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J Wardrope

Publications and source records attributed to J Wardrope.

At least 37 records · Page 2Linked to original sources
PubMed2002

The psychological burden of injury: an 18 month prospective cohort study.

OBJECTIVES: To determine the prevalence of post-trauma psychological problems among a cohort of male accident and emergency department patients admitted to hospital. To identify the changes in their psychological symptoms over an 18 month follow up period. METHODS: A prospective cohort study of male accident and emergency department patients who were admitted for treatment of an injury. Baseline interview recorded demographic details and accident details. Standardised questionnaires measured baseline psychological state and personality type. Follow up at six weeks, six months, and 18 months after injury was by face to face interview or postal questionnaire and recorded progress since injury, and documented psychological status through the use of standardised questionnaires to detect psychiatric disorder and symptoms of post-traumatic stress disorder (PTSD). RESULTS: 210 male patients were recruited into the study. Psychiatric disorder was identified in 47.6% of responders at six weeks, and 43.4% at six months after injury. This improved significantly at 18 months. PTSD symptoms were moderate in 25%-30% and severe in 5%-14% and did not change significantly over the study period. A significant relation was found between previous psychiatric history and psychological symptoms at 18 months after injury. No relation was identified between injury severity and psychological status after injury. CONCLUSION: This study finds a high prevalence of psychological distress in male accident and emergency department patients after injury. Although some symptoms resolve over the follow up period, a proportion remain and may be related to previous psychiatric history. There was no relation identified between severity of injury and psychological morbidity.

Adolescent↗
PubMed2001

Article 1. Introduction--St Jude's, the "virtual" A&E department.

Management is part of everyday life in emergency care. This project will hopefully bring alive management issues, give a "real" framework to assist the discussion of management theory and hopefully to entertain. We look forward to your feedback on the tasks and welcome ideas on how the St Jude's should go forward.

Computer Communication Networks↗
PubMed2001

The Sheffield experiment: the effects of centralising accident and emergency services in a large urban setting.

OBJECTIVES: To assess the effects of centralisation of accident and emergency (A&E) services in a large urban setting. The end points were the quality of patient care judged by time to see a doctor or nurse practitioner, time to admission and the cost of the A&E service as a whole. METHODS: Sheffield is a large industrial city with a population of 471000. In 1994 Sheffield health authority took a decision to centralise a number of services including the A&E services. This study presents data collected over a three year period before, during and after the centralisation of adult A&E services from two sites to one site and the centralisation of children's A&E services to a separate site. A minor injury unit was also established along with an emergency admissions unit. The study used information from the A&E departments' computer system and routinely available financial data. RESULTS: There has been a small decrease in the number of new patient attendances using the Sheffield A&E system. Most patients go to the correct department. The numbers of acute admissions through the adult A&E have doubled. Measures of process efficiency show some improvement in times to admission. There has been measurable deterioration in the time to be seen for minor injuries in the A&E departments. This is partly offset by the very good waiting time to be seen in the minor injuries unit. The costs of providing the service within Sheffield have increased. CONCLUSION: Centralisation of A&E services in Sheffield has led to concentration of the most ill patients in a single adult department and separate paediatric A&E department. Despite a greatly increased number of admissions at the adult site this change has not resulted in increased waiting times for admission because of the transfer of adequate beds to support the changes. There has however been a deterioration in the time to see a clinician, especially in the A&E departments. The waiting times at the minor injury unit are very short.

Admitting Department, Hospital↗
PubMed2000

Journal scan.

Explore the source record for details and available documents.

Acute Disease↗
PubMed1999

Care of minor injuries by emergency nurse practitioners or junior doctors: a randomised controlled trial.

BACKGROUND: We aimed to assess the care and outcome of patients with minor injuries who were managed by a nurse practitioner or a junior doctor in our accident and emergency department. METHODS: 1453 eligible patients, over age 16 years, who presented at our department with minor injuries were randomly assigned care by a nurse practitioner (n=704) or by a junior doctor (n=749). Each patient was first assessed by the nurse practitioner or junior doctor who did a clinical assessment; the assessments were transcribed afterwards to maintain masked conditions. Patients were then assessed by an experienced accident and emergency physician (research registrar) who completed a research assessment, but took no part in the clinical management of the patient. A standard form was used to compare the clinical assessment of the nurse practitioner or junior doctor with the assessment of the research registrar. The primary outcome measure was the adequacy of care (history taking, examination of patient, interpretation of radiographs, treatment decision, advice, and follow-up). FINDINGS: Compared with the rigorous standard of the experienced accident and emergency research registrar, nurse practitioners and junior doctors made clinically important errors in 65 (9.2%) of 704 patients and in 80 (10.7%) of 749 patients, respectively. This difference was not significant. The nurse practitioners were better than junior doctors at recording medical history and fewer patients seen by a nurse practitioner had to seek unplanned follow-up advice about their injury. There were no significant differences between nurse practitioners and junior doctors in the accuracy of examination, adequacy of treatment, planned follow-up, or requests for radiography. Interpretation of radiographs was similar in the two groups. INTERPRETATION: Properly trained accident and emergency nurse practitioners, who work within agreed guidelines can provide care for patients with minor injuries that is equal or in some ways better than that provided by junior doctors.

Adult↗