ABSTRACT
AIMS: The aim of this study was to review current legislation and guidance on information governance and to audit clinicians' management of confidential patient information and knowledge of published guidelines in a teaching hospital. MATERIALS AND METHODS: A questionnaire was developed based on published Department of Health, General Dental Council and National Health Service guidance. This was then piloted and distributed to clinicians to complete. RESULTS: A review of the current guidance revealed many confusing and unclear areas. However, clinicians' knowledge of information governance was generally good, with an overall correct response rate of 73%. CONCLUSIONS: All clinicians have an ethical and legal obligation to protect confidential patient data and to be aware of their responsibilities. Local guidelines need to be clarified to help clinicians to manage patient data effectively.
Subject(s)
Clinical Governance/legislation & jurisprudence , Confidentiality/legislation & jurisprudence , Information Management/legislation & jurisprudence , Practice Patterns, Dentists' , Computer Security , Guidelines as Topic , Health Knowledge, Attitudes, Practice , Humans , State Dentistry , Surveys and Questionnaires , United KingdomABSTRACT
We present a case of a malnourished 68-year old man with occult hypothyroidism who presented with malaise, pyrexia, tongue swelling, oral ulceration and dysphagia after a 6-month period of increasing lethargy and failing self-care. Severe necrotic oral ulcerative lesions were accompanied by cutaneous purpura, blood-filled blisters and bedsores. It was concluded that the patient's clinical condition reflected necrotizing stomatitis on a background of malnutrition with scorbutic skin lesions and hypothyroidism. The patient made a good recovery with scrupulous oral hygiene, debridement, intravenous metronidazole and nutritional support. Healing occurred with marked fibrosis and trismus, which has slowly improved with mouth-opening exercises. Necrotizing stomatitis is more commonly encountered in malnourished children in developing countries, and may subsequently result in devastating facial defects and death. Patients in the developed world with poor oral hygiene, malnourishment and immunosuppression are also at risk, but early diagnosis and treatment is life-saving and reduces subsequent disability.
