WorldWideScience

Sample records for hospital room environment

  1. Hacking the hospital environment: young adults designing youth-friendly hospital rooms together with young people with cancer experiences.

    Science.gov (United States)

    Boisen, Kirsten A; Boisen, Anne; Thomsen, Stine Legarth; Matthiesen, Simon Meggers; Hjerming, Maiken; Hertz, Pernille Grarup

    2015-12-09

    There is a need for youth-friendly hospital environments as the ward environment may affect both patient satisfaction and health outcomes. To involve young people in designing youth-friendly ward environment. We arranged a design competition lasting 42 h (Hackathon). Students in architecture, design, engineering, communication and anthropology participated (27 young adults) - forming eight groups. Adolescents and young adults (AYA) with current or former cancer experience participated as sparring partners. We provided workspace and food during the weekend. The groups presented their products to a jury and relevant stakeholders. The groups created eight unique design concepts. The young designers were extremely flexible listening to ideas and experiences from the young patients, which led to common features including individual and flexible design, privacy in two-bed wardrooms and social contact with other hospitalized AYA. The winning project included an integrated concept for both wardrooms and the AYA day room, including logos and names for the rooms and an 'energy wall' in the day room. A hackathon event was an effective mode of youth participation. The design concepts and ideas were in line with current evidence regarding pleasing hospital environment and youth-friendly inpatient facilities and may be applicable to other young patients.

  2. [Hospital emergency rooms].

    Science.gov (United States)

    Tudela, Pere; Mòdol, Josep Maria

    2003-05-17

    Overuse of hospital emergency rooms (HERs) is parallel to their controversy. To understand this problem, some concepts should be first clarified. In HERs, there are some intrinsic aspects which are directly related to the emergency itself and thus cannot be modified (intermittent patient flow, need to prioritize, difficulty to achieve a rapid diagnosis, influence of time on treatment, value of clinical follow up, patient's expectations, impact of HER on the overall hospital working dynamics). On the other hand, there are some extrinsic aspects which indeed are not related to HER itself but are rather historically associated with it (precarious structure, delay on admission, lack of privacy, inadequate triage of cases, lack of professionalization); these latter aspects may be potentially modified and should be reconsidered.

  3. Qualities of Inpatient Hospital Rooms: Patients' Perspectives.

    Science.gov (United States)

    Devlin, Ann Sloan; Andrade, Cláudia Campos; Carvalho, Diana

    2016-04-01

    The aim of this qualitative study was to investigate what design features of hospital rooms are valued by inpatients. Little research has explored how patients evaluate the physical environment of their hospital rooms. Most responses are captured by the Hospital Consumer Assessment of Healthcare Providers and Systems survey, which includes only two questions about the physical environment. Two hundred thirty-six orthopedic patients (78 in the United States and 158 in Portugal) listed three features of their hospital room that influenced their level of satisfaction with their hospital stay, indicating whether the feature was positive or negative. The comments were more positive (71.4%) than negative (28.6%). Using the framework of supportive design from Ulrich, over half the comments (64.31%) could be categorized in one of the three dimensions: 33.2% (positive distraction), 22.4% (perceived control), and 6.0% (social support). This total includes Internet (2.7%), which could be categorized as either social support or positive distraction. Comments called "other aspects" focused on overall environmental appraisals, cleanliness, and functionality and maintenance. The majority of comments could be accommodated by Ulrich's theory, but it is noteworthy that other aspects emerge from patients' comments and affect their experience. Cross-cultural differences pointed to the greater role of light and sun for Portuguese patients and health status whiteboard for U.S. Qualitative research can add significantly to our understanding of the healthcare experience and may inform design decisions. © The Author(s) 2015.

  4. Analysis of room acoustics in Danish Hospitals

    DEFF Research Database (Denmark)

    Hoffmann, Ida Ørduk; Zapata Rodriguez, Valentina; Jeong, Cheol-Ho

    2018-01-01

    time (EDT) and T20, and the sound pressure level metrics, namely the equivalent level and peak level. In addition, the staff at the hospitals is asked about their personal perception of the acoustic and noise conditions and the correlation between their subjective disturbances......This project aims to compare room acoustic parameters and noise levels in various Danish hospitals: Odense, Gentofte, Bispebjerg, Hillerød and Aarhus Hospitals. Room acoustic conditions are measured in audiometric rooms at Odense, Gentofte, Bispebjerg and Aarhus hospitals. The noise levels...

  5. Hacking the hospital environment

    DEFF Research Database (Denmark)

    Boisen, Kirsten A; Boisen, Anne Bank; Thomsen, Stine Legarth

    2017-01-01

    BACKGROUND: There is a need for youth-friendly hospital environments as the ward environment may affect both patient satisfaction and health outcomes. OBJECTIVE: To involve young people in designing youth-friendly ward environment. METHODS: We arranged a design competition lasting 42 h (Hackathon...

  6. Displacement Ventilation in Hospital Environments

    DEFF Research Database (Denmark)

    Li, Yuguo; Nielsen, Peter V.; Sandberg, Mats

    2011-01-01

    Hospital differ from conventional buildings in terms of ventilation needs. Exhaled infectious droplets or droplet nuclei of an infected patient need to be removed in general wards, waiting areas and isolation rooms to minimize transmission to health-care workers, other patients and visitors. In m....... In most health-care environments, harmful microorganisms and infectious aerosols may exist in relatively high concentration. They are particularly harmful to patients due to reduced immunity, and to those with open wounds.......Hospital differ from conventional buildings in terms of ventilation needs. Exhaled infectious droplets or droplet nuclei of an infected patient need to be removed in general wards, waiting areas and isolation rooms to minimize transmission to health-care workers, other patients and visitors...

  7. Operating Room Utilization at Frederick Memorial Hospital

    National Research Council Canada - National Science Library

    Edwards, Jonathan A

    2007-01-01

    .... A logistical regression analysis was used to identify the impact of variables on operating room utilization rates and therefore help explain how or why some operating rooms incurred higher utilization rates than others...

  8. A room of one's own--Being cared for in a hospital with a single-bed room design.

    Science.gov (United States)

    Persson, Eva; Anderberg, Patrice; Ekwall, Anna Kristensson

    2015-06-01

    To illuminate patients' experiences of being hospitalised in a hospital with a single-bed room design. Many patients seem to prefer single-bed hospital rooms. However, studies have also shown that patients do see the advantages of multiple-bed rooms. Interviews were conducted with 16 inpatients from a surgical ward in a hospital building with a single-bed room design. A hermeneutical-phenomenological approach guided by van Manen's four life-world existentials was used to analyse the interviews. The essential meaning was that patients felt secure because they could create a personal environment without disruptive elements. The room was private, and this implied feelings of homeliness, which allowed patients to focus on themselves and was thought to facilitate the recovery process. The patients preferred staying in their room, and the relationship with the personnel was central. Feelings of loneliness and isolation could occur and could be frightening. Being hospitalised in a single-bed room meant balancing between feeling secure and feeling insecure. The following four themes emerged: A homely environment, The need for company and security, Time as unpredictable and involving waiting and Focus on healing the body. Patients experienced that a single-bed room allowed them to focus on their recovery, have visitors without disturbing others and create a feeling of homeliness. However, mobilisation is not a natural part of the recovery process when patients have all they need in their rooms. The patients' need for social interaction and confirmation was not satisfied without effort and planning on the part of staff. © 2014 Nordic College of Caring Science.

  9. Indoor environmental quality in Hellenic hospital operating rooms

    Energy Technology Data Exchange (ETDEWEB)

    Dascalaki, Elena G.; Gaglia, Athina G.; Balaras, Constantinos A. [Group Energy Conservation, Institute for Environmental Research and Sustainable Development, National Observatory of Athens, I. Metaxa and Vas. Pavlou, GR 152 36 P. Penteli (Greece); Lagoudi, Argyro [Terra Nova Ltd., Environmental Engineering Consultancy, Athens, Kaisareias 39, GR 115 27 Athens (Greece)

    2009-05-15

    Indoor environmental quality (IEQ) in hospital operating rooms (ORs) constitutes a major challenge for the proper design and operation of an energy efficient hospital. A subjective assessment of the indoor environment along with a short monitoring campaign was performed during the audits of 18 ORs at nine major Hellenic hospitals. A total of 557 medical personnel participated in an occupational survey, providing data for a subjective assessment of IEQ in the audited ORs. The OR personnel reported work related health symptoms and an assessment of indoor conditions (thermal, visual and acoustical comfort, and air quality). Overall, personnel reported an average of 2.24 work-related symptoms each, and 67.2% of respondents reported at least one. Women suffer more health symptoms than men. Special dispositions, such as smoking and allergies, increase the number of reported symptoms for male and female personnel. Personnel that perceive satisfactory indoor comfort conditions (temperature, humidity, ventilation, light, and noise) average 1.18 symptoms per person, while for satisfactory indoor air quality the average complaints are 0.99. The perception of satisfactory IEQ (satisfactory comfort conditions and air quality) reduces the average number of health complaints to 0.64 symptoms per person and improves working conditions, even in a demanding OR environment. (author)

  10. Latex in the Hospital Environment

    Science.gov (United States)

    LATEX in the Hospital Environment Updated Fall 2015 This list provides a guide to some of the most common objects containing latex and offers some ... remover–Sepha Pharm) 1 LATEX in the Hospital Environment (continued) Frequently contains LATEX OR/Infection Control masks, ...

  11. Pseudomonas aeruginosa from hospital environment

    Directory of Open Access Journals (Sweden)

    Milind Davane

    2014-03-01

    Full Text Available Hospital acquired infection is an additional affliction to the patient admitted to the hospital for some serious illness and is caused by pathogens which are prevalent in hospital environment. In the hospital, microbes are ubiquitous; and can reach the sick patient through various sources, such as air, water, food, contaminated equipments, linen, catheters, scopes, ventilators, contaminated disinfectants and other preparations used for treatment, visitors, infected patients, etc.

  12. Overview of the LHD central control room data monitoring environment

    International Nuclear Information System (INIS)

    Emoto, M.; Yoshinuma, M.; Yoshida, M.; Nakanishi, H.; Iwata, C.; Ohsuna, M.; Nonomura, M.; Imazu, S.; Yokota, M.; Aoyagi, M.; Ogawa, H.; Ida, K.; Watanabe, K.; Kaneko, O.

    2016-01-01

    Highlights: • In this paper, the data monitoring environments in the LHD central control room, for example, summary data graph and video monitoring tools are introduced. Also, the environments for the remote participants are introduced. - Abstract: During the Large Helical Device (LHD) experiments, many scientists and technical staff are working in the central control room to operate the experiment. They must manage the diagnostics and controlling devices referring to the results of the last plasma shot. Also, the experiment coordinator must decide the conditions for the subsequent experiments using the results. Furthermore, many scientists are participating in the experiment from remote sites. Therefore, it is important to share the information in the control room quickly, such as the results of the last plasma discharge, with the remote user as well as with the staff in the room. In this paper, the data monitoring environment in the LHD central control room is introduced.

  13. Overview of the LHD central control room data monitoring environment

    Energy Technology Data Exchange (ETDEWEB)

    Emoto, M., E-mail: emoto.masahiko@nifs.ac.jp; Yoshinuma, M.; Yoshida, M.; Nakanishi, H.; Iwata, C.; Ohsuna, M.; Nonomura, M.; Imazu, S.; Yokota, M.; Aoyagi, M.; Ogawa, H.; Ida, K.; Watanabe, K.; Kaneko, O.

    2016-11-15

    Highlights: • In this paper, the data monitoring environments in the LHD central control room, for example, summary data graph and video monitoring tools are introduced. Also, the environments for the remote participants are introduced. - Abstract: During the Large Helical Device (LHD) experiments, many scientists and technical staff are working in the central control room to operate the experiment. They must manage the diagnostics and controlling devices referring to the results of the last plasma shot. Also, the experiment coordinator must decide the conditions for the subsequent experiments using the results. Furthermore, many scientists are participating in the experiment from remote sites. Therefore, it is important to share the information in the control room quickly, such as the results of the last plasma discharge, with the remote user as well as with the staff in the room. In this paper, the data monitoring environment in the LHD central control room is introduced.

  14. Fungal contamination in hospital environments.

    Science.gov (United States)

    Perdelli, F; Cristina, M L; Sartini, M; Spagnolo, A M; Dallera, M; Ottria, G; Lombardi, R; Grimaldi, M; Orlando, P

    2006-01-01

    To assess the degree of fungal contamination in hospital environments and to evaluate the ability of air conditioning systems to reduce such contamination. We monitored airborne microbial concentrations in various environments in 10 hospitals equipped with air conditioning. Sampling was performed with a portable Surface Air System impactor with replicate organism detection and counting plates containing a fungus-selective medium. The total fungal concentration was determined 72-120 hours after sampling. The genera most involved in infection were identified by macroscopic and microscopic observation. The mean concentration of airborne fungi in the set of environments examined was 19 +/- 19 colony-forming units (cfu) per cubic meter. Analysis of the fungal concentration in the different types of environments revealed different levels of contamination: the lowest mean values (12 +/- 14 cfu/m(3)) were recorded in operating theaters, and the highest (45 +/- 37 cfu/m(3)) were recorded in kitchens. Analyses revealed statistically significant differences between median values for the various environments. The fungal genus most commonly encountered was Penicillium, which, in kitchens, displayed the highest mean airborne concentration (8 +/- 2.4 cfu/m(3)). The percentage (35%) of Aspergillus documented in the wards was higher than that in any of the other environments monitored. The fungal concentrations recorded in the present study are comparable to those recorded in other studies conducted in hospital environments and are considerably lower than those seen in other indoor environments that are not air conditioned. These findings demonstrate the effectiveness of air-handling systems in reducing fungal contamination.

  15. Novel bed integrated ventilation method for hospital patient rooms

    DEFF Research Database (Denmark)

    Bivolarova, Mariya Petrova; Melikov, Arsen Krikor; Kokora, Monika

    2014-01-01

    This study presents a novel method for advanced ventilation of hospital wards leading to improved air quality at reduced ventilation rate. The idea is to evacuate the bio-effluents generated from patients’ body by local exhaustion before being spread in the room. This concept was realized by using...... a mattress having a suction opening from which bio-effluents generated from human body are exhausted. Experiments were conducted in a full-scale two-bed hospital room mock-up, 4.7 x 5.3 x 2.6 m3 (W x L x H). Only one of the patients’ beds was equipped with the ventilated mattress. The room was air...... conditioned via mixing total volume ventilation system supplying air through a ceiling mounted diffuser. All experiments were performed at room air temperature of 23ºC. A thermal manikin was used to simulate a polluting patient on the bed equipped with the ventilated mattress. Two heated dummies were used...

  16. Interior design criteria for successful hospital patient rooms

    OpenAIRE

    Bilir, Seda

    1997-01-01

    Ankara : The Department of Interior Architecture and Environmental Design and Institute of Fine Arts of Bilkent University, 1997. Thesis (Master's) -- Bilkent University, 1997. Includes bibliographical references leaves 94-99 In this study, the design requirements of hospital acute-care patient rooms, which support the recovery and well-being of the patients, are examined. Patients' psycho-spatial needs which may be complementary to the healing effects of the medical treatme...

  17. Acoustic pollution in hospital environments

    International Nuclear Information System (INIS)

    Olivera, J M; Rocha, L A; Rotger, V I; Herrera, M C

    2011-01-01

    There are many different services within a hospital. This means different types of noise which can be considered as acoustic pollution. Knowing that preterm infants exposed to high amounts of noise in the NICU are at a much higher risk because of their neurologic immaturity and physiologic instability, that excessive levels of noise also affect the persons and it can also impede some studies on patients, it was proposed to evaluate the Sound Pressure Level in some services of the Instituto de Maternidad, Tucumán, Argentina. There were evaluated the Level III NICU, the laundry service, a physical space destined for a service of evoked potential and a neonatal incubator under working conditions. The measurements were performed with a type II sonometer (CENTER 322) and it was also used an incubator analyzer (FLUKE INCU) for the incubator. The average values obtained were of 63.6 dBA for the NICU, 82.5dBA for the laundry room, 52.7 dBA for the evoked potential room and 62.8 dBA in the inside of the incubator under 64 dBA in the outside. The reports were documented in compliance with the appropriate standards.

  18. Studies of Radon and Radon Progeny in Air Conditioned Rooms in Hospitals

    International Nuclear Information System (INIS)

    Marley, F.; Denman, A.R.; Phillips, P.S.

    1998-01-01

    A series of continuous real-time radon and radon progeny measurements together with passive etched track detector measurements were performed in hospital premises during 1996. In one small room, detailed measurements over several weeks showed that both the radon concentration and the Equilibrium Factor depended on the intermittent operation of a filtered positive pressure displacement air-conditioning system, which was designed to conform to operating theatre standards. The average radon level measured while the air-conditioning was off was almost four times higher than that recorded whilst it was on. The progeny level was over five times higher than that whilst it was on. Thus, the Equilibrium Factor (F), was significantly lower when the air-conditioning was on. Measurements in similar rooms in two hospitals, confirmed that the reduction in radon level was a general finding. Thus staff working in such environments receive significantly lower radiation dose from radon than staff working in nearby normally ventilated rooms. (author)

  19. Game theory: applications for surgeons and the operating room environment.

    Science.gov (United States)

    McFadden, David W; Tsai, Mitchell; Kadry, Bassam; Souba, Wiley W

    2012-11-01

    Game theory is an economic system of strategic behavior, often referred to as the "theory of social situations." Very little has been written in the medical literature about game theory or its applications, yet the practice of surgery and the operating room environment clearly involves multiple social situations with both cooperative and non-cooperative behaviors. A comprehensive review was performed of the medical literature on game theory and its medical applications. Definitive resources on the subject were also examined and applied to surgery and the operating room whenever possible. Applications of game theory and its proposed dilemmas abound in the practicing surgeon's world, especially in the operating room environment. The surgeon with a basic understanding of game theory principles is better prepared for understanding and navigating the complex Operating Room system and optimizing cooperative behaviors for the benefit all stakeholders. Copyright © 2012 Mosby, Inc. All rights reserved.

  20. Clinical Education Environment Experiences of Operating Room Students

    Directory of Open Access Journals (Sweden)

    Tahereh khazaei

    2016-01-01

    Full Text Available Background and purpose: The objective of medical education is to train competent and qualified workforce in order to provide services in various health environments. One of the important objectives of Operating Room students is to train workforce who can involve in patient’s health and recovery. Training these students should cause clinical ability and independent decision making during surgery. Since students during internship face with many problems, this study has been conducted to explore and describe the challenges and experiences.Methods: This qualitative study is a phenomenology that was conducted based on 20 students in the last semester of Operating Room associate’s degree with purposive sampling. Deep and semi-structured interviews were used to collect data and data were analyzed by content analysis method.Results: The findings in 5 main themes: (1 Physical space and equipment in the operating room, (2 The student’s position in operating room, (3 Integrating knowledge and action, (4 Managing education environment and 5- Student’s viewpoint about operating room and working in it.Conclusions: Interviews with students revealed the educational environment challenges with which they are faced during their study. Teachers can provide solutions to overcome the challenges and create a positive atmosphere for students' learning using results of this study and students may continue their interest in education and improve the quality of their education.Keywords: CLINICAL EDUCATION, OPERATING ROOM STUDENTS, CHALLENGE

  1. Assessment on nursing serviceat hospital external consulting rooms

    Directory of Open Access Journals (Sweden)

    Mª Dolores Poyatos Ruiz

    2013-05-01

    Full Text Available The social needs and requests change constantly, so that health care is evolving to a more focused on the users, in order to meet users´ needs and expectations of those who are going to get our assistance. Aim: We have developed a research to evaluate the quality of the assistance received by the patientst in their first encounter in the hospital external consulting rooms of traumathology at Santa Bárbara Hospital, letting us know about the patient´s satisfaction after the consulting has finished. Material and method: A transverse descriptive study on the traumathology consulting room of Santa Bárbara Hospital in Puertollano was developed for two months. The research is formed by the patients who attend this consulting room for their first time. A self made multiple choice questionnaire, which was designe by experts, and patients were asked to answer it once their first consulting at traumathology service had finished. Results: 95.6% of the patients considered as good or very good the nursing kindness (confidence/reliabitity when seeing them; 93.5% of them considered as good or very good the information given to them and 90.6% of them considered as good or very good the medical explanations they got. We also noticed a significant statistical difference among nursing kindness (confidence/reliabitity, enough consultation time and explanations received, with regard to the variant high resolution. Conclusions: The study reveals that more than 90% of the interviewed people considered as good or very good the clinical assistance and service given. The research has allowed us to know the areas that we can work on and improve.

  2. Planning of Operating Rooms at the Danish National Hospital

    OpenAIRE

    Taltavull Mercadal, Ignasi

    2016-01-01

    The irnport.ance of t.he rnanagerial aspects of hospitals can be seen in hvo mam aspects. On one hand, healt.h spending has a big irnpact on the budget. of t.he count.ries. For instance, it accounted for 11% of GDP in Demnark dnring 2014. JVloreover, it is estimated that around of 10-30% of thcse expenditures is destined to surgical facilities. Therefore, as expense centres, an cfficient pla.nning of opernting rooms is highly important to reduce costs ancl optimizc rcsou...

  3. THE APPLICATION OF EVIDENCE BASED DESIGN IN EMERGENCY ROOM OF PUBLIC HOSPITAL OF DR. R. SOSODORO DJATIKOESOEMO BOJONEGORO

    Directory of Open Access Journals (Sweden)

    Noerkayatin ,

    2015-07-01

    Full Text Available The Hospital facilities built under Evidence Based Design (EBD will create a safe and comfortable environment, lower the nosocomial infection, quicken the patient recovery, lower the treatment cost, and improve staffs’ performance. The emergency room of public hospital of Dr.R.Sosodoro Djatikoesoemo Bojonegoro needs to be redesigned because the existing design does not meet physical safety. The reparation should refer to Facilities and Safety Management (FMS, Indonesian regulation, EBD concept and benchmarking to RSCM Jakarta considered as an application sample. This research applies case study with descriptive single case study design. The result of the research shows that reparation should be done that includes site and location, building components, and rooms lay out. The width of the rooms should meet minimal standard. The placing of triage room and resuscitation should be in the front area. Sinks should be located near the entrance of every room. The isolation and decontamination rooms should be provided.

  4. Bacteriological Evaluation of Kwale General Hospital Environment ...

    African Journals Online (AJOL)

    ... Pharmacy (40.7%) and Theatre (18.5%). This study showed that Kwale General Hospital environment is heavily contaminated and therefore underlies the necessity for regular evaluation of the hospital environment. Keywords: Bacteriological evaluation, hospital, environment. Journal of Medical Laboratory Sciences Vol.

  5. Control of the Environment in the Operating Room.

    Science.gov (United States)

    Katz, Jonathan D

    2017-10-01

    There is a direct relationship between the quality of the environment of a workplace and the productivity and efficiency of the work accomplished. Components such as temperature, humidity, ventilation, drafts, lighting, and noise each contribute to the quality of the overall environment and the sense of well-being of those who work there.The modern operating room is a unique workplace with specific, and frequently conflicting, environmental requirements for each of the inhabitants. Even minor disturbances in the internal environment of the operating room can have serious ramifications on the comfort, effectiveness, and safety of each of the inhabitants. A cool, well-ventilated, and dry climate is optimal for many members of the surgical team. Any significant deviation from these objectives raises the risk of decreased efficiency and productivity and adverse surgical outcomes. A warmer, more humid, and quieter environment is necessary for the patient. If these requirements are not met, the risk of surgical morbidity and mortality is increased. An important task for the surgical team is to find the correct balance between these 2 opposed requirements. Several of the components of the operating room environment, especially room temperature and airflow patterns, are easily manipulated by the members of the surgical team. In the following discussion, we will examine these elements to better understand the clinical ramifications of adjustments and accommodations that are frequently made to meet the requirements of both the surgical staff and the patient.

  6. Game-based training environment for nuclear plant control room

    International Nuclear Information System (INIS)

    Hung Tamin; Sun Tienlung; Yang Chihwei; Yang Lichen; Cheng Tsungchieh; Wang Jyhgang

    2011-01-01

    Nuclear power plant's safety is very important problem. In this very conscientious environment if operator has a little mistake, they may threaten with many people influence their safety. Therefore, operating training of control room is very important. However, the operator training is in limited space and time. Each operator must go to simulative control room do some training. If we can let each trainee having more time to do training and does not go to simulative control room. It may have some advantages for trainee. Moreover, in the traditional training ways, each operator may through the video, teaching manual or through the experienced instructor to learn the knowledge. This training way may let operator feel bored and stressful. So, in this paper aims, we hope utilizing virtual reality technology developing a game-based virtual training environment of control room. Finally, we will use presence questionnaire evaluating realism and feasibility of our virtual training environment. Expecting this initial concept of game-based virtual training environment can attract trainees having more learning motivation to do training in off-hour. (author)

  7. Hospital Patient Room Design: The Issues Facing 23 Occupational Groups Who Work in Medical/Surgical Patient Rooms.

    Science.gov (United States)

    Lavender, Steven A; Sommerich, Carolyn M; Patterson, Emily S; Sanders, Elizabeth B-N; Evans, Kevin D; Park, Sanghyun; Umar, Radin Zaid Radin; Li, Jing

    2015-01-01

    The aim of this study was to learn from a wide range of hospital staff members about how the design of the patient room in which they work adversely affects their ergonomics or hinders their job performance. In addition to providing a healing space for patients, hospital patient rooms need to serve as functional workplaces for the people who provide clinical care, to clean, or to maintain room functions. Therefore, from a design perspective, it is important to understand the needs of all the users of hospital patient rooms with regard to room design. One hundred forty-seven people, representing 23 different occupational stakeholder groups, participated in either focus groups or interviews in which they were asked to identify room design issues that affect the performance of their work tasks. Key issues shared across multiple stakeholder groups included an inability to have eye contact with the patient when entering the room, inadequate space around the bed for the equipment used by stakeholders, the physical demands experienced as stakeholders move furnishings to accomplish their activities or access equipment, and a lack of available horizontal surfaces. Unique issues were also identified for a number of stakeholder groups. There are a number of issues that should be addressed in the next generation of hospital patient rooms, or when refurbishing existing facilities, so that all occupational stakeholder groups can work effectively, efficiently, and without undue physical stress. © The Author(s) 2015.

  8. Virtual environment display for a 3D audio room simulation

    Science.gov (United States)

    Chapin, William L.; Foster, Scott

    1992-06-01

    Recent developments in virtual 3D audio and synthetic aural environments have produced a complex acoustical room simulation. The acoustical simulation models a room with walls, ceiling, and floor of selected sound reflecting/absorbing characteristics and unlimited independent localizable sound sources. This non-visual acoustic simulation, implemented with 4 audio ConvolvotronsTM by Crystal River Engineering and coupled to the listener with a Poihemus IsotrakTM, tracking the listener's head position and orientation, and stereo headphones returning binaural sound, is quite compelling to most listeners with eyes closed. This immersive effect should be reinforced when properly integrated into a full, multi-sensory virtual environment presentation. This paper discusses the design of an interactive, visual virtual environment, complementing the acoustic model and specified to: 1) allow the listener to freely move about the space, a room of manipulable size, shape, and audio character, while interactively relocating the sound sources; 2) reinforce the listener's feeling of telepresence into the acoustical environment with visual and proprioceptive sensations; 3) enhance the audio with the graphic and interactive components, rather than overwhelm or reduce it; and 4) serve as a research testbed and technology transfer demonstration. The hardware/software design of two demonstration systems, one installed and one portable, are discussed through the development of four iterative configurations. The installed system implements a head-coupled, wide-angle, stereo-optic tracker/viewer and multi-computer simulation control. The portable demonstration system implements a head-mounted wide-angle, stereo-optic display, separate head and pointer electro-magnetic position trackers, a heterogeneous parallel graphics processing system, and object oriented C++ program code.

  9. Evaluating the auralization of a small room in a virtual sound environment using objective room acoustic measures

    DEFF Research Database (Denmark)

    Ahrens, Axel; Marschall, Marton; Dau, Torsten

    2016-01-01

    To study human auditory perception in realistic environments, loudspeaker-based reproduction techniques have recently become state-of-the-art. To evaluate the accuracy of a simulation-based room auralization of a small room, objective measures, such as early-decay-time (EDT), reverberation time...... of the room. The auralizations were generated using the loudspeaker-based room auralization toolbox (LoRA; Favrot and Buchholz, 2010) and reproduced in a 64-channel loudspeaker array, set up in an anechoic chamber. Differences between the objective measures evaluated in the real and the virtual room were......, clarity, interaural cross-correlation (IACC), and the speech transmission index were measured in an IEC listening room for 28 source-receiver combinations. The room was then modeled in the room acoustics software ODEON, and the same objective measures were also evaluated for the auralized version...

  10. Bed Microenvironment in Hospital Patient Rooms with Natural or Mechanical Ventilation

    DEFF Research Database (Denmark)

    Melikov, Arsen Krikor; Li, Yuguo; Georgiev, Emanuil

    2012-01-01

    We studied how to provide patients in bed with thermally comfortable microenvironment in both naturally and mechanically ventilated hospital rooms for both winter and summer seasons. A climate chamber was used to resemble a hospital room and thermal manikin to simulate a patient lying in a bed...

  11. Leadership in Surgery for Public Sector Hospitals in Jamaica: Strategies for the Operating Room

    Science.gov (United States)

    Cawich, Shamir O; Harding, Hyacinth E; Crandon, Ivor W; McGaw, Clarence D; Barnett, Alan T; Tennant, Ingrid; Evans, Necia R; Martin, Allie C; Simpson, Lindberg K; Johnson, Peter

    2013-01-01

    The barriers to health care delivery in developing nations are many: underfunding, limited support services, scarce resources, suboptimal health care worker attitudes, and deficient health care policies are some of the challenges. The literature contains little information about health care leadership in developing nations. This discursive paper examines the impact of leadership on the delivery of operating room (OR) services in public sector hospitals in Jamaica. Delivery of OR services in Jamaica is hindered by many unique cultural, financial, political, and environmental barriers. We identify six leadership goals adapted to this environment to achieve change. Effective leadership must adapt to the environment. Delivery of OR services in Jamaica may be improved by addressing leadership training, workplace safety, interpersonal communication, and work environment and by revising existing policies. Additionally, there should be regular practice audits and quality control surveys. PMID:24355903

  12. Noise and room acoustic conditions in a tertiary referral hospital in Seoul, Korea

    DEFF Research Database (Denmark)

    Jeong, Cheol-Ho; Cho, Wan-Ho; Chang, Ji-ho

    2018-01-01

    Noise levels and room acoustic parameters at a tertiary referral hospital, Seoul National University Hospital in Korea, are investigated. Through a questionnaire, acoustically problematic rooms are identified. Noise levels in emergency rooms (ERs) and intensive care units (ICUs) are measured over...... level for the first night was 66 dBA, which came down to 56 dBA for the next day. The reason for the higher noise level for the first night in the ICU was frequent alarm sound and treatment noise related to a critical patient. The noise level in the measured ERs is about 10 dB lower than those measured...... about three days. Acoustically critical and problematic rooms in the otolaryngology department are measured: examination rooms, operating rooms, nurse stations, patient rooms, and audiometric rooms. The equivalent A-weighted noise level, LAeq, ranges from 54 to 56 dBA in two ERs. In an ICU, the noise...

  13. Qualified operator training in the simulated control room environment

    International Nuclear Information System (INIS)

    Ionescu, Teodor; Studineanu, Emil; Radulescu, Catalina; Bolocan, Gabriel

    2005-01-01

    Full text: Mainly designed for the training of the Cernavoda NPP Unit 2 operators, the virtual simulated environment allows the training of the already qualified operators for Cernavoda NPP Unit 1, adding to the already trained knowledge, the differences which has occurred in the Unit 2 design. Using state-of-the-art computers and displays and qualified software, the virtual simulated panels could offer a viable alternative to classic hardware-based training. This approach allows quick training of the new procedures required by the new configuration of the re-designed operator panels in the main control room of Cernavoda NPP Unit 2. (authors)

  14. Qualified operator training in the simulated control room environment

    International Nuclear Information System (INIS)

    Ionescu, Teodor; Studineanu, Emil; Radulescu, Catalina; Bolocan, Gabriel

    2005-01-01

    Mainly designed for the training of the Cernavoda NPP Unit 2 operators, the virtual simulated environment allows the training of the already qualified operators for Cernavoda NPP Unit 1, adding to the already trained knowledge, the differences which have occurred in the Unit 2 design. Using state-of-the-art computers and displays and qualified software, the virtual simulated panels could offer a viable alternative to classic hardware-based training. This approach allows quick training of the new procedures required by the new configuration of the re-designed operator panels in the main control room of Cernavoda NPP Unit 2. (authors)

  15. Extensive severe fever with thrombocytopenia syndrome virus contamination in surrounding environment in patient rooms.

    Science.gov (United States)

    Ryu, B-H; Kim, J Y; Kim, T; Kim, M-C; Kim, M J; Chong, Y-P; Lee, S-O; Choi, S-H; Kim, Y S; Woo, J H; Kim, S-H

    2018-01-31

    Severe fever with thrombocytopenia syndrome (SFTS) is an emerging tick-borne disease in Korea and China. Although there is previous evidence of person-to-person transmission via direct contact with body fluids, the role of environmental contamination by SFTS virus (SFTSV) in healthcare settings has not been established. We therefore investigated the contamination of the healthcare environment by SFTSV. We investigated the possible contamination of hospital air and surfaces with SFTSV transmission by collecting air and swabbing environmental surface samples in two hospitals treating six SFTS patients between March and September 2017. The samples were tested using real-time RT-PCR for SFTS M and S segments. Of the six SFTS patients, four received mechanical ventilation and three died. Five rooms were occupied by those using mechanical ventilation or total plasma exchange therapy in isolation rooms without negative pressure and one room was occupied by a patient bedridden due to SFTS. SFTSV was detected in 14 (21%) of 67 swab samples. Five of 24 swab samples were obtained from fomites including stethoscopes, and 9 of 43 were obtained from fixed structures including doorknobs and bed guardrails. Some samples from fixed structures such as television monitors and sink tables were obtained in areas remote from the patients. SFTSV RNA was not detected in five air samples from three patients' rooms. Our data suggest that SFTSV contamination was extensive in surrounding environments in SFTS patients' rooms. Therefore, more strict isolation methods and disinfecting procedures should be considered when managing SFTS patients. Copyright © 2018 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

  16. Nurses' Perceptions of Pediatric Intensive Care Unit Environment and Work Experience After Transition to Single-Patient Rooms.

    Science.gov (United States)

    Kudchadkar, Sapna R; Beers, M Claire; Ascenzi, Judith A; Jastaniah, Ebaa; Punjabi, Naresh M

    2016-09-01

    The architectural design of the pediatric intensive care unit may play a major role in optimizing the environment to promote patients' sleep while improving stress levels and the work experience of critical care nurses. To examine changes in nurses' perceptions of the environment of a pediatric critical care unit for promotion of patients' sleep and the nurses' work experience after a transition from multipatient rooms to single-patient rooms. A cross-sectional survey of nurses was conducted before and after the move to a new hospital building in which all rooms in the pediatric critical care unit were single-patient rooms. Nurses reported that compared with multipatient rooms, single-patient private rooms were more conducive to patients sleeping well at night and promoted a more normal sleep-wake cycle (P noise in single-patient rooms (33%) than in multipatient rooms (79%; P pediatric intensive care unit environment for promoting patients' sleep and the nurses' own work experience. ©2016 American Association of Critical-Care Nurses.

  17. Time Delay Estimation in Room Acoustic Environments: An Overview

    Directory of Open Access Journals (Sweden)

    Benesty Jacob

    2006-01-01

    Full Text Available Time delay estimation has been a research topic of significant practical importance in many fields (radar, sonar, seismology, geophysics, ultrasonics, hands-free communications, etc.. It is a first stage that feeds into subsequent processing blocks for identifying, localizing, and tracking radiating sources. This area has made remarkable advances in the past few decades, and is continuing to progress, with an aim to create processors that are tolerant to both noise and reverberation. This paper presents a systematic overview of the state-of-the-art of time-delay-estimation algorithms ranging from the simple cross-correlation method to the advanced blind channel identification based techniques. We discuss the pros and cons of each individual algorithm, and outline their inherent relationships. We also provide experimental results to illustrate their performance differences in room acoustic environments where reverberation and noise are commonly encountered.

  18. Home health agency work environments and hospitalizations.

    Science.gov (United States)

    Jarrín, Olga; Flynn, Linda; Lake, Eileen T; Aiken, Linda H

    2014-10-01

    An important goal of home health care is to assist patients to remain in community living arrangements. Yet home care often fails to prevent hospitalizations and to facilitate discharges to community living, thus putting patients at risk of additional health challenges and increasing care costs. To determine the relationship between home health agency work environments and agency-level rates of acute hospitalization and discharges to community living. Analysis of linked Center for Medicare and Medicaid Services Home Health Compare data and nurse survey data from 118 home health agencies. Robust regression models were used to estimate the effect of work environment ratings on between-agency variation in rates of acute hospitalization and community discharge. Home health agencies with good work environments had lower rates of acute hospitalizations and higher rates of patient discharges to community living arrangements compared with home health agencies with poor work environments. Improved work environments in home health agencies hold promise for optimizing patient outcomes and reducing use of expensive hospital and institutional care.

  19. Islam and the healthcare environment: designing patient rooms.

    Science.gov (United States)

    Kopec, D A K; Han, Li

    2008-01-01

    Islam and the Muslim population are often the source of much misunderstanding and media-influenced misconceptions. Muslim patients who enter the healthcare environment are often weak and likely to experience feelings of vulnerability. Because of the complex and interwoven nature of culture and religion in a person's identity, it is important to consider patient belief systems and values when designing a patient's immediate environment. Through an exploration of literature related to culture and diversity and the beliefs and value system of the Muslim population, the authors were able to identify flexible design initiatives that could accommodate an array of cultural and spiritual practices. Islam and the Muslim population were chosen as the points of reference for this study because of the strong influence of the religion on the culture, and because of the many nuances that differ from the dominant culture within the United States. From these points of reference, a hypothetical design was developed for a patient room that considers differing notions of privacy, alternatives for cultural and religious practices, and ways to include symbolic meaning derived from attributes such as color.

  20. Comparison of hospital room surface disinfection using a novel ultraviolet germicidal irradiation (UVGI) generator.

    Science.gov (United States)

    Jelden, Katelyn C; Gibbs, Shawn G; Smith, Philip W; Hewlett, Angela L; Iwen, Peter C; Schmid, Kendra K; Lowe, John J

    2016-09-01

    The estimated 721,800 hospital acquired infections per year in the United States have necessitated development of novel environmental decontamination technologies such as ultraviolet germicidal irradiation (UVGI). This study evaluated the efficacy of a novel, portable UVGI generator (the TORCH, ChlorDiSys Solutions, Inc., Lebanon, NJ) to disinfect surface coupons composed of plastic from a bedrail, stainless steel, chrome-plated light switch cover, and a porcelain tile that were inoculated with methicillin-resistant Staphylococcus aureus (MRSA) or vancomycin-resistant Enterococcus faecalis (VRE). Each surface type was placed at 6 different sites within a hospital room and treated by 10-min ultraviolet-C (UVC) exposures using the TORCH with doses ranging from 0-688 mJ/cm(2) between sites. Organism reductions were compared with untreated surface coupons as controls. Overall, UVGI significantly reduced MRSA by an average of 4.6 log10 (GSD: 1.7 log10, 77% inactivation, p surfaces, while VRE was reduced significantly less on chrome (p = 0.0004) and stainless steel (p = 0.0012) than porcelain tile. Organisms out of direct line of sight of the UVC generator were reduced significantly less (p surfaces evaluated within the hospital environment in direct line of sight of UVGI treatment with variation between organism and surface types.

  1. Flexibility in hospital building and application by means of standardized medical room types

    NARCIS (Netherlands)

    Kamp, Pieter; Kooistra, Rien; Ankersmid, H.A.H.G.; Bonnema, Gerrit Maarten

    2014-01-01

    This paper presents an approach to standardization of hospital rooms. As hospitals are becoming more complex, the need for quality assurance and validation increases as well. Several sources mention the responsibility of the medical personnel for the quality and safety of the equipment with which

  2. Experimental investigation of performance of a novel ventilation method for hospital patient rooms

    DEFF Research Database (Denmark)

    Melikov, Arsen Krikor; Bolashikov, Zhecho Dimitrov; Brand, Marek

    2010-01-01

    A novel hospital bed integrated ventilation and cleaning unit (HBIVCU) was developed to reduce the exposure of medical staff, visitors, etc. to coughed air from a sick patient. The performance efficiency of the unit was studied in a full-scale mock-up of a hospital room with two beds with patients...

  3. The impact of single and shared rooms on family-centred care in children's hospitals.

    Science.gov (United States)

    Curtis, Penny; Northcott, Andy

    2017-06-01

    To explore whether and how spatial aspects of children's hospital wards (single and shared rooms) impact upon family-centred care. Family-centred care has been widely adopted in paediatric hospitals internationally. Recent hospital building programmes in many countries have prioritised the provision of single rooms over shared rooms. Limited attention has, however, been paid to the potential impact of spatial aspects of paediatric wards on family-centred care. Qualitative, ethnographic. Phase 1; observation within four wards of a specialist children's hospital. Phase 2; interviews with 17 children aged 5-16 years and 60 parents/carers. Sixty nursing and support staff also took part in interviews and focus group discussions. All data were subjected to thematic analysis. Two themes emerged from the data analysis: 'role expectations' and 'family-nurse interactions'. The latter theme comprised three subthemes: 'family support needs', 'monitoring children's well-being' and 'survey-assess-interact within spatial contexts'. Spatial configurations within hospital wards significantly impacted upon the relationships and interactions between children, parents and nurses, which played out differently in single and shared rooms. Increasing the provision of single rooms within wards is therefore likely to directly affect how family-centred care manifests in practice. Nurses need to be sensitive to the impact of spatial characteristics, and particularly of single and shared rooms, on families' experiences of children's hospital wards. Nurses' contribution to and experience of family-centred care can be expected to change significantly when spatial characteristics of wards change and, as is currently the vogue, hospitals maximise the provision of single rather than shared rooms. © 2016 John Wiley & Sons Ltd.

  4. A qualitative study of Western Australian women's perceptions of using a Snoezelen room for breastfeeding during their postpartum hospital stay.

    Science.gov (United States)

    Hauck, Yvonne L; Summers, Lisa; White, Ellie; Jones, Cheryl

    2008-08-13

    There is limited evidence on the use of the Snoezelen concept for maternity clients. Snoezelen, a Dutch concept, initiated in the 1970s as a leisure activity for severely disabled people, involves creating an indoor environment using controllable stimuli to enhance comfort and relaxation. These specially designed rooms expose the user to multiple sensory stimulations combining vision, touch, sounds and aromas. The aim of this study was to provide insight into breastfeeding women's experience of using a Snoezelen room during hospitalisation. A qualitative exploratory design was chosen to reveal women's perceptions of using the Snoezelen room. Osborne Park Hospital, the study setting is the second largest public provider of obstetric services in Western Australia. A purposive sample was drawn from breastfeeding women who used the Snoezelen room during their postpartum stay from March 2006 to March 2007. Saturation was achieved after eleven breastfeeding women were interviewed six weeks post discharge. Data analysis involved the constant comparison method. Participants entered the room feeling tired and emotional with an unsettled baby and breastfeeding issues aggravated by maternal stress and anxiety. All women indicated they were able to achieve relaxation while in the room and would recommend its use to other breastfeeding mothers. Two key themes revealed how the Snoezelen room facilitated maternal relaxation, which ultimately enhanced the breastfeeding experience. The first theme, "Finding Relaxation for the Breastfeeding Mother" incorporates three subthemes: 'Time out' for mother; Control in own personal space; and a Quiet/calm environment with homelike atmosphere. The second theme, "Enabling Focus on Breastfeeding", occurred after relaxation was achieved and involved four subthemes: Able to get one-on-one attention; Not physically exposed to others; Away from prying, judgemental eyes and Able to safely attempt breastfeeding alone knowing help is nearby. Insight

  5. A qualitative study of Western Australian women's perceptions of using a Snoezelen room for breastfeeding during their postpartum hospital stay

    Directory of Open Access Journals (Sweden)

    White Ellie

    2008-08-01

    Full Text Available Abstract Background There is limited evidence on the use of the Snoezelen concept for maternity clients. Snoezelen, a Dutch concept, initiated in the 1970s as a leisure activity for severely disabled people, involves creating an indoor environment using controllable stimuli to enhance comfort and relaxation. These specially designed rooms expose the user to multiple sensory stimulations combining vision, touch, sounds and aromas. The aim of this study was to provide insight into breastfeeding women's experience of using a Snoezelen room during hospitalisation. Methods A qualitative exploratory design was chosen to reveal women's perceptions of using the Snoezelen room. Osborne Park Hospital, the study setting is the second largest public provider of obstetric services in Western Australia. A purposive sample was drawn from breastfeeding women who used the Snoezelen room during their postpartum stay from March 2006 to March 2007. Saturation was achieved after eleven breastfeeding women were interviewed six weeks post discharge. Data analysis involved the constant comparison method. Results Participants entered the room feeling tired and emotional with an unsettled baby and breastfeeding issues aggravated by maternal stress and anxiety. All women indicated they were able to achieve relaxation while in the room and would recommend its use to other breastfeeding mothers. Two key themes revealed how the Snoezelen room facilitated maternal relaxation, which ultimately enhanced the breastfeeding experience. The first theme, "Finding Relaxation for the Breastfeeding Mother" incorporates three subthemes: 'Time out' for mother; Control in own personal space; and a Quiet/calm environment with homelike atmosphere. The second theme, "Enabling Focus on Breastfeeding", occurred after relaxation was achieved and involved four subthemes: Able to get one-on-one attention; Not physically exposed to others; Away from prying, judgemental eyes and Able to safely

  6. Key facilitators and best practices of hotel-style room service in hospitals.

    Science.gov (United States)

    Sheehan-Smith, Lisa

    2006-04-01

    This qualitative study sought to identify the features, advantages, and disadvantages of hotel-style room service; the barriers to, and facilitators for, implementing the process; and "best practices." The study took place in four heterogeneous hospitals. Participants included hospital administrators, managers, and room-service employees. Data-collection methods included semi-structured interviews, observations, and document analysis. Common features of hotel-style room service were meal delivery within 30 to 45 minutes, a restaurant-style menu, procedures to feed ineligible patients, tray assembly on demand, scripting, and waitstaff uniforms for room-service employees. The major barrier to implementing room service was obtaining nursing support. The key facilitators were the hospital's service-oriented culture, using a multidisciplinary planning team, engaging nursing departments early in the planning stages, and intense customer-service training of room-service employees. The overwhelming advantage was patients' control over their food choices. The main disadvantage was cost. Initial best practices in hotel-style room service include: (a) taking a multidisciplinary team approach for developing and implementing the process, (b) customer-service training, (c) using a customer-driven menu, (d) wearing waitstaff uniforms, and (e) using carts with airpots for dispensing hot beverages.

  7. Comparison of two whole-room ultraviolet irradiation systems for enhanced disinfection of contaminated hospital patient rooms.

    Science.gov (United States)

    Ali, S; Yui, S; Muzslay, M; Wilson, A P R

    2017-10-01

    Ultraviolet (UV) light decontamination systems are being used increasingly to supplement terminal disinfection of patient rooms. However, efficacy may not be consistent in the presence of soil, especially against Clostridium difficile spores. To demonstrate in-use efficacy of two whole-room UV decontamination systems against three hospital pathogens with and without soil. For each system, six patient rooms were decontaminated with UV irradiation (enhanced disinfection) following manual terminal cleaning. Total aerobic colony counts of surface contamination were determined by spot-sampling 15 environmental sites before and after terminal disinfection and after UV irradiation. Efficacy against biological indicator coupons (stainless-steel discs) was performed for each system using test bacteria (10 6  cfu EMRSA-15 variant A, carbapenemase-producing Klebsiella pneumoniae) or spores (10 5  cfu C. difficile 027), incorporating low soiling [0.03% bovine serum albumin (BSA)], heavy soiling (10% BSA) or synthetic faeces (C. difficile only) placed at five locations in the room. UV disinfection eliminated contamination after terminal cleaning in 8/14 (57%) and 11/14 (79%) sites. Both systems demonstrated 4-5 log 10 reductions in meticillin-resistant Staphylococcus aureus and K. pneumoniae at low soiling. Lower and more variable log 10 reductions were achieved when heavy soiling was present. Between 0.1 and 4.8 log 10 reductions in C. difficile spores were achieved with low but not heavy soil challenge. Terminal disinfection should be performed on all surfaces prior to UV decontamination. In-house validation studies should be considered to ensure optimal positioning in each room layout and sufficient cycle duration to eliminate target pathogens. Copyright © 2017 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

  8. TOF Imaging in Smart Room Environments towards Improved People Tracking

    DEFF Research Database (Denmark)

    Guðmundsson, Sigurjón Árni; Larsen, Rasmus; Aanæs, Henrik

    2008-01-01

    In this Paper we present the use of Time-of-Flight (TOF) cameras in Smart-rooms and how this leads to improved results in segmenting the people in the room from the background and consequently better 3D reconstruction of the people. A calibrated rig of one Swissranger SR3100 Time-of-flight range ...... regional artifacts and therefore a more robust input for higher level applications such people tracking or human motion analysis....

  9. The Practice of Medicine at a District Hospital Emergency Room ...

    African Journals Online (AJOL)

    To remain in touch with the changing environment of medicine, one has to keep on learning and sometimes attend refresher courses far away from the place of work. The rewarding part of the practice is that many junior doctors benefit from the experience of the senior colleagues, who teach them basic skills. A practitioner ...

  10. Impact of imaging room environment: staff job stress and satisfaction, patient satisfaction, and willingness to recommend.

    Science.gov (United States)

    Quan, Xiaobo; Joseph, Anjali; Ensign, Janet C

    2012-01-01

    The built environment significantly affects the healthcare experiences of patients and staff. Healthcare administrators and building designers face the opportunity and challenge of improving healthcare experience and satisfaction through better environmental design. The purpose of the study was to evaluate how a novel environmental intervention for imaging rooms, which integrated multiple elements of healing environments including positive distractions and personal control over environment, affects the perceptions and satisfactions of its primary users-patients and staff. Anonymous questionnaire surveys were conducted to compare patient and staff perceptions of the physical environment, satisfaction, and stress in two types of imaging rooms: imaging rooms with the intervention installed (intervention rooms) and traditionally designed rooms without the intervention (comparison rooms). Imaging technologists and patients perceived the intervention rooms to be significantly more pleasant-looking. Patients in the intervention rooms reported significantly higher levels of environmental control and were significantly more willing to recommend the intervention rooms to others. The environmental intervention was effective in improving certain aspects of the imaging environment: pleasantness and environmental control. Further improvement of the imaging environment is needed to address problematic areas such as noise.

  11. AT HOME IN HOSPITAL? COMPETING CONSTRUCTIONS OF HOSPITAL ENVIRONMENTS

    Directory of Open Access Journals (Sweden)

    Peter Kellett

    2009-03-01

    Full Text Available Large institutions housed in large buildings are frequently regarded as the antithesis of personalised, small scale, domestic, home environments. However the attribute of ‘homeliness’ appears to be used more broadly to describe places where people feel a sense of attachment, control and identification. In a large multi-disciplinary study of a hospital rebuilding project in northern England a range of users were interviewed to ascertain their responses to the original older buildings and later the new purpose built hospital. We found both staff and patients retained a strong sense of affection for the older buildings and frequently used the language of home to describe their responses. In contrast, the newer buildings were generally recognised as efficient but impersonal, lacking many of the positive qualities they were familiar with. In addition some respondents suggested that despite efforts to include art projects, the new architectural language was inappropriate for healthcare, believing that small scale, ‘home-like’ environments were more conducive to health and well-being. The authors will draw on anthropological and architectural frameworks to analyse the data which consists of extensive interview transcripts complemented by photographs. The paper aims to understand the conceptualisations which underpin the various user responses and to offer a critique of the design language of the current healthcare building programme.

  12. Ergonomics and nursing in hospital environments.

    Science.gov (United States)

    Rogers, Bonnie; Buckheit, Kathleen; Ostendorf, Judith

    2013-10-01

    This study describes workplace conditions, the environment, and activities that may contribute to musculoskeletal injuries among nurses, as well as identifies solutions to decrease these risks and improve work-related conditions. The study used a mixed-methods design. Participants included nurses and stakeholders from five hospitals. Several focus groups were held with nurses, walk-throughs of clinical units were conducted, and stakeholder interviews with key occupational health and safety personnel were conducted in each of the five hospitals, as well as with representatives from the American Nurses Association, Veterans Health Administration hospital, and National Institute for Occupational Safety and Health. Several key contributing factors, including the physical environment (e.g., layout and organization of work stations), work organization and culture (e.g., heavy workload, inadequate staffing, lack of education), and work activities (e.g., manual lifting of patients, lack of assistive devices), were identified. Recommendations included the need for a multifaceted and comprehensive approach to developing a sound ergonomics program. Copyright 2013, SLACK Incorporated.

  13. Radio frequency identification applications in hospital environments.

    Science.gov (United States)

    Wicks, Angela M; Visich, John K; Li, Suhong

    2006-01-01

    Radio frequency identification (RFID) technology has recently begun to receive increased interest from practitioners and academicians. This interest is driven by mandates from major retailers such as Wal-Mart, Target and Metro Group, and the United States Department of Defense, in order to increase the efficiency and visibility of material and information flows in the supply chain. However, supply chain managers do not have a monopoly on the deployment of RFID. In this article, the authors discuss the potential benefits, the areas of applications, the implementation challenges, and the corresponding strategies of RFID in hospital environments.

  14. Traffic flow and microbial air contamination in operating rooms at a major teaching hospital in Ghana

    DEFF Research Database (Denmark)

    Stauning, M. T.; Bediako-Bowan, A.; Andersen, L. P.

    2018-01-01

    . Aim: To assess microbial air contamination in operating rooms at a Ghanaian teaching hospital and the association with door-openings and number of people present. Moreover, we aimed to document reasons for door-opening. Methods: We conducted active air-sampling using an MAS 100® portable impactor...

  15. Protective shielding parameters of diagnostic x-ray rooms in some hospitals in Benue State

    International Nuclear Information System (INIS)

    Agba, E.H.; Gemanam, S.; Sombo, T.

    2011-01-01

    Protective shielding parameters of diagnostic x-ray units at Federal Medical Centre, Makurdi, Baki Hospital, Gboko and Mkar Christian Hospital, Gboko have been determined using a radiation meter, (Inspector, Exp.S.E). The parameters determined include: Operating potential, Workload and Use factors of each diagnostic x-ray room. These parameters were used to estimate the primary and secondary protective barriers for the hospitals. The primary and secondary protective barrier values at Mkar Christian Hospital, Baki Hospital, Gboko and Federal Medical Centre, Makurdi are found to be: 11.0±0.11 x10 -1 mm and 9.0±9x10 -2 mm; 6.0±6.0x10 -1 mm and 6.0±6.0x10 -2 mm; and 7.0±7.0x10 -1 mm and 6.0±6.0x10 -2 mm respectively. The wall thicknesses around the x-ray rooms of the respective hospitals are 300±3.0x1 0 -1 mm for Mkar Christian Hospital and Federal Medical Centre, Makurdi, while that of Baki Hospital, Gboko is 270±2.7x10 -1 mm. The measured wall thicknesses are seen to be adequate protective structural shields on the basis of International NCRP Standards on Structural Shielding.

  16. To provide care and be cared for in a multiple-bed hospital room.

    Science.gov (United States)

    Persson, Eva; Määttä, Sylvia

    2012-12-01

    To illuminate patients' experiences of being cared for and nurses' experiences of caring for patients in a multiple-bed hospital room. Many patients and healthcare personnel seem to prefer single-bed hospital rooms. However, certain advantages of multiple-bed hospital rooms (MBRs) have also been described. Eight men and eight women being cared for in a multiple-bedroom were interviewed, and two focus-group interviews (FGI) with 12 nurses were performed. A qualitative content analysis was used. One theme--Creating a sphere of privacy--and three categories were identified based on the patient interviews. The categories were: Being considerate, Having company and The patients' area. In the FGI, one theme--Integrating individual care with care for all--and two categories emerged: Experiencing a friendly atmosphere and Providing exigent care. Both patients and nurses described the advantages and disadvantages of multiple-bed rooms. The patient culture of taking care of one another and enjoying the company of room-mates were considered positive and gave a sense of security of both patients and nurses. The advantages were slight and could easily become disadvantages if, for example, room-mates were very ill or confused. The patients tried to maintain their privacy and dignity and claimed that there were small problems with room-mates listening to conversations. In contrast, the nurses stressed patient integrity as a main disadvantage and worked to protect the integrity of individual patients. Providing care for all patients simultaneously had the advantage of saving time. The insights gained in the present study could assist nurses in reducing the disadvantages and taking advantage of the positive elements of providing care in MBRs. Health professionals need to be aware of how attitudes towards male and female patients, respectively, could affect care provision. © 2012 The Authors. Scandinavian Journal of Caring Sciences © 2012 Nordic College of Caring Science.

  17. Floor cleaning: effect on bacteria and organic materials in hospital rooms.

    Science.gov (United States)

    Andersen, B M; Rasch, M; Kvist, J; Tollefsen, T; Lukkassen, R; Sandvik, L; Welo, A

    2009-01-01

    Routine surface cleaning is recommended to control the spread of pathogens in hospital environments. In Norway, ordinary cleaning of patient rooms is traditionally performed with soap and water. In this study, four floor-mopping methods--dry, spray, moist and wet mopping--were compared by two systems using adenosine triphosphate (ATP) bioluminescence (Hygiena and Biotrace). These systems assess residual organic soil on surfaces. The floor-mopping methods were also assessed by microbiological samples from the floor and air, before and after cleaning. All methods reduced organic material on the floors but wet and moist mopping seemed to be the most effective (P < 0.001, P < 0.011, respectively, ATP Hygiena). The two ATP methods were easy to use, although each had their own reading scales. Cleaning reduced organic material to 5-36% of the level present before cleaning, depending upon mopping method. All four mopping methods reduced bacteria on the floor from about 60-100 to 30-60 colony-forming units (cfu)/20cm2 floor. Wet, moist and dry mopping seemed to be more effective in reducing bacteria on the floor, than the spray mopping (P=0.007, P=0.002 and P=0.011, respectively). The burden of bacteria in air increased for all methods just after mopping. The overall best cleaning methods seemed to be moist and wet mopping.

  18. Bed-integrated local exhaust ventilation system combined with local air cleaning for improved IAQ in hospital patient rooms

    DEFF Research Database (Denmark)

    Bivolarova, Mariya Petrova; Melikov, Arsen Krikor; Mizutani, Chiyomi

    2016-01-01

    the exposure to body generated bio-effluents in a hospital room was determined. Full-scale experiments were conducted in a climate chamber furnished as a single-bed patient room. Two heated dummies were used to simulate a patient and a doctor in the room. The patient was lying on a bed equipped with the VM...

  19. Reduced exposure to coughed air by a novel ventilation method for hospital patient rooms

    DEFF Research Database (Denmark)

    Bolashikov, Zhecho Dimitrov; Melikov, Arsen Krikor; Brand, Marek

    2012-01-01

    A novel hospital bed integrated ventilation and cleaning unit (HBIVCU) for local airflow control and cleansing, limiting the airborne spread of contagious air coughed from a sick patient in a hospital room, was developed. The performance efficiency of the unit, to successfully reduce occupants......’ exposure to coughed air, was studied in a full-scale, two-bed hospital room mock-up, 4.65 m x 4.65 m x 2.60 m (W x L x H), with two patients and a doctor. Four units were placed along the two sides of both beds close to the head. The room was ventilated by overhead mixing air distribution at 22 °C room air...... of the novel unit, at background ventilation rates of 3 h-1and 6 h-1, was evaluated by measuring the excess CO2 concentration at the mouth of both the doctor and the exposed patient. When the novel method was not used, the CO2 concentration (exposure) measured in the air “inhaled” by the doctor exceeded 20...

  20. First-Case Operating Room Delays: Patterns Across Urban Hospitals of a Single Health Care System

    Directory of Open Access Journals (Sweden)

    Callie M. Cox Bauer

    2016-08-01

    Full Text Available Purpose: Operating room delays decrease health care system efficiency and increase costs. To improve operating room efficiency in our system, we retrospectively investigated delay frequencies, causes and costs. Methods: We studied all first-of-the-day nonemergent surgical cases performed at three high-volume urban hospitals of a large health system from July 2012 to November 2013. Times for patient flow from arrival to procedure start and documented reasons for delay were obtained from electronic medical records. Delay was defined as patient placement in the operating room later than scheduled surgery time. Effects of patient characteristics, late patient arrival to the hospital, number of planned procedures, years of surgeon experience, service department and hospital facility on odds of delay were examined using logistic regression. Results: Of 5,598 cases examined, 88% were delayed. Patients arrived late to the hospital (surgery in 65% of first cases. Mean time from arrival to scheduled surgery and in-room placement was 104.6 and 127.4 minutes, respectively. Mean delay time was 28.2 minutes. Nearly 60% of delayed cases had no documented reason for delay. For cases with documentation, causes included the physician (52%, anesthesia (15%, patient (13%, staff (9%, other sources (6% and facility (5%. Regression analysis revealed age, late arrival, department and facility as significant predictors of delay. Estimated delay costs, based on published figures and representing lost revenue, were $519,388. Conclusions: To improve operating room efficiency, multidisciplinary strategies are needed for increasing patient adherence to recommended arrival times, documentation of delay by medical staff and consistency in workflow patterns among facilities and departments.

  1. Eliciting Patients’ Health Concerns in Consulting Rooms and Wards in Vietnamese Public Hospitals

    Directory of Open Access Journals (Sweden)

    Huong Thi Linh Nguyen

    2018-03-01

    Full Text Available This article examines the doctor’s elicitation of the patient’s presenting health concern in two clinical settings in the Vietnamese public hospital system: the consulting room and the ward. The data were taken from 66 audio-recorded consultations. Our analysis shows that the elicitors used by the doctor in the consulting room often communicate a weak epistemic stance towards the patient’s health issue, while those used in the ward tend to signal a strong epistemic stance. In addition, this contrast between the elicitors employed in the consulting room and the ward is evident in our data regardless of whether the consultation is a first visit or a same follow-up (in which the doctor is the same one that treated the patient on their last visit, though the contrast is less clear for different follow-ups (in which the doctor has not treated the patient before. An additional finding is that the clinical setting has some bearing on the use of inappropriate elicitation formats (in which the doctor opens the visit with an elicitor which is more appropriate for another type of visit. The precise way in which each of the consulting room and the ward operates is, of course, a feature of the Vietnamese public hospital system itself. Hence, the overall contrast between the elicitors and elicitation formats used in these two settings illustrates how, on a more general level, the institutional context can have an impact on doctor-patient communication.

  2. Room service improves patient food intake and satisfaction with hospital food.

    Science.gov (United States)

    Williams, R; Virtue, K; Adkins, A

    1998-07-01

    Cancer therapy causes side effects that interfere with oral intake. Frequently, patients undergoing such therapy suffer from anorexia, nausea, vomiting, food aversions, dysgeusia, and xerostomia, all which adversely affect oral intake. Adequate nutrition intake is an important part of therapy for the cancer patient, especially when that patient is a child. Children who are well nourished are better able to withstand infection and tolerate therapy. Parents and staff at our hospital have worked diligently to improve patient's oral intake with limited success. Hence, a multidisciplinary team was organized to develop a new approach to food services that would improve patients' oral intake. The team initiated patient "room service," and patients were allowed to call the kitchen when they were ready to eat. The system works much like room service in a hotel. After the introduction of room service, patients' caloric intake improved significantly (P = .008), and protein intake increased by 18%. Patient satisfaction with hospital food service also improved; excellent ratings increased by as much as 35%. We conclude that room service is a viable alternative to traditional food services in the pediatric oncology setting and may be useful in other patient populations, such as maternity and general pediatrics.

  3. Poor Compliance with Sepsis Guidelines in a Tertiary Care Children’s Hospital Emergency Room

    OpenAIRE

    Benjamin Louis Moresco; Benjamin Louis Moresco; Clinton Woosley; Clinton Woosley; Morris Sauter; Utpal Bhalala; Utpal Bhalala

    2018-01-01

    ObjectivesThis study aimed to assess factors related to adherence to the Pediatric Advanced Life Support guidelines for severe sepsis and septic shock in an emergency room (ER) of a tertiary care children’s hospital.MethodsThis was a retrospective, observational study of children (0–18 years old) in The Children’s Hospital of San Antonio ER over 1 year with the International Consensus Definition Codes, version-9 (ICD-9) diagnostic codes for “severe sepsis” and “shocks.” Patients in the adhere...

  4. Nitrous oxide levels in operating and recovery rooms of Iranian hospitals.

    Science.gov (United States)

    Maroufi, Sh Sadigh; Gharavi, Mj; Behnam, M; Samadikuchaksaraei, A

    2011-01-01

    Nitrous oxide (N(2)O) is the oldest anesthetic in routine clinical use and its occupational exposure is under regulation by many countries. As studies are lacking to demonstrate the status of nitrous oxide levels in operating and recovery rooms of Iranian hospitals, we aimed to study its level in teaching hospitals of Tehran University of Medical Sciences. During a 6-month period, we have measured the shift-long time weighted average concentration of N(2)O in 43 operating and 12 recovery rooms of teaching hospitals of Tehran University of Medical Sciences. The results show that the level of nitrous oxide in all hospitals is higher than the limits set by different countries and anesthetists are at higher risk of exposure. In addition, it was shown that installation of air ventilation could reduce not only the overall exposure level, but also the level of exposure of anesthetists in comparison with other personnel. The high nitrous oxide level in Iranian hospitals necessitates improvement of waste gas evacuation systems and regular monitoring to bring the concentration of this gas into the safe level.

  5. An Analysis of Operating Room Performance Metrics at Reynolds Army Community Hospital

    Science.gov (United States)

    2009-06-28

    Orthopedic Care NEC Physical Therapy Clinic Occupation Therapy Clinic Hypertension Clinic Physical Medicine Clinic Medical Clinics Cost Pool Medical...high ICU and ward occupancy rates are limited in the number of inpatient surgeries they can perform. On the other hand, hospitals with inefficient... Rheumatology , 9(5), 325 - 327. Mazzei, W.J. (1999). Maximizing operating room utilization: A landmark study. Anesthesia & Analgesia, 89(1), 1 -2. MEPRS

  6. An Investigation of the Prevalence of Antibiotic Resistance in Enterococcus Species Isolated from Delivery Room of University Hospital of Qom City, 2015, Iran

    Directory of Open Access Journals (Sweden)

    Faezeh Kabiri

    2016-06-01

    Full Text Available Background and Objectives: Enterococci are Gram-positive cocci that are found in abundance in the environment. The ability of these bacteria for long-term survival in hospital environment, increases the chance of patients for infections caused by this bacterium. Therefore, identification of possible sources and reservoirs is helpful in identifying the potential sources in sudden outbreaks. The current study was conducted to determine the prevalence rate and antibiotic resistance pattern in environmental Enterococcus isolates collected from delivery room environment of Alzahra and Izadi university hospitals in Qom. Methods: In this descriptive cross-sectional study, over a period of 3 month, sampling was performed using swabbing method from delivery rooms of alzahra and izadi hospitals in Qom, and were examined for the presence of Enterococci. After isolation, Enterococcus species were examined using different biochemical tests, and the antibiotic resistance pattern in the environmental was assessed according to disk-diffusion test according to Clinical and Laboratory Standards Institute (CLSI standards. The data were described by frequency tables. Results: In this study, out of 216 obtained isolates, 7(3.2% belonged to Enterococcus genus. 4(57% out of 7 Enterococcus strains isolated from surfaces of delivery room, had multiple resistances based on antibiotic sensitivity test using antiobiogram test. Conclusion: According to increasing growth of nosocomial infection caused by resistant strains of Enterococcus spp. and their spread in hospital environment, use of infection control measures are necessary to eliminate the potential sources and prevent the infection.  

  7. HOSPITAL SOUNDSCAPE: ACOUSTICS EVALUATION IN NEONATAL INTENSIVE CARE UNIT (NICU ROOM OF A NATIONAL HOSPITAL IN JAKARTA, INDONESIA

    Directory of Open Access Journals (Sweden)

    SARWONO R. Sugeng Joko

    2016-12-01

    Full Text Available Acoustics comfort in a room is one of the most important building physics aspect that should be observed. in public spaces like hospital, especially in an intensive care unit such as NICU. Researches on the acoustic conditions of NICU in Indonesia are still limited. The acoustical study conducted in this research is using objective, subjective, and simulation methods based on soundscape concept with the concern on the nurse’s perception. This research was conducted at a national hospital in Jakarta. According to National Standardization Agency of Indonesia (SNI and World Health Organization (WHO, the suitable sound pressure level (SPL for noise in patient’s room is 35 dBA. From the study, it was found that the equivalent SPL value exceeded the standard. Soundscape in NICU can be improve with the addition of curtain on the incubator’s side, installation of glass partition, and ceiling absorber in the nurse station area. The result of simulation showed that the SPL in the room decreased with average value 8.9 dBA for sound source alarm ventilator and 8.2 dBA for sound source medical officer conversations. And the speech transmission index (STI increased from “bad” to “good” range became “fair” to “excellent” range.

