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61. Hearing loss in adults: assessment and management

, or recurs abnormal appearance of the outer ear or the eardrum, such as: inflammation polyp formation perforated eardrum abnormal bony or skin growths swelling of the outer ear blood in the ear canal a middle ear effusion in the absence of, or that persists after, an acute upper respiratory tract infection. Adults with suspected or diagnosed dementia, mild cognitiv Adults with suspected or diagnosed dementia, mild cognitive impairment or a e impairment or a learning disability learning disability 1.1.8 (...) Consider referring adults with diagnosed or suspected dementia or mild cognitive impairment to an audiology service for a hearing assessment because hearing loss may be a comorbid condition. 1.1.9 Consider referring adults with diagnosed dementia or mild cognitive impairment to an audiology service for a hearing assessment every 2 years if they have not previously been diagnosed with hearing loss. 1.1.10 Consider referring people with a diagnosed learning disability to an audiology service

2018 National Institute for Health and Clinical Excellence - Clinical Guidelines

62. Dementia: assessment, management and support for people living with dementia and their carers

professionals should not rely solely on cognition scores in circumstances in which it would be inappropriate to do so. These include: if the cognition score is not, or is not by itself, a clinically appropriate tool for assessing the severity of that patient's dementia because of the patient's learning difficulties or other disabilities (for example, sensory impairments), linguistic or other communication difficulties or level of education or or if it is not possible to apply the tool in a language in which (...) 1.3 Care coordination 19 1.4 Interventions to promote cognition, independence and wellbeing 20 1.5 Pharmacological interventions for dementia 21 1.6 Medicines that may cause cognitive impairment 25 1.7 Managing non-cognitive symptoms 25 1.8 Assessing and managing other long-term conditions in people living with dementia 27 1.9 Risks during hospital admission 29 1.10 Palliative care 30 1.11 Supporting carers 31 1.12 Moving to different care settings 32 1.13 Staff training and education 32 T erms

2018 National Institute for Health and Clinical Excellence - Clinical Guidelines

63. Brain tumours (primary) and brain metastases in adults

for brain metastases and how they might affect practice, see rationale and impact. 1.9 Care needs of people with brain tumours 1.9.1 Be aware that the care needs of people with brain tumours represent a unique challenge, because (in addition to physical disability) the tumour and treatment can have effects on: behaviour cognition Brain tumours (primary) and brain metastases in adults (NG99) © NICE 2019. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions

2018 National Institute for Health and Clinical Excellence - Clinical Guidelines

64. Venous thromboembolism in over 16s: reducing the risk of hospital-acquired deep vein thrombosis or pulmonary embolism

size or shape preventing correct fit. Use caution and clinical judgement when applying anti-embolism stockings over venous ulcers or wounds. [2010, amended 2018] [2010, amended 2018] 1.3.2 Ensure that people who need anti-embolism stockings have their legs measured and that they are provided with the correct size of stocking. Anti-embolism stockings should be fitted and patients shown how to use them by staff trained in their use. [2010] [2010] 1.3.3 Ensure that people who develop oedema (...) , and there may be an associated increased risk of surviving with severe disability. [2018] [2018] 1.4.5 When using intermittent pneumatic compression for people who are admitted with acute stroke, provide it for 30 days or until the person is mobile or discharged, whichever is sooner. [2018] [2018] Acutely ill medical patients Acutely ill medical patients 1.4.6 Offer pharmacological VTE prophylaxis for a minimum of 7 days to acutely ill medical patients whose risk of VTE outweighs their risk of bleeding: Use

2018 National Institute for Health and Clinical Excellence - Clinical Guidelines

65. Physical activity and the environment

, for example by providing safe areas in which children can play and picnic facilities lighting and other measures to prevent or reduce antisocial behaviour, such as maintaining vegetation clear signs that can be understood by everyone, including people with visual impairments and learning disabilities seats with arms and backrests, sited at frequent intervals shelter and shade accessible toilets that are clean, well maintained and unlocked during daylight hours footpaths with even, non-reflective, anti (...) their needs. Examples may include: some disabled people, including people with sensory impairments or learning disabilities people using wheelchairs, cycles or other mobility aids, or those supporting people using these aids Physical activity and the environment (NG90) © NICE 2019. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 14 of 57some older or frail people people using buggies, prams or cargo cycles for transporting children

