Significant Differences In Error Rates Research Articles

Event-related potentials and behavioral correlates of emotional recognition memory in late pregnancy.

Research on cognitive and emotional functions during pregnancy challenges the prevalent perception of cognitive decline in pregnant women. This study investigates the behavioral and neural dynamics of cognitive-affective processing in third-trimester pregnant women, comparing them with non-pregnant controls. Using a 64-channel EEG-ERP system, we recorded brain activity as participants engaged in an emotional word recognition task. This task involved initially viewing a sequence of emotional and neutral words, followed by a recognition test where participants identified each word as 'new' or 'previously seen'. Contrary to widespread beliefs about diminished recognition ability during late pregnancy, our results revealed no significant differences in error rates between groups. However, pregnant participants demonstrated slower reaction times. In terms of neural responses, pregnant women exhibited increased amplitudes in the N1, P2, and N400 ERP components, suggesting that they may require additional brain resources compared with non-pregnant individuals to process perceptual information. A significant interaction was observed between pregnancy status and the emotional valence of stimuli. Pregnant women showed heightened N1 and N400 responses to negative words, indicating increased sensitivity to stimuli potentially representing threat. This enhanced response was not observed for positive or neutral words. Furthermore, there was an amplified N1 response to 'new' words, but not to 'old' words. These findings suggest that late pregnancy is characterized by heightened responsiveness to new and particularly negative stimuli, potentially leading to a more cautious behavioral approach. Heightened vigilance and sensitivity could offer evolutionary advantages, optimizing fetal development and enhancing maternal well-being.

Spelling Development of Korean 1st Graders with and without Developmental Dyslexia

Objectives: This study examined the word writing abilities of Korean 1st graders with and without developmental dyslexia (DD) considering meaning accessibility and the structure of a Korean syllable. Methods: Fifteen typically developing children (TD) and fifteen children with developmental dyslexia were assigned word writing tasks in the first and second semesters of the first year. The word writing task contains ten words and ten non-words containing forty syllable-initial and syllable-medial graphemes, and twenty-two syllable-final graphemes. The analysis of the results was conducted in grapheme units, and the accuracy for each word/nonword and the error rate for each structure of a syllable was determined. Results: The DD group showed significant growth in both words/nonwords writing accuracy by the second semester, and the error rates of syllable-initial, syllable-medial, and syllable-final graphemes significantly decreased from the first to the second semester for the DD group. The TD group showed no significant difference in word/non-words writing, and there was no significant difference in error rates according to the structure of a syllable. Both the DD and TD groups showed higher error rates in final graphemes in both the first and second semesters. Conclusion: The word writing abilities of the DD group showed significant growth between the first and second semesters but still had difficulties, particularly in the final grapheme writing. The TD group developed word writing first, and nonword writing was still in development. But final grapheme writing was difficult even for TD group. Follow-up studies are needed to closely observe the developmental processes comparing with decoding level matched TD children.

Alterations in performance and discriminating power of the death/suicide implicit association test across the lifespan

The Death/Suicide Implicit Association Test (d/s-IAT) has differentiated individuals with prior and prospective suicide attempts in previous studies, however, age effects on test results remains to be explored. A three-site study compared performance on the d/s-IAT among participants aged 16–80 years with depression and prior suicide attempt (n = 82), with depression and no attempts (n = 80), and healthy controls (n = 86). Outcome measures included the standard difference (D) score, median reaction times, and error rates. Higher D scores represent a stronger association between death/suicide and self, while lower scores represent a stronger association between life and self. The D scores differed significantly among groups overall. Participants with depression exhibited higher scores compared to healthy controls, but there was no difference between participants with and without prior suicide attempts(F[2,242]=8.76, p<.001). Response times for participants with prior attempts differed significantly from other groups, with no significant differences in error rates. The D score was significantly affected by age (β =-0.007, t = 3.65, p<.001), with slowing of response times in older ages. Results suggest reaction time d/s-IAT D scores may not distinguish implicit thinking about suicide as response times slow with age, but slowed response times may be sensitive to suicide risk potentially indicating basic information processing deficits.

