A randomized, controlled trial to measure the frequency of use of a hospital telephone line for new parents.

New parents have fewer supports today than in previous decades due to factors such as short postpartum hospital stay, fragmentation of services, and long-distance families. This controlled trial evaluated the frequency of use of a 24-hour, in-hospital telephone line by 130 parents randomly invited to use the service and 130 who were not aware of this service. A special line with a separate extension was installed on the postpartum unit. Randomly arranged, sealed envelopes were given to 260 women at the time of discharge, containing a congratulations message or description of a new 24-hour telephone line for advice given by postpartum nurses. Of 53 calls requesting help, 36 were received on the special line and 17 on regular ward telephones; 28 percent of those invited to call back did so, and 13 percent of those without an invitation called on the regular extension, (P = 0.015). Recommendations for future program planning are based on the results of this study.

A review of staphylococcal colonization and infection rates in a family-centred maternity unit 1979-89.

The usefulness of routine bacteriological surveillance of newborns in a family-centred maternity unit is explored. Colonization and infection rates were reviewed for a 10 year period. This review demonstrated a correlation between infection and colonization rates only when the colonization rate with Staphylococcus aureus was greater than 40%. The ability of this unit in the last years of the review to maintain a colonization rate of less than 25% enabled the practice to be discontinued and replaced with random point prevalence determinations, and has provided a method for researching various nursery practices. This review looks at the cost of monitoring Staph aureus colonization and summarizes some of the current practices in this unit.

A study to identify who is the responsible physician for each patient in a teaching hospital.

A one-day study was conducted to confirm evidence of disagreement about which physician was responsible for the care of patients in a teaching hospital. Sixteen percent of the patients reported the responsible physician as someone different from the physician listed on their medical record, and 13% could not provide any physician's name. Significant disagreement was also discovered between the name given by the charge nurse, the patient's identification band, and the face sheet on the patient's chart. Twenty-nine percent of the charts reviewed revealed no documented involvement by the responsible physician within the previous ten days. As a result of the study, the hospital changed its documentation procedures and the hospital and the medical school became aware of the need to improve monitoring of supervision of student physicians.