Reviewing systemic treatment regimens to reduce unintentional errors.

2017 ◽  
Vol 35 (8_suppl) ◽  
pp. 51-51
Author(s):  
Andrea Crespo ◽  
Erin Redwood ◽  
Kathy Vu ◽  
Vishal Kukreti
Keyword(s):  
Human Error ◽  
Systemic Treatment ◽  
Patient Harm ◽  
High Quality ◽  
Hub And Spoke ◽  
Treatment Delivery ◽  
Treatment Regimens ◽  
Maintenance Process ◽  
Computerized Prescriber Order Entry

51 Background: Use of systemic treatment computerized prescriber order entry (ST CPOE) and pre-printed orders (PPO) are proven error reduction measures. Such systems are not failsafe, as regimen development depends on cognitive input at critical points and is susceptible to human error. No known guidance currently exists in oncology to ensure regimens are of high quality and built as intended. The purpose of this initiative was to improve the quality of oncology regimens in Ontario. Methods: A review of 35 centres, representing 75 treatment centres in a hub-and-spoke model, was conducted for all active regimens (PPO and CPOE) to ensure they were built as intended, with respect to drugs and doses. Centres completed an exploratory survey to report any unintentional discrepancies and existing maintenance review processes. The survey collected centre demographics and contained descriptive questions to document details of the regimen review and maintenance processes. Results: The review yielded an 86% response rate (12 regional and 18 community cancer centres). Upwards of 700 regimens were reviewed by a multidisciplinary team at each participating centre. Unintentional discrepancies were reported by 7 of the 30 (23%) centres (range of 2 – 141 per centre); types and examples are presented in the Table. Only 2 of 30 centres (7%) had an established regimen maintenance process. Conclusions: The review identified unintentional discrepancies and, due to the potential for patient harm, corrective action has been taken. There is a need for guidance and adoption of a standardized approach in order to sustain a high-quality regimen build and review process across the province. Consensus-based recommendations for ST CPOE and PPO regimen development and maintenance have been developed. Identified discrepancies have been amended and maintenance review processes are now implemented to improve the quality and safety of systemic treatment delivery. [Table: see text]

scholarly journals Improving the Safety and Quality of Systemic Treatment Regimens in Computerized Prescriber Order Entry Systems

2018 ◽  
Vol 14 (6) ◽  
pp. e393-e402 ◽  
Author(s):  
Andrea Crespo ◽  
Erin Redwood ◽  
Kathy Vu ◽  
Vishal Kukreti
Keyword(s):  
Best Practice ◽  
Systemic Treatment ◽  
Order Entry ◽  
Standard Regimen ◽  
Treatment Delivery ◽  
Treatment Regimens ◽  
Expert Working Group ◽  
Treatment Facilities ◽  
Computerized Prescriber Order Entry

Purpose: Systemic treatment (ST) computerized prescriber order entry (CPOE) and preprinted orders (PPO) are proven to reduce errors. There is no known guidance in oncology to facilitate high-quality, accurate regimen development and review; hence, this was identified as a system-wide gap. This provincial initiative aimed to improve the quality of oncology regimens through a comprehensive review of systemic treatment (ST) regimens and the development of standards. Methods: A system-wide analysis of all active regimens (both CPOE and PPO) to ensure they were built as intended was conducted in 2015. Thirty-five hospitals (on behalf of 75 treatment facilities) were asked to report any unintentional discrepancies and details of the maintenance review process. Discrepancies were compiled, categorized, and analyzed for potential to cause harm. In addition, a multidisciplinary expert working group was formed to create best practice recommendations. Results: The review yielded a 94% response rate and took a total of 18 months to complete (70% completed within 9 months). The average number of regimens reviewed was 336 (range, 15 to 700; n = 9). Unintentional discrepancies were reported by nine hospitals (27%). A total of 369 discrepancies were reported (average, 55 per hospital), and 28 were deemed to have a moderate potential for harm. Only two hospitals (6%) had an established maintenance process; now, all have standard processes for review. Consensus-based recommendations for ST-CPOE and PPO regimen development and maintenance were developed. Conclusion: The review identified unintentional discrepancies and, because of the potential for patient harm, corrective action has been taken. Identified discrepancies have been amended, and standard regimen development and maintenance review processes are now implemented system-wide to improve the quality and safety of systemic treatment delivery.