2018 National Institute for Health and Clinical Excellence - Clinical Guidelines

66. Emergency and acute medical care in over 16s: service delivery and organisation

. It aims to reduce the need for hospital admissions by giving advanced training to paramedics and providing community alternatives to hospital care. It also promotes good-quality care in hospital and joint working between health and social services. Who is it for? Commissioners and providers of health and social care Health and social care practitioners People with or at risk of a medical emergency or acute illness, and their families and carers Implementation statement We recognise that implementing (...) this guideline will take time, with additional infrastructure and training needed in some areas. Service providers should note where the recommendations are consistent with other national initiatives, especially NHS England's seven day services clinical standards. See putting this guideline into practice. Emergency and acute medical care in over 16s: service delivery and organisation (NG94) © NICE 2019. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice

2018 National Institute for Health and Clinical Excellence - Clinical Guidelines

67. Post-traumatic stress disorder

is it for? Healthcare professionals Other professionals who work with people at risk of or who have PTSD, including in criminal justice and education services and non-government organisations Commissioners and providers, including directors of public health, NHS trust managers and managers in clinical commissioning groups People at risk of or who have PTSD (including complex PTSD), their families and carers, and the public Post-traumatic stress disorder (NG116) © NICE 2019. All rights reserved. Subject to Notice (...) health training and supervision be delivered in a way that reduces the risk of exacerbating symptoms provide information and help to access services. [2018] [2018] Maintaining safe en Maintaining safe environments vironments 1.4.4 Be aware of the risk of continued exposure to trauma-inducing environments. Avoid exposing people to triggers that could worsen their symptoms or stop them from engaging with treatment, for example, assessing or treating people in noisy or restricted environments, placing

2018 National Institute for Health and Clinical Excellence - Clinical Guidelines

68. Chronic obstructive pulmonary disease in over 16s: diagnosis and management

. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 27 of 651.2.80 Pulmonary rehabilitation programmes should include multicomponent, multidisciplinary interventions that are tailored to the individual person's needs. The rehabilitation process should incorporate a programme of physical training, disease education, and nutritional, psychological and behavioural intervention. [2004] [2004] 1.2.81 Advise people of the benefits of pulmonary rehabilitation (...) 53 Oral prophylactic antibiotic therapy 54 Long-term oxygen therapy 55 Ambulatory and short-burst oxygen therapy 56 Managing pulmonary hypertension and cor pulmonale 57 Lung volume reduction procedures, bullectomy and lung transplantation 58 Risk factors for COPD exacerbations 59 Self-management, education and telehealth monitoring 60 Context 62 Finding more information and resources 63 Update information 64 Chronic obstructive pulmonary disease in over 16s: diagnosis and management (NG115) ©

2018 National Institute for Health and Clinical Excellence - Clinical Guidelines

69. Subacromial decompression surgery for adults with shoulder pain Full Text available with Trip Pro

decompression surgery should not be offered to patients with SAPS. However, there is substantial uncertainty in what alternative treatment is best. Up to a quarter of adults have experienced shoulder pain over the past year, and it represents the third most common musculoskeletal problem. About half of those affected will recover completely within six months. Pain beyond three months is associated with poorer recovery, disability, and reduced ability to work. Subacromial pain is the most common form (up (...) . The panel was confident that surgery provides no important benefit on pain, function, quality of life, and global perceived effect informed by moderate to high certainty evidence in a one year timeframe. Surgery also comes with burdens and the risk of harm (see main infographic). Clinicians should not offer patients subacromial decompression surgery unprompted, and clinicians, public healthcare providers, and others should make efforts to educate the public regarding the ineffectiveness of surgery

2019 BMJ Rapid Recommendations

70. The Australian and New Zealand Intensive Care Society (ANZICS) COVID-19 Guidelines

Care Society Suite 1.01, Level 1, 277 Camberwell Road, Camberwell VIC 3124 Phone: +613 9340 3400 Email: anzics@anzics.com.au Website: anzics.com.au © Australian and New Zealand Intensive Care Society 2020. This work is copyright. It may be reproduced in whole or in part for study or training purposes, subject to the inclusion of an acknowledgment of the source. Requests and enquiries concerning reproduction and rights for purposes other than those indicated above require the written permission (...) -19 viral pandemic will likely represent an unprecedented challenge to intensive care services throughout Australia and New Zealand. We are fortunate to have world class intensive care services, with a highly trained and professional workforce who are ready and able to serve their communities at this time. This document aims to provide a series of recommendations and suggestions to ensure continued high-quality clinical care in the setting of a pandemic. High-quality evidence to guide medical

