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By Hole Ousia Posted on September 7, 2017February 1, 2023

Delirium screening (some years later)

Over three years ago I wrote this summary of my concerns about mandatory delirium screening. The consequences for me in writing this were life changing: the reality of having the courage to … Continue reading Delirium screening (some years later)

Categories: Ageing, Delirium, Medical Education, Medical humanities, NHS Scotland, Omphalos films, Philosophy, Screening, This is Not yesterday, Two culturesTags: #followthefellows, 11 May 2017, 4AT, 5th August 2017: Dr Sharon Inoyue, A letter to Professor Jason Leitch, a new instrument for rapid delirium screening: a study in 234 hospitalised older people, A Sunshine Act for Scotland, Alasdair MacLullich, AMT4, antipsychotic prescribing, antipsychotics, Antiquary, antispsychotic, as a direct consequence of mandatory [HIS] screening that elderly and frail patients were frequently being prescribed powerful anti-psychotics such as Haloperidol, “evidence has found that Haloperidol actually worsens the outcome of delirium”, “Haloperidol does increase mortality in older people compared with other antipsychotics. That message has been out for a while but has not really got across.”, Bellelli, Britton Review, CAM, Capacity and Consent, Care Standards, case-finding, change page, cognitive impairment, compliance, comprehensive delirium pathway, comprehensive delirium pathway as developed by SDA and HIS includes use of prescribed Haloperidol, Concerns about the over-prescribing of antipsychotic drugs in the elderly led me to consider possible explanations for this behaviour by doctors, considerations on delirium assessment, Continuing Medical Education (CME), courage to care, Cumberlege Review, dated 17th May 2017, Delirium, Delirium and frailty assessment tools work, delirium detection, Delirium Screening, Delirium screening (some years later), Dementia, Dementia: who is in the “driving seat, detection, Do we care enough about consent?, Doing damage in delirium, Doing damage in delirium the hazards of antipsychotic treatment in elderly people, Don't use antipsychotics routinely to treat agitation and aggression, Dr Iona Heath, Dr Margaret McCartney, Dr Suzanne Reeve, Dr Suzanne Reeve: “Haloperidol does increase mortality in older people compared with other antipsychotics. That message has been out for a while but has not really got across.”, Dr Thompsell replied “evidence has found that Haloperidol actually worsens the outcome of delirium”., epidemic, ethics, Faculty of Old Age Psychiatry, Faculty of Old Age Psychiatry - Spring Meeting, first do no harm, fully informed consent, Fully informed consent: NHS Scotland, General Medical Council, GMC, Haloperidol, Haloperidol does increase mortality in older people compared with other antipsychotics, Haloperidol in Scotland, Haloperidol prescribing in NHS Scotland, Haloperidol prescribing to Scotland's elders, harm, Healthcare Improvement Scotland, HEAT target 4, HIS, Hole Ousia, Hospital prescribing of Haloperidol in your NHS Health Board area, How many more inquiries, I also wonder if the Mental Welfare Commission may have a view of starting out with a screening test without any perceived need (as per HIS recommendations) for individual consent?, I am writing to Healthcare Improvement Scotland as I find myself confused, I asked about the wide use of haloperidol in older adults in hospitals in NHS