scholarly journals Are blood tests being performed for new inpatient admissions to a psychiatric hospital as recommended by RCPsych guidelines?

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S98-S98
Author(s):  
Isabella Piper
Keyword(s):  
Physical Health ◽  
Blood Test ◽  
Health Conditions ◽  
Full Blood Count ◽  
Thyroid Function Tests ◽  
Electronic Reminder ◽  
Blood Tests ◽  
Standard Set ◽  
Clinical Records ◽  
Health And Mortality

AimsSevere mental illness (SMI) has a significant impact on a person's physical health and mortality. There is a 10–25-year life expectancy reduction in patients with SMI. The majority of deaths are due to physical health conditions. The Royal College of Psychiatry (RCPsych) sets out a standard that new inpatient admissions to Mental Health Services should have routine blood tests performed within 24 hours of admission, unless they have had a recent blood test. The aim of this audit was to review whether blood tests were performed either in the 48 hours preceding admission or the 48 hours after admission to Leverndale Hospital.MethodClinical records were reviewed for new inpatient admissions to two general adult wards over a four-month period.Result79 patients were admitted (M = 39, F = 40, Age: 18–62 years old). 70/79 (89%) had blood tests performed within the 48-hour timeframe. 5/79 (6%) had a blood test performed after 48 hours of their admission. 4/79 (5%) did not have a blood test. The blood tests performed varied. 51/75 (68%) patients had at least one abnormal blood test. The yield of abnormal blood results ranged from 2% for thyroid function tests to 35% for a full blood count.ConclusionThis audit has established that the majority of patients had blood tests performed within the 48-hour timeframe. This could be improved by setting up an electronic reminder to prompt the clinician to perform a blood test at 24 hours as per RCPsych guidance if one had not yet been done. The blood tests performed varied. RCPsych guidance does not specify which blood tests should be done. A further scope for this audit could be to review the clinical significance of abnormal blood results to develop a standard set of blood tests for admission.

scholarly journals Audit on monitoring physical health of patients on mood stabilisers following NICE guidelines

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S104-S105
Author(s):  
Sathyan Soundararajan ◽  
Asha Dhandapani ◽  
Claire Jones
Keyword(s):  
Physical Health ◽  
Practice Guidelines ◽  
Health Monitoring ◽  
Good Practice ◽  
Patient Case ◽  
Nice Guidelines ◽  
Blood Tests ◽  
Retrospective Audit ◽  
Clinical Records

AimsThe aim is to find out if the physical health monitoring is adhered to in accordance with NICE guidelines in individuals with Intellectual disability who are on mood stabilisers and known to LD services.MethodWe sought to explore if the physical health monitoring for prescribing mood stabilisers in a sample of people with ID was consistent with good practice guidelines.We collected the data by reviewing the clinical records of individuals with LD who were under the care of mental health services in the CLDT- Wrexham and prescribed a mood stabiliser drug. We also contacted the patient's carers who came to outpatients and by calling the GP surgery and enquiring about the details. We also assessed the Welsh clinical portal in order to assess the blood tests.Data were collected by trainee doctors in Psychiatry. This was a retrospective audit, looking at data from Learning Disability psychiatry caseload. We identified about 16 patients on mood stabilisers.ResultPhysical health monitoring for prescribing mood stabilisers was almost consistent with good practice guidelines. This has shown that the majority of the monitoring has complied. There are few lacunae, such as Thyroid function not being monitored every 6 months for patients on Lithium, Serum Carbamazepine levels not being monitored as per guidelines with 1 patient not having blood done at all whilst on Carbamazepine. Moreover, the details are not readily available for the Consultant/ team when needed, thus making it very tedious for them to search/ contact the GP, etc.ConclusionMedications such as mood stabilisers can increase the risk further if the patient's physical health is not monitored regularly. This can lead to compromised quality of life for the patient and in some cases increased morbidity. Hence we have come up with a proforma that can be attached to patient case notes. This will serve as a record for us and prompt for physical monitoring. We will keep a database online with reminders set. This is to ensure a continuity of care for the patients.

