Definition Of Error Research Articles

Non-reporting of Medication Administration Errors among Nurses in Qatar

Background: Prompt recognition and reporting of Medication Administration Errors (MAE) are paramount in ensuring patient safety in hospitals. The data on under-reporting MAE in Middle East Area is limited.
 Aim: The study intended to estimate the percentage of fear factor and explore the perception of nursing professionals regarding the reason for the occurrence and underreporting of MAE.
 Design: A cross-sectional design was utilized to conduct the current study.
 Place and Duration of Study: The study was conducted in eight hospitals working under Public health sector of Qatar between August and September 2016 
 Methodology: The data were collected with a purposive sample of 487 clinical nurses employed by the public health sector of Qatar who responded to a pre-designed online questionnaire.
 Results: The perceived prevalence of fear factor in non-reporting MAE was 23.45%, 95% confidence interval (C.I).: 16% to 33%. The single factor confirmatory factor analysis (CFA) model explained 65% of the variance in the fear factor of nonreporting of medication administration errors. The highest mean score in the subscale of reasons for non-reporting of MAEs includes fear (mean 0.652±1.671) and administrative responses (mean 0.304±1.466), and reporting processes (mean -0.505±1.669), whereas disagreement over hospital definition (mean -1.158±1.528) of error was the least significant reason for nonreporting of MAE by the clinical nurses.
 Conclusion: The study focuses on quantifying the fear factor and underscores the Nurses' fear about the professional consequences of reporting MAE. The findings in this study not only provide evidence concerning the fear of reporting MAE but also shed light on the contributing factors and reasons for the nonreporting of MAE. Nursing leadership needs to concentrate on modifying existing strategies and policies to more comprehensible approaches to reporting errors.

Assessment of Remote Sensing Techniques Applicability for Beach Morphology Mapping: A Case Study of Hvar Island, Central Adriatic, Croatia

This study investigates the quality and accuracy of remote sensing data in beach surveys based on three different data sources covering a 10-year period (2011–2021). Orthophotos from State Geodetic Administration Geoportal and satellite imagery from Google Earth were compared with orthophotos generated from UAV using ArcGIS Pro and Drone2Map. The beach area and length of 20 beaches on the island of Hvar were measured using each data source from different years. The average deviation for beach area (−2.3 to 5.6%) and length (−1 to 2.7%) was determined (without outliers). This study confirms that linear feature measurement is more accurate than polygon-based measurement. Hence, smaller beach areas were associated with higher errors. Furthermore, it was observed that morphological complexity of the beach may also affect the measurement accuracy. This work showed that different remote sensing sources could be used for relatively accurate beach surveys, as there is no statistically significant difference between the calculated errors. However, special care should always be addressed to the definition of errors.

Adaptive particle refinement strategies in smoothed particle hydrodynamics

Adaptive particle refinement (APR) can increase the efficiency of mesh-free particle methods by splitting mother particles into smaller daughter particles. However, most APR algorithms are based on solving a minimization problem in which a single mother particle is split into several daughter particles. This may cause insufficient accuracy because APR is typically adopted in problems where many mother particles are involved in splitting, and a superposition effect may occur in the refinement error field between neighboring mother particles. Hence, we develop a novel APR strategy for the smoothed particle hydrodynamics (SPH) method based on direct splitting multiple mother particles to obtain more accurate optimal APR parameters. In addition, angular momentum conservation conditions are derived and a new algorithm is proposed to implement periodic boundary conditions for open-channel flows. Furthermore, for the first time, we conduct a rigorous parametric study to investigate factors affecting the optimal APR parameters, including the split patterns, kernel types, the density calculation algorithms as well as refinement error definitions. This APR strategy is validated through five benchmark test cases. Test results show that the proposed algorithm can both improve the simulation accuracy, reduce the computational cost and show good flexibility for implementation.

