Paints contain at least two components: a colorant and a polymeric binder, dispersed in a fluid medium. The first imparts color to the paint coating, while the second encapsulates the colorant upon drying in a robust polymeric film adherent to the surface substrate. Photonic pigments, inspired by nature's coloration strategy, hold promise as a replacement for toxic and fade‐prone absorptive colorants, most prominently in the fabrication of stable and sustainable water‐based paints. Crucially however, the step to combine photonic pigments with polymeric binders has not yet been taken. Here, a water‐based paint is designed and realized containing both photonic pigments synthesized by a scalable emulsion process and commercial polymeric binders in an aqueous dispersion. The photonic pigments are silica spheres containing a close‐packed array of air pores, of which both the periodicity and degree of long‐range ordering can be controlled to produce pigments of varying colors and degrees of iridescence. The readiness of the photonic paints for application is demonstrated by applying them like traditional paints in homages of famous artistic paintings. These findings should stimulate widespread application of structural pigments as colorants in not only paints but also a variety of industrially important materials, such as plastics, inks, or cosmetics.

The purpose of this study was to examine the impact of 0.12% chlorhexidine rinses and an oral care protocol on ventilator-associated pneumonia rates. A quasi-experimental preintervention-postintervention design was used. The sample included all patients admitted to critical care and on mechanical ventilation at any time during the study period. Data were collected 6 months before and 12 months after intervention. Ventilator-associated pneumonia rates were reduced from 4.3 to 1.86 per 1000 ventilator-days during the study period, with an estimated cost avoidance of $700,000 to $798,000.

he Clinical Nurse Leader (CNL) is a transformational leader that facilitates change by improving patient outcomes. The CNL is the first master's-prepared nursing role introduced since the NP in 1965. 1 This role evolved as a collaborative effort between nursing practice and nursing education, in response to the growing realization of the critical issues facing our complex system of care. Our dynamic healthcare system serves as a catalyst for multiple preventable medical errors each year. 2 The CNL role evolved as an effort to provide the crucial link in minimizing fragmentation of care at the microsystem (unit) level by impacting patient management at the point of care.The CNL functions within a unit microsystem, using a generalist approach to assume accountability for patient outcomes for a specific population. He or she places a high priority on patient satisfaction and can T

Over 1.4 million cardiac catheterization procedures(CCPs) take place yearly. CCP related stroke incidence in 1973 was reported as 0.23%. CCPs are invasive in nature; complications occurring due to unintentional trauma to atherosclerotic aortic plaques or thrombus formation on catheters/guidewires. With improved practice, current incidence is 0.06%. Performing >4000 procedures in FY2017, our facility sought to compare our statistics vs. current literature. Cardiovascular disease was the leading cause of global death in 2013 (17.3 million); stroke at 11.8 million. Ninety-two million Americans live with cardiovascular disease/stroke after effects accruing $316 billion in indirect costs. Seventeen percent of strokes occur in hospital; with stroke suffered post CCPs having morbidity/mortality rates 19-37%. Time to recognition/treatment of stroke symptoms is vital for best outcomes. Increase in visual symptoms post CCPs was noted with questionable correlation to radial access. Staff education on atypical stroke symptom recognition/empowerment and comfort to initiate Code Strokes was conducted. There was variability in practitioner approach to calling Code Strokes vs. observing patients post symptom recognition. Meetings held with Cardiology, Neurology, Hospital Administration, Departmental Leadership, Stroke Manager came to consensus on patient management. There should be low threshold for performing screening neurological exams and calling Code Strokes. With more sensitive diagnostic tools, diagnosis should be streamlined. Code Stroke data was collected December 2015-November 2017. Data analysis showed 48 Code Strokes called; 30 confirmed (67% male, 63% radial, 57% interventional procedures). Presenting symptoms, in order of frequency, were: vision, arm drift/weakness, facial droop, speech. The typical FAST stroke assessment would not be helpful in majority of these patients, however, education to atypical symptoms was beneficial. Literature shows women have higher stroke risk after CCPs. Our analysis showed higher prevalence in men with radial access. The most common symptom of visual changes, results in NIHSS of 0, which may impact practitioners ordering stroke work-ups; when focus should be patient disability.

Over 1.4 million cardiac catheterization procedures (CCPs) take place yearly. CPP related stroke incidence in 1973 was reported as 0.23%. CCPs are invasive in nature with complications occurring due to unintentional trauma to preexisting atherosclerotic aortic plaques or thrombus formation at catheter/guidewire tips. Less common causes of ischemic stroke are air, left ventricular clot, hypotension, arterial dissection, fractured guidewire. Transient neurological deficits have been reported following high-osmolar contrast injection into carotid/vertebral arteries. With improved practice, current stroke incidence is 0.06%. Performing >4000 procedures in FY 2017, our facility sought to compare our statistics vs. current literature. Cardiovascular disease was the leading cause of global death in 2013 (17.3 million); stroke close behind at 11.8 million. Ninety-two million Americans live with cardiovascular disease/stroke after effects accruing $316 billion in indirect costs: health expenditures/lost productivity. Seventeen percent of strokes occur in the hospital; with stroke suffered post CCPs having morbidity/mortality rates of 19-37%.Time to recognition/treatment of stroke symptoms is vital to provide best outcomes. Increase in visual symptoms post CCPs was noted by Procedural Care Unit staff with questionable correlation to radial access usage. Staff education on atypical stroke symptom recognition/empowerment and comfort to initiate Code Stroke protocol was conducted. There was variability in practitioner approach to calling Code Strokes vs. observing patients post symptom recognition. Meetings were held with Cardiology, Neurology, Hospital Administration, Departmental Leadership, Stroke Manager to come to consensus on patient management. There should be a low threshold for performing screening neurologic exams: alertness, speech, visual, sensory, motor symptoms and for calling Code Strokes. With more sensitive diagnostic tools, the process of diagnosis should be streamlined. Real time Code Stroke data was collected from December 2015-November 2017;with final analysis completed in November 2017.The research team consisted of PCU Clinical Manager, PCU Clinical Lead, Stroke Manager. Data analysis showed 48 Code Strokes called; 30 being confirmed as strokes. Of confirmed cases 67% were male, 63% were radial, 57% had interventional procedures. Presenting symptoms of stroke, in order of frequency, were vision, arm drift/weakness, then facial droop and speech. The typical act FAST stroke assessment tool would not be helpful in the majority of these patients. Literature shows women have higher stroke risk after CCPs. Our analysis showed higher prevalence in men and with radial access. The most common symptom of visual changes, results in NIHSS scores of 0, which may impact practitioners ordering stroke work-ups; when focus should be on patient disability.