Maintaining lasting progress in laboratory test utilization is difficult to do without a reminder tool for providers. Since implementation of a quarterly physician report card in 2003, we have seen sustained improvement in the ordering of wellness tests in an ambulatory care network in the United States for over four...

Reprinted from AMERICAN JOURNAL OF CRITICAL CARE, November 2006, Volume 15, No 6, 595-599 Hudson TL, Dukes SF, Reilly K. Use of local anesthesia for arterial puncture. Copyright with permission from American Journal of Critical Care BACKGROUND Except for intravenous therapy, arterial access is the most common...

Part 2: Red flags The transition from fetus to newborn is a process of rapid physiological adaptation that is sometimes delayed by complications. Most newborns complete the process of transition with little or no delay.  These infants may demonstrate normal transitional findings, including tachypnea and tachycardia, ...

Part 1: The physiology of transition The transition from fetus to neonate is a critical time of physiological adaptation. While the majority of term infants complete this process in a smooth and organized fashion, some infants experience a delay in transition or exhibit symptoms of underlying disease. Careful...

This essay is a follow-up to the 2006 series expressing concern that there is a widespread gap between QC theory and QC practice. Now we are giving you, the reader, the opportunity to rate your own QC practice and to help prove or disprove that gap.  If the QC theories generally recommended by recognized QC experts ...

In most hospitals, the amount of nursing time spent on actual patient care is only 33 %, while problem solving consumes 40 % of their time. That’s the bad news. The good news is that inverting this ratio may be easier than you think.  According to Dr John Kenagy and David Sundahl of the US-based Kenagy & Associates,...

Blood gas analysis is a complex field that has a direct impact on patient care in a critical care environment. Healthcare professionals consistently emphasize high-quality results in order to properly treat patients, and recognize the need and usefulness of quality standards.  Using a path-of-workflow analysis as part ...

Century City Doctors Hospital (CCDH) is a Los Angeles, California-based acute care medical center that is one of the largest physician-owned and -operated hospitals in the United States. The 178-bed facility was designed and built to be fully digital, paperless, and state-of-the-art, with integrated information...

In the majority of U.S. healthcare institutions, patient wristbands do not contain barcodes, creating a situation where patient data is manually typed into a database or point-of-care device, leaving plenty of room for error.  In light of error statistics issued by the United Kingdom’s National Patient Safety Agency...

Where do you go for help, when you are a parent of a child who stops breathing while it sleeps? If you live in the south of Sweden, you go to Halmstad County Hospital, where a team of specialists are ready to monitor your sleeping child by polysomnography (PSG). The neonatal intensive care unit (NICU) in Halmstad has ...