Probabilistic Storm Surge Estimation for Landfalling Hurricanes: Advancements in Computational Efficiency Using Quasi-Monte Carlo Techniques

During landfalling tropical storms, predictions of the expected storm surge are critical for guiding evacuation and emergency response/preparedness decisions, both at regional and national levels. Forecast errors related to storm track, intensity, and size impact these predictions and, thus, should be explicitly accounted for. The Probabilistic tropical storm Surge (P-Surge) model is the established approach from the National Weather Service (NWS) to achieve this objective. Historical forecast errors are utilized to specify probability distribution functions for different storm features, quantifying, ultimately, the uncertainty in the National Hurricane Center advisories. Surge statistics are estimated by using the predictions across a storm ensemble generated by sampling features from the aforementioned probability distribution functions. P-Surge relies, currently, on a full factorial sampling scheme to create this storm ensemble, combining representative values for each of the storm features. This work investigates an alternative formulation that can be viewed as a seamless extension to the current NHC framework, adopting a quasi-Monte Carlo (QMC) sampling implementation with ultimate goal to reduce the computational burden and provide surge predictions with the same degree of statistical reliability, while using a smaller number of sample storms. The definition of forecast errors adopted here directly follows published NWS practices, while different uncertainty levels are considered in the examined case studies, in order to offer a comprehensive validation. This validation, considering different historical storms, clearly demonstrates the advantages QMC can offer.

Drug Dose Calculator Application to Prevent Medication Errors

As a part of the essentials in achieving patient safety, medication errors are one of the most financially detrimental problems in the treatment process faced by health institutions. This article firstly debriefs the definition of medication error and its general classification based on the treatment process. Wrong dose calculation has become one of the most frequent medication errors, especially among anesthesiology-care providers. This article then concisely defines the side effects of commonly-used anesthesia drugs in critical and perioperative care. This article examines medication errors prevalence among anesthesiologists and investigates the line between several risk factors and wrong dosage calculation. Finally, this article concludes with the elucidation of current trends of drug dosage calculators and several studies that aim to validate and prove the efficacy of those applications.

Perturbation analysis of baroclinic torque in low-Mach-number flows

In this paper, we propose a series expansion of the baroclinic torque in low-Mach-number flows, so that the accuracy and universality of any buoyancy term could be examined analytically, and new types of buoyancy terms could be constructed and validated. We first demonstrate that the purpose of introducing a buoyancy term is to approximate the baroclinic torque, and straightforwardly the error of any buoyancy term could be defined with the deviation of its curl from the corresponding baroclinic torque. Then a regular perturbation method is introduced for the elliptic equation of the hydrodynamic pressure in low-Mach-number flows, resulting in a sequence of Poisson equations, whose solutions lead to the series representation of the baroclinic torque and the new types of buoyancy terms. It is found that the frame invariance of the momentum equation is maintained with one of the new types of buoyancy terms. With the error definition of buoyancy terms and the series representation of the baroclinic torque, the validity and accuracy of previous and new buoyancy terms are examined. Finally, numerical simulations confirm that, with a decreasing density variation or an increasing order of our new buoyancy term, the simplified equations can converge to the original low-Mach-number equations.

Improving patient safety through identifying barriers to reporting medication administration errors among nurses: an integrative review

BackgroundThe aim of the third WHO challenge released in 2017 was to attain a global commitment to lessen the severity and to prevent medication-related harm by 50% within the next five years. To achieve this goal, comprehensive identification of barriers to reporting medication errors is imperative.ObjectiveThis review systematically identified and examined the barriers hindering nurses from reporting medication administration errors in the hospital setting.DesignAn integrative review.Review methodsPubMed, Web of Science, EMBASE, and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) including Google scholar were searched to identify published studies on barriers to medication administration error reporting from January 2016 to December 2020. Two reviewers (AA, and KDK) independently assessed the quality of all the included studies using the Mixed Methods Appraisal Tool (MMAT) version 2018.ResultsOf the 10, 929 articles retrieved, 14 studies were included in this study. The main themes and subthemes identified as barriers to reporting medication administration errors after the integration of results from qualitative and quantitative studies were: organisational barriers (inadequate reporting systems, management behaviour, and unclear definition of medication error), and professional and individual barriers (fear of management/colleagues/lawsuit, individual reasons, and inadequate knowledge of errors).ConclusionProviding an enabling environment void of punitive measures and blame culture is imperious for nurses to report medication administration errors. Policymakers, managers, and nurses should agree on a uniform definition of what constitutes medication error to enhance nurses’ ability to report medication administration errors.

