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[Hypotheses for an organizational model for obligatory reporting of infectious disease].

The authors, in view of the continuously changing contagious diseases outline, deal with the problem of a better qualification and reorganization of the direct interventions in the contagious diseases prophylaxis. In this respect, the authors deem that the reporting of the cases must assume a primary importance and that all the locally operating health and social services, where the general medicine practitioners have an integrating part, ought to be redefined in their tasks and reorganized in view of the new outlines. So, it is necessary to found a more flexible reporting system. A bidirectional information flux model is also proposed between the public health-services and the general medicine practitioners.

Communicable Disease Control↗

[What is the use of hemovigilance?].

The French Blood Agency has developed a national system of surveillance and alert, from blood collection to the follow-up of the recipients, called haemovigilance. The French haemovigilance network is now operational, and aims at detecting, gathering and analysing unexpected or undesirable effects associated with transfusion in order to remedy their causes and prevent their recurrence. Thanks to 1) traceability of blood products from donors to recipients, 2) spontaneous reports of transfusion adverse events, and 3) rigorous management of information related to the transfusion process, haemovigilance effectively contributes to blood transfusion safety.

Blood Banks↗

Proposed policies and procedures for the establishment of a cord blood bank.

To carry out cord blood transplants from allogeneic unrelated donors, cord blood stem cell banks must be established. This report proposed the policies and procedures that can be used to establish cord blood banks. The areas covered include donor consent and suitability criteria; infectious and genetic disease testing; collection, processing, and preservation of the cord blood; retention of specimens for special testing; confidentiality; documentation and record keeping; establishment of a quality control program; and related regulatory issues. There are no technologic impediments to establishing cord blood banks. Agreement on some standard policies and procedures would facilitate exchange of cord blood stem cells among transplant centers and should increase the number of transplants that can be done.

Blood↗

Evolving practices of medical equipment. Management following FDA inspections.

This paper outlines one hospital's response to the changing needs for: quality of care; risk management; cost control; and regulatory agency requirements. All recall, update, and product safety alerts are now routed to the office of The Director of Materials Management. The director notifies the appropriate department manager, who must reply in writing. The Clinical Engineering Department maintains a historical data file for medical equipment, which includes service costs information. New purchasing forms and terms have been developed for use in purchasing equipment and service. Maintenance of accurate historical data for medical devices begins at purchase, and continues to installation and through ongoing service. This requires the cooperation of the manufacturer, the service vendor, and the clinical department using the device. Because technology management can improve the quality of care and reduce risk, it is worth doing and can also reduce costs.

Capital Expenditures↗

Pharmacy protocol for adjusting patient-controlled analgesia.

The use of patient-controlled analgesia (PCA) to manage pain post-operatively is becoming increasingly popular. The potential for pharmacist involvement is larger. Traditional areas of pharmacy involvement include PCA pump evaluation and selection, choice of narcotic-analgesic to be used, education of other health care professionals on PCA use, and development of PCA protocol guidelines. Monitoring post-operative pain and adjusting the PCA dosage are not traditional areas of pharmacist involvement. The purpose of this report is to describe a protocol which allows hospital pharmacists in an inpatient setting to adjust the PCA dose so that postoperative pain relief is maximized and sedation is minimized.

Analgesia, Patient-Controlled↗

Developing and evaluating a departmental universal precautions policy.

Universal precautions have been proposed by various organizations, and are now being enforced by the Department of Labor's Occupational Safety and Health Administration (OSHA). This article is designed to serve as a guide for the radiology manager in implementing universal precautions.

Acquired Immunodeficiency Syndrome↗

TB control in the hospital environment.

Tuberculosis is again on the rise in the United States. Several outbreaks of TB in hospitals have heightened interest in the development and use of mechanisms that prevent the spread of this airborne pathogen. Controlling the spread of TB to hospital patients, workers, and others can be accomplished through various administrative engineering and design controls, and infection control programs, as recommended by the Centers for Disease Control and Prevention (CDC). The hazard of TB is real, but workers, patients, and visitors can be protected by implementing programs that guard against the diseases spread in the hospital environment.

Centers for Disease Control and Prevention, U.S.↗

Charting by exception.

Documentation takes up a significant portion of a home care nurse's daily workload. As cost containment measures reduce the amount of time nurses can spend with each patient, they need to find ways to make documentation more efficient to avoid compromising patient care. One agency found that charting by exception reduces documentation time so that nurses can devote more hours to hands-on care.

Community Health Nursing↗