of the teledermatologist, registrar, treating dermatologist and histopathology. The impact of the AI algorithm on diagnostic and management decisions will be evaluated by: (1) comparing the initial management decision of the registrar with their AI-assisted decision and (2) comparing the benign to malignant ratio (for lesions biopsied) between the preintervention and postintervention periods.Ethics and disseminationHuman Research Ethics Committee (HREC) approval received from the Alfred Hospital Ethics Committee on 14 February 2019 (HREC/48865/Alfred-2018). Findings from this study will be disseminated through peer-reviewed publications, non-peer reviewed media and conferences.Trial registration numberNCT04040114.
32
O'Brien, Michelle, Jennifer Britton, Miriam Clarke, and Orla Collins. "226 Staff Knowledge of Orthostatic Hypotension." Age and Ageing 48, Supplement_3 (September 2019): iii17—iii65. http://dx.doi.org/10.1093/ageing/afz103.136.
Full textAbstract:
Abstract Background The prevalence of orthostatic hypotension increases with age(1). The aim of this audit was to assess healthcare provider’s knowledge of identifying and measuring orthostatic hypotension (OH) in the acute setting. Early identification and management of OH is an important step to prevent adverse outcomes and improve patient’s overall functional performance. Methods Fifty-one questionnaires were distributed to a random selection of non-consultant doctors and nurses in our hospital. The questionnaires included questions regarding basic knowledge of OH and its measurement. Questions were based on international guidelines on the appropriate measurement and assessment of OH(1). An education session was then offered to junior doctors and nurses, and subsequently carried out by a senior nurse. Staff were educated on OH and how to correctly assess it. Doctors and nurses were subsequently reassessed using the same questionnaire. Results Initial results showed that many of the respondents were interns (37%) and nurses (35%). 94% of respondents had never received formal training in the evaluation of OH. 51% knew that a patient should lie supine for 5 minutes prior to initial BP assessment. 61% knew to take the BP at 1-minute post standing, and 45% knew that the BP should again be taken at 3 minutes. 71% knew to take the pulse alongside the BP checks. The education sessions and repeat audit are ongoing. Conclusion Many of the hospital staff who assess for OH have not received specific training on how to evaluate and diagnose OH. It is our aim to educate front line staff as to the importance of looking for OH and how to diagnose it.
33
Browne, Clíodhna, Catherine M. Dowling, Patrick O’Malley, Nadeem Nusrat, Kilian Walsh, Syed Jaffry, Eamonn Rogers, Garrett C. Durkan, and Frank T. D’Arcy. "Outcomes from the Introduction of a Combined Urology Outpatient Clinic." Advances in Urology 2018 (November 29, 2018): 1–4. http://dx.doi.org/10.1155/2018/9738548.
Full textAbstract:
Background. A combined urology clinic staffed by four consultants and four non‐consultant hospital doctors (NCHDs) was introduced in our institution in October 2015. This clinic is supported by a pre‐clinic radiology meeting and a synchronous urology clinical nurse specialist (CNS) clinic with protected uroflow/trial of void slots. Herein, we report on the outcomes of this clinic in comparison with the standard format of urology outpatient review. Methods. We carried out a retrospective review of clinic attendances from May to July 2016. We recorded the number of new and return attendances, which team members had reviewed the patient and patient outcomes. We also calculated the waiting times for new patients to be reviewed in the outpatient clinic. Results. The combined urology clinic reviewed an average of 12 new and 46 return patients per clinic. The standard urology clinic reviewed an average of 8 new and 23 return patients per clinic. 54% of patients were seen by a consultant in the combined urology clinic, and 20% of patients were seen by a consultant in the standard urology clinic. The rate of patient discharge for new patients was 14.8% in the combined clinic compared to 5.9% in the standard clinic. Overall patient outcomes are outlined in the table. The waiting time for review of new patients in the combined clinic was reduced by 39% from 144 days to 89 days over a one-year period. Conclusions. The introduction of a combined urology outpatient clinic with the support of pre‐clinic radiology meeting and synchronous urology CNS clinic facilitates patient discharge.
34
Carney, Michael WP, and Brian F. Sheffield. "Alcoholism diagnosis and Celtic names." Irish Journal of Psychological Medicine 12, no. 3 (September 1995): 95–100. http://dx.doi.org/10.1017/s0790966700014518.
Full textAbstract:
AbstractObjective: To investigate assertions that Celts have higher rates of alcoholism and mental illness than non-Celts.Method: The records of 3,000 admissions to Northwick Park Hospital Psychiatric Unit, Harrow (a North West London suburban middle class borough research hospital with a strictly defined catchment area – the London Borough of Harrow: population 200,000), from June 1987 for three years under the clinical care of four consultant psychiatrists, were examined.Results: There were 683 with non-Celtic names and 175 with Celtic names (16.7%) (data on 10 patients incomplete). 306 (35%) of non-Celts and 88 (50%) of Celts were aged under 40 years. Alcohol dependence (ICD 303) was significantly commoner (p<0.001) among the Celts (35.3%) than among the non-Celts (12.9%). There were highly significant excesses (p<0.001) of native-born Celts with ICD 303 (54%) compared with non-Celts 12.9% or with Celts born outside Celtdom (23%). Patients with Norman names tended to follow the Celts in these respects. There were no differences with respect to the prevalence of psychosis or other ICD categories among Celts and non-Celts.Conclusion: Doctors should be aware of the high prevalence of alcoholic dependence among people with Celtic names, whether these were born in Celtic countries or not, entertain a high index of diagnostic suspicion and take preventative measures accordingly. However, we found no excess of other categories of psychiatric disorder among Celts as compared with non-Celts. Patients with Norman-derived names seemed to follow the Celts in these respects.
