Promoting an environment conductive to sleep in hospital is a challenge. Although patients may appear to sleep in hospital, it may not be refreshing or restorative. The reasons for this can be categorized into three groups: environmental, physiological and psychological. These factors can work concomitantly, making sleep virtually impossible for some patients. Nurses can help their patients by understanding what influences sleep patterns and acting on this knowledge. This may include a variety of interventions, from allowing patients to carry out their own bedtime routine, to explaining to elderly people how their sleeping patterns changes with age.
This paper describes a new tool called 'Day-of-Care Survey', developed to assess inpatient delays in acute hospitals. Using literature review, iterative testing and feedback from professional groups, a national multidisciplinary team developed the survey criteria and methodology. Review teams working in pairs visited wards and used case records and bedside charts to assess the patient's status against severity of illness and service intensity criteria. Patients who did not meet the survey criteria for acute care were identifi ed and delays were categorised. From March 2012 to December 2013, nine acute hospitals across Scotland, Australia and England were surveyed. A total of 3,846 adult general inpatient beds (excluding intensive care and maternity) were reviewed. There were 145 empty beds at the time of surveys across the nine sites, with 270 defi nite discharges planned on the day of the survey. The total number of patients not meeting criteria for acute care was 798/3,431 (23%, range 18−28%). Six factors accounted for 61% (490/798) of the reasons why patients not meeting acute care criteria remained in hospital. This survey gives important insights into the challenges of managing inpatient fl ow using system level information as a method to target interventions designed to address delay.
WE beg to send you a negative of a frog taken by Prof. Rontgen's method. The clearness with which the several bones have come out is so remarkable, that we consider the picture well worth reproduction, and trust you will find space for it. The larger transparent patch upon one side of the vertebral column is due to a distended lung, its collapsed fellow being evident upon the opposite side (this was proved by subsequent dissec
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