Challenges in Measuring the Impact of Interruption on Patient Safety and Workflow Outcomes

2011 ◽  
Vol 50 (05) ◽  
pp. 447-453 ◽  
Author(s):  
S. Y. W. Li ◽  
A. G. Dunn ◽  
E. Coeira ◽  
F. Magrabi
Keyword(s):  
Patient Safety ◽  
Observational Studies ◽  
Computational Models ◽  
Experimental Studies ◽  
Primary Task ◽  
Electronic Prescribing ◽  
Time On Task ◽  
Specific Effects ◽  
Multiple Variables ◽  
The Impact

SummaryObjective: To examine the problem of studying interruption in healthcare.Methods: Review of the interruption literature from psychology, human-computer interaction; experimental studies of electronic prescribing and error behaviour; observational studies in emergency and intensive care.Results: Primary task and interruption variables which contribute to the outcomes of an interruption include the type of task (primary and interrupting task); point of interruption; duration of interruption; similarity of interruptive task to primary task; modality of interruption; environmental cues; and interruption handling strategy. Effects of interruption on task performance can be examined by measuring errors, the time on task, interruption lag and resumption lag.Conclusions: Interruptions are a complex phenomenon where multiple variables including the characteristics of primary tasks, the interruptions themselves, and the environment may influence patient safety and work-flow outcomes. Observational studies present significant challenges for recording many of the process variables that influence the effects of interruptions. Controlled experiments provide an opportunity to examine the specific effects of variables on errors and efficiency. Computational models can be used to identify the situations in which interruptions to clinical tasks could be disruptive and to investigate the aggregate effects of interruptions.

scholarly journals A Systematic Review of Research Investigating the Combined Ecological Impact of Anthropogenic Noise and Artificial Light at Night

2021 ◽  
Vol 9 ◽  
Author(s):  
Wouter Halfwerk ◽  
Paul Jerem
Keyword(s):  
Systematic Review ◽  
Observational Studies ◽  
Ecological Impact ◽  
Experimental Studies ◽  
Ecological Impacts ◽  
Anthropogenic Noise ◽  
Light Pollution ◽  
Artificial Light ◽  
Light At Night ◽  
The Impact

Levels of anthropogenic noise and artificial light at night (ALAN) are rapidly rising on a global scale. Both sensory pollutants are well known to affect animal behavior and physiology, which can lead to substantial ecological impacts. Most studies on noise or light pollution to date have focused on single stressor impacts, studying both pollutants in isolation despite their high spatial and temporal co-occurrence. However, few studies have addressed their combined impact, known as multisensory pollution, with the specific aim to assess whether the interaction between noise and light pollution leads to predictable, additive effects, or less predictable, synergistic or antagonistic effects. We carried out a systematic review of research investigating multisensory pollution and found 28 studies that simultaneously assessed the impact of anthropogenic noise and ALAN on animal function (e.g., behavior, morphology or life-history), physiology (e.g., stress, oxidative, or immune status), or population demography (e.g., abundance or species richness). Only fifteen of these studies specifically tested for possible interactive effects when both sensory pollutants were combined. Four out of eight experimental studies revealed a significant interaction effect, in contrast to only three out seven observational studies. We discuss the benefits and limitations of experimental vs. observational studies addressing multisensory pollution and call for more specific testing of the diverse ways in which noise and light pollution can interact to affect wildlife.

ENGINEERING METHOD FOR CALCULATING SHOCK NOISE ISOLATIONBETWEEN FLOORS WITH FLOORS MADE OF WOOD MATERIALS

2020 ◽  
Vol 90 (4) ◽  
pp. 3-11
Author(s):  
V.A. GORIN ◽  
◽  
V.V. KLIMENKO ◽  
M.A. POROZHENKO ◽  
◽  
...  
Keyword(s):  
Noise Level ◽  
Computational Models ◽  
Experimental Studies ◽  
Engineering Method ◽  
Sound Insulation ◽  
Good Correspondence ◽  
Method Of Calculation ◽  
Impact Noise ◽  
The Impact ◽  
Approximate Formulas

