Physical healthcare

Health promotion and illness prevention Physical healthcare on psychiatric wards Physical healthcare in the community Liaising with other health care professionals Medical emergencies References Further reading Health monitoring ... 

Table 9.1 Example of bio-psyrho-sorial management Chapter 10 Physical healthcare Table 10.1 Metabolic syndrome Chapter 11 Medications...

Medium term (weeks -months) Monitor medication response Try different medications Ongoing physical healthcare CBT for psychosis Motivational interviewing around cannabis use Liaise with hostel and enployer Review benefits bcational training Input from faith group... 

Loi term (months -years) Wtithdraw/reduce medications Ongoing physical healthcare Family therapy Relapse prevention work bluntary/ paid enployment Cultural support groups/day centres Carer support groups... 

Mental illness makes it harder to access physical healthcare for many reasons ... 

If you re concerned about your ward s physical healthcare, discuss this with your consultant in supervision, and consider providing formal teaching. 

Expectations - supervisor Trust physical healthcare policy... 

Teams usually welcome physical healthcare audits. Ideas include standards of ... 

The Francis report highlighted the failings of care in Mid Staffordshire NHS Foundation Trust In psychiatric services, further reports (e.g. Schizophrenia Commission, National Audit of Schizophrenia) have pointed to shortcomings, for example, in service user involvement and standards of physical healthcare. Your Trust will be under pressure to meet targets, and will be reviewed by the quality regulator, the Care Quality Commission (CQC). You can directly contribute to quality of care through audits and Quality Improvement Projects - endearing yourself to your seniors. 

Recent trends have seen physical healthcare move from secondary to primary care, and from general hospitals to specialist cenmes. Mental health has had its own parallels, moving care from asylums to the community in the late 20th century, and more recendy enphasising GP-led care of manageable mental illnesses. You may play a part in this, e.g. by visiting GP practices to offer education or advice on patients. 

Encourage good physical healthcare early and organise monitoring for ... 

Check GP guidelines on physical healthcare (see resources). An annual health check is required if moderate-profound LD, and particular syndromes need specific tests (e.g. yearly thyroid testing in Down syndrome)... 

Healthcare providers who work with the elderly must understand and address not only the physical but mental, emotional, and social changes of the aging process. They need to be able to distinguish between normal characteristics associated with aging and illness. (60) Most crucially, they should look beyond symptoms and consider ways that will help a senior maintain and improve her quality of life. 

Inhalant abuse is a financial drain on society as well. Indian Health Services estimates a cost of 1.6 million to treat a young adult with a history of inhalant abuse and all its associated physical, mental, legal, occupational, and social problems. The Office of National Drug Control Policy (ONDCP) estimates that illegal drugs cost the U.S. economy 160 billion in the year 2000, an annual increase of 5.8% between 1998 and 2000. That estimate includes 14.8 billion in healthcare costs and 110.4 billion in lost productivity from drug-related illness, incarceration, and death. 

Navazio, F.M. and Testa, M., Benefits of physical exercise, in Physiological basis of aging and geriatrics, 4th ed., Timiras, P.S., ed., Informa Healthcare, New York, 2007, chap. 24. 

Reduced startup costs/less risk Less time required to show a profit Buyer receives established goodwill Business has an established clientele Business provides buyer with trained employees, inventory, physical facilities, and established relationships area healthcare providers... 

Omission errors, incorrect doses, and prescribing errors were the top three causes of medication errors reported by health systems in 2002. The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) tracks sentinel events submitted to it by accredited heathcare facilities. A sentinel event is an unexpected occurrence involving death or serious physical or psychological injury, or the risk thereof. Table 16.3 lisfs fhe roof causes of medication errors reported by JCAHO-accredited organizations. ... 

VA, 363 male military veterans were randomly sampled and found to have a current prevalence of 32% for full PTSD and 10% for partial PTSD. Prevalence of PTSD varied as a function of risk and protective factors, including volunteering, physical symptoms during the tests, and prohibited disclosure. Veterans with full PTSD reported poorer physical health, a higher likelihood of several chronic illnesses and health-related disability, greater functional impairment, and higher likelihood of healthcare use than those with no PTSD. Veterans with partial PTSD also had poorer outcomes than did veterans with no PTSD in a subset of these domains. 

Without documentation, there is no physical evidence that validation took place, regardless of whether it was sufficient. Hence the saying If it ain t written, it ain t done. GxP regulatory authorities may well believe on a personal level that a pharmaceutical or healthcare company did conduct suitable validation to accept GxP compliance without documentary evidence. It is imperative that pharmaceutical and healthcare companies collate documentation supporting their validation as evidence to be presented to GxP regulators on inspection. 

The largest commercially available datasets are the Physical Properties (PHYSPROP) and AQUASOL databases ca. 6000 compounds in each database). The AQUASOL database has been published as a book. Furthermore, two relatively large sets of aqueous solubility data models were used in many other studies.Data from the AQUASOL database had an interlaboratory variation of about a = 0.49 log-units (as estimated for A=1031 molecules).Moreover, large inter-laboratory errors mask the influence of temperature, and differences as large as AT = 30 °C do not increase this error. In-house models developed at pharmaceutical companies could be based on similar or even larger numbers of measurements. For example, about 5000 molecules were used to develop a model at Bayer Healthcare AG. " ... 

When prescribing medications for the elderly, it is important to consider physical disability, visual impairment, the shape or color of medications (ability to differentiate), and the belief system of the patient. It would be beneficial to have healthcare professionals review the technique of using certain devices and to discuss the use of compliance aids. 

In order for healthcare providers to triage chemically exposed casualties effectively and appropriately, they must be provided with accurate and timely information about the chemical release. This information should include a description of the chemical of concern including synonyms, physical properties, and applicable exposure standards. In addition, healthcare providers will need pertinent toxicological information on the potential routes of exposure involved, target organ systems, dose-response relationships, potential exposure sequelae, the risk, if any, of secondary exposure to healthcare staff and facilities, and recommended medical procedures to be followed for exposed individuals. 

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