Search results for: patient safety practices
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 9872

Search results for: patient safety practices

9842 Associated Factors the Safety of the Patient in Hemodialysis Clinics of a Brazilian Municipality: Cross-Sectional Study

Authors: Magda Milleyde de Sousa Lima, Letícia Lima Aguiar, Marina Guerra Martins, Erika Veríssimo Dias Sousa, Lizandra Sampaio de Oliveira, Lívia Moreira Barros, Joselany Áfio Caetano

Abstract:

Patients with chronic kidney disease are vulnerable to episodes which make the safety of their health vulnerable, mainly due to the treatment process that exposes them to high rates of interventions during hemodialysis sessions. Some factors associated with health care contribute to the risk of death and complications. However, there are a small number of scientific studies evaluating the level of safety of hemodialysis clinics, and the sociodemographic characteristics of patients and professionals associated with this safety. Therefore, the present study aims to examine the level of patient safety in hemodialysis clinics in the Brazilian capital, to identify the sociodemographic and clinical factors of patients and nursing staff associated with the level of safety. This is an observational, descriptive and quantitative research conducted in three hemodialysis clinics placed in the city of Fortaleza-CE, Brazil, from September to November 2019. The sample was formed after a sample calculation for finite inhabitants of correlation with 200 chronic renal patients, 30 nursing technicians and seven nurses. Conventional sampling was used based on the inclusion criteria: being present at the hemodialysis session on the day the researcher performed the data collection and being 18 years of age or older. Participants who presented communication difficulties to listen to and/or answer the sociodemographic and clinical questionnaire were excluded. Two instruments were applied: sociodemographic and clinical characterization form and Chronic Renal Patient Safety Assessment Scale on Hemodialysis (EASPRCH). The data were analyzed using the Kruskal Walls Test for categorical variables and Spearman correlation coefficient for non-categorical variables, using the Statistical Package SPSS version 20.0. The present study respected the ethical and legal principles determined by resolution 466/2012 of the National Health Council, under the approval of the Ethics and Research Committee with an opinion number: 3,255,635. The results showed that a hemodialysis clinic presented unsafe care practices of 32 points in the EASPRCH (p=0.001). A statistical association was identified between the level of safety and the variables of the patients: level of education (p=0.018), family income (p=0.049), type of employment (p=0.012), venous access site (p=0.009), use of medication during the session (p=0.008) and time of hemodialysis (p=0.002). When evaluating the profile of nurses, a statistical association was evidenced between the level of safety with the variables: marital status (p=0.000), race (p=0.017), schooling (p= 0.000), income (p=0.013), age (p=0.000), clinic workload (p=0.000), time working with hemodialysis (p=0.000), time working in the clinic (p= 0.007) and clinic sizing (p=0.000). In order, the sociodemographic factors of nursing technicians associated with the level of patient safety were: race (p= 0.001) and weekly workload at (p=0.010). Therefore, it is concluded that there is a non-conformity in the level of patient safety in one of the clinics studied and, that sociodemographic and clinical factors of patients and health professionals corroborate the level of safety of the health unit.

Keywords: hemodialysis, nursing, patient safety, quality improvement

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9841 Body-Worn Camera Use in the Emergency Department: Patient and Provider Satisfaction

Authors: Jeffrey Ho, Scott Joing, Paul Nystrom, William Heegaard, Danielle Hart, David Plummer, James Miner

Abstract:

Body-Worn Cameras (BWCs) are used in public safety to record encounters. They are shown to enhance the accuracy of documentation in virtually every situation. They are not widely used in medical encounters in part because of concern for patient acceptance. The goal of this pilot study was to determine if BWC use is acceptable to the patient. This was a prospective, observational study of the AXON Flex BWC (TASER International, Scottsdale, AZ) conducted at an urban, Level 1 Trauma Center Emergency Department (ED). The BWC was worn by Emergency Physicians (EPs) on their shifts during a 30-day period. The BWC was worn at eye-level mounted on a pair of clear safety glasses. Patients seen by the EP were enrolled in the study by a trained research associate. Patients who were <18 years old, who were with other people in the exam room, did not speak English, were critically ill, had chief complaints involving genitalia or sexual assault, were considered to be vulnerable adults, or with an altered mental status were excluded. Consented patients were given a survey after the encounter to determine their perception of the BWC. The questions asked involved the patients’ perceptions of a BWC being present during their interaction with their EP. Data were analyzed with descriptive statistics. There were 417 patients enrolled in the study. 3/417 (0.7%) patients were intimidated by the BWC, 1/417 (0.2%) was nervous because of the BWC, 0/417 (0%) were inhibited from telling the EP certain things because of the BWC, 57/417 (13.7%) patients did not notice the device, and 305/417 (73.1%) patients were had a favorable perception about the BWC being used during their encounter. The use of BWCs appears feasible in the ED, with largely favorable perceptions and acceptance of the device by the patients. Further study is needed to determine the best use and practices of BWCs during ED patient encounters.

Keywords: body-worn camera, documentation, patient satisfaction, video

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9840 The Asia-European Union (EU) Traffic Safety Benchmarking

Authors: Ghazwan Al-Haji

Abstract:

Traffic safety has become a major concern in Southeast Asia due to the increasing number of road accidents resulting in fatalities and injuries. Southeast Asia has one of the highest road traffic fatality rates in the world, in terms of both population and number of cars, nearly six times higher than the EU region. One of the reasons for this concerning trend is the increasing share of motorcycles as a form of transportation throughout Southeast Asia. The purpose of this study is to benchmark traffic safety situations and statistics in six countries in Asia and the EU, which Indonesia, Malaysia, Vietnam, Italy, Portugal and Sweden. The research will assess the priorities and causes of road accidents in the target nations. Further, the study will analyze the existing practices and promote best practices that can be implemented toward safer roads in Asian target countries. In order to achieve this goal, the study categorizes various factors contributing to traffic accidents and best practices into 4 pillars (Safer Behavior, Safer Roads, Safer Vehicles and Road Safety Management). The result of the study consists of a list of recommendations that can be applied by policymakers to promote safer roads in Asia towards 2030. The study is co-financed by the EU project ASIASAFE.

