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'Medical assessment unit'

Ashfaque Memon, Jose Miranda
A 58 years old woman, known case of multiple sclerosis, was referred to the acute medical assessment unit for worsening liver function. She was recently started on a new drug (fingolimod) for multiple sclerosis. After excluding common causes of acute hepatitis in the community, a working diagnosis of drug-induced liver injury was made. When liver enzymes kept rising, further investigations were carried out, which revealed acute hepatitis E virus (HEV) infection. This finding was unexpected, as this patient had no risk factor to acquire HEV infection and there was not a single case of HEV diagnosed in our hospital since long time...
January 31, 2017: BMJ Case Reports
Oluwatosin Akinbobuyi, Louise Shalders, Tim Nokes
The Department of Health has defined hospital acquired venous thromboembolism (VTE) as any VTE event occurring within 90 days of hospital admission or surgery. (1) Hospital acquired thrombosis (HAT) is common during and after hospital admission and is considered a major patient safety issue. Current NICE guideline (CG 92) 2010, recommends that medical patients assessed at risk of VTE should have pharmacological prophylaxis commenced as soon as possible after risk assessment has been completed and continued until the patient is no longer at increased risk of VTE...
2016: BMJ Quality Improvement Reports
Michael M Dinh, Saartje Berendsen Russell, Kendall J Bein, Kris Rogers, David Muscatello, Richard Paoloni, Jon Hayman, Dane R Chalkley, Rebecca Ivers
BACKGROUND: Disposition decisions are critical to the functioning of Emergency Departments. The objectives of the present study were to derive and internally validate a prediction model for inpatient admission from the Emergency Department to assist with triage, patient flow and clinical decision making. METHODS: This was a retrospective analysis of State-wide Emergency Department data in New South Wales, Australia. Adult patients (age ≥ 16 years) were included if they presented to a Level five or six (tertiary level) Emergency Department in New South Wales, Australia between 2013 and 2014...
December 3, 2016: BMC Emergency Medicine
Christine Toye, Richard Parsons, Susan Slatyer, Samar M Aoun, Rachael Moorin, Rebecca Osseiran-Moisson, Keith D Hill
BACKGROUND: Hospital discharge of older people receiving care at home offers a salient opportunity to identify and address their family caregivers' self-identified support needs. OBJECTIVES: This study tested the hypothesis that the extent to which family caregivers of older people discharged home from hospital felt prepared to provide care at home would be positively influenced by their inclusion in the new Further Enabling Care at Home program. DESIGN: This single-blind randomised controlled trial compared outcomes from usual care alone with those from usual care plus the new program...
December 2016: International Journal of Nursing Studies
Carole Rushton, Julia Crilly, Adeniyi Adeleye, Laurie Grealish, Mandy Beylacq, Mark Forbes
OBJECTIVES: To explore current knowledge of medical assessment units (MAUs) with specific reference to older people with complex needs and to stimulate new topics and questions for future policy, research and practice. METHODS: A scoping review was conducted using an integrated-latent thematic approach. RESULTS: This review provides a unique perspective on MAUs and older people which is framed using four themes: efficiency, effectiveness, equity and time...
September 23, 2016: Australasian Journal on Ageing
Kirsty Hendry, Terence J Quinn, Jonathan Evans, Valeria Scortichini, Hazel Miller, Jennifer Burns, AnneLouise Cunnington, David J Stott
INTRODUCTION: screening all unscheduled older adults for delirium is recommended in national guidelines, but there is no consensus on how to perform initial assessment. AIM: to evaluate the test accuracy of five brief cognitive assessment tools for delirium diagnosis in routine clinical practice. METHODS: a consecutive cohort of non-elective, elderly care (older than 65 years) hospital inpatients admitted to a geriatric medical assessment unit of an urban teaching hospital...
November 2016: Age and Ageing
Roses Parker, Kay deVries, Maureen A Coombs
CONTEXT: While the patient-carer dyad has been broadly described, there is little exploration of patient-carer models in use. AIM: To explore types of patient-carer models in use for those with advanced and progressive disease. METHODS: Qualitative interviews were undertaken with patients at risk of dying in the next year and their carers across three sites (residential care home, medical assessment unit, general medical unit). Thematic analysis was undertaken...
June 2016: International Journal of Palliative Nursing
Mitchell N Sarkies, Kelly-Ann Bowles, Elizabeth H Skinner, Romi Haas, Deb Mitchell, Lisa O'Brien, Kerry May, Marcelle Ghaly, Melissa Ho, Terry P Haines
RATIONALE, AIMS AND OBJECTIVES: The aim of this study was to determine if the addition of daily ward interview data improves the capture of hospital quality and safety indicators compared with incident reporting systems alone. An additional aim was to determine the potential characteristics influencing under-reporting of hospital quality and safety indicators in incident reporting systems. METHODS: A prospective, observational study was performed at two tertiary metropolitan public hospitals...
October 2016: Journal of Evaluation in Clinical Practice
Erin Dean
No abstract text is available yet for this article.
March 2016: Nursing Older People
Jude Kivlin, Harith Altemimi
The Queen Elizabeth Hospital in King's Lynn, Norfolk is a 488 bed hospital providing services to approximately 331,000 people across 750 square miles. In 2012 a need was recognised for documentation (pathways) in a practical format to increase usage of national guidelines and facilitate adherence to best practice (gold standards of care) that could be easily version controlled, auditable and provide support in clinical decision-making by junior doctors. BMJ Action Sets[1] fulfilled the brief with expert knowledge, version control and support, though they were deemed too lengthy and unworkable in fast paced settings like the medical assessment unit; they formed the base creation of concise care bundles (CCB)...
