Potential and limitations of ChatGPT and generative artificial intelligence in medical safety education

The primary objectives of medical safety education are to provide the public with essential knowledge about medications and to foster a scientific approach to drug usage.The era of using artificial intelligence to revolutionize medical safety education has already dawned,and ChatGPT and other generative artificial intelligence models have immense potential in this domain.Notably,they offer a wealth of knowledge,anonymity,continuous availability,and personalized services.However,the practical implementation of generative artificial intelligence models such as ChatGPT in medical safety education still faces several challenges,including concerns about the accuracy of information,legal responsibilities,and ethical obligations.Moving forward,it is crucial to intelligently upgrade ChatGPT by leveraging the strengths of existing medical practices.This task involves further integrating the model with real-life scenarios and proactively addressing ethical and security issues with the ultimate goal of providing the public with comprehensive,convenient,efficient,and personalized medical services.

The Relationship between Nurses＇ Errors of Treatment and Supervisors＇ Constructive Listening

Nurses＇ unintentional medication errors during treatment are relatively frequent and yet inevitable. Errors provoke emotions which influence the nurses＇ professional careers. Little is known about the relationship between nurses＇ supervisors constructive listening （CL） and the emotional reactions of nurses who committed an error and its relation to patients＇ safety. Our purpose was to explore the relationship between nurses＇ perceptions regarding their supervisors＇ CL and their emotional experiences after committing an error related to patient care. Dependent variables included of guilt, empathy towards the patient, general and professional self-assessment, shame, and Negative and Positive Affect （NA/PA）. In this descriptive study, we used a snowball sampling method. Participants were asked to sign an informed-consent form and complete the questionnaire before or after work. No compensation （material or otherwise） was offered to participants. The study was approved by the ethics committee of the academic institution involved. A total of 162 nurses participated： 103 （63.6%） held a registered and 40 （25%） held a managerial role. Seniority had high variability, ranging from 3 months to 45 years （M=1 3.54, SD=0.78）. The majority of errors reported （67.7%） concerned the administration of medications. We used Structural Equation Modeling to measure relationships between the main variables （X2（9）=14.52, p=.105, CFI=.911, RMSEA=.062 （90% CI=.00-. 11）. The main findings were： a high rating of perceived supervisor＇s CL led to high state-guilt （β=. 15, p=.04）. Next, higher state-guilt led to high PA （β=.18, p=.02） and to high NA （β=.45, p〈.001）. High PA led to reporting the error （β=.17, p=.03）, whereas high NA led to a high degree of empathy towards the patient （β=.17, p=.03）. Our findings show the importance of CL, which led to reporting error and to empathy towards patients, mediated by increased state-guilt and by increased positive and negative effect. Supervisor nurses should use CL to create an atmosphere of trust which fosters the reporting of errors and improves patients＇ safety.

Diagnostic value and safety of medical thoracoscopy for pleural effusion of different causes

BACKGROUND Pleural effusions occur for various reasons,and their diagnosis remains challenging despite the availability of different diagnostic modalities.Medical thoracoscopy(MT)can be used for both diagnostic and therapeutic purposes,especially in patients with undiagnosed pleural effusion.AIM To assess the diagnostic efficacy and safety of MT in patients with pleural effusion of different causes.METHODS Between January 1,2012 and April 30,2021,patients with pleural effusion underwent MT in the Department of Respiratory Medicine,The Second Affiliated Hospital of Xi’an Jiaotong University(Shaanxi,China).According to the discharge diagnosis,patients were divided into malignant pleural effusion(MPE),tuberculous pleural effusion(TBPE),and inflammatory pleural effusion(IPE)groups.General information,and tuberculosis-and effusion-related indices of the three groups were analyzed.The diagnostic yield,diagnostic accuracy,performance under thoracoscopy,and complications of patients were compared among the three groups.Then,the significant predictive factors for diagnosis between the MPE and TBPE groups were analyzed.RESULTS Of the 106 patients enrolled in this 10-year study,67 were male and 39 female,with mean age of 57.1±14.184 years.Among the 74 thoracoscopy-confirmed patients,41(38.7%)had MPE,21 had(19.8%)TBPE,and 32(30.2%)were undiagnosed.Overall diagnostic yield of MT was 69.8%(MPE:75.9%,TBPE:48.8%,and IPE:75.0%,with diagnostic accuracies of 100%,87.5%,and 75.0%,respectively).Under thoracoscopy,single or multiple pleural nodules were observed in 81.1%and pleural adhesions in 34.0%with pleural effusions.The most common complication was chest pain(41.5%),followed by chest tightness(11.3%)and fever(10.4%).Multivariate logistic regression analyses showed effusion appearance[odds ratio(OR):0.001,95%CI:0.000-0.204;P=0.010]and carcinoembryonic antigen(OR:0.243,95%CI:0.081-0.728;P=0.011)as significant for differentiating MPE and TBPE,with area under the receiver operating characteristic curve of 0.977(95%CI:0.953-1.000;P<0.001).CONCLUSION MT is an effective,safe,and minimally invasive procedure with high diagnostic yield for pleural effusion of different causes.

