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Improving healthcare quality has become a worldwide effort. Strategic problem solving (SPS) is one approach to improve quality in healthcare settings. This case study aims to illustrate the process of applying the SPS approach in implementing a quality improvement project in a referral hospital.

A project team was formed to reduce the hospital-acquired infection (HAI) rate in the neonatology unit. A new injection policy was implemented according to the root cause identified.

The HAI rate decreased from 6.4 per cent pre-intervention to 4.2 per cent post-intervention. The compliance of performing the aseptic injection technique significantly improved by 60 per cent.

This case study illustrated the detailed application of the SPS approach in establishing a quality improvement project to address HAI and injection technique compliance, cost-effectively. Other departments or hospitals can apply the same approach to improve quality of care.

This study helps inform other hospitals in similar settings, the steps to create a quality improvement project using the SPS approach.

Nomenclature is of fundamental importance in healthcare. Different professionals interpret different terms in different ways. This has implications for measurement, clinical governance, risk management and any comparative studies where clear definitions are not predetermined. A project to determine how aseptic dispensing activity in pharmacies and clinical areas should be measured found this to be the case, primarily between nurses and pharmacists. It was essential to have consistently used terms and definitions for the purposes of the project. A preliminary list was audited with senior staff in clinical areas to ascertain local views and practices. Commonly used alternatives and other relevant terms were identified. The results were validated by a multidisciplinary workshop to determine a final list. Evaluation of these and wider examples highlights the many implications and the need for the issue to be directly addressed, particularly in a multi‐professional environment.

The purpose of this paper is to establish a methodology for the design and development of patient-specific elbow implant with an elastic modulus close to that of the human bone. One of the most preferred implant material is titanium alloy which is about 8 to 9 times higher in strength than that of the human bone and is the closest than other metallic biomedical materials.

The methodology begins with the design of the implant from patient-specific computed tomography information and incorporates the manufacturing of the implant via a novel rapid prototyping assisted microwave sintering process.

The elastic modulus and the flexural strength of the implant were observed to be comparable to that of human elbow bones. The fatigue test depicts that the implant survives the one million cycles under physiological loading conditions. Other mechanical properties such as impact energy absorption, hardness and life cycle tests were also evaluated. The implant surface promotes human cell growth and adhesion and does not cause any adverse or undesired effects i.e. no cytotoxicity.

Stress shielding, and therefore, aseptic loosening of the implant shall be avoided. In the event of any trauma post-implantation, the implant would not hurt the patient.

The present study describes a methodology for the first time to be able to obtain the strength required for the medical implant without sacrificing the fatigue life requirement.

Develops and exemplifies the proposition that the key factors determining the success of packaging innovation can be unified by considering them as consumer driven, technology driven, and distribution driven. The concept of the packaging and distribution mix is developed to show how organisations can respond, through marketing variables under their control, to attempt to gain a competitive advantage over rivals. A packaging optimisation strategy is described, based on a total systems approach, which proposes a balance between the complex mix of external influences.

For upwards of a century the Mother of Parliaments has pioneered social and particularly public health legislation all over the world. The parliamentary democracies planted by Mother England in forty new Englands beyond the seas followed our lead. We have grown accustomed to this and it is now something of a shock to find this is no longer completely true. Except perhaps in housing, we do not lead in this field, but seem to be following. It was always said of the law “You cannot legislate in advance of public opinion!” In the control of food purity and quality, public opinion cannot be the arbiter and for it, there has to be substituted research, technology and scientific knowledge. During recent years, this country has tended to follow the U.S.A. in food control legislation; at least that part of it which deals with chemical treatment and food additives. This casts no reflection on the advances made in Britain, but these are neither adequate nor fast enough to keep abreast of the food technological explosion. The vast research programmes in the U.S.A., are better able to do this; their complaint is not of the shortage of money, only of brains. In the taxed‐to‐death, economic wilderness that is now Britain, we have the brains, but no money. It is hardly surprising that those with brains should seek in foreign fields the rewards and appreciation to which they are entitled.

Approaches for the systematic evaluation of nursing practice are outlined. Practical methods and steps in auditing care at ward and individual patient level are discussed. Standard‐setting at ward level is systematically described and examples given. Monitoring and measuring outcomes and individual patient unit (IPA) are also described.

“Give us the tools …”—one of those clarion calls which will sound down the years, has certainly been answered by the successive Conservative Governments of the past decade when it comes to the legislative tools for those engaged in public health and consumer protection. From the sole standpoint of politics, it seems curious that so much of our social legislation comes from Conservative Governments, rather than Socialist, but looking back, it is obvious that this is so.

As well as the relatively large number of cases of typhoid fever resulting from the Zermatt outbreak, the last few months have seen several outbreaks of both typhoid and paratyphoid in different parts of the country, all having food as the suspected or proven vehicle, except perhaps for the most recent South Shields out‐break, where as yet the source has not been traced, although canned meat is suspected. In small outbreaks it is rarely easy to quickly pin‐point the food vehicle; usually none of the infected food remains; it takes time to confirm clinical diagnoses by bacteriological exam‐ination of sera, faeces, etc., and frequently a food is implicated only by suspicion, although usually based upon good circumstantial evidence.

The main cause of aseptic inflammation after an in vivo implantation is that Poly(L-lactide) (PLLA) and Poly(D-lactide) have a slower degradation and absorption rate, while Poly(D, L-lactide) (PDLLA) has a much faster degradation rate than PLLA because of its amorphous structure. Also, the hydrolyzate of Hydroxyapatite (HA) is alkaline, which can neutralize local tissue peracid caused by hydrolysis of Polylactic acid.

In this study, the selective laser sintering (SLS) technique was chosen to prepare bone scaffolds using nano-HA/PDLLA composite microspheres, which were prepared by the solid-in-oil-in-water (S/O/W) method. First, the SLS parameters range of bulk was determined by the result of a single-layer experiment and the optimized parameters were then obtained by the orthogonal experiment. The tensile property, hydrophobicity, biocompatibility, biological toxicity and in vitro degradation of the samples with optimized SLS parameters were characterized.

As a result, the samples showed a lower tensile strength because of the many holes in their interior, which was conducive to better cell adhesion and nutrient transport. In addition, the samples retained their inherent properties after SLS and the hydrophobicity was improved after adding nano-HA because of the OH group. Furthermore, the samples showed good biocompatibility with the large number of cells adhering to the material through pseudopods and there was no significant difference between the pure PDLLA and 10% HA/PDLLA in terms of biological toxicity. Finally, the degradation rate of the composites could be tailored by the amount of nano-HA.

This study combined the S/O/W and SLS technique and provides a theoretical future basis for the preparation of drug-loaded microsphere scaffolds through SLS using HA/PDLLA composites.

To assess patients' attitude towards information leaflets, their understanding of the given information, and the time factor involved in an out‐patient clinic set‐up.

A total of 50 patients who received depot preparation of Methyl Prednisolone as local injections in an out‐patient hand‐clinic were given 15 minutes to read the patient information leaflet and were simultaneously asked to answer a questionnaire.

Patients want to be informed and are willing to spend more time and effort on information leaflets. Their ability to grasp and retain the relevant information is highly variable. Excess of information, poor presentation/format, lack of time, irrelevant data are factors which seem to adversely affect the effectiveness of information leaflets.

This study gives recommendations to those providing patient care. Emphasises the need for a careful review of all written information with respect to patients' better understanding of the treatment they will receive for the condition being treated.