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Issue

Vol 123 No 1324: 15 October 2010

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Issue Summary

SUMMARY

The excess cost associated with healthcare-associated bloodstream infections at Auckland City Hospital

Andrew Burns, Lesley Bowers, Nick Pak, Jean Wignall, Sally Roberts

Up to 5 to 10% of patients admitted to hospital acquire an infection which may prolong their hospital stay. These infections cost the health sector money and prevent the bed being used for other purposes. This study has put a monetary value on the cost of an episode of healthcare-associated bloodstream infection. This is the cost to the hospital not to the patient. There will also be a cost to the patient in terms of loss of income for them, or family members, as they support the patients delayed return to full health. Initiatives within the health sector that are aimed at reducing healthcare-associated infections need to be supported.

SUMMARY

Christchurch experience of pulmonary embolism with and without thrombolysis

Wandy Chan, Tiffany Campbell, Sharyn MacDonald, Ian Crozier

We documented our first 6-year experience of thrombolysis (powerful clot busting agent) in patients with pulmonary embolism (blood clot to the lungs) with large clot burden. Our experience was good with a relatively low in-hospital and 6-month event rate. When comparing CT chest markers for clot burden and right heart strain (markers of severity of pulmonary embolism), they had good correlation with echocardiography.

SUMMARY

Introduction of continuous regional analgesia via wound catheters in a peripheral hospital

Ei Thu Aung, Pascale Fluri, Semisi Aiono

This study reviewed the effectiveness of continuous regional analgesia (CRA) via wound catheters after abdominal surgery in a district general hospital (Wanganui). Results showed that CRA via wound catheters provides effective and safe analgesia (pain relief) after abdominal surgery for patients in a small district general hospital. This technique was readily accepted by theatre, HDU, ward, and anaesthetics colleagues in the hospital.

SUMMARY

Surgical outcomes following laparoscopic adrenalectomy for treatment of Conn’s syndrome (primary hyperaldosteronism) between 1999 and 2006

Andrew Herd, Richard Harman, Eletha Taylor

In a small number of people, high blood pressure and electrolyte disturbances can be caused by a benign growth in the adrenal gland. This can lead to further health complications and requirement for medications with side effects. Laparoscopic resection of this growth is safe and offers potential cure in a number of cases.

SUMMARY

Ten-year review of intussusception at Starship Hospital: 1998–2007

Hemal Kodikara, Amiria Lynch, Phillip Morreau, Sally Vogel

Intussusception, a condition in children where part of the bowel telescopes into another part, is being managed successfully at Starship Hospital. Rates of reducing the intussusception by enema and rates of surgery and outcomes of both are comparable to other studies around the world.

SUMMARY

Task Manager: an innovative approach to improving hospital communication after hours

Mary E Seddon, David Hay

In the evenings and overnight the hospital is staffed with fewer doctors and nurses than it is during the day. It is important that these healthcare professionals are able to communicate quickly and clearly so that patients receive the care that they need. At Middlemore Hospital we have introduced a tool (Task Manager), that staff are able to access on any computer. This tool shows all the tasks that need to be done, it colour codes them for urgency and it displays who has accepted the task. This has dramatically reduced the number of pagers that each doctor receives (allowing them to do their work without distraction) and has shown for the first time, what tasks are actually being done, by whom, and when. This should inform how we staff hospitals at night.

SUMMARY

Outcome of patients on azathioprine: a need for a better pre-treatment assessment and dosing guideline

Dinar Jabin, Sunil Kumar, Peter J Gow

This is a retrospective study on rheumatologic patients who were on Azathioprine (AZA), a disease modifying anti-rheumatic medication. AZA metabolism depends on few enzymes; TMPT is one of them. British Society of Rheumatology (BSR) recommended TPMT testing prior to initiation of AZA to avoid bone marrow toxicity. This study looked at our practice of AZA dosing and escalation regimen, compared with the BSR guideline. Also identified patients who suffered drug-related side-effects. Finally, we emphasized on guideline based practice of AZA dosing regimen as well as TPMT testing prior to initiation of the drug.

ALL ARTICLES
SUMMARY

Answer to NZMJ about Ron Jones' research

Elizabeth Overton

Saunders Essentials of Medical Assisting (2nd edition; Diane M Klieger)

Edwin Beenen

Medical image. Combination NSAID-codeine preparations and gastrointestinal toxicity

Claire Evans, Teresa A Chalmers-Watson, Richard B Gearry

The excess cost associated with healthcare-associated bloodstream infections at Auckland City Hospital

Andrew Burns, Lesley Bowers, Nick Pak, Jean Wignall, Sally Roberts

Christchurch experience of pulmonary embolism with and without thrombolysis

Wandy Chan, Tiffany Campbell, Sharyn MacDonald, Ian Crozier

Introduction of continuous regional analgesia via wound catheters in a peripheral hospital

Ei Thu Aung, Pascale Fluri, Semisi Aiono

Surgical outcomes following laparoscopic adrenalectomy for treatment of Conn’s syndrome (primary hyperaldosteronism) between 1999 and 2006

Andrew Herd, Richard Harman, Eletha Taylor

Fibrates plus betaine: a winning combination?

