Search results for: hospital emergencies.
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 265

Search results for: hospital emergencies.

205 Aggressive Interactions in Hospital Emergency Units

Authors: C. Blatier, M. El Methni, F. Carpentier, S. Abdellaoui, C. Kock, M. Maillard

Abstract:

International literature emphasizes on the concern regarding the phenomenon of aggression in hospital. This paper focuses on the reality of aggressive interactions reigning within an emergency triage involving three chaps of protagonists: the professionals, the patients and their carers. The data collection was made from a grid of observation, in which the various variables exposed in the literature were integrated. They observations took place around the clock, for three weeks, at the rate of one week a month. In this research 331 aggressive interactions have been listed and analyzed by means of the software SPSS. This research is one of the very few continuous observation surveys in the literature. It shows the various human factors at play in the emergence of aggressive interaction. The data may be used both for taking steps in primary prevention, thanks to the analysis of interaction modes, and in secondary prevention by integrating the useful results in situational prevention.

Keywords: Aggressive interaction, emergency unit, observational study.

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204 Patient’s Knowledge and Use of Sublingual Glyceryl Trinitrate Therapy in Taiping Hospital, Malaysia

Authors: Wan Azuati Wan Omar, Selva Rani John Jasudass, Siti Rohaiza Md Saad

Abstract:

Background: The objectives of this study were to assess patient’s knowledge of appropriate sublingual glyceryl trinitrate (GTN) use as well as to investigate how patients commonly store and carry their sublingual GTN tablets. Methodology: This was a cross-sectional survey, using a validated researcher-administered questionnaire. The study involved cardiac patients receiving sublingual GTN attending the outpatient and inpatient departments of Taiping Hospital, a non-academic public care hospital. The minimum calculated sample size was 92, but 100 patients were conveniently sampled. Respondents were interviewed on 3 areas, including demographic data, knowledge and use of sublingual GTN. Eight items were used to calculate each subject’s knowledge score and six items were used to calculate use score. Results: Of the 96 patients who consented to participate, majority (96.9%) were well aware of the indication of sublingual GTN. With regards to the mechanism of action of sublingual GTN, 73 (76%) patients did not know how the medication works. Majority of the patients (66.7%) knew about the proper storage of the tablet. In relation to the maximum number of sublingual GTN tablets that can be taken during each angina episode, 36.5% did not know that up to 3 tablets of sublingual GTN can be taken during each episode of angina. Fifty four (56.2%) patients were not aware that they need to replace sublingual GTN every 8 weeks after receiving the tablets. Majority (69.8%) of the patients demonstrated lack of knowledge with regards to the use of sublingual GTN as prevention of chest pain. Conclusion: Overall, patients’ knowledge regarding the self-administration of sublingual GTN is still inadequate. The findings support the need for more frequent reinforcement of patient education, especially in the areas of preventive use, storage and drug stability.

Keywords: Glyceryl trinitrate, knowledge, adherence.

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203 Post-Traumatic Stress Disorder: Management at the Montfort Hospital

Authors: Kay-Anne Haykal, Issack Biyong

Abstract:

The post-traumatic stress disorder (PTSD) rises from exposure to a traumatic event and appears by a persistent experience of this event. Several psychiatric co-morbidities are associated with PTSD and include mood disorders, anxiety disorders, and substance abuse. The main objective was to compare the criteria for PTSD according to the literature to those used to diagnose a patient in a francophone hospital and to check the correspondence of these two criteria. 700 medical charts of admitted patients on the medicine or psychiatric unit at the Montfort Hospital were identified with the following diagnoses: major depressive disorder, bipolar disorder, anxiety disorder, substance abuse, and PTSD for the period of time between April 2005 and March 2006. Multiple demographic criteria were assembled. Also, for every chart analyzed, the PTSD criteria, according to the Manual of Mental Disorders (DSM) IV were found, identified, and grouped according to pre-established codes. An analysis using the receiver operating characteristic (ROC) method was elaborated for the study of data. A sample of 57 women and 50 men was studied. Age was varying between 18 and 88 years with a median age of 48. According to the PTSD criteria in the DSM IV, 12 patients should have the diagnosis of PTSD in opposition to only two identified in the medical charts. The ROC method establishes that with the combination of data from PTSD and depression, the sensitivity varies between 0,127 and 0,282, and the specificity varies between 0,889 and 0,917. Otherwise, if we examine the PTSD data alone, the sensibility jumps to 0.50, and the specificity varies between 0,781 and 0,895. This study confirms the presence of an underdiagnosed and treated PTSD that causes severe perturbations for the affected individual.

Keywords: Post-Traumatic Stress Disorder, diagnosis, co-morbidities, mental health disorders.

