The New Zealand medical journal
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The process of care of older patients with fractured neck of femur at Auckland City Hospital has recently changed with selected patients "fast-tracked" as soon as possible postoperatively to a specialised Older People's Health (OPH) ward. ⋯ Many patients experience a delay to surgery for non-medical reasons. The percentage transferred to Older Peoples Health is high. Fast-tracking to Older Peoples Health shortens overall length of stay due to fewer days in Orthopaedics. Many patients require a higher level of care after hip fracture, particularly if already resident in Rest Home. Demographics and inpatient mortality are comparable, but total length of stay is longer than similar New Zealand studies due to a longer length of stay in Older Peoples Health. Review of previous data from Auckland City Hospital and from other New Zealand centres shows significant variability in process of care for older patients with hip fracture.
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To investigate staff perceptions of the burden of alcohol-related presentations on emergency departments (ED) in New Zealand and the impact on staff of alcohol-related ED presentations. ⋯ This small exploratory study found that alcohol-related presentations have a negative impact on ED staff workload and safety, and may compromise treatment of all patients. More research is needed to corroborate these findings and to investigate policies to reduce the impacts of alcohol-related presentations in the ED.
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To survey new patients, presenting to three drug clinics, on the patterns, usage and costs of prescription pharmaceuticals. ⋯ Morphine and methadone remain the predominant street opioid PDs in this region. Street prices have reduced, perhaps reflecting greater drug availability in accordance with increased national prescribing of opioids. There is continuing diversion of PDs to the street which is an ongoing Public Health issue requiring coordinated responses, including improved prescribing training, pain guidelines, drug clinic policy and actions by Medsafe, Police and regulatory bodies to contain this problem.