Assessment and management of dementia in the general hospital setting

2014 ◽  
Vol 24 (3) ◽  
pp. 205-218 ◽  
Author(s):  
Inderpal Singh ◽  
Amrita Varanasi ◽  
Kathryn Williamson
Keyword(s):  
General Hospital ◽  
Staff Training ◽  
Medical Training ◽  
Oldest Old ◽  
Quality Care ◽  
Hospital Setting ◽  
Ageing Population ◽  
People With Dementia ◽  
The Uk ◽  
Training And Support

SummaryPopulations are ageing worldwide. The prevalence of dementia will rise exponentially with the oldest old the most rapidly growing segment of society. Caring for this ageing population with dementia, many of whom will have multiple chronic and disabling diseases, will be a challenge to healthcare systems, particularly general hospitals. At any one time, a quarter of acute hospital beds in the UK are in use by people with dementia. Delivery of high-quality care to this growing and vulnerable population must be high on any health service agenda.Current medical training not only generates relatively low numbers of geriatricians and specialists with interest in dementia, but also there is a lack of appropriate training in assessment and management of dementia. There remains huge need for better staff training and support to provide safe, holistic and dignified dementia care. Here we explore various key features for non-specialist assessment and management of older people with dementia in the general hospital setting.

Serological prevalence of herpes simplex virus type 2 amongst GUM clinic attenders in a district general hospital setting

2000 ◽  
Vol 11 (6) ◽  
pp. 379-382 ◽  
Author(s):  
P D Woolley ◽  
S Chandiok ◽  
J Pumphrey ◽  
S Sharratt ◽  
L Shanley ◽  
...  
Keyword(s):  
Herpes Simplex Virus ◽  
Herpes Simplex ◽  
General Hospital ◽  
Hospital Setting ◽  
District General Hospital ◽  
Clinical Problem ◽  
Asymptomatic Infection ◽  
The Uk ◽  
Simplex Virus

Our objective was to determine the seroprevalence of herpes simplex virus (HSV) type 2 infection amongst genitourinary medicine (GUM) clinic attenders at a district general hospital using a commercially available enzyme immunoassay (EIA). In a prospective study, heterosexual patients attending the Department of GUM at Trafford General Hospital attending with a new clinical problem and having a blood sample taken for routine syphilis serology had the same sample tested for HSV type 2 antibodies. The prevalence of HSV type 2 seropositivity amongst participants was 9.9% (24/242) for men and 18.7% (46/246) for women. With respect to undiagnosed, asymptomatic infection the seroprevalence was 8.6% and 17% respectively. For those attenders locally resident the seroprevalence was 10.1% and 17.5% respectively, and undiagnosed, asymptomatic infection 8.5% and 17.1% respectively. Although seroprevalence figures in this study are lower than the only previous report in the UK, these results, nevertheless, show that seropositivity is not confined to large urban centres. Patients attending GUM clinics are likely to have high rates of undiagnosed HSV type 2 infection.

Management of patients on oral anticoagulants in dental practice

Dental Update ◽  
2020 ◽  
Vol 47 (11) ◽  
pp. 912-922
Author(s):  
Shrina Nathwani
Keyword(s):  
Best Practice ◽  
Dental Treatment ◽  
Oral Anticoagulants ◽  
Quality Care ◽  
Current Evidence ◽  
Ageing Population ◽  
Oral Surgical Procedures ◽  
Dental Patients ◽  
Dental Practitioners ◽  
The Uk

The UK has an increasingly ageing population and, inevitably, the prevalence of anticoagulation among dental patients will grow. This same group of patients are retaining their natural teeth longer and will potentially require dental treatment and oral surgical procedures and so, general dental practitioners will need to be aware of the implications of anticoagulant drugs. Equally, to comply with requirements set by the General Dental Council's ‘Standards for the Dental Team’ it is imperative to ensure that, as clinicians, we put patients' interests first, and provide quality care based on current evidence. CPD/Clinical Relevance: It is important that dentists have knowledge and expertise to consult and treat medically compromised patients for patient safety and to adhere to best practice guidelines.

