Analysis on the application of FMEA in 'instrument and equipment surface cleaning and disinfection' in hospitals based on standardization and cleaning and disinfection information system management.

Purpose: To analyze the application of 'instrument and equipment surface cleaning and disinfection' in hospitals based on standardization and the management of cleaning and disinfection information systems. Methods: Employees and all cleaning and disinfected instruments and equipment from 56 inpatient departments in our hospital were selected as the subjects of observation. The period before the intervention (January 2023) was designated as the control group, while the period after the intervention (July 2023) was designated as the study group. In the control group, the instruments and equipment under routine management were disinfected. The research team applied the Failure Mode and Effects Analysis (FMEA) method to clean and disinfect the surfaces of instruments and equipment on the basis of standardization and cleaning and disinfection information system management. Employees' theoretical knowledge points and operational skill scores before and after the intervention were compared and evaluated. The changes in the risk priority coefficient (RPN) values of high-risk factors were analyzed. Fifty-six clinical medical staff from 56 inpatient departments in the hospital were selected to evaluate the clinical satisfaction of the cleaning and disinfection management of instruments and equipment before and after the intervention, and the clinical satisfaction of the two groups was compared. Results: The scores of theoretical knowledge and operational skills of the staff in the research group were significantly higher than those in the control group. The passing rates of theoretical knowledge and operational skills in the control group and the research group were 44.64 and 94.64% respectively, and 55.36 and 96.43%, respectively. The qualified rate of theoretical knowledge and operational skills of staff in the study group was significantly higher than that in the control group (p < 0.05). The RPN scores of medical personnel, environment, system and system guarantee factors in the control group were 80, 80, 80, and 100, respectively. The RPN scores of medical personnel factors, environmental factors, system factors and system guarantee factors in the research group were 6, 24, 24, and 36, respectively. Conclusion: Through standardization and cleaning and disinfection information system management, the theoretical knowledge and technical operation capabilities of cleaning can be effectively improved.

[The quality of the anthropometric data on children under five years of age in information systems in the State of São Paulo, Brazil]. / Qualidade dos dados antropométricos de crianças menores de cinco anos em sistemas de informação no estado de São Paulo, Brasil.

This paper involves the analysis of the quality of anthropometric data on children under five years of age in two information systems in the State of São Paulo. The sample included 2,117,108 children from the Food and Nutrition Surveillance System (SISVAN), and 748,551 from the State Milk Project (VIVALEITE). Initially, we evaluated the frequency of missing values and others outside the equipment spectrum and calculated the digit-to-weight preference index. After calculating height-for-age (HAZ), weight-for-age (WAZ), and body mass index-for-age (BAZ), we flagged the biologically implausible values (BIV) and calculated the standard deviation (SD). For each municipality, we calculated the mean and the SD of HAZ, WAZ, and BAZ; and plotted the SD values as a function of the mean. The digit-to-weight preference index was greater among children aged between 24 and 59 months in SISVAN. The frequency of BIV for HAZ (SISVAN 2.56%; VIVALEITE 0.98%) was higher than for WAZ (SISVAN 2.10%; VIVALEITE 0.18%). For HAZ, variations among municipalities were more pronounced in VIVALEITE than in SISVAN. The height variable presents low reliability in both systems. The weight variable reveals satisfactory quality in VIVALEITE and unsatisfactory quality in SISVAN.

O objetivo foi analisar a qualidade dos dados antropométricos de crianças menores de cinco anos em dois sistemas de informação no estado de São Paulo. A amostra compreendeu 2.117.108 crianças do Sistema de Vigilância Alimentar e Nutricional (Sisvan) e 748.551 do Projeto Estadual do Leite (Vivaleite). Inicialmente, avaliamos a frequência de valores faltantes e fora do espectro do equipamento, e calculamos o índice de preferência de dígito para peso. Após calcular os índices de altura para idade (A-I), peso para idade (P-I) e índice de massa corporal para idade (IMC-I), identificamos os valores biologicamente implausíveis (VBI) e calculamos o desvio-padrão (DP). Para cada município, calculamos a média e o DP de A-I, P-I e IMC-I; e plotamos os valores de DP em função da média. A preferência de dígito no peso foi maior em crianças de 24 a 59 meses no Sisvan. A frequência de VBI para A-I (SISVAN 2,56%; Vivaleite 0,98%) foi maior do que para P-I (Sisvan 2,10%; Vivaleite 0,18%). Para o índice A-I as variações entre os municípios foram mais acentuadas no Vivaleite do que no Sisvan. A variável altura apresentou baixa confiabilidade nos dois sistemas. A variável peso apresentou qualidade satisfatória no Vivaleite e insatisfatória no Sisvan.

