WorldWideScience

Sample records for technology error patients

  1. Patient error: a preliminary taxonomy.

    NARCIS (Netherlands)

    Buetow, S.; Kiata, L.; Liew, T.; Kenealy, T.; Dovey, S.; Elwyn, G.

    2009-01-01

    PURPOSE: Current research on errors in health care focuses almost exclusively on system and clinician error. It tends to exclude how patients may create errors that influence their health. We aimed to identify the types of errors that patients can contribute and help manage, especially in primary ca

  2. Orthogonality of inductosyn angle-measuring system error and error-separating technology

    Institute of Scientific and Technical Information of China (English)

    任顺清; 曾庆双; 王常虹

    2003-01-01

    Round inductosyn is widely used in inertial navigation test equipment, and its accuracy has significant effect on the general accuracy of the equipment. Four main errors of round inductosyn,i. e. the first-order long-period (360°) harmonic error, the second-order long-period harmonic error, the first-order short-period harmonic error and the second-order short-period harmonic error, are described, and the orthogonality of these tour kinds of errors is studied. An error separating technology is proposed to separate these four kinds of errors,and in the process of separating the short-period harmonic errors, the arrangement in the order of decimal part of the angle pitch number can be omitted. The effectiveness of the technology proposed is proved through measuring and adjusting the angular errors.

  3. Patient identification errors: the detective in the laboratory.

    Science.gov (United States)

    Salinas, Maria; López-Garrigós, Maite; Lillo, Rosa; Gutiérrez, Mercedes; Lugo, Javier; Leiva-Salinas, Carlos

    2013-11-01

    The eradication of errors regarding patients' identification is one of the main goals for safety improvement. As clinical laboratory intervenes in 70% of clinical decisions, laboratory safety is crucial in patient safety. We studied the number of Laboratory Information System (LIS) demographic data errors registered in our laboratory during one year. The laboratory attends a variety of inpatients and outpatients. The demographic data of outpatients is registered in the LIS, when they present to the laboratory front desk. The requests from the primary care centers (PCC) are made electronically by the general practitioner. A manual step is always done at the PCC to conciliate the patient identification number in the electronic request with the one in the LIS. Manual registration is done through hospital information system demographic data capture when patient's medical record number is registered in LIS. Laboratory report is always sent out electronically to the patient's electronic medical record. Daily, every demographic data in LIS is manually compared to the request form to detect potential errors. Fewer errors were committed when electronic order was used. There was great error variability between PCC when using the electronic order. LIS demographic data manual registration errors depended on patient origin and test requesting method. Even when using the electronic approach, errors were detected. There was a great variability between PCC even when using this electronic modality; this suggests that the number of errors is still dependent on the personnel in charge of the technology. © 2013.

  4. Near field communications technology and the potential to reduce medication errors through multidisciplinary application

    LENUS (Irish Health Repository)

    O’Connell, Emer

    2016-07-01

    Patient safety requires optimal management of medications. Electronic systems are encouraged to reduce medication errors. Near field communications (NFC) is an emerging technology that may be used to develop novel medication management systems.

  5. Reducing Diagnostic Errors through Effective Communication: Harnessing the Power of Information Technology

    Science.gov (United States)

    Naik, Aanand Dinkar; Rao, Raghuram; Petersen, Laura Ann

    2008-01-01

    Diagnostic errors are poorly understood despite being a frequent cause of medical errors. Recent efforts have aimed to advance the "basic science" of diagnostic error prevention by tracing errors to their most basic origins. Although a refined theory of diagnostic error prevention will take years to formulate, we focus on communication breakdown, a major contributor to diagnostic errors and an increasingly recognized preventable factor in medical mishaps. We describe a comprehensive framework that integrates the potential sources of communication breakdowns within the diagnostic process and identifies vulnerable steps in the diagnostic process where various types of communication breakdowns can precipitate error. We then discuss potential information technology-based interventions that may have efficacy in preventing one or more forms of these breakdowns. These possible intervention strategies include using new technologies to enhance communication between health providers and health systems, improve patient involvement, and facilitate management of information in the medical record. PMID:18373151

  6. Trends in Health Information Technology Safety: From Technology-Induced Errors to Current Approaches for Ensuring Technology Safety

    OpenAIRE

    Borycki,Elizabeth

    2013-01-01

    Objectives Health information technology (HIT) research findings suggested that new healthcare technologies could reduce some types of medical errors while at the same time introducing classes of medical errors (i.e., technology-induced errors). Technology-induced errors have their origins in HIT, and/or HIT contribute to their occurrence. The objective of this paper is to review current trends in the published literature on HIT safety. Methods A review and synthesis of the medical and life s...

  7. Patient motion tracking in the presence of measurement errors.

    Science.gov (United States)

    Haidegger, Tamás; Benyó, Zoltán; Kazanzides, Peter

    2009-01-01

    The primary aim of computer-integrated surgical systems is to provide physicians with superior surgical tools for better patient outcome. Robotic technology is capable of both minimally invasive surgery and microsurgery, offering remarkable advantages for the surgeon and the patient. Current systems allow for sub-millimeter intraoperative spatial positioning, however certain limitations still remain. Measurement noise and unintended changes in the operating room environment can result in major errors. Positioning errors are a significant danger to patients in procedures involving robots and other automated devices. We have developed a new robotic system at the Johns Hopkins University to support cranial drilling in neurosurgery procedures. The robot provides advanced visualization and safety features. The generic algorithm described in this paper allows for automated compensation of patient motion through optical tracking and Kalman filtering. When applied to the neurosurgery setup, preliminary results show that it is possible to identify patient motion within 700 ms, and apply the appropriate compensation with an average of 1.24 mm positioning error after 2 s of setup time.

  8. Use of Techno-Anthropologic Approaches in Studying Technology--induced Errors.

    Science.gov (United States)

    Borycki, Elizabeth M; Kushniruk, Andre W

    2015-01-01

    In this book chapter the authors review several Techno-Anthropologic approaches that can be used to improve the quality and safety of health information technology (HIT) by eliminating or reducing the incidence and occurrence of technology-induced errors. Technology-induced errors arise from interactions between health professionals, patients and/or HIT (i.e., software and hardware) and lead to a medical error. Techno-Anthropologic methods can be used to address these types of medical errors before they occur. In this book chapter they are discussed in the context of: (a) how they can be applied to identifying technology-induced errors and (b) how this information can be used to design and implement safer HIT. Important in this chapter is a review of several methods: traditional ethnography, rapid assessment of clinical information systems, video ethnography and photovoice as they are applied to the discovery of potential (i.e., near misses) and actual (i.e., mistakes) technology-induced errors.

  9. Profiles in patient safety: when an error occurs.

    Science.gov (United States)

    Hobgood, Cherri; Hevia, Armando; Hinchey, Paul

    2004-07-01

    Medical error is now clearly established as one of the most significant problems facing the American health care system. Anecdotal evidence, studies of human cognition, and analysis of high-reliability organizations all predict that despite excellent training, human error is unavoidable. When an error occurs and is recognized, providers have a duty to disclose the error. Yet disclosure of error to patients, families, and hospital colleagues is a difficult and/or threatening process for most physicians. A more thorough understanding of the ethical and social contract between physicians and their patients as well as the professional milieu surrounding an error may improve the likelihood of its disclosure. Key among these is the identification of institutional factors that support disclosure and recognize error as an unavoidable part of the practice of medicine. Using a case-based format, this article focuses on the communication of error with patients, families, and colleagues and grounds error disclosure in the cultural milieu of medial ethics.

  10. Medication errors : the impact of prescribing and transcribing errors on preventable harm in hospitalised patients

    NARCIS (Netherlands)

    van Doormaal, J.E.; van der Bemt, P.M.L.A.; Mol, P.G.M.; Egberts, A.C.G.; Haaijer-Ruskamp, F.M.; Kosterink, J.G.W.; Zaal, Rianne J.

    2009-01-01

    Background: Medication errors (MEs) affect patient safety to a significant extent. Because these errors can lead to preventable adverse drug events (pADEs), it is important to know what type of ME is the most prevalent cause of these pADEs. This study determined the impact of the various types of pr

  11. Methods to reduce prescribing errors in elderly patients with multimorbidity

    Directory of Open Access Journals (Sweden)

    Lavan AH

    2016-06-01

    Full Text Available Amanda H Lavan, Paul F Gallagher, Denis O’Mahony Department of Geriatric Medicine, Cork University Hospital, University College Cork, Cork, Ireland Abstract: The global population of multimorbid older people is growing steadily. Multimorbidity is the principal cause of complex polypharmacy, which in turn is the prime risk factor for inappropriate prescribing and adverse drug reactions and events. Those who prescribe for older frailer multimorbid people are particularly prone to committing prescribing errors of various kinds. The causes of prescribing errors in this patient population are multifaceted and complex, including prescribers’ lack of knowledge of aging physiology, geriatric medicine, and geriatric pharmacotherapy, overprescribing that frequently leads to major polypharmacy, inappropriate prescribing, and inappropriate drug omission. This review examines the various ways of minimizing prescribing errors in multimorbid older people. The role of education in physician prescribers and clinical pharmacists, the use of implicit and explicit prescribing criteria designed to improve medication appropriateness in older people, and the application of information and communication-technology systems to minimize errors are discussed in detail. Although evidence to support any single intervention to prevent prescribing errors in multimorbid elderly people is inconclusive or lacking, published data support focused prescriber education in geriatric pharmacotherapy, routine application of STOPP/START (screening tool of older people’s prescriptions/screening tool to alert to right treatment criteria for potentially inappropriate prescribing, electronic prescribing, and close liaison between clinical pharmacists and physicians in relation to structured medication review and reconciliation. Carrying out a structured medication review aimed at optimizing pharmacotherapy in this vulnerable patient population presents a major challenge. Another

  12. Patient safety and technology-driven medication

    DEFF Research Database (Denmark)

    Orbæk, Janne; Gaard, Mette; Keinicke Fabricius, Pia

    2015-01-01

    ways of educating nursing students in today's medication administration. AIM: To explore nursing students' experiences and competences with the technology-driven medication administration process. METHODS: 16 pre-graduate nursing students were included in two focus group interviews which were recorded...... for the technology-driven medication process, nursing students face difficulties in identifying and adopting best practices. The impact of using technology on the frequency, type and severity of medication errors; the technologies implications on nursing professionalism and the nurses ability to secure patient......BACKGROUND: The technology-driven medication process is complex, involving advanced technologies, patient participation and increased safety measures. Medication administration errors are frequently reported, with nurses implicated in 26-38% of in-hospital cases. This points to the need for new...

  13. Disclosing medical errors to patients: effects of nonverbal involvement.

    Science.gov (United States)

    Hannawa, Annegret F

    2014-03-01

    The purpose of this study was to test causal effects of physicians' nonverbal involvement on medical error disclosure outcomes. 216 hospital outpatients were randomly assigned to two experimental treatment groups. The first group watched a video vignette of a verbally effective and nonverbally involved error disclosure. The second group was exposed to a verbally effective but nonverbally uninvolved error disclosure. All patients responded to seven outcome measures. Patients in the nonverbally uninvolved error disclosure treatment group perceived the physician's apology as less sincere and remorseful compared to patients in the involved disclosure group. They also rated the implications of the error as more severe, were more likely to ascribe fault to the physician, and indicated a higher intent to change doctors after the disclosure. The results of this study imply that nonverbal involvement during medical error disclosures facilitates more accurate patient understanding and assessment of the medical error and its consequences on their health and quality of life. In the context of disclosing medical errors, nonverbal involvement increases the likelihood that physicians will be able to continue caring for their patient. Thus, providers are advised to consider adopting this communication skill into their medical practice. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  14. Research on the technology for processing errors of photoelectric theodolite based on error design idea

    Science.gov (United States)

    Guo, Xiaosong; Pu, Pengcheng; Zhou, Zhaofa; Wang, Kunming

    2012-10-01

    The errors existing in photoelectric theodolite were studied according to the error design idea , that is - the correction of theodolite errors was achieved by analyzing the effect of errors actively instead of processing the data with error passively. Aiming at the shafting error, the relationship between different errors was analyzed by the error model based on coordinate transformation, and the real-time error compensation method based on the normal-reversed measuring method and levelness auto-detection was supposed. As to the eccentric error of dial, the idea of eccentric residual error was presented and its influence to measuring precision was studied, then the dynamic compensation model was build, so the influence of eccentric error of dial to measuring precision can be eliminated. For the centering deviation in the process of measuring angle, the compensation method based on the error model was supposed, in which the centering deviation was detected automatically based on computer vision. The above method based on error design idea reduced the influence to measuring result by software compensation method effectively, and improved the automation degree of azimuth angle measuring of theodolite, at the same time the precision was not depressed.

  15. Medication error reduction and the use of PDA technology.

    Science.gov (United States)

    Greenfield, Sue

    2007-03-01

    The purpose of this study was to determine whether nursing medication errors could be reduced and nursing care provided more efficiently using personal digital assistant (PDA) technology. The sample for this study consisted of junior and senior undergraduate baccalaureate nursing students. By self-selection of owning a PDA or not, students were placed in the PDA (experimental) group or the textbook (control) group, provided with a case study to read, and asked to answer six questions (i.e., three medication administration calculations and three clinical decisions based on medication administration). The analysis of collected data, calculated using a t test, revealed that the PDA group answered the six questions with greater accuracy and speed than did the textbook group.

  16. Medical errors and patient safety strategies to reduce and disclose medical errors and improve patient safety

    CERN Document Server

    Kalra, Jay

    2011-01-01

    This book shows with real cases from health care and beyond that most errors come from flaws in the system. It also shows why they don't get reported and how medical error disclosure around the world is shifting away from blaming people to a ?no-fault? model. The book will examine issues that stymie efforts made to reduce preventable adverse events and medical errors, and will moreover highlight their impact on clinical laboratories and other areas. It identifies possible intelligent system approaches that can be adopted to help control and eliminate these errors.

  17. The Impact of Bar Code Medication Administration Technology on Reported Medication Errors

    Science.gov (United States)

    Holecek, Andrea

    2011-01-01

    The use of bar-code medication administration technology is on the rise in acute care facilities in the United States. The technology is purported to decrease medication errors that occur at the point of administration. How significantly this technology affects actual rate and severity of error is unknown. This descriptive, longitudinal research…

  18. ERROR ANALYSIS ON INFORMATION AND TECHNOLOGY STUDENTS’ SENTENCE WRITING ASSIGNMENTS

    Directory of Open Access Journals (Sweden)

    Rentauli Mariah Silalahi

    2015-03-01

    Full Text Available Students’ error analysis is very important for helping EFL teachers to develop their teaching materials, assessments and methods. However, it takes much time and effort from the teachers to do such an error analysis towards their students’ language. This study seeks to identify the common errors made by 1 class of 28 freshmen students studying English in their first semester in an IT university. The data is collected from their writing assignments for eight consecutive weeks. The errors found were classified into 24 types and the top ten most common errors committed by the students were article, preposition, spelling, word choice, subject-verb agreement, auxiliary verb, plural form, verb form, capital letter, and meaningless sentences. The findings about the students’ frequency of committing errors were, then, contrasted to their midterm test result and in order to find out the reasons behind the error recurrence; the students were given some questions to answer in a questionnaire format. Most of the students admitted that careless was the major reason for their errors and lack understanding came next. This study suggests EFL teachers to devote their time to continuously check the students’ language by giving corrections so that the students can learn from their errors and stop committing the same errors.

  19. Detection of Patients at High Risk of Medication Errors

    DEFF Research Database (Denmark)

    Sædder, Eva Aggerholm; Lisby, Marianne; Nielsen, Lars Peter

    2016-01-01

    Medication errors (MEs) are preventable and can result in patient harm and increased expenses in the healthcare system in terms of hospitalization, prolonged hospitalizations and even death. We aimed to develop a screening tool to detect acutely admitted patients at low or high risk of MEs...

  20. Actualities and Development of Heavy-Duty CNC Machine Tool Thermal Error Monitoring Technology

    Science.gov (United States)

    Zhou, Zu-De; Gui, Lin; Tan, Yue-Gang; Liu, Ming-Yao; Liu, Yi; Li, Rui-Ya

    2017-09-01

    Thermal error monitoring technology is the key technological support to solve the thermal error problem of heavy-duty CNC (computer numerical control) machine tools. Currently, there are many review literatures introducing the thermal error research of CNC machine tools, but those mainly focus on the thermal issues in small and medium-sized CNC machine tools and seldom introduce thermal error monitoring technologies. This paper gives an overview of the research on the thermal error of CNC machine tools and emphasizes the study of thermal error of the heavy-duty CNC machine tool in three areas. These areas are the causes of thermal error of heavy-duty CNC machine tool and the issues with the temperature monitoring technology and thermal deformation monitoring technology. A new optical measurement technology called the "fiber Bragg grating (FBG) distributed sensing technology" for heavy-duty CNC machine tools is introduced in detail. This technology forms an intelligent sensing and monitoring system for heavy-duty CNC machine tools. This paper fills in the blank of this kind of review articles to guide the development of this industry field and opens up new areas of research on the heavy-duty CNC machine tool thermal error.

  1. Prevalence of refractive errors in Mexican patients with keratoconus

    Directory of Open Access Journals (Sweden)

    Cruz-Becerril A

    2015-06-01

    Full Text Available Aníbal Cruz-Becerril,1 Alejandra Valdivia,1 Raúl Peralta,2 Ruth N Domínguez-Fernández,1 Marco A Castro-Reyes1 1Instituto Politécnico Nacional, Sección de Estudios de Posgrado e Investigación, Centro Interdisciplinario en Ciencias de la Salud, Unidad Milpa Alta, 2Centro de Investigación en Dinámica Celular, Instituto de Investigación en Ciencias Básicas y Aplicadas, Universidad Autónoma del Estado de Morelos, Cuernavaca, Morelos, México Background: The purpose of this study was to determine the prevalence of refractive errors in Mexican patients with keratoconus (KCN and to describe their clinical characteristics.Methods: In this retrospective study, we reviewed the records of Mexican patients with KCN for the year 2012. Criteria for classifying refractive errors included the following: emmetropia -0.25 to +0.25 sphere, myopia >-0.25 sphere, hyperopia >+0.25 sphere, and astigmatism >-1.00 cylinder. Patient information was collected on refraction results, refractive diagnosis, slit-lamp examination, keratometry values, contact lens features, and best visual acuity with a contact lens. The prevalence of refractive errors was estimated by dividing the total number of eyes in the study by the number of refractive errors found.Results: The study population comprised 426 patients, including 785 eyes with KCN. KCN was found more frequently in males (55.6% than in females. The mean patient age was 28.1±10.3 years, and there was a greater frequency of moderate KCN. Compound myopic astigmatism had a prevalence of 87.3% and was present in all grades, although there are other types of refractive errors. The spherical rigid contact lens was the most frequently adapted lens (96%, and the contact lens parameters varied with disease progression.Conclusion: The most common refractive error is compound myopic astigmatism, although there are many refractive errors that have not been described to date in the KCN population. The main lens used for

  2. Ophthalmologic findings in patients with inborn errors of metabolism

    Directory of Open Access Journals (Sweden)

    Guevara Márquez Yamel Carolina

    2014-07-01

    Full Text Available In patient with inborn errors of metabolism (IEM, the presence of characteristic findings in ophthalmic assessment are important for the diagnosis. The presence of cataracts, cherry-red spot, corneal opacities, corneal crystals, lens dislocation, gyrate atrophy, etc., are some of the ocular abnormalities present in certain IEM. The role of the ophthalmologist in the evaluation of patients with IEM is essential. We describe the most frequent ocular findings in patients with different IEM, which are a diagnostic aid for ophthalmologists and pediatricians.

  3. Reducing medication errors and increasing patient safety: case studies in clinical pharmacology.

    Science.gov (United States)

    Benjamin, David M

    2003-07-01

    is a lot to analyze. Implementing safer practices requires developing safer systems. Many errors occur as a result of poor oral or written communications. Enhanced communication skills and better interactions among members of the health care team and the patient are essential. The informed consent process should be used as a patient safety tool, and the patient should be warned about material and foreseeable serious side effects and be told what signs and symptoms should be immediately reported to the physician before the patient is forced to go to the emergency department for urgent or emergency care. Last, reducing medication errors is an ongoing process of quality improvement. Faculty systems must be redesigned, and seamless, computerized integrated medication delivery must be instituted by health care professionals adequately trained to use such technological advances. Sloppy handwritten prescriptions should be replaced by computerized physician order entry, a very effective technique for reducing prescribing/ordering errors, but another far less expensive yet effective change would involve writing all drug orders in plain English, rather than continuing to use the elitists' arcane Latin words and shorthand abbreviations that are subject to misinterpretation. After all, effective communication is best accomplished when it is clear and simple.

  4. Surgical errors and risks - the head and neck cancer patient.

    Science.gov (United States)

    Harréus, Ulrich

    2013-12-13

    Head and neck surgery is one of the basic principles of head and neck cancer therapy. Surgical errors and malpractice can have fatal consequences for the treated patients. It can lead to functional impairment and has impact in future chances for disease related survival. There are many risks for head and neck surgeons that can cause errors and malpractice. To avoid surgical mistakes, thorough preoperative management of patients is mandatory. As there are ensuring operability, cautious evaluation of preoperative diagnostics and operative planning. Moreover knowledge of anatomical structures of the head and neck, of the medical studies and data as well as qualification in modern surgical techniques and the surgeons ability for critical self assessment are basic and important prerequisites for head and neck surgeons in order to make out risks and to prevent from mistakes. Additionally it is important to have profound knowledge in nutrition management of cancer patients, wound healing and to realize and to be able to deal with complications, when they occur. Despite all precaution and surgical care, errors and mistakes cannot always be avoided. For that it is important to be able to deal with mistakes and to establish an appropriate and clear communication and management for such events. The manuscript comments on recognition and prevention of risks and mistakes in the preoperative, operative and postoperative phase of head and neck cancer surgery.

  5. Error compensation algorithm for patient positioning robotics system

    Science.gov (United States)

    Murty, Pilaka V.; Talpasanu, Ilie; Roz, Mugur A.

    2009-03-01

    Surgeons in various medical areas (orthopedic surgery, neurosurgery, dentistry etc.) are using motor-driven drilling tools to make perforations in hard tissues (bone, enamel, dentine, cementum etc.) When the penetration requires very precise angles and accurate alignment with respect to different targets, precision cannot be obtained by using visual estimation and hand-held tools. Robots have been designed to allow for very accurate relative positioning of the patient and the surgical tools, and in certain classes of applications the location of bone target and inclination of the surgical tool can be accurately specified with respect to an inertial frame of reference. However, patient positioning errors as well as position changes during surgery can jeopardize the precision of the operation, and drilling parameters have to be dynamically adjusted. In this paper the authors present a quantitative method to evaluate the corrected position and inclination of the drilling tool, to account for translational and rotational errors in displaced target position. The compensation algorithm applies principles of inverse kinematics wherein a faulty axis in space caused by the translational and rotational errors of the target position is identified with an imaginary true axis in space by enforcing identity through a modified trajectory. In the absence of any specific application, this algorithm is verified on Solid Works, a commercial CAD tool and found to be correct. An example problem given at the end vindicates this statement.

  6. TWO-COORDINATE DUAL-SERVO CONTOUR ERROR COMPENSATION TECHNOLOGY FOR ULTRA-PRECISION MANUFACTURING

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    A technology of two-coordinate dual-servo(TCDS)is proposed. Using this technology which is based on error compensation, workpieces of higher contour accuracy could be turned on ultra-precision machine tool with poor dynamic performances. The principle, constitute and operation of a TCDS system are described.Mathematical proof and experiments are achieved in addition.

  7. Avoiding Errors in the Management of Pediatric Polytrauma Patients.

    Science.gov (United States)

    Chin, Kenneth; Abzug, Joshua; Bae, Donald S; Horn, Bernard D; Herman, Martin; Eberson, Craig P

    2016-01-01

    Management of pediatric polytrauma patients is one of the most difficult challenges for orthopaedic surgeons. Multisystem injuries frequently include complex orthopaedic surgical problems that require intervention. The physiology and anatomy of children and adolescent trauma patients differ from the physiology and anatomy of an adult trauma patient, which alters the types of injuries sustained and the ideal methods for management. Errors of pediatric polytrauma care are included in two broad categories: missed injuries and inadequate fracture treatment. Diagnoses may be missed most frequently because of a surgeon's inability to reliably assess patients who have traumatic brain injuries and painful distracting injuries. Cervical spine injuries are particularly difficult to identify in a child with polytrauma and may have devastating consequences. In children who have multiple injuries, the stabilization of long bone fractures with pediatric fixation techniques, such as elastic nails and other implants, allows for easier care and more rapid mobilization compared with cast treatments. Adolescent polytrauma patients who are approaching skeletal maturity, however, are ideally treated as adults to avoid complications, such as loss of fixation, and to speed rehabilitation.

  8. Correcting image placement errors using registration control (RegC®) technology in the photomask periphery

    Science.gov (United States)

    Cohen, Avi; Lange, Falk; Ben-Zvi, Guy; Graitzer, Erez; Vladimir, Dmitriev

    2012-11-01

    The ITRS roadmap specifies wafer overlay control as one of the major tasks for the sub 40 nm nodes in addition to CD control and defect control. Wafer overlay is strongly dependent on mask image placement error (registration errors or Reg errors)1. The specifications for registration or mask placement accuracy are significantly tighter in some of the double patterning techniques (DPT). This puts a heavy challenge on mask manufacturers (mask shops) to comply with advanced node registration specifications. The conventional methods of feeding back the systematic registration error to the E-beam writer and re-writing the mask are becoming difficult, expensive and not sufficient for the advanced nodes especially for double pattering technologies. Six production masks were measured on a standard registration metrology tool and the registration errors were calculated and plotted. Specially developed algorithm along with the RegC Wizard (dedicated software) was used to compute a correction lateral strain field that would minimize the registration errors. This strain field was then implemented in the photomask bulk material using an ultra short pulse laser based system. Finally the post process registration error maps were measured and the resulting residual registration error field with and without scale and orthogonal errors removal was calculated. In this paper we present a robust process flow in the mask shop which leads up to 32% registration 3sigma improvement, bringing some out-of-spec masks into spec, utilizing the RegC® process in the photomask periphery while leaving the exposure field optically unaffected.

  9. Preventing technology-induced errors in healthcare: the role of simulation.

    Science.gov (United States)

    Kushniruk, Andre W; Borycki, Elizabeth M; Anderson, James G; Anderson, Marilyn M

    2009-01-01

    We describe a novel approach to the study and prediction of technology-induced error in healthcare. The objective of our approach is to identify and reduce the potential for error so that the benefits of introducing information technology, such as Computerized Physician Order Entry (CPOE) or Electronic Health Records (EHRs), are maximized. The approach involves four phases. In Phase 1, we typically conduct small scale clinical simulations to assess whether or not the use of a new information technology can introduce error. (Human subjects are involved and user-system interactions are recorded.) In Phase 2, we analyze the results from Phase 1 to identify statistically significant relationships between usability issues and the occurrence of error (e.g., medication error). In Phase 3, we enter the results from Phase 2 into computer-based simulation models to explore the potential impact of the technology over time and across user populations. In Phase 4, we conduct naturalistic studies to examine whether or not the predictions made in Phases 2 and 3 apply to the real world. In closing, we discuss how the approach can be used to increase the safety of health information systems.

  10. Anticoagulant medication errors in nursing homes: characteristics, causes, outcomes, and association with patient harm.

    Science.gov (United States)

    Desai, Rishi J; Williams, Charlotte E; Greene, Sandra B; Pierson, Stephanie; Hansen, Richard A

    2013-01-01

    Appropriate and safe use of medications is an important aspect of quality of care in nursing home patients. Because of their complex medication use process, anticoagulants are prone to medication errors in the frail elderly. Therefore, we designed this study to characterize anticoagulant medication errors and to evaluate their association with patient harm using individual medication error incidents reported by all North Carolina nursing homes to the Medication Error Quality Initiative (MEQI) during fiscal years 2010-2011. Characteristics, causes, and specific outcomes of harmful anticoagulant medication errors were reported as frequencies and proportions and compared between anticoagulant errors and other medication errors using chi-square tests. A multivariate logistic regression model explored the relationship between anticoagulant medication errors and patient harm, controlling for patient- and error-related factors.

  11. Mechanical Coupling Error Suppression Technology for an Improved Decoupled Dual-Mass Micro-Gyroscope

    Directory of Open Access Journals (Sweden)

    Bo Yang

    2016-04-01

    Full Text Available This paper presents technology for the suppression of the mechanical coupling errors for an improved decoupled dual-mass micro-gyroscope (DDMG. The improved micro-gyroscope structure decreases the moment arm of the drive decoupled torque, which benefits the suppression of the non-ideal decoupled error. Quadrature correction electrodes are added to eliminate the residual quadrature error. The structure principle and the quadrature error suppression means of the DDMG are described in detail. ANSYS software is used to simulate the micro-gyroscope structure to verify the mechanical coupling error suppression effect. Compared with the former structure, simulation results demonstrate that the rotational displacements of the sense frame in the improved structure are substantially suppressed in the drive mode. The improved DDMG structure chip is fabricated by the deep dry silicon on glass (DDSOG process. The feedback control circuits with quadrature control loops are designed to suppress the residual mechanical coupling error. Finally, the system performance of the DDMG prototype is tested. Compared with the former DDMG, the quadrature error in the improved dual-mass micro-gyroscope is decreased 9.66-fold, and the offset error is decreased 6.36-fold. Compared with the open loop sense, the feedback control circuits with quadrature control loop decrease the bias drift by 20.59-fold and the scale factor non-linearity by 2.81-fold in the ±400°/s range.

  12. Mechanical Coupling Error Suppression Technology for an Improved Decoupled Dual-Mass Micro-Gyroscope.

    Science.gov (United States)

    Yang, Bo; Wang, Xingjun; Deng, Yunpeng; Hu, Di

    2016-01-01

    This paper presents technology for the suppression of the mechanical coupling errors for an improved decoupled dual-mass micro-gyroscope (DDMG). The improved micro-gyroscope structure decreases the moment arm of the drive decoupled torque, which benefits the suppression of the non-ideal decoupled error. Quadrature correction electrodes are added to eliminate the residual quadrature error. The structure principle and the quadrature error suppression means of the DDMG are described in detail. ANSYS software is used to simulate the micro-gyroscope structure to verify the mechanical coupling error suppression effect. Compared with the former structure, simulation results demonstrate that the rotational displacements of the sense frame in the improved structure are substantially suppressed in the drive mode. The improved DDMG structure chip is fabricated by the deep dry silicon on glass (DDSOG) process. The feedback control circuits with quadrature control loops are designed to suppress the residual mechanical coupling error. Finally, the system performance of the DDMG prototype is tested. Compared with the former DDMG, the quadrature error in the improved dual-mass micro-gyroscope is decreased 9.66-fold, and the offset error is decreased 6.36-fold. Compared with the open loop sense, the feedback control circuits with quadrature control loop decrease the bias drift by 20.59-fold and the scale factor non-linearity by 2.81-fold in the ±400°/s range.

  13. Visual memory errors in Parkinson's disease patient with visual hallucinations.

    Science.gov (United States)

    Barnes, J; Boubert, L

    2011-03-01

    The occurrences of visual hallucinations seem to be more prevalent in low light and hallucinators tend to be more prone to false positive type errors in memory tasks. Here we investigated whether the richness of stimuli does indeed affect recognition differently in hallucinating and nonhallucinating participants, and if so whether this difference extends to identifying spatial context. We compared 36 Parkinson's disease (PD) patients with visual hallucinations, 32 Parkinson's patients without hallucinations, and 36 age-matched controls, on a visual memory task where color and black and white pictures were presented at different locations. Participants had to recognize the pictures among distracters along with the location of the stimulus. Findings revealed clear differences in performance between the groups. Both PD groups had impaired recognition compared to the controls, but those with hallucinations were significantly more impaired on black and white than on color stimuli. In addition, the group with hallucinations was significantly impaired compared to the other two groups on spatial memory. We suggest that not only do PD patients have poorer recognition of pictorial stimuli than controls, those who present with visual hallucinations appear to be more heavily reliant on bottom up sensory input and impaired on spatial ability.

  14. Patient-empowerment interactive technologies.

    Science.gov (United States)

    Bruggers, Carol S; Altizer, Roger A; Kessler, Robert R; Caldwell, Craig B; Coppersmith, Kurt; Warner, Laura; Davies, Brandon; Paterson, Wade; Wilcken, Jordan; D'Ambrosio, Troy A; German, Massiell L; Hanson, Glen R; Gershan, Lynn A; Korenberg, Julie R; Bulaj, Grzegorz

    2012-09-19

    Video games capture the rapt attention of an individual player's mind and body, providing new opportunities for personalized health care. An example of therapeutic interactive technologies is an incentive-based video game that translates physical exercise into mental empowerment via motivational metaphoric visualization in order to help patients psychologically overcome cancer. Such nonpharmacological interventions may enhance patients' resilience toward various chronic disorders via neuronal mechanisms that activate positive emotions and the reward system.

  15. Avoiding and identifying errors in health technology assessment models: qualitative study and methodological review.

    Science.gov (United States)

    Chilcott, J; Tappenden, P; Rawdin, A; Johnson, M; Kaltenthaler, E; Paisley, S; Papaioannou, D; Shippam, A

    2010-05-01

    Health policy decisions must be relevant, evidence-based and transparent. Decision-analytic modelling supports this process but its role is reliant on its credibility. Errors in mathematical decision models or simulation exercises are unavoidable but little attention has been paid to processes in model development. Numerous error avoidance/identification strategies could be adopted but it is difficult to evaluate the merits of strategies for improving the credibility of models without first developing an understanding of error types and causes. The study aims to describe the current comprehension of errors in the HTA modelling community and generate a taxonomy of model errors. Four primary objectives are to: (1) describe the current understanding of errors in HTA modelling; (2) understand current processes applied by the technology assessment community for avoiding errors in development, debugging and critically appraising models for errors; (3) use HTA modellers' perceptions of model errors with the wider non-HTA literature to develop a taxonomy of model errors; and (4) explore potential methods and procedures to reduce the occurrence of errors in models. It also describes the model development process as perceived by practitioners working within the HTA community. A methodological review was undertaken using an iterative search methodology. Exploratory searches informed the scope of interviews; later searches focused on issues arising from the interviews. Searches were undertaken in February 2008 and January 2009. In-depth qualitative interviews were performed with 12 HTA modellers from academic and commercial modelling sectors. All qualitative data were analysed using the Framework approach. Descriptive and explanatory accounts were used to interrogate the data within and across themes and subthemes: organisation, roles and communication; the model development process; definition of error; types of model error; strategies for avoiding errors; strategies for

  16. Error Types and Error Positions in Neglect Dyslexia: Comparative Analyses in Neglect Patients and Healthy Controls

    Science.gov (United States)

    Weinzierl, Christiane; Kerkhoff, Georg; van Eimeren, Lucia; Keller, Ingo; Stenneken, Prisca

    2012-01-01

    Unilateral spatial neglect frequently involves a lateralised reading disorder, neglect dyslexia (ND). Reading of single words in ND is characterised by left-sided omissions and substitutions of letters. However, it is unclear whether the distribution of error types and positions within a word shows a unique pattern of ND when directly compared to…

  17. Chemotherapeutic errors in hospitalised cancer patients: attributable damage and extra costs

    Science.gov (United States)

    2011-01-01

    Background In spite of increasing efforts to enhance patient safety, medication errors in hospitalised patients are still relatively common, but with potentially severe consequences. This study aimed to assess antineoplastic medication errors in both affected patients and intercepted cases in terms of frequency, severity for patients, and costs. Methods A 1-year prospective study was conducted in order to identify the medication errors that occurred during chemotherapy treatment of cancer patients at a French university hospital. The severity and potential consequences of intercepted errors were independently assessed by two physicians. A cost analysis was performed using a simulation of potential hospital stays, with estimations based on the costs of diagnosis-related groups. Results Among the 6, 607 antineoplastic prescriptions, 341 (5.2%) contained at least one error, corresponding to a total of 449 medication errors. However, most errors (n = 436) were intercepted before medication was administered to the patients. Prescription errors represented 91% of errors, followed by pharmaceutical (8%) and administration errors (1%). According to an independent estimation, 13.4% of avoided errors would have resulted in temporary injury and 2.6% in permanent damage, while 2.6% would have compromised the vital prognosis of the patient, with four to eight deaths thus being avoided. Overall, 13 medication errors reached the patient without causing damage, although two patients required enhanced monitoring. If the intercepted errors had not been discovered, they would have resulted in 216 additional days of hospitalisation and cost an estimated annual total of 92, 907€, comprising 69, 248€ (74%) in hospital stays and 23, 658€ (26%) in additional drugs. Conclusion Our findings point to the very small number of chemotherapy errors that actually reach patients, although problems in the chemotherapy ordering process are frequent, with the potential for being dangerous and

  18. Errors and surprise in patients with focal brain lesions

    NARCIS (Netherlands)

    Ullsperger, M.

    2016-01-01

    Recent theories of performance monitoring suggest that not only errors and negative action outcomes but also valence-free expectancy violations can trigger cognitive and behavioral adaptations. EEG and fMRI evidence suggests that monitoring of both errors and surprising but valence-free action

  19. Brain State Before Error Making in Young Patients With Mild Spastic Cerebral Palsy.

    Science.gov (United States)

    Hakkarainen, Elina; Pirilä, Silja; Kaartinen, Jukka; van der Meere, Jaap J

    2015-10-01

    In the present experiment, children with mild spastic cerebral palsy and a control group carried out a memory recognition task. The key question was if errors of the patient group are foreshadowed by attention lapses, by weak motor preparation, or by both. Reaction times together with event-related potentials associated with motor preparation (frontal late contingent negative variation), attention (parietal P300), and response evaluation (parietal error-preceding positivity) were investigated in instances where 3 subsequent correct trials preceded an error. The findings indicated that error responses of the patient group are foreshadowed by weak motor preparation in correct trials directly preceding an error. © The Author(s) 2015.

  20. Strategies for improving patient safety: linking task type to error type.

    Science.gov (United States)

    Mattox, Elizabeth Andersson

    2012-02-01

    This article reviews the connection between task type (skill based, rule based and knowledge based) and human error. Using real-life examples, each task type and error type is described in detail. Understanding how task type contributes to medical error enhances the ability of nurses to make meaningful changes in health care systems. Through error wisdom, nurses and other health care providers can more successfully navigate health care delivery and ultimately provide safer care to patients.

  1. [Communication of medical errors to patients: questions and tools].

    Science.gov (United States)

    Bascuñán, María Luz; Arriagada, Ana María

    2016-09-01

    For several years and in many different ways, medical errors have been studied. As expected, the majority of efforts have been directed to prevent clinical errors during the different phases of health care. Nevertheless, less attention has been given to what happens when a negative effect has already occurred. The present work describes the doubts and difficulties that doctors deal with when facing an error and to describe the communicational tools that the literature offers to cope with them. The definition of medical error was the starting point that was used to later analyze the evidence about what, why and how to inform medical errors from an ethical and technical point of view. In the light of new legal exigencies, communicational and health protocols are revised, distinguishing those that are used for conveying bad news and medical errors. The importance of the ethical and communicational formation of the professionals is emphasized, identifying certain hindering aspects of the medical culture. This culture promotes an idea of the doctor as a professional who knows everything, does not make mistakes and acts in isolation. These do not reflect personal attributes in the professional and in the health team, required for a good professional practice.

  2. Improving Patients\\\\\\' Care through Electronic Medical Error Reporting System

    Directory of Open Access Journals (Sweden)

    Fatemeh Rangraz Jeddi

    2015-06-01

    Full Text Available Medical errors are unintentional acts that take place due to the negligence or lead to undesirable consequences in medical practice. The purpose of this study was to design a conceptual model for medical error reporting system. This applied descriptive cross-sectional research employed Delphi method carried out from 2012 to 2013. The study population was medical and paramedical personnel of health workers and paramedical personnel of hospitals, deputy of treatment, faculty members of Kashan University of Medical Sciences in addition to the internet and library resources. Sample size included 30 expert individuals in the field of medical errors. The one-stage stratified sampling procedure was used. The items with opposition ranging 0 to 25 were confirmed and those exceeding 50 were rejected whereas the items with the opposition 25 to 50 were reevaluated in the second session. This process continued for three times and the items that failed to be approved were eliminated in the model. Based on the results of this research, repeated informing about and reporting operation at on-line bases that have access to the incidence of error detected on time, identifying cause and damage due to the incidence reported confidential and anonymously immediately after the occurrence is necessary. Analysis of data quantitatively and qualitatively by using computer software is needed. Classifying the errors reports based on feedback provision according to the cause of error is needed. In addition, confidential report and possible manual retrieval were suggested It is essential to determine the means of reporting and items in the reporting form including time, cause and damage of medical error, media of reporting and method of recording and analysis.

  3. Information technology for patient empowerment in healthcare

    CERN Document Server

    Grando, Maria Adela; Bates, David

    2015-01-01

    The authors explore novel information-based mechanisms that are changing the way patients are involved in their own health care. The book covers models, frameworks and technologies to improve patient-to-provider communication, patient interaction with information technologies, patient education and involvement in health care decision processes, and patient access, understanding and control over their clinical data.

  4. Approaches to reducing the most important patient errors in primary health-care: patient and professional perspectives.

    NARCIS (Netherlands)

    Buetow, S.; Kiata, L.; Liew, T.; Kenealy, T.; Dovey, S.; Elwyn, G.

    2010-01-01

    We have previously reported a preliminary taxonomy of patient error. However, approaches to managing patients' contribution to error have received little attention in the literature. This paper aims to assess how patients and primary care professionals perceive the relative importance of different p

  5. Nurses' Behaviors and Visual Scanning Patterns May Reduce Patient Identification Errors

    Science.gov (United States)

    Marquard, Jenna L.; Henneman, Philip L.; He, Ze; Jo, Junghee; Fisher, Donald L.; Henneman, Elizabeth A.

    2011-01-01

    Patient identification (ID) errors occurring during the medication administration process can be fatal. The aim of this study is to determine whether differences in nurses' behaviors and visual scanning patterns during the medication administration process influence their capacities to identify patient ID errors. Nurse participants (n = 20)…

  6. Relating faults in diagnostic reasoning with diagnostic errors and patient harm.

    NARCIS (Netherlands)

    Zwaan, L.; Thijs, A.; Wagner, C.; Wal, G. van der; Timmermans, D.R.M.

    2012-01-01

    Purpose: The relationship between faults in diagnostic reasoning, diagnostic errors, and patient harm has hardly been studied. This study examined suboptimal cognitive acts (SCAs; i.e., faults in diagnostic reasoning), related them to the occurrence of diagnostic errors and patient harm, and studied

  7. Improving reliability of non-volatile memory technologies through circuit level techniques and error control coding

    Science.gov (United States)

    Yang, Chengen; Emre, Yunus; Cao, Yu; Chakrabarti, Chaitali

    2012-12-01

    Non-volatile resistive memories, such as phase-change RAM (PRAM) and spin transfer torque RAM (STT-RAM), have emerged as promising candidates because of their fast read access, high storage density, and very low standby power. Unfortunately, in scaled technologies, high storage density comes at a price of lower reliability. In this article, we first study in detail the causes of errors for PRAM and STT-RAM. We see that while for multi-level cell (MLC) PRAM, the errors are due to resistance drift, in STT-RAM they are due to process variations and variations in the device geometry. We develop error models to capture these effects and propose techniques based on tuning of circuit level parameters to mitigate some of these errors. Unfortunately for reliable memory operation, only circuit-level techniques are not sufficient and so we propose error control coding (ECC) techniques that can be used on top of circuit-level techniques. We show that for STT-RAM, a combination of voltage boosting and write pulse width adjustment at the circuit-level followed by a BCH-based ECC scheme can reduce the block failure rate (BFR) to 10-8. For MLC-PRAM, a combination of threshold resistance tuning and BCH-based product code ECC scheme can achieve the same target BFR of 10-8. The product code scheme is flexible; it allows migration to a stronger code to guarantee the same target BFR when the raw bit error rate increases with increase in the number of programming cycles.

  8. Discussing harm-causing errors with patients: an ethics primer for plastic surgeons.

    Science.gov (United States)

    Vercler, Christian J; Buchman, Steven R; Chung, Kevin C

    2015-02-01

    Plastic surgery is a field that demands perfection, yet despite our best efforts errors occur every day. Most errors are minor, but occasionally patients are harmed by our mistakes. Although there is a strong ethical requirement for full disclosure of medical errors, data suggest that surgeons have a difficult time disclosing errors and apologizing. "Conventional wisdom" has been to avoid frank discussion of errors with patients. This concept is fueled by the fear of litigation and the notion that any expression of apology leads to malpractice suits. Recently, there has been an increase in the literature pointing to the inadequacy of this approach. Policies that require disclosure of harm-causing medical errors to the patient and the family, apology, and an offer of compensation cultivate the transparency necessary for quality improvement efforts as well as the positive moral development of trainees. There is little published in the plastic surgery literature regarding error disclosure to provide guidance to practitioners. In this article, we will review the ethical, therapeutic, and practical issues involved in discussing the error with the patient and apologizing by presenting a representative case. This primer will provide an understanding of the definition of medical error, the ethical support of error disclosure, the barriers to disclosure, and how to overcome those barriers.

  9. Reducing patient identification errors related to glucose point-of-care testing

    Directory of Open Access Journals (Sweden)

    Gaurav Alreja

    2011-01-01

    Full Text Available Background: Patient identification (ID errors in point-of-care testing (POCT can cause test results to be transferred to the wrong patient′s chart or prevent results from being transmitted and reported. Despite the implementation of patient barcoding and ongoing operator training at our institution, patient ID errors still occur with glucose POCT. The aim of this study was to develop a solution to reduce identification errors with POCT. Materials and Methods: Glucose POCT was performed by approximately 2,400 clinical operators throughout our health system. Patients are identified by scanning in wristband barcodes or by manual data entry using portable glucose meters. Meters are docked to upload data to a database server which then transmits data to any medical record matching the financial number of the test result. With a new model, meters connect to an interface manager where the patient ID (a nine-digit account number is checked against patient registration data from admission, discharge, and transfer (ADT feeds and only matched results are transferred to the patient′s electronic medical record. With the new process, the patient ID is checked prior to testing, and testing is prevented until ID errors are resolved. Results: When averaged over a period of a month, ID errors were reduced to 3 errors/month (0.015% in comparison with 61.5 errors/month (0.319% before implementing the new meters. Conclusion: Patient ID errors may occur with glucose POCT despite patient barcoding. The verification of patient identification should ideally take place at the bedside before testing occurs so that the errors can be addressed in real time. The introduction of an ADT feed directly to glucose meters reduced patient ID errors in POCT.

  10. Evaluation of positioning errors of the patient using cone beam CT megavoltage; Evaluacion de errores de posicionamiento del paciente mediante Cone Beam CT de megavoltaje

    Energy Technology Data Exchange (ETDEWEB)

    Garcia Ruiz-Zorrilla, J.; Fernandez Leton, J. P.; Zucca Aparicio, D.; Perez Moreno, J. M.; Minambres Moro, A.

    2013-07-01

    Image-guided radiation therapy allows you to assess and fix the positioning of the patient in the treatment unit, thus reducing the uncertainties due to the positioning of the patient. This work assesses errors systematic and errors of randomness from the corrections made to a series of patients of different diseases through a protocol off line of cone beam CT (CBCT) megavoltage. (Author)

  11. Medication errors in HIV-infected hospitalized patients: a pharmacist's impact.

    Science.gov (United States)

    Eginger, Kristin H; Yarborough, Laura L; Inge, Lisa DeVito; Basile, Sharon A; Floresca, Donald; Aaronson, Patrick M

    2013-01-01

    Treatment with highly active antiretroviral therapy (HAART) decreases morbidity and mortality associated with HIV infection. Unfortunately, HAART medication errors are prevalent in hospitalized patients with HIV infection. Appropriate regimen administration and adherence are essential for treatment success. To assess the impact of pharmacist interventions on the rate of medication errors in HIV-infected hospitalized patients who had been prescribed HAART in the outpatient setting. Hospitalized patients aged 18 years or older receiving HAART and/or opportunistic infection (OI) prophylaxis were screened for inclusion. Data collection for each enrolled patient included demographic information, pertinent laboratory results, and inpatient and outpatient medication regimens. Patient medication profiles were reviewed within 72 hours of admission. HAART and/or OI prophylaxis errors were classified by type and frequency. Following the pharmacist intervention, prescribers' responses to each recommendation and the estimated time per intervention were recorded. Eighty-six patients were included in this investigation and 210 HAART and OI prophylaxis errors were documented. Of patients receiving HAART and/or OI prophylaxis, 54.7% had at least 1 medication error on admission. An average of 2.4 errors per patient was identified. Dose omission (45.5%) was the most common error type among combined HAART and OI prophylaxis regimens, followed by incorrect regimen (17.1%) and incorrect dose (15.1%). Prescribers accepted 90% of pharmacist recommendations. A pharmacist was able to amend 94.7% of correctable HAART errors, as well as 89.9% of correctable combined HAART and OI prophylaxis errors. An estimated 18.5 minutes of pharmacist time were spent per patient requiring an intervention. A clinical pharmacist's targeted review of outpatient-prescribed HAART and/or OI primary prophylaxis regimens of hospitalized HIV-infected patients can reduce most medication errors during hospitalization.

  12. Relationship between incident types and impact on patients in drug name errors: a correlational study.

    Science.gov (United States)

    Tsuji, Toshikazu; Irisa, Toshihiro; Ohata, Shunichi; Kokubu, Chiyo; Kanaya, Akiko; Sueyasu, Masanori; Egashira, Nobuaki; Masuda, Satohiro

    2015-01-01

    There are many reports regarding various medical institutions' attempts at incident prevention, but the relationship between incident types and impact on patients in drug name errors has not been studied. Therefore, we analyzed the relationship between them, while also assessing the relationship between preparation and inspection errors. Furthermore, the present study aimed to clarify the incident types that lead to severe patient damage. The investigation object in this study was restricted to "drug name errors", preparation and inspection errors in them were classified into three categories (similarity of drug efficacy, similarity of drug name, similarity of drug appearance) or two groups (drug efficacy similarity (+) group, drug efficacy similarity (-) group). Then, the relationship between preparation and inspection errors was investigated in three categories, the relationship between incident types and impact on patients was examined in two groups. The frequency of preparation errors was liable to be caused by the following order: similarity of drug efficacy > similarity of drug name > similarity of drug appearance. In contrast, the rate of inspection errors was liable to be caused by the following order: similarity of drug efficacy < similarity of drug name < similarity of drug appearance. In addition, the number of preparation errors in the drug efficacy similarity (-) group was fewer than that in the drug efficacy similarity (+) group. However, the rate of inspection errors in the drug efficacy similarity (-) group was significantly higher than that in the drug efficacy similarity (+) group. Furthermore, the occupancy rate of preparation errors, incidents more than Level 0, 1, and 2 in the drug efficacy similarity (-) group increased gradually according to the rise of patient damage. Our results suggest that preparation errors caused by the similarity of drug appearance and/or drug name are likely to lead to the incidents (inspection errors

  13. RETROSPECTIVE ANALYSIS: TO ENHANCE PATIENT SAFETY BY MINIMIZING MEDICATION ERRORS IN TERTIARY CARE CARDIAC HOSPITAL

    Directory of Open Access Journals (Sweden)

    Lal Sukhbir

    2012-09-01

    Full Text Available To identify and measure the frequency of medication errors, to understand the causes for errors and best strategies to decrease medication errors rate in a cardiac hospital New Delhi. The Retrospective study of 137 case files, was undertaken to find out the medication errors in new drugs to be included in hospital formulary and to study policy compliances,for the period of a month, February 2010.We studied 137 patient files and Medication error related were reported most often at the stages of prescription- 32 cases(23.35%, 12 administration errors(8.75%, 9 documentation errors(6.56%, 7 transcription errors (5.1%. This study has demonstrated a whole range of different types of errors in different phases of medication use and documentation process. We have seen that handwritten prescriptions are associated with large number of errors. A combined effort is required by the physician’s, managerial staff, nursing staff and educational interventions to improve patient safety in hospital.KEY WORDS:

  14. Cost effectiveness of a pharmacist-led information technology intervention for reducing rates of clinically important errors in medicines management in general practices (PINCER).

    Science.gov (United States)

    Elliott, Rachel A; Putman, Koen D; Franklin, Matthew; Annemans, Lieven; Verhaeghe, Nick; Eden, Martin; Hayre, Jasdeep; Rodgers, Sarah; Sheikh, Aziz; Avery, Anthony J

    2014-06-01

    We recently showed that a pharmacist-led information technology-based intervention (PINCER) was significantly more effective in reducing medication errors in general practices than providing simple feedback on errors, with cost per error avoided at £79 (US$131). We aimed to estimate cost effectiveness of the PINCER intervention by combining effectiveness in error reduction and intervention costs with the effect of the individual errors on patient outcomes and healthcare costs, to estimate the effect on costs and QALYs. We developed Markov models for each of six medication errors targeted by PINCER. Clinical event probability, treatment pathway, resource use and costs were extracted from literature and costing tariffs. A composite probabilistic model combined patient-level error models with practice-level error rates and intervention costs from the trial. Cost per extra QALY and cost-effectiveness acceptability curves were generated from the perspective of NHS England, with a 5-year time horizon. The PINCER intervention generated £2,679 less cost and 0.81 more QALYs per practice [incremental cost-effectiveness ratio (ICER): -£3,037 per QALY] in the deterministic analysis. In the probabilistic analysis, PINCER generated 0.001 extra QALYs per practice compared with simple feedback, at £4.20 less per practice. Despite this extremely small set of differences in costs and outcomes, PINCER dominated simple feedback with a mean ICER of -£3,936 (standard error £2,970). At a ceiling 'willingness-to-pay' of £20,000/QALY, PINCER reaches 59 % probability of being cost effective. PINCER produced marginal health gain at slightly reduced overall cost. Results are uncertain due to the poor quality of data to inform the effect of avoiding errors.

  15. Medical errors in hospitalized pediatric trauma patients with chronic health conditions

    Directory of Open Access Journals (Sweden)

    Xiaotong Liu

    2014-01-01

    Full Text Available Objective: This study compares medical errors in pediatric trauma patients with and without chronic conditions. Methods: The 2009 Kids’ Inpatient Database, which included 123,303 trauma discharges, was analyzed. Medical errors were identified by International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis codes. The medical error rates per 100 discharges and per 1000 hospital days were calculated and compared between inpatients with and without chronic conditions. Results: Pediatric trauma patients with chronic conditions experienced a higher medical error rate compared with patients without chronic conditions: 4.04 (95% confidence interval: 3.75–4.33 versus 1.07 (95% confidence interval: 0.98–1.16 per 100 discharges. The rate of medical error differed by type of chronic condition. After controlling for confounding factors, the presence of a chronic condition increased the adjusted odds ratio of medical error by 37% if one chronic condition existed (adjusted odds ratio: 1.37, 95% confidence interval: 1.21–1.5, and 69% if more than one chronic condition existed (adjusted odds ratio: 1.69, 95% confidence interval: 1.48–1.53. In the adjusted model, length of stay had the strongest association with medical error, but the adjusted odds ratio for chronic conditions and medical error remained significantly elevated even when accounting for the length of stay, suggesting that medical complexity has a role in medical error. Higher adjusted odds ratios were seen in other subgroups. Conclusion: Chronic conditions are associated with significantly higher rate of medical errors in pediatric trauma patients. Future research should evaluate interventions or guidelines for reducing the risk of medical errors in pediatric trauma patients with chronic conditions.

  16. Safety coaches in radiology: decreasing human error and minimizing patient harm

    Energy Technology Data Exchange (ETDEWEB)

    Dickerson, Julie M.; Adams, Janet M. [Cincinnati Children' s Hospital Medical Center, Department of Radiology, MLC 5031, Cincinnati, OH (United States); Koch, Bernadette L.; Donnelly, Lane F. [Cincinnati Children' s Hospital Medical Center, Department of Radiology, MLC 5031, Cincinnati, OH (United States); Cincinnati Children' s Hospital Medical Center, Department of Pediatrics, Cincinnati, OH (United States); Goodfriend, Martha A. [Cincinnati Children' s Hospital Medical Center, Department of Quality Improvement, Cincinnati, OH (United States)

    2010-09-15

    Successful programs to improve patient safety require a component aimed at improving safety culture and environment, resulting in a reduced number of human errors that could lead to patient harm. Safety coaching provides peer accountability. It involves observing for safety behaviors and use of error prevention techniques and provides immediate feedback. For more than a decade, behavior-based safety coaching has been a successful strategy for reducing error within the context of occupational safety in industry. We describe the use of safety coaches in radiology. Safety coaches are an important component of our comprehensive patient safety program. (orig.)

  17. Patient QA systems for rotational radiation therapy: a comparative experimental study with intentional errors.

    Science.gov (United States)

    Fredh, Anna; Scherman, Jonas Bengtsson; Fog, Lotte S; Munck af Rosenschöld, Per

    2013-03-01

    The purpose of the present study was to investigate the ability of commercial patient quality assurance (QA) systems to detect linear accelerator-related errors. Four measuring systems (Delta(4®), OCTAVIUS(®), COMPASS, and Epiqa™) designed for patient specific quality assurance for rotational radiation therapy were compared by measuring four clinical rotational intensity modulated radiation therapy plans as well as plans with introduced intentional errors. The intentional errors included increasing the number of monitor units, widening of the MLC banks, and rotation of the collimator. The measurements were analyzed using the inherent gamma evaluation with 2% and 2 mm criteria and 3% and 3 mm criteria. When applicable, the plans with intentional errors were compared with the original plans both by 3D gamma evaluation and by inspecting the dose volume histograms produced by the systems. There was considerable variation in the type of errors that the various systems detected; the failure rate for the plans with errors varied between 0% and 72%. When using 2% and 2 mm criteria and 95% as a pass rate the Delta(4®) detected 15 of 20 errors, OCTAVIUS(®) detected 8 of 20 errors, COMPASS detected 8 of 20 errors, and Epiqa™ detected 20 of 20 errors. It was also found that the calibration and measuring procedure could benefit from improvements for some of the patient QA systems. The various systems can detect various errors and the sensitivity to the introduced errors depends on the plan. There was poor correlation between the gamma evaluation pass rates of the QA procedures and the deviations observed in the dose volume histograms.

  18. A Technological Innovation to Reduce Prescribing Errors Based on Implementation Intentions: The Acceptability and Feasibility of MyPrescribe.

    Science.gov (United States)

    Keyworth, Chris; Hart, Jo; Thoong, Hong; Ferguson, Jane; Tully, Mary

    2017-08-01

    "If-Then" plans for patient management. Technology, as opposed to other methods of learning (eg, traditional "paper based" learning), was seen as a positive advancement for continued learning. MyPrescribe was perceived as an acceptable and feasible learning tool for changing prescribing practices, with participants suggesting that it would make an important addition to medical prescribers' training in reflective practice. MyPrescribe is a novel theory-based technological innovation that provides the platform for doctors to create personalized implementation intentions. Applying the COM-B model allows for a more detailed understanding of the perceived mechanisms behind prescribing practices and the ways in which interventions aimed at changing professional practice can be implemented.

  19. The medication process in a psychiatric hospital: are errors a potential threat to patient safety?

    Directory of Open Access Journals (Sweden)

    Soerensen AL

    2013-09-01

    Full Text Available Ann Lykkegaard Soerensen,1,2 Marianne Lisby,3 Lars Peter Nielsen,4 Birgitte Klindt Poulsen,4 Jan Mainz5,6 1Faculty of Social Sciences and of Health Sciences, Aalborg University, Aalborg, Denmark; 2Department of Nursing, University College of Northern Denmark, Aalborg, Denmark; 3Research Centre of Emergency Medicine, Aarhus University Hospital, Aarhus, Denmark; 4Department of Clinical Pharmacology, Aarhus University Hospital, Aarhus, Denmark; 5Aalborg Psychiatric University hospital, Aalborg, Denmark; 6Department for Health Services Research, University of Southern Denmark, Denmark Purpose: To investigate the frequency, type, and potential severity of errors in several stages of the medication process in an inpatient psychiatric setting. Methods: A cross-sectional study using three methods for detecting errors: (1 direct observation; (2 unannounced control visits in the wards collecting dispensed drugs; and (3 chart reviews. All errors, except errors in discharge summaries, were assessed for potential consequences by two clinical pharmacologists. Setting: Three psychiatric wards with adult patients at Aalborg University Hospital, Denmark, from January 2010–April 2010. The observational unit: The individual handling of medication (prescribing, dispensing, and administering. Results: In total, 189 errors were detected in 1,082 opportunities for error (17% of which 84/998 (8% were assessed as potentially harmful. The frequency of errors was: prescribing, 10/189 (5%; dispensing, 18/189 (10%; administration, 142/189 (75%; and discharge summaries, 19/189 (10%. The most common errors were omission of pro re nata dosing regime in computerized physician order entry, omission of dose, lack of identity control, and omission of drug. Conclusion: Errors throughout the medication process are common in psychiatric wards to an extent which resembles error rates in somatic care. Despite a substantial proportion of errors with potential to harm patients, very

  20. Using clinical and computer simulations to reason about the impact of context on system safety and technology-induced error.

    Science.gov (United States)

    Kushniruk, Andre W; Borycki, Elizabeth M; Anderson, James; Anderson, Marilyn; Nicoll, James; Kannry, Joseph

    2013-01-01

    This paper describes how simulations can be used to reason about the impact of user interface design features in exploring the effect of different contexts of use on the occurrence of technology-induced errors. The paper describes our approach in several phases, using an example from the analysis of technology-induced errors in medication administration. In the initial phase a clinical simulation is conducted to gather baseline data on the occurrence of technology-induced error using the technology under study. In this phase of the study, data arising from the clinical simulation are collected and then analyzed using qualitative and quantitative approaches to assess the relationship between aspects of interface design (i.e. usability problems) and rates of technology-induced error. In the next phase, the base rates for error associated with specific types of usability problems (from the initial phase) form the input into computer-based mathematical simulations. This approach links clinical simulations with computer-based simulations and demonstrates the potential impact of aspects of interface design and contextual factors upon medical error along with the implications for correcting interface design issues.

  1. Health Technology Assessment and patient safety

    Directory of Open Access Journals (Sweden)

    Andrew Mulcahy

    2005-12-01

    Full Text Available

    Health Technology Assessment (HTA is a process used to evaluate the clinical effectiveness and costeffectiveness of health technologies by a systematic review of clinical, economic, and utilization research.

    Despite widespread investment in patient safety technologies in the U.K., U.S., and elsewhere, little HTA has been done to establish the clinical or cost-effectiveness of these technologies. The HTA and patient safety literature suggests there are four categories of patient safety HTA, including HTA for existing safety technologies, underutilized safety technologies, emerging safety technologies, as well as safety aspects of technologies with a non-safety primary purpose.

    Recent HTA and other research, including a 2002 evidencebased evaluation of patient safety technologies from the U.S. Agency for Health Research and Quality, provide an important foundation for a more comprehensive approach to patient safety HTA. However, HTA programs must address prioritization, methodology, and dissemination challenges introduced by patient safety technologies before significant progress can Te made.

  2. Radio Frequency Identification (RFID) technology and patient safety.

    Science.gov (United States)

    Ajami, Sima; Rajabzadeh, Ahmad

    2013-09-01

    Radio frequency identification (RFID) systems have been successfully applied in areas of manufacturing, supply chain, agriculture, transportation, healthcare, and services to name a few. However, the different advantages and disadvantages expressed in various studies of the challenges facing the technology of the use of the RFID technology have been met with skepticism by managers of healthcare organizations. The aim of this study was to express and display the role of RFID technology in improving patient safety and increasing the impact of it in healthcare. This study was non-systematical review, which the literature search was conducted with the help of libraries, books, conference proceedings, PubMed databases and also search engines available at Google, Google scholar in which published between 2004 and 2013 during Febuary 2013. We employed the following keywords and their combinations; RFID, healthcare, patient safety, medical errors, and medication errors in the searching areas of title, keywords, abstract, and full text. The preliminary search resulted in 68 articles. After a careful analysis of the content of each paper, a total of 33 papers was selected based on their relevancy. We should integrate RFID with hospital information systems (HIS) and electronic health records (EHRs) and support it by clinical decision support systems (CDSS), it facilitates processes and reduce medical, medication and diagnosis errors.

  3. Radio Frequency Identification (RFID technology and patient safety

    Directory of Open Access Journals (Sweden)

    Sima Ajami

    2013-01-01

    Full Text Available Background: Radio frequency identification (RFID systems have been successfully applied in areas of manufacturing, supply chain, agriculture, transportation, healthcare, and services to name a few. However, the different advantages and disadvantages expressed in various studies of the challenges facing the technology of the use of the RFID technology have been met with skepticism by managers of healthcare organizations. The aim of this study was to express and display the role of RFID technology in improving patient safety and increasing the impact of it in healthcare. Materials and Methods: This study was non-systematical review, which the literature search was conducted with the help of libraries, books, conference proceedings, PubMed databases and also search engines available at Google, Google scholar in which published between 2004 and 2013 during Febuary 2013. We employed the following keywords and their combinations; RFID, healthcare, patient safety, medical errors, and medication errors in the searching areas of title, keywords, abstract, and full text. Results: The preliminary search resulted in 68 articles. After a careful analysis of the content of each paper, a total of 33 papers was selected based on their relevancy. Conclusion: We should integrate RFID with hospital information systems (HIS and electronic health records (EHRs and support it by clinical decision support systems (CDSS, it facilitates processes and reduce medical, medication and diagnosis errors.

  4. Radio Frequency Identification (RFID) technology and patient safety

    Science.gov (United States)

    Ajami, Sima; Rajabzadeh, Ahmad

    2013-01-01

    Background: Radio frequency identification (RFID) systems have been successfully applied in areas of manufacturing, supply chain, agriculture, transportation, healthcare, and services to name a few. However, the different advantages and disadvantages expressed in various studies of the challenges facing the technology of the use of the RFID technology have been met with skepticism by managers of healthcare organizations. The aim of this study was to express and display the role of RFID technology in improving patient safety and increasing the impact of it in healthcare. Materials and Methods: This study was non-systematical review, which the literature search was conducted with the help of libraries, books, conference proceedings, PubMed databases and also search engines available at Google, Google scholar in which published between 2004 and 2013 during Febuary 2013. We employed the following keywords and their combinations; RFID, healthcare, patient safety, medical errors, and medication errors in the searching areas of title, keywords, abstract, and full text. Results: The preliminary search resulted in 68 articles. After a careful analysis of the content of each paper, a total of 33 papers was selected based on their relevancy. Conclusion: We should integrate RFID with hospital information systems (HIS) and electronic health records (EHRs) and support it by clinical decision support systems (CDSS), it facilitates processes and reduce medical, medication and diagnosis errors. PMID:24381626

  5. Analysis of Technology and Hydrological Regime Changes Induced Errors of Forecasts

    Science.gov (United States)

    Balint, G.; Rozsa, K.; Bartha, P.