Effects of Visual and Auditory Instructions on Space Station Procedural Tasks

In order to compare the effects of visual and auditory instructions on the crew when guiding astronauts to complete the procedural tasks in the space station, in this study, subjects were recruited to complete the programmed task of starting from the node module, locating the scientific cabinet and spectrometer, and finally operating the orbital replaceable unit on the spectrometer. Meanwhile, the task performance, eye movement parameters, and cognitive load induced by 2 kinds of instructions in the task were statistically analyzed. The results showed that there were highly significant differences in terms of task completion time, the NASA-TLX (Task Load Index) total score, and eye movement index between the 2 instructions ( P &lt; 0.01). There were also significant differences in error rate and effort ( P &lt; 0.05). This study proves that visual instruction interaction is better than auditory instruction. Our work provides important reference for the selection of human–computer interaction mode for procedural tasks on space stations. It also provides the experience and theoretical evidence missing so far and proves the benefits of augmented reality assistance in terms of task performance and human factors.

Distance-invoked difficulty as a trigger for errors in Chinese and Japanese EFL learners’ English writings

Abstract This study investigates how distance-invoked difficulty, proficiency level and cross-linguistic similarity affect error occurrences by analysing 240 English compositions from Chinese and Japanese learners of English as a foreign language (EFL). Dependency distance was used as a metric to measure distance-invoked difficulty and four major types of dependency relations were investigated. The findings reveal that low- and middle-level Chinese and Japanese EFL learners have higher error rates with long-distance dependency relations, but high-level learners can overcome the distance-invoked difficulty and make fewer errors. Chinese and Japanese EFL learners make more errors in long-distance adverbial and relative clauses than in short-distance ones, which are L1-dissimilar dependency relations. They make fewer errors in L1-similar relations, i.e., long-distance subject-predicate dependency relations. Japanese EFL learners, however, showed no significant differences in error rates between long- and short-distance predicate-object dependency relations. The results indicate the complex interaction between the EFL learners’ cognition, proficiency and L1.

91 Intraindividual Variability and Executive Functioning Differences in Pedophilic and Non-Pedophilic Child Molesters and Non-Sexual Offenders

Objective:Research has found that child molesters (both pedophilic and non-pedophilic) tend to have poorer executive functioning (EF), particularly inhibition, as compared to other types of criminal offenders (Eastvold, Suchy, Strassberg, &amp; 2011; Suchy, Whittaker, Strassberg, &amp; Eastvold, 2009). Poorer performance on measures of inhibition may have different mechanisms for pedophilic child molesters (PCM; i.e., those offenders who are sexually attracted only to children) than non-pedophilic child molesters (N-PCM; i.e., those offenders whose sexual attraction is not limited to children). Specifically, poor inhibition in PCM may be explained by slower processing speed (Suchy, et al., 2009; Suchy, Eastvold, Strassberg, &amp; Franchow, 2014), whereas it may be explained by impulsive errors in N-PCM (Eastvold, Suchy, &amp; Strassberg, 2011). Intraindividual variability (IIV) refers to transient, short-term fluctuations in performance (Nesselroade, 1991). IIV is sometimes interpreted as a measure of cognitive control, an aspect of EF that could impact performance speed and accuracy due to poorer focus.Greater IIV also appreas to be associated with greater vulnerability to EF depletion after behavioral inhibition (DesRuisseaux, Suchy, &amp; Franchow, 2021), which could represent a mechanism whereby vulnerability to EF depletion could be a precursor of offense. However, given that poor performance on measures of inhibition seem to have different underlying mechanisms for PCM and N-PCM, it is unclear whether both groups would exhibit greater IIV compared to non-sexual offenders.Participants and Methods:Participants were PCM (n = 76, M age = 33.61(7.74), Range = 1947; 92.1% White, 2.6% Hispanic/Latino, 2.6% Native American, 1.3% Black, 1.3% Other), N-PCM (n = 52, M age = 30-88(6.37), Range = 2045; 73.1% White, 13.5% Hispanic/Latino, 7.7% Other, 3.8% Native American, 1.9% Black), and non-sexual offenders (n = 25, M age = 29.96(8.16), Range = 22-45; 80% White, 8% Hispanic/Latino, 8% Other, 8% Asian) recruited as part of two larger studies examining cognition in sex offenders. IIV was assessed using the Push-Turn-Tap-Tap (PTT) task, an experimental computerized measure of EF from which IIV can be calculated (DesRuisseaux et al., 2021).Results:Independent samples t-tests found that both PCM and N-PCM had greater IIV than nonsexual offenders (t(99) = 2.13, p = .04; t(75) = 2.23, p = .03, respectively). Even on their fastest responses, PCM had greater time elapsed between correct sequences (i.e., slower response style; t(126) = 2.23, p = .03) than N-PCM. There were no significant differences in error rates between any groups (p &gt; .05).Conclusions:These results suggest that IIV varies between sexual and non-sexual offenders but does not vary between PCM and N-PCM. This is consistent with prior research suggesting that both PCM and N-PCM have poorer EF than non-sexual offenders. Additionally, consistent with prior research, PCM had a slower response style than N-PCM and non-sexual offenders. Unlike prior research that has found significant differences in accuracy rates between PCM and N-PCM, the present results did not find a significant difference. Since IIV has been associated with increased likelihood of EF depletion (likely increasing risk of lapses), future research could examine whether CM with greater IIV have an increased likelihood of reoffending.

