Abstract: Dengue is a mosquito-borne viral disease endemic in
many countries in the tropics and sub-tropics. The state of Punjab in
India shows cyclical and seasonal variation in dengue cases. The
Case Fatality Rate of Dengue has ranged from 0.6 to 1.0 in the past
years. The department has initiated review of the cases that have died
due to dengue in order to know the exact cause of the death in a case
of dengue. The study has been undertaken to know the other
associated co-morbidities and factors causing death in a case of
dengue. The study used the predesigned proforma on which the
records (medical and Lab) were recorded and reviewed by the expert
committee of the doctors. This study has revealed that cases of
dengue having co-morbidities have longer stay in hospital. Fluid
overload and co-morbidities have been found as major factors leading
to death, however, in a confirmed case of dengue hepatorenal
shutdown was found to be major cause of mortality. The data
obtained will help in sensitizing the treating physicians in order to
decrease the mortality due to dengue in future.
Abstract: Myocardial infarction is one of the leading causes of
death in the world. Some of these deaths occur even before the
patient reaches the hospital. Myocardial infarction occurs as a result
of impaired blood supply. Because the most of these deaths are due to
coronary artery disease, hence the awareness of the warning signs of
a heart attack is essential. Some heart attacks are sudden and intense,
but most of them start slowly, with mild pain or discomfort, then
early detection and successful treatment of these symptoms is vital to
save them. Therefore, importance and usefulness of a system
designing to assist physicians in early diagnosis of the acute heart
attacks is obvious. The main purpose of this study would be to enable patients to
become better informed about their condition and to encourage them
to seek professional care at an earlier stage in the appropriate
situations. For this purpose, the data were collected on 711 heart
patients in Iran hospitals. 28 attributes of clinical factors can be
reported by patients; were studied. Three logistic regression models
were made on the basis of the 28 features to predict the risk of heart
attacks. The best logistic regression model in terms of performance
had a C-index of 0.955 and with an accuracy of 94.9%. The variables,
severe chest pain, back pain, cold sweats, shortness of breath, nausea
and vomiting, were selected as the main features.
Abstract: Healthcare safety has been perceived important. It is
essential to prevent troubles in healthcare processes for healthcare
safety. Trouble prevention is based on trouble prediction using
accumulated knowledge on processes, troubles, and countermeasures.
However, information on troubles has not been accumulated in
hospitals in the appropriate structure, and it has not been utilized
effectively to prevent troubles. In the previous study, however a
detailed knowledge acquisition process for trouble prediction was
proposed, the knowledgebase for countermeasures was not involved.
In this paper, we aim to propose the structure of the knowledgebase for
countermeasures, in the knowledge acquisition process for trouble
prediction in healthcare process. We first design the structure of
countermeasures and propose the knowledge representation form on
countermeasures. Then, we evaluate the validity of the proposal, by
applying it into an actual hospital.
Abstract: Taiwan is a hyper endemic area for the Hepatitis B
virus (HBV). The estimated total number of HBsAg carriers in the
general population who are more than 20 years old is more than 3
million. Therefore, a case record review is conducted from January
2003 to June 2007 for all patients with a diagnosis of acute hepatitis
who were admitted to the Emergency Department (ED) of a
well-known teaching hospital. The cost for the use of medical
resources is defined as the total medical fee. In this study, principal
component analysis (PCA) is firstly employed to reduce the number of
dimensions. Support vector regression (SVR) and artificial neural
network (ANN) are then used to develop the forecasting model. A total
of 117 patients meet the inclusion criteria. 61% patients involved in
this study are hepatitis B related. The computational result shows that
the proposed PCA-SVR model has superior performance than other
compared algorithms. In conclusion, the Child-Pugh score and
echogram can both be used to predict the cost of medical resources for
patients with acute hepatitis in the ED.
Abstract: Advances in the use of health care technology have
resulted in increased adverse events (AEs) related to the use of
medical devices. The study focused on the existing reporting systems.
This study was conducted in a tertiary care public sector hospital.
Devices included Syringe infusion pumps, Cardiac monitors, Pulse
oximeters, Ventilators and Defibrillators. A total of 211 respondents
were recruited. Interviews were held with 30 key informants. Medical
records were scrutinized. Relevant statistical tests were used.