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202 Innovativeness, Risk Taking, Focusing on Opportunity Attitudes on Nurse Managers and Nurses

Authors: Melek Kalkan, Hatice Odacı, Hatice Epli Koç

Abstract:

The aim of this study is to compare the innovativeness, risk taking, and focusing on opportunity of the nurse managers and nurses. The data are collected from nurse managers and nurses in Ondokuz Mayıs University, Faculty of Medicine Hospital and Karadeniz Technical University, Faculty of Medicine Hospital. The study sample consisted of 151 participants, 76 nurse managers (50.3%) and 75 nurses (49.7%). All participants have been assessed by Participant Information Form and Corporate Entrepreneurship Scale. In data analysis, independent t-test has applied. The results show that there are significant differences between nurse managers and nurses on innovativeness (t = 2.42, p < 0.05), risk taking (t = 3.62, p < 0.01), and focusing on opportunity (t = 2.16, p < 0.05). Consequently, it can be said that nurse managers have more innovativeness than nurses and tend to take more risks and focus more on opportunities. 

Keywords: Focusing on opportunity attitudes, innovativeness, risk taking, nurse.

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201 Heat Recovery System from Air-Cooled Chillers in Iranian Hospitals

Authors: Saeed Vahidifar, Mohammad Nakhaee Sharif, Mohammad Ghaffari

Abstract:

Few people would dispute the fact that one of the most common applications of energy is creating comfort in buildings, so it is probably true to say that management of energy consumption is required due to the environmental issues and increasing the efficiency of mechanical systems. From the geographical point of view, Iran is located in a warm and semi-arid region; therefore, air-cooled chillers are usually used for cooling residential buildings, commercial buildings, medical buildings, etc. In this study, a heat exchanger was designed for providing laundry hot water by utilizing condenser heat lost base on analytical results of a 540-bed hospital in the city of Mashhad in Iran. In this paper, by using the analytical method, energy consumption reduces about 13%, and coefficient of performance increases a bit. Results show that this method can help in the management of energy consumption a lot.

Keywords: Energy management, air-cooled chiller, heat exchanger, hospital laundry system.

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200 A New blaVIM Gene in a Pseudomonas putida Isolated from ENT Units in Sulaimani Hospitals

Authors: Dalanya Asaad Mohammed, Dara Abdul Razaq

Abstract:

A total of twenty tensile biopsies were collected from children undergoing tonsillectomy from teaching hospital ENT department and Kurdistan private hospital in sulaimani city. All biopsies were homogenized and cultured; the obtained bacterial isolates were purified and identified by biochemical tests and VITEK 2 compact system. Among the twenty studied samples, only one Pseudomonas putida with probability of 99% was isolated. Antimicrobial susceptibility was carried out by disk diffusion method, Pseudomonas putida showed resistance to all antibiotics used except vancomycin. The isolate further subjected to PCR and DNA sequence analysis of blaVIM gene using different set of primers for different regions of VIM gene. The results were found to be PCR positive for the blaVIM gene. To determine the sequence of blaVIM gene, DNA sequencing performed. Sequence alignment of blaVIM gene with previously recorded blaVIM gene in NCBI- database showed that P. putida isolate have different blaVIM gene.

Keywords: Clinical isolates, Putida, Sulaimani, Vim gene.

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199 Design Patterns for Emergency Management Processes

Authors: Tomáš Ludík, Jiří Barta, Josef Navrátil

Abstract:

Natural or human made disasters have a significant negative impact on the environment. At the same time there is an extensive effort to support management and decision making in emergency situations by information technologies. Therefore the purpose of the paper is to propose a design patterns applicable in emergency management, enabling better analysis and design of emergency management processes and therefore easier development and deployment of information systems in the field of emergency management. It will be achieved by detailed analysis of existing emergency management legislation, contingency plans and information systems. The result is a set of design patterns focused at emergency management processes that enable easier design of emergency plans or development of new information system. These results will have a major impact on the development of new information systems as well as to more effective and faster solving of emergencies.

Keywords: Analysis and Design, Business Process Modeling Notation, Contingency Plans, Design Patterns, Emergency Management.

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198 Screening of Strategic Management Criterions in Hospitals Using Delphi-Fuzzy Method

Authors: Helia Moayedi, Mahdi Moaidi

Abstract:

Nowadays, the managing and planning of hospitals is facing many problems. Failure to recognize the main criteria for strategic management to ensure long-term hospital performance can lead to many health problems. To achieve this goal, a qualitative-quantitate method titled Delphi-Fuzzy has been applied. This strategy makes it possible for experts to screen among the most important criteria in strategic management. To conduct this operation, a statistical society consisting of 20 experts in Ahwaz hospitals has been questioned. The final model confirms the key criterions after three stages of Delphi. This model provides the possibility to focus on the basic criteria and can determine the organization’s main orientation.

