ࡱ> HG \p Nick Foster Ba==<[,#8X@"1+Arial1+Arial1+Arial1+Arial1+Arial1+Arial1 +Arial1 +Arial1+Arial1 +Arial1 +Arial""#,##0;\-""#,##0""#,##0;[Red]\-""#,##0""#,##0.00;\-""#,##0.00#""#,##0.00;[Red]\-""#,##0.005*0_-""* #,##0_-;\-""* #,##0_-;_-""* "-"_-;_-@_-,)'_-* #,##0_-;\-* #,##0_-;_-* "-"_-;_-@_-=,8_-""* #,##0.00_-;\-""* #,##0.00_-;_-""* "-"??_-;_-@_-4+/_-* #,##0.00_-;\-* #,##0.00_-;_-* "-"??_-;_-@_-"Yes";"Yes";"No""True";"True";"False""On";"On";"Off"],[$ -2]\ #,##0.00_);[Red]\([$ -2]\ #,##0.00\)                + ) , *                            x   `$Sheet1BkSheet2YlSheet3,"(}How useful was the session?/As a result of this session I now feel able to& -The least useful aspects of the session were& If yes, please give suggestionsYesNo*Session 2:- Rowan Harwood - "Polypharmacy" )/Session 3:- Dr Ben Lobo - "Mental Capacity Act" .PWould you be interested in further training around "Mental Capacity Act" issues?3H9Session 4:- Joint - "Frailty Management in Primary Care"_Would you be interested in further training around "Frailty Management in Primary Care" issues?2XHWould you be interested in further training around "Polpharmacy" issues?34 ?@DWould you be interested in further training around "Frailty" issues?34 ;=EGood session-would have liked more time to discuss the examples givenManipulate + stop drugsCase examples in small groups@Assess the advanced directive and consider this with the patientSmall group, patient examples-Think about CGA and how we can implement thisBetter idea re: CGABetter assess medicationFuture sessionsComplex Slides-Simplify%Assess 'older' people for their needsToo long - too much information,Adopt frailty approach to assessing patients>Feel confident stopping medications if patient has S\E + 5 x s2Be able to decide how best to apply these services5Need to think more about frail people and their needs;It would be very helpful if this can be funded by the PCT's$Overview frailty and think about CGA$Consider a further medication review(Not heard of this before - good handouts(MDT-Management fall etc. of older peopleCommon 'bad ' drugsConsider ADRT for patients Assessment of aspects of frailty>Confidence to approach polypharmacy with medical prescriptionsTackle issues of MCA & ADRT Examples were realistic and goodMore clinical scenarios pleasePhilosophical discussionAssess the medication of people3Reconsider the effectiveness of the same medication9Would have been more useful you have examples in practicetTo understand ADRT and being able to discuss these with patients. Good to see how website works and self assessment<In future when a GP- make better care pathways for the frail)Session 1:- Professor Gladman - "Frailty" Better assess an elderly + frail patient and remember to involve a variety of healthcare professionals. I feel I could be more confident managing issues in a primary care setting.XMake decisions regarding prescribing for chronic diseases - looking at person as a wholeKThe impression that we don't review medication. It is done at least yearlyRecognise culprit drugs'More clinical scenarios & more examplesDidactic lecture#Organisational rather than clinical-It gave us a good introduction to the conceptCI would have liked more practical ideas about what comprises of COA Lots of text?Start learning and understanding practically what to do re ADRTFThink about how I am going to aspire and operate when I am independent[Group discussions-it wasn't clear exactly what we were supposed to be doing with the cases.Identify patients who are frailhMore specific information about 'Genetic Giants' management & investigation would have been more usefulQConsider stopping medications + think carefully about rational behind medications)Didn't tell me much I didn't know already"Where to get more information fromNDiscussions-we weren t sure exactly what we were supposed to be talking about3Think about new ways of organising care for elderlyMake a problem list'Take extra care while they are reviewedWebsite4Do appropriate medication review-but time permitting<Going through ADRT website which we can go through ourselves4I know living will / advance directives are obsoletetConsider the importance of making a diagnosis following comprehensive assessment so that best treatment can be given7Review a patient's medication and rationalise treatmentIdentify frail PH More clinical scenarios/problems=Think about ethics of stopping treatment if end of life comes-Problem solving aspects re medication reviews>Too short-would have liked to talk about some subjects further2Better understanding of ADRT and practical aspectsbEspecially re case plane e.g. bournewood group and practical aspects e.g. best interest assessment9Frailty assessment and identification of the frail personGeneral introduction RationaliseSpecific examples"More specific examples-when to use!Understand the concept of frailty;Understand and assess and address the issue of polypharmacy*Appreciate the complexity of the geriatricDo more medication reviews#Consider identifying frail patients More cases-Review medications in a more effective mannerCasesCDiscuss living wills/ADRTs, Access website for further information With examplesObjectives weren't clearZAttempt to do more thorough medication reviews which will improve with practice/experienceTalk to patients about ADRTs and give them some guidance - although there are many areas where I will need to liaise with someone who is more familiar with the process/How to get/be aware of services in your GP areaoNot enough on how to tackle polypharmacy-how to do this in general practice consultations and the time it takes.Examples good, video very good - lent didacticnUnderstand more about ADRT and how they are made. Help a patient who wishes to complete on Advanced directiveThink about and talk about ADRT3Quite vague, but a good introduction to the concepteNot enough time to address relevant issues. Difficulty of access to services available not addressedJThink about how and where community geriatric assessment should take placeNRealise that there is a gap in terms of frailty provision and this will hinder`I thought that this was an excellent session and understand the importance of medication reviews#Could look at cases in small groupsPImportant topic but quite abstract. Would have been good to be more interactive+Know where to access resources e.g. website-Locality teaching group-real life discussionsCould have been more specific?Able to access resources for further learning e.g. websites-BGSBMight have been good to discuss services available e.g. falls etc.Not very practical8Most useful part was to look at website or DVD once home-Group Discussion i.e. no provision of answersdI feel a group answer of Q & A session would be better relating to issues around care of the elderlyPAlways more time for practical examples and evidence base - perhaps to take awayOAlways more time for practical examples and evidence based to perhaps take away Not long enough to discuss cases j   Jhy5S B` a &Kib!%"cc  (;CKSw[+cme  dMbP?_*+%63&C&"Arial,Bold"&11Nottingham VTS Website Assessment&Q?'vn?((\?)ffffff?M\\nchprint01\VTS_C01C 4dXXA4DINU"4+,IUPHdA4 [none] [none]Arial6P d?JSCOTT7<Automatic>Type new Quick Set name herei j.k k m m EXCEL.EXE" dXXffffff? `?U} I } } } I} m6        @                  , , , , , , , , / $$$$$$$$$ #########*?@@@ @@ $$$*?@?3@?@  ''''''''' ######### """"""""" !5!!!!!!!! !< !!!!!!!! !| !!!!!!!! !!!!!!!!! # ######## "  """""""" "0""""""& !!!!!!!!! !!!!!!!!! !!!!!!!!! !!!!!!!!! !1!!!!!!!! !!!!!!!!! !'!!!!!!!! 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