Lean principles and statistical analysis have been successfully implemented to hospitals and healthcare systems. These principles among other process improvement principles aim to detect and eliminate wastes in the system and its processes. In this paper, lean and statistical analysis were applied to systematically investigate the causes of low operating room (OR) block utilization and recommen...

BACKGROUND It is well known that many healthcare systems have poor reliability; however, the size and pervasiveness of this problem and its impact has not been systematically established in the UK. The authors studied four clinical systems: clinical information in surgical outpatient clinics, prescribing for hospital inpatients, equipment in theatres, and insertion of peripheral intravenous lin...

A base-controlled synthesis of 2-substituted secondary and tertiary 1H-indole-3-carboxamides through PdCl(2)-catalyzed cyclization of o-alkynyltrifluoroacetanilides followed by isocyanide insertion has been developed. The reaction proceeds smoothly at ambient temperature using O(2) in air as the sole oxidant of the palladium catalyst.

The procedure of inserting tunnelled central venous catheters was once carried out by surgeons or radiologists at Glasgow NHS Trust. However, increased workloads meant that these health care professionals were left with less time to devote to these procedures, which resulted in unacceptable waiting times for those requiring them. After visiting several centres in England where nurses were alrea...

The strategic role of health care within the Brazilian development agenda has been increasingly recognized and institutionalized. Aside from its importance as a structural element of the Welfare State, health care plays a leading role in generating innovation. Despite this, the productive base of Brazil’s health care system is extremely fragile, jeopardizing both the universal provision of heal...

Cutaneous skin changes are common in patients undergoing treatment for cancer. However, changes in central line care, maintenance practices, and chemotherapy protocols in the early 2000s may have led to the development of a common problem of irritant contact dermatitis (ICD) at peripherally inserted central catheter (PICC) insertion sites. Repeated exposure to chlorhexidine gluconate topical an...

OBJECTIVES To identify risk factors for short-term percutaneously inserted central venous catheter-related infections in children and to evaluate the accuracy of a mortality score in predicting the risk of infection. METHOD After reviewing the charts of patients who developed catheter-related infection in a university hospital's pediatric intensive care unit, we conducted a case-controlled st...

BACKGROUND The i-gel has a gel-like cuff composed of thermoplastic elastomer that does not require cuff inflation. As the elimination of cuff inflation may shorten insertion time, the i-gel might be a useful tool in emergency situations requiring prompt airway care. This systematic review and meta-analysis of previous adult manikin studies for inexperienced personnel was performed to compare th...

A central venous catheter (CVC) is an important medical tool used in critical care and emergent situations. Integral to proper care in many circumstances, insertion of a CVC introduces the risk of central line-associated blood stream infections and mechanical adverse events; proper training is important for safe CVC insertion. Cognitive task analysis (CTA) methods have been successfully impleme...

Background. Direct percutaneous endoscopic jejunostomy (DPEJ) insertion is a useful technique for artificial nutritional support in selected patients. However, it is technically difficult and most case series report significant procedural failure rates. Methods. We reviewed our case series of DPEJ insertions, done in a tertiary care referral centre from 2002 to 2008. Patients were selected for ...