• Title/Summary/Keyword: Patient Care Errors

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The Intelligent Clinical Laboratory as a Tool to Increase Cancer Care Management Productivity

  • Mohammadzadeh, Niloofar;Safdari, Reza
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.6
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    • pp.2935-2937
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    • 2014
  • Studies of the causes of cancer, early detection, prevention or treatment need accurate, comprehensive, and timely cancer data. The clinical laboratory provides important cancer information needed for physicians which influence clinical decisions regarding treatment, diagnosis and patient monitoring. Poor communication between health care providers and clinical laboratory personnel can lead to medical errors and wrong decisions in providing cancer care. Because of the key impact of laboratory information on cancer diagnosis and treatment the quality of the tests, lab reports, and appropriate lab management are very important. A laboratory information management system (LIMS) can have an important role in diagnosis, fast and effective access to cancer data, decrease redundancy and costs, and facilitate the integration and collection of data from different types of instruments and systems. In spite of significant advantages LIMS is limited by factors such as problems in adaption to new instruments that may change existing work processes. Applications of intelligent software simultaneously with existing information systems, in addition to remove these restrictions, have important benefits including adding additional non-laboratory-generated information to the reports, facilitating decision making, and improving quality and productivity of cancer care services. Laboratory systems must have flexibility to change and have the capability to develop and benefit from intelligent devices. Intelligent laboratory information management systems need to benefit from informatics tools and latest technologies like open sources. The aim of this commentary is to survey application, opportunities and necessity of intelligent clinical laboratory as a tool to increase cancer care management productivity.

Critical Thinking Disposition, Medication Error Risk Level of High-alert Medication and Medication Safety Competency among Intensive Care Unit Nurses (중환자실 간호사의 비판적 사고성향, 고위험약물 투약오류 위험수준 및 투약안전역량)

  • Lee, Yoon Hee;Lee, Youngjin;Ahn, Jeong-Ah;Kim, Hee Jun
    • Journal of Korean Critical Care Nursing
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    • v.15 no.2
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    • pp.1-13
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    • 2022
  • Purpose : The study aimed to identify relationship among intensive care unit (ICU) nurses' critical thinking disposition, medication error risk level of high-alert medication, and medication safety competency, as well as the factors affecting medication safety competency. Methods : The participants were 266 ICU nurses of one higher-tier general hospital and one general hospital in Province. The data were collected using structured self-administered questionnaire from August 10 to August 31, 2021. Measurements included the critical thinking disposition questionnaire, nurses's knowledge of high-alert medication questionnaire, the medication safety competency scale. Data were analyzed using hierarchical multiple regressions using SPSS/WIN 28.0. Results : In the multiple regression analysis, the medication safety competence has a statistically significant correlation with the working department, the critical thinking disposition, and medication error risk level of high-alert medication. Conclusion : Based on the results of this study, it is suggested to develop and apply an educational strategy that can strengthen the knowledge and skills of critical thinking disposition and medication error risk level of high-alert medication to improve the ICU nurse's medication safety competency.

Wearable Approach of ECG Monitoring System for Wireless Tele-Home Care Application

  • Kew, Hsein-Ping;Noh, Yun-Hong;Jeong, Do-Un
    • Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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    • 2009.05a
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    • pp.337-340
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    • 2009
  • Wireless tele-home-care application gives new possibilities for ECG (electrocardiogram) monitoring system with wearable biomedical sensors. Thus, continuously development of high convenient ECG monitoring system for high-risk cardiac patients is essential. This paper describes to monitor a person's ECG using wearable approach. A wearable belt-type ECG electrode with integrated electronics has been developed and has proven long-term robustness and monitoring of all electrical components. The measured ECG signal is transmitted via an ultra low power consumption wireless sensor node. ECG signals carry a lot clinical information for a cardiologist especially the R-peak detection in ECG. R-peak detection generally uses the threshold value which is fixed thus it bring errors due to motion artifacts and signal size changes. Variable threshold method is used to detect the R-peak which is more accurate and efficient. In order to evaluate the performance analysis, R-peak detection using MIT-BIH databases and Long Term Real-Time ECG is performed in this research. This concept able to allow patient to follow up critical patients from their home and early detecting rarely occurrences of cardiac arrhythmia.

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Workflow Interruptions and Failed Action Regulation in Surgery Personnel

  • Elfering, Achim;Nutzi, Marina;Koch, Patricia;Baur, Heiner
    • Safety and Health at Work
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    • v.5 no.1
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    • pp.1-6
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    • 2014
  • Background: Workflow interruptions during surgery may cause a threat to patient's safety. Workflow interruptions were tested to predict failure in action regulation that in turn predicts near-accidents in surgery and related health care. Methods: One-hundred-and-thirty-three theater nurses and physicians from eight Swiss hospitals participated in a cross-sectional questionnaire survey. The study participation rate was 43%. Results: Structural equation modeling confirmed an indirect path from workflow interruptions through cognitive failure in action regulation on near-accidents (p < 0.05). The indirect path was stronger for workflow interruptions by malfunctions and task organizational blockages compared with workflow interruptions that were caused by persons. The indirect path remained meaningful when individual differences in conscientiousness and compliance with safety regulations were controlled. Conclusion: Task interruptions caused by malfunction and organizational constraints are likely to trigger errors in surgery. Work redesign is recommended to reduce workflow interruptions by malfunction and regulatory constraints.

