Medication bar coding: to scan or not to scan?

Practical steps for implementing a medication verification system using bar coding are provided. The authors describe the process that a two-hospital system embarked upon to implement a bedside medication verification system. Building blocks of the system are described that made the project successful and met the Patient Safety Goals of the Joint Commission on Accreditation of Healthcare Organizations. The authors identify the "pitfalls" organizations need to be prepared to handle and quantify financial and safety results achieved with this project.     

Taking blood pressure: too important to trust to humans?

The measurement of blood pressure in the physician's office is subject to a number of observer errors and also to the "white-coat effect." Automatic devices that measure blood pressure without a human observer in the room can eliminate many of these problems. We argue for greater use of these devices in the physician's office.     

Unruptured brain aneurysms: when to screen and when to treat?

The detection rate of intracranial aneurysms has increased with the improved availability of non-invasive imaging methods. Moreover, persons who have relatives with intracranial aneurysms increasingly demand imaging to rule out aneurysms. To deal with these problems, radiologists require basic knowledge regarding the detection and treatment of unruptured intracranial aneurysms. The prevalence of aneurysms in the normal population is 2?-?3?%. It increases to 4?-?10?% in persons with one relative with an aneurysm and to about 20?% in persons with two relatives with an aneurysm. The average natural rupture risk is estimated to be 5?% within 5 years of detection. In the individual case it depends on several variables that are discussed here. According to the literature, the risk of endovascular aneurysm treatment is about 5?%. On the basis of these data, the benefit of MRA screening needs to be discussed individually with the patient.     

Family presence during resuscitation: to see or not to see?

Encouraging family presence during resuscitation is controversial. Health care providers should use evidence-based practice to review this issue and be open to the idea of allowing the family to be present. The literature supports family presence during resuscitation and there is insufficient research in opposition to family presence. Health care institutions should revise their practices to coincide with the wants and needs of their patients and families. Nurses have an ethical obligation to intervene and create family presence programs.     

DNA vaccines and apoptosis: to kill or not to kill?

The apoptotic machinery has become the latest target of vaccinologists attempting to improve the efficacy of DNA vaccines. While workers have previously sought to induce apoptotic death in transfected DCs as a means to activate immunity, a new approach (see related article on pages 109–117) instead seeks to delay apoptosis in host DCs after DNA vaccination.