Provision of adequate care

Elimination of absorbed substances may be accomplished by administering multiple dose activated charcoal for poisons with entero-hepatic recirculation or by altering urine pH to promote excretion. Forced diuresis, if warranted, should only be done after carefully exercising precautions such as the provision of adequate hydration and maintaining electrolyte balance. 

Vaccine approval also requires the provision of adequate product labeling to allow health care providers to understand the vaccine s proper use, including its potential benefits and risks, to communicate with patients and parents, and to safely deliver the vaccine to the public. 

There have been disproportionately high numbers of medical specialists compared with generalists since the 1960s. Worldwide, there are approximately five to six generalists for every subspecialist. For various reasons, perhaps most importantly, economics, this ratio is reversed in the American health care system. For well over 20 years, governmental agencies and medical academicians have tried to increase the numbers of primary care providers without significant success. With millions of underinsured Americans, the provision of primary care has become a national priority. Clinical pharmacists must become more involved in the provision of primary patient care. Most clinical pharmacists, however, have not viewed themselves as primary care providers and, therefore, may not feel adequately prepared to become a member of an interdisciplinary primary care team. 

To achieve a high degree of combustion of the waste feed in a combustion system it is necessary to ensure an adequate combustion temperature, a sufficient excess supply of air, an ample mixing of the air and the thermal decomposition gas, and an adequate reaction time. In a successful incinerator design, careful consideration is given to the provision of adequate excess air and the appropriate location of the air supplies the combustion temperature is carefully controlled the gas flow velocities through the combustion chamber are adequately low and the gas and solid waste residence times in the combustion chamber are of sufficient duration. 

Exposure to sexually transmitted diseases (STDs) is also a concern for women who are sexually active. It is estimated that 15 million people in the United States become newly infected annually with an STD.5 Given that not all methods of contraception protect the user adequately against STDs, the provision of proper patient education by health care professionals regarding this risk is absolutely essential. 

Access to a patient s medical records is essential to the provision of collaborative drug therapy management. In fact, it is only under these conditions, wherein the phamiacist has adequate knowledge of the patient and the patient s history, disease states, drug therapy, and laboratory and procedure results, that quality care can be rendered. Much work is being done in this area, via computerization of medical records and network facilitation of electronic data, to ensure this key element is in place to facilitate patient care by health care providers. 

A similar model is used to present the recommended levels of service and personnel from a pharmacy department and hospital perspective. Fundamental serviee includes the use of patient profiles, provision of ready to administer medications and parenterals, and adequate quality improvement programs. Desirable pharmacy services include computerized information management systems and an ICU satellite. Optimal pharmacy department services include a 24-hour satellite, physician order entry, and continuous availability of pharmaceutical care services. This document challenges practitioners and institutions to measure their progress and strive for the deli-... 

A close cooperation between workers and employers is needed for the most effective application of measures. Employers have several responsibilities to fulfll and workers are required to take care of their own safety and that of other persons. This means instruction on safe practices and use of personal protective equipment should be adhered to. At the same time, workers should have the right to obtain information from the employer so as to enable them to take adequate precautions and protect themselves from hazards. This includes the provision of information, training and education. 

In a small number of patients whose respiratory center is depressed by long-term retention of carbon dioxide, injury, or drugs, ventilation is maintained largely by stimulation of carotid and aortic chemoreceptors, commonly referred to as the hypoxic drive. The provision of too much oxygen can depress this drive, resulting in respiratory acidosis. In these cases, supplemental oxygen should be titrated carefully to ensure adequate arterial saturation. If hypoventilation results, then mechanical ventilatory support with or without tracheal intubation should be provided. 

The authors concluded that major differences occurred between the 13 European countries and that these were probably explained by the historical origin of home care in each country, the different impact of commercial companies, and the supervision of insurance companies on doctor s prescriptions. To improve the uniformity and quality of HMV provision, they proposed the establishment of further national registries to improve data collection, a standardized Europe-wide set of guidelines to advice clinicians, and finally a system that would ensure adequate equipment performance and maintenance. 

Although Section 304 satisfied some of the liability concerns, it failed to address health care worker worries about compensation for lost wages due to side effects of the vaccine (27). In addition. Section 304 did not address hospital and health care worker concerns about whether compensation would be adequate for victims of vaccine complications, including victims, such as household contacts, who were not vaccine recipients. Consequently, on April 30, 2003, the President signed a law to compensate health care workers or first responders injured by the preevent smallpox vaccination program. The law established a no-fault fund that had the following provisions (35) ... 

The installed plant should have a minimum of moving parts and those that are essential must be capable of replacement without loss of containment. The materials and methods of fabrication must be chosen and controlled carefully to ensure longevity. Because of the inaccessibility of the plant, careful supervision must be exercised over the siting of sample points and instruments, and adequate provision must be made for supplemental equipment of this nature to be introduced as needed. 

---