Establishing best practice recommendations for systemic treatment regimen development and maintenance.

2017 ◽  
Vol 35 (8_suppl) ◽  
pp. 40-40
Author(s):  
Andrea Crespo ◽  
Erin Redwood ◽  
Kathy Vu ◽  
Vishal Kukreti
Keyword(s):  
Best Practices ◽  
Best Practice ◽  
Systemic Treatment ◽  
Careful Analysis ◽  
Patient Harm ◽  
Stakeholder Groups ◽  
Practice Recommendations ◽  
Multidisciplinary Group ◽  
Quality Process ◽  
Computerized Prescriber Order Entry

40 Background: A province-wide review of oncology regimens identified discrepancies in a number of regimens in systemic treatment computerized prescriber order entry (ST CPOE) systems. The potential patient harm from such discrepancies includes unnecessary toxicities and reduced treatment efficacy. The regimen review highlighted the need for a high-quality process to improve the safety of systemic treatment prescribing in Ontario. The objective of this work was to develop recommendations on best practices for the development and maintenance of oncology regimens. Methods: An expert multidisciplinary group of oncology clinicians and administrators was formed to review available literature and leverage their expertise to establish oncology-specific recommendations. These were then circulated to broader stakeholder groups for feedback and consensus. Results: Practical, consensus-based best practice recommendations for ST CPOE and pre-printed order regimen development and maintenance were created. Detailed processes for new regimen development are outlined in the table below. Moreover, broad areas of roles and responsibility, frequency of review, and sign-off were highlighted. This was repeated for regimen changes (not shown). Conclusions: There is a lack of guidance in the literature on best practices for oncology regimen development and maintenance. Careful analysis and application of the expertise of oncology professionals resulted in consensus-based best practice recommendations that will enable the advancement of safe, standardized, systemic treatment prescribing.[Table: see text]

Influence of technology parameters of free-cutting steel continuous casting on the billet internal structure

2020 ◽  
Vol 76 (2) ◽  
pp. 139-142
Author(s):  
A. T. Kunakbaeva ◽  
A. M. Stolyarov ◽  
M. V. Potapova
Keyword(s):  
Regression Analysis ◽  
Continuous Casting ◽  
Internal Structure ◽  
Sulfur Content ◽  
Manganese Content ◽  
High Quality ◽  
Correlation And Regression Analysis ◽  
Cutting Steel ◽  
Continuously Cast

Free-cutting steel gains specific working properties thanks to the high content of sulfur and phosphorus. These elements, especially sulfur, have a rather high tendency to segregation. Therefore, segregation defects in free-cutting steel continuously cast billets can be significantly developed. The aim of the work was to study the influence of the chemical composition of freecutting steel and casting technological parameters on the quality of the macrostructure of continuously cast billets. A metallographic assessment of the internal structure of cast metal made of free-cutting steel and data processing by application of correlation and regression analysis were the research methods. The array of production data of 43 heats of free-cutting steel of grade A12 was studied. Steel casting on a five-strand radial type continuous casting machine was carried out by various methods of metal pouring from tundish into the molds. Metal of 19 heats was poured with an open stream, and 24 heats – by a closed stream through submerged nozzles with a vertical hole. High-quality billets had a cross-sectional size of 150×150 mm. The macrostructure of high-quality square billets made of free-cutting steel of A12 grade is characterized by the presence of central porosity, axial segregation and peripheral point contamination, the degree of development of which was in the range from 1.5 to 2.0 points, segregation cracks and strips – about 1.0 points. In the course of casting with an open stream, almost all of these defects are more developed comparing with the casting by a closed stream. As a result of correlation and regression analysis, linear dependences of the development degree of segregation cracks and strips both axial and angular on the sulfur content in steel and on the ratio of manganese content to sulfur content were established. The degree of these defects development increases with growing of sulfur content in steel of A12 grade. These defects had especially strong development when sulfur content in steel was of more than 0.10%. To improve the quality of cast metal, it is necessary to have the ratio of the manganese content to the sulfur content in the metal more than eight.

