The Role of High Reliability Organization Foundational Practices in Building a Culture of Safety.

Background: High reliability organizations are designed to operate under complex conditions for extended periods by strengthening systems that help serious adverse events for patients. The US Department of Veterans Affairs formally began its enterprise-wide journey to high reliability in 2019. Four foundational practices were identified to advance a culture of safety across all Veterans Health Administration facilities.

Proficiency of nerve conduction using standard methods and reference values (Cl. NPhys Trial 4).

Introduction: The Cl. NPhys Trial 3 showed that attributes of nerve conduction (NC) were without significant intraobserver differences, although there were significant interobserver differences.

Methods: Trial 4 tested whether use of written instructions and pretrial agreement on techniques and use of standard reference values, diagnostic percentile values, or broader categorization of abnormality could reduce significant interobserver disagreement and improve agreement among clinical neurophysiologists.

A trial of proficiency of nerve conduction: greater standardization still needed.

Introduction: The aim of this study was to test the proficiency (accuracy among evaluators) of measured attributes of nerve conduction (NC).

Methods: Expert clinical neurophysiologists, without instruction or consensus development, from 4 different medical centers, independently assessed 8 attributes of NC in 24 patients with diabetes mellitus (DM) on consecutive days.

Results: No significant intraobserver differences between days 1 and 2 were found, but significant interobserver differences were seen.

Use of a sacral silicone border foam dressing as one component of a pressure ulcer prevention program in an intensive care unit setting.

In 2008, patients in the intensive care unit (ICU) at Danbury Hospital, Danbury, Connecticut, experienced 79 pressure ulcers. As a result, pressure ulcer-prevention interventions were standardized in critical care and medical-surgical units and education was provided to all direct patient care staff about principles of skin care and prevention. Following these efforts, 53 ICU patients developed pressure ulcers in the sacral area in fiscal year 2009, representing a 12.

Adult-derived stem cells and their potential for use in tissue repair and molecular medicine.

This report reviews three categories of precursor cells present within adults. The first category of precursor cell, the epiblast-like stem cell, has the potential of forming cells from all three embryonic germ layer lineages, e.g.

Risk factors for Burkholderia cepacia complex colonization and infection among patients with cystic fibrosis.

Objectives: To determine risk factors for acquiring Burkholderia cepacia complex among patients with cystic fibrosis (CF).

Study Design: A case-control study was conducted with active surveillance for B cepacia complex colonization/infection among patients at 21 CF centers from April 1986 to March 1989 (study period). A case-patient was defined as any CF patient with B cepacia complex colonization for the first time during the study period.