Staff Doctors Research Articles

Pasienttilfredshet i en avrusningsinstitusjon for pasienter med rusmiddelproblemer - en kvantitativ deskriptiv studie

Patient satisfaction in inpatient detoxification for substance use disorders - a quantitative descriptive studyThe primary purpose of the study is to discover important factors for patients at inpatient detoxification by studying patient satisfaction. Data were collected from a patient experience survey carried out from 2013-2015 at a detoxification unit in Norway. The study includes 185 responses (response rate 62 %). Data were analyzed with descriptive and inferential statistics. Significant associations were found between patients’ satisfaction and all the factors of the therapeutic relationship except respect and courtesy, support and motivation, which were non-significant in this study. Conversations with therapist showed the largest effect on patient satisfaction (effect size (ES) = 1.27), followed by conversations with doctor (ES = 0.78) and compassionate staff (ES = 0.52). The results suggest that the therapeutic relationship is associated with patient satisfaction in inpatient detoxification.

Robotic versus laparoscopic urological surgery: incidence of reoperation and complications

Objective: To report the introduction of minimum invasive surgery in Denmark with focus on the reoperation and complication rates.Materials and methods: Data were prospectively collected at the national UroLap database. The database was established in 2003 in Denmark to register all laparoscopic urological procedures as well as their peri- and post-operative outcomes. In the period from 2009–2014, 10,843 patients were registered with the database, of which 10,546 (97%) had a complete Clavien-Dindo score within the first 30 postoperative days.Results: The mean age of patients was 60.5 years (S.D. = 16.2), and 415 patients (4%) were under the age of 17 years. The male-to-female ratio was 4:1. At the end of 2010, 25% of surgeries used the robotic technique, but the frequency of robotic surgeries increased to 56% in 2014. No complications were reported in 74.6% of the urological procedures. The mortality rate was reported at only 0.27% of all patients. Patients who underwent a urological procedure performed by consultant urologists had a lower rate of complication compared to procedures performed by trainees (p = 0.03) but not staff doctors (p = 0.9). There were no significant differences in complication rates between staff doctors and trainee (p = 0.2).Conclusion: Robotic and laparoscopic urological procedures are associated with low serious complication rates. Postoperative complications were more common among surgeries performed by trainees. The robotic approach is associated with a shorter L.O.S. compared to the laparoscopic approach and linked to lower reoperation rates.

Characteristics of awareness and behavior of medical staff for prevention of falling accidents among inpatients.

The purpose of this study is to clarify the characteristics of awareness and behavior for falling accident prevention according to medical profession. We used a questionnaire called "Self-Evaluation of Awareness and Behavior for Falling Accident Prevention," which was originally designed for nurses. In October and November 2016, the questionnaire was administered to 1,670 medical staff (nurses, doctors, lab technicians, nursing assistants, radiological technicians, pharmacists, physical therapists, nutritionists, and occupational therapists, among others) at a hospital in Japan, using a 5-step scale and a not applicable (N/A) option. Valid responses were obtained from 923 (55.3%) participants, and all seven factors extracted by factor analysis had Cronbach's α coefficients of greater than 0.9. Using cluster analysis based on principal component analysis, four categories were identified. According to the results of the N/A χ2 (chi-square) test question item and occupation, nurses answered N/A the least, followed by doctors, physical therapists, and occupational therapists. Nursing assistants' awareness and behavior were both low, suggesting the necessity of education on preventing falling accidents. By applying the "Self-Evaluation of Awareness and Behavior for Falling Accident Prevention" to all medical staff, we succeeded in clarifying their characteristics of awareness and behavior for falling accident prevention.

The Judgment of the Court of Appeals in Białystok of April 24, 2013 (I ACa 787/12). Considerations Regarding the Consequences of the Lack of Reliable Information about the Patient’s Condition

The article is about compensation responsibility for prenatal injuries also wrongful life and wrongful birth. The study is an attempt to define the concept of harm in the context of the birth of a child and to protect the personal rights of parents in the form of the right to family planning in the event of the birth of a child with a disability. The text also refers to the information obligation of the doctor and medical staff, as well as its scope and method of providing the patient with information about his condition.