Experience of clinical testing of personal telemedicine system ‘Obereg’ for remote monitoring of patients in intensive care units

2020 ◽  
pp. 52-58 ◽  
Author(s):  
A. A. Eryomenko ◽  
N. V. Rostunova ◽  
S. A. Budagyan ◽  
V. V. Stets
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Remote Monitoring ◽  
Clinical Testing ◽  
Transportation Of Patients ◽  
High Quality ◽  
Telemedicine System ◽  
Accuracy Of Measurements ◽  
Hospital Equipment

The experience of clinical testing of the personal telemedicine system ‘Obereg’ for remote monitoring of patients at the intensive care units of leading Russian clinics is described. The high quality of communication with the remote receiving devices of doctors, the accuracy of measurements, resistance to interference from various hospital equipment and the absence of its own impact on such equipment were confirmed. There are significant advantages compared to stationary patient monitors, in particular, for intra and out-of-hospital transportation of patients.

METHODOLOGICAL ASPECTS OF VISUALIZATION OF CORONARY ARTERIES WITH TRANSTHORACIC ECHOCARDIOGRAPHY

2018 ◽  
pp. 26-35
Author(s):  
Z. A. Agaeva ◽  
K. B. Baghdasaryan
Keyword(s):  
Blood Flow ◽  
Coronary Blood Flow ◽  
Coronary Arteries ◽  
Transthoracic Echocardiography ◽  
Second Harmonic ◽  
Anatomic Reconstruction ◽  
High Quality ◽  
Acoustic Window ◽  
Methodological Aspects

The transthoracic echocardiography made by multifrequency probes with support of the mode of the second harmonic imaging, is a competitive method for visualization of the main coronary arteries and allows to estimate coronary blood flow with high quality. Of course, the method has considerable restrictions, most important of which is the low spatial resolution of a method, due to small acoustic window. Because of this the transthoracic visualization of coronary arteries perhaps will not become the leading method of anatomic reconstruction of separately taken coronary artery and especially all coronary arteries system. However uniqueness and indisputable advantage of this method is an opportunity to noninvasively estimate a coronary blood flow both once, and in dynamics.

Estimates on poverty in Russia and the additional measures to reduce it at the regional level

2020 ◽  
Vol 18 (4) ◽  
pp. 739-752 ◽  
Author(s):  
R.M. Sadykov
Keyword(s):  
Poverty Rate ◽  
Regional Level ◽  
Living Standards ◽  
Standard Of Living ◽  
High Quality ◽  
Social Standard ◽  
Republic Of Bashkortostan ◽  
The Republic ◽  
Sociological Studies

Subject. This article deals with the issues of social justice and a high quality of life, creating favorable economic and social conditions. Objectives. The article aims to assess the rate and changes in poverty in Russia and the Republic of Bashkortostan and develop complementary measures to reduce it. Methods. For the study, I used the methods of logical, comparative, economic and statistical analyses, the results of sociological studies, and official statistics. Results. The article highlights additional measures to reduce poverty in the region, including the establishment of a minimum social standard of living in each particular region that determines the poverty rate. Conclusions. Various factors, such as economic sanctions, economic slowdowns, territorial and regional imbalances, lead to living standards decline and poverty rise.

SCIENTIFIC BASIS OF POSTGRADUATE TRAINING FOR OFFICER WORKING ETHNIC AFFAIRS USING STATE BUDGET IN THE PERIOD OF 2018 – 2025

2017 ◽  
Author(s):  
La Duc Minh ◽  
Nguyen Thi Hao ◽  
Vu Thi Thuy
Keyword(s):  
Economic Development ◽  
Ethnic Groups ◽  
Human Resource ◽  
Postgraduate Training ◽  
Scientific Basis ◽  
National Defense ◽  
High Quality ◽  
State Budget ◽  
International Integration

Ethnic affairs play an important role in socio of ethnic groups’ solidarity, assurance of security and national defense stability. In -economic development, maintenanceorder to improve the quality of ethnic affairs, it is practical to carry out postgraduate training of officer implementing ethnic affairs using state budget with the aim of encouraging and enhancing officer quality to satisfy high-quality human resource in international integration.

