0 mmol/L within 7 days of a high level has also significantly increased (p < 0.0001). Further research into the long term toxic effects of
high lithium levels specifically the duration of the high level and the magnitude is on-going. These results do however suggest that an actively managed database for lithium aids more effective monitoring of lithium and by improving the response times to high levels reduces patient exposure to the potentially toxic effects of lithium levels >1.0 mmol/L. A major limitation of this research is that other external factors impacting on the re-test rates and times to next level <1.0 mmol/L could not be controlled. The reasons for the high levels and the actions taken by the clinical team are not known from the information on the database. 1. NICE. National Institute for Clinical Excellence. Bipolar disorder: The management AP24534 of bipolar disorder in adults, children and adolescents, in primary and secondary care. Clinical Guideline 38 2006. 2006. Sally Jacobs, Karen Hassell, Sheena Johnson University of Manchester, Manchester,
UK This review identified and synthesised existing evidence for the effectiveness of organisational interventions designed to prevent or manage workplace stress. A range of interventions was identified demonstrating benefits for both employees and organisations and a model derived of BIBW2992 datasheet best practice. These findings constitute a good starting point for community pharmacies seeking to develop effective organisational
solutions to workplace stress. Workplace stress is a current concern amongst community pharmacists.1 The response of community pharmacies to perceived increases in workplace pressures could be instrumental in ensuring that they do not adversely affect pharmacists’ wellbeing or lead to an increase in dispensing errors. Yet no evidence exists of cost-effective solutions to workplace stress in community pharmacy settings. As part of a scoping study, a review of the wider organisational literature was conducted to identify effective organisational clonidine interventions for preventing or managing workplace stress. This review did not require ethical approval. A secondary synthesis of existing reviews (1995–2010) from peer-reviewed and professional sources was conducted. Reviews were identified through existing knowledge and keyword searching of the internet and electronic databases (OVID: Medline, Cinahl, HMIC; CSA: social science databases, ABI Inform). Search terms included those relating to work stress, intervention studies, and review papers. Inclusion/exclusion criteria limited the scope of the review and guided the identification and selection of papers. Crucially, only reviews of interventions including an organisational element (i.e.