    Real time hydrological forecasting results inevitable contain some errors. The source of the difference between calculated and observed values can be most diverse. In- put data of forecasting models are themselves not the true estimates of the ongoing processes U it can be followed by comparing operationally computed water levels with those checked and corrected on annual basis as they appear in hydrological year- books. Modelling errors are the most common ones and systematic or regular parts of those are often compensated by appropriate updating procedures. ARMA techniques are frequently used, but in most cases for major part of this error component can be compensated by n-step autoregressive procedure where n is a sufficiently low number. Basic statements are illustrated by the history of short term water level forecasting on the Hungarian section of the Danube. No strict calculation algorithm or defined tech- nique was used in the 1950s the forecast was the product of subjective judgement by an (usually) experienced forecaster. A simple linear regression expression was used in the 60s, early 70s often combined with results of an empirical flood routing tech- nique and/or during floods with results of graphical correlation technique used for flood crest forecasting. Most of the 70s and till mid-1980s the empirical flood routing technique developed by Szesztay remained in use, combined with flood crests fore- casting. The age of micro-computes changed the approaches in use. A flood routing model based on DLCM later combined with rainfall-runoff models (GAPI) took over as tool for daily forecasting. The graphical flood crests forecasting was replaced by a multivariate linear or polynomial regression technique. The change of techniques and more advanced technology was not followed by clear improvement represented by decreasing errors. This is mostly due to changes in hydrological regime for low flow periods often having the impact of the peak regime of hydro power

  6. A dynamic compensation strategy to correct patient-positioning errors in conformal prostate radiotherapy.

    Science.gov (United States)

    Lauve, A D; Siebers, J V; Crimaldi, A J; Hagan, M P; Kealla, P J

    2006-06-01

    Traditionally, pretreatment detected patient-positioning errors have been corrected by repositioning the couch to align the patient to the treatment beam. We investigated an alternative strategy: aligning the beam to the patient by repositioning the dynamic multileaf collimator and adjusting the beam weights, termed dynamic compensation. The purpose of this study was to determine the geometric range of positioning errors for which the dynamic compensation method is valid in prostate cancer patients treated with three-dimensional conformal radiotherapy. Twenty-five previously treated prostate cancer patients were replanned using a four-field technique to deliver 72 Gy to 95% of the planning target volume (PTV). Patient-positioning errors were introduced by shifting the patient reference frame with respect to the treatment isocenter. Thirty-six randomly selected isotropic displacements with magnitudes of 1.0, 2.0, 4.0, 6.0, 8.0, and 10.0 cm were sampled for each patient, for a total of 5400 errors. Dynamic compensation was used to correct each of these errors by conforming the beam apertures to the new target position and adjusting the monitor units using inverse-square and off-axis factor corrections. The dynamic compensation plans were then compared with the original treatment plans via dose-volume histogram (DVH) analysis. Changes of more than 5% of the prescription dose, 3.6 Gy, were deemed significant. Compared with the original treatment plans, dynamic compensation produced small discrepancies in isodose distributions and DVH analyses. These differences increased with the magnitudes of the initial patient-positioning errors. Coverage of the PTV was excellent: D95 and Dmean were not increased or decreased by more than 5% of the prescription dose, and D5 was not decreased by more than 5% of the prescription dose for any of the 5400 simulated positioning errors. D5 was increased by more than 5% of the prescription dose in only three of the 5400 positioning errors

  7. The alarming reality of medication error: a patient case and review of Pennsylvania and National data

    Science.gov (United States)

    da Silva, Brianna A.; Krishnamurthy, Mahesh

    2016-01-01

    Case description A 71-year-old female accidentally received thiothixene (Navane), an antipsychotic, instead of her anti-hypertensive medication amlodipine (Norvasc) for 3 months. She sustained physical and psychological harm including ambulatory dysfunction, tremors, mood swings, and personality changes. Despite the many opportunities for intervention, multiple health care providers overlooked her symptoms. Discussion Errors occurred at multiple care levels, including prescribing, initial pharmacy dispensation, hospitalization, and subsequent outpatient follow-up. This exemplifies the Swiss Cheese Model of how errors can occur within a system. Adverse drug events (ADEs) account for more than 3.5 million physician office visits and 1 million emergency department visits each year. It is believed that preventable medication errors impact more than 7 million patients and cost almost $21 billion annually across all care settings. About 30% of hospitalized patients have at least one discrepancy on discharge medication reconciliation. Medication errors and ADEs are an underreported burden that adversely affects patients, providers, and the economy. Conclusion Medication reconciliation including an ‘indication review’ for each prescription is an important aspect of patient safety. The decreasing frequency of pill bottle reviews, suboptimal patient education, and poor communication between healthcare providers are factors that threaten patient safety. Medication error and ADEs cost billions of health care dollars and are detrimental to the provider–patient relationship. PMID:27609720

  8. The alarming reality of medication error: a patient case and review of Pennsylvania and National data

    Directory of Open Access Journals (Sweden)

    Brianna A. da Silva

    2016-09-01

    Full Text Available Case description: A 71-year-old female accidentally received thiothixene (Navane, an antipsychotic, instead of her anti-hypertensive medication amlodipine (Norvasc for 3 months. She sustained physical and psychological harm including ambulatory dysfunction, tremors, mood swings, and personality changes. Despite the many opportunities for intervention, multiple health care providers overlooked her symptoms. Discussion: Errors occurred at multiple care levels, including prescribing, initial pharmacy dispensation, hospitalization, and subsequent outpatient follow-up. This exemplifies the Swiss Cheese Model of how errors can occur within a system. Adverse drug events (ADEs account for more than 3.5 million physician office visits and 1 million emergency department visits each year. It is believed that preventable medication errors impact more than 7 million patients and cost almost $21 billion annually across all care settings. About 30% of hospitalized patients have at least one discrepancy on discharge medication reconciliation. Medication errors and ADEs are an underreported burden that adversely affects patients, providers, and the economy. Conclusion: Medication reconciliation including an ‘indication review’ for each prescription is an important aspect of patient safety. The decreasing frequency of pill bottle reviews, suboptimal patient education, and poor communication between healthcare providers are factors that threaten patient safety. Medication error and ADEs cost billions of health care dollars and are detrimental to the provider–patient relationship.

  9. [Prevention of medication errors in healthcare transition of patients treated with apomorphine].

    Science.gov (United States)

    Ucha Sanmartin, M; Martín Vila, A; López Vidal, C; Caaamaño Barreiro, M; Piñeiro Corrales, G

    2014-05-01

    The transition of patients between different levels of care process is a particular risk in the production of medication errors. The aim of this paper is to analyze the role of the pharmacist in preventing errors transition care to ensure a safe and cross pharmacotherapy of patients.Transversal, observational and descriptive study in a University Hospital that has a pharmacy service that integrates specialized inpatient care and health centers. Transition of care a patient treated with Apormorfina was analyzed to determine the keypoints of action of the pharmacist. Demographics, disease and medication history, and care transition episodes were collected through the pharmacy program and electronics history.The pharmacist did tasks adapting, reconciliation, management and reporting of medication to the health care team to prevent medication errors in care transition of patients treated with drugs requiring special handling .In conclusion, this work represents perfectly the key role of the pharmacist as coordinator of safe and transverse pharmacotherapy of patients.

  10. Phonological analysis of substitution errors of patients with apraxia of speech

    Directory of Open Access Journals (Sweden)

    Maysa Luchesi Cera

    Full Text Available Abstract The literature on apraxia of speech describes the types and characteristics of phonological errors in this disorder. In general, phonemes affected by errors are described, but the distinctive features involved have not yet been investigated. Objective: To analyze the features involved in substitution errors produced by Brazilian-Portuguese speakers with apraxia of speech. Methods: 20 adults with apraxia of speech were assessed. Phonological analysis of the distinctive features involved in substitution type errors was carried out using the protocol for the evaluation of verbal and non-verbal apraxia. Results: The most affected features were: voiced, continuant, high, anterior, coronal, posterior. Moreover, the mean of the substitutions of marked to markedness features was statistically greater than the markedness to marked features. Conclusions: This study contributes toward a better characterization of the phonological errors found in apraxia of speech, thereby helping to diagnose communication disorders and the selection criteria of phonemes for rehabilitation in these patients.

  11. Three-dimensional patient setup errors at different treatment sites measured by the Tomotherapy megavoltage CT

    Energy Technology Data Exchange (ETDEWEB)

    Hui, S.K.; Lusczek, E.; Dusenbery, K. [Univ. of Minnesota Medical School, Minneapolis, MN (United States). Dept. of Therapeutic Radiology - Radiation Oncology; DeFor, T. [Univ. of Minnesota Medical School, Minneapolis, MN (United States). Biostatistics and Informatics Core; Levitt, S. [Univ. of Minnesota Medical School, Minneapolis, MN (United States). Dept. of Therapeutic Radiology - Radiation Oncology; Karolinska Institutet, Stockholm (Sweden). Dept. of Onkol-Patol

    2012-04-15

    Reduction of interfraction setup uncertainty is vital for assuring the accuracy of conformal radiotherapy. We report a systematic study of setup error to assess patients' three-dimensional (3D) localization at various treatment sites. Tomotherapy megavoltage CT (MVCT) images were scanned daily in 259 patients from 2005-2008. We analyzed 6,465 MVCT images to measure setup error for head and neck (H and N), chest/thorax, abdomen, prostate, legs, and total marrow irradiation (TMI). Statistical comparisons of the absolute displacements across sites and time were performed in rotation (R), lateral (x), craniocaudal (y), and vertical (z) directions. The global systematic errors were measured to be less than 3 mm in each direction with increasing order of errors for different sites: H and N, prostate, chest, pelvis, spine, legs, and TMI. The differences in displacements in the x, y, and z directions, and 3D average displacement between treatment sites were significant (p < 0.01). Overall improvement in patient localization with time (after 3-4 treatment fractions) was observed. Large displacement (> 5 mm) was observed in the 75{sup th} percentile of the patient groups for chest, pelvis, legs, and spine in the x and y direction in the second week of the treatment. MVCT imaging is essential for determining 3D setup error and to reduce uncertainty in localization at all anatomical locations. Setup error evaluation should be performed daily for all treatment regions, preferably for all treatment fractions. (orig.)

  12. Decision support system for determining the contact lens for refractive errors patients with classification ID3

    Science.gov (United States)

    Situmorang, B. H.; Setiawan, M. P.; Tosida, E. T.

    2017-01-01

    Refractive errors are abnormalities of the refraction of light so that the shadows do not focus precisely on the retina resulting in blurred vision [1]. Refractive errors causing the patient should wear glasses or contact lenses in order eyesight returned to normal. The use of glasses or contact lenses in a person will be different from others, it is influenced by patient age, the amount of tear production, vision prescription, and astigmatic. Because the eye is one organ of the human body is very important to see, then the accuracy in determining glasses or contact lenses which will be used is required. This research aims to develop a decision support system that can produce output on the right contact lenses for refractive errors patients with a value of 100% accuracy. Iterative Dichotomize Three (ID3) classification methods will generate gain and entropy values of attributes that include code sample data, age of the patient, astigmatic, the ratio of tear production, vision prescription, and classes that will affect the outcome of the decision tree. The eye specialist test result for the training data obtained the accuracy rate of 96.7% and an error rate of 3.3%, the result test using confusion matrix obtained the accuracy rate of 96.1% and an error rate of 3.1%; for the data testing obtained accuracy rate of 100% and an error rate of 0.

  13. DNA methylation imprinting errors in spermatogenic cells from maturation arrest azoospermic patients.

    Science.gov (United States)

    Marques, P I; Fernandes, S; Carvalho, F; Barros, A; Sousa, M; Marques, C J

    2017-03-10

    Imprinting errors have been described in spermatozoa from infertile patients with oligozoospermia and azoospermia. However, little is known about methylation of imprinted genes in other spermatogenic cells from azoospermic patients. Therefore, we aimed to evaluate the methylation status of single CpGs located in the differentially methylated regions (DMRs) of two imprinted genes, one paternally (H19) and one maternally (MEST) methylated, in primary spermatocytes of azoospermic patients presenting complete (MAc, n = 7) and incomplete (MAi, n = 8) maturation arrest, as well as in other spermatogenic cells from MAi patients that presented focus of complete spermatogenesis in some seminiferous tubules. We observed H19 imprinting errors in primary spermatocytes from one MAi patient and MEST imprinting errors in one MAi and two MAc patients. Additionally, H19 imprinting errors were observed in elongated spermatids/spermatozoa from one MAi patient. Nevertheless, no statistical differences were found for H19 and MEST global methylation levels (percentage of methylated and unmethylated CpGs, respectively) between patients with complete and incomplete MA and also between MA groups and a control group. These results provide further evidence that imprinting errors occur in spermatogenic cells from patients presenting impaired spermatogenesis, as we and others have previously described in ejaculated and testicular spermatozoa. As paternal imprinting errors can be transmitted to the embryo by the sperm cell, they can provide a possible explanation for poor embryo development and/or low pregnancy rates as correct expression of imprinted genes is crucial for embryo and placental development and function. Therefore, in cases with male factor infertility where unsuccessful in vitro fertilization (IVF) treatments are recurrent, analysis of imprinting marks in spermatozoa might be a useful diagnostic tool.

  14. Spatial reconstruction by patients with hippocampal damage is dominated by relational memory errors.

    Science.gov (United States)

    Watson, Patrick D; Voss, Joel L; Warren, David E; Tranel, Daniel; Cohen, Neal J

    2013-07-01

    Hippocampal damage causes profound yet circumscribed memory impairment across diverse stimulus types and testing formats. Here, within a single test format involving a single class of stimuli, we identified different performance errors to better characterize the specifics of the underlying deficit. The task involved study and reconstruction of object arrays across brief retention intervals. The most striking feature of patients' with hippocampal damage performance was that they tended to reverse the relative positions of item pairs within arrays of any size, effectively "swapping" pairs of objects. These "swap errors" were the primary error type in amnesia, almost never occurred in healthy comparison participants, and actually contributed to poor performance on more traditional metrics (such as distance between studied and reconstructed location). Patients made swap errors even in trials involving only a single pair of objects. The selectivity and severity of this particular deficit creates serious challenges for theories of memory and hippocampus.

  15. Reducing wrong patient selection errors: exploring the design space of user interface techniques.

    Science.gov (United States)

    Sopan, Awalin; Plaisant, Catherine; Powsner, Seth; Shneiderman, Ben

    2014-01-01

    Wrong patient selection errors are a major issue for patient safety; from ordering medication to performing surgery, the stakes are high. Widespread adoption of Electronic Health Record (EHR) and Computerized Provider Order Entry (CPOE) systems makes patient selection using a computer screen a frequent task for clinicians. Careful design of the user interface can help mitigate the problem by helping providers recall their patients' identities, accurately select their names, and spot errors before orders are submitted. We propose a catalog of twenty seven distinct user interface techniques, organized according to a task analysis. An associated video demonstrates eighteen of those techniques. EHR designers who consider a wider range of human-computer interaction techniques could reduce selection errors, but verification of efficacy is still needed.

  16. Connecting Self-Awareness and Error-Awareness in Patients with Traumatic Brain Injury.

    Science.gov (United States)

    Dockree, Paul M; Tarleton, Yvonne M; Carton, Simone; FitzGerald, Mary C C

    2015-08-01

    Impaired self-awareness after traumatic brain injury (TBI) is often seen in stark contrast to the observations of significant-others, who are acutely aware of the difficulties experienced by patients. Our objective was to investigate the relationship between metacognitive knowledge in daily life and emergent awareness of errors during laboratory tasks, since the breakdown of error detection mechanisms may impose limitations on the recovery of metacognitive knowledge after TBI. We also examined the extent to which these measures of awareness can predict dysexecutive behaviors. A sample of TBI patients (n=62) and their significant-others, provided reports of daily functioning post injury. In addition, patients underwent a neuropsychological assessment and were instructed to signal their errors during go/no-go tests. Interrelationships between metacognitive and emergent levels of awareness were examined, after controlling for the influence of secondary cognitive variables. Significant-other ratings correlated with errors made by the patients on neuropsychological tests but not with their premorbid function. Patients who under-reported daily life difficulties or over-reported their competency, compared to significant-other reports, were less likely to show awareness of laboratory errors. Emergent awareness was also identified as the sole predictor of performance on the modified six-element test, an ecologically valid test of multitasking. The online breakdown of error awareness after brain injury is related to difficulties with metacognitive awareness as reported in daily life, and is also predictive of dysexecutive behaviors. These findings are discussed in the context of multidimensional and neural models of awareness and error monitoring.

  17. Detection and correct handling of prescribing errors in Dutch hospital pharmacies using test patients.

    Science.gov (United States)

    Beex-Oosterhuis, Marieke M; de Vogel, Ed M; van der Sijs, Heleen; Dieleman, Hetty G; van den Bemt, Patricia M L A

    2013-12-01

    Hospital pharmacists and pharmacy technicians play a major role in detecting prescribing errors by medication surveillance. At present the frequency of detected and correctly handled prescribing errors is unclear, as are factors associated with correct handling. To examine the frequency of detection of prescribing errors and the frequency of correct handling, as well as factors associated with correct handling of prescribing errors by hospital pharmacists and pharmacy technicians. This study was conducted in 57 Dutch hospital pharmacies. Prospective observational study with test patients, using a case-control design to identify factors associated with correct handling. A questionnaire was used to collect the potential factors. Test patients containing prescribing errors were developed by an expert panel of hospital pharmacists (a total of 40 errors in nine medication records divided among three test patients; each test patient was used in 3 rounds; on average 4.5 prescribing error per patient per round). Prescribing errors were defined as dosing errors or therapeutic errors (contra-indication, drug-drug interaction, (pseudo)duplicate medication). The errors were selected on relevance and unequivocalness. The panel also defined how the errors should be handled in practice using national guidelines and this was defined as 'correct handling'. The test patients had to be treated as real patients while conducting medication surveillance. The pharmacists and technicians were asked to report detected errors to the investigator. The percentages of detected and correctly handled prescribing errors were the main outcome measures. Factors associated with correct handling were determined, using multivariate logistic regression analysis. Fifty-nine percent of the total number of intentionally added prescribing errors were detected and 57 % were handled correctly by the hospital pharmacists and technicians. The use of a computer system for medication surveillance compared to no

  18. Impact of Work Conditions and Minority Patient Populations on Quality and Errors

    Directory of Open Access Journals (Sweden)

    Anita B. Varkey MD

    2016-02-01

    Full Text Available Objectives: To determine whether workplace conditions affect care quality and errors, especially in primary care clinics serving minority patients. Methods: We conducted a 3-year assessment of work conditions and patient outcomes in 73 primary care clinics in the upper Midwest and New York City. Study participants included 287 physicians and 1204 patients with hypertension and/or diabetes. Chart audit data were contrasted between clinics with ≥30% minority patients (minority-serving clinics, or MSCs and those with <30% (nonminority-serving clinics, or NMSCs. Physicians reported on time pressure, work control, clinical resources, and specialty referral access; managers described room availability; and chart audits determined care errors and quality. Two-level hierarchical models tested work conditions as mediators between MSC status and clinical outcomes. Results: Error rates were higher in MSCs than NMSCs (29.6% vs 24.8%, P < .05. Lack of clinical resources explained 41% of the effect of MSC status on errors (P < .05. Diabetes control was poorer in MSCs than in NMSCs (53.8% controlled vs 76.1%, P < .05; lack of clinical resources explained 24% of this difference (P < .05. Room availability increased quality in both MSCs and NMSCs by 5.95% for each additional room per clinician per session. Lack of access to rooms and specialists decreased the likelihood of blood pressure control in MSCs. Conclusion: Work conditions such as clinical resources, examination room availability, and access to referrals are significantly associated with errors and quality, especially in MSCs.

  19. Using Healthcare Failure Mode and Effect Analysis to Reduce Intravenous Chemotherapy Errors in Chinese Hospitalized Patients.

    Science.gov (United States)

    Li, Gui; Xu, Bo; He, Rui-Xian; Zhang, Shu-Xiang

    Intravenous chemotherapy administration is a high-risk process; attention must be paid to preventing errors that might occur during the administration of chemotherapy. The aim of this study is to investigate whether the healthcare failure mode and effect analysis (HFMEA) is a valid proactive method to apply to chemotherapy administration in the Chinese oncology inpatient setting. A multidisciplinary team created a flow diagram of the chemotherapy administration process and potential failure modes were identified and evaluated using a hazard-scoring matrix. Using a decision tree, failure mode recommendations were made. Chemotherapy error rates before and after the HFMEA were compared. A total of 5 failure modes were identified with high hazard scores, and 15 recommendations were made. After the intervention, the chemotherapy error rate decreased significantly from 2.05% to 0.17%. The complexity of intravenous chemotherapy makes it vulnerable to error, and with serious consequences. Multiple errors can occur during ordering, preparing, compounding, dispensing, and administering the chemotherapy. The process of HFMEA helped reduce the chemotherapy error rate in Chinese hospitalized patients. Clinicians in oncology can take effective measures to avoid chemotherapy errors using the HFMEA.

  20. MOST COMMON TACTICAL ERRORS IN CHRONIC SYSTOLIC HEART FAILURE PATIENTS MANAGEMENT: PRACTICAL RECOMMENDATIONS

    Directory of Open Access Journals (Sweden)

    A. S. Poskrebysheva

    2012-01-01

    Full Text Available Treatment of chronic heart failure (CHF often can be a rather difficult task. Proper selection of therapy and strict adherence to the recommendations is vital in these patients. Unfortunately, in practice we often encounter with free interpretation of the recommendations, which leads to tactical errors and reduce the effectiveness of treatment. This article deals with the most common tactical errors, and contains recommendations for the management of patients with CHF, which can be very useful to the practitioner.

  1. Impact of Communication Errors in Radiology on Patient Care, Customer Satisfaction, and Work-Flow Efficiency.

    Science.gov (United States)

    Siewert, Bettina; Brook, Olga R; Hochman, Mary; Eisenberg, Ronald L

    2016-03-01

    The purpose of this study is to analyze the impact of communication errors on patient care, customer satisfaction, and work-flow efficiency and to identify opportunities for quality improvement. We performed a search of our quality assurance database for communication errors submitted from August 1, 2004, through December 31, 2014. Cases were analyzed regarding the step in the imaging process at which the error occurred (i.e., ordering, scheduling, performance of examination, study interpretation, or result communication). The impact on patient care was graded on a 5-point scale from none (0) to catastrophic (4). The severity of impact between errors in result communication and those that occurred at all other steps was compared. Error evaluation was performed independently by two board-certified radiologists. Statistical analysis was performed using the chi-square test and kappa statistics. Three hundred eighty of 422 cases were included in the study. One hundred ninety-nine of the 380 communication errors (52.4%) occurred at steps other than result communication, including ordering (13.9%; n = 53), scheduling (4.7%; n = 18), performance of examination (30.0%; n = 114), and study interpretation (3.7%; n = 14). Result communication was the single most common step, accounting for 47.6% (181/380) of errors. There was no statistically significant difference in impact severity between errors that occurred during result communication and those that occurred at other times (p = 0.29). In 37.9% of cases (144/380), there was an impact on patient care, including 21 minor impacts (5.5%; result communication, n = 13; all other steps, n = 8), 34 moderate impacts (8.9%; result communication, n = 12; all other steps, n = 22), and 89 major impacts (23.4%; result communication, n = 45; all other steps, n = 44). In 62.1% (236/380) of cases, no impact was noted, but 52.6% (200/380) of cases had the potential for an impact. Among 380 communication errors in a radiology department, 37

  2. Preventing medication errors in transitions of care: A patient case approach.

    Science.gov (United States)

    Johnson, Ashley; Guirguis, Erenie; Grace, Yasmin

    2015-01-01

    To discuss common causes of medication errors occurring upon transitions of care and review key interventions that should be implemented to ensure effective communication and accurate completion of medication reconciliation. MEDLINE (1946 to November 2014) using MeSH terms medication errors, medication reconciliation, and nursing homes in addition to conventional text words, including transitions of care and medication safety; Agency for Healthcare Research and Quality Patient Safety Network using search terms transitions of care, medication errors, and medication reconciliation; and relevant websites of national organizations pertaining to transitions of care and medication reconciliation. Limited to English-language journals with no limitation set on the year of publication for clinical trials, meta-analyses, and reviews. At the authors' discretion, preference was given to references focusing on pharmacists' role in transitions of care and medication reconciliation. Most medication errors stem from a lack of effective communication between health care providers during transitions of care. Part of successful communication and correct patient hand-off is completing accurate medication reconciliation. A patient case highlights a life-threatening medication error that occurred during a transition of care due to ineffective communication between a pharmacist and nurse while transferring medication information. To provide patients with accurate medication information, pharmacists should perform medication reconciliation upon transitions of care using The Joint Commission's five-step process. Pharmacists can conduct numerous interventions to prevent medication errors during transitions of care and ensure patient safety. Pharmacists are integral to evaluating the appropriateness of medication use, ensuring information is updated in the health record, and verbally communicating accurate information to other health professionals.

  3. One-step generation of error-prone PCR libraries using Gateway® technology

    Directory of Open Access Journals (Sweden)

    Gruet Antoine

    2012-01-01

    Full Text Available Abstract Background Error-prone PCR (epPCR libraries are one of the tools used in directed evolution. The Gateway® technology allows constructing epPCR libraries virtually devoid of any background (i.e., of insert-free plasmid, but requires two steps: the BP and the LR reactions and the associated E. coli cell transformations and plasmid purifications. Results We describe a method for making epPCR libraries in Gateway® plasmids using an LR reaction without intermediate BP reaction. We also describe a BP-free and LR-free sub-cloning method for in-frame transferring the coding sequence of selected clones from the plasmid used to screen the library to another one devoid of tag used for screening (such as the green fluorescent protein. We report preliminary results of a directed evolution program using this method. Conclusions The one-step method enables producing epPCR libraries of as high complexity and quality as does the regular, two-step, protocol for half the amount of work. In addition, it contributes to preserve the original complexity of the epPCR product.

  4. Modeling error in experimental assays using the bootstrap principle: understanding discrepancies between assays using different dispensing technologies

    Science.gov (United States)

    Hanson, Sonya M.; Ekins, Sean; Chodera, John D.

    2015-12-01

    All experimental assay data contains error, but the magnitude, type, and primary origin of this error is often not obvious. Here, we describe a simple set of assay modeling techniques based on the bootstrap principle that allow sources of error and bias to be simulated and propagated into assay results. We demonstrate how deceptively simple operations—such as the creation of a dilution series with a robotic liquid handler—can significantly amplify imprecision and even contribute substantially to bias. To illustrate these techniques, we review an example of how the choice of dispensing technology can impact assay measurements, and show how large contributions to discrepancies between assays can be easily understood and potentially corrected for. These simple modeling techniques—illustrated with an accompanying IPython notebook—can allow modelers to understand the expected error and bias in experimental datasets, and even help experimentalists design assays to more effectively reach accuracy and imprecision goals.

  5. Modeling error in experimental assays using the bootstrap principle: understanding discrepancies between assays using different dispensing technologies.

    Science.gov (United States)

    Hanson, Sonya M; Ekins, Sean; Chodera, John D

    2015-12-01

    All experimental assay data contains error, but the magnitude, type, and primary origin of this error is often not obvious. Here, we describe a simple set of assay modeling techniques based on the bootstrap principle that allow sources of error and bias to be simulated and propagated into assay results. We demonstrate how deceptively simple operations--such as the creation of a dilution series with a robotic liquid handler--can significantly amplify imprecision and even contribute substantially to bias. To illustrate these techniques, we review an example of how the choice of dispensing technology can impact assay measurements, and show how large contributions to discrepancies between assays can be easily understood and potentially corrected for. These simple modeling techniques--illustrated with an accompanying IPython notebook--can allow modelers to understand the expected error and bias in experimental datasets, and even help experimentalists design assays to more effectively reach accuracy and imprecision goals.

  6. A pharmacist-led information technology intervention for medication errors (PINCER): a multicentre, cluster randomised, controlled trial and cost-effectiveness analysis.

    Science.gov (United States)

    Avery, Anthony J; Rodgers, Sarah; Cantrill, Judith A; Armstrong, Sarah; Cresswell, Kathrin; Eden, Martin; Elliott, Rachel A; Howard, Rachel; Kendrick, Denise; Morris, Caroline J; Prescott, Robin J; Swanwick, Glen; Franklin, Matthew; Putman, Koen; Boyd, Matthew; Sheikh, Aziz

    2012-04-07

    Medication errors are common in primary care and are associated with considerable risk of patient harm. We tested whether a pharmacist-led, information technology-based intervention was more effective than simple feedback in reducing the number of patients at risk of measures related to hazardous prescribing and inadequate blood-test monitoring of medicines 6 months after the intervention. In this pragmatic, cluster randomised trial general practices in the UK were stratified by research site and list size, and randomly assigned by a web-based randomisation service in block sizes of two or four to one of two groups. The practices were allocated to either computer-generated simple feedback for at-risk patients (control) or a pharmacist-led information technology intervention (PINCER), composed of feedback, educational outreach, and dedicated support. The allocation was masked to researchers and statisticians involved in processing and analysing the data. The allocation was not masked to general practices, pharmacists, patients, or researchers who visited practices to extract data. [corrected]. Primary outcomes were the proportions of patients at 6 months after the intervention who had had any of three clinically important errors: non-selective non-steroidal anti-inflammatory drugs (NSAIDs) prescribed to those with a history of peptic ulcer without co-prescription of a proton-pump inhibitor; β blockers prescribed to those with a history of asthma; long-term prescription of angiotensin converting enzyme (ACE) inhibitor or loop diuretics to those 75 years or older without assessment of urea and electrolytes in the preceding 15 months. The cost per error avoided was estimated by incremental cost-effectiveness analysis. This study is registered with Controlled-Trials.com, number ISRCTN21785299. 72 general practices with a combined list size of 480,942 patients were randomised. At 6 months' follow-up, patients in the PINCER group were significantly less likely to have

  7. Evaluation of medication errors with implementation of electronic health record technology in the medical intensive care unit

    Directory of Open Access Journals (Sweden)

    Liao TV

    2017-05-01

    Full Text Available T Vivian Liao,1 Marina Rabinovich,2 Prasad Abraham,2 Sebastian Perez,3 Christiana DiPlotti,4 Jenny E Han,5 Greg S Martin,5 Eric Honig5 1Department of Pharmacy Practice, College of Pharmacy, Mercer Health Sciences Center, 2Department of Pharmacy and Clinical Nutrition, Grady Health System, 3Department of Surgery, Emory University, 4Pharmacy, Ingles Markets, 5Department of Medicine, Emory University, Atlanta, GA, USA Purpose: Patients in the intensive care unit (ICU are at an increased risk for medication errors (MEs and adverse drug events from multifactorial causes. ME rate ranges from 1.2 to 947 per 1,000 patient days in the medical ICU (MICU. Studies with the implementation of electronic health records (EHR have concluded that it significantly reduced overall prescribing errors and the number of errors that caused patient harm decreased. However, other types of errors, such as wrong dose and omission of required medications increased after EHR implementation. We sought to compare the number of MEs before and after EHR implementation in the MICU, with additional evaluation of error severity.Patients and methods: Prospective, observational, quality improvement study of all patients admitted to a single MICU service at an academic medical center. Patients were evaluated during four periods over 2 years: August–September 2010 (preimplementation; period I, January–February 2011 (2 months postimplementation; period II, August–September 2012 (21 months postimplementation; period III, and January–February 2013 (25 months postimplementation; period IV. All medication orders and administration records were reviewed by an ICU clinical pharmacist and ME was defined as a deviation from established standards for prescribing, dispensing, administering, or documenting medication. The frequency and classification of MEs were compared between groups by chi square; p<0.05 was considered significant.Results: There was a statistically significant increase

  8. Using total quality management approach to improve patient safety by preventing medication error incidences(*).

    Science.gov (United States)

    Yousef, Nadin; Yousef, Farah

    2017-09-04

    Whereas one of the predominant causes of medication errors is a drug administration error, a previous study related to our investigations and reviews estimated that the incidences of medication errors constituted 6.7 out of 100 administrated medication doses. Therefore, we aimed by using six sigma approach to propose a way that reduces these errors to become less than 1 out of 100 administrated medication doses by improving healthcare professional education and clearer handwritten prescriptions. The study was held in a General Government Hospital. First, we systematically studied the current medication use process. Second, we used six sigma approach by utilizing the five-step DMAIC process (Define, Measure, Analyze, Implement, Control) to find out the real reasons behind such errors. This was to figure out a useful solution to avoid medication error incidences in daily healthcare professional practice. Data sheet was used in Data tool and Pareto diagrams were used in Analyzing tool. In our investigation, we reached out the real cause behind administrated medication errors. As Pareto diagrams used in our study showed that the fault percentage in administrated phase was 24.8%, while the percentage of errors related to prescribing phase was 42.8%, 1.7 folds. This means that the mistakes in prescribing phase, especially because of the poor handwritten prescriptions whose percentage in this phase was 17.6%, are responsible for the consequent) mistakes in this treatment process later on. Therefore, we proposed in this study an effective low cost strategy based on the behavior of healthcare workers as Guideline Recommendations to be followed by the physicians. This method can be a prior caution to decrease errors in prescribing phase which may lead to decrease the administrated medication error incidences to less than 1%. This improvement way of behavior can be efficient to improve hand written prescriptions and decrease the consequent errors related to administrated

  9. Technology innovation for patients with kidney disease.

    Science.gov (United States)

    Mitsides, Nicos; Keane, David F; Lindley, Elizabeth; Mitra, Sandip

    2014-01-01

    The loss of kidney function is a life-changing event leading to life-long dependence on healthcare. Around 5000 people are diagnosed with kidney failure every year. Historically, technology in renal medicine has been employed for replacement therapies. Recently, a lot of emphasis has been placed on technologies that aid early identification and prevent progression of kidney disease, while at the same time empowering affected individuals to gain control over their chronic illness. There is a shift in diversity of technology development, driven by collaborative innovation initiatives such the National Institute's for Health Research Healthcare Technology Co-operative for Devices for Dignity. This has seen the emergence of the patient as a key figure in designing technologies that are fit for purpose, while business involvement has ensured uptake and sustainability of these developments. An embodiment of this approach is the first successful Small Business Research Initiative in the field of renal medicine in the UK.

  10. Medication errors in chemotherapy: incidence, types and involvement of patients in prevention. A review of the literature.

    Science.gov (United States)

    Schwappach, D L B; Wernli, M

    2010-05-01

    Medication errors in chemotherapy occur frequently and have a high potential to cause considerable harm. The objective of this article is to review the literature of medication errors in chemotherapy, their incidences and characteristics, and to report on the growing evidence on involvement of patients in error prevention. Among all medication errors and adverse drug events, administration errors are common. Current developments in oncology, namely, increased outpatient treatment at ambulatory infusion units and the diffusion of oral chemotherapy to the outpatient setting, are likely to increase hazards since the process of preparing and administering the drug is often delegated to patients or their caregivers. While professional activities to error incidence reduction are effective and important, it has been increasingly acknowledged that patients often observe errors in the administration of drugs and can thus be a valuable resource in error prevention. However, patients need appropriate information, motivation and encouragement to act as 'vigilant partners'. Examples of simple strategies to involve patients in their safety are presented. Evidence indicates that high self-efficacy and perceived effectiveness of the specific preventive actions increase likelihood of participation in error prevention. Clinicians play a crucial role in supporting and enabling the chemotherapy patient in approaching errors.

  11. The incidence and types of medication errors in patients receiving antiretroviral therapy in resource-constrained settings.

    Directory of Open Access Journals (Sweden)

    Kenneth Anene Agu

    Full Text Available PURPOSE: This study assessed the incidence and types of medication errors, interventions and outcomes in patients on antiretroviral therapy (ART in selected HIV treatment centres in Nigeria. METHODS: Of 69 health facilities that had program for active screening of medication errors, 14 were randomly selected for prospective cohort assessment. All patients who filled/refilled their antiretroviral medications between February 2009 and March 2011 were screened for medication errors using study-specific pharmaceutical care daily worksheet (PCDW. All potential or actual medication errors identified, interventions provided and the outcomes were documented in the PCDW. Interventions included pharmaceutical care in HIV training for pharmacists amongst others. Chi-square was used for inferential statistics and P0.05. The major medications errors identified were 26.4% incorrect ART regimens prescribed; 19.8% potential drug-drug interaction or contraindication present; and 16.6% duration and/or frequency of medication inappropriate. Interventions provided included 67.1% cases of prescriber contacted to clarify/resolve errors and 14.7% cases of patient counselling and education; 97.4% of potential/actual medication error(s were resolved. CONCLUSION: The incidence rate of medication errors was somewhat high; and majority of identified errors were related to prescription of incorrect ART regimens and potential drug-drug interactions; the prescriber was contacted and the errors were resolved in majority of cases. Active screening for medication errors is feasible in resource-limited settings following a capacity building intervention.

  12. Evolution of oral and written confrontation naming errors in aphasia. A retrospective study on vascular patients.

    Science.gov (United States)

    Basso, A; Corno, M; Marangolo, P

    1996-02-01

    Impaired naming is a common finding in aphasia but while it is known that naming errors diminish over time, longitudinal studies are rare. In this retrospective study, naming errors of 84 vascular aphasic patients are studied. Errors in oral and written confrontation naming tasks in two successive evaluations are tabulated and coded into one of 10 error types. No Response, Word-Finding Difficulty, Semantic Paraphasia, Unrelated Paraphasia, Phonemic/Orthographic Paraphasia, Neologism, Paraphasic Jargon, Phonemic/Neologistic Jargon, Stereotypy, and Other. All analyses were carried out on the difference scores, that is, the score in the second examination minus the score in the first examination. Results indicate that there is a significant decrease of No Responses (in oral and written naming) and Neologisms (in oral naming), and a significant increase of Orthographic Paraphasias in written naming. Moreover, the difference score for Phonemic/Orthographic Paraphasias was higher in written than oral naming. The difference scores for the other types of error were not statistically significant.

  13. Classification of Patient Care Complexity: Cloud Technology.

    Science.gov (United States)

    de Oliveira Riboldi, Caren; Macedo, Andrea Barcellos Teixeira; Mergen, Thiane; Dias, Vera Lúcia Mendes; da Costa, Diovane Ghignatti; Malvezzi, Maria Luiza Falsarella; Magalhães, Ana Maria Muller; Silveira, Denise Tolfo

    2016-01-01

    Presentation of the computerized structure to implement, in a university hospital in the South of Brazil, the Patients Classification System of Perroca, which categorizes patients according to the care complexity. This solution also aims to corroborate a recent study at the hospital, which evidenced that the increasing workload presents a direct relation with the institutional quality indicators. The tools used were the Google applications with high productivity interconnecting the topic knowledge on behalf of the nursing professionals and information technology professionals.

  14. Validation of the Mobius system for patient-specific quality assurance using introduced intentional errors.

    Science.gov (United States)

    Au, Ivy Win Long; Ciurlionis, Laura; Campbell, Neil; Goodwin, Daniel

    2017-03-01

    Mobius3D and MobiusFX are model-based verification tools for treatment plan dose calculation and treatment delivery. The software facilitates patient-specific quality assurance by extracting data from linear accelerator treatment log files and performing a 3D dose calculation on the original patient CT dataset using an independent collapsed cone algorithm. In this study, we evaluate the ability of the Mobius system to detect linear accelerator-related errors compared with existing measurement-based systems, namely the ArcCHECK(®) and 3DVH(®) systems. Three original treatment plans and 47 plans with introduced delivery errors, for a total of 50 plan deliveries, were investigated. The results from this study demonstrated comparable gamma passing rates and error detectability between the Mobius and ArcCHECK(®) systems while the 3DVH system generally exhibited a lower sensitivity. This work also demonstrated the ability of the Mobius system to detect delivery errors of down to 2° collimator rotation, 1 mm MLC bank offset and 10 mm collimator jaw offset.

  15. Error signals in the subthalamic nucleus are related to post-error slowing in patients with Parkinson's disease

    NARCIS (Netherlands)

    Siegert, S.; Herrojo Ruiz, M.; Brücke, C.; Hueble, J.; Schneider, H.G.; Ullsperger, M.; Kühn, A.A.

    2014-01-01

    Error monitoring is essential for optimizing motor behavior. It has been linked to the medial frontal cortex, in particular to the anterior midcingulate cortex (aMCC). The aMCC subserves its performance-monitoring function in interaction with the basal ganglia (BG) circuits, as has been demonstrated

  16. Per-beam, planar IMRT QA passing rates do not predict clinically relevant patient dose errors

    Energy Technology Data Exchange (ETDEWEB)

    Nelms, Benjamin E.; Zhen Heming; Tome, Wolfgang A. [Canis Lupus LLC and Department of Human Oncology, University of Wisconsin, Merrimac, Wisconsin 53561 (United States); Department of Medical Physics, University of Wisconsin, Madison, Wisconsin 53705 (United States); Departments of Human Oncology, Medical Physics, and Biomedical Engineering, University of Wisconsin, Madison, Wisconsin 53792 (United States)

    2011-02-15

    Purpose: The purpose of this work is to determine the statistical correlation between per-beam, planar IMRT QA passing rates and several clinically relevant, anatomy-based dose errors for per-patient IMRT QA. The intent is to assess the predictive power of a common conventional IMRT QA performance metric, the Gamma passing rate per beam. Methods: Ninety-six unique data sets were created by inducing four types of dose errors in 24 clinical head and neck IMRT plans, each planned with 6 MV Varian 120-leaf MLC linear accelerators using a commercial treatment planning system and step-and-shoot delivery. The error-free beams/plans were used as ''simulated measurements'' (for generating the IMRT QA dose planes and the anatomy dose metrics) to compare to the corresponding data calculated by the error-induced plans. The degree of the induced errors was tuned to mimic IMRT QA passing rates that are commonly achieved using conventional methods. Results: Analysis of clinical metrics (parotid mean doses, spinal cord max and D1cc, CTV D95, and larynx mean) vs IMRT QA Gamma analysis (3%/3 mm, 2/2, 1/1) showed that in all cases, there were only weak to moderate correlations (range of Pearson's r-values: -0.295 to 0.653). Moreover, the moderate correlations actually had positive Pearson's r-values (i.e., clinically relevant metric differences increased with increasing IMRT QA passing rate), indicating that some of the largest anatomy-based dose differences occurred in the cases of high IMRT QA passing rates, which may be called ''false negatives.'' The results also show numerous instances of false positives or cases where low IMRT QA passing rates do not imply large errors in anatomy dose metrics. In none of the cases was there correlation consistent with high predictive power of planar IMRT passing rates, i.e., in none of the cases did high IMRT QA Gamma passing rates predict low errors in anatomy dose metrics or vice versa

  17. Engineering the electronic health record for safety: a multi-level video-based approach to diagnosing and preventing technology-induced error arising from usability problems.

    Science.gov (United States)

    Borycki, Elizabeth M; Kushniruk, Andre W; Kuwata, Shigeki; Kannry, Joseph

    2011-01-01

    Electronic health records (EHRs) promise to improve and streamline healthcare through electronic entry and retrieval of patient data. Furthermore, based on a number of studies showing their positive benefits, they promise to reduce medical error and make healthcare safer. However, a growing body of literature has clearly documented that if EHRS are not designed properly and with usability as an important goal in their design, rather than reducing error, EHR deployment has the potential to actually increase medical error. In this paper we describe our approach to engineering (and reengineering) EHRs in order to increase their beneficial potential while at the same time improving their safety. The approach described in this paper involves an integration of the methods of usability analysis with video analysis of end users interacting with EHR systems and extends the evaluation of the usability of EHRs to include the assessment of the impact of these systems on work practices. Using clinical simulations, we analyze human-computer interaction in real healthcare settings (in a portable, low-cost and high fidelity manner) and include both artificial and naturalistic data collection to identify potential usability problems and sources of technology-induced error prior to widespread system release. Two case studies where the methods we have developed and refined have been applied at different levels of user-computer interaction are described.

  18. Cardiovascular pressure measurement in safety assessment studies: technology requirements and potential errors.

    Science.gov (United States)

    Sarazan, R Dustan

    2014-01-01

    In the early days of in vivo nonclinical pressure measurement, most laboratories were required to have considerable technical/engineering expertise to configure and maintain pressure transducers, amplifiers, tape recorders, chart recorders, etc. Graduate students and postdoctoral fellows typically had some training in the requirements and limitations of the technology they used and were closely engaged in the collection and evaluation of data from their own experiments. More recently, pressure sensing telemetry and data acquisition/analysis systems are provided by vendors as turnkey systems, often resulting in a situation where users are less familiar with the technicalities of their operation. Also, investigators are now more likely to be absent and rely on technical staff for the collection of raw in vivo pressure data from their experiments than in the past. Depending on the goals of an experiment, an investigator may require the measurement of a variety of different pressure parameters, over varying periods of time. A basic understanding of the requirements and limitations that can affect the accuracy and precision of these parameters is important to ensure that the results and conclusions from an experiment are reliable. Factors to consider include the possibility of hydrostatic pressure effects from blood inside the vasculature of the animal, depending on the location of the sensor, as well as from fluid inside a fluid-filled catheter system; long-term stability (lack of drift) of a sensor over time, which can affect the interpretation of absolute pressure changes over a prolonged experiment; frequency response of the sensor and associated electronics; and the phase shift that occurs depending on location of the sensor in the vasculature or because of a fluid-filled catheter system. Each of these factors is discussed, and the particular requirements of frequency response as applied to the measurement of cardiac left ventricular pressure are emphasized. When

  19. Call for Enrolling More Professionals in the IFCC Project on Laboratory Errors and Patient Safety.

    Science.gov (United States)

    Plebani, Mario; Laura, Sciacovelli

    2011-03-01

    Patient safety is the foundation of good care. In the last decades, a body of evidence has been accumulated to demonstrate that pre- and post-analytical phase are more vulnerable to errors in laboratory medicine than the analytical phase. Aims of the project of the IFCC Working Group on "Laboratory Errors and Patient Safety" (WG-LEPS) are: a) to develop a series of Quality Indicators (QIs), specifically designed for clinical laboratories, b) to create a common reporting system for clinical laboratories based on standardized data collection, and c) to define state-of the-art and Quality Specifications (QSs) for each QI Preliminary results demonstrate that a Model of Quality Indicators can serve as a tool to monitor and control the pre-, intra- and post-analytical activities. However, only after enrolling a more consistent number of clinical laboratories, it should be possible to assure consistency to the data collected and reliability to the QIs identified and to related QSs.

  20. Can stimulating massage improve joint repositioning error in patients with knee osteoarthritis?

    DEFF Research Database (Denmark)

    Lund, Hans; Henriksen, Marius; Bartels, Else M

    2009-01-01

    PURPOSE: The purpose of this study was to investigate the effect of massage applied to the thigh muscles on joint repositioning error (JRE) in patients suffering from osteoarthritis (OA).We hypothesized that stimulating massage of the muscles around an osteoarthritic knee joint, could improve...... of rheumatology, were randomly allocated to either receive massage and a week later, act as controls or vice versa. The applied massage consisted of stimulating massage of the quadriceps femoris, sartorious, gracilus, and hamstrings muscles for 10 min on the affected leg. Participants had their JRE measured...... before and immediately after the 10 min massage and control sessions. Data were analyzed by using paired t-test. RESULTS: No significant change in JRE was observed (95% CI: -0.62 degrees to 0.85 degrees, p = 0.738). CONCLUSION: Massage has no effect on the immediate joint repositioning error in patients...

  1. Can stimulating massage improve joint repositioning error in patients with knee osteoarthritis?

    DEFF Research Database (Denmark)

    Lund, Hans; Henriksen, Marius; Bartels, Else M

    2009-01-01

    PURPOSE: The purpose of this study was to investigate the effect of massage applied to the thigh muscles on joint repositioning error (JRE) in patients suffering from osteoarthritis (OA).We hypothesized that stimulating massage of the muscles around an osteoarthritic knee joint, could improve...... of rheumatology, were randomly allocated to either receive massage and a week later, act as controls or vice versa. The applied massage consisted of stimulating massage of the quadriceps femoris, sartorious, gracilus, and hamstrings muscles for 10 min on the affected leg. Participants had their JRE measured...... before and immediately after the 10 min massage and control sessions. Data were analyzed by using paired t-test. RESULTS: No significant change in JRE was observed (95% CI: -0.62 degrees to 0.85 degrees, p = 0.738). CONCLUSION: Massage has no effect on the immediate joint repositioning error in patients...

  2. Visual outcome after correcting the refractive error of large pupil patients with wavefront-guided ablation

    Directory of Open Access Journals (Sweden)

    Khalifa MA

    2012-12-01

    Full Text Available Mounir A Khalifa,1,2 Waleed A Allam,1,2 Mohamed S Shaheen2,31Ophthalmology Department, Tanta University Eye Hospital, Tanta, Egypt; 2Horus Vision Correction Center, Alexandria, Egypt; 3Ophthalmology Department, Alexandria University, Alexandria, EgyptPurpose: To investigate the efficacy and predictability of wavefront-guided laser in situ keratomileusis (LASIK treatments using the iris registration (IR technology for the correction of refractive errors in patients with large pupils.Setting: Horus Vision Correction Center, Alexandria, Egypt.Methods: Prospective noncomparative study including a total of 52 eyes of 30 consecutive laser refractive correction candidates with large mesopic pupil diameters and myopia or myopic astigmatism. Wavefront-guided LASIK was performed in all cases using the VISX STAR S4 IR excimer laser platform. Visual, refractive, aberrometric and mesopic contrast sensitivity (CS outcomes were evaluated during a 6-month follow-up.Results: Mean mesopic pupil diameter ranged from 8.0 mm to 9.4 mm. A significant improvement in uncorrected distance visual acuity (UCDVA (P < 0.01 was found postoperatively, which was consistent with a significant refractive correction (P < 0.01. No significant change was detected in corrected distance visual acuity (CDVA (P = 0.11. Efficacy index (the ratio of postoperative UCDVA to preoperative CDVA and safety index (the ratio of postoperative CDVA to preoperative CDVA were calculated. Mean efficacy and safety indices were 1.06 ± 0.33 and 1.05 ± 0.18, respectively, and 92.31% of eyes had a postoperative spherical equivalent within ±0.50 diopters (D. Manifest refractive spherical equivalent improved significantly (P < 0.05 from a preoperative level of −3.1 ± 1.6 D (range −6.6 to 0 D to −0.1 ± 0.2 D (range −1.3 to 0.1 D at 6 months postoperative. No significant changes were found in mesopic CS (P ≥ 0.08, except CS for three cycles/degree, which improved significantly (P = 0

  3. Dosage uniformity problems which occur due to technological errors in extemporaneously prepared suppositories in hospitals and pharmacies.

    Science.gov (United States)

    Kalmár, Eva; Lasher, Jason Richard; Tarry, Thomas Dean; Myers, Andrea; Szakonyi, Gerda; Dombi, György; Baki, Gabriella; Alexander, Kenneth S

    2014-09-01

    The availability of suppositories in Hungary, especially in clinical pharmacy practice, is usually provided by extemporaneous preparations. Due to the known advantages of rectal drug administration, its benefits are frequently utilized in pediatrics. However, errors during the extemporaneous manufacturing process can lead to non-homogenous drug distribution within the dosage units. To determine the root cause of these errors and provide corrective actions, we studied suppository samples prepared with exactly known errors using both cerimetric titration and HPLC technique. Our results show that the most frequent technological error occurs when the pharmacist fails to use the correct displacement factor in the calculations which could lead to a 4.6% increase/decrease in the assay in individual dosage units. The second most important source of error can occur when the molding excess is calculated solely for the suppository base. This can further dilute the final suppository drug concentration causing the assay to be as low as 80%. As a conclusion we emphasize that the application of predetermined displacement factors in calculations for the formulation of suppositories is highly important, which enables the pharmacist to produce a final product containing exactly the determined dose of an active substance despite the different densities of the components.

  4. Dosage uniformity problems which occur due to technological errors in extemporaneously prepared suppositories in hospitals and pharmacies

    Science.gov (United States)

    Kalmár, Éva; Lasher, Jason Richard; Tarry, Thomas Dean; Myers, Andrea; Szakonyi, Gerda; Dombi, György; Baki, Gabriella; Alexander, Kenneth S.

    2013-01-01

    The availability of suppositories in Hungary, especially in clinical pharmacy practice, is usually provided by extemporaneous preparations. Due to the known advantages of rectal drug administration, its benefits are frequently utilized in pediatrics. However, errors during the extemporaneous manufacturing process can lead to non-homogenous drug distribution within the dosage units. To determine the root cause of these errors and provide corrective actions, we studied suppository samples prepared with exactly known errors using both cerimetric titration and HPLC technique. Our results show that the most frequent technological error occurs when the pharmacist fails to use the correct displacement factor in the calculations which could lead to a 4.6% increase/decrease in the assay in individual dosage units. The second most important source of error can occur when the molding excess is calculated solely for the suppository base. This can further dilute the final suppository drug concentration causing the assay to be as low as 80%. As a conclusion we emphasize that the application of predetermined displacement factors in calculations for the formulation of suppositories is highly important, which enables the pharmacist to produce a final product containing exactly the determined dose of an active substance despite the different densities of the components. PMID:25161378

  5. Measurement error in grip and pinch force measurements in patients with hand injuries.

    Science.gov (United States)

    Schreuders, Ton A R; Roebroeck, Marij E; Goumans, Janine; van Nieuwenhuijzen, Johan F; Stijnen, Theo H; Stam, Henk J

    2003-09-01

    There is limited documentation of measurement error of grip and pinch force evaluation methods. The purposes of this study were (1) to determine indexes of measurement error for intraexaminer and interexaminer measurements of grip and pinch force in patients with hand injuries and (2) to investigate whether the measurement error differs between measurements of the injured and noninjured hands and between experienced and inexperienced examiners. The subjects were a consecutive sample of 33 patients with hand injuries who were seen in the Department of Rehabilitation Medicine of Erasmus MC-University Medical Center Rotterdam in the Netherlands. Repeated measurements were taken of grip and pinch force, with a short break of 2 to 3 minutes between sessions. For the grip force in 2 handle positions (distance between handles of 4.6 and 7.2 cm, respectively), tip pinch (with the index finger on top and the thumb below, with the other fingers flexed) and key pinch force (with the thumb on top and the radial side of the index finger below) data were obtained on both hands of the subjects by an experienced examiner and an inexperienced examiner. Intraclass correlation coefficients (ICCs), standard errors of measurement (SEMs), and associated smallest detectable differences (SDDs) were calculated and compared with data from previous studies. The reliability of the measurements was expressed by ICCs between .82 and .97. For grip force measurements (in the second handle position) by the experienced examiner, an SDD of 61 N was found. For tip pinch and key pinch, these values were 12 N and 11 N, respectively. For measurements by the inexperienced examiner, SDDs of 56 N for grip force and 13 N and 18 N for tip pinch and key pinch were found. Based on the SEMs and SDDs, in individual patients only relatively large differences in grip and pinch force measurements can be adequately detected between consecutive measurements. Measurement error did not differ between injured and

  6. Calculation errors of Set-up in patients with tumor location of prostate. Exploratory study; Calculo de errores de Set-up en pacientes con localizacion tumoral de prostata. Estudio exploratorio

    Energy Technology Data Exchange (ETDEWEB)

    Donis Gil, S.; Robayna Duque, B. E.; Jimenez Sosa, A.; Hernandez Armas, O.; Gonzalez Martin, A. E.; Hernandez Armas, J.

    2013-07-01

    The calculation of SM is done from errors in positioning (set-up). These errors are calculated from movements in 3D of the patient. This paper is an exploratory study of 20 patients with tumor location of prostate in which errors of set-up for two protocols of work are evaluated. (Author)

  7. [Patient identification errors and biological samples in the analytical process: Is it possible to improve patient safety?].

    Science.gov (United States)

    Cuadrado-Cenzual, M A; García Briñón, M; de Gracia Hills, Y; González Estecha, M; Collado Yurrita, L; de Pedro Moro, J A; Fernández Pérez, C; Arroyo Fernández, M

    2015-01-01

    Patient identification errors and biological samples are one of the problems with the highest risk factor in causing an adverse event in the patient. To detect and analyse the causes of patient identification errors in analytical requests (PIEAR) from emergency departments, and to develop improvement strategies. A process and protocol was designed, to be followed by all professionals involved in the requesting and performing of laboratory tests. Evaluation and monitoring indicators of PIEAR were determined, before and after the implementation of these improvement measures (years 2010-2014). A total of 316 PIEAR were detected in a total of 483,254 emergency service requests during the study period, representing a mean of 6.80/10,000 requests. Patient identification failure was the most frequent in all the 6-monthly periods assessed, with a significant difference (P<.0001). The improvement strategies applied showed to be effective in detecting PIEAR, as well as the prevention of such errors. However, we must continue working with this strategy, promoting a culture of safety for all the professionals involved, and trying to achieve the goal that 100% of the analytical and samples are properly identified. Copyright © 2015 SECA. Published by Elsevier Espana. All rights reserved.

  8. Impact of Spacecraft Shielding on Direct Ionization Soft Error Rates for sub-130 nm Technologies

    Science.gov (United States)

    Pellish, Jonathan A.; Xapsos, Michael A.; Stauffer, Craig A.; Jordan, Michael M.; Sanders, Anthony B.; Ladbury, Raymond L.; Oldham, Timothy R.; Marshall, Paul W.; Heidel, David F.; Rodbell, Kenneth P.

    2010-01-01

    We use ray tracing software to model various levels of spacecraft shielding complexity and energy deposition pulse height analysis to study how it affects the direct ionization soft error rate of microelectronic components in space. The analysis incorporates the galactic cosmic ray background, trapped proton, and solar heavy ion environments as well as the October 1989 and July 2000 solar particle events.

  9. Living with inborn errors of cholesterol biosynthesis: lessons from adult patients.

    Science.gov (United States)

    Cardoso, M L; Barbosa, M; Serra, D; Martins, E; Fortuna, A; Reis-Lima, M; Bandeira, A; Balreira, A; Marques, F

    2014-02-01

    In the last decades, nine inherited errors of the distal part of cholesterol biosynthesis have been recognized. Affected patients present complex malformation syndromes involving different organs and systems with variable degrees of severity. We report on the phenotype evolution of three patients with enzymatic defects at three distinct steps of such pathway: Smith-Lemli-Opitz syndrome, X-linked dominant chondrodysplasia punctata type 2 and congenital hemidysplasia with ichthyosiform erythroderma and limb defects syndrome. The patients' natural history, from childhood to adulthood, is thoroughly described in order to contribute for a better knowledge of these diseases. Our ultimate goals are to contribute for a better characterization of the long-term course of these metabolic disorders and for the recognition of such diseases in older patients.

  10. Improving patient safety through education: how visual recognition skills may reduce medication errors on surgical wards

    Directory of Open Access Journals (Sweden)

    Christopher R. Davis

    2011-12-01

    Full Text Available Medication errors compromise patient safety and cost £500m per annum in the UK. Patients who forget the name of their medication may describe the appearance to the doctor. Nurses use recognition skills to assist in safe administration of medications. This study quantifies healthcare professionals’ accuracy in visually identifying medications. Members of the multidisciplinary team were asked to identify five commonly prescribed medications. Mean recognition rate (MRR was defined as the percentage of correct responses. Dunn’s multiple comparison tests quantified inter-professional variation. Fifty-six participants completed the study (93% response rate. MRRs were: pharmacists 61%; nurses 35%; doctors 19%; physiotherapists 11%. Pharmacists’ MRR were significantly higher than both doctors and physiotherapists (P<0.001. Nurses’ MRR was statistically comparable to pharmacists (P>0.05. The majority of healthcare professionals cannot accurately identify commonly prescribed medications on direct visualization. By increasing access to medication identification resources and improving undergraduate education and postgraduate training for all healthcare professionals, errors may be reduced and patient safety improved.

  11. Erro médico em pacientes hospitalizados Medical errors in hospitalized patients

    Directory of Open Access Journals (Sweden)

    Manoel de Carvalho

    2002-01-01

    sistema, e encarados como oportunidade de revisão do processo e aprimoramento da assistência prestada ao paciente.Objective: to review the current literature and to discuss medical errors in hospitalized patients emphasizing its incidence, predisposing factors and prevention mechanism. Special attention is given to medication errors and adverse drug events in newborn infants and pediatric patients. Sources: bibliographic review of the current literature through electronic search in Medline data-base, with selection of the most relevant articles. Summary of the findings: even though most medical errors are not reported, it is important to notice that its incidence is greater than previously assumed. In the USA, approximately one million of patients/year are victims of medical errors and adverse drug events. Today, deaths resulting from these episodes are the fourth cause of mortality in the USA. In neonatal and pediatric intensive care units, where the complexity and frequency of technical procedures are high, medical errors are frequent. Fifteen percent of all admissions to a neonatal intensive care unit is followed by medical errors. Most of these errors occur during night shifts and include incorrect administration of drugs (35% and errors regarding the interpretation of medical prescription (26%. Environmental factors (noise, heat, psychological factors (anxiety, stress and physiologic factors (fatigue, absence of sleep contribute to the occurrence of errors. Recent study shows that after working 24 hours without sleeping, the performance of a health professional is similar to a legally drunk person (serum alcohol level > 0.08%. Conclusions: errors are part of human behavior. The prevention of errors should include a careful review of the organizational system. Medical errors should be seen as an opportunity to change or re-structure the system and to improve the quality of health care delivered and patient safety.

  12. Optimum design for optical proximity correction in submicron bipolar technology using critical shape error analysis

    Science.gov (United States)

    Arthur, Graham G.; Martin, Brian; Wallace, Christine

    2000-06-01

    A production application of optical proximity correction (OPC) aimed at reducing corner-rounding and line-end shortening is described. The methodology, using critical shape error analysis, to calculate the correct serif size is given and is extended to show the effect of OPC on the process window (i.e. depth-of-focus and exposure latitude). The initial calculations are made using the lithography simulation tools PROLITH/2 and SOLID-C, the results of which are transferred to the photo-cell for practical results.

  13. Shedding light on the dark side of doctor-patient interactions: verbal and nonverbal messages physicians communicate during error disclosures.

    Science.gov (United States)

    Hannawa, Annegret F

    2011-09-01

    Existing investigations on medical error disclosures have neglected the fact that a disproportionately large amount of the meaning in messages is derived from nonverbal cues. This study provides an empirical assessment of the verbal and nonverbal messages physicians communicate when disclosing medical errors to standardized patients. Sixty hypothetical error disclosures by a volunteer sample of attending physicians were videotaped, coded, and statistically analyzed. Physicians used friendly, smooth, approaching and invested nonverbal styles as they disclosed medical errors to standardized patients. Female physicians smiled more and were more attentive to patients than male physicians, and physicians tended to exhibit more positive affect in the form of facial pleasantness toward angry female patients than toward angry male patients. Furthermore, physicians touched and smiled at patients more frequently at the beginning and at the end of their error disclosures, and displayed decreased attentiveness and interactional fluency. Future research needs to examine which disclosure styles patients perceive as competent, and to assess their causal impacts on objective and relational disclosure outcomes. This study provides an important baseline understanding of medical error disclosures that is essential for the successful implementation of empirically based training programs. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  14. Establishment and application of medication error classification standards in nursing care based on the International Classification of Patient Safety

    Directory of Open Access Journals (Sweden)

    Xiao-Ping Zhu

    2014-09-01

    Conclusion: Application of this classification system will help nursing administrators to accurately detect system- and process-related defects leading to medication errors, and enable the factors to be targeted to improve the level of patient safety management.

  15. Can stimulating massage improve joint repositioning error in patients with knee osteoarthritis?

    DEFF Research Database (Denmark)

    Lund, Hans; Henriksen, Marius; Bartels, Else M

    2009-01-01

    PURPOSE: The purpose of this study was to investigate the effect of massage applied to the thigh muscles on joint repositioning error (JRE) in patients suffering from osteoarthritis (OA).We hypothesized that stimulating massage of the muscles around an osteoarthritic knee joint, could improve...... the neuromuscular function and thereby optimize the positive and minimize the negative performance factors in relation to an exercise program. METHODS: In a cross-over design, 19 patients with knee osteoarthritis, mean age of 73.1 years (SD: 9.4; range 56 to 88 years), recruited from the local department...... with knee osteoarthritis, ie, if an improved JRE is important for improving the performance factors when exercising, stimulating massage may not be recommendable to use....

  16. The Usability-Error Ontology

    DEFF Research Database (Denmark)

    2013-01-01

    ability to do systematic reviews and meta-analyses. In an effort to support improved and more interoperable data capture regarding Usability Errors, we have created the Usability Error Ontology (UEO) as a classification method for representing knowledge regarding Usability Errors. We expect the UEO...... in patients coming to harm. Often the root cause analysis of these adverse events can be traced back to Usability Errors in the Health Information Technology (HIT) or its interaction with users. Interoperability of the documentation of HIT related Usability Errors in a consistent fashion can improve our...... will grow over time to support an increasing number of HIT system types. In this manuscript, we present this Ontology of Usability Error Types and specifically address Computerized Physician Order Entry (CPOE), Electronic Health Records (EHR) and Revenue Cycle HIT systems....

  17. Nurses' Perceptions of the Impact of Work Systems and Technology on Patient Safety during the Medication Administration Process

    Science.gov (United States)

    Gallagher Gordon, Mary

    2012-01-01

    This dissertation examines nurses' perceptions of the impacts of systems and technology utilized during the medication administration process on patient safety and the culture of medication error reporting. This exploratory research study was grounded in a model of patient safety based on Patricia Benner's Novice to Expert Skill Acquisition model,…

  18. Nurses' Perceptions of the Impact of Work Systems and Technology on Patient Safety during the Medication Administration Process

    Science.gov (United States)

    Gallagher Gordon, Mary

    2012-01-01

    This dissertation examines nurses' perceptions of the impacts of systems and technology utilized during the medication administration process on patient safety and the culture of medication error reporting. This exploratory research study was grounded in a model of patient safety based on Patricia Benner's Novice to Expert Skill…

  19. Nurses' Perceptions of the Impact of Work Systems and Technology on Patient Safety during the Medication Administration Process

    Science.gov (United States)

    Gallagher Gordon, Mary

    2012-01-01

    This dissertation examines nurses' perceptions of the impacts of systems and technology utilized during the medication administration process on patient safety and the culture of medication error reporting. This exploratory research study was grounded in a model of patient safety based on Patricia Benner's Novice to Expert Skill Acquisition model,…

  20. Implication of spot position error on plan quality and patient safety in pencil-beam-scanning proton therapy

    Energy Technology Data Exchange (ETDEWEB)

    Yu, Juan; Beltran, Chris J., E-mail: beltran.chris@mayo.edu; Herman, Michael G. [Division of Medical Physics, Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota 55905 (United States)

    2014-08-15

    Purpose: To quantitatively and systematically assess dosimetric effects induced by spot positioning error as a function of spot spacing (SS) on intensity-modulated proton therapy (IMPT) plan quality and to facilitate evaluation of safety tolerance limits on spot position. Methods: Spot position errors (PE) ranging from 1 to 2 mm were simulated. Simple plans were created on a water phantom, and IMPT plans were calculated on two pediatric patients with a brain tumor of 28 and 3 cc, respectively, using a commercial planning system. For the phantom, a uniform dose was delivered to targets located at different depths from 10 to 20 cm with various field sizes from 2{sup 2} to 15{sup 2} cm{sup 2}. Two nominal spot sizes, 4.0 and 6.6 mm of 1 σ in water at isocenter, were used for treatment planning. The SS ranged from 0.5 σ to 1.5 σ, which is 2–6 mm for the small spot size and 3.3–9.9 mm for the large spot size. Various perturbation scenarios of a single spot error and systematic and random multiple spot errors were studied. To quantify the dosimetric effects, percent dose error (PDE) depth profiles and the value of percent dose error at the maximum dose difference (PDE [ΔDmax]) were used for evaluation. Results: A pair of hot and cold spots was created per spot shift. PDE[ΔDmax] is found to be a complex function of PE, SS, spot size, depth, and global spot distribution that can be well defined in simple models. For volumetric targets, the PDE [ΔDmax] is not noticeably affected by the change of field size or target volume within the studied ranges. In general, reducing SS decreased the dose error. For the facility studied, given a single spot error with a PE of 1.2 mm and for both spot sizes, a SS of 1σ resulted in a 2% maximum dose error; a SS larger than 1.25 σ substantially increased the dose error and its sensitivity to PE. A similar trend was observed in multiple spot errors (both systematic and random errors). Systematic PE can lead to noticeable hot

  1. Relationship Between Patients' Perceptions of Care Quality and Health Care Errors in 11 Countries: A Secondary Data Analysis.

