[Assessment of factors affecting kidney transplant survival based on literature review between 2000 and 2014]

Background: Improvements in immune-suppressing drugs have a short-term effect on kidney transplants but do not have much long-term effect. In order to increase the duration of kidney transplant survival, understanding the significant parameters is of great importance. This study aims to identify key parameters [before the transplant occurs] which affect kidney transplant survival

Materials and methods: To conduct this review, the scientific databases was searched and more than 200 related titles were retrieved; and the abstracts were reviewed to determine which studies were relevant to the study. The literature analysis was based on the goals of the studies themselves, the number of citations, and the reliability of the sources cited. Ultimately, 60 studies included for further analysis

Results: Based on the frequency of each parameter which influenced graft survival, the following parameters were determined to have higher frequencies compared to other parameters, with regards to survival time of the kidney transplant: the ages of the donor and recipient, socioeconomic status, immune-suppressing drugs, HLA matching, time on the waiting list, live or deceased donor, the decade in which the operation occurred, cold ischemia time, and reaction to antibiotics

Conclusion: The influence of some of the kidney transplant survival parameters was acknowledged in the majority of studies; however, some parameters have been the subject of disagreement among studies. In order to resolve this issue, we suggest a search of international data and meta-analysis of current literature to better understand the parameters of kidney transplant survival

Evaluation of Nursing Information Systems: Application of Usability Aspects in the Development of Systems / 대한의료정보학회지

OBJECTIVES: As the largest group providing healthcare services, nurses require well-designed information systems in their practice. This study aims to evaluate the usability of nursing information systems (NIS). METHODS: This cross-sectional survey was conducted in 2015. The settings of the study consisted of four hospitals affiliated with three medical universities in Tehran (Iran). The subjects of the study included nurses who had access to and used a NIS developed by four major software companies. The data were collected using a modified version of a usability questionnaire known as IsoMetrics, based on the International Standard ISO 9241, Part 11. The questionnaire is composed of 35 questions divided into seven general criteria. The validity of the questionnaire was determined by experts in the field, and the reliability was checked using Cronbach's alpha (α = 0.91). The questionnaire was then distributed to 184 nurses. RESULTS: The response rate was 64.6%. Among the seven ISO usability criteria, suitability for the task (3.10 ± 1.24) and suitability for learning (3.10 ± 1.27) had the highest mean value. The lowest mean value (2.37 ± 1.29) was related to the suitability for individualization. CONCLUSIONS: Addressing issues related to individualization and self-descriptiveness could improve the usability of nursing systems. Considering usability requirements in the design of a NIS will lead to the efficient and effective use of these systems.

Electronic health record architecture: a systematic review

Numerous advantages are derived from the electronic health record [EHR]. Though achieving such advantages depends on its architecture, at present no unique understanding of the architecture dimensions and specifications is available. Therefore, the aim of the present study is a systematic review of architecture perception of the electronic health record. The authors searched the literature in Science Direct, Scopus, PubMed and Proudest Databases [2000 to Jun 2015]. Data extraction was done by 2 reviewers on content, structure, content/structure relationship, confidentiality and security of the EHR. Subsequent to refining the 87 retrieved studies, 25 studies were finally included in the study. In the studies and paradigms so far proposed for the EHR, a unique comprehensive architecture model from the viewpoint of research criteria has not been investigated and it has been considered only from some dimensions. Hence, we provide a new definition of the EHR architecture

Pharmacy Information Systems in Teaching Hospitals: A Multi-dimensional Evaluation Study / 대한의료정보학회지

OBJECTIVES: In hospitals, the pharmacy information system (PIS) is usually a sub-system of the hospital information system (HIS). The PIS supports the distribution and management of drugs, shows drug and medical device inventory, and facilitates preparing needed reports. In this study, pharmacy information systems implemented in general teaching hospitals affiliated to medical universities in Tehran (Iran) were evaluated using a multi-dimensional tool. METHODS: This was an evaluation study conducted in 2015. To collect data, a checklist was developed by reviewing the relevant literature; this checklist included both general and specific criteria to evaluate pharmacy information systems. The checklist was then validated by medical informatics experts and pharmacists. The sample of the study included five PIS in general-teaching hospitals affiliated to three medical universities in Tehran (Iran). Data were collected using the checklist and through observing the systems. The findings were presented as tables. RESULTS: Five PIS were evaluated in the five general-teaching hospitals that had the highest bed numbers. The findings showed that the evaluated pharmacy information systems lacked some important general and specific criteria. Among the general evaluation criteria, it was found that only two of the PIS studied were capable of restricting repeated attempts made for unauthorized access to the systems. With respect to the specific evaluation criteria, no attention was paid to the patient safety aspect. CONCLUSIONS: The PIS studied were mainly designed to support financial tasks; little attention was paid to clinical and patient safety features.

Improving the quality of clinical coding: a comprehensive audit model

Introduction: The review of medical records with the aim of assessing the quality of codes has long been conducted in different countries. Auditing medical coding, as an instructive approach, could help to review the quality of codes objectively using defined attributes, and this in turn would lead to improvement of the quality of codes

Method: The current study aimed to present a model for auditing the quality of clinical codes. The audit model was formed after reviewing other audit models, considering their strengths and weaknesses. A clear definition was presented for each quality attribute and more detailed criteria were then set for assessing the quality of codes

Results: The audit tool [based on the quality attributes included legibility, relevancy, completeness, accuracy, definition and timeliness]; led to development of an audit model for assessing the quality of medical coding. Delphi technique was then used to reassure the validity of the model

Conclusion: The inclusive audit model designed could provide a reliable and valid basis for assessing the quality of codes considering more quality attributes and their clear definition. The inter-observer check suggested in the method of auditing is of particular importance to reassure the reliability of coding