Scotland, IHI, improvement science, Improvement Work in Scotland, incentivised target for the early diagnosis of dementia, informed consent, Informed consent is a fundamental principle underlying all healthcare, Infusion of worldwide teas, Institute of Healthcare Improvement, Inverse care, Jason Leitch, journal of Age and Ageing, kept in the dark, Lancet Psychiatry, LearnPro, mandatory, mandatory delirium screening, Mary Midgley, mental Welfare Commission, most patients with delirium discharged on a new antipsychotic had no instructions for discontinuation, My concerns over prescribing of antipsychotic drugs like Haloperidol in a frail elderly population led me to raise a petition for a Sunshine Act with the Scottish Government, National Improvement, National Improvement work, NHS Scotland, no consent is deemed necessary, no special training is required, Older People in Acute Care, OPAC, OPAC tools are working, Over three years ago I wrote this summary of my concerns about mandatory delirium screening., Patient consent in NHS Scotland, PE1493, PE1493 by Peter John Gordon on a Sunshine Act for Scotland. To close the petition, PE1517 Polypropylene Mesh Medical Devices, PE1571, Peter Gordon, Polypropylene Mesh Medical Devices, Prescribed drug dependence and withdrawal, Prescribed harm, primum non nocere, Principles and Practice of Screening for Disease. World Health Organisation, Professor Alasdair MacLullich, proxy measures, rapid delirium screening, rebel antiquary, reductionism, response from Healthcare Improvement Scotland, Royal College of Psychiatrists, Royal College of Psychiatrists in Scotland, Scotland's approach to dementia diagnosis, Scottish Delirium Association, Scottish Government, Scottish Parliament, screening, screening for cognitive impairment, SDA, Shona Robison, Should we not be spelling out this shortfall to Scottish Government as part of improvement recommendations, Sir Harry Burns, Social maverick, Studies show dramatic increase in antipsychotic treatment with mandatory delirium screening, Sunshine Act, Sunshine legislation, target-driven, The 4AT has recently been re-branded an "assessment test", The Antiquary, The consequences for me in writing this were life changing: the reality of having the courage to care in NHS Scotland, The faltering unfaltering steps, the hazards of antipsychotic treatment in elderly people, the history of reductionism versus holistic approaches to scientific research, The mesh of relationships between doctors and industry, The patient paradox, The Rebel Antiquary, The report of the Independent Medicines and Medical Devices Safety Review, The Scottish Government has missed an opportunity, The Scottish Government has no plans to introduce a sunshine act, The Scottish Government [Prescribed harm], The use of antipsychotic medication for people with dementia: Time for action, THINK delirium, truly madly deeply, Two heavyweights of the delirium world: Wes Daly takes on Professor Alasdair Maclullich: to screen or not to screen. Let the battle commence, unforeseen consequences, Validation of the 4AT, Very important. Studies show dramatic increase in antipsychotic treatment with mandatory delirium screening, We must be wary of faltering steps into a world of inverse-care, we need to engage beyond clinicians and improvement staff, where the mesh inquiry leaves us regarding a register of doctors' interests, why ethics matter, why ethics matters, why ethics matters to us all, Wilson and Jungner