    Science.gov (United States)

    Hincapie, Ana L; Slack, Marion; Malone, Daniel C; MacKinnon, Neil J; Warholak, Terri L

    2016-01-01

    Patients may be the most reliable reporters of some aspects of the health care process; their perspectives should be considered when pursuing changes to improve patient safety. The authors evaluated the association between patients' perceived health care quality and self-reported medical, medication, and laboratory errors in a multinational sample. The analysis was conducted using the 2010 Commonwealth Fund International Health Policy Survey, a multinational consumer survey conducted in 11 countries. Quality of care was measured by a multifaceted construct developed using Rasch techniques. After adjusting for potentially important confounding variables, an increase in respondents' perceptions of care coordination decreased the odds of self-reporting medical errors, medication errors, and laboratory errors (P < .001). As health care stakeholders continue to search for initiatives that improve care experiences and outcomes, this study's results emphasize the importance of guaranteeing integrated care.

  2. Comparison of community and hospital pharmacists' attitudes and behaviors on medication error disclosure to the patient: A pilot study.

    Science.gov (United States)

    Kim, ChungYun; Mazan, Jennifer L; Quiñones-Boex, Ana C

    To determine pharmacists' attitudes and behaviors on medication errors and their disclosure and to compare community and hospital pharmacists on such views. An online questionnaire was developed from previous studies on physicians' disclosure of errors. Questionnaire items included demographics, environment, personal experiences, and attitudes on medication errors and the disclosure process. An invitation to participate along with the link to the questionnaire was electronically distributed to members of two Illinois pharmacy associations. A follow-up reminder was sent 4 weeks after the original message. Data were collected for 3 months, and statistical analyses were performed with the use of IBM SPSS version 22.0. The overall response rate was 23.3% (n = 422). The average employed respondent was a 51-year-old white woman with a BS Pharmacy degree working in a hospital pharmacy as a clinical staff member. Regardless of practice settings, pharmacist respondents agreed that medication errors were inevitable and that a disclosure process is necessary. Respondents from community and hospital settings were further analyzed to assess any differences. Community pharmacist respondents were more likely to agree that medication errors were inevitable and that pharmacists should address the patient's emotions when disclosing an error. Community pharmacist respondents were also more likely to agree that the health care professional most closely involved with the error should disclose the error to the patient and thought that it was the pharmacists' responsibility to disclose the error. Hospital pharmacist respondents were more likely to agree that it was important to include all details in a disclosure process and more likely to disagree on putting a "positive spin" on the event. Regardless of practice setting, responding pharmacists generally agreed that errors should be disclosed to patients. There were, however, significant differences in their attitudes and behaviors

  3. TECHNOLOGY VS NATURE: HUMAN ERROR IN DEALING WITH NATURE IN CRICHTON'S JURASSIC PARK

    Directory of Open Access Journals (Sweden)

    Sarah Prasasti

    2000-01-01

    Full Text Available Witnessing the euphoria of the era of biotechnology in the late twentieth century, Crichton exposes the theme of biotechnology in his works. In Jurassic Park, he voices his concern about the impact of the use of biotechnology to preserve nature and its living creatures. He further describes how the purpose of preserving nature and the creatures has turned out to be destructive. This article discusses Crichton's main character, Hammond, who attempts to control nature by genetically recreating the extinct fossil animals. It seems that the attempt ignores his human limitations. Although he is confident that has been equipped with the technology, he forgets to get along with nature. His way of using technology to accomplish his purpose proves not to be in harmony with nature. As a consequence, nature fights back. And he is conquered.

  4. DISTURBANCE ERROR INVARIANCE IN AUTOMATIC CONTROL SYSTEMS FOR TECHNOLOGICAL OBJECT TRAJECTORY MOVEMENT

    Directory of Open Access Journals (Sweden)

    A. V. Lekareva

    2016-09-01

    Full Text Available We consider combined control in automatic control systems for technological objects trajectory movements. We present research results of the system disturbance invariance ensuring on the example of the technological manipulator that implements hydrocutting of the oil pipelines. Control is based on the propositions of the fourth modified invariance form with the use of bootstrapping methods. The paper presents analysis of results obtained by two different correction methods. The essence of the first method lies in injection of additional component into the already established control signal and formation of the channel for that component. Control signal correction during the signal synthesis stage in the control device constitutes the basis for the second method. Research results have shown high efficiency of application for both correction methods. Both methods have roughly the same precision. We have shown that the correction in the control device is preferable because it has no influence on the inner contour of the system. We have shown the necessity of the block usage with the variable transmission coefficient, which value is determined by technological trajectory parameters. Research results can be applied in practice for improvement of the precision specifications of automatic control systems for trajectorial manipulators.

  5. Deaths during general anesthesia: technology-related, due to human error, or unavoidable? An ECRI technology assessment.

    Science.gov (United States)

    1985-01-01

    More than 2,000 healthy Americans die each year during general anesthesia, and at least half of these deaths may be preventable. Anesthetists and equipment manufacturers have made considerable progress in improving anesthesia safety. However, much more needs to be done, especially in "human-factors" areas such as improved training, consistent use of preanesthesia checklists, and anesthetists' willingness to enhance their vigilance by using appropriate monitoring equipment. While defective equipment and supplies are the direct cause of relatively few deaths, inexpensive oxygen analyzers and disconnect alarms could, if available in more ORs, warn anesthetists in time to convert many deaths to near misses. Some anesthetists are using other monitoring technologies that are more costly, but can detect a wider range of problems. The anesthesia community could expand its anesthesia-safety leadership and guidance, by improving technology-related training and by developing practice standards for anesthetists and safety standards for equipment. The Joint Commission on Accreditation of Hospitals could impose specific safety requirements on hospitals; malpractice insurance carriers could require anesthetists and hospitals to use monitors and alarms during all procedures; and the Food and Drug Administration could actively stimulate and oversee these efforts and perhaps provide seed money for some of them. The necessary equipment costs would likely be offset by long-term savings in malpractice premiums, as anesthesia incidents are the most costly of all types of malpractice claims. Concerted efforts such as these could greatly reduce the number of avoidable anesthesia-related deaths.

  6. Intricacies and strategies for the implementation of new technologies in radiotherapy: Reflections on the meaning and prevention of the error

    Science.gov (United States)

    Espejo-Villalobos, J. D.; Franco-Cabrera, M. C.; Estrada-Hernandez, C.; Quintero-Castelan, M. S.

    2012-10-01

    When facing the challenge of implementing new technologies in Radiotherapy, a reflection on philosophical and ethical principles is in order for the Medical Physicist to assume a reality of increased risks of harm to the patient. A series of ideas from philosophers and clinical professionals are reviewed to encourage an increased awareness of our ethical responsibility towards patients that entrust us with their hopes for alleviating their disease.

  7. Intricacies and strategies for the implementation of new technologies in radiotherapy: Reflections on the meaning and prevention of the error

    Energy Technology Data Exchange (ETDEWEB)

    Espejo-Villalobos, J. D.; Franco-Cabrera, M. C.; Estrada-Hernandez, C.; Quintero-Castelan, M. S. [Centro Medico Hospital San Jose -TEC Salud, Department of Radiothrapy. Av. Ignacio Morones Prieto 3000 Pte. Col. Los Doctores, Monterrey, Nuevo Leon, 64710 (Mexico)

    2012-10-23

    When facing the challenge of implementing new technologies in Radiotherapy, a reflection on philosophical and ethical principles is in order for the Medical Physicist to assume a reality of increased risks of harm to the patient. A series of ideas from philosophers and clinical professionals are reviewed to encourage an increased awareness of our ethical responsibility towards patients that entrust us with their hopes for alleviating their disease.

  8. Enhancing patient safety: the importance of direct supervision for avoiding medication errors and near misses by undergraduate nursing students.

    Science.gov (United States)

    Reid-Searl, Kerry; Moxham, Lorna; Happell, Brenda

    2010-06-01

    Medication errors have been the focus of considerable research attention in nursing; however, the extent to which nursing students might contribute to errors has not been researched. Using a grounded theory approach, in-depth semi-structured interviews were conducted with undergraduate nursing students based in a university in Queensland to explore their experiences of administering medication in the clinical setting. Almost a third of the participants reported making an actual medication error or a near miss. Where medication errors occurred, participants described not receiving direct and appropriate supervision by a registered nurse. Medication errors by nursing students have the potential to impact significantly on patient safety, quality of health care, and on nursing students' perceptions of their professional competence. Ensuring direct supervision is provided at all times must become an urgent priority for undergraduate nursing education.

  9. Improvements in Boron Plate Coating Technology for Higher Efficiency Neutron Detection and Coincidence Counting Error Reduction

    Energy Technology Data Exchange (ETDEWEB)

    Menlove, Howard Olsen [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Henzlova, Daniela [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2016-08-25

    This informal report presents the measurement data and information to document the performance of the advanced Precision Data Technology, Inc. (PDT) sealed cell boron-10 plate neutron detector that makes use of the advanced coating materials and procedures. In 2015, PDT changed the boron coating materials and application procedures to significantly increase the efficiency of their basic corrugated plate detector performance. A prototype sealed cell unit was supplied to LANL for testing and comparison with prior detector cells. Also, LANL had reference detector slabs from the original neutron collar (UNCL) and the new Antech UNCL with the removable 3He tubes. The comparison data is presented in this report.

  10. Preserved Error-Monitoring in Borderline Personality Disorder Patients with and without Non-Suicidal Self-Injury Behaviors.

    Directory of Open Access Journals (Sweden)

    Daniel Vega

    Full Text Available The presence of non-suicidal self-injury acts in Borderline Personality Disorder (BPD is very prevalent. These behaviors are a public health concern and have become a poorly understood phenomenon in the community. It has been proposed that the commission of non-suicidal self-injury might be related to a failure in the brain network regulating executive functions. Previous studies have shown that BPD patients present an impairment in their capacity to monitor actions and conflicts associated with the performance of certain actions, which suppose an important aspect of cognitive control.We used Event Related Potentials to examine the behavioral and electrophysiological indexes associated with the error monitoring in two BPD outpatients groups (17 patients each differentiated according to the presence or absence of non-suicidal self-injury behaviors. We also examined 17 age- and intelligence- matched healthy control participants.The three groups did not show significant differences in event-related potentials associated with errors (Error-Related Negativity and Pe nor in theta power increase following errors.This is the first study investigating the behavioral and electrophysiological error monitoring indexes in BPD patients characterized by their history of non-suicidal self-injury behaviors. Our results show that error monitoring is preserved in BPD patients and suggest that non-suicidal self-injury acts are not related to a dysfunction in the cognitive control mechanisms.

  11. Preserved Error-Monitoring in Borderline Personality Disorder Patients with and without Non-Suicidal Self-Injury Behaviors

    Science.gov (United States)

    Vega, Daniel; Vilà-Balló, Adrià; Soto, Àngel; Amengual, Julià; Ribas, Joan; Torrubia, Rafael; Rodríguez-Fornells, Antoni; Marco-Pallarés, Josep

    2015-01-01

    Background The presence of non-suicidal self-injury acts in Borderline Personality Disorder (BPD) is very prevalent. These behaviors are a public health concern and have become a poorly understood phenomenon in the community. It has been proposed that the commission of non-suicidal self-injury might be related to a failure in the brain network regulating executive functions. Previous studies have shown that BPD patients present an impairment in their capacity to monitor actions and conflicts associated with the performance of certain actions, which suppose an important aspect of cognitive control. Method We used Event Related Potentials to examine the behavioral and electrophysiological indexes associated with the error monitoring in two BPD outpatients groups (17 patients each) differentiated according to the presence or absence of non-suicidal self-injury behaviors. We also examined 17 age- and intelligence- matched healthy control participants. Results The three groups did not show significant differences in event-related potentials associated with errors (Error-Related Negativity and Pe) nor in theta power increase following errors. Conclusions This is the first study investigating the behavioral and electrophysiological error monitoring indexes in BPD patients characterized by their history of non-suicidal self-injury behaviors. Our results show that error monitoring is preserved in BPD patients and suggest that non-suicidal self-injury acts are not related to a dysfunction in the cognitive control mechanisms. PMID:26636971

  12. [Measures to prevent patient identification errors in blood collection/physiological function testing utilizing a laboratory information system].

    Science.gov (United States)

    Shimazu, Chisato; Hoshino, Satoshi; Furukawa, Taiji

    2013-08-01

    We constructed an integrated personal identification workflow chart using both bar code reading and an all in-one laboratory information system. The information system not only handles test data but also the information needed for patient guidance in the laboratory department. The reception terminals at the entrance, displays for patient guidance and patient identification tools at blood-sampling booths are all controlled by the information system. The number of patient identification errors was greatly reduced by the system. However, identification errors have not been abolished in the ultrasound department. After re-evaluation of the patient identification process in this department, we recognized that the major reason for the errors came from excessive identification workflow. Ordinarily, an ultrasound test requires patient identification 3 times, because 3 different systems are required during the entire test process, i.e. ultrasound modality system, laboratory information system and a system for producing reports. We are trying to connect the 3 different systems to develop a one-time identification workflow, but it is not a simple task and has not been completed yet. Utilization of the laboratory information system is effective, but is not yet perfect for patient identification. The most fundamental procedure for patient identification is to ask a person's name even today. Everyday checks in the ordinary workflow and everyone's participation in safety-management activity are important for the prevention of patient identification errors.

  13. Errors in the management of cardiac arrests: an observational study of patient safety incidents in England.

    Science.gov (United States)

    Panesar, Sukhmeet S; Ignatowicz, Agnieszka M; Donaldson, Liam J

    2014-12-01

    The aim of this qualitative study is to better understand the types of error occurring during the management of cardiac arrests that led to a death. All patient safety incidents involving management of cardiac arrests and resulting in death which were reported to a national patient safety database over a 17-month period were analysed. Structured data from each report were extracted and these together with the free text, were subjected to content analysis which was inductive, with the coding scheme emerged from continuous reading and re-reading of incidents. There were 30 patient safety incidents involving management of cardiac arrests and resulting in death. The reviewers identified a main shortfall in the management of each cardiac arrest and this resulted in 12 different factors being documented. These were grouped into four themes that highlighted systemic weaknesses: miscommunication involving crash number (4/30, 13%), shortfalls in staff attending the arrest (4/30, 13%), equipment deficits (11/30, 36%), and poor application of knowledge and skills (11/30, 37%). The factors identified represent serious shortfalls in the quality of response to cardiac arrests resulting in death in hospital. No firm conclusion can be drawn about how many deaths in the study population would have been averted if the emergency had been managed to a high standard. The effective management of cardiac arrests should be considered as one of the markers of safe care within a healthcare organisation.

  14. Improving patient safety in radiotherapy by learning from near misses, incidents and errors.

    Science.gov (United States)

    Williams, M V

    2007-05-01

    Radiotherapy incidents involving a major overdose such as that which affected a patient in Glasgow in 2006 are rare. The publicity surrounding this patient's treatment and the subsequent publication of the enquiry by the Scottish Executive have led to a re-evaluation of procedures in many departments. However, other incidents and near misses that might also generate learning are often surrounded by obsessive secrecy. With the passage of time, even those incidents that have been subject to a public enquiry are lost from view. Indeed, the report on the incident in Glasgow draws attention to strong parallels with that in North Staffordshire, the report of which is not freely available despite being in the public domain. A web-based system to archive and make available previously published reports should be relatively simple to establish. A greater challenge is to achieve open reporting of near misses, incidents and errors. The key elements would be the effective use of keywords, a system of classification and a searchable anonymized database with free access. There should be a well designed system for analysis, response and feedback. This would ensure the dissemination of learning. The development of a more open culture for reports under the Ionising Radiation (Medical Exposure) Regulations (IR(ME)R) is essential: at the very least, their main findings and recommendations should be routinely published. These changes should help us to achieve greater safety for our patients.

  15. Identification errors in pathology and laboratory medicine.

    Science.gov (United States)

    Valenstein, Paul N; Sirota, Ronald L

    2004-12-01

    Identification errors involve misidentification of a patient or a specimen. Either has the potential to cause patients harm. Identification errors can occur during any part of the test cycle; however, most occur in the preanalytic phase. Patient identification errors in transfusion medicine occur in 0.05% of specimens; for general laboratory specimens the rate is much higher, around 1%. Anatomic pathology, which involves multiple specimen transfers and hand-offs, may have the highest identification error rate. Certain unavoidable cognitive failures lead to identification errors. Technology, ranging from bar-coded specimen labels to radio frequency identification tags, can be incorporated into protective systems that have the potential to detect and correct human error and reduce the frequency with which patients and specimens are misidentified.

  16. Impact of a clinical pharmacy admission medication reconciliation program on medication errors in "high-risk" patients.

    Science.gov (United States)

    Buckley, Mitchell S; Harinstein, Lisa M; Clark, Kimberly B; Smithburger, Pamela L; Eckhardt, Doug J; Alexander, Earnest; Devabhakthuni, Sandeep; Westley, Craig A; David, Butch; Kane-Gill, Sandra L

    2013-12-01

    Medication errors are common upon hospital admission. Clinical pharmacist involvement in medication reconciliation is effective in identifying and rectifying medication errors. However, data is lacking on the economic impact, time requirements, and severity of errors resolved by clinical pharmacists. To determine the incidence of unintended admission medication discrepancies resolved by clinical pharmacists. Secondary objectives were to determine the type of discrepancies, potential severity, proximal cause, and economic impact of this clinical pharmacy program. This was a single-center, prospective, observational study conducted at a major teaching medical institution. Following institutional review board approval, data collection was conducted over a 4-week period (August 22, 2011, to September 16, 2011). Descriptive statistical methods were performed for all data analyses. A total of 517 patients involving 5006 medications were included in this study. More than 25% (n = 132) of patients had at least 1 error associated with a medication ordered on hospital admission. Pharmacists resolved a total of 467 admission medication errors (3.5 ± 2.3 errors/patient). The most common type of medication error resolved was medication omission (79.6%). In regard to severity, 46% of medication errors were considered significant or serious. Overall, the mean total time was 44.4 ± 21.8 minutes per medication reconciliation. This clinical pharmacy program was estimated to carry a net present value of $5.7 million over 5 years. Clinical pharmacist involvement within a multidisciplinary health care team during the admission medication reconciliation process demonstrated a significant improvement in patient safety and an economic benefit.

  17. Dispersion sensitivity of the eight inch advanced ramjet munitions technology projectile due to wind and minor thrust errors

    Science.gov (United States)

    Poole, S. R.

    1984-09-01

    Advanced Ramjet Munitions Technology (ARMT) is an ongoing DARPA project to research ramjet munitions. The ARMT eight inch projectile uses ramjet thrust for a boosted trajectory, but operates on a thrust drag balance concept to create pseudovacuum trajectory during powered flight. The trajectory was analyzed using an IBM-370 computer simulation for three and five degrees of freedom. Work was also done to adapt the Ballistics Research Laboratories six degrees of freedom program to the IBM system. Projectile aerodynamic and mass properties were obtained from the Norden Systems Wind Tunnel Data. Dispersion from the vaccuum trajectory due to wind prior to ramjet burnout proved minor. Dispersion due to constant thrust errors under 5% was within a 600 radius at terminal guidance over a range of 33 miles.

  18. Advanced Communications Technology Satellite (ACTS) Fade Compensation Protocol Impact on Very Small-Aperture Terminal Bit Error Rate Performance

    Science.gov (United States)

    Cox, Christina B.; Coney, Thom A.

    1999-01-01

    The Advanced Communications Technology Satellite (ACTS) communications system operates at Ka band. ACTS uses an adaptive rain fade compensation protocol to reduce the impact of signal attenuation resulting from propagation effects. The purpose of this paper is to present the results of an analysis characterizing the improvement in VSAT performance provided by this protocol. The metric for performance is VSAT bit error rate (BER) availability. The acceptable availability defined by communication system design specifications is 99.5% for a BER of 5E-7 or better. VSAT BER availabilities with and without rain fade compensation are presented. A comparison shows the improvement in BER availability realized with rain fade compensation. Results are presented for an eight-month period and for 24 months spread over a three-year period. The two time periods represent two different configurations of the fade compensation protocol. Index Terms-Adaptive coding, attenuation, propagation, rain, satellite communication, satellites.

  19. Route learning in amnesia: a comparison of trial-and-error and errorless learning in patients with the Korsakoff syndrome.

    Science.gov (United States)

    Kessels, Roy P C; van Loon, Eke; Wester, Arie J

    2007-10-01

    To examine the errorless learning approach using a procedural memory task (i.e. learning of actual routes) in patients with amnesia, as compared to trial-and-error learning. Counterbalanced self-controlled cases series. Psychiatric hospital (Korsakoff clinic). A convenience sample of 10 patients with the Korsakoff amnestic syndrome. All patients learned a route in four sessions on separate days using an errorless approach and a different route using trial-and-error. Error rate was scored during route learning and standard neuro-psychological tests were administered (i.e. subtest route recall of the Rivermead Behavioural Memory Test (RBMT) and the Dutch version of the California Verbal Learning Test (VLGT)). A significant learning effect was found in the trial-and-error condition over consecutive sessions (P = 0.006), but no performance difference was found between errorless and trial-and-error learning of the routes. VLGT performance was significantly correlated with a trial-and-error advantage (P amnesia).

  20. Refusing to Report the Medication Errors and It\\'s Effects on Patient\\'s Safety in Razi Teaching Hospital during 2014-2015

    Directory of Open Access Journals (Sweden)

    Sahar Geravandi

    2016-07-01

    Full Text Available Background & Aims of the Study: one of the most important health aspects health care systems is patient safety and medication errors can threaten this safety. The purpose of this research was evaluation of refusing to report the medication errors and effect on Patent safety in Razi teaching hospital after healthcare reform during 2014-2015. Materials and Methods: This study is cross-sectional study that has been accomplished in way of descriptive-analytical. The environment of research is Razi teaching hospital of Ahwaz. The population studied consisted of nurses working in different wards of selected hospital. The data collection tool was a questionnaire. The results were analyzed by Excel and SPSS 16.0. Results: The results showed 60% of medication errors report by nurses. The results showed that the most important reasons for not reporting medication errors were related to the managerial factors (3.85 ± 1.512. This factor can be very important on patent safety. Factors related to the fear of the consequences of reporting 3.80 ± 1.301 and process of reporting were 3.21 ± 1.231, respectively. Conclusion: The results of this study showed that the management factors was important reason not reporting medication errors. Encourage nursing, good drug administration, Training of appropriate, using instruments suitable and decrease direct contact with patient can increase causes report errors. Increase the report of medication errors can help to management these errors and reduction of injures to patients.

  1. Inferring reward prediction errors in patients with schizophrenia: a dynamic reward task for reinforcement learning.

    Science.gov (United States)

    Li, Chia-Tzu; Lai, Wen-Sung; Liu, Chih-Min; Hsu, Yung-Fong

    2014-01-01

    Abnormalities in the dopamine system have long been implicated in explanations of reinforcement learning and psychosis. The updated reward prediction error (RPE)-a discrepancy between the predicted and actual rewards-is thought to be encoded by dopaminergic neurons. Dysregulation of dopamine systems could alter the appraisal of stimuli and eventually lead to schizophrenia. Accordingly, the measurement of RPE provides a potential behavioral index for the evaluation of brain dopamine activity and psychotic symptoms. Here, we assess two features potentially crucial to the RPE process, namely belief formation and belief perseveration, via a probability learning task and reinforcement-learning modeling. Forty-five patients with schizophrenia [26 high-psychosis and 19 low-psychosis, based on their p1 and p3 scores in the positive-symptom subscales of the Positive and Negative Syndrome Scale (PANSS)] and 24 controls were tested in a feedback-based dynamic reward task for their RPE-related decision making. While task scores across the three groups were similar, matching law analysis revealed that the reward sensitivities of both psychosis groups were lower than that of controls. Trial-by-trial data were further fit with a reinforcement learning model using the Bayesian estimation approach. Model fitting results indicated that both psychosis groups tend to update their reward values more rapidly than controls. Moreover, among the three groups, high-psychosis patients had the lowest degree of choice perseveration. Lumping patients' data together, we also found that patients' perseveration appears to be negatively correlated (p = 0.09, trending toward significance) with their PANSS p1 + p3 scores. Our method provides an alternative for investigating reward-related learning and decision making in basic and clinical settings.

  2. Patient safety and technology-driven medication - A qualitative study on how graduate nursing students navigate through complex medication administration.

    Science.gov (United States)

    Orbæk, Janne; Gaard, Mette; Fabricius, Pia; Lefevre, Rikke S; Møller, Tom

    2015-05-01

    The technology-driven medication process is complex, involving advanced technologies, patient participation and increased safety measures. Medication administration errors are frequently reported, with nurses implicated in 26-38% of in-hospital cases. This points to the need for new ways of educating nursing students in today's medication administration. To explore nursing students' experiences and competences with the technology-driven medication administration process. 16 pre-graduate nursing students were included in two focus group interviews which were recorded, transcribed and analyzed using the systematic horizontal phenomenological-hermeneutic template methodology. The interviews uncovered that understanding the technologies; professionalism and patient safety are three crucial elements in the medication process. The students expressed positivity and confidence in using technology, but were fearful of committing serious medication errors. From the nursing students' perspective, experienced nurses deviate from existing guidelines, leaving them feeling isolated in practical learning situations. Having an unclear nursing role model for the technology-driven medication process, nursing students face difficulties in identifying and adopting best practices. The impact of using technology on the frequency, type and severity of medication errors; the technologies implications on nursing professionalism and the nurses ability to secure patient adherence to the medication process, still remains to be studied. Copyright © 2014 Elsevier Ltd. All rights reserved.

  3. Patient Safety in Drug Therapy and the Influence of the Prescription in Dose Errors

    OpenAIRE

    GIMENES, Fernanda Raphael Escobar; Mota,Maria Ludermiller Sabóia; Teixeira,Thalyta Cardoso Alux; Silva,Ana Elisa Bauer de Camargo; Opitz,Simone Perufo; Cassiani, Silvia Helena De Bortoli

    2010-01-01

    The aims of this study were to analyze the redaction of the prescription in dose errors that occurred in general medical units of five Brazilian hospitals and to identify the pharmacological classes involved in these errors. This was a descriptive study that used secondary data obtained from a multicenter study conducted in 2005. The population consisted of 1,425 medication errors and the sample of 215 dose errors. Of these, 44.2% occurred in hospital E. The presence of acronyms and/or abbrev...

  4. Inferring reward prediction errors in patients with schizophrenia: a dynamic reward task for reinforcement learning

    Directory of Open Access Journals (Sweden)

    Chia-Tzu eLi

    2014-11-01

    Full Text Available Abnormalities in the dopamine system have long been implicated in explanations of reinforcement learning and psychosis. The updated reward prediction error (RPE—a discrepancy between the predicted and actual rewards—is thought to be encoded by dopaminergic neurons. Dysregulation of dopamine systems could alter the appraisal of stimuli and eventually lead to schizophrenia. Accordingly, the measurement of RPE provides a potential behavioral index for the evaluation of brain dopamine activity and psychotic symptoms. Here, we assess two features potentially crucial to the RPE process, namely belief formation and belief perseveration, via a probability learning task and reinforcement-learning modeling. Forty-five patients with schizophrenia (26 high-psychosis and 19 low-psychosis, based on their p1 and p3 scores in the positive-symptom subscales of the Positive and Negative Syndrome Scale (PANSS and 24 controls were tested in a feedback-based dynamic reward task for their RPE-related decision making. While task scores across the three groups were similar, matching law analysis revealed that the reward sensitivities of both psychosis groups were lower than that of controls. Trial-by-trial data were further fit with a reinforcement learning model using the Bayesian estimation approach. Model fitting results indicated that both psychosis groups tend to update their reward values more rapidly than controls. Moreover, among the three groups, high-psychosis patients had the lowest degree of choice perseveration. Lumping patients’ data together, we also found that patients’ perseveration appears to be negatively correlated (p = .09, trending towards significance with their PANSS p1+p3 scores. Our method provides an alternative for investigating reward-related learning and decision making in basic and clinical settings.

  5. Inhalation errors due to device switch in patients with chronic obstructive pulmonary disease and asthma: critical health and economic issues

    Directory of Open Access Journals (Sweden)

    Roggeri A

    2016-03-01

    Full Text Available Alessandro Roggeri,1 Claudio Micheletto,2 Daniela Paola Roggeri1 1ProCure Solutions, Nembro, Bergamo, Italy, 2Respiratory Unit, Mater Salutis Hospital, Legnago, Verona, Italy Background: Different inhalation devices are characterized by different techniques of use. The untrained switching of device in chronic obstructive pulmonary disease (COPD and asthma patients may be associated with inadequate inhalation technique and, consequently, could lead to a reduction in adherence to treatment and limit control of the disease. The aim of this analysis was to estimate the potential economic impact related to errors in inhalation in patients switching device without adequate training. Methods: An Italian real-practice study conducted in patients affected by COPD and asthma has shown an increase in health care resource consumption associated with misuse of inhalers. Particularly, significantly higher rates of hospitalizations, emergency room visits (ER, and pharmacological treatments (steroids and antimicrobials were observed. In this analysis, those differences in resource consumption were monetized considering the Italian National Health Service (INHS perspective. Results: Comparing a hypothetical cohort of 100 COPD patients with at least a critical error in inhalation vs 100 COPD patients without errors in inhalation, a yearly excess of 11.5 hospitalizations, 13 ER visits, 19.5 antimicrobial courses, and 47 corticosteroid courses for the first population were revealed. In the same way, considering 100 asthma patients with at least a critical error in inhalation vs 100 asthma patients without errors in inhalation, the first population is associated with a yearly excess of 19 hospitalizations, 26.5 ER visits, 4.5 antimicrobial courses, and 21.5 corticosteroid courses. These differences in resource consumption could be associated with an increase in health care expenditure for INHS, due to inhalation errors, of €23,444/yr in COPD and €44,104/yr in

  6. Preventing errors in administration of parenteral drugs: the results of a four-year national patient safety program.

    NARCIS (Netherlands)

    Blok, C. de; Schilp, J.; Wagner, C.

    2013-01-01

    Objectives: To evaluate the implementation of a four-year national patient safety program concerning the parenteral drug administration process in the Netherlands. Methods: Structuring the preparation and administration process of parenteral drugs reduces the number of medication errors. A nationwid

  7. Route learning in amnesia: a comparison of trial-and-error and errorless learning in patients with the Korsakoff syndrome.

    NARCIS (Netherlands)

    Kessels, R.P.C.; Loon, E. van; Wester, A.J.

    2007-01-01

    OBJECTIVE: To examine the errorless learning approach using a procedural memory task (i.e. learning of actual routes) in patients with amnesia, as compared to trial-and-error learning. DESIGN: Counterbalanced self-controlled cases series. SETTING: Psychiatric hospital (Korsakoff clinic). SUBJECTS: A

  8. Preventing errors in administration of parenteral drugs: the results of a four-year national patient safety program.

    NARCIS (Netherlands)

    Blok, C. de; Schilp, J.; Wagner, C.

    2013-01-01

    Objectives: To evaluate the implementation of a four-year national patient safety program concerning the parenteral drug administration process in the Netherlands. Methods: Structuring the preparation and administration process of parenteral drugs reduces the number of medication errors. A nationwid

  9. Technologies of compliance? Telecare technologies and self-management of chronic patients

    NARCIS (Netherlands)

    Maathuis, Ivo

    2015-01-01

    Telecare technologies are instruments that enable care at a distance via the use of information and communication technologies (ICTs). One of the aims of telecare technologies is to support self-management strategies of chronic patients. However, the ways in which self-management is articulated in

  10. Research on Error Correcting Technology of Softswitch System%软交换系统纠错技术研究

    Institute of Scientific and Technical Information of China (English)

    陈少军

    2012-01-01

    针对软交换系统软件错误产生的原因及呼叫过程每个步骤可能产生错误的原因进行了分析。基于分析结果提出了分层系统结构优化方案以避免错误的产生,并针对无法避免的错误提出了系统纠错和拥塞纠错概念。根据纠错机制,给出了软交换系统软件架构设计、系统纠错和拥塞纠错等方面解决方法。对纠错机制进行了实际测试,实现了系统错误的处理。%This paper analyzes the error reason for softswitch system software and call flow each setp.Based on the analysis results,it proposes the optimization scheme of hierarchical system struction to avoid the error,and the conception of system error correcting and congestion error correcting against the avoidless errors.According to the error correction mechanism,we implement the design of softswitch system software framework and the solution of system error correcting and congestion error correcting.The error correcting mechanism is tested in practice and the system error correcting is realized.

  11. AWARENESS OF DE NTISTS ABOUT MEDICATION ERRORS

    Directory of Open Access Journals (Sweden)

    Sangeetha

    2014-01-01

    Full Text Available OBJECTIVE: To assess the awareness of medication errors among dentists. METHODS: Medication errors are the most common single preventable cause o f adverse events in medication practice. We conducted a survey with a sample of sixty dentists. Among them 30 were general dentists (BDS and 30 were dental specialists (MDS. Questionnaires were distributed to them with questions regarding medication erro rs and they were asked to fill up the questionnaire. Data was collected and subjected to statistical analysis using Fisher exact and Chi square test. RESULTS: In our study, sixty percent of general dentists and 76.7% of dental specialists were aware about the components of medication error. Overall 66.7% of the respondents in each group marked wrong duration as the dispensing error. Almost thirty percent of the general dentists and 56.7% of the dental specialists felt that technologic advances could accompl ish diverse task in reducing medication errors. This was of suggestive statistical significance with a P value of 0.069. CONCLUSION: Medication errors compromise patient confidence in the health - care system and increase health - care costs. Overall, the dent al specialists were more knowledgeable than the general dentists about the Medication errors. KEY WORDS: Medication errors; Dosing error; Prevention of errors; Adverse drug events; Prescribing errors; Medical errors.

  12. Quality Indicators in Laboratory Medicine: the status of the progress of IFCC Working Group "Laboratory Errors and Patient Safety" project.

    Science.gov (United States)

    Sciacovelli, Laura; Lippi, Giuseppe; Sumarac, Zorica; West, Jamie; Garcia Del Pino Castro, Isabel; Furtado Vieira, Keila; Ivanov, Agnes; Plebani, Mario

    2017-03-01

    The knowledge of error rates is essential in all clinical laboratories as it enables them to accurately identify their risk level, and compare it with those of other laboratories in order to evaluate their performance in relation to the State-of-the-Art (i.e. benchmarking) and define priorities for improvement actions. Although no activity is risk free, it is widely accepted that the risk of error is minimized by the use of Quality Indicators (QIs) managed as a part of laboratory improvement strategy and proven to be suitable monitoring and improvement tools. The purpose of QIs is to keep the error risk at a level that minimizes the likelihood of patients. However, identifying a suitable State-of-the-Art is challenging, because it calls for the knowledge of error rates measured in a variety of laboratories throughout world that differ in their organization and management, context, and the population they serve. Moreover, it also depends on the choice of the events to keep under control and the individual procedure for measurement. Although many laboratory professionals believe that the systemic use of QIs in Laboratory Medicine may be effective in decreasing errors occurring throughout the total testing process (TTP), to improve patient safety as well as to satisfy the requirements of International Standard ISO 15189, they find it difficult to maintain standardized and systematic data collection, and to promote continued high level of interest, commitment and dedication in the entire staff. Although many laboratories worldwide express a willingness to participate to the Model of QIs (MQI) project of IFCC Working Group "Laboratory Errors and Patient Safety", few systematically enter/record their own results and/or use a number of QIs designed to cover all phases of the TTP. Many laboratories justify their inadequate participation in data collection of QIs by claiming that the number of QIs included in the MQI is excessive. However, an analysis of results suggests

  13. El Camino Hospital: using health information technology to promote patient safety.

    Science.gov (United States)

    Bukunt, Susan; Hunter, Christine; Perkins, Sharon; Russell, Diana; Domanico, Lee

    2005-10-01

    El Camino Hospital is a leader in the use of health information technology to promote patient safety, including bar coding, computerized order entry, electronic medical records, and wireless communications. Each year, El Camino Hospital's board of directors sets performance expectations for the chief executive officer, which are tied to achievement of local, regional, and national safety and quality standards, including the six Institute of Medicine quality dimensions. He then determines a set of explicit quality goals and measurable actions, which serve as guidelines for the overall hospital. The goals and progress reports are widely shared with employees, medical staff, patients and families, and the public. For safety, for example, the medication error reduction team tracks and reviews medication error rates. The hospital has virtually eliminated transcription errors through its 100% use of computerized physician order entry. Clinical pathways and standard order sets have reduced practice variation, providing a safer environment. Many projects focused on timeliness, such as emergency department wait time, lab turnaround time, and pneumonia time to initial antibiotic. Results have been mixed, with projects most successful when a link was established with patient outcomes, such as in reducing time to percutaneous transluminal coronary angioplasty for patients with acute myocardial infarction.

  14. Reducing medication errors.

    Science.gov (United States)

    Nute, Christine

    2014-11-25

    Most nurses are involved in medicines management, which is integral to promoting patient safety. Medicines management is prone to errors, which depending on the error can cause patient injury, increased hospital stay and significant legal expenses. This article describes a new approach to help minimise drug errors within healthcare settings where medications are prescribed, dispensed or administered. The acronym DRAINS, which considers all aspects of medicines management before administration, was devised to reduce medication errors on a cardiothoracic intensive care unit.

  15. Identifying and preventing medical errors in patients with limited English proficiency: key findings and tools for the field.

    Science.gov (United States)

    Wasserman, Melanie; Renfrew, Megan R; Green, Alexander R; Lopez, Lenny; Tan-McGrory, Aswita; Brach, Cindy; Betancourt, Joseph R

    2014-01-01

    Since the 1999 Institute of Medicine (IOM) report To Err is Human, progress has been made in patient safety, but few efforts have focused on safety in patients with limited English proficiency (LEP). This article describes the development, content, and testing of two new evidence-based Agency for Healthcare Research and Quality (AHRQ) tools for LEP patient safety. In the content development phase, a comprehensive mixed-methods approach was used to identify common causes of errors for LEP patients, high-risk scenarios, and evidence-based strategies to address them. Based on our findings, Improving Patient Safety Systems for Limited English Proficient Patients: A Guide for Hospitals contains recommendations to improve detection and prevention of medical errors across diverse populations, and TeamSTEPPS Enhancing Safety for Patients with Limited English Proficiency Module trains staff to improve safety through team communication and incorporating interpreters in the care process. The Hospital Guide was validated with leaders in quality and safety at diverse hospitals, and the TeamSTEPPS LEP module was field-tested in varied settings within three hospitals. Both tools were found to be implementable, acceptable to their audiences, and conducive to learning. Further research on the impact of the combined use of the guide and module would shed light on their value as a multifaceted intervention.

  16. The application of SHERPA (Systematic Human Error Reduction and Prediction Approach) in the development of compensatory cognitive rehabilitation strategies for stroke patients with left and right brain damage.

    Science.gov (United States)

    Hughes, Charmayne M L; Baber, Chris; Bienkiewicz, Marta; Worthington, Andrew; Hazell, Alexa; Hermsdörfer, Joachim

    2015-01-01

    Approximately 33% of stroke patients have difficulty performing activities of daily living, often committing errors during the planning and execution of such activities. The objective of this study was to evaluate the ability of the human error identification (HEI) technique SHERPA (Systematic Human Error Reduction and Prediction Approach) to predict errors during the performance of daily activities in stroke patients with left and right hemisphere lesions. Using SHERPA we successfully predicted 36 of the 38 observed errors, with analysis indicating that the proportion of predicted and observed errors was similar for all sub-tasks and severity levels. HEI results were used to develop compensatory cognitive strategies that clinicians could employ to reduce or prevent errors from occurring. This study provides evidence for the reliability and validity of SHERPA in the design of cognitive rehabilitation strategies in stroke populations.

  17. Tracking surgical day care patients using RFID technology

    NARCIS (Netherlands)

    L.S.G.L. Wauben; A.C.P. Guédon; D.F. de Korne (Dirk); J.J. van den Dobbelsteen (John)

    2015-01-01

    markdownabstract__Abstract__ __Objective__: Measure wait times, characterise current information flow and define requirements for a technological information system that supports the patient’s journey. __Design__: First, patients were observed during eight random weekdays and the durations of act

  18. Tracking surgical day care patients using RFID technology

    National Research Council Canada - National Science Library

    Wauben, L.S.G.L; Guédon, A.C.P; Korne, Dirk; Dobbelsteen, John

    2015-01-01

    ... (RFID) technology was installed and patients were tracked during 52 weekdays. Length of hospital stay, length of stay and wait times per phase, and differences in wait times between the two types of administered anaesthesia were analysed...

  19. Practice improvement, part II: update on patient communication technologies.

    Science.gov (United States)

    Roett, Michelle A; Coleman, Mary Thoesen

    2013-11-01

    Patient portals (ie, secure web-based services for patient health record access) and secure messaging to health care professionals are gaining popularity slowly. Advantages of web portals include timely communication and instruction, access to appointments and other services, and high patient satisfaction. Limitations include inappropriate use, security considerations, organizational costs, and exclusion of patients who are uncomfortable with or unable to use computers. Attention to the organization's strategic plan and office policies, patient and staff expectations, workflow and communication integration, training, marketing, and enrollment can facilitate optimal use of this technology. Other communication technologies that can enhance patient care include automated voice or text reminders and brief electronic communications. Social media provide another method of patient outreach, but privacy and access are concerns. Incorporating telehealthcare (health care provided via telephone or Internet), providing health coaching, and using interactive health communication applications can improve patient knowledge and clinical outcomes and provide social support.

  20. Value of acoustic perceptual method for analysis of compensatory articulation errors in postoperative patients with cleft palate

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Objective To establish an acoustic perceptual method analyzing the compensatory articulation errors in children with operated cleft palate via the formants of Chinese pure vowels. Methods The first three formants which represent vocal transmission character in Chinese pure vowels of 84 subjects with operated cleft palate, were measured by Computerized Speech Signal Processing System (CSSPS). The Chinese vowel graph of postoperative patients with cleft palate was stated by the first formant frequencies (F1) ...

  1. Evaluation of antiretroviral-related errors and interventions by the clinical pharmacist in hospitalized HIV-infected patients.

    Science.gov (United States)

    Carcelero, E; Tuset, M; Martin, M; De Lazzari, E; Codina, C; Miró, J; Gatell, Jm

    2011-09-01

    The aim of the study was to identify antiretroviral-related errors in the prescribing of medication to HIV-infected inpatients and to ascertain the degree of acceptance of the pharmacist's interventions. An observational, prospective, 1-year study was conducted in a 750-bed tertiary-care teaching hospital by a pharmacist trained in HIV pharmacotherapy. Interactions with antiretrovirals were checked for contraindicated combinations. Inpatient antiretroviral prescriptions were compared with outpatient dispensing records for reconciliation. Renal and hepatic function was monitored to determine the need for dose adjustments. The prescriptions for 247 admissions (189 patients) were reviewed. Sixty antiretroviral-related problems were identified in 41 patients (21.7%). The most common problem was contraindicated combinations (n=20; 33.3%), followed by incorrect dose (n=10; 16.7%), dose omission (n=9; 15%), lack of dosage reduction in patients with renal or hepatic impairment (n=6; 10% and n=1; 1.7%, respectively), omission of an antiretroviral (n=6; 10%), addition of an alternative antiretroviral (n=5; 8.3%) and incorrect schedule according to outpatient treatment (n=3; 5%). Fifteen out of 20 errors were made during admission. A multivariate analysis showed that factors associated with an increased risk of antiretroviral-related problems included renal impairment [odds ratio (OR) 3.95; 95% confidence interval (CI) 1.39-11.23], treatment with atazanavir (OR 3.53; 95% CI 1.61-7.76) and admission to a unit other than an infectious diseases unit (OR 2.50; 95% CI 1.28-4.88). Use of a nonnucleoside reverse transcriptase inhibitor was a protective factor (OR 0.33; 95% CI 0.13-0.81). Ninety-two per cent of the pharmacist's interventions were accepted. Antiretroviral-related errors affected more than one-in-five patients. The most common causes of error were contraindicated or not recommended drug-drug combinations and dose-related errors. A clinical pharmacist trained in HIV

  2. Innovation in practice: mobile phone technology in patient care.

    Science.gov (United States)

    Blake, Holly

    2008-04-01

    Mobile phones are becoming increasingly important in everyday life and now in healthcare. There has been a steady growth of information and communication technologies in health communication and technology is used progressively in telemedicine, wireless monitoring of health outcomes in disease and in the delivery of health interventions. Mobile phones are becoming an important method of encouraging better nurse-patient communication and will undoubtedly increase in application over coming years. This article presents recent developments and applications of mobile technology for health promotion and patient-monitoring in chronic disease.

  3. How technology is empowering patients? A literature review.

    Science.gov (United States)

    Calvillo, Jorge; Román, Isabel; Roa, Laura M

    2015-10-01

    The term 'Patient Empowerment' (PE) is a growing concept – so in popularity as in application – covering situations where citizens are encouraged to take an active role in the management of their own health. This concept is serving as engine power for increasing the quality of health systems, but a question is still unanswered, 'how PE will be effectively achieved?' Beyond psychological implications, empowerment of patients in daily practice relies on technology and the way it is used. Unfortunately, the heterogeneity of approaches and technologies makes difficult to have a global vision of how PE is being performed. To clarify how technology is being applied for enhancing patient empowerment as well as to identify current (and future) trends and milestones in this issue. Searches for relevant English language articles using Medline, Scopus, ACM Digital Library, Springer Link, EBSCO host and ScienceDirect databases from the year 2000 until October 2012 were conducted. Among others, a selection criterion was to review articles including terms 'patient' and 'empowerment' in title, abstract or as keywords. Results state that practical approaches to empower patients vary in scope, aim and technology. Health literacy of patients, remote access to health services, and self-care mechanisms are the most valued ways to accomplish PE. Current technology already allows establishing the first steps in the road ahead, but a change of attitude by all stakeholders (i.e. professionals, patients, policy makers, etc.) is required. © 2013 John Wiley & Sons Ltd.

  4. Patient safety and technology-driven medication e A qualitative study on how graduate nursing students navigate through complex medication administration

    DEFF Research Database (Denmark)

    Orbæk, Janne; Gaard, Mette; Fabricius, Pia

    2014-01-01

    ways of educating nursing students in today's medication administration. Aim: To explore nursing students' experiences and competences with the technology-driven medication administration process. Methods: 16 pre-graduate nursing students were included in two focus group interviews which were recorded...... for the technology-driven medication process, nursing students face difficulties in identifying and adopting best practices. The impact of using technology on the frequency, type and severity of medication errors; the technologies implications on nursing professionalism and the nurses ability to secure patient......Background: The technology-driven medication process is complex, involving advanced technologies, patient participation and increased safety measures. Medication administration errors are frequently reported, with nurses implicated in 26e38% of in-hospital cases. This points to the need for new...

  5. The Relationships Among Perceived Patients' Safety Culture, Intention to Report Errors, and Leader Coaching Behavior of Nurses in Korea: A Pilot Study.

    Science.gov (United States)

    Ko, YuKyung; Yu, Soyoung

    2017-09-01

    This study was undertaken to explore the correlations among nurses' perceptions of patient safety culture, their intention to report errors, and leader coaching behaviors. The participants (N = 289) were nurses from 5 Korean hospitals with approximately 300 to 500 beds each. Sociodemographic variables, patient safety culture, intention to report errors, and coaching behavior were measured using self-report instruments. Data were analyzed using descriptive statistics, Pearson correlation coefficient, the t test, and the Mann-Whitney U test. Nurses' perceptions of patient safety culture and their intention to report errors showed significant differences between groups of nurses who rated their leaders as high-performing or low-performing coaches. Perceived coaching behavior showed a significant, positive correlation with patient safety culture and intention to report errors, i.e., as nurses' perceptions of coaching behaviors increased, so did their ratings of patient safety culture and error reporting. There is a need in health care settings for coaching by nurse managers to provide quality nursing care and thus improve patient safety. Programs that are systematically developed and implemented to enhance the coaching behaviors of nurse managers are crucial to the improvement of patient safety and nursing care. Moreover, a systematic analysis of the causes of malpractice, as opposed to a focus on the punitive consequences of errors, could increase error reporting and therefore promote a culture in which a higher level of patient safety can thrive.

  6. Vaccination coverage of patients with inborn errors of metabolism and the attitudes of their parents towards vaccines.

    Science.gov (United States)

    Cerutti, Marta; De Lonlay, Pascale; Menni, Francesca; Parini, Rossella; Principi, Nicola; Esposito, Susanna

    2015-11-27

    To evaluate vaccination coverage of children and adolescents with inborn errors of metabolism (IEMs) and the attitudes of their parents towards vaccination, the vaccination status of 128 patients with IEM and 128 age- and gender-matched healthy controls was established by consulting the official vaccination chart. In children with IEMs, compared with healthy controls, low vaccination rates and/or delays in administration were observed for pneumococcal conjugate, meningococcus C, measles, mumps, rubella, diphtheria-tetanus-pertussis-inactivated polio, Bacillus Calmette-Guerin, and influenza vaccines. Among the parents of IEM patients, vaccine schedule compliance was primarily driven by the doctors at the hospital's reference centres; among the parents of the healthy controls, compliance was driven by the primary care paediatricians. These results show that IEM patients demonstrate sub-optimal vaccination coverage. Further studies of the different vaccines in each IEM disorder and educational programmes aimed at physicians and parents to increase immunization coverage in these patients are urgently needed.

  7. User-centered design and interactive health technologies for patients.

    Science.gov (United States)

    De Vito Dabbs, Annette; Myers, Brad A; Mc Curry, Kenneth R; Dunbar-Jacob, Jacqueline; Hawkins, Robert P; Begey, Alex; Dew, Mary Amanda

    2009-01-01

    Despite recommendations that patients be involved in the design and testing of health technologies, few reports describe how to involve patients in systematic and meaningful ways to ensure that applications are customized to meet their needs. User-centered design is an approach that involves end users throughout the development process so that technologies support tasks, are easy to operate, and are of value to users. In this article, we provide an overview of user-centered design and use the development of Pocket Personal Assistant for Tracking Health (Pocket PATH) to illustrate how these principles and techniques were applied to involve patients in the development of this interactive health technology. Involving patient-users in the design and testing ensured functionality and usability, therefore increasing the likelihood of promoting the intended health outcomes.

  8. Advances of information technology in communication with adolescent patients

    OpenAIRE

    Zisovska, Elizabeta; Serafimov, Aleksandar; Panova, Gordana; Simeonovska Joveva, Elena

    2013-01-01

    21.century is rapidly becoming an era of educated consumers/patients utilizing the most up-to-date technology to assume control over their health care. The computer will change the patient too. He is coming now with more and better information to the doctor. Adolescent patients particularly are fond of IT communication. On-line counseling becomes the health care environment of tomorrow. New definitions of quality therapeutic relationships occur.

  9. Evidence for Treatable Inborn Errors of Metabolism in a Cohort of 187 Greek Patients with Autism Spectrum Disorder (ASD

    Directory of Open Access Journals (Sweden)

    Martha eSpilioti

    2013-12-01

    Full Text Available We screened for the presence of inborn errors of metabolism (IEM in 187 children (105 males; 82 females, ages 4 -14 years old who presented with confirmed features of ASD. Twelve patients (7% manifested increased 3-hydroxyisovaleric acid (3-OH-IVA excretion in urine, and minor to significant improvement in autistic features was observed in seven patients following supplementation with biotin. Five diagnoses included: Lesch Nyhan syndrome (2, succinic semialdehyde dehydrogenase (SSADH deficiency (2 and phenylketonuria (1 (2.7%. Additional metabolic disturbances suggestive of IEMs included two patients whose increased urine 3-OH-IVA was accompanied by elevated methylcitrate and lactate in sera, and 30 patients that showed abnormal glucose-loading tests. In the latter group, 16/30 patients manifested increased sera beta hydroxybutyrate (b-OH-b production and 18/30 had a paradoxical increase of sera lactate. Six patients with elevated b-OH-b in sera showed improved autistic features following implementation of a ketogenic diet. Five patients showed decreased serum ketone body production with glucose loading. Twelve of 187 patients demonstrated nonspecific MRI pathology, while 25/187 had abnormal EEG findings. Finally, family history was positive for 22/187 patients (1st or 2nd degree relative with comparable symptomatology and consanguinity was documented for 12/187 patients. Our data provide evidence for a new biomarker (3-OH-IVA and novel treatment approaches in ASD patients.Concise 1 sentence take-home message: Detailed metabolic screening in a Greek cohort of autismspectrum disorder (ASD patients revealed biomarkers (urine 3-hydroxyisovaleric acid and serum b-OH-b in 7% (13/187 of patients for whom biotin supplementation or institution of a ketogenic diet resulted in mild to significant clinical improvement in autistic features.

  10. 全极化微波辐射计数字化引入误差分析%The Error Analysis of Digital Technology in Polarimetric Microwave Radiometer

    Institute of Scientific and Technical Information of China (English)

    陆浩; 王振占

    2013-01-01

    全极化微波辐射计是一种用于海洋表面风场测量的新型被动微波遥感器。数字相关器是全极化辐射计的核心部件。数字相关器的应用相对于模拟相关辐射计具有可配置、集成度高和易于控制的特点。同时,数字化技术会给辐射计带来量化误差和相位抖动误差。具体的误差分析验证了全极化微波辐射计中数字化的可行性。文中详细分析了定量误差,并根据实际工程应用说明了多比特数字化带来的误差可以在系统整体误差中忽略。%Polarimetric microwave radiometer is a new passive microwave remote sensor used to measure ocean surface wind field .Digital correlator is the core component of polarimetric radiometer .Compared to analog correlator ,the digital correlator ra-diometer has the configurable ,highly integrated and easy-to-control features/At the same time ,digital technology will bring ra-diometer quantization error and phase jitter .Detailed error analysis is the way to verify the feasibility of digital technology in fully polarimetric microwave radiometer .The quantitative error is analyzed .According to practical application ,the error caused by multi-bit digital technology can be ignored in the overall system .

  11. Patient-specific errors in agreement between International Normalized Ratios measured by a whole blood coagulometer and by a routine plasma-based method.

    Science.gov (United States)

    Attermann, Jørn; Andersen, Niels T; Korsgaard, Helle; Maegaard, Marianne; Hasenkam, J Michael

    2004-04-01

    We applied a new statistical method to improve comparisons between systems measuring prothrombin time (PT) by splitting disagreement into systematic errors, which can be eliminated, and random errors, which can not. We found that the disagreement between International Normalized Ratio (INR) measurements based on plasma and whole blood was significantly patient-dependent.

  12. Diagnostic errors in older patients: a systematic review of incidence and potential causes in seven prevalent diseases

    Directory of Open Access Journals (Sweden)

    Skinner TR

    2016-05-01

    Full Text Available Thomas R Skinner,1 Ian A Scott,2,3 Jennifer H Martin3,4 1Department of Internal Medicine, Sunshine Coast Health Service District, Nambour Hospital, Nambour, QLD, Australia; 2Internal Medicine and Clinical Epidemiology, Princess Alexandra Hospital, Woolloongabba, QLD, Australia; 3Southern School of Medicine, University of Queensland, Brisbane, QLD, Australia; 4School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, Australia Background: Misdiagnosis, either over- or underdiagnosis, exposes older patients to increased risk of inappropriate or omitted investigations and treatments, psychological distress, and financial burden. Objective: To evaluate the frequency and nature of diagnostic errors in 16 conditions prevalent in older patients by undertaking a systematic literature review. Data sources and study selection: Cohort studies, cross-sectional studies, or systematic reviews of such studies published in Medline between September 1993 and May 2014 were searched using key search terms of “diagnostic error”, “misdiagnosis”, “accuracy”, “validity”, or “diagnosis” and terms relating to each disease. Data synthesis: A total of 938 articles were retrieved. Diagnostic error rates of >10% for both over- and underdiagnosis were seen in chronic obstructive pulmonary disease, dementia, Parkinson’s disease, heart failure, stroke/transient ischemic attack, and acute myocardial infarction. Diabetes was overdiagnosed in <5% of cases. Conclusion: Over- and underdiagnosis are common in older patients. Explanations for overdiagnosis include subjective diagnostic criteria and the use of criteria not validated in older patients. Underdiagnosis was associated with long preclinical phases of disease or lack of sensitive diagnostic criteria. Factors that predispose to misdiagnosis in older patients must be emphasized in education and clinical guidelines. Keywords: older patient, elderly, overdiagnosis, underdiagnosis

  13. Value of acoustic perceptual method for analysis of compensatory articulation errors in postoperative patients with cleft palate

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Objective To establish an acoustic perceptual method analyzing the compensatory articulation errors in children with operated cleft palate via the formants of Chinese pure vowels. Methods The first three formants which represent vocal transmission character in Chinese pure vowels of 84 subjects with operated cleft palate, were measured by Computerized Speech Signal Processing System (CSSPS). The Chinese vowel graph of postoperative patients with cleft palate was stated by the first formant frequencies (F1) and the second formant frequencies (F2) of the Chinese pure vowels between the two groups. Results Values of F1 and F2 of vowels except [a] in the poor articulation group (Group A) were significantly different from those in the good articulation group (Group B) (P<0.05 or P<0.01). As compared with that in Group B, the vowel graph demonstrated the decreased perceptual distances in Group A. These findings indicated that there might still be the backward movements of tongue, perverted mandibular movements and disharmonious lip movements in addition to the velopharyngeal insufficiency (VPI) in Group A. Conclusion The speech articulation of children with repaired cleft palate should be gained by correcting the aberrant compensatory articulation errors in the condition of velopharyngeal competence. Computerized Speech Signal Processing System (CSSPS), which is regarded as the content of objective quantitative measurement, is a precise, simple, reliable and atroumatic technique for children with cleft palate to analyze pathological compensatory articulation errors.

  14. Do schizophrenia patients make more perseverative than non-perseverative errors on the Wisconsin Card Sorting Test? A meta-analytic study.

    Science.gov (United States)

    Li, Chiang-Shan Ray

    2004-12-15

    The Wisconsin Card Sorting Test (WCST) is widely used to explore executive functions in patients with schizophrenia. Among other findings, a higher number of perseverative errors has been suggested to implicate a deficit in task switching and inhibitory functions in schizophrenia. Many studies of patients with schizophrenia have focused on perseverative errors as the primary performance index in the WCST. However, do schizophrenia patients characteristically make more perseverative than non-perseverative errors compared with healthy controls? We reviewed the literature where schizophrenia patients were engaged in the WCST irrespective of the primary goal of the study. The results showed that while both schizophrenia patients and healthy participants made more perseverative than non-perseverative errors, the contrast between perseverative and non-perseverative errors is higher in schizophrenia patients only at a marginal level of significance. This result suggests that schizophrenia patients do make a comparable number of non-perseverative errors and cautions against simplistic interpretation of poor performance of schizophrenia patients in WCST as entirely resulting from impairment in set-shifting or inhibitory functions.

  15. Cloud computing and patient engagement: leveraging available technology.

    Science.gov (United States)

    Noblin, Alice; Cortelyou-Ward, Kendall; Servan, Rosa M

    2014-01-01

    Cloud computing technology has the potential to transform medical practices and improve patient engagement and quality of care. However, issues such as privacy and security and "fit" can make incorporation of the cloud an intimidating decision for many physicians. This article summarizes the four most common types of clouds and discusses their ideal uses, how they engage patients, and how they improve the quality of care offered. This technology also can be used to meet Meaningful Use requirements 1 and 2; and, if speculation is correct, the cloud will provide the necessary support needed for Meaningful Use 3 as well.

  16. Use of antisense oligonucleotides to correct the splicing error in ISCU myopathy patient cell lines.

    Science.gov (United States)

    Holmes-Hampton, Gregory P; Crooks, Daniel R; Haller, Ronald G; Guo, Shuling; Freier, Susan M; Monia, Brett P; Rouault, Tracey A

    2016-12-01

    ISCU myopathy is an inherited disease that primarily affects individuals of northern Swedish descent who share a single point mutation in the fourth intron of the ISCU gene. The current study shows correction of specific phenotypes associated with disease following treatment with an antisense oligonucleotide (ASO) targeted to the site of the mutation. We have shown that ASO treatment diminished aberrant splicing and increased ISCU protein levels in both patient fibroblasts and patient myotubes in a concentration dependent fashion. Upon ASO treatment, levels of SDHB in patient myotubular cell lines increased to levels observed in control myotubular cell lines. Additionally, we have shown that both patient fibroblast and myotubular cell lines displayed an increase in complex II activity with a concomitant decrease in succinate levels in patient myotubular cell lines after ASO treatment. Mitochondrial and cytosolic aconitase activities increased significantly following ASO treatment in patient myotubes. The current study suggests that ASO treatment may serve as a viable approach to correcting ISCU myopathy in patients. Published by Oxford University Press 2016. This work is written by US Government employees and is in the public domain in the US.

  17. Two sides of the safety coin?: How patient engagement and safety climate jointly affect error occurrence in hospital units.

    Science.gov (United States)

    Schiffinger, Michael; Latzke, Markus; Steyrer, Johannes

    2016-01-01

    Safety climate (SC) and more recently patient engagement (PE) have been identified as potential determinants of patient safety, but conceptual and empirical studies combining both are lacking. On the basis of extant theories and concepts in safety research, this study investigates the effect of PE in conjunction with SC on perceived error occurrence (pEO) in hospitals, controlling for various staff-, patient-, and hospital-related variables as well as the amount of stress and (lack of) organizational support experienced by staff. Besides the main effects of PE and SC on error occurrence, their interaction is examined, too. In 66 hospital units, 4,345 patients assessed the degree of PE, and 811 staff assessed SC and pEO. PE was measured with a new instrument, capturing its core elements according to a recent literature review: Information Provision (both active and passive) and Activation and Collaboration. SC and pEO were measured with validated German-language questionnaires. Besides standard regression and correlational analyses, partial least squares analysis was employed to model the main and interaction effects of PE and SC on pEO, also controlling for stress and (lack of) support perceived by staff, various staff and patient attributes, and potential single-source bias. Both PE and SC are associated with lower pEO, to a similar extent. The joint effect of these predictors suggests a substitution rather than mutually reinforcing interaction. Accounting for control variables and/or potential single-source bias slightly attenuates some effects without altering the results. Ignoring PE potentially amounts to forgoing a potential source of additional safety. On the other hand, despite the abovementioned substitution effect and conjectures of SC being inert, PE should not be considered as a replacement for SC.

  18. Clinical characteristics of adult patients with inborn errors of metabolism in Spain: A review of 500 cases from university hospitals

    Directory of Open Access Journals (Sweden)

    J. Pérez-López

    2017-03-01

    Full Text Available Patients with inborn errors of metabolism (IEMs have become an emerging and challenging group in the adult healthcare system whose needs should be known in order to implement appropriate policies and to adapt adult clinical departments. We aimed to analyze the clinical characteristics of adult patients with IEMs who attend the most important Spanish hospitals caring for these conditions. A cohort study was conducted in 500 patients, categorized by metabolic subtype according to pathophysiological classification. The most prevalent group of IEMs was amino acid disorders, with 108 (21.6% patients diagnosed with phenylketonuria. Lysosomal storage disorders were the second group, in which 32 (6.4% and 25 (5% patients had Fabry disease and Gaucher disease respectively. The great clinical heterogeneity, the significant delay in diagnosis after symptom onset, the existence of some degree of physical dependence in a great number of patients, the need for a multidisciplinary and coordinated approach, and the lack of specific drug treatment are common features in this group of conditions.

  19. Empowering Patients through Healthcare Technology and Information? The Challenge of becoming a Patient 2.0

    DEFF Research Database (Denmark)

    Brodersen, Søsser Grith Kragh; Lindegaard, Hanne

    2015-01-01

    Abstract: In the mid-2000s, the term Patient 2.0 began to be used to denote a new patient role: empowered patients were expected to engage with various types of information and specific technologies in order to manage their own illnesses. Headlines such as Future patients will take care of themse......Abstract: In the mid-2000s, the term Patient 2.0 began to be used to denote a new patient role: empowered patients were expected to engage with various types of information and specific technologies in order to manage their own illnesses. Headlines such as Future patients will take care......), and domestication (Silverstone, 1989; Lie and S Keywords: patient empowerment; Patient 2.0; self-management; future healthcare system; change in healthcare practices; chronic/treated challenges...

  20. Selective screening of 650 high risk Iranian patients for detection of inborn error of metabolism

    Directory of Open Access Journals (Sweden)

    Narges Pishva

    2015-02-01

    Full Text Available Objective: Although metabolic diseases individually are rare ,but overall have an incidence of 1/2000 and can cause devastating and irreversible effect if not diagnosed early and treated promptly. selective screening is an acceptable method for detection of these multi presentation diseases.Method: using panel neonatal screening for detection of metabolic diseases in 650 high risk Iranian patients in Fars province. The following clinical features were used as inclusion criteria for investigation of the patients.Lethargy, poor feeding ,persistent vomiting, cholestasis, intractable seizure ,decreased level of consciousness ,persistent hypoglycemia, unexplained acid base disturbance and unexplained neonatal death.Result: Organic acidemia with 40 cases (42% was the most frequent disorder diagnosed in our high risk populations, followed by disorder of galactose metabolism(30%, 15 patient had classic galactosemia(GALT

  1. Selective screening of 650 high risk Iranian patients for detection of inborn error of metabolism

    Directory of Open Access Journals (Sweden)

    Narges Pishva

    2015-02-01

    Full Text Available Objective: Although metabolic diseases individually are rare ,but overall have an incidence of 1/2000 and can cause devastating and irreversible effect if not diagnosed early and treated promptly. selective screening is an acceptable method for detection of these multi presentation diseases. Method: using panel neonatal screening for detection of metabolic diseases in 650 high risk Iranian patients in Fars province. The following clinical features were used as inclusion criteria for investigation of the patients. Lethargy, poor feeding ,persistent vomiting, cholestasis, intractable seizure ,decreased level of consciousness ,persistent hypoglycemia, unexplained acid base disturbance and unexplained neonatal death. Result: Organic acidemia with 40 cases (42% was the most frequent disorder diagnosed in our high risk populations, followed by disorder of galactose metabolism(30%, 15 patient had classic galactosemia(GALT

  2. Development of sterilized porridge for patients by combined treatment of food technology with radiation technology

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jaehun; Choi, Jongil; Song, Beomseok; and others

    2010-09-15

    This research was conducted to develop patient foods of high quality using a radiation fusion technology with food processing. Radiation technique to increase calorie of porridge was established, and it was investigated that radiation effects on functional materials, which can could be added to increase functionality of patient foods. Moreover, sterilized semi-fluid meal (milk porridge) for patients with higher calorie was developed by a sterilization process by gamma irradiation, combined treatments to improve the sensory qualities, and fortification with various nutrients. Also, sensory survey on irradiated commercial patient foods was performed to find the problems and improvement points of the developed products. Optimal packaging material was selected by evaluation of effect of irradiation in packaging materials and a convenient package for consuming by patients was decided. Safety of the irradiated milk porridge was confirmed by in-vivo genotoxicological test, and its nutritional composition for patients was evaluated by nutritional analysis. Finally, the milk porridge was developed as liquid, dried, powdered, and pellet type products. This research may contribute to improve life quality of patients by supplement of various foods with high quality to immuno-compromised patients. Furthermore, economic profits and technological advances are expected by commercialization of the patient foods.