Automated identification of diagnostic labelling errors in medicine.

ObjectivesIdentification of diagnostic error is complex and mostly relies on expert ratings, a severely limited procedure. We developed a system that allows to automatically identify diagnostic labelling error from diagnoses coded according to the international classification of diseases (ICD), often available as routine health care data.MethodsThe system developed (index test) was validated against rater based classifications taken from three previous studies of diagnostic labeling error (reference standard). The system compares pairs of diagnoses through calculation of their distance within the ICD taxonomy. Calculation is based on four different algorithms. To assess the concordance between index test and reference standard, we calculated the area under the receiver operating characteristics curve (AUROC) and corresponding confidence intervals. Analysis were conducted overall and separately per algorithm and type of available dataset.ResultsDiagnoses of 1,127 cases were analyzed. Raters previously classified 24.58% of cases as diagnostic labelling errors (ranging from 12.3 to 87.2% in the three datasets). AUROC ranged between 0.821 and 0.837 overall, depending on the algorithm used to calculate the index test (95% CIs ranging from 0.8 to 0.86). Analyzed per type of dataset separately, the highest AUROC was 0.924 (95% CI 0.887–0.962).ConclusionsThe trigger system to automatically identify diagnostic labeling error from routine health care data performs excellent, and is unaffected by the reference standards’ limitations. It is however only applicable to cases with pairs of diagnoses, of which one must be more accurate or otherwise superior than the other, reflecting a prevalent definition of a diagnostic labeling error.

PReCEP: Automatic insertion of Partial Redundancy based on Critical Error Probability

As constrained edge devices face growingly compute-intensive applications, efficient accelerators must be designed under tight budgets, especially when fault tolerance is required. Costs can be reduced with partial redundancy techniques, but they typically aim at minimizing the occurrence of errors regardless of application-level definitions of critical errors. In this work we propose Partial Redundancy based on Critical Error Probability (PReCEP). With a critical error definition provided by application developers, PReCEP automatically inserts partial redundancy to mitigate critical errors. Results show that with half the overhead of traditional triplication, up to 93% (76% on average) critical error mitigation is achieved by PReCEP.

Nurses' Decisions in Error Reporting and Disclosing Based on Error Scenarios: A Mixed-method Study

Background: It is ensured that nurses’ error reporting and disclosing improve services to patients and are considered a movement toward creating a culture of transparency in the healthcare system. Objectives: This study aimed to investigate the nurses' decisions on reporting and disclosing Medical Errors (MEs). Methods: This research followed a mixed-method embedded design that was performed in five hospitals in Iran in 2018. A total of 491 nurses participated in the quantitative phase of the study with stratified sampling, followed by a simple random sampling technique. Also, 22 nurses joined the qualitative phase. Data were collected using a researcher-made questionnaire and semi-structured interviews through a scenario-based method. Quantitative data analysis was performed using descriptive and analytical statistics by SPSS 21.0 and Expert Choice 10.0 software. The qualitative data were analyzed based on the content analysis approach. Results: The most important perceived barriers with the highest impact coincided with educational (57.17%) and motivational (56.77%) factors based on SEM analysis (ES: 1.33, SE: 0.16). Regression analysis showed that error-reporting mechanisms, educational factors, and reporting consequences were significantly associated with age, sex, and work experience (P-Value ≤0.05). Error scenarios were thematized into three categories: Error perception (including ambiguity and weakness in error definition, the severity of the error, unawareness of guidelines, deviation from standards, and untrained staff), error reporting (including ineffective reporting system, hesitation in reporting to a formal system, increased workload, improper reaction, punitive responses, and concerns about consequences), and error disclosure (including no disclosure, partial disclosure, and full disclosure). Conclusions: The obtained results contributed to a better understanding of the barriers to error reporting and disclosing. In addition, these results can help hospitals encourage error reporting and ultimately make organizational changes, which reduce the incidence of errors.

Suppression of the High-Frequency Errors in Surface Topography Measurements Based on Comparison of Various Spline Filtering Methods.

