Search results for: patient safety in home hemodialysis

Authors: K. Alaka, A. Obi

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Home garden has proved to be significant to rural inhabitants by providing a wide range of useful products such as fruits, vegetables and medicine. There is need for quantitative information on its benefits and contributions to rural household. The main objective of this study is to investigate contributions of home garden to income of rural households in Raymond Mhlaba Local Municipality, formerly Nkonkobe Local Municipality of Eastern Cape Province South Africa. The stratified random sampling method was applied in order to choose a sample of 160 households.The study was conducted among 80 households engaging in home gardens and 80 non- participating households in the study area. Data analysis employed descriptive statistics with the use of frequency table and one way sample T test to show actual contributions. The overall model shows that social grant has the highest contribution to total household income for both categories while income generated from home garden has the second largest share to total household income, this shows that the majority of rural households in the study area rely on social grant as their source of income. However, since most households are net food buyers, it is essential to have policies that are formulated with an understanding that household food security is not only a function of the food that farming households produce for their own consumption but more so a function of total household income. The results produced sufficient evidence that home gardens contribute significantly to income of rural household.

Keywords: food security, home gardening, household, income

Procedia PDF Downloads 225

Authors: Fabiana Souza Orlandi, Izabel Cristina Chavez Gomes, Barbara Isabela De Paula Morais, Ana Carolina Ottaviani

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Chronic Kidney Disease (CKD) is considered a public health problem. Patients who present CKD in their more advanced stages usually present several biopsychosocial changes, which may include pain. Pain can be considered subjective and personal, and its perception is characterized as a multidimensional experience. The objective of this study was to evaluate the level and descriptors of pain of adults and elderly patients with chronic kidney disease, through the Multidimensional Pain Evaluation Scale (EMADOR). This is a descriptive cross-sectional study with a quantitative approach. The sample consisted of 100 subjects with CKD in hemodialysis treatment at a Renal Replacement Therapy Service in the interior of the state of São Paulo. Data were collected through an individual interview, using a Sociodemographic Characterization and Multidimensional Pain Evaluation Scale (EMADOR). All ethical precepts were respected. The majority of the respondents were men (61.0%), white (56.0%) and with a high school education (34.0%). Regarding the pain of the individuals, 89 patients reported pain, with Chronic Pain predominating (50.0%, n = 50), followed by Acute Pain (39.0%, n = 39). Of the subjects who presented acute pain most of the 89.0% described the pain felt as unbearable, and of those who presented chronic pain, 35.0% described the pain felt as painful, unbearable and uncomfortable. It was concluded that there was a significant presence of pain, being the chronic pain dominant in the studied population. Faced with such factors, the present study motivates researches in this population, in order to establish interventions with the objective of improving the quality of life of these individuals.

Keywords: pain, chronic kidney disease, dialysis, evaluation

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Authors: Huang Wei-Yi

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Objective: This article explores the intensive care nursing experience of a lung cancer patient with pulmonary embolism who was placed on ECMO. Following a sudden change in the patient’s condition and a consensus reached during a family meeting, the decision was made to withdraw life-sustaining equipment and collaborate with the palliative care team. Methods: The nursing period was from October 20 to October 27, 2023. The author monitored physiological data, observed, provided direct care, conducted interviews, performed physical assessments, and reviewed medical records. Together with the critical care team and bypass personnel, a comprehensive assessment was conducted using Gordon's Eleven Functional Health Patterns to identify the patient’s health issues, which included pain related to lung cancer and invasive devices, fear of death due to sudden deterioration, and altered tissue perfusion related to hemodynamic instability. Results: The patient was admitted with fever, back pain, and painful urination. During hospitalization, the patient experienced sudden discomfort followed by cardiac arrest, requiring multiple CPR attempts and ECMO placement. A subsequent CT angiogram revealed a pulmonary embolism. The patient's condition was further complicated by severe pain due to compression fractures, and a diagnosis of terminal lung cancer was unexpectedly confirmed, leading to emotional distress and uncertainty about future treatment. Throughout the critical care process, ECMO was removed on October 24, stabilizing the patient’s body temperature between 36.5-37°C and maintaining a mean arterial pressure of 60-80 mmHg. Pain management, including Morphine 8mg in 0.9% N/S 100ml IV drip q6h PRN and Ultracet 37.5 mg/325 mg 1# PO q6h, kept the pain level below 3. The patient was transferred to the ward on October 27 and discharged home on October 30. Conclusion: During the care period, collaboration with the medical team and palliative care professionals was crucial. Adjustments to pain medication, symptom management, and lung cancer-targeted therapy improved the patient’s physical discomfort and pain levels. By applying the unique functions of nursing and the four principles of palliative care, positive encouragement was provided. Family members, along with social workers, clergy, psychologists, and nutritionists, participated in cross-disciplinary care, alleviating anxiety and fear. The consensus to withdraw ECMO and life-sustaining equipment enabled the patient and family to receive high-quality care and maintain autonomy in decision-making. A follow-up call on November 1 confirmed that the patient was emotionally stable, pain-free, and continuing with targeted lung cancer therapy.

