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Biomedical subjects

Jillian R Sewell

Publications and source records attributed to Jillian R Sewell.

5 recordsLinked to original sources

Task transfer: the view of the Royal Australasian College of Physicians.

Health service imperatives such as workforce shortages of doctors and nurses and changing models of care are driving task transfer in Australia. The Royal Australasian College of Physicians (RACP) supports task transfer both across its specialty groups and to other health professionals as appropriate. The RACP's new education standards, with explicit curricula and competency-based assessments, underpin its capacity for task transfer. Task transfer must be evidence-based, safe, cost-efficient and facilitate best patient care.

Academies and Institutes↗

Lessons from the Clinical Support Systems Program: facilitating better practice through leadership and team building.

The increasing array of strategies and models for improving clinical practice and patient outcomes can be confusing for clinicians. The Clinical Support Systems (CSS) model has proved to be effective in local environments because it demystifies the design and implementation of evidence-based practice improvement projects. The CSS model is simple and has a wide scope. It provides a broad framework with minimalist specifications, enabling clinicians to design their own systems of care that cut across fragmented organisational structures. Implementing simple rules can be an effective strategy for change in complex care systems. These rules do not impose solutions on clinicians, but rather, help them to find creative solutions that have meaning for them and are contextually relevant.

Australia↗

Prescribing of psychotropic medications for children by Australian pediatricians and child psychiatrists.

OBJECTIVE: To describe the pattern of prescribing of psychotropic medications for Australian children. DESIGN: Australia-wide cross-sectional postal survey conducted in 2000. PARTICIPANTS: All registered general pediatricians and child and adolescent psychiatrists. RESULTS: The survey was completed by 435 general pediatricians and 187 child and adolescent psychiatrists (response rates 72% and 70%, respectively). Stimulants and clonidine were the most frequently prescribed medications. Seventy-two percent of practitioners reported that they had prescribed a combination of medications. Frequent combinations included a stimulant and clonidine (64% of pediatricians, 51% of child psychiatrists) and a stimulant and a selective serotonin reuptake inhibitor (SSRI; 29% of pediatricians, 36% of child psychiatrists). Pediatricians were more likely than child psychiatrists to report prescribing clonidine for sleep problems (67% vs 36%). Child psychiatrists were more likely than pediatricians to report prescribing SSRIs (93% vs 75%) and mood stabilizers (45% vs 11%) for depression, and SSRIs (74% vs 50%) and tricyclic antidepressants (37% vs 12%) for obsessive compulsive disorder. Off-label prescribing (indication or age not included in the product information) was reported by 40%. Over 5% of practitioners in this study had prescribed clonidine, methylphenidate, dexamphetamine, and typical neuroleptics for children under 3 years of age. CONCLUSIONS: A broad range of psychotropic medications are being prescribed for Australian children, with some medication groups being prescribed frequently. Combinations of psychotropic medications are used regularly, and there is some prescribing for very young children. The safety and efficacy of several of the agents prescribed have not been adequately researched in children. There is an urgent need for pediatric psychopharmacology research to inform current prescribing practice.

Adult↗