The Effect of Prehospital Clinical Trial-Related Procedures on Scene Interval, Cognitive Load, and Error: A Randomized Simulation Study

Introduction Globally, very few settings have undertaken prehospital randomized controlled trials. Given this lack of experience, there is a risk that such trials in these settings may result in protocol deviations, increased prehospital intervals, and increased cognitive load, leading to error. Ultimately, this may affect patient safety and mortality. The aim of this study was to assess the effect of trial-related procedures on simulated scene interval, self-reported cognitive load, medical errors, and time to action. Methods This was a prospective simulation study. Using a cross-over design, ten teams of prehospital clinicians were allocated to three separate simulation arms in a random order. Simulations were: (1) Eligibility assessment and administration of freeze-dried plasma (FDP) and a hemoglobin-based oxygen carrier (HBOC), (2) Eligibility assessment and administration of HBOC, (3) Eligibility assessment and standard care. All simulations also required clinical management of hemorrhagic shock. Simulated scene interval, error rates, cognitive load (measured by NASA Task Load Index), and competency in clinical care (assessed using the Simulation Assessment Tool Limiting Assessment Bias (SATLAB)) were measured. Mean differences between simulations with and without trial-related procedures were sought using one-way ANOVA or Kruskal-Wallis test. A p-value of <0.05 within the 95% confidence interval was considered significant. Results Thirty simulations were undertaken, representing our powered sample size. The mean scene intervals were 00:16:56 for Simulation 1 (FDP and HBOC), 00:17:22 for Simulation 2 (HBOC only), and 00:14:24 for Simulation 3 (standard care). Scene interval did not differ between the groups (p = 0.27). There were also no significant differences in error rates (p = 0.28) or cognitive load (p = 0.67) between the simulation groups. There was no correlation between cognitive load and error rates (r = 0.15, p = 0.42). Competency was achieved in all the assessment criteria for all simulation groups. Conclusion In a simulated environment, eligibility screening, performance of trial-related procedures, and clinical management of patients with hemorrhagic shock can be completed competently by prehospital advanced life support clinicians without delaying transport or emergency care. Future prehospital clinical trials may use a similar approach to help ensure graded and cautious implementation of clinical trial procedures into prehospital emergency care systems.

Using global navigation satellite systems for modeling athletic performances in elite football players

This study aims to predict individual Acceleration-Velocity profiles (A-V) from Global Navigation Satellite System (GNSS) measurements in real-world situations. Data were collected from professional players in the Superleague division during a 1.5 season period (2019–2021). A baseline modeling performance was provided by time-series forecasting methods and compared with two multivariate modeling approaches using ridge regularisation and long short term memory neural networks. The multivariate models considered commercial features and new features extracted from GNSS raw data as predictor variables. A control condition in which profiles were predicted from predictors of the same session outlined the predictability of A-V profiles. Multivariate models were fitted either per player or over the group of players. Predictor variables were pooled according to the mean or an exponential weighting function. As expected, the control condition provided lower error rates than other models on average (p = 0.001). Reference and multivariate models did not show significant differences in error rates (p = 0.124), regardless of the nature of predictors (commercial features or extracted from signal processing methods) or the pooling method used. In addition, models built over a larger population did not provide significantly more accurate predictions. In conclusion, GNSS features seemed to be of limited relevance for predicting individual A-V profiles. However, new signal processing features open up new perspectives in athletic performance or injury occurrence modeling, mainly if higher sampling rate tracking systems are considered.

