Search results for: Patient Safety

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

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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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Authors: Jih-Rue Pan, Feng-Chuan Pan

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Today-s healthcare industries had become more patient-centric than profession-centric, from which the issues of quality of healthcare and the patient safety are the major concerns in the modern healthcare facilities. An unplanned extubation (UE) may be detrimental to the patient-s life, and thus is one of the major indexes of patient safety and healthcare quality. A high UE rate not only defeated the healthcare quality as well as the patient safety policy but also the nurses- morality, and job satisfaction. The UE problem in a psychiatric hospital is unique and may be a tough challenge for the healthcare professionals for the patients were mostly lacking communication capabilities. We reported with this essay a particular project that was organized to reduce the UE rate from the current 2.3% to a lower and satisfactory level in the long-term care units of a psychiatric hospital. The project was conducted between March 1st, 2011 and August 31st, 2011. Based on the error information gathered from varied units of the hospital, the team analyzed the root causes with possible solutions proposed to the meetings. Four solutions were then concluded with consensus and launched to the units in question. The UE rate was now reduced to a level of 0.17%. Experience from this project, the procedure and the tools adopted would be good reference to other hospitals.

Keywords: Unplanned extubation, patient safety, error information

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Authors: Mannan Mridha, Mohammad S. Islam

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

Keywords: Accidents reporting system, patient car and safety, safe medical devices.

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

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

Keywords: Drug safety, good pharmacovigilance practice, patient support program, pharmacovigilance.

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Authors: Mohammad Rajabalinejad

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Safety is often seen as a requirement or a performance indicator through the design process, and this does not always result in optimally safe products or systems. This paper suggests integrating the best safety practices with the design process to enrich the exploration experience for designers and add extra values for customers. For this purpose, the commonly practiced safety standards and design methods have been reviewed and their common blocks have been merged forming Safety Cube. Safety Cube combines common blocks for design, hazard identification, risk assessment and risk reduction through an integral approach. An example application presents the use of Safety Cube for design of machinery.

Keywords: Safety, safety cube, design, product, system, machinery.

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Authors: Oluwatosin A. Ijabadeniyi

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The fact that traditional food safety system in the absence of food safety culture is inadequate has recently become a cause of concern for food safety professionals and other stakeholders. Focusing on implementation of traditional food safety system i.e HACCP prerequisite program and HACCP without the presence of food safety culture in the food industry has led to the processing, marketing and distribution of contaminated foods. The results of this are regular out breaks of food borne illnesses and recalls of foods from retail outlets with serious consequences to the consumers and manufacturers alike. This article will consider the importance of food safety culture, the cases of outbreaks and recalls that occurred when companies did not make food safety culture a priority. Most importantly, the food safety cultures of some food industries in South Africa were assessed from responses to questionnaires from food safety/food industry professionals in Durban South Africa. The article was concluded by recommending that both food industry employees and employers alike take food safety culture seriously.

Keywords: Good Manufacturing Practices (GMPs), food borne illnesses, food safety culture, food safety system, HACCP.

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Authors: M. Tsirintani

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The article is proposing a base plan for the future Patient Care Information Systems in a changing health care environment where it is necessary to assure quality patient care services and reducing cost and where new technology trends give the opportunities to develop clinical applications and services patient focused according to new business objectives.

Keywords: Health care management, planning patient care information system.

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Authors: Guilherme Ribeiro, Alexandre Oliveira, Antonio Ferreira, Shyam Visweswaran, Gregory Cooper

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Patient-specific models are instance-based learning algorithms that take advantage of the particular features of the patient case at hand to predict an outcome. We introduce two patient-specific algorithms based on decision tree paradigm that use AUC as a metric to select an attribute. We apply the patient specific algorithms to predict outcomes in several datasets, including medical datasets. Compared to the patient-specific decision path (PSDP) entropy-based and CART methods, the AUC-based patient-specific decision path models performed equivalently on area under the ROC curve (AUC). Our results provide support for patient-specific methods being a promising approach for making clinical predictions.

Keywords: Approach instance-based, area Under the ROC Curve, Patient-specific Decision Path, clinical predictions.

