scholarly journals The National Audit of Violence: in-patient care for adults of working age

2006 ◽  
Vol 30 (12) ◽  
pp. 444-446 ◽  
Author(s):  
Robert Chaplin ◽  
Maureen McGeorge ◽  
Paul Lelliott

Aims and MethodWe audited 184 psychiatric wards against clinical practice guidelines for the management of violence. Staff and service users completed anonymous questionnaires. Environmental inspections were performed by two teams.ResultsThere were 4460 questionnaires returned. Nurses (78%) were significantly more likely to report the experience of violence than service users (37%). Drugs were reported by 72% of nurses and alcohol by 61% as causing problems. Other standards frequently not met included staffing levels, training, provision of activities, ward design and ambience.Clinical ImplicationsSpecific issues are identified that must be addressed by national and local action. A baseline is set against which the impact of this action can be judged. Priorities must include tackling drug and alcohol use in psychiatric wards.

2021 ◽  
Author(s):  
Michael T. Barton ◽  
Emile Latour ◽  
Alison Small ◽  
Sabra Leitenberger ◽  
Tracy Funk

2021 ◽  
Vol 11 (3) ◽  
pp. 352-369
Author(s):  
Louisa L. Foss-Kelly ◽  
Margaret M. Generali ◽  
Michael J. Crowley

The consequences of adolescent drug and alcohol use may be serious and far-reaching, forecasting problematic use or addictive behaviors into adulthood. School counselors are particularly well suited to understand the needs of the school community and to seamlessly deliver sustainable substance use prevention. This pilot study with 46 ninth-grade students investigates the impact of the Making Choices and Reducing Risk (MCARR) program, a drug and alcohol use prevention program for the school setting. The MCARR curriculum addresses general knowledge of substances and their related risks, methods for evaluating risk, and skills for avoiding or coping with drug and alcohol use. Using a motivational interviewing framework, MCARR empowers students to choose freely how they wish to behave in relation to drugs and alcohol and to contribute to the health of others in the school community. The authors hypothesized that the implementation of the MCARR curriculum would influence student attitudes, knowledge, and use of substances. Results suggest that the MCARR had a beneficial impact on student attitudes and knowledge. Further, no appreciable increases in substance use during the program were observed. Initial results point to the promise of program feasibility and further research with larger samples including assessment of longitudinal impact.


1996 ◽  
Vol 20 (1) ◽  
pp. 40-42 ◽  
Author(s):  
Claire Palmer

The Clinical Practice Guidelines (CPG) Steering Group commissioned a survey to find out which areas of clinical practice the mental health community view as priority for the development of clinical practice guidelines (CPGs). Fifty per cent of all professionals and service users surveyed considered the assessment of risk and management of deliberate self-harm and dangerousness' a priority area for guideline development. These findings provided the basis for a successful bid to the Department of Health for the development of The Royal College of Psychiatrists' first CPG.


2010 ◽  
Vol 34 (5) ◽  
pp. 181-186 ◽  
Author(s):  
Ankush Singhal ◽  
Deepak Garg ◽  
Alok Kumar Rana ◽  
Miriam Naheed

Aims and methodTo investigate, through a semi-qualitative survey at three geographical sites, health professionals' and service users' opinion about the impact of providing separate consultants for in-patient and community settings. It looked at the perceived affect on various issues such as the course of the illness, service delivery, patients' satisfaction as well as the skills and training of psychiatrists.ResultsOpinion was divided about the level of satisfaction, advantages, consultants' skills and success of this model. The most consistent theme related to the problems with the continuation of care and therapeutic relationship. Most of the respondents were not fully informed about this change. An overwhelming majority believed that in-patient psychiatry is not a separate specialty.Clinical implicationsCommunication and the sharing of information between the two consultants is the key to success in this model.


