BackgroundThe 2-week wait referral pathway for suspected colorectal cancer was introduced in England to improve time from referral from a general practitioner (GP) to diagnosis and treatment. Patients are required to be seen by a hospital clinician within 2 weeks if their symptoms meet the criteria set by the National Institute for Health and Care Excellence (NICE) and to start cancer treatment within 62 days. To achieve this, many hospitals have introduced a straight-to-test (STT) strategy requiring hospital-based triage of referrals. We describe the impact and learning from a new pathway which has removed triage and moved the process of requesting tests from hospital to GPs in primary care.MethodAn electronic STT pathway was introduced allowing GPs to book tests supported by a decision aid based on NICE guidance eliminating the need for a standard referral form or triage process. The hospital identified referrals as being on a cancer pathway and dealt with all ongoing management. Routinely collected cancer data were used to identify time to cancer diagnosis compared with national dataResults11357 patients were referred via the new pathway over 3 years. Time from referral to diagnosis reduced from 39 to 21 days and led to a dramatic improvement in patients starting treatment within 62 days. Challenges included adapting to a change in referral criteria and developing a robust hospital system to monitor the pathway.ConclusionWe have changed the way patients with suspected colorectal cancer are managed within the National Health Service by giving GPs the ability to order tests electronically within a monitored cancer pathway halving time from referral to diagnosis
Introduction In the national training survey undertaken by the GMC in 2019 the general surgery teaching programme at North Bristol Trust scored 35.24 for local teaching; significantly lower than the national average. We aimed to introduce a teaching programme for foundation doctors on their general surgery rotations to help them meet the objectives set out by The UK Foundation Programme curriculum and gain further insight into general surgery and the roles of allied healthcare professionals. Methods A survey consisting of Likert scale and open ended questions was distributed to foundation doctors at the start and end of their foundation programme placements from August to December 2019. During this period a general surgery teaching programme was introduced consisting of once weekly sessions led by allied healthcare professionals and once weekly consultant led sessions. Results The number of foundation doctors agreeing with the statement ‘I think the General Surgical Unit is a good training and learning environment for foundation doctors rose by 33% (59% to 92%). There was an increase of 59% (24% to 83%) in the number of foundation doctors who felt they had good educational opportunities during their general surgical attachment. Conclusion The implementation of a general surgery teaching programme involving specific consultant-led sessions and sessions led by allied healthcare professionals (bariatric specialists, amputation counsellors, palliative care specialists) is invaluable to foundation doctors. It retains the interest of surgically and non-surgically inclined foundation doctors and is an essential element of a general surgical placement in a teaching hospital.
Gastroenteritis in the childhood is one of the most common cause of morbidity and mortality throughout the world. Acute gastroenteritis is caused by bacteria, viruses, parasites, and rarely fungi. The cases of viral gastroenteritis are gradually increasing resulting in a global problem among children. This warrants the need of local, regional and national epidemiological data on the most common agents causing childhood gastroenteritis for clinicians for treatment protocol, Public health officials to implement control measures and for Researchers to develop suitable vaccines. The present study was conducted to determine the prevalence of Rotavirus and adenovirus in the childhood gastroenteritis and its epidemiological importance in a tertiary care teaching hospital. Children below 14 years of age attending a rural tertiary care hospital with diarrhea, vomiting and fever of less than 3 days were included in our study. The sample size was 38. General physical examination, clinical findings and other epidemiological data were also recorded. A commercial Rotavirus and Adenovirus antigen detection kit was used to detect the presence of Rotavirus and Adenovirus antigen from the stool sample. Out of 38 children screened, 11 children (28.94%) were positive for Rotavirus, 1 (2.63%) child was positive for Adenovirus and 26 (68.42%) children were negative for both Adenovirus and Rotavirus. The positivity rate of rotavirus in children aged less than 5 years was of 54.4 %. Diarrhoea, fever and vomiting were the commonest symptoms seen in Rotavirus positive children. There is no single gold standard test to discriminate the viral gastroenteritis from other agents of gastroenteritis. A simple, rapid immunochromatography test is useful cost effective aid in the developing countries to detect and screen Adenovirus and Rotavirus.
Direct shedding of microbes by patients and health care workers results in contamination of Intensive care unit environment. Intensive care unit acquired infections due to microbial contamination is a major concern because the patient’s immunity is already compromised. To determine the rate of bacterial contamination on environmental surfaces of Intensive care unit and health care workers and to determine the antibiogram of the isolates. Air samples and swabs from healthcare workers, their accessories, surrounding environmental surfaces were collected randomly over a period of 2 months in Adult Intensive care units. Bacterial isolates were identified by standard microbiological techniques. Antibiotic sensitivity testing was performed by Kirby Bauer disc diffusion method and data analyzed by Statistical Product and Service Solutions 22 version software. A total of 208 samples were randomly collected over 2 months, of which 56 samples yielded positive bacterial growth. Of 56 growth, 12 isolates were detected from air sampling method and 44 isolates from swabs. Among 44 isolates identified from swabs, 10 were isolated from healthcare workers, 4 from health care worker’s accessories and 30 from environmental surfaces. Six different bacterial isolates were identified, Coagulase Negative Staphylococcus (24) and Micrococcus (15) were the major isolates followed by Non fermenters (6), Staphylococcus aureus(4), Bacillus species(4) and diphtheroids (3) The antimicrobial sensitivity pattern of these bacterial isolates were sensitive to commonly used antibacterial agents. Study results showed Intensive care unit staff and environmental surfaces as probable sources of bacterial contamination. Study highlights the importance of cleaning and disinfection process and educate the health care workers about the possible sources of infections within Intensive care unit.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.