Keywords: intensive care, lung cancer, pulmonary embolism, ECMO

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Authors: Yu Sin Syu

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Objective: The study aimed to improve the patient guidance satisfaction of patients hospitalized in iodine-131 isolation rooms, as well as the patient guidance completion rate for such patients. Method: A patient care guidance checklist and patient care guidance satisfaction questionnaire were administered to 29 patients who had previously been hospitalized in iodine-131 isolation rooms. The evaluation was conducted on a one-on-one basis, and its results showed that the patients’ satisfaction with patient guidance was only 3.7 points and that the completion rate for the patient guidance performed by nurses was only 67%. Therefore, various solutions were implemented to create a more complete patient guidance framework for nurses, including the incorporation of regular care-related training in in-service education courses; the establishment of patient care guidance standards for patients in iodine-131 isolation rooms; the establishment of inpatient care standards and auditing processes for iodine-131 isolation rooms; the creation of an introductory handbook on ward environment; Invite other the care team the revision of iodine-131 health education brochures; the creation of visual cards and videos covering equipment operation procedures; and introduction of QR codes. Results: Following the implementation of the above measures, the overall satisfaction of patients hospitalized in iodine-131 isolation rooms increased from 3.7 points to 4.6 points, and the completion rate for patient guidance rose from 67% to 100%. Conclusion: Given the excellent results achieved in this study, it is hoped that this nursing project can serve as a benchmark for other relevant departments.

Keywords: admission care guidance, guidance satisfaction, integrity, Iodine131 isolation

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Authors: Claudia Seabra, Elisabeth Kastenholz, José Luís Abrantes, Manuel Reis

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In a world of increasing mobility and global risks, terrorism has, in a perverse way, capitalized on contemporaneous society’s growing interest in travel to explore a world whose national boundaries and distances have decreased. Terrorists have identified the modern tourist flows originated from the economically more developed countries as new appealing targets so as to: i) call attention to the causes they defend and ii) destroy a country’s foundations of tourism, with the final aim of disrupting the economic and consequently social fabric of the affected countries. The present study analyses sensitivity towards risk and travel behaviors in international travel amongst a sample of 600 international tourists from 49 countries travelling by air. Specifically, the sample was segmented according to the Global Peace Index. This index defines country profiles regarding the levels of peace. The indicators used are established over three broad themes: i) ongoing domestic and international conflict; ii) societal safety and security; and iii) militarisation. Tourists were segmented, according to their country of origin, in different levels of peacefulness. Several facets of travel behavior were evaluated, namely motivations, attitude towards trip planning, quality perception and perceived value of the trip. Also factors related with risk perception were evaluated, specifically terrorism risk perception during the trip, unsafety sensation as well as importance attributed to safety in travel. Results contribute to our understanding of the role of previous exposure to the lack of peace and safety at home in the international tourists behaviors, which is further discussed in terms of tourism management and marketing implications which should particularly interest tourism services and destinations more affected by terrorism, war, political turmoil, crime and other safety risks.

Keywords: terrorism, tourism, safety, risk perception

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Authors: Erol Karaca

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This study aims to analyze ceramic employees’ occupational health and safety training expectations. To that general objective, the study tries to examine whether occupational health and safety training expectations of ceramic employees meaningfully differentiate depending on demographic features and professional, social and economic conditions. For this purpose, the research data was collected through “Questionnaire of Occupational Health and Safety Training Expectation” (QSOHSTE) consisting of 25 open and close-ended questions developed by the researcher on the base of the literature review. QSOHSTE was applied to 125 ceramic employees working in Kutahya, Turkey. Data obtained from questionnaires were analyzed via SPSS 21. The findings, obtained from the study, revealed that employees’ agreement level to occupational health and safety training expectation statements is generally high-level. These findings also reveals that employees have various expectations about occupational health and safety training. These expectations are increasing sensitivity towards occupational health and safety training about the prevention of occupational accidents and diseases, contributing occupational health and safety training in establishing healthy and safe working environment, requiring occupational health and safety training before starting work, in case of changing working equipment and new technological applications, necessity of measurement and evaluation after occupational health and safety training. Besides these findings, employees’ agreement level to occupational health and safety training expectation statements also varies in terms of educational level, professional seniority, income level and perception of economic condition.

Keywords: occupational health and safety, occupational training, occupational expectation, professional seniority

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Authors: Kristin Prentice, Carri Hand

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As the Canadian population ages and chronic health conditions continue to escalate, older adults will require various types of housing, such as long term care or retirement homes. Moving to a new home may require a change in leisure activities and social networks, which could be challenging to maintain identity and create a sense of home. Leisure has been known to help older adults maintain or increase their quality of life and life satisfaction and may help older adults in moving to new homes. Sense of home and identity within older adults' transitions to new homes are concepts that may also relate to leisure engagement. Literature is scant regarding the role of leisure in older adults moving to new homes and how the sense of home and identity inter-relate. This study aims to explore how leisure may play a role in older adults' transitioning to new homes, including how sense of home and identity inter-relate. An ethnographic approach will be used to understand the culture of older adults transitioning to new homes. This study will involve older adults who have recently relocated to a mid-sized city in Ontario, Canada. The study will focus on the older adult’s interactions with and connections to their home environment through leisure. Data collection will take place via video-conferencing and will include a narrative interview and two other interviews to discuss an activity diary of leisure engagement pre and post move and mental maps to capture spaces where participants engaged in leisure. Participants will be encouraged to share photographs of leisure engagement taken inside and outside their home to help understand the social spaces the participants refer to in their activity diaries and mental maps. Older adults attempt to adjust to their new homes by maintaining their identity, developing a sense of home through creating attachment to place, and maintaining social networks, all of which have been linked to engaging in leisure. This research will provide insight into the role of leisure in this transition process and the extent that the home and community can contribute to aiding their transition to the new home. This research will contribute to existing literature on the inter-relationships of leisure, sense of home, and identity and how they relate to older adults moving to new homes. This research also has potential for influencing policy and practice for meeting the housing needs of older adults.

