Is quality control useful? An audit of the saving measures regarding prescriptions at National District Hospital in Bloemfontein

Background This is a follow-up study to evaluate and improve quality health care for the majority of the population in Bloemfontein. The aim of this study was to evaluate the changes implemented to address the cost of prescribing drugs at National District Hospital, Bloemfontein as described in a previous study. Methods The 20 most expensive or inappropriate prescribed drugs were identified from the results of the first study. These drugs were grouped together in order to address the problems systematically, e.g. revising and updating the current treatment protocols for chronic conditions and using cheaper alternatives. Three months after the implementation of the new measures, the affected drugs were re-evaluated over an eight-week period. Results A total of 28 drugs (the 20 drugs + eight drugs on which they may have a direct influence) was evaluated over an eight-week period. The introduction of the treatment protocols not only saved a large amount of money, but also made prescribers aware of the correct dosages of the drugs. A saving of R215 395 in the dispensing of medicine in eight weeks was demonstrated. A massive calculated saving of R1.4 million could be achieved over a one-year period at NDH with adherence to the saving measures. Conclusion Drug costs can be substantially reduced through review of drug use and introduction of protocols and guidelines.Keywords:Quality control; prescriptions; treatment protocols; quality treatment For full text, click here:SA Fam Pract 2005;47(9):60-6

Local anaesthetic toxicity

Local anaesthetic toxicity has been known since the introduction of local anaesthetic drugs into anaesthetic practice more than a hundred years ago. The aim of this review is to follow the history of the search for less toxic local anaesthetic drugs, to highlight molecular mechanisms thought to contribute to the clinical phenomenon of toxicity, and to finally discuss novel treatment strategies

Herbal and alternative medicine: the impact on anesthesia

The use of herbal and alternative therapies is increasing all over the developed as well as the developing world. As pharmacological data on drug interactions involving herbal therapies becomes available, it is important to be familiar with the challenges that concomitant use of these medications may present within the  peri-operative period. This review aims to shed light on the more commonly used herbal drugs, and to discuss drug interactions and complications that may be expected in their use.Keywords: anaesthesia, drug interactions, herbal medicin

How to keep the potjie boiling : a sociolinguistic study of intercultural communication in a Cape Town workplace

Bibliography: pages [184]-191.The aim of this study was to investigate intercultural communication in a South African business setting. After initial observations at various companies, a Cape Town construction firm was chosen as the subject of study. It was hypothesised that the communication at the firm was successful. Successful communication includes various aspects: messages are communicated effectively and accurately, members of the company are made to feel secure, valued and motivated and there is no sense of discrimination or disrespect. Data was gathered (a) at meetings of the labour committee which represents the workers and (b) at site visits. All recordings but one were made using a tape-recorder with a large microphone designed for group recordings. The final meeting was video-recorded so that communicative cues such as eye gaze, facial expressions and gestures could be analysed. Data gathered was in English, Afrikaans and Xhosa with regular code-switching and mixing. English was the language used most frequently in meetings and communication in English was the main focus of this research. Interesting uses and common functions of Xhosa and Afrikaans are also discussed. Additional information about the company studied was obtained from interviews, company documents and Webber's (1997) MBA thesis which looks closely at the company's partcipative processes. Data was analysed in keeping with the concerns and methods of interactional sociolinguistics, a field which focuses on interaction between individuals. Brown & Levinson (1987) and Scollon & Scollon' s (1995) models of politeness and face theory and Myers-Scotton's social functions of code-switching were also particularly useful. Other theories which were of value were Fairclough's (1989) notions of language and power and Giles (1975. 1981) and his colleagues in social psychology's speech accommodation theon A background to business terms and concepts is provided for readers from other disciplines. Organisational structures, management styles and corporate culture, including the philosophy of Ubuntu (community spirit) are discussed. These terms and concepts are used to evaluate the success of the company and the role played by communication in this success

Identifying the role of pre-hospital intercostal chest drains in South Africa

Includes abstract. Includes bibliographical references

New morphological information of the parasitic copepod Kroyeria dispar Wilson, 1935 (Copepoda: Kroyeriidae) from the east coast of South Africa

Features of laxonomic importance of Kroyeria dispar Wilson, 1935 are described from females collected from the gills of tiger shares (Gsleocerdo cuvier) captured in the southern Indian Ocean This is a first record of K dispar from South Africa and additional morphological information is given Observations were made wtth the aid of scanning electron microscopy (SEM)