The metrology of so-called “engineering surfaces” is burdened with a substantial risk of both measurement and data analysis errors. One of the most encouraging issues is the definition of frequency-defined measurement errors. This paper proposes a new method for the suppression and reduction of high-frequency measurement errors from the surface topography data. This technique is based on comparisons of alternative types of noise detection procedures with the examination of profile (2D) or surface (3D) details for both measured and modelled surface topography data. In this paper, the results of applying various spline filters used for suppressions of measurement noise were compared with regard to several kinds of surface textures. For the purpose of the article, the influence of proposed approaches on the values of surface topography parameters (from ISO 25178 for areal and ISO 4287 for profile standards) was also performed. The effect of the distribution of some features of surface texture on the results of suppressions of high-frequency measurement noise was also closely studied. Therefore, the surface topography analysis with Power Spectral Density, Autocorrelation Function, and novel approaches based on the spline modifications or studies of the shape of an Autocorrelation Function was presented.

Using Patient Experience Surveys to Assess Diagnostic Safety in Urgent Care

Research ObjectiveDiagnostic error is the leading patient safety concern in the U.S. One in twenty patients seeking care in the U.S. is estimated to be harmed by diagnostic errors annually. Identifying diagnostic pitfalls is a significant challenge. This study explored the utility of negative sentiment free‐text comments from patient satisfaction surveys to identify patient‐perceived failures in the diagnostic process within an urgent care context.Study DesignWe used an exploratory mixed‐methods study design to explore perceived breakdowns in diagnosis in urgent care. We systematically coded negative sentiment free‐text responses from de‐identified Clinician and Group Consumer Assessment of Healthcare Providers and Systems (CG‐CAHPS) surveys using content and semantic analyses. The coding schema was designed to discern concepts within the definition of diagnostic error and the pitfalls in the diagnostic process presented in the National Academy of Medicine's 2015 report on improving diagnosis. The process includes six domains: patient engagement with the health system, information gathering, information interpretation, working diagnosis, diagnosis communication, and treatment. Descriptive statistics are used to summarize the results.Population StudiedAdult patients (≥18 years) presenting to urgent care centers between January and December 2019 who completed a CG‐CAHPS survey and included a response to one of two open ended questions on the survey. We selected urgent care for the study because patients do not have an existing relationship with the provider and access urgent care for primary and emergent care concerns.Principal FindingsDuring the study period, 7245 CG‐CAHPS surveys were completed and returned. Of these, 4315 (60%) patients included a free‐text comment. Most of the comments were from women (n = 3072; 71.2%) with a mean age of 58 years (SD = 17). Of the total reports, 1630 (37.8%) were sentiment coded as negative. Negative reporters were primarily women (n = 1175; 72.1%) and younger than those reporting positive, neutral, or both positive and negative sentiments. Of the free‐text responses coded as negative, 328 (20%) reported at least one breakdown in the diagnostic process. The 328 reports translated to 548 breakdowns in the diagnostic process. Breakdowns were reported by patients across all six domains of the diagnostic process. Most breakdowns occurred during information gathering (n = 172;31.4%) and treatment (n = 148; 27.0%). Phrases used to describe a wrong diagnosis included “misdiagnosed,” “incorrectly diagnosed,” “my diagnosis was incorrect,” “get the diagnosis correct,” “proper diagnosis and care,” and “wrong diagnosis” (n = 91; 27.7%). We also observed 15 (4.5%) reports of “missed diagnosis”. Diagnostic accuracy and timeliness were also questioned in 117 (35.7%) and 139 (42.4%) of reports.ConclusionsPatients have unique and powerful insights on diagnostic safety in urgent care settings. Patient experience surveys are an unlikely but rich source of patient‐perceived diagnostic safety issues, particularly identifying issues in information gathering (history and physical examination) and treatment.Implications for Policy or PracticeLearning healthcare systems should promote the utilization of patient experience surveys to estimate the impact of diagnostic errors and to design systems‐based solutions for improving diagnostic safety.Primary Funding SourceAgency for Healthcare Research and Quality.