By Hole Ousia Posted on August 12, 2017February 1, 2023

“ethical approval is less burdensome”

It is most welcome to hear from Philippa Whitford about positive outcomes of NHS Scotland’s collaborative approach to quality improvement and the learning that this might provide for the rest … Continue reading “ethical approval is less burdensome”

Categories: British Medical Journal, Delirium, Medical Education, Medical humanities, Medical writings, NHS Scotland, Philosophy, Scotland, Screening, Two culturesTags: #followthefellows, 'ethical approval is less burdensome for QI', A letter to Professor Jason Leitch, Acute perspective, as a direct consequence of mandatory [HIS] screening that elderly and frail patients were frequently being prescribed powerful anti-psychotics such as Haloperidol, BGS, British Geriatrics Society, Change Page: “Don’t use antipsychotics routinely to treat agitation and aggression in people with dementia, compliance, comprehensive delirium pathway, comprehensive delirium pathway as developed by SDA and HIS includes use of prescribed Haloperidol, Consent, Delirium, Delirium Screening, DNA of frontline staff, Doing damage in delirium, Doing damage in delirium the hazards of antipsychotic treatment in elderly people, Dr Suzanne Reeve: “Haloperidol does increase mortality in older people compared with other antipsychotics. That message has been out for a while but has not really got across.”, Dr Thompsell replied “evidence has found that Haloperidol actually worsens the outcome of delirium”., eal paucity of evidence about the field of improvement science, ethical approval is less burdensome, ethical issues arise in QI because attempts to improve quality may inadvertently cause harm, ethics, frailty, Frailty Hub, Frailty Industry, Haloperidol does increase mortality in older people compared with other antipsychotics, Haloperidol in Scotland, Haloperidol prescribing in NHS Scotland, Health Foundation, Healthcare Improvement Scotland, HIS, Huddle, If NHS Scotland has been genetically-modified with QI, IHI, IHI Fellows, Improvement Fellows, Infusion of worldwide teas, Institute for Healthcare Improvement, Jason Leitch, mandatory delirium screening, National Improvement, NHS Scotland, OPAC, PDSA cycle, Philippa Whitford, phlosophy, prescribing figures for Haloperidol in NHS Scotland, Professor Jason Leitch - letter of the 2nd June 2015 on Haloperidol prescribing ro Scotland's older generation, QI, Quality Improvement, Quality improvement has made its way into the DNA of frontline staff, rapid delirium screening, real paucity of evidence about the field of improvement science, screening, Steve Parry, The BMJ, The faltering unfaltering steps, the history of reductionism versus holistic approaches to scientific research, the Principles and Practice of Screening for Disease, Tools, truly madly deeply, was also concerned that this approach could lead to greater use of antipsychotic medication, Wilson and Jungner

By Hole Ousia Posted on August 5, 2017February 1, 2023

We are far more than our labels

“National Improvement” work for older people has focused on Frailty and in NHS Scotland we are reminded by healthcare Improvement Scotland to “THINK frailty” This short film is based on … Continue reading We are far more than our labels

Categories: Medical Education, Medical humanities, Narrative medicine, NHS Scotland, Omphalos films, Philosophy, Scotland, This is Not yesterday, Two culturesTags: "National Improvement" work for older people has focused on Frailty and in NHS Scotland we are reminded by healthcare Improvement Scotland to "THINK frailty", 583, ageism, And may God concede that you grow old either never or late, Anna Magnusson, Antiquary, BGS, British Geriatrics Society, but the caption is wrong, Concedatque Deus (Mavisbank), Dr Peter Gordon, eventually the labels ran out, Films about Psychiatry, frailty, Frailty Industry, Healthcare Improvement Scotland, HIS, Hole Ousia, How we regard and make use of this windfall of elders will define the world in which we live, I mistook myself for a scientific label, IHI, improvement science, Institute for Healthcare Improvement, labeling, Labelling, Labelling Theory of Mental Illness, labels, National Improvement, Omphalos, Omphalos films, one hundred labels, OPAC, Peter Gordon, QI, QI connect, rebel antiquary, reductionism, Seeing the future, Social maverick, stigma, The Ageing Stone, The Antiquary, The Frailty Industry, The Frailty Industry: Too Much Too Soon?, the history of reductionism versus holistic approaches to scientific research, The Rebel Antiquary, THINK Frailty, thought for the day, We are far more than our labels

By Hole Ousia Posted on June 4, 2017July 5, 2022

Improvement science and consent: a failure of NHS Governance

I am an employee of NHS Lothian and have been ‘sign posted’ to the “New Capacity and Consent intranet page: important information for all staff.” This is a screenshot taken on Friday … Continue reading Improvement science and consent: a failure of NHS Governance

Categories: Delirium, Medical Education, Medical humanities, Medical writings, NHS Scotland, StigmaTags: ageism, assault, capacity, Common Law, compliance, Consent, Delirium, Don't use antipsychotics routinely, ethics, Haloperidol, Healthcare Improvement Scotland, Iatrogenic harm, Improvement science and consent: a failure of NHS Governance, incapacity, intelligent kindness, intervention, most patients with delirium discharged on a new antipsychotic had no instructions for discontinuation, New Capacity and Consent intranet page: important information for all staff., NHS Governance, NHS Lothian, Obtaining consent, OPAC, Policy, reductionism, Scotland, screening, stigma, the hazards of antipsychotic treatment in elderly people, Tools, unforseen consequences

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