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PubMed2005

Practical management of recurrent urinary tract infections in premenopausal women.

Recurrent urinary tract infections (UTIs) are a major healthcare concern for premenopausal, healthy, sexually active women. A practical approach to the management and prevention of recurrent UTIs should be simple, practical, and cost effective. Low-dose or postcoital antimicrobial therapy can be effective for women with constellations of many recurrent UTIs, but for women with 2 to 4 UTIs per year, the most cost-effective and empowering management strategy is patient-initiated antimicrobial treatment.

Journal Article↗
PubMed2000

Routine veterinary anaesthetic management practices in South Africa.

A survey of the routine anaesthetic management of dogs and cats during sterilisation by veterinarians in South Africa was conducted. This report describes the premedication, induction and maintenance agents most commonly used in dogs and cats. Information about monitoring of patients during the procedure and who is responsible for induction of anaesthesia and monitoring was obtained. Questionnaires were analysed with regard to demographic data, practice size, continuing education, the number of surgical procedures and sterilisations performed per week and an estimate of yearly mortality. Acetylpromazine is the most commonly used premedication in dogs and xylazine in cats. Thiopentone in dogs and alphaxalone/alphadolone in cats were the induction agents most commonly used. Alphaxalone/alphadolone in cats and halothane in dogs are the most commonly used maintenance agents. Records of anaesthesia are poorly kept and monitoring of patients is poorly performed. Respiratory rate is the parameter most commonly monitored (90.7%), and in most cases is the sole parameter. On average 10.34 +/- 8.25 cats were operated per week, of which 5.45 +/- 5.60 were sterilised; 17.79 +/- 11.61 dogs were operated per week, of which 8.65 +/- 7.10 were sterilised. In total, 190 patients died under anaesthesia, a mortality rate of 1:1,243. Just over 50% of practitioners had attended continuing education courses during their careers.

Anesthesia↗
PubMed2001

How do general practices manage requests from patients for 'same-day' appointments? A questionnaire survey.

Same-day appointment requests are common and can be problematic for general practices that run appointment systems. In a questionnaire survey sent to 90 general practices in one health authority area (response rate 88%), a variety of management systems existed for dealing with same-day appointment requests. Managing the requests was found to be a significant cause of stress for many general practitioners. Registrars, locums, and practice nurses play only a small part in meeting patient demands and few practices operate telephone triage to help manage these requests.

Appointments and Schedules↗
PubMed1992

Dr Edward Charles Gawthorn. An expert in practice management.

Dr Ted Gawthorn's adult life started as a naval fighter pilot during World War II. He was led to medicine after meeting his future father-in-law who was a GP. An early involvement with the young RACGP led to many years of service and diverse contributions, among the most memorable being the development of the medical record system and the Manual for General Practice.

Australia↗
PubMed2005

Vitreous haemorrhage without obvious cause: national survey of management practices.

AIM: We undertook a national survey to establish the management of dense vitreous haemorrhage without obvious cause. METHODS DESIGN: Cross-sectional anonymous self-reporting survey of ophthalmic practitioners within three target groups: vitreoretinal specialists (VRS), nonvitreoretinal specialists (NVRS), and associate specialists (AS). INTERVENTION: Presentation of the hypothetical scenario of a patient presenting with recent onset (fresh) vitreous haemorrhage with no retinal view and no apparent cause on history taken at presentation. OUTCOME MEASURES: The relative importance assigned by respondents to eight examination techniques at presentation. The proportion of respondents stating that they would review patients and perform B-scan examination at or prior to 2 weeks after presentation. The stated time to surgical intervention by VRS, and the time to referral by NVRS and AS. RESULTS: VRS ranked B-scan examination higher than AS (P<0.001). A total of 98.1% of VRS indicated that they would next review patients within 2 weeks of presentation, this figure fell to 86.5% for NVRS and 47% for AS (P<0.001). A 98.1% of VRS indicated that they would next perform B-scan ultrasound within 2 weeks of presentation, this figure fell to 88.9% for NVRS and 70.6% for AS (P<0.001). The mean time to surgical intervention by VRS was 9.5 weeks without retinal tear demonstrated on B-scan, 1.7 weeks with retinal tear demonstrated on B-scan and 1 week with retinal detachment demonstrated on B-scan. The mean time to referral by NVRS was 6.7 weeks and by AS was 11.9 weeks. CONCLUSIONS: Vitreoretinal specialists considered B-scan the most important examination tool, and typically perform B-scan early and frequently after presentation. Non-VR ophthalmologists (particularly associate specialists) review patients and perform B-scan ultrasound later and less often than vitreoretinal specialists. We recommend early referral to VR specialists, as reported referral even in uncomplicated cases would often be outside the timeframe within which VR specialists would typically choose to operate.

Clinical Competence↗
PubMed1995

Doc practice management set to explode.

An industry that barely existed give years ago is emerging as a prime mechanism to organize doctors. Independent physician management companies are uniquely situated to do the job as HMOs rethink the strategy of employing physicians and as hospitals find doctors reluctant to come under their control.

Commerce↗
PubMed2004

Psychotropic PRN: a model for best practice management of acute psychotic behavioural disturbance in inpatient psychiatric settings.

PRN, or 'as needed', medications are administered frequently by mental health nurses in psychiatric inpatient settings to manage difficult and disturbed behaviour when other strategies fail. Research indicates that approximately 50% of psychiatric inpatients receive a PRN medication at some stage of their treatment. Although evidence indicates that traditional antipsychotics and benzodiazepines are equally effective in managing acute agitation and other psychotic symptoms, it has been recommended that benzodiazepines should be the first-line of action because they do not cause the serious side-effects that are common with the traditional antipsychotics. Unfortunately, research indicates that doctors and nurses are not taking advantage of the latest evidence to guide their practice. This paper reviews the limited research available in the area and makes recommendations for evidence-based practice.

Drug Administration Schedule↗
PubMed1989

Using demographic data for ambulatory health care planning: a dental health practice management model.

The use of sociodemographic data in planning ambulatory health services is discussed and illustrated. Five global indices are identified as important for establishing contours of need within local community areas: social class, population heterogeneity, resident mobility, family organization, and general stress factors. Knowledge of sociodemographic distributions within a given community can serve as an adjunct for rational decision making in planning and placement of ambulatory health care services. It can also establish a means for evaluating whether extant health services reach their intended targets via comparisons to the social demography of patients receiving care in private practices or public clinics. Such analyses are germane to ambulatory health care practitioners in both the public and private sector.

Ambulatory Care↗