scholarly journals Droperidol dropped; consultants not consulted

2003 ◽  
Vol 27 (8) ◽  
pp. 301-304 ◽  
Author(s):  
Gavin Reid ◽  
Mark Hughson
Keyword(s):  
Questionnaire Survey ◽  
Clinical Care ◽  
Postal Questionnaire ◽  
Clinical Implications ◽  
The West ◽  
Abrupt Withdrawal ◽  
Before And After ◽  
Adequate Evaluation ◽  
Psychiatric Profession ◽  
The Impact

Aims and MethodWe conducted a postal questionnaire survey of the practice of rapid tranquillisation among 215 consultant psychiatrists in the West of Scotland, before and after the withdrawal of droperidol by the manufacturer.ResultsOne hundred and eighty questionnaires (84% of those sent) were returned. Droperidol had been used extensively, often combined with lorazepam, for rapid tranquillisation. The main replacement suggested for droperidol was haloperidol. About half of the respondents to our survey chose to comment on the withdrawal of droperidol. More than half of the comments were unfavourable, including lack of an adequate replacement and lack of consultation with the psychiatric profession.Clinical ImplicationsThe abrupt withdrawal of droperidol, partly for commercial reasons, was regrettable. There was no time for an adequate evaluation of possible replacement medications and a lack of consultation with the profession regarding the impact on clinical care.

scholarly journals Droperidol dropped; consultants not consulted

2003 ◽  
Vol 27 (08) ◽  
pp. 301-304
Author(s):  
Gavin Reid ◽  
Mark Hughson
Keyword(s):  
Questionnaire Survey ◽  
Clinical Care ◽  
Postal Questionnaire ◽  
Clinical Implications ◽  
The West ◽  
Abrupt Withdrawal ◽  
Before And After ◽  
Adequate Evaluation ◽  
Psychiatric Profession ◽  
The Impact

Aims and Method We conducted a postal questionnaire survey of the practice of rapid tranquillisation among 215 consultant psychiatrists in the West of Scotland, before and after the withdrawal of droperidol by the manufacturer. Results One hundred and eighty questionnaires (84% of those sent) were returned. Droperidol had been used extensively, often combined with lorazepam, for rapid tranquillisation. The main replacement suggested for droperidol was haloperidol. About half of the respondents to our survey chose to comment on the withdrawal of droperidol. More than half of the comments were unfavourable, including lack of an adequate replacement and lack of consultation with the psychiatric profession. Clinical Implications The abrupt withdrawal of droperidol, partly for commercial reasons, was regrettable. There was no time for an adequate evaluation of possible replacement medications and a lack of consultation with the profession regarding the impact on clinical care.

scholarly journals Psychiatrists' views of evidence-based psychiatric practice

1999 ◽  
Vol 23 (3) ◽  
pp. 159-161 ◽  
Author(s):  
Stephen Carey ◽  
David J. Hall
Keyword(s):  
Decision Making ◽  
Critical Analysis ◽  
Postal Questionnaire ◽  
Clinical Implications ◽  
Evidence Based ◽  
Further Training ◽  
The West ◽  
Effective Care ◽  
Almost All ◽  
Based Medicine

Aims and methodTo determine the attitudes of psychiatrists towards the practice of evidence-based medicine by use of a postal questionnaire. A survey was sent to Consultant Psychiatrists and to Higher Trainees in Psychiatry in the West of Scotland Region.ResultsWhile older influences on decision-making such as tradition and deference still play a part, almost all respondents consider the adoption of more effective care based on best available external evidence desirable; most think it attainable. The technology is generally available, but further training is desired to access the information and its critical analysis.Clinical implicationsEducational activities should increasingly focus on skills for data search and critical analysis.

scholarly journals The recovery approach to care in psychiatric services: staff attitudes before and after training

2010 ◽  
Vol 34 (8) ◽  
pp. 326-329 ◽  
Author(s):  
Gisli H. Gudjonsson ◽  
Gemma Webster ◽  
Timothy Green
Keyword(s):  
Great Majority ◽  
Clinical Implications ◽  
Forensic Mental Health ◽  
The Core ◽  
Knowledge And Attitudes ◽  
Before And After ◽  
Core Components ◽  
Trained Staff ◽  
Recovery Approach ◽  
The Impact

Aims and methodTo investigate the attitude of staff towards the recovery approach in forensic mental health services and the impact of training on staff knowledge and attitudes. A specially constructed 50-item recovery approach staff questionnaire, which focused on the core components of the recovery approach, was completed by 137 members of staff in in-patient forensic services in Lambeth, south London.ResultsStaff were generally very positive about the implementation of the recovery approach in forensic services and those who had received training scored significantly higher on the questionnaire than non-trained staff.Clinical implicationsThe great majority of staff agree that the recovery approach to care does have a place in forensic services. This is important and needs to be built into the implementation of this approach in forensic services.