Study to Assess the Effect of Nursing Interventions on the Stress Level of Parents of Neonates Admitted to Neonatal Intensive Care Unit

Introduction: A pre-experimental study to assess the effect of nursing interventions on the stress level of parents of neonates admitted to NICU in selected hospital. The primary objective of the study was to assess the effectiveness of nursing intervention on parental stress among the parents of neonates admitted to NICU. Methods: The present study was conducted among 30 parents of neonates admitted to NICU in a government hospital of New Delhi. The purposive sampling technique was applied. Parents were assessed for stress level by using PSS: NICU (developed by Miles& Funk et al.). On the first day (within 24 hours of admission) followed by nursing interventions which included an informational session of 40 minutes for one time regarding introduction of NICU, indications for admission to NICU, routine care given by staff nurses and doctors to the neonates admitted to NICU, commonly used equipment’s and disposable items at NICU, general instructions regarding the care of neonate at home or after discharge and danger signs for neonates. On the third day, parents were reassessed for parental stress score by using same PSS: NICU scale. Results: Out of 30 parents 21 were mothers and 9 were fathers. The mean pre-nursing intervention parental stress score of 72.9±12.98 were more than the mean posts nursing intervention parental stress score of 58.7±12.37 with mean difference of 14.2±5.61 which shows the significant reduction in stress level of parents of neonates admitted to NICU. The mean pre-nursing intervention parental stress score for other three subscales of PSS: NICU; ‘sight and sound’ 14±4.37, ‘looks and behavior’ 30.4±9.57, ‘parental role’ 28.5±4.92 was more than the mean post nursing intervention parental stress score for these three subscales; ‘sight and sound’8.6±2.84, ‘looks and behavior’ 24.9±9.03 and ‘Parental role’ 25.1±4.44. These results showed that most leading cause of stress among all three subscales was parental role followed by looks and behavior and sight and sounds. The Data were analyzed using descriptive and inferential statistics using SPSS v.20. Conclusion: Nursing Intervention was effective in reducing the stress level of parents of neonates admitted to NICU.

Parents’ opinions of children and teenagers’ vaccination in Lower Silesia.

Background: Immunization in Poland might be seriously threatened because of inaccurate information about its safety and effectiveness. It is necessary to monitor people’s opinions about immunization in order to stop the negative process of disinformation. Aim of the study: The aim of the diploma paper was to understand parents’ attitude and concerns about immunization in Poland. Material and methods: Two hundred parents from Lower Silesia were enrolled in the study in 2016. The research tool was the author’s unnamed questionnaire. Results: The research shows that the majority of parents 92.5% (183) have positive attitudes towards immunization. The obligatory immunization rate among children in Poland was very high 96% (191). 70.4% (138) of children were given at least one vaccination that was not obligatory in Poland and in most cases that was vaccination against pneumococcus – 61% (103) of children and chickenpox – 54.4% (92) of children. A relationship was noted between the recommended vaccination and financial situation of parents and their education level. There were several reasons why people’s attitudes to vaccination might be negative: financial reasons 60.3% (41), vaccine injury 27.19% (19), ineffectiveness 7.4% (5), and natural ways of supporting immunity 20.6% (14). More than half of respondents 51.6% (101) claim that their knowledge about the immunization is insufficient. The main source of information about immunization for parents is medical staff (doctors, nurses and midwifes). Nevertheless, 32.8% (65) of respondents reported not receiving any information about recommended vaccination from their attending physician. Conclusion: The uptake of immunization is related on parents’ education and financial reasons. Medical staff do not inform parents and promote immunization adequately. Parents are not informed about the possibility of extended vaccination. It is necessary to educate parents about the safety and effectiveness of immunization.