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Authors: Benson Chizubem

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Because of the severe hazards that substantially impact workers' lives and assets lost, the oil and gas industry has established a goal of establishing zero occurrences or accidents in operations. Using leading indicators to measure and assess an organization's safety performance is a proactive approach to safety management. Also, it will provide early warning signals to solve inherent safety issues before they lead to an accident in the study industry. The analysis of these indicators' performance was based on a questionnaire-based methodology. A total number of 1000 questionnaires were disseminated to the workers, of which 327 were returned to the researcher team. The data collected were analysed to evaluate their safety perceptions on indicators performance. Data analysis identified safety training, safety system, safety supervision, safety rules and procedures, safety auditing, strategies and policies, management commitment, safety meeting and safety behaviour, as potential leading indicators that are capable of measuring organizational safety performance and as capable of providing early warning signals of weak safety area in an operational environment. The findings of this study have provided safety researchers and industrial safety practitioners with helpful information on the improvement of the existing safety monitoring process in the oil and gas industry, both locally and globally, as proactive actions.

Keywords: Early warning, safety, accident risks, oil and gas industry.

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Authors: Charita Jashi

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The aim of the paper is to explore the role of social marketing in changing the behavior of consumers on road safety, identify critical aspects and priority needs which impede the implementation of road safety program in Georgia. Given the goals of the study, a quantitative method was used to carry out interviews for primary data collection. This research identified the awareness level of road safety, legislation base, and marketing interventions to change behavior of drivers and pedestrians. During several years the non-governmental sector together with the local authorities and media have been very intensively working on the road safety issue in Georgia, but only seat-belts campaign should be considered rather successful. Despite achievements in this field, efficiency of road safety programs far from fulfillment and needs strong empowering.

Keywords: Road safety, social marketing interventions, behavior change, well-being.

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Authors: Efua Ehiaguina, Haruna Moda

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Interest in the development of appropriate safety culture in the oil and gas industry has taken centre stage among stakeholders in the industry. Human behaviour has been identified as a major contributor to occupational accidents, where abnormal activities associated with safety management are taken as normal behaviour. Poor safety culture is one of the major factors that influence employee’s safety behaviour at work, which may consequently result in injuries and accidents and strengthening such a culture can improve workers safety performance. Nigeria oil and gas industry has contributed to the growth and development of the country in diverse ways. However, in terms of safety and health of workers, this industry is a dangerous place to work as workers are often exposed to occupational safety and health hazard. To ascertain the impact of employees’ safety and how it impacts health and safety compliance within the local industry, online safety culture survey targeting frontline workers within the industry was administered covering major subjects that include; perception of management commitment and style of leadership; safety communication method and its resultant impact on employees’ behaviour; employee safety commitment and training needs. The preliminary result revealed that 54% of the participants feel that there is a lack of motivation from the management to work safely. In addition, 55% of participants revealed that employers place more emphasis on work delivery over employee’s safety on the installation. It is expected that the study outcome will provide measures aimed at strengthening and sustaining safety culture in the Nigerian oil and gas industry.

Keywords: Oil and gas safety, safety behaviour, safety culture, safety compliance.

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Authors: Leslie Beale

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Being a patient with a chronic disease is both a physical and emotional experience. The ability to recognize a patient’s emotional health is an important part of a health care provider’s skills. For the purposes of this paper, emotional health is viewed as the way that we feel, and the way that our feelings affect us. Understanding the patient’s emotional health leads to improved provider-patient relationships and health outcomes. For example, when a patient first hears his or her diagnosis from a provider, they might find it difficult to cope with their emotions. Struggling to cope with emotions interferes with the patient’s ability to read, understand, and act on health information and services. As a result, the patient becomes more frustrated and confused, creating barriers to accessing healthcare services. These barriers are challenging for both the patient and their healthcare providers. There are five basic emotions that are part of who we are and are always with us: fear, anger, sadness, joy, and compassion. Living with a chronic disease however can cause a patient to experience and express these emotions in new and unique ways. Within the provider-patient relationship, there needs to be an understanding that each patient experiences these five emotions and, experiences them at different times. In response to this need, the paper highlights a health promotion framework for patients with chronic disease. This framework emphasizes the emotional health of patients.

Keywords: Health promotion, emotional health, patients with chronic disease, patient-centered care.

