Background Checklists have been shown to reduce morbidity and mortality in medicine by improving documentation and reducing errors. In the modern era of care, where patients are the centre of decision‐making, this study examines patient perception of care and error prevention with the use of ward round checklist. Methods We conducted a prospective stepped‐wedge cluster randomized controlled checklist intervention study using a standardized questionnaire to investigate patients' perception of ward rounds before and after implementation of a ward round checklist. Results A total of 124 patients completed the questionnaire. The overall percentage of items endorsed increased significantly by 5.1% from 64.8% to 70.0% (P = 0.014). Statistically significant improvements were seen in patients knowing their diagnosis (P = 0.027), the day's plan (P = 0.038), observing a medication chart (P < 0.001) and observation chart review (P = 0.008). Conclusion Our study indicates that the use of a ward round checklist leads to patient‐perceived improvements in aspects of quality of care.

Purpose: To investigate whether non-immersive virtual reality interventions, either as an adjunct or an alternative to traditional therapy, can improve physical outcomes in rehabilitation. Methods: We searched MEDLINE (1950 to present), CINAHL (1981, AMED (1985 to present), EMBASE (1947 to present), Web of Science, PEDro, and Cochrane (no date limitation). Randomized controlled trials which explored the effects of non-immersive virtual reality on physical outcomes (physical function, movement, and balance) in populations of any age, sex, ethnicity or health condition, receiving rehabilitation were selected for review. We included virtual reality interventions that did not fully immerse the user; full immersion was defined as 'a psychological state characterized by perceiving oneself to be enveloped by, included in, and interacting with an environment that provides a continuous stream of stimuli and experiences'. Results: Sixteen randomized controlled trials were identified which matched inclusion and exclusion criteria. These studies explored the use of non-immersive virtual reality on physical outcomes in the rehabilitation of persons with stroke, cardiopulmonary conditions, cerebral palsy, osteoarthritis, and balance disorders. Conclusion: There is growing evidence for the usefulness of non-immersive virtual reality as an adjunct to conventional therapy on physical outcomes particularly in stroke rehabilitation. There is little evidence to suggest that non-immersive virtual reality is more effective than conventional rehabilitation on physical outcomes in all populations included for review.

Background: Clopidogrel is the recommended P2Y12 inhibitor in ST-elevation myocardial infarctions (STEMIs) treated with thrombolysis. Current available evidence (from the recently published Ticagrelor in Patients With ST-Elevation Myocardial Infarction Treated With Pharmacological Thrombolysis [TREAT] Trial; May 2018) supports the use of ticagrelor 12 hours post-thrombolytic therapy but does not provide data allowing its use before then. This approach is echoed by major international guidelines. The aim of this audit was to investigate current practices regarding P2Y12 inhibitors given within 12 hours of a fibrinolytic agent in thrombolysed STEMIs in Waikato District Health Board (WDHB).Method: A retrospective analysis of P2Y12 inhibitor use was conducted of all thrombolysed STEMIs of patients domiciled in WDHB between 1 January and 31 December 2018 (as recorded by All New Zealand Acute Coronary Syndrome Quality Improvement [ANZACS-QI]) and who either initially presented to satellite hospitals (Taumaranui, Te Kuiti, Tokoroa, or Thames) or who were thrombolysed in the community and subsequently transferred to Waikato Hospital. Thirty of 177 STEMIs in WDHB patients received thrombolysis.Results: In this cohort of thrombolysed STEMIs, clopidogrel was given in 40% (n = 12/30), ticagrelor was given in 43% (n = 13/30), and no P2Y12 inhibitor was given in 17% (n = 5/30). There was one bleeding-related death due to intracranial haemorrhage after receiving ticagrelor (3 h) post-thrombolysis.Conclusion: Despite the small sample size, this audit demonstrates significant heterogeneity in current practice in WDHB around P2Y12 inhibitor use in thrombolysed STEMIs. A previously created algorithm for administering thrombolysis in WDHB is no longer readily available. A future audit should re-examine P2Y12 inhibitor administration practices across WDHB after implementation and dissemination of a clear STEMI thrombolysis algorithm.

No abstract