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.
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.
Complex ethical issues of Emergency Medical Techinician (EMT) out-of hospital emergency medical scene and the ER (Emergency Room) behaviors were studied. The survey was conducted by 500 EMT group members working in the field of ambulance work and general hospital and it was about their work ethics, discussions and solutions about the transferred patients, and ethics regarding Do Not Attempt Resuscitate (DNAR). The survey includes work ethics, awareness about the target job, a discussion on the transfer of patients, measures, and deathbed. Discussions about the patient's condition and diagnosis results were majorly absent during patient transportation at the emergency care scene. More than 90% of emergency care transfer were inappropriate. Sometimes, EMT working in the field facing morally unethical problems beyond their responsibility. When EMT, who can not make death diagnosis, received deathbed related DNAR issues, they gone through severe ethical conflicts. The institutional support and therapy for EMT was weak. In Korea, especially in the accident site, ethical issues education is more needed than DNAR prevalence of education and guidance. If ethics training and guidance are given to EMT, a lot of moral errors in the field can be resolved.
Maternity services is often perceived as a troublesome business and obstetric litigation is on the increase in Western countries. Overall, the number of claim and cost of litigation to the NHS Litigation Authority (NHSLA) from maternity services in the UK is increasing every year. Maternity services account for 60-70% of the total sum paid. This has widespread implications for both the individual practitioners and the institutions where they work, due to increasing malpractice insurance premiums. Fear of litigation is also attracting fewer medical graduates into the specialty, leading to a recruitment crisis in obstetrics and gynaecology. The litigation process can cause pain, suffering and distress to clinicians as well as to the patients and their families. Litigation in maternity services is the result of a complex of events when malpractice (presumed or real) impacts on the attitude of pregnant women and their environment. In such complexity, information is mandatory but may often be misinterpreted. If messages are not tailored to the receiver's capacity, communicating well with the pregnant patient becomes crucial. Therefore, to reduce medicallegal issues in obstetrics, increasing attention and an applicable standard of obstetric care to avoid negligence and medical errors should go along with other measures. Considering UK's experiences, NHS redress scheme make it easier to pursue small claims and birth related claims, without necessarily reducing the number of claims processed through the conventional legal system and perhaps encouraging even more of them. The task of dealing with the greater number of inquiries into their practice would inevitably create an added burden for clinicians and hospital managers. Thus further proposals are required to limit the cost of processing inflated claims and to consider whether clinicians should be given some protection from litigation alleging a failure to prevent birth related impairment.
In this paper, we propose health risk management using feature extraction and cluster analysis considering time flow. The proposed method proceeds in three steps. The first is the pre-processing and feature extraction step. It collects user's lifelog using a wearable device, removes incomplete data, errors, noise, and contradictory data, and processes missing values. Then, for feature extraction, important variables are selected through principal component analysis, and data similar to the relationship between the data are classified through correlation coefficient and covariance. In order to analyze the features extracted from the lifelog, dynamic clustering is performed through the K-means algorithm in consideration of the passage of time. The new data is clustered through the similarity distance measurement method based on the increment of the sum of squared errors. Next is to extract information about the cluster by considering the passage of time. Therefore, using the health decision-making system through feature clusters, risks able to managed through factors such as physical characteristics, lifestyle habits, disease status, health care event occurrence risk, and predictability. The performance evaluation compares the proposed method using Precision, Recall, and F-measure with the fuzzy and kernel-based clustering. As a result of the evaluation, the proposed method is excellently evaluated. Therefore, through the proposed method, it is possible to accurately predict and appropriately manage the user's potential health risk by using the similarity with the patient.
Digital Radiography is a big part of diagnostic radiology. Because uncorrected digital radiography image supported false effect of Patient's health care. We must be manage the correct digital radiography image. Thus, the artifact images can have effect to make a wrong diagnosis. We report types of occurrence by analyzing the artifacts that occurs in digital radiography system. We had collected the artifacts occurred in digital radiography system of general hospital from 2007 to 2014. The collected data had analyzed and then had categorize as the occurred causes. The artifacts could be categorized by hardware artifacts, software artifacts, operating errors, system artifacts, and others. Hardware artifact from a Ghost artifact that is caused by lag effect occurred most frequently. The others cases are the artifacts caused by RF noise and foreign body in equipments. Software artifacts are many different types of reasons. The uncorrected processing artifacts and the image processing error artifacts occurred most frequently. Exposure data recognize (EDR) error artifacts, the processing error of commissural line, and etc., the software artifacts were caused by various reasons. Operating artifacts were caused when the user didn't have the full understanding of the digital medical image system. System artifacts had appeared the error due to DICOM header information and the compression algorithm. The obvious artifacts should be re-examined, and it could result in increasing the exposure dose of the patient. The unclear artifact leads to a wrong diagnosis and added examination. The ability to correctly determine artifact are required. We have to reduce the artifact occurrences by understanding its characteristic and providing sustainable education as well as the maintenance of the equipments.
