Search results for: patient's characteristics

Authors: Temitope O. Tokosi, Visvanathan Naicker

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Patient health records contain sensitive information for which an electronic patient record (EPR) system can safely secure and transmit amongst clinicians for use in improving health delivery. Clinician’s use of the behaviour of these systems is under scrutiny to assess their attributes towards health technology. South Africa (SA) clinicians responded to a pilot study survey to assess their understanding of EPR, what attributes are important towards technology use and more importantly streamlining the survey for a larger study. Descriptive statistics using mean scores was used because of the small sample size of 11 clinicians who completed the survey. Nine (9) constructs comprising 62 items were used and a Cronbach alpha score of 0.883 was obtained. Limitations and discussions conclude the study.

Keywords: EPR, clinicians, pilot study, South Africa

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Authors: Sorayya Kazemi, Hamed Kharrati, Mehdi Abedinpour Fallah

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This paper presents the design and implementation of a novel electric pressure-sensitive toothbrush, capable of measuring the forces applied to the head of the brush. The developed device is used for gum recession measurement. In particular, the percentage of gum recession is measured by a Programmable Automation controller (PAC). Moreover, the brushing forces are measured by a Force Sensing Resistor (FSR) sensor. These forces are analog inputs of PAC. According to the applied forces during patient’s brushing and the patient’s percentage of gum recession, dentist sets the standard force range. The instrument alarms when the patient applies a force over the set range.

Keywords: gum recession, force sensing resistor, controller, toothbrush

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Authors: Dinku Seyoum Zeleke, Rong Fung Huang, Ching Min Hsu

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Comparison of flow and mixing characteristics between non-oscillating jet and transversely oscillating jet was investigated experimentally. Flow evolution process was detected by using high-speed digital camera, and jet spread width was calculated using binary edge detection techniques by using the long-exposure images. The velocity characteristics of transversely oscillating jet induced by a V-shaped fluidic oscillator were measured using single component hot-wire anemometer. The jet spread width of non-oscillating jet was much smaller than the jet exit gap because of behaving natural jet behaviors. However, the transversely oscillating jet has a larger jet spread width, which was associated with the excitation of the flow by self-induced oscillation. As a result, the flow mixing characteristics desperately improved both near-field and far-field. Therefore, this transversely oscillating jet has a better turbulence intensity, entrainment, and spreading width so that it augments flow-mixing characteristics desperately.

Keywords: flow mixing, transversely oscillating, spreading width, velocity characteristics

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Authors: Katie Dolaghan, Christina Tran, Kim Hamilton, Amanda Beresford, Vicky Adams, Jamie Toole, John Marley

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During the Covid 19 pandemic routine outpatient appointments were not possible face to face. That resulted in many branches of healthcare starting virtual clinics. These clinics have continued following the return to face to face patient appointments. With these new types of clinic it is important to ensure that a high standard of patient care is maintained. In order to improve patient and clinician experience of the telephone clinics a quality improvement project was carried out to ensure the patient and clinician experience of these clinics was enhanced whilst remaining a safe, effective and an efficient use of resources. The project began by developing a process map for the consultation process and agreed on the design of a driver diagram and tests of change. In plan do study act (PDSA) cycle1 a single consultant completed an online survey after every patient encounter over a 5 week period. Baseline patient responses were collected using a follow-up telephone survey for each patient. Piloting led to several iterations of both survey designs. Salient results of PDSA1 included; patients not receiving appointment letters, patients feeling more anxious about a virtual appointment and many would prefer a face to face appointment. The initial clinician data showed a positive response with a provisional diagnosis being reached in 96.4% of encounters. PDSA cycle 2 included provision of a patient information sheet and information leaflets relevant to the patients’ conditions were developed and sent following new patient telephone clinics with follow-up survey analysis as before to monitor for signals of change. We also introduced the ability for patients to send an images of their lesion prior to the consultation. Following the changes implemented we noted an improvement in patient satisfaction and, in fact, many patients preferring virtual clinics as it lead to less disruption of their working lives. The extra reading material both before and after the appointments eased patients’ anxiety around virtual clinics and helped them to prepare for their appointment. Following the patient feedback virtual clinics are now used for review patients as well, with all four consultants within the department continuing to utilise virtual clinics. During this presentation the progression of these clinics and the reasons that these clinics are still operating following the return to face to face appointments will be explored. The lessons that have been gained using a QI approach have helped to deliver an optimal service that is valid and reliable as well as being safe, effective and efficient for the patient along with helping reduce the pressures from ever increasing waiting lists. In summary our work in improving the quality of virtual clinics has resulted in improved patient satisfaction along with reduced pressures on the facilities of the health trust.