Lessons learned from urgent computing in Europe: Tackling the COVID-19 pandemic.

PRACE (Partnership for Advanced Computing in Europe), an international not-for-profit association that brings together the five largest European supercomputing centers and involves 26 European countries, has allocated more than half a billion core hours to computer simulations to fight the COVID-19 pandemic. Alongside experiments, these simulations are a pillar of research to assess the risks of different scenarios and investigate mitigation strategies. While the world deals with the subsequent waves of the pandemic, we present a reflection on the use of urgent supercomputing for global societal challenges and crisis management.

Controle mensal de funcionamento de bancos de leite humano e postos de coleta de leite humano: dados de produção / Control mensual del funcionamiento de los bancos de leche humana y centros de recolección de leche humana: datos de producción / Monthly operation control of banks human milk and human milk collection stations: production data

Esta Norma Técnica tem por objetivo estabelecer os critérios necessários para o cadastro e manutenção das informações mensais dos Bancos de Leite Humano e Postos de Coleta de Leite Humano no sistema de informação, segundo as diretrizes definidas pela Rede Brasileira de Bancos de Leite Humano, visando a garantia da qualidade nestes serviços e sua certificação

Esta Norma Técnica tiene como objetivo establecer los criterios necesarios para el registro y mantenimiento de las informaciones mensuales de los Bancos de Leche Humana y de los Centros de Recolección de Leche Humana en el sistema de información, de acuerdo con las directrices establecidas por la Red Brasileña de Bancos de Leche Humana, con el fin de garantizar la calidad de estos servicios y su certificación.

Mapping a high-level overview of information flows in the Dutch declaration chain for medical specialist health care.

This study is based on Philippe van der Voorn's master's dissertation at the Utrecht University, Department of Science, Information and Computing Sciences. The problem identified was a lack of an integrated information chain and clear governance structure for information flow in the Netherlands' health care sector. The method of Design Science was followed to construct an overview model of the chain, and towards a business process model that is intuitive for both technical and business users. An initial declaration chain was identified in the literature and presented, to be confirmed and elaborated on via eight interviews at seven different organisations in the medical specialist health care sector. Based on these interviews, the draft overview was adjusted and a Business Process Model and Notation model created that indicates the shared understanding of the data elements and activities between the organisations. The contribution of the overview of the declaration chain, in particular, can help medical specialist staff obtain an understanding of the administrative side of their work, and with a clear information infrastructure lead to better working processes and information quality. F.J.

The inclusion of health data standards in the implementation of pharmacogenomics systems: a scoping review.

Background: Despite potential benefits, the practice of incorporating pharmacogenomics (PGx) results in clinical decisions has yet to diffuse widely. In this study, we conducted a review of recent discussions on data standards and interoperability with a focus on sharing PGx test results among health systems. Materials & methods: We conducted a literature search for PGx clinical decision support systems between 1 January 2012 and 31 January 2020. Thirty-two out of 727 articles were included for the final review. Results: Nine of the 32 articles mentioned data standards and only four of the 32 articles provided solutions for the lack of interoperability. Discussions: Although PGx interoperability is essential for widespread implementation, a lack of focus on standardized data creates a formidable challenge for health information exchange. Conclusion: Standardization of PGx data is essential to improve health information exchange and the sharing of PGx results between disparate systems. However, PGx data standards and interoperability are often not addressed in the system-level implementation.

Discrimination Ability of Patient Reported Outcome Measurement Information System Pediatric Domains Compared With Scoliosis Research Society-22r and Legacy Patient Reported Outcome Measures in Juvenile and Adolescent Idiopathic Scoliosis.

