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8341. Evaluation of the Uptake of Advice, Directives and Guidelines to the NHS Concerning Patient Safety by the SABS System

Action 29 th July 2004 Patient Safety Alert 03 Safe delivery of radiotherapy DH Action 23 rd December 2004 None Reduction of risks associated with mobile food trolleys DH Estates and Facilities Action 17 th August 2005 DH (2005) 11 Reduction of risk associated with problems with implantable cardioverter defibrillators (ICDs) MHRA medical device alert Action and updates Multiple in 2005 & 2006 Numerous (10) Reduction of harm caused by misplaced nasogastric feeding tubes NPSA Immediate action 21 st (...) not necessarily reach all levels of an organisation and for many front line staff, paper copies of alerts or the resulting policies and procedures were available in folders, for example on wards . Findings: management of alerts It was striking how differently senior staff viewed the need to be aware of those alerts (particularly those from the NPSA) which required changes in nursing and medical practice. A small number of senior managers clearly stated that the management of safety alerts was not at the top

2007 York Health Economics Consortium

8342. Intermediate care - Hospital at Home in COPD

service evaluation which were applicable to admission avoidance for patients with exacerbations of COPD, and one RCT related to early supported discharge. The evidence statements can be summarised as follows: N There were no significant differences in forced expiratory volume in 1 second (FEV 1 ), 3–5 re- admission rates, 3–6 mortality 4–6 or number of days in care 5 between HaH and hospital care. N Two studies showed no difference between the groups for health status, 34 but a Spanish study showed (...) in deciding which patients can be managed at home. Since they have repeatedly shown no increase in admission/readmission rates, it is likely that their criteria for managing at home are safe. The least restrictive set of absolute criteria for admission which were used in three studies 367 were impaired level of consciousness, acute confusion, pH ,7.35, acute changes on the chest radiograph, a concomitant medical problem requiring inpatient stay, insufficient social support, no telephone and residence

2007 British Thoracic Society

8343. Safeguarding children

sexual activities, or encouraging children to behave in sexually inappropriate ways. Neglect is the persistent failure to meet a child’s basic physical and / or psychological needs, likely to result in the serious impairment of the child’s health or development. It may involve a parent or carer failing to provide Neglect adequate food, shelter and clothing, failing to protect a child from physical harm or danger, or the failure to ensure access to appropriate medical care or treatment. It may also (...) needs because of a psychological or medical dif?culty. For example, deaf or autistic children may demonstrate challenging behaviour, which may or may not be as a result of abuse. Children with special needs are more likely to be abused than children in the general population. Children in need Children who are de?ned as being ‘in need’ are those whose vulnerability is such that they are unlikely to reach or maintain a satisfactory level of health or development, or their health and development

2006 Joint Royal Colleges Ambulance Liaison Committee

8344. Neck and back trauma

no randomised controlled trials comparing out of hospital spinal immobilisation techniques 1 : ? soft collars do not limit movement 2,3 ? there is variable difference between the various types of semi-rigid collars 2-4 ? addition of side supports and tapes increases immobilisation 2,3 ? combining collar with extrication board improves immobilisation 5 ? the application of devices is more important than the variation of devices 6 ? neutral position needs slight ?exion of the neck and the occiput should (...) should have manual immobilisation commenced at the earliest time, whilst initial assessment is undertaken. HISTORY It is vital to determine the mechanism of injury in order to understand the forces involved in causing the injury including: hyper?exion, hyperextension, rotation and compression and combinations of all the above. Injury most frequently occurs at junctions of mobile and ?xed sections of the spine. Hence fractures are more commonly seen in the lower cervical vertebrae where the cervical

2006 Joint Royal Colleges Ambulance Liaison Committee

8345. Evidence Based Research: Effectiveness of Grabrail Orientations During the Sit-to-Stand Transfer

of Statistics, 2005). The increase in the older population is due primarily to an increased life expectancy in combination with a decreased fertility rate. Concurrent with the ageing process, bodily changes may affect an older person’s functional performance such as mobility and self care. For example, the ageing process has been linked to a generalised decrease in muscle strength and joint range of motion, especially at the hip, knee and spine, as well as difficulties with proprioception and balance which (...) (Allied and Complementary Medicine) AMI: Australasian Medical Index ARCH: Australian Architecture Database AVE: Avery Index to Architectural Periodicals CINAHL (Nursing and Allied Health) Compendex Plus Current Contents Dissertation abstracts Expanded Academic Index ASAP Medline OSH-ROM ProQuest 5000 PsycINFO PubMed Science Direct University of Sydney Theses Web of Science WWW via the Google and Google Scholar Search engine Legislative and Regulatory Documents $ # The following

