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Biomedical subjects

D Heaney

Publications and source records attributed to D Heaney.

26 records · Page 2Linked to original sources
PubMed1996

Evaluating the workload of practice nurses: a study.

In 1990 and 1991, 67 practice nurses with a total of 12,725 consultations took part in a before and after study of health board attached and practice-employed nurse workload. The intervention of the New General Practitioner Contract (DoH 1989) and other primary care changes in April 1990 provided an opportunity to examine the process of care, and identify and changes in workload or differences in working patterns of attached and practice-employed nurses, as a result of these modifications. Practice-employed nurses initiated more of their own appointments following implementation of the New Contract and saw fewer GP referrals. Routing treatment room work had decreased for both groups of nurses in the second year. Both groups of nurses had also increased their level of therapeutic listening in the second year, but practice-employed nurses reported higher levels of therapeutic listening than their attached colleagues during both recording periods.

Adult↗
PubMed1993

General practice fundholding: observations on prescribing patterns and costs using the defined daily dose method.

OBJECTIVE: To compare prescribing patterns between a group of fundholding practices and a group of non-fundholding practices in north east Scotland using a method which provides more accurate statements about volumes prescribed than standard NHS statistics. DESIGN: The pharmacy practice division of the National Health Service in Scotland provided data for selected British National Formulary sections over two years. Each prescription issued was converted using the World Health Organisation "defined daily dose" mechanism. SETTING: Six fundholding groups (nine practices) in Grampian and Tayside regions and six non-fundholding practices in Grampian. RESULTS: During the past two years both fundholding and control practices reduced the volume of their prescribing for the classes of drug analysed. The unit costs of drugs in some classes, however, rose substantially, contributing to higher costs per patient. The unit costs rose more in the control practices (24%) than in the fundholding practices (11% in Tayside, 16% in Grampian). CONCLUSION: The use of defined daily doses helped identify cost and volume trends in specific areas of prescribing in fundholding and control practices. The basis on which funds are set needs improving, and defined daily doses may prove useful for setting volume targets within drug classes for all practices, whether fundholding or not.

Age Factors↗
PubMed1978

Treatment of hypoparathyroid patients with chlorthalidone.

In an effort to maintain normal serum calcium levels without inducing hypercalciuria, we treated seven hypoparathyroid patients for up to 25 months with chlorthalidone, a thiazide-like sulfonamide diuretic, plus a salt-restricted diet, without added vitamin D. Mean 24-hour calcium excretion decreased from 179 to 88 mg (P less than 0.001), and mean serum calcium increased from 8.2 to 9.3 mg per deciliter (P less than 0.05). Diuretic therapy or moderate salt restriction alone was not as effective as combined therapy. Beneficial effects were sustained for as long as therapy was maintained. The rise in serum calcium, which involves the filterable and ionized fractions, cannot be due entirely to reduced excretion and may in part be explained by increased intestinal absorption. Oral chlorthalidone plus a low salt diet appears to be an effective alternative to vitamin D in the maintenance therapy of at least some patients with hypoparathyroidism.

Administration, Oral↗
PubMed1977

Bilateral renal artery stenosis causing acute oliguric renal failure. Report of a case corrected by renovascular surgery.

A 70-year-old woman with chronic hypertension and previously normal renal function had acute oliguric renal failure requiring hemodialysis. Renal arteriograms revealed the presence of bilateral renal artery stenosis and normal-sized kidneys. Nineteen days after admission to hospital, after undergoing nine hemodialysis procedures, surgical revascularization of renal artery stenosis was performed utilizing a single bypass graft of the left renal artery. Postoperatively, an immediate diuresis ensued, with resolution of acute renal failure. It is critically important in the evaluation of patients with anuria, acute renal failure without obvious cause, or impending uremia in patients with chronic stable renal insufficiency, to consider the possibility of renal artery stenosis or thrombosis. Recognition and then surgical correction of significant renal arterial hypoperfusion allows the reasonable potential for reversibility of this important form of acute or progressive renal failure.

Acute Kidney Injury↗
PubMedDate not supplied

Massive colchicine overdose: a report on the toxicity.

A case of an overdose of colchicine for suicidal purposes is presented. The main complications observed involved the hematopoietic, the gastrointestinal, the respiratory and the central nervous system. Heinz bodies were noticed in the red blood cells, a finding which had not been previously documented in patients with colchicine overdose. Despite intensive management the patient died on the thirteenth hospital day of central nervous system complications.

Adolescent↗
PubMedDate not supplied

Evaluation of a nurse-led minor injuries unit.

This article, the first of two, reports the evaluation of a minor injuries clinic. The authors describe the background to the service and the methodology and results of the study. Some 20,000 patients attended the clinic during its first two years, at an average cost of 33 pounds per patient. Waiting times were low and 67 per cent of patients were discharged. Independent clinical audit rated 98 per cent of cases as satisfactorily treated. The clinic has generally been accepted by the local medical community and was funded permanently in late 1996.

Emergency Nursing↗