PD48-09 COMPARISON OF NON-INVASIVE MEASUREMENTS OF PENILE CURVATURE IN PEYRONIE'S DISEASE

You have accessJournal of UrologySexual Function/Dysfunction: Peyronie's Disease (PD48)1 Sep 2021PD48-09 COMPARISON OF NON-INVASIVE MEASUREMENTS OF PENILE CURVATURE IN PEYRONIE'S DISEASE Rubens Pedrenho Neto, Bruno C. G. Nascimento, Cristovão Machado Barbosa Neto, Jose de Bessa Junior, Miguel Srougi, and William Carlos Nahas Rubens Pedrenho NetoRubens Pedrenho Neto More articles by this author , Bruno C. G. NascimentoBruno C. G. Nascimento More articles by this author , Cristovão Machado Barbosa NetoCristovão Machado Barbosa Neto More articles by this author , Jose de Bessa JuniorJose de Bessa Junior More articles by this author , Miguel SrougiMiguel Srougi More articles by this author , and William Carlos NahasWilliam Carlos Nahas More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002070.09AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Peyronie’s disease (PD) is a fibrotic disorder of the tunica albuginea, leading to penile deformities. Non-invasive estimates of penile deformities are practical, but have low accuracy when compared to objective measurements with induced erection and a goniometer. Our aim was to evaluate the agreement between different non-invasive methods of measuring penile curvature and the objective measurement. METHODS: We retrospectively reviewed medical records of patients who underwent surgery in a sexual medicine tertiary center. During the clinical visit, pre-operatively, a set of different non-invasive estimates were performed including asking the patient to explain their primary curvature with a goniometer, a drawing of the penis and a malleable implant prosthesis to be molded. Also, at home photography were required with maximal erection. The agreement of those methods and intra-operative measurement using a goniometer after saline induced erection was analyzed. A tolerable error was considered if a difference smaller than 10o or 20% of the gold standard measurement was found. RESULTS: The sample consisted of 69 men with a mean age of 62 ± 6 years old. The direction of the curvature was dorsal in 59%, left in 35%, right in 5% and ventral in 1%. Mean curvature with of estimates with the goniometer was 57o (±31), drawing 60 o (±28), Prosthesis 60o (±25), Photography 57 o (±27), and mean intra-operative measurement was 51 o (± 24). Overall precision considering the above mentioned tolerable error definition was 45%, and the single non-invasive method with better precision was Prosthesis with 46,5% fo concordance. There was no statistical difference between them (p=0.99) for concordance and disagreement by the Dunnett's multiple comparisons test. CONCLUSIONS: In our comparison study of 4 non-invasive curvature assessment methods, we found a low precision (approximately 45%), regardless of the chosen method. Formal curvature assessment with induced erection and a goniometer appears to be imperative. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e841-e841 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Rubens Pedrenho Neto More articles by this author Bruno C. G. Nascimento More articles by this author Cristovão Machado Barbosa Neto More articles by this author Jose de Bessa Junior More articles by this author Miguel Srougi More articles by this author William Carlos Nahas More articles by this author Expand All Advertisement Loading ...

Self-Adaptive Path Tracking Control for Mobile Robots under Slippage Conditions Based on an RBF Neural Network

Wheeled mobile robots are widely implemented in the field environment where slipping and skidding may often occur. This paper presents a self-adaptive path tracking control framework based on a radial basis function (RBF) neural network to overcome slippage disturbances. Both kinematic and dynamic models of a wheeled robot with skid-steer characteristics are established with position, orientation, and equivalent tracking error definitions. A dual-loop control framework is proposed, and kinematic and dynamic models are integrated in the inner and outer loops, respectively. An RBF neutral network is employed for yaw rate control to realize adaptability to longitudinal slippage. Simulations employing the proposed control framework are performed to track snaking and a DLC reference path with slip ratio variations. The results suggest that the proposed control framework yields much lower position and orientation errors compared with those of a PID and a single neuron network (SNN) controller. It also exhibits prior anti-disturbance performance and adaptability to longitudinal slippage. The proposed control framework could thus be employed for autonomous mobile robots working on complex terrain.