2006 Home Modification Information Clearinghouse

8346. Coatings: Evidence Based Research: Selecting Coatings for Tiled Floors

with mobility impairments a COF 0.6 is considered better practice. The performance outcomes of coatings vary depending on tile type, coating components, the application process, the cleaning process and the maintenance regime. Correct coating selection and application as needed are critical factors believed to improve slip resistance performance outcomes. Results: The results include information from 35 published sources. In addition, 54 manufacturer product specifications and 14 legislative and regulatory (...) a person with a mobility impairment or a shuffling gait to stumble. This review found only one research article about the effectiveness of different ingredients in surface coatings (Ali & Khashaba, 1998). Several pieces of anecdotal evidence and expert opinion were also found. Riders (2003) reported that pre-formulated coatings may be more effective than coatings that consumers are required to mix before application or coatings that required particles to be broadcast into them while wet (Riders, 2003

2005 Home Modification Information Clearinghouse

8347. Evidence Based Research: Selecting Diameters for Grabrails

of the grabrail are critical design elements. Application of AS1428.1 requirements rather than assessing and applying the individual’s attributes to prescribe a grabrail may not be valid and may breach duty of care. Since hand grip diameter is critical in determining the most appropriate outside grabrail diameter, as the fingers and thumb must be able to wrap around the grabrail (Maki, 1985), valid and reliable measurements and tools for relating Diameter: Evidence based research: Selecting diameters (...) & Bridge, 2003) project's systematic review protocol, the research question was refined into an operational format that could be researched systematically by application of appropriate search criteria. See Table 4 below. Table 5 contains the synonyms and search terms used. * - & % ( %%& grabrail diameter 25mm diameter Maximised support at home Decrease falls risk Decrease severity of injury in the event of a fall Increased confidence Decrease secondary disability Increased quality

2006 Home Modification Information Clearinghouse

8348. Evidence Based Research: Use of Reeded (Ribbed) Timber for Decks, Ramps and Paths

Health Organisation, 2001) were considered in relation to the application of reeded decking in ramps or walkways used by people with a mobility impairment. The identified features are as follows: 6 Law (BCA via AS1428) – for ramps with total length less than 1520mm, the steepest complying gradient is 1:8. Where the ramp length is greater than 1520mm then the gradient shall not be steeper than 1:14. ? . Law (BCA) –the load limit is dependant on proposed activity e.g. limited pedestrian versus car (...) Evidence Based Research: Use of Reeded (Ribbed) Timber for Decks, Ramps and Paths Reeded Timber: Evidence based research: May 2003 F ISBN: 1 86487 568 2 www.homemods.info ! Objectives: To determine the occupational risk and safety factors surrounding the prescription of reeded decking ramps in the homes of persons with mobility impairment. Design: Systematic review of electronic and other published literature. Main outcome measures: Co-efficient of friction (COF

2003 Home Modification Information Clearinghouse

8349. Acupuncture

in American medicine was rare until the visit of President Nixon to China in 1972. Since that time, there has been an explosion of interest in the United States and Europe in the application of the technique of acupuncture to Western medicine. Acupuncture describes a family of procedures involving stimulation of anatomical locations on the skin by a variety of techniques. There are a variety of approaches to diag­ nosis and treatment in American acupuncture that incor­ porate medical traditions from China (...) that may benefit from the use of acupuncture or moxibustion. Such applications include prevention and treatment of nausea and vomiting; treatment of pain and addictions to alcohol, tobacco, and other drugs; treatment of pulmonary problems such as asthma and bronchitis; and rehabilitation from neurological damage such as that caused by stroke. To address important issues regarding acupuncture, the NIH Office of Alternative Medicine and the NIH Office of Medical Applications of Research organized a 2 1

1997 NIH Consensus Statements

8350. Interventions to Prevent HIV Risk Behaviors

and morning of the third. This statement is an independent report of the consensus panel and is not a policy statement of the NIH or the Federal Government. Reference Information For making bibliographic reference to this consensus state­ ment, it is recommended that the following format be used, with or without source abbreviations, but without authorship attribution: Interventions to Prevent HIV Risk Behaviors. NIH Consens Statement 1997 Feb 11-13; 15(2): 1-41. Continuing Medical Education (...) The Continuing Medical Education activity included with this statement was planned and produced in accordance with the Accreditation Council for Continuing Medical Education Essentials. Publications Ordering Information NIH Consensus Statements, NIH Technology Assessment Statements and related materials are available by writing to the NIH Consensus Program Information Center, P.O. Box 2577, Kensington, MD 20891; by calling toll free 1-888-NIH-CON­ SENSUS (888-644-2667); or by visiting the NIH Consensus