Keywords: clinic, satisfaction, telephone, virtual

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Authors: Rachel Ashwell, Sally Millett

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Introduction: Adequate post-operative pain relief is a key priority in the delivery of caesarean sections. This improves patient experience, reduces morbidity and enables optimal mother-infant interaction. Recommendations outlined in the NICE guidelines for caesarean section (CS) include offering peri-operative intrathecal/epidural diamorphine and post-operative opioid analgesics; offering non-steroidal anti-inflammatory drugs (NSAIDs) unless contraindicated and taking hourly observations for 12 hours following intrathecal diamorphine. Method: This audit assessed the provision of post-CS analgesia in 29 women over a two-week period. Indicators used were the use of intrathecal/epidural opioids, use of post-operative opioids and NSAIDs, frequency of observations and patient satisfaction with pain management on post-operative days 1 and 2. Results: All women received intrathecal/epidural diamorphine, 97% were prescribed post-operative opioids and all were prescribed NSAIDs unless contraindicated. Hourly observations were not maintained for 12 hours following intrathecal diamorphine. 97% of women were satisfied with their pain management on post-operative day 1 whereas only 75% were satisfied on day 2. Discussion: This service meets the proposed standards for the provision of post-operative analgesia, achieving high levels of patient satisfaction 1 day after CS. However, patient satisfaction levels are significantly lower on post-operative day 2, which may be due to reduced frequency of observations. The lack of an official audit standard for patient satisfaction on postoperative day 2 may result in reduced incentive to prioritise pain management at this stage.

Keywords: Caesarean section, analgesia, postoperative care, patient satisfaction

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Authors: Suresh Ramachandra

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Accounting values of firms are determined by strategies that firms pursue which are influenced by board characteristics specific to firms. Using two broad constructs of board characteristics, namely, board capital and board control, in the Malaysian context, this research attempts to infer their conjoint relevance to accounting values. The results of this research indicate that firms are able to increase their accounting values by deliberately selecting board characteristics which include director reputation and political affiliations.

Keywords: accounting values, board characteristics, board capital, board control

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Authors: Vahid Nademi

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In response to widely used wearable medical devices equipped with a continuous glucose monitor (CGM) and insulin pump, the advanced control methods are still demanding to get the full benefit of these devices. Unlike costly clinical trials, implementing effective insulin-glucose control strategies can provide significant contributions to the patients suffering from chronic diseases such as diabetes. This study deals with a key role of two-layer insulin-glucose regulator based on model-predictive-control (MPC) scheme so that the patient’s predicted glucose profile is in compliance with the insulin level injected through insulin pump automatically. It is achieved by iterative optimization algorithm which is called an integrated perturbation analysis and sequential quadratic programming (IPA-SQP) solver for handling uncertainties due to unexpected variations in glucose-insulin values and body’s characteristics. The feasibility evaluation of the discussed control approach is also studied by means of numerical simulations of two case scenarios via measured data. The obtained results are presented to verify the superior and reliable performance of the proposed control scheme with no negative impact on patient safety.

Keywords: blood glucose monitoring, insulin pump, predictive control, optimization

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Authors: Lateef Bamidele

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Over the years, radiographic examinations are the most used diagnostic tools in the Nigerian health care system, but most diagnostic examinations carried out do not have records of patient doses. Lack of adequate information on patient doses has been a major hindrance in quantifying the radiological risk associated with radiographic examinations. This study aimed at estimating dose–area product (DAP) of patient examined in X-Ray units in selected hospitals in Southern Nigeria. The standard projections selected are chest posterior-anterior (PA), abdomen anterior-posterior (AP), pelvis AP, pelvis lateral (LAT), skull AP/PA, skull LAT, lumbar spine AP, lumbar spine, LAT. Measurement of entrance surface dose (ESD) was carried out using thermoluminescent dosimeter (TLD). Measured ESDs were converted into DAP using the beam area of patients. The results show that the mean DAP ranged from 0.17 to 18.35 Gycm². The results obtained in this study when compared with those of NRPB-HPE were found to be higher. These are an indication of non optimization of operational conditions.

Keywords: dose–area product, radiographic examinations, patient doses, optimization

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Authors: Jia Liu

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This article explores the shifting nature of physician-patient relationship in mainland China. Specifically, it takes the physician-patient relationship during the barefoot doctor program in 1968-1978, the marketization of healthcare services in 1978-2002, and the healthcare reform in 2003-2020 as three typical historical periods, illustrating how the nature of the physician-patient relationship has changed over time in mainland China. Drawing on recent jurisprudential literature that emphasizes the roles and functions done by and through obligation rather than right, it explores how the obligations of physicians and patients along with the implementation of informed consent, marketization of the healthcare system, and the basic healthcare reform have affected their relationship. One key feature of this article is that it analyzes the ways in which commodification and decommodification of healthcare have defined and in many different ways have determined the expectations and practices of physicians and patients, which illustrates how the trust between physicians and patients threatens to collapse and the bond between the citizen and the state fails to be firmly established in the mainland Chinese healthcare context. It also pays special attention to the role played by law and legal institutions—for instance, the implementation of informed consent and the liability law—in being complicit in facilitating the decoupling of the practices of physicians and patients from their ethical senses of obligation and undermining the bond (the trust relationship) between them.