Effects of semi-automatic pistol slide pull device on law-enforcement racking process

Under life-threatening circumstances, the interaction between law enforcement officers and pistol slides during the racking and reloading process is critical to survival. Nine expert law-enforcement officers were recruited to investigate the effects of slide pull devices on application time and performance using semi-automatic pistols. Participants were asked to manually rack both standard and augmented slide pull devices and then clean three magazines. Videos and times were recorded to compare the slide types. Using a Welch’s t-test, no racking time difference between standard and augmented (p=0.9756) was found, but there is a slightly statistically significant difference in error rate (p=0.0765), with the augmented slide causing fewer errors. Additionally, seven of the nine officers preferred the augmented to the standard slide. Despite the lack of statistical significance with an α-level of.05, the biomechanical differences between slides and user preferences may indicate that slide types can augment participants’ performances to be more precise.

The Effect of Mask Wearing on the Accuracy of Radiology Reports in an Academic Hospital Setting.

In response to the pandemic, some public health agencies recommend the wearing of surgical masks in indoor spaces including radiology common reporting rooms. We aim to demonstrate whether mask wearing may lead to increased errors incidence in radiology reports. Our prospective studywas conveyed in 2 parts. Firstly, the participants were surveyed if they believed that mask affected dictation. Then participants performed a dictation: they read artificial radiology reports using a commercial voice recognition (VR) system. They performed this task 5 times, each time donning a different mask in random order: a surgical mask, surgical visor, N-95, combination of 2 surgical masks and no mask. Error rates were compared with the Friedman test followed by pairwise Wilcoxon with bootstrapping. Multivariate Poisson regression was performed to test for interaction effects between potential predictors. 52 members of an academic radiology department participatedin the study (January - March 2021) . 65.4% of survey participants did not think or were not sure whether mask wearing could affect dictation process. Treating the no-mask condition as baseline, our study found that mean error rates significantly increased up to 2 times the baseline rate when a surgical mask, surgical visor, N-95 or a combination of 2 masks was donned (p < 0.0001). No significant differences in error rates were found between the different mask types (p > 0.05). Error rates were higher for participants with shorter VR training time (p < 0.0001) or who were non-native English speakers (p < 0.0001). There were no interaction effects between mask type, VR training time or English nativity, suggesting these variables to be independent predictors for error rate. Academic rank did not significantly affect the error rate. radiologists underestimate the influence of masks on dictation accuracy. mask wearing may lead to significant increase in dictational errors.

Wrong-Patient Orders in Obstetrics.

To compare rates of wrong-patient orders among patients on obstetric units compared with reproductive-aged women admitted to medical-surgical units. This was an observational study conducted in a large health system in New York between January 1, 2016, and December 31, 2018. The primary outcome was near-miss wrong-patient orders identified using the National Quality Forum-endorsed Wrong-Patient Retract-and-Reorder measure. All electronic orders placed for eligible patients during the study period were extracted retrospectively from the health system data warehouse, and the unit of analysis was the order session (consecutive orders placed by a single clinician for a patient within 60 minutes). Multilevel logistic regression models were used to estimate odds ratios (ORs) and 95% CIs comparing the probability of retract-and-reorder events in obstetric and medical-surgical units, overall, and in subgroups defined by clinician type and order timing. Overall, 1,329,463 order sessions were placed during the study period, including 676,643 obstetric order sessions (from 45,436 patients) and 652,820 medical-surgical order sessions (from 12,915 patients). The rate of 79.5 retract-and-reorder events per 100,000 order sessions in obstetric units was significantly higher than the rate in the general medical-surgical population of 42.3 per 100,000 order sessions (OR 1.98, 95% CI 1.64-2.39). The obstetric retract-and-reorder event rate was significantly higher for attending physicians and house staff compared with advanced practice clinicians. There were no significant differences in error rates between day and night shifts. Order errors occurred more frequently on obstetric units compared with medical-surgical units. Systems strategies shown to decrease these events in other high-risk specialties should be explored in obstetrics to render safer maternity care.