1997 NIH Consensus Statements

8351. Cervical Cancer

disease, advances in laparoscopic surgical staging and therapy techniques, and the application of newer imaging techniques such as magnetic resonance. Prospects for both prophylactic and therapeutic4 vaccines against HPV offer hope for fundamental alterations in the prevention and management of this disease. To address these and related issues, the National Cancer Insti- tute and the NIH Office of Medical Applications of Research convened a Consensus Development Conference on Cervical Cancer (...) are available by writing to the NIH Consensus Program Information Center, P.O. Box 2577, Kensington, Maryland 20891; by calling toll free 1-888- NIH-CONSENSUS (1-888-644-2667); or by visiting the NIH Consensus Development Program home page on the World Wide Web at http://consensus.nih.gov.NIH Consensus Statement Volume 14, Number 1 April 1Ð3, 1996 Cervical Cancer NATIONAL INSTITUTES OF HEALTH Office of the Director National Institutes Of Health Continuing Medical Education1 Abstract Objective To provide

1996 NIH Consensus Statements

8352. Guidelines for the Management of Colorectal Cancer

addressing the specific recommendation (levels Ia, Ib). B: Requires the availability of well-conducted clinical studies but no randomised clinical trials on the topic of recommendation (levels IIa, IIb, III) C: Requires evidence from expert committee reports or opinions and/or clinical experience of respected authorities. Indicates absence of directly applicable clinical studies of good quality (level IV) Note: Every recommendation (given in bold type in each section of the detailed guidelines (...) III). In addition, inexperience combined with failure to distend the caecum can produce misleading appearances, which can be misinterpreted as malignancy and can result in unnecessary laparotomy. It is not always possible to be certain of the radiological findings in barium enemas for reasons including the state of the preparation and physical considerations such as the mobility of the patient and colonic anatomy including diverticular disease and overlapping loops, but non-committal reporting

2007 Association of Coloproctology of Great Britain and Ireland

8353. Position Statements on Malignant Large Bowel Obstruction & Anal Fistula

mobile and retain the contrast. No comment can be made on the viability of the proximal distended bowel and in con?rmed cases there is no information on the extent of the primary lesion or of distant metastases. Findings CT scanning provides further information over and above plain and contrast radiographs in patients with suspected malignant large bowel obstruction (Level III). Recommendation CT scanning, if available, should be used in patients with suspected large bowel obstruction and should (...) Britain and Ireland. Colorectal Disease, 9 (Suppl. 4), 1–17however, found an increased rate of wound infection and anastomotic leakage (although reported as ‘minor’) in the SC group and recommended subtotal colectomy except where the anastomosis is very low. Subtotal or total colectomy? Findings Subtotal colectomy results in increased frequency of defae- cation but most patients do not require long-term anti- diarrhoeal medication (Level I). There are numerous studies from different units in which

2006 Association of Coloproctology of Great Britain and Ireland

8354. Administration of Intravenous Radiopharmaceuticals

techniques 14 Frusemide 14 Lymphoscintigram 14 Inserting a Cannula 14 MIBG I123 15 Transplant Renogram 15 Paediatric Injections 15 BIBLIOGRAPHY 15 Page 3 of 30 FURTHER READING 16 APPENDIX 1: LOG SHEETS 17 Page 4 of 30 Executive Summary This document been produced by representatives from the BNMS Technology group and the Nurses group. It was instigated by the Professional Standards and Education committee, who saw the need for a transferable record of practical experience for non- medical staff performing (...) in the past, if so take extra precautions i.e. lie the patient down. If the patient feels faint stop the procedure. If the patient faints call for help. Do not allow the patient to leave until confident that they are fit Accidental puncture of artery Be aware of position of brachial artery. Avoid pulsating areas. If artery is punctured withdraw needle and apply firm digital pressure for 15 minutes or more. Elevate arm, document, and inform medical staff. Patient Identification Correct identification

2006 British Nuclear Medicine Society

8355. Breast Scintigraphy

-bis bis(2- ethoxy-ethylphosphine)ethane) breast scintigraphy protocols used in the current clinical routine. The guideline should therefore not be taken as exclusive of other nuclear medicine procedures useful to obtain comparable results. It is important to remember that the resources and the facilities available for patient care may vary from one country to another and from one medical institution to another. The present guide has been prepared for nuclear medicine physicians and intends (...) of the European Atomic Energy Community Treaty, and in particular article 31, which has been adopted by the Council of the European Union (Directive 97/43/EURATOM). This Directive supplements Directive 96/29/EURATOM and guarantees health protection of individuals with respect to the dangers of ionising radiation in the context of medical exposures. According to this Directive, Member States are required to bring into force such regulations as may be necessary to comply with the Directive. One of the criteria