2020 Covid-19 Ad hoc guidelines

71. Covid-19: National supporting guidance for Scottish General Practice

pages and community councils may be helpful to support local communications and messaging. Consideration needs to be given as to how to communicate with vulnerable groups such as frail elderly, learning disabilities and other vulnerable groups. 22. Practices should put a COVID-19 message on the practice phone line advising patients of the screening criteria (for those who should not come into the practice without phoning for triage) and directing appropriate patients to the NHS Inform website (...) should introduce processes to triage all appointment requests (on the day or in future). Each practice should identify the most appropriate clinical members of the practice team to carry out this role and ensure that they have appropriate internal training, guidance and support to carry out this role. See Annex A for further guidance on practice telephone triage. 15. The RCGP Action Cards should be reviewed and amended to reflect the agreed practice processes if required and then circulated

2020 Covid-19 Ad hoc guidelines

72. COVID-19: Personal Protective Equipment (PPE)

COVID-19: Personal Protective Equipment (PPE) Personal Protective Equipment (PPE) COVID-19 guidance for clinicians | Royal College of Psychiatrists This site uses cookies: Search Search Become a psychiatrist Choose Psychiatry Medical students Foundation doctors Help us promote psychiatry Training Curricula and guidance Your training Exams Neuroscience in training International Medical Graduates Members Supporting you Submitting your CPD Membership Your Faculties Devolved Nations English (...) Divisions International members Special Interest Groups Your monthly eNewsletter Specialist and Associate Specialty Doctors President's lectures Obituaries Events Conferences and training events In house training Improving care College Centre for Quality Improvement (CCQI) Campaigning for better mental health policy Planning the psychiatric workforce National Collaborating Centre for Mental Health Working sustainably Mental health Problems and disorders Support, care and treatment Translations Personal

2020 Royal College of Psychiatrists

73. COVID-19: Ethical considerations

and Treatment) (Scotland) Act 2003 and the Mental Health (Northern Ireland) Order 1986. For doctors working in mental health, learning disability and autism services, usual ethics principles apply – see and . In addition, see the . However, this pandemic is likely to throw up some dilemmas for which more specific advice is needed. It is strongly recommended that all psychiatrists check that their local clinical ethics committees are in place as they can provide advice and guidance in real-time. The BMA have (...) therapeutic and recreational activities on offer) Blanket restrictions on all patients Greater reliance on physical and procedural security measures to compensate for reduced relational security Less communication with families, relatives, carers In secure services, less ability to support escorted community leave Mental health, learning disability and autism services may need to prioritise the most unwell individuals and those presenting the most severe behavioural challenges. Principles to be borne

2020 Royal College of Psychiatrists

74. Patient engagement - COVID-19 guidance for clinicians

Patient engagement - COVID-19 guidance for clinicians Patient engagement - COVID-19 guidance for clinicians | Royal College of Psychiatrists This site uses cookies: Search Search Become a psychiatrist Choose Psychiatry Medical students Foundation doctors Help us promote psychiatry Training Curricula and guidance Your training Exams Neuroscience in training International Medical Graduates Members Supporting you Submitting your CPD Membership Your Faculties Devolved Nations English Divisions (...) International members Special Interest Groups Your monthly eNewsletter Specialist and Associate Specialty Doctors President's lectures Obituaries Events Conferences and training events In house training Improving care College Centre for Quality Improvement (CCQI) Campaigning for better mental health policy Planning the psychiatric workforce National Collaborating Centre for Mental Health Working sustainably Mental health Problems and disorders Support, care and treatment Translations Patient engagement

2020 Royal College of Psychiatrists

75. Workforce - COVID-19 guidance for clinicians

and that any contracts will be in line with standard terms and conditions. and Training and CPD As per the (PDF), refresher physical healthcare training should be provided to all mental health, learning disability and/or autism staff delivering patient care covering physical health care, vital signs and the deteriorating patient. We have developed an to support psychiatrists and other clinicians working in mental health settings in gaining or refreshing knowledge and skills to support patients and staff (...) , carers, voluntary community sector (VCS) organisations as well as neighbouring MH / Learning Disability and Autism providers. This will include planning within an NHS-led Provider Collaborative, with social care partners, the Criminal Justice System, commissioners, and education providers for children and young people (CYP). Providers will need to maximise delivery through digital technologies to ensure continuity of care where patients are asked to isolate and in response to reduced staff numbers

2020 Royal College of Psychiatrists

76. Guidance for maternal medicine in the evolving coronavirus (COVID-19) pandemic

of depression during the postpartum period. This has the potential to be worse in the pandemic situation, and so should be screened for appropriately. 20 3.7.2 Neurological diseases which are most vulnerable to COVID-19 effects Adults with motor neurone disease, multiple sclerosis (MS), a learning disability or cerebral palsy have been identified as being more vulnerable to the severe effects of COVID-19 and have been advised to stringently follow social distancing measures. 1 The Association of British (...) validated GDM risk model uses routine information collected in the first trimester and predicts the GDM with good discrimination (C-statistic 0.77; 95% CI 0.73-0.81) and calibration (slope 1.1). It also has good predictive accuracy in nulliparous women (C-statistic 0.75; 95% CI 0.68-0.82).39 Appendix 4: Antenatal care of pregnant women with gestational diabetes (GDM) First appointment with diabetes specialist midwife/ nurse, held face-to-face or remotely, to cover: • Training on use of glucose meter

