[Comprehensive system integration and networking in operating rooms].
Feußner, H; Ostler, D; Kohn, N; Vogel, T; Wilhelm, D; Koller, S; Kranzfelder, M
2016-12-01
A comprehensive surveillance and control system integrating all devices and functions is a precondition for realization of the operating room of the future. Multiple proprietary integrated operation room systems are currently available with a central user interface; however, they only cover a relatively small part of all functionalities. Internationally, there are at least three different initiatives to promote a comprehensive systems integration and networking in the operating room: the Japanese smart cyber operating theater (SCOT), the American medical device plug-and-play interoperability program (MDPnP) and the German secure and dynamic networking in operating room and hospital (OR.NET) project supported by the Federal Ministry of Education and Research. Within the framework of the internationally advanced OR.NET project, prototype solution approaches were realized, which make short-term and mid-term comprehensive data retrieval systems probable. An active and even autonomous control of the medical devices by the surveillance and control system (closed loop) is expected only in the long run due to strict regulatory barriers.
Rockstroh, M; Franke, S; Hofer, M; Will, A; Kasparick, M; Andersen, B; Neumuth, T
2017-08-01
Clinical working environments have become very complex imposing many different tasks in diagnosis, medical treatment, and care procedures. During the German flagship project OR.NET, more than 50 partners developed technologies for an open integration of medical devices and IT systems in the operating room. The aim of the present work was to evaluate a large set of the proposed concepts from the perspectives of various stakeholders. The demonstration OR is focused on interventions from the head and neck surgery and was developed in close cooperation with surgeons and numerous colleagues of the project partners. The demonstration OR was qualitatively evaluated including technical as well as clinical aspects. In the evaluation, a questionnaire was used to obtain feedback from hospital operators. The clinical implications were covered by structured interviews with surgeons, anesthesiologists and OR staff. In the present work, we qualitatively evaluate a subset of the proposed concepts from the perspectives of various stakeholders. The feedback of the clinicians indicates that there is a need for a flexible data and control integration. The hospital operators stress the need for tools to simplify risk management in openly integrated operating rooms. The implementation of openly integrated operating rooms will positively affect the surgeons, the anesthesiologists, the surgical nursing staff, as well as the technical personnel and the hospital operators. The evaluation demonstrated the need for OR integration technologies and identified the missing tools to support risk management and approval as the main barriers for future installments.
Sterilization Monitoring management of the integration of the operating room with CSSD
Directory of Open Access Journals (Sweden)
Shu-yan XIA
2014-08-01
Full Text Available Objective: Explore the Sterilization Monitoring management of the integration of the operating room with CSSD. Methods: Compare sterilization process monitoring with biological monitoring and chemical monitoring. Results: The management in Biological monitoring, chemical monitoring and sterilization process monitoring is crucial. Conclusion: Sterilization monitoring is to ensure the safe use of sterile goods so as to protect the safety of surgical patients.
Operating room management and operating room productivity: the case of Germany.
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.
The operating room of the future: observations and commentary.
Satava, Richard M
2003-09-01
The Operating Room of the Future is a construct upon which to develop the next generation of operating environments for the patient, surgeon, and operating team. Analysis of the suite of visions for the Operating Room of the Future reveals a broad set of goals, with a clear overall solution to create a safe environment for high-quality healthcare. The vision, although planned for the future, is based upon iteratively improving and integrating current systems, both technology and process. This must become the Operating Room of Today, which will require the enormous efforts described. An alternative future of the operating room, based upon emergence of disruptive technologies, is also presented.
Foucault could have been an operating room nurse.
Riley, Robin; Manias, Elizabeth
2002-08-01
Operating room nursing is an under-researched area of nursing practice. The stereotypical image of operating room nursing is one of task- and technically-orientated aspects of practice, where nurses work in a medical model and are dominated by constraints from outside their sphere of influence. This paper explores the possibility of understanding operating room nursing in a different way. Using the work of Michel Foucault to analyse the work of operating room nursing, this paper argues the relevance of the framework for a more in-depth analysis of this specialty area of practice. The concepts of power, discipline and subjectivity are used to demonstrate how operating room nursing is constructed as a discipline and how operating room nurses act to govern and construct the specialty. Exemplars are drawn from extensive professional experience, from guidelines of professional operating room nursing associations, as well as published texts. The focus is predominantly on the regulation of space and time to maintain the integrity of the sterile surgical field and issues of management, as well as the use of the ethical concept of the 'surgical conscience'. This form of analysis provides a level and depth of inquiry that has rarely been undertaken in operating room nursing. As such, it has the potential to provide a much needed, different view of operation room nursing that can only help to strengthen its professional foundations and development.
[Handling modern imaging procedures in a high-tech operating room].
Hüfner, T; Citak, M; Imrecke, J; Krettek, C; Stübig, T
2012-03-01
Operating rooms are the central unit in the hospital network in trauma centers. In this area, high costs but also high revenues are generated. Modern operating theater concepts as an integrated model have been offered by different companies since the early 2000s. Our hypothesis is that integrative concepts for operating rooms, in addition to improved operating room ergonomics, have the potential for measurable time and cost savings. In our clinic, an integrated operating room concept (I-Suite, Stryker, Duisburg) was implemented after analysis of the problems. In addition to the ceiling-mounted arrangement, the system includes an endoscopy unit, a navigation system, and a voice control system. In the first 6 months (9/2005 to 2/2006), 112 procedures were performed in the integrated operating room: 34 total knee arthroplasties, 12 endoscopic spine surgeries, and 66 inpatient arthroscopic procedures (28 shoulder and 38 knee reconstructions). The analysis showed a daily saving of 22-45 min, corresponding to 15-30% of the daily changeover times, calculated to account for potential savings in the internal cost allocation of 225-450 EUR. A commercial operating room concept was evaluated in a pilot phase in terms of hard data, including time and cost factors. Besides the described effects further savings might be achieved through the effective use of voice control and the benefit of the sterile handle on the navigation camera, since waiting times for an additional nurse are minimized. The time of the procedure of intraoperative imaging is also reduced due to the ceiling-mounted concept, as the C-arm can be moved freely in the operating theater without hindering cables. By these measures and ensuing improved efficiency, the initial high costs for the implementation of the system may be cushioned over time.
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.
Design concepts for an integrated control room used as a site-wide operations facility
International Nuclear Information System (INIS)
Simon, B.H.; Raghavan, R.; Ujita, H.; Utena, S.; Sakuma, A.; Itoh, T.; Fukura, M.; Ono, I.
1995-01-01
The concept of an Integrated Main Control Room (IMCR) evolved from surveys conducted by Tokyo Electric Power Company (TEPCO) with plant managers and workers as their existing GE-type boiling water reactors (BWRs) on the need for improved operating conditions in a new generation of reactors being developed for the next century (around 2010). These reactors will be a further enhancement of the advanced boiling water reactors (ABWRs) now being constructed at the Kashiwazaki-Kariwa site in Japan (no.6 and no.7). TEPCO also saw a need for new thinking on control room design because of projected social conditions in Japan for the 21st century. These projections forecast a smaller number of skilled engineering graduates and those graduates less willing to work in nuclear power because such work is seen as unappealing, conducted in remote geographical locations, and requiring extensive night duty. As one solution to reducing operator burden and decreasing the night shift staff, while making nuclear plant operation more interesting for the operators and reducing labor and construction costs, the IMCR was conceived. (author)
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
Buzink, S.N.; Van Lier, L.; De Hingh, I.H.J.T.; Jakimowicz, J.J.
2010-01-01
Background - Awareness of the relative high rate of adverse events in laparoscopic surgery created a need to safeguard quality and safety of performance better. Technological innovations, such as integrated operating room (OR) systems and checklists, have the potential to improve patient safety, OR
Closed-loop approach for situation awareness of medical devices and operating room infrastructure
Directory of Open Access Journals (Sweden)
Rockstroh Max
2015-09-01
Full Text Available In recent years, approaches for information and control integration in the digital operating room have emerged. A major step towards an intelligent operating room and a cooperative technical environment would be autonomous adaptation of medical devices and systems to the surgical workflow. The OR staff should be freed from information seeking and maintenance tasks. We propose a closed-loop concept integrating workflow monitoring, processing and (semi-automatic interaction to bridge the gap between OR integration of medical devices and workflow-related information management.
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
Operating room fires in periocular surgery.
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.
A new remote control room for tokamak operations
Energy Technology Data Exchange (ETDEWEB)
Schissel, D.P., E-mail: schissel@fusion.gat.com [General Atomics, P.O. Box 85608, San Diego, CA (United States); Abla, G.; Flanagan, S.; Kim, E.N. [General Atomics, P.O. Box 85608, San Diego, CA (United States)
2012-12-15
This paper presents a summary of a new remote tokamak control room constructed near the offices of DIII-D's scientific staff. This integrated system combines hardware, software, data, and control of the room (R-232) into a unified package that has been designed and constructed in a generic fashion so that it can be used with any tokamak operating worldwide. The room is approximately 300 ft{sup 2} and can accommodate up to 12 seated participants. Mounted on the wall facing each scientist are five 52 Double-Prime LCD televisions and mounted to the wall on their right are six 24 Double-Prime LCD monitors. Each seat has associated with it a 24 Double-Prime monitor, network connection, and power and the scientist is either provided with a computer or they can use their own. The room has been used for operation of DIII-D, EAST, and KSTAR. Due to the long distances, data from EAST and KSTAR was brought back to local DIII-D computers in one large parallel network transfer and subsequently served to scientists in the remote control room to other US collaborators. This parallel data transfer allowed the data to be available to US participants between pulses making remote experimental participation highly effective.
Analysis of the operator's tasks: An aid to control room design
International Nuclear Information System (INIS)
Blanc, P.; Guesnier, G.P.; Heilbronn, B.; Monnier, B.
1983-01-01
The control room designer usually has no knowledge of the tasks performed by the operator in the control room since an overall picture of the situation only becomes available once the whole facility has been constructed. In order to study and design control rooms for its future PWR units, Electricite de France (EDF) felt it was essential to analyse these tasks: the work was facilitated by the existence of 900 MW PWR units which were already in operation and which are controlled in much the same manner as future units of the same type. Accordingly, by analysing the control procedures of these 900 MW PWR units, a data base describing the control and monitoring tasks performed by operators in normal, incident and accident situations has been built up. The data-base files, which were established from a study of 130 control procedures, record all the commands given and data available in the control room (about 7000), describe the tasks connected with these commands and data, and identify the times at which they are made use of by the operator. Using this data base, the principle of operator-system communication and of data processing in the control room of the future has been established: in such a control room, most controls and data will be accessible through computer communication systems to ensure that control and monitoring systems are closely integrated under normal operating conditions as well as in incident and post-accident situations and to enable the plant to be controlled by one or two operators in a seated position. (author)
Improving safety through an integrated approach for advanced control room development
International Nuclear Information System (INIS)
Haugset, K.; Berg, O.; Bologna, S.; Foerdestroemmen, N.T.; Kvalem, J.; Nelson, W.R.; Yamane, N.
1992-01-01
With the fast development of computer technology, the potential exists for improving operational safety of nuclear plants by using advanced operator tools in the control room. Specific systems are being introduced, such as systems for alarm handling, failure detection, disturbance diagnosis, procedural advice and others, often based on process modeling techniques or expert system technology. To ensure a maximum benefit from the new technology, a careful integration of the various systems must, however, take place, resulting in a well coordinated interface between the operator and the process. The OECD Halden Reactor Project has started the development of an Integrated Surveillance And Control System (ISACS). The basis for the activity is the experience at Halden in developing specific Computerized Operator Support Systems (COSSs), and the activity around the experimental control room HAMMLAB where detailed validations of operator tools have been performed for a number of years. The first goal in the ISACS project is to have a first, limited prototype in operation at the end of 1990. Validation experiments will follow. (orig.)
Improving safety through an integrated approach for advanced control room development
International Nuclear Information System (INIS)
Haugset, K.; Berg, O.; Foerdestroemmen, N.T.; Kvalem, J.; Nelson, W.R.
1990-01-01
With the fast development of computer technology, the potential exists for improving operational safety of nuclear plants by using advanced operator tools in the control room. Specific systems are being introduced, such as systems for alarm handling, failure detection, disturbance diagnosis, procedural advice and others, often based on process modeling techniques or expert system technology. To ensure a maximum benefit from the new technology, a careful integration of the various systems must, however, take place, resulting in a well coordinated interface between the operator and the process. The OECD Halden Reactor Project has started the development of an Integrated Surveillance And Control System (ISACS). The basis for the activity is the experience at Halden in developing specific Computerized Operator Support Systems (COSSs), and the activity around the experimental control room HAMMLAB where detailed validations of operator tools have been performed for a number of years. The first goal in the ISACS project is to have a first, limited prototype in operation at the end of 1990. Validation experiments will follow
Revisiting the Operating Room Basics
Directory of Open Access Journals (Sweden)
Tushar Chakravorty
2015-12-01
Full Text Available Young doctors walking into the operating room are eager to develop their skills to become efficient and knowledgeable professionals in future. But precious little is done to actively develop the basic practical skills of the budding doctors. They remain unaware about the layout of the operating room, the OR etiquette and often do not have sound scientific understanding and importance of meticulous execution of the basic operating room protocols. This article stresses the need to develop the basics of OR protocol and to improve the confidence of the young doctor by strengthening his foundation by showing him that attention to the basics of medical care and empathy for the patient can really make a difference to the outcome of a treatment.
Integrated ADIOS-IGENPRO operator advisory support system
International Nuclear Information System (INIS)
Lee, Dong Young; Park, J. H.; Kim, J. T.; Kim, C. H.; Park, W. M.; Hwang, I. K.; Cheon, S. W.; Song, S. J.
2001-05-01
The I and C systems and control rooms of nuclear power plants have been constructed by using the automatic control concept and changed to computer-based systems in nowadays. For Increase of an automation and CRT, the role of operators is changed to monitor the condition of the nuclear power plants. Therefore, the information that is offered to operators has to integrate in order for operator to understand the hole condition of plants. In commercial nuclear plants, raw data of sensors and components are shown in a control room. So, operators can not diagnose the condition of plants correctly. For a development of an integrated operator aid system which contain an alarm processing system and a fault diagnosis system, we integrated IGENPRO of ANL(Argonne National Lab.) and ADIOS of KAERI (Korea Atomic Energy Institute). IGENPRO is a fault diagnosis system contains three module such as PROTREN, PRODIAG and PROTREN. ADIOS is an alarm processing system that informs operators of important alarms. The integrated operator advisory support system developed in the research is composed of an alarm processing module and a fault diagnosis module. The alarm processing module shows important alarms to operator by using dynamic alarm filtering methods. The fault diagnosis module shows the cause of faults of sensors and hardwares
Integrated ADIOS-IGENPRO operator advisory support system
Energy Technology Data Exchange (ETDEWEB)
Lee, Dong Young; Park, J. H.; Kim, J. T.; Kim, C. H.; Park, W. M.; Hwang, I. K.; Cheon, S. W.; Song, S. J
2001-05-01
The I and C systems and control rooms of nuclear power plants have been constructed by using the automatic control concept and changed to computer-based systems in nowadays. For Increase of an automation and CRT, the role of operators is changed to monitor the condition of the nuclear power plants. Therefore, the information that is offered to operators has to integrate in order for operator to understand the hole condition of plants. In commercial nuclear plants, raw data of sensors and components are shown in a control room. So, operators can not diagnose the condition of plants correctly. For a development of an integrated operator aid system which contain an alarm processing system and a fault diagnosis system, we integrated IGENPRO of ANL(Argonne National Lab.) and ADIOS of KAERI (Korea Atomic Energy Institute). IGENPRO is a fault diagnosis system contains three module such as PROTREN, PRODIAG and PROTREN. ADIOS is an alarm processing system that informs operators of important alarms. The integrated operator advisory support system developed in the research is composed of an alarm processing module and a fault diagnosis module. The alarm processing module shows important alarms to operator by using dynamic alarm filtering methods. The fault diagnosis module shows the cause of faults of sensors and hardwares.
Rethinking theatre in modern operating rooms.
Riley, Robin; Manias, Elizabeth
2005-03-01
Metaphor is a means through which a widely accepted meaning of a word is used in a different context to add understanding that would otherwise be difficult to conceive. Through etymological and metaphorical associations, we contend that aspects of "theatre" are still relevant in the modern operating rooms and that the use of dramaturgical metaphors can add another layer of understanding about the social reality in this setting. We begin by exploring the historical roots and derivation of the word theatre as it applied to anatomical dissection and surgery. Briefly, we touch on the work of Erving Goffman and examine how his work has been used by others to explore aspects of operating room nursing. Then, drawing on data from a postmodern ethnographic study that has been used to examine communication in operating room nursing, four dramaturgical metaphors are used to illustrate the argument. They are drama, the script and learning the lines, the show must go on, and changing between back stage and front stage. To conclude, the small amount of previously published literature on this topic is compared and contrasted, and the relevance of using dramaturgical metaphors to understand modern operating rooms is discussed. Being able to distinguish between the inherent drama in operating room work and the dramatic realisation of individuals who work within, can help operating room nurses to think differently about, and perhaps re-evaluate their social situation and how they function within it.
Control room human engineering influences on operator performance
International Nuclear Information System (INIS)
Finlayson, F.C.
1977-01-01
Three general groups of factors influence operator performance in fulfilling their responsibilities in the control room: (1) control room and control system design, informational data displays (operator inputs) as well as control board design (for operator output); (2) operator characteristics, including those skills, mental, physical, and emotional qualities which are functions of operator selection, training, and motivation; (3) job performance guides, the prescribed operating procedures for normal and emergency operations. This paper presents some of the major results of an evaluation of the effect of human engineering on operator performance in the control room. Primary attention is given to discussion of control room and control system design influence on the operator. Brief observations on the influences of operator characteristics and job performance guides (operating procedures) on performance in the control room are also given. Under the objectives of the study, special emphasis was placed on the evaluation of the control room-operator relationships for severe emergency conditions in the power plant. Consequently, this presentation is restricted largely to material related to emergency conditions in the control room, though it is recognized that human engineering of control systems is of equal (or greater) importance for many other aspects of plant operation
[The hybrid operating room. Home of high-end intraoperative imaging].
Gebhard, F; Riepl, C; Richter, P; Liebold, A; Gorki, H; Wirtz, R; König, R; Wilde, F; Schramm, A; Kraus, M
2012-02-01
A hybrid operating room must serve the medical needs of different highly specialized disciplines. It integrates interventional techniques for cardiovascular procedures and allows operations in the field of orthopaedic surgery, neurosurgery and maxillofacial surgery. The integration of all steps such as planning, documentation and the procedure itself saves time and precious resources. The best available imaging devices and user interfaces reduce the need for extensive personnel in the OR and facilitate new minimally invasive procedures. The immediate possibility of postoperative control images in CT-like quality enables the surgeon to react to problems during the same procedure without the need for later revision.
New heuristics for planning operating rooms.
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
A comprehensive operating room information system using the Kinect sensors and RFID.
Nouei, Mahyar Taghizadeh; Kamyad, Ali Vahidian; Soroush, Ahmad Reza; Ghazalbash, Somayeh
2015-04-01
Occasionally, surgeons do need various types of information to be available rapidly, efficiently and safely during surgical procedures. Meanwhile, they need to free up hands throughout the surgery to necessarily access the mouse to control any application in the sterility mode. In addition, they are required to record audio as well as video files, and enter and save some data. This is an attempt to develop a comprehensive operating room information system called "Medinav" to tackle all mentioned issues. An integrated and comprehensive operating room information system is introduced to be compatible with Health Level 7 (HL7) and digital imaging and communications in medicine (DICOM). DICOM is a standard for handling, storing, printing, and transmitting information in medical imaging. Besides, a natural user interface (NUI) is designed specifically for operating rooms where touch-less interactions with finger and hand tracking are in use. Further, the system could both record procedural data automatically, and view acquired information from multiple perspectives graphically. A prototype system is tested in a live operating room environment at an Iranian teaching hospital. There are also contextual interviews and usability satisfaction questionnaires conducted with the "MediNav" system to investigate how useful the proposed system could be. The results reveal that integration of these systems into a complete solution is the key to not only stream up data and workflow but maximize surgical team usefulness as well. It is now possible to comprehensively collect and visualize medical information, and access a management tool with a touch-less NUI in a rather quick, practical, and harmless manner.
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...
Radiation protection in the operating room
International Nuclear Information System (INIS)
Kunz, B.; Stargardt, A.
1978-01-01
On the basis of legally provided area dose measurements and time records of fluoroscopic examinations during the operation, radiation doses to medical personnel and patients are evaluated. Adequate radiation protection measures and a careful behaviour in the operating room keep the radiation exposure to the personnel below the maximum permissible exposure. Taking into account the continuous personnel radiation monitoring and medical supervision, radiation hazards in the operating room can be considered low
The Operating Room of the Future Versus the Future of the Operating Room.
Kassam, Amin B; Rovin, Richard A; Walia, Sarika; Chakravarthi, Srikant; Celix, Juanita; Jennings, Jonathan; Khalili, Sammy; Gonen, Lior; Monroy-Sosa, Alejandro; Fukui, Melanie B
2017-06-01
Technological advancement in the operating room is evolving into a dynamic system mirroring that of the aeronautics industry. Through data visualization, information is continuously being captured, collected, and stored on a scalable informatics platform for rapid, intuitive, iterative learning. The authors believe this philosophy (paradigm) will feed into an intelligent informatics domain fully accessible to all and geared toward precision, cell-based therapy in which tissue can be targeted and interrogated in situ. In the future, the operating room will be a venue that facilitates this real-time tissue interrogation, which will guide in situ therapeutics to restore the state of health. Copyright © 2017 Elsevier Inc. All rights reserved.
The investigation of the design of hybrid operating room
International Nuclear Information System (INIS)
Jiang Weihao; Li Jun
2011-01-01
Objective: To investigate the design of the interventional operating room that can meet the needs of modern DSA operation, and the overall arrangement of the hybrid operating room should be reasonable, practical and perspective. Methods: The experience and understanding obtained from the designing and planning of the new Building of Radiology and Surgery in authors' hospital were summarized. In order to meet the requirements of aseptic surgical practices and a full-featured hybrid operating room the following factors should be carefully and synthetically taken into account: the room size, the functional sub-areas, the operational procedures, the aseptic specification, etc. Results: The sufficient verification and scientific design were the important link for building a hybrid operating room. It could provide the surgeons and interventional physicians with more alternative operating methods and it could represent the development trend of medical technology. Conclusion: When planning and designing a new DSA operating room, various factors related to the interventional procedures, such as the room size, the functional sub-areas, the operational procedures and the aseptic specification, should be carefully and synthetically taken into account. The standard of aseptic procedure must be strictly complied with and the various functional sub-areas need to be rationally distributed. The design of hybrid operating room, which joins the functions of both open surgery and interventional management together, should be scientific, practical and perspective. (authors)
Operation Aspect of the Main Control Room of NPP
International Nuclear Information System (INIS)
Sahala M Lumbanraja
2009-01-01
The main control room of Nuclear Power Plant (NPP) is operational centre to control all of the operation activity of NPP. NPP must be operated carefully and safely. Many aspect that contributed to operation of NPP, such as man power whose operated, technology type used, ergonomic of main control room, operational management, etc. The disturbances of communication in control room must be anticipated so the high availability of NPP can be achieved. The ergonomic of the NPP control room that will be used in Indonesia must be designed suitable to anthropometric of Indonesia society. (author)
Engineering Process Monitoring for Control Room Operation
Bätz, M
2001-01-01
A major challenge in process operation is to reduce costs and increase system efficiency whereas the complexity of automated process engineering, control and monitoring systems increases continuously. To cope with this challenge the design, implementation and operation of process monitoring systems for control room operation have to be treated as an ensemble. This is only possible if the engineering of the monitoring information is focused on the production objective and is lead in close collaboration of control room teams, exploitation personnel and process specialists. In this paper some principles for the engineering of monitoring information for control room operation are developed at the example of the exploitation of a particle accelerator at the European Laboratory for Nuclear Research (CERN).
Prepare to protect: Operating and maintaining a tornado safe room.
Herseth, Andrew; Goldsmith-Grinspoon, Jennifer; Scott, Pataya
2017-06-01
Operating and maintaining a tornado safe room can be critical to the effective continuity of business operations because a firm's most valuable asset is its people. This paper describes aspects of operations and maintenance (O&M) for existing tornado safe rooms as well as a few planning and design aspects that affect the ultimate operation of a safe room for situations where a safe room is planned, but not yet constructed. The information is based on several Federal Emergency Management Agency safe room publications that provide guidance on emergency management and operations, as well as the design and construction of tornado safe rooms.
The radiation dose dilemma in the hybrid operating room
de Ruiter, QMB
2016-01-01
The of the hybrid Operation room (an operation room combined with advanced radiological X-ray equipment) is gaining popularity, as it is now the preferred room to perform (complex) endovascular aortic procedures. The fixed C-arms equipped in these rooms make it possible to gain very high image
9 CFR 590.522 - Breaking room operations.
2010-01-01
... personnel. (m) Ingredients and additives used in, or for, processing egg products, shall be handled in a..., Processing, and Facility Requirements § 590.522 Breaking room operations. (a) The breaking room shall be kept... clean and reasonably dry during breaking operations and free of egg meat and shells. (b) All breaking...
[Operating Room Nurses' Experiences of Securing for Patient Safety].
Park, Kwang Ok; Kim, Jong Kyung; Kim, Myoung Sook
2015-10-01
This study was done to evaluate the experience of securing patient safety in hospital operating rooms. Experiential data were collected from 15 operating room nurses through in-depth interviews. The main question was "Could you describe your experience with patient safety in the operating room?". Qualitative data from the field and transcribed notes were analyzed using Strauss and Corbin's grounded theory methodology. The core category of experience with patient safety in the operating room was 'trying to maintain principles of patient safety during high-risk surgical procedures'. The participants used two interactional strategies: 'attempt continuous improvement', 'immersion in operation with sharing issues of patient safety'. The results indicate that the important factors for ensuring the safety of patients in the operating room are manpower, education, and a system for patient safety. Successful and safe surgery requires communication, teamwork and recognition of the importance of patient safety by the surgical team.
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.
Chen, Yue; Gao, Qin; Song, Fei; Li, Zhizhong; Wang, Yufan
2017-08-01
In the main control rooms of nuclear power plants, operators frequently have to switch between procedure displays and system information displays. In this study, we proposed an operation-unit-based integrated design, which combines the two displays to facilitate the synthesis of information. We grouped actions that complete a single goal into operation units and showed these operation units on the displays of system states. In addition, we used different levels of visual salience to highlight the current unit and provided a list of execution history records. A laboratory experiment, with 42 students performing a simulated procedure to deal with unexpected high pressuriser level, was conducted to compare this design against an action-based integrated design and the existing separated-displays design. The results indicate that our operation-unit-based integrated design yields the best performance in terms of time and completion rate and helped more participants to detect unexpected system failures. Practitioner Summary: In current nuclear control rooms, operators frequently have to switch between procedure and system information displays. We developed an integrated design that incorporates procedure information into system displays. A laboratory study showed that the proposed design significantly improved participants' performance and increased the probability of detecting unexpected system failures.
Advanced control room caters for the operator
International Nuclear Information System (INIS)
George, C.R.; Rygg, D.E.
1980-01-01
In existing control rooms the operators' efficiency is often limited by widely scattered and sometimes illogically arranged controls which tend to increase the potential for outages or equipment damage. The advanced control room described allows instant and ready access to preselected information and control by one or two operators from a seated or standing position. (author)
International Nuclear Information System (INIS)
Li Xue; Zhang Weiguo; Zhang Lianyang; Chen Tingjing; Chen Jinhua
2011-01-01
Objective: Through carrying out the normalized administration of hybrid operating room the application of the operating room is expanded to the performing of multiple injuries, and, in this way, the operative management become standardized and programmed, the cooperation and efficiency of hybrid operations for multiple injuries are improved and the surgeries can be ensured. Methods: According to the characteristics of hybrid interventional operation for multiple injuries, the basic construction of the hybrid operating room improved, the hybrid operation team was organized, and the administrative system as well as the working program were established. The green channel for rescuing patients with multiple injuries was set up. The cooperative behavior during interventional treatment for multiple injuries was specified. Results: The coordination and working efficiency of physicians, nurses, technicians and anesthetists were well improved. The qualified rate of lamina flow administration reached 100%. The success rate of the rescue of multiple injuries was increased. Conclusion: As one-stop complex interventional operation for multiple injuries is a new technique, there is no integrated administration system. Therefore, the establishment of standardized management of one-stop complex interventional operation is of great significance in guiding clinical practice. (authors)
How do strategic decisions and operative practices affect operating room productivity?
Peltokorpi, Antti
2011-12-01
Surgical operating rooms are cost-intensive parts of health service production. Managing operating units efficiently is essential when hospitals and healthcare systems aim to maximize health outcomes with limited resources. Previous research about operating room management has focused on studying the effect of management practices and decisions on efficiency by utilizing mainly modeling approach or before-after analysis in single hospital case. The purpose of this research is to analyze the synergic effect of strategic decisions and operative management practices on operating room productivity and to use a multiple case study method enabling statistical hypothesis testing with empirical data. 11 hypotheses that propose connections between the use of strategic and operative practices and productivity were tested in a multi-hospital study that included 26 units. The results indicate that operative practices, such as personnel management, case scheduling and performance measurement, affect productivity more remarkably than do strategic decisions that relate to, e.g., units' size, scope or academic status. Units with different strategic positions should apply different operative practices: Focused hospital units benefit most from sophisticated case scheduling and parallel processing whereas central and ambulatory units should apply flexible working hours, incentives and multi-skilled personnel. Operating units should be more active in applying management practices which are adequate for their strategic orientation.
Evaluation of new control rooms by operator performance analysis
International Nuclear Information System (INIS)
Mori, M; Tomizawa, T.; Tai, I.; Monta, K.; Yoshimura, S.; Hattori, Y.
1987-01-01
An advanced supervisory and control system called PODIA TM (Plant Operation by Displayed Information and Automation) was developed by Toshiba. Since this system utilizes computer driven CRTs as a main device for information transfer to operators, thorough system integration tests were performed at the factory and evaluations were made of operators' assessment from the initial experience of the system. The PODIA system is currently installed at two BWR power plants. Based on the experiences from the development of PODIA, a more advanced man-machine interface, Advanced-PODIA (A-PODIA), is developed. A-PODIA enhances the capabilities of PODIA in automation, diagnosis, operational guidance and information display. A-PODIA has been validated by carrying out systematic experiments with a full-scope simulator developed for the validation. The results of the experiments have been analyzed by the method of operator performance analysis and applied to further improvement of the A-PODIA system. As a feedback from actual operational experience, operator performance data in simulator training is an important source of information to evaluate human factors of a control room. To facilitate analysis of operator performance, a performance evaluation system has been developed by applying AI techniques. The knowledge contained in the performance evaluation system was elicited from operator training experts and represented as rules. The rules were implemented by employing an object-oriented paradigm to facilitate knowledge management. In conclusion, it is stated that the feedback from new control room operation can be obtained at an early stage by validation tests and also continuously by comprehensive evaluation (with the help of automated tools) of operator performance in simulator training. The results of operator performance analysis can be utilized for improvement of system design as well as operator training. (author)
Developing control room operator selection procedures
International Nuclear Information System (INIS)
Bosshardt, M.J.; Bownas, D.A.
1979-01-01
PDRI is performing a two-year study to identify the tasks performed and attributes required in electric power generating plant operating jobs, and focusing on the control room operator position. Approximately 65 investor-owned utilities are participating in the study
The role of the control room operator
International Nuclear Information System (INIS)
Williams, M.C.
A control room operator at an Ontario Hydro nuclear power plant operates a reactor-turbine unit according to approved procedures within imposed constraints to meet the objectives of the organization. A number of operating and administrative tasks make up this role. Control room operators spend approximately six percent of their time physically operating equipment exclusive of upset conditions, and another one percent operating in upset conditions. Testing occupies five percent of an operator's time. Operators must be trained to recognize the entire spectrum of inputs available to them and use them all effectively. Any change in system or unit state is always made according to an approved procedure. Extensive training is required; operators must be taught and pracised in what to do, and must know the reasons behind their actions. They are expected to memorize emergency procedures, to know when to consult operating procedures, and to have sufficient understanding and practice to perform these procedures reliably
Integration of analog and digital instrumentation and control systems in hybrid control rooms
International Nuclear Information System (INIS)
2010-01-01
he IAEA's activities in the area of nuclear power plant operating performance and life cycle management are aimed at increasing Member State capabilities in utilizing good engineering and management practices as developed and transferred by the IAEA. In particular, the IAEA supports the improvement of nuclear power plant performance, plant life management, training, power uprating, operational license renewal, and the modernization of instrumentation and control (I and C) systems of plants. The issue of the integration of analog and digital I and C systems in hybrid control rooms was suggested by the IAEA Technical Working Group on Nuclear Power Plant Control and Instrumentation (TWG-NPPCI) at its meetings in 2003 and 2005. The subject was then approved by the IAEA and included in its work programmes for 2006-2009. The purpose of this report is to help nuclear utilities in planning control room and other human system interface (HSI) changes, making appropriate use of modern technologies. These technologies would aid in managing ageing and obsolescence, and facilitate improvements in plant performance and safety. This report covers a broad spectrum of potential changes to the control room ranging from the replacement of a few obsolete components with newer digital devices to a fully computerized control room. New digital technologies offer significant opportunities to improve access to and presentation of information to the user, e.g. operators, maintenance staff and management. However, this technology should be used prudently. In some cases, modernization is undertaken to resolve ageing and obsolescence or to meet regulatory requirements for license renewal. The integration of new technologies during main control room (MCR) modernizations should be performed cautiously and all affected aspects of plant maintenance, and operation should be carefully considered, paying particular attention to the human factors elements of these aspects. This report describes a
International Nuclear Information System (INIS)
Berg, O.
1997-01-01
At the Halden Project efforts are made to explore the possibilities through design, development and validation of Computer-based Operator Support Systems (COSSes) which can assist the operators in different operational situations, ranging from normal operation to disturbance and accident conditions. The programme comprises four main activities: 1) verification and validation of safety critical software systems; 2) man-machine interaction research emphasizing improvements in man-machine interfaces on the basis of human factors studies; 3) computerized operator support systems assisting the operator in fault detection/diagnosis and planning of control actions; and 4) control room development providing a basis for retrofitting of existing control rooms and for the design of advanced concepts. The paper presents the status of this development programme, including descriptions of specific operator support functions implemented in the simulator-based, experimental control room at Halden (HAMMLAB, HAlden Man-Machine LABoratory). These operator aids comprise advanced alarms systems, diagnostic support functions, electronic procedures, critical safety functions surveillance and accident management support systems. The different operator support systems development at the Halden Project are tested and evaluated in HAMMLAB with operators from the Halden Reactor, and occasionally from commercial NPPs, as test subjects. These evaluations provide data on the merits of different operator support systems in an advanced control room setting, as well as on how such systems should be integrated to enhance operator performance. The paper discusses these aspects and the role of computerized operator support systems in plant operation based on the experience from this work at the Halden Project. 15 refs, 5 figs
Energy Technology Data Exchange (ETDEWEB)
Berg, O [Institutt for Energiteknikk, OECD Halden Reactor Project (Netherlands)
1997-07-01
At the Halden Project efforts are made to explore the possibilities through design, development and validation of Computer-based Operator Support Systems (COSSes) which can assist the operators in different operational situations, ranging from normal operation to disturbance and accident conditions. The programme comprises four main activities: 1) verification and validation of safety critical software systems; 2) man-machine interaction research emphasizing improvements in man-machine interfaces on the basis of human factors studies; 3) computerized operator support systems assisting the operator in fault detection/diagnosis and planning of control actions; and 4) control room development providing a basis for retrofitting of existing control rooms and for the design of advanced concepts. The paper presents the status of this development programme, including descriptions of specific operator support functions implemented in the simulator-based, experimental control room at Halden (HAMMLAB, HAlden Man-Machine LABoratory). These operator aids comprise advanced alarms systems, diagnostic support functions, electronic procedures, critical safety functions surveillance and accident management support systems. The different operator support systems development at the Halden Project are tested and evaluated in HAMMLAB with operators from the Halden Reactor, and occasionally from commercial NPPs, as test subjects. These evaluations provide data on the merits of different operator support systems in an advanced control room setting, as well as on how such systems should be integrated to enhance operator performance. The paper discusses these aspects and the role of computerized operator support systems in plant operation based on the experience from this work at the Halden Project. 15 refs, 5 figs.
Development of contextual task analysis for NPP control room operators' work
International Nuclear Information System (INIS)
Hukki, K.
1998-01-01
The paper introduces a contextual approach to task analysis concerning control room operators' tasks and task conditions in nuclear power plants. The approach is based on the ecological concept of the situational appropriateness of activity. The task demands are dependent on the ultimate task of the operators which is to maintain the critical safety functions of the process. The context also sets boundary conditions to the fulfilment of these demands. The conceptualisation of the context affords possibilities to comprehend and make visible the core demands of the operators' work. Characteristic to the approach is that the conceptualisation is made both from the point of the operators who are making interpretations of the situation and from the point of the process to be controlled. The context is described as a world of operators' possibilities and constraints and, at the same time, in relation to the demands set by the nature of the process. The method is under development and has been applied in simulator training, in the evaluation of the control room information and in the integrated development of reliability analysis. The method emphasizes the role of explicit conceptualisation of the task situations. Explicity enhances its role as a conceptual tool and, therefore, promotes common awareness in these domains. (orig.)
Operational Strategy of CBPs for load balancing of Operators in Advanced Main Control Room
International Nuclear Information System (INIS)
Kim, Seunghwan; Kim, Yochan; Jung, Wondea
2014-01-01
With the using of a computer-based control room in an APR1400 (Advanced Pressurized Reactor-1400), the operators' behaviors in the main control room had changed. However, though the working environment of operators has been changed a great deal, digitalized interfaces can also change the cognitive tasks or activities of operators. First, a shift supervisor (SS) can confirm/check the conduction of the procedures and the execution of actions of board operators (BOs) while confirming directly the operation variables without relying on the BOs. Second, all operators added to their work the use of a new CBP and Soft Controls, increasing their procedural workload. New operational control strategies of CBPs are necessary for load balancing of operator's task load in APR1400. In this paper, we compared the workloads of operators in an APR1400 who work with two different usages of the CBP. They are SS oriented usage and SS-BO collaborative usage. In this research, we evaluated the workloads of operators in an advanced main control room by the COCOA method. Two types of CBP usages were defined and the effects of these usages on the workloads were investigated. The obtained results showed that the workloads between operators in a control room can be balanced according to the CBP usages by assigning control authority to the operators
Operational Strategy of CBPs for load balancing of Operators in Advanced Main Control Room
Energy Technology Data Exchange (ETDEWEB)
Kim, Seunghwan; Kim, Yochan; Jung, Wondea [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)
2014-05-15
With the using of a computer-based control room in an APR1400 (Advanced Pressurized Reactor-1400), the operators' behaviors in the main control room had changed. However, though the working environment of operators has been changed a great deal, digitalized interfaces can also change the cognitive tasks or activities of operators. First, a shift supervisor (SS) can confirm/check the conduction of the procedures and the execution of actions of board operators (BOs) while confirming directly the operation variables without relying on the BOs. Second, all operators added to their work the use of a new CBP and Soft Controls, increasing their procedural workload. New operational control strategies of CBPs are necessary for load balancing of operator's task load in APR1400. In this paper, we compared the workloads of operators in an APR1400 who work with two different usages of the CBP. They are SS oriented usage and SS-BO collaborative usage. In this research, we evaluated the workloads of operators in an advanced main control room by the COCOA method. Two types of CBP usages were defined and the effects of these usages on the workloads were investigated. The obtained results showed that the workloads between operators in a control room can be balanced according to the CBP usages by assigning control authority to the operators.