Keywords: traffic safety, ASIASAFE, Southeast Asia, EU project

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9839 A Study on Consumer Awareness, Safety Perceptions and Practices About Food Preservatives and Flavouring Agents Used in Packed / Canned Foods from South India

Authors: Harsha Kumar H. N., Anshu Kumar Jha, Khushboo Kamal Taneja, Krishan Kabra, Mohamed Hafeez Sadiq

Abstract:

Introduction: The increasing use of preservatives and flavouring agents has the potential to cause health problem among the people. There are no published studies from India exploring the awareness, safety perception, & practices about Food Preservatives (FPs) and Flavouring Agents (FAs). So this study was conducted with the objectives of assessing the awareness, safety perceptions & practices about Food Preservatives (FPs), Flavouring Agents (FAs) in commonly bought / purchased packed food items. Materials & method: This cross-sectional study was conducted in January 2012. Sample size of 126 was computed using the formula for infinite population. People who bought packed food items in malls were approached and requested to fill a pre-tested semi-structured questionnaire. The questionnaire explored awareness, safety perception & practices of FPs & FAs. Data was then analyzed using SPSS version 10.0. Chi-square test was used to know if the observed differences were statistically significant. ‘p’ value <0.05 was considered significant. Results: Totally 123 people (males- 48.8% and females-51.2%) participated (response rate of 97.6%) in the study. Majority of the people were aware about presence of ‘FPs’ (91.7%) and ‘FAs’ (84.9%) though their knowledge was inadequate. Breakup of the study subjects according to level of awareness about FPs was as follows (%): Good (37.4), Satisfactory (40.6), Poor (22) & FAs (%): Good (49.6), Satisfactory (36) & Poor (14). Distribution according to type of practices for FPs was as follows (%): Favourable (14), Unfavourable (86) & FAs (%): Favourable (30.5), Unfavourable (69.5). There was a gap between knowledge and practices. Conclusion: Though there was awareness, the knowledge was inadequate. Unfavourable practices were observed. The gaps in the knowledge and unhealthy practices need to be addressed by public awareness campaign.

Keywords: food preservatives, flavouring agents, knowledge and practices, general population

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9838 Evaluation of Food Safety and Security Practices in Midday Meal Programmes in Rural Areas of Beed District

Authors: Nuzhat Sultana M. B.

Abstract:

Children are high-risk population in terms of food born illnesses. Food safety and security are the most important aspect of the success of midday meal programmes. Improper holding temperatures, cross-contamination and poor personal hygiene of food handlers are the main causes for the prevalence of pathogenic microbes in the food servicing areas. Two hundred and fifty preschool children in the age of 3 to 6 years from urban and rural anganwadies (pre school center) of Beed district were selected. Nutritional status of preschool children were assessed by anthropometrical and clinical measurement. The study assessed the food safety and security with the help of personal hygiene and other safety measures maintained by the food personnel working for midday meal programme, supplying mid meals to children in govt. anganwadies (pre school center). The hygiene level, sanitary condition and microbial quality of food and water, pathological health examination of food handlers were assessed with the help of checklist. A questionnaire was designed to evaluate knowledge, attitude, and practices of food handlers. Results of the study show that the nutritional and health status of rural and urban preschool children was very poor. Many of the food handlers were not aware of general knowledge and hygiene practices to be followed during food preparation areas. An intervention programme of education and importing training at workplaces has shown a positive impact on the outcome of safety and security practices and safe, hygienic practices of food handlers at workplace.

Keywords: food, health, preschool children, safety, security

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9837 Assessment of Intern Students' Attitudes towards Medical Errors

Authors: Nilgün Katrancı, Pınar Göv

Abstract:

With the acceleration and assessment of quality and patient safety works in healthcare services in the 21st century, activities to reduce errors have gained importance. The prevention and reduction of unintended consequences related to healthcare services and errors made during the delivery of healthcare services can be achieved by understanding the causes of the errors. Communication is the basic reason most frequently seen in such cases. Nurses who communicate with patients more closely and for longer time play a more critical role in ensuring patient safety compared to other healthcare professionals. To reduce the risk of medical errors and increase the quality of care, it is important to raise the awareness of nurses about patient safety in training period. This descriptive study was conducted between February 2017 and May 2017 to assess intern students' attitudes towards and knowledge of patient safety and medical errors. The target population of the study consists of intern students at the Faculty of Nursing in Gaziantep University (N=180). The study did not apply any sample selection method, and the research group consisted of 90 female and 37 male senior students who were available and accepted to take part in the study (N=127). The study used personal information form and medical error attitude scale to collect data. The medical error attitude scale consists of 16 items and 3 sub-dimensions. The most frequently seen medical error in the clinics the interns worked at was found as ‘Failure to comply with asepsis rules’ with a rate of 67,7%. The most frequent case among reasons for not disclosing an error is ‘noticing and correcting the error before affecting the patient’ with the rate of 70,9%. The most frequently expressed implications of disclosing a serious error for the intern students participating in the study are ‘harming patient trust (78%)’ and ‘possibility of overreaction by patient (62,2%)’. According to the results of the study, the awareness of the students about the importance of medical errors and error reporting was found high (3,48 ± 0,49). Consequently, it is important to assess and positively improve the attitudes of nurses and other healthcare professionals towards medical errors for the determination of causes of medical errors and their prevention.

Keywords: healthcare service, intern student, medical error, patient safety

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9836 Surgical Team Perceptions of the Surgical Safety Checklist in a Tertiary Hospital in Jordan: A Descriptive Qualitative Study

Authors: Rania Albsoul, Muhammad Ahmed Alshyyab, Baraa Ayed Al Odat, Nermeen Borhan Al Dwekat, Batool Emad Al-masri, Fatima Abdulsattar Alkubaisi, Salsabil Awni Flefil, Majd Hussein Al-Khawaldeh, Ragad Ayman Sa’ed, Maha Waleed Abu Ajamieh, Gerard Fitzgerald

Abstract:

Purpose: The purpose of this paper is to explore the perceptions of operating room staff towards the use of the World Health Organization Surgical Safety Checklist in a tertiary hospital in Jordan. Design/methodology/approach: This was a qualitative descriptive study. Semi-structured interviews were conducted with a purposeful sample of 21 healthcare staff employed in the operating room (nurses, residents, surgeons, and anaesthesiologists). The interviews were conducted in the period from October to December 2021. Thematic analysis was used to analyse the data. Findings: Three main themes emerged from data analysis, namely compliance with the surgical safety checklist, the impact of the surgical safety checklist, and barriers and facilitators to the use of the surgical safety checklist. The use of the checklist was seen as enabling staff to communicate effectively and thus accomplish patient safety and positive outcomes. The perceived barriers to compliance included excessive workload, congestion, and lack of training and awareness. Enhanced training and education were thought to improve the utilization of the surgical safety checklist and help enhance awareness about its importance. Originality/value: While steps to utilize the surgical safety checklist by the operation room personnel may seem simple, the quality of its administration is not necessarily robust. There are several challenges to consistent, complete, and effective administration of the surgical safety checklist by the surgical team members. Healthcare managers must employ interventions to eliminate barriers to and offer facilitators of adherence to the application of the surgical safety checklist, therefore promoting quality healthcare and patient safety.