  8. Improving operating room efficiency in academic children's hospital using Lean Six Sigma methodology.

    Science.gov (United States)

    Tagge, Edward P; Thirumoorthi, Arul S; Lenart, John; Garberoglio, Carlos; Mitchell, Kenneth W

    2017-06-01

    Lean Six Sigma (LSS) is a process improvement methodology that utilizes a collaborative team effort to improve performance by systematically identifying root causes of problems. Our objective was to determine whether application of LSS could improve efficiency when applied simultaneously to all services of an academic children's hospital. In our tertiary academic medical center, a multidisciplinary committee was formed, and the entire perioperative process was mapped, using fishbone diagrams, Pareto analysis, and other process improvement tools. Results for Children's Hospital scheduled main operating room (OR) cases were analyzed, where the surgical attending followed themselves. Six hundred twelve cases were included in the seven Children's Hospital operating rooms (OR) over a 6-month period. Turnover Time (interval between patient OR departure and arrival of the subsequent patient) decreased from a median 41min in the baseline period to 32min in the intervention period (p<0.0001). Turnaround Time (interval between surgical dressing application and subsequent surgical incision) decreased from a median 81.5min in the baseline period to 71min in the intervention period (p<0.0001). These results demonstrate that a coordinated multidisciplinary process improvement redesign can significantly improve efficiency in an academic Children's Hospital without preselecting specific services, removing surgical residents, or incorporating new personnel or technology. Prospective comparative study, Level II. Copyright © 2017 Elsevier Inc. All rights reserved.

  9. A room acoustical computer model for industrial environments - the model and its verification

    DEFF Research Database (Denmark)

    Christensen, Claus Lynge; Foged, Hans Torben

    1998-01-01

    This paper presents an extension to the traditional room acoustic modelling methods allowing computer modelling of huge machinery in industrial spaces. The program in question is Odeon 3.0 Industrial and Odeon 3.0 Combined which allows the modelling of point sources, surface sources and line...... of an omnidirectional sound source and a microphone. This allows the comparison of simulated results with the ones measured in real rooms. However when simulating the acoustic environment in industrial rooms, the sound sources are often far from being point like, as they can be distributed over a large space...

  10. Evaluation of noise pollution level in the operating rooms of hospitals: A study in Iran.

    Science.gov (United States)

    Giv, Masoumeh Dorri; Sani, Karim Ghazikhanlou; Alizadeh, Majid; Valinejadi, Ali; Majdabadi, Hesamedin Askari

    2017-06-01

    Noise pollution in the operating rooms is one of the remaining challenges. Both patients and physicians are exposed to different sound levels during the operative cases, many of which can last for hours. This study aims to evaluate the noise pollution in the operating rooms during different surgical procedures. In this cross-sectional study, sound level in the operating rooms of Hamadan University-affiliated hospitals (totally 10) in Iran during different surgical procedures was measured using B&K sound meter. The gathered data were compared with national and international standards. Statistical analysis was performed using descriptive statistics and one-way ANOVA, t -test, and Pearson's correlation test. Noise pollution level at majority of surgical procedures is higher than national and international documented standards. The highest level of noise pollution is related to orthopedic procedures, and the lowest one related to laparoscopic and heart surgery procedures. The highest and lowest registered sound level during the operation was 93 and 55 dB, respectively. Sound level generated by equipments (69 ± 4.1 dB), trolley movement (66 ± 2.3 dB), and personnel conversations (64 ± 3.9 dB) are the main sources of noise. The noise pollution of operating rooms are higher than available standards. The procedure needs to be corrected for achieving the proper conditions.

  11. Perceptions of the hospital ethical environment among hospital social workers in the United States.

    Science.gov (United States)

    Pugh, Greg L

    2015-01-01

    Hospital social workers are in a unique context of practice, and one where the ethical environment has a profound influence on the ethical behavior. This study determined the ratings of ethical environment by hospital social workers in large nationwide sample. Correlates suggest by and compared to studies of ethical environment with nurses are explored. Positive ratings of the ethical environment are primarily associated with job satisfaction, as well as working in a centralized social work department and for a non-profit hospital. Religiosity and MSW education were not predictive. Implications and suggestions for managing the hospital ethical environment are provided.

  12. Microenvironments in swine farrowing rooms: the thermal, lighting, and acoustic environments of sows and piglets

    Directory of Open Access Journals (Sweden)

    Gabriela Munhoz Morello

    Full Text Available ABSTRACT: The present research hypothesized that the thermal, lighting and acoustic environments in commercial swine farrowing rooms vary over time and from crate to crate. This study was conducted on 27 replicates in two commercial farrowing rooms in North Central Indiana, each equipped with 60 farrowing crates. Temperature, relative humidity, light intensity, sound intensity, and air velocity were continuously monitored and estimated for each crate at the sow level, for 48 h post-farrowing, which is usually a critical period for piglet survivability. Average daily temperature for all the crates in Room 1 was 24.1 ± 2.0 °C, 1.0 °C lower (p < 0.05 than in Room 2. Although the overall mean temperature was similar between rooms and seasons, frequency distribution diagrams revealed that the proportion of time spent within distinct limits of mean daily temperature ranged from 15.0 °C to 28.0 °C and varied substantially between rooms and seasons. Similar results were found for all variables measured in this study. Differences in temperature, relative humidity, light intensity, air velocity, and sound intensity in crates were as high as 9.6 °C, 57 %, 3,847.3 Lx, 0.87 m s–1, and 38.7 dBC, respectively, in the same farrowing room when measured at the same instant. The results of the present research indicate that aspects that go beyond the physical environment of the sows, such as thermal, lighting, and acoustic environment can vary substantially over time and between crates of automatically climate controlled farrowing rooms. These differences should be taken into consideration in production setting and research.

  13. Persistence of mixed staphylococci assemblages following disinfection of hospital room surfaces.

    Science.gov (United States)

    Sigler, V; Hensley, S

    2013-03-01

    The distribution of staphylococcal assemblages on surfaces in hospital rooms was assessed before and after daily disinfection with quaternary ammonia products. DNA was extracted from enrichment cultures of bacteria, which were swabbed from each of nine surface types, and subjected to analysis by staphylococci-specific, denaturing gradient gel electrophoresis. A genetic marker for Staphylococcus epidermidis/kloosii was detected on all surface types before and after cleaning, whereas markers for Staphylococcus aureus and Staphylococcus lugdunensis were detected on five surface types. Overall, genetic makers for several staphylococci known to colonize and infect humans remained ubiquitous in each room following daily disinfection practices. Copyright © 2013 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

  14. Investigating Performance Installation of Hospital Room Surgery of Six Hospitals in Special Region of Yogyakarta by Using Data Envelopment Analysis Model Constant Return to Scale

    Directory of Open Access Journals (Sweden)

    Bhimo Rizky Samudro

    2018-03-01

    Full Text Available This study aims to investigate the efficiency level of hospital surgery hospital installation in Special Region of Yogyakarta Province. Research conceptual constructs are based on input and output performance in institutional performance processes. This research approach uses positivist pattern and is derived by quantitative method. This is to explain the efficiency pattern of the installation of hospital and private hospital surgery rooms. The quantitative method chosen is the concept of Data Envelopment Analysis (DEA. The results showed that 1 the installation of a private hospital surgery room tends to be more efficient than government property; 2 the installation of a special hospital surgical hospital is not absolutely more efficient than a public hospital. As a recommendation, this research provides scenario for setting input usage for efficient performance.

  15. Investigating Performance Installation of Hospital Room Surgery of Six Hospitals in Special Region of Yogyakarta by Using Data Envelopment Analysis Model Constant Return to Scale

    OpenAIRE

    Bhimo Rizky Samudro; Yogi Pasca Pratama

    2018-01-01

    This study aims to investigate the efficiency level of hospital surgery hospital installation in Special Region of Yogyakarta Province. Research conceptual constructs are based on input and output performance in institutional performance processes. This research approach uses positivist pattern and is derived by quantitative method. This is to explain the efficiency pattern of the installation of hospital and private hospital surgery rooms. The quantitative method chosen is the concept of Dat...

  16. Exposure of hospital operating room personnel to potentially harmful environmental agents

    International Nuclear Information System (INIS)

    Sass-Kortsak, A.M.; Purdham, J.T.; Bozek, P.R.; Murphy, J.H.

    1992-01-01

    Epidemiologic studies of risk to reproductive health arising from the operating room environment have been inconclusive and lack quantitative exposure information. This study was undertaken to quantify exposure of operating room (OR) personnel to anesthetic agents, x-radiation, methyl methacrylate, and ethylene oxide and to determine how exposure varies with different operating room factors. Exposures of anesthetists and nurses to these agents were determined in selected operating rooms over three consecutive days. Each subject was asked to wear an x-radiation dosimeter for 1 month. Exposure to anesthetic agents was found to be influenced by the age of the OR facility, type of surgical service, number of procedures carried out during the day, type of anesthetic circuitry, and method of anesthesia delivery. Anesthetists were found to have significantly greater exposures than OR nurses. Exposure of OR personnel to ethylene oxide, methyl methacrylate, and x-radiation were well within existing standards. Exposure of anesthetists and nurses to anesthetic agents, at times, was in excess of Ontario exposure guidelines, despite improvements in the control of anesthetic pollution

  17. Using the Hospital Nutrition Environment Scan to Evaluate Health Initiative in Hospital Cafeterias.

    Science.gov (United States)

    Derrick, Jennifer Willahan; Bellini, Sarah Gunnell; Spelman, Julie

    2015-11-01

    Health-promoting environments advance health and prevent chronic disease. Hospitals have been charged to promote health and wellness to patients, communities, and 5.3 million adults employed in United States health care environments. In this cross-sectional observational study, the Hospital Nutrition Environment Scan (HNES) was used to measure the nutrition environment of hospital cafeterias and evaluate the influence of the LiVe Well Plate health initiative. Twenty-one hospitals in the Intermountain West region were surveyed between October 2013 and May 2014. Six hospitals participated in the LiVe Well Plate health initiative and were compared with 15 hospitals not participating. The LiVe Well Plate health initiative identified and promoted a healthy meal defined as health initiative branding were also posted at point of purchase. Hospital cafeterias were scored on four subcategories: facilitators and barriers, grab-and-go items, menu offerings, and selection options at point of purchase. Overall, hospitals scored 35.3±13.7 (range=7 to 63) points of 86 total possible points. Cafeterias in health initiative hospitals had significantly higher mean nutrition composite scores compared with non-health initiative hospitals (49.2 vs 29.7; Penvironment of hospital cafeterias. Additional research is needed to quantify and strategize ways to improve nutrition environments within hospital cafeterias and assess the influence on healthy lifestyle behaviors. Copyright © 2015 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

  18. Dose field research of analysis room for in-hospital neutron irradiator

    International Nuclear Information System (INIS)

    Zhang Zizhu; Song Mingzhe; Li Wei; Chen Jun; Yang Yong; Li Yiguo

    2012-01-01

    Neutron equivalent dose rate and y ray dose rate inside the analysis room of the in-hospital neutron irradiator (IHNI) and outdoor were measured. The results show that γ ray dose rate inside the analysis room exceeds calculation value many times and γ/ ray dose rate outdoor is higher than supervision region dose limit of 7.5 μSv/h. According to the measurement results and the Monte Carlo simulation, the following shielding plan was adopted. Lead shielding with thickness of 16 cm was installed on the wall, which faces the neutron beam, to shield γ ray, and lithium polyethylene plate with thickness of l cm was installed on all the wall (not including ceiling and floor) to shield scattering neutron. After shielding transformation, the highest γ ray dose rate point inside the analysis room decreased 277 times, the neutron equivalent dose rate decreased 5.8 times, and the outdoor γ/ray dose rate decreased nearly 90 times. (authors)

  19. Applied patent RFID systems for building reacting HEPA air ventilation system in hospital operation rooms.

    Science.gov (United States)

    Lin, Jesun; Pai, Jar-Yuan; Chen, Chih-Cheng

    2012-12-01

    RFID technology, an automatic identification and data capture technology to provide identification, tracing, security and so on, was widely applied to healthcare industry in these years. Employing HEPA ventilation system in hospital is a way to ensure healthful indoor air quality to protect patients and healthcare workers against hospital-acquired infections. However, the system consumes lots of electricity which cost a lot. This study aims to apply the RFID technology to offer a unique medical staff and patient identification, and reacting HEPA air ventilation system in order to reduce the cost, save energy and prevent the prevalence of hospital-acquired infection. The system, reacting HEPA air ventilation system, contains RFID tags (for medical staffs and patients), sensor, and reacting system which receives the information regarding the number of medical staff and the status of the surgery, and controls the air volume of the HEPA air ventilation system accordingly. A pilot program was carried out in a unit of operation rooms of a medical center with 1,500 beds located in central Taiwan from Jan to Aug 2010. The results found the air ventilation system was able to function much more efficiently with less energy consumed. Furthermore, the indoor air quality could still keep qualified and hospital-acquired infection or other occupational diseases could be prevented.

  20. Study of the thermal comfort, of the energy consumption and of the indoor environment control in surgery rooms

    NARCIS (Netherlands)

    Melhado, M.D.A.; Beyer, P.O.; Hensen, J.L.M.; Siqueira, L.F.G.

    2005-01-01

    In this research were investigated the influence of different layouts of operating rooms on thermal comfort, on the indoor environment control and on energy consumption. The layouts studied were: Case 1 (a surgery room and a hallway); Case 2 (a surgery room and two hallways); and Case 3 (a surgery

  1. [Impact of HIV infection in hospital environment].

    Science.gov (United States)

    Martínez Avilés, P; López Benito, I; Berbegal Serra, J

    1998-12-01

    Retrospective study to review the admissions at the Hospital Marina Alta due to infection for HIV or its complications and look for risk factors. Clinical charts of patients admitted at the hospital from 1989 to 1996 were analyzed. From 11,932 admissions, 199 (1.7%) were due to patients with infection from HIV, resulting in the 2.4% of the total stay. The medium stays were higher (8.6 +/- 7.4 vs 6 +/- 4.5) more re-admissions (42.7% vs 25.5%) and higher mortality (11% vs 7.8%). The parasitic infestations of the nervous central system and cardiovascular were the most numerous number of admissions and also the longer stays. Throughout the years we saw a increase in the patients at the outpatient clinic with HIV infection and a paradogic decrease in the inpatient admissions, and also a decrease in the media stay and total stays. There is a decrease in the admissions at the inpatient level in contrast with a increment of the prevalence in the outpatients with HIV infection. The improved treatments, the experience of the physicians, the use of the Day Hospital and the use of the service of Home Care Hospitalization allows to keep more patients with less admissions and more outpatient visits.

  2. Designing EvoRoom: An Immersive Simulation Environment for Collective Inquiry in Secondary Science

    Science.gov (United States)

    Lui, Michelle Mei Yee

    This dissertation investigates the design of complex inquiry for co-located students to work as a knowledge community within a mixed-reality learning environment. It presents the design of an immersive simulation called EvoRoom and corresponding collective inquiry activities that allow students to explore concepts around topics of evolution and biodiversity in a Grade 11 Biology course. EvoRoom is a room-sized simulation of a rainforest, modeled after Borneo in Southeast Asia, where several projected displays are stitched together to form a large, animated simulation on each opposing wall of the room. This serves to create an immersive environment in which students work collaboratively as individuals, in small groups and a collective community to investigate science topics using the simulations as an evidentiary base. Researchers and a secondary science teacher co-designed a multi-week curriculum that prepared students with preliminary ideas and expertise, then provided them with guided activities within EvoRoom, supported by tablet-based software as well as larger visualizations of their collective progress. Designs encompassed the broader curriculum, as well as all EvoRoom materials (e.g., projected displays, student tablet interfaces, collective visualizations) and activity sequences. This thesis describes a series of three designs that were developed and enacted iteratively over two and a half years, presenting key features that enhanced students' experiences within the immersive environment, their interactions with peers, and their inquiry outcomes. Primary research questions are concerned with the nature of effective design for such activities and environments, and the kinds of interactions that are seen at the individual, collaborative and whole-class levels. The findings fall under one of three themes: 1) the physicality of the room, 2) the pedagogical script for student observation and reflection and collaboration, and 3) ways of including collective

  3. [Design of an anesthesia and micro-environment information management system in mobile operating room].

    Science.gov (United States)

    Wang, Xianwen; Liu, Zhiguo; Zhang, Wenchang; Wu, Qingfu; Tan, Shulin

    2013-08-01

    We have designed a mobile operating room information management system. The system is composed of a client and a server. A client, consisting of a PC, medical equipments, PLC and sensors, provides the acquisition and processing of anesthesia and micro-environment data. A server is a powerful computer that stores the data of the system. The client gathers the medical device data by using the C/S mode, and analyzes the obtained HL7 messages through the class library call. The client collects the micro-environment information with PLC, and finishes the data reading with the OPC technology. Experiment results showed that the designed system could manage the patient anesthesia and micro-environment information well, and improve the efficiency of the doctors' works and the digital level of the mobile operating room.

  4. Identifying Patients with Bacteremia in Community-Hospital Emergency Rooms: A Retrospective Cohort Study.

    Directory of Open Access Journals (Sweden)

    Taro Takeshima

    Full Text Available (1 To develop a clinical prediction rule to identify patients with bacteremia, using only information that is readily available in the emergency room (ER of community hospitals, and (2 to test the validity of that rule with a separate, independent set of data.Multicenter retrospective cohort study.To derive the clinical prediction rule we used data from 3 community hospitals in Japan (derivation. We tested the rule using data from one other community hospital (validation, which was not among the three "derivation" hospitals.Adults (age ≥ 16 years old who had undergone blood-culture testing while in the ER between April 2011 and March 2012. For the derivation data, n = 1515 (randomly sampled from 7026 patients, and for the validation data n = 467 (from 823 patients.We analyzed 28 candidate predictors of bacteremia, including demographic data, signs and symptoms, comorbid conditions, and basic laboratory data. Chi-square tests and multiple logistic regression were used to derive an integer risk score (the "ID-BactER" score. Sensitivity, specificity, likelihood ratios, and the area under the receiver operating characteristic curve (i.e., the AUC were computed.There were 241 cases of bacteremia in the derivation data. Eleven candidate predictors were used in the ID-BactER score: age, chills, vomiting, mental status, temperature, systolic blood pressure, abdominal sign, white blood-cell count, platelets, blood urea nitrogen, and C-reactive protein. The AUCs was 0.80 (derivation and 0.74 (validation. For ID-BactER scores ≥ 2, the sensitivities for derivation and validation data were 98% and 97%, and specificities were 20% and 14%, respectively.The ID-BactER score can be computed from information that is readily available in the ERs of community hospitals. Future studies should focus on developing a score with a higher specificity while maintaining the desired sensitivity.

  5. Effect of automated ultraviolet C-emitting device on decontamination of hospital rooms with and without real-time observation of terminal room disinfection.

    Science.gov (United States)

    Penno, Katie; Jandarov, Roman A; Sopirala, Madhuri M

    2017-11-01

    We studied the effectiveness of an ultraviolet C (UV-C) emitter in clinical settings and compared it with observed terminal disinfection. We cultured 22 hospital discharge rooms at a tertiary care academic medical center. Phase 1 (unobserved terminal disinfection) included cultures of 11 high-touch environmental surfaces (HTSs) after terminal room disinfection (AD) and after the use of a UV-C-emitting device (AUV). Phase 2 (observed terminal disinfection) included cultures before terminal room disinfection (BD), AD, and AUV. Zero-inflated Poisson regression compared mean colony forming units (CFU) between the groups. Two-sample proportion tests identified significance of the observed differences in proportions of thoroughly cleaned HTSs (CFU cleaning significantly reduced microbial burden and improved the thoroughness of terminal disinfection. We found no further benefit to UV-C use if standard terminal disinfection was observed. Copyright © 2017 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  6. Air, water, and surface bacterial contamination in a university-hospital autopsy room.

    Science.gov (United States)

    Maujean, Géraldine; Malicier, Daniel; Fanton, Laurent

    2012-03-01

    Today, little is known about the bacteriological environment of the autopsy room and its potential interest for medico-legal practices. Seven hundred fifty microbiological samples were taken from surface (n = 660), air (n = 48), and water (n = 42) to evaluate it in a French University Forensic Department. Median bacterial counts were compared before and during autopsy for air samples, and before and after autopsy for surface samples, using Wilcoxon matched pairs signed ranks test. Bacterial identification relied on traditional phenotypic methods. Bacterial counts in the air were low before autopsy, increased significantly during procedure, and seemed more linked to the number of people in the room than to an important production of aerosol-containing bacteria. Despite cleaning, human fecal flora was omnipresent on surfaces, which revealed insufficient disinfection. Bacteriological sampling is an easy way to monitor cleaning practices in postmortem rooms, but chiefly a way to improve the reliability of medico-legal proofs of infectious deaths. © 2012 American Academy of Forensic Sciences.

  7. Clinical and cost effectiveness of eight disinfection methods for terminal disinfection of hospital isolation rooms contaminated with Clostridium difficile 027.

    Science.gov (United States)

    Doan, L; Forrest, H; Fakis, A; Craig, J; Claxton, L; Khare, M

    2012-10-01

    Clostridium difficile spores can survive in the environment for months or years, and contaminated environmental surfaces are important sources of nosocomial C. difficile transmission. To compare the clinical and cost effectiveness of eight C. difficile environmental disinfection methods for the terminal cleaning of hospital rooms contaminated with C. difficile spores. This was a novel randomized prospective study undertaken in three phases. Each empty hospital room was disinfected, then contaminated with C. difficile spores and disinfected with one of eight disinfection products: hydrogen peroxide vapour (HPV; Bioquell Q10) 350-700 parts per million (ppm); dry ozone at 25 ppm (Meditrox); 1000 ppm chlorine-releasing agent (Actichlor Plus); microfibre cloths (Vermop) used in combination with and without a chlorine-releasing agent; high temperature over heated dry atomized steam cleaning (Polti steam) in combination with a sanitizing solution (HPMed); steam cleaning (Osprey steam); and peracetic acid wipes (Clinell). Swabs were inoculated on to C. difficile-selective agar and colony counts were performed pre and post disinfection for each method. A cost-effectiveness analysis was also undertaken comparing all methods to the current method of 1000 ppm chlorine-releasing agent (Actichlor Plus). Products were ranked according to the log(10) reduction in colony count from contamination phase to disinfection. The three statistically significant most effective products were hydrogen peroxide (2.303); 1000 ppm chlorine-releasing agent (2.223) and peracetic acid wipes (2.134). The cheaper traditional method of using a chlorine-releasing agent for disinfection was as effective as modern methods. Copyright © 2012 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

  8. Optimum Operating Room Environment for the Prevention of Surgical Site Infections.

    Science.gov (United States)

    Gaines, Sara; Luo, James N; Gilbert, Jack; Zaborina, Olga; Alverdy, John C

    Surgical site infections (SSI), whether they be incisional or deep, can entail major morbidity and death to patients and additional cost to the healthcare system. A significant amount of effort has gone into optimizing the surgical patient and the operating room environment to reduce SSI. Relevant guidelines and literature were reviewed. The modern practice of surgical antisepsis involves the employment of strict sterile techniques inside the operating room. Extensive guidelines are available regarding the proper operating room antisepsis as well as pre-operative preparation. The use of pre-operative antimicrobial prophylaxis has become increasingly prevalent, which also presents the challenge of opportunistic and nosocomial infections. Ongoing investigative efforts have brought about a greater appreciation of the surgical patient's endogenous microflora, use of non-bactericidal small molecules, and pre-operative microbial screening. Systematic protocols exist for optimizing the surgical sterility of the operating room to prevent SSIs. Ongoing research efforts aim to improve the precision of peri-operative antisepsis measures and personalize these measures to tailor the patient's unique microbial environment.

  9. Traffic flow and microbial air contamination in operating rooms at a major teaching hospital in Ghana.

    Science.gov (United States)

    Stauning, M T; Bediako-Bowan, A; Andersen, L P; Opintan, J A; Labi, A-K; Kurtzhals, J A L; Bjerrum, S

    2018-07-01

    Current literature examining the relationship between door-opening rate, number of people present, and microbial air contamination in the operating room is limited. Studies are especially needed from low- and middle-income countries, where the risk of surgical site infections is high. To assess microbial air contamination in operating rooms at a Ghanaian teaching hospital and the association with door-openings and number of people present. Moreover, we aimed to document reasons for door-opening. We conducted active air-sampling using an MAS 100 ® portable impactor during 124 clean or clean-contaminated elective surgical procedures. The number of people present, door-opening rate and the reasons for each door-opening were recorded by direct observation using pretested structured observation forms. During surgery, the mean number of colony-forming units (cfu) was 328 cfu/m 3 air, and 429 (84%) of 510 samples exceeded a recommended level of 180 cfu/m 3 . Of 6717 door-openings recorded, 77% were considered unnecessary. Levels of cfu/m 3 were strongly correlated with the number of people present (P = 0.001) and with the number of door-openings/h (P = 0.02). In empty operating rooms, the mean cfu count was 39 cfu/m 3 after 1 h of uninterrupted ventilation and 52 (51%) of 102 samples exceeded a recommended level of 35 cfu/m 3 . The study revealed high values of intraoperative airborne cfu exceeding recommended levels. Minimizing the number of door-openings and people present during surgery could be an effective strategy to reduce microbial air contamination in low- and middle-income settings. Copyright © 2017 The Author(s). Published by Elsevier Ltd.. All rights reserved.

  10. Analysis of hospital infection control awareness of ultrasound room office personnel in Busan

    Energy Technology Data Exchange (ETDEWEB)

    Kim, JJung Hoon; Kang, Se Sik; Kim, Chang Soo [Dept. of Radiological Science, College of Health Sciences, Catholic University of Pusan, Pusan (Korea, Republic of)

    2015-06-15

    146 people working in the ultrasound room in Busan were surveyed, and their perception of hospital infection was analyzed. According to the results of the survey, academic background showed the highest number in terms of awareness and performance of personal hygiene management and hand washing management, and the group with experience of infection education showed the highest number in terms of awareness of ultrasound equipment hygiene, and the group with less than college education showed the highest number in terms of performance of ultrasound equipment hygiene. The difference was statistically significant. Based on the results of this study, performance was lower than awareness in general. This result indicates that the degree of performance is inadequate. Therefore, it can be concluded that individuals need to change their perception of personal hygiene and take interest in it through infection education.

  11. Analysis of hospital infection control awareness of ultrasound room office personnel in Busan

    International Nuclear Information System (INIS)

    Kim, JJung Hoon; Kang, Se Sik; Kim, Chang Soo

    2015-01-01

    146 people working in the ultrasound room in Busan were surveyed, and their perception of hospital infection was analyzed. According to the results of the survey, academic background showed the highest number in terms of awareness and performance of personal hygiene management and hand washing management, and the group with experience of infection education showed the highest number in terms of awareness of ultrasound equipment hygiene, and the group with less than college education showed the highest number in terms of performance of ultrasound equipment hygiene. The difference was statistically significant. Based on the results of this study, performance was lower than awareness in general. This result indicates that the degree of performance is inadequate. Therefore, it can be concluded that individuals need to change their perception of personal hygiene and take interest in it through infection education

  12. Cleaning Hospital Room Surfaces to Prevent Health Care-Associated Infections: A Technical Brief.

    Science.gov (United States)

    Han, Jennifer H; Sullivan, Nancy; Leas, Brian F; Pegues, David A; Kaczmarek, Janice L; Umscheid, Craig A

    2015-10-20

    The cleaning of hard surfaces in hospital rooms is critical for reducing health care-associated infections. This review describes the evidence examining current methods of cleaning, disinfecting, and monitoring cleanliness of patient rooms, as well as contextual factors that may affect implementation and effectiveness. Key informants were interviewed, and a systematic search for publications since 1990 was done with the use of several bibliographic and gray literature resources. Studies examining surface contamination, colonization, or infection with Clostridium difficile, methicillin-resistant Staphylococcus aureus, or vancomycin-resistant enterococci were included. Eighty studies were identified-76 primary studies and 4 systematic reviews. Forty-nine studies examined cleaning methods, 14 evaluated monitoring strategies, and 17 addressed challenges or facilitators to implementation. Only 5 studies were randomized, controlled trials, and surface contamination was the most commonly assessed outcome. Comparative effectiveness studies of disinfecting methods and monitoring strategies were uncommon. Future research should evaluate and compare newly emerging strategies, such as self-disinfecting coatings for disinfecting and adenosine triphosphate and ultraviolet/fluorescent surface markers for monitoring. Studies should also assess patient-centered outcomes, such as infection, when possible. Other challenges include identifying high-touch surfaces that confer the greatest risk for pathogen transmission; developing standard thresholds for defining cleanliness; and using methods to adjust for confounders, such as hand hygiene, when examining the effect of disinfecting methods.

  13. An indoor radon survey of the X-ray rooms of Mexico City hospitals

    Energy Technology Data Exchange (ETDEWEB)

    Juarez, Faustino [Facultad de Ciencias, Universidad Autonoma del Estado de Mexico, Instituto Literario No. 100. Estado de Mexico, 50000, Mexico. Instituto de Geofisica, Universidad Nacional Autonoma de Mexico, Circuito (Mexico); Reyes, Pedro G. [Facultad de Ciencias, Universidad Autonoma del Estado de Mexico, Instituto Literario No. 100. Estado de Mexico, 50000 (Mexico); Espinosa, Guillermo [Instituto de Fisica, Universidad Nacional Autonoma de Mexico, Circuito Exterior Ciudad Universitaria, Mexico D.F. Cp.04510 (Mexico)

    2013-07-03

    This paper presents the results of measurements of indoor radon concentrations in the X-ray rooms of a selection of hospitals in the metropolitan area of Mexico City. The metropolitan area of Mexico City is Mexico's largest metropolitan area by population; the number of patients requiring the use of X-rays is also the highest. An understanding of indoor radon concentrations in X-ray rooms is necessary for the estimation of the radiological risk to which patients, radiologists and medical technicians are exposed. The indoor radon concentrations were monitored for a period of six months using nuclear track detectors (NTD) consisting of a closed-end cup system with CR-39 (Lantrack Registered-Sign ) polycarbonate as detector material. The indoor radon concentrations were found to be between 75 and 170 Bq m{sup -3}, below the USEPA-recommended indoor radon action level for working places of 400 Bq m{sup -3}. It is hoped that the results of this study will contribute to the establishment of recommended action levels by the Mexican regulatory authorities responsible for nuclear safety.

  14. Action research to improve methods of delivery and feedback in an Access Grid Room environment

    Science.gov (United States)

    McArthur, Lynne C.; Klass, Lara; Eberhard, Andrew; Stacey, Andrew

    2011-12-01

    This article describes a qualitative study which was undertaken to improve the delivery methods and feedback opportunity in honours mathematics lectures which are delivered through Access Grid Rooms. Access Grid Rooms are facilities that provide two-way video and audio interactivity across multiple sites, with the inclusion of smart boards. The principal aim was to improve the student learning experience, given the new environment. The specific aspects of the course delivery that the study focused on included presentation of materials and provision of opportunities for interaction between the students and between students and lecturers. The practical considerations in the delivery of distance learning are well documented in the literature, and similar problems arise in the Access Grid Room environment; in particular, those of limited access to face-to-face interaction and the reduction in peer support. The nature of the Access Grid Room classes implies that students studying the same course can be physically situated in different cities, and possibly in different countries. When studying, it is important that students have opportunity to discuss new concepts with others; particularly their peers and their lecturer. The Access Grid Room environment also presents new challenges for the lecturer, who must learn new skills in the delivery of materials. The unique nature of Access Grid Room technology offers unprecedented opportunity for effective course delivery and positive outcomes for students, and was developed in response to a need to be able to interact with complex data, other students and the instructor, in real-time, at a distance and from multiple sites. This is a relatively new technology and as yet there has been little or no studies specifically addressing the use and misuse of the technology. The study found that the correct placement of cameras and the use of printed material and smart boards were all crucial to the student experience. In addition, the

  15. Evaluation of hospital-learning environment for pediatric residency in eastern region of Saudi Arabia

    Directory of Open Access Journals (Sweden)

    Waleed H. BuAli

    2015-04-01

    Full Text Available Purpose: No study had been conducted to assess the hospitals’ environment for learning purposes in multicenter sites in Saudi Arabia. It aims to evaluate the environment of hospitals for learning purposes of pediatric residents. Methods: We applied Postgraduate Hospital Educational Environment Measure (PHEEM to measure the learning environment at six teaching hospitals in the Eastern Region of Saudi Arabia from September to December 2013. Results: The number of respondents was 104 (86.7% out of 120 residents and 37 females and 67 male residents have responded. The residents’ response scored 100 out of 160 maximum score in rating of PHEEM that showed overall learning environment is favorable for training. There were some items in the social support domain suggesting improvements. There was no significant difference between male and female residents. There was a difference among the participant teaching hospitals (p<0.05. Conclusion: The result pointed an overall positive rating. Individual item scores suggested that their social life during residency could be uninspiring. They have the low satisfactory level and they feel racism, and sexual discrimination. Therefore, there is still a room for improvement.

  16. Association between occupational exposure levels of antineoplastic drugs and work environment in five hospitals in Japan.

    Science.gov (United States)

    Yoshida, Jin; Koda, Shigeki; Nishida, Shozo; Yoshida, Toshiaki; Miyajima, Keiko; Kumagai, Shinji

    2011-03-01

    The aim of the present study was to evaluate the measurement of contamination by antineoplastic drugs for safer handling of such drugs by medical workers. We investigated the relationship between the contamination level of antineoplastic drugs and the conditions of their handling. Air samples and wipe samples were collected from equipment in the preparation rooms of five hospitals (hospitals A-E). These samples were subjected to measurement of the amounts of cyclophosphamide (CPA), fluorouracil (5FU), gemcitabine (GEM), and platinum-containing drugs (Pt). Twenty-four-hour urine samples were collected from the pharmacists who handled or audited, the antineoplastic drugs were analyzed for CPA and Pt. Pt was detected from air samples inside BSC in hospital B. Antineoplastic drugs were detected from wipe samples of the BSC in hospitals A, B, D, and E and of other equipment in the preparation rooms in hospitals A, B, C, and D. Cyclophosphamide and 5FU were detected from wipe samples of the air-conditioner filter in hospital A, and CPA was detected from that in hospital D. Cyclophosphamide was detected from urine samples of workers in hospitals B, D, and E. The contamination level of antineoplastic drugs was suggested to be related with the amount of drugs handled, cleaning methods of the equipment, and the skill level of the technique of maintaining negative pressure inside a vial. In order to reduce the contamination and exposure to antineoplastic drugs in the hospital work environment very close to zero, comprehensive safety precautions, including adequate mixing and cleaning methods was required in addition to BSC and closed system device.

  17. Cancer patients and positive sensory impressions in the hospital environment

    DEFF Research Database (Denmark)

    Timmermann, Connie; Uhrenfeldt, Lisbeth; Birkelund, Regner

    2013-01-01

    This study explores how cancer patients experience the meaning of positive sensory impressions in the hospital environment such as architecture, decoration and the interior. Data were obtained at a general hospital in Denmark by interviewing six cancer patients at two different wards. The analysis...... process was guided by the hermeneutical–phenomenological theory of interpretation as presented by the French philosopher Paul Ricoeur. Two main themes were identified: to preserve identity and positive thoughts and feelings. The participants experienced that positive sensory impressions in the hospital...... to recall some of their feelings of identity. This paper adds knowledge about how cancer patients experience sensory impressions in the hospital environment. An environment that provides homeliness and offers a view to nature seems to help some patients to preserve their identity. Furthermore, positive...

  18. Patient‐friendly hospital environments: exploring the patients’ perspective

    Science.gov (United States)

    Douglas, Calbert H.; Douglas, Mary R.

    2004-01-01

    Abstract Objective  To investigate the perceptions and attitudes of patients to the built environments of NHS Trust hospitals, in order to inform design excellence so as to make future hospitals places and spaces responsive to patient needs. Design  An exploratory study of patients perceptions based on qualitative semi‐structured personal interviews. Setting and participants  Fifty one‐to‐one interviews held with hospital in‐patients across the four directorates of surgery, medicine, care of the elderly and maternity at Salford Royal Hospitals NHS Trust, Salford, UK. Results  The research found that there was much similarity in the priorities, issues and concerns raised by patients in each of the four directorates. Patients perceived the built environment of the hospital as a supportive environment. Their accounts in each area pointed to the significance of the factors that immediately impacted on them and their families. Patients identified having a need for personal space, a homely welcoming atmosphere, a supportive environment, good physical design, access to external areas and provision of facilities for recreation and leisure. Responses suggest that patient attitudes and perceptions to the built environment of hospital facilities relates to whether the hospital provides a welcoming homely space for themselves and their visitors that promotes health and wellbeing. Conclusions  The findings have important implications for capital development teams, clinical staff, managers and NHS Estates personnel. Although the study has immediate relevance for Salford Royal Hospitals Trust, findings and recommendations reported provide NHS Estates and other relevant stakeholders with evidence‐based knowledge and understanding of patients’ perceptions and expectations of and preferences for particular facilities and estates provision in NHS hospitals. PMID:14982500

  19. Fire environment determination in the LaSalle NPP control room

    Energy Technology Data Exchange (ETDEWEB)

    Usher, J.L.; Boccio, J.L.; Singhal, A.K.; Tam, L.T.

    1986-01-01

    One objective of NRC's Fire Protection Research Program (FPRP) is to improve the modeling of environments caused by fires in typical nuclear power plant enclosures. A three-dimensional fluid dynamics computer code (PHOENICS) has been adapted as a field-model fire code (SAFFIRE) for this purpose. The model has been applied to simulate two distinct fires in the control room of the LaSalle County power plant. The environments determined illustrate hazardous potential for both personnel and equipment.

  20. Dose rate in the reactor room and environment during maintenance in fusion reactors

    International Nuclear Information System (INIS)

    Maki, Koichi; Satoh, Satoshi; Takatsu, Hideyuki; Seki, Yasushi

    1995-01-01

    According to the International Thermonuclear Experimental Reactor (ITER) conceptual design activity, after reactor shutdown, damaged segments are pulled up from the reactor and hung from the reactor room ceiling by a remote handling device. The dose rate in the reactor room and the environment is estimated for this situation, and the following results are obtained. First, the dose rate in the room is > 10 8 μSv/h. Since this dose rate is 10 7 times greater than the biological radiation shielding design limit of 25 μSv/h, workers cannot enter the room. Second, lenses and optical fiber composed of glass that is radiation resistant up to 10 6 Gy would be damaged after <100 h near the segment, and devices using semiconductors could not work after several hours or so in the aforementioned dose-rate conditions. Third, during suspension of one blanket segment from the ceiling, the dose rate in the site boundary can be reduced by one order by a 23-cm-thicker reactor building roof. To reduce dose rate in public exposure to a value that is less than one-tenth of the public exposure radiation shielding design limit of 100 μSv/yr, the distance of the site boundary from the reactor must be greater than 200 m for a reactor building with a 160-cm-thick concrete roof. 9 refs., 6 figs., 2 tabs

  1. Associated Roles of Perioperative Medical Directors and Anesthesia: Hospital Agreements for Operating Room Management.

    Science.gov (United States)

    Dexter, Franklin; Epstein, Richard H

    2015-12-01

    As reviewed previously, decision making can be made systematically shortly before the day of surgery based on reducing the hours of overutilized operating room (OR) time and tardiness of case starts (i.e., patient waiting). We subsequently considered in 2008 that such decision making depends on rational anesthesia-hospital agreements specifying anesthesia staffing. Since that prior study, there has been a substantial increase in understanding of the timing of decision making to reduce overutilized OR time. Most decisions substantively influencing overutilized OR time are those made within 1 workday before the day of surgery and on the day of surgery, because only then are ORs sufficiently full that case scheduling and staff assignment decisions affect overutilized OR time. Consequently, anesthesiologists can easily be engaged in such decisions, because generally they must be involved to ensure that the corresponding anesthesia staff assignments are appropriate. Despite this, at hospitals with >8 hours of OR time used daily in each OR, computerized recommendations are superior to intuition because of cognitive biases. Decisions need to be made by a Perioperative Medical Director who has knowledge of the principles of perioperative managerial decision making published in the scientific literature rather than by a committee lacking this competency. Education in the scientific literature, and when different analytical methods should be used, is important. The addition that we make in this article is to show that an agreement between an anesthesia group and a hospital can both reduce overutilized OR time and patient waiting: The anesthesia group and hospital will ensure, hourly, that, when there are case(s) waiting to start, the number of ORs in use for each service will be at least the number that maximizes the efficiency of use of OR time. Neither the anesthesia group nor the hospital will be expected to run more than that number of ORs without mutual agreement

  2. Improved scores for observed teamwork in the clinical environment following a multidisciplinary operating room simulation intervention.

    Science.gov (United States)

    Weller, Jennifer M; Cumin, David; Civil, Ian D; Torrie, Jane; Garden, Alexander; MacCormick, Andrew D; Gurusinghe, Nishanthi; Boyd, Matthew J; Frampton, Christopher; Cokorilo, Martina; Tranvik, Magnus; Carlsson, Lisa; Lee, Tracey; Ng, Wai Leap; Crossan, Michael; Merry, Alan F

    2016-08-05

    We ran a Multidisciplinary Operating Room Simulation (MORSim) course for 20 complete general surgical teams from two large metropolitan hospitals. Our goal was to improve teamwork and communication in the operating room (OR). We hypothesised that scores for teamwork and communication in the OR would improve back in the workplace following MORSim. We used an extended Behavioural Marker Risk Index (BMRI) to measure teamwork and communication, because a relationship has previously been documented between BMRI scores and surgical patient outcomes. Trained observers scored general surgical teams in the OR at the two study hospitals before and after MORSim, using the BMRI. Analysis of BMRI scores for the 224 general surgical cases before and 213 cases after MORSim showed BMRI scores improved by more than 20% (0.41 v 0.32, pteamwork score would translate into a clinically important reduction in complications and mortality in surgical patients. We demonstrated an improvement in scores for teamwork and communication in general surgical ORs following our intervention. These results support the use of simulation-based multidisciplinary team training for OR staff to promote better teamwork and communication, and potentially improve outcomes for general surgical patients.

  3. Food environments in university dorms: 20,000 calories per dorm room and counting.

    Science.gov (United States)

    Nelson, Melissa C; Story, Mary

    2009-06-01

    Few young adults meet national dietary recommendations. Although home food availability likely has important influences on dietary intake, little research has examined this issue among young adults. The objective of this research was to conduct a detailed, observational assessment of food and beverages available in college-student dormitory rooms. Dormitory-residing students (n=100) were recruited from a large, public university. Research staff completed a detailed inventory of food and beverages in the dorm rooms, including nutrient contents and purchasing sources. Data were collected and analyzed in 2008. The mean number of food and beverage items per participant was 47 (range: 0-208), with 4% of participants not having any food or beverages. More than 70% of students had each of the following types of items: salty snacks, cereal or granola bars, main dishes, desserts or candy, and sugar-sweetened beverages. Fewer students had low-calorie beverages, fruits and vegetables, dairy products, tea/coffee, and 100% fruit/vegetable juice. The average number of calories per dorm room was 22,888. Items purchased by parents had a higher calorie and fat content than items purchased by students. Findings indicate that students maintain a wide array of food and beverages in their dormitory rooms. Parents purchased a substantial amount of food for their children's dormitory rooms, and these food items were less healthful than the food that students purchased. The foods observed in college students' living spaces may have an important impact on eating habits. Overall, young adult-oriented obesity prevention efforts are needed, and improving the various facets of campus food environments may mark an important component of such strategies.

  4. The Natural Hospital Environment: a Socio-Technical-Material perspective.

    Science.gov (United States)

    Fernando, Juanita; Dawson, Linda

    2014-02-01

    This paper introduces two concepts into analyses of information security and hospital-based information systems-- a Socio-Technical-Material theoretical framework and the Natural Hospital Environment. The research is grounded in a review of pertinent literature with previously published Australian (Victoria) case study data to analyse the way clinicians work with privacy and security in their work. The analysis was sorted into thematic categories, providing the basis for the Natural Hospital Environment and Socio-Technical-Material framework theories discussed here. Natural Hospital Environments feature inadequate yet pervasive computer use, aural privacy shortcomings, shared workspace, meagre budgets, complex regulation that hinders training outcomes and out-dated infrastructure and are highly interruptive. Working collaboratively in many cases, participants found ways to avoid or misuse security tools, such as passwords or screensavers for patient care. Workgroup infrastructure was old, architecturally limited, haphazard in some instances, and was less useful than paper handover sheets to ensure the quality of patient care outcomes. Despite valiant efforts by some participants, they were unable to control factors influencing the privacy of patient health information in public hospital settings. Future improvements to hospital-based organisational frameworks for e-health can only be made when there is an improved understanding of the Socio-Technical-Material theoretical framework and Natural Hospital Environment contexts. Aspects within control of clinicians and administrators can be addressed directly although some others are beyond their control. An understanding and acknowledgement of these issues will benefit the management and planning of improved and secure hospital settings. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  5. Potential Role of Staphylococcus cohnii in a Hospital Environment

    OpenAIRE

    Szewczyk, Eligia M.; Nowak, Tomasz; Cieślikowski, Tomasz; Róźalska, Magorzata

    2011-01-01

    We have analysed the isolates of Staphylococcus cohnii found in the intensive care unit of a pediatric teaching hospital: in the environment, 159 isolates; on the skin of hospitalized premature infants, 26; and on the skin of ward personnel, 49. Sixteen phenotypic features were used to characterize the isolates at metabolic, biologic and antibiotic resistance level. All selected attributes were treated as equivalent, and numerical analysis of all isolates was performed on this basis. Each iso...

  6. Analysis of the spatial dose according to the type of radiation source used in multi-bed hospital room

    Energy Technology Data Exchange (ETDEWEB)

    Jang, Dong Gun [Dept. of Nuclear Medicine, Dongnam Institute of Radiological and Medical Sciences Cancer center, Busan (Korea, Republic of); Kim, Jung Hoon [Dept. of Radiological Science, College of Health Sciences, Catholic University of Pusan, Busan (Korea, Republic of); Park, Eun Tae [Dept. of Radiation Oncology, Busan Paik Hospital, Inje University, Busan (Korea, Republic of)

    2017-09-15

    Medical radiation offers significant benefits in diagnosing and treating patients, but it also generates unnecessary radiation exposure to those nearby. Accordingly, the objective of the present study was to analyze spatial dose rate according to types of radiation source term in multi-bed hospital rooms occupied by patients and general public. MCNPX was used for geometric simulation of multi-bed hospital rooms and radiation source terms, while the radiation source terms were established as whole body bone scan patients and imaging using a portable X-ray generator. The results of simulation on whole body bone scan patients showed 3.46 μSv/hr to another patient position, while experimental results on imaging using a portable X-ray generator showed 1.47 × 10{sup -8} μSv/irradiation to another patient position in chest imaging and 2.97 × 10{sup -8} μSv/irradiation to another patient position in abdomen imaging. Multi-bed hospital room, unnecessary radiation generated in the surrounding patients, while legal regulations and systematic measures are needed for radiation exposure in multi-bed hospital rooms that are currently lacking in Korea.

  7. Caring Mental Patients Sharing the Same Rooms with Somatic Patients in General and Referral Hospitals in Rwanda: Analysis of Disadvantages and Advantages.

    Science.gov (United States)

    Gitimbwa, Siméon Sebatukura

    2014-01-01

    Hospitalizing mental patients in the same rooms with somatic patients is one of the consequences of the decentralization of mental health units in all hospitals of Rwanda. There is a necessity to discover and to analyze advantages and disadvantages of this practice. Mental health staffs of 31 general and referral hospitals have been interviewed on questions about disadvantages and advantages to hospitalize mental patients together with somatic patients. Results show these disadvantages: a therapeutic environment not appropriate or a lack of harmony in the rooms (58.1% of respondents); a lack of bodily safety for somatic patients (51.6%); a lack of safety on the properties of somatic patients (45.2%); a lack of psychological wellbeing of somatic patients (29%); a lack of safety for mental patients (29%). About the main advantages, 100% of respondents pointed out the treatment of mental patients followed even during the week-end and the break time by the guard nurses doing the ward round visit or the guard; 72.2% said it prevents discrimination, because mental patient feel that he is a patient like others; 50% said it prevents stigmatization (to avoid for example, the expression "he is mad"); 16.7% said that mental patients receive help from somatic patients.

  8. Depressed Patients Hospitalized in Southeast-Facing Rooms Are Discharged Earlier than Patients in Northwest-Facing Rooms

    DEFF Research Database (Denmark)

    Gbyl, Krzysztof; Madsen, Helle Ostergaard; Svendsen, Signe Dunker

    2017-01-01

    in a specialized affective disorders unit investigated the impact of daylight on the length of hospital stay and improvement of depression. Methods: For a period of 1 year, we collected data on sociodemographics, length of stay, vitamin D, and depression severity for patients in an inpatient affective disorders....... Conclusion: Due to the study design, no causality for the observed difference in length of stay can be given, but the results support findings in previous studies of the importance of architectural orientation providing natural daylight as a factor for improvement....

  9. The perceived urgency of auditory warning alarms used in the hospital operating room is inappropriate.

    Science.gov (United States)

    Mondor, Todd A; Finley, G Allen

    2003-03-01

    To examine the perceived urgency of 13 auditory warning alarms commonly occurring in the hospital operating room. Undergraduate students, who were naïve with respect to the clinical situation associated with the alarms, judged perceived urgency of each alarm on a ten-point scale. The perceived urgency of the alarms was not consistent with the actual urgency of the clinical situation that triggers it. In addition, those alarms indicating patient condition were generally perceived as less urgent than those alarms indicating the operation of equipment. Of particular interest were three sets of alarms designed by equipment manufacturers to indicate specific priorities for action. Listeners did not perceive any differences in the urgency of the 'information only', 'medium' and 'high' priority alarms of two of the monitors with all judged as low to moderate in urgency. In contrast, the high priority alarm of the third monitor was judged as significantly more urgent than its low and medium urgency counterparts. The alarms currently in use do not convey the intended sense of urgency to naïve listeners, and this holds even for two sets of alarms designed specifically by manufacturers to convey different levels of urgency.

  10. An environment-friendly microemulsion approach to α-FeOOH nanorods at room temperature

    International Nuclear Information System (INIS)

    Geng Fengxia; Zhao Zhigang; Cong Hongtao; Geng Jianxin; Cheng Huiming

    2006-01-01

    α-FeOOH nanorods have been prepared at room temperature by an environment-friendly microemulsion approach. X-ray diffraction and transmission electron microscopy revealed that the single-crystalline orthorhombic α-FeOOH nanorods are 8.2 ± 1.5 nm in diameter and 106 ± 16 nm in length. Furthermore, the mechanism for the formation of α-FeOOH nanorods is preliminarily presented. This method may be widely used for reference to fabricate other inorganic one-dimensional nanostructured materials and easily realized in industrial-scale synthesis

  11. Virtual Visual Effect of Hospital Waiting Room on Pain Modulation in Healthy Subjects and Patients with Chronic Migraine

    Directory of Open Access Journals (Sweden)

    Marina de Tommaso

    2013-01-01

    Full Text Available Environmental context has an important impact on health and well being. We aimed to test the effects of a visual distraction induced by classical hospital waiting room (RH versus an ideal room with a sea view (IH, both represented in virtual reality (VR, on subjective sensation and cortical responses induced by painful laser stimuli (LEPs in healthy volunteers and patients with chronic migraine (CM. Sixteen CM and 16 controls underwent 62 channels LEPs from the right hand, during a fully immersive VR experience, where two types of waiting rooms were simulated. The RH simulated a classical hospital waiting room while the IH represented a room with sea viewing. CM patients showed a reduction of laser pain rating and vertex LEPs during the IH vision. The sLORETA analysis confirmed that in CM patients the two VR simulations induced a different modulation of bilateral parietal cortical areas (precuneus and superior parietal lobe, and superior frontal and cingulate girus, in respect to controls. The architectural context may interfere with pain perception, depending upon the status of subject. Many variables may change patients’ outcome and support the use of VR technology to test the best conditions for their management.

  12. Clinical bacterial isolates from hospital environment as agents of ...

    African Journals Online (AJOL)

    The relationship between bacteria isolated from the hospital environment and those from wounds of operated patients was investigated to determine the causal agents of surgical site nosocomial infections. The study was carried out on bacterial species isolated from the theatre, surgical ward and patients' surgical wounds ...

  13. A companionship between strangers - the hospital environment as a challenge in patient-patient interaction in oncology wards.

    Science.gov (United States)

    Larsen, Lene Søndergård; Larsen, Birte Hedegaard; Birkelund, Regner

    2014-02-01

    To present an identification and discussion of the impact of the hospital environment on interaction among people with cancer. In recent years, researchers have focused on identifying and describing features of the hospital environment that promote healing, recovery and well-being. It has been discovered that architectural features affect hospitalized patients both positively and negatively. But the research has failed to include fellow patients as part of the hospital environment. A qualitative approach influenced by ethnography. Participant observation and individual qualitative interviews were used to collect data. From a total of 85 observed people with cancer 10 men and 10 women were interviewed. Data were collected over 6 months in 2010-2011 and analysed using inductive thematic analysis. Patients had ambiguous views regarding their fellow patients and the hospital environment. The hospital environment imposed conditions that caused stress factors such as the loss of personal privacy and control, but it also offered the possibility of good company and support from fellow patients. Refuge from fellow patients was hard to achieve and the fact that personal conversations might be overheard by fellow patients caused patients to withhold important information from healthcare professionals. Nevertheless, patients accepted the hospital environment uncritically, with resignation or with silent rebellion. Despite the challenges, 18 of 20 patients preferred multiple-bed rooms with the company of fellow patients. The influence of the hospital environment on hospitalized people with cancer and their interpersonal interaction needs to be acknowledged by healthcare professionals. In addition, evidence-based hospital design must include research into patient preferences and arguments. Further investigation is needed. © 2013 John Wiley & Sons Ltd.

  14. Poor Compliance with Sepsis Guidelines in a Tertiary Care Children’s Hospital Emergency Room

    Directory of Open Access Journals (Sweden)

    Benjamin Louis Moresco

    2018-04-01

    Full Text Available ObjectivesThis study aimed to assess factors related to adherence to the Pediatric Advanced Life Support guidelines for severe sepsis and septic shock in an emergency room (ER of a tertiary care children’s hospital.MethodsThis was a retrospective, observational study of children (0–18 years old in The Children’s Hospital of San Antonio ER over 1 year with the International Consensus Definition Codes, version-9 (ICD-9 diagnostic codes for “severe sepsis” and “shocks.” Patients in the adherent group were those who met all three elements of adherence: (1 rapid vascular access with at most one IV attempt before seeking alternate access (unless already in place, (2 fluids administered within 15 min from sepsis recognition, and (3 antibiotic administration started within 1 h of sepsis recognition. Comparisons between groups with and without sepsis guideline adherence were performed using Student’s t-test (the measurements expressed as median values. The proportions were compared using chi-square test. p-Value ≤0.05 was considered significant.ResultsA total of 43 patients who visited the ER from July 2014 to July 2015 had clinically proven severe sepsis or SS ICD-9 codes. The median age was 5 years. The median triage time, times from triage to vascular access, fluid administration and antibiotic administration were 26, 48.5, 76, and 135 min, respectively. Adherence to vascular access, fluid, and antibiotic administration guidelines was 21, 26, and 34%, respectively. Appropriate fluid bolus (20 ml/kg over 15–20 min was only seen in 6% of patients in the non-adherent group versus 38% in the adherent group (p = 0.01. All of the patients in the non-adherent group used an infusion pump for fluid resuscitation. Hypotension and ≥3 organ dysfunction were more commonly observed in patients in adherent group as compared to patients in non-adherent group (38 vs. 14% p = 0.24; 63 vs. 23% p = 0.03.Conclusion

  15. Quality assurance in radiological protection in a Hospital environment

    International Nuclear Information System (INIS)

    Alonso, M.; Castaneda, M.J.

    1992-01-01

    This paper presents a model for the application of Quality Assurance criteria in the protection against radiation in a hospital environment. A description is made of the radiation protection manual and of the General procedures. Details are given of how these were elaborated, revised, approved and distributed under control, and the need is stressed for all affected areas to participate. Finally and analysis is made of the current situation and the intrinsic difficulties involved in the application of these concepts in a hospital. (author)

  16. Assessment of operating room air distribution in a mobile hospital: field experiment based on VDI 2167

    NARCIS (Netherlands)

    Forejt, L.; Drkal, F.; Hensen, J.L.M.; Seppänen, O.; Säteri, J.

    2007-01-01

    Air distribution in mobile operating room was assessed according to the recent acceptance test (VDI, 2004 [1]). This standard presents a simple and uniform validation procedure of operating room air distribution systems. Therefore it was applied as an objective method for evaluating performance of

  17. Evaluation of awareness concerning fire prevention and control methods among personnel of operating room in a hospital

    Directory of Open Access Journals (Sweden)

    2012-09-01

    Full Text Available Introduction: There are risk of fire accidents in Operating rooms during surgery. Experts estimate annually around 100 fire accidents occur in the operating rooms of United States’s hospitals. 10 to 20 of these accidents lead to severe injuries and about 1 to 2 lead to death. Despite such accidents rarely happen, but they can lead to serious injury or death of patients. .Material and Method: This Cross-sectional questionnaire based survey was conducted among several hospitals belonged to Shiraz University of Medical Sciences. In this study, all personnel of operating rooms were investigated. Questionnaire were used to collect information and the chi-square test was applied to examine the relationship between the Knowledge of operating room personels on fire prevention and control methods, jobs and work experience. For statistical analysis SPSS14 were used. .Result: In this study from 220 participants, about 19.72% had full awareness, 19.62% had partial knowledge, 19.37% had low awareness and 40.97% had no knowledge on fire prevention methods, concerning fire control methods. However, 76% of the participate had full awareness and 24% had no knowledge. Test result Statistically showed that the relationship between the awareness of operating room personnel to fire control methods and work experience were significant (P-value <0.05. But, the relationship between the knowledge of operating room to fire control methods and the type of jobs were not significant. Also no significant relationship were found between the level of awareness in operating room personnel to fire prevention methods, work experience and job title. .Conclusion: The results indicated that the operating room staff awareness of fire prevention and control methods are low. The results also showed that awareness of fires prevention are lower than the awareness of fire control among the studied personel. Regarding to the potential risk of fire in the operating room, it is suggested

  18. Prevalence of Allergy to Natural Rubber Latex and Potential Cross Reacting Food in Operation Room Staff in Shiraz Hospitals -2006

    OpenAIRE

    H Nabavizade; R Amin

    2007-01-01

    Introduction & Objective: Allergic reactions to natural rubber latex have increased during past 10 years especially among health care workers and patients with high exposure to latex allergens. Allergic reaction to latex is related to many diseases like occupational asthma. This study was performed to determine the prevalence of allergy to natural rubber latex and potential cross reacting food in operation room staff in Shiraz hospitals. Materials & Methods: In this cross-sectional descr...

  19. The emergency room at the Rotunda Hospital: evidence of an improving service over the past 3 years.

    LENUS (Irish Health Repository)

    Talukdar, S

    2014-12-01

    This is a retrospective review of the Rotunda Hospital Emergency Room (ER) documentation with respect to attendances for a 4-month period (August-November) in both 2009 and 2012. The aim was to quantify the workload and assess the quality of care offered to patients attending the ER over the two time periods and to highlight any improvements in care after changes were implemented following the initial 2009 review.

  20. Study of Development for RFID System to Hospital Environment.

    Science.gov (United States)

    Hong, Seung Kwon; Sung, Myung-Whun

    2015-01-01

    RFID/USN develops information systems for anytime, anywhere to anybody access Electronic Medical Records (EMR). The goal of the present study is to develop a RFID/USN-based information system for the hospital environment. First, unable to recognize, second, able to recognize as a pursuit of place and suppose the time of medical examination. A retrospective analysis of 235 RFID monitoring results, from four ENT ambulatory clinics of Seoul National University Hospital were extracted by a reader program and monitoring of RFID tag (2006.11.16~2006.12.16). RFID detection for sensing reader of this study has been put into representing "place" and "spending time" of patients for medical history taking and examination. Through the RFID of detection for specific place and spending time of medical examination, RFID/USN develops information system progressing in the EMR of hospital system.

  1. Dialogic leadership: strategies for application in the hospital environment

    Directory of Open Access Journals (Sweden)

    Simone Coelho Amestoy

    2014-04-01

    Full Text Available Objective. To analyze the strategies used by nurses to support the insertion of dialogic leadership in the hospital environment. Methodology. Qualitative study, case study type. Twenty five nurses working in three hospitals in the city of Florianopolis, in the state of Santa Catarina (Brazil participated in the study. Data were collected from May to December 2010. For data collection, semi-structured interviews were performed, non-participant observation and dialogue workshops. Data analysis was performed through Minayo's operational proposal. Results. The strategies mentioned by the study participants were: dialogue, humility, setting an example, resoluteness, meetings and teamwork. It was observed that one strategy completed the other, which contributed to the nurses' leadership. Conclusion. The acceptance of dialogic leadership strategies in hospitals helps nurses strengthen the care provided in their workplace.

  2. Population Dynamics of Patients with Bacterial Resistance in Hospital Environment

    Directory of Open Access Journals (Sweden)

    Leilei Qu

    2016-01-01

    Full Text Available During the past decades, the increase of antibiotic resistance has become a major concern worldwide. The researchers found that superbugs with new type of resistance genes (NDM-1 have two aspects of transmission characteristics; the first is that the antibiotic resistance genes can horizontally transfer among bacteria, and the other is that the superbugs can spread between humans through direct contact. Based on these two transmission mechanisms, we study the dynamics of population in hospital environment where superbugs exist. In this paper, we build three mathematic models to illustrate the dynamics of patients with bacterial resistance in hospital environment. The models are analyzed using stability theory of differential equations. Positive equilibrium points of the system are investigated and their stability analysis is carried out. Moreover, the numerical simulation of the proposed model is also performed which supports the theoretical findings.

  3. DHM simulation in virtual environments: a case-study on control room design.

    Science.gov (United States)

    Zamberlan, M; Santos, V; Streit, P; Oliveira, J; Cury, R; Negri, T; Pastura, F; Guimarães, C; Cid, G

    2012-01-01

    This paper will present the workflow developed for the application of serious games in the design of complex cooperative work settings. The project was based on ergonomic studies and development of a control room among participative design process. Our main concerns were the 3D human virtual representation acquired from 3D scanning, human interaction, workspace layout and equipment designed considering ergonomics standards. Using Unity3D platform to design the virtual environment, the virtual human model can be controlled by users on dynamic scenario in order to evaluate the new work settings and simulate work activities. The results obtained showed that this virtual technology can drastically change the design process by improving the level of interaction between final users and, managers and human factors team.

  4. Ergonomic evaluation of the environment: a case study in a control room of the hydroelectric sector.

    Science.gov (United States)

    Falcão, Christianne Soares; Soares, Marcelo Marcio

    2012-01-01

    Representative systematic evaluation studies of the workspace and the extent to which that space is suitable for performing tasks have been developed by professionals engaged on finding evidence as to the importance of users and designers being joint participants in drawing up projects. In this context, this paper sets out to evaluate the environment of a control room in the hydroelectric sector, based on a multidisciplinary method which integrates ergonomics, architecture and environmental psychology so as to assess the influence of space on the user, and thus to identify the user's level of satisfaction with it. It was observed that some adaptation strategies of the space for activities were not implemented satisfactorily, resulting in the need for further studies on making workspaces suitable.

  5. Wear Behavior of Selected Nuclear Grade Graphites at Room Temperature in Ambient Air Environment

    International Nuclear Information System (INIS)

    Kim, Eung-Seon; Park, Kwang-Seok; Kim, Yong-Wan

    2008-01-01

    In a very high temperature reactor (VHTR), graphite will be used not only for as a moderator and reflector but also as a major structural component due to its excellent neutronic, thermal and mechanical properties. In the VHTR, wear of graphite components is inevitable due to a neutron irradiation-induced dimensional change, thermal gradient, relative motions of graphite components and a shock load such as an earthquake. Large wear particles accumulated at the bottom of a reactor can influence the cooling of the lower part and small wear particles accumulated on the primary circuit and heat exchanger tube can make it difficult to inspect the equipment, and also decrease the heat exchange rate. In the present work, preliminary wear tests were performed at room temperature in ambient air environment to understand the basic wear characteristics of selected nuclear grade graphites for the VHTR

  6. The thermal comfort, the indoor environment control, and the energy consumption in three types of operating rooms

    NARCIS (Netherlands)

    Melhado, M.D.A.; Beyer, P.O.; Hensen, J.L.M.; Siqueira, L.F.G.

    2005-01-01

    This research investigated the influence of three layouts of operating rooms on the indoor environment control, on thermal comfort and on energy consumption. It was used the EnergyPlus software. The parameters of the environment were described in accordance with standards. The three layouts had

  7. Lifestyle practices and the health promoting environment of hospital nurses.

    Science.gov (United States)

    Hope, A; Kelleher, C C; O'Connor, M

    1998-08-01

    Lifestyle practices and the health promoting environment of hospital nurses This paper examined the lifestyle practices of hospital nurses and the impact of specific interventions in the hospital environment. The perception of nurse as health promoter and as carer of AIDS patients was also examined. A self-administered questionnaire was used to collect data at two different time periods. The sample represented 729 nurses (at pre- and post-time periods), both qualified and student nurses. Qualified nurses reported the highest stress levels while student nurses reported more negative lifestyle practices such as smoking, alcohol consumption and drug use. A greater number of current smokers (29%) consumed alcohol and used drugs than non-smokers. The impact of intervention strategies around compliance with smoking policy and work-site walk routes reduced exposure to passive smoking at work for qualified nurses and increased exercise participation for both groups of nurses. Workplace was identified as the main source of stress which included relationships at work and demands of the job. Hospital nurses experiencing high work stress were more likely to use professional support and personal coping (discuss problems with friends/family, have a good cry and eat more) than others. Nurses believed in the importance of health promotion as part of their work; however, qualified nurses felt more confident and gave more health related information than student nurses. Student nurses perceived a lower risk of contacting AIDS through work and a higher concern/worry in caring for AIDS patients than qualified nurses.

  8. Lifestyle practices and the health promoting environment of hospital nurses.

    LENUS (Irish Health Repository)

    Hope, A

    1998-08-01

    Lifestyle practices and the health promoting environment of hospital nurses This paper examined the lifestyle practices of hospital nurses and the impact of specific interventions in the hospital environment. The perception of nurse as health promoter and as carer of AIDS patients was also examined. A self-administered questionnaire was used to collect data at two different time periods. The sample represented 729 nurses (at pre- and post-time periods), both qualified and student nurses. Qualified nurses reported the highest stress levels while student nurses reported more negative lifestyle practices such as smoking, alcohol consumption and drug use. A greater number of current smokers (29%) consumed alcohol and used drugs than non-smokers. The impact of intervention strategies around compliance with smoking policy and work-site walk routes reduced exposure to passive smoking at work for qualified nurses and increased exercise participation for both groups of nurses. Workplace was identified as the main source of stress which included relationships at work and demands of the job. Hospital nurses experiencing high work stress were more likely to use professional support and personal coping (discuss problems with friends\\/family, have a good cry and eat more) than others. Nurses believed in the importance of health promotion as part of their work; however, qualified nurses felt more confident and gave more health related information than student nurses. Student nurses perceived a lower risk of contacting AIDS through work and a higher concern\\/worry in caring for AIDS patients than qualified nurses.

  9. Measuring Situation Awareness of Operating Team in Different Main Control Room Environments of Nuclear Power Plants

    Directory of Open Access Journals (Sweden)

    Seung Woo Lee

    2016-02-01

    Full Text Available Environments in nuclear power plants (NPPs are changing as the design of instrumentation and control systems for NPPs is rapidly moving toward fully digital instrumentation and control, and modern computer techniques are gradually introduced into main control rooms (MCRs. Within the context of these environmental changes, the level of performance of operators in a digital MCR is a major concern. Situation awareness (SA, which is used within human factors research to explain to what extent operators of safety-critical systems know what is transpiring in the system and the environment, is considered a prerequisite factor to guarantee the safe operation of NPPs. However, the safe operation of NPPs can be guaranteed through a team effort. In this regard, the operating team's SA in a conventional and digital MCR should be measured in order to assess whether the new design features implemented in a digital MCR affect this parameter. This paper explains the team SA measurement method used in this study and the results of applying this measurement method to operating teams in different MCR environments. The paper also discusses several empirical lessons learned from the results.

  10. Exposure to antineoplastic drugs outside the hospital environment.

    Science.gov (United States)

    Meijster, T; Fransman, W; Veldhof, R; Kromhout, H

    2006-10-01

    The objectives were (i) to identify occupational populations outside hospitals working with antineoplastic drugs, (ii) to determine the size of the populations 'at risk', (iii) to identify major determinants and routes of exposure outside hospitals and (iv) to estimate exposure levels and frequencies relative to levels found in hospitals. The survey consisted of two phases; (i) identification of activities with potential exposure to antineoplastic drugs by literature review, interviews, questionnaires and workplace visits, (ii) exploratory measurements of exposure and surface contamination in selected sectors. Eight sectors were identified with potential exposure to antineoplastic drugs: pharmaceutical industry, pharmacies, universities, veterinary medicine, nursing homes, home care, laundry facilities, and waste treatment. Four sectors were of primary concern: veterinary medicine, home care, nursing homes and industrial laundries. The populations potentially exposed in these sectors vary considerably (from several tens to thousands of workers), as do their levels of exposure. Exposure measurements collected in the veterinary medicine sector showed that workers are indeed exposed to antineoplastic drugs and, in some cases (on gloves after administration), levels were 15 times higher than levels measured during administration in hospitals. Workers sorting contaminated hospital laundry in industrial laundry facilities were exposed to antineoplastic drugs through inhalation. For the home care and nursing homes sectors the highest exposure levels were found when cleaning toilets and washing treated patients. These two sectors are expected to have the largest exposed population (5,000-10,000 individuals). This study has resulted in a comprehensive overview of populations with potential exposure to antineoplastic drugs. Exposure levels can potentially be high compared with the hospital environment, because exposure routes are complex and awareness of the hazard (and

  11. Auditing the needs of recovery room staff providing care for the child in an acute hospital.

    Science.gov (United States)

    Nicholas-Holley, J

    2016-05-01

    This article examines the results of an audit into recovery nurse knowledge and understanding of paediatric care standards. It will critically analyse the availability of current standards for children's services in the recovery room and discuss the need for a national document specifically dedicated to standards of practise for the care of the child in the recovery room providing immediate post operative care. The article will also look at the development of such a document.