Keywords: healthcare, marketization, physician-patient relationship, sense of obligation

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Authors: Matjaž Divjak, Simon Zelič, Aleš Holobar

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We present a dedicated video-based monitoring system for quantification of patient’s attention to visual feedback during robot assisted gait rehabilitation. Two different approaches for eye gaze and head pose tracking are tested and compared. Several metrics for assessment of patient’s attention are also presented. Experimental results with healthy volunteers demonstrate that unobtrusive video-based gaze tracking during the robot-assisted gait rehabilitation is possible and is sufficiently robust for quantification of patient’s attention and assessment of compliance with the rehabilitation therapy.

Keywords: video-based attention monitoring, gaze estimation, stroke rehabilitation, user compliance

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Authors: Andrew Anis Fakhrey Mosaad

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Introduction: Sports- and physical activity-related injuries may be more likely if there is a genetic predisposition, improper coaching and/or training, and no follow-up care from sports medicine. Goal: To evaluate the frequency of injuries among athletes receiving care at a sportsfocused physical therapy clinic. Methods: The survey of injuries in athletes' treatment records over a period of eight years of activity was done to obtain data. The data collected included: the patient's features, the sport, the type of injury, the injury's characteristics, and the body portion injured. Results: The athletes were drawn from 1090 patient/athlete records, had an average age of 25, participated in 44 different sports, and were 75% men on average. Joint injuries were the most frequent type of injury, then damage to the muscles and bones. The most prevalent type of injury was chronic (47%), while the knee, ankle, and shoulder were the most frequently damaged body parts. The most injured athletes were seen in soccer, futsal, and track and field, respectively, out of all the sports. Conclusion: The most popular sport among injured players was soccer, and the most common injury type was joint damage, with the knee being the most often damaged body area. The majority of the injuries were chronic.

Keywords: sports injuries, athletes, joint injuries, injured players

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Authors: Sophia Shi

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Acute kidney injury (AKI) is the sudden onset of kidney damage in which the kidneys cannot filter waste from the blood, requiring emergency hospitalization. AKI patient mortality rate is high in the ICU and is virtually impossible for doctors to predict because it is so unexpected. Currently, there is no hybrid model predicting AKI that takes advantage of two types of data. De-identified patient data from the MIMIC-III database and de-identified kidney images and corresponding patient records from the Beijing Hospital of the Ministry of Health were collected. Using data features including serum creatinine among others, two numeric models using MIMIC and Beijing Hospital data were built, and with the hospital ultrasounds, an image-only model was built. Convolutional neural networks (CNN) were used, VGG and Resnet for numeric data and Resnet for image data, and they were combined into a hybrid model by concatenating feature maps of both types of models to create a new input. This input enters another CNN block and then two fully connected layers, ending in a binary output after running through Softmax and additional code. The hybrid model successfully predicted AKI and the highest AUROC of the model was 0.953, achieving an accuracy of 90% and F1-score of 0.91. This model can be implemented into urgent clinical settings such as the ICU and aid doctors by assessing the risk of AKI shortly after the patient’s admission to the ICU, so that doctors can take preventative measures and diminish mortality risks and severe kidney damage.

Keywords: Acute kidney injury, Convolutional neural network, Hybrid deep learning, Patient record data, ResNet, Ultrasound kidney images, VGG

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Authors: Bhavna Malik

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The study is build on a theoretical framework that links characteristics of job, key attitudes and intention to leave, why faculty may be disengaging from institutional service. The literature indicates that job characteristics, key attitudes and intention to leave are very important for effective organizational functioning. In general, the literature showed that some job characteristics might be the antecedents of job satisfaction and the aggregate variable job scope was positively associated with organizational commitment, and these key attitudes predicted intention to leave negatively. The present study attempted to propose a new integrative model of the relationships among job characteristics, key attitudes, and intention to leave. The main purpose of the present study is to examine the effects of job characteristics on intention to leave. While examining the role of job characteristics, the mediating roles of key attitudes were taken into account in order to better understand how job characteristics affect the exhibition of intention to leave. The secondary purpose is to investigate the effects of job characteristics on key attitudes, and the effects of key attitudes on intention to leave. Job characteristics of remuneration, resource for professional activities, career opportunities were positively associated with the work attitude of job satisfaction. The aggregate job scope was positively associated with the work attitude of organizational commitment although no single job characteristic was significantly associated with organizational commitment. Commitment, however, did not significantly affect time spent on institutional service. Two job characteristics—time spent on research and time spent on teaching—were negatively associated with this behavior. In general, the literature showed that some job characteristics might be the antecedents of job satisfaction and the aggregate variable job scope was positively associated with organizational commitment, and these key attiudes predicted intention to leave negatively. In turn, job satisfaction and organizational commitment were negatively associated with the intention to leave. In addition to these, organizational commitment was negatively associated with the intention to leave. However, no significant direct association was found between job characteristics and intention to leave.

