Ventilator Alarms in Intensive Care Units: Frequency, Duration, Priority, and Relationship to Ventilator Parameters.

Ventilator alarms have long been presumed to contribute substantially to the overall alarm burden in the intensive care unit. In a prospective observational study, we determined that each ventilator triggered an alarm cascade of up to 8 separate notifications once every 6 minutes. In 1 intensive care unit with different ventilator manufacturers, the distribution of high-priority alarms was manufacturer dependent with 8.6% of alarms from 1 type and 89.8% of alarms from another type of ventilator. Alarm limits were not a function of patient-specific ventilator settings.

Child protection decision making: a factorial analysis using case vignettes.

This study explored decision making by child protection social workers in the province of British Columbia, Canada. A factorial survey method was used in which case vignettes were constructed by randomly assigning a number of key characteristics associated with decision making in child protection. Child protection social workers (n = 118) assessed case vignettes (n = 327) for risk, service provision, and importance of client contact. In British Columbia, child protection social workers are expected to make decisions using a risk assessment model. However, as social workers begin to work with clients to facilitate change, relationship factors such as home visits and client contact also become important. The research indicated that social workers made decisions through an integration of objective, procedural, and experiential knowledge. Decisions about risk and service provision were influenced by technocratic knowledge, such as the risk assessment model. Decisions related to the amount of contact with clients and other supportive functions were influenced by individual characteristics of the social workers. The results suggest that in child protection decision making, social workers are moving beyond a reliance on objective tools such as risk assessment to also use internalized subjective knowledge.

Information exchange.

The Royal College of Nursing has established a group to look at standards, nutrition and the older adult. The aim of the group is to devise national guidelines by a process of analysis and consensus in which standards set locally are compared with those written by the expert group.