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41.
Medication errors cause substantial harm to patients, and considerable cost to healthcare systems. Evidence suggests that communication plays a crucial role in the generation, management and prevention of such incidents. This review identifies how paediatric medication errors can be managed, and in particular focuses on the pathway of steps that can operationalise the current research findings. Furthermore, the current data suggesting how communication can help to prevent errors occurring in the first place is examined. From this data, it is apparent that there are three domains in which communication could play an important preventative role: first, patient doctor communication, and second interprofessional communication and finally researcher/professional dialogue. This review is an attempt to identify the importance of communication in paediatric mediation safety and to allow practical application of these findings. 相似文献
42.
Background
The study investigated the extent to which approaches to work, workplace climate, stress, burnout and satisfaction with medicine as a career in doctors aged about thirty are predicted by measures of learning style and personality measured five to twelve years earlier when the doctors were applicants to medical school or were medical students.Methods
Prospective study of a large cohort of doctors. The participants were first studied when they applied to any of five UK medical schools in 1990. Postal questionnaires were sent to all doctors with a traceable address on the current or a previous Medical Register. The current questionnaire included measures of Approaches to Work, Workplace Climate, stress (General Health Questionnaire), burnout (Maslach Burnout Inventory), and satisfaction with medicine as a career and personality (Big Five). Previous questionnaires had included measures of learning style (Study Process Questionnaire) and personality.Results
Doctors' approaches to work were predicted by study habits and learning styles, both at application to medical school and in the final year. How doctors perceive their workplace climate and workload is predicted both by approaches to work and by measures of stress, burnout and satisfaction with medicine. These characteristics are partially predicted by trait measures of personality taken five years earlier. Stress, burnout and satisfaction also correlate with trait measures of personality taken five years earlier.Conclusions
Differences in approach to work and perceived workplace climate seem mainly to reflect stable, long-term individual differences in doctors themselves, reflected in measures of personality and learning style.43.
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45.
Adrenal cysts: imaging and percutaneous aspiration 总被引:5,自引:0,他引:5
Six patients with primary adrenal cysts were encountered during a period of 3 years. Multiple imaging modalities were used to characterize these lesions, including magnetic resonance imaging in one case. Percutaneous aspiration was performed on four of the six cysts - in one case, in the operating room prior to excision of the cyst. Cholesterol was detected in four cysts and cortisol in one cyst. Cytologic findings from aspiration biopsy were benign in all five cases. Two cysts were removed, one of them after reaccumulation of the fluid after needle aspiration. The findings in this small series of adrenal cysts suggest that in certain cases, complete cyst aspiration, rather than surgical excision, may be carried out initially for diagnosis and management of indeterminate suprarenal cystic lesions and symptomatic cysts of the adrenal gland. 相似文献
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47.
LEWIS NP; MACDOUGALL IC; WILLIS N; HENDERSON AH 《QJM : monthly journal of the Association of Physicians》1992,83(4):523-531
The cardiorespiratory responses to maximal treadmill exercisewere compared in matched groups of patients with chronic renalanaemia or treated chronic heart failure, and in normal controls.Exercise capacity was similarly reduced in both patient groupscompared to normal controls, the raised respiratory exchangeratio at peak exercise implying anaerobic metabolism due tolimited oxygen delivery in heart failure and limited oxygencarrying capacity in anaemia. Minute ventilation (VF) was relatedlinearly to minute CO2 production (VCO2) in all subjects (eachr>0.92) from all three groups. The slope of the VE/VCO2 relationshipwas normal in anaemia but steeper in heart failure, reflectingventilation/perfusion mismatching in chronic heart failure. 相似文献
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50.
Lessing MP; Crook DW; Bowler IC; Gribbin B 《QJM : monthly journal of the Association of Physicians》1996,89(11):855-858
Coagulase-negative staphylococci cause about 5% of native-valve
endocarditis. Staphylococcus lugdunensis, a recently-described species of
coagulase-negative staphylococci, has been reported to cause destructive
native-valve endocarditis with a high mortality. We report four consecutive
cases of definite Staphylococcus lugdunensis native- valve endocarditis by
the Duke criteria over a 4-year period. All patients required urgent aortic
valve replacement 1-5 days after admission, and recovered. An intriguing,
aspect in the presentation of these patients was a history of vasectomy and
inguinal skin breaks in the immediate period preceding the occurrence of
endocarditis.
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