Änderung des Therapieziels am Lebensende: Effekte einer Klinik-Leitlinie [Changing the treatment goal at the end of life: effects of a guideline at a hospital].

BACKGROUND AND OBJECTIVE: Deciding about treatment goals at the end of life is a frequent and difficult challenge to medical staff. As more health care institutions issue ethico-legal guidelines to their staff the effects of such a guideline should be investigated in a pilot project.¦PARTICIPANTS AND METHODS: Prospective evaluation study using the pre-post method. Physicians and nurses working in ten intensive care units of a university medical center in Germany answered a specially designed questionnaire before and one year after issuance of the guideline.¦RESULTS: 197 analyzable answers were obtained from the first (pre-guideline) and 251 from the second (post-guideline) survey (54 % and 58 % response rate, respectively). Initially the clinicians expressed their need for guidelines, advice on ethical problems, and continuing education. One year after introduction of the guideline one third of the clinicians was familiar with the guideline's content and another third was aware of its existence. 90% of those who knew the document welcomed it. Explanation of the legal aspects was seen as its most useful element. The pre- and post-guideline comparison demonstrated that uncertainty in decision making and fear of legal consequences were reduced, while knowledge of legal aspects and the value given to advance directives increased. The residents had derived the greatest benefit.¦CONCLUSION: By promoting the knowledge of legal aspects and ethical considerations, guidelines given to medical staff can lead to more certainty when making in end of life decision.

Essential diagnostics - the role of the Department of Biomedical Research of the Royal Tropical Institute in the 21st century

In the light of emerging and overlooked infectious diseases and widespread drug resistance, diagnostics have become increasingly important in supporting surveillance, disease control and outbreak management programs. In many low-income countries the diagnostic service has been a neglected part of health care, often lacking quantity and quality or even non-existing at all. High-income countries have exploited few of their advanced technical abilities for the much-needed development of low-cost, rapid diagnostic tests to improve the accuracy of diagnosis and accelerate the start of appropriate treatment. As is now also recognized by World Healt Organization, investment in the development of affordable diagnostic tools is urgently needed to further our ability to control a variety of diseases that form a major threat to humanity. The Royal Tropical Institute's Department of Biomedical Research aims to contribute to the health of people living in the tropics. To this end, its multidisciplinary group of experts focuses on the diagnosis of diseases that are major health problems in low-income countries. In partnership we develop, improve and evaluate simple and cheap diagnostic tests, and perform epidemiological studies. Moreover, we advice and support others - especially those in developing countries - in their efforts to diagnose infectious diseases.

Get your 10 a day! The Nursing Care Standards for Patient Food in Hospital (PDF 1.92 MB)

Standards to improve the nutritional care and food experience of patients in hospital.

Top Tips for Parents

Your Guide to Positve Parenting, Top Tips for Parenting Teenagers and Happy Homes Poster

Appendices for Complex Needs - The Nursing Response to Children and Young People with Complex Physical Healthcare Needs (PDF 708 KB)

Appendices to Complex Needs Report

Complex Needs - The Nursing Response to Children and Young People with Complex Physical Healthcare Needs (PDF 832 KB)

Departmental review of nursing services in order to ensure that they are facilitated to fully support and respond to children with complex needs and their families, and for them to work in partnership with other professions and agencies.

Continuity of Supply of the Home Oxygen Service in England, Wales, Scotland and Northern Ireland (PDF 96 KB)

Arrangements to support continuity of oxygen supply to patients using the NHS home oxygen service in the four countries within the United Kingdom

PCHR Booklet (PDF 497 KB)

Personal Child Health Record Booklet

Improving Patients' Access to Medicines: A Guide to Implementing Nurse and Pharmacist Independent Prescribing within the HPSS in Northern Ireland (PDF 704 KB)

A Guide to Implementing Nurse and Pharmacist Independent Prescribing within the HPSS in Northern Ireland

Health for All Children : Guidelines and Principles of Practice for Professional Staff (PDF 403 KB)

Sets out a clear core programme of child health contacts that every family can expect.

Ward Sisters' Charter (PDF 2341 KB)

An action plan for cleaner hospitals in Northern Ireland

Maintien des capacités des myopathes ou l'art de prescrire l'exercice physique [How to maintain the motor capacities in neuromuscular disorders or the art to prescribe physical exercises].

Optimum management of non-acquired neuromuscular disorders requires a multidisciplinary approach in order to prevent secondary complications related to the progression of the disease and to maintain the patient's independency in daily activities. For treatments, the physiotherapists and occupational therapists must have precise and measurable goals to quantify muscle strength and functions in conjunction with a specialist in neurorehabilitation. Examples of simple motor scores or scales are given in order to transmit precise information to the GP and the multidisciplinary team, and type of orthosis and physiotherapy programmes are given as pieces of advice to assume the follow-up of patients.

Degree in Social Work Incentive Scheme 2006 (PDF 45 KB)

Student Bursaries Incentive Scheme

Code of Practice on Confidentiality of Patient Information (PDF 108 KB)

Code of Practice on Confidentiality of Patient Information

Best Practice Guidance for Supplementary Prescribing by Nurses Within the HPSS in Northern Ireland (PDF 270 KB)

Provides clear information on the practical implementation of supplementary prescribing.