Comparative Study of the Awareness Regarding the Medicolegal Reporting of injuries among Medical Students and Residents in Sohag University Hospital (original) (raw)
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Patients must be told of unintended injuries during treatment
BMJ, 1999
Expansion in consultant numbers is needed Editor-Forgacs's review provides an excellent picture of the unpleasant reality of acute medicine, as practised at present. 1 The Royal College of Physicians is well aware of the need to cost future improvements in increasing the number of hospital doctors and to provide evidence of the likely benefits. The latter will be a difficult task but must be tackled. Indeed, a working group of the three Royal Colleges of Physicians is currently reviewing all aspects of the problems regarding acute medicine. As chairman of the group which produced the document "Consultant physicians working for patients" and main author, 2 I (JDW) can assure readers that I have had experience, on many occasions, of handling more than 20 acutely ill patients during a 24 hour period of acute medicine as a general physician in Sheffield. Our working group realises that hundreds more consultants tomorrow and much smaller numbers of "take patients" is unrealistic. We do know from several sources that doctors are working 14-16 sessions per week and close to a 60 hour week. We know that consultation times in outpatient departments have been pared to the bone. We know that clinical governance in all its guises will place further demands on consultants. If we do not state our requirements now for an expansion in the number of consultants we will never achieve improvements.
South African Family Practice, 2009
Background: Despite the official precautionary measures against percutaneous injuries, incidents still occur. Consequently, it is possible that healthcare workers could contract infections like HBV, HCV, HGV (hepatitis B, C and G viruses) and HIV (human immune deficiency virus). The most serious problem lies in the fact that percutaneous injuries are often underestimated, resulting in non-reporting of the incident. The aim of this study was to determine the incidence of percutaneous injuries in doctors in the School of Medicine at the University of the Free State (UFS), whether the incidents were reported, and the reasons for non-reporting. The use of gloves during procedures was also evaluated. Methods: A mainly descriptive study design was used. Questionnaires were administered from October 2006 through January 2007 to collect information. Participants were selected randomly, and the respondents were divided into surgical and non-surgical groups. Results: The respondents fulfilled the following roles and/or functions in their respective departments of employment: 35 (67.3%) were registrars, 12 (23.1%) were specialists/consultants, four (7.7%) were medical officers, and one (1.9%) was exclusively involved in student training. Two of the respondents did not indicate their roles and functions in their respective departments. A total of 82 incidents of percutaneous injuries occurred. Although the surgical groups handled sharp objects more frequently per week than the non-surgical groups (p-value = 0.04), more incidents occurred in the non-surgical groups (p-value = 0.02). Only 39 (47.6%) of the incidents were reported, while 44.4% of the respondents were aware of the correct reporting procedures. The reasons given for the non-reporting of these incidents were "too busy" (58.1%), "did not think it was serious" (48.8%), and "was not aware of the reporting procedures" (7%). Only 13.7% of the respondents indicated that they always used gloves when drawing blood, 17.4% used them when injections were administered, and 22.4% used gloves during intravenous cannulation. However, 86.8% of the respondents wore gloves when they used a scalpel or any other incision object. The respondents (n = 51) suggested that the three most important precautionary measures to take into consideration when working with sharp objects were (i) the use of gloves (23/51; 45.1%), (ii) never recapping a needle (9/51; 17.6%), and (iii) keeping the container for disposing of sharp objects close at hand (6/51; 11.8%). Conclusions: Despite the risk of percutaneous injuries, non-reporting still occurs. Although the rate of reporting these incidents could be compared with international findings published in the literature, it remains too low. Drastic measures should be taken to ensure that physicians are informed of the hazards of percutaneous injuries, as well as of the appropriate mechanisms of reporting these incidents.
Open Access Emergency Medicine
Introduction: A medico-legal case (MLC) involves any injury or medical condition in which law enforcement agencies investigate and fix the responsibility regarding of an injury or medical condition. Incorrect or incomplete medico-legal reports (MLRs) may trigger a pause or delay in legal proceedings and patients' rights could be violated. The aim of this study is to describe the characteristics of MLCs and to identify errors in the MLRs. Materials and Methods: This retrospective, descriptive study was conducted in a teaching hospital in the Eastern Province of Saudi Arabia. In total, 418 MLRs furnished during a 6-month period and reviewed for characteristics of MLCs and identification of errors. Results: A total of 418 MLRs were included in the present study. Fights or physical assault and battery formed the major proportion of MLCs amounting to 83% of MLCs. Blunt injury was the dominant type of injury in most of the cases (81.8%). In relation to errors in MLRs, no MLR in the present study were without errors. Conclusion: Fights or physical assault and battery formed the major proportion of MLCs. Multiple errors were identified in the MLRs furnished by the physicians. Writing MLRs must follow standardized guidelines as it has a bearing on legal proceedings and patients' rights. We recommend training for physicians in writing MLRs in the interest of proper administration of justice.