Resident doctors reported maximum frequency of AEs, followed
by nurses; and least by consultants. A significant association was
found between the cadre of health care personnel and awareness that
the patients and bystanders have a risk of sustaining AE. Awareness
regarding reporting of AEs was low, and it was generally done
verbally. Other critical findings are discussed in the light of the
barriers to reporting, reasons for non-compliance, recording system,
and so on.
Abstract: Background: The objectives of this study were to
assess patient’s knowledge of appropriate sublingual glyceryl
trinitrate (GTN) use as well as to investigate how patients commonly
store and carry their sublingual GTN tablets. Methodology: This was
a cross-sectional survey, using a validated researcher-administered
questionnaire. The study involved cardiac patients receiving
sublingual GTN attending the outpatient and inpatient departments of
Taiping Hospital, a non-academic public care hospital. The minimum
calculated sample size was 92, but 100 patients were conveniently
sampled. Respondents were interviewed on 3 areas, including
demographic data, knowledge and use of sublingual GTN. Eight
items were used to calculate each subject’s knowledge score and six
items were used to calculate use score. Results: Of the 96 patients
who consented to participate, majority (96.9%) were well aware of
the indication of sublingual GTN. With regards to the mechanism of
action of sublingual GTN, 73 (76%) patients did not know how the
medication works. Majority of the patients (66.7%) knew about the
proper storage of the tablet. In relation to the maximum number of
sublingual GTN tablets that can be taken during each angina episode,
36.5% did not know that up to 3 tablets of sublingual GTN can be
taken during each episode of angina. Fifty four (56.2%) patients were
not aware that they need to replace sublingual GTN every 8 weeks
after receiving the tablets. Majority (69.8%) of the patients
demonstrated lack of knowledge with regards to the use of sublingual
GTN as prevention of chest pain. Conclusion: Overall, patients’
knowledge regarding the self-administration of sublingual GTN is
still inadequate. The findings support the need for more frequent
reinforcement of patient education, especially in the areas of
preventive use, storage and drug stability.
Abstract: Disasters are quite experienced in our days. They are
caused by floods, landslides, and building fires that is the main
objective of this study. To cope with these unexpected events,
precautions must be taken to protect human lives. The emphasis on
disposal work focuses on the resolution of the evacuation problem in
case of no-notice disaster. The problem of evacuation is listed as a
dynamic network flow problem. Particularly, we model the
evacuation problem as an earliest arrival flow problem with load
dependent transit time. This problem is classified as NP-Hard. Our
challenge here is to propose a metaheuristic solution for solving the
evacuation problem. We define our objective as the maximization of
evacuees during earliest periods of a time horizon T. The objective
provides the evacuation of persons as soon as possible. We
performed an experimental study on emergency evacuation from the
tunisian children’s hospital. This work prompts us to look for
evacuation plans corresponding to several situations where the
network dynamically changes.
Abstract: Hospitals represent approximately 6% of total energy consumption in the utility buildings sector. Heating, Ventilation and Air Conditioning (HVAC) systems are the major part of electrical energy consumption at the hospitals. The air-conditioning system is responsible for around 70% of total electricity consumption. Electric motors and lighting systems in a hospital represent approximately 19% and 21% of the total energy consumption, respectively. In this paper, profiles of hospital energy end-use consumption and an overview of energy saving areas at the hospitals are presented.
Abstract: 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.
Abstract: Recently research on human wayfinding has focused
mainly on mental representations rather than processes of
wayfinding. The objective of this paper is to demonstrate the
rationality behind applying multi-agent simulation paradigm to the
modeling of rescuer team wayfinding in order to develop
computational theory of perceptual wayfinding in crisis situations
using image schemata and affordances, which explains how people
find a specific destination in an unfamiliar building such as a
hospital. The hypothesis of this paper is that successful navigation is
possible if the agents are able to make the correct decision through
well-defined cues in critical cases, so the design of the building
signage is evaluated through the multi-agent-based simulation. In
addition, a special case of wayfinding in a building, finding one-s
way through three hospitals, is used to demonstrate the model.
Thereby, total rescue time for rescue operation during building fire is
computed. This paper discuses the computed rescue time for various
signage localization and provides experimental result for
optimization of building signage design. Therefore the most
appropriate signage design resulted in the shortest total rescue time in
various situations.