Non-Geographic Variation in Aethomys chrysophilus (De Winton, 1897) and A. namaquensis (A. Smith, 1834) (Rodentia: Muridae) from Southern Africa

Prior to a systematic revision of African rock rats (genus AethomysThomas) in southern Africa, the nature and extent of non-geographic variation due to sex and age in two samples each of A. chrysophilus (De Winton, 1897) and A. namaquensis (A. Smith, 1834) were examined using both univariate and multivariate statistical procedures. Results of Model I two-way analysis of variance, % sum of squares and a series ol multivariate procedures were congruent and showed a lack ol sexual dimorphism in all samples examined, but marked variation between seven age categories based on the degree ol tooth wear on the maxillary tooth row. When univariate and multivariate results were considered together, pooling of sexes as well as individuals of tooth-wear classes IV, V and VI for subsequent recording and analysis was justified. Very few tooth-wear class VII individuals were available and their exclusion was largely arbitrary. Few measurements showed sexage interaction. The largest per cent contribution to the total variance was due to error. In general, variance partitioning indicated that if comparisons are to be made, caution needs to be exercised on the type of characters, number of factor levels and methodology used

Language awareness and communication as part of teacher education at the University of Pretoria, South Africa

Teacher language proficiency is central to learner success – where a teacher is not proficient in the medium of instruction the likelihood of a learner experiencing success is minimal. Within the South African context the majority of teachers (and learners) are not home language speakers of English and thus ensuring teacher proficiency to teach through the medium of instruction is vital. Success in the classroom depends on the teacher’s discourse and interactive skills, and requires effective communication skills and a high level of language proficiency. Teachers need to be aware of the importance of language in their classrooms, regardless of which subject or learning area they teach. To address the issue of teacher language proficiency, the University of Pretoria requires all students in the BEd programme to complete a one year module dealing with teacher language awareness. This module, entitled “Language across the Curriculum’ (JTK 200), is for some students teachers the only exposure to teacher English language awareness. It is, indeed, questionable if a single year module can address the entire scope of teacher language awareness. This article focuses on the issues surrounding teacher English language proficiency and the design of the theoretical aspects demonstrated through community engagement projects as constituted in the current JTK 200 module. This article addresses issues of course design and development with regards to teacher language proficiency, what has been learned thus far and how this will be incorporated into future offerings of the course.Keywords: teacher training, language across the curriculum, medium of instruction, community engagement, teacher language proficiency, course design

Paediatric organophosphate poisoning - a rural hospital experience

Objectives. To document the presentation and course of organophosphate poisoning (OPP) in children  and to record the frequency of atropine toxicity during treatment.Design. A retrospective observational study was conducted of all recorded paediatric cases of OPP  admitted to a regional hospital over a 5-year period from 1 June 1996 to 31 May 2001.Setting. The study was conducted at Eben Donges Hospital, a regional hospital in the Boland/Overberg area of the Western Cape, where pesticide-intensive fruit farming remains the largest revenue generator.Subjects. The study included all children aged 12 years or less (as per health services classification) with confirmed OPP.Results. There were 23 patients. Most of the cases came from the De Dooms area (35%), with poisoning by ingestion accounting for 61% of cases. A distinct seasonal predominance was found that coincided with the summer harvest. Mode of presentation was variable and was not related to the initial  pseudocholinesterase level. Evidence of atropine toxicity occurred in 8 of the 18 cases treated with atropine. No statistically significant risk factor was found for atropine toxicity. The average duration of hospitalisation was 5,05 days, with 2 children requiring transfer to tertiary .facilities.Conclusions. The high number of referrals from a specific geographical area, combined with a 61%  accidental ingestion rate, illustrates an area where legislation has failed to limit unnecessary exposure. Awareness of the seasonal predominance could prove pivotal to the success of future preventive strategies. Initial presentation and serum pseudocholinesterase levels did not correlate with duration ofstay. The decision to transfer to a tertiary facility should only be explored once the patient has been stabilised with atropine. Atropine treatment is effective but carries a risk of toxicity. Glycopyrrolate may constitute an alternative treatment option

Editorial: Triage is easy, said no triage nurse ever

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