Hospital vocational training Local audits are helpful

Rickenbach, Mark; Hicks, Randolph D.; Hargreaves, Simon

doi:10.1136/bmj.309.6948.196a

Cited by 3 publications

(1 citation statement)

References 2 publications

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“…The management, with views of maintaining delivery of good quality medical service to the community, should review the reports from the authorities and encourage audits on pain control and conduct regular training sessions to develop a positive and constructive outlook on patient feedback to enhance the quality. The infrastructure should be excellent, and it is the stakeholder’s responsibility to ensure this quality [ 22 , 23 ].…”

Section: Discussionmentioning

confidence: 99%

An Observational Study to Assess Postoperative Pain Control and Formulate a Comprehensive Approach to the Implementation of Policy Change for Pain Control in Postoperative Units

Venkatesan¹,

Thulasiraman²,

Kesavan³

et al. 2022

Cureus

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Background Postoperative pain control irrespective of the magnitude of surgery has always remained a challenge for clinicians and healthcare workers. Good postoperative pain control is pivotal for unremarkable recovery and shorter hospital stays. Unfortunately, there is no uniform approach across the globe to address postoperative pain control. This provoked our thought to conduct a prospective observational study in our center to assess the already existing efficacy of pain management. Materials and methods This is a prospective observational study conducted in a tertiary care center in Coimbatore, India. The aim of this study is to assess the efficacy of an ongoing pain management system to compare it with standards in the literature to introduce changes and re-examine the results. A total of 100 patients who underwent major surgical procedures from various specialities were included after satisfying the inclusion criteria. The study was conducted over a period of four months to collect data from patients in the postoperative ward. Data were collected, pain-related variables were tabulated, and deficits were identified. Standardized pain assessment tools were not used. The results suggested the need for a policy change for quality improvement. This article gives reports on initial study results and plans to address the deficits in the current pain management system. A systematic and schematic approach for the implementation of the policy change and the framework for the new acute pain service team aiming at quality improvement have been discussed in detail. Results The results show that 28 patients were prescribed only routine paracetamol and rescue nonsteroidal anti-inflammatory drugs (NSAIDs). At rest, 56 patients had some pain, and 29 complained of moderate to severe pain. On movement, only seven patients had no pain, 48 had mild pain, and 45 had moderate to severe pain. Only 12 patients out of 100 had good sleep, 27 had moderate, and 43 had little sleep. Twelve patients had no sleep due to continuous ongoing pain in spite of ongoing pain control modalities. Sixteen patients complained of undue delay in receiving their analgesics. Twenty-two patients were dissatisfied, and 44 suggested the need for improvement of current pain control strategies. These data clearly suggest that the pain control strategies are inadequate and need improvement undoubtedly for quality improvement. The Wendy Hirsch model is chosen to create a framework for implementing a new change, and a detailed report is done to present to the hospital quality control department. These changes will be done after the approval, and a post-implementation outcome will be studied. Conclusion Good postoperative pain control is of paramount significance for both patients and healthcare professionals. With the current availability of various pain relief modalities, one should consider establishing a pain control pathway, if possible an acute pain team with a systematic a...

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Section: Discussionmentioning

confidence: 99%

An Observational Study to Assess Postoperative Pain Control and Formulate a Comprehensive Approach to the Implementation of Policy Change for Pain Control in Postoperative Units

Venkatesan¹,

Thulasiraman²,

Kesavan³

et al. 2022

Cureus

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Innovative training posts: trust-attached general practice registrars

Rickenbach¹,

Mullee

Smith

et al. 2006

Education for Primary Care

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WHAT IS ALREADY KNOWN IN THIS AREA • Research suggests that traditional GP. SHO education has little or no contact with general practice during the hospital years, something viewed negatively by GP trainees. It also Suggests that the quality of training is variable, due, among other things, to heavy service commitment, and the lack of structured educational input and support. WHAT THIS WORK ADDS • This study reports a pilot of an innovative training programme that sought to address the problems previously identified with traditional GP SHO training. The posts were found to be popular and successful, offering integrated training between primary and secondary care' during the SHO years. SUGGESTIONS FOR FUTURE RESEARCH • Innovative training posts offer a much-needed way to extend the menu of training opportunities for general. practice, and further work is needed 18 explore-how they can be developed forther, as well as to continue to monitor the quality and development of the trust-attached posts now in existence in Severn and Wessex.

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Senior house officer training

Bunch

Bahrami

Macdonald

et al. 1997

BMJ

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Editor-I welcome the publication of the open letter to the prime minister about tobacco-the most important preventable cause of death in Europe. 1 As Jo E Asvall points out in the letter, tobacco control demands the support of, and action by, the total government, not just the Department of Health. Among the actions Asvall calls for is that "support for smoking cessation is made widely available, particularly through primary health care professionals, including doctors, nurses, pharmacists, and dentists."Nicotine replacement therapy (nicotine gum, patches, nasal spray, and oral inhaler) is now fully established as an effective adjunct to such professional advice and support. Systematic review of many trials has shown a doubling of sustained smoking cessation when nicotine replacement therapy is compared with placebo. 2 The offer of nicotine patches to motivated subjects for a week in the first instance could be a useful policy. 3 But the recommendation of such therapy by health professionals and the use of such therapy by smokers are severely limited by NHS "blacklisting." I can prescribe on the NHS for alcohol problems and even obesity. I can also prescribe for tobacco addiction-but only products of unproved efficacy for this problem, such as tranquillisers and antidepressants, not one of proved effectiveness. Why not nicotine replacement therapy? So much for evidence based medicine.

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Hospital vocational training Local audits are helpful

Cited by 3 publications

References 2 publications

An Observational Study to Assess Postoperative Pain Control and Formulate a Comprehensive Approach to the Implementation of Policy Change for Pain Control in Postoperative Units

An Observational Study to Assess Postoperative Pain Control and Formulate a Comprehensive Approach to the Implementation of Policy Change for Pain Control in Postoperative Units

Innovative training posts: trust-attached general practice registrars

Senior house officer training

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