发布求助
文献互助 智能选刊 最新文献

Acute Medicine最新文献

筛选
英文 中文
Becoming the medical registrar: a qualitative study of a professional transition as a transformative learning event 成为一名医疗注册员:一项定性研究，将专业过渡作为一种变革性的学习事件
Acute Medicine Pub Date : 2023-07-01 DOI: 10.52964/amja.0949
Zachary Ferguson, Rebecca Selman
{"title":"Becoming the medical registrar: a qualitative study of a professional transition as a transformative learning event","authors":"Zachary Ferguson, Rebecca Selman","doi":"10.52964/amja.0949","DOIUrl":"https://doi.org/10.52964/amja.0949","url":null,"abstract":"Background: The medical registrar is a daunting role to take on for the first time. While studies have explored how preparedness can be improved through simulation, less has been written about how doctors learn to be registrars through clinical practice. Method: Doctors working as medical registrars were invited to participate in semi-structured interviews. The qualitative data collected underwent thematic analysis. Results: The clinical environment was considered fertile ground for transformative experiential learning, but opportunities for debriefing and guided reflection were rare. Participants felt they needed additional support from supervisors after difficult experiences and mistakes, but this support was not always forthcoming. Conclusion: Acute physicians involved in supervising new medical registrars must facilitate meaningful independent practice to encourage the next generation of medical generalists.","PeriodicalId":39743,"journal":{"name":"Acute Medicine","volume":"59 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135807307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Society for Acute Medicine’s Patients: Learning from Experience Report (SAM-PLER) A service evaluation of patient reported experience in Acute Medicine – establishing the feasibility of a quality improvement collaborative 急性医学患者学会:从经验报告中学习(SAM-PLER)对急性医学患者报告经验的服务评估-建立质量改进协作的可行性
Acute Medicine Pub Date : 2023-07-01 DOI: 10.52964/amja.0948
Christian Peter Subbe, Catherine Atkin, Adnan Gebril, Latif Raiyan Rahman, Ragit Varia
{"title":"Society for Acute Medicine’s Patients: Learning from Experience Report (SAM-PLER) A service evaluation of patient reported experience in Acute Medicine – establishing the feasibility of a quality improvement collaborative","authors":"Christian Peter Subbe, Catherine Atkin, Adnan Gebril, Latif Raiyan Rahman, Ragit Varia","doi":"10.52964/amja.0948","DOIUrl":"https://doi.org/10.52964/amja.0948","url":null,"abstract":"Patient reported experience measures (PREMS) are a key part of measured quality. There is no tool currently used in the UK in Acute Medicine. On the 8th of September 2022 10 units based in England, Scotland and Wales collected data for the validated PREM, alongside the EQ-5D and variables from the Society for Acute Medicine’s Benchmarking Audit (SAMBA) dataset. 365 patients were screened, 200 were included (55%): 159 patients from AMUs and 41 from SDEC units. Overall experience of patients was rated 8.5/10, patients rated their experience of safety, trust and listening highly. Collection of PREMS was feasible. Further research is required to link experience to clinical outcome and explore tools that capture experience of patients with altered mental status.","PeriodicalId":39743,"journal":{"name":"Acute Medicine","volume":"101 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135807304","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A whole healthcare system mortality review of the second wave COVID-19 pandemic response, were lessons learned? 对第二波COVID-19大流行应对的整个医疗系统死亡率进行审查，是否吸取了教训?