Keywords: Job Characteristics Model, job satisfaction, organizational commitment, intention to leave

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Authors: Mark Andrew Tu, Raymond Olazo, Cybele Abad

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Cryptococcosis is an invasive infection most commonly found in patients who are immuno compromised. However, patients with this infection usually present with meningitis and rarely pulmonary infection in isolation. We present a case of a Filipino HIV patient who developed cryptococcal pneumonia without meningitis.

Keywords: Cryptococcal Pneumonia, HIV, Filipino, immune system

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Authors: A. Kaeotawee, N. Bunmas, W. Chomthong

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Background: The cancellation of elective surgery is a major indicator of poor operating room efficiency. Furthermore, it is recognized as a major cause of emotional trauma to patients as well as their families. This study was carried out to assess the incidence and causes of elective surgery cancellation in our setting and to find the appropriate solutions for better quality management. Objective: To determine the incidence and causes of elective surgery cancellations in Songklanagarind Hospital. Material and Method: A prospective survey was conducted from September to November 2012. All patients who had their scheduled elective operations cancelled were assessed. Data was collected on the following 2 components: (1) patient demographics;(2) main reasons for cancellations, which were grouped into patient-related factors and organizational-related factors. Data are reported as a percentage of patients whose operations were cancelled. The association between cancellation status and patient demographics was assessed using univariate logistic regression. Results: 2,395 patients were scheduled for elective surgery and of these 343 (14.3%) had their operations cancelled. Cardiothoracic surgery had the highest rate of cancellations (28.7%) while the least number of cancellations occurred in ophthalmology (10.1%). The main reasons for cancellations were related to the unit's organization (53.6%), due to the surgeon (48.4%). Patient related causes (46.4%), due to non medical reasons (32.1%). The most common cause of cancellation by the surgeon was lack of theater time (21.3%), by patients due to the patient’s nonappearance (25.1%). Cancellation was significantly associated with type of patient, health insurance, type of anesthesia and specialties (p<0.05). Conclusion: Surgery cancellations by surgeons relating to a lack of theater time was a significant problem in our setting. Appropriate solutions for better quality improvement are needed.

Keywords: elective cases, surgery cancellation, quality management, appropriate solutions

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Authors: Ali Bakhtiari Gharibdosti, Mohammad Hosein Bijeh Keshavarzi, Samira Alijani

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To understand internal characteristics relationships and determine factors which explain under consideration characteristics in rapeseed varieties, 10 rapeseed genotypes were implemented in complete accidental plot with three-time repetitions under drought stress in 2009-2010 in research field of agriculture college, Islamic Azad University, Karaj branch. In this research, 11 characteristics include of characteristics related to growth, production and functions stages was considered. Variance analysis results showed that there is a significant difference among rapeseed varieties characteristics. By calculating simple correlation coefficient under both conditions, normal and drought stress indicate that seed function characteristics in plant and pod number have positive and significant correlation in 1% probable level with seed function and selection on the base of these characteristics was effective for improving this function. Under normal and drought stress, analyzing the main factors showed that numbers of factors which have more than one amount, had five factors under normal conditions which were 82.72% of total variance totally, but under drought stress four factors diagnosed which were 76.78% of total variance. By considering total results of this research and by assessing effective characteristics for factor analysis and selecting different components of these characteristics, they can be used for modifying works to select applicable and tolerant genotypes in drought stress conditions.

Keywords: correlation, drought stress, factor analysis, rapeseed

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Authors: Ines Zemni, Maher Slimane, Jamel Ben Hassouna, Khaled Rahal

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Background: Neurofibromatosis type 1 (NF1) is a genetic disease, which is associated with an increased risk of developing different malignancies including breast cancer. The association between NF1 band breast sarcoma is a rare entity. Herein we present a 25-year-old woman with NF1 who had fibrosarcoma of the left breast. Case presentation: The patient has multiple thoraco-abdominal 'café au lait' spots. Clinical examination showed a lump of the left breast measuring 9 cm of diameter, which was noticed for 6 months. There was a left inguinal mass of 6 cm of diameter. The patient underwent first a left lumpectomy. Histopathological exam revealed a high-grade fibrosarcoma of the left breast measuring 7.5 cm. Three months later, the patient underwent a left mastectomy and excision of the inguinal mass, which was a neurofibroma. An adjuvant chemotherapy and radiation therapy were indicated, but not applied because of the timeout. The patient is now alive after a follow up of 6 years, with no loco-regional recurrence or metastasis. Conclusion: The relationship between NF1 and breast cancer need to be more clarified by further studies. Establishing a specific screening program of these patients may help to make an earlier diagnosis of breast cancer.

