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Biomedical subjects

P Priest

Publications and source records attributed to P Priest.

12 recordsLinked to original sources
PubMed1992

Which tasks performed by pre-registration house officers out of hours are appropriate?

This paper seeks to identify tasks performed out of hours by pre-registration house officers and to determine whether they could be performed by someone other than a doctor. It was conducted in two parts: a descriptive study in four hospitals using diaries and interviews and a consensus panel consisting of four consultants, three junior doctors, and two nurses. The panel agreed that one-third of the tasks performed by house officers at night could be done by someone other than a doctor. The work-load of house officers could be reduced considerably by providing additional clerical and administrative support and a more widespread adoption of an extended role for nurses. However, the greater professional independence of nurses which may result might require doctors to redefine some of their roles.

Humans↗
PubMed1992

Can out-of-hours work by junior doctors in obstetrics be reduced?

OBJECTIVE: Against a background of concerns about the hours of work of junior doctors, this study examines how the night-time work of junior staff in obstetrics may be reduced by giving greater responsibility to midwives. DESIGN: In the first phase of the study, the tasks undertaken at night in four hospitals were identified. In the second phase a nominal group technique was used to seek the extent of agreement among professionals about the appropriateness of postponing surgery to the following day in certain circumstances. RESULTS: There were considerable variations between hospitals in the rate of obstetric intervention and the division of tasks between doctors and midwives. The panel concluded that many tasks currently performed by senior house officers could be undertaken by midwives. CONCLUSION: This study suggests that there scope for reducing the workload of junior obstetricians at night through the adoption of an extended role by midwives.

Attitude of Health Personnel↗
PubMed1992

Can out-of-hours operating in gynaecology be reduced?

Against a background of concerns about future hospital medical staffing and the safety of unsupervised operations at night, this study examines which gynaecological operations now undertaken at night may be safely postponed until the following day. In the first phase of the study, the operations taking place at night in four hospitals were identified. In the second phase a nominal group technique was used to seek the extent of agreement among professionals about the appropriateness of postponing surgery to the following day in certain circumstances. There were considerable variations between hospitals in the volume of work and the grade of staff involved. The panel concluded that most operations now performed at night should not be postponed. This study suggests that there is limited scope for postponing gynaecological operations currently undertaken at night.

Female↗
PubMed1992

Achieving consensus on out-of-hours laboratory tests.

Many reports on guidelines for investigation describe either the guidelines themselves or their implementation. Implicitly these assume that there has been general agreement about the guidelines, whereas there may be uncertainty about the appropriateness of a particular investigation in a given situation. We report the use of a technique for developing guidelines which explicitly seeks to identify areas of agreement and disagreement, and focuses on the reasons that particular decisions were made and the causes of disagreement.

Clinical Laboratory Techniques↗
PubMed1991

How representative are members of expert panels?

A study was undertaken to test the hypothesis that consultants who are willing to participate in expert panels are similar, in terms of routinely available characteristics, to those who are not participating. All consultants in acute specialties in North-east Thames Region were asked to participate in a series of expert panels. Routinely available data was used to compare those who agreed to participate with those who declined or did not reply. Consultants who are willing to participate in expert panels are similar to those who are not in terms of years since qualification, specialty, sex, country of graduation, and possession of higher degrees. Consultants working in district general hospitals seem to be more likely to be willing to participate than those employed in teaching hospitals (37% versus 26%, p less than 0.02), although this difference may be accounted for by errors in the list of teaching hospital consultants.

Attitude of Health Personnel↗
PubMed1991

Suicide and other unexpected deaths among psychiatric in-patients. The Bristol confidential inquiry.

By matching information collected from coroner inquest records with hospital admission and discharge registers, 27 suicides and 5 other unexpected deaths were identified over 30 months among persons who either were psychiatric in-patients at the time or had been up to eight weeks previously. The relevant consultant completed a questionnaire concerning assessment and management in each case. It is suggested that such an approach might usefully be adopted widely as an audit of unexpected deaths. In 20 of the suicides the seriousness of the risk was not fully recognised; 13 absented themselves from the hospital ward without leave. Misleading clinical improvement in the absence of corresponding alleviation of situational problems, and patient alienation appeared important hazards. The findings have implications for service development, particularly when major reduction of bed numbers is planned.

Adult↗
PubMed1991

Which general surgical operations must be done at night?

During the 1980s there has been increasing concern about hospital medical staffing. Achieving a Balance will lead to a reduction in the number of registrars and a possible increase in the work done out-of-hours by consultants. The deleterious effects of long hours of work have also attracted attention and, in particular, there is concern about the safety of operations performed at night by unsupervised junior doctors. There is an urgent need to examine how out-of-hours work can be reduced. This study was conducted in two phases. The out-of-hours surgical workload in four hospitals was examined. Appropriateness of the procedures and activities being carried out was then considered by a consensus panel, aided by a literature review. Most out-of-hours operations were performed by junior staff. The principal reasons suggested for operating at night are lack of day-time theatre space and the need to gain experience. There was considerable variation in the frequency with which different types of operation were performed among hospitals. The views of the panel suggest that up to one-third of operations currently performed at night could be postponed. It may be possible to postpone a higher proportion of operations performed after midnight. The appropriateness of the remaining operations has major implications for the work of consultants following the implementation of Achieving a Balance.

Emergencies↗
PubMed1976

Human fat cell sizing--a quick, simple method.

Two methods were used to determine the mean cell diameters of 37 samples of human adipose tissue, obtained by open or needle biopsy. Method I was the sizing of cells in cell suspensions and Method II was a quick, simple method of sizing cells from fixed sections. The agreement between the two methods was good (r = 0.93, P = less than 0.001). The results using Method II were slightly lower than those using Method I, and a correction factor is suggested. Method II has several advantages over Method I and we propose that it is a suitable method for sizing cells when a quick method with a permanent record is required.

Adipose Tissue↗