Acute Medicine Pub Date : 2023-01-01 DOI: 10.52964/AMJA.0932
Jeremy W Tankel, David Ratcliffe, Martin Smith, Clare Hindley, Andrew Mullarkey, Dee Waterhouse, Andrea Riley, Darren Green
{"title":"A whole healthcare system mortality review of the second wave COVID-19 pandemic response, were lessons learned?","authors":"Jeremy W Tankel,&nbsp;David Ratcliffe,&nbsp;Martin Smith,&nbsp;Clare Hindley,&nbsp;Andrew Mullarkey,&nbsp;Dee Waterhouse,&nbsp;Andrea Riley,&nbsp;Darren Green","doi":"10.52964/AMJA.0932","DOIUrl":"https://doi.org/10.52964/AMJA.0932","url":null,"abstract":"<p><p>We previously reported a study of features of emergency healthcare response to COVID-19 that could be modified to mitigate against future excess deaths. Here we determined what themes persisted in later waves. This was an expert panel review of all components of care delivered to COVID-19 patients who died (primary and secondary care, community services, NHS 111 and 999, COVID oximetry at home, virtual wards). 174 deaths were included. 5% were deemed >50% avoidable, 75% included avoidability themes. Contact with primary care remains mostly via telephone, creating diagnostic risk. Patient decision to avoid healthcare contact was common. Recommendations include: better utilisation of home monitoring in future pandemics; improved avoidance of nosocomial spread; patients be encouraged to seek medical advice earlier.</p>","PeriodicalId":39743,"journal":{"name":"Acute Medicine","volume":"22 1","pages":"39-46"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9289134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Quantitative assessment of the relative effects of patient and pulmonary embolism-related factors on longer-term mortality after pulmonary embolism. 定量评估患者和肺栓塞相关因素对肺栓塞后长期死亡率的相对影响。
Acute Medicine Pub Date : 2023-01-01
I Le Jeune, R Hubbard
{"title":"Quantitative assessment of the relative effects of patient and pulmonary embolism-related factors on longer-term mortality after pulmonary embolism.","authors":"I Le Jeune, R Hubbard","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>This observational study used a large audit dataset to examine the relative effects of patient-related factors and those related to the pulmonary embolism (PE) on longer-term mortality after PE. We identified that longer-term mortality is higher in provoked compared to unprovoked PE and that, in this group, obesity is relatively protective. Simplified PE severity index (sPESI), known to link to short term mortality, remains predictive in the longer-term and there is no relationship of mortality to right heart strain or extent of clot. Interestingly mortality is higher in those with negative CTPA scans than those with PE. These clinically important results should encourage careful, holistic clinical assessment of patients in these groups prior to discharge to look for treatable comorbidities.</p>","PeriodicalId":39743,"journal":{"name":"Acute Medicine","volume":"22 4","pages":"188-194"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139571618","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Wilson's disease - a tricky diagnosis on the acute take. 威尔逊氏病——急性发作时的疑难诊断。
Acute Medicine Pub Date : 2023-01-01 DOI: 10.52964/AMJA.0941
J Baker, S Chakraborty, R Buccoliero, S Thakur
{"title":"Wilson's disease - a tricky diagnosis on the acute take.","authors":"J Baker,&nbsp;S Chakraborty,&nbsp;R Buccoliero,&nbsp;S Thakur","doi":"10.52964/AMJA.0941","DOIUrl":"https://doi.org/10.52964/AMJA.0941","url":null,"abstract":"<p><p>Wilson's disease is a rare genetic disorder that affects copper metabolism in the body, leading to excess copper accumulation in various organs, including the liver and brain. It often presents to both primary and secondary care, with a combination of liver disease and neurological or psychiatric symptoms, but the presentation can be highly variable. Early recognition and treatment of Wilson's disease is important to prevent critical hepatic and neurological complications. In this case report, we describe the presentation of an 18-year-old male university student with a combination of dysphagia, tremors, and slurred speech, which progressed over several months. Through a series of investigations, the patient was diagnosed with Wilson's disease and received appropriate treatment. This report highlights the importance of considering Wilson's disease in patients with a wide range of symptoms and the need for a pragmatic approach to diagnosis, including routine and additional testing as necessary.</p>","PeriodicalId":39743,"journal":{"name":"Acute Medicine","volume":"22 2","pages":"96-100"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9621789","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Acute Medicine: How will we grow? - An analysis of organisational capabilities for quality improvement, research & education from SAMBA 2021. 急性医学：我们将如何成长SAMBA 2021对质量改进、研究和教育的组织能力的分析。
Acute Medicine Pub Date : 2023-01-01
