Reviving 30 Year Old Technology: Lessons Learned from Transferring Patient Data Using Data Matrix Codes.

In patient care and medical research patient data often has to be transferred between different electronic systems. These systems can be very heterogeneous, sometimes even legacy systems, and thus, often do not support standardized interfaces for data transfer. Since nowadays barcode scanners are commonly used in clinical routine and smartphones are accessible to most patients, we implemented different interfaces based on Data Matrix codes to transfer patient data between several medical applications. Objective of this work is to show different use cases in which Data Matrix codes have been successfully applied and discuss the lessons we have learned during the process of implementation and practical usage.

Novel primers improve species delimitation in Cercospora.

The genus Cercospora includes many important plant pathogens that are commonly associated with leaf spot diseases on a wide range of cultivated and wild plant species. Due to the lack of useful morphological features and high levels of intraspecific variation, host plant association has long been a decisive criterion for species delimitation in Cercospora. Because several taxa have broader host ranges, reliance on host data in Cercospora taxonomy has proven problematic. Recent studies have revealed multi-gene DNA sequence data to be highly informative for species identification in Cercospora, especially when used in a concatenated alignment. In spite of this approach, however, several species complexes remained unresolved as no single gene proved informative enough to act as DNA barcoding locus for the genus. Therefore, the aims of the present study were firstly to improve species delimitation in the genus Cercospora by testing additional genes and primers on a broad set of species, and secondly to find the best DNA barcoding gene(s) for species delimitation. Novel primers were developed for tub2 and rpb2 to supplement previously published primers for these loci. To this end, 145 Cercospora isolates from the Iranian mycobiota together with 25 additional reference isolates preserved in the Westerdijk Fungal Biodiversity Institute were subjected to an eight-gene (ITS, tef1, actA, cmdA, his3, tub2, rpb2 and gapdh) analysis. Results from this study provided new insights into DNA barcoding in Cercospora, and revealed gapdh to be a promising gene for species delimitation when supplemented with cmdA, tef1 and tub2. The robust eight-gene phylogeny revealed several novel clades within the existing Cercospora species complexes, such as C. apii, C. armoraciae, C. beticola, C. cf. flagellaris and Cercospora sp. G. The C. apii s. lat. isolates are distributed over three clades, namely C. apii s. str., C. plantaginis and C. uwebrauniana sp. nov. The C. armoraciae s. lat. isolates are distributed over two clades, C. armoraciae s. str. and C. bizzozeriana. The C. beticola s. lat. isolates are distributed over two clades, namely C. beticola s. str. and C. gamsiana, which is newly described.

The use of information technology to enhance patient safety and nursing efficiency.

BACKGROUND: Issues in patient safety and nursing efficiency have long been of concern. Advancing the role of nursing informatics is seen as the best way to address this. OBJECTIVES: The aim of this study was to determine if the use, outcomes and satisfaction with a nursing information system (NIS) improved patient safety and the quality of nursing care in a hospital in Taiwan. METHOD: This study adopts a quasi-experimental design. Nurses and patients were surveyed by questionnaire and data retrieval before and after the implementation of NIS in terms of blood drawing, nursing process, drug administration, bar code scanning, shift handover, and information and communication integration. RESULTS: Physiologic values were easier to read and interpret; it took less time to complete electronic records (3.7 vs. 9.1 min); the number of errors in drug administration was reduced (0.08% vs. 0.39%); bar codes reduced the number of errors in blood drawing (0 vs. 10) and transportation of specimens (0 vs. 0.42%); satisfaction with electronic shift handover increased significantly; there was a reduction in nursing turnover (14.9% vs. 16%); patient satisfaction increased significantly (3.46 vs. 3.34). CONCLUSIONS: Introduction of NIS improved patient safety and nursing efficiency and increased nurse and patient satisfaction. Medical organizations must continually improve the nursing information system if they are to provide patients with high quality service in a competitive environment.

Blood Culture Testing via a Mobile App That Uses a Mobile Phone Camera: A Feasibility Study.

