Clinical pathway intervention compliance and effectiveness when used in the treatment of patients with severe sepsis and septic shock at an Intensive Care Unit in Spain

The purpose of this quasi-experimental study was to assess levels of compliance with the intervention bundles contained in a clinical pathway used in the treatment of patients with severe sepsis and septic shock, and to analyze the pathway’s impact on survival and duration of hospital stays. We used data on 125 patients in an Intensive Care Unit, divided into a control group (N=84) and an intervention group (N=41). Levels of compliance increased from 13.1% to 29.3% in 5 resuscitation bundle interventions and from 14.3% to 22% in 3 monitoring bundle interventions. In-hospital mortality at 28 days decreased by 11.2% and the duration of hospital stay was reduced by 5 days. Although compliance was low, the intervention enhanced adherence to the instructions given in the clinical pathway and we observed a decline in mortality at 28 days and shorter hospital stays.

Acceleration and Deflection Analysis for Class C Edge Protection Systems in Construction Work

The requirements for edge protection systems on most sloped work surfaces (class C, according to EN 13374-2013 code) in construction works are studied in this paper. Maximum deceleration suffered by a falling body and maximum deflection of the protection system were analyzed through finite-element models and confirmed through full-scale experiments. The aim of this work is to determine which value for deflection system entails a safe deceleration for the human body. This value is compared with the requirements given by the current version of EN 13374-2013. An additional series of experiments were done to determine the acceleration linked to minimum deflection required by code (200 mm) during the retention process. According to the obtained results, a modification of this value is recommended. Additionally, a simple design formula for this falling protection system is proposed as a quick tool for the initial steps of design.