Clinical negligence

Clinical negligence cases are based on the assumption that a doctor owes patients a duty to take reasonable care when treating or advising them. Doctors breach this duty if their treatment falls below the standard expected by a responsible body of medical opinion. The doctor will be held to have acted negligently. A patient may then have a claim for compensation if, and only if, the patient can prove, on the balance of probabilities, that the negligence has caused physical or emotional injury. A claim must be commenced within 3 years of when the injury occurred or it will be time barred.     

Lumbar microdiscectomy as a day-case procedure: Scope for improvement?

Background and purpose

There are no significant differences in outcomes between patients receiving inpatient and day-case lumbar microdiscectomy, but the latter is still underused in the NHS. Here we aimed to identify factors contributing to successful same-day discharge in day-case patients.

Validation of a Novel Surgical Data Capturing System Following Total Hip Arthroplasty

Background

The OrthoMiDaS (Orthopedic Minimal Data Set) Episode of Care (OME) database was developed in an effort to advance orthopedic outcome measurements on a national scale. This study was designed to evaluate if the OME data capture system would increase the quality of data collected in the context of primary and revision total hip arthroplasty (THA) compared to conventional operative notes.

基层医务人员隐性缺勤现状及影响因素研究

目的了解基层医务人员隐性缺勤现状及影响因素。方法多阶段整群抽取陕西省汉中市9所乡镇医院及其下属村卫生室580名医务人员,采用斯坦福隐性缺勤量表进行调查。结果基层医务人员隐性缺勤得分中位数为15,高隐性缺勤率为49.4%;Logistic回归分析显示,性别、文化程度、职称、所属机构、是否倒班是隐性缺勤的影响因素(P<0.05,P<0.01)。结论基层医务人员隐性缺勤程度较高,应根据不同医务人员的个人特征开展干预研究,同时合理配置医疗资源,改善基层医疗工作状态,以降低隐性缺勤。     

输尿管皮肤造口患者单J管更换就诊延迟的质性研究

目的深入了解输尿管皮肤造口患者对单J管更换就诊延迟的认知及影响因素,为采取更有效的干预提供依据。方法运用质性研究中的现象学研究方法,分析14例输尿管皮肤造口患者单J管更换就诊延迟的真实感受。结果患者单J管更换就诊延迟主要表现为焦虑、侥幸和麻木3种心理;经济保障不足、路途遥远、家庭支持不足和相关知识缺乏是影响其就诊延迟的原因。结论输尿管皮肤造口患者术后门诊单J管定期更换依从性差,既有主观上的认知缺陷,也有客观上的就医障碍。期待多部门共同合作,增强患者门诊定期换管的依从性,改善其生活质量。     

Medical textiles in orthopedics: An overview

The use of textile in the medical field is not new; this has given rise to a new branch known as medical textiles. These are being used to repair or replace various other musculoskeletal tissues. The most common uses of biomaterials are to create aseptic conditions for protection, general health care, and hygiene including bedding and clothing, surgical gowns, face masks, head and shoe covers, sterilization wraps, suture anchors, fiber cast and braces/orthotics. These are also used as materials for preparation of wipes, swabs, wound dressings, bandages, gauzes, plasters, pressure garments, orthopedic belts and for new applications, such as heart valves, vascular grafts, artificial veins, artificial ligaments, artificial joints, artificial skin, and artificial cartilage. The truth is that nowadays the use of biomedical textiles is more rampant than anyone realizes. Commonly used materials for preparation of biomedical textiles includes Cotton, Nylon, Silk, Ultra-high molecular weight polyethylene, Polyester, Polypropylene, Poly tetra-fluoro ethylene, Polyether ether ketone, and Polyether ketone. These are prepared from various monomers in varying proportions as per the requirement of the material to be used. Various methods are used in their preparation like Braiding, Knitting, and Weaving, which helps in the development of certain kinds of materials with different specificity and character. Other important measures in the preparation of the medical textile include Denier (the filament counts in multifilament fibers), Tenacity (the strength per denier) and Heat shrink (the amount of shrinkage at a particular time and temperature).