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Authors: Zulhisyam Salleh, Erita M. Mazlan, Saiful A. Mazlan, Norzainariah A. Hassan, Fizatul A. Patakor

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Technical laboratories are typically considered as highly hazardous places in the polytechnic institution when addressing the problems of high incidences and fatality rates. In conjunction with several topics covered in the technical curricular, safety and health precaution should be highlighted in order to connect to few key ideas of being safe. Therefore the assessment of safety awareness in terms of safety and health about hazardous and risks at laboratories is needed and has to be incorporated with technical education and other training programmes. The purpose of this study was to determine the efficacy of technical laboratory safety in one of the polytechnics in northern region. The study examined three related issues that were; the availability of safety material and equipment, safety practice adopted by technical teachers and administrator-s safety attitudes in enforcing safety to the students. A model of efficacy technical laboratory was developed to test the linear relationship between existing safety material and equipment, teachers- safety practice and administrators- attitude in enforcing safety and to identify which of technical laboratory safety issues was the most pertinent factor to realize safety in technical laboratory. This was done by analyzing survey-based data sets particularly those obtained from samples of 210 students in the polytechnic. The Pearson Correlation was used to measure the association between the variables and to test the research hypotheses. The result of the study has found that there was a significant correlation between existing safety material and equipment, safety practice adopted by teacher and administrator-s attitude. There was also a significant relationship between technical laboratory safety and safety practice adopted by teacher and between technical laboratory safety and administrator attitude. Hence, safety practice adopted by teacher and administrator attitude is vital in realizing technical laboratory safety.

Keywords: Polytechnic, Safety attitudes, Safety practices, Technical laboratory

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Authors: Pimmada Wichasin, Nuntiya Doungphummes

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While service quality is acceptably most valued in the tourism industry, the issue of safety and security plays a key role in sustaining the industry success. Such an issue has been part of Thailand-s tourism development and promotion for several years. Evidently, the Tourist Police Department was set up for this purpose. Its main responsibility is to deal with international tourists- safety and confidence in travelling within Thai territory. However, to strengthen the tourism safety of the country, it is important to better understand international tourists- safety concerns about Thailand. This article seeks to compare international tourists- safety needs and Thai tourist polices- perception towards the tourists- safety concern to determine what measure should be taken to assure the tourist of Thailand-s secure environment. Through the employment of quantitative and qualitative methodological approaches, the tourism safety need of international tourists from Europe, North America and Asia was excavated, how Thai tourist polices and local polices perceived the international tourist-s safety concern was investigated, and opinion and experiences about how the police deal with international tourists- problems in eight touristic areas were also explored. A comparative result reveals a certain degrees of differences in international tourists- safety needs and Thai polices- perception towards their needs. The tourism safety prevention and protection measure and practice are also suggested.

Keywords: Tourism risk, Tourism safety, Travel safety need, Travelling in Thailand

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Authors: Yi-Yun Ko, Der-Ming Liou

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The Electronic Health Record (EHR) system is very general and we should pay more attention to a patient-s privacy. The patient-s consent is one of the elements when dealing with privacy topics. This study focuses on the creating and managing of patient consent. The integration of the HL7 standards and the IHE BPPC profile provides a base for the creation of patient consent. Establishing the platform offers the patients a way to create, revoke or update their consents. Through this platform, they can manage their consents in an easier manner.

Keywords: consent, EHR, HL7, IHE

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Authors: Nuray Gökçek Karaca

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This study aims to examine the application of occupational health and safety supervision in Turkey and EU countries in terms of legal regulations. The results of research reveal that occupational health and safety supervision in EU countries, whatever the understanding of welfare state, is effectively carried out and almost all legal regulations on this subject are consistent with the EU directives. On the other hand, there are serious problems in applications, not legal regulations, of occupational health and safety supervision in Turkey by the side of EU countries. Indeed, Turkey has modern regulations on occupational health and safety supervision whereas there are several problems such as ignoring prevention policy on occupational health and safety supervision, understanding of monotype inspector, problems resulting from this understanding and dispersed structure of occupational health and safety organizations in workplaces. As a result, Turkey needs to carry out effective supervision mechanisms.

Keywords: Legal Rules, Occupational Health and Safety, Inspection, Supervision, Legislation.

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Authors: Qazi Umer Jamil, Abubakr Siddique, Mubeen Ur Rehman, Nida Aziz, Mohsin I. Tiwana

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This paper discusses a brain controlled robotic gait trainer for neurorehabilitation of Spinal Cord Injury (SCI) patients. Patients suffering from Spinal Cord Injuries (SCI) become unable to execute motion control of their lower proximities due to degeneration of spinal cord neurons. The presented approach can help SCI patients in neuro-rehabilitation training by directly translating patient motor imagery into walkers motion commands and thus bypassing spinal cord neurons completely. A non-invasive EEG based brain-computer interface is used for capturing patient neural activity. For signal processing and classification, an open source software (OpenVibe) is used. Classifiers categorize the patient motor imagery (MI) into a specific set of commands that are further translated into walker motion commands. The robotic walker also employs fall detection for ensuring safety of patient during gait training and can act as a support for SCI patients. The gait trainer is tested with subjects, and satisfactory results were achieved.

