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Background: Extracorporeal shock wave lithotripsy is an effective treatment for kidney stones which does not require general anaesthesia and can be performed as a daycase procedure. The fragmentation of calculi can be painful and various analgesic regimens have been described. A small minority of our patients are unable to tolerate ESWL with enteral analgesia. We offered a repeat ESWL treatment with remifentanil Patient Controlled Analgesia (R-PCA) to this group.

ABPI: CORRECT TECHNIQUE ESSENTIAL MANAGING EPIDERMOLYSIS BULLOSA OCCLUSIVE DRESSINGS GIVE PAIN RELIEF CYCLE TIMES OF PRODUCTS USED FOR INTERMITTENT COMPRESSION TREATMENT.

Objective: Relative to the global investment in hospital accreditation programs overall, both the total amount and methodological quality of existing accreditation research is mediocre. To address this apparent gap in knowledge, we undertook a study of the experiences and perspectives of hospital staff, those most underrepresented in the accreditation research literature, including those working on the front lines and non-leaders who may or may not have been directly involved in the preparation for the accreditation survey visit.Methods: Design: Qualitative descriptive interview study. Setting: Tertiary care teaching hospital in Toronto, Ontario Canada. Study Participants:  Program directors, unit managers, physicians, nurses, health discipline professionals (HDP), and non-clinical staff.Results: We have grouped what we heard from the data into three major groups of findings which we have titled: a) perceptions of the purpose of accreditation; b) the “work” of accreditation; and c) dissemination gaps regarding results. Informative finding from this study include the fact that participants put surprising value on the accreditation process, although mistaken feel it is mandatory; that the “work” of accreditation can be disappointing and feels disconnected from the bigger QI picture, and that the disconnect also exists in terms of their knowledge of and belief in the actual results of the process.Conclusions: These findings point to potential gaps in the accreditation culture which can be detrimental to the impact of the accreditation process.  Such gaps likely exist in other health care organizations and could inform similar evaluations in other settings.

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