35
Akinsola, Oluwatosin, Kingsley Nwachukwu, and Annette Kavanagh. "Prescription chart writing practices in an acute psychiatric unit." Irish Journal of Psychological Medicine 28, no. 2 (June 2011): 82–83. http://dx.doi.org/10.1017/s0790966700011484.
Full textAbstract:
AbstractObjectives: The survey was designed to evaluate the current prescribing practice of the doctors in our local psychiatric unit against the standards outlined by the National Health Office in the Code of Practice for Healthcare Records Management, and to assess the changes in practice by completing an audit cycle.Method: The survey was carried out in a 27 bed acute psychiatric unit. A single assessor reviewed 51 inpatient drug prescription charts using a standardised data collection form derived from the Code of Practice document. Results were presented to the relevant clinical staff and a repeat survey was conducted a few months afterwards. All data were categorical and the frequencies were computed using SPSS 13.0.Results: A total of 51 medication prescription charts were analysed on each occasion during the period of the study. The information contained on the drug charts were assessed against explicit predefined criteria as per the approved standard. At the initial survey, allergy documentation was absent in 59% of charts, only 18% of charts had generic only prescriptions, 90% of ‘as required’ medication lacked review dates, and only 33% of charts were considered to be reasonably neat. The repeat survey showed improvements in these practices, generic only prescribing increased to 39%, and 55% of charts were considered to be reasonably neat by the assessor.Conclusion: Our study has identified deficiencies in prescribing practices and we have shown improvement in some of these practices at the repeat survey, however, further improvement is required. Given that the non-consultant hospital doctors are mostly involved in prescribing on drug charts, approved standards should be incorporated into the induction programme at the commencement of training in this unit. This standard should be monitored and maintained through the means of regular audits.
36
Ip, Brian, Chern Beverly Brenda Lim, Satvinder Chauhan, and Douglas Black. "From knife to paper: an audit of surgical communication." Clinical Governance: An International Journal 19, no. 1 (December 20, 2013): 41–51. http://dx.doi.org/10.1108/cgij-07-2013-0018.
Full textAbstract:
Purpose – The paper aims to assess the quality (content and legibility) of handwritten operation notes and the reader's interpretation of legibility by clinical seniority. Design/methodology/approach – Consecutive elective and emergency general surgical operations over a six-week period from September 2011 at one hospital were retrospectively collected. Non-retrieval of operation notes, typed notes and endoscopies were excluded. The content of each operation note was assessed against a 26-item checklist. Legibility was assessed by 4 readers (2 Foundation Doctors and 2 Registrars in General Surgery) using an original objective scoring system. Findings – A total of 404 operations were identified; 45 were excluded following review of operation notes. Operation notes were derived from 12 consultants and 11 registrars. Analysis of the content score suggested that time of procedure (1 per cent), ASA grade (1 per cent) and blood loss (5 per cent) were poorly reported. Clinical indication and post-operative instructions were documented in only 52 per cent and 66 per cent of operation notes respectively. Registrar notes had a higher content score compared with consultant notes (15.8 vs 13.5, p<0.001). Legibility scores were reported to be higher for Registrar readers, compared with Foundation Doctor readers (OR 1.95, 95 per cent CI 1.75-2.18, p<0.001). Registrar-written notes had higher legibility scores compared with consultants (OR 19.0, 95 per cent CI 11.6-31.2, p<0.001). Research limitations/implications – The quality of handwritten notes varies. Registrar-written notes are more content-rich and legible. Practical implications – Clinical seniority and specialty training may improve the interpretation of handwritten operation notes. This study adds to growing evidence supporting the widespread adoption of a computerized immediate operation note. Originality/value – An objective scoring system to assess legibility of operation notes written as freehand was used. Also, legibility according to the reader's seniority in clinical training was evaluated.
37
Tong, Kezanne, Eimear McMahon, Bronwyn Reid-McDermott, Dara Byrne, and Anne M. Doherty. "SafePsych: improving patient safety by delivering high-impact simulation training on rare and complex scenarios in psychiatry." BMJ Open Quality 10, no. 3 (September 2021): e001533. http://dx.doi.org/10.1136/bmjoq-2021-001533.
Full textAbstract:
IntroductionDespite an evidence base demonstrating simulation to be an effective medical education tool, it is not commonly used in postgraduate psychiatry training as it is in other medical specialties.ObjectiveThis paper outlines the development and effectiveness of a hybrid-virtual simulation-based workshop designed to improve patient care by improving clinical skills of non-consultant hospital doctors (NCHDs) in detecting and managing rare and complex psychiatric emergencies.MethodsThree clinical vignettes based on near-miss psychiatric cases were developed by a multidisciplinary team of physicians and nurses in psychiatry and experts in simulation-based medical education. The workshop, ‘SafePsych’ was delivered in a simulation laboratory while and broadcast via Zoom video-conferencing platform to observers. Debriefing followed each clinical scenario. Participants completed preworkshop and postworkshop questionnaires to evaluate clinical knowledge.ResultsThe workshop was attended by consultants (n=12) and NCHDs in psychiatry and emergency medicine (n=19), and psychiatric nurses (n=5). In the psychiatry NCHD group, test scores significantly improved following the workshop (p<0.001). There were significant improvements in the test scores with a mean difference of 2.56 (SD 1.58, p<0.001). Feedback from participants and observers was positive, with constructive appraisals to improve the virtual element of the workshop.ConclusionSimulation-based training is effective in teaching high risk, rare complex psychiatric cases to psychiatry NCHDs. Further exploration of the learning needs of nursing staff is required. Future workshop delivery is feasible in the COVID-19 environment and beyond, using a virtual element to meet social distancing requirements while enhancing the reach of the training.
