Internal medicine journal
-
Internal medicine journal · Jul 2021
Adherence to Guidelines Regarding Anticoagulation and Risk Factors for Progression of Atrial Fibrillation in a Nurse-Led Clinic.
Atrial fibrillation (AF) is the commonest cardiac arrhythmia associated with an increased risk of stroke. Evidence suggests that management in a specialty clinic improves clinical outcomes of patients. ⋯ Management of AF in a nurse-led clinic was associated with high level of adherence to anticoagulation guidelines. Age, obesity and excessive alcohol intake were significant predictors for progression of AF.
-
Internal medicine journal · Jul 2021
Supporting cancer care clinicians to 'hold' their patients during and beyond the COVID-19 pandemic: a role for reflective ethics discussions.
The COVID-19 pandemic has placed an overwhelming burden on healthcare delivery globally. This paper examines how COVID-19 has affected cancer care clinicians' capacity to deliver cancer care in the Australian context. We use the lens of 'holding patients' (drawing from attachment theory, psychology and from Australian Indigenous knowledge) to conceptualise cancer clinicians' processes of care and therapeutic relationships with patients. ⋯ They enrich ethical language beyond duties to benefit, avoid harm, respect patients' autonomy and provide just treatment. We consider the disruptive effects of COVID-19 on care delivery and on clinicians themselves. We then show how models of clinical ethics and other similar reflective discussion approaches are a relevant support mechanism to assist clinicians to process and make sense of COVID-19's disruptions to their professional ethical role of holding patients during and beyond the pandemic.
-
Internal medicine journal · Jul 2021
Management of diabetes-related foot disease in the outpatient setting during the COVID-19 pandemic.
The use of telephone and/or video consultation in routine management of acute diabetes-related foot disease (DFD) before the coronavirus disease 2019 (COVID-19) pandemic at a tertiary hospital is unprecedented. In March 2020, the Diabetes Feet Australia (DFA) released a national guideline to inform DFD management during the COVID-19 pandemic. The present study aimed to describe the adherence to the DFA guideline of managing acute DFD using telephone and/or video consultation at a Western Australian tertiary hospital during this period. We found >80% adherence rate to the DFA guideline and the management of active DFD using telephone and/or video consultations was feasible and acceptable in carefully selected patients.