Quality indicators in respiratory therapy

Quality indicators in healthcare refer to measurable and quantifiable parameters used to assess and monitor the performance,effectiveness,and safety of healthcare services.These indicators provide a systematic way to evaluate the quality of care offered,and thereby to identify areas for improvement and to ensure that patient care meets established standards and best practices.Respiratory therapists play a vital role in areas of clinical administration such as infection control practices and quality improvement initiatives.Quality indicators serve as essential metrics for respiratory therapy departments to assess and enhance the overall quality of care.By systematically tracking and analyzing indicators related to infection control,treatment effectiveness,and adherence to protocols,respiratory care practitioners can identify areas to improve and implement evidence-based changes.This article reviewed how to identify,implement,and monitor quality indicators specific to the respiratory therapy departments to set benchmarks and enhance patient outcomes.

Quality indicators for the care of older adults with disabilities in longterm care facilities based on Maslow’s hierarchy of needs

Purpose:This study aimed to develop quality indicators for the care of older adults with disabilities in long-term care facilities(LTCFs)based on Maslow’s hierarchy of needs.Methods:The draft of the quality indicators was drawn up based on a literature review and research group discussion.The quality indicators were finalized by two rounds of expert consultation(involving 15 experts)using the Delphi method.The Analytic Hierarchy Process was applied to calculate the indicators’weight.Results:The response rates of the two rounds of consultation were 100%and 93%,and the expert authority coefficients were 0.86 and 0.87.After two rounds of consultation,the expert opinion coordination coefficients of the first-,second-and third-level indicators were 0.42,0.25,and 0.96,respectively(P<0.05),and the variation coefficient was0.25.The final quality indicators for the care of older adults with disabilities in LTCFs included 7 first-level,19 second-level,and 107 third-level indicators.Conclusion:The quality indicators for the care of older adults with disabilities in LTCFs are reliable,scientific,comprehensive,and practical and specify the content of person-centered care needs.This can provide a reference for evaluating and improving care quality in LTCFs.

Effect of Storage Time on Main Quality Indicators of Cotton

The quality indicators of cotton will change during storage.Taking the 5.89 million t of Xinjiang cotton from 2016 to 2021 as a sample,this paper analyzed the main fiber quality indicator data of warehouse-in and warehouse-out cotton for storage of 1.5,3.0,4.0,5.0,6.0,and 7.0 years.It was found that the color grade of cotton decreased with the extension of storage time.The cotton with storage time of 5.0 years mainly changed from white cotton grade 2 and white cotton grade 3 to light yellow stained cotton grade 1 and yellow stained cotton grade 1.Among them,the increase of light yellow stained cotton grade 1 was the largest,and the change to yellow stained cotton grade 1 was the largest at the storage 6.0-7.0 years.In addition,there were no significant changes in moisture regain,Micronaire value,upper half mean length,length uniformity index and fiber strength.

Effect of quality of bowel preparation on quality indicators of adenoma detection rates and colonoscopy completion rates

Background and aim:Adequate bowel preparation is important for safe and effective colonoscopy.Quality indicators(QI)for colonoscopy include achieving at least 95%completion rate and an adenoma detection rate(ADR)of at least 25%in average-risk men and 15%in average-risk women aged over 50.Our aim was to investigate the impact of bowel preparation on ADR and colonoscopy completion rates.Methods:This retrospective cohort study included patients who underwent colonoscopy between January 2008 and December 2009.The main outcome measurements were ADR and colonoscopy completion rates to the cecum.Results:A total of 2519 patients was included;1030(41.0%)had excellent preparation,1145(45.5%)good-,240(9.5%)fair-,and 104(4.1%)poor preparation.Colonoscopy completion rates were significantly lower in patients with poor or fair preparation(72.1%and 75.4%,respectively)than in those with good and excellent preparation(99.7%and 99.9%,respectively;P<0.001),and significantly lower than the QI of 95%(P<0.001).ADR in men and women combined was similar in all four grades of preparation(excellent,good,fair and poor)at 24.2%vs.26.8%vs.32.1%vs.22.1%,respectively;P¼0.06.All the groups had ADR above the QI(25%for men and 15%for women)with evidence of significantly higher ADR in the women with excellent or good preparation and in men with excellent,good or fair preparation.On multivariate analysis,male gender was significantly associated with increased ADR(P<0.001),while the quality of bowel preparation did not influence ADR.Conclusions:Patients with fair and poor standards of preparation have significantly lower colonoscopy completion rates than those with excellent and good preparation.However,there was no difference in ADR between the different grades of preparation.

