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Atlanta Falcons Introduce Shockingly Low Food Prices at New Stadium
What goes up must come down is an axiom that applies to Hail Marys and prices charged for food by one NFL team.
What goes up must come down is an axiom that applies to Hail Marys and prices charged for food by one NFL team.
The city of Danbury has scheduled this years Memorial Day Parade.
This past Friday, in the restroom at the Danbury Walmart, Aimee Toms was washing her hands when a stranger approached and told her she was disgusting and she didn't belong there.
Gabriel Medina has just gone into surfing lore.
Old tensions boiled over -- and then some -- during Sunday's game between the Toronto Blue Jays and Texas Rangers.
I try to pass along as much information from the Food and Drug Administration about safety recalls. This instance is all about Connecticut receiving a big chunk of change towards food safety.
Like traffic isn't bad enough this time of year. Well if you travel on the Taconic State Parkway, get ready for lane closures this week.
Looking for something for your kids to do for a few days? I've got a suggestion for you.
Do you think big pharma is aggressively pushing the sale of opioids to the point of addiction?
Have you seen Mr. Magoo?
One person is fighting for his life after a five-car crash on Interstate 84 in the Hudson Valley. Many others were injured.
You just can not get enough of a good thing. Especially when it comes to potholes.
Danbury firefighters got the call when a mother duck started quacking hysterically this past Monday morning on Delay Street.
Do you love to kayak? Do you enjoy helping out by raising money for worthwhile causes? Do I have an event for you!
Money, possible murder, and a body lost at sea are the things of intrigue for sure. The saga of Nathan Carman continues.


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Saturday, August 30, 2014
Pseudo-macro shot on Nikon 18-70mm lens, D3100.
Here is a recent picture taken on my Nikon D3100 (18-70mm lens). Not a true macro shot so i had to crop quite significantly but nevertheless not bad.
Hoping to one day add a proper macro lens to my collection like the Tamron 90mm SP. The location was in Colchester area, near our home in Prettygate, whilst out for a walk.
Friday, August 29, 2014
If you are looking for high quality resources for your next creative project then check out Creative Market. You will find plenty of possibilities all at a reasonable price.
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Hammer time! How great are the British Grand Prix and Lewis Hamilton!
Silverstone Circuit Map | by Stephen Hill Photography You can't really ask for more when it comes to thrills and excitement than the...
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All hotels in Savannah, Georgia, United States of America
1 room, 2 adults
11520 Abercorn Street, Savannah, GA, 31419, United States of America, 800-491-6126
Gateway Inn-Savannah, Savannah
Basic guestrooms in Midtown with comfy beds
- Free WiFi and free parking
Main amenities
- 39 guestrooms
- 24-hour front desk
- Coffee/tea in a common area
- Air conditioning
- Daily housekeeping
- Free WiFi and free parking
For families
- Refrigerator
- Private bathroom
- Premium TV channels
- Free toiletries
- Daily housekeeping
- Blackout drapes/curtains
What's around
- In Midtown
- St Joseph's Hospital (0.4 mi / 0.7 km)
- Armstrong Atlantic State University (0.8 mi / 1.3 km)
- Savannah Mall (1.5 mi / 2.4 km)
- Oglethorpe Mall (3.8 mi / 6.2 km)
- Hunter Golf Course (5.4 mi / 8.7 km)
See all 67 Hotels.com reviews
Room needs to be improved
Great location
Fantastic service
More comfort would be nice
TripAdvisor Traveller Rating: 2
From 27 reviews
Gateway Inn-Savannah, Savannah
Hotel Info: 866-539-8117from $39
- Standard room-1 king bed
- Standard room - 1 full bed
- Standard Room, Smoking
- Standard room-2 double beds
Want more choice? Check out our other properties in Savannah.
