Abstract：
BACKGROUND:Inadequate medical documentation has been associated with a higher rate of adverse events and may have medicolegal consequences. An accurate admission note is critical as it is frequently referred to during inpatient stay, particularly when the patient is acutely unwell and during handover of care. AIM:We set out to implement a surgical admission proforma and evaluate its impact on the quality of acute surgical admission notes. METHODS:A standardised, structured admission proforma for use with all emergency general surgery patients in a busy model 3 hospital was designed and implemented. Previously, all admission notes were performed freehand. The quality and completeness of admission notes was evaluated both before and after implementation of the proforma over two separate 4-week periods by assessing documentation across 19 criteria. RESULTS:Two hundred and fifty-one admission notes before proforma implementation and 273 admission notes after implementation were assessed. Proforma uptake was 97%. Documentation improved in all 19 criteria, with statistical significance achieved in 17 of these. These include past medical history, medication lists, allergy status, physical examination findings, blood results, vital signs and management plan. The proforma showed evidence of improved communication with both nursing staff and senior colleagues. CONCLUSIONS:The surgical admission proforma has significantly improved the quality and completeness of admission documentation, ensuring improved patient safety and efficiency of care. Structured admission proformas have a positive impact on patient outcomes, doctors' performance, hospital efficiency, communication and audit quality control, thus providing multiple clear benefits in comparison to freehand admission notes.
journal_name
Ir J Med Scijournal_title
Irish journal of medical scienceauthors
Hannan E,Ahmad A,O'Brien A,Ramjit S,Mansoor S,Toomey Ddoi
10.1007/s11845-020-02475-1subject
Has Abstractpub_date
2021-01-19 00:00:00eissn
0021-1265issn
1863-4362pii
10.1007/s11845-020-02475-1pub_type
杂志文章abstract：:Reproductive surrogacy can be altruistic or commercial, each with complex ethical considerations that are complicated by heterogeneity in governing laws across jurisdictions. Surrogacy in Ireland is relatively new and largely unregulated, so this review aims to elucidate its current regulatory status and associated et...
journal_title：Irish journal of medical science
pub_type： 杂志文章,评审
doi：10.1007/s11845-020-02402-4
更新日期：2020-10-31 00:00:00
abstract：:Percutaneous tracheostomy (PCT) facilitates easy, bedside insertion of a tracheostomy tube. The percutaneous approach to tracheostomy is used in some parts of the world. This is the first report of a PCT method, in Ireland. The percutaneous technique appears to have advantages over conventional, surgical tracheostomy....
journal_title：Irish journal of medical science
pub_type： 杂志文章
doi：10.1007/BF02996321
更新日期：1993-10-01 00:00:00
abstract：:The development of the Free Cortisol Index, an indirect measurement of the free or metabolically active portion of circulating cortisol, is described. Patients with non-adrenal disease had FCl values in the same range as normal subjects and in patients with adrenal disease the FCl values moved in the same direction as...
journal_title：Irish journal of medical science
pub_type： 杂志文章
doi：10.1007/BF02939036
更新日期：1975-12-01 00:00:00
abstract：BACKGROUND:Wound botulism occurs as a consequence of inoculation of Clostridium botulinum spores into a wound. AIM:To describe such a case of wound botulism. RESULTS:A 23-year-old drug-injecting user presented with bulbar symptoms and progressive signs over a three-day period. The diagnosis of botulism was suspected ...
journal_title：Irish journal of medical science
pub_type： 杂志文章
doi：10.1007/BF02914502
更新日期：2003-07-01 00:00:00
abstract：:Advocates of transhiatal oesophagectomy warn of the danger of tracheal injury resulting from the blind dissection of tumours of the upper and middle thirds of the oesophagus when the tumour has invaded the membranous part of the trachea. We report an unusual cause of tracheal injury at transhiatal oesophagectomy due t...
journal_title：Irish journal of medical science
pub_type： 杂志文章
doi：10.1007/BF02947266
更新日期：1991-03-01 00:00:00
abstract：AIMS:A retrospective post-mortem analysis was undertaken to determine the aetiology of sudden cardiac death (SCD) amongst individuals aged journal_title：Irish journal of medical science pub_type： 杂志文章 doi：10.1007/s11845-009-0294-8 更新日期：2009-09-01 00:00:00
abstract：AIMS:Imported childhood malaria has never been studied in Ireland. We aimed to document the incidence and species of malaria in children presenting to paediatric hospitals in Dublin and to examine management and outcome measures. METHODS:Subjects were identified through laboratory archives from the three paediatric ho...
journal_title：Irish journal of medical science
pub_type： 杂志文章
doi：10.1007/s11845-009-0343-3
更新日期：2009-09-01 00:00:00
abstract：BACKGROUND:Vitamin D deficiency in pregnancy has important maternal and fetal implications, with increased risk of developing gestational diabetes, preeclampsia, preterm birth and small for gestational age birthweight. It is recommended that every pregnant woman should take 5 μg (200 IU) of vitamin D per day during pre...
