scholarly journals Emergency psychiatric assessments: implications for senior house officer training

2006 ◽  
Vol 30 (6) ◽  
pp. 220-222 ◽  
Author(s):  
Alan A. Woodall ◽  
Seren Roberts ◽  
Gary P. Slegg ◽  
David B. Menkes
Keyword(s):  
Retrospective Cohort ◽  
Waiting Times ◽  
District General Hospital ◽  
House Officer ◽  
Psychiatric Training ◽  
Clinical Implications ◽  
Suicidal Risk ◽  
Officer Training ◽  
Out Of Hours ◽  
Self Harm

Aims and MethodIn order to examine the opportunities for senior house officers (SHOs) to undertake emergency psychiatric assessments we conducted a retrospective cohort study of such assessments in a district general hospital.ResultsSenior house officers conducted few assessments for self-harm compared with psychiatric liaison nurses (P< 0.001), and were involved in only 40% of emergency referrals where psychiatric opinion was requested. Senior house officers continue to undertake more assessments out of hours than any other group (P< 0.01).Clinical ImplicationsAlthough the introduction of psychiatric liaison nurses has improved capacity and reduced waiting times for emergency assessment, the opportunity for SHOs to undertake emergency assessments has been reduced, particularly with regard to assessment of suicidal risk following self-harm. These results suggest the need for better monitoring of SHO experience, particularly in the light of service developments that have an impact on psychiatric training.

scholarly journals Psychiatric training of pre-registration house officers

1999 ◽  
Vol 23 (5) ◽  
pp. 283-285 ◽  
Author(s):  
J. M. O'Dwyer
Keyword(s):  
Postal Questionnaire ◽  
House Officer ◽  
Psychiatric Training ◽  
Clinical Implications ◽  
Officer Training ◽  
Almost All

Aims and methodThe aim of the paper is to describe the pre-registration house officer training in psychiatry available in Sheffield. The report is the result of a postal questionnaire, involving all of those who undertook pre-registration house officer training in psychiatry, since the inception of this option.ResultsThe results suggest that the psychiatry option as part of pre-registration house officer training was regarded as useful by almost all undertaking this training. Some of the suggestions to improve the experience are already incorporated into the current posts.Clinical implicationsThe findings support the development of further posts of this type, and such developments may assist in overcoming some of the difficulties in recruitment into psychiatry as a career.

scholarly journals Pre-registration house officer training in psychiatry: the London experience

2003 ◽  
Vol 27 (5) ◽  
pp. 192-194
Author(s):  
Joe Herzberg ◽  
Maryanne Aitken ◽  
Fiona Moss
Keyword(s):  
General Practice ◽  
General Medical Council ◽  
House Officer ◽  
Clinical Implications ◽  
Medical Council ◽  
Officer Training ◽  
Before And After ◽  
Target Skills ◽  
Structured Questionnaire

Aims and MethodTo evaluate whether new pre-registration house officer posts in psychiatry deliver training leading to increased confidence in target skills, based on General Medical Council requirements, and to evaluate trainees' satisfaction with these posts. A structured questionnaire was filled out by the first nine incumbents of the PRHO posts before and after the placements.ResultsTrainees' confidence improved in all the target skills and the posts were all rated as good or excellent. The posts attracted trainees who were potentially interested in a career in psychiatry or general practice.Clinical ImplicationsPRHO posts in psychiatry deliver training that meets General Medical Council objectives, and trainees' confidence with core psychiatric skills improves after undertaking the placements.

scholarly journals Psychiatry at night: experience of the senior house officer

2006 ◽  
Vol 30 (9) ◽  
pp. 329-333 ◽  
Author(s):  
Jules Mason ◽  
Tina Irani ◽  
Garyfallia Fountoulaki ◽  
Sylvia Warwick ◽  
Jane da Roza Davis ◽  
...  
Keyword(s):  
Service Provision ◽  
House Officer ◽  
Adverse Impact ◽  
Clinical Implications ◽  
Senior House Officer ◽  
Training Experience ◽  
Prospective Data ◽  
Out Of Hours ◽  
Senior Nurse ◽  
Working Time Directive

