Eczane bilgi yönetim sistemlerinin serbest eczanelerde kullanımının değerlendirilmesi : İstanbul ili örneği

ÖZET Amaç: Bu araştırmada, Eczane Bilgi Yönetim Sistemlerinin (EBYS) serbest eczanelerde kullanılmasına yönelik mevcut durum değerlendirmek amaçlanmıştır.Gereç ve Yöntem: Araştırmaya 119 Eczacı ve 170 Eczane çalışanı katılmıştır. Veriler, yüz yüze görüşme yöntemi ile doldurulan yapılandırılmış anket formu ile elde edilmiştir. Hem Eczane Teknoloji Kabul Modeli (E-TKM) ölçeği hem de Eczane Bilgi Yönetim Sistemi ölçek geliştirilmesi sürecinde yapısal geçerliliği incelemek için faktör analizi uygulandı. Eczane TKM tek modelde toplanırken, EBYS ölçeği 4 alt boyutta oluşmuştur. Bu alt boyutlar; Hasta Güvenliği, Fonksiyonellik, Sistem Güvenliği ve Mahremiyet ve Kullanışlılık olarak isimlendirilmiştir. EBYS alt boyut puanlarının bağımlı değişken olduğu aracı analizlerde; EBYS kullanım becerisi bağımsız değişken iken Eczane TKM puanı ise olası aracı değişken olarak analiz edilmiştir. Bulgular: Araştırma grubunda, “Eczane Bilgi Yönetim Sistemi kullanma becerisi’ iyi olanlarda “Eczane Teknoloji Kabul Modeli (E-TKM)” puanı (p=0,007) ile EBYS “Hasta Güvenliği” (p=0,003), “Fonksiyonellik” (p=0,001) ve “Mahremiyet ve Kullanışlılık” alt boyut puanlarının (p=0,000) diğerlerine göre daha yüksek olduğu belirlenmiştir. EBYS kullanım becerisinin iyi olmasının hem EBYS Fonksiyonellik alt boyut puanı (β:0,1084 p=0.000) hem de EBYS Mahremiyet ve Kullanışlılık puanının (β:0,1812 p=0,0001) artışı ile ilişkili olduğu belirlenmiştir. Eczane TKM puanının ise her iki modelde de aracı değişken olduğu belirlenmiştir (p<0.05).Sonuç: Hem EBYS kullanım becerisi hem de E-TKM düzeyi EBYS’nin “Fonksiyonellik” ile “Mahremiyet ve Kullanışlılık” alt boyutları için önemli değişkenler olduğu belirlenmiştir.İÇİNDEKİLER Sayfa No.ÖZET1ABSTRACT2GİRİŞ VE AMAÇ31.BİLGİ, BİLGİ TOPLUMU ve BİLGİ TEKNOLOJİLERİ51.1.Bilgi Kavramı ve Önemi51.2.Bilgi Toplumu61.3.Bilgi Teknolojileri71.4.Bilgi Teknolojilerinin Gelişim Aşamaları91.5.Bilgi Teknolojilerinin Sınıflandırılması101.5.1.Veri işleme sistemleri101.5.2.Yönetim bilgi sistemleri101.5.3.Karar destek sistemleri111.5.4.Yapay Zeka ve Uzman Sistemler111.5.5.Ofis Otomasyon Sistemleri111.5.6.Üst Yönetim Bilgi Sistemleri122.SAĞLIK BİLGİ SİSTEMLERİ ve E-SAĞLIK UYGULAMALARI132.1.Sağlık Bilgi Sistemleri152.2.Sağlık Bilgi Sistemlerinin Uygulama Alanları172.3.Sağlık Bilgi Sistemlerinin Temel Bileşenleri182.4.Sağlık Bilgi Sistemi Standartları182.4.1.Ulusal sağlık veri sözlüğü182.4.2.Sağlık kodlama referans sunucusu192.4.3.Sağlık seviye 7 standardı (Health Level-7)192.5.Ulusal Sağlık Sistemi192.5.1.Sağlık.Net192.5.2.Merkezi hekim randevu sistemi (MHRS)202.5.3.Tele-Tıp202.5.4.E-Nabız212.5.5.Mobil sağlık213.İLAÇ HATALARI ve İLAÇ GÜVENLİĞİ YÖNETİMİ223.1.İlaç Hataları ve Sınıflandırılması223.1.1.Reçetelendirme hataları233.1.2.Kayıt hataları233.1.3.İlaç hazırlama hataları233.1.4.Uygulama hataları233.2.İlaç Güvenliği Yönetimi243.3.İlaç Güvenliği Yönetim Süreci Planlama243.3.1.Hasta bilgisi243.3.2.İlaç bilgileri253.3.3.Etkili iletişim253.3.4.İlaç adı, etiket ve paketlerinin düzenlenmesi263.3.5.Uygun koşullarda saklama ve dağıtım263.3.6.