Keywords: Brain Computer Interface (BCI), gait trainer, Spinal Cord Injury (SCI), neurorehabilitation.

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Authors: Shahram Jafari, Mohammad-Ali Nikouei Mahani, Mohammad Arabnezhad, Mahdi Sharifi

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Car accident is one of the major causes of death in many countries. Many researchers have attempted to design and develop techniques to increase car safety in the past recent years. In spite of all the efforts, it is still challenging to design a system adaptive to the driver rather than the automotive characteristics. In this paper, the adaptive car safety system is explained which attempts to find a balance.

Keywords: Analog to Digital Converter (ADC), AdaptiveCar Safety System, Multi-Media Card (MMC).

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Authors: Heungsu Lee, Youngseok Kim, Jonghwa Yi, Chul Park

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A landing pier is subjected to safety assessment by visual inspection and design data, but it is difficult to check the damage in real-time. In this study, real - time damage detection and safety evaluation methods were studied. As a result of structural analysis of the arbitrary landing pier structure, the inflection point of deformation and moment occurred at 10%, 50%, and 90% of pile length. The critical value of Fiber Bragg Grating (FBG) sensor was set according to the safety factor, and the FBG sensor application method for real - time safety evaluation was derived.

Keywords: FBG sensor, harbor structure, maintenance, safety evaluation system.

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Authors: Sadia Afroza, Rakiba Rouf

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Road safety and associated behaviors have received significant attention in recent years, reflecting general public concern. This paper portrays a statistical scenario of the young drivers in UAE with emphasis on various concern points of young driver’s behavior and license issuance. Although there are many factors contributing to road accidents, statistically it is evident that age plays a major role in road accidents. Despite ensuring strict road safety laws enforced by the UAE government, there is a staggering correlation among road accidents and young driver’s at UAE. However, private organizations like BMW and RoadSafetyUAE have extended its support on conducting surveys on driver’s behavior with an aim to ensure road safety. Various strategies such as road safety law enforcement, license issuance, adapting new technologies like safety cameras and raising awareness can be implemented to improve the road safety concerns among young drivers.

Keywords: Driving behavior, GLDS, road safety, UAE drivers, young drivers.

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Authors: Josephine Mutwale-Ziko, Nonde Lushinga, Inonge Akakandelwa

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The study discusses the effectiveness of health and safety induction practices on construction sites against the background of the Zambian construction industry experience. The research design included the literature review of relevant literature. Questionnaires and interviews were administered to regulatory bodies, health, and safety personnel. Observation was also employed on construction sites to assess the health and safety practices being used. Health and safety in the construction industry are not something to be ignored or overlooked. The construction industry needs to take heed of the serious consequences of inadequate health and safety induction practices. The implications of inadequate health and safety induction procedures included among others threats to profitability, corporate social responsibility and increased turnover of the workforce leading to poor productivity. Adequate health and safety practices can improve the health and wellbeing of employees, reduce financial implications on firms and encourage productivity on construction sites. Despite this, accidents are still prevalent on construction sites in Zambia. The overall result of this research denotes that the implementation of health and safety induction practices is inadequate, as indicated by the negligent and non-adherent attitude to health and safety induction aspects on the sites by most stakeholders on construction sites. Therefore, health and safety induction practices are ineffective as preventive measures for reduction of accidents on construction sites in Zambia.

Keywords: Accidents, employees, health and safety, inadequate induction.

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Authors: Julian Becker, Wiebke Hartmann, Sebastian Bertsch, Johannes Nywlt, Matthias Schmidt

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In order to ensure a high service level industrial enterprises have to maintain safety-stock that directly influences the economic efficiency at the same time. This paper analyses established mathematical methods to calculate safety-stock. Therefore, the performance measured in stock and service level is appraised and the limits of several methods are depicted. Afterwards, a new dynamic approach is presented to gain an extensive method to calculate safety-stock that also takes the knowledge of future volatility into account.

Keywords: Inventory dimensioning, material requirement planning, safety-stock calculation.