  3. Ocular Co-morbidity in Patients with Refractive Errors in Nigeria

    African Journals Online (AJOL)

    The consultation of 'road-side dispensers' by most patients in developing countries and lack of .... There w ere 4 ind ivid u als w ith d ou ble co-morbidities, two had ..... Buhrmann RR, Quigley HA, Barron Y, West SK, Oliva MS,. Mmbaga BB.

  4. Hand-held dynamometry in patients with haematological malignancies: Measurement error in the clinical assessment of knee extension strength

    Directory of Open Access Journals (Sweden)

    Uebelhart Daniel

    2009-03-01

    Full Text Available Abstract Background Hand-held dynamometry is a portable and inexpensive method to quantify muscle strength. To determine if muscle strength has changed, an examiner must know what part of the difference between a patient's pre-treatment and post-treatment measurements is attributable to real change, and what part is due to measurement error. This study aimed to determine the relative and absolute reliability of intra and inter-observer strength measurements with a hand-held dynamometer (HHD. Methods Two observers performed maximum voluntary peak torque measurements (MVPT for isometric knee extension in 24 patients with haematological malignancies. For each patient, the measurements were carried out on the same day. The main outcome measures were the intraclass correlation coefficient (ICC ± 95%CI, the standard error of measurement (SEM, the smallest detectable difference (SDD, the relative values as % of the grand mean of the SEM and SDD, and the limits of agreement for the intra- and inter-observer '3 repetition average' and the 'highest value of 3 MVPT' knee extension strength measures. Results The intra-observer ICCs were 0.94 for the average of 3 MVPT (95%CI: 0.86–0.97 and 0.86 for the highest value of 3 MVPT (95%CI: 0.71–0.94. The ICCs for the inter-observer measurements were 0.89 for the average of 3 MVPT (95%CI: 0.75–0.95 and 0.77 for the highest value of 3 MVPT (95%CI: 0.54–0.90. The SEMs for the intra-observer measurements were 6.22 Nm (3.98% of the grand mean (GM and 9.83 Nm (5.88% of GM. For the inter-observer measurements, the SEMs were 9.65 Nm (6.65% of GM and 11.41 Nm (6.73% of GM. The SDDs for the generated parameters varied from 17.23 Nm (11.04% of GM to 27.26 Nm (17.09% of GM for intra-observer measurements, and 26.76 Nm (16.77% of GM to 31.62 Nm (18.66% of GM for inter-observer measurements, with similar results for the limits of agreement. Conclusion The results indicate that there is acceptable relative reliability

  5. An investigation of the relationship between patient safety climate and barriers to nursing error reporting in Social Security Hospitals of Kerman Province, Iran

    Directory of Open Access Journals (Sweden)

    Noohi E

    2015-02-01

    Full Text Available Background and Objective: The receipt of appropriate and safe health care is of the basic rights of patiants and its provision is the main task of the health care delivery system. The role of error reporting in the reduction of future occurrence of that error is undeniable. Therefore, the removal of barriers to error reporting has particular importance. The present study aimed to investigate the association between patient safety climate and barriers to reporting of nursing error in Social Security Hospitals in Kerman province, Iran. Materials and Method: This was a cross-sectional, descriptive-correlative study. The study population consisted of all nurses of Social Security Hospitals in Kerman in 2014. Sampling was performed using the census method (n = 233. The Patient Safety Climate Questionnaire and Barriers to Nursing Error Reporting Questionnaire were used after obtaining satisfactory reliability and validity. Data were analyzed using SPSS software version 16 and frequency distribution tables and central indices. To achieve goals, the parametric test of t-test, one way ANOVA, and Pearson correlation coefficient were used. Results: The mean and standard deviations of the safety climate score (66 ± 10 and the barriers to nursing error reporting score (69 ± 13 were obtained: both were at a medium level. A significant inverse relationship was observed between patient safety climate and barriers to error reporting (P < 0.020 (r = -0.15. Conclusion: Based on the results, the error reporting barriers and safety climate scores were at an average level. Given the inverse relationship between safety climate and barriers to reporting error, it can be concluded that the most important step toward removing barriers is creating an atmosphere in which each of the nursing staff voluntarily reports her/his error and its causes to other members of the treatment team.

  6. Patient safety and error management in endoscopy ATR Axon MD FRCP

    Directory of Open Access Journals (Sweden)

    Anthony Thomas Roger Axon

    2016-01-01

    Full Text Available This paper addresses the risk of complications in patients who undergo digestive endoscopy, the reasons why they arise and the precautions that should be taken to prevent them. It also considers issues relating to potential litigation and how to minimize this risk. The advice focuses on the importance of maintaining high-quality endoscopic practice including the day-to-day running of the service. It emphasizes the importance of teamwork, the preparation of in-house protocols, patient management before, during, and after the examination, and what measures should be taken in the event that problems do arise. It is an updated and expanded version of an invited lecture given at the Asian Pacific meeting in Bali in 2014 on behalf of the World Endoscopy Organization.

  7. The Impact of a Patient Safety Program on Medical Error Reporting

    Science.gov (United States)

    2005-05-01

    incident severity showed 172 (86 percent) near misses (no impact on patient) in 1998 and 251 (91 percent) in 2001. In 1998 there were 28 (14 percent...aviation mishaps. Crew Resource Management also emphasizes the need for anonymous reporting of near misses and the removal of blame as a deterrent to the...Management Office), and each is categorized as a near miss , an adverse event, or a sentinel event. A near miss is a mistake that is caught and corrected

  8. [GASTROSTOMY POSITIVELY AFFECTS NUTRITIONAL STATUS AND DIMINISHES HOSPITAL DAYS IN PATIENTS WITH INBORN ERRORS OF METABOLISM].

    Science.gov (United States)

    Guillén-López, Sara; Vela-Amieva, Marcela; Juárez-Cruz, Merit Valeria; González-Zamora, José Francisco; Monroy-Santoyo, Susana; Belmont-Martínez, Leticia

    2015-07-01

    Introducción: el tratamiento nutricional de los pacientes con errores innatos del metabolismo (EIM) implica el uso permanente de fórmulas modificadas en aminoácidos cuyas características organolépticas pueden dificultar su aceptación por vía oral. Estos pacientes pueden tener alteraciones gastrointestinales y requieren el uso constante de medicamentos, lo cual complica la adherencia al tratamiento, comprometiéndose con ello su estado nutricional y el control de la enfermedad. La gastrostomía es una alternativa para facilitar la alimentación y el tratamiento, pero existen controversias sobre su uso. Objetivo: comparar el estado nutricional y la duración de las hospitalizaciones antes y después de la realización de la gastrostomía en un grupo de pacientes con EIM. Métodos: análisis retrospectivo de datos antropométricos, número de internamientos por descompensación metabólica y su duración en pacientes pediátricos con EIM antes y después de la gastrostomía. Resultados: se analizaron 16 niños; 40% con defectos del propionato, 25% con alteraciones del ciclo de la urea y 35% con otros EIM. Después de la gastrostomía, la proporción de pacientes eutróficos aumentó del 6 al 56% y la desnutrición disminuyó del 94 al 44%. Después de la gastrostomía, la duración de los periodos hospitalarios disminuyó significativamente de 425 a 131 días (p = 0.011); el número de internamientos disminuyó de 33 antes de la intervención a 17, sin embargo, esta diferencia no tuvo significación estadística. Conclusión: en esta muestra, la gastrostomía mejoró el estado nutricional en 56% de los pacientes con EIM, y redujo significativamente los días de hospitalización por descompensación metabólica.

  9. Use of Multimedia Technology in the Doctor-Patient Relationship for Obtaining Patient Informed Consent.

    Science.gov (United States)

    Michalski, Andrzej; Stopa, Marcin; Miśkowiak, Bogdan

    2016-10-26

    Patient informed consent for surgery or for high-risk methods of treatment or diagnosis means that unlawful breach of the patient's personal interests is avoided and the patient accepts the risk of surgery and takes the brunt of it. Patient awareness - their knowledge of the condition and circumstances of continued therapeutic procedure, including offered and available methods of treatment and their possible complications - constitutes a particular aspect of the informed-consent process. The rapid development of technologies and methods of treatment may cause communication problems between the doctor and the patient regarding the scope and method of patient education prior to surgery. The use of multimedia technology (e.g., videos of surgical procedures, computer animation, and graphics), in addition to media used in preoperative patient education, may be a factor in improving the quality of the informed consent process. Studies conducted in clinical centers show that with use of multimedia technology, patients remember more of the information presented. The use of new technology also makes it possible to reduce the difference in the amount of information assimilated by patients with different levels of education. The use of media is a way to improve the quality of preoperative patient education and, at the same time, a step towards their further empowerment in the healing process.

  10. Touch and technology: Two paradigms of patient care.

    Science.gov (United States)

    Gadow, S

    1984-03-01

    Technology violates human dignity only to the extent that its use reduces persons to the moral status of objects. The prevalence of technology in health care is an extension of the scientific paradigm, in which the body is reduced to an object void of subjectivity. The empathie paradigm, in contrast, is based upon the moral primacy of subjectivity. Empathic touch-as distinct from instrumental and philanthropic touch-establishes a clinical relation of intersubjectivity, affirming in patients the dignity and worth that morally distinguish persons from objects.

  11. Correction of patient positioning errors based on in-line cone beam CTs: clinical implementation and first experiences

    Directory of Open Access Journals (Sweden)

    Häring Peter

    2006-05-01

    Full Text Available Abstract Background The purpose of the study was the clinical implementation of a kV cone beam CT (CBCT for setup correction in radiotherapy. Patients and methods For evaluation of the setup correction workflow, six tumor patients (lung cancer, sacral chordoma, head-and-neck and paraspinal tumor, and two prostate cancer patients were selected. All patients were treated with fractionated stereotactic radiotherapy, five of them with intensity modulated radiotherapy (IMRT. For patient fixation, a scotch cast body frame or a vacuum pillow, each in combination with a scotch cast head mask, were used. The imaging equipment, consisting of an x-ray tube and a flat panel imager (FPI, was attached to a Siemens linear accelerator according to the in-line approach, i.e. with the imaging beam mounted opposite to the treatment beam sharing the same isocenter. For dose delivery, the treatment beam has to traverse the FPI which is mounted in the accessory tray below the multi-leaf collimator. For each patient, a predefined number of imaging projections over a range of at least 200 degrees were acquired. The fast reconstruction of the 3D-CBCT dataset was done with an implementation of the Feldkamp-David-Kress (FDK algorithm. For the registration of the treatment planning CT with the acquired CBCT, an automatic mutual information matcher and manual matching was used. Results and discussion Bony landmarks were easily detected and the table shifts for correction of setup deviations could be automatically calculated in all cases. The image quality was sufficient for a visual comparison of the desired target point with the isocenter visible on the CBCT. Soft tissue contrast was problematic for the prostate of an obese patient, but good in the lung tumor case. The detected maximum setup deviation was 3 mm for patients fixated with the body frame, and 6 mm for patients positioned in the vacuum pillow. Using an action level of 2 mm translational error, a target point

  12. Heart Failure Patients' Perceptions and Use of Technology to Manage Disease Symptoms

    OpenAIRE

    Hall, Amanda K.; Dodd, Virginia; Harris, Amy; McArthur, Kara; Dacso, Clifford; Colton, Lara M.

    2014-01-01

    Background: Technology use for symptom management is beneficial for both patients and physicians. Widespread acceptance of technology use in healthcare fuels continued development of technology with ever-increasing sophistication. Although acceptance of technology use in healthcare by medical professionals is evident, less is known about the perceptions, preferences, and use of technology by heart failure (HF) patients. This study explores patients' perceptions and current use of technolog...

  13. High penetrance of sequencing errors and interpretative shortcomings in mtDNA sequence analysis of LHON patients.

    Science.gov (United States)

    Bandelt, Hans-Jürgen; Yao, Yong-Gang; Salas, Antonio; Kivisild, Toomas; Bravi, Claudio M

    2007-01-12

    For identifying mutation(s) that are potentially pathogenic it is essential to determine the entire mitochondrial DNA (mtDNA) sequences from patients suffering from a particular mitochondrial disease, such as Leber hereditary optic neuropathy (LHON). However, such sequencing efforts can, in the worst case, be riddled with errors by imposing phantom mutations or misreporting variant nucleotides, and moreover, by inadvertently regarding some mutations as novel and pathogenic, which are actually known to define minor haplogroups. Under such circumstances it remains unclear whether the disease-associated mutations would have been determined adequately. Here, we re-analyse four problematic LHON studies and propose guidelines by which some of the pitfalls could be avoided.

  14. Collaborative Affordances of Hybrid Patient Record Technologies in Medical Work

    DEFF Research Database (Denmark)

    Houben, Steven; Frost, Mads; Bardram, Jakob E

    2015-01-01

    to digitally augment a paper medical record. We report on two studies: a field study in which we describe the benefits and challenges of using a combination of electronic and paper-based medical records in a large university hospital and a deployment study in which we analyze how 8 clinicians used the Hy......PR in a medical simulation. Based on these empirical studies, this paper introduces and discusses the concept of collaborative affordances, which describes a set of properties of the medical record that foster collaborative collocated work....... explored the integration of paper and digital technology, there are still a wide range of open issues in the design of technologies that integrate digital and paper-based medical records. This paper studies the use of one such novel technology, called the Hybrid Patient Record (HyPR), that is designed...

  15. Improving patient access to novel medical technologies in Europe.

    LENUS (Irish Health Repository)

    Kearney, Peter

    2012-02-03

    The European Society of Cardiology (ESC) organized a one-day workshop with clinicians, health economic experts, and health technology appraisal experts to discuss the equity of patient access to novel medical technologies in Europe. Two index technologies were considered: implantable cardioverter defibrillators (ICDs) and drug-eluting stents (DES). The use of ICDs range from 35 implants\\/million population in Portugal to 166 implants\\/million population in Germany, whereas for implants of DES (as percentage of total stents) it is lowest in Germany at 14% and high in Portugal at 65%. These differences can in part be explained by a lack of structured implementation of guidelines, the direct cost in relation to the overall healthcare budget, and to differences in procedures and models applied by Health Technology Assessment (HTA) agencies in Europe. The workshop participants concluded that physicians need to be involved in a more structured way in HTA and need to become better acquainted with its methods and terminology. Clinical guidelines should be systematically translated, explained, disseminated, updated, and adopted by cardiologists in Europe. Clinically appropriate, consistent and transparent health economic models need to be developed and high-quality international outcome and cost data should be used. A process for funding of a technology should be developed after a positive recommendation from HTA agencies. Both the ESC and the national cardiac societies should build-up health economic expertise and engage more actively in discussions with stakeholders involved in the provision of healthcare.

  16. Collaborative Affordances of Hybrid Patient Record Technologies in Medical Work

    DEFF Research Database (Denmark)

    Houben, Steven; Frost, Mads; Bardram, Jakob E

    2015-01-01

    The medical record is a central artifact used to organize, communicate and coordinate information related to patient care. Despite recent deployments of electronic health records (EHR), paper medical records are still widely used because of the affordances of paper. Although a number of approache......PR in a medical simulation. Based on these empirical studies, this paper introduces and discusses the concept of collaborative affordances, which describes a set of properties of the medical record that foster collaborative collocated work.......The medical record is a central artifact used to organize, communicate and coordinate information related to patient care. Despite recent deployments of electronic health records (EHR), paper medical records are still widely used because of the affordances of paper. Although a number of approaches...... explored the integration of paper and digital technology, there are still a wide range of open issues in the design of technologies that integrate digital and paper-based medical records. This paper studies the use of one such novel technology, called the Hybrid Patient Record (HyPR), that is designed...

  17. Effects of two commercial electronic prescribing systems on prescribing error rates in hospital in-patients: a before and after study.

    Directory of Open Access Journals (Sweden)

    Johanna I Westbrook

    2012-01-01

    Full Text Available BACKGROUND: Considerable investments are being made in commercial electronic prescribing systems (e-prescribing in many countries. Few studies have measured or evaluated their effectiveness at reducing prescribing error rates, and interactions between system design and errors are not well understood, despite increasing concerns regarding new errors associated with system use. This study evaluated the effectiveness of two commercial e-prescribing systems in reducing prescribing error rates and their propensities for introducing new types of error. METHODS AND RESULTS: We conducted a before and after study involving medication chart audit of 3,291 admissions (1,923 at baseline and 1,368 post e-prescribing system at two Australian teaching hospitals. In Hospital A, the Cerner Millennium e-prescribing system was implemented on one ward, and three wards, which did not receive the e-prescribing system, acted as controls. In Hospital B, the iSoft MedChart system was implemented on two wards and we compared before and after error rates. Procedural (e.g., unclear and incomplete prescribing orders and clinical (e.g., wrong dose, wrong drug errors were identified. Prescribing error rates per admission and per 100 patient days; rates of serious errors (5-point severity scale, those ≥3 were categorised as serious by hospital and study period; and rates and categories of postintervention "system-related" errors (where system functionality or design contributed to the error were calculated. Use of an e-prescribing system was associated with a statistically significant reduction in error rates in all three intervention wards (respectively reductions of 66.1% [95% CI 53.9%-78.3%]; 57.5% [33.8%-81.2%]; and 60.5% [48.5%-72.4%]. The use of the system resulted in a decline in errors at Hospital A from 6.25 per admission (95% CI 5.23-7.28 to 2.12 (95% CI 1.71-2.54; p<0.0001 and at Hospital B from 3.62 (95% CI 3.30-3.93 to 1.46 (95% CI 1.20-1.73; p<0.0001. This

  18. Measuring and improving patient safety through health information technology: The Health IT Safety Framework.

    Science.gov (United States)

    Singh, Hardeep; Sittig, Dean F

    2016-04-01

    Health information technology (health IT) has potential to improve patient safety but its implementation and use has led to unintended consequences and new safety concerns. A key challenge to improving safety in health IT-enabled healthcare systems is to develop valid, feasible strategies to measure safety concerns at the intersection of health IT and patient safety. In response to the fundamental conceptual and methodological gaps related to both defining and measuring health IT-related patient safety, we propose a new framework, the Health IT Safety (HITS) measurement framework, to provide a conceptual foundation for health IT-related patient safety measurement, monitoring, and improvement. The HITS framework follows both Continuous Quality Improvement (CQI) and sociotechnical approaches and calls for new measures and measurement activities to address safety concerns in three related domains: 1) concerns that are unique and specific to technology (e.g., to address unsafe health IT related to unavailable or malfunctioning hardware or software); 2) concerns created by the failure to use health IT appropriately or by misuse of health IT (e.g. to reduce nuisance alerts in the electronic health record (EHR)), and 3) the use of health IT to monitor risks, health care processes and outcomes and identify potential safety concerns before they can harm patients (e.g. use EHR-based algorithms to identify patients at risk for medication errors or care delays). The framework proposes to integrate both retrospective and prospective measurement of HIT safety with an organization's existing clinical risk management and safety programs. It aims to facilitate organizational learning, comprehensive 360 degree assessment of HIT safety that includes vendor involvement, refinement of measurement tools and strategies, and shared responsibility to identify problems and implement solutions. A long term framework goal is to enable rigorous measurement that helps achieve the safety

  19. How does pharmacogenetic testing alter the treatment course and patient response for chronic-pain patients in comparison with the current "trial-and-error" standard of care?

    Science.gov (United States)

    DeFeo, Kelly; Sykora, Kristen; Eley, Susan; Vincent, Debra

    2014-10-01

    To evaluate if pharmacogenetic testing (PT) holds value for pain-management practitioners by identifying the potential applications of pharmacogenetic research as well as applications in practice. A review of the literature was conducted utilizing the databases EBSCOhost, Biomedical Reference Collection, CINAHL, Health Business: Full Text, Health Source: Nursing/Academic Edition, and MEDLINE with the keywords, personalized medicine, cytochrome P450, and phamacogenetics. Chronic-pain patients present some of the most challenging patients to manage medically. Often paired with persistent, life-altering pain, they might also have oncologic and psychological comorbidities that can further complicate their management. One-step in-office PT is now widely available to optimize management of complicated patients and affectively remove the "trial-and-error" process of medication therapy. Practitioners must be familiar with the genetic determinants that affect a patient's response to medications in order to decrease preventable morbidity and mortality associated with drug-drug and patient-drug interactions, and to provide cost-effective care through avoidance of inappropriate medications. Improved pain managements will impove patient outcomes and satisfaction. ©2014 American Association of Nurse Practitioners.

  20. Using femtosecond laser to create customized corneal flaps for patients with low and moderate refractive error differing in corneal thickness.

    Science.gov (United States)

    Zhang, Chi; Che, Jingbin; Yu, Jianhong; Yu, Linli; Yu, Dan; Zhao, Gangping

    2015-01-01

    This study is designed to evaluate the visual outcomes, accuracy, and predictability of corneal flaps with different thicknesses created by 60-kHz femtosecond laser according to different corneal thicknesses in the patients with low and moderate refractive error. A total of 182 eyes were divided according to the central corneal thickness (470 μm-499 μm in Group A, 500 μm-549 μm in Group B, and 550 μm-599 μm in Group C) and underwent femtosecond laser-assisted LASIK for a target corneal flap thickness (100 μm for Group A, 110 μm for Group B, and 120 μm for Group C). Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), and refractive status were examined. The flap thickness of each eye was measured by anterior segment optical coherence tomography (AS-OCT) on 30 points at 1-month follow-up to assess the accuracy and predictability. Postoperatively, at least 75% of eyes had a UDVA of 20/16 or better, less than 2% of eyes lost one line, over 30% of eyes gained one or more lines in CDVA, at least 95% of eyes had astigmatism of less than 0.25 D, all eyes achieved a correction within ± 1.00 D from the target spherical equivalent refraction. The visual and refractive outcomes did not differ significantly in all groups (P >0.05). The mean flap thickness was 100.36 ± 4.32 μm (range: 95-113 μm) in Group A, 111.64 ± 3.62 μm (range: 108-125 μm) in Group B, and 122.32 ± 2.88 μm (range: 112-128 μm) in Group C. The difference at each measured point among the three groups was significant (P refractive error.

  1. Paediatric Patient Safety and the Need for Aviation Black Box Thinking to Learn From and Prevent Medication Errors.

    Science.gov (United States)

    Huynh, Chi; Wong, Ian C K; Correa-West, Jo; Terry, David; McCarthy, Suzanne

    2017-04-01

    Since the publication of To Err Is Human: Building a Safer Health System in 1999, there has been much research conducted into the epidemiology, nature and causes of medication errors in children, from prescribing and supply to administration. It is reassuring to see growing evidence of improving medication safety in children; however, based on media reports, it can be seen that serious and fatal medication errors still occur. This critical opinion article examines the problem of medication errors in children and provides recommendations for research, training of healthcare professionals and a culture shift towards dealing with medication errors. There are three factors that we need to consider to unravel what is missing and why fatal medication errors still occur. (1) Who is involved and affected by the medication error? (2) What factors hinder staff and organisations from learning from mistakes? Does the fear of litigation and criminal charges deter healthcare professionals from voluntarily reporting medication errors? (3) What are the educational needs required to prevent medication errors? It is important to educate future healthcare professionals about medication errors and human factors to prevent these from happening. Further research is required to apply aviation's 'black box' principles in healthcare to record and learn from near misses and errors to prevent future events. There is an urgent need for the black box investigations to be published and made public for the benefit of other organisations that may have similar potential risks for adverse events. International sharing of investigations and learning is also needed.

  2. Labview Based ECG Patient Monitoring System for Cardiovascular Patient Using SMTP Technology.

    Science.gov (United States)

    Singh, Om Prakash; Mekonnen, Dawit; Malarvili, M B

    2015-01-01

    This paper leads to developing a Labview based ECG patient monitoring system for cardiovascular patient using Simple Mail Transfer Protocol technology. The designed device has been divided into three parts. First part is ECG amplifier circuit, built using instrumentation amplifier (AD620) followed by signal conditioning circuit with the operation amplifier (lm741). Secondly, the DAQ card is used to convert the analog signal into digital form for the further process. Furthermore, the data has been processed in Labview where the digital filter techniques have been implemented to remove the noise from the acquired signal. After processing, the algorithm was developed to calculate the heart rate and to analyze the arrhythmia condition. Finally, SMTP technology has been added in our work to make device more communicative and much more cost-effective solution in telemedicine technology which has been key-problem to realize the telediagnosis and monitoring of ECG signals. The technology also can be easily implemented over already existing Internet.

  3. Noticias de prensa sobre errores clínicos y sensación de seguridad al acudir al hospital News items about clinical errors and safety perceptions in hospital patients

    Directory of Open Access Journals (Sweden)

    José Joaquín Mira

    2010-01-01

    Full Text Available Objetivo: Analizar el tratamiento informativo que realiza la prensa de los errores clínicos y su influencia en los pacientes. Métodos: Estudio cualitativo y cuantitativo. Primero, análisis de contenido de las noticias publicadas en 6 periódicos entre abril y noviembre de 2007. Segundo, encuesta a 829 pacientes de 5 hospitales de 4 comunidades autónomas. Resultados: Se analizan 90 casos que generan 128 noticias, con una media de 16 impactos mensuales. En 91 (71,1% se contrastó la fuente. En 78 (60,9% apareció el autor. El impacto de las noticias fue de -4,86 puntos (intervalo de confianza del 95% [IC95%]: -4,15-5,57. En 59 casos (57% se atribuye el error al sistema, en 27 (21,3% a los profesionales y en 41 (32,3% a ambos. Ni el número de columnas (p=0,702, ni la inclusión de postitular (p=0,195, ni el apoyo gráfico (p=0,9 se mostraron relacionados con las consecuencias del error. De 829 pacientes, 515 (62,1%; IC95%: 58,8-65,4% afirmaron haber visto u oído recientemente noticias sobre errores clínicos en prensa, radio o televisión. La percepción de seguridad disminuye cuando coinciden la preocupación por ser víctima de un error clínico y el impacto reciente de noticias sobre errores en la prensa (c² o = 15,17; p=0,001. Conclusiones: Todas las semanas aparece alguna noticia sobre errores clínicos en algún medio. El tratamiento en el periódico de las denuncias de supuestos errores es similar al de las noticias sobre sentencias judiciales por negligencia con daño irreparable. Las noticias sobre errores generan inseguridad en los pacientes. Es aconsejable crear espacios de encuentro entre periodistas y profesionales sanitarios.Objective: To analyze how news items about clinical errors are treated by the press in Spain and their influence on patients. Methods: We performed a quantitative and qualitative study. Firstly, news items published between April and November 2007 in six newspapers were analyzed. Secondly, 829 patients from

  4. Effect of Body Mass Index on Magnitude of Setup Errors in Patients Treated With Adjuvant Radiotherapy for Endometrial Cancer With Daily Image Guidance

    Energy Technology Data Exchange (ETDEWEB)

    Lin, Lilie L., E-mail: lin@uphs.upenn.edu [Department of Radiation Oncology, University of Pennsylvania School of Medicine, Philadelphia, PA (United States); Hertan, Lauren; Rengan, Ramesh; Teo, Boon-Keng Kevin [Department of Radiation Oncology, University of Pennsylvania School of Medicine, Philadelphia, PA (United States)

    2012-06-01

    Purpose: To determine the impact of body mass index (BMI) on daily setup variations and frequency of imaging necessary for patients with endometrial cancer treated with adjuvant intensity-modulated radiotherapy (IMRT) with daily image guidance. Methods and Materials: The daily shifts from a total of 782 orthogonal kilovoltage images from 30 patients who received pelvic IMRT between July 2008 and August 2010 were analyzed. The BMI, mean daily shifts, and random and systematic errors in each translational and rotational direction were calculated for each patient. Margin recipes were generated based on BMI. Linear regression and spearman rank correlation analysis were performed. To simulate a less-than-daily IGRT protocol, the average shift of the first five fractions was applied to subsequent setups without IGRT for assessing the impact on setup error and margin requirements. Results: Median BMI was 32.9 (range, 23-62). Of the 30 patients, 16.7% (n = 5) were normal weight (BMI <25); 23.3% (n = 7) were overweight (BMI {>=}25 to <30); 26.7% (n = 8) were mildly obese (BMI {>=}30 to <35); and 33.3% (n = 10) were moderately to severely obese (BMI {>=} 35). On linear regression, mean absolute vertical, longitudinal, and lateral shifts positively correlated with BMI (p = 0.0127, p = 0.0037, and p < 0.0001, respectively). Systematic errors in the longitudinal and vertical direction were found to be positively correlated with BMI category (p < 0.0001 for both). IGRT for the first five fractions, followed by correction of the mean error for all subsequent fractions, led to a substantial reduction in setup error and resultant margin requirement overall compared with no IGRT. Conclusions: Daily shifts, systematic errors, and margin requirements were greatest in obese patients. For women who are normal or overweight, a planning target margin margin of 7 to 10 mm may be sufficient without IGRT, but for patients who are moderately or severely obese, this is insufficient.

  5. Using femtosecond laser to create customized corneal flaps for patients with low and moderate refractive error differing in corneal thickness.

    Directory of Open Access Journals (Sweden)

    Chi Zhang

    Full Text Available This study is designed to evaluate the visual outcomes, accuracy, and predictability of corneal flaps with different thicknesses created by 60-kHz femtosecond laser according to different corneal thicknesses in the patients with low and moderate refractive error. A total of 182 eyes were divided according to the central corneal thickness (470 μm-499 μm in Group A, 500 μm-549 μm in Group B, and 550 μm-599 μm in Group C and underwent femtosecond laser-assisted LASIK for a target corneal flap thickness (100 μm for Group A, 110 μm for Group B, and 120 μm for Group C. Uncorrected distance visual acuity (UDVA, corrected distance visual acuity (CDVA, and refractive status were examined. The flap thickness of each eye was measured by anterior segment optical coherence tomography (AS-OCT on 30 points at 1-month follow-up to assess the accuracy and predictability. Postoperatively, at least 75% of eyes had a UDVA of 20/16 or better, less than 2% of eyes lost one line, over 30% of eyes gained one or more lines in CDVA, at least 95% of eyes had astigmatism of less than 0.25 D, all eyes achieved a correction within ± 1.00 D from the target spherical equivalent refraction. The visual and refractive outcomes did not differ significantly in all groups (P >0.05. The mean flap thickness was 100.36 ± 4.32 μm (range: 95-113 μm in Group A, 111.64 ± 3.62 μm (range: 108-125 μm in Group B, and 122.32 ± 2.88 μm (range: 112-128 μm in Group C. The difference at each measured point among the three groups was significant (P < 0.05. The accuracy and predictability were satisfactory in all three groups. In conclusion, this customized treatment yielded satisfactory clinical outcomes with accurate and predictable flap thickness for patients with low and moderate refractive error.

  6. [Supervised administration of Alzheimer's patients using information communication technology].

    Science.gov (United States)

    Noda, Yasuha; Sakata, Yoshifumi; Kubota, Masakazu; Uemura, Kengo; Kihara, Takeshi; Kimura, Toru; Ino, Masashi; Tsuji, Teruyuki; Hayashi, Michiyuki; Kinoshita, Ayae

    2014-12-01

    Drug adherence is central to the treatment of dementia, which might reduce compliance due to memory loss, particularly among home-based patients with dementia. In order to improve drug adherence, we suggest the efficient and effective supervised administration by use of information communication technology(ICT). ICT makes face-to-face real-time communication possible, and it also enables picture sharing. Therefore, it might be useful to apply ICT to controlling and supervising medication for patients with dementia to improve drug adherence. Accordingly, we enrolled patients who were supposed to take a newly prescribed anti-dementia patch containing the choline esterase inhibitor rivastigmine(Rivastach®)and investigated the effect of ICT-based intervention for drug adherence, emotional change, and cognitive change, utilizing Skype, a free communication software program. Scheduled Skype interventions increased drug adherence ratio, levels of subjective satisfaction, and instrumental activities of daily living(IADL). Furthermore, we can provide patients and their caregivers with a feeling of safety through regular bidirectional communication, as patients can easily consult medical staff regarding the adverse effects of newly prescribed drugs. Instead of frequent visits to their primary physicians, ICT-based communications can be used as a substitute for supervision of medication, given the availability of the telecommunication system. By directly connecting the medical institution to the home, we expect that this ICT-based system will expand into the geriatric care field, including the care of elderly individuals living alone.

  7. On-ward participation of a hospital pharmacist in a Dutch intensive care unit reduces prescribing errors and related patient harm: an intervention study.

    Science.gov (United States)

    Klopotowska, Joanna E; Kuiper, Rob; van Kan, Hendrikus J; de Pont, Anne-Cornelie; Dijkgraaf, Marcel G; Lie-A-Huen, Loraine; Vroom, Margreeth B; Smorenburg, Susanne M

    2010-01-01

    Patients admitted to an intensive care unit (ICU) are at high risk for prescribing errors and related adverse drug events (ADEs). An effective intervention to decrease this risk, based on studies conducted mainly in North America, is on-ward participation of a clinical pharmacist in an ICU team. As the Dutch Healthcare System is organized differently and the on-ward role of hospital pharmacists in Dutch ICU teams is not well established, we conducted an intervention study to investigate whether participation of a hospital pharmacist can also be an effective approach in reducing prescribing errors and related patient harm (preventable ADEs) in this specific setting. A prospective study compared a baseline period with an intervention period. During the intervention period, an ICU hospital pharmacist reviewed medication orders for patients admitted to the ICU, noted issues related to prescribing, formulated recommendations and discussed those during patient review meetings with the attending ICU physicians. Prescribing issues were scored as prescribing errors when consensus was reached between the ICU hospital pharmacist and ICU physicians. During the 8.5-month study period, medication orders for 1,173 patients were reviewed. The ICU hospital pharmacist made a total of 659 recommendations. During the intervention period, the rate of consensus between the ICU hospital pharmacist and ICU physicians was 74%. The incidence of prescribing errors during the intervention period was significantly lower than during the baseline period: 62.5 per 1,000 monitored patient-days versus 190.5 per 1,000 monitored patient-days, respectively (P Medication Error Reporting and Prevention severity categories E and F) were reduced from 4.0 per 1,000 monitored patient-days during the baseline period to 1.0 per 1,000 monitored patient-days during the intervention period (P = 0.25). Per monitored patient-day, the intervention itself cost €3, but might have saved €26 to €40 by preventing

  8. Learning curves, taking instructions, and patient safety: using a theoretical domains framework in an interview study to investigate prescribing errors among trainee doctors.

    Science.gov (United States)

    Duncan, Eilidh M; Francis, Jill J; Johnston, Marie; Davey, Peter; Maxwell, Simon; McKay, Gerard A; McLay, James; Ross, Sarah; Ryan, Cristín; Webb, David J; Bond, Christine

    2012-09-11

    Prescribing errors are a major source of morbidity and mortality and represent a significant patient safety concern. Evidence suggests that trainee doctors are responsible for most prescribing errors. Understanding the factors that influence prescribing behavior may lead to effective interventions to reduce errors. Existing investigations of prescribing errors have been based on Human Error Theory but not on other relevant behavioral theories. The aim of this study was to apply a broad theory-based approach using the Theoretical Domains Framework (TDF) to investigate prescribing in the hospital context among a sample of trainee doctors. Semistructured interviews, based on 12 theoretical domains, were conducted with 22 trainee doctors to explore views, opinions, and experiences of prescribing and prescribing errors. Content analysis was conducted, followed by applying relevance criteria and a novel stage of critical appraisal, to identify which theoretical domains could be targeted in interventions to improve prescribing. Seven theoretical domains met the criteria of relevance: "social professional role and identity," "environmental context and resources," "social influences," "knowledge," "skills," "memory, attention, and decision making," and "behavioral regulation." From critical appraisal of the interview data, "beliefs about consequences" and "beliefs about capabilities" were also identified as potentially important domains. Interrelationships between domains were evident. Additionally, the data supported theoretical elaboration of the domain behavioral regulation. In this investigation of hospital-based prescribing, participants' attributions about causes of errors were used to identify domains that could be targeted in interventions to improve prescribing. In a departure from previous TDF practice, critical appraisal was used to identify additional domains that should also be targeted, despite participants' perceptions that they were not relevant to

  9. Learning curves, taking instructions, and patient safety: using a theoretical domains framework in an interview study to investigate prescribing errors among trainee doctors

    Directory of Open Access Journals (Sweden)

    Duncan Eilidh M

    2012-09-01

    Full Text Available Abstract Background Prescribing errors are a major source of morbidity and mortality and represent a significant patient safety concern. Evidence suggests that trainee doctors are responsible for most prescribing errors. Understanding the factors that influence prescribing behavior may lead to effective interventions to reduce errors. Existing investigations of prescribing errors have been based on Human Error Theory but not on other relevant behavioral theories. The aim of this study was to apply a broad theory-based approach using the Theoretical Domains Framework (TDF to investigate prescribing in the hospital context among a sample of trainee doctors. Method Semistructured interviews, based on 12 theoretical domains, were conducted with 22 trainee doctors to explore views, opinions, and experiences of prescribing and prescribing errors. Content analysis was conducted, followed by applying relevance criteria and a novel stage of critical appraisal, to identify which theoretical domains could be targeted in interventions to improve prescribing. Results Seven theoretical domains met the criteria of relevance: “social professional role and identity,” “environmental context and resources,” “social influences,” “knowledge,” “skills,” “memory, attention, and decision making,” and “behavioral regulation.” From critical appraisal of the interview data, “beliefs about consequences” and “beliefs about capabilities” were also identified as potentially important domains. Interrelationships between domains were evident. Additionally, the data supported theoretical elaboration of the domain behavioral regulation. Conclusions In this investigation of hospital-based prescribing, participants’ attributions about causes of errors were used to identify domains that could be targeted in interventions to improve prescribing. In a departure from previous TDF practice, critical appraisal was used to identify additional domains

  10. Patient innovation: an analysis of patients' designs of digital technology support for everyday living with diabetes.

    Science.gov (United States)

    Kanstrup, Anne Marie; Bertelsen, Pernille; Nohr, Christian

    2015-01-01

    The aim of this paper is to identify characteristics of patients' contributions to innovation in health information technology (HIT). The paper outlines a theoretical definition of patient innovation and presents an analysis of four digital prototypes and 22 low-fidelity mock-ups designed by people affected by the chronic illness diabetes mellitus. Seventeen families (a total of 60 people) with one or more diabetic family members participated in design activities in a four-year research project focused on the design of digital support for everyday living with diabetes. Our analysis documented the originality of the analysed patient designs and identified three characteristics of patients' designs: socio-technical networks, objects with associated personal meanings and technology supporting the expression of identity. The paper concludes that patient innovation is defined by what is perceived as new by patients and/or others within the social system of adaptation. The analysed patient designs are original (as distinct from replications of or improvements on known products), and their characteristics are innovative contributions to the social system of everyday living with diabetes (i.e. they are perceived as new to the patients in the research study). The results of the analysis contribute to the credentials of patients as key actors in HIT innovation and call for participatory approaches in health informatics.

  11. Target registration and target positioning errors in computer-assisted neurosurgery: proposal for a standardized reporting of error assessment.

    Science.gov (United States)

    Widmann, Gerlig; Stoffner, Rudolf; Sieb, Michael; Bale, Reto

    2009-12-01

    Assessment of errors is essential in development, testing and clinical application of computer-assisted neurosurgery. Our aim was to provide a comprehensive overview of the different methods to assess target registration error (TRE) and target positioning error (TPE) and to develop a proposal for a standardized reporting of error assessment. A PubMed research on phantom, cadaver or clinical studies on TRE and TPE has been performed. Reporting standards have been defined according to (a) study design and evaluation methods and (b) specifications of the navigation technology. The proposed standardized reporting includes (a) study design (controlled, non-controlled), study type (non-anthropomorphic phantom, anthropomorphic phantom, cadaver, patient), target design, error type and subtypes, space of TPE measurement, statistics, and (b) image modality, scan parameters, tracking technology, registration procedure and targeting technique. Adoption of the proposed standardized reporting may help in the understanding and comparability of different accuracy reports. Copyright (c) 2009 John Wiley & Sons, Ltd.

  12. Leveraging information technology to drive improvement in patient satisfaction.

    Science.gov (United States)

    Nash, Mary; Pestrue, Justin; Geier, Peter; Sharp, Karen; Helder, Amy; McAlearney, Ann Scheck

    2010-01-01

    A healthcare organization's commitment to quality and the patient experience requires senior leader involvement in improvement strategies, and accountability for goals. Further, improvement strategies are most effective when driven by data, and in the world of patient satisfaction, evidence is growing that nurse leader rounding and discharge calls are strategic tactics that can improve patient satisfaction. This article describes how The Ohio State University Medical Center (OSUMC) leveraged health information technology (IT) to apply a data-driven strategy execution to improve the patient experience. Specifically, two IT-driven approaches were used: (1) business intelligence reporting tools were used to create a meaningful reporting system including dashboards, scorecards, and tracking reports and (2) an improvement plan was implemented that focused on two high-impact tactics and data to hardwire accountability. Targeted information from the IT systems enabled clinicians and administrators to execute these strategic tactics, and senior leaders to monitor achievement of strategic goals. As a result, OSUMC's inpatient satisfaction scores on the Hospital Consumer Assessment of Healthcare Providers and Systems survey improved from 56% nines and tens in 2006 to 71% in 2009.

  13. On-ward participation of a hospital pharmacist in a Dutch intensive care unit reduces prescribing errors and related patient harm: an intervention study

    NARCIS (Netherlands)

    Klopotowska, J.E.; Kuiper, R.; van Kan, H.J.; de Pont, A.C.; Dijkgraaf, M.G.; Lie-A-Huen, L.; Vroom, M.B.; Smorenburg, S.M.

    2010-01-01

    Introduction: Patients admitted to an intensive care unit (ICU) are at high risk for prescribing errors and related adverse drug events (ADEs). An effective intervention to decrease this risk, based on studies conducted mainly in North America, is on-ward participation of a clinical pharmacist in an

  14. Effect of fatigue on landing performance assessed with the landing error scoring system (less) in patients after ACL reconstruction. A pilot study

    NARCIS (Netherlands)

    Gokeler, A; Eppinga, P; Dijkstra, P U; Welling, Wouter; Padua, D A; Otten, E.; Benjaminse, A

    2014-01-01

    BACKGROUND: Fatigue has been shown to affect performance of hop tests in patients after anterior cruciate ligament reconstruction (ACLR) compared to uninjured controls (CTRL). This may render the hop test less sensitive in detecting landing errors. The primary purpose of this study was to investigat

  15. Characteristics and evidence of nursing scientific production for medication errors at the hospital environment

    Directory of Open Access Journals (Sweden)

    Lolita Dopico da Silva

    2012-06-01

    Full Text Available This study aimed to identify the characteristics of nurses’ publications about medication errors. It was used an Integrative methodology review covering January 2005 to October 2010 with "medication errors" and "nursing" descriptors and it was also collected data from electronic databases via “Capes Portal”. Results show four categories, the conduct of health professionals in medication errors, types and rates of errors, medication system weaknesses, and barriers to error. Discussion of the prevalent practice was not to notify the error. The prevalent error type was administration and error rates which ranged from 14.8 to 56.7%. Ilegible handwriting, communication failures among professionals, and lack of technical knowledge were weaknesses. Among the barriers, the civility from patient, nurses and technology were evident. Advances in researches for testing barriers were found and some gaps were apparent concerning lack of study that address pharmacodynamics or pharmacokinetic aspects of drugs involved in errors.

  16. Reliability of clinical impact grading by healthcare professionals of common prescribing error and optimisation cases in critical care patients.

    Science.gov (United States)

    Bourne, Richard S; Shulman, Rob; Tomlin, Mark; Borthwick, Mark; Berry, Will; Mills, Gary H

    2017-04-01

    To identify between and within profession-rater reliability of clinical impact grading for common critical care prescribing error and optimisation cases. To identify representative clinical impact grades for each individual case. Electronic questionnaire. 5 UK NHS Trusts. 30 Critical care healthcare professionals (doctors, pharmacists and nurses). Participants graded severity of clinical impact (5-point categorical scale) of 50 error and 55 optimisation cases. Case between and within profession-rater reliability and modal clinical impact grading. Between and within profession rater reliability analysis used linear mixed model and intraclass correlation, respectively. The majority of error and optimisation cases (both 76%) had a modal clinical severity grade of moderate or higher. Error cases: doctors graded clinical impact significantly lower than pharmacists (-0.25; P pharmacists (0.28; P clinical impact significantly lower than nurses and pharmacists (-0.39 and -0.5; P pharmacists (0.88 and 0.89; P error cases, respectively. Representative clinical impact grades for over 100 common prescribing error and optimisation cases are reported for potential clinical practice and research application. The between professional variability highlights the importance of multidisciplinary perspectives in assessment of medication error and optimisation cases in clinical practice and research.

  17. [Efficacy of motivational interviewing for reducing medication errors in chronic patients over 65 years with polypharmacy: Results of a cluster randomized trial].

    Science.gov (United States)

    Pérula de Torres, Luis Angel; Pulido Ortega, Laura; Pérula de Torres, Carlos; González Lama, Jesús; Olaya Caro, Inmaculada; Ruiz Moral, Roger

    2014-10-21

    To evaluate the effectiveness of an intervention based on motivational interviewing to reduce medication errors in chronic patients over 65 with polypharmacy. Cluster randomized trial that included doctors and nurses of 16 Primary Care centers and chronic patients with polypharmacy over 65 years. The professionals were assigned to the experimental or the control group using stratified randomization. Interventions consisted of training of professionals and revision of patient treatments, application of motivational interviewing in the experimental group and also the usual approach in the control group. The primary endpoint (medication error) was analyzed at individual level, and was estimated with the absolute risk reduction (ARR), relative risk reduction (RRR), number of subjects to treat (NNT) and by multiple logistic regression analysis. Thirty-two professionals were randomized (19 doctors and 13 nurses), 27 of them recruited 154 patients consecutively (13 professionals in the experimental group recruited 70 patients and 14 professionals recruited 84 patients in the control group) and completed 6 months of follow-up. The mean age of patients was 76 years (68.8% women). A decrease in the average of medication errors was observed along the period. The reduction was greater in the experimental than in the control group (F=5.109, P=.035). RRA 29% (95% confidence interval [95% CI] 15.0-43.0%), RRR 0.59 (95% CI:0.31-0.76), and NNT 3.5 (95% CI 2.3-6.8). Motivational interviewing is more efficient than the usual approach to reduce medication errors in patients over 65 with polypharmacy. Copyright © 2013 Elsevier España, S.L.U. All rights reserved.

  18. Measuring uncertainty in dose delivered to the cochlea due to setup error during external beam treatment of patients with cancer of the head and neck

    Energy Technology Data Exchange (ETDEWEB)

    Yan, M.; Lovelock, D.; Hunt, M.; Mechalakos, J.; Hu, Y.; Pham, H.; Jackson, A., E-mail: jacksona@mskcc.org [Department of Medical Physics, Memorial Sloan-Kettering Cancer Center, New York, New York 10065 (United States)

    2013-12-15

    Purpose: To use Cone Beam CT scans obtained just prior to treatments of head and neck cancer patients to measure the setup error and cumulative dose uncertainty of the cochlea. Methods: Data from 10 head and neck patients with 10 planning CTs and 52 Cone Beam CTs taken at time of treatment were used in this study. Patients were treated with conventional fractionation using an IMRT dose painting technique, most with 33 fractions. Weekly radiographic imaging was used to correct the patient setup. The authors used rigid registration of the planning CT and Cone Beam CT scans to find the translational and rotational setup errors, and the spatial setup errors of the cochlea. The planning CT was rotated and translated such that the cochlea positions match those seen in the cone beam scans, cochlea doses were recalculated and fractional doses accumulated. Uncertainties in the positions and cumulative doses of the cochlea were calculated with and without setup adjustments from radiographic imaging. Results: The mean setup error of the cochlea was 0.04 ± 0.33 or 0.06 ± 0.43 cm for RL, 0.09 ± 0.27 or 0.07 ± 0.48 cm for AP, and 0.00 ± 0.21 or −0.24 ± 0.45 cm for SI with and without radiographic imaging, respectively. Setup with radiographic imaging reduced the standard deviation of the setup error by roughly 1–2 mm. The uncertainty of the cochlea dose depends on the treatment plan and the relative positions of the cochlea and target volumes. Combining results for the left and right cochlea, the authors found the accumulated uncertainty of the cochlea dose per fraction was 4.82 (0.39–16.8) cGy, or 10.1 (0.8–32.4) cGy, with and without radiographic imaging, respectively; the percentage uncertainties relative to the planned doses were 4.32% (0.28%–9.06%) and 10.2% (0.7%–63.6%), respectively. Conclusions: Patient setup error introduces uncertainty in the position of the cochlea during radiation treatment. With the assistance of radiographic imaging during setup

  19. Robotic technologies and rehabilitation: new tools for stroke patients' therapy.

    Science.gov (United States)

    Poli, Patrizia; Morone, Giovanni; Rosati, Giulio; Masiero, Stefano

    2013-01-01

    The role of robotics in poststroke patients' rehabilitation has been investigated intensively. This paper presents the state-of-the-art and the possible future role of robotics in poststroke rehabilitation, for both upper and lower limbs. We performed a comprehensive search of PubMed, Cochrane, and PeDRO databases using as keywords "robot AND stroke AND rehabilitation." In upper limb robotic rehabilitation, training seems to improve arm function in activities of daily living. In addition, electromechanical gait training after stroke seems to be effective. It is still unclear whether robot-assisted arm training may improve muscle strength, and which electromechanical gait-training device may be the most effective for walking training implementation. In the field of robotic technologies for stroke patients' rehabilitation we identified currently relevant growing points and areas timely for developing research. Among the growing points there is the development of new easily transportable, wearable devices that could improve rehabilitation also after discharge, in an outpatient or home-based setting. For developing research, efforts are being made to establish the ideal type of treatment, the length and amount of training protocol, and the patient's characteristics to be successfully enrolled to this treatment.

  20. Which medical error to disclose to patients and by whom? Public preference and perceptions of norm and current practice.

    Science.gov (United States)

    Hammami, Muhammad M; Attalah, Sahar; Al Qadire, Mohammad

    2010-10-18

    Disclosure of near miss medical error (ME) and who should disclose ME to patients continue to be controversial. Further, available recommendations on disclosure of ME have emerged largely in Western culture; their suitability to Islamic/Arabic culture is not known. We surveyed 902 individuals attending the outpatient's clinics of a tertiary care hospital in Saudi Arabia. Personal preference and perceptions of norm and current practice regarding which ME to be disclosed (5 options: don't disclose; disclose if associated with major, moderate, or minor harm; disclose near miss) and by whom (6 options: any employee, any physician, at-fault-physician, manager of at-fault-physician, medical director, or chief executive director) were explored. Mean (SD) age of respondents was 33.9 (10) year, 47% were males, 90% Saudis, 37% patients, 49% employed, and 61% with college or higher education. The percentage (95% confidence interval) of respondents who preferred to be informed of harmful ME, of near miss ME, or by at-fault physician were 60.0% (56.8 to 63.2), 35.5% (32.4 to 38.6), and 59.7% (56.5 to 63.0), respectively. Respectively, 68.2% (65.2 to 71.2) and 17.3% (14.7 to 19.8) believed that as currently practiced, harmful ME and near miss ME are disclosed, and 34.0% (30.7 to 37.4) that ME are disclosed by at-fault-physician. Distributions of perception of norm and preference were similar but significantly different from the distribution of perception of current practice (P preference of disclosure of near miss ME, while younger age and male gender predicted preference of no-disclosure of ME. Female gender also predicted preferring disclosure by the at-fault-physician. We conclude that: 1) there is a considerable diversity in preferences and perceptions of norm and current practice among respondents regarding which ME to be disclosed and by whom, 2) Distributions of preference and perception of norm were similar but significantly different from the distribution of perception

  1. Which medical error to disclose to patients and by whom? Public preference and perceptions of norm and current practice

    Directory of Open Access Journals (Sweden)

    Al Qadire Mohammad

    2010-10-01

    Full Text Available Abstract Background Disclosure of near miss medical error (ME and who should disclose ME to patients continue to be controversial. Further, available recommendations on disclosure of ME have emerged largely in Western culture; their suitability to Islamic/Arabic culture is not known. Methods We surveyed 902 individuals attending the outpatient's clinics of a tertiary care hospital in Saudi Arabia. Personal preference and perceptions of norm and current practice regarding which ME to be disclosed (5 options: don't disclose; disclose if associated with major, moderate, or minor harm; disclose near miss and by whom (6 options: any employee, any physician, at-fault-physician, manager of at-fault-physician, medical director, or chief executive director were explored. Results Mean (SD age of respondents was 33.9 (10 year, 47% were males, 90% Saudis, 37% patients, 49% employed, and 61% with college or higher education. The percentage (95% confidence interval of respondents who preferred to be informed of harmful ME, of near miss ME, or by at-fault physician were 60.0% (56.8 to 63.2, 35.5% (32.4 to 38.6, and 59.7% (56.5 to 63.0, respectively. Respectively, 68.2% (65.2 to 71.2 and 17.3% (14.7 to 19.8 believed that as currently practiced, harmful ME and near miss ME are disclosed, and 34.0% (30.7 to 37.4 that ME are disclosed by at-fault-physician. Distributions of perception of norm and preference were similar but significantly different from the distribution of perception of current practice (P Conclusions We conclude that: 1 there is a considerable diversity in preferences and perceptions of norm and current practice among respondents regarding which ME to be disclosed and by whom, 2 Distributions of preference and perception of norm were similar but significantly different from the distribution of perception of current practice, 3 most respondents preferred to be informed of ME and by at-fault physician, and 4 one third of respondents preferred to be

  2. A comprehensive overview of medical error in hospitals using incident-reporting systems, patient complaints and chart review of inpatient deaths.

    Directory of Open Access Journals (Sweden)

    Jeantine M de Feijter

    Full Text Available BACKGROUND: Incident reporting systems (IRS are used to identify medical errors in order to learn from mistakes and improve patient safety in hospitals. However, IRS contain only a small fraction of occurring incidents. A more comprehensive overview of medical error in hospitals may be obtained by combining information from multiple sources. The WHO has developed the International Classification for Patient Safety (ICPS in order to enable comparison of incident reports from different sources and institutions. METHODS: The aim of this paper was to provide a more comprehensive overview of medical error in hospitals using a combination of different information sources. Incident reports collected from IRS, patient complaints and retrospective chart review in an academic acute care hospital were classified using the ICPS. The main outcome measures were distribution of incidents over the thirteen categories of the ICPS classifier "Incident type", described as odds ratios (OR and proportional similarity indices (PSI. RESULTS: A total of 1012 incidents resulted in 1282 classified items. Large differences between data from IRS and patient complaints (PSI = 0.32 and from IRS and retrospective chart review (PSI = 0.31 were mainly attributable to behaviour (OR = 6.08, clinical administration (OR = 5.14, clinical process (OR = 6.73 and resources (OR = 2.06. CONCLUSIONS: IRS do not capture all incidents in hospitals and should be combined with complementary information about diagnostic error and delayed treatment from patient complaints and retrospective chart review. Since incidents that are not recorded in IRS do not lead to remedial and preventive action in response to IRS reports, healthcare centres that have access to different incident detection methods should harness information from all sources to improve patient safety.

  3. Refractive Errors

    Science.gov (United States)

    ... does the eye focus light? In order to see clearly, light rays from an object must focus onto the ... The refractive errors are: myopia, hyperopia and astigmatism [See figures 2 and 3]. What is hyperopia (farsightedness)? Hyperopia occurs when light rays focus behind the retina (because the eye ...

  4. Medication Errors

    Science.gov (United States)

    ... Proprietary Names (PDF - 146KB) Draft Guidance for Industry: Best Practices in Developing Proprietary Names for Drugs (PDF - 279KB) ... or (301) 796-3400 druginfo@fda.hhs.gov Human Drug ... in Medication Errors Resources for You Agency for Healthcare Research and Quality: ...

  5. Error-Free Software

    Science.gov (United States)

    1989-01-01

    001 is an integrated tool suited for automatically developing ultra reliable models, simulations and software systems. Developed and marketed by Hamilton Technologies, Inc. (HTI), it has been applied in engineering, manufacturing, banking and software tools development. The software provides the ability to simplify the complex. A system developed with 001 can be a prototype or fully developed with production quality code. It is free of interface errors, consistent, logically complete and has no data or control flow errors. Systems can be designed, developed and maintained with maximum productivity. Margaret Hamilton, President of Hamilton Technologies, also directed the research and development of USE.IT, an earlier product which was the first computer aided software engineering product in the industry to concentrate on automatically supporting the development of an ultrareliable system throughout its life cycle. Both products originated in NASA technology developed under a Johnson Space Center contract.

  6. Time trend of injection drug errors before and after implementation of bar-code verification system.

    Science.gov (United States)

    Sakushima, Ken; Umeki, Reona; Endoh, Akira; Ito, Yoichi M; Nasuhara, Yasuyuki

    2015-01-01

    Bar-code technology, used for verification of patients and their medication, could prevent medication errors in clinical practice. Retrospective analysis of electronically stored medical error reports was conducted in a university hospital. The number of reported medication errors of injected drugs, including wrong drug administration and administration to the wrong patient, was compared before and after implementation of the bar-code verification system for inpatient care. A total of 2867 error reports associated with injection drugs were extracted. Wrong patient errors decreased significantly after implementation of the bar-code verification system (17.4/year vs. 4.5/year, pcode medication administration is effective for prevention of wrong patient errors. However, ordinary bar-code verification systems are limited in their ability to prevent incorrect drug preparation in hospital wards.

  7. Setup errors in patients with head-neck cancer (HNC), treated using the Intensity Modulated Radiation Therapy (IMRT) technique: how it influences the customised immobilisation systems, patient's pain and anxiety.

    Science.gov (United States)

    Contesini, Massimiliano; Guberti, Monica; Saccani, Roberta; Braglia, Luca; Iotti, Cinzia; Botti, Andrea; Abbati, Emilio; Iemmi, Marina

    2017-04-27

    In patients with head-neck cancer treated with IMRT, immobility of the upper part of the body during radiation is maintained by means of customised immobilisation devices. The main purpose of this study was to determine how the procedures for preparation of customised immobilisation systems and the patients characteristics influence the extent of setup errors. A longitudinal, prospective study involving 29 patients treated with IMRT. Data were collected before CT simulation and during all the treatment sessions (528 setup errors analysed overall); the correlation with possible risk factors for setup errors was explored using a linear mixed model. Setup errors were not influenced by the patient's anxiety and pain. Temporary removal of the thermoplastic mask before carrying out the CT simulation shows statistically borderline, clinically relevant, increase of setup errors (+24.7%, 95% CI: -0.5% - 55.8%). Moreover, a unit increase of radiation therapists who model the customised thermoplastic mask is associated to a -18% (-29.2% - -4.9%) reduction of the errors. The setup error is influenced by the patient's physical features; in particular, it increases both in patients in whom the treatment position is obtained with 'Shoulder down' (+27.9%, 2.2% - 59.7%) and in patients with 'Scoliosis/kyphosis' problems (+65.4%, 2.3% - 164.2%). Using a 'Small size standard plus customized neck support device' is associated to a -52.3% (-73.7% - -11.2%) reduction. The increase in number of radiation therapists encountered during the entire treatment cycle does not show associations. Increase in the body mass index is associated with a slight reduction in setup error by (-2.8%, -5% - -0.7%). The position of the patient obtained by forcing the shoulders downwards, clinically significant scoliosis or kyphosis and the reduction of the number of radiation therapists who model the thermoplastic mask are found to be statistically significant risk factors that can cause an increase in setup

  8. Labview Based ECG Patient Monitoring System for Cardiovascular Patient Using SMTP Technology

    Directory of Open Access Journals (Sweden)

    Om Prakash Singh

    2015-01-01

    Full Text Available This paper leads to developing a Labview based ECG patient monitoring system for cardiovascular patient using Simple Mail Transfer Protocol technology. The designed device has been divided into three parts. First part is ECG amplifier circuit, built using instrumentation amplifier (AD620 followed by signal conditioning circuit with the operation amplifier (lm741. Secondly, the DAQ card is used to convert the analog signal into digital form for the further process. Furthermore, the data has been processed in Labview where the digital filter techniques have been implemented to remove the noise from the acquired signal. After processing, the algorithm was developed to calculate the heart rate and to analyze the arrhythmia condition. Finally, SMTP technology has been added in our work to make device more communicative and much more cost-effective solution in telemedicine technology which has been key-problem to realize the telediagnosis and monitoring of ECG signals. The technology also can be easily implemented over already existing Internet.

  9. Labview Based ECG Patient Monitoring System for Cardiovascular Patient Using SMTP Technology

    Science.gov (United States)

    Singh, Om Prakash; Mekonnen, Dawit; Malarvili, M. B.

    2015-01-01

    This paper leads to developing a Labview based ECG patient monitoring system for cardiovascular patient using Simple Mail Transfer Protocol technology. The designed device has been divided into three parts. First part is ECG amplifier circuit, built using instrumentation amplifier (AD620) followed by signal conditioning circuit with the operation amplifier (lm741). Secondly, the DAQ card is used to convert the analog signal into digital form for the further process. Furthermore, the data has been processed in Labview where the digital filter techniques have been implemented to remove the noise from the acquired signal. After processing, the algorithm was developed to calculate the heart rate and to analyze the arrhythmia condition. Finally, SMTP technology has been added in our work to make device more communicative and much more cost-effective solution in telemedicine technology which has been key-problem to realize the telediagnosis and monitoring of ECG signals. The technology also can be easily implemented over already existing Internet. PMID:27006940

  10. Potential prescription patterns and errors in elderly adult patients attending public primary health care centers in Mexico City

    Science.gov (United States)

    Corona-Rojo, José Antonio; Altagracia-Martínez, Marina; Kravzov-Jinich, Jaime; Vázquez-Cervantes, Laura; Pérez-Montoya, Edilberto; Rubio-Poo, Consuelo

    2009-01-01

    Introduction Six out of every 10 elderly persons live in developing countries. Objective To analyze and assess the drug prescription patterns and errors in elderly outpatients attending public health care centers in Mexico City, Mexico. Materials and methods A descriptive and retrospective study was conducted in 2007. Fourteen hundred prescriptions were analyzed. Prescriptions of ambulatory adults aged >70 years who were residents of Mexico City for at least two years were included. Prescription errors were divided into two groups: (1) administrative and legal, and (2) pharmacotherapeutic. In group 2, we analyzed drug dose strength, administration route, frequency of drug administration, treatment length, potential drug–drug interactions, and contraindications. Variables were classified as correct or incorrect based on clinical literature. Variables for each drug were dichotomized as correct (0) or incorrect (1). A Prescription Index (PI) was calculated by considering each drug on the prescription. SPSS statistical software was used to process the collected data (95% confidence interval; p <0.05). Results The drug prescription pattern in elderly outpatients shows that 12 drugs account for 70.72% (2880) of prescribed drugs. The most prescribed drugs presented potential pharmacotherapeutic errors (as defined in the present study). Acetylsalicylic acid–captopril was the most common potential interaction (not clinically assessed). Potential prescription error was high (53% of total prescriptions). Most of the prescription errors were due to omissions of dosage, administration route, and length of treatment and may potentially cause harm to the elderly outpatients. Conclusions A high number of potential prescription errors were found, mainly due to omissions. The drug prescription pattern of the study population is mainly constituted by 12 drugs. The results indicate that prescription quality depends on the number of prescribed drugs per prescription (p < 0

  11. Imaging and dosimetric errors in 4D PET/CT-guided radiotherapy from patient-specific respiratory patterns: a dynamic motion phantom end-to-end study

    Science.gov (United States)

    Bowen, S. R.; Nyflot, M. J.; Herrmann, C.; Groh, C. M.; Meyer, J.; Wollenweber, S. D.; Stearns, C. W.; Kinahan, P. E.; Sandison, G. A.

    2015-05-01

    Effective positron emission tomography / computed tomography (PET/CT) guidance in radiotherapy of lung cancer requires estimation and mitigation of errors due to respiratory motion. An end-to-end workflow was developed to measure patient-specific motion-induced uncertainties in imaging, treatment planning, and radiation delivery with respiratory motion phantoms and dosimeters. A custom torso phantom with inserts mimicking normal lung tissue and lung lesion was filled with [18F]FDG. The lung lesion insert was driven by six different patient-specific respiratory patterns or kept stationary. PET/CT images were acquired under motionless ground truth, tidal breathing motion-averaged (3D), and respiratory phase-correlated (4D) conditions. Target volumes were estimated by standardized uptake value (SUV) thresholds that accurately defined the ground-truth lesion volume. Non-uniform dose-painting plans using volumetrically modulated arc therapy were optimized for fixed normal lung and spinal cord objectives and variable PET-based target objectives. Resulting plans were delivered to a cylindrical diode array at rest, in motion on a platform driven by the same respiratory patterns (3D), or motion-compensated by a robotic couch with an infrared camera tracking system (4D). Errors were estimated relative to the static ground truth condition for mean target-to-background (T/Bmean) ratios, target volumes, planned equivalent uniform target doses, and 2%-2 mm gamma delivery passing rates. Relative to motionless ground truth conditions, PET/CT imaging errors were on the order of 10-20%, treatment planning errors were 5-10%, and treatment delivery errors were 5-30% without motion compensation. Errors from residual motion following compensation methods were reduced to 5-10% in PET/CT imaging, <5% in treatment planning, and <2% in treatment delivery. We have demonstrated that estimation of respiratory motion uncertainty and its propagation from PET/CT imaging to RT planning, and RT

  12. The impact of mobile handheld technology on hospital physicians' work practices and patient care: a systematic review.

    Science.gov (United States)

    Prgomet, Mirela; Georgiou, Andrew; Westbrook, Johanna I

    2009-01-01

    The substantial growth in mobile handheld technologies has heralded the opportunity to provide physicians with access to information, resources, and people at the right time and place. But is this technology delivering the benefits to workflow and patient care promised by increased mobility? The authors conducted a systematic review to examine evidence regarding the impact of mobile handheld technology on hospital physicians' work practices and patient care, focusing on quantification of the espoused virtues of mobile technologies. The authors identified thirteen studies that demonstrated the ability of personal digital assistants (PDAs) to positively impact on areas of rapid response, error prevention, and data management and accessibility. The use of PDAs demonstrates the greatest benefits in contexts where time is a critical factor and a rapid response crucial. However, the extent to which these devices improved outcomes and workflow efficiencies because of their mobility was largely absent from the literature. The paucity of evidence calls for much needed future research that asks explicit questions about the impact the mobility of devices has on work practices and outcomes.

  13. Reliability and measurement error of frontal and horizontal 3D spinal motion parameters in 219 patients with chronic low back pain

    DEFF Research Database (Denmark)

    Harsted, Steen; Mieritz, Rune M; Bronfort, Gert

    2016-01-01

    mechanical LBP, classified as either Quebec Task Force group 1, 2, 3 or 4 were included, and kinematics of the lumbar spine were sampled during standardized spinal lateral flexion and rotation motion using a 6-df instrumented spatial linkage system. Test-retest reliability and measurement error were...... a stable pain level between tests, and were male. ROM measurements were more reliable in patients with a BMI higher than 30, and measurements on patients with LBP and leg pain showed higher reliability and smaller measurement error in all parameters except for the jerk index. CONCLUSION: Frontal plane......BACKGROUND: In order for measurements to be clinically useful, data on psychometric conditions such as reliability should be available in the population for which the measurements are intended to be used. This study comprises a test-retest design separated by 7 to 14 days, and evaluates the intra...