Rapid and simultaneous analysis of multiple wine quality indicators through near-infrared spectroscopy with twice optimization for wavelength model

Alcohol,total sugar,total acid,and total phenol contents are the main indicators of wine quality detection.This study aims to establish simultaneous analysis models for the four indicators through near-infrared(NIR)spectroscopy with wavelength optimization.A Norris derivative filter(NDF)platform with multiparameter optimization was established for spectral pretreatment.The optimal parameters(i.e.,derivative order,number of smoothing points,and number of differential gaps)were(2,9,3)for alcohol,(1,19,5)for total sugar,(1,17,11)for total acid,and(1,1,1)for total phenol.The equidistant combinationpartial least squares(EC-PLS)was used for large-scale wavelength screening.The wavelength step-by-step phaseout PLS(WSP-PLS)and exhaustive methods were used for secondary optimization.The final optimization models for the four indicators included 7,10,15,and 13 wavelengths located in the overtone or combination regions,respectively.In an independent validation,the root mean square errors,correlation coefficient for prediction(i.e.,SEP and RP),and ratio of performance-to-deviation(RPD)were 0.41 v/v,0.947,and 3.2 for alcohol;1.48 g/L,0.992,and 6.8 for total sugar;0.68 g/L,0.981,and5.1 for total acid;and 0.181 g/L,0.948,and 2.9 for total phenol.The results indicate high correlation,low error,and good overall prediction performance.Consequently,the established reagent-free NIR analytical models are important in the rapid and real-time quality detection of the wine fermentation process and finished products.The proposed wavelength models provide a valuable reference for designing small dedicated instruments.

Groundwater quality assessment for drinking and irrigation purposes in Boumerdes Region,Algeria

In Algeria,water is a critically limited resource.Rapid demographic,urban and economic development has significantly increased water demand,the particularly for drinking water supply and agriculture.Groundwater serves as the primary source of water in the Boumerdes Region,located in northern Algeria,Therefore evaluating groundwater quality for water supply and irrigation purposes is very crucial.In this study,49 groundwater samples were collected in 2021 and analyzed based on 17 physicochemical parameters.These results were processed using multivariate analysis and compared against the standards established by both the World Health Organization and Algerian Standards.The findings revealed that the concentrations of Sodium,Calcium,Magnesium,and Nitrate of some samples exceeded acceptable limits,indicating that physicochemical treatment is necessary before use for drinking water supply.For irrigation suitability,several indices were employed,including Sodium Adsorption Rate(SAR),Wilcox diagram,Magnesium Absorption Ratio(MAR),Residual Sodium Bicarbonate(RSB),Permeability Index(PI)and Stuyfzand Index.The results of these indices show that groundwater in the region generally meets irrigation standards with a low risk.However,the groundwater should still be managed carefully to prevent salinityrelated issues.This study highlights the current status of groundwater quality the Boumerdes region and offers important insights for the sustainable management of water resources in the area.

Multivariate Approach to Characterizing Soil Quality of Gabonese’s Ferralitic Soils