Sharp Injuries Among Medical Students
Global Journal of Health Science, 2015
Introduction: Sharp injuries threaten the health of healthcare employees. They cause the transmission of many diseases such as hepatitis B and C, AIDS, etc., which can increase the associated costs associated with them. The aim of this study was to investigate the frequency of sharp injuries among the students of Hormozgan University of Medical Sciences.
Trauma Survey of 476 Doctors: Now We know What We Do not know
Panamerican Journal of Trauma, Critical Care & Emergency Surgery
Boletín del Instituto de Estadísticas de Turquía informó de 3.685 muertos y 274.829 heridos en 161.306 colisiones de tráfico. El objetivo de este estudio fue determinar las actitudes, la conciencia y los conocimientos generales de los médicos acerca del trauma. Métodos: Se realizó una encuesta con un cuestionario entre febrero de 2015 y abril de 2015. Comprendía tres preguntas demográficas, siete de actitud y ocho de conocimiento sobre el trauma. Los médicos fueron estratificados como: Grupo 1médicos generales; Grupo 2-residentes quirúrgicos; Grupo 3cirujanos; Grupo 4-especialidades quirúrgicas académicas. Resultados: Se completó y analizó un total de 476 (75%) de los 636 cuestionarios. La mediana de edad fue de 36 años. Los médicos generalistas (38,7%) y los cirujanos (38,7%) representaron la mayoría de los encuestados. El nivel medio de confianza de los encuestados en la realización de intervenciones de salvamento fue 98 (53%), 25 (34%), 44 (24%) y 8 (24%), respectivamente. Por otra parte, 161 (88%), 68 (92%), 162 (88%) y 32 (94%) de los encuestados no eligieron el orden correcto de priorización en un escenario de tres víctimas, respectivamente. Sólo 36 (20%) en el grupo 1, 22 (30%) en el grupo 2, 40 (22%) en el grupo 3 y 7 (21%) en el grupo 4 calcularon correctamente el porcentaje de pérdida de sangre en el shock hemorrágico clase III. Conclusiones: El estudio actual sugiere que Turquía todavía requiere un sistema de trauma bien organizado. Se necesitan más estudios para evaluar las capacidades del Sistema Turco de Emergencias.
Journal of Nepal Medical Association, 2022
Introduction: A medico-legal issue arises whenever an injured person visits a hospital. Therefore, all physicians who treat such patients have a legal duty to accurately document injuries as part of medical treatment. The study aimed to find out the prevalence of mechanical injury among medicolegal cases in the Department of Emergency in a tertiary care centre. Methods: A descriptive cross-sectional study was conducted among patients admitted to the Emergency Department of a tertiary centre from May 2018 to April 2020 after obtaining ethical approval from the Institutional Review Committee (Reference number: 356). Convenience sampling method was used among patients who met the eligibility criteria. All relevant data were extracted using hospital records. Point estimate and 95% Confidence Interval were calculated. Results: Out of 3486 medicolegal cases registered in the Department of Emergency, 856 (24.55%) (28.37-29.96, 95% Confidence interval) were cases of mechanical injuries. Males 616 (71.96%) outnumbered females for all types of mechanical injuries. Road Traffic Accident 527 (61.56%) was the leading cause of injury and laceration 351 (29.52%) was the most common pattern of injury. The majority 628 (73.36%) of the injuries were simple in nature. Conclusions: The prevalence of mechanical injuries among medicolegal cases was similar in comparison to other studies done in similar settings. The majority of the injuries were caused by traffic accidents, which could have been prevented if a safe system approach to road safety was followed.
Medico-Legal Journal of Sri Lanka, 2020
Introduction: Details mentioned in Bed head ticket (BHT) and investigations are taken into consideration when an opinion is made with regards to the medico legally significant trauma. Shortfalls of documents can lead to misdiagnosis or wrongful diagnosis. This study was conducted to find out the adequacy of records on BHTs and availability of investigations on patients who had been admitted following trauma with medico legal significance. Methods: A prospective descriptive study was carried out on patents who were admitted following medico-legally significant trauma during a period of one year, from Aug 2017 to Aug 2018 by perusing their records. The adequacy of the documentation was assessed according to a pre-prepared scale. Results: Analysis of on admission historical and preliminary details revealed that out of 1102 records, only 26% (n=286) had mentioned the time duration since the incident. Recorded cardiovascular stability on admission was above 86% (n=950) though level of consciousness was not mentioned by 19% (n=211). Nature of the injuries were correctly recorded by 65% (n=720) while the location of them were correctly recorded only by 29% (n=316). Surgical procedures were adequately mentioned only among 39% (n=425). Conclusions: The study revealed that there are gross inadequacies with regard to the records on BHTs made by the doctors. This can lead to limitations in addressing medico-legal issues and sometimes can result in wrong opinions leading to injustice. Need for continuous professional training with special attention to record keeping is highlighted. Further, the quality of records can be further improved with regular audits, continuous professional developmental activities and introducing a common format for documentation in admission, surgical procedures and investigations.