Keywords: Delphi-Fuzzy Method, hospital management, long-term planning, qualitative-quantitate method, screening of strategic criteria, strategic planning.

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197 Intelligent Home: SMS Based Home Security System with Immediate Feedback

Authors: Sheikh I. Azid, Bibhya Sharma

Abstract:

A low cost Short Message System (SMS) based Home security system equipped with motion, smoke, temperature, humidity and light sensors has been studied and tested. The sensors are controlled by a microprocessor PIC 18F4520 through the SMS having password protection code for the secure operation. The user is able to switch light and the appliances and get instant feedback. Also in cases of emergencies such as fire or robbery the system will send alert message to occupant and relevant civil authorities. The operation of the home security has been tested on Vodafone- Fiji network and Digicel Fiji Network for emergency and feedback responses for 25 samples. The experiment showed that it takes about 8-10s for the security system to respond in case of emergency. It takes about 18-22s for the occupant to switch and monitor lights and appliances and then get feedback depending upon the network traffic.

Keywords: Smart Home, SMS, Sensors, Microprocessor.

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196 Continuity Planning in Supply Chain Networks: Degrees of Freedom and Application in the Risk Management Process

Authors: Marco Bötel, Tobias Gelau, Wendelin Gross

Abstract:

Supply chain networks are frequently hit by unplanned events which lead to disruptions and cause operational and financial consequences. It is neither possible to avoid disruption risk entirely, nor are network members able to prepare for every possible disruptive event. Therefore a continuity planning should be set up which supports effective operational responses in supply chain networks in times of emergencies. In this research network related degrees of freedom which determine the options for responsive actions are derived from interview data. The findings are further embedded into a common risk management process. The paper provides support for researchers and practitioners to identify the network related options for responsive actions and to determine the need for improving the reaction capabilities.

Keywords: Supply Chain Risk Management, Business Continuity Planning, Degrees of Freedom, Risk Management Process, Mitigation Measures.

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195 Risk Assessment for Aerial Package Delivery

Authors: Haluk Eren, Ümit Çelik

Abstract:

Recent developments in unmanned aerial vehicles (UAVs) have begun to attract intense interest. UAVs started to use for many different applications from military to civilian use. Some online retailer and logistics companies are testing the UAV delivery. UAVs have great potentials to reduce cost and time of deliveries and responding to emergencies in a short time. Despite these great positive sides, just a few works have been done for routing of UAVs for package deliveries. As known, transportation of goods from one place to another may have many hazards on delivery route due to falling hazards that can be exemplified as ground objects or air obstacles. This situation refers to wide-range insurance concept. For this reason, deliveries that are made with drones get into the scope of shipping insurance. On the other hand, air traffic was taken into account in the absence of unmanned aerial vehicle. But now, it has been a reality for aerial fields. In this study, the main goal is to conduct risk analysis of package delivery services using drone, based on delivery routes.

Keywords: Drone risk assessment, drone package delivery.

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194 On-line Control of the Natural and Anthropogenic Safety in Krasnoyarsk Region

Authors: T. Penkova, A. Korobko, V. Nicheporchuk., L. Nozhenkova, A. Metus

Abstract:

This paper presents an approach of on-line control of the state of technosphere and environment objects based on the integration of Data Warehouse, OLAP and Expert systems technologies. It looks at the structure and content of data warehouse that provides consolidation and storage of monitoring data. There is a description of OLAP-models that provide a multidimensional analysis of monitoring data and dynamic analysis of principal parameters of controlled objects. The authors suggest some criteria of emergency risk assessment using expert knowledge about danger levels. It is demonstrated now some of the proposed solutions could be adopted in territorial decision making support systems. Operational control allows authorities to detect threat, prevent natural and anthropogenic emergencies and ensure a comprehensive safety of territory.

Keywords: Decision making support systems, Emergency risk assessment, Natural and anthropogenic safety, On-line control, Territory.

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193 A Study of Distinctive Models for Pre-hospital EMS in Thailand: Knowledge Capture

Authors: R. Sinthavalai, N. Memongkol, N. Patthanaprechawong, J. Viriyanantavong, C. Choosuk

Abstract:

In Thailand, the practice of pre-hospital Emergency Medical Service (EMS) in each area reveals the different growth rates and effectiveness of the practices. Those can be found as the diverse quality and quantity. To shorten the learning curve prior to speed-up the practices in other areas, story telling and lessons learnt from the effective practices are valued as meaningful knowledge. To this paper, it was to ascertain the factors, lessons learnt and best practices that have impact as contributing to the success of prehospital EMS system. Those were formulized as model prior to speedup the practice in other areas. To develop the model, Malcolm Baldrige National Quality Award (MBNQA), which is widely recognized as a framework for organizational quality assessment and improvement, was chosen as the discussion framework. Remarkably, this study was based on the consideration of knowledge capture; however it was not to complete the loop of knowledge activities. Nevertheless, it was to highlight the recognition of knowledge capture, which is the initiation of knowledge management.