Assessing soil quality is essential for crop management and soil temporal changes. The present study aims to evaluate soil quality in the Ferralitic soils context countrywide. This assessment was done using multivariate soil quality indice (SQI) models, such as additive quality index (AQI), weighted quality indexes (WQIadd and WQIcom) and Nemoro quality index (NQI), applied to two approaches of indicator selection: total data set (TDS) and minimum data set (MDS). Physical and chemical soil indicators were extracted from the ORSTOM’s reports resulting from a sampling campaign in different provinces of Gabon. The TDS approach shows soil quality status according to eleven soil indicators extracted from the analysis of 1,059 samples from arable soil layer (0 - 30 cm depth). The results indicated that 87% of all provinces presented a very low soil quality (Q5) whatever the model. Among soil indicators, exchangeable K+ and Mg2+, bulk density and C/N ratio were retained in MDS, using principal component analysis (PCA). In the MDS approach, 50 to 63% of provinces had low soil quality grades with AQI, WQIadd and NQI, whereas the total was observed with WQIcom. Only 25% of provinces had medium soil quality grades with AQI and NQI models, while 12.5% (NQI) and 25% (AQI) presented high quality grades. Robust statistical analyses confirmed the accuracy and validation (0.80 r P ≤ 0.016) of AQI, WQIadd and NQI into the TDS and MDS approaches. The same sensitivity index value (1.53) was obtained with AQI and WQIadd. However, WQIadd was chosen as the best SQI model, according to its high linear regression value (R2 = 0.82) between TDS and MDS. This study has important implications in decision-making on monitoring, evaluation and sustainable management of Gabonese soils in a pedoclimatic context unfavorable to plant growth.

Comprehensive evaluation of water quality parameters in Tianjin Dagu Dainage Canal

In this paper, some indices of sulfide, organic carbon, oil and heavy metals （copper, lead, zinc, cadmium, mercury, arsenic and chromium） in the sediments from Dagu Dainage Canal at the Bohai Bay during four seasons in 2012 - 2013 are selected, and Water Quality Pollution Index （API） is applied to evaluate water quality indices, aiming for the systematic evaluation of the water quality of Dagu Dainage Canal. The results showed that four stations of D3, D6, D7and D9 for S2 had the type Ⅱand Ⅲ of water; others had the type Ⅰ ; the total level of TOC, TPH, Cu, Pb, Zn, Cd, Hg, As and Cr were type Ⅰ, Ⅳ, Ⅱ, Ⅴ, Ⅱ, Ⅴ, Ⅲ, Vand Ⅴ. Water Quality Pollution Index （API） was 3.28, which illustrated Dagu Dainage Canal was in the state of contamination and the degree of pollution exceeded the standard functional areas.

Quality assessment of Continuous Operating Reference Stations(CORS)-GPS stations in Mexico

The present analysis provided the quality assessment of 65 Continuous Operating Reference Stations(CORS) situated in and around Mexico using the data of about ten years(January 2010 to January 2020).To accomplish the assessment,we considered 4 quality indexes for performing the quality check,incluing the multipath effect on L1 and L2 bands,signal-to-noise ratio in both bands,cycle slips,and integrity.Meanwhile,a new reference parameter named regio nal values for Mexico(RVM) was calculated for the stations situated in Mexico.Additionally,an exhaustive analysis of the quality indicators in the worst and best cases was performed.The signal degradation was proved by a long-term time series and cru stal defo rmation analysis in GAMIT/GLOBK platform.The results showed a stro ng correlation between integrity,cycle slips and daily observations time,and the multipath effect is strong in the case of outdated systems.The study indicates that the estimated quality indexes and values could be the basis for establishing new CORS in Mexico,and the errors corrections which cannot be mitigated in the postprocessing stage would greatly help utilize the data for different scientific applications.The results were supported by deformation analysis in part of Baja California Peninsula in Mexico indicating northern and eastern velocity vector of -3.08±0.02 mm/yr,-7.85±0.02 mm/yr and-0.07±0.03 mm/yr,-9.33±0.02 mm/yr respectively at MPR1 and INEG stations.

Sustainable living neighbourhoods:Measuring public space quality and walking environment in Lisbon