Keywords: neurofibromatosis, breast, sarcoma, cancer

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Authors: Haya Salah, Srinivas Sharan

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Healthcare facilities use appointment systems to schedule their appointments and to manage access to their medical services. With the growing demand for outpatient care, it is now imperative to manage physician's time effectively. However, high variation in consultation duration affects the clinical scheduler's ability to estimate the appointment duration and allocate provider time appropriately. Underestimating consultation times can lead to physician's burnout, misdiagnosis, and patient dissatisfaction. On the other hand, appointment durations that are longer than required lead to doctor idle time and fewer patient visits. Therefore, a good estimation of consultation duration has the potential to improve timely access to care, resource utilization, quality of care, and patient satisfaction. Although the literature on factors influencing consultation length abound, little work has done to predict it using based data-driven approaches. Therefore, this study aims to predict consultation duration using supervised machine learning algorithms (ML), which predicts an outcome variable (e.g., consultation) based on potential features that influence the outcome. In particular, ML algorithms learn from a historical dataset without explicitly being programmed and uncover the relationship between the features and outcome variable. A subset of the data used in this study has been obtained from the electronic medical records (EMR) of four different outpatient clinics located in central Pennsylvania, USA. Also, publicly available information on doctor's characteristics such as gender and experience has been extracted from online sources. This research develops three popular ML algorithms (deep learning, random forest, gradient boosting machine) to predict the treatment time required for a patient and conducts a comparative analysis of these algorithms with respect to predictive performance. The findings of this study indicate that ML algorithms have the potential to predict the provider service time with superior accuracy. While the current approach of experience-based appointment duration estimation adopted by the clinic resulted in a mean absolute percentage error of 25.8%, the Deep learning algorithm developed in this study yielded the best performance with a MAPE of 12.24%, followed by gradient boosting machine (13.26%) and random forests (14.71%). Besides, this research also identified the critical variables affecting consultation duration to be patient type (new vs. established), doctor's experience, zip code, appointment day, and doctor's specialty. Moreover, several practical insights are obtained based on the comparative analysis of the ML algorithms. The machine learning approach presented in this study can serve as a decision support tool and could be integrated into the appointment system for effectively managing patient scheduling.

Keywords: clinical decision support system, machine learning algorithms, patient scheduling, prediction models, provider service time

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Authors: Mohammad Shokoohi-Yekta, Hamid Mirebrahim

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A body of research has been devoted to investigating the preferences of computer programmers. These researches used various questionnaires to find out what programming language is most popular among programmers. The problem with such research is that the programmers are usually familiar with only a few languages; therefore, disregarding a number of other languages which might have characteristics that match their preferences more closely. To overcome such a problem, we decided to investigate the preferences of programmers in regards to the characteristics of languages, which help us to discover the languages that include the most characteristics preferred by the users. We conducted a user study to measure the preferences of programmers on different characteristics of programming languages and then tried to compare existing languages in the areas of application, Web and system programming. Overall, the results of our study indicated that the Ruby programming language has the highest preference score in the two areas of application and Web, and C++ has the highest score in the system area. The results of our study can also help programming language designers know the characteristics they should consider when developing new programming languages in order to attract more programmers.

Keywords: object orientation, programming language design, programmers' preferences, characteristic

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Authors: Amber Elyse Corrigan, Alexander Smith, Anna Pennington, Ben Carter, Jonathan Hewitt