Errors, faults and failures

Aim. To harmonize the definitions of errors, faults, failures in the Russian and English languages. The Object of the paper is one of the most important subject matters of the dependability theory and functional safety. The Subject of the paper is the concepts and definitions of failures, errors, faults.Results of the research: analysis of the definitions of the concepts describing the dependability and functional safety of items in the Russian and international standards, such as GOST 27.002-2015, GOST R/IEC 61508-2012, IEC 60050, DIN 40041, as well as in publications by a number of authors. The analysis shows that failure is always associated with the loss of function, i.e., the ability to perform as required by all standards. It should be noted that wrong user expectation does qualify as failure. A failure should be distinguished from unintended functions. A fault is defined as a system’s inability to perform the required operation to the full extent that, under certain conditions, may escalate into a failure. An error as a discrepancy between a calculated, observed or measured value or condition and a true, specified or theoretically correct value or condition is a deviation that is present and, under certain conditions, would probably turn into a failure. A typical example is non-critical software errors. The so-called systematic failures are actually errors that can turn into critical errors (failures). Let us note that the definitions in the IEC 60050 international electrotechnical vocabulary can be used, as they show general agreement, which is not surprising for an international standard.

Error Evaluation of the Crown Profile of Logarithmic Generatrix Roller

In order to realize the accurate assessment of the profile error of the crown of the bearing roller, according to the geometric characteristics and the definition of the shape error of the contour element of the logarithmic bus-type roller, based on the principle of least squares, the least squares piece-wise fitting and error evaluation method of the logarithmic bus-type (combined form of the two-segment logarithmic curve) bearing roller crown profile are studied. Firstly, the three-point method is used to determine the curvature of the discrete data points of the convexity curve, and the boundary point of the two logarithmic curves is determined by the curvature difference method. Secondly, the measuring points adjacent to both sides of the dividing point are selected as auxiliary dividing points; the auxiliary dividing points and the corresponding logarithmic curve segment measuring points are fitted together to fit a series of least squares curves and calculate the corresponding errors. Through comparison and judgment, the least square error of the logarithmic bus-type roller profile is finally determined. Finally, through comparison and judgment, the least square error of the logarithmic bus-type roller profile is finally determined. The example results show that the total error of the logarithmic bus-type roller crown profile curve is 0.0071mm. The method in this paper can effectively realize the fitting and error evaluation of the bearing crown profile error, and it also verifies that the logarithmic prime line can reduce the stress concentration and improve the service life of the bearing.

What do you mean by false positive.

Misunderstandings regarding the term “false positive” present a significant hurdle to broad adoption of eDNA monitoring methods. Here, we identify three challenges to clear communication of false-positive error between scientists, managers, and the public. The first arises from a failure to distinguish between false-positive eDNA detection at the sample level and false-positive inference of taxa presence at the site level. The second is based on the large proportion of false positives that may occur when true-positive detections are likely to be rare, even when rates of contamination or other error are low. And the third misunderstanding occurs when conventional species detection approaches, often based on direct capture, are used to confirm eDNA approaches without acknowledging or quantifying the conventional approach’s detection probability. The solutions to these issues include careful and consistent communication of error definitions, managing expectations of error rates, and providing a balanced discussion not only of alternative sources of species DNA, but also of the detection limitations of conventional methods. We argue that the benefit of addressing these misunderstandings will be increased confidence in the utility of eDNA methods and, ultimately, improved resource management using eDNA approaches.The term false positive is often misused in eDNA research and natural resource management. There are issues of scale of inference, the base rate fallacy, and confirmation errors using conventional methods of detection. We offer a perspective to guide discussions of errors in species detection.

