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Annals of the Royal College of Surgeons... Apr 2024Surgical care practitioners (SCPs) are non-medical workers involved in various aspects of the management of surgical patients. The role includes assisting and performing...
INTRODUCTION
Surgical care practitioners (SCPs) are non-medical workers involved in various aspects of the management of surgical patients. The role includes assisting and performing surgical procedures. More than 60,000 laparoscopic cholecystectomies (LC) are performed annually in the UK. With ever-increasing pressure on waiting lists, it is important to look at fully utilising the skills of our entire workforce. We report what we believe is the first published series of LC performed by an SCP.
METHODS
A retrospective review of a prospectively collected database was performed. The primary outcome was any complication requiring intervention. Secondary outcomes were minor complications, operative time, length of stay, conversion and readmission.
RESULTS
In total, 170 patients were operated on. Indications were biliary colic in 127 (74.7%), cholecystitis in 30 (17.6%) and pancreatitis in 13 (7.6%). Mean operating time was 65min (range 35-152min). Fifty-three operations were assisted by a consultant, 110 by a specialist or associate specialist grade (SAS) doctor and 7 by a core trainee (CT2). Some 139 (81.7%) patients were discharged on the day of surgery and 24 (14.1%) stayed one night in hospital. There were no major complications. Five patients required readmission, three with pain and two with port site infections. There were no conversions or transfusions required.
CONCLUSIONS
There is a paucity of published data on surgical outcomes of procedures performed by SCPs. With a structured, supervised approach, SCPs could be trained to take on more complex procedures and further strengthen the surgical workforce. This study demonstrates that elective LC can be safely performed by an appropriately trained and supervised SCP.
PubMed: 38660827
DOI: 10.1308/rcsann.2023.0058 -
Bulletin of the World Health... Sep 2023The role of health practitioner regulation in ensuring patient safety is well recognized. Less recognized is the role of regulation in addressing broader health system...
The role of health practitioner regulation in ensuring patient safety is well recognized. Less recognized is the role of regulation in addressing broader health system priorities. These goals include managing the costs, capacities and distribution of health professional education institutions; ensuring the competence and equitable distribution of health workers; informing workforce planning and mobilization; enabling the use of digital technologies; and addressing challenges related to the international mobility of health workers. Even where health practitioner regulation is designed to advance these goals, important gaps exist between the potential of regulatory systems and their performance. The response to the coronavirus disease 2019 (COVID-19) pandemic led many countries to introduce regulatory changes to allow more flexibility and innovations in the mobilization of health practitioners. Building on this experience, we need to critically re-examine health practitioner regulatory systems to ensure that these systems support rather than impede progress towards national health goals. We discuss the role of health practitioner regulation in contemporary health systems, highlighting recent regulatory reforms in selected countries, including during the COVID-19 pandemic. We identify the importance of dynamic, effective and flexible health practitioner regulatory systems in progress towards universal health coverage and health security.
Topics: Humans; COVID-19; Digital Technology; Goals; Health Personnel; Pandemics
PubMed: 37638356
DOI: 10.2471/BLT.21.287728 -
Indian Dermatology Online Journal 2024
PubMed: 38550847
DOI: 10.4103/idoj.idoj_91_24 -
Australian and New Zealand Journal of... Dec 2023To investigate the level of Q fever awareness in Australia. (Review)
Review
OBJECTIVE
To investigate the level of Q fever awareness in Australia.
METHODS
A scoping review was conducted by searching the electronic databases Medline, PubMed and Web of Science using keywords for Q fever, awareness, knowledge, and Australian locations. The search was initially limited to articles published in the 10 years prior to June 2022 and then extended up to and including August 2023; yielding 387 records.
RESULTS
Fifteen articles were assessed as being eligible. These articles reported on surveys and interviews conducted with farmers, veterinary practitioners and nurses, medical practitioners, policy makers, researchers, industry representatives, animal science students, cat breeders, wildlife rehabilitators, and agriculture show attendees. Farmers were the largest group represented. Level of Q fever awareness amongst these communities, including those at high-risk, was generally low. The need for increased awareness was recognised. General practitioner awareness levels were low and recognised to be so by high-risk groups. Awareness of preventive measures including vaccination was greater among those with greater awareness and risk.
CONCLUSION
With the availability of a highly effective vaccine in Australia, there is a need to increase Q fever knowledge and awareness among high-risk groups and primary health care practitioners.
IMPLICATIONS FOR PUBLIC HEALTH
Strategies to increase awareness and knowledge of Q fever risks and prevention strategies may assist with reducing Q fever burden in Australia.
Topics: Animals; Humans; Q Fever; Australia; Health Knowledge, Attitudes, Practice; Surveys and Questionnaires; Vaccination
PubMed: 38016201
DOI: 10.1016/j.anzjph.2023.100099 -
Scientific Reports Nov 2023In China, the prevalence of diabetic retinopathy (DR) is increasing, so it is necessary to provide convenient and effective community outreach screening programs for DR,...
In China, the prevalence of diabetic retinopathy (DR) is increasing, so it is necessary to provide convenient and effective community outreach screening programs for DR, especially in rural and remote areas. The purpose of this study was to use the results of ophthalmologists as the gold standard to evaluate the accuracy of community general practitioners' judgement and grading of DR to find a feasible and convenient DR screening method to reduce the risk of visual impairment and blindness in known diabetes patients. Retinal images of 1646 diabetic patients who underwent DR screening through teleophthalmology at Nanchang First Hospital were collected for 30 months (January 2020 to June 2022). Retinal images were collected without medication for mydriasis, stored by community general practitioner, and diagnosed by both community general practitioner and ophthalmologist of our hospital through teleophthalmology. The grading of ophthalmologist was used as a reference or gold standard for comparison with that of community general practitioner. A total of 1646 patients and 3185 eyes were examined, including 2310 eyes with DR. The evaluation by the community general practitioner had a Kappa value of 0.578, sensitivity of 80.58%, specificity of 89.94%, and accuracy of 83.38%% in 2020; a Kappa value of 0.685, sensitivity of 95.43%, specificity of 78.55%, and accuracy of 90.77% in 2021; and a Kappa value of 0.744, sensitivity of 93.99%, specificity of 88.97%, and accuracy of 92.86% in 2022. Teleophthalmology helped with large-scale screening of DR and made it possible for community general practitioner to grade images with high accuracy after appropriate training. It is possible to solve the current shortage of eye care personnel, promote the early recognition of disease and reduce the impact of diabetes-associated blindness.
Topics: Humans; Diabetic Retinopathy; Telemedicine; Ophthalmology; Mass Screening; Blindness; Photography; Diabetes Mellitus
PubMed: 37949948
DOI: 10.1038/s41598-023-46554-6