Keywords: patient safety, surgical safety checklist, compliance, utility, operating room, quality healthcare, communication, teamwork

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9835 Enhancing Nursing Students’ Communication Using TeamSTEPPS to Improve Patient Safety

Authors: Stefanie Santorsola, Natasha Frank

Abstract:

Improving healthcare safety necessitates examining current trends and beliefs about safety and devising strategies to improve. Errors in healthcare continue to increase and be experienced by patients, which is preventable and directly correlated to a breakdown in healthcare communication. TeamSTEPPS is an evidence-based process designed to improve the quality and safety of healthcare by improving communication and team processes. Communication is at the core of effective team collaboration and is vital for patient safety. TeamSTEPPS offers insights and strategies for improving communication and teamwork and reducing preventable errors to create a safer healthcare environment for patients. The academic, clinical, and educational environment for nursing students is vital in preparing them for professional practice by providing them with foundational knowledge and abilities. This environment provides them with a prime opportunity to learn about errors and the importance of effective communication to enhance patient safety, as nursing students are often unprepared to deal with errors. Proactively introducing and discussing errors through a supportive culture during the nursing student’s academic beginnings has the potential to carry key concepts into practice to improve and enhance patient safety. TeamSTEPPS has been used globally and has collectively positively impacted improvements in patient safety and teamwork. A workshop study was introduced in winter 2023 of registered practical nurses (RPN) students bridging to the baccalaureate nursing program; the majority of the RPNs in the bridging program were actively employed in a variety of healthcare facilities during the semester. The workshop study did receive academic institution ethics board approval, and participants signed a consent form prior to participating in the study. The premise of the workshop was to introduce TeamSTEPPS and a variety of strategies to these students and have students keep a reflective journal to incorporate the presented communication strategies in their practicum setting and keep a reflective journal on the effect and outcomes of the strategies in the healthcare setting. Findings from the workshop study supported the objective of the project, resulting in students verbalizing notable improvements in team functioning in the healthcare environment resulting from the incorporation of enhanced communication strategies from TeamSTEPPS that they were introduced to in the workshop study. Implication for educational institutions is the potential of further advancing the safety literacy and abilities of nursing students in preparing them for entering the workforce and improving safety for patients.

Keywords: teamstepps, education, patient safety, communication

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9834 Immigrant Workers’ Perspectives of Occupational Health and Safety and Work Conditions that Challenge Work Safety

Authors: Janki Shankar, Shu-Ping Chen

Abstract:

This Canadian study explored the perspectives of recent immigrant workers regarding occupational health and safety (OHS) and workplace conditions that increase workers’ vulnerability to sustaining injury or illness. Using an interpretive research approach and semi structured qualitative interviews, 42 recent immigrant workers from a range of industries operating in two cities in a province in Canada were interviewed. A constant comparative approach was used to identify key themes across the workers’ experiences. The findings revealed that these workers have an incomplete understanding of OHS. In many workplaces, poor job training, little worker support, lack of power in the workplace, and a poor workplace safety culture make it difficult for recent immigrant workers to acquire OHS information and implement safe work practices. This study proposes workplace policies and practices that will improve worker OHS awareness and make workplaces safer for immigrant workers.

Keywords: new immigrant workers, occupational health and safety, workplace challenges, policy, practice

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9833 Dietary Practices of Adult Type 2 Diabetes Mellitus Patients Attending Kitui Out Patient Clinic at Kitui County, Kenya

Authors: Alice W. Theuri, Anselimo O. Makokha, Florence M. Kyallo

Abstract:

Type 2 diabetes mellitus (T2DM) is a serious metabolic disorder whose prevalence among adults has been increasing in the last decade. It is estimated that by 2030, the number of cases in Africa will almost double. Diet and lifestyle modifications are considered the cornerstone for the treatment and management of T2DM. Despite this, there is minimum literature assessing the dietary practices and glycemic control in a semi arid region context in Kenya. The objective of this study was to determine the dietary practices of adult T2DM patients attending Kitui out patient clinic in Kitui County. This was a cross sectional study design where every consenting second patient attending diabetic clinic was interviewed. A total of 138 T2DM patients were interviewed using a structured interview guide on socio-economic and dietary practices administered. The study was carried out in April and May 2017. There were more female (64%) than male (36%) in this study with majority being unemployed (38.4%). Forty seven percent (47.6%) had elevated HbA1c. Majority took three meals per day while DDS was 4.3 ± 1.09. The mean energy intake for men and women was 2823.8 ± 82.45 and 2766.3.30 ± 76.74 respectively. There was a non significant positive relationship (r= 131; P value = 0.124) between amount energy consumed and glycemic control. There were suboptimal dietary practices leading to poor glycemic control among T2DM patients attending diabetic clinic at Kitui District Hospital.

Keywords: adults, dietary practices, semi arid region, T2DM

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9832 Industrial and Environmental Safety in the Integrated Security Policy of the Industry: A Corporation and an Enterprise

Authors: Vladimir A. Grachev

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Today, in the context of rapidly developing technosphere and hourly emerging new technologies, the industrial and environmental safety issue is ever more pressing. The article is devoted to the relationship of social, environmental, and industrial policies with industrial safety, occupational health and safety, environmental safety, and environmental protection. The author assesses the up-to-day situation through system analysis and on the basis of the existing practices. A complex system of the policies implementation without "gaps" and missing links ensures preservation of human lives, health and a favorable living environment. The author demonstrates that absence of an "environmental safety" high-priority link can lead to a significant loss of human lives and health and the global changes in the environment. The role of implementing the environmental policy of enterprises and organizations, and of economic sectors in the implementation of national environmental policy is shown. It was established that the system for implementing environmental policy should be based on a system analysis.