Subgroups Of At-risk Workers With Chronic Physical Health Conditions: From The Manage At Work Trial

2017 ◽  
Author(s):  
Susan E. Peters ◽  
William S. Shaw ◽  
Elyssa Besen ◽  
Robert K. McLellan ◽  
Torill H. Tveito
Keyword(s):  
At Risk ◽  
Physical Health ◽  
Health Conditions

Blood Analysis Requests of Patients’ and Clinical Reflections in Primary Care

2020 ◽  
Vol 9 (2) ◽  
pp. 96-102
Author(s):  
Zerrin Gamsizkan ◽  
Mehmet Ali Sungur ◽  
Yasemin Çayır
Keyword(s):  
Chronic Disease ◽  
Blood Test ◽  
Family Health ◽  
Cross Sectional Study ◽  
Blood Analysis ◽  
Primary Role ◽  
Cross Sectional ◽  
High Expectations ◽  
Blood Tests ◽  
Study Results

Aim: The aim of the study is to determine the factors that may affect the demands of patients who come with the request to have a blood test without any chronic disease or a planned examination check. Methods: The data of this descriptive, cross-sectional study, were collected with a questionnaire that was prepared to examine the opinions of the patients who claim to have a blood test by coming to the family health center without any complaints. Patients over 18 years of age, who did not have any chronic disease and had no scheduled examination appointments were included in the study. Results: A total of 278 patients who wanted to have a blood test within the 6-months period were included in the study. Female patients who wanted to have a blood test were significantly more than male patients. When we look at the causes of patients who wanted to have a blood test; 61.2% (n=170) patients stated that they are concerned about their health and 6.1% (n=17) stated that they were affected by media warnings. There was no significant relationship between the frequency of blood test requests of patients and their age, gender, education, and general health status. Conclusion: Patients with high expectations and anxiety may be more willing to perform blood tests at inappropriate intervals. Family physicians, whose primary role is preventive medicine, have consultancy and information duties in order to protect their patients from the risk of over-examination and diagnosis. Keywords: blood tests, patient, screening, routine diagnostic tests

scholarly journals Causes of death and comorbidities in hospitalized patients with COVID-19

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Sefer Elezkurtaj ◽  
Selina Greuel ◽  
Jana Ihlow ◽  
Edward Georg Michaelis ◽  
Philip Bischoff ◽  
...  
Keyword(s):  
Cause Of Death ◽  
Causes Of Death ◽  
Pulmonary Infection ◽  
Diffuse Alveolar Damage ◽  
University Hospital ◽  
Health Conditions ◽  
Teaching Hospitals ◽  
Increased Risk ◽  
Clinical Records ◽  
Full Body

AbstractInfection by the new corona virus strain SARS-CoV-2 and its related syndrome COVID-19 has been associated with more than two million deaths worldwide. Patients of higher age and with preexisting chronic health conditions are at an increased risk of fatal disease outcome. However, detailed information on causes of death and the contribution of pre-existing health conditions to death yet is missing, which can be reliably established by autopsy only. We performed full body autopsies on 26 patients that had died after SARS-CoV-2 infection and COVID-19 at the Charité University Hospital Berlin, Germany, or at associated teaching hospitals. We systematically evaluated causes of death and pre-existing health conditions. Additionally, clinical records and death certificates were evaluated. We report findings on causes of death and comorbidities of 26 decedents that had clinically presented with severe COVID-19. We found that septic shock and multi organ failure was the most common immediate cause of death, often due to suppurative pulmonary infection. Respiratory failure due to diffuse alveolar damage presented as immediate cause of death in fewer cases. Several comorbidities, such as hypertension, ischemic heart disease, and obesity were present in the vast majority of patients. Our findings reveal that causes of death were directly related to COVID-19 in the majority of decedents, while they appear not to be an immediate result of preexisting health conditions and comorbidities. We therefore suggest that the majority of patients had died of COVID-19 with only contributory implications of preexisting health conditions to the mechanism of death.