Obesity and global warming are two major challengesthat affect communities’health and quality of life.Providing good walking environments,with appropriate pedestrian infrastructure,green areas and access to commercial retail and transport hubs favour liveable,healthy,and sustainable cities.The Lisbon City Hall has implemented an intervention program in the public space as a strategy to improve environmental quality and mitigate the effects of climate change.The program“A square in each neighbourhood”intends not only to reinforce the economic base of Lisbon,namely tourism,restaurants,commerce,and creative activities but also to promote physical activity and improve the quality of living of all citizens.For studying the impact of the public space quality on the walking environment,Campolide,a typical Lisbon neighbourhood,Portugal,which includes one of the requalified squares,was selected.A two-step methodology based on spatial modelling is proposed.In the first step,the public space quality was evaluated based on a set of 13 urban quality attributes.Attributes,intended for the street level,were collected from open data platforms and complemented with a field survey.Then,through spatial analysis,these attributes were used to build the Pedestrian Environment Quality Indicator and the Priority Intervention Indicator.Using these indicators,walking-friendly streets were mapped and the most critical sites that require priority intervention were identified to prepare for the requalification planning process.The street with the highest quality in the study area according to the dimensions evaluated-connectivity,convenience,comfort,cleanliness,and conviviality-has a great offer of trees,bus stops,commercial establishments,commercial diversity,crossings,paper bins/eco points and esplanades.On the opposite side of the rank,the street with the lowest quality has no trees or green areas,transport stops,benches and tables,or commercial activity.The urban quality indicators constitute a helpful tool for city planners and policymakers when planning sustainable living neighbourhoods.

Cultivar,Nitrogen and Irrigation Influence on Grain Quality and Its Forecasting Methods by In situ Reflected Spectrum of Winter Wheat

Field experiments were conducted to examine the influence factors of cultivar, nitrogen application and irrigation on grain protein content, gluten content and grain hardness in three winter wheat cultivars under four levels of nitrogen and irrigation treatments. Firstly, the influence of cultivars and environment factors on grain quality were studied, the effective factors were cultivars, irrigation, fertilization, etc. Secondly, total nitrogen content around winter wheat anthesis stage was proved to be significantly correlative with grain protein content, and spectral vegetation index significantly correlated to total nitrogen content around anthesis stage were the potential indicators for grain protein content. Accumulation of total nitrogen content and its transfer to grain is the physical link to produce the final grain protein, and total nitrogen content at anthesis stage was proved to be an indicator of final grain protein content. The selected normalized photochemical reflectance index (NPRI) was proved to be able to predict grain protein content on the close correlation between the ratio of total carotenoid to chlorophyll a and total nitrogen content. The method contributes towards developing optimal procedures for predicting wheat grain quality through analysis of their canopy reflected spectrum at anthesis stage. Regression equations were established to forecast grain protein and dry gluten content by total nitrogen content at anthesis stage, so it is feasible for forecasting grain quality by establishing correlation equations between biochemical constitutes and canopy reflected spectrum.

Does financial development moderate the link between technological innovation and environmental indicators?An advanced panel analysis

This study analyzes the role of financial development(FD)on the impact of technologi-cal innovation(TI)on six environmental quality indicators for the 25 economies that are part of the Organization for Economic Cooperation and Development for the period from 2000 to 2019.We use a two-step dynamic generalized method of moments approach to understand this relationship.The results show that FD augments the posi-tive effects of TI on four of the six environmental indicators,namely ecological foot-print,adjusted net savings,pressure on nature,and environmental performance.However,no significant effects on environmental sustainability and environmental vulnerability indices were found.When considering all of the environmental quality indicators,TI appears to enhance environmental quality.We find evidence to support the existence of the environmental Kuznets curve in the context of each environmen-tal indicator and economic growth.Moreover,FD and energy consumption appear to accelerate environmental degradation.Based on these results,FD should be viewed as an important parameter in designing policies for innovation to achieve the goal of net-zero carbon emissions.Highlights.Technological innovation and environmental quality nexus is studied.The moderating role of financial development is analyzed.Six different environmental quality indicators are used for OECD countries.Financial development intensifies the environmental benefits of innovation.•The EKC hypothesis is confirmed for all six environmental indicators.

Electric Power Quality Analysis 6-10/0.4 kV Distribution Networks

The paper reports quality analysis and evaluation at 6 - 10/0.4 kV low-voltage distribution grids in Uzbekistan. Power quality frequently does not correspond to the rated value which is largely due to unbalanced phase loading in grids and which also results in increased power loss. The study of the asymmetrical operating modes of the rural distribution networks of 0.4 kV was conducted in three steps: measurement, calculations and analysis of relevant data;providing practical guidelines and finally, implementing instruments to normalize grid operation. Measuring was conducted using certified instrumentation analyzer “MALIKA” designed by authors. The study and analysis of additional power losses as the function of indicators of asymmetrical features of voltage and current in operating 0.4 kV grids reveals that, quality of electric power at grids under investigation, merely does not meet the requirements of the Interstate Standard.

