Safety Items Research Articles

Еще раз о прорезывании зубов у детей

The article focuses on teething in infants. Some disputable and additional points of this physiological process are discussed. Special attention is attributed to the facilities available for management of pathological symptoms accompanying primary tooth eruption process. Safety items and toxicological quality control of plant-based teething gels for infants are considered.

Analysis of fluid behaviour inside the brake lines in non anti-lock braking system

In a vehicle brake and steering systems are considered as critical safety items which have high severity however the brake pedal pulsation effect is seen unique in non anti-lock braking system (Non-ABS) cars. This effect in the non-ABS cars is practically solved by the service centers by adopting an orifice in the system. The reason behind the problem is analyzed by this study of brake fluid behavior under various operating conditions through the software as well as experiments. The fluid particles inside the brake system are affected by the presence of turbulence which will results in pulsation effect on brake pedals. Although the pedal feel was best in class under various circumstances, this study focuses on fixing the issue forecasting customer complaints by simulating practical results.

IMPLEMENTING HOME SAFETY TOOLKIT TO CAREGIVERS OF VETERANS WITH DEMENTIA

The purpose of this project was to study the processes necessary to make a Home Safety Toolkit (HST) for Veterans with dementia accessible to veterans and their caregivers. This Type 3 Implementation–Effectiveness Hybrid Research Design, included diagnostic analyses of the current processes by which Veterans receive home safety items, and identification of modifications necessary in order to provide the HST to Veterans with dementia. Two Veterans Health Administration Networks, one in the Northeast and one in the Mid-Atlantic region, participated. A formative evaluation used semi-structured interviews with key staff informants and caregivers identified facilitators and barriers to successful acquisition and use of home safety items. Qualitative data analysis reveals key barriers of time and cost, selection of best items, and caregiver reluctance to change. There was resounding support from caregivers regarding the potential benefits of self-paced toolkit including education and home safety items to implement for their veteran.

Directed content analysis of Veterans Affairs policy documents: A strategy to guide implementation of a dementia home safety toolkit for Veterans to promote ageing in place.

Older adults' preference to age in place, coupled with an increasing prevalence of dementia, creates an imperative to address home safety risks that occur due to cognitive impairment. Providing caregivers with home safety items and education can facilitate ageing in place for older adults living with dementia. In 2015-2017, we examined barriers and facilitators within 17 policy documents and dementia guidelines of the United States (US) Veterans Health Administration pertinent to implementation of a home safety toolkit (HST) for Veterans living with dementia. The documents were issued from 2000 to 2015. Directed qualitative content analysis of these documents guided by themes from stakeholder interviews revealed two key implementation barriers: a focus on physical rather than cognitive risks when determining medical necessity for home equipment, and a focus on rehabilitation and treatment rather than prevention. Mandates for person-centred care planning, including comprehensive assessment, interdisciplinary collaboration, staff education and a focus on population health in primary care facilitate HST implementation. Content analysis can identify policy-level barriers that slow innovation and facilitators that can increase access to care that support ageing in place.

Impact on Clinical Performance of Required Participation in a Student-Run Pro Bono Clinic

Background and Purpose. Early opportunities for students to develop clinical skills and professional attributes are important to maximize clinical learning. Student-run pro bono clinics have the potential to provide early contextual exposure. This article describes the impact of required compared to voluntary participation in a student-run pro bono clinic on clinical performance during the first full-time internship. Method/Model Description and Evaluation. Students in the University of Florida Doctor of Physical Therapy program were assigned to one of four service learning groups including a pro bono clinic. While attendance at the clinic was encouraged for all students, only the assigned group was required to attend twice a semester. A retrospective analysis of student performance on the Clinical Performance Instrument (CPI) for the first internship was conducted. Clinician CPI ratings were categorized as beginner or intermediate and above. Median scores for safety, professional practice, and practice management items for those students who were required to attend the clinic were compared to students from the other service learning groups who did not attend or attended voluntarily using Chi-square analysis. Outcomes. At midterm, a higher proportion of the required pro bono group were rated as intermediate or above by clinical instructors for safety, all professional practice items except professional development, and all patient management items except diagnosis/prognosis, education, and consideration of financial resources. Differences were present at the final evaluation for safety, professional behavior, cultural competence, clinical reasoning, and examination. Discussion and Conclusion. Positive outcomes were present for students involved in the pro bono clinic, illustrating the potential benefits of required pro bono clinic experiences early in a professional curriculum for accelerating clinical performance.