G K Galloway, C P Subbe, M Holland, C Atkin
{"title":"Acute Medicine: How will we grow? - An analysis of organisational capabilities for quality improvement, research & education from SAMBA 2021.","authors":"G K Galloway,&nbsp;C P Subbe,&nbsp;M Holland,&nbsp;C Atkin","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Education, research, and Quality Improvement (QI) are key enablers for high quality care. We aimed to map the capability of Acute Medical Units (AMUs) to facilitate excellence in these areas.</p><p><strong>Methods: </strong>AMUs were surveyed in an organisational questionnaire within the Society for Acute Medicine Benchmarking Audit 2021.</p><p><strong>Results: </strong>143 units participated. 80 units had a QI lead, 24 had a research lead and 99 had a medical education lead. 15 units had all three leadership roles. Most QI work considered service structure rather than changes in processes or care outcomes.</p><p><strong>Conclusion: </strong>The organisational capability of AMUs in the strategic areas considered is variable. Improving leadership and disseminating learning could help build a strategic foundation for acute medicine to grow.</p>","PeriodicalId":39743,"journal":{"name":"Acute Medicine","volume":"22 3","pages":"130-136"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41159822","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A retrospective observational study investigating safety netting documentation in the emergency department. 调查急诊科安全网文件的回顾性观察研究。
Acute Medicine Pub Date : 2023-01-01
C H Wood, R Whiticar
{"title":"A retrospective observational study investigating safety netting documentation in the emergency department.","authors":"C H Wood, R Whiticar","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Safety netting is an important aspect of medical practice, especially for first contact clinicians. Adequate safety netting provision and documentation is vital for optimal patient care and medicolegal security. This is the first study to report safety netting documentation practices in the emergency department, a specialty with a variety of high-acuity presentations and which is particularly vulnerable to medicolegal issues.</p><p><strong>Methods: </strong>A retrospective observational study was conducted at University Hospital Wales (UHW) Emergency Department (ED) in the months January-February and August 2023. Randomized paper notes review was performed for adult patients who were discharged from the ED without admission to hospital. Patient characteristics, time of consultation, grade of emergency medicine practitioner (EMP) and presence/level of safety netting documentation was recorded. The statistical software STATA was used to identify any associations between these factors on safety netting practices.</p><p><strong>Results: </strong>A total of 500 notes were included. Safety netting advice was documented in 45% of consultations (n=224). This was 'basic' in 166 cases, 'general' in 32, 'specific' in 15 and both 'general and specific' in 11. Frequency of safety netting documentation was higher for ages < 65 years and consultations within working hours (09:00 - 17:00).</p><p><strong>Conclusion: </strong>This study shows that there is no 'universal' level of safety netting documentation amongst practicing EMPs. Although there is well-established guidance about when, what and how safety netting should be provided, there is little guidance in terms of documentation details. Further audit and quality improvement to embed safety netting documentation in ED clerking is required to further improve safety netting practices.</p>","PeriodicalId":39743,"journal":{"name":"Acute Medicine","volume":"22 4","pages":"195-200"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139571598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Real-world characteristics and outcomes of patients with intermediate high risk acute pulmonary embolism. 中高危急性肺栓塞患者的真实世界特征和预后。
Acute Medicine Pub Date : 2023-01-01 DOI: 10.52964/AMJA.0936
Ajc Overgaauw, L J Meijboom, J van Es, E J Lust, E H Serne, Pwb Nanayakkara, Y M Smulders, A J Kooter, R W Sprengers, H J de Grooth, R J Lely, A Thijs, A Vonk Noordegraaf, Lma Heunks, Pwg Elbers, H J Bogaard, P R Tuinman, E J Nossent
{"title":"Real-world characteristics and outcomes of patients with intermediate high risk acute pulmonary embolism.","authors":"Ajc Overgaauw, L J Meijboom, J van Es, E J Lust, E H Serne, Pwb Nanayakkara, Y M Smulders, A J Kooter, R W Sprengers, H J de Grooth, R J Lely, A Thijs, A Vonk Noordegraaf, Lma Heunks, Pwg Elbers, H J Bogaard, P R Tuinman, E J Nossent","doi":"10.52964/AMJA.0936","DOIUrl":"10.52964/AMJA.0936","url":null,"abstract":"<p><strong>Background: </strong>Exact benefits of currently recommended close monitoring in intermediate high risk acute pulmonary embolism (PE) patients are unknown.