Analysis of the use of point-of-care ultrasonography in Emergency Departments in public hospitals in Catalonia. ECURCAT Study

The aim of this study was to determine the degree of implantation, the characteristics and the formation of point-of-care ultrasonography, performed by emergency physicians in the public hospital emergency department (ED) of Catalonia. Descriptive study based on a survey conducted with those responsible for the public ED in Catalonia and structured in three blocks: difficulty of implementing the technique and perceived reasons for this difficulty, equipment available in the emergency room and its use, and training of emergency physicians. The survey was answered by 96.3% of public ED; in 63.5% of them the emergency physicians performed point-of-care ultrasonography. Implementing ultrasonography was considered to have a high degree of difficulty in 86.5%, and 78.8% had their own ultrasound. The most frequent use is abdominal (87.9%), thoracic (72.7%) and peripheral vascular (69.7%). The presence of protocols and registers of the activity is scarce. The training is not uniform between staff doctors and those on call. No significant differences were found according to the type of hospital, the degree of activity or the presence of a radiologist 24 hours a day, the exception being the FAST protocol, which was more used in regional hospitals (89.5% vs. 42.9%; p=0.007). Point-of-care ultrasonography done by emergency physicians is used in more than half of the Catalan public ED. There is a need for extending the use of ultrasound in the ED, it should be more regulated, appropriately registered and involve all physicians working in the emergency department.

Dual practice of hospital staff doctors: hippocratic or hypocritic?

Dual practice of hospital staff doctors: hippocratic or hypocritic?

Assessment of Patient Safety Culture in an Adult Oncology Department in Saudi Arabia.

We sought to evaluate patient safety culture across different healthcare professionals from different countries of origin working in an adult oncology department in a medical facility in Saudi Arabia. This cross-sectional survey of 130 healthcare staff (doctors, pharmacists, nurses) was conducted in February 2017. We used the Hospital Survey of Patient Safety Culture (HSOPSC) to examine healthcare staff perceptions of safety culture. A total of 127 questionnaires were returned, yielding a response rate of 97.7%. Eight out of 12 HSOPSC composites were considered areas for improvement (percent positivity < 50.0%). Significantly different mean scores were observed across the three professional groups in all 12 HSOPSC composites. Doctors tended to rate patient safety culture significantly more positively than nurses or pharmacists. Nurses scored significantly lower than pharmacists in the majority of HSOPSC composites. No significant differences in patient safety culture composite scores were observed between Saudi/Gulf Cooperation Council (GCC) and non-Saudi/GCC groups. Regression analysis showed that the frequency of reported events is predicted by feedback and communication about errors, and teamwork across units. Perception of patient safety is associated with respondents' profession and teamwork across units. This study brings to the fore the assumption that all healthcare professionals have a shared understanding of patient safety. We urge healthcare leaders and policy makers to look at patient safety culture at this granular level in their contexts and use this information to develop strategies and training to improve patient safety culture.

Malaria training for community health workers in the setting of elimination: a qualitative study from China

BackgroundContinuous training of health workers is a key intervention to maintain their good performance and keep their vigilance during malaria elimination programmes. However, countries progressing toward malaria elimination have a largely decreased malaria disease burden, less frequent exposure of health workers to malaria patients, and new challenges in the epidemiology of the remaining malaria cases. Moreover, competing health priorities and usually a decline in resources and in political commitment also pose challenges to the elimination programme. As a consequence, the acceptability, sustainability, and impact of malaria training and education programmes face challenges. However, little is known of the perceptions and expectations of malaria training and education programmes of health workers being engaged in countries with malaria elimination programmes.MethodsThis qualitative study provides information on perceptions and expectations of health workers of malaria training programmes from China, which aims to malaria elimination by the year 2020. This study was embedded into a larger study on the challenges and lessons learned during the malaria surveillance strategy in China, involving 42 interviews with malaria experts, health staff, laboratory practitioners, and village doctors at the provincial, city, county, township, and village levels from Gansu province (northwestern China) and Jiangsu province (southeastern China).ResultsIn the context of an increasing number of imported malaria cases in China, the majority of respondents emphasized the necessity and importance of such programmes and complained about a decreasing frequency of training courses. Moreover, they called for innovative strategies to improve the implementation and sustainability of the malaria training programmes until the elimination goal has been achieved. Perceptions and expectations of health workers from different health centres were quite different. Health workers from higher-level facilities were more concerned about technical training aspects, while health workers from periphery of the health system expected to receive more training on field work coordination and on specific public health actions with regard to case detection and focus investigation.ConclusionsThere is need to guarantee an ongoing good training of health workers in China on malaria aspects until the year 2020 and probably beyond.