Implementation of a specific safety check is associated with lower postoperative mortality in cardiac surgery

IntroductionIn cardiac surgery, a preincision safety checklist may decrease complications and improve survival. Until now, it has not been demonstrated whether the implementation of such a checklist indeed reduces mortality. ObjectiveIntroduction of a preincision safety checklist on mortality was studied in a large adult cardiac surgery population. MethodsThis prospective, multicenter cohort study included 5937 consecutive adult patients, undergoing cardiac surgery, between January 2015 and December 2015, in 7 Dutch non-academic cardiac centers. The Isala Safety Check (ISC) is a short checklist addressing specific cardiac surgery safety items, in combination with a concise postinduction transesophageal echocardiography, which was gradually over time introduced in the 7 hospitals during 2015. We compared 120-day mortality and major complications between patients undergoing surgery with or without the use of the ISC. Propensity matching and Cox regression analyses were performed to adjust for potential confounders. ResultsThe ISC was applied in 2718 patients (46%). Comorbidity and age were comparable in both groups. In the ISC group, 120-day mortality was significantly lower (1.7% vs 3.0%; P < .01). Both after propensity matching (hazard ratio, 0.44; 95% confidence interval, 0.22-0.87) and Cox regression analysis (hazard ratio, 0.56; 95% confidence interval, 0.35-0.90), the use of the ISC was still associated with reduced 120-day mortality. Deep sternal wound infection, surgical re-exploration, and stroke were not significantly different between both groups. ConclusionsApplication of a short preincision safety checklist in a mixed population of adult cardiac surgery patients is associated with significantly reduced 120-day mortality.

Agricultural Spray Inspection According to ISO 16122: Part II—Determination of the State of Use and Conservation of Agricultural Sprayers

Considering the need to reduce environmental contamination and uplift the effectiveness and quality of pesticide application, this work had the goal to determine the conditions of use and conservation of agricultural sprayers used in the Central and Western border of the state of Rio Grande do Sul, and to identify the most frequent problems in agricultural sprayers. Fifty-six sprayers connected to a three-point hydraulic system and the tractor drawbar were inspected, evaluating the safety and operation items using the methodology described in the Standard ISO 16122. After the evaluations, the collected data were submitted to an exploratory analysis by using descriptive statistics with the use of percentage frequency. Based on the obtained results, it is possible to observe that the most serious problems are mainly related to the safety of the operator and the environment, since 41.07% of the sprayers did not have the protection of the cardan transmission and 33.93% did not have the protection of straps and pulleys. In addition, static leaks were present in 46.43% of the samples and 87.50% presented dynamic leaks. In 71.43% of the cases, there was no presence of a clean water reservoir to wash the rigid packagings. Therefore, it is possible to conclude that the state of use and conservation of the inspected sprayers is serious, justifying the need for inspections on agricultural sprayers to become mandatory in Brazil, also requiring government policies for the renewal of these equipments, as well as, the homologation of research centers to conduct tests on agricultural machinery and implements before their commercialization. In addition is also necessary to invest in training of operators by conducting technical courses about the importance of equipment knowledge, available technologies and necessary maintenance, as the level of knowledge is low about the basics of operational safety, maintenance and use of the sprayers which contributes to the high percentages of nonconformity with ISO 16122.

Sexting, Web-Based Risks, and Safety in Two Representative National Samples of Young Australians: Prevalence, Perspectives, and Predictors.

