Health bulletin
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An employer's 'duty of care' is enshrined in statute and common law. This responsibility extends to identifying areas of risk to employee's safety and emotional well being. ⋯ Staff are generally satisfied with the steps taken to safeguard them against hazardous substances and serious infection. Assault by and abuse from patients is a considerable risk, especially for trained nurses. In terms of bullying, harassment, discrimination and victimization, the abuse of power by colleagues is also a distressing and under-reported phenomenon which needs to be addressed by regular audit and the creation of a climate in which employees feel secure enough to report such abuse and to have faith in the mechanisms set up to deal with such complaints.
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Comparative Study
Effect of general practitioner hospitals on district general hospital bed use in the Highlands of Scotland.
To examine hospital bed use by General Practices with and without access to General Practitioner beds. ⋯ These findings largely replicate work in England that found substantial decreases in General Medical and Geriatric Medicine bed use in Practices with access to GP beds, combined with an overall increase in occupied bed day use of 6-8% per 1000 patients. The lower use of surgical beds was unexpected, and may reflect more flexible use of GP beds in the Highlands for observation or rehabilitation, possibly related to the far greater distances involved than in the English studies.
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To ascertain whether local guidelines for diabetes management influence the content of GP referral letters to a diabetes specialist clinic. ⋯ Diabetes guidelines per se appeared to have very little effect on increasing the information provided in GP referral letters on relevant medical problems and did not appear to have influenced screening for complications in patients with Type 2 diabetes by GPs before specialist referral. Methods other than the issue of written guidelines are required to achieve optimal assessment of diabetic patients in the community.
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Comparative Study
Pathways to psychiatric admission: a study of 100 consecutive admissions to south Glasgow acute adult psychiatric wards.
To examine routes of admission to psychiatric beds and to identify factors that influence this. ⋯ Patients are referred for admission to acute psychiatric wards from a variety of sources. Most admissions occur outwith office hours. In a large majority of cases the admitting psychiatrist is the on-call SHO, rather than a doctor from the team responsible for the patient's management. Our data suggest that this is not a reflection of the type of cases referred for urgent assessment but rather a failure of certain aspects of service provision.
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The Scottish Trauma Audit Group was established in 1991 to observe and improve the management of seriously injured patients in four Scottish teaching hospitals. There are currently 25 hospitals contributing to the national database. This prospective audit monitors the management of approximately 98% of seriously injured patients in Scotland. ⋯ There was no evidence of a trimodal distribution of death as a result of injury. There has been a significant increase in the survival of seriously injured patients over the last six years from 65.3% to 75.6%. In terms of survival, the management of injured patients in Scotland is significantly better than that of the rest of the UK.