RESUMEN
From 16 November 2009, all doctors require a license to practise in the UK. Revalidation encompasses relicensing and recertification. This article focuses on recertification for gastroenterologists. Revalidation should not be viewed as a threat, and for the vast majority of doctors it should be straightforward, with the aim of demonstrating safe doctors, while keeping to a minimum time spent on exhaustive data collection. Specialty specific standards for physician medicine are ready to be endorsed by the General Medical Council and the first revalidations will be introduced around 2011. Subspecialty specific standards for gastroenterology are under evaluation and in the early stages of consultation.
Asunto(s)
Ciego , Colonoscopía/normas , Íleon , Intubación Gastrointestinal/estadística & datos numéricos , Indicadores de Calidad de la Atención de Salud/estadística & datos numéricos , Competencia Clínica/estadística & datos numéricos , Colonoscopía/estadística & datos numéricos , Inglaterra/epidemiología , Humanos , Auditoría Médica , Estudios ProspectivosAsunto(s)
Benzamidas/uso terapéutico , Compuestos de Bencilo/uso terapéutico , Dispepsia/tratamiento farmacológico , Anciano de 80 o más Años , Antiinflamatorios no Esteroideos/uso terapéutico , Aspirina/uso terapéutico , Dispepsia/virología , Helicobacter pylori/aislamiento & purificación , Humanos , FumarAsunto(s)
Antiinflamatorios no Esteroideos/efectos adversos , Antiulcerosos/uso terapéutico , Aspirina/efectos adversos , Infecciones por Helicobacter/tratamiento farmacológico , Helicobacter pylori , Omeprazol/análogos & derivados , Omeprazol/uso terapéutico , Úlcera Péptica/prevención & control , 2-Piridinilmetilsulfinilbencimidazoles , Humanos , Lansoprazol , Úlcera Péptica/etiología , Inhibidores de la Bomba de Protones , Prevención SecundariaRESUMEN
OBJECTIVE: To determine the indications, technical success and outcomes of open access percutaneous endoscopic gastrostomy (PEG) insertion in the district general hospital setting. DESIGN: This study was a retrospective audit of patients receiving PEG by the thread pull method from November 1998 to November 1999, followed by a prospective audit of patients receiving PEG from December 1999 to May 2000. Prophylactic antibiotics were not used. Patient data were collected using a computerized endoscopy unit record system. Clinical assessment was performed and case notes were reviewed. Whenever necessary, telephone follow-up of patients in the community was performed. PARTICIPANTS: Sixty-five consecutive, unselected patients underwent PEG and 64 were followed up for a total of 7799 patient days. Fifty-seven of 64 (89%) were in-patients. The median age of the patients was 74 years (range, 26-95 years). MAIN OUTCOME MEASURES: Indications, technical success, early complications and long-term outcomes of PEG. RESULTS: Cerebrovascular disease was the most common indication for PEG (35/64 (55%)). Technical success was achieved in 62/64 (97%) patients. No serious complications from the procedure were reported: PEG site infection was rare (1/64). Pneumonia was uncommon (8/64 (12.5%)). There were eight (12.5%) deaths during the first week after PEG insertion and 18/64 (28%) during the first month. Mortality at 1 year was 36/64 (56%). Ten of 64 patients (16%) recovered to PEG removal; 18 (28%) continue to be fed via PEG. CONCLUSION: This audit demonstrates that referral patterns, technical success and long-term outcome of open access referral for PEG in a district general hospital setting are consistent with published series from specialist and tertiary referral centres.