Improving Patient Safety through the Use of Nursing Surveillance

2017 ◽  
Vol 51 (s2) ◽  
pp. 34-43 ◽  
Author(s):  
Karen K. Giuliano
Keyword(s):  
Patient Care ◽  
Clinical Care ◽  
Warning System ◽  
Rapid Response Team ◽  
Hospital Length ◽  
Rapid Response ◽  
Hospital Length Of Stay ◽  
Clinical Implications ◽  
Response Team ◽  
The Impact

Surveillance and monitoring each represent a distinct process in patient care. Monitoring involves observation, measurement, and recording of physiological parameters, while surveillance is a systematic, goal-directed process based on early detection of signs of change, interpretation of the clinical implications of such changes, and initiation of rapid, appropriate interventions. Through use of an illustrative clinical example based on Early Warning System scoring and rapid response teams, this article seeks to distinguish between nurse monitoring and surveillance to demonstrate the impact of surveillance on improving both care processes and patient care. Using a clinical example, differences between surveillance and monitoring as a trigger for deployment of the rapid response team were reviewed. The use of surveillance versus monitoring resulted in a mean reduction in rapid response team deployment time of 291 minutes. The median hospital length of stay for patients whose clinical care included using surveillance to initiate the deployment of the rapid response team was reduced by 4 days. Monitoring relies on observation and assessment while nursing surveillance incorporates monitoring with recognition and interpretation of the clinical implications of changes to guide decisions about subsequent actions. The clinical example described here supports that the use of an automated surveillance system versus monitoring had a measurable impact on clinical care.

The interface between general and prison psychiatry – the consultant's perception

2002 ◽  
Vol 26 (4) ◽  
pp. 130-132 ◽  
Author(s):  
Sara Smith ◽  
Vincent Baxter ◽  
Martin Humphreys
Keyword(s):  
Psychiatric Care ◽  
Discharge Planning ◽  
Postal Questionnaire ◽  
Psychiatric Services ◽  
Clinical Implications ◽  
The West ◽  
Care Programme ◽  
West Midlands ◽  
Prison Psychiatry

AIMS AND METHODA postal questionnaire was sent to 100 Section 12 (2) approved consultant psychiatrists in the West Midlands to ascertain their perceptions of the role of general psychiatric services in the care of imprisoned patients with mental disorder previously cared for by generic services.RESULTSOf 59 respondents 90% believed they could contribute to the care of imprisoned patients with mental disorders. Ten per cent would delegate total responsibility to specialist forensic services. Lack of awareness of imprisonment of patients was a common problem.CLINICAL IMPLICATIONSInsufficient liaison between prison and general psychiatric services may impede the provision of psychiatric care in prison and prevent discharge planning in line with the Care Programme Approach and current Government guidelines.

scholarly journals Part-time training: will it lead to part-time consultant?

2000 ◽  
Vol 24 (2) ◽  
pp. 64-65 ◽  
Author(s):  
Lucy Caswell ◽  
Kate Lowe
Keyword(s):  
Exponential Growth ◽  
Questionnaire Survey ◽  
Overall Response Rate ◽  
Response Rate ◽  
Workforce Planning ◽  
Clinical Implications ◽  
The West ◽  
Flexible Working ◽  
West Midlands ◽  
Part Time

Aims and MethodTo determine the preference of flexible trainees in psychiatry for consultant posts. A questionnaire survey was conducted among all flexible trainees in psychiatry in the West Midlands Region.ResultsThe overall response rate was 19 out of 21 (90%). The majority 15 out of 19 (68%) hoped to gain such a post at the end of their training. Of those wanting a consultant post, 15 of the 19 (79%) would only consider working part-time. If such a parttime consultant post was not available, 12 of the15 (80%) said they would considera non-career grade post.Clinical ImplicationsIn the West Midlands Region there has been an exponential growth in the number of flexible trainees. Approximately a third are within psychiatry alone and most wish to continue flexible working patterns as consultants. This has major workforce planning implications for the future.

scholarly journals The role of the educational supervisor

2000 ◽  
Vol 24 (6) ◽  
pp. 216-218 ◽  
Author(s):  
Edward Day ◽  
Nick Brown
Keyword(s):  
Response Rate ◽  
Educational Development ◽  
Postal Questionnaire ◽  
Clinical Implications ◽  
The West ◽  
Educational Plan ◽  
West Midlands ◽  
Educational Supervision ◽  
Educational Supervisor

Aims and MethodsA postal questionnaire of all pre-membership psychiatric trainees in the West Midlands was used to investigate the role of the educational supervisor. The trainees were asked about their experience of educational supervision, and also asked to rank a number of possible roles for their supervisor in order of importance.ResultsA response rate of 70% was achieved. Trainees rated regular appraisal and assessment of skills and deficits as the most important role of the educational supervisor, but had only experienced this in 55% of their training posts thus far. Less than half of the respondents had developed a written educational plan with their educational supervisors, and trainees rated this the least important task of good educational supervision.Clinical ImplicationsThe results of this survey inform the training agenda for trainers, and emphasise the need to equip consultants with the skills to appraise their trainee's educational development.