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Background and Purpose: Morbidity secondary to stroke is highly heterogeneous, but it is important to both patients and clinicians in post-stroke management and adjustment to life after stroke. The consideration of post-stroke morbidity clinically and from the patient perspective has been poorly measured. The patient-reported outcome measures (PROs) in morbidity assessment help improve this knowledge gap. The primary aim of this study was to consider the association between PRO outcomes and stroke predictors. Methods: A multicenter prospective cohort study assessed 549 stroke patients at 19 hospital sites across England and Wales during 2019. Following a stroke event, demographic, clinical, and PRO measures were collected. Prevalence of morbidity within PRO measures was calculated with associated 95% confidence intervals. Predictors of domain outcome were calculated using a multilevel generalized linear model. Associated P -values and 95% confidence intervals are reported. Results: Data were collected from 549 participants, 317 men (57.7%) and 232 women (42.3%) with ages ranging from 25 to 97 (mean 72.7). PRO morbidity was high post-stroke; 93.2% of the cohort report post-stroke PRO morbidity. Previous stroke, diabetes, and gender are associated with worse patient-reported outcomes across both the physical and cognitive domains. Conclusions: This large-scale multicenter cohort study illustrates the high proportion of morbidity in PRO measures. Further, we demonstrate key predictors of adverse outcomes (Diabetes, previous stroke, and gender) congruence with clinical predictors. The PRO has been demonstrated to be an informative and useful stroke when considering patient-reported outcomes and has wider implications for considerations of PROs in clinical management. Future longitudinal follow-up with PROs is needed to consider association of long-term morbidity.

Keywords: morbidity, patient-reported outcome, PRO, stroke

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Authors: Bruno R. Mendes, Francisco J. Caldeira, Rita S. Luís

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Population ageing is directly correlated to an increase in medicine consumption. Beyond the latter and the polymedicated profile of elderly, it is possible to see a need for pharmacotherapeutic monitoring due to cognitive and physical impairment. In this sense, the tracking, organization and administration of medicines become a daily challenge and the pill-box dispenser system a solution. The pill-box dispenser (system) consists in a small compartmentalized container to unit dose organization, which means a container able to correlate the patient’s prescribed dose regimen and the time schedule of intake. In many European countries, this system is part of pharmacist’s role in clinical pharmacy. Despite this simple solution, therapy compliance is only possible if the patient adheres to the system, so it is important to establish a qualitative and quantitative analysis on the perception of the patient on the benefits and risks of the pill-box dispenser as well as the identification of the ideal system. The analysis was conducted through an observational study, based on the application of a standardized questionnaire structured with the numerical scale of Likert (5 levels) and previously validated on the population. The study was performed during a limited period of time and under a randomized sample of 188 participants. The questionnaire consisted of 22 questions: 6 background measures and 16 specific measures. The standards for the final comparative analysis were obtained through the state-of-the-art on the subject. The study carried out using the Likert scale afforded a degree of agreement and discordance between measures (Sample vs. Standard) of 56,25% and 43,75%, respectively. It was concluded that the pill-box dispenser has greater acceptance among a younger population, that was not the initial target of the system. However, this allows us to guarantee a high adherence in the future. Additionally, it was noted that the cost associated with this service is not a limiting factor for its use. The pill-box dispenser system, as currently implemented, demonstrates an important weakness regarding the quality and effectiveness of the medicines, which is not understood by the patient, revealing a significant lack of literacy when it concerns with medicine area. The characteristics of an ideal system remain unchanged, which means that the size, appearance and availability of information in the pill-box continue to be indispensable elements for the compliance with the system. The pill-box dispenser remains unsuitable regarding container size and the type of treatment to which it applies. Despite that, it might be a future standard for clinical pharmacy, allowing a differentiation of the pharmacist role, as well as a wider range of applications to other age groups and treatments.

Keywords: clinical pharmacy, medicines, patient safety, pill-box dispenser

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Authors: R. A. Qawasma, F. M. Haddad, H. O. Salhab

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Hemodialysis is a life-preserving treatment for a number of patients with kidney failure. The standard procedure of hemodialysis is three times a week during the hemodialysis procedure, the patient usually suffering from many inconvenient, exhausting feeling and effect on the heart and cardiovascular system are the most common signs. This paper provides a solution to reduce the previous problems by designing a wearable artificial kidney (WAK) taking in consideration a minimization the size of the dialysis machine. The WAK system consists of two circuits: blood circuit and dialysate circuit. The blood from the patient is filtered in the dialyzer before returning back to the patient. Several parameters using an advanced microcontroller and array of sensors. WAK equipped with visible and audible alarm system to aware the patients if there is any problem.

Keywords: artificial kidney, home dialysis, renal failure, wearable kidney

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Authors: Yu-Chieh Chen, Kuei-Feng Shen, Chia-Ling Chao

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The purpose of this report was to present the nursing experience and case of an unexpected cerebellar hemorrhagic stroke with acute hydrocephalus patient after lumbar spine surgery. The patient had been suffering from an emergent external ventricular drainage and stayed in the Surgical Intensive Care Unit from July 8, 2016, to July 22, 2016. During the period of the case, the data were collected for attendance, evaluation, observation, interview, searching medical record, etc. An integral evaluation of the patient's physiological 'psychological' social and spiritual states was also noted. The author noticed the following major nursing problems including ineffective cerebral perfusion 'physical activity dysfunction' family resource preparation for disability. The author provided nursing care to maintain normal intracranial pressure, along with a well-therapeutic relationship and applied interdisciplinary medical/nursing team to draft an individualized and appropriate nursing plan for them to face the psychosocial impact of the patient disabilities. We also actively participated in the rehabilitation treatments to improve daily activity and confidence. This was deemed necessary to empower them to a more positive attitude in the future.