Virtual reality in the operating room of the future.
Müller, W; Grosskopf, S; Hildebrand, A; Malkewitz, R; Ziegler, R
1997-01-01
In cooperation with the Max-Delbrück-Centrum/Robert-Rössle-Klinik (MDC/RRK) in Berlin, the Fraunhofer Institute for Computer Graphics is currently designing and developing a scenario for the operating room of the future. The goal of this project is to integrate new analysis, visualization and interaction tools in order to optimize and refine tumor diagnostics and therapy in combination with laser technology and remote stereoscopic video transfer. Hence, a human 3-D reference model is reconstructed using CT, MR, and anatomical cryosection images from the National Library of Medicine's Visible Human Project. Applying segmentation algorithms and surface-polygonization methods a 3-D representation is obtained. In addition, a "fly-through" the virtual patient is realized using 3-D input devices (data glove, tracking system, 6-DOF mouse). In this way, the surgeon can experience really new perspectives of the human anatomy. Moreover, using a virtual cutting plane any cut of the CT volume can be interactively placed and visualized in realtime. In conclusion, this project delivers visions for the application of effective visualization and VR systems. Commonly known as Virtual Prototyping and applied by the automotive industry long ago, this project shows, that the use of VR techniques can also prototype an operating room. After evaluating design and functionality of the virtual operating room, MDC plans to build real ORs in the near future. The use of VR techniques provides a more natural interface for the surgeon in the OR (e.g., controlling interactions by voice input). Besides preoperative planning future work will focus on supporting the surgeon in performing surgical interventions. An optimal synthesis of real and synthetic data, and the inclusion of visual, aural, and tactile senses in virtual environments can meet these requirements. This Augmented Reality could represent the environment for the surgeons of tomorrow.
Stress, performance, and control room operations
International Nuclear Information System (INIS)
Fontaine, C.W.
1990-01-01
The notion of control room operator performance being detrimentally affected by stress has long been the focus of considerable conjecture. It is important to gain a better understanding of the validity of this concern for the development of effective severe-accident management approaches. This paper illustrates the undeniable negative impact of stress on a wide variety of tasks. A computer-controlled simulated work environment was designed in which both male and female operators were closely monitored during the course of the study for both stress level (using the excretion of the urine catecholamines epinephrine and norepinephrine as an index) and job performance. The experimental parameters employed by the study when coupled with the subsequent statistical analyses of the results allow one to make some rather striking comments with respect to how a given operator might respond to a situation that he or she perceives to be psychologically stressful (whether the stress be externally or internally generated). The findings of this study clearly indicated that stress does impact operator performance on tasks similar in nature to those conducted by control room operators and hence should be seriously considered in the development of severe-accident management strategies
Operating Room Fires and Surgical Skin Preparation.
Jones, Edward L; Overbey, Douglas M; Chapman, Brandon C; Jones, Teresa S; Hilton, Sarah A; Moore, John T; Robinson, Thomas N
2017-07-01
Operating room fires are "never events" that remain an under-reported source of devastating complications. One common set-up that promotes fires is the use of surgical skin preparations combined with electrosurgery and oxygen. Limited data exist examining the incidence of fires and surgical skin preparations. A standardized, ex vivo model was created with a 15 × 15 cm section of clipped porcine skin. An electrosurgical "Bovie" pencil was activated for 2 seconds on 30 Watts coagulation mode in 21% oxygen (room air), both immediately and 3 minutes after skin preparation application. Skin preparations with and without alcohol were tested, and were applied with and without pooling. Alcohol-based skin preparations included 70% isopropyl alcohol (IPA) with 2% chlorhexidine gluconate, 74% IPA with 0.7% iodine povacrylex, and plain 70% IPA. No fires occurred with nonalcohol-based preparations (p fires occurred in 38% (23 of 60) at 0 minutes and 27% (16 of 60) at 3 minutes. Alcohol-based skin preparations fuel operating room fires in common clinical scenarios. Following manufacturer guidelines and allowing 3 minutes for drying, surgical fires were still created in 1 in 10 cases without pooling and more than one-quarter of cases with pooling. Surgeons can decrease the risk of an operating room fire by using nonalcohol-based skin preparations or avoiding pooling of the preparation solution. Published by Elsevier Inc.
Influence of disturbances on bacteria level in an operating room
DEFF Research Database (Denmark)
Brohus, Henrik; Hyldig, Mikkel; Kamper, Simon
2008-01-01
In operating rooms great effort is manifested to reduce the bacteria level in order to decrease the risk of infections. The main source of bacteria is the staff and the patient, thus, the resulting bacteria concentration is roughly speaking a combination of the ventilation system and the emission...... from the occupants. This study investigates the influence of two main disturbances in an operating room namely the door opening during the operation and the activity level of the staff. It is found that the frequent door opening in this case does not cause significant transport of air from outside...... the operating room to the wound area of the patient. However, a significant influence of the activity level on the bacteria emission and concentration is found. Counting the number of persons in an operating room to estimate the bacteria source strength is not sufficient, the corresponding activity level must...
Fügener, Andreas; Schiffels, Sebastian; Kolisch, Rainer
2017-03-01
The planning of surgery durations is crucial for efficient usage of operating theaters. Both planning too long and too short durations for surgeries lead to undesirable consequences, e.g. idle time, overtime, or rescheduling of surgeries. We define these consequences as operating room inefficiency. The overall objective of planning surgery durations is to minimize expected operating room inefficiency, since surgery durations are stochastic. While most health care studies assume economically rational behavior of decision makers, experimental studies have shown that decision makers often do not act according to economic incentives. Based on insights from health care operations management, medical decision making, behavioral operations management, as well as empirical observations, we derive hypotheses that surgeons' behavior deviates from economically rational behavior. To investigate this, we undertake an experimental study where experienced surgeons are asked to plan surgeries with uncertain durations. We discover systematic deviations from optimal decision making and offer behavioral explanations for the observed biases. Our research provides new insights to tackle a major problem in hospitals, i.e. low operating room utilization going along with staff overtime.
Game theory: applications for surgeons and the operating room environment.
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.
Attitudes to teamwork and safety among Italian surgeons and operating room nurses.
Prati, Gabriele; Pietrantoni, Luca
2014-01-01
Previous studies have shown that surgical team members' attitudes about safety and teamwork in the operating theatre may play a role in patient safety. The aim of this study was to assess attitudes about teamwork and safety among Italian surgeons and operating room nurses. Fifty-five surgeons and 48 operating room nurses working in operating theatres at one hospital in Italy completed the Operating Room Management Attitudes Questionnaire (ORMAQ). Results showed several discrepancies in attitudes about teamwork and safety between surgeons and operating room nurses. Surgeons had more positive views on the quality of surgical leadership, communication, teamwork, and organizational climate in the theatre than operating room nurses. Operating room nurses reported that safety rules and procedures were more frequently disregarded than the surgeons. The results are only partially aligned with previous ORMAQ surveys of surgical teams in other countries. The differences emphasize the influence of national culture, as well as the particular healthcare system. This study shows discrepancies on many aspects in attitudes to teamwork and safety between surgeons and operating room nurses. The findings support implementation and use of team interventions and human factor training. Finally, attitude surveys provide a method for assessing safety culture in surgery, for evaluating the effectiveness of training initiatives, and for collecting data for a hospital's quality assurance programme.
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.
[Operating room during natural disaster: lessons from the 2011 Tohoku earthquake].
Fukuda, Ikuo; Hashimoto, Hiroshi; Suzuki, Yasuyuki; Satomi, Susumu; Unno, Michiaki; Ohuchi, Noriaki; Nakaji, Shigeyuki
2012-03-01
Objective of this study is to clarify damages in operating rooms after the 2011 Tohoku Earthquake. To survey structural and non-structural damage in operating theaters, we sent questionnaires to 155 acute care hospitals in Tohoku area. Questionnaires were sent back from 105 hospitals (70.3%). Total of 280 patients were undergoing any kinds of operations during the earthquake and severe seismic tremor greater than JMA Seismic Intensity 6 hit 49 hospitals. Operating room staffs experienced life-threatening tremor in 41 hospitals. Blackout occurred but emergency electronic supply unit worked immediately in 81 out of 90 hospitals. However, emergency power plant did not work in 9 hospitals. During earthquake some materials fell from shelves in 44 hospitals and medical instruments fell down in 14 hospitals. In 5 hospitals, they experienced collapse of operating room wall or ceiling causing inability to maintain sterile operative field. Damage in electric power and water supply plus damage in logistics made many operating rooms difficult to perform routine surgery for several days. The 2011 Tohoku earthquake affected medical supply in wide area of Tohoku district and induced dysfunction of operating room. Supply-chain management of medical goods should be reconsidered to prepare severe natural disaster.
Optimum Operating Room Environment for the Prevention of Surgical Site Infections.
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.
Review of operating room ventilation standards
Melhado, M.D.A.; Hensen, J.L.M.; Loomans, M.G.L.C.
2006-01-01
This article reviews standards applied to operating room ventilation design used by European, South and North American countries. Required environmental parameters are compared with regard to type of surgery, and ventilation system. These requirements as well as their relation to infection control
Bayramzadeh, Sara; Joseph, Anjali; Allison, David; Shultz, Jonas; Abernathy, James
2018-07-01
This paper describes the process and tools developed as part of a multidisciplinary collaborative simulation-based approach for iterative design and evaluation of operating room (OR) prototypes. Full-scale physical mock-ups of healthcare spaces offer an opportunity to actively communicate with and to engage multidisciplinary stakeholders in the design process. While mock-ups are increasingly being used in healthcare facility design projects, they are rarely evaluated in a manner to support active user feedback and engagement. Researchers and architecture students worked closely with clinicians and architects to develop OR design prototypes and engaged clinical end-users in simulated scenarios. An evaluation toolkit was developed to compare design prototypes. The mock-up evaluation helped the team make key decisions about room size, location of OR table, intra-room zoning, and doors location. Structured simulation based mock-up evaluations conducted in the design process can help stakeholders visualize their future workspace and provide active feedback. Copyright © 2018 Elsevier Ltd. All rights reserved.
Mobility, Context and Cloud – Exploring Integration Issues in a Meeting Room Scenario
Directory of Open Access Journals (Sweden)
Tor-Morten Grønli
2012-04-01
Full Text Available In this paper we pursue the context-aware paradigm in a distributed mobile environment. Context-awareness plays a significant role in the domain of implicit human computer interaction and we present an intelligent context-aware meeting room application. The distributed mobile application consists of multiple mobile operating system clients, a Google Android based presenter that, through proximity technology, communicates with a server in the meeting room, and a Google Cloud backend server. Over 40 users have evaluated the application. Results show that the context aware meeting room was well received by users who displayed a strong positive bias towards cloud integration and, in particular, automatic meeting-note push. We conclude that our context-aware meeting assistant can provide valuable assistance to end users and that there is promise for such use of heterogeneous mobile context-aware platforms.
Human factors design of nuclear power plant control rooms including computer-based operator aids
International Nuclear Information System (INIS)
Bastl, W.; Felkel, L.; Becker, G.; Bohr, E.
1983-01-01
The scientific handling of human factors problems in control rooms began around 1970 on the basis of safety considerations. Some recent research work deals with the development of computerized systems like plant balance calculation, safety parameter display, alarm reduction and disturbance analysis. For disturbance analysis purposes it is necessary to homogenize the information presented to the operator according to the actual plant situation in order to supply the operator with the information he most urgently needs at the time. Different approaches for solving this problem are discussed, and an overview is given on what is being done. Other research projects concentrate on the detailed analysis of operators' diagnosis strategies in unexpected situations, in order to obtain a better understanding of their mental processes and the influences upon them when such situations occur. This project involves the use of a simulator and sophisticated recording and analysis methods. Control rooms are currently designed with the aid of mock-ups. They enable operators to contribute their experience to the optimization of the arrangement of displays and controls. Modern control rooms are characterized by increasing use of process computers and CRT (Cathode Ray Tube) displays. A general concept for the integration of the new computerized system and the conventional control panels is needed. The technical changes modify operators' tasks, and future ergonomic work in nuclear plants will need to consider the re-allocation of function between man and machine, the incorporation of task changes in training programmes, and the optimal design of information presentation using CRTs. Aspects of developments in control room design are detailed, typical research results are dealt with, and a brief forecast of the ergonomic contribution to be made in the Federal Republic of Germany is given
Engineering Process Monitoring for Control Room Operation
Bätz, M
2001-01-01
A major challenge in process operation is to reduce costs and increase system efficiency whereas the complexity of automated process engineering, control and monitoring systems increases continuously. To cope with this challenge the design, implementation and operation of process monitoring systems for control room operation have to be treated as an ensemble. This is only possible if the engineering of the monitoring information is focused on the production objective and is lead in close coll...
Chen, Xi; Viehland, Christian; Carrasco-Zevallos, Oscar M; Keller, Brenton; Vajzovic, Lejla; Izatt, Joseph A; Toth, Cynthia A
2017-05-01
Intraoperative optical coherence tomography (OCT) has gained traction as an important adjunct for clinical decision making during vitreoretinal surgery, and OCT angiography (OCTA) has provided novel insights in clinical evaluation of retinal diseases. To date, these two technologies have not been applied in combination to evaluate retinal vascular disease in the operating suite. To conduct microscope-integrated, swept-source OCTA (MIOCTA) in children with retinal vascular disease. In this case report analysis, OCT imaging in pediatric patients, MIOCTA images were obtained during examination under anesthesia from a young boy with a history of idiopathic vitreous hemorrhage and a female infant with familial exudative vitreoretinopathy. Side-by-side comparison of research MIOCT angiograms and clinically indicated fluorescein angiograms. In 2 young children with retinal vascular disease, the MIOCTA images showed more detailed vascular patterns than were visible on the fluorescein angiograms although within a more posterior field of view. The MIOCTA system allowed visualization of small pathological retinal vessels in the retinal periphery that were obscured in the fluorescein angiograms by fluorescein staining from underlying, preexisting laser scars. This is the first report to date of the use of MIOCTA in the operating room for young children with retinal vascular disease. Further optimization of this system may allow noninvasive detailed evaluation of retinal vasculature during surgical procedures and in patients who could not cooperate with in-office examinations.
Control of the Environment in the Operating Room.
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.
Integrated Practice Improvement Solutions-Practical Steps to Operating Room Management.
Chernov, Mikhail; Pullockaran, Janet; Vick, Angela; Leyvi, Galina; Delphin, Ellise
2016-10-01
Perioperative productivity is a vital concern for surgeons, anesthesiologists, and administrators as the OR is a major source of hospital elective admissions and revenue. Based on elements of existing Practice Improvement Methodologies (PIMs), "Integrated Practice Improvement Solutions" (IPIS) is a practical and simple solution incorporating aspects of multiple management approaches into a single open source framework to increase OR efficiency and productivity by better utilization of existing resources. OR efficiency was measured both before and after IPIS implementation using the total number of cases versus room utilization, OR/anesthesia revenue and staff overtime (OT) costs. Other parameters of efficiency, such as the first case on-time start and the turnover time (TOT) were measured in parallel. IPIS implementation resulted in increased numbers of surgical procedures performed by an average of 10.7%, and OR and anesthesia revenue increases of 18.5% and 6.9%, respectively, with a simultaneous decrease in TOT (15%) and OT for anesthesia staff (26%). The number of perioperative adverse events was stable during the two-year study period which involved a total of 20,378 patients. IPIS, an effective and flexible practice improvement model, was designed to quickly, significantly, and sustainably improve OR efficiency by better utilization of existing resources. Success of its implementation directly correlates with the involvement of and acceptance by the entire OR team and hospital administration.
Delays in the operating room: signs of an imperfect system.
Wong, Janice; Khu, Kathleen Joy; Kaderali, Zul; Bernstein, Mark
2010-06-01
Delays in the operating room have a negative effect on its efficiency and the working environment. In this prospective study, we analyzed data on perioperative system delays. One neurosurgeon prospectively recorded all errors, including perioperative delays, for consecutive patients undergoing elective procedures from May 2000 to February 2009. We analyzed the prevalence, causes and impact of perioperative system delays that occurred in one neurosurgeon's practice. A total of 1531 elective surgical cases were performed during the study period. Delays were the most common type of error (33.6%), and more than half (51.4%) of all cases had at least 1 delay. The most common cause of delay was equipment failure. The first cases of the day and cranial cases had more delays than subsequent cases and spinal cases, respectively. A delay in starting the first case was associated with subsequent delays. Delays frequently occur in the operating room and have a major effect on patient flow and resource utilization. Thorough documentation of perioperative delays provides a basis for the development of solutions for improving operating room efficiency and illustrates the principles underlying the causes of operating room delays across surgical disciplines.
Tritium Room Air Monitor Operating Experience Review
Energy Technology Data Exchange (ETDEWEB)
L. C. Cadwallader; B. J. Denny
2008-09-01
Monitoring the breathing air in tritium facility rooms for airborne tritium is a radiological safety requirement and a best practice for personnel safety. Besides audible alarms for room evacuation, these monitors often send signals for process shutdown, ventilation isolation, and cleanup system actuation to mitigate releases and prevent tritium spread to the environment. Therefore, these monitors are important not only to personnel safety but also to public safety and environmental protection. This paper presents an operating experience review of tritium monitor performance on demand during small (1 mCi to 1 Ci) operational releases, and intentional airborne inroom tritium release tests. The tritium tests provide monitor operation data to allow calculation of a statistical estimate for the reliability of monitors annunciating in actual tritium gas airborne release situations. The data show a failure to operate rate of 3.5E-06/monitor-hr with an upper bound of 4.7E-06, a failure to alarm on demand rate of 1.4E-02/demand with an upper bound of 4.4E-02, and a spurious alarm rate of 0.1 to 0.2/monitor-yr.
Optimization of recirculating laminar air flow in operating room air conditioning systems
Directory of Open Access Journals (Sweden)
Enver Yalcin
2016-04-01
Full Text Available The laminar flow air-conditioning system with 100% fresh air is used in almost all operating rooms without discrimination in Turkey. The laminar flow device which is working with 100% fresh air should be absolutely used in Type 1A operating rooms. However, there is not mandatory to use of 100% fresh air for Type 1B defined as places performed simpler operation. Compared with recirculating laminar flow, energy needs of the laminar flow with 100 % fresh air has been emerged about 40% more than re-circulated air flow. Therefore, when a recirculating laminar flow device is operated instead of laminar flow system with 100% fresh air in the Type 1B operating room, annual energy consumption will be reduced. In this study, in an operating room with recirculating laminar flow, optimal conditions have been investigated in order to obtain laminar flow form by analyzing velocity distributions at various supply velocities by using computational fluid dynamics method (CFD.
Complementing Operating Room Teaching With Video-Based Coaching.
Hu, Yue-Yung; Mazer, Laura M; Yule, Steven J; Arriaga, Alexander F; Greenberg, Caprice C; Lipsitz, Stuart R; Gawande, Atul A; Smink, Douglas S
2017-04-01
Surgical expertise demands technical and nontechnical skills. Traditionally, surgical trainees acquired these skills in the operating room; however, operative time for residents has decreased with duty hour restrictions. As in other professions, video analysis may help maximize the learning experience. To develop and evaluate a postoperative video-based coaching intervention for residents. In this mixed methods analysis, 10 senior (postgraduate year 4 and 5) residents were videorecorded operating with an attending surgeon at an academic tertiary care hospital. Each video formed the basis of a 1-hour one-on-one coaching session conducted by the operative attending; although a coaching framework was provided, participants determined the specific content collaboratively. Teaching points were identified in the operating room and the video-based coaching sessions; iterative inductive coding, followed by thematic analysis, was performed. Teaching points made in the operating room were compared with those in the video-based coaching sessions with respect to initiator, content, and teaching technique, adjusting for time. Among 10 cases, surgeons made more teaching points per unit time (63.0 vs 102.7 per hour) while coaching. Teaching in the video-based coaching sessions was more resident centered; attendings were more inquisitive about residents' learning needs (3.30 vs 0.28, P = .04), and residents took more initiative to direct their education (27% [198 of 729 teaching points] vs 17% [331 of 1977 teaching points], P based coaching is a novel and feasible modality for supplementing intraoperative learning. Objective evaluation demonstrates that video-based coaching may be particularly useful for teaching higher-level concepts, such as decision making, and for individualizing instruction and feedback to each resident.
Anticipating urgent surgery in operating room departments
van der Lans, M.; Hans, Elias W.; Hurink, Johann L.; Wullink, Gerhard; van Houdenhoven, M.; Kazemier, G.
2005-01-01
Operating Room (OR) departments need to create robust surgical schedules that anticipate urgent surgery, while minimizing urgent surgery waiting time and overtime, and maximizing utilization. We consider two levels of planning and control to anticipate urgent surgery. At the tactical level, we study
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
Directory of Open Access Journals (Sweden)
Chin-Sheng Tang
Full Text Available To prevent surgical site infection (SSI, the airborne microbial concentration in operating theaters must be reduced. The air quality in operating theaters and nearby areas is also important to healthcare workers. Therefore, this study assessed air quality in the post-operative recovery room, locations surrounding the operating theater area, and operating theaters in a medical center. Temperature, relative humidity (RH, and carbon dioxide (CO2, suspended particulate matter (PM, and bacterial concentrations were monitored weekly over one year. Measurement results reveal clear differences in air quality in different operating theater areas. The post-operative recovery room had significantly higher CO2 and bacterial concentrations than other locations. Bacillus spp., Micrococcus spp., and Staphylococcus spp. bacteria often existed in the operating theater area. Furthermore, Acinetobacter spp. was the main pathogen in the post-operative recovery room (18% and traumatic surgery room (8%. The mixed effect models reveal a strong correlation between number of people in a space and high CO2 concentration after adjusting for sampling locations. In conclusion, air quality in the post-operative recovery room and operating theaters warrants attention, and merits long-term surveillance to protect both surgical patients and healthcare workers.
Tang, Chin-Sheng; Wan, Gwo-Hwa
2013-01-01
To prevent surgical site infection (SSI), the airborne microbial concentration in operating theaters must be reduced. The air quality in operating theaters and nearby areas is also important to healthcare workers. Therefore, this study assessed air quality in the post-operative recovery room, locations surrounding the operating theater area, and operating theaters in a medical center. Temperature, relative humidity (RH), and carbon dioxide (CO2), suspended particulate matter (PM), and bacterial concentrations were monitored weekly over one year. Measurement results reveal clear differences in air quality in different operating theater areas. The post-operative recovery room had significantly higher CO2 and bacterial concentrations than other locations. Bacillus spp., Micrococcus spp., and Staphylococcus spp. bacteria often existed in the operating theater area. Furthermore, Acinetobacter spp. was the main pathogen in the post-operative recovery room (18%) and traumatic surgery room (8%). The mixed effect models reveal a strong correlation between number of people in a space and high CO2 concentration after adjusting for sampling locations. In conclusion, air quality in the post-operative recovery room and operating theaters warrants attention, and merits long-term surveillance to protect both surgical patients and healthcare workers.
Start time delays in operating room: Different perspectives
Directory of Open Access Journals (Sweden)
Babita Gupta
2011-01-01
Full Text Available Background: Healthcare expenditure is a serious concern, with escalating costs failing to meet the expectations of quality care. The treatment capacities are limited in a hospital setting and the operating rooms (ORs. Their optimal utilization is vital in efficient hospital management. Starting late means considerable wait time for staff, patients and waste of resources. We planned an audit to assess different perspectives of the residents in surgical specialities and anesthesia and OR staff nurses so as to know the causative factors of operative delay. This can help develop a practical model to decrease start time delays in operating room (ORs. Aims: An audit to assess different perspectives of the Operating room (OR staff with respect to the varied causative factors of operative delay in the OR. To aid in the development of a practical model to decrease start time delays in ORs and facilitate on-time starts at Jai Prakash Narayan Apex Trauma centre (JPNATC, All India Institute of Medical Sciences (AIIMS, New Delhi. Methods: We prepared a questionnaire seeking the five main reasons of delay as per their perspective. Results: The available data was analysed. Analysis of the data demonstrated the common causative factors in start time operative delays as: a lack of proper planning, deficiencies in team work, communication gap and limited availability of trained supporting staff. Conclusions: The preparation of the equipment and required material for the OR cases must be done well in advance. Utilization of newer technology enables timely booking and scheduling of cases. Improved inter-departmental coordination and compliance with preanesthetic instructions needs to be ensured. It is essential that the anesthesiologists perform their work promptly, well in time . and supervise the proceedings as the OR manager. This audit is a step forward in defining the need of effective OR planning for continuous quality improvement.
A master surgical scheduling approach for cyclic scheduling in operating room departments
van Oostrum, Jeroen M.; van Houdenhoven, M.; Hurink, Johann L.; Hans, Elias W.; Wullink, Gerhard; Kazemier, G.
This paper addresses the problem of operating room (OR) scheduling at the tactical level of hospital planning and control. Hospitals repetitively construct operating room schedules, which is a time-consuming, tedious, and complex task. The stochasticity of the durations of surgical procedures
Effect of ventilation rate on air cleanliness and energy consumption in operation rooms at rest.
Lee, Shih-Tseng; Liang, Ching-Chieh; Chien, Tsung-Yi; Wu, Feng-Jen; Fan, Kuang-Chung; Wan, Gwo-Hwa
2018-02-27
The interrelationships between ventilation rate, indoor air quality, and energy consumption in operation rooms at rest are yet to be understood. We investigate the effect of ventilation rate on indoor air quality indices and energy consumption in ORs at rest. The study investigates the air temperature, relative humidity, concentrations of carbon dioxide, particulate matter (PM), and airborne bacteria at different ventilation rates in operation rooms at rest of a medical center. The energy consumption and cost analysis of the heating, ventilating, and air conditioning (HVAC) system in the operation rooms at rest were also evaluated for all ventilation rates. No air-conditioned operation rooms had very highest PM and airborne bacterial concentrations in the operation areas. The bacterial concentration in the operation areas with 6-30 air changes per hour (ACH) was below the suggested level set by the United Kingdom (UK) for an empty operation room. A 70% of reduction in annual energy cost by reducing the ventilation rate from 30 to 6 ACH was found in the operation rooms at rest. Maintenance of operation rooms at ventilation rate of 6 ACH could save considerable amounts of energy and achieve the goal of air cleanliness.
Feasibility of touch-less control of operating room lights.
Hartmann, Florian; Schlaefer, Alexander
2013-03-01
Today's highly technical operating rooms lead to fairly complex surgical workflows where the surgeon has to interact with a number of devices, including the operating room light. Hence, ideally, the surgeon could direct the light without major disruption of his work. We studied whether a gesture tracking-based control of an automated operating room light is feasible. So far, there has been little research on control approaches for operating lights. We have implemented an exemplary setup to mimic an automated light controlled by a gesture tracking system. The setup includes a articulated arm to position the light source and an off-the-shelf RGBD camera to detect the user interaction. We assessed the tracking performance using a robot-mounted hand phantom and ran a number of tests with 18 volunteers to evaluate the potential of touch-less light control. All test persons were comfortable with using the gesture-based system and quickly learned how to move a light spot on flat surface. The hand tracking error is direction-dependent and in the range of several centimeters, with a standard deviation of less than 1 mm and up to 3.5 mm orthogonal and parallel to the finger orientation, respectively. However, the subjects had no problems following even more complex paths with a width of less than 10 cm. The average speed was 0.15 m/s, and even initially slow subjects improved over time. Gestures to initiate control can be performed in approximately 2 s. Two-thirds of the subjects considered gesture control to be simple, and a majority considered it to be rather efficient. Implementation of an automated operating room light and touch-less control using an RGBD camera for gesture tracking is feasible. The remaining tracking error does not affect smooth control, and the use of the system is intuitive even for inexperienced users.
Korb, Werner; Bohn, Stefan; Burgert, Oliver; Dietz, Andreas; Jacobs, Stephan; Falk, Volkmar; Meixensberger, Jürgen; Strauss, Gero; Trantakis, Christos; Lemke, Heinz U
2006-01-01
For better integration of surgical assist systems into the operating room, a common communication and processing plattform that is based on the users needs is needed. The development of such a system, a Surgical Picture Aquisition and Communication System (S-PACS), according the systems engineering cycle is oulined in this paper. The first two steps (concept and specification) for the engineering of the S-PACS are discussed.A method for the systematic integration of the users needs', the Quality Function Deployment (QFD), is presented. The properties of QFD for the underlying problem and first results are discussed. Finally, this leads to a first definition of an S-PACS system.
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.
Reducing start time delays in operating rooms
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
Factors related to teamwork performance and stress of operating room nurses.
Sonoda, Yukio; Onozuka, Daisuke; Hagihara, Akihito
2018-01-01
To evaluate operating room nurses' perception of teamwork performance and their level of mental stress and to identify related factors. Little is known about the factors affecting teamwork and the mental stress of surgical nurses, although the performance of the surgical team is essential for patient safety. The questionnaire survey for operation room nurses consisted of simple questions about teamwork performance and mental stress. Multivariate analyses were used to identify factors causing a sense of teamwork performance or mental stress. A large number of surgical nurses had a sense of teamwork performance, but 30-40% of operation room nurses were mentally stressed during surgery. Neither the patient nor the operation factors were related to the sense of teamwork performance in both types of nurses. Among scrub nurses, endoscopic and abdominal surgery, body mass index, blood loss and the American Society of Anesthesiologists physical status class were related to their mental stress. Conversely, circulating nurses were stressed about teamwork performance. The factors related to teamwork performance and mental stress during surgery differed between scrub and circulating nurses. Increased support for operation room nurses is necessary. The increased support leads to safer surgical procedures and better patient outcomes. © 2017 John Wiley & Sons Ltd.
The positive impact of structured teaching in the operating room.
Leung, Yee; Salfinger, Stuart; Mercer, Annette
2015-12-01
A survey of obstetric and gynaecology trainees in Australia found the trainee's opinion of the consultants' teaching ability for laparoscopic procedures and procedures dealing with complications as 'poor' in 21.2% and 23.4% of responses, respectively (Aust NZ J Obstet Gynaecol 2009; 49: 84). Surgical caseload per trainee is falling for a variety of reasons. Strategies need to be adopted to enhance the surgical learning experience of trainees in the operating room. We describe the use of a structured encounter template to facilitate the teaching of surgery in the operating room and report the response of the trainees to this intervention. Trainees attached to a gynaecologic surgery unit all underwent surgical training using a set format based on the surgical encounter template, including briefing, goal setting and intra-operative teaching aims as well as debriefing. Data on the trainees' experience and perception of their learning experience were then collected and analysed as quantitative and qualitative data sets. The trainees reported satisfaction with the use of a structured encounter template to facilitate the surgical teaching in the operating room. Some trainees had not received such clarity of feedback or the opportunity to complete a procedure independently prior to using the structured encounter template. A structured surgical encounter template based on andragogy principles to focus consultant teaching in the operating room is highly acceptable to obstetric and gynaecology trainees in Australia. Allowing the trainee the opportunity to set objectives and receive feedback empowers the trainee and enhances their educational experience. © 2015 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.
A Foot Operated Timeout Room Door Latch.
Foxx, R. M.; And Others
1982-01-01
This report describes the design and implementation of a foot operated timeout room door latch that permits staff members to maintain a misbehaving retarded individual in timeout without locking the door. Use of the latch also frees the staff member involved to record behavioral observations or reinforce appropriate behavior. (Author)
Time Management in the Operating Room: An Analysis of the Dedicated Minimally Invasive Surgery Suite
Hsiao, Kenneth C.; Machaidze, Zurab
2004-01-01
Background: Dedicated minimally invasive surgery suites are available that contain specialized equipment to facilitate endoscopic surgery. Laparoscopy performed in a general operating room is hampered by the multitude of additional equipment that must be transported into the room. The objective of this study was to compare the preparation times between procedures performed in traditional operating rooms versus dedicated minimally invasive surgery suites to see whether operating room efficiency is improved in the specialized room. Methods: The records of 50 patients who underwent laparoscopic procedures between September 2000 and April 2002 were retrospectively reviewed. Twenty-three patients underwent surgery in a general operating room and 18 patients in an minimally invasive surgery suite. Nine patients were excluded because of cystoscopic procedures undergone prior to laparoscopy. Various time points were recorded from which various time intervals were derived, such as preanesthesia time, anesthesia induction time, and total preparation time. A 2-tailed, unpaired Student t test was used for statistical analysis. Results: The mean preanesthesia time was significantly faster in the minimally invasive surgery suite (12.2 minutes) compared with that in the traditional operating room (17.8 minutes) (P=0.013). Mean anesthesia induction time in the minimally invasive surgery suite (47.5 minutes) was similar to time in the traditional operating room (45.7 minutes) (P=0.734). The average total preparation time for the minimally invasive surgery suite (59.6 minutes) was not significantly faster than that in the general operating room (63.5 minutes) (P=0.481). Conclusion: The amount of time that elapses between the patient entering the room and anesthesia induction is statically shorter in a dedicated minimally invasive surgery suite. Laparoscopic surgery is performed more efficiently in a dedicated minimally invasive surgery suite versus a traditional operating room. PMID
Psychological factors of professional success of nuclear power plant main control room operators
Directory of Open Access Journals (Sweden)
Kosenkov A.A.
2014-12-01
Full Text Available Aim: to conduct a comparative analysis of the psychological characteristics of the most and least successful main control room operators. Material and Methods. Two NPP staff groups: the most and least successful main control room operators, who worked in routine operating conditions, were surveyed. Expert evaluation method has been applied to identify the groups. The subjects were administered the Minnesota Multiphasic Personality Inventory (MMPI, Cattell's Sixteen Personality Factor Questionnaire (16PF form A and Raven's Progressive Matrices test. Results. Numerous significant psychological differences between the groups of most and least successful control room operators were obtained: the best operators were significantly more introverted and correctly solved more logical tasks with smaller percentage of mistakes under time pressure than worst ones. Conclusions: 1. The psychodiagnostic methods used in the study were adequate to meet research objective 2. Tendency to introversion, as well as developed the ability to solve logic problems undertime pressure, apparently, are important professional qualities for control room operators. These indicators should be considered in the process of psychological selection and professional guidance of nuclear power plant operators.
Empirical investigation of workloads of operators in advanced control rooms
International Nuclear Information System (INIS)
Kim, Yochan; Jung, Wondea; Kim, Seunghwan
2014-01-01
This paper compares the workloads of operators in a computer-based control room of an advanced power reactor (APR 1400) nuclear power plant to investigate the effects from the changes in the interfaces in the control room. The cognitive-communicative-operative activity framework was employed to evaluate the workloads of the operator's roles during emergency operations. The related data were obtained by analyzing the tasks written in the procedures and observing the speech and behaviors of the reserved operators in a full-scope dynamic simulator for an APR 1400. The data were analyzed using an F-test and a Duncan test. It was found that the workloads of the shift supervisors (SSs) were larger than other operators and the operative activities of the SSs increased owing to the computer-based procedure. From these findings, methods to reduce the workloads of the SSs that arise from the computer-based procedure are discussed. (author)
Effect of Resident Involvement on Operative Time and Operating Room Staffing Costs.
Allen, Robert William; Pruitt, Mark; Taaffe, Kevin M
The operating room (OR) is a major driver of hospital costs; therefore, operative time is an expensive resource. The training of surgical residents must include time spent in the OR, but that experience comes with a cost to the surgeon and hospital. The objective of this article is to determine the effect of surgical resident involvement in the OR on operative time and subsequent hospital labor costs. The Kruskal-Wallis statistical test is used to determine whether or not there is a difference in operative times between 2 groups of cases (with residents and without residents). This difference leads to an increased cost in associated hospital labor costs for the group with the longer operative time. Cases were performed at Greenville Memorial Hospital. Greenville Memorial Hospital is part of the larger healthcare system, Greenville Health System, located in Greenville, SC and is a level 1 trauma center with up to 33 staffed ORs. A total of 84,997 cases were performed at the partnering hospital between January 1st, 2011 and July 31st, 2015. Cases were only chosen for analysis if there was only one CPT code associated with the case and there were more than 5 observations for each group being studied. This article presents a comprehensive retrospective analysis of 29,134 cases covering 246 procedures. The analysis shows that 45 procedures took significantly longer with a resident present in the room. The average increase in operative time was 4.8 minutes and the cost per minute of extra operative time was determined to be $9.57 per minute. OR labor costs at the partnering hospital was found to be $2,257,433, or $492,889 per year. Knowing the affect on operative time and OR costs allows managers to make smart decisions when considering alternative educational and training techniques. In addition, knowing the connection between residents in the room and surgical duration could help provide better estimates of surgical time in the future and increase the predictability of
Xiang, Wei; Yin, Jiao; Lim, Gino
2015-02-01
Operating room (OR) surgery scheduling determines the individual surgery's operation start time and assigns the required resources to each surgery over a schedule period, considering several constraints related to a complete surgery flow and the multiple resources involved. This task plays a decisive role in providing timely treatments for the patients while balancing hospital resource utilization. The originality of the present study is to integrate the surgery scheduling problem with real-life nurse roster constraints such as their role, specialty, qualification and availability. This article proposes a mathematical model and an ant colony optimization (ACO) approach to efficiently solve such surgery scheduling problems. A modified ACO algorithm with a two-level ant graph model is developed to solve such combinatorial optimization problems because of its computational complexity. The outer ant graph represents surgeries, while the inner graph is a dynamic resource graph. Three types of pheromones, i.e. sequence-related, surgery-related, and resource-related pheromone, fitting for a two-level model are defined. The iteration-best and feasible update strategy and local pheromone update rules are adopted to emphasize the information related to the good solution in makespan, and the balanced utilization of resources as well. The performance of the proposed ACO algorithm is then evaluated using the test cases from (1) the published literature data with complete nurse roster constraints, and 2) the real data collected from a hospital in China. The scheduling results using the proposed ACO approach are compared with the test case from both the literature and the real life hospital scheduling. Comparison results with the literature shows that the proposed ACO approach has (1) an 1.5-h reduction in end time; (2) a reduction in variation of resources' working time, i.e. 25% for ORs, 50% for nurses in shift 1 and 86% for nurses in shift 2; (3) an 0.25h reduction in
Directory of Open Access Journals (Sweden)
Guangwei Zhou
2012-01-01
Full Text Available Objectives. To review our experience of conducting auditory brainstem response (ABR test on children in the operating room and discuss the benefits versus limitations of this practice. Methods. Retrospective review study conducted in a pediatric tertiary care facility. A total of 267 patients identified with usable data, including ABR results, medical and surgical notes, and follow-up evaluation. Results. Hearing status successfully determined in all patients based on the ABR results form the operating room. The degrees and the types of hearing loss also documented in most of the cases. In addition, multiple factors that may affect the outcomes of ABR in the operating room identified. Conclusions. Hearing loss in children with complicated medical issues can be accurately evaluated via ABR testing in the operating room. Efforts should be made to eliminate adverse factors to ABR recording, and caution should be taken when interpreting ABR results from the operating room.