An engineering method for calculating shock noise isolation by floor-to-floor overlappings with wood-based materials is proposed. The calculation considers overlaps with floors made of wood materials laid on glue and with floors laid on an elastic substrate. The calculation takes into account the effect on sound insulation of the surface density and stiffness of the floor covering material and the sound insulation layer. The calculation is reduced to calculating the frequency characteristic of reducing the impact noise level due to the construction of a floor made of wood materials and comparing the calculated value of the index of the reduced impact noise level with the standard ones. The list of necessary input data and the sequence of calculation execution is given. Approximate formulas for calculating the frequencies that limit the application of computational models of the overlaps under consideration are compiled. Equations and approximate formulas are given for determining the critical (antiresonance) and resonant frequencies of vibrations, one -, two-and three-layer overlaps, and their values are determined for various mechanical and geometric parameters of layers. Frequency ranges of growth and decrease of shock noise level by these overlaps are determined. Comparison of the calculated and measured frequency characteristics of shock noise reduction showed a good correspondence of the results obtained by the engineering method of calculation with experimental studies. The developed practical recommendations for improving the isolation of shock noise between floors with floors made of wood materials, used in the construction of civil buildings, can increase acoustic comfort in buildings under construction and under reconstruction.

scholarly journals Sensitivity analysis for an unmeasured confounder: a review of two independent methods

2010 ◽  
Vol 13 (2) ◽  
pp. 188-198 ◽  
Author(s):  
Ronir Raggio Luiz ◽  
Maria Deolinda Borges Cabral
Keyword(s):  
Sensitivity Analysis ◽  
Causal Inference ◽  
Observational Studies ◽  
Experimental Studies ◽  
Epidemiological Studies ◽  
Strong Constraint ◽  
Unmeasured Confounder ◽  
Direct Sensitivity ◽  
Hidden Biases ◽  
The Impact

One of the main purposes of epidemiological studies is to estimate causal effects. Causal inference should be addressed by observational and experimental studies. A strong constraint for the interpretation of observational studies is the possible presence of unobserved confounders (hidden biases). An approach for assessing the possible effects of unobserved confounders may be drawn up through the use of a sensitivity analysis that determines how strong the effects of an unmeasured confounder should be to explain an apparent association, and which should be the characteristics of this confounder to exhibit such an effect. The purpose of this paper is to review and integrate two independent sensitivity analysis methods. The two methods are presented to assess the impact of an unmeasured confounder variable: one developed by Greenland under an epidemiological perspective, and the other developed from a statistical standpoint by Rosenbaum. By combining (or merging) epidemiological and statistical issues, this integration became a more complete and direct sensitivity analysis, encouraging its required diffusion and additional applications. As observational studies are more subject to biases and confounding than experimental settings, the consideration of epidemiological and statistical aspects in sensitivity analysis strengthens the causal inference.

The Impact of Visual Stereotypes on Judgments about Rape

2016 ◽  
Vol 75 (3) ◽  
pp. 133-140
Author(s):  
Robert Busching ◽  
Johannes Lutz
Keyword(s):  
Mental Representations ◽  
Irrelevant Information ◽  
Clear Distinction ◽  
Rape Myth ◽  
Facial Features ◽  
Reverse Correlation ◽  
Correlation Technique ◽  
Specific Effects ◽  
Legal Judgments ◽  
The Impact

Abstract. Legally irrelevant information like facial features is used to form judgments about rape cases. Using a reverse-correlation technique, it is possible to visualize criminal stereotypes and test whether these representations influence judgments. In the first step, images of the stereotypical faces of a rapist, a thief, and a lifesaver were generated. These images showed a clear distinction between the lifesaver and the two criminal representations, but the criminal representations were rather similar. In the next step, the images were presented together with rape scenarios, and participants (N = 153) indicated the defendant’s level of liability. Participants with high rape myth acceptance scores attributed a lower level of liability to a defendant who resembled a stereotypical lifesaver. However, no specific effects of the image of the stereotypical rapist compared to the stereotypical thief were found. We discuss the findings with respect to the influence of visual stereotypes on legal judgments and the nature of these mental representations.

Воздействиеультразвуковогополянадинамическуювязкостьводы

2019 ◽  
pp. 27-29
Author(s):  
P. Vikulin ◽  
K. Khlopov ◽  
M. Cherkashin
Keyword(s):  
Dynamic Viscosity ◽  
Experimental Studies ◽  
Ultrasonic Field ◽  
Maximum Effect ◽  
Ultrasonic Frequency ◽  
Ultrasonic Vibrations ◽  
Wastewater Disposal ◽  
Laboratory Setup ◽  
Sonic Treatment ◽  
The Impact