Keywords: Emergency Medical Service, Modeling, MBNQA, Thailand.

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192 Investigating the Possible use of Session Initiation Protocol for Extending Mobility Service to the Biomedical Engineers

Authors: Anwar Sadat

Abstract:

Today, the Internet based communication has widen the opportunity of event monitoring system in the medical field. There is always a need of analyzing and designing secure and reliable mobile communication between the hospital and biomedical engineers mobile units. This study has been carried out to find possible solution using SIP-based event notification for alerting the technical staff about the Biomedical Device (BMD) status and Patients treatment session. The Session Initiation Protocol (SIP) can be used to create a medical event notification system. SIP can work on a variety of devices. Its adoption as the protocol of choice for third generation wireless networks allows for a robust and scalable environment. One of the advantages of SIP is that it supports personal mobility through the separation of user addressing and device addressing. The solution for Telemed alert notification system is based on SIP - Specific Event Notification. The aim of this project is to extend mobility service to the hospital technicians who are using Telemedicine system.

Keywords: Biomedical, Mobility Service, Notify, Proxy Server, SIP, Subscribe, Telemedicine.

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191 Survey on Awareness, Knowledge and Practices: Managing Osteoporosis among Practitioners in a Tertiary Hospital, Malaysia

Authors: P. H. Tee, S. M. Zamri, K. M. Kasim, S. K. Tiew

Abstract:

This study evaluates the management of osteoporosis in a tertiary care government hospital in Malaysia. As the number of admitted patients having osteoporotic fractures is on the rise, osteoporotic medications are an increasing financial burden to government hospitals because they account for half of the orthopedic budget and expenditure. Comprehensive knowledge among practitioners is important to detect early and avoid this preventable disease and its serious complications. The purpose of this study is to evaluate the awareness, knowledge, and practices in managing osteoporosis among practitioners in Hospital Tengku Ampuan Rahimah (HTAR), Klang. A questionnaire from an overseas study in managing osteoporosis among primary care physicians is adapted to Malaysia’s Clinical Practice Guideline of Osteoporosis 2012 (revised 2015) and international guidelines were distributed to all orthopedic practitioners in HTAR Klang (including surgeons, orthopedic medical officers), endocrinologists, rheumatologists and geriatricians. The participants were evaluated on their expertise in the diagnosis, prevention, treatment decision and medications for osteoporosis. Collected data were analyzed for all descriptive and statistical analyses as appropriate. All 45 participants responded to the questionnaire. Participants scored highest on expertise in prevention, followed by diagnosis, treatment decision and lastly, medication. Most practitioners stated that own-initiated continuing professional education from articles and books was the most effective way to update their knowledge, followed by attendance in conferences on osteoporosis. This study confirms the importance of comprehensive training and education regarding osteoporosis among tertiary care physicians and surgeons, predominantly in pharmacotherapy, to deliver wholesome care for osteoporotic patients.

Keywords: Awareness, knowledge, osteoporosis, practices.

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190 The Effect of X-Ray on Plasma and Erythrocyte Concentration of Zn and Cu in Radiology Staff of Tehran Oil Hospital

Authors: L. Nekoozad, M. Salehi Barough, B. Salmasian

Abstract:

Introduction: Some parameters should be considered to investigate the chronic effects of radiation absorption in radiation workers. Trace elements are parameters which small changes in them can cause significant effects on live systems. The role of trace element concentration in human health is significant. These elements play an important role in the developing and functioning of the immune system, cellular respiration, and oxidation processes. Considering the importance and necessity of this issue and few studies, measurements of concentration changes of these elements due to the absorbed dose are important. Purpose: This study aimed to determine the biological effects of occupational dose absorption on plasma and erythrocyte concentration of Zn and Cu in the radiology staff of Tehran Oil Hospital. Material and methods: In this analytical-comparative study, 72 people have entered. 36 people (18 males and 18 females) were selected as radiology staff in the diagnostic and therapeutic departments of Tehran Oil Hospital. And 36 people (18 males and 18 females) were selected as general section staff in the same hospital as a control group. Radiology and control groups’ age and sex were matched. 10 ml of venous blood was taken from all people.  An atomic absorption spectrometer was used to obtain zinc and copper plasma concentrations. Levine test was used to compare these results validity. Results: The mean concentrations of copper and zinc were measured as 0.951 and 0.754 mg/L in the plasma phase and 3.2  and 0.401 mg/L in the RBC phase for the radiology group.  Copper and zinc average concentrations, respectively 0.976 and 0.813 mg/L in the plasma phase and 2.906 and 0.476 mg/L in the RBC phase, were measured for the control group. These elements Concentrations in the plasma phase were significantly different from that of the control group, but the concentrations in the red blood cell phase did not show a significant difference compared to the control group. In comparison, a separate comparison between men and women in the experimental and control groups showed a significant difference in the values of the elements mentioned. With a significant increase in samples, a better justification than the available statistical results can be extracted. Conclusions: Within this study results, chronic occupational probabilistic absorption destructive effects (even within the permitted range) on blood trace element concentration have been confirmed.