Caring for people with dementia in hospital: findings from a survey to identify barriers and facilitators to implementing best practice dementia care

2016 ◽  
Vol 29 (3) ◽  
pp. 467-474 ◽  
Author(s):  
Joanne Tropea ◽  
Dina LoGiudice ◽  
Danny Liew ◽  
Carol Roberts ◽  
Caroline Brand
Keyword(s):  
Best Practice ◽  
Quality Care ◽  
Hospital Setting ◽  
Hospital Staff ◽  
Dementia Care ◽  
Perceived Barriers ◽  
Barriers And Enablers ◽  
People With Dementia ◽  
Multidisciplinary Staff ◽  
Survey Responses

ABSTRACTBackground:Best practice dementia care is not always provided in the hospital setting. Knowledge, attitudes and motivation, practitioner behavior, and external factors can influence uptake of best practice and quality care. The aim of this study was to determine hospital staff perceived barriers and enablers to implementing best practice dementia care.Methods:A 17-item survey was administered at two Australian hospitals between July and September 2014. Multidisciplinary staff working in the emergency departments and general medical wards were invited to participate in the survey. The survey collected data about the respondents’ current role, work area, and years of experience, their perceived level of confidence and knowledge in dementia care and common symptoms of dementia, barriers and enablers to implementing best practice dementia care, job satisfaction in caring for people with dementia, and to rate the hospital's capacity and available resources to support best practice dementia care.Results:A total of 112 survey responses were received. The environment, inadequate staffing levels and workload, time, and staff knowledge and skills were identified as barriers to implementing best practice dementia care. Most respondents rated their knowledge of dementia care and common symptoms of dementia, and confidence in recognizing whether a person has dementia, as moderate or high dementia. Approximately, half the respondents rated access to training and equipment as low or very low.Conclusion:The survey findings highlighted hospital staff perceived barriers to implementing best practice dementia care that can be used to inform locally tailored improvement interventions.

scholarly journals Feasibility of a staff training and support programme to improve pain assessment and management in people with dementia living in care homes

2017 ◽  
Vol 33 (1) ◽  
pp. 221-231 ◽  
Author(s):  
Anya Petyaeva ◽  
Martine Kajander ◽  
Vanessa Lawrence ◽  
Lei Clifton ◽  
Alan J. Thomas ◽  
...  
Keyword(s):  
Pain Assessment ◽  
Staff Training ◽  
Care Homes ◽  
Support Programme ◽  
People With Dementia ◽  
Training And Support

Population-based end-of-life care

2019 ◽  
pp. 739-762
Keyword(s):  
End Of Life ◽  
End Of Life Care ◽  
Quality Care ◽  
Population Based ◽  
Ageing Population ◽  
Life Care ◽  
Care Services ◽  
The Face ◽  
The Uk ◽  
Developed Nations

This chapter describes the changing face of end-of-life care in the face of demographic changes and the need for a population-based approach in providing end-of-life care in a meaningful manner. Building on the major advances in palliative or end of life care across the world over recent decades, there now seems to be radical groundswell of change in this area, as we face the major challenge of meeting the needs the ageing population. This challenge, most noted in the developed nations, now places specific and seemingly overwhelming unprecedented demands on all our health and social care services. Some would argue that a new approach is needed, building on lessons learnt, to care for the rising numbers of people nearing the last stage of life within our population—in other words, a population approach to end-of-life care. Using examples from the Gold Standards Framework in the UK, the chapter explores the importance of enabling generalists to deliver high quality care across a population, citing a variety of examples and programmes promoting person-centred care at the end of life.

scholarly journals Managing the open abdomen in a district general hospital

2014 ◽  
Vol 96 (3) ◽  
pp. 194-198 ◽  
Author(s):  
J De Siqueira ◽  
O Tawfiq ◽  
J Garner
Keyword(s):  
General Hospital ◽  
Open Abdomen ◽  
Hospital Setting ◽  
District General Hospital ◽  
Hospital Environment ◽  
Fascial Closure ◽  
Trauma Patients ◽  
Temporary Abdominal Closure ◽  
Hospital Stays ◽  
The Uk

Introduction The need to manage an open abdomen is becoming more common in general surgical practice and a variety of methods of temporary abdominal closure (TAC) are available. The evidence for the efficacy of the various forms of TAC as well as the subsequent definitive fascial closure (DFC) rates and complications comes mainly from large trauma series in the US, which represent a different patient population to those in the UK in whom TAC is usually required. Methods All cases of open abdomen management in our hospital over a five-year period were reviewed to ascertain the methods of TAC used, our success in achieving DFC and the applicability of managing such cases in a district hospital environment. Results Nineteen patients underwent TAC, with two deaths (10.5%) and an overall DFC rate at hospital discharge of 12/17 (70.6%). The median lengths of critical care and hospital stays were 19.5 and 38.0 days respectively. Thirteen out of seventeen survivors had at least one significant complication. Conclusions The management of the open abdomen can be achieved safely in a district general hospital setting with acceptable outcomes for the non-trauma patients commonly seen in UK practice but it is a resource intensive and expensive undertaking.