Public Health Information Behavior at Flood-Prone Area In Bandung Regency: A Case Study in Baleendah Village, Andir Village, Bojongsoang Village and Dayeuh Kolot Village

This study aims to understand the public health information behavior in the vicinity of flood prone area by examining 1) The public health information behavior in identifying diseases that may occur because of a flood. 2) The information behavior in finding health information solution required for dealing with diseases that may occur because of a flood. 3) The public health information behavior in determining health information sources which is used. 4) The public health information behavior in making use of health information for diseases that may occur because of a flood. 5) The public health information behavior in making use of health institution to satisfy its information needs. 6) The public health information behavior in flood prone area. The method used in this research is qualitative method supported by Case Study approach. In this research, we analyze data obtained from Focus Group Discussion (FGD) conducted by 11 informants and in-depth interview with 20 interviewees that are competent with this research research for triangulation. The result of this research reveals that people living in the flood prone area vicinity in Baleendah Village, Andir Village, Dayeuh Kolot Village and Bojongsoang Village, Bandung Regency (1) identify the potential of a flood disease based on their experience and identification during a flood (2) search for health information solution required for overcoming disease potential because of a flood by asking directly to a doctor or health center staff or volunteers during a flood. For psychological problem, usually people consult with religious leader, although Social Agency provice service to overcome this problem. (3) The main information source used is one that is informed by the health center or village midwife. (4) People use health information to help healing process when they get sick during the disaster. Health information obtained when a flood does not happen is only for adding insights. (5) Health Agency through health center and village midwife are actively involved to give health counseling to the public on various occasions. Those five things influence The public health information behavior in the flood prone area.

The impact of a ward round manager: A time and motion study

Aim: This study seeks to evaluate the impact of a ward round manager via a cost consequences analysis. Background: One approach to combating junior doctor staff shortages is to delegate duties to non-physicians. However, the evidence supporting their cost-efficiency is limited. Design: A time and motion study was conducted comparing junior doctors with and without the support of a ward round manager. Their actions were timed, recorded and categorised for ease of interpretation. The ward round manager's impact was discerned by the differences in time and task allocation between the groups. Results: The ward round manager reduced the length of ward round by 136 minutes and prevented 70 minutes of overtime. Those doctors with ward round manager support also benefited from 38 minutes of extra breaks and 16 minutes of additional teaching per day. Other benefits include taking a shorter route around the ward, as well as more time for communication and afternoon clinical reviews. Conclusion: This study has shown that the ward round manager is a high cost-saving intervention, and has multiple positive effects on patient care and staff satisfaction.

Questionnaire survey on nutritional supplement therapy and exercise training at hemodialysis facilities in Japan

