ITEMAS ontology for healthcare technology innovation.

BACKGROUND: The Platform for Innovation in Medical and Health Technologies (ITEMAS) is a network of 66 healthcare centres focused on fostering innovation in medical and health technologies as an essential tool for increasing the sustainability of the Spanish healthcare system. The present research is focused on defining a formal representation that details the most relevant concepts associated with the creation and adoption of innovative medical technology in the Spanish healthcare system. METHODS: The methodology applied is based on the methontology process, including peer-review identification and selection of concepts from the ITEMAS innovation indicators and innovation management system standards. This stage was followed by an iterative validation process. Concepts were then conceptualised, formalised and implemented in an ontology. RESULTS: The ontology defined describes how relationships between employees, organisations, projects and ideas can be applied to generate results that are transferrable to the market, general public and scientific forums. Overall, we identified 136 concepts, 138 object properties and 30 properties in a five-level hierarchy. The ontology was tested and validated as an appropriate framework for calculating the ITEMAS innovation indicators. CONCLUSIONS: The consensus concepts were expressed in the form of an ontology to be used as a single communication format between the members of the ITEMAS network. Healthcare centres can compare their innovation results and obtain a better understanding of their innovation context based on the reasoning techniques of artificial intelligence. As a result, they can benefit from advanced analytical capabilities to define the most appropriate innovation policies for each centre based on the common experience of the large number of healthcare centres involved. The results can be used to create a map of agents and knowledge to show capabilities, projects and services provided by each of the participating centres. The ontology could also be applied as an instrument to match needs with existing projects and capabilities from the community of organisations working in healthcare technology innovation.

Refeeding syndrome.

Refeeding syndrome is a complex syndrome that occurs as a result of reintroducing nutrition (oral, enteral or parenteral) to patients who are starved or malnourished. Patients can develop fluid-balance abnormalities, electrolyte disorders (hypophosphataemia, hypokalaemia and hypomagnesaemia), abnormal glucose metabolism and certain vitamin deficiencies. Refeeding syndrome encompasses abnormalities affecting multiple organ systems, including neurological, pulmonary, cardiac, neuromuscular and haematological functions. Pathogenic mechanisms involved in the refeeding syndrome and clinical manifestations have been reviewed. We provide suggestions for the prevention and treatment of refeeding syndrome. The most important steps are to identify patients at risk, reintroduce nutrition cautiously and correct electrolyte and vitamin deficiencies properly.

Conciliación de lamedicación en unaunidad de cortaestancia médica / Conciliation in medication in a short stay medical unit

Objetivo: identificar los posibles errores de conciliación y sus características,así como analizar la discrepancia consignada por profesionalesfarmacéuticos y enfermeros.Material y métodos: estudio descriptivo transversal realizado en unaunidad de corta estancia médica del Complexo Hospitalario de Ourense,durante el primer trimestre de 2008. Variables estudiadas:características de los fármacos crónicos, discrepancias detectadas, historialde intolerancias y alergias y grado de concordancia de la valoraciónde farmacéutico-enfermera.Resultados: se estudiaron 151 pacientes y 859 fármacos. El consumomedio de fármacos por persona fue de 5,58 (DE: 3,65) fármacos. Elporcentaje global de errores de conciliación varía entre 49% (valoraciónenfermera) y el 28% (valoración farmacéutica). Grado deconcordancia a través del índice Kappa= 0,739. La discrepancia másfrecuente fue la omisión de fármacos con un 64%. La media de discrepanciaspor paciente fue de 1,73 (DE:1,9) de los que en un 44%presentan dos o más discrepancias a la vez.Conclusiones: la enfermera tiene un papel clave en la detecciónde errores de medicación derivados de discrepancias de conciliación.Conciliar la medicación es un instrumento fácil que permitedetectar los errores antes de que puedan producir daño (AU)

Objective: to identify the possible errors in conciliation and theircharacteristics as web as to analyse discrepancies detected by pharmacistsand nursesMaterial and methods: a cross-sectional, descriptive study conductedin a short stay medical unit at the Ourense medical centre duringthe first trimester of 2008. Studies variables: characteristics ofchronic drugs, identified discrepancies, medical history of intoleranceand allergies, and grade of concordance between the pharmacistand the nurse’s assessment.Results: 151 patients and 859 drugs were studied. Mean pharmaceuticaldrug consumption per person was 5.58 (SD: 3,65) drugs. Theoverall percentage of errors in conciliation varies between 49% (nursingassessment) and 28% (pharmacist assessment). Degree of concordanceobtained using Kappa’s index = 0.739. The strongest discrepancywas the omission of drugs with a 64%. Mean discrepancyper patient was 1.73 (SD:1.9) of which 44% present two or morediscrepancies simultaneously.Conclusions: the nurse plays a key role in detecting medicationerrors derived from conciliation discrepancies. Medication conciliationis an easy instrument that allows the nurse to identify errorsbefore any damage is caused (AU)