Azzi, Alain Joe; Shah, Karan; Seely, Andrew; Villeneuve, James Patrick; Sundaresan, Sudhir R; Shamji, Farid M; Maziak, Donna E; Gilbert, Sebastien
2016-05-01
Health care resources are costly and should be used judiciously and efficiently. Predicting the duration of surgical procedures is key to optimizing operating room resources. Our objective was to identify factors influencing operative time, particularly surgical team turnover. We performed a single-institution, retrospective review of lobectomy operations. Univariate and multivariate analyses were performed to evaluate the impact of different factors on surgical time (skin-to-skin) and total procedure time. Staff turnover within the nursing component of the surgical team was defined as the number of instances any nurse had to leave the operating room over the total number of nurses involved in the operation. A total of 235 lobectomies were performed by 5 surgeons, most commonly for lung cancer (95%). On multivariate analysis, percent forced expiratory volume in 1 second, surgical approach, and lesion size had a significant effect on surgical time. Nursing turnover was associated with a significant increase in surgical time (53.7 minutes; 95% confidence interval, 6.4-101; P = .026) and total procedure time (83.2 minutes; 95% confidence interval, 30.1-136.2; P = .002). Active management of surgical team turnover may be an opportunity to improve operating room efficiency when the surgical team is engaged in a major pulmonary resection. Copyright © 2016 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.
[Integrate the surgical hand disinfection as a quality indicator in an operating room of urology].
Francois, M; Girard, R; Mauranne, C C; Ruffion, A; Terrier, J E
2017-12-01
The surgical hand disinfection by friction (SDF) helps to reduce the risk of surgical site infections. For this purpose and in order to promote good compliance to quality care, the urology service of Centre Hospitalier Lyon Sud achieved a continuous internal audit to improve the quality of the SDF. An internal audit executed by the medical students of urology was established in 2013. The study population was all operators, instrumentalists and operating aids of urology operating room (OR). Each student realized 5-10 random observations, of all types of professionals. The criteria measured by the audit were criteria for friction. The evolution of indicators was positive. Particularly, the increasing duration of the first and second friction was statistically significant during follow-up (P=0.001). The total duration of friction shows a similar trend for all professionals. The surgical hand disinfection by friction in the urology OR of the Centre Hospitalier Lyon Sud has gradually improved over the iterative audits. Copyright © 2017 Elsevier Masson SAS. All rights reserved.
Game theoretic approaches to operating room management.
Marco, Alan P
2002-05-01
All interactions between people can be considered games with rules and outcomes. However, modern business practices demand that the players in the game go beyond traditional game theory and look at new ways to improve the outcome of the game. Choosing the right strategy is important to a player's success. A new business strategy, "co-opetition," can be used to increase the value of the game ("create a bigger pie") through cooperative behavior, whereas competition is used to divided the "pie." By looking at how the players adopt simultaneous roles such as complementor and competitor the stakeholders in the operating room (managers, surgeons, anesthesiologists, and nursing staff) can apply the principles of co-opetition to improve the overall success of their facility. Such stakeholders can utilize knowledge of how populations act in games to enhance cooperative play. Adopting such a perspective may lead to increases in the satisfaction and morale of those involved with the operating rooms. Increased morale should increase productivity and staff retention and reduce recruiting needs.
National Research Council Canada - National Science Library
Amsink, William L
2005-01-01
.... This study describes the inefficient use of the current operating room management software system, and identifies strategies to improve operating room efficiency by analyzing the most common causes...
Wang, Rongmei; Shi, Nianke; Bai, Jinbing; Zheng, Yaguang; Zhao, Yue
2015-07-09
The present study was designed to implement an interprofessional simulation-based education program for nursing students and evaluate the influence of this program on nursing students' attitudes toward interprofessional education and knowledge about operating room nursing. Nursing students were randomly assigned to either the interprofessional simulation-based education or traditional course group. A before-and-after study of nursing students' attitudes toward the program was conducted using the Readiness for Interprofessional Learning Scale. Responses to an open-ended question were categorized using thematic content analysis. Nursing students' knowledge about operating room nursing was measured. Nursing students from the interprofessional simulation-based education group showed statistically different responses to four of the nineteen questions in the Readiness for Interprofessional Learning Scale, reflecting a more positive attitude toward interprofessional learning. This was also supported by thematic content analysis of the open-ended responses. Furthermore, nursing students in the simulation-based education group had a significant improvement in knowledge about operating room nursing. The integrated course with interprofessional education and simulation provided a positive impact on undergraduate nursing students' perceptions toward interprofessional learning and knowledge about operating room nursing. Our study demonstrated that this course may be a valuable elective option for undergraduate nursing students in operating room nursing education.
The development of a mobile CT-scanner gantry for use in the operating room
International Nuclear Information System (INIS)
Okudera, Hiroshi; Kobayashi, Shigeaki; Koike, Jouji; Harada, Takanobu; Kanemaru, Kei
1989-01-01
We report the development of a mobile CT-scanner gantry which uses a gantry platter. This system has been developed for use in the operating room. We designed a small lift to move the gantry unit of the scanner: the gantry carrier. The scanner gantry is fixed to the gantry carrier. A phantom test with a digitalized operating table worked well in the laboratory, and operating-room use showed that there was no deterioration in image quality. The mobile gantry system has been developed to increase the efficiency of the operating CT-scanner system. This system enables us to obtain CT images during surgery of immediately after surgery in the operating room, i.e., in cases that are not transferable to the radiological department. The operability is basically the same as that of a conventional mobile X-ray unit. Theoretically, this unit could be used with any CT scanner and in any operating room. (author)
Directory of Open Access Journals (Sweden)
Şeyda Gür
2018-01-01
Full Text Available Increased healthcare costs are pushing hospitals to reduce costs and increase the quality of care. Operating rooms are the most important source of income and expense for hospitals. Therefore, the hospital management focuses on the effectiveness of schedules and plans. This study includes analyses of recent research on operating room scheduling and planning. Most studies in the literature, from 2000 to the present day, were evaluated according to patient characteristics, performance measures, solution techniques used in the research, the uncertainty of the problem, applicability of the research, and the planning strategy to be dealt within the solution. One hundred seventy studies were examined in detail, after scanning the Emerald, Science Direct, JSTOR, Springer, Taylor and Francis, and Google Scholar databases. To facilitate the identification of these studies, they are grouped according to the different criteria of concern and then, a detailed overview is presented.
Operating Room Delays: Meaningful Use in Electronic Health Record.
Van Winkle, Rachelle A; Champagne, Mary T; Gilman-Mays, Meri; Aucoin, Julia
2016-06-01
Perioperative areas are the most costly to operate and account for more than 40% of expenses. The high costs prompted one organization to analyze surgical delays through a retrospective review of their new electronic health record. Electronic health records have made it easier to access and aggregate clinical data; 2123 operating room cases were analyzed. Implementing a new electronic health record system is complex; inaccurate data and poor implementation can introduce new problems. Validating the electronic health record development processes determines the ease of use and the user interface, specifically related to user compliance with the intent of the electronic health record development. The revalidation process after implementation determines if the intent of the design was fulfilled and data can be meaningfully used. In this organization, the data fields completed through automation provided quantifiable, meaningful data. However, data fields completed by staff that required subjective decision making resulted in incomplete data nearly 24% of the time. The ease of use was further complicated by 490 permutations (combinations of delay types and reasons) that were built into the electronic health record. Operating room delay themes emerged notwithstanding the significant complexity of the electronic health record build; however, improved accuracy could improve meaningful data collection and a more accurate root cause analysis of operating room delays. Accurate and meaningful use of data affords a more reliable approach in quality, safety, and cost-effective initiatives.
A work process and information flow description of control room operations
International Nuclear Information System (INIS)
Davey, E.; Matthews, G.
2007-01-01
The control room workplace is the location from which all plant operations are supervised and controlled on a shift-to-shift basis. The activities comprising plant operations are structured into a number of work processes, and information is the common currency that is used to convey work requirements, communicate business and operating decisions, specify work practice, and describe the ongoing plant and work status. This paper describes the motivation for and early experience with developing a work process and information flow model of CANDU control room operations, and discusses some of the insights developed from model examination that suggest ways in which changes in control centre work specification, organization of resources, or asset layout could be undertaken to achieve operational improvements. (author)
[Controlling systems for operating room managers].
Schüpfer, G; Bauer, M; Scherzinger, B; Schleppers, A
2005-08-01
Management means developing, shaping and controlling of complex, productive and social systems. Therefore, operating room managers also need to develop basic skills in financial and managerial accounting as a basis for operative and strategic controlling which is an essential part of their work. A good measurement system should include financial and strategic concepts for market position, innovation performance, productivity, attractiveness, liquidity/cash flow and profitability. Since hospitals need to implement a strategy to reach their business objectives, the performance measurement system has to be individually adapted to the strategy of the hospital. In this respect the navigation system developed by Gälweiler is compared to the "balanced score card" system of Kaplan and Norton.
Local Exhaust Efficiency in an Operating Room Ventilated by Horizontal Unidirectional Airflow
DEFF Research Database (Denmark)
Brohus, Henrik; Balling, K. D.; Jeppesen, D.
2004-01-01
The paper examines the efficiency of a local exhaust applied during an orthopaedic surgical operation. During operations performing hip replacements bone cement is sometimes applied to fasten the new metal hip to the existing thighbone, especially in case of elderly patients. The bone cement emits...... harmful VOCs that may influence the operating room personnel and the patient. A local exhaust is applied to reduce the VOC concentration in the operating room air, however, apparently without success. The aim is to assess the efficiency of the existing solution and to provide an alternative and better...
Environmental Protection Agency, Research Triangle Park, NC. Air Pollution Training Inst.
This Operator's Manual is a supplement to a self-instructional course prepared for the United States Environmental Protection Agency. This publication is the Boiler Room Handbook for operating and maintaining the boiler and the boiler room. As the student completes this handbook, he is putting together a manual for running his own boiler. The…
Energy Technology Data Exchange (ETDEWEB)
Husum, B; Niebuhr, E; Wulf, H C; Norgaard, I
1983-06-01
Information on possible chromosomal damage in humans after long-term exposure to trace concentrations of waste anaesthetic gases is scarce. We examined peripheral lymphocytes in operating room personnel for both chromosome aberrations and sister chromatid exchanges (SCE). Following a standardized procedure of cultivation and staining, 30 cells from each person were scored for SCE and 100 cells from each person were examined for chromosome aberrations. A total of 45 persons were examined, representing anaesthetists (n . 15), operating room nurses assisting the surgeon (n . 10), nurses circulating in the operating room (n . 8) and healthy, unexposed controls (n . 12). The median duration of working in the operating room was 102 months, respectively. Time-weighted concentration levels of 2.5-4.3 p.p.m. of halothane and 25-400 p.p.m. of nitrous oxide were measured in the breathing zones of the anaesthetists during mask anaesthesia. Examination of SCE and chromosome aberrations yielded corresponding qualitative results. With both tests, no statistically significant difference was observed between the four groups of persons. It was concluded that by examination of both SCE and chromosome aberrations in peripheral lymphocytes in operating room personnel, no indication was found of a mutagenic effect of long-term exposure to trace concentrations of waste anaesthetic gases.
The development of a model of control room operator cognition
International Nuclear Information System (INIS)
Harrison, C. Felicity
1998-01-01
The nuclear generation station CRO is one of the main contributors to plant performance and safety. In the past, studies of operator behaviour have been made under emergency or abnormal situations, with little consideration being given to the more routine aspects of plant operation. One of the tasks of the operator is to detect the early signs of a problem, and to take steps to prevent a transition to an abnormal plant state. In order to do this CRO must determine that plant indications are no longer in the normal range, and take action to prevent a further move away from normal. This task is made more difficult by the extreme complexity of the control room, and by the may hindrances that the operator must face. It would therefore be of great benefit to understand CRO cognitive performance, especially under normal operating conditions. Through research carried out at several Canadian nuclear facilities we were able to develop a deeper understanding of CRO monitoring of highly automated systems during normal operations, and specifically to investigate the contributions of cognitive skills to monitoring performance. The consultants were asked to develop a deeper understanding of CRO monitoring during normal operations, and specifically to investigate the contributions of cognitive skills to monitoring performance. The overall objective of this research was to develop and validate a model of CRO monitoring. The findings of this research have practical implications for systems integration, training, and interface design. The result of this work was a model of operator monitoring activities. (author)
Can efficient supply management in the operating room save millions?
Park, Kyung W; Dickerson, Cheryl
2009-04-01
Supply expenses occupy an ever-increasing portion of the expense budget in today's increasingly technologically complex operating rooms. Yet, little has been studied and published in the anesthesia literature. This review attempts to bring the topic of supply management to anesthesiologists, who play a significant role in operating room management. Little investigative work has been performed on supply management. Anecdotal reports suggest the benefits of a perpetual inventory system over a periodic inventory system. A perpetual inventory system uses utilization data to update inventory on hand continually and this information is linked to purchasing and restocking, whereas a periodic inventory system counts inventory at some regular intervals (such as annually) and uses average utilization to set par levels. On the basis of application of operational management concepts, ways of taking advantage of a perpetual inventory system to achieve savings in supply expenses are outlined. These include linking the operating room scheduling and supply order system, distributor-driven just-in-time delivery of case carts, continual updating of preference lists based on utilization patterns, increasing inventory turnovers, standardizing surgical practices, and vendor consignment of high unit-cost items such as implants. In addition, Lean principles of visual management and elimination of eight wastes may be applicable to supply management.
Safety culture in the gynecology robotics operating room.
Zullo, Melissa D; McCarroll, Michele L; Mendise, Thomas M; Ferris, Edward F; Roulette, G D; Zolton, Jessica; Andrews, Stephen J; von Gruenigen, Vivian E
2014-01-01
To measure the safety culture in the robotics surgery operating room before and after implementation of the Robotic Operating Room Computerized Checklist (RORCC). Prospective study. Gynecology surgical staff (n = 32). An urban community hospital. The Safety Attitudes Questionnaire domains examined were teamwork, safety, job satisfaction, stress recognition, perceptions of management, and working conditions. Questions and domains were described using percent agreement and the Cronbach alpha. Paired t-tests were used to describe differences before and after implementation of the checklist. Mean (SD) staff age was 46.7 (9.5) years, and most were women (78%) and worked full-time (97%). Twenty respondents (83% of nurses, 80% of surgeons, 66% of surgical technicians, and 33% of certified registered nurse anesthetists) completed the Safety Attitudes Questionnaire; 6 were excluded because of non-matching identifiers. Before RORCC implementation, the highest quality of communication and collaboration was reported by surgeons and surgical technicians (100%). Certified registered nurse anesthetists reported only adequate levels of communication and collaboration with other positions. Most staff reported positive responses for teamwork (48%; α = 0.81), safety (47%; α = 0.75), working conditions (37%; α = 0.55), stress recognition (26%; α = 0.71), and perceptions of management (32%; α = 0.52). No differences were observed after RORCC implementation. Quality of communication and collaboration in the gynecology robotics operating room is high between most positions; however, safety attitude responses are low overall. No differences after RORCC implementation and low response rates may highlight lack of staff support. Copyright © 2014. Published by Elsevier Inc.
Mobile devices in the operating rooms: intended and unintended consequences for nurses’ work
Sergeeva, A.; Aij, K.H.; van den Hooff, B.J.; Huysman, M.H.
2016-01-01
This article reports the results of a case study of the consequences of mobile device use for the work practices of operating room nurses. The study identifies different patterns of mobile technology use by operating room nurses, including both work-related and non-work-related use. These patterns
Risks and health effects in operating room personnel
van den Berg-Dijkmeijer, Marleen L.; Frings-Dresen, Monique H. W.; Sluiter, Judith K.
2011-01-01
The objective was to find the factors that pose a possible health risk to OR personnel. Work-related health problems of operating room (OR) personnel were signalled by an occupational physician and preparations for the development of new Worker's Health Surveillance (WHS) were started with a
Nuclear power plant control room operator control and monitoring tasks
International Nuclear Information System (INIS)
Bovell, C.R.; Beck, M.G.; Carter, R.J.
1998-01-01
Oak Ridge National Laboratory is conducting a research project the purpose of which is to develop the technical bases for regulatory review criteria for use in evaluating the safety implications of human factors associated with the use of artificial intelligence and expert systems, and with advanced instrumentation and control (I and C) systems in nuclear power plants (NPP). This report documents the results from Task 8 of that project. The primary objectives of the task was to identify the scope and type of control and monitoring tasks now performed by control-room operators. Another purpose was to address the types of controls and safety systems needed to operate the nuclear plant. The final objective of Task 8 was to identify and categorize the type of information and displays/indicators required to monitor the performance of the control and safety systems. This report also discusses state-of-the-art controls and advanced display devices which will be available for use in control-room retrofits and in control room of future plants. The fundamental types of control and monitoring tasks currently conducted by operators can be divided into four classifications: function monitoring tasks, control manipulation tasks, fault diagnostic tasks, and administrative tasks. There are three general types of controls used in today's NPPs, switches, pushbuttons, and analog controllers. Plant I and C systems include components to achieve a number of safety-related functions: measuring critical plant parameters, controlling critical plant parameters within safety limits, and automatically actuating protective devices if safe limits are exceeded. The types of information monitored by the control-room operators consist of the following parameters: pressure, fluid flow and level, neutron flux, temperature, component status, water chemistry, electrical, and process and area radiation. The basic types of monitoring devices common to nearly all NPP control rooms include: analog meters
Response Times of Operators in a Control Room
DEFF Research Database (Denmark)
Platz, O.; Rasmussen, Jens; Skanborg, Preben Zacho
A statistical analysis was made of operator response times recorded in the control room of a research reactor during the years 1972-1974. A homogeneity test revealed that the data consist of a mixture of populations. A small but statistically significant difference is found between day and night...
Wind energy and power system operations: a review of wind integration studies to date
Energy Technology Data Exchange (ETDEWEB)
Cesaro, Jennifer de; Porter, Kevin; Milligan, Michael
2009-12-15
Wind integration will not be accomplished successfully by doing ''more of the same.'' It will require significant changes in grid planning and operations, continued technical evolution in the design and operation of wind turbines, further adoption and implementation of wind forecasting in the control room, and incorporation of market and policy initiatives to encourage more flexible generation. (author)
Ergonomic relationship during work in nursing staff of intensive care unit with operating room
Directory of Open Access Journals (Sweden)
Yousef Mahmoudifar
2017-01-01
Full Text Available Background and Objectives: High prevalence of work-related musculoskeletal disorders, especially in jobs such as nursing which covers tasks like patients' repositioning, has attracted great attentions from occupational healthcare experts to necessitate the knowledge of ergonomic science. Therefore, this study was performed aiming at ergonomic relationship during work in nursing staff of Intensive Care Unit (ICU with operating room. Materials and Methods: In this descriptive-analytical study (cohort, fifty personnel of ICU staff and fifty of operating room staff were selected through a census method and were assessed using tools such as Nordic questionnaire and Rapid Entire Body Assessment (REBA standards in terms of body posture ergonomics. The obtained data were analyzed by SPSS software and Chi-Square test after collection. Results: The most complaints were from the operating room group (68% and ICU staff (60% for the lumbar musculoskeletal system. There was a significant relationship between the total REBA scores of body, legs, neck, arm, force status, load fitting with hands and static or dynamic activities in the operating room and ICU staff groups (P < 0.05. In operating room and ICU groups, most subjects obtained score 11–15 and very high-risk level. Conclusion: Nurses working at operating room and ICU ward are subjected to high-risk levels and occupational injuries which is dramatically resulted from inappropriate body posture or particular conditions of their works. As a result, taking corrective actions along with planning and identifying ways will help prohibiting the prevalence of disorders in the future.
Control-room operator alertness and performance in nuclear power plants
International Nuclear Information System (INIS)
Baker, T.l.; Campbell, S.C.; Linder, K.D.; Moore-Ede, M.C
1990-02-01
All industries requiring round-the-clock operation must deal with the potential problem of impaired alertness, especially among those who work night shifts. In the nuclear power industry, maintaining optimal alertness and performance of control room operators at all times of day is critical. Many of the toot causes of reduced alertness are straightforward and can be easily remedied with tangible solutions; this manual both discusses the reasons for the problem and suggests solutions. The manual surveys factors that influence operator alertness and performance, including shift schedules, caffeine and alcohol use, diet and family lifestyle factors, the control room enviornment, staffing and overtime practices, and work task design. Specific recommendations are made in each of these areas. The project team, consisting of experts on managing round-the-clock operations and scientists who study human alertness and performance, prepared this manual using the latest scientific research and direct input from shift supervisors and operators via interviews, on-site observation, and questionnaires distributed to every nuclear power station. The material contained within is relevant to shiftwork managers, shift supervisors, and operators, each of whom plays a vital role in maintaining optimal alertness and performance on the job. 90 refs., 35 figs
Rogers, David A; Lingard, Lorelei; Boehler, Margaret L; Espin, Sherry; Schindler, Nancy; Klingensmith, Mary; Mellinger, John D
2013-09-01
Prior research has shown that surgeons who effectively manage operating room conflict engage in a problem-solving stage devoted to modifying systems that contribute to team conflict. The purpose of this study was to clarify how systems contributed to operating room team conflict and clarify what surgeons do to modify them. Focus groups of circulating nurses and surgeons were conducted at 5 academic medical centers. Narratives describing the contributions of systems to operating room conflict and behaviors used by surgeons to address those systems were analyzed using the constant comparative approach associated with a constructivist grounded theory approach. Operating room team conflict was affected by 4 systems-related factors: team features, procedural-specific staff training, equipment management systems, and the administrative leadership itself. Effective systems problem solving included advocating for change based on patient safety concerns. The results of this study provide clarity about how systems contribute to operating room conflict and what surgeons can do to effectively modify these systems. This information is foundational material for a conflict management educational program for surgeons. Copyright © 2013 Elsevier Inc. All rights reserved.
A novel interactive educational system in the operating room--the IE system.
Nakayama, Takayuki; Numao, Noboru; Yoshida, Soichiro; Ishioka, Junichiro; Matsuoka, Yoh; Saito, Kazutaka; Fujii, Yasuhisa; Kihara, Kazunori
2016-02-02
The shortage of surgeon is one of the serious problems in Japan. To solve the problem, various efforts have been undertaken to improve surgical education and training. However, appropriate teaching methods in the operating room have not been well established. The aim of this study is to assess the utility of a novel interactive educational (IE) system for surgical education on urologic surgeries in the operating room. A total of 20 Japanese medical students were educated on urologic surgery using the IE system in the operating room. The IE system consists of two parts. The first is three-dimensional (3D) magnified vision of the operative field using a 3D head-mounted display and a 3D endoscope. The second is interactive educative communication between medical students and surgeons using a small-sized wireless communication device. The satisfaction level with the IE system and the physical burden on medical students was examined via questionnaire. All students utilized the IE system in urologic surgery and responded to the survey. Most students were satisfied with the IE system. They also felt more welcomed by the surgeon when using the IE system than when not using it. No major unpleasant symptoms were observed but five students (25 %) experienced mild eye fatigue as a result of viewing the medical images. The IE system has the potential to motivate students to become interested in surgery and could be an efficient method of surgical education in the operating room.
Issues of integrating high-tech concepts into nuclear power plant operation
International Nuclear Information System (INIS)
Kisner, R.A.; Carter, R.J.; Lindsay, R.W.
1990-01-01
The stockpile of new ideas continues to grow for monitoring nuclear power plant parameters, characteristics, and vital signs and for controlling systems, subsystems, and components. This wide selection of monitoring and control software increases the difficulty of designing an integrated control room. As plant control room operators increase their reliance on computerized systems, including real-time plant data and data base systems, the integration of monitoring, diagnostics, and control software into uniform and seamless environment becomes imperative. A systematic approach to evaluating the usefulness of such high-tech control concepts is needed. This paper concentrates on methods to evaluate control concepts by assessing factors that determine a system's potential effectiveness within the context of the overall environment, including both human and machine components. Although not an in-depth study, this paper serves to outline several measures of utility. 21 refs., 3 figs., 2 tabs
Panni, M K; Shah, S J; Chavarro, C; Rawl, M; Wojnarwsky, P K; Panni, J K
2013-10-01
There are multiple components leading to improved operating room efficiency. We undertook a project focusing on first case starts; accounting for each delay component on a global basis. Our hypothesis was there would be a reduction in first start delays after we implemented strategies to address the issues identified through this accounting process. An orange sheet checklist was implemented, with specific items that needed to be clear prior to roll back to the operating room (OR), and an OR facilitator was employed to intervene whenever there were any missing items needed for a specific patient. We present the data from this quality improvement project over an 18-month period. Initially, 10.07 (± 0.73) delayed first starts occurred per day but declined steadily over time to a low of 4.95 (± 0.38) per day after 6 months (-49.2 %, P < 0.001). By the end of the project, the most common reasons for delay still included late surgical attending (19%), schedule changes (14%) as well as 'other reasons' (13%), but with an overall reduction per day of each. Total anaesthesia delay initially totalled 11% of the first start delays, but was negligible (< 1%) at the project's completion. While we have a challenging operating room environment based on our patient population, multiple trainees in both the surgery and anaesthesiology teams: an orange sheet - pre-operative checklist in addition to a dedicated pre-operative facilitator; allowed us to make a substantial improvement in our first start on time starts. © 2013 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.
Guidelines for control room design reviews
International Nuclear Information System (INIS)
1981-09-01
whether the control room provides the system status information, control capabilities, feedback, and analytic aids necessary for control room operators to accomplish their functions effectively. To identify characteristics of the existing control room instrumentation, controls, other equipment, and physical arrangements that may detract from operator performance. o analyze and evaluate the problems that could arise from discrepancies of the above kinds, and to analyze means of correcting those discrepancies which could lead to substantial problems. To define and put into effect a plan of action that applies human factors principles to improve control room design and enhance operator effectiveness. Particular emphasis should be placed on improvements affecting control room design and operator performance under abnormal or emergency conditions. To integrate the control room design review with other areas of human factors inquiry identified in the NRC Task Action Plan
Facets of operational performance in an emergency room (ER)
van der Vaart, Taco; Vastag, Gyula; Wijngaard, Jacob
This paper, using detailed time measurements of patients complemented by interviews with hospital management and staff, examines three facets of an emergency room's (ER) operational performance: (1) effectiveness of the triage system in rationing patient treatment; (2) factors influencing ER's
The development of an advanced computerised control room
International Nuclear Information System (INIS)
Haugset, K.
1988-01-01
Control room improvements by use of computer technology is a major activity within the OECD Halden Reactor Project. The goal is to improve operational efficiency and safety by supplying the operator with the information relevant for the specific operational situation, assisting him both in identifying plant state, plan operational strategies and implement such plans. The research activity consists of development of specific operator support systems, validation of such systems under realistic conditions and integration under the scope of an advanced control room concept. The work is carried out in close cooperation with the many member organisations. (author) 2 figs., 8 refs
Crew resource management: using aviation techniques to improve operating room safety.
Ricci, Michael A; Brumsted, John R
2012-04-01
Since the publication of the Institute of Medicine report estimating nearly 100,000 deaths per year from medical errors, hospitals and physicians have a renewed focus upon error reduction. We implemented a surgical crew resource management (CRM) program for all operating room (OR) personnel. In our academic medical center, 19,000 procedures per year are performed in 27 operating rooms. Mandatory CRM training was implemented for all peri-operative personnel. Aviation techniques introduced included a pre-operative checklist and brief, post-operative debrief, read and initial files, and various other aviation-based techniques. Compliance with conduct of the brief/debrief was monitored as well as wrong-site surgeries and retained foreign body events. The malpractice insurance database for claims was also queried for the period prior to and after training. Initial training was accomplished for 517 people, including all anesthesiologists, surgeons, nurses, technicians, and OR assistants. Pre-operative briefing increased from 6.7 to 99% within 4 mo. Wrong site surgeries and retained foreign bodies decreased from a high of seven in 2007 to none in 2008, but, after 14 mo without additional training, these rose to five in 2009. Malpractice expenses (payouts and legal fees) totaled $793,000 (2003-2007), but have been zero since 2008. CRM training and implementation had an impact on reducing the incidence of wrong site surgery and retained foreign bodies in our operating rooms. However, constant reinforcement and refresher training is necessary for sustained results. Though no one technique can prevent all errors, CRM can effect culture change, producing a safer environment.
Heiner, Jeremy S.
2013-01-01
Student registered nurse anesthetists are an important part of an operating room team, yet little research has investigated how they perceive teamwork or approach team related issues specific to the operating room. This mixed methods study evaluated junior and senior student registered nurse anesthetists' attitudes toward and perceptions of…
Managing rumor and gossip in operating room settings.
Blakeley, J A; Ribeiro, V; Hughes, A
1996-07-01
The unique features of the operating room (OR) make it an ideal setting for the proliferation of gossip and rumor. Although not always negative, these "grapevine" communications can reduce productivity and work satisfaction. Hence, OR managers need to understand these forms of communication and prevent or control their negative consequences. The authors offer suggestions for undertaking this challenge.
NKA/KRU project on operator training, control room designing and human reliability. Summary report
International Nuclear Information System (INIS)
1981-06-01
A Nordic integrated project on human reliability in the conditions of new advanced technology seeks to establish: - The actual repertoire of activities and tasks performed by the operating staff of a nuclear power plant and its dependence on the present and future levels of automation. - The knowledge required for these activities and appropriate means for training plant operators and for competence evaluation and retraining in coping with the rare events. - Models of human operator performance; how do operators read information and make decisions under normal and abnormal plant conditions and how does their performance depend upon control room design. - The typical limits of human capabilities and mechanisms of human errors as they are represented in existing records of incidents and accidents in industrial plants. - The use of process computers for improved design of data presentation and operator support systems, especially for disturbance analysis and diagnosis during infrequent plant disturbance. - Development of experimental techniques to validate research results and proposals for improved man/machine interfaces and other computer-based support systems. (EG)
International Nuclear Information System (INIS)
Passos, J.C.
1987-01-01
The adequate operation conditions of a dark-room are essential to guarantee the image quality, the least exposure of the patient and the staff, contributing also to reduce the expenses with specific equipments and processing solutions. Therefore, to install a dark-room, it is necessary a previous study about its physical dimensions, the location of equipments, accessories, light safeguards and visual warning, besides adequate darkening and correct filme processing. We propose three basic tests to check the adequacy and the integrity of a dark-room: light safeguards test, hygiene test, developing time and temperature test. (Author) [pt
Red-light-emitting laser diodes operating CW at room temperature
Kressel, H.; Hawrylo, F. Z.
1976-01-01
Heterojunction laser diodes of AlGaAs have been prepared with threshold current densities substantially below those previously achieved at room temperature in the 7200-8000-A spectral range. These devices operate continuously with simple oxide-isolated stripe contacts to 7400 A, which extends CW operation into the visible (red) portion of the spectrum.
Patient safety in the operating room: an intervention study on latent risk factors
Directory of Open Access Journals (Sweden)
van Beuzekom Martie
2012-06-01
Full Text Available Abstract Background Patient safety is one of the greatest challenges in healthcare. In the operating room errors are frequent and often consequential. This article describes an approach to a successful implementation of a patient safety program in the operating room, focussing on latent risk factors that influence patient safety. We performed an intervention to improve these latent risk factors (LRFs and increase awareness of patient safety issues amongst OR staff. Methods Latent risk factors were studied using a validated questionnaire applied to the OR staff before and after an intervention. A pre-test/post-test control group design with repeated measures was used to evaluate the effects of the interventions. The staff from one operating room of an university hospital acted as the intervention group. Controls consisted of the staff of the operating room in another university hospital. The outcomes were the changes in LRF scores, perceived incident rate, and changes in incident reports between pre- and post-intervention. Results Based on pre-test scores and participants’ key concerns about organizational factors affecting patient safety in their department the intervention focused on the following LRFs: Material Resources, Training and Staffing Recourses. After the intervention, the intervention operating room - compared to the control operating room - reported significantly fewer problems on Material Resources and Staffing Resources and a significantly lower score on perceived incident rate. The contribution of technical factors to incident causation decreased significantly in the intervention group after the intervention. Conclusion The change of state of latent risk factors can be measured using a patient safety questionnaire aimed at these factors. The change of the relevant risk factors (Material and Staffing resources concurred with a decrease in perceived and reported incident rates in the relevant categories. We conclude that
Red-light-emitting laser diodes operating cw at room temperature
International Nuclear Information System (INIS)
Kressel, H.; Hawrylo, F.Z.
1976-01-01
Heterojunction laser diodes of AlGaAs have been prepared with threshold current densities substantially below those previously achieved at room temperature in the 7200 to 8000-A spectral range. These devices operate cw with simple oxide-isolated stripe contacts to 7400 A, which extends cw operation for the first time into the visible (red) portion of the spectrum
Energy Technology Data Exchange (ETDEWEB)
Jones, Lawrence E. [Alstom Grid Inc., Washington, DC (United States)
2011-11-01
This report provides findings from the field regarding the best ways in which to guide operational strategies, business processes and control room tools to support the integration of renewable energy into electrical grids.
Resident Autonomy in the Operating Room: Expectations Versus Reality.
Meyerson, Shari L; Sternbach, Joel M; Zwischenberger, Joseph B; Bender, Edward M
2017-09-01
There is concern about graduating thoracic trainees' independent operative skills due to limited autonomy in training. This study compared faculty and trainee expected levels of autonomy with intraoperative measurements of autonomy for common cardiothoracic operations. Participants underwent frame-of-reference training on the 4-point Zwisch scale of operative autonomy (show and tell → active help → passive help → supervision only) and evaluated autonomy in actual cases using the Zwisch Me!! mobile application. A separate "expected autonomy" survey elicited faculty and resident perceptions of how much autonomy a resident should have for six common operations: decortication, wedge resection, thoracoscopic lobectomy, coronary artery bypass grafting, aortic valve replacement, and mitral valve repair. Thirty-three trainees from 7 institutions submitted evaluations of 596 cases over 18 months (March 2015 to September 2016). Thirty attendings subsequently provided their evaluation of 476 of those cases (79.9% response rate). Expected autonomy surveys were completed by 21 attendings and 19 trainees from 5 institutions. The six operations included in the survey constituted 47% (226 of 476) of the cases evaluated. Trainee and attending expectations did not differ significantly for senior trainees. Both groups expected significantly higher levels of autonomy than observed in the operating room for all six types of cases. Although faculty and trainees both expect similar levels of autonomy in the operating room, real-time measurements of autonomy show a gap between expectations and reality. Decreasing this gap will require a concerted effort by both faculty and residents to focus on the development of independent operative skills. Copyright © 2017 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.
International Nuclear Information System (INIS)
Lee, Seung Jun
2007-02-01
As digital and computer technologies have grown, human-machine interfaces (HMIs) have evolved. In safety critical systems, especially in nuclear power plants (NPPs), HMIs are important for reducing operational costs, for reducing the number of necessary operators, and for reducing the probability of accident occurrence. Efforts have been made to improve main control room (MCR) interface design and to develop automation or support systems to ensure convenient operation and maintenance. In this paper, an integrated decision support system to aid the cognitive activities of operators is proposed for advanced MCRs in future NPPs. The proposed system supports not merely a particular task, but also the entire operation process based on a human cognitive process model. It supports the operator's entire cognitive process by integrating decision support systems that support each cognitive activity. In this paper, the operator's operation processes are analyzed based on a human cognitive process model and appropriate support systems that support each activity of the human cognitive process are suggested. Two decision support systems were developed in this paper. The first one is the fault diagnosis advisory system (FDAS) which detects faults and diagnoses them. The FDAS provides a list of possible faults and expected causes to operators. It was implemented using two kinds of neural networks for more reliable diagnosis results. The second system is the multifunctional operator support system for operation guidance, which includes the FDAS and the operation guidance system. The operation guidance system is to prevent operator's commission errors and omission errors. Furthermore, the effect of the proposed system was estimated because to evaluate decision support systems in order to validate their efficiency is as important as to design highly reliable decision support systems. The effect estimations were performed theoretically and experimentally. The Bayesian
Laparoscopic assistance by operating room nurses: Results of a virtual-reality study.
Paschold, M; Huber, T; Maedge, S; Zeissig, S R; Lang, H; Kneist, W
2017-04-01
Laparoscopic assistance is often entrusted to a less experienced resident, medical student, or operating room nurse. Data regarding laparoscopic training for operating room nurses are not available. The aim of the study was to analyse the initial performance level and learning curves of operating room nurses in basic laparoscopic surgery compared with medical students and surgical residents to determine their ability to assist with this type of procedure. The study was designed to compare the initial virtual reality performance level and learning curves of user groups to analyse competence in laparoscopic assistance. The study subjects were operating room nurses, medical students, and first year residents. Participants performed three validated tasks (camera navigation, peg transfer, fine dissection) on a virtual reality laparoscopic simulator three times in 3 consecutive days. Laparoscopic experts were enrolled as a control group. Participants filled out questionnaires before and after the course. Nurses and students were comparable in their initial performance (p>0.05). Residents performed better in camera navigation than students and nurses and reached the expert level for this task. Residents, students, and nurses had comparable bimanual skills throughout the study; while, experts performed significantly better in bimanual manoeuvres at all times (p<0.05). The included user groups had comparable skills for bimanual tasks. Residents with limited experience reached the expert level in camera navigation. With training, nurses, students, and first year residents are equally capable of assisting in basic laparoscopic procedures. Copyright © 2017 Elsevier Ltd. All rights reserved.
van Oostrum, J.M.; van Houdenhoven, M.; Hurink, Johann L.; Hans, Elias W.; Wullink, Gerhard; Kazemier, G.