EXPERIMENTAL VERIFICATION OF READINESS OF HEADS OF GENERAL SECONDARY EDUCATION INSTITUTIONS FOR ANTI-CRISIS MANAGEMENT IN THE PROCESS OF INCREASING QUALITY

In the article the step-by-step analysis of experimental check of readiness of heads of establishments of general secondary education to anti-crisis management in system of advanced training is carried out. It is concluded that the pedagogical experiment in order to diagnose the readiness of general secondary education managers for crisis management consisted of three successive stages: diagnostic, ascertaining and formative. Theoretical researches of general problems of management are analyzed. The procedure of selection of test methods, which were used to establish the state of readiness of general secondary education managers for crisis management in the system of advanced training, is described. It was found that each diagnostic tool, ie measurement, must meet the criteria for quality assessment, the most important of which are: objectivity, reliability, validity, accuracy. Each diagnostic tool, depending on the measurement tools, made it possible to obtain results only with some degree of accuracy, which characterizes the degree of fluctuation of the measured parameter, and is defined as the minimum or systematic measurement error by this method. Objectivity involves minimizing the impact of subjective factors, which is ensured by standardization of the procedure of measurement, data processing and interpretation of diagnostic results. Reliability implies the degree of stability of diagnostic results, which is ensured by the optimization of parameters and objectivity of the measuring instrument and the stability of the feature, the level of which is diagnosed; quantitative characteristic of reliability - reliability coefficient R. Accuracy involves the definition and minimization of measurement error. Error is the opposite of reliability. The diagnostic tool is as reliable as it accurately reveals the true achievements or abilities of general secondary education managers to crisis management in the training system.
 The validity of the diagnostic tool involves the conformity of what is measured to what needs to be measured. Validity is legality, reality, validity, fidelity, correctness, suitability, as well as relevance - relevance. Validity indicates whether the test measures the specified values.
 Psychodiagnostic techniques used in the study were represented as tests of achievements of heads of secondary education institutions in the field of crisis management; they were provided to highlight the extent to which principals had accomplished the training objectives.
 It is taken into account that the test should measure what has been stated and studied, nothing more, nothing less, nothing superfluous. The digital results of the statement experiment are represented. According to the digital indicators of the input control (statement stage of the experimental study), the heads of secondary schools KG (control groups) and EG (experimental groups) had the same conditions for admission to the experimental study.

Performance Characteristics of Breezhaler® and Aerolizer® in the Real-World Setting.

The evaluation of errors in use with different inhaler devices is challenging to quantify as there are a number of definitions of critical and non-critical errors with respect to inhaler use; in addition, performance characteristics of the device, such as airflow resistance, can also influence effective use in the real-world setting. Repeated observations and checking/correcting inhaler use are essential to optimise clinical effectiveness of inhaled therapy in patients. Breezhaler® is a single unit-dose dry powder inhaler used in chronic obstructive pulmonary disease and in asthma (budesonide) that has low airflow resistance, making it easier for patients of varying disease severities to achieve the inhalation flow rate required for lung deposition of treatment. Similar to Breezhaler®, the Aerolizer® is a single unit-dose dry powder inhaler used in asthma management with low airflow resistance. Studies have shown relatively low rates of critical errors with Breezhaler® and Aerolizer®, with similarities in the critical errors reported; these data on critical errors together with similarities in the usability of Breezhaler® and Aerolizer® further support the functional similarity between the two devices in both asthma and chronic obstructive pulmonary disease. Breezhaler® also has patient-feedback features, including use of a transparent drug capsule that can be checked after inhalation to see it is empty. The low resistance of the dose-confirming Breezhaler® results in less inspiratory effort being required by patients for its effective use, which allows the device to be used effectively across a wide age range of patients and disease severities.

Barriers to Incident Reporting among Nurses: A Qualitative Systematic Review.

Incident reporting in health care prevents error recurrence, ultimately improving patient safety. A qualitative systematic review was conducted, aiming to identify barriers to incident reporting among nurses. Joanna Briggs Institute methodology for qualitative systematic reviews was followed, with data extracted using JBI QARI tools, and selected studies assessed for methodological quality using Critical Appraisal Skills Program (CASP). A meta-aggregation synthesis was carried out, and confidence in findings was assessed using GRADE ConQual. A total of 921 records were identified, but only five studies were included. The overall methodological quality of these studies was good and GRADE ConQual assessment score was "moderate." Fear of negative consequences was the most cited barrier to nursing incident reporting. Barriers also included inadequate incident reporting systems and lack of interdisciplinary and interdepartmental cooperation. Lack of nurses' necessary training made it more difficult to understand the importance of incident reporting and the definition of error. Lack of effective feedback and motivation and a pervasive blame culture were also identified.