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Key facts
Hotel size
- This hotel has 39 rooms
- This hotel is arranged over 2 floors
- Check-in time starts at 1 PM
- Check-out time is 11 AM
Required at check in
- Credit card or cash deposit required
- Government-issued photo ID required
- Minimum check-in age is 21
Travelling with others
- No cribs (infant beds)
- Pets not allowed
- Free WiFi in public areas
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Food and drink
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Sleep well
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Freshen up
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- Gateway Hotel Savannah
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The NCIMS is governed by an Executive Board that is elected or appointed to represent a broad variety of regulatory agencies, across geographic regions and disciplines. In addition to the Executive Board, committees have been established to study various proposals and report their findings to the Board, the Councils and to the following Conference. These studies and reports aid the council members and delegates in making informed decisions as they deliberate and vote on the proposals.To facilitate the basic function of the Conference, Councils have been appointed to consider the improvements in and modification of the NCIMS agreements.
[fruitful_ibox column="ffs-three-one" title="Executive Board"]
[fruitful_ibox column="ffs-three-one" title="Councils"]
[fruitful_ibox column="ffs-three-one" title="Committees" last="true"]


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Just stayed here last weekend and must say it was a great experiance for the price. location is good, justed off the A1 junction 29. and was great for visiting family in Durham. Check in was Quick and staff on the desk good. given a...More
Getting you more information on this room
Getting you more information on this room
"Room 19 is good for disabled guersts and it has a door to the next room for a separate carer."
"Don't accept Room 19 unless you want a poor sleep from noise, or need an access room"


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Home > News > Raymor Announces New International Clients for Titanium Powders
September 19th, 2006
Raymor Announces New International Clients for Titanium Powders
Raymor Industries Inc. (TSX VENTURE: RAR) is pleased to announce that the company's wholly-owned subsidiary, AP&C Advanced Powders and Coatings, has added four (4) new international clients for its unique spherical titanium and titanium alloy powders, including Johnson Matthey Plc (UK), Stealth Medical Technologies (USA), Korea Institute of Industrial Technology, and the University of Twente (Netherlands).
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Carbon displays quantum effects July 13th, 2017
Meniscus-assisted technique produces high efficiency perovskite PV films July 7th, 2017
Regulation of two-dimensional nanomaterials: New driving force for lithium-ion batteries July 26th, 2017
Liquid electrolyte contacts for advanced characterization of resistive switching memories July 26th, 2017
Phenom-World Launches Phenom Pro and ProX Generation 5 SEMs at Microscopy & Microanalysis Conference USA: The excellent performance in a wide range of applications offers a serious alternative to floor model SEMs July 26th, 2017
Graduate Students from Across the Country Attend Hands-on NanoCamp: Prominent scientists Warren Oliver, Ph.D., and George Pharr, Ph.D., presented a weeklong NanoCamp for hand-picked graduate students across the United States July 26th, 2017
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|Buy The Book
|►Get The FREE Ebook◄
|Part I: Spirituality
|Part II: Physicality
|Part III: Issues
Exercise is good. Muscle tone is good. Use your muscles every chance you have, that's what they're there for. This'll make you stronger. Then everyday moving around and carrying things will become easier, more natural and healthier.
Use your arm muscles when carrying bags don't just keep your arms straight. If you carry your groceries for a little exercise estimate how much you're carrying. Watery liquids weigh 1kg per liter and a can of beans, soup or similar around ½kg each. Balance the weight between your hands.
The key to starting to exercise is walking. The key to starting to exercise is walking (in case you missed it). You control the pace, it's safe to do at some level for almost everyone, it's a good buzz (from the endorphins generated), it's free to do, no special equipment is required (though sneakers and sweatsocks help heaps) and you can stop or rest when you want. Find a store to walk to or a park or a beach to walk around. Say you walk at 4½kmph, put in an hour's walk and you've done 4½km. If your toes blister in your sneakers then wrap tape, micropore works well, around them before setting off. If your skin chafes on your inner thighs again tape it and continue to walk to health.
