scholarly journals Specialist pneumonia intervention nurse service improves pneumonia care and outcome

2021 ◽  
Vol 8 (1) ◽  
pp. e000863
Author(s):  
Robert C Free ◽  
Matthew Richardson ◽  
Camilla Pillay ◽  
Kayleigh Hawkes ◽  
Julie Skeemer ◽  
...  
Keyword(s):  
Quality Improvement ◽  
National Health Service ◽  
Low Cost ◽  
Community Acquired Pneumonia ◽  
National Audit ◽  
Mortality Benefit ◽  
Model Of Care ◽  
Spin Period ◽  
National Health Service Trust ◽  
Set Up

BackgroundA specialist pneumonia intervention nursing (SPIN) service was set up across a single National Health Service Trust in an effort to improve clinical outcomes. A quality improvement evaluation was performed to assess the outcomes associated with implementing the service before (2011–2013) and after (2014–2016) service implementation.ResultsThe SPIN service reviewed 38% of community-acquired pneumonia (CAP) admissions in 2014–2016. 82% of these admissions received antibiotic treatment in <4 hours (68.5% in the national audit). Compared with the pre-SPIN period, there was a significant reduction in both 30-day (OR=0.77 (0.70–0.85), p<0.0001) and in-hospital (OR=0.66 (0.60–0.73), p<0.0001) mortality after service implementation, with a review by the service showing the largest independent 30-day mortality benefit (HR=0.60 (0.53–0.67), p<0.0001). There was no change in length of stay (median 6 days).ConclusionImplementation of a SPIN service improved adherence to BTS guidelines and achieved significant reductions in CAP-associated mortality. This enhanced model of care is low cost, highly effective and readily adoptable in secondary care.

scholarly journals Training in quality improvement for the next generation of psychiatrists

2017 ◽  
Vol 41 (1) ◽  
pp. 45-50 ◽  
Author(s):  
Elizabeth Ewins ◽  
Rob Macpherson ◽  
Geoff van der Linden ◽  
Stephen Arnott
Keyword(s):  
Quality Improvement ◽  
General Practitioner ◽  
National Health Service ◽  
Pilot Project ◽  
First Year ◽  
Psychiatry Training ◽  
Leadership And Management ◽  
The Core ◽  
National Health Service Trust ◽  
Management Experience

SummaryQuality improvement (QI) projects have been shown to positively influence patient care. They provide opportunities for trainees to present and publish their work locally and nationally, and to gain valuable leadership and management experience. We describe a pilot project to engage in QI trainees across a National Health Service trust and a school of psychiatry. After the first year of this programme over half of psychiatry trainees in the school (58% of core trainees and 47% of advanced trainees) are participating in 28 individual QI projects and QI project methodology is to become embedded in the core psychiatry training course. Specialty doctors, consultants, foundation doctors, general practitioner trainees, medical students and the wider multidisciplinary team have all become engaged alongside trainees, working with patients and their families to identify problems to tackle and ideas to test.

Development of a Capacitor Probe to Detect Subsurface Deterioration in Concrete

1997 ◽  
Vol 503 ◽  
Author(s):  
B. K. Diefenderfer ◽  
I. L. Al-Qadi ◽  
J. J. Yoho ◽  
S. M. Riad ◽  
A. Loulizi
Keyword(s):  
Dielectric Constant ◽  
Portland Cement ◽  
Electromagnetic Waves ◽  
Low Cost ◽  
Complex Dielectric Constant ◽  
Life Cycle Costs ◽  
Parallel Plates ◽  
Portland Cement Concrete ◽  
Cement Concrete ◽  
Set Up

ABSTRACTPortland cement concrete (PCC) structures deteriorate with age and need to be maintained or replaced. Early detection of deterioration in PCC (e.g., alkali-silica reaction, freeze/thaw damage, or chloride presence) can lead to significant reductions in maintenance costs. However, it is often too late to perform low-cost preventative maintenance by the time deterioration becomes evident. By developing techniques that would enable civil engineers to evaluate PCC structures and detect deterioration at early stages (without causing further damage), optimization of life-cycle costs of the constructed facility and minimization of disturbance to the facility users can be achieved.Nondestructive evaluation (NDE) methods are potentially one of the most useful techniques ever developed for assessing constructed facilities. They are noninvasive and can be performed rapidly. Portland cement concrete can be nondestructively evaluated by electrically characterizing its complex dielectric constant. The real part of the dielectric constant depicts the velocity of electromagnetic waves in PCC. The imaginary part, termed the “loss factor,” describes the conductivity of PCC and the attenuation of electromagnetic waves.Dielectric properties of PCC have been investigated in a laboratory setting using a parallel plate capacitor operating in the frequency range of 0.1 to 40.1MIHz. This capacitor set-up consists of two horizontal-parallel plates with an adjustable separation for insertion of a dielectric specimen (PCC). While useful in research, this approach is not practical for field implementation. A new capacitor probe has been developed which consists of two plates, located within the same horizontal plane, for placement upon the specimen to be tested. Preliminary results show that this technique is feasible and results are promising; further testing and evaluation is currently underway.

Fault Localization of Power-Ground Short via Signal Injection and Oscilloscope Technique

2010 ◽  
Author(s):  
Binh Nguyen
Keyword(s):  
Low Cost ◽  
Short Circuit ◽  
Fault Localization ◽  
Fault Isolation ◽  
Test Apparatus ◽  
Good Working ◽  
Signal Injection ◽  
Set Up ◽  
Non Destructive ◽  
Short Circuit Condition

Abstract For those attempting fault isolation on computer motherboard power-ground short issues, the optimal technique should utilize existing test equipment available in the debug facility, requiring no specialty equipment as well as needing a minimum of training to use effectively. The test apparatus should be both easy to set up and easy to use. This article describes the signal injection and oscilloscope technique which meets the above requirements. The signal injection and oscilloscope technique is based on the application of Ohm's law in a short-circuit condition. Two experiments were conducted to prove the effectiveness of these techniques. Both experiments simulate a short-circuit condition on the VCC3 power rail of a good working PC motherboard and then apply the signal injection and oscilloscope technique to localize the short. The technique described is a simple, low cost and non-destructive method that helps to find the location of the power-ground short quickly and effectively.

