Journal of the Royal College of Physicians of London
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J R Coll Physicians Lond · May 1996
The junior doctor handover: current practices and future expectations.
Restructuring junior doctors' patterns of work has led to several changes, including the increasing implementation of shift and partial-shift rotas. These changes heighten the necessity for good communication between the doctors responsible at different times for the patients. ⋯ In our opinion, the lack of advice and guidance on the structure of handover has impeded good practice, and a standard of professional practice needs to be set. Opportunities exist within the NHS to utilise information systems to obtain the necessary information and to improve the format of the handover.
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J R Coll Physicians Lond · Mar 1996
When can elderly patients be excluded from discussing resuscitation?
Case notes of elderly medical patients were surveyed to determine when "do not resuscitate' (DNR) decisions could legitimately be made without consulting them. Patients were thought to be suitable for exclusion from decisions if morbidity scores indicated that they were unlikely to survive cardiopulmonary resuscitation (CPR) or if they were mentally incompetent. ⋯ Of those with DNR decisions, 59% were predicted not to survive and a further 24% were incompetent. Discussing resuscitation would have been appropriate with 17% of those with DNR decisions.