38
Synnott, Pádraig, Michelle Brennan, Shaun O'Keeffe, and Michelle Canavan. "279 Quality Improvement Audit on Bone Health Assessment and Secondary Prevention of Patients Discharged from an In-patient Rehabilitation Unit Post Fracture." Age and Ageing 48, Supplement_3 (September 2019): iii17—iii65. http://dx.doi.org/10.1093/ageing/afz103.175.
Full textAbstract:
Abstract Background Osteoporosis accounts for more disability-adjusted life years than many non-communicable diseases. Identification and treatment is important to reduce morbidity and mortality associated with further fracture.(1) National Osteoporosis Guideline Group recommends all patients with a fragility fracture should undergo a bone health assessment and commence pharmacological therapy if indicated.(2) Methods Electronic discharge summaries of all patients with a diagnosis of fracture discharged from an off-site rehabilitation unit from 1st January 2018 to 31st December 2018 were reviewed. Patient details, location and mechanism of fracture, bone health assessment and discharge prescription were assessed. Following data collection, an education session directed at NCHDs was performed and a discharge checklist prompting bone health review and consideration of pharmacological therapy was introduced. A re-audit was performed at 4 months to assess change following this intervention. Results 74 patients had a diagnosis of fracture. 4 were excluded as fracture resulted from high impact trauma. 100% had corrected calcium measured. 93%(n=65) had Vitamin D(OH) measured. 91%(n=64) had PTH measured. 55%(n=39) were discharged on calcium/vitamin D(OH) supplementation. 33%(n=23) were discharged on Vitamin D(OH) alone. 66%(n=46) were discharged on antiresorptive therapy: 28%(n=13) bisphosphonate, 67% (n=31) denosumab, 4% others. 33%(n=23) were not prescribed any bone protection on discharge. 4 had advanced chronic kidney disease. 6%(n=4) were discharged without calcium/Vitamin D or antiresorptive therapy. A re-audit from January to April 2019 of 15 patients post NCHD education has shown an increase in antiresorptive therapy prescription 86%(n=13) Conclusion Bone health assessment and prescribing practices of antiresorptive therapy in patients undergoing rehabilitation post fracture is sub-optimal. Education of non-consultant hospital doctors can substantially improve rates of antiresorptive therapy prescription.
39
Kirrane, Michelle, Rob Cunney, Roisin McNamara, and Ike Okafor. "P39 Start smart: improving the quality of empiric antimicrobial prescribing at a tertiary paediatric hospital." Archives of Disease in Childhood 103, no. 2 (January 19, 2018): e2.43-e2. http://dx.doi.org/10.1136/archdischild-2017-314585.48.
Full textAbstract:
Appropriate choice of empiric antibiotic therapy, in line with local guidelines, improves outcome for children with infection, while reducing adverse drug effects, cost, and selection of antimicrobial resistance. Data from national point prevalence surveys showed compliance with local prescribing guidelines at our hospital was suboptimal. A team with representatives from the pharmacy, microbiology and emergency departments collaborated with prescribers to improve the quality of empiric antibiotic prescribing. The project aim was, using the ‘Model for Improvement’, to ensure ≥90% of children admitted via the Emergency Department (ED) and commenced on antibiotic therapy, have a documented indication and a choice of therapy in line with local antimicrobial guidelines.MethodResults of weekly audits of the first ten children admitted via ED and started on antibiotics were fed back to prescribers. Front line ownership techniques were used to develop ideas for change, including; regular antibiotic prescribing discussion at Monday morning handover meeting, antibiotic ‘spot quiz’ for prescribers, updates to prescribing guidelines (along with improved access and promotion of prescribing app), printed ID badge guideline summary cards, reminders and guideline summaries at point of prescribing in ED.Collection of audit data initially proved challenging, but was resolved through a series of rapid PDSA cycles. Initial support from ED consultants and other ED staff facilitated establishment of the project. Presentation of weekly run charts to prescribers fostered considerable support among consultants and non-consultant doctors (NCHDs). We saw a shift in perspective from ‘how is your project going?’ to ‘How are we doing?’.ResultsDocumentation of indication and guideline compliance increased from a median of 30% in December 2014/January 2015 to 100% consistently from February 2015 to the present. It is felt that a change in approach to antimicrobial prescribing is now embedded in our hospital culture as this improvement has remained constant through three NCHD changeovers. A comparison of 2014 Antimicrobial expenditure to 2015 figures shows a reduction in expenditure of €101,078.44.ConclusionThis project has inspired other departments to develop local QIPs and has encouraged the surgical teams to lead their own audits in antimicrobial stewardship. An improvement in other areas of antimicrobial prescribing has also been noted e.g. documentation of review date.The initiative has been shared with other hospitals throughout Ireland via presentations at the National Patient Safety Conference, Antimicrobial Awareness day and the Irish Antimicrobial Pharmacist’s Group meeting. It has also been shared at both European and international conferences. The project was a shortlisted finalist for a national healthcare excellence award and has been rolled out as part of a national quality improvement collaborative.
40
Eneh, Oliaku, and Sabina Fahy. "Audit of documentation of allergies in a psychiatric inpatient unit." Irish Journal of Psychological Medicine 28, no. 4 (December 2011): 213–16. http://dx.doi.org/10.1017/s079096670001168x.
