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protocol implementation in hospital infection control practice: an Italian experience of preoperative antibiotic prophylaxis

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JOURNAL OF HOSPITAL INFECTION 2001年第4期47卷 288-293页

作者： Brusaferro, S Rinaldi, O Pea, F Faruzzo, A Barbone, F Univ Udine Chair Hyg & Epidemiol Dept Exptl & Clin Pathol & Med I-33100 Udine Italy

This study evaluates the effectiveness of a protocol implemented to induce behavioural modifications in healthcare workers (HCWs). A preoperative antibiotic prophylaxis protocol for surgical procedures in clean and clean-contaminated wounds was used. The study was conducted in a 300-bed Italian university hospital between 1998 and 1999. The protocol's impact was analysed by retrospective examination of the clinical records for selected common surgical procedures. The study also investigated the reasons for the low compliance with the protocol through a focus group methodology. We examined 723 surgical procedures and the overall compliance was 30.8% (56/182) before the implementation of the protocol and 45.2% (76/168) after 1 year (P <0.01). During the same period compliance with the use of antibiotics increased when antibiotics were recommended by the protocol (5/115 vs. 19/109, P <0.01) and use decreased when they were not (51/67 vs. 57/59, P <0.01). As reported in the focus groups, reasons for low compliance included hospital policy weaknesses in protocol definition and implementation and the cultural behaviour of HCWs. Our results reinforce previous findings that monitoring the effectiveness of protocol implementation in the medical care setting is essential Critical points that might increase the effectiveness of protocol implementation have also been identified. (C) 2001 The Hospital Infection Society.

关键词： protocol implementation preoperative antibiotic prophylaxis effectiveness

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A Language-Based Approach to protocol implementation

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IEEE-ACM TRANSACTIONS ON NETWORKING 1993年第1期1卷 4-19页

作者： Abbott, Mark B. Peterson, Larry L. Univ Arizona Dept Comp Sci Tucson AZ 85721 USA

Morpheus is a special-purpose programming language that facilitates the efficient implementation of communication protocols. protocols are divided into three categories, called shapes, so that they can inherit code and data structures based on their category. The programmer implements a particular protocol by refining the inherited structure. Morpheus optimization techniques reduce per-layer overhead on time-critical operations to a few assembler instructions even though the protocol stack is not determined until run time. This supports divide-and-conquer simplification of the programming task by minimizing the penalty for decomposing complex protocols into combinations of simpler protocols.

关键词： Optimisation Programming Languages protocols Language Based Approach protocol implementation Morpheus Special Purpose Programming Language Optimization Techniques Divide And Conquer Simplification Programming Task protocols Shape Data Structures Programming Profession Computer Languages Time Factors Assembly Vehicles Design Engineering Computer Science

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EXPERIENCES WITH ESTELLE, LOTOS AND SDL - A protocol implementation EXPERIM ENT

COMPUTER NETWORKS AND ISDN SYSTEMS

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COMPUTER NETWORKS AND ISDN SYSTEMS 1991年第1期22卷 51-59页

作者： MURPHY, SC GUNNINGBERG, P KELLY, JPJ SWEDISH INST COMP SCI COMP ARCHITECTURES COMMUN RES GRPSTOCKHOLMSWEDEN UNIV CALIF SANTA BARBARA DEPT ELECT & COMP ENGNSANTA BARBARACA 93106 CALTECH JET PROP LABDIV MISSION OPERATTECH STATEPASADENACA 91109

A controlled experiment was conducted in which six protocol implementations were developed. They were derived by integrating two protocols specified with the ISO and CCITT Formal Description Techniques (FDTs) Estelle, LOTOS, and SDL. The implementations were written in the Ada programming language by six independent programming teams (two teams worked from each FDT). Experience with the specifications is presented: in particular, how readable and precise the teams found their specifications and how they mapped the specifications into Ada constructs. Results are also presented concerning the number and classification of implementation faults. Experience using Ada, particularly its concurrency features and the efficiency of the implementation, is also included.