Optimum Design for the Frame of Open Type Abrasive Flow Polish Machine

2012 ◽  
Vol 497 ◽  
pp. 89-93
Author(s):  
Liang Liang Yuan ◽  
Ke Hua Zhang ◽  
Li Min
Keyword(s):  
Finite Element ◽  
Natural Frequency ◽  
Finite Element Methods ◽  
Optimization Design ◽  
Low Cost ◽  
Three Dimensional ◽  
Force Model ◽  
Optimization Analysis ◽  
Open Type ◽  
Set Up

In order to process heterotype hole of workpiece precisely, an open abrasive flow polish machine is designed, and the optimization design of machine frame is done for low cost. Firstly, basing on the parameters designed with traditional ways, three-dimensional force model is set up with the soft of SolidWorks. Secondly, the statics and modal analysis for machine body have been done in Finite element methods (FEM), and then the optimization analysis of machine frame has been done. At last, the model of rebuild machine frame has been built. Result shows that the deformation angle value of machine frame increased from 0.72′ to 1.001′, the natural frequency of the machine decreased from 75.549 Hz to 62.262 Hz, the weight of machine decreased by 74.178 Kg after optimization. It meets the strength, stiffness and angel stiffness requirement of machine, reduces the weight and cost of machine.

scholarly journals Innovative passive reinforcements for the gradual stabilization of a landslide according with the observational method

Landslides ◽  
2021 ◽  
Author(s):  
Lorenzo Brezzi ◽  
Alberto Bisson ◽  
Davide Pasa ◽  
Simonetta Cola
Keyword(s):  
Monitoring System ◽  
Low Cost ◽  
Economic Losses ◽  
Fe Model ◽  
Site Conditions ◽  
Observational Method ◽  
Rainy Period ◽  
Sustainable Solutions ◽  
Before And After ◽  
Set Up

AbstractA large number of landslides occur in North-Eastern Italy during every rainy period due to the particular hydrogeological conditions of this area. Even if there are no casualties, the economic losses are often significant, and municipalities frequently do not have sufficient financial resources to repair the damage and stabilize all the unstable slopes. In this regard, the research for more economically sustainable solutions is a crucial challenge. Floating composite anchors are an innovative and low-cost technique set up for slope stabilization: it consists in the use of passive sub-horizontal reinforcements, obtained by coupling a traditional self-drilling bar with some tendons cemented inside it. This work concerns the application of this technique according to the observational method described within the Italian and European technical codes and mainly recommended for the design of geotechnical works, especially when performed in highly uncertain site conditions. The observational method prescribes designing an intervention and, at the same time, using a monitoring system in order to correct and adapt the project during realization of the works on the basis of new data acquired while on site. The case study is the landslide of Cischele, a medium landslide which occurred in 2010 after an exceptional heavy rainy period. In 2015, some floating composite anchors were installed to slow down the movement, even if, due to a limited budget, they were not enough to ensure the complete stabilization of the slope. Thanks to a monitoring system installed in the meantime, it is now possible to have a comparison between the site conditions before and after the intervention. This allows the evaluation of benefits achieved with the reinforcements and, at the same time, the assessment of additional improvements. Two stabilization scenarios are studied through an FE model: the first includes the stabilization system built in 2015, while the second evaluates a new solution proposed to further increase the slope stability.

scholarly journals Applying quality improvement principles to improve accident and emergency department overcrowding and flow in Rwanda: a case study

2015 ◽  
Vol 4 (5) ◽  
pp. 47 ◽  
Author(s):  
Jean Claude Byiringiro ◽  
Rex Wong ◽  
Caroline Davis ◽  
Jeffery Williams ◽  
Joseph Becker ◽  
...  
Keyword(s):  
Emergency Department ◽  
Quality Improvement ◽  
Success Factors ◽  
Low Cost ◽  
Post Intervention ◽  
Triage System ◽  
Accident And Emergency ◽  
Number Of Patients ◽  
Accident And Emergency Department ◽  
The Impact

Few case studies exist related to hospital accident and emergency department (A&E) quality improvement efforts in lowerresourced settings. We sought to report the impact of quality improvement principles applied to A&E overcrowding and flow in the largest referral and teaching hospital in Rwanda. A pre- and post-intervention study was conducted. A linked set of strategies included reallocating room space based on patient/visitor demand and flow, redirecting traffic, establishing a patient triage system and installing white boards to facilitate communication. Two months post-implementation, the average number of patients boarding in the A&E hallways significantly decreased from 28 (pre-intervention) to zero (post-intervention), p < .001. Foot traffic per dayshift hour significantly decreased from 221 people to 160 people (28%, p < .001), and non-A&E related foot traffic decreased from 81.4% to 36.3% (45% decrease, p < .001). One hundred percent of the A&E patients have been formally triaged since the implementation of the newly established triage system. Our project used quality improvement principles to reduce the number of patients boarding in the hallways and to decrease unnecessary foot traffic in the A&E department with little investment from the hospital. Key success factors included a collaborative multidisciplinary project team, strong internal champions, data-driven analysis, evidence-based interventions, senior leadership support, and rapid application of initial implementation learnings. Results to date show the application of quality improvement principles can help hospitals in resource-limited settings improve quality of care at relatively low cost.

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