The trend in modern nursing is toward the performance of comprehensive nursing care. Psychiatric nursing emphasizes education which enables the nurse to understand the underlying difficulties being expressed through a wide range of emotions and through practice to be more adept in her selection of a manner of approach which best meets the needs of a given situation. Presently, in Korea, there is nothing in the literature regarding evaluation of the effect of psychiatric nursing education on the attitudes of nurses towards mental illness and mentally ill patients. This stud!1 was attempted in order to understand 1) some of the problems in psychiatric nursing education 2) some of tile factors which affect the attitudes of nurses towards mental illness and mental patients. A questionnaire, a Korean translation of the "Opinions about Mental illness Scale" by Cohen and Stranding, 1962, was administered to 188 nonpsychiatric registered nurses employed in Yonsei University Hospital (Y. Hospital) and Seoul National University Hospital (S. Hospital) located in the city of Seoul. All of the nurses were directly involved with adult patient care. They graduated from various nursing schools. The data was collected during the period of October 2 to October 16,1972. The age, educational background , marital status, type of previous psychiatric experience, experience as a graduate nurse and close personal relationship with someone who was a psychiatric patient were compared with the O.M.I. scores. The mean and standard errors for each of the comparison groups were computed and tile relationships calculated by a t-test. The results of the study are summarized as follow: 1. There is no significant difference between the age of the nurses and their attitudes toward mental illness and mental patients. 2. There is no significant difference between the. educational backgrounds of the nurses and their attitudes toward mental illness and mental patients. 3. There is a significant difference in the nurses ′student psychiatric nursing experience and their attitudes towards mental illness and mental patients for the nurses in 5. Hospital only. The nurses who had 3-4 week of student psychiatric nursing experience had a significantly higher mean score for Benevolence (factor B) than nurses whose student psychiatric experience had been less than 1 Ivcek (P<0.05). The nurses who had 1-2 weeks, 3-4 weeks and more than 4 weeks of student psychiatric nursing experience had significantly higher mean scores for Interpersonal Ethology (factor E) than nurses whose student psychiatric had been less than 1 week (p<0.05), 4. There is a significant difference in the nurses′student psychiatric nursing experience by types of institution and their attitudes towards mental illness and mental patients for S. Hospital nurses only. The nurses who had their student psychiatric nursing experience in the government psychiatric hospitals recorded significantly higher mean score for Authoritarianism (factor A) than nurses who had their. experience in private psychiatric hospitals (p<0.05). 5. There is no significant difference in the nurses′psychiatric nursing experience as a graduate nurse and their attitudes toward mental illness and mental patients. 6. There is no significant difference in the nature and variety of the nurses′experience as a graduate nurse and their attitude toward mental illness and mental patients. 7. There is no significant difference in the presence or absence of a close personal relationship with a mentally ill person and the nurses′attitude toward mental illness and mental patients. 8. There is no significant difference in the nurses′ marital status and their attitude toward mental illness and mental patients. 9. There is no significant difference between the nurses who were employed ill S. and Y. hospitals and their attitudes towards mental illness and mental patients. Major suggestion for further study was to have more larger and wider scale research for establishing of the reliability and validity of the Korean translation of the O.H.I. Scale.
Journal of the Institute of Convergence Signal Processing
/
v.9
no.2
/
pp.104-111
/
2008
The ECG is biomedical electrical signal occurring on the surface of the body due to the contraction and relaxation of the heart. This signal represents an extremely important measure for health monitoring, as it provides vital information about a patient's cardiac condition and general health. ECG signals are contaminated with high frequency noise such as power line interference, muscle artifact and low frequency nose such as motion artifact. But it is difficult to filter nose from ECG signal, and errors resulting from filtering can distort a ECG signal. The present study implemented a small-size and low-power ECG measurement system that can remove motion artifact for convenient health monitoring during daily life. The implemented ECG monitoring system consists of ECG amplifier, a low power microprocessor, bluetooth module and monitoring program. Amplifier was designed and implemented using low power instrumentation amplifier, and microprocessor was interfaced to the ECG amplifier to collect the data, process, store and feed to a transmitter. And bluetooth module used to wirelessly transmit and receive the vital sign data from the microprocessor to an PC at the receiving site. In order to evaluate the performance of the implemented system, we assessed motion artifact rejection performance in each situation with artificially set condition using adaptive filter.
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