Keywords: environmental protection, environmental safety, industrial safety, occupational health and safety

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9831 A Development of Practice Guidelines for Surgical Safety Management to Reduce Undesirable Incidents from Surgical Services in the Operating Room of Songkhla Hospital, Thailand

Authors: Thitima Plejai

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The practice in the operating room has been continually performed according to standards of services; however, undesirable incidents from surgical services are found such as surgical complications in the operating room. This participation action research aimed to develop practice guidelines for surgical safety management to reduce undesirable incidents from surgical services in the operating room of Songkhla Hospital. The target population was all 84 members of the multidisciplinary team who were involved in surgical services in the operating room consisting of 28 surgeons from five branches of surgery, 27 anesthetists and nurse anesthetists, and 29 surgical nurses. The data were collected through in-depth interviews, and non-participatory observations. The research instrument was tested by three experts, and the steps of the development consisted of four cycles, each consisting of assessment, planning, practice, practice reflection, and improvement until every step is practicable. The data were validated through triangulation research method, analyzed through content analysis and statistical analysis with number and percentage. The results of the development of practice guidelines surgical safety management to reduce undesirable incidents from surgical services could be concluded as follows. 1) The multidisciplinary team in surgery participated in the needs assessment for development of practice guidelines for surgical patient safety, and agreed on adapting the WHO Surgical Safety Checklists for use. 2) The WHO Surgical Safety Checklists was implemented, and meetings were held for the multidisciplinary team in surgery and the organizational risk committee to improve the practice guidelines to make them more practicable. 3) The multidisciplinary team consisting of surgeons from five branches of surgery, anesthetists, nurse anesthetists, surgical nurses, and the organizational risk committee announced policy on safety for surgical patients; the organizational risk committee designated the Surgical Safety Checklist as an instrument for surgical patient safety. The results of the safety management found that the surgical team members who could follow 100 percent of the guidelines were: professional nurses who checked patient identity and information before taking the patient to the operating room and kept complete records of data on the patients; surgical nurses who checked readiness of the patient before surgery; nurse anesthetists who assessed readiness before administering anesthetic drugs, and confirmed correctness of the patient; and circulating perioperative nurses who gave confirmation to the surgical team after completion of the surgery. The rates of undesirable incidents (surgical complications rates) before and after the implementation of the surgical safety management were 1.60 percent and 0.66 percent, respectively. The satisfaction of the surgery-related teams towards the use of the guidelines was 89 percent. The practice guidelines for surgical safety management to reduce undesirable incidents were taken as guidelines for surgical safety that the multidisciplinary team involved in the surgical process implemented correctly and in the same direction and clearly reduced undesirable incidents in surgical patients.

Keywords: practice guidelines, surgical safety management, reduce undesirable incidents, operating Room

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9830 Safety Culture, Mindfulness and Safe Behaviours of Students Residing in the Halls of Residence of Obafemi Awolowo University, Ile Ife, Nigeria

Authors: Olajumoke Adetoun Ojeleye

Abstract:

The study assessed the safety culture, mindfulness and safe behaviors of students residing in the halls of residence of Obafemi Awolowo University (OAU), Ile Ife, Nigeria. The objectives of the study were to assess the level of safety mindfulness of students residing in the halls of residence of OAU, examine their safety culture and establish whether these students are involved in unsafe practices. The study employed a cross-sectional research design and instrument used for data collection was a self-structured, self-administered questionnaire. The questionnaire was tested for validity and reliability with its reliability coefficient at 0.71 before being used for data collection. Respondents were selected by multi-stage sampling technique and the sample size was 530. Data collection took 2 weeks and analysed using descriptive statistical techniques. Results showed that about half of the respondents’ population (49.8%) was between the ages of 20-24 years. There were more males (56.2%) than females (43.8%). Although data demonstrated that majority (91.7%) of the respondents are highly safety minded and the safety culture of an equally high proportion (83.4%) was adjudged fair, a lot of improvement is needed in the area of alerting or informing management of impending dangers and studying the hall handbook to internalize its contents. The study further showed that only 43.6% of respondents had good safety practices and behaviors and majority (56.4%) had fair safety practices and behaviors. One accidental discovery of the study is the finding that not a few of the students squat their counterparts. The study recommended the establishment of clearly written out complaint procedure that is accessible and available to all hall residents, building more hostels with adequate facilities to address the issue of overcrowding and also putting systems in place in order to encourage residents to report incidences/accidents.

Keywords: safe behaviours, safety culture, safety mindfulness, student

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9829 Predictors of School Safety Awareness among Malaysian Primary School Teachers

Authors: Ssekamanya, Mastura Badzis, Khamsiah Ismail, Dayang Shuzaidah Bt Abduludin

Abstract:

With rising incidents of school violence worldwide, educators and researchers are trying to understand and find ways to enhance the safety of children at school. The purpose of this study was to investigate the extent to which the demographic variables of gender, age, length of service, position, academic qualification, and school location predicted teachers’ awareness about school safety practices in Malaysian primary schools. A stratified random sample of 380 teachers was selected in the central Malaysian states of Kuala Lumpur and Selangor. Multiple regression analysis revealed that none of the factors was a good predictor of awareness about school safety training, delivery methods of school safety information, and available school safety programs. Awareness about school safety activities was significantly predicted by school location (whether the school was located in a rural or urban area). While these results may reflect a general lack of awareness about school safety among primary school teachers in the selected locations, a national study needs to be conducted for the whole country.

Keywords: school safety awareness, predictors of school safety, multiple regression analysis, malaysian primary schools

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9828 The Current Home Hemodialysis Practices and Patients’ Safety Related Factors: A Case Study from Germany