BackgroundNutritional therapy and exercise training (ET) are important interventions for hemodialysis patients. We investigated the status of nutritional therapy and ET provided at hemodialysis facilities across Japan.MethodThis was a cross-sectional study. The facilities investigated were 3993 facility member institutions of the Japanese Society for Dialysis Therapy in August 2015. Data was collected on the facility type, number of staff (doctors, nurses, and medic al engineers), presence of staff (clinical dietitians, pharmacists, and physical therapists), proportion of elderly patients (age ≥ 65 years), patients with albumin ≤ 3.5 g/dL, and types of oral nutritional supplements (ONS), intradialytic parenteral nutrition (IDPN), and ET in the facility. We summarized data on facilities and patient characteristics and calculated the proportion of the nutrition that were ONS, IDPN, and exercise interventions provided. We used multiple logistic analyses to examine the facility characteristics associated with the provision of nutritional support and ET.ResultsWe obtained responses from 1048 facilities (response rate 26.2%) and 88,492 patients (27.6%). Patients aged ≥ 65 years accounted for 63.4% of all investigated patients. Patients with Alb ≤ 3.5 g/dL accounted for 37.6% of all investigated patients. Meals during hemodialysis sessions were provided at 601 facilities (64%), ONS were used at 382 facilities (40%), and IDPN was administered at 471 facilities (46%). Exercise during hemodialysis sessions was provided at 190 facilities (20%). These trends did not change after adjustment of response rates by affiliations of facility type and region. At the patient level, only a limited number of patients were provided with ONS, IDPN, and ET, 2.1, 2.7, and 3.0%, respectively. ONS and IDPN were less likely to be offered in hospitals than in clinics without beds (odds ratio (OR) 0.21; 95% confidence interval (CI) 0.09–0.45) (OR 0.37; 95% CI 0.17–0.82). ET was also less likely to be offered in hospitals (OR 0.20; 95% CI 0.08–0.49).ConclusionsNutritional support therapy is provided in a considerable number of hemodialysis facilities, ET is increasing but offered by fewer facilities compared to other countries, while a limited number of patients were provided with ET.

Score level multibiometrics fusion approach for healthcare

Biometric traits such as iris and face can help for the elementary assessment of human diseases and healthcare monitoring. It has several advantages such as increased patient and staff (doctors and nurses) safety, the accuracy and quality of the healthcare system, reduction of the healthcare fraud. In addition, it provides a secure way to detect the inhabitant’s mood and ocular pathologies in order to treat them. The paper introduces a prototype for biometric-based healthcare monitoring. In the proposed prototype, the patient/user seeking for healthcare assistance can send a request by his/her biometric traits. The biometric traits are processed in the cloud management. The caregiver with valid identification/verification can receive the request and analyze it in order for further treatment. This paper also introduces an efficient multibiometrics fusion framework based on Aczel-Alsina triangular norm. The proposed approach utilizes the 1D-log Gabor iris features, two-directional two-dimensional modified fisher principal component analysis ( $$(2\hbox {D})^{2}$$ MFPCA) and Complex Gabor Jet Descriptor face features to be used for healthcare monitoring. Results show that the multibiometrics fusion approach has better performance compared with the previous fusion approaches.

Workflow barriers out of hours: optimising critical care outreach to support clinical decision making in medical and surgical care settings

Introduction : The out-of-hours period is associated with less favourable patient health outcomes as well as unpredictable workloads and reduced support structures for clinical activity. In particular, appropriate skill mix, staff numbers, resources, communication structures and access to diagnostic services can influence patient safety and risk. As part of continued efforts to improve patient care and hospital management, one major academic hospital is in Ireland has been engaged in work re-design during the out-of-hours service period to improve supports for clinical decision-making in medical and surgical care wards. Aim : To gain understanding of facilitators and challenges and barriers to effective work flow and clinical decision-making out-of-hours To undertake work redesign as needed to enable critical care outreach to medical and surgical out of hours Methods : An exploratory mixed methods design included surveys and semi-structured interviews and focus groups with various stakeholders involved in out-of-hours service delivery and management as well as nursing staff and non-consultant hospital doctors. Ethical approval was granted by the Trinity School of Nursing and Midwifery Ethics Committee. Results : Overall, these findings provide an overview of the typical patient activity patterns within the medical/surgical wards and highlight the potential impact of changing hospital environment on out-of-hours clinical workflow and gives some insight into potential flashpoints that may arise. The on call task activities indicate recurring patterns in relation the nature of routine activity and prescribing patterns out-of-hours. Findings from inductive analysis of qualitative interviews identify the nuances of the experience of working out-of-hours for staff and the barriers to workflow, the centrality of communication to effective performance, and the latent effects of call arrangements and work design. There was consensus across all grades of clinical staff around the positive benefits of the Emergency Response Team/ Early Warning Score (ERT/EWS) systems. Discussion : This study has identified areas of service delivery out-of-hours that are working well such as the EWS system but has also revealed areas that might benefit from improvement for example communication strategies, medical workflow design, logistical access to equipment, services and clinical support at bedside. Conclusions : (comprising key findings) The task of delivering health care effectively and safely out-of-hours should be considered against a backdrop of a changed health care environment with increased survival rates, greater levels of chronic illness and considerable innovation in technology, diagnostics and medical interventions. A critical care outreach senior nursing role for the out of hours period was found to be needed and has been recently implemented to support nurses caring for high dependency patients on the wards and to provide advice and support to NCHDs out of hours. Suggestions for future research : Following implementation of new clinical support role conduct a longer term evaluation of the impact on workflow, task allocation and staff/patient experience out-of-hours. Conduct larger studies in partnership with other hospitals that employ innovative solutions to out-of-hours support to contribute to the wider body of knowledge nationally and internationally