BackgroundThe rapid uptake of information and communication technology (ICT) over the past decade—particularly the smartphone—has coincided with large increases in sexting. All previous Australian studies examining the prevalence of sexting activities in young people have relied on convenience or self-selected samples. Concurrently, there have been recent calls to undertake more in-depth research on the relationship between mental health problems, suicidal thoughts and behaviors, and sexting. How sexters (including those who receive, send, and two-way sext) and nonsexters apply ICT safety skills warrants further research.ObjectiveThis study aimed to extend the Australian sexting literature by measuring (1) changes in the frequency of young people’s sexting activities from 2012 to 2014; (2) young people’s beliefs about sexting; (3) association of demographics, mental health and well-being items, and internet use with sexting; and (4) the relationship between sexting and ICT safety skills.MethodsComputer-assisted telephone interviewing using random digit dialing was used in two Young and Well National Surveys conducted in 2012 and 2014. The participants included representative and random samples of 1400 young people aged 16 to 25 years.ResultsFrom 2012 to 2014, two-way sexting (2012: 521/1369, 38.06%; 2014: 591/1400, 42.21%; P=.03) and receiving sexts (2012: 375/1369, 27.39%; 2014: 433/1400, 30.93%; P<.001) increased significantly, not sexting (2012: 438/1369, 31.99%; 2014: 356/1400, 25.43%; P<.001) reduced significantly, whereas sending sexts (2012: n=35/1369, 2.56%; 2014: n=20/1400, 1.43%; P>.05) did not significantly change. In addition, two-way sexting and sending sexts were found to be associated with demographics (male, second language, and being in a relationship), mental health and well-being items (suicidal thoughts and behaviors and body image concerns), and ICT risks (cyberbullying others and late-night internet use). Receiving sexts was significantly associated with demographics (being male and not living with parents or guardians) and ICT risks (being cyberbullied and late-night internet use). Contrary to nonsexters, Pearson correlations demonstrated that all sexting groups (two-way, sending, and receiving) had a negative relationship with endorsing the ICT safety items relating to being careful when using the Web and not giving out personal details.ConclusionsOur research demonstrates that most young Australians are sexting or exposed to sexting in some capacity. Sexting is associated with some negative health and well-being outcomes—specifically, sending sexts is linked to suicidal thoughts and behaviors, body image issues, and ICT safety risks, including cyberbullying and late-night internet use. Those who do sext are less likely to engage in many preventative ICT safety behaviors. How the community works in partnership with young people to address this needs to be a multifaceted approach, where sexting is positioned within a wider proactive conversation about gender, culture, psychosocial health, and respecting and caring for each other when on the Web.

PPGIS and Public Use in Protected Areas: A Case Study in the Ebro Delta Natural Park, Spain

This paper analyses public use in the Ebro Delta Natural Park using PPGIS (public participation geographic information system) methodology. An online survey was designed using Google Maps API, HTML, and JAVASCRIPT. Respondents were asked to place and rate thirteen items on an interactive map to characterize and georeference public use with regard to accessibility, facilities and services, signposting, safety and security, and leisure activities. In total we collected 209 valid surveys and mapped 2617 georeferenced opinions. Facilities and services were rated highly by users (72.46% were “very satisfied”). These were followed by accessibility (61%, “very satisfied”) and signposting (60.2%, “satisfied” or “quite satisfied”). Safety and security items were hardly rated perhaps because users do not feel insecure in the area. Respondents’ mapping of opinions and experiences, which are heterogeneous and were well rated, enabled us to visualize areas that might be understood as social hotspots. Our results show that PPGIS is an effective procedure for measuring public use in protected areas and may be a valuable tool for park managers and planners.

