Current density mapping and optical flow visualisation of a polymer electrolyte membrane water electrolyser

A polymer electrolyte membrane water electrolyser (PEMWE) employing a segmented current collector made from a printed circuit board (PCB) with optical access to the channel has been demonstrated for the first time. The cell allows the local current density, flow regime and bubble formation dynamics to be studied in real time. Transition is observed from a flow of discrete bubbles at the start of the channel to long bullet shaped bubbles towards the end of the channel associated with a significant increase in local current density

Increasing frailty is associated with higher prevalence and reduced recognition of delirium in older hospitalised inpatients: results of a multi-centre study

Purpose Delirium is a neuropsychiatric disorder delineated by an acute change in cognition, attention, and consciousness. It is common, particularly in older adults, but poorly recognised. Frailty is the accumulation of deficits conferring an increased risk of adverse outcomes. We set out to determine how severity of frailty, as measured using the CFS, affected delirium rates, and recognition in hospitalised older people in the United Kingdom. Methods Adults over 65 years were included in an observational multi-centre audit across UK hospitals, two prospective rounds, and one retrospective note review. Clinical Frailty Scale (CFS), delirium status, and 30-day outcomes were recorded. Results The overall prevalence of delirium was 16.3% (483). Patients with delirium were more frail than patients without delirium (median CFS 6 vs 4). The risk of delirium was greater with increasing frailty [OR 2.9 (1.8–4.6) in CFS 4 vs 1–3; OR 12.4 (6.2–24.5) in CFS 8 vs 1–3]. Higher CFS was associated with reduced recognition of delirium (OR of 0.7 (0.3–1.9) in CFS 4 compared to 0.2 (0.1–0.7) in CFS 8). These risks were both independent of age and dementia. Conclusion We have demonstrated an incremental increase in risk of delirium with increasing frailty. This has important clinical implications, suggesting that frailty may provide a more nuanced measure of vulnerability to delirium and poor outcomes. However, the most frail patients are least likely to have their delirium diagnosed and there is a significant lack of research into the underlying pathophysiology of both of these common geriatric syndromes

Interventions to support safe medication administration by emergency department nurses: an integrative review

Aim: To collate and synthesise current research evidence related to interventions that support safe medication administration by nurses in emergency departments (ED). Introduction: Medications are associated with a higher incidence of adverse events than other healthcare interventions and they remain one of the most common causes of accidental harm to health consumers. Between 5 and 10% of medications administered to acutely unwell patients may include some form of medication administration error. The error rate is particularly high during emergency admissions; perhaps associated with concomitant factors including an increased use of high-risk medications, patient acuity and the high rate of patient turnover. Methods: Five databases were systematically searched to identify studies that described medication administration interventions designed to support ED nurses. 85 studies were identified and screened; 13 were selected for inclusion and quality assessment by two independent reviewers. The studies were analysed using a thematic analysis method and the quality of studies was assessed using the Mixed Methods Assessment Tool v 2011. Results: 11 primary studies and 2 reviews met the inclusion criteria. Types of interventions clustered around four themes: protocols/standardisation (n = 5), education (n = 1), technology (n = 4) and intervention bundles (n = 1). The described interventions were largely context specific with weakness in internal and/or internal validity apparent in most included studies. Conclusions: A very small number of studies have provided evidence for task-specific interventions. However, this review highlights a surprising lack of published evidence describing interventions that can help ED nurses to improve medication administration safety and it identifies a clear need for further research in this speciality area