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...

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 ...

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 ...

Hypoxia and hypoxemia describe states of oxygen deficiency: hypoxia is deficiency in oxygenation at tissue or cellular level whilst hypoxemia is a suboptimal normal partial pressure of oxygen. Hypoxia and hypoxemia are interrelated, as untreated hypoxemia will ultimately result in hypoxia.  It should also be noted...

Mock inspections are a great way to prepare for real-life inspections from regulatory agencies such as CAP and JCAHO. But where do you start? And most importantly, what should you look for? Lou Ann Wyer, Clinical Specialist, POCT at the Virginia-based Sentara Laboratory Services and Theresa Kulik, Point-of-care...

Ever since the landmark document “To err is human” [1] was released, patient safety has been the paramount objective in US hospitals. “Patient safety” became the catch phrase and focus for all activities; a trend that was rapidly taken up by the rest of the world’s hospitals. Suddenly a new catch phrase – “lean” – ...