Enhancing water purification processes is provided by various methods including physical ones, in particular, exposure to ultrasonic vibrations. The change in the dynamic viscosity of water affects the rate of deposition of particles in the aquatic environment which can be used in natural and wastewater treatment. At the Department Water Supply and Wastewater Disposal of the National Research Moscow State University of Civil Engineering experimental studies were conducted under laboratory conditions to study the effect of ultrasound on the change in the dynamic viscosity of water. A laboratory setup has been designed consisting of an ultrasonic frequency generator of the relative intensity, a transducer (concentrator) that transmits ultrasonic vibrations to the source water, and sonic treatment tanks. Experimental studies on the impact of the ultrasonic field in the cavitation mode on the dynamic viscosity of the aqueous medium were carried out the exposure time was obtained to achieve the maximum effect.Интенсификация процессов очистки воды осуществляется с помощью различных методов, в том числе и физических, в частности воздействием ультразвуковых колебаний. Изменение динамической вязкости воды влияет на скорость осаждения частиц в водной среде, что может быть использовано в процессах очистки природных и сточных вод. На кафедре Водоснабжение и водоотведение Национального исследовательского Московского государственного строительного университета в лабораторных условиях проведены экспериментальные исследования по изучению влияния ультразвука на изменение динамической вязкости воды. Разработана схема лабораторной установки, состоящая из генератора ультразвуковых частот с соответствующей интенсивностью, преобразователя (концентратора), передающего ультразвуковые колебания в исходную воду, и емкости для озвучивания. Выполнены экспериментальные исследования по влиянию ультразвукового поля в режиме кавитации на динамическую вязкость водной среды, получено время экспозиции для достижения максимального эффекта.

Family Influences on Youth Offending

2018 ◽  
pp. 377-403
Author(s):  
Abigail A. Fagan ◽  
Kristen M. Benedini
Keyword(s):  
Life Course ◽  
Family Environment ◽  
Parenting Practices ◽  
Experimental Studies ◽  
The United States ◽  
Parental Violence ◽  
Youth Delinquency ◽  
The Impact ◽  
Children’S Exposure

This chapter reviews the degree to which empirical evidence demonstrates that families influence youth delinquency. Because they are most likely to be emphasized in life-course theories, this chapter focuses on parenting practices such as parental warmth and involvement, supervision and discipline of children, and child maltreatment. It also summarizes literature examining the role of children's exposure to parental violence, family criminality, and young (teenage) parents in affecting delinquency. Because life-course theories are ideally tested using longitudinal data, which allow examination of, in this case, the impact of parenting practices on children's subsequent behaviors, this chapter focuses on evidence generated from prospective studies conducted in the United States and other countries. It also discusses findings from experimental studies designed to reduce youth substance use and delinquency by improving the family environment.

scholarly journals Understanding sex differences in long-term blood pressure regulation: insights from experimental studies and computational modeling

2019 ◽  
Vol 316 (5) ◽  
pp. H1113-H1123 ◽  
Author(s):  
Sameed Ahmed ◽  
Rui Hu ◽  
Jessica Leete ◽  
Anita T. Layton
Keyword(s):  
Blood Pressure ◽  
Sex Differences ◽  
Computational Models ◽  
Experimental Studies ◽  
Pressure Control ◽  
Blood Pressure Regulation ◽  
Pressure Regulation ◽  
Physiological Processes ◽  
Key Players

Sex differences in blood pressure and the prevalence of hypertension are found in humans and animal models. Moreover, there has been a recent explosion of data concerning sex differences in nitric oxide, the renin-angiotensin-aldosterone system, inflammation, and kidney function. These data have the potential to reveal the mechanisms underlying male-female differences in blood pressure control. To elucidate the interactions among the multitude of physiological processes involved, one may apply computational models. In this review, we describe published computational models that represent key players in blood pressure regulation, and highlight sex-specific models and their findings.

scholarly journals P044 Can an electronic prescribing system ensure clear anticoagulation discharge communication?

2019 ◽  
Vol 104 (7) ◽  
pp. e2.49-e2
Author(s):  
Susie Gage
Keyword(s):  
Patient Safety ◽  
Discharge Summary ◽  
Electronic Prescribing ◽  
List Type ◽  
Heparin Infusion ◽  
National Patient Safety Agency ◽  
High Dependency ◽  
National Patient ◽  
Discharge Summaries

