A new approach to training in intravenous drug therapy.

A multidisciplinary team organised an intravenous infusion training day for nurses on the preceptorship programme at Chesterfield and North Derbyshire Royal Hospital. Theoretical and practical sessions were set up to provide instruction and supervision of safe practice principles for an activity that is widely acknowledged as being a source of risk. The results of the training day showed that more than 90 per cent of the participants evaluated the experience positively and this helped to improve both their competence and confidence in the procedures involved.

Factors associated with probability of patient rejecting a repeat 24 h ambulatory blood pressure monitoring, despite recommendation by the physician.

Objective: The aim of our study was to find out factors associated with patient acceptance of repeat 24 h ambulatory blood pressure monitoring (ABPM) using the Mobil-O-Graph ambulatory blood pressure monitor.

Methods: Six hundred and fifty patients had ABPM performed between July 1999 and Oct 2000. Following 24 h ABPM patients were asked to complete 13-item questionnaire.

Obstetric complications and anxiety during pregnancy: is there a relationship?

This review examines the contribution of recent research into the effects of anxiety during pregnancy. The focus of interest is upon the process of labor and delivery rather than its timing or the size of the baby. Therefore studies directed at areas of prematurity or low birthweight are specifically excluded as these have already been well evaluated in the literature.

Implementation of a patient falls risk-management strategy.

The Department of Health has identified patient falls as a priority area for improvement in its National Service Framework for Older People. Such falls have financial and emotional costs. In one trust, clinical-incident reporting of falls led to an audit and the introduction of a falls risk-management improvement programme as part of its clinical governance strategy.

Optident prize 2000.

This paper describes the orthodontic treatment of two cases, which were awarded the 2000 Optident prize.

A day in the life of a children's nurse.

Practice development posts have evolved in the past decade since the demise of the Clinical Nurse Manager role. The Practice Development Adviser supports and facilitates clinical practice innovations with the aim of improving the quality of patient-focused care. Clinicians are encouraged to utilise ward-based clinical developments as an integral part of a course leading to academic qualifications.

The modified twin block appliance in the treatment of Class II division 2 malocclusions.

Two case reports illustrate the effective treatment of Class II division 2 malocclusion with modifications to the Twin Block appliance. This approach may reduce the total treatment time and reduce the need for extra-oral anchorage. In each of the cases presented treatment has been carried out on a non-extraction basis with full correction of the malocclusion.

Acp. Best practice no 155. Pathological investigation of deaths following surgery, anaesthesia, and medical procedures.

The pathological investigation of deaths following surgery, anaesthesia, and medical procedures is discussed. The definition of "postoperative death" is examined and the classification of deaths following procedures detailed. The review of individual cases is described and the overall approach to necropsy and interpretation considered.

Evidence-based health care: its place within clinical governance.

This article explores the principles of evidence-based practice and its role in achieving quality improvements within the clinical governance framework advocated by the recent White Papers 'The New NHS: Modern, Dependable' (Department of Health (DoH), 1997) and 'A First Class Service: Quality in the New NHS' (DoH, 1998a). Within these White Papers there is an emphasis on improving quality of care, treatment and services through employing the principles of clinical governance. A major feature of clinical governance is guaranteeing quality to the public and the NHS, and ensuring that clinical, managerial and educational practice is based on scientific evidence.

Comparing 1997 Resuscitation Council (UK) recovery position with recovery position of 1992 European Resuscitation Council guidelines: a user's perspective.

Both the 1992 and the 1997 recovery positions were demonstrated to 100 employees attending for Basic Life Support resuscitation training at a district general hospital (Chesterfield and North Derbyshire Royal Hospital NHS Trust). They used both positions, experiencing being the first-aider and the casualty and then completed a closed questionnaire. The results were evaluated from this 100% response.

New long stay patients: from acute wards to where?

Inadequate alternatives to the old mental hospitals have placed many inner city acute psychiatric units under great pressure as bed numbers have contracted and disturbed patients have accumulated. This study set out to assess the outcome at two-year follow-up of a cohort of 26 patients resident on an acute psychiatric ward for more than six months. Results showed that a substantial minority of 'new long stay' patients made a successful return to independent living, but that at two-year follow-up half the cohort remained in a highly supported setting.