Use of a digital delirium pathway and quality improvement to improve delirium detection in the emergency department and outcomes in an acute hospital.

Background: delirium is a common condition associated with hospital admission. Detection and diagnosis is important to identify the underlying precipitating cause and implement effective management and treatment. Quality improvement (QI) methodology has been applied in limited publications.

The role of appropriate diagnostic testing in acute respiratory tract infections: An antibiotic stewardship strategy to minimise diagnostic uncertainty in primary care.

Antibiotic resistance has increased worldwide to the extent that it is now regarded as a global public health crisis. Interventions to reduce excessive antibiotic prescribing to patients can reduce resistance and improve microbiological and clinical outcomes. Therefore, although improving outpatient antibiotic use is crucial, few data are provided on the key interventional components and the effectiveness of antibiotic stewardship in the primary care setting, in South Africa.

The spread of carbapenem-resistant Enterobacteriaceae in South Africa: risk factors for acquisition and prevention.

New, effective antibiotics are only likely to become available in 15 - 20 years. To prevent deaths from untreatable Gram-negative infections in South Africa, the rights of any doctor, whether in general or in hospital practice, to indiscriminately prescribe whatever antibiotic they wish, and in whatever fashion, must be challenged. Furthermore, although prevention of the emergence and subsequent spread of carbapenem-resistant Enterobacteriaceae (CRE) has focused on acute and chronic care facilities and inter alia on antibiotic exposure in these institutions, CRE may soon become an issue within entire communities, highlighting a role for public health authorities in CRE prevention efforts.

Potential for medical error: incorrectly completed request forms for thyroid function tests limit pathologists' advice to clinicians.

Background: Various publications have highlighted the significance of laboratory errors in the pre- and post-analytical phases and their impact on results. Thyroid-stimulating hormone (TSH) is a first-line thyroid function test and, if abnormal, reflex thyroxine (T4) or tri-iodothyronine (T3) testing is requested, depending on clinical and medication data provided. Interpretative comments are added to all TFT results.

An audit on the reporting of critical results in a tertiary institute.

Background: Critical result reporting is a requirement for accreditation by accreditation bodies worldwide. Accurate, prompt communication of results to the clinician by the laboratory is of extreme importance. Repeating of the critical result by the recipient has been used as a means to improve the accuracy of notification.

Incomplete laboratory request forms: the extent and impact on critical results at a tertiary hospital in South Africa.

Background: Research has demonstrated that most laboratory errors occur in the preanalytical phase of testing. In view of the paucity of studies examining preanalytical errors, we evaluated our laboratory request forms for the frequency and impact of incomplete data.

Methods: This study examined all request forms received at our laboratory during a five-day period.

Fatal human infection with rabies-related Duvenhage virus, South Africa.

Duvenhage virus was isolated from a patient who died of a rabies-like disease after being scratched by a bat early in 2006. This occurred approximately 80 km from the site where the only other known human infection with the virus had occurred 36 years earlier.