The Experts below are selected from a list of 27936 Experts worldwide ranked by ideXlab platform
Filip De Turck - One of the best experts on this subject based on the ideXlab platform.
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Design of ICU Medical decision support applications by integrating service oriented applications with a rule-based system
2009 2nd International Symposium on Applied Sciences in Biomedical and Communication Technologies, 2009Co-Authors: Femke Ongenae, Thomas Dupont, Wannes Kerckhove, Wouter Haerick, Kristof Taveirne, Filip De Turck, Johan DecruyenaereAbstract:The ICU of Ghent University Hospital is currently evaluating a Service-Oriented Architecture (SOA) that supports physicians in the follow-up of patients by providing a number of Medical support services. The main idea behind SOA is the separation of the functions of the system into well-defined, independent, reusable and distributable services. However, sometimes physicians require a more specific or slightly different functionality than the existing services offer. In these situations the system architecture imposes the time-consuming and error-prone development and testing of a new service. To counter this, a framework was developed that integrates a Rule-based component with the existing SOA platform. This allows users to add new functionalities as easy understandable Rules. This integration can be constructed in two ways. In the database-driven approach the Rule-based system is an extra layer between the database and the services. The service-oriented approach, on the other hand, works with the data provided by the services and does not interact directly with the database. Both approaches are detailed and compared to each other. Both solutions were evaluated with a Medical use case, namely detecting Systemic Inflammatory Response Syndrome (SIRS) in patients in the ICU
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Design of a JAIN SLEE/ESB-based platform for routing Medical data in the ICU
Computer methods and programs in biomedicine, 2008Co-Authors: Bruno Van Den Bossche, Johan Decruyenaere, Sofie Van Hoecke, Chris Danneels, Bart Dhoedt, Filip De TurckAbstract:The importance of computer aided decision making is continuously increasing. In the ICU, Medical decision support services gather and process Medical data of patients and present results and suggestions to the Medical staff. The Medical decision support services can monitor for example blood pressure, creatinine levels or the usage of antibiotics. If certain levels are crossed, they raise alerts so that the Medical staff can take appropriate actions if required. This significantly reduces the amount of data needing to be processed by the Medical staff. To handle the large amount of data that is generated by the ICU on a daily basis, a platform for routing and processing this data is necessary. In this paper we propose a platform based on JAIN SLEE and an Enterprise Service Bus. The platform takes care of the routing of the data to the appropriate services and allows to easily deploy and manage services. In this paper, we present the design details and the evaluation results. Furthermore, it is shown that the platform is capable of routing and processing all the events generated by the ICU within strict time constraints.
W Schaffner - One of the best experts on this subject based on the ideXlab platform.
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Focused microbiologic surveillance by specific hospital unit: practical application and clinical utility.
Clinical therapeutics, 1993Co-Authors: C W Stratton, H Ratner, P E Johnston, W SchaffnerAbstract:Focused microbiologic surveillance by specific hospital intensive care units (ICUs) revealed important differences in the occurrence of pathogens among units and at different times. Moreover, there were striking differences between the antibiogram summaries from certain ICUs and those from the hospital as a whole. Accordingly, an ongoing focused microbiologic surveillance was conducted for hospital ICUs to define unit-specific problems more clearly. To apply these data practically, results of focused surveillance were given to the ICU Medical directors. The directors were able to institute unit-specific modifications of antimicrobial usage based upon the prevalent pathogens and their susceptibility patterns within each unit. After 1 year of this approach, the susceptibility patterns of Pseudomonas aeruginosa to imipenem and other antipseudomonal beta-lactam agents were improved in a number of ICUs that had previously noted resistance problems of several years' duration. Susceptibility of P aeruginosa was markedly improved in the Medical ICU. The susceptibility patterns of Enterobacter cloacae were less affected, if at all. A review of antimicrobial use revealed that the use of most antipseudomonal agents in the Medical ICU had decreased by approximately 50% or more. It is concluded that modification of antimicrobial use in ICUs based on focused microbiologic surveillance is a promising way to detect and minimize problems with resistance.
Johan Decruyenaere - One of the best experts on this subject based on the ideXlab platform.