STUDY DESIGN: Comparative cohort study. OBJECTIVE: To compare patient reported outcome measures (PROMs) in children and adolescents with varying extent of spinal deformity. SUMMARY OF BACKGROUND DATA: Several PROMs have been proposed to help assess health-related quality-of-life (HRQoL) in pediatric spinal deformity surgery and research, but it is unclear which are sensitive to deformity severity. METHODS: Pediatric patients diagnosed with spinal asymmetry or juvenile/adolescent idiopathic scoliosis completed the patient-reported outcomes management information system (PROMIS) pediatric computer adaptive test bank (Domains: Mobility, Pain Interference, Physical Activity, Physical Stress Experiences, Psychological Stress Experiences), Scoliosis Research Society-22r (SRS-22r), Hospital for Special Surgery Pediatric Functional Activity Brief Scale (HSS Pedi-FABS) activity scale, and Trunk Appearance Perception Scale. Patients were grouped as spinal asymmetry, mild deformity, and substantial deformity by major Cobb angle measuring less than 10°, between 10° and 40°, and greater than 40° respectively. One-way analysis of variance with a Tukey post-hoc correction was used to determine score differences between groups. RESULTS: Final analyses included 206 patients, of which 135 (66%) were female. The mean age was 13.0 ±â€Š2.2 years, and the mean major Cobb angle was 20.1 ±â€Š14.1° (range: 0-74.2°). Compared with both spinal asymmetry and mild deformity patients, patients with substantial deformity reported worse outcomes, including lower function, more pain, and decreased psychological health by legacy PROMs and PROMIS. PROMIS Physical Activity and Psychological Stress Experiences did not capture any significant differences between all groups. There were no significant differences in outcomes between the spinal asymmetry and mild deformity groups for all PROMs measured. CONCLUSION: Patients with substantial spinal deformity reported lower activity and function, more pain, and greater physical and psychological stress compared with patients without clinical spinal deformity by legacy PROMs and several PROMIS domains. As PROMIS Physical Activity and Psychological Stress Experiences did not capture these differences, these PROMs may measure different constructs than the legacy PROMs as they relate to spinal curvature and may be less relevant to measure HRQoL in this population.Level of Evidence 3.

Availability, Affect, and Decisions to Seek Information about Cancer Risks.

How do people decide which risks they want to get informed about? The present study examines the role of the availability and affect heuristics on these decisions. Participants (N = 100, aged 19-72 years) selected for which of 23 cancers they would like to receive an information brochure, reported the number of occurrences of each type of cancer in their social circle (availability), and rated their dread reaction to each type of cancer (affect); they also made relative judgments about which of 2 cancers was more common in Germany (judged risk). Participants tended to choose information brochures for those cancers for which they indicated a higher availability within their social networks as well as for cancers they dreaded. Mediation analyses suggested that the influence of availability and affect on information choice was only partly mediated by judged risk. The results demonstrate the operation of 2 key judgment heuristics (availability and affect), previously studied in risk perception, also in decisions about information choice. We discuss how our findings can be used to identify which risks are likely to fall from people's radar.

Identifying Mobile Health Engagement Stages: Interviews and Observations for Developing Brief Message Content.

BACKGROUND: Interest in mobile health (mHealth) has increased recently, and research suggests that mHealth devices can enhance end-user engagement, especially when used in conjunction with brief message content. OBJECTIVE: This research aims to explore the stages of engagement framework for mHealth devices and develop a method to generate brief message content to promote sustained user engagement. This study uses the framework by O'Brien and Toms as a point of departure, where engagement is defined as the uptake or the use of an mHealth device. The framework is a linear repeatable process, including point of engagement, period of engagement, disengagement, and re-engagement. Each stage is characterized by attributes related to a person's technology experience. Although the literature has identified stages of engagement for health-related technology, few studies explore mHealth engagement. Furthermore, little research has determined a method for creating brief message content at each stage in this engagement journey. METHODS: Interviews and observations from 19 participants who used mHealth technologies (apps, devices, or wellness websites) in a solo capacity were recruited for sample group 1. In sample group 2, interviews, and observations from 25 participants using mHealth technologies in a group capacity through the Global Corporate Challenge were used. These samples were investigated at 3 time points in both research contexts. The results underwent deductive-inductive thematic analysis for the engagement stages' framework and attributes. RESULTS: In addition to the 4 stages identified by O'Brien and Toms, 2 additional stages, self-management and limited engagement, were identified. Self-management captures where users had disengaged from their technology but were still engaged with their health activity. Limited engagement captures where group mHealth users had minimal interaction with their mHealth technology but continued to engage in a group fitness activity. The results revealed that mHealth engagement stages were nonlinear and embedded in a wider engagement context and that each stage was characterized by a combination of 49 attributes that could be organized into 8 themes. Themes documented the total user experience and included technology usability, technology features, technology aesthetics, use motivations, health awareness, goal setting, social support, and interruptions. Different themes were found to have more relevance at different engagement stages. Knowing themes and attributes at all engagement stages allows technology developers and health care professionals to generate relevant brief message content informed by a person-centered approach. CONCLUSIONS: This research extends an existing engagement stages framework and identifies attributes and themes relevant to mHealth technology users' total user experience and incorporates concepts derived from health, business studies, and information systems literature. In addition, we offer a practical 5-step process based on a person-centered approach to develop mHealth technology brief message content for sustained engagement.