Keywords: Chronic absorption, atomic absorption spectrometry, radiology staff, trace element concentration.

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189 Exploring Elder Care in Different Settings in West Bengal: A Psycho-Social Study of Private Homes, Hospitals and Long-Term Care Facilities

Authors: Tulika Bhattacharyya, Suhita C. Chatterjee

Abstract:

West Bengal, one of the most rapidly ageing states in India, has inadequate structure for elder care. Therefore, there is an urgent need to improve elder care which involves focusing on different care settings where the elderly exists, like - Homes, Hospitals and Long-Term Care facilities (e.g. - Old Age Homes, Hospices). The study explores various elder care settings, with the intention to develop an understanding about them, and thereby generate comprehensive information about the entire spectrum of elder care in Kolkata. Empirical data are collected from the elderly and their caregivers in different settings. The tools for data collection are narratives, in-depth interviews and focus group discussions, along with field observations. Mixed method design is adopted to analyze the complexities of elder care in different set ups. The major challenges of elder care in private Homes are: architecturally inadequate housing conditions, paucity of financial support and scarcity of skilled caregivers. While the key factors preventing the Hospital and Long-Term Care Facilities from providing elder care services are inadequate policies and set governmental standards for elder care for the hospitalized elderly in various departments of the Hospital and the elderly residing in different kinds of Long Term Care Facilities. The limitations in each care setting results in considerable neglect and abuse of the elderly. The major challenges in elder care in West Bengal are lack of continuum between different care settings/ peripheral location of private Homes within public health framework and inadequate state Palliative policy- including narcotic regulations. The study suggests remedial measures to improve the capacity to deliver elder care in different settings.

Keywords: Elder care settings, family caregiver, home care, geriatric hospital care, long term care facility.

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188 Usage of Military Continuity Management System for Supporting of Emergency Management

Authors: R. Hajkova, J. Palecek, H. Malachova, A. Oulehlova

Abstract:

Ensuring of continuity of business is basic strategy of every company. Continuity of organization activities includes comprehensive procedures that help in solving unexpected situations of natural and anthropogenic character (for example flood, blaze, economic situations). Planning of continuity operations is a process that helps identify critical processes and implement plans for the security and recovery of key processes. The aim of this article is to demonstrate application of system approach to managing business continuity called business continuity management systems in military issues. This article describes the life cycle of business continuity management which is based on the established cycle PDCA (Plan- Do-Check-Act). After this is carried out by activities which are making by University of Defence during activation of forces and means of the integrated rescue system in case of emergencies - accidents at a nuclear power plant in Czech Republic. Activities of various stages of deployment earmarked forces and resources are managed and evaluated by using MCMS application (Military Continuity Management System).

Keywords: Business continuity management system, emergency management, military, nuclear safety.

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187 Effectiveness of Cellular Phone with Active RFID Tag for Evacuation - The Case of Evacuation from the Underground Shopping Mall of Tenjin

Authors: Masatora Daito, Noriyuki Tanida

Abstract:

The underground shopping mall has the constructional problem of the fire evacuation. Also, the people sometimes lose their direction and information of current time in the mall. If the emergencies such as terrorist explosions or gas explosions are happened, they have to go out soon. Under such circumstances, inside of the mall has high risk for life. In this research, the authors propose a way that he/she can go out from the underground shopping mall quickly. If the narrow exits are discovered by using active RFID (Radio Frequency Identification) tags and using cellular phones, they can evacuate as soon as possible. To verify this hypothesis, the authors design the model and carry out the agent-based simulation. They treat, as a case study, the Tenjin mall in Fukuoka Prefecture in Japan. The result of the simulation is that the case of the pedestrian with using active RFID tags and cellular phones reduced the amount of time to spend on the evacuation. Even if the diffusion of RFID tags and cellular phones was not perfect, they could show the effectiveness of reducing the time of evacuation.

Keywords: Evacuation, active RFID tag and cellular phone, underground shopping mall, agent-based simulation.