Authors: Ilyas Khan. Liliane Pintelon, Harry Martin, Michael Shömig

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The increasing costs of healthcare on one hand, and the rise in aging population and associated chronic disease, on the other hand, are putting increasing burden on the current health care system in many Western countries. For instance, chronic kidney disease (CKD) is a common disease and in Europe, the cost of renal replacement therapy (RRT) is very significant to the total health care cost. However, the recent advancement in healthcare technology, provide the opportunity to treat patients at home in their own comfort. It is evident that home healthcare offers numerous advantages apparently, low costs and high patients’ quality of life. Despite these advantages, the intake of home hemodialysis (HHD) therapy is still low in particular in Germany. Many factors are accounted for the low number of HHD intake. However, this paper is focusing on patients’ safety-related factors of current HHD practices in Germany. The aim of this paper is to analyze the current HHD practices in Germany and to identify risks related factors if any exist. A case study has been conducted in a dialysis center which consists of four dialysis centers in the south of Germany. In total, these dialysis centers have 350 chronic dialysis patients, of which, four patients are on HHD. The centers have 126 staff which includes six nephrologists and 120 other staff i.e. nurses and administration. The results of the study revealed several risk-related factors. Most importantly, these centers do not offer allied health services at the pre-dialysis stage, the HHD training did not have an established curriculum; however, they have just recently developed the first version. Only a soft copy of the machine manual is offered to patients. Surprisingly, the management was not aware of any standard available for home assessment and installation. The home assessment is done by a third party (i.e. the machines and equipment provider) and they may not consider the hygienic quality of the patient’s home. The type of machine provided to patients at home is similar to the one in the center. The model may not be suitable at home because of its size and complexity. Even though portable hemodialysis machines, which are specially designed for home use, are available in the market such as the NxStage series. Besides the type of machine, no assistance is offered for space management at home in particular for placing the machine. Moreover, the centers do not offer remote assistance to patients and their carer at home. However, telephonic assistance is available. Furthermore, no alternative is offered if a carer is not available. In addition, the centers are lacking medical staff including nephrologists and renal nurses.

Keywords: home hemodialysis, home hemodialysis practices, patients’ related risks in the current home hemodialysis practices, patient safety in home hemodialysis

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9827 Improving Health Care and Patient Safety at the ICU by Using Innovative Medical Devices and ICT Tools: Examples from Bangladesh

Authors: Mannan Mridha, Mohammad S. Islam

Abstract:

Innovative medical technologies offer more effective medical care, with less risk to patient and healthcare personnel. Medical technology and devices when properly used provide better data, precise monitoring and less invasive treatments and can be more targeted and often less costly. The Intensive Care Unit (ICU) equipped with patient monitoring, respiratory and cardiac support, pain management, emergency resuscitation and life support devices is particularly prone to medical errors for various reasons. Many people in the developing countries now wonder whether their visit to hospital might harm rather than help them. This is because; clinicians in the developing countries are required to maintain an increasing workload with limited resources and absence of well-functioning safety system. A team of experts from the medical, biomedical and clinical engineering in Sweden and Bangladesh have worked together to study the incidents, adverse events at the ICU in Bangladesh. The study included both public and private hospitals to provide a better understanding for physical structure, organization and practice in operating processes of care, and the occurrence of adverse outcomes the errors, risks and accidents related to medical devices at the ICU, and to develop a ICT based support system in order to reduce hazards and errors and thus improve the quality of performance, care and cost effectiveness at the ICU. Concrete recommendations and guidelines have been made for preparing appropriate ICT related tools and methods for improving the routine for use of medical devices, reporting and analyzing of the incidents at the ICU in order to reduce the number of undetected and unsolved incidents and thus improve the patient safety.

Keywords: intensive care units, medical errors, medical devices, patient care and safety

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9826 Exploring Safety Culture in Interventional Radiology: A Cross-Sectional Survey on Team Members' Attitudes

Authors: Anna Bjällmark, Victoria Persson, Bodil Karlsson, May Bazzi

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Introduction: Interventional radiology (IR) is a continuously growing discipline that allows minimally invasive treatments of various medical conditions. The IR environment is, in several ways, comparable to the complex and accident-prone operation room (OR) environment. This implies that the IR environment may also be associated with various types of risks related to the work process and communication in the team. Patient safety is a central aspect of healthcare and involves the prevention and reduction of adverse events related to patient care. To maintain patient safety, it is crucial to build a safety culture where the staff are encouraged to report events and incidents that may have affected patient safety. It is also important to continuously evaluate the staff´s attitudes to patient safety. Despite the increasing number of IR procedures, research on the staff´s view regarding patients is lacking. Therefore, the main aim of the study was to describe and compare the IR team members' attitudes to patient safety. The secondary aim was to evaluate whether the WHO safety checklist was routinely used for IR procedures. Methods: An electronic survey was distributed to 25 interventional units in Sweden. The target population was the staff working in the IR team, i.e., physicians, radiographers, nurses, and assistant nurses. A modified version of the Safety Attitudes Questionnaire (SAQ) was used. Responses from 19 of 25 IR units (44 radiographers, 18 physicians, 5 assistant nurses, and 1 nurse) were received. The respondents rated their level of agreement for 27 items related to safety culture on a five-point Likert scale ranging from “Disagree strongly” to “Agree strongly.” Data were analyzed statistically using SPSS. The percentage of positive responses (PPR) was calculated by taking the percentage of respondents who got a scale score of 75 or higher. The respondents rated which corresponded to response options “Agree slightly” or “Agree strongly”. Thus, average scores ≥ 75% were classified as “positive” and average scores < 75% were classified as “non-positive”. Findings: The results indicated that the IR team had the highest factor scores and the highest percentages of positive responses in relation to job satisfaction (90/94%), followed by teamwork climate (85/92%). In contrast, stress recognition received the lowest ratings (54/25%). Attitudes related to these factors were relatively consistent between different professions, with only a few significant differences noted (Factor score: p=0.039 for job satisfaction, p=0.050 for working conditions. Percentage of positive responses: p=0.027 for perception of management). Radiographers tended to report slightly lower values compared to other professions for these factors (p<0.05). The respondents reported that the WHO safety checklist was not routinely used at their IR unit but acknowledged its importance for patient safety. Conclusion: This study reported high scores concerning job satisfaction and teamwork climate but lower scores concerning perception of management and stress recognition indicating that the latter are areas of improvement. Attitudes remained relatively consistent among the professions, but the radiographers reported slightly lower values in terms of job satisfaction and perception of the management. The WHO safety checklist was considered important for patient safety.

Keywords: interventional radiology, patient safety, safety attitudes questionnaire, WHO safety checklist

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9825 Iot-Based Interactive Patient Identification and Safety Management System

Authors: Jonghoon Chun, Insung Kim, Jonghyun Lim, Gun Ro

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We believe that it is possible to provide a solution to reduce patient safety accidents by displaying correct medical records and prescription information through interactive patient identification. Our system is based on the use of smart bands worn by patients and these bands communicate with the hybrid gateways which understand both BLE and Wifi communication protocols. Through the convergence of low-power Bluetooth (BLE) and hybrid gateway technology, which is one of short-range wireless communication technologies, we implement ‘Intelligent Patient Identification and Location Tracking System’ to prevent medical malfunction frequently occurring in medical institutions. Based on big data and IOT technology using MongoDB, smart band (BLE, NFC function) and hybrid gateway, we develop a system to enable two-way communication between medical staff and hospitalized patients as well as to store locational information of the patients in minutes. Based on the precise information provided using big data systems, such as location tracking and movement of in-hospital patients wearing smart bands, our findings include the fact that a patient-specific location tracking algorithm can more efficiently operate HIS (Hospital Information System) and other related systems. Through the system, we can always correctly identify patients using identification tags. In addition, the system automatically determines whether the patient is a scheduled for medical service by the system in use at the medical institution, and displays the appropriateness of the medical treatment and the medical information (medical record and prescription information) on the screen and voice. This work was supported in part by the Korea Technology and Information Promotion Agency for SMEs (TIPA) grant funded by the Korean Small and Medium Business Administration (No. S2410390).

