Development and evaluation of an electronic nursing documentation system

Background Nursing documentation is a critical aspect of the nursing care workflow. There is a varying degree in how detailed nursing reports are described in scientific literature and care practice, and no uniform structured documentation is provided. This study aimed to describe the process of designing and evaluating the content of an electronic clinical nursing documentation system (ECNDS) to provide consistent and unified reporting in this context. Methods A four-step sequential methodological approach was utilized. The Minimum Data Set (MDS) development process consisted of two phases, as follows: First, a literature review was performed to attain an exhaustive overview of the relevant elements of nursing and map the available evidence underpinning the development of the MDS. Then, the data included from the literature review were analyzed using a two-round Delphi study with content validation by an expert panel. Afterward, the ECNDS was developed according to the finalized MDS, and eventually, its performance was evaluated by involving the end-users. Results The proposed MDS was divided into administrative and clinical sections; including nursing assessment and the nursing diagnosis process. Then, a web-based system with modular and layered architecture was developed based on the derived MDS. Finally, to evaluate the developed system, a survey of 150 registered nurses (RNs) was conducted to identify the positive and negative impacts of the system. Conclusions The developed system is suitable for the documentation of patient care in nursing care plans within a legal, ethical, and professional framework. However, nurses need further training in documenting patient care according to the nursing process, and in using the standard reporting templates to increase patient safety and improve documentation.

A minimally invasive cerclage of the tibia in a modified Goetze technique: operative technique and first clinical results

Introduction In spiral fractures of the tibia, the stability of an osteosynthesis may be significantly increased by additive cerclages and, according to biomechanical studies, be brought into a state that allows immediate full weight bearing. As early as 1933, Goetze described a minimally invasive technique for classic steel cerclages. This technique was modified, so that it can be used for modern cable cerclages in a soft part saving way. Method After closed reduction, an 8 Fr redon drain is first inserted in a minimally invasive manner, strictly along the bone and placed around the tibia via 1 cm incisions on the anterolateral and dorsomedial tibial edges using a curette and a tissue protection sleeve. Via this drain, a 1.7 mm cable cerclage can be inserted. The fracture is then anatomically reduced while simultaneously tightening the cerclage. Subsequently, a nail or a minimally invasive plate osteosynthesis is executed using the standard technique. Using the hospital documentation system, data of patients that were treated with additional cerclages for tibial fractures between 01/01/2014 and 06/30/2020 were subjected to a retrospective analysis for postoperative complications (wound-healing problems, infections and neurovascular injury). Inclusion criteria were: operatively treated tibial fractures, at least one minimally invasive additive cerclage, and age of 18 years or older. Exclusion criteria were: periprosthetic or pathological fractures and the primary need of reconstructive plastic surgery. SPSS was used for statistical analysis. Results 96 tibial shaft spiral fractures were treated with a total of 113 additive cerclages. The foregoing resulted in 10 (10.4%) postoperative wound infections, 7 of which did not involve the cerclage. One lesion of the profundal peroneal nerve was detected, which largely declined after cerclage removal. In 3 cases, local irritation from the cerclage occurred and required removal of material. Conclusion In the described technique, cerclages may be inserted additively at the tibia in a minimally invasive manner and with a few complications, thus significantly increasing the stability of an osteosynthesis. How this ultimately affects fracture healing is the subject of an ongoing study.

Evaluation of Documentation System in Iraqi Construction Projects

In Iraq, the construction industry is considered one of the main sectors that contribute strongly to the Iraqi economy. Documentation is a process of collecting documents from past and current works of corporations, then archiving and classification of information to become easy and useful for reuse in the future. The aim of this study is to investigate the reality of documentation in the Iraqi construction industry and how to improve archiving and classification of documents and how documentation can be useful used in contractor and consultant corporations. This research has been conducted through literature reviews followed by a field survey. 80 questionnaires were distributed to contractors and engineering offices. 70 useful questionnaires were received from respondents with an 87% response rate. The findings indicated that the construction projects in the Diyala governorate are applying documentation. The study found that foundations classified and updating the documents as printed and written files and computer files, but foundations lack computer programs and web models for easy archiving and discovery of documents, documentation system currently used doesn't prevent Confusing, conflict in schemas because they still used Auto CAD and paper documentation. The large number and accumulation of paper documents are also considered the most often problem in the documentation system currently used, and construction projects don't have a database for all information related to projects where, it is limited to cabinets full of paper documents, which causes a waste of time and effort when searching for any document or information related to the projects. The study recommended that companies and foundations have to increase cost and effort consumed in the documentation process, improve the owner and staff abilities in computer and web applications, assign a key person for collection and archiving project documents, establishing an internet website for companies, or using cloud applications for storage of documents and sharing information.