Be aware of your breathing. Breathe in through your nose. For walking try, without using too much force, breathing in for four steps then out for four steps. In, Left, In, Left, Out, Left, Out, Left. For jogging try breathing in for two steps then out for two.
Use a GPS app (like Google MyTracks ) with a GPS phone and you can easily measure the amount of exercise that you do.
Sit-ups and press-ups are also excellent muscle building exercises that are easy to do at home each morning. If you can't manage press-ups try being stiff to your knees rather than your feet. When doing sit-ups don't pull on your neck instead place your hands by your ears.
Stretching is excellent for your body. Especially stretch after you exercise when your muscles are warmed up. It's difficult to explain advanced stretching in detail without pictures. We strongly recommend getting a beginners book on yoga.
Muscles grow by the muscle fibers breaking and regrowing larger. This is the kind-of bruised feeling you get after exercising a lot. You need to give yourselves recovery time for this to happen. Take a day off after every large exercise day.
If you come home sweaty, change your clothing and shower off.
Get to an effort level that you are comfortable with then simply put in the time. If you can follow this simple formula you'll get exercising healthily in no time at all and it won't be long before you can feel yourselves getting fitter.
|© 2016 Terra Sanctuaria – Read Our


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We recommend using a modern web browser such as Google Chrome or Microsoft Edge with their default settings.
At the yearly gathering of booklovers held in Chicago's McCormick Place convention center June 22 – 27, Wordsworth the Better World Bookmobile is...
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MICROSOFT WORD 2000 STEP BY STEP is the easiest and fastest way to teach yourself to use the latest version of Microsoft's bestselling word processor. Work through every lesson to complete the full course, or do individual lessons to learn just the skills you need. Either way, you learn at your optimum pace from the teacher who knows you best--you.
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Content count5,590
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About Red Dragonette
Aqua and Terra, the sexy couple!
- Birthday 05/06/1991
I am a proud pro-choice, pro-gay rights (I'm straight), libertarian, equalist, atheist! I'll stand by my beliefs, no matter what.3DS Friend Code: 0903-2806-9408My Scroll My DeviantArt Page. Picknick's and mine RP remake.
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**1st Prior Wishlist**
CB Gold
clean 4th gen or lower Holly
Neglected (any lineage, whether it be CB or not)
2nd gen Bronze Tinsel
2nd gen Silver Tinsel
2nd gen or lower Gold Tinsel
2nd gen or lower Bronze Shimmer
clean 3rd gen or lower Silver Shimmer
clean 3rd gen or lower Gold Shimmer
CB Zyumorph (any color, except red and blue)
**2nd prior wishlist**
non-inbred Black Alt
non-inbred Vine Alt
2nd gen Yellow Undine
**3rd Priority Wishlist**
**RPs I'm in**
Great War: Dragons vs Humans remake
**RPs I may be interested in joining in the future**
Azure Wyrm
**Currently Reading Right Now**
**Currently Playing**
Fire Emblem Heroes
Fire Emblem: Shadows of Valentia
Fire Emblem: Sacred Stones randomizer
**Planning on Buying**
Kingdom Hearts 3 (once it gets released)
Final Fantasy VII remake (once it gets released)
Fire Emblem Warriors (once it gets released)
Pokemon Ultra Moon (once it gets released)
Crash Bandicoot trilogy (maybe)
**Owe List**
shan93 - paper egg
Kat - paper egg
**To Holiday Breed List**
Lei Kuugo x Oersted
Camilla x Ryoma
Pumpkin Soup x a magelight pygmy
Shiki Misaki x Beat


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ABRAMORAMA ROLLS OUT NATIONAL THEATRICAL TOUR FOR TURN IT AROUND: THE STORY OF EAST BAY PUNK TIMED TO GREEN DAY'S NORTH AMERICAN TOUR DATES New York, NY — July 13, 2017 — Abramorama will kick off the national film tour of TURN IT AROUND: THE STORY OF EAST BAY PUNK with a week long run at the IFC Center in New…Read More
STREAM: 9 Audio Podcasts about Turn It Around!
