• Title/Summary/Keyword: Compliance assessment

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Compliance with Screening Recommendations According to Breast Cancer Risk Levels in Izmir, Turkey

  • Acikgoz, Ayla;Ergor, Gul
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.3
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    • pp.1737-1742
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    • 2013
  • Early diagnosis has a major role in improving prognosis of breast cancer. The purpose of this study was to assess the risk status of women 35-69 years of age using risk assessment models and the prevalence of mammography in a community setting. The sample of this cross sectional study consisted of 227 women, 35-69 years of age residing in Izmir, a city located in western region of Turkey. A questionnaire was used to collect data and the Gail and Cuzick-Tyrer models were applied to assess the risk of breast cancer. In this study, 52.7% of women had mammography at least once, and 41.3% of the women over the age of 40 had mammography screening in the last two years. The five years risk for breast cancer was high in 15.8% of women according to the Gail model and ten years risk was high in 21.7% with the Cuzick-Tyrer model. In the present study, the breast cancer risk levels were assessed in a population setting for the first time in Turkey using breast cancer risk level assessment models. Being in 60-69 age group, having low education and not being in menopause were significant risk factors for not having mammography according to logistic regression analysis. Mammography utilization rate was low. Women must be educated about breast cancer screening methods and early diagnosis. The women in the high risk group should be informed on their risk status which may increase their attendance at breast cancer screening.

Prescription Errors with Chemotherapy: Quality Improvement through Standardized Order Templates

  • Saad, Aline;Der-Nigoghossian, Caroline A.;Njeim, Rachel;Sakr, Riwa;Salameh, Pascale;Massoud, Marcel
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.4
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    • pp.2329-2336
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    • 2016
  • Background: Despite the existence of established guidelines advocating the use and value of chemotherapy order templates, chemotherapy orders are still handwritten in many hospitals in Lebanon. This manuscript describes the implementation of standardized chemotherapy order templates (COT) in a Lebanese tertiary teaching hospital through multiple steps. Initial Assessment: An initial assessment was conducted through a retrospective appraisal of completeness of handwritten chemotherapy orders for 100 adult patients to serve as a baseline for the project and identify parameters that might afford improvement. Choice of solution: Development of over 300 standardized pre-printed COTs based on the National Comprehensive Cancer Network templates and adapted to the practice culture and patient population. Implementation: The COTs were implemented, using Kotter's 8-step model for leading change, by engaging health care providers, and identifying and removing barriers. Evaluation: Assessment of physicians' compliance with the new practice (122 orders assessed) was completed through two phases and allowed for the identification of areas of improvement. Lessons Learned: Overall, COT implementation showed an average improvement in order completion from 49.5% (handwritten orders) to 77.6% (phase 1-COT) to 87.6% (phase 2-COT) reflecting an increase of 38.1% between baseline and phase 2 and demonstrating that chemotherapy orders completeness was improved by pre-printed COT. As many of the hospitals in Lebanon are moving towards standardized COTs and computerized physician order entry (CPOE) in the next few years, this study provides a prototype for the successful implementation of COT and demonstrates their role in promoting quality improvement of cancer care.

Development of Job Description of HIV/AIDS Counselling Nurse in Korea (에이즈 상담간호사 자격제도 개발을 위한 직무 분석 - 포커스 그룹 연구방법과 데이컴 기법을 중심으로 -)

  • Kwon, Young-Mi;Cho, Kyung-Mi;Joo, Hye-Joo;Kim, Sung-Jae;June, Kyung-Ja;Park, Eun-Hee
    • Journal of Korean Academy of Nursing Administration
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    • v.15 no.1
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    • pp.91-105
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    • 2009
  • Purpose: The aim of this study was to analyze the needs of HIV/AIDS care and to develop the job description of HIV/AIDS Counselling nurse in Korea. Methods: The needs assessment was done by focus group interview with HIV/AIDS care recipients who are 16 persons living with HIV/AIDS and four their family members, seven persons from HIV/AIDS high risk group, and five nurses working on HIV/AIDS clinics. Based on the result of needs assessment, job description was developed using the DACUM. Mail survey was done to identify the frequency, importance, and difficulty of duties, tasks, and task elements. Results: The job description was classified under 8 duties, 36 tasks, and 290 task elements. Duties were categorized as needs assessment, health promotion and quality of life, improvement of treatment compliance, symptom care, health education, resource network, administrative activity, and career development. The importance of all duties and tasks showed high score from the survey, but the frequency and the performance level were middle range. Conclusion: It is suggested that the special training program based on the job description needs to be developed. In the political aspects, the introduction of HIV/AIDS nurse specialist certification could be considered.