Cultural Impact on the Intention to Use Nursing Information Systems of Nurses in Taiwan and China: Survey and Analysis.

BACKGROUND: Nursing workforce shortage has emerged as a global problem. Foreign nurse importation is a popular strategy to address the shortage. The interactions between nursing staff on either side of the Taiwan Strait continue to increase. Since both nurses in Taiwan and nurses in China have adopted nursing information systems to improve health care processes and quality, it is necessary to investigate factors influencing nursing information system usage in nursing practice. OBJECTIVE: This study examined the effects of cultural and other related factors on nurses' intentions to use nursing information systems. The findings were expected to serve as an empirical base for further benchmarking and management of cross-strait nurses. METHODS: This survey was conducted in two case hospitals (one in Taiwan and one in China). A total of 880 questionnaires were distributed (n=440 in each hospital). RESULTS: The results showed effort expectancy had a significant effect on the intention to use nursing information systems of nurses in China (P=.003) but not nurses in Taiwan (P=.16). CONCLUSIONS: Findings suggest nursing managers should adopt different strategies to motivate cross-strait nurses to use nursing information systems. Promoting effort expectancy is more likely to motivate nurses in China than in Taiwan. This discrepancy is probably due to the less hierarchical and more feminine society in Taiwan.

Completeness of tuberculosis records held on the Notifiable Health Conditions Information System (SINAN) in Santa Catarina, Brazil, 2007-2016. / Completude dos registros de tuberculose no Sistema de Informação de Agravos de Notificação (Sinan) em Santa Catarina, Brasil, 2007-2016.

Objective to describe the completeness of tuberculosis (TB) case records in Santa Catarina, Brazil, from 2007 to 2016. Methods this was a descriptive study using Notifiable Health Conditions Information System data; completeness, consistency of notification form records and timely notification were analyzed in order to assess data quality. Results completeness of notification form mandatory fields was considered good; essential fields were less complete, in particular the 'Schooling' field; low completeness of follow-up sputum smear microscopy and failure to update culture tests and HIV serology tests demonstrate weaknesses in follow-up records. Conclusion the tuberculosis surveillance system data were considered adequate for guiding tuberculosis prevention and control actions; record monitoring and periodical evaluation, as well as adoption of strategies to improve follow-up report completeness are recommended.

INCREASE OF INCIDENCE OF CONGENITAL SYPHILIS IN SANTA CATARINA STATE BETWEEN 2007-2017: TEMPORAL TREND ANALYSIS.

OBJECTIVE: To estimate the incidence of congenital syphilis and temporal trends of the reported cases of the disease in the state of Santa Catarina between 2007 and 2017. METHODS: Observational study with retrospective cohort design, with secondary data from the Injury of Notification Information System (SINAN). Linear trend test and geoprocessing were performed to verify the behavior of the cases in the period. RESULTS: There were 2,898 reported cases of congenital syphilis in the period, with an average of 2.9 per 1,000 live births in the period. There was an exponential increase of 0.9 percentage points per year, considered statistically significant (p<0.001). There was no difference between the incidences of cases in the different regions of the State. The fatality rate was 8.5%, considering deaths from syphilis, miscarriages and stillbirths. The profile was predominant of white mothers, with low schooling and 11.8% did not perform prenatal care. For this reason, 26.9% of them had a diagnosis of syphilis at the time of delivery. Most of the pregnant women (51.9%) had inadequate pharmacological treatment and 65.1% of the partners were not treated. CONCLUSIONS: There was an exponential increase tendency in cases of congenital syphilis in the State of Santa Catarina in the period studied in all regions of the State, which reveals the failure of prenatal care, late diagnosis and inadequate treatment of the pregnant woman and her partner.