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186 Assessing the Physiological, Psychological Stressors and Coping Strategies among Hemodialysis Patients in the Kingdom of Saudi Arabia

Authors: A. Seham A. Elgamal, Reham H. Saleh

Abstract:

Chronic kidney disease became a global health problem worldwide. Therefore, in order to maintain a patient’s life and improve the survival rate, hemodialysis is essential to replace the function of their kidneys. However, those patients may complain about multiple physical and psychological stressors due to the nature of the disease and the need for frequent hemodialysis sessions. So, those patients use various strategies to cope with the stressors related to their disease and the treatment procedures. Cross-sectional, descriptive study was carried out to achieve the aim of the study. A convenient sample including all adult patients was recruited for this study. Hemodialysis Stressors Scale (HSS) and Jalowiec Coping Scale (JCS) were used to investigate the stressors and coping strategies of 89 hemodialysis patients, at a governmental hospital (King Khalid Hospital-Jeddah). Results of the study revealed that 50.7% experienced physiological stressors and 38% experienced psychosocial stressors. Also, optimistic, fatalistic, and supportive coping strategies were the most common coping strategies used by the patients with mean scores (2.88 + 0.75, 2.87 + 0.75, and 1.82 + 0.71), respectively. In conclusion, being familiar with the types of stressors and the effective coping strategies of hemodialysis patients and their families are important in order to enhance their adaptation with chronic kidney diseases.

Keywords: Coping strategies, hemodialysis, physiological stressors, psychological stressors.

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185 Data Integrity: Challenges in Health Information Systems in South Africa

Authors: T. Thulare, M. Herselman, A. Botha

Abstract:

Poor system use, including inappropriate design of health information systems, causes difficulties in communication with patients and increased time spent by healthcare professionals in recording the necessary health information for medical records. System features like pop-up reminders, complex menus, and poor user interfaces can make medical records far more time consuming than paper cards as well as affect decision-making processes. Although errors associated with health information and their real and likely effect on the quality of care and patient safety have been documented for many years, more research is needed to measure the occurrence of these errors and determine the causes to implement solutions. Therefore, the purpose of this paper is to identify data integrity challenges in hospital information systems through a scoping review and based on the results provide recommendations on how to manage these. Only 34 papers were found to be most suitable out of 297 publications initially identified in the field. The results indicated that human and computerized systems are the most common challenges associated with data integrity and factors such as policy, environment, health workforce, and lack of awareness attribute to these challenges but if measures are taken the data integrity challenges can be managed.

Keywords: Data integrity, data integrity challenges, hospital information systems, South Africa.

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184 A Study on the Leadership Behavior, Safety Culture, and Safety Performance of the Healthcare Industry

Authors: Cheng-Chia Yang , Yi-Shun Wang , Sue-Ting Chang, Suh-Er Guo, Mei-Fen Huang

Abstract:

Object: Review recent publications of patient safety culture to investigate the relationship between leadership behavior, safety culture, and safety performance in the healthcare industry. Method: This study is a cross-sectional study, 350 questionnaires were mailed to hospital workers with 195 valid responses obtained, and a 55.7% valid response rate. Confirmatory factor analysis (CFA) was carried out to test the factor structure and determine if the composite reliability was significant with a factor loading of >0.5, resulting in an acceptable model fit. Results: Through the analysis of One-way ANOVA, the results showed that physicians significantly have more negative patient safety culture perceptions and safety performance perceptions than non- physicians. Conclusions: The path analysis results show that leadership behavior affects safety culture and safety performance in the health care industry. Safety performance was affected and improved with contingency leadership and a positive patient safety organization culture. The study suggests improving safety performance by providing a well-managed system that includes: consideration of leadership, hospital worker training courses, and a solid safety reporting system.

Keywords: Leadership Behavior, Patient Safety, Safety Culture, Safety Performance

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183 The Role of Local Government Authorities in Managing the Pre-Hospital Emergency Medical Service (EMS) Systems in Thailand

Authors: Chanisada Choosuk, Napisporn Memongkol Runchana Sinthavalai, Fareeda Lambensah

Abstract:

The objective of this research is to explore the role of actors at the local level in managing the Pre-hospital Emergency Medical Service (EMS) system in Thailand. The research method was done through documentary research, individual interviews, and one forum conducted in each province. This paper uses the case of three provinces located in three regions in Thailand including; Ubon Ratchathani (North-eastern region), Lampang (Northern Region), and Songkhla (Southern Region). The result shows that, recently, the role of the local government in being the service provider for their local people is increasingly concerned. In identifying the key success factors towards the EMS system, it includes; (i) the local executives- vision and influence that the decisions made by them, for both PAO (Provincial Administration Organisation (PAO) and TAO (Tambon Administration Organisation), is vital to address the overall challenges in EMS development, (ii) the administrative system through reforming their working style create the flexibility in running the EMS task, (iii) the network-based management among different agencies at the local level leads to the better EMS practices, and (iv) the development in human resource is very vital in delivering the effective services.