  14. Potential prescription patterns and errors in elderly adult patients attending public primary health care centers in Mexico City

    Directory of Open Access Journals (Sweden)

    José Antonio Corona-Rojo

    2009-08-01

    Full Text Available José Antonio Corona-Rojo1, Marina Altagracia-Martínez1, Jaime Kravzov-Jinich1, Laura Vázquez-Cervantes1, Edilberto Pérez-Montoya2, Consuelo Rubio-Poo31Division of Biological Sciences and Health, Metropolitan Autonomous University, Campus Xochimilco (UAM-X, Xochimilco, México; 2National Polytechnical Institute (IPN, México DF; 3Faculty of Higher Studies – Zaragoza (FES-Zaragoza, National Autonomous University of México (UNAM, México City, MéxicoIntroduction: Six out of every 10 elderly persons live in developing countries.Objective: To analyze and assess the drug prescription patterns and errors in elderly outpatients attending public health care centers in Mexico City, Mexico.Materials and methods: A descriptive and retrospective study was conducted in 2007. Fourteen hundred prescriptions were analyzed. Prescriptions of ambulatory adults aged >70 years who were residents of Mexico City for at least two years were included. Prescription errors were divided into two groups: (1 administrative and legal, and (2 pharmacotherapeutic. In group 2, we analyzed drug dose strength, administration route, frequency of drug administration, treatment length, potential drug–drug interactions, and contraindications. Variables were classified as correct or incorrect based on clinical literature. Variables for each drug were dichotomized as correct (0 or incorrect (1. A Prescription Index (PI was calculated by considering each drug on the prescription. SPSS statistical software was used to process the collected data (95% confidence interval; p < 0.05.Results: The drug prescription pattern in elderly outpatients shows that 12 drugs account for 70.72% (2880 of prescribed drugs. The most prescribed drugs presented potential pharmacotherapeutic errors (as defined in the present study. Acetylsalicylic acid–captopril was the most common potential interaction (not clinically assessed. Potential prescription error was high (53% of total prescriptions. Most

  15. Radio Frequency Identification (RFID) technology and patient safety

    National Research Council Canada - National Science Library

    Ajami, Sima; Rajabzadeh, Ahmad

    2013-01-01

    .... However, the different advantages and disadvantages expressed in various studies of the challenges facing the technology of the use of the RFID technology have been met with skepticism by managers...

  16. [Technological advances and micro-inflammation in dialysis patients].

    Science.gov (United States)

    Ferro, Giuseppe; Ravaglia, Fiammetta; Ferrari, Elisa; Romoli, Elena; Michelassi, Stefano; Caiani, David; Pizzarelli, Francesco

    2015-01-01

    As currently performed, on line hemodiafiltration reduces, but does not normalize, the micro-inflammation of uremic patients. Recent technological advances make it possible to further reduce the inflammation connected to the dialysis treatment. 
Short bacterial DNA fragments are pro-inflammatory and can be detected in the dialysis fluids. However, their determination is not currently within normal controls of the quality of the dialysate. The scenario may change once the analysis of these fragments yields reliable, inexpensive, quick and easy to evaluate the results. At variance with standard bicarbonate dialysate, Citrate dialysate induces far less inflammation both for the well-known anti-inflammatory effect of such buffer and also because it is completely acetate free, e.g. a definitely pro-inflammatory buffer. However, the extensive use of citrate dialysate in chronic dialysis is prevented because of concerns about its potential calcium lowering effect. In our view, high convective exchange on line hemodiafiltration performed with dialysate, whose sterility and a-pirogenicity is guaranteed by increasingly sophisticated controls and with citrate buffer whose safety is certified, can serve as the gold standard of dialysis treatments in future.

  17. Error Proofing Technology Applied to Urban Rail Transit Operation Management%防错技术在城市轨道交通运营管理中的应用

    Institute of Scientific and Technical Information of China (English)

    张标

    2012-01-01

    城市轨道交通的系统构成和运营组织结构的特点包括专业多、覆盖面广、联动性强等,这些特点给保持长期的安全平稳运营带来很大挑战,反思各地城市轨道交通运营的事故案例,发现人为错误是最易出现也是最难控制的.从防错技术的提出、人为错误机理、防错核心思想入手,分析防错技术在城市轨道交通中应用的重要性;依据运营实际需求,提出防错技术应用的原则和推广实施“三阶六步”法,并结合运营实践进行案例分析.%An urban rafl transit system and its operation organization structure involve many different disciplines and joint efforts among different work departments in different places. Therefore, maintaining long-term safe and smooth operation constitutes a very big ehalbnge. By reviewing operation accidents in urban rail transit, it has been found that human errors are probably the most common to occur and the most difficult to control. This article introduces the error proofing technology. Starting from human error mechanism and the key idea for error proofing, the author analyzes the importance of applying the error proofing technology to urban rail transit system. In line with the actual operation needs for the proposed error proofing technology, the implementation principles are formulated and a "three-stage and six-step" method is proposed, with the operation practice of case studies presented.

  18. FAKTOR PENYEBAB MEDICATION ERROR DI INSTALASI RAWAT DARURAT FACTORS AFFECTING MEDICATION ERRORS AT EMERGENCY UNIT

    OpenAIRE

    2014-01-01

    Background: Incident of medication errors is an importantindicator in patient safety and medication error is most commonmedical errors. However, most of medication errors can beprevented and efforts to reduce such errors are available.Due to high number of medications errors in the emergencyunit, understanding of the causes is important for designingsuccessful intervention. This research aims to identify typesand causes of medication errors.Method: Qualitative study was used and data were col...

  19. Clinical Inquiries: Can mobile technology improve weight loss in overweight and obese patients?

    Science.gov (United States)

    Harris, Lisa M; Mounsey, Anne; Nashelsky, Joan

    2017-02-01

    Yes, this technology can help in the short term. Mobile technology compared with minimal or no intervention increases short-term (⟨6 months) weight loss (1.4 to 2.7 kg) in overweight and obese patients. Interventions that combine nonelectronic measures with mobile technology increase weight loss more effectively (3.7 kg) than no intervention.

  20. The Learning Objective Catalogue for Patient Safety in Undergraduate Medical Education – A Position Statement of the Committee for Patient Safety and Error Management of the German Association for Medical Education

    Directory of Open Access Journals (Sweden)

    Kiesewetter, Jan

    2016-02-01

    Full Text Available Background: Since the report “To err is human” was published by the Institute of Medicine in the year 2000, topics regarding patient safety and error management are in the focal point of interest of science and politics. Despite international attention, a structured and comprehensive medical education regarding these topics remains to be missing.Goals: The Learning Objective Catalogue for Patient Safety described below the Committee for Patient Safety and Error Management of the German Association for Medical Education (GMA has aimed to establish a common foundation for the structured implementation of patient safety curricula at the medical faculties in German-speaking countries. Methods: The development the Learning Objective Catalogue resulted via the participation of 13 faculties in two committee meetings, two multi-day workshops, and additional judgments of external specialists.Results: The Committee of Patient Safety and Error Management of GMA developed the present Learning Objective Catalogue for Patient Safety in Undergraduate Medical Education, structured in three chapters: , and . The learning objectives within the chapters are organized on three levels with a hierarchical organization of the topics. Overall, the Learning Objective Catalogue consists of 38 learning objectives. All learning objectives are referenced with the National Competency-based Catalogue of Learning Objectives for Undergraduate Medical Education.Discussion: The Learning Objective Catalogue for Patient Safety in Undergraduate Medical Education is a product that was developed through collaboration of members from 13 medical faculties. In the German-speaking countries, the Learning Objective Catalogue should advance discussion regarding the topics of patient safety and error management and help develop subsequent educational structures. The Learning Objective Catalogue for Patient Safety can serve as a common ground for an intensified, constructive, subject

  1. Medication Errors - A Review

    OpenAIRE

    Vinay BC; Nikhitha MK; Patel Sunil B

    2015-01-01

    In this present review article, regarding medication errors its definition, medication error problem, types of medication errors, common causes of medication errors, monitoring medication errors, consequences of medication errors, prevention of medication error and managing medication errors have been explained neatly and legibly with proper tables which is easy to understand.

  2. Medication Errors - A Review

    OpenAIRE

    Vinay BC; Nikhitha MK; Patel Sunil B

    2015-01-01

    In this present review article, regarding medication errors its definition, medication error problem, types of medication errors, common causes of medication errors, monitoring medication errors, consequences of medication errors, prevention of medication error and managing medication errors have been explained neatly and legibly with proper tables which is easy to understand.

  3. The medium is the (health) measure: patient engagement using personal technologies.

    Science.gov (United States)

    Wasson, John H; Forsberg, Helena Hvitfeldt; Lindblad, Staffan; Mazowita, Garey; McQuillen, Kelly; Nelson, Eugene C

    2012-01-01

    With the phrase "the medium is the message", Marshall McLuhan argued that technologies are the messages themselves and not just the medium. Almost 50 years later, we understand that modern information and communication technologies expand our ability to perceive our world to an extent that would be impossible without the medium. In this article, we contend that information and communication technologies are becoming the dominant medium for patient engagement. Information and communication technologies will efficiently change patient-reported measurement into much more behaviorally sophisticated information that will create a very different interaction between patients and a new kind of health care workforce.

  4. Neurological rehabilitation of stroke patients via motor imaginary-based brain-computer interface technology

    Institute of Scientific and Technical Information of China (English)

    Hongyu Sun; Yang Xiang; Mingdao Yang

    2011-01-01

    The present study utilized motor imaginary-based brain-computer interface technology combined with rehabilitation training in 20 stroke patients. Results from the Berg Balance Scale and the Holden Walking Classification were significantly greater at 4 weeks after treatment (P < 0.01), which suggested that motor imaginary-based brain-computer interface technology improved balance and walking in stroke patients.

  5. Reducing medication errors in critical care: a multimodal approach

    Directory of Open Access Journals (Sweden)

    Kruer RM

    2014-09-01

    Full Text Available Rachel M Kruer,1 Andrew S Jarrell,1 Asad Latif2,3 1Department of Pharmacy, The Johns Hopkins Hospital, Baltimore, MD, USA; 2Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA; 3Armstrong Institute for Patient Safety and Quality, Johns Hopkins Medicine, Baltimore, MD, USA Abstract: The Institute of Medicine has reported that medication errors are the single most common type of error in health care, representing 19% of all adverse events, while accounting for over 7,000 deaths annually. The frequency of medication errors in adult intensive care units can be as high as 947 per 1,000 patient-days, with a median of 105.9 per 1,000 patient-days. The formulation of drugs is a potential contributor to medication errors. Challenges related to drug formulation are specific to the various routes of medication administration, though errors associated with medication appearance and labeling occur among all drug formulations and routes of administration. Addressing these multifaceted challenges requires a multimodal approach. Changes in technology, training, systems, and safety culture are all strategies to potentially reduce medication errors related to drug formulation in the intensive care unit. Keywords: medication safety, drug design, drug formulation, patient safety

  6. Errors in Neonatology

    Directory of Open Access Journals (Sweden)

    Antonio Boldrini

    2013-06-01

    Full Text Available Introduction: Danger and errors are inherent in human activities. In medical practice errors can lean to adverse events for patients. Mass media echo the whole scenario. Methods: We reviewed recent published papers in PubMed database to focus on the evidence and management of errors in medical practice in general and in Neonatology in particular. We compared the results of the literature with our specific experience in Nina Simulation Centre (Pisa, Italy. Results: In Neonatology the main error domains are: medication and total parenteral nutrition, resuscitation and respiratory care, invasive procedures, nosocomial infections, patient identification, diagnostics. Risk factors include patients’ size, prematurity, vulnerability and underlying disease conditions but also multidisciplinary teams, working conditions providing fatigue, a large variety of treatment and investigative modalities needed. Discussion and Conclusions: In our opinion, it is hardly possible to change the human beings but it is likely possible to change the conditions under they work. Voluntary errors report systems can help in preventing adverse events. Education and re-training by means of simulation can be an effective strategy too. In Pisa (Italy Nina (ceNtro di FormazIone e SimulazioNe NeonAtale is a simulation center that offers the possibility of a continuous retraining for technical and non-technical skills to optimize neonatological care strategies. Furthermore, we have been working on a novel skill trainer for mechanical ventilation (MEchatronic REspiratory System SImulator for Neonatal Applications, MERESSINA. Finally, in our opinion national health policy indirectly influences risk for errors. Proceedings of the 9th International Workshop on Neonatology · Cagliari (Italy · October 23rd-26th, 2013 · Learned lessons, changing practice and cutting-edge research

  7. Controlling errors in unidosis carts

    Directory of Open Access Journals (Sweden)

    Inmaculada Díaz Fernández

    2010-01-01

    Full Text Available Objective: To identify errors in the unidosis system carts. Method: For two months, the Pharmacy Service controlled medication either returned or missing from the unidosis carts both in the pharmacy and in the wards. Results: Uncorrected unidosis carts show a 0.9% of medication errors (264 versus 0.6% (154 which appeared in unidosis carts previously revised. In carts not revised, the error is 70.83% and mainly caused when setting up unidosis carts. The rest are due to a lack of stock or unavailability (21.6%, errors in the transcription of medical orders (6.81% or that the boxes had not been emptied previously (0.76%. The errors found in the units correspond to errors in the transcription of the treatment (3.46%, non-receipt of the unidosis copy (23.14%, the patient did not take the medication (14.36%or was discharged without medication (12.77%, was not provided by nurses (14.09%, was withdrawn from the stocks of the unit (14.62%, and errors of the pharmacy service (17.56% . Conclusions: It is concluded the need to redress unidosis carts and a computerized prescription system to avoid errors in transcription.Discussion: A high percentage of medication errors is caused by human error. If unidosis carts are overlooked before sent to hospitalization units, the error diminishes to 0.3%.

  8. SU-E-J-172: Bio-Physical Effects of Patients Set-Up Errors According to Whole Breast Irradiation Techniques

    Energy Technology Data Exchange (ETDEWEB)

    Lee, S; Suh, T; Park, S; Kim, M; Lee, M [Research Institute of Biomedical Engineering, The Catholic University of Korea, Seoul (Korea, Republic of); Park, J [Stanford University School of Medicine, Stanford, CA (United States)

    2015-06-15

    Purpose: The dose-related effects of patient setup errors on biophysical indices were evaluated for conventional wedge (CW) and field-in-field (FIF) whole breast irradiation techniques. Methods: The treatment plans for 10 patients receiving whole left breast irradiation were retrospectively selected. Radiobiological and physical effects caused by dose variations were evaluated by shifting the isocenters and gantry angles of the treatment plans. Dose-volume histograms of the planning target volume (PTV), heart, and lungs were generated, and conformity index (CI), homogeneity index (HI), tumor control probability (TCP), and normal tissue complication probability (NTCP) were determined. Results: For “isocenter shift plan” with posterior direction, the D95 of the PTV decreased by approximately 15% and the TCP of the PTV decreased by approximately 50% for the FIF technique and by 40% for the CW; however, the NTCPs of the lungs and heart increased by about 13% and 1%, respectively, for both techniques. Increasing the gantry angle decreased the TCPs of the PTV by 24.4% (CW) and by 34% (FIF). The NTCPs for the two techniques differed by only 3%. In case of CW, the CIs and HIs were much higher than that of the FIF in all cases. It had a significant difference between two techniques (p<0.01). According to our results, however, the FIF had more sensitive response by set up errors rather than CW in bio-physical aspects. Conclusions: The radiobiological-based analysis can detect significant dosimetric errors then, can provide a practical patient quality assurance method to guide the radiobiological and physical effects.

  9. Effectiveness of Barcoding for Reducing Patient Specimen and Laboratory Testing Identification Errors: A Laboratory Medicine Best Practices Systematic Review and Meta-Analysis

    Science.gov (United States)

    Snyder, Susan R.; Favoretto, Alessandra M.; Derzon, James H.; Christenson, Robert; Kahn, Stephen; Shaw, Colleen; Baetz, Rich Ann; Mass, Diana; Fantz, Corrine; Raab, Stephen; Tanasijevic, Milenko; Liebow, Edward B.

    2015-01-01

    Objectives This is the first systematic review of the effectiveness of barcoding practices for reducing patient specimen and laboratory testing identification errors. Design and Methods The CDC-funded Laboratory Medicine Best Practices Initiative systematic review methods for quality improvement practices were used. Results A total of 17 observational studies reporting on barcoding systems are included in the body of evidence; 10 for patient specimens and 7 for point-of-care testing. All 17 studies favored barcoding, with meta-analysis mean odds ratios for barcoding systems of 4.39 (95% CI: 3.05 – 6.32) and for point-of-care testing of 5.93 (95% CI: 5.28 – 6.67). Conclusions Barcoding is effective for reducing patient specimen and laboratory testing identification errors in diverse hospital settings and is recommended as an evidence-based “best practice.” The overall strength of evidence rating is high and the effect size rating is substantial. Unpublished studies made an important contribution comprising almost half of the body of evidence. PMID:22750145

  10. Distributed Computing and Monitoring Technologies for Older Patients

    DEFF Research Database (Denmark)

    Klonovs, Juris; Haque, Mohammad Ahsanul; Krüger, Volker

    , telemonitoring, ambient intelligence, ambient assisted living, gerontechnology, and aging-in-place technology. The book discusses relevant experimental studies, highlighting the application of sensor fusion, signal processing and machine learning techniques. Finally, the text discusses future challenges...

  11. How do technologies influence the interaction between nurse and patient?

    OpenAIRE

    Chalabalová, Zdeňka

    2016-01-01

    The thesis deals with technologies that nurses use in their work. These technologies are computers and tablets when nurses write electronic nursing documentation, use barcode readers when administering medications to clients of health services and in collecting blood and other laboratory samples. The theoretical part is devoted to medical and nursing documentation what legislation is in force, what the content of documentation is. After that there are presented companies that provide digitiza...

  12. E-Prescribing Errors in Community Pharmacies: Exploring Consequences and Contributing Factors

    Science.gov (United States)

    Stone, Jamie A.; Chui, Michelle A.

    2014-01-01

    Objective To explore types of e-prescribing errors in community pharmacies and their potential consequences, as well as the factors that contribute to e-prescribing errors. Methods Data collection involved performing 45 total hours of direct observations in five pharmacies. Follow-up interviews were conducted with 20 study participants. Transcripts from observations and interviews were subjected to content analysis using NVivo 10. Results Pharmacy staff detected 75 e-prescription errors during the 45 hour observation in pharmacies. The most common e-prescribing errors were wrong drug quantity, wrong dosing directions, wrong duration of therapy, and wrong dosage formulation. Participants estimated that 5 in 100 e-prescriptions have errors. Drug classes that were implicated in e-prescribing errors were antiinfectives, inhalers, ophthalmic, and topical agents. The potential consequences of e-prescribing errors included increased likelihood of the patient receiving incorrect drug therapy, poor disease management for patients, additional work for pharmacy personnel, increased cost for pharmacies and patients, and frustrations for patients and pharmacy staff. Factors that contribute to errors included: technology incompatibility between pharmacy and clinic systems, technology design issues such as use of auto-populate features and dropdown menus, and inadvertently entering incorrect information. Conclusion Study findings suggest that a wide range of e-prescribing errors are encountered in community pharmacies. Pharmacists and technicians perceive that causes of e-prescribing errors are multidisciplinary and multifactorial, that is to say e-prescribing errors can originate from technology used in prescriber offices and pharmacies. PMID:24657055

  13. Use of amplitude integrated electroencephalography (aEEG) in patients with inborn errors of metabolism - a new tool for the metabolic geneticist.

    Science.gov (United States)

    Theda, Christiane

    2010-01-01

    Patients with metabolic disorders often, especially as newborns, present with encephalopathy and seizures, frequently requiring intensive care during metabolic crises. Cerebral function monitoring using amplitude integrated electroencephalography (aEEG) can be utilized to supplement clinical assessment and other monitoring already in use in the intensive care setting. In this technique, a one or two-channel EEG tracing is obtained, processed, compressed and displayed. Use of aEEG is well established in evaluation and treatment of newborns with hypoxic ischemic encephalopathy. The basis of aEEG interpretation is the recognition of patterns which have been defined for different degrees of encephalopathy. Seizures are identified on the compressed tracing in combination with analysis of the corresponding raw EEG tracing. This review discusses the experience, although limited at this time, with use of aEEG in infants with inborn errors of metabolism. Through an international collaborative, the International Registry for Cerebral Function Monitoring in Patients with Genetics Disorders and Brain Malformations, aEEG tracings of patients with inborn errors of metabolism were collected. The features of 25 traces are included in this review. This collection includes patients with hyperammonemia (HA, n=4), disorders of energy metabolism (DEM, n=9), disorders of amino and organic acid metabolism (DAOAM, n=7), and peroxisomal disorders (PD, n=5). Fifteen of 25 patients demonstrated encephalopathic changes, including patients with HA, DEM and DAOAM, but not PD. In 15 of 25 patients seizure potentials were identified. In HA, DEM, and DAOAM both encephalopathy and seizures may coincide, while in peroxisomal disorders seizures were seen without background patterns indicating encephalopathy, likely due to neuronal migration defects as the underlying cause. The current experience with the use of aEEG in these patients, while limited, indicates that cerebral function monitoring

  14. Long-chain polyunsaturated fatty acid concentration in patients with inborn errors of metabolism Concentración de ácidos grasos poliinsaturados de cadena larga en pacientes con errores innatos del metabolismo

    Directory of Open Access Journals (Sweden)

    M.ª A. Vilaseca

    2011-02-01

    Full Text Available Introduction: Long-chain polyunsaturated fatty acid (LCPUFA can be provided by diet (fatty fish, eggs, viscera and human milk or synthetised from essential fatty acids linoleic and α-linolenic acids through the microsomal pathway. However, endogenous LCPUFA synthesis is rather low, especially for docosahexaenoic (DHA, and seems insufficient to achieve normal DHA values in individuals devoid of preformed dietary supply. Inborn errors of metabolism (IEMs are therefore diseases with a special risk for LCPUFA deficient status. Aim: Our aim was to evaluate LCPUFA status in 132 patients with different IEMs. Methods: We performed a cross-sectional study of plasma and erythrocyte LCPUFA composition of 63 patients with IEMs treated with protein-restricted diets compared with data from 69 patients with IEMs on protein-unrestricted diets, and 43 own reference values. Results: Erythrocyte and plasma DHA and arachidonic acid concentrations were significantly decreased in patients treated with protein-restriction compared with those on protein-unrestricted diets and with our reference values (p Introducción: Los ácidos grasos poliinsaturados de cadena larga (LCPUFA pueden ser suministrados por la dieta o sintetizados a partir de los ácidos grasos esenciales, linoleico y α-linolénico. La síntesis endógena de LCPUFA es escasa, especialmente la de ácido docosahe-xaenoico (DHA, e insuficiente para alcanzar los valores normales de DHA en individuos que carecen de un suministro dietético de dichos ácidos preformados. Por ello, los errores innatos del metabolismo (IEM son enfermedades con riesgo especial de deficiencia de LCPUFAs. Objetivos: Evaluar el estado de LCPUFA en 132 pacientes con diferentes IEMs. Métodos: Estudio transversal de LCPUFA en plasma y eritrocitos de 63 pacientes con IEMs tratados con dieta restringida en proteínas comparados con 69 pacientes con IEMs con una dieta libre y 43 valores de referencia. Resultados: Las concentraciones de

  15. Using information technology for patient education: realizing surplus value?

    Science.gov (United States)

    Stoop, Arjen P; van't Riet, Annemarie; Berg, Marc

    2004-08-01

    Computer-based patient information systems are introduced to replace traditional forms of patient education like brochures, leaflets, videotapes and, to a certain extent, face-to-face communication. In this paper, we claim that though computer-based patient information systems potentially have many advantages compared to traditional means, the surplus value of these systems is much harder to realize than often expected. By reporting on two computer-based patient information systems, both found to be unsuccessful, we will show that building computer-based patient information systems for patient education requires a thorough analysis of the advantages and limitations of IT compared to traditional forms of patient education. When this condition is fulfilled, however, these systems have the potential to improve health status and to be a valuable supplement to (rather than a substitute for) traditional means of patient education.

  16. Pre-analytical workstations: a tool for reducing laboratory errors.

    Science.gov (United States)

    Da Rin, Giorgio

    2009-06-01

    Laboratory testing, a highly complex process commonly called the total testing process (TTP), is usually subdivided into three traditional (pre-, intra-, and post-) analytical phases. The majority of errors in TTP originate in the pre-analytical phase, being due to individual or system design defects. In order to reduce errors in TTP, the pre-analytical phase should therefore be prioritized. In addition to developing procedures, providing training, improving interdepartmental cooperation, information technology and robotics may be a tool to reduce errors in specimen collection and pre-analytical sample handling. It has been estimated that >2000 clinical laboratories worldwide use total or subtotal automation supporting pre-analytic activities, with a high rate of increase compared to 2007; the need to reduce errors seems to be the catalyst for increasing the use of robotics. Automated systems to prevent medical personnel from drawing blood from the wrong patient were introduced commercially in the early 1990s. Correct patient identification and test tube labelling before phlebotomy are of extreme importance for patient safety in TTP, but currently few laboratories are interested in such products. At San Bassiano hospital, the implementation of advanced information technology and robotics in the pre-analytical phase (specimen collection and pre-analytical sample handling) have improved accuracy, and clinical efficiency of the laboratory process and created a TTP that minimizes errors.

  17. 冗余 MEMS-IMU 误差补偿技术研究%Redundant MEMS-IMU error compensation technology

    Institute of Scientific and Technical Information of China (English)

    邵玉萍; 何昆鹏

    2015-01-01

    为提高惯性导航系统的精度和可靠性,设计了一种基于冗余MEMS-IMU的惯性导航系统(3 MEMS-IMU分别斜置安装在正四面体的3个面上),并针对该系统的惯性测量单元( IMU)进行了误差分析,建立了精确的误差补偿数学模型。在此基础上提出了一种标定方法,给出了计算误差模型参数的推导过程以及各误差参数的数学表达式。通过多组试验验证了该方法简单可靠,可以有效估计出各误差参数,并能有效进行误差补偿,标定精度较高,适用于短时间、低中精度导航系统。%To improve the accuracy and reliability of the inertial navigation system , an inertial navigation system based on redundant MEMS-IMU was designed ( 3 MEMS-IMUs were installed obliquely at three surfaces of a regular tetrahedron ) .And the error of the IMU was analyzed and a precise mathematical model of error compensation was established .A calibration method was proposed , and a detailed derivation of the calculation of error parameters and mathematical expressions of all error parameters were given .Many groups of experiments proved that the method is simple and reliable and can estimate each error parameters effectively , and can carry out error compensation effec-tively, which has high calibration precision , suitable for short-time, low or medium precision inertial navigation system.

  18. USE OF TECHNOLOGIES OF PLASTIC AND RECONSTRUCTIVE MICROSURGERY IN TREATMENT OF PATIENTS WITH PATHOLOGY OF ELBOW

    Directory of Open Access Journals (Sweden)

    L. A. Rodomanova

    2011-01-01

    Full Text Available We have analyzed the results of using modern technologies of plastic and reconstructive microsurgery in treatment of 39 patients with pathology of elbow. We have stated that while using microsurgical technologies as independent and exhaustive method of treating such patients the operations have mainly mobilizing character. They aim to delete scarry contractures and recreate motion in elbow joint. The use of microsurgical technologies in a system of the specialized orthopedic treatment opens a lot of additional opportunities for the reabilitation of patients with pathology of elbow. It mainly concerns indications for performing total elbow arthroplasty and improving its results.

  19. Effectiveness of educational technology to improve patient care in pharmacy curricula.

    Science.gov (United States)

    Smith, Michael A; Benedict, Neal

    2015-02-17

    A review of the literature on the effectiveness of educational technologies to teach patient care skills to pharmacy students was conducted. Nineteen articles met inclusion criteria for the review. Seven of the articles included computer-aided instruction, 4 utilized human-patient simulation, 1 used both computer-aided instruction and human-patient simulation, and 7 utilized virtual patients. Educational technology was employed with more than 2700 students at 12 colleges and schools of pharmacy in courses including pharmacotherapeutics, skills and patient care laboratories, drug diversion, and advanced pharmacy practice experience (APPE) orientation. Students who learned by means of human-patient simulation and virtual patients reported enjoying the learning activity, whereas the results with computer-aided instruction were mixed. Moreover, the effect on learning was significant in the human-patient simulation and virtual patient studies, while conflicting data emerged on the effectiveness of computer-aided instruction.

  20. SU-E-T-318: The Effect of Patient Positioning Errors On Target Coverage and Cochlear Dose in Stereotactic Radiosurgery Treatment of Acoustic Neuromas

    Energy Technology Data Exchange (ETDEWEB)

    Dellamonica, D.; Luo, G.; Ding, G. [Vanderbilt University, Nashville, TN (United States)

    2014-06-01

    Purpose: Setup errors on the order of millimeters may cause under-dosing of targets and significant changes in dose to critical structures especially when planning with tight margins in stereotactic radiosurgery. This study evaluates the effects of these types of patient positioning uncertainties on planning target volume (PTV) coverage and cochlear dose for stereotactic treatments of acoustic neuromas. Methods: Twelve acoustic neuroma patient treatment plans were retrospectively evaluated in Brainlab iPlan RT Dose 4.1.3. All treatment beams were shaped by HDMLC from a Varian TX machine. Seven patients had planning margins of 2mm, five had 1–1.5mm. Six treatment plans were created for each patient simulating a 1mm setup error in six possible directions: anterior-posterior, lateral, and superiorinferior. The arcs and HDMLC shapes were kept the same for each plan. Change in PTV coverage and mean dose to the cochlea was evaluated for each plan. Results: The average change in PTV coverage for the 72 simulated plans was −1.7% (range: −5 to +1.1%). The largest average change in coverage was observed for shifts in the patient's superior direction (−2.9%). The change in mean cochlear dose was highly dependent upon the direction of the shift. Shifts in the anterior and superior direction resulted in an average increase in dose of 13.5 and 3.8%, respectively, while shifts in the posterior and inferior direction resulted in an average decrease in dose of 17.9 and 10.2%. The average change in dose to the cochlea was 13.9% (range: 1.4 to 48.6%). No difference was observed based on the size of the planning margin. Conclusion: This study indicates that if the positioning uncertainty is kept within 1mm the setup errors may not result in significant under-dosing of the acoustic neuroma target volumes. However, the change in mean cochlear dose is highly dependent upon the direction of the shift.

  1. The feasibility of using technology to enhance the transition of palliative care for rural patients.

    Science.gov (United States)

    Holland, Diane E; Vanderboom, Catherine E; Ingram, Cory J; Dose, Ann Marie; Borkenhagen, Lynn S; Skadahl, Phyllis; Pacyna, Joel E; Austin, Christine M; Bowles, Kathryn H

    2014-06-01

    Palliative care services for patients with life-limiting conditions enhance their quality of life. Most palliative care services, however, are located in hospitals with limited transitional care for patients who live in distant locations. The long-term goal of this program of research is to use existing technology for virtual visits to provide transitional care for patients initially hospitalized in an urban setting by a nurse practitioner located closer to patients' homes in distant, rural settings. The purpose of this proof-of-concept study was to determine the resources needed to use the system (efficiency) and the quality of the audio and visual components (effectiveness) to conduct virtual visits between a clinician at an academic center and community-dwelling adults living in rural locations. Guided by the Technology Acceptance Model, a mixed-methods field design was used. Because of the burden of testing technology with patients with life-limiting conditions, the sample included eight healthy adults. Participant satisfaction and perceptions of the ease of using the technology were also measured. Virtual visits were conducted using a 3G-enabled Apple iPad, cellular phone data service, and a Web-based video conference service. Participants and clinicians perceived the technology as easy to use. Observations revealed the importance of the visual cues provided by the technology to enhance communication, engagement, and satisfaction. Findings from this study will inform a subsequent study of technology-enhanced transitional care with palliative care patients.

  2. Error correcting coding for OTN

    DEFF Research Database (Denmark)

    Justesen, Jørn; Larsen, Knud J.; Pedersen, Lars A.

    2010-01-01

    Forward error correction codes for 100 Gb/s optical transmission are currently receiving much attention from transport network operators and technology providers. We discuss the performance of hard decision decoding using product type codes that cover a single OTN frame or a small number...... of such frames. In particular we argue that a three-error correcting BCH is the best choice for the component code in such systems....

  3. Empowering Patients with COPD Using Tele-Homecare Technology

    DEFF Research Database (Denmark)

    Huniche, Lotte

    2010-01-01

    Abstract. This paper describes how a tele-rehabilitation program using home tele-monitoring empowers patients with COPD. The paper is based on findings from an ongoing research and innovation project, called “Telehomecare, chronic patients and the integrated healthcare system” (the TELEKAT project......) that employs triple interventions related to patients, professionals, and the organisation of care. The ways COPD patients utilize home tele-monitoring in the TELEKAT project points to the relevance of empowerment, as rooted in ideologies of social action, and focusing on the improvement of both personal...

  4. Errors on the Trail Making Test Are Associated with Right Hemispheric Frontal Lobe Damage in Stroke Patients

    Directory of Open Access Journals (Sweden)

    Bruno Kopp

    2015-01-01

    Full Text Available Measures of performance on the Trail Making Test (TMT are among the most popular neuropsychological assessment techniques. Completion time on TMT-A is considered to provide a measure of processing speed, whereas completion time on TMT-B is considered to constitute a behavioral measure of the ability to shift between cognitive sets (cognitive flexibility, commonly attributed to the frontal lobes. However, empirical evidence linking performance on the TMT-B to localized frontal lesions is mostly lacking. Here, we examined the association of frontal lesions following stroke with TMT-B performance measures (i.e., completion time and completion accuracy measures using voxel-based lesion-behavior mapping, with a focus on right hemispheric frontal lobe lesions. Our results suggest that the number of errors, but not completion time on the TMT-B, is associated with right hemispheric frontal lesions. This finding contradicts common clinical practice—the use of completion time on the TMT-B to measure cognitive flexibility, and it underscores the need for additional research on the association between cognitive flexibility and the frontal lobes. Further work in a larger sample, including left frontal lobe damage and with more power to detect effects of right posterior brain injury, is necessary to determine whether our observation is specific for right frontal lesions.

  5. Comparison the post operative refractive errors in same size corneal transplantation through deep lamellar keratoplasty and penetrating keratoplasty methods after sutures removing in keratoconus patients

    Directory of Open Access Journals (Sweden)

    Hasan Razmjoo

    2016-01-01

    Full Text Available Background: Corneal transplantation is a surgery in which cornea is replaced by a donated one and can be completely penetrating keratoplasty (PK or included a part of cornea deep lamellar keratoplasty (DLK. Although the functional results are limited by some complications, it is considered as one of the most successful surgeries. This study aimed to compare the refractive errors after same size corneal transplantation through DLK and PK methods in keratoconus patients over 20 years. Materials and Methods: This descriptive, analytical study was conducted in Feiz Hospital, Sadra and Persian Clinics of Isfahan in 2013–2014. In this study, 35 patients underwent corneal transplantation by PK and 35 patients by DLK, after removing the sutures, the patients were compared in terms of best corrected visual acuity (BCVA and refractive errors. Data were analyzed using Chi-square and t Student tests by SPSS software. Results: The BCVA mean in DLK and PK groups was 6/10 ± 2/10 and 5/10 ± 2/10, respectively, with no significant difference (P = 0.4. The results showed 9 cases of DLK and 6 cases of PK had normal (8/10 ≤ BCVA visual acuity (25.7% vs. 17.1%, 24 cases of DLK and 27 cases of PK had mild vision impairment (68.6% vs. 77.1% and 2 cases of the DLK group and 2 cases of PK had moderate vision impairment, (5.7% vs. 5.7%, there was no significant difference in “BCVA” (P = 0.83. Conclusions: Both methods were acceptably effective in improving BCVA, but according to previous articles (5,9,10 the DLK method due to fewer complications and less risk of rejection was superior to another method and in the absence of any prohibition this method is recommended.

  6. Supporting cancer patients' unanchored health information management with mobile technology.

    Science.gov (United States)

    Klasnja, Predrag; Hartzler, Andrea; Powell, Christopher; Pratt, Wanda

    2011-01-01

    Cancer patients often need to manage care-related information when they are away from home, when they are experiencing pain or treatment side effects, or when their abilities to deal with information effectively are otherwise impaired. In this paper, we describe the results from a four-week evaluation of HealthWeaver Mobile, a mobile phone application that we developed to support such "unanchored" patient information activities. Based on experiences from nine cancer patients, our results indicate that HealthWeaver Mobile can help patients to access care-related information from anywhere, to capture information whenever a need arises, and to share information with clinicians during clinic visits. The enhanced ability to manage information, in turn, helps patients to manage their care and to feel more confident in their ability to stay in control of their information and their health.

  7. Transient Error Data Analysis.

    Science.gov (United States)

    1979-05-01

    Analysis is 3.2 Graphical Data Analysis 16 3.3 General Statistics and Confidence Intervals 1" 3.4 Goodness of Fit Test 15 4. Conclusions 31 Acknowledgements...MTTF per System Technology Mechanism Processor Processor MT IE . CMUA PDP-10, ECL Parity 44 hrs. 800-1600 hrs. 0.03-0.06 Cm* LSI-1 1, NMOS Diagnostics...OF BAD TIME ERRORS: 6 TOTAL NUMBER OF ENTRIES FOR ALL INPUT FILESs 18445 TIME SPAN: 1542 HRS., FROM: 17-Feb-79 5:3:11 TO: 18-1Mj-79 11:30:99

  8. A probabilistic model for reducing medication errors.

    Directory of Open Access Journals (Sweden)

    Phung Anh Nguyen

    Full Text Available BACKGROUND: Medication errors are common, life threatening, costly but preventable. Information technology and automated systems are highly efficient for preventing medication errors and therefore widely employed in hospital settings. The aim of this study was to construct a probabilistic model that can reduce medication errors by identifying uncommon or rare associations between medications and diseases. METHODS AND FINDINGS: Association rules of mining techniques are utilized for 103.5 million prescriptions from Taiwan's National Health Insurance database. The dataset included 204.5 million diagnoses with ICD9-CM codes and 347.7 million medications by using ATC codes. Disease-Medication (DM and Medication-Medication (MM associations were computed by their co-occurrence and associations' strength were measured by the interestingness or lift values which were being referred as Q values. The DMQs and MMQs were used to develop the AOP model to predict the appropriateness of a given prescription. Validation of this model was done by comparing the results of evaluation performed by the AOP model and verified by human experts. The results showed 96% accuracy for appropriate and 45% accuracy for inappropriate prescriptions, with a sensitivity and specificity of 75.9% and 89.5%, respectively. CONCLUSIONS: We successfully developed the AOP model as an efficient tool for automatic identification of uncommon or rare associations between disease-medication and medication-medication in prescriptions. The AOP model helps to reduce medication errors by alerting physicians, improving the patients' safety and the overall quality of care.

  9. Assessing the quality of decision support technologies using the International Patient Decision Aid Standards instrument (IPDASi).

    NARCIS (Netherlands)

    Elwyn, G.; O'Connor, A.M.; Bennett, C.; Newcombe, R.G.; Politi, M.; Durand, M.A.; Drake, E.; Joseph-Williams, N.; Khangura, S.; Saarimaki, A.; Sivell, S.; Stiel, M.; Bernstein, S.J.; Col, N.; Coulter, A.; Eden, K.; Harter, M.; Rovner, M.H.; Moumjid, N.; Stacey, D.; Thomson, R.; Whelan, T.; Weijden, G.D.E.M. van der; Edwards, A.

    2009-01-01

    OBJECTIVES: To describe the development, validation and inter-rater reliability of an instrument to measure the quality of patient decision support technologies (decision aids). DESIGN: Scale development study, involving construct, item and scale development, validation and reliability testing. SETT

  10. Facilitating patient self-management through telephony and web technologies in seasonal influenza

    Directory of Open Access Journals (Sweden)

    Zsolt Nagykaldi

    2010-03-01

    Conclusions Primary care patients and their clinicians can adopt and successfully utilise influenza self-management technologies. Our pilot study suggests that web resources combined with telephony technology are feasible to set up and easy to use in primary care settings.

  11. Ethics and technology transfer: patients, patents, and public trust.

    Science.gov (United States)

    Zucker, Deborah

    2011-06-01

    Universities and academic medical centers have been increasing their focus on technology transfer and research commercialization. With this shift in focus, academic-industry ties have become prevalent. These relationships can benefit academic researchers and help then to transform their research into tangible societal benefits. However, there also are concerns that these ties and the greater academic focus on commercialization might lead to conflicts of interest, especially financial conflicts of interest. This paper briefly explores some of these conflicts of interest, particularly relating to research and training. This paper also discusses some of the policies that have been, and are being, developed to try to mitigate and manage these conflicts so that academic involvement in technology transfer and commercialization can continue without jeopardizing academic work or the public's trust in them.

  12. Involving patient in the early stages of health technology assessment (HTA): a study protocol

    OpenAIRE

    Gagnon, Marie-Pierre; Candas, Bernard; Desmartis, Marie; Gagnon, Johanne; Roche, Daniel La; Rhainds, Marc; Coulombe, Martin; Dipankui, Mylène Tantchou; Légaré, France

    2014-01-01

    Background Public and patient involvement in the different stages of the health technology assessment (HTA) process is increasingly encouraged. The selection of topics for assessment, which includes identifying and prioritizing HTA questions, is a constant challenge for HTA agencies because the number of technologies requiring an assessment exceeds the resources available. Public and patient involvement in these early stages of HTA could make assessments more relevant and acceptable to them. ...

  13. Patients' and carers' experiences of interacting with home haemodialysis technology: implications for quality and safety.

    Science.gov (United States)

    Rajkomar, Atish; Farrington, Ken; Mayer, Astrid; Walker, Diane; Blandford, Ann

    2014-12-11

    Little is known about patients' and carers' experiences of interacting with home haemodialysis (HHD) technology, in terms of user experience, how the design of the technology supports safety and fits with home use, and how the broader context of service provision impacts on patients' use of the technology. Data were gathered through ethnographic observations and interviews with 19 patients and their carers associated with four different hospitals in the UK, using five different HHD machines. All patients were managing their condition successfully on HHD. Data were analysed qualitatively, focusing on themes of how individuals used the machines and how they managed their own safety. Findings are organised by three themes: learning to use the technology, usability of the technology, and managing safety during dialysis. Home patients want to live their lives fully, and value the freedom and autonomy that HHD gives them; they adapt use of the technology to their lives and their home context. They also consider the machines to be safe; nevertheless, most participants reported feeling scared and having to learn through mistakes in the early months of dialysing at home. Home care nurses and technicians provide invaluable support. Although participants reported on strategies for anticipating problems and keeping safe, perceived limitations of the technology and of the broader system of care led some to trade off safety against immediate quality of life. Enhancing the quality and safety of the patient experience in HHD involves designing technology and the broader system of care to take account of how individuals manage their dialysis in the home. Possible design improvements to enhance the quality and safety of the patient experience include features to help patients manage their dialysis (e.g. providing timely reminders of next steps) and features to support communication between families and professionals (e.g. through remote monitoring).

  14. Empowering patients with COPD using Tele-homecare technology.

    Science.gov (United States)

    Huniche, Lotte; Dinesen, Birthe; Grann, Ove; Toft, Egon; Nielsen, Carl

    2010-01-01

    This paper discusses how a tele-rehabilitation program using home tele-monitoring may empower patients with chronic obstructive pulmonary disease (COPD). The paper is based on preliminary findings from an ongoing research and innovation project, called "Tele-homecare, chronic patients and the integrated healthcare system" (the TELEKAT project) that employs triple interventions related to patients, professionals, and the organization of care. The ways COPD patients make use of home tele-monitoring in the TELEKAT project points to the relevance of a concept of empowerment rooted in ideologies of social action, and focusing on the improvement of both personal and social conditions at the intersection of individual, organizational and community development.

  15. The Impact of Technology on Patients, Providers, and Care Patterns.

    Science.gov (United States)

    Fagerhaugh, Shizuko; And Others

    1980-01-01

    Examines the problems technical innovation has brought to health care professionals, administrators, and patients from the standpoints of increased specialization, equipment obsolescence, bureaucracy, retraining, regulations, high costs of services, depersonalization, and ethical dilemmas. (CT)

  16. Analgesic medication errors in North Carolina nursing homes.

    Science.gov (United States)

    Desai, Rishi J; Williams, Charrlotte E; Greene, Sandra B; Pierson, Stephanie; Caprio, Anthony J; Hansen, Richard A

    2013-06-01

    The objective of this study was to characterize analgesic medication errors and to evaluate their association with patient harm. The authors conducted a cross-sectional analysis of individual medication error incidents reported by North Carolina nursing homes to the Medication Error Quality Initiative (MEQI) during fiscal years 2010-2011. Bivariate associations between analgesic medication errors with patient factors, error-related factors, and impact on patients were tested with chi-square tests. A multivariate logistic regression model explored the relationship between type of analgesic medication errors and patient harm, controlling for patient- and error-related factors. A total of 32,176 individual medication error incidents were reported over a 2-year period in North Carolina nursing homes, 12.3% (n = 3949) of which were analgesic medication errors. Of these analgesic medication errors, opioid and nonopioid analgesics were involved in 3105 and 844 errors, respectively. Opioid errors were more likely to be wrong drug errors, wrong dose errors, and administration errors compared with nonopioid errors (P errors were found to have higher odds of patient harm compared with nonopioid errors (odds ratio [OR] = 3, 95% confodence interval [CI]: 1.1-7.8). The authors conclude that opioid analgesics represent the majority of analgesic error reports, and these error reports reflect an increased likelihood of patient harm compared with nonopioid analgesics.

  17. A randomised open-label cross-over study of inhaler errors, preference and time to achieve correct inhaler use in patients with COPD or asthma: comparison of ELLIPTA with other inhaler devices.

    Science.gov (United States)

    van der Palen, Job; Thomas, Mike; Chrystyn, Henry; Sharma, Raj K; van der Valk, Paul Dlpm; Goosens, Martijn; Wilkinson, Tom; Stonham, Carol; Chauhan, Anoop J; Imber, Varsha; Zhu, Chang-Qing; Svedsater, Henrik; Barnes, Neil C

    2016-11-24

    Errors in the use of different inhalers were investigated in patients naive to the devices under investigation in a multicentre, single-visit, randomised, open-label, cross-over study. Patients with chronic obstructive pulmonary disease (COPD) or asthma were assigned to ELLIPTA vs DISKUS (Accuhaler), metered-dose inhaler (MDI) or Turbuhaler. Patients with COPD were also assigned to ELLIPTA vs Handihaler or Breezhaler. Patients demonstrated inhaler use after reading the patient information leaflet (PIL). A trained investigator assessed critical errors (i.e., those likely to result in the inhalation of significantly reduced, minimal or no medication). If the patient made errors, the investigator demonstrated the correct use of the inhaler, and the patient demonstrated inhaler use again. Fewer COPD patients made critical errors with ELLIPTA after reading the PIL vs: DISKUS, 9/171 (5%) vs 75/171 (44%); MDI, 10/80 (13%) vs 48/80 (60%); Turbuhaler, 8/100 (8%) vs 44/100 (44%); Handihaler, 17/118 (14%) vs 57/118 (48%); Breezhaler, 13/98 (13%) vs 45/98 (46%; all PELLIPTA and did not require investigator instruction. Instruction was required for DISKUS (65%), MDI (85%), Turbuhaler (71%), Handihaler (62%) and Breezhaler (56%). Fewer asthma patients made critical errors with ELLIPTA after reading the PIL vs: DISKUS (3/70 (4%) vs 9/70 (13%), P=0.221); MDI (2/32 (6%) vs 8/32 (25%), P=0.074) and significantly fewer vs Turbuhaler (3/60 (5%) vs 20/60 (33%), PELLIPTA over the other devices (all P⩽0.002). Significantly, fewer COPD patients using ELLIPTA made critical errors after reading the PIL vs other inhalers. More asthma and COPD patients preferred ELLIPTA over comparator inhalers.

  18. Proprioception rehabilitation training system for stroke patients using virtual reality technology.

    Science.gov (United States)

    Kim, Sun I; Song, In-Ho; Cho, Sangwoo; Kim, In Young; Ku, Jeonghun; Kang, Youn Joo; Jang, Dong Pyo

    2013-01-01

    We investigated a virtual reality (VR) proprioceptive rehabilitation system that could manipulate the visual feedback of upper-limb during training and could do training by relying on proprioception feedback only. Virtual environments were designed in order to switch visual feedback on/off during upper-limb training. Two types of VR training tasks were designed for evaluating the effect of the proprioception focused training compared to the training with visual feedback. In order to evaluate the developed proprioception feedback virtual environment system, we recruited ten stroke patients (age: 54.7± 7.83years, on set: 3.29± 3.83 years). All patients performed three times PFVE task in order to check the improvement of proprioception function just before training session, after one week training, and after all training. In a comparison between FMS score and PFVE, the FMS score had a significant relationship with the error distance(r = -.662, n=10, p = .037) and total movement distance(r = -.726, n=10, p = .018) in PFVE. Comparing the training effect between in virtual environment with visual feedback and with proprioception, the click count, error distance and total error distance was more reduced in PFVE than VFVE. (Click count: p = 0.005, error distance: p = 0.001, total error distance: p = 0.007). It suggested that the proprioception feedback rather than visual feedback could be effective means to enhancing motor control during rehabilitation training. The developed VR system for rehabilitation has been verified in that stroke patients improved motor control after VR proprioception feedback training.

  19. The Risk Criteria for Discriminating Technology Innovation Investment Decision Errors of High-tech Enterprises%判别高新技术企业技术创新投资决策错误的风险准则

    Institute of Scientific and Technical Information of China (English)

    边云岗; 郭开仲

    2014-01-01

    The technological innovation of high-tech enterprises is a high-risk activity. High-risk means the probability of obtaining high risk gain or suffering large risk loss. Therefore, the correct decision on technological innovation investment is help-ful to maximize the investment income. Through an analysis of the law on technological innovation investment risk-benefit, it is found that an optimal degree of risk and a critical degree of risk exist in the technological innovation investment objectives. For rational decision makers, a risk tolerance interval including the optimal degree of risk should be determined, based on the enterprise's own risk tolerance and business strategy, as a the risk criteria for discriminating technology innovation investment decision errors, and an error function should be created to measure the degree of the investment decision error based on the error-eliminating theory in order to take appropriate remedial measures. Finally, a wrong decision example is analyzed to illustrate the risk criteria is scientific and rational.%高新技术企业的技术创新是一种高风险活动,高风险意味着面临获得高风险收益或遭受高风险损失的可能。因此,正确的技术创新投资决策有利于实现收益的最大化。通过对企业技术创新投资风险收益规律的分析发现,企业技术创新投资客观上存在最佳风险度和临界风险度,认为对于理性的技术创新投资决策者而言,应根据企业自身的风险承担能力和经营战略,确定包括最佳风险度在内的风险容忍区间,作为判别技术创新投资决策错误的风险准则,并通过消错理论中的错误函数度量投资决策错误的程度,以便采取相应的补救措施。最后通过错误投资决策的实例分析,说明了该风险准则的科学性和合理性。

  20. Reducing errors in emergency surgery.

    Science.gov (United States)

    Watters, David A K; Truskett, Philip G

    2013-06-01

    Errors are to be expected in health care. Adverse events occur in around 10% of surgical patients and may be even more common in emergency surgery. There is little formal teaching on surgical error in surgical education and training programmes despite their frequency. This paper reviews surgical error and provides a classification system, to facilitate learning. The approach and language used to enable teaching about surgical error was developed through a review of key literature and consensus by the founding faculty of the Management of Surgical Emergencies course, currently delivered by General Surgeons Australia. Errors may be classified as being the result of commission, omission or inition. An error of inition is a failure of effort or will and is a failure of professionalism. The risk of error can be minimized by good situational awareness, matching perception to reality, and, during treatment, reassessing the patient, team and plan. It is important to recognize and acknowledge an error when it occurs and then to respond appropriately. The response will involve rectifying the error where possible but also disclosing, reporting and reviewing at a system level all the root causes. This should be done without shaming or blaming. However, the individual surgeon still needs to reflect on their own contribution and performance. A classification of surgical error has been developed that promotes understanding of how the error was generated, and utilizes a language that encourages reflection, reporting and response by surgeons and their teams. © 2013 The Authors. ANZ Journal of Surgery © 2013 Royal Australasian College of Surgeons.

  1. Being in front of the patient. Nurse-patient interaction and use of technology in emergency services

    Directory of Open Access Journals (Sweden)

    Yeimy Yesenia Granados-Pembertty

    2013-12-01

    Full Text Available Objective. This study sought to describe how the use of technology intervenes in the nurse-patient relationship, from the nurse's point of view. Methodology. This was a qualitative research with tools from grounded theory. Twenty semi-structured interviews were conducted with nurses working in emergency services in three municipalities of Colombia. Results. Four categories emerged: 1 direct care, the maximum interaction or being in front of the patient; 2 fairly direct care; 3 indirect care, institutional management; and 4 minimum interaction; technology as facilitator of the interaction and awareness of the necessity for interaction. Conclusion. This study shows the irreplaceable nature of the nurse and the fundamental necessity of technology. The dual mediations of technology constitute a paradoxical matter that reveals the importance of placing it as a means; warning on the danger of converting it an end in and of itself.

  2. The use of information technology to enhance patient safety and nursing efficiency.

    Science.gov (United States)

    Lee, Tso-Ying; Sun, Gi-Tseng; Kou, Li-Tseng; Yeh, Mei-Ling

    2017-08-08

    Issues in patient safety and nursing efficiency have long been of concern. Advancing the role of nursing informatics is seen as the best way to address this. The aim of this study was to determine if the use, outcomes and satisfaction with a nursing information system (NIS) improved patient safety and the quality of nursing care in a hospital in Taiwan. This study adopts a quasi-experimental design. Nurses and patients were surveyed by questionnaire and data retrieval before and after the implementation of NIS in terms of blood drawing, nursing process, drug administration, bar code scanning, shift handover, and information and communication integration. Physiologic values were easier to read and interpret; it took less time to complete electronic records (3.7 vs. 9.1 min); the number of errors in drug administration was reduced (0.08% vs. 0.39%); bar codes reduced the number of errors in blood drawing (0 vs. 10) and transportation of specimens (0 vs. 0.42%); satisfaction with electronic shift handover increased significantly; there was a reduction in nursing turnover (14.9% vs. 16%); patient satisfaction increased significantly (3.46 vs. 3.34). Introduction of NIS improved patient safety and nursing efficiency and increased nurse and patient satisfaction. Medical organizations must continually improve the nursing information system if they are to provide patients with high quality service in a competitive environment.

  3. Purchasing medical innovation the right technology, for the right patient, at the right price

    CERN Document Server

    Robinson, James C

    2015-01-01

    Innovation in medical technology generates a remarkable supply of new drugs, devices, and diagnostics that improve health, reduce risks, and extend life. But these technologies are too often used on the wrong patient, in the wrong setting, or at an unaffordable price. The only way to moderate the growth in health care costs without undermining the dynamic of medical innovation is to improve the process of assessing, pricing, prescribing, and using new technologies. Purchasing Medical Innovation analyzes the contemporary revolution in the purchasing of health care technology, with a focus on th

  4. Errors in transfusion medicine: have we learned our lesson?

    Science.gov (United States)

    Fastman, Barbara Rabin; Kaplan, Harold S

    2011-01-01

    The phrase "patient safety" represents freedom from accidental or preventable harm due to events occurring in the healthcare setting. Practitioners aim to reduce, if not prevent, medical errors and adverse outcomes. Yet studies performed from many perspectives show that medical error constitutes a serious worldwide problem. Transfusion medicine, with its interdisciplinary intricacies and the danger of fatal outcomes, serves as an exemplar of lessons learned. Opportunity for error in complex systems is vast, and although errors are traditionally blamed on humans, they are often set up by preexisting factors. Transfusion has inherent hazards such as clinical vulnerabilities (eg, contracting an infectious agent or experiencing a transfusion reaction), but there also exists the possibility of hazards associated with process errors. Sample collection errors, or preanalytic errors, may occur when samples are drawn from donors during blood donation, as well as when drawn from patients prior to transfusion-related testing, and account for approximately one-third of events in transfusion. Errors in the analytic phase of the transfusion chain, slips and errors in the laboratory, comprise close to one-third of patient safety-related transfusion events. As many as 40% of mistransfusions are due to errors in the postanalytic phase: often failures in the final check of the right blood and the right patient at the bedside. Bar-code labels, radiofrequency identification tags, and even palm vein-scanning technology are increasingly being utilized in patient identification. The last phase of transfusion, careful monitoring of the recipient for adverse signs or symptoms, when performed diligently can help prevent or manage a potentially fatal reaction caused by an earlier process error or an unavoidable physiologic condition. Ways in which we can and do deal with potential hazards of transfusion are discussed, including a method of hazard reduction termed inherently safer design

  5. Investigation of gamma knife image registration errors resulting from misalignment between the patient and the imaging axis.

    Science.gov (United States)

    Cernica, George; Wang, Zhou; Malhotra, Harish; de Boer, Steven; Podgorsak, Matthew B

    2006-04-01

    The ability of Leksell GammaPlan to perform stereotactic space localizations with image sets where there is misalignment of the patient's head (stereotactic frame and fiducial apparatus) relative to the computed tomography (CT) scanner coordinate system was studied. Misalignment is sometimes necessary for patient comfort. Results equally apply to magnetic resonance imaging. Seven 0.5 mm diameter CT-visible spheres were rigidly mounted to a string tied tightly at each end to diagonally opposite posts attached to a Leksell stereotactic frame. A standard CT fiducial box was applied to the frame in the usual clinical manner. A baseline CT scan (1 mm slice thickness) was obtained with the fiducial box perfectly aligned with the scanner axis. After localization of the image set, the (x,y,z) coordinate of the center of each sphere was recorded. Repeat CT scans with varying fiducial box misalignments with the imaging axis were subsequently obtained. The mean difference between the base line and the respective coordinates in misaligned geometries was approximately 0.2 mm (sigma=0.2 mm), well within the accuracy of the image sets and the delivery of radiosurgery with the Gamma Knife.

  6. A patient centred framework for improving LTC quality of life through Web 2.0 technology.

    Science.gov (United States)

    Pulman, Andy

    2010-03-01

    The NHS and Social Care Model - a blueprint supporting organisations in improving services for people with long-term conditions (LTCs) - noted options to support people with LTCs might include technological tools supporting personalised care and choice and providing resources for patients to self-care and self-manage. Definitions concerning the integration of health information and support with Web 2.0 technology are primarily concerned with approaches from the healthcare perspective. There is a need to design a patient centred framework, encapsulating the use of Web 2.0 technology for people with LTCs who want to support, mitigate or improve quality of life. Existing theoretical frameworks offer a means of informing the design and measurement of this framework. This article describes how Web 2.0 technology could impact on the quality of life of individuals with LTCs and suggests a starting point for developing a theoretically informed patient centred framework.

  7. New technologies in treatment of atrial fibrillation in cardiosurgical patients

    Science.gov (United States)

    Evtushenko, A. V.; Evtushenko, V. V.; Bykov, A. N.; Sergeev, V. S.; Syryamkin, V. I.; Kistenev, Yu. V.; Anfinogenova, Ya. D.; Smyshlyaev, K. A.; Kurlov, I. O.

    2015-11-01

    The article is devoted to the evaluation of the results of clinical application of penetrating radiofrequency ablation techniques on atrial myocardium. Total operated on 241 patients with valvular heart disease and coronary heart disease complicated with atrial fibrillation. All operations were performed under cardiopulmonary bypass and cardioplegia. The main group consists of 141 patients which were operated using penetrating technique radiofrequency exposure. The control group consisted of 100 patients who underwent surgery with the use of "classical" monopolar RF-ablation technique. Both groups were not significantly different on all counts before surgery. Patients with previous heart surgery were excluded during the selection of candidates for the procedure, due to the presence of adhesions in the pericardium, that do not allow good visualization of left atrium, sufficient to perform this procedure. Penetrating technique has significantly higher efficiency compared to the "classic" technique in the early and long-term postoperative periods. In the early postoperative period, its efficiency is 93%, and in the long term is 88%. The efficacy of "classical" monopolar procedure is below: 86% and 68% respectively.

  8. Impact of Gender on Patient Preferences for Technology-Based Behavioral Interventions

    Directory of Open Access Journals (Sweden)

    David J. Kim

    2014-08-01

    Full Text Available Introduction: Technology-based interventions offer an opportunity to address high-risk behaviors in the emergency department (ED. Prior studies suggest behavioral health strategies are more effective when gender differences are considered. However, the role of gender in ED patient preferences for technology-based interventions has not been examined. The objective was to assess whether patient preferences for technology-based interventions varies by gender. Methods: This was a secondary analysis of data from a systematic survey of adult (18 years of age, English-speaking patients in a large urban academic ED. Subjects were randomly selected during a purposive sample of shifts. The iPad survey included questions on access to technology, preferences for receiving health information, and demographics. We defined ‘‘technology-based’’ as web, text message, e-mail, social networking, or DVD; ‘‘non-technology-based’’ was defined as in-person, written materials, or landline. We calculated descriptive statistics and used univariate tests to compare men and women. Gender-stratified multivariable logistic regression models were used to examine associations between other demographic factors (age, race, ethnicity, income and technology-based preferences for information on specific risky behaviors. Results: Of 417 participants, 45.1% were male. There were no significant demographic differences between men and women. Women were more likely to use computers (90.8% versus 81.9%; p¼0.03, Internet (66.8% versus 59.0%; p¼0.03, and social networks (53.3% versus 42.6%; p¼0.01. 89% of men and 90% of women preferred technology-based formats for at least type of health information; interest in technology-based for individual health topics did not vary by gender. Concern about confidentiality was the most common barrier to technology-based use for both genders. Multivariate analysis showed that for smoking, depression, drug/alcohol use, and injury

  9. Leveraging on information technology to enhance patient care: a doctor's perspective of implementation in a Singapore academic hospital.

    Science.gov (United States)

    Ong, B K C

    2002-11-01

    Information technology (IT) can improve the safety of patient care by minimising prescribing errors and organising patient-specific information from diverse databases. Apart from legibility, prescribing safety is enhanced as online access to databases carrying patient drug history, scientific drug information and guideline reference, and patient-specific information is available to the physician. Such specific information includes discharge summaries, surgical procedure summaries, laboratory data and investigation reports. In addition, decision support and prompts can be built in to catch errant orders. For such system implementations to work, the IT backbone must be fast, reliable and simple to use. End-user involvement and ownership of all aspects of development are key to a usable system. However, the hospital leadership must also have the will to mandate and support these development efforts. With such support, the design and implementation team can then map out a strategy where the greatest impact is achieved in both safety and enhanced information flow. The system should not be considered a finished work, but a continual work in progress. The National University Hospital's continuously updated Computerised Patient Support System (CPSS) is an example of an IT system designed to manage information and facilitate prescribing. It is a client-server based, one-point ordering and information access portal for doctors that has widespread adoption for drug prescription at outpatient and discharge medication usage areas. This system has built in safety prompts and rudimentary decision support. It has also become the choice means of accessing patient-related databases that impact on diagnoses and management.

  10. Nonlinear error testing method based on sine wave click rate technology%基于正弦波点击率的非线性误差测试方法

    Institute of Scientific and Technical Information of China (English)

    杨景阳; 刘路扬; 吕兵

    2016-01-01

    针对ADC在通讯和多媒体技术上的应用需求,研究了基于正弦波点击率的ADC非线性误差测试方法,实现了正弦波点击率技术在ADC非线性误差测试中的应用。向ADC输入正弦波信号,对输出数字码进行标准化处理,补偿正弦波形电压分布的不均匀性,通过点击率算法推算 ADC 的微分非线性误差,并在大规模数模混合测试设备Catalyst-200上验证了算法的可靠性和精确性。实验结果表明,该算法能够精确地估算 ADC非线性误差,完整地表征了ADC线性度和丢码率,为ADC在通讯和多媒体技术上的应用提供了重要的参数依据,具有较强的工程实用性和市场前景性。%To fulfill the ADC applied on communication and imedia technology,this article researches the ADC’s Nonlinear error testing method based on Sine Wave click rate technology,and realizes the application of Sine wave click technology in ADC’s nonlinearity error testing.Put the sine wave into ADC’s input,deal the output data with normalized conduct to compensate the uneven distribution of sine waveform voltage,and then,calculate the ADC’s differential Nonlinearity Error by means of click rate algorithm,at the end,verify reliability and accuracy of the algorithm at the e-scale mixed-signal test equipment Catalyst-200.The experimental results show that this algorithm can estimate the ADC’s nonlinearity error accurately,represent the ADC’s linearity and dropout rate entirely,provide important parameter to the application of ADC on communication and imedia technology.it has a strong engineering practicality and a fine market outlook.

  11. COHERENT EFFORT FOR COPD PATIENTS  WITH A SPECIAL FOCUS ON WELFARE TECHNOLOGY

    DEFF Research Database (Denmark)

    Vestergaard*, Kitt; Bagger, Bettan; Jensen, Lars Heegaard

    2014-01-01

    is given by health professionals whom they have feel safe with and related to. Some expressed that they did not feel familiar with technology and therefore do not expect to use it in their daily life. Others felt that the new experiences with technological aid would make them feel more secure in daily life......Background: Welfare technology is considered to be cost effective, promoting consistent quality in health care (1, 2), including the care pathways for individuals with Chronic Obstructive Pulmonary Disease (COPD). Welfare technology has been found to ensure more freedom and responsibility for ones...... own illness leading to prevention of hospitalizations (3, 4). Technologies therefore are assumed to enhance the quality and consistency of treatment programs for patients with COPD. Prior to implementation of welfare technology in the Region of Zealand, Denmark, University College Zealand and COPD...

  12. Poster COHERENT EFFORT FOR COPD PATIENTS  WITH A SPECIAL FOCUS ON WELFARE TECHNOLOGY

    DEFF Research Database (Denmark)

    Vestergaard*, Kitt; Bagger, Bettan; Bech, Lone

    2014-01-01

    is given by health professionals whom they have feel safe with and related to. Some expressed that they did not feel familiar with technology and therefore do not expect to use it in their daily life. Others felt that the new experiences with technological aid would make them feel more secure in daily life......Background: Welfare technology is considered to be cost effective, promoting consistent quality in health care (1, 2), including the care pathways for individuals with Chronic Obstructive Pulmonary Disease (COPD). Welfare technology has been found to ensure more freedom and responsibility for ones...... own illness leading to prevention of hospitalizations (3, 4). Technologies therefore are assumed to enhance the quality and consistency of treatment programs for patients with COPD. Prior to implementation of welfare technology in the Region of Zealand, Denmark, University College Zealand and COPD...

  13. [Survey in hospitals. Nursing errors, error culture and error management].

    Science.gov (United States)

    Habermann, Monika; Cramer, Henning

    2010-09-01

    Knowledge on errors is important to design safe nursing practice and its framework. This article presents results of a survey on this topic, including data of a representative sample of 724 nurses from 30 German hospitals. Participants predominantly remembered medication errors. Structural and organizational factors were rated as most important causes of errors. Reporting rates were considered low; this was explained by organizational barriers. Nurses in large part expressed having suffered from mental problems after error events. Nurses' perception focussing on medication errors seems to be influenced by current discussions which are mainly medication-related. This priority should be revised. Hospitals' risk management should concentrate on organizational deficits and positive error cultures. Decision makers are requested to tackle structural problems such as staff shortage.