  12. Assessment of safety levels in operation rooms at two major tertiary care public hospitals of Karachi. Safe surgery saves life

    International Nuclear Information System (INIS)

    Minhas, M.S.; Muzzammil, M.; Effendi, J.

    2017-01-01

    The objectives of this study are to determine the knowledge and attitude towards surgical safety among the health care professionals including surgeons, anaesthetist, hospital administrators, and operation room personnel and raise awareness towards the importance of safe surgery. Method: A pilot cross- sectional study of 543 healthcare providers working in the operating rooms and the surgical intensive care units was conducted in two tertiary care hospitals, within a study period of one month. A structured questionnaire was constructed and an informed verbal consent was taken. The questionnaire was then distributed; data collected and analysed on SPSS 20.0. Results: A total of 543 respondents participated in the study out of which there were 375 (69%) men and 168 (31%) women. The ages ranged between 23-58 years, mean 40.5+-24.74. There were 110 (20.25%) surgeons, 58 (10.68%) anaesthetist, 132 (24.30%) trainees, 125 (23.02%) technicians, and were 118 (21.73%) nurses. The question regarding briefing operation room personnel is important for patient safety was agreed by 532 (98%) respondents. Amongst the respondents, 239 (44%) did not feel safe to be operated in their own setup. Team communication improvement through the check list implementation was agreed by 483 (89%) respondents. 514 (94.7%) opted for the checklist to be used while they are being operated. That operation room personnel frequently disregard established protocols was agreed by 374 (69%) respondents. 193 (35.54%) of the respondents stated that it is difficult for them to speak up in the or if they perceive a problem with patient care. Conclusion: Operation room personnel were not aware of several important areas related to briefing, communication, safety attitude, following standard protocols and use of WHO Surgical Safety check list. A pre-post intervention study should be conducted after formal introduction of the Checklist. Successful implementation will require taking all stake holders on board

  13. Prevalence of Allergy to Natural Rubber Latex and Potential Cross Reacting Food in Operation Room Staff in Shiraz Hospitals -2006

    Directory of Open Access Journals (Sweden)

    H Nabavizade

    2007-07-01

    Full Text Available Introduction & Objective: Allergic reactions to natural rubber latex have increased during past 10 years especially among health care workers and patients with high exposure to latex allergens. Allergic reaction to latex is related to many diseases like occupational asthma. This study was performed to determine the prevalence of allergy to natural rubber latex and potential cross reacting food in operation room staff in Shiraz hospitals. Materials & Methods: In this cross-sectional descriptive study five hundred eighty operation room staff of ten private and state hospitals in Shiraz completed latex allergy questionnaire. They were questioned about personal history and previous history of latex sensitivity, symptoms of latex reactivity and about other allergies particularly to foods that may cross react with latex. Informed consent was obtained and skin prick testing was performed with natural rubber latex. Skin prick tests were done with three potentially cross reacting food (banana, Kiwi, and potato. The obtained data were analyzed with SPSS software and Chi-square test. Results: Among the 580 operation room workers 104 (17.9 % of participants were positive to latex skin test. We found a significant association between positive skin test to latex in operation room staff and atopy, urticaria and food allergy. Positive skin test to latex related to positive kiwi skin test (p<0.05. The prevalence did not vary by sex, age, education, surgical and non surgical glove users, history of contact dermatitis or smoking status. Conclusion: Latex allergy has a high prevalence in personnel of operation room. Evaluation of present symptom and prediction of future disease necessitate screening test in individuals at risk.

  14. Psychometric properties of the postgraduate hospital educational environment measure in an Iranian hospital setting.

    Science.gov (United States)

    Shokoohi, Shahrzad; Hossein Emami, Amir; Mohammadi, Aeen; Ahmadi, Soleiman; Mojtahedzadeh, Rita

    2014-01-01

    Students' perceptions of the educational environment are an important construct in assessing and enhancing the quality of medical training programs. Reliable and valid measurement, however, can be problematic - especially as instruments developed and tested in one culture are translated for use in another. This study sought to explore the psychometric properties of the Postgraduate Hospital Educational Environment Measure (PHEEM) for use in an Iranian hospital training setting. We translated the instrument into Persian and ensured its content validity by back translation and expert review prior to administering it to 127 residents of Urmia University of Medical Science. Overall internal consistency of the translated measure was good (a=0.94). Principal components analysis revealed five factors accounting for 52.8% of the variance. The Persian version of the PHEEM appears to be a reliable and potentially valid instrument for use in Iranian medical schools and may find favor in evaluating the educational environments of residency programs nationwide.

  15. Genetic diversity of Aspergillus fumigatus in indoor hospital environments.

    Science.gov (United States)

    Araujo, Ricardo; Amorim, António; Gusmão, Leonor

    2010-09-01

    Environmental isolates of Aspergillus fumigatus are less studied than those recovered from clinical sources. In the present study, the genetic diversity among such environmental isolates was assessed, as well as their dispersion ability and the acquisition of new strains in 19 medical units of the same hospital. A. fumigatus isolates were genotyped using a single multiplex PCR-based reaction with eight microsatellite markers and an insertion/deletion polymorphism. A total of 130 unique genotypes were found among a total of 250 A. fumigatus isolates. Genotypic diversity ranged from 0.86 to 1 in samples from hospital rooms, and there was no correlation between these samples and the presence of high-efficiency particulate air filters or any other air filtration system. Four of the six most prevalent A. fumigatus strains were recovered from water samples. The occurrence of microvariation was common among environmental isolates, which affected each of the microsatellite markers. The assessment of the genetic diversity of A. fumigatus is a useful tool for illustrating the presence or absence of specific clonal populations in a clinical setting. A. fumigatus populations were highly dynamic indoors, and new populations were found in just a few months. Due to the high indoor dispersion capability of A. fumigatus, more attention should be given to strains with increased pathogenic potential or reduced susceptibility to anti-fungal drugs.

  16. DigiScope--unobtrusive collection and annotating of auscultations in real hospital environments.

    Science.gov (United States)

    Pereira, D; Hedayioglu, F; Correia, R; Silva, T; Dutra, I; Almeida, F; Mattos, S S; Coimbra, M

    2011-01-01

    Digital stethoscopes are medical devices that can collect, store and sometimes transmit acoustic auscultation signals in a digital format. These can then be replayed, sent to a colleague for a second opinion, studied in detail after an auscultation, used for training or, as we envision it, can be used as a cheap powerful tool for screening cardiac pathologies. In this work, we present the design, development and deployment of a prototype for collecting and annotating auscultation signals within real hospital environments. Our main objective is not only pave the way for future unobtrusive systems for cardiac pathology screening, but more immediately we aim to create a repository of annotated auscultation signals for biomedical signal processing and machine learning research. The presented prototype revolves around a digital stethoscope that can stream the collected audio signal to a nearby tablet PC. Interaction with this system is based on two models: a data collection model adequate for the uncontrolled hospital environments of both emergency room and primary care, and a data annotation model for offline metadata input. A specific data model was created for the repository. The prototype has been deployed and is currently being tested in two Hospitals, one in Portugal and one in Brazil.

  17. The rehabilitation team: staff perceptions of the hospital environment, the interdisciplinary team environment, and interprofessional relations.

    Science.gov (United States)

    Strasser, D C; Falconer, J A; Martino-Saltzmann, D

    1994-02-01

    Although inpatient rehabilitation is an interdisciplinary activity organized around a treatment team, there is a limited understanding of the workings of the interdisciplinary process. To elucidate staff perceptions of key aspects of the rehabilitation treatment process, we surveyed staff (n = 113) from selected inpatient teams. The staff completed social psychological instruments that measure perceptions of the hospital environment (The Ward Atmosphere Scale [WAS]), the team's environment (the Group Environment Scale [GES]), and interprofessional relations (Interprofessional Perception Scale [IPS]). Rehabilitation staff generally endorse the team approach, but express concerns over professional boundaries. Interprofessional difficulties seemed to be independent of team membership or professional training. Compared with published data from other settings, rehabilitation teams resembled task-oriented groups, but showed significant differences across teams in their perceptions of the team and hospital environments. The task-oriented character of rehabilitation teams, team-specific characteristics, and discord in interprofessional relationships may need to be considered in studies of rehabilitation teams effectiveness.

  18. Ultraviolet (UV)-reflective paint with ultraviolet germicidal irradiation (UVGI) improves decontamination of nosocomial bacteria on hospital room surfaces.

    Science.gov (United States)

    Jelden, Katelyn C; Gibbs, Shawn G; Smith, Philip W; Hewlett, Angela L; Iwen, Peter C; Schmid, Kendra K; Lowe, John J

    2017-06-01

    An ultraviolet germicidal irradiation (UVGI) generator (the TORCH, ClorDiSys Solutions, Inc.) was used to compare the disinfection of surface coupons (plastic from a bedrail, stainless steel, and chrome-plated light switch cover) in a hospital room with walls coated with ultraviolet (UV)-reflective paint (Lumacept) or standard paint. Each surface coupon was inoculated with methicillin-resistant Staphylococcus aureus (MRSA) or vancomycin-resistant Enterococcus faecalis (VRE), placed at 6 different sites within a hospital room coated with UV-reflective paint or standard paint, and treated by 10 min UVC exposure (UVC dose of 0-688 mJ/cm 2 between sites with standard paint and 0-553 mJ/cm 2 with UV-reflective paint) in 8 total trials. Aggregated MRSA concentrations on plastic bedrail surface coupons were reduced on average by 3.0 log 10 (1.8 log 10 Geometric Standard Deviation [GSD]) with standard paint and 4.3 log 10 (1.3 log 10 GSD) with UV-reflective paint (p = 0.0005) with no significant reduction differences between paints on stainless steel and chrome. Average VRE concentrations were reduced by ≥4.9 log 10 (surface types with UV-reflective paint and ≤4.1 log 10 (hospital bed from the UVGI generator, MRSA concentrations on average were reduced by 1.3 log 10 (1.7 log 10 GSD) with standard paint and 4.7 log 10 (1.3 log 10 GSD) with UV-reflective paint (p hospital room walls with UV-reflective paint enhanced UVGI disinfection of nosocomial bacteria on various surfaces compared to standard paint, particularly at a surface placement site indirectly exposed to UVC light.

  19. The effect of working in an infection isolation room on hospital nurses' job satisfaction.

    Science.gov (United States)

    Kagan, Ilya; Fridman, Shoshana; Shalom, Esther; Melnikov, Semyon

    2018-03-01

    To examine how the nature of working in a carbapenemase-producing Klebsiella pneumoniae infection isolation room affects nurses' job performance and job satisfaction. Job satisfaction is under intensive research as a factor in the retention of nursing staff. In a cross-sectional design study, a convenience sample of 87 registered nurses who had worked in carbapenemase-producing Klebsiella pneumoniae isolation rooms in a tertiary medical centre in Israel answered a self-administered questionnaire. Data were analysed by descriptive statistics, Pearson correlation coefficients, t tests, one-way ANOVA and multiple regression analysis. Job satisfaction was significantly correlated with perceived knowledge of carbapenemase-producing Klebsiella pneumoniae, with personal experience of working in an isolation room and the perceived level of professional functioning. Multiple regression analysis found that the quality of the nurses' personal experience of isolation room work and their perceived level of professional functioning there explained 33% of the variance in job satisfaction. Managers need to take into account that prolonged work in isolation can negatively impinge upon both performance and job satisfaction. Managers can consider refraining from lengthy nurse assignment to the isolation room. This would also apply to other areas of nursing practice where work is performed in isolation. © 2017 John Wiley & Sons Ltd.

  20. [Ants as carriers of microorganisms in hospital environments].

    Science.gov (United States)

    Pereira, Rogério Dos Santos; Ueno, Mariko

    2008-01-01

    Concern exists regarding the real possibility of public health threats caused by pathogenic agents that are carried by urban ants. The present study had the objective of isolating and identifying the microorganisms that are associated with ants in hospital environments. One hundred and twenty-five ants of the same species were collected from different units of a university hospital. Each ant was collected using a swab soaked with physiological solution and was transferred to a tube containing brain heart infusion broth and incubated at 35 degrees C for 24 hours. From each tube, with growth, inoculations were made into specific culturing media, to isolate any microorganisms. The ants presented a high capacity for carrying microorganism groups: spore-producing Gram-positive bacilli 63.5%, Gram-negative bacilli 6.3%, Gram-positive cocci 23.1%, filamentous fungi 6.7% and yeast 0.5%. Thus, it can be inferred that ants may be one of the agents responsible for disseminating microorganisms in hospital environments.

  1. Purchasing practices in a hospital environment: an ethical analysis.

    Science.gov (United States)

    Florsheim, R; Paderon, E S

    1992-05-01

    The critical state of the hospital industry, as previously described, generates a difficult decision environment for the materiel manager and those in the purchasing function. The unique life- and death circumstances of hospitals impose a further onus on those who manage them. In the name of saving lives, they can find a convenient excuse to disregard all moral principles, forgetting the Socratic dictum "it is not enough that one lives, but that one lives well." Without the moral "right stuff," they can easily give in to the seductions of momentary gains and glory through ethical short-cuts. There is wisdom and consolation in the words that "nice guys may appear to finish last, but usually they're running in a different race." Studies have established a direct relationship between corporate excellence and ethical values. The reality of competition in the hospital industry dictates that the integration of ethics into the life of the organization should happen by design and not by accident. This is what is meant by strategy. If hospitals would strive for excellence to survive and grow, they should have a strategy with a mission statement that also embodies its moral values and moral agenda. Such an approach does not guarantee that an organization will become immune to moral contamination, but it does provide an antidote.

  2. Recovery Room

    African Journals Online (AJOL)

    defined postoperative unit or on the hospital ward. Patients were frequently transferred from the operating room directly to the ward where they were placed close to the nursing station. In 1947 the. Anesthesia Study Commission of the Philadelphia.

  3. Exploring Bacterial Diversity in Hospital Environments by GS-FLX Titanium Pyrosequencing

    OpenAIRE

    Poza, Margarita; Gayoso, Carmen; Gómez, Manuel J.; Rumbo-Feal, Soraya; Tomás, María; Aranda, Jesús; Fernández, Ana; Bou, Germán

    2012-01-01

    Understanding microbial populations in hospital environments is crucial for improving human health. Hospital-acquired infections are an increasing problem in intensive care units (ICU). In this work we present an exploration of bacterial diversity at inanimate surfaces of the ICU wards of the University Hospital A Coruña (Spain), as an example of confined hospital environment subjected to selective pressure, taking the entrance hall of the hospital, an open and crowded environment, as referen...

  4. Exposure of health care workers and occupants to coughed airborne pathogens in a double-bed hospital patient room with overhead mixing ventilation

    DEFF Research Database (Denmark)

    Bolashikov, Zhecho D.; Melikov, Arsen K.; Brand, Marek

    2012-01-01

    The exposure of a doctor and a second patient was studied in a simulated two-bed hospital isolation room. The room was ventilated at three air change rates (3h-1, 6h-1, and 12h-1) by mixing air distribution keeping at 22C (71.6F). The effect of the distance between the doctor and the coughing...

  5. Hospitality Healthscapes: The New Standard for Making Hospitals More Hospitable

    Directory of Open Access Journals (Sweden)

    Courtney Suess Raeisinafchi

    2017-06-01

    Full Text Available What comes to mind when you think of a hospital room? Stark. Sterile. Bare. Clinical. What might it mean for patients if the association with the environment shifted to something like: Comforting. Bright. Elegant. Personal?

  6. Efficacy Assessment of Lemon Peel Aromatherpy Againts Airborne Bacteria Experimental Study in ICU Room of Sultan Agung Islamic Hospital Semarang

    Directory of Open Access Journals (Sweden)

    Merin Awu Sari

    2012-06-01

    Design and Method: This experimental study used post test only control groups design. The number of airborne bacteria colonies obtained from ICU room of Sultan Agung Islamic Hospital Semarang treated with lemon peel aromatherapy at the concentration of 100 % and the control group (-.The data were analyzed for normality using Shapiro Wilk followed by independent T-test Result: independent inT-test Independent showed a significant differences in the number of bacterial colonies between the treated groups receiving 100% concentration of lemon peel aromatherapy and control group (- (p < 0.045. Conclusion: Aromatherapy extracts of lemon peel has effect on reducing the number of airborne bacteria in the ICU of Sultan Agung Islamic Hospital Semarang (Sains Medika, 4(1:71-77.

  7. Neonatal Resuscitation in the Delivery Room from a Tertiary Level Hospital: Risk Factors and Outcome

    OpenAIRE

    Afjeh, Seyyed-Abolfazl; Sabzehei, Mohammad-Kazem; Esmaili, Fatemeh

    2013-01-01

    Objective Timely identification and prompt resuscitation of newborns in the delivery room may cause a decline in neonatal morbidity and mortality. We try to identify risk factors in mother and fetus that result in birth of newborns needing resuscitation at birth. Methods Case notes of all deliveries and neonates born from April 2010 to March 2011 in Mahdieh Medical Center (Tehran, Iran), a Level III Neonatal Intensive Care Unit, were reviewed; relevant maternal, fetal and perinatal data was e...

  8. PM2.5 constituents and hospital emergency-room visits in Shanghai, China.

    Science.gov (United States)

    Qiao, Liping; Cai, Jing; Wang, Hongli; Wang, Weibing; Zhou, Min; Lou, Shengrong; Chen, Renjie; Dai, Haixia; Chen, Changhong; Kan, Haidong

    2014-09-02

    Although ambient PM2.5 has been linked to adverse health effects, the chemical constituents that cause harm are largely unclear. Few prior studies in a developing country have reported the health impacts of PM2.5 constituents. In this study, we examined the short-term association between PM2.5 constituents and emergency room visits in Shanghai, China. We measured daily concentrations of PM2.5, organic carbon (OC), elemental carbon (EC), and eight water-soluble ions between January 1, 2011 and December 31, 2012. We analyzed the data using overdispersed generalized linear Poisson models. During our study period, the mean daily average concentration of PM2.5 in Shanghai was 55 μg/m(3). Major contributors to PM2.5 mass included OC, EC, sulfate, nitrate, and ammonium. For a 1-day lag, an interquartile range increment in PM2.5 mass (36.47 μg/m(3)) corresponded to 0.57% [95% confidence interval (CI): 0.13%, 1.01%] increase of emergency room visits. In all the three models used, we found significant positive associations of emergency room visits with OC and EC. Our findings suggest that PM2.5 constituents from the combustion of fossil fuel (e.g., OC and EC) may have an appreciable influence on the health impact attributable to PM2.5.

  9. A STUDY OF PRE OPERATION NURSING VISIT ABOUT THE NURSES’ VIEW FROM THE SURGERY ROOM OF A UNIVERSITY HOSPITAL.

    Directory of Open Access Journals (Sweden)

    Izilda Esmenia Muglia Araújo

    2004-08-01

    Full Text Available This study to do an analysis of the PONV`s importance, by nurses from the Daily’s SurgeryRoom of an University Hospital, through forms distributed to them and to apply the written communicationinstrument on the PONV,proposed by NORONHA & ARAÚJO (1995. The results this research were: 92,9% ofthe nurses from the Daily’s Surgery Room think that it is important the performance of the PONV to the patientand Nursing aid, and 85,7% think the PONV is important for the nurse who works in a Surgery Room. Thewritten communication instrument on the PONV was applied with success, being really easy to fill it in with clearquestions , showing so to be a lot of viable but some items of the instrument like blood group and FATOR RHcouldn’t be filled even after the records check. In this way, I think it is worth the suggestion o9f sitting the writtencommunication instrument proposed by ARAÚJO AND NORONHA (1995 at this State University, proposinghowever, inclusion on the patients’ records data about blood group and FATOR RH.

  10. Nursing care system development for patients with cleft lip-palate and craniofacial deformities in operating room Srinagarind Hospital.

    Science.gov (United States)

    Riratanapong, Saowaluck; Sroihin, Waranya; Kotepat, Kingkan; Volrathongchai, Kanittha

    2013-09-01

    For a successful surgical outcome for patients with cleft lip/palate (CLP), the attending nurses must continuously develop their potential, knowledge, capacity and skills. The goal is to meet international standards of patient safety and efficiency. To assess and improve the nursing care system for patients with CLP and craniofacial deformities at the operating room (OR), Srinagarind Hospital, Khon Kaen University. Data were collected for two months (between March 1, 2011 and April 30, 2011). Part I was an enquiry regarding the attitude of OR staff on serving patients with CLP; and, Part 2.1) patient and caregiver satisfaction with service from the OR staff and 2.2) patient and caregiver satisfaction with the OR transfer service. The authors interviewed 28 staff in OR unit 2 of the OR nursing division and 30 patients with CLP and his/her caregiver. The respective validity according to the Cronbach's alpha coefficient was 0.87 and 0.93. The OR staff attitude visa-vis service provision for patients with CLP service was middling. Patient and caregiver satisfaction with both OR staff and the transfer service was very satisfactory. Active development of the nursing care system for patients with CLP and craniofacial deformities in the operating room, Srinagarind Hospital improved staff motivation with respect to serving patients with CLP. The operating theater staff was able to co-ordinate the multidisciplinary team through the provision of surgical service for patients with CLP.

  11. An Investigation on the Current Status of the Operation Recovery Rooms in Yazd Hospitals in 2010-2011

    Directory of Open Access Journals (Sweden)

    MR Khajeh Aminian

    2012-08-01

    Full Text Available Introduction: The recovery ward is a vital unit to care patients awaking from anesthesia and is a standard requirement for the operating room. Recovery ward is located adjacent to the operation room and is easily accessible to trained and skilled individuals. The unit must have adequate equipment for surveillance and monitoring of patients and required medication should also be provided. Methods: This study is a cross-sectional conducted in one phase through referring to hospital facilities and equipment. Physical space, personnel and their skill levels and other factors that are involved in the care of patients in the recovery have been investigated. The instruments used in this study were a check list and observe sheet which were completed by the researchers. Data analysis was conducted by SPSS software. Results: The results showed that the standards of buildings and physical space in the researched areas were mostly nonstandard. Equipment standards were to some extent in line with the criteria set by American Association of Anesthesia. Besides, some equipment was blow standard levels. Personnel standards regarding the number of nurses toward the number of recovery beds did not meet the standard criteria in most of the cases. Conclusion: The research shows that building standards in most cases are not in line with mentioned references. Undertaking equipment standards in the hospital recovery wards needs reviewing and providing controlling equipment for preventing the complications of recovery phase of anesthesia in recovery wards.

  12. Is single room hospital accommodation associated with differences in healthcare-associated infection, falls, pressure ulcers or medication errors? A natural experiment with non-equivalent controls.

    Science.gov (United States)

    Simon, Michael; Maben, Jill; Murrells, Trevor; Griffiths, Peter

    2016-07-01

    A wide range of patient benefits have been attributed to single room hospital accommodation including a reduction in adverse patient safety events. However, studies have been limited to the US with limited evidence from elsewhere. The aim of this study was to assess the impact on safety outcomes of the move to a newly built all single room acute hospital. A natural experiment investigating the move to 100% single room accommodation in acute assessment, surgical and older people's wards. Move to 100% single room accommodation compared to 'steady state' and 'new build' control hospitals. Falls, pressure ulcer, medication error, meticillin-resistant Staphylococcus aureus and Clostridium difficile rates from routine data sources were measured over 36 months. Five of 15 time series in the wards that moved to single room accommodation revealed changes that coincided with the move to the new all single room hospital: specifically, increased fall, pressure ulcer and Clostridium difficile rates in the older people's ward, and temporary increases in falls and medication errors in the acute assessment unit. However, because the case mix of the older people's ward changed, and because the increase in falls and medication errors on the acute assessment ward did not last longer than six months, no clear effect of single rooms on the safety outcomes was demonstrated. There were no changes to safety events coinciding with the move at the new build control site. For all changes in patient safety events that coincided with the move to single rooms, we found plausible alternative explanations such as case-mix change or disruption as a result of the re-organization of services after the move. The results provide no evidence of either benefit or harm from all single room accommodation in terms of safety-related outcomes, although there may be short-term risks associated with a move to single rooms. © The Author(s) 2016.

  13. Hospital hero: a game for reducing stress and anxiety of children while waiting in emergency room

    OpenAIRE

    Tranquada, Sara Patrícia Fernandes

    2014-01-01

    This report tells a story which started as an idea that came to us to fight the battle-cry feeling commonly known as stress and anxiety. Before creating the solution of the idea, we first need to understand the feelings underneath and its effects on our well-being. Throughout the course of our lives, we experience states of weakness and fear. These feelings can arise, for instance, while we are in an emergency room. Needless to say, how much it would have imaginable effects on children,...

  14. Psychometric properties of the Postgraduate Hospital Educational Environment Measure in an Iranian hospital setting

    Directory of Open Access Journals (Sweden)

    Shahrzad Shokoohi

    2014-08-01

    Full Text Available Background: Students’ perceptions of the educational environment are an important construct in assessing and enhancing the quality of medical training programs. Reliable and valid measurement, however, can be problematic – especially as instruments developed and tested in one culture are translated for use in another. Materials and method: This study sought to explore the psychometric properties of the Postgraduate Hospital Educational Environment Measure (PHEEM for use in an Iranian hospital training setting. We translated the instrument into Persian and ensured its content validity by back translation and expert review prior to administering it to 127 residents of Urmia University of Medical Science. Results: Overall internal consistency of the translated measure was good (a=0.94. Principal components analysis revealed five factors accounting for 52.8% of the variance. Conclusion: The Persian version of the PHEEM appears to be a reliable and potentially valid instrument for use in Iranian medical schools and may find favor in evaluating the educational environments of residency programs nationwide.

  15. Noise disturbance in open-plan study environments: a field study on noise sources, student tasks and room acoustic parameters.

    Science.gov (United States)

    Braat-Eggen, P Ella; van Heijst, Anne; Hornikx, Maarten; Kohlrausch, Armin

    2017-09-01

    The aim of this study is to gain more insight in the assessment of noise in open-plan study environments and to reveal correlations between noise disturbance experienced by students and the noise sources they perceive, the tasks they perform and the acoustic parameters of the open-plan study environment they work in. Data were collected in five open-plan study environments at universities in the Netherlands. A questionnaire was used to investigate student tasks, perceived sound sources and their perceived disturbance, and sound measurements were performed to determine the room acoustic parameters. This study shows that 38% of the surveyed students are disturbed by background noise in an open-plan study environment. Students are mostly disturbed by speech when performing complex cognitive tasks like studying for an exam, reading and writing. Significant but weak correlations were found between the room acoustic parameters and noise disturbance of students. Practitioner Summary: A field study was conducted to gain more insight in the assessment of noise in open-plan study environments at universities in the Netherlands. More than one third of the students was disturbed by noise. An interaction effect was found for task type, source type and room acoustic parameters.

  16. Radon Quantification and epidemiological assessment in room environments, according to construction material

    International Nuclear Information System (INIS)

    Flores Bolivar, E.H.

    1990-01-01

    This work deals with the quantification of radon concentrations en the Ecuadorian region called 'Sierra', the contribution of building materials to the radioactive contamination and the rooms with greatest contents of radon and his daughters. The most representative zones are: Cuenca, Riobamba, San Gabriel and Puyango, this means that per m3 of air 429.14 radon atoms decay in a second to Po-218, the analyzed materials were: cement, black stone, bricks the rooms: bedroom, hall, dining room and bethroom. Knowing the biological damage that occurs by interaction of a particles with lung tissues. We suggest the follow research in order to get the average concentration for every province

  17. Improved 3D reconstruction in smart-room environments using ToF imaging

    DEFF Research Database (Denmark)

    Guðmundsson, Sigurjón Árni; Pardas, Montse; Casas, Josep R.

    2010-01-01

    This paper presents the use of Time-of-Flight (ToF) cameras in smart-rooms and how this leads to improved results in segmenting the people in the room from the background and consequently better 3D reconstruction of foreground objects. A calibrated rig consisting of one Swissranger SR3100 Time-of...... of eliminating regional artifacts and therefore creating a more robust input for higher level applications such as people tracking or human motion analysis....

  18. Professional Satisfaction Of Nurses Working In Operating Room Of A Hospital School

    Directory of Open Access Journals (Sweden)

    Jéssica Helena Dantas de Oliveira

    2017-05-01

    Full Text Available Objective: to characterize in a sociodemographic way the nursing staff of the surgical center; Check the degree of importance assigned to each component of satisfaction: autonomy, interaction, professional status, task requirements, organizational policies, and pay; verify job satisfaction perceived by nurses. Method: exploratory, descriptive, quantitative study, consisting of 9 nurses working in the operating room. The research project was approved by the CEP/HULW, CAAE Nº 24597513.2.0000.5183. Data were collected through questionnaires and then analyzed using descriptive statistics in SPSS 20. Results: We found that the standby component was considered the most important for job satisfaction and Professional Status least important. Conclusion: nurses have a low level of job satisfaction, impacting the performance of its activities. Descriptors: Job Satisfaction. Perioperative Nursing. Quality of Life.

  19. The use of a metronome during cardiopulmonary resuscitation in the emergency room of a university hospital

    OpenAIRE

    Botelho,Renata Maria de Oliveira; Campanharo,Cássia Regina Vancini; Lopes,Maria Carolina Barbosa Teixeira; Okuno,Meiry Fernanda Pinto; Góis,Aécio Flávio Teixeira de; Batista,Ruth Ester Assayag

    2016-01-01

    ABSTRACT Objective: to compare the rate of return of spontaneous circulation (ROSC) and death after cardiac arrest, with and without the use of a metronome during cardiopulmonary resuscitation (CPR). Method: case-control study nested in a cohort study including 285 adults who experienced cardiac arrest and received CPR in an emergency service. Data were collected using In-hospital Utstein Style. The control group (n=60) was selected by matching patients considering their neurological condit...

  20. Pre-hospital advanced airway management by anaesthesiologists: is there still room for improvement?

    Science.gov (United States)

    Sollid, Stephen J M; Heltne, Jon Kenneth; Søreide, Eldar; Lossius, Hans Morten

    2008-07-21

    Endotracheal intubation is an important part of pre-hospital advanced life support that requires training and experience, and should only be performed by specially trained personnel. In Norway, anaesthesiologists serve as Helicopter Emergency Medical Service HEMS physicians. However, little is known about how they themselves evaluate the quality and safety of pre-hospital advanced airway management. Using a semi-structured questionnaire, we interviewed anaesthesiologists working in the three HEMS programs covering Western Norway. We compared answers from specialists and non-specialists as well as full- and part-time HEMS physicians. Of the 17 available respondents, most (88%) felt that their continuous exposure to intubations was not sufficient. Additional training was mainly acquired through other clinical practice and mannequin- or cadaver-based skills training. Of the respondents, 77% and 35% reported having experienced difficult and failed intubations, respectively. Further, 59% reported knowledge of airway management-related deaths in their HEMS program. Significantly more full- than part-time HEMS physicians had experienced these problems. All respondents had airway back-up equipment in their service, but 29% were not familiar with all the equipment. The majority of anaesthesiologists working as HEMS physicians view pre-hospital advanced airway management as a high-risk procedure. Relevant airway management competencies for HEMS physicians in Norway seem to be insufficiently trained and maintained. A better-defined level of competence with better training methods and systems seems warranted.

  1. Pre-hospital advanced airway management by anaesthesiologists: Is there still room for improvement?

    Directory of Open Access Journals (Sweden)

    Søreide Eldar

    2008-07-01

    Full Text Available Abstract Background Endotracheal intubation is an important part of pre-hospital advanced life support that requires training and experience, and should only be performed by specially trained personnel. In Norway, anaesthesiologists serve as Helicopter Emergency Medical Service HEMS physicians. However, little is known about how they themselves evaluate the quality and safety of pre-hospital advanced airway management. Method Using a semi-structured questionnaire, we interviewed anaesthesiologists working in the three HEMS programs covering Western Norway. We compared answers from specialists and non-specialists as well as full- and part-time HEMS physicians. Results Of the 17 available respondents, most (88% felt that their continuous exposure to intubations was not sufficient. Additional training was mainly acquired through other clinical practice and mannequin- or cadaver-based skills training. Of the respondents, 77% and 35% reported having experienced difficult and failed intubations, respectively. Further, 59% reported knowledge of airway management-related deaths in their HEMS program. Significantly more full- than part-time HEMS physicians had experienced these problems. All respondents had airway back-up equipment in their service, but 29% were not familiar with all the equipment. Conclusion The majority of anaesthesiologists working as HEMS physicians view pre-hospital advanced airway management as a high-risk procedure. Relevant airway management competencies for HEMS physicians in Norway seem to be insufficiently trained and maintained. A better-defined level of competence with better training methods and systems seems warranted.

  2. Association between weather conditions and the number of patients at the emergency room in an Argentine hospital

    Science.gov (United States)

    Rusticucci, Matilde; Bettolli, Laura M.; de los Angeles Harris, M.

    2002-02-01

    The aim of this paper is to study the relationships between hospital emergencies and weather conditions by analysing summer and winter cases of patients requiring attention at the emergency room of a hospital in the city of Buenos Aires, Argentina. Hospital data have been sorted into seven different diagnostic groups as follows: (1) respiratory, cardiovascular and chest-pain complaints; (2) digestive, genitourinary and abdominal complaints; (3) neurological and psychopathological disorders; (4) infections; (5) contusion and crushing, bone and muscle complaints; (6) skin and allergies and (7) miscellaneous complaints. In general, there is an increase of 16.7% in winter while, for group 2 and group 6, there are more patients in summer, 54% and 75% respectively. In summer, the total number of patients for group 6 shows a significant positive correlation with temperature and dew-point temperature, and a negative correlation with the sea-level pressure for the same day. In winter, the same relationship exists, however its correlation is not as strong. The lags observed between these three variables: maximum dew-point temperature, maximum temperature, minimum air pressure and the peaks in admissions are 1, 2 and 4 days respectively. In winter, increases in temperature and dew point and decreases in pressure are followed by a peak in admissions for group 2. In winter, there are significantly more cases in group 5 on warm, dry days and on warm, wet days in the summer.

  3. Noise Pollution Control System in the Hospital Environment

    Science.gov (United States)

    Figueroa Gallo, LM; Olivera, JM

    2016-04-01

    Problems related to environmental noise are not a new subject, but they became a major issue to solve because of the increasing, in complexity and intensity, of human activities due technological advances. Numerous international studies had dealt with the exposure of critical patients to noisy environment such as the Neonatal Intensive Care Units; their results show that there are difficulties in the organization in the developing brain, it can damage the delicate auditory structures and can cause biorhythm disorders, specially in preterm infants. The objective of this paper is to present the development and implementation of a control system that includes technical-management-training aspects to regulate the levels of specific noise sources in the neonatal hospitalization environment. For this purpose, there were applied different tools like: observations, surveys, procedures, an electronic control device and a training program for a Neonatal Service Unit. As a result, all noise sources were identified -some of them are eliminable-; all the service stable staff categories participated voluntarily; environmental noise measurements yielded values between 62.5 and 64.6 dBA and maximum were between 86.1 and 89.7 dBA; it was designed and installed a noise control device and the staff is being trained in noise reduction best practices.

  4. Noise Pollution Control System in the Hospital Environment

    International Nuclear Information System (INIS)

    Figueroa Gallo, LM; Olivera, JM

    2016-01-01

    Problems related to environmental noise are not a new subject, but they became a major issue to solve because of the increasing, in complexity and intensity, of human activities due technological advances. Numerous international studies had dealt with the exposure of critical patients to noisy environment such as the Neonatal Intensive Care Units; their results show that there are difficulties in the organization in the developing brain, it can damage the delicate auditory structures and can cause biorhythm disorders, specially in preterm infants. The objective of this paper is to present the development and implementation of a control system that includes technical-management-training aspects to regulate the levels of specific noise sources in the neonatal hospitalization environment. For this purpose, there were applied different tools like: observations, surveys, procedures, an electronic control device and a training program for a Neonatal Service Unit. As a result, all noise sources were identified -some of them are eliminable-; all the service stable staff categories participated voluntarily; environmental noise measurements yielded values between 62.5 and 64.6 dBA and maximum were between 86.1 and 89.7 dBA; it was designed and installed a noise control device and the staff is being trained in noise reduction best practices. (paper)

  5. Application requirements for Robotic Nursing Assistants in hospital environments

    Science.gov (United States)

    Cremer, Sven; Doelling, Kris; Lundberg, Cody L.; McNair, Mike; Shin, Jeongsik; Popa, Dan

    2016-05-01

    In this paper we report on analysis toward identifying design requirements for an Adaptive Robotic Nursing Assistant (ARNA). Specifically, the paper focuses on application requirements for ARNA, envisioned as a mobile assistive robot that can navigate hospital environments to perform chores in roles such as patient sitter and patient walker. The role of a sitter is primarily related to patient observation from a distance, and fetching objects at the patient's request, while a walker provides physical assistance for ambulation and rehabilitation. The robot will be expected to not only understand nurse and patient intent but also close the decision loop by automating several routine tasks. As a result, the robot will be equipped with sensors such as distributed pressure sensitive skins, 3D range sensors, and so on. Modular sensor and actuator hardware configured in the form of several multi-degree-of-freedom manipulators, and a mobile base are expected to be deployed in reconfigurable platforms for physical assistance tasks. Furthermore, adaptive human-machine interfaces are expected to play a key role, as they directly impact the ability of robots to assist nurses in a dynamic and unstructured environment. This paper discusses required tasks for the ARNA robot, as well as sensors and software infrastructure to carry out those tasks in the aspects of technical resource availability, gaps, and needed experimental studies.

  6. Infrastructure and contamination of the physical environment in three Bangladeshi hospitals: putting infection control into context.

    Science.gov (United States)

    Rimi, Nadia Ali; Sultana, Rebeca; Luby, Stephen P; Islam, Mohammed Saiful; Uddin, Main; Hossain, Mohammad Jahangir; Zaman, Rashid Uz; Nahar, Nazmun; Gurley, Emily S

    2014-01-01

    This paper describes the physical structure and environmental contamination in selected hospital wards in three government hospitals in Bangladesh. The qualitative research team conducted 48 hours of observation in six wards from three Bangladeshi tertiary hospitals in 2007. They recorded environmental contamination with body secretions and excretions and medical waste and observed ward occupant handwashing and use of personal protective equipment. They recorded number of persons, number of open doors and windows, and use of fans. They measured the ward area and informally observed waste disposal outside the wards. They conducted nine focus group discussions with doctors, nurses and support staff. A median of 3.7 persons were present per 10 m(2) of floor space in the wards. A median of 4.9 uncovered coughs or sneezes were recorded per 10 m(2) per hour per ward. Floors in the wards were soiled with saliva, spit, mucous, vomitus, feces and blood 125 times in 48 hours. Only two of the 12 patient handwashing stations had running water and none had soap. No disinfection was observed before or after using medical instruments. Used medical supplies were often discarded in open containers under the beds. Handwashing with soap was observed in only 32 of 3,373 handwashing opportunities noted during 48 hours. Mosquitoes and feral cats were commonly observed in the wards. The physical structure and environment of our study hospitals are conducive to the spread of infection to people in the wards. Low-cost interventions on hand hygiene and cleaning procedures for rooms and medical equipment should be developed and evaluated for their practicality and effectiveness.

  7. Infrastructure and contamination of the physical environment in three Bangladeshi hospitals: putting infection control into context.

    Directory of Open Access Journals (Sweden)

    Nadia Ali Rimi

    Full Text Available OBJECTIVE: This paper describes the physical structure and environmental contamination in selected hospital wards in three government hospitals in Bangladesh. METHODS: The qualitative research team conducted 48 hours of observation in six wards from three Bangladeshi tertiary hospitals in 2007. They recorded environmental contamination with body secretions and excretions and medical waste and observed ward occupant handwashing and use of personal protective equipment. They recorded number of persons, number of open doors and windows, and use of fans. They measured the ward area and informally observed waste disposal outside the wards. They conducted nine focus group discussions with doctors, nurses and support staff. RESULTS: A median of 3.7 persons were present per 10 m(2 of floor space in the wards. A median of 4.9 uncovered coughs or sneezes were recorded per 10 m(2 per hour per ward. Floors in the wards were soiled with saliva, spit, mucous, vomitus, feces and blood 125 times in 48 hours. Only two of the 12 patient handwashing stations had running water and none had soap. No disinfection was observed before or after using medical instruments. Used medical supplies were often discarded in open containers under the beds. Handwashing with soap was observed in only 32 of 3,373 handwashing opportunities noted during 48 hours. Mosquitoes and feral cats were commonly observed in the wards. CONCLUSIONS: The physical structure and environment of our study hospitals are conducive to the spread of infection to people in the wards. Low-cost interventions on hand hygiene and cleaning procedures for rooms and medical equipment should be developed and evaluated for their practicality and effectiveness.

  8. Evaluation of an ultraviolet room disinfection protocol to decrease nursing home microbial burden, infection and hospitalization rates.

    Science.gov (United States)

    Kovach, Christine R; Taneli, Yavuz; Neiman, Tammy; Dyer, Elaine M; Arzaga, Alvin Jason A; Kelber, Sheryl T

    2017-03-03

    The focus of nursing home infection control procedures has been on decreasing transmission between healthcare workers and residents. Less evidence is available regarding whether decontamination of high-touch environmental surfaces impacts infection rates or resident outcomes. The purpose of this study was to examine if ultraviolet disinfection is associated with changes in: 1) microbial counts and adenosine triphosphate counts on high-touch surfaces; and 2) facility wide nursing home acquired infection rates, and infection-related hospitalization. The study was conducted in one 160-bed long-term care facility. Following discharge of each resident, their room was cleaned and then disinfected using a newly acquired ultraviolet light disinfection device. Shared living spaces received weekly ultraviolet light disinfection. Thirty-six months of pretest infection and hospitalization data were compared with 12 months of posttest data. Pre and posttest cultures were taken from high-touch surfaces, and luminometer readings of adenosine triphosphate were done. Nursing home acquired infection rates were analyzed relative to hospital acquired infection rates using analysis of variance procedures. Wilcoxon signed rank tests, The Cochran's Q, and Chi Square were also used. There were statistically significant decreases in adenosine triphosphate readings on all high-touch surfaces after cleaning and disinfection. Culture results were positive for gram-positive cocci or rods on 33% (n = 30) of the 90 surfaces swabbed at baseline. After disinfectant cleaning, 6 of 90 samples (7.1%) tested positive for a gram-positive bacilli, and after ultraviolet disinfection 4 of the 90 samples (4.4%) were positive. There were significant decreases in nursing home acquired relative to hospital-acquired infection rates for the total infections (p = .004), urinary tract infection rates (p = .014), respiratory system infection rates (p = .017) and for rates of infection of the skin

  9. A study of job stress, stress coping strategies, and job satisfaction for nurses working in middle-level hospital operating rooms.

    Science.gov (United States)

    Chen, Chung-Kuang; Lin, Cecilia; Wang, Shu-Hui; Hou, Tung-Hsu

    2009-09-01

    Understanding the interactive relationships between demographics and work-related variables, job stress, job stress coping strategies, and job satisfaction for operating room (OR) nurses is important. The purpose of this study was to determine the stressors, the stress coping strategies, and the job satisfaction of nursing staff who worked in the OR and to evaluate influence of demographic characteristics on job stress, stress coping strategies, and job satisfaction. A cross-sectional research design was used to collect data. Participants included 121 nurses with more than 6 months of work experience at seven hospitals in Yunlin and Chiayi Counties. Data were collected from March through May 2008. One hundred twelve questionnaires were returned, giving a response rate of 92.56%. The questionnaire included four parts designed to gather data on demographics and work-related information, job stress, stress coping strategies, and job satisfaction. Major findings of this study were as follows: (a) stress level and frequency perception of OR nurses were significantly related to the type of hospital; (b) the most intense stressor perceived by OR nurses was patient safety; (c) the stressor most frequently perceived by OR nurses was administrative feedback; (d) although all job stressors were positively related to destructive stress coping strategies, professional status, patient safety, and OR environment were also positively related to constructive stress coping strategies; (e) factors including work rewards, OR environment, and administrative management of job satisfaction were inversely related to destructive stress coping strategies; and (f) factors including work rewards, OR environment, and administrative management of job satisfaction were inversely related to all job stressors. Major suggestions of this study include the following: (a) hospitals should ensure set standard operating procedures for the OR, strengthen the designed-in security of the OR working

  10. Risks of the ionizing radiations for the anesthesia personnel in operating room in Hospital Dr. Rafael Angel Calderon Guardia

    International Nuclear Information System (INIS)

    Moro Alujas, Yassell N.

    2005-01-01

    The extent of the problem on the radiological exposure of anesthesiologists in the operating rooms was identified in the Hospital Rafael Angel Calderon Guardia, San Jose, Costa Rica. It was necessary to establish the risks in the professional disciplines more exposed to ionizing radiations, including Anesthesiology. Provides information on the radiations received by the anesthesia personnel as a risk factor of labor during professional practice. Within the findings were met dose ionizing radiation received by the participating subjects. It was determined that the monthly doses do not reach the limits of permissible dose average. Besides, no relationship was found between the number of procedures that were used ionizing radiations and the values of dosimetric measurements personal; but, if the type of procedure. In this way was showed that in some radiointerventional procedures there is a higher risk of irradiation [es

  11. ATTENTION TO THE EMERGENCY ROOM WITH EMPHASIS ON PRE-HOSPITAL CARE: INTEGRATIVE REVIEW

    Directory of Open Access Journals (Sweden)

    B. S. Santos

    2017-08-01

    Full Text Available The study aims to identify the factors, which influence positively and negatively the implementation of public policies geared to the needs in scope of mobile, found in the publications of brazilian researchers since the implementation of the National Policy of Attention to the Emergency room in Brazil. This is a study of Integrative Literature Review. Composing the basis of methodology, have been used official documents to guide the findings that comprised the conceptual bases of the study and to guide the Integrative Review were used publications that report on the issue in question respecting all steps of the protocol review. The results show the changes in the organizational structure of the Service Mobile Emergency, given the regionalization as something positive for the growth of this service modality and discuss prematurely early articulation between the sectors that make up the public health system in Brazil. In conclusion, the policies of attention to the urgencies, in particular within mobile, have favored beneficially all of the users who require this type of care, in the meantime, make the necessary reflections about this theme in the attempt of a better understanding of the regionalization process and coordination among the municipalities that will offer the mobile care so as to ensure continuity of care through the mechanisms of reference and counter-reference

  12. Modular Robotic System as Multisensory Room in Children’s Hospital

    DEFF Research Database (Denmark)

    Lund, Henrik Hautop; Henningsen, Anders; Nielsen, Rasmus

    2009-01-01

    immediate feedback based upon physical interaction with the system. The modularity, ease of use and the functionality of the devices such as modular robotic tiles and cubic I-BLOCKS suit well into these kinds of scenarios, because they can provide feedback in terms of light, vibration, sound and possibly...... of the tests conducted here at a children’s hospital, is that it was found to be very important to create feedback that was easily recognised by the users, and it was found that the interaction was boring if the feedback was too implicit (subtle) and not well understood by the user. Instead, users appreciated...... explicit immediate feedback very much because it was obvious and understandable, and did not require any a priori knowledge of the application....

  13. Will there be room for the teaching of internal medicine in a university hospital?

    Science.gov (United States)

    Junod, Alain F

    2002-01-12

    To answer the question addressed, two working groups, one made of the staff of a University clinic, the other one composed of practising general internists, have discussed the assets and weaknesses of a University service of Internal Medicine for postgraduate training. The groups agreed on a number of points: patients' characteristics (complexity and co-morbidities), quality of teaching, method acquisition for clinical reasoning, as well as absence of exposure to ambulatory patients and of follow-up. The groups differed in their views related to the lack of training in psychiatry and psychosocial problems or to hospital dysfunctions. Opening of internal medicine to primary care appears to be necessary at the same time as individual qualities among the senior staff are to be developed, such as critical analysis and self-questioning.

  14. Neonatal Resuscitation in the Delivery Room from a Tertiary Level Hospital: Risk Factors and Outcome

    Science.gov (United States)

    Afjeh, Seyyed-Abolfazl; Sabzehei, Mohammad-Kazem; Esmaili, Fatemeh

    2013-01-01

    Objective Timely identification and prompt resuscitation of newborns in the delivery room may cause a decline in neonatal morbidity and mortality. We try to identify risk factors in mother and fetus that result in birth of newborns needing resuscitation at birth. Methods Case notes of all deliveries and neonates born from April 2010 to March 2011 in Mahdieh Medical Center (Tehran, Iran), a Level III Neonatal Intensive Care Unit, were reviewed; relevant maternal, fetal and perinatal data was extracted and analyzed. Findings During the study period, 4692 neonates were delivered; 4522 (97.7%) did not require respiratory assistance. One-hundred seven (2.3%) newborns needed resuscitation with bag and mask ventilation in the delivery unit, of whom 77 (1.6%) babies responded to bag and mask ventilation while 30 (0.65%) neonates needed endotracheal intubation and 15 (0.3%) were given chest compressions. Epinephrine/volume expander was administered to 10 (0.2%) newborns. In 17 patients resuscitation was continued for >10 mins. There was a positive correlation between the need for resuscitation and following risk factors: low birth weight, preterm labor, chorioamnionitis, pre-eclampsia, prolonged rupture of membranes, abruptio placentae, prolonged labor, meconium staining of amniotic fluid, multiple pregnancy and fetal distress. On multiple regression; low birth weight, meconium stained liquor and chorioamnionitis revealed as independent risk factors that made endotracheal intubation necessary. Conclusion Accurate identification of risk factors and anticipation at the birth of a high-risk neonate would result in adequate preparation and prompt resuscitation of neonates who need some level of intervention and thus, reducing neonatal morbidity and mortality. PMID:24910747

  15. Waste management in small hospitals: trouble for environment.

    Science.gov (United States)

    Pant, Deepak

    2012-07-01

    Small hospitals are the grassroots for the big hospital structures, so proper waste management practices require to be initiated from there. Small hospitals contribute a lot in the health care facilities, but due to their poor waste management practices, they pose serious biomedical waste pollution. A survey was conducted with 13 focus questions collected from the 100 hospital present in Dehradun. Greater value of per day per bed waste was found among the small hospitals (178 g compared with 114 g in big hospitals), indicating unskilled waste management practices. Small hospitals do not follow the proper way for taking care of segregation of waste generated in the hospital, and most biomedical wastes were collected without segregation into infectious and noninfectious categories.

  16. Impact of terminal cleaning and disinfection on isolation of Acinetobacter baumannii complex from inanimate surfaces of hospital rooms by quantitative and qualitative methods.

    Science.gov (United States)

    Manian, Farrin A; Griesnauer, Sandra; Senkel, Diane

    2013-04-01

    Quantitative broth cultures were obtained from hospital rooms newly vacated by patients positive for multidrug-resistant Acinetobacter baumannii complex (ABC) before and after terminal cleaning and disinfection. Of 10 ABC-positive precleaned room surfaces, 6 (60%) remained culture-positive after terminal cleaning and disinfection. Of a total of 16 room surfaces with detectable ABC by the quantitative method, 5 (31.2%; 95% confidence interval, 13.9%-55.8%) were also culture-positive by the qualitative technique. Copyright © 2013 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

  17. The microbiological effects of hospital wastes on the environment ...

    African Journals Online (AJOL)

    The effect of twenty four (24) hospital wastes samples taken from different hospitals waste dumpsites on its surrounding soil was examined. The counts of microorganisms in hospital dumpsite soil include the following; aerobic heterotrophic counts from 4.2 x 105 to 1.6 x 1010, anaerobic heterotrophic counts from 1.0 x 105 to ...

  18. Physical environment design criteria for the new control room in the ENEA TRIGA-RC1 plant

    International Nuclear Information System (INIS)

    Alberti, M.; Di Giulio, A.

    1986-01-01

    Parallelly to the plant modifications, many changes of the instrumentation in the Control Room (CR) were necessary in order to deal with the various aged components and the completion and integration needs turning out from the experience in reactor running. In the room, besides the control activity of the RC1 plant, continuous training and updating activities are currently performed which are intended for the operators working in the control rooms of nuclear power plants. The design of the physical environment of the new CR - carried out in a more general research project between ENEA and Politecnico di Milano - was based on the following fundamental criteria: - to ensure conditions fit for the performance of the suspervision, diagnosis and control tasks the operators are entrusted with; - to set up a model of control room for the more complex power plants. First of all a detailed analysis of the environmental conditions relating to microclimate, lighting and noise was accomplished. Afterwards, the goals to be attained were defined as well as the technical means necessary for providing the operators with comfortable working conditions

  19. Use of the hospital anxiety and depression scale (HADS in a cardiac emergency room: chest pain unit

    Directory of Open Access Journals (Sweden)

    Gastão L. F. Soares-Filho

    2009-03-01

    Full Text Available OBJECTIVE: To determine the prevalence of anxiety and depression in patients complaining of chest pain who seek a chest pain unit attendance. INTRODUCTION: Patients arriving at a Chest Pain Unit may present psychiatric disorders not identified, isolated or co-morbid to the main illness, which may interfere in the patient prognosis. METHODOLOGY: Patients were assessed by the "Hospital Anxiety and Depression Scale" as a screening instrument wile following a systematized protocol to rule out the diagnosis of acute coronary syndrome and other potentially fatal diseases. Patients with 8 or more points in the scale were considered "probable case" of anxiety or depression. RESULTS: According to the protocol, 59 (45.4% of 130 patients studied presented Chest Pain of Determined Cause, and 71 (54.6% presented Chest Pain of Indefinite Cause. In the former group, in which 43 (33.1% had acute coronary syndrome, 33.9% were probable anxiety cases and 30.5% depression cases. In the second group, formed by patients without acute coronary syndrome or any clinical conditions involving greater morbidity and mortality risk, 53.5% were probable anxiety cases and 25.4% depression. CONCLUSION: The high anxiety and depression prevalence observed may indicate the need for early and specialized approach to these disorders. When coronary arterial disease is present, this may decrease complications and shorten hospital stay. When psychiatric disorder appears isolated, is possible to reduce unnecessary repeated visits to emergency room and increase patient's quality of life.

  20. Use of the hospital anxiety and depression scale (HADS) in a cardiac emergency room: chest pain unit.

    Science.gov (United States)

    Soares-Filho, Gastão L F; Freire, Rafael C; Biancha, Karla; Pacheco, Ticiana; Volschan, André; Valença, Alexandre M; Nardi, Antonio E

    2009-01-01

    To determine the prevalence of anxiety and depression in patients complaining of chest pain who seek a chest pain unit attendance. Patients arriving at a Chest Pain Unit may present psychiatric disorders not identified, isolated or co-morbid to the main illness, which may interfere in the patient prognosis. Patients were assessed by the 'Hospital Anxiety and Depression Scale' as a screening instrument wile following a systematized protocol to rule out the diagnosis of acute coronary syndrome and other potentially fatal diseases. Patients with 8 or more points in the scale were considered 'probable case' of anxiety or depression. According to the protocol, 59 (45.4%) of 130 patients studied presented Chest Pain of Determined Cause, and 71 (54.6%) presented Chest Pain of Indefinite Cause. In the former group, in which 43 (33.1%) had acute coronary syndrome, 33.9% were probable anxiety cases and 30.5% depression cases. In the second group, formed by patients without acute coronary syndrome or any clinical conditions involving greater morbidity and mortality risk, 53.5% were probable anxiety cases and 25.4% depression. The high anxiety and depression prevalence observed may indicate the need for early and specialized approach to these disorders. When coronary arterial disease is present, this may decrease complications and shorten hospital stay. When psychiatric disorder appears isolated, is possible to reduce unnecessary repeated visits to emergency room and increase patient's quality of life.

  1. A Boiler Room in a 600-Bed Hospital Complex: Study, Analysis, and Implementation of Energy Efficiency Improvements

    Directory of Open Access Journals (Sweden)

    Juan-Carlos Fraile

    2014-05-01

    Full Text Available The aim of energy efficiency is to use less energy to provide the same service. In hospitals, energy efficiency offers a powerful and cost-effective tool to reduce greenhouse gas emissions, fuel consumption, and also running costs. Over a six-month period, the six gas-fired boilers that provide both a hospital’s heat and hot water were monitored. Analysis of the data obtained led to several actions being implemented in the hospital boiler room control system to improve the efficiency of the heat production system. Comparative studies were conducted, during similar weather periods, of the performance of the hospital’s hot water production system before and after the controls were implemented. Results indicate that the control actions applied proved to be effective. Finally; the paper offers a financial; primary energy saving and CO2 reduction analysis that points to a 3,434.00 €/week savings in natural gas consumption; and a cut in CO2 emissions of 20.3 tons/week; as compared to the reference facility.

  2. Costs of disposable material in the operating room do not show high correlation with surgical time: Implications for hospital payment.

    Science.gov (United States)

    Delo, Caroline; Leclercq, Pol; Martins, Dimitri; Pirson, Magali

    2015-08-01

    The objectives of this study are to analyze the variation of the surgical time and of disposable costs per surgical procedure and to analyze the association between disposable costs and the surgical time. The registration of data was done in an operating room of a 419 bed general hospital, over a period of three months (n = 1556 surgical procedures). Disposable material per procedure used was recorded through a barcode scanning method. The average cost (standard deviation) of disposable material is €183.66 (€183.44). The mean surgical time (standard deviation) is 96 min (63). Results have shown that the homogeneity of operating time and DM costs was quite good per surgical procedure. The correlation between the surgical time and DM costs is not high (r = 0.65). In a context of Diagnosis Related Group (DRG) based hospital payment, it is important that costs information systems are able to precisely calculate costs per case. Our results show that the correlation between surgical time and costs of disposable materials is not good. Therefore, empirical data or itemized lists should be used instead of surgical time as a cost driver for the allocation of costs of disposable materials to patients. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  3. The use of a metronome during cardiopulmonary resuscitation in the emergency room of a university hospital

    Directory of Open Access Journals (Sweden)

    Renata Maria de Oliveira Botelho

    Full Text Available ABSTRACT Objective: to compare the rate of return of spontaneous circulation (ROSC and death after cardiac arrest, with and without the use of a metronome during cardiopulmonary resuscitation (CPR. Method: case-control study nested in a cohort study including 285 adults who experienced cardiac arrest and received CPR in an emergency service. Data were collected using In-hospital Utstein Style. The control group (n=60 was selected by matching patients considering their neurological condition before cardiac arrest, the immediate cause, initial arrest rhythm, whether epinephrine was used, and the duration of CPR. The case group (n=51 received conventional CPR guided by a metronome set at 110 beats/min. Chi-square and likelihood ratio were used to compare ROSC rates considering p≤0.05. Results: ROSC occurred in 57.7% of the cases, though 92.8% of these patients died in the following 24 hours. No statistically significant difference was found between groups in regard to ROSC (p=0.2017 or the occurrence of death (p=0.8112. Conclusion: the outcomes of patients after cardiac arrest with and without the use of a metronome during CPR were similar and no differences were found between groups in regard to survival rates and ROSC.

  4. Aspects related to the occurrence of workplace violence in hospital emergency rooms

    Directory of Open Access Journals (Sweden)

    Amanda Alves Miranda de Souza

    2014-03-01

    Full Text Available Objetivo: Analisar os aspectos relacionados à violência ocupacional nos setores de urgência de um hospital situado em Natal, Rio Grande do Norte. Método: Estudo exploratório e descritivo, com abordagem quantitativa. Para a coleta de dados foi utilizado um questionário validado, cujos pesquisados eram as equipes de enfermagem dos setores selecionados. Resultados: Dentre os 86 questionados, 87,2% eram mulheres, 49,4% tinham ensino médio completo e 46,5% eram casados. A ocorrência da violência foi considerada normal por 82,9% e 91,8% dos sujeitos relataram nunca ter participado de algum treinamento sobre como agir no momento do ato de violência. Conclusão: É necessária a construção de políticas nacionais e institucionais que atuem sobre a violência, além da minimização da sua invisibilidade desde o ensino na graduação destes profissionais, até o ambiente laboral. Descritores: Condições de Trabalho, Equipe de Enfermagem, Qualidade de Vida, Saúde do Trabalhador, Violência.

  5. Consumer Nutrition Environments of Hospitals: An Exploratory Analysis Using the Hospital Nutrition Environment Scan for Cafeterias, Vending Machines, and Gift Shops, 2012

    Science.gov (United States)

    Sallis, James F.; Swartz, Michael D.; Hoelscher, Deanna M.; Peskin, Melissa F.

    2013-01-01

    Introduction Hospitals are the primary worksite of over 5 million adults in the United States, and millions of meals are procured and consumed in this setting. Because many worksite nutrition initiatives use an ecological framework to improve the dietary habits of employees, the nutrition values of foods served in hospitals is receiving attention. Methods This study used the Hospital Nutrition Environment Scan for Cafeterias, Vending Machines, and Gift Shops to quantitatively describe the consumer nutrition environments of 39 hospitals in Southern California. Data were collected by visiting each facility once from February 2012 through May 2012. Results On average, hospitals achieved only 29%, 33%, and less than 1% of the total possible points for their cafeteria, vending machines, and gift shops sections, respectively; overall, hospitals scored 25% of the total possible points. Large facility size and contracted food service operations were associated with some healthy practices in hospital cafeterias, but we found no association between these variables and the sectional or overall nutrition composite scores. Conclusion The average consumer nutrition environment of hospitals in this sample was minimally conducive to healthful eating. Nutrition-related interventions are warranted in hospital settings. PMID:23823699

  6. Consumer nutrition environments of hospitals: an exploratory analysis using the Hospital Nutrition Environment Scan for Cafeterias, Vending Machines, and Gift Shops, 2012.

    Science.gov (United States)

    Winston, Courtney P; Sallis, James F; Swartz, Michael D; Hoelscher, Deanna M; Peskin, Melissa F

    2013-07-03

    Hospitals are the primary worksite of over 5 million adults in the United States, and millions of meals are procured and consumed in this setting. Because many worksite nutrition initiatives use an ecological framework to improve the dietary habits of employees, the nutrition values of foods served in hospitals is receiving attention. This study used the Hospital Nutrition Environment Scan for Cafeterias, Vending Machines, and Gift Shops to quantitatively describe the consumer nutrition environments of 39 hospitals in Southern California. Data were collected by visiting each facility once from February 2012 through May 2012. On average, hospitals achieved only 29%, 33%, and less than 1% of the total possible points for their cafeteria, vending machines, and gift shops sections, respectively; overall, hospitals scored 25% of the total possible points. Large facility size and contracted food service operations were associated with some healthy practices in hospital cafeterias, but we found no association between these variables and the sectional or overall nutrition composite scores. The average consumer nutrition environment of hospitals in this sample was minimally conducive to healthful eating. Nutrition-related interventions are warranted in hospital settings.

  7. Use of a "secure room" and a security guard in the management of the violent, aggressive or suicidal patient in a rural hospital: a 3-year audit.

    Science.gov (United States)

    Brock, Gordon; Gurekas, Vydas; Gelinas, Anne-Fredrique; Rollin, Karina

    2009-01-01

    Little has been published on the management of psychiatric crises in rural areas, and little is known of the security needs or use of "secure rooms" in rural hospitals. We conducted a 3-year retrospective chart audit on the use of our secure room/security guard system at a rural hospital in a town of 3500, located 220 km from our psychiatric referral centre. Use of our secure room/security guard system occurred at the rate of 1.1 uses/1000 emergency department visits, with the most common indication being physician perception of risk of patient suicide or self-harm. Concern for staff safety was a factor in 10% of uses. Eighty percent of patients were treated locally, with most being released from the secure room after 2 days or less. Fourteen percent of patients required ultimate transfer to our psychiatric referral centre and 6% to a detoxification centre. The average annual cost of security was $16 259.61. A secure room can provide the opportunity for close observation of a potentially self-harming patient, additional security for staff and early warning if a patient flees the hospital. Most admissions were handled locally, obviating the need for transfer to distant psychiatric referral centres. Most patients who were admitted were already known as having a psychiatric illness and 80% of the patients required the use of the secure room/security guard system for less than a 2-night stay, suggesting that most rural mental health crises pass quickly. Most patients admitted to a rural hospital with a mental health crisis can be managed locally if an adequate secure room/security guard system is available.

  8. Management challenges at the intersection of public policy environments and strategic decision making in public hospitals.

    Science.gov (United States)

    Longest, Beaufort B

    2012-01-01

    Hospitals in the United States are heavily impacted by public policies that affect them. For example, Medicare and Medicaid programs account for more than half the revenue in most of the nation's almost 5,000 community hospitals, including the almost 1,100 public hospitals controlled by state and local governments (American Hospital Association, 2012). The public hospitals are especially closely aligned with and controlled by governmental entities compared with hospitals with other kinds of sponsorship. This article addresses the management challenges at the intersection of the strategic management of public hospitals and their public policy environments. Public hospitals are complicated entities designed not only to provide health services but also in many cases to play key roles in health-related research and education and to play important general economic development roles in their communities. The multi-faceted strategic decision making in these organizations is as heavily affected by their public policy environments as by their business, demographic, technological or other external environments. Effectively managing the intersection of their public policy environments and their strategic management is indeed vital for contemporary public hospitals. This article is intended to clarify certain aspects of this intersection through a description and model of the strategic activity in public hospitals and the connection between this activity and their external environments. Specific attention is focused on the concept of public policy environments and their features. Attention is also given to how managers can assess public policy environments and incorporate the results into strategic activities.

  9. The use of a metronome during cardiopulmonary resuscitation in the emergency room of a university hospital.

    Science.gov (United States)

    Botelho, Renata Maria de Oliveira; Campanharo, Cássia Regina Vancini; Lopes, Maria Carolina Barbosa Teixeira; Okuno, Meiry Fernanda Pinto; Góis, Aécio Flávio Teixeira de; Batista, Ruth Ester Assayag

    2016-11-21

    to compare the rate of return of spontaneous circulation (ROSC) and death after cardiac arrest, with and without the use of a metronome during cardiopulmonary resuscitation (CPR). case-control study nested in a cohort study including 285 adults who experienced cardiac arrest and received CPR in an emergency service. Data were collected using In-hospital Utstein Style. The control group (n=60) was selected by matching patients considering their neurological condition before cardiac arrest, the immediate cause, initial arrest rhythm, whether epinephrine was used, and the duration of CPR. The case group (n=51) received conventional CPR guided by a metronome set at 110 beats/min. Chi-square and likelihood ratio were used to compare ROSC rates considering p≤0.05. ROSC occurred in 57.7% of the cases, though 92.8% of these patients died in the following 24 hours. No statistically significant difference was found between groups in regard to ROSC (p=0.2017) or the occurrence of death (p=0.8112). the outcomes of patients after cardiac arrest with and without the use of a metronome during CPR were similar and no differences were found between groups in regard to survival rates and ROSC. comparar a taxa de retorno da circulação espontânea e óbito após parada cardiorrespiratória, com e sem a utilização do metrônomo durante ressuscitação cardiopulmonar. estudo caso-controle aninhado a estudo de coorte, com 285 adultos atendidos em parada cardíaca em um serviço de emergência e submetidos à ressuscitação cardiopulmonar. Os dados foram coletados por meio do In-hospital Utstein Style. O grupo controle (n=60) foi selecionado pelo pareamento dos pacientes considerando-se o estado neurológico pré-parada cardiorrespiratória, causa imediata e ritmo inicial da parada, utilização de epinefrina e duração da ressuscitação. O grupo caso (n=51) foi submetido à ressuscitação cardiopulmonar convencional com a utilização do metrônomo a 110sons/min. Para comparar

  10. Using integrated control methodology to optimize energy performance for the guest rooms in UAE hospitality sector

    International Nuclear Information System (INIS)

    AlFaris, Fadi; Abu-Hijleh, Bassam; Abdul-Ameer, Alaa

    2016-01-01

    Highlights: • Energy efficiency in 4 and 5 star luxury hotels in the United Arab Emirates. • The normalized energy use index (EUI) ranges between 241.5 and 348.4 kWh/m"2/year for post 2003 hotels. • The normalized energy use index (EUI) ranges between 348.4 and 511.1 kWh/m"2/year for pre 2003 hotels. • Integrated HVAC and lighting control strategies can reduce total energy consumption by up to 31.5%. - Abstract: The hospitality sector is growing rapidly in the UAE and especially in Dubai. As a result, it contributes substantially in the UAE's carbon footprint. This research was conducted to measure, evaluate and increase the energy efficiency in 4 and 5 star luxury hotels in UAE. Energy benchmarking analysis was used to analyze the energy data of 19 hotel buildings to differentiate between usual and best practice of energy performance. Moreover, the normalized energy use index (EUI) kWh/m"2/year has been identified for the best, usual and poor practice hotels. It was found that the normalized EUI ranges between 241.5 kWh/m"2/year or less as a best practice to more than 361.3 kWh/m"2/year of the poor energy practice for the hotels constructed after the year of 2003. Whereas the hotels' energy data showed higher values for those constructed before 2003, as the normalized EUI varies between 348.4 kWh/m"2/year as best practice to more than 511.1 kWh/m"2/year. An integrated control strategy has been employed to improve the energy performance and assess the energy saving for the guestroom. This technique showed that the overall energy performance improvement reached to 31.5% out of entire energy consumption of the hotel including electricity and gas. This reduction resulted in 43.2% savings from the cooling system and 13.2% from the lighting system due to the installing of the integrated control system in the guestrooms.

