MDT

MDT
  • 文章类型: Journal Article
    背景:多学科团队(MDT)方法可以最大程度地减少多发性创伤患者的发病率和死亡率。该项目评估了英国骨科协会目前在多大程度上满足了针对体弱骨科患者的创伤管理指南标准。
    方法:在2022年3月1日至2022年3月14日的2周捕获期内,对多家医疗机构的所有创伤和骨科患者进行了回顾性分析。收集的数据包括年龄,性别,损伤,停留时间和专业输入日期。
    结果:共纳入27家医院的1,050名患者。中位年龄是80岁,560(53.3%)的所有骨折是股骨颈骨折。在1,050名患者中,870例(82.9%)接受手术治疗。不同专业参与的中位数为3;645(61.4%)进行了正畸(OG)审查。在主要创伤中心(MTC),93.3%有OG输入,与非MTC的66.3%相比。输入最多的专业是放射学,塑料具有最低的输入。
    结论:需要一种标准化的MDT方法来优化骨科创伤患者的护理和康复。有关专业参与的结果差异很大,需要加以解决,以最大程度地减少这一脆弱的患者队列所接受的护理差异。
    BACKGROUND: A multidisciplinary team (MDT) approach to polytrauma patients minimises morbidity and mortality. This project assesses the extent to which British Orthopaedic Association Standards for Trauma guidelines for the management of the frail Orthopaedic patient are currently being met.
    METHODS: A retrospective analysis was performed of all Trauma and Orthopaedic patients in multiple medical institutions over a 2-week capture period from 1 March 2022 until 14 March 2022 inclusive. Data collected included age, sex, injury, length of stay and dates of speciality input.
    RESULTS: A total of 1,050 patients were included from 27 hospitals. The median age was 80 years, with 560 (53.3%) of all fractures being neck of femur fractures. Of the 1,050 patients, 870 (82.9%) were managed operatively. The median number of different speciality involvements was 3; 645 (61.4%) had an orthogeriatric (OG) review. In major trauma centres (MTC), 93.3% had OG input, compared with 66.3% in non-MTC. The speciality with the greatest input was Radiology, with Plastics having the lowest input.
    CONCLUSIONS: A standardised MDT approach is needed to optimise care and recovery in orthopaedic trauma patients. The difference in results regarding speciality involvement is substantial and needs to be addressed to minimise disparities in care received by this vulnerable cohort of patients.
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  • 文章类型: Journal Article
    目的:2022年,美国泌尿外科协会(AUA)要求进行更新的文献综述(ULR),以纳入自本指南2020年发布以来产生的新证据。由此产生的2023年指南修正案解决了晚期前列腺癌患者的最新建议。
    方法:ULR解决了原始38项指南声明中的23项,并包括了自2020年系统综述以来发表的合格研究的抽象级别综述。选择了16项研究进行全文回顾。本报告介绍了由于新文献而对指南所做的更新。
    结果:晚期前列腺癌小组根据最新综述修改了基于证据和共识的声明,以帮助临床医生管理晚期前列腺癌患者。这些陈述总结在图中并在本文中详述。
    结论:本指南修正案提供了一个框架,旨在提高临床医生利用最新的循证信息治疗晚期前列腺癌患者的能力。高质量临床试验的进一步研究和出版对于继续提高这些患者的护理质量至关重要。
    In 2022 the American Urological Association (AUA) requested an Update Literature Review (ULR) to incorporate new evidence generated since the 2020 publication of this guideline. The resulting 2023 Guideline Amendment addresses updated recommendations for patients with advanced prostate cancer.
    The ULR addressed 23 of the original 38 guideline statements and included an abstract-level review of eligible studies published since the 2020 systematic review. Sixteen studies were selected for full text review. The current summary presents the updates made to the Guideline as a result of that new literature.
    The Advanced Prostate Cancer Panel amended evidence- and consensus-based statements based on an updated review to aid clinicians in the management of patients with advanced prostate cancer. These statements are detailed herein.
    This Guideline Amendment provides a framework designed to improve a clinician\'s ability to treat patients diagnosed with advanced prostate cancer with the most current evidence-based information. Further research and publication of high-quality clinical trials will be essential to continue to improve the quality of care for these patients.
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  • 文章类型: Journal Article
    炎性肠病(IBD)的症状和临床过程因个体而异。因此,个性化护理对于有效管理至关重要,由强大的以患者为中心的多学科团队提供,在精心设计的服务中工作。这项研究旨在完全重写英国成人和儿童IBD医疗保健标准,并开发IBD服务基准测试工具,以支持当前和未来的个性化护理模式。
    由英国IBD领导,由患者组成的全国多学科联盟,并提名了IBD护理所有主要利益相关者的代表,标准要求由689名患者和151名医疗保健专业人员的调查数据确定。在三轮修改的electronic-Delphi上起草和完善了标准。
    就涵盖七个临床领域的59项标准达成共识;(1)多学科IBD服务的设计和交付;(2)诊断前转诊途径,协议和时间表;(3)新诊断患者的整体护理;(4)支持患者赋权的耀斑管理,自我管理,并在需要时接触专家;(5)手术,包括适当的专业知识,术前信息,心理支持和术后护理;(6)住院医疗服务提供(7)以及门诊和初级护理环境中的持续长期护理,包括共享护理。使用这些以患者为中心的标准,并由IBD质量改善项目(IBDQIP)提供信息,本文提出了一个国家基准框架。
    标准和基准测试工具为医疗保健提供者和患者提供了一个评估其服务质量的框架。这将承认优秀的护理,促进质量改进,IBD的审计和服务开发。
    UNASSIGNED: Symptoms and clinical course during inflammatory bowel disease (IBD) vary among individuals. Personalised care is therefore essential to effective management, delivered by a strong patient-centred multidisciplinary team, working within a well-designed service. This study aimed to fully rewrite the UK Standards for the healthcare of adults and children with IBD, and to develop an IBD Service Benchmarking Tool to support current and future personalised care models.
    UNASSIGNED: Led by IBD UK, a national multidisciplinary alliance of patients and nominated representatives from all major stakeholders in IBD care, Standards requirements were defined by survey data collated from 689 patients and 151 healthcare professionals. Standards were drafted and refined over three rounds of modified electronic-Delphi.
    UNASSIGNED: Consensus was achieved for 59 Standards covering seven clinical domains; (1) design and delivery of the multidisciplinary IBD service; (2) prediagnostic referral pathways, protocols and timeframes; (3) holistic care of the newly diagnosed patient; (4) flare management to support patient empowerment, self-management and access to specialists where required; (5) surgery including appropriate expertise, preoperative information, psychological support and postoperative care; (6) inpatient medical care delivery (7) and ongoing long-term care in the outpatient department and primary care setting including shared care. Using these patient-centred Standards and informed by the IBD Quality Improvement Project (IBDQIP), this paper presents a national benchmarking framework.
    UNASSIGNED: The Standards and Benchmarking Tool provide a framework for healthcare providers and patients to rate the quality of their service. This will recognise excellent care, and promote quality improvement, audit and service development in IBD.
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