  14. Trialling computer touch-screen technology to assess psychological distress in patients with gynaecological cancer

    Directory of Open Access Journals (Sweden)

    Georgia Halkett

    2010-12-01

    Full Text Available BackgroundCancer impacts on the psychological well-being of many cancer patients. Appropriate tools can be used to assist health professionals in identifying patient needs and psychological distress. Recent research suggests that touchscreen technology can be used to administer surveys. The aim of this study was to evaluate the use of a touchscreen system in comparison to written questionnaires in a large tertiary hospital in Western Australia (WA.Method Patients who were scheduled to commence treatment for gynaecological cancer participated in this study. Patients were assigned to complete either a written questionnaire or the same survey using the touchscreen technology. Both methods of survey contained the same scales. All participants were asked to complete a follow-up patient satisfaction survey. Semi-structured interviews were conducted with health professionals to elicit views about the implementation of the technology and the available referral pathways. Data was analysed using descriptive statistics and content analysis. ResultsThirty patients completed the touchscreen questionnaires and an equal number completed the survey on paper. Participants who used the touchscreens were not significantly more satisfied than other participants. Four themes were noted in the interviews with health professionals: usability of technology, patients’ acceptance of technology, advantages of psychological screening and the value of the instruments included.ConclusionAlthough previous studies report that computerised assessments are a feasible option for assessing cancer patients’ needs, the data collected in this study demonstrates that the technology was not reliable with significant practical problems. The technology did not serve these patients better than pen and paper.

  15. Patients' perspectives in health technology assessment: a route to robust evidence and fair deliberation.

    Science.gov (United States)

    Facey, Karen; Boivin, Antoine; Gracia, Javier; Hansen, Helle Ploug; Lo Scalzo, Alessandra; Mossman, Jean; Single, Ann

    2010-07-01

    There is increasing emphasis on providing patient-focused health care and ensuring patient involvement in the design of health services. As health technology assessment (HTA) is meant to be a multidisciplinary, wide-ranging policy analysis that informs decision making, it would be expected that patients' views should be incorporated into the assessment. However, HTA is still driven by collection of quantitative evidence to determine the clinical and cost effectiveness of a health technology. Patients' perspectives about their illness and the technology are rarely included, perhaps because they are seen as anecdotal, biased views. There are two distinct but complementary ways in which HTAs can be strengthened by: (i) gathering robust evidence about the patients' perspectives, and (ii) ensuring effective engagement of patients in the HTA process from scoping, through evidence gathering, assessment of value, development of recommendations and dissemination of findings. Robust evidence eliciting patients' perspectives can be obtained through social science research that is well conducted, critically appraised and carefully reported, either through meta-synthesis of existing studies or new primary research. Engagement with patients can occur at several levels and we propose that HTA should seek to support effective patient participation to create a fair deliberative process. This should allow two-way flow of information, so that the views of patients are obtained in a supportive way and fed into decision-making processes in a transparent manner.

  16. Medication administration technologies and patient safety: a mixed-method systematic review.

    Science.gov (United States)

    Wulff, Kelly; Cummings, Greta G; Marck, Patricia; Yurtseven, Ozden

    2011-10-01

    Healthcare leaders need evidence-based information on nursing medication administration technologies to guide the design of improvements to patient safety. The aim of this study was to evaluate the research evidence on relationships between the use of medication administration technologies and incidence of medication administration incidents and preventable adverse drug events to inform decision-making about existing technology options. Thirteen electronic databases and seven relevant patient safety websites were searched for the years 1980-2009. A mixed-method systematic literature review of research on medication administration technologies and associated links to patient safety, operationalized as medication administration incidents and preventable adverse drug events, was conducted. Twelve studies (two qualitative, five pre- and postinterventions and five correlational) met the inclusion criteria. All were assessed as medium quality with low generalizability of study findings. Only two studies sampled more than one hospital and none of the studies was driven by an explicit theoretical framework. The studies included in this review are generally positive towards medication administration technologies and their potential benefits, yet the level of evidence overall is equivocal. The majority of studies pointed to the development of workarounds by nurses following medication administration technology implementation that could compromise patient safety. More theoretically driven research is needed to determine which medication administration technologies should be implemented in what ways to most effectively reduce medication administration incidents and preventable adverse drug events and minimize the development of potentially unsafe workarounds. Further evidence is required to accurately assess the actual contribution of medication administration technologies for improving patient safety. © 2011 The Authors. Journal of Advanced Nursing © 2011 Blackwell

  17. Barriers to medical error reporting

    Directory of Open Access Journals (Sweden)

    Jalal Poorolajal

    2015-01-01

    Full Text Available Background: This study was conducted to explore the prevalence of medical error underreporting and associated barriers. Methods: This cross-sectional study was performed from September to December 2012. Five hospitals, affiliated with Hamadan University of Medical Sciences, in Hamedan,Iran were investigated. A self-administered questionnaire was used for data collection. Participants consisted of physicians, nurses, midwives, residents, interns, and staffs of radiology and laboratory departments. Results: Overall, 50.26% of subjects had committed but not reported medical errors. The main reasons mentioned for underreporting were lack of effective medical error reporting system (60.0%, lack of proper reporting form (51.8%, lack of peer supporting a person who has committed an error (56.0%, and lack of personal attention to the importance of medical errors (62.9%. The rate of committing medical errors was higher in men (71.4%, age of 50-40 years (67.6%, less-experienced personnel (58.7%, educational level of MSc (87.5%, and staff of radiology department (88.9%. Conclusions: This study outlined the main barriers to reporting medical errors and associated factors that may be helpful for healthcare organizations in improving medical error reporting as an essential component for patient safety enhancement.

  18. A Qualitative Study on Patient Perceptions Towards mHealth Technology Among High Risk, Chronic Disease Patients

    OpenAIRE

    Martinez, Phillip Rico

    2015-01-01

    Background: For over 17 years, the Prevention and Access to Care and Treatment (PACT) Project has actively developed a Community Health Worker model for care of chronically ill, high risk patients. Given the high burden of chronic disease and associated rising health expenditures, mHealth technology has emerged as a promising low cost, high efficacy intervention for delivery of patient-centered care and as a tool for self-management of chronic disease Objective: Attitudes and perceptions r...

  19. Collaborative Affordances of Hybrid Patient Record Technologies in Medical Work

    DEFF Research Database (Denmark)

    Houben, Steven; Frost, Mads; Bardram, Jakob E

    2015-01-01

    The medical record is a central artifact used to organize, communicate and coordinate information related to patient care. Despite recent deployments of electronic health records (EHR), paper medical records are still widely used because of the affordances of paper. Although a number of approaches...... to digitally augment a paper medical record. We report on two studies: a field study in which we describe the benefits and challenges of using a combination of electronic and paper-based medical records in a large university hospital and a deployment study in which we analyze how 8 clinicians used the Hy...

  20. Health information technologies in systemic lupus erythematosus: focus on patient assessment.

    Science.gov (United States)

    Tani, Chiara; Trieste, Leopoldo; Lorenzoni, Valentina; Cannizzo, Sara; Turchetti, Giuseppe; Mosca, Marta

    2016-01-01

    Recent advances in health information technologies (HIT) in systemic lupus erythematosus have included electronic databases and registries, computerised clinical charts for patient monitoring, computerised diagnostic tools, computerised prediction rules and, more recently, disease-specific applications for mobile devices for physicians, health care professionals, and patients. Traditionally, HIT development has been oriented primarily to physicians and public administrators. However, more recent development of patient-centered Apps could improve communication and empower patients in the daily management of their disease. Economic advantages could also result from the use of HIT, including these Apps by collecting real life data that could be used in both economic analyses and to improve patient care.

  1. [The contribution of Web 2.0 technologies to the empowerment of active patients].

    Science.gov (United States)

    Oliver-Mora, Martí; Iñiguez-Rueda, Lupicinio

    2017-03-01

    The Spanish health system has recently been marked by the emergence of more active patients who are characterized as being better informed about their disease, having a more participatory attitude, wanting to have a greater influence in making decisions about their health and asserting their rights as patients. Therefore, this article aims to report on how the introduction of Web 2.0 technologies can contribute to the empowering of more active patients. To achieve this, 14 semi-structured interviews were conducted with patients and representatives of patient associations who have used Web 2.0 technologies to interact with other patients or to communicate with health professionals. From the results obtained, we highlight the fact that Web 2.0 technologies provide greater access to health-related information, improve communication between patients and health professionals, and enable the creation of new spaces of interaction among patients. All of the facts above contribute to the formation of a more active role on the part of patients.

  2. Use of expert system and data analysis technologies in automation of error detection, diagnosis and recovery for ATLAS Trigger-DAQ Controls framework

    CERN Document Server

    Kazarov, A; The ATLAS collaboration; Magnoni, L; Lehmann Miotto, G

    2012-01-01

    Trigger and DAQ (Data AQuisition) System of the ATLAS experiment on LHC at CERN is a very complex distributed computing system, composed of O(10000) applications running on a farm of commodity CPUs. The system is being designed and developed by dozens of software engineers and physicists since end of 1990's and it will be maintained in operational mode during the lifetime of the experiment. The TDAQ system is controlled by the Controls framework, which includes a set of software components and tools used for system configuration, distributed processes handling, synchronization of Run Control state transitions etc. The huge flow of operational monitoring data produced is constantly monitored by operators and experts in order to detect problems or misbehaviour. Given the scale of the system and the rates of data to be analyzed, the automation of the Controls framework functionality in the areas of operational monitoring, system verification, error detection and recovery is a strong requirement. The paper descri...

  3. 电力科技论文写作中常见错误分析%Analysis of the Common errors in electric Power Science and Technology Thesis

    Institute of Scientific and Technical Information of China (English)

    陆莹

    2015-01-01

    为提高电力科技论文的规范性和可读性,着重从量和单位、文字用法两个方面,分析并归纳了电力科技论文中常见的错误,提出了修改的建议,以期帮助作者写出高质量的电力科技论文。%Im order to improve the mormalizatiom amd the readability of electric power sciemce amd techmology thesis, the paper amalyzes amd summarizes the commom errors of electric power sciemce amd techmology thesis maimly from two aspects of quamtity amd umits as well as word usage, im the hope of helpimg the authors write sciemce amd techmology thesis better.

  4. USE OF TECHNOLOGIES OF PLASTIC AND RECONSTRUCTIVE MICROSURGERY IN TREATMENT OF PATIENTS WITH PATHOLOGY OF KNEE

    Directory of Open Access Journals (Sweden)

    L. A. Rodomanova

    2012-01-01

    Full Text Available Analysis of the results of surgical treatment of 63 patients with knee-joint pathology who were treated in Vreden’s Scientific-research Institute of traumatology and orthopaedics (Saint-Petersburg, Russia within the period from 2000 to 2011. All the patients had pedicled flap transfer or free tissue transfer. 53 patients (84,1% had additionally various orthopedic operations on the knee joint: 42 patients had primary or revision total knee arthroplasty, 6 patients had resections of bony tumors and total knee arthroplasty, 4 - knee arthrodesis, 1 - open reduction and internal fixation of patella. The results of treatment were estimated according to WOMAC knee score. 4 patients had total necrosis of flap what demanded repeated reconstructive microsurgical operation. 6 patients had knee arthroplasty surgical site infection, 1 patient had recidive of osteoblastic sarcoma and he was made leg amputation. 65,7% of patients had good results according to WOMAC knee score, 28,6% patients had satisfactory results. Microsurgical operations in patients with pathology of knee-joint mainly aim to correct various pathological changes of tissues located in this particular area. In cases of scarry deformations and defects of tissues located in the area of knee-joint microsurgical technologies increase the opportunities for fulfilling total knee arthroplasty and improve its results as well as results of other orthopedical operations. At the same time microsurgical technologies may be used as preparative operations, single-step maneuvers and operations fulfilled in case of development of local infectious complications.

  5. Patient Outcomes as Transformative Mechanisms to Bring Health Information Technology Industry and Research Informatics Closer Together.

    Science.gov (United States)

    Krive, Jacob

    2015-01-01

    Despite the fast pace of recent innovation within the health information technology and research informatics domains, there remains a large gap between research and academia, while interest in translating research innovations into implementations in the patient care settings is lacking. This is due to absence of common outcomes and performance measurement targets, with health information technology industry employing financial and operational measures and academia focusing on patient outcome concerns. The paper introduces methodology for and roadmap to introduction of common objectives as a way to encourage better collaboration between industry and academia using patient outcomes as a composite measure of demonstrated success from health information systems investments. Along the way, the concept of economics of health informatics, or "infonomics," is introduced to define a new way of mapping future technology investments in accordance with projected clinical impact.

  6. Unmet Communication and Information Needs for Patients with IBD: Implications for Mobile Health Technology.

    Science.gov (United States)

    Khan, Sameer; Dasrath, Florence; Farghaly, Sara; Otobo, Emamuzo; Riaz, Muhammad Safwan; Rogers, Jason; Castillo, Anabella; Atreja, Ashish

    2016-01-01

    In order to develop an application that addresses the most significant challenges facing IBD patients, this qualitative study explored the major hurdles of living with IBD, the information needs of IBD patients, and how application technology may be used to improve quality of life. 15 IBD patients participated in two focus groups of 120 minutes each. Data collection was achieved by combining focus groups with surveys and direct observation of patients looking at a patient-engaged app (HealthPROMISE) screenshots. The survey elicited information on demographics, health literacy and quality of life through the Short IBD Questionnaire (SIBDQ). The needs of IBD patients center around communication as it relates to both patient information needs and navigating the social impacts of IBD on patients' lives: Communication Challenges regarding Information Needs: Patients cited a doctor-patient communication divide where there is a continued lack of goal setting when discussing treatments and a lack of objectivity in disease control. When objectively compared with the SIBDQ, nearly half of the patients in the focus groups wrongly estimated their IBD control.Communication Challenges regarding Social Impacts of IBD: Patients strongly felt that while IBD disrupts routines, adds significant stress, and contributes to a sense of isolation, the impact of these issues would be significantly alleviated through more conversation and better support.Implication for Mobile Health Solutions: Patients want a tool that improves tracking of symptoms, medication adherence and provides education. Physician feedback to patient input on an application is required for long-term sustainability. IBD patients need mobile health technologies that evaluate disease control and the goals of care. Patients feel an objective assessment of their disease control, goal setting and physician feedback will greatly enhance utilization of all mobile health applications.

  7. Retinopatia da prematuridade: achados refrativos pós-tratamento com crioterapia ou laser Retinopathy of prematurity: refractive errors in patients treated with cryotherapy or laser

    Directory of Open Access Journals (Sweden)

    Sara Pozzi

    2000-10-01

    Full Text Available Objetivos: Determinar e comparar as características refrativas de uma população composta de crianças pré-termo com retinopatia da prematuridade que necessitaram de tratamento com crioterapia ou laserterapia. Método: Análise dos resultados da refração estática de 14 pacientes (de um total de 761 fichas de crianças que nasceram no Hospital São Paulo da Universidade Federal de São Paulo - Escola Paulista de Medicina, entre janeiro de 1988 e abril de 1998, que completaram um ano de idade e que apresentaram Retinopatia da Prematuridade grau 3 com características de "doença limiar" sendo tratadas com crioterapia ou laserterapia. Foram utilizados os testes estatísticos de Wilcoxon e Mann-Whitney para a avaliação dos resultados. Resultados: 64,3% dos pacientes apresentaram miopia. No grupo de pacientes que receberam tratamento com crioterapia, 80% mostrou miopia, que em todos os casos foi alta; 20% hipermetropia leve, com uma média para o equivalente esférico de --3,10 D no olho direito e --3,25 D no olho esquerdo (diferença entre ambos os olhos estatísticamente não significante. No grupo de laserterapia, 55,6% mostrou miopia, sendo 20 % dos casos miopia alta e 80% miopia leve; 11,1% apresentou-se sem ametropia e 33,3 % com hipermetropia leve. O valor da média para o equivalente esférico foi --0,58 D no olho direito e --0,83D no olho esquerdo (diferença entre ambos os olhos estatisticamente significante. A comparação dos resultados refracionais dos dois grupos mostrou uma maior incidência para miopia alta no grupo de pacientes que receberam tratamento com crioterapia (PPurpose: To examine the spherical equivalent of refractive errors in preterm children with threshold retinopathy of prematurity treated with cryotherapy or laser. Patients and Method: A group of 14 one-year-old children (selected from 761 preterm children born at the Hospital São Paulo of the Universidade Federal de São Paulo between 1988 and 1998 with stage

  8. Remote patient management: technology-enabled innovation and evolving business models for chronic disease care.

    Science.gov (United States)

    Coye, Molly Joel; Haselkorn, Ateret; DeMello, Steven

    2009-01-01

    Remote patient management (RPM) is a transformative technology that improves chronic care management while reducing net spending for chronic disease. Broadly deployed within the Veterans Health Administration and in many small trials elsewhere, RPM has been shown to support patient self-management, shift responsibilities to non-clinical providers, and reduce the use of emergency department and hospital services. Because transformative technologies offer major opportunities to advance national goals of improved quality and efficiency in health care, it is important to understand their evolution, the experiences of early adopters, and the business models that may support their deployment.

  9. Three technological enhancements in nursing education: informatics instruction, personal response systems, and human patient simulation.

    Science.gov (United States)

    Jensen, Rebecca; Meyer, Linda; Sternberger, Carol

    2009-03-01

    With the healthcare system in a state of flux, nursing education faces many challenges. Nursing faculty must design a dynamic curriculum that deals with the explosion of information, the complexity of the healthcare system, and optimal patient outcomes while addressing the diverse expectations of learners. Inclusion of information management and interactive technology facilitates learner engagement promoting critical thinking and improving clinical judgment. This paper details the faculty's vision for an ubiquitous information technology curricula, highlighting an undergraduate informatics course, use of a personal response system, and integration of human patient simulations.

  10. Towards safe information technology in health care

    NARCIS (Netherlands)

    J.E.C.M. Aarts (Jos)

    2011-01-01

    textabstractHealth information technology is widely accepted to increase patient safety and reduce medical errors. The widespread implementation makes evident that health information technology has become of a complex sociotechnical system that is health care. Design and implementation may result in

  11. Towards safe information technology in health care

    NARCIS (Netherlands)

    J.E.C.M. Aarts (Jos)

    2011-01-01

    textabstractHealth information technology is widely accepted to increase patient safety and reduce medical errors. The widespread implementation makes evident that health information technology has become of a complex sociotechnical system that is health care. Design and implementation may result in

  12. Errors in CT colonography.

    Science.gov (United States)

    Trilisky, Igor; Ward, Emily; Dachman, Abraham H

    2015-10-01

    CT colonography (CTC) is a colorectal cancer screening modality which is becoming more widely implemented and has shown polyp detection rates comparable to those of optical colonoscopy. CTC has the potential to improve population screening rates due to its minimal invasiveness, no sedation requirement, potential for reduced cathartic examination, faster patient throughput, and cost-effectiveness. Proper implementation of a CTC screening program requires careful attention to numerous factors, including patient preparation prior to the examination, the technical aspects of image acquisition, and post-processing of the acquired data. A CTC workstation with dedicated software is required with integrated CTC-specific display features. Many workstations include computer-aided detection software which is designed to decrease errors of detection by detecting and displaying polyp-candidates to the reader for evaluation. There are several pitfalls which may result in false-negative and false-positive reader interpretation. We present an overview of the potential errors in CTC and a systematic approach to avoid them.

  13. Aesthetic treatment option for completely edentulous patients using CAD/CAM technology.

    Science.gov (United States)

    Kleinman, Alejandro; Avendano, Sergio; Leyva, Francisco

    2008-04-01

    In recent years, advancements have been made in CAD/CAM technology that have allowed for the development of different treatments regarding the rehabilitation of patients with natural dentition, as well as patients with dental implants. Contemporary systems can also allow prosthetic rehabilitation for partially and completely edentulous patients. This article describes a restorative alternative to fixed implant-supported reconstruction of completely edentulous patients, utilizing a CAD/CAM-generated framework and CAD/CAM-generated all-ceramic cement-retained crowns. In addition to delivering an optimally aesthetic restoration, this design permits a precise and passive prosthetic fit.

  14. Designing a patient monitoring system for bipolar disorder using Semantic Web technologies.

    Science.gov (United States)

    Thermolia, Chryssa; Bei, Ekaterini S; Petrakis, Euripides G M; Kritsotakis, Vangelis; Tsiknakis, Manolis; Sakkalis, Vangelis

    2015-01-01

    The new movement to personalize treatment plans and improve prediction capabilities is greatly facilitated by intelligent remote patient monitoring and risk prevention. This paper focuses on patients suffering from bipolar disorder, a mental illness characterized by severe mood swings. We exploit the advantages of Semantic Web and Electronic Health Record Technologies to develop a patient monitoring platform to support clinicians. Relying on intelligently filtering of clinical evidence-based information and individual-specific knowledge, we aim to provide recommendations for treatment and monitoring at appropriate time or concluding into alerts for serious shifts in mood and patients' non response to treatment.

  15. Clinical Effectiveness Of Dynamic Out-Patient Control Technology Over Hypertensive Patients Based On Computer System And Mobile Phone Connection

    Directory of Open Access Journals (Sweden)

    O.M. Posnenkova

    2009-09-01

    Full Text Available A new follow-up technology of dynamic out-patient control based on system of mobile monitoring of patients with arterial hypertension (SMMAH has been created in Saratov Scientific Research Institute of Cardiology. SMMAH is based on exchange of information between patient and doctor with the help of Internet and standard short mobile messages. The aim of the present work is to study the effectiveness of SMMAH for follow-up control of hypertensive patients for the period of 12 months. 79 patients with hypertension aged 49±11 were included in the investigation. Control period lasted 12 months. Control visits were made in the 1st, 6th and 12th months. The number of patients became out of control, its causes, percentage of patients who achieved and maintained target blood pressure (BP were analyzed after each visit. Data were presented as M (95% confidence interval. As a result in 1 month period of investigation 88,6% of patients regularly used mobile messages, 11% of patients were out of control. In 6 months period 68,4% of participants were under control, 31,6% of patients dropped out. In 12 months period — 67% and 33% of patients accordingly. Target BP was maintained in 87% (77%-96% of patients in 1 month period, in 78% (66%-90% of patients in 6 months period and in 68% of patients (53%-84% in 12 months period. High clinical effectiveness of SMMAH has been proved during the study: 67% of patients have followed prescribed therapy after the investigation period and 68% of them have maintained target BP level.

  16. Patient safety

    African Journals Online (AJOL)

    406 CME Nov/Dec 2012 Vol. 30 No. 11 ... The message remains the same: around 10% of all patients ... error rates in healthcare in South Africa, no real data exist. ... so as technology progresses. The medical .... top priority and they will include it in planning and .... Reason J. Managing the risks of organisational accidents.

  17. Error detection and reduction in blood banking.

    Science.gov (United States)

    Motschman, T L; Moore, S B

    1996-12-01

    Error management plays a major role in facility process improvement efforts. By detecting and reducing errors, quality and, therefore, patient care improve. It begins with a strong organizational foundation of management attitude with clear, consistent employee direction and appropriate physical facilities. Clearly defined critical processes, critical activities, and SOPs act as the framework for operations as well as active quality monitoring. To assure that personnel can detect an report errors they must be trained in both operational duties and error management practices. Use of simulated/intentional errors and incorporation of error detection into competency assessment keeps employees practiced, confident, and diminishes fear of the unknown. Personnel can clearly see that errors are indeed used as opportunities for process improvement and not for punishment. The facility must have a clearly defined and consistently used definition for reportable errors. Reportable errors should include those errors with potentially harmful outcomes as well as those errors that are "upstream," and thus further away from the outcome. A well-written error report consists of who, what, when, where, why/how, and follow-up to the error. Before correction can occur, an investigation to determine the underlying cause of the error should be undertaken. Obviously, the best corrective action is prevention. Correction can occur at five different levels; however, only three of these levels are directed at prevention. Prevention requires a method to collect and analyze data concerning errors. In the authors' facility a functional error classification method and a quality system-based classification have been useful. An active method to search for problems uncovers them further upstream, before they can have disastrous outcomes. In the continual quest for improving processes, an error management program is itself a process that needs improvement, and we must strive to always close the circle

  18. Soft errors in modern electronic systems

    CERN Document Server

    Nicolaidis, Michael

    2010-01-01

    This book provides a comprehensive presentation of the most advanced research results and technological developments enabling understanding, qualifying and mitigating the soft errors effect in advanced electronics, including the fundamental physical mechanisms of radiation induced soft errors, the various steps that lead to a system failure, the modelling and simulation of soft error at various levels (including physical, electrical, netlist, event driven, RTL, and system level modelling and simulation), hardware fault injection, accelerated radiation testing and natural environment testing, s

  19. Hospital based patient coordination for ethnic minority patients - a health technology assessment

    DEFF Research Database (Denmark)

    Sodemann, Morten

    especially on public medicine expenses and social services. Ethnic minority patients can achieve increased empowerment & Equity in type and quality of hospital care through cross dicplinary cross specialty cultural case management & support between hospital departments and primary sectors......A cross diciplinary, cross specialty, cross sectoral hospital based approach to cultural management of ethnic minority patients is effective in creating more approprite patient flows, better quality of care and increases functional level of patients. Surprisingly the aggregated effect saves...

  20. Generalized Gaussian Error Calculus

    CERN Document Server

    Grabe, Michael

    2010-01-01

    For the first time in 200 years Generalized Gaussian Error Calculus addresses a rigorous, complete and self-consistent revision of the Gaussian error calculus. Since experimentalists realized that measurements in general are burdened by unknown systematic errors, the classical, widespread used evaluation procedures scrutinizing the consequences of random errors alone turned out to be obsolete. As a matter of course, the error calculus to-be, treating random and unknown systematic errors side by side, should ensure the consistency and traceability of physical units, physical constants and physical quantities at large. The generalized Gaussian error calculus considers unknown systematic errors to spawn biased estimators. Beyond, random errors are asked to conform to the idea of what the author calls well-defined measuring conditions. The approach features the properties of a building kit: any overall uncertainty turns out to be the sum of a contribution due to random errors, to be taken from a confidence inter...

  1. Classification of Spreadsheet Errors

    OpenAIRE

    Rajalingham, Kamalasen; Chadwick, David R.; Knight, Brian

    2008-01-01

    This paper describes a framework for a systematic classification of spreadsheet errors. This classification or taxonomy of errors is aimed at facilitating analysis and comprehension of the different types of spreadsheet errors. The taxonomy is an outcome of an investigation of the widespread problem of spreadsheet errors and an analysis of specific types of these errors. This paper contains a description of the various elements and categories of the classification and is supported by appropri...

  2. Technology-assisted patient access to clinical information: an evaluation framework for blue button.

    Science.gov (United States)

    Hogan, Timothy P; Nazi, Kim M; Luger, Tana M; Amante, Daniel J; Smith, Bridget M; Barker, Anna; Shimada, Stephanie L; Volkman, Julie E; Garvin, Lynn; Simon, Steven R; Houston, Thomas K

    2014-03-27

    Patient access to clinical information represents a means to improve the transparency and delivery of health care as well as interactions between patients and health care providers. We examine the movement toward augmenting patient access to clinical information using technology. Our analysis focuses on "Blue Button," a tool that many health care organizations are implementing as part of their Web-based patient portals. We present a framework for evaluating the effects that technology-assisted access to clinical information may have on stakeholder experiences, processes of care, and health outcomes. A case study of the United States Department of Veterans Affairs' (VA) efforts to make increasing amounts of clinical information available to patients through Blue Button. Drawing on established collaborative relationships with researchers, clinicians, and operational partners who are engaged in the VA's ongoing implementation and evaluation efforts related to Blue Button, we assessed existing evidence and organizational practices through key informant interviews, review of documents and other available materials, and an environmental scan of published literature and the websites of other health care organizations. Technology-assisted access to clinical information represents a significant advance for VA patients and marks a significant change for the VA as an organization. Evaluations of Blue Button should (1) consider both processes of care and outcomes, (2) clearly define constructs of focus, (3) examine influencing factors related to the patient population and clinical context, and (4) identify potential unintended consequences. The proposed framework can serve as a roadmap to guide subsequent research and evaluation of technology-assisted patient access to clinical information. To that end, we offer a series of related recommendations.

  3. Technology-Assisted Patient Access to Clinical Information: An Evaluation Framework for Blue Button

    Science.gov (United States)

    Nazi, Kim M; Luger, Tana M; Amante, Daniel J; Smith, Bridget M; Barker, Anna; Shimada, Stephanie L; Volkman, Julie E; Garvin, Lynn; Simon, Steven R; Houston, Thomas K

    2014-01-01

    Background Patient access to clinical information represents a means to improve the transparency and delivery of health care as well as interactions between patients and health care providers. We examine the movement toward augmenting patient access to clinical information using technology. Our analysis focuses on “Blue Button,” a tool that many health care organizations are implementing as part of their Web-based patient portals. Objective We present a framework for evaluating the effects that technology-assisted access to clinical information may have on stakeholder experiences, processes of care, and health outcomes. Methods A case study of the United States Department of Veterans Affairs' (VA) efforts to make increasing amounts of clinical information available to patients through Blue Button. Drawing on established collaborative relationships with researchers, clinicians, and operational partners who are engaged in the VA’s ongoing implementation and evaluation efforts related to Blue Button, we assessed existing evidence and organizational practices through key informant interviews, review of documents and other available materials, and an environmental scan of published literature and the websites of other health care organizations. Results Technology-assisted access to clinical information represents a significant advance for VA patients and marks a significant change for the VA as an organization. Evaluations of Blue Button should (1) consider both processes of care and outcomes, (2) clearly define constructs of focus, (3) examine influencing factors related to the patient population and clinical context, and (4) identify potential unintended consequences. Conclusions The proposed framework can serve as a roadmap to guide subsequent research and evaluation of technology-assisted patient access to clinical information. To that end, we offer a series of related recommendations. PMID:24675395

  4. Long Burst Error Correcting Codes Project

    Data.gov (United States)

    National Aeronautics and Space Administration — Long burst error mitigation is an enabling technology for the use of Ka band for high rate commercial and government users. Multiple NASA, government, and commercial...

  5. Causes and consequences of e-prescribing errors in community pharmacies

    Directory of Open Access Journals (Sweden)

    Abramson EL

    2015-05-01

    Full Text Available Erika L Abramson Departments of Pediatrics and Healthcare Policy and Research, Weill Cornell Medical College, New York, NY, USA Abstract: Major national policy forces are promoting the adoption and use of health information technology (health IT to improve the quality, safety, and efficiency of health care delivery. One such health IT is electronic prescribing (e-prescribing, which is the direct transmission of prescription information from a provider to a pharmacy. Given research showing that handwritten prescriptions are unsafe and associated errors can lead to tremendous inefficiency for patients and pharmacists, e-prescribing has many potential benefits. However, as with the introduction of any new technology, unintended, adverse consequences may result. The purpose of this review is to explore the causes and consequences of e-prescribing errors in community pharmacies, which are pharmacies not affiliated with a hospital or clinic. Many new types of errors – including provider order entry errors, transcription errors, and dispensing errors – appear to result from e-prescribing. These lead to important consequences for pharmacies, including safety threats to patients, reduced efficiency for pharmacists, processing delays, and increased pharmacy cost. Increased attention to system design and pharmacist training, as well as additional research in this area, will be critical to realize the full benefits of e-prescribing. Keywords: electronic prescribing, medication errors, community pharmacies 

  6. Literacy disparities in patient access and health-related use of Internet and mobile technologies.

    Science.gov (United States)

    Bailey, Stacy C; O'Conor, Rachel; Bojarski, Elizabeth A; Mullen, Rebecca; Patzer, Rachel E; Vicencio, Daniel; Jacobson, Kara L; Parker, Ruth M; Wolf, Michael S

    2015-12-01

    Age and race-related disparities in technology use have been well documented, but less is known about how health literacy influences technology access and use. To assess the association between patients' literacy skills and mobile phone ownership, use of text messaging, Internet access, and use of the Internet for health-related purposes. A secondary analysis utilizing data from 1077 primary care patients enrolled in two, multisite studies from 2011-2013. Patients were administered an in-person, structured interview. Patients with adequate health literacy were more likely to own a mobile phone or smartphone in comparison with patients having marginal or low literacy (mobile phone ownership: 96.8 vs. 95.2 vs. 90.1%, respectively, P text messaging (78.6 vs. 75.2 vs. 53.1%, P literacy-related disparities in technology access and use are widespread, with lower literate patients being less likely to own smartphones or to access and use the Internet, particularly for health reasons. Future interventions should consider these disparities and ensure that health promotion activities do not further exacerbate disparities. © 2014 John Wiley & Sons Ltd.

  7. Development of a multilayer technology for HTS RSFQ circuits and first measurements of the error rate; Entwicklung von Multilagenbauelementen fuer HTSL-RSFQ-Schaltungen und erste Messungen zur Fehlerrate

    Energy Technology Data Exchange (ETDEWEB)

    Ruck, B.

    1998-07-01

    Superconducting digital circuits based on the concept of rapid single quantum logic (RSFQ) offer high speed operation at very low power dissipation. The product of switching time and dissipated power of these circuits is very small compared to semiconductor devices. However, due the cooling demands of superconducting circuits, reasonable applications are only those where the higher performance justifies higher cooling costs. RSFQ circuits in niobium technology are already well developed. High temperature superconductors (HTSC) like YBa{sub 2}Cu{sub 3}O{sub 7-{delta}} allow operation temperatures above the temperature of liquid helium and higher clock frequencies due to the larger energy gap. Unfortunately, the technology for HTSC is still immature. In this work, different aspects of HTSC RSFQ circuits have been investigated, with the emphasis on multilayer technology and on measurements of the bit error rate. In addition, a first step towards a three-dimensional integration of low temperature RSFQ circuits was developed. A new device consisting of two vertically stacked separately shunted Nb/AlO{sub x}Al/Nb Josephson junctions was used to test the possibility of three dimensional integration for RSFQ circuits for the first time. A T-flipflop was designed its operation as a voltage divider was verified experimentally. For HTSC circuits, basic devices like resistors and multilayer structures, e.g., cross overs, insulating layers and inductances with groundplane were fabricated, and the electrical properties were investigated. These devices are indispensable for a future technology allowing the realization of more complex circuits. Based on stacked bicrystal junctions in multilayer technology, a first order delta sigma modulator for analog to digital conversion was designed and characterized by electrical measurements. (orig.)

  8. Medical errors: legal and ethical responses.

    Science.gov (United States)

    Dickens, B M

    2003-04-01

    Liability to err is a human, often unavoidable, characteristic. Errors can be classified as skill-based, rule-based, knowledge-based and other errors, such as of judgment. In law, a key distinction is between negligent and non-negligent errors. To describe a mistake as an error of clinical judgment is legally ambiguous, since an error that a physician might have made when acting with ordinary care and the professional skill the physician claims, is not deemed negligent in law. If errors prejudice patients' recovery from treatment and/or future care, in physical or psychological ways, it is legally and ethically required that they be informed of them in appropriate time. Senior colleagues, facility administrators and others such as medical licensing authorities should be informed of serious forms of error, so that preventive education and strategies can be designed. Errors for which clinicians may be legally liable may originate in systemically defective institutional administration.

  9. L’errore nel laboratorio di Microbiologia

    Directory of Open Access Journals (Sweden)

    Paolo Lanzafame

    2006-03-01

    Full Text Available Error management plays one of the most important roles in facility process improvement efforts. By detecting and reducing errors quality and patient care improve. The records of errors was analysed over a period of 6 months and another was used to study the potential bias in the registrations.The percentage of errors detected was 0,17% (normalised 1720 ppm and the errors in the pre-analytical phase was the largest part.The major rate of errors was generated by the peripheral centres which send only sometimes the microbiology tests and don’t know well the specific procedures to collect and storage biological samples.The errors in the management of laboratory supplies were reported too. The conclusion is that improving operators training, in particular concerning samples collection and storage, is very important and that an affective system of error detection should be employed to determine the causes and the best corrective action should be applied.

  10. Avaliação antropométrica de pacientes com suspeita de erros inatos do metabolismo Anthropometric evaluation of patients with suspected innate errors of metabolism

    Directory of Open Access Journals (Sweden)

    Francilia de Kássia Brito-Silva

    2012-09-01

    Full Text Available OBJETIVOS: avaliar antropometricamente os pacientes com suspeita de erros inatos do metabolismo (EIM e descrever a prevalência de distúrbios nutricionais (desnutrição, sobrepeso e obesidade. MÉTODOS: foram avaliados 55 pacientes de 0 a 10 anos, de acordo com os índices antropométricos (A/I, P/I E P/A e IMC/I, no laboratório de erros inatos do metabolismo (LEIM da Universidade Federal do Pará, através de balança e antropômetro. Os dados foram coletados a partir da ficha de atendimento do LEIM. Para o diagnóstico nutricional foram utilizados os programas Anthro e Anthro Plus e o programa SPSS para a análise estatística. RESULTADOS: os pacientes atendidos pertenciam, na maioria, a faixa etária de sete meses a nove anos. Os principais sintomas foram atraso no desenvolvimento neuropsicomotor e infecções frequentes. Quanto ao estado nutricional, foi observado déficit de 23,7% no indicador de peso para idade, déficit de 50,9% no indicador de altura para idade, excesso de peso e obesidade de 15,4% para peso para altura, e 25,1% para índice de massa corporal para idade. CONCLUSÕES: os pacientes apresentaram estado nutricional inadequados, o qual na ausência de diagnóstico de EIM, os fatores envolvidos devem ser mais bem averiguados.OBJECTIVES: to provide an anthropometric evaluation of patients suspected of having innate errors of metabolism (IEMs and report the prevalence of nutritional disorders (malnutrition, overweight and obesity. METHODS: fifty-five patients aged between 0 and 10 years were evaluated for anthropometric indices (H/A, W/A and W/H and BMI/A, in the innate errors of metabolism laboratory (LEIM of the Federal University of Pará, using scales and an anthropometer. The data were collected using an LEIM form. Nutritional diagnosis was carried out using the Anthro and Anthro Plus programs and the SPSS statistics package. RESULTS: the patients attended were mostly aged between seven months and nine years. The main

  11. Patient and public involvement in scope development for a palliative care health technology assessment in europe

    NARCIS (Netherlands)

    Brereton, L.; Goyder, E.; Ingleton, C.; Gardiner, C.; Chilcott, J.; Wilt, G.J. van der; Oortwijn, W.; Mozygemba, K.; Lysdahl, K.B.; Sacchini, D.; Lepper, W.

    2014-01-01

    BACKGROUND: Patient and Public Involvement (PPI) helps to ensure that study findings are useful to end users but is under-developed in Health Technology Assessment (HTA). "INTEGRATE-HTA, (a co-funded European Union project -grant agreement 30614) is developing new methods to assess complex health te

  12. Predicting Personal Healthcare Management: Impact of Individual Characteristics on Patient Use of Health Information Technology

    Science.gov (United States)

    Sandefer, Ryan Heath

    2017-01-01

    The use of health information and health information technology by consumers is a major factor in the current healthcare systems' effort to address issues related to quality, cost, and access. Patient engagement in the healthcare process through access to information related to diagnoses, procedures, and treatment has the potential to improve…

  13. Simulated human patients and patient-centredness: The uncanny hybridity of nursing education, technology, and learning to care.

    Science.gov (United States)

    Ireland, Aileen V

    2017-01-01

    Positioned within a hybrid of the human and technology, professional nursing practice has always occupied a space that is more than human. In nursing education, technology is central in providing tools with which practice knowledge is mobilized so that students can safely engage with simulated human patients without causing harm to real people. However, while there is an increased emphasis on deploying these simulated humans as emissaries from person-centred care to demonstrate what it is like to care for real humans, the nature of what is really going on in simulation-what is real and what is simulated-is very rarely discussed and poorly understood. This paper explores how elements of postcolonial critical thought can aid in understanding the challenges of educating nurses to provide person-centred care within a healthcare culture that is increasingly reliant on technology. Because nursing education is itself a hybrid of real and simulated practice, it provides an appropriate case study to explore the philosophical question of technology in healthcare discourse, particularly as it relates to the relationship between the human patient and its uncanny simulated double. Drawing on postcolonial elements such as the uncanny, diaspora, hybridity, and créolité, the hybrid conditions of nursing education are examined in order to open up new possibilities of thinking about how learning to care is entangled with this technological space to assist in shaping professional knowledge of person-centred care. Considering these issues through a postcolonial lens opens up questions about the nature of the difficulty in using simulated human technologies in clinical education, particularly with the paradoxical aim of providing person-centred care within a climate that increasingly characterized as posthuman. © 2016 John Wiley & Sons Ltd.

  14. Electronic game: A key effective technology to promote behavioral change in cancer patients

    Directory of Open Access Journals (Sweden)

    Reza Safdari

    2016-01-01

    Full Text Available Cancer diagnosis is a very unpleasant and unbelievable experience. Appropriate management and treatment of these diseases require a high degree of patient engagement. Interactive health electronic games are engaging, fun, challenging, and experiential and have the potential to change the attitude and behavior, which can improve the player's health. The use of these digital tools, as one of the most attractive and entertaining modern technologies, canem power patients, provide suitable palliative care, promote health behavior change strategies, increase patient engagement, enhance healthy lifestyle habits, improve self.management, and finally improve the quality of life of the patients. Finally, the aim of this article was to describe electronic games and their effects on the promotion of behavior change in cancer patients. In addition, this article describes categories, characteristic features, and benefits of this digital media in the lifestyle modification of cancer patients.

  15. Electronic game: A key effective technology to promote behavioral change in cancer patients.

    Science.gov (United States)

    Safdari, Reza; Ghazisaeidi, Marjan; Goodini, Azadeh; Mirzaee, Mahboobeh; Farzi, Jebraeil

    2016-01-01

    Cancer diagnosis is a very unpleasant and unbelievable experience. Appropriate management and treatment of these diseases require a high degree of patient engagement. Interactive health electronic games are engaging, fun, challenging, and experiential and have the potential to change the attitude and behavior, which can improve the player's health. The use of these digital tools, as one of the most attractive and entertaining modern technologies, canem power patients, provide suitable palliative care, promote health behavior change strategies, increase patient engagement, enhance healthy lifestyle habits, improve self.management, and finally improve the quality of life of the patients. Finally, the aim of this article was to describe electronic games and their effects on the promotion of behavior change in cancer patients. In addition, this article describes categories, characteristic features, and benefits of this digital media in the lifestyle modification of cancer patients.

  16. A comparative study of voluntarily reported medication errors among ...

    African Journals Online (AJOL)

    Pharmacotherapy Group, Faculty of Pharmacy, University of Benin, Benin City, ... errors among adult patients in intensive care (IC) and non- .... category include system error, documentation .... the importance of patient safety and further.

  17. Acceptability of robotic technology in neuro-rehabilitation: preliminary results on chronic stroke patients.

    Science.gov (United States)

    Mazzoleni, Stefano; Turchetti, Giuseppe; Palla, Ilaria; Posteraro, Federico; Dario, Paolo

    2014-09-01

    During the last decade, different robotic devices have been developed for motor rehabilitation of stroke survivors. These devices have been shown to improve motor impairment and contribute to the understanding of mechanisms underlying motor recovery after a stroke. The assessment of the robotic technology for rehabilitation assumes great importance. The aim of this study is to present preliminary results on the assessment of the acceptability of the robotic technology for rehabilitation on a group of thirty-four chronic stroke patients. The results from questionnaires on the patients' acceptability of two different robot-assisted rehabilitation scenarios show that the robotic approach was well accepted and tolerated by the patients. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  18. Psychosocial support for patients in pediatric oncology: the influences of parents, schools, peers, and technology.

    Science.gov (United States)

    Suzuki, Lalita K; Kato, Pamela M

    2003-01-01

    The diagnosis and treatment of pediatric cancer can be associated with profound psychosocial changes in the life of young patients. Although nurses, physicians, and other health care professionals are important sources of support, psychosocial support is also available through parents, schools, and peers. This article presents a review of the literature on how parents, schools, and peers affect the coping and adjustment of young patients with cancer and critically reviews interventions directed at improving functioning in these areas. Special attention is paid to recent interventions that exploit technology such as video games, CD-ROMs, and the Internet to provide creative new forms of support for patients in pediatric oncology. Existing research on both technological and interpersonal forms of intervention and support shows promising results, and suggestions for further study are provided.

  19. Reducing medication errors: Teaching strategies that increase nursing students' awareness of medication errors and their prevention.

    Science.gov (United States)

    Latimer, Sharon; Hewitt, Jayne; Stanbrough, Rebecca; McAndrew, Ron

    2017-02-14

    Medication errors are a patient safety and quality of care issue. There is evidence to suggest many undergraduate nursing curricula do not adequately educate students about the factors that contribute to medication errors and possible strategies to prevent them. We designed and developed a suite of teaching strategies that raise students' awareness of medication error producing situations and their prevention.

  20. Towards a framework for teaching about information technology risk in health care: Simulating threats to health data and patient safety

    Directory of Open Access Journals (Sweden)

    Elizabeth M. Borycki

    2015-09-01

    Full Text Available In this paper the author describes work towards developing an integrative framework for educating health information technology professionals about technology risk. The framework considers multiple sources of risk to health data quality and integrity that can result from the use of health information technology (HIT and can be used to teach health professional students about these risks when using health technologies. This framework encompasses issues and problems that may arise from varied sources, including intentional alterations (e.g. resulting from hacking and security breaches as well as unintentional breaches and corruption of data (e.g. resulting from technical problems, or from technology-induced errors. The framework that is described has several levels: the level of human factors and usability of HIT, the level of monitoring of security and accuracy, the HIT architectural level, the level of operational and physical checks, the level of healthcare quality assurance policies and the data risk management strategies level. Approaches to monitoring and simulation of risk are also discussed, including a discussion of an innovative approach to monitoring potential quality issues. This is followed by a discussion of the application (using computer simulations to educate both students and health information technology professionals about the impact and spread of technology-induced and related types of data errors involving HIT.

  1. Towards a wireless patient: chronic illness, scarce care and technological innovation in the United Kingdom.

    Science.gov (United States)

    May, Carl; Finch, Tracy; Mair, Frances; Mort, Maggie

    2005-10-01

    'Modernization' is a key health policy objective in the UK. It extends across a range of public service delivery and organizational contexts, and also means there are radical changes in perspective on professional behaviour and practice. New information and communications technologies have been seen as one of the key mechanisms by which these changes can be engendered. In particular, massive investment in information technologies promises the rapid distribution and deployment of patient-centred information across internal organizational boundaries. While the National Health Service (NHS) sits on the edge of a pound sterling 6 billion investment in electronic patient records, other technologies find their status as innovative vehicles for professional behaviour change and service delivery in question. In this paper, we consider the ways that telemedicine and telehealthcare systems have been constructed first as a field of technological innovation, and more recently, as management solutions to problems around the distribution of health care. We use NHS responses to chronic illness as a medium for understanding these shifts. In particular, we draw attention to the shifting definitions of 'innovation' and to the ways that these shifts define a move away from notions of technological advance towards management control.

  2. Medication errors in the intensive care unit: literature review using the SEIPS model.

    Science.gov (United States)

    Frith, Karen H

    2013-01-01

    Medication errors in intensive care units put patients at risk for injury or death every day. Safety requires an organized and systematic approach to improving the tasks, technology, environment, and organizational culture associated with medication systems. The Systems Engineering Initiative for Patient Safety model can help leaders and health care providers understand the complicated and high-risk work associated with critical care. Using this model, the author combines a human factors approach with the well-known structure-process-outcome model of quality improvement to examine research literature. The literature review reveals that human factors, including stress, high workloads, knowledge deficits, and performance deficits, are associated with medication errors. Factors contributing to medication errors are frequent interruptions, communication problems, and poor fit of health information technology to the workflow of providers. Multifaceted medication safety interventions are needed so that human factors and system problems can be addressed simultaneously.

  3. 引入易错PCR和DNA-shuffling技术构建单链抗体库%The introduction of error-prone PCR and DNA-shuffling technology to build mono-chain antibody library

    Institute of Scientific and Technical Information of China (English)

    杨浩; 杨青平; 查成喜; 韩跃武

    2012-01-01

    目的 引入易错PCR和DNA-shuffling技术构建高库容量的单链抗体库.方法 收集不同年龄、性别、健康状态的人的静脉血各5 mL,提取单个核细胞总RNA,反转录为cDNA,PCR扩增VH和VL基因,应用易错PCR对VH和VL基因进行突变,同时用DNA-shuffling技术对全长单链抗体基因进行体外改组,获得的分子与T载体连接,转化E.coli DH5α,选取阳性克隆,经菌落PCR后酶切鉴定抗体库多样性,计算分析单链抗体库容量.结果 成功构建了库容量为4.37×1013的单链抗体库,经酶切鉴定,初步判定抗体库多样性良好.结论 引入易错PCR和DNA-shuffling技术,成功构建了单链抗体库,为后续筛选高亲和力抗体奠定了实验基础.%Objective To construct a mono-storage capacity single-chain antibody (scFv) library using error-prone PCR and DNA-shuffling technologies. Methods Peripheral blood was collected from different age, gender and healthy people. Total RNA was extracted from human peripheral blood mononuclear cells and reversely transcribed to cDNA by RT-PCR. VH and VL genes were amplified by PCR and mutated by error-prone PCR. The full-length ScFv fragments were recombinated with the DNA-shuffling technology in vitro, and then connected with T vector and transformed into E. Coli DH5α. Antibody library diversity was identified by restriction enzyme digestion after colony PCR, and then the capacity of scFv was calculated. Results The 4. 37 x 1013 capacity and better diversity ScFv library was constructed by error-prone PCR and DNA-shuffling techniques. Conclusions The scFv library with high-storage capacity and genetic diversity has been constructed, which laid a foundation of selection high-affinity antibodies.

  4. Developing next-generation telehealth tools and technologies: patients, systems, and data perspectives.

    Science.gov (United States)

    Ackerman, Michael J; Filart, Rosemarie; Burgess, Lawrence P; Lee, Insup; Poropatich, Ronald K

    2010-01-01

    The major goals of telemedicine today are to develop next-generation telehealth tools and technologies to enhance healthcare delivery to medically underserved populations using telecommunication technology, to increase access to medical specialty services while decreasing healthcare costs, and to provide training of healthcare providers, clinical trainees, and students in health-related fields. Key drivers for these tools and technologies are the need and interest to collaborate among telehealth stakeholders, including patients, patient communities, research funders, researchers, healthcare services providers, professional societies, industry, healthcare management/economists, and healthcare policy makers. In the development, marketing, adoption, and implementation of these tools and technologies, communication, training, cultural sensitivity, and end-user customization are critical pieces to the process. Next-generation tools and technologies are vehicles toward personalized medicine, extending the telemedicine model to include cell phones and Internet-based telecommunications tools for remote and home health management with video assessment, remote bedside monitoring, and patient-specific care tools with event logs, patient electronic profile, and physician note-writing capability. Telehealth is ultimately a system of systems in scale and complexity. To cover the full spectrum of dynamic and evolving needs of end-users, we must appreciate system complexity as telehealth moves toward increasing functionality, integration, interoperability, outreach, and quality of service. Toward that end, our group addressed three overarching questions: (1) What are the high-impact topics? (2) What are the barriers to progress? and (3) What roles can the National Institutes of Health and its various institutes and centers play in fostering the future development of telehealth?

  5. Medical errors recovered by critical care nurses.

    Science.gov (United States)

    Dykes, Patricia C; Rothschild, Jeffrey M; Hurley, Ann C

    2010-05-01

    : The frequency and types of medical errors are well documented, but less is known about potential errors that were intercepted by nurses. We studied the type, frequency, and potential harm of recovered medical errors reported by critical care registered nurses (CCRNs) during the previous year. : Nurses are known to protect patients from harm. Several studies on medical errors found that there would have been more medical errors reaching the patient had not potential errors been caught earlier by nurses. : The Recovered Medical Error Inventory, a 25-item empirically derived and internally consistent (alpha =.90) list of medical errors, was posted on the Internet. Participants were recruited via e-mail and healthcare-related listservs using a nonprobability snowball sampling technique. Investigators e-mailed contacts working in hospitals or who managed healthcare-related listservs and asked the contacts to pass the link on to others with contacts in acute care settings. : During 1 year, 345 CCRNs reported that they recovered 18,578 medical errors, of which they rated 4,183 as potentially lethal. : Surveillance, clinical judgment, and interventions by CCRNs to identify, interrupt, and correct medical errors protected seriously ill patients from harm.

  6. Technology.

    Science.gov (United States)

    Online-Offline, 1998

    1998-01-01

    Focuses on technology, on advances in such areas as aeronautics, electronics, physics, the space sciences, as well as computers and the attendant progress in medicine, robotics, and artificial intelligence. Describes educational resources for elementary and middle school students, including Web sites, CD-ROMs and software, videotapes, books,…

  7. The ratio of weight loss to planning target volume significantly impacts setup errors in nasopharyngeal cancer patients undergoing helical tomotherapy with daily megavoltage computed tomography

    Directory of Open Access Journals (Sweden)

    Hou Wei-Hsien

    2016-12-01

    Full Text Available Changes in head and neck anatomy during radiation therapy (RT produce setup uncertainties of nasopharyngeal cancer (NPC irradiation. We retrospectively analyzed image guidance data to identify clinical predictors of setup errors.

  8. Demand Forecasting Errors

    OpenAIRE

    Mackie, Peter; Nellthorp, John; Laird, James

    2005-01-01

    Demand forecasts form a key input to the economic appraisal. As such any errors present within the demand forecasts will undermine the reliability of the economic appraisal. The minimization of demand forecasting errors is therefore important in the delivery of a robust appraisal. This issue is addressed in this note by introducing the key issues, and error types present within demand fore...

  9. When errors are rewarding

    NARCIS (Netherlands)

    Bruijn, E.R.A. de; Lange, F.P. de; Cramon, D.Y. von; Ullsperger, M.

    2009-01-01

    For social beings like humans, detecting one's own and others' errors is essential for efficient goal-directed behavior. Although one's own errors are always negative events, errors from other persons may be negative or positive depending on the social context. We used neuroimaging to disentangle br

  10. Healthcare model with use of information and communication technology for patients with chronic disease.

    Science.gov (United States)

    Lisiecka-Biełanowicz, Mira; Wawrzyniak, Zbigniew

    2016-07-15

    The healthcare system is positioned in the patient's environment and works with other determinants of the treatment. Patient care requires a whole system compatible to the needs of organizational and technical solutions. The purpose of this study is to present a new model of patient-oriented care, in which the use of information and communication technology (ICT) can improve the effectiveness of healthcare for patients with chronic diseases. The study material is the process of healthcare for chronically ill patients. Knowledge of the circumstances surrounding ecosystem and of the patients' needs, taking into account the fundamental healthcare goals allows us to build a new models of care, starting with the economic assumptions. The method used is modeling the construction of efficient healthcare system with the patient-centered model using ICT tools. We present a new systemic concept of building patient's environment in which he is the central figure of the healthcare organization - so called patient centered system. The use of ICT in the model of chronic patient's healthcare can improve the effectiveness of this kind of care. The concept is a vision to making wide platform of information management in chronic disease in a real environment ecosystem of patient using ICT tools. On the basis of a systematic approach to the model of chronic disease, and the knowledge of the patient itself, a model of the ecosystem impacts and interactions through information feedback and the provision of services can be constructed. ICT assisted techniques will increase the effectiveness of patient care, in which nowadays information exchange plays a key role.

  11. Assessment of the prevalence of refractive eye error and IOP during pregnancy and after delivery in patients referred to ophthalmology clinic of Boo-Ali Hospital of Qazvin in 1387

    Directory of Open Access Journals (Sweden)

    Mohammad Khalaj

    2009-01-01

    Full Text Available (Received 30 Jan 2010, 2010 ; Accepted 25 April, 2010AbstractBackground and purpose: Many pregnant women some of whom also suffer from refractive errors and use eyeglasses attend eye clinics The aim of this study was to assess the prevalence of refractive eye errors and changes in IOP, during pregnancy and after delivery among patients referred to ophthalmology clinic of Boo-Ali Hospital of Qazvin.Materials and methods: The study was conducted at eye clinic of Boo-Ali Hospital in Gazvin- Iran. A total of 150 pregnant women aged 17 to 38 years (mean 24.76 ± 4.61 were treated by ophthalmologist in three stages (16- and 32- week of pregnancy and 4 months after childbirth. Initially, all pregnant women were visited by a gynecologist and then they were referred to the ophthalmology clinic. The visual acuity was determined using chart Snellen from a distance of 6m and then refractive errors were measured by static retinoscopy and autorefractometer. Intraocular pressure was measured using air-puls noncontact tonometer in three stages.Results: In the first stage (16-week of pregnancy, hyperopia was seen in 12 patients (%8, myopia in 104 patients (%69.3, astigmatism in 26 patients (%17.3 and 8 patients (%5.3 were normal. The results of the second stage (32-week of pregnancy showed that 3 patients (%2 were hyperopia, 143 patients (%95 myopia, 2 patients (%1.3 astigmatism and 2 patients (%1.3 were normal. Four months after childbirth, 5 patients (%3.3 were hyperopia, 129 patients (%86 myopia, 13 patients (%13.7 astigmatism and 3 patients (%2 normal. The estimated relative risk of myopia was increased significantly in the second stage. The patients' IOP in the first stage was higher than the second stage and this difference was statistically significant (P<0.05.Conclusion: The results of this research showed that there is a significant relationship between pregnancy and myopia. IOP was reduced during pregnancy and return to the normal level after delivery

  12. 基于InSAR技术的DEM提取及误差分析%DEM Extraction and Error Analysis Based on InSAR Technology

    Institute of Scientific and Technical Information of China (English)

    陈雷

    2016-01-01

    The synthetic aperture radar has the advantages of all-weather and all-time observation for the ground. Combined with the characteristics of high interferometry precision, InSAR technology can extract high precision digital elevation model and monitor the small deformation of the surface. Interferometry transforms its abundant phase information into elevation information. The advantage of accessing SAR image makes the application of extracting DEM by InSAR more wide. It is one of the hot spot of research in recent years. Based on a variety of spaceborne SAR data, this paper uses many SAR interference processing softwares to study DEM extraction and carry out the precision comparison. It firstly expounds the basic principle of synthetic aperture radar and introduces the main work pattern of interferometric measure. And then, it studies the basic processing procedure of InSAR to generate DEM, the processing procedure includs data registration, the generation of interference fringes pattern, elimination of flat-earth effect and smoothing, phase unwrapping, geocoding, DEM generation. ERS-1/2 and ENVISAT data is taken as an example to process by tha application of InSAR module of ERDAS IMAGINE, each step is given the specific instructions.%合成孔径雷达具有全天时全天候的对地实时观测优势,结合干涉测量精度高的特点,InSAR技术能够提取高精度的数字高程模型以及对地表微小形变进行监测。干涉测量利用其丰富的相位信息转化为高程信息,再加上获取SAR图像的优势使得InSAR提取DEM得以广泛应用,是近年来研究的热点之一。本文以多种星载SAR数据为基础,应用多种SAR干涉处理软件进行DEM提取的研究,并进行精度对比。首先阐述了合成孔径雷达的基本原理,并介绍了干涉测量的主要工作方式。然后研究了InSAR生成DEM的基本处理流程,包括数据配准,干涉条纹图的生成,去平地效应

  13. System modeling based measurement error analysis of digital sun sensors

    Institute of Scientific and Technical Information of China (English)

    WEI; M; insong; XING; Fei; WANG; Geng; YOU; Zheng

    2015-01-01

    Stringent attitude determination accuracy is required for the development of the advanced space technologies and thus the accuracy improvement of digital sun sensors is necessary.In this paper,we presented a proposal for measurement error analysis of a digital sun sensor.A system modeling including three different error sources was built and employed for system error analysis.Numerical simulations were also conducted to study the measurement error introduced by different sources of error.Based on our model and study,the system errors from different error sources are coupled and the system calibration should be elaborately designed to realize a digital sun sensor with extra-high accuracy.

  14. Systematic error revisited

    Energy Technology Data Exchange (ETDEWEB)

    Glosup, J.G.; Axelrod, M.C.

    1996-08-05

    The American National Standards Institute (ANSI) defines systematic error as An error which remains constant over replicative measurements. It would seem from the ANSI definition that a systematic error is not really an error at all; it is merely a failure to calibrate the measurement system properly because if error is constant why not simply correct for it? Yet systematic errors undoubtedly exist, and they differ in some fundamental way from the kind of errors we call random. Early papers by Eisenhart and by Youden discussed systematic versus random error with regard to measurements in the physical sciences, but not in a fundamental way, and the distinction remains clouded by controversy. The lack of a general agreement on definitions has led to a plethora of different and often confusing methods on how to quantify the total uncertainty of a measurement that incorporates both its systematic and random errors. Some assert that systematic error should be treated by non- statistical methods. We disagree with this approach, and we provide basic definitions based on entropy concepts, and a statistical methodology for combining errors and making statements of total measurement of uncertainty. We illustrate our methods with radiometric assay data.

  15. Analysis of the concept of nursing educational technology applied to the patient

    Directory of Open Access Journals (Sweden)

    Aline Cruz Esmeraldo Áfio

    2014-04-01

    Full Text Available It is aimed at analyzing the concept of educational technology, produced by nursing, applied to the patient. Rodgers´ Evolutionary Method of Concept Analysis was used, identifying background, attributes and consequential damages. 13 articles were selected for analysis in which the background was identified: knowledge deficiency, shortage of nursing professionals' time, to optimize nursing work, the need to achieve the goals of the patients. Attributes: tool, strategy, innovative approach, pedagogical approach, mediator of knowledge, creative way to encourage the acquisition of skills, health production instrument. Consequences: to improve the quality of life, encouraging healthy behavior, empowerment, reflection and link. It emphasizes the importance of educational technologies for the care in nursing, to boost health education activities.

  16. Normal accidents: human error and medical equipment design.

    Science.gov (United States)

    Dain, Steven

    2002-01-01

    High-risk systems, which are typical of our technologically complex era, include not just nuclear power plants but also hospitals, anesthesia systems, and the practice of medicine and perfusion. In high-risk systems, no matter how effective safety devices are, some types of accidents are inevitable because the system's complexity leads to multiple and unexpected interactions. It is important for healthcare providers to apply a risk assessment and management process to decisions involving new equipment and procedures or staffing matters in order to minimize the residual risks of latent errors, which are amenable to correction because of the large window of opportunity for their detection. This article provides an introduction to basic risk management and error theory principles and examines ways in which they can be applied to reduce and mitigate the inevitable human errors that accompany high-risk systems. The article also discusses "human factor engineering" (HFE), the process which is used to design equipment/ human interfaces in order to mitigate design errors. The HFE process involves interaction between designers and endusers to produce a series of continuous refinements that are incorporated into the final product. The article also examines common design problems encountered in the operating room that may predispose operators to commit errors resulting in harm to the patient. While recognizing that errors and accidents are unavoidable, organizations that function within a high-risk system must adopt a "safety culture" that anticipates problems and acts aggressively through an anonymous, "blameless" reporting mechanism to resolve them. We must continuously examine and improve the design of equipment and procedures, personnel, supplies and materials, and the environment in which we work to reduce error and minimize its effects. Healthcare providers must take a leading role in the day-to-day management of the "Perioperative System" and be a role model in

  17. Coherent efforts in relation to COPD patients with special emphasis on the quality and technological solutions

    DEFF Research Database (Denmark)

    Bagger, Bettan; Vestergaard*, Kitt; Andresen, Mette

    2014-01-01

    with respect to COPD patients. National Board of Health has produced series of recommendations to ensure quality based among others on The Chronic Care Model. But how do COPD patients and health professionals define quality themselves in daily life? University College Zealand and COPD Competence Center......, Hospital Naestved investigate COPD patients’ and health professionals’ perspectives with respect to their assessments of quality in clinical pathways and daily life focusing on clinical pathways, interdisciplinary sharing of knowledge and use of technology. Identification of parameters will be important...... insights in developing new ways of interconnections between key players in strengthening quality and consistency of patient care in pathways between sectors for the COPD patient. Aims: - To explore parameters for quality focusing on clinical pathways, competencies and daily life with respect to COPD...

  18. Advanced lightweight cooling-garment technology: functional improvements in thermosensitive patients with multiple sclerosis.

    Science.gov (United States)

    Meyer-Heim, A; Rothmaier, M; Weder, M; Kool, J; Schenk, P; Kesselring, J

    2007-03-01

    Cooling of thermosensitive patients with multiple sclerosis (MS) can improve clinical symptoms. In order to study the effectiveness of an advanced lightweight cooling-garment technology based on aquatic evaporation, a single-blinded balanced crossover study was performed on 20 patients with an Expanded Disability Status Scale score garment prototype for peripheral cooling suggest improvement of a timed-walking test, leg-strength, fine-motor skills and subjective benefits. Preliminary data of the heart rate variability (HRV) including six patients suggest that the MS patients show an abnormal HRV after sham condition, which is normalized after cooling. Technical information was gained about the cooling activity and the practicability and handling of the device. These encouraging findings promote further adaptations of the prototype to increase its cooling properties and ameliorate the practicability of the cooling garment.

  19. Medication errors in anesthesia: unacceptable or unavoidable?

    OpenAIRE

    Ira Dhawan; Anurag Tewari; Sankalp Sehgal; Ashish Chandra Sinha

    2017-01-01

    Abstract Medication errors are the common causes of patient morbidity and mortality. It adds financial burden to the institution as well. Though the impact varies from no harm to serious adverse effects including death, it needs attention on priority basis since medication errors' are preventable. In today's world where people are aware and medical claims are on the hike, it is of utmost priority that we curb this issue. Individual effort to decrease medication error alone might not be succes...

  20. Medication errors recovered by emergency department pharmacists.

    Science.gov (United States)

    Rothschild, Jeffrey M; Churchill, William; Erickson, Abbie; Munz, Kristin; Schuur, Jeremiah D; Salzberg, Claudia A; Lewinski, Daniel; Shane, Rita; Aazami, Roshanak; Patka, John; Jaggers, Rondell; Steffenhagen, Aaron; Rough, Steve; Bates, David W

    2010-06-01

    We assess the impact of emergency department (ED) pharmacists on reducing potentially harmful medication errors. We conducted this observational study in 4 academic EDs. Trained pharmacy residents observed a convenience sample of ED pharmacists' activities. The primary outcome was medication errors recovered by pharmacists, including errors intercepted before reaching the patient (near miss or potential adverse drug event), caught after reaching the patient but before causing harm (mitigated adverse drug event), or caught after some harm but before further or worsening harm (ameliorated adverse drug event). Pairs of physician and pharmacist reviewers confirmed recovered medication errors and assessed their potential for harm. Observers were unblinded and clinical outcomes were not evaluated. We conducted 226 observation sessions spanning 787 hours and observed pharmacists reviewing 17,320 medications ordered or administered to 6,471 patients. We identified 504 recovered medication errors, or 7.8 per 100 patients and 2.9 per 100 medications. Most of the recovered medication errors were intercepted potential adverse drug events (90.3%), with fewer mitigated adverse drug events (3.9%) and ameliorated adverse drug events (0.2%). The potential severities of the recovered errors were most often serious (47.8%) or significant (36.2%). The most common medication classes associated with recovered medication errors were antimicrobial agents (32.1%), central nervous system agents (16.2%), and anticoagulant and thrombolytic agents (14.1%). The most common error types were dosing errors, drug omission, and wrong frequency errors. ED pharmacists can identify and prevent potentially harmful medication errors. Controlled trials are necessary to determine the net costs and benefits of ED pharmacist staffing on safety, quality, and costs, especially important considerations for smaller EDs and pharmacy departments. Copyright (c) 2009 American College of Emergency Physicians

  1. [Use of plasma technology in treatment of patients with pyo-inflammatory diseases of soft tissues].