Keywords: leisure, older adults, transition, identity

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Authors: Pieter A. Cornelissen, Joris J. Van Hoof

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The interest in improving occupational safety started almost simultaneously with the beginning of the Industrial Revolution. Yet, it was not until the late 1970’s before the role of communication was considered in scientific research regarding occupational safety. In recent years the importance of communication as a means to improve occupational safety has increased. Not only as communication might have a direct effect on safety performance and safety outcomes, but also as it can be viewed as a major component of other important safety-related elements (e.g., training, safety meetings, leadership). And while safety communication is an increasingly important topic in research, its operationalization is often vague and differs among studies. This is not only problematic when comparing results, but also in applying these results to practice and the work floor. By means of an in-depth analysis—building on an existing dataset—this review aims to overcome these problems. The initial database search yielded 25.527 articles, which was reduced to a research corpus of 176 articles. Focusing on the 37 articles of this corpus that addressed communication (related to safety outcomes and safety performance), the current study will provide a comprehensive overview of the role and effects of safety communication and outlines the conditions under which communication contributes to a safer work environment. The study shows that in literature a distinction is commonly made between safety communication (i.e., the exchange or dissemination of safety-related information) and feedback (i.e. a reactive form of communication). And although there is a consensus among researchers that both communication and feedback positively affect safety performance, there is a debate about the directness of this relationship. Whereas some researchers assume a direct relationship between safety communication and safety performance, others state that this relationship is mediated by safety climate. One of the key findings is that despite the strongly present view that safety communication is a formal and top-down safety management tool, researchers stress the importance of open communication that encourages and allows employees to express their worries, experiences, views, and share information. This raises questions with regard to other directions (e.g., bottom-up, horizontal) and forms of communication (e.g., informal). The current review proposes a framework to overcome the often vague and different operationalizations of safety communication. The proposed framework can be used to characterize safety communication in terms of stakeholders, direction, and characteristics of communication (e.g., medium usage).

Keywords: communication, feedback, occupational safety, review

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Authors: Aodai Abdul-Illah Ismail

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Even though the dramatic progress that has been made in traffic safety, but still millions of peoples get killed or injured as a result of traffic crashes, besides the huge amount of economic losses due to these crashes. So traffic safety continues to be one of the most important serious issues worldwide, and it affects everyone who uses the road network system, whether you drive, walk, cycle, or push a pram. One of the most important sides that offers promise for further progress in relation to traffic safety is related to risky groups (special population groups) who may have higher potential to be involved in accidents. Traffic safety needs of risky groups are different from each other and also from the average population. Due to the various limitations between these special groups from each other and from the average population, it is not possible to address all the issues –at the same time- raising the importance ranking among the other safety issues. This paper explains a procedure used to identify the most critical traffic safety issues of five risky groups, which include younger, older and female drivers, people with disabilities and school aged children. Multi criteria used in selecting the critical issues because the single criteria is not sufficient. Highway safety professionals were surveyed to obtain the ranking of importance among the risky groups and then to develop the final ranking among issues by applying weight for each of the criteria.

Keywords: traffic safety, risky groups, old drivers, young drivers

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Authors: Pi-Chi Wu, Tsui-Ping Chu, Hsiu-Hung Wang

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Background: The ability to provide immediate medical service in outpatient departments is one of the keys to patient satisfaction. Objectives: This project used electronic equipment to integrate nursing care information to patient care at a blood pressure diagnostic counter. Through process reengineering, the average patient waiting time decreased from 35 minutes to 5 minutes, while service satisfaction increased from a score of 2.7 to 4.6. Methods: Data was collected from a local hospital in Southern Taiwan from a daily average of 2,200 patients in the outpatient department. Previous waiting times were affected by (1) space limitations, (2) the need to help guide patient mobility, (3) the need for nurses to appease irate patients and give instructions, (4), the need for patients to replace lost counter tickets, (5) the need to re-enter information, (6) the replacement of missing patient information. An ad hoc group was established to enhance patient satisfaction and shorten waiting times for patients to see a doctor. A four step strategy consisting of (1) counter relocation, (2) queue reorganization, (3) electronic information integration, (4) process reengineering was implemented. Results: Implementation of the developed strategy decreased patient waiting time from 35 minutes to an average of 5 minutes, and increased patient satisfaction scores from 2.7 to 6.4. Conclusion: Through the integration of information technology and process transformation, waiting times were drastically reduced, patient satisfaction increased, and nurses were allowed more time to engage in more cost-effective services. This strategy was simultaneously enacted in separate hospitals throughout Taiwan.

