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Getting Access to Toxbase for Doctors in the Avon and Wiltshire Partnership

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BMJ Quality Improvement Reports

British Publishing Group

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      Abstract

      Doctors working in mental health often review patients who have taken an overdose. Having an evidence based resource which has information regarding the toxic doses of the drug taken enables informed discussions with senior doctors and decision making about whether to admit the patient to hospital. No site across the Avon and Wiltshire Partnership (AWP) Trust had access to TOXBASE, the Public Health England drug Toxicology database.A primary questionnaire (n= 39) found 97% of doctors thought that TOXBASE would be useful and 84.5% could not think of a better alternative.Through a series of Plan, Do, Study, Act cycles, TOXBASE access was gained for one site (Imber ward, Devizes) and following successful implementation this could be rolled out across all sites in the Trust. Doctors were surveyed and one month after the first site gained access, two out of seven doctors had used TOXBASE and found it useful. Further questionnaires were distributed following three months at three sites and then at six months to everyone. The final questionnaire showed that one third knew they had access and five doctors had used it in clinical context. Action was then taken by creating a TOXBASE on the Intranet site which directed doctors to their local inpatient unit for login details. By the end of the project access to TOXBASE was successfully gained at six out of the seven sites in the Trust. The surveys showed that access to the resource was highly regarded by doctors, and that it had enabled informed discussions with medical colleagues leading to reduced potentially lengthy transfers of patients to medical units. This has high cost implications of the transport of mental health patients, as well as reducing the distress caused to patients.

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      TOXBASE: poisons information on the internet.

      To assess the uptake, usage and acceptability of TOXBASE, the National Poisons Information Service internet toxicology information service. An observational study of database usage, and a questionnaire of users were undertaken involving users of TOXBASE within the UK between August 1999, when the internet site was launched, and May 2000. The main outcome measures were numbers of registered users, usage patterns on the database, responses to user satisfaction questionnaire. The number of registered users increased from 567 to 1500. There was a 68% increase in accident and emergency departments registered, a 159% increase in general practitioners, but a 324% increase in other hospital departments. Between January 2000 and the end of May there had been 60 281 accesses to the product database, the most frequent to the paracetamol entry (7291 accesses). Ecstasy was the seventh most frequent entry accessed. Altogether 165 of 330 questionnaires were returned. The majority came from accident and emergency departments, the major users of the system. Users were generally well (>95%) satisfied with ease and speed of access. A number of suggestions for improvements were put forward. TOXBASE has been extensively accessed since being placed on the internet (http://www.spib.axl.co.uk). The pattern of enquiries mirrors clinical presentation with poisoning. The system seems to be easily used. It is a model for future delivery of treatment guidelines at the point of patient care.
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        Five years of poisons information on the internet: the UK experience of TOXBASE.

         D N Bateman,  A M Good (2006)
        In 1999, the UK adopted a policy of using TOXBASE, an internet service available free to registered National Health Service (NHS) departments and professionals, as the first point of information on poisoning. This was the first use worldwide of the internet for provision of clinical advice at a national level. We report the impact on database usage and NPIS telephone call loads.
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          Author and article information

          Affiliations
          Avon and Wiltshire Partnership
          Author notes
          [Correspondence to ] Catherine Coombs c-coombs@ 123456hotmail.com
          Journal
          BMJ Qual Improv Rep
          BMJ Qual Improv Rep
          bmjqir
          bmjqir
          BMJ Quality Improvement Reports
          British Publishing Group
          2050-1315
          2015
          11 November 2015
          : 4
          : 1
          4693103
          bmjquality_uu207117.w2865
          10.1136/bmjquality.u207117.w2865
          © 2015, Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions

          This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. See: http://creativecommons.org/licenses/by-nc/2.0/ http://creativecommons.org/licenses/by-nc/2.0/legalcode

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