    Science.gov (United States)

    Khasanov, A G; Nikmatsianov, S S; Nurtdinov, M A; Bakiev, I M; Men'shikov, A M; Shaĭbakov, D G

    2007-01-01

    The authors substantiated the method of treatment of pyo-inflammatory diseases based on experiments in white rats, using plasma flow at different stages of the process. The plasma technology was used in the clinic in 130 patients that allowed shortening the period of preparing the wounds to operative treatment and reducing the period of hospital stay from 15.3 to 9.2 days, improving results of treatment by 20% and saving on expensive bandaging materials and medicines.

  2. Ethical perspectives on recommending digital technology for patients with mental illness.

    Science.gov (United States)

    Bauer, Michael; Glenn, Tasha; Monteith, Scott; Bauer, Rita; Whybrow, Peter C; Geddes, John

    2017-12-01

    The digital revolution in medicine not only offers exciting new directions for the treatment of mental illness, but also presents challenges to patient privacy and security. Changes in medicine are part of the complex digital economy based on creating value from analysis of behavioral data acquired by the tracking of daily digital activities. Without an understanding of the digital economy, recommending the use of technology to patients with mental illness can inadvertently lead to harm. Behavioral data are sold in the secondary data market, combined with other data from many sources, and used in algorithms that automatically classify people. These classifications are used in commerce and government, may be discriminatory, and result in non-medical harm to patients with mental illness. There is also potential for medical harm related to poor quality online information, self-diagnosis and self-treatment, passive monitoring, and the use of unvalidated smartphone apps. The goal of this paper is to increase awareness and foster discussion of the new ethical issues. To maximize the potential of technology to help patients with mental illness, physicians need education about the digital economy, and patients need help understanding the appropriate use and limitations of online websites and smartphone apps.

  3. Medication Errors: New EU Good Practice Guide on Risk Minimisation and Error Prevention.

    Science.gov (United States)

    Goedecke, Thomas; Ord, Kathryn; Newbould, Victoria; Brosch, Sabine; Arlett, Peter

    2016-06-01

    A medication error is an unintended failure in the drug treatment process that leads to, or has the potential to lead to, harm to the patient. Reducing the risk of medication errors is a shared responsibility between patients, healthcare professionals, regulators and the pharmaceutical industry at all levels of healthcare delivery. In 2015, the EU regulatory network released a two-part good practice guide on medication errors to support both the pharmaceutical industry and regulators in the implementation of the changes introduced with the EU pharmacovigilance legislation. These changes included a modification of the 'adverse reaction' definition to include events associated with medication errors, and the requirement for national competent authorities responsible for pharmacovigilance in EU Member States to collaborate and exchange information on medication errors resulting in harm with national patient safety organisations. To facilitate reporting and learning from medication errors, a clear distinction has been made in the guidance between medication errors resulting in adverse reactions, medication errors without harm, intercepted medication errors and potential errors. This distinction is supported by an enhanced MedDRA(®) terminology that allows for coding all stages of the medication use process where the error occurred in addition to any clinical consequences. To better understand the causes and contributing factors, individual case safety reports involving an error should be followed-up with the primary reporter to gather information relevant for the conduct of root cause analysis where this may be appropriate. Such reports should also be summarised in periodic safety update reports and addressed in risk management plans. Any risk minimisation and prevention strategy for medication errors should consider all stages of a medicinal product's life-cycle, particularly the main sources and types of medication errors during product development. This article

  4. PREVENTABLE ERRORS: NEVER EVENTS

    Directory of Open Access Journals (Sweden)

    Narra Gopal

    2014-07-01

    Full Text Available Operation or any invasive procedure is a stressful event involving risks and complications. We should be able to offer a guarantee that the right procedure will be done on right person in the right place on their body. “Never events” are definable. These are the avoidable and preventable events. The people affected from consequences of surgical mistakes ranged from temporary injury in 60%, permanent injury in 33% and death in 7%”.World Health Organization (WHO [1] has earlier said that over seven million people across the globe suffer from preventable surgical injuries every year, a million of them even dying during or immediately after the surgery? The UN body quantified the number of surgeries taking place every year globally 234 million. It said surgeries had become common, with one in every 25 people undergoing it at any given time. 50% never events are preventable. Evidence suggests up to one in ten hospital admissions results in an adverse incident. This incident rate is not acceptable in other industries. In order to move towards a more acceptable level of safety, we need to understand how and why things go wrong and have to build a reliable system of working. With this system even though complete prevention may not be possible but we can reduce the error percentage2. To change present concept towards patient, first we have to change and replace the word patient with medical customer. Then our outlook also changes, we will be more careful towards our customers.

  5. Technology

    Directory of Open Access Journals (Sweden)

    Xu Jing

    2016-01-01

    Full Text Available The traditional answer card reading method using OMR (Optical Mark Reader, most commonly, OMR special card special use, less versatile, high cost, aiming at the existing problems proposed a method based on pattern recognition of the answer card identification method. Using the method based on Line Segment Detector to detect the tilt of the image, the existence of tilt image rotation correction, and eventually achieve positioning and detection of answers to the answer sheet .Pattern recognition technology for automatic reading, high accuracy, detect faster

  6. Patients welcome the Sickle Cell Disease Mobile Application to Record Symptoms via Technology (SMART).

    Science.gov (United States)

    Shah, Nirmish; Jonassaint, Jude; De Castro, Laura

    2014-01-01

    The widespread use of mobile phones among patients provides a unique opportunity for the development of mobile health intervention designed specifically for sickle cell disease, which will improve self-management as well as health care delivery. Our objective was to determine the receptiveness of patients with sickle cell disease to technology and a mobile application (app) designed for sickle cell disease. Phase I included 100 patients who completed a survey inquiring about receptiveness to technology and use of mobile devices to self-manage and communicate with providers. Phase II surveyed 17 additional patients who tested a newly developed sickle cell disease app, to report its usability and utility. In Phase I, on a 0-10 Likert scale where 0 is not comfortable, and 10 is extremely comfortable, 87.0% of participants reported >5 comfort level using a mobile device for health care management. Participants were comfortable with texting (81.0%) and emailing (77.0%) but not with social media (40.0%). Most participants (84.0%) owned computer devices (desktops, laptops, tablets, or iPads), and 92.0% owned mobile devices. In Phase II, participants reported that the app tested was useful to track pain (88.0%), and 94.0% reported that it was easy to use, practical, and useful for health self-management. All reported that the app was useful to help one communicate with providers. Following the use of our app, patients found it an extremely valuable tool for tracking pain, health management, and communicating with providers. We conclude that mobile technology might provide an appropriate venue for sickle cell disease healthcare management.

  7. 非老视患者的近距离屈光矫正%Necessity of correcting short distance refractive error in non-presbyopia patients

    Institute of Scientific and Technical Information of China (English)

    刘文兰; 王莉; 杨扬; 刘珍

    2014-01-01

    and the appropriate method of correcting short distance refractive error in non-presbyopia patients by analyzing the relation between astigmatic refractive error and fixation distance. METHODS: In this prospective clinical study, 166 right eyes with myopic astigmatism were selected by sequential processing to measure at distance of 5m, 40cm and 20cm. The distance corrected near vision acuity ( NCNVA) and accommodative astigmatism corrected near vision acuity ( ACNVA) were measured with distance-corrected glasses and near -corrected glasses, respectively, using near vision chart. The astigmatism at near were measured under monocular condition with cross-cylinder lenses, with the tested eye looking straight ahead at the line of its best corrected vision acuity in near vision chart. The degree and axis of astigmatism between two distance of the three, DCNVA and ACNVA were compared by paired t test respectively if the data are normal distribution, if not, compared by Wilcoxon matched-pairs signed-ranks test. RESULTS:The degree of astigmatism with accommodation was increased significantly as follow order: fixating at 20cm, 40cm and distance.[(40cm-5m): Z=-5.316, P40cm, (0.78DC± 0.43D)>5m, 0.63DC ±0.47D)]; The near vision acuity when fixing at 40cm and 20cm were both increased significantly when accommodative astigmatism corrected (Z=-5.741, P CONCLUSION: The degree of astigmatism has a tendency of increasing when fixating at near, and astigmatism with the rule will be followed by the axis, while this change is random and personalized, asthenopia is more likely to appear at the distance of maxium astigmatism change, so correct the refractive error at near may be a appropriate method to treat asthenopia.

  8. Application of RFID technology in patient tracking and medication traceability in emergency care.

    Science.gov (United States)

    Martínez Pérez, María; Cabrero-Canosa, Mariano; Vizoso Hermida, José; Carrajo García, Lino; Llamas Gómez, Daniel; Vázquez González, Guillermo; Martín Herranz, Isabel

    2012-12-01

    One of the most important factors that directly affects the quality of health care is patient safety. Minimize the occurrence of adverse events is one of the main challenges for health professionals. This requires continuous tracking of the patient by different areas and services, a process known as traceability and proper patient identification and medication prescribed. This article presents an information system for patient tracking and drugs developed for the Emergency Department of Hospital A Coruña. The systems use RFID technology to perform various tasks: (1) locate patients in different areas; (2) measure patient care times and waiting times; (3) identify unitary doses of medication; and (4) ensure the correct matching between the patient and the medication prescribed by the doctor. The hardware infrastructure as well as the optimal configuration of devices interconnected via a wireless network was determined by conducting a detailed coverage study. To support all the functionality needed, specific tools were designed and integrated with proprietary software applications. The RFID system was evaluated positively by staff from different professional profiles involved in its development or subsequent implementation.

  9. Design simplicity influences patient portal use: the role of aesthetic evaluations for technology acceptance.

    Science.gov (United States)

    Lazard, Allison J; Watkins, Ivan; Mackert, Michael S; Xie, Bo; Stephens, Keri K; Shalev, Heidi

    2016-04-01

    This study focused on patient portal use and investigated whether aesthetic evaluations of patient portals function are antecedent variables to variables in the Technology Acceptance Model. A cross-sectional survey of current patient portals users (N = 333) was conducted online. Participants completed the Visual Aesthetics of Website Inventory, along with items measuring perceived ease of use (PEU), perceived usefulness (PU), and behavioral intentions (BIs) to use the patient portal. The hypothesized model accounted for 29% of the variance in BIs to use the portal, 46% of the variance in the PU of the portal, and 29% of the variance in the portal's PEU. Additionally, one dimension of the aesthetic evaluations functions as a predictor in the model - simplicity evaluations had a significant positive effect on PEU. This study provides evidence that aesthetic evaluations - specifically regarding simplicity - function as a significant antecedent variable to patients' use of patient portals and should influence patient portal design strategies. © The Author 2015. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  10. Cardiac manifestations of inborn errors of metabolism.

    NARCIS (Netherlands)

    Evangeliou, A.; Papadopoulou-Legbelou, K.; Daphnis, E.; Ganotakis, E.; Vavouranakis, I.; Michailidou, H.; Hitoglou-Makedou, A.; Nicolaidou, P.; Wevers, R.A.; Varlamis, G.

    2007-01-01

    AIM: The aim of the study was to investigate the frequency and type of cardiac manifestations in a defined group of patients with inborn errors of metabolism. This paper also explores the key role of cardiac manifestations in the diagnosis of inborn errors of metabolism in daily practice. METHODS: O

  11. Technology-dependency among patients discharged from a children's hospital: a retrospective cohort study

    Directory of Open Access Journals (Sweden)

    Sharp Virginia

    2005-05-01

    Full Text Available Abstract Background Advances in medical technology may be increasing the population of children who are technology-dependent (TD. We assessed the proportion of children discharged from a children's hospital who are judged to be TD, and determined the most common devices and number of prescription medications at the time of discharge. Methods Chart review of 100 randomly selected patients from all services discharged from a children's hospital during the year 2000. Data were reviewed independently by 4 investigators who classified the cases as TD if the failure or withdrawal of the technology would likely have adverse health consequences sufficient to require hospitalization. Only those cases where 3 or 4 raters agreed were classified as TD. Results Among the 100 randomly sampled patients, the median age was 7 years (range: 1 day to 24 years old, 52% were male, 86% primarily spoke English, and 54% were privately insured. The median length of stay was 3 days (range: 1 to 103 days. No diagnosis accounted for more than 5% of cases. 41% were deemed to be technology dependent, with 20% dependent upon devices, 32% dependent upon medications, and 11% dependent upon both devices and medications. Devices at the time of discharge included gastrostomy and jejeunostomy tubes (10%, central venous catheters (7%, and tracheotomies (1%. The median number of prescription medications was 2 (range: 0–13, with 12% of cases having 5 or more medications. Home care services were planned for 7% of cases. Conclusion Technology-dependency is common among children discharged from a children's hospital.

  12. Patient-Specific Therapy via Cell-Reprogramming Technology: a Curative Potential for Patients with Diabetes

    Science.gov (United States)

    Luo, Haizhao; Wang, Xianbao; Zhang, Ruyi; Chen, Youping; Shu, Yi; Li, Huixian; Chen, Hong

    2015-12-01

    Gene therapeutics provides great opportunities for curing diabetes. Numerous attempts have been made to establish a safe and high-efficiency gene delivery strategy, but all of them are unsuccessful. To achieve an ideal transfection, a novel gene delivery strategy was presented in this research. The novel system proposed was transfection mediated by the combination of ultrasound with microbubbles and cross-linked polyethylenimines (PEIs). Ultrasound with microbubbles enhances the permeability of target cells; moreover, cross-linked PEIs enabled DNA to escape from endosomes into the cytoplasm. If the proposed method is feasible and effective, the endogenous secretion system of insulin would be re-established in patients with diabetes.

  13. Error processing in Huntington's disease.

    Directory of Open Access Journals (Sweden)

    Christian Beste

    Full Text Available BACKGROUND: Huntington's disease (HD is a genetic disorder expressed by a degeneration of the basal ganglia inter alia accompanied with dopaminergic alterations. These dopaminergic alterations are related to genetic factors i.e., CAG-repeat expansion. The error (related negativity (Ne/ERN, a cognitive event-related potential related to performance monitoring, is generated in the anterior cingulate cortex (ACC and supposed to depend on the dopaminergic system. The Ne is reduced in Parkinson's Disease (PD. Due to a dopaminergic deficit in HD, a reduction of the Ne is also likely. Furthermore it is assumed that movement dysfunction emerges as a consequence of dysfunctional error-feedback processing. Since dopaminergic alterations are related to the CAG-repeat, a Ne reduction may furthermore also be related to the genetic disease load. METHODOLOGY/PRINCIPLE FINDINGS: We assessed the error negativity (Ne in a speeded reaction task under consideration of the underlying genetic abnormalities. HD patients showed a specific reduction in the Ne, which suggests impaired error processing in these patients. Furthermore, the Ne was closely related to CAG-repeat expansion. CONCLUSIONS/SIGNIFICANCE: The reduction of the Ne is likely to be an effect of the dopaminergic pathology. The result resembles findings in Parkinson's Disease. As such the Ne might be a measure for the integrity of striatal dopaminergic output function. The relation to the CAG-repeat expansion indicates that the Ne could serve as a gene-associated "cognitive" biomarker in HD.

  14. Patient participation in medication safety management: prevention of drug administration errors%患者参与用药安全管理在预防临床给药差错中的作用

    Institute of Scientific and Technical Information of China (English)

    邵志伟; 周瑞红; 周燕; 潘洁; 余慧琼

    2012-01-01

    目的 探讨患者参与用药安全管理的方法.方法 在“患者参与患者安全”理念的指导下,成立给药安全管理小组,开展护士安全教育,改进健康教育流程,改进查对流程增加患者参与给药前查对的步骤.结果 实施患者参与安全用药管理后,给药差错发生率显著低于实施前(P<0.01).结论 患者参与安全用药管理可有效预防和降低给药差错.%Objective To explore methods for encouraging patients' participation in management of medication safety. Methods Guided by the WHO's patients for patient safety, we established a medication safety management team, provided training about patient safety for nurses, improved health education process, and encouraged patients' participation in checking before drug administration. Results Drug administration errors were significantly reduced after implement of patient participation in medication safety management (P<0. 01). Conclusion Patient participation in medication safety management prevents drug administration errors.

  15. Remote Patient Monitoring via Non-Invasive Digital Technologies: A Systematic Review

    Science.gov (United States)

    Tran, Melody; Angelaccio, Michele; Arcona, Steve

    2017-01-01

    Abstract Background: We conducted a systematic literature review to identify key trends associated with remote patient monitoring (RPM) via noninvasive digital technologies over the last decade. Materials and Methods: A search was conducted in EMBASE and Ovid MEDLINE. Citations were screened for relevance against predefined selection criteria based on the PICOTS (Population, Intervention, Comparator, Outcomes, Timeframe, and Study Design) format. We included studies published between January 1, 2005 and September 15, 2015 that used RPM via noninvasive digital technology (smartphones/personal digital assistants [PDAs], wearables, biosensors, computerized systems, or multiple components of the formerly mentioned) in evaluating health outcomes compared to standard of care or another technology. Studies were quality appraised according to Critical Appraisal Skills Programme. Results: Of 347 articles identified, 62 met the selection criteria. Most studies were randomized control trials with older adult populations, small sample sizes, and limited follow-up. There was a trend toward multicomponent interventions (n = 26), followed by smartphones/PDAs (n = 12), wearables (n = 11), biosensor devices (n = 7), and computerized systems (n = 6). Another key trend was the monitoring of chronic conditions, including respiratory (23%), weight management (17%), metabolic (18%), and cardiovascular diseases (16%). Although substantial diversity in health-related outcomes was noted, studies predominantly reported positive findings. Conclusions: This review will help decision makers develop a better understanding of the current landscape of peer-reviewed literature, demonstrating the utility of noninvasive RPM in various patient populations. Future research is needed to determine the effectiveness of RPM via noninvasive digital technologies in delivering patient healthcare benefits and the feasibility of large-scale implementation. PMID:27116181

  16. Leveraging electronic healthcare record standards and semantic web technologies for the identification of patient cohorts.

    Science.gov (United States)

    Fernández-Breis, Jesualdo Tomás; Maldonado, José Alberto; Marcos, Mar; Legaz-García, María del Carmen; Moner, David; Torres-Sospedra, Joaquín; Esteban-Gil, Angel; Martínez-Salvador, Begoña; Robles, Montserrat

    2013-12-01

    The secondary use of electronic healthcare records (EHRs) often requires the identification of patient cohorts. In this context, an important problem is the heterogeneity of clinical data sources, which can be overcome with the combined use of standardized information models, virtual health records, and semantic technologies, since each of them contributes to solving aspects related to the semantic interoperability of EHR data. To develop methods allowing for a direct use of EHR data for the identification of patient cohorts leveraging current EHR standards and semantic web technologies. We propose to take advantage of the best features of working with EHR standards and ontologies. Our proposal is based on our previous results and experience working with both technological infrastructures. Our main principle is to perform each activity at the abstraction level with the most appropriate technology available. This means that part of the processing will be performed using archetypes (ie, data level) and the rest using ontologies (ie, knowledge level). Our approach will start working with EHR data in proprietary format, which will be first normalized and elaborated using EHR standards and then transformed into a semantic representation, which will be exploited by automated reasoning. We have applied our approach to protocols for colorectal cancer screening. The results comprise the archetypes, ontologies, and datasets developed for the standardization and semantic analysis of EHR data. Anonymized real data have been used and the patients have been successfully classified by the risk of developing colorectal cancer. This work provides new insights in how archetypes and ontologies can be effectively combined for EHR-driven phenotyping. The methodological approach can be applied to other problems provided that suitable archetypes, ontologies, and classification rules can be designed.

  17. Probabilistic quantum error correction

    CERN Document Server

    Fern, J; Fern, Jesse; Terilla, John

    2002-01-01

    There are well known necessary and sufficient conditions for a quantum code to correct a set of errors. We study weaker conditions under which a quantum code may correct errors with probabilities that may be less than one. We work with stabilizer codes and as an application study how the nine qubit code, the seven qubit code, and the five qubit code perform when there are errors on more than one qubit. As a second application, we discuss the concept of syndrome quality and use it to suggest a way that quantum error correction can be practically improved.

  18. USE OF TECHNOLOGIES OF PLASTIC AND RECONSTRUCTIVE MICROSURGERY IN TREATMENT OF PATIENTS WITH WRIST PATHOLOGY

    Directory of Open Access Journals (Sweden)

    D. I. Kutyanov

    2011-01-01

    Full Text Available We have analyzed the results of treatment of 44 patients with injuries and tumors of wrist. The main aims of microsurgical interventions in such patients were replacement of bone defects (40,9%, replacement of skin defects (25,0%, and also elimination of contractures of wrist joint and fingers (20,5%. At the same time high frequency of use of bony flaps was caused mostly not by the need in replacement of defects of bones, but by the need in stabilization of wrist joint aiming to create the conditions for normal function of fingers. It has been stated that the use of technologies of plastic and reconstructive microsurgery in patients with wrist pathology is not the main factor determing the good result of treatment. The good result of treatment is mainly determined by the condition of fingers, not only appropriate surgical treatment but also adequate rehabilitation helps them achieve their necessary function.

  19. Using Active Learning to Identify Health Information Technology Related Patient Safety Events.

    Science.gov (United States)

    Fong, Allan; Howe, Jessica L; Adams, Katharine T; Ratwani, Raj M

    2017-01-18

    The widespread adoption of health information technology (HIT) has led to new patient safety hazards that are often difficult to identify. Patient safety event reports, which are self-reported descriptions of safety hazards, provide one view of potential HIT-related safety events. However, identifying HIT-related reports can be challenging as they are often categorized under other more predominate clinical categories. This challenge of identifying HIT-related reports is exacerbated by the increasing number and complexity of reports which pose challenges to human annotators that must manually review reports. In this paper, we apply active learning techniques to support classification of patient safety event reports as HIT-related. We evaluated different strategies and demonstrated a 30% increase in average precision of a confirmatory sampling strategy over a baseline no active learning approach after 10 learning iterations.

  20. Using technology and collaborative working for a positive patient experience and to improve safety.

    Science.gov (United States)

    Desai, Usha

    2016-09-01

    Clinicians who treat patients with wounds need access to the resources that will enable them to deliver the best and most appropriate treatments. A partnership working initiative between Greenwich CCG Medicines management (commissioner), Oxleas NHS Foundation Trust (provider) and ConvaTec (commercial partner) was set up to provide wound-care dressings and products to patients via the community services. It lead to improved access, greater patient benefits, a reduction in dressings waste, and an increase in clinical confidence to make cost-effective, evidence-based prescribing decisions. This inspired the commissioners to collaborate with BlueBay (technology partner) to 'trailblaze' the development and introduction of an electronic wound care template for practice nurses and doctors in primary care to use in conjunction with VISION and EMIS, clinical software systems used in GP practices. This interoperability of clinical systems to improve wound care is, to date, the only one of its kind in the UK.

  1. Assessing the quality of decision support technologies using the International Patient Decision Aid Standards instrument (IPDASi.

    Directory of Open Access Journals (Sweden)

    Glyn Elwyn

    Full Text Available OBJECTIVES: To describe the development, validation and inter-rater reliability of an instrument to measure the quality of patient decision support technologies (decision aids. DESIGN: Scale development study, involving construct, item and scale development, validation and reliability testing. SETTING: There has been increasing use of decision support technologies--adjuncts to the discussions clinicians have with patients about difficult decisions. A global interest in developing these interventions exists among both for-profit and not-for-profit organisations. It is therefore essential to have internationally accepted standards to assess the quality of their development, process, content, potential bias and method of field testing and evaluation. METHODS: Scale development study, involving construct, item and scale development, validation and reliability testing. PARTICIPANTS: Twenty-five researcher-members of the International Patient Decision Aid Standards Collaboration worked together to develop the instrument (IPDASi. In the fourth Stage (reliability study, eight raters assessed thirty randomly selected decision support technologies. RESULTS: IPDASi measures quality in 10 dimensions, using 47 items, and provides an overall quality score (scaled from 0 to 100 for each intervention. Overall IPDASi scores ranged from 33 to 82 across the decision support technologies sampled (n = 30, enabling discrimination. The inter-rater intraclass correlation for the overall quality score was 0.80. Correlations of dimension scores with the overall score were all positive (0.31 to 0.68. Cronbach's alpha values for the 8 raters ranged from 0.72 to 0.93. Cronbach's alphas based on the dimension means ranged from 0.50 to 0.81, indicating that the dimensions, although well correlated, measure different aspects of decision support technology quality. A short version (19 items was also developed that had very similar mean scores to IPDASi and high correlation

  2. Sensitivity of volumetric modulated arc therapy patient specific QA results to multileaf collimator errors and correlation to dose volume histogram based metrics.

    LENUS (Irish Health Repository)

    Coleman, Linda

    2013-11-01

    This study investigates the impact of systematic multileaf collimator (MLC) positional errors on gamma analysis results used for quality assurance (QA) of Rapidarc treatments. In addition, this study evaluates the relationship of these gamma analysis results and clinical dose volume histogram metrics (DVH) for Rapidarc treatment plans.

  3. Transforming Patient Care in Adventist Health (West) Through Use of Information Technology

    Energy Technology Data Exchange (ETDEWEB)

    Huff, Wynelle J.; Bancarz, Gloria P.

    2009-07-01

    In 2002, Adventist Health(West) embarked upon a major project to better serve its communities by enhancing the safety, quality and clinical outcomes of the patients served by its 20 hospitals, i.e. the transformation of patient care through the use of information technology. The project is the implementation of the Cerner Millenium clinical information system (CIS) entitled Project IntelliCare. Budgeted allocations will go toward the training of 'super users' in 5-7 California Sites scheduled for installation and go-live of Phases I and II in 2005 and early 2006. Numerous super users in each hospital must be educated to provide support for every shift, every unit/department throughout the hospital. The hospitals experience significant costs associated with training these super users to thoroughly understand the CIS software, to train clinical users, to support the 'go-live' installations, and be there as a 'cheerleader to encourage and support all clinical users, and most importantly help guide users to transform their work processes using this information technology to provide the safest, highest quality care possible. Indeed, super users are critical to the success of Project IntelliCare. The 'super users' contributed significantly to the success of the 'go-live' impementations as well as ongoing support. Care has been transformed through clinicians use of information technology.

  4. [Medication errors in Spanish intensive care units].

    Science.gov (United States)

    Merino, P; Martín, M C; Alonso, A; Gutiérrez, I; Alvarez, J; Becerril, F

    2013-01-01

    To estimate the incidence of medication errors in Spanish intensive care units. Post hoc study of the SYREC trial. A longitudinal observational study carried out during 24 hours in patients admitted to the ICU. Spanish intensive care units. Patients admitted to the intensive care unit participating in the SYREC during the period of study. Risk, individual risk, and rate of medication errors. The final study sample consisted of 1017 patients from 79 intensive care units; 591 (58%) were affected by one or more incidents. Of these, 253 (43%) had at least one medication-related incident. The total number of incidents reported was 1424, of which 350 (25%) were medication errors. The risk of suffering at least one incident was 22% (IQR: 8-50%) while the individual risk was 21% (IQR: 8-42%). The medication error rate was 1.13 medication errors per 100 patient-days of stay. Most incidents occurred in the prescription (34%) and administration (28%) phases, 16% resulted in patient harm, and 82% were considered "totally avoidable". Medication errors are among the most frequent types of incidents in critically ill patients, and are more common in the prescription and administration stages. Although most such incidents have no clinical consequences, a significant percentage prove harmful for the patient, and a large proportion are avoidable. Copyright © 2012 Elsevier España, S.L. and SEMICYUC. All rights reserved.

  5. Health Information Technology, Patient Safety, and Professional Nursing Care Documentation in Acute Care Settings.

    Science.gov (United States)

    Lavin, Mary Ann; Harper, Ellen; Barr, Nancy

    2015-04-14

    The electronic health record (EHR) is a documentation tool that yields data useful in enhancing patient safety, evaluating care quality, maximizing efficiency, and measuring staffing needs. Although nurses applaud the EHR, they also indicate dissatisfaction with its design and cumbersome electronic processes. This article describes the views of nurses shared by members of the Nursing Practice Committee of the Missouri Nurses Association; it encourages nurses to share their EHR concerns with Information Technology (IT) staff and vendors and to take their place at the table when nursing-related IT decisions are made. In this article, we describe the experiential-reflective reasoning and action model used to understand staff nurses' perspectives, share committee reflections and recommendations for improving both documentation and documentation technology, and conclude by encouraging nurses to develop their documentation and informatics skills. Nursing issues include medication safety, documentation and standards of practice, and EHR efficiency. IT concerns include interoperability, vendors, innovation, nursing voice, education, and collaboration.

  6. Correction for quadrature errors

    DEFF Research Database (Denmark)

    Netterstrøm, A.; Christensen, Erik Lintz

    1994-01-01

    In high bandwidth radar systems it is necessary to use quadrature devices to convert the signal to/from baseband. Practical problems make it difficult to implement a perfect quadrature system. Channel imbalance and quadrature phase errors in the transmitter and the receiver result in error signal...

  7. ERRORS AND CORRECTION

    Institute of Scientific and Technical Information of China (English)

    1998-01-01

    To err is human . Since the 1960s, most second language teachers or language theorists have regarded errors as natural and inevitable in the language learning process . Instead of regarding them as terrible and disappointing, teachers have come to realize their value. This paper will consider these values, analyze some errors and propose some effective correction techniques.

  8. Realization of a universal patient identifier for electronic medical records through biometric technology.

    Science.gov (United States)

    Leonard, D C; Pons, Alexander P; Asfour, Shihab S

    2009-07-01

    The technology exists for the migration of healthcare data from its archaic paper-based system to an electronic one, and, once in digital form, to be transported anywhere in the world in a matter of seconds. The advent of universally accessible healthcare data has benefited all participants, but one of the outstanding problems that must be addressed is how the creation of a standardized nationwide electronic healthcare record system in the United States would uniquely identify and match a composite of an individual's recorded healthcare information to an identified individual patients out of approximately 300 million people to a 1:1 match. To date, a few solutions to this problem have been proposed that are limited in their effectiveness. We propose the use of biometric technology within our fingerprint, iris, retina scan, and DNA (FIRD) framework, which is a multiphase system whose primary phase is a multilayer consisting of these four types of biometric identifiers: 1) fingerprint; 2) iris; 3) retina scan; and 4) DNA. In addition, it also consists of additional phases of integration, consolidation, and data discrepancy functions to solve the unique association of a patient to their medical data distinctively. This would allow a patient to have real-time access to all of their recorded healthcare information electronically whenever it is necessary, securely with minimal effort, greater effectiveness, and ease.

  9. Analysis on the causes of medical charges error in the hospitalized patients and countermeasures%住院患者医疗收费差错原因分析与对策

    Institute of Scientific and Technical Information of China (English)

    刘凤萍

    2016-01-01

    Objective To reduce the hospitalized patients medical charges error ,improve patient's satisfaction ,re‐duce costs and cause medical disputes . Methods Through spot check our hospital from January 2014 to January 2014 medical records of 720 ,which found that charging mistake medical records of 162 ,analyses the reason of charge errors occur .To organize relevant personnel to study medical fee standards ,strengthen the audit and timely guidance to formulate rewards and punishment system ,etc .,in order to reduce charge errors occur . Results Af‐ter the improvement measures sampling in february 2015 to february 2016 discharged medical records of 718 copies for review ,find charge mistake medical records of 76 ,the charging error 106 ,respectively ,wrong charge 34 ,charges on 50 leakage ,charge more 22 .The error rate is 10 .58% ,was reduced by 12% ,from 22 .50% before improvement methodscharging error rate declined obviously . Conclusion Change the old concept of charge ,iIn a timely man‐ner to understand the new project price ,charge the auditor is not regular inspection guidance ,the implementation of the system of rewards and punishments ,can reduce charging errors occur .%目的:减少住院患者医疗收费差错,降低费用差错引起的医患纠纷,提高患者满意度。方法通过抽查我院2014年1月~2015年1月的病历资料720份,其中发现收费差错病历162份,并对收费差错发生的原因进行分析。结果通过组织相关人员学习医疗收费标准,加大审核力度和及时指导,制定奖惩制度等管理措施,差错率显著降低,由实施改进方法前的22.5%降至改进后的10.58%。结论针对收费差错实施有效的管理措施,明显降低差错率的发生,提高了病人满意度。

  10. Medication Error, What Is the Reason?

    Directory of Open Access Journals (Sweden)

    Ali Banaozar Mohammadi

    2015-09-01

    Full Text Available Background: Medication errors due to different reasons may alter the outcome of all patients, especially patients with drug poisoning. We introduce one of the most common type of medication error in the present article. Case:A 48 year old woman with suspected organophosphate poisoning was died due to lethal medication error. Unfortunately these types of errors are not rare and had some preventable reasons included lack of suitable and enough training and practicing of medical students and some failures in medical students’ educational curriculum. Conclusion:Hereby some important reasons are discussed because sometimes they are tre-mendous. We found that most of them are easily preventable. If someone be aware about the method of use, complications, dosage and contraindication of drugs, we can minimize most of these fatal errors.

  11. ERROR AND ERROR CORRECTION AT ELEMENTARY LEVEL

    Institute of Scientific and Technical Information of China (English)

    1994-01-01

    Introduction Errors are unavoidable in language learning, however, to a great extent, teachers in most middle schools in China regard errors as undesirable, a sign of failure in language learning. Most middle schools are still using the grammar-translation method which aims at encouraging students to read scientific works and enjoy literary works. The other goals of this method are to gain a greater understanding of the first language and to improve the students’ ability to cope with difficult subjects and materials, i.e. to develop the students’ minds. The practical purpose of using this method is to help learners pass the annual entrance examination. "To achieve these goals, the students must first learn grammar and vocabulary,... Grammar is taught deductively by means of long and elaborate explanations... students learn the rules of the language rather than its use." (Tang Lixing, 1983:11-12)

  12. Errors on errors - Estimating cosmological parameter covariance

    CERN Document Server

    Joachimi, Benjamin

    2014-01-01

    Current and forthcoming cosmological data analyses share the challenge of huge datasets alongside increasingly tight requirements on the precision and accuracy of extracted cosmological parameters. The community is becoming increasingly aware that these requirements not only apply to the central values of parameters but, equally important, also to the error bars. Due to non-linear effects in the astrophysics, the instrument, and the analysis pipeline, data covariance matrices are usually not well known a priori and need to be estimated from the data itself, or from suites of large simulations. In either case, the finite number of realisations available to determine data covariances introduces significant biases and additional variance in the errors on cosmological parameters in a standard likelihood analysis. Here, we review recent work on quantifying these biases and additional variances and discuss approaches to remedy these effects.

  13. An overview of intravenous-related medication administration errors as reported to MEDMARX, a national medication error-reporting program.

    Science.gov (United States)

    Hicks, Rodney W; Becker, Shawn C

    2006-01-01

    Medication errors can be harmful, especially if they involve the intravenous (IV) route of administration. A mixed-methodology study using a 5-year review of 73,769 IV-related medication errors from a national medication error reporting program indicates that between 3% and 5% of these errors were harmful. The leading type of error was omission, and the leading cause of error involved clinician performance deficit. Using content analysis, three themes-product shortage, calculation errors, and tubing interconnectivity-emerge and appear to predispose patients to harm. Nurses often participate in IV therapy, and these findings have implications for practice and patient safety. Voluntary medication error-reporting programs afford an opportunity to improve patient care and to further understanding about the nature of IV-related medication errors.

  14. Proofreading for word errors.

    Science.gov (United States)

    Pilotti, Maura; Chodorow, Martin; Agpawa, Ian; Krajniak, Marta; Mahamane, Salif

    2012-04-01

    Proofreading (i.e., reading text for the purpose of detecting and correcting typographical errors) is viewed as a component of the activity of revising text and thus is a necessary (albeit not sufficient) procedural step for enhancing the quality of a written product. The purpose of the present research was to test competing accounts of word-error detection which predict factors that may influence reading and proofreading differently. Word errors, which change a word into another word (e.g., from --> form), were selected for examination because they are unlikely to be detected by automatic spell-checking functions. Consequently, their detection still rests mostly in the hands of the human proofreader. Findings highlighted the weaknesses of existing accounts of proofreading and identified factors, such as length and frequency of the error in the English language relative to frequency of the correct word, which might play a key role in detection of word errors.

  15. Using Automated Writing Evaluation to Reduce Grammar Errors in Writing

    Science.gov (United States)

    Liao, Hui-Chuan

    2016-01-01

    Despite the recent development of automated writing evaluation (AWE) technology and the growing interest in applying this technology to language classrooms, few studies have looked at the effects of using AWE on reducing grammatical errors in L2 writing. This study identified the primary English grammatical error types made by 66 Taiwanese…

  16. Speak Up: Help Prevent Errors in Your Care: Laboratory Services

    Science.gov (United States)

    SpeakUP TM Help Prevent Errors in Your Care Laboratory Services To prevent health care errors, patients are ... making health care safe. That includes doctors, nurses, laboratory technologists, phlebotomists (health care staff who take blood), ...

  17. AN ASSESSMENT OF PATIENT NEED FOR A TECHNOLOGY-ENABLED REMOTE EXERCISE REHABILITATION PROGRAMME AMONG A CHRONIC ILLNESS POPULATION

    Directory of Open Access Journals (Sweden)

    Deirdre Walsh

    2015-10-01

    Conclusion: This study provides evidence of patient desire for a technology-enabled remote exercise rehabilitation programme. Further to this, the current study provides promising preliminary evidence for both the high level of technology use and capability among a cohort of people with chronic illness.

  18. Erro de medicação: importância da notificação no gerenciamento da segurança do paciente Error de medicación: la importancia de la notificación para la seguridad del paciente Medication errors: importance of notification in the management of patient safety

    Directory of Open Access Journals (Sweden)

    Elena Bohomol

    2007-02-01

    Full Text Available A notificação dos erros de medicação é um instrumento importante para o gerenciamento da qualidade da assistência e segurança do paciente. Este estudo objetivou verificar junto à equipe de enfermagem o seu entendimento do que é um erro de medicação e apresentar a sua opinião quanto à notificação deste evento. Foi realizada um survey descritivo/exploratória com 89 profissionais cujos resultados demonstraram uma ausência de uniformidade na compreensão do que é um erro de medicação e quando ele deve ser notificado ao médico ou preenchido o relatório de ocorrências. Concluímos que há necessidade de se desenvolver programas educacionais que elucidem o que são os erros de medicação, discutindo cenários para entender as causas do problema com propostas de melhoria.La notificación de los errores en la medicación es un instrumiento importante para la gerencia en lo que se refiere a la calidad de la asistencia y seguridad del paciente. Este estudio tiene como objetivo verificar junto al equipo de la enfermaría el entendimiento del mismo sobre lo que es un error de medicación y presentar su opinión referente a la notificación de este evento. Fue realizado un survey descriptivo/exploratorio con 89 profesionales cuyos resultados demostraron una no-uniformidad en la comprensión de lo que es un error de medicación y cuando este debe ser notificado al medico o notificado en el relatorio de ocurrencias. Concluimos que hay necesidades de sé desenvolver programas educacionales que esclarezcan lo que son errores de medicación, discutiendo escenarios para entender las causas del problema con propuestas de mejoría.Notifying medication errors is an important instrument in managing assistance quality and safety for the patient. The objective of this study was to verify with the nursing team their understanding that a medication error had been committed, and to observe how they notified responsible physicians of the event. To

  19. Medication errors in anesthesia: unacceptable or unavoidable?

    Directory of Open Access Journals (Sweden)

    Ira Dhawan

    Full Text Available Abstract Medication errors are the common causes of patient morbidity and mortality. It adds financial burden to the institution as well. Though the impact varies from no harm to serious adverse effects including death, it needs attention on priority basis since medication errors' are preventable. In today's world where people are aware and medical claims are on the hike, it is of utmost priority that we curb this issue. Individual effort to decrease medication error alone might not be successful until a change in the existing protocols and system is incorporated. Often drug errors that occur cannot be reversed. The best way to ‘treat' drug errors is to prevent them. Wrong medication (due to syringe swap, overdose (due to misunderstanding or preconception of the dose, pump misuse and dilution error, incorrect administration route, under dosing and omission are common causes of medication error that occur perioperatively. Drug omission and calculation mistakes occur commonly in ICU. Medication errors can occur perioperatively either during preparation, administration or record keeping. Numerous human and system errors can be blamed for occurrence of medication errors. The need of the hour is to stop the blame - game, accept mistakes and develop a safe and ‘just' culture in order to prevent medication errors. The newly devised systems like VEINROM, a fluid delivery system is a novel approach in preventing drug errors due to most commonly used medications in anesthesia. Similar developments along with vigilant doctors, safe workplace culture and organizational support all together can help prevent these errors.

  20. [Medication errors in anesthesia: unacceptable or unavoidable?

    Science.gov (United States)

    Dhawan, Ira; Tewari, Anurag; Sehgal, Sankalp; Sinha, Ashish Chandra

    Medication errors are the common causes of patient morbidity and mortality. It adds financial burden to the institution as well. Though the impact varies from no harm to serious adverse effects including death, it needs attention on priority basis since medication errors' are preventable. In today's world where people are aware and medical claims are on the hike, it is of utmost priority that we curb this issue. Individual effort to decrease medication error alone might not be successful until a change in the existing protocols and system is incorporated. Often drug errors that occur cannot be reversed. The best way to 'treat' drug errors is to prevent them. Wrong medication (due to syringe swap), overdose (due to misunderstanding or preconception of the dose, pump misuse and dilution error), incorrect administration route, under dosing and omission are common causes of medication error that occur perioperatively. Drug omission and calculation mistakes occur commonly in ICU. Medication errors can occur perioperatively either during preparation, administration or record keeping. Numerous human and system errors can be blamed for occurrence of medication errors. The need of the hour is to stop the blame - game, accept mistakes and develop a safe and 'just' culture in order to prevent medication errors. The newly devised systems like VEINROM, a fluid delivery system is a novel approach in preventing drug errors due to most commonly used medications in anesthesia. Similar developments along with vigilant doctors, safe workplace culture and organizational support all together can help prevent these errors. Copyright © 2016. Publicado por Elsevier Editora Ltda.

  1. Medication errors in anesthesia: unacceptable or unavoidable?

    Science.gov (United States)

    Dhawan, Ira; Tewari, Anurag; Sehgal, Sankalp; Sinha, Ashish Chandra

    Medication errors are the common causes of patient morbidity and mortality. It adds financial burden to the institution as well. Though the impact varies from no harm to serious adverse effects including death, it needs attention on priority basis since medication errors' are preventable. In today's world where people are aware and medical claims are on the hike, it is of utmost priority that we curb this issue. Individual effort to decrease medication error alone might not be successful until a change in the existing protocols and system is incorporated. Often drug errors that occur cannot be reversed. The best way to 'treat' drug errors is to prevent them. Wrong medication (due to syringe swap), overdose (due to misunderstanding or preconception of the dose, pump misuse and dilution error), incorrect administration route, under dosing and omission are common causes of medication error that occur perioperatively. Drug omission and calculation mistakes occur commonly in ICU. Medication errors can occur perioperatively either during preparation, administration or record keeping. Numerous human and system errors can be blamed for occurrence of medication errors. The need of the hour is to stop the blame - game, accept mistakes and develop a safe and 'just' culture in order to prevent medication errors. The newly devised systems like VEINROM, a fluid delivery system is a novel approach in preventing drug errors due to most commonly used medications in anesthesia. Similar developments along with vigilant doctors, safe workplace culture and organizational support all together can help prevent these errors. Copyright © 2016. Published by Elsevier Editora Ltda.

  2. 应用品管圈降低住院患者给药差错发生率的探索%The effect of Quality Control Circle on reducing hospitalized patients' medication errors

    Institute of Scientific and Technical Information of China (English)

    贡浩凌

    2013-01-01

    目的:降低住院患者给药差错发生率,促进患者用药安全.方法:按品管圈理论的步骤进行计划、实施、确认和处置,分析导致住院患者给药差错发生的真因,探讨解决对策并实施,进行效果评价.结果:住院患者给药差错发生率由活动前的1.54‰降低至活动后的0.76‰,差异有统计学意义(P<0.01).结论:品管圈活动可有效改进给药护理质量,降低给药差错发生率,从而保证患者用药安全和治疗效果.%Objectives:To reduce the hospitalized patients' medication errors and to promote medication safety.Methods:According to ten steps of Quality Control Circle (QCC) theory,We applied planning,implementation,verification and disposal to analyze the real causes of hospitalized patients' medication errors,to probe and implement countermeasures,and to evaluate the effects.Results:The incidence of medication errors was decreased from 1.54‰ before QCC activity in 2011 to 0.76‰ after QCC activity in 2012 (P<0.01).Conclusion:The QCC activities could effectively improve the medication nursing quality,reduce medication errors,and ensure medication safety and therapeutic effect of hospitalized patients.

  3. A proposal for monitoring patients with heart failure via "smart phone technology"-based electrocardiograms.

    Science.gov (United States)

    Madias, John E

    2016-01-01

    The ubiquitous smart phone/device technology (SPT) has enabled the safe acquisition/transmission (A/T) of clinical and laboratory patient data, including the electrocardiogram (ECG). SPT-based A/T of the ECG has been found useful in the detection of atrial fibrillation, in monitoring of the QTc interval, in patients undergoing antiarrhythmic drug loading, and in management of patients with acute ST-elevation myocardial infarction. Previous work has shown a relationship between changes in the voltage of the ECG QRS complexes, with perturbations in the edematous state of various etiologies, including heart failure (HF). It is proposed herein to employ serially SPT-based 3-lead ECG A/T for the monitoring and management of patients with HF in their ambient environment. The proposed method will enable patients with HF to acquire/transmit their 3-lead ECG to the caring HF team, using only their smart phone and it takes into consideration the advanced degrees of physical incapacitation and age-related infirmities inherent to the HF population. Copyright © 2016 Elsevier Inc. All rights reserved.

  4. Information and communication technologies for better patient self-management and self-efficacy.

    Science.gov (United States)

    Ilioudi, Stamatia; Lazakidou, Athina; Tsironi, Maria

    2010-01-01

    Achieving benefits from the introduction of ICTs as part of processes aimed at building sustainable self-efficacy and self-management is very difficult, not least because of a desire to avoid simply replacing patient dependency on health professionals with dependency on technology. Chronic illnesses require ongoing attention that differs from traditional, encounter-based care for acute illnesses. Patients with chronic illnesses such as asthma, cardiovascular disease, depression, diabetes, heart failure and migraine headaches play a central role in managing the broad array of factors that contribute to their health. Individuals with diabetes, for example, provide close to 95% of their own care. Self-efficacy is enhanced when patients succeed in solving patient-identified problems. Patients with chronic conditions make day-to-day decisions about - self-manage - their illnesses. The paper highlights that in deploying ICTs, it is important to ensure that solutions implemented are based on a detailed understanding of users, their needs and complex interactions with health professionals, the health system and their wider environment.

  5. Sustainability of Endovenous Iron Deficiency Anaemia Treatment: Hospital-Based Health Technology Assessment in IBD Patients

    Directory of Open Access Journals (Sweden)

    A. Poscia

    2017-01-01

    Full Text Available Iron deficiency anaemia (IDA is the main extraintestinal manifestation affecting patients with inflammatory bowel disease (IBD. The Health Technology Assessment approach was applied to evaluate the sustainability of intravenous (IV iron formulations in the Italian hospital setting, with particular focus on ferric carboxymaltose. Data on the epidemiology of IBD and associated IDA, in addition to the efficacy and safety of IV iron formulations currently used in Italy, were retrieved from scientific literature. A hospital-based cost-analysis of the outpatient delivery of IV iron treatments was performed. Organizational and ethical implications were discussed. IDA prevalence in IBD patients varies markedly from 9 to 73%. IV iron preparations were proven to have good efficacy and safety profiles, and ferric carboxymaltose provided a fast correction of haemoglobin and serum ferritin levels in iron-deficient patients. Despite a higher price, ferric carboxymaltose would confer a beneficial effect to the hospital, in terms of reduced cost related to individual patient management and additionally to the patient by reducing the number of infusions and admissions to healthcare facilities. Ethically, the evaluation is appropriate due to its efficacy and compliance. This assessment supports the introduction of ferric carboxymaltose in the Italian outpatient setting.

  6. A comparative review of patient safety initiatives for national health information technology

    DEFF Research Database (Denmark)

    Magrabi, Farah; Aarts, Jos; Nøhr, Christian

    2013-01-01

    by searching the websites of regional and national agencies and programmes in a non-exhaustive set of exemplar countries including England, Denmark, the Netherlands, the USA, Canada and Australia. Initiatives were categorised by type and software systems covered. RESULTS: We found 27 patient safety initiatives...... regulations in some countries, the safety of the most common types of HIT systems such as EHRs and CPOE without decision support is not being explicitly addressed in most nations. Appropriate mechanisms for safety assurance are required for the full range of HIT systems for health professionals and consumers......OBJECTIVE: To collect and critically review patient safety initiatives for health information technology (HIT). METHOD: Publicly promulgated set of advisories, recommendations, guidelines, or standards potentially addressing safe system design, build, implementation or use were identified...

  7. Multilayer flow modulator stent technology: a treatment revolution for US patients?

    Science.gov (United States)

    Sultan, Sherif; Hynes, Niamh

    2015-05-01

    Thoracoabdominal aortic repair is a high-risk procedure in most experienced centers, not only because of anatomical complexity but also due to the fragility of the patients in whom these aneurysms occur. Such repairs are complex, time-consuming and impose a systemic injury upon the patients, regardless of whether the repair is performed by open surgery or via a fenestrated/branched technique. The substantive risks associated with such repairs include death, dialysis and paralysis. The multilayer flow modulator (MFM) is a disruptive technology which promises a minimally invasive reproducible treatment option, with clinical results demonstrating physiological modulation of the aortic sac with abolition of spinal injury. The mode of action of MFM forces us to completely rethink aneurysm pathogenesis and, consequently, it has been met with much cynicism. We aim to uncloak some of the mystery surrounding the MFM, clarify its mode of action and explore the truth behind its clinical effectiveness.

  8. Uncorrected refractive errors

    Directory of Open Access Journals (Sweden)

    Kovin S Naidoo

    2012-01-01

    Full Text Available Global estimates indicate that more than 2.3 billion people in the world suffer from poor vision due to refractive error; of which 670 million people are considered visually impaired because they do not have access to corrective treatment. Refractive errors, if uncorrected, results in an impaired quality of life for millions of people worldwide, irrespective of their age, sex and ethnicity. Over the past decade, a series of studies using a survey methodology, referred to as Refractive Error Study in Children (RESC, were performed in populations with different ethnic origins and cultural settings. These studies confirmed that the prevalence of uncorrected refractive errors is considerably high for children in low-and-middle-income countries. Furthermore, uncorrected refractive error has been noted to have extensive social and economic impacts, such as limiting educational and employment opportunities of economically active persons, healthy individuals and communities. The key public health challenges presented by uncorrected refractive errors, the leading cause of vision impairment across the world, require urgent attention. To address these issues, it is critical to focus on the development of human resources and sustainable methods of service delivery. This paper discusses three core pillars to addressing the challenges posed by uncorrected refractive errors: Human Resource (HR Development, Service Development and Social Entrepreneurship.

  9. Uncorrected refractive errors.

    Science.gov (United States)

    Naidoo, Kovin S; Jaggernath, Jyoti

    2012-01-01

    Global estimates indicate that more than 2.3 billion people in the world suffer from poor vision due to refractive error; of which 670 million people are considered visually impaired because they do not have access to corrective treatment. Refractive errors, if uncorrected, results in an impaired quality of life for millions of people worldwide, irrespective of their age, sex and ethnicity. Over the past decade, a series of studies using a survey methodology, referred to as Refractive Error Study in Children (RESC), were performed in populations with different ethnic origins and cultural settings. These studies confirmed that the prevalence of uncorrected refractive errors is considerably high for children in low-and-middle-income countries. Furthermore, uncorrected refractive error has been noted to have extensive social and economic impacts, such as limiting educational and employment opportunities of economically active persons, healthy individuals and communities. The key public health challenges presented by uncorrected refractive errors, the leading cause of vision impairment across the world, require urgent attention. To address these issues, it is critical to focus on the development of human resources and sustainable methods of service delivery. This paper discusses three core pillars to addressing the challenges posed by uncorrected refractive errors: Human Resource (HR) Development, Service Development and Social Entrepreneurship.

  10. Errors in Radiologic Reporting

    Directory of Open Access Journals (Sweden)

    Esmaeel Shokrollahi

    2010-05-01

    Full Text Available Given that the report is a professional document and bears the associated responsibilities, all of the radiologist's errors appear in it, either directly or indirectly. It is not easy to distinguish and classify the mistakes made when a report is prepared, because in most cases the errors are complex and attributable to more than one cause and because many errors depend on the individual radiologists' professional, behavioral and psychological traits."nIn fact, anyone can make a mistake, but some radiologists make more mistakes, and some types of mistakes are predictable to some extent."nReporting errors can be categorized differently:"nUniversal vs. individual"nHuman related vs. system related"nPerceptive vs. cognitive errors"n1. Descriptive "n2. Interpretative "n3. Decision related Perceptive errors"n1. False positive "n2. False negative"n Nonidentification "n Erroneous identification "nCognitive errors "n Knowledge-based"n Psychological  

  11. Errors in neuroradiology.

    Science.gov (United States)

    Caranci, Ferdinando; Tedeschi, Enrico; Leone, Giuseppe; Reginelli, Alfonso; Gatta, Gianluca; Pinto, Antonio; Squillaci, Ettore; Briganti, Francesco; Brunese, Luca

    2015-09-01

    Approximately 4 % of radiologic interpretation in daily practice contains errors and discrepancies that should occur in 2-20 % of reports. Fortunately, most of them are minor degree errors, or if serious, are found and corrected with sufficient promptness; obviously, diagnostic errors become critical when misinterpretation or misidentification should significantly delay medical or surgical treatments. Errors can be summarized into four main categories: observer errors, errors in interpretation, failure to suggest the next appropriate procedure, failure to communicate in a timely and a clinically appropriate manner. Misdiagnosis/misinterpretation percentage should rise up in emergency setting and in the first moments of the learning curve, as in residency. Para-physiological and pathological pitfalls in neuroradiology include calcification and brain stones, pseudofractures, and enlargement of subarachnoid or epidural spaces, ventricular system abnormalities, vascular system abnormalities, intracranial lesions or pseudolesions, and finally neuroradiological emergencies. In order to minimize the possibility of error, it is important to be aware of various presentations of pathology, obtain clinical information, know current practice guidelines, review after interpreting a diagnostic study, suggest follow-up studies when appropriate, communicate significant abnormal findings appropriately and in a timely fashion directly with the treatment team.

  12. Study of Errors among Nursing Students

    Directory of Open Access Journals (Sweden)

    Ella Koren

    2007-09-01

    Full Text Available The study of errors in the health system today is a topic of considerable interest aimed at reducing errors through analysis of the phenomenon and the conclusions reached. Errors that occur frequently among health professionals have also been observed among nursing students. True, in most cases they are actually “near errors,” but these could be a future indicator of therapeutic reality and the effect of nurses' work environment on their personal performance. There are two different approaches to such errors: (a The EPP (error prone person approach lays full responsibility at the door of the individual involved in the error, whether a student, nurse, doctor, or pharmacist. According to this approach, handling consists purely in identifying and penalizing the guilty party. (b The EPE (error prone environment approach emphasizes the environment as a primary contributory factor to errors. The environment as an abstract concept includes components and processes of interpersonal communications, work relations, human engineering, workload, pressures, technical apparatus, and new technologies. The objective of the present study was to examine the role played by factors in and components of personal performance as compared to elements and features of the environment. The study was based on both of the aforementioned approaches, which, when combined, enable a comprehensive understanding of the phenomenon of errors among the student population as well as a comparison of factors contributing to human error and to error deriving from the environment. The theoretical basis of the study was a model that combined both approaches: one focusing on the individual and his or her personal performance and the other focusing on the work environment. The findings emphasize the work environment of health professionals as an EPE. However, errors could have been avoided by means of strict adherence to practical procedures. The authors examined error events in the

  13. [Innovative patient access schemes for the adoption of new technology: risk-sharing agreements].

    Science.gov (United States)

    Espín, Jaime; Oliva, Juan; Rodríguez-Barrios, José Manuel

    2010-01-01

    The incorporation of new treatments, procedures and technologies into the services' portfolio of healthcare providers should aim to improve three areas equally: patient access to innovative solutions, the sustainability of the health system and compensation for innovation. However, traditional schemes based on fixed prices that fail to consider the product's appropriate use or its results in terms of effectiveness may lead to inefficient decision-making processes. Recently, risk-sharing agreements have appeared as new access schemes based on results that aim to reduce the uncertainty of the distinct health care players involved in reaching an agreement on new health technology financing and conditions of use. Key elements in the debate on these instruments are the huge variety of instruments available (especially those based on results), the implications for different players involved in their design and supervision, and their possible implementation in Spain. Our main conclusion is that risk-sharing agreements should be used in highly limited cases when standard conditions of access cannot be applied due to uncertainty about long-term effectiveness. These measures are aimed not only at regulating price but also at acting on the appropriate use of new technology. However, because international experience is limited, drawing a solid conclusion on the final results of the application of risk-sharing agreements would be premature. Copyright © 2010 SESPAS. Published by Elsevier Espana. All rights reserved.

  14. Possibilities of technologies that replace in-patient facilities in uroandrology

    Directory of Open Access Journals (Sweden)

    T. I. Derevyanko

    2015-01-01

    Full Text Available One of the main directions in improvement of medical service became invasion of stationary substitute technologies. In Stavropol since 2007 has been organized the Men, s health protection service based on Regional clinical specialized uroandrological center. In uroandrological short stay surgical department successfully provides treatment in all forms of male genital in children and adult pathology with using minimally invasive methodics in short stay conditions and absence postsurgical complications. The operation rooms are staffed with all necessary equipment for carry out activities in full volume. All patients treated in urological department had sorted by anaesthesiological and somatic criterias.The main strategical directions are male reproductive health, pediatric urology-andrology, oncouroandrology. Human resources, high technology staff and intelligent work organization are fundamental for modern stationary substitute service. Human resource conception is urologist-andrologist – urologist – surgeon with laparoscopic, transurethral, microsurgery, reconstructive and plastic technique with endocrinology and psychiatric skills.Work indicators of medical center tells about high effectiveness and possibility of release profile urological beds for “big” surgical help and transfer male genital surgery on stationary substitute technologies.

  15. The influence of assistive technology on occupational performance and satisfaction of leprosy patients with grade 2 disabilities

    Directory of Open Access Journals (Sweden)

    Lucas da Silva Muniz

    Full Text Available Abstract INTRODUCTION: We aimed to investigate the feasibility of assistive technology (AT devices to improve leprosy patients' occupational performances and satisfaction. METHODS: This is a pretest-posttest design study. The Canadian Occupational Performance Measure was used to assess the occupational performance and satisfaction of five leprosy participants with grade 2 disabilities before and after ten 45-minute interventions using assistive technology devices. RESULTS: The data showed a statistically significant 7-point average improvement (p<0.05 in participants' post-intervention performance and satisfaction scores. CONCLUSIONS: Assistive technology devices may be useful therapeutic tools to enhance autonomy/independence and satisfaction of leprosy patients with grade 2 disabilities.

  16. Impact of Hearing Aid Technology on Outcomes in Daily Life I: The Patients' Perspective.

    Science.gov (United States)

    Cox, Robyn M; Johnson, Jani A; Xu, Jingjing

    2016-01-01

    difference in outcomes between premium- and basic-feature devices. Participants did not report better outcomes with premium processing with any measure. It could reasonably be asserted that the patient's perspective is the gold standard for hearing aid effectiveness. While the acoustical processing provided by premium features can potentially improve scores on tests conducted in contrived conditions in a laboratory, or on specific items in a questionnaire, this does not ensure that the processing will be of noteworthy benefit when the hearing aid is used in the real world challenges faced by the patient. If evidence suggests the patient cannot detect that premium features yield improvements over basic features in daily life, what is the responsibility of the provider in recommending hearing aid technology level? In the present research, there was no evidence to suggest that premium-feature devices yielded better outcomes than basic-feature devices from the patient's point of view. All of the research hearing aids were substantially, but equally, helpful. Further research is needed on this topic with other hearing aids and other manufacturers. In the meantime, providers should insist on scientifically credible independent evidence to support effectiveness claims for any hearing help devices.

  17. Enhancing Lay Counselor Capacity to Improve Patient Outcomes with Multimedia Technology.

    Science.gov (United States)

    Robbins, Reuben N; Mellins, Claude A; Leu, Cheng-Shiun; Rowe, Jessica; Warne, Patricia; Abrams, Elaine J; Witte, Susan; Stein, Dan J; Remien, Robert H

    2015-06-01

    Multimedia technologies offer powerful tools to increase capacity of health workers to deliver standardized, effective, and engaging antiretroviral medication adherence counseling. Masivukeni-is an innovative multimedia-based, computer-driven, lay counselor-delivered intervention designed to help people living with HIV in resource-limited settings achieve optimal adherence. This pilot study examined medication adherence and key psychosocial outcomes among 55 non-adherent South African HIV+ patients, on antiretroviral therapy (ART) for at least 6 months, who were randomized to receive either Masivukeni or standard of care (SOC) counseling for ART non-adherence. At baseline, there were no significant differences between the SOC and Masivukeni groups on any outcome variables. At post-intervention (approximately 5-6 weeks after baseline), -clinic-based pill count adherence data available for 20 participants (10 per intervention arm) showed a 10 % improvement for-participants and a decrease of 8 % for SOC participants. Masivukeni participants reported significantly more positive attitudes towards disclosure and medication social support, less social rejection, and better clinic-patient relationships than did SOC participants. Masivukeni shows promise to promote optimal adherence and provides preliminary evidence that multimedia, computer-based technology can help lay counselors offer better adherence counseling than standard approaches.

  18. Web versus app: compliance of patients in a telehealth diabetes management programme using two different technologies.

    Science.gov (United States)

    Schreier, Günter; Eckmann, Harald; Hayn, Dieter; Kreiner, Karl; Kastner, Peter; Lovell, Nigel

    2012-12-01

    Patients with diabetes were enrolled into a telemonitoring programme. They were offered the choice of collecting their health data either by using Near Field Communication (NFC) enabled mobile phones equipped with a dedicated application (App), or by means of a web-browser based user interface (Web). At the end of the study, each patient was categorized as belonging to either the App or Web group, based on the proportion of data they had transmitted using each method. Of the 403 patients, there were 291 in the App group and 112 in the Web group. The two groups were similar in their demographics, except for gender distribution where 68% of men preferred using the App method in contrast to 95% for women (P < 0.001). Kaplan-Meier analysis showed a steady decline of the compliance rate for both groups, at a similar rate during the first year. It also showed a more rapid decline of the compliance rate thereafter for the Web group, which resulted in a significantly higher rate for the App group over the whole observation period (P = 0.03). We conclude that different types of data acquisition technologies may have an important effect on patients' willingness to participate in telehealth programmes in the long-term.

  19. Use of mobile technologies in patients with psychosis: A systematic review.

    Science.gov (United States)

    Bonet, Lucia; Izquierdo, Clara; Escartí, Maria Jose; Sancho, José Vicente; Arce, David; Blanquer, Ignacio; Sanjuan, Julio

    There is a growing interest in mobile Health interventions (m-Health) in patients with psychosis. The aim of this study is to conduct a systematic review in order to analysethe current state of research in this area. The search of articles was carried out following the PRISMA criteria, focusing on those studies that used mobile technologies in patients with psychosis during the period from 1990 to 2016. A total of 20 articles were selected from the 431 studies found. Three types of studies are distinguished: 1) Analysis of quality and usability, 2) Improving treatment adherence and reducing hospital admissions, and 3) Analysisof patient symptoms. m-Health interventions are feasible, and are easy to use for patients with psychosis. They evaluate the evolution of psychotic symptoms more efficiently, and improve adherence to treatment, as well as symptoms and hospital admissions. However, a particular strategy does not stand out over the rest, because differences in methodology make them difficult to compare. Copyright © 2017 SEP y SEPB. Publicado por Elsevier España, S.L.U. All rights reserved.

  20. Serum Protein Fingerprint of Patients with Pancreatic Cancer by SELDI Technology

    Institute of Scientific and Technical Information of China (English)

    MA Ning; GE Chun-lin; LUAN Feng-ming; YAO Dian-bo; HU Chao-jun; LI Ning; LIU Yong-feng

    2008-01-01

    Objective:To study the serum protein fingerprint of patients with pancreatic cancer and to screen for protein molecules closely related to pancreatic cancer during the onset and progression of the disease using surface-enhanced laser desorption and ionization time of fight mass spectrometry(SELDI-TOF-MS).Methods:Serum samples from 20 pancreatic cancers,20 healthy volunteers and 18 patients with other pancreatic diseases.WCX magnetic beans and PBSII-C protein chips reader(Ciphergen Biosystems Ins.)were used.The protein fingerprint expression of all the Serum samples and the resulting profiles between cancer and normal were analyzed with Biomarker Wizard system.Results:A group of proteomic peaks were detected.Four differently expressed potential biomarkers were identified with the relative molecular weights of 5705 Da,4935 Da,5318 Da and 3243 Da.Among them,two proteins with m/z5705,5318Da down-regulated,and two proteins with m/z 4935,3243 Da were up-regulated in pancreatic cancers.Conclusion:SELDI technology can be used to screen significant proteins of differential expression in the serum of pancreatic cancer patients.These different proteins could be specific biomarkers of the patients with pancreatic cancer in the serum and have the potential value of further investigation.

  1. Improving patient outcomes with technology and social media in paediatric diabetes.

    Science.gov (United States)

    Ng, Sze May

    2015-01-01

    The UK has the highest number of children and young people with diagnosed Type 1 diabetes mellitus (T1DM) in Europe, but the lowest numbers attaining good diabetes control (1, 2). Novel strategies and incorporation of digital strategies were identified in the team for development to improve overall patient care and outcomes in our population of children and young people with T1DM. Within a dual-site integrated care organisation, 3 digital initiatives were proposed from 2012-2013 to 1) establish Facebook communications with parents/patients, 2) to implement an electronic diabetes information management system (using Twinkle.Net) and 3) to undertake routine uploading of blood glucose meters and insulin pumps (using DIASEND®) with the aim to improve outcomes in paediatric diabetes care. Key objectives for the three initiatives were aimed to optimise the following outcomes: • Reduce HbA1c levels • Decrease emergency admissions, reduce diabetes-related complications and minimise the length of hospital stays • Improve patient satisfaction and communication • Improve efficiencies with mandatory audit submissions • Empower patients, parents, and the multidisciplicnary team with accurate, real-time information. These digital initiatives showed effective use of technology and social media in achieving significant improvements in all the outcomes within the objectives.