Accuracy and Electromagnetic Safety Evaluation of a Portable Electromagnetic Localization System for Micro Invasive Medical Devices in Vivo

Aiming at localizing the telemetric capsule for detecting gastrointestinal physiological parameters in vivo accurately,a portable alternating current(AC)electromagnetic localization system is designed.To verify the feasibility of the method,the model and construction of the localization system are detailed.And static and dynamic accuracy of the localization system are tested by experiments.Next,we compare the simulating results of the electromagnetic radiation aroused by the localization system with the electromagnetic safety standards of human(ICNIRP guidelines and IEEE standard C95.1-1991).Finally,in terms of the results of the static and dynamic experiments,conclusions are drawn that the accuracy of portable positioning system is high(less than 10 mm)enough to satisfy the localization need of the micro invasive medical devices in vivo,and there is no harm of electromagnetic radiation to human.

Patient safety practices and medical errors: Perception of health care providers at Jimma University Specialized Hospital, Southwest Ethiopia

Background: Even though evidences are limited in developing countries, the probability of patients being harmed in hospitals when receiving care might be much greater than that of the industrialized nations. Thus, aim of this study was to assess patient safety practice and the perceived prevalence of medical errors at Jimma University Specialized Hospital, Southwest Ethiopia. Methods: A facility based cross-sectional study was conducted during June, July and August 2010 in Jimma University Specialized Hospital. Patient safety grade and the perceived prevalence of medical errors were computed descriptively. Then, the effect of various independent variables on patient safety grade was assessed using multiple linear regressions analysis. Result: The overall patient safety grade as rated by the participants was excellent (7.2%), very good (20.7%), acceptable (36.0%), poor (30.0%) and failing (6.4%). Complications related to anesthesia occurred sometimes, rarely and never according to 30.8%, 43% and 15.8% of the respondents, respectively. Death in low mortality patients was reported to occur most of the time by 10.4% of the respondents. In addition, failure to rescue, infection due to medical care, postoperative hemorrhage, postoperative sepsis, birth injury to the neonate, obstetric trauma to the mother were reported to happened. Supervisor expectation and actions promoting patient safety (p < 0.001), and communication openness and feedback about errors (p = 0.002) had positive correlation with patient safety grade. Conclusion: this study indicated that poor patient safety practice and potentially preventable medical errors in the hospital.

The Impact of Medical Profession Type, Gender, and Years of Experience on Thinking Styles: What Are the Implications for Patient Safety?

Background: Healthcare providers were faced daily with many decision-making that impacted patients’ safety. According to dual process theory, there were two types of thinking: Experiential style (ES) and Rational Style (RS). Both thinking styles had an impact on individuals’ decisions making. Therefore, the aim of this study was to find out nurses’ and physicians’ styles of thinking and how this impacted patients’ safety. Design: A cross-sectional study. Methods: Nurses and physicians sample of adults (n = 308), 190 (61.7%) of the sample were nurses and 118 (38.3%) of the sample were physicians. Participants completed a self-report online survey, which included demographic information followed by questionnaires to measure thinking style and a cognitive puzzle to see if the medical error was associated with certain styles of thinking. Results: The main findings were that nurses (M = 2.41, SD = 0.37) had significantly higher scores compared to physicians (M = 2.29, SD = 0.39) in their ES, t(305) = 2.73, p = 0.007;with medium effect size, d = 0.37692. Conclusion: Nurses differed from physicians in ES where nurses had a significantly higher score than physicians which could be positive for patients’ safety as higher ES would report errors compared to lower ES.