journal_title：Irish journal of medical science
pub_type： 杂志文章
doi：10.1007/s11845-017-1707-8
更新日期：2018-08-01 00:00:00
abstract：:It has been suggested in the literature that an eight hour period of distal oesophageal monitoring is adequate for the diagnosis of reflux in symptomatic patients. The aim of this study was to investigate whether 3 hour intra-oesophageal pH-metry could be substituted for the eight hour test period without loss of sens...
journal_title：Irish journal of medical science
pub_type： 杂志文章
doi：10.1007/BF02947641
更新日期：1991-02-01 00:00:00
abstract：OBJECTIVE:Evaluate condylar, ramal, and condylar plus ramal vertical mandibular asymmetry in patients with unilateral posterior crossbite (UPCB) and in patients with unilateral cleft lip and palate (UCLP) compared with subjects having normal occlusion. DESIGN:This cross-sectional study evaluated panoramic radiographs ...
journal_title：Irish journal of medical science
pub_type： 杂志文章
doi：10.1007/s11845-013-1020-0
更新日期：2014-09-01 00:00:00
abstract：BACKGROUND:Dysphagia affects up to 30% of hospitalized patients, and it is associated with numerous complications. AIMS:Assess the impact of a 24/7 dysphagia screening protocol in an Internal Medicine Unit regarding respiratory complications (such as aspiration pneumonia) as the primary outcome. Length of stay and dis...
journal_title：Irish journal of medical science
pub_type： 杂志文章
doi：10.1007/s11845-020-02371-8
更新日期：2020-09-22 00:00:00
abstract：BACKGROUND:Cardiac arrest due to ischaemia is frequently the first manifestation of cardiovascular disease. We sought to describe the characteristics and outcomes of patients admitted to the Intensive Care Unit (ICU) with a diagnosis of cardiac arrest secondary to acute coronary syndrome (ACS). METHODS:We performed a ...
journal_title：Irish journal of medical science
pub_type： 杂志文章
doi：10.1007/s11845-016-1422-x
更新日期：2017-02-01 00:00:00
abstract：BACKGROUND:It has been recognised for some time that mortality rates vary across social class groups, with lower rates in the higher social classes. Internationally, but particularly in Ireland, many studies on the topic of inequalities in mortality have been confined to men, partly because the most frequently used soc...
journal_title：Irish journal of medical science
pub_type： 杂志文章
doi：10.1007/s11845-014-1189-x
更新日期：2015-09-01 00:00:00
abstract：BACKGROUND:Secondary prevention therapies, such as angiotension converting enzyme (ACE) inhibitors, beta-blockers and statins, are known to reduce cardiovascular morbidity and mortality. OBJECTIVE:The aim of the study was to examine the prevalence of coronary heart disease (CHD) and the prescribing of secondary preven...
journal_title：Irish journal of medical science
pub_type： 杂志文章
doi：10.1007/BF03169139
更新日期：2005-07-01 00:00:00
abstract：:The use of injectable gold in the treatment of rheumatoid arthritis (RA) is hampered by the high incidence of adverse reactions of which myelotoxicity is potentially the most serious. Regular full blood count (FBC) monitoring prior to each injection, a practice which requires much time and effort, has never been fully...
journal_title：Irish journal of medical science
pub_type： 杂志文章
doi：10.1007/BF02983717
更新日期：1992-03-01 00:00:00
abstract：:An unusual case of a well-documented granulomatous hepatitis in secondary syphilis in a 47-year-old male is presented. This hepatic pathology in secondary syphilis is summarised, and a review of the literature regarding syphilitic granulomatous hepatitis presented. ...
journal_title：Irish journal of medical science
pub_type： 杂志文章,评审
doi：10.1007/BF02937251
更新日期：1990-02-01 00:00:00
abstract：INTRODUCTION:One in eight paediatric primary care presentations is for a musculoskeletal (MSK) disorder. These patients are frequently referred to paediatric orthopaedic surgeons; however, up to 50% of referrals are for normal variants. This results in excessive wait-times and impedes access for urgent surgical cases. ...
journal_title：Irish journal of medical science
pub_type： 杂志文章,评审
doi：10.1007/s11845-017-1611-2
更新日期：2018-02-01 00:00:00
abstract：:It is widely acknowledged that there is interplay between physical and mental health, with causality in both directions. A common theme across countries is the uncertainty surrounding who should act as gatekeeper for physical health matters in psychiatry. Much of the metabolic monitoring is carried out by psychiatrist...
journal_title：Irish journal of medical science
pub_type： 杂志文章,评审
doi：10.1007/s11845-014-1205-1
更新日期：2015-03-01 00:00:00
abstract：:We describe a man who was diagnosed with non-small cell lung cancer following previous treatment for small cell lung cancer. He developed dyspnoea, paroxysmal nocturnal dyspnoea and orthopnoea. Trans-thoracic echocardiogram revealed a large mass within the right atrium. The patient proceeded to thoracotomy at which ti...
