The use of a validated pre-discharge questionnaire to improve the quality of patient experience of orthopaedic care.

Patient experience is central to the delivery of excellent healthcare. As such it is enshrined within the 2015 NHS outcomes framework, a set of indicators against which quality in healthcare is measured. A variety of tools are available to quantify patient experience across clinical settings. When combined with a framework for continued data collection and suitable mechanisms for analysis, feedback, and intervention, these tools allow improvements in patient care and clinical services to be realised. In response to an increasing number of patient complaints and friends and family scores below the trust average within our orthopaedic department we instituted an improvement programme in March 2015. The programme was based around the Picker Patient Experience 15 questionnaire and aimed to improve friends and family test scores, reduce complaints and improve patient experience scores over an 18-month period. An improvement model including baseline measurement and 2 improvement cycles over an 18-month period was used. Initial benchmarks for practice were created by referencing national data allowing problem areas of care to be identified and interventions to address these developed. This process identified areas for improvement including improving staff awareness and engagement with patient experience, improving staff and patient communication and ensuring patients were aware and involved in plans for their own care. Actions to address these issues resulted in a 38% decrease in patient complaints, a >10% increase in patient experience, and improvements in patient satisfaction and friends and family scores.

Graphene nanomesh as highly sensitive chemiresistor gas sensor.

Graphene is a one atom thick carbon allotrope with all surface atoms that has attracted significant attention as a promising material as the conduction channel of a field-effect transistor and chemical field-effect transistor sensors. However, the zero bandgap of semimetal graphene still limits its application for these devices. In this work, ethanol-chemical vapor deposition (CVD) of a grown p-type semiconducting large-area monolayer graphene film was patterned into a nanomesh by the combination of nanosphere lithography and reactive ion etching and evaluated as a field-effect transistor and chemiresistor gas sensors. The resulting neck-width of the synthesized nanomesh was about ∼20 nm and was comprised of the gap between polystyrene (PS) spheres that was formed during the reactive ion etching (RIE) process. The neck-width and the periodicities of the graphene nanomesh (GNM) could be easily controlled depending on the duration/power of the RIE and the size of the PS nanospheres. The fabricated GNM transistor device exhibited promising electronic properties featuring a high drive current and an I(ON)/I(OFF) ratio of about 6, significantly higher than its film counterpart. Similarly, when applied as a chemiresistor gas sensor at room temperature, the graphene nanomesh sensor showed excellent sensitivity toward NO(2) and NH(3), significantly higher than their film counterparts. The ethanol-based graphene nanomesh sensors exhibited sensitivities of about 4.32%/ppm in NO(2) and 0.71%/ppm in NH(3) with limits of detection of 15 and 160 ppb, respectively. Our demonstrated studies on controlling the neck width of the nanomesh would lead to further improvement of graphene-based transistors and sensors.

The production of oxygenated polycrystalline graphene by one-step ethanol-chemical vapor deposition.

Large-area mono- and bilayer graphene films were synthesized on Cu foil (~ 1 inch(2)) in about 1 min by a simple ethanol-chemical vapor deposition (CVD) technique. Raman spectroscopy and high resolution transmission electron microscopy revealed the synthesized graphene films to have polycrystalline structures with 2-5 nm individual crystallite size which is a function of temperature up to 1000°C. X-ray photoelectron spectroscopy investigations showed about 3 atomic% carboxylic (COOH) functional groups were formed during growth. The field-effect transistor devices fabricated using polycrystalline graphene as conducting channel (L(c)=10 µm; W(c)=50 µm) demonstrated a p-type semiconducting behavior with high drive current and Dirac point at ~35 V. This simple one-step method of growing large area polycrystalline graphene films with semiconductor properties and easily functionalizable groups should assist in the realization of potential of polycrystalline graphene for nanoelectronics, sensors and energy storage devices.

Synthesis of a pillared graphene nanostructure: a counterpart of three-dimensional carbon architectures.

Graphene is a single sheet of carbon atoms with outstanding electrical and physical properties and is being exploited for applications in electronics, sensors, photovoltaics, and energy storage. A novel 3D architecture called a pillared graphene nanostructure (PGN) is a combination of two allotropes of carbon, including graphene and carbon nanotubes. A one-step chemical vapor deposition process for large-area PGN fabrication via a combination of surface catalysis and in situ vapor-liquid-solid mechanisms is described. A process by which PGN layers can be transferred onto arbitrary substrates while keeping the 3D architecture intact is also described. Single and multilayer stacked PGNs are envisioned for future ultralarge and tunable surface-area applications in hydrogen storage and supercapacitors.

Heterogeneous graphene nanostructures: ZnO nanostructures grown on large-area graphene layers.

In this work, the synthesis and characterization of three-dimensional hetergeneous graphene nanostructures (HGN) comprising continuous large-area graphene layers and ZnO nanostructures, fabricated via chemical vapor deposition, are reported. Characterization of large-area HGN demonstrates that it consists of 1-5 layers of graphene, and exhibits high optical transmittance and enhanced electrical conductivity. Electron microscopy investigation of the three-dimensional heterostructures shows that the morphology of ZnO nanostructures is highly dependent on the growth temperature. It is observed that ordered crystalline ZnO nanostructures are preferably grown along the <0001> direction. Ultraviolet spectroscopy and photoluminescence spectroscopy indicates that the CVD-grown HGN layers has excellent optical properties. A combination of electrical and optical properties of graphene and ZnO building blocks in ZnO-based HGN provides unique characteristics for opportunities in future optoelectronic devices.