İlaç uygulamasında doğru cihazların seçimi263.3.7.Çevresel faktörler ve personel iş yükü273.3.8.Personel yeterliği ve eğitim273.3.9.Hasta eğitimi273.3.10.Kalite Süreçleri ve Risk Yönetimi284.İLAÇ HATALARINI ÖNLEMEDE KULLANILAN SAĞLIK BİLGİ SİSTEMLERİ294.1.Hekim Orderlarının Elektronik Ortama Girişi (Computerized Physician Order Entry)294.2.Klinik Karar Destek Sistemleri (Clinical Decision Support Systems)294.3.Elektronik Sağlık Kayıtları (Electronic Health Records)304.4.Advers Olay ve Uyarı Sistemleri304.5.Elektronik İnfüzyon Cihazları314.6.Barkodlu İlaç Uygulama Sistemleri314.7.Elektronik Reçete Sistemleri (E-Reçete)324.8.İlaç Takip Sistemleri344.9.Eczane Bilgi Yönetim Sistemleri344.9.1.Eczane bilgi yönetim sistemi temel bileşenleri354.9.1.1.Reçete yönetimi modülü364.9.1.2.Stok ve satınalma yönetimi modülü364.9.1.3.Raporlama modülü364.9.1.4.Klinik gözlem modülü374.9.1.5.Diğer sistemlerle bağlantı kurma374.9.1.6.Taburcu ve faturalandırma işlemleri modülü384.9.1.7.Veri güvenliği384.9.1.8.Veri yedekleme384.9.1.9.Eczane bilgi yönetim sistemleri ve teknolojik yapı395.ARACI ANALİZİ405.1.Basit Aracı Model406.GEREÇ VE YÖNTEM426.1.Araştırma Evreni, Örneklemi ve Veri Toplama Yöntemi426.2.Veri Toplama Aracı426.3.Geçerlik ve Güvenirlik446.4.Araştırmanın Hipotezleri476.5.İstatistiksel Değerlendirme476.5.1.Aracı analizi486.5.1.1.Basit aracı model487.BULGULAR498.TARTIŞMA VE SONUÇ789.KAYNAKLAR9410.EKLER11711.ÖZGEÇMİŞ122--------------------ABSTRACTObjective: In this study, it was aimed to evaluate current status of Pharmacy Information Management Systems (PIMS) used in community pharmacies. Materials and Methods: 119 pharmacists and 170 pharmacy staff working in the community pharmacies were included in the study. The data were collected by a structured questionnaire in face to face interviews. Factor analyses were performed to examine structural validity in the development of the both Pharmacy Technology Acceptance Model scale and PIMS scale. Items of the Pharmacy TAM were collected in a single model whereas 4 subgroups regarding Patient Safety, Functionality, System Safety and Confidentiality and Usability were occured in PIMS scale. In mediation analysis, PIMS subscale scores were dependent variables, Pharmacy TAM score was analyzed as a possible mediator variable and PIMS score was an indepent variable.Results: In the study group, "Pharmacy Technology Acceptance Model (P-TAM)" score (p=0.007) and PIMS "Patient Safety" (p=0.003), "Functionality" (p=0.001) and "Confidentiality and Usability" subscale scores (p=0.000) were higher than others for those who are good at "skills of using Pharmacy Information Management Systems". Good ability to use PIMS was determined to be associated with both increasing in Functionality subscale score (β:0.1084 p=0.000) and Confidentiality and Usability subscale score (β:0.1812 p=0.0001). In both model, P_TAM scores were observed to be mediators (p<0.05).Conclusions: PIMS skills and Pharmacy TAM levels were determined to be important variables for the increase in “Functionality” and “Confidentiality and Usability” subscale scores for PIMS