Keywords: process reengineering, electronic information integration, patient satisfaction, patient waiting time

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Authors: Paula C. Latorre Arroyo, Andrea C. Latorre Arroyo

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In the present society, children are exposed to and impacted by technology from very early on in various ways. Artificial intelligence (AI), in particular, directly affects them, be it positively or negatively. The concept of artificial intelligence is commonly defined as the technological programming of computers or robotic mechanisms with humanlike capabilities and characteristics. These technologies are often designed as helpful machines or disguised as handy tools that could ultimately steal private information for illicit purposes. Children, being one of the most vulnerable groups due to their lack of experience and knowledge, do not have the ability to recognize or have the malice to distinguish if an apparatus with artificial intelligence is good or bad for them. For this reason, as a society, there must be a sense of responsibility to regulate and monitor different types of uses for artificial intelligence to protect children from potential risks that might arise. This article aims to investigate the many implications that artificial intelligence has in the lives of children, starting from a home setting, within the classroom, and, ultimately, in online spaces. Irrefutably, there are numerous beneficial aspects to the use of artificial intelligence. However, due to its limitless potential and lack of specific and substantial regulations to prevent the illicit use of this technology, safety and privacy concerns surface, specifically regarding the youth. This written work aims to provide an in-depth analysis of how artificial intelligence can both help children and jeopardize their safety. Concluding with resources and data supporting the aforementioned statement.

Keywords: artificial intelligence, children, privacy, rights, safety

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Authors: Jonathan Doku

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The study's goal was to evaluate construction site safety management in Ghana. The construction sector has long been seen as a high-risk business. It entails a variety of hazardous and challenging labor duties, such as lifting and working at a height, among others. The accident rate is a standard indicator for comparing the safety performance of construction projects. Because of its high-risk and fast-changing work environment, the construction business is regarded as one of the industries with the highest accident rates in the world. Many mishaps and work-related diseases have occurred there, and construction workers are particularly vulnerable to catastrophic calamities such as falls, collapses, and burial. The study's main goals were to discover characteristics that have a substantial impact on construction site safety, to evaluate the safety management methods utilized on construction sites, and to assess the obstacles associated with construction site safety management. The study was conducted using a quantitative research method and a purposive sampling strategy. Google forms were used to distribute self-administered surveys to 85 responders. 72 of the 85 questionnaires were completed and submitted for analysis, accounting for 84.7 percent of the total. The variables were analyzed using descriptive statistics, mean score ranking, and Cronbach's Alpha Coefficient to ensure the scale's reliability. The formal safety organization structure and the Safety checklist were identified as the key practices of safety management on site as part of the study goals. In addition, it was discovered that the most serious problem with safety management is ineffective supervision. To guarantee efficient monitoring and proper implementation of health and safety rules on building sites, management must be on the ball.

Keywords: construction, safety, risk, management

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Authors: Qiang Zhang, Xiaojian Hu

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Aiming at the problem of the existing real-time evaluation methods for traffic safety status, a video information-based urban road section traffic safety status evaluation method was established, and the rapid detection method of traffic flow parameters based on video information is analyzed. The concept of the speed dispersion of the road section that affects the traffic safety state of the urban road section is proposed, and the method of evaluating the traffic safety state of the urban road section based on the speed dispersion of the road section is established. Experiments show that the proposed method can reasonably evaluate the safety status of urban roads in real-time, and the evaluation results can provide a corresponding basis for the traffic management department to formulate an effective urban road section traffic safety improvement plan.

Keywords: intelligent transportation system, road traffic safety, video information, vehicle speed dispersion

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Authors: Sean Hall

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Prior to COVID-19, the world was preoccupied with opioids, effectiveness versus risk, and specifically toxicity versus abuse. Historically underpinning opioid use was a concept of safety. As use over time and real-world data evolved, a pursuit for efficacy associated with non-opioid alternatives became mainstream. On January 8, 2021, the US signed back into the opioid problem, with these two fundamental questions still unresolved. The author will share the current progression of a lead non-opioid cancer bone pain candidate, NanaBis™. NanaBis™ represents two innovative factors: The active ingredients are from cannabinoids; these ingredients are in a proprietary sub-micron delivery platform, NanoCelle®. The author will offer an opinion piece, potentiating the future role of delivery platforms in medicine to increase both patient safety and compliance.

Keywords: NanaBis, nanoCelle, opioids, toxicity

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Authors: Pradeep Kumar, Shibashish Chakraborty, Sasadhar Bera

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In the anticipation of demand fluctuations, services cannot be inventoried and hence it creates a difficult problem in marketing of services. The inability to meet customers (patients) requirements in healthcare context has more serious consequences than other service sectors. In order to meet patient requirements in the current uncertain environment, healthcare organizations are seeking ways for improved service delivery. Flexibility provides a mechanism for reducing variability in service encounters and improved performance. Flexibility is defined as the ability of the organization to cope with changing circumstances or instability caused by the environment. Patient satisfaction is an important performance outcome of healthcare organizations. However, the paucity of information exists in healthcare delivery context to examine the impact of flexibility on patient satisfaction and behavioral intention. The present study is an attempt to develop a conceptual foundation for investigating overall impact of flexibility on patient satisfaction and behavioral intention. Several dimensions of flexibility in healthcare context are examined and proposed to have a significant impact on patient satisfaction and intention. Furthermore, the study involves a critical examination of determinants of patient satisfaction and development of a comprehensive view the relationship between flexibility, patient satisfaction and behavioral intention. Finally, theoretical contributions and implications for healthcare professionals are suggested from flexibility perspective.