623 Patient safety challenges during pregnancy hospitalizations: wrong-patient orders on obstetric vs. Non-obstetric units

Patient safety in obstetrics is critical and peripartum patients may be at high risk of wrong-patient order errors due to similar characteristics and admission diagnoses. This study compares rates of wrong-patient orders among obstetric patients with reproductive age medical-surgical patients. This cross-sectional study was conducted in a large health system from January 1, 2016 to December 31, 2018. The primary outcome was near-miss, wrong-patient orders identified using the National Quality Forum-endorsed Wrong-Patient Retract-and-Reorder (RAR) measure. All electronic orders placed for eligible patients were extracted retrospectively from the data warehouse. Eligibility criteria included women aged 18 years or older receiving care in obstetric units and women aged 18–50 years admitted to medical-surgical units. Multilevel logistic regression models were used to estimate odds ratios (OR) and 95% confidence intervals (CI) comparing the probability of RAR events in obstetric and medical-surgical units overall, and in subgroups by clinician type and order timing. 676,643 obstetric order sessions from 45,436 patients and 652,820 medical-surgical order sessions from 12,915 patients were included with lower mean age and higher proportion of non-Hispanic white and privately insured patients on obstetric units (Table 1). The rate of 79.5 RAR events/100,000 order sessions in obstetrics was significantly higher than the rate in the medical-surgical population of 42.3/100,000 order sessions (OR 1.98, 95% CI 1.64–2.39) (Figure 1). The obstetric RAR event rate was significantly higher for attendings and housestaff compared to advanced practice providers and there were no significant differences in error rates between day and night shifts. Wrong-patient orders occurred at significantly higher rates for obstetric patients than for reproductive age women on medical-surgical units. Systems strategies shown to decrease these events in other high-risk specialties should be explored in obstetrics in efforts to render maternity care safer.View Large Image Figure ViewerDownload Hi-res image Download (PPT)

The role of base-layer cooling conditions in human error occurrences during doffing of personal protective equipment in health care

This study compared error rates during the personal protective equipment (PPE) removal process under different base-layer cooling conditions while performing the doffing procedures. Ten participants were recruited and received training on the standard doffing procedures before participating in the experiments. The participants were randomly assigned to one of the three base-layer conditions and ran on a treadmill for 30 min. Their physiological biometrics were monitored during exercise trials, and error rates were calculated. The results revealed a significant difference in error rates when PPE was worn over base-layer scrubs made of a cooling fabric versus when it was worn over the conventional medical scrubs. Further, there was a strong negative relationship between the body coverage amount with the cooling fabric and error rates occurring during the doffing procedures. Findings suggested practical considerations for the operational monitoring system and improved PPE design to avoid unintentional errors during the doffing procedures.

Development and assessment of a verbal response scale for the Patient-Specific Functional Scale (PSFS) in a low-literacy, non-western population.

The Patient-Specific Functional Scale (PSFS) is a routinely used measure of physical function with a 0-10 response scale. We aimed to develop verbal response options for the PSFS, pre-test it for use in a multilingual, low-literacy country- Nepal, and compare preference and error rates between numeric and verbal scale. We hypothesized that a verbal scale would be preferred by respondents and yield fewer errors. We interviewed 42 individuals with musculoskeletal, neurological, and cardiopulmonary conditions to understand how people describe varying levels of physical ability. Transcripts were thematically analyzed, and through consensus, we developed two sets of verbal responses for the PSFS. Next, we pre-tested the scales on an additional 119 respondents following which participants were asked to specify their preferred scale. Error rates were analyzed retrospectively using pre-specified criteria. Participants described their ability in terms of the quality (95%) and the quantity of task performance (88%). Although the verbal scales were preferred over the numeric scale (50% versus 12%), there was no significant difference in error rates between numeric (34%) and verbal scales (32% and 36%). Higher error rates were associated with greater age, fewer years of education, and inexperience with numeric scales. Despite a higher preference for verbal scale, 1 out of 3 patients made errors in using the PSFS, even with an interview format. The error rates were higher among participants with low literacy. The findings raise questions about the utility of PROMs in countries with low literacy rates.

Improving junior doctor medicine prescribing and patient safety: An intervention using personalised, structured, video-enhanced feedback and deliberate practice.