Aims and MethodWe gathered detailed prospective data for first on-call activity of senior house officers (SHOs) in order to help plan changes in service provision so that SHOs in psychiatry complied with the Working Time Directive and to determine whether service changes affected training experience while on call. The incumbent SHOs designed a simple form to monitor on-call activity in West Berkshire.ResultsAdmissions and assessments make up a quarter of calls but three-quarters of the work. An overnight crisis service reduced the number of assessments made by SHOs out of hours by 68%. Screening of calls by a senior nurse reduced the number of calls about in-patients by 60% on weekday nights. Between 73% and 100% of calls about in-patients after midnight were for assessment of patients in seclusion and rapid tranquillisation.Clinical ImplicationsThis survey helped to plan service delivery and to monitor the training of SHOs during on call. Screening of calls by a senior nurse, alternatives to seclusion and nurse-led prescribing for rapid tranquillisation would have the largest impact on the work generated by in-patients. The overnight crisis service reduced the number of assessments, but might have an adverse impact on training.

scholarly journals Pre-registration house officer training in psychiatry: the London experience

2003 ◽  
Vol 27 (05) ◽  
pp. 192-194 ◽  
Author(s):  
Joe Herzberg ◽  
Maryanne Aitken ◽  
Fiona Moss
Keyword(s):  
General Practice ◽  
General Medical Council ◽  
House Officer ◽  
Clinical Implications ◽  
Medical Council ◽  
Officer Training ◽  
Before And After ◽  
Target Skills ◽  
Structured Questionnaire

Aims and Method To evaluate whether new pre-registration house officer posts in psychiatry deliver training leading to increased confidence in target skills, based on General Medical Council requirements, and to evaluate trainees' satisfaction with these posts. A structured questionnaire was filled out by the first nine incumbents of the PRHO posts before and after the placements. Results Trainees' confidence improved in all the target skills and the posts were all rated as good or excellent. The posts attracted trainees who were potentially interested in a career in psychiatry or general practice. Clinical Implications PRHO posts in psychiatry deliver training that meets General Medical Council objectives, and trainees' confidence with core psychiatric skills improves after undertaking the placements.

scholarly journals Patients with first versus multiple episodes of self-harm: how do their profiles differ?

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Philippe Golay ◽  
Louise Ostertag ◽  
Alessandra Costanza ◽  
Bénédicte Van der Vaeren ◽  
Yves Dorogi ◽  
...  
Keyword(s):  
Emergency Department ◽  
Personality Disorder ◽  
Suicide Attempt ◽  
Professional Activity ◽  
Suicidal Risk ◽  
Factors Influencing ◽  
Several Variables ◽  
French Speaking ◽  
Self Harm ◽  
Multiple Episodes

Abstract Background Self-harm (SH) is among the strongest predictors of further episodes of SH, suicide attempt, and death by suicide. People who repeteadly harm themselves are at even higher risk for suicide. Factors influencing the repetition are important to identify when assessing suicidal risk and thereafter to offer specific interventions. Therefore, this study aimed to compare first versus multiple episodes characteristics in a large sample of patients in french-speaking Switzerland. Method We used the database from the French-speaking Swiss program for monitoring SH. Data of the psychiatric assessment of all adults admitted for SH were collected in the emergency department of four Swiss city hospitals between December 2016 and October 2019. Results 1730 episodes of SH were included. Several variables were significantly associated with multiple episodes, including diagnosis (over representation of personality disorders and under representation of anxiety disorders), professional activity (Invalidity insurance more frequent) and prior psychiatry care. Conclusions Patients suffering from a personality disorder and those with invalidity insurance are at risk for multiple episodes of SH and should be targeted with specific interventions.

scholarly journals Adverse medication events in a psychiatric practice: a naturalistic study

2013 ◽  
Vol 37 (12) ◽  
pp. 395-397
Author(s):  
Eugene G. Breen
Keyword(s):  
Adverse Event ◽  
Adverse Events ◽  
Adverse Drug Events ◽  
Psychiatric Training ◽  
Clinical Implications ◽  
Naturalistic Study ◽  
Near Misses ◽  
Significant Events ◽  
Core Module ◽  
Sector Service