关键词： FORMAL protocol SPECIFICATION protocol implementation FAULT-TOLERANCE TESTING ADA

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Improving the efficiency of automated protocol implementation using Estelle

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COMPUTER COMMUNICATIONS 1996年第14期19卷 1226-1235页

作者： Gotzhein, R Bredereke, J Effelsberg, W Fischer, S Held, T Konig, H Department of Computer Science University of Kaiserslautern PO Box 3049 D-67653 Kaiserslautern Germany Praktische Informatik IV University of Mannheim D-68131 Mannheim Germany Department of Computer Science TU Cottbus PO Box 10 13 44 D-03013 Cottbus Germany

Correctness and runtime efficiency are essential properties of software in general and of high-speed protocols in particular. Establishing correctness requires the use of FDTs during protocol design, and to prove the protocol code correct with respect to its formal specification. Another approach to boost confidence in the correctness of the implementation is to generate protocol code automatically from the specification. However, the runtime efficiency of this code is often insufficient. This has turned out to be a major obstacle to the use of FDTs in practice. One of the FDTs currently applied to communication protocols is Estelle. We show how runtime efficiency can be significantly improved by several measures carried out during the design, implementation and runtime of a protocol. Recent results of improvements in the efficiency of Estelle-based protocol implementations are extended and interpreted.

关键词： communication protocol formal specification Estelle protocol implementation efficiency

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OpParIm: A method and tool for optimized parallel protocol implementation

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JOURNAL OF HIGH SPEED NETWORKS 1996年第2期5卷 125-143页

作者： Leue, S Oechslin, P UNIV WATERLOO DEPT ELECT & COMP ENGNWATERLOOON N2L 3G1CANADA ECOLE POLYTECH FED LAUSANNE COMP NETWORKING LABSWISS FED INST TECHNOLDI LTICH-1015 LAUSANNESWITZERLAND

We are introducing and discussing a method for the optimized and parallel implementation of protocols as well as a tool OPPARIM to apply the method automatically to the specification of a protocol. We present a study case representing an IP/TCP/FTP protocol stack specified in SDL. We show how OPPARIM generates dependence graphs from the specification and how it manipulates these graphs to allow for an optimised and possibly parallelised implementation. We then present a hardware architecture on which the protocol stack could be implemented and show the effects of our optimizations on the processing time of an incoming packet. Using two processing elements the optimised implementation executes in less than half the time of what we call a ''faithful'' implementation.

关键词： protocol implementation TCP/IP/FTP specification and description language (SDL) data- and control flow analysis high speed protocols protocol optimization

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Intussusception protocol implementation: Single-Site Outcomes With Clinician and Family Satisfaction

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JOURNAL OF SURGICAL RESEARCH 2019年 244卷 122-129页

作者： McLeod, Jennifer S. Gavulic, Amelia E. Wendt, Wendi Hilu, Matthew H. Dunbar, Erin Macy, Michelle Sroufe, Nicole Perrone, Erin E. Univ Michigan Dept Surg CS Mott Childrens Hosp Michigan MedSect Pediat Surg Ann Arbor MI 48109 USA Univ Michigan Dept Emergency Med Michigan Med CS Mott Childrens Hosp Ann Arbor MI 48109 USA Virginia Commonwealth Univ Dept Pediat Emergency Med Richmond VA USA Ann & Robert H Lurie Childrens Hosp Chicago Div Emergency Med Dept Pediat Chicago IL 60611 USA Northwestern Univ Feinberg Sch Med Chicago IL 60611 USA Univ Michigan Dept Pediat Michigan Med CS Mott Childrens Hosp Ann Arbor MI 48109 USA