Indicator Selection for Quality Measurement in Maternal Neonatal and Child Health Services: Application of Random Forest Classifier

Quality of Maternal, Neonatal and Child (MNCH) care is an important aspect in ensuring healthy outcomes and survival of mothers and children. To maintain quality in health services provided, organizations and other stakeholders in maternal and child health recommend regular quality measurement. Quality indicators are the key components in the quality measurement process. However, the literature shows neither an indicator selection process nor a set of quality indicators for quality measurement that is universally accepted. The lack of a universally accepted quality indicator selection process and set of quality indicators results in the establishment of a variety of quality indicator selection processes and several sets of quality indicators whenever the need for quality measurement arises. This adds extra processes that render quality measurement process. This study, therefore, aims to establish a set of quality indicators from a broad set of quality indicators recommended by the World Health Organization (WHO). The study deployed a machine learning technique, specifically a random forest classifier to select important indicators for quality measurement. Twenty-nine indicators were identified as important features and among those, eight indicators namely maternal mortality ratio, still-birth rate, delivery at a health facility, deliveries assisted by skilled attendants, proportional breach delivery, normal delivery rate, born before arrival rate and antenatal care visit coverage were identified to be the most important indicators for quality measurement.

Evaluation of Care Quality Related to Dietary Intake and Swallowing Functions of Residents at Long-Term Facilities in Japan

This study aimed to evaluate the quality of healthcare services pertaining to the dietary intake and swallowing functions of residents, nutrition management practices, and performance of residents at long-term care facilities. We investigated outcome indicators, such as changes in dietary intake and swallowing function levels of residents, and clarified which structural and process indicators were associated with the outcome indicators. This was a retrospective study, analyzing information on healthcare services from 1067 long-term care facilities during the fiscal year 2012, sampled from among those registered with the Welfare, Health and Medical Care Information Network of the Welfare and Medical Service Agency in Japan. Five outcome indicators were identified. Next, we examined the relationships between the outcome indicators and structural or process indicators using a multivariate linear regression model, adjusting for facility type. The findings showed how the five outcome indicators were used in long-term care facilities over a period of one year and determined the independent predictors of these outcome indicators. The amplification of dietary function 1 was associated with “assessment of oral functions using a feeding and swallowing assessment checklist every three months”, “holding care conferences related to ingestion and swallowing every three months”, and “maintaining a 1:2 ratio for meal-time assistants to residents”. To improve the quality of care, it is necessary to increase the number of staff (e.g., to provide meal assistance to residents) and to understand changes in the residents’ status through accurate assessment and monitoring.

Endoscopic submucosal dissection for early gastric cancer:It is time to consider the quality of its outcomes

Endoscopic resection,particularly endoscopic submucosal dissection(ESD),is widely used as a standard treatment modality for early gastric cancer(EGC)when the risk of lymph node metastasis is negligible.Compared with surgical gastrectomy,ESD is a minimally invasive procedure with additional advantages,such as preservation of the entire stomach and maintenance of the patient’s quality of life.However,not all patients achieve curative resection after ESD of EGC.Several patients require surgical gastrectomy after ESD to achieve a curative treatment.Additional surgery after ESD,owing to non-curative resection,places considerable emotional and financial burdens on patients.Recently,as the number of endoscopists performing ESD has increased,the rate of non-curative resection after ESD has increased correspondingly.In order to decrease the non-curative resection rate,as well as determine the ideal rate of non-curative resection after ESD,it is time to consider quality indicators for the outcomes of ESD for EGC.

