Overcoming barriers to patient safety

Creating a culture of patient safety is a critical goal of all patient care unit staff. An analysis of the key barriers to patient safety on a typical inpatient unit in an acute care hospital (unclear unit values), the fear of punishment for errors, the lack of systematic analysis of mistakes, the complexity of the nurses' work, and inadequate teamwork are presented. Nine practices to overcome these barriers and achieve patient safety are discussed.     

Organizational characteristics and their effect on health

There is a complex relationship between work, employee health, and successful business results. At the individual level, multiple factors including physical, psychological, and social aspects of the work environment affect workers' health and well-being. At the organizational level, the consequences of unhealthy work environments may be traced to a decrease in the quality of service and products, and a loss in productivity. A brief overview of the contemporary literature on workplace stressors is presented to help identify future research directions.     

Alcohol as a risk factor for unintentional rail injury fatalities during daylight hours

Railway fatalities account for approximately 10% of transport fatalities in Cape Town. The objective of this study was to examine alcohol intoxication as a risk factor during daylight hours by conducting a case - control study to compare rail passenger and pedestrian fatalities (cases) with motor vehicle passenger and pedestrian fatalities (controls). Rail passenger and rail pedestrian fatalities were defined as cases with motor vehicle passenger and pedestrian fatalities as the respective controls. Data were collected from post-mortem reports at two mortuaries from 1994 to 1996. Blood alcohol concentration was the dependent variable. The independent variables were age, gender, date of death, day of week, time of injury and external cause of death. The late afternoon and early evening period from 1600 hours to 1900 hours had the highest frequency of fatalities for all case and control groups. Of the 56 predominately male (89%) railway passenger cases with an average age of 34.5 (SD 12.5) years, Friday (27%) was the most frequent day of death. Railway pedestrian cases (89% male, average age 36.8 years (SD 13.3)) were more likely to be killed on a Monday (11% of cases). Among the controls, motor vehicle passengers (63% male, average age 39.9 (SD 15.5)) were more likely to die on a Sunday (25%) and pedestrians (82% male, average age 41 (SD 14.7)) on a Saturday (21%). The study showed that alcohol consumption is an important risk factor for rail fatalities during daylight hours, with rail passenger fatalities being 4.71 (1.72 - 12.88) and rail pedestrian fatalities 1.62 (0.98 - 2.69) times more likely to be intoxicated than the respective controls. The results provide more evidence for public health campaigners to tackle endemic alcohol abuse and to develop diverse interventions that do not exclusively target motor vehicle drivers.     

2005年都市银幕

在阿姆斯特丹召开的新一轮会议, 展示了公共空间如何运用二极管银幕把艺术和文化结合起来。     

压光对纸张表面性能的影响

纸张压光是一道工业整饰工序,它可以提高纸张表面的平滑度,改善其光泽度和印刷适性。本文讨论了压光对微观和宏观尺度上纸张粗糙度的影响以及这种表面改性与纤维形态之间的关系。实验原料为两种不同的纤维以及它们的混合物,采用光学轮廓仪表征纸张表面的性能。实验结果表明,在所测定的尺度范围内,压光均可以改善纸张的表面性能,通过简单的比例转换后,这些变化具有相关性,这一结果也适用于由混合纤维抄造的纸张。     

社会网络与民工工资：来自中国的证据

 本文基于来自中国22个省的农户调查数据研究了利用的不同社会网络对于不同的民工在城市劳动力市场上的工资水平的影响,结果发现：并不是利用所有的社会网络都能够提高所有民工的工资水平。首先,只有利用亲友关系找到的工作才能够得到更高的工资;其次,即使亲友关系也不能提高利用它找到工作的所有民工的工资水平,而只能显著提高女性和已婚民工的工资水平。所以,在研究中忽略社会网络和民工的差异性会导致错误的研究结论。本文有助于帮助理解中国的劳动力流动及社会网络在劳动力市场中的作用。     

Evolution of the chronic care role of the registered nurse in primary care

High-quality, accessible, and efficient primary care is needed as the U.S. health care system undergoes significant change. Advancing the role of registered nurses in the primary care setting is important to the solution. A large academic health center implemented five initiatives to improve the care of chronically ill patients through the expanded role of RNs in the context of the health care team. Role evolution of nurses in the pilots required some continuing education and some additional nursing support to release the pilot nurses from their usual duties. These strategies allowed the nurses to apply interventions that enhanced the coordination of care and promoted patient self-management skills. Some short-term improvements in health status were realized and barriers to self-care were identified and resolved.