OBJECTIVES: Some hospitals have implemented computerized physician order entry (CPOE) systems to reduce the medical error rates. However, research in this area has been very limited, especially regarding the impact of CPOE use on the reduction of prescribing errors. Moreover, the past studies have dealt with the overall impact of CPOE on the reduction of broadly termed "medical errors", and they have not specified which medical errors have been reduced by CPOE. Furthermore, the majority of the past research in this field has been either qualitative or has not used robust empirical techniques. This research examined the impacts of usability of CPOE systems on the reduction of doctors' prescribing errors. METHODS: One hundred and sixty-six questionnaires were used for quantitative data analyses. Since the data was not normally distributed, partial least square path modelling-as the second generation of multivariate data analyses-was applied to analyze data. RESULTS: It was found that the ease of use of the system and information quality can significantly reduce prescribing errors. Moreover, the user interface consistency and system error prevention have a significant positive impact on the perceived ease of use. More than 50% of the respondents believed that CPOE reduces the likelihood of drug allergy, drug interaction, and drug dosing errors thus improving patient safety. CONCLUSIONS: Prescribing errors in terms of drug allergy, drug interaction, and drug dosing errors are reduced if the CPOE is not error-prone and easy to use, if the user interface is consistent, and if it provides quality information to doctors.
Drug Hypersensitivity ; Drug Interactions ; Humans ; Medical Errors ; Medical Order Entry Systems ; Statistics as Topic ; Surveys and Questionnaires

Among 8, 350 patients seen in the department of ophthalmology, Yonsei University Medical Center from August 1, 1968 to July 31, 1971 there were 2,313 who were seen because of refractive error. These were selected for classification and special statistical study. We reported two similar studies of 2,004 patients having errors in refraction among a total of 9,716 patients seen from August 1, 1958 to July 31, 1961 and 1,919 patients having errors in refraction among a total of 8,796 patients from August 1, 1965 to July 31, 1968 seen in the same department in 1962 and 1968 respectively. The finding of the more recently studied groups are compared with the studies made in 1962 and 1968. 1. 2,313 out of 8,350 patients seen in the department of ophthalmology had errors in refraction (27.7%). 2. 2,949 cases (63.8%) had refractive errors of the myopic type. 626 cases (13.5%) were hyperopic. The others had a simple and a mixed astigmatism. 3. 61.2% of the total group studied had astigmatism. 4. The highest incidence of refractive errors was found between 11 and 20 years of age The older patients had a low incidence. 5. Among the total number of refractive errors 56.3% were found to be in myopic patients who had less than a -3.00 diopters error. 16.8% were found among hyperopic patients who had less than a +3.00 diopters error. 6. Among the three types of astigmatic error seen 1,507 cases (53.2%) were "with the rule", 872 cases (30.8%) were "against the rule", and 456 cases (16.0%) were "oblique". 7. 6.9% of the total refractive errors were those of different types of anisometropia. The most commonly seen type was that of compound myopic anisometropia. The next type seen was simple myopic anisometropia and the least frequently seen type was compound hyperopic anisometropia. 8. When the results of the present study were compared with those found in 1962 and 1968 there are no significant difference between these three groups.
Academic Medical Centers ; Anisometropia ; Astigmatism ; Classification ; Humans ; Incidence ; Ophthalmology ; Refractive Errors ; Statistics as Topic

Among 8,796 patients seen in the department of ophthalmology Yonsei University Medical Center from August 1. 1965 to July 31, 1968 there were 1,919 who were seen because of refractive error. These were selected for classification and special statistical study. In 1962 we reported a similar study of 2,004 patients having errors in refraction among a total of 9,716 patients seen in the same department from August 1. 1958 to July 31. 1961. The findings of the more recently studied group are compared with the study made in 1962. 1. 1,919 out of 8.796 patients seen in the department of ophthalmology had errors in refraction (21.8%). 2. 2,932(76.3%) had refractive error of the myopic (including simple myopic astigmatism) type. 740(19.4%) were hyperopic (had simple hyperopic astigmatism). The others had a mixed astigmatism. 3. 56.5% of the total group studied had astigmatism. 4. The highest incidence of refractive errors was found between 11 and 20 years of age. The older patients had a low incidence. 5. There was no relationship between sex and the incidence of refractive error. 6. Among the total number of refractive errors 55.9% were found to be in myopic patients who had less than a -3.00 diopter error. 18.9% were found among hyperopic patients who had less than a +3.00 diopter error. 7. Among the three types of astigmatic errors seen 970 cases(44.7%) were "with the rule"; 864 cases(39.8%) were "against the rule"; and 336 cases (15.5%) were "oblique". 8. 9.6% of the total refractive errors were those of different types of anisometropia. The most commanly seen type was that of compound myopic anisometropia. The next type seen was compound hypo eropic anisometropia and the least frequently seen type was mixed anisometropia. 9. When the results of the present study were compared with those found in 1962 there were no significant differences found between the two groups.
Academic Medical Centers ; Anisometropia ; Astigmatism ; Classification ; Humans ; Incidence ; Ophthalmology ; Refractive Errors ; Statistics as Topic