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Internal Dosimetry: State of the Art and Research Needed

  • Francois Paquet
    • Journal of Radiation Protection and Research
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    • v.47 no.4
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    • pp.181-194
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    • 2022
  • Internal dosimetry is a discipline which brings together a set of knowledge, tools and procedures for calculating the dose received after incorporation of radionuclides into the body. Several steps are necessary to calculate the committed effective dose (CED) for workers or members of the public. Each step uses the best available knowledge in the field of radionuclide biokinetics, energy deposition in organs and tissues, the efficiency of radiation to cause a stochastic effect, or in the contributions of individual organs and tissues to overall detriment from radiation. In all these fields, knowledge is abundant and supported by many works initiated several decades ago. That makes the CED a very robust quantity, representing exposure for reference persons in reference situation of exposure and to be used for optimization and assessment of compliance with dose limits. However, the CED suffers from certain limitations, accepted by the International Commission on Radiological Protection (ICRP) for reasons of simplification. Some of its limitations deserve to be overcome and the ICRP is continuously working on this. Beyond the efforts to make the CED an even more reliable and precise tool, there is an increasing demand for personalized dosimetry, particularly in the medical field. To respond to this demand, currently available tools in dosimetry can be adjusted. However, this would require coupling these efforts with a better assessment of the individual risk, which would then have to consider the physiology of the persons concerned but also their lifestyle and medical history. Dosimetry and risk assessment are closely linked and can only be developed in parallel. This paper presents the state of the art of internal dosimetry knowledge and the limitations to be overcome both to make the CED more precise and to develop other dosimetric quantities, which would make it possible to better approximate the individual dose.

Recommendation and current status in exposure assessment using monitoring data in ship building industry - focused on the similar exposure group(SEG) (조선업의 작업환경측정결과를 이용한 노출평가의 문제점과 해결방향 - 유사노출군을 중심으로 -)

  • Roh, Youngman;Yim, Hyeon Woo;Kim, Suk Il;Park, Hyo Man;Jung, Jae Yeol;Park, Sook Kyung;Kim, Hyun-Wook;Chung, Chee Kyung;Lee, Won Chul;Kim, Jung Man;Kim, Soo Keun;Koh, Sang Baek;Karl, Sieber;Kim, Euna;Choi, Jung Keun
    • Journal of Korean Society of Occupational and Environmental Hygiene
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    • v.11 no.2
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    • pp.126-134
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    • 2001
  • Statistical approaches for analysis of data from the limited number of samples in ship building industry(SBI) collected by an industrial hygienist for checking compliance to an occupational standard were considered. Sampling for compliance usually has been guided by judgment selection, rather than true randomness, resulting in the creation of compliance samples which approximate a censored sample from the upper tail of the exposure distribution. Similar exposure groups(SEGs) including welding and painting process were established to assess representative values in each groups after reviewing the whole production line in SBI. For the convenient statistical approaches, the code has assigned to each SEGs. The descriptive statistics and probability plotting were used to yield the representative values in each SEGs. In the first step, SEGs of 558 were established from 5 ship building companies. The 38 SEGs showed the uncertainty are divided into each 5 companies and assessed the representative values again. The 44 SEGs in each companies was not showed the normal and lognormal distribution was analyzed each data. And also, recommendation was suggested to resolve the uncertainty in each groups.

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How to Reflect Sustainable Development, exemplified by the Equator Principles, in Overseas Investment (해외투자(海外投資)와 지속가능발전 원칙 - 프로젝트 파이낸스의 적도원칙(赤道原則)을 중심으로 -)