Strategic Environmental Assessment (SEA) Process towards the Sustainable Design and Construction of Computer, Communication, Network Engineering, Machine Learning and Artificial Intelligence Systems

Strategic Environmental Assessment (SEA) Process towards the Sustainable Design and Construction of Computer, Communication, Network Engineering, Machine Learning and Artificial Intelligence Systems

National Survey of Medication Safety Practice: Patient Education, Quality Process and Risk Management at Primary Healthcare Centers/Community Pharmacies in Riyadh, Saudi Arabia

Pharmacology, Toxicology and Biomedical Reports,2019,5,1,36-43.DOI:10.5530/PTB.2019.5.7Published:January 2019Type:Research ArticleAuthors:Yousef Ahmed Alomi, Zainab Abdulmunem Almuallem, Manar Mohammed Alslim, Khulud Abdulrahman Alamoudi, Adel Mehmas H. Alragas, and Rana Mohammed Alslim Author(s) affiliations:Yousef Ahmed Alomi*, The Past General Manager of General Administration of Pharmaceutical Care, Head, National Clinical Pharmacy and Pharmacy Practice, Head, Pharmacy R & D Administration, Ministry of Health, Riyadh- 11392, SAUDI ARABIA. Zainab Abdulmunem Almuallem, Saudi Food and Drug Authority, Riyadh, SAUDI ARABIA. Manar Mohammed Alslim, Staff Pharmacist, Prince Sultan Military Medical City, Riyadh, SAUDI ARABIA. Khulud Abdulrahman Alamoudi, Narcotic in-charge, Alhammadi Hospital, Riyadh, SAUDI ARABIA. Adel Mehmas H. Alragas, Medical City-king Saud University, Riyadh, SAUDI ARABIA. Rana Mohammed Alslim, Staff Pharmacist, Ministry of Health, Riyadh, SAUDI ARABIA. Abstract:Objective: To explore the national medication safety practice such as patient education, quality process and risk management at primary healthcare centers (PHCs) and community pharmacies (CPs) in Riyadh city, Kingdom of Saudi Arabia. Methods: This is a four-month cross-sectional medication safety practice survey conducted at PHC pharmacies and CPs in Riyadh city. The survey consisted of the modified version of the Medication Safety Self-Assessment® for Community/Ambulatory Pharmacy from the Institute of Safe Medication Practice (ISMP). The survey consisted of a demographic section and 10 domains with 198 questions. The domains included questions on patient information; drug information; communication of drug orders and other drug information; drug labeling and packaging and nomenclature; use of devices; environmental factors; staff competency and education; patient education; quality processes; and risk management domain. In this study, we emphasized on patient education, quality process and risk management; it is a finding from medication safety self-assessment for community/ ambulatory pharmacy in Riyadh city. Results: The survey was distributed to 13 PHC pharmacies and 23 CPs. The average score of all ISMP-self assessment of medication safety items at PHCs was 2.75±0.36 (54.94%) (95% confidence interval (95% CI)=2.55–2.95; P<0.05; range=2.04–3.38). The average score of all ISMP-self assessment of medication safety items at CPs was 3.14±0.42 (62.86%) (95% CI=2.90–4.38; P<0.05; range=2.40–3.88). The average score of patient education at PHCs was 3.04±0.365 (60.8%) (95% CI=2.89–3.19; P<0.05; range=2.00–3.73) and at CPs, it was 3.73±0.29 (74.6%) (95% CI=3.61–3.85; P<0.05; range=3.11–4.22). The average score of quality processes and risk management at PHCs was 2.76±0.35 (55.2 %) (95% CI=2.64–2.88; P<0.05; range=2.09–3.50) and at CPs, it was 3.20 ±0.38 (64%) (95% CI=3.07–3.33; P<0.05; range=2.47–3.89). Conclusion: The implementation of patient education and quality processes and risk management at PHCs and CPs were inadequate. Targeting to improve all meditations safety assessment tools at PHCs and CPs is highly recommended in the Kingdom of Saudi Arabia. Keywords:Community Pharmacies, Education, Medication, Primary Healthcare Centers, Quality, Risk Management, Riyadh, Safety, Saudi ArabiaView:PDF (384.85 KB) PDF PDF Images National Survey of Medication Safety Practice: Patient Education, Quality Process and Risk Management at Primary Healthcare Centers/Community Pharmacies in Riyadh, Saudi Arabia

National Survey of Medication Safety Practice: Preparation of Medication and Dispensing at Primary Healthcare Centers/Community Pharmacies in Riyadh, Saudi Arabia