2020 Royal College of Obstetricians and Gynaecologists

77. COVID-19 Guidelines for Outbreaks in Residential Care Facilities

and Human Services 6 1.3.3. Australian Aged Care Quality and Safety Commission 6 2. UNDERSTANDING COVID-19 7 2.1. Recognising COVID-19 7 2.2. Incubation Period 8 2.3. Routes of Transmission 8 2.4. People at risk of complications from COVID-19 8 2.5. Complications of COVID-19 8 3. PREPAREDNESS AND PREVENTION 9 3.1. Preparation 9 3.1.1. Prepare an Outbreak Management Plan 9 3.1.2. Education 10 3.1.3. Workforce Management 11 3.1.4. Staff Education and Training 11 3.1.5. Consumable Stocks 11 3.2. Prevention (...) absentee rate. Developing and maintaining a contact list for casual staff members or external nursing agencies is essential to timely activation of a surge workforce should an outbreak occur. Leave planning should also consider the nature of the pandemic and current outbreaks. 3.1.4. Staff Education and Training Each RCF is responsible for ensuring their staff are adequately trained and competent in all aspects of outbreak management prior to an outbreak. Staff should know the signs and symptoms

2020 Covid-19 Ad hoc guidelines

78. Clinical care of severe acute respiratory infections – Tool kit

and adapted when caring for adult patients.Clinical Care for Severe Acute Respiratory Infection—Toolkit viii Acknowledgements This critical care training is the product of contributions by many individuals under the coordination of the World Health Organization’s Global Influenza Programme and guidance of Nikki Shindo. Major contributions were provided by Janet Diaz (Emergency Programme, WHO), Neill Adhikari (Sunnybrook Health Sciences Centre and University of Toronto, Toronto, Canada) and Paula Lister (...) University School of Medicine, Nashville, TN, United States of America); Sabine Heinrich (Berlin, Germany); Michael Ison (Northwestern University, Chicago, IL, United States of America); Arjun Karki (Patan Academy of Health Sciences, Kathmandu, Nepal); John Luce (San Francisco General Hospital, San Francisco, California, United States of America); Lung Injury Knowledge Network, National Heart, Lung, and Blood Institute (Bethesda, MD, United States of America); Kirsten Lunghi (San Francisco General

2020 WHO Coronavirus disease (COVID-19) Pandemic

79. Infection Prevention and Control guidance for Long-Term Care Facilities in the context of COVID-19

reports for COVID-19. COVID-19 is an acute respiratory illness caused by a novel human coronavirus (SARS-CoV-2, called COVID-19 virus), which causes higher mortality in people aged =60 years and in people with underlying medical conditions such as cardiovascular disease, chronic respiratory disease, diabetes and cancer. Long-term care facilities (LTCFs), such as nursing homes and rehabilitative centers, are facilities that care for people who suffer from physical or mental disability, some of who (...) these recommendations as new information becomes available. All technical guidance for COVID-19 is available online. 1 Training videos on COVID-19, including IPC, can be found here: System and service coordination to provide long-term care • Coordinate with relevant authorities (e.g. Ministry of Health, Ministry of Social Welfare, Ministry of Social Justice, etc.) should be in place to provide continuous care in LTCFs. • Activate the local health and social care network to facilitate continuous care (clinic, acute

2020 WHO Coronavirus disease (COVID-19) Pandemic

80. The Geriatricians’ Perspective on Medical Services to Residential Aged Care Facilities (RCFs) in Australia.

in multidisciplinary policy and procedure development. 9. There is a need for the establishment of a medical special interest group, dedicated to promoting high quality research and medical care for the residential care population, in which the Australian and New Zealand Society for Geriatric Medicine should have a major role. This body could progressively establish education and training requirements for recognition of competency in residential care medicine. This recognition could become an entitlement (...) care standards, regular review and reassessment, and participation in audit, education, and staff training. The American Medical Directors Association takes a similar position and oversees certification of competency in these aspects of the medical role in long-term care [35]. Dr Peter Ford, Chairman of the Australian Medical Association (AMA) committee on care of older-aged people, in a 2008 commentary to the AMA, placed some responsibility on the Aged Care Accreditation Agency

2020 Australian and New Zealand Society for Geriatric Medicine

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