Blood ◽  
2016 ◽  
Vol 128 (22) ◽  
pp. 5954-5954
Author(s):  
Dominique Farge

Abstract Venous thromboembolism (VTE) is a major therapeutic concern in cancer patients and the leading cause of death after metastasis. Providing anticoagulant therapy to this patient population is challenging because cancer patients are at increased risk of VTE recurrence and bleeding, and treatment management is often complicated by other co-morbidities that affect choice of anticoagulation. The International Initiative on Thrombosis and Cancer (ITAC-CME) is a multidisciplinary group of International academic clinicians, researchers, and experts dedicated to reducing the global burden of VTE and its consequences in cancer patients. In 2013, the group published international clinical practice guidelines for the treatment and prophylaxis of VTE in cancer (1, 2). In collaboration with CME solutions, an accredited CME provider, ITAC-CME developed a mobile web-based application to promote the international implementation of the 2013 guidelines, in English and French (www.itacc-cme.org). Usage of the app has steadily increased every year since its release. ITAC-CME recently revised its consensus recommendations according to a systematic review of the literature up to January 2016. In particular, the ISTH-endorsed updated recommendations provide a guidance on the use of the direct oral anticoagulants based on the current level of evidence (3). ITAC-CME and CME solutions have updated the web-based application to support the 2016 guidelines. The app also includes several new features, including interactive case-based CME learning activities, with pre- and post-activity practice assessments. These pre- and post-test metrics will be documented to record international clinical practice patterns, and monitor the impact of the app on the adoption of the 2016 guidelines into clinical practice worldwide. Translation of the 2016 updated app into additional languages is planned. The application has been submitted for accreditation with the royal College of Physicians and surgeons of Canada, the American Medical Association, the European Union of Medical Specialists, l' Organisme Gestionnaire du Développement Professionnel Continu, and the European Board for Accreditation in Hematology. 1 Debourdeau P, Farge D, Beckers M, Baglin C, Bauersachs RM, Brenner B, Brilhante D, Falanga A, Gerotzafias GT, Haim N, Kakkar AK, Khorana AA, Lecumberri R, Mandala M, Marty M, Monreal M, Mousa SA, Noble S, Pabinger I, Prandoni P, Prins MH, Qari MH, Streiff MB, Syrigos K, Büller HR, Bounameaux H. International clinical practice guidelines for the treatment and prophylaxis of thrombosis associated with central venous catheters in patients with cancer. J Thromb Haemost. 2013 Jan;11(1):71-80. 2 Farge D, Debourdeau P, Beckers M, Baglin C, Bauersachs RM, Brenner B, Brilhante D, Falanga A, Gerotzafias GT, Haim N, Kakkar AK, Khorana AA, Lecumberri R, Mandala M, Marty M, Monreal M, Mousa SA, Noble S, Pabinger I, Prandoni P, Prins MH, Qari MH, Streiff MB, Syrigos K, Bounameaux H, Büller HR. International clinical practice guidelines for the treatment and prophylaxis of venous thromboembolism in patients with cancer.J Thromb Haemost. 2013 Jan;11(1):56-70 3 Farge D, Bounameaux H , Brenner B, Cajfinger F, Debourdeau P, Khorana AA, Pabinger I, Solymoss S, Douketis J, Kakkar A. 2016 International Clinical Practice Guidelines Including Guidance for the Direct Oral Anticoagulants in the Treatment and Prophylaxis of Venous Thromboembolism in Patients With Cancer. Lancet Onccology 2016 (in press) Disclosures No relevant conflicts of interest to declare.


2020 ◽  
Vol 62 (9) ◽  
pp. 712-717
Author(s):  
Renan C. Castillo ◽  
Sara Heins ◽  
Dorianne Feldman ◽  
Eva H. DuGoff ◽  
Eric Roberts ◽  
...  

Author(s):  
Ronen Avraham ◽  
Max M. Schanzenbach

This chapter assesses theory and evidence on the efficacy of medical malpractice liability and limitations to it in improving healthcare outcomes, and identifies unresolved issues that merit further attention from scholars. First, it explores the theoretical and legal background on medical malpractice. It then turns to the available evidence by focusing on three basic areas of study: the impact of malpractice limitations on payouts and litigation, the effect of malpractice limitations on overall healthcare costs, and the effect of malpractice on two major cost drivers in the healthcare system: cardiac and obstetrics practice. It argues that limitations on liability did not and likely cannot significantly reduce healthcare costs. Finally, the chapter discusses new and important trends in the literature regarding reforms to standards of care and the role of clinical practice guidelines and communication and disclosure programs.


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