A Study of Safety Evaluation Method for Medical Diagnostic Table

Medical diagnostic tables are widely used inthemedical diagnostic equipment. For multifarious diagnostic needs, the medical diagnostic table works in various operating modes. In order to ensure patient safety, safety factor of medical diagnostic table must meet safety requirement. The paper puts forward a method to find relations between key parameters and stress of table, identify maximum stress modes, reduce modes number of load test, and remove conservative high stress areas from finite element analysis result, by synthesizingthestress result of finite element analysis and measurement data for various operating modes of medical diagnostic table. It will help shorten test time, avoid over strength design, and reduce table’s cost. An application example of the method is presented by evaluating a specific CT medical diagnostictable. This method can be a reference for safety evaluation of all medical diagnostic tables.

LIS质量控制管理系统的设计与实现

目的建立和完善LIS质量控制管理系统,提高检验信息的准确性和完整性。方法基于医院现有信息系统提供的检验数据结构和软件系统,采用构件式开发方法、Windows多线程处理技术和VC++7.0开发工具,整合临床实验室设备和系统,并对工作流程进行优化。结果质量控制管理系统可以将各种型号的自动检验仪器连接成有机整体,自动完成质控信息、质控规则的判定以及相关质控图表的生成,随时监控各种仪器的工作状况,精确管理,保证检验质量。

利用LIS平台提升检验科医疗废物管理能力

文章介绍了利用LIS平台加强检验科医疗废物管理的具体办法和可行措施。通过LIS规范了检验科医疗废物处理流程,提高了工作效率,实现了对医疗废物处理各个环节的实时监控,保证了医疗废物的正确、安全处理。

床边check-list安全记录表在便携式化疗泵中的设计和应用

目的基于定时称重观察法配合床边check-list安全记录表,对使用便携式球囊化疗泵行化疗的消化道肿瘤患者进行研究,旨在探讨床边check-list安全记录表在管理便携式球囊化疗泵中的临床应用价值。方法抽取2020年1—5月在安徽医科大学第一附属医院肿瘤内科二病区行5氟尿嘧啶(5-FU)泵入化疗的消化道肿瘤患者84例,采用基于电子秤定时称重法的床边check-list安全记录表对化疗泵进行管理。结果62例使用5 ml/h型号的百特化疗泵,平均输注总时间为44.59 h(41.4~50.6 h属正常值范围);22例使用2 ml/h型号的百特化疗泵,平均输注总时间为116.25 h(108~132 h属正常值范围)。在输注过程中,共有26例出现速度快于标准速度(+10%)的情况,其中5 ml/h 19例,2 ml/h 7例;9例出现慢于标准速度(-10%)的情况,其中5 ml/h 5例,2 ml/h 4例。经过相对应的流速控制措施后均按时、顺利完成化疗药物的输注。结论使用化疗泵床边check-list安全记录表对便携式球囊化疗泵进行用药安全管理,能够确保化疗药物的按时、顺利输注,规范临床护士的操作行为,对恒定地维持患者体内的血药浓度,提高患者用药安全具有一定的积极意义。

LIS与“军卫一号”HIS系统集成

针对目前医院信息化建设中出现的医疗信息共享问题,介绍了部队医院信息系统"军卫一号"HIS系统与LIS系统集成流程,其中包括医生站发出检验申请,采样程序打印条码,检验科接受标本并且实现自动计价。主要接口开发工作包括住院医生站检验申请模块二次开发,oracle检验项目计价存储过程修改,门诊医生站和住院医生站检验结果查询模块拓展。

Evaluation of the safety and quality of day-case cataract surgery based on 4151 cases

