• Title/Summary/Keyword: Patient Care Errors

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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.

Increasing Work Efficiency with Prevention of Reinspection for Bone Mineral Density (BMD) Exams (골밀도 검사의 재검사 방지에 따른 업무효율 향상)

  • Kim, Ho-Sung;Dong, Kyung-Rae
    • The Journal of the Korea Contents Association
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    • v.9 no.5
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    • pp.174-181
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    • 2009
  • Recently hospitals are implementing a One Stop Service as part of patient-care service. With the One Stop Service, medical treatment including consultation, inspection, and results are changing to be made available in one visit. Therefore most examinations are reserved for the same day; however, there are cases in which additional visits are necessary because of certain properties related to exams. This study compares and analyzes the number of reinspections before and after reforms. By designating the order of priority for BMD examinations and implementing education from information obtained in the OCS E-manual update, the number of reinspections for wards was reduced from 58 to 21, Outpatient departments were reduced from 51 to 12, and errors in reservations made by employees in the department of radiology were reduced from 98 to 11. Reinspections can be reduced with full understanding the factors related to reinspection and a background check prior to inspection in order to determine the order of priority for inspections. This will also reduce workers' stress and increase their efficiency and at the same time decease patient dissatisfaction and improve hospital reliability.

Analysis of Set-up Errors during CT-scan, Simulation, and Treatment Process in Breast Cancer Patients (유방암 환자의 모의치료, CT 스캔 및 치료 과정에서 발생되는 준비 오차 분석)

  • Lee, Re-Na
    • Radiation Oncology Journal
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    • v.23 no.3
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    • pp.169-175
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    • 2005
  • Purpose: Although computed tomography (CT) simulators are commonly used in radiation therapy department, many Institution still use conventional CT for treatments. In this study the setup errors that occur during simulation, CT scan (diagnostic CT scanner), and treatment were evaluated for the twenty one breast cancer patients. Materials and Methods: Errors were determined by calculating the differences in isocenter location, SSD, CLD, and locations of surgical clips implanted during surgery. The anatomic structures on simulation film and DRR image were compared to determine the movement of isocenter between simulation and CT scan. The isocetner point determined from the radio-opaque wires placed on patient's surface during CT scan was moved to new position if there was anatomic mismatch between the two images Results: In 7/21 patients, anatomic structures on DRR Image were different from the simulation Image thus new isocenter points were placed for treatment planning. The standard deviations of the diagnostic CT setup errors relative to the simulator setup in lateral, longitudinal, and anterior-posterior directions were 2.3, 1.6, and 1.6 mm, respectively. The average variation and standard deviation of SSD from AP field were 1.9 mm and 2.3 mm and from tangential fields were 2.8 mm and 3.7 mm. The variation of the CLD for the 21 patients ranged from 0 to 6 mm between simulation and DRR and 0 to 5 mm between simulation and treatment. The group systematic errors analyzed based on clip locations were 1.7 mm in lateral direction, 2.1 mm in AP direction, and 1.7 mm in SI direction. Conclusion: These results represent that there was no significant differences when SSD, CLD, clips' locations and isocenter locations were considered. Therefore, it is concluded that when a diagnostic CT scanner is used to acquire an image, the set-up variation is acceptable compared to using CT simulator for the treatment of breast cancer. However, the patient has to be positioned with care during CT scan in order to reduce the setup error between simulation and CT scan.