JACEP
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The hypothesis that the results of process measures of the quality of care would be improved in a busy municipal hospital emergency department by using a medical record audit and reviewing findings with house staff and those responsible for their training was tested over a one year period and, tentatively, rejected. Out of 21 audit items, 14 showed no significant change. Of the remaining seven, only three items showed significant improvement. Other mediating factors are related to quality of care in this setting such as patient/staff ratios, supervision, the focus of training programs, the physical plant, staff attitudes, behavior and questions of control.
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The purpose of this study was to examine the influence of the fluid dynamics of syringe irrigation on the efficacy of wound cleansing and the infection rate of experimental wounds. The pressure experienced by a surface following wound irrigation was directly proportional to the pressure within the syringe and the size of the needle. ⋯ Low pressure irrigation with an asepto syringe did not significantly cleanse the wound of its bacterial contaminants and had no demonstrable clinical merit. On the basis of these studies, high pressure syringe irrigation is being employed routinely in our emergency department for the care of traumatic wounds.