Malva parviflora Leaves Mucilage: An Eco-Friendly and Sustainable Biopolymer with Antioxidant Properties

Malva parviflora L. is an edible and medicinal herb containing mucilaginous cells in its leaves. Mucilage obtained from M. parviflora leaves (MLM) was extracted in distilled water (1:10 w/v) at 70 °C followed by precipitation with alcohol. Preliminary phytochemical tests were performed to assess the purity of the extracted mucilage. Results showed that the yield of mucilage was 7.50%, and it was free from starch, alkaloids, glycosides, saponins, steroids, lipids and heavy metals. MLM had 16.19% carbohydrates, 13.55% proteins and 4.76% amino acids, which indicate its high nutritional value. Physicochemical investigations showed that MLM is neutral and water-soluble, having 5.84% moisture content, 15.60% ash content, 12.33 swelling index, 2.57 g/g water-holding capacity and 2.03 g/g oil-binding capacity. The functional properties, including emulsion capacity, emulsion stability, foaming capacity and stability increased with increased concentrations. Micromeritic properties, such as bulk density, tapped density, Carr’s index, Hausner ratio, and angle of repose, were found to be 0.69 g/cm3, 0.84 g/cm3, 17.86%, 1.22 and 28.5, respectively. Scanning electron microscopy (SEM) showed that MLM is an amorphous powder possessing particles of varying size and shape; meanwhile, rheological studies revealed the pseudoplastic behavior of MLM. The thermal transition process of MLM revealed by a differential scanning calorimetry (DSC) thermogram, occurring at a reasonable enthalpy change (∆H), reflects its good thermal stability. The presence of functional groups characteristic of polysaccharides was ascertained by the infrared (IR) and gas chromatography/mass spectrometry (GC/MS) analyses. GC revealed the presence of five neutral monosaccharides; namely, galactose, rhamnose, arabinose, glucose and mannose, showing 51.09, 10.24, 8.90, 1.80 and 0.90 mg/g of MLM, respectively. Meanwhile, galacturonic acid is the only detected acidic monosaccharide, forming 15.06 mg/g of MLM. It showed noticeable antioxidant activity against the DPPH (1,1-diphenyl-2-picrylhydrazyl) radical with an IC50 value of 154.27 µg/mL. It also prevented oxidative damage to DNA caused by the Fenton reagent, as visualized in gel documentation system. The sun protection factor was found to be 10.93 ± 0.15 at 400 µg/mL. Thus, MLM can be used in food, cosmetic and pharmaceutical industry and as a therapeutic agent due to its unique properties.

The Application of Manufacturing Execution System in Virtual Manufacturing

Compaired with mart manufacturing and digital manufacturing, virtual manufacturing is a more advanced mode, which is more flexible, more inexpensive and more suitable for modern competitive society. No matter what type of manufacturing, Manufacturing Execution System (MES) is necessary and plays a key role. So this paper focuses on the MES in virtual manufacturing. MES serves as a bridge to connect the upper planning layer and the control layer of the factory. It has at least 8 functions, including data collection, production process management, human resource management, workpieces tracking, production planning and scheduling, quality control, documentation system and maintenance management. As a typical virtual manufacturing enterprise, the company A is chosen to be introduced, including the background, composition of MES and implementation of MES.

Standardised research methods and documentation in cultural adaptation: The need, the potential and future steps

Background Refugees and asylum seekers in Europe are affected by high prevalence of common mental disorders. Under the call ‘mental health of refugee populations’, the German Federal Ministry of Education and Research (FMER) funded a series of research projects to test evidence-based psychological interventions among refugee populations in Germany. In addition, the “Task force for cultural adaptation of mental health interventions for refugees” was established to develop a structured procedure for harmonising and documenting cultural adaptations across the FMER-funded research projects. Method A template for documenting cultural adaptations in a standardised manner was developed and completed by researchers in their respective projects. Documentation contained original data from formative research, as well as references and other sources that had been used during the adaptation process. All submitted templates and additional materials were analysed using qualitative content analysis. Results Research projects under the FMER call include minors, adults, and families from different origins with common mental disorders. Two studies used and adapted existing manuals for the treatment of PTSD. Four studies adapted existing transdiagnostic manuals, three of which had already been developed with a culture-sensitive focus. Four other studies developed new intervention manuals using evidence-based treatment components. The levels of cultural adaptation varied across studies, ranging from surface adaptations of existing manuals to the development of new, culture-sensitive interventions for refugees. Conclusions Cultural adaptation is often an iterative process of piloting, feedback, and further adaptation. Having a documentation system in place from start helps structuring this process and increases transparency.