Abstract: In managing healthcare logistics, cost is not the only
factor to be considered. The level of items- criticality used in patient
care services plays an important role as well. A stock-out incident of
a high critical item could threaten a patient's life. In this paper, the
DMAIC (Define-Measure-Analyze-Improve-Control) methodology is
used to drive improvement projects based on customer driven critical
to quality characteristics at a Jordanian hospital. This paper shows
how the application of Six Sigma improves the performance of the
case hospital logistics system by reducing the number of stock-out
incidents.
Abstract: A collaboration among the Hospital S. Giovanni Battista
of Turin, the Politecnico of Turin, and the MUST company is
described. The content of the collaboration has been and is the use of
ICT-s, e-learning, and blended learning for the internal professional
education, training, and keeping up to date of the personnel of the
hospital. A platform for the delivery of the teaching materials has
been built, including an evaluation and self-evaluation tool. The first
on line courses have been developed and delivered and many more
are in preparation. The first results of the monitoring of the efficacy
of the online education have been positive.
Abstract: An accident is an unexpected and unplanned situation
that happens and affects human in a negative outcome. The accident
can cause an injury to a human biological organism. Thus, the
provision of initial care for an illness or injury is very important
move to prepare the patients/victims before sending to the doctor. In
this paper, a First Aid Application is developed to give some
directions for preliminary taking care of patient/victim via Android
mobile device. Also, the navigation function using Google Maps API
is implemented in this paper for searching a suitable path to the
nearest hospital. Therefore, in the emergency case, this function can
be activated and navigate patients/victims to the hospital with the
shortest path.
Abstract: Severe symptoms, such as dissociation, depersonalization, self-mutilation, suicidal ideations and gestures, are the main reasons for a person to be diagnosed with Borderline Personality Disorder (BPD) and admitted to an inpatient Psychiatric Hospital. However, these symptoms are also indicators of a severe traumatic history as indicated by the extensive research on the topic. Unfortunately patients with such clinical presentation often are treated repeatedly only for their symptomatic behavior, while the main cause for their suffering, the trauma itself, is usually left unaddressed therapeutically. All of the highly structured, replicable, and manualized treatments lack the recognition of the uniqueness of the person and fail to respect his/her rights to experience and react in an idiosyncratic manner. Thus the communicative and adaptive meaning of such symptomatic behavior is missed. Only its pathological side is recognized and subjected to correction and stigmatization, and the message that the person is damaged goods that needs fixing is conveyed once again. However, this time the message would be even more convincing for the victim, because it is sent by mental health providers, who have the credibility to make such a judgment. The result is a revolving door of very expensive hospitalizations for only a temporary and patchy fix. In this way the patients, once victims of abuse and hardship are left invalidated and thus their re-victimization is perpetuated in their search for understanding and help. Keywordsborderline personality disorder (BPD), complex PTSD, integrative treatment of trauma, re-victimization of trauma victims.
Abstract: This paper discusses about an intelligent system to be
installed in ambulances providing professional support to the paramedics on board. A video conferencing device over mobile 4G services enables specialists virtually attending the patient being transferred to the hospital. The data centre holds detailed databases
on the patients past medical history and hospitals with the specialists. It also hosts various software modules that compute the shortest traffic –less path to the closest hospital with the required facilities, on inputting the symptoms of the patient, on a real time basis.
Abstract: The technological concepts such as wireless hospital
and portable cardiac telemetry system require the development of
physiological signal acquisition devices to be easily integrated into
the hospital database. In this paper we present the low cost, portable
wireless ECG acquisition hardware that transmits ECG signals to a
dedicated computer.The front end of the system obtains and
processes incoming signals, which are then transmitted via a
microcontroller and wireless Bluetooth module. A monitoring
purpose Bluetooth based end user application integrated with patient
database management module is developed for the computers. The
system will act as a continuous event recorder, which can be used to
follow up patients who have been resuscitatedfrom cardiac arrest,
ventricular tachycardia but also for diagnostic purposes for patients
with arrhythmia symptoms. In addition, cardiac information can be
saved into the patient-s database of the hospital.
