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A useful patient admission prediction model that helps the emergency department of a hospital admit patients efficiently is of great importance. It not only improves the care quality provided by the emergency department but also reduces waiting time of patients. This paper proposes an automatic prediction method for patient admission based on a fuzzy min–max neural network (FMM) with rules extraction. The FMM neural network forms a set of hyperboxes by learning through data samples, and the learned knowledge is used for prediction. In addition to providing predictions, decision rules are extracted from the FMM hyperboxes to provide an explanation for each prediction. In order to simplify the structure of FMM and the decision rules, an optimization method that simultaneously maximizes prediction accuracy and minimizes the number of FMM hyperboxes is proposed. Specifically, a genetic algorithm is formulated to find the optimal configuration of the decision rules. The experimental results using a large data set consisting of 450740 real patient records reveal that the proposed method achieves comparable or even better prediction accuracy than state-of-the-art classifiers with the additional ability to extract a set of explanatory rules to justify its predictions.
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Ongoing challenges for nurses working in the primary care/community setting include professional development external policy which esteems productivity greater than the quality of care and changes in the economy which have shaped the community at large.
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Ongoing challenges for nurses working in the primary care/community setting include professional development external policy which esteems productivity greater than the quality of care and changes in the economy which have shaped the community at large.
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The aim of the present paper was to review the opportunities currently available to health service planners to advance sustainable development in their future-facing roles within health service organisation. Critical challenges and enablers to facilitate health services planners in adopting a pro-environmental lens are discussed. What is known about the topic? Despite its harmful effect on the environment, health has been slower than other industries to embrace the sustainable development agenda. The attitudes and knowledge base of health service planners with regard to environmental sustainability has not been widely studied. For health service planners, embracing pro-environmental considerations in sustainable model of care development is a powerful opportunity to review care paradigms and prepare for the implementation of meaningful, improved health and system efficiency. What does this paper add? This paper advances the case for health service planners to embrace a pro-environmental stance and guides health service leaders in the preparation and implementation of sustainable and improved health and system efficiency. What are the implications for practitioners? Health service planers are in an ideal position to champion the sustainable development agenda as they explore what care is delivered, how care is delivered and where care is delivered. External policy, health service leadership and carbon literacy are advanced as critical contextual factors to facilitate the key role that health service planners can play in building sustainable healthcare organisations.
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Little is known about why nurses escalate a Medical Emergency Team (MET) response based on ‘worried’ criteria or what clinical findings define a ‘worried’ MET call. Limited clarity exists in nursing literature regarding the clinical definition of ‘worried’ in medical emergencies. Commonly ‘worried’ terminology is associated with nursing intuition about a patient's condition before signs of decline in clinical condition. This research has identified the exact clinical cause of ‘worried’ escalations, with evidence to support that clinical reasoning and patient deterioration are the main cause of ‘worried’ activation. This research has also highlighted areas for further professional development to enhance levels of patient safety and quality care within a regional hospital setting.
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Introduction: Rural and remote populations experience the greatest burden of chronic obstructive pulmonary disease (COPD), the fifth leading cause of death in Australia. Currently there is a need to prioritise health services to improve health outcomes among those at higher risk of COPD. Objectives: To investigate the differences in COPD hospitalisation between rural and urban populations and determine predictive factors contributing to COPD hospitalisation. Methods: Statewide hospitalisation data from 2010 to 2015 were obtained through the Victorian Admitted Episodes Dataset and other key data sets. The rates of hospitalisation were analysed using hierarchical multiple regression to examine the association between COPD hospitalisations and a number of predictor variables. Results: The highest COPD incidence occurred in metropolitan males aged 85 years of age and older (35.092 hospitalisations per 1000 population). Among metropolitan residents, smoking, population density and household income had a significant association with COPD hospitalisations for both sexes. Among rural males, smoking rates, household income and rural land use (farming) were significant predictors of COPD hospitalisations. There was an overall stability in statewide COPD hospitalisation over the 5 years to 2015, P = 0.420. Conclusion: This investigation highlights many rural and regional areas have much lower COPD hospitalisation rates than metropolitan areas. Between males and females, there are heterogenetic factors that contribute to the significant variation associated with COPD hospitalisation in metropolitan and rural areas, such as rural land use among rural males. This indicates that risk factor assessments, beyond smoking alone, need to be individualised and prioritised in practice to optimise care.
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Introduction: Rural and remote populations experience the greatest burden of chronic obstructive pulmonary disease (COPD), the fifth leading cause of death in Australia. Currently there is a need to prioritise health services to improve health outcomes among those at higher risk of COPD. Objectives: To investigate the differences in COPD hospitalisation between rural and urban populations and determine predictive factors contributing to COPD hospitalisation. Methods: Statewide hospitalisation data from 2010 to 2015 were obtained through the Victorian Admitted Episodes Dataset and other key data sets. The rates of hospitalisation were analysed using hierarchical multiple regression to examine the association between COPD hospitalisations and a number of predictor variables. Results: The highest COPD incidence occurred in metropolitan males aged 85 years of age and older (35.092 hospitalisations per 1000 population). Among metropolitan residents, smoking, population density and household income had a significant association with COPD hospitalisations for both sexes. Among rural males, smoking rates, household income and rural land use (farming) were significant predictors of COPD hospitalisations. There was an overall stability in statewide COPD hospitalisation over the 5 years to 2015, P = 0.420. Conclusion: This investigation highlights many rural and regional areas have much lower COPD hospitalisation rates than metropolitan areas. Between males and females, there are heterogenetic factors that contribute to the significant variation associated with COPD hospitalisation in metropolitan and rural areas, such as rural land use among rural males. This indicates that risk factor assessments, beyond smoking alone, need to be individualised and prioritised in practice to optimise care.
