scholarly journals Improving the quality of weekend medical handover on non-receiving medical hospital wards

2021 ◽  
Vol 10 (4) ◽  
pp. e000991
Author(s):  
Ruairidh Nicoll ◽  
Mark White ◽  
Luis Loureiro Harrison ◽  
Ruth LM Cordiner ◽  
Malcolm Daniel ◽  
...  
Keyword(s):  
Electronic System ◽  
Royal Infirmary ◽  
Time Period ◽  
Pdsa Cycle ◽  
Paper Form ◽  
Medical Wards ◽  
National Training ◽  
Short Time ◽  
Hospital Wards

IntroductionHandover is the system by which the responsibility for immediate and ongoing care is transferred between healthcare professionals and can be an area of risk. The Royal College of Physicians (RCP) has recommended improvement and standardisation of handover. Locally, national training surveys have reported poor feedback regarding handover at Glasgow Royal Infirmary.AimTo improve and standardise handover from weekday to weekend teams.MethodsThe Plan–Do–Study–Act (PDSA) quality improvement framework was used. Interventions were derived from a driver diagram after consultation with relevant stakeholders. Four PDSA cycles were completed over a 4-month period:PDSA cycle 1—Introduction of standardised paper form on three wards.PDSA cycle 2—Introduction of electronic handover system on three wards.PDSA cycle 3—Expansion of electronic handover to seven wards.PDSA cycle 4—Expansion of electronic handover to all non-receiving medical wards.The outcome of interest was the percentage of patients with full information handed over based on a six-point scale derived from the RCP. Data were collected weekly throughout the study period.Results18 data collection exercises were performed including 525 patients. During the initial phase there was an improvement in handover quality with 0/28 (0%) at baseline having all six points completed compared with 13/48 (27%) with standardised paper form and 21/42 (50%) with the electronic system (p<0.001). When the electronic handover form was expanded to all wards, the increased quality was maintained, however, to a lesser extent compared with the initial wards.ConclusionA standardised electronic handover system was successfully introduced to downstream medical wards over a short time period. This led to an in improvement in the quality of handover in the initial wards involved. When expanded to a greater number of wards there was still an improvement in quality but to a lesser degree.

scholarly journals The good, the bad and the ugly: pandemic priority decisions and triage

2020 ◽  
pp. medethics-2020-106489 ◽  
Author(s):  
Hans Flaatten ◽  
Vernon Van Heerden ◽  
Christian Jung ◽  
Michael Beil ◽  
Susannah Leaver ◽  
...  
Keyword(s):  
Critical Care ◽  
Intensive Care ◽  
Point Of View ◽  
Just In Time ◽  
Time Period ◽  
Utilitarian Approach ◽  
Bed Capacity ◽  
Trained Staff ◽  
Short Time

In this analysis we discuss the change in criteria for triage of patients during three different phases of a pandemic like COVID-19, seen from the critical care point of view. Availability of critical care beds has become a hot topic, and in many countries, we have seen a huge increase in the provision of temporary intensive care bed capacity. However, there is a limit where the hospitals may run out of resources to provide critical care, which is heavily dependent on trained staff, just-in-time supply chains for clinical consumables and drugs and advanced equipment. In the first (good) phase, we can still do clinical prioritisation and decision-making as usual, based on the need for intensive care and prognostication: what are the odds for a good result with regard to survival and quality of life. In the next (bad phase), the resources are mostly available, but the system is stressed by many patients arriving over a short time period and auxiliary beds in different places in the hospital being used. We may have to abandon admittance of patients with doubtful prognosis. In the last (ugly) phase, usual medical triage and priority setting may not be sufficient to decrease inflow and there may not be enough intensive care unit beds available. In this phase different criteria must be applied using a utilitarian approach for triage. We argue that this is an important transition where society, and not physicians, must provide guidance to support triage that is no longer based on medical priorities alone.