  • Park, Whon-Il
    • THE INTERNATIONAL COMMERCE & LAW REVIEW
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    • v.31
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    • pp.27-56
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    • 2006
  • Today's financial institutions usually take environmental issues seriously into consideration as they could not evade lender liability in an increasing number of cases. On the international scene, a brand-new concept of the "Equator Principles" in the New Millenium has driven more and more international banks to adopt these Principles in project financing. Sustainable development has been a key word in understanding new trends of the governments, financial institutions, corporations and civic groups in the 21st century. The Equator Principles are a set of voluntary environmental and social guidelines for sustainable finance. These Principles commit bank officers to avoid financial support to projects that fail to meet these guidelines. The Principles were conceived in 2002 on an initiative of the International Finance Corporation(IFC), and launched in June 2003. Since then, dozens of major banks, accounting for up to 80 percent of project loan market, have adopted the Principles. Accordingly, the Principles have become the de facto standard for all banks and investors on how to deal with potential social and environmental issues of projects to be financed. Compliance with the Equator Principles facilitates for endorsing banks to participate in the syndicated loan and help them to manage the risks associated with large-scale projects. The Equator Principles call for financial institutions to provide loans to projects under the following circumstances: - The risk of the project is categorized in accordance with internal guidelines based upon the environmental and social screening criteria of the IFC. - For Category A and B projects, borrowers or sponsors are required to conduct a Social and Environmental Assessment, the preparation of which must meet certain requirements and satisfactorily address key social and environmental issues. - The Social and Environmental Assessment report should address baseline social and environmental conditions, requirements under host country laws and regulations, sustainable development, and, as appropriate, IFC's Environmental, Health and Safety Guidelines, etc. - Based on the Social and Environmental Assessment, Equator banks then make agreements with borrowers on how they mitigate, monitor and manage the risks through a Social and Environmental Management System. Compliance with the plan is included in the covenant clause of loan agreements. If the borrower doesn't comply with the agreed terms, the bank will take corrective actions. The Equator Principles are not a mere declaration of cautious banks but a full commitment of lenders. A violation of the Principles in the process of project financing, which led to an unexpected damage to the affected community, would not give rise to any specific legal remedies other than ordinary lawsuits. So it is more effective for banks to ensure consistent implementation of the Principles and to have them take responsible measures to solve social and environmental issues. Public interests have recently mounted up with respect to environmental issues on the occasion of the Supreme Court's decision (2006Du330) on the fiercely debated reclamation project at Saemangeum. The majority Justices said that the expected environmental damages like probable pollution of water and soil were not believed so serious and that the Administration should continue to implement the project seeking ways to make it more environment friendly. In this case, though the Category A Saemangeum Project was carried out by a government agency, the Supreme Court behaved itself as a signal giver to approve or stop the environment-related project like an Equator bank in project financing. At present, there is no Equator bank in Korea in contrast to three big banks in Japan. Also Korean contractors, which are aggressively bidding for Category A-type projects in South East Asia and Mideast, might find themselves in a disadvantageous position because they are generally ignorant of the environmental assessment associated with project financing. In this regard, Korean banks and overseas project contractors should care for the revised Equator Principles and the latest developments in project financing more seriously. It's because its scope has expanded to the capital cost of US$10 million or more across all industry sectors regardless of developing countries or not. It should be noted that, for a Korean bank, being an Equator bank is more or less burdensome in a short-term period, but it must be conducive to minimizing risks and building up good reputation in the long run.

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A Study about Assessment on Operation Program of Local Festivals (향토지역축제 운영프로그램 평가에 관한 연구)

  • Lee, Hee-Koung;Ahn, Deug-Soo
    • Journal of the Korean Institute of Traditional Landscape Architecture
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    • v.30 no.1
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    • pp.103-112
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    • 2012
  • This study aims at assessment of local festivals focused on analysis of operation program for local festivals held in Jeonbuk province. The subjects were 65 local festivals held in Jeonbuk in 2010 excluding festivals held in province, county, and town level, and those held with single purpose. Type of festivals were classified to type for residents' unity, tourism, industry, and special purpose type. The portion was industry type 36.9%, type for residents' unity 23.1% in the order. By theme, animal, plant, nature phenomenon, history, culture and tradition, special product, regional industry were classified - the portion was special product 36.9%, culture and tradition 24.6%, history 13.8%. Assessment of operation program was conducted with assessment indexes such as compliance with theme, uniqueness, diversity, effect of experience, size, educational effect, and entertainment. As a result, it appeared that because local festivals of Jeonbuk had high uniqueness, duplication of program between local festivals was very low and educational effect was comparatively high. On the other hand, because entertainment and effect of experience was very low, considerations of entertainment and effect of experience are necessary in planning of program.

