The New Zealand medical journal
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Comparative Study Historical Article
Patients admitted with an acute coronary syndrome (ACS) in New Zealand in 2007: results of a second comprehensive nationwide audit and a comparison with the first audit from 2002.
To audit all patients admitted to a New Zealand (NZ) Hospital with an acute coronary syndrome (ACS) over a 14-day period, to assess their number, presentation type and patient management during the hospital admission and at discharge. To compare patient management in 2007 with the 1st NZ Cardiac Society ACS Audit from 2002. ⋯ A collaborative group of clinicians and nurses has performed a second nationwide audit of ACS patients. Despite a small increase in access to cardiac angiography, guideline recommended risk stratification following the index suspected ACS admission with a treadmill test or cardiac angiogram occurred in only 1 in 2 (48%) patients. Furthermore, in patients with a definite ACS, levels of revascularisation are low. (PCI 19%, CABG 2.8%). These aspects of care remain of significant concern and have not substantially changed in 5 years. There remains an urgent need to develop a comprehensive national strategy to improve all aspects of ACS patient management.
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There are few published ERAS cost-analyses in colorectal surgery. The aim of this paper is to evaluate whether costs saved by reduced postoperative resource utilisation would offset the financial burden of setting up and maintaining such an ERAS programme. ⋯ Implementing an ERAS program is cost-effective in the medium term, with costs offset by those recovered by reduced resource utilisation in the postoperative period.
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To compare the management of acute coronary syndrome (ACS) patients presenting to interventional versus non-interventional New Zealand hospitals, with emphasis, on access delays for invasive assessment and revascularisation treatments. ⋯ Patients admitted to a New Zealand hospital with an acute coronary syndrome experience delays in accessing investigations and subsequent revascularisation. Furthermore, inequity exists with delays being significantly longer for patients admitted to a non-intervention centre. A comprehensive national strategy is needed to improve access to optimal cardiac care.
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Medical students at the University of Otago are now required to sign a 'student code' on beginning medical school. This new requirement has been put in place in response to changes to the medical curriculum that have resulted in earlier and increased contact with patients, healthcare staff and the general public, and in order to recognise and formalise the students' own learning needs. ⋯ The student code, while having common values espoused in other extant codes, is framed with the student experience in mind. The authors discuss the process of development, implementation and proposed review.