ABSTRACT
PURPOSE: - The purpose of this paper is to evaluate a new Intellectual Disability (ID) screening service within a women's prison in England. DESIGN/METHODOLOGY/APPROACH: - Analysis of prisoner records was carried out to establish characteristics of women entering the prison, rates of screening completion and time intervals for all stages of the assessment pathway. FINDINGS: - In total 198 women were received into prison and underwent 202 ID screens. Nine out of ten women completed a screen, almost all on arrival or very soon afterwards. There were 23 referrals for secondary assessment but only four were completed. Most of the women identified for additional screening left the prison before this could be achieved. ORIGINALITY/VALUE: - This evaluation is the first to show that preliminary screening for ID is feasible in prison. This screening alone is useful for prisons to make the kind of reasonable adjustment required of public bodies by the Equality Act. However, its value is constrained unless resources are also dedicated to the kind of additional screening which might lead to definitive diagnosis and care planning for intellectual disability. This model of assessment would be of considerable value in establishing prisoners at risk by virtue of different levels of intellectual disability and could be used to provide more reliable and routine estimates of prevalence contributing to overall better service planning.
ABSTRACT
Postoperative nausea and vomiting (PONV) is a frequent complication of surgery. Guidelines recommend using a 5-HT3 receptor antagonist (eg, ondansetron, dolasetron, granisetron) combined with a second agent (eg, dexamethasone) for patients at moderate to high risk for PONV. Although all 5-HT3 antagonists are effective, ondansetron and granisetron have been found to be effective at substantially lower doses than those approved by the US Food and Drug Administration. Metabolism of granisetron differs from metabolism of other 5-HT, antagonists, so it is less likely to adversely interact with other medications. This article explains the clinical pharmacology of 5-HT3 antagonists and provides recommendations for nursing management of PONV.