Full textAbstract:
AbstractObjectives: This audit aimed to: identify the level of allergy documentation in admission notes, case notes and medication charts in the Department of Psychiatry, Portlaoise; establish the degree of compliance to the gold standard guidelines; highlight areas requiring further improvement and make realistic recommendations to ensure better compliance with the stipulated guidelines on allergy documentation; and re-audit after six months.Methods: Gold standard guidelines on allergy documentation were obtained from various sources. Audit was performed over three days during which data was collected from the allergy section of medication charts, current case notes and original admission notes in both acute and long-stay wards. Recommendations were made and some were adopted, changes to practice were implemented for six months; at which time re-audit was performed.Results: The initial audit revealed that: the allergy section was completed in 25% of medication charts; only 12% of current case notes had any documentation of allergy status; an for the original admission notes, the allergy section was documented in 65% of notes. Based on these results, a formal initial assessment proforma with a designated allergy section was introduced and a renewed awareness of the importance of the documentation of allergy status was actively promoted amongst non consultant hospital doctors (NCHDs). Six months later, re-audit showed that: in the medication charts there was a significant improvement in the level of compliance with documentation of allergy status (allergy or NKDA) in the allergy section up from 25% to 58.1%; in the current case notes, there was only marginal improvement in the level of compliance on the front of case notes from 12-19.1%; and in the original admission notes, there was also considerable improvement in the level of compliance with documentation of allergy status up from 65% to 80.9%.Conclusion: This audit improved the level of documentation of allergy sections in the relevant areas and therefore helped in preventing avoidable and potentially fatal allergic reactions. It will also help save money for the Health Service Executive by reducing compensation costs filed by patients.
41
Salooja, Nina, Steffie van der Werf, Maura Faraci, Angela Hamblin, Anja van Biezen, Grzegorz W. Basak, and Rafael F. Duarte. "Provision of Long-Term Monitoring and Late Effects Services Following Hematopoietic Cell Transplantation (HCT): A Survey of European Programs By the Complications and Quality of Life Working Party of the EBMT." Blood 128, no. 22 (December 2, 2016): 4607. http://dx.doi.org/10.1182/blood.v128.22.4607.4607.
Full textAbstract:
Abstract Introduction:Wider indications and improvements in outcome continue to increase the number of HCT recipients requiring long term post-HCT survivorship care. The Institute of Medicine of the US National Academy of Sciences specifically recognizes the importance of coordination of care to optimize delivery in cancer survivors. HCT recipients have particularly complex clinical needs (Majhail et al; Bone Marrow Transplant 2012), but existing evidence on which to base models of care is weak in relation to either cost-effectiveness or quality of care. Additional complexity occurs where models of care require transition from pediatric to adult services. Methods:We undertook an online survey of 430 centers within 48 countries registered with the EBMT as of February 2016. This included questions about service organization including transition models, access to non-hematological specialist services, and perceived barriers to improving services. Results:74 centers (17%) responded including data from 28 countries (58%). 83% centers were JACIE accredited or else working towards it. 41 centers included pediatric patients and follow up was until age 14-25 (median 18) years. Several models of transition were cited, the most frequent being for children to go into an adult transplant or haem-oncology clinic . Although 5 models included transfer to a different town/city, the majority transitioned within the same hospital. Late effects services were not invariably led by a single individual and sometimes occurred within the unit as part of good practise. Co-ordinated models, were most likely to be led by medical consultants (60/72 ) and the minority (only 6/72, 8%) by nurse specialists. The most frequent model of care was review within a dedicated transplant clinic that also included new patients (34/74; 46%). Management was frequently guided by a dedicated internal structured guideline (45/74; 61%). 12 centers only (16%) had a dedicated clinic for patients with chronic GVHD. Almost two thirds of responding centers (45) had a late effects mutli-disciplinary team (MDT) and for 19 centers this applied to all ages. Composition of the MDT varied. Most frequent components were: consultant hematologist (n=36), psychologist (31), endocrinologist (28), social workers (26) and nurses (20). There was widespread access (80% or more) to endocrine, cardiology, respiratory, dermatology, gastroenterology and ophthalmology.Less than half of the specialist consultant support services available had an interest in late effects however. Systematic screening for medical problems occurred within 2 years for more than 80% of centers for at least one parameter (e.g. endocrine), however some centers did not initiate routine surveillance until 10 years or more post SCT. Only 5 centers incorporated psychological assessment into their follow up. The number of responding centers with well-coordinated late effects services was high. However,notably the number of centers following up the majority (>90% ) of their patients declined substantially with time. The biggest perceived barrier to late effects services was resources: either clinical staffing or costs of investigations. Financial barriers arose from policy decision making at a National or hospital level rather than departmental level. Conclusions:This hospital based survey has identified frequent examples of good practice including dedicated clinics, clear transition services for pediatric patients undergoing HCT and the use of MDT. Notably, however, these services only cover the very long term survivors who remain under follow up at their transplant center and systematic screening starts late (>10 years) in some models. Psychological support services were not widely available. The study indicates some variation in models of care for addressing late effects after HCT across European centers. As many of the models described do not include all of the very long term survivors of HCT, it will be important to ensure engagement of non-transplant doctors in the community or referring hospitals. With a 17% response rate it is probable that there is a bias towards reporting details of services with a particular interest in this area. Nonetheless this survey is a useful starting point to improve practice and a basis to design studies that address outcome measures linked to model of care. Disclosures No relevant conflicts of interest to declare.
42
Lo, Alice, and Chloe Benn. "P66 Standardising strengths of unlicensed medicines in a large London hospital trust." Archives of Disease in Childhood 105, no. 9 (August 19, 2020): e40.2-e41. http://dx.doi.org/10.1136/archdischild-2020-nppg.74.