Completeness of yellow fever notification forms in the state of Espírito Santo, Brazil, 2017. / Completude das fichas de notificação de febre amarela no estado do Espírito Santo, 2017.

Objective to describe the completeness of data on yellow fever notification forms in the municipalities of the state of Espírito Santo, Brazil, in 2017. Methods this is a descriptive ecological study with data from the Notifiable Health Conditions Information System (SINAN); form completeness was categorized as poor (<70.0%), regular (70-89.9%) or excellent (≥90.0%); thematic maps were prepared. Results 53.1% of the municipalities had poor or regular classification for many notification form variables, especially case Final Classification (57.1%), Confirmation/Dismissal Criterion (63.2%) and Closure Date (26.5%), which are required fields. Conclusion completeness was poor or regular for several variables, pointing to the need for a systematic assessment of information on yellow fever held on SINAN.

Analysis of the application of a deterministic routine for identifying multiple pregnancies on SINASC, Brazil. / Análise da aplicação de uma rotina determinística para a identificação de gestações múltiplas no Sistema de Informações sobre Nascidos Vivos.

OBJECTIVE: to evaluate the application of a deterministic routine for identifying multiple pregnancies on the Brazilian Live Birth Information System (SINASC). METHODS: SINASC data deduplication and linkage with the mortality database (fetal deaths) for Rio de Janeiro state for the period 2007-2008; we used a deterministic routine, using a key based on SINASC maternal and birth information, complemented by manual review. RESULTS: of the 433,874 SINASC records, 9,036 (2.1%) were classified as multiple pregnancy newborns; after implementing the routine, we reclassified 385 records as twins, and 286 as singletons; accuracy of multiple pregnancy information on the SINASC database was high (sensitivity=95.8%; specificity=99.9%); applying the routine without the manual review process increased sensitivity by 4.2%, with no significant change of specificity. CONCLUSION: despite the accuracy of information regarding multiple pregnancy held on SINASC, we suggest the use of this routine as an option for improving classification of twins.

Trust in the smart home: Findings from a nationally representative survey in the UK.

Businesses in the smart home sector are actively promoting the benefits of smart home technologies for consumers, such as convenience, economy and home security. To better understand meanings of and trust in the smart home, we carried out a nationally representative survey of UK consumers designed to measure adoption and acceptability, focusing on awareness, ownership, experience, trust, satisfaction and intention to use. We analysed the results using theories of meanings and acceptability of technologies including semiotics, social construction of technology (SCOT) and sociotechnical affordance. Our findings suggest that the meaning and value proposition of the smart home have not yet achieved closure for consumers, but is already foregrounding risks to privacy and security amongst the other meaning-making possibilities it could afford. Anxiety about the likelihood of a security incident emerges as a prominent factor influencing adoption of smart home technology. This factor negatively impacts adoption. These findings underline how businesses and policymakers will need to work together to act on the sociotechnical affordances of smart home technology in order to increase consumers' trust. This intervention is necessary if barriers to adoption and acceptability of the smart home are to be addressed now and in the future.

Efficient and Secure Attribute Based Access Control Architecture for Smart Healthcare.

The smart health medical system is expected to enhance the quality of health care services significantly. These system keeps patients related record and provides the services over the insecure public channel which may cause data security and privacy concerns in a smart health system. On the other hand, ciphertext attribute-based encryption(CP-ABE) provides possible encrypted data security. There are some security flaws in CP-ABE, where the existing access policies are in the cleartext form for accessing encrypted sensitive data. On the other hand, it supports the small attribute universe, which restricts the practical deployments of CP-ABE. Moreover, outsider adversary observed the communication, which also creates a serious threat to CP-ABE model. To overcome security and privacy risk, efficient access control have been designed and devolved for medical services. Although we also demonstrate the security analysis of Zhang et al.'s scheme, which is vulnerable to inefficient security proof and man in the middle attack. In the proposed scheme, we proposed an efficient and security preserve scheme to overcome the weaknesses of Zhang's et al.'s system. The protocol satisfies the attribute values of the medical user with hidden access policies. It has been proved under the standard model, which ensure the security of the protocol. Moreover, performance analysis comparison shows that the proposed scheme is more efficient than the existing one.