  11. The effects of nature images on pain in a simulated hospital patient room.

    Science.gov (United States)

    Vincent, Ellen; Battisto, Dina; Grimes, Larry; McCubbin, James

    2010-01-01

    Views of nature have been reported to relieve stress and pain, making nature an ideal medium for use in healthcare settings. In hospitals whose design does not allow for a view of nature, virtual and surrogate views of nature may be viable therapeutic options. This study tests the effects of specific nature images, as defined by Appleton's prospect refuge theory of landscape preference, on participants experiencing pain. The hypotheses were: (1) Nature views are variable in their impact on specific psychological and physiological health status indicators; and (2) Prospect and refuge nature scenes are more therapeutic than hazard nature scenes. The research question was (1) Which nature image categories are most therapeutic as evidenced by reduced pain and positive mood? An experiment using mixed methods assessed the effects of four different nature scenes on physiological (blood pressure, heart rate) and psychological (mood) responses when a person was subjected to a pain stressor. Four groups were subjected to a specific nature image category of prospect, refuge, hazard, or mixed prospect and refuge; the fifth group viewed no image. The Short-Form McGill Pain Questionnaire and the Profile of Mood States survey instruments were used to assess pain and mood, respectively. Continuous physiological readings of heart rate and blood pressure were collected. Pain was induced through a cold pressor task, which required participants to immerse their nondominant hand in ice water for up to 120 seconds. The mixed prospect and refuge image treatment showed significantly lower sensory pain responses, and the no-image treatment indicated significantly higher affective pain perception responses. The hazard image treatment had significantly lower diastolic blood pressure readings during the pain treatment, but it also had significantly high total mood disturbance. Although there was no clear "most" therapeutic image, the mixed prospect and refuge image showed significant

  12. Assessment of Educational Environment of Surgical Theatre at a Teaching Hospital of a Saudi University: Using Surgical Theatre Educational Environment Measures

    Directory of Open Access Journals (Sweden)

    Mona Faisal Al-Qahtani

    2012-05-01

    Full Text Available Objectives: This study was aimed to determine how medical interns perceive the important factors of the learning environment the surgical theatre at the teaching hospital of the medical school, University of Dammam (UoD. The study also investigated the relationships between the learning environment and academic achievements. Finally, it determined the role and significance of gender on the above perceptions and relationships.Methods: The Surgical Theatre Educational Environment Measure (STEEM was used to identify the perceptions of interns on the most important factors prevalent in the surgical theatre as an educational environment. STEEM was administered to all interns during the period of June-September 2009. Ninety-one out of 145 students completed the questionnaire representing a response rate of 63%. Non-parametric statistical analysis was performed using Statistical Package for the Social Sciences (SPSS Version 17.Results: The STEEM was shown to be internally consistent for the assessment of the overall educational environment in the surgical theatre of UoD. The overall STEEM mean score was 110. For male and female students, the mean scores were 114 and 107 respectively. There were statistically significant gender differences in the perceptions of "learning opportunities" and "teaching and training". Females rated these subscales lower than males. There were no significant associations between academic achievements and perceptions of the educational environment.Conclusion: The interns perceived the learning environment of the surgical theatre as less than satisfactory. In comparison with the males; the perception of the females was less positive, particularly in the areas of learning opportunities, and teaching and training. The study also revealed some other problematic areas in the learning environment of surgical theatre of the teaching hospital of UoD. The results imply that there is much room for improvement. They also indicate that

  13. [Improving operating room efficiency: an observational and multidimensional approach in the San Camillo-Forlanini Hospital, Rome].

    Science.gov (United States)

    Mitello, Lucia; D'Alba, Fabrizio; Milito, Francesca; Monaco, Cinzia; Orazi, Daniela; Battilana, Daniela; Marucci, Anna Rita; Longo, Angelo; Latina, Roberto

    2017-01-01

    The management of operating rooms (ORs) is a complex process which requires an effective organizational scheme. In order to amore convinient allocation of resources a rigorous monitoring plan is needed to ensure operating rooms performances. All the necessary actions should be taken to improve the quality of the planning and scheduling procedure. Between April-December, 2016 an organizational analysis has been carried out on the performances of the A.O. S. Camillo-Forlanini Hospital Operating Block applying the "process management" approach to the ORs efficiency. The project involved two different surgical areas of the same operating block the multi-specialist and elective surgery and cardio-vascular surgery . The analyses of the processes was made through the product, patient and safety approach and from different points of view: the "asis", process and stakeholder perspectives. Descriptive statistics was used to process raw data and Student's t-distribution was used to assess the difference between the two means (significant p value ˂0,05). The Coefficient of Variation (CV) was used to describe the variabilityamong data. The asis approach allowed us to describe the ORs inbound activities. For both operating block the most demanding weekly commitments in terms of time turned out to be the inventory management procedures of controlling and stocking medicines, general medical supplies and instruments (130[DS=±14] for BOE and 30[DS=±18] for CCH. The average time spent on preparing the operating room, separately calculated starting from the first surgical case, was of 27 minutes (SD=± 17) while for the following surgical procedures preparation time decreased to 15 minutes (SD= ± 10), which highlighted a meaningful difference of 12 minutes. A great variability was registered in CCH due to the unpredictability of these operations (CV 82%). The stakeholders' perspective revealed a reasonable level of satisfaction among nurses and surgeons (2.9 vs 2.3, respectively

  14. Exposure to Exhaled Air from a Sick Occupant in a Two-Bed Hospital Room with Mixing Ventilation: Effect of Posture of Doctor and Air Change Rate

    DEFF Research Database (Denmark)

    Bolashikov, Zhecho Dimitrov; Melikov, Arsen Krikor; Barova, Mariya

    2013-01-01

    Full-scale measurements were performed in a climate chamber set as a two-bed hospital room, ventilated at 3, 6 and 12 ACH with overhead mixing ventilation. Air temperature was kept constant at 22 °C. Two breathing thermal manikins were used to mimic a sick patient lying on one side in one of the ...

  15. Exposure to coughed airborne pathogens in a double bed hospital patient room with overhead mixing ventilation: impact of posture of coughing patient and location of doctor

    DEFF Research Database (Denmark)

    Kierat, W.; Bolashikov, Zhecho Dimitrov; Melikov, Arsen Krikor

    2010-01-01

    The exposure of a doctor and a patient to air coughed by a second infected patient was studied in a mock-up of two-bed hospital infectious ward with mixing ventilation at 22oC (71.6 F) room air temperature. The effect of posture of the coughing patient lying sideways or on back), position...

  16. The thermal comfort, the indoor environment control, and the energy consumption in three types of operating rooms

    Energy Technology Data Exchange (ETDEWEB)

    Melhado, M.A.; Hensen, J.M. [Eindhoven Technical Univ., Eindhoven (Netherlands). Center for Building and Systems; Beyer, P.O. [Rio Grande do Sul Federal Univ., Rio Grande do Sul (Brazil). Dept. of Mechanical Engineering; Siqueira, L.F.G. [Sao Paulo Univ., Sao Paulo (Brazil). Dept. of Epidemiology

    2005-07-01

    This paper investigated the influence of layout on the thermal comfort, indoor environment and energy consumption in different types of operating rooms (OR) in Brazil. Three different types of layout were evaluated: (1) a hallway and a surgery room; (2) a clean hallway, an operating room, and another hallway; and (3) a hallway, an anteroom and an operating room. The dimensions of the environments were established by Ministerio da Saude regulations. Modeling was achieved with EnergyPlus software. Orthopaedic and abdominal surgeries were considered. The type of surgery defined the dimensions of the environment, patient requirements and the number of people, as well as the amount and type of equipment and hours spent in the ORs, and these parameters were used in the simulation. Two types of software were used: Cterm version 2002 and EnergyPlus version 1.03. The results in of the simulation were in agreement with previous experiments in the literature. Cterm was used to calculate the levels of activity of different people, the thermal resistance of clothes and work activity. Data included the relative humidity and wind speed. The data were then used in the EnergyPlus simulation. Heat source variables included medical equipment, lighting and cleaning activities, as well as temperatures for neighbouring environments and climatic conditions. Results indicated that out of 60 cases simulated, 88 per cent presented a relative humidity above acceptable limits. Dehumidifiers were added to the simulation, which in turn influenced overall energy consumption. Patient discomfort was measured, as well the comfort levels of the anesthesiologist. Details of annual energy consumption for the different scenarios were presented. It was concluded that layout had a significant impact on the thermal comfort of the ORs, as well as on relative humidity and temperature. Case 2 presented the most significant advantages relating to environmental control. However, case 2 was also the most

  17. Association between birth order and emergency room visits and acute hospital admissions following pediatric vaccination: a self-controlled study.

    Science.gov (United States)

    Hawken, Steven; Kwong, Jeffrey C; Deeks, Shelley L; Crowcroft, Natasha S; Ducharme, Robin; Manuel, Douglas G; Wilson, Kumanan

    2013-01-01

    We investigated the association between a child's birth order and emergency room (ER) visits and hospital admissions following 2-,4-,6- and 12-month pediatric vaccinations. We included all children born in Ontario between April 1(st), 2006 and March 31(st), 2009 who received a qualifying vaccination. We identified vaccinations, ER visits and admissions using health administrative data housed at the Institute for Clinical Evaluative Sciences. We used the self-controlled case series design to compare the relative incidence (RI) of events among 1(st)-born and later-born children using relative incidence ratios (RIR). For the 2-month vaccination, the RIR for 1(st)-borns versus later-born children was 1.37 (95% CI: 1.19-1.57), which translates to 112 additional events/100,000 vaccinated. For the 4-month vaccination, the RIR for 1(st)-borns vs. later-borns was 1.70 (95% CI: 1.45-1.99), representing 157 additional events/100,000 vaccinated. At 6 months, the RIR for 1(st) vs. later-borns was 1.27 (95% CI: 1.09-1.48), or 77 excess events/100,000 vaccinated. At the 12-month vaccination, the RIR was 1.11 (95% CI: 1.02-1.21), or 249 excess events/100,000 vaccinated. Birth order is associated with increased incidence of ER visits and hospitalizations following vaccination in infancy. 1(st)-born children had significantly higher relative incidence of events compared to later-born children.

  18. Association between birth order and emergency room visits and acute hospital admissions following pediatric vaccination: a self-controlled study.

    Directory of Open Access Journals (Sweden)

    Steven Hawken

    Full Text Available OBJECTIVE: We investigated the association between a child's birth order and emergency room (ER visits and hospital admissions following 2-,4-,6- and 12-month pediatric vaccinations. METHODS: We included all children born in Ontario between April 1(st, 2006 and March 31(st, 2009 who received a qualifying vaccination. We identified vaccinations, ER visits and admissions using health administrative data housed at the Institute for Clinical Evaluative Sciences. We used the self-controlled case series design to compare the relative incidence (RI of events among 1(st-born and later-born children using relative incidence ratios (RIR. RESULTS: For the 2-month vaccination, the RIR for 1(st-borns versus later-born children was 1.37 (95% CI: 1.19-1.57, which translates to 112 additional events/100,000 vaccinated. For the 4-month vaccination, the RIR for 1(st-borns vs. later-borns was 1.70 (95% CI: 1.45-1.99, representing 157 additional events/100,000 vaccinated. At 6 months, the RIR for 1(st vs. later-borns was 1.27 (95% CI: 1.09-1.48, or 77 excess events/100,000 vaccinated. At the 12-month vaccination, the RIR was 1.11 (95% CI: 1.02-1.21, or 249 excess events/100,000 vaccinated. CONCLUSIONS: Birth order is associated with increased incidence of ER visits and hospitalizations following vaccination in infancy. 1(st-born children had significantly higher relative incidence of events compared to later-born children.

  19. [Feasibility and relevance of an operating room safety checklist for developing countries: Study in a French hospital in Djibouti].

    Science.gov (United States)

    Becret, A; Clapson, P; Andro, C; Chapelier, X; Gauthier, J; Kaiser, E

    2013-01-01

    The use of the World Health Organization surgical safety checklist, mandatory in operating rooms (OR) in France, significantly reduces morbidity and mortality. Our objective was to evaluate the use of this checklist in the OR of a French military hospital in Djibouti (Horn of Africa). The study was performed in three stages: a retrospective evaluation of the checklist use over the previous two months, to assess the utilization and completeness rates; provision of information to the OR staff; and thereafter, prospective evaluation for a one-month period of checklist use, the reasons for non-compliance, and the cases in which the checklist identified errors and thus prevented serious adverse events. The initial utilization rate was 49%, with only 24% complete. After staff training and during the study these rates reached 100% and 99%. The staff encountered language difficulties in 53% of cases, and an interpreter was available for 81% of them. The capacity of the surgical safety checklist to detect serious adverse events was highlighted. The utilization and completeness rates were initially worse than those observed in metropolitan French ORs, but a simple staff information program was rapidly effective. Language difficulties are frequent but an interpreter is often available, unlike in developed countries where language problems are uncommon and the availability of interpreters difficult. Moreover, this study illustrates the ability of the checklist to detect and therefore prevent potentially serious adverse events.

  20. Diversity changes of microbial communities into hospital surface environments.

    Science.gov (United States)

    Yano, Rika; Shimoda, Tomoko; Watanabe, Reina; Kuroki, Yasutoshi; Okubo, Torahiko; Nakamura, Shinji; Matsuo, Junji; Yoshimura, Sadako; Yamaguchi, Hiroyuki

    2017-07-01

    Previous works have demonstrated considerable variability in hospital cleanliness in Japan, suggesting that contamination is driven by factors that are currently poorly controlled. We undertook 16S rRNA sequence analysis to study population structures of hospital environmental microbiomes to see which factor(s) impacted contamination. One hundred forty-four samples were collected from surfaces of three hospitals with distinct sizes ("A": >500 beds, "B": 100-500 beds, "C": diversity changes of hospital environmental microbiomes with a skewed population, presumably by medical staff pushing NWs or sinks shared by patients or visitors. Copyright © 2017 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

  1. Comparison of the Value of Nursing Work Environments in Hospitals Across Different Levels of Patient Risk.

    Science.gov (United States)

    Silber, Jeffrey H; Rosenbaum, Paul R; McHugh, Matthew D; Ludwig, Justin M; Smith, Herbert L; Niknam, Bijan A; Even-Shoshan, Orit; Fleisher, Lee A; Kelz, Rachel R; Aiken, Linda H

    2016-06-01

    The literature suggests that hospitals with better nursing work environments provide better quality of care. Less is known about value (cost vs quality). To test whether hospitals with better nursing work environments displayed better value than those with worse nursing environments and to determine patient risk groups associated with the greatest value. A retrospective matched-cohort design, comparing the outcomes and cost of patients at focal hospitals recognized nationally as having good nurse working environments and nurse-to-bed ratios of 1 or greater with patients at control group hospitals without such recognition and with nurse-to-bed ratios less than 1. This study included 25 752 elderly Medicare general surgery patients treated at focal hospitals and 62 882 patients treated at control hospitals during 2004-2006 in Illinois, New York, and Texas. The study was conducted between January 1, 2004, and November 30, 2006; this analysis was conducted from April to August 2015. Focal vs control hospitals (better vs worse nursing environment). Thirty-day mortality and costs reflecting resource utilization. This study was conducted at 35 focal hospitals (mean nurse-to-bed ratio, 1.51) and 293 control hospitals (mean nurse-to-bed ratio, 0.69). Focal hospitals were larger and more teaching and technology intensive than control hospitals. Thirty-day mortality in focal hospitals was 4.8% vs 5.8% in control hospitals (P value in the focal group. For the focal vs control hospitals, the greatest mortality benefit (17.3% vs 19.9%; P risk quintile, with a nonsignificant cost difference of $941 per patient ($53 701 vs $52 760; P = .25). The greatest difference in value between focal and control hospitals appeared in patients in the second-highest risk quintile, with mortality of 4.2% vs 5.8% (P value (lower mortality with similar costs) compared with hospitals without nursing environment recognition and with below-average staffing, especially for higher

  2. Introducing Namaste Care to the hospital environment: a pilot study.

    Science.gov (United States)

    St John, Kimberley; Koffman, Jonathan

    2017-10-01

    The rising prevalence of dementia is impacting on acute hospitals and placing increased expectations on health and social care professionals to improve the support and services they are delivering. It has been recommended that good practice in dementia care relies on adopting a palliative approach to care and meeting people's physical, psychological, social and spiritual needs. Increased dementia training for staff that includes initiatives that promote dignity; enhancing communication skills and recognizing that a person with dementia may be approaching the end of their lives are needed. Our study aim was to explore whether Namaste Care is an acceptable and effective service for people with advanced dementia being cared for on an acute hospital ward. This was an exploratory qualitative interview, pilot study. Individual, semi-structured, face-to-face interviews were conducted with hospital healthcare staff working in an area of the hospital where Namaste Care had been implemented. Data were analysed using the framework approach. Eight interviews were completed with members of the multidisciplinary ward team. Two themes were identified: (I) difficulties establishing relationships with people with dementia in hospital (subthemes: lack of time and resources, lack of confidence leading to fear and anxiety); (II) the benefits of a Namaste Care service in an acute hospital setting (subthemes: a reduction in agitated behavior; connecting and communicating with patients with dementia using the senses; a way of showing people with dementia they are cared for and valued). This small-scale study indicates that Namaste Case has the potential to improve the quality of life of people with advanced dementia being cared for in an acute hospital setting. However, further research is required to explore more specifically its benefits in terms of improved symptom management and wellbeing of people with dementia on acute hospitals wards.

  3. Indoor air bacterial load and antibiotic susceptibility pattern of isolates in operating rooms and surgical wards at jimma university specialized hospital, southwest ethiopia.

    Science.gov (United States)

    Genet, Chalachew; Kibru, Gebre; Tsegaye, Wondewosen

    2011-03-01

    Surgical site infection is the second most common health care associated infection. One of the risk factors for such infection is bacterial contamination of operating rooms' and surgical wards' indoor air. In view of that, the microbiological quality of air can be considered as a mirror of the hygienic condition of these rooms. Thus, the objective of this study was to determine the bacterial load and antibiotic susceptibility pattern of isolates in operating rooms' and surgical wards' indoor air of Jimma University Specialized Hospital. A cross sectional study was conducted to measure indoor air microbial quality of operating rooms and surgical wards from October to January 2009/2010 on 108 indoor air samples collected in twelve rounds using purposive sampling technique by Settle Plate Method (Passive Air Sampling following 1/1/1 Schedule). Sample processing and antimicrobial susceptibility testing were done following standard bacteriological techniques. The data was analyzed using SPSS version 16 and interpreted according to scientifically determined baseline values initially suggested by Fisher. The mean aerobic colony counts obtained in OR-1(46cfu/hr) and OR-2(28cfu/hr) was far beyond the set 5-8cfu/hr acceptable standards for passive room. Similarly the highest mean aerobic colony counts of 465cfu/hr and 461cfu/hr were observed in Female room-1 and room-2 respectively when compared to the acceptable range of 250-450cfu/hr. In this study only 3 isolates of S. pyogenes and 48 isolates of S. aureus were identified. Over 66% of S. aureus was identified in Critical Zone of Operating rooms. All isolates of S. aureus showed 100% and 82.8% resistance to methicillin and ampicillin respectively. Higher degree of aerobic bacterial load was measured from operating rooms' and surgical wards' indoor air. Reducing foot trafficking, improving the ventilation system and routine cleaning has to be made to maintain the aerobic bacteria load with in optimal level.

  4. Impact of the physical environment in paediatric hospitals on health outcomes: a systematic review.

    Science.gov (United States)

    Watts, Robin; Wilson, Sally

    support a healing environment within paediatric hospitals or paediatric wards in general hospitals. The review clearly illustrates the need for more research in this area assessing the health outcomes of innovations in physical design in paediatric hospitals or units. There are numerous opportunities for multidisciplinary studies and in varying cultural contexts. This review suggests a number of aspects of physical design that can be implemented although cost and cultural appropriateness are a consideration in several cases. These include the use of single rooms with negative pressure ventilation to control cross infection; the provision of both private and 'public' space for adolescent inpatients with 'public' spaces including spaces for interaction just with other peers; the incorporation of interactive gardens, however small, designed for families and their use encouraged by staff; and specially designed play structures to encourage symbolic play.

  5. Structural characteristics of hospitals and nurse-reported care quality, work environment, burnout and leaving intentions.

    Science.gov (United States)

    Lindqvist, Rikard; Smeds Alenius, Lisa; Griffiths, Peter; Runesdotter, Sara; Tishelman, Carol

    2015-03-01

    To investigate whether hospital characteristics not readily susceptible to change (i.e. hospital size, university status, and geographic location) are associated with specific self-reported nurse outcomes. Research often focuses on factors within hospitals (e.g. work environment), which are susceptible to change, rather than on structural factors in their own right. However, numerous assumptions exist about the role of structural factors that may lead to a sense of pessimism and undermine efforts at constructive change. Data was derived from survey questions on assessments of work environment and satisfaction, intention to leave, quality of care and burnout (measured by the Maslach Burnout Inventory), from a population-based sample of 11 000 registered nurses in Sweden. Mixed model regressions were used for analysis. Registered nurses in small hospitals were slightly more likely to rank their working environment and quality of nursing care better than others. For example 23% of staff in small hospitals were very satisfied with the work environment compared with 20% in medium-sized hospitals and 21% in large hospitals. Registered nurses in urban areas, who intended to leave their job, were more likely to seek work in another hospital (38% vs. 32%). While some structural factors were related to nurse-reported outcomes in this large sample, the associations were small or of questionable importance. The influence of structural factors such as hospital size on nurse-reported outcomes is small and unlikely to negate efforts to improve work environment. © 2013 John Wiley & Sons Ltd.

  6. Sound Spectrum Influences Auditory Distance Perception of Sound Sources Located in a Room Environment

    Directory of Open Access Journals (Sweden)

    Ignacio Spiousas

    2017-06-01

    Full Text Available Previous studies on the effect of spectral content on auditory distance perception (ADP focused on the physically measurable cues occurring either in the near field (low-pass filtering due to head diffraction or when the sound travels distances >15 m (high-frequency energy losses due to air absorption. Here, we study how the spectrum of a sound arriving from a source located in a reverberant room at intermediate distances (1–6 m influences the perception of the distance to the source. First, we conducted an ADP experiment using pure tones (the simplest possible spectrum of frequencies 0.5, 1, 2, and 4 kHz. Then, we performed a second ADP experiment with stimuli consisting of continuous broadband and bandpass-filtered (with center frequencies of 0.5, 1.5, and 4 kHz and bandwidths of 1/12, 1/3, and 1.5 octave pink-noise clips. Our results showed an effect of the stimulus frequency on the perceived distance both for pure tones and filtered noise bands: ADP was less accurate for stimuli containing energy only in the low-frequency range. Analysis of the frequency response of the room showed that the low accuracy observed for low-frequency stimuli can be explained by the presence of sparse modal resonances in the low-frequency region of the spectrum, which induced a non-monotonic relationship between binaural intensity and source distance. The results obtained in the second experiment suggest that ADP can also be affected by stimulus bandwidth but in a less straightforward way (i.e., depending on the center frequency, increasing stimulus bandwidth could have different effects. Finally, the analysis of the acoustical cues suggests that listeners judged source distance using mainly changes in the overall intensity of the auditory stimulus with distance rather than the direct-to-reverberant energy ratio, even for low-frequency noise bands (which typically induce high amount of reverberation. The results obtained in this study show that, depending on

  7. Hospital administrators in a market environment: the case of Utah.

    Science.gov (United States)

    Dwore, R B; Murray, B P

    1987-11-01

    This study describes selected characteristics of hospital administrators in Utah, who are implementing a market strategy of cost containment. A mail survey was used to query hospital administrators concerning their personal backgrounds, professional practice patterns, and perceived role performance. The questionnaire elicited a 75.6 percent return from a limited universe sample. Analytical results disclose that Utah hospital administrators are relatively young, professionally dynamic, well educated, and subject to frequent career-motivated moves. Using Mintzberg's ten administrative roles, respondents identified two as key: "Leader" ranks as the role performed best, the role second most critical to survival, second best prepared for, second most time-consuming, and second most satisfying. "Entrepreneur" ranks as the role most critical to survival, most satisfying, most deserving of improvement, second least prepared for, and second best performed. Suggestions for innovative ways in which administrators can develop their skills to be better prepared to meet future challenges are listed.

  8. Thermal environment in a simulated double office room with convective and radiant cooling systems

    DEFF Research Database (Denmark)

    Mustakallio, Panu; Bolashikov, Zhecho Dimitrov; Rezgals, Lauris

    2017-01-01

    anddraught rate was calculated. Manikin-based equivalent temperature (MBET) was determined by using two thermal manikins. CCMV provided slightly more uniform thermal environment and the least sensitive to different workstation layouts than the other systems. CB provided a bit higher draught rate levels than...

  9. Another link to improving the working environment in acute care hospitals: registered nurses' spirit at work.

    Science.gov (United States)

    Urban, Ann-Marie; Wagner, Joan I

    2013-12-01

    Hospitals are situated within historical and socio-political contexts; these influence the provision of patient care and the work of registered nurses (RNs). Since the early 1990s, restructuring and the increasing pressure to save money and improve efficiency have plagued acute care hospitals. These changes have affected both the work environment and the work of nurses. After recognizing this impact, healthcare leaders have dedicated many efforts to improving the work environment in hospitals. Admirable in their intent, these initiatives have made little change for RNs and their work environment, and thus, an opportunity exists for other efforts. Research indicates that spirit at work (SAW) not only improves the work environment but also strengthens the nurse's power to improve patient outcomes and contribute to a high-quality workplace. In this paper, we present findings from our research that suggest SAW be considered an important component in improving the work environment in acute care hospitals.

  10. Fine Particulate Air Pollution and Hospital Emergency Room Visits for Respiratory Disease in Urban Areas in Beijing, China, in 2013.

    Directory of Open Access Journals (Sweden)

    Qin Xu

    Full Text Available Heavy fine particulate matter (PM2.5 air pollution occurs frequently in China. However, epidemiological research on the association between short-term exposure to PM2.5 pollution and respiratory disease morbidity is still limited. This study aimed to explore the association between PM2.5 pollution and hospital emergency room visits (ERV for total and cause-specific respiratory diseases in urban areas in Beijing.Daily counts of respiratory ERV from Jan 1 to Dec 31, 2013, were obtained from ten general hospitals located in urban areas in Beijing. Concurrently, data on PM2.5 were collected from the Beijing Environmental Protection Bureau, including 17 ambient air quality monitoring stations. A generalized-additive model was used to explore the respiratory effects of PM2.5, after controlling for confounding variables. Subgroup analyses were also conducted by age and gender.A total of 92,464 respiratory emergency visits were recorded during the study period. The mean daily PM2.5 concentration was 102.1±73.6 μg/m3. Every 10 μg/m3 increase in PM2.5 concentration at lag0 was associated with an increase in ERV, as follows: 0.23% for total respiratory disease (95% confidence interval [CI]: 0.11%-0.34%, 0.19% for upper respiratory tract infection (URTI (95%CI: 0.04%-0.35%, 0.34% for lower respiratory tract infection (LRTI (95%CI: 0.14%-0.53% and 1.46% for acute exacerbation of chronic obstructive pulmonary disease (AECOPD (95%CI: 0.13%-2.79%. The strongest association was identified between AECOPD and PM2.5 concentration at lag0-3 (3.15%, 95%CI: 1.39%-4.91%. The estimated effects were robust after adjusting for SO2, O3, CO and NO2. Females and people 60 years of age and older demonstrated a higher risk of respiratory disease after PM2.5 exposure.PM2.5 was significantly associated with respiratory ERV, particularly for URTI, LRTI and AECOPD in Beijing. The susceptibility to PM2.5 pollution varied by gender and age.

  11. Fine Particulate Air Pollution and Hospital Emergency Room Visits for Respiratory Disease in Urban Areas in Beijing, China, in 2013.

    Science.gov (United States)

    Xu, Qin; Li, Xia; Wang, Shuo; Wang, Chao; Huang, Fangfang; Gao, Qi; Wu, Lijuan; Tao, Lixin; Guo, Jin; Wang, Wei; Guo, Xiuhua

    2016-01-01

    Heavy fine particulate matter (PM2.5) air pollution occurs frequently in China. However, epidemiological research on the association between short-term exposure to PM2.5 pollution and respiratory disease morbidity is still limited. This study aimed to explore the association between PM2.5 pollution and hospital emergency room visits (ERV) for total and cause-specific respiratory diseases in urban areas in Beijing. Daily counts of respiratory ERV from Jan 1 to Dec 31, 2013, were obtained from ten general hospitals located in urban areas in Beijing. Concurrently, data on PM2.5 were collected from the Beijing Environmental Protection Bureau, including 17 ambient air quality monitoring stations. A generalized-additive model was used to explore the respiratory effects of PM2.5, after controlling for confounding variables. Subgroup analyses were also conducted by age and gender. A total of 92,464 respiratory emergency visits were recorded during the study period. The mean daily PM2.5 concentration was 102.1±73.6 μg/m3. Every 10 μg/m3 increase in PM2.5 concentration at lag0 was associated with an increase in ERV, as follows: 0.23% for total respiratory disease (95% confidence interval [CI]: 0.11%-0.34%), 0.19% for upper respiratory tract infection (URTI) (95%CI: 0.04%-0.35%), 0.34% for lower respiratory tract infection (LRTI) (95%CI: 0.14%-0.53%) and 1.46% for acute exacerbation of chronic obstructive pulmonary disease (AECOPD) (95%CI: 0.13%-2.79%). The strongest association was identified between AECOPD and PM2.5 concentration at lag0-3 (3.15%, 95%CI: 1.39%-4.91%). The estimated effects were robust after adjusting for SO2, O3, CO and NO2. Females and people 60 years of age and older demonstrated a higher risk of respiratory disease after PM2.5 exposure. PM2.5 was significantly associated with respiratory ERV, particularly for URTI, LRTI and AECOPD in Beijing. The susceptibility to PM2.5 pollution varied by gender and age.

  12. Current practices in the management of patients with ureteral calculi in the emergency room of a university hospital

    Directory of Open Access Journals (Sweden)

    Oliver Rojas Claros

    2012-01-01

    Full Text Available OBJECTIVE: Urinary lithiasis is a common disease. The aim of the present study is to assess the knowledge regarding the diagnosis, treatment and recommendations given to patients with ureteral colic by professionals of an academic hospital. MATERIALS AND METHODS: Sixty-five physicians were interviewed about previous experience with guidelines regarding ureteral colic and how they manage patients with ureteral colic in regards to diagnosis, treatment and the information provided to the patients. RESULTS: Thirty-six percent of the interviewed physicians were surgeons, and 64% were clinicians. Forty-one percent of the physicians reported experience with ureterolithiasis guidelines. Seventy-two percent indicated that they use noncontrast CT scans for the diagnosis of lithiasis. All of the respondents prescribe hydration, primarily for the improvement of stone elimination (39.3%. The average number of drugs used was 3.5. The combination of nonsteroidal anti-inflammatory drugs and opioids was reported by 54% of the physicians (i.e., 59% of surgeons and 25.6% of clinicians used this combination of drugs (p = 0.014. Only 21.3% prescribe alpha blockers. CONCLUSION: Reported experience with guidelines had little impact on several habitual practices. For example, only 21.3% of the respondents indicated that they prescribed alpha blockers; however, alpha blockers may increase stone elimination by up to 54%. Furthermore, although a meta-analysis demonstrated that hydration had no effect on the transit time of the stone or on the pain, the majority of the physicians reported that they prescribed more than 500 ml of fluid. Dipyrone, hyoscine, nonsteroidal anti-inflammatory drugs, and opioids were identified as the most frequently prescribed drug combination. The information regarding the time for the passage of urinary stones was inconsistent. The development of continuing education programs regarding ureteral colic in the emergency room is necessary.

  13. Effects of Air Pollution on Hospital Emergency Room Visits for Respiratory Diseases: Urban-Suburban Differences in Eastern China

    Directory of Open Access Journals (Sweden)

    Peng Liu

    2016-03-01

    Full Text Available A study on the relationships between ambient air pollutants (PM2.5, SO2 and NO2 and hospital emergency room visits (ERVs for respiratory diseases from 2013 to 2014 was performed in both urban and suburban areas of Jinan, a heavily air-polluted city in Eastern China. This research was analyzed using generalized additive models (GAM with Poisson regression, which controls for long-time trends, the “day of the week” effect and meteorological parameters. An increase of 10 μg/m3 in PM2.5, SO2 and NO2 corresponded to a 1.4% (95% confidence interval (CI: 0.7%, 2.1%, 1.2% (95% CI: 0.5%, 1.9%, and 2.5% (95%: 0.8%, 4.2% growth in ERVs for the urban population, respectively, and a 1.5% (95%: 0.4%, 2.6%, 0.8% (95%: −0.7%, 2.3%, and 3.1% (95%: 0.5%, 5.7% rise in ERVs for the suburban population, respectively. It was found that females were more susceptible than males to air pollution in the urban area when the analysis was stratified by gender, and the reverse result was seen in the suburban area. Our results suggest that the increase in ERVs for respiratory illnesses is linked to the levels of air pollutants in Jinan, and there may be some urban-suburban discrepancies in health outcomes from air pollutant exposure.

  14. Context dependent memory in two learning environments: the tutorial room and the operating theatre

    OpenAIRE

    Coveney, Andrew P; Switzer, Timothy; Corrigan, Mark A; Redmond, Henry P

    2013-01-01

    Background Psychologists have previously demonstrated that information recall is context dependent. However, how this influences the way we deliver medical education is unclear. This study aimed to determine if changing the recall context from the learning context affects the ability of medical students to recall information. Methods Using a free recall experimental model, fourteen medical student participants were administered audio lists of 30 words in two separate learning environments, a ...

  15. Postgraduate residents' perception of the clinical learning environment; use of postgraduate hospital educational environment measure (PHEEM) in Pakistani context.

    Science.gov (United States)

    Bari, Attia; Khan, Rehan Ahmed; Rathore, Ahsan Waheed

    2018-03-01

    To evaluate the perception of postgraduate residents about the clinical educational environment and to investigate the association of their perception with different specialities and years of residency. The study was conducted in August 2016 at The Children's Hospital, Lahore, Pakistan, and comprised postgraduate residents who were asked to complete postgraduate hospital educational environment measure questionnaire. The residents' individual perception scores were calculated and the means of both individual domain and global score of the questionnaire were compared by different specialities and different levels of residency training year. SPSS 20 was used for statistical analysis. Of the 160 residents who completed the questionnaire, 114(71.3%) were related to paediatric medicine. The residents perceived their educational environment positive with a global mean score of 88.16±14.18. Autonomy and teaching were rated most highly by paediatric diagnostic residents, i.e. 32.23±8.148 and 36.23±9.010, respectively. Social support was rated the highest by paediatric surgery residents 24.36±4.653. There was no significant difference of perception between different specialities (p=0.876) or different years of residency (p=0.474). Postgraduate hospital educational environment measure can be used to identify areas of strengths and weaknesses in a hospital environment. Educational environment of study site was more positive than negative.

  16. The microbiological effects of hospital wastes on the environment

    African Journals Online (AJOL)

    PRECIOUS

    2009-11-16

    Nov 16, 2009 ... pathological, infectious, hazardous chemicals, radioactive wastes, stock cultures, blood .... suppurative disease as stated by Ernest et al. (1984), C. equi has the .... Ministry of. Environment and Forest notification. New Delhi. p.

  17. A Distributed Control System Prototyping Environment to Support Control Room Modernization

    Energy Technology Data Exchange (ETDEWEB)

    Lew, Roger Thomas [Idaho National Lab. (INL), Idaho Falls, ID (United States); Boring, Ronald Laurids [Idaho National Lab. (INL), Idaho Falls, ID (United States); Ulrich, Thomas Anthony [Idaho National Lab. (INL), Idaho Falls, ID (United States)

    2014-12-01

    Operators of critical processes, such as nuclear power production, must contend with highly complex systems, procedures, and regulations. Developing human-machine interfaces (HMIs) that better support operators is a high priority for ensuring the safe and reliable operation of critical processes. Human factors engineering (HFE) provides a rich and mature set of tools for evaluating the performance of HMIs, however the set of tools for developing and designing HMIs is still in its infancy. Here we propose a rapid prototyping approach for integrating proposed HMIs into their native environments before a design is finalized. This approach allows researchers and developers to test design ideas and eliminate design flaws prior to fully developing the new system. We illustrate this approach with four prototype designs developed using Microsoft’s Windows Presentation Foundation (WPF). One example is integrated into a microworld environment to test the functionality of the design and identify the optimal level of automation for a new system in a nuclear power plant. The other three examples are integrated into a full-scale, glasstop digital simulator of a nuclear power plant. One example demonstrates the capabilities of next generation control concepts; another aims to expand the current state of the art; lastly, an HMI prototype was developed as a test platform for a new control system currently in development at U.S. nuclear power plants. WPF possesses several characteristics that make it well suited to HMI design. It provides a tremendous amount of flexibility, agility, robustness, and extensibility. Distributed control system (DCS) specific environments tend to focus on the safety and reliability requirements for real-world interfaces and consequently have less emphasis on providing functionality to support novel interaction paradigms. Because of WPF’s large user-base, Microsoft can provide an extremely mature tool. Within process control applications,WPF is

  18. Distribution of multi-resistant Gram-negative versus Gram-positive bacteria in the hospital inanimate environment.

    Science.gov (United States)

    Lemmen, S W; Häfner, H; Zolldann, D; Stanzel, S; Lütticken, R

    2004-03-01

    We prospectively studied the difference in detection rates of multi-resistant Gram-positive and multi-resistant Gram-negative bacteria in the inanimate environment of patients harbouring these organisms. Up to 20 different locations around 190 patients were surveyed. Fifty-four patients were infected or colonized with methicillin-resistant Staphylococcus aureus (MRSA) or vancomycin-resistant enterococci (VRE) and 136 with multi-resistant Gram-negative bacteria. The environmental detection rate for MRSA or VRE was 24.7% (174/705 samples) compared with 4.9% (89/1827 samples) for multi-resistant Gram-negative bacteria (PGram-positive bacteria were isolated more frequently than Gram-negatives from the hands of patients (PGram-positive and Gram-negative isolates. Our results suggest that the inanimate environment serves as a secondary source for MRSA and VRE, but less so for Gram-negative bacteria. Thus, strict contact isolation in a single room with complete barrier precautions is recommended for MRSA or VRE; however, for multi-resistant Gram-negative bacteria, contact isolation with barrier precautions for close contact but without a single room seems sufficient. This benefits not only the patients, but also the hospital by removing some of the strain placed on already over-stretched resources.

  19. Acupuncture performed by nurses in the recovery room at a Danish biomedical hospital: how patients experience the effect of acupuncture treatment

    DEFF Research Database (Denmark)

    Larsen, Anne Bolt

    2016-01-01

    The abstract build on a master thesis submitted to Department of Anthropology, Aarhus University, Denmark. The thesis aims at investigating a new trend in Danish hospitals, where acupuncture increasingly is used in treating post-operative nausea and vomiting (PONV) and pain. It is a novelty...... that patients may receive acupuncture treatment in hospital. No scientific research has been completed to examine patients experience when treated with acupuncture at a modern hospital based on technology and natural science. This study took place in the recovery room at a regional hospital in Denmark, where...... acupuncture during the past 3-4 years has been implemented by nurses as an option for patients with PONV and post-operative pain. The purpose is to analyse the encounter between acupuncture and biomedicine, how patients experience the effect of acupuncture treatment and their view of acupuncture...

  20. Staphylococcus cohnii--resident of hospital environment: cell-surface features and resistance to antibiotics.

    Science.gov (United States)

    Szewczyk, E M; Rózalska, M

    2000-01-01

    Staphylococcus cohnii strains dominated in the environment of investigated hospitals. We isolated 420 strains of the species mainly from hospitals environments, but also from infants--Intensive Care Units patients, its medical staff and non-hospital environments. S. cohnii subspecies cohnii was seen to dominate (361 strains). Seventy seven percent of these strains expressed cell-surface hydrofobicity, most of them were slime producers (61%) and this feature was correlated with their methicillin resistance. Among S. cohnii ssp. cohnii strains isolated from ICU environment 90% were resistant to methicillin, 43% expressed high-level resistance to mupirocin and high percentages were resistant to many other antibiotics. These strains may constitute a dangerous reservoir of resistance genes in a hospital.

  1. The value of the pre-hospital learning environment as part of the emergency nursing programme

    Directory of Open Access Journals (Sweden)

    Sonett van Wyk

    2015-06-01

    Conclusion: The research findings support the value and continuation of utilising the pre-hospital clinical learning environment for placing post-basic emergency nursing students when enrolled in the emergency nursing programme.

  2. 医院洁净层流(手术)室的维护管理%Maintenance Management of Hospital Operation Room with Clean Laminar Flow

    Institute of Scientific and Technical Information of China (English)

    马龙飞; 史立; 李源

    2011-01-01

    This paper introduce that maintenance management of hospital operation room with clean laminar flow and its effect. And point out the importance of preventive maintenance prolonging the clean equipment's life.%本文介绍了医院洁净层流(手术)室设备的维护管理方法及效果,简述了预防性保养工作对延长洁净设备使用寿命的重要性.

  3. Understanding thermal comfort perception of nurses in a hospital ward work environment.

    NARCIS (Netherlands)

    Derks, M.T.H.; Mishra, A.K.; Loomans, M.G.L.C.; Kort, H.S.M.

    2018-01-01

    In indoor comfort research, thermal comfort of care-professionals in hospital environment is a little explored topic. To address this gap, a mixed methods study, with the nursing staff in hospital wards acting as participants, was undertaken. Responses were collected during three weeks in the summer

  4. The impact of the hospital work environment on social support from physicians in breast cancer care.

    Science.gov (United States)

    Ansmann, Lena; Wirtz, Markus; Kowalski, Christoph; Pfaff, Holger; Visser, Adriaan; Ernstmann, Nicole

    2014-09-01

    Research on determinants of a good patient-physician interaction mainly disregards systemic factors, such as the work environment in healthcare. This study aims to identify stressors and resources within the work environment of hospital physicians that enable or hinder the physicians' provision of social support to patients. Four data sources on 35 German breast cancer center hospitals were matched: structured hospital quality reports and surveys of 348 physicians, 108 persons in hospital leadership, and 1844 patients. Associations between hospital structures, physicians' social resources as well as job demands and control and patients' perceived support from physicians have been studied in multilevel models. Patients feel better supported by their physicians in hospitals with high social capital, a high percentage of permanently employed physicians, and less physically strained physicians. The results highlight the importance of the work environment for a good patient-physician interaction. They can be used to develop interventions for redesigning the hospital work environment, which in turn may improve physician satisfaction, well-being, and performance and consequently the quality of care. Health policy and hospital management could create conditions conducive to better patient-physician interaction by strengthening the social capital and by increasing job security for physicians. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  5. Occupational therapist care in the introduction of Alternative Communication features in hospital environment

    OpenAIRE

    Janaína Santos Nascimento; Juliana Mannini; Miryam Bonadiu Pelosi; Mariana Mapelli de Paiva

    2017-01-01

    Introduction: Alternative and Extended Communication (CAA) is an area of assistive technology, and its introduction in the hospital environment has contributed decisively to the care and integration of patients with speech or writing difficulties. However, in order for the use of CAA resources to be effective in this environment, actions are essential to prevent and control Hospital Infections (HI). Objective: To describe the strategies related to the control of HI, used for the i...

  6. The use of Am-241 as Equivalence Thickness Measurement for Irradiation Room at National institute for Cancer and Malacca Hospital: A Review

    International Nuclear Information System (INIS)

    Mohd Khalid Matori; Azuhar Ripin; Husaini Salleh

    2013-01-01

    Lead equivalent thickness measurement of a shielding material in diagnostic radiology is very important to ensure that requirements for the purpose of radiation protection of patients, employees and the public are met. The Malaysian Ministry of Health (MOH) has established that the irradiation room must have sufficient shielding thickness, for example for general radiography it must be at least equal to 2.0 mm of Pb, for panoramic dental radiography at least equal to 1.5 mm of Pb and for mammography should be a minimum of 1.0 mm of Pb. This paper presents a technique using americium-241 source to test and verify the integrity of the shielding thickness in term of lead equivalent for irradiation room at National Institute for Cancer (IKN) and General Malacca Hospital. Results of measurement of 10 irradiation rooms conducted in 2012 were analyzed for this presentation. Technical comparison of the attenuation of gamma rays from Am-241 source through the walls of the irradiation room and pieces of lead were used to assess the lead equivalent thickness of the walls. Results showed that almost all the irradiation rooms tested meet the requirements of the Ministry of Health and is suitable for the installation of the intended diagnostic X-ray apparatus. Some specific positions such as door knobs and locks, electrical plug sockets were identified with potential to not met the required lead equivalent thickness hence may contribute to higher radiation exposure to workers and the public. (author)

  7. Operating room manager game

    NARCIS (Netherlands)

    Hans, Elias W.; Nieberg, T.

    2007-01-01

    The operating room (OR) department of a hospital forms the heart of the organization, where the single largest cost is incurred. This document presents and reports on the “Operating Room Manager Game,” developed to give insight into managing a large hospital's OR department at various levels of

  8. Older people's perspectives on an elderly-friendly hospital environment: an exploratory study

    Directory of Open Access Journals (Sweden)

    Karki S

    2015-05-01

    Full Text Available Sushmita Karki,1 Dharma Nand Bhatta,1,2 Umesh Raj Aryal3 1Department of Public Health, Nobel College, Pokhara University, Kathmandu, Nepal; 2Faculty of Medicine, Epidemiology Unit, Prince of Songkla University, Songkhla, Thailand; 3Department of Community Medicine, Kathmandu Medical College, Kathmandu, Nepal Background: Many older people are vulnerable with multiple health problems and need of extensive care and support for quality of life. The main objective of this study was to explore the older people's perspectives on an "elderly-friendly" hospital. Methods: Hospital was stratified by four domains including government, semi-government, community, and private. We interviewed 33 hospitalized older patients and four hospital managers between June and December 2014 in Kathmandu, Nepal, using purposive sampling technique. We executed a qualitative content analysis step with extensive review of the interviews. Final name of the theme was given after the agreement between the research team and experts to improve trustworthiness. Elderly-friendly services, expectation from government and hospital, and health policy related to senior citizen were developed as main themes. Results: Most of the participants were satisfied with the behavior of health personnel. However, none of the health personnel were trained with geriatric health care. Elderly-friendly hospital guidelines and policy were not developed by any hospitals. Older people health card, advocacy for older people's health and benefit, and hospital environment were the common expectations of older patients. Government policy and budget constraint were the main obstacles to promote elderly-friendly health care services. Conclusion: Elderly-related health policies, physical environments of hospital, elderly-friendly health manpower, advocacy, and other facilities and benefits should be improved and developed. There are urgent needs to develop elderly-friendly hospital policies and guidelines that

  9. Implementation of Advanced Warehouses in a Hospital Environment - Case study

    Science.gov (United States)

    Costa, J.; Sameiro Carvalho, M.; Nobre, A.

    2015-05-01

    In Portugal, there is an increase of costs in the healthcare sector due to several factors such as the aging of the population, the increased demand for health care services and the increasing investment in new technologies. Thus, there is a need to reduce costs, by presenting the effective and efficient management of logistics supply systems with enormous potential to achieve savings in health care organizations without compromising the quality of the provided service, which is a critical factor, in this type of sector. In this research project the implementation of Advanced Warehouses has been studied, in the Hospital de Braga patient care units, based in a mix of replenishment systems approaches: the par level system, the two bin system and the consignment model. The logistics supply process is supported by information technology (IT), allowing a proactive replacement of products, based on the hospital services consumption records. The case study was developed in two patient care units, in order to study the impact of the operation of the three replenishment systems. Results showed that an important inventory holding costs reduction can be achieved in the patient care unit warehouses while increasing the service level and increasing control of incoming and stored materials with less human resources. The main conclusion of this work illustrates the possibility of operating multiple replenishment models, according to the types of materials that healthcare organizations deal with, so that they are able to provide quality health care services at a reduced cost and economically sustainable. The adoption of adequate IT has been shown critical for the success of the project.

  10. Designing new collaborative learning spaces in clinical environments: experiences from a children's hospital in Australia.

    Science.gov (United States)

    Bines, Julie E; Jamieson, Peter

    2013-09-01

    Hospitals are complex places that provide a rich learning environment for students, staff, patients and their families, professional groups and the community. The "new" Royal Children's Hospital opened in late 2011. Its mission is focused on improving health and well-being of children and adolescents through leadership in healthcare, research and education. Addressing the need to create "responsive learning environments" aligned with the shift to student-centred pedagogy, two distinct learning environments were developed within the new Royal Children's Hospital; (i) a dedicated education precinct providing a suite of physical environments to promote a more active, collaborative and social learning experience for education and training programs conducted on the Royal Children's Hospital campus and (ii) a suite of learning spaces embedded within clinical areas so that learning becomes an integral part of the daily activities of this busy Hospital environment. The aim of this article is to present the overarching educational principles that lead the design of these learning spaces and describe the opportunities and obstacles encountered in the development of collaborative learning spaces within a large hospital development.

  11. Relationship between Fungal Colonisation of the Respiratory Tract in Lung Transplant Recipients and Fungal Contamination of the Hospital Environment.

    Directory of Open Access Journals (Sweden)

    Christine Bonnal

    Full Text Available Aspergillus colonisation is frequently reported after lung transplantation. The question of whether aspergillus colonisation is related to the hospital environment is crucial to prevention.To elucidate this question, a prospective study of aspergillus colonisation after lung transplantation, along with a mycological survey of the patient environment, was performed.Forty-four consecutive patients were included from the day of lung transplantation and then examined weekly for aspergillus colonisation until hospital discharge. Environmental fungal contamination of each patient was followed weekly via air and surface sampling. Twelve patients (27% had transient aspergillus colonisation, occurring 1-13 weeks after lung transplantation, without associated manifestation of aspergillosis. Responsible Aspergillus species were A. fumigatus (6, A. niger (3, A. sydowii (1, A. calidoustus (1 and Aspergillus sp. (1. In the environment, contamination by Penicillium and Aspergillus was predominant. Multivariate analysis showed a significant association between occurrence of aspergillus colonisation and fungal contamination of the patient's room, either by Aspergillus spp. in the air or by A.fumigatus on the floor. Related clinical and environmental isolates were genotyped in 9 cases of aspergillus colonisation. For A. fumigatus (4 cases, two identical microsatellite profiles were found between clinical and environmental isolates collected on distant dates or locations. For other Aspergillus species, isolates were different in 2 cases; in 3 cases of aspergillus colonisation by A. sydowii, A. niger and A. calidoustus, similarity between clinical and environmental internal transcribed spacer and tubulin sequences was >99%.Taken together, these results support the hypothesis of environmental risk of hospital acquisition of aspergillus colonisation in lung transplant recipients.

  12. Reduction in the microbial load on high-touch surfaces in hospital rooms by treatment with a portable saturated steam vapor disinfection system.

    Science.gov (United States)

    Sexton, Jonathan D; Tanner, Benjamin D; Maxwell, Sheri L; Gerba, Charles P

    2011-10-01

    Recent scientific literature suggests that portable steam vapor systems are capable of rapid, chemical-free surface disinfection in controlled laboratory studies. This study evaluated the efficacy of a portable steam vapor system in a hospital setting. The study was carried out in 8 occupied rooms of a long-term care wing of a hospital. Six surfaces per room were swabbed before and after steam treatment and analyzed for heterotrophic plate count (HPC), total coliforms, methicillin-intermediate and -resistant Staphylococcus aureus (MISA and MRSA), and Clostridium difficile. The steam vapor device consistently reduced total microbial and pathogen loads on hospital surfaces, to below detection in most instances. Treatment reduced the presence of total coliforms on surfaces from 83% (40/48) to 13% (6/48). Treatment reduced presumptive MISA (12/48) and MRSA (3/48) to below detection after cleaning, except for 1 posttreatment isolation of MISA (1/48). A single C difficile colony was isolated from a door push panel before treatment, but no C difficile was detected after treatment. The steam vapor system reduced bacterial levels by >90% and reduced pathogen levels on most surfaces to below the detection limit. The steam vapor system provides a means to reduce levels of microorganisms on hospital surfaces without the drawbacks associated with chemicals, and may decrease the risk of cross-contamination. Copyright © 2011 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

  13. Understanding Personal Learning Environment Perspectives of Thai International Tourism and Hospitality Higher Education Students

    Science.gov (United States)

    Tanyong, Siriwan; Sharafuddin, Mohamed Ali

    2016-01-01

    This paper is part of a periodic research conducted in developing a personal learning environment for Thailand's higher education students with English as medium of instruction. The objective of the first phase in this research was to understand the personal learning environment perspectives of Thai International tourism and hospitality higher…

  14. Hospital nurses' work environment, quality of care provided and career plans.

    Science.gov (United States)

    Hinno, S; Partanen, P; Vehviläinen-Julkunen, K

    2011-06-01

    In several European countries, the availability of qualified nurses is insufficient to meet current healthcare requirements. Nurses are highly dissatisfied with the rising demands of the healthcare environment and increasingly considering leaving their jobs. The study aims to investigate the relationships between the characteristics of hospital nurses' work environment and the quality of care provided, and furthermore to examine Dutch nurses' career plans. A cross-sectional, questionnaire survey of registered nurses (n = 334) working in the academic and district hospitals was conducted in 2005/2006. Previously validated questionnaires translated into the participants' language were used. Factor and regression analysis were used for data analysis. Overall, nurses rated their work environment rather favourably. Five work environment characteristics were identified: support for professional development, adequate staffing, nursing competence, supportive management and teamwork. Significant relationships were found between nurses' perceptions of their work environment characteristics and quality of care provided and nurses' career plans. When work environment characteristics were evaluated to be better, nurse-assessed quality of care also increased and intentions to leave current job decreased linearly. Study findings suggest that nurses' perceptions of their work environment are important for nurse outcomes in hospital settings. Further research is needed to explore the predictive ability of the work environment for nurse, patient and organizational outcomes in hospitals. © 2011 The Authors. International Nursing Review © 2011 International Council of Nurses.

  15. Hand hygiene in hospital environments: use of conformity indicators

    Directory of Open Access Journals (Sweden)

    Thaíne Cristina Romualdo dos SANTOS

    Full Text Available An exploratory descriptive study with a quantitative approach whose objective was to use indicators to evaluate the frequency and infrastructure for hand hygiene, as well as the nursing team's knowledge about the subject. Systematized observation was carried out at hospital in the state of São Paulo, Brazil of the routine activities of 33 participating professionals (nurses and technicians as well as the application of an individual questionnaire about the subject.1206 opportunities for hand hygiene were identified, though it was effected in only 481 (39.9% of them. Alcohol solution was not used at any opportunity. The infrastructure indicator for hand hygiene was close to the ideal value (83.3%. The professionals reported a high frequency of hand hygiene, demonstrating knowledge in relation to its importance, yet contradicting the findings of the observation. It was concluded that, despite the adequate infrastructure, hand hygiene was below that expected, requiring actions and strategies to overcomes these barrier and increase the use of alcohol solution.

  16. Effects of hospital care environment on patient mortality and nurse outcomes.

    Science.gov (United States)

    Aiken, Linda H; Clarke, Sean P; Sloane, Douglas M; Lake, Eileen T; Cheney, Timothy

    2008-05-01

    The objective of this study was to analyze the net effects of nurse practice environments on nurse and patient outcomes after accounting for nurse staffing and education. Staffing and education have well-documented associations with patient outcomes, but evidence on the effect of care environments on outcomes has been more limited. Data from 10,184 nurses and 232,342 surgical patients in 168 Pennsylvania hospitals were analyzed. Care environments were measured using the practice environment scales of the Nursing Work Index. Outcomes included nurse job satisfaction, burnout, intent to leave, and reports of quality of care, as well as mortality and failure to rescue in patients. Nurses reported more positive job experiences and fewer concerns with care quality, and patients had significantly lower risks of death and failure to rescue in hospitals with better care environments. Care environment elements must be optimized alongside nurse staffing and education to achieve high quality of care.

  17. The relationship between hospital work environment and nurse outcomes in Guangdong, China: a nurse questionnaire survey.

    Science.gov (United States)

    Liu, Ke; You, Li-Ming; Chen, Shao-Xian; Hao, Yuan-Tao; Zhu, Xiao-Wen; Zhang, Li-Feng; Aiken, Linda H

    2012-05-01

    This study examines the relationship between hospital work environments and job satisfaction, job-related burnout and intention to leave among nurses in Guangdong province, China. The nursing shortage is an urgent global problem and also of concern in China. Studies in Western countries have shown that better work environments are associated with higher nurse satisfaction and lower burnout, thereby improving retention and lowering turnover rates. However, there is little research on the relationship between nurse work environments and nurse outcomes in China. This is a cross-sectional study. Survey data were collected from 1104 bedside nurses in 89 medical, surgical and intensive care units in 21 hospitals across the Guangdong province in China. Stratified convenience sampling was used to select hospitals, and systematic sampling was used to select units. All staff nurses working on participating units were surveyed. The China Hospital Nurse Survey, including the Practice Environment Scale of the Nursing Work Index and Maslach Burnout Inventory, was employed to collect data from nurses. Statistical significance level was set at 0·05. Thirty-seven per cent of the nurses experienced high burnout, and 54% were dissatisfied with their jobs. Improving nurses' work environments from poor to better was associated with a 50% decrease in job dissatisfaction and a 33% decrease in job-related burnout among nurses. Burnout and job dissatisfaction are high among hospital nurses in Guangdong province, China. Better work environments for nurses were associated with decreased job dissatisfaction and job-related burnout, which may successfully address the nursing shortage in China. The findings of this study indicate that improving work environments is essential to deal with the nursing shortage; the findings provide motivation for nurse managers and policy makers to improve work environments of hospital nurses in China. © 2012 Blackwell Publishing Ltd.

  18. Understanding Design Vulnerabilities in the Physical Environment Relating to Patient Fall Patterns in a Psychiatric Hospital: Seven Years of Sentinel Events.

    Science.gov (United States)

    Bayramzadeh, Sara; Portillo, Margaret; Carmel-Gilfilen, Candy

    2018-05-01

    The influence of the physical environment on patient falls has not been fully explored in psychiatric units, despite this patient population's vulnerability and the critical role of the physical environment in patient safety. The research objective is to describe the spatial and temporal pattern of falls occurrences and their location in relation to the levels of safety continuum model. This article presents an exploratory case study design. Seven years of retrospective data on patient falls, yielding 818 sentinel events, in an 81-bed psychiatric hospital in the United States were collected and analyzed. Data focused on extrinsic factors for falls, emphasizing the physical environment. Through a content analysis of the sentinel event narratives, recorded by the hospital staff, this study explored patient falls related to location and elements of the physical environment. The analysis revealed that 15% of recorded falls were attributed to some aspect of or element within the physical environment. The most typical locations of falls were patient rooms (39%), patient bathrooms (22%), and dayrooms (20%). Also, the results identified patterns of environmental factors that appeared linked to increasing patients' susceptibility to falls. Risk factors included poor nighttime lighting, flooring surfaces that were uneven, and spaces that inadvertently limited visual access and supervision. The physical environment plays an often-unexamined role in fall events and specific locations. These results are deserving of further research on design strategies and applications to reduce patient falls in psychiatric hospital settings.

  19. Well-being and employee health-how employees' well-being scores interact with demographic factors to influence risk of hospitalization or an emergency room visit.

    Science.gov (United States)

    Gandy, William M; Coberley, Carter; Pope, James E; Rula, Elizabeth Y

    2014-02-01

    The goal of this study was to determine the relationship between individual well-being and risk of a hospital event in the subsequent year. The authors hypothesized an inverse relationship in which low well-being predicts higher likelihood of hospital use. The study specifically sought to understand how well-being segments and demographic variables interact in defining risk of a hospital event (inpatient admission or emergency room visit) in an employed population. A retrospective study design was conducted with data from 8835 employees who completed a Well-Being Assessment questionnaire based on the Gallup-Healthways Well-Being Index. Cox proportional hazards models were used to examine the impact of Individual Well-Being Score (IWBS) segments and member demographics on hazard ratios (HRs) for a hospital event during the 12 months following assessment completion. Significant main effects were found for the influence of IWBS segments, sex, education, and relationship status on HRs of a hospital event, but not for age. However, further analysis revealed significant interactions between age and IWBS segments (P=0.005) and between age and sex (Pwell-being and higher risk of an event in employees ages 44 years and older is mitigated in younger age groups. These results suggest that youth attenuates the risk engendered in poor well-being; therefore, methods to maintain or improve well-being as individuals age presents a strong opportunity for reducing hospital events.

  20. Well-Being and Employee Health—How Employees' Well-Being Scores Interact with Demographic Factors to Influence Risk of Hospitalization or an Emergency Room Visit

    Science.gov (United States)

    Gandy, William M.; Coberley, Carter; Pope, James E.

    2014-01-01

    Abstract The goal of this study was to determine the relationship between individual well-being and risk of a hospital event in the subsequent year. The authors hypothesized an inverse relationship in which low well-being predicts higher likelihood of hospital use. The study specifically sought to understand how well-being segments and demographic variables interact in defining risk of a hospital event (inpatient admission or emergency room visit) in an employed population. A retrospective study design was conducted with data from 8835 employees who completed a Well-Being Assessment questionnaire based on the Gallup-Healthways Well-Being Index. Cox proportional hazards models were used to examine the impact of Individual Well-Being Score (IWBS) segments and member demographics on hazard ratios (HRs) for a hospital event during the 12 months following assessment completion. Significant main effects were found for the influence of IWBS segments, sex, education, and relationship status on HRs of a hospital event, but not for age. However, further analysis revealed significant interactions between age and IWBS segments (P=0.005) and between age and sex (Pwell-being and higher risk of an event in employees ages 44 years and older is mitigated in younger age groups. These results suggest that youth attenuates the risk engendered in poor well-being; therefore, methods to maintain or improve well-being as individuals age presents a strong opportunity for reducing hospital events. (Population Health Management 2014;17:13–20) PMID:23560493

  1. Birth environment facilitation by midwives assisting in non-hospital births: a qualitative interview study.

    Science.gov (United States)

    Igarashi, Toshiko; Wakita, Mariko; Miyazaki, Kikuko; Nakayama, Takeo

    2014-07-01

    midwifery homes (similar to birth centres) are rich in midwifery wisdom and skills that differ from those in hospital obstetrical departments, and a certain percentage of pregnant women prefer birth in these settings. This study aimed to understand the organisation of the perinatal environment considered important by independent midwives in non-hospital settings and to clarify the processes involved. semi-structured qualitative interview study and constant comparative analysis. 14 independent midwives assisting at births in midwifery homes in Japan, and six independent midwives assisting at home births. Osaka, Kyoto, Nara, and Shiga, Japan. midwives assisting at non-hospital births organised the birth environment based on the following four categories: 'an environment where the mother and family are autonomous'; 'a physical environment that facilitates birth'; 'an environment that facilitates the movement of the mother for birth'; and 'scrupulous safety preparation'. These, along with their sub-categories, are presented in this paper. independent midwives considered it important to create a candid relationship between the midwife and the woman/family from the period of pregnancy to facilitate birth in which the woman and her family were autonomous. They also organised a distinctive environment for non-hospital birth, with preparations to guarantee safety. Experiential knowledge and skills played a major part in creating an environment to facilitate birth, and the effectiveness of this needs to be investigated objectively in future research. Copyright © 2014 Elsevier Ltd. All rights reserved.

  2. Identifying competitive strategies to improve the performance of hospitals in a competitive environment.

    Science.gov (United States)

    Chang, Chuan-Hui; Chiao, Yu-Ching; Tsai, Yafang

    2017-11-21

    This study is based on competitive dynamics theory, and discusses competitive actions (including their implementation requirements, strategic orientation, and action complexity) that influence hospitals' performance, while also meeting the requirements of Taiwan's "global budget" insurance payment policy. In order to investigate the possible actions of hospitals, the study was conducted in two stages. The first stage investigated the actions of hospitals from March 1 to May 31, 2009. Semi-structured questionnaires were used, which included in-depth interviews with senior supervisors of 10 medium- and large-scale hospitals in central Taiwan. This stage collected data related to the types of actions adopted by the hospitals in previous years. The second stage was based on the data collected from the first stage and on developed questionnaires, which were distributed from June 29 to November 1, 2009. The questionnaires were given to 20 superintendents, deputy superintendents, and supervisors responsible for the management of a hospital, and focused on medical centers and regional hospitals in central Taiwan in order to determine the types and number of competitive actions. First, the strategic orientation of an action has a significantly positive influence on subjective performance. Second, action complexity has a significantly positive influence on the subjective and the objective performance of a hospital. Third, the implementation requirements of actions do not have a significantly positive impact on the subjective or the objective performance of a hospital. Managers facing a competitive healthcare environment should adopt competitive strategies to improve the performance of the hospital.

  3. Performance of the Operating Room Personnel in following of the standards of Infection Control in the Educational Hospitals of Yasuj University of Medical Sciences in 2009

    Directory of Open Access Journals (Sweden)

    A Rostaminejad

    2011-04-01

    Full Text Available Introduction & Objective: Surgical wound infection is one of the common nosocomial infections. During operation, members of the surgical team which are in contact with the tissue incision should observe the standards of infection control in the operating room since it has a great role in prevention and control of these infections. The present study aimed to determine the performance of the operating room personnel in observing the standards of infection control in educational hospitals of Yasuj University of Medical Sciences in 2009. Materials & Methods: Forty two operating room personnel participated in this cross-sectional analytic-descriptive study. A check list was used for unnoticeably collecting the data about the performance of personnel in respect of infection control standards at three different times. Their performances were classified into four levels (very weak, weak, moderate and good and the results were shown as absolute and relative frequency distribution. Data were analyzed using Chi-square and Fischer exact test by the SPSS software. Results: Performance of personnel in following the standards of infection control in this study was moderate. Conclusion: The results indicate that the participants of the study do not follow some of the standards of infection control in the operating rooms. Therefore, further activities of the committees of infection control and using of new antiseptic for surgical scrub are recommended.

  4. [The 'healing environment' and the fate of autonomous art in hospitals].

    Science.gov (United States)

    Brands, Faye E M; Witte, Arnold A

    2013-01-01

    Attention to the role of art within healthcare is on the rise. Dutch hospitals are increasingly embracing the concept of the 'healing environment', which aims to create agreeable hospital surroundings for the well-being of employees and patients. The concept is being interpreted in diverse ways; irrespective of the specific outcome of this interpretation, the healing environment does have consequences for the healthcare facilities' policies related to art. Research at a few Dutch hospitals has revealed that the more stringently the guidelines on the healing environment are followed, the more emphasis is placed on the medical-functional approach to art and the lesser attention is paid to the intrinsic value of art. Hospitals that reject the concept of the healing environment, however, also clearly demonstrate defining art in terms of making the surroundings agreeable to the patient. The healing environment therefore cannot serve as a new legitimation of autonomous artworks in existing hospital collections, but it is congruent with the recent attention given to the societal role of art.

  5. Evaluation of Architectural Spatial Quality in Patients’ Rooms in the Context of User Satisfaction in General Hospitals: A Case study in Gaziantep

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    Aslı SUNGUR ERGENOĞLU

    2013-04-01

    Full Text Available Healthcare facilities are being evaluated throughout the world determine to what extent they are meeting the needs of patients. Evidence-based research is gaining importance in Turkey as hospital designers strive to increase patients’ satisfaction. In this paper, we will examine the results of a case study conducted to evaluate the spatial quality of patients’ rooms in the context of their satisfaction. Two private general healthcare buildings in Gaziantep were examined in the case study. We chose to evaluate private hospitals because we assumed they would have better conditions than state hospitals. We also took into consideration that these healthcare institutions are in the process of accreditation. Surgeries are frequently conducted here and long-term stays are common. In order to evaluate the subject thoroughly, we used a both a questionnaire and a checklist to gather information. Problems with the spatial quality of the rooms will be identified in the discussion chapter. The examples chosen for the study have showed significant development in available services and space. Using the data obtained from the case study, we have chosen three categories of design criteria through which to evaluate these facilities. Findings will be presented under the headings of function, aesthetics and safety in the results chapter.

  6. Staff Nurse Perceptions of Open-Pod and Single Family Room NICU Designs on Work Environment and Patient Care.

    Science.gov (United States)

    Winner-Stoltz, Regina; Lengerich, Alexander; Hench, Anna Jeanine; OʼMalley, Janet; Kjelland, Kimberly; Teal, Melissa

    2018-06-01

    Neonatal intensive care units have historically been constructed as open units or multiple-bed bays, but since the 1990s, the trend has been toward single family room (SFR) units. The SFR design has been found to promote family-centered care and to improve patient outcomes and safety. The impact of the SFR design NICU on staff, however, has been mixed. The purposes of this study were to compare staff nurse perceptions of their work environments in an open-pod versus an SFR NICU and to compare staff nurse perceptions of the impact of 2 NICU designs on the care they provide for patients/families. A prospective cohort study was conducted. Questionnaires were completed at 6 months premove and again at 3, 9, and 15 months postmove. A series of 1-way analyses of variance were conducted to compare each group in each of the 8 domains. Open-ended questions were evaluated using thematic analysis. The SFR design is favorable in relation to environmental quality and control of primary workspace, privacy and interruption, unit features supporting individual work, and unit features supporting teamwork; the open-pod design is preferable in relation to walking. Incorporating design features that decrease staff isolation and walking and ensuring both patient and staff safety and security are important considerations. Further study is needed on unit design at a microlevel including headwall design and human milk mixing areas, as well as on workflow processes.

  7. Occupational therapist care in the introduction of Alternative Communication features in hospital environment

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    Janaína Santos Nascimento

    2017-03-01

    Full Text Available Introduction: Alternative and Extended Communication (CAA is an area of assistive technology, and its introduction in the hospital environment has contributed decisively to the care and integration of patients with speech or writing difficulties. However, in order for the use of CAA resources to be effective in this environment, actions are essential to prevent and control Hospital Infections (HI. Objective: To describe the strategies related to the control of HI, used for the introduction of CAA resources on a in a university hospital. Method: It presents as methodological strategy the experience report, the descriptive and exploratory mode, based on the experience of five therapists occupational - four residents and a supervisor professor -, during the introductory work of CAA resource at a university hospital, from June 2012 to July 2014. Results: The main precautions adopted were: to laminate the printed boards; to wrap with plastic film computers, tablets, communicators, tablet pen, mouse and driver; protect with plastic bags support materials for activities such as table and inclined plane, and transport by means of a plastic cart. After the materials use, they were placed in plastic bags and sent for cleaning and disinfection the purge. Conclusion: The data showed the complexity of the use of CAA resources in the hospital environment by occupational therapists, and the need for training of professionals involved in actions by Hospital Infection Control Committees team (CCIH.