AIM: To evaluate the safety, quality and prospects of day-case cataract surgery performed in a Jiangsu public tertiary hospital METHODS: The general and clinical data for patients who underwent day-case cataract surgery between August 1, 2014 and December 31, 2016 at this hospital were collected. The incidences of intraoperative and postoperative complications, preoperative and postoperative bestcorrected visual acuities(BCVAs), delayed discharge rate, rate of unplanned re-admission to hospital, and patient satisfaction were analyzed. RESULTS: A total of 4151 patients received cataract phacoemulsification surgery to correct age-related, congenital, traumatic, or complicated cataracts. Of these, age-related cataracts were the most frequently occurring. Patient age ranged from 18 to 101 y and the vast majority of patients were between 60 and 80 years old. Of the 4151 patients, 64.73%(2687/4151) had a systemic disease. The number of patients increased over the years, with the average number of patients per month being 90.4, 124.83, and 183.42 in 2014, 2015 and 2016, respectively. The average preoperative BCVA was 0.102±0.057 and average postoperative BCVAs at 1 d, 1 wk, and 1 mo post surgery were 0.453±0.264, 0.657±0.285, and 0.734±0.244, respectively. For intraoperative complications, 4.12%(171/4151) had posterior capsule rupture, 0.79%(33/4151) had iris or ciliary body injury, and 0.048%(2/4151) had suprachoroidal hemorrhage. For postoperative complications, 4.38%(182/4151) had cornea edema, 7.78%(323/4151) had intraocular hypertension, 0.096%(4/4151) had IOL toxicity syndrome, 0.28%(12/4151) had retained lens cortex, and 0.048%(2/4151) had hyphema. The delayed discharge rate was 0.82%(44/4151) and the unplanned re-admission to the hospital was 0(0/4151). The patient satisfaction rate was 91.42%(3795/4151). CONCLUSION: Day-case cataract surgery is safe and effective with good prospects for development.

Research on Southern Herbs and Li Medical Plants in Hainan

The current situation, development advantages and presenting problems of southern herbs and Li medical plants in Hainan Province were analyzed in this pa-per. ln addition, some ideas and solutions were proposed, providing a reference to government departments and investors.

Assessment of knowledge,cultural beliefs,and behavior regarding medication safety among residents in Harbin,China

BACKGROUND Medication misuse or overuse is significantly associated with poor health outcomes.Information regarding the knowledge,cultural beliefs,and behavior about medication safety in the general population is important.AIM To conduct a survey on medication habits and explored the potential factors impacting medication safety.METHODS The current survey included adults from 18 districts and counties in Harbin,China.A questionnaire on medication safety was designed based on knowledge,cultural beliefs,and behavior.Both univariate and multivariate analyses were used to explore the factors that impacted medication safety.RESULTS A total of 394 respondents completed the questionnaires on medication safety.The mean scores for knowledge,cultural beliefs,and behavior about medication safety were 59.41±19.33,40.66±9.24,and 60.97±13.69,respectively.The medication knowledge score was affected by age(P=0.044),education(P<0.001),and working status(P=0.015).Moreover,the cultural beliefs score was significantly affected by education(P<0.001).Finally,education(P=0.003)and working status(P=0.011)significantly affected the behavior score.CONCLUSION The knowledge,cultural beliefs,and behavior about medication safety among the general population was moderate.Health education should be provisioned for the elderly,individuals with a low education level,and the unemployed to improve medication safety in Harbin,China.

Promoting Clinician Well-Being and Patient Safety Using Human Factors Science: Reducing Unnecessary Occupational Stress

