1. NICE in my practice Dr Matthew Snowsill Foundation Year Clinical Practice Student Champion 2011-12

2. One of many sources of information  NICE has its place in the big world of evidence based medicine  Is not a one size fits all approach to any problem  Is not a substitute for clinical judgement in the context of the individual  But, it’s trustworthy, reviewed by experts and lay experts, and becoming easier and easier to access

3. My day to day role  Documenting the ward round assessment and management decisions  Speaking with families  Facilitating discharges  Only a small amount of time is making management decisions

4. Main areas NICE has been an influence  Quality and safety improvement  My own learning  My own information  The learning of others  Patient safety

5. Responsibilities of all health care professionals 1. The UK Foundation Programme Curriculum 2012 (Updated 2014) 2. Standards of Conduct, Ethics and Performance; General Pharmaceutical Council 2012 3. The Code: Standards of conduct, performance and ethics for nurses and midwives; Nursing and Midwifery Council 2008 4. Standards for the Dental Team; General Dental Council 2013 5. Code of Ethics and Professional Conduct; College of Occupational Therapists, Revised edition 2010

6. A patient has something you’ve never heard of… 1. Many good quality online medical encyclopaedias/ data sources around 2. Some more reliable that others 3. Some more relevant to the NHS and UK medical practice than others 4. One of the first ones I use for quick answers is Clinical Knowledge Summaries 1. Includes brief overview 2. Correlation with drug history

7. Clinical knowledge summaries

9. So you’re on acute medical take… Your job: 1. Find a patient that the med reg has accepted from the ED (not too tricky) 2. Clerk a patient (just like medical school) 3. Establish a management plan….

11. What to do?  They’re stable, you have some time to think about it  You aren’t 100% confident on what you should write on the plan  Your consultant will call you soon to review the patient

12. NICE Pathways http://beta.pathways.nice.org.uk/?utm_source=nicesite&utm_medium=banner&utm_campaign=nicebanner#

13. Elderly male, confused, not eating or drinking http://beta.pathways.nice.org.uk/pathways/acute-kidney-injury#path=view%3A/pathways/acute-kidney-injury/management-of- acute-kidney-injury.xml&content=view-node%3Anodes-indications-for-renal-replacement-therapy

14. Quality and safety improvement- Audit  Can be scary  Mandatory  Make your mark on your hospital  Where do I start?? http://i1.kym-cdn.com/photos/images/original/000/234/765/b7e.jpg

15. NICE Audit tools – AKI

17. Ward cover night shift….  Asked to come and review patient who has been struggling to sleep for a couple of days  After appropriate clinical assessment you decide they would benefit from zopiclone. http://i.dailymail.co.uk/i/pix/2011/09/21/article-2040037-0E04BC2A00000578-667_634x324.jpg

18. Safe prescribing

19. The night time classic…  “Doctor, one of our patients has had a fall. We’ve started neuro-obs but would you please come and review him?”  85  Admitted for UTI  Atrial fibrillation for which he has warfarin  Seems OK… To scan or not to scan

20. Best practice in your pocket

21. Summary  Just a taste, much more to come from the workshops today  Becomes easier and quicker the more you use it and look for what is available  Huge number of resources available  Evidence based medicine needs to be accessible, reliable and safe  Diverse range of features which NICE offer for various aspects of initial training  Also- Post graduate membership exams, teaching students, preparing for this talk

22. Invitation for questions