Keywords: family resourace preparation inability, hemorrhagic sroke, ineffective tissue cerebral perfusion, lumbar spine surgery

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Authors: Auni Idi Muhire

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Background: Prior to April 2012, resuscitations were often ineffective resulting in poor patient outcomes. An initiative was implemented at Rwanda Military Hospital (RMH) to review root causes and plan strategies to improve patient outcomes. An interdisciplinary committee was developed to review this problem. Purpose: Analyze the frequency, obstacles, and outcome of patient resuscitation following cardiac and/or respiratory arrest. Methods: A form was developed to allow recording of all actions taken during resuscitation including response times, staff present, and equipment and medications used. Results:-The patient population requiring the most resuscitation effort are the intensive care patients, most frequently the neonatal the intensive care patients (42.8%) -Despite having trained staff representatives, not all resuscitations follow protocol -Lack of compliance with drug administration guidelines was noted, particularly in initiating use of drugs despite the drug being available (59%). Lesson Learned: Basic Life Support training for interdisciplinary staff resulted in more effective response to cardiac and/or respiratory arrest at RMH. Obstacles to effective resuscitation included number of staff, knowledge and skill level of staff, availability of appropriate equipment and medications, staff communication, and patient Do not Attempt Resuscitation (DNR) status.

Keywords: resuscitation, case analysis of knowledge versus practice, intensive care, critical care

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Authors: Hala Kama Ahmed Rashwan

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Ensuring the patient safety especially at intensive care units and those exposed to hospital tools and equipment is one of the most important challenges facing healthcare today. Outbreak of food poisoning as a result of food-borne pathogens has been reported in many hospitals and care homes all over the world due to hospital meals. Patient safety of eating hospital meals is a fundamental principle of healthcare; it is new healthcare disciplines that assure the food raw materials, food storage, meals processing, and control of kitchen errors that often lead to adverse healthcare events. The aim of this article is to promote any hospital in attaining the hygienic practices and better quality system during processing of the ready-to- eat meals for intensive care units patients according to the WHO safety guidelines.

Keywords: hospitals, meals, safety, intensive care

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Authors: Belly Yordan

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Orthodontic treatment can be done by using the fix and removable orthodontic appliance. The success of treatment depends on the patient’s age, the type of malocclusion, treatment of space discrepancy, patient’s oral hygiene, operator skills, and patient cooperation. This case report was aimed to show the success of orthodontic treatment in patients with skeletal class I relationship, class I angle dental malocclusion with anterior crowding and rotation by using a removable appliance with modification. The removable appliance used is standard with removable plate components such as passive clasp (Adam’s hook clasp) accompanied with some active clasps (labial bow, some springs, etc.). A button is used as an additional tool or combined with other tools to correct tooth in rotated position. The results obtained by the success of treatments which is shown in pre and post-treatment photos, the overjet was reduced, the arch form became normal, the tooth malposition became normal, and rotation was corrected. Facial profile appearance of the patient is getting better, and the dental coordination also became better. This case report is to prove that treatment with the removable appliance is quite successful with the robust wearing of appropriate retainers.

Keywords: success rate, anterior crowding, orthodontic treatment, removable appliances

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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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Authors: Fatma Refaat Ahmed, PhD, RN. Assistant Professor, Department of Nursing, College of Health Sciences, University of Sharjah, UAE. ([email protected]). Sally Mohamed Farghaly, Nursing Administration Department, Faculty of Nursing, Alexandria University, Alexandria, Egypt. ([email protected])

Abstract:

