The New Zealand medical journal
-
Comparative Study
Passing the buck: clinical handovers at a tertiary hospital.
To survey house officers and nurses regarding timing, structure and content of clinical handover and compare these results. Secondary aims included the development of an 'on-call' sheet and the development of guidelines for handovers from the results collated. ⋯ In this study, we identified that health professionals perceive that clinical problems can be attributed to poor clinical handover. The majority of respondents in the study felt that an effective handover system should include a set location for handover, a standardised 'on-call' sheet and training related to handovers.
-
To estimate the effectiveness of colorectal cancer screening with faecal occult blood testing (FOBT), flexible sigmoidoscopy (FS), and combinations of FOBT and FS in preventing colorectal cancer (CRC) deaths. ⋯ There is high-quality evidence showing that guaiac-based FOBT screening reduces mortality from CRC. No such evidence exists for screening with FS either alone, or in combination with FOBT, but this should be re-evaluated once data become available from four large ongoing trials.
-
Comparative Study
The influence of hospital environment on postoperative length of stay following major colorectal surgery.
Elective colorectal resection is associated with a postoperative stay (LOS) of 7-10 days. Counties Manukau District Health Board (DHB) has two sites for elective colorectal surgery: Manukau Surgery Centre (MSC)-a stand-alone elective surgical site; and Middlemore Hospital (MMH)-a general hospital. MSC opened in 2001 and it was noted that patients recovered more quickly there than patients operated on at MMH. It was thus our aim to identify if LOS following major elective colorectal surgery is influenced by hospital environment. ⋯ Because MSC and MMH are both part of the same DHB, share the same surgeons, and service an identical population, it can be concluded that environmental differences are likely to be influential in the recovery process. However, further research is required to elucidate the significance of individual factors.
-
To quantify the proportion of emergency department (ED) discharges that could have been managed in primary care, and to determine the consistency with which healthcare professionals assess cases as 'primary care appropriate'. ⋯ Our study has shown retrospectively that a significant number of ED presentations may have been managed in primary care. However this was determined with knowledge of investigation results and final diagnosis, by clinicians who had poor agreement about individual cases. In reality, triage nurses in ED have only the presenting complaint. This study shows how variable clinicians can be in determining primary care appropriateness even with full clinical details.