Effects of implementing an electronic system for the collection of patient reported symptoms on clinic note transcription length

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 17035-17035
Author(s):  
P. W. Cobb ◽  
M. Kofstad ◽  
C. Bealer
Keyword(s):  
Information Technology ◽  
Office Visit ◽  
Electronic System ◽  
Time Period ◽  
Patient Reported ◽  
Within Subjects ◽  
Practice Efficiency ◽  
The Impact ◽  
Touch Screen Computer

17035 Background: Recent advances in information technology have made the goal of incorporating patient-reported symptoms possible. Initial studies have examined the validity of these systems but no systematic work has been done to examine the impact on overall practice efficiency. The PACE (Patient Assessment, Care, and Education) System captures patient-reported symptoms, quality of life, social and family history changes, and other clinical data at every office visit. The PACE System includes the Patient Care Monitor (PCM), a standardized, comprehensive assessment of a patient's condition that allows for a self-reported review of systems (ROS) via a wireless, touch screen computer tablet. The purpose of this study was to determine if implementation of the PCM had an impact on total transcription length. Methods: The study utilized a retrospective within subjects control design comparing transcription length by physicians practicing both with and without the PCM. The PACE System was implemented in October 2004 in a main outpatient oncology site in Billings, MT (PACE site). The analysis compared transcription length by physicians who practice in the Billings office where the PACE system was available, and also in four sites in Montana and Wyoming where the PACE system was not available during the same time period (January to October 2006). All available, consecutive physician notes were analyzed from eligible physicians during the analysis period. Results: Four physicians met inclusion criteria and 8,150 notes were analyzed. The average number of dictation words at PCM sites was 406.7 as compared to 485.5 at non- PCM sites (a 16% reduction). The average number of dictation lines at the PCM sites was 54.0 as compared to 58.5 at non-PCM sites (an 8% reduction). Conclusions: Increases in the use of information technology in outpatient oncology necessitate increased understanding of the validity and utility of these systems. This study of the PACE system suggests that there may be an efficiency benefit by implementing patient self-reporting systems. No significant financial relationships to disclose.

scholarly journals Respon Pemupukan Terhadap Hasil dan Kualitas Hasil Salak Gula Pasir (Salacca zalacca cv. Gula Pasir) di Luar Musim Serta Kandungan Air Dan Klorofil Daun

2020 ◽  
Vol 10 (1) ◽  
pp. 88
Author(s):  
NI MADE KESUMA DEWI ◽  
I NYOMAN RAI ◽  
I WAYAN WIRAATMAJA
Keyword(s):  
Chlorophyll Content ◽  
Fruit Set ◽  
Block Design ◽  
Fruit Weight ◽  
Harvest Time ◽  
Randomized Block Design ◽  
Time Period ◽  
Relative Water ◽  
Short Time

Fertilization Response to Off-Season Production and Fruit Quality of Salak Gula Pasir (Salacca Zalacca cv. Gula Pasir) and water and Chlorophyll Content of Leaves. Naturally salak Gula Pasir (Salacca zalacca cv. Gula Pasir) flowers every three months a year, but only one to two seasons of the flowers can develop into fruit. Failure of flowers develop into fruit, usually call fruit-set failure, causes the fruits be available seasonally in a short time period, only 2-3 months a year, i.e. during the harvest time (on-season period) from December to February. This research aimed to know response of fertilization to off-season production and fruits quality of salak Gula Pasir and its ralatinship to water and chlorophyll content of leaves. The study used a randomized block design with the treatment was fertilization, consists of 14 levels (fertilized according farmers’ way with leaf midrib only/control, fertilized with compost, mycorrhizal biofertilizer, inorganic NPK, combination of farmers' way and compost, combination of farmers’ way and mycorrhizal biofertilizer,  combination of farmers' way and inorganic NPK, combination of compost and mycorrhizal biofertilizer,  combination of compost and inorganic NPK,  combination of mycorrhizal and inorganic NPK,  combination of farmers’ way, compost, and mycorrhizal biofertilizer,  combination of farmers’ way, compost, inorganic NPK,  combination of farmers’ way, mycorrhizal biofertilizer and inorganic NPK, and  combination of farmers’ way, compost, mycorrhizal biofertilizer, and inorganic NPK). Each treatment was repeated 3 times. The study was carried out in the off season period from April to Nopember 2018 at the production center of salak Gula Pasir plantation i.e. at Sibetan Village, Bebandem District, Karangasem Regency. The results showed that the highest fruit weight per tree at the off-season was obtained on combination of fertilization of farmers' way and mycorrhizal biofertilizer  (of 2536.67 g) and the lowest was on  control/fertilized according farmers’ way  (1,220.00 g). Fertilization with compost, mycorrhizal biofertilizer, and inorganic NPK singly, or by combining it, increases the quality of off-season fruit of salak Gula Pasir, reflected by the increase of weight per fruit, fruit diameter and fruit sweetness compared to control. The lower of yield per tree and quality of fruit on control compared to other fertilization treatments was relate to low relative water content and chlorophyll content of leaves.