  8. Nursing students' perceptions of their clinical learning environment in placements outside traditional hospital settings.

    Science.gov (United States)

    Bjørk, Ida T; Berntsen, Karin; Brynildsen, Grethe; Hestetun, Margrete

    2014-10-01

    To explore students' opinions of the learning environment during clinical placement in settings outside traditional hospital settings. Clinical placement experiences may influence positively on nursing students attitudes towards the clinical setting in question. Most studies exploring the quality of clinical placements have targeted students' experience in hospital settings. The number of studies exploring students' experiences of the learning environment in healthcare settings outside of the hospital venue does not match the growing importance of such settings in the delivery of health care, nor the growing number of nurses needed in these venues. A survey design was used. The Clinical Learning Environment Inventory was administered to two cohorts of undergraduate nursing students (n = 184) after clinical placement in mental health care, home care and nursing home care. Nursing students' overall contentment with the learning environment was quite similar across all three placement areas. Students in mental health care had significantly higher scores on the subscale individualisation, and older students had significantly higher scores on the total scale. Compared with other studies where the Clinical Learning Environment Inventory has been used, the students' total scores in this study are similar or higher than scores in studies including students from hospital settings. Results from this study negate the negative views on clinical placements outside the hospital setting, especially those related to placements in nursing homes and mental healthcare settings. Students' experience of the learning environment during placements in mental health care, home care and nursing homes indicates the relevance of clinical education in settings outside the hospital setting. © 2014 The Authors. Journal of Clinical Nursing published by John Wiley & Sons Ltd.

  9. Older people’s perspectives on an elderly-friendly hospital environment: an exploratory study

    Science.gov (United States)

    Karki, Sushmita; Bhatta, Dharma Nand; Aryal, Umesh Raj

    2015-01-01

    Background Many older people are vulnerable with multiple health problems and need of extensive care and support for quality of life. The main objective of this study was to explore the older people’s perspectives on an “elderly-friendly” hospital. Methods Hospital was stratified by four domains including government, semi-government, community, and private. We interviewed 33 hospitalized older patients and four hospital managers between June and December 2014 in Kathmandu, Nepal, using purposive sampling technique. We executed a qualitative content analysis step with extensive review of the interviews. Final name of the theme was given after the agreement between the research team and experts to improve trustworthiness. Elderly-friendly services, expectation from government and hospital, and health policy related to senior citizen were developed as main themes. Results Most of the participants were satisfied with the behavior of health personnel. However, none of the health personnel were trained with geriatric health care. Elderly-friendly hospital guidelines and policy were not developed by any hospitals. Older people health card, advocacy for older people’s health and benefit, and hospital environment were the common expectations of older patients. Government policy and budget constraint were the main obstacles to promote elderly-friendly health care services. Conclusion Elderly-related health policies, physical environments of hospital, elderly-friendly health manpower, advocacy, and other facilities and benefits should be improved and developed. There are urgent needs to develop elderly-friendly hospital policies and guidelines that focus on older people’s health benefits and friendly services. PMID:26028980

  10. Reliability of the hospital nutrition environment scan for cafeterias, vending machines, and gift shops.

    Science.gov (United States)

    Winston, Courtney P; Sallis, James F; Swartz, Michael D; Hoelscher, Deanna M; Peskin, Melissa F

    2013-08-01

    According to ecological models, the physical environment plays a major role in determining individual health behaviors. As such, researchers have started targeting the consumer nutrition environment of large-scale foodservice operations when implementing obesity-prevention programs. In 2010, the American Hospital Association released a call-to-action encouraging health care facilities to join in this movement and improve their facilities' consumer nutrition environments. The Hospital Nutrition Environment Scan (HNES) for Cafeterias, Vending Machines, and Gift Shops was developed in 2011, and the present study evaluated the inter-rater reliability of this instrument. Two trained raters visited 39 hospitals in southern California and completed the HNES. Percent agreement, kappa statistics, and intraclass correlation coefficients were calculated. Percent agreement between raters ranged from 74.4% to 100% and kappa statistics ranged from 0.458 to 1.0. The intraclass correlation coefficient for the overall nutrition composite scores was 0.961. Given these results, the HNES demonstrated acceptable reliability metrics and can now be disseminated to assess the current state of hospital consumer nutrition environments. Copyright © 2013 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

  11. Heat-related inpatient hospitalizations and emergency room visits among California residents, May-September, 2000-2010.

    Data.gov (United States)

    California Environmental Health Tracking Program — This dataset contains case counts, rates, and confidence intervals of heat-related inpatient hospitalizations and ED visits among California residents for the years...

  12. The relationship between healthy work environments and retention of nurses in a hospital setting.

    Science.gov (United States)

    Ritter, Desiree

    2011-01-01

    The purpose of the present paper was to determine the effect a healthy work environment has on the retention of nurses in a hospital setting. There is a nursing shortage that has been ongoing and is expected to continue, resulting in challenges for the healthcare system in the United States. The significance of this issue is the impact the nursing shortage will have on healthcare organizations and patients. The present paper included an extensive review of the current literature. The literature reviewed encompassed scholarly peer-reviewed journal articles. This article focused on nurses, work environments and the impact of the work environments on retention. Important issues that emerged from this analysis were the dangers of an unhealthy environment, the impact a healthy work environment has on patient outcomes and retention, the Magnet link to healthy work environments and the manager's role in creating and sustaining a healthy work environment. The literature provided evidence of the link between healthy work environments and the retention of nurses in a hospital setting. The implications for management are to implement changes now to create a healthy work environment that will recruit and retain nurses to secure their position in the future. © 2010 The Author. Journal compilation © 2010 Blackwell Publishing Ltd.

  13. The Association of Chinese Hospital Work Environment with Nurse Burnout, Job Satisfaction, and Intention to Leave

    Science.gov (United States)

    Zhang, Li-feng; You, Li-ming; Liu, Ke; Zheng, Jing; Fang, Jin-bo; Lu, Min-min; Lv, Ai-li; Ma, Wei-guang; Wang, Jian; Wang, Shu-hong; Wu, Xue; Zhu, Xiao-wen; Bu, Xiu-qing

    2014-01-01

    The purpose of this study was to describe nurse burnout, job satisfaction, and intention to leave, and to explore the relationship of work environment to nurse outcomes in a sample of 9,698 nurses from 181 hospitals in China. Nurses reported moderate levels of emotional exhaustion and depersonalization, and high levels of reduced personal accomplishment. Nearly one fifth of the nurses reported high levels of burnout on all three dimensions. Forty-five percent of the nurses were dissatisfied with their current job; these nurses were most dissatisfied with their salary. Five percent of nurses reported intention to leave. Nurses reporting mixed and good work environments were less likely to report high burnout, job dissatisfaction, and intention to leave compared with those in poor work environments. The results suggest that high burnout and low job satisfaction are prominent problems for Chinese nurses, and improving work environment might be an effective strategy for better nurse outcomes in Chinese hospitals. PMID:24345617

  14. Impact of nurse work environment and staffing on hospital nurse and quality of care in Thailand.

    Science.gov (United States)

    Nantsupawat, Apiradee; Srisuphan, Wichit; Kunaviktikul, Wipada; Wichaikhum, Orn-Anong; Aungsuroch, Yupin; Aiken, Linda H

    2011-12-01

    To determine the impact of nurse work environment and staffing on nurse outcomes, including job satisfaction and burnout, and on quality of nursing care. Secondary data analysis of the 2007 Thai Nurse Survey. The sample consisted of 5,247 nurses who provided direct care for patients across 39 public hospitals in Thailand. Multivariate logistic regression was used to estimate the impact of nurse work environment and staffing on nurse outcomes and quality of care. Nurses cared for an average of 10 patients each. Forty-one percent of nurses had a high burnout score as measured by the Maslach Burnout Inventory; 28% of nurses were dissatisfied with their job; and 27% rated quality of nursing care as fair or poor. At the hospital level, after controlling for nurse characteristics (age, years in unit), the addition of each patient to a nurse's workload was associated with a 2% increase in the odds on nurses reporting high emotional exhaustion (odds ratio [OR] 1.02; 95% confidence interval [CI] 1.00-1.03; p work environments were about 30% less likely to report fair to poor care quality (OR 0.69; 95% CI 0.48-0.98; p work environments. The addition of each patient to a nurse's workload was associated with a 4% increase in the odds on nurses reporting quality of nursing care as fair or poor (OR 1.04; 95% CI 1.02-1.05; p work environments and nurse staffing in Thai hospitals holds promise for reducing nurse burnout, thus improving nurse retention at the hospital bedside as well as potentially improving the quality of care. Nurses should work with management and policymakers to achieve safe staffing levels and good work environments in hospitals throughout the world. © 2011 Sigma Theta Tau International.

  15. Under-reporting of notifiable infectious disease hospitalizations in a health board region in Ireland: room for improvement?

    LENUS (Irish Health Repository)

    Brabazon, E D

    2008-02-01

    Rapid notification of infectious diseases is essential for prompt public health action and for monitoring of these diseases in the Irish population at both a local and national level. Anecdotal evidence suggests, however, that the occurrence of notifiable infectious diseases is seriously underestimated. This study aims to assess the level of hospitalization for notifiable infectious diseases for a 6-year period in one health board region in Ireland and to assess whether or not there was any under-reporting during this period. All hospital in-patient admissions from 1997 to 2002 inclusive with a principal diagnosis relating to \\'infectious and parasitic diseases\\' (ICD codes 001-139) of residents from a health board region in Ireland were extracted from the Hospital In-Patient Enquiry System (HIPE). All notifiable infectious diseases were identified based on the 1981 Irish Infectious Disease Regulations and the data were analysed in the statistical package, JMP. These data were compared with the corresponding notification data. Analysis of the hospital in-patient admission data revealed a substantial burden associated with notifiable infectious diseases in this health board region: there were 2758 hospitalizations by 2454 residents, 17,034 bed days and 33 deaths. The statutory notification data comprises both general practitioner and hospital clinician reports of infectious disease. Therefore, only in cases where there are more hospitalizations than notifications can under-reporting be demonstrated. This occurred in nine out of 22 notifiable diseases and amounted to an additional 18% of notifications (or 572 cases) which were \\'missed\\' due to hospital clinician under-reporting. The majority of these under-reported cases were for viral meningitis (45%), infectious mononucleosis (27%), viral hepatitis C unspecified (15%) and acute encephalitis (5.8%). This study has highlighted the extent of under-reporting of hospitalized notifiable infectious diseases, in a

  16. [Humanization through the art of environment of children's emergency in a hospital].

    Science.gov (United States)

    Ullán, Ana M; Fernández, Esperanza; Belver, Manuel H

    2011-09-01

    This article aims to present and discuss a case-study of human betterment through the arts applied to a children's hospital. The experience related to the betterment of these environments took place in the Children's Emergency Service of the University Hospital in Salamanca. After describing the context of the case-study some attention will be devoted to the phases of the process, emphasizing those aspects linked to children's care culture and their families as well as the symbolic dimension of the space and the participation of different professionals in the experience. The case-study is assessed from different standpoints but special importance is given to parents' opinions. 51 parents of children in the emergency unit were interweaved during a month. Parents valued positively the service and stated that artists' intervention had been beneficial for the children's emotional state. The article concludes with a debate about the meaning of the hospital environment and the quality associated with its physical premises.

  17. Conflict management: challenges experienced by nurse-leaders in the hospital environment

    Directory of Open Access Journals (Sweden)

    Simone Coelho Amestoy

    Full Text Available This study aimed to understand the main conflicts experienced by nurses-leaders in the hospital environment, as well as the strategies adopted to face them. The study reflects a qualitative descriptive type approach, which was used in the case study as research strategy. The study included 25 nurses who worked in three hospitals in the city of Florianopolis, Santa Catarina. Information where obtained in the months of May to December of 2010 through semi-structured interviews, non-participant observation and dialogical workshops. Data were analyzed using the Thematic Analysis. The results demonstrated the predominant of interpersonal conflicts involving the multidisciplinary team, nurses and the nursing staff. Adopting a participatory leadership, based on dialogue emerges as a strategy for coping with conflicts in the hospital environment.

  18. [Conflict management: challenges experienced by nurse-leaders in the hospital environment].

    Science.gov (United States)

    Amestoy, Simone Coelho; Backes, Vânia Marli Schubert; Thofehrn, Maira Buss; Martini, Jussara Gue; Meirelles, Betina Hörner Schlindwein; Trindade, Letícia de Lima

    2014-06-01

    This study aimed to understand the main conflicts experienced by nurses-leaders in the hospital environment, as well as the strategies adopted to face them.The study reflects a qualitative descriptive type approach, which was used in the case study as research strategy. The study included 25 nurses who worked in three hospitals in the city of Florianopolis, Santa Catarina. Information where obtained in the months of May to December of 2010 through semi-structured interviews, non-participant observation and dialogical workshops. Data were analyzed using the Thematic Analysis. The results demonstrated the predominant of interpersonal conflicts involving the multidisciplinary team, nurses and the nursing staff Adopting a participatory leadership, based on dialogue emerges as a strategy for coping with conflicts in the hospital environment.

  19. Cold air plasma to decontaminate inanimate surfaces of the hospital environment.

    Science.gov (United States)

    Cahill, Orla J; Claro, Tânia; O'Connor, Niall; Cafolla, Anthony A; Stevens, Niall T; Daniels, Stephen; Humphreys, Hilary

    2014-03-01

    The hospital environment harbors bacteria that may cause health care-associated infections. Microorganisms, such as multiresistant bacteria, can spread around the patient's inanimate environment. Some recently introduced biodecontamination approaches in hospitals have significant limitations due to the toxic nature of the gases and the length of time required for aeration. This study evaluated the in vitro use of cold air plasma as an efficient alternative to traditional methods of biodecontamination of hospital surfaces. Cultures of methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci (VRE), extended-spectrum-β-lactamase (ESBL)-producing Escherichia coli, and Acinetobacter baumannii were applied to different materials similar to those found in the hospital environment. Artificially contaminated sections of marmoleum, mattress, polypropylene, powder-coated mild steel, and stainless steel were then exposed to a cold air pressure plasma single jet for 30 s, 60 s, and 90 s, operating at approximately 25 W and 12 liters/min flow rate. Direct plasma exposure successfully reduced the bacterial load by log 3 for MRSA, log 2.7 for VRE, log 2 for ESBL-producing E. coli, and log 1.7 for A. baumannii. The present report confirms the efficient antibacterial activity of a cold air plasma single-jet plume on nosocomial bacterially contaminated surfaces over a short period of time and highlights its potential for routine biodecontamination in the clinical environment.

  20. Hospital environment: Generator of stigma and rejection of pregnant women with HIV/aids

    Directory of Open Access Journals (Sweden)

    Yolanda Munévar-Torres

    2016-10-01

    Full Text Available Introduction: For the mothers included in this study, pregnancy is normal until they are diagnosed with HIV/AIDS. Studies on experiences in hospital environments are scarce. Objective: To understand the experiences of pregnant women living with HIV/AIDS during prenatal attention in two hospitals. Materials and methods: Interpretative phenomenological qualitative study, in which ten women, diagnosed with HIV during pregnancy and selected according to relevance and adequacy, participated. The sample size was established by theoretical saturation. Data were collected during in-depth interviews and analyzed through Colaizzi strategy. Results: Categorizing the hospital environment as a generator of stigma and rejection of pregnant women with HIV/AIDS is part of a research project on living with HIV/AIDS during pregnancy. The hospital environment shows the spaces and actors around these mothers during diagnosis and treatment of this infection. Participants refer to the first stage as “accidental diagnosis” and described attention as full of “reckless professionals”. Conclusions: Attitudes and behaviors of health professionals can generate a hostile environment for pregnant women with HIV/AIDS, heightening negative feelings, fears and uncertainties. However, they can also offer a friendly and human scenario that contributes to care and trust between professionals and pregnant women, thus helping mothers to cope with this complex experience.

  1. ANALYSIS OF INA-CBG’S FARE AND GOVERNOR REGULATION FAREON SURGERY AT INPATIENT ROOM OF UNDATA REGIONAL PUBLIC HOSPITAL IN PALU

    Directory of Open Access Journals (Sweden)

    Muh. Ryman Napirah

    2016-03-01

    Full Text Available Aim: In order to determine the fares of surgery, there are two types of fares used by hospitals namely Indonesian Case Based Groups fare (INA-CBG s and Governor Regulation fare. This study aimed to identify and analyze both types of fares in orthopedic surgery, general, eyes, midwifery, mouth, ENT, urology at inpatient room of Undata Regional Public Hospital in Palu during year 2014. Method: This was a quantitative study with descriptive approach with 46 cases as the number of surgery. Data were collected through observation and analysis of secondary data were gotten from medical record, pharmaceutical installation of IBS/IDR, inpatient therapy room (Matahari, Aster, and Teratai pavilions and cashier of inpatient room in form of cost details and patient data from January to December 2014. Data Presentation was formed on tables, where the existing fares are grouped based on the component of each cost then summed and calculated the deviation between the two types of fares. Results: This study indicated that orthopedic surgery with deviation of Rp 11.311.365, general surgery with deviation of Rp 6.438.409, eyes surgery with deviation of Rp 45.173.741, midwifery surgery with deviation of Rp 6.645.765, oral surgery with deviation of Rp 6.105.659, and urological surgery with deviation of Rp. 3.809.959. Conclusion: It can be concluded that INA-CBG's fares are higher than Governor Regulation fares except orthopedic surgery, where the Governor Regulation faresare higher than INA-CBG’s fares.

  2. Managing risk and expected financial return from selective expansion of operating room capacity: mean-variance analysis of a hospital's portfolio of surgeons.

    Science.gov (United States)

    Dexter, Franklin; Ledolter, Johannes

    2003-07-01

    Surgeons using the same amount of operating room (OR) time differ in their achieved hospital contribution margins (revenue minus variable costs) by >1000%. Thus, to improve the financial return from perioperative facilities, OR strategic decisions should selectively focus additional OR capacity and capital purchasing on a few surgeons or subspecialties. These decisions use estimates of each surgeon's and/or subspecialty's contribution margin per OR hour. The estimates are subject to uncertainty (e.g., from outliers). We account for the uncertainties by using mean-variance portfolio analysis (i.e., quadratic programming). This method characterizes the problem of selectively expanding OR capacity based on the expected financial return and risk of different portfolios of surgeons. The assessment reveals whether the choices, of which surgeons have their OR capacity expanded, are sensitive to the uncertainties in the surgeons' contribution margins per OR hour. Thus, mean-variance analysis reduces the chance of making strategic decisions based on spurious information. We also assess the financial benefit of using mean-variance portfolio analysis when the planned expansion of OR capacity is well diversified over at least several surgeons or subspecialties. Our results show that, in such circumstances, there may be little benefit from further changing the portfolio to reduce its financial risk. Surgeon and subspecialty specific hospital financial data are uncertain, a fact that should be taken into account when making decisions about expanding operating room capacity. We show that mean-variance portfolio analysis can incorporate this uncertainty, thereby guiding operating room management decision-making and reducing the chance of a strategic decision being made based on spurious information.

  3. Unplanned return to operating room after endovascular repair of abdominal aortic aneurysm (EVAR) is associated with increased risk of hospital readmission.

    Science.gov (United States)

    Aziz, Faisal; Ferranti, Katelynn; Lehman, Erik B

    2018-04-01

    Objectives Hospital readmissions after surgical operations are considered serious events. Centers for Medicare and Medicaid (CMS) consider surgical readmissions as preventable and hold hospitals responsible for them. Endovascular abdominal aortic aneurysm (EVAR) has become the first line modality of treatment for suitable patients with abdominal aortic aneurysm (AAA). The purpose of this study is to retrospectively review the factors associated with hospital readmission after EVAR. Methods The 2013 EVAR targeted American College of Surgeons (ACS-NSQIP) database and generalized 2013 general and vascular surgery ACS-NSQIP participant use files were used for this study. Patient, diagnosis, and procedure characteristics of patients undergoing EVAR surgery were assessed. Multivariate logistic regression analysis was used to determine independent risk factors for hospital readmission within 30 days after surgery. Results A total of 2277 patients (81% males, 19% females) underwent EVAR operations in the year 2013. Indications for operations included: asymptomatic large diameter (79%), symptomatic (5.7%), rupture without hypotension (4.3%), and rupture with hypotension (2.8%). Among these patients, 178 (7.8%) were readmitted to the hospital within 30 days after surgery. About 53% of all readmissions were within two weeks after the discharge. Risk factors, associated with readmission included: body mass index (per 5-units, OR 1.23, CI 1.06-1.42, p readmission for patients with presence of all these seven factors was 99.9%. Conclusions Readmission after EVAR is a serious occurrence. Various factors predispose a patient at a high risk for readmission. Unplanned return to operating room after EVAR is associated with a 11-fold increase in hospital readmission.

  4. Exploring bacterial diversity in hospital environments by GS-FLX Titanium pyrosequencing.

    Directory of Open Access Journals (Sweden)

    Margarita Poza

    Full Text Available Understanding microbial populations in hospital environments is crucial for improving human health. Hospital-acquired infections are an increasing problem in intensive care units (ICU. In this work we present an exploration of bacterial diversity at inanimate surfaces of the ICU wards of the University Hospital A Coruña (Spain, as an example of confined hospital environment subjected to selective pressure, taking the entrance hall of the hospital, an open and crowded environment, as reference. Surface swab samples were collected from both locations and recovered DNA used as template to amplify a hypervariable region of the bacterial 16S rRNA gene. Sequencing of the amplicons was performed at the Roche 454 Sequencing Center using GS-FLX Titanium procedures. Reads were pre-processed and clustered into OTUs (operational taxonomic units, which were further classified. A total of 16 canonical bacterial phyla were detected in both locations. Members of the phyla Firmicutes (mainly Staphylococcus and Streptococcus and Actinobacteria (mainly Micrococcaceae, Corynebacteriaceae and Brevibacteriaceae were over-represented in the ICU with respect to the Hall. The phyllum Proteobacteria was also well represented in the ICU, mainly by members of the families Enterobacteriaceae, Methylobacteriaceae and Sphingomonadaceae. In the Hall sample, the phyla Proteobacteria, Bacteroidetes, Deinococcus-Thermus and Cyanobacteria were over-represented with respect to the ICU. Over-representation of Proteobacteria was mainly due to the high abundance of Enterobacteriaceae members. The presented results demonstrate that bacterial diversity differs at the ICU and entrance hall locations. Reduced diversity detected at ICU, relative to the entrance hall, can be explained by its confined character and by the existence of antimicrobial selective pressure. This is the first study using deep sequencing techniques made in hospital wards showing substantial hospital microbial

  5. Exploring bacterial diversity in hospital environments by GS-FLX Titanium pyrosequencing.

    Science.gov (United States)

    Poza, Margarita; Gayoso, Carmen; Gómez, Manuel J; Rumbo-Feal, Soraya; Tomás, María; Aranda, Jesús; Fernández, Ana; Bou, Germán

    2012-01-01

    Understanding microbial populations in hospital environments is crucial for improving human health. Hospital-acquired infections are an increasing problem in intensive care units (ICU). In this work we present an exploration of bacterial diversity at inanimate surfaces of the ICU wards of the University Hospital A Coruña (Spain), as an example of confined hospital environment subjected to selective pressure, taking the entrance hall of the hospital, an open and crowded environment, as reference. Surface swab samples were collected from both locations and recovered DNA used as template to amplify a hypervariable region of the bacterial 16S rRNA gene. Sequencing of the amplicons was performed at the Roche 454 Sequencing Center using GS-FLX Titanium procedures. Reads were pre-processed and clustered into OTUs (operational taxonomic units), which were further classified. A total of 16 canonical bacterial phyla were detected in both locations. Members of the phyla Firmicutes (mainly Staphylococcus and Streptococcus) and Actinobacteria (mainly Micrococcaceae, Corynebacteriaceae and Brevibacteriaceae) were over-represented in the ICU with respect to the Hall. The phyllum Proteobacteria was also well represented in the ICU, mainly by members of the families Enterobacteriaceae, Methylobacteriaceae and Sphingomonadaceae. In the Hall sample, the phyla Proteobacteria, Bacteroidetes, Deinococcus-Thermus and Cyanobacteria were over-represented with respect to the ICU. Over-representation of Proteobacteria was mainly due to the high abundance of Enterobacteriaceae members. The presented results demonstrate that bacterial diversity differs at the ICU and entrance hall locations. Reduced diversity detected at ICU, relative to the entrance hall, can be explained by its confined character and by the existence of antimicrobial selective pressure. This is the first study using deep sequencing techniques made in hospital wards showing substantial hospital microbial diversity.

  6. Health Promoting Behaviors and the Expectations for the Environment of the Hospital Administrative Staff

    Directory of Open Access Journals (Sweden)

    Hilal Ozcebe

    2012-12-01

    Full Text Available Amac: It is important to learn how the people perceive their environment to promote health and to improve their perspectives. This study is aimed to determine the behaviors of smoking, physical activity, stres management and healthy eating of the administrative hospital staff and evaluate their perspectives about hospital environment. Gerec ve Yontem: The universe of the study was the administrative staffs working at a hospital. The questionnarie developed by the researchers .were used to collect data. The official permission was taken from hospital management, and the verbal permission was from the staff. Bulgular: The mean age of the participants was 34.4±7.43 and the mean year of working in this hospital was 10.7±7.1 years. The most common nutritional habit seen among all staff was drinking excess amount of tea, coffee, coke. Among the participants, 51.8% of the participants did not do any physical activity. The people interviewed in the study pointed out that the most given information among all topics was tobacco control (36.7%. Hospital staff declared the first desired expectations for their workplace as “having a seperate place to rest”, “professional support on communication skills”, “professional support on stress management”. The least expectation declared by the staff was "removing salt from the table". Sonuc: It is found that the hospital administrative staff interviewed in our study did not have enough awareness about health promoting behaviors and their accessibility to health promoting environment. The interventions should be developed to improve institutional policies, environmental infrastructure and also the level of awareness of staff. [TAF Prev Med Bull 2012; 11(6.000: 707-716

  7. General practice: the DREEM attachment? Comparing the educational environment of hospital and general practice placements.

    Science.gov (United States)

    Kelly, Martina; Bennett, Deirdre; O'Flynn, Siun

    2012-01-01

    The clinical learning environment is changing. General practice placements are now a fundamental part of undergraduate medical education. There is growing recognition that changes in hospital work practices are altering the breadth of exposure available to students. Surprisingly little work has been done comparing the quality of clinical placements between the hospital and community using validated tools. Such comparisons inform curriculum planning and resource allocation. The aim of this study was to compare the quality of the educational environment experienced by junior medical students during hospital and general practice placements using a widely used tool. Following the introduction of a new integrated curriculum, all Year 3 students (n=108) completed a standardised evaluation instrument, the Dundee Ready Education Environment Measure (DREEM) at the end of each of their clinical attachments (two different hospital sites and one in general practice), giving a total of 324 questionnaires. All forms were analysed and input into Graphpad INSTAT version 3. Total DREEM scores as well as subscale scores were calculated for each site. These were compared across sites using a Mann-Whitney U non-parametric test. By comparison with international standards, clinical attachments in our new integrated curriculum were rated highly. In particular, attachments in general practice scored highly with a mean score of 156.6 and perform significantly better (P students' perceptions of atmosphere and students' social self-perceptions. Finally, significant differences also emerged in students' perceptions of teachers in general practice when compared to those in the hospital setting. These findings provide evidence of the high-quality educational environment afforded students in primary care. They challenge the traditional emphasis on hospital-based teaching and preempt the question - Is the community a better place for junior students to learn?

  8. Comparison of waste anesthetic gases in operating rooms with or without an scavenging system in a Brazilian University Hospital

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    Leandro Gobbo Braz

    2017-09-01

    Full Text Available Background and objectives: Occupational exposure to waste anesthetic gases in operating room without active scavenging system has been associated with adverse health effects. Thus, this study aimed to compare the trace concentrations of the inhalational anesthetics isoflurane and sevoflurane in operating room with and without central scavenging system. Method: Waste concentrations of isoflurane and sevoflurane were measured by infrared analyzer at different locations (near the respiratory area of the assistant nurse and anesthesiologist and near the anesthesia station and at two times (30 and 120 min after the start of surgery in both operating room types. Results: All isoflurane and sevoflurane concentrations in unscavenged operating room were higher than the US recommended limit (2 parts per million, regardless of the location and time evaluated. In scavenged operating room, the average concentrations of isoflurane were within the limit of exposure, except for the measurements near the anesthesia station, regardless of the measurement times. For sevoflurane, concentrations exceeded the limit value at all measurement locations and at both times. Conclusions: The exposure to both anesthetics exceeded the international limit in unscavenged operating room. In scavenged operating room, the concentrations of sevoflurane, and to a lesser extent those of isoflurane, exceeded the recommended limit value. Thus, the operating room scavenging system analyzed in the present study decreased the anesthetic concentrations, although not to the internationally recommended values. Resumo: Justificativa e objetivos: A exposição ocupacional aos resíduos de gases anestésicos em salas de operação (SO sem sistema ativo de exaustão tem sido associada a efeitos adversos à saúde. Assim, o objetivo do estudo foi comparar os resíduos dos anestésicos inalatórios isoflurano e sevoflurano em SO com e sem sistema de exaustão. Método: Concentrações residuais

  9. Qualitative assessment of bacteria and fungi in the indoor environment of hospitals of Islamabad, Pakistan

    International Nuclear Information System (INIS)

    Tahir, S.S.; Rauf, N.; Batool, A.

    2012-01-01

    This study was conducted to determine the health risks in the indoor air of the four government. hospitals of the Islamabad city, Pakistan. Four different main wards, i.e., general male/female surgical wards, children's ward and microbiology laboratory were included. The sampling was done in the summer season due to the possibility of maximum recovery of microorganisms. Results showed presence of bacterial and fungal pathogens in the air of hospitals especially in surgical wards of all hospitals. Lowest bacterial counts were recorded in microbiology laboratory. Among bacterial isolates Micrococcus and Staphylococcus auleus were abundantly found in all hospitals as 22.09 % and 21.2 %, respectively followed by gram negative group of bacteria i.e, Enterobacteriaceae spp. (Escherichia coil), Pseudomonas spp. were found to be lowest as 6.5 % of the total bacterial load in all hospitals. Among the fungi Aspergillus (fumigatus.niger; flavus) recovery was the most in the environment of all hospitals with the value of 27.7 % and Tricosporon was observed lowest with the value of 1.15 %. p- value for total microbial load among the hospitals sampled was not significant. (author)

  10. Hospital-acquired infections associated with poor air quality in air-conditioned environments

    Directory of Open Access Journals (Sweden)

    Daniela Pinheiro da Silva

    2013-10-01

    Full Text Available Backgound and Objectives: Individuals living in cities increasingly spend more time indoors in air-conditioned environments. Air conditioner contamination can be caused by the presence of aerosols from the external or internal environment, which may be associated with disease manifestations in patients present in this type of environment. Therefore, the aim of this review was to assess the air quality in air-conditioned hospital environments as a risk factor for hospital-acquired infections – HAI – as the air can be a potential source of infection, as well as assess the exposure of professionals and patients to different pollutants. Material and Methods: A literature review was performed in the LILACS, MEDLINE, SCIELO, SCIENCE DIRECT databases, CAPES thesis database and Ministry of Health – Brazil, including studies published between 1982 and 2008. The literature search was grouped according to the thematic focus, as follows: ventilation, maintenance and cleaning of systems that comprehend the environmental quality standard. Discussion and Conclusion: Outbreaks of hospital-acquired infections associated with Aspergillus, Acinetobacter, Legionella, and other genera such as Clostridium and Nocardia, which were found in air conditioners, were observed, thus indicating the need for air-conditioning quality control in these environments.

  11. Increases in heart rate and serum cortisol concentrations in healthy dogs are positively correlated with an indoor waiting-room environment.

    Science.gov (United States)

    Perego, Roberta; Proverbio, Daniela; Spada, Eva

    2014-03-01

    Few studies have investigated the effect of veterinary clinical procedures on the welfare of dogs, with specific emphasis on the veterinary practice environment. Clinicopathologic variables have also not been assessed in these potentially stressful situations. Similar to human clinical studies, the veterinary clinical waiting room could present a significant stress factor for dogs. The present study was designed to investigate the effect of waiting-room environment on serum cortisol and glucose alterations as well as heart rate in privately owned healthy dogs. The clinical trial included 24 healthy dogs that were divided into 2 groups: the clinical waiting-room group (A) and the control group (B) that waited outside in a garden. During the entire experiment, 18 dogs (9 dogs per group) were monitored with a human heart rate monitor fastened around the chest. After 20 minutes of waiting, blood samples were collected from all of the dogs (24 dogs) to determine serum cortisol concentration. Serum cortisol concentration and mean, maximum, and minimum heart rate were significantly higher in group A compared with group B, but there was no statistical difference in serum glucose concentrations between the 2 study groups. Results of this study suggest that the waiting room is a potentially stressful situation for dogs in clinical veterinary practice, when compared with a garden, based on the assessment of adrenal cortex function and heart rate evaluation. © 2014 American Society for Veterinary Clinical Pathology and European Society for Veterinary Clinical Pathology.

  12. Study on the living environment of semi-underground room with attached green house; Fusetsu onshitsu no aru hanchikashitsu no kyojusei ni kansuru kenkyu

    Energy Technology Data Exchange (ETDEWEB)

    Tanaka, T; Tsukayama, N [Ochanomizu University, Tokyo (Japan)

    1996-10-27

    In response to demand for the expansion of living space, the living environment of semi-underground room has been investigated. An attached green house (passive solar house) is adjacent to the semi-underground room. This is reinforced concrete construction, having flat type solar collector on its roof and lighting window in its north side. It does not have artificial air conditioners. Based on the measurements of daylight factor, artificial lighting is not required at the window in the daytime, but it is desirable to use daylight and artificial lighting together at the center. The performance of sound insulation depends on the high performance soundproof sash level. There is less daily temperature variation due to its large heat capacity, and less yearly temperature variation than the outside. By shielding the solar radiation, the insolation in the green house in summer can be restricted in the same as in winter. The insolation can be easily received in winter due to its large vertical intensity of solar radiation. The green house in the south side is useful for improving the living environment of semi-underground room. The temperature rise in the semi-underground room can be restricted by opening window in summer. It is desirable for the comfortable living to use artificial cooling to reduce the daytime temperature by 3 to 4{degree}C. In winter, it is comfortable to heat by 4 to 5{degree}C. 2 refs., 7 figs.

  13. Operating room fires in periocular surgery.

    Science.gov (United States)

    Connor, Michael A; Menke, Anne M; Vrcek, Ivan; Shore, John W

    2018-06-01

    A survey of ophthalmic plastic and reconstructive surgeons as well as seven-year data regarding claims made to the Ophthalmic Mutual Insurance Company (OMIC) is used to discuss operating room fires in periocular surgery. A retrospective review of all closed claim operating room fires submitted to OMIC was performed. A survey soliciting personal experiences with operating room fires was distributed to all American Society of Oculoplastic and Reconstructive Surgeons. Over the last 2 decades, OMIC managed 7 lawsuits resulting from an operating room fire during periocular surgery. The mean settlement per lawsuit was $145,285 (range $10,000-474,994). All six patients suffered burns to the face, and three required admission to a burn unit. One hundred and sixty-eight surgeons participated in the online survey. Approximately 44% of survey respondents have experienced at least one operating room fire. Supplemental oxygen was administered in 88% of these cases. Most surgical fires reported occurred in a hospital-based operating room (59%) under monitored anesthesia care (79%). Monopolar cautery (41%) and thermal, high-temperature cautery (41%) were most commonly reported as the inciting agents. Almost half of the patients involved in a surgical fire experienced a complication from the fire (48%). Sixty-nine percent of hospital operating rooms and 66% of ambulatory surgery centers maintain an operating room fire prevention policy. An intraoperative fire can be costly for both the patient and the surgeon. Ophthalmic surgeons operate in an oxygen rich and therefore flammable environment. Proactive measures can be undertaken to reduce the incidence of surgical fires periocular surgery; however, a fire can occur at any time and the entire operating room team must be constantly vigilant to prevent and manage operating room fires.

  14. Environment surveillance of filamentous fungi in two tertiary care hospitals in China.

    Science.gov (United States)

    Hao, Zhen-feng; Ao, Jun-hong; Hao, Fei; Yang, Rong-ya; Zhu, He; Zhang, Jie

    2011-07-05

    Invasive fungal infections have constituted an increasingly important cause of morbidity and mortality in immunocompromised patients. In this study, a surveillance project was conducted in three different intensive care units of two large tertiary hospitals in China. A one-year surveillance project was conducted in two tertiary hospitals which located in northern China and southwest China respectively. Air, surfaces and tap water were sampled twice a month in a central intensive care unit, a bone marrow transplant unit, a neurosurgery intensive care unit and a live transplant department. Environmental conditions such as humidity, temperature and events taking place, for example the present of the visitors, healthcare staff and cleaning crew were also recorded at the time of sampling. The air fungal load was 91.94 cfu/m(3) and 71.02 cfu/m(3) in the southwest China hospital and the northern China hospital respectively. The five most prevalent fungi collected from air and surfaces were Penicillium spp., Cladospcrium spp., Alternaria spp., Aspergillus spp. and Saccharomyces spp. in the southwest China hospital, meanwhile Penicillium spp., Fusarium spp., Aspergillus spp., Alternaria spp. and Cladospcrium spp. in the northern China hospital. The least contaminated department was intensive care units, and the heaviest contaminated department was neurosurgery intensive care unit. Seventy-three percent of all surfaces examined in the northern China hospital and eighty-six percent in the southwest China hospital yielded fungi. Fifty-four percent of water samples from the northern China hospital and forty-nine percent from the southwest China hospital yielded fungi. These findings suggested that the fungus exist in the environment of the hospital including air, surface and water. Air and surface fungal load fluctuated over the year. Air fungal load was lower in winter and higher in summer and autumn, but seldom exceeded acceptable level. The higher values were created during

  15. Nitrous Oxide Exposure of Health Care Personnel in the Operating Rooms and Intensive Care Units in Hospitals in Macedonia

    Directory of Open Access Journals (Sweden)

    Biljana Eftimova

    2017-10-01

    CONCLUSIONS: Study indicated significant exposure of personal working in substandard ORs in CH – Shtip. Applying proper work practices and maintain control equipment (general ventilation and scavenging systems in operation, could provide for safe work environment.

  16. Restorative green outdoor environments at acute care hospitals - case studies in Denmark

    DEFF Research Database (Denmark)

    Abdul Shukor, Shureen Faris Binti

    The PhD thesis is based on research which was conducted between 2009 and 2012. It deals with green outdoor environments (GOEs) at acute care hospitals in the capital region of Denmark. The aim of this PhD study is to gain deeper knowledge about the design and use of GOEs which supports mental...... the buildings. The majority of users are satisfied with the existing GOEs and the results gained from the PRS indicate that they regard the GOEs as having potential for mental restoration. The important contributions of this PhD study are that it highlights the importance of having GOE at acute care hospitals...

  17. Use of the hospital anxiety and depression scale (HADS) in a cardiac emergency room: chest pain unit

    OpenAIRE

    Soares-Filho, Gastão L. F.; Freire, Rafael C.; Biancha, Karla; Pacheco, Ticiana; Volschan, André; Valença, Alexandre M.; Nardi, Antonio E.

    2009-01-01

    OBJECTIVE: To determine the prevalence of anxiety and depression in patients complaining of chest pain who seek a chest pain unit attendance. INTRODUCTION: Patients arriving at a Chest Pain Unit may present psychiatric disorders not identified, isolated or co-morbid to the main illness, which may interfere in the patient prognosis. METHODOLOGY: Patients were assessed by the "Hospital Anxiety and Depression Scale" as a screening instrument wile following a systematized protocol to rule out the...

  18. Development of a technical scheme for the management of chemical dangerous substances in hospitable environments

    International Nuclear Information System (INIS)

    Calleja Amador, C.E.

    2002-01-01

    The chemical substances that are used in the hospitals, and their remainders, represent risks for the environment, the health and security of those who work in these establishments, and of the civil population. The deficiency of a norm that establishes the directives for the handling responsible for such products in the hospitals that our country has motivated the elaboration of a technical scheme that serves as it guides for the correct manipulation, storage and safe disposition of chemical substances in the twenty-nine hospitals of the Caja Costarricense del Seguro Social, establishing Procedures of Standard Operation for its management. To development of the guideline proposal it took a sample of hospitals that includes three levels of comple complexity: national, regional and peripheral. Applying a methodology of evaluation of risks two factors of risk of hospitable were determined, the zones and the population but affected by the existence of chemical substances, which allowed to identify some operative deficiencies in the product handling diverse. The qualitative analysis of the results lead to the elaboration of a technical scheme that includes an instrument for the identification of risks, guideline for the management responsible for hospitable chemical substances, a friendly tool computations like complementary source of intelligence and the proposal of a governing group in charge of the monitoring of the fulfillment of these lineament. (Author) [es

  19. Public health safety and environment in inadequate hospital and healthcare settings: a review.

    Science.gov (United States)

    Baguma, D

    2017-03-01

    Public health safety and environmental management are concerns that pose challenges worldwide. This paper briefly assesses a selected impact of the environment on public health. The study used an assessment of environmental mechanism to analyse the underlying different pathways in which the health sector is affected in inadequate hospital and health care settings. We reviewed the limited available evidence of the association between the health sector and the environment, and the likely pathways through which the environment influences health. The paper also models the use of private health care as a function of costs and benefits relative to public care and no care. The need to enhancing policies to improve the administration of health services, strengthening interventions on environment using international agreements, like Rio Conventions, including measures to control hospital-related infection, planning for human resources and infrastructure construction development have linkage to improve environment care and public health. The present study findings partly also demonstrate the influence of demand for health on the environment. The list of possible interventions includes enhancing policies to improve the administration of health services, strengthening Rio Conventions implementation on environmental concerns, control of environmental hazards and public health. Copyright © 2016 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  20. Nursing practice environment, quality of care, and morale of hospital nurses in Japan.

    Science.gov (United States)

    Anzai, Eriko; Douglas, Clint; Bonner, Ann

    2014-06-01

    The purpose of this study was to describe Japanese hospital nurses' perceptions of the nursing practice environment and examine its association with nurse-reported ability to provide quality nursing care, quality of patient care, and ward morale. A cross-sectional survey design was used including 223 nurses working in 12 acute inpatient wards in a large Japanese teaching hospital. Nurses rated their work environment favorably overall using the Japanese version of the Practice Environment Scale of the Nursing Work Index. Subscale scores indicated high perceptions of physician relations and quality of nursing management, but lower scores for staffing and resources. Ward nurse managers generally rated the practice environment more positively than staff nurses except for staffing and resources. Regression analyses found the practice environment was a significant predictor of quality of patient care and ward morale, whereas perceived ability to provide quality nursing care was most strongly associated with years of clinical experience. These findings support interventions to improve the nursing practice environment, particularly staffing and resource adequacy, to enhance quality of care and ward morale in Japan. © 2013 Wiley Publishing Asia Pty Ltd.

  1. Changes in hospital nurse work environments and nurse job outcomes: an analysis of panel data.

    Science.gov (United States)

    Kutney-Lee, Ann; Wu, Evan S; Sloane, Douglas M; Aiken, Linda H

    2013-02-01

    One strategy proposed to alleviate nursing shortages is the promotion of organizational efforts that will improve nurse recruitment and retention. Cross-sectional studies have shown that the quality of the nurse work environment is associated with nurse outcomes related to retention, but there have been very few longitudinal studies undertaken to examine this relationship. To demonstrate how rates of burnout, intention to leave, and job dissatisfaction changed in a panel of hospitals over time, and to explore whether these outcomes were associated with changes in nurse work environments. A retrospective, two-stage panel design was chosen for this study. Survey data collected from large random samples of registered nurses employed in Pennsylvania hospitals in 1999 and 2006 were used to derive hospital-level rates of burnout, intention to leave current position, and job dissatisfaction, and to classify the quality of nurses' work environments at both points in time. A two-period difference model was used to estimate the dependence of changes in rates of nurse burnout, intention to leave, and job dissatisfaction on changes in nurse work environments between 1999 and 2006 in 137 hospitals, accounting for concurrent changes in nurse staffing levels. In general, nurse outcomes improved between 1999 and 2006, with fewer nurses reporting burnout, intention to leave, and job dissatisfaction in 2006 as compared to 1999. Our difference models showed that improvements in work environment had a strong negative association with changes in rates of burnout (β=-6.42%, pjob dissatisfaction (β=-8.00%, pburnout, intention to leave current position, and job dissatisfaction. Copyright © 2012 Elsevier Ltd. All rights reserved.

  2. Molecular characterization of methicillin resistant Staphylococcus aureus isolated from hospitals environments and patients in Northern Palestine

    Directory of Open Access Journals (Sweden)

    Ghaleb Adwan

    2015-09-01

    Full Text Available BACKGROUND: Staphylococcus aureus (S. aureus is considered one of the most common pathogen to humans. Infections caused by this mocroorganism can be acquired through both hospital and community settings. This study was carried out to investigate molecular characterization of MRSA strains isolated from the patients and their environment in two hospitals (Rafidia hospital and Thabet hospital inNorthern Palestine, and to determine the clonal identity between these strains and their possible contribution to nosocomial infections.METHODS: Two hundred sixty five swabbed samples were collected from these hospitals, S. aureus was isolated,  antibiotic resistant genes were Panton–Valentin leukocidin (PVL gene were detected and SCCmec and spA were typed by PCR and/or sequencing.RESULTS: The prevalence of MRSA among S. aureus isolates was 29% and 8.2% in Rafidia hospital and Thabet hospital, respectively. All strains resistant to oxacilllin disk were carried mecA gene. Majority of strains (84.6% carried SCCmec type II (n = 11, type IVa and non-typeable were also detected. In addition, PVL was detected in 2 (14.3% clinical strains. ERIC PCR patterns revealed that 2 strains recovered from patient bed and nasal swab isolated from Thabet Hospital were nontypeable, spA typing showed that they belonged to type t386 and have identical DNA sequences. Other 2 clinical isolates were spa typed, one belonged to clone t044, while the other is new clone not exist in database.CONCLUSIONS: Results may give evidence that environmental contamination possibly contributing to nosocomial infections.

  3. Nurses' work environment and intent to leave in Lebanese hospitals: implications for policy and practice.

    Science.gov (United States)

    El-Jardali, Fadi; Alameddine, Mohamad; Dumit, Nuhad; Dimassi, Hani; Jamal, Diana; Maalouf, Salwa

    2011-02-01

    The dual burden of nursing shortages and poor work environments threatens quality of patient care and places additional pressures on resource-stretched health care systems, particularly in the Eastern Mediterranean Region (EMR). There is a paucity of research in the EMR examining the quality of nurses' work environment and its association to nurses' intent to leave their jobs/countries. Systematically examine the characteristics of nurses' work environment and their relation to nurses' intent to leave their jobs within the context of Lebanon. A secondary objective is to assess the utility and validity of the NWI-R within the context of the EMR. A cross-sectional survey design was utilized to survey a total of 1793 registered nurses in 69 Lebanese hospitals. The survey instrument included questions on nurses' background, hospital characteristics, intent to leave, and the Revised Nurse Working Index (NWI-R). Data analysis included descriptive statistics for demographic characteristics, t-test and ANOVA to assess differences in agreement scores, and a multinomial logistic regression model to predict intent to leave. Thematic analysis of open-ended questions was utilized to extract themes that fit under issues relating to nurses' work environment in Lebanese hospitals. The NWI-R subscale with the lowest mean score related to control. Younger nurses had lower scores on organizational support and career development. Regression analysis revealed that for every 1 point score decrease on career development there was a 93% increase in likelihood of reporting intent to leave country. Likewise, for every 1 point score decrease on participation there was an observed 51% and 53% increase in likelihood of reporting intent to leave country and hospital, respectively. Findings show that hospital characteristics (size, accreditation status and presence of a recruitment and retention strategy) were significantly associated with NWI-R subscales. Participation, control and career

  4. Work Environment in the Operating Room during Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy : Factors Influencing Choice of Protective Equipment

    OpenAIRE

    Näslund Andréasson, Sara

    2011-01-01

    Peritoneal carcinomatosis (PC) is a common metastatic manifestation of both gastrointestinal and gynecological malignancies. Curative modes of treatment are cytoreductive surgery (CRS) combined with intraoperative hyperthermic intraperitoneal chemotherapy (HIPEC). Surgeons and operating room (OR) staff attending these procedures are exposed to chemotherapy and electrocautery smoke. Heated chemotherapy (HIPEC) may vaporize and become inhaled by those administering it and, moreover, large quant...

  5. Quotidian of accompanying family members in an environment of care: the emergence of hospital tribes

    Directory of Open Access Journals (Sweden)

    Silvia da Silva Santos Passos

    2016-06-01

    Full Text Available ABSTRACT OBJECTIVE Understand the quotidian relationships of accompanying family members in an environment of care, which are close to the metaphor of a tribe in hospital environment. METHODQualitative study with data gathered from semi-structured interviews and observations with 16 family members accompanying hospitalized individuals with dependence on self-care. Data were submitted to thematic analysis, and analyzed through the metaphor of "tribe" proposed by comprehensive sociology. RESULTS Family members build up social clusters around caring, where we find traits typical of tribes: emotional ambience; solidarity based on links of sympathy and mutual assistance; an affectual nebula in the process of interaction; a logic of fusion in tactile relations; and communion/religiosity in the process of connecting in a collective identity. CONCLUSION In the presence of tragedy, families build social clusters similar to tribes having care as a totem.

  6. [Comparison of waste anesthetic gases in operating rooms with or without an scavenging system in a Brazilian University Hospital].

    Science.gov (United States)

    Braz, Leandro Gobbo; Braz, José Reinaldo Cerqueira; Cavalcante, Guilherme Aparecido Silva; Souza, Kátina Meneghetti; Lucio, Lorena Mendes de Carvalho; Braz, Mariana Gobbo

    Occupational exposure to waste anesthetic gases in operating room (OR) without active scavenging system has been associated with adverse health effects. Thus, this study aimed to compare the trace concentrations of the inhaled anesthetics isoflurane and sevoflurane in OR with and without central scavenging system. Waste concentrations of isoflurane and sevoflurane were measured by infrared analyzer at different locations (near the respiratory area of the assistant nurse and anesthesiologist and near the anesthesia station) and at two times (30 and 120minutes after the start of surgery) in both OR types. All isoflurane and sevoflurane concentrations in unscavenged OR were higher than the US recommended limit (2 parts per million), regardless of the location and time evaluated. In scavenged OR, the average concentrations of isoflurane were within the limit of exposure, except for the measurements near the anesthesia station, regardless of the measurement times. For sevoflurane, concentrations exceeded the limit value at all measurement locations and at both times. The exposure to both anesthetics exceeded the international limit in unscavenged OR. In scavenged OR, the concentrations of sevoflurane, and to a lesser extent those of isoflurane, exceeded the recommended limit value. Thus, the OR scavenging system analyzed in the present study decreased the anesthetic concentrations, although not to the internationally recommended values. Copyright © 2017 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.

  7. Association of the nurse work environment with nurse incivility in hospitals.

    Science.gov (United States)

    Smith, Jessica G; Morin, Karen H; Lake, Eileen T

    2018-03-01

    To determine whether nurse coworker incivility is associated with the nurse work environment, defined as organisational characteristics that promote nurse autonomy. Workplace incivility can negatively affect nurses, hospitals and patients. Plentiful evidence documents that nurses working in better nurse work environments have improved job and health outcomes. There is minimal knowledge about how nurse coworker incivility relates to the United States nurse work environment. Quantitative, cross-sectional. Data were collected through online surveys of registered nurses in a southwestern United States health system. The survey content included the National Quality Forum-endorsed Practice Environment Scale of the Nursing Work Index and the Workplace Incivility Scale. Data analyses were descriptive and correlational. Mean levels of incivility were low in this sample of 233 staff nurses. Incivility occurred 'sporadically' (mean = 0.58; range 0.00-5.29). The nurse work environment was rated highly (mean = 3.10; range of 1.00-4.00). The nurse work environment was significantly inversely associated with coworker incivility. The nurse manager qualities were the principal factor of the nurse work environment associated with incivility. Supportive nurse managers reduce coworker incivility. Nurse managers can shape nurse work environments to prevent nurse incivility. © 2017 John Wiley & Sons Ltd.

  8. The role of participatory music making in supporting people with dementia in hospital environments.

    Science.gov (United States)

    Daykin, Norma; Parry, Barbara; Ball, Kerry; Walters, David; Henry, Ann; Platten, Bronwyn; Hayden, Rachel

    2017-01-01

    Background Improving the quality of care for people with dementia in general hospitals is a key priority. Creative activities including music have been examined for their potential role in enhancing quality of life for people with dementia, although relatively few studies have evaluated their use in acute hospital settings. Methods A mixed methods study examined the effects of a ten week period of weekly music sessions on the wellbeing of patients with dementia and on the ward environment in an acute elderly care service in a UK hospital. Potential effects of the music project on the ward environment were examined by comparing descriptive quantitative ward level data for two equivalent time periods, one with music and one with no music. The impact of the activity on participants' wellbeing was assessed using observational data as well as semi-structured interviews and focus groups with patients, visitors, the musician and staff. Results Ward level data were available for 85 patients with a dementia diagnosis who had stayed on the wards during the study periods. Comparison between the two periods showed a number of differences between the music and the non-music time periods, including a reduction in prescription of antipsychotic drugs. However, many factors could have contributed to the differences in the ward environment. Observational data revealed nuanced responses to music and suggested that participants generally enjoyed the activity. The impacts of music making were mediated strongly by staff responses and hospital organisation. Conclusion Data from this limited pilot study suggest that music is a useful intervention for enhancing patient and staff experiences and improving care in acute dementia care environments. The suggestion that use of anti-psychotic drugs may be reduced when music is present warrants further research.

  9. An integrated healthcare system for personalized chronic disease care in home-hospital environments.

    Science.gov (United States)

    Jeong, Sangjin; Youn, Chan-Hyun; Shim, Eun Bo; Kim, Moonjung; Cho, Young Min; Peng, Limei

    2012-07-01

    Facing the increasing demands and challenges in the area of chronic disease care, various studies on the healthcare system which can, whenever and wherever, extract and process patient data have been conducted. Chronic diseases are the long-term diseases and require the processes of the real-time monitoring, multidimensional quantitative analysis, and the classification of patients' diagnostic information. A healthcare system for chronic diseases is characterized as an at-hospital and at-home service according to a targeted environment. Both services basically aim to provide patients with accurate diagnoses of disease by monitoring a variety of physical states with a number of monitoring methods, but there are differences between home and hospital environments, and the different characteristics should be considered in order to provide more accurate diagnoses for patients, especially, patients having chronic diseases. In this paper, we propose a patient status classification method for effectively identifying and classifying chronic diseases and show the validity of the proposed method. Furthermore, we present a new healthcare system architecture that integrates the at-home and at-hospital environment and discuss the applicability of the architecture using practical target services.

  10. Consumer opinions of emergency room medical care.

    Science.gov (United States)

    McMillan, J R; Younger, M S; DeWine, L C

    1984-12-01

    If hospital management is to adapt successfully to an increasingly competitive environment, and to retain a viable emergency department, it well be necessary to objectively and accurately assess the hospital's image in the community served. Knowledge of the consumers' views is an essential input into the formulation of strategic plans. This article reports on a study in which consumer opinions on 15 dimensions of emergency room health care were obtained from 723 respondents using a mail questionnaire. Findings reveal that consumers view the emergency room as being more expensive than other health care providers. Except for being available or convenient, little or no advantage is perceived for the emergency room over the personal physician. Even though the emergency room has specialized staff and equipment, consumers do not believe patients receive better or faster treatment in an emergency room than would be obtained in a physician's office. Unless changed, these perceptions will diminish the role of the emergency room in the delivery of health care services.

  11. Nurses' perceptions of the organizational attributes of their practice environment in acute care hospitals.

    Science.gov (United States)

    Hinno, Saima; Partanen, Pirjo; Vehviläinen-Julkunen, Katri; Aaviksoo, Ain

    2009-12-01

    The aim of the present study was to examine Estonian nurses' thinking with regard to how they perceive their autonomy, control over practice, teamwork and organizational support in regional, central and general hospitals. BACKGROUND; Despite the well-documented fact that there is a need to improve nurses' working environments in hospitals to promote safe patient care, in Europe broader studies on this topic have not received priority thus far. A nationally representative stratified random sample of 478 acute care hospital nurses was surveyed using the Nursing Work Index-Revised (NWI-R) instrument in 2005/2006. Nurses perceived their autonomy, control over practice and organizational support remarkably lower than nurse-physician relationships. Age and tenure were highly related to the nurses' perceptions. The Estonian nurses' ambivalent perceptions of the organizational attributes reflected the effects ascribed to hospital reforms. There is an urgent need for nurse managers to be particularly alert and attentive with regard to nurses who have been practising the profession for more than a decade. Support for their practice should be provided with the long-term goal of assuring the retention of those experienced nurses. Continuous monitoring of nurses' perceptions should be used systematically as a tool for staffing decisions at the hospital level.

  12. Emission of extensively-drug-resistant Acinetobacter baumannii from hospital settings to the natural environment.

    Science.gov (United States)

    Seruga Music, M; Hrenovic, J; Goic-Barisic, I; Hunjak, B; Skoric, D; Ivankovic, T

    2017-08-01

    Acinetobacter baumannii is a leading emerging pathogen that is frequently recovered from patients during hospital outbreaks. The role of environmental A. baumannii reservoirs is therefore of great concern worldwide. To investigate the connection between A. baumannii causing hospital outbreaks and environmental isolates from hospital wastewater, urban sewage and river water as the final natural recipient of wastewaters. Clinical isolates from patients with hospital-acquired pneumonia and environmental isolates from water were collected during a two-month monitoring period. Recovery of A. baumannii was performed using CHROMagar Acinetobacter plates, incubated at 42°C for 48 h. Identification was performed by matrix-assisted laser desorption ionization-time of flight mass spectrometry and analyses of rpoB gene. The antibiotic resistance profiles were interpreted according to criteria given for clinical isolates of A. baumannii. The sequence types (ST) were retrieved by multi-locus sequence typing. Fourteen of 19 isolates recovered from patients, hospital wastewaters, urban sewage and river water belonged to ST-195. The remaining five isolates recovered from patients and river water were assigned to ST-1421. All isolates showed very strong relatedness and clustered into CC92, which corresponds to IC2. All isolates were non-susceptible to at least one agent in all but two or fewer antimicrobial categories, and thus were classified as 'extensively-drug-resistant' (XDR). Heteroresistance to colistin was found in two isolates from hospital wastewater. Close relatedness of clinical and environmental isolates suggests the emission of XDR A. baumannii via the untreated hospital wastewater in the natural environment. Copyright © 2017 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

  13. Re-evaluation of the shielding adequacy of the brachytherapy treatment room at Korle-Bu teaching hospital, Ghana

    International Nuclear Information System (INIS)

    Arwui, C. C.

    2009-06-01

    Staff and the general public's safety during the operation of the 137 Cs brachytherapy unit at the Korle Bu teaching hospital depends on the adequacy of the shielding of the facility. Shielding design of the brachytherapy unit at the hospital was based on postulated workload and postulated occupancy factors to critical locations at the facility where the public and staff may occupy. This facility has been in existence for the past twelve (12) years and has accumulated operational workload data which differs from the postulated one. A study was carried out to re-evaluate the integrity of the biological shielding of the 137 Cs brachytherapy unit. This study analyzed the accumulated workload data and used the information to perform shielding calculations to verify the adequacy of the biological shielding thicknesses to provide sufficient protection of staff and the public. Dose rate calculations were verified by measurements with calibrated dose rate meters. This provided the basis for determining the current state of protection and safety for staff and the general public. The results show that despite the variation in actual and postulated workloads, the dose rates were below the reference values of 0.5μSv/h for public areas and 7.5μSv/h for controlled areas. It was confirmed that the present shielding thickness of 535 mm can accommodate a high dose rate (HDR) 192 Ir source with activity in the range 370 - 570 GBq with an operational workload of 30 patients per week and an average treatment time of 10 minutes.

  14. Do smoke-free environment policies reduce smoking on hospital grounds? Evaluation of a smoke-free health service policy at two Sydney hospitals.

    Science.gov (United States)

    Poder, Natasha; Carroll, Therese; Wallace, Cate; Hua, Myna

    2012-05-01

    To evaluate the compliance of hospital staff, inpatients and visitors with Sydney South West Area Health Service's Smoke-free Environment Policy. Six sites were observed at two Sydney hospitals 2 weeks before implementation of the policy and at 2 weeks, 6 months, 12 months, 18 months and 2 years after implementation. There was an overall significant 36% (P≤0.05) reduction in observed smoking incidents on hospital grounds 2 years after implementation. Two years after implementation, observed smoking incidents reduced by 44% (P≤0.05) in staff, 37% (P≤0.05) in visitors and remained unchanged among inpatients. The Smoke-free Environment Policy was effective in reducing visitors and staff observed smoking on hospital grounds, but had little effect on inpatients' smoking. Identifying strategies to effectively manage nicotine addiction and promote cessation amongst hospital inpatients remains a key priority.

  15. Success of commonly used operating room management tools in reducing tardiness of first case of the day starts: evidence from German hospitals.

    Science.gov (United States)

    Ernst, Christian; Szczesny, Andrea; Soderstrom, Naomi; Siegmund, Frank; Schleppers, Alexander

    2012-09-01

    One of the declared objectives of surgical suite management in Germany is to increase operating room (OR) efficiency by reducing tardiness of first case of the day starts. We analyzed whether the introduction of OR management tools by German hospitals in response to increasing economic pressure was successful in achieving this objective. The OR management tools we considered were the appointment of an OR manager and the development and adoption of a surgical suite governance document (OR charter). We hypothesized that tardiness of first case starts was less in ORs that have adopted one or both of these tools. Using representative 2005 survey data from 107 German anesthesiology departments, we used a Tobit model to estimate the effect of the introduction of an OR manager or OR charter on tardiness of first case starts, while controlling for hospital size and surgical suite complexity. Adoption reduced tardiness of first case starts by at least 7 minutes (mean reduction 15 minutes, 95% confidence interval (CI): 7-22 minutes, P case starts figure prominently the objectives of surgical suite management in Germany. Our results suggest that the appointment of an OR manager or the adoption of an OR charter support this objective. For short-term decision making on the day of surgery, this reduction in tardiness may have economic implications, because it reduced overutilized OR time.

  16. [Psychosocial stress environment and health workers in public health: Differences between primary and hospital care].

    Science.gov (United States)

    García-Rodríguez, Antonio; Gutiérrez-Bedmar, Mario; Bellón-Saameño, Juan Ángel; Muñoz-Bravo, Carlos; Fernández-Crehuet Navajas, Joaquín

    2015-01-01

    To describe the psychosocial environment of health professionals in public health in primary and hospital care, and compare it with that of the general Spanish working population, as well as to evaluate the effect of psychosocial risk factors on symptoms related to perceived stress. Cross-sectional study with stratified random sampling. Health care workers in the province of Granada, distributed in 5 hospitals and 4 health districts. A total of 738 employees (medical and nursing staff) of the Andalusian Health Service (SAS) were invited to take part. CopSoQ/Istas21 questionnaire developed for the multidimensional analysis of the psychosocial work environment. Stress symptoms were measured with the Stress Profile questionnaire. The response rate was 67.5%. Compared with the Spanish workforce, our sample showed high cognitive, emotional, and sensory psychological demands, possibilities for development and sense of direction in their work. Primary care physicians were the group with a worse psychosocial work environment. All the groups studied showed high levels of stress symptoms. Multivariate analysis showed that variables associated with high levels of stress symptom were younger and with possibilities for social relations, role conflict, and higher emotional demands, and insecurity at work. Our findings support that the psychosocial work environment of health workers differs from that of the Spanish working population, being more unfavorable in general practitioners. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

  17. The association of Chinese hospital work environment with nurse burnout, job satisfaction, and intention to leave.

    Science.gov (United States)

    Zhang, Li-Feng; You, Li-Ming; Liu, Ke; Zheng, Jing; Fang, Jin-Bo; Lu, Min-Min; Lv, Ai-Li; Ma, Wei-Guang; Wang, Jian; Wang, Shu-Hong; Wu, Xue; Zhu, Xiao-Wen; Bu, Xiu-Qing

    2014-01-01

    The purpose of this study was to describe nurse burnout, job satisfaction, and intention to leave and to explore the relationship of work environment to nursing outcomes in a sample of 9,698 nurses from 181 hospitals in China. Nurses reported moderate levels of emotional exhaustion and depersonalization and high levels of reduced personal accomplishment. Nearly one-fifth of the nurses reported high levels of burnout on all three dimensions. Forty-five percent of the nurses were dissatisfied with their current job; these nurses were most dissatisfied with their salary. Five percent of nurses reported an intention to leave. Nurses reporting mixed and good work environments were less likely to report high burnout, job dissatisfaction, and intention to leave compared with those in poor work environments. The results suggest that high burnout and low job satisfaction are prominent problems for Chinese nurses, and improving work environment might be an effective strategy for better nursing outcomes in Chinese hospitals. Copyright © 2014 Elsevier Inc. All rights reserved.

  18. Nurses' Perspectives on the Geriatric Nursing Practice Environment and the Quality of Older People's Care in Ontario Acute Care Hospitals.

    Science.gov (United States)

    Fox, Mary T; Sidani, Souraya; Butler, Jeffrey I; Tregunno, Deborah

    2017-06-01

    Background Cultivating hospital environments that support older people's care is a national priority. Evidence on geriatric nursing practice environments, obtained from studies of registered nurses (RNs) in American teaching hospitals, may have limited applicability to Canada, where RNs and registered practical nurses (RPNs) care for older people in predominantly nonteaching hospitals. Purpose This study describes nurses' perceptions of the overall quality of care for older people and the geriatric nursing practice environment (geriatric resources, interprofessional collaboration, and organizational value of older people's care) and examines if these perceptions differ by professional designation and hospital teaching status. Methods A cross-sectional survey, using Dillman's tailored design, that included Geriatric Institutional Assessment Profile subscales, was completed by 2005 Ontario RNs and registered practical nurses to assess their perceptions of the quality of care and geriatric nursing practice environment. Results Scores on the Geriatric Institutional Assessment Profile subscales averaged slightly above the midpoint except for geriatric resources which was slightly below. Registered practical nurses rated the quality of care and geriatric nursing practice environment higher than RNs; no significant differences were found by hospital teaching status. Conclusions Nurses' perceptions of older people's care and the geriatric nursing practice environment differ by professional designation but not hospital teaching status. Teaching and nonteaching hospitals should both be targeted for geriatric nursing practice environment improvement initiatives.

  19. The value of the pre-hospital learning environment as part of the emergency nursing programme

    Directory of Open Access Journals (Sweden)

    Sonett van Wyk

    2015-10-01

    Objective: The study explored the views of the emergency nurse students regarding the value of rotating through the pre-hospital learning environment during an emergency nursing programme. Methods: A qualitative, explorative, descriptive and contextual research design using an Appreciative Inquiry approach was used to collect the data. Through purposive sampling a total of 45 emergency nursing students participated. Data was collected by means of selfreported Appreciative Inquiry interview guides and individual Appreciative Inquiry interviews.The data was analysed using content analysis. Results: Four major themes were identified: an unpredictable environment, role players in emergency medical services, team work, and competencies. Conclusion: The research findings support the value and continuation of utilising the prehospital clinical learning environment for placing post-basic emergency nursing students when enrolled in the emergency nursing programme.

  20. THE QUALITY OF AIR IN HOSPITAL ENVIRONMENTS CLIMATIZED AND ITS INFLUENCE IN THE OCCURRENCE OF INFECTIONS

    Directory of Open Access Journals (Sweden)

    Patrícia Staciarini Anders

    2004-08-01

    Full Text Available Climatized environment is defined as the environment where temperature and humidity are controlled.We have made a review of literature, from 1990 to 2001, through data base MEDLINE, LILACS and Ministry ofHealth – Brazil. The aim of this study was to analyze the air quality in climatized environment and the last as a riskfactor for hospital infection – HI. Twenty-three articles where analyzed and gathered by the focused theme;patterns and principles for maintaining the air quality; air quality and isolation of microorganism; air quality andoccurrence of infection. The standard of quality quotes: ventilation, maintenance and cleanness of climatizationsystems. Aspergillus, Legionella, Acinetobacter, Clostridium, Nocardia, among others where found in airconditioned devices and the first three ones being responsable for booms of HI.

  1. Determination of the exposure speed of radiation emitted by the linear accelerator, using the code MCNP5 to evaluate the radiotherapy room shields of ABC Hospital

    International Nuclear Information System (INIS)

    Corral B, J. R.