Context: Intensive care unit (ICU) nurses often face pressure and constraints in their work, leading to the rationing of care when demands exceed available time and resources. Observations suggest that ICU nurses are frequently distracted from their core nursing roles by non-core tasks. This study aims to provide evidence on ICU nurses' multitasking activities and explore the association between nurses' personal and clinical characteristics and their time allocation. Research Aim: The aim of this study is to quantify the time spent by ICU nurses on multitasking activities and investigate the relationship between their personal and clinical characteristics and time allocation. Methodology: A self-observation form utilizing the "Diary" recording method was used to record the number of tasks performed by ICU nurses and the time allocated to each task category. Nurses also reported on the distractions encountered during their nursing activities. A convenience sample of 60 ICU nurses participated in the study, with each nurse observed for one nursing shift (6 hours), amounting to a total of 360 hours. The study was conducted in two ICUs within a university teaching hospital in Alexandria, Egypt. Findings: The results showed that ICU nurses completed 2,730 direct patient-related tasks and 1,037 indirect tasks during the 360-hour observation period. Nurses spent an average of 33.65 minutes on ventilator care-related tasks, 14.88 minutes on tube care-related tasks, and 10.77 minutes on inpatient care-related tasks. Additionally, nurses spent an average of 17.70 minutes on indirect care tasks per hour. The study identified correlations between nursing time and nurses' personal and clinical characteristics. Theoretical Importance: This study contributes to the existing research on ICU nurses' multitasking activities and their relationship with personal and clinical characteristics. The findings shed light on the significant time spent by ICU nurses on direct care for mechanically ventilated patients and the distractions that require attention from ICU managers. Data Collection: Data were collected using self-observation forms completed by participating ICU nurses. The forms recorded the number of tasks performed, the time allocated to each task category, and any distractions encountered during nursing activities. Analysis Procedures: The collected data were analyzed to quantify the time spent on different tasks by ICU nurses. Correlations were also examined between nursing time and nurses' personal and clinical characteristics. Question Addressed: This study addressed the question of how ICU nurses allocate their time across multitasking activities and whether there is an association between nurses' personal and clinical characteristics and time allocation. Conclusion: The findings of this study emphasize the need for a lean evaluation of ICU nurses' activities to identify and address potential gaps in patient care and distractions. Implementing lean techniques can improve efficiency, safety, clinical outcomes, and satisfaction for both patients and nurses, ultimately enhancing the quality of care and organizational performance in the ICU setting.

Keywords: motion study, ICU nurse, lean, nursing time, multitasking activities

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Authors: M. Dabirinezhad, M. Bayat Pour, A. Dabirinejad

Abstract:

Recognition of the color spectrum of the teeth plays a significant role in the dental laboratories to produce dentures. Since there are various types and colours of teeth for each patient, there is a need to specify the exact and the most suitable colour to produce a denture. Usually, dentists utilize pallets to identify the color that suits a patient based on the color of the adjacent teeth. Consistent with this, there can be human errors by dentists to recognize the optimum colour for the patient, and it can be annoying for the patient. According to the statistics, there are some claims from the patients that they are not satisfied by the colour of their dentures after the installation of the denture in their mouths. This problem emanates from the lack of sufficient accuracy during the colour recognition process of denture production. The colour recognition pen (CRP) is a technology to distinguish the colour spectrum of the intended teeth with the highest accuracy. CRP is equipped with a sensor that is capable to read and analyse a wide range of spectrums. It is also connected to a database that contains all the spectrum ranges, which exist in the market. The database is editable and updatable based on market requirements. Another advantage of this invention can be mentioned as saving time for the patients since there is no need to redo the denture production in case of failure on the first try.

Keywords: colour recognition pen, colour spectrum, dental laboratory, denture

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Authors: Phoutsathaphone Sibounheuang, Phayom Sookaneknun Olson, Chanuttha Ploylearmsang, Santiparp Sookaneknun, Chanthanom Manithip

Abstract:

Patient satisfaction is an outcome that can be measured and used to improve diabetes care and management. There are limited instruments for assessing patient satisfaction covering the whole process of diabetes management. In this study, the questionnaire was developed with items pooled from a systematic review of qualitative studies of patients’ and healthcare providers’ perspectives in diabetes management. The questionnaire consists of 11 domains with 45 items. The Thai version was translated to Lao and then checked by back-translating it into Thai. We tested the questionnaire on 150 diabetes patients in Thailand and 150 in Lao People Democratic Republic (PDR). Validity was performed by factor analysis and Pearson correlation. Internal consistency reliability was estimated by calculating Cronbach’s alpha. The study was approved by the Mahasarakham University Ethics Committee, and the National Ethics Committee for Health Research, Lao PDR. The Thai and Lao versions showed the construct validity by principal component analysis. This consisted of 11 domains which account for 71.23% of the variance (Thai version) and 71.66% of the variance (Lao version) in the total patient satisfaction scores. The Kaiser-Meyer-Olkin (KMO) measures were 0.85 for the Thai version and 0.75 for the Lao version. The Bartlett tests of sphericity of both versions were significant (p < 0.001). The factor loadings of all items in both versions were > 0.40. The convergent validity of the Thai and Lao versions was 93.63% and 79.54% respectively. The discriminant validity for the Thai and Lao versions was 92.68% and 88.68% respectively. Cronbach’s alpha was 0.95 in both versions. The Patient Satisfaction Questionnaire (PSQ) in both versions had acceptable properties. This study has yielded evidence supporting the validity and reliability of both versions.

Keywords: construct validity, diabetes management, patient satisfaction, questionnaire development, reliability

Procedia PDF Downloads 115