  2. Families, nurses and organisations contributing factors to medication administration error in paediatrics: a literature review

    Directory of Open Access Journals (Sweden)

    Albara Alomari

    2015-05-01

    Full Text Available Background: Medication error is the most common adverse event for hospitalised children and can lead to significant harm. Despite decades of research and implementation of a number of initiatives, the error rates continue to rise, particularly those associated with administration. Objectives: The objective of this literature review is to explore the factors involving nurses, families and healthcare systems that impact on medication administration errors in paediatric patients. Design: A review was undertaken of studies that reported on factors that contribute to a rise or fall in medication administration errors, from family, nurse and organisational perspectives. The following databases were searched: Medline, Embase, CINAHL and the Cochrane library. The title, abstract and full article were reviewed for relevance. Articles were excluded if they were not research studies, they related to medications and not medication administration errors or they referred to medical errors rather than medication errors. Results: A total of 15 studies met the inclusion criteria. The factors contributing to medication administration errors are communication failure between the parents and healthcare professionals, nurse workload, failure to adhere to policy and guidelines, interruptions, inexperience and insufficient nurse education from organisations. Strategies that were reported to reduce errors were doublechecking by two nurses, implementing educational sessions, use of computerised prescribing and barcoding administration systems. Yet despite such interventions, errors persist. The review highlighted families that have a central role in caring for the child and therefore are key to the administration process, but have largely been ignored in research studies relating to medication administration. Conclusions: While there is a consensus about the factors that contribute to errors, sustainable and effective solutions remain elusive. To date, families have not

  3. Evaluation of drug administration errors in a teaching hospital.

    Science.gov (United States)

    Berdot, Sarah; Sabatier, Brigitte; Gillaizeau, Florence; Caruba, Thibaut; Prognon, Patrice; Durieux, Pierre

    2012-03-12

    Medication errors can occur at any of the three steps of the medication use process: prescribing, dispensing and administration. We aimed to determine the incidence, type and clinical importance of drug administration errors and to identify risk factors. Prospective study based on disguised observation technique in four wards in a teaching hospital in Paris, France (800 beds). A pharmacist accompanied nurses and witnessed the preparation and administration of drugs to all patients during the three drug rounds on each of six days per ward. Main outcomes were number, type and clinical importance of errors and associated risk factors. Drug administration error rate was calculated with and without wrong time errors. Relationship between the occurrence of errors and potential risk factors were investigated using logistic regression models with random effects. Twenty-eight nurses caring for 108 patients were observed. Among 1501 opportunities for error, 415 administrations (430 errors) with one or more errors were detected (27.6%). There were 312 wrong time errors, ten simultaneously with another type of error, resulting in an error rate without wrong time error of 7.5% (113/1501). The most frequently administered drugs were the cardiovascular drugs (425/1501, 28.3%). The highest risks of error in a drug administration were for dermatological drugs. No potentially life-threatening errors were witnessed and 6% of errors were classified as having a serious or significant impact on patients (mainly omission). In multivariate analysis, the occurrence of errors was associated with drug administration route, drug classification (ATC) and the number of patient under the nurse's care. Medication administration errors are frequent. The identification of its determinants helps to undertake designed interventions.

  4. Evaluation of drug administration errors in a teaching hospital

    Directory of Open Access Journals (Sweden)

    Berdot Sarah

    2012-03-01

    Full Text Available Abstract Background Medication errors can occur at any of the three steps of the medication use process: prescribing, dispensing and administration. We aimed to determine the incidence, type and clinical importance of drug administration errors and to identify risk factors. Methods Prospective study based on disguised observation technique in four wards in a teaching hospital in Paris, France (800 beds. A pharmacist accompanied nurses and witnessed the preparation and administration of drugs to all patients during the three drug rounds on each of six days per ward. Main outcomes were number, type and clinical importance of errors and associated risk factors. Drug administration error rate was calculated with and without wrong time errors. Relationship between the occurrence of errors and potential risk factors were investigated using logistic regression models with random effects. Results Twenty-eight nurses caring for 108 patients were observed. Among 1501 opportunities for error, 415 administrations (430 errors with one or more errors were detected (27.6%. There were 312 wrong time errors, ten simultaneously with another type of error, resulting in an error rate without wrong time error of 7.5% (113/1501. The most frequently administered drugs were the cardiovascular drugs (425/1501, 28.3%. The highest risks of error in a drug administration were for dermatological drugs. No potentially life-threatening errors were witnessed and 6% of errors were classified as having a serious or significant impact on patients (mainly omission. In multivariate analysis, the occurrence of errors was associated with drug administration route, drug classification (ATC and the number of patient under the nurse's care. Conclusion Medication administration errors are frequent. The identification of its determinants helps to undertake designed interventions.

  5. 基于AJAX、JMX技术开发无差错传输设备Web网管系统%Based on AJAX, JMX Technology to Develop Error-free Transmission Device Web Network Management System

    Institute of Scientific and Technical Information of China (English)

    高建国; 戴海鸿; 傅永根

    2011-01-01

    探讨运用目前比较流行的AJAX( Asynchronous Java.Script and XML)、JMX(Java Management Extensions)、Comet(彗星)技术来设计无差错传输设备Web网络管理系统的方法以达到增强Web网管系统用户体验效果的目的.提出了一种将GWT-Ext、JMX、EJB3.0、JBoss Errai消息系统分别应用于网管系统的Web表现层、管理业务处理层、数据持久化层和实时告警功能设计的方案.给出了网管系统的结构以及具体的实现方法.按此方案设计出的系统具有用户界面美观、操作便捷、告警实时性强的特点,提升了用户使用Web网管系统的体验.%This paper discusses the method of designing Error-Free Transmission Device Web network management system by using the AJAX (Asynchronous JavaScript and XML) ,JMX (Java Management Extensions), Comet technology in order to achieve enhanced user experience. The paper proposes a scheme which uses GWT-Ext,JMX,EJB3.0,and Jboss Errai message system to design the Web presentation layer,network management business process layer,data persistence layer,and real-time alarm function for the network management system. It describes the structure of the network management system and the specific implementation. The system shows a good user interface, easy operation, real-time alarm strong features Improved the user experience using Web network management system.

  6. Understanding and Confronting Our Mistakes: The Epidemiology of Error in Radiology and Strategies for Error Reduction.

    Science.gov (United States)

    Bruno, Michael A; Walker, Eric A; Abujudeh, Hani H

    2015-10-01

    Arriving at a medical diagnosis is a highly complex process that is extremely error prone. Missed or delayed diagnoses often lead to patient harm and missed opportunities for treatment. Since medical imaging is a major contributor to the overall diagnostic process, it is also a major potential source of diagnostic error. Although some diagnoses may be missed because of the technical or physical limitations of the imaging modality, including image resolution, intrinsic or extrinsic contrast, and signal-to-noise ratio, most missed radiologic diagnoses are attributable to image interpretation errors by radiologists. Radiologic interpretation cannot be mechanized or automated; it is a human enterprise based on complex psychophysiologic and cognitive processes and is itself subject to a wide variety of error types, including perceptual errors (those in which an important abnormality is simply not seen on the images) and cognitive errors (those in which the abnormality is visually detected but the meaning or importance of the finding is not correctly understood or appreciated). The overall prevalence of radiologists' errors in practice does not appear to have changed since it was first estimated in the 1960s. The authors review the epidemiology of errors in diagnostic radiology, including a recently proposed taxonomy of radiologists' errors, as well as research findings, in an attempt to elucidate possible underlying causes of these errors. The authors also propose strategies for error reduction in radiology. On the basis of current understanding, specific suggestions are offered as to how radiologists can improve their performance in practice.

  7. Inpatients’ medical prescription errors

    Directory of Open Access Journals (Sweden)

    Aline Melo Santos Silva

    2009-09-01

    Full Text Available Objective: To identify and quantify the most frequent prescription errors in inpatients’ medical prescriptions. Methods: A survey of prescription errors was performed in the inpatients’ medical prescriptions, from July 2008 to May 2009 for eight hours a day. Rresults: At total of 3,931 prescriptions was analyzed and 362 (9.2% prescription errors were found, which involved the healthcare team as a whole. Among the 16 types of errors detected in prescription, the most frequent occurrences were lack of information, such as dose (66 cases, 18.2% and administration route (26 cases, 7.2%; 45 cases (12.4% of wrong transcriptions to the information system; 30 cases (8.3% of duplicate drugs; doses higher than recommended (24 events, 6.6% and 29 cases (8.0% of prescriptions with indication but not specifying allergy. Cconclusion: Medication errors are a reality at hospitals. All healthcare professionals are responsible for the identification and prevention of these errors, each one in his/her own area. The pharmacist is an essential professional in the drug therapy process. All hospital organizations need a pharmacist team responsible for medical prescription analyses before preparation, dispensation and administration of drugs to inpatients. This study showed that the pharmacist improves the inpatient’s safety and success of prescribed therapy.

  8. Toward an agent-based patient-physician model for the adoption of continuous glucose monitoring technology.

    Science.gov (United States)

    Verella, J Tipan; Patek, Stephen D

    2009-03-01

    Health care is a major component of the U.S. economy, and tremendous research and development efforts are directed toward new technologies in this arena. Unfortunately few tools exist for predicting outcomes associated with new medical products, including whether new technologies will find widespread use within the target population. Questions of technology adoption are rife within the diabetes technology community, and we particularly consider the long-term prognosis for continuous glucose monitoring (CGM) technology. We present an approach to the design and analysis of an agent model that describes the process of CGM adoption among patients with type 1 diabetes mellitus (T1DM), their physicians, and related stakeholders. We particularly focus on patient-physician interactions, with patients discovering CGM technology through word-of-mouth communication and through advertising, applying pressure to their physicians in the context of CGM device adoption, and physicians, concerned about liability, looking to peers for a general level of acceptance of the technology before recommending CGM to their patients. Repeated simulation trials of the agent-based model show that the adoption process reflects the heterogeneity of the adopting community. We also find that the effect of the interaction between patients and physicians is agents. Each physician, say colored by the nature of the environment as defined by the model parameters. We find that, by being able to represent the diverse perspectives of different types of stakeholders, agent-based models can offer useful insights into the adoption process. Models of this sort may eventually prove to be useful in helping physicians, other health care providers, patient advocacy groups, third party payers, and device manufacturers understand the impact of their decisions about new technologies.

  9. Novel X-ray image noise reduction technology reduces patient radiation dose while maintaining image quality in coronary angiography

    NARCIS (Netherlands)

    Cate, T.J. ten; Wely, M.H. van; Gehlmann, H.R.; Mauti, M.; Camaro, C.; Reifart, N.; Suryapranata, H.; Boer, M.J. de

    2015-01-01

    AIMS: The consequences of high radiation dose for patient and staff demand constant improvements in X-ray dose reduction technology. This study assessed non-inferiority of image quality and quantified patient dose reduction in interventional cardiology for an anatomy-specific optimised cine

  10. Toward a model for field-testing patient decision-support technologies : a qualitative field-testing study

    NARCIS (Netherlands)

    Evans, R.; Elwyn, G.; Edwards, A.; Watson, E.; Austoker, J.; Grol, R.P.T.M.

    2007-01-01

    BACKGROUND: Field-testing is a quality assurance criterion in the development of patient decision-support technologies (PDSTs), as identified in the consensus statement of the International Patient Decision Aids Standards Collaboration. We incorporated field-testing into the development of a Web-bas

  11. Information and communication technology in patient education and support for people with schizophrenia.

    Science.gov (United States)

    Välimäki, Maritta; Hätönen, Heli; Lahti, Mari; Kuosmanen, Lauri; Adams, Clive E

    2012-10-17

    Poor compliance with treatment often means that many people with schizophrenia or other severe mental illness relapse and may need frequent and repeated hospitalisation. Information and communication technology (ICT) is increasingly being used to deliver information, treatment or both for people with severe mental disorders. To evaluate the effects of psychoeducational interventions using ICT as a means of educating and supporting people with schizophrenia or related psychosis. We searched the Cochrane Schizophrenia Group Trials Register (2008, 2009 and September 2010), inspected references of identified studies for further trials and contacted authors of trials for additional information. All clinical randomised controlled trials (RCTs) comparing ICT as a psychoeducational and supportive tool with any other type of psychoeducation and supportive intervention or standard care. We selected trials and extracted data independently. For homogenous dichotomous data we calculated fixed-effect risk ratios (RR) with 95% confidence intervals (CI). For continuous data, we calculated mean differences (MD). We assessed risk of bias using the criteria described in the Cochrane Handbook for Systematic Reviews of Interventions. We included six trials with a total of 1063 participants. We found no significant differences in the primary outcomes (patient compliance and global state) between psychoeducational interventions using ICT and standard care.Technology-mediated psychoeducation improved mental state in the short term (n = 84, 1 RCT, RR 0.75, 95% CI 0.56 to 1.00; n = 30, 1 RCT, MD -0.51, 95% CI -0.90 to -0.12) but not global state (n = 84, 1 RCT, RR 1.07, 95% CI 0.82 to 1.42). Knowledge and insight were not effected (n = 84, 1 RCT, RR 0.89, 95% CI 0.68 to 1.15; n = 84, 1 RCT, RR 0.77, 95% CI 0.58 to 1.03). People allocated to technology-mediated psychoeducation perceived that they received more social support than people allocated to the standard care group (n = 30, 1 RCT, MD

  12. The high frequency of sperm aneuploidy in klinefelter patients and in nonobstructive azoospermia is due to meiotic errors in euploid spermatocytes.

    Science.gov (United States)

    Vialard, François; Bailly, Marc; Bouazzi, Habib; Albert, Martine; Pont, Jean Christophe; Mendes, Vanda; Bergere, Marianne; Gomes, Denise Molina; de Mazancourt, Philippe; Selva, Jacqueline

    2012-01-01

    For nonobstructive azoospermic (NOA) patients with a normal karyotype or for Klinefelter syndrome (47,XXY) patients, intracytoplasmic sperm injection is associated with an increased aneuploidy risk in offspring. We examined testicular cells from patients with different azoospermia etiologies to determine the origin of the aneuploid spermatozoa. The incidence of chromosome abnormalities was investigated in all types of azoospermia. Four study subgroups were constituted: Klinefelter patients (group 1), NOA patients with spermatogenesis failure but a normal karyotype (group 2), obstructive azoospermic patients with normal spermatogenesis (group 3), and control patients with normal sperm (group 4). The pachytene stage (in the three azoospermic groups) and postmeiotic cells (in all groups) were analyzed with fluorescence in situ hybridization. No aneuploid pachytene spermatocytes were observed. Postmeiotic aneuploidy rates were higher in the two groups with spermatogenesis failure (5.3% and 4.0% for groups 1 and 2, respectively) than in patients with normal spermatogenesis (0.6% for group 3 and group 4). Whatever the etiology of the azoospermia, the spermatozoa originated from euploid pachytene spermatocytes. These results strengthen the hypothesis whereby sperm aneuploidy in both Klinefelter patients and NOA patients with a normal karyotype results from meiotic abnormalities and not from aneuploid spermatocytes. The fact that sperm aneuploidy was more frequent when spermatogenesis was altered suggests a deleterious testicular environment. The study results also provide arguments for offering preimplantation genetic diagnosis or prenatal diagnosis when a pregnancy occurs for fathers with NOA (whatever the karyotype).

  13. Educating patients about warfarin therapy using information technology: A survey on healthcare professionals’ perspectives

    Directory of Open Access Journals (Sweden)

    Mullan J

    2012-06-01

    Full Text Available Objective: To explore healthcare professionals’ views about the benefits and challenges of using information technology (IT resources for educating patients about their warfarin therapy.Methods: A cross-sectional survey of both community and hospital-based healthcare professionals (e.g., doctors, pharmacists and nurses involved using a purpose-designed questionnaire. The questionnaires were distributed using a multi-modal approach to maximise response rates.Results: Of the total 300 questionnaires distributed, 109 completed surveys were received (43.3% response rate. Over half (53.2% of the healthcare participants were aged between 40-59 years, the majority (59.5% of whom were female. Fifty nine (54.1% participants reported having had no access to warfarin-specific IT-based patient education resources, and a further 19 (38.0% of the participants who had IT-access reported that they never used such resources. According to the healthcare participants, the main challenges associated with educating their patients about warfarin therapy included: patient-related factors, such as older age, language barriers, cognitive impairments and/or ethnic backgrounds or healthcare professional factors, such as time constraints. The healthcare professionals reported that there were several aspects about warfarin therapy which they found difficult to educate their patients about which is why they identified computers and interactive touch screen kiosks as preferred IT devices to deliver warfarin education resources in general practices, hospital-based clinics and community pharmacies. At the same time, the healthcare professionals also identified a number of facilitators (e.g., to reinforce warfarin education, to offer reliable and easily comprehensible information and barriers (e.g., time and costs of using IT resources, difficulty in operating the resources that could impact on the effective implementation of these devices in educating patients about their

  14. Error monitoring in musicians

    Directory of Open Access Journals (Sweden)

    Clemens eMaidhof

    2013-07-01

    Full Text Available To err is human, and hence even professional musicians make errors occasionally during their performances. This paper summarizes recent work investigating error monitoring in musicians, i.e. the processes and their neural correlates associated with the monitoring of ongoing actions and the detection of deviations from intended sounds. EEG Studies reported an early component of the event-related potential (ERP occurring before the onsets of pitch errors. This component, which can be altered in musicians with focal dystonia, likely reflects processes of error detection and/or error compensation, i.e. attempts to cancel the undesired sensory consequence (a wrong tone a musician is about to perceive. Thus, auditory feedback seems not to be a prerequisite for error detection, consistent with previous behavioral results. In contrast, when auditory feedback is externally manipulated and thus unexpected, motor performance can be severely distorted, although not all feedback alterations result in performance impairments. Recent studies investigating the neural correlates of feedback processing showed that unexpected feedback elicits an ERP component after note onsets, which shows larger amplitudes during music performance than during mere perception of the same musical sequences. Hence, these results stress the role of motor actions for the processing of auditory information. Furthermore, recent methodological advances like the combination of 3D motion capture techniques with EEG will be discussed. Such combinations of different measures can potentially help to disentangle the roles of different feedback types such as proprioceptive and auditory feedback, and in general to derive at a better understanding of the complex interactions between the motor and auditory domain during error monitoring. Finally, outstanding questions and future directions in this context will be discussed.

  15. Analyzing temozolomide medication errors: potentially fatal.

    Science.gov (United States)

    Letarte, Nathalie; Gabay, Michael P; Bressler, Linda R; Long, Katie E; Stachnik, Joan M; Villano, J Lee

    2014-10-01

    The EORTC-NCIC regimen for glioblastoma requires different dosing of temozolomide (TMZ) during radiation and maintenance therapy. This complexity is exacerbated by the availability of multiple TMZ capsule strengths. TMZ is an alkylating agent and the major toxicity of this class is dose-related myelosuppression. Inadvertent overdose can be fatal. The websites of the Institute for Safe Medication Practices (ISMP), and the Food and Drug Administration (FDA) MedWatch database were reviewed. We searched the MedWatch database for adverse events associated with TMZ and obtained all reports including hematologic toxicity submitted from 1st November 1997 to 30th May 2012. The ISMP describes errors with TMZ resulting from the positioning of information on the label of the commercial product. The strength and quantity of capsules on the label were in close proximity to each other, and this has been changed by the manufacturer. MedWatch identified 45 medication errors. Patient errors were the most common, accounting for 21 or 47% of errors, followed by dispensing errors, which accounted for 13 or 29%. Seven reports or 16% were errors in the prescribing of TMZ. Reported outcomes ranged from reversible hematological adverse events (13%), to hospitalization for other adverse events (13%) or death (18%). Four error reports lacked detail and could not be categorized. Although the FDA issued a warning in 2003 regarding fatal medication errors and the product label warns of overdosing, errors in TMZ dosing occur for various reasons and involve both healthcare professionals and patients. Overdosing errors can be fatal.

  16. Defining a roadmap for harmonizing quality indicators in Laboratory Medicine: a consensus statement on behalf of the IFCC Working Group "Laboratory Error and Patient Safety" and EFLM Task and Finish Group "Performance specifications for the extra-analytical phases".

    Science.gov (United States)

    Sciacovelli, Laura; Panteghini, Mauro; Lippi, Giuseppe; Sumarac, Zorica; Cadamuro, Janne; Galoro, César Alex De Olivera; Pino Castro, Isabel Garcia Del; Shcolnik, Wilson; Plebani, Mario

    2017-08-28

    The improving quality of laboratory testing requires a deep understanding of the many vulnerable steps involved in the total examination process (TEP), along with the identification of a hierarchy of risks and challenges that need to be addressed. From this perspective, the Working Group "Laboratory Errors and Patient Safety" (WG-LEPS) of International Federation of Clinical Chemistry and Laboratory Medicine (IFCC) is focusing its activity on implementation of an efficient tool for obtaining meaningful information on the risk of errors developing throughout the TEP, and for establishing reliable information about error frequencies and their distribution. More recently, the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) has created the Task and Finish Group "Performance specifications for the extra-analytical phases" (TFG-PSEP) for defining performance specifications for extra-analytical phases. Both the IFCC and EFLM groups are working to provide laboratories with a system to evaluate their performances and recognize the critical aspects where improvement actions are needed. A Consensus Conference was organized in Padova, Italy, in 2016 in order to bring together all the experts and interested parties to achieve a consensus for effective harmonization of quality indicators (QIs). A general agreement was achieved and the main outcomes have been the release of a new version of model of quality indicators (MQI), the approval of a criterion for establishing performance specifications and the definition of the type of information that should be provided within the report to the clinical laboratories participating to the QIs project.

  17. Unpredicted spontaneous extrusion of a renal calculus in an adult male with spina bifida and paraplegia: report of a misdiagnosis. Measures to be taken to reduce urological errors in spinal cord injury patients

    Directory of Open Access Journals (Sweden)

    Singh Gurpreet

    2001-12-01

    Full Text Available Abstract Background A delay in diagnosis or a misdiagnosis may occur in patients with spinal cord injury (SCI or spinal bifida as typical symptoms of a clinical condition may be absent because of their neurological impairment. Case presentation A 29-year old male, who was born with spina bifida and hydrocephalus, became unwell and developed a swelling and large red mark in his left loin eighteen months ago. Pyonephrosis or perinephric abscess was suspected. X-ray of the abdomen showed left-sided staghorn calculus. Since ultrasound scan showed no features of pyonephrosis or perinephric abscess, he was prescribed a prolonged course of antibiotics for infection presumed to arise from the site of metal implant in spine. He developed a discharging sinus, following which the loin swelling and red mark subsided. About three months ago, he again developed a red mark and minimal swelling in the left loin. Ultrasound scan detected no abnormality in the renal or perinephric region. Therefore, the red mark and swelling were attributed to pressure from the backrest of his chair. Five weeks later, the swelling in the left loin burst open and a large stone was extruded spontaneously. An X-ray of the abdomen showed that he had extruded the central portion of the staghorn calculus from left kidney. With hindsight, the extruded renal calculus could be seen lying in the subcutaneous tissue of left loin lateral to the 10th rib in the X-ray of abdomen, which was taken when he presented with red mark and minimal swelling. Conclusion This case illustrates how mistakes in diagnosis could occur in spinal cord injury patients, and highlights the need for corrective measures to reduce urological errors in these patients. Voluntary reporting of urological errors is recommended to facilitate learning from our mistakes. In the patients who have marked spinal curvature, ultrasonography of kidneys and perinephric region may not be entirely reliable. As clinical symptoms and

  18. Smoothing error pitfalls

    Science.gov (United States)

    von Clarmann, T.

    2014-09-01

    The difference due to the content of a priori information between a constrained retrieval and the true atmospheric state is usually represented by a diagnostic quantity called smoothing error. In this paper it is shown that, regardless of the usefulness of the smoothing error as a diagnostic tool in its own right, the concept of the smoothing error as a component of the retrieval error budget is questionable because it is not compliant with Gaussian error propagation. The reason for this is that the smoothing error does not represent the expected deviation of the retrieval from the true state but the expected deviation of the retrieval from the atmospheric state sampled on an arbitrary grid, which is itself a smoothed representation of the true state; in other words, to characterize the full loss of information with respect to the true atmosphere, the effect of the representation of the atmospheric state on a finite grid also needs to be considered. The idea of a sufficiently fine sampling of this reference atmospheric state is problematic because atmospheric variability occurs on all scales, implying that there is no limit beyond which the sampling is fine enough. Even the idealization of infinitesimally fine sampling of the reference state does not help, because the smoothing error is applied to quantities which are only defined in a statistical sense, which implies that a finite volume of sufficient spatial extent is needed to meaningfully discuss temperature or concentration. Smoothing differences, however, which play a role when measurements are compared, are still a useful quantity if the covariance matrix involved has been evaluated on the comparison grid rather than resulting from interpolation and if the averaging kernel matrices have been evaluated on a grid fine enough to capture all atmospheric variations that the instruments are sensitive to. This is, under the assumptions stated, because the undefined component of the smoothing error, which is the

  19. 肿瘤患者术中给药错误原因分析及预防对策%Analysis of Medication Errors and the Related Preventive Strategies during the Operation for Cancer Patients

    Institute of Scientific and Technical Information of China (English)

    曾丽萍; 李桂芳; 杨薇薇

    2012-01-01

    目的:分析肿瘤患者术中给药错误的原因并探讨解决的方法.方法:对34起手术室给药错误事件进行回顾性分析.结果:在给药错误发生的手术级别中,三级手术占58.8%,四级手术占35.3%;在给药错误的分类中,给药时间错误占44.1%,其次为遗漏给药占17.6%;在给药错误的药品种类中,抗生素给药造成的错误占73.5%;91.2%的给药错误未对患者造成伤害.在给药错误的人为因素中以人力不足和不遵守操作规程为主要原因,分别占61.8%和17.6%;给药错误的主要人群为工作年限5年以下的低年资护士,占76.5%.结论:加强术中给药管理,合理配备手术室护理人员.加强低年资护理人员用药相关知识和技能的培训以及责任心的培养和职业道德的教育,以减少给药错误事件的发生.%Objective; To analyze the causes and to explore the preventive ways of medication errors during the operation for cancer patients. Methods; Thirty-four cases of administering errors occurred in the operating room were retrospectively analyzed. Re-sults: Among the 34 cases, 58. 8% occurred in the third grade operations and 35. 3% in the fourth grade operations. As for the classification of theses errors, 44. 1% of the medicine was given in incorrect time, 17. 6% was the missed administrate ring. Antibiotics administrate ring errors accounted for 73. 5% of all errors; 91. 2% of the medication errors didn' t bring any harm to the patients. Under-staffing(61. 8% ) and disobeying of the operation procedures ( 17.1% ) were the main causes of human factors. Nurses with working experience fewer than 5 years accounted for 76. 5% of the crowds who made the medication administering errors. Conclusion; Medica- tion administering errors may be decreased by enhancing the medicineadministering managemetn during operation and improving the understaffing status in the hospital. The training of medication related basic knowledge-,skill and responsibility as

  20. Learning from Errors

    Directory of Open Access Journals (Sweden)

    MA. Lendita Kryeziu

    2015-06-01

    Full Text Available “Errare humanum est”, a well known and widespread Latin proverb which states that: to err is human, and that people make mistakes all the time. However, what counts is that people must learn from mistakes. On these grounds Steve Jobs stated: “Sometimes when you innovate, you make mistakes. It is best to admit them quickly, and get on with improving your other innovations.” Similarly, in learning new language, learners make mistakes, thus it is important to accept them, learn from them, discover the reason why they make them, improve and move on. The significance of studying errors is described by Corder as: “There have always been two justifications proposed for the study of learners' errors: the pedagogical justification, namely that a good understanding of the nature of error is necessary before a systematic means of eradicating them could be found, and the theoretical justification, which claims that a study of learners' errors is part of the systematic study of the learners' language which is itself necessary to an understanding of the process of second language acquisition” (Corder, 1982; 1. Thus the importance and the aim of this paper is analyzing errors in the process of second language acquisition and the way we teachers can benefit from mistakes to help students improve themselves while giving the proper feedback.

  1. Error Correction in Classroom

    Institute of Scientific and Technical Information of China (English)

    Dr. Grace Zhang

    2000-01-01

    Error correction is an important issue in foreign language acquisition. This paper investigates how students feel about the way in which error correction should take place in a Chinese-as-a foreign-language classroom, based on empirical data of a large scale. The study shows that there is a general consensus that error correction is necessary. In terms of correction strategy, the students preferred a combination of direct and indirect corrections, or a direct only correction. The former choice indicates that students would be happy to take either so long as the correction gets done.Most students didn't mind peer correcting provided it is conducted in a constructive way. More than halfofthe students would feel uncomfortable ifthe same error they make in class is corrected consecutively more than three times. Taking these findings into consideration, we may want to cncourage peer correcting, use a combination of correction strategies (direct only if suitable) and do it in a non-threatening and sensitive way. It is hoped that this study would contribute to the effectiveness of error correction in a Chinese language classroom and it may also have a wider implication on other languages.

  2. Nursing student medication errors involving tubing and catheters: a descriptive study.

    Science.gov (United States)

    Wolf, Zane Robinson; Hicks, Rodney W; Altmiller, Geralyn; Bicknell, Patricia

    2009-08-01

    This retrospective case study examined reports (N=27) of medication errors made by nursing students involving tubing and catheter misconnections. Characteristics of misconnection errors included attributes of events recorded on MEDMARX error reports of the United States Pharmacopeia. Two near miss errors or Category B errors (medication error occurred, did not reach patient) were identified, with 21 Category C medication errors (occurred, with no resulting patient harm), and four Category D errors (need for increased patient monitoring, no patient harm) reported. Reported intravenous tubing errors were more frequent than other type of tubing errors and problems with clamps were present in 12 error reports. Registered nurses discovered most of the errors; some were implicated in the mistakes along with the students.

  3. Alcohol dependence and anxiety increase error-related brain activity

    NARCIS (Netherlands)

    Schellekens, A.F.A.; Bruijn, E.R.A. de; Lankveld, C.A.A. van; Hulstijn, W.; Buitelaar, J.K.; Jong, C.A.J. de; Verkes, R.J.

    2010-01-01

    Aims Detection of errors is crucial for efficient goal-directed behaviour. The ability to monitor behaviour is found to be diminished in patients with substance dependence, as reflected in decreased error-related brain activity, i.e. error-related negativity (ERN). The ERN is also decreased in other

  4. Learning from medication errors through a nationwide reporting programme

    NARCIS (Netherlands)

    Cheung, K.C.

    2015-01-01

    One of the strategies to enhance patient safety is the spontaneous reporting and analysis of medication errors. Sharing this information with other healthcare providers will help to prevent the reoccurrence of similar medication errors. In The Netherlands medication errors can be reported to a natio

  5. Alcohol dependence and anxiety increase error-related brain activity.

    NARCIS (Netherlands)

    Schellekens, A.F.A.; Bruijn, E.R. de; Lankveld, C.A. van; Hulstijn, W.; Buitelaar, J.K.; Jong, C.A.J. de; Verkes, R.J.

    2010-01-01

    AIMS: Detection of errors is crucial for efficient goal-directed behaviour. The ability to monitor behaviour is found to be diminished in patients with substance dependence, as reflected in decreased error-related brain activity, i.e. error-related negativity (ERN). The ERN is also decreased in othe

  6. A comparative review of patient safety initiatives for national health information technology

    DEFF Research Database (Denmark)

    Magrabi, Farah; Aarts, Jos; Nøhr, Christian

    2013-01-01

    OBJECTIVE: To collect and critically review patient safety initiatives for health information technology (HIT). METHOD: Publicly promulgated set of advisories, recommendations, guidelines, or standards potentially addressing safe system design, build, implementation or use were identified...... with blood bank and image management software which is regulated in the USA. Of the 16 initiatives directed at unregulated software, 11 were aimed at increasing standardisation using guidelines and standards for safe system design, build, implementation and use. Three initiatives for unregulated software...... were aimed at certification in the USA, Canada and Australia. Safety is addressed alongside interoperability in the Australian certification programme but it is not explicitly addressed in the US and Canadian programmes, though conformance with specific functionality, interoperability, security...

  7. Mobile teledermatology: As doctors and patients are increasingly mobile, technology keeps us connected.

    Science.gov (United States)

    Farshidi, Dina; Craft, Noah; Ochoa, Maria Teresa

    2011-01-01

    With advancements in electronics and health informatics, telemedicine has emerged as a cost-effective tool capable of increasing care to remote regions, facilitating specialist consults, supporting self-management by patients, and sharing knowledge over great distances. In this review, the authors discuss existing telemedicine modalities, highlight examples of mobile systems documented in the literature to date, and emphasize the data supporting the feasibility of telecommunication technologies to deliver dermatology services and education remotely. While many studies have suggested the potential for teledermatology to increase access to care in developing countries with few dermatologists, the authors share some of the most recent developments, including the use of diagnostic decision support software. The authors encourage a thriving and open network that will enhance the ongoing research and development of innovative and useful products. This network will also connect dermatologists willing to volunteer their consultation to health care workers in remote areas lacking specialists.

  8. When a Surgical Colleague Makes an Error.

    Science.gov (United States)

    Antiel, Ryan M; Blinman, Thane A; Rentea, Rebecca M; Gonzalez, Katherine W; Knott, E Marty; Juang, David; Oyetunji, Tolulope; Holcomb, G W; Angelos, Peter; Lantos, John D

    2016-03-01

    Professionalism requires that doctors acknowledge their errors and figure out how to avoid making similar ones in the future. Over the last few decades, doctors have gotten better at acknowledging mistakes and apologizing to patients when a mistake happens. Such disclosure is especially complicated when one becomes aware of an error made by a colleague. We present a case in which consultant surgeons became aware that a colleague seemed to have made a serious error. Experts in surgery and bioethics comment on appropriate responses to this situation.

  9. Information and communication technology use in asthmatic patients: a cross-sectional study in Latin America.

    Science.gov (United States)

    Calderón, Juan; Cherrez, Annia; Ramón, Germán Darío; Lopez Jove, Orlando; Baptist, Alan; Matos, Edgar; Morfín Maciel, Blanca; Calero, Erick; Sanchez-Borges, Mario; Cherrez, Sofia; Simancas-Racines, Daniel; Cherrez Ojeda, Ivan

    2017-07-01

    Rapid diffusion, low cost and broad availability of information and communication technologies (ICTs) make them an attractive platform for managing care, communication and interventions in asthma. There is little information in Latin America about usage frequency of ICTs in asthmatic patients. The analysis undertaken consisted of an observational, cross-sectional study that aimed to identify the frequency and type of ICTs most often used by asthmatics. The Spanish version of the Michigan questionnaire was employed in five Latin American countries. Age and educational level was categorised. Logistic regression was performed among these groups concerning the frequency of ICT usage and the level of interest shown in seeking and receiving information about asthma. In total, 673 asthma patients were surveyed. The mean age was 43.44 years. Over two-thirds of the participants were female (68.4%). The most used ICT was the short message service (SMS) (69.9%). SMS and E-mail are useful tools for communicating (i.e. receiving and seeking information) with all asthma patients, irrespective of their age. WhatsApp (61.5%) and Facebook (32.0%) were rated as being the most interesting channels of communication for receiving information. Regression analysis showed that younger asthmatics and asthmatics with higher educational levels were most likely to use almost all forms of ICTs. ICTs are generally an attractive platform for managing care, communication and interventions to improve asthma care. SMS and E-mail were found to be the preferred ICT forms among users. However, social media forms such as WhatsApp and Facebook may also be appropriate for certain types of patient.

  10. Improving medication administration safety in solid organ transplant patients through barcode-assisted medication administration.

    Science.gov (United States)

    Bonkowski, Josesph; Weber, Robert J; Melucci, Joseph; Pesavento, Todd; Henry, Mitchell; Moffatt-Bruce, Susan

    2014-01-01

    Solid organ transplant recipients are prescribed a high number of medications, increasing the potential for medication errors. Barcode-assisted medication administration (BCMA) is technology that reduces medication administration errors. An observational study was conducted at an academic medical center solid organ transplant unit before and after BMCA implementation. Medication accuracy was determined and administration errors were categorized by type and therapeutic class of medication. A baseline medication administration error rate of 4.8% was observed with wrong dose errors representing 78% of the errors. During the post-BCMA period the medication administration error rate was reduced by 68% to 1.5% (P = .0001). Wrong dose errors were reduced by 67% (P = .001), and unauthorized medication administrations were reduced by 73%. Steroids were associated with the highest error rate. The results of this study suggest that routinely adopting BCMA has the potential to reduce medication administration errors in transplant patients.

  11. Prescribing errors in a Brazilian neonatal intensive care unit

    Directory of Open Access Journals (Sweden)

    Ana Paula Cezar Machado

    2015-12-01

    Full Text Available Abstract Pediatric patients, especially those admitted to the neonatal intensive care unit (ICU, are highly vulnerable to medication errors. This study aimed to measure the prescription error rate in a university hospital neonatal ICU and to identify susceptible patients, types of errors, and the medicines involved. The variables related to medicines prescribed were compared to the Neofax prescription protocol. The study enrolled 150 newborns and analyzed 489 prescription order forms, with 1,491 medication items, corresponding to 46 drugs. Prescription error rate was 43.5%. Errors were found in dosage, intervals, diluents, and infusion time, distributed across 7 therapeutic classes. Errors were more frequent in preterm newborns. Diluent and dosing were the most frequent sources of errors. The therapeutic classes most involved in errors were antimicrobial agents and drugs that act on the nervous and cardiovascular systems.

  12. Error Free Software

    Science.gov (United States)

    1985-01-01

    A mathematical theory for development of "higher order" software to catch computer mistakes resulted from a Johnson Space Center contract for Apollo spacecraft navigation. Two women who were involved in the project formed Higher Order Software, Inc. to develop and market the system of error analysis and correction. They designed software which is logically error-free, which, in one instance, was found to increase productivity by 600%. USE.IT defines its objectives using AXES -- a user can write in English and the system converts to computer languages. It is employed by several large corporations.

  13. LIBERTARISMO & ERROR CATEGORIAL

    Directory of Open Access Journals (Sweden)

    Carlos G. Patarroyo G.

    2009-01-01

    Full Text Available En este artículo se ofrece una defensa del libertarismo frente a dos acusaciones según las cuales éste comete un error categorial. Para ello, se utiliza la filosofía de Gilbert Ryle como herramienta para explicar las razones que fundamentan estas acusaciones y para mostrar por qué, pese a que ciertas versiones del libertarismo que acuden a la causalidad de agentes o al dualismo cartesiano cometen estos errores, un libertarismo que busque en el indeterminismo fisicalista la base de la posibilidad de la libertad humana no necesariamente puede ser acusado de incurrir en ellos.

  14. Patients' perspectives on high-tech home care: a qualitative inquiry into the user-friendliness of four technologies

    Directory of Open Access Journals (Sweden)

    Lehoux Pascale

    2004-10-01

    Full Text Available Abstract Background The delivery of technology-enhanced home care is growing in most industrialized countries. The objective of our study was to document, from the patient's perspective, how the level of user-friendliness of medical technology influences its integration into the private and social lives of patients. Understanding what makes a technology user-friendly should help improve the design of home care services. Methods Four home care interventions that are frequently used and vary in their technical and clinical features were selected: Antibiotic intravenous therapy, parenteral nutrition, peritoneal dialysis and oxygen therapy. Our qualitative study relied on the triangulation of three sources of data: 1 interviews with patients (n = 16; 2 interviews with carers (n = 6; and 3 direct observation of nursing visits of a different set of patients (n = 16. Participants of varying socioeconomic status were recruited through primary care organizations and hospitals that deliver home care within 100 km of Montreal, the largest urban area in the province of Quebec, Canada. Results The four interventions have both a negative and positive effect on patients' lives. These technologies were rarely perceived as user-friendly, and user-acceptance was closely linked to user-competence. Compared with acute I.V. patients, who tended to be passive, chronic patients seemed keener to master technical aspects. While some of the technical and human barriers were managed well in the home setting, engaging in the social world was more problematic. Most patients found it difficult to maintain a regular job because of the high frequency of treatment, while some carers found their autonomy and social lives restricted. Patients also tended to withdraw from social activities because of social stigmatization and technical barriers. Conclusions While technology contributes to improving the patients' health, it also imposes significant constraints on their lives

  15. The Impact of Health Information Technology on the Doctor-Patient Relationship in Child and Adolescent Psychiatry.

    Science.gov (United States)

    Krishna, Rajeev

    2017-01-01

    As health information technology continues to expand and permeate medicine, there is increasing concern for the effect on the therapeutic relationship between patient and psychiatrist. This article explores this impact, seeking wisdom from adult psychiatry and more broadly from general medical disciplines to draw conclusions regarding how the child psychiatry encounter may be affected. Several proposed strategies to mitigate potential negative impacts of health information technology on the therapeutic relationship across practice settings are offered.

  16. Application of 3D rapid prototyping technology in posterior corrective surgery for Lenke 1 adolescent idiopathic scoliosis patients.

    Science.gov (United States)

    Yang, Mingyuan; Li, Chao; Li, Yanming; Zhao, Yingchuan; Wei, Xianzhao; Zhang, Guoyou; Fan, Jianping; Ni, Haijian; Chen, Ziqiang; Bai, Yushu; Li, Ming

    2015-02-01

    A retrospective study to evaluate the effectiveness of 3-dimensional rapid prototyping (3DRP) technology in corrective surgery for Lenke 1 adolescent idiopathic scoliosis (AIS) patients. 3DRP technology has been widely used in medical field; however, no study has been performed on the effectiveness of 3DRP technology in corrective surgery for Lenke 1 AIS patients. Lenke 1 AIS patients who were preparing to undergo posterior corrective surgery from a single center between January 2010 and January 2012 were included in this analysis. Patients were divided into 2 groups. In group A, 3-dimensional (3D) printing technology was used to create subject-specific spine models in the preoperative planning process. Group B underwent posterior corrective surgery as usual (by free hand without image guidance). Perioperative and postoperative clinical outcomes were compared between 2 groups, including operation time, perioperative blood loss, transfusion volume, postoperative hemoglobin (Hb), postoperative complications, and length of hospital stay. Radiological outcomes were also compared, including the assessment of screw placement, postoperative Cobb angle, coronal balance, sagittal vertical axis, thoracic kyphosis, and lumbar lordosis. Subgroup was also performed according to the preoperative Cobb angle: mean Cobb angle 50°. Besides, economic evaluation was also compared between 2 groups. A total of 126 patients were included in this study (group A, 50 and group B, 76). Group A had significantly shorter operation time, significantly less blood loss and transfusion volume, and higher postoperative Hb (all, P 0.05). There was also no significant difference in misplacement of screws in total populations (16.90% vs 18.82%, P = 0.305), whereas a low misplacement rate of pedicle screws was observed in patients whose mean Cobb angle was >50° (9.15% vs 13.03%, P = 0.02). Besides, using 3DRP increased the economic burden of patients (157,000 ± 9948.85 Ren Min Bi

  17. Factors which affect the occurrence of nursing errors in medication administration and the errors' management

    Directory of Open Access Journals (Sweden)

    Theodore Kapadohos

    2012-04-01

    Full Text Available Nursing, as a humanitarian science, offers its services, on the comprehensive care of patients. Each nurse handling, involves the possibility of error. Meurier appointed nursing error as "any act, any decision or omission by a nurse, assessed as incorrect, by more experienced colleagues, and have adverse consequences for patients". Medication errors are the most common category of nursing errors. They affect health, patient safety and also have a high economic impact to health systems of each country. Aim: The present study investigated the causative factors of nursing errors, the frequency of medication errors and the ways of reporting, recording and managing these errors in the hospitals of Greece. Method: For the purpose of this study, a descriptive cross-sectional design was used. The sample consisted of 176 registered nurses, from eight public and three private hospitals, working in the ICU and their duties included the administration of drugs. Data collection was performed using an anonymous structured questionnaire that included demographic characteristics of the sample and closed questions about the factors implicated in the occurrence of errors and their management. To investigate the existence of correlation between demographics and various questions referred to the management of errors by nurses, the criterion of heterogeneity X2 of Pearson was used and to check for correlation between questions that reflect the participants' views on working conditions and management of errors, the non-parametric correlation coefficient of Spearman (Spearman rho was applied. The statistical analysis was performed using SPSS 17 software. Results: After statistical analysis of data, the most important causative factors for the occurrence of errors are the nursing workload (78.9%, the distraction of nurses (75.8% and the burnout (56.8%. More than 9 out of 10 nurses have made errors in drug administration (91.5%, especially with the wrong dose (34.7% and

  18. W频段卫星通信中正交频分复用技术的误码性能分析%Bit error rate analysis of orthogonal frequency division multiplexing technology in W-band satellite communication

    Institute of Scientific and Technical Information of China (English)

    赵乐; 宋爱民; 刘剑; 薛斌; 郭兴阳

    2015-01-01

    针对传统的卫星通信频段( C频段、Ku频段、Ka频段)应用逐渐趋于饱和的问题,研究了更高的W频段卫星通信。该频段带宽更宽,可以支持更高的数据传输速率,同等条件下天线尺寸更小并可获得更大的天线增益。正交频分复用技术具有很高的频带利用率,适合于高速数据传输,在W频段具有很好的应用前景。参照“IKNOW”项目中的链路预算,采用固态功放的Rapp模型,对OFDM技术应用在W频段卫星通信中的误码性能进行了仿真分析。仿真结果表明:在考虑功放非线性时,存在一个最佳的输入功率补偿点,使OFDM系统的误码率最低,并且发射功率越高,最佳补偿点对应的误码率越低。%Since traditional band applications ( C-band, Ku-band, Ka-band) for satellite communication will gradually tend to be saturated, the higher W-band was studied. W-band has a wider bandwidth, supports a higher data rate, acquires a smaller equipment size and a bigger antenna gain under the same conditions. Orthogonal Frequency Division Multiplexing ( OFDM) technology has a high spectrum efficiency, which makes it be suitable for high data rate transmission, so it has a good application prospect in W-band. Referring to the link budget of “IKNOW” project and using the Rapp model of solid-state power amplifier, the Bit Error Rate ( BER) of OFDM in W-band was simulated and analyzed. The simulation results show that there is a best input power backoff point which makes the BER be lowest when the nonlinear power amplifier is taken in account, and the higher the transmission power is, the lower the BER of the best input power backoff point will be.

  19. Medication administration errors in an intensive care unit in Ethiopia

    OpenAIRE

    2012-01-01

    Background Medication administration errors in patient care have been shown to be frequent and serious. Such errors are particularly prevalent in highly technical specialties such as the intensive care unit (ICU). In Ethiopia, the prevalence of medication administration errors in the ICU is not studied. Objective To assess medication administration errors in the intensive care unit of Jimma University Specialized Hospital (JUSH), Southwest Ethiopia. Methods Prospective observation based cross...

  20. Medication Errors In Relation To Education & Years of Nursing Experience

    OpenAIRE

    2012-01-01

    Medication error is defined as any preventable event that might cause or lead to an inappropriate use orharming of the patient. The purpose of this study was to determine the relationship between the level ofeducation and medication errors; years of work experience and medication errors. With a betterunderstanding of these relationships, nursing professionals can learn what characteristics tend to make anurse prone to medication errors and can develop methods and procedures to reduce incidenc...

  1. Learning effect of humphrey matrix frequency doubling technology perimetry in patients with ocular hypertension.

    Science.gov (United States)

    Centofanti, Marco; Fogagnolo, Paolo; Oddone, Francesco; Orzalesi, Nicola; Vetrugno, Michele; Manni, Gianluca; Rossetti, Luca

    2008-09-01

    To evaluate the learning effect of Frequency Doubling Technology (FDT) perimetry using the Humphrey Matrix-FDT perimetry (Matrix) 24-2 full-threshold program on patients with ocular hypertension experienced with standard automated perimetry. Twenty-four patients with ocular hypertension underwent 5 full-threshold Matrix tests at intervals of 5+/-2 days. Learning effect was defined as an improvement at results for duration, perimetric indices, foveal sensitivity, Glaucoma Hemifield Test, and the number of points with a Plearning effect. Test-retest variability was also calculated for each repetition as the mean of the point-to-point interindividual standard deviations. A learning effect was demonstrated for mean defect (P=0.031, analysis of variance) and foveal sensitivity (P=0.009) and it only affected the first test for both parameters. All the other parameters did not show any significant learning effect. The effect was independent from eccentricity and quadrant or hemifield sensitivities. The results of this study demonstrate that the learning effect for Matrix-FDT is mild and it may affect only the first test. Caution is needed in the analysis of the first Matrix-FDT examination and retest may be advisable in the presence of low mean defect.

  2. Impact of new X-ray technology on patient dose in pacemaker and implantable cardioverter defibrillator (ICD) implantations.

    Science.gov (United States)

    van Dijk, Joris D; Ottervanger, Jan Paul; Delnoy, Peter Paul H M; Lagerweij, Martine C M; Knollema, Siert; Slump, Cornelis H; Jager, Pieter L

    2017-01-01

    New X-ray technology providing new image processing techniques may reduce radiation exposure. The aim of this study was to quantify this radiation exposure reduction for patients during pacemaker and implantable cardioverter defibrillator (ICD) implantation. In this retrospective study, 1185 consecutive patients who had undergone de novo pacemaker or ICD implantation during a 2-year period were included. All implantations in the first year were performed using the reference technology (Allura Xper), whereas in the second year, the new X-ray technology (AlluraClarity) was used. Radiation exposure, expressed as the dose area product (DAP), was compared between the two time periods to determine the radiation exposure reduction for pacemaker and ICD implantations without cardiac resynchronization therapy (CRT) and with CRT. Procedure duration and contrast volume were used as measures to compare complexity and image quality. The study population consisted of 591 patients who had undergone an implantation using the reference technology, and 594 patients with the new X-ray technology. The two groups did not differ in age, gender, or body mass index. The DAP decreased with 69 % from 16.4 ± 18.5 to 5.2 ± 6.6 Gy cm(2) for the non-CRT implantations (p pacemaker and ICD implantation while image quality was unaffected.

  3. Orwell's Instructive Errors

    Science.gov (United States)

    Julian, Liam

    2009-01-01

    In this article, the author talks about George Orwell, his instructive errors, and the manner in which Orwell pierced worthless theory, faced facts and defended decency (with fluctuating success), and largely ignored the tradition of accumulated wisdom that has rendered him a timeless teacher--one whose inadvertent lessons, while infrequently…

  4. Mobile technology supporting trainee doctors’ workplace learning and patient care: an evaluation

    Science.gov (United States)

    2013-01-01

    Background The amount of information needed by doctors has exploded. The nature of knowledge (explicit and tacit) and processes of knowledge acquisition and participation are complex. Aiming to assist workplace learning, Wales Deanery funded “iDoc”, a project offering trainee doctors a Smartphone library of medical textbooks. Methods Data on trainee doctors’ (Foundation Year 2) workplace information seeking practice was collected by questionnaire in 2011 (n = 260). iDoc baseline questionnaires (n = 193) collected data on Smartphone usage alongside other workplace information sources. Case reports (n = 117) detail specific instances of Smartphone use. Results Most frequently (daily) used information sources in the workplace: senior medical staff (80% F2 survey; 79% iDoc baseline); peers (70%; 58%); and other medical/nursing team staff (53% both datasets). Smartphones were used more frequently by males (p < 0.01). Foundation Year 1 (newly qualified) was judged the most useful time to have a Smartphone library because of increased responsibility and lack of knowledge/experience. Preferred information source varied by question type: hard copy texts for information-based questions; varied resources for skills queries; and seniors for more complex problems. Case reports showed mobile technology used for simple (information-based), complex (problem-based) clinical questions and clinical procedures (skills-based scenarios). From thematic analysis, the Smartphone library assisted: teaching and learning from observation; transition from medical student to new doctor; trainee doctors’ discussions with seniors; independent practice; patient care; and this ‘just-in-time’ access to reliable information supported confident and efficient decision-making. Conclusion A variety of information sources are used regularly in the workplace. Colleagues are used daily but seniors are not always available. During transitions, constant access to the electronic

  5. Mobile technology supporting trainee doctors’ workplace learning and patient care: an evaluation

    Directory of Open Access Journals (Sweden)

    Hardyman Wendy

    2013-01-01

    Full Text Available Abstract Background The amount of information needed by doctors has exploded. The nature of knowledge (explicit and tacit and processes of knowledge acquisition and participation are complex. Aiming to assist workplace learning, Wales Deanery funded “iDoc”, a project offering trainee doctors a Smartphone library of medical textbooks. Methods Data on trainee doctors’ (Foundation Year 2 workplace information seeking practice was collected by questionnaire in 2011 (n = 260. iDoc baseline questionnaires (n = 193 collected data on Smartphone usage alongside other workplace information sources. Case reports (n = 117 detail specific instances of Smartphone use. Results Most frequently (daily used information sources in the workplace: senior medical staff (80% F2 survey; 79% iDoc baseline; peers (70%; 58%; and other medical/nursing team staff (53% both datasets. Smartphones were used more frequently by males (p  Preferred information source varied by question type: hard copy texts for information-based questions; varied resources for skills queries; and seniors for more complex problems. Case reports showed mobile technology used for simple (information-based, complex (problem-based clinical questions and clinical procedures (skills-based scenarios. From thematic analysis, the Smartphone library assisted: teaching and learning from observation; transition from medical student to new doctor; trainee doctors’ discussions with seniors; independent practice; patient care; and this ‘just-in-time’ access to reliable information supported confident and efficient decision-making. Conclusion A variety of information sources are used regularly in the workplace. Colleagues are used daily but seniors are not always available. During transitions, constant access to the electronic library was valued. It helped prepare trainee doctors for discussions with their seniors, assisting the interchange between explicit and tacit knowledge. By

  6. Mobile technology supporting trainee doctors' workplace learning and patient care: an evaluation.

    Science.gov (United States)

    Hardyman, Wendy; Bullock, Alison; Brown, Alice; Carter-Ingram, Sophie; Stacey, Mark

    2013-01-21

    The amount of information needed by doctors has exploded. The nature of knowledge (explicit and tacit) and processes of knowledge acquisition and participation are complex. Aiming to assist workplace learning, Wales Deanery funded "iDoc", a project offering trainee doctors a Smartphone library of medical textbooks. Data on trainee doctors' (Foundation Year 2) workplace information seeking practice was collected by questionnaire in 2011 (n = 260). iDoc baseline questionnaires (n = 193) collected data on Smartphone usage alongside other workplace information sources. Case reports (n = 117) detail specific instances of Smartphone use. Most frequently (daily) used information sources in the workplace: senior medical staff (80% F2 survey; 79% iDoc baseline); peers (70%; 58%); and other medical/nursing team staff (53% both datasets). Smartphones were used more frequently by males (p < 0.01). Foundation Year 1 (newly qualified) was judged the most useful time to have a Smartphone library because of increased responsibility and lack of knowledge/experience.Preferred information source varied by question type: hard copy texts for information-based questions; varied resources for skills queries; and seniors for more complex problems. Case reports showed mobile technology used for simple (information-based), complex (problem-based) clinical questions and clinical procedures (skills-based scenarios). From thematic analysis, the Smartphone library assisted: teaching and learning from observation; transition from medical student to new doctor; trainee doctors' discussions with seniors; independent practice; patient care; and this 'just-in-time' access to reliable information supported confident and efficient decision-making. A variety of information sources are used regularly in the workplace. Colleagues are used daily but seniors are not always available. During transitions, constant access to the electronic library was valued. It helped prepare trainee doctors for discussions

  7. Dosimetry study of different irradiation technologies for patients with recurrence of cervical cancer

    Directory of Open Access Journals (Sweden)

    Jian NING

    2011-07-01

    Full Text Available Objective To compare the dosimetric characteristics of intensity-modulated radiation therapy(IMRT,three-dimensional conformal radiation therapy(3D-CRT and super gamma knife arc conformal radiotherapy(SGS-CRT for patients with recurrence of cervical cancer.Methods Treatment planning of IMRT,3D-CRT and SGS-CRT for 15 patients with recurrence of cervical cancer was designed,and the prescription dose(50Gy,2.0Gy×25 covered 95% of the planning target volume(PTV.The dosimetric characteristics of the 3 irradiation technologies in target region and organs at risk were compared by analyzing dose-volume histogram(DVH.Results The target volume of 95% prescription dose was significantly higher in 3D-CRT(99.9%±0.2% than in IMRT(99.5%±0.5% and SGS-CRT(99.3%±0.8%,P < 0.05;the dose gradient of target region was significantly higher in SGS-CRT(85%±20% than in IMRT(10%±7% and 3D-CRT(8%±5%,P < 0.05;the conformal index of target region was higher in IMRT(0.9±0.3 than in SGS-CRT(0.8±0.2,P < 0.05,and the latter was higher than that in 3D-CRT(0.7±0.5,P < 0.05.The DVH showed that the radiation volumes of bladder was lower in SGS-CRT(27.8% than in IMRT(40.1% and 3D-CRT(57.4%,P < 0.05 when the dosage ranged from 10 to 30 Gy,and the radiation volumes of rectum was lower in SGS-CRT(25.4% than in IMRT(48.9% and 3D-CRT(73.2%,P < 0.05 when the dosage ranged from 5 to 45 Gy,while there was no significant difference among the 3 irradiation technologies of the radiation volumes of small bowel.Conclusion SGS-CRT shows some dosimetric advantages in treating patients with recurrence of cervical cancer.

  8. Challenge and Error: Critical Events and Attention-Related Errors

    Science.gov (United States)

    Cheyne, James Allan; Carriere, Jonathan S. A.; Solman, Grayden J. F.; Smilek, Daniel

    2011-01-01

    Attention lapses resulting from reactivity to task challenges and their consequences constitute a pervasive factor affecting everyday performance errors and accidents. A bidirectional model of attention lapses (error [image omitted] attention-lapse: Cheyne, Solman, Carriere, & Smilek, 2009) argues that errors beget errors by generating attention…

  9. Using health information technology to manage a patient population in accountable care organizations.

    Science.gov (United States)

    Wu, Frances M; Rundall, Thomas G; Shortell, Stephen M; Bloom, Joan R

    2016-06-20

    Purpose - The purpose of this paper is to describe the current landscape of health information technology (HIT) in early accountable care organizations (ACOs), the different strategies ACOs are using to develop HIT-based capabilities, and how ACOs are using these capabilities within their care management processes to advance health outcomes for their patient population. Design/methodology/approach - Mixed methods study pairing data from a cross-sectional National Survey of ACOs with in-depth, semi-structured interviews with leaders from 11 ACOs (both completed in 2013). Findings - Early ACOs vary widely in their electronic health record, data integration, and analytic capabilities. The most common HIT capability was drug-drug and drug-allergy interaction checks, with 53.2 percent of respondents reporting that the ACO possessed the capability to a high degree. Outpatient and inpatient data integration was the least common HIT capability (8.1 percent). In the interviews, ACO leaders commented on different HIT development strategies to gain a more comprehensive picture of patient needs and service utilization. ACOs realize the necessity for robust data analytics, and are exploring a variety of approaches to achieve it. Research limitations/implications - Data are self-reported. The qualitative portion was based on interviews with 11 ACOs, limiting generalizability to the universe of ACOs but allowing for a range of responses. Practical implications - ACOs are challenged with the development of sophisticated HIT infrastructure. They may benefit from targeted assistance and incentives to implement health information exchanges with other providers to promote more coordinated care management for their patient population. Originality/value - Using new empirical data, this study increases understanding of the extent of ACOs' current and developing HIT capabilities to support ongoing care management.

  10. Evaluation of hyperspectral imaging technology in patients with peripheral vascular disease.

    Science.gov (United States)

    Chiang, Nathaniel; Jain, Jitendra K; Sleigh, Jamie; Vasudevan, Thodur

    2017-05-22

    Hyperspectral imaging technology is a novel method of using transcutaneous measurement of oxyhemoglobin (HT-Oxy) and deoxyhemoglobin (HT-Deoxy) concentrations to create a two-dimensional, color-coded "oxygen map." The aims of this study were to compare the use of a hyperspectral imaging device with the transcutaneous oxygen measurement (TCOM), ankle-brachial index (ABI), and severity of peripheral vascular disease (PVD) and to assess their correlations. This prospective study recruited 294 participants divided into three distinct groups composed of healthy volunteers and patients with PVD. Patients underwent measurements of lower limbs at a standardized point over the head of the first metatarsal on the plantar aspect using the hyperspectral imaging device, generating four outputs including HT-Oxy, HT-Deoxy, oxygen saturation (HT-Sat), and skin temperature, and the TCOM system, generating transcutaneous partial pressure of oxygen (TcpO2) and carbon dioxide (TcpCO2). Demographic data, severity of PVD, ABI, and other pertinent information were obtained from both the participants and medical records. Interoperator reliability ranged from 86% to 94% across the four hyperspectral imaging device outputs, whereas intraoperator reliability ranged from 92% to 94%. The HT-Oxy, HT-Sat, TcpCO2, and ABI of the diseased limb correlated significantly with the severity of PVD. HT-Sat significantly correlated with TcpO2 (R = 0.19), TcpCO2 (R = -0.26), ABI (R = 0.42), and skin temperature (R = 0.56). HT-Deoxy also correlated with TcpCO2 (R = 0.27). This study demonstrates the reliability of hyperspectral imaging in comparison to TCOM, ABI, skin temperature, and severity of PVD in a series of patients. Its correlation to other established modalities and low interoperator and intraoperator variability could enable this modality to be a useful screening tool in PVD. Copyright © 2017 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.

  11. Learning from incident reports in the Australian medical imaging setting: handover and communication errors.

    Science.gov (United States)

    Hannaford, N; Mandel, C; Crock, C; Buckley, K; Magrabi, F; Ong, M; Allen, S; Schultz, T

    2013-02-01

    To determine the type and nature of incidents occurring within medical imaging settings in Australia and identify strategies that could be engaged to reduce the risk of their re-occurrence. 71 search terms, related to clinical handover and communication, were applied to 3976 incidents in the Radiology Events Register. Detailed classification and thematic analysis of a subset of incidents that involved handover or communication (n=298) were undertaken to identify the most prevalent types of error and to make recommendations about patient safety initiatives in medical imaging. Incidents occurred most frequently during patient preparation (34%), when requesting imaging (27%) and when communicating a diagnosis (23%). Frequent problems within each of these stages of the imaging cycle included: inadequate handover of patients (41%) or unsafe or inappropriate transfer of the patient to or from medical imaging (35%); incorrect information on the request form (52%); and delayed communication of a diagnosis (36%) or communication of a wrong diagnosis (36%). The handover of patients and clinical information to and from medical imaging is fraught with error, often compromising patient safety and resulting in communication of delayed or wrong diagnoses, unnecessary radiation exposure and a waste of limited resources. Corrective strategies to address safety concerns related to new information technologies, patient transfer and inadequate test result notification policies are relevant to all healthcare settings. Handover and communication errors are prevalent in medical imaging. System-wide changes that facilitate effective communication are required.

  12. How technology in care at home affects patient self-care and self-management: a scoping review.

    Science.gov (United States)

    Peeters, José M; Wiegers, Therese A; Friele, Roland D

    2013-10-29

    The use of technology in care at home has potential benefits such as improved quality of care. This includes greater focus on the patients' role in managing their health and increased patient involvement in the care process. The objective of this scoping review is to analyse the existing evidence for effects of technology in home-based care on patients' self-care and self-management. Using suitable search terms we searched the databases of Pubmed, Embase, Cochrane Library, Cinahl, Picarta and NIVEL dating from 2002 to 2012. Thirty-three studies (six review studies and twenty-seven individual studies) were selected. Effects were extracted from each study and were classified. In almost all the studies, the concepts self-care and self-management are not clearly defined or operationalized. Therefore, based on a meta-analysis, we made a new classification of outcome measures, with hierarchical levels: (1) competence (2) illness-management (3) independence (social participation, autonomy). In general, patient outcomes appear to be positive or promising, but most studies were pilot studies. We did not find strong evidence that technology in care at home has (a positive) effect on patient self-care and self-management according to the above classification. Future research is needed to clarify how technology can be used to maximize its benefits.

  13. Medication errors: hospital pharmacist perspective.

    Science.gov (United States)

    Guchelaar, Henk-Jan; Colen, Hadewig B B; Kalmeijer, Mathijs D; Hudson, Patrick T W; Teepe-Twiss, Irene M

    2005-01-01

    In recent years medication error has justly received considerable attention, as it causes substantial mortality, morbidity and additional healthcare costs. Risk assessment models, adapted from commercial aviation and the oil and gas industries, are currently being developed for use in clinical pharmacy. The hospital pharmacist is best placed to oversee the quality of the entire drug distribution chain, from prescribing, drug choice, dispensing and preparation to the administration of drugs, and can fulfil a vital role in improving medication safety. Most elements of the drug distribution chain can be optimised; however, because comparative intervention studies are scarce, there is little scientific evidence available demonstrating improvements in medication safety through such interventions. Possible interventions aimed at reducing medication errors, such as developing methods for detection of patients with increased risk of adverse drug events, performing risk assessment in clinical pharmacy and optimising the drug distribution chain are discussed. Moreover, the specific role of the clinical pharmacist in improving medication safety is highlighted, both at an organisational level and in individual patient care.

  14. 患者身份识别错误事件中患者因素的调查分析%Investigation and analysis of patient factors in identification error events

    Institute of Scientific and Technical Information of China (English)

    葛莉娜; 范玲

    2013-01-01

    Objective To analyze the characteristics of patients involved in identification error events,try to recognize patients group who had high risk of being wrongly identified.Methods 68 patient identification error events in 64 hospitals in Liaoning province from 2007 to 2011 were investigated.The results were analyzed from four aspects,which were education,age,consciousness and sensory disability state of patients.Results 68 identification error events were investigated.Among these events,patients who graduated from middle school or less constituted 79.41% ;patients older than 60 years old constituted 55.88%;patients with hearing and speaking inability constituted 41.18%;patients without clear consciousness constitutes 14.70% Conclusions Patients who graduated from middle school or less,older than 60 years old,with heating and speaking inability constitute the group who has high risk of being wrongly identified.Enhancing the education of patients,promoting the use of wrist band,and decreasing the dependence on hearing and speaking ability during identification process constitute the main reformation aspect of new patient identification rules.%目的 探讨易发生患者身份识别错误事件的高危人群的特点.方法 采用自行设计的患者身份识别错误调查表对辽宁省64所三级医院在2007年至2011年发生的68起患者身份识别错误事件进行回顾性研究.从患者文化程度、年龄、感官障碍及神志状态四方面进行分析.结果 患者身份识别错误事件中,文化程度为初中及以下的患者占79.41%;年龄>60岁的患者占55.88%;存在听力和语言障碍的患者占41.18%;神志不清的患者只占14.70%.结论 文化程度为初中及以下、年龄>60岁和有听说障碍的患者是出现身份识别错误的高危人群.加强对身份识别错误高危人群的宣教,推广腕带识别技术,降低身份识别过程中对患者听力和语言能力依赖程度,是降低患

  15. Hurdles overcome in technology transfer for AIET and Positive outcome in Indian patients

    Directory of Open Access Journals (Sweden)

    Dedeepiya V

    2012-01-01

    Full Text Available Introduction Cell based immunotherapies have been in practice in Japan for the past two decades with established clinical trials on its efficacy in both solid tumours and hematological malignancies including gastric cancer, ovarian cancer , lung cancer and liver cancer. [1,2,3,4] In India, NCRM has been providing Autologous Immune Enhancement Therapy (AIET using autologous Natural Killer (NK cells and activated T Lymphocytes for Cancer since 2005 following the established protocols practiced by the Biotherapy Institute of Japan. Significant outcome achieved after AIET in advanced pancreatic cancer, Acute Myeloid leukemia (AML in Indian patients have already been reported. [5, 6] Here we report our experience in few more patients and present the hurdles overcome and lessons learned in translating the technology from Japan to India Case Details: Case 1: A 54 year-old female presented with Stage IV recurrent ovarian malignancy in 2010 with a history of previous surgery and chemotherapy for ovarian malignancy in June 2009. The CA-125 level of 243 U/ml. CT scan revealed lesions in the liver, spleen, along the greater curvature of body of stomach and in the perisplenic region, between the medial aspect of liver and stomach and in the right inguinal region. She was suggested six cycles of chemotherapy with Doxorubicin (50 mg and Carboplatin (450 mg along with AIET. After proper informed consent, the peripheral blood was withdrawn and the in vitro expansion of the NK cells, activated T Lymphocytes from the peripheral blood was performed using the protocol reported earlier. [7] Average cell count after the in vitro expan