Our healthcare delivery system has accumulated complexity of payment, regulation systems, expectations and requirements. Often these are not designed to align with clinical thinking process flow of patient care. As a result, clinicians are utilizing enormous mental (cognitive) resource to comply with these complexities, over and above the baseline mental effort required to give good care to the patient. Recent studies suggest a significant number of physicians, advanced practice providers and nurses no longer want to stay in healthcare due to difficult work expectations and conditions that have become unreasonable. Technology has benefitted healthcare delivery, but also is a conduit of many expectations that have been grafted upon clinician workloads, exceeding the resources provided to accomplish them. Cognitive load is a measure of mental effort and is divided into Intrinsic, Germane and Extraneous Cognitive Load. Extraneous Cognitive Load (ECL) is what is not necessary and can be removed by better design. High cognitive load is associated with increased risk of both medical error and clinician burnout. Chronic high level occupational stress occurs from dealing with this job/resource imbalance and is showing serious personal health impact upon clinicians and the quality of the work they can provide for patients. Since organizational systems have become more complex, leadership methods, clinician wellbeing and patient safety efforts need to adjust to adapt and succeed. Safety efforts have tended to predominantly follow methods of a few decades ago with predominant focus upon how things go wrong (Safety I) but are now being encouraged to include more of the study of how things go right (Safety II). Human Factors/Ergonomics (HFE) science has been used in many industries to preserve worker wellbeing and improve system performance. Patient safety is a product of good system performance. HFE science helps inform mechanisms behind Safety I and II approach. HFE concepts augment existing burnout and safety interventions by providing a conceptual roadmap to follow that can inform how to improve the multiple human/technology, human/system, and human/work environment interfaces that comprise healthcare delivery. Healthcare leaders, by their influence over culture, resource allocation, and implementation of requirements and workflows are uniquely poised to be effective mitigators of the conditions leading to clinician burnout and latent medical error. Basic knowledge of HFE science is a strategic advantage to leaders and individuals tasked with achieving quality of care, controlling costs, and improving the experiences of receiving and providing care.

Knowledge Representation in Patient Safety Reporting: An Ontological Approach

Purpose： The current development of patient safety reporting systems is criticized for loss of information and low data quality due to the lack of a uniformed domain knowledge base and text processing functionality. To improve patient safety reporting, the present paper suggests an ontological representation of patient safety knowledge. Design/methodology/approach： We propose a framework for constructing an ontological knowledge base of patient safety. The present paper describes our design, implementation,and evaluation of the ontology at its initial stage. Findings： We describe the design and initial outcomes of the ontology implementation. The evaluation results demonstrate the clinical validity of the ontology by a self-developed survey measurement. Research limitations： The proposed ontology was developed and evaluated using a small number of information sources. Presently, US data are used, but they are not essential for the ultimate structure of the ontology.Practical implications： The goal of improving patient safety can be aided through investigating patient safety reports and providing actionable knowledge to clinical practitioners.As such, constructing a domain specific ontology for patient safety reports serves as a cornerstone in information collection and text mining methods.Originality/value： The use of ontologies provides abstracted representation of semantic information and enables a wealth of applications in a reporting system. Therefore, constructing such a knowledge base is recognized as a high priority in health care.

LIS系统的开放教学对医学检验专业教学质量的促进作用

医学检验技术是一类实践应用性专业,通过LIS平台培养学生的专业素养,提高学生的心理素质,激发学习兴趣;增进学生与专业教师之间的交流,锻炼教师队伍,对提高教学质量等方面起着很好的促进作用。

Patient Safety Efforts in Tanzania: A Rapid Review of Two-Decades Efforts (2002-2022) to Inform Interventions towards Attainment of 2030 Targets

Introduction: The need to address the problem of patient safety has been a focus of World Health Assembly (WHA) meetings of 2002, 2019 and 2021. The 2019 WHA Resolution urged the Member States to take action on patient safety. We aimed to review patient safety efforts in Tanzania from 2002 to 2022 to inform improvement efforts towards the 2030 target. Methods: A rapid literature review was conducted between January 2002 and April 2022. We searched Google, PubMed and PubMed Central in April and May 2022 using the following search terms: PubMed—“patient safety Tanzania”, “blood safety in Tanzania”, “safe surgery Tanzania”, and “healthcare-associated infections Tanzania”;Google—“blood safety in Tanzania”, injection safety in Tanzania”, “infection prevention and control”, “radiation safety in health facilities in Tanzania”;and PubMed Central—“injection safety in Tanzania. Results: The search identified 4160 articles, of which 4053 were removed in initial screening;21 were duplicates, giving 86 relevant articles for full screening. Of the 86 articles, 04 were removed after the full screening, hence remaining with 82 articles. Among the 82 eligible articles, 27 are on IPC, 26 on safe surgery, 12 on blood safety, 07 on radiation safety, 06 on injection safety, and 02 on medication safety. One article was relevant to—blood safety, IPC and injection safety;and one article was relevant to—IPC and injection safety. Conclusion: Most of the eligible literature was on IPC and safe surgery, followed by blood safety, radiation safety, injection safety and medication safety. The literature on IPC has highlighted the need to strengthen efforts to address AMR. Findings from the implementation of the safe surgery 2020 intervention warrants for its scale-up to other zones. There is a need to strengthen hemovigilance and pharmacovigilance functions;and strengthen quality management and assurance systems and regulatory functions to ensure radiation safety.