AimThe National Patient Safety Agency (NPSA)1 identified heparin as a major cause of adverse events associated with adverse incidents, including some fatalities. By ensuring good communication, this should be associated with risk reduction.1 The aim of this study was to ensure there is clear anticoagulation communication on discharge, from the paediatric intensive care unit (PICU) electronic prescribing system (Philips), to the paediatric cardiac high dependency unit and paediatric cardiac ward. To investigate whether the heparin regimen complies with the hospital’s anticoagulant guidelines and if there is any deviation; that this is clearly documented. To find out if there is an indication documented for the heparin regimen chosen and if there is a clear long term plan documented for the patient, after heparin cessation.MethodsA report was generated for all patients who were prescribed a heparin infusion on PICU, between 1st January 2018 and 30th June 2018, from the Philips system. All discharge summaries from the PICU Philips system were reviewed. Only paediatric cardiac patients were included that had a heparin infusion prescribed on discharge, all other discharge summaries were excluded from the study. Each discharge summary was reviewed in the anticoagulant section; for the heparin regimen chosen, whether it complies with the hospital’s anticoagulant guidelines and if there was any deviation whether this was documented. The indication documented of which heparin regimen was chosen and whether a clear long term plan was documented after heparin cessation; for example if the patient is to be transferred onto aspirin, clopidogrel, warfarin or enoxaparin.Results82 discharge summaries were reviewed over the 6 month period between 1st January 2018 and 30th June 2018; 16 were excluded as were not paediatric cardiac, leaving 66 paediatric cardiac discharge summaries that were reviewed. 45 out of 66 (68%) complied with the hospital’s heparin anticoagulation guidelines. Of the 32% that deviated from the protocol; only 33% (7 out of 21) had a reason documented. Only 50% (33) of the summaries reviewed had an indication for anticoagulation noted on the discharge summary and 91% of discharge summaries had a long term anticoagulant plan documented.ConclusionThe electronic prescribing system can help to ensure a clear anticoagulation communication as shown by 91% of the anticoagulation long term plan being clearly documented; making it a more seamless patient transfer. On the Philips PICU electronic prescribing system there is an anticoagulant section on the discharge summary that has 3 boxes that need to be completed; heparin regimen, indication and anticoagulation long term plan. However, despite these boxes; deviations from the anticoagulant protocol were poorly documented as highlighted by only 33% having the reason highlighted in the discharge summary, only 50% of the indications were documented. Despite having prompts for this information on the discharge summary, the medical staffs needs to be aware to complete this information, in order to reduce potential medication errors and risk.ReferenceThe National Patient Safety Agency (NPSA). Actions that make anticoagulant therapy safer. NPSA; March 2007.

The impact of craniotomy for brain tumor case volume on patient safety indicators and in-hospital mortality

2020 ◽  
Vol 196 ◽  
pp. 106043
Author(s):  
Paul R. Clark ◽  
Robert J. Dambrino ◽  
Sean M. Himel ◽  
Zachary S. Smalley ◽  
Wondwosen K. Yimer ◽  
...  
Keyword(s):  
Patient Safety ◽  
Brain Tumor ◽  
Hospital Mortality ◽  
Case Volume ◽  
Patient Safety Indicators ◽  
The Impact

scholarly journals Evaluation of the impact of compliance of precast discs of overlapping on the work of the frame of a multi-storey building

2019 ◽  
Vol 97 ◽  
pp. 04022
Author(s):  
Nikolay Trekin ◽  
Emil Kodysh ◽  
Alexander Bybka ◽  
Alexander Yamalov ◽  
Nikita Konkov
Keyword(s):  
Economic Performance ◽  
Computational Models ◽  
Precast Concrete ◽  
Building Frames ◽  
Frame Building ◽  
Numerical Studies ◽  
Frame Buildings ◽  
The Impact ◽  
Structural Solutions ◽  
Storey Building

The article provides an analysis and justification of the need to take into account the compliance of discs of overlapping and coatings when calculating frames from precast concrete structures. Previously conducted full-scale experiments showed that the rigidity of the precast overlapping with full filling of the seams, in comparison with the monolithic overlapping, decreases by 3-15 times due to the ductility of the joints. The use of refined computational models of structural solutions for frames, which take into account the compliance of the conjugations of elements, makes it possible to trace possible redistribution of efforts. Such an approach when reconstructing, it is possible to optimally select and calculate the enforcement of structure, and on new designing, to increase reliability and / or improve the economic performance of frame buildings. According to the results of analytical studies, formulas were adopted for the parameters that allow one to take into account the overall compliance of overlapping disks and coatings in computational models of building frames. Numerical studies on the computational model of a frame building made it possible to evaluate the effect of accounting for compliance on the stress-strain state of a multi-storey frame.

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