Search PubMed⌕ Search

Biomedical subjects

M Kljakovic

Publications and source records attributed to M Kljakovic.

15 recordsLinked to original sources
PubMed1992

The effect of emergency department policy change on Hutt district general practices.

AIM: To determine the impact of the new Hutt Hospital emergency care policy as perceived by general practitioners and measure the level of general practitioner emergency services provided. METHOD: Postal survey one year after policy instituted of Hutt district general practitioners. RESULTS: Sixty-three general practitioners replied (93% response). Eighty-one percent of general practitioners were in favour of the new policy or wanted it extended further, although 79% had noticed a slight increase in patient numbers. Most surgeries were less than 10 km from the hospital, 44% had one general practitioner, 38% had no practice nurse, 84% were staffed between 40-59 hours a week. No practice had staff on the premises between the night time hours of 8 pm and 8 am but all had after hours cover by telephone. Most practices were equipped to manage at least some emergency conditions: all had peak flow meters, 94% had nebulisers, 69% oxygen cylinders, and 47% had an ECG machine. Only two practices had slit lamps and plaster of paris facilities, and one a defibrillation machine. Almost all general practitioners suture wounds, strap ankles, and most treat fractures and pack noses. Seventy-five percent of general practitioners expressed a need for better communication with the Hutt Hospital emergency department. CONCLUSION: A general acceptance of the policy change by Hutt general practitioners although more research is needed to determine the impact of this change on patients.

Adult↗
PubMed1992

The quality of a laboratory test in general practice: the throat swab example.

AIM: To measure the repeatability, the flow of information, and the data entry error of the throat swab test from a suburban general practice. METHOD: A prospective study of consecutive patients seen in routine consultation for a sore throat as their primary complaint. Repeated throat swabs were taken for each patient. Carbon copies of routine laboratory forms were collected. RESULTS: The kappa statistic for reproducibility of the throat swab test was 0.63 (95% CI 0.50-0.77). In 5.8% of patients, one swab was positive and the other negative. Information took one day or less to travel to and from the laboratory for 25.7% of patients with a beta-haemolytic streptococcal growth compared to the 9.9% of patients with no growth (chi 2 = 6.17, p < 0.02). The laboratory received 53% of the swabs on the day they were taken. Delays in getting the swabs to the laboratory occurred when swabs were taken in the afternoon session or on weekends. Monday morning gave the quickest return. Data entry errors were found on 15.9% of patient forms. CONCLUSION: The quality of the throat swab test needs improvement in the suburban general practice context.

Clinical Laboratory Techniques↗
PubMed1991

The change in prevalence of wheeze in seven year old children over 19 years.

OBJECT: to determine the change in prevalence of wheeze on clinical examination and history over a 19 year period. METHODS: a survey of random samples of seven year old children at primary schools in an urban area (Hutt Valley). Outcome measures were answers to a questionnaire and auscultation of children's chest for wheeze. RESULTS: in 1971, 1981, and 1990, the point prevalence of clinical wheeze by auscultation remained steady between 3.2% and 5.9%. However there was a significant increase in the prevalence of reported wheeze from 23% to 36% (p less than 0.001). Between 1981 and 1990 there was a 10.7% increase in the number of children who had been to their general practitioner for wheeze (p less than 0.001), a 5.3% increase in children who were on daily medication (p less than 0.001) and a 8.2% increase in the family history of asthma (p less than 0.001). There was no significant increase in the number of children who had been to hospital for wheezing. The proportion of children who were found to be wheezing on the day and whose parents did not identify a problem in their child had not changed between 1981 and 1990. CONCLUSION: there was an increasing high level of wheeze reported in the Hutt Valley with a corresponding steady level of clinical wheeze. More educational efforts are needed by primary health care workers to improve on parental perception of wheeze because a steady third of those children who were found to be clinically wheezing were recognised by their parents to have a problem.

Asthma↗
PubMed1990

Domestic unintentional injuries presenting to the accident and emergency departments in the Wellington region.

A prospective descriptive study of domestic unintentional injuries attending accident and emergency (A & E) departments in the Wellington region is presented. In a three month period there were 2207 such attendances. There was no difference in the proportion of males and females seen. A disproportionate number of the very young (under five years of age) and the elderly (65 years and over) attended A & E departments for these injuries. Approximately one-quarter of the attendances were for cuts or lacerations (26.6%) and one-fifth were for fractures (18.0%). Crude estimates of distance indicate that, on average, people travel greater distances for fractures than for other injuries. General practitioners referred one-tenth (10.6%) of all the attendances. Outcomes from the A & E attendances were: 70.4% were discharged, 7.7% were admitted to hospital, 14.6% were referred to outpatient clinics, and 7.2% were referred back to their general practitioners. There were no deaths in A & E departments.

Accidents, Home↗
PubMed1989

An audit of a cervical smear screening programme.

An audit of a computer based screening and recall programme in a Wellington group general practice is reported (practice population 13,866). The records of all women aged between 20 and 59 years (4133 women) were checked to determine if they had had a cervical smear test in the previous two years. A random sample of women who had a cervical smear result recorded in the notes (107 women called "responders") showed that 71% gave "familiarity with the family doctor" and "acting in response to a recall letter" as reasons for choosing the place of their last smear. Satisfaction with the service was indicated by 95% of these women stating they would have their next smear at the medical centre. In the audit of all the records, a group of 667 women who had been sent a letter inviting them to have a smear done and who had apparently declined the procedure was identified (called "nonresponders"). A random sample of this group (168 women) was taken and an attempt made to interview them. In fact only 38 women could be identified as requiring a smear and even if those who refused to be interviewed (13) and those unable to be contacted (23) are added, then less than half of this sample were "true nonresponders". This suggests that the percentage of women in the practice who have been offered a smear and have refused to have one is less than 8%.

Adult↗
PubMed1985

A & E utilisation.

Explore the source record for details and available documents.

Emergency Medical Services↗
PubMed1985

Raised intraocular pressure: an alternative method of referral.

To assess delay in referring patients with suspected glaucoma two methods were studied in a randomised trial: direct referral from optician to ophthalmologist and referral through the patient's general practitioner. Direct referral was reliable for all 49 patients involved, whereas, of the 44 patients referred through their general practitioner, seven waited over three weeks for referral.

Family Practice↗