journal_title：Irish journal of medical science
pub_type： 杂志文章
doi：10.1007/s11845-008-0240-1
更新日期：2011-06-01 00:00:00
abstract：BACKGROUND:Patients' awareness of the increased cardiovascular risk associated with their diabetes is poorly documented. AIM:The aim of this study was to assess the awareness of diabetes complications among patients with diabetes in Ireland. METHODS:Patients attending diabetes outpatient clinics in two teaching hospi...
journal_title：Irish journal of medical science
pub_type： 杂志文章
doi：10.1007/s11845-009-0301-0
更新日期：2009-12-01 00:00:00
abstract：AIM:The aim of this study was to investigate the microbiology of secondary bacterial peritonitis due to appendicitis and the appropriateness of current antimicrobial practice in one institution. METHODS:A 14-year retrospective single-centre study of 69 consecutive paediatric patients (age 1-14 years) with appendicitis...
journal_title：Irish journal of medical science
pub_type： 杂志文章
doi：10.1007/s11845-013-1055-2
更新日期：2014-12-01 00:00:00
abstract：OBJECTIVES:The European and American colonoscopy guidelines recommend mandatory photodocumentation of caecal intubation to allow retrospective analysis and improve outcomes. We aim to demonstrate whether photodocumentation of caecal intubation improves colonoscopy outcomes. METHODS:We extracted images and procedural d...
journal_title：Irish journal of medical science
pub_type： 杂志文章
doi：10.1007/s11845-020-02469-z
更新日期：2021-01-20 00:00:00
abstract：BACKGROUND AND AIMS:Assess the association between the Society for Vascular Surgery/American Association for Vascular Surgery (SVS/AVSS) (Rutherford et al., J Vasc Surg 26: 517-38, 1997; Chaikof et al., J Vasc Surg 35:1061-6, 2002) medical comorbidity scoring scheme (MCS), and the global scoring system (GS) and major m...
journal_title：Irish journal of medical science
pub_type： 杂志文章
doi：10.1007/s11845-019-02160-y
更新日期：2020-08-01 00:00:00
abstract：:1. Rats were rendered hypoxic by maintaining them within silicone rubber membrane covered enclosures. In experiment one the inspired oxygen concentration was progressively reduced from 21 per cent to 7 per cent over a period of 13 days. In the second experiment the inspired oxygen was maintained at nine per cent for s...
journal_title：Irish journal of medical science
pub_type： 杂志文章
doi：10.1007/BF02939026
更新日期：1975-12-01 00:00:00
abstract：:Hepatic haemangiosarcoma is a rare condition although there are known carcinogens in 25%. This case reports hepatic haemangiosarcoma in a 59 year old man with psoriasis and Crohn's disease who had previously received combined treatment with psoralen and UVA light. ...
journal_title：Irish journal of medical science
pub_type： 杂志文章,评审
doi：10.1007/BF02942382
更新日期：1992-12-01 00:00:00
abstract：BACKGROUND:Treatment of pilonidal sinus disease is controversial. Many claim policy of marsupialisation and healing by secondary intention. This is demanding in terms of nursing care and time lost from work. AIMS:To examine outcome of excision and primary closure of chronic pilonidal disease on recurrence rate and pat...
journal_title：Irish journal of medical science
pub_type： 杂志文章
doi：10.1007/s11845-010-0532-0
更新日期：2011-03-01 00:00:00
abstract：OBJECTIVE:To analyze the capability of four-dimensional surface rendering mode ultrasound (4D SRM USG) in the detection of fetal abnormalities, and also compare it with 2D USG. MATERIALS AND METHODS:A total of 1,379 pregnant women were enrolled in the study, and they all underwent 2D USG screening. In the same session...
journal_title：Irish journal of medical science
pub_type： 杂志文章
doi：10.1007/s11845-014-1184-2
更新日期：2015-09-01 00:00:00
abstract：:Susceptibility to metronidazole of 213 clinical strains of H. pylori from dyspeptic patients was determined by a plate dilution method. Seventy two (33.8%) of the strains were resistant to metronidazole (MIC > 8 mg/L), 20 of these were from 24 patients who had received previously metronidazole (83.3%), giving a primar...
journal_title：Irish journal of medical science
pub_type： 杂志文章
doi：10.1007/BF02942098
更新日期：1993-03-01 00:00:00
abstract：BACKGROUND:Acute appendicitis is the most common surgical emergency. Its management reflects the efficacy of acute care surgery. Limited theatre space is an escalating issue, especially without dedicated emergency theatre access. Pre-operative delays are associated with longer length of stay, higher costs and post-oper...
journal_title：Irish journal of medical science
pub_type： 杂志文章
doi：10.1007/s11845-019-02135-z
更新日期：2020-05-01 00:00:00
abstract：:This article was published online with an error. In Table 3, the name of the variable in the last row is missing. It just says 'mmHg'. The name to be written is 'MAP (mmHg)'. ...
journal_title：Irish journal of medical science
pub_type： 已发布勘误
doi：10.1007/s11845-020-02363-8
更新日期：2020-09-09 00:00:00