Abstract: The need to increase the efficiency of health care
systems is becoming an obligation, and one of area of improvement
is the discharge process. The objective of this work is to minimize
the patients discharge time (for insured patients) to be less than 50
minutes by using six sigma approach, this improvement will also:
lead to an increase in customer satisfaction, increase the number of
admissions and turnover on the rooms, increase hospital
profitability.Three different departments were considered in this
study: Female, Male, and Paediatrics. Six Sigma approach coupled
with simulation has been applied to reduce the patients discharge
time for pediatrics, female, and male departments at hospital. Upon
applying these recommendations at hospital: 60%, 80%, and 22% of
insured female, male, and pediatrics patients respectively will have
discharge time less than the upper specification time i.e. 50 min.
Abstract: Nurses in an Armed Force Hospital (AFH) expose to stronger stress than those in a civil hospital, especially in an emergency department (ED). Ironically, stresses of these nurses received few if any attention in academic research in the past. This study collects 227 samples from the emergency departments of four armed force hospitals in central and southern Taiwan. The research indicates that the top five stressors are a massive casualty event, delayed physician support, overloads of routine work, overloads of assignments, and annoying paper work. Excessive work loading was found to be the primary source of stress. Nurses who were perceived to have greater stress levels were more inclined to deploy emotion-oriented approaches and more likely to seek job rotations. Professional stressors and problem-oriented approaches were positively correlated. Unlike other local studies, this study concludes that the excessive work-loading is more stressful in an AFH.
Abstract: Due to the emergence of “Humanized Healthcare"
introduced by Professor Dr. Prawase Wasi in 2003[1], the
development of this paradigm tends to be widely implemented. The
organizations included Healthcare Accreditation Institute (public
organization), National Health Foundation, Mahidol University in
cooperation with Thai Health Promotion Foundation, and National
Health Security Office (Thailand) have selected the hospitals or
infirmaries that are qualified for humanized healthcare since 2008-
2010 and 35 of them are chosen to be the outstandingly navigating
organizations for the development of humanized healthcare,
humanized healthcare award [2].
The research aims to study the current issue, characteristics and
patterns of hospital administration contributing to humanized
healthcare system in Thailand. The selected case studies are from
four hospitals including Dansai Crown Prince Hospital, Leoi;
Ubolrattana Hospital, Khon Kaen; Kapho Hospital, Pattani; and
Prathai Hospital, Nakhonrachasima. The methodology is in-depth
interviewing with 10 staffs working as hospital executive directors,
and representatives from leader groups including directors,
multidisciplinary hospital committees, personnel development
committees, physicians and nurses in each hospital. (Total=40) In
addition, focus group discussions between hospital staffs and general
people (including patients and their relatives, the community leader,
and other people) are held by means of setting 4 groups including 8
people within each group. (Total=128) The observation on the
working in each hospital is also implemented. The findings of the
study reveal that there are five important aspects found in each
hospital including (1) the quality improvement under the mental and
spiritual development policy from the chief executives and lead
teams, leaders as Role model and they have visionary leadership; (2)
the participation hospital administration system focusing on learning
process and stakeholder- needs, spiritual human resource
management and development; (3) the relationship among people
especially staffs, team work skills, mutual understanding, effective
communication and personal inner-development; (4) organization
culture relevant to the awareness of patients- rights as well as the
participation policy including spiritual growth achieving to the same
goals, sharing vision, developing public mind, and caring; and (5)
healing structures or environment providing warmth and convenience
for hospital staffs, patients and their relatives and visitors.
Abstract: The hospital and the health-care center of a
community, as a place for people-s life-care and health-care settings,
must provide more and better services for patients or residents. After
Establishing Electronic Medical Record (EMR) system -which is a
necessity- in the hospital, providing pervasive services is a further
step. Our objective in this paper is to use pervasive computing in a
case study of healthcare, based on EMR database that coordinates
application services over network to form a service environment for
medical and health-care. Our method also categorizes the hospital
spaces into 3 spaces: Public spaces, Private spaces and Isolated
spaces. Although, there are many projects about using pervasive
computing in healthcare, but all of them concentrate on the disease
recognition, designing smart cloths, or provide services only for
patient. The proposed method is implemented in a hospital. The
obtained results show that it is suitable for our purpose.