Laws, Ethics and Standards
John Fry, Nat Yuen in Principles and Practice of Primary Care and Family Medicine: Asia-Pacific Perspectives, 2018
There is still not any limitation or restriction to practising any branch or specific area of medicine. An individual doctor’s standard of practice is measured against a minimal acceptable standard, maintained and upheld by a group of doctors with recognized specialty training and experience in the respective field. This minimal acceptable standard of practice is necessary to protect patients’ interests and to maintain professional standards. Qualifications recognized by the Academy of Medicine of Hong Kong could be one way to identify the group doctors deemed to be qualified to uphold this minimal acceptable standard of practice in any specified field, with a possible mandatory requirement of continuing medical education. Regardless of whether or not they have recognized qualifications or specialized training, the Medical Council is likely to introduce regulations that require doctors to practise good standards of medical care.
Queensland's new physical restraint framework
Bernadette McSherry, Yvette Maker in Restrictive Practices in Health Care and Disability Settings, 2020
Mental health legislation appears to be a ‘command and control’ regulatory environment. In practice, although investigatory powers are often used to shed light on incidents and breaches, the powers of penalty and censure are rarely used, particularly where there is a desire to improve practice. Policies that are compulsory and guidelines that are not form the basis of a standard of practice but rely on their implementation at a local level. The relationship between consumer and clinician and the culture of safety and harm reduction that is promoted on the ward is very important in reducing restrictive practices and has the chance to be preventative. Censure, whether by internal mechanisms such as Chief Executives or externally by the Chief Psychiatrist or other bodies, usually occurs after the fact. Although spectacular failure can be a platform for reform (Wright et al. 2017), the goal of governance systems should be to prevent these situations arising.
Paediatric and neonatal transfusions
Jennifer Duguid, Lawrence Tim Goodnough, Michael J. Desmond in Transfusion Medicine in Practice, 2020
Transfusion of blood or blood products to children and infants requires special consideration for a number of reasons. Careful thought needs to be given both to the clinical indication for blood and blood products and to any special requirements of the products resulting from the age of the recipient. Children receiving transfusions are largely expected to have a normal life expectancy and therefore to have longer in which to manifest any long term ill-effects of the transfusion process. Transfusion of any blood component is a potentially hazardous procedure; the parents of a child requiring blood products often worry about possible transmission of infection, but do not realize that the greatest risk is that a child will get a product intended for someone else as a result of one or more human errors at some stage of the process.12 It is important to be clear that any transfusion of blood product is clearly needed and that the indication is recorded in the case record. Unfortunately, there are many areas of paediatric transfusion practice where evidence for efficacy is lacking. Despite this, guidelines based upon opinion and standard of practice can be very useful – at least as a base against which to audit practice and outcomes.
Sex differences in symptom presentation and functional outcomes: a pilot study in a matched sample of veterans with mild TBI
Published in Brain Injury, 2020
Max Gray, Maheen M. Adamson, Ryan C. Thompson, Kristopher I. Kapphahn, Summer Han, Joyce S. Chung, Odette A. Harris
Data extraction for each female/male pair was conducted using the computerized patient record system (CPRS). Patient clinical data are prospectively entered into CPRS as part of routine clinical procedure. Notes related to TBI assessment and subsequent progress notes pertaining to treatment and management of Polytrauma/TBI were retrospectively abstracted and analyzed. Personnel conducting chart review and data extraction were trained to establish consistency and areas of ambiguity were reviewed on a case by case basis. The standard of practice at our site is for an interdisciplinary team consisting of a physician, psychologist and social worker to collaboratively determine diagnoses. Therefore, the diagnoses entered into the medical record reflect a consensus among multiple providers. A majority of the abstracted data were collected from the Comprehensive TBI Evaluation (CTBIE). The CTBIE is a standardized diagnostic procedure conducted by a team of clinicians including a physical exam, psychiatric history, deployment and injury history, and neurobehavioral and post-concussive self-report questionnaires(20). VA clinicians’ use of the CTBIE has demonstrated good sensitivity and specificity (25) and is the gold standard for TBI diagnosis in the PNS clinics.
Factors influencing the use of outcome measures in knee osteoarthritis: A mixed method study of physiotherapists in Nigeria
Published in Physiotherapy Theory and Practice, 2019
Adesola C. Odole, Nse A. Odunaiya, Joshua O. Ojo, Aderonke O Akinpelu
The implication of our findings to practice will be to have standard of practice and clinical guidelines. There is need for establishment of good organizational structure focusing on the use of outcome measures in practice and development of a concessional toolkit of short and easily applicable instruments with user description. These will certainly result in the use of outcome measures among physiotherapists in Nigeria. There is the need to organize training workshops and seminars for physiotherapists in Nigeria, especially the older physiotherapists who seemingly are at managerial cadres, who may not be interested in postgraduate studies. This should ultimately enhance their knowledge and perceived importance on the use of outcome measures. The authors intend writing a policy brief to the national professional bodies for physiotherapists to embark on development of standard of practice and clinical guidelines in the management of knee OA.
Nursing and allied health professionals’ views about using health literacy screening tools and a universal precautions approach to communication with older adults: a qualitative study
Published in Disability and Rehabilitation, 2020
Charlotte Brooks, Claire Ballinger, Don Nutbeam, Clare Mander, Jo Adams
Practices participants described using for identifying health literacy varied according to individuals, professions and teams; there was no standard practice. Many participants discussed using verbal and non-verbal indicators of low health literacy, interpreted as tacit cues about health literacy. Participants primarily focused on the identification of literacy abilities, which appeared to be linked to their understanding of health literacy. Practices were often ones which could be routinely integrated into standard treatment processes by individual professions or clinical teams. For instance, it was only nurses who discussed picking up cues regarding patients’ reading ability during medication reviews (nurses being the only healthcare profession interviewed who routinely completed medication reviews):
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