Full textAbstract:
BackgroundA UK national position statement on standardised strengths of unlicensed liquid medicines recommend that when children require unlicensed liquid medications, they should receive the recommended strength. By standardising strengths of these medicines, the risk of errors being made in the doses given to children will be reduced and prevent accidental under and overdoses.1 Our Trust has 4 hospital sites since merging in 2012, we found the process of switching to a standard strength far from simple.MethodsThe strengths of unlicensed liquid medicines listed in the position statement available on the pharmacy dispensing system (JAC) were identified, along with the speciality users. Pharmacy and clinical leads were consulted for agreement to switching to the standardised strengths. Pharmacy procurement identified new products in standardised strengths and products were reviewed for suitability by paediatric pharmacist. A cost impact analysis was carried out. Communication was sent to stakeholders including, doctors, nurses, pharmacy and primary care.Results and DiscussionWe found the standardised strengths of azathioprine, clonazepam, ethambutol, isoniazid, melatonin, omeprazole, phenobarbitone and pyrazinamide strengths were on formulary. Clopidogrel, hydrocortisone, sertraline and tacrolimus liquids are not used. Different strengths of the listed unlicensed liquid medicines were used by different sites and specialties. Lead speciality pharmacists agreed with the standardisation. We identified use of unlicensed products where licensed products are available (sildenafil 20 mg/5 mL and furosemide 5 mg/5 mL). We added the use of these items to our review. We were not able to agree on a single standard strength for some items; the neonatal intensive care unit (NICU) have babies under 500 g who may require furosemide, spironolactone and sildenafil in doses that measure less than 0.1 mL using the recommended strengths. This volume is deemed less than satisfactory to be measured safely1. It has been agreed with the neonatal lead pharmacist that additional strengths of the sildenafil (unlicensed 20 mg/5 mL), spironolactone (unlicensed 10 mg/5 mL) and furosemide (20 mg/5 mL) be available for inpatient NICU use only. The potential for patients to be discharged on the non-standard strength is reduced by specifying ‘Not for discharge - inpatient use only’ on the pharmacy system as well as having them only as NICU stock from medicines distribution. Patients admitted on other strengths will be switched (with consent); to minimise risk pharmacists will ensure carers are aware of the change & correct dose volume to administer and endorse TTAs noting the change in concentration for the GP. Primary care have been engaged with the switch and invited the consultant pharmacist to discuss this at the interface meeting. We were not able to source the recommended midazolam 10 mg/5 mL. The switch to chloral hydrate to 1 g/5 mL was calculated to have a significant cost pressure therefore it was agreed that that we would not change from chloral hydrate 500 mg/5 mL at this time as it is mainly used in the in-patient setting within our Trust. Based on current usage there is an estimated cost saving of over £5 k based on the switch of sodium chloride, sildenafil, furosemide and spironolactone. The impact will be reviewed in 6 months.ConclusionA successful switch requires a team approach but will benefit patient safety and save money.ReferenceThe Neonatal and Paediatric Pharmacists Group (NPPG) and Royal College of Paediatric and Child Health (RCPCH). Position statement 18–01 Using Standardised Strengths of Unlicensed Liquid Medicines in Children. Version 2. May 2019.
43
Singh Sidhu, Deshwinder, and Guy Molyneux. "Implementation of physical examination pro forma – a complete audit cycle." BJPsych Open 7, S1 (June 2021): S104. http://dx.doi.org/10.1192/bjo.2021.310.
Full textAbstract:
AimsAim of this audit is to achieve and maintain 100% compliance in physical examination on admission.BackgroundConducting physical examination on admission is a mandatory requirement and is monitored by the Mental Health Commission during yearly inspections. A report published by Inspectorate of the Mental Health Commission recently in 2019 identifies a gap in physical health monitoring. We conducted a complete audit cycle in an inner city hospital psychiatric ward to monitor compliance with physical examination on admission.MethodWe based the audit on Judgment Support Framework (JSF) version 5 standards. A retrospective review of all of the patient's medical records was carried out. 13 medical records were reviewed in the first cycle. The results of the first cycle were presented to the Multi Disciplinary Team (MDT) members, including the Non-Consultant Hospital Doctors (NCHD). Physical health policy was reviewed, in consultation with the committee and Clinical Director, a Physical Examination pro-forma (colour coded) was developed and implemented. It was based on the National Guidelines and the JSF ver.5. All members of the MDT and NCHDs were briefed on the pro forma introduced. A repeat audit cycle was conducted of all patients admitted after first audit cycle. Data were collected using a simple audit tool indicating if physical examination was conducted or refused.ResultA total of 22 medical records were audited. 13 medical records in the first cycle indicted only 3 patients had physical examination on admission. However, prior to admission a total of six patients had physical exam in the Emergency Department (ED). Upon implementation of the pro forma, 9 medical records of all patients admitted post-first cycle were audited. A total of 7 patients had physical examination on admission to the ward. Two patients refused physical examination and this was clearly documented. One patient had physical examination completed in ED. All newly admitted patients had physical examination completed or the reason why it wasn't completed documented clearly.ConclusionPhysical examination pro forma was successfully implemented, raising current compliance to a 100%, with a significant improvement from 23% compliance in the first cycle. Existing pro forma is helpful as a reminder to NCHDs. Colour coding of pro forma improves accessibility and distinguishability during the process of admission and auditing. Physical examination pro forma will be audited every 6 monthly.
44
Campaner, Gabriel Rene M. "The presence of a Surgical Care Practitioner in the perioperative team is of benefit both to the patient and the consultant-led extended surgical team." Journal of Perioperative Practice 29, no. 4 (May 4, 2018): 81–86. http://dx.doi.org/10.1177/1750458918764520.
Full textAbstract:
Non-medically qualified professionals have progressively advanced and developed in line with the country’s constantly evolving health care system. Recently, increasing hospital activity, underfunding in health care and a falling number of doctors have left the NHS perpetually underdoctored, underfunded and overstretched. As the current health care climate demands these ‘non-doctors’ to demonstrate competent knowledge and skill in providing safe and effective care, this paper discusses limitations, the scope of practice as well as the benefits the Surgical Care Practitioner provides to the modern extended surgical team, and most importantly – the patients under their care.
