Fluid input/output charts in hospital inpatients are a valuable source of information for doctors reviewing intravenous fluid prescription, but are notorious for being incomplete and inaccurate. Lack of awareness of the importance of fluid balance amongst nursing staff and an excess of unnecessary monitoring are two factors contributing to the problem. We conducted a quality improvement project on the respiratory ward in a large district general hospital aiming to specifically address these two factors. Pre-intervention audit showed that only 53% of input/output monitoring was clinically indicated, with an average chart completion of 50%. Using e-Learning and verbal presentation to raise awareness around fluid balance, we implemented a new system whereby daily medical review of charts lead to rationalisation of monitoring. Post-intervention audit showed a 93% reduction in unnecessary monitoring, with corresponding increases in completion (40%) and accuracy (48%) of remaining charts. In conclusion, education has enabled a culture change on the ward that has drastically increased the quality of fluid balance monitoring.
ChatGPT is currently a trending topic worldwide triggering extensive debate about its predictive power, potential uses, and its wider implications. Recent publications have demonstrated that ChatGPT can correctly answer questions from undergraduate exams such as the United States Medical License Examination (USMLE). We challenged it answer questions from a more demanding, post-graduate exam - the European Exam in Core Cardiology (EECC), the final exam for the completion of specialty training in Cardiology in many countries. Our results demonstrate that ChatGPT succeeds in the EECC.
The work was motivated by the increasing awareness of the need for bone age assessment (BAA) schemes featuring an appropriate methodology for skeletal age estimation. The endocrinological problems in youngsters are already evident in many countries worldwide, varying in scale and intensity for different age groups and sexes. Change in lifestyles and eating habits of people also contribute to endocrine disorders, increasing the need for a system that predicts such problems well in advance. Skeletal bone age assessment is a procedure often used in the management and diagnosis of endocrine disorders. It also serves as an indication of the therapeutic effect of treatment. It is of much significance in pediatric medicine in the detection of hormonal growth or even genetic disorders. Bone age is assessed from the left-hand wrist radiograph and then compared with the chronological age. A discrepancy between the two indicates abnormalities. This paper consists of an overall review and technical assessments of various skeletal age assessment schemes in the literature. This review also recommends some research areas in this field and those leading to high efficiency are highlighted
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