In-hospital Paging Systems: An Effective Method of Communication between Hospital Staff in 2015?

Policies in relation to paging are designed to achieve effective in-hospital communication. This study recorded data in relation to pages received by interns over a two-week period. A survey was conducted assessing perceptions on paging and existing hospital policy. Four interns collected data in relation to 20 regular-day, 4 extended-day and 4 on-call (two weekday and two weekend) shifts (n = 423 pages). Sixty-nine pages (16%) were made during pager-free periods. On average 3 minutes per hour were spent dealing with pages. Compliance with ISBAR ranged from 50.1% to 83.4%. Of the episodes where pages were made during protected times (n = 85), 67% did not meet urgent criteria. While the majority of these pages were from nurses, they were less likely to violate the policy than other staff (relative risk 0.648, p = 0.016). Efforts need to be made to ensure pager-free periods are respected in the interest of effective communication, staff morale and protected training time.

Lysolecithin: a factor in the pathogenesis of gastric ulceration?

Lysolecithin is formed when pancreatic juice and bile mix in the duodenum. Lysolecithin concentrations have been measured in intermittent samples of night gastric juice from patients with gastric ulcers and duodenal ulcers and in normal controls. In gastric ulcer patients, the mean of the peak concentrations (444 mug/ml) and mean of concentrations in all samples (199 mug/ml) were significantly higher than in controls (34 mug/ml and 18 mug/ml respectively). Duodenal ulcer patients had normal or moderately raised values. The levels in gastric ulcer patients were as high as those which have been found experimentally to cause severe damage to the gastric mucosal barrier, and it is concluded that lysolecithin may be as important, or more important, than bile salts in the destruction of the gastric mucosal barrier and therefore in the aetiology of gastric ulcer.