[Safeguarding Medication Use Through Interprofessional Collaboration: Example of Inpatient Medication Management and Use].

The majority of patient safety incidents cited in the latest Taiwan Patient Safety Reporting System Annual Report were medication-related, with human factors and communication issues identified as the key underlying causes of these incidents. Focusing on inpatient settings, the complex yet multiprofessional-linked drug supply scheme currently in place in medical institutions in Taiwan is described, with the aim of facilitating the accessibility and appropriateness of medication use by detailing the responsibilities of each professional role. Institutional medication management and use comprise several sequential and interconnected stages, including formulary management and drug procurement, medication storage, physician prescribing, pharmacist dispensing, nurse administration, and efficacy-and-safety monitoring and reporting. The principal tasks and personnel duties at each stage are addressed. In summary, institutional drug distribution and control is an intricate process that involves multiple processes and a diverse array of professionals and administrative staff. It is imperative to actively engage the relevant parties, especially through in-service training, in order to understand their essential roles and responsibilities and to enable communication and collaboration among stakeholders in the drug distribution chain. Implementing the appropriate initiatives in a timely manner will help establish an effective and robust safe-medication-use system.

Using a Text-Mining Approach to Evaluate the Quality of Nursing Records.

Nursing records in Taiwan have been computerized, but their quality has rarely been discussed. Therefore, this study employed a text-mining approach and a cross-sectional retrospective research design to evaluate the quality of electronic nursing records at a medical center in Northern Taiwan. SAS Text Miner software Version 13.2 was employed to analyze unstructured nursing event records. The results show that SAS Text Miner is suitable for developing a textmining model for validating nursing records. The sensitivity of SAS Text Miner was approximately 0.94, and the specificity and accuracy were 0.99. Thus, SAS Text Miner software is an effective tool for auditing unstructured electronic nursing records.

Improving inpatient fall prevention strategies using interactive data repository information system.

Observing the pattern changes of inpatient fall and validating the Fall Prevention Tool Kit (FPTK) are essential for developing fall prevention strategies. However, the work requires the collection, calculation, and comparison of large amount of data. The information is often scattered in diverse information systems and lack of integration, which makes the work difficult and often neglected. This study demonstrates the development of an Interactive Data Repository System (IDRS) and uses it in the analysis of the pattern changes of inpatient fall within the institute, and validates efficiency of the FPTK across time. This study collected the incident data of year 2011 and compared it with the previous analysis in 2001. The result shows that reasons for patient fall had turned from physical disability to impaired conscious or cognition. The scoring result may be too sensitive in identifying patient falls. Patients with high scores needed to reinforce in functional strength.

An architecture model for multiple disease management information systems.

Disease management is a program which attempts to overcome the fragmentation of healthcare system and improve the quality of care. Many studies have proven the effectiveness of disease management. However, the case managers were spending the majority of time in documentation, coordinating the members of the care team. They need a tool to support them with daily practice and optimizing the inefficient workflow. Several discussions have indicated that information technology plays an important role in the era of disease management. Whereas applications have been developed, it is inefficient to develop information system for each disease management program individually. The aim of this research is to support the work of disease management, reform the inefficient workflow, and propose an architecture model that enhance on the reusability and time saving of information system development. The proposed architecture model had been successfully implemented into two disease management information system, and the result was evaluated through reusability analysis, time consumed analysis, pre- and post-implement workflow analysis, and user questionnaire survey. The reusability of the proposed model was high, less than half of the time was consumed, and the workflow had been improved. The overall user aspect is positive. The supportiveness during daily workflow is high. The system empowers the case managers with better information and leads to better decision making.

An information technology framework for strengthening telehealthcare service delivery.

OBJECTIVE: Telehealthcare has been used to provide healthcare service, and information technology infrastructure appears to be essential while providing telehealthcare service. Insufficiencies have been identified, such as lack of integration, need of accommodation of diverse biometric sensors, and accessing diverse networks as different houses have varying facilities, which challenge the promotion of telehealthcare. This study designs an information technology framework to strengthen telehealthcare delivery. MATERIALS AND METHODS: The proposed framework consists of a system architecture design and a network transmission design. The aim of the framework is to integrate data from existing information systems, to adopt medical informatics standards, to integrate diverse biometric sensors, and to provide different data transmission networks to support a patient's house network despite the facilities. The proposed framework has been evaluated with a case study of two telehealthcare programs, with and without the adoption of the framework. RESULTS: The proposed framework facilitates the functionality of the program and enables steady patient enrollments. The overall patient participations are increased, and the patient outcomes appear positive. The attitudes toward the service and self-improvement also are positive. CONCLUSIONS: The findings of this study add up to the construction of a telehealthcare system. Implementing the proposed framework further assists the functionality of the service and enhances the availability of the service and patient acceptances.

The evaluation of the nurses' work performance after nursing information system implementation in one medical center in Taiwan.

The purpose of this study was to evaluate the nurses' work performance before and after implementation of two nursing information subsystems: Patient Admission Nursing Documentation(PAND) and Physical Examination Documentation(PED) in 2351 beds medical center in Taiwan. Nurses' work performance was measured by time observation. The results of research showed that PAND increased the nurses' work performance 19.7% and PED increase the nurses' performance 2.8%.

The assessment of the mobile nursing cart in hospital adopting.

The purpose of this article was to express our assessment in mobile nursing cart adoption. The result shows the proper mobile nursing cart for the 150-160 cm height and 45-50 kg weight nurses should including below requirements 1. the height should be 95-100 cm, 2. the total weight should be less then 60 kg, 3. the lowest height of the notebook arm should be 90 cm away form the ground, 4. the power supply time should be more than six hours, 5. the computer screen size should be 15 inch, 6. the cart wheel size should be 5 inch. These should be the consideration for nursing managers to purchase mobile nursing carts in the future.