Study on Weak Children Information Collection Using Personal Health Record (PHR) (개인건강기록 (PHR)을 이용한 허약아 정보 수집 연구)

  • Lee, Seungho;Kim, Anna;Jang, Hyunchul;Jeong, Minjeong
    • The Journal of Pediatrics of Korean Medicine
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    • v.31 no.3
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    • pp.46-63
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    • 2017
  • Objectives The Korean Medicine (KM) PHR platform is a personalized healthcare service which allows individuals to keep and manage their own health records. When parents are reporting for their children from their memories, there is high possibility of recall errors. In these cases, it could be useful for doctors to collect the patient's symptoms through PHR platform. In this study, we aimed to investigate the clinical significance of the PHR by using the KM PHR platform in the pediatric clinic. Methods The PHR platform was used to collect child health information from parents and child care teachers. The collected data were analyzed in comparison with the results of screening by pediatrician. Results A total of 58 children were recruited, 44 of which health information were collected from their parents and their child care teachers. The remaining 14 children's health information were collected from their parents only. As a result the parents tended to perceive their children weaker than the child care teacher. Compared to other organs, there was a only significant difference in the heart weakness score and spleen weakness score in the comparison of the weak and healthy children. Conclusions Although the study was conducted on a small group of subjects, and used PHR platform developed specifically for adults to indirectly input child's symptoms, and analyzed their health information, there was a difference in health records between information providers. Development of PHR platform for children is needed to collect more reliable information.

Awareness and satisfaction on dental implant treatment (임플란트 시술에 대한 인지도 및 만족도)

  • Kim, Soo-Kyung;Kim, Sun-Yi;Jeon, Hee-Young;Lee, Kyeong-Hee
    • Journal of Korean society of Dental Hygiene
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    • v.13 no.3
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    • pp.395-401
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    • 2013
  • Objectives : The purpose of this research was to investigate the awareness of an adult on implants and the relevant factors which affect the satisfaction of a patient after an implant treatment. Methods : This study was conducted to 407 adult subjects in Seoul and Gyeonggi. A total of 384 data were analyzed except the questionnaires having poor responses or errors. Results : The acquaintance route of implant was TV advertisements, self-knowledge, internet, news, and newspapers. Dentist's ability to practice implant was the most important factor in patient's choice. The responents answered the expected lifespan of an implant was more than 5 years to 10 years. In terms of dental health management behavior on implants, the average response of the highest 4.07 points of 5 Likert scale. Generally women are more concerned with implant than men(p<0.01). The highly educated and elderly patients had tendency to receive more treatment(p<0.0001). Patients were more satisfactory after receiving regular checkups after treatment(p<0.05). The low expenses of implant satisfied the patients(p<0.05). Conclusions : As implant technology advances, the concern of patients on implants also increase. So reduction of cost can make the patients have access to the dentist and the patients' oral health must be improved through continuous dental care.

Clinical image quality evaluation for panoramic radiography in Korean dental clinics

  • Choi, Bo-Ram;Choi, Da-Hye;Huh, Kyung-Hoe;Yi, Won-Jin;Heo, Min-Suk;Choi, Soon-Chul;Bae, Kwang-Hak;Lee, Sam-Sun
    • Imaging Science in Dentistry
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    • v.42 no.3
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    • pp.183-190
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    • 2012
  • Purpose: The purpose of this study was to investigate the level of clinical image quality of panoramic radiographs and to analyze the parameters that influence the overall image quality. Materials and Methods: Korean dental clinics were asked to provide three randomly selected panoramic radiographs. An oral and maxillofacial radiology specialist evaluated those images using our self-developed Clinical Image Quality Evaluation Chart. Three evaluators classified the overall image quality of the panoramic radiographs and evaluated the causes of imaging errors. Results: A total of 297 panoramic radiographs were collected from 99 dental hospitals and clinics. The mean of the scores according to the Clinical Image Quality Evaluation Chart was 79.9. In the classification of the overall image quality, 17 images were deemed 'optimal for obtaining diagnostic information,' 153 were 'adequate for diagnosis,' 109 were 'poor but diagnosable,' and nine were 'unrecognizable and too poor for diagnosis'. The results of the analysis of the causes of the errors in all the images are as follows: 139 errors in the positioning, 135 in the processing, 50 from the radiographic unit, and 13 due to anatomic abnormality. Conclusion: Panoramic radiographs taken at local dental clinics generally have a normal or higher-level image quality. Principal factors affecting image quality were positioning of the patient and image density, sharpness, and contrast. Therefore, when images are taken, the patient position should be adjusted with great care. Also, standardizing objective criteria of image density, sharpness, and contrast is required to evaluate image quality effectively.