Keywords: healthcare, flexibility, patient satisfaction, behavioral intention

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Authors: Itsuo Yokoyama, Rikako Kikuti, Miti Sekikawa, Tosinori Asai, Sarai Tsuyoshi

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Introduction: Vascular access for hemodialysis therapy is often difficult, even for experienced medical personnel. Ultrasound guided needle placement have been performed occasionally but is not always helpful in certain cases with complicated vascular anatomy. Obtaining precise anatomical knowledge of the vascular structure is important to prevent access-related complications. With augmented reality (AR) device such as AR glasses, the virtual vascular structure is shown superimposed on the actual patient vessels, thus enabling the operator to maneuver catheter placement easily with free both hands. We herein report our method of AR guided vascular access method in dialysis treatment Methods: Three dimensional (3D) object of the arm with arteriovenous fistula is computer graphically created with 3D software from the data obtained by computer tomography, ultrasound echogram, and image scanner. The 3D vascular object thus created is viewed on the screen of the AR digital display device (such as AR glass or iPad). The picture of the vascular anatomical structure becomes visible, which is superimposed over the real patient’s arm, thereby the needle insertion be performed under the guidance of AR visualization with ease. By this method, technical difficulty in catheter placement for dialysis can be lessened and performed safely. Considerations: Virtual reality technology has been applied in various fields and medical use is not an exception. Yet AR devices have not been widely used among medical professions. Visualization of the virtual vascular object can be achieved by creation of accurate three dimensional object with the help of computer graphical technique. Although our experience is limited, this method is applicable with relative easiness and our accumulating evidence has suggested that our method of vascular access with the use of AR can be promising.

Keywords: abdominal-aorta, calcification, extraskeletal, dialysis, computer graphics, 3DCG, CT, calcium, phosphorus

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Authors: Daniel Y. Abebe, Jaehyouk Choi

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The safety of door has not given much attention. The main problem of doors during and after earthquake is that they are unable to be opened because deviation from its original position by the lateral load. The aim of this research is to develop and evaluate a safety door that keeps the door frame in its original position or keeps its edge angles perpendicular during and post-earthquake. Nonlinear finite element analysis was conducted in order to evaluate the structural performance and behavior of the proposed door under both monotonic and cyclic loading.

Keywords: safety-door, earthquake disaster, low yield point steel, passive energy dissipating device, FE analysis

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Authors: Shilpa Balan

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Radio Frequency Identification, also popularly known as RFID is used to automatically identify and track tags attached to items. This study focuses on the application of RFID in healthcare. The adoption of RFID in healthcare is a crucial technology to patient safety and inventory management. Data from RFID tags are used to identify the locations of patients and inventory in real time. Medical errors are thought to be a prominent cause of loss of life and injury. The major advantage of RFID application in healthcare industry is the reduction of medical errors. The healthcare industry has generated huge amounts of data. By discovering patterns and trends within the data, big data analytics can help improve patient care and lower healthcare costs. The number of increasing research publications leading to innovations in RFID applications shows the importance of this technology. This study explores the current state of research of RFID in healthcare using a text mining approach. No study has been performed yet on examining the current state of RFID research in healthcare using a data mining approach. In this study, related articles were collected on RFID from healthcare journal and news articles. Articles collected were from the year 2000 to 2015. Significant keywords on the topic of focus are identified and analyzed using open source data analytics software such as Rapid Miner. These analytical tools help extract pertinent information from massive volumes of data. It is seen that the main benefits of adopting RFID technology in healthcare include tracking medicines and equipment, upholding patient safety, and security improvement. The real-time tracking features of RFID allows for enhanced supply chain management. By productively using big data, healthcare organizations can gain significant benefits. Big data analytics in healthcare enables improved decisions by extracting insights from large volumes of data.

Keywords: RFID, data mining, data analysis, healthcare

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Authors: Tanja Salary

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This paper discusses a study conducted in a juvenile justice facility regarding medication errors. It includes an introduction to data collected about medication errors in a juvenile justice facility from 2011 - 2019 and explores contributing factors that relate to those errors. The data was obtained from electronic incident records of medication errors that were documented from the years 2011 through 2019. In addition, the presentation reviews both current and historical research of empirical data about patient safety standards and quality care comparing traditional health care facilities to juvenile justice residential facilities and acknowledges a gap in research. The theoretical/conceptual framework for the research study was Bandura and Adams’s self-efficacy theory of behavioral change and Mark Friedman’s results-based accountability theory. Despite the lack of evidence in previous studies addressing medication errors in juvenile justice facilities, this presenter will share information that adds to the body of knowledge, including the potential relationship of medication errors and contributing factors of race and age. Implications for future research include the effect that education and training will have on the communication among juvenile justice staff, including nurses, who administer medications to juveniles to ensure adherence to patient safety standards. There are several opportunities for future research concerning other characteristics about factors that may affect medication administration errors within the residential juvenile justice facility.

Keywords: Juvenile justice, medication errors, juveniles, error reduction strategies