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Authors: Lertchai Ratana-Arporn, Aphisith Angkhanit

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The objective of this study was to develop safety practices which is suitable for Thai industrial operators from Incident and Injury Free, IIF to create safety behavior and reduce the un-safe records in the petroleum industry. A number of 310 technicians i.e., 295 males and 15 females, in service maintenance section participated in this program. The safety attitude level and safety behavior level for pre-attended and post-attended the developed safety practices of the technicians were evaluated using questionnaire procedure and on-site observation. After applied the developed practice program, both of the safety attitudes and safety behavior were increased to be at very good level and good level, respectively. Evaluating the follow-up unsafe records, it was found that the injury was reduced from 0.11 to 0 case/month, the medical treatment case was reduced from 0.22 to 0 case/month and the first aid case was reduced from 1 to 0.33 case/month. The developed safety working practice was successfully implemented to Thai industrial operators.

Keywords: Incident and Injury Free, safety practices, Thai industrial operators, "WeCare".

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Authors: Gyou-tae Park, Young-gyu Kim, Jeong-rock Kwon, Yongwoo Lee, Hiesik Kim

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The gas safety management system using an intelligent gas meter we proposed is to monitor flow and pressure of gas, earthquake, temperature, smoke and leak of methane. Then our system takes safety measures to protect a serious risk by the result of an event, to communicate with a wall-pad including a gateway by zigbee network in buildings and to report the event to user by the safety management program in a server. Also, the inner cutoff valve of an intelligent gas meter is operated if any event occurred or abnormal at each sensor.

Keywords: micom gas-meter, gas safety, zigbee, ubiquitous

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Authors: Sung Kyu Kim, Yong Soo Kim

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Safety instrumented systems (SISs) are becoming increasingly complex and the proportion of programmable electronic parts is growing. The IEC 61508 global standard was established to ensure the functional safety of SISs, but it was expressed in highly macroscopic terms. This study introduces an evaluation process for hardware safety integrity levels through failure modes, effects, and diagnostic analysis (FMEDA).FMEDA is widely used to evaluate safety levels, and it provides the information on failure rates and failure mode distributions necessary to calculate a diagnostic coverage factor for a given component. In our evaluation process, the components of the SIS subsystem are first defined in terms of failure modes and effects. Then, the failure rate and failure mechanism distribution are assigned to each component. The safety mode and detectability of each failure mode are determined for each component. Finally, the hardware safety integrity level is evaluated based on the calculated results.

Keywords: Safety instrumented system; Safety integrity level; Failure modes, effects, and diagnostic analysis; IEC 61508.

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Authors: Nuray Gökçek Karaca, Berrin Gökçek

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Employers occupational safety and health training obligations are regulated in 89/391/EEC Framework Directive and also in 6331 numbered Occupational Health and Safety Law in Turkey. The main objective of this research is to determine and evaluate the employers’ occupational health and safety training obligations in Framework Directive in comparison with the 6331 numbered Occupational Health and Safety Law and to examine training principles in Turkey. For this purpose, employers’ occupational health and safety training obligations examined in Framework Directive and Occupational Health and Safety Law. This study carried out through comparative scanning model and literature model. The research data were collected through European Agency and ministry legislations. As a result, employers’ occupational health and safety training obligations in the 6331 numbered Occupational Health and Safety Law are compatible with the 89/391/EEC numbered Framework Directive and training principles are determined by in different ways like the trained workers, training issues, training period, training time and trainers. In this study, employers’ training obligations are evaluated in detail.

Keywords: Directive, occupational health and safety, training.

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Authors: Kazeem A. Adebiyi

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Despite many success stories of manufacturing safety, many organizations are still reluctant, perceiving it as cost increasing and time consuming. The clear contributor may be due to the use of lagging indicators rather than leading indicator measures. The study therefore proposes a combinatorial model for determining the best safety strategy. A combination theory and cost benefit analysis was employed to develop a monetary saving / loss function in terms value of preventions and cost of prevention strategy. Documentations, interviews and structured questionnaire were employed to collect information on Before-And-After safety programme records from a Tobacco company between periods of 1993-2001(for pre-safety) and 2002-2008 (safety period) for the model application. Three combinatorial alternatives A, B, C were obtained resulting into 4, 6 and 4 strategies respectively with PPE and Training being predominant. A total of 728 accidents were recorded for a 9 year period of pre-safety programme and 163 accidents were recorded for 7 years period of safety programme. Six preventions activities (alternative B) yielded the best results. However, all the years of operation experienced except year 2004. The study provides a leading resources for planning successful safety programme

Keywords: Combination, Manufacturing Safety, Monetary Savings, Prevention Strategies.

