North Bristol NHS Trust

About: North Bristol NHS Trust is a healthcare organization based out in Bristol, United Kingdom. It is known for research contribution in the topics: Population & Medicine. The organization has 2204 authors who have published 2811 publications receiving 61110 citations.

Replacing tracheostomy with overnight intubation to manage the airway in head and neck oncology patients: towards an improved recovery.

Abstract: In maxillofacial head and neck oncology, tracheostomy is often used to secure the airway, but not without risk. This study compared the existing practice of two units: one where tracheostomy was routinely done with one where overnight intubation was used. From both units we retrospectively analysed 50 consecutive patients who had intraoral resection, neck dissection, and microvascular reconstruction for head and neck cancer. When compared with tracheostomy, overnight intubation resulted in a shorter mean stay in the intensive therapy unit (ITU) (1.4 compared with 3.7 days), a shorter overall hospital stay (12.9 compared with 18.0 days), less time to first oral intake (8.9 compared with 12.8 days), and a lower rate of lower respiratory tract infection (LRTI) (10% compared with 38%). This study supports the discontinuation of routine tracheostomy and the adoption of a more selective practice to improve recovery.

Shared decision making and its role in end of life care

Abstract: Currently, 'shared decision making', which involves the multi-disciplinary team, i.e. the patient, nurse and doctor making joint decisions is advocated in many governing policies to improve the care of the dying patient. The UK population is ageing at an ever-increasing rate, which means that more people are experiencing a progressive death typical of that associated with chronic disease. These patients are suitable for participation in end of life decision making due to the pre-existing knowledge of impending death. Health-care professionals can assist the patient to achieve a 'good death' based on the patient's preferences, wishes and needs. The aim of the literature review discussed in this article was to identify the extent to which shared decision making currently exists during end of life care in the acute/hospice setting. Particular attention is paid to patient participation, the nurse's role, and the doctor/nurse relationship - factors that may facilitate or prevent shared decision making. Eighteen qualitative research papers published between 1997-2007 were reviewed and analysed, and demonstrated a strong link between shared decision making and a 'good death'. However, the research reviewed identified that although shared decision making can exist within end of life care, there are a number of reasons why this is not being achieved throughout the secondary care setting.

Is Fixation Failure After Plate Fixation of the Symphysis Pubis Clinically Important

Abstract: Background Plate fixation is a recognized treatment for pelvic ring injuries involving disruption of the pubic symphysis. Although fixation failure is well known, it is unclear whether early or late fixation failure is clinically important.