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Authors: Tristance Kee

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With an unprecedented increase in elderly population around the world, the severe lack of quality housing and health-and-safety provisions to serve this cohort cannot be ignored any longer. Many elderly citizens, especially singletons, live in unsafe housing conditions with poorly executed planning and design. Some suffer from deteriorating mobility, sight and general alertness and their sub-standard living conditions further hinder their daily existence. This research explains how concepts such as Universal Design and Co-Design operate in a high density city such as Hong Kong, China where innovative design can become an alternative solution where government and the private sector fail to provide quality elderly friendly facilities to promote a sustainable urban development. Unlike other elderly research which focuses more on housing policies, nursing care and theories, this research takes a more progressive approach by providing an in-depth impact assessment on how innovative design can be practical solutions for creating a more sustainable built environment. The research objectives are to: 1) explain the relationship between innovative design for elderly and a healthier and sustainable environment; 2) evaluate the impact of human ergonomics with the use of universal design; and 3) explain how innovation can enhance the sustainability of a city in improving citizen’s sight, sound, walkability and safety within the ageing population. The research adopts both qualitative and quantitative methodologies to examine ways to improve elderly population’s relationship to our built environment. In particular, the research utilizes collected data from questionnaire survey and focus group discussions to obtain inputs from various stakeholders, including designers, operators and managers related to public housing, community facilities and overall urban development. In addition to feedbacks from end-users and stakeholders, a thorough analysis on existing elderly housing facilities and Universal Design provisions are examined to evaluate their adequacy. To echo the theme of this conference on Innovation and Sustainable Development, this research examines the effectiveness of innovative design in a risk-benefit factor assessment. To test the hypothesis that innovation can cater for a sustainable development, the research evaluated the health improvement of a sample size of 150 elderly in a period of eight months. Their health performances, including mobility, speech and memory are monitored and recorded on a regular basis to assess if the use of innovation does trigger impact on improving health and home safety for an elderly cohort. This study was supported by district community centers under the auspices of Home Affairs Bureau to provide respondents for questionnaire survey, a standardized evaluation mechanism, and professional health care staff for evaluating the performance impact. The research findings will be integrated to formulate design solutions such as innovative home products to improve elderly daily experience and safety with a particular focus on the enhancement on sight, sound and mobility safety. Some policy recommendations and architectural planning recommendations related to Universal Design will also be incorporated into the research output for future planning of elderly housing and amenity provisions.

Keywords: elderly population, innovative design, sustainable built environment, universal design

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Authors: Qiuhu Shao

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Community home-based care service system, which is based on the family pension, supported by community pension and supplied by institutions pension, is an effective pension system to solve the current situation of China's accelerated aging. However, due to the fundamental realities of our country, the government is not able to bear the unilateral supply of the old-age service of the community. Therefore, based on the theory of welfare pluralism, the participation of social organizations in the home-based care service center has become an important part of the diversified supply of the old-age service for the elderly. Meanwhile, the home-based care service industry is still in the early stage, the management is relatively rough, which resulted in a large number of social resources waste. Thus, scientific, objective and long-term implementation is needed for social organizations to participate in home-based care services to guide its performance management. In order to realize the design of the performance management system, the author has done a research work that clarifies the research status of social organization's participation in home-based care service. Relevant theories such as welfare pluralism, community care theory, and performance management theory have been used to demonstrate the feasibility of data envelopment analysis method in social organization performance research. This paper analyzes the characteristics of the operation mode of the home-based care service center, and hackles the national as well as local documents, standards and norms related to the development of the home-based care industry, particularly studies those documents in Nanjing. Based on this, the paper designed a set of performance management PDCA system for home-based care service center in Nanjing and clarified each step of the system in detail. Subsequently, the research methods of performance evaluation and performance management and feedback, which are two core steps of performance management have been compared and screened in order to establish the overall framework of the performance management system of the home-based care service center. Through a large number of research, the paper summarized and analyzed the characteristics of the home-based care service center. Based on the research results, combined with the practice of the industry development in Nanjing, the paper puts forward a targeted performance evaluation index system of home-based care service center in Nanjing. Finally, the paper evaluated and sub-filed the performance of 186 home-based care service centers in Nanjing and then designed the performance optimization direction and performance improvement path based on the results. This study constructs the index system of performance evaluation of home-based care service and makes the index detailed to the implementation level, and constructs the evaluation index system which can be applied directly. Meanwhile, the quantitative evaluation of social organizations participating in the home-based care service changed the subjective impression in the previous practice of evaluation.

Keywords: data envelopment analysis, home-based care, performance management, social organization

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Authors: Jeonghyun Chang, Taegeun Lee, Heungsup Sung, Yoon-Seon Lee, Youn-Jung Kim, Mi-Na Kim

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Background: Safety device has been applied to improve safety and performance of blood culture practice. BD vacutainer® Safety-Lokᵀᴹ blood collection sets with pre-attached holder (Safety-Lok) (BD, USA) was evaluated in the emergency room (ER) of a tertiary care hospital. Methods: From April to June 2017, interns and nurses in ER were surveyed for blood culture practices with a questionnaire before and after 2 or 3 weeks of experience of Safety-Lok. All of them participated in exercise workshop for 1 hour combined with video education prior to the initial survey. The blood volume, positive and contamination rates of Safety-Lok-drawn (SD) blood cultures were compared to those of overall blood cultures. Results: Eighteen interns and 30 nurses were enrolled. As a result of the initial survey, interns had higher rates of needlestick incidence (27.8%), carriage of the blood-filled syringe with needle (88.9%) and lower rates of vacutainer use (38.9%) than nurses (13.3%, 53.3%, and 60.0%). Interns preferred to use safety devices (88.9%) rather than nurses (40.0%). The number of overall blood cultures and SD blood cultures was 9,053 and 555, respectively. While the overall blood volume of aerobic bottles was 2.6±2.1 mL, those of SD blood cultures were 5.0±3.0 mL in aerobic bottles and 6.0±3.0 mL in anaerobic bottles. Positive and contamination rates were 6.5% and 0.72% with SD blood cultures and 6.2% and 0.3% with overall blood cultures. Conclusions: The introduction of the safety device would encourage healthcare workers to collect adequate blood volume as well as lead to safer practices in the ER.

