Impact of computerised provider order entry on the quality and quantity of clinical information included with investigation requests: an interrupted time series analysis.

Introduction: Relevant clinical information is vital to inform the analytical and interpretative phases of most investigations. The aim of this study is to evaluate the impact of implementation of computerised provider order entry (CPOE), featuring order-specific electronic order entry forms (eOEFs), on the quality and quantity of clinical information included with investigation requests.

Methods: The CPOE module of a commercially available electronic health record (Cerner Millennium) was implemented at a large, tertiary care centre.

Evaluation of procalcitonin-guided antimicrobial stewardship in patients admitted to hospital with COVID-19 pneumonia.

Background: Procalcitonin is a biomarker that may be able to identify patients with COVID-19 pneumonia who do not require antimicrobials for bacterial respiratory tract co-infections.

Objectives: To evaluate the safety and effectiveness of a procalcitonin-guided algorithm in rationalizing empirical antimicrobial prescriptions in non-critically ill patients with COVID-19 pneumonia.

Methods: Retrospective, single-site, cohort study in adults hospitalized with confirmed or suspected COVID-19 pneumonia and receiving empirical antimicrobials for potential bacterial respiratory tract co-infection.

is a rare cause of infected chronic contained rupture of abdominal aortic aneurysm.

is an anaerobic, partially acid-fast, Gram-positive bacillus associated with abscess formation. We present the case of a 70-year-old male with chronic contained rupture of abdominal aortic aneurysm (CCR-AAA) complicated by intra-abdominal abscess formation. An abdominal computed tomography scan revealed a rim-enhancing retroperitoneal collection tracking into the subcutaneous layer of the left flank and buttock, suggestive of CCR-AAA with infected haematoma.

Preventing sepsis; how can artificial intelligence inform the clinical decision-making process? A systematic review.

Background And Objectives: Sepsis is a life-threatening condition that is associated with increased mortality. Artificial intelligence tools can inform clinical decision making by flagging patients at risk of developing infection and subsequent sepsis. This systematic review aims to identify the optimal set of predictors used to train machine learning algorithms to predict the likelihood of an infection and subsequent sepsis.

A qualitative study of nursing staff experiences of delirium in the hospice setting.

Background:: Delirium is a common condition occurring in 13-42% of people admitted to palliative care units and up to 88% of these patients are at the end of their lives. It is frequently unrecognised and distressing to all those affected-patients, families and health professionals. In addition, there is considerable uncertainty surrounding its trajectory and optimal management, both of which can be inconsistent.

Typhimurium gastroenteritis leading to chronic prosthetic vascular graft infection.

It is estimated up to 6 % of prosthetic vascular grafts become infected. is predominant in early infection and coagulase-negative staphylococci are predominant in late infections. cause 14-40 % of prosthetic vascular graft infections.

Screening for delirium in specialist palliative care inpatient units: perceptions and outcomes.

Objectives: The UK National Institute for Health and Care Excellence (NICE) indicate that palliative care patients are at high risk of delirium and should be screened for it using the short confusion assessment method (short CAM). This study aimed to assess the perceptions of the short CAM for delirium screening amongst health-care workers in specialist palliative care inpatient units (SPCUs) and to investigate its use as a screening instrument.

Methods: Patients in 5 SPCUs in the North East of England were screened for delirium using the short CAM and a staff survey assessed the acceptability of the short-CAM in this setting.

Crystals seen on CSF microscopy in a case of suspected subarachnoid haemorrhage.

Although crystals are rarely identified on cerebrospinal fluid (CSF) microscopy, their presence can be of significant diagnostic value. We report a case of oxalate crystals seen on CSF microscopy of a 43-year-old woman. The patient presented with headaches, nausea and vomiting.

The rising tide of bloodstream infections with Actinomyces species: bimicrobial infection with Actinomyces odontolyticus and Escherichia coli in an intravenous drug user.

Clinicians of all specialties need to be aware of a recent, nationwide increase in the number of Actinomyces bloodstream infections. We report a case of bimicrobial bloodstream infection with Actinomyces odontolyticus and Escherichia coli in an intravenous drug user. A 36-year-old, male intravenous drug user was admitted with acute-onset pleuritic chest pain, back pain, pyrexia, tachycardia, tachypnoea and hypotension.

Assessing and improving adherence with multidrug therapy.

Introduction: Adherence with multidrug therapy (MDT) in the treatment of leprosy is important to minimise the risk of relapse and avoid the emergence of drug resistance. Adherence is defined as the extent to which the patient's behaviour matches recommendations from the prescriber. This paper reviews the methods for assessing adherence with MDT in leprosy, and community approaches to improving adherence based on evidence from the treatment of tuberculosis (TB) and HIV, as well as leprosy.

Qualitative assessment of medication adherence at an urban leprosy outpatient clinic in Hyderabad, India.

Objectives: The objective of this study was to measure medication adherence amongst outpatients attending an urban leprosy clinic in Hyderabad, India.

Design: In this study of observational design, the urine spot test and Morisky Scale questionnaire were concurrently used as qualitative measures of medication adherence.

Results: Fifty two patients met the inclusion criteria for this study; 13 patients (25%) were non-adherent according to the Morisky scale questionnaire and 17 patients (33%) according to the urine spot test.