scholarly journals 236 Novel Guidelines to Avoid Routine Blood Tests After Robotic Assisted Radical Prostatectomy (RARP)

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
A Nathan ◽  
N Hanna ◽  
A Rashid ◽  
S Patel ◽  
Y Phuah ◽  
...  
Keyword(s):  
Blood Test ◽  
Open Surgery ◽  
Clinical Judgement ◽  
Robotic Assisted ◽  
Blood Tests ◽  
Routine Blood ◽  
Operative Complications ◽  
Robotic Assisted Radical Prostatectomy ◽  
The Uk ◽  
Post Operative Complications

Abstract Introduction Patients undergoing RARP commonly require routine post-operative blood tests. This practice dates from an era of open surgery, with increased blood loss and complications. We aim to improve specificity of blood test requests with novel guidelines. Method 1039 consecutive RARP patients at two tertiary urology centres in the UK were audited. Novel guidelines constructed based on risk stratified evidence from the initial audit were used to prospectively audit 133 patients. Results 16% had clinical concerns post-operatively. 1% and 4% had an intra- and post-operative complication. Intra- or post-operative clinical judgement flagged post-operative complications in 99.9%. 80% had routine blood tests with no clinical concerns. 6% had delayed discharge due to delayed processing of blood tests. 0.9% received a peri-operative transfusion. Re-Audit Novel guidelines reduced the number of blood tests requested from 100% to 36%. Specificity in diagnosing a complication improved from 0% to 67%. Discharge delays reduced from 6% to 0% and no post-operative complications were missed (sensitivity 100%). Conclusions Routine blood tests, without an indication, did not flag any additional post-operative complications. Blood transfusion is rare for RARP. Novel guidelines to request post-operative blood tests will reduce costs and discharge delays whilst maintaining appropriate patient safety and care.

scholarly journals The use of routine blood tests to assist the diagnosis of COVID-19 in symptomatic hospitalized patients

2021 ◽  
pp. 000456322199907
Author(s):  
IT Parsons ◽  
AT Parsons ◽  
E Balme ◽  
G Hazell ◽  
R Gifford ◽  
...  
Keyword(s):  
Cell Count ◽  
Retrospective Review ◽  
Blood Test ◽  
Patient Flow ◽  
White Cell Count ◽  
Area Under The Curve ◽  
White Cell ◽  
Test Results ◽  
Rt Pcr ◽  
Blood Tests

Introduction Specific patterns of blood test results are associated with COVID-19 infection. The aim of this study was to identify which blood tests could be used to assist in diagnosing COVID-19. Method A retrospective review was performed on consecutive patients referred to hospital with a clinical suspicion of COVID-19 over a period of four weeks. The patient’s clinical presentation and severe acute respiratory syndrome coronavirus 2 reverse-transcription polymerase chain reaction (SARS-CoV-2 RT-PCR) were recorded. The patients were divided by diagnosis into COVID (COVID-19 infection) or CONTROL (an alternate diagnosis). A retrospective review of consecutive patients over a further two-week period was used for the purposes of validation. Results Overall, 399 patients (53% COVID, 47% CONTROL) were analysed. White cell count, neutrophils and lymphocytes were significantly lower, while lactate dehydrogenase and ferritin were significantly higher, in the COVID group in comparison to CONTROL. Combining the white cell count, lymphocytes and ferritin results into a COVID Combined Blood Test (CCBT) had an area under the curve of 0.79. Using a threshold CCBT of –0.8 resulted in a sensitivity of 0.85 and a specificity of 0.63. Analysing this against a further retrospective review of 181 suspected COVID-19 patients, using the same CCBT threshold, resulted in a sensitivity of 0.73 and a specificity of 0.75. The sensitivity was comparable to the SARS-CoV-2 RT PCR. Discussion Mathematically combining the blood tests has the potential to assist clinical acumen allowing for rapid streaming and more accurate patient flow pending definitive diagnosis. This may be of particular use in low-resource settings.