A Study on Environmental Impact Assessment Guidelines for Marine Environmentsin Construction Projects of Offshore Waste Disposal Landfills (해상최종처리장 건설사업의 해양환경 환경영향평가 가이드라인 개발 연구)

  • Lee, Haemi;Son, Minho;Kang, Taesoon;Maeng, Junho
    • Journal of Environmental Impact Assessment
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    • v.28 no.3
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    • pp.312-331
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    • 2019
  • An offshore waste disposal facility refers to a landfill site for final landfilling of stabilized inorganic solid waste such as land and marine waste incineration materials, and the aim of such a facility is to solve the problem of insufficient waste disposal space on land and create and develop environmentally friendly marine spaces. The purpose of this study is to prepare guidelines for the construction of offshore waste disposal facilities, which reflect the need and importance of paying sufficient heed to environmental considerations from the initial stage of the project, in order to investigate, predict, and assess how such guidelines will affect the marine environment in relation to the construction of offshore waste disposal facilities, with the goal of minimizing the impact on and damage to the environment. For the purpose of this research, guidelines focusing on the construction of offshore waste disposal facilities were derived through an analysis of domestic cases and similar foreign cases and an assessment of their level of compliance with existing EIA guidelines through the operation of a discussion forum. In order to review the EIA report on similar cases in Korea, 17 EIA documents (2005~2016) for dredged soil dumping areas and ash ponds of thermal power plants were analyzed to investigate the status of marine organisms, marine physics, marine water quality, and marine sediment and to understand what types of problems can occur and what improvement measures can be taken. The purpose of these guidelines were to minimize damage to the marine environment by promoting EIA protocols in accordance with scientific and systematic procedures, to reduce the consultation period related to projects, to resolve social conflicts, and to reduce economic costs.

Derivation of Methodology Tailoring Rules in Healthcare Industry (의료업에 있어서 방법론 테일러링 규칙의 도출)

  • Choi, Won-Young;Kim, Soon-Gohn
    • Journal of Digital Contents Society
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    • v.12 no.4
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    • pp.593-600
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    • 2011
  • In the case of the domestic medical industry, work is conducting according to the convenience of the developer without guiding principles regarding tailoring and a number of processes and products that should not have been omitted considering the characteristics of corresponding sites were discovered. As a result of this omission, it was found that the delivery period was not met and problems arose for an extensive period of time after the activation of the system. The lack of critical processes and products had a negative impact on the productivity and quality of the software. This paper defines the processes that need to be followed as a basis and the products that need to be prepared during the development of a medical information system. Also, additional processes and products are presented depending upon the condition of the project. Especially, the step-by-step assessment processes and products to manage the assessment results were seriously dealt with in this study to strengthen the compliance of processes and the product quality.

Improving Safety-Related Knowledge, Attitude and Practices of Nurses Handling Cytotoxic Anticancer Drug: Pharmacists' Experience in a General Hospital, Malaysia

  • Keat, Chan Huan;Sooaid, Nor Suhada;Yun, Cheng Yi;Sriraman, Malathi
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.1
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    • pp.69-73
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    • 2013
  • Background: An increasing trend of cytotoxic drug use, mainly in cancer treatment, has increased the occupational exposure among the nurses. This study aimed to assess the change of nurses' safety-related knowledge as well as attitude levels and subsequently to assess the change of cytotoxic drug handling practices in wards after a series of pharmacist-based interventions. Materials and Methods: This prospective interventional study with a before and after design requested a single group of 96 nurses in 15 wards actively providing chemotherapy to answer a self-administered questionnaire. A performance checklist was then used to determine the compliance of all these wards with the recommended safety measures. The first and second assessments took 2 months respectively with a 9-month intervention period. Pharmacist-based interventions included a series of technical, educational and administrative support measures consisting of the initiation of closed-system cytotoxic drug reconstitution (CDR) services, courses, training workshops and guideline updates. Results: The mean age of nurses was $32.2{\pm}6.19$ years. Most of them were female (93.8%) and married (72.9%). The mean knowledge score of nurses was significantly increased from $45.5{\pm}10.52$ to $73.4{\pm}8.88$ out of 100 (p<0.001) at the end of the second assessment. Overall, the mean practice score among the wards was improved from $7.6{\pm}5.51$ to $15.3{\pm}2.55$ out of 20 (p<0.001). Conclusions: The pharmacist-based interventions improved the knowledge, attitude and safe practices of nurses in cytotoxic drug handling. Further assessment may help to confirm the sustainability of the improved practices.