45
Segura, Peter Paul. "Oliverio O. Segura, MD (1933-2021) Through A Son’s Eyes – A Tribute to Dad." Philippine Journal of Otolaryngology Head and Neck Surgery 36, no. 1 (May 30, 2021): 73. http://dx.doi.org/10.32412/pjohns.v36i1.1679.
Full textAbstract:
I was born and raised in the old mining town of Barrio DAS (Don Andres Soriano), Lutopan, Toledo City where Atlas Consolidated Mining and Development Corp. (ACMDC) is situated. Dad started his practice in the company’s hospital as an EENT specialist in the early 60’s and was the ‘go to’ EENT Doc not only of nearby towns or cities (including Cebu City) but also the surrounding provinces in the early 70’s. In my elementary years, he was Assistant Director of ACMDC Hospital (we lived just behind in company housing, only a 3-minute walk). I grew interested in what my dad did, sometimes staying in his clinic an hour or so after school, amazed at how efficiently he handled his patients who always felt so satisfied seeing him. At the end of the day, there was always ‘buyot’ (basket) of vegetables, live chickens, freshwater crabs, crayfish, catfish or tilapia. I wondered if he went marketing earlier, but knew he was too busy for that (and mom did that) until I noticed endless lines of patients outside and remembered when he would say: “Being a doctor here - you’ll never go hungry!” I later realized they were PFs (professional fees) of his patients. As a company doctor, Dad received a fixed salary, free housing, utilities, gasoline, schooling for kids and a company car. It was the perfect life! The company even sponsored his further training in Johns-Hopkins, Baltimore, USA.
A family man, he loved us so much and was a bit of a joker too, especially at mealtimes. Dad’s daily routine was from 8 am – 5 pm and changed into his tennis, pelota, or badminton outfit. He was the athlete, winning trophies and medals in local sports matches.
Dad wanted me to go to the University of the Philippines (UP) High School in the city. I thought a change of environment would be interesting, but I would miss my friends. Anyway, I complied and there I started to understand that my dad was not just an EENT practicing in the Mines but was teaching in Cebu Institute of Medicine and Cebu Doctors College of Medicine (CDCM) and was a consultant in most of the hospitals in Cebu City. And still he went back up to the mountains, back to Lutopan, our mining town where our home was. The old ACMDC hospital was replaced with a new state-of-the-art hospital now named ACMDC Medical Center, complete with Burn Unit, Trauma center and an observation deck in the OR for teaching interns from CDCM. Dad enjoyed teaching them. Most of them are consultants today who are so fond of my dad that they always send their regards when they see me.
My dad loved making model airplanes, vehicles, etc. and I realized I had that skill when I was 8 years old and I made my first airplane model. He used to build them out of Balsa wood which is so skillful. I can’t be half the man he was but I realized this hobby enhanced his surgical skills. My dad was so diplomatic and just said to get an engineering course before you become a pilot (most of dads brothers are engineers). I actually gave engineering a go, but after 1 ½ years I realized I was not cut out for it. I actually loved Biology and anything dealing with life and with all the exposure to my dad’s clinic and hospital activities … med school it was!
At this point, my dad was already President of the ORL Central Visayas Chapter and was head of ENT Products and Hearing Center. As a graduate of the UP College of Medicine who finished Otorhinolaryngology residency with an additional year in Ophthalmology as one of the last EENTs to finish in UP PGH in the late 50’s, he hinted that if I finished my medical schooling in CDCM that I consider Otorhinolaryngology as a residency program and that UP-PGH would be a good training center. I ended up inheriting the ORL practice of my dad mostly, who taught me some of Ophthalmology outpatient procedures. Dad showed me clinical and surgical techniques in ENT management especially how to deal with patients beyond being a doctor! You don’t learn this in books but from experience. I learned a lot from my dad. Just so lucky I guess! He actually designed and made his own ENT Treatment Unit, which I’m still using to this day (with some modifications of my own). And he created a certain electrically powered ‘eye magnet’ with the help of my cousin (who’s an engineer now in Chicago) which can attract metallic foreign bodies from within the eyeball to the surface so they can easily be picked out – it really works!
Dad loved to travel in his younger years especially abroad for conventions or just simply leisure or vacations, most of the time with my mom. But as he was getting older, travels became uncomfortable. His last travel with me was in 2012 for the AAO-HNS Convention in Washington DC. It was a great time as we then proceeded to a US Navy Airshow in nearby Virginia after the convention, meeting up with my brother who is retired from the USN. Then we took the train to New York and stayed with my sister who is a PICU nurse in NY Presbyterian. Then off to Missouri and Ohio visiting the National Museum of the US Air Force, the largest military aircraft museum in the world.
For years, Dad had been battling with heredofamilial-hypercholesterolemia problem which took its toll on his liver and made him weak and tired but still he practiced and continued teaching and sharing his knowledge until he retired at the age of 80. By then, my wife and I would take him and my mom out on weekends, he loved to be driven around and eat in different places. I really witnessed and have seen how he suffered from his illness in his final years. But he never showed it or complained, never even wanted to use a cane! He didn’t want to be a burden to anyone. What most affected me was that my dad passed and I wasn’t even there. I had helped call for a physician to rush to the house and had oxygen cylinders to be brought for him as his end stage liver cirrhosis was causing cardio-pulmonary complications (non-COVID). Amidst all this I was the one admitted for 14 days because of COVID-19 pneumonia. My dad passed away peacefully at home as I was being discharged from the hospital. He was 88. I never reached him just to say good bye and cried when I reached home still dyspneic recovering from the viral pneumonia. I realized from my loved ones who told me that dad didn’t want me to stress out taking care of him, as I’ve been doing ever since, but instead to rest and recuperate myself. I cried again with that thought. In my view, he was not only a great Physician and Surgeon but also the greatest Dad. He lived a full life and touched so many lives with his treatments, charity services and teaching new physicians. It’s seeing, remembering and carrying on what he showed and taught us that really makes us miss him. I really love and miss my dad and with a smile on my face, I see he’s also happy to be with his brothers and sisters who passed on ahead. And that he’s rested. He is a man content, I remember he always said this, ‘ As long as I have a roof over my head and a bed to rest my back, I’m okay!”
