After hours medical ward duties in a teaching hospital

Ting, Joseph Y.S. and Humphrey, Kevin J. (2005) After hours medical ward duties in a teaching hospital. Australian Health Review, 29 1: 37-42. doi:10.1071/AH050037

Author Ting, Joseph Y.S.
Humphrey, Kevin J.
Title After hours medical ward duties in a teaching hospital
Journal name Australian Health Review   Check publisher's open access policy
ISSN 0156-5788
Publication date 2005-02
Sub-type Article (original research)
DOI 10.1071/AH050037
Volume 29
Issue 1
Start page 37
End page 42
Total pages 6
Editor J. Dwyer
S. Leggat
Place of publication Collingwood, VIC, Australia
Publisher C S I R O Publishing
Collection year 2005
Language eng
Subject 321208 Primary Health Care
730199 Clinical health not specific to particular organs, diseases and conditions
320100 Medicine - General
Abstract In many Australian hospitals a medical officer is available for urgent review of in-patients outside normal working hours. Current practice in nurse-initiated requests for medical officer involvement out of hours may adversely affect patient outcome as well as medical and nursing resource use at these times. Of 10 523 nurse-initiated requests for out-of-hours review recorded by medical officers at our hospital in 2002-2003, the most frequent reasons for the requests were medication review, IV fluid orders, IV resite, venesection and pathology review, none of which are related to acute changes in clinical condition. Requests for routine review of medication and fluid orders were found to be rarely essential and often inappropriate. Medical officer activity was highest before midnight and least after midnight, suggesting most requests are fulfilled in the evening. Several strategies to reduce inappropriate out-of-hours requests were identified. Routine tasks could be completed by primary treating unit staff before going off-duty. IV cannulation and venesection may be performed by appropriately trained phlebotomists or skilled advanced practice nursing staff. Meticulous ordering of 'as required' analgesia and night sedation would reduce unnecessary requests. Clinical protocols for nurse-initiated adjustment of drugs with variable dosing may also decrease inefficiencies. This would leave the ward cover medical officers more available for their primary function of urgent patient review.
Keyword After hours medical care
In-patient care
Nurse-initiated request
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: 2006 Higher Education Research Data Collection
School of Medicine Publications
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Created: Wed, 15 Aug 2007, 07:16:13 EST