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"This study uses two examples of occupational health and safety problems encountered in nine major hospitals to illustrate that hospitals fail to identify, evaluate and share information adequately. The two safety examples used are 1. Needle-stick incidents 2. The potential for injuries associated with floor cleaning methods."
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Masters Degree in Applied Science, Occupational Health and Safety
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Information technology and high-tech systems used daily in hospitals increase the demand for measuring information security threats in the healthcare industry. The impact of complexity of using new healthcare information and communications technology (ICT) devices places more pressure on the healthcare community to perceive different information systems (IS) security threats as they involve different IS management models. This research study focused on measuring the healthcare community perceptions and on the following issues to include definition of information security perception of information security threats perception of information security management and perception of information security in the context of another healthcare community. To assess to plan, design and implement a national information security strategy for their healthcare sector. A survey was developed and interviewed 60 healthcare employees from three hospitals based in Dubai. The research results assist in creating awareness for easy access to hands-on guidelines for the healthcare community, thereby increasing the awareness levels of information security in the United Arab Emirates (UAE). These results assist the UAE government to further adapt the training and education programs for the healthcare community to increase their effectiveness and efficiency levels of IT and subsequent IS development. A discussion of the current status of Dubai hospitals privacy, confidentiality and security challenge is presented.
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Summary Objective To investigate the effect of cathodal transcranial direct‐current stimulation (c‐tDCS) on seizure frequency in patients with drug‐resistant temporal lobe epilepsy (TLE). Method Twenty‐nine patients with drug‐resistant TLE participated in this study. They were randomized to experimental or sham group. Twenty participants (experimental group) received within‐session repeated c‐tDCS intervention over the affected temporal lobe, and nine (sham group) received sham tDCS. Paired‐pulse transcranial magnetic stimulation was used to assess short interval intracortical inhibition (SICI) in primary motor cortex ipsilateral to the affected temporal lobe. SICI was measured from motor evoked potentials recorded from the contralateral first dorsal interosseous muscle. Adverse effects were monitored during and after each intervention in both groups. A seizure diary was given to each participant to complete for 4 weeks following the tDCS intervention. The mean response ratio was calculated from their seizure rates before and after the tDCS intervention. Results The experimental group showed a significant increase in SICI compared to the sham group (F = 10.3, p = 0.005). None of the participants reported side effects of moderate or severe degree. The mean response ratio in seizure frequency was −42.14% (standard deviation [SD] 35.93) for the experimental group and −16.98% (SD 52.41) for the sham group. Significance Results from this pilot study suggest that tDCS may be a safe and efficacious nonpharmacologic intervention for patients with drug‐resistant TLE. Further evaluation in larger double‐blind randomized controlled trials is warranted.
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ObjectivesThis study aimed to examine COVID-19 patients’ experiences in a Fangcang shelter hospital in China, to provide insights into the effectiveness of this centralised isolation strategy as a novel solution to patient management during emerging infectious disease outbreaks.DesignThis study adopted a qualitative descriptive design. Data were collected by individual semistructured interviews and analysed using thematic analysis.SettingThis study was undertaken in 1 of the 16 Fangcang shelter hospitals in Wuhan, China between 28 February 2020 and 7 March 2020. Fangcang shelter hospitals were temporary healthcare facilities intended for large-scale centralised isolation, treatment and disease monitoring of mild-to-moderate COVID-19 cases. These hospitals were an essential component of China’s response to the first wave of the COVID-19 pandemic.ParticipantsA total of 27 COVID-19 patients were recruited by purposive sampling. Eligible participants were (1) COVID-19 patients (2) above 18 years of age and (3) able to communicate effectively. Exclusion criteria were (1) being clinically or emotionally unstable and (2) experiencing communication difficulties.ResultsThree themes and nine subthemes were identified. First, COVID-19 patients experienced a range of psychological reactions during hospitalisation, including fear, uncertainty, helplessness and concerns. Second, there were positive and negative experiences associated with communal living. While COVID-19 patients’ evaluation of essential services in the hospital was overall positive, privacy and hygiene issues were highlighted as stressors during their hospital stay. Third, positive peer support and a trusting patient–healthcare professional relationship served as a birthplace for resilience, trust and gratitude in COVID-19 patients.ConclusionsOur findings suggest that, while sacrificing privacy, centralised isolation has the potential to mitigate negative psychological impacts of social isolation in COVID-19 patients by promoting meaningful peer connections, companionship and support within the shared living space. To our knowledge, this is the first study bringing patients’ perspectives into healthcare service appraisal in emergency shelter hospitals.