Internal medicine journal
-
Internal medicine journal · Jul 2014
Multicenter Study Comparative Study Observational StudyComparison of not for resuscitation (NFR) forms across five Victorian health services.
Within Australian hospitals, cardiac and respiratory arrests result in a resuscitation attempt unless the patient is documented as not for resuscitation. ⋯ NFR forms should be reviewed and standardised so as to be clear, uniform and consistent with the legislative framework. We propose a two-stage process of documentation. Stage 1 facilitates discussion of patient-specific goals of care and consideration of limitations of treatment. Stage 2 serves to communicate a NFR order. Decisions to withhold resuscitation are inherently complex but could be aided by separating the decision-making process from the communication of the decision, resulting in improved end-of-life care.
-
Internal medicine journal · Jul 2014
Observational StudyAdverse drug events are a major cause of acute medical admission.
Adverse drug events (ADE) contribute significantly to hospital admissions. Prospective New Zealand data are scant, and the ability of clinical coding to identify ADE associated admissions is uncertain. Outcomes after cessation of causative medications are unknown. ⋯ ADE are a common cause of hospital admission. The most frequent problems are postural hypotension and vasovagal syncope, intentional drug misuse and dehydration.
-
Internal medicine journal · Jul 2014
Can hospital-based doctors change their working hours? Evidence from Australia.
To explore factors predicting hospital-based doctors' desire to work less, and then their success in making that change. ⋯ Several factors predict the desire of hospital-based doctors to reduce hours and then their subsequent success in doing so. Designing policies that seek to reduce attrition may alleviate some of the ongoing pressures in the Australian hospital system.
-
Internal medicine journal · Jul 2014
Prognostic value of systemic inflammation-based markers in advanced pancreatic cancer.
The prognostic significance of various systemic inflammation-based markers has been explored in different cancers. These markers can be used to assist with decision-making in oncology clinics. ⋯ Our findings suggest that the NLR, PLR and mGPS derived from routine blood tests can be used as clinically meaningful biomarkers to stratify advanced pancreatic cancer patients into different prognostic groups.