Some medical and economic implications of oxygen therapy - abstract

Oxygen is widely used in hospital practice. This paper documents critically its use in a 500-bed teaching hospital in Kingston, Jamaica. Three aspects of oxygen therapy were examined, namely, the prescription and administration of oxygen, the condition and maintenance of oxygen equipment and lastly the supplies of oxygen to the hospital. It was apparent that the same thought and precision normally accorded the prescribing of drugs was not exercised in the case of oxygen, which often seemed to be given as a routine measure. It was also noted that both medical and nursing staff were often unfamiliar with the performance of oxygen equipment and not always able to supervise its use. Little awareness of the likely inspired concentrations delivered by oxygen equipment was found. Much of the equipment used for oxygen therapy, including anaesthetic machines, was found to be defective and no regular preventive maintenance was being carried out. As a result, there was an enormous wastage of oxygen as well as deficient therapy. There was an enormous rise in the cost of oxygen. The cost of a 100-cubic foot oxygen was found to have increased from J$3.3 in 1977 to J$14.8 in 1984, and its transportation cost from the manufacturing plant to the hospital from J$1,000 to J$4,000 per month. Since the cost of oxygen is likely to rise even further, serious consideration should be given to the installation of oxygen concentrators or possibly to the use of industrial grade oxygen. In addition, there is clearly a need for further education in the use of oxygen and for improved maintenance and operation of equipment used for oxygen therapy (AU)

Good manufacturing practices in the herbal industry

Good manufacturing practices (GMPs) define a quality system that manufacturers use as they build quality into their products, for example, herbal products developed and produced according to GMPs are safe, properly identified, of the correct formulation and of high quality. Originally, GMPs were based upon the best practices of the industry. As technology and practices improved, the GMPs evolved as well. GMPs in different countries have been undergoing significant changes, making them more compatible with international standards, regulations and guidelines. Guidelines are referred to as Good Manufacturing Practices and include (1) equipment and facilities being properly designed and maintained, (2) standard operating procedures being written and approved, (3) operating an independent quality unit and (4) ensuring well trained personnel and management. General requirements are provided for the maintenance of physical facilities, cleaning compounds, sanitisers and pesticides under the umbrella GMPs. There are also specific GMPs that emphasize the wholesomeness and safety of manufactured products. Once these practices can be established, one can safely say that a good Quality Assurance programme has begun. Quality Assurance does not cost, but it may cost not to have it. A company with a QA programme can offset the cost with improved product image, consumer satisfaction and improved sales (AU)