scholarly journals The Impact of Stress Stability on Job Satisfaction and the Quality of Human Capital

2017 ◽  
Vol 6 (5) ◽  
pp. 333 ◽  
Author(s):  
Irina A. Rudaleva ◽  
Askar N. Mustafin
Keyword(s):  
Job Satisfaction ◽  
Psychological State ◽  
Negative Consequences ◽  
Professional Stress ◽  
Time Period ◽  
Bank Employees ◽  
Short Time ◽  
The Impact ◽  
Main Factor

<p>Long professional stress has a significant impact on the psychological state of employees that inevitably affects the activities of any organization. Therefore, at present, more and more attention is being paid to minimize the negative consequences of stressful staff conditions, with the help of specific procedures of stress management. In this paper, we investigated the impact of stress, the types of stress-resistance of staff individual, and the influence of stress on the degree of job satisfaction of bank employees. The study concludes that the following factors affect the level of job satisfaction of bank employees: wage satisfaction, the level of stress at the workplace, and the relationships in the team. The main factor of the bank employees stress is a large amount of work and a short time period for doing the work. </p>

Application of the Modified Snyder's Program for the Data Processing of an Automated X-Ray Powder Diffractometer

1981 ◽  
Vol 25 ◽  
pp. 261-265
Author(s):  
G. Platbrood ◽  
J. M. Quitin ◽  
H. Barten
Keyword(s):  
Data Processing ◽  
Diffraction Analysis ◽  
Analytical Tool ◽  
Short Time Period ◽  
X Ray Diffraction ◽  
X Ray ◽  
Powder Diffractometer ◽  
Time Period ◽  
Short Time

X-ray diffraction analysis is an excellent analytical tool. But if a certain quality of the results is needed or if solutions of analytical problems are to be obtained in a short time period, the X-ray diffractometer must be automated and the spectra reduced with dedicated algorithms.In LABORELEC, three programs are principally used to solve the problems encountered in the X-ray diffraction analysis: a modified program given by R. L. Snyder; the search/match G. G. Johnson program (last version); and the POWD5 program.

World Economy: Prospects and Barriers for Recovery

2012 ◽  
pp. 61-83 ◽  
Author(s):  
M. Ershov
Keyword(s):  
World Economy ◽  
Western World ◽  
Short Time Period ◽  
Market Segments ◽  
Junk Bonds ◽  
The Past ◽  
Time Period ◽  
The Us ◽  
Global Liquidity ◽  
Short Time

According to the latest forecasts, it will take 10 years for the world economy to get back to “decent shape”. Some more critical estimates suggest that the whole western world will have a “colossal mess” within the next 5–10 years. Regulators of some major countries significantly and over a short time‑period changed their forecasts for the worse which means that uncertainty in the outlook for the future persists. Indeed, the intensive anti‑crisis measures have reduced the severity of the past problems, however the problems themselves have not disappeared. Moreover, some of them have become more intense — the eurocrisis, excessive debts, global liquidity glut against the backdrop of its deficit in some of market segments. As was the case prior to the crisis, derivatives and high‑risk operations with “junk” bonds grow; budget problems — “fiscal cliff” in the US — and other problems worsen. All of the above forces the regulators to take unprecedented (in their scope and nature) steps. Will they be able to tackle the problems which emerge?

ANALISIS VISUAL PADA SAMPUL DEPAN MAJALAH DESAIN GRAFIS “CONCEPT” EDISI ULTAH PERDANA (Sebuah Kajian Semiotika)

DeKaVe ◽  
2013 ◽  
Vol 1 (2) ◽  
Author(s):  
Prayanto WH
Keyword(s):  
Graphic Design ◽  
Roland Barthes ◽  
Specific Design ◽  
Design Work ◽  
Design Elements ◽  
Semiotic Approach ◽  
Short Time ◽  
Content Information ◽  
Magazine Cover