Objective To study the medical malpractice cases involving death, and discuss the identification ideas and methods of medical malpractice cases. Methods A total of 291 medical malpractice cases involving death accepted and settled from January 2012 to December 2017 at the Judicial Appraisal Center of Southern Medical University were collected. Based on the age, gender, hospital level, clinical department, whether or not autopsy was performed, cause of death, cause of medical mistakes, causality and causative potency of the appraised person, statistical analysis was made. Results There were more males than females in medical malpractice cases involving death. Mostly young adults or children were involved in these cases. The number of cases involving tertiary hospitals was the highest; among the clinical departments, the internal medicine department had the largest number of cases, followed by surgery, obstetrics and gynecology, pediatrics, etc. Autopsy rate has a trend of increasing year by year. Most patients die from the natural outcomes of their disease or ineffective treatment. Most hospitals have certain medical mistakes, and have an indirect correlation with the patient's death, mainly slight factors. Conclusion Judicial appraisal of medical malpractice should follow the principle of "one-effect and multi-cause", and comprehensively consider various factors such as, the diseases and constitution of the patient, natural outcomes of the diseases, the current medical technology and the level of diagnosis and treatment of the hospital, etc.
Autopsy ; Cause of Death ; Child ; Death ; Female ; Hospital Departments/statistics & numerical data* ; Humans ; Male ; Malpractice/statistics & numerical data* ; Medical Errors/statistics & numerical data* ; Pregnancy ; Retrospective Studies ; Young Adult

OBJECTIVE: To explore the general characteristics of medical negligence in surgery in order to provide the reference for forensic practices. METHODS: One hundred and twelve cases of medical negligence in surgical department were retrospectively analyzed in Fada Institute of Forensic Medicine and Science from 2008 to 2010. RESULTS: The common types of medical negligence cases in the surgery were improper operation procedure (28.57%), failure of consent (26.79%), and inadequate monitoring (22.32%). The results of complications included disability or functional impairment (61.61%), death (31.25%) and transient impairment with no obvious adverse reactions (7.14%). The most common roles played by the medical negligence cases were minor role (26.79%), equal role (19.64%), and slight role (14.29%). CONCLUSION Significant attention should be paid to the operation procedure, consent, and monitoring. It should be cautious to not make assessment on involvement degree of medical negligence.
Cause of Death ; China ; Diagnostic Errors/statistics & numerical data* ; Expert Testimony/legislation & jurisprudence* ; Female ; Forensic Medicine ; Humans ; Informed Consent ; Intraoperative Complications/mortality* ; Male ; Malpractice/statistics & numerical data* ; Medical Errors/statistics & numerical data* ; Retrospective Studies ; Surgical Procedures, Operative

OBJECTIVETo investigate the knowledge level related to medical device adverse events (MDAEs) among medical personnels, some factors influencing the reporting behavior and supervision and administrative strategies.

METHODSStratified sampling, cluster sampling and random sampling were adopted together and a questionnaire survey was conducted among 1897 subjects from 33 hospitals.

RESULTSMedical personnels knew a very little about MDAEs and medical devices' post-market monitoring, but their attitudes towards its benefits were positive. Their intentions to report MDAEs were relatively strong, but there were still some barriers about it.

CONCLUSIONA monitoring system and a professional training model about MDAEs reporting should be established and improved in hospitals.