Keywords: BLE, hybrid gateway, patient identification, IoT, safety management, smart band

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9824 Nurse-Reported Perceptions of Medication Safety in Private Hospitals in Gauteng Province.

Authors: Madre Paarlber, Alwiena Blignaut

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Background: Medication administration errors remains a global patient safety problem targeted by the WHO (World Health Organization), yet research on this matter is sparce within the South African context. Objective: The aim was to explore and describe nurses’ (medication administrators) perceptions regarding medication administration safety-related culture, incidence, causes, and reporting in the Gauteng Province of South Africa, and to determine any relationships between perceived variables concerned with medication safety (safety culture, incidences, causes, reporting of incidences, and reasons for non-reporting). Method: A quantitative research design was used through which self-administered online surveys were sent to 768 nurses (medication administrators) (n=217). The response rate was 28.26%. The survey instrument was synthesised from the Agency of Healthcare Research and Quality (AHRQ) Hospital Survey on Patient Safety Culture, the Registered Nurse Forecasting (RN4CAST) survey, a survey list prepared from a systematic review aimed at generating a comprehensive list of medication administration error causes and the Medication Administration Error Reporting Survey from Wakefield. Exploratory and confirmatory factor analyses were used to determine the validity and reliability of the survey. Descriptive and inferential statistical data analysis were used to analyse quantitative data. Relationships and correlations were identified between items, subscales and biographic data by using Spearmans’ Rank correlations, T-Tests and ANOVAs (Analysis of Variance). Nurses reported on their perceptions of medication administration safety-related culture, incidence, causes, and reporting in the Gauteng Province. Results: Units’ teamwork deemed satisfactory, punitive responses to errors accentuated. “Crisis mode” working, concerns regarding mistake recording and long working hours disclosed as impacting patient safety. Overall medication safety graded mostly positively. Work overload, high patient-nurse ratios, and inadequate staffing implicated as error-inducing. Medication administration errors were reported regularly. Fear and administrative response to errors effected non-report. Non-report of errors’ reasons was affected by non-punitive safety culture. Conclusions: Medication administration safety improvement is contingent on fostering a non-punitive safety culture within units. Anonymous medication error reporting systems and auditing nurses’ workload are recommended in the quest of improved medication safety within Gauteng Province private hospitals.

Keywords: incidence, medication administration errors, medication safety, reporting, safety culture

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9823 Extending the AOP Joinpoint Model for Memory and Type Safety

Authors: Amjad Nusayr

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Software security is a general term used to any type of software architecture or model in which security aspects are incorporated in this architecture. These aspects are not part of the main logic of the underlying program. Software security can be achieved using a combination of approaches, including but not limited to secure software designs, third part component validation, and secure coding practices. Memory safety is one feature in software security where we ensure that any object in memory has a valid pointer or a reference with a valid type. Aspect-Oriented Programming (AOP) is a paradigm that is concerned with capturing the cross-cutting concerns in code development. AOP is generally used for common cross-cutting concerns like logging and DB transaction managing. In this paper, we introduce the concepts that enable AOP to be used for the purpose of memory and type safety. We also present ideas for extending AOP in software security practices.

Keywords: aspect oriented programming, programming languages, software security, memory and type safety

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9822 Patient Support Program in Pharmacovigilance: Foster Patient Confidence and Compliance

Authors: Atul Khurana, Rajul Rastogi, Hans-Joachim Gamperl

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The pharmaceutical companies are getting more inclined towards patient support programs (PSPs) which assist patients and/or healthcare professionals (HCPs) in more desirable disease management and cost-effective treatment. The utmost objective of these programs is patient care. The PSPs may include financial assistance to patients, medicine compliance programs, access to HCPs via phone or online chat centers, etc. The PSP has a crucial role in terms of customer acquisition and retention strategies. During the conduct of these programs, Marketing Authorisation Holder (MAH) may receive information related to concerned medicinal products, which is usually reported by patients or involved HCPs. This information may include suspected adverse reaction(s) during/after administration of medicinal products. Hence, the MAH should design PSP to comply with regulatory reporting requirements and avoid non-compliance during PV inspection. The emergence of wireless health devices is lowering the burden on patients to manually incorporate safety data, and building a significant option for patients to observe major swings in reference to drug safety. Therefore, to enhance the adoption of these programs, MAH not only needs to aware patients about advantages of the program, but also recognizes the importance of time of patients and commitments made in a constructive manner. It is indispensable that strengthening the public health is considered as the topmost priority in such programs, and the MAH is compliant to Pharmacovigilance (PV) requirements along with regulatory obligations.

Keywords: drug safety, good pharmacovigilance practice, patient support program, pharmacovigilance

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9821 To Study the Existing System of Surgical Safety for Cataract Surgery at Tertiary Care Ophthalmic Centre to Implement Who Surgical Safety Checklist

Authors: Ruchi Garg

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Background: Dr. Rajendra Prasad Centre for Ophthalmic Sciences, named after the first President of India, was established on the 10th of March, 1967 as a National Center for ophthalmic science to provide state-of-the-art patient care, expand human resources for medical education and undertake research to find solutions to eye health problems of national importance. The average number of cataract surgeries performed per month is 700 to 1000. Methods: Anticipating implementation in 50% cases hundred cases of cataract surgery were observed to study the existing system of surgical safety followed at Dr. R.P. Center and gap analysis done against the WHO surgical safety checklist for cataract surgery. A modified WHO surgical safety checklist for cataract surgery was developed and implemented in the center. Barriers in the implementation of the surgical safety checklist were also identified, and remedial measures were suggested. Results: Significant improvement was noticed in all the parameters after the introduction of the modified checklist. The additional points which were added in the modified surgical safety checklist were implemented in almost all the cases by the nursing staff. The overall mean compliance percentage before the implementation of the modified surgical safety checklist at Dr. R.P.C was 37%±10.1 (P=0.001). While after the introduction of the modified surgical safety checklist, the mean compliance has improved to 62.7%±10.3; the Wilcoxon rank sum test/Independent test is applied for each domain. Conclusions: The cataract procedure is the most common surgical procedure performed in the population in India. High volume and high turnover increase the potential for errors. Compliance with the surgical safety checklist before intervention was 32%. After intervention in the form of a focus group discussion and introduction of a modified surgical safety checklist has resulted in an increase in the compliance rate to 67%, this study revealed that changes or additional work are not happily accepted by the staff. After six months of intervention with the modified surgical safety checklist compliance rate was still high, this suggests that constant supervision and monitoring by senior staff can sustain the compliance rate.