Les conduites à risques des enfants et adolescents vis-à-vis du dopage sportif

The main purpose of this review is to examine the patterns and prevalence of doping among child and adolescent athletes. The number of abnormal test findings recorded by anti-doping authorities worldwide cannot be considered to be a reliable picture of the use of prohibited substances and methods. Only specific questionnaires to detect the use of prohibited substances are useful to identify the extent of doping despite the risk of biased responses in self-reported declarations. Based on the different surveys and types of questionnaires it is believed that 1.5 to 6% of young athletes use prohibited substances. Prohibited substances are also being used out the sportive framework. Several studies showed that approximately 3 to 11% of non-athlete students use anabolic steroids. There were also significant associations between the use of anabolic steroids and the use of marijuana, cocaine, cigarettes, smokeless tobacco, alcohol, unhealthy nutrition, etc. The use of nutritional supplements by athletes is associated with a twofold risk, first to use adulterated supplements, either by accidental contamination or by deliberate spiking, and second to use prohibited substances with doping being viewed as a gradual progression from the use of nutritional supplements to the misuse of harder drugs. That is why nutritional supplements should not be used by young athletes (under 18 years) except where medically indicated. Doping has of multifactorial origins; the immediate family, friends, team staff, and sport doctors mainly exacerbate individual psychological factors. The estimated prevalence of doping in young athletes, and the well-known adverse effects of most prohibited substances, including hormones, anabolic steroids and stimulants, on developing endocrine and nervous systems in growing athletes, support the development of a specific policy for the prevention of doping in sports, especially designed for young athletes, their family, medical and team staffs.

Evaluation of a visual tool co-developed for training hospital staff on the prevention and control of the spread of healthcare associated infections.

Staff training in infection prevention and control (IPC) across hospital settings has a crucial role in reducing the incidence of healthcare associated infections (HAIs). However the application of dynamic visualisation approaches in this context is under-developed, with very few in-depth evaluation studies of related processes and impacts. A prototype training tablet app for hospital staff, using interactive visuals was developed and evaluated. To demonstrate different pathogen behaviour, dynamic visualisations of norovirus, Clostridium difficile, and MRSA were developed in relation to location, survival and transmission within a virtual hospital ward model using evidence-based microbiological and staff behavioural data. A three-stage evaluation process was designed, involving a mixed sample of UK National Health Service staff (doctors, nurses and domestic staff, n=150). Participants reported improved awareness and understanding of the pathogens responsible for HAI, the types of information relevant for different staff cohorts, those aspects of the visualisations which worked well and those which were prone to cause misunderstandings, and suggestions for further development and improvement. The tool appeared to offer staff a new perspective on pathogens, being able to 'see' them contextualised in the virtual ward, making them seem more real. Results showed the benefits of a detailed co-development process and a more contextualised understanding of the potential for visual apps to be used in IPC training.

