Postgraduate medical journal
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The Resuscitation Council advocates debriefing after cardiac arrests, as both a training tool and to improve patient outcomes. There is, however, a large variation between hospitals in their implementation of debriefing. This potentially disadvantages trainees, as they are unable to use the presented opportunity to improve their skills and knowledge. The primary aim of this survey was to investigate the utility and perception of debriefing postcardiac arrest among staff at a district general hospital. The secondary aim was to evaluate our specifically designed postcardiac arrest debrief tool. ⋯ Debriefing postcardiac arrest has been associated with improved return of spontaneous circulation (ROSC) neurological outcomes, hands-off compression times as well as reduced time delay to first compression. Despite the benefits, this survey has shown a lack of debriefing at our hospital. We have developed a concise debriefing tool aimed at providing much-needed training for those involved. The tool allows identification of key concerns in leadership, and teamwork and encourages open discussions around areas of concern. We believe that its implementation may improve resuscitation outcomes, and therefore, recommend its use postcardiac arrests.
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We measured medical students' and resident trainees' hand hygiene behaviour, knowledge and attitudes in order to identify important predictors of hand hygiene behaviour in this population. ⋯ Medical students and residents have similar attitudes about hand hygiene, but differ in their level of knowledge and compliance. Concerns about hierarchy may have a significant negative impact on hand hygiene advocacy.
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To identify whether the clinical maturity of medical trainees impacts upon the level of trainee competency in evidence-based medicine (EBM). ⋯ Clinical maturity is the only one factor that may influence medical trainees' competency in EBM. Other predictors of EBM competency may include previous training and exposure to epidemiology, biostatistics and information literacy. While graduate-entry medical students may have more 'life' experience, or maturity, it does not necessarily translate into clinical maturity and integration into the clinical environment.
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This paper considers how the three principles of evidence based practice (clinical expertise, scientific evidence, and patient preference) can be applied to the complexity of treatment for anorexia nervosa AN. ⋯ Thus treatment has to work with motivation and readiness to change and tackle the various domains of ill health.
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Assessing the effects of excessive weight gain before pregnancy, in the first and second trimesters and in the month preceding glucose challenge test (GCT) on GCT results and gestational diabetes mellitus (GDM). ⋯ Elevated pre-pregnancy BMI independently increases the risk of GDM and false-positive GCT. First trimester weight gain is the most important predictor of GCT and GDM regardless of pre-pregnancy BMI. The weight gain during the subsequent period affects the risk of developing GDM only in women with excessive first-trimester weight gain.