    2015-01-01

    Humans should avoid exposure to radiation, because the consequences are harmful to health. Although there are different emission sources of radiation, generated by medical devices they are usually of great interest, since people who attend hospitals are exposed in one way or another to ionizing radiation. Therefore, is important to conduct studies on radioactive levels that are generated in hospitals, as a result of the use of medical equipment. To determine levels of exposure speed of a radioactive facility there are different methods, including the radiation detector and computational method. This thesis uses the computational method. With the program MCNP5 was determined the speed of the radiation exposure in the radiotherapy room of Cancer Center of ABC Hospital in Mexico City. In the application of computational method, first the thicknesses of the shields were calculated, using variables as: 1) distance from the shield to the source; 2) desired weekly equivalent dose; 3) weekly total dose equivalent emitted by the equipment; 4) occupation and use factors. Once obtained thicknesses, we proceeded to model the bunker using the mentioned program. The program uses the Monte Carlo code to probabilistic ally determine the phenomena of interaction of radiation with the shield, which will be held during the X-ray emission from the linear accelerator. The results of computational analysis were compared with those obtained experimentally with the detection method, for which was required the use of a Geiger-Muller counter and the linear accelerator was programmed with an energy of 19 MV with 500 units monitor positioning the detector in the corresponding boundary. (Author)

  2. Learning to care for older patients: hospitals and nursing homes as learning environments.

    Science.gov (United States)

    Huls, Marije; de Rooij, Sophia E; Diepstraten, Annemie; Koopmans, Raymond; Helmich, Esther

    2015-03-01

    A significant challenge facing health care is the ageing of the population, which calls for a major response in medical education. Most clinical learning takes place within hospitals, but nursing homes may also represent suitable learning environments in which students can gain competencies in geriatric medicine. This study explores what students perceive as the main learning outcomes of a geriatric medicine clerkship in a hospital or a nursing home, and explicitly addresses factors that may stimulate or hamper the learning process. This qualitative study falls within a constructivist paradigm: it draws on socio-cultural learning theory and is guided by the principles of constructivist grounded theory. There were two phases of data collection. Firstly, a maximum variation sample of 68 students completed a worksheet, giving brief written answers on questions regarding their geriatric medicine clerkships. Secondly, focus group discussions were conducted with 19 purposively sampled students. We used template analysis, iteratively cycling between data collection and analysis, using a constant comparative process. Students described a broad range of learning outcomes and formative experiences that were largely distinct from their learning in previous clerkships with regard to specific geriatric knowledge, deliberate decision making, end-of-life care, interprofessional collaboration and communication. According to students, the nursing home differed from the hospital in three aspects: interprofessional collaboration was more prominent; the lower resources available in nursing homes stimulated students to be creative, and students reported having greater autonomy in nursing homes compared with the more extensive educational guidance provided in hospitals. In both hospitals and nursing homes, students not only learn to care for older patients, but also describe various broader learning outcomes necessary to become good doctors. The results of our study, in particular the

  3. Soft qualities in healthcare. Method and tools for soft qualities design in hospitals' built environments.

    Science.gov (United States)

    Capolongo, S; Bellini, E; Nachiero, D; Rebecchi, A; Buffoli, M

    2014-01-01

    The design of hospital environments is determined by functional requirements and technical regulations, as well as numerous protocols, which define the structure and system characteristics that such environments need to achieve. In order to improve people's well-being and the quality of their experience within public hospitals, design elements (soft qualities) are added to those 'necessary' features. The aim of this research has been to experiment a new design process and also to create health care spaces with high environmental quality and capable to meet users' emotional and perceptual needs. Such needs were investigated with the help of qualitative research tools and the design criteria for one of these soft qualities - colour - were subsequently defined on the basis of the findings. The colour scheme design for the new San Paolo Hospital Emergency Department in Milan was used as case study. Focus groups were fundamental in defining the project's goals and criteria. The issues raised have led to believe that the proper procedure is not the mere consultation of the users in order to define the goals: users should rather be involved in the whole design process and become co-agents of the choices that determine the environment characteristics, so as to meet the quality requirements identified by the users themselves. The case study has shown the possibility of developing a designing methodology made by three steps (or operational tools) in which users' groups are involved in the choices, loading to plan the environments where compliance with expectations is already implied and verified by means of the process itself. Thus, the method leads to the creation of soft qualities in Healthcare.

  4. Validation of the Postgraduate Hospital Educational Environment Measure (PHEEM) in a sample of 731 Greek residents.

    Science.gov (United States)

    Koutsogiannou, Persa; Dimoliatis, Ioannis D K; Mavridis, Dimitris; Bellos, Stefanos; Karathanos, Vassilis; Jelastopulu, Eleni

    2015-11-30

    The Greek version of the Postgraduate Hospital Educational Environment Measure (PHEEM) was evaluated to determine its psychometric properties, i.e., validity, internal consistency, sensitivity and responsiveness to be used for measuring the learning environment in Greek hospitals. The PHEEM was administered to Greek hospital residents. Internal consistency was measured using Cronbach's alpha. Root Mean Square Error of Approximation (RMSEA) was used to evaluate the fit of Structural Equation Models. Content validity was addressed by the original study. Construct validity was tested using confirmatory (to test the set of underlying dimensions suggested by the original study) and exploratory (to explore the dimensions needed to explain the variability of the given answers) factor analysis using Varimax rotation. Convergent validity was calculated by Pearson's correlation coefficient regarding the participant's PHEEM score and participant's overall satisfaction score of the added item "Overall, I am very satisfied with my specialization in this post". Sensitivity was checked by comparing good versus poor aspects of the educational environment and by satisfied versus unsatisfied participants. A total of 731 residents from 83 hospitals and 41 prefectures responded to the PHEEM. The original three-factor model didn't fit better compared to one factor model that is accounting for 32% of the variance. Cronbach's α was 0.933 when assuming one-factor model. Using a three-factor model (autonomy, teaching, social support), Cronbach's α were 0.815 (expected 0.830), 0.908 (0.839), 0.734 (0.793), respectively. The three-factor model gave an RMSEA value of 0.074 (90% confidence interval 0.071, 0.076), suggesting a fair fit. Pearson's correlation coefficient between total PHEEM and global satisfaction was 0.765. Mean question scores ranged from 19.0 (very poor) to 73.7 (very good), and mean participant scores from 5.5 (very unsatisfied) to 96.5 (very satisfied). The Greek version

  5. CLINICAL SURFACES - Activity-Based Computing for Distributed Multi-Display Environments in Hospitals

    Science.gov (United States)

    Bardram, Jakob E.; Bunde-Pedersen, Jonathan; Doryab, Afsaneh; Sørensen, Steffen

    A multi-display environment (MDE) is made up of co-located and networked personal and public devices that form an integrated workspace enabling co-located group work. Traditionally, MDEs have, however, mainly been designed to support a single “smart room”, and have had little sense of the tasks and activities that the MDE is being used for. This paper presents a novel approach to support activity-based computing in distributed MDEs, where displays are physically distributed across a large building. CLINICAL SURFACES was designed for clinical work in hospitals, and enables context-sensitive retrieval and browsing of patient data on public displays. We present the design and implementation of CLINICAL SURFACES, and report from an evaluation of the system at a large hospital. The evaluation shows that using distributed public displays to support activity-based computing inside a hospital is very useful for clinical work, and that the apparent contradiction between maintaining privacy of medical data in a public display environment can be mitigated by the use of CLINICAL SURFACES.

  6. Behavior characterization of informal caregivers of wounded patients in the hospital environment

    Directory of Open Access Journals (Sweden)

    Taynara Kelly Guimarães

    2017-11-01

    Full Text Available Wound care in the hospital environment continues at home after discharge and performed by the informal caregiver. The objective of this study was to characterize the behavior of the informal caregiver during the treatment of wounds in hospitalized patient. This is a prospective study with 39 caregivers of wounded patients in a university hospital in the Brazilian Midwest. We collected the data through direct non-participant observation and interview. We found that 94.9% of the caregivers remained in the ward during the dressing. Of these, 97.3% were close to the patient; 73% observed closely; 54.1% were familiar to the evolution of the wound; 59.5% were involved in the procedure and questioned about the dressing and/or used materials. Most caregivers of persons hospitalized with wounds are interested in and somehow participate of the dressing procedure. The nursing staff can take advantage of such moments to guide the caregivers and prepare them for homecare.

  7. Radiation exposure from liquid discharges from I-131 therapy rooms into the piping system of a hospital building

    International Nuclear Information System (INIS)

    Tuntawiroon, M.; Sritongkul, N.; Pusuwan, P.; Chaudakshetrin, P.

    2008-01-01

    Over 80% of the activity from patients undergoing radioiodine therapy for thyroid cancer is eliminated during the first three days. In our I-131 therapy unit, the number of hospitalized patients has increased from less than 200 in 2004 to more than 300 in 2006. The total amount of radio activity used is about 1,800 GBq per year, and the estimated amount excreted is calculated to be about 1,500 GBq. This results in significant volume of contaminated liquid discharges into the piping system. In this study, we monitored external dose rates in non-radiation use areas adjacent to pipeline connections in the building to ensure that the dose to non-occupational workers who reside in offices below the unit does not exceed 1 mSv per year. Exposure rates in areas adjacent to the pipeline junction connections were measured periodically from April 2006 to February 2007 five floors below the therapy unit. The measurements were made inside the wall at contact with the junction, outside the wall and in hallways at 1 meter from the wall, using a GM detector or an ionization chamber. The results were recorded in μSv/h and the dose received was estimated for members of the public. Significant increases in dose rates were detected in three floors below the unit. They were 20--30, 10--30 and 5--15 μSv/h at contact with the pipeline connections, 9--15, 10--15 and 3--5 μSv/h outside the wall, and 3--6, 4--6 and 2--5 μSv/h in hallways on floors 1, 2 and 3 respectively. After appropriate wall shielding has been provided, dose rate outside the wall was reduced to 1.4 μSv/h, and to 0.5.3 μSv/h in hallways. By using an occupancy factor 1/4 for hallways, the calculated dose now meets the public dose limits of 1 mSv per year. Therapeutic application of I-131 for the treatment of thyroid cancer generates a significant amount of contaminated liquid waste into the sewers. These wastes originate mainly from toilets, showers, wash basins and floor drains. Although waste discharges can be

  8. Paramedics' experiences of financial medicine practices in the pre-hospital environment. A pilot study

    Directory of Open Access Journals (Sweden)

    Craig Vincent-Lambert

    2016-10-01

    Objectives: This qualitative pilot study explored and described the experiences of South African Paramedics with regard to the practicing of financial medicine in the local pre-hospital emergency care environment. Method: A sample of South African Paramedics were interviewed either face-to-face or telephonically. The interviews were audio recorded and transcripts produced. Content analysis was conducted to explore, document and describe the participants' experiences with regard to financial medicine practices in the local pre-hospital environment. Results: It emerged that all of the participants had experienced a number of financial medicine practices and associated unethical conduct. Examples included Over-servicing, Selective Patient Treatment, Fraudulent Billing Practices, Eliciting of kickbacks, incentives or benefits and Deliberate Time Wasting. Conclusion: The results of this study are concerning as the actions of service providers described by the participants constitute gross violations of the ethical and professional guidelines for health care professionals. The authors recommend additional studies be conducted to further explore these findings and to establish the reasons for, and ways of, limiting financial medicine practices in the South African emergency care environment.

  9. Hypoxia Room

    Data.gov (United States)

    Federal Laboratory Consortium — The Hypoxia Room is a 8x8x8 ft. clear vinyl plastic and aluminum frame construction enclosure located within USAREIM laboratory 028. The Hypoxia Room (manufactured...

  10. Biofilm Formation and Antimicrobial Susceptibility of Staphylococcus epidermidis Strains from a Hospital Environment

    Directory of Open Access Journals (Sweden)

    Robert D. Wojtyczka

    2014-04-01

    Full Text Available The hospital environment microflora comprise a wide variety of microorganisms which are more or less pathogenic and where staphylococci are one of the most common types. The aim of the presented study was to evaluate the prevalence of the biofilm forming coagulase-negative staphylococci (CoNS in a hospital environment as a risk factor for nosocomial infections. Among 122 isolated and tested strains of CoNS the most frequent were: S. epidermidis—32 strains, S. haemolyticus—31 strains, S. capitis subsp. capitis— 21 strains, S. hominis—11 strains, S. cohnii subsp. cohnii—nine strains. In case of CoNS, the main molecule responsible for intercellular adhesion is a polysaccharide intercellular adhesin (PIA, encoded on the ica gene operon. The analysis revealed the presence of the icaADBC operon genes in 46.88% of S. epidermidis isolates. IcaA and icaD were present in 34.38% and 28.13% of strains respectively while IcaC gene was present in 37.50% of strains. IcaB gene was found in 21.88% of S. epidermidis strains. In 15 (63% strains all icaADBC operon genes were observed. The assessment of antibacterial drugs susceptibility demonstrated that analyzed CoNS strains were highly resistant to macrolides and lincosamides and more sensitive to rifampicin and linezolid. Our data indicates that the hospital environment can be colonized by biofilm forming coagulase-negative staphylococci and transmission of these strains can cause an increased risk of serious nosocomial infections.

  11. Biofilm formation and antimicrobial susceptibility of Staphylococcus epidermidis strains from a hospital environment.

    Science.gov (United States)

    Wojtyczka, Robert D; Orlewska, Kamila; Kępa, Małgorzata; Idzik, Danuta; Dziedzic, Arkadiusz; Mularz, Tomasz; Krawczyk, Michał; Miklasińska, Maria; Wąsik, Tomasz J

    2014-04-25

    The hospital environment microflora comprise a wide variety of microorganisms which are more or less pathogenic and where staphylococci are one of the most common types. The aim of the presented study was to evaluate the prevalence of the biofilm forming coagulase-negative staphylococci (CoNS) in a hospital environment as a risk factor for nosocomial infections. Among 122 isolated and tested strains of CoNS the most frequent were: S. epidermidis-32 strains, S. haemolyticus-31 strains, S. capitis subsp. capitis- 21 strains, S. hominis-11 strains, S. cohnii subsp. cohnii-nine strains. In case of CoNS, the main molecule responsible for intercellular adhesion is a polysaccharide intercellular adhesin (PIA), encoded on the ica gene operon. The analysis revealed the presence of the icaADBC operon genes in 46.88% of S. epidermidis isolates. IcaA and icaD were present in 34.38% and 28.13% of strains respectively while IcaC gene was present in 37.50% of strains. IcaB gene was found in 21.88% of S. epidermidis strains. In 15 (63%) strains all icaADBC operon genes were observed. The assessment of antibacterial drugs susceptibility demonstrated that analyzed CoNS strains were highly resistant to macrolides and lincosamides and more sensitive to rifampicin and linezolid. Our data indicates that the hospital environment can be colonized by biofilm forming coagulase-negative staphylococci and transmission of these strains can cause an increased risk of serious nosocomial infections.

  12. Practice environment as perceived by nurses in acute care hospitals in Sharjah and North Emirates.

    Science.gov (United States)

    Al-Maaitah, Rowaida; AbuAlRub, Raeda F; Al Blooshi, Sumaya

    2018-04-01

    To explore nurses' perceptions of their practice environment in acute care hospitals in Sharjah and North Emirates in the United Arab Emirates (UAE). The health of the environment in which registered nurses' work is critical to nursing outcomes. The interest to examine the practice environment extended to the Gulf area which has a complex healthcare system including the UAE. The study used an exploratory descriptive design with a qualitative part using two focus group interviews. The sample size was 450 nurses selected through a random sampling method. A self-administered questionnaire including the Practice Environment Scale of Nursing Work Index (PES-NWI) was used. In addition, semi-structured interviews for two focus groups were done. The results showed that UAE practicing nurses reported favorable perceptions of most aspects of their practice environment. Unfavorable perceptions were only reported for Staffing and Resource Adequacy. The analysis of focus group discussions resulted in different emerged themes such as Lack of Recognition and Career Promotion, and Nurses' Workload due to Paper and Administrative Work. The findings of this study suggest that strategic interventions are needed to secure adequate staff and resources and implement an effective system for evaluation of performance. © 2018 Wiley Periodicals, Inc.

  13. Hospitals

    Data.gov (United States)

    Department of Homeland Security — This database contains locations of Hospitals for 50 states and Washington D.C. , Puerto Rico and US territories. The dataset only includes hospital facilities and...

  14. Calculation of Appropriate Minimum Size of Isolation Rooms based on Questionnaire Survey of Experts and Analysis on Conditions of Isolation Room Use

    Science.gov (United States)

    Won, An-Na; Song, Hae-Eun; Yang, Young-Kwon; Park, Jin-Chul; Hwang, Jung-Ha

    2017-07-01

    After the outbreak of the MERS (Middle East Respiratory Syndrome) epidemic, issues were raised regarding response capabilities of medical institutions, including the lack of isolation rooms at hospitals. Since then, the government of Korea has been revising regulations to enforce medical laws in order to expand the operation of isolation rooms and to strengthen standards regarding their mandatory installation at hospitals. Among general and tertiary hospitals in Korea, a total of 159 are estimated to be required to install isolation rooms to meet minimum standards. For the purpose of contributing to hospital construction plans in the future, this study conducted a questionnaire survey of experts and analysed the environment and devices necessary in isolation rooms, to determine their appropriate minimum size to treat patients. The result of the analysis is as follows: First, isolation rooms at hospitals are required to have a minimum 3,300mm minor axis and a minimum 5,000mm major axis for the isolation room itself, and a minimum 1,800mm minor axis for the antechamber where personal protective equipment is donned and removed. Second, the 15 ㎡-or-larger standard for the floor area of isolation rooms will have to be reviewed and standards for the minimum width of isolation rooms will have to be established.

  15. Room for caring

    DEFF Research Database (Denmark)

    Timmermann, Connie; Uhrenfeldt, Lisbeth; Birkelund, Regner

    2015-01-01

    Aim This study explores how seriously ill hospitalized patients' experience and assign meaning to their patient room. Background Modern hospitals and the rational underlying care and treatment of today have their emphasis on diagnosis, cure and treatment. Consequently, aesthetics in the patient...... rooms such as a view of nature or natural light entering the room are often neglected in caring for these patients. Method A phenomenological-hermeneutic study design was applied and data was collected through multiple qualitative interviews combined with observations at a teaching hospital in Denmark......-being, relief and hope for the patients during serious illness. Therefore, these sensory impressions should be thought of as holding palliative potential and should be included as a part of caring for the seriously ill patients....

  16. Associations of PM2.5 and Black Carbon with Hospital Emergency Room Visits during Heavy Haze Events: A Case Study in Beijing, China.

    Science.gov (United States)

    Liang, Fengchao; Tian, Lin; Guo, Qun; Westerdahl, Dane; Liu, Yang; Jin, Xiaobin; Li, Guoxing; Pan, Xiaochuan

    2017-07-05

    In January 2013, severe haze events over northeastern China sparked substantial health concerns. This study explores the associations of fine particulate matter less than 2.5 μm (PM 2.5 ) and black carbon (BC) with hospital emergency room visits (ERVs) during a haze season in Beijing. During that period, daily counts of ERVs for respiratory, cardiovascular and ocular diseases were obtained from a Level-3A hospital in Beijing from 1 December 2012 to 28 February 2013, and associations of which with PM 2.5 and BC were estimated by time-stratified case-crossover analysis in single- and two-pollutant models. We found a 27.5% (95% confidence interval (CI): 13.0, 43.9%) increase in respiratory ERV (lag02), a 19.4% (95% CI: 2.5, 39.0%) increase in cardiovascular ERV (lag0), and a 12.6% (95% CI: 0.0, 26.7%) increase in ocular ERV (lag0) along with an interquartile range (IQR) increase in the PM 2.5 . An IQR increase of BC was associated with 27.6% (95% CI: 9.6, 48.6%) (lag02), 18.8% (95% CI: 1.4, 39.2%) (lag0) and 11.8% (95% CI: -1.4, 26.8%) (lag0) increases for changes in these same health outcomes respectively. Estimated associations were consistent after adjusting SO₂ or NO₂ in two-pollutant models. This study provides evidence that improving air quality and reducing haze days would greatly benefit the population health.

  17. Human Body Exergy Balance: Numerical Analysis of an Indoor Thermal Environment of a Passive Wooden Room in Summer

    Directory of Open Access Journals (Sweden)

    Koichi Isawa

    2015-09-01

    Full Text Available To obtain a basic understanding of the resultant changes in the human body exergy balance (input, consumption, storage, and output accompanying outdoor air temperature fluctuations, a “human body system and a built environmental system” coupled with numerical analysis was conducted. The built environmental system assumed a wooden room equipped with passive cooling strategies, such as thermal insulation and solar shading devices. It was found that in the daytime, the cool radiation exergy emitted by surrounding surfaces, such as walls increased the rate of human body exergy consumption, whereas the warm radiant exergy emitted by the surrounding surfaces at night decreased the rate of human body exergy consumption. The results suggested that the rates and proportions of the different components in the exergy balance equation (exergy input, consumption, storage, and output vary according to the outdoor temperature and humidity conditions.

  18. Fundamental study on the simultaneous removal of gaseous and particulate matters in room environment by fibrous filters

    International Nuclear Information System (INIS)

    Otani, Y.; Emi, H.; Mori, J.

    1991-01-01

    In order to achieve simultaneous removal of gaseous and particulate room air pollutants, two approaches were taken. The use of activated carbon fiber (ACF) filter, focusing on the improvement of its particle collection efficiency by using electrostatic charge caused by surface modification with chemicals and enhancement of adsorption capacity by chemical impregnation, and conversion of gaseous components to particles so as to collect them by air filters. It was shown that the immersion of ACF filter in hydrogen peroxide solution brings electrostatic charge on the fibers, which markedly increases the collection efficiency for charged particles. The impregnation of aniline is very effective for the adsorption of acetaldehyde, and by the use of corona discharge, acetaldehyde is decomposed to other gaseous matters, but some olefin compounds in cigarette smoke are converted to particles via a reaction with ozone. (author)

  19. Mold contamination in a controlled hospital environment: a 3-year surveillance in southern Italy.

    Science.gov (United States)

    Caggiano, Giuseppina; Napoli, Christian; Coretti, Caterina; Lovero, Grazia; Scarafile, Giancarlo; De Giglio, Osvalda; Montagna, Maria Teresa

    2014-11-15

    Environmental monitoring of airborne filamentous fungi is necessary to reduce fungal concentrations in operating theaters and in controlled environments, and to prevent infections. The present study reports results of a surveillance of filamentous fungi carried out on samples from air and surfaces in operating theaters and controlled environments in an Italian university hospital. Sampling was performed between January 2010 and December 2012 in 32 operating theaters and five departments with high-risk patients. Indoor air specimens were sampled using a microbiological air sampler; Rodac contact plates were used for surface sampling. Fungal isolates were identified at the level of genera and species. Sixty-one samples (61/465; 13.1%) were positive for molds, with 18 from controlled environments (18/81; 22.2%) and 43 (43/384; 11.2%) from operating theaters. The highest air fungal load (AFL, colony-forming units per cubic meter [CFU/m(3)]) was recorded in the ophthalmology operating theater, while the pediatric onco-hematology ward had the highest AFL among the wards (47 CFU/m(3)). The most common fungi identified from culture of air specimens were Aspergillus spp. (91.8%), Penicillium spp., (6%) and Paecilomyces spp. (1.5%). During the study period, a statistically significant increase in CFU over time was recorded in air-controlled environments (p = 0.043), while the increase in AFL in operating theaters was not statistically significant (p = 0.145). Molds were found in 29.1% of samples obtained from surfaces. Aspergillus fumigatus was the most commonly isolated (68.5%). Our findings will form the basis for action aimed at improving the air and surface quality of these special wards. The lack of any genetic analysis prevented any correlation of fungal environmental contamination with onset of fungal infection, an analysis that will be undertaken in a prospective study in patients admitted to the same hospital.

  20. Transcultural comparison of hospital and hospice as caring environments for dying patients.

    Science.gov (United States)

    Gates, M F

    1991-01-01

    Leininger's nursing Theory of Cultural Care Diversity and Universality provided the framework for this comparative study of two environments for persons who are dying; namely a hospital oncology unit and a free-standing hospice unit. Analysis of data from ethnographic and ethnonursing research methods including unstructured interviews, observation-participation, and field journal materials yielded contrasts with two settings. The presence of a caring atmosphere/ambience was apparent in both the hospital and hospice. Universal patterns common to both were: caring beliefs and practices of staff; identification of each setting as "community" or "home"; and multiple symbolic uses of humor and food. Diversities included hierarchical organizational structure and cure orientation in the hospital; interdisciplinary collaboration and care orientation in hospice; more pronounced use of touch as a caring modality; and greater evidence of symbolism and ritual related to death and dying in hospice. Adoption of the cultural care modes of accommodation, repatterning, and maintenance are suggested in promoting a caring atmosphere wherever dying patients are served.

  1. An optimization design proposal of automated guided vehicles for mixed type transportation in hospital environments.

    Science.gov (United States)

    González, Domingo; Romero, Luis; Espinosa, María Del Mar; Domínguez, Manuel

    2017-01-01

    The aim of this paper is to present an optimization proposal in the automated guided vehicles design used in hospital logistics, as well as to analyze the impact of its implementation in a real environment. This proposal is based on the design of those elements that would allow the vehicles to deliver an extra cart by the towing method. So, the proposal intention is to improve the productivity and the performance of the current vehicles by using a transportation method of combined carts. The study has been developed following concurrent engineering premises from three different viewpoints. First, the sequence of operations has been described, and second, a proposal of design of the equipment has been undertaken. Finally, the impact of the proposal has been analyzed according to real data from the Hospital Universitario Rio Hortega in Valladolid (Spain). In this particular case, by the implementation of the analyzed proposal in the hospital a reduction of over 35% of the current time of use can be achieved. This result may allow adding new tasks to the vehicles, and according to this, both a new kind of vehicle and a specific module can be developed in order to get a better performance.

  2. An optimization design proposal of automated guided vehicles for mixed type transportation in hospital environments.

    Directory of Open Access Journals (Sweden)

    Domingo González

    Full Text Available The aim of this paper is to present an optimization proposal in the automated guided vehicles design used in hospital logistics, as well as to analyze the impact of its implementation in a real environment.This proposal is based on the design of those elements that would allow the vehicles to deliver an extra cart by the towing method. So, the proposal intention is to improve the productivity and the performance of the current vehicles by using a transportation method of combined carts.The study has been developed following concurrent engineering premises from three different viewpoints. First, the sequence of operations has been described, and second, a proposal of design of the equipment has been undertaken. Finally, the impact of the proposal has been analyzed according to real data from the Hospital Universitario Rio Hortega in Valladolid (Spain. In this particular case, by the implementation of the analyzed proposal in the hospital a reduction of over 35% of the current time of use can be achieved. This result may allow adding new tasks to the vehicles, and according to this, both a new kind of vehicle and a specific module can be developed in order to get a better performance.

  3. Exploring the Environment/Energy Pareto Optimal Front of an Office Room Using Computational Fluid Dynamics-Based Interactive Optimization Method

    Directory of Open Access Journals (Sweden)

    Kangji Li

    2017-02-01

    Full Text Available This paper is concerned with the development of a high-resolution and control-friendly optimization framework in enclosed environments that helps improve thermal comfort, indoor air quality (IAQ, and energy costs of heating, ventilation and air conditioning (HVAC system simultaneously. A computational fluid dynamics (CFD-based optimization method which couples algorithms implemented in Matlab with CFD simulation is proposed. The key part of this method is a data interactive mechanism which efficiently passes parameters between CFD simulations and optimization functions. A two-person office room is modeled for the numerical optimization. The multi-objective evolutionary algorithm—non-dominated-and-crowding Sorting Genetic Algorithm II (NSGA-II—is realized to explore the environment/energy Pareto front of the enclosed space. Performance analysis will demonstrate the effectiveness of the presented optimization method.

  4. Nursing students' perceptions of hospital learning environments--an Australian perspective.

    Science.gov (United States)

    Chan, Dominic S

    2004-01-01

    Clinical education is a vital component in the curricula of pre-registration nursing courses and provides student nurses with the opportunity to combine cognitive, psychomotor, and affective skills. Various studies have suggested that not all practice settings are able to provide nursing students with a positive learning environment. In order to maximize nursing students' clinical learning outcomes, there is a need to examine the clinical learning environment. The purpose of this study was to assess pre-registration nursing students' perceptions of hospital learning environments during clinical field placement. Quantitative and qualitative methodology was used. One hundred and eight students provided quantitative data through completion of the survey instrument, the Clinical Learning Environment Inventory (Actual and Preferred forms). Each form is a 5-point Likert-type questionnaire, made up of 35 items consisted of 5 scales with 7 items per scale. Qualitative data, obtained through semi-structured interview of 21 students from the same cohort, were used to explain and support the quantitative findings. There were significant differences between students' actual and preferred perceptions of the clinical learning environments. Generally students preferred a more positive and favourable clinical environment than they perceived as being actually present. Since participants consisted of nursing students from just one university nursing school in South Australia, the findings may not be representative of all nursing students in general with respect to their clinical placement. However, the value of this study lies in the resulting implication for nursing education and future research. A better understanding of what constitutes quality clinical education from the students' perspective would be valuable in providing better educational experiences.

  5. Hospitals as a 'risk environment': an ethno-epidemiological study of voluntary and involuntary discharge from hospital against medical advice among people who inject drugs.

    Science.gov (United States)

    McNeil, Ryan; Small, Will; Wood, Evan; Kerr, Thomas

    2014-03-01

    People who inject drugs (PWID) experience high levels of HIV/AIDS and hepatitis C (HCV) infection that, together with injection-related complications such as non-fatal overdose and injection-related infections, lead to frequent hospitalizations. However, injection drug-using populations are among those most likely to be discharged from hospital against medical advice, which significantly increases their likelihood of hospital readmission, longer overall hospital stays, and death. In spite of this, little research has been undertaken examining how social-structural forces operating within hospital settings shape the experiences of PWID in receiving care in hospitals and contribute to discharges against medical advice. This ethno-epidemiological study was undertaken in Vancouver, Canada to explore how the social-structural dynamics within hospitals function to produce discharges against medical advice among PWID. In-depth interviews were conducted with thirty PWID recruited from among participants in ongoing observational cohort studies of people who inject drugs who reported that they had been discharged from hospital against medical advice within the previous two years. Data were analyzed thematically, and by drawing on the 'risk environment' framework and concepts of social violence. Our findings illustrate how intersecting social and structural factors led to inadequate pain and withdrawal management, which led to continued drug use in hospital settings. In turn, diverse forms of social control operating to regulate and prevent drug use in hospital settings amplified drug-related risks and increased the likelihood of discharge against medical advice. Given the significant morbidity and health care costs associated with discharge against medical advice among drug-using populations, there is an urgent need to reshape the social-structural contexts of hospital care for PWID by shifting emphasis toward evidence-based pain and drug treatment augmented by harm

  6. Sporothrix schenckii in a hospital and home environment in the city of Pelotas/RS - Brazil

    Directory of Open Access Journals (Sweden)

    Antonella S. Mattei

    2011-12-01

    Full Text Available This study describes the isolation of S. schenckii in hospital and home environments in Brazil. Samples were collected from surfaces of a veterinary service place and at home. S. schenckii was detected in 1.5% of the samples from the hospital environment. However, this fungus was isolated from all sampled areas in home environments. The isolation of S. schenckii deonstrates that these surfaces could act as infection sources to anials and huans. Therefore, employees and pet owners could be exposed to this agent, and the contamination, through surfaces, could occur through the traumatic inoculation of the fungus or by direct contact with pre-existing lesions.Esse estudo descreve o isolamento de S. schenckii em ambiente hospitalar e domiciliar, no Brasil. Foram colhidas amostras de superfície de local de atendimento veterinário e ambiente domiciliar. S. schenckii foi isolado em 1,5% das amostras do ambiente hospitalar. Entretanto, esse fungo foi isolado em todas as amostras do ambiente domiciliar. O isolamento do S. schenckii demonstra a importância dessas superfícies atuarem como fontes de infecção para animais e humanos. Portanto, funcionários e proprietários de animais de estimação estariam expostos a esse agente e a contaminação, através das superfícies, poderia ocorrer pela inoculação traumática do fungo ou pelo contato direto com lesões pré-existentes.

  7. Noise disturbance in open-plan study environments : a field study on noise sources, student tasks and room acoustic parameters

    NARCIS (Netherlands)

    Braat-Eggen, P.E.; van Heijst, A.W.M.; Hornikx, M.C.J.; Kohlrausch, A.G.

    2017-01-01

    The aim of this study is to gain more insight in the assessment of noise in open-plan study environments and to reveal correlations between noise disturbance experienced by students and the noise sources they perceive, the tasks they perform and the acoustic parameters of the open-plan study

  8. Multi-bed patient room architectural evaluation

    Directory of Open Access Journals (Sweden)

    Evangelia Sklavou

    2016-12-01

    Full Text Available Introduction: Leveraging the physical environment’s merits is crucial in healthcare settings towards fostering sustainable healing conditions. In the future, the need to retrofit hospitals already appears more probable than to build new facilities. In Greece, holistic healthcare architecture has significant potential and room to develop. Aim: The architectural research of multi-bed patient room environment. Method: A sample of multi-bed patient rooms of a Greek hospital was studied per architectural documentation and user evaluation survey. Beyond recording the existing situation and user experience, user group differences and the influence of window proximity were studied. The survey sample was based on convenience and comprised 160 patients and 136 visitors. Statistical analysis was performed in SPSS 20, using chi-square exact tests of independence. The chosen level of significance was p < 0.05. Results: Architectural documentation showed that the building morphology had a positive impact in patient rooms, with regard to sunlight penetration and view. Further solar daylight control was deemed necessary, to facilitate overall environmental comfort conditions. High spatial density and considerable disadvantages of the middle patient bed, compared to the one bedside the window and the one further in the back of the room, were also ascertained. User groups did not evaluate their surroundings significantly different, with the exception of ease of access to the view. Window proximity influenced both patients and visitors in evaluating ease of access to the view and visual discomfort. Patients were further affected on window size evaluation and visitors on view related aspects. Conclusions: Synergy between building form and function contributes in creating holistic sustainable healing environments. User evaluation can deviate from objective documentation. Patients and visitors experienced the patient room in a similar manner. The middle bed was

  9. Room Acoustics

    Science.gov (United States)

    Kuttruff, Heinrich; Mommertz, Eckard

    The traditional task of room acoustics is to create or formulate conditions which ensure the best possible propagation of sound in a room from a sound source to a listener. Thus, objects of room acoustics are in particular assembly halls of all kinds, such as auditoria and lecture halls, conference rooms, theaters, concert halls or churches. Already at this point, it has to be pointed out that these conditions essentially depend on the question if speech or music should be transmitted; in the first case, the criterion for transmission quality is good speech intelligibility, in the other case, however, the success of room-acoustical efforts depends on other factors that cannot be quantified that easily, not least it also depends on the hearing habits of the listeners. In any case, absolutely "good acoustics" of a room do not exist.

  10. Formigas como veiculadoras de microrganismos em ambiente hospitalar Ants as carriers of microorganisms in hospital environments

    Directory of Open Access Journals (Sweden)

    Rogério dos Santos Pereira

    2008-10-01

    Full Text Available Existe preocupação sobre as reais possibilidades de agravos à saúde pública que possam ser causados pela veiculação de agentes patogênicos através de formigas urbanas. O presente trabalho teve por objetivo isolar e identificar os microrganismos associados às formigas em ambiente hospitalar. Foram coletadas 125 formigas, da mesma espécie, em diferentes unidades de um Hospital Universitário. Cada formiga foi coletada com swab embebido em solução fisiológica e transferida para um tubo com caldo Brain Heart Infusion e incubados 35ºC por 24 horas. A partir de cada tubo, com crescimento, foram realizadas inoculações, em meios específicos, para isolamento dos microrganismos. As formigas apresentaram alta capacidade de veiculação de grupos de microrganismos, sendo que 63,5% das cepas eram bacilos Gram positivos produtores de esporos, 6,3% eram bacilos Gram negativos, cocos Gram positivos corresponderam a 23,1% das cepas, 6,7% eram fungos filamentosos e 0,5% eram leveduras. Desta forma, pode-se inferir que as formigas podem ser um dos responsáveis pela disseminação de microrganismos em ambientes hospitalares.Concern exists regarding the real possibility of public health threats caused by pathogenic agents that are carried by urban ants. The present study had the objective of isolating and identifying the microorganisms that are associated with ants in hospital environments. One hundred and twenty-five ants of the same species were collected from different units of a university hospital. Each ant was collected using a swab soaked with physiological solution and was transferred to a tube containing brain heart infusion broth and incubated at 35ºC for 24 hours. From each tube, with growth, inoculations were made into specific culturing media, to isolate any microorganisms. The ants presented a high capacity for carrying microorganism groups: spore-producing Gram-positive bacilli 63.5%, Gram-negative bacilli 6.3%, Gram-positive cocci

  11. We Are Going to Name Names and Call You Out! Improving the Team in the Academic Operating Room Environment.

    Science.gov (United States)

    Bodor, Richard; Nguyen, Brian J; Broder, Kevin

    2017-05-01

    Communication failures between multidisciplinary teams can impact efficiency, performance, and morale. Academic operating rooms (ORs) often have surgical, anesthesia, and nursing teams, each teaching multiple trainees. Incorrectly identifying name and "rank" (postgraduate year [PGY]) of resident trainees can disrupt performance evaluations and team morale and even potentially impair delivery of quality care when miscommunication errors proliferate. Our OR-based survey asked 50 participants (18 surgeons, 14 anesthesiologists, and 18 nursing members), to recall basic identification data including provider names and PGY levels from their recent collaborating OR teams. Participants also weighed in on the importance of using accurate "names and ranks" for all OR participants. Each service reliably knew their own team members' names and rank. However, surgery and anesthesia teams displayed decreased knowledge about their lower level trainees, whereas nursing teams performed best, identifying all level nurses present. Deficits occurred whenever participants tried recalling basic identifying data about contributors from any other collaborating team. Typically, misidentified participants were lower level PGY residents working on other teams' services. All survey respondents desired improving systems to better remember "names and ranks" identifications among OR participants, citing both safety and team morale benefits. Many fail to know the names and ranks of contributors among members of different OR teams. Even our most reliable nursing team was inconsistent at identification information from collaborating practitioners. Despite universally acknowledged benefits, participants rarely learned basic background identification data beyond their own team. Those surveyed all desired improving identifications with suggestions including sterile name and rank tags and proper notification of entry and exit from the OR. Because successful collaborations require appropriate level task

  12. Porter's generic strategies, discontinuous environments, and performance: a longitudinal study of changing strategies in the hospital industry.

    Science.gov (United States)

    Lamont, B T; Marlin, D; Hoffman, J J

    1993-12-01

    Changes in generic strategies in response to discontinuous environments have been relatively ignored in the management literature. This study reports an examination of the relationships between Porter's (1980) generic strategies, discontinuous environments, and performance. Archival data for 1984 and 1988 were collected for 172 acute care hospitals in Florida in order to test these relationships. To examine fully the performance impact of changes in strategy in a discontinuous environment, a longitudinal research design that identified a firm's strategy at two points in time, 1984 and 1988, was used. Results indicate that firms with a proper strategy environment fit performed the highest, firms that did not change their strategy had no change in performance, and firms that changed their strategy toward a proper strategy environment showed an increase in performance. Findings support the notion that hospitals with appropriate strategy-environment combinations will exhibit higher performance.

  13. Nurse odor perception in various Japanese hospital settings

    Directory of Open Access Journals (Sweden)

    Masami Horiguchi

    2015-12-01

    Full Text Available Because unpleasant hospital odors affect the nursing environment, we investigated nurses' perceptions of the odors of various hospital settings: hospital rooms, nurse stations, and human waste disposal rooms to discard the urine, stools and diapers. A questionnaire based on the Japanese Ministry of the Environment's guidelines on odor index regulation was used to assess nurses' perceptions of odor intensity, comfort, tolerability, and description in the aforementioned settings. Questionnaires were distributed to nursing department directors at three Japanese hospitals, who then disseminated the questionnaires to nursing staff. Of the 1,151 questionnaires distributed, 496 nurses participated. Human waste disposal rooms had greater odor intensity and were perceived as more uncomfortable than the other settings. Unpleasant odors in disposal rooms, hospital rooms, and nurse stations were rated as slightly intolerable in comparison. Hospital and disposal rooms were mainly described as having a “pungent odor such as of urine and stool.” In contrast, nurse stations were described as having other unpleasant odors, such as chemical, human-body-related, or sewage-like odors. Given that nurses spend much of their time in hospital rooms and nurse stations, odor management in these two settings would likely improve nurses' working conditions at hospitals. Improving odors at nurse stations is feasible. Such improvements could have indirect effects on nurse turnover and burnout.

  14. Effect of nurses' work environment on patient satisfaction: A cross-sectional study of four hospitals in Japan.

    Science.gov (United States)

    Tei-Tominaga, Maki; Sato, Fusako

    2016-01-01

    The Magnet Recognition Program is a system in the USA that recognizes a hospital as a magnet hospital for having a high retention rate of nurses and providing high quality patient care. The purpose of this study was to examine the effect of nurses' work environment with characteristics that are similar to those of magnet hospitals on patient satisfaction in Japan. The authors distributed anonymous self-administered questionnaires in August 2011 to all nurses via the directors of the nursing departments of four private hospitals. The response rates were 91% (n = 425) for nurses and 51% (n = 379) for patients. In the questionnaire for nurses, the items addressed basic attributes and a scale of work environment characteristics of a magnet hospital (the Japanese version of the Practice Environment Scale of the Nursing Work Index [PES-NWI]). The questionnaire for patients addressed basic attributes, information about their hospitalization, and items to assess patient satisfaction. To examine the effects of the PES-NWI subscales on patient satisfaction, the authors conducted multivariate logistic regression analysis for groups, which were dichotomized by 75 percentile of the scores of patient satisfaction. The result of model 1 in the multivariate logistic regression analysis demonstrated that collegial nurse-physician relations showed significant relationships with low patient satisfaction (odds ratio = 0.144, P patient satisfaction in hospitals in Japan. © 2015 Japan Academy of Nursing Science.

  15. Do nurses provide a safe sleep environment for infants in the hospital setting? An integrative review.

    Science.gov (United States)

    Patton, Carla; Stiltner, Denise; Wright, Kelly Barnhardt; Kautz, Donald D

    2015-02-01

    Sudden infant death syndrome (SIDS) may be the most preventable cause of death for infants 0 to 6 months of age. The American Academy of Pediatrics (AAP) first published safe sleep recommendations for parents and healthcare professionals in 1992. In 1994, new guidelines were published and they became known as the "Back to Sleep" campaign. After this, a noticeable decline occurred in infant deaths from SIDS. However, this number seems to have plateaued with no continuing significant improvements in infant deaths. The objective of this review was to determine whether nurses provide a safe sleep environment for infants in the hospital setting. Research studies that dealt with nursing behaviors and nursing knowledge in the hospital setting were included in the review. A search was conducted of Google Scholar, CINAHL, PubMed, and Cochrane, using the key words "NICU," "newborn," "SIDS," "safe sleep environment," "nurse," "education," "supine sleep," "prone sleep," "safe sleep," "special care nursery," "hospital policy for safe sleep," "research," "premature," "knowledge," "practice," "health care professionals," and "parents." The review included research reports on nursing knowledge and behaviors as well as parental knowledge obtained through education and role modeling of nursing staff. Only research studies were included to ensure that our analysis was based on rigorous research-based findings. Several international studies were included because they mirrored findings noted in the United States. All studies were published between 1999 and 2012. Healthcare professionals and parents were included in the studies. They were primarily self-report surveys, designed to determine what nurses, other healthcare professionals, and parents knew or had been taught about SIDS. Integrative review. Thirteen of the 16 studies included in the review found that some nurses and some mothers continued to use nonsupine positioning. Four of the 16 studies discussed nursing knowledge and

  16. Experiences from Real-World Deployment of Context-Aware Technologies in a Hospital Environment

    DEFF Research Database (Denmark)

    Bardram, Jakob Eyvind; Hansen, Thomas Riisgaard; Mogensen, Martin

    2006-01-01

    and discuss our experiences from an ongoing deployment of a suite of context-aware technologies and applications in a hospital environment, including a context-awareness infrastructure, a location tracking system, and two context-aware applications running on interactive wall displays and mobile phones. Based......Context-aware computing is a central concept in ubiquitous computing and many suggestions for context-aware technologies and applications have been proposed. There is, however, little evidence on how these concepts and technologies play out in a real-world setting. In this paper we describe...... on an analysis of the use of these systems, we observe that many of the ideas behind context-aware computing are valid, and that the context-aware applications are useful for clinicians in their work. By reflecting on the nature of the designed context-aware technologies, we present a model which states...

  17. [Cardiorespiratory arrest of the adult patient in a hospital environment: nursing contributions].

    Science.gov (United States)

    Luzia, Melissa de Freitas; Lucena, Amália de Fátima

    2009-06-01

    The objective of this study was to analyse the scientific production regarding cardiorespiratory arrest (CA) in adult patients in a hospital environment, as to support nursing knowledge. This is a systematic review, which were used SciELO, LILACS and MEDLINE databases from 1997 to 2007. Most of the articles used in the analysis referred to the survival prognostic factors of patients submitted to cardiopulmonary ressucitation (CPR) and to the results of this intervention. The prospective studies were methodologically prevalent. The nursing scientific production was numerically small when compared to the medical area. The importance of a nursing team trained and apt for CA treatment and prevention was pointed out; continual education programs were stimulated. The conclusion is that there are few nursing studies about CPR, and continual incentive to the scientific production regarding its acting both in CA prevention and RCP management is imperative.

  18. A survey on distribution and toxigenicity of Aspergillus flavus from indoor and outdoor hospital environments.

    Science.gov (United States)

    Sepahvand, Asghar; Shams-Ghahfarokhi, Masoomeh; Allameh, Abdolamir; Jahanshiri, Zahra; Jamali, Mojdeh; Razzaghi-Abyaneh, Mehdi

    2011-11-01

    In the present study, genetic diversity and mycotoxin profiles of Aspergillus flavus isolated from air (indoors and outdoors), levels (surfaces), and soils of five hospitals in Southwest Iran were examined. From a total of 146 Aspergillus colonies, 63 isolates were finally identified as A. flavus by a combination of colony morphology, microscopic criteria, and mycotoxin profiles. No Aspergillus parasiticus was isolated from examined samples. Chromatographic analyses of A. flavus isolates cultured on yeast extract-sucrose broth by tip culture method showed that approximately 10% and 45% of the isolates were able to produce aflatoxin B(1) (AFB(1)) and cyclopiazonic acid (CPA), respectively. Around 40% of the isolates produced sclerotia on Czapek-Dox agar. The isolates were classified into four chemotypes based on the ability to produce AF and CPA that majority of them (55.5%) belonged to chemotype IV comprising non-mycotoxigenic isolates. Random amplified polymorphic DNA (RAPD) profiles generated by a combination of four selected primers were used to assess genetic relatedness of 16 selected toxigenic and non-toxigenic isolates. The resulting dendrogram demonstrated the formation of two separate clusters for the A. flavus comprised both mycotoxigenic and non-toxigenic isolates in a random distribution. The obtained results in this study showed that RAPD profiling is a promising and efficient tool to determine intra-specific genetic variation among A. flavus populations from hospital environments. A. flavus isolates, either toxigenic or non-toxigenic, should be considered as potential threats for hospitalized patients due to their obvious role in the etiology of nosocomial aspergillosis.

  19. Short-term effects of fine particulate air pollution on cardiovascular hospital emergency room visits: a time-series study in Beijing, China.

    Science.gov (United States)

    Su, Chang; Breitner, Susanne; Schneider, Alexandra; Liu, Liqun; Franck, Ulrich; Peters, Annette; Pan, Xiaochuan

    2016-05-01

    The link between particulate matter (PM) and cardiovascular morbidity has been investigated in numerous studies. Less evidence exists, however, about how age, gender and season may modify this relationship. The aim of this study was to evaluate the association between ambient PM2.5 (PM ≤ 2.5 µm) and daily hospital emergency room visits (ERV) for cardiovascular diseases in Beijing, China. Moreover, potential effect modification by age, gender, season, air mass origin and the specific period with 2008 Beijing Olympic were investigated. Finally, the temporal lag structure of PM2.5 has also been explored. Daily counts of cardiovascular ERV were obtained from the Peking University Third Hospital from January 2007 to December 2008. Concurrently, data on PM2.5, PM10 (PM ≤ 10 µm), nitrogen dioxide and sulfur dioxide concentrations were obtained from monitoring networks and a fixed monitoring station. Poisson regression models adjusting for confounders were used to estimate immediate, delayed and cumulative air pollution effects. The temporal lag structure was also estimated using polynomial distributed lag (PDL) models. We calculated the relative risk (RR) for overall cardiovascular disease ERV as well as for specific causes of disease; and also investigated the potential modifying effect of age, gender, season, air mass origin and the period with 2008 Beijing Olympics. We observed adverse effects of PM2.5 on cardiovascular ERV--an IQR increase (68 μg/m(3)) in PM2.5 was associated with an overall RR of 1.022 (95% CI 0.990-1.057) obtained from PDL model. Strongest effects of PM2.5 on cardiovascular ERV were found for a lag of 7 days; the respective estimate was 1.012 (95% CI 1.002-1.022). The effects were more pronounced in females and in spring. Arrhythmia and cerebrovascular diseases showed a stronger association with PM2.5. We also found stronger PM-effects for stagnant and southern air masses and the period of Olympics modified the air pollution effects. We

  20. Factors associated with the use of cognitive aids in operating room crises: a cross-sectional study of US hospitals and ambulatory surgical centers.

    Science.gov (United States)

    Alidina, Shehnaz; Goldhaber-Fiebert, Sara N; Hannenberg, Alexander A; Hepner, David L; Singer, Sara J; Neville, Bridget A; Sachetta, James R; Lipsitz, Stuart R; Berry, William R

    2018-03-26

    Operating room (OR) crises are high-acuity events requiring rapid, coordinated management. Medical judgment and decision-making can be compromised in stressful situations, and clinicians may not experience a crisis for many years. A cognitive aid (e.g., checklist) for the most common types of crises in the OR may improve management during unexpected and rare events. While implementation strategies for innovations such as cognitive aids for routine use are becoming better understood, cognitive aids that are rarely used are not yet well understood. We examined organizational context and implementation process factors influencing the use of cognitive aids for OR crises. We conducted a cross-sectional study using a Web-based survey of individuals who had downloaded OR cognitive aids from the websites of Ariadne Labs or Stanford University between January 2013 and January 2016. In this paper, we report on the experience of 368 respondents from US hospitals and ambulatory surgical centers. We analyzed the relationship of more successful implementation (measured as reported regular cognitive aid use during applicable clinical events) with organizational context and with participation in a multi-step implementation process. We used multivariable logistic regression to identify significant predictors of reported, regular OR cognitive aid use during OR crises. In the multivariable logistic regression, small facility size was associated with a fourfold increase in the odds of a facility reporting more successful implementation (p = 0.0092). Completing more implementation steps was also significantly associated with more successful implementation; each implementation step completed was associated with just over 50% higher odds of more successful implementation (p ≤ 0.0001). More successful implementation was associated with leadership support (p organizational context and following a multi-step implementation process. Building strong organizational support and

  1. Working at Night in Hospital Environment is a Risk Factor for Arterial Stiffness

    Directory of Open Access Journals (Sweden)

    Sinem Özbay

    2012-09-01

    Full Text Available Aim: Arterial stiffness is an independent risk factor for cardiovascular disease. In previous studies, emotional stress has been reported to be a risk factor for cardiovascular disease. In this study, we aimed to investigate the effects of anxiety, stress and fatigue associated with working at night in hospital environment on arterial stiffness in physicians. Methods: The study was carried out with 30 physicians employed in Medical Faculty of Uludağ University between October 2011 and March 2012. Measurements were made using Pulse Wave Sensor HDI system (Hypertension Diagnostics Inc, Eagan, MN(Set No: CR000344 by radial artery pulse wave at the onset and end of night shift. Results: The mean age of night doctors included in the study was 26 years (range: 22-38 and the female/male ratio was 2/1. It was determined that mean values of arterial stiffness were significantly higher after night shift (1330±360 dyne/sn/cm-5 compared to mean values before night shift (1093±250 dyn/s/cm-5 (p=0.01. In the evaluation of other parameters before and after night shift, no statistically significant difference was detected (p>0.05. Conclusion: The increasing arterial stiffness in hospital employees after night shift could be attributed to the effects of stress and fatigue experienced during night shift. (The Me di cal Bul le tin of Ha se ki 2012; 50: 93-5

  2. [Aspergillus species in hospital environments with pediatric patients in critical condition].

    Science.gov (United States)

    Fernández, Mariana; Cattana, María; Rojas, Florencia; Sosa, María de Los Ángeles; Aguirre, Clarisa; Vergara, Marta; Giusiano, Gustavo

    2014-01-01

    Aspergillus is a group of opportunistic fungi that cause infections, with high morbimortality in immunosuppressed patients. Aspergillus fumigatus is the most frequent species in these infections, although the incidence of other species has increased in the last few years. To evaluate the air fungal load and the diversity of Aspergillus species in hospitals with pediatric patients in critical condition. The Intensive Care Unit and Burns Unit of a pediatric hospital were sampled every 15 days during the autumn and spring seasons. The air samples were collected with SAS Super 100(®) and the surface samples were collected by swab method. The UFC/m(3) counts found exceeded the acceptable levels. The UFC/m(3) and the diversity of Aspergillus species found in the Intensive Care Unit were higher than those found in the Burns Unit. The fungal load and the diversity of species within the units were higher than those in control environments. The use of both methods -SAS and swab- allowed the detection of a higher diversity of species, with 96 strains of Aspergillus being isolated and 12 species identified. The outstanding findings were Aspergillus sydowii, Aspergillus niger, Aspergillus flavus, Aspergillus terreus and Aspergillus parasiticus, due to their high frequency. Aspergillus fumigatus, considered unacceptable in indoor environments, was isolated in both units. Aspergillus was present with high frequency in these units. Several species are of interest in public health for being potential pathogenic agents. Air control and monitoring are essential in the prevention of these infections. Copyright © 2013 Revista Iberoamericana de Micología. Published by Elsevier Espana. All rights reserved.

  3. [A Survey of the Perception of Nurses Toward the Practice Environment at a Regional Teaching Hospital in Central Taiwan].

    Science.gov (United States)

    Hung, Jui-Tai; Lin, Ching-Wen; Wen, Wei-Chun; Lin, Esther Ching-Lan

    2015-08-01

    The nursing practice environment has been shown to wield significant influence on nursing retention and nursing quality of care. Because a large percentage of Taiwan nurses currently work at regional teaching hospitals, exploring the perception toward the practice environment of nurses working at this type of hospital is important. This study explored the perception of nurses working at a regional teaching hospital in central Taiwan toward their practice environment. A cross-sectional research design with a sample of 474 nurses from a regional hospital in central Taiwan was conducted. Instruments including the demographic data and the Chinese-version Practice Environment Scale-Nursing Work Index (CPES-NWI) were anonymously self-administered. Overall, participants were moderately satisfied with their practice environment, with the greatest dissatisfaction focused on staffing and resource adequacy. Work unit and nursing level, respectively, had significant impacts on perceptions regarding the practice environment. Furthermore, discriminant analysis identified two new compound variables: 1) adequate staffing resources and partnership in the workplace and 2) supportive administrative management environment. Participants who worked in medical and surgical units were significantly more dissatisfied with the adequacy of staffing resources and partnership in the workplace than participants who worked in acute/intensive and special units. Participants at the N2 level were significantly more dissatisfied with the supportive nature of the administrative management environment. These findings support that the nursing practice environment of regional hospitals may be improved using several measures, including: modifying the staffing and resource adequacy of nurses, fostering collaborative nurse-physician relationships, and further involving nurses in administrative management and decision-making.

  4. Recovery room nurses' knowledge regarding postoperative airway ...

    African Journals Online (AJOL)

    Adele

    room nurses in private hospitals in Northern Gauteng, South Af- rica, regarding ... room nurse' is used. The same principle applies when reference is made to the terms ... Ethical considerations. Written consent ..... Principles of CPR in theatre.

  5. The application of hospitality elements in hospitals.

    Science.gov (United States)

    Wu, Ziqi; Robson, Stephani; Hollis, Brooke

    2013-01-01

    In the last decade, many hospital designs have taken inspiration from hotels, spurred by factors such as increased patient and family expectations and regulatory or financial incentives. Increasingly, research evidence suggests the value of enhancing the physical environment to foster healing and drive consumer decisions and perceptions of service quality. Although interest is increasing in the broader applicability of numerous hospitality concepts to the healthcare field, the focus of this article is design innovations, and the services that such innovations support, from the hospitality industry. To identify physical hotel design elements and associated operational features that have been used in the healthcare arena, a series of interviews with hospital and hotel design experts were conducted. Current examples and suggestions for future hospitality elements were also sought from the experts, academic journals, and news articles. Hospitality elements applied in existing hospitals that are addressed in this article include hotel-like rooms and decor; actual hotels incorporated into medical centers; hotel-quality food, room service, and dining facilities for families; welcoming lobbies and common spaces; hospitality-oriented customer service training; enhanced service offerings, including concierges; spas or therapy centers; hotel-style signage and way-finding tools; and entertainment features. Selected elements that have potential for future incorporation include executive lounges and/or communal lobbies with complimentary wireless Internet and refreshments, centralized controls for patients, and flexible furniture. Although the findings from this study underscore the need for more hospitality-like environments in hospitals, the investment decisions made by healthcare executives must be balanced with cost-effectiveness and the assurance that clinical excellence remains the top priority.

  6. Isolation of pathogenic yeasts in the air from hospital environments in the city of Fortaleza, northeast Brazil

    Directory of Open Access Journals (Sweden)

    Rossana A Cordeiro

    Full Text Available This paper reports the results of environmental surveillance of yeasts in specific areas of two tertiary local hospitals. From March 2007 to February 2008, samples from the air of two public hospitals were collected on a monthly basis. The samples were collected through passive sedimentation method (day and night exposure of Petri dishes. A total of 240 air samples from 10 hospital environments were analyzed. These environments presented similar contamination levels, from which 80 fungi isolates were isolated: Candida parapsilosis (n = 34, Rhodotorula spp. (19, Trichosporon asahii (11, C. tropicalis (8, C. albicans (4, C. glabrata (1, C. guilliermondii (1, C. krusei (1 and Saccharomyces spp. (1. Regarding the presence of yeasts and climatic conditions, there were 40 strains (50% in semi-critical areas (natural ventilation and critical areas (air conditioned. Considering the presence of microorganisms with pathogenic potential, environmental monitoring is necessary to prevent possible hospital infections.

  7. [Job retention and nursing practice environment of hospital nurses in Japan applying the Japanese version of the Practice Environment Scale of the Nursing Work Index (PES-NWI)].

    Science.gov (United States)

    Ogata, Yasuko; Nagano, Midori; Fukuda, Takashi; Hashimoto, Michio

    2011-06-01

    The purpose of this study was to examine how the nursing practice environment affects job retention and the turnover rate among hospital nurses. The Practice Environment Scale of the Nursing Work Index (PES-NWI) was applied to investigate the nurse working environment from the viewpoint of hospital nurses in Japan. Methods A postal mail survey was conducted using the PES-NWI questionnaire targeting 2,211 nurses who were working at 91 wards in 5 hospitals situated in the Tokyo metropolitan area from February to March in 2008. In the questionnaire, hospital nurses were asked about characteristics such as sex, age and work experience as a nurse, whether they would work at the same hospital in the next year, the 31 items of the PES-NWI and job satisfaction. Nurse managers were asked to provide staff numbers to calculate the turnover rate of each ward. Logistic regression analyses were carried out, with "intention to retain or leave the workplace next year" as the dependent variable, with composite and 5 sub-scale scores of the PES-NWI and nurse characteristics as independent variables. Correlation coefficients were calculated to investigate the relationship between nurse turnover rates and nursing practice environments. A total of 1,067 full-time nurses (48.3%) from 5 hospitals responded. Almost all of them were men (95.9%), with an average age of 29.2 years old. They had an average of 7.0 years total work experience in hospitals and 5.8 years of experience at their current hospital. Cronbach's alpha coefficients were 0.75 for composite of the PES-NWI, and 0.77-0.85 for the sub-scales. All correlation coefficients between PES-NWI and job satisfaction were significant (P Leadership, and Support of Nurses" and "Staffing and Resource Adequacy" among the 5 sub-scales correlated with the intention of nurses to stay on (P < 0.05). The means for turnover rate were 10.4% for nurses and 17.6% for newly hired nurses. These rates were significantly correlated to the composite and

  8. Suspended particle and drug ingredient concentrations in hospital dispensaries and implications for pharmacists' working environments.

    Science.gov (United States)

    Inaba, Ryoichi; Hioki, Atsushi; Kondo, Yoshihiro; Nakamura, Hiroki; Nakamura, Mitsuhiro

    2016-03-01

    The aim of this study was to assess the present status of working environments for pharmacists, including the concentrations of suspended particles and suspended drug ingredients in dispensaries. We conducted a survey on the work processes and working environment in 15 hospital dispensaries, and measured the concentrations of suspended particles and suspended drug ingredients using digital dust counter and high-performance liquid chromatography tandem mass spectrometry (LC-MS/MS), respectively. Of 25 types of powdered drugs that were frequently handled in the 15 dispensaries surveyed, 11 could be quantitatively determined. The amounts of suspended particles were relatively high, but below the reference value, in three dispensaries without dust collectors. The sedative-hypnotic drug zopiclone was detected in the suspended particles at one dispensary that was not equipped with dust collectors, and the antipyretic and analgesic drug acetaminophen was detected in two dispensaries equipped with dust collectors. There was no correlation between the daily number of prescriptions containing powdered drugs and the concentration of suspended particles in dispensaries. On the basis of the suspended particle concentrations measured, we concluded that dust collectors were effective in these dispensaries. However, suspended drug ingredients were detected also in dispensaries with dust collectors. These results suggest that the drug dust control systems of individual dispensaries should be properly installed and managed.

  9. In a moment of mismatch: overseas doctors' adjustments in new hospital environments.

    Science.gov (United States)

    Harris, Anna

    2011-02-01

    This paper contributes to studies of healthcare worker migration and, more broadly, to the study of occupational adjustment, with an analysis of finely detailed sensorial data. It focuses upon doctors, who are increasingly on the move around the world, working in hospital environments different from those in which they have trained. A number of unexamined questions remain in relation to how medical practitioners shift their work across contexts, in particular the tactile nature of adjustment, which has been under-explored in health sociology. This paper examines a procedural skill; a skill in which tools have become almost natural extensions of the doctor's hands. It focuses upon what happens when doctors travel overseas and find unfamiliar equipment, and their habitual practice is interrupted. The paper argues that by studying overseas doctors' bodily adjustment during such moments of mismatch, we learn more about the environment of the doctors' past and present. It suggests that by looking at the rupture between habit and the unfamiliar, we also understand something about the ways in which we adjust to the unexpected. © 2011 The Author. Sociology of Health & Illness © 2011 Foundation for the Sociology of Health & Illness/Blackwell Publishing Ltd.

  10. Nurse practice environment, workload, burnout, job outcomes, and quality of care in psychiatric hospitals: a structural equation model approach.

    Science.gov (United States)

    Van Bogaert, Peter; Clarke, Sean; Willems, Riet; Mondelaers, Mieke

    2013-07-01

    To study the relationships between nurse practice environment, workload, burnout, job outcomes and nurse-reported quality of care in psychiatric hospital staff. Nurses' practice environments in general hospitals have been extensively investigated. Potential variations across practice settings, for instance in psychiatric hospitals, have been much less studied. A cross-sectional design with a survey. A structural equation model previously tested in acute hospitals was evaluated using survey data from a sample of 357 registered nurses, licensed practical nurses, and non-registered caregivers from two psychiatric hospitals in Belgium between December 2010-April 2011. The model included paths between practice environment dimensions and outcome variables, with burnout in a mediating position. A workload measure was also tested as a potential mediator between the practice environment and outcome variables. An improved model, slightly modified from the one validated earlier in samples of acute care nurses, was confirmed. This model explained 50% and 38% of the variance in job outcomes and nurse-reported quality of care respectively. In addition, workload was found to play a mediating role in accounting for job outcomes and significantly improved a model that ultimately explained 60% of the variance in these variables. In psychiatric hospitals as in general hospitals, nurse-physician relationship and other organizational dimensions such as nursing and hospital management were closely associated with perceptions of workload and with burnout and job satisfaction, turnover intentions, and nurse-reported quality of care. Mechanisms linking key variables and differences across settings in these relationships merit attention by managers and researchers. © 2012 Blackwell Publishing Ltd.

  11. Methicillin resistance of airborne coagulase-negative staphylococci in homes of persons having contact with a hospital environment.

    Science.gov (United States)

    Lis, Danuta O; Pacha, Jerzy Z; Idzik, Danuta

    2009-04-01

    The persons having contact with a hospital environment (hospital personnel workers and discharged patients) are highly exposed to colonization with multidrug-resistant bacteria. The aim of this study was to evaluate the airborne Staphylococcus genus features in homes in which inhabitants have had contact with the hospital environment. Airborne bacteria were collected using a 6-stage Anderson impactor. The Staphylococcus species composition and resistance to methicillin, and other antimicrobial agents among 3 coagulase-negative staphylococci (CNS) species (S cohnii spp cohnii, S epidermidis, S hominis), were determined. Antibiotic resistance of isolates was tested using the agar screen method with methicillin, the polymerase chain reaction technique to detect the mecA gene, and the disk diffusion method. A higher prevalence of methicillin-resistant (MR) strains among the species isolated (40% of S epidermidis, 40% of S hominis, and 60% of S cohnii spp cohnii) was found in homes of persons who had contact with a hospital environment compared with the reference homes (only 12% of S hominis). The mecA gene was revealed in all MR S epidermidis strains and in some MR S hominis (50%) and S cohnii spp cohnii (33%) strains. All isolated MR CNS strains were susceptible to vancomycin, rifampicin, and linezolid. High numbers of airborne multidrug-resistant MR CNS in the homes of persons having contact with a hospital environment indicates that such inhabitants pose a risk of intrafamilial spreading of MR strains via air.

  12. A Transaction Cost Analysis of Dutch Hospital Care Contracting between hospitals and health insurance companies in a deregulated environment

    NARCIS (Netherlands)

    C.A. Brandenburg (Claudia)

    2008-01-01

    textabstractThe Dutch government has started a process of reformation in the Dutch healthcare. The goal of this reformation is cost efficient healthcare in the Netherlands. Hospitals and health insurance companies in the Netherlands experience changes in regulations and funding. They are expected

  13. Hospitals

    DEFF Research Database (Denmark)

    Mullins, Michael

    2013-01-01

    The challenge could be briefly seen in these terms: hospitals as places for treatment where there’s a technology focus and hospitals for healing where there’s a human focus. In the 60s - 70s wave of new hospital building, an emphasis on technology can be seen. It’s time to move from the technology...... focus. It is not enough to consider only the factors of function within architecture, hygiene, economy and logistics. We also need to look at aspects of aesthetics, bringing nature into the building, art, color, acoustics, volume and space as we perceive them. Contemporary methods and advances...... placed, accessible, provided with plenty of greenery, and maximize sensory impressions, providing sounds, smells, sight and the possibility to be touched. This is a very well documented area I can say. Hygiene, in terms of architecture can give attention to hand wash facilities and their positioning...

  14. At most hospitals in the state of Iowa, most surgeons' daily lists of elective cases include only 1 or 2 cases: Individual surgeons' percentage operating room utilization is a consistently unreliable metric.

    Science.gov (United States)

    Dexter, Franklin; Jarvie, Craig; Epstein, Richard H

    2017-11-01

    Percentage utilization of operating room (OR) time is not an appropriate endpoint for planning additional OR time for surgeons with high caseloads, and cannot be measured accurately for surgeons with low caseloads. Nonetheless, many OR directors claim that their hospitals make decisions based on individual surgeons' OR utilizations. This incongruity could be explained by the OR managers considering the earlier mathematical studies, performed using data from a few large teaching hospitals, as irrelevant to their hospitals. The important mathematical parameter for the prior observations is the percentage of surgeon lists of elective cases that include 1 or 2 cases; "list" meaning a combination of surgeon, hospital, and date. We measure the incidence among many hospitals. Observational cohort study. 117 hospitals in Iowa from July 2013 through September 2015. Surgeons with same identifier among hospitals. Surgeon lists of cases including at least one outpatient surgical case, so that Relative Value Units (RVU's) could be measured. Averaging among hospitals in Iowa, more than half of the surgeons' lists included 1 or 2 cases (77%; P<0.00001 vs. 50%). Approximately half had 1 case (54%; P=0.0012 vs. 50%). These percentages exceeded 50% even though nearly all the surgeons operated at just 1 hospital on days with at least 1 case (97.74%; P<0.00001 vs. 50%). The cases were not of long durations; among the 82,928 lists with 1 case, the median was 6 intraoperative RVUs (e.g., adult inguinal herniorrhaphy). Accurate confidence intervals for raw or adjusted utilizations are so wide for individual surgeons that decisions based on utilization are equivalent to decisions based on random error. The implication of the current study is generalizability of that finding from the largest teaching hospital in the state to the other hospitals in the state. Copyright © 2017 Elsevier Inc. All rights reserved.

  15. The relationships between nurses' perceptions of the hemodialysis unit work environment and nurse turnover, patient satisfaction, and hospitalizations.