46
Croghan, Stefanie M., Paul Carroll, Paul F. Ridgway, Amy E. Gillis, and Sarah Reade. "Robot-assisted surgical ward rounds: virtually always there." BMJ Health & Care Informatics 25, no. 1 (January 2018): 41–56. http://dx.doi.org/10.14236/jhi.v25i1.982.
Full textAbstract:
BackgroundWhile an explosion in technological sophistication has revolutionised surgery within the operating theatre, delivery of surgical ward-based care has seen little innovation. Use of telepresence allowing offsite clinicians communicate with patients has been largely restricted to outpatient settings or use of complex, expensive and static devices. We designed a prospective study ascertaining feasibility and face validity of a remotely controlled mobile audiovisual drone (LUCY) to access inpatients. This device is, uniquely, lightweight, freely mobile and emulates ‘human’ interaction by swiveling and adjusting height to patients’ eye-level.MethodsRobot-assisted ward rounds (RASWRs) were conducted over 3 months. A remotely located consultant surgeon communicated with patients/bedside teams via encrypted audiovisual telepresence robot (DoubleRobotics, Burlingame, CA). Likert-scale satisfaction questionnaires, incorporating free-text sections for mixed-methods data collection, were disseminated to patient and staff volunteers following RASWRs. The same cohort completed a linked questionnaire following conventional (gold-standard) rounds, acting as a control group. Data were paired and non-parametric analysis was performed.ResultsRASWRs are feasible (>90% completed without technical difficulty). The RASWR (n = 52 observations) demonstrated face validity with strong correlations (r > 0.7; Spearman, p-value < 0.05) between robotic and conventional ward rounds among patients and staff on core themes, including dignity/confidentiality/communication/satisfaction with management plan. Patients (96.08%, n = 25) agreed RASWR were a satisfactory alternative when consultant physical presence was not possible. There was acceptance of nursing/non-consultant hospital doctor cohort [100% (n = 11) willing to regularly partake in RASWR].ConclusionRASWRs receive high levels of patient and staff acceptance, and offer a valid alternative to conventional ward rounds when a consultant cannot be physically present.
47
Lilley, Andrew. "O9 Are parents and patients happy to see an advanced paediatric pharmacist practitioner (APPP)?" Archives of Disease in Childhood 104, no. 7 (June 19, 2019): e2.61-e2. http://dx.doi.org/10.1136/archdischild-2019-nppc.9.
Full textAbstract:
IntroductionPharmacist independent prescribers have become common in both community and hospital environments. However most prescribing courses contain limited clinical skills and diagnosis training.1 2 NHS England conducted a study to assess the benefit of having pharmacists in the Emergency department (ED). They found that in order to have the biggest impact pharmacists would need additional training above that of an independent prescriber particularly clinical examination and diagnosis skills.3 One pharmacist from the audit hospital completed the post graduate certificate in Advanced Emergency Medicine at Manchester University. The assessments taught included Respiratory, Gastroenterology, Musculoskeletal, Neurological and ENT examinations.Additionally, it required 210 hours of in practice training. On completion of the course the local centre had no resources to appoint an APPP in ED. Instead the APPP took up the role within the respiratory team due to experience within this speciality. An APPP now reviews new and follow up patients in clinic as well as those acutely ill. As this was a new role it was decided to perform an audit of parent perception of the role.MethodsQuestions were integrated into every consultation for a two month period. Pre clinic: Are you happy to see the pharmacist today instead of the consultant? (Yes/No/Will wait to see outcome) Post clinic: Did you think a pharmacist could perform this role? (Yes/No). Do you feel like you need to see the consultant still? (Yes/No) Were you happy with the consultation? (Yes/No) Further commentsResults132 separate consultations were included. 45 of these were new referrals, 67 were follow up appointments and 20 acute examinations. In 124 consultations parents stated they would decide if they needed to see the consultant after. Of these all were happy with the outcome post consultation and did not see the consultant. 9 parents had no reservations to the pharmacist running the consultation from the outset and remained happy post consultation. 126 stated they did not realise a pharmacist could perform this role. Comments received included ‘I had no idea a pharmacist could perform clinical examinations’; ‘At first I had reservations however if the hospital felt comfortable with you running clinic I am happy’; ‘You took the time to make us feel at ease’; ‘You are always approachable when my child is acutely unwell…you know our child better than any ED doctor and would rather see you’.ConclusionAs with Advanced Nurse Practitioners (ANPs) it will take time for parents and patients to adapt to a pharmacist diagnosing and managing them instead of a doctor. This audit has shown the pre-conceptions of what a pharmacist can do could hold some back; however after seeing the pharmacist all were happy with the consultation. This is an exciting new role for pharmacists however it is essential to undertake advanced clinical and diagnosis skills in order to make it a successful.Referenceshttp://www.edgehill.ac.uk/health/cpd-modules/non-medical-prescribing-v300-2 (accessed June 2018)https://www.ljmu.ac.uk/study/cpd/other-cpd-courses/non-medical-prescribing (accessed June 2018)Pharmacists in Emergency Departments - A commissioned study by health education England. available via: https://www.rpharms.com/Portals/0/RPS%20document%20library/Open%20access/Policy%20statements/PIED%20National%20Report.pdf?ver=2016-10-13-150131-640
48
Adams, Alayne Mary, Rushdia Ahmed, Tanzir Ahmed Shuvo, Sifat Shahana Yusuf, Sadika Akhter, and Iqbal Anwar. "Exploratory qualitative study to understand the underlying motivations and strategies of the private for-profit healthcare sector in urban Bangladesh." BMJ Open 9, no. 7 (July 2019): e026586. http://dx.doi.org/10.1136/bmjopen-2018-026586.