Keywords: patient safety, hospital safety, quality, WHO surgical safety checklist

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9820 Food Safety Management in Riyadh’s Ministry of Health Hospitals

Authors: A. Alrasheed, I. Connerton

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Providing patients with safe meals on a daily basis is one of the challenges in the healthcare sector. In Saudi Arabia matters related to food safety and hygiene have been the heart of the Ministry of Health (MOH) and Saudi Food and Drugs Authority (SFDA). The aim of this study is to examine the causes of inadequate implementation of food safety management systems such as HACCP in Riyadh’s MOH hospitals. By the law, food safety must be managed using a documented, HACCP based approach, and food handlers must be appropriately trained in food safety. Food handlers in Saudi Arabia are not required to provide a certificate or attend a food handling training course even in healthcare sectors. Since food safety and hygiene issues are of increasing importance for Saudi Arabian health decision makers, the SFDA has been established to apply food hygiene requirements in all food operations. It should be pointed out that the implications of food outbreaks on the whole society may potentially go beyond individual health impacts but also impact on the Nation’s health and bring about economic repercussions.

Keywords: food safety, patient, hospital, HACCP

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9819 Assessment of Knowledge, Attitudes and Practices of Street Vendors in Mangaung Metro South Africa

Authors: Gaofetoge Lenetha, Malerato Moloi, Ntsoaki Malebo

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Microbial contamination of ready-to-eat foods and beverages sold by street vendors has become an important public health issue. In developing countries including South Africa, health risks related to such kinds of foods are thought to be common. Thus, this study assessed knowledge, attitude and practices of street food vendors. Street vendors in the city of Mangaung Metro were investigated in order to assess their knowledge, attitudes and handling practices. A semi-structured questionnaire and checklist were used in interviews to determine the status of the vending sites and associa. ted food-handling practices. Data was collected by means of a face-to-face interview. The majority of respondents were black females. Hundred percent (100%) of the participants did not have any food safety training. However, street vendors showed a positive attitude towards food safety. Despite the positive attitude, vendors showed some non-compliance when it comes to handling food. During the survey, it was also observed that the vending stalls lack basic infrastructures like toilets and potable water that is currently a major problem. This study indicates a need for improvements in the environmental conditions at these sites to prevent foodborne diseases. Moreover, based on the results observed food safety and food hygiene training or workshops for street vendors are highly recommended.

Keywords: food hygiene, foodborne illnesses, food safety, Street foods

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9818 An Investigation on the Relationship between Taxi Company Safety Climate and Safety Performance of Taxi Drivers in Iloilo City

Authors: Jasper C. Dioco

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The study was done to investigate the relationship of taxi company safety climate and drivers’ safety motivation and knowledge on taxi drivers’ safety performance. Data were collected from three Taxi Companies with taxi drivers as participants (N = 84). The Hiligaynon translated version of Transportation Companies’ Climate Scale (TCCS), Safety Motivation and Knowledge Scale, Occupational Safety Motivation Questionnaire and Global Safety Climate Scale were used to study the relationships among four parameters: (a) Taxi company safety climate; (b) Safety motivation; (c) Safety knowledge; and (d) Safety performance. Correlational analyses found that there is no relation between safety climate and safety performance. A Hierarchical regression demonstrated that safety motivation predicts the most variance in safety performance. The results will greatly impact how taxi company can increase safe performance through the confirmation of the proximity of variables to organizational outcome. A strong positive safety climate, in which employees perceive safety to be a priority and that managers are committed to their safety, is likely to increase motivation to be safety. Hence, to improve outcomes, providing knowledge based training and health promotion programs within the organization must be implemented. Policy change might include overtime rules and fatigue driving awareness programs.

Keywords: safety climate, safety knowledge, safety motivation, safety performance, taxi drivers

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9817 Exploring the Meaning of Safety in Acute Mental Health Inpatient Units from the Consumer Perspective

Authors: Natalie Cutler, Lorna Moxham, Moira Stephens

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Safety is a priority in mental health services, and no more so than in the acute inpatient setting. Mental health service policies and accreditation frameworks commonly approach safety from a risk reduction or elimination perspective leading to service approaches that are arguably more focused on risk than on safety. An exploration what safety means for people who have experienced admission to an acute mental health inpatient unit is currently under way in Sydney, Australia. Using a phenomenographic research approach, this study is seeking to understand the meaning of safety from the perspective of people who use, rather than those who deliver mental health services. Preliminary findings suggest that the meanings of safety for users of mental health services vary from the meanings inherent in the policies and frameworks that inform how mental health services and mental health practice are delivered. This variance has implications for the physical and environmental design of acute mental health inpatient facilities, the policies and practices, and the education and training of mental health staff in particular nurses, who comprise the majority of the mental health workforce. These variances will be presented, along with their implications for the way quality and safety in mental health services are evaluated.

Keywords: acute inpatient, mental health, nursing, phenomenography, recovery, safety

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9816 The Relationship between Job Stress and Handover Effectiveness of Nurses

Authors: Rujnan Tuna, Ayse Cil Akinci

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Work life takes up an important place in human life, and an employed person faces many stimuli from internal and external environments and is affected by them in a positive or negative way. Also, the handover process, which is the process of sharing information about the patient with other health professionals, is an important criterion to maintain patient care and enhance the quality of care provided. Handover is a key component for sustaining daily basic clinical practices and is also essential to maintain the safe patient care. This investigation followed a descriptive and correlation design in order to establish job stress and the handover efficiency of nurses and the relationship in between. The study was conducted with 192 nurses working in a public hospital in Istanbul between January and March 2017. Descriptive information form, Job Stressors Scale, and Handover Evaluation Scale were used to collect the data of the study. The data were analyzed by using IBM SPSS Statistics 22.0 statistical software. Approvals from participants, managers of institution, and ethics committee were taken for the study. As a result of the research, it was found that job stress was above the median value, and the highest score in the ‘work role conflict’ subdimension. Also, it was found that the effectiveness of the nurses' handover effectiviness was above the median value and the highest score in the ‘quality of information’ subdimension. In the study, there was a negatively weak correlation between ‘work role overload’ subdimension of Job Stressors Scale and ‘interaction and support’ subdimension of Handover Evaluation Scale. There is a need for further study in order to maintain patient safety.

