Patient Safety in Nursing Homes From an Ecological Perspective: An Integrated Review.

OBJECTIVES: The aims of the study were to identify the systemic factors affecting the characteristics and safety of older adults living in nursing homes and the resulting resident outcomes and to explore the relationship between them through an integrated literature review. METHODS: A literature search was conducted from April 22 to May 6, 2021, in the PubMed, Embase, Cochrane CENTRAL, CIHNAL, RISS, NDL, and KoreaMed databases. The following key words and MeSH terms were used for the search: "nursing home," "skilled nursing facility," "long-term care facility," and "patient safety" or "safety." RESULTS: Forty-seven qualifying articles were finally selected. Three domains were derived as personal factors, 12 as facility factors, and one as a policy factor. The interrelationships between them could result in positive or negative resident outcomes. The relationship between them was also reconstructed from an ecological perspective. CONCLUSIONS: The results demonstrated that the safety and quality of life of older adults living in nursing homes were affected by both individual and institutional factors.

Development of freshwater sediment management standards for organic matters, nutrients, and metals in Korea.

Korean water quality managers are required to promptly develop national assessment standards for freshwater sediment quality due to the Four Major River Restoration Project in Korea in 2009. We conducted this study to develop sediment management standards (SMSs), determining obviously and severely polluted sediment, which could have adverse impacts on water quality and aquatic ecosystem. The SMSs values were derived from the 95th percentile of concentration distribution for organic matter and nutrients in sediment quality database. For the SMSs of metals, foreign sediment quality guidelines (SQGs) were adopted. As a result, 13% for loss on ignition (LOI), 1,600 mg/kg for total phosphorus (TP), and 5,600 mg/kg for total nitrogen (TN) were set as the SMSs for freshwater sediment in Korea. These values were higher than the range of heavily polluted sediment from USEPA Region 5 guideline derived by the similar approaches for the Great Lakes harbor sediments, and similar or lower than the severe effect level (SEL) from provincial sediment quality guideline (PSQG) of Ontario, Canada by screening level concentration (SLC) approach. However, SMSs in the present study are appropriate considering the concentration ranges and the Korean SMSs' definition for freshwater sediments in Korea. The Puget Sound marine sediment cleanup screening level (CSL) in Washington State, USA were adopted as the Korean SMSs for As (93 mg/kg), Cd (6.7 mg/kg), Cr (270 mg/kg), Cu (390 mg/kg), Pb (530 mg/kg), and Zn (960 mg/kg) in freshwater sediments. Hg concentration (0.59 mg/kg) of CSL was too low to determine the polluted freshwater sediments in Korea, and the SEL of Ontario, Canada for mercury concentration (2 mg/kg) was selected as the SMS for Hg. These values were found reasonable through the assessment of applicability with the datasets from locations directly affected by obvious point sources. These results indicate that SMSs for organic matter, nutrient, and metals derived within the present study can successfully determine obviously and severely polluted sediment in Korea. However, the SMSs have limits to specifically determine the effects of polluted sediment on water quality and aquatic ecosystem in Korea. Thus, we will revise and specify SMSs considering those effects and further sediment quality assessment framework in the near future.

Pure SF6 and SF6-N2 mixture gas hydrates equilibrium and kinetic characteristics.

Sulfur hexafluoride (SF6), whether pure or mixed with inexpensive inert gas, has been widely used in a variety of industrial processes, but it is one of the most potent greenhouse gases. For this reason, it is necessary to separate and/or collect it from waste gas streams. In this study, we investigated the pure SF6 and SF6-N2 mixture gas hydrates formation equilibrium aswell asthe gas separation efficiency in the hydrate process. The equilibrium pressure of SF6-N2 mixture gas was higher than that of pure SF6 gas. Phase equilibrium data of SF6-N2 mixture gas was similar to SF6 rather than N2. The kinetics of SF6-N2 mixture gas was controlled by the amount of SF6 at the initial gas composition as well as N2 gas incorporation into the S-cage of structure-II hydrate preformed by the SF6 gas. Raman analysis confirmed the N2 gas incorporation into the S-cage of structure-II hydrate. The compositions in the hydrate phase were found to be 71, 79, 80, and 81% of SF6 when the feed gas compositions were 40, 65, 70, and 73% of SF6, respectively. The present study provides basic information for the separation and purification of SF6 from mixed SF6 gas containing inert gases.

Development of a computerized observational data collection tool for a medication error study.

The purpose of this study was to introduce the development of a computerized tool, called 'MedObs Collector' and its' qualitative usefulness in a medication error study. The requirements for a tool were driven from the medication error research design and users of five research assistants. The MedObs Collector was designed to support multi-user data input and automatic match between data records. MS Access(R) was used in implementation. We applied this tool to collecting and managing data in a clinical setting and received feedback from users. Through the informal evaluation we found several advantages in training and establishing reliability. It has also reduced the amount of time required for data entry.