    Science.gov (United States)

    Gardner, Jane K; Thomas-Hawkins, Charlotte; Fogg, Louis; Latham, Carolyn E

    2007-01-01

    While the nephrology nursing shortage persists despite the continued growth of the population of individuals with Stage 5 chronic kidney disease, there is a paucity of empirical data regarding nephrology nurses' perceptions of their work environments. Moreover, there are no studies that have examined the relationship of work environment attributes to patient and nurse outcomes in dialysis settings. The purpose of this study was to examine the relationships between staff nurses' perceptions of dialysis work environments, nurses' intentions to leave their current jobs, nurse turnover, patient satisfaction, and patient hospitalization rates. A descriptive, correlational design was used. Nurse level and facility level data were obtained. The sample for nurse-level data consisted of 199 registered nurses in staff nurse roles in 56 dialysis facilities of a national dialysis company. The sample for facility-level analysis consisted of 46 dialysis facilities, and nurse-level data were aggregated for facility-level analysis. The Practice Environment Scale-Nursing Work Index (PES-NWI) was used to measure nurses' perceptions of the dialysis work environment. Nurses' intention to leave their jobs and facility-level turnover rates were the nurse outcomes examined in this study. Facility-level patient satisfaction and hospitalization rates were the patient outcomes examined. Correlation coefficients were computed to measure the relationships between study variables, and independent t-tests were performed to examine subgroup differences in work environment perceptions. Overall, nurses rated the work environment somewhat favorably. Nurses who expressed intention to leave their jobs rated the work environment more negatively compared to nurses who intended to stay. Significant correlations were found between nurses' perceptions of the dialysis work environment, nurses' intention to leave their jobs, nurse turnover rates, and patient hospitalizations. Study findings suggest that

  16. The quality of hospital work environments and missed nursing care is linked to heart failure readmissions: a cross-sectional study of US hospitals

    Science.gov (United States)

    Carthon, J Margo Brooks; Lasater, Karen B; Sloane, Douglas M; Kutney-Lee, Ann

    2015-01-01

    Introduction Threats to quality and patient safety may exist when necessary nursing care is omitted. Empirical research is needed to determine how missed nursing care is associated with patient outcomes. Aim The aim of this study was to examine the relationship between missed nursing care and hospital readmissions. Methods Cross-sectional examination, using three linked data sources—(1) nurse survey, (2) patient discharge data from three states (California, New Jersey and Pennsylvania) and (3) administrative hospital data— from 2005 to 2006. We explored the incidence of 30-day readmission for 160 930 patients with heart failure in 419 acute care hospitals in the USA. Logistic regression was used to assess the effect of missed care on the odds of readmission, adjusting for patient and hospital characteristics. Results The most frequently missed nursing care activities across all hospitals in our sample included talking to and comforting patients (42.0%), developing and updating care plans (35.8%) and educating patients and families (31.5%). For 4 of the 10 studied care activities, each 10 percentage-point increase in the number of nurses reporting having missed the activity was associated with an increase in the odds of readmission by 2–8% after adjusting for patient and hospital characteristics. However, missed nursing care was no longer a significant predictor of readmission once adjusting for the nurse work environment, except in the case of the delivery of treatments and procedures (OR 1.08, 95% CI 1.02 to 1.14). Conclusions Missed care is an independent predictor of heart failure readmissions. However, once adjusting for the quality of the nurse work environment, this relationship is attenuated. Improvements in nurses’ working conditions may be one strategy to reduce care omissions and improve patient outcomes. PMID:25672342

  17. A numerical study on the effects of exhaust locations on energy consumption and thermal environment in an office room served by displacement ventilation

    International Nuclear Information System (INIS)

    Ahmed, Ahmed Qasim; Gao, Shian; Kareem, Ali Khaleel

    2016-01-01

    Highlights: • An advanced CFD program was developed and validated successfully. • The relation between the exhaust positions and heat sources was analysed. • Energy saving, thermal comfort and inhaled air quality were studied for 5 cases. • By combining the exhaust with office lamps, a 25% of energy saving was achieved. - Abstract: In an office room, many factors affect the pattern of airflow, thermal comfort, indoor air quality and energy saving. In this study, the effects of the location of exhaust diffusers where the warm and contaminant air is extracted and their relation to room heat sources on thermal comfort and energy saving were investigated numerically for an office served by a displacement ventilation system. The indoor air quality in the breathing level and the inhaled zone were also evaluated. The contaminants were released from window and door frames in order to simulate the contaminants coming from outside. The amount of energy consumption and the indoor thermal environment for various exhaust locations were investigated numerically using the computational fluid dynamics techniques. The results showed that the thermal indoor environment, thermal comfort, quality of indoor air and energy saving were greatly improved by combining the exhaust outlets with some of the room’s heat sources such as ceiling lamps and external walls. In particular, a 25.0% of energy saving was achieved by combining the exhaust diffuser with room’s ceiling lamps. In addition, locating the exhaust diffuser near the heat sources also reduced the cooling coil load by 13.8%. The risk of a large difference in temperature between the head and foot levels, increased particle concentration in the occupied zone, as well as increased energy consumption was also clearly demonstrated when the exhaust and recirculated air outlet (return opening) were combined in one unit in the occupied boundary area that is located at 2 m away from the occupants. Thus, for the optimum energy

  18. Effect of environmental change in radiography room and psychological impact on young patients

    International Nuclear Information System (INIS)

    Kim, Seon Chil; Seok, Eun Jo

    2007-01-01

    The attempt to enhance the environment of hospitals has increased recently to minimize young patients' anxiety about tests and inspections. This gives more satisfaction with the medical service to kids and young patients. The department of radiology endeavors to improve the conditions of existing radiography rooms to help young patients psychologically feel relaxed. This facilitates the process of inspections. This paper examines the relationship between the environment of radiography rooms and its effect on young patients' state of mind. 94 patients at the age of five were observed before and after the improvement of environment of the hospital. Positive results about the psychological state of the young patients were shown after the change of the environment. The result of this paper gives an idea that the modification of hospital environment has a critical importance to the young patients' psychological state. By this conclusion it may help to improve the quality of the medical service

  19. Effect of environmental change in radiography room and psychological impact on young patients

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Seon Chil; Seok, Eun Jo [Daegu Health College, Daegu (Korea, Republic of)

    2007-03-15

    The attempt to enhance the environment of hospitals has increased recently to minimize young patients' anxiety about tests and inspections. This gives more satisfaction with the medical service to kids and young patients. The department of radiology endeavors to improve the conditions of existing radiography rooms to help young patients psychologically feel relaxed. This facilitates the process of inspections. This paper examines the relationship between the environment of radiography rooms and its effect on young patients' state of mind. 94 patients at the age of five were observed before and after the improvement of environment of the hospital. Positive results about the psychological state of the young patients were shown after the change of the environment. The result of this paper gives an idea that the modification of hospital environment has a critical importance to the young patients' psychological state. By this conclusion it may help to improve the quality of the medical service.

  20. A comparison of hospital- and community-based mental health nurses: perceptions of their work environment and psychological health.

    Science.gov (United States)

    Fielding, J; Weaver, S M

    1994-06-01

    This study compares hospital- (n = 67) and community-based (n = 55) mental health nurses in relation to their perceptions of the work environment and also their psychological health. Measures include: the General Health Questionnaire, the Maslach Burnout Inventory and the Work Environment Scale. The data, obtained from self-returned questionnaires, show that community nurses rated their work environments higher for the dimensions of Involvement, Supervisor Support, Autonomy, Innovation and Work Pressure. Hospital nurses saw their environments as being higher in (managerial) Control. There were no differences between the groups for the dimensions of Peer Cohesion, Task Orientation, Clarity or (physical) Comfort. Furthermore, there were no overall differences between the two groups in relation to psychological health, although the pattern of factors associated with emotional well-being differed. Finally, analyses of the community data revealed that those nurses with 'flexitime' arrangements evaluated their work environments less positively and showed higher levels of psychological strain than did those working 'fixed-time' schedules. The findings suggest that the hospital and community environments make different demands on nursing staff, and that this should be considered when organizing nursing services if stress is to be avoided.

  1. Causes of drug-related problems in the emergency room of a hospital in southern Brazil Problemas relacionados con medicamentos en el servicio de urgencias de un hospital en el sur de Brasil

    Directory of Open Access Journals (Sweden)

    Roberta Simone Andreazza

    2011-12-01

    Full Text Available Objective: To assess the frequency and types of drug-related problems (DRPs in patients seeking emergency care in a teaching hospital in southern Brazil and to identify the possible causes and drugs involved in these problems. Method: A cross-sectional study was performed, using a structured questionnaire for data collection. Multivariate logistic regression was used to control for possible confounding factors and to establish an independent association between the presence of DRPs and the amount of medication, patient's age and their educational level. Results: A total of 350 patients were interviewed. The frequency of DRPs was 31.6%. Quantitative ineffectiveness was observed in 30.9% of DRPs and the main cause of the DRP was an inadequate dosing regimen. Sixty-six DRPs (53.7% were caused by the health system or the health professionals. Factors independently influencing the development of DRPs were educational level and the number of drugs being taken. Conclusions: Our data suggest that one-third of the patients attending the emergency room of our hospital had a drug-related problem, highlighting the importance of considering drugs as a possible cause of health problems and the need for their more rational use.Objetivo: Evaluar la frecuencia y el tipo de problemas relacionados con medicamentos que presentan los pacientes que acuden al servicio de urgencias en un hospital universitario del sur de Brasil, e identificar las posibles causas y los fármacos involucrados. Método: La investigación siguió el modelo de estudio transversal, con una encuesta estructurada para la recogida de los datos. Se empleó el análisis de regresión logística múltiple para controlar posibles factores de confusión y establecer una asociación independiente entre la presencia de problemas relacionados con medicamentos y el número de éstos, la edad y el nivel educativo. Resultados: Se entrevistaron 350 pacientes y la frecuencia de problemas relacionados con

  2. Changing the food environment: the effect of trained volunteers on mealtime care for older people in hospital.

    Science.gov (United States)

    Roberts, Helen C

    2018-05-01

    This review will describe the evidence for changing the hospital environment to improve nutrition of older people, with particular emphasis on the role of additional mealtime assistance. Poor nutrition among older people in hospital is well recognised in many countries and is associated with poor outcomes of hospital care including increased mortality and longer lengths of stay. Factors recognised to contribute to poor dietary intake include acute illness, co-morbidities, cognitive impairment, low mood and medication. The hospital environment has also been scrutinised with reports from many countries of food being placed out of reach or going cold because time-pressured ward and catering staff often struggle to help an increasingly dependent group of patients at mealtimes. Routine screening in hospital for people at risk of under nutrition is recommended. Coloured trays and protected mealtimes are widespread although there is relatively little evidence for their impact on dietary intake. Volunteers can be trained to sfely give additional mealtime assistance including feeding to older patients on acute medical wards. They can improve the quality of mealtime care for patients and nursing staff although the evidence for improved dietary intake is mixed. In conclusion, improving the nutrition of older patients in hospital is challenging. Initiatives such as routine screening, the use of coloured trays, protected mealtimes and additional mealtime assistance can work together synergistically. Volunteers are likely to be increasingly important in an era when healthcare systems are generally limited in both financial resources and the ability to recruit sufficient nursing staff.

  3. Electromagnetic interference-aware transmission scheduling and power control for dynamic wireless access in hospital environments.

    Science.gov (United States)

    Phunchongharn, Phond; Hossain, Ekram; Camorlinga, Sergio

    2011-11-01

    We study the multiple access problem for e-Health applications (referred to as secondary users) coexisting with medical devices (referred to as primary or protected users) in a hospital environment. In particular, we focus on transmission scheduling and power control of secondary users in multiple spatial reuse time-division multiple access (STDMA) networks. The objective is to maximize the spectrum utilization of secondary users and minimize their power consumption subject to the electromagnetic interference (EMI) constraints for active and passive medical devices and minimum throughput guarantee for secondary users. The multiple access problem is formulated as a dual objective optimization problem which is shown to be NP-complete. We propose a joint scheduling and power control algorithm based on a greedy approach to solve the problem with much lower computational complexity. To this end, an enhanced greedy algorithm is proposed to improve the performance of the greedy algorithm by finding the optimal sequence of secondary users for scheduling. Using extensive simulations, the tradeoff in performance in terms of spectrum utilization, energy consumption, and computational complexity is evaluated for both the algorithms.

  4. Coping styles relate to health and work environment of Norwegian and Dutch hospital nurses : A comparative study

    NARCIS (Netherlands)

    Schreuder, Jolanda A. H.; Roelen, Corne A. M.; Groothoff, Johan W.; van der Klink, Jac J. L.; Mageroy, Nils; Pallesen, Stale; Bjorvatn, Bjorn; Moen, Bente E.

    2012-01-01

    Nurses exposed to high nursing stress report no health complaints as long as they have high coping abilities. The purpose of this study was to investigate coping styles in relation to the health status and work environment of Norwegian and Dutch hospital nurses. This comparative study included a

  5. Survey of Staphylococcus isolates among hospital personnel, environment and their antibiogram with special emphasis on methicillin resistance

    Directory of Open Access Journals (Sweden)

    Shobha K

    2005-01-01

    Full Text Available The objective of this study was to find the prevalence of Staphylococcus spp. carriage among hospital personnel and hospital environment and their antibiogram with special emphasis on methicillin resistance. A total of 205 samples from hospital personnel and environment were collected from casualty, oncology and multidisciplinary cardiac unit ward of Kasturba Medical College Hospital, Manipal. Samples were collected using sterile cotton wool swabs and inoculated into brain heart infusion broth. Subcultures were done onto blood agar and MacConkey′s agar. Isolates were identified by standard methods up to species level. Antimicrobial susceptibility test was performed according to standardized disc diffusion Kirby-Bauer method. Each of the isolates was screened for methicillin resistance using oxacillin disc on Mueller Hinton agar plate followed by MIC for methicillin and cefoxitin susceptibility test by disc diffusion method. Sixty five out of 205 strains (31.7% were Staphylococcus spp. and all of them were coagulase negative. Most of the strains belonged to S.epidermidis 49.23%(32/65 followed by S. saprophyticus 26.15%(17/65. Maximum isolates of S.epidermidis were from anterior nares 28.12%(9/32 strains of S.epidermidis . Highest number of methicillin resistant coagulase negative strains (3/9, 33.33% were isolated from stethoscope of multidisciplinary cardiac unit ward followed by carriers in the anterior nares (2/9, 22.22%. Methicillin resistant coagulase negative staphylococci are prevalent in anterior nares of hospital personnel and in the hospital environment thereby providing a definite source for hospital acquired infection. All isolates were sensitive to vancomycin, ciprofloxacin and amikacin.

  6. Single room occupancy (SRO) hotels as mental health risk environments among impoverished women: the intersection of policy, drug use, trauma, and urban space.

    Science.gov (United States)

    Knight, Kelly R; Lopez, Andrea M; Comfort, Megan; Shumway, Martha; Cohen, Jennifer; Riley, Elise D

    2014-05-01

    Due to the significantly high levels of comorbid substance use and mental health diagnosis among urban poor populations, examining the intersection of drug policy and place requires a consideration of the role of housing in drug user mental health. In San Francisco, geographic boundedness and progressive health and housing polices have coalesced to make single room occupancy hotels (SROs) a key urban built environment used to house poor populations with co-occurring drug use and mental health issues. Unstably housed women who use illicit drugs have high rates of lifetime and current trauma, which manifests in disproportionately high rates of post-traumatic stress disorder (PTSD), anxiety, and depression when compared to stably housed women. We report data from a qualitative interview study (n=30) and four years of ethnography conducted with housing policy makers and unstably housed women who use drugs and live in SROs. Women in the study lived in a range of SRO built environments, from publicly funded, newly built SROs to privately owned, dilapidated buildings, which presented a rich opportunity for ethnographic comparison. Applying Rhodes et al.'s framework of socio-structural vulnerability, we explore how SROs can operate as "mental health risk environments" in which macro-structural factors (housing policies shaping the built environment) interact with meso-level factors (social relations within SROs) and micro-level, behavioral coping strategies to impact women's mental health. The degree to which SRO built environments were "trauma-sensitive" at the macro level significantly influenced women's mental health at meso- and micro-levels. Women who were living in SROs which exacerbated fear and anxiety attempted, with limited success, to deploy strategies on the meso- and micro-level to manage their mental health symptoms. Study findings underscore the importance of housing polices which consider substance use in the context of current and cumulative trauma

  7. Empowerment, environment and person-centred care: A qualitative study exploring the hospital experience for adults with cognitive impairment.

    Science.gov (United States)

    Prato, Laura; Lindley, Lyndsay; Boyles, Miriam; Robinson, Louise; Abley, Clare

    2018-01-01

    It is acknowledged that there are many challenges to ensuring a positive hospital experience for patients with cognitive impairment. The study ('Improving hospital care for adults with cognitive impairment') aimed to explore the positive and negative experiences of older adults with cognitive impairment (dementia and delirium) and their relatives and/or carers, during an acute hospital stay, from admission to discharge, using a qualitative, case study methodology. Six participants with cognitive impairment, eight relatives and 59 members of the health care team were recruited. Data was collected via ethnographic, observational periods at each stage of the hospital journey and through the use of semi-structured interviews with relatives, carers and health care staff including: medical staff; nursing staff; physiotherapists and ward managers. Interpretive phenomenological analysis was used to facilitate data analysis. 52 hours 55 minutes of ethnographic observations and 18 interviews with ward staff and relatives were undertaken. Three superordinate themes emerged from the data as crucial in determining the quality of the hospital experience: valuing the person; activities of empowerment and disempowerment and the interaction of environment with patient well-being. Whether the patient's hospital experience was positive or negative was powerfully influenced by family involvement and ward staff actions and communication. Participants identified a requirement for a ward based activity service for patients with cognitive impairment. Further research must be undertaken focusing on the development of ward based activities for patients with cognitive impairment, alongside a move towards care which explores measures to improve and expand relative involvement in hospital care.

  8. Clonal relatedness and biofilm formation of OXA-23-producing carbapenem resistant Acinetobacter baumannii isolates from hospital environment.

    Science.gov (United States)

    Aliramezani, Amir; Douraghi, Masoumeh; Hajihasani, Azade; Mohammadzadeh, Mona; Rahbar, Mohammad

    2016-10-01

    Carbapenem-resistant Acinetobacter baumannii (CRAB) is a serious threat for hospitalized patients and it can survive for long periods in hospital settings, particularly on inanimate surfaces. The environment occupied by these resistant and resilient isolates may act as a reservoir for cross-colonization and outbreaks. Here, we aimed to determine the distribution of CRAB in the hospital environment and to characterize their clonal relatedness, susceptibility profile, carriage of bla OXA genes, and biofilm formation. A total of 1080 samples were collected from various environmental surfaces and equipment of two referral hospitals in Tehran, Iran. The A. baumannii isolates were subjected to gyrB multiplex PCR, antibiotic susceptibility testing, biofilm formation assay, pulsed field gel electrophoresis (PFGE), and multiplex PCR for bla OXA-58 , bla OXA-24 , and bla OXA-23 genes. Eighteen Acinetobacter spp. were isolated; 8 were identified as A. baumannii and 10 as A. lwoffii. Five of A. baumannii isolates were CRAB and exhibited the multidrug-resistant (MDR) phenotype as well. All CRAB isolates produced biofilm, albeit with different levels. Four of CRAB isolates harbored the bla OXA-23 . The CRAB isolates were clustered into 3 distinct pulsotypes (PTs). The CRAB isolates belonging to PT1 were detected in two geographically distinct hospitals whereas those belonging to PT3 were found in two different units of same hospital. This study revealed the presence of clonally related OXA-23-producing CRAB in high risk units of referral hospitals as inter- or intra-hospital dissemination. The distribution of multiresistant A. baumannii on several surfaces and areas may increase the risk of transmission of resistant isolates to vulnerable patients. Copyright © 2016 Elsevier Ltd. All rights reserved.

  9. Occurrence of methicillin-resistant Staphylococci in surgically treated dogs and the environment in a Swedish animal hospital.

    Science.gov (United States)

    Bergström, A; Gustafsson, C; Leander, M; Fredriksson, M; Grönlund, U; Trowald-Wigh, G

    2012-07-01

    To investigate whether hospitalised dogs treated surgically may become culture positive for methicillin-resistant Staphylococcus pseudintermedius or methicillin-resistant Staphylococcus aureus. Surgically treated dogs (n=45) were sampled for methicillin-resistant Staphylococcus pseudintermedius or methicillin-resistant Staphylococcus aureus on admission, before and after surgery and at the time of removal of surgical stitches. The hospital environment (n=57), including healthy dogs in the veterinary hospital environment (n=34), were sampled for methicillin-resistant Staphylococcus pseudintermedius or methicillin-resistant Staphylococcus aureus. Genetic variations among methicillin-resistant Staphylococcus pseudintermedius or methicillin-resistant Staphylococcus aureus isolates were identified through detection of restriction fragment polymorphisms. No dogs developed a wound infection due to methicillin-resistant Staphylococcus pseudintermedius or methicillin-resistant Staphylococcus aureus. However, there was a significant increase in the number of dogs carrying methicillin-resistant Staphylococcus pseudintermedius after hospitalisation compared to admission (Ppresent in the environment. Methicillin-resistant Staphylococcus pseudintermedius isolates were recovered from environmental surfaces and hospitalised animals, but not from healthy dogs. Methicillin-resistant Staphylococcus pseudintermedius isolates representing nine different restriction endonuclease digestion patterns were found, with two of these occurring in both the environment and on dogs. Dogs may contract methicillin-resistant Staphylococcus pseudintermedius in association with surgery and hospitalisation. Resistant bacteria may be transmitted between dogs, staff and the environment. Dogs colonised with methicillin-resistant Staphylococcus pseudintermedius may be a source for hospital- and community-acquired infections. © 2012 British Small Animal Veterinary Association.

  10. Operating Room Environment Control. Part A: a Valve Cannister System for Anesthetic Gas Adsorption. Part B: a State-of-the-art Survey of Laminar Flow Operating Rooms. Part C: Three Laminar Flow Experiments

    Science.gov (United States)

    Meyer, J. S.; Kosovich, J.

    1973-01-01

    An anesthetic gas flow pop-off valve canister is described that is airtight and permits the patient to breath freely. Once its release mechanism is activated, the exhaust gases are collected at a hose adapter and passed through activated coal for adsorption. A survey of laminar air flow clean rooms is presented and the installation of laminar cross flow air systems in operating rooms is recommended. Laminar flow ventilation experiments determine drying period evaporation rates for chicken intestines, sponges, and sections of pig stomach.

  11. Proton Radiation Therapy in the Hospital Environment: Conception, Development, and Operation of the Initial Hospital-Based Facility

    Science.gov (United States)

    Slater, James M.; Slater, Jerry D.; Wroe, Andrew J.

    The world's first hospital-based proton treatment center opened at Loma Linda University Medical Center in 1990, following two decades of development. Patients' needs were the driving force behind its conception, development, and execution; the primary needs were delivery of effective conformal doses of ionizing radiation and avoidance of normal tissue to the maximum extent possible. The facility includes a proton synchrotron and delivery system developed in collaboration with physicists and engineers at Fermi National Accelerator Laboratory and from other high-energy-physics laboratories worldwide. The system, operated and maintained by Loma Linda personnel, was designed to be safe, reliable, flexible in utilization, efficient in use, and upgradeable to meet demands of changing patient needs and advances in technology. Since the facility opened, nearly 14,000 adults and children have been treated for a wide range of cancers and other diseases. Ongoing research is expanding the applications of proton therapy, while reducing costs.

  12. Environment of care: Is it time to reassess microbial contamination of the operating room air as a risk factor for surgical site infection in total joint arthroplasty?

    Science.gov (United States)

    Parvizi, Javad; Barnes, Sue; Shohat, Noam; Edmiston, Charles E

    2017-11-01

    In the modern operating room (OR), traditional surgical mask, frequent air exchanges, and architectural barriers are viewed as effective in reducing airborne microbial populations. Intraoperative sampling of airborne particulates is rarely performed in the OR because of technical difficulties associated with sampling methodologies and a common belief that airborne contamination is infrequently associated with surgical site infections (SSIs). Recent studies suggest that viable airborne particulates are readily disseminated throughout the OR, placing patients at risk for postoperative SSI. In 2017, virtually all surgical disciplines are engaged in the implantation of selective biomedical devices, and these implants have been documented to be at high risk for intraoperative contamination. Approximately 1.2 million arthroplasties are performed annually in the United States, and that number is expected to increase to 3.8 million by the year 2030. The incidence of periprosthetic joint infection is perceived to be low (<2.5%); however, the personal and fiscal morbidity is significant. Although the pharmaceutic and computer industries enforce stringent air quality standards on their manufacturing processes, there is currently no U.S. standard for acceptable air quality within the OR environment. This review documents the contribution of air contamination to the etiology of periprosthetic joint infection, and evidence for selective innovative strategies to reduce the risk of intraoperative microbial aerosols. Copyright © 2017 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  13. Light and Mediaprojections in Patient Rooms

    DEFF Research Database (Denmark)

    Bonde, Esben Oxholm Skjødt; Nielsen, Stine Maria Louring; Hansen, Ellen Kathrine

    2018-01-01

    the specific needs of the patients and thereby provide higher patient satisfaction. Hereto, the main findings suggest that the control of the lighting needs to be less complicated, the different lighting settings needs to be better tailored to the actual needs, noise from the projector and light coming from......New media and lighting technology and new ways to connect and control it has potentials to improve the environment in hospitals with the goal of increasing patient satisfaction. How should such system be designed to do so and how can it be tested? In this paper it is investigated how a specific...... case, an interactive lighting and media system installed in a patient room, can be improved to support a greater experience of patient satisfaction. Through questionnaires given to 14 mothers who have just given birth and their husbands staying in an interactive patient room, the experience of staying...

  14. Kids’ Perceptions toward Children’s Ward Healing Environments: A Case Study of Taiwan University Children’s Hospital

    Directory of Open Access Journals (Sweden)

    Jeng-Chung Woo

    2016-01-01

    Full Text Available This paper summarizes the opinions of experts who participated in designing the environment of a children’s hospital and reports the results of a questionnaire survey conducted among hospital users. The grounded theory method was adopted to analyze 292 concepts, 79 open codes, 25 axial codes, and 4 selective codes; in addition, confirmatory factor analysis and reliability analysis were performed to identify elements for designing a healing environment in a children’s hospital, and 21 elements from 4 dimensions, namely, emotions, space design, interpersonal interaction, and pleasant surroundings, were determined. Subsequently, this study examined the perceptions of 401 children at National Taiwan University Children’s Hospital. The results revealed that, regarding the children’s responses to the four dimensions and their overall perception, younger children accepted the healing environment to a significantly higher degree than did older children. The sex effect was significant for the space design dimension, and it was not significant for the other dimensions.

  15. Noise pollution in the hospital environment of a developing country: A case study of Lahore (Pakistan).

    Science.gov (United States)

    Baqar, Mujtaba; Arslan, Muhammad; Abbasi, Saddam A; Ashraf, Uzma; Khalid, Anam; Zahid, Hina

    2017-08-24

    The present study investigates the noise pollution levels in public- and private-sector hospitals of Lahore. The noise pollution parameters were investigated from 20 public and 10 private hospitals. We observed that the equivalent continuous sound level (Leq) values varied significantly in different departments of the hospitals as well as at different times of the day. The public-sector hospitals had significantly higher noise pollution compared to the private-sector hospitals. The Wilcoxon Mann-Whitney two-sample rank-sum test revealed significant difference between noise levels in intensive care unit (ICU) during morning and in emergency, waiting area, intensive care unit (ICU), and reception during daytimes. However, no significant differences were found for any department during the evening. The Leq values were found to be higher than the international norms (WHO standards) for all hospitals, higher than USEPA for 29 hospitals and higher than local standards for 27 hospitals. Overall, significantly lower sound levels were always observed in private hospitals.

  16. Developing a General Decision Tool for Future Cancer Care: Getting Feedback from Users in Busy Hospital Environments

    DEFF Research Database (Denmark)

    Dankl, Kathrina; Akoglu, Canan; Dahl Steffensen, Karina

    2017-01-01

    a specific challenge for involving all stakeholders in the design development process and therefore require the development of methods that work in busy healthcare environments. Based on this perspective, the abstract presents an ongoing research collaboration (started in 2014) between The Patients Cancer...... and patients choose the same design proposals - 90% went for the identical design suggestion, commenting on it as being friendly, easy to understand and positive. In one oncology department’s staff room an alternative proposal received the majority of votes. Conclusions: Human-centered design in healthcare...

  17. Analyzing Katana referral hospital as a complex adaptive system: agents, interactions and adaptation to a changing environment.

    Science.gov (United States)

    Karemere, Hermès; Ribesse, Nathalie; Marchal, Bruno; Macq, Jean

    2015-01-01

    This study deals with the adaptation of Katana referral hospital in Eastern Democratic Republic of Congo in a changing environment that is affected for more than a decade by intermittent armed conflicts. His objective is to generate theoretical proposals for addressing differently the analysis of hospitals governance in the aims to assess their performance and how to improve that performance. The methodology applied approach uses a case study using mixed methods ( qualitative and quantitative) for data collection. It uses (1) hospital data to measure the output of hospitals, (2) literature review to identify among others, events and interventions recorded in the history of hospital during the study period and (3) information from individual interviews to validate the interpretation of the results of the previous two sources of data and understand the responsiveness of management team referral hospital during times of change. The study brings four theoretical propositions: (1) Interaction between key agents is a positive force driving adaptation if the actors share a same vision, (2) The strength of the interaction between agents is largely based on the nature of institutional arrangements, which in turn are shaped by the actors themselves, (3) The owner and the management team play a decisive role in the implementation of effective institutional arrangements and establishment of positive interactions between agents, (4) The analysis of recipient population's perception of health services provided allow to better tailor and adapt the health services offer to the population's needs and expectations. Research shows that it isn't enough just to provide support (financial and technical), to manage a hospital for operate and adapt to a changing environment but must still animate, considering that it is a complex adaptive system and that this animation is nothing other than the induction of a positive interaction between agents.

  18. Operating room management and operating room productivity: the case of Germany.

    Science.gov (United States)

    Berry, Maresi; Berry-Stölzle, Thomas; Schleppers, Alexander

    2008-09-01

    We examine operating room productivity on the example of hospitals in Germany with independent anesthesiology departments. Linked to anesthesiology group literature, we use the ln(Total Surgical Time/Total Anesthesiologists Salary) as a proxy for operating room productivity. We test the association between operating room productivity and different structural, organizational and management characteristics based on survey data from 87 hospitals. Our empirical analysis links improved operating room productivity to greater operating room capacity, appropriate scheduling behavior and management methods to realign interests. From this analysis, the enforcing jurisdiction and avoiding advance over-scheduling appear to be the implementable tools for improving operating room productivity.

  19. Study of the Accident Environment During Sea Transport of Nuclear Material: Analysis of an Engine-room Fire on a Purpose-built Ship (invited paper)

    International Nuclear Information System (INIS)

    Yamamoto, K.; Kitamura, T.; Shibata, K.; Ouchi, Y.; Ito, T.; Hohnstreiter, G.F.; Pierce, J.D.; Koski, J.A.; Dukart, R.K.

    2000-01-01

    The programme goal was to show that the IAEA safe transport regulations adequately cover the thermal effects of an engine-room fire on plutonium transport packages stowed aboard a purpose-built ship. The packages are stored in transport containers located in a cargo hold of the ship. For this study, it was assumed that the packages in No 5 hold, adjacent to an engine-room, could be subject to heating due to a fire in the engine-room. The No 5 hold and the engine-room are separated by a water-filled bulkhead. This study addressed the heat transfer from an engine-room fire that could heat and evaporate water out of the water-filled bulkhead and the resulting temperature conditions around the packages and inside the packages near their elastometric seals. (author)

  20. Acidentes e violências: caracterização dos atendimentos no pronto-socorro de um hospital universitário Accidents and violence: characteristics of the medical cares in the emergency room's university hospital

    Directory of Open Access Journals (Sweden)

    José Luís Guedes dos Santos

    2008-09-01

    Full Text Available Este artigo, de caráter exploratório-descritivo, tem como objetivo caracterizar os atendimentos por acidentes e violências realizados no pronto-socorro de um hospital universitário localizado no interior do Rio Grande do Sul (RS. Os dados foram obtidos a partir dos registros de um sistema de vigilância, denominado "Observatório de Acidentes e Violência", existente nos serviços de urgência e emergência no RS, que atuam como sentinela desses agravos. Os resultados mostraram que os adultos jovens, com baixo nível de instrução e não-trabalhadores são as principais vítimas de acidentes e violências. Quanto ao tipo de ocorrência, destacaram-se os acidentes de trânsito e acidentes domésticos, gerando como agravos mais constantes ferimentos na cabeça e fraturas de fêmur. Com relação ao sexo, embora para alguns tipos de acidentes e violências a predominância tenha variado entre eles, o conjunto dos dados mostrou maior vulnerabilidade masculina, em especial nos casos de violência interpessoal. Nesse sentido, as consequências dos acidentes e violências para o sistema de saúde e para a sociedade apontam a necessidade de aprimoramento dos sistemas de informações de morbimortalidade por causas externas, visando subsidiar políticas públicas de prevenção e melhoria no atendimento às vítimas.This article, of an exploratory-descriptive character, aims to characterize the medical care provided in cases of accidents and violence in the emergency room of a university hospital, located in the interior of the state of Rio Grande do Sul (RS. The data were obtained from the registers of a monitoring system called "Observatório de Acidentes e Violência" (Observatory of Accidents and Violence, which exists in the urgency and emergency services in RS and acts as a sentry of these injuries. The results showed that young adults who are non-workers and have low schooling are the main victims of accidents and violence. The most frequent

  1. Phage types, antibiograms and R-plasmids of Klebsiella and Enterobacter isolated from hospital environment and food.

    Science.gov (United States)

    Horváth, J; Lantos, J; Fekete, J; Marjai, E

    1986-01-01

    Four-hundred and twenty-two Klebsiella strains and 294 Enterobacter strains were isolated from direct or indirect environment of hospitalized patients, from foodstuffs, foods, culinary utensils and staff in hospital and in catering establishments. Of Klebsiella, the species K. aerogenes (76.5%) of Enterobacter, the species E. cloacae (77.6%) occurred the most frequently in all specimens. Klebsiella strains were typable in 68.5%; 53.1% of the Enterobacter strains were sensitive to phage. Most of the untypable Klebsiella and Enterobacter strains and the multiresistant strains originated from screening in hospitals. Sensitive bacteria as well as those resistant to one or two antibiotics may be potentially dangerous for the patient consuming them, since they may become multiresistant due to R-plasmid transfer.

  2. Creators Room

    DEFF Research Database (Denmark)

    Iversholt, Lene; Iversholt Toft, Karina

    2012-01-01

    Creators Room er et koncept til daginsitutioner, der indrammer og giver bud på en forståelse mellem inkluderende pædagogik og fysiske rammer. Konceptet er udviklet i et tværfagligt procesforløb, hvor formålet har været at skabe stadig bedre indendørsmiljøer for børn ved at forene pædagogiske...

  3. Efficiency Evaluation of Hospitals in the Environment of the Czech and Slovak Republic

    Directory of Open Access Journals (Sweden)

    Stanislav Sendek

    2015-01-01

    Full Text Available The paper applies the Data Envelopment Analysis as a deterministic non-parametric method based on the linear programming, to measure the efficiency of Czech and Slovak hospitals based on input and output performance. Managing physician or hospital practice patterns is an important tool to reduce health care costs. State-run hospitals, as decision-making units working in an operating healthcare system, might have some excess resources in the process of providing care. Ehealth tools are expected to contribute to the cost containment in them, enhancing finally the quality of patient care in the overall assessment.

  4. Still making progress to improve the hospital workplace environment? Results from the 2008 National Survey of Registered Nurses.

    Science.gov (United States)

    Buerhaus, Peter I; DesRoches, Catherine; Donelan, Karen; Hess, Robert

    2009-01-01

    Despite the majority of RNs perceiving a shortage of nurses, findings from the 2008 National Survey of RNs indicate the hospital workplace improved in several areas compared to a 2006 survey. Improvements included the time RNs spend with patients, quality of nursing care, and a decreasing impact of the shortage on delaying nurses' responses to pages or calls, staff communication, patients' wait time for surgery, and timeliness and efficiency of care. Areas the environment was perceived to have worsened included overtime hours, sexual harassment/hostile, and physical violence. RNs hold mixed views about the consequences of reporting errors and mistakes with a majority agreeing that reporting them had led to positive changes to prevent future errors, but that mistakes were held against them. Overall, results suggest that hospital managers can be reassured that their efforts to improve the workplace environment are having their intended effect but, at the same time, important areas for improvement remain.

  5. Quality of life of nurses in the operating room

    Directory of Open Access Journals (Sweden)

    Raquel Murano Alfaia dos Santos

    2009-03-01

    Full Text Available Objective: To evaluate the quality of life of operating room nurses and collect their opinions as to the influence their professional activity exerts on their quality of life. Methods: This was a cross-sectional study carried out on a sample of 24 nurses that work in the operating room of a large private hospital in the city of São Paulo. Two questionnaires were applied; one was designed by the authors of this research project, and the other was the Quality of Life Questionnaire (WHOQOL-BREF. Rresults: As to quality of life, the environment domain obtained the highest score, while the psychological domain obtained the lowest. When asked if their professional activity in the operating room influenced their quality of life, most responded affirmatively. Regarding the justifications offered by the nurses for the influence of their professional activity on their quality of life, 50% mentioned environment-related stress, responsibilities, duties, risk situations, relationships with the multiprofessional team, and the type of work carried out in the operating room. Cconclusions: The psychological domain obtained the lowest score in the nurse quality of life evaluation, pointing out the need to facilitate and/or encourage nurses to seek psychological support. As to the influence of their professional activity on their quality of life, the nurses mentioned stress related to their work environment and professional activities in the operating room. This highlights the importance of managers in this area, paying greater attention to the individual and collective needs of their employees.

  6. An investigation into the application of customer profitability analysis as a strategic decision-making tool in a hospitality environment

    OpenAIRE

    Noone, Breffni M

    1997-01-01

    The primary objective of this study was to investigate the Applicability of Customer Profitability Analysis as a strategic decision-making technique in a hospitality environment. The study commenced with a review of literature in the fields of Yield Management, Customer Profitability Analysis (CPA) and Activity-Based Costing (ABC), with ABC being identified as an appropriate method of costing to use in CPA. Issues arising from the implementation of an Activity-Based CPA including the purpose ...

  7. Efficacy of manual cleaning and an ultraviolet C room decontamination device in reducing health care-associated pathogens on hospital floors.

    Science.gov (United States)

    Mustapha, Aishat; Alhmidi, Heba; Cadnum, Jennifer L; Jencson, Annette L; Donskey, Curtis J

    2018-05-01

    Recent studies suggest that floors may be an underappreciated source for transmission of health care-associated pathogens. However, there are limited data on the effectiveness of current cleaning and disinfection methods in reducing floor contamination. We demonstrated that manual postdischarge cleaning by environmental services personnel significantly reduced floor contamination, and an automated ultraviolet C room disinfection device was effective as an adjunct to manual cleaning. Published by Elsevier Inc.

  8. Public-private partnerships in the Canadian environment: options for hospital pharmacies.

    Science.gov (United States)

    Uddin, Z; Bear, R A

    1997-01-01

    This brief report explores the direction being pursued by hospitals interested in outsourcing non-core activities within the pharmacy department. Private sector logistics companies are looking to position themselves in the drug product supply chain to facilitate seamless transfers of drug products, ordering information and payments between drug manufacturers and hospitals. Opportunities for implementing consolidated purchasing, unit dosing, just-in-time inventory and electronic commerce systems are discussed.

  9. Marketing skills for hospital-based laboratory managers in a managed care environment.

    Science.gov (United States)

    Marchwinski, J; Coggins, F

    1997-01-01

    Managers of hospital-based laboratories have begun to realize the importance of a successful outreach program in protecting against declining inpatient activity. Succeeding in the highly competitive field of outpatient testing requires some new skills and techniques that may not have been apparent when addressing normal inpatient requirements. This article provides an overview of some very basic marketing concepts and attempts to show how they can assist the hospital-based laboratory manager in developing a successful outreach program.

  10. Resident cats in small animal veterinary hospitals carry multi-drug resistant enterococci and are likely involved in cross-contamination of the hospital environment

    Directory of Open Access Journals (Sweden)

    Anuradha eGhosh

    2012-02-01

    Full Text Available In the U.S., small animal veterinary hospitals (SAVHs commonly keep resident cats living permanently as pets within their facilities. Previously, multi-drug resistant (MDR enterococci were found as a contaminant of multiple surfaces within such veterinary hospitals, and nosocomial infections are a concern. The objectives of this study were to determine whether resident cats carry MDR enterococci and if they potentially play a role in the contamination of the hospital environment. Enterococcal strains (n=180 were isolated from the feces of six healthy resident cats from different SAVHs. The concentration of enterococci ranged from 1.1 x 105 to 6.0 x 108 CFU g-1 of feces, and the population comprised E. hirae (38.3±18.6%, E. faecium (35.0±14.3%, E. faecalis (23.9±11.0%, and E. avium (2.8±2.2%. Testing of phenotypic resistance to 14 antimicrobial agents revealed multi-drug resistance (≥3 antimicrobials in 48.9% of all enterococcal isolates with most frequent resistance to tetracycline (72.8%, erythromycin (47.8%, and rifampicin (35.6%. Vancomycin resistant E. faecalis (3.9% with vanB not horizontally transferable in in vitro conjugation assays were detected from one cat. Genotyping (pulsed-field gel electrophoresis demonstrated a host-specific clonal population of MDR E. faecalis and E. faecium. Importantly, several feline isolates were genotypically identical or closely related to isolates from surfaces of cage door, thermometer, and stethoscope of the corresponding SAVHs. These data demonstrate that healthy resident cats at SAVHs carry MDR enterococci and likely contribute to contamination of the SAVH environment. Proper disposal and handling of fecal material and restricted movement of resident cats within the ward is recommended.

  11. Contextual Research for Healing Patient Rooms Design: Patient Experience Flow Studies in Neurology Departments

    NARCIS (Netherlands)

    Daemen, E.M.L; Cuppen, R.P.G.; Flinsenberg, I.C.M.; Loenen, van E.J.; Rajae-Joordens, R.J.E.

    2012-01-01

    Our aim is to explore possibilities of enhancing the healing process in single patient hospital rooms by means of a context-related adaptation of the environment. The gained knowledge and understanding is used to develop relevant solutions addressing the needs of both patients and staff. For the

  12. Automated Epileptic Seizure Detection Based on Wearable ECG and PPG in a Hospital Environment.

    Science.gov (United States)

    Vandecasteele, Kaat; De Cooman, Thomas; Gu, Ying; Cleeren, Evy; Claes, Kasper; Paesschen, Wim Van; Huffel, Sabine Van; Hunyadi, Borbála

    2017-10-13

    Electrocardiography has added value to automatically detect seizures in temporal lobe epilepsy (TLE) patients. The wired hospital system is not suited for a long-term seizure detection system at home. To address this need, the performance of two wearable devices, based on electrocardiography (ECG) and photoplethysmography (PPG), are compared with hospital ECG using an existing seizure detection algorithm. This algorithm classifies the seizures on the basis of heart rate features, extracted from the heart rate increase. The algorithm was applied to recordings of 11 patients in a hospital setting with 701 h capturing 47 (fronto-)temporal lobe seizures. The sensitivities of the hospital system, the wearable ECG device and the wearable PPG device were respectively 57%, 70% and 32%, with corresponding false alarms per hour of 1.92, 2.11 and 1.80. Whereas seizure detection performance using the wrist-worn PPG device was considerably lower, the performance using the wearable ECG is proven to be similar to that of the hospital ECG.

  13. Automated Epileptic Seizure Detection Based on Wearable ECG and PPG in a Hospital Environment

    Directory of Open Access Journals (Sweden)

    Kaat Vandecasteele

    2017-10-01

    Full Text Available Electrocardiography has added value to automatically detect seizures in temporal lobe epilepsy (TLE patients. The wired hospital system is not suited for a long-term seizure detection system at home. To address this need, the performance of two wearable devices, based on electrocardiography (ECG and photoplethysmography (PPG, are compared with hospital ECG using an existing seizure detection algorithm. This algorithm classifies the seizures on the basis of heart rate features, extracted from the heart rate increase. The algorithm was applied to recordings of 11 patients in a hospital setting with 701 h capturing 47 (fronto-temporal lobe seizures. The sensitivities of the hospital system, the wearable ECG device and the wearable PPG device were respectively 57%, 70% and 32%, with corresponding false alarms per hour of 1.92, 2.11 and 1.80. Whereas seizure detection performance using the wrist-worn PPG device was considerably lower, the performance using the wearable ECG is proven to be similar to that of the hospital ECG.

  14. An economic evaluation of Clostridium difficile infection management in an Italian hospital environment.

    Science.gov (United States)

    Magalini, S; Pepe, G; Panunzi, S; Spada, P L; De Gaetano, A; Gui, D

    2012-12-01

    Clostridium difficile infection (CDI) accounts for the majority of nosocomial cases of diarrhea, and with recent upsurge of multidrug-resistant strains, morbidity and mortality have increased. Data on clinical impact of CDI come mostly from Anglo-Saxon countries, while in Italy only two studies address the issue and no economic data exist on costs of CDI in the in hospital setting. A retrospective cross-sectional study with pharmacoeconomic analysis was performed on the CDI series of the Policlinico Gemelli of Rome, a major 1400 bed Hospital. The clinical charts of 133 patients in a 26 month period were reviewed. All costs of the involved resources were calculated and statistical analysis was carried out with means and standard deviations, and categorical variables as number and percentages. The results show the significant sanitary costs of CDI in an Italian hospital setting. The cost analysis of the various elements (exams, imaging studies, therapies, etc.) shows that none independently influences the high cost burden of CDI, but that it is the simple length of hospital stay that represents the most important factor. Prevention of CDI is the most cost-effective approach. The major break-through in cost reduction of CDI would be a therapeutical intervention or procedure that shortens hospital length of stay.

  15. Job satisfaction, work environment and intention to leave among migrant nurses working in a publicly funded tertiary hospital.

    Science.gov (United States)

    Goh, Yong-Shian; Lopez, Violeta

    2016-10-01

    This study sought to explore the job satisfaction level of migrant nurses working in a multicultural society and, more specifically, the relationship between their job satisfaction levels, work environment, their intentions to leave and the predictors of their intentions to leave. Nursing shortages have led to the increasing trend of employing migrant nurses, which necessitated studies examining nurses' migration. A cross-sectional, correlational design using a stratified random sample was conducted on 495 migrant nurses working in a tertiary public-funded hospital in Singapore. The results showed that migrant nurses were satisfied with their jobs; with job satisfaction negatively correlated with work environment. Interestingly, pre-existing groups of Chinese migrant nurses did not help newly arrived Chinese migrant nurses to assimilate better. Predictors of migrant nurses' intentions to leave included having supportive nurse managers and nursing practice environment. The presence of a supportive work environment is essential to retain migrant nurses. Health administrators need to empower nursing managers with skills to implement career development plans as part of hospitals' retention strategies for migrant nurses. Information should also be provided during recruitment campaigns to enable migrant nurses to make informed choices. © 2016 John Wiley & Sons Ltd.

  16. Risk Factors for Transmission of HIV in a Hospital Environment of Yaoundé, Cameroon

    Directory of Open Access Journals (Sweden)

    Dora Mbanya

    2010-05-01

    Full Text Available Risk factors for HIV transmission within a hospital setting were assessed using pre-structured questionnaires and observations. Of 409 respondents, 66.3% corresponded to the nursing staff, 14.4% doctors and 8.3% laboratory staff. The irregular use of gloves and other protective clothing for risky tasks, and recapping of needles after use were some of the risk factors identified, especially amongst nurses. Preventive measures were not always implemented by health personnel. More emphasis should be placed not only on diffusing universal precautions and recommendations for hospital staff safety, but accompanying measures for monitoring and evaluation of implementation of these standards are also indispensable.

  17. Poor work environments and nurse inexperience are associated with burnout, job dissatisfaction and quality deficits in Japanese hospitals.

    Science.gov (United States)

    Kanai-Pak, Masako; Aiken, Linda H; Sloane, Douglas M; Poghosyan, Lusine

    2008-12-01

    To describe nurse burnout, job dissatisfaction and quality of care in Japanese hospitals and to determine how these outcomes are associated with work environment factors. Nurse burnout and job dissatisfaction are associated with poor nurse retention and uneven quality of care in other countries but comprehensive data have been lacking on Japan. Cross-sectional survey of 5956 staff nurses on 302 units in 19 acute hospitals in Japan. Nurses were provided information about years of experience, completed the Maslach Burnout Inventory and reported on resource adequacy and working relations with doctors using the Nursing Work Index-Revised. Fifty-six per cent of nurses scored high on burnout, 60% were dissatisfied with their jobs and 59% ranked quality of care as only fair or poor. About one-third had fewer than four years of experience and more than two-thirds had less than 10. Only one in five nurses reported there were enough registered nurses to provide quality care and more than half reported that teamwork between nurses and physicians was lacking. The odds on high burnout, job dissatisfaction and poor-fair quality of care were twice as high in hospitals with 50% inexperienced nurses than with 20% inexperienced nurses and 40% higher in hospitals where nurses had less satisfactory relations with physicians. Nurses in poorly staffed hospitals were 50% more likely to exhibit burnout, twice as likely to be dissatisfied and 75% more likely to report poor or fair quality care than nurses in better staffed hospitals. Improved nurse staffing and working relationships with physicians may reduce nurse burnout, job dissatisfaction and low nurse-assessed quality of care. Staff nurses should engage supervisors and medical staff in discussions about retaining more experienced nurses at the bedside, implementing strategies to enhance clinical staffing and identifying ways to improve nurse-physician working relations.

  18. Effectiveness of a drinking-motive-tailored emergency-room intervention among adolescents admitted to hospital due to acute alcohol intoxication: A randomized controlled trial

    NARCIS (Netherlands)

    Wurdak, M.; Wolstein, J.; Kuntsche, E.N.

    2016-01-01

    The aim of this study is to develop and test the effectiveness of a drinking-motive-tailored intervention for adolescents hospitalized due to alcohol intoxication in eight cities in Germany between December 2011 and May 2012 against a similar, non-motive-tailored intervention. In a randomized

  19. The value of the pre-hospital learning environment as part of the ...

    African Journals Online (AJOL)

    Results: Four major themes were identified: an unpredictable environment, role players in emergency medical services, team work, and competencies. Conclusion: The research findings support the value and continuation of utilising the prehospital clinical learning environment for placing post-basic emergency nursing ...

  20. A Multi-Modal Digital Game-Based Learning Environment for Hospitalized Children with Chronic Illnesses.

    Science.gov (United States)

    Chin, Jui-Chih; Tsuei, Mengping

    2014-01-01

    The aim of this study was to explore the digital game-based learning for children with chronic illnesses in the hospital settings. The design-based research and qualitative methods were applied. Three eight-year-old children with leukemia participated in this study. In the first phase, the multi-user game-based learning system was developed and…

  1. Impact of urban atmospheric environment on hospital admissions in the elderly

    Directory of Open Access Journals (Sweden)

    Edelci Nunes da Silva

    2012-08-01

    Full Text Available OBJECTIVE: To analyze the impact of intra-urban atmospheric conditions on circulatory and respiratory diseases in elder adults. METHODS: Cross-sectional study based on data from 33,212 hospital admissions in adults over 60 years in the city of São Paulo, southeastern Brazil, from 2003 to 2007. The association between atmospheric variables from Congonhas airport and bioclimatic index, Physiological Equivalent Temperature, was analyzed according to the district's socioenvironmental profile. Descriptive statistical analysis and regression models were used. RESULTS: There was an increase in hospital admissions due to circulatory diseases as average and lowest temperatures decreased. The likelihood of being admitted to the hospital increased by 12% with 1ºC decrease in the bioclimatic index and with 1ºC increase in the highest temperatures in the group with lower socioenvironmental conditions. The risk of admission due to respiratory diseases increased with inadequate air quality in districts with higher socioenvironmental conditions. CONCLUSIONS: The associations between morbidity and climate variables and the comfort index varied in different groups and diseases. Lower and higher temperatures increased the risk of hospital admission in the elderly. Districts with lower socioenvironmental conditions showed greater adverse health impacts.

  2. Out-of-hospital emergency care providers' work and challenges in a changing care environment.

    Science.gov (United States)

    Mikkola, Riitta; Paavilainen, Eija; Salminen-Tuomaala, Mari; Leikkola, Päivi

    2018-03-01

    Acutely ill patients are often treated on site instead of being transported to hospital, so wide-ranging professional competence is required from staff. The aim of this study was to describe and produce new information about out-of-hospital emergency care providers' competence, skills and willingness to engage in self-development activities, and to uncover challenges experienced by care providers in the midst of changing work practices. A quantitative questionnaire was sent to out-of-hospital emergency care providers (N = 142, response rate 53%) of one Finnish hospital district. Data were analysed using spss for Windows 22 software. Almost all respondents found their work interesting and their ability to work independently sufficient. The majority found the work meaningful. Almost 20% felt that work was dominated by constant rush, and 40%, more than half of 25-year-olds but <10% of over 45-years-olds, found the work physically straining. The majority indicated that they had a sufficient theoretical-practical basis to perform their regular duties, and more than one-third felt that they had sufficient skills to deal with multiple patient or disaster situations. Over 20% stated that they were unsure about performing new or infrequent procedures. A number of factors experienced as challenging were revealed. The results provide a basis for improving care providers' initial and further training. © 2017 Nordic College of Caring Science.

  3. Characterisation, dissemination and persistence of gentamicin resistant Escherichia coli from a Danish university hospital to the waste water environment

    DEFF Research Database (Denmark)

    Jakobsen, Lotte; Sandvang, Dorthe; Hansen, Lars H

    2008-01-01

    The aim of the study was to investigate the potential spread of gentamicin resistant (GEN(R)) Escherichia coli isolates or GEN(R) determinants from a Danish university hospital to the waste water environment. Waste water samples were collected monthly from the outlets of the hospital bed wards...... (aac(3)-II, aac(3)-IV, ant(2'')-I, armA), phenotypic resistance pattern, and virulence genes (hlyA, chuA, sfaS, fogG, malX, traT, iutA, fyuA, iroN, cnf1) to investigate if the hospital and waste water could be reservoirs of antimicrobial resistance and virulence. The ability for GEN(R) determinants......, indicating a potential spread of the gene from patient isolates to waste water isolates. Regardless of origin, most isolates exhibited multi-resistance and contained several virulence genes. In conclusion, our study showed a possible spread of aac(3)-II from the hospital to the waste water. Most of the GEN...

  4. Room for improvement

    DEFF Research Database (Denmark)

    Sandal, Louise F; Thorlund, Jonas B; Moore, Andrew J

    2018-01-01

    -reported outcomes and qualitative findings supported the primary finding, while improvements in muscle strength and aerobic capacity did not differ between exercise groups. CONCLUSION: Results suggest that the physical environment contributes to treatment response. Matching patients' preferences to treatment rooms...... significance (p=0.07). Waitlist group reported no improvement (-0.05 95% CI -0.5 to 0.4). In interviews, participants from the standard environment expressed greater social cohesion and feeling at home. Qualitative themes identified; reflection, sense of fellowship and transition. Secondary patient...... may improve patient-reported outcomes. TRIAL REGISTRATION NUMBER: ClinicalTrials.gov identifier: NCT02043613....

  5. Binaural room simulation

    Science.gov (United States)

    Lehnert, H.; Blauert, Jens; Pompetzki, W.

    1991-01-01

    In every-day listening the auditory event perceived by a listener is determined not only by the sound signal that a sound emits but also by a variety of environmental parameters. These parameters are the position, orientation and directional characteristics of the sound source, the listener's position and orientation, the geometrical and acoustical properties of surfaces which affect the sound field and the sound propagation properties of the surrounding fluid. A complete set of these parameters can be called an Acoustic Environment. If the auditory event perceived by a listener is manipulated in such a way that the listener is shifted acoustically into a different acoustic environment without moving himself physically, a Virtual Acoustic Environment has been created. Here, we deal with a special technique to set up nearly arbitrary Virtual Acoustic Environments, the Binaural Room Simulation. The purpose of the Binaural Room Simulation is to compute the binaural impulse response related to a virtual acoustic environment taking into account all parameters mentioned above. One possible way to describe a Virtual Acoustic Environment is the concept of the virtual sound sources. Each of the virtual sources emits a certain signal which is correlated but not necessarily identical with the signal emitted by the direct sound source. If source and receiver are non moving, the acoustic environment becomes a linear time-invariant system. Then, the Binaural Impulse Response from the source to a listener' s eardrums contains all relevant auditory information related to the Virtual Acoustic Environment. Listening into the simulated environment can easily be achieved by convolving the Binaural Impulse Response with dry signals and representing the results via headphones.

  6. "... As we forgive those who trespass against us...": theological reflections on sin and guilt in the hospital environment.

    Science.gov (United States)

    Schmidt, Kurt W

    2005-08-01

    In general parlance the term sin has lost its existential meaning. Originally a Jewish-Christian term within a purely religious context, referring to a wrongdoing with regard to God, sin has slowly become reduced to guilt in the course of the secularization process. Guilt refers to a wrongdoing, especially with regard to fellow human beings. It also refers to errors of judgement with what can be tragic consequences. These errors can occur whenever human beings are called upon to act, including the hospital environment. A Christian hospital has to address the issue of how to deal not only with guilt-ridden misdemeanors, but also with wrongdoing unto God, which overshadows every instance of guilt-ridden human behavior. Here, as in every parish, the Church Service is the place to acknowledge sin, confess sin, and forgive sin, beyond the boundaries of the parish itself.

  7. The humanization of catheter room design: its clinical practice

    International Nuclear Information System (INIS)

    Lin Hanying; Shi Fengxia; Guo Huiying

    2011-01-01

    American scholar Engeer has proposed biological, psychological and sociological medicine pattern, which has been well accepted by the society, It has manifested the medical arena humanism return and has made the profound influence on the nursing development. The idea, 'the human is a whole', has gradually become the mainstream of the nurse service concept, meanwhile, the environment has more and more become a beneficial part for diagnosing and treating in hospitalization. The improvement and more user-friendly design of the diagnosing and treating environment has already become an important ring linked with the whole nursing work. At the beginning of the fitting up design for the Catheter Lab Room of Interventional Radiology in General Hospital of PLA, the authors receive the idea 'the environment experience and admiration of the patient', put more attention to the humanization in the diagnosing and treating environmental construction. The functional compartments are separated clearly. The color, the background music as well as the video are designed to be coordinated with each other in order to produce a relaxing system. Practice for the past three years indicates that the use of humanization environment design can markedly reduce the patient intense and the anxious level in perioperative period, it can also significantly promote the patient to be restored to health. This article will describe user-friendly diagnosing and treating environmental construction practice in the Catheter Lab Room of Interventional Radiology in General Hospital of PLA. (authors)

  8. Psychosocial work environment and hospital admissions due to mental disorders: a 15-year prospective study of industrial employees.

    Science.gov (United States)

    Joensuu, Matti; Väänänen, Ari; Koskinen, Aki; Kivimäki, Mika; Virtanen, Marianna; Vahtera, Jussi

    2010-07-01

    Low levels of job control and social support may increase the risk of mental disorders, particularly depression, but the evidence is mostly based on self-reports. We examined whether components of job control and work-related social support predict medically-certified mental disorders. 13868 forest company employees with no previous hospital admissions for mental disorders responded to questionnaires on decision authority, skill discretion, co-worker and supervisor support. They were followed-up for hospital admissions due to mental disorders (ICD-9 codes 290 to 319), using national hospital discharge records (577 hospitalized, mean follow-up 15.1 years). In analyses adjusted for confounders, high skill discretion was associated with a reduced risk of hospital admission for mental disorders (HR 0.74, 95% CI 0.58-0.95). High decision authority was associated with an elevated risk (HR 1.48, 95% CI 1.17-1.87). Diagnosis-specific analyses showed high skill discretion to associate with a reduced risk of both depressive and non-depressive non-alcohol-related mental disorders. High decision authority was a risk factor for alcohol-related and depressive disorders. Good co-worker support was associated with a reduced risk of non-depressive non-alcohol-related mental disorders. Supervisor support was not associated with any mental disorders. We used a single time point estimate in an industrial sample comprising largely of men. Contrary to previous research on job control, high decision authority increased the risk of depressive and alcohol-related disorders, which suggest a need to reconsider the strategies for prevention and clinical practise in regard to psychosocial work environment and mental health.

  9. Value stream mapping as a tool for systematic employee based improvement of the psychosocial work environment in hospitals

    DEFF Research Database (Denmark)

    Hasle, Peter; Starheim, Liv; Jensen, Per Langaa

    2016-01-01

    Problems in communication and coordination in hospitals often hamper operations and constitute important stress factor for the staff. A specific methodology (P-lean) based on value stream mapping (VSM) has been developed and tested in practice. Key processes with a potential for psychosocial strain...... are selected and analysed in employee groups. VSM is followed up by collection of data and development of solutions. Results from the practical test show that VSM and process data provide new insights to the employees which help to improve the psychosocial work environment. However, working across departmental...

  10. The Hospital Water Environment as a Reservoir for Carbapenem-Resistant Organisms Causing Hospital-Acquired Infections-A Systematic Review of the Literature.

    Science.gov (United States)

    Kizny Gordon, Alice E; Mathers, Amy J; Cheong, Elaine Y L; Gottlieb, Thomas; Kotay, Shireen; Walker, A Sarah; Peto, Timothy E A; Crook, Derrick W; Stoesser, Nicole

    2017-05-15

    Over the last 20 years there have been 32 reports of carbapenem-resistant organisms in the hospital water environment, with half of these occurring since 2010. The majority of these reports have described associated clinical outbreaks in the intensive care setting, affecting the critically ill and the immunocompromised. Drains, sinks, and faucets were most frequently colonized, and Pseudomonas aeruginosa the predominant organism. Imipenemase (IMP), Klebsiella pneumoniae carbapenemase (KPC), and Verona integron-encoded metallo-β-lactamase (VIM) were the most common carbapenemases found. Molecular typing was performed in almost all studies, with pulse field gel electrophoresis being most commonly used. Seventy-two percent of studies reported controlling outbreaks, of which just more than one-third eliminated the organism from the water environment. A combination of interventions seems to be most successful, including reinforcement of general infection control measures, alongside chemical disinfection. The most appropriate disinfection method remains unclear, however, and it is likely that replacement of colonized water reservoirs may be required for long-term clearance. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

  11. Workplace culture among operating room nurses.

    Science.gov (United States)

    Eskola, Suvi; Roos, Mervi; McCormack, Brendan; Slater, Paul; Hahtela, Nina; Suominen, Tarja

    2016-09-01

    To investigate the workplace culture in the Operating Room (OR) environment and the factors associated with it. In health care, the workplace culture affects the delivery and experience of care. The OR can be a stressful practice environment, where nurses might have occasionally either job stress or job satisfaction based on their competence. A quantitative cross-sectional approach was used. The study consisted of 96 Finnish OR nurses. A Nursing Context Index instrument was used to obtain data by way of an electronic questionnaire. The primary role and working unit of respondents were the main components relating to workplace culture, and especially to job stress. Nurse anaesthetists were found to be slightly more stressed than scrub nurses. In local hospitals, job stress related to workload was perceived less than in university hospitals (P = 0.001). In addition, OR nurses in local hospitals were more satisfied with their profession (P = 0.007), particularly around issues concerning adequate staffing and resources (P = 0.001). It is essential that nurse managers learn to recognise the different expressions of workplace culture. In particular, this study raises a need to recognise the factors that cause job stress to nurse anaesthetists. © 2016 John Wiley & Sons Ltd.

  12. Insects associated with hospital environment in Egypt with special reference to the medically important species.

    Science.gov (United States)

    Kenawy, Mohamed A; Amer, Hanan S; Lotfy, Nadia M; Khamis, Nagwa; Abdel-Hamid, Yousrya M

    2014-12-01

    A study was planned to examine the insect fauna associated with two hospitals: urban (A) in Cairo and rural (B) in Banha, Egypt with varying hygienic levels and their adjacent residential areas (AC) and (BC), respectively and to investigate the effect of hygienic level on species composition and relative abundance. A total of 22 species belonging to 7 orders and 15 families were reported in the four study areas of which, Dipterous flies were the most common (8/22, 36.36% species). A total of 5257 adults were collected of which Dipterous flies were the abundant (3800, 72.28% insect) and Musca domestica was the most abundant species (3535, 67.24% insect) which was present in all areas where it was more common / predominant species (21.94%-90.91% insect). Moreover, higher densities of M domestica were in (B) and BC than in (A) or (AC). The heavily infested area was AC (54.55% species) followed by (A), (BC) and (B) however, the total number of the collected insects was higher in (BC) and (B) than in (AC) and (A). This was confirmed by finding maximum diversity indices in (AC) and minimum ones in B. In all areas, means of M domestica was more common during summer/autumn and spring than in the winter. Periplaneta americana collected oily during autumn in AC and was more common in autumn in (BC) while Blatella germanica collected only during summer in (AC) and was more common in autumn in (B). The prevalence and higher abundance of the medically important species mainly M domestica, P. americana and B. germanica in rural hospital than in urban one attribute mainly to the lower hygienic level of rural hospital This require a control program based mainly on sanitation supplemented by other measures to overcome the risk of disease transmission by such insects

  13. The value of the pre-hospital learning environment as part of the ...

    African Journals Online (AJOL)

    Background: Professional nurses enrolled in a post-basic emergency nursing programme presented at a tertiary nursing education institution in South Africa are placed in different clinical learning environments to reach the set clinical outcomes and gain appropriate clinical experience. These students are placed in the ...

  14. Paramedics' experiences of financial medicine practices in the pre-hospital environment. A pilot study

    Directory of Open Access Journals (Sweden)

    Craig Vincent-Lambert

    2016-12-01

    Conclusion: The results of this study are concerning as the actions of service providers described by the participants constitute gross violations of the ethical and professional guidelines for health care professionals. The authors recommend additional studies be conducted to further explore these findings and to establish the reasons for, and ways of, limiting financial medicine practices in the South African emergency care environment.

  15. CLINICAL SURFACES -- Activity-Based Computing for Distributed Multi-Display Environments in Hospitals

    DEFF Research Database (Denmark)

    Bardram, Jakob Eyvind; Bunde-Pedersen, Jonathan; Doryab, Afsaneh

    2009-01-01

    A multi-display environment (MDE) is made up of co-located and networked personal and public devices that form an integrated workspace enabling co-located group work. Traditionally, MDEs have, however, mainly been designed to support a single “smart room”, and have had little sense of the tasks...

  16. Speech-Language and Nutritional Sciences in hospital environment: analysis of terminology of food consistencies classification.

    Science.gov (United States)

    Amaral, Ana Cláudia Fernandes; Rodrigues, Lívia Azevedo; Furlan, Renata Maria Moreira Moraes; Vicente, Laélia Cristina Caseiro; Motta, Andréa Rodrigues

    2015-01-01

    To verify if there is an agreement between speech-language pathologists and nutritionists about the classification of food textures used in hospitals and their opinions about the possible consequences of differences in this classification. This is a descriptive, cross-sectional study with 30 speech-language pathologists and 30 nutritionists who worked in 14 hospitals of public and/or private network in Belo Horizonte, Brazil. The professionals answered a questionnaire, prepared by the researchers, and classified five different foods, with and without theoretical direction. The data were analyzed using Fisher's exact and Z -tests to compare ratios with a 5% significance level. Both speech-language therapists (100%) and nutritionists (90%) perceive divergence in the classification and, 86.2% and 100% of them, respectively, believe that this difference may affect the patients' recovery. Aspiration risk was the most mentioned problem. For the general classification of food textures, most of the professionals (88.5%) suggested four to six terms. As to the terminology used in the classification of food presented without theoretical direction, the professionals cited 49 terms and agreed only in the solid and liquid classifications. With theoretical direction, the professionals also agreed in the classification of thick and thin paste. Both the professionals recognized divergences in the classification of food textures and the consequent risk of damage to patient's recovery. The use of theoretical direction increased the agreement between these professionals.

  17. Study of the relationship between nurses’ work environment indices and their burnout aspects in TUMS teaching hospitals

    Directory of Open Access Journals (Sweden)

    M Arab

    2012-12-01

    Full Text Available   Background and Aims: In a healthy organization, staff's physical and mental health is as important and considerable as production and productivity. Burnout is a result of long-term tension and stress in the job environment. Its symptoms occur when employees' power and potency is not enough for the job environment demands. Emotional exhaustion, depersonalization and lack of personal accomplishment are three dimensions of burnout. In this survey we studied the nursing job environment considering nurses' participation in hospital affairs, foundation for quality of nursing care, managerial support and leadership, staffing/resource adequacy and collegial nurse-physician relation and their effects on nurses' burnout level.   Methods:   This survey is a cross-sectional, descriptive-analytical study to review of nursing job environment on nurses' burnout dimensions in TUMS (Tehran … general-teaching hospitals in 1386. For this study, 214 nurses (confidence interval %95, powers %80 and attrition %30 were selected randomly. Data were gathered using Maslach Burnout Inventory (MBI and Nursing Work Index(NWI questionnaires filled in by studied nurses.   The validity of these questionnaires determined using masters' instructions. To determine the reliability of NWI questionnaire, a pilot study was conducted and its reliability coefficient (Cronbach’s alpha was 0.88. The reliability and internal validity of MBI questionnaire had been proved in previous studies. Data were analyzed by SPSS 11.5 and Logistic regression and Chi-Square test.   Results:   Results show that hospital type and nurses' sex have effects on lack of personal accomplishment frequency and hospital type influences lack of personal accomplishment severity. Depersonalization frequency is effected negatively by decreasing foundation for quality of nursing care (OR=2.326 and lack of managerial support and leadership (OR=4.553 and limited collegial nurse-physician relation (OR=1

  18. Advancing the integration of hospital IT. Pitfalls and perspectives when replacing specialized software for high-risk environments with enterprise system extensions.

    Science.gov (United States)

    Engelmann, Carsten; Ametowobla, Dzifa

    2017-05-17

    Planning and controlling surgical operations hugely impacts upon productivity, patient safety, and surgeons' careers. Established, specialized software for this task is being increasingly replaced by "Operating Room (OR)-modules" appended to enterprise-wide resource planning (ERP) systems. As a result, usability problems are re-emerging and require developers' attention. Systematic evaluation of the functionality and social repercussions of a global, market-leading IT business control system (SAP R3, Germany), adapted for real-time OR process steering. Field study involving document analyses, interviews, and a 73-item survey addressed to 77 qualified (> 1-year system experience) senior planning executives (end users; "planners") working in surgical departments of university hospitals. Planners reported that 57% of electronic operation requests contained contradictory information. Key screens contained clinically irrelevant areas (36 +/- 29%). Compared to the legacy system, users reported either no improvements or worse performance, in regard to co-ordination of OR stakeholders, intra-day program changes, and safety. Planners concluded that the ERP-planning module was "non-intuitive" (66%), increased planning work (56%, p=0.002), and did not impact upon either organizational mishap spectrum or frequency. Interviews evidenced intra-institutional power shifts due to increased system complexity. Planners resented e.g. a trend towards increased personal culpability for mishap. Highly complex enterprise system extensions may not be directly suited to specific process steering tasks in a high risk/low error-environment like the OR. In view of surgeons' high primary task load, the repeated call for simpler IT is an imperative for ERP extensions. System design should consider a) that current OR IT suffers from an input limitation regarding planning-relevant real-time data, and b) that there are social processes that strongly affect planning and particularly ERP use beyond

  19. Study of accident environment during sea transport of nuclear material: Analysis of an engine room fire on a purpose built ship. Annex 5

    International Nuclear Information System (INIS)

    Yamamoto, K.; Shibata, H.; Ouchi, Y.; Kitamura, T.; Ito, T.; Hohnstreiter, G.F.; Pierce, J.D.; Koski, J.A.; Dukart, R.J.