</p><p><strong>Methods: </strong>This prospective observational cohort study determined clinical characteristics, and disease course of intermediate high risk acute PE patients in an academic hospital setting . Frequency of hemodynamic deterioration, use of rescue reperfusion therapy and PE related mortality, were outcomes of interest.</p><p><strong>Results: </strong>Of 98 intermediate high risk PE patients included for analysis, 81 patients (83%) were closely monitored. Two deteriorated hemodynamically and were treated with rescue reperfusion therapy. One patient survived after this.</p><p><strong>Conclusions: </strong>In these 98 intermediate high risk PE patients, hemodynamic deterioration occurred in three patients and rescue reperfusion therapy of two closely monitored patients led to survival of one. Underlining the need for better recognition of patients benefitting from and research in the optimal way of close monitoring.</p>","PeriodicalId":39743,"journal":{"name":"Acute Medicine","volume":"22 2","pages":"61-66"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9621787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The COVID-19 pandemic has not affected the mortality for patients admitted with pneumonia in Denmark. COVID-19大流行并未影响丹麦入院的肺炎患者的死亡率。
Acute Medicine Pub Date : 2023-01-01 DOI: 10.52964/AMJA.0934
Mikkel Brabrand, Christian B Laursen, Marianne Fløjstrup, Søren Bie Bogh
{"title":"The COVID-19 pandemic has not affected the mortality for patients admitted with pneumonia in Denmark.","authors":"Mikkel Brabrand,&nbsp;Christian B Laursen,&nbsp;Marianne Fløjstrup,&nbsp;Søren Bie Bogh","doi":"10.52964/AMJA.0934","DOIUrl":"https://doi.org/10.52964/AMJA.0934","url":null,"abstract":"<p><p>During the COVID-19 pandemic, several hospital systems observed a reduction in patients with respiratory complaints. Using the Danish national registers, we conducted an observational study on disease severity and 30-day all-cause mortality for acutely admitted pneumonia patients before (3/19-3/20) and during (3/20-2/21) the pandemic. We calculated mortality rate ratios and Cox regression analyses. We identified 54,405 patients and during the pandemic, patients were older, more likely to be male, had more co-morbidity and a lower albumin on admission. Crude mortality was higher during the pandemic (8.4 vs. 6.9%). Adjusted hazard ratio for 30-day all-cause mortality was 1.07 (95%CI 1.01-1.14). We showed a small but significant, increase in mortality risk for patients admitted to hospital during the COVID-19 pandemic in Denmark.</p>","PeriodicalId":39743,"journal":{"name":"Acute Medicine","volume":"22 1","pages":"50-52"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9289141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Centralization of emergency hospital care is not associated with increased in-hospital mortality; a population-based cohort study. 医院紧急护理的集中化与院内死亡率的增加无关;一项基于人群的队列研究。
Acute Medicine Pub Date : 2023-01-01 DOI: 10.52964/AMJA.0928
Søren Bie Bogh, Jonathan Harbak, Marianne Fløjstrup, Lars Morsø, Mikkel Brabrand, Mickael Bech
{"title":"Centralization of emergency hospital care is not associated with increased in-hospital mortality; a population-based cohort study.","authors":"Søren Bie Bogh,&nbsp;Jonathan Harbak,&nbsp;Marianne Fløjstrup,&nbsp;Lars Morsø,&nbsp;Mikkel Brabrand,&nbsp;Mickael Bech","doi":"10.52964/AMJA.0928","DOIUrl":"https://doi.org/10.52964/AMJA.0928","url":null,"abstract":"<p><strong>Background: </strong>We describe changes in the distance travelled, the utilization of emergency services, and the inhospital mortality before and after the centralization of hospital emergency services in Denmark.</p><p><strong>Methods: </strong>All unplanned non-psychiatric hospital contacts from adults (aged ≥18 years) in 2008 and 2016 are included. Analyses are age-standardized and conducted at a municipality level. The municipalities are divided into groups according to the presence of emergency hospital services.</p><p><strong>Results: </strong>Municipalities where hospitals with emergency services have been closed differed by having the most significant increase in distance travelled from 2008 to 2016. All groups experienced a reduction in overall in-hospital mortality. The reduction in mortality was not present for acute myocardial infarct contacts from municipalities where hospitals with emergency services have been closed.</p><p><strong>Conclusion: </strong>Our data do not suggest that hospital closures, and thereby increased travel distance, have contributed significantly as a barrier to emergency-care access and changes to in-hospital mortality.</p>","PeriodicalId":39743,"journal":{"name":"Acute Medicine","volume":"22 1","pages":"4-11"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9289140","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
首页 上一页 下一页 尾页
0
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整，为了账户安全，请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
请完成安全验证×
相关产品
×
本文献相关产品
联系我们：info@booksci.cn Book学术提供免费学术资源搜索服务，方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号：604180095
Book学术官方微信
小红书