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Design of ICU Medical decision support applications by integrating service oriented applications with a rule-based system
2009 2nd International Symposium on Applied Sciences in Biomedical and Communication Technologies, 2009Co-Authors: Femke Ongenae, Thomas Dupont, Wannes Kerckhove, Wouter Haerick, Kristof Taveirne, Filip De Turck, Johan DecruyenaereAbstract:The ICU of Ghent University Hospital is currently evaluating a Service-Oriented Architecture (SOA) that supports physicians in the follow-up of patients by providing a number of Medical support services. The main idea behind SOA is the separation of the functions of the system into well-defined, independent, reusable and distributable services. However, sometimes physicians require a more specific or slightly different functionality than the existing services offer. In these situations the system architecture imposes the time-consuming and error-prone development and testing of a new service. To counter this, a framework was developed that integrates a Rule-based component with the existing SOA platform. This allows users to add new functionalities as easy understandable Rules. This integration can be constructed in two ways. In the database-driven approach the Rule-based system is an extra layer between the database and the services. The service-oriented approach, on the other hand, works with the data provided by the services and does not interact directly with the database. Both approaches are detailed and compared to each other. Both solutions were evaluated with a Medical use case, namely detecting Systemic Inflammatory Response Syndrome (SIRS) in patients in the ICU
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Design of a JAIN SLEE/ESB-based platform for routing Medical data in the ICU
Computer methods and programs in biomedicine, 2008Co-Authors: Bruno Van Den Bossche, Johan Decruyenaere, Sofie Van Hoecke, Chris Danneels, Bart Dhoedt, Filip De TurckAbstract:The importance of computer aided decision making is continuously increasing. In the ICU, Medical decision support services gather and process Medical data of patients and present results and suggestions to the Medical staff. The Medical decision support services can monitor for example blood pressure, creatinine levels or the usage of antibiotics. If certain levels are crossed, they raise alerts so that the Medical staff can take appropriate actions if required. This significantly reduces the amount of data needing to be processed by the Medical staff. To handle the large amount of data that is generated by the ICU on a daily basis, a platform for routing and processing this data is necessary. In this paper we propose a platform based on JAIN SLEE and an Enterprise Service Bus. The platform takes care of the routing of the data to the appropriate services and allows to easily deploy and manage services. In this paper, we present the design details and the evaluation results. Furthermore, it is shown that the platform is capable of routing and processing all the events generated by the ICU within strict time constraints.
Evelina Tacconelli - One of the best experts on this subject based on the ideXlab platform.
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Methicillin-resistant Staphylococcus aureus: source control and surveillance organization
Clinical Microbiology and Infection, 2009Co-Authors: Evelina TacconelliAbstract:Methicillin-resistant Staphylococcus aureus (MRSA) has been a common nosocomial pathogen since the 1960s, and has become a major problem in hospitals worldwide. Patients and the public are increasingly seeing MRSA and rates of MRSA infections as indicators of the quality of patient care. The control measures aimed at reducing the spread of MRSA among hospitals and communities include the following: education of healthcare workers, with implementation and adherence to hand-washing practices; restriction of antibiotic use; active surveillance cultures (ASCs); contact isolation of MRSA-positive patients; and pre-emptive isolation of high-risk patients. However, despite these interventions, MRSA is still endemic in many hospitals worldwide. In partICUlar, the role of ASCs is still under debate. International guidelines suggest that extensive ASCs should only be used in intensive-care units (ICUs), and routine screening of all hospital admissions is not usually advocated. Local decisions can be made on the basis of types of risk factor of non-ICU patients. Before starting ASCs, laboratories should be prepared for the workload, and the turn-around time for screening tests should be reduced and arrangements made to monitor the effectiveness of this intervention. Most recently, rapid methods for molecular detection of MRSA colonization have been developed. Published studies differ in their settings (ICU, Medical wards, surgical wards), choice of patient population, severity of illness, hospital infection control measures, and study design. The existing evidence does not support the wide application of rapid molecular screening for MRSA.
Victoria J. Fraser - One of the best experts on this subject based on the ideXlab platform.
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Preventing catheter-associated bloodstream infections: a survey of policies for insertion and care of central venous catheters from hospitals in the prevention epicenter program.
Infection control and hospital epidemiology, 2006Co-Authors: David K. Warren, Deborah S. Yokoe, Michael W. Climo, Loreen A. Herwaldt, Gary A. Noskin, Gianna Zuccotti, Jermone I Tokars, Trish M. Perl, Victoria J. FraserAbstract:OBJECTIVE. To determine the extent to which evidence-based practices for the prevention of central venous catheter (CVC)-associated bloodstream infections are incorporated into the policies and practices of academic intensive care units (ICUs) in the United States and to determine variations in the policies on CVC insertion, use, and care. DESIGN. A 9-page written survey of practices and policies for nontunneled CVC insertion and care. SETTING. ICUs in 10 academic tertiary-care hospitals. PARTICIPANTS. ICU Medical directors and nurse managers. RESULTS. Twenty-five ICUs were surveyed (1-6 ICUs per hospital). In 80% of the units, 5 separate groups of clinicians inserted 24%-50% of all nontunneled CVCs. In 56% of the units, placement of more than two-thirds of nontunneled CVCs was performed in a single location in the hospital. Twenty units (80%) had written policies for CVC insertion. Twenty-eight percent of units had a policy requiring maximal sterile-barrier precautions when CVCs were placed, and 52% of the units had formal educational programs with regard to CVC insertion. Eighty percent of the units had a policy requiring staff to perform hand hygiene before inserting CVCs, but only 36% and 60% of the units required hand hygiene before accessing a CVC and treating the exit site, respectively. CONCLUSION. ICU policy regarding the insertion and care of CVCs varies considerably from hospital to hospital. ICUs may be able to improve patient outcome if evidence-based guidelines for CVC insertion and care are implemented.