    2001-01-01

    The program goal was to show that the IAEA safe transport regulations adequately cover the thermal effects of an engine-room fire on plutonium transportation packages stowed aboard a purpose built ship. The packages are stored in transportation containers located in a cargo hold of the ship. This study addressed the heat transfer from an engine-room fire that could heat and evaporate water out of the water-filled bulkhead and the resulting temperature conditions around the packages and inside the packages near their elastomeric seals. This study was designed to estimate the thermal response of a plutonium package in the hold of a purpose built ship during a shipboard fire, and furthermore, to confirm the sufficiency and adequacy of the current IAEA transport regulation

  20. Firearm Injuries Received in Emergency Room of a Nigerian ...

    African Journals Online (AJOL)

    2017-05-22

    May 22, 2017 ... the emergency room of Federal Teaching Hospital Abakaliki from January 2005 to. December 2014. Results: There were 214 ... Hospital: Analysis of Pattern, Morbidity, and Mortality. NI Omoke. Original Article ..... rapid evacuation of casualties to hospital emergency room. In this study, there was no ...

  1. Pro-environment behaviors of hospitality employees. The case of a certified hotel in Huatulco, Mexico

    Directory of Open Access Journals (Sweden)

    Elva Esther Vargas-Martínez

    2017-01-01

    Full Text Available More and more companies are taking actions for the environment, among the most common is the adoption of environmental management systems or eco-labeling schemes, not only because they streamline resources and reduce costs, resulting in greater profitability, but because they improve public image with commit to society and nature. In the case of the tourist destination Huatulco, they have focused on the environmental dimension of sustainability activities, which has resulted in the hotel sector being immersed in dynamic certification. This research focused on the values, environmental awareness, organizational commitment and job satisfaction of workers as determinants of pro-environment behavior. From a survey of 178 workers of a hotel certified by EarthCheck and applying Multiple Regression Model, it was identified that values and environmental awareness have a significant effect on environmental behaviors.

  2. Effectiveness of a drinking-motive-tailored emergency-room intervention among adolescents admitted to hospital due to acute alcohol intoxication - A randomized controlled trial.

    Science.gov (United States)

    Wurdak, Mara; Wolstein, Jörg; Kuntsche, Emmanuel

    2016-06-01

    The aim of this study is to develop and test the effectiveness of a drinking-motive-tailored intervention for adolescents hospitalized due to alcohol intoxication in eight cities in Germany between December 2011 and May 2012 against a similar, non-motive-tailored intervention. In a randomized controlled trial, 254 adolescents received a psychosocial intervention plus motive-tailored (intervention group; IG) or general exercises (control group; CG). Adolescents in the IG received exercises in accordance with their drinking motives as indicated at baseline (e.g. alternative ways of spending leisure time or dealing with stress). Exercises for the CG contained alcohol-related information in general (e.g. legal issues). The data of 81 adolescents (age: M = 15.6, SD = 1.0; 42.0% female) who participated in both the baseline and the follow-up were compared using ANOVA with repeated measurements and effect sizes (available case analyses). Adolescents reported lower alcohol use at the four-week follow-up independently of the kind of intervention. Significant interaction effects between time and IG were found for girls in terms of drinking frequency (F = 7.770, p effect sizes of drinking frequency (d = - 1.18), binge drinking (d = - 1.61) and drunkenness (d = - 2.87) were much higher than the .8 threshold for large effects. Conducting psychosocial interventions in a motive-tailored way appears more effective for girls admitted to hospital due to alcohol intoxication than without motive-tailoring. Further research is required to address the specific needs of boys in such interventions. (German Clinical Trials Register, DRKS ID: DRKS00005588).

  3. Design for Distributed Moroccan Hospital Pharmacy Information Environment with Service Oriented Architecture

    OpenAIRE

    Omrana, Hajar; Nassiri, Safae; Belouadha, Fatima-Zahra; Roudiés, Ounsa

    2012-01-01

    In the last five years, Moroccan e-health system has focused on improving the quality of patient care services by making use of advanced Information and Communications Technologies (ICT) solutions. In actual fact, achieving runtime and efficient information sharing, through large-scale distributed environments such as e-health system, is not a trivial task. It seems to present many issues due to the heterogeneity and complex nature of data resources. This concerns, in particular, Moroccan Hos...

  4. Environment

    DEFF Research Database (Denmark)

    Valentini, Chiara

    2017-01-01

    The term environment refers to the internal and external context in which organizations operate. For some scholars, environment is defined as an arrangement of political, economic, social and cultural factors existing in a given context that have an impact on organizational processes and structures....... For others, environment is a generic term describing a large variety of stakeholders and how these interact and act upon organizations. Organizations and their environment are mutually interdependent and organizational communications are highly affected by the environment. This entry examines the origin...... and development of organization-environment interdependence, the nature of the concept of environment and its relevance for communication scholarships and activities....

  5. New heuristics for planning operating rooms.

    NARCIS (Netherlands)

    Molina-Pariente, J.M.; Hans, Elias W.; Framinan, J.M.; Gomez-Cia, T.

    2015-01-01

    We tackle the operating room planning problem of the Plastic Surgery and Major Burns Specialty of the University Hospital “Virgen del Rocio” in Seville (Spain). The decision problem is to assign an intervention date and an operating room to a set of surgeries on the waiting list, minimizing access

  6. Sistema de controle interno ambiental: estudo realizado em um hospital público = System of internal control environment: study done in a public hospital

    Directory of Open Access Journals (Sweden)

    Danúbia Vegini

    2012-05-01

    Full Text Available As preocupações com o meio ambiente estão assumindo proporções cada vez maiores, em decorrência dos desequilíbrios gerados pelos homens na natureza. Com isso, a administração pública está adotando políticas mais específicas e concretas, responsabilizando os agentes pelos seus atos. Como meio de garantir resultados positivos para o meio ambiente, as instituições passaram a adotar ações de controles internos, de gestão ambiental, e sistemas de gestão ambiental. O objetivo deste trabalho é analisar a sustentabilidade ambiental através da aplicação parcial do SICOGEA – geração 2. A metodologia adotada é descritiva e exploratória em relação aos objetivos; quanto aos procedimentos adota-se pesquisa bibliográfica e análise dos resultados, este aplicado em um hospital público utilizando-se de uma entrevista semi-estruturada. A trajetória metodológica divide-se em três fases; sendo, a primeira fundamentação teórica onde são estudados os temas: sistema de controles internos, gestão e certificação ambiental, controladoria, auditoria, contabilidade ambiental, sistema de gestão ambiental e resíduos hospitalares. A segunda fase abrange a análise dos resultados, onde primeiramente fez-se um breve histórico da instituição pesquisada, após realiza-se as entrevistas com base na lista de verificação; e finalmente a terceira fase apresenta o diagnóstico dos resultados, a sustentabilidade parcial e total, bem como o planejamento 5W2H. Assim, em decorrência da pesquisa alcançou-se uma sustentabilidade global da instituição em 2011 de 61,01%, a organização é classificada com resultado “Bom” conforme tabela de avaliação da sustentabilidade e desempenho ambiental, tendo uma queda de 4,45% em relação ao exercício anterior.Concerns about the environment are taking greater and greater, due to the imbalances created by man in nature. With this, the government is adopting policies that are more specific

  7. Avaliação da preceptoria na residência médica em cirurgia geral, no centro cirúrgico, comparação entre um hospital universitário e um hospital não universitário Assessment of preceptorship in general surgery residency in the operating room, comparison between a teaching hospital and a non teaching hospital

    Directory of Open Access Journals (Sweden)

    Elizabeth Gomes Santos

    2012-12-01

    Full Text Available OBJETIVO: Avaliar e comparar a preceptoria no programa de residência médica em Cirurgia Geral, no centro cirúrgico, em um hospital universitário e em um hospital não universitário, a partir da ótica dos residentes que ingressaram em 2010 e 2011. MÉTODOS: Questionário aplicado aos residentes, modificado de Sarker SK, Vincent C, e Darzi AW e usando-se a escala de Likert para qualificar o ítem pesquisado sobre as atitudes dos preceptores. A comparação da distribuição das respostas entre os dois hospitais foi analisada pelo teste de c² para tendências. RESULTADOS: No hospital universitário foram avaliados 12 preceptores por sete residentes. No hospital não universitário foram 11 preceptores avaliados por 13 residentes. O hospital não universitário apresentou a tendência de resposta discordante e indiferente (DC, D e I maior que o hospital universitário. Só o resultado de uma pergunta apresentou significância estatística. Não houve diferença significativa na comparação das respostas nas demais perguntas entre os dois hospitais. CONCLUSÃO: Os hospitais apresentaram preceptoria semelhante.BACKGROUND: Medical residency is well known as the best training method after graduation. It is a moment when, in addition to receiving technical guidance, residents should also develop attitudes, ethics, and professionalism. In order for that to occur, preceptors should be prepared for their task. OBJECTIVE: To evaluate and compare the preceptorship in the Medical Residency in General Surgery program, in the operating room of a Teaching Hospital (TH and a Non-teaching Hospital (NTH, from the viewpoint of the residents who entered in 2010 and 2011. METHODS: A questionnaire was applied to the residents, adapted from Sarker, Vincent and Darzi, and the Likert scale was used to qualify the survey items on the preceptors' attitudes. RESULTS: At the TH, 12 preceptors were evaluated by 7 residents. One of the residents did not answer the

  8. WORKING ENVIRONMENT AND JOB SATISFACTION AMONG HEALTH PROFESSIONAL WORKING AT A TERTIARY CARE HOSPITAL OF PAKISTAN.

    Science.gov (United States)

    Aziz, Imrana; Kumar, Ramesh; Rathore, Anita; Lal, Manohr

    2015-01-01

    Work environment is believed to be a major factor for better performance of human resource for health in any organization. This study concentrated on multiple factors involved in job satisfaction was appraised to critique their efficient significance in calculation of the health professional liking. Factors included job matched with workers' skills/experience, incentives, supervision, administrator support; convenient work load, training, appreciation, low pay and job protection were major contributors in job satisfaction. A mix method study was done in 2014; an initial descriptive cross sectional survey was done followed by qualitative approach. Eighteen in-depth interviews with health care providers were conducted after taking written consent. Nodes, sub-nodes and final themes were generated during qualitative data analysis. Main findings and themes were, generated after making the nodes and sub-nodes from the most frequent responses. These themes were; absence of work pressure, work place safety, social support, learning opportunities, and employee influence on conditions and recognition individual or team efforts. Work environment is a major contributing factor towards job satisfaction among the health workers.

  9. A Novel Approach for Creating Activity-Aware Applications in a Hospital Environment

    Science.gov (United States)

    Bardram, Jakob E.

    Context-aware and activity-aware computing has been proposed as a way to adapt the computer to the user’s ongoing activity. However, deductively moving from physical context - like location - to establishing human activity has proved difficult. This paper proposes a novel approach to activity-aware computing. Instead of inferring activities, this approach enables the user to explicitly model their activity, and then use sensor-based events to create, manage, and use these computational activities adjusted to a specific context. This approach was crafted through a user-centered design process in collaboration with a hospital department. We propose three strategies for activity-awareness: context-based activity matching, context-based activity creation, and context-based activity adaptation. We present the implementation of these strategies and present an experimental evaluation of them. The experiments demonstrate that rather than considering context as information, context can be a relational property that links ’real-world activities’ with their ’computational activities’.

  10. Healthcare Providers' Formative Experiences with Race and Black Male Patients in Urban Hospital Environments.

    Science.gov (United States)

    Plaisime, Marie V; Malebranche, David J; Davis, Andrea L; Taylor, Jennifer A

    2017-12-01

    We explored health providers' formative personal and professional experiences with race and Black men as a way to assess their potential influence on interactions with Black male patients. Utilizing convenience sampling with snowballing techniques, we identified healthcare providers in two urban university hospitals. We compared Black and White providers' experiences based on race and level of training. We used the Gardener's Tale to conceptualize how racism may lead to racial health disparities. A semi-structured interview guide was used to conduct in-person interviews (n = 16). Using the grounded theory approach, we conducted three types of coding to examine data patterns. We found two themes reflective of personally mediated racism: (1) perception of Black males accompanied by two subthemes (a) biased care and (b) fear and discomfort and (2) cognitive dissonance. While this latter theme is more reflective of Jones's internalized racism level, we present its results because its novelty is compelling. Perception of Black males and cognitive dissonance appear to influence providers' approaches with Black male patients. This study suggests the need to develop initiatives and curricula in health professional schools that address provider racial bias. Understanding the dynamics operating in the patient-provider encounter enhances the ability to address and reduce health disparities.

  11. Pseudomonas aeruginosa Genome Evolution in Patients and under the Hospital Environment

    Directory of Open Access Journals (Sweden)

    Céline Lucchetti-Miganeh

    2014-04-01

    Full Text Available Pseudomonas aeruginosa is a Gram-negative environmental species and an opportunistic microorganism, establishing itself in vulnerable patients, such as those with cystic fibrosis (CF or those hospitalized in intensive care units (ICU. It has become a major cause of nosocomial infections worldwide and a serious threat to Public Health because of overuse and misuse of antibiotics that have selected highly resistant strains against which very few therapeutic options exist. Herein is illustrated the intraclonal evolution of the genome of sequential isolates collected in a single CF patient from the early phase of pulmonary colonization to the fatal outcome. We also examined at the whole genome scale a pair of genotypically-related strains made of a drug susceptible, environmental isolate recovered from an ICU sink and of its multidrug resistant counterpart found to infect an ICU patient. Multiple genetic changes accumulated in the CF isolates over the disease time course including SNPs, deletion events and reduction of whole genome size. The strain isolated from the ICU patient displayed an increase in the genome size of 4.8% with major genetic rearrangements as compared to the initial environmental strain. The annotated genomes are given in free access in an interactive web application WallGene  designed to facilitate large-scale comparative analysis and thus allowing investigators to explore homologies and syntenies between P. aeruginosa strains, here PAO1 and the five clinical strains described.

  12. Planning for patient privacy and hospitability: a must do in oncology care.

    Science.gov (United States)

    Easter, James G

    2003-01-01

    The number one design challenge in the healthcare environment is the patient room. This space is one of the primary functional areas impacting hospital design and, quite often, the place of greatest controversy. This controversy is due to the length of time the patient spends in the room (compared to other areas), the amount of overall space required and the time dedicated to patient room utilization, maintenance, general arrangement and overall efficiency. In addition, there is a growing list of room types to be considered, many are of the ambulatory care, short stay and observation category. Other room types beyond the routine medical/surgical room include Intensive Care, Coronary Care, Surgical Intensive Care, Skilled Nursing, Rehabilitation and Oncology Care as well as more intensive Bone Marrow Transplantation, for example. Major features of the traditional acute care patient room require the space to be flexible, convertible, expandable and, most importantly, hospitable. For many, many years the patient room was considered a shared space with multiple beds and multiple users. The term semi-private has been used to describe the traditional two-bed and, sometimes 4-bed patient room. This article will address the programmatic elements of an inpatient area, the room and its functional components along with some examples for comparative purposes. For the oncology patient, the development of a family-focused, private room is mandatory. The private room is more flexible, less expensive to operate, safer and environmentally more appealing for the patient, family and staff.

  13. Perceived organizational support and job involvement in the Iranian health care system: A case study of emergency room nurses in general hospitals.

    Science.gov (United States)

    Gorji, Hassan Abolghasem; Etemadi, Manal; Hoseini, Fatemeh

    2014-01-01

    Researchers believe that there are social exchanges between the employers and employees, because the employees would be interested in their organization and trust it based on how the organization values them and their welfare, comfort, and security. This belief is known as perceived organizational support that makes employees consider themselves as a part of their organization and have a commitment to it. The literature review is very limited in both variables in Iran and thus few studies also report the perceived organizational support and job involvement at the lower levels in our country. This research aimed at studying the levels of perceived organizational support and job involvement, relationship between this two, and the demographic factors relationship with both of them. This research was a descriptive analytical study conducted in 2012. The population included 123 emergency nurses in General Hospitals of Qom. Data were collected through Perceived Organizational Support and Job Involvement Questionnaires and analyzed using SPSS software, descriptive statistics and Spearman correlation and Chi-square test. Both mean scores for perceived organizational support and job involvement were in average level, 146/12 and 35/38, respectively. There was a significant relationship between perceived organizational support and age, education, tenure, organizational position, and job shift. There was also a significant relationship between job involvement and age and education and finally between perceived organizational support and job involvement (P = 0/029). The high correlation between perceived organizational support and job involvement indicates that the improvement of perceived organizational support are necessary through motivating the employees, showing interest in them, paying attention to them, respecting them, and providing development opportunity in the organization. These should be always considered by managers to improve job involvement.

  14. Determination of Anger Expression and Anger Management Styles and an Application on Operating Room Nurses

    Directory of Open Access Journals (Sweden)

    Hülya Aslan

    2016-12-01

    Full Text Available This research has been carried out in order to determine anger expression and anger management styles in operating room nurses. By applying an in-depth interview technique on operating room nurses working in a private hospital, a qualitative study has been performed in order to determine anger expression and anger management styles in operating room nurses. The interview consisted of ten questions such as demographic questions addressing the workers’ age, sex, education level and duration of employment in the organization they work, aiming to determine their anger expression and anger management styles. Since operating room environments contain various risk factors, and require active team work in a stressful dynamic setting under excessive workload, , it has been found that operating room nurses display their anger through loud speaking, fail to settle their anger positively, fail to control their anger in a behavioural pattern despite their cognitive awareness in anger management. Thus, it has been suggested that operating room nurses should be trained on anger management methods so that they can manage their anger in a stressful operating room environment.

  15. Impact of Operating Room Environment on Postoperative Central Nervous System Infection in a Resource-Limited Neurosurgical Center in South Asia.

    Science.gov (United States)

    Chidambaram, Swathi; Vasudevan, Madabushi Chakravarthy; Nair, Mani Nathan; Joyce, Cara; Germanwala, Anand V

    2018-02-01

    Postoperative central nervous system infections (PCNSIs) are serious complications following neurosurgical intervention. We previously investigated the incidence and causative pathogens of PCNSIs at a resource-limited, neurosurgical center in south Asia. This follow-up study was conducted to analyze differences in PCNSIs at the same institution following only one apparent change: the operating room air filtration system. This was a retrospective study of all neurosurgical cases performed between December 1, 2013, and March 31, 2016 at our center. Providers, patient demographic data, case types, perioperative care, rate of PCNSI, and rates of other complications were reviewed. These results were then compared with the findings of our previous study of neurosurgical cases between June 1, 2012, and June 30, 2013. All 623 neurosurgical operative cases over the study period were reviewed. Four patients (0.6%) had a PCNSI, and no patients had a positive cerebrospinal fluid (CSF) culture. In the previous study, among 363 cases, 71 patients (19.6%) had a PCNSI and 7 (1.9%) had a positive CSF culture (all Gram-negative organisms). The differences in both parameters are statistically significant (P system inside the neurosurgical operating rooms; this environmental change occurred during the 5 months between the 2 studies. This study demonstrates the impact of environmental factors in reducing infections. Copyright © 2017 Elsevier Inc. All rights reserved.

  16. Antibiotic resistance in hospitals: a ward-specific random effect model in a low antibiotic consumption environment.

    Science.gov (United States)

    Aldrin, Magne; Raastad, Ragnhild; Tvete, Ingunn Fride; Berild, Dag; Frigessi, Arnoldo; Leegaard, Truls; Monnet, Dominique L; Walberg, Mette; Müller, Fredrik

    2013-04-15

    Association between previous antibiotic use and emergence of antibiotic resistance has been reported for several microorganisms. The relationship has been extensively studied, and although the causes of antibiotic resistance are multi-factorial, clear evidence of antibiotic use as a major risk factor exists. Most studies are carried out in countries with high consumption of antibiotics and corresponding high levels of antibiotic resistance, and currently, little is known whether and at what level the associations are detectable in a low antibiotic consumption environment. We conduct an ecological, retrospective study aimed at determining the impact of antibiotic consumption on antibiotic-resistant Pseudomonas aeruginosa in three hospitals in Norway, a country with low levels of antibiotic use. We construct a sophisticated statistical model to capture such low signals. To reduce noise, we conduct our study at hospital ward level. We propose a random effect Poisson or binomial regression model, with a reparametrisation that allows us to reduce the number of parameters. Inference is likelihood based. Through scenario simulation, we study the potential effects of reduced or increased antibiotic use. Results clearly indicate that the effects of consumption on resistance are present under conditions with relatively low use of antibiotic agents. This strengthens the recommendation on prudent use of antibiotics, even when consumption is relatively low. Copyright © 2012 John Wiley & Sons, Ltd.

  17. Resident training in a teaching hospital: How do attendings teach in the real operative environment?

    Science.gov (United States)

    Glarner, Carly E; Law, Katherine E; Zelenski, Amy B; McDonald, Robert J; Greenberg, Jacob A; Foley, Eugene F; Wiegmann, Douglas A; Greenberg, Caprice C

    2017-07-01

    The study aim was to explore the nature of intraoperative education and its interaction with the environment where surgical education occurs. Video and audio recording captured teaching interactions between colorectal surgeons and general surgery residents during laparoscopic segmental colectomies. Cases and collected data were analyzed for teaching behaviors and workflow disruptions. Flow disruptions (FDs) are considered deviations from natural case progression. Across 10 cases (20.4 operative hours), attendings spent 11.2 hours (54.7%) teaching, using directing (M = 250.1), and confirming (M = 236.1) most. FDs occurred 410 times, accounting for 4.4 hours of case time (21.57%). Teaching occurred with FD events for 2.4 hours (22.2%), whereas 77.8% of teaching happened outside FD occurrence. Teaching methods shifted from active to passive during FD events to compensate for patient safety. Understanding how FDs impact operative learning will inform faculty development in managing interruptions and improve its integration into resident education. Copyright © 2016. Published by Elsevier Inc.

  18. CEBAF Control Room Renovation

    International Nuclear Information System (INIS)

    Michael Spata; Anthony Cuffe; Thomas Oren

    2005-01-01

    The Machine Control Center (MCC) at Jefferson Lab's Continuous Electron Beam Accelerator Facility (CEBAF) was constructed in the early 1990s and based on proven technology of that era. Through our experience over the last 15 years and in our planning for the facilities 12 GeV upgrade we reevaluated the control room environment to capitalize on emerging visualization and display technologies and improve on work-flow processes and ergonomic attributes. The renovation was performed in two phases during the summer of 2004, with one phase occurring during machine operations and the latter, more extensive phase, occurring during our semi-annual shutdown period. The new facility takes advantage of advances in display technology, analog and video signal management, server technology, ergonomic workspace design, lighting engineering, acoustic ceilings and raised flooring solutions to provide a marked improvement in the overall environment of machine operations

  19. [Sensitivity to disinfectants of Candid albicans strains isolated from the hospital environment].

    Science.gov (United States)

    Tadeusiak, B

    1998-01-01

    In recent years an increase of the incidence of Candida infections caused mainly by C. albicans strains especially in high risk inpatients with neoplasms, decreased immunity, burns and after treatment with multiple antibiotics has been observed. Candida organisms are particularly dangerous for newborns being responsible for about 30% of septicaemia cases in newborns in intensive care units. Fungal infections can be endogenous in origin but exogenous infection sources occur in hospitals. The cause of the latter are errors in aseptic management and insufficiently disinfected medical instruments and equipment. The purpose of the study was a comparison of the sensitivity to disinfectants of C. albicans belonging to two laboratory strains C. albicans PZH and C. albicans ATCC 10231 used for the determination of concentrations of two disinfectants used. Besides that, this sensitivity was determined in 14 strains isolated from the patients and one from the circuit of dialysis solution supply to artificial kidney. The study was carried out by the qualitative suspension method, in which the cells in the fluid were subjected to the action of disinfectants, and by the carrier method in which the cells of the microorganisms were present on the surface of metal cylinders. By the suspension method the sensitivity was determined to chloramine T in concentrations from 5.0% to 0.001%, formalin from 10.0% to 0.25%, glutaraldehyde from 2.0% to 0.1%, Septyl from 3.5% to 0.25%. The exposure time was 5, 10, 15, 30 and 60 minutes. The tested strains differed in their sensitivity to the disinfectants used. The greatest interstrain differences were observed in the sensitivity to the disinfectants used. The greatest interstrain differences were observed in the sensitivity to chloramine T. The highest concentrations were tolerated by the strains isolated from the patients and from the artificial kidney circuit as well as by the standard strain ATCC 10231. In the 10-minute exposure time

  20. Control room lay-out

    International Nuclear Information System (INIS)

    Toma, Violeta

    2004-01-01

    TRIUMF (Tri-University Meson Facility) is Canada's national laboratory for particle and nuclear physics. There are 6 accelerators and 3 Control Rooms at TRIUMF. The main control room serves the big cyclotron, the 500 MeV, and the adjacent experiment. The 42 MeV and two 32 MeV ones are production dedicated. These cyclotrons belong to a private company but are operated by TRIUMF staff from ATG (Applied Technology Group) Control Room. The last is ISAC (Isotope Acceleration and Separation) Control Room, from which the LINAC is controlled. Research areas cover theoretical (2 subjects), pure (5 subjects) and applied (8 subjects) physics. In the early '70s, as the 500 MeV was being completed, the first Control Room was built in the main accelerator building. The recent topics covered by this paper are proton and pion therapy, what are the operator's duties?, the CP42, TR30 and TR13 cyclotron control rooms, the ISAC control systems including control room modification. Due to the nature of an operator's job, the Control Room layout is pretty important. This is true for any work environment, but when working shifts it becomes essential. Lots of time and effort, not to mention money, were spent to figure out the optimum configuration. It seems to me that the key factor in the control room layout is versatility, and this is because it has to keep happy a group of people with different inclinations, which have a tendency to become quite moody after the second night shift. No matter what, there will still be unhappy people, but we are trying our best. (Y. Tanaka)

  1. Controlling Hospital-Acquired Infection: Focus on the Role of the Environment and New Technologies for Decontamination

    Science.gov (United States)

    2014-01-01

    SUMMARY There is increasing interest in the role of cleaning for managing hospital-acquired infections (HAI). Pathogens such as vancomycin-resistant enterococci (VRE), methicillin-resistant Staphylococcus aureus (MRSA), multiresistant Gram-negative bacilli, norovirus, and Clostridium difficile persist in the health care environment for days. Both detergent- and disinfectant-based cleaning can help control these pathogens, although difficulties with measuring cleanliness have compromised the quality of published evidence. Traditional cleaning methods are notoriously inefficient for decontamination, and new approaches have been proposed, including disinfectants, steam, automated dispersal systems, and antimicrobial surfaces. These methods are difficult to evaluate for cost-effectiveness because environmental data are not usually modeled against patient outcome. Recent studies have reported the value of physically removing soil using detergent, compared with more expensive (and toxic) disinfectants. Simple cleaning methods should be evaluated against nonmanual disinfection using standardized sampling and surveillance. Given worldwide concern over escalating antimicrobial resistance, it is clear that more studies on health care decontamination are required. Cleaning schedules should be adapted to reflect clinical risk, location, type of site, and hand touch frequency and should be evaluated for cost versus benefit for both routine and outbreak situations. Forthcoming evidence on the role of antimicrobial surfaces could supplement infection prevention strategies for health care environments, including those targeting multidrug-resistant pathogens. PMID:25278571

  2. Reducing start time delays in operating rooms

    NARCIS (Netherlands)

    Does, R.J.M.M.; Vermaat, T.M.B.; Verver, J.P.S.; Bisgaard, S.; van den Heuvel, J.

    2009-01-01

    Problem: Health care today is facing serious problems: quality of care does not meet patients’ needs and costs are exploding. Inefficient utilization of expensive operating rooms is one of the major problems in many hospitals worldwide. A benchmark study of 13 hospitals in the Netherlands and

  3. The hospital educational environment and performance of residents in the General Medicine In-Training Examination: a multicenter study in Japan

    Directory of Open Access Journals (Sweden)

    Shimizu T

    2013-07-01

    Full Text Available Taro Shimizu,1 Yusuke Tsugawa,2,3 Yusuke Tanoue,4 Ryota Konishi,5 Yuji Nishizaki,6 Mitsumasa Kishimoto,7 Toshiaki Shiojiri,8 Yasuharu Tokuda9 1Hospitalist Division, Department of Medicine, Nerima Hikarigaoka Hospital, Tokyo, Japan; 2Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA; 3Center for Clinical Epidemiology, St Luke's Life Science Institute, 4Department of Vascular and Oncological Surgery, Hospital of Tokyo University, 5Department of General Internal Medicine, Kanto Rousai Hospital, 6Department of Cardiology, Juntendo University School of Medicine, 7Division of Rheumatology, St Luke's International Hospital, Tokyo, Japan; 8Asahi Chuo Hospital, Chiba, Japan; 9Department of Medicine, Tsukuba University Mito Kyodo General Hospital, Mito City, Ibaraki, Japan Background: It is believed that the type of educational environment in teaching hospitals may affect the performance of medical knowledge base among residents, but this has not yet been proven. Objective: We aimed to investigate the association between the hospital educational environment and the performance of the medical knowledge base among resident physicians in Japanese teaching hospitals. Methods: To assess the knowledge base of medicine, we conducted the General Medicine In-Training Examination (GM-ITE for second-year residents in the last month of their residency. The items of the exam were developed based on the outcomes designated by the Japanese Ministry of Health, Labor, and Welfare. The educational environment was evaluated using the Postgraduate Hospital Educational Environment Measure (PHEEM score, which was assessed by a mailed survey 2 years prior to the exam. A mixed-effects linear regression model was employed for the analysis of variables associated with a higher score. Results: Twenty-one teaching hospitals participated in the study and a total of 206 residents (67 women participated and

  4. Evaluation and Improvement of the Nurse Satisfactory Status in a Tertiary Hospital using the Professional Practice Environment Scale.

    Science.gov (United States)

    Liu, Jun; Zhou, Hui; Yang, Xiaoqin

    2017-02-18

    The present study was performed to quantitatively examine nurse satisfaction, to investigate the associated factors influencing satisfaction, and to evaluate the effect of improvement measures based on these factors. A survey using the 38-item Chinese version of the Practice Environment Scale (CPPE-38) was performed in a university-affiliated tertiary hospital in Shanghai, China in 2013. Linear regression analysis was performed to screen for associated factors related to each CPPE-3 score and the total satisfaction score. Several improvement measures were established to improve nurse satisfaction, and the CPPE-38 survey was again performed in 2015 to evaluate the effect of these improvement measures. A total of 1,050 respondents were recruited in 2013, with a response rate of 87.6%. The total satisfaction score of the CPPE-38 was 2.99±0.64. The lowest score in a subscale of the CPPE-38 was 2.40±0.59 for interpersonal interaction and the highest score was 3.15±0.40 for internal work motivation. Work location was associated with scores for work motivation and total satisfaction, while the highest education degree was associated with scores for internal relationship and autonomy. The scores for internal work motivation, control over practice, interpersonal interaction, and internal relationship and autonomy were significantly improved in 2015 after two years of improvement efforts, while the total satisfaction score was not significantly different compared to the 2013 score. Working location and education degree were two factors correlated with CPPE-38 scores in our hospital. Humanistic concerns, continuing education, and pay raise may improve the practice satisfaction of nurses.

  5. Parents' Perceived Satisfaction of Care, Communication and Environment of the Pediatric Intensive Care Units at a Tertiary Children's Hospital.

    Science.gov (United States)

    Abuqamar, Maram; Arabiat, Diana H; Holmes, Sandra

    2016-01-01

    This study aims to identify parental perceptions on pediatric intensive care-related satisfaction within three domains: environment, child's care provided and communication. In addition, it aims to identify whether parent's socio-demographics and child's clinical variables predict parents' perceived satisfaction. In this study, a total of 123 parents whose child received care in the PICU of a tertiary children's hospital in Amman completed the Arabic version of the parents satisfaction survey (PSS). A cross-sectional, descriptive-correlational design was used to collect data. All data were collected between June and October of 2013. Central tendency measures and percentages of replies for each domain revealed that at least 7 items were rated poorly satisfied. More than half of the parents were not satisfied with the noise level of the PICU, the time nurses spent at the child's bedside, as well as the way the healthcare team prepare them for the child's admission. Almost 90% of the parents believed that the nurses ignored their child's needs by not listening to parents and by responding slowly to child's needs. Stepwise regression analysis showed that that the number of hospital admissions, health insurance and the severity of illness was the main predictor of parents' satisfaction. In conclusion, the availability of health care professionals, the support and the information they share with the child's parents are all significant to parent's satisfaction and hence to better quality of care. Targeting the domains of low satisfaction reported by the parents could increase parent's satisfaction and achieve quality improvement required for this population. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. The impact of service-specific staffing, case scheduling, turnovers, and first-case starts on anesthesia group and operating room productivity: a tutorial using data from an Australian hospital.

    Science.gov (United States)

    McIntosh, Catherine; Dexter, Franklin; Epstein, Richard H

    2006-12-01

    In this tutorial, we consider the impact of operating room (OR) management on anesthesia group and OR labor productivity and costs. Most of the tutorial focuses on the steps required for each facility to refine its OR allocations using its own data collected during patient care. Data from a hospital in Australia are used throughout to illustrate the methods. OR allocation is a two-stage process. During the initial tactical stage of allocating OR time, OR capacity ("block time") is adjusted. For operational decision-making on a shorter-term basis, the existing workload can be considered fixed. Staffing is matched to that workload based on maximizing the efficiency of use of OR time. Scheduling cases and making decisions on the day of surgery to increase OR efficiency are worthwhile interventions to increase anesthesia group productivity. However, by far, the most important step is the appropriate refinement of OR allocations (i.e., planning service-specific staffing) 2-3 mo before the day of surgery. Reducing surgical and/or turnover times and delays in first-case-of-the-day starts generally provides small reductions in OR labor costs. Results vary widely because they are highly sensitive both to the OR allocations (i.e., staffing) and to the appropriateness of those OR allocations.

  7. Adjoint acceleration of Monte Carlo simulations using TORT/MCNP coupling approach: A case study on the shielding improvement for the cyclotron room of the Buddhist Tzu Chi General Hospital

    International Nuclear Information System (INIS)

    Sheu, R. J.; Sheu, R. D.; Jiang, S. H.; Kao, C. H.

    2005-01-01

    Full-scale Monte Carlo simulations of the cyclotron room of the Buddhist Tzu Chi General Hospital were carried out to improve the original inadequate maze design. Variance reduction techniques are indispensable in this study to facilitate the simulations for testing a variety of configurations of shielding modification. The TORT/MCNP manual coupling approach based on the Consistent Adjoint Driven Importance Sampling (CADIS) methodology has been used throughout this study. The CADIS utilises the source and transport biasing in a consistent manner. With this method, the computational efficiency was increased significantly by more than two orders of magnitude and the statistical convergence was also improved compared to the unbiased Monte Carlo run. This paper describes the shielding problem encountered, the procedure for coupling the TORT and MCNP codes to accelerate the calculations and the calculation results for the original and improved shielding designs. In order to verify the calculation results and seek additional accelerations, sensitivity studies on the space-dependent and energy-dependent parameters were also conducted. (authors)

  8. Effects of coaching supervision, mentoring supervision and abusive supervision on talent development among trainee doctors in public hospitals: moderating role of clinical learning environment.

    Science.gov (United States)

    Subramaniam, Anusuiya; Silong, Abu Daud; Uli, Jegak; Ismail, Ismi Arif

    2015-08-13

    Effective talent development requires robust supervision. However, the effects of supervisory styles (coaching, mentoring and abusive supervision) on talent development and the moderating effects of clinical learning environment in the relationship between supervisory styles and talent development among public hospital trainee doctors have not been thoroughly researched. In this study, we aim to achieve the following, (1) identify the extent to which supervisory styles (coaching, mentoring and abusive supervision) can facilitate talent development among trainee doctors in public hospital and (2) examine whether coaching, mentoring and abusive supervision are moderated by clinical learning environment in predicting talent development among trainee doctors in public hospital. A questionnaire-based critical survey was conducted among trainee doctors undergoing housemanship at six public hospitals in the Klang Valley, Malaysia. Prior permission was obtained from the Ministry of Health Malaysia to conduct the research in the identified public hospitals. The survey yielded 355 responses. The results were analysed using SPSS 20.0 and SEM with AMOS 20.0. The findings of this research indicate that coaching and mentoring supervision are positively associated with talent development, and that there is no significant relationship between abusive supervision and talent development. The findings also support the moderating role of clinical learning environment on the relationships between coaching supervision-talent development, mentoring supervision-talent development and abusive supervision-talent development among public hospital trainee doctors. Overall, the proposed model indicates a 26 % variance in talent development. This study provides an improved understanding on the role of the supervisory styles (coaching and mentoring supervision) on facilitating talent development among public hospital trainee doctors. Furthermore, this study extends the literature to better

  9. Nosocomial acquisition of Escherichia coli by infants delivered in hospitals.

    Science.gov (United States)

    Fujita, K; Murono, K

    1996-04-01

    The delivery of infants in hospitals is desirable for obstetric reasons, but exposes the neonates to the microbiological hazards of a maternity unit. When neonates are born and cared for in hospital, the Escherichia coli strains that colonize the intestine tend to be acquired from the environment or from other babies, and are potentially pathogenic. The colonization of the infant with maternal flora should be promoted by strict rooming-in of mother and baby, or by delivery at home.

  10. Ausências dos colaboradores de enfermagem do pronto-socorro de um hospital universitário Ausencias de los colaboradores de enfermería del servicio de emergencia de un hospital universitario Nursing staff absences in the emergency room of a university hospital

    Directory of Open Access Journals (Sweden)

    Flávio Trevisani Fakih

    2012-01-01

    .OBJECTIVE: To verify and analyze absences of nursing staff of the adult emergency room (AER of a university hospital. METHODS: A study using a quantitative approach, observational and prospective, conducted between January and December, 2009, involving the nursing staff of a AER. RESULTS: The AER had, on average, 96.8 employees per month. Expected absences corresponded to 30.1% of working days. The absenteeism rate was 11.7%. There was a greater incidence of unplanned absences during the periods of May (15.3% and August (13.3%. CONCLUSION: There was a correlation between the variables: professional category, employment contract and shift work, and the distribution of expected and unexpected absences. Absenteeism was considered high and motivated, mainly, by allowances for health care greater than 15 days. The monthly deficit of staff also contributed to the work overload of the team.

  11. Development of a Questionnaire to Assess Nursing Competencies for the Care of People with Psychiatric Disabilities in a Hospital Environment.

    Science.gov (United States)

    Feng, Danjun; Li, Hongyao; Meng, Lu; Zhong, Gengkun

    2018-02-19

    The recovery of people with psychiatric disabilities requires high-quality nursing care. However, the existing research on the nursing competencies needed for caring for people with psychiatric disabilities have been based on a narrow competency framework. By adopting a broader competency framework, this study aimed to find the competencies needed for the nursing care of people with psychiatric disabilities in a hospital environment. Accordingly, a questionnaire will be developed to measure these competences. First, a literature review and interviews with psychiatrists, psychiatric nurses, and people with psychiatric disabilities were conducted to develop the pool of competency items. Second, a pilot study was conducted to review the initial pool of items. Finally, a survey of 581 psychiatric nurses was used to conduct a series of principal component analyses to explore the structure of the questionnaire. The 17-item questionnaire included 5 factors, which accounted for 68.60% of the total variance: sense of responsibility, vocational identification, agreeableness, cooperation capacity, and carefulness; the Cronbach's alpha coefficients were 0.85, 0.85, 0.74, 0.80, and 0.77, respectively. Most of the competencies belonged to attitudes, values, and traits, which were overlooked in previous studies. The questionnaire has satisfactory internal reliability and structural validity, and could contribute some to the selection of the psychiatric workforce.

  12. The Western Primary School 'Quiet Room' Project.

    Science.gov (United States)

    King, Angus; Chantler, Zara

    2002-01-01

    This article describes a "Quiet Room" project for students with social, emotional, and behavioral problems at a British primary school. The Quiet Room was designed to provide a nurturing environment away from the classroom in which a child's emotional needs can be explored on a one-to-one basis. Benefits for children, parents, and…

  13. The Ethics of the Collegiate Locker Room

    Science.gov (United States)

    Roper, Larry D.

    2017-01-01

    Locker rooms are a fixture in the athletic culture of colleges and universities. Given the important roles those spaces play in the learning, growth, and development of student-athletes, collegiate leaders should consider how to influence locker room environments in positive ways.

  14. CEBAF Control Room Renovation

    International Nuclear Information System (INIS)

    Michael Spata; Thomas Oren

    2005-01-01

    The Machine Control Center (MCC) at Jefferson Lab's Continuous Electron Beam Accelerator Facility (CEBAF) was initially constructed in the early 1990s and based on proven technology of that era. Through our experience over the last 15 years and in our planning for the facility's 12 GeV upgrade we reevaluated the control room environment to capitalize on emerging visualization and display technologies and improve workflow processes and ergonomic attributes. This effort also sets the foundation for the redevelopment of the accelerator's control system to deliver high reliability performance with improvements in beam specifications management and information flow. The complete renovation was performed over a three-week maintenance period with no interruption to beam operations. We present the results of this effort

  15. CEBAF Control Room Renovation

    International Nuclear Information System (INIS)

    Michael Spata; Thomas Oren

    2005-01-01

    The Machine Control Center at Jefferson Lab's Continuous Electron Beam Accelerator Facility was initially constructed in the early 1990s and based on proven technology of that era. Through our experience over the last 15 years and in our planning for the facilities 12 GeV upgrade we reevaluated the control room environment to capitalize on emerging visualization and display technologies and improve on workflow processes and ergonomic attributes. This effort also sets the foundation for the redevelopment of the accelerator's control system to deliver high reliability performance with improvements in beam specifications management and information flow. The complete renovation was performed over a three-week period with no interruption to beam operations. We present the results of this effort

  16. Associations between characteristics of the nurse work environment and five nurse-sensitive patient outcomes in hospitals : A systematic review of literature

    NARCIS (Netherlands)

    Stalpers, Dewi; de Brouwer, Brigitte J M; Kaljouw, Marian J.; Schuurmans, Marieke J.

    2015-01-01

    Objective: To systematically review the literature on relationships between characteristics of the nurse work environment and five nurse-sensitive patient outcomes in hospitals. Data sources: The search was performed in Medline (PubMed), Cochrane, Embase, and CINAHL. Review methods: Included were

  17. Associations between characteristics of the nurse work environment and five nurse-sensitive patient outcomes in hospitals: a systematic review of literature

    NARCIS (Netherlands)

    Stalpers, D.; Brouwer, B.J.M. de; Kaljouw, M.J.; Schuurmans, M.J.

    2015-01-01

    OBJECTIVE: To systematically review the literature on relationships between characteristics of the nurse work environment and five nurse-sensitive patient outcomes in hospitals. DATA SOURCES: The search was performed in Medline (PubMed), Cochrane, Embase, and CINAHL. REVIEW METHODS: Included were

  18. Presence, distribution, and molecular epidemiology of methicillin-resistant Staphylococcus aureus in a small animal teaching hospital: a year-long active surveillance targeting dogs and their environment.

    Science.gov (United States)

    van Balen, Joany; Kelley, Christina; Nava-Hoet, Rocio C; Bateman, Shane; Hillier, Andrew; Dyce, Jonathan; Wittum, Thomas E; Hoet, Armando E

    2013-05-01

    Methicillin-resistant Staphylococcus aureus (MRSA) is known to be present in small animal veterinary clinical environments. However, a better understanding of the ecology and dynamics of MRSA in these environments is necessary for the development of effective infectious disease prevention and control programs. To achieve this goal, a yearlong active MRSA surveillance program was established at The Ohio State University (OSU) Veterinary Medical Center to describe the spatial and molecular epidemiology of this bacterium in the small animal hospital. Antimicrobial susceptibility testing, staphylococcal chromosomal cassette mec (SCCmec) typing, pulsed-field gel electrophoresis (PFGE) typing, and dendrogram analysis were used to characterize and analyze the 81 environmental and 37 canine-origin MRSA isolates obtained during monthly sampling events. Overall, 13.5% of surfaces were contaminated with MRSA at 1 or more sampling times throughout the year. The majority of the environmental and canine isolates were SCCmec type II (93.8% and 86.5%, respectively) and USA100 (90.1% and 86.5%, respectively). By PFGE analysis, these isolates were found to be closely related, which reflects a low diversity of MRSA strains circulating in the hospital. For 5 consecutive months, 1 unique pulsotype was the most prevalent across the medical services and was recovered from a variety of surfaces and hospital locations. Carts/gurneys, doors, and examination tables/floors were the most frequently contaminated surfaces. Some surfaces maintained the same pulsotypes for 3 consecutive months. Molecular analysis found that incoming MRSA-positive dogs were capable of introducing a new pulsotype into the hospital environment during the surveillance period. Our results suggest that once a MRSA strain is introduced into the hospital environment, it can be maintained and spread for extended periods of time. These findings can aid in the development of biosecurity and biocontainment protocols aimed at

  19. Improving operating room safety

    Directory of Open Access Journals (Sweden)

    Garrett Jill

    2009-11-01

    Full Text Available Abstract Despite the introduction of the Universal Protocol, patient safety in surgery remains a daily challenge in the operating room. This present study describes one community health system's efforts to improve operating room safety through human factors training and ultimately the development of a surgical checklist. Using a combination of formal training, local studies documenting operating room safety issues and peer to peer mentoring we were able to substantially change the culture of our operating room. Our efforts have prepared us for successfully implementing a standardized checklist to improve operating room safety throughout our entire system. Based on these findings we recommend a multimodal approach to improving operating room safety.

  20. Knowledge concerning the nursing staff hospital-acquired infections in the prevention and transmission paths microorganisms living in the hospital environment .

    Directory of Open Access Journals (Sweden)

    Monika Teresa Pierzak

    2017-08-01

    Full Text Available Introduction: The level of knowledge in the filed of infections associated with health care is a very important element affecting the health and lives of patients and medical staff working covering the entire interdisciplinary team. In the various stages of the nursing process, which consists of diagnosis, planning, implementation and evaluation, there is the problem of hospital infections. Objectives of work: The aim of the study is to assess the level of knowledge of nursing staff in the field of hospital infections, prevention and routes of transmission of microorganisms. Material and Method: The study was conducted in the period from 01.01.2017-01.06.2017 in the Regional Hospital in Kielce. The research was voluntary and those involved agreed to participate in them. The study included 92 (100% of the nursing staff. These were women 96.65% (n = 88 and men 4.35% (n = 4. The subjects were informed about the anonymity of the research. Method was used diagnostic survey, using the author, anonymous questionnaire consisting of 26 questions, which was developed on the basis of the latest reports from scientific articles on the subject of nosocomial infections. Results: Our study showed different levels of knowledge of hospital infection among nursing staff. The respondents do not know the importance of washing hands in the prevention of nosocomial infections. Alarming is the fact that only 64.13% (n = 59 of those participating in the survey asked about the most common source of hospital-acquired infections answered that it is "direct contact, usually by hand during the performed treatments and medicines." The nursing staff involved in the study I am aware of the need for training organization to raise knowledge of hospital infections. Respondents asked about the need to provide training for the prevention of infection in the workplace 84.78% (n = 78 responded that there is such a necessity. Conclusions: The level of knowledge of nursing staff is

  1. Identification of hospitalized elderly patients at risk for adverse in-hospital outcomes in a university orthopedics and trauma surgery environment.

    Directory of Open Access Journals (Sweden)

    Janine Gronewold

    Full Text Available As a consequence of demographic changes, hospitals are confronted with increasing numbers of elderly patients, who are at high risk of adverse events during hospitalization. Geriatric risk screening followed by comprehensive geriatric assessment (CGA and treatment has been requested by geriatric societies and task forces to identify patients at risk. Since empirical evidence on factors predisposing to adverse hospital events is scarce, we now prospectively evaluated implications of geriatric risk screening followed by CGA in a university hospital department of orthopedics and trauma surgery.Three hundred and eighty-one patients ≥75 years admitted to the Department of Orthopedics and Trauma Surgery of the University Hospital Essen received Identification of Seniors at Risk (ISAR Screening followed by CGA via a geriatric liaison service in case of positive screening results. Associations between ISAR, CGA, comorbid risk factors and diseases, length of hospital stay, number of nursing and physiotherapy hours, and falls during hospital stay were analyzed.Of 381 ISAR screenings, 327 (85.8% were positive, confirming a high percentage of patients at risk of adverse events. Of these, 300 CGAs revealed 82.7% abnormal results, indicating activities of daily living impairment combined with cognitive, emotional or mobility disturbances. Abnormal CGA resulted in a longer hospital stay (14.0±10.3 days in ISAR+/CGA abnormal compared with 7.6±7.0 days in ISAR+/CGA normal and 8.1±5.4 days in ISAR-, both p<0.001, increased nursing hours (3.4±1.1 hours/day in ISAR+/CGA abnormal compared with 2.5±1.0 hours/day in ISAR+/CGA normal and 2.2±0.8 hours/day in ISAR-, both p<0.001, and increased falls (7.3% in ISAR+/CGA abnormal, 0% in ISAR+/CGA normal, 1.9% in ISAR-. Physiotherapy hours were only significantly increased in ISAR+/CGA abnormal (3.0±2.7 hours compared with in ISAR+/CGA normal (1.6±1.4 hours, p<0.001 whereas the comparison with ISAR- (2.4±2

  2. Room temperature superconductors

    International Nuclear Information System (INIS)

    Sleight, A.W.

    1995-01-01

    If the Holy Grail of room temperature superconductivity could be achieved, the impact on could be enormous. However, a useful room temperature superconductor for most applications must possess a T c somewhat above room temperature and must be capable of sustaining superconductivity in the presence of magnetic fields while carrying a significant current load. The authors will return to the subject of just what characteristics one might seek for a compound to be a room temperature superconductor. 30 refs., 3 figs., 1 tab

  3. Experimental Investigation of Ventilation Efficiency in a Dentistry Surgical Room

    Directory of Open Access Journals (Sweden)

    Oladokun Majeed Olaide

    2016-01-01

    Full Text Available As a response to the need to provide an acceptable thermal comfort and air quality in indoor environments, various ventilation performance indicators were developed over the years. These metrics are mainly geared towards air distribution, heat and pollutant removals. Evidence exists of influencing factors on these indicators as centered on ventilation design and operations. Unlike other indoor environments, health care environment requires better performance of ventilation system to prevent an incidence of nosocomial and other hospital acquired illnesses. This study investigates, using in-situ experiments, the ventilation efficiency in a dentistry surgical room. Thermal and hygric parameters were monitored on the air terminal devices and occupied zone over a period of one week covering both occupied and unoccupied hours. The resulting time-series parameters were used to evaluate the room’s ventilation effectiveness. Also, the obtained parameters were benchmarked against ASHRAE 170 (2013 and MS1525 (2014 requirements for ventilation in health care environment and building energy efficiency respectively. The results show that the mean daily operative conditions failed to satisfy the provisions of both standards. Regarding effectiveness, the findings reveal that the surgical room ventilation is ineffective with ventilation efficiency values ranging between 0 and 0.5 indicating air distribution short-circuiting. These results suggest further investigations, through numerical simulation, on the effect of this short-circuiting on thermal comfort, infection risk assessments and possible design improvements, an endeavour that forms our next line of research inquiries.

  4. Nuclear power station main control room habitability

    International Nuclear Information System (INIS)

    Paschal, W.B.; Knous, W.S.

    1989-01-01

    The main control room at a nuclear power station must remain habitable during a variety of plant conditions and postulated events. The control room habitability requirement and the function of the heating, ventilating, air-conditioning, and air treatment system are to control environmental factors, such as temperature, pressure, humidity, radiation, and toxic gas. Habitability requirements provide for the safety of personnel and enable operation of equipment required to function in the main control room. Habitability as an issue has been gaining prominence with the Advisor Committee of Reactor Safeguards and the Nuclear Regulatory Commission since the incident at Three Mile Island. Their concern is the ability of the presently installed habitability systems to control the main control room environment after an accident. This paper discusses main control room HVAC systems; the concern, requirements, and results of NRC surveys and notices; and an approach to control room habitability reviews

  5. Perceptual effects in auralization of virtual rooms

    Science.gov (United States)

    Kleiner, Mendel; Larsson, Pontus; Vastfjall, Daniel; Torres, Rendell R.

    2002-05-01

    By using various types of binaural simulation (or ``auralization'') of physical environments, it is now possible to study basic perceptual issues relevant to room acoustics, as well to simulate the acoustic conditions found in concert halls and other auditoria. Binaural simulation of physical spaces in general is also important to virtual reality systems. This presentation will begin with an overview of the issues encountered in the auralization of room and other environments. We will then discuss the influence of various approximations in room modeling, in particular, edge- and surface scattering, on the perceived room response. Finally, we will discuss cross-modal effects, such as the influence of visual cues on the perception of auditory cues, and the influence of cross-modal effects on the judgement of ``perceived presence'' and the rating of room acoustic quality.

  6. Custeio ABC no ambiente hospitalar: um estudo nos hospitais universitários e de ensino brasileiros ABC costing in hospital environment: a study in brazilian university hospitals

    Directory of Open Access Journals (Sweden)

    Gilberto José Miranda

    2007-08-01

    Full Text Available O Custeio Baseado em Atividades tem se mostrado como uma alternativa promissora para fazer frente à complexidade que caracteriza os custos hospitalares. Nos últimos dez anos, somente na Plataforma Lattes, foram encontrados mais de uma centena de estudos dessa natureza. Este trabalho tem como objetivo, conhecer, empiricamente, a utilização do Custeio ABC nos hospitais universitários e de ensino brasileiros e comparar os resultados, conforme as possibilidades, com as pesquisas realizadas nas maiores empresas brasileiras pelos autores: Khoury (1999, Beuren e Roedel (2002 e Azevedo, Santos e Pamplona (2004. Dos 115 questionários enviados aos hospitais universitários, 34 foram respondidos. O estudo levou a conclusões importantes, como: Os sistemas de custos atuais dos hospitais têm poucas condições de fornecer informações úteis à gestão; o Custeio ABC é bastante conhecido no ambiente, mas o número de usuários ainda é relativamente pequeno: apenas 15% da amostra; mas existe expectativa por parte de 44% dos hospitais com relação ao uso futuro da abordagem. As principais causas apresentadas para a não-utilização do Sistema ABC foram: (a o sistema utilizado atende às necessidades da organização e (b o Custeio Baseado em Atividades é muito complexo.The Cost Based Activity has been a promising alternative to deal with the complexity that characterizes hospital costs. In the last ten years, only in the Plataforma Lattes, more than a hundred studies of this nature had been found. This work aims to find out, empirically, the use of ABC Costing in Brazilian university hospitals and to compare the results, according to the possibilities, with the researches that have been made in the biggest Brazilian companies by the authors: Khoury (1999, Beuren and Roedel (2002 and Azevedo, Santos and Pamplona (2004. A hundred and fifteen questionnaires were sent to the university hospitals, 34 had been answered. The study relates important

  7. Tackling the climate targets set by the Paris Agreement (COP 21: Green leadership empowers public hospitals to overcome obstacles and challenges in a resource-constrained environment

    Directory of Open Access Journals (Sweden)

    E Weimann

    2017-01-01

    Full Text Available The healthcare sector itself contributes to climate change, the creation of hazardous waste, use of toxic metals such as mercury, and water and air pollution. To mitigate the effect of healthcare provision on the deteriorating environment and avoid creating further challenges for already burdened health systems, Global Green Hospitals was formed as a global network. Groote Schuur Hospital (GSH, as the leading academic hospital in Africa, joined the network in 2014. Since then, several projects have been initiated to reduce the amount of general waste, energy consumption and food waste, and create an environmentally friendlier and more sustainable hospital in a resource-constrained public healthcare setting. We outline the various efforts made to reduce the carbon footprint of GSH and reduce waste and hazardous substances such as mercury and polystyrene, and elaborate how obstacles and resistance to change were overcome. The hospital was able to halve the amount of coal and water used, increase recycling by 50% over 6 months, replace polystyrene cups and packaging with Forest Stewardship Council recyclable paper-based products, reduce the effect of food wastage by making use of local farmers, and implement measures to reduce the amount of expired pharmaceutical drugs. To improve commitment from all involved roleplayers, political leadership, supportive government policies and financial funding is mandatory, or public hospitals will be unable to tackle the exponentially increasing costs related to climate change and its effects on healthcare.

  8. Tackling the climate targets set by the Paris Agreement (COP 21): Green leadership empowers public hospitals to overcome obstacles and challenges in a resource-constrained environment.

    Science.gov (United States)

    Weimann, E; Patel, B

    2016-12-21

    The healthcare sector itself contributes to climate change, the creation of hazardous waste, use of toxic metals such as mercury, and water and air pollution. To mitigate the effect of healthcare provision on the deteriorating environment and avoid creating further challenges for already burdened health systems, Global Green Hospitals was formed as a global network. Groote Schuur Hospital (GSH), as the leading academic hospital in Africa, joined the network in 2014. Since then, several projects have been initiated to reduce the amount of general waste, energy consumption and food waste, and create an environmentally friendlier and more sustainable hospital in a resource-constrained public healthcare setting. We outline the various efforts made to reduce the carbon footprint of GSH and reduce waste and hazardous substances such as mercury and polystyrene, and elaborate how obstacles and resistance to change were overcome. The hospital was able to halve the amount of coal and water used, increase recycling by 50% over 6 months, replace polystyrene cups and packaging with Forest Stewardship Council recyclable paper-based products, reduce the effect of food wastage by making use of local farmers, and implement measures to reduce the amount of expired pharmaceutical drugs. To improve commitment from all involved roleplayers, political leadership, supportive government policies and financial funding is mandatory, or public hospitals will be unable to tackle the exponentially increasing costs related to climate change and its effects on healthcare.

  9. The Effect of Various Hot Environments on Physiological Responses and Information Processing Performance Following Firefighting Activities in a Smoke-Diving Room.

    Science.gov (United States)

    Hemmatjo, Rasoul; Motamedzade, Majid; Aliabadi, Mohsen; Kalatpour, Omid; Farhadian, Maryam

    2017-12-01

    Fire service workers often implement multiple duties in the emergency conditions, with such duties being mostly conducted in various ambient temperatures. The aim of the current study was to assess the firefighters' physiological responses, information processing, and working memory prior to and following simulated firefighting activities in three different hot environments. Seventeen healthy male firefighters performed simulated firefighting tasks in three separate conditions, namely (1) low heat (LH; 29-31°C, 55-60% relative humidity), (2) moderate heat (MH; 32-34°C, 55-60% relative humidity), and (3) severe heat (SH; 35-37°C, 55-60% relative humidity). It took about 45-50 minutes for each firefighter to finish all defined firefighting activities and the paced auditory serial addition test (PASAT). At the end of all the three experimental conditions, heart rate (HR) and tympanic temperature (TT) increased, while PASAT scores as a measure of information processing performance decreased relative to baseline. HR and TT were significantly higher at the end of the experiment in the SH (159.41 ± 4.25 beats/min; 38.22 ± 0.10°C) compared with the MH (156.59 ± 3.77 beats/min; 38.20 ± 0.10°C) and LH (154.24 ± 4.67 beats/min; 38.17 ± 0.10°C) conditions ( p   0.05). Nonetheless, there was a measurable difference in PASAT scores between LH and SH ( p  information processing and working memory during firefighting activity.

  10. Facts about Hospital Worker Safety

    Science.gov (United States)

    ... statistics show that hospitals are still relatively hazardous workplaces, and they have much room to improve. OSHA has developed this factbook to help hospital safety managers and other stakeholders understand the challenges of worker ...

  11. Determination of the exposure speed of radiation emitted by the linear accelerator, using the code MCNP5 to evaluate the radiotherapy room shields of ABC Hospital; Determinacion de la rapidez de exposicion de la radiacion emitida por el acelerador lineal, utilizando el codigo MCNP5, para evaluar los blindajes de la sala de radioterapia del Hospital ABC

    Energy Technology Data Exchange (ETDEWEB)

    Corral B, J. R.

    2015-07-01

    Humans should avoid exposure to radiation, because the consequences are harmful to health. Although there are different emission sources of radiation, generated by medical devices they are usually of great interest, since people who attend hospitals are exposed in one way or another to ionizing radiation. Therefore, is important to conduct studies on radioactive levels that are generated in hospitals, as a result of the use of medical equipment. To determine levels of exposure speed of a radioactive facility there are different methods, including the radiation detector and computational method. This thesis uses the computational method. With the program MCNP5 was determined the speed of the radiation exposure in the radiotherapy room of Cancer Center of ABC Hospital in Mexico City. In the application of computational method, first the thicknesses of the shields were calculated, using variables as: 1) distance from the shield to the source; 2) desired weekly equivalent dose; 3) weekly total dose equivalent emitted by the equipment; 4) occupation and use factors. Once obtained thicknesses, we proceeded to model the bunker using the mentioned program. The program uses the Monte Carlo code to probabilistic ally determine the phenomena of interaction of radiation with the shield, which will be held during the X-ray emission from the linear accelerator. The results of computational analysis were compared with those obtained experimentally with the detection method, for which was required the use of a Geiger-Muller counter and the linear accelerator was programmed with an energy of 19 MV with 500 units monitor positioning the detector in the corresponding boundary. (Author)

  12. Web based emergency room PACS

    International Nuclear Information System (INIS)

    Cha, Soon Joo; Cheon, Yong Kyung; Choi, Sung Woo Kim

    2005-01-01

    We wished to develop the web based Picture Archiving and Communication System in the emergency room for early decision making in emergency treatment planning at a full PACS Hospital. The program tools were Microsoft Visual Studio 6.0 - Visual C++ 6.0, and the Microsoft SQL 7.0 under the Microsoft Windows 2000 server operation system. The achievement of images was performed by an auto transport program installed in the ER and the radiology department. The average compression rates were 5:1 for CT and MR, and 20:1 for CR with JPEG 2000 lossy compression. All the images were stored on hard disk for 3 months. The patients' information was displayed for 2 weeks for reducing the security risk. For interdepartmental consultation, patient query by patient hospital number was available. Our Web based ER PACS could be useful system for early decision making for treatment planning in the emergency room because it reduces the risk factors for the security of the Web Paces by using a system independent from PACS in the hospital and minimizing the information patients

  13. Web based emergency room PACS

    Energy Technology Data Exchange (ETDEWEB)

    Cha, Soon Joo; Cheon, Yong Kyung; Choi, Sung Woo Kim [Ilsan Paik Hospital, Inje University, Seoul (Korea, Republic of)] (and others)

    2005-07-15

    We wished to develop the web based Picture Archiving and Communication System in the emergency room for early decision making in emergency treatment planning at a full PACS Hospital. The program tools were Microsoft Visual Studio 6.0 - Visual C++ 6.0, and the Microsoft SQL 7.0 under the Microsoft Windows 2000 server operation system. The achievement of images was performed by an auto transport program installed in the ER and the radiology department. The average compression rates were 5:1 for CT and MR, and 20:1 for CR with JPEG 2000 lossy compression. All the images were stored on hard disk for 3 months. The patients' information was displayed for 2 weeks for reducing the security risk. For interdepartmental consultation, patient query by patient hospital number was available. Our Web based ER PACS could be useful system for early decision making for treatment planning in the emergency room because it reduces the risk factors for the security of the Web Paces by using a system independent from PACS in the hospital and minimizing the information patients.

  14. The Patient Safety Attitudes among the Operating Room Personnel

    Directory of Open Access Journals (Sweden)

    Cherdsak Iramaneerat

    2016-07-01

    Full Text Available Background: The first step in cultivating the culture of safety in the operating room is the assessment of safety culture among operating room personnel. Objective: To assess the patient safety culture of operating room personnel at the Department of Surgery, Faculty of Medicine Siriraj Hospital, and compare attitudes among different groups of personnel, and compare them with the international standards. Methods: We conducted a cross-sectional survey of safety attitudes among 396 operating room personnel, using a short form of the Safety Attitudes Questionnaire (SAQ. The SAQ employed 30 items to assess safety culture in six dimensions: teamwork climate, safety climate, stress recognition, perception of hospital management, working conditions, and job satisfaction. The subscore of each dimension was calculated and converted to a scale score with a full score of 100, where higher scores indicated better safety attitudes. Results: The response rate was 66.4%. The overall safety culture score of the operating room personnel was 65.02, higher than an international average (61.80. Operating room personnel at Siriraj Hospital had safety attitudes in teamwork climate, safety climate, and stress recognition lower than the international average, but had safety attitudes in the perception of hospital management, working conditions, and job satisfaction higher than the international average. Conclusion: The safety culture attitudes of operating room personnel at the Department of Surgery, Siriraj Hospital were comparable to international standards. The safety dimensions that Siriraj Hospital operating room should try to improve were teamwork climate, safety climate, and stress recognition.

  15. Patient safety in surgical environments: Cross-countries comparison of psychometric properties and results of the Norwegian version of the Hospital Survey on Patient Safety

    Directory of Open Access Journals (Sweden)

    Nortvedt Monica W

    2010-09-01

    Full Text Available Abstract Background How hospital health care personnel perceive safety climate has been assessed in several countries by using the Hospital Survey on Patient Safety (HSOPS. Few studies have examined safety climate factors in surgical departments per se. This study examined the psychometric properties of a Norwegian translation of the HSOPS and also compared safety climate factors from a surgical setting to hospitals in the United States, the Netherlands and Norway. Methods This survey included 575 surgical personnel in Haukeland University Hospital in Bergen, an 1100-bed tertiary hospital in western Norway: surgeons, operating theatre nurses, anaesthesiologists, nurse anaesthetists and ancillary personnel. Of these, 358 returned the HSOPS, resulting in a 62% response rate. We used factor analysis to examine the applicability of the HSOPS factor structure in operating theatre settings. We also performed psychometric analysis for internal consistency and construct validity. In addition, we compared the percent of average positive responds of the patient safety climate factors with results of the US HSOPS 2010 comparative data base report. Results The professions differed in their perception of patient safety climate, with anaesthesia personnel having the highest mean scores. Factor analysis using the original 12-factor model of the HSOPS resulted in low reliability scores (r = 0.6 for two factors: "adequate staffing" and "organizational learning and continuous improvement". For the remaining factors, reliability was ≥ 0.7. Reliability scores improved to r = 0.8 by combining the factors "organizational learning and continuous improvement" and "feedback and communication about error" into one six-item factor, supporting an 11-factor model. The inter-item correlations were found satisfactory. Conclusions The psychometric properties of the questionnaire need further investigations to be regarded as reliable in surgical environments. The operating

  16. Thermal comfort assessment of a surgical room through computational fluid dynamics using local PMV index.

    Science.gov (United States)

    Rodrigues, Nelson J O; Oliveira, Ricardo F; Teixeira, Senhorinha F C F; Miguel, Alberto Sérgio; Teixeira, José Carlos; Baptista, João S

    2015-01-01

    Studies concerning indoor thermal conditions are very important in defining the satisfactory comfort range in health care facilities. This study focuses on the evaluation of the thermal comfort sensation felt by surgeons and nurses, in an orthopaedic surgical room of a Portuguese hospital. Two cases are assessed, with and without the presence of a person. Computational fluid dynamic (CFD) tools were applied for evaluating the predicted mean vote (PMV) index locally. Using average ventilation values to calculate the PMV index does not provide a correct and enough descriptive evaluation of the surgical room thermal environment. As studied for both cases, surgeons feel the environment slightly hotter than nurses. The nurses feel a slightly cold sensation under the air supply diffuser and their neutral comfort zone is located in the air stagnation zones close to the walls, while the surgeons feel the opposite. It was observed that the presence of a person in the room leads to an increase of the PMV index for surgeons and nurses. That goes in line with the empirical knowledge that more persons in a room lead to an increased heat sensation. The clothing used by both classes, as well as the ventilation conditions, should be revised accordingly to the amount of persons in the room and the type of activity performed.

  17. Environment

    International Nuclear Information System (INIS)

    McIntyre, A.D.; Turnbull, R.G.H.

    1992-01-01

    The development of the hydrocarbon resources of the North Sea has resulted in both offshore and onshore environmental repercussions, involving the existing physical attributes of the sea and seabed, the coastline and adjoining land. The social and economic repercussions of the industry were equally widespread. The dramatic and speedy impact of the exploration and exploitation of the northern North Sea resources in the early 1970s, on the physical resources of Scotland was quickly realised together with the concern that any environmental and social damage to the physical and social fabric should be kept to a minimum. To this end, a wide range of research and other activities by central and local government, and other interested agencies was undertaken to extend existing knowledge on the marine and terrestrial environments that might be affected by the oil and gas industry. The outcome of these activities is summarized in this paper. The topics covered include a survey of the marine ecosystems of the North Sea, the fishing industry, the impact of oil pollution on seabirds and fish stocks, the ecology of the Scottish coastline and the impact of the petroleum industry on a selection of particular sites. (author)

  18. A pilot study on the effects of a team building process on the perception of work environment in an integrative hospital for neurological rehabilitation

    OpenAIRE

    Ostermann, Thomas; Bertram, Mathias; Büssing, Arndt

    2010-01-01

    Abstract Background Neurological rehabilitation is one of the most care-intensive challenges in the health care system re