Magazine is one of the forms of mass media that has fungsikomunikasi to convey information to mass audiences. The cover is an important element because it is through cover / cover one can guess the contents of the magazine, as well as further interested to know further information contained therein. On a magazine cover consists of drawings and writings are arranged in such a way that looks interesting and has meaning Press publications, especially magazines, today's not enough just to rely on the quality of news or manuscript, although verbal aspect is very important. It must be recognized that the visual aspects (design) as the cover / envelope has crucial role to capture the prospective reader. For the cover of a magazine is a window that shows the content information, can be either a text or photographs, illustrations, and design elements. The function of a magazine cover is to attract, dazzle prospective readers, by way influence the thoughts flow in a short time. So it's no wonder much current the magazine publisher who made the cover of such a way as to attract the attention of prospective readers. Thus the task of designers to magazine cover to create designs that attract the attention of the reader becomes increasingly severe. This study tries to analyze a visual on the front cover Magazine Graphic Design 'Concept' birthday inaugural edition by using the Roland Barthes' semiotic approach. As Roland Barthes (1984), any simple "design work (magazine cover)" continue to play in management of the sign. So that will generate a message (image) specific. Design cover, usually contains the elements of the sign in the form of objects, context of the environment, people or other beings who provide meaning to objects, and text (of writing) that reinforce the meaning.Keyword: cover, magazine Concept, semiotics

Arrangement of Archives of Cloud Computing Based and Utilization of Microsoft Access

2018 ◽  
Vol 1 ◽  
pp. 198
Author(s):  
Lusy Tunik Muharlisiani ◽  
Henny Sukrisno ◽  
Emmy Wahyuningtyas ◽  
Shofiya Syidada ◽  
Dina Chamidah
Keyword(s):  
Cloud Computing ◽  
Public Service ◽  
Human Life ◽  
Electronic System ◽  
Main Function ◽  
Scientific Publications ◽  
Data Manipulation ◽  
Administrative Management ◽  
Microsoft Access

Service at the “Kelurahan” is a very important part in determining the success of development, especially in public service. The problem faced is the lack of skill level of the “Kelurahan” apparatus with the more dynamic demands of the community and the archive management system is still conventional and manual that is writing the identity of the archive into the book agenda, expedition, control card, and borrowed archive card, so it takes a more practical electronic system, effective and efficient so required to develop themselves in order to improve public services. Conventional administration and archive management must be transformed into cloud-based computing (digital), for which archiving managers should always be responsive and follow these developments and wherever possible in order to utilize for archival activities, with greater access expected archives are evidence at once able to talk about historical facts and events and be able to give meaning and benefit to human life, so archives that were only visible and readable at archival centers can now be accessed online, and even their services have led to automated service systems. Using Microsoft Access which its main function is to handle the process of data manipulation and manufacture of a system, this system is built so that the bias runs on Cloud which means Cloud itself is a paradigm in which information is permanently stored on servers on the internet and stored. The purpose of this program is the implementation of administrative management that has been based cloud computing (digital) and is expected to be a solution in managing the archive so that if it has been designed and programmed, it can be stored in the computer and benefi- cial to the “Kelurahan” apparatus and add in the field of management archives in the form of improving the quality of service to the community, can facilitate and scientific publications.

Effect of short-term use of oral contraceptive pills on intraocular pressure

2020 ◽  
Vol 35 (3) ◽  
Author(s):  
Tayyaba Gul Malik ◽  
Hina Nadeem ◽  
Eiman Ayesha ◽  
Rabail Alam
Keyword(s):  
Oral Contraceptive ◽  
Childbearing Age ◽  
Short Term ◽  
Oral Contraceptive Pills ◽  
Contraceptive Pills ◽  
Time Period ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
Short Time

Objective: To study the effect of short-term use of oral contraceptive pills on intra-ocular pressures of women of childbearing age.   Methods: It was a comparative observational study, conducted at Arif memorial teaching hospital and Allied hospital Faisalabad for a period of six months. Hundred female subjects were divided into two groups of 50 each. Group A, included females, who had been taking oral contraceptive pills (OCP) for more than 6 months and less than 36 months. Group B, included 50 age-matched controls, who had never used OCP. Ophthalmic and systemic history was taken. Careful Slit lamp examination was performed and intraocular pressures (IOP) were measured using Goldman Applanation tonometer. Fundus examination was done to rule out any posterior segment disease. After collection of data, we analyzed and compared the intra ocular pressures between the two groups by using ANOVA in SPSS version 21.   Results: Average duration of using OCP was 14.9 months. There was no significant difference of Cup to Disc ratios between the two groups (p= 0.109). However, significant difference was noted between the IOP of OCP group and controls. (p=0.000). Conclusion: OCP significantly increase IOP even when used for short time period.

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