Full textAbstract:
ObjectivesThis paper explores the underlying motivations and strategies of formal small and medium-sized formal private for-profit sector hospitals and clinics in urban Bangladesh and their implications for quality and access.MethodsThis exploratory qualitative study was conducted in Dhaka, Sylhet and Khulna City Corporations. Data collection methods included key informant interviews (20) with government and private sector leaders, in-depth interviews (30) with clinic owners, managers and providers and exit interviews (30) with healthcare clients.ResultsProfit generation is a driving force behind entry into the private healthcare business and the provision of services. However, non-financial motivations are also emphasised such as aspirations to serve the disadvantaged, personal ambition, desire for greater social status, obligations to continue family business and adverse family events.The discussion of private sector motivations and strategies is framed using the Business Policy Model. This model is comprised of three components:products and services, and efforts to make these attractive including patient-friendly discounts and service-packages, and building ‘good’ doctor-patient relationships;the market environment, cultivated using medical brokers and referral fees to bring in fresh clientele, and receipt of pharmaceutical incentives; and finally,organisational capabilities, in this case overcoming human resource shortages by relying on medical staff from the public sector, consultant specialists, on-call and less experienced doctors in training, unqualified nursing staff and referring complicated cases to public facilities.ConclusionsIn the context of low public sector capacity and growing healthcare demands in urban Bangladesh, private for-profit engagement is critical to achieving universal health coverage (UHC). Given the informality of the sector, the nascent state of healthcare financing, and a weak regulatory framework, the process of engagement must be gradual. Further research is needed to explore how engagement in UHC can be enabled while maintaining profitability. Incentives that support private sector efforts to improve quality, affordability and accountability are a first step in building this relationship.
49
Khan, Bushra Asif Ali, Faiza Muzahir, Sahar Abdul Rauf, Syeda Rubab Fatima, Abida Pervaiz, and Sadaf Jamil. "Trends of Self-Medication Amongst the Patients Visiting the Out-Patient Department of Combined Military Hospital, Lahore." esculapio 17, no. 1 (March 29, 2021): 30–33. http://dx.doi.org/10.51273/esc21.2516.
Full textAbstract:
Objective: The purpose of our study was to assess the trends of self-medication practices and to determine the prevalence, characteristics, related factors, and effects of self-medication among the patients conducted. Methods: This descriptive cross-sectional study was on patients of Combined Military Hospital Lahore on a sample size of 365. The data was collected and entered in a predesigned questionnaire about self-medication later analyzed using SPSS version 17.0. Results: The prevalence of self-medication was 95.3% and effectiveness was 87.7%. The common reasons for self-medication were prior knowledge of usefulness of remedy (63.3%), non-affordability of consultant charges (18.4%), and lack of time (21.9%). Frequently used medicines included antibiotics (30.1%), analgesics (69.6%), antipyretics (51.0%), and antihistamines (23.6%). Respondents claimed to receive information about these drugs from various sources including doctor (38.6%), previous prescription (31.8%), retailer seller (13.4%), family/friends (43.6%), media (7.9%) and other sources (1.6%). Conclusion: It had been concluded that there is a high prevalence of self-medication. There is a need to raise public awareness about the appropriate use in order to prevent potential hazards of self-medication. Key Words: trends, self-medication, out-patient department How to cite: Khan B.A.A, Muzahir F, Rauf S.A, Fatima S.R, Pervaiz A, Jamil S. Trends of self- medication amongst the patients visiting the out-patient department of Combined Military Hospital, Lahore. Esculapio.2021. 30-33
50
Ali Khan, Bushra Asif, Faiza Muzahir, Sahar Abdul Rauf, Syeda Rubab Fatima, Abida Pervaiz, and Sadaf Jamil. "Trends of Self-Medication Amongst the Patients Visiting the Out-Patient Department of Combined Military Hospital, Lahore." Esculapio 17, no. 1 (March 29, 2021): 30–33. http://dx.doi.org/10.51273/esc21.251716.
Full textAbstract:
Objective: The purpose of our study was to assess the trends of self-medication practices and to determine the prevalence, characteristics, related factors, and effects of self-medication among the patients conducted. Methods: This descriptive cross-sectional study was on patients of Combined Military Hospital Lahore on a sample size of 365. The data was collected and entered in a predesigned questionnaire about self-medication later analyzed using SPSS version 17.0. Results: The prevalence of self-medication was 95.3% and effectiveness was 87.7%. The common reasons for self-medication were prior knowledge of usefulness of remedy (63.3%), non-affordability of consultant charges (18.4%), and lack of time (21.9%). Frequently used medicines included antibiotics (30.1%), analgesics (69.6%), antipyretics (51.0%), and antihistamines (23.6%). Respondents claimed to receive information about these drugs from various sources including doctor (38.6%), previous prescription (31.8%), retailer seller (13.4%), family/friends (43.6%), media (7.9%) and other sources (1.6%). Conclusion: It had been concluded that there is a high prevalence of self-medication. There is a need to raise public awareness about the appropriate use in order to prevent potential hazards of self-medication. Key Words: trends, self-medication, out-patient department How to cite: Khan B.A.A, Muzahir F, Rauf S.A, Fatima S.R, Pervaiz A, Jamil S. Trends of self- medication amongst the patients visiting the out-patient department of Combined Military Hospital, Lahore. Esculapio.2021. 30-33