Airborne pollen grains of Manisa

Manisa ilinin atmosferik polenleri, iki yıllık periyotta (1990-1991) Durham cihazı kullanılarak çalışılmıştır. İki yıllık sürede 55 taksona ait toplam 8858 adet polen tespit edilmiştir. Bunların 5148'i 1990, 3710'u ise 1991 yılında tanımlanmıştır. Toplam polen miktarının % 78.60'ı odunsu, % 20.17'si otsu ve % 1.23'ü ise tanımlanamamıştır. Çalışılan bölgede, sırası ile Pinus spp., Gramineae, Cupressaceae I Taxaceae, Olea spp., Quercus spp., Platanus spp., Morus spp., Casuarina spp., Plantago spp. ve Chenopodiaceae I Amaranthaceae taksonlarma ait polenler yoğun olarak bulunmuştur. Çalışma süresince en fazla polene Mart ile Mayıs arasında rastlanmıştır.The airborne pollen grains of Manisa have been studied for two years (1990-1991) with a Durham sampler. During these two years, a total of 8858 pollen grains belonging to 55 taxa have been identified and recorded with some unidentified ones. of them, 5148 were identified in 1990 and 3710 in 1991. of the total pollen grains, 78.60 % were arboreal, 20.17 % non-arboreal and 1.23 % unidentified. Pinus spp., Gramineae, Cupressaceae I Taxaceae, Olea spp., Quercus spp., Platanus spp., Morus spp., Casuarina spp., Plantago spp. and Chenopodiaceae I Amaranthaceae released the greatest amounts of pollen grains in the region investigated. During the study period, the pollen concentration reached its highest level between March and May

In vitro evaluation of microleakage of class V cavities restored with new flowable compomers on the primary teeth.

INTRODUCTION: The aim of the study was to evaluate the in vitro microleakage of new flowable compomers in the class V cavities of primary teeth. METHODS: Thirty freshly extracted, non-carious, primary molars without visible defects were used in this study. Class V cavities (n = 60), with the occlusal and cervical margins located in the enamel, were prepared on the buccal and lingual surfaces. The samples were randomly divided into 3 groups of 20 each. Group 1: restored with Twinky Star Flow (Voco, Cuxhaven, Germany), Group 2: restored with Dyract Flow (Dentsply, Konstanz, Germany) and Group 3: restored with R&amp;D Series Nova Compomer Flow (Imicryl, Konya, Turkey) according to the manufacturer's instructions. After a thermocycling regimen of 1000 cycles between 5°C and 55°C, the samples were isolated, immersed in 0.5% basic fuchsine solution for 24 h at 37°C and sectioned longitudinally in a buccolingual direction. The sections were evaluated for values of microleakage with a stereomicroscope. RESULTS: All materials showed microleakage but no statistically significant difference was observed among the groups (p&gt;0.05). The highest microleakage score was observed in group II (1.65 ± 0.49) and group I (1.75 ± 0.44) at occlusal and gingival margins, respectively. CONCLUSIONS: Flowable compomers showed insignificantly least amount of microleakage in class V cavities prepared on primary molars

Determination level of heavy metal in Ayvalik Saltern using Halimione portulacoides (L.) plant

