SSCs, Audits, Research and 4th Year Projects
The Chest department is always happy to have students attached to the unit, whether just tagging along to clinics and ward rounds, getting involved in small group teaching, or SSC blocks. We always have research projects on the go, there’s always a junior doctor needing help with an audit project, there’s usually enough going on to go around!
A simple way to get involved is simply to ask us! We respond to e-mails, comments on DC 3.0, or even come down in person. We have a reasonable capacity to take on students from each year to do SSCs, so get to us early.
Current ongoing projects that need input from students (List to be completed in due course):
Last year we polled the medical staff to determine their understanding of radiation doses associated with commonly requested radiological interventions. We presented the findings at the Scottish Thoracic Society Spring Meeting 2009, and locally at the Medical Grand Round. We have ideas of how to improve the situation, and now we need to instigate the changes and re-poll the medical floor. It’s (very nearly) an audit project, and it’s (sort of) research too. Scoring points in all directions.
We form part of a Scottish national program to collect prospective data on all patients with community acquired pneumonia. The data collected by us is our intellectual property, so we can interrogate that data as we see fit. Any individual who puts in 50 cases to the database will automatically get their name on every paper published based on that data. I currently have one student preparing to do a 4th year project based on this endeavour, but anyone else who is interested can be involved.
We form part of a Scottish national program to collect prospective data on all patients with COPD exacerbatuions. The data collected by us is our intellectual property, so we can interrogate that data as we see fit. Any individual who puts in 50 cases to the database will automatically get their name on every paper published based on that data. I currently have one student preparing to do a 4th year project based on this endeavour, but anyone else who is interested can be involved.
We are currently auditing our chest drain practice on ward 3. We have a chest drain insertion bundle, and a sticker for the notes and the audit book. This would make a lovely little project for a couple of students to do, if anyone is interested.
Also, the latest sub-analysis of the MIST2 trial showed that flushing of chest drains is vitally important in the management of complicated parapneumonic effusion and empyema. We have a local protocol for chest drain flushing, but I suspect it is not being particularly well adhered to. This would make a neat audit project for a couple of students, if anyone is interested.
We have a machine to test inspiratory flow rates, timing of plunger press, and co-ordination of the technique. We’d like to test the current staff to determine their competence, and the competence of patients. After an intervention, we can re-do the study, completing the cycle. This will definitely generate a poster at the Scottish and British Thoracic Society meetings, and possibly a paper in there too.
Acute Oxygen Administration
We have a group of 5th years who have been looking at oxygen administration on ward 3, but we will need to audit the oxygen pathway on other wards, so we’ll need more students to help out.
Long Term Oxygen Administration
We are trying to rationalise the long term oxygen delivery for patients in the community. We know there is inappropriate oxygen prescription in primary care, and as a consequence of secondary care discharges. We need students to look into the oxygen prescribing of individual practices and put into place solutions to suit each individual. This would be ideal for a 4th year project, and could generate a couple of posters, and probably a paper.
High Flow Nasal Oxygen
We are trialling high flow nasal oxygen in the high dependency areas of the hospital, and soon will be rolling it out to the wards. We need students to look at the protocol for utilising high flow nasal oxygen, and help fine tune its usage.
Sleep Apnoea and CPAP
We have over 1500 patients on CPAP machines for obstructive sleep apnoea. There are a wealth of data out there to analyse – perfect for a 4th year project.
There are at least 5 audit projects that need to be completed urgently. These could be done as 4th year projects, or as individual data gathering projects to be done in an SSC. We also have a long term project on SCLC that requires a student, or two, every year to follow up patients with SCLC.
The numbers of patients with chronic cough is increasing, certainly if our referral rate is anything to go by. I would like to look retrospectively at the cough referrals to see how many we have had, if the numbers are increasing, and what was done before referral. This should lead us to generate a pre-referral guideline for GPs, with roll out to the practices, and then a re-analysis 6 months later. We could even get the students involved with giving presentations to the GPs at the time of the roll out. - We have two students interested in this now.
I have many more elegant projects in my mind, but no space in this margin to demonstrate them….
(If you get the last reference, I’ll buy you a pint)