scholarly journals Barriers to mental healthcare for psychiatrists

2006 ◽  
Vol 30 (10) ◽  
pp. 382-384 ◽  
Author(s):  
Alfred White ◽  
Purushottam Shiralkar ◽  
Tariq Hassan ◽  
Niall Galbraith ◽  
Rhiannon Callaghan
Keyword(s):  
Mental Illness ◽  
Mental Healthcare ◽  
Postal Survey ◽  
Clinical Implications ◽  
Vulnerable Group ◽  
The West ◽  
Adequate Treatment ◽  
West Midlands ◽  
Psychiatric Profession

Aims and MethodTo determine the opinions of psychiatrists on mental illness among themselves and their colleagues a postal survey was conducted across the West Midlands.ResultsMost psychiatrists (319/370, 86.2%) would be reluctant to disclose mental illness to colleagues or professional organisations (323/370, 87.3%). Their choices regarding disclosure and treatment would be influenced by issues of confidentiality (n=245, 66%), stigma (n=83, 22%) and career implications (n=128, 35%) rather than quality of care (n=60, 16%).Clinical ImplicationsThe stigma associated with mental illness remains prevalent among the psychiatric profession and may prevent those affected from seeking adequate treatment and support. Appropriate, confidential specialist psychiatric services should be provided for this vulnerable group, and for doctors as a whole, to ensure that their needs, and by extension those of their patients, are met.

scholarly journals How does the outcome of research training fellowships funded via the NHS compare with that from competitively funded fellowships from the MRC and other charities: a cross-sectional retrospective survey of trainees undertaking research training in the West Midlands

BMJ Open ◽  
2018 ◽  
Vol 8 (1) ◽  
pp. e019630
Author(s):  
Charlotte Maybury ◽  
Matthew David Morgan ◽  
Russell Smith ◽  
Lorraine Harper
Keyword(s):  
Clinical Training ◽  
Online Survey ◽  
Research Training ◽  
Clinical Care ◽  
Clinical Work ◽  
Research Experience ◽  
The West ◽  
Cross Sectional ◽  
West Midlands ◽  
The Impact

ObjectivesThis study aimed to investigate the impact of research training funded via the National Health Service (NHS) on medical trainees compared with traditional clinical research training fellowships (CRTFs).Design, setting and participantsOnline survey of 221 clinical trainees who had completed a period of research during their clinical training between 2009 and 2015 in the West Midlands.Main outcome measuresResearch outcomes.ResultsOverall response rate was 59%, of whom 72 participants were funded by CRTFs and 51 funded by the NHS. Although participants with CRTFs were more likely to be awarded a higher degree compared with those on NHS-administered funding (66/72 CRTFs and 37/51 NHS, P=0.005), similar proportions of NHS-funded and CRTF-funded participants entered clinical lecturer posts on completing initial research training (8/51 NHS and 16/72 CRTF, P=0.37). 77% of participants had three or more publications (CRTF 57 and NHS 39, P=0.72). 57 participants had completed clinical training; similar proportions of CRTF-funded and NHS-funded trainees had research included in their consultant contract (12/22 NHS and 14/26 CRTF, P=0.96) or were appointed to academic posts (3 of 25 NHS funded and 6 of 32 CRTF, P>0.05). 95% of participants would recommend to colleagues and 82% of participants felt the research experience improved their provision of clinical care with no difference between CRTF-funded and NHS-funded participants (P=0.49). Continuing to participate in clinical work during the research reduced reports of trainee difficulty on returning to clinical work (23/108 continued clinical work vs 12/22 no clinical work, P=0.001).ConclusionResearch training funded by the NHS provides a quality experience and contributes to the clinical academic capacity within the UK. More needs to be done to support NHS participants to successfully achieve a higher degree.

A regional paleolimnological assessment of the impact of clear-cutting on lakes from the west coast of Vancouver Island, British Columbia

2001 ◽  
Vol 58 (3) ◽  
pp. 479-491 ◽  
Author(s):  
Kathleen Laird ◽  
Brian Cumming ◽  
Rick Nordin
Keyword(s):  
Organic Matter ◽  
Species Composition ◽  
West Coast ◽  
Forest Harvesting ◽  
Diatom Species ◽  
The West ◽  
Clear Cutting ◽  
Before And After ◽  
The Impact ◽  
Reference Lakes

The impact of forest harvesting on lakes within the temperate rainforest on the west coast of Vancouver Island was examined in a paleolimnological study of four lakes that had 35–92% of their watersheds progressively clear-cut over a period of 15–30 years (impact lakes) and four lakes that had experienced little or no known anthropogenic disturbance in their watersheds (reference lakes). Changes in diatom species composition and percent organic matter in the 210Pb-dated sediment cores were compared over the last 100 years in each of the impact lakes before and after the onset of forest harvesting, which began in 1950, and before and after 1950 in the four reference lakes. Only one impact lake showed significant changes in percent organic matter. Significant changes (p < 0.05) in species composition following forest harvesting were detected in all four impact lakes and in one of the four reference lakes. However, the changes in diatom species composition following clear-cutting in the impact lakes were small, with changes in the relative abundance of the most common species being maximally 20%, but more typically 3–10%.

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