AimsThis research investigated the effectiveness of an intervention for improving the prescribing and patient safety behaviour among Foundation Year doctors. The intervention consisted of simulated clinical encounters with subsequent personalised, structured, video‐enhanced feedback and deliberate practice, undertaken at the start of four‐month sub‐specialty rotations.MethodsThree prospective, non‐randomised control intervention studies were conducted, within two secondary care NHS Trusts in England. The primary outcome measure, error rate per prescriber, was calculated using daily prescribing data. Prescribers were grouped to enable a comparison between experimental and control conditions using regression analysis. A break‐even analysis evaluated cost‐effectiveness.ResultsThere was no significant difference in error rates of novice prescribers who received the intervention when compared with those of experienced prescribers. Novice prescribers not participating in the intervention had significantly higher error rates (P = .026, 95% confidence interval [CI] Wald 0.093 to 1.436; P = .026, 95% CI 0.031 to 0.397) and patients seen by them experienced significantly higher prescribing error rates (P = .007, 95% CI 0.025 to 0.157). Conversely, patients seen by the novice prescribers who received the intervention experienced a significantly lower rate of significant errors compared to patients seen by the experienced prescribers (P = .04, 95% CI −0.068 to −0.001). The break‐even analysis demonstrates cost‐effectiveness for the intervention.ConclusionSimulated clinical encounters using personalised, structured, video‐enhanced feedback and deliberate practice improves the prescribing and patient safety behaviour of Foundation Year doctors. The intervention is cost‐effective with potential to reduce avoidable harm.

Transcranial static magnetic stimulation over the primary motor cortex alters sequential implicit motor learning

Transcranial static magnetic stimulation (tSMS) is a recently introduced noninvasive brain stimulation technique that can modulate brain excitability. Here, we investigated a hypothesis that motor learning would be altered by tSMS applied to the primary motor cortex (M1). For motor task, we chose a serial reaction time task consisting of sequential trials and random trials in which the visual cue doesn’t play out a repeating pattern of positions to evaluate an implicit motor learning, where the M1 is a key structure for skill acquisition and early consolidation. Forty-four healthy right-handed volunteers participated in the present study. TSMS was placed over the right M1 or dorsolateral prefrontal cortex (DLPFC). The control group received Sham stimulation over the right M1. Reaction times (RTs) of left hand were analyzed before (Pre session) and after (Post session) practice to examine online learning, and were also assessed 24 h later to examine offline learning (Cons session). The results showed that the RTs became faster in Post than Pre session regardless of the stimulation location. Interestingly, the RTs were significantly faster with the M1 stimulation than the DLPFC or Sham stimulation in Cons session. There was not significant difference in error rate among sessions or stimulation locations. These findings suggest that the modulation of the M1 using tSMS can enhance offline motor learning in an implicit task.

Probing oculomotor inhibition with the minimally delayed oculomotor response task

The ability to not execute (i.e. to inhibit) actions is important for behavioural flexibility and frees us from being slaves to our immediate sensory environment. The antisaccade task is one of several used to investigate behavioural inhibitory control. However, antisaccades involve a number of important processes besides inhibition such as attention and working memory. In the minimally delayed oculomotor response (MDOR) task, participants are presented with a simple target step, but instructed to saccade not to the target when it appears (a prosaccade response), but when it disappears (i.e. on target offset). Varying the target display duration prevents offset timing being predictable from the time of target onset, and saccades prior to the offset are counted as errors. Antisaccade error rate and latency are modified by alterations in fixation conditions produced by inserting a gap between fixation target offset and stimulus onset (the gap paradigm; error rate increases, latency decreases) or by leaving the fixation target on when the target appears (overlap paradigm; error rate decreases, latency increases). We investigated the effect of gaps and overlaps on performance in the MDOR task. In Experiment 1 we confirmed that, compared to a control condition in which participants responded to target onsets, in the MDOR task saccade latency was considerably increased (increases of 122–272 ms depending on target display duration and experimental condition). However, there was no difference in error rate or saccade latency between gap and synchronous (fixation target offset followed immediately by saccade target onset) conditions. In Experiment 2, in a different group of participants, we compared overlap and synchronous conditions and again found no statistically significant differences in error rate and saccade latency. The timing distribution of errors suggested that most were responses to target onsets, which we take to be evidence of inhibition failure. We conclude that the MDOR task evokes behaviour that is consistent across different groups of participants. Because it is free of the non-inhibitory processes operative in the antisaccade task, it provides a useful means of investigating behavioural inhibition.