Keywords: handover, job stress, nurse, patient

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9815 Comparison of the Hospital Patient Safety Culture between Bulgarian, Croatian and American: Preliminary Results

Authors: R. Stoyanova, R. Dimova, M. Tarnovska, T. Boeva, R. Dimov, I. Doykov

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Patient safety culture (PSC) is an essential component of quality of healthcare. Improving PSC is considered a priority in many developed countries. Specialized software platform for registration and evaluation of hospital patient safety culture has been developed with the support of the Medical University Plovdiv Project №11/2017. The aim of the study is to assess the status of PSC in Bulgarian hospitals and to compare it to that in USA and Croatian hospitals. Methods: The study was conducted from June 01 to July 31, 2018 using the web-based Bulgarian Version of the Hospital Survey on Patient Safety Culture Questionnaire (B-HSOPSC). Two hundred and forty-eight medical professionals from different hospitals in Bulgaria participated in the study. To quantify the differences of positive scores distributions for each of the 42 HSOPSC items between Bulgarian, Croatian and USA samples, the x²-test was applied. The research hypothesis assumed that there are no significant differences between the Bulgarian, Croatian and US PSCs. Results: The results revealed 14 significant differences in the positive scores between the Bulgarian and Croatian PSCs and 15 between the Bulgarian and the USA PSC, respectively. Bulgarian medical professionals provided less positive responses to 12 items compared with Croatian and USA respondents. The Bulgarian respondents were more positive compared to Croatians on the feedback and communication of medical errors (Items - C1, C4, C5) as well as on the employment of locum staff (A7) and the frequency of reported mistakes (D1). Bulgarian medical professionals were more positive compared with their USA colleagues on the communication of information at shift handover and across hospital units (F5, F7). The distribution of positive scores on items: ‘Staff worries that their mistakes are kept in their personnel file’ (RA16), ‘Things ‘fall between the cracks’ when transferring patients from one unit to another’ (RF3) and ‘Shift handovers are problematic for patients in this hospital’ (RF11) were significantly higher among Bulgarian respondents compared with Croatian and US respondents. Conclusions: Significant differences of positive scores distribution were found between Bulgarian and USA PSC on one hand and between Bulgarian and Croatian on the other. The study reveals that distribution of positive responses could be explained by the cultural, organizational and healthcare system differences.

Keywords: patient safety culture, healthcare, HSOPSC, medical error

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9814 Handling Patient's Supply during Inpatient Stay: Using Lean Six Sigma Techniques to Implement a Comprehensive Medication Handling Program

Authors: Erika Duggan

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A Major Hospital had identified that there was no standard process for handling a patient’s medication that they brought with them to the hospital. It was also identified that each floor was handling the patient’s medication differently and storing it in multiple locations. Based on this disconnect many patients were leaving the hospital without their medication. The project team was tasked with creating a cohesive process to send a patient’s unneeded medication home on admission, storing any of the patient’s medication that could not be sent home, storing any of the patient’s medication for inpatient administration, and sending all of the patient’s medication home on discharge. The project team consisted of pharmacists, RNs, LPNs, members from nursing informatics and a project engineer and followed a DMAIC framework. Working together observations were performed to identify what was working and not working on the different floors which resulted in process maps. Using the multidisciplinary team, brainstorming, including affinity diagramming and other lean six sigma techniques, the best process for receiving, storing, and returning the medication was created. It was highlighted that being able to track the medication throughout the patient’s stay would be beneficial and would help make sure the medication left with the patient on discharge. Using an automated medications dispensing system would help store, and track patient’s medications. Also, the use of a specific order that would show up on the discharge instructions would assist the front line staff in retrieving the medication from a set location and sending it home with the patient. This new process will effectively streamline the admission and discharge process for patients who brought their medication with them as well as effectively tracking the medication during the patient’s stay. As well as increasing patient safety as it relates to medication administration.

Keywords: lean six sigma, medication dispensing, process improvement, process mapping

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9813 Artificial Intelligence in Patient Involvement: A Comprehensive Review

Authors: Igor A. Bessmertny, Bidru C. Enkomaryam

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Active involving patients and communities in health decisions can improve both people’s health and the healthcare system. Adopting artificial intelligence can lead to more accurate and complete patient record management. This review aims to identify the current state of researches conducted using artificial intelligence techniques to improve patient engagement and wellbeing, medical domains used in patient engagement context, and lastly, to assess opportunities and challenges for patient engagement in the wellness process. A search of peer-reviewed publications, reviews, conceptual analyses, white papers, author’s manuscripts and theses was undertaken. English language literature published in 2013– 2022 period and publications, report and guidelines of World Health Organization (WHO) were also assessed. About 281 papers were retrieved. Duplicate papers in the databases were removed. After application of the inclusion and exclusion criteria, 41 papers were included to the analysis. Patient counseling in preventing adverse drug events, in doctor-patient risk communication, surgical, drug development, mental healthcare, hypertension & diabetes, metabolic syndrome and non-communicable chronic diseases are implementation areas in healthcare where patient engagement can be implemented using artificial intelligence, particularly machine learning and deep learning techniques and tools. The five groups of factors that potentially affecting patient engagement in safety are related to: patient, health conditions, health care professionals, tasks and health care setting. Active involvement of patients and families can help accelerate the implementation of healthcare safety initiatives. In sub-Saharan Africa, using digital technologies like artificial intelligence in patient engagement context is low due to poor level of technological development and deployment. The opportunities and challenges available to implement patient engagement strategies vary greatly from country to country and from region to region. Thus, further investigation will be focused on methods and tools using the potential of artificial intelligence to support more simplified care that might be improve communication with patients and train health care professionals.

Keywords: artificial intelligence, patient engagement, machine learning, patient involvement

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