ObjectivesThere is an increased reliance on online referral systems (ORS) within neurosurgical departments across the UK. Opinions of neurosurgeons on ORS are extensively reported but those of referrers have hardly been sought. Our study aims at ascertaining our referring colleagues’ views on our ORS and its impact on patient care, their opinions on neurosurgeons and how to improve our referral process.Setting14 district general hospitals and one teaching hospital.Participants641 healthcare professionals across a range of medical and surgical specialties including doctors of all grades, nurses and physiotherapists. Survey responses were obtained by medical students using a smartphone application.ResultsAlthough 92% of respondents were aware of the ORS, 74% would routinely phone the on-call registrar either before or after making referrals online. The majority (44%) believed their call to relate to a life-threatening emergency. 62% of referrers considered the ORS helpful in informing patients’ care and 48% had a positive opinion of their interaction with neurosurgical registrars. On ways to improve the ORS, 50% selected email/text confirmation of response sent to referrers and 16% to referring consultants.ConclusionOur results confirm that referrers feel that using our ORS positively impacts patient care but that it remains in need of improvement in order to better suit our colleagues’ needs when it comes to managing neurosurgical patients. We feel that the promotion of neurosurgical education and mitigation of the effects of adverse workplace human factors are likely to achieve the common goal of neurosurgeons and referrers alike: a high standard in patient care.
AimsAnalysis of paediatric burns, including pre-hospital care, presentation and management to the Urgent Care Centre and Accident and Emergency in a district hospital over the course of twelve months for quality improvement.MethodsThe audit was undertaken in partnership with consultant medical staff. A data collection form was produced to collect data on all paediatric burn presentations to emergency care services. Mode of presentation, first aid management and pre-hospital care, patient statistics, description and documentation of the incident, including safeguarding protocols, and management in hospital were documented. 145 cases were recorded, over a twelve month period between 1/11/2014–31/10/2015, with a varied distribution in site and severity of burn.Results63% of patients carried out some form of first aid prior to hospital attendance, but of these only 8.7% completed the STOP protocol, as recommended on National Burns Awareness day. 15% of patients had a clear description of the burn, including parameters such as size, severity and percentage documented patient notes, but 9.7% of documentation of severity was incorrect, and 46.9% had no documentation. Only 1.4% of patients and their guardians received written guidance after presentation on burn aftercare and prevention with 37.9% receiving no information, written or verbal.ConclusionsThe audit revealed three targets of improvement:Public education detailing pre hospital care using the STOP protocol, and after care management.Education of staff, highlighting correct documentation and grading of burns.A policy of provision of written information to patients post presentation.Adoption of these suggestions could affect emergency department attendance and long term prognosis of paediatric burns.
Every day presents new and interesting challenges for Diana Matthews in her role as an Independent School Nurse but she loves every minute of it. From teaching Life Skills and attending meetings, to organizing study days for other School Nurses, life is never quiet or boring.
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