Background: The objective of this study was to evaluate clinical outcomes, costs, and clinician and parent satisfaction after implementation of a protocol to discharge patients from the emergency department (ED) after successful reduction of uncomplicated ileocolic intussusception. Materials and methods: In March 2017, an intussusception management protocol was implemented for children presenting with ultrasound findings of ileocolic intussusception. Those meeting inclusion criteria were observed after successful radiological reduction in the ED and discharged after 6 h with resolution of symptoms. Retrospective chart review was completed for cases before and after protocol implementation for clinical outcomes and costs. Clinicians and parents were surveyed to assess overall satisfaction. Results: Charts were reviewed before (42 encounters, 37 patients) and after (30 encounters, 23 patients) protocol implementation. After implementation, admission rates decreased from 95% (40/42) to 23% (7/30;P < 0.001) and antibiotic use was eliminated (91% to 0%, P < 0.001). There was no difference in recurrence rates (17% versus 23%, P = 0.44). Median total length of stay decreased from 18.87 to 9.52 h (P < 0.001), whereas median ED length of stay increased from 4.37 to 9.87 h (P < 0.001). In addition, there was an overall hospital cost saving of over $2000 ($9595 +/- 3424 to $7465 +/- 3723;P = 0.009) per encounter. Clinicians and parents were overall satisfied with the protocol and parents showed no changes in patient satisfaction with protocol implementation. Conclusions: An intussusception protocol can facilitate early discharge from the ED and improve patient care without increased risk of recurrence. Additional benefits include decreased hospital- and patient-related costs, elimination of antibiotic use, and parent as well as clinician satisfaction. (C) 2019 Elsevier Inc. All rights reserved.

关键词： Intussusception Cost analysis Clinician satisfaction Parent satisfaction protocol implementation

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The Security Testing Case Research of protocol implementation

The Security Testing Case Research of Protocol Implementatio...

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International Conference on Information Science and Cloud Computing Companion (ISCC-C)

作者： Zhang, Lei An, Jing You, Chunlan Chen, Guangxuan Logist Acad Beijing 100000 Peoples R China Peoples Publ Secur Univ China Beijing 100000 Peoples R China

ISBN: (纸本)9781479952458

As the underlying design of the security protection technology, security protocol plays an indispensable role in the protection of data storage and transmission of the network and information system. This paper analyzes the existing method for generating test cases based on the security testing research of protocol implementation according to the three key steps, formal description of the protocol model, the generation of test sequence and the description of test cases. This paper also provides the reference for the research of new method to generate test cases.

关键词： protocol implementation security testing test cases

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Standardized Patient Walkthroughs in the National Drug Abuse Treatment Clinical Trials Network: Common Challenges to protocol implementation

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AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2011年第5期37卷 434-439页

作者： Fussell, Holly E. Kunkel, Lynn E. McCarty, Dennis Lewy, Colleen S. Oregon Hlth & Sci Univ Dept Publ Hlth & Prevent Med Portland OR 97239 USA Oregon Hlth & Sci Univ Dept Psychiat Portland OR 97239 USA

Background: Training research staff to implement clinical trials occurring in community-based addiction treatment programs presents unique challenges. Standardized patient walkthroughs of study procedures may enhance training and protocol implementation. Objectives: Examine and discuss cross-site and cross-study challenges of participant screening and data collection procedures identified during standardized patient walkthroughs of multi-site clinical trials. Method: Actors portrayed clients and "walked through" study procedures with protocol research staff. The study completed 57 walkthroughs during implementation of 4 clinical trials. Results: Observers and walkthrough participants identified three areas of concern (consent procedures, screening and assessment processes, and protocol implementation) and made suggestions for resolving the concerns. Conclusions and Scientific Significance: Standardized patient walkthroughs capture issues with study procedures previously unidentified with didactic training or unscripted rehearsals. Clinical trials within the National Drug Abuse Treatment Clinical Trials Network are conducted in addiction treatment centers that vary on multiple dimensions. Based on walkthrough observations, the national protocol team and local site leadership modify standardized operating procedures and resolve cross-site problems prior to recruiting study participants. The standardized patient walkthrough improves consistency across study sites and reduces potential site variation in study outcomes.

