Utilization management: improving patient care while maintaining cost control.

An outbreak of serious wound infections occurring in an orthopaedic ward is reported. The outbreak involved 10 patients, all of whom had undergone clean, orthopaedic operative procedures. The outbreak was eventually terminated by discarding five damaged and contaminated mattresses. The costs incurred during this outbreak were calculated using a retrospective comparative study. The infected patients had an average increased hospital stay of 17 days and average increased costs of 2220 pounds. The outbreak demonstrated the high costs of hospital-acquired infection and the need for further investment in infection control programmes.

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PubMed1992

Assessment of thermal conditions in neonatal care: use of a manikin of premature baby size.

A thermal manikin of the size of a 1 kg premature baby has been constructed. The nonevaporative heat loss from eight different regions and the total heat loss were measured. The measurements of heat loss have high repeatability and the values are in good agreement with measurements of dry heat loss for premature babies, using indirect calorimetry. The heat losses from the manikin in a single-walled, air-heated incubator and on a recently described heated, water-filled mattress have been compared. The total heat loss was found to be 20 to 30 W/m2 with both methods at ambient temperatures between 15 degrees and 25 degrees C. Treatment on a heated, water-filled mattress provides a means of direct conductive heat input to the baby, with a conductive heat transfer coefficient of 0.4 W/degrees C or 21 W/m2 degrees C. The thermal manikin appears to provide an accurate method for assessment of the thermal conditions in neonatal care.

Beds↗