In this study, the level of Pb, Zn, Cd of Ayvalik Saltern, determined by using Halimione portulacoides (L.) Aellen, analysis were done by using Perkin Elmer Analyst 700 Flame Atomic Absorption Spectrophotometer (FAAS) device. Saltern which is located adjacent to the Izmir-Canakkale highway, heavy metals changes determined, depending on the distance to the highway. The root, stem, leaves, and cultivation soil of plant was formed material of this study. Sampling, were done 7 station which was determined on the soil dam is surrounding saltern between 2009-2010. Through 12 months, samples regularly collected from every station. As a result of all analysis, we saw the level of Pb <0.001-0.977 ppm, Zn 0.099-1.650 ppm, Cd <0.001-0.102 ppm in the soil Pb 0.523-1.599 ppm, Zn 0.143-1.248 ppm ve Cd 0.006-0.432 ppm. Accumulation of Pb and Zn increased depend on a highway, Cd accumulation couldn’t be obtained clear correlation with distance highway. The fact that the results İn the analysis are below the limit values is because the dominant direction of the wind is North-west (through Tuzla motorway), there aren’t any crossroads or signalization on the motorway on the southern part of Tuzla and there aren’t any industrial plants having polluting effects

Ayvalık Tuzlasında Yayılış Gösteren Suaeda prostrata subsp. prostrata Pall. Alttürünün Ağır Metal Birikimi

In this study, were determined level of Pb, Zn, Cd and Ni in Suaeda prostrata subsp. prostrata Pall. which is spread in Ayvalık Saltern is partaking Izmir-Canakkale highway. Analysis were done by using Perkin Elmer Analyst 700 Flame Atomic Absorption Spectrophotometer (FAAS) device. The root, stem, leaves and cultivation soil of plant was formed material of this study. Sampling, were done 8 station which is determined on the soil dam is surrounding saltern. Through 12 months, samples regulary receipt from every station. As a result of all analysis, we saw the level Pb <0.001-1.026 ppm, Zn 0.016-1.389 ppm, Cd <0.001-0.166 ppm and Ni 0.006-0.809 ppm in the soil Pb 0.523-1.599 ppm, Zn 0.143-1.248 ppm, Cd 0.006-0.298 ppm and Ni 0.112-1.098 ppm... The fact that the results İn the analysis are below the limit values is because of the fact that the dominant diraction of the wind is North-west (through Tuzla motorway), there aren’t any crossroads or signalization on the motorway on the soutern part of Tuzla and there aren’t any industrial plants having polluting effects

Ayvalık Tuzlasında Halimione portulacoides ( L. ) Aellen Bitkisi Kullanılarak Nikel Düzeyinin Belirlenmesi

In this study, the level of nickel of Ayvalik Saltern which is partaking Izmir-Canakkale highway, determined by using Halimione portulacoides (L.) Aellen plants. The root, stem, leaves and cultivation soil of plant was formed material of this study. Sampling, were done 7 station which is determined on the soil dam is surrounding saltern. Through 12 months, samples regulary receipt from every station. As a result of all analysis, we saw the level of Ni was very low ( n.d-1,094 ppm). Analysis were done by using Perkin Elmer Analyst 700 flame atomic absorption spectrophotometer (FAAS) device

Evaluation of the Effects of GnRH and hCG Administrations during and after Insemination on Fertility Parameters of Dairy Cows

Background: Getting pregnant and maintenance of the pregnancy in cows is crucial for the dairy farmers for sustainable production. Many methods are used for this purpose, one of them is the administration of gonadotropins at insemination and later in the early embryonic period. In this study, it was aimed to investigate the effects of different gonadotropin applications on fertility.Methods: A total of 406 dairy cows were divided randomly into five treatment groups according to GnRH (10 µg buserelin acetate, im) and hCG (1500 IU, im) administrations in different time periods at AI and post AI as; GI (n=84, d7; hCG), GII (n=106, d7; GnRH), GIII (n=62, d0 and d7; hCG), GIV (n=80, d0 and d7; GnRH), GV (n=74, d0 and d7; placebo: 2.5 ml 0.9% NaCl). Pregnancy control was done on day 30 and 45 post AI. Fertility parameters (conception rate, first service pregnancy rate, pregnancy per AI, embryonic loss) were calculated with the obtained data.Result: Our findings indicated that double dose hCG administration caused an improvement on the fertility parameters in cows with greater than 150 DIM. Also, conception rates of the cows with higher parity, milk yield and lower BCS improved with the administration of hCG on d0 and d7. We concluded that double-dose hCG administrations on d0 and d7 can be used to improve fertility after 150 DIM in cows with higher parity and milk yield.</jats:p