2024

Each Baby Counts: Learn and Support (2024)

Posted on by

Type of publication:

Service improvement case study

Author(s):

*Paula Pryce

Citation:

SaTH Improvement Hub, September 2024

Abstract:

To introduce the communication tool and terminology of Each Baby Counts: Learn and Support to the team by the end of August 2024 as evidenced by observation of conversations and documentation.

Link to PDF poster

Medical Acute Take Handover (2024)

Posted on by

Type of publication:

Service improvement case study

Author(s):

*Navya Basavaraju, *Dr Sam Craik, *Hazel Green, *Dr Nawaid Ahmad, *Dr Shakawan Ismaeel, * Dr Thimmegowda Govindagowda

Citation:

SaTH Improvement Hub, September 2024

Abstract:

Improve how colleagues feel about the content and structure of a Medical Acute Take Handover by 1st September 2024. To improve the structure and standardization of handover at our hospital in concordance with Royal College of Physicians (RCP) recommendations for good clinical handover

Link to PDF poster

PRH ED Waiting Room Improvements (2024)

Posted on by

Type of publication:

Service improvement case study

Author(s):

*Laura Wild

Citation:

SaTH Improvement Hub, August 2024

Abstract:

Improve the quality of care provided to patients as measured by an increase in compliance to observations, analgesia provision, reduction in interruptions and improvement in patient feedback by 31/07/2024.

Link to PDF poster

SATH Children’s Assessment Unit Improvement Programme (2024)

Posted on by

Type of publication:

Service improvement case study

Author(s):

*Rachel Triggs

Citation:

SaTH Improvement Hub, October 2024

Abstract:

To facilitate a core group of Registered children's nurses who work in the Children’s Assessment Unit (CAU) to become competent in conducting a Triage on all paediatric patients referred to the unit using the Manchester Triage system.

Link to PDF poster

AMA Seated Area Test of Change (2024)

Posted on by

Type of publication:

Service improvement case study

Author(s):

*Rebekah Tudor

Citation:

SaTH Improvement Hub, November 2024

Abstract:

  • Improve the Length of stay (LoS) in the RSH Emergency Department (for medical patients) during the test of change weeks (by 25/10/2024)
  • Improve the LoS in the AMA Seated Area at RSH during the test of change weeks (by 25/10/2024)
  • Improve the number of discharges (all discharge destinations) from the RSH acute floor during the test of change weeks (by 25/10/2024)

Link to PDF poster

Mucus plugging and mucolytics in patients admitted with acute exacerbation of chronic obstructive pulmonary disease (COPD); investigating impact on short term mortality (2024)

Posted on by

Type of publication:

Conference abstract

Author(s):

*Abugassa E.; *Bosher O.; *Makan N.; *Crawford E.; *Saleem M.A.; *Srinivasan K.; *Moudgil H.

Citation:

European Respiratory Journal. Conference: European Respiratory Society International Congress, ERS 2024. Vienna Austria. 64(Supplement 68) (pp PA3010), 2024. Date of Publication: 01 Sep 2024.

Abstract:

Background: Although mucus plugging occluding medium to large sized airways in COPD is associated with increased long term all-cause mortality, acute exacerbations require further investigation, particularly where, despite reducing morbidity and improving quality of life, long-term use of mucolytics remains controversial. Objectives were (1) to quantify chest CT evidence of mucus plugging, (2) relate findings to mucolytics, and (3) investigate mucus plugging association with short term mortality.

Method(s): Retrospective review of 100 patients admitted with exacerbation of COPD (105 admissions).comparative analysis by chi square (x2) and logistic regression, significant p<.05.

Result(s): Mean (SD, range) age was 74.7 (10.5, 41-97) years with 54% male; mean FEV1/FVC 55% with FEV1 1.2(0.59, 0.4-3.6) litres at 49% predicted. 23 were on long term oxygen (LTOT). Mean stay was 6.3 (1-41) days. 24 died in the first 6 months. Where a historical or admission chest CT was available (n=82), 12 (15%) had mucus plugging with mucolytics prescribed to 6 (50%) compared to 32/70 (46%) without plugging (x2 0.057, NS). 9/56 (16%) with mucus plugging vs 3/26 (12%) without (x2 0.2921, NS) had emphysema and 3/13 (23%) vs 9/69 (13%) without (x2 1.016, NS) bronchiectasis. Regression investigating mortality at 6 months showed adverse outcomes for male sex, lower FEV1, and LTOT.

Conclusion(s): 15% with acute COPD admissions have current or historical evidence of mucus plugging. Mucolytics are prescribed for 45% irrespective of prior CT radiology. Mortality (24%) at 6 months is high but not shown related to mucus plugging or reduced by mucolytics.

Link to full-text [no password required]

Cost of Tuberculosis (TB) screening and contact tracing an Eastern European immigrant population seasonally employed at an agricultural farm in the United Kingdom (2024)

Posted on by

Type of publication:

Conference abstract

Author(s):

*George S.; *Moudgil H.;

Citation:

European Respiratory Journal. Conference: European Respiratory Society International Congress, ERS 2024. Vienna Austria. 64(Supplement 68) (pp PA1475), 2024. Date of Publication: 01 Sep 2024.

Abstract:

Background: Economic data inform public health measures; a co-ordinated approach to TB contact tracing, guided by Public Health England (PHE), was undertaken assessing a non English speaking Eastern European immigrant population seasonally employed at an agricultural farm and we (1) report direct costs, (2) identify cultural issues and risks employing such a population Methods: After an initial pilot study of work-based contacts of an index case, contact lists incorporating workforce in every shift pattern back-dated two years to his UK entry were identified. Direct costs included T-spot testing (Oxford Immunotec) and translators (Romanian, Polish, Lithuanian, Italian) along with secondary care charges at tariff with uniform cross-charge among providers. TB drug costs (managing latent or disease) were from the British National Formulary.
Result(s): 258/331 (78%) workers took up testing. 80 (31%) were then referred for contact screening; of these, 47 had latent and 3 active disease. 16 defaulted, 5 declined, 4 were pregnant, and 5 lost moved elsewhere. Most had no registered General Practitioner and no pre-employment health check, BCG or radiology. Anecdotally, several returned to their parent countries for healthcare advice despite measures to overcome language barriers. Main direct costs (51,497-52) equated to 199-60/person screening and 1029-95/person treated for either latent or TB disease.
Conclusion(s): Language and cultural barriers are challenges to TB screening/contact tracing. Direct costs are 200 (UK pound sterling = 1.17 Euro) per patient screened and five times this amount treating latent or active disease.

Link to full-text [no password required]