Early evaluation of the transition from an analog to an electronic surgical logbook system in Sierra Leone

Background Surgical logbooks are a commonly used tool for quality assurance of surgical training. Electronic logbooks are increasingly applied in low-resource settings, but there is limited research on their quality. The aim of this study is to evaluate the quality of an app-based surgical e-logbook system shortly after its implementation in a low-income country and to identify potential areas of improvement for the system. Methods Entries in the e-logbook system were cross-checked with hospital records and categorized as matched or overreported. Moreover, the hospital records were checked for underreported procedures. Additionally, semi-structured interviews were conducted with users of the e-logbook system. Results A total of 278 e-logbook database entries and 379 procedures in the hospital records from 14 users were analyzed. Matches were found in the hospital records for 67.3% of the database entries. Moreover, 32.7% of the database entries were overreported and 50.7% of the procedures in the hospital records were underreported. A previous study of an analog surgical logbook system in the same setting estimated that 73.1% of the entries were matches or close matches. Interviews with 12 e-logbook users found overall satisfaction but also identified potential areas of improvement, including the need for more training in the use of the system, modifications to improve user-friendliness, and better access to the necessary technology. Conclusions A reliable documentation system is necessary to evaluate the quality of health workforce training. The early evaluation of a surgical e-logbook system in a low-income country showed that the collected data should be approached with caution. The quantitative analysis suggests that the e-logbook system needs to be improved in terms of accuracy. In interviews, users reported that digitalization of the logbook system was a much-needed innovation but also identified important areas of improvement. Recognition of these aspects at an early stage facilitates guidance and adjustment of further implementation and might improve the accuracy of the system.

Quality risk analysis of cocoa agroindustry: a case study in Pesawaran District, Lampung Province

Quality is a critical issue in small and medium scale cocoa agroindustry, which affected competitiveness significantly. Product quality is strongly influenced by implementing best practices in cocoa production and processing. This study aims to identify quality risks, analyze risks, and develop risk management strategies in the cocoa agroindustry using a case study. Analysis used Quality Risk Matrix to map the risks and Analytical hierarchy process to develop a quality risk management (QRM). The results showed that blooming is the highest quality risk, followed by taste differences, moisture content of raw materials, and color differences. From the management aspect, QRM in the cocoa agroindustry includes documentation system management, implementation of training regularly, implementation of internal audit, periodic reviews, impact assessment, development reports and controls verification, and development of an integrated supply chain systems. QRM includes providing facilities, maintenance of equipment and utilities, material management development, packaging and labeling, and continuous production methods from the technical side. The implementation of QRM in the cocoa agroindustry is carried out through improvements in the production process. In addition, the implementation of QRM requires support from the government and other stakeholders in the cocoa value chain.

IMPLEMENTATION OF QUALITY MANAGEMENT SYSTEM ISO 9001:2008 IN IMPROVING TEACHER PERFORMANCE IN SMA DARUL ULUM 2 UNGGULAN BPPT JOMBANG

The ISO 9001:2008 quality management system is one of the implementation forms of total quality management (TQM) concept. This total quality management system requires an organization to have standards such as resource management standards, product realization, measurement and evaluation, and documentation system. The purpose of ISO 9001:2008 quality management systemis toimprovecustomer satisfaction by fulfilling customer requerements through complete facilities, profesional teachers, achievement improvement and many others. This research used qualitative approach with field research design. The results obtained that performance of theachers in SMA Darul Ulum 2 Unggulan BPPT Jombang has a good predicate and implementation of ISO 9001:2008 quality management system run well with the commitment of school principals and all the citizens of the school, and take the field. the ISO allows teachers to continue to learn and improve performance. That is also supported by commitment from high school princupals and high schoolcommunity by continuously improving the quality of work and there is a complete facility to facilitate school activities. so far, not many obstacles are heavy when schools use the ISO 9001:2008 management system, it just takes adjustment for each member to use this ISO management system.

Occupational Infections among Dental Health Workers in Germany—14-Year Time Trends

Dental health workers (DHW) are at increased risk of acquiring occupational infections. Due to various protective measures, it can be assumed that infections have decreased over the past 14 years. Secondary data from a German accident insurance company was analyzed in terms of reported and confirmed occupational diseases (OD) in DHW from 2006 to 2019. A total of 271 claims were reported, of which 112 were confirmed as OD, representing an average of eight per year. However, the number of claims and confirmed ODs has decreased by 65.6% and 85.7%, respectively. The decrease was most evident for hepatitis B (HBV) and C (HCV) infections, while tuberculosis (TB) infections were stable. A total of 44 HCV, 33 HBV, 6 TB and 24 latent TB infections were confirmed as ODs. For DHW, 0.05, and for hospital workers, 0.48 claims per 1000 full-time equivalents (FTE) were registered in 2019. In a separate documentation system, between March 2020 and February 2021, 155 COVID-19 claims were registered, and 47 cases were confirmed as ODs. For DHW, 0.7, and for hospital workers, 47.3 COVID-19 claims per 1000 FTE were registered since 2020. Occupational infectious diseases rarely occur among DHW. Nevertheless, new infectious diseases such as COVID-19 pose a major challenge for DHW. Continued attention should be paid to infectious disease prevention.