Internal medicine journal
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Internal medicine journal · Oct 2009
Comparative StudyExamination of opioid prescribing in Australia from 1992 to 2007.
Opioid prescribing is controversial with evidence of both significant under-utilization and over-utilization. There is some evidence to support efficacy for chronic non-malignant pain, but community and individual harms are increasingly reported. ⋯ Opioid use is increasing. There is a pressing need for co-ordinated assessment of efficacy and harms to facilitate quality usage of opioids.
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Internal medicine journal · Oct 2009
Comparative StudyThe development and implementation of the pathway for improving the care of the dying in general medical wards.
The majority of deaths in Australia occur in general hospital wards and most are neither sudden nor unexpected. The Pathway for Improving the Care of the Dying (PICD) is an adaptation of the Liverpool Care Pathway to the Australian healthcare setting (or 'to Australian conditions') and is designed to help ensure a 'good death' for patients dying outside the palliative care system. PICD consists of a series of prompts, guidelines, revised medical and nursing care plans and a number of medication algorithms.
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Internal medicine journal · Sep 2009
ReviewPreventing healthcare-associated infection: risks, healthcare systems and behaviour.
More than 177 000 potentially preventable healthcare-associated infections (HAIs) occur per annum in Australia with sizable attributable mortality. Organizational systems to protect against HAI in hospitals in Australia are relatively poorly developed. Awareness and practice of infection control by medical and other healthcare staff are often poor. ⋯ They are also potentially effective system engineers who can embed safer practices in all elements of patient care and promote essential structural and organizational change. Patients and the public in general are becoming increasingly aware of the risk of infection when entering a hospital and expect their carers to adhere to safe practice. Poor infection control practice will be regarded in a negative light by patients and their families, regardless of any other manifest skills of the practitioner.
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Internal medicine journal · Sep 2009
Understanding organ donation in the collaborative era: a qualitative study of staff and family experiences.
Despite the success of the Breakthrough Collaborative Methodology (BCM) in increasing organ donation rates there has been little published evidence on the effect of the BCM on the wider attitudes and experiences of those involved in organ donation. This study sought to identify whether the National Organ Donation Collaborative in Australia had any additional influence on improving the experiences of staff and family members in the organ donation process. ⋯ This study identified valuable insights into the processes by which family members and intensive care unit staff deal with the actual processes of donation. Findings suggest that the process for families is far more complex than a simple agreement or refusal to donate. This study suggests that we should not assume that 'rates' of donation in Australia would increase merely through administrative programmes or marketing campaigns.