PURPOSE: The purpose of this study was to develop and evaluate an error reporting promoting program(ERPP) to systematically reduce the incidence rate of nursing errors in operating room. METHODS: A non-equivalent control group non-synchronized design was used. Twenty-six operating room nurses who were in one university hospital in Busan participated in this study. They were stratified into four groups according to their operating room experience and were allocated to the experimental and control groups using a matching method. Mann-Whitney U Test was used to analyze the differences pre and post incidence rates of nursing errors between the two groups. RESULTS: The incidence rate of nursing errors decreased significantly in the experimental group compared to the pre-test score from 28.4% to 15.7%. The incidence rate by domains, it decreased significantly in the 3 domains-"compliance of aseptic technique", "management of document", "environmental management" in the experimental group while it decreased in the control group which was applied ordinary error-reporting method. CONCLUSION: Error-reporting system can make possible to hold the errors in common and to learn from them. ERPP was effective to reduce the errors of recognition-related nursing activities. For the wake of more effective error-prevention, we will be better to apply effort of risk management along the whole health care system with this program.
Adult ; Double-Blind Method ; Female ; Humans ; *Internet ; Korea ; Medical Errors/*prevention & control/statistics & numerical data ; *Operating Room Nursing ; Risk Management/*methods ; *Staff Development ; Statistics, Nonparametric

OBJECTIVE: To analyze the main causes of medical dispute and the main types of medical malpractice. The related problems were discussed in forensic expertise. METHODS: Forty cases of medical dispute from 2006 to 2008 in our institute were analyzed retrospectively. RESULTS: In 40 cases of medical dispute, city-level hospitals, county-level hospitals, town-level hospitals and private clinics were 11 (27.5%), 24 (60.0%), 2 (5.0%) and 3 (7.5%) cases respectively. The internal medicine departments, surgical departments, gynaecological and obstetric departments, pediatric departments and outpatient center were 16 (40.0%),10 (25.0%), 9 (22.5%), 2 (5.0%) and 3 (7.5%) cases, respectively. The amount of cases from city-level hospitals, county-level hospitals diagnosed by the medical experts as the medical malpractice showed less than that from town-level hospitals and private clinics. CONCLUSION The amount of cases of medical dispute from city-level and county-level hospitals were more than that of town-level hospitals. But the amount of cases diagnosed by the medical experts as medical malpractice from city-level and county-level hospitals were less than that of town-level hospital and private clinics.
Expert Testimony ; Female ; Forensic Medicine ; Hospitals, County ; Hospitals, Urban ; Humans ; Male ; Malpractice/statistics & numerical data* ; Medical Errors/statistics & numerical data* ; Retrospective Studies

OBJECTIVE: To explore the main reasons of medical malpractice of fetal abnormalities and to analyze the key points and the ideas in judicial appraisal. METHODS: According to the related laws, regulations and clinical practice guidelines, the medical faults and the contribution degree in 12 medical malpractice cases about fetal abnormalities were analyzed. RESULTS: There were medical faults in five cases. Among them, the doctors did not fulfill the duty of inform in 2 cases, did not analyze the abnormal results comprehensively in 2 cases, did not have qualified medical conditions and normative reports in 1 case. The hospitals needed to take the minor responsibility in 2 cases and slight responsibility in 2 cases. CONCLUSION The key points in the judicial appraisal are whether the doctors abide by the related laws, regulations and clinical practice guidelines in prenatal examination, screen and diagnosis, and whether the doctors realize the limitations of ultrasonic testing and fulfill the obligation of inform.
Expert Testimony ; Female ; Fetus/abnormalities* ; Forensic Medicine ; Humans ; Informed Consent ; Malpractice/statistics & numerical data* ; Medical Errors/statistics & numerical data* ; Pregnancy ; Prenatal Diagnosis ; Retrospective Studies ; Ultrasonography, Prenatal

OBJECTIVE: To analyze the characteristics of medical malpractice from different grades of hospitals and to explore forensic investigation strategies in assessing medical dispute. METHODS: A total of 206 cases of medical dispute from 2009 to 2010 investigated by the Department of Forensic Medicine in Nanjing Medical University were selected and analyzed according to fault incidence, fault-prone part, and degree of causality in the treatment. RESULTS: Among the 206 cases analyzed, tertiary hospitals, secondary hospitals and primary hospitals showed medium, high and low error rate, respectively. A majority of medical malpractice cases were distributed in the departments of surgery, medicine and gynecology. CONCLUSION The frequency and severity of medical malpractice in primary hospitals were high, which were gradually reduced in tertiary and secondary hospitals.
Dissent and Disputes ; Expert Testimony ; Forensic Medicine ; Gynecology/statistics & numerical data* ; Hospital Departments/statistics & numerical data* ; Humans ; Incidence ; Malpractice/statistics & numerical data* ; Medical Errors/statistics & numerical data* ; Retrospective Studies ; Time Factors