Acute stroke initiative involving an acute care team.

The Acute Care Team Educational Initiative (ACTEI) was developed as a quality improvement initiative for the recognition and initial management of time-sensitive medical conditions. For our first time-sensitive disease process, we focused on acute stroke [acute stroke initiative (ASI)]. As part of the larger ACTEI, the ASI included creating an ACT that responds to all suspected emergency department stroke patients.

Inter-observer variation in the assessment of skin ulceration.

Six observers (three physicians and three nurses) assessed 27 wounds of different types in 20 elderly patients, using five different classification systems. Using classification by colours, inter-observer agreement was moderate when six colours were used (70% agreement, group kappa 53%), and good if this was reduced to three (80% agreement, group kappa 64%). Results were only moderate using the Shea scoring system (68% agreement, group kappa 42%).

Pressure-reducing effects of heel protectors.

This study examined the pressure-reducing effects of 13 different heel-protecting devices. A group of 40 elderly patients (mean age 82 years, range 71-94) admitted to the Geriatric Department of the University Hospitals in Leuven, Belgium participated in this study. The pressures were registered by means of a sensitive computerized diagnostic system, which measured vertical forces.

Saphenous nerve entrapment at the adductor canal.

A retrospective study of 30 patients who met the clinical criteria for saphenous nerve entrapment at the adductor canal is described. Patients experienced symptoms, usually anterior knee pain, for an average of 36 +/- 7 months. Each patient received an average of 1.