Excited to hear more about our film Turn It Around: The Story of East Bay Punk? Well, look no further! Below are streaming audio links to NINE podcasts recently released celebrating our film and East Bay punk music culture! LISTEN NOW BY CLICKING THE LINKS BELOW! 104.5 KFOG NO NAME'S PODCAST 7/25/17: 'Turn It Around: The…Read More
FILM REVIEW: 'Turn It Around: The Story of East Bay Punk'
FROM VARIETY.COM: "Corbett Redford offers a dynamic, three-hour chronicle of the Berkeley punk scene that birthed Green Day and other pop-punk bands. By now rivaling Bloomsbury and the Beats as the Most Exhaustively Chronicled Artistic Movement Ever, punk gets yet another regional recap in the documentary "Turn It Around." Yet these nearly three hours devoted…Read More
Check out this Turn It Around-inspired Spotify playlist now!
Excited to see our documentary? Check out this Spotify playlist curated by Turn It Around director/producer Corbett Redford! Featuring 38 songs clocking in at almost two hours of music and inspired by the artists and culture featured in the documentary, the playlist is a sonic walk through over 30 years of Bay Area punk (and…Read More
Exclusive Trailer Premiere: Legendary East Bay Punk Scene Comes to Life in Green Day-Assisted Doc
Green Day plays Gilman, 1990 – Photo by Murray Bowles Turn it Around: The Story of East Bay Punk is the latest project to get the coveted Green Day co-sign. The exciting new doc tells the story of the hyper-influential San Francisco-area punk scene that nurtured numerous notable bands. "In the mid-'90s, I found a…Read More
New Noise Magazine features 'Armstrongs' song from 'Turn It Around' documentary
The next New Noise Magazine flexi & cover info revealed! The flexi features East Bay supergroup Armstrongs, made up of Billie Joe (Green Day), Tim (Rancid), Joey (SWMRS), and Rey Armstrong. The song, "If There Was Ever A Time," is featured in the film Turn It Around: The Story of East Bay Punk. Flexi subs…Read More
REVIEW FROM KQED ARTS: The Definitive Documentary on East Bay Punk is Coming
When I think of the new documentary Turn It Around: The Story of East Bay Punk, I think about a teenager named Jimmy Mahoney, who last year was called up on stage by Billie Joe Armstrong from Green Day for a dream opportunity: to play guitar with his favorite band in front of thousands of…Read More
WORLD PREMIERE of "Turn It Around: The Story of East Bay Punk" at Opening Night of SF DocFest!
BIG NEWS! The 16th SF DocFest will kick off on Wednesday, May 31st at the Alamo Drafthouse New Mission Theater at 7PM with the World Premiere of Corbett Redford's TURN IT AROUND: THE STORY OF EAST BAY PUNK. The film spans over 30 years of the California Bay Area's punk music history with a…Read More
New Website Design Launched!
Welcome to the newly-designed website for our documentary, Turn It Around: The Story of East Bay Punk! Based on artwork by Jesse Michaels and featuring handwriting by Aaron Cometbus, the site was Designed By Monkeys in coordination with One Day Labs! Take a look around and stay posted to this site (and our social media…Read More
First Key Art From "Turn It Around" Released!
The first teasers of key art for our film "Turn It Around: The Story of East Bay Punk" have been released on our Facebook page! Longtime East Bay punk scene participants Jesse Michaels (Operation Ivy) and Aaron Cometbus (Cometbus zine, Pinhead Gunpowder and Crimpshrine) came together to give us some great elements to represent our…Read More


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Guide to the X Men timeline
Guide to the X Men timeline
X-men: First Class (2011) dir. Matthew Vaughn
"Eins. Zwei. Drei."
James McAvoy, April 21st 1979
Happy Birthday, Jamesy! ❤
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Photo taken by Jon Premosch
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Miles Hilton-Barbermore...