Improving collaboration between professionals supporting mentally ill offenders

PurposeInterprofessional collaboration is necessary when supporting mentally ill offenders but little is understood of these interactions. The purpose of this paper is to explore prison officers’ perceptions of current and desirable levels of interprofessional collaboration (relational coordination (RC)) to understand how collaboration between these systems can be improved.Design/methodology/approachGittell’s RC scale was administered to prison officers within the Norwegian prison system (n=160) using an adaptation of the instrument in which actual and desired levels of RC are evaluated. This differentiates between prison officers’ expectations of optimum levels of collaboration with other professional groups, dependent on the role function and codependence, vs actual levels of collaboration.FindingsPrison officers reported different RC levels across professional groups, the lowest being with specialist mental health staff and prison doctors and highest with nurses, social workers and other prison officers. Significant differences between desired and actual RC levels suggest expertise of primary care staff is insufficient, as prison officers request much greater contact with mental health specialists when dealing with the mentally ill offender.Originality/valueThe paper contributes to limited literature on collaborative practice between prison and health care professionals. It questions the advisability of enforcing care pathways that promote the lowest level of effective care in the prison system and suggest ways in which mental health specialists might be better integrated into the prison system. It contributes to the continued debate on how mental health services should be integrated into the prison system, suggesting that the current import model used in Norway and other countries, may not be conducive to generating the close professional relationships required between mental health and prison staff.

Staff, associate specialist and specialty doctors' national audit on the management of gonorrhoea in the United Kingdom, 2015.

The British Association for Sexual Health and HIV (BASHH) revised United Kingdom national guideline for the management of gonorrhoea in adults, 2011, identified five auditable outcome measures, namely, that all patients should receive first-line treatment, be screened or treated for chlamydial infection, have a test of cure (TOC), be offered written information and have partner notification carried out. The UK National Guideline for Gonorrhoea Testing, Clinical Effectiveness Group, BASHH, 2012, recommended in addition that all reactive nucleic acid amplification tests (NAATs) from pharynx and rectum should be confirmed by supplementary testing, using a second NAAT which detects a different nucleic acid target, all those with a positive NAAT for gonorrhoea should have culture and antimicrobial susceptibility testing and that TOC should be done by two weeks. Staff, associate specialist and specialty doctors performed a national audit against these standards. Data from 3233 cases were submitted; 8% of cases of gonorrhoea diagnosed in England, Scotland and Wales over this period. We found that 83% patients received first-line treatment with a reason for not doing so provided for 11%. TOC was documented for 62% and written information was offered to 41%. Results about supplementary testing were inconsistent. The results for the other outcomes were satisfactory.

Patient and community attitudes toward perioperative biobanking and genomic research.

We surveyed hospital patients and clinicians to ascertain their attitudes to the establishment of a perioperative biobank for future genomics research, and whether the requirements for an opt-out approach to consent can be met. We enrolled hospital patients (n=187), patient spouse/family members (n=64), ethics committee members (n=14), and clinical staff (doctors and nurses [n=67]), and unspecified community members (n=10). They were asked to rate and describe their views on medical research and biobanking, the need for individual consent, and the importance of confidentiality. Of 406 survey forms distributed, 342 (84%) were returned. Nearly all participants (98%) indicated that a perioperative biobank is important, 93% were comfortable with de-identified genetic research, and 90% indicated that the hospital should be able to use leftover blood for medical research, provided the research has been approved by an ethics committee and personally identifying information has been removed. Participants were more likely to support biobanking if it used de-identified samples, and if, for this reason, their consent was not sought. Participants with chronic medical and surgical conditions were significantly more supportive and comfortable with genetic research, as were most in the hospital community. Most hospital patients, community members and clinicians are supportive of the development of a perioperative biobank used for genomic research. This supports the adoption of an opt-out approach to consent model.