Pharmacology, Toxicology and Biomedical Reports,2018,4,3,49-57.DOI:10.5530/PTB.2018.4.15Published:September 2018Type:Research ArticleAuthors:Yousef Ahmed Alomi, Adel Mehmas H. Alragas, Manar Mohammed Alslim, Rana Mohammed Alslim, Khulud Abdulrahman Alamoudi, and Zainab Abdulmunem Almuallem Author(s) affiliations:Yousef Ahmed Alomi1, Adel Mehmas H. Alragas2, Manar Mohammed Alslim3, Rana Mohammed Alslim4, Khulud Abdulrahman Alamoudi5, Zainab Abdulmunem Almuallem​6 1The Former General Manager of General Administration of Pharmaceutical Care, The Former Head, National Clinical pharmacy and pharmacy practice, The Former Head, Pharmacy R and D Administration, Ministry of Health, Riyadh, SAUDI ARABIA. 2Medical city-king Saud university, Riyadh, SAUDI ARABIA. 3Staff pharmacist, Prince Sultan Military Medical City, Riyadh, SAUDI ARABIA. 4Staff pharmacist, Ministry of Health, Riyadh, SAUDI ARABIA. 5Narcotic in-charge, Alhammadi hospital Riyadh, SAUDI ARABIA. 6Saudi Food and Drug Authority Riyadh, SAUDI ARABIA. Abstract:Objective: To explore the national medication safety practice in terms of medication preparation and dispensing at Primary Healthcare Centers (PHCs) and Community Pharmacies (CPs) in Riyadh, Kingdom of Saudi Arabia. Methods: This is a 4-month cross-sectional medication safety practice survey conducted at PHCs and CPs in Riyadh. The survey consisted of the modified version of the Medication Safety Self-Assessment® for Community/Ambulatory Pharmacy from the Institute for Safe Medication Practices (ISMP). The survey consisted of a demographic section and 10 domains with 198 questions. The 10 domains included patient information; drug information; communication of drug orders and other drug information; drug labeling, packaging and nomenclature; use of medical devices; environmental factors; staff competency and education; patient education; quality processes; and risk management. This study emphasizes on the medication preparation and dispensing as per the Medication Safety Self-Assessment for Community/Ambulatory Pharmacy, Riyadh. Results: The survey was distributed to 13 PHCs and 23 CPs. The average score of all the ISMP self-assessment of medication safety items at PHCs was 2.75±0.36 (54.94 %) with 95% confidence interval (95% CI) = 2.55–2.95 (P<0.05; range = 2.04–3.38). The average score of all the ISMP self-assessment of medication safety items at CPs was 3.14±0.42 (62.86%) with 95% CI = 2.90–4.38 (P<0.05; range = 2.40–3.88). The average score of the communication of drug orders and other drug information domain at all hospitals were 2.57±0.38 (51.4 %) with 95% CI = 2.36–2.78 (P<0.05; range = 1.92–3.25) at PHCs and in the CPs, it was 2.44±0.35 (48.8 %) with 95% CI = 2.245–2.635 (P<0.05; range = 2.00–3.09). The average score of drug labeling, packaging and nomenclature domain at all hospitals was 2.57± 0.41 (51.4 %) with 95% CI = 2.35–2.79 (P<0.05; range = 1.83–3.08) at PHCs and in CPs, it was 3.2±0.59 (64%) with 95% CI = 2.89–3.51, (P<0.05; range = 2.20–4.05). Conclusion: Fifty percent of medication safety critical elements of ISMP standards was implemented during the preparation and dispensing of medication in the PHCs and CPs. Targeting to improve medication safety key at PHCs and CPs to prevent drug-related problems is required in the Kingdom of Saudi Arabia. Keywords:Adverse drug reaction, Ministry of Health, Pharmaceutical Care, Saudi Arabia, SystemView:PDF (316.8 KB) PDF PDF Images Scores of Items of Communication of Drug Orders and other Drug Information Domain.