Aims and methodTo document the number and type of adverse medication events in a psychiatric sector service. Significant new adverse events were collated by the author and team over 30 months. Intervention to prevent any adverse event was enacted as soon as any were noticed or anticipated.ResultsThirty-six significant events occurred including three deaths and nine near misses. Corrective action was taken immediately any adverse event occurred. Inadequate communication between various hospital clinics, general practitioner practices, psychiatric clinics and pharmacies was the biggest avoidable cause of adverse events.Clinical implicationsAwareness of adverse drug events is essential in psychiatry. Clear, transparent pathways of prescribing are a key requirement to reduce avoidable adverse medication events. Psychopharmacology is a core module for psychiatric training.

It's Getting Better: Progress in Medical Senior House Officer Training in Scotland

2007 ◽  
Vol 52 (1) ◽  
pp. 32-35
Author(s):  
M Roberts ◽  
K McHardy ◽  
J Wakeling ◽  
E Dalgetty ◽  
A Cadzow ◽  
...  
Keyword(s):  
House Officer ◽  
Senior House Officer ◽  
Officer Training

SP9.1.5 Compliance with the NELA pathway at a District General Hospital. Reducing time to theatre by limiting CT-associated delay - A prospective closed loop audit

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Shahrukh Ahmad ◽  
Nazhatul Hasbullah ◽  
Siddhartha Handa ◽  
Panna Patel
Keyword(s):  
Patient Outcomes ◽  
Closed Loop ◽  
Ct Scanning ◽  
District General Hospital ◽  
Electronic Records ◽  
Emergency Laparotomy ◽  
Out Of Hours ◽  
Included Patient ◽  
Ct Protocol ◽  
Reduced Time

Abstract Aim NELA recommends rapid request, conduct and reporting of CT to reduce the delay in time to theatre and thus ultimately improving patient outcomes. Our aim was to identify and reduce delays with regards to CT scanning and reporting. Methods Our Local Laparotomy Pathway standard recommends that CT scans be performed within one hour of being requested and reported within one hour of being performed. NELA data and electronic records were reviewed over a 3 month period (January 2020 to March 2020) - revealing that only 59% of pre-laparotomy CTs done (n = 17) complied with this standard. A dedicated “CT Emergency Laparotomy” protocol was introduced, which assigned the scan as top priority for both radiographers and radiologists. After making this change, data was prospectively collected to see if there was reduced time from CT request to report. Results Compliance with the pathway standard for the three month period from October 2020 to January 2021 increased to 81% (n = 21). Reasons for non-compliance included patient instability, awaiting renal profile; and COVID-related deep cleaning between patients. Out of hours, CT reporting was outsourced, which led to even quicker reporting – with multiple scans being both performed and reported within one hour of the request. Of the 16 patients that fit the criteria for urgent laparotomy, 87.5% (14 patients) were operated on within 6 hours of initial intention to operate. Conclusion Our re-audit showed that after the introduction of a dedicated laparotomy CT protocol, there was reduced time to CT report and ultimately reduced delay to Laparotomy.

The Know-how of Infant Care, by Sylvia Close, S.A.N.C. Bristol, England: John Wright and Sons, Ltd., 1967, 49 pp., $3.50. (The Williams and Wilkins Co., Baltimore, exclusive U.S. agents)

PEDIATRICS ◽  
1969 ◽  
Vol 43 (1) ◽  
pp. 154-154
Author(s):  
Abraham B. Bergman
Keyword(s):  
Child Care ◽  
Child Health ◽  
Health Services ◽  
House Officer ◽  
Child Health Services ◽  
Officer Training ◽  
Know How ◽  
Well Child Care ◽  
Bath Water ◽  
Physician Time

The less physician time spent on routine well child care, the better. The growing demand for child health services without concomitant addition of manpower is forcing pediatricians to focus on tasks which require their unique talents and delegate those which do not to others. Surely medical school and house officer training do not (and should not) prepare one to serve as arbiter of what brand of shoes to purchase, the technique of rinsing diapers, or the correct temperature of bath water.

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