The effect of implementing a modified early warning scoring (MEWS) system on the adequacy of vital sign documentation

Introduction and objectives Early recognition of deteriorating patients results in better patient outcomes. Modified early warning scores (MEWS) attempt to identify deteriorating patients early so timely interventions can occur thus reducing serious adverse events. We compared frequencies of vital sign recording 24 h post-ICU discharge and 24 h preceding unplanned ICU admission before and after a new observation chart using MEWS and an associated educational programme was implemented into an Australian Tertiary referral hospital in Brisbane. Design Prospective before-and-after intervention study, using a convenience sample of ICU patients who have been discharged to the hospital wards, and in patients with an unplanned ICU admission, during November 2009 (before implementation; n = 69) and February 2010 (after implementation; n = 70). Main outcome measures Any change in a full set or individual vital sign frequency before-and-after the new MEWS observation chart and associated education programme was implemented. A full set of vital signs included Blood pressure (BP), heart rate (HR), temperature (T°), oxygen saturation (SaO2) respiratory rate (RR) and urine output (UO). Results After the MEWS observation chart implementation, we identified a statistically significant increase (210%) in overall frequency of full vital sign set documentation during the first 24 h post-ICU discharge (95% CI 148, 288%, p value <0.001). Frequency of all individual vital sign recordings increased after the MEWS observation chart was implemented. In particular, T° recordings increased by 26% (95% CI 8, 46%, p value = 0.003). An increased frequency of full vital sign set recordings for unplanned ICU admissions were found (44%, 95% CI 2, 102%, p value = 0.035). The only statistically significant improvement in individual vital sign recordings was urine output, demonstrating a 27% increase (95% CI 3, 57%, p value = 0.029). Conclusions The implementation of a new MEWS observation chart plus a supporting educational programme was associated with statistically significant increases in frequency of combined and individual vital sign set recordings during the first 24 h post-ICU discharge. There were no significant changes to frequency of individual vital sign recordings in unplanned admissions to ICU after the MEWS observation chart was implemented, except for urine output. Overall increases in the frequency of full vital sign sets were seen.

Hardware design and implementation of a MAVLink interface for an FPGA-based autonomous UAV flight control system

This paper details the initial design and planning of a Field Programmable Gate Array (FPGA) implemented control system that will enable a path planner to interact with a MAVLink based flight computer. The design is aimed at small Unmanned Aircraft Vehicles (UAV) under autonomous operation which are typically subject to constraints arising from limited on-board processing capabilities, power and size. An FPGA implementation for the de- sign is chosen for its potential to address such limitations through low power and high speed in-hardware computation. The MAVLink protocol offers a low bandwidth interface for the FPGA implemented path planner to communicate with an on-board flight computer. A control system plan is presented that is capable of accepting a string of GPS waypoints generated on-board from a previously developed in- hardware Genetic Algorithm (GA) path planner and feeding them to the open source PX4 autopilot, while simultaneously respond- ing with flight status information.

Optimal sign tests for data from ranked set samples

This paper considers the one-sample sign test for data obtained from general ranked set sampling when the number of observations for each rank are not necessarily the same, and proposes a weighted sign test because observations with different ranks are not identically distributed. The optimal weight for each observation is distribution free and only depends on its associated rank. It is shown analytically that (1) the weighted version always improves the Pitman efficiency for all distributions; and (2) the optimal design is to select the median from each ranked set.

Guidelines on building design and operation to minimize air quality impacts from major roads in transit oriented development

Poor air quality has a huge detrimental effect, both economic and on the quality of life, in Australia. Transit oriented design (TOD), which aims to minimise urban sprawl and lower dependency on vehicles, leads to an increasing number of buildings close to transport corridors. This project aims at providing guidelines that are appropriate to include within City Plan to inform future planning along road corridors, and provide recommendations on when mitigation measures should be utilised.