Errors in light-emitting diodes positioning when curing bulk fill and incremental composites: impact on properties after aging

  • Abdulrahman A. Balhaddad;Isadora M. Garcia;Haifa Maktabi;Maria Salem Ibrahim;Qoot Alkhubaizi;Howard Strassler;Fabricio M. Collares;Mary Anne S. Melo
    • Restorative Dentistry and Endodontics
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    • v.46 no.4
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    • pp.51.1-51.13
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    • 2021
  • Objectives: This study aimed to evaluate the effect of improper positioning single-peak and multi-peak lights on color change, microhardness of bottom and top, and surface topography of bulk fill and incremental composites after artificial aging for 1 year. Materials and Methods: Bulk fill and incremental composites were cured using multi-peak and single-peak light-emitting diode (LED) following 4 clinical conditions: (1) optimal condition (no angulation or tip displacement), (2) tip-displacement (2 mm), (3) slight tip angulation (α = 20°) and (4) moderate tip angulation (α = 35°). After 1-year of water aging, the specimens were analyzed for color changes (ΔE), Vickers hardness, surface topography (Ra, Rt, and Rv), and scanning electron microscopy. Results: For samples cured by single-peak LED, the improper positioning significantly increases the color change compared to the optimal position regardless of the type of composite (p < 0.001). For multi-peak LED, the type of resin composite and the curing condition displayed a significant effect on ΔE (p < 0.001). For both LEDs, the Vickers hardness and bottom/top ratio of Vickers hardness were affected by the type of composite and the curing condition (p < 0.01). Conclusions: The bulk fill composite presented greater resistance to wear, higher color stability, and better microhardness than the incremental composite when subjected to improper curing. The multi-peak LED improves curing under improper conditions compared to single-peak LED. Prevention of errors when curing composites requires the attention of all personnel involved in the patient's care once the clinical relevance of the appropriate polymerization reflects on reliable long-term outcomes.

A Comparison of Efficiency between Computerized Nursing Records and the Paper-based Nursing Records - focus on patients with a stroke - (전산간호기록과 서면간호기록의 효율성에 관한 비교연구 - 급성 뇌졸중 환자의 간호기록 중심으로 -)

  • Sung Young-Hye;Cho Myung-Sook;Choi Bok-Yeon;Jang Mi-Ra
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.13 no.1
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    • pp.24-32
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    • 2006
  • Purpose: This study was a comparative review of the computerized nursing records and paper-based nursing records to examine effects of a nursing process documentation system focusing on patients who have had stroke. Method: First, the researchers collected all the foci from the computerized records and the paper-based records. They selected ten nursing foci, used frequently in both groups and analyzed the number of foci per patient, appropriateness of foci, the number of nursing activities per nursing focus and whether outcomes were described or not in the nursing record. Results: There was fewer errors in nursing diagnosis selection, and a larger number of activities in the records than trle paper based ones. Also, there was a better description of the nursing outcomes in the computerized records. Conclusion: This study suggests that the computerized nursing records is significantly effective in increasing accuracy of the nursing care plan and quality of the nursing record.

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Development of Case Review Form for Detecting Adverse Events (위해사건 확인을 위한 증례검토지 개발)

  • Ock, Min-su;Lee, Sang-il;Kim, Yoon;Lee, Jae-ho;Lee, Jin-yong;Jo, Min-woo;Kim, Seon-ha;Son, Woo-seung;Kim, Hyun-joo
    • Quality Improvement in Health Care
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    • v.21 no.1
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    • pp.66-76
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    • 2015
  • Objectives: The purpose of this study is to develop a case review form for detecting adverse events through a medical records review in hospitalized patients in South Korea. Methods: To develop the case review form, several literatures were reviewed, first. Through the clinical expert meeting, screening criteria were selected and case review form was developed. Result: The Korean version of case review form consisted of the review form-1 for adverse event screening and form-2 for adverse event identification. The applied methodology for the case review form is determined according to the previous studies. For example, the method used in the first stage review is nurse review. Furthermore, the National Coordinating Council for Medication Errors Reporting and Prevention index is used to categorize disability, and a scale of 1 to 6 was used in the causation scores and preventability scores, respectively. Through the clinical expert meeting, a total of 41 screening criteria were selected. Conclusion: The Korean specific case review form was developed for detecting adverse events in hospitalized patients. The results from this study can be used in a large-scale study regarding the nationwide incidence of adverse events.