Analytic Hierarchy Process for Evaluation Weights on Occupational Safety and Hygiene Items in the Bridge Construction Site

This paper aims to evaluate key factors that associate Occupational Safety and Hygiene management during bridge constructions by the Analytic Hierarchy Process (AHP). Data were collected from experts’ questionnaires and conducted on the Expert Choice 2000 software. It finds that electrocution factor plays an important factor on this study rather than fall injury factor as one knows. The reason maybe cause by that electrocution events have less been reported by supervisor than fall injury events. This study found that the results from AHP analysis were partial consistent with traditional labor safety and hygiene assessment item that fall injury factor shows. Hence, it is ensured that AHP model has capacity to evaluate weights on occupational safety and hygiene management assessment items in bridge constructions and to provide more in-sighted objective (electrocution) on this topic.

The Colonoscopy Satisfaction and Safety Questionnaire (CSSQP) for Colorectal Cancer Screening: A Development and Validation Study.

Colonoscopy services working in colorectal cancer screening programs must perform periodic controls to improve the quality based on patients’ experiences. However, there are no validated instruments in this setting that include the two core dimensions for optimal care: satisfaction and safety. The aim of this study was to design and validate a specific questionnaire for patients undergoing screening colonoscopy after a positive fecal occult blood test, the Colonoscopy Satisfaction and Safety Questionnaire based on patients’ experience (CSSQP). The design included a review of available evidence and used focus groups to identify the relevant dimensions to produce the instrument (content validity). Face validity was analyzed involving 15 patients. Reliability and construct and empirical validity were calculated. Validation involved patients from the colorectal cancer screening program at two referral hospitals in Spain. The CSSQP version 1 consisted of 15 items. The principal components analysis of the satisfaction items isolated three factors with saturation of elements above 0.52 and with high internal consistency and split-half readability: Information, Care, and Service and Facilities features. The analysis of the safety items isolated two factors with element saturations above 0.58: Information Gaps and Safety Incidents. The CSSQP is a new valid and reliable tool for measuring patient’ experiences, including satisfaction and safety perception, after a colorectal cancer screening colonoscopy.

Strategic Environmental Assessment (SEA) Process for Green Materials and Environmental Engineering Systems towards Sustainable Development-Business Excellence Achievements

Strategic Environmental Assessment (SEA) Process for Green Materials and Environmental Engineering Systems towards Sustainable Development-Business Excellence Achievements

Implementation of Occupational Sun Safety at a 2-Year Follow-Up in a Randomized Trial: Comparison of Sun Safe Workplaces Policy Intervention to Attention Control.

Implementation of employer sun safety actions was assessed in a 2-year follow-up to an occupational sun protection policy intervention. Two-year follow-up assessment in a randomized pretest-posttest controlled design. Local government organizations with workers in public safety, public works, and parks and recreation. Sixty-three local government organizations (participation = 64%) and 330 frontline supervisors and 1454 workers. Sun Safe Workplaces (SSW) intervention promoting occupational sun safety policy and education. Observations of SSW messages and sun safety items and surveys on organizations' communication and actions on sun safety. Comparison between SSW and control groups was conducted using regression models and adjusted for clustering where appropriate, with α criterion set at P = .05 (2-tailed). At intervention worksites, more SSW messages ( P < .001) and sun safety items ( P = .025) were observed; more frontline supervisors reported organizations provided free/reduced price sunscreen ( P = .005) and communicated about sun safety ( P < .001); and more workers recalled receiving sun safety messages ( P < .001) and sun safety training ( P <.001) compared to control organizations. Implementation was greater at larger than smaller intervention organizations for wide-brimmed hats ( P = .009), long work pants ( P = .017), and shade structures ( P = .036). Older workers received the most written messages ( P = .015). Sun Safe Workplaces appeared to produce actions by organizations to support employee sun safety. Large organizations may have processes, communication channels, and slack resources to achieve more implementation.

Injury Prevention Education in the Waiting Room of an Underserved Pediatric Primary Care Clinic.

