INTRODUCTION Portions of Montgomery County, Virginia, are designated a Medically Underserved Area with a large portion of this population experiencing limited access to healthcare services. In September 2008, the Federal Bureau of Primary Care awarded the authors a planning grant to assess community need in Montgomery County and to develop a strategic plan to establish a Federally Qualified Hea...

Health care systems today are complex, technically proficient, competitive, and market-driven. One outcome of this environment is the recent phenomenon in the health care field of “consumerism.” Strong emphasis is placed on customer service, with organized efforts to understand, measure, and meet the needs of customers served. The purpose of this article is to describe the current understanding...

As the most influential catalysts for health care reform in America, the time for nurses to emulate wellness and prevention has never been more critical. By creating healthy habits for ourselves, we flourish as ambassadors of self-care for our patients, families, colleagues, and communities. By taking care of ourselves first, we bring positive energy and vitality to work that positively affects...

Older adults who visit emergency departments (EDs) often experience delirium, but it is infrequently recognized. A systematic review was therefore conducted to identify what delirium screening tools have been used in ED-based epidemiologic studies of delirium, whether there is a validated set of screening instruments to identify delirium among older adults in the ED or prehospital environments,...

Postoperative delirium is a common complication in the older surgical population, occurring in 10-50 % of cases. It is thought to be more common if an individual is identified as frail. Postoperative delirium is associated with poor outcome including higher mortality rates, prolonged length of hospital stay, increased care needs on discharge and longer term post-traumatic stress disorder. Guide...

I thank Bajona [1] for his interest in the article regarding a European Training Programme in Cardiothoracic Surgery [2] and the comments by Hamilton [3], and for the caveats raised. The selection of appropriate trainees for a training programme is of vital importance, equal to having the appropriate trainers and training programmes as one of three sides of a successful training programme trian...

The paper deals with a quantitative approach to safety assessment process applicable to the safety-related system, specially the railway interlocking one. The authors present the methodology based on the Failure Mode and Effects Analysis (FMEA) and the Fault Tree Analysis (FTA) that is applicable to performing safety analysis of both electronic and computer based systems. The mathematical basis...

Offering employees self-care information, which encourages them to decide what to do for themselves with and without provider assistance, can be a low-cost, effective approach to health care cost management. Components of such a program may include a printed self-care guide, workshops, software and a nurse advice line. Self-care is a process, not an event and, to be effective, a self-care progr...