2005-01-01
This paper addresses the problem of operating room scheduling at the tactical level of hospital planning and control. Hospitals repetitively construct operating room schedules, which is a time consuming tedious and complex task. The stochasticity of the durations of surgical procedures complicates
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
Auditing Operating Room Recycling: A Management Case Report.
McGain, Forbes; Jarosz, Katherine Maria; Nguyen, Martin Ngoc Hoai Huong; Bates, Samantha; O'Shea, Catherine Jane
2015-08-01
Much waste arises from operating rooms (ORs). We estimated the practical and financial feasibility of an OR recycling program, weighing all waste from 6 ORs in Melbourne, Australia. Over 1 week, 237 operations produced 1265 kg in total: general waste 570 kg (45%), infectious waste 410 kg (32%), and recyclables 285 kg (23%). The achieved recycling had no infectious contamination. The achieved recycling/potential recycling rate was 285 kg/517 kg (55%). The average waste disposal costs were similar for general waste and recycling. OR recycling rates of 20%-25% total waste were achievable without compromising infection control or financial constraints.
Ma, Meng; Fallavollita, Pascal; Habert, Séverine; Weidert, Simon; Navab, Nassir
2016-06-01
In the modern day operating room, the surgeon performs surgeries with the support of different medical systems that showcase patient information, physiological data, and medical images. It is generally accepted that numerous interactions must be performed by the surgical team to control the corresponding medical system to retrieve the desired information. Joysticks and physical keys are still present in the operating room due to the disadvantages of mouses, and surgeons often communicate instructions to the surgical team when requiring information from a specific medical system. In this paper, a novel user interface is developed that allows the surgeon to personally perform touchless interaction with the various medical systems, switch effortlessly among them, all of this without modifying the systems' software and hardware. To achieve this, a wearable RGB-D sensor is mounted on the surgeon's head for inside-out tracking of his/her finger with any of the medical systems' displays. Android devices with a special application are connected to the computers on which the medical systems are running, simulating a normal USB mouse and keyboard. When the surgeon performs interaction using pointing gestures, the desired cursor position in the targeted medical system display, and gestures, are transformed into general events and then sent to the corresponding Android device. Finally, the application running on the Android devices generates the corresponding mouse or keyboard events according to the targeted medical system. To simulate an operating room setting, our unique user interface was tested by seven medical participants who performed several interactions with the visualization of CT, MRI, and fluoroscopy images at varying distances from them. Results from the system usability scale and NASA-TLX workload index indicated a strong acceptance of our proposed user interface.
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)
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)
Control room design of a nuclear reactor used to produce radioisotope
Energy Technology Data Exchange (ETDEWEB)
Santos, Isaac Jose Antonio Luquetti dos; Carvalho, Paulo Vitor R.; Lacerda, Fabio de; Szabo, Andre P.; Vianna Filho, Alfredo Marques, E-mail: luquetti@ien.gov.br [Instituto Engenharia Nuclear (IEN/CNEN-RJ), Rio Janeiro, RJ (Brazil). Divisao de Instrumentacao e Confiabilidade Humana; Falcao, Mariana A. [Escola de Belas Artes da Universidade Federal do Rio de Janeiro, RJ (Brazil)
2011-07-01
A control room is defined as a functional entity with an associated physical structure, where the operators carry out the centralized control, monitoring and administrative responsibilities. Inadequate integration between control room and operators reduces safety, increases the operation complexity, complicates operator training and increases the likelihood of human errors occurrence. The purpose of this paper is to present a specific approach for the design of the main control room of a nuclear reactor used to produce radioisotope. The approach is based on human factors standards and the participation of a multidisciplinary team in the conceptual and basic phases of the design. Using the information gathered from standards and from the multidisciplinary an initial sketch 3D of the main control room is being developed. (author)
Control room design of a nuclear reactor used to produce radioisotope
International Nuclear Information System (INIS)
Santos, Isaac Jose Antonio Luquetti dos; Carvalho, Paulo Vitor R.; Lacerda, Fabio de; Szabo, Andre P.; Vianna Filho, Alfredo Marques
2011-01-01
A control room is defined as a functional entity with an associated physical structure, where the operators carry out the centralized control, monitoring and administrative responsibilities. Inadequate integration between control room and operators reduces safety, increases the operation complexity, complicates operator training and increases the likelihood of human errors occurrence. The purpose of this paper is to present a specific approach for the design of the main control room of a nuclear reactor used to produce radioisotope. The approach is based on human factors standards and the participation of a multidisciplinary team in the conceptual and basic phases of the design. Using the information gathered from standards and from the multidisciplinary an initial sketch 3D of the main control room is being developed. (author)
Operating room teamwork among physicians and nurses: teamwork in the eye of the beholder.
Makary, Martin A; Sexton, J Bryan; Freischlag, Julie A; Holzmueller, Christine G; Millman, E Anne; Rowen, Lisa; Pronovost, Peter J
2006-05-01
Teamwork is an important component of patient safety. In fact, communication errors are the most common cause of sentinel events and wrong-site operations in the US. Although efforts to improve patient safety through improving teamwork are growing, there is no validated tool to scientifically measure teamwork in the surgical setting. Operating room personnel in 60 hospitals were surveyed using the Safety Attitudes Questionnaire. Surgeons, anesthesiologists, certified registered nurse anesthetists, and operating room nurses rated their own peers and each other using a 5-point Likert scale (1 = very low, 5 = very high). Overall response rate was 77.1% (2,135 of 2,769). Ratings of teamwork differed substantially by operating room caregiver type, with the greatest differences in ratings shown by physicians: surgeons (F[4, 2058] = 41.73, p teamwork exist in the operating room, with physicians rating the teamwork of others as good, but at the same time, nurses perceive teamwork as mediocre. Given the importance of communication and collaboration in patient safety, health care organizations should measure teamwork using a scientifically valid method. The Safety Attitudes Questionnaire can be used to measure teamwork, identify disconnects between or within disciplines, and evaluate interventions aimed at improving patient safety.
Assessing Nurse Anaesthetists' Non-Technical Skills in the operating room.
Lyk-Jensen, H T; Jepsen, R M H G; Spanager, L; Dieckmann, P; Østergaard, D
2014-08-01
Incident reporting and fieldwork in operating rooms have shown that some of the errors that arise in anaesthesia relate to inadequate use of non-technical skills. To provide a tool for training and feedback on nurse anaesthetists' non-technical skills, this study aimed to adapt the Anaesthetists' Non-Technical Skills (ANTS) as a behavioural marker system for the formative assessment of nurse anaesthetists' non-technical skills in the operating room. A qualitative approach with focus group interviews was used to identify the non-technical skills of nurse anaesthetists in the operating room. The interview data were transcribed verbatim. Directed content analysis was used to code and sort data deductively into the ANTS categories: task management, team working, situation awareness and decision making. The prototype named Nurse Anaesthetists' Non-Technical Skills (N-ANTS) was presented and discussed in a group of subject matter experts to ensure face validity. The N-ANTS system consists of the same four categories as ANTS and 15 underlying elements. Three to five good and poor behavioural markers for each element were identified. The headings and definitions of the categories and elements were adjusted to encompass the behavioural markers in N-ANTS. The differences that emerged mainly reflected statements regarding the establishment of role, competence, and task delegation. A behavioural marker system, N-ANTS, for nurse anaesthetists was adapted from a behavioural marker system, ANTS, for anaesthesiologists. © 2014 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.
Basques, Bryce A; Golinvaux, Nicholas S; Bohl, Daniel D; Yacob, Alem; Toy, Jason O; Varthi, Arya G; Grauer, Jonathan N
2014-10-15
Retrospective database review. To evaluate whether microscope use during spine procedures is associated with increased operating room times or increased risk of infection. Operating microscopes are commonly used in spine procedures. It is debated whether the use of an operating microscope increases operating room time or confers increased risk of infection. The American College of Surgeons National Surgical Quality Improvement Program database, which includes data from more than 370 participating hospitals, was used to identify patients undergoing elective spinal procedures with and without the use of an operating microscope for the years 2011 and 2012. Bivariate and multivariate linear regressions were used to test the association between microscope use and operating room times. Bivariate and multivariate logistic regressions were similarly conducted to test the association between microscope use and infection occurrence within 30 days of surgery. A total of 23,670 elective spine procedures were identified, of which 2226 (9.4%) used an operating microscope. The average patient age was 55.1±14.4 years. The average operative time (incision to closure) was 125.7±82.0 minutes.Microscope use was associated with minor increases in preoperative room time (+2.9 min, P=0.013), operative time (+13.2 min, Pmicroscope and nonmicroscope groups for occurrence of any infection, superficial surgical site infection, deep surgical site infection, organ space infection, or sepsis/septic shock, regardless of surgery type. We did not find operating room times or infection risk to be significant deterrents for use of an operating microscope during spine surgery. 3.
Building a Smooth Medical Service for Operating Room Using RFID Technologies
Directory of Open Access Journals (Sweden)
Lun-Ping Hung
2014-01-01
Full Text Available Due to the information technology advancement, the feasibility for the establishment of mobile medical environments has been strengthened. Using RFID to facilitate the tracing of patients’ mobile position in hospital has attracted more attentions from researchers due to the demand on advanced features. Traditionally, the management of surgical treatment is generally manually operated and there is no consistent operating procedure for patients transferring among wards, surgery waiting rooms, operating rooms, and recovery rooms, resulting in panicky and urgent transferring work among departments and, thus, leading to delays and errors. In this paper, we propose a new framework using radio frequency identification (RFID technology for a mobilized surgical process monitoring system. Through the active tag, an application management system used before, during, and after the surgical processes has been proposed. The concept of signal level matrix, SLM, was proposed to accurately identify patients and dynamically track patients’ location. By updating patient’s information real-time, the preprocessing time needed for various tasks and incomplete transfers among departments can be reduced, the medical resources can be effectively used, unnecessary medical disputes can be reduced, and more comprehensive health care environment can be provided. The feasibility and effectiveness of our proposed system are demonstrated with a number of experimental results.
International Nuclear Information System (INIS)
2002-01-01
A modern approach to control room design, be it for upgrading or complete refurbishment, requires the integration of many disciplines and approaches. The integration of human factors into such a process continues to present challenges. How such a process should be conceived, planned, and carried out is of considerable interest to designers, operators and regulators. Many NPPs around the world have been, or will be faced with decisions concerning modernization of their control rooms. Such changes can be driven by a range of issues including; the need to replace outdated control and instrumentation systems; increasing regulatory concern about human performance; or the need to provide a better process control environment for NPPs whose life cycles extend beyond that originally intended. Considering the importance of operator performance for safe and profitable operations, a process for ensuring that human factors issues are properly addressed could be central to the success or failure of such a project. Human factors is of particular importance when a combination of existing and new systems are to be used, resulting in a so-called 'hybrid' control room. The workshop addressed this topical area by providing a forum where a number of important areas could be discussed and experiences and lessons shared. Topics identified before hand as important and worthy of discussion included: - Exploration of how human factors issues can be identified. - Consideration of those processes and techniques necessary to ensure that appropriate requirements are specified, and that suitable data is gathered and analysed. - Identification and discussion of issues related to the above topics together with lessons from utilities, vendors and regulators which have faced, or are currently facing, these challenges. The meeting itself focused on the state of knowledge and current best practices within these areas and provided a forum for the open discussion of the human factors issues, as seen by
Response times of operators in a control room
International Nuclear Information System (INIS)
Platz, O.; Rasmussen, J.; Skanborg, P.Z.
1982-12-01
A statistical analysis was made of operator response times recorded in the control room of a research reactor during the years 1972-1974. A homogeneity test revealed that the data consist of a mixture of populations. A small but statistically significant difference is found between day and night response times. Lognormal distributions are found to provide the best fit of the day and the night response times. (author)
Integrated circuits and logic operations based on single-layer MoS2.
Radisavljevic, Branimir; Whitwick, Michael Brian; Kis, Andras
2011-12-27
Logic circuits and the ability to amplify electrical signals form the functional backbone of electronics along with the possibility to integrate multiple elements on the same chip. The miniaturization of electronic circuits is expected to reach fundamental limits in the near future. Two-dimensional materials such as single-layer MoS(2) represent the ultimate limit of miniaturization in the vertical dimension, are interesting as building blocks of low-power nanoelectronic devices, and are suitable for integration due to their planar geometry. Because they are less than 1 nm thin, 2D materials in transistors could also lead to reduced short channel effects and result in fabrication of smaller and more power-efficient transistors. Here, we report on the first integrated circuit based on a two-dimensional semiconductor MoS(2). Our integrated circuits are capable of operating as inverters, converting logical "1" into logical "0", with room-temperature voltage gain higher than 1, making them suitable for incorporation into digital circuits. We also show that electrical circuits composed of single-layer MoS(2) transistors are capable of performing the NOR logic operation, the basis from which all logical operations and full digital functionality can be deduced.
Gynaecological surgical training in the operating room : an exploratory study
van der Houwen, Clasien; Boor, Klarke; Essed, Gerard G. M.; Boendermaker, Peter M.; Scherpbier, Albert A. J. J. A.; Scheele, Fedde
Objective: One of the challenging goals of gynaecological education is preparing trainees for independent practice of surgery. Research, however, on how to acquire surgical skills in the operating room safely, effectively and efficiently is scarce. We performed this study to explore trainers' and
Operating room sound level hazards for patients and physicians.
Fritsch, Michael H; Chacko, Chris E; Patterson, Emily B
2010-07-01
Exposure to certain new surgical instruments and operating room devices during procedures could cause hearing damage to patients and personnel. Surgical instruments and related equipment generate significant sound levels during routine usage. Both patients and physicians are exposed to these levels during the operative cases, many of which can last for hours. The noise loads during cases are cumulative. Occupational Safety and Health Administration (OSHA) and National Institute for Occupational Safety and Health (NIOSH) standards are inconsistent in their appraisals of potential damage. Implications of the newer power instruments are not widely recognized. Bruel and Kjaer sound meter spectral recordings for 20 major instruments from 5 surgical specialties were obtained at the ear levels for the patient and the surgeon between 32 and 20 kHz. Routinely used instruments generated sound levels as high as 131 dB. Patient and operator exposures differed. There were unilateral dominant exposures. Many instruments had levels that became hazardous well within the length of an average surgical procedure. The OSHA and NIOSH systems gave contradicting results when applied to individual instruments and types of cases. Background noise, especially in its intermittent form, was also of significant nature. Some patients and personnel have additional predisposing physiologic factors. Instrument noise levels for average length surgical cases may exceed OSHA and NIOSH recommendations for hearing safety. Specialties such as Otolaryngology, Orthopedics, and Neurosurgery use instruments that regularly exceed limits. General operating room noise also contributes to overall personnel exposures. Innovative countermeasures are suggested.
Lean Strategies in the Operating Room.
Robinson, Stephen T; Kirsch, Jeffrey R
2015-12-01
Lean strategies can be readily applied to health care in general and operating rooms specifically. The emphasis is on the patient as the customer, respect and engagement of all providers, and leadership from management. The strategy of lean is to use continuous improvement to eliminate waste from the care process, leaving only value-added activities. This iterative process progressively adds the steps of identifying the 7 common forms of waste (transportation, inventory, motion, waiting, overproduction, overprocessing, and defects), 5S (sort, simplify, sweep, standardize, sustain), visual controls, just-in-time processing, level-loaded work, and built-in quality to achieve the highest quality of patient care. Copyright © 2015 Elsevier Inc. All rights reserved.
The Effect of Gender on Resident Autonomy in the Operating room.
Meyerson, Shari L; Sternbach, Joel M; Zwischenberger, Joseph B; Bender, Edward M
Discrimination against women training in medicine and surgery has been subjectively described for decades. This study objectively documents gender differences in the degree of autonomy given to thoracic surgery trainees in the operating room. Thoracic surgery residents and faculty underwent frame of reference training on the use of the 4-point Zwisch scale to measure operative autonomy. Residents and faculty then submitted evaluations of their perception of autonomy granted for individual operations as well as operative difficulty on a real-time basis using the "Zwisch Me!!" mobile application. Differences in autonomy given to male and female residents were elucidated using chi-square analysis and ordered logistic regression. Seven academic medical centers with thoracic surgery training programs. Volunteer thoracic surgery residents in both integrated and traditional training pathways and their affiliated cardiothoracic faculty. Residents (n = 33, female 18%) submitted a total of 596 evaluations to faculty (n = 48, female 12%). Faculty gave less autonomy to female residents with only 56 of 184 evaluations (30.3%) showing meaningful autonomy (passive help or supervision only) compared to 107 of 292 evaluations (36.7%) at those levels for male residents (p = 0.02). Resident perceptions of autonomy showed even more pronounced differences with female residents receiving only 38 of 197 evaluations (19.3%) with meaningful autonomy compared to 133 of 399 evaluations (33.3%) for male residents (p autonomy granted to residents. Evaluations of operative autonomy reveal a significant bias against female residents. Faculty education is needed to encourage allowing female residents more operative autonomy. Copyright © 2017 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.
International Nuclear Information System (INIS)
Weber, Andreas; Erfle, Robert; Feinkohl, Dirk
2012-01-01
The integration of a browser based operator manual in the system environment of a process computer system is an optimization of the operating procedure in the control room and a safety enhancement due to faster and error-free access to the manual contents. Several requirements by the authorities have to be fulfilled: the operating manual has to be available as hard copy, the format has to be true to original, protection against manipulation has to be provided, the manual content of the browser-based version and the hard copy have to identical, and the display presentation has to be consistent with ergonomic principals. The integration of the on-line manual in the surveillance process computer system provides the operator with the relevant comments to the surveillance signal. The described integration of the on-line manual is an optimization of the operator's everyday job with respect to ergonomics and safety (human performance).
Implications of Perioperative Team Setups for Operating Room Management Decisions.
Doll, Dietrich; Kauf, Peter; Wieferich, Katharina; Schiffer, Ralf; Luedi, Markus M
2017-01-01
Team performance has been studied extensively in the perioperative setting, but the managerial impact of interprofessional team performance remains unclear. We hypothesized that the interplay between anesthesiologists and surgeons would affect operating room turnaround times, and teams that worked together over time would become more efficient. We analyzed 13,632 surgical cases at our hospital that involved 64 surgeons and 48 anesthesiologists. We detrended and adjusted the data for potential confounders including age, American Society of Anesthesiologists physical status, and surgical list (scheduled cases of specific surgical specialties). The surgical lists were categorized as ear, nose, and throat surgery; trauma surgery; general surgery; and gynecology. We assessed the relationship between turnaround times and assignment of different anesthesiologists to specific surgeons using a Monte Carlo simulation. We found significant differences in team performances among the different surgical lists but no team learning. We constructed managerial decision tables for the assignment of anesthesiologists to specific surgeons at our hospital. We defined a decision algorithm based on these tables. Our analysis indicated that had this algorithm been used in staffing the operating room for the surgical cases represented in our data, median turnaround times would have a reduction potential of 6.8% (95% confidence interval 6.3% to 7.1%). A surgeon is usually predefined for scheduled surgeries (surgical list). Allocation of the right anesthesiologist to a list and to a surgeon can affect the team performance; thus, this assignment has managerial implications regarding the operating room efficiency affecting turnaround times and thus potentially overutilized time of a list at our hospital.
Structure determination of an integral membrane protein at room temperature from crystals in situ
International Nuclear Information System (INIS)
Axford, Danny; Foadi, James; Hu, Nien-Jen; Choudhury, Hassanul Ghani; Iwata, So; Beis, Konstantinos; Evans, Gwyndaf; Alguel, Yilmaz
2015-01-01
The X-ray structure determination of an integral membrane protein using synchrotron diffraction data measured in situ at room temperature is demonstrated. The structure determination of an integral membrane protein using synchrotron X-ray diffraction data collected at room temperature directly in vapour-diffusion crystallization plates (in situ) is demonstrated. Exposing the crystals in situ eliminates manual sample handling and, since it is performed at room temperature, removes the complication of cryoprotection and potential structural anomalies induced by sample cryocooling. Essential to the method is the ability to limit radiation damage by recording a small amount of data per sample from many samples and subsequently assembling the resulting data sets using specialized software. The validity of this procedure is established by the structure determination of Haemophilus influenza TehA at 2.3 Å resolution. The method presented offers an effective protocol for the fast and efficient determination of membrane-protein structures at room temperature using third-generation synchrotron beamlines
Structure determination of an integral membrane protein at room temperature from crystals in situ
Energy Technology Data Exchange (ETDEWEB)
Axford, Danny [Diamond Light Source, Harwell Science and Innovation Campus, Oxfordshire OX11 0DE (United Kingdom); Foadi, James [Diamond Light Source, Harwell Science and Innovation Campus, Oxfordshire OX11 0DE (United Kingdom); Imperial College London, London SW7 2AZ (United Kingdom); Hu, Nien-Jen; Choudhury, Hassanul Ghani [Diamond Light Source, Harwell Science and Innovation Campus, Oxfordshire OX11 0DE (United Kingdom); Imperial College London, London SW7 2AZ (United Kingdom); Rutherford Appleton Laboratory, Oxfordshire OX11 0FA (United Kingdom); Iwata, So [Diamond Light Source, Harwell Science and Innovation Campus, Oxfordshire OX11 0DE (United Kingdom); Diamond Light Source, Harwell Science and Innovation Campus, Oxfordshire OX11 0DE (United Kingdom); Imperial College London, London SW7 2AZ (United Kingdom); Rutherford Appleton Laboratory, Oxfordshire OX11 0FA (United Kingdom); Kyoto University, Kyoto 606-8501 (Japan); Beis, Konstantinos [Diamond Light Source, Harwell Science and Innovation Campus, Oxfordshire OX11 0DE (United Kingdom); Imperial College London, London SW7 2AZ (United Kingdom); Rutherford Appleton Laboratory, Oxfordshire OX11 0FA (United Kingdom); Evans, Gwyndaf, E-mail: gwyndaf.evans@diamond.ac.uk [Diamond Light Source, Harwell Science and Innovation Campus, Oxfordshire OX11 0DE (United Kingdom); Alguel, Yilmaz, E-mail: gwyndaf.evans@diamond.ac.uk [Diamond Light Source, Harwell Science and Innovation Campus, Oxfordshire OX11 0DE (United Kingdom); Imperial College London, London SW7 2AZ (United Kingdom); Rutherford Appleton Laboratory, Oxfordshire OX11 0FA (United Kingdom)
2015-05-14
The X-ray structure determination of an integral membrane protein using synchrotron diffraction data measured in situ at room temperature is demonstrated. The structure determination of an integral membrane protein using synchrotron X-ray diffraction data collected at room temperature directly in vapour-diffusion crystallization plates (in situ) is demonstrated. Exposing the crystals in situ eliminates manual sample handling and, since it is performed at room temperature, removes the complication of cryoprotection and potential structural anomalies induced by sample cryocooling. Essential to the method is the ability to limit radiation damage by recording a small amount of data per sample from many samples and subsequently assembling the resulting data sets using specialized software. The validity of this procedure is established by the structure determination of Haemophilus influenza TehA at 2.3 Å resolution. The method presented offers an effective protocol for the fast and efficient determination of membrane-protein structures at room temperature using third-generation synchrotron beamlines.
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
Marcoule pilot work-room: process automatic operation
International Nuclear Information System (INIS)
Mus, G.; Linger, C.
1987-01-01
Commissioned in the early 1960s, the Marcoule Pilot Plant has undergone a series of sweeping transformations. The Research and Development resources concerning irradiated fuel processing have been expanded and modified. Its reprocessing capacity has also been raised from 2 to 5 t/year. Simultaneously, the installation control system was completely remodelled. The control consoles, which were previously positioned locally near the different units, have been grouped together in a centralized control room. To do this, the measurement and operating circuits were replaced by new data acquisition and processing systems requiring the use of numerical algorithms. The management and control of certain units, including mechanical fuel preparation, sampling, and sample transport to the laboratories, have been entrusted to programmable automata. Certain unit operations, such as concentration by evaporation, are set up with complete automation. These new arrangements will expand the resources for analysing the operation of the Pilot Plant, while offering a more overall view of the operations. They have been made possible by a major effort in the development of sensors, and represent the indispensable prerequisite for the installation of expert systems [fr
The use of shore wave ultraviolet radiation for disinfection in operating rooms
International Nuclear Information System (INIS)
Baanrud, H.; Moan, J.
1999-01-01
Over a number of years short wave ultraviolet radiation (UVC;200-280 nm) has been used to disinfect air and surfaces in operating rooms, patient rooms and laboratories, as well as air in ventilation ducts. Despite the well-documented effect of ultraviolet radiation on air quality, this technology has been relatively little used. One advantage of this method is that the UVC sources ensure a continuous reduction in the number of airborne microorganisms that are generated all the time. There are, however, some disadvantages with this method. Human exposure to ultraviolet C may cause keratoconjunctivitis and erythema and requires protection of the skin and the eyes of people exposed to levels above recommended exposure limits. However, by enclosing the UVC sources or by irradiation in the absence of human activity, human exposure is eliminated. These and other aspects concerning the use of short wave ultraviolet radiation as a disinfection agent in operating rooms are discussed in this article
Alcohol based surgical prep solution and the risk of fire in the operating room: a case report
Directory of Open Access Journals (Sweden)
Gupta Rajiv
2008-04-01
Full Text Available Abstract A few cases of fire in the operating room are reported in the literature. The factors that may initiate these fires are many and include alcohol based surgical prep solutions, electrosurgical equipment, flammable drapes etc. We are reporting a case of fire in the operating room while operating on a patient with burst fracture C6 vertebra with quadriplegia. The cause of the fire was due to incomplete drying of the covering drapes with an alcohol based surgical prep solution. This paper discusses potential preventive measures to minimize the incidence of fire in the operating room.
International Nuclear Information System (INIS)
Visciola, M.; Bagnara, S.; Ruggeri, R.
1986-01-01
When a control room undergoes to a redesign process it is of crucial importance to analyze how operators critically review it and which improvements they suggest. This is even more critical when presumably the same people will operate in the new 'redesigned' control room: Consistency in the mental models possessed by the operators of the plant functions and of their control should be emphasized. Consistency in the mental models can be assumed when redesign follows well-established guidelines drawn from experiences and studies carried out in very similar situations. However, this condition is not fulfilled when a nuclear research control room has to be redesigned, since available guidelines (e.g.; NUREG-0700) are based on studies conducted on nuclear power plant control rooms. These two types of facilities are of much difference as for activities performed in the control room, goals to be aimed at, costs and risks. As a consequence, the available guidelines cannot be safely applied to such a situation as the redesign of a TRIGA RC-1 control room. So, data have to be collected in order to allow the operators to efficiently and easily adapt to the new control room by consistently 'updating' their mental models. In the present study, these data have been collected through structured interviews, which consisted of a modified version of EPRI. The results can be summarized as follows: 1) The operators critically reviewed the present control room and underlined the lack of 'transparency' of the control system as for the plant's conditions and for the feedbacks about their own activities. 2) The operators' work analysis showed that they spend much of their time out of the control room. This means that, if the operators have to stay in the control room, they should be allowed to perform more and higher-level activities than those presently required, to prevent understimulation. So, the redesign should or allow and support the central control and maintenance, and other
Enhancement opportunities in operating room utilization; with a statistical appendix
van Veen-Berkx, Elizabeth; Elkhuizen, Sylvia G.; van Logten, Sanne; Buhre, Wolfgang F.; Kalkman, Cor J.; Gooszen, Hein G.; Kazemier, Geert; Balm, Ron; Cornelisse, Diederich C. C.; Ackermans, Hub J.; Stolker, Robert Jan; Bezstarosti, Jeanne; Pelger, Rob C. M.; Schaad, Roald R.; Krooneman-Smits, Irmgard; Meyer, Peter; van Dijk-Jager, Mirjam; Broecheler, Simon A. W.; Kroese, A. Christiaan; Kanters, Jeffrey; Krabbendam, Johannes J.; Hans, Erwin W.; Veerman, Derk P.; Aij, Kjeld H.
2015-01-01
Background: The purpose of this study was to assess the direct and indirect relationships between first-case tardiness (or "late start"), turnover time, underused operating room (OR) time, and raw utilization, as well as to determine which indicator had the most negative impact on OR utilization to
Enhancement opportunities in operating room utilization; with a statistical appendix
Veen-Berkx, E. van; Elkhuizen, S.G.; Logten, S. van; Buhre, W.F.; Kalkman, C.J.; Gooszen, H.G.; Kazemier, G.
2015-01-01
BACKGROUND: The purpose of this study was to assess the direct and indirect relationships between first-case tardiness (or "late start"), turnover time, underused operating room (OR) time, and raw utilization, as well as to determine which indicator had the most negative impact on OR utilization to
Effect of Individual Surgeons and Anesthesiologists on Operating Room Time
van Eijk, Ruben P A; van Veen-Berkx, Elizabeth; Kazemier, Geert; Eijkemans, Marinus J C
BACKGROUND:: Variability in operating room (OR) time causes overutilization and underutilization of the available ORs. There is evidence that for a given type of procedure, the surgeon is the major source of variability in OR time. The primary aim was to quantify the variability between surgeons and
Ergonomics in the operating room.
Janki, Shiromani; Mulder, Evalyn E A P; IJzermans, Jan N M; Tran, T C Khe
2017-06-01
Since the introduction of minimally invasive surgery, surgeons appear to be experiencing more occupational musculoskeletal injuries. The aim of this study is to investigate the current frequency and effects of occupational musculoskeletal injuries on work absence. An online questionnaire was conducted among all surgeons affiliated to the Dutch Society for Endoscopic Surgery, Gastrointestinal Surgery, and Surgical Oncology. In addition, this survey was conducted among surgeons, gynaecologists, and urologists of one cluster of training hospitals in the Netherlands. There were 127 respondents. Fifty-six surgeons currently suffer from musculoskeletal complaints, and 30 have previously suffered from musculoskeletal complaints with no current complaints. Frequently reported localizations were the neck (39.5 %), the erector spinae muscle (34.9 %), and the right deltoid muscle (18.6 %). Most of the musculoskeletal complaints were present while operating (41.8 %). Currently, 37.5 % uses medication and/or therapy to reduce complaints. Of surgeons with past complaints, 26.7 % required work leave and 40.0 % made intraoperative adjustments. More surgeons with a medical history of musculoskeletal complaints have current complaints (OR 6.1, 95 % CI 1.9-19.6). There were no significant differences between surgeons of different operating techniques in localizations and frequency of complaints, or work leave. Despite previous various ergonomic recommendations in the operating room, the current study demonstrated that musculoskeletal complaints and subsequent work absence are still present among surgeons, especially among surgeons with a positive medical history for musculoskeletal complaints. Even sick leave was necessary to fully recover. There were no significant differences in reported complaints between surgeons of different operating techniques. Almost half of the respondents with complaints made intraoperative ergonomic adjustments to prevent future complaints. The
International Nuclear Information System (INIS)
Lee, June Seung
2009-01-01
The advanced main control room (MCR) in GEN III + nuclear power plants has been designed by adapting modern digital I and C techniques and an advanced man machine interface system (MMIS). Large Display Panels (LDPs) and computer based workstations are installed in the MCR. A Computerized Procedure System (CPS) and Computerized Operation Support System (COSS) with high degrees of automation are supplied to operators. Therefore, it is necessary to set up new operation concepts in advanced MCRs that are different from those applied in conventional MCRs regarding role allocations and communications of operators. The following presents a discussion of the main differences between advanced MCRs and conventional MCRs from the viewpoint of role allocations and communications. Efficient models are then proposed on the basis of a task analysis on a series of emergency operation steps
Digitized operator evaluation system for main control room of nuclear power plant
International Nuclear Information System (INIS)
Chen Yu; Yan Shengyuan; Chen Wenlong
2014-01-01
In order to evaluate the human-machine system matching relation of main control room in nuclear power plant accurately and efficiently, the expression and parameters of operator human body model were analyzed, and the evaluation required function of digital operator was determined. Based on the secondary development technology, the digital operator evaluation body model was developed. It could choose generation, gender, operation posture, single/eyes horizon, and left/right hand up to the domain according to the needs of specific evaluation, it was used to evaluate whether display information can be visible and equipment can be touch, and it also has key evaluation functions such as workspace and character visibility at the same time. The examples show that this method can complete the evaluation work of human-machine matching relation for main control room of nuclear power plant accurately, efficiently and quickly, and achieve the most optimal human-machine coordination relationship. (authors)
Evaluation of noise pollution level in the operating rooms of hospitals: A study in Iran.
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.
The use of virtual reality to simulate room and pillar operations
Energy Technology Data Exchange (ETDEWEB)
Crawshaw, S A.M.; Denby, B; McClarnon, D [Long-Airdox International Limited, Ilkeston (United Kingdom)
1997-01-01
Virtual Reality systems allow a user to interact with dynamic three-dimensional computer models of real world situations. The authors show how the complexity of room and pillar mining operations may be mirrored in a user-configurable system. Additionally, an understanding is gained of the mining method, and the operation of equipment in the actual working environment. 1 ref., 5 figs.
International Nuclear Information System (INIS)
Han, Zongwei; Zhang, Yanqing; Meng, Xin; Liu, Qiankun; Li, Weiliang; Han, Yu; Zhang, Yanhong
2016-01-01
In order to improve the energy efficiency of air conditioning systems in computer rooms, this paper proposed a new concept of integrating evaporative cooling air-conditioning system with heat pipes. Based on a computer room in Shenyang, China, a mathematical model was built to perform transient simulations of the new system. The annual dynamical performance of the new system was then compared with a typical conventional computer room air-conditioning system. The result showed that the new integrated air-conditioning system had better energy efficiency, i.e. 31.31% reduction in energy consumption and 29.49% increase in COP (coefficient of performance), due to the adoption of evaporative condenser and the separate type heat pipe technology. Further study also revealed that the incorporated heat pipes enabled a 36.88% of decrease in the operation duration of the vapor compressor, and a 53.86% of reduction for the activation times of the compressor, which could lead to a longer lifespan of the compressor. The new integrated evaporative cooling air-conditioning system was also tested in different climate regions. It showed that the energy saving of the new system was greatly affected by climate, and it had the best effect in cold and dry regions like Shenyang with up to 31.31% energy saving. In some warm and humid climate regions like Guangzhou, the energy saving could be achieved up to 13.66%. - Highlights: • A novel combined air-conditioning system of computer room is constructed. • The performance of the system and conventional system is simulated and compared. • The applicability of the system in different climate regions is investigated.
Operating room nursing directors' influence on anesthesia group operating room productivity.
Masursky, Danielle; Dexter, Franklin; Nussmeier, Nancy A
2008-12-01
Implementation of initiatives to increase anesthesia group productivity depends not just on anesthesia groups, but on operating room (OR) nursing administration. OR nursing directors may encourage organizational change based on the needs of their hospitals and nurses. These changes may differ from those that would increase the anesthesia group's productivity. We assessed reward structures using (A) letters of nomination for the "OR Manager of the Year" award offered annually by the publication OR Manager, and (B) data from a salary/career survey of OR directors by the same publication. (A) There were 164 nomination letters submitted from 2004 through 2007 for 45 nominees. The letters contained n = 2659 full sentences and n = 50,821 words. We systematically created a list of 36 terms related to finance, profit, and productivity. We also analyzed the frequency of use of these terms relative to the use of the 15 most common relationship-oriented terms (e.g., compassion, encourage, mentor, and respect). (B) The salary/career survey's questions relevant to anesthesia group productivity had responses from 303 US OR directors, 97% of whom were nurses. We tested the strength of the relationship between the budget responsibility of the OR nursing director and his or her annual salary. (A) 2.6% of sentences in the nomination letters included at least one term related to profit and productivity (95% confidence interval 2.0%-3.2%). Relationship-oriented terms were 9.0 times more prevalent (95% confidence interval 7.1-11.4). (B) There was statistically significant positive proportionality between the OR nursing director's operational budget (including personnel) and his or her salary (Pearson r = 0.64, P time and OR nursing labor costs. Resulting decisions can differ from those that would increase the productivity (profit) of the anesthesia group. Anesthesia groups need to champion initiatives to increase anesthesia productivity, while being sensitive to institutional
Re-envisioning the operator consoles for Dhruva control room
International Nuclear Information System (INIS)
Gaur, S.; Sridharan, P.; Nair, P.M.; Diwakar, M.P.; Gohel, N.; Pithawa, C.K.
2012-01-01
Control Room design is undergoing rapid changes with the progressive adoption of computerization and Automation. Advances in man-machine interfaces have further accelerated this trend. This paper presents the design and main features of Operator consoles (OC) for Dhruva control room developed using new technologies. The OCs have been designed so as not to burden the operator with information overload but to help him quickly assess the situation and timely take appropriate steps. The consoles provide minimalistic yet intuitive interfaces, context sensitive navigation, display of important information and progressive disclosure of situation based information. The use of animations, 3D graphics, and real time trends with the benefit of hardware acceleration to provide a resolution independent rich user experience. The use of XAML, an XML based Mark-up Language for User Interface definition and C for application logic resulted in complete separation of visual design, content, and logic. This also resulted in a workflow where separate teams could work on the UI and the logic of an application. The introduction of Model View View-Model has led to more testable and maintainable software. (author)
Two loose screws: near-miss fall of a morbidly obese patient after an operating room table failure.
McAllister, Russell K; Booth, Robert T; Bittenbinder, Timothy M
2016-09-01
Operating room surgical table failure is a rare event but can lead to a dangerous situation when it does occur. The dangers can be compounded in the presence of obesity, especially in the anesthetized or sedated patient. We present a case of a near-miss fall of a morbidly obese patient while turning the patient in preparation to transfer from the operating room table to the hospital bed when 2 fractured bolts in the tilt cylinder mechanism led to an operating room table failure. Copyright © 2016 Elsevier Inc. All rights reserved.
International Nuclear Information System (INIS)
Stroebeck, Einar; Olausson, Jesper; Van Gemst, Paul
1998-01-01
This paper discusses the performance and tasks of the operators in the control room during refuelling outages. Analyses of such events have, during the last years, shown that the risk for nuclear accidents is not negligible compared with the risk at higher reactor power levels. Some experts have the opinion that, due to mistakes during an outage, the risk for such accidents during the outage and other accidents later on during power operation is higher than in other plant situations. The high risk level is mainly a result of errors at maintenance actions and supervision of lining up of safety systems. Most of the control rooms in existing NPPs were designed more than 10 years ago. At that time the activities and the tasks for the operators were not very well understood. Procedures for refuelling and other activities during the outages were not described very well. Often the utility organisation for refuelling outages was not established at the start of the control room design. Experience from operation during many years has shown that the performance of operators can be improved in existing plant, and thus risks be reduced, by upgrading the control room. These issues have been studied as a part of the modernisation project for Ringhals 1, an ABB Atom BWR owned by Vattenfall AB in Sweden. The paper will describe the working model for upgrading the control room and important issues to take care of with respect to refuelling outages. The identified issues will be used as the input for improving control room philosophy and the individual technical systems. (authors)
Improving operating room coordination: communication pattern assessment.