Trauma at a Nigerian teaching hospital: pattern and docu-mentation of presentation
African health sciences, 2006
This study is aimed at identifying the characteristics of injuries and determining the efficiency of documentation of patients' records in a tertiary hospital where there is no trauma registry. A retrospective case record analysis was conducted of injured patients seen at the Accident and Emergency unit over a 12 month period from January to December 2003. A total of 1078 records of injured patients that attended the A&E were analysed. Their mean age was 31 years (range 3 months to 85 years). Laceration (n = 408) and fractures (n = 266) representing 62.5% of injuries were seen. Injuries to the lower limb occurred in 239 patients, multiple anatomical sites 224, head 224, upper limb 203, the neck 20, and the abdomen 11 patients. Trauma was due to road traffic accident in 977 patients, fall in 39, assault in 14 while burns and firearm injuries occurred in 5 and 7 patients respectively. The mean injury severity score (ISS) was 4. Severe injuries, ISS > 15 occurred in 54 patients ...
International Journal of Pharma and Bio Sciences, 2019
Forensic medicine encompasses various subspecialties that involve resolving legal issues using diverse techniques. Medical students should be prepared for their near future career, in particular, the challenge of facing medico-legal cases with their consequent legal responsibilities. The aim of the study was to assess final year medical students' knowledge, attitude and practice of medico-legal problems. This crosssectional study included randomly selected 138 6 th year medical students at Ibn Sina National College in Jeddah. 56 (40.6%) were male and 82 (59.4%) were female, aged 24.46±1.45 years, and 114 (82.6%) were Saudis. A pre-designed, self-answered 23-item questionnaire in English was devised by a specialist in the field and circulated though Survey-Monkey forms from November 2018 to January 2019. Most students had good knowledge (66.27%) and positive attitude (71.47%). Some had poor (14.49%) or no knowledge (19.24%), negative (15.67%), or borderline attitude (14.31%). Poor responses were the legal value of incomplete reports (28.99%), notifications of relatives before police notification (15.94%) and informed consent before photographing (21.74%). Many students (44%) had negative attitude towards their current medico-legal overall education and knowledge. Only 14.5% had been previously involved in photographic documentation. Students thought that the main sources of stress/pressure during managing medico-legal problems were the victim's relatives (69.79%), followed by fear of legal consequences (54.17%). They also thought that the best educational stage for medico-legal training programs should be during undergraduate years (57.25%), or less frequently during residency (55.8%) or postgraduate years (46.38%). In conclusion, final year medical students were prepared for their future practice by good knowledge and positive attitude towards medico-legal problems. However, many gaps were detected between theory and practice. Therefore, we recommend medical colleges to initiate an undergraduate clinical forensic medicine training program. Moreover, residents and post graduate emergency physicians need to know their medico-legal responsibilities and to acquire technical skills to perform forensic evaluations of victims.
Injuries Presented at a Primary Care Setting in Oman
Oman Medical Journal, 2012
Objective: This study aims to measure the rate, types, and causes of injuries presented at a primary care setting in the Muscat governorate. Methods: A cross-sectional study was carried out where all patients who attended the Al Moabelah Health Center from the period of 1 st January 2010 to the 31 st December 2010 were identified from the electronic medical records. Patients identified with any type of injury were then selected for further data collection with their age and gender recorded. Details such as the type, cause and nature of the injury at the clinic were gathered from the clinical notes. Results: A total number of 86,554 visits were recorded for the year 2010. The rate of injury visits was 24 per 1000 visits. In this study, the rate of injury visits was found to be four times more common in males (44.4 per 1000) than in females (11.5 per 1000), p≤0.001. While children aged under 12 years accounted for 41.4%, and elderly patients aged over 60 years accounted for 3.5% of the total visits emanating from injuries. The results show that home was the most common place where the majority of injuries occurred (42%), followed by playgrounds (10.2%). The most common causes of injury visits were falls, followed by cutting/piercing by sharp objects and sports injuries, which accounted for 40%, 13.4%, and 12%, respectively. Conclusion: Injuries in a primary care setting with close proximity to emergency departments of secondary and tertiary hospitals may only account to less than 3% of the total visits.