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News Anime Expo Hosts Death Note Anime Director, Designer
posted on 2007-04-23 15:14 EDT
Anime Expo 2007 announced the Death Note television anime's director Tetsuro Araki and character designer Masaru Kitao as its first non-musical Japanese Guests of Honor. The convention also announced that it has the rights to screen the separate live-action films, Death Note and Death Note: The Last Name in 35 mm.
Araki has worked steadily up the anime production ladder with credits that include the storyboards and technical animation direction for Panyo Panyo Di Gi Charat and three Galaxy Angel television series. He made his directorial debut with the Otogi-Jushi Akazukin video series. Kitao worked as an animation director on episodes of Card Captor Sakura and Rozen Maiden, and he created apparel as well as animated an opening on NANA. Previously, he was the character designer of the Madhouse video Pops.
The live-action Death Note films were based on the same Shonen Jump manga as the anime, but were created by a different crew. The two movies recently had their North American premiere in the Newport Beach Film Festival this past weekend.
This Week in Anime - What's Stain's Real Problem With Heroes?
Interview: The Staff of Welcome to the Ballroom
Vice & Luna - The Leaked Jedi
Garo Season Two: Crimson Moon BD+DVD
The Summer 2017 Anime Preview Guide
Reviews Include: Gamers! - Classroom of the Elite - My First Girlfriend is a Gal - Magic Circle Guru-Guru - In Another World with my Smartphone - New Game!! - Angel's 3Piece! - Chronos Ruler - Princess Principal - A Centaur's Life - Hitorijime My Hero - Action Heroine Cheer Fruits - and much more! ― Welcome t...


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Painful headache, dizziness, exhausted with high BP, high pulse rate. Has Costochondritis. Connected?
HI, I am 17 years old. Since Sunday I have been getting extremely shaky, dizzy, and exhausted and the first thing that comes is a sudden painful headache on the crown of my head. At church Wednesday a man took my blood sugar count and my blood pressure along with my pulse . everything was very high. I take very good care of myself, I eat very healthy and work out often. I recently had Costochondritis , took xrays of my chest and had an xray of my head about a month ago because of bad sinus stuff.
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Atthe moment you are havtng
. Change your life style. Increase your physical activity. Now get your diabetic and hypertention profile done. Examining the report start treatment with advise of physician.
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Atthe moment you are havtng anxiety neurosis. Change your life style. Increase your physical activity. Now get your diabetic and hypertention profile done. Examining the report start treatment with advise of physician.
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William Nelson, fire protection chief, busted for impersonating peace officer, DUI, pot in truck
As fire protection chief for Hygiene, William Nelson is called upon to ensure the safety and well-being of people in his community. But on Saturday night, at least one local allegedly needed protection from him.
Nelson, 57, has been arrested on a potpourri of charges, including impersonating a police officer, DUI and possession of marijuana.
According to Rick Brough, spokesman for the Boulder County Sheriff's Office, Nelson and the driver of another car got into "some type of traffic altercation" -- one which apparently pissed off Nelson enough that he hit the red overhead lights mounted to the roof of his personal truck and pulled over the other driver near the intersection of North Foothills and North Saint Vrain Road. That would be a no-no even for someone employed fulltime as a firefighter. But the Hygiene department is a volunteer force. According to the Longmont Times-Call, makes his living as a real estate broker.
At this point, Nelson and the other driver got into what Brough cautiously refers to as "an interaction" -- one presumably serious enough that afterward, the other driver reported the incident. When BCSO deputies stopped Nelson, they soon came to the conclusion that he'd been drinking. He also had a pistol and a rifle in his car, as well as some marijuana and "drug paraphernalia," Brough says.
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The final tally of charges: impersonating a peace officer (a class six felony), prohibited use of weapons, DUI, misuse of emergency lights, possession of less than two ounces of marijuana and possession of drug paraphernalia.