scholarly journals Laser depilation as adjuvant therapy in prevention of recurrence of pilonidal sinus disease: initial experience of a district general hospital in the UK

2020 ◽  
Vol 102 (9) ◽  
pp. 685-688
Author(s):  
ASD Liyanage ◽  
Y Woods ◽  
MA Javed ◽  
C Deftly ◽  
H Shaban ◽  
...  
Keyword(s):  
General Hospital ◽  
Recurrence Rate ◽  
Elective Surgery ◽  
Pilonidal Disease ◽  
Hospital Setting ◽  
Final Analysis ◽  
District General Hospital ◽  
Disease Recurrence ◽  
Pilonidal Sinus Disease ◽  
The Uk

Introduction Pilonidal disease is a chronic condition involving the sacrococcygeal area. It can have a significant impact on quality of life, social activities and occupation. Surgery is the mainstay of treatment. However, laser depilation has been proposed as an adjunct to surgery and has shown improved results in some studies. We present our experience of laser depilation in the treatment of pilonidal disease in a district general hospital setting in the UK. Materials and methods A prospectively maintained database of all consecutive patients who received laser depilation after elective surgery for pilonidal disease was analysed. Patients were offered a minimum of two sessions of laser depilation. The primary outcome measure was disease recurrence. Evidence of new symptoms or signs of pilonidal disease after one year from the latest surgical intervention was defined as recurrent disease. Data are presented as medians with interquartile ranges. Results A total of 64 patients underwent laser depilation after elective surgery between 1 June 2013 and 1 June 2018; 57 were eligible for final analysis. Sixty-five per cent of patients received six or more sessions of laser treatment. There were no short- or long-term complications related to laser depilation. Patients who had more than two sessions of laser depilation showed an improved recurrence rate. Overall, recurrence rate in our series was 12% at a median follow-up of 172 weeks. Conclusion Laser depilation is a safe and effective adjunct to surgery in minimising the recurrence of pilonidal disease. Patients with primary pilonidal disease and those who are undergoing minimally invasive surgery may also benefit from adjuvant laser depilation. Further high-quality control trials are required to assess its efficacy and safety.

scholarly journals Pain and delirium in people with dementia in the acute general hospital setting

2018 ◽  
Vol 47 (6) ◽  
pp. 841-846 ◽  
Author(s):  
Alexandra R Feast ◽  
Nicola White ◽  
Kathryn Lord ◽  
Nuriye Kupeli ◽  
Victoria Vickerstaff ◽  
...  
Keyword(s):  
General Hospital ◽  
Hospital Setting ◽  
People With Dementia

scholarly journals Music therapy for neuropsychiatric symptoms in the general hospital: a systematic literature review

2017 ◽  
Vol 9 (4) ◽  
pp. 217
Author(s):  
Carol-Anne Sherriff ◽  
Jillian Mathews ◽  
Emma L Reynish ◽  
Susan D Shenkin
Keyword(s):  
Literature Review ◽  
Music Therapy ◽  
General Hospital ◽  
Systematic Literature Review ◽  
Neuropsychiatric Symptoms ◽  
Complex Interventions ◽  
Hospital Setting ◽  
General Hospitals ◽  
People With Dementia ◽  
Published Evidence

Dementia and delirium are common in medical and surgical inpatients, and neuropsychiatric symptoms can be challenging to manage. Non-pharmacological interventions such as music therapy have been used to treat these symptoms in psychiatric hospitals and care homes but are not routinely used in general hospitals. We performed a systematic literature review to establish whether music therapy improves neuropsychiatric symptoms in adults with dementia and/or delirium in the general hospital setting. We searched CINAHL, Medline, PsycINFO in November 2015. Search terms included music therapy, dementia and delirium. Of 5054 titles reviewed we read 142 in full text of which none met inclusion criteria. We qualitatively reviewed six articles including 202 patients which could inform future research in music in general hospitals for people with dementia and/or delirium.  Music delivery was feasible and had a positive effect on some aspects of neuropsychiatric symptoms in various settings, but the studies were generally small, at high risk of bias, and did not use recognised frameworks for evaluating complex interventions. We found no published evidence for the use of music therapy in the treatment of neuropsychiatric symptoms in patients with dementia and/or delirium in the general hospital setting. Well-designed studies of this intervention are needed.

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