Using rapid assessment to evaluate noise on an in-patient unit.

Rapid assessment was used to evaluate a noise problem on a busy, high-traffic, high-acuity medical/surgical telemetry unit over a 4-week period. Six sources of environmental noise were identified including conversational noise, noise from doors, noise from housekeeping activities, noise from the pneumatic message tube station, hallway noise, and miscellaneous noise. Our study also demonstrates the value of rapid-assessment methodology for the evaluation of clinical problems such as noise.

Peer case review sharpens event analysis.

This manuscript describes a scholarly approach to peer case review that identifies and analyzes quality-of-care issues in response to a question about nursing care of a specific patient. The comprehensive method provides a structured format that critically examines untoward patient events, generates an awareness of gaps in care from a systems perspective, ensures action planning focused on legitimate root causes, stimulates performance improvement initiatives, and provides a forum to share learning throughout the organization.