2015: BMJ Quality Improvement Reports
Alister Gomes-Pinto, Ruta Kuzminskyte, Katie Wooding, Katherine Asplin, Liz Ewins
Psychiatry liaison services provide the interface between mental and physical health in the acute medical hospital, however there can be logistical and operational difficulties to overcome. This quality improvement project aimed to improve the timeliness of referrals to a liaison service from an acute hospital through simple interventions of a newsletter, email to staff, and a pilot including attending post-take ward rounds on the Medical Assessment Unit (MAU) of the hospital. This resulted in a faster referral process to liaison as well as improved staff satisfaction with the liaison service, both of which will have a positive benefit on the clinical management of patients and the patients experience in hospital...
2015: BMJ Quality Improvement Reports
Maylin Oppenheimer, Nivin Rezwan
Urinary tract infections (UTI) are a common presentation in a medical assessment unit, and we wanted to check compliance with hospital guidelines for antibiotic prescribing in patients presenting to hospital with urinary tract infection. The guidelines are based on local organisms and sensitivities. A retrospective audit of 40 patient records with positive urine cultures from July to August 2013 showed that 20% of patients with culture confirmed UTI were not given antibiotics at all. Of those prescribed antibiotics, 25% were non-compliant with local policy, and nearly one in two patients received more than one antibiotic...
2015: BMJ Quality Improvement Reports
Xavier Boland
Our aim was firstly to assess adherence to best practice guidelines for the prevention of healthcare associated causes of inpatient mortality and morbidity by junior doctors. Secondly, we wanted to measure the impact of a ward round checklist on rates of adherence. The rates of correct prescribing of antibiotics, venous thrombo-embolism prophylaxis, and oxygen (pro re nata) as well as correctly completed paperwork for peripheral venous cannulas were measured in a spot audit of all medical notes of patients on a medical assessment unit...
2015: BMJ Quality Improvement Reports
I Siddique, H Mahmood, R Mohammed-Ali
INTRODUCTION: There have been documented cases of serious and life-threatening health effects due to patients taking unintentional analgesia overdose secondary to dental pain. We aimed to determine firstly what proportion of unintentional paracetamol overdose cases admitted to an acute medical assessment unit (MAU) were secondary to dental pain, secondly what proportion of such cases encountered barriers to accessing emergency dental care and finally what clinical burden such cases placed on the hospital services...
September 25, 2015: British Dental Journal
Scott Rice
INTRODUCTION: There have been documented cases of serious and life-threatening health effects due to patients taking unintentional analgesia overdose secondary to dental pain. We aimed to determine firstly what proportion of unintentional paracetamol overdose cases admitted to an acute medical assessment unit (MAU) were secondary to dental pain, secondly what proportion of such cases encountered barriers to accessing emergency dental care and finally what clinical burden such cases placed on the hospital services...
September 25, 2015: British Dental Journal
A Fallon, J Armstrong, T Coughlan, D R Collins, D O'Neill, S P Kennelly
The care of older persons accounts for an increasing proportion of the unscheduled care workload for acute hospitals. The recent development of acute medical assessment units (AMAU) has provided an alternative model for acute unscheduled care for all medical patients. Screening instruments have been developed to capture the higher levels of clinical complexity and medical comorbidities that older patients present with. The aim of this study was to report on the characteristics and outcomes for older patients reviewed in the AMAU of a tertiary referral university teaching hospital...
July 2015: Irish Medical Journal
Orlaith O'Reilly, Fiona Cianci, Avelene Casey, Eilish Croke, Celine Conroy, Anne-Marie Keown, Gemma Leane, Barbara Kearns, Shane O'Neill, Garry Courtney
BACKGROUND: The National Acute Medicine Programme (NAMP) was established to address the unsatisfactory management of acutely ill medical patients in Ireland. It aimed to improve quality of care and patient safety, streamline access to healthcare, and reduce cost through efficiency gains. METHOD: A model of care was developed to describe 4 distinct clinical pathways for medical patients streamed through acute medical assessment units. A patient flow model was used to build system capacity and predict demand for each hospital...
December 2015: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
Elizabeth Elder, Amy N B Johnston, Julia Crilly
OBJECTIVE: The aim of this study was to explore the impact of incorporating a physician at triage (PAT) and the implementation of a medical assessment unit (MAU) on emergency department (ED) patient throughput. METHODS: A retrospective comparative analysis of two additional models of care (standard care, T1; PAT, T2 and PATplusMAU, T3) was undertaken. Patient presentations to a large public teaching hospital in South-East Queensland between 10th January 2013 and 25th February 2013, and the same time period in 2012, were included...
March 2016: International Emergency Nursing
Elizabeth Elder, Amy Nb Johnston, Julia Crilly
To explore the literature regarding three key strategies designed to promote patient throughput in the ED. CINAHL, Medline, PubMed, Scopus and Australian Government databases were searched for articles published between 1980 and 2014 using the key search terms ED flow/throughput, ED congestion, crowding, overcrowding, models of care, physician-assisted triage, medical assessment units, nurse practitioner, did not wait (DNW) and ED length of stay (LOS). Abstracts and articles not published in English and articles published before 1980 were excluded from the review...
October 2015: Emergency Medicine Australasia: EMA
Christine Toye, Rachael Moorin, Susan Slatyer, Samar M Aoun, Richard Parsons, Desley Hegney, Sean Maher, Keith D Hill
BACKGROUND: Presentations to hospital of older people receiving family care at home incur substantial costs for patients, families, and the health care system, yet there can be positive carer outcomes when systematically assessing/addressing their support needs, and reductions in older people's returns to hospital attributed to appropriate discharge planning. This study will trial the Further Enabling Care at Home program, a 2-week telephone outreach initiative for family carers of older people returning home from hospital...
2015: BMC Geriatrics
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