3 results
Development of a Multi-Disciplinary Team Memory Clinic Checklist: A Quality Improvement Project
- Shona Ginty, Jiann Lin Loo, Salvador Olivio Tereza, Sarmishtha Bhattacharyya
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- Journal:
- BJPsych Open / Volume 9 / Issue S1 / July 2023
- Published online by Cambridge University Press:
- 07 July 2023, pp. S90-S91
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Aims
Although “to err is human”, human error in medical practice can be costly for both patients and the healthcare organisation. Different preventive methods have been developed and one of the approaches is the use of checklist. The conceptualisation of this quality improvement project (QIP) came about after a near-miss prescribing error occurred in the memory clinic. Therefore, the Memory Clinic Multi-disciplinary Team (MDT) Checklist has been created to make the documentation process of diagnosis, investigation, and treatment more systematic and structured, which will in turn reduce the risk of errors associated with it. The checklist is separated into the subtype of Initial Assessment and Follow Up. This article is aimed to share the outcome of the QIP.
MethodsThe QIP was carried using the Plan-Do-Study-Act (PDSA) model. Version 1 of the checklist was made based on the guidance from the National Institute of Clinical Excellence (NICE) guideline NG97, which was tried in the Memory Clinic MDT discussion of Older Person Mental Health Community Team of Wrexham Maelor Hospital (OPCMHT WMH), Betsi Cadwaladr University Health Board (BCUHB). Microsoft Forms survey was performed to capture the feedback from the junior doctors using the checklist. The following five properties were ranked using a five-point Likert scale (with one as the lowest and five as the highest): ease of use, time efficiency, environmentally friendly, capturing important information and space availability. The checklist was then updated based on the qualitative feedback and PDSA cycle was repeated until the feedback was rated more than 4/5 on average for all domains.
ResultsTwo PDSA cycles were needed to reach the version that was rated as more than 4/5 on average for all domains and the final version of the checklist was accepted as the completed version, i.e. the Version 3. There was a significant improvement in the ease of use, time efficiency, environmentally friendly and space availability. All versions of the Memory Clinic MDT checklists were good for capturing important information but not performing well for the other domains.
ConclusionThe Memory Clinic MDT Checklist are now fully in use in OPCMHT WMH BCUHB. Long term evaluation is still required to maximise the efficiency of the checklist. There is further plan of expanding the use of checklist in different memory clinic of BCUHB.
Assessment of Knowledge About Frailty Syndrome Among Doctors and Its Intervention: A Literature Review
- Jiann Lin Loo, Manjula Simiyon, Catrin Thomas, Shona Ginty, Wamiqur Rehman Gajdhar, Sioned Mai Griffiths, Mohammed Ibrahim Hassan Ibrahim
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- Journal:
- BJPsych Open / Volume 9 / Issue S1 / July 2023
- Published online by Cambridge University Press:
- 07 July 2023, p. S49
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Aims
Under-detection of frailty syndrome or sarcopenia can result in significant mortality and morbidity among elderly patients, especially in old-age mental health settings. Therefore, it is crucial to ensure doctors are equipped with the competency of early identification and management of frailty syndrome. To date, there is limited information about any systematic approaches to assess and improve the knowledge, attitude, and practice of doctors about frailty syndrome. This literature review is aimed to identify the tools used to assess the knowledge of doctors about frailty syndrome and the available educational intervention to improve doctors’ knowledge.
MethodsA literature search was performed in Google Scholar, PubMed, SCOPUS, Ovid, and EMBASE using the keywords of “frailty syndrome” AND “knowledge” AND “doctors”. Data collected included the assessment tool used to understand the knowledge level and the intervention used to improve the knowledge. The inclusion criteria were: studies published in English in the last 10 years which assessed the knowledge of doctors about frailty syndrome.
ResultsThere were five studies fulfilling the inclusion criteria after the title and abstract screening, two from the Americas, two from Europe, and one from Australia.
The target group of studies involved general practitioners and doctors working in the primary healthcare setting (three), orthopaedic surgeons (one), and doctors working in the trauma setting (one). Two of the studies included non-medical healthcare practitioners as their participants.
One study used qualitative semi-structured individual interviews, two used a self-report questionnaire, one combined knowledge testing and self-report questionnaire, and one study compared the clinical assessment with a validated tool.
Only one study provided an educational intervention, i.e., a single-day training course conducted by three geriatricians.
ConclusionDespite a comprehensive search, there were limited studies identified on this topic. The methods used to assess doctors’ knowledge about frailty syndrome are heterogeneous and no standardised tool has been identified in the process. There is only one study using educational intervention to improve knowledge, which was found to be effective and sustainable based on the change in self-perception, i.e. Kirkpatrick Level 1 of evaluation. There is a need to develop systematic assessment approaches or tools and training modules to improve the knowledge of doctors about frailty syndrome. Nevertheless, this review is limited only to studies published in English.
Adherence to Public Health England (PHE) guidance for the use of personal protective equipment (PPE) in north Wales mental health unit- a regional audit
- Asha Dhandapani, Sathyan Soundararajan, Alberto Salmoiraghi, Shona Ginty, Tajnin Mitu, Justina Akinlua, Catrin Thomas, Rahul Malhotra, Zeenish Azhar, Haseeb Bhutta, Hanani Taib, Nikhil Gauri Shankar, Vikram Bhangu, Gathoni Kamau, Elizabeth Chamberlain, Anna Mackenzie, Henrik PAHLEN, Hannah Lock, Aniis Rymansaib, Pauline Mclean, Rodrigo Trujillo, Manjula Simiyon, Adam Chappell, Agnieszka Gross, Gaynor Gaskell
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- Journal:
- BJPsych Open / Volume 7 / Issue S1 / June 2021
- Published online by Cambridge University Press:
- 18 June 2021, p. S318
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Aims
To ensure that the PPE guidance is strictly adhered to.
To ensure that patient care is not compromised.
To help us in areas of need in order to educate the staff regarding the techniques of PPE and thus ensure patient and staff safety and care during the pandemic.
MethodNovel coronavirus 2019 was first described in December 2019 in Wuhan in China. Since those initial few cases, it has rapidly proliferated to a global pandemic, putting an inordinate amount of strain on healthcare systems around the world. We believe that the technique of donning and doffing if followed as per PHE guidelines would be of help in both preventing the infection and improve the care and safety of both patients and staff.
This Audit includes both In-patient and Out-patient units in Psychiatric services across North Wales. Data were collected from 19 units out of 39. We observed covertly 325 staff members belonging to various cadres. Apart from the Donning and Doffing techniques, we also observed the availability of designated areas for this purpose and the availability of PPE as well.
Data collection was by junior and senior doctors from various sites of the mental health unit in North Wales. A proforma was provided, the standards were based on PHE guidelines.
ResultIt was noted that just about 50% of the staff followed donning as per guidance. Amongst all three sites, the Central team showed a better adherence with 85% of them donning PPE correctly. whereas only 22% adhered to donning in the West team.
Only 21% of them managed to doff PPE as per guidance amongst all 3 centres in North Wales.
It was also noted that there are no designated areas to Don and Doff in outpatient units. Staff, in general, seem to not adhere to the guidance of utilising a mask, especially when within 2 meters distance of other staff.
ConclusionWe will be presenting the Audit at the regional meeting. After discussion with the infection prevention control team and Health and safety lead, we intend to improvise the wards with designated areas for donning and doffing. Teaching sessions for the staff in all three sites, reminders in various areas of the community mental health units and inpatient units.
We are hoping that these recommendations will help us in achieving our aim of health and safety during this pandemic.