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Senior Clinicians (senior + clinician)
Selected AbstractsAssessing prolonged recovery in first-episode psychosisACTA PSYCHIATRICA SCANDINAVICA, Issue 2002L. Wong The Early Psychosis Prevention and Intervention Centre (EPPIC) is a comprehensive, specialized treatment service for individuals residing in the western metropolitan region of Melbourne who are experiencing their first psychotic episode. A subprogramme of EPPIC, the Treatment Resistance Early Assessment Team (TREAT), has been developing a framework for the management of individuals experiencing ,prolonged recovery' in early psychosis. TREAT is a consultation team that provides technical assistance to clinicians within EPPIC, comprising senior clinicians with expertise in the biopsychosocial treatment of early psychosis and persisting positive and negative symptoms. A system has recently been set up within the TREAT framework to routinely assess clinical and functional outcomes of these clients using standardized instruments. Case managers are trained to conduct assessments at multiple timepoints over the duration of their clients' treatment at EPPIC. A summary will be presented on the current sample (n=15) and examples of clinician and client feedback reports will be illustrated. Discussion is also provided on the development of training, procedures and materials to enhance integration of clinician and client outcome measures into routine clinical practice. [source] Discussing withdrawing and withholding of life-sustaining medical treatment in a tertiary paediatric hospital: A survey of clinician attitudes and practicesJOURNAL OF PAEDIATRICS AND CHILD HEALTH, Issue 7-8 2008Tom Forbes Aim: To better understand current attitudes and practices relating to discussions concerning the withholding and withdrawing of life-sustaining medical treatment (WWLSMT) among medical staff in the paediatric setting. Methods: An anonymous online survey of paediatricians (senior medical staff , SMS) and paediatric trainees (junior medical staff , JMS) likely to be involved in the care of children with life limiting illness. Results: A total of 162 responses were obtained (response rate 42%). SMS indicated feeling more comfortable with their abilities to discuss WWLSMT than JMS. Barriers to discussing WWLSMT were numerous and included clinician concerns about family readiness for the discussion, prognostic uncertainty, family disagreement with the treating team regarding the child's prognosis/diagnosis and concerns about how to manage family requests for treatments that are not perceived to be in the child's best interests. Fifty-eight per cent of JMS and 35.8% of SMS reported receiving no specific communication training regarding WWLSMT. Most learned through experience and by observing more senior colleagues. There was a high level of support for additional training in this area and for the provision of resources such as discussion guidelines and a structured form for documenting the outcomes WWLSMT discussions. Conclusion: The majority of JMS feel less comfortable with their abilities to facilitate these discussions than their senior colleagues. The results of this study suggest that although confidence correlates with experience, junior and senior clinicians are eager to improve their skills through ongoing professional development and the provision of resources. The education needs of JMS and SMS appear to be different. [source] Exploring the clinical utility of the Development And Well-Being Assessment (DAWBA) in the detection of hyperkinetic disorders and associated diagnoses in clinical practiceTHE JOURNAL OF CHILD PSYCHOLOGY AND PSYCHIATRY AND ALLIED DISCIPLINES, Issue 4 2009David Foreman Background:, The clinical diagnosis of ADHD is time-consuming and error-prone. Secondary care referral results in long waiting times, but primary care staff may not provide reliable diagnoses. The Development And Well-Being Assessment (DAWBA) is a standardised assessment for common child mental health problems, including attention deficit/hyperactivity disorder (ADHD), which can be rapidly scored by skilled specialist clinicians, who may be remote from the interview, thus avoiding referral. Method:, A representative clinic sample of routine cases suspected of ADHD underwent an assessment which included the DAWBA alongside a confirmatory assessment with a skilled clinician. Another clinician provided DAWBA-based diagnoses blind to the clinic view. Bayesian statistical modelling was used to include clinic diagnostic uncertainty in the analyses. Results:, Eighty-four cases were assessed. For ADHD, the predictive value of a positive or negative DAWBA diagnosis was greater than .8, with negligible bias. Non-hyperkinetic behaviour disorders had higher, emotional and autistic disorders lower predictive values, though all greater than .75: there was, however, evidence of bias. Conclusions:, Diagnoses of ADHD based on senior clinician review of the DAWBA completed by parents, teachers and young people aged 11 plus may be sufficiently accurate to permit clinical diagnosis without direct patient contact by the diagnosing clinician. This could improve access to accurate diagnoses of ADHD in primary care while freeing up senior clinicians to focus on complex and refractory cases in secondary care. [source] How clinicians in neonatal care see the introduction of neonatal nurse practitionersACTA PAEDIATRICA, Issue 2 2002ME Redshaw The aim of this study was to investigate the views of UK clinicians in neonatal care who were working with nurses trained as neonatal nurse practitioners (NNPs). A questionnaire survey was used with a total sample of senior clinicians in the 66 neonatal units with one or more qualified NNPs. The main outcome measures were type and frequency of response, and similar data from NNPs were used to make comparisons. Data were returned from 57 of the 66 clinicians contacted (86%). NNP clinical practice as perceived by them was largely similar to that recorded by NNPs, though the clinicians expected more NNP involvement in some procedures (inserting central venous lines, umbilical arterial catheters, chest drains and peripheral arterial cannulae) than was actually found. Perceptions of the NNP role were similar, though the clinicians were significantly less likely to see taking a case-load, conducting a ward round, accepting outside referrals and taking charge of emergency transfers as integral elements. Reflections on the utilization of NNPs in neonatal care and the impact on junior medical staff education referred to NNPs filling gaps, a reduction in the intensity of work, improvements in training and in the quality of care. Conclusion: The introduction of NNPs is seen positively from the perspective of clinicians working alongside them in neonatal care. The development of similar models of care in countries where the introduction of NNPs is being considered is likely to be similarly supported. [source] | ||||||||||