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Authors: Ola A. Nassr, Ali M. Abd Alridha, Rua A. Naser, Rasha S. Abbas

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Background: Excessive and inappropriate use of antimicrobial agents among hospitalized patients remains an important patient safety and public health issue worldwide. Not only does this behavior incur unnecessary cost but it is also associated with increased morbidity and mortality. The objective of this study is to obtain an insight into the prescribing patterns of antibiotics in surgical and medical wards, to help identify a scope for improvement in service delivery. Method: A simple point prevalence survey included a convenience sample of 200 patients admitted to medical and surgical wards in a government teaching hospital in Baghdad between October 2017 and April 2018. Data were collected by a trained pharmacy intern using a standardized form. Patient’s demographics and details of the prescribed antibiotics, including dose, frequency of dosing and route of administration, were reported. Patients were included if they had been admitted at least 24 hours before the survey. Patients under 18 years of age, having a diagnosis of cancer or shock, or being admitted to the intensive care unit, were excluded. Data were checked and entered by the authors into Excel and were subjected to frequency analysis, which was carried out on anonymized data to protect patient confidentiality. Results: Overall, 88.5% of patients (n=177) received 293 antibiotics during their hospital admission, with a small variation between wards (80%-97%). The average number of antibiotics prescribed per patient was 1.65, ranging from 1.3 for medical patients to 1.95 for surgical patients. Parenteral third-generation cephalosporins were the most commonly prescribed at a rate of 54.3% (n=159) followed by nitroimidazole 29.4% (n=86), quinolones 7.5% (n=22) and macrolides 4.4% (n=13), while carbapenems and aminoglycosides were the least prescribed together accounting for only 4.4% (n=13). The intravenous route was the most common route of administration, used for 96.6% of patients (n=171). Indications were reported in only 63.8% of cases. Culture to identify pathogenic organisms was employed in only 0.5% of cases. Conclusion: Broad-spectrum antibiotics are prescribed at an alarming rate. This practice may provoke antibiotic resistance and adversely affect the patient outcome. Implementation of an antibiotic stewardship program is warranted to enhance the efficacy, safety and cost-effectiveness of antimicrobial agents.

Keywords: Acute care, antibiotic misuse, Iraq, prescribing.

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Authors: Marilena Ianculescu, Adriana Alexandru

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Internet of Health Things (IoHT) has already proved to be a persuasive means to support a proper assessment of the living conditions by collecting a huge variety of data. For a customized health management of a senior patient, IoHT provides the capacity to build a dynamic solution for sustaining the shift inside the patient-physician relationship by allowing a real-time and continuous remote monitoring of the health status, well-being, safety and activities of the senior, especially in a non-clinical environment. Thus, is created a win-win solution in which both the patient and the physician enhance their involvement and shared decision-making, with significant outcomes. Health monitoring systems in smart environments are becoming a viable alternative to traditional healthcare solutions. The ongoing “Non-invasive monitoring and health assessment of the elderly in a smart environment (RO-SmartAgeing)” project aims to demonstrate that the existence of complete and accurate information is critical for assessing the health condition of the seniors, improving wellbeing and quality of life in relation to health. The researches performed inside the project aim to highlight how the management of IoHT devices connected to the RO-SmartAgeing platform in a secure way by using a role-based access control system, can allow the physicians to provide health services at a high level of efficiency and accessibility, which were previously only available in hospitals. The project aims to identify deficient aspects in the provision of health services tailored to a senior patient’s specificity and to offer a more comprehensive perspective of proactive and preventive medical acts.

Keywords: Health management, Internet of Health Things, remote monitoring, senior patient.

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Authors: L. Parisi

Abstract:

A method which allows a diabetic quadriplegic patient that has had four limb amputations (above the knee and elbow) to self-administer injections of insulin has been designed. The aim of this research project is to improve a quadriplegic patient’s selfmanagement, affected by diabetes, by designing a suitable device for self-administering insulin. The quadriplegic patient affected by diabetes has to be able to selfadminister insulin safely and independently to guarantee stable healthy conditions. The device also should be designed to adapt to a number of different varying personal characteristics such as height and body weight.

Keywords: Robotics, diabetes, quadriplegia, self-management.

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