Unintentional injuries are the leading cause of childhood mortality in the United States. Study aims included educating families about injury prevention and improving satisfaction with the waiting room experience. Two hundred caregivers with young children in the waiting room of an underserved pediatric primary care clinic participated in brief individual education sessions and received a toolkit containing small safety items and content highlighting age-appropriate safety topics. Participants completed 2 follow-up surveys, and most caregivers (94%) reported learning new information about injury prevention and thought that the intervention resulted in a better waiting room experience (91%). Of those who completed the 2-week follow-up survey (84%), 93.5% made changes at home and 42.7% bought new safety equipment. Injury prevention education can be effectively provided in the waiting room of a pediatric primary care clinic by improving reported caregiver safety knowledge and behaviors as well as satisfaction with the waiting room experience.

Management of Construction Safety: The Failure and Success of Stakeholders

At global level, the building construction sites are unsafe, Nigeria in particular. Site operatives are unprotected against risk. Fall, slip, trip, struck-by, and electric shock are predominant accidents on the building construction sites, while stakeholders are only engrossed with passion for cost, quality and timely delivery of project. Consequent upon the persistent accident occurrence on the building construction sites, the study aimed at revealing the failures of construction stakeholders in the effective management of construction safety. In achieving this, an extensive literature review was engaged, which exposes a copious number of factors responsible for accident as a result of failure on the part of the construction stakeholders. Establishing the causes of these accidents is paramount, as it serves as a precursor to unveiling the playable roles by the stakeholders in mitigating accident occurrence on building construction sites. Consequently, the study unearths the success factors for effective management of safety on construction sites which are inclusive of: consultants awarding contracts to contractors with good safety records, contractors enforcing the use of safety items and compliance of workers with safety regulations, giving necessary reports on safety issues, organising safety training, setting up safety committee, and embarking on thorough safety inspection and supervision. Finally, the client should ensure that enough funds are devoted to safety of workers as well as engaging competent and safety conscious professionals in building project.

Use of a Novel, Electronic Health Record–Centered, Interprofessional ICU Rounding Simulation to Understand Latent Safety Issues*

The electronic health record is a primary source of information for all professional groups participating in ICU rounds. We previously demonstrated that, individually, all professional groups involved in rounds have significant blind spots in recognition of patient safety issues in the electronic health record. However, it is unclear how team dynamics impacts identification and verbalization of viewed data. Therefore, we created an ICU rounding simulation to assess how the interprofessional team recognized and reported data and its impact on decision-making. Each member of the ICU team reviewed a simulated ICU chart in the electronic health record which contained embedded patient safety issues. The team conducted simulated rounds according to the ICU's existing rounding script and was assessed for recognition of safety issues. Academic medical center. ICU residents, nurses, and pharmacists. None. Twenty-eight teams recognized 68.6% of safety issues with only 50% teams having the primary diagnosis in their differential. Individually, interns, nurses, and pharmacists recognized 30.4%, 15.6%, and 19.6% of safety items, respectively. However, there was a negative correlation between the intern's performance and the nurse's or the pharmacist's performance within a given team. The wide variance in recognition of data resulted in wide variance in orders. Overall, there were 21.8 orders requested and 21.6 orders placed per case resulting in 3.6 order entry inconsistencies/case. Between the two cases, there were 145 distinct orders place with 43% being unique to a specific team and only 2% placed by all teams. Although significant blind spots exist in the interprofessional team's ability to recognize safety issues in the electronic health record, the inclusion of other professional groups does serve as a partial safety net to improve recognition. Electronic health record-based, ICU rounding simulations can serve as a test-bed for innovations in ICU rounding structure and data collection.

Safety and Health Cost Allocation for Urban Rail Infrastructure Project: Identifying issues and importance

This paper presents the findings of a preliminary survey, which is consist of the identification of issues and importance of safety and health cost allocation. Semi-structured interviews were conducted with seven (7) construction stakeholders who are involved in urban rail infrastructure project. The transcription and interpretation from the interview findings were carried out using Atlas.ti© qualitative software. The respondent views are needed to obtain safety items and related issues in developing this framework mainly for estimating the safety cost allocation.