Moss, Jacqueline; Xiao, Yan
2004-02-01
To capture communication patterns in operating room (OR) management to characterize the information needs of OR coordination. Technological applications can be used to change system processes to improve communication and information access, thereby decreasing errors and adverse events. The successful design of such applications relies on an understanding of communication patterns among healthcare professionals. Charge nurse communication was observed and documented at four OR suites at three tertiary hospitals. The data collection tool allowed rapid coding of communication patterns in terms of duration, mode, target person, and the purpose of each communication episode. Most (69.24%) of the 2074 communication episodes observed occurred face to face. Coordinating equipment was the most frequently occurring purpose of communication (38.7%) in all suites. The frequency of other purposes in decreasing order were coordinating patient preparedness (25.7%), staffing (18.8%), room assignment (10.7%), and scheduling and rescheduling surgery (6.2%). The results of this study suggest that automating aspects of preparing patients for surgery and surgical equipment management has the potential to reduce information exchange, decreasing interruptions to clinicians and diminishing the possibility of adverse events in the clinical setting.
Foran, Paula
2016-01-01
The aim of this research was to determine if guided operating theatre experience in the undergraduate nursing curricula enhanced surgical knowledge and understanding of nursing care provided outside this specialist area in the pre- and post-operative surgical wards. Using quantitative analyses, undergraduate nurses were knowledge tested on areas of pre- and post-operative surgical nursing in their final semester of study. As much learning occurs in nurses' first year of practice, participants were re-tested again after their Graduate Nurse Program/Preceptorship year. Participants' results were compared to the model of operating room education they had participated in to determine if there was a relationship between the type of theatre education they experienced (if any) and their knowledge of surgical ward nursing. Findings revealed undergraduates nurses receiving guided operating theatre experience had a 76% pass rate compared to 56% with non-guided or no experience (p nurses achieved a 100% pass rate compared to 53% with non-guided or no experience (p research informs us that undergraduate nurses achieve greater learning about surgical ward nursing via guided operating room experience as opposed to surgical ward nursing experience alone. Copyright © 2015 Elsevier Ltd. All rights reserved.
Space shuttle operations integration plan
1975-01-01
The Operations Integration Plan is presented, which is to provide functional definition of the activities necessary to develop and integrate shuttle operating plans and facilities to support flight, flight control, and operations. It identifies the major tasks, the organizations responsible, their interrelationships, the sequence of activities and interfaces, and the resultant products related to operations integration.
Energy Technology Data Exchange (ETDEWEB)
Weber, Andreas [Westinghouse Electric Germany GmbH (Germany); Erfle, Robert [DOSCO GmbH, Heidelberg (Germany); Feinkohl, Dirk [E.ON Kernkraft GmbH (Germany). Kernkraftwerk Unterweser
2012-11-01
The integration of a browser based operator manual in the system environment of a process computer system is an optimization of the operating procedure in the control room and a safety enhancement due to faster and error-free access to the manual contents. Several requirements by the authorities have to be fulfilled: the operating manual has to be available as hard copy, the format has to be true to original, protection against manipulation has to be provided, the manual content of the browser-based version and the hard copy have to identical, and the display presentation has to be consistent with ergonomic principals. The integration of the on-line manual in the surveillance process computer system provides the operator with the relevant comments to the surveillance signal. The described integration of the on-line manual is an optimization of the operator's everyday job with respect to ergonomics and safety (human performance).
Waeschle, R M; Sliwa, B; Jipp, M; Pütz, H; Hinz, J; Bauer, M
2016-08-01
The difficult financial situation in German hospitals requires measures for improvement in process quality. Associated increases in revenues in the high income field "operating room (OR) area" are increasingly the responsibility of OR management but it has not been shown that the introduction of an efficiency-oriented management leads to an increase in process quality and revenues in the operating theatre. Therefore the performance in the operating theatre of the University Medical Center Göttingen was analyzed for working days in the core operating time from 7.45 a.m. to 3.30 p.m. from 2009 to 2014. The achievement of process target times for the morning surgery start time and the turnover times of anesthesia and OR-nurses were calculated as indicators of process quality. The number of operations and cumulative incision-suture time were also analyzed as aggregated performance indicators. In order to assess the development of revenues in the operating theatre, the revenues from diagnosis-related groups (DRG) in all inpatient and occupational accident cases, adjusted for the regional basic case value from 2009, were calculated for each year. The development of revenues was also analyzed after deduction of revenues resulting from altered economic case weighting. It could be shown that the achievement of process target values for the morning surgery start time could be improved by 40 %, the turnover times for anesthesia reduced by 50 % and for the OR-nurses by 36 %. Together with the introduction of central planning for reallocation, an increase in operation numbers of 21 % and cumulative incision-suture times of 12% could be realized. Due to these additional operations the DRG revenues in 2014 could be increased to 132 % compared to 2009 or 127 % if the revenues caused by economic case weighting were excluded. The personnel complement in anesthesia (-1.7 %) and OR-nurses (+2.6 %) as well as anesthetists (+6.7 %) increased less compared to the
Human reliability analysis of control room operators
Energy Technology Data Exchange (ETDEWEB)
Santos, Isaac J.A.L.; Carvalho, Paulo Victor R.; Grecco, Claudio H.S. [Instituto de Engenharia Nuclear (IEN), Rio de Janeiro, RJ (Brazil)
2005-07-01
Human reliability is the probability that a person correctly performs some system required action in a required time period and performs no extraneous action that can degrade the system Human reliability analysis (HRA) is the analysis, prediction and evaluation of work-oriented human performance using some indices as human error likelihood and probability of task accomplishment. Significant progress has been made in the HRA field during the last years, mainly in nuclear area. Some first-generation HRA methods were developed, as THERP (Technique for human error rate prediction). Now, an array of called second-generation methods are emerging as alternatives, for instance ATHEANA (A Technique for human event analysis). The ergonomics approach has as tool the ergonomic work analysis. It focus on the study of operator's activities in physical and mental form, considering at the same time the observed characteristics of operator and the elements of the work environment as they are presented to and perceived by the operators. The aim of this paper is to propose a methodology to analyze the human reliability of the operators of industrial plant control room, using a framework that includes the approach used by ATHEANA, THERP and the work ergonomics analysis. (author)
Integration of computerized operation support systems on a nuclear power plant environment
Energy Technology Data Exchange (ETDEWEB)
Jaime, Guilherme D.G.; Almeida, Jose C.S.; Oliveira, Mauro V., E-mail: gdjaime@ien.gov.br, E-mail: jcsa@ien.gov.br, E-mail: mvitor@ien.gov.br [Instituto Engenharia Nuclear (IEN/CNEN-RJ), Rio de Janeiro, RJ (Brazil). Servico de Sistemas Complexos. Divisao de Engenharia Nuclear
2015-07-01
Automation of certain tasks in a Nuclear Power Plant (NPP) control room is expected to result in reduced operators' mental workload, which may induce other benefits such as enhanced situation awareness and improved system performance. The final goal should be higher level of operational safety. Thus, recent works are increasingly assessing automation. The LABIHS compact NPP simulator, though, still operates under strictly manual printed hard-copy procedures, despite of the fact that the simulator incorporates several advancements in design of digitalized Human-Interfaces (HSIs). This work presents the development, implementation and integration of selected components to achieve increased level of computerized/automated operation of the LABIHS compact NPP simulator. Specifically, we discuss three components: (I) Automatic Plant Mode Detection, (II) Automatic Alarm Filtering, and (III) Computerized Procedures. Each one of these components has to be carefully designed/integrated so that one can avoid the undesired effects of some known implementations of automated systems on NPP, such as the reduction in the operator's system awareness, an increase in monitoring workload, and the degradation in manual skills, which could lead to automation-induced system failures. (author)
Integration of computerized operation support systems on a nuclear power plant environment
International Nuclear Information System (INIS)
Jaime, Guilherme D.G.; Almeida, Jose C.S.; Oliveira, Mauro V.
2015-01-01
Automation of certain tasks in a Nuclear Power Plant (NPP) control room is expected to result in reduced operators' mental workload, which may induce other benefits such as enhanced situation awareness and improved system performance. The final goal should be higher level of operational safety. Thus, recent works are increasingly assessing automation. The LABIHS compact NPP simulator, though, still operates under strictly manual printed hard-copy procedures, despite of the fact that the simulator incorporates several advancements in design of digitalized Human-Interfaces (HSIs). This work presents the development, implementation and integration of selected components to achieve increased level of computerized/automated operation of the LABIHS compact NPP simulator. Specifically, we discuss three components: (I) Automatic Plant Mode Detection, (II) Automatic Alarm Filtering, and (III) Computerized Procedures. Each one of these components has to be carefully designed/integrated so that one can avoid the undesired effects of some known implementations of automated systems on NPP, such as the reduction in the operator's system awareness, an increase in monitoring workload, and the degradation in manual skills, which could lead to automation-induced system failures. (author)
Skill retention and control room operator competency
International Nuclear Information System (INIS)
Stammers, R.B.
1981-12-01
The problem of skill retention in relation to the competency of control room operators is addressed. Although there are a number of related reviews of the literature, this particular topic has not been examined in detail before. The findings of these reviews are summarised and their implications for the area discussed. The limited research on skill retention in connection with process control is also reviewed. Some topics from cognitive and instructional psychology are also raised. In particular overlearning is tackled and the potential value of learning strategies is assessed. In conclusion the important topic of measurement of performance is introduced and a number of potentially valuable training approaches are outlined. (author)
Bacterial burden in the operating room: impact of airflow systems.
Hirsch, Tobias; Hubert, Helmine; Fischer, Sebastian; Lahmer, Armin; Lehnhardt, Marcus; Steinau, Hans-Ulrich; Steinstraesser, Lars; Seipp, Hans-Martin
2012-09-01
Wound infections present one of the most prevalent and frequent complications associated with surgical procedures. This study analyzes the impact of currently used ventilation systems in the operating room to reduce bacterial contamination during surgical procedures. Four ventilation systems (window-based ventilation, supported air nozzle canopy, low-turbulence displacement airflow, and low-turbulence displacement airflow with flow stabilizer) were analyzed. Two hundred seventy-seven surgical procedures in 6 operating rooms of 5 different hospitals were analyzed for this study. Window-based ventilation showed the highest intraoperative contamination (13.3 colony-forming units [CFU]/h) followed by supported air nozzle canopy (6.4 CFU/h; P = .001 vs window-based ventilation) and low-turbulence displacement airflow (3.4 and 0.8 CFU/h; P system showed no increase of contamination in prolonged durations of surgical procedures. This study shows that intraoperative contamination can be significantly reduced by the use of adequate ventilation systems. Copyright © 2012 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.
Ergonomics in the operating room: protecting the surgeon.
Rosenblatt, Peter L; McKinney, Jessica; Adams, Sonia R
2013-01-01
To review elements of an ergonomic operating room environment and describe common ergonomic errors in surgeon posture during laparoscopic and robotic surgery. Descriptive video based on clinical experience and a review of the literature (Canadian Task Force classification III). Community teaching hospital affiliated with a major teaching hospital. Gynecologic surgeons. Demonstration of surgical ergonomic principles and common errors in surgical ergonomics by a physical therapist and surgeon. The physical nature of surgery necessitates awareness of ergonomic principles. The literature has identified ergonomic awareness to be grossly lacking among practicing surgeons, and video has not been documented as a teaching tool for this population. Taking this into account, we created a video that demonstrates proper positioning of monitors and equipment, and incorrect and correct ergonomic positions during surgery. Also presented are 3 common ergonomic errors in surgeon posture: forward head position, improper shoulder elevation, and pelvic girdle asymmetry. Postural reset and motion strategies are demonstrated to help the surgeon learn techniques to counterbalance the sustained and awkward positions common during surgery that lead to muscle fatigue, pain, and degenerative changes. Correct ergonomics is a learned and practiced behavior. We believe that video is a useful way to facilitate improvement in ergonomic behaviors. We suggest that consideration of operating room setup, proper posture, and practice of postural resets are necessary components for a longer, healthier, and pain-free surgical career. Copyright © 2013 AAGL. Published by Elsevier Inc. All rights reserved.
Energy Technology Data Exchange (ETDEWEB)
Jones, Lawrence E. [Alstom Grid, Inc., Washington, DC (United States)
2011-11-01
This is the executive summary for a report that provides findings from the field regarding the best ways in which to guide operational strategies, business processes and control room tools to support the integration of renewable energy into electrical grids.
Liu, Baozhen; Liu, Zhiguo; Wang, Xianwen
2015-06-01
A mobile operating room information management system with electronic medical record (EMR) is designed to improve work efficiency and to enhance the patient information sharing. In the operating room, this system acquires the information from various medical devices through the Client/Server (C/S) pattern, and automatically generates XML-based EMR. Outside the operating room, this system provides information access service by using the Browser/Server (B/S) pattern. Software test shows that this system can correctly collect medical information from equipment and clearly display the real-time waveform. By achieving surgery records with higher quality and sharing the information among mobile medical units, this system can effectively reduce doctors' workload and promote the information construction of the field hospital.
LOFT advanced control room operator diagnostic and display system (ODDS)
International Nuclear Information System (INIS)
Larsen, D.G.; Robb, T.C.
1980-01-01
The Loss-of-Fluid Test (LOFT) Reactor Facility in Idaho includes a highly instrumented nuclear reactor operated by the Department of Energy for the purpose of establishing nuclear safety requirements. The results of the development and installation into LOFT of an Operator Diagnostic and Display System (ODDS) are presented. The ODDS is a computer-based graphics display system centered around a PRIME 550 computer with several RAMTEK color graphic display units located within the control room and available to the reactor operators. Use of computer-based color graphics to aid the reactor operator is discussed. A detailed hardware description of the LOFT data system and the ODDS is presented. Methods and problems of backfitting the ODDS equipment into the LOFT plant are discussed
Fire in the Operating Room During Hypospadias Repair
Directory of Open Access Journals (Sweden)
Alessandro Boscarelli
2017-11-01
Full Text Available Fire in the operating room (OR is a very distressful and shocking occurrence with potential dramatic consequences. Despite safety rules and rigorous recommendations, such unintentional events do occur every so often. Notably, the vast majority of cases have been reported in the adult population, with very few pediatric cases described to date. Herein, we report on a 16-month-old boy undergoing reconstructive surgery for penoscrotal hypospadias, who experienced an OR fire most likely related to the use of alcohol-based solution ignited by monopolar electrocautery.
Nuclear power plant control room operators' performance research
International Nuclear Information System (INIS)
Gray, L.H.; Haas, P.M.
1984-01-01
A research program is being conducted to provide information on the performance of nuclear power plant control room operators when responding to abnormal/emergency events in the plants and in full-scope training simulators. The initial impetus for this program was the need for data to assess proposed design criteria for the choice of manual versus automatic action for accomplishing safety-related functions during design basis accidents. The program also included studies of training simulator capabilities, of procedures and data for specifying and verifying simulator performance, and of methods and applications of task analysis
Haarbrandt, Birger; Wilschko, Andreas; Marschollek, Michael
2016-01-01
In order to integrate operative report documents from two operating room management systems into a data warehouse, we investigated the application of the two-level modelling approach of openEHR to create a shared data model. Based on the systems' analyses, a template consisting of 13 archetypes has been developed. Of these 13 archetypes, 3 have been obtained from the international archetype repository of the openEHR foundation. The remaining 10 archetypes have been newly created. The template was evaluated by an application system expert and through conducting a first test mapping of real-world data from one of the systems. The evaluation showed that by using the two-level modelling approach of openEHR, we succeeded to represent an integrated and shared information model for operative report documents. More research is needed to learn about the limitations of this approach in other data integration scenarios.
[Management for the operating room].
Tschudi, O; Schüpfer, G
2015-03-01
Business companies, which in the current times also includes hospitals, must create customer benefits and as a prerequisite for this must sustainably generate profits. Management in the world of business means the formation and directing of a company or parts of a company on a permanent basis, whereby management in this context is not exercising power but function. This concept of management is exemplary developed in this article for the important services sector of the operating room (OR) and individual functions, such as resource control, capacity planning and materials administration are presented in detail. Some OR-specific management challenges are worked out. From this it becomes clear that the economic logic of the most efficient implementation possible is not a contradiction of medical ethics, enabling the most effective treatment possible for patients while safeguarding the highest possible levels of safety and quality. The article aims to build a bridge for medical specialists to the language and world of commerce, emphasizing the profession-based competence and hopefully to arouse interest to go into more detail.
Design of air distribution system in operating rooms -theory versus practice
Melhado, M.A.; Loomans, M.G.L.C.; Hensen, J.L.M.; Lamberts, R.
2016-01-01
Air distribution systems need to secure a good indoor air quality in operating rooms (ORs), minimize the risk of surgical site infections, and establish suitable working conditions for the surgical team through the thermal comfort. The paper presents an overview of the design and decision process of
Hybrid control rooms: the effects of introducing new technology into existing control rooms
International Nuclear Information System (INIS)
Morisseau, Dolores S.
2001-02-01
The goal of this part of the Hybrid Control Room Project is to gain a perspective on the issues and problems that are an integral part of introducing new technology, automated systems, or support systems into nuclear power plant (NPP) control rooms, particularly when they are introduced on a system-by-system basis. For purposes of this project, hybrid control rooms are defined as those into which new technology, such as digital and computer-based controls are gradually incorporated as opposed to those that are completely, or nearly completely, refitted with new technology. Although the focus of this project is the introduction of computer based, digital systems into NPP control rooms, it is not possible to exclude the effects throughout the process that are inevitable when new technology is introduced anywhere in complex process control systems. Thus, this document examines the effects of such changes within the context of the organisation in which they occur, including the management of change, work procedures and work methods, communications and crew interaction, training, and the interdependent functions in the operational context. (Author)
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.
Psychophysical workload in the operating room: primary surgeon versus assistant.
Rieger, Annika; Fenger, Sebastian; Neubert, Sebastian; Weippert, Matthias; Kreuzfeld, Steffi; Stoll, Regina
2015-07-01
Working in the operating room is characterized by high demands and overall workload of the surgical team. Surgeons often report that they feel more stressed when operating as a primary surgeon than in the function as an assistant which has been confirmed in recent studies. In this study, intra-individual workload was assessed in both intraoperative functions using a multidimensional approach that combined objective and subjective measures in a realistic work setting. Surgeons' intraoperative psychophysiologic workload was assessed through a mobile health system. 25 surgeons agreed to take part in the 24-hour monitoring by giving their written informed consent. The mobile health system contained a sensor electronic module integrated in a chest belt and measuring physiological parameters such as heart rate (HR), breathing rate (BR), and skin temperature. Subjective workload was assessed pre- and postoperatively using an electronic version of the NASA-TLX on a smartphone. The smartphone served as a communication unit and transferred objective and subjective measures to a communication server where data were stored and analyzed. Working as a primary surgeon did not result in higher workload. Neither NASA-TLX ratings nor physiological workload indicators were related to intraoperative function. In contrast, length of surgeries had a significant impact on intraoperative physical demands (p NASA-TLX sum score (p < 0.01; η(2) = 0.287). Intra-individual workload differences do not relate to intraoperative role of surgeons when length of surgery is considered as covariate. An intelligent operating management that considers the length of surgeries by implementing short breaks could contribute to the optimization of intraoperative workload and the preservation of surgeons' health, respectively. The value of mobile health systems for continuous psychophysiologic workload assessment was shown.
GOTHIC Simulation of APR1400 Auxiliary Charging Pump room heat up
Energy Technology Data Exchange (ETDEWEB)
Ha, Hui-Un; Heo, Sun [KHNP, Daejeon (Korea, Republic of)
2014-10-15
As a part of the Advanced Power Reactor 1400 (APR1400) U. S. Nuclear Regulatory Commission Design Certification (NRC DC) project, we have been investigating Auxiliary Charging Pump (ACP) room heat up. With reference to the design specification of the ACP room, we determined input information and developed a GOTHIC model of the APR1400 ACP room. This calculation model is described herein, and representative results from the calculation are presented as well. The results of the present paper are used to determine the integrity of ACP operating in the accident. APR 1400 GOTHIC model was developed for ACP room heat up calculation. Calculation results confirm that door opening is cooling the room properly. It is found that the difference due to the surface option of heat conductors is insignificant. Based on this result, further studies should be performed to confirm integrity of ACP.
Development of an integrated decision support system to aid cognitive activities of operators
International Nuclear Information System (INIS)
Lee, Seung Jun; Seong, Poong Hyun
2007-01-01
As digital and computer technologies have grown, Human-Machine Interfaces (HMIs) have evolved. In safety-critical systems, especially in Nuclear Power Plants (NPPs), HMIs are important for reducing operational costs, the number of necessary operators, and the probability of accident occurrence. Efforts have been made to improve Main Control Room (MCR) interface design and to develop automated or decision support systems to ensure convenient operation and maintenance. In this paper, an integrated decision support system to aid operator cognitive processes is proposed for advanced MCRs of future NPPs. This work suggests the design concept of a decision support system which accounts for an operator's cognitive processes. The proposed system supports not only a particular task, but also the entire operation process based on a human cognitive process model. In this paper, the operator's operation processes are analyzed according to a human cognitive process model and appropriate support systems that support each cognitive process activity are suggested
International Nuclear Information System (INIS)
Yuzhakov, A.Yu.
2010-01-01
The author reports on the application of full-scale simulators for training and maintaining proficiency of unit control room operators that is an essential element of Russian NPPs personnel education system. The existing simulators for the unit control room operating personnel are listed. The integrated approach to developing and maintaining the training hardware is described. The integrated approach is being implemented on the basis of observance of the existing requirements to training hardware, improvement of regulations, control from a single centre responsible for the provision of support to the activities, inclusion into the plans of simulators for development of skills for operating control over equipment and systems, as well as control from local boards [ru
Numerical simulation of manual operation at MID stand control room
International Nuclear Information System (INIS)
Doca, C.; Dobre, A.; Predescu, D.; Mielcioiu, A.
2003-01-01
Since 2000 at INR Pitesti a package of software products devoted to numerical simulation of manual operations at fueling machine control room was developed. So far, specified, designed, worked out and implemented was the PUPITRU code. The following issues were solved: graphical aspects of specific computer - human operator interface; functional and graphical simulation of the whole associated equipment of the control desk components; implementation of the main notation as used in the automated schemes of the control desk in view of the fast identification of the switches, lamps, instrumentation, etc.; implementation within PUPITRU code of the entire data base used in the frame of MID tests; implementation of a number of about 1000 numerical simulation equations describing specific operational MID testing situations
Have it your way. A modular approach to custom compact control rooms
International Nuclear Information System (INIS)
Harmon, Daryl; Scarola, Ken
2003-01-01
) to integrate fully qualified HMI devices directly into individual normal operational consoles. This paper describes a modular approach to designing custom compact control rooms. In particular, it (1) describes the Westinghouse HMI building blocks for a compact control room, (2) describes the integration of standard, software-based HMI resources using the building block approach, (3) provides examples of compact control room configurations based on this approach that support new plant construction and existing plant modernizations and (4) discusses the advantages of this compact control room design approach. (author)
Nitrous oxide levels in operating and recovery rooms of Iranian hospitals.
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.
Li, Xiangyong; Rafaliya, N; Baki, M Fazle; Chaouch, Ben A
2017-03-01
Scheduling of surgeries in the operating rooms under limited competing resources such as surgical and nursing staff, anesthesiologist, medical equipment, and recovery beds in surgical wards is a complicated process. A well-designed schedule should be concerned with the welfare of the entire system by allocating the available resources in an efficient and effective manner. In this paper, we develop an integer linear programming model in a manner useful for multiple goals for optimally scheduling elective surgeries based on the availability of surgeons and operating rooms over a time horizon. In particular, the model is concerned with the minimization of the following important goals: (1) the anticipated number of patients waiting for service; (2) the underutilization of operating room time; (3) the maximum expected number of patients in the recovery unit; and (4) the expected range (the difference between maximum and minimum expected number) of patients in the recovery unit. We develop two goal programming (GP) models: lexicographic GP model and weighted GP model. The lexicographic GP model schedules operating rooms when various preemptive priority levels are given to these four goals. A numerical study is conducted to illustrate the optimal master-surgery schedule obtained from the models. The numerical results demonstrate that when the available number of surgeons and operating rooms is known without error over the planning horizon, the proposed models can produce good schedules and priority levels and preference weights of four goals affect the resulting schedules. The results quantify the tradeoffs that must take place as the preemptive-weights of the four goals are changed.
The design and operation of the THORP central control room: a human factors perspective
International Nuclear Information System (INIS)
Reed, Julie.
1996-01-01
The new Thermal Oxide Reprocessing Plant (THORP) at British Nuclear Fuels (BNFL) Sellafield Site is now operational. This paper describes the Central Control Room (CCR), focusing on the control system components. Throughout the design, commissioning and operation of THORP, human factors played an important part. (author)
Review of the Operability for the Components Under the Loss of the HVAC System of the Pump Room
International Nuclear Information System (INIS)
Hwang Mee Jeong; Yoon, Churl; Yang, Joon Eon; Park, Joo Hwan
2005-01-01
In this paper, we estimated the temperature of the pump rooms and reviewed the operability of the components under the loss of the HVAC (Heating, Ventilation, and Air Condition) system. The issues relevant to the HVAC system in the PSA (Probabilistic Safety Assessment) FT (Fault Tree) model are as follows: does the loss of the HVAC system bring about a function failure of other components?. Can the operator take action to reduce the temperature of the room in case of a HVAC function failure?. At present we do not know whether a component will lose its function or not under the loss of the HVAC. ASME Standard describes that a recovery action can be credited if the related recovery action is included in the procedure or there are similar recovery experiences in the plant. However, there is no description about the recovery action of the HVAC in the EOP (Emergency Operation Procedure) of the UCN3, 4 under the situation of a loss of the HVAC. Even though we consider this assumption positively, it would be limited to the rooms such as the Switchgear Room, Inverter Room, and Main Control Room etc. where a real recovery action can be performed easily. However, if we consider the HVAC failure in the PSA FT model according to the above background, the problem is that the unavailability induced from the loss of a HVAC is highly unrealistically. From a viewpoint of the PSA, it is not true that the related system always fails even though the HVAC system fails. Therefore, we reviewed the necessity of the HVAC model through the identification of the operable temperature of the components' within the pump room and the change of the temperature of the pump room under the situation of a loss of the HVAC system
International Nuclear Information System (INIS)
Spurgin, A.J.; Orvis, D.D.; Spurgin, J.P.; Luna, C.J.
1990-05-01
This report presents the results of a project sponsored by the Electric Power Research Institute (EPRI) and Taiwan Power Company (TPC) and conducted by APG and TPC to perform evaluation of the Emergency Operating Procedures Tracking System (EOPTS). The EOPTS is an expert system employing artificial intelligence techniques developed by EPRI for Boiling Water Reactor (BWR) plants based on emergency operating procedures (EOPs). EOPTS is a computerized decision aid used to assist plant operators in efficient and reliable use of EOPs. The main objective of this project was to evaluate the EOPTS and determine how an operator aid of this type could noticeably improve the response time and the reliability of control room crews to multi-failure scenarios. A secondary objective was to collect data on how crew performance was affected. Experiments results indicate that the EOPTS measurably improves crew performance over crews using the EOP flow charts. Time-comparison measurements indicate that crews using the EOPTS perform required actions more quickly than do those using the flowcharts. The results indicate that crews using the EOPTS are not only faster and more consistent in their actions but make fewer errors. In addition, they have a higher likelihood of recovering from the errors that they do make. Use of the EOPTS in the control room should result in faster termination and mitigation of accidents and reduced risk of power plant operations. Recommendations are made towards possible applications of the EOPTS to operator training and evaluation, and for the applicability of the evaluation methodology developed for this project to the evaluation of similar operator aides. 17 refs., 14 figs., 14 tabs
Feo, Claudio F; Ginesu, Giorgio C; Bellini, Alessandro; Cherchi, Giuseppe; Scanu, Antonio M; Cossu, Maria Laura; Fancellu, Alessandro; Porcu, Alberto
2017-09-01
Totally implantable venous access devices (TIVADs) represent a convenient way for the administration of medications or nutrients. Traditionally, chest ports have been positioned by surgeons in the operating room, however there has been a transition over the years to port insertion by interventional radiologists in the radiology suite. The optimal method for chest port placement is still under debate. Data on all adult patients undergoing isolated chest port placement at our institution in a 12-year period were retrospectively reviewed. The aim of this cohort study was to compare cost and morbidity for chest port insertion in two different settings: outpatient clinic and operating room. Between 2003 and 2015 a total of 527 chest ports were placed in adult patients. Of them, 262 procedures were performed in the operating room and 265 procedures were undertaken in the outpatient clinic. Patient characteristics were similar and there was no significant difference in early (port was 1270 Euros in the operating room versus 620 Euros in the outpatient clinic. Our results suggest that chest ports can be safely placed in most patients under local anesthesia in the office setting without fluoroscopy or ultrasound guidance. Future randomized controlled studies may evaluate if surgeons or interventional radiologists should routinely perform these procedures in a dedicated office setting and reserve more sophisticated facilities only for patients at high risk of technical failure.
Case review analysis of operating room decisions to cancel surgery.
Chang, Ju-Hsin; Chen, Ke-Wei; Chen, Kuen-Bao; Poon, Kin-Shing; Liu, Shih-Kai
2014-07-23
Cancellation of surgery close to scheduled time causes a waste of healthcare resources. The current study analyzes surgery cancellations occurring after the patient has been prepared for the operating room, in order to see whether improvements in the surgery planning process may reduce the number of cancellations. In a retrospective chart review of operating room surgery cancellations during the period from 2006 to 2011, cancellations were divided into the following categories: inadequate NPO; medical; surgical; system; airway; incomplete evaluation. The relative use of these reasons in relation to patient age and surgical department was then evaluated. Forty-one percent of cancellations were for other than medical reasons. Among these, 17.7% were due to incomplete evaluation, and 8.2% were due to family issues. Sixty seven percent of cancelled cases eventually received surgery. The relative use of individual reasons for cancellation varied with patient age and surgical department. The difference between cancellations before and after anesthesia was dependent on the causes of cancellation, but not age, sex, ASA status, or follow-up procedures required. Almost half of the cancellations were not due to medical reasons, and these cancellations could be reduced by better administrative and surgical planning and better communication with the patient and/or his family.
Operator-based metric for nuclear operations automation assessment
Energy Technology Data Exchange (ETDEWEB)
Zacharias, G.L.; Miao, A.X.; Kalkan, A. [Charles River Analytics Inc., Cambridge, MA (United States)] [and others
1995-04-01
Continuing advances in real-time computational capabilities will support enhanced levels of smart automation and AI-based decision-aiding systems in the nuclear power plant (NPP) control room of the future. To support development of these aids, we describe in this paper a research tool, and more specifically, a quantitative metric, to assess the impact of proposed automation/aiding concepts in a manner that can account for a number of interlinked factors in the control room environment. In particular, we describe a cognitive operator/plant model that serves as a framework for integrating the operator`s information-processing capabilities with his procedural knowledge, to provide insight as to how situations are assessed by the operator, decisions made, procedures executed, and communications conducted. Our focus is on the situation assessment (SA) behavior of the operator, the development of a quantitative metric reflecting overall operator awareness, and the use of this metric in evaluating automation/aiding options. We describe the results of a model-based simulation of a selected emergency scenario, and metric-based evaluation of a range of contemplated NPP control room automation/aiding options. The results demonstrate the feasibility of model-based analysis of contemplated control room enhancements, and highlight the need for empirical validation.
Factors Affecting Acoustics and Speech Intelligibility in the Operating Room: Size Matters.
McNeer, Richard R; Bennett, Christopher L; Horn, Danielle Bodzin; Dudaryk, Roman
2017-06-01
Noise in health care settings has increased since 1960 and represents a significant source of dissatisfaction among staff and patients and risk to patient safety. Operating rooms (ORs) in which effective communication is crucial are particularly noisy. Speech intelligibility is impacted by noise, room architecture, and acoustics. For example, sound reverberation time (RT60) increases with room size, which can negatively impact intelligibility, while room objects are hypothesized to have the opposite effect. We explored these relationships by investigating room construction and acoustics of the surgical suites at our institution. We studied our ORs during times of nonuse. Room dimensions were measured to calculate room volumes (VR). Room content was assessed by estimating size and assigning items into 5 volume categories to arrive at an adjusted room content volume (VC) metric. Psychoacoustic analyses were performed by playing sweep tones from a speaker and recording the impulse responses (ie, resulting sound fields) from 3 locations in each room. The recordings were used to calculate 6 psychoacoustic indices of intelligibility. Multiple linear regression was performed using VR and VC as predictor variables and each intelligibility index as an outcome variable. A total of 40 ORs were studied. The surgical suites were characterized by a large degree of construction and surface finish heterogeneity and varied in size from 71.2 to 196.4 m (average VR = 131.1 [34.2] m). An insignificant correlation was observed between VR and VC (Pearson correlation = 0.223, P = .166). Multiple linear regression model fits and β coefficients for VR were highly significant for each of the intelligibility indices and were best for RT60 (R = 0.666, F(2, 37) = 39.9, P the size and contents of an OR can predict a range of psychoacoustic indices of speech intelligibility. Specifically, increasing OR size correlated with worse speech intelligibility, while increasing amounts of OR contents
Modeling of a dependence between human operators in advanced main control rooms
International Nuclear Information System (INIS)
Lee, Seung Jun; Kim, Jaewhan; Jang, Seung-Cheol; Shin, Yeong Cheol
2009-01-01
For the human reliability analysis of main control room (MCR) operations, not only parameters such as the given situation and capability of the operators but also the dependence between the actions of the operators should be considered because MCR operations are team operations. The dependence between operators might be more prevalent in an advanced MCR in which operators share the same information using a computerized monitoring system or a computerized procedure system. Therefore, this work focused on the computerized operation environment of advanced MCRs and proposed a model to consider the dependence representing the recovery possibility of an operator error by another operator. The proposed model estimates human error probability values by considering adjustment values for a situation and dependence values for operators during the same operation using independent event trees. This work can be used to quantitatively calculate a more reliable operation failure probability for an advanced MCR. (author)
Directory of Open Access Journals (Sweden)
Shima Moshfegh
2017-07-01
Full Text Available Background Recently, X-rays radiation hazards rise with the exposure of patients and personnel. Exposure of people to radiation in the operating rooms is an important problem to study the safety of personnel and patients. To date, few studies are accomplished to evaluate knowledge, attitude, and practice (KAP among personnel in hospitals. The current study aimed at evaluating KAP level of radiation hazards and protection amongst personnel in the operating room. Methods A questionnaire-based, cross sectional study was conducted in 11 provinces of Iran from 2014 to 2015. Respondents in the current study were 332 personnel of operating room, endoscopic retrograde cholangiopancreatography, and extracorporeal shock-wave lithotripsy. Demographic characteristics, as well as knowledge, attitude, and practice levels of operating room personnel were collected. The selected hospitals were 3 types (educational, non-educational, and private clinics located in 5 different regions of Iran (Tehran, Center, East, North, and West. Data were analyzed using SPSS version 16.0 and statistical analyses were accomplished with the one-way ANOVA. Results The current study results showed no statistically significant difference in the KAP level of operating room personnel towards radiation protection for both genders (P = 0.1, time since graduation (P = 0.4, and work experience (P = 0.1. According to the analyses, the highest level of KAP concerning radiation protection was observed in the personnel of private clinics (mean score = 53.60 and the lowest value was observed in non-educational hospitals (mean score = 45.61. Besides, the KAP level was significantly higher in the Northern region (P < 0.0001 and the lowest was observed in the hospital personnel of the Central region (mean score = 34.27. Conclusions The current study findings showed that the level of KAP regarding radiation protection among operating room personnel was inadequate and it is necessary to pay
Use of hands-free technique among operating room nurses in the Republic of Korea.
Jeong, Ihn Sook; Park, Sunmi
2009-03-01
The recently introduced concept of hands-free technique (HFT) currently has no recommendations or formal educational program for use in the Republic of Korea. This study evaluated the level of HFT use and investigated factors related to HFT use among Korean operating room nurses. Data were obtained through a self-administered questionnaire from 158 operating room nurses in 7 general hospitals in Busan, Republic of Korea, in April and May 2006. The questionnaire elicited information on demographics, exposure to education on HFT, attitude toward the need for HFT, concerns about exposure to bloodborne pathogens, and experience with HTF use. Multilevel multiple logistic regression analysis with generalized estimating equations was used, and adjusted odds ratios (ORs) and their 95% confidence intervals (CIs) were calculated. We found that 56% of the participants had used HFT, and 50% had received education on HFT. The use of HFT had a significant association with both education on HFT (OR = 12.02; 95% CI = 7.50 to 19.25) and attitude toward the need for HFT (OR = 4.22; 95% CI = 2.43 to 7.35). Increasing education about HFT could be the most important approach to increasing the use of HFT among Korean operating room nurses. Thus, routine teaching about HFT should be provided to these nurses.
Future control room design (modernization of control room systems)
International Nuclear Information System (INIS)
Reischl, Ludwig; Freitag, Timo; Dergel, Rene
2009-01-01
In the frame of lifetime extension for nuclear power plants the modernization of the complete safety and operational control technology will be digitalized. It is also recommended to modernize the operator facilities, monitoring systems in the control room, the back-up shut-down center and the local control stations. The authors summarize the reasons for the modernization recommendations and discuss possible solutions for display-oriented control rooms. A concept for control room backfitting includes generic requirements, requirements of the local authorities, ergonomic principles information content and information density, and the design process. The backfitting strategy should include a cooperation with the operational personnel, The quality assurance and training via simulator needs sufficient timing during the implementation of the backfitting.
What factors influence attending surgeon decisions about resident autonomy in the operating room?
