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Bava M.,IRCCS Burlo Garofolo Institute for Maternal and Child Health | Bava M.,University of Trieste | Bradaschia F.,IRCCS Burlo Garofolo Institute for Maternal and Child Health | Rovere F.,IRCCS Burlo Garofolo Institute for Maternal and Child Health | And 5 more authors.
Biomedical Sciences Instrumentation | Year: 2010

Total Parenteral Nutrition (TPN) is defined as feeding a patient by infusing nutrients intravenously, bypassing the usual process of eating and digestion. There are two kinds of TPN: short-term TPN may be used when a patient's digestive system is temporarily nonfunctional because of an interruption in its continuity; long-term TPN is used to treat patients with an impairment or a lack in nutrient absorption. TPN has extended the life of children born with nonexistent or severely deformed digestive organs and is a vital support for these patients. In Burlo's Pediatric Department, pediatricians fill in a pharmacy request form in which nutritional needs are included for each patient. Subsequently, clinical pharmacists evaluate the patient's individual data and decide which TPN formula to prepare. To enhance the TPN prescription process, an intranet web-based system has been developed to replicate the original paper-based forms. The software, developed in PHP and based on open source tools and services, has been constructed according to pharmacists' requirements. These professionals, together with the Hospital Information System technicians, thanks to the availability of affordable instruments, perceive the advantages that such a system would have in improving clinical practice and quality of care. The system was devised with the goal to avoid common reading errors, to improve the correct text comprehension, to ensure prescription preparation, administration and tracking. According to a process of total quality control, the system reduces clinical risks regarding issues such as the correct and rapid availability of medical prescriptions and the incorrect identification of the patients. In comparison with paper-based TPN prescriptions, electronic-based forms have reduced the incidence of errors, the possible lack of patient data and reading misunderstandings. Regarding future improvements, IT technicians are defining the procedures to implement digital signature and medical aspects of the electronic TPN medical prescriptions.


Zotti D.,IRCCS Burlo Garofolo Institute for Maternal and Child Health | Zotti D.,University of Trieste | Bava M.,IRCCS Burlo Garofolo Institute for Maternal and Child Health | Bava M.,University of Trieste | Delendi M.,IRCCS Burlo Garofolo Institute for Maternal and Child Health
Biomedical Sciences Instrumentation | Year: 2010

According to the Italian law which regulates executive healthcare contracts, the professional evaluation is mandatory. The goal of the periodic evaluation is to enhance and motivate the professional involved. In addition this process should 1. increase the sense of duty towards the patients, 2. become aware of one's own professional growth and aspirations and 3. enhance the awareness of the healthcare executive regarding the company's strategies. To satisfy these requirements a data sheet has been modeled for every evaluated subject, divided in two sections. In the first part, the chief executive officer (CEO) scores: 1. behavioral characteristics, 2. multidisciplinary collaboration and involvement, 3. organizational skills, 4. professional quality and training, 5. relationships with the citizens. The scores for these fields are decided by the CEO. In the second part the CEO evaluates: 1. quantitative job dimension, 2.technology innovation, 3. scientific and educational activities. The value scores of these fields are decided by the CEO together with the professional under evaluation. A previously established correction coefficient can be used for all the scores. This evaluation system model has been constructed according to the enhancement quality approaches (Deming cycle) and a web-based software has been developed on a Linux platform using LAMP technology and php programming techniques. The program replicates all the evaluation process creating different profiles of authentications and authorizations which can then give to the evaluator the possibility to make lists of the professionals to evaluate, to upload documents regarding their activities and goals, to receive individual documents in automatically generated folders, to change the correction coefficients, to obtain year by year the individual scores. The advantages of using this web-based software include easy data consultation and update, the implementation of IT security issues, the easy portability and scalability of the system itself in different contexts even beyond healthcare. Copyright 2010 ISA. All Rights Reserved.

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