Удобрение перца сладкого

2018 ◽  
Author(s):  
V.A. Borisov ◽  
A.M. Menshikh ◽  
V.S. Sosnov ◽  
G.F. Monakhos
Keyword(s):  
Drip Irrigation ◽  
Sweet Pepper ◽  
Water Soluble ◽  
Mineral Fertilizers ◽  
High Quality ◽  
Organic Mineral ◽  
Soluble Fertilizer

Показано действие минеральных удобрений, микрокристаллического комплексного водорастворимого удобрения «Мастер» и органоминерального наноудобрения с ростостимулирующей активностью «Арксойл» при капельном орошении на урожайность и качество сладкого перца нового гибрида F1 Темп. Сочетание основного удобрения с листовой и корневой подкормками позволяет получить до 65 т/га плодов перца высокого качества.The action of mineral fertilizers, microcrystalline complex water soluble fertilizer Master and organic mineral nano-fertilizer with growth-stimulating activity Arksoil under drip irrigation on the productivity and quality of sweet pepper of the new hybrid F1 Temp is shown. The combination of basic fertilizer with leaf and root fertilizing allows to obtain up to 65 t/ha of pepper fruits of high quality.

Child Diagnosis of Autism - How It Can Change the Family Life

2017 ◽  
Vol 5 (1) ◽  
pp. 498
Author(s):  
Maria Stănescu
Keyword(s):  
Early Intervention ◽  
Family Life ◽  
Social Life ◽  
Decisive Role ◽  
Autistic Children ◽  
Child Behaviors ◽  
High Quality ◽  
Child Diagnosis ◽  
The Family

The article is about the role of the family in the education and formation of children and, especially, in the life and development of autistic children. It describes the problems their family is facing and the need for counseling to parents with autistic children. The reaction to finding the diagnosis of autism varies from one family to another and may encounter a large variety: from disbelief, anger, guilt, helplessness, devastation, surprise, or even rejection of the child, to understanding and relief when finally the parents have an explanation for their child behaviors. Early intervention is important in psychological sustaining of the parent, as parent involvement in the recovery of the child with autism has a determinant role in his development and in ensuring a high quality of life of the child and the life of the hole family. The response to a child's autism diagnosis varies from one family to another. The family goes through a variety of disbelief, anger, guilt, helplessness, devastation, surprise, or even rejection of the child, to understanding and relief. Early intervention is very important in the psychological support of the parent. Because any change disturbs the family equilibrium. A diagnosis of autism changes not only the life of the diagnosed child, but also the life of family members. All the resources are focused on the need of the child. Although each parent is different, after diagnosing the child with autism, all parents are overwhelmed by confusion, shock and denial. Parents' feelings can be influenced by how their children's situation affects different aspects of life - it has an impact on service, on social life and all their personal life. If we look at the family as a system and when a disturbing factor appears, all parts of the system are affected. The involvement of parents in the recovery of the child with autism has a decisive role in its development and in ensuring a high quality of child's life and family life.

REORGANIZATION OF A MULTI-SPECIALTY HOSPITAL IN AN UNFAVORABLE EPIDEMIOLOGICAL SITUATION

2020 ◽  
pp. 43-46
Author(s):  
Nikitin A.E. ◽  
Znamenskiy I.А ◽  
Shikhova Yu.A. ◽  
Kuzmina I.V. ◽  
Melchenko D.S. ◽  
...  
Keyword(s):  
Contact Time ◽  
Laboratory Diagnostics ◽  
Protective Equipment ◽  
Timely Manner ◽  
High Quality ◽  
Institu Tions ◽  
Quality Of Medical Care ◽  
Spread Of Infection ◽  
Epidemiological Situation

This study provides a retrospective analysis of work to ensure high quality of medical care in an unfavorable epidemic situation. The consequence of COVID-19 was the implementation of a program to prevent the spread of infection, the re-profiling of medical institu-tions, and the introduction of restrictive and anti-epidemic measures. The experience of our work has shown the effectiveness of changing the order of med-ical care, the organization of the functioning of de-partments and patient routing. The study reflects the measures implemented in the hospital departments, the Department of clinical and laboratory diagnostics, radiation diagnostics and pathology Department. To ensure the safety of patients, it was decided to place patients on a single bed according to the type of infec-tious boxes. The safety of employees was ensured by the use of personal protective equipment, minimiza-tion of contact time with patients, and preventive weekly examination of staff for SARS-CoV-2 infection. The organized and well-coordinated work of the en-tire staff of the institution made it possible to prevent the spread of COVID-19 among employees, to detect cases of infection in a timely manner, and to carry out appropriate isolation and monitoring measures. At the time of completion of infectious diseases departments, the mortality rate among patients was less than 9%. Our experience in reorganizing a multi-specialty facil-ity can be used in the future when working with pa-tients who have undergone COVID-19, as well as in the context of a worsening epidemic situation.

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