Irish journal of medical science
-
Although the General Medical Council has published guidelines for procedural consent, there is evidence to suggest that deficiencies still occur in completion demographics, documentation of procedural risks and information regarding alternative therapies. We assessed the accuracy and completeness of vascular consent within our unit. ⋯ Vascular consent is a complex process involving a number of discussions and meetings with patients. Our unit has demonstrated compliance of nearly 90% for all consent-related processes and remains consistent with current GMC guidance. However, further improvement including the documentation of intended benefits, provision of additional written information whilst reducing the use of abbreviations is desired.
-
High incidence of difficult or failed intubation in obstetric patients is still a major problem to challenge anaesthesiologists. Although the probability of difficult intubation is impossible to predict preoperatively, some simple, practical bedside tests may help. This study used five simple tests in an attempt to better evaluate airway changes in pregnant women before and after delivery. ⋯ Within 24 h after delivery, Mallampati scores changed in one-third (n 21, 36.6%) of the patients. Significant differences between the two measurements of thyromental and sternomental distances, mouth opening, and the degree of neck extension confirm difficult airway management in pregnant women.
-
Few studies have investigated regional variation in medication-taking behaviour. The purpose of this study was to investigate whether there are regional differences in non-persistence and non-adherence to oral anti-hyperglycaemic agents in patients initiating therapy and examine if any association exists between different types of comorbidity in terms of medication-taking behaviour. ⋯ Interventions to optimise medication-taking in patients with T2DM should be implemented nationally to improve the overall level of adherence and persistence, especially in patients with no comorbidity.
-
Award incentives encourage higher standards of personal performance, which closely reflects the quality of patient care. We report the development, implementation, and success of our internal medicine department awards program. ⋯ In summary, we feel that this transparent, objective, and peer-nominated awards program could serve as an incentivized model for healthcare providers to elevate the standards of personal performance, which in turn will benefit the advancement of patient care.
-
Venous thromboembolism (VTE) is a common complication of hospital admission. The incidence of hospital-acquired deep vein thrombosis is approximately 10-40% amongst medical and general surgical patients without prophylaxis. Pulmonary embolism accounts for 5-10% of deaths in hospitalised patients, making hospital-acquired VTE the most common preventable cause of in-hospital death. Studies suggest that prophylactic measures are widely under- and inappropriately used. ⋯ Compliance with VTE guidelines is inadequate. Medication charts with specific sections on VTE assessment and prophylaxis may increase compliance with guidelines.