At least one of these counts should strike Nelson as familiar. The Times-Call notes that he was charged with driving while ability impaired back in 1996. He was sentenced to ten days in jail, one year of probation and 24 hours of community service.
He won't be able to serve the community as fire protection chief for a while. The day after the bust, the district announced that the board of directors had met in special session and decided to suspend Nelson "pending further investigation."
No word about whether he'll have to give up the red lights on the top of his truck, too.
More from our Colorado Crimes archive: "Purse theft leads to 15 hours trapped in vent at Englewood's Charles Hay Elementary."
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Journal Article > Review
A systematic review of measurement tools for the proactive assessment of patient safety in general practice.
Lydon S, Cupples ME, Murphy AW, Hart N, O'Connor P. J Patient Saf. 2017 Apr 4; [Epub ahead of print].
This systematic review identified multiple methods to measure patient safety in primary care, including staff surveys, chart audits, interviews, and a checklist of recommended practices. The authors conclude that many existing safety measures are feasible for use in primary care.
Journal Article > Study
Design and reliability of a specific instrument to evaluate patient safety for patients with acute myocardial infarction treated in a predefined care track: a retrospective patient record review study in a single tertiary hospital in the Netherlands.
Eindhoven DC, Borleffs CJW, Dietz MF, Schalij MJ, Brouwers C, de Bruijne MC. BMJ Open. 2017;7:e014360.
Although adverse events among hospitalized patients are common, less is known about the safety of acute cardiac care. In this retrospective study, researchers described the development and validation of a tool to assess the safety of patients treated for acute myocardial infarction.
Journal Article > Study
Pediatric prehospital medication dosing errors: a national survey of paramedics.
Hoyle JD Jr, Crowe RP, Bentley MA, Beltran G, Fales W. Prehosp Emerg Care. 2017;21:185-191.
This survey of paramedics found that pediatric dosing errors in the prehospital period are common. Respondents used varied methods for estimating weight of pediatric patients in order to calculate drug doses, and they advocated for pediatric training and standardized weight estimation methods to reduce risks. These findings suggest several possible interventions to enhance pediatric medication safety in the prehospital setting.
Journal Article > Study
Performance of a trigger tool for identifying adverse events in oncology.
Lipitz-Snyderman A, Classen D, Pfister D, et al. J Oncol Pract. 2017;13:e223-e230.
Investigators developed and validated a trigger tool to identify a range of harms in cancer care. Although their final tool had only a modestly accurate positive predictive value, they advocate refining and automating the trigger approach to enhance the detection of adverse events in oncology.
Journal Article > Study
Impact of the Opioid Safety Initiative on opioid-related prescribing in veterans.
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Lin LA, Bohnert AS, Kerns RD, Clay MA, Ganoczy D, Ilgen MA. Pain. 2017;158:833-839.
Opioids are known to be high-risk medications, and unsafe prescribing practices are common. This intervention at Veterans Affairs medical centers used an electronic dashboard to provide feedback to clinicians about high-risk opioid prescribing. Local champions implemented the dashboard tool and spearheaded safer opioid prescribing. Using an interrupted time series analysis, researchers determined that the intervention reduced two unsafe prescribing practices: high-dose opioid prescriptions and concurrent use of opioids and benzodiazepines. The authors suggest that this type of large-scale intervention could be applied in other health care systems to enhance opioid safety. A recent Annual Perspective discussed the extent of harm associated with opioid prescribing and described promising practices to foster safer opioid use.
Journal Article > Commentary
Understanding interrater reliability and validity of risk assessment tools used to predict adverse clinical events.
Siedlecki SL, Albert NM. Clin Nurse Spec. 2017;31:23-29.
The ability to proactively identify and mitigate risk is key to safety improvement. This commentary describes several risk assessment tools available to develop estimates of potential adverse events and discusses how to ensure those assessments are valid and reliable.
Journal Article > Study
Adverse event and error of unexpected life-threatening events within 24h of emergency department admission.