Williams, Reed G; George, Brian C; Meyerson, Shari L; Bohnen, Jordan D; Dunnington, Gary L; Schuller, Mary C; Torbeck, Laura; Mullen, John T; Auyang, Edward; Chipman, Jeffrey G; Choi, Jennifer; Choti, Michael; Endean, Eric; Foley, Eugene F; Mandell, Samuel; Meier, Andreas; Smink, Douglas S; Terhune, Kyla P; Wise, Paul; DaRosa, Debra; Soper, Nathaniel; Zwischenberger, Joseph B; Lillemoe, Keith D; Fryer, Jonathan P
2017-12-01
Educating residents in the operating room requires balancing patient safety, operating room efficiency demands, and resident learning needs. This study explores 4 factors that influence the amount of autonomy supervising surgeons afford to residents. We evaluated 7,297 operations performed by 487 general surgery residents and evaluated by 424 supervising surgeons from 14 training programs. The primary outcome measure was supervising surgeon autonomy granted to the resident during the operative procedure. Predictor variables included resident performance on that case, supervising surgeon history with granting autonomy, resident training level, and case difficulty. Resident performance was the strongest predictor of autonomy granted. Typical autonomy by supervising surgeon was the second most important predictor. Each additional factor led to a smaller but still significant improvement in ability to predict the supervising surgeon's autonomy decision. The 4 factors together accounted for 54% of decision variance (r = 0.74). Residents' operative performance in each case was the strongest predictor of how much autonomy was allowed in that case. Typical autonomy granted by the supervising surgeon, the second most important predictor, is unrelated to resident proficiency and warrants efforts to ensure that residents perform each procedure with many different supervisors. Copyright © 2017 Elsevier Inc. All rights reserved.
Finite volume method room acoustic simulations integrated into the architectural design process
DEFF Research Database (Denmark)
Pind Jörgensson, Finnur Kári; Jeong, Cheol-Ho; Engsig-Karup, Allan Peter
2017-01-01
with the architectural design from the earliest design stage, as a part of a holistic design process. A new procedure to integrate room acoustics into architectural design is being developed in a Ph.D. project, with the aim of promoting this early stage holistic design process. This project aims to develop a new hybrid...
Early Extubation in the Operating Room after Congenital Open-Heart Surgery.
Fukunishi, Takuma; Oka, Norihiko; Yoshii, Takeshi; Kobayashi, Kensuke; Inoue, Nobuyuki; Horai, Tetsuya; Kitamura, Tadashi; Okamoto, Hirotsugu; Miyaji, Kagami
2018-01-27
Early extubation in the operating room after congenital open-heart surgery is feasible, but extubation in the intensive care unit after the operation remains common practice at many institutions. The purpose of this study was to evaluate retrospectively the adequacy of our early-extubation strategy and exclusion criteria through analysis based on the Risk Adjustment in Congenital Heart Surgery method (RACHS-1).This retrospective analysis included 359 cases requiring cardiopulmonary bypass (male, 195; female, 164; weight > 3.0 kg; aged 1 month to 18 years). Neonates and preoperatively intubated patients were excluded. Other exclusion criteria included severe preoperative pulmonary hypertension, high-dose catecholamine requirement after cardiopulmonary bypass, delayed sternal closure, laryngomalacia, serious bleeding, and delayed awakening. The early-extubation rates were compared between age groups and RACHS-1 classes.Overall, 83% of cases (298/359) were extubated in the operating room, classified by RACHS-1 categories as follows: 1, 59/59 (100%); 2, 164/200 (84%); 3, 61/78 (78%); and 4-6, 10/22 (45%). The early extubation rate in categories 1-3 (86%, 288/337) was significantly higher than for categories 4-6 (45.5%, 10/22) (P open-heart surgery was feasible based on our criteria, especially for patients in the low RACHS-1 categories, and involves a very low rate of re-intubation.
Use of face masks by non-scrubbed operating room staff: a randomized controlled trial.
Webster, Joan; Croger, Sarah; Lister, Carolyn; Doidge, Michelle; Terry, Michael J; Jones, Ian
2010-03-01
Ambiguity remains about the effectiveness of wearing surgical face masks. The purpose of this study was to assess the impact on surgical site infections (SSIs) when non-scrubbed operating room staff did not wear surgical face masks. Eight hundred twenty-seven participants undergoing elective or emergency obstetric, gynecological, general, orthopaedic, breast or urological surgery in an Australian tertiary hospital were enrolled. Complete follow-up data were available for 811 patients (98.1%). Operating room lists were randomly allocated to a 'Mask group' (all non-scrubbed staff wore a mask) or 'No Mask group' (none of the non-scrubbed staff wore masks). The primary end point, SSI was identified using in-patient surveillance; post discharge follow-up and chart reviews. The patient was followed for up to six weeks. Overall, 83 (10.2%) surgical site infections were recorded; 46/401 (11.5%) in the Masked group and 37/410 (9.0%) in the No Mask group; odds ratio (OR) 0.77 (95% confidence interval (CI) 0.49 to 1.21), p = 0.151. Independent risk factors for surgical site infection included: any pre-operative stay (adjusted odds ratio [aOR], 0.43 (95% CI, 0.20; 0.95), high BMI aOR, 0.38 (95% CI, 0.17; 0.87), and any previous surgical site infection aOR, 0.40 (95% CI, 0.17; 0.89). Surgical site infection rates did not increase when non-scrubbed operating room personnel did not wear a face mask.
Directory of Open Access Journals (Sweden)
Damarys Relova
2017-12-01
Full Text Available Worldwide cooperation between laboratories working with classical swine fever virus (CSFV requires exchange of virus isolates. For this purpose, shipment of CSFV RNA is a safe alternative to the exchange of infectious material. New techniques using desiccation have been developed to store RNA at room temperature and are reported as effective means of preserving RNA integrity. In this study, we evaluated the stability and integrity of dried CSFV RNA stored at room temperature. First, we determined the stability of CSFV RNA covering CSFV genome regions used typically for the detection of viral RNA in diagnostic samples by reverse transcription-polymerase chain reaction (RT-PCR. To this end, different concentrations of in vitro-transcribed RNAs of the 5’-untranslated region and of the NS5B gene were stored as dried RNA at 4, 20, and 37oC for two months. Aliquots were analyzed every week by CSFV-specific quantitative real-time RT-PCR. Neither the RNA concentration nor the storage temperature did affect CSFV RNA yields at any of the time evaluated until the end of the experiment. Furthermore, it was possible to recover infectious CSFV after transfection of SK-6 cells with dried viral RNA stored at room temperature for one week. The full-length E2 of CSFV was amplified from all the recovered viruses, and nucleotide sequence analysis revealed 100% identity with the corresponding sequence obtained from RNA of the original material. These results show that CSFV RNA stored as dried RNA at room temperature is stable, maintaining its integrity for downstream analyses and applications.
International Nuclear Information System (INIS)
Jackson, A.R.G.
1988-01-01
This paper reports on the use of operator surveys and trip report analysis methods which the Central Electricity Generating Board has developed to assess the extent and adequacy of operator support systems currently installed on its four twin-reactor, first generation Advanced Gas Cooled Reactor nuclear power plants. The survey consisted of a programme of structured interviews with control room engineers. The scope of the questions addressed; working environment, communications, man-machine interface, procedural information, and the diagnostic and predictive support system. The analysis of trip reports was targetted at identifying aspects of the performance of the operator support systems which might have been contributory to the cause of reactor trip. The results of this work are being used to assist in determining guidelines for the development of operator support systems, computerised controls and the structure of station operating procedures
Single-use surgical clothing system for reduction of airborne bacteria in the operating room.
Tammelin, A; Ljungqvist, B; Reinmüller, B
2013-07-01
It is desirable to maintain a low bacterial count in the operating room air to prevent surgical site infection. This can be achieved by ventilation or by all staff in the operating room wearing clothes made from low-permeable material (i.e. clean air suits). We investigated whether there was a difference in protective efficacy between a single-use clothing system made of polypropylene and a reusable clothing system made of a mixed material (cotton/polyester) by testing both in a dispersal chamber and during surgical procedures. Counts of colony-forming units (cfu)/m(3) air were significantly lower when using the single-use clothing system in both settings. Copyright © 2013 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.
Arakelian, E; Gunningberg, L; Larsson, J
2008-11-01
How to increase efficiency in operating departments has been widely studied. However, there is no overall definition of efficiency. Supervisors urging staff to work efficiently may meet strong reactions due to staff believing that demands for efficiency means just stress at work. Differences in how efficiency is understood may constitute an obstacle to supervisors' efforts to promote it. This study aimed to explore how staff and leadership understand operating room efficiency. Twenty-one members of staff and supervisors in an operating department in a Swedish county hospital were interviewed. The analysis was performed with a phenomenographic approach that aims to discover the variations in how a phenomenon is understood by a group of people. Six categories were found in the understanding of operation room efficiency: (A) having the right qualifications; (B) enjoying work; (C) planning and having good control and overview; (D) each professional performing the correct tasks; (E) completing a work assignment; and (F) producing as much as possible per time unit. The most significant finding was that most of the nurses and assistant nurses understood efficiency as individual knowledge and experience emphasizing the importance of the work process, whereas the supervisors and physicians understood efficiency in terms of production per time unit or completing an assignment. The concept 'operating room efficiency' is understood in different ways by leadership and staff members. Supervisors who are aware of this variation will have better prerequisites for defining the concept and for creating a common platform towards becoming efficient.
Measuring quality indicators in the operating room: cleaning and turnover time.
Jericó, Marli de Carvalho; Perroca, Márcia Galan; da Penha, Vivian Colombo
2011-01-01
This exploratory-descriptive study was carried out in the Surgical Center Unit of a university hospital aiming to measure time spent with concurrent cleaning performed by the cleaning service and turnover time and also investigated potential associations between cleaning time and the surgery's magnitude and specialty, period of the day and the room's size. The sample consisted of 101 surgeries, computing cleaning time and 60 surgeries, computing turnover time. The Kaplan-Meier method was used to analyze time and Pearson's correlation to study potential correlations. The time spent in concurrent cleaning was 7.1 minutes and turnover time was 35.6 minutes. No association between cleaning time and the other variables was found. These findings can support nurses in the efficient use of resources thereby speeding up the work process in the operating room.
International Nuclear Information System (INIS)
Aro, Ilari; Koizumi, Hiroyoshi; Manzella, Pietro
1998-01-01
The CNRA believes that safety inspections are a major element in the regulatory authority's efforts to ensure the safe operation of nuclear facilities. Considering the importance of these issues, the Committee has established a special Working Group on Inspection Practices (WGIP). The purpose of WGIP, is to facilitate the exchange of information and experience related to regulatory safety inspections between CNRA Member countries In 1996, members of WGIP discussed various ways in which regulatory inspectors look at and evaluate how licenses are given to control room operators and shift supervisors in the Member countries. As a result of these discussions it was proposed to put together a short comparison report on this issue. The CNRA approved work on this at its annual meeting that year. This CNRA/WGIP study concentrates on the regulatory inspection of control room operator competence and authorisation. As noted in the text, fourteen Member countries supplied input by responding to the questionnaire. This report presents a comparison of inspection practices in participating OECD countries relating to control room operator and shift supervisor licenses. The report has been derived from answers to a questionnaire on the basis of guidance given in Appendix 1.1 with the detailed answers being given in Appendix 1. Key questions for this comparison were 'What are the regulatory or licensee requirements for holding and up-keeping a license or authorisation' and 'How does the regulatory body inspect the training and competence of shift teams and individual operators'. The main conclusion from the comparison is that the general practice within the participating countries for ensuring the competence of operators is broadly similar although regulatory practices differ markedly. For example, the regulatory bodies in some countries are actively involved in the examination and licensing process of individual operators whereas other regulatory bodies
Hybrid simulation: bringing motivation to the art of teamwork training in the operating room.
Kjellin, A; Hedman, L; Escher, C; Felländer-Tsai, L
2014-12-01
Crew resource management-based operating room team training will be an evident part of future surgical training. Hybrid simulation in the operating room enables the opportunity for trainees to perform higher fidelity training of technical and non-technical skills in a realistic context. We focus on situational motivation and self-efficacy, two important factors for optimal learning in light of a prototype course for teams of residents in surgery and anesthesiology and nurses. Authentic operating room teams consisting of residents in anesthesia (n = 2), anesthesia nurses (n = 3), residents in surgery (n = 2), and scrub nurses (n = 6) were, during a one-day course, exposed to four different scenarios. Their situational motivation was self-assessed (ranging from 1 = does not correspond at all to 7 = corresponds exactly) immediately after training, and their self-efficacy (graded from 1 to 7) before and after training. Training was performed in a mock-up operating theater equipped with a hybrid patient simulator (SimMan 3G; Laerdal) and a laparoscopic simulator (Lap Mentor Express; Simbionix). The functionality of the systematic hybrid procedure simulation scenario was evaluated by an exit questionnaire (graded from 1 = disagree entirely to 5 = agree completely). The trainees were mostly intrinsically motivated, engaged for their own sake, and had a rather great degree of self-determination toward the training situation. Self-efficacy among the team members improved significantly from 4 to 6 (median). Overall evaluation showed very good result with a median grading of 5. We conclude that hybrid simulation is feasible and has the possibility to train an authentic operating team in order to improve individual motivation and confidence. © The Finnish Surgical Society 2014.
Deuchler, Svenja; Wagner, Clemens; Singh, Pankaj; Müller, Michael; Al-Dwairi, Rami; Benjilali, Rachid; Schill, Markus; Ackermann, Hanns; Bon, Dimitra; Kohnen, Thomas; Schoene, Benjamin; Koss, Michael; Koch, Frank
2016-01-01
To evaluate the efficacy of the virtual reality training simulator Eyesi to prepare surgeons for performing pars plana vitrectomies and its potential to predict the surgeons' performance. In a preparation phase, four participating vitreoretinal surgeons performed repeated simulator training with predefined tasks. If a surgeon was assigned to perform a vitrectomy for the management of complex retinal detachment after a surgical break of at least 60 hours it was randomly decided whether a warmup training on the simulator was required (n = 9) or not (n = 12). Performance at the simulator was measured using the built-in scoring metrics. The surgical performance was determined by two blinded observers who analyzed the video-recorded interventions. One of them repeated the analysis to check for intra-observer consistency. The surgical performance of the interventions with and without simulator training was compared. In addition, for the surgeries with simulator training, the simulator performance was compared to the performance in the operating room. Comparing each surgeon's performance with and without warmup trainingshowed a significant effect of warmup training onto the final outcome in the operating room. For the surgeries that were preceeded by the warmup procedure, the performance at the simulator was compared with the operating room performance. We found that there is a significant relation. The governing factor of low scores in the simulator were iatrogenic retinal holes, bleedings and lens damage. Surgeons who caused minor damage in the simulation also performed well in the operating room. Despite the large variation of conditions, the effect of a warmup training as well as a relation between the performance at the simulator and in the operating room was found with statistical significance. Simulator training is able to serve as a warmup to increase the average performance.
Directory of Open Access Journals (Sweden)
Svenja Deuchler
Full Text Available To evaluate the efficacy of the virtual reality training simulator Eyesi to prepare surgeons for performing pars plana vitrectomies and its potential to predict the surgeons' performance.In a preparation phase, four participating vitreoretinal surgeons performed repeated simulator training with predefined tasks. If a surgeon was assigned to perform a vitrectomy for the management of complex retinal detachment after a surgical break of at least 60 hours it was randomly decided whether a warmup training on the simulator was required (n = 9 or not (n = 12. Performance at the simulator was measured using the built-in scoring metrics. The surgical performance was determined by two blinded observers who analyzed the video-recorded interventions. One of them repeated the analysis to check for intra-observer consistency. The surgical performance of the interventions with and without simulator training was compared. In addition, for the surgeries with simulator training, the simulator performance was compared to the performance in the operating room.Comparing each surgeon's performance with and without warmup trainingshowed a significant effect of warmup training onto the final outcome in the operating room. For the surgeries that were preceeded by the warmup procedure, the performance at the simulator was compared with the operating room performance. We found that there is a significant relation. The governing factor of low scores in the simulator were iatrogenic retinal holes, bleedings and lens damage. Surgeons who caused minor damage in the simulation also performed well in the operating room.Despite the large variation of conditions, the effect of a warmup training as well as a relation between the performance at the simulator and in the operating room was found with statistical significance. Simulator training is able to serve as a warmup to increase the average performance.
Automation inflicted differences on operator performance in nuclear power plant control rooms
Energy Technology Data Exchange (ETDEWEB)
Andersson, Jonas; Osvalder, A.L. [Chalmers Univ. of Technology, Dept. of Product and Producton Development (Sweden)
2007-03-15
Today it is possible to automate almost any function in a human-machine system. Therefore it is important to find a balance between automation level and the prerequisites for the operator to maintain safe operation. Different human factors evaluation methods can be used to find differences between automatic and manual operations that have an effect on operator performance; e.g. Predictive Human Error Analysis (PHEA), NASA Task Load Index (NASA-TLX), Halden Questionnaire, and Human Error Assessment and Reduction Technique (HEART). Results from an empirical study concerning automation levels, made at Ringhals power plant, showed that factors as time pressure and criticality of the work situation influenced the operator's performance and mental workload more than differences in level of automation. The results indicate that the operator's attention strategies differ between the manual and automatic sequences. Independently of level of automation, it is essential that the operator retains control and situational understanding. When performing a manual task, the operator is 'closer' to the process and in control with sufficient situational understanding. When the level of automation increases, the demands on information presentation increase to ensure safe plant operation. The need for control can be met by introducing 'control gates' where the operator has to accept that the automatic procedures are continuing as expected. Situational understanding can be established by clear information about process status and by continuous feedback. A conclusion of the study was that a collaborative control room environment is important. Rather than allocating functions to either the operator or the system, a complementary strategy should be used. Key parameters to consider when planning the work in the control room are time constraints and task criticality and how they affect the performance of the joint cognitive system.However, the examined working
Automation inflicted differences on operator performance in nuclear power plant control rooms
International Nuclear Information System (INIS)
Andersson, Jonas; Osvalder, A.L.
2007-03-01
Today it is possible to automate almost any function in a human-machine system. Therefore it is important to find a balance between automation level and the prerequisites for the operator to maintain safe operation. Different human factors evaluation methods can be used to find differences between automatic and manual operations that have an effect on operator performance; e.g. Predictive Human Error Analysis (PHEA), NASA Task Load Index (NASA-TLX), Halden Questionnaire, and Human Error Assessment and Reduction Technique (HEART). Results from an empirical study concerning automation levels, made at Ringhals power plant, showed that factors as time pressure and criticality of the work situation influenced the operator's performance and mental workload more than differences in level of automation. The results indicate that the operator's attention strategies differ between the manual and automatic sequences. Independently of level of automation, it is essential that the operator retains control and situational understanding. When performing a manual task, the operator is 'closer' to the process and in control with sufficient situational understanding. When the level of automation increases, the demands on information presentation increase to ensure safe plant operation. The need for control can be met by introducing 'control gates' where the operator has to accept that the automatic procedures are continuing as expected. Situational understanding can be established by clear information about process status and by continuous feedback. A conclusion of the study was that a collaborative control room environment is important. Rather than allocating functions to either the operator or the system, a complementary strategy should be used. Key parameters to consider when planning the work in the control room are time constraints and task criticality and how they affect the performance of the joint cognitive system.However, the examined working situations were too different
AIS ASM Operational Integration Plan
2013-08-01
Rack mount computer AIS Radio Interface Ethernet Switch 192.168.0.x Firewall Cable Modem 192.168.0.1 VTS Accred. Boundary AIS ASM Operational... AIS ASM Operational Integration Plan Distribution Statement A: Approved for public release; distribution is unlimited. August 2013 Report No...CD-D-07-15 AIS ASM Operational Integration Plan ii UNCLAS//Public | CG-926 R&DC | I. Gonin, et al. | Public August 2013 N O T I C
Seim, Andreas R; Sandberg, Warren S
2010-12-01
To review the current state of anesthesiology for operative and invasive procedures, with an eye toward possible future states. Anesthesiology is at once a mature specialty and in a crisis--requiring breakthrough to move forward. The cost of care now approaches reimbursement, and outcomes as commonly measured approach perfection. Thus, the cost of further improvements seems ready to topple the field, just as the specialty is realizing that seemingly innocuous anesthetic choices have long-term consequences, and better practice is required. Anesthesiologists must create more headroom between costs and revenues in order to sustain the academic vigor and creativity required to create better clinical practice. We outline three areas in which technological and organizational innovation in anesthesiology can improve competitiveness and become a driving force in collaborative efforts to develop the operating rooms and perioperative systems of the future: increasing the profitability of operating rooms; increasing the efficiency of anesthesia; and technological and organizational innovation to foster improved patient flow, communication, coordination, and organizational learning.
Team interaction skills evaluation criteria for nuclear power plant control room operators
International Nuclear Information System (INIS)
Montgomery, J.C.; Hauth, J.T.
1991-01-01
Team interaction skills are an essential aspect of safe nuclear power plant control room operations. Previous research has shown that, when a group works together, rather than as individuals, more effective operations are possible. However, little research has addressed how such team interaction skills can be measured. In this study rating scales were developed specifically for such a measurement purpose. Dimensions of team skill performance were identified from previous research and experience in the area, incorporating the input of Pacific Northwest Laboratory (PNL) contract operator licensing examiners. Rating scales were developed on the basis of these dimensions, incorporating a modified Behaviorally Anchored Rating Scale (BARS) as well as Behavioral Frequency formats. After a pilot-testing/revision process, rating data were collected using 11 control room crews responding to simulator scenarios at a boiling water and a pressurized water reactor. Statistical analyses of the resulting data revealed moderate inter-rater reliability using the Behavioral Frequency scales, relatively low inter-rater reliability using the BARS, and moderate support for convergent and discriminant validity of the scales. It was concluded that the scales show promise psychometrically and in terms of user acceptability, but that additional scale revision is needed before field implementation. Recommendations for scale revision and directions for future research were presented
Bonrath, Esther M; Dedy, Nicolas J; Gordon, Lauren E; Grantcharov, Teodor P
2015-08-01
The aim of the study was to determine whether individualized coaching improved surgical technical skill in the operating room to a higher degree than current residency training. Clinical training in the operating room is a valuable opportunity for surgeons to acquire skill and knowledge; however, it often remains underutilized. Coaching has been successfully used in various industries to enhance performance, but its role in surgery has been insufficiently investigated. This randomized controlled trial was conducted at one surgical training program. Trainees undergoing a minimally invasive surgery rotation were randomized to either conventional training (CT) or comprehensive surgical coaching (CSC). CT included ward and operating room duties, and regular departmental teaching sessions. CSC comprised performance analysis, debriefing, feedback, and behavior modeling. Primary outcome measures were technical performance as measured on global and procedure-specific rating scales, and surgical safety parameters, measured by error count. Operative performance was assessed by blinded video analysis of the first and last cases recorded by the participants during their rotation. Twenty residents were randomized and 18 completed the study. At posttraining the CSC group (n = 9) scored significantly higher on a procedure-specific skill scale compared with the CT group (n = 9) [median, 3.90 (interquartile range, 3.68-4.30) vs 3.60 (2.98-3.70), P = 0.017], and made fewer technical errors [10 (7-13) vs 18 (13-21), P = 0.003]. Significant within-group improvements for all skill metrics were only noted in the CSC group. Comprehensive surgical coaching enhances surgical training and results in skill acquisition superior to conventional training.
Forced-air warming: a source of airborne contamination in the operating room?
Albrecht, Mark; Gauthier, Robert; Leaper, David
2009-10-10
Forced-air-warming (FAW) is an effective and widely used means for maintaining surgical normothermia, but FAW also has the potential to generate and mobilize airborne contamination in the operating room.We measured the emission of viable and non-viable forms of airborne contamination from an arbitrary selection of FAW blowers (n=25) in the operating room. A laser particle counter measured particulate concentrations of the air near the intake filter and in the distal hose airstream. Filtration efficiency was calculated as the reduction in particulate concentration in the distal hose airstream relative to that of the intake. Microbial colonization of the FAW blower's internal hose surfaces was assessed by culturing the microorganisms recovered through swabbing (n=17) and rinsing (n=9) techniques.Particle counting revealed that 24% of FAW blowers were emitting significant levels of internally generated airborne contamination in the 0.5 to 5.0 µm size range, evidenced by a steep decrease in FAW blower filtration efficiency for particles 0.5 to 5.0 µm in size. The particle size-range-specific reduction in efficiency could not be explained by the filtration properties of the intake filter. Instead, the reduction was found to be caused by size-range-specific particle generation within the FAW blowers. Microorganisms were detected on the internal air path surfaces of 94% of FAW blowers.The design of FAW blowers was found to be questionable for preventing the build-up of internal contamination and the emission of airborne contamination into the operating room. Although we did not evaluate the link between FAW and surgical site infection rates, a significant percentage of FAW blowers with positive microbial cultures were emitting internally generated airborne contamination within the size range of free floating bacteria and fungi (<4 µm) that could, conceivably, settle onto the surgical site.
Poster - 26: Electronic Waiting Room Management for a busy Cancer Centre
Energy Technology Data Exchange (ETDEWEB)
Kildea, John; Hijal, Tarek [McGill University Health Center (Canada)
2016-08-15
We describe an electronic waiting room management system that we have developed and deployed in our cancer centre. Our system connects with our electronic medical records systems, gathers data for a machine learning algorithm to predict future patient waiting times, and is integrated with a mobile phone app. The system has been in operation for over nine months and has led to reduced lines, calmer waiting rooms and overwhelming patient and staff satisfaction.
Poster - 26: Electronic Waiting Room Management for a busy Cancer Centre
International Nuclear Information System (INIS)
Kildea, John; Hijal, Tarek
2016-01-01
We describe an electronic waiting room management system that we have developed and deployed in our cancer centre. Our system connects with our electronic medical records systems, gathers data for a machine learning algorithm to predict future patient waiting times, and is integrated with a mobile phone app. The system has been in operation for over nine months and has led to reduced lines, calmer waiting rooms and overwhelming patient and staff satisfaction.
International Nuclear Information System (INIS)
Lirvall, Peter
1998-02-01
This report describes a user-centred approach to control room design adopted by IFE for the nuclear industry. The novelty of this approach is the development of a Control Room Philosophy, and the use of Virtual Reality (VR) technology as a tool in the design process, integrated with a specially developed Design Documentation System (DDS) and a process display prototyping tool PICASSO-3. The control room philosophy identifies all functional aspects of a control centre, to define the baseline principles and guidelines for the design. The use of VR technology enables end-users of the control room design (e.g. control room operators) to specify their preferred design of the new control room, and to replace the need for a physical mock-up to test and evaluate the proposed design. The DDS, integrated with the VR design tool, guides the control room operators, through a structured approach, to document the proposed design in a complete design specification. The VR tool, specially developed by IFE, is called the VR based Design, Test and Training tool (VR DTandT). It is not only intended to visualise the design, but also to test and evaluate the design. When the design is implemented, the same model is re-used as a VR based training simulator for operators. A special feature in the VR DTandT tool is that the verification and validation (VandV) tests, concerning human factors, are according to the regulative standards for nuclear control rooms
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.
HYBRID ALARM SYSTEMS: COMBINING SPATIAL ALARMS AND ALARM LISTS FOR OPTIMIZED CONTROL ROOM OPERATION
Energy Technology Data Exchange (ETDEWEB)
Ronald L. Boring; J.J. Persensky
2012-07-01
The US Department of Energy (DOE) is sponsoring research, development, and deployment on Light Water Reactor Sustainability (LWRS), in which the Idaho National Laboratory (INL) is working closely with nuclear utilities to develop technologies and solutions to help ensure the safe operational life extension of current nuclear power plants. One of the main areas of focus is control room modernization. Within control room modernization, alarm system upgrades present opportunities to meet the broader goals of the LWRS project in demonstrating the use and safety of the advanced instrumentation and control (I&C) technologies and the short-term and longer term objectives of the plant. In this paper, we review approaches for and human factors issues behind upgrading alarms in the main control room of nuclear power plants.
GUIDANCE FOR NUCLEAR POWER PLANT CONTROL ROOM AND HUMAN-SYSTEM INTERFACE MODERNIZATION
International Nuclear Information System (INIS)
Naser, J.; Morris, G.
2004-01-01
Several nuclear power plants in the United States are starting instrumentation and control (I and C) modernization programs using digital equipment to address obsolescence issues and the need to improve plant performance while maintaining high levels of safety. As an integral part of the I and C modernization program at a nuclear power plant, the control room and other human-system interfaces (HSIs) are also being modernized. To support safe and effective operation, it is critical to plan, design, implement, train for, operate, and maintain the control room and HSI changes to take advantage of human cognitive processing abilities. A project, jointly funded by the Electric Power Research Institute (EPRI) and the United States Department of Energy (DOE) under the Nuclear Energy Plant Optimization (NEPO) Program, is developing guidance for specifying and designing control rooms, remote shut-down panels, HSIs etc. The guidance is intended for application by utilities and suppliers of control room and HSI modernization. The guidance will facilitate specification, design, implementation, operations, maintenance, training, and licensing activities. This guidance will be used to reduce the likelihood of human errors and licensing risk, to gain maximum benefit of implemented technology, and to increase performance. The guidance is of five types. The first is planning guidance to help a utility develop its plant-specific control room operating concepts, its plant-specific endpoint vision for the control room, its migration path to achieve that endpoint vision, and its regulatory, licensing, and human factors program plans. The second is process guidance for general HSI design and integration, human factors engineering analyses, verification and validation, in-service monitoring processes, etc. The third is detailed human factors engineering guidance for control room and HSI technical areas. The fourth is guidance for licensing. The fifth is guidance for special topics
Design of the control room of the N4-type PWR: main features and feedback operating experience
International Nuclear Information System (INIS)
Peyrouton, J.M.; Guillas, J.; Nougaret, Ch.
2004-01-01
This article presents the design, specificities and innovating features of the control room of the N4-type PWR. A brief description of control rooms of previous 900 MW and 1300 MW -type PWR allows us to assess the change. The design of the first control room dates back to 1972, at that time 2 considerations were taken into account: first the design has to be similar to that of control rooms for thermal plants because plant operators were satisfied with it and secondly the normal operating situation has to be privileged to the prejudice of accidental situations just as it was in a thermal plant. The turning point was the TMI accident that showed the weight of human factor in accidental situations in terms of pilot team, training, procedures and the ergonomics of the work station. The impact of TMI can be seen in the design of 1300 MW-type PWR. In the beginning of the eighties EDF decided to launch a study for a complete overhaul of the control room concept, the aim was to continue reducing the human factor risk and to provide a better quality of piloting the plant in any situation. The result is the control room of the N4-type PWR. Today the cumulated feedback experience of N4 control rooms represents more than 20 years over a wide range of situations from normal to incidental, a survey shows that the N4 design has fulfilled its aims. (A.C.)
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.
Uncovering the History of Operating Room Attire through Photographs.
Adams, Lu Wang; Aschenbrenner, Carol A; Houle, Timothy T; Roy, Raymond C
2016-01-01
Although early proponents for each of the four basic articles of operating room clothing--gowns, caps, masks, and gloves--can be identified, it is unclear from historical commentaries when each article achieved general acceptance and was consistently worn by surgeons and by anesthesia providers. Historical photographs were identified from the Web sites of the National Library of Medicine, Google, and the archives of the Wood Library-Museum of Anesthesiology for the 11 decades 1860 to 1970. The presence or absence of each article of clothing was then determined for the surgical and anesthesia providers depicted. Over 1,000 photographs were identified and examined. Photographs were then eliminated for repetition, lack of available dating, questionable dating, and poor quality. In 338 remaining photographs that met inclusion criteria, 640 surgical providers and 219 anesthesia providers were depicted and used in the analysis. Statistical definitions for historical terms general acceptance and routine use were proposed. The probability that a surgeon was wearing nonstreet clothes (gown) was 0.66 (95% CI, 0.22 to 0.93) in 1863. The years (95% lower bound to 95% upper bound) associated with a 0.5 probability for wearing cap, gloves, and mask were 1900 (1896 to 1904), 1907 (1903 to 1910), and 1916 (1913 to 1919), respectively. The years associated with a 0.5 probability that an anesthesia provider would be wearing nonstreet clothes (gown), cap, and mask were 1883 (1863 to 1889), 1905 (1900 to 1911), and 1932 (1929 to 1937), respectively. Timelines for the adoption of each basic article of surgical attire by surgeons and anesthesia providers were determined by analysis of historical operating room photographs from 1863 to 1969.
On the Riesz representation theorem and integral operators ...
African Journals Online (AJOL)
We present a Riesz representation theorem in the setting of extended integration theory as introduced in [6]. The result is used to obtain boundedness theorems for integral operators in the more general setting of spaces of vector valued extended integrable functions. Keywords: Vector integral, integral operators, operator ...
Mitigating operating room fires: development of a carbon dioxide fire prevention device.
Culp, William C; Kimbrough, Bradly A; Luna, Sarah; Maguddayao, Aris J
2014-04-01
Operating room fires are sentinel events that present a real danger to surgical patients and occur at least as frequently as wrong-sided surgery. For fire to occur, the 3 points of the fire triad must be present: an oxidizer, an ignition source, and fuel source. The electrosurgical unit (ESU) pencil triggers most operating room fires. Carbon dioxide (CO2) is a gas that prevents ignition and suppresses fire by displacing oxygen. We hypothesize that a device can be created to reduce operating room fires by generating a cone of CO2 around the ESU pencil tip. One such device was created by fabricating a divergent nozzle and connecting it to a CO2 source. This device was then placed over the ESU pencil, allowing the tip to be encased in a cone of CO2 gas. The device was then tested in 21%, 50%, and 100% oxygen environments. The ESU was activated at 50 W cut mode while placing the ESU pencil tip on a laparotomy sponge resting on an aluminum test plate for up to 30 seconds or until the sponge ignited. High-speed videography was used to identify time of ignition. Each test was performed in each oxygen environment 5 times with the device activated (CO2 flow 8 L/min) and with the device deactivated (no CO2 flow-control). In addition, 3-dimensional spatial mapping of CO2 concentrations was performed with a CO2 sampling device. The median ± SD [range] ignition time of the control group in 21% oxygen was 2.9 s ± 0.44 [2.3-3.0], in 50% oxygen 0.58 s ± 0.12 [0.47-0.73], and in 100% oxygen 0.48 s ± 0.50 [0.03-1.27]. Fires were ignited with each control trial (15/15); no fires ignited when the device was used (0/15, P fire prevention device can be created by using a divergent nozzle design through which CO2 passes, creating a cone of fire suppressant. This device as demonstrated in a flammability model effectively reduced the risk of fire. CO2 3-dimensional spatial mapping suggests effective fire reduction at least 1 cm away from the tip of the ESU pencil at 8 L/min CO2 flow
The SmartOR: a distributed sensor network to improve operating room efficiency.
Huang, Albert Y; Joerger, Guillaume; Fikfak, Vid; Salmon, Remi; Dunkin, Brian J; Bass, Barbara L; Garbey, Marc
2017-09-01
Despite the significant expense of OR time, best practice achieves only 70% efficiency. Compounding this problem is a lack of real-time data. Most current OR utilization programs require manual data entry. Automated systems require installation and maintenance of expensive tracking hardware throughout the institution. This study developed an inexpensive, automated OR utilization system and analyzed data from multiple operating rooms. OR activity was deconstructed into four room states. A sensor network was then developed to automatically capture these states using only three sensors, a local wireless network, and a data capture computer. Two systems were then installed into two ORs, recordings captured 24/7. The SmartOR recorded the following events: any room activity, patient entry/exit time, anesthesia time, laparoscopy time, room turnover time, and time of preoperative patient identification by the surgeon. From November 2014 to December 2015, data on 1003 cases were collected. The mean turnover time was 36 min, and 38% of cases met the institutional goal of ≤30 min. Data analysis also identified outlier cases (>1 SD from mean) in the domains of time from patient entry into the OR to intubation (11% of cases) and time from extubation to patient exiting the OR (11% of cases). Time from surgeon identification of patient to scheduled procedure start time was 11 min (institution bylaws require 20 min before scheduled start time), yet OR teams required 22 min on average to bring a patient into the room after surgeon identification. The SmartOR automatically and reliably captures data on OR room state and, in real time, identifies outlier cases that may be examined closer to improve efficiency. As no manual entry is required, the data are indisputable and allow OR teams to maintain a patient-centric focus.
Siu, Joey; Maran, Nikki; Paterson-Brown, Simon
2016-06-01
The importance of non-technical skills in improving surgical safety and performance is now well recognised. Better understanding is needed of the impact that non-technical skills of the multi-disciplinary theatre team have on intra-operative incidents in the operating room (OR) using structured theatre-based assessment. The interaction of non-technical skills that influence surgical safety of the OR team will be explored and made more transparent. Between May-August 2013, a range of procedures in general and vascular surgery in the Royal Infirmary of Edinburgh were performed. Non-technical skills behavioural markers and associated intra-operative incidents were recorded using established behavioural marking systems (NOTSS, ANTS and SPLINTS). Adherence to the surgical safety checklist was also observed. A total of 51 procedures were observed, with 90 recorded incidents - 57 of which were considered avoidable. Poor situational awareness was a common area for surgeons and anaesthetists leading to most intra-operative incidents. Poor communication and teamwork across the whole OR team had a generally large impact on intra-operative incidents. Leadership was shown to be an essential set of skills for the surgeons as demonstrated by the high correlation of poor leadership with intra-operative incidents. Team-working and management skills appeared to be especially important for anaesthetists in the recovery from an intra-operative incident. A significant number of avoidable incidents occur during operative procedures. These can all be linked to failures in non-technical skills. Better training of both individual and team in non-technical skills is needed in order to improve patient safety in the operating room. Copyright © 2014 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved.
Integrated Interface Strategy toward Room Temperature Solid-State Lithium Batteries.
Ju, Jiangwei; Wang, Yantao; Chen, Bingbing; Ma, Jun; Dong, Shanmu; Chai, Jingchao; Qu, Hongtao; Cui, Longfei; Wu, Xiuxiu; Cui, Guanglei
2018-04-25
Solid-state lithium batteries have drawn wide attention to address the safety issues of power batteries. However, the development of solid-state lithium batteries is substantially limited by the poor electrochemical performances originating from the rigid interface between solid electrodes and solid-state electrolytes. In this work, a composite of poly(vinyl carbonate) and Li 10 SnP 2 S 12 solid-state electrolyte is fabricated successfully via in situ polymerization to improve the rigid interface issues. The composite electrolyte presents a considerable room temperature conductivity of 0.2 mS cm -1 , an electrochemical window exceeding 4.5 V, and a Li + transport number of 0.6. It is demonstrated that solid-state lithium metal battery of LiFe 0.2 Mn 0.8 PO 4 (LFMP)/composite electrolyte/Li can deliver a high capacity of 130 mA h g -1 with considerable capacity retention of 88% and Coulombic efficiency of exceeding 99% after 140 cycles at the rate of 0.5 C at room temperature. The superior electrochemical performance can be ascribed to the good compatibility of the composite electrolyte with Li metal and the integrated compatible interface between solid electrodes and the composite electrolyte engineered by in situ polymerization, which leads to a significant interfacial impedance decrease from 1292 to 213 Ω cm 2 in solid-state Li-Li symmetrical cells. This work provides vital reference for improving the interface compatibility for room temperature solid-state lithium batteries.
