ABSTRACT
We conducted a factfinding survey about the difficulties of handling the telephone consultations at a Kampo medicine outpatient clinic. We extracted the details of consultations that could not be handled by an outpatient nurse alone from the descriptive data of the telephone responses described by the nurses in the survey. We, then, identified the factors that were involved in the difficulties encountered in these consultations, and countermeasures were established and implemented. One year later, we compared and examined the status of telephone consultations between before and after the fact-finding survey. We classified the telephone consultations that were difficult for the outpatient nurses to handle alone into four categories : (1) consultation about a physical disorder, (2) questions about prescribed Kampo medicines, (3) reports and questions based on the patient's own judgment, and (4) questions about treatment and hospitalization. Some of the questions about Kampo medicines included the continued use of the medicine and drug interactions, and the main topics of the survey's nurse self-judgment reports were dose reductions and changes in Kampo medicine regimens. As a result of the introduction of guidelines prepared by the nurses together with physicians at the clinics, the outpatient nurses became able to handle telephone consultations about frequently asked questions (FAQs). At 1 year after the survey, the number of cases of difficulties in handling telephone consultations decreased to less than half the original value, and no telephone consultations were made within 1 week after the patients' first visits to the outpatient clinic.
ABSTRACT
One of the commonest complaints, for which a patient arrives in hospitals, is the presence of foreign body. It could be due to accidental ingestion or any other cause which leads to presences of a foreign body in the gastrointestinal tract. It is believed that foreign objects larger than 5–6 cm in size are unlikely to pass through the duodenum. Here, we describe a case wherein the patient accidentally swallowed a 7-cm-sized mouthguard that could not be removed by emergency upper gastrointestinal endoscopy but was subsequently removed via the anus after a period of watchful waiting