Difference among the quality indices,chemical composition and frying performance of galangal flavored sunflower oil prepared by three methods

Flavored vegetable oils have attracted more and more attentions from consumers and researchers due to their high oxidative stability and sensory quality.In the present study,the quality indices,chemical composition and frying performance of galangal flavored sunflower oil prepared by infusion method(GFSO-I),combination pressing method(GFSO-C)and direct addition method(GFSO-A)were investigated.The results displayed that the preparation time,the levels for the acid value(AV),peroxide value(PV),p-anisidine value(AnV),total oxidation value(TOTOX),and the values for total polar compounds(TPC),thiobarbituric acid(TBA),K232 and K268 of GFSO-C were prominently low(P<0.05),compared with that of GFSO-I and GFSO-A,while the fatty acid composition of them were similar.In the frying of Chinese Maye(tradional Chinese food,fried dough stick)at 180°C for 30 h,the values for TPC,TBA,K232 and K268,polymer,viscosity and b*of GFSO-C were obviously low(P<0.05),while the value for L*was obviously high(P<0.05),compared with that of GFSO-I and GFSO-A.In the sensory evaluation,the flavor,taste,crispness and overall acceptance of Chinese Maye fried by GFSO-C were better than that of Chinese Maye fried by GFSO-I and GFSO-A.Consequently,GFSO-C is more suitable for cooking,and the combination pressing method is optimal for industrial production of GFSO.

Training indicators and quantitative criteria for emergency nurse specialists

Objective： By constructing a training system of quality evaluation standards for emergency nurse specialist（ENS）, we can ensure smooth operations and quality training for ENS.Methods： First, the frame structure of indicators was designed on the basis of system theory and the balanced scorecard method. Meanwhile, corresponding quantitative standard indicators were compiled through literature analysis and a review of training characteristics. Next, screening indicators were collected through consultation with experts and statistical calculations. The indicators weight coefficient was calculated using the analytic hierarchy process（AHP）. Finally, indicators were validated in two groups of nurses in two different training courses.Results：（1） We created a three-level indicator system： level-Ⅰ dimensions have 4 indicators, while level-Ⅱ dimensions and level-Ⅲ dimensions have 13 and 34 indicators, respectively;（2） The coefficient of expert＇s judgment is 0.840, familiarity is 0.914 and authority is 0.877, and the three rounds of coordination coefficient are 0.456, 0.553 and 0.715, respectively;（3） There are at least 56 indicators in alternative quantitative standards; and（4） The alpha reliability value of the indicator system in the two training course had no significant difference（P 〉 0.05）. The same result was observed when examining two groups of nurses in one training course（P 〉 0.05）.Conclusions： This study established a training system of quality evaluation standards for emergency nurse specialists that is objective, reliable, easy to operate and representative according to scientific selection and verification. This system can therefore provide a basis for quality evaluation and targeted improvement for ENS training in addition to promoting health.

Improving Clinical Laboratory Quality through Reduction of Tests’ Turnaround Time in Democratic Republic of the Congo: Key Strategies

In Democratic Republic of the Congo (DRC), the laboratory TAT is significantly very long and do not comply with either international standards or the suggestions of customers. However, there is neither a national nor a local strategy to improve the laboratory TAT. The aim of the present study is to develop practical management strategies to shorten clinical laboratory tests’ TAT. This was a qualitative study conducted in Kinshasa. Focus groups and Lean tools were used respectively to generate a wide range of views from a variety of laboratory staff and to eliminate several form of waste in the laboratory flow process. Based on the identified root causes of delay, focus groups participants reported that there is a lot of scope for the improvement of TAT in DRC. Consistent attendance and punctuality are essential. The hospital management should implement the Laboratory Information Systems (LIS) and install Middleware. Total laboratory automation, inventory system for all reagents and supplies used in the laboratory, expansion of the sampling area, sufficient number of high-power machine and a clear job description are indispensable. LIS, 3.5 mL BD vacutainer BarricorTM tube and point-of-care testing (POCT) are necessary for workflow improvement. A reduction of 312 minutes was achieved by eliminating or decreasing non-value-added activities. Applying the suggested key strategies, and particularly the new workflow process, is a basis for improving the laboratory tests’ TAT. The algorithm presented can be easily implemented in other laboratories that face this type of problem.