Transforming Healthcare Cybersecurity from Reactive to Proactive: Current Status and Future Recommendations.

The recent rise in cybersecurity breaches in healthcare organizations has put patients' privacy at a higher risk of being exposed. Despite this threat and the additional danger posed by such incidents to patients' safety, as well as operational and financial threats to healthcare organizations, very few studies have systematically examined the cybersecurity threats in healthcare. To lay a firm foundation for healthcare organizations and policymakers in better understanding the complexity of the issue of cybersecurity, this study explores the major type of cybersecurity threats for healthcare organizations and explains the roles of the four major players (cyber attackers, cyber defenders, developers, and end-users) in cybersecurity. Finally, the paper discusses a set of recommendations for the policymakers and healthcare organizations to strengthen cybersecurity in their organization.

Assessing Community Health Information Systems: Evidence from Child Health Records in Food Insecure Areas of the Ethiopian Highlands.

OBJECTIVES: This study assessed the completeness of child health records maintained and collected within community health information system in Ethiopia. METHODS: A household listing was carried out in 221 enumeration areas in food insecure areas of Ethiopia to determine the presence of a child less than 24-months. This list of children was then compared against the information stored at the local health posts. A household survey was administered to a sample of 2155 households that had a child less than 24-months of age to assess determinants and consequences of exclusion from the health post registers. RESULTS: Out of the 10,318 children identified during the listing, 36% were found from the health post records. Further analysis based on the household survey data indicated that health posts that had adopted nationally recommended recordkeeping practices had more complete records (p < 0.01) and that children residing farther from health posts were less likely to be found from the registers (p < 0.05). Mothers whose child was found from the registers were more likely to know a health extension worker (p < 0.01), had a contact with one (p < 0.01), and their child was more likely to have received growth monitoring (p < 0.05). CONCLUSIONS FOR PRACTICE: The incompleteness of the data collected at the health posts poses a challenge for effective implementation of the national health extension program and various complementary programs in Ethiopia.

The Impact of Portal Satisfaction on Portal Use and Health-Seeking Behavior: Structural Equation Analysis.

BACKGROUND: Our study addresses a gap in the modern information systems (IS) use literature by investigating factors that explain patient portal satisfaction (SWP) and perceptions about health-seeking behavior (HSB). A novel feature of our study is the incorporation of actual portal use data rather than the perceptions of use intention, which prevails in the modern IS literature. OBJECTIVE: This study aimed to empirically validate factors that influence SWP as an influencing agent on portal use and HSB. Our population segment was comprised of college students with active patient portal accounts. METHODS: Using web-based survey data from a population of portal users (n=1142) in a university health center, we proposed a theoretical model that adapts constructs from the Technology Acceptance Model by Davis, the revised Technology Adoption Model by Venkatesh, the Unified Theory of the Acceptance and Use of Technology 2, and the Health Belief Model by Rosenstock et al. We validated our model using structural equation modeling techniques. RESULTS: Our model explained nearly 65% of the variance in SWP (R2=0.6499), nearly 33% of the variance in portal use (R2=0.3250), and 29% of the variance in HSB (R2=0.2900). Statistically significant antecedents of SWP included social influence (beta=.160, t499=6.145), habit (beta=.114, t499=4.89), facilitating conditions (beta=.062, t499=2.401), effort expectancy (beta=.311, t499=11.149), and performance expectancy (beta=.359, t499=11.588). SWP influenced HSB (beta=.505, t499=19.705) and portal use (beta=.050, t499=2.031). We did not find a statistically significant association between portal use and HSB (beta=.015, t499=0.513). Perceived severity significantly influenced HSB (beta=.129, t499=4.675) but not portal use (beta=.012, t499=.488). CONCLUSIONS: Understanding the importance of SWP and the role it plays in influencing HSB may point to future technology design considerations for information technology developers and health care providers. We extend current Expectancy Confirmation Theory research by finding a positive association between SWP and portal use.