Keywords: blood culture, needlestick, safety device, volume

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Authors: Nyambayar Davaadorj, Ichiro Koshijima

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Safety or the state of being safe can be described as a condition of being not dangerous or not harmful. It is necessary for an individual to avoid dangerous situations every day. Also, an organization is subject to legal requirements for the health and safety of persons inside and around the immediate workplace, or who are exposed to the workplace activities. Although it might be difficult to keep a situation where complete safety is ensured, efforts must nonetheless be made to consider ways of removing any potential danger within an organization. In order to ensure a safe working environment, the capability of responding (i.e., resilience) to signals (i.e., information concerning events that could pose future problems that must be taken into account) that occur in and around corporations is necessary. The ability to evaluate this essential point is thus one way in which safety and security can be managed. This study focuses on OHSAS18001, an internationally applied standard for the construction and operation of occupational health and safety management systems, by using IDEF0 for Function Modeling (IDEF0) and the Resilience Matrix originally made by Bracco. Further, this study discusses a method for evaluating a manner in which Occupational Health and Safety Assessment Series (OHSAS) systematically functions within corporations. Based on the findings, this study clarifies the potential structural objection for corporations when implementing and operating the OHSAS standard.

Keywords: OHSAS18001, IDEF0, resilience engineering, safety culture

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Authors: Pim Terachinda, Witaya Wannasuphoprasit, Wasuwat Kitisomprayoonkul, Anan Srikiatkhachorn

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Restoration of hand function and dexterity remain challenges in rehabilitation after stroke. We have developed soft exoskeleton hand robot in which using tendon-driven mechanism. Finger flexion and extension can be triggered by a foot switch and force can be adjusted manually depending on patient’s grip strength. The objective of this study is to investigate feasibility and safety of this device. The study was done in 2 stroke patients with the strength of the finger flexors/extensors grade 1/0 and 3/1 on Medical Research Council scale, respectively. Grasp and release training was performed for 30 minutes. No complication was observed. Results demonstrated that the device is safe, and therapy can be tailored to individual patient’s need. However, further study is required to determine recovery and rehabilitation outcomes after training in patients after nervous system injury.

Keywords: hand, rehabilitation, robot, stroke

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Authors: Mehravar Javid, Rohma Hassan, J. DeSilva

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In this exploratory case study, a 37-year-old male patient who previously terminated treatment after four months of therapy with a different therapist begins anew with a 38-year-old female therapist and undergoes a similar cycle of premature termination, with added discourse caused by erotic transference. Process notes and records of the therapy treatment indicate that during the short course of treatment, the patient explored his difficulties navigating personal relationships, both current and past, and his difficulties coping with hypochondriasis. The therapist becomes tasked with not only navigating the patient’s inner conflict but also how she relates to the patient in the countertransference process while maintaining professional boundaries. This includes empathizing with the patient while also experiencing discomfort in the erotic transference from a professional standpoint. When the patient terminates once more, the therapist reflects on the possible reasons for termination. This includes the patient’s difficulties with tolerating interpretations, which cause him to blame himself for past events. These interpretations were also very frequent, contributing to the emotional burden the patient experienced. The therapist reflected on the use of interpretation versus exploration of the patient’s feelings and how exploring his feelings, including his feelings towards her, would have allowed for an opportunity to explore the emotions that troubled him more deeply. This includes exploring the patient’s anger and fear, which stem from unresolved conflicts from his childhood. Moreover, the erotic transference served as an enactment of previous experiences in which the patient feared losing what he loved, leading him to opt for premature termination instead of losing his ability to control the relationship and experience loss.

Keywords: countertransference, erotic transference, premature termination, therapist-client boundaries, transference

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Authors: Ibrahim A. Alkali

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There is no reservation on the outstanding contribution of patient families in restoration of hospitalised patients, hence their consideration as essential component of hospital ward regimen. The psychological and emotional support a patient requires has been found to be solely provided by the patient’s family. However, consideration of their presence as one of the major functional requirements of an inpatient setting design have always been a source of disquiet, especially in developing countries where policies, norms and protocols of healthcare administration have no consideration for the patients’ family. This have been a major challenge to the hospital ward facilities, a concern for the hospital administration and patient management. The study therefore is aimed at obtaining a consensus opinion on the best approach for family integration in the design of an inpatient setting.  A one day visioning charrette involving Architects, Nurses, Medical Doctors, Healthcare assistants and representatives from the Patient families was conducted with the aim of arriving at a consensus opinion on practical design approach for sustainable family integration. Patient’s family are found to be decisive character of hospital ward regimen that cannot be undermined. However, several challenges that impede family integration were identified and subsequently a recommendation for an ideal approach. This will serve as a guide to both architects and hospital management in implementing much desired Patient and Family Centred Care.

Keywords: patient's family, inpatient setting, care giving, integration

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Authors: Maithem Al-Saadi, Min An

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During airport planning and design stages, the major issues of capacity and safety in construction and operation of an airport need to be taken into consideration. The airside of an airport is a major and critical infrastructure that usually consists of runway(s), taxiway system, and apron(s) etc., which have to be designed according to the international standards and recommendations, and local limitations to accommodate the forecasted demands. However, in many cases, airport airsides are suffering from unexpected risks that occurred during airport operations. Therefore, safety risk assessment should be applied in the planning and design of airsides to cope with the probability of risks and their consequences, and to make decisions to reduce the risks to as low as reasonably practicable (ALARP) based on safety risk assessment. This paper presents a combination approach of Failure Modes, Effect, and Criticality Analysis (FMECA), Fuzzy Reasoning Approach (FRA), and Fuzzy Analytic Hierarchy Process (FAHP) to develop a risk analysis model for safety risk assessment. An illustrated example is used to the demonstrate risk assessment process on how the design of an airside in an airport can be analysed by using the proposed safety design risk assessment model.