关键词： standardized patient training protocol implementation clinical trial substance abuse treatment substance abuse

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implementation of a dispatch-instruction protocol for cardiopulmonary resuscitation according to various abnormal breathing patterns: a population-based study

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SCANDINAVIAN JOURNAL OF TRAUMA RESUSCITATION & EMERGENCY MEDICINE 2015年第1期23卷 1-7页

作者： Fukushima, Hidetada Imanishi, Masami Iwami, Taku Kitaoka, Hironori Asai, Hideki Seki, Tadahiko Kawai, Yasuyuki Norimoto, Kazunobu Urisono, Yasuyuki Nishio, Kenji Okuchi, Kazuo Nara Med Univ Dept Emergency & Crit Care Med Kashihara Nara 6348522 Japan Nara Saiseikai Gose Hosp Gose City Nara 6392306 Japan Kyoto Univ Hlth Serv Sakyo Ku Kyoto 6068501 Japan Nara Med Univ Dept Gen Med Kashihara Nara 6348522 Japan

Background: We modified the dispatch protocol for cardiopulmonary resuscitation (CPR) using results of a retrospective analysis that identified descriptions by laypersons of possible patterns of agonal respiration. The purpose of this study was to assess the effectiveness of this modified protocol by comparing the frequency of dispatch instructions for CPR and bystander CPR before and after protocol implementation. We also identified descriptions of abnormal breathing patterns among 'Not in cardiac arrest (CA)' unresponsive cases. Methods: This study was conducted prospectively using the population-based registry of out-of-hospital cardiac arrests (OHCAs). For 8 months we implemented this modified protocol in cooperation with 4 fire departments that cover regions with a total population of 840,000. Results: There were 478 and 427 OHCAs before and after implementation, respectively. Among them, 69 and 71 layperson-witnessed OHCAs for pre- and post-implementation, respectively, were analyzed. Dispatchers provided CPR instructions more frequently after protocol implementation than before (55/71 [77.5 %] vs. 41/69 [59.4 %], p < 0.05). Based on breathing patterns described by emergency callers, dispatchers assessed 143 'Not in CA' unresponsive cases and provided CPR instruction for 45 cases. Sensitivity and specificity of this protocol was 93 % and 50 %, respectively. Conclusions: This modified protocol based on abnormal breathing described by laypersons significantly increased CPR instructions. Considering high sensitivity and low specificity for abnormal breathing to identify CA and the low risk of chest compression for 'Not in CA' cases, our study suggested that dispatchers can provide CPR instruction assertively and safely for those unresponsive individuals with various abnormal breathing patterns.

关键词： Cardiac Arrest Emergency Medical Service Chest Compression Breathing Pattern protocol implementation

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A hardware accelerated implementation of the IEEE 802.15.3 MAC protocol

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TELECOMMUNICATION SYSTEMS 2009年第3-4期40卷 161-167页

作者： Dietterle, Daniel Kraemer, Rolf IHP Microelect GmbH Wireless Commun Syst D-15204 Frankfurt Oder Germany

We present a hardware/software implementation of the IEEE 802.15.3 MAC protocol. Processing-intensive and time-critical protocol tasks are handled by a protocol accelerator that is integrated on-chip with a 32-bit general-purpose processor in order to achieve a moderate (20-40 MHz) system clock frequency. This enables low-power wireless devices compliant with this standard, providing high data rate, multimedia communication. One of the main tasks of the protocol accelerator is to analyze received or transmitted beacons. Based on the channel time allocations broadcast in the beacon and frame information stored in a hardware transmission queue, frames are transmitted without immediate control of the processor. Other features of the protocol accelerator include CRC generation, handling of immediate acknowledgment frames, and direct memory access.

关键词： Personal area networks protocol implementation Hardware accelerator

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