Assess of the Status of the Karaj Operating Rooms in Comparison with International Standards in 2011
Directory of Open Access Journals (Sweden)
M.H. Naseri
2012-10-01
Full Text Available Background: Because of making money, the operating room (OR is known as the beating heart of any clinical & health center. The effective and regular activity of the operating room guarantees a sustainable income for the hospital. So, in order to provide high quality treatment and care services, and to save the health and safety of OR staff, exploiting standard equipments and spaces as well as employing professional and skilled personnel is necessary. This study was aimed to assess the status of the Karaj operating rooms from physical, safety, sterilization, staffing and equipment aspects in comparison to the International Standards. Methods: This sectional descriptive study was conducted in Alborz University of Medical Sciences in 2011. Samples were 10 operating room wards from 10 surgical hospitals. Data were collected by a 70 items check-list at 5 fields of physical, safety, sterilization, staffing and equipment conditions and then compared to the international standards. The data were recorded in SPSS software and analyzed by statistical methods. Results: The results showed that compared to the international standards, the physical aspect was 60.5%, safety aspect 66%, sterilization aspect 68%, staffing aspect 63%, and equipment aspect was 80% close to the standard criteria. On the whole, in 10 assessed hospitals, equipment aspect with 80% had the best and the physical aspect with 60.5% had the worst conditions respectively. Conclusion: Due to admission in different medical and paramedical programs in Alborz University of Medical Sciences, renovation of the ORs is essential for training skilled students. Considering the results of this study could help the University authorities to improve the current condition.
Wearing long sleeves while prepping a patient in the operating room decreases airborne contaminants.
Markel, Troy A; Gormley, Thomas; Greeley, Damon; Ostojic, John; Wagner, Jennifer
2018-04-01
The use of long sleeves by nonscrubbed personnel in the operating room has been called into question. We hypothesized that wearing long sleeves and gloves, compared with having bare arms without gloves, while applying the skin preparation solution would decrease particulate and microbial contamination. A mock patient skin prep was performed in 3 different operating rooms. A long-sleeved gown and gloves, or bare arms, were used to perform the procedure. Particle counters were used to assess airborne particulate contamination, and active and passive microbial assessment was achieved through air samplers and settle plate analysis. Data were compared with Student's t-test or Mann-Whitney U, and P airborne contamination while the skin prep is applied, which may lead to decreased surgical site infections. Copyright © 2018 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.
Energy Technology Data Exchange (ETDEWEB)
NONE
2007-07-01
that digital technology offers are needed to increase cost-effective electricity production. As an integral part of the I and C modernization program at a nuclear power plant, the control room and other human-system interfaces (HSIs) will also be modernized. To support safe and effective operation, it is critical to specify, design, implement, operate, and maintain, as well as train for, the control room and HSI changes to take advantage of human cognitive processing abilities. This consideration of human factors is essential to increase performance and to reduce the likelihood of human errors. The plant I and C and HSI modifications can affect personnel in various ways. They can impact the role of personnel, the tasks to be performed, the way tasks are performed, and the knowledge, skills and training required of personnel. As part of modernization, HSIs are becoming more computer-based, incorporating features such as soft controls and computerized procedures, touch-screen interfaces, sit-down workstations, and large-screen overview displays. As computer-based technologies are integrated into control rooms that were largely based on conventional technology, hybrid control rooms are created. The potential benefits of implementing digital technology include more efficient operations and maintenance, leading to improved power plant availability and safety through the avoidance of transients, forced outages, and unnecessary shutdowns. The potential benefits also include increased efficiency and power output as well as reduced operating costs. New digital systems provide the opportunity to give personnel information they did not have with conventional systems. The importance of these issues has led the IAEA to organize (in conjunction with AECL) an international forum for presentations and discussions on the potential benefits and challenges related to the integration of Analog and Digital Instrumentation and Control Systems in Hybrid Main Control Rooms. Many of these
The operating room case-mix problem under uncertainty and nurses capacity constraints.
Yahia, Zakaria; Eltawil, Amr B; Harraz, Nermine A
2016-12-01
Surgery is one of the key functions in hospitals; it generates significant revenue and admissions to hospitals. In this paper we address the decision of choosing a case-mix for a surgery department. The objective of this study is to generate an optimal case-mix plan of surgery patients with uncertain surgery operations, which includes uncertainty in surgery durations, length of stay, surgery demand and the availability of nurses. In order to obtain an optimal case-mix plan, a stochastic optimization model is proposed and the sample average approximation method is applied. The proposed model is used to determine the number of surgery cases to be weekly served, the amount of operating rooms' time dedicated to each specialty and the number of ward beds dedicated to each specialty. The optimal case-mix selection criterion is based upon a weighted score taking into account both the waiting list and the historical demand of each patient category. The score aims to maximizing the service level of the operating rooms by increasing the total number of surgery cases that could be served. A computational experiment is presented to demonstrate the performance of the proposed method. The results show that the stochastic model solution outperforms the expected value problem solution. Additional analysis is conducted to study the effect of varying the number of ORs and nurses capacity on the overall ORs' performance.
Pressure and Temperature of the Room 1 for the Pipe Break Accidents of the 3-Pin Fuel Test Loop
Energy Technology Data Exchange (ETDEWEB)
Park, S. K.; Chi, D. Y.; Sim, B. S.; Park, K. N.; Ahn, S. H.; Lee, J. M.; Lee, C. Y.; Kim, H. R
2005-08-15
This report deals with the prediction of the pressure and temperature of the room 1 for the pipe break accidents of the 3-pin fuel test loop. The 3-pin fuel test loop is an experimental facility for nuclear fuel tests at the operation conditions similar to those of PWR and CANDU power plants. Because the most processing systems of the 3-pin fuel test loop are placed in the room 1. The structural integrity of the room 1 should be evaluated for the postulated accident conditions. Therefore the pressures and temperatures of the room 1 needed for the structural integrity evaluation have been calculated by using MARS code. The pressures and temperatures of the room 1 have been calculated in various conditions such as the thermal hydraulic operation parameters, the locations of pipe break, and the thermal properties of the room 1 wall. It is assumed that the pipe break accident occurs in the letdown operation without regeneration, because the mass and energy release to the room 1 is expected to be the largest. As a result of the calculations the maximum pressure and temperature are predicted to be 208kPa and 369.2K(96.0 .deg. C) in case the heat transfer is considered in the room 1 wall. However the pressure and temperature are asymptotically 243kPa and 378.1K(104.9 .deg. C) assuming that the heat transfer does not occur in the room 1 wall.
Mental workload measurement in operator control room using NASA-TLX
Sugarindra, M.; Suryoputro, M. R.; Permana, A. I.
2017-12-01
The workload, encountered a combination of physical workload and mental workload, is a consequence of the activities for workers. Central control room is one department in the oil processing company, employees tasked with monitoring the processing unit for 24 hours nonstop with a combination of 3 shifts in 8 hours. NASA-TLX (NASA Task Load Index) is one of the subjective mental workload measurement using six factors, namely the Mental demand (MD), Physical demand (PD), Temporal demand (TD), Performance (OP), Effort (EF), frustration levels (FR). Measurement of a subjective mental workload most widely used because it has a high degree of validity. Based on the calculation of the mental workload, there at 5 units (DTU, NPU, HTU, DIST and OPS) at the control chamber (94; 83.33; 94.67; 81, 33 and 94.67 respectively) that categorize as very high mental workload. The high level of mental workload on the operator in the Central Control Room is a requirement to have high accuracy, alertness and can make decisions quickly
DEFF Research Database (Denmark)
Freiberg, Florentina J; Brynskov, Troels; Munk, Marion R
2017-01-01
PURPOSE: To evaluate the rate of presumed endophthalmitis (EO) after intravitreal anti-vascular endothelial growth factor (anti-VEGF) injections in three European hospitals performed in an operation room (OR) under sterile conditions. METHODS: A retrospective multicenter study between 2003 and 2016...... at three European sites, City Hospital Triemli Zurich, Switzerland (CHT), Zealand University Hospital Roskilde, Denmark (ZUH) and University Clinic Bern, Switzerland (UCB). Intravitreal injection (IVI) database of each department was reviewed. All anti-vascular endothelial growth factor injections were...... performed using a standardized sterile technique in an operation room. Injection protocols were similar between the three sites. No preinjection antibiotics were given. Postoperative antibiotics varied among sites. RESULTS: A total of 134,701 intravitreal injections were performed at the 3 sites between...
Continuous-Wave Operation of GaN Based Multi-Quantum-Well Laser Diode at Room Temperature
International Nuclear Information System (INIS)
Li-Qun, Zhang; Shu-Ming, Zhang; Hui, Yang; Lian, Ji; Jian-Jun, Zhu; Zong-Shun, Liu; De-Gang, Zhao; De-Sheng, Jiang; Li-Hong, Duan; Hai, Wang; Yong-Sheng, Shi; Su-Ying, Liu; Jun-Wu, Liang; Qing, Cao; Liang-Hui, Chen
2008-01-01
Room-temperature operation of cw GaN based multi-quantum-well laser diodes (LDs) is demonstrated. The LD structure is grown on a sapphire (0001) substrate by metalorganic chemical vapour deposition. A 2.5μm × 800μm ridge waveguide structure is fabricated. The electrical and optical characteristics of the laser diode under direct current injection at room temperature are investigated. The threshold current and voltage of the LD under cw operation are 110 mA and 10.5 V, respectively. Thermal induced series resistance decrease and emission wavelength red-shift are observed as the injection current is increased. The full width at half maximum for the parallel and perpendicular far field pattern (FFP) are 12° and 32°, respectively
Durable improvements in efficiency, safety, and satisfaction in the operating room.
Heslin, Martin J; Doster, Barbara E; Daily, Sandra L; Waldrum, Michael R; Boudreaux, Arthur M; Smith, A Blair; Peters, Glenn; Ragan, Debbie B; Buchalter, Scott; Bland, Kirby I; Rue, Loring W
2008-05-01
Enhanced productivity and efficiency in the operating room must be balanced with patient safety and staff satisfaction. In December 2004, transition to an expanded replacement hospital resulted in mandatory overtime, unpredictable work hours, and poor morale among operating room (OR) staff. A staff-retention crisis resulted, which threatened the viability of the OR and the institution. We report the changes implemented to efficiently deliver safe patient care in a supportive environment for surgeons and OR staff. University of Alabama at Birmingham University Hospital OR data were evaluated for fiscal year 2004 and compared with fiscal years 2005 and 2006. Case volumes, number of operational ORs, and on-time case starts were evaluated. OR adverse events were tabulated. Percentage of registered nurse hires and staff departures served as a proxy for staff satisfaction. Short, intermediate, and longterm strategies were implemented by an engaged OR management committee with the guidance of surgical, anesthesia, and hospital leadership. These included new block time release policies; use of traveling nurses until new staff could be hired and trained; and incentive-based, voluntary, employee-scheduled overtime. Mandatory nursing education time was blocked weekly. Enforcement of the National Patient Safety Goals were implemented and adjudicated with a "surgeon-of-the-day" system providing backup for nurse management. We demonstrated an increase in operations per year, on-time starts, and registered nurse hires in fiscal years 2005 and 2006. During this same time, we were able to markedly decrease the number of adverse events, admitting delays, and staff departures. Change is difficult to accept but essential when vital clinical activities are impaired and at risk. To maintain important clinical environments like the OR in an academic center, we developed and implemented effective, data-driven changes. This allowed us to retain critical human resources and restore a
Human factors in surgery: from Three Mile Island to the operating room.
D'Addessi, Alessandro; Bongiovanni, Luca; Volpe, Andrea; Pinto, Francesco; Bassi, PierFrancesco
2009-01-01
Human factors is a definition that includes the science of understanding the properties of human capability, the application of this understanding to the design and development of systems and services, the art of ensuring their successful applications to a program. The field of human factors traces its origins to the Second World War, but Three Mile Island has been the best example of how groups of people react and make decisions under stress: this nuclear accident was exacerbated by wrong decisions made because the operators were overwhelmed with irrelevant, misleading or incorrect information. Errors and their nature are the same in all human activities. The predisposition for error is so intrinsic to human nature that scientifically it is best considered as inherently biologic. The causes of error in medical care may not be easily generalized. Surgery differs in important ways: most errors occur in the operating room and are technical in nature. Commonly, surgical error has been thought of as the consequence of lack of skill or ability, and is the result of thoughtless actions. Moreover the 'operating theatre' has a unique set of team dynamics: professionals from multiple disciplines are required to work in a closely coordinated fashion. This complex environment provides multiple opportunities for unclear communication, clashing motivations, errors arising not from technical incompetence but from poor interpersonal skills. Surgeons have to work closely with human factors specialists in future studies. By improving processes already in place in many operating rooms, safety will be enhanced and quality increased.
Advanced tools for enhancing control room collaborations
International Nuclear Information System (INIS)
Abla, G.; Flanagan, S.M.; Peng, Q.; Burruss, J.R.; Schissel, D.P.
2006-01-01
The US National Fusion Collaboratory (NFC) project has been exploring a variety of computer and network technologies to develop a persistent, efficient, reliable and convenient collaborative environment for magnetic fusion research. One goal is to enhance remote and collocated team collaboration by integrating collaboration software tools into control room operations as well as with data analysis tools. To achieve this goal, the NFC recently introduced two new collaboration technologies into the DIII-D tokamak control room. The first technology is a high-resolution, large format Shared Display Wall (SDW). By creating a shared public display space and providing real time visual information about the multiple aspects of complex experiment activity, the large SDW plays an important role in increasing the rate of information dissemination and promoting interaction among team members. The second technology being implemented is the 'tokamak control room aware' Instant Messaging (IM) service. In addition to providing text-chat capabilities for research scientists, it enables them to automatically receive information about experiment operations and data analysis processes to remotely monitor the status of ongoing tokamak experiment. As a result, the IM service has become a unified portal interface for team collaboration and remote participation
Advanced tools for enhancing control room collaborations
Energy Technology Data Exchange (ETDEWEB)
Abla, G. [General Atomics, P.O. Box 85608, San Diego, CA 92186 5608 (United States)]. E-mail: abla@fusion.gat.com; Flanagan, S.M. [General Atomics, P.O. Box 85608, San Diego, CA 92186 5608 (United States); Peng, Q. [General Atomics, P.O. Box 85608, San Diego, CA 92186 5608 (United States); Burruss, J.R. [General Atomics, P.O. Box 85608, San Diego, CA 92186 5608 (United States); Schissel, D.P. [General Atomics, P.O. Box 85608, San Diego, CA 92186 5608 (United States)
2006-07-15
The US National Fusion Collaboratory (NFC) project has been exploring a variety of computer and network technologies to develop a persistent, efficient, reliable and convenient collaborative environment for magnetic fusion research. One goal is to enhance remote and collocated team collaboration by integrating collaboration software tools into control room operations as well as with data analysis tools. To achieve this goal, the NFC recently introduced two new collaboration technologies into the DIII-D tokamak control room. The first technology is a high-resolution, large format Shared Display Wall (SDW). By creating a shared public display space and providing real time visual information about the multiple aspects of complex experiment activity, the large SDW plays an important role in increasing the rate of information dissemination and promoting interaction among team members. The second technology being implemented is the 'tokamak control room aware' Instant Messaging (IM) service. In addition to providing text-chat capabilities for research scientists, it enables them to automatically receive information about experiment operations and data analysis processes to remotely monitor the status of ongoing tokamak experiment. As a result, the IM service has become a unified portal interface for team collaboration and remote participation.
Balakrishnan, Karthik; Goico, Brian; Arjmand, Ellis M
2015-04-01
(1) To describe the application of a detailed cost-accounting method (time-driven activity-cased costing) to operating room personnel costs, avoiding the proxy use of hospital and provider charges. (2) To model potential cost efficiencies using different staffing models with the case study of outpatient adenotonsillectomy. Prospective cost analysis case study. Tertiary pediatric hospital. All otolaryngology providers and otolaryngology operating room staff at our institution. Time-driven activity-based costing demonstrated precise per-case and per-minute calculation of personnel costs. We identified several areas of unused personnel capacity in a basic staffing model. Per-case personnel costs decreased by 23.2% by allowing a surgeon to run 2 operating rooms, despite doubling all other staff. Further cost reductions up to a total of 26.4% were predicted with additional staffing rearrangements. Time-driven activity-based costing allows detailed understanding of not only personnel costs but also how personnel time is used. This in turn allows testing of alternative staffing models to decrease unused personnel capacity and increase efficiency. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2015.
A Generalized Analytic Operator-Valued Function Space Integral and a Related Integral Equation
International Nuclear Information System (INIS)
Chang, K.S.; Kim, B.S.; Park, C.H.; Ryu, K.S.
2003-01-01
We introduce a generalized Wiener measure associated with a Gaussian Markov process and define a generalized analytic operator-valued function space integral as a bounded linear operator from L p into L p-ci r cumflexprime (1< p ≤ 2) by the analytic continuation of the generalized Wiener integral. We prove the existence of the integral for certain functionals which involve some Borel measures. Also we show that the generalized analytic operator-valued function space integral satisfies an integral equation related to the generalized Schroedinger equation. The resulting theorems extend the theory of operator-valued function space integrals substantially and previous theorems about these integrals are generalized by our results
International Nuclear Information System (INIS)
Zinke, H.
1980-01-01
To control a 1300 megawatt nuclear power plant, about 15000 plant parameters must be collected together to control and operate the plant. The control room design therefore is of particular importance. The main design criteria are: Required functions of the power plant process - Level of Automation - Ergonomics - Available Technology. Extensive analysis has resulted in a control room design method. This ensures that an objective solution will be reached. Resulting from this methodical approach are: 1. Scope, position and appearance of the instrumentation. 2. Scope, position and appearance of the operator controls. Process analysis dictates what instrumentation and operator controls are needed. The priority and importance of the control and instrumentation (this we define as the utilisation areas), dictates the rough layout of the control room. (orig./RW)
Melhado, M.D.A.
2012-01-01
One of the important performance requirements for an air distribution system for an operating room (OR) is to provide good indoor environmental conditions in which to perform operations. Important conditions in this respect relate to the air quality and to the thermal conditions for the surgical
Richard, Raveesh Daniel; Bowen, Thomas R
2017-07-01
Contaminated operating room surfaces can increase the risk of orthopaedic infections, particularly after procedures in which hardware implantation and instrumentation are used. The question arises as to how surgeons can measure surface cleanliness to detect increased levels of bioburden. This study aims to highlight the utility of adenosine triphosphate (ATP) bioluminescence technology as a novel technique in detecting the degree of contamination within the sterile operating room environment. What orthopaedic operating room surfaces are contaminated with bioburden? When energy is required for cellular work, ATP breaks down into adenosine biphosphate (ADP) and phosphate (P) and in that process releases energy. This process is inherent to all living things and can be detected as light emission with the use of bioluminescence assays. On a given day, six different orthopaedic surgery operating rooms (two adult reconstruction, two trauma, two spine) were tested before surgery with an ATP bioluminescence assay kit. All of the cases were considered clean surgery without infection, and this included the previously performed cases in each sampled room. These rooms had been cleaned and prepped for surgery but the patients had not been physically brought into the room. A total of 13 different surfaces were sampled once in each room: the operating room (OR) preparation table (both pre- and postdraping), OR light handles, Bovie machine buttons, supply closet countertops, the inside of the Bair Hugger™ hose, Bair Hugger™ buttons, right side of the OR table headboard, tourniquet machine buttons, the Clark-socket attachment, and patient positioners used for total hip and spine positioning. The relative light units (RLUs) obtained from each sample were recorded and data were compiled and averaged for analysis. These values were compared with previously published ATP benchmark values of 250 to 500 RLUs to define cleanliness in both the hospital and restaurant industries. All
Auditory display as feedback for a novel eye-tracking system for sterile operating room interaction.
Black, David; Unger, Michael; Fischer, Nele; Kikinis, Ron; Hahn, Horst; Neumuth, Thomas; Glaser, Bernhard
2018-01-01
The growing number of technical systems in the operating room has increased attention on developing touchless interaction methods for sterile conditions. However, touchless interaction paradigms lack the tactile feedback found in common input devices such as mice and keyboards. We propose a novel touchless eye-tracking interaction system with auditory display as a feedback method for completing typical operating room tasks. Auditory display provides feedback concerning the selected input into the eye-tracking system as well as a confirmation of the system response. An eye-tracking system with a novel auditory display using both earcons and parameter-mapping sonification was developed to allow touchless interaction for six typical scrub nurse tasks. An evaluation with novice participants compared auditory display with visual display with respect to reaction time and a series of subjective measures. When using auditory display to substitute for the lost tactile feedback during eye-tracking interaction, participants exhibit reduced reaction time compared to using visual-only display. In addition, the auditory feedback led to lower subjective workload and higher usefulness and system acceptance ratings. Due to the absence of tactile feedback for eye-tracking and other touchless interaction methods, auditory display is shown to be a useful and necessary addition to new interaction concepts for the sterile operating room, reducing reaction times while improving subjective measures, including usefulness, user satisfaction, and cognitive workload.
New thinking for the boiler room.
Rose, Wayne
2008-09-01
Wayne Rose, marketing manager at integrated plant room manufacturer Armstrong Integrated Systems, explains how increasing use of off-site manufacture, the latest 3D modelling technology, and advances in control technology, are revolutionising boiler room design and construction.
An Analysis of Operating Room Performance Metrics at Reynolds Army Community Hospital
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
Completely integrable operator evolution equations. II
International Nuclear Information System (INIS)
Chudnovsky, D.V.
1979-01-01
The author continues the investigation of operator classical completely integrable systems. The main attention is devoted to the stationary operator non-linear Schroedinger equation. It is shown that this equation can be used for separation of variables for a large class of completely integrable equations. (Auth.)
Integrated Ground Operations Demonstration Units
National Aeronautics and Space Administration — The overall goal of the AES Integrated Ground Operations Demonstration Units (IGODU) project is to demonstrate cost efficient cryogenic operations on a relevant...
Cancienne, Jourdan M; Crosen, Matelin P; Yarboro, Seth R
2016-01-01
Ankle fractures are one of the most common orthopedic injuries requiring operative treatment, and approximately 1 in 4 ankle fractures will have an associated distal tibiofibular syndesmosis disruption. Syndesmotic reduction is crucial to restoring ankle function and preventing the development of arthritis. The hybrid operating room provides 3-dimensional intraoperative imaging capabilities that can enable the surgeon to ensure the syndesmosis is appropriately reduced, particularly by comparing it with the contralateral ankle. By confirming the syndesmosis reduction intraoperatively, the risk of a return to the operating room for revision surgery is decreased. Copyright © 2015 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.
Design of an integrated operator support system for advanced NPP MCRs. Issues and perspectives
International Nuclear Information System (INIS)
Lee, Seung Jun; Seong Poong-Hyun
2010-01-01
Recently, human error has been highlighted as one of the main causes of accidents in nuclear power plants (NPPs). In order to prevent human errors during the main control room (MCR) operations, which are highly complex and mentally taxing activities, improved interfaces and operator support systems have been developed for advanced MCRs. Although operator support systems have the capability to improve the safety and reliability of an NPP, inappropriate designs can have adverse effects on the system safety. Designs based on systematic development frames and validation/verification of the systems are pivotal strategies to circumvent the negative effects of operator support systems. In this paper, an integrated operator support system designed to aid the cognitive activities of operators as well as theoretical and experimental evaluation methods of operator support systems are reviewed. From this review, it was concluded that not only issues about systems (e.g., the accuracy of the system outputs), but also issues about human operators who use the systems (for instance, information quality, the operator's trust and dependency on support systems) should be considered in the design of efficient operator support systems. (author)
International Nuclear Information System (INIS)
Andreoli, S.; Moretti, R.; Catalano, M.; Locatelli, F.
2006-01-01
Intra-Operative Radiation Therapy (I.O.R.T.) is carried out with electron beams produced by a Linac (Linear Accelerator) generally used for conventional radiotherapy with external beam, or by dedicated accelerators that can be employed directly into an operating room. I.O.R.T. refers to the application of radiation during a surgical intervention, after the removal of a neoplastic mass. I.O.R.T. uses on the tumour area a direct irradiation, for the possible localisation of sub-clinic illness or macroscopic residue in the case of non-radical resection. Intra-Operative Radiotherapy foresees a single session only, generally preceded or followed by radiotherapy with external beam. It allows the achievement of a selective radiation boost on the tumour volume. In some cases, it can also be used as a one-time/stand alone treatment in initial cancer of small volume, or in unresectable malignancies for palliative purpose. The technical advantages of I.O.R.T. consist in the direct visual control of the target volume, and in the possibility to protect the healthy tissues by moving them away from the path of the radiation beam. The use of electron beams allows the administration of a homogeneous dose to a selected layer of tissues surrounding the tumour. The following professional staff forms the Operative Group: radiation oncologist, surgeon, anaesthetist, medical physicist, radiation technologist, nurse.The choice of a simulation geometry very similar to the clinical situation allows to evaluate radioprotection data very close to the real situation. For a fixed layout, an anthropomorphic phantom was positioned on the operating bed and a breast I.O.R.T. treatment was simulated positioning all the accessories of the operating room in their typical positions. A detailed dose mapping was performed with a Victoreen 450P ionisation chamber and with environment film-dosimeter on the walls of the operating room during the simulation of the clinical treatment. The simulation appears
International Nuclear Information System (INIS)
Verghese, Clement C.; Joseph, Jose; Biswas, B.B.; Patil, R.K.
2005-01-01
Advanced Heavy Water Reactor (AHWR) is a next generation nuclear power plant being developed by Bhabha Atomic Research Centre. A modern control room has been conceived for operation and monitoring of the plant in tune with the advanced features of the reactor. A state of the art C and I architecture based on extensive use of computers and networking has been conceived for this plant. This architecture enables the implementation of a fully computerised operator friendly control room with soft HMIs. Features of the modern control room and control room and concept of soft HMI based operator interfaces have been described in the paper. (author)
Factors contributing to airborne particle dispersal in the operating room.
Noguchi, Chieko; Koseki, Hironobu; Horiuchi, Hidehiko; Yonekura, Akihiko; Tomita, Masato; Higuchi, Takashi; Sunagawa, Shinya; Osaki, Makoto
2017-07-06
Surgical-site infections due to intraoperative contamination are chiefly ascribable to airborne particles carrying microorganisms. The purpose of this study is to identify the actions that increase the number of airborne particles in the operating room. Two surgeons and two surgical nurses performed three patterns of physical movements to mimic intraoperative actions, such as preparing the instrument table, gowning and donning/doffing gloves, and preparing for total knee arthroplasty. The generation and behavior of airborne particles were filmed using a fine particle visualization system, and the number of airborne particles in 2.83 m 3 of air was counted using a laser particle counter. Each action was repeated five times, and the particle measurements were evaluated through one-way analysis of variance multiple comparison tests followed by Tukey-Kramer and Bonferroni-Dunn multiple comparison tests for post hoc analysis. Statistical significance was defined as a P value ≤ .01. A large number of airborne particles were observed while unfolding the surgical gown, removing gloves, and putting the arms through the sleeves of the gown. Although numerous airborne particles were observed while applying the stockinet and putting on large drapes for preparation of total knee arthroplasty, fewer particles (0.3-2.0 μm in size) were detected at the level of the operating table under laminar airflow compared to actions performed in a non-ventilated preoperative room (P airborne particles near a sterile area and that laminar airflow has the potential to reduce the incidence of bacterial contamination.
Energy Technology Data Exchange (ETDEWEB)
Ronald Boring; Vivek Agarwal
2012-07-01
This paper provides background on a reconfigurable control room simulator for nuclear power plants. The main control rooms in current nuclear power plants feature analog technology that is growing obsolete. The need to upgrade control rooms serves the practical need of maintainability as well as the opportunity to implement newer digital technologies with added functionality. There currently exists no dedicated research simulator for use in human factors design and evaluation activities for nuclear power plants in the US. The new research simulator discussed in this paper provides a test bed in which operator performance on new control room concepts can be benchmarked against existing control rooms and in which new technologies can be validated for safety and usability prior to deployment.
Learning from aviation to improve safety in the operating room - a systematic literature review
L.S.G.L. Wauben; J.F. Lange (Johan); R.H.M. Goossens (Richard)
2012-01-01
textabstractLessons learned from other high-risk industries could improve patient safety in the operating room (OR). This review describes similarities and differences between high-risk industries and describes current methods and solutions within a system approach to reduce errors in the OR. PubMed
TUGAS ROOM ATTENDANT DALAM MENANGANI COMPLAINT TAMU DELUXE ROOM HOTEL HYAAT REGENCY BANDUNG
Directory of Open Access Journals (Sweden)
Reza Gustia Purnama
2016-05-01
Full Text Available Abstract - The problem is how meticulous the duties and responsibilities of the room attendant in the deluxe room Hotel Hyatt Regency Bandung, standard operational procedures in the deluxe room Hotel Hyatt Regency Bandung, and handling guest complaint in deluxe room Hotel Hyatt Regency Bandung. Author uses descriptive analysis, which is a form of writing in the actual situation describes strive about the object of research, then the data obtained in the form of a report compiled in. Based on the results of observation it can be concluded that the task and responsibility of the room attendant in the deluxe room Hyatt Regency Bandung already carry it out in accordance with standard operational procedures (SOP which is divided into two shifts, morning and evening shift which has a slightly different task, standard operational procedures in the deluxe room Hyatt Regency Bandung has been standard operating procedure in applying it at the hotel Hyatt Regency Bandung, and Guest complaint handling in deluxe room Hyatt Regency Bandung Hotel how to deal with and resolve the complaint vary slightly in view of the type of complaint. Based on the results of observation and discussion, the authors conclude that the Duty room attendant in handling customers compaint deluxe room in the Hyatt Regency Bandung Hotel when his handlers was conducted appropriately and propesional effects will be good for the image of the hyatt regency hotel bandung. Keywords: Room Attendant, Complaint, Deluxe room Abstraksi - Masalah yang di teliti adalah tugas dan tanggung jawab room attendant di deluxe room Hotel Hyatt Regency Bandung, standar operasional prosedur di deluxe room Hotel Hyatt Regency Bandung, dan penanganan complaint tamu di deluxe room Hotel Hyatt Regency Bandung. Metode yang di gunakan menggunakan analisis deskriptif, yaitu bentuk penulisan yang di upayakan menggambarkan keadaan yang sebenarnya tetang objek penelitian,kemudian data yang di peroleh disusun
Rosenkrantz, Andrew B; Lepor, Herbert; Taneja, Samir S; Recht, Michael P
2014-05-01
The authors describe their initial experience in implementing an integrated radiology reading room within a urologic oncology clinic, including the frequency and nature of clinician consultations and the perceived impact on patient management by clinicians. A radiology reading room was established within an office-based urologic oncology clinic in proximity to the surgeon's work area. A radiologist was present in this reading room for a 3-hour shift each day. The frequency and nature of consultations during these shifts were recorded. Also, the clinic's staff completed a survey assessing perceptions of the impact of the integrated reading room on patient management. One hundred two consultations occurred during 57 included dates (average, 1.8 consultations per shift): 52% for review of external cases brought in by patients on discs, 43% for review of internal cases, and 5% for direct review by the radiologist of imaging with patients. The maximum number of consultations during a single shift was 8. All of the clinic's urologists indicated that >90% of consultations benefited patient care. The clinicians indicated tendencies to view consultations as affecting management in the majority of cases, to be more likely to seek consultation for outside imaging when the radiologist was on site, and to be less likely to repeat outside imaging when the radiologist was on site. The integrated reading room within the clinic has potential to improve the quality of care, for instance by facilitating increased review of outside imaging studies and thereby potentially reducing duplicate ordering and by enabling occasional direct image review with patients by radiologists. Copyright © 2014 American College of Radiology. Published by Elsevier Inc. All rights reserved.
International Nuclear Information System (INIS)
Zhang Li; Hu Hong; Li Pengcheng; Jiang Jianjun; Yi Cannan; Chen Qingqing
2015-01-01
In order to build a quantitative model to analyze operators' monitoring behavior reliability of digital main control room of nuclear power plants, based on the analysis of the design characteristics of digital main control room of a nuclear power plant and operator's monitoring behavior, and combining with operators' monitoring behavior process, monitoring behavior reliability was divided into three parts including information transfer reliability among screens, inside-screen information sampling reliability and information detection reliability. Quantitative calculation model of information transfer reliability among screens was established based on Senders's monitoring theory; the inside screen information sampling reliability model was established based on the allocation theory of attention resources; and considering the performance shaping factor causality, a fuzzy Bayesian method was presented to quantify information detection reliability and an example of application was given. The results show that the established model of monitoring behavior reliability gives an objective description for monitoring process, which can quantify the monitoring reliability and overcome the shortcomings of traditional methods. Therefore, it provides theoretical support for operator's monitoring behavior reliability analysis in digital main control room of nuclear power plants and improves the precision of human reliability analysis. (authors)
Phasor Simulator for Operator Training Project
Energy Technology Data Exchange (ETDEWEB)
Dyer, Jim [Electric Power Group, Llc, Pasadena, CA (United States)
2016-09-14
Synchrophasor systems are being deployed in power systems throughout the North American Power Grid and there are plans to integrate this technology and its associated tools into Independent System Operator (ISO)/utility control room operations. A pre-requisite to using synchrophasor technologies in control rooms is for operators to obtain training and understand how to use this technology in real-time situations. The Phasor Simulator for Operator Training (PSOT) project objective was to develop, deploy and demonstrate a pre-commercial training simulator for operators on the use of this technology and to promote acceptance of the technology in utility and ISO/Regional Transmission Owner (RTO) control centers.
Workplace culture among operating room nurses.
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.
Read-Brown, Sarah; Sanders, David S; Brown, Anna S; Yackel, Thomas R; Choi, Dongseok; Tu, Daniel C; Chiang, Michael F
2013-01-01
Efficiency and quality of documentation are critical in surgical settings because operating rooms are a major source of revenue, and because adverse events may have enormous consequences. Electronic health records (EHRs) have potential to impact surgical volume, quality, and documentation time. Ophthalmology is an ideal domain to examine these issues because procedures are high-throughput and demand efficient documentation. This time-motion study examines nursing documentation during implementation of an EHR operating room management system in an ophthalmology department. Key findings are: (1) EHR nursing documentation time was significantly worse during early implementation, but improved to a level near but slightly worse than paper baseline, (2) Mean documentation time varied significantly among nurses during early implementation, and (3) There was no decrease in operating room turnover time or surgical volume after implementation. These findings have important implications for ambulatory surgery departments planning EHR implementation, and for research in system design.
The conference hybrid control room
International Nuclear Information System (INIS)
Gieci, A.; Caucik, J.; Macko, J.
2008-01-01
An original concept of a hybrid control room was developed for the Mochovce-3 and Mochovce-4 reactor units which are under construction. The basic idea underlying the concept is that the control room should be a main working place for the operators (reactor operator and turbine operator) and for the shift supervisor, designed as a comprehensive unit desk shaped so that all members of the control room crew are in a face-to-face contact constantly. The main desk consists of three clearly identified areas serving the operators and the unit supervisor as their main working places. A soft control system is installed at the main working places. A separate safety-related working place, designed as a panel with classical instrumentations at the conference hybrid control room, is provided in case of abnormal conditions or emergency situation. Principles of ergonomics and cognitive engineering were taken into account when designing the new conference hybrid control room for the Mochovce-3 and -4 reactor units. The sizes, propositions, shapes and disposition of the equipment at the control room have been created and verified by using virtual reality tools. (orig.)
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)
Operational Amplifer Integrator
van Tuijl, Adrianus Johannes Maria
2003-01-01
An integrator circuit comprises an operational amplifier which has a transistor stage (1) with an input terminal (4) and an output terminal (3), a feedback capacitor (2) connected between the input terminal (4) and the output terminal (3), and a resistor (5) connected to the input terminal (4), and
Integrated application of human factors to a power plant control room information system
International Nuclear Information System (INIS)
Fish, H.C. Jr.; Gutierrez, R.
1988-01-01
The human factors plan was developed as a methodology to apply human factors from the conceptual design of the EPIC system to the functional verification conducted at the plant. An integral part of the Human Factors Plan was the Functional Verification Plan. Developed in parallel, this second plan and its resultant programs verified functional appropriateness of the SPDS display, NSSS displays, EOP displays, man-machine interfaces (MMI), and workstation designs. The functional verification process was performed at the hardware/software developer's factory and at the JAFNPP, following installation of the EPIC system. Because the EPIC system replaces existing control room equipment, it is important that human factors be applied in a systematic manner consistent with other control room displays and controls. To ensure that this goal was met, a human factors plan was developed
Evaluation on the habitability of a reactor control room for a 1300 MWe PWR following a LOCA
International Nuclear Information System (INIS)
Chang, Si Young; Ha, Chung Woo
1988-01-01
An evaluation on the habitability of a reactor control room for a French 1300 MWe P'4 type PWR following a LOCA has been performed through exposure dose assessment for a reactor operator. A computer code COREX calculating the time-integrated exposure dose has been developed to provide a reasonable basis in this evaluation. Using COREX the exposure dose reduction factors in the reactor control room, the time--integrated radioactivities released into the atmosphere and the time-integrated exposure dose up to 30 days following the LOCA can be also calculated. From the exposure dose assessment, the time-integrated exposure dose to whole body and thyroid of a reactor operator were 0.36 mSv(0.036 rem) and 480 mSv(48.0 rem), respectively after 30 days following the LOCA. The thyroid dose of 480 mSv was nearly 10 times greater than the dose equivalent limit of 50 mSv(5.0 rem) set by the ICRP. Regarding the habitability of a reactor control room, this exceeding thyroid exposure dose could be reduced to 1.2 mSv(0.12 rem), which is 400 times less than the original, by considering the practical 4 work-shifts a day, and by improving the iodine removal efficiency of the filtration system n the reactor control room through the reinforcement of charcoal bed filters for iodine removal. The radiological habitability of a reactor control room, therefore, could be assured by comparing with the dose equivalent limit of the ICRP
Verification and Validation of Digitally Upgraded Control Rooms
International Nuclear Information System (INIS)
Boring, Ronald; Lau, Nathan
2015-01-01
As nuclear power plants undertake main control room modernization, a challenge is the lack of a clearly defined human factors process to follow. Verification and validation (V&V) as applied in the nuclear power community has tended to involve efforts such as integrated system validation, which comes at the tail end of the design stage. To fill in guidance gaps and create a step-by-step process for control room modernization, we have developed the Guideline for Operational Nuclear Usability and Knowledge Elicitation (GONUKE). This approach builds on best practices in the software industry, which prescribe an iterative user-centered approach featuring multiple cycles of design and evaluation. Nuclear regulatory guidance for control room design emphasizes summative evaluation - which occurs after the design is complete. In the GONUKE approach, evaluation is also performed at the formative stage of design - early in the design cycle using mockups and prototypes for evaluation. The evaluation may involve expert review (e.g., software heuristic evaluation at the formative stage and design verification against human factors standards like NUREG-0700 at the summative stage). The evaluation may also involve user testing (e.g., usability testing at the formative stage and integrated system validation at the summative stage). An additional, often overlooked component of evaluation is knowledge elicitation, which captures operator insights into the system. In this report we outline these evaluation types across design phases that support the overall modernization process. The objective is to provide industry-suitable guidance for steps to be taken in support of the design and evaluation of a new human-machine interface (HMI) in the control room. We suggest the value of early-stage V&V and highlight how this early-stage V&V can help improve the design process for control room modernization. We argue that there is a need to overcome two shortcomings of V&V in current practice
Verification and Validation of Digitally Upgraded Control Rooms
Energy Technology Data Exchange (ETDEWEB)
Boring, Ronald [Idaho National Lab. (INL), Idaho Falls, ID (United States); Lau, Nathan [Idaho National Lab. (INL), Idaho Falls, ID (United States)
2015-09-01
As nuclear power plants undertake main control room modernization, a challenge is the lack of a clearly defined human factors process to follow. Verification and validation (V&V) as applied in the nuclear power community has tended to involve efforts such as integrated system validation, which comes at the tail end of the design stage. To fill in guidance gaps and create a step-by-step process for control room modernization, we have developed the Guideline for Operational Nuclear Usability and Knowledge Elicitation (GONUKE). This approach builds on best practices in the software industry, which prescribe an iterative user-centered approach featuring multiple cycles of design and evaluation. Nuclear regulatory guidance for control room design emphasizes summative evaluation—which occurs after the design is complete. In the GONUKE approach, evaluation is also performed at the formative stage of design—early in the design cycle using mockups and prototypes for evaluation. The evaluation may involve expert review (e.g., software heuristic evaluation at the formative stage and design verification against human factors standards like NUREG-0700 at the summative stage). The evaluation may also involve user testing (e.g., usability testing at the formative stage and integrated system validation at the summative stage). An additional, often overlooked component of evaluation is knowledge elicitation, which captures operator insights into the system. In this report we outline these evaluation types across design phases that support the overall modernization process. The objective is to provide industry-suitable guidance for steps to be taken in support of the design and evaluation of a new human-machine interface (HMI) in the control room. We suggest the value of early-stage V&V and highlight how this early-stage V&V can help improve the design process for control room modernization. We argue that there is a need to overcome two shortcomings of V&V in current practice
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.