Keywords: Local governments, Management, Emergency Medical Services (EMS), Thailand

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182 Providing Emotional Support to Children under Long-Term Health Treatments

Authors: Ramón Cruzat, Sergio F. Ochoa, Ignacio Casas, Luis A. Guerrero, José Bravo

Abstract:

Patients under health treatments that involve long  stays at a hospital or health center (e.g. cancer, organ transplants and  severe burns), tend to get bored or depressed because of the lack of  social interaction with family and friends. Such a situation also  affects the evolution and effectiveness of their treatments. In many  cases, the solution to this problem involves extra challenges, since  many patients need to rest quietly (or remain in bed) to their being  contagious. Considering the weak health condition in which usually  are these kinds, keeping them motivated and quiet represents an  important challenge for nurses and caregivers. This article presents a  mobile ubiquitous game called MagicRace, which allows hospitalized  kinds to interact socially with one another without putting to risk  their sensitive health conditions. The game does not require a  communication infrastructure at the hospital, but instead, it uses a  mobile ad hoc network composed of the handheld devices used by  the kids to play. The usability and performance of this application  was tested in two different sessions. The preliminary results show  that users experienced positive feelings from this experience.

 

Keywords: Ubiquitous game, children's emotional support, social isolation, mobile collaborative interactions.

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181 Clique and Clan Analysis of Patient-Sharing Physician Collaborations

Authors: Shahadat Uddin, Md Ekramul Hossain, Arif Khan

Abstract:

The collaboration among physicians during episodes of care for a hospitalised patient has a significant contribution towards effective health outcome. This research aims at improving this health outcome by analysing the attributes of patient-sharing physician collaboration network (PCN) on hospital data. To accomplish this goal, we present a research framework that explores the impact of several types of attributes (such as clique and clan) of PCN on hospitalisation cost and hospital length of stay. We use electronic health insurance claim dataset to construct and explore PCNs. Each PCN is categorised as ‘low’ and ‘high’ in terms of hospitalisation cost and length of stay. The results from the proposed model show that the clique and clan of PCNs affect the hospitalisation cost and length of stay. The clique and clan of PCNs show the difference between ‘low’ and ‘high’ PCNs in terms of hospitalisation cost and length of stay. The findings and insights from this research can potentially help the healthcare stakeholders to better formulate the policy in order to improve quality of care while reducing cost.

Keywords: Clique, clan, electronic health records, physician collaboration.

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180 An Exhaustive Investigation of Green Building Certification on the Productivity and Mental and Physical Health of Buildings Occupants in Tehran, Iran

Authors: Armin Samarghandi, Amirreza Jafari, Mohamad Ghiasi

Abstract:

Since individuals spend the majority of their time indoors, this immediately affects their productivity and health. An essential factor in occupational health and public health is the influence of indoor environmental quality (IEQ) in buildings on occupant welfare and productivity. Since then, empirical data have been equivocal, indicating either that the studies are inaccurate or that the research has just scratched the surface of green buildings in offices, accommodation, and hospital settings and not taken the aforementioned holistically. This study compared three green-certified buildings — a residential green building, a green hospital, and a green school — with conventional structures in Tehran, Iran by means of a questionnaire spread among those utilizing these buildings, and assessing their productivity and health rate as opposed to the time they resided, worked in conventional buildings. The results demonstrated higher scores pertaining to productivity, physical and mental wellness as a consequence of better indoor environmental quality (IEQ), natural lighting, design, and sustainability of these building against non-green buildings. In addition, ancillary matters — environmental, financial, intellectual, emotional, social, spiritual dimensions of participants — were indirectly evaluated, and the same results are produced.

Keywords: Green building, Iran, productivity, physical and mental health, Tehran.

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179 Risk Management Approach for a Secure and Performant Integration of Automated Drug Dispensing Systems in Hospitals

Authors: Hind Bouami, Patrick Millot

Abstract:

Medication dispensing system is a life-critical system whose failure may result in preventable adverse events leading to longer patient stays in hospitals or patient death. Automation has led to great improvements in life-critical systems as it increased safety, efficiency, and comfort. However, critical risks related to medical organization complexity and automated solutions integration can threaten drug dispensing security and performance. Knowledge about the system’s complexity aspects and human machine parameters to control for automated equipment’s security and performance will help operators to secure their automation process and to optimize their system’s reliability. In this context, this study aims to document the operator’s situation awareness about automation risks and parameters involved in automation security and performance. Our risk management approach has been deployed in the North Luxembourg hospital center’s pharmacy, which is equipped with automated drug dispensing systems since 2009. With more than 4 million euros of gains generated, North Luxembourg hospital center’s success story was enabled by the management commitment, pharmacy’s involvement in the implementation and improvement of the automation project, and the close collaboration between the pharmacy and Sinteco’s firm to implement the necessary innovation and organizational actions for automated solutions integration security and performance. An analysis of the actions implemented by the hospital and the parameters involved in automated equipment’s integration security and performance has been made. The parameters to control for automated equipment’s integration security and performance are human aspects (6.25%), technical aspects (50%), and human-machine interaction (43.75%). The implementation of an anthropocentric analysis system before automation would have prevented and optimized the control of risks related to automation.

Keywords: Automated drug delivery systems, hospitals, human-centered automated system, risk management.

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178 The Appropriateness of Antibiotic Prescribing within Dundee Dental Hospital

Authors: Salma Ainine, Colin Ritchie, Tracey McFee

Abstract:

Background: The societal impact of antibiotic resistance is a major public health concern. The increase in incidence of resistant bacteria can ultimately be fatal. Objective: To analyse the appropriateness of antibiotic prescribing in Dundee Dental Hospital, ultimately improving the safety and quality of patient care. Methods: Two examiners independently crosschecked approximately fifty consecutive prescriptions, and corresponding patient case notes, for three data collection cycles between August 2014 – September 2015. The Scottish Dental Clinical Effectiveness Program (SDCEP) Drug Prescribing for Dentistry guidelines was the standard utilised. The criteria: clinical justification, regime justification and review arrangements was measured, and compared to the standard. Results: Cycle one revealed 42% of antibiotic prescriptions were appropriate. Interventions included: multiple staff meetings, introduction of a checklist attached to the prescription pack, and production of patient leaflets explaining indications for antibiotics. Cycle two and three revealed 44%, and 30% compliance, respectively. Conclusion: The results of the audit have yet to meet target standards set out in prescribing guidelines. However, steps are being taken and change has occurred on a cultural level.

Keywords: Antibiotic resistance, antibiotic stewardship, dental infection and hygiene standards.

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177 Building a Performance Outline for Health Care Workers at Teaching Hospitals, Nigeria: The Role of Different Leadership Styles

Authors: Osuagwu Justine Ugochukwu, Sazali Abd Wahab, Sunday Sunday Akpan

Abstract:

Investigating the effects of transformational and transactional leadership styles on the performance of healthcare employees at the University Teaching Hospital (UNTH) in Enugu, Nigeria, was the goal of the research. The respondents were asked to fill out a structured questionnaire. The respondents were chosen using a straightforward random sampling technique and consisted of 370 health workers at the hospital. The result of the analysis revealed that transactional and transformational leadership style has a positive while ambidextrous leadership has a negative effect on healthcare workers' performance in UNTH, Enugu. Therefore, the management of public hospitals that have the capacity to change their top management approach to leadership styles will gain substantial support from their employees’ thereby increasing organizational commitment and performance among health workers. This will have remarkable social implications, one of which is a change in the work culture and attitude of medical personnel from the seemingly anti-community of patients to friendly engagement and treatment of patients leading to a harmonious coexistence among these individuals in society. Investigating ambidextrous leadership and the use of nonparametric analysis is unique and has brought knowledge to leadership literature.

Keywords: Workers’ performance, transformational leadership, transactional leadership, governance quality, ambidextrous leadership.

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176 Identifying the Strength of Cyclones and Earthquakes Requiring Military Disaster Response

Authors: Chad A. Long

Abstract:

The United States military is now commonly responding to complex humanitarian emergencies and natural disasters around the world. From catastrophic earthquakes in Haiti to typhoons devastating the Philippines, U.S. military assistance is requested when the event exceeds the local government's ability to assist the population. This study assesses the characteristics of catastrophes that surpass a nation’s individual ability to respond and recover from the event. The paper begins with a historical summary of military aid and then analyzes over 40 years of the United States military humanitarian response. Over 300 military operations were reviewed and coded based on the nature of the disaster. This in-depth study reviewed the U.S. military’s deployment events for cyclones and earthquakes to determine the strength of the natural disaster requiring external assistance. The climatological data for cyclone landfall and magnitude data for earthquake epicenters were identified, grouped into regions and analyzed for time-based trends. The results showed that foreign countries will likely request the U.S. military for cyclones with speeds greater or equal to 125 miles an hour and earthquakes at the magnitude of 7.4 or higher. These results of this study will assist the geographic combatant commands in determining future military response requirements.

Keywords: Cyclones, earthquakes, natural disasters, military.

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