A Study to Assess Basic Food Safety Knowledge among University Students

Background: University students who visit off-campus university cafeterias during their academic life may lack some basic food safety knowledge. Study Aim: To evaluate university students’ basic knowledge of food safety in off-campus cafeterias. To explore whether the knowledge reported was influenced by the students’ educational backgrounds. Objects and Methods: Students from three different universities in Saudi Arabia were included. University A represented medical majors, University B represented a mix of both majors medical and non-medical, and University C represented only non-medical majors. Data Collection: An electronic questionnaire was circulated among 500 university students to evaluate their knowledge of food safety. The questionnaire had three main sections covering the cafeteria’s location as a food serving area, staff hygiene skills, and food preparation standards. The 5-point Likert scale consists of the following points: yes, maybe, no, it does not matter, I do not know. Only a “yes” answer indicated a positive response and proper awareness of the subject. Results: A total of 408 students participated, and the results showed significant differences in student knowledge between the three universities. In fact, University A’s students had better overall knowledge than University C’s students (0.001 < P). However, there was no significant difference between University A’s and University B’s students. The positive responses for the first part of the questionnaire which focused on off-campus cafeteria location, for 18 statements were from 26% to 90.4%. The positive responses for the second part of the questionnaire that focused on staff skills, for 8 statements were from 54.4% to 87.3%. Finally, the positive responses for the third part of the questionnaire which focused on food preparation, for 9 statements were 54.4% to 87.3%. Conclusion: Based on the overall comparison among universities, University A’s students have more knowledge in food safety in comparison to University C’s. University B’s students showed no significant difference with the latter two universities. The overall results suggest that students’ educational backgrounds can contribute effectively to the general knowledge of food safety.

Medication Safety Climate Questionnaire： Development and Psychometric Analysis

Medication safety improvement strategies require a better understanding of the safety culture specifically related to medicines. In healthcare, safety climate questionnaires are often used as a proxy measure of the underlying safety culture. However, there are currently not known instruments to assess medication safety climate. The study therefore aimed to develop and evaluate a medication safety climate questionnaire for healthcare staff in UK hospitals. Two validated patient safety climate instruments were adapted to develop a Medication Safety Climate （MSC） questionnaire. Data was collected from 510 healthcare professionals （response rate 9.4%）; routinely involved with prescribing, dispensing, administering and monitoring medication; in two acute NHS hospitals in London. Confirmatory factor analysis and reliability analyses were conducted to determine the psychometric properties of the MSC questionnaire. Results showed that the 50-item MSC questionnaire contained nine factors--teamwork climate, safety climate, job satisfaction, stress recognition, perceptions of management, working conditions, organisational learning, feedback and communication about error and management support for medication safety. Internal consistency reliability scores for eight of the nine factors were 〉 0.7 and ranged from 0.64 to 0.9. Correlations between eight factors showed a moderate relationship between the factors; ranging from 0.232 to 0.669. One factor, Stress recognition, had a weak and negative correlation with all other factors. Confirmatory factor analysis achieved an almost adequate model fit （x2/df ratio 2.572; root mean square error of approximation （RMSEA） 0.069; comparative fit index （CFI） 0.791）. The MSC questionnaire demonstrated reasonable psychometric properties. Further refinement using exploratory factor analysis is, however, required to improve the questionnaire＇s validity. This is the first known instrument to measure mediation safety climate in the UK and could be used to inform medication safety improvement strategies and monitor change in healthcare staff perceptions, related to medication safety, over time.