Zhang E, Hung SC, Wu CH, Chen LL, Tsai MT, Lee WH. Am J Emerg Med. 2017;35:479-483.
Trigger tools are frequently utilized to identify adverse events. The authors of this prospective study suggest that unexpected life-threatening events that occur within 24 hours of admission from the emergency department may be a useful trigger tool.
Journal Article > Commentary
Peer feedback, learning, and improvement: answering the call of the Institute of Medicine report on diagnostic error.
Larson DB, Donnelly LF, Podberesky DJ, Merrow AC, Sharpe RE Jr, Kruskal JB. Radiology. 2017;283:231-241.
Improving the culture of safety within health care is an essential component of preventing errors. This commentary discusses the culture of radiology in the context of recent progress in understanding and reducing diagnostic error. The authors suggest that peer-oriented feedback and assessment would drive progress in improving safety in radiology.
Journal Article > Study
Operating room–to-ICU patient handovers: a multidisciplinary human-centered design approach.
Segall N, Bonifacio AS, Barbeito A, et al. Jt Comm J Qual Patient Saf. 2016;42:400-414.
Human factors engineering aims to optimize performance by examining the relationship between individuals and the system within which they work. This field of study has long been used to improve the safety of industries like manufacturing and aviation, and it has more recently been applied to health care. This study used human factors approaches to conduct observations, surveys, interviews, and focus groups about handoffs, specifically for postsurgical patients transferred from the operating room to the intensive care unit. The investigators identified flaws in handoff practices; then they designed a standardized handoff process to address these vulnerabilities. The redesigned handoff did not take more time than prior handoffs but did demonstrate better participant satisfaction. The authors suggest that their human factors-based improvement approach could be applied to other patient safety processes. A past PSNet interview discussed the application of human factors to health care.
Journal Article > Study
Vital signs are still vital: instability on discharge and the risk of post-discharge adverse outcomes.
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Nguyen OK, Makam AN, Clark C, et al. J Gen Intern Med. 2017;32:42-48.
Identifying patients at high risk of readmission following hospital discharge is a patient safety priority. This observational cohort study found that patients with abnormal vital signs—temperature, blood pressure, heart rate, respiratory rate, and oxygen saturation—upon hospital discharge were more likely to be readmitted to the hospital or die within 30 days compared to patients without vital sign abnormalities. The authors suggest vital signs should be used to assess safety for hospital discharge.
Journal Article > Study
How to monitor patient safety in primary care? Healthcare professionals' views.
Samra R, Car J, Majeed A, Vincent C, Aylin P. JRSM Open. 2016;7:2054270416648045.
This survey of British primary care clinicians was designed to elicit clinicians' suggestions for improving safety in primary care. Clinicians expressed a desire for more resources devoted to ensuring patient safety and more feedback after adverse events occurred.
Adverse Events in Rehabilitation Hospitals: National Incidence Among Medicare Beneficiaries.
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Levinson DR. Washington, DC: US Department of Health and Human Services, Office of the Inspector General; July 2016. Report No. OEI-06-14-00110.
The Office of the Inspector General (OIG) has issued a series of reports analyzing the incidence and preventability of adverse events among Medicare beneficiaries receiving care in acute care hospitals and skilled nursing facilities. This report used similar methodology based on trigger tools to determine adverse event incidence among patients in rehabilitation hospitals—post-acute care facilities that provide intensive rehabilitation to patients recovering from hospitalization for an acute illness or injury. The study found that 29% of patients experienced an adverse event during their stay, a proportion nearly identical to rates at acute care hospitals and skilled nursing facilities. Nearly half of the events were considered preventable, with the most common types of events including pressure ulcers, delirium, and medication errors. Nearly one-fourth of patients who had an adverse event required transfer to an acute care hospital for diagnosis or management, leading to a large increase in costs of care. Based on these data, the OIG has recommended that the Agency for Healthcare Research and Quality and Centers for Medicare and Medicaid Services disseminate information about patient harms in the rehabilitation setting and work to improve safety at rehabilitation hospitals. A previous WebM&M commentary discussed an adverse event at a rehabilitation facility.