Predicting abnormal laboratory blood test results in the intensive care unit using novel features based on information theory and historical conditional probability (Preprint)

2021 ◽  
Author(s):  
Camilo E. Valderrama ◽  
Daniel J. Niven ◽  
Henry T. Stelfox ◽  
Joon Lee
Keyword(s):  
Machine Learning ◽  
Intensive Care ◽  
Conditional Probability ◽  
Blood Test ◽  
Laboratory Tests ◽  
Conditional Entropy ◽  
Admission Diagnosis ◽  
Test Results ◽  
Abnormal Laboratory ◽  
Blood Tests

BACKGROUND Redundancy in laboratory blood tests is common in intensive care units (ICU), affecting patients' health and increasing healthcare expenses. Medical communities have made recommendations to order laboratory tests more judiciously. Wise selection can rely on modern data-driven approaches that have been shown to help identify redundant laboratory blood tests in ICUs. However, most of these works have been developed for highly selected clinical conditions such as gastrointestinal bleeding. Moreover, features based on conditional entropy and conditional probability distribution have not been used to inform the need for performing a new test. OBJECTIVE We aimed to address the limitations of previous works by adapting conditional entropy and conditional probability to extract features to predict abnormal laboratory blood test results. METHODS We used an ICU dataset collected across Alberta, Canada which included 55,689 ICU admissions from 48,672 patients with different diagnoses. We investigated conditional entropy and conditional probability-based features by comparing the performances of two machine learning approaches to predict normal and abnormal results for 18 blood laboratory tests. Approach 1 used patients' vitals, age, sex, admission diagnosis, and other laboratory blood test results as features. Approach 2 used the same features plus the new conditional entropy and conditional probability-based features. RESULTS Across the 18 blood laboratory tests, both Approach 1 and Approach 2 achieved a median F1-score, AUC, precision-recall AUC, and Gmean above 80%. We found that the inclusion of the new features statistically significantly improved the capacity to predict abnormal laboratory blood test results in between ten and fifteen laboratory blood tests depending on the machine learning model. CONCLUSIONS Our novel approach with promising prediction results can help reduce over-testing in ICUs, as well as risks for patients and healthcare systems. CLINICALTRIAL N/A

Should Strengthening Bonds Be a Public Health Priority?

2021 ◽  
Vol 28 (2) ◽  
pp. 79-87
Author(s):  
Valerie M. Wood ◽  
Heather Stuart
Keyword(s):  
Physical Activity ◽  
Health Behaviors ◽  
Physical Health ◽  
Social Interactions ◽  
Social Relationships ◽  
Health Conditions ◽  
Emotional Bonds ◽  
Important Health ◽  
Negative Social Interactions

Abstract. Background: Previous research demonstrates the importance of close relationships on our physical health. However, to what extent the quality of our social relationships impacts our health, relative to other important health behaviors (e.g., smoking, drinking alcohol, and physical exercise), is less clear. Aims: Our goal was to use a nationally representative sample of Canadian adults to assess the relative importance of the quality of one’s social relationships (close emotional bonds and negative social interactions), relative to important health behaviors on physical health outcomes previously linked to social relationship quality. Method: Data ( N = 25,113) came from the Canadian Community Health Survey in 2012, a cross-sectional survey administered by Statistics Canada (2013) . The predictor variables were the presence of close emotional bonds, negative social relationships, type of smoker, type of drinker, and weekly hours of physical activity. The outcome variables were a current or previous diagnosis of high blood pressure, cancer, stroke, reports of current illness or injury, pain, and self-reported physical health. Results: Using regressions, we found that negative social interactions were more important than other health behaviors in relation to current injury/illness and pain. Physical activity was most strongly related to self-rated health, followed by negative social interactions and then close emotional bonds. Alcohol consumption was more related to the prevalence of stroke. Conclusions: Our findings suggest that negative social interactions may be more related to acute or minor physical health conditions, but social relationships may not be more strongly related to more chronic, life-threatening health conditions than other health behaviors.

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