Search results

Ireland’s physicians have a legal and an ethical duty to protect confidential patient information. Most healthcare records in Ireland remain paper based, so the purpose of this paper is to: assess the protection afforded to paper records; log highest risk records; note the variations that occurred during the working week; and observe the varying protection that occurred when staff, students and public members were present.

A customised audit tool was created using Sphinx software. Data were collected for three months. All wards included in the study were visited once during four discrete time periods across the working week. The medical records trolley’s location was noted and total unattended medical records, total unattended nursing records, total unattended patient lists and when nursing personnel, medical students, public and a ward secretary were visibly present were recorded.

During 84 occasions when the authors visited wards, unattended medical records were identified on 33 per cent of occasions, 49 per cent were found during weekend visiting hours and just 4 per cent were found during morning rounds. The unattended medical records belonged to patients admitted to a medical specialty in 73 per cent of cases and a surgical specialty in 27 per cent. Medical records were found unattended in the nurses’ station with much greater frequency when the ward secretary was off duty. Unattended nursing records were identified on 67 per cent of occasions the authors visited the ward and were most commonly found unattended in groups of six or more.

This study is a timely reminder that confidential patient information is at risk from inappropriate disclosure in the hospital. There are few context-specific standards for data protection to guide healthcare professionals, particularly paper records. Nursing records are left unattended with twice the frequency of medical records and are found unattended in greater numbers than medical records. Protection is strongest when ward secretaries are on duty. Over-reliance on vigilant ward secretaries could represent a threat to confidential patient information.

While other studies identified data protection as an issue, this study assesses how data security varies inside and outside conventional working hours. It provides a rationale and an impetus for specific changes across the whole working week. By identifying the on-duty ward secretary’s favourable effect on medical record security, it highlights the need for alternative arrangements when the ward secretary is off duty. Data were collected prospectively in real time, giving a more accurate healthcare record security snapshot in each data collection point.

It may be remarked that the area immediately concerned is about 1,700 square miles, or somewhat greater than the area of the County of Kent. We say immediately concerned, as the Governments of St. Vincent, St. Lucia, and others submitted samples for examination, but these related to criminal investigations and call for no comment. In Trinidad itself what may be called the upper classes are of European origin—British, French, or Spanish. There is a high proportion of East Indians, i.e., from Asia, and the lower classes are of mixed negro origin. It is, perhaps, as well to remind readers of these facts. The records of criminal investigation undertaken by the Department at the request of the police authorities suggest by their number and nature that we are here concerned with people who in general are in a somewhat lower state of social culture than that which is found, for instance, in an English district. This would tend to react on the Health Administration generally by increasing the difficulties already existing that arise from a tropical climate and a sparse population very largely engaged in agricultural pursuits, or in industries closely allied thereto. The Port of Spain, the capital, contains perhaps a fifth of the total population and a higher proportion of persons of European origin than elsewhere. The Health Authorities of the city, however, still seem disinclined to avail themselves as fully as they might do of the resources of the Government Chemist's Department. Few samples appear to be sent for examination, though it hopefully stated that more samples of foods and drugs may be sent in when the new Food and Drugs Act replaces the existing one. The Medical Officer of the Port of Spain sends in water samples from the main sources of supply every week for chemical examination. The results of examination are satisfactory, but even in the British Isles water is not the chief form of sustenance, and the need for a due examination of foods and drugs—especially the last—is shown by the facts that while the number of food samples submitted for examination has decreased, the number found to be unsatisfactory has increased. As to drugs, it is sufficient to quote the words of the report, “No samples of drugs were submitted under the Ordinance, so that it is not possible to offer any opinion as to whether or not adulteration is practised of these important articles which are sold to the public. We believe this sin of omission to be one of long standing. The total number of samples and exhibits of all kinds was 4,950. Of these, 4,359 were official and 548 were unofficial, a decrease of 437 and 131 respectively. Out of this total 1,058 were samples of foods, or baking powder, vinegar, and so forth. The number found to be unsatisfactory was 131, or 12·4 per cent. This is a high percentage of failures. It is due almost entirely to cows' milk of poor quality. Three hundred and eighty‐five samples were examined, and 12·4, or 32·2 per cent. were reported against. Out of 163 samples of butter and cooking butter 2·5 per cent were deficient in fat. Having regard to the tenor of this report, the distinction here made between “butter” and “cooking butter” seems to be a rather unfortunate one. In the shops and kitchens of this country the distinction used to be accepted. But why a substance which is, by implication, inferior or unpalatable and unfit to be eaten with bread, might still be used in cooking, has never been clear to us. The unaccepted defence of a baker—convicted over here of putting bad eggs in his pastry—“The stink goes off in the baking,” comes to mind. The fat deficiency ranged from 6·10 to 3·63. Out of 128 coffee samples three were adulterated with burnt sugar. The general position with regard to food—especially in the case of milk—seems to be very unsatisfactory. The remarks of the Govern‐ment Chemist are unquestionably fully justified.

Globalization and outsourcing have decoupled country of origin into the country of origin of manufacture (COM) and the country of origin of the brand (COB). This study seeks to extend the work of Gurhan‐Canli and Maheswaran and Lee et al. by investigating the interactive influence of COB and personal involvement with a product on purchase intention.

A total of 168 young adults in Hong Kong were intercepted for mall interviews and presented with mock advertisements for personal computers ostensibly with brands originating in Japan and Korea. Their personal involvement with such products was measured using an instrument designed by Zaichkowsky, and their purchase intentions were self‐assessed.

COB was found to predict purchase intentions among consumers with a low level of personal involvement with computers, but not among consumers with a high level of personal involvement.

First, to improve internal validity, the study involved a single product type and a sample limited to 15‐34 year olds. However, this improvement in internal validity places limitations on generalisability. Second, a median split was used to divide the subjects into low and high involvement groups. Third, only one dependent variable, purchase intention, was studied.

For marketers whose product is branded in a country with a favorable image, emphasizing the COB would be appropriate when communicating with low involvement consumers. Marketers whose product is branded in a country with a less favorable image ought to emphasize other peripheral cues when communicating with low involvement consumers.

By finding that COB has a significant impact on the purchase intentions of low involvement consumers, but not with those more highly involved, this research constitutes a small but important extension of the conclusions of Gurhan‐Canli and Maheswaran and Lee et al.