Clinical medicine (London, England)
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Although COVID-19 was first recognised as an acute respiratory illness, extra-pulmonary manifestations are increasingly being recognised. Acute gastrointestinal side effects have been well reported with COVID-19 infection and are estimated to affect around 17% of patients. With COVID-19 still being a relatively new illness, the chronic gastrointestinal symptoms are less well characterised. ⋯ We have conducted one of the few UK studies on gastrointestinal symptoms, with the longest follow-up duration of 6 months. We have found that gastrointestinal symptoms are common at 6 months, affecting 43.8% of our patients. Further research is needed to explore whether this represents a new post-COVID-19 IBS, which has not previous been described in the literature, including its clinical course and response to any potential medical therapies.
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The safe hospital administration of oxygen has been shown to improve outcomes for specific patient groups, including those with chronic obstructive pulmonary disease (COPD). Oxygen prescribing is therefore recognised as a quality standard within the COPD Clinical Audit of the National Asthma and Chronic Obstructive Pulmonary Disease Programme. ⋯ This confirmed the complexity of the socio-technical healthcare system in which care is delivered and the variability of steps in the process, and provided new potential interventions to improve the safe administration of oxygen. The use of human factors tools within QI projects may help bridge normative models of work-as-prescribed and inductive models of work-as-done to support improvement and sustainability of care delivery interventions.
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A new UK medical postgraduate curriculum prompted the creation of a novel national medical postgraduate 'boot camp'. An enhanced simulation-based mastery learning (SBML) methodology was created to deliver procedural skills teaching within this national boot camp. This study aimed to explore the impact of SBML in a UK medical boot camp. ⋯ An enhanced SBML methodology in a boot camp model enabled streamlined, standardised procedural skill teaching to a national cohort of junior doctors. Training curricular competencies were achieved alongside increased skill confidence.
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One in three deaths of people who are homeless are preventable. The morbidity and mortality of people who are homeless is shocking. With people who are homeless having a higher rate of emergency department attendance and hospital admission compared with the general population, we have a unique opportunity to change their health and their life. ⋯ Teaching sessions on the health of people who are homeless and the HAT were given to doctors and nurses. Feedback commended the HAT's comprehensiveness, ease of use, and utility in assessing and managing a patient who is homeless. As such, the HAT is accepted as a standard by the Faculty for Homeless and Inclusion Health, further demonstrating its merits in assessing patients who are homeless.