BACKGROUND: To evaluate patients with fever of unknown origin or those with suspected bacteremia, the precision of blood culture tests is critical. An inappropriate step in the test process or error in a parameter could lead to a false-positive result, which could then affect the direction of treatment in critical conditions. Mobile health apps can be used to resolve problems with blood culture tests, and such apps can hence ensure that point-of-care guidelines are followed and processes are monitored for blood culture tests. OBJECTIVE: In this pilot project, we aimed to investigate the feasibility of using a mobile blood culture app to manage blood culture test quality. We implemented the app at a university hospital in South Korea to assess the potential for its utilization in a clinical environment by reviewing the usage data among a small group of users and by assessing their feedback and the data related to blood culture sampling. METHODS: We used an iOS-based blood culture app that uses an embedded camera to scan the patient identification and sample number bar codes. A total of 4 medical interns working at 2 medical intensive care units (MICUs) participated in this project, which spanned 3 weeks. App usage and blood culture sampling parameters (including sampler, sampling site, sampling time, and sample volume) were analyzed. The compliance of sampling parameter entry was also measured. In addition, the participants' opinions regarding patient safety, timeliness, efficiency, and usability were recorded. RESULTS: In total, 356/644 (55.3%) of all blood culture samples obtained at the MICUs were examined using the app, including 254/356 (71.3%) with blood collection volumes of 5-7 mL and 256/356 (71.9%) with blood collection from the peripheral veins. The sampling volume differed among the participants. Sampling parameters were completely entered in 354/356 cases (99.4%). All the participants agreed that the app ensured good patient safety, disagreed on its timeliness, and did not believe that it was efficient. Although the bar code scanning speed was acceptable, the Wi-Fi environment required improvement. Moreover, the participants requested feedback regarding their sampling quality. CONCLUSIONS: Although this app could be used in the clinical setting, improvements in the app functions, environment network, and internal policy of blood culture testing are needed to ensure hospital-wide use.

Bar Coding and Tracking in Pathology.

Bar coding and specimen tracking are intricately linked to pathology workflow and efficiency. In the pathology laboratory, bar coding facilitates many laboratory practices, including specimen tracking, automation, and quality management. Data obtained from bar coding can be used to identify, locate, standardize, and audit specimens to achieve maximal laboratory efficiency and patient safety. Variables that need to be considered when implementing and maintaining a bar coding and tracking system include assets to be labeled, bar code symbologies, hardware, software, workflow, and laboratory and information technology infrastructure as well as interoperability with the laboratory information system. This article addresses these issues, primarily focusing on surgical pathology.

Implementation of electronic identification system for blood transfusion in the setting of hematopoietic progenitor cell infusion at the bedside.

Hematopoietic progenitor cell (HPC) infusion at the bedside is a critical step in HPC transplantation. In this study, we implemented a bar code-based electronic identification system (EIS) for blood transfusion in the setting of HPC infusion at the bedside. Between July 2003 and December 2014, a total of 518 HPC products were infused to 190 patients without a single misinfusion in the hospital. An overall compliance rate with the electronic pre-infusion check for HPC infusion at the bedside was 100%. Our observations suggest that an EIS can be successfully applied to the infusion of HPC products at the bedside.

Bar Coding and Tracking in Pathology.

Bar coding and specimen tracking are intricately linked to pathology workflow and efficiency. In the pathology laboratory, bar coding facilitates many laboratory practices, including specimen tracking, automation, and quality management. Data obtained from bar coding can be used to identify, locate, standardize, and audit specimens to achieve maximal laboratory efficiency and patient safety. Variables that need to be considered when implementing and maintaining a bar coding and tracking system include assets to be labeled, bar code symbologies, hardware, software, workflow, and laboratory and information technology infrastructure as well as interoperability with the laboratory information system. This article addresses these issues, primarily focusing on surgical pathology.

Automatización en el laboratorio clínico / Automation in the clinical laboratory

La automatización de los laboratorios clínicos es un fenómeno que va en aumento, un proceso aplicable a todas las etapas del proceso analítico; el uso de la computación, la incorporación de autoanalizadores y otros elementos automáticos proporciona una serie de ventajas mejorando la eficiencia y la capacidad productiva en beneficio de los pacientes, de los profesionales y del propio laboratorio, reconocer el momento adecuado en que debe aplicarse la automatización así como el grado y etapas en las que se puede intervenir reporta una serie de beneficios, este cambio debe hacerse en forma planificada considerando elementos tales como los costos, la capacitación del personal y las tecnologías disponibles.

The automation of the clinical laboratories is a phenomenon that increases, a process applicable to all the stages of the analytical process, the use of the computation, the incorporation of autoanalyzers and other automatic elements provide a series of advantages improving the efficiency and the productive capacity to the benefit of the patients, of the professionals and the own laboratory, to recognize the suitable moment in which it must be applied to the automation as well as the degree and stages in which it is possible to be taken part reports a series of benefits, this change must be made in planned form considering elements such as the costs, the qualification of the personnel and the technologies available.