Improving water quality in a dialysis unit using root cause analysis.

Background: Water quality levels from hemodialysis (HD) and reverse osmosis (RO) machines in dialysis units must meet standards set by the American Association of Medical Instrumentation. Researchers used a root cause analysis (RCA) approach to identify and address factors affecting water quality in the HD and portable RO machines at our institution.

Methods: A multidisciplinary team reviewed processes, interviewed staff members, and identified opportunities to improve the current sampling and machine disinfection processes.

Subtotal Nasal Reconstruction: Military-civilian Collaboration in Care of an Afghan-American Woman's Plight.

Military plastic surgeons perform reconstructive surgeries for various congenital, oncologic, and traumatic craniofacial injuries or deformities. Recently, our Walter Reed National Military Medical Center Plastic Surgery team was tasked to care for a woman who bravely sought a new and better life in the United States after she suffered amputation of her nose and bilateral ears while in her home country of Afghanistan. A military-civilian team collaborated throughout her reconstructive planning, treatment, and postoperative course to create both an aesthetically acceptable and functional subtotal nasal reconstruction.

On the scene: St Mary's Hospital, Madison, Wisconsin.

In this article, we discuss Shared Governance as the foundation of our nursing professional practice model. Through the use of case examples and reflections from our management team, we demonstrate how this accountability-based practice model promotes excellence through developing, connecting, and engaging people, clarifying and communicating goals, using data to make decisions, and even shaping our organizational response to a critical incident. We close with a look to our future as our hospital embraces whole-system shared decision making.

Analysis of candidate genes on chromosome 2 in oral cleft case-parent trios from three populations.

Isolated oral clefts, including cleft lip with/without cleft palate (CL/P) and cleft palate (CP), have a complex and heterogeneous etiology. Case-parent trios from three populations were used to study genes spanning chromosome 2, where single nucleotide polymorphic (SNP) markers were analyzed individually and as haplotypes. Case-parent trios from three populations (74 from Maryland, 64 from Singapore and 95 from Taiwan) were genotyped for 962 SNPs in 104 genes on chromosome 2, including two well-recognized candidate genes: TGFA and SATB2.

Relief of upper airway obstruction with mandibular distraction surgery: Long-term quantitative results in young children.

Objective: To evaluate the long-term benefits of mandibular distraction on sleep-related upper airway obstruction in young children with mandibular hypoplasia.

Design: Cross-sectional study. Subjects were examined for sleep-disordered breathing using medical history, physical examination results, and a written questionnaire.