A comparison of medication administration errors from original medication packaging and multi-compartment compliance aids in care homes: A prospective observational study

BackgroundNo published study has been specifically designed to compare medication administration errors between original medication packaging and multi-compartment compliance aids in care homes, using direct observation. ObjectivesCompare the effect of original medication packaging and multi-compartment compliance aids on medication administration accuracy. DesignProspective observational. SettingTen Greater London care homes. ParticipantsNurses and carers administering medications. MethodsBetween October 2014 and June 2015, a pharmacist researcher directly observed solid, orally administered medications in tablet or capsule form at ten purposively sampled care homes (five only used original medication packaging and five used both multi-compartment compliance aids and original medication packaging). The medication administration error rate was calculated as the number of observed doses administered (or omitted) in error according to medication administration records, compared to the opportunities for error (total number of observed doses plus omitted doses). ResultsOver 108.4h, 41 different staff (35 nurses, 6 carers) were observed to administer medications to 823 residents during 90 medication administration rounds. A total of 2452 medication doses were observed (1385 from original medication packaging, 1067 from multi-compartment compliance aids). One hundred and seventy eight medication administration errors were identified from 2493 opportunities for error (7.1% overall medication administration error rate). A greater medication administration error rate was seen for original medication packaging than multi-compartment compliance aids (9.3% and 3.1% respectively, risk ratio (RR)=3.9, 95% confidence interval (CI) 2.4 to 6.1, p<0.001). Similar differences existed when comparing medication administration error rates between original medication packaging (from original medication packaging-only care homes) and multi-compartment compliance aids (RR=2.3, 95%CI 1.1 to 4.9, p=0.03), and between original medication packaging and multi-compartment compliance aids within care homes that used a combination of both medication administration systems (RR=4.3, 95%CI 2.7 to 6.8, p<0.001). A significant difference in error rate was not observed between use of a single or combination medication administration system (p=0.44). ConclusionThe significant difference in, and high overall, medication administration error rate between original medication packaging and multi-compartment compliance aids supports the use of the latter in care homes, as well as local investigation of tablet and capsule impact on medication administration errors and staff training to prevent errors occurring. As a significant difference in error rate was not observed between use of a single or combination medication administration system, common practice of using both multi-compartment compliance aids (for most medications) and original packaging (for medications with stability issues) is supported.

Visual Encodings of Temporal Uncertainty: A Comparative User Study.

A number of studies have investigated different ways of visualizing uncertainty. However, in the temporal dimension, it is still an open question how to best represent uncertainty, since the special characteristics of time require special visual encodings and may provoke different interpretations. Thus, we have conducted a comprehensive study comparing alternative visual encodings of intervals with uncertain start and end times: gradient plots, violin plots, accumulated probability plots, error bars, centered error bars, and ambiguation. Our results reveal significant differences in error rates and completion time for these different visualization types and different tasks. We recommend using ambiguation - using a lighter color value to represent uncertain regions - or error bars for judging durations and temporal bounds, and gradient plots - using fading color or transparency - for judging probability values.

Effects of Implant Angulation and Impression Coping Type on the Dimensional Accuracy of Impressions.

To analyze the accuracy of impressions in relation to implant angulation and type of impression coping. Three metal master models with 2 implants of 3 different angulations (parallel, mesiodistal, and buccolingual) were fabricated. Nine groups of experimental models were fabricated to duplicate the 3 master models using 3 types of impression copings: transfer, pick-up, and hybrid. The distance between the analogs for each model was measured using a video measuring system. The influence of angulation and type of impression coping was analyzed by a two-way ANOVA (P < 0.05). There were significant differences in error rates in relation to implant angulation and type of impression coping (P < 0.05). Impressions of buccolingually divergent implants with transfer copings showed statistically higher error rates than other groups (P < 0.05). Buccolingual divergence can be a variable that influences the impression accuracy of transfer copings compared with pick-up and hybrid copings. Hybrid copings demonstrate reasonable reproducibility similar to that of pick-up copings.