Tidsskrift for den Norske lægeforening : tidsskrift for praktisk medicin, ny række
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Tidsskr. Nor. Laegeforen. · Oct 2007
Comparative Study[Workers' perceptions of safety culture at a hospital].
Little is known about the quality of work practices regarding patient safety and the safety culture as such in the Norwegian health care services. ⋯ The results indicate a need to improve safety culture and patient safety in Norwegian health care.
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Sedation of terminally ill patients is a debated issue. The prescription of sedative drugs to dying patients in a Norwegian unit for palliative care has been studied. ⋯ Drugs that may reduce consciousness are often prescribed to dying patients. As long as the aim is to reduce specific symptoms, this is a natural part of palliative treatment. Documentation with specification for the aim of the treatment is mandatory. This is especially important when consciousness is reduced.
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Stress, acute illness and surgery are known to increase blood sugar. Hyperglycaemia in critically ill patients is associated with increased mortality irrespective of diabetes status. The effect of treating critically ill patients with insulin infusions has been assessed in many randomised trials in recent years. Possible mechanisms related to hyperglycaemia and the effects of insulin have also been studied. ⋯ Insulin therapy is an inexpensive and safe way to improve outcome in critically ill patients. Insulin infusions should therefore be used more to treat hyperglycaemia in critically ill hospitalized patients, especially in coronary care- and intensive care units.
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Pulmonary air-leakage (PAL), especially pneumothorax, is a potentially severe complication of pulmonary disease in newborn infants. It is often related to therapeutic procedures such as resuscitation and mechanical ventilation. ⋯ PAL often occurred spontaneously and shortly after birth in connection with resuscitation and stabilization for respirator treatment. The risk for PAL in mechanically ventilated infants was lower once the start-up process had been completed. In infants who had received porcine surfactant for RDS the incidence of PAL during mechanical ventilation was low.