Journal Article > Study
Do physicians clean their hands? Insights from a covert observational study.
Kovacs-Litman A, Wong K, Shojania KG, Callery S, Vearncombe M, Leis JA. J Hosp Med. 2016;11:862-864.
This study compared covert hand hygiene observation by students to traditional overt hand hygiene audits. Investigators found much lower hand hygiene performance with covert observation, especially for nurses, suggesting that covert observation may be more accurate. These results demonstrate the challenge of achieving optimal hand hygiene compliance.
Journal Article > Study
Safe implementation of standard concentration infusions in paediatric intensive care.
Arenas-López S, Stanley IM, Tunstell P, et al. J Pharm Pharmacol. 2017;69:529-536.
Pediatric medication safety is particularly challenging due to complexity around weight-based dosing. According to a retrospective study in a pediatric intensive care unit, most morphine-related medication administration errors could have been prevented with technology interventions such as barcode medication administration. The authors advocate for implementing standardized morphine infusions to improve safety.
Journal Article > Study
Reviewing deaths in British and US hospitals: a study of two scales for assessing preventability.
Manaseki-Holland S, Lilford RJ, Bishop JRB, et al; UK Case Note Review Group. BMJ Qual Saf. 2017;26:408-416.
Ascertaining whether adverse events are preventable is a continuing challenge in patient safety. Comparing two scales that assess preventability for mortality, this study found that there is high variability among experts rating the preventability of the same mortality event. These results suggest that preventability remains subjective despite attempts to define it in a reproducible fashion.
Journal Article > Study
Development of an emergency department trigger tool using a systematic search and modified Delphi process.
Griffey RT, Schneider RM, Adler LM, et al. J Patient Saf. 2016 Jun 16; [Epub ahead of print].
Researchers sought to develop an emergency-department specific trigger tool to identify adverse events. Their Delphi process resulted in a 46-item proposed tool that will require validation and testing in order to determine its usefulness in practice. This formative work fills a gap in available trigger tools.
Journal Article > Study
Outcomes are worse in US patients undergoing surgery on weekends compared with weekdays.
Glance LG, Osler T, Li Y, et al. Med Care. 2016;54:608-615.
The weekend effect, in which patient outcomes are worse outside of usual business hours, is well-documented across multiple care settings. Analyzing administrative data, this study found a higher rate of complications in both urgent and elective surgery on the weekend compared to the weekdays. This finding emphasizes the need to develop and test strategies to enhance safety on evenings and weekends in acute care settings.
Newspaper/Magazine Article
Tackling disrespectful, unprofessional provider behaviors.
ED Manag. June 2016;28:S1-S4.
Disrespectful conduct among health care providers can hinder safe care delivery. This article reviews insights from one hospital's unique program to encourage staff members to help identify individuals that could benefit from personalized coaching and training to manage their disruptive behaviors.
Journal Article > Commentary
Driving surgical quality using operative video.
O'Mahoney PRA, Yeo HL, Lange MM, Milsom JW. Surg Innov. 2016;23:337-340.
Although using video documentation while providing care is controversial, it has been shown to contribute to error and near miss analysis. This commentary describes how utilizing videos in operating rooms can enhance patient safety and clinician accountability.
Journal Article > Study
How does audit and feedback influence intentions of health professionals to improve practice? A laboratory experiment and field study in cardiac rehabilitation.
Gude WT, van Engen-Verheul MM, van der Veer SN, de Keizer NF, Peek N. BMJ Qual Saf. 2017;26:279-287.
Audit and feedback are key patient safety strategies. This combined simulation and pre–post implementation study found that staff-reported intentions to improve practice increased after receiving feedback. However, nearly half did not compare their own performance to available benchmarks.