Keywords: airport airside planning and design, design for safety, fuzzy reasoning approach, fuzzy AHP, risk assessment

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Authors: Tuji Jemal Ahmed

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This paper is to provides a comprehensive review of current research works on foodborne illness and food safety, including the risks associated with foodborne illnesses, the latest research on food safety, and the mitigation strategies used to prevent and control foodborne illnesses. Foodborne illness is a major public health concern that affects millions of people every year. As foodborne illnesses have grown more common and dangerous in recent years, it is vital that we research and build upon methods to ensure food remains safe throughout consumption. Additionally, this paper will discuss future directions for food safety research, including emerging technologies, changes in regulations and standards, and collaborative efforts to improve food safety. The first section of the paper provides an overview of the risks of foodborne illness, including a definition of foodborne illness, the causes of foodborne illness, the types of foodborne illnesses, and high-risk foods for foodborne illness, Health Consequences of Foodborne Illness. The second section of the paper focuses on current research on food safety, including the role of regulatory agencies in food safety, food safety standards and guidelines, emerging food safety concerns, and advances in food safety technology. The third section of the paper explores mitigation strategies for foodborne illness, including preventative measures, hazard analysis and critical control points (HACCP), good manufacturing practices (GMPs), and training and education. Finally, this paper examines future directions for food safety research, including hurdle technologies and their impact on food safety, changes in food safety regulations and standards, collaborative efforts to improve food safety, and research gaps and areas for further exploration. In general, this work provides a comprehensive review of current research and future directions in food safety and understanding the risks associated with foodborne illness. The implications of the assessment for food safety and public health are discussed, as well as recommended for research scholars.

Keywords: food safety, foodborne illness, technologies, mitigation

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Authors: Qing Wu, Xuchun Ye, Qiuchen Wang, Kirsten Corazzini

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Objective: It’s increasing acknowledged that patient engagement in healthcare and health literacy both have positive impact on patient outcome. Health literacy emphasizes the ability of individuals to understand and apply health information and manage health. Patients' health literacy affected their willingness to participate in decision-making, but its impact on the behavior and willingness of patient engagement in healthcare is not clear, especially in China. Therefore, this study aimed to explore the correlation between the behavior and willingness of patient engagement and health literacy. Methods: A cross-sectional survey was employed using the behavior and willingness of patient engagement in healthcare questionnaire, Chinese version All Aspects of Health Literacy Scale (AAHLS). A convenient sample of 443 patients was recruited from 8 general hospitals in Shanghai, Jiangsu Province and Zhejiang Province, from September 2016 to January 2017. Results: The mean score for the willingness was (4.41±0.45), and the mean score for the patient engagement behavior was (4.17±0.49); the mean score for the patient's health literacy was (2.36±0.29)，the average score of its three dimensions- the functional literacy, the Communicative/interactive literacy and the Critical literacy, was (2.26±0.38), (2.28±0.42), and (2.61±0.43), respectively. Patients' health literacy was positively correlated with their willingness of engagement (r = 0.367, P < 0.01), and positively correlated with patient engagement behavior (r = 0.357, P < 0.01). All dimensions of health literacy were positively correlated with the behavior and willingness of patient engagement in healthcare; the dimension of Communicative/interactive literacy (r = 0.312, P < 0.01; r = 0.357, P < 0.01) and the Critical literacy (r = 0.357, P < 0.01; r = 0.357, P < 0.01) are more relevant to the behavior and willingness than the dimension of basic/functional literacy (r=0.150, P < 0.01; r = 0.150, P < 0.01). Conclusions: The behavior and willingness of patient engagement in healthcare are positively correlated with health literacy and its dimensions. In clinical work, medical staff should pay attention to patients’ health literacy, especially the situation that low literacy leads to low participation and provide health information to patients through health education or communication to improve their health literacy as well as guide them to actively and rationally participate in their own health care.

Keywords: patient engagement, health literacy, healthcare, correlation

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Authors: Armana Sabiha Huq, Tahmina Rahman Chowdhury

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In this paper, based on the stated preference experiment, the service quality of Bangladesh Railway has been assessed, and particular importance has been given to investigate if there exists a relationship between service quality and safety. For investigation purposes, environmental and organizational factors were assumed to determine the safety performance of the railway. Data collected from the survey has been analyzed by importance-performance analysis (IPA). In this paper, a modification of the well-known importance-performance analysis (IPA) has been done by adopting the importance of the weights determined through a structural equation modeling (SEM) approach and by plotting the gap between importance and performance on a visual graph. It has been found that there exists a relationship between safety and serviceability to some extent. Limited resources are an important factor to improve the safety and serviceability condition of the BD railway. Moreover, it is observed that the limited resources available to monitor and improve the safety performance of railway.

Keywords: importance-performance analysis, GAP-IPA, SEM, serviceability, safety, factor analysis

Procedia PDF Downloads 140