Michael Lever, Peter M George, Sandy Slow, Jane L Elmslie, Brett I Shand, Russell S Scott , Stephen T Chambers

Hype around high-dose vitamin C is unjustified

Shaun Holt

Axillary breast cancer in a Nigerian woman

Emmanuel Sule, Emmanuel Akpo, Afeyodion Akhator, Darlington Obaseki

Ten-year review of intussusception at Starship Hospital: 1998–2007

Hemal Kodikara, Amiria Lynch, Phillip Morreau, Sally Vogel

Persistent arthritis following Chikungunya virus infection

Nora Lynch, Rod Ellis Pegler

Task Manager: an innovative approach to improving hospital communication after hours

Mary E Seddon, David Hay

Very cheap drinking in New Zealand: some alcohol is more affordable than bottled water and nearly as cheap as milk

Fiona Imlach Gunasekara, Nick Wilson

Using economic data to reduce healthcare-acquired infection

Kate Halton, Nicholas Graves

Front-of-pack nutrition labelling: where to now?

John White, George Thomson, Louise Signal

A Case of Caesarian Section

Pituitary involvement in Langerhans-cell histiocytosis

Daniel Garofalo, Rick Cutfield

Proceedings of the Health Research Society of Canterbury Seminar Series, Thursday 23 September 2010

Regional anaesthesia and pain relief after surgery

Michael J Fredrickson, R Ross Kennedy

Thomas Guy Hawley

Outcome of patients on azathioprine: a need for a better pre-treatment assessment and dosing guideline

Dinar Jabin, Sunil Kumar, Peter J Gow

SUMMARY

The excess cost associated with healthcare-associated bloodstream infections at Auckland City Hospital

Andrew Burns, Lesley Bowers, Nick Pak, Jean Wignall, Sally Roberts

Up to 5 to 10% of patients admitted to hospital acquire an infection which may prolong their hospital stay. These infections cost the health sector money and prevent the bed being used for other purposes. This study has put a monetary value on the cost of an episode of healthcare-associated bloodstream infection. This is the cost to the hospital not to the patient. There will also be a cost to the patient in terms of loss of income for them, or family members, as they support the patients delayed return to full health. Initiatives within the health sector that are aimed at reducing healthcare-associated infections need to be supported.

SUMMARY

Christchurch experience of pulmonary embolism with and without thrombolysis

Wandy Chan, Tiffany Campbell, Sharyn MacDonald, Ian Crozier

We documented our first 6-year experience of thrombolysis (powerful clot busting agent) in patients with pulmonary embolism (blood clot to the lungs) with large clot burden. Our experience was good with a relatively low in-hospital and 6-month event rate. When comparing CT chest markers for clot burden and right heart strain (markers of severity of pulmonary embolism), they had good correlation with echocardiography.

SUMMARY

Introduction of continuous regional analgesia via wound catheters in a peripheral hospital

Ei Thu Aung, Pascale Fluri, Semisi Aiono

This study reviewed the effectiveness of continuous regional analgesia (CRA) via wound catheters after abdominal surgery in a district general hospital (Wanganui). Results showed that CRA via wound catheters provides effective and safe analgesia (pain relief) after abdominal surgery for patients in a small district general hospital. This technique was readily accepted by theatre, HDU, ward, and anaesthetics colleagues in the hospital.

SUMMARY

Surgical outcomes following laparoscopic adrenalectomy for treatment of Conn’s syndrome (primary hyperaldosteronism) between 1999 and 2006

Andrew Herd, Richard Harman, Eletha Taylor

In a small number of people, high blood pressure and electrolyte disturbances can be caused by a benign growth in the adrenal gland. This can lead to further health complications and requirement for medications with side effects. Laparoscopic resection of this growth is safe and offers potential cure in a number of cases.

SUMMARY

Ten-year review of intussusception at Starship Hospital: 1998–2007

Hemal Kodikara, Amiria Lynch, Phillip Morreau, Sally Vogel

Intussusception, a condition in children where part of the bowel telescopes into another part, is being managed successfully at Starship Hospital. Rates of reducing the intussusception by enema and rates of surgery and outcomes of both are comparable to other studies around the world.

SUMMARY

Task Manager: an innovative approach to improving hospital communication after hours

Mary E Seddon, David Hay

In the evenings and overnight the hospital is staffed with fewer doctors and nurses than it is during the day. It is important that these healthcare professionals are able to communicate quickly and clearly so that patients receive the care that they need. At Middlemore Hospital we have introduced a tool (Task Manager), that staff are able to access on any computer. This tool shows all the tasks that need to be done, it colour codes them for urgency and it displays who has accepted the task. This has dramatically reduced the number of pagers that each doctor receives (allowing them to do their work without distraction) and has shown for the first time, what tasks are actually being done, by whom, and when. This should inform how we staff hospitals at night.

SUMMARY

Outcome of patients on azathioprine: a need for a better pre-treatment assessment and dosing guideline

Dinar Jabin, Sunil Kumar, Peter J Gow

This is a retrospective study on rheumatologic patients who were on Azathioprine (AZA), a disease modifying anti-rheumatic medication. AZA metabolism depends on few enzymes; TMPT is one of them. British Society of Rheumatology (BSR) recommended TPMT testing prior to initiation of AZA to avoid bone marrow toxicity. This study looked at our practice of AZA dosing and escalation regimen, compared with the BSR guideline. Also identified patients who suffered drug-related side-effects. Finally, we emphasized on guideline based practice of AZA dosing regimen as well as TPMT testing prior to initiation of the drug.

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