solution of gum and finely triturated chalk, was applied. This dned quickly, and formed a hard, snugly-fitting case. At the end of the third month the cure was complete : the shape of the limb perfect; the actions of supination and pronation smooth and free ; and the only restriction of motion, and this of small degree, was noticed in extenso-flexion, and which I ascribed to the injury that had been sustained by the os magnum, for upon pressure being applied at its site, the patient still experienced some tenderness. From the long confinement of the limb, the hand had become small and delicate, and its muscular strength much diminished; but the symmetry of the limb was unaffected. The patient was invalided in order that he might have light z , duty in harbour service at home, and so be placed under the ' , most favourable circumstances for the recovery of his strength. Spring-gardens, Oct. 1868. ' A Mirror OF THE PRACTICE OF MEDICINE AND SURGERY IN THE HOSPITALS OF LONDON. GUY'S HOSPITAL. CASES OF OPERATIONS ON THE FOOT. (Under the care of Mr. JOHN BIRKETT.) Nulla autem est alia pro certo noscendi via, nisi quamplurimas et morborum et dissectionum historias, tum aliorum, turn proprias collectas habere, et inter se comparare.—MoB&AajM De Bed. et Cau8. Morb., lib. iv. Proaemiurn. ' resembling "Ma.m") constituted his attempts at speech.
Aim Reported paediatric prescribing error rates are up to 13% and in our trust a baseline audit found our local error rate was 5.4%. A number of these errors are made by non paediatricians prescribing for paediatric patients. We wanted to increase their confidence in paediatric prescribing to try and reduce paediatric prescribing errors. Method We organised interactive case based teaching sessions for both the emergency medicine doctors and surgical doctors who commonly prescribe for our paediatric patients. We asked doctors to self-rate their confidence from strongly agree to strongly disagree with regards to prescribing in paediatrics. We then asked them to self-rate their confidence after the teaching session. Results Prior to the teaching sessions the majority of doctors said they either strongly disagreed or disagreed about their confidence in paediatric prescribing (25 out of 34 doctors). After the teaching sessions all doctors said they either agreed or strongly agreed that the session had increased their confidence in prescribing. Furthermore, we received many positive comments, in particular doctors appreciating the opportunity to practice prescribing for paediatric patients in an interactive environment. A repeat audit has shown a reduction in local error rate to an average of 3.4% from January to September 2018. We feel that the teaching sessions for non-paediatricians have helped to play a role with this. Conclusion Increasing confidence in paediatric prescribing for non-paediatricians is extremely important. We used interactive case studies in our teaching sessions, although we know this does not replicate seeing an actual patient, giving doctors a safe environment in which to learn in and ask questions helped improved confidence in prescribing. We feel that these teaching sessions have also helped to reduce our local error rate.Background Gastrostomy skin related stoma complications in children and young people (CYP) have negative effects and can be managed by a range of people including families, carers, special school staff, nurses and doctors. Within one educational institution we noted variations in practice, knowledge and leadership in gastrostomy problems management, this project was to explore reasons for this.No local or nationally recognised guidance were identified to help consistent management. Aims and objectives To evaluate current knowledge around gastrostomy complications and confidence of staff involved in managing these.
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