1323and still be labelled "approximately 141 mmol/l" and comply with the BPC standard. Another variant of Difusor is stated to contain approximately 130 mmol/l of sodium, and a 5% variation would allow a range of 123-5 to 136-5 mmol/l.The BPC limits for sodium content of haemodialysis solutions are ±3%, and the manufacturers of our haemodialysis solutions work to limits of ±3 mmol/l, which is equivalent to 2-16% on a sodium content of 139 mmol/l. We appreciate the difficulties encountered in manufacturing to narrow limits and possible problems with moisture loss on storage but think that a variation of 5% on the sodium content of peritoneal dialysis fluid is too wide. We would suggest that the British Pharmaceutical Codex limits be reduced to ±3 mmol/l.

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The development and use of tailored interventions in overcoming barriers to optimum health in long-term care facility residents is of the highest importance. One successful approach to improving health outcomes is the use of a checklist by health care providers. Despite the evidence of the success of such checklists in nursing and medicine, there is little evidence on their use in improving dental outcomes. This study investigated whether an intervention comprising the daily use of a checklist for oral care by nursing staff supplemented by random inspections by a charge nurse resulted in lower dental plaque scores in patient participants at a long-term care facility (n=19) as compared with in those at another long-term care facility that did not receive the intervention (n=13). All participants received a dental cleaning at baseline. At a follow-up examination at 6 to 8 weeks post-baseline, significant differences were observed in the plaque scores between the participants at each location, with the median plaque scores in those undergoing the intervention being less than half of those in the patients that did not (20.8% vs. 52.8%, p<0.001). After adjusting for age in a linear regression model, this difference remained significant. The use of a daily checklist for oral care supplemented by random inspections by a charge nurse was associated with lower plaque scores (p<0.001). These results warrant further research, including prospective studies aimed at establishing how use of both clinical supervision and a checklist for oral health may influence plaque scores in geriatric patients in long-term care facilities over time.

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