2003 European Association of Nuclear Medicine

8356. Bone Scintigraphy

that the resources and facilities available to care for patients may vary from one country to another and from one medical institution to another. This document has been prepared primarily for nuclear medicine physicians and is intended to offer assistance in optimising the diagnostic information that can currently be obtained from bone scintigraphy. The corresponding guidelines from the Society of Nuclear Medicine (SNM) have been taken into consideration, reviewed and partial- ly integrated into this text (...) should be determined after taking account of the Euro- pean Atomic Energy Community Treaty, and in particu- lar article 31, which has been adopted by the Council of the European Union (Directive 97/43/EURATOM). This Directive supplements Directive 96/29/EURAT- OM and guarantees health protection of individuals with respect to the dangers of ionising radiation in the context of medical exposures. According to this Direc- tive, Member States are required to bring into force such regulations as may

2003 European Association of Nuclear Medicine

8357. Paediatric Endocrine Tumour Guidelines

to collect incidence and outcome data systematically through a national registration system. The latter has been confounded to date by the difficult distinction between malignant and benign disease in certain endocrine tumours, the prophylactic surgical treatment of at risk individuals identified through genetic screening, and the multiplicity of presentations to a number of paediatric or adult medical and surgical disciplines. In November 2001, a multidisciplinary working party of paediatric (...) websites, with appropriate links and alerts to the whole membership, during which comments were invited and received. In addition, just prior to publication, the consensus statements were subjected to external review by five leading, international medical and surgical experts in the field (3 physicians, 1 surgeon, 1 geneticist), and also to the members of the Clinical Committee of the Society for Endocrinology. Each were asked for their agreement to the recommendations and any comments. The final

2005 British Association of Endocrine and Thyroid Surgeons

8358. PET-CT in the UK

radiopharmaceuticals would come from the closest cyclotron. • Initially, one PET-CT per 1.5 million population is planned to re?ect the current role in cancer management.A Strategy for PET-CT in the UK August 2005 7 • The requirement for cyclotrons may increase as the applications develop. • PET-CT should be introduced in a phased approach. Twelve new Hubs each with a single, static or mobile Satellite are recommended in Phase I in the UK. A further eight to twelve Hubs plus Satellites are recommended in Phase II (...) combine the bene?ts of specialist expertise and procedures with the facility for more local delivery of common PET procedures. The proposal for Hubs and Satellites is based on current PET-CT applications (predominantly in cancer care) but future development must acknowledge the development of applications across the medical specialties. On this basis, it is proposed that one PET-CT scanner should be provided for populations of 1-1.5 million people re?ecting the distribution and location of cancer

2005 British Nuclear Medicine Society

8359. Review of computer-generated outpatient health behavior interventions: clinical encounters 'in absentia'

and future directions. Int J Technol Assess Health Care 1996;12:195-208. This additional published commentary may also be of interest. Greene B. Review: computer generated targeted and tailored interventions are modestly effective for improving patient health behaviur. Evid Based Nurs 2001;4:85. Indexing Status Subject indexing assigned by NLM MeSH Ambulatory Care; Communication; Computer Systems; Exercise; Health Behavior; Humans; Medical Informatics Applications; Models, Psychological; Nutritional (...) -experimental studies with some evidence of instrument reliability and validity were included. Specific interventions included in the review Studies were included if they considered at least one patient-interactive feedback, reminder, or education intervention intended to influence or improve a stated health behaviour. Specific interventions were categorised as mobile communications, automated telephone communications, or print communications. Participants included in the review The authors do not state any

2001 DARE.

8360. A review of the literature on shortwave diathermy as applied to osteo-arthritis of the knee

diathermy or shortwave diathermy combined with exercise or shortwave diathermy combined with medication compared to ultrasound, exercise, ice, infra-red, Faradism, wax, ultrasound combined with exercise, placebo shortwave diathermy, no treatment, interferential current, galvanic current, longwave diathermy, placebo tablets and placebo injections. One trial compared shortwave diathermy alone to shortwave diathermy plus exercise. Studies on both continuous SWD and pulsed SWD were included. Participants (...) presented in tables included: participant details (age, sex, sample size, diagnosis); study design; interventions; outcome measures; results. Methods of synthesis How were the studies combined? A narrative synthesis was undertaken. Outcomes were categorised in terms of favourable, non-favourable and questionable effects on pain and mobility. How were differences between studies investigated? There was no formal investigation of heterogeneity. Results of the review Eleven studies (n=815), of which 9 were

1999 DARE.

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