Cognitive models and computer aids for nuclear plant control room operators
International Nuclear Information System (INIS)
Sheridan, T.B.
1982-01-01
This paper reviews what is usually meant by a cognitive model of a control room operator in a nuclear power plant. It emphasizes the idea of internal (that is, mental) representation of external events and the use of such representation for the cognitive steps of attending, recognizing or learning, assessing and deciding. As computers play an increasingly important role in nuclear power plants, especially as cognitive aids to human supervisors of highly automated control systems, it is important that the software and computer interface characteristics be compatible with the operator's internal model. Specific examples discussed in this paper are in the monitoring and prediction of the plant state and in the detection and diagnosis of failures. Current trends in SPDS (safety parameter display system) and failure detection/location systems will be discussed in this regard
Integrated formal operations plan
Energy Technology Data Exchange (ETDEWEB)
Cort, G.; Dearholt, W.; Donahue, S.; Frank, J.; Perkins, B.; Tyler, R.; Wrye, J.
1994-01-05
The concept of formal operations (that is, a collection of business practices to assure effective, accountable operations) has vexed the Laboratory for many years. To date most attempts at developing such programs have been based upon rigid, compliance-based interpretations of a veritable mountain of Department of Energy (DOE) orders, directives, notices, and standards. These DOE dictates seldom take the broad view but focus on highly specialized programs isolated from the overall context of formal operations. The result is a confusing array of specific, and often contradictory, requirements that produce a patchwork of overlapping niche programs. This unnecessary duplication wastes precious resources, dramatically increases the complexity of our work processes, and communicates a sense of confusion to our customers and regulators. Coupled with the artificial divisions that have historically existed among the Laboratory`s formal operations organizations (quality assurance, configuration management, records management, training, etc.), this approach has produced layers of increasingly vague and complex formal operations plans, each of which interprets its parent and adds additional requirements of its own. Organizational gridlock ensues whenever an activity attempts to implement these bureaucratic monstrosities. The integrated formal operations plan presented is to establish a set of requirements that must be met by an integrated formal operations program, assign responsibilities for implementation and operation of the program, and specify criteria against which the performance of the program will be measured. The accountable line manager specifies the items, processes, and information (the controlled elements) to which the formal operations program specified applies. The formal operations program is implemented using a graded approach based on the level of importance of the various controlled elements and the scope of the activities in which they are involved.
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)
International Nuclear Information System (INIS)
Winden, A; Mikulics, M; Grützmacher, D; Hardtdegen, H
2013-01-01
Important technological steps are discussed and realized for future room-temperature operation of III-nitride single photon emitters. First, the growth technology of positioned single pyramidal InN nanostructures capped by Mg-doped GaN is presented. The optimization of their optical characteristics towards narrowband emission in the telecommunication wavelength range is demonstrated. In addition, a device concept and technology was developed so that the nanostructures became singularly addressable. It was found that the nanopyramids emit in the telecommunication wavelength range if their size is chosen appropriately. A p-GaN contacting layer was successfully produced as a cap to the InN pyramids and the top p-contact was achievable using an intrinsically conductive polymer PEDOT:PSS, allowing a 25% increase in light transmittance compared to standard Ni/Au contact technology. Single nanopyramids were successfully integrated into a high-frequency device layout. These decisive technology steps provide a promising route to electrically driven and room-temperature operating InN based single photon emitters in the telecommunication wavelength range. (paper)
International Nuclear Information System (INIS)
Cheon, Se Woo; Sur, Sang Moon; Lee, Yong Hee; Lee, Jeong Wun
1993-01-01
This paper presents the development strategies of cognitive task network modeling for accident scenarios in nuclear power plant control rooms. Task network modeling is used to provide useful predictions of operator's performance times and error rates, based upon plant procedures and/or control room changes. Two accident scenarios, small-break loss of coolant accident (LOCA) and steam generator tube rupture (SGTR), are selected for task simulation. To obtain the input data for the model, task elements are extracted by the task analysis of emergency operating procedures. The input data include task performance time, communication ink, panel location, component operating mode, and data for performance shaping factors (PSFs). Operator's verbs are categorized according to the elements of cognitive behavior. The simulation of the task network for the small-break LOCA scenario is presented in this paper. (Author)
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
Towards a model of surgeons' leadership in the operating room.
Henrickson Parker, Sarah; Yule, Steven; Flin, Rhona; McKinley, Aileen
2011-07-01
There is widespread recognition that leadership skills are essential for effective performance in the workplace, but the evidence detailing effective leadership behaviours for surgeons during operations is unclear. Boolean searches of four on-line databases and detailed hand search of relevant references were conducted. A four stage screening process was adopted stipulating that articles presented empirical data on surgeons' intraoperative leadership behaviours. Ten relevant articles were identified and organised by method of investigation into (i) observation, (ii) questionnaire and (iii) interview studies. This review summarises the limited literature on surgeons' intraoperative leadership, and proposes a preliminary theoretically based structure for intraoperative leadership behaviours. This structure comprises seven categories with corresponding leadership components and covers two overarching themes related to task- and team-focus. Selected leadership theories which may be applicable to the operating room environment are also discussed. Further research is required to determine effective intraoperative leadership behaviours for safe surgical practice.
Room temperature continuous wave mid-infrared VCSEL operating at 3.35 μm
Jayaraman, V.; Segal, S.; Lascola, K.; Burgner, C.; Towner, F.; Cazabat, A.; Cole, G. D.; Follman, D.; Heu, P.; Deutsch, C.
2018-02-01
Tunable vertical cavity surface emitting lasers (VCSELs) offer a potentially low cost tunable optical source in the 3-5 μm range that will enable commercial spectroscopic sensing of numerous environmentally and industrially important gases including methane, ethane, nitrous oxide, and carbon monoxide. Thus far, achieving room temperature continuous wave (RTCW) VCSEL operation at wavelengths beyond 3 μm has remained an elusive goal. In this paper, we introduce a new device structure that has enabled RTCW VCSEL operation near the methane absorption lines at 3.35 μm. This device structure employs two GaAs/AlGaAs mirrors wafer-bonded to an optically pumped active region comprising compressively strained type-I InGaAsSb quantum wells grown on a GaSb substrate. This substrate is removed in processing, as is one of the GaAs mirror substrates. The VCSEL structure is optically pumped at room temperature with a CW 1550 nm laser through the GaAs substrate, while the emitted 3.3 μm light is captured out of the top of the device. Power and spectrum shape measured as a function of pump power exhibit clear threshold behavior and robust singlemode spectra.
Energy Technology Data Exchange (ETDEWEB)
R. Fink, D. Hill, J. O' Hara
2004-11-30
Nuclear plant operators face a significant challenge designing and modifying control rooms. This report provides guidance on planning, designing, implementing and operating modernized control rooms and digital human-system interfaces.
International Nuclear Information System (INIS)
Fink, R.; Hill, D.; O'Hara, J.
2004-01-01
Nuclear plant operators face a significant challenge designing and modifying control rooms. This report provides guidance on planning, designing, implementing and operating modernized control rooms and digital human-system interfaces
International Nuclear Information System (INIS)
Kim, Seunghwan; Kim, Yochan; Jung, Wondea
2014-01-01
Highlights: • An advanced MMIS in the advanced MCR requires new roles and tasks of operators. • A new workload evaluation framework is needed for a new MMIS environment. • This work suggests a new workload measurement approach (COCOA) for an advanced MCR. • COCOA enables 3-dimensional measurement of cognition, communication and operation. • COCOA workload evaluation of the reference plant through simulation was performed. - Abstract: An advanced man–machine interface system (MMIS) with a computer-based procedure system and high-tech control/alarm system is installed in the advanced main control room (MCR) of a nuclear power plant. Accordingly, though the task of the operators has been changed a great deal, owing to a lack of appropriate guidelines on the role allocation or communication method of the operators, operators should follow the operating strategies of conventional MCR and the problem of an unbalanced workload for each operator can be raised. Thus, it is necessary to enhance the operation capability and improve the plant safety by developing guidelines on the role definition and communication of operators in an advanced MCR. To resolve this problem, however, a method for measuring the workload according to the work execution of the operators is needed, but an applicable method is not available. In this research, we propose a COgnitive, Communicative and Operational Activities measurement approach (COCOA) to measure and evaluate the workload of operators in an advanced MCR. This paper presents the taxonomy for additional operation activities of the operators to use the computerized procedures and soft control added to an advanced MCR, which enables an integrated measurement of the operator workload in various dimensions of cognition, communication, and operation. To check the applicability of COCOA, we evaluated the operator workload of an advanced MCR of a reference power plant through simulation training experiments. As a result, the amount
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.
Directory of Open Access Journals (Sweden)
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
An integrated operation mode for green logistics of enterprises
Institute of Scientific and Technical Information of China (English)
Yu Chengxue; Wu Chunyou; Fan Yu
2006-01-01
The integrated operation mode of green logistics is a new enterprise's logistics operation and management mode concerning environment issues based on the traditional integrated mode. Through comparative study on the integrated operation mode of logistics based on self-operation, the operation mode of an integrated logistics of enterprises based on TPL, the green-supply chain management, and the operation mode of eco-industrial park (EIP), a relatively complete objective system structure is put forward for the integrated operation mode of green logistics of enterprises. Furthermore, the correspondent practical mode is also set up to help enterprises, especially for the manufacturing companies, not only improve the environment effectively, but support the technological framework for the enterprise's economic performance and social benefits in order to realize economic, social and environmental benefits are concerned.
Improving operating room turnover time: a systems based approach.
Bhatt, Ankeet S; Carlson, Grant W; Deckers, Peter J
2014-12-01
Operating room (OR) turnover time (TT) has a broad and significant impact on hospital administrators, providers, staff and patients. Our objective was to identify current problems in TT management and implement a consistent, reproducible process to reduce average TT and process variability. Initial observations of TT were made to document the existing process at a 511 bed, 24 OR, academic medical center. Three control groups, including one consisting of Orthopedic and Vascular Surgery, were used to limit potential confounders such as case acuity/duration and equipment needs. A redesigned process based on observed issues, focusing on a horizontally structured, systems-based approach has three major interventions: developing consistent criteria for OR readiness, utilizing parallel processing for patient and room readiness, and enhancing perioperative communication. Process redesign was implemented in Orthopedics and Vascular Surgery. Comparisons of mean and standard deviation of TT were made using an independent 2-tailed t-test. Using all surgical specialties as controls (n = 237), mean TT (hh:mm:ss) was reduced by 0:20:48 min (95 % CI, 0:10:46-0:30:50), from 0:44:23 to 0:23:25, a 46.9 % reduction. Standard deviation of TT was reduced by 0:10:32 min, from 0:16:24 to 0:05:52 and frequency of TT≥30 min was reduced from 72.5to 11.7 %. P systems-based focus should drive OR TT design.
Ge-Based Spin-Photodiodes for Room-Temperature Integrated Detection of Photon Helicity
Rinaldi, Christian
2012-05-02
Spin-photodiodes based on Fe/MgO/Ge(001) heterostructures are reported. These devices perform the room-temperature integrated electrical detection of the spin polarization of a photocurrent generated by circularly polarized photons with a wavelength of 1300 nm, for light pulses with intensity I 0 down to 200 μW. A forward and reverse-biased average photocurrent variation of 5.9% is measured for the complete reversal of the incident light helicity. Copyright © 2012 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.
Computer-aided operations engineering with integrated models of systems and operations
Malin, Jane T.; Ryan, Dan; Fleming, Land
1994-01-01
CONFIG 3 is a prototype software tool that supports integrated conceptual design evaluation from early in the product life cycle, by supporting isolated or integrated modeling, simulation, and analysis of the function, structure, behavior, failures and operation of system designs. Integration and reuse of models is supported in an object-oriented environment providing capabilities for graph analysis and discrete event simulation. Integration is supported among diverse modeling approaches (component view, configuration or flow path view, and procedure view) and diverse simulation and analysis approaches. Support is provided for integrated engineering in diverse design domains, including mechanical and electro-mechanical systems, distributed computer systems, and chemical processing and transport systems. CONFIG supports abstracted qualitative and symbolic modeling, for early conceptual design. System models are component structure models with operating modes, with embedded time-related behavior models. CONFIG supports failure modeling and modeling of state or configuration changes that result in dynamic changes in dependencies among components. Operations and procedure models are activity structure models that interact with system models. CONFIG is designed to support evaluation of system operability, diagnosability and fault tolerance, and analysis of the development of system effects of problems over time, including faults, failures, and procedural or environmental difficulties.
International Nuclear Information System (INIS)
Bouwmeester, R.
1996-03-01
A major modification of the Borssele Nuclear Power Plant (NPP), scheduled in 1997, includes the installation of a new Integrated Process Status Overview (IPSO) display in the extensively modified control room. The IPSO display is to promote effective communications among all individuals present in the control room with a clear overview of the main process systems. The flexible LCD rear-projection technique is selected for the replacement of the existing IPSO display with engraved process symbols and hard-wired LEDs. The relation between the IPSO display and the CRT based Process Presentation System (PPS) is described after an elaborate introduction to the nuclear technology and the modification project. The followed IPSO design methodology includes interviews with all IPSO user groups to acquire their experience and comment on the current IPSO in order to enhance the functionality and the acceptance of the new IPSO graphics. The ergonomic design requirements for the new IPSO display concern both generic aspects of information presentation on human-machine interfaces, as well as specific issues related to the selected LCD rear-projection technique. Intermediate stages in the design of the IPSO graphics are outlined as well as the results of the concept evaluation by the user groups. For special interest the functionality of a three dimensional (3-D) display was explored. The design study concludes with a 'final' IPSO graphics design to be used for evaluations on the control room simulator. The presentation of one graphic was found to be most appropriate with adjustment of colour (grey) of components and systems which do not need to operate during the current process conditions or plant mode. (orig.)
Management of Surgical Instruments Package in the Operating Room%手术室器械包的管理
Institute of Scientific and Technical Information of China (English)
刘萍; 张娟; 潘文琴; 戴榕娟
2017-01-01
Objective Cleaning, maintenance, disinfection and preoperative preparation of surgical instruments in the past are done by the operation room, but with the development of China's hospitals and national new surgical management practices, certain progress has been achieved in the integrated management of surgical instruments for the operating rooms.Practical experiences in the management were discussed in this article.MethodsIn order to improve work quality and work efficiency and to reduce cost in the management of instruments in operation room, we analyzed the current situation of the management of equipment in the operation room based on the reality and tried to find out the method of surgical instrument package innovation, including the production of classification photo album for the surgical instrument package, paper list of all equipments, and production of marking cards for the instruments that can stand the sterilization under high pressure.Results and Conclusion From the implementation point of view, the total loss rate is reduced from the original 0.43% to 0.14%,and the loss rate of the micro device from 0.725% to 0.23%, effectively reducing the device losses.Great progress has been made in the use of the new methods, the quality of the personnel, in charge of the surgical instruments, classification management and the mapping and marking of cards.%目的 手术器械包的清洗、保养、消毒灭菌和术前准备工作以往均由手术室自行完成,随着我国医院洁净手术室的发展和国家新手术管理规范的实施,手术器械管理实施手供一体化相关工作逐步取得一定的效果.方法 分析手术器械包的管理及成效,改善工作品质,提高工作效率,降低成本等情况;找出手术器械包新的管理方法,包括制作手术器械包分类相册,以及手术器械包中加入纸质的器械清单、制作能够高压灭菌的金属器械牌等手段.结果与结论
Lin, Luo; Yueming, Zhang; Meisheng, Li; Jiexue, Wang; Yang, Ji
2017-12-01
To study the effectiveness of dexmedetomidine used for general anesthesia maintenance in children undergoing odontotherapy in day-surgery operating room in reducing the incidence of emergence agitation (EA). Eighty children undergoing odontotherapy and under general anesthesia in day-surgery operating room were randomized into two groups, group A (n=40) and group B (n=40). Each patient in group A was administered with a bolus dose of dexmedetomidine (1.0 μg·kg⁻¹, saline diluted to 10 mL) pump-infused after intubation and a maintenance dose of 0.1-0.4 mL·(kg·h)⁻¹ followed-up until 45 min before the end of operation. Each patient in group B was administered with a bolus dose of normal saline 10 mL pump-infused after intubation and maintenance dose of 0.1-0.4 mL·(kg·h)⁻¹ followed-up until 45 min before the end of operation. Gender, age, weight, physical status according to the American Society of Anesthesiologists, perioperative heart rate (HR), mean arterial pressure (MAP), pulse oxygen saturation (SpO₂), sufentanil dosage, duration of surgery, time of extubation, time of regaining consciousness, and time to reach modified Aldrete's score≥12 were recorded. Behavior in postanesthesia care unit was rated on the four-point agitation scale. Compared with group B, decreases were observed in HR and MAP at the beginning of operation, in 10 and 30 min, 1 and 2 h after the beginning of operation, and after extubation of group A (Pgeneral anesthesia maintenance in children undergoing odontotherapy in day-surgery operating room, dexmedetomidine results in low incidence of EA during recovery and more stable vital signs.
Human Factors methods concerning integrated validation of nuclear power plant control rooms
International Nuclear Information System (INIS)
Oskarsson, Per-Anders; Johansson, Bjoern J.E.; Gonzalez, Natalia
2010-02-01
The frame of reference for this work was existing recommendations and instructions from the NPP area, experiences from the review of the Turbic Validation and experiences from system validations performed at the Swedish Armed Forces, e.g. concerning military control rooms and fighter pilots. These enterprises are characterized by complex systems in extreme environments, often with high risks, where human error can lead to serious consequences. A focus group has been performed with representatives responsible for Human Factors issues from all Swedish NPP:s. The questions that were discussed were, among other things, for whom an integrated validation (IV) is performed and its purpose, what should be included in an IV, the comparison with baseline measures, the design process, the role of SSM, which methods of measurement should be used, and how the methods are affected of changes in the control room. The report brings different questions to discussion concerning the validation process. Supplementary methods of measurement for integrated validation are discussed, e.g. dynamic, psychophysiological, and qualitative methods for identification of problems. Supplementary methods for statistical analysis are presented. The study points out a number of deficiencies in the validation process, e.g. the need of common guidelines for validation and design, criteria for different types of measurements, clarification of the role of SSM, and recommendations for the responsibility of external participants in the validation process. The authors propose 12 measures for taking care of the identified problems
Wagner, Debra L; Lawrence, Stephen; Xu, Jing; Melsom, Janice
2018-04-01
Transporting a newborn out of the operating room after cesarean birth can contribute to maternal awareness of discomfort, anxiety, and the need for administration of analgesics and anxiolytics for relief. This retrospective study analyzed the association between skin-to-skin contact in the operating room and administration of analgesics and anxiolytics to women in the operating and recovery rooms after cesarean birth. Our results indicated a trend toward decreased medication administration for women who experienced skin-to-skin contact and add to evidence supporting the incorporation of skin-to-skin contact in the operating room as the standard of care for cesarean birth. This practice has the potential to enhance the birth experience, promote breastfeeding, and provide greater safety with less exposure to opioids and benzodiazepines for women and their newborns. © 2018 AWHONN, the Association of Women’s Health, Obstetric and Neonatal Nurses.
Energy Technology Data Exchange (ETDEWEB)
Reischl, Ludwig; Freitag, Timo; Dergel, Rene [AREVA NP (Germany). NLLR-G ' ' Reactor I and C' '
2009-07-01
In the frame of lifetime extension for nuclear power plants the modernization of the complete safety and operational control technology will be digitalized. It is also recommended to modernize the operator facilities, monitoring systems in the control room, the back-up shut-down center and the local control stations. The authors summarize the reasons for the modernization recommendations and discuss possible solutions for display-oriented control rooms. A concept for control room backfitting includes generic requirements, requirements of the local authorities, ergonomic principles information content and information density, and the design process. The backfitting strategy should include a cooperation with the operational personnel, The quality assurance and training via simulator needs sufficient timing during the implementation of the backfitting.
Quantum confinement of zero-dimensional hybrid organic-inorganic polaritons at room temperature
Nguyen, H. S.; Han, Z.; Abdel-Baki, K.; Lafosse, X.; Amo, A.; Lauret, J.-S.; Deleporte, E.; Bouchoule, S.; Bloch, J.
2014-02-01
We report on the quantum confinement of zero-dimensional polaritons in perovskite-based microcavity at room temperature. Photoluminescence of discrete polaritonic states is observed for polaritons localized in symmetric sphere-like defects which are spontaneously nucleated on the top dielectric Bragg mirror. The linewidth of these confined states is found much sharper (almost one order of magnitude) than that of photonic modes in the perovskite planar microcavity. Our results show the possibility to study organic-inorganic cavity polaritons in confined microstructure and suggest a fabrication method to realize integrated polaritonic devices operating at room temperature.
Quantum confinement of zero-dimensional hybrid organic-inorganic polaritons at room temperature
International Nuclear Information System (INIS)
Nguyen, H. S.; Lafosse, X.; Amo, A.; Bouchoule, S.; Bloch, J.; Han, Z.; Abdel-Baki, K.; Lauret, J.-S.; Deleporte, E.
2014-01-01
We report on the quantum confinement of zero-dimensional polaritons in perovskite-based microcavity at room temperature. Photoluminescence of discrete polaritonic states is observed for polaritons localized in symmetric sphere-like defects which are spontaneously nucleated on the top dielectric Bragg mirror. The linewidth of these confined states is found much sharper (almost one order of magnitude) than that of photonic modes in the perovskite planar microcavity. Our results show the possibility to study organic-inorganic cavity polaritons in confined microstructure and suggest a fabrication method to realize integrated polaritonic devices operating at room temperature
Pokrywka, Marian; Byers, Karin
2013-06-01
Surgical wound contamination leading to surgical site infection can result from disruption of the intended airflow in the operating room (OR). When personnel enter and exit the OR, or create unnecessary movement and traffic during the procedure, the intended airflow in the vicinity of the open wound becomes disrupted and does not adequately remove airborne contaminants from the sterile field. An increase in the bacterial counts of airborne microorganisms is noted during increased activity levels within the OR. Researchers have studied OR traffic and door openings as a determinant of air contamination. During a surgical procedure the door to the operating room may be open as long as 20 minutes out of each surgical hour during critical procedures involving implants. Interventions into limiting excessive movement and traffic in the OR may lead to reductions in surgical site infections in select populations.
Improving the Interdisciplinary Team Work in the Operating Room
DEFF Research Database (Denmark)
Tørring, Birgitte
In surgical teams, where health professionals are highly interdependent and work under time pressure, it is of particular importance that the team work is well-functioning to secure treatment quality and patient safety. Using the theory of relational coordination (RC) may be the key to unlocking...... the black box of teamwork in search for relational elements critical to successful collaboration and communication. Few single studies exists which explore how RC could be observed and improved in this context. The present study examines surgical teams in selected operating rooms (OR) focusing on RC...... period in 2014 in two orthopedic surgical wards in a university hospital. A directed content analysis on the basis of theory of RC is used to transform the data to show different typologies of interdisciplinary team work. RC was subsequently measured using the RC Survey. Data describe very complex...
International Nuclear Information System (INIS)
Meshkati, N.; Buller, B.J.; Azadeh, M.A.
1995-01-01
The goal of this research is threefold: (1) use of the Skill-, Rule-, and Knowledge-based levels of cognitive control -- the SRK framework -- to develop an integrated information processing conceptual framework (for integration of workstation, job, and team design); (2) to evaluate the user interface component of this framework -- the Ecological display; and (3) to analyze the effect of operators' individual information processing behavior and decision styles on handling plant disturbances plus their performance on, and preference for, Traditional and Ecological user interfaces. A series of studies were conducted. In Part I, a computer simulation model and a mathematical model were developed. In Part II, an experiment was designed and conducted at the EBR-II plant of the Argonne National Laboratory-West in Idaho Falls, Idaho. It is concluded that: the integrated SRK-based information processing model for control room operations is superior to the conventional rule-based model; operators' individual decision styles and the combination of their styles play a significant role in effective handling of nuclear power plant disturbances; use of the Ecological interface results in significantly more accurate event diagnosis and recall of various plant parameters, faster response to plant transients, and higher ratings of subject preference; and operators' decision styles affect on both their performance and preference for the Ecological interface
Energy Technology Data Exchange (ETDEWEB)
Meshkati, N.; Buller, B.J.; Azadeh, M.A. [Univ. of Southern California, Los Angeles, CA (United States)
1995-04-01
The goal of this research is threefold: (1) use of the Skill-, Rule-, and Knowledge-based levels of cognitive control -- the SRK framework -- to develop an integrated information processing conceptual framework (for integration of workstation, job, and team design); (2) to evaluate the user interface component of this framework -- the Ecological display; and (3) to analyze the effect of operators` individual information processing behavior and decision styles on handling plant disturbances plus their performance on, and preference for, Traditional and Ecological user interfaces. A series of studies were conducted. In Part I, a computer simulation model and a mathematical model were developed. In Part II, an experiment was designed and conducted at the EBR-II plant of the Argonne National Laboratory-West in Idaho Falls, Idaho. It is concluded that: the integrated SRK-based information processing model for control room operations is superior to the conventional rule-based model; operators` individual decision styles and the combination of their styles play a significant role in effective handling of nuclear power plant disturbances; use of the Ecological interface results in significantly more accurate event diagnosis and recall of various plant parameters, faster response to plant transients, and higher ratings of subject preference; and operators` decision styles affect on both their performance and preference for the Ecological interface.
Kirschbaum, Kristin
2012-01-01
Communication variables that are associated with face-negotiation theory were examined in a sample of operating-room physicians. A survey was administered to anesthesiologists and surgeons at a teaching hospital in the southwestern United States to measure three variables commonly associated with face-negotiation theory: conflict-management style, face concern, and self-construal. The survey instrument that was administered to physicians includes items that measured these three variables in previous face-negotiation research with slight modification of item wording for relevance in the medical setting. The physician data were analyzed using confirmatory factor analysis, Pearson's correlations, and t-tests. Results of this initial investigation showed that variables associated with face-negotiation theory were evident in the sample physician population. In addition, the correlations were similar among variables in the medical sample as those found in previous face-negotiation research. Finally, t-tests suggest variance between anesthesiologists and surgeons on specific communication variables. These findings suggest three implications that warrant further investigation with expanded sample size: (1) An intercultural communication theory and instrument can be utilized for health communication research; (2) as applied in a medical context, face-negotiation theory can be expanded beyond traditional intercultural communication boundaries; and (3) theoretically based communication structures applied in a medical context could help explain physician miscommunication in the operating room to assist future design of communication training programs for operating-room physicians.
An integrated architecture for the ITER RH control system
International Nuclear Information System (INIS)
Hamilton, David Thomas; Tesini, Alessandro
2012-01-01
Highlights: ► Control system architecture integrating ITER remote handling equipment systems. ► Standard control system architecture for remote handling equipment systems. ► Research and development activities to validate control system architecture. ► Standardization studies to select standard parts for control system architecture. - Abstract: The ITER remote handling (RH) system has been divided into 7 major equipment system procurements that deliver complete systems (operator interfaces, equipment controllers, and equipment) according to task oriented functional specifications. Each equipment system itself is an assembly of transporters, power manipulators, telemanipulators, vehicular systems, cameras, and tooling with a need for controllers and operator interfaces. From an operational perspective, the ITER RH systems are bound together by common control rooms, operations team, and maintenance team; and will need to achieve, to a varying degree, synchronization of operations, co-operation on tasks, hand-over of components, and sharing of data and resources. The separately procured RH systems must, therefore, be integrated to form a unified RH system for operation from the RH control rooms. The RH system will contain a heterogeneous mix of specially developed RH systems and off-the-shelf RH equipment and parts. The ITER Organization approach is to define a control system architecture that supports interoperable heterogeneous modules, and to specify a standard set of modules for each system to implement within this architecture. Compatibility with standard parts for selected modules is required to limit the complexity for operations and maintenance. A key requirement for integrating the control system modules is interoperability, and no module should have dependencies on the implementation details of other modules. The RH system is one of the ITER Plant systems that are integrated and coordinated through the hierarchical structure of the ITER CODAC system
Energy Technology Data Exchange (ETDEWEB)
Kelley, C.T.; Xue, Z.Q. [North Carolina State Univ., Raleigh, NC (United States)
1994-12-31
Many discretizations of integral equations and compact fixed point problems are collectively compact and strongly convergent in spaces of continuous functions. These properties not only lead to stable and convergent approximations but also can be used in the construction of fast multilevel algorithms. Recently the GMRES algorithm has become a standard coarse mesh solver. The purpose of this paper is to show how the special properties of integral operators and their approximations are reflected in the performance of the GMRES iteration and how these properties can be used to strengthen the norm in which convergence takes place. The authors illustrate these ideas with composite Gauss rules for integral equations on the unit interval.
DEFF Research Database (Denmark)
Li, Ruixin; Sekhar ., S. C.; Melikov, Arsen Krikor
2011-01-01
A comprehensive study comprising physical measurements and human subject experiments was conducted to explore the potential for improving occupants' thermal comfort and indoor air quality (IAQ) using a personalized ventilation (PV) system combined with an under-floor air distribution(UFAD) system....... The integrated PV-UFAD system, when operated at relatively high temperature of the air supplied from the UFAD system, provided comfortable cooling of the facial region, improved inhaled air quality, and decreased the risk of "cold feet," which is often reported in rooms with UFAD alone. This article explores...... and a secondary AHU for 100% recirculated air that is supplied through UFAD outlets. Velocity and temperature distribution in the chamber were measured. A breathing thermal manikin was used to measure the heat loss from 26 body segments and to determine the equivalent temperature. The responses of 30 human...
An analysis of auditory cues for inclusion in a close quarters battle room clearing operation
Greenwald, Thomas W.
2002-01-01
Approved for public release, distribution is unlimited The purpose of this thesis is to examine which auditory cues need to be included in a virtual representation of a Close Quarters Combat Room Clearing Operation. Future missions of the United States Armed Forces, especially those of the Army and Marine Corps, are increasingly likely to be conducted in cities or built-up areas. A critical need exists for MOUT (Military Operations in Urban Terrain) training by our armed forces, and the en...
Control room habitability assessment and in-leakage test for Korean NPP - 15510
International Nuclear Information System (INIS)
Song, D.S.; Lee, J.B.; Ha, S.J.; Seong, J.J.
2015-01-01
The assessment of control room habitability for Wolsung unit 1 was performed based on GL 2003-01 and Reg. Guide 1.197. The control room habitability program including Control Room Envelope (CRE) in-leakage test procedures, self assessment guidance, CRE boundary control program, CRE maintenance/sealing program was developed for Wolsung unit 1. The integrated CRE test was performed utilizing ASTM E741. There are two operating modes of pressurization and isolation for CRE ventilation test, and four tests were performed using each of the control room HVAC sub-trains. The control room HVAC system lineup of pressurization mode test was based upon a lineup that encompassed the design basis radiological analyses. The other control room HVAC system lineup of isolation mode test was based on an operation mode that considers toxic gas. The in-leakage testing was performed in accordance with CRE in-leakage test procedures. In the pressurization mode, measured unfiltered in-leakage rates for train A and train B were 0 CFM and 405 CFM respectively. In the isolation mode, measured unfiltered in-leakage rates for train A and train B were 1,739 CFM and 1,502 CFM, respectively. Maximum concentration of ammonia at the control room HVAC intake is calculated to be 0.027 g/m 3 (39 ppm), and satisfied the toxicity limit of 300 ppm. The test result shows that the measured unfiltered in-leakage is bounded by the regulatory criteria assumed in the design basis radiological analyses. (authors)
Integration of emergency action levels with Combustion Engineering Emergency Operating Procedures
International Nuclear Information System (INIS)
Faletti, D.W.; Jamison, J.D.
1985-09-01
This report documents the development of a method for integrating Emergency Action Levels (EALs) with plant-specific Emergency Operating Procedures (EOPs) using the Combustion Engineering Owners' Group Emergency Operating Procedure Technical Guidelines (CEOG EOPTFs). EALs are discrete conditions or values of plant operating parameters which, if exceeded, require declaration of an appropriate level of emergency. At most operating plants, the EALs and event classification procedures are totally separate from the Emergency Operating Procedures used by the plant staff to control the plant during abnormal conditions. Control room personnel using the EOPs to deal with abnormal plant conditions must recognize when plant safety is sufficiently degraded that an emergency declaration may be warranted, and then enter a separate classification procedure containing EALs for a number of plant conditions and parameters. The operator then compares the existing plant conditions to the EALs and makes an emergency declaration accordingly. Using the Combustion Engineering Owners' Group Technical Guidelines document, a set of emergency class definitions and criteria were developed based on the status of the three main fission product barriers (fuel cladding, primary coolant system and containment). The EOPTGs were then annotated with suggested guidance to a procedure writer. The proposed method was tested by applying it to the reactor accident sequences that were shown in the reactor safety study to dominate accident risk. The object of the test was to determine if an EAL set linked to the EOP annotations would produce timely and accurate classification of the risk-dominant sequences. 6 refs., 13 figs., 31 tabs
International Nuclear Information System (INIS)
Yang Chihwei; Cheng Tsungchieh
2011-01-01
This study proposes the performance assessment in three-dimension virtual reality (3D-VR) main control room (MCR). The assessment is conducted for integrated system validation (ISV) purposes, and also for human reliability analyses (HRA). This paper describes the latest developments in 3D-VR applications, designated for the familiarization with MCR, specially taking into account the ISV and HRA. The experiences in 3D-VR application, the benefits and advantages of use of VR in training and maintenances of MCR operators in the target NPP are equally presented in this paper. Results gathered from the performance measurement lead to hazard mitigation and reduces the risk of human error in the operation and maintenance of nuclear equipments. The latest developments in simulation techniques, including 3D presentation enhances the above mentioned benefits, brings the MCR simulators closer to reality. In the near future, this type of 3D solutions should be applied more and more often in the design of MCR simulators. The presented 3D-VR are related to the MCR in NPPs, but the concept of composition and navigation through the system's elements can be easily applied for the purpose of any type of technical equipment and shall contribute in a similar manner to hazard prevention. (author)
Energy Technology Data Exchange (ETDEWEB)
Ronald Boring; Roger Lew; Thomas Ulrich; Jeffrey Joe
2014-03-01
As control rooms are modernized with new digital systems at nuclear power plants, it is necessary to evaluate the operator performance using these systems as part of a verification and validation process. There are no standard, predefined metrics available for assessing what is satisfactory operator interaction with new systems, especially during the early design stages of a new system. This report identifies the process and metrics for evaluating human system interfaces as part of control room modernization. The report includes background information on design and evaluation, a thorough discussion of human performance measures, and a practical example of how the process and metrics have been used as part of a turbine control system upgrade during the formative stages of design. The process and metrics are geared toward generalizability to other applications and serve as a template for utilities undertaking their own control room modernization activities.
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
Screening Criteria for a Room Cooling Failure of the AFW MDP Room
International Nuclear Information System (INIS)
Hwang, Mee Jeong; Yoon, Churl; Yang, Joon Eon; Park, Joo Hwan
2006-01-01
In this paper, we performed a heat up calculation for the Auxiliary Feedwater Motor Operated Pump (AFW MDP) room, PAB-077-11A with CFX-10 and RATT when the HVAC (Heating, Ventilation, and Air Condition) system is failed. We also reviewed the operability of the components under a loss of the HVAC. Room cooling failure does not need to be modeled if the components maintain their operability after a loss of a room cooling function during the mission time. ASME Standard describes that a recovery action can be credited if the related recovery action is included in the procedure or there are similar recovery experiences in the plant. However, there is no description about the recovery action of the HVAC in the EOP (Emergency Operation Procedure) of the UCN3, 4 under the situation of a loss of the HVAC. However, if we consider the HVAC failure in the PSA FT model, the problem is that the unavailability induced from a loss of the HVAC is unrealistically high. From a viewpoint of the PSA, it is not true that the related system always fails even if the HVAC system fails. Therefore, we reviewed the necessity of the HVAC model through two cases of a room heat up calculation under the situation of a loss of the HVAC system with conservative and realistic input data respectively
Assessment of Durable SiC JFET Technology for +600 C to -125 C Integrated Circuit Operation
Neudeck, P. G.; Krasowski, M. J.; Prokop, N. F.
2011-01-01
Electrical characteristics and circuit design considerations for prototype 6H-SiC JFET integrated circuits (ICs) operating over the broad temperature range of -125 C to +600 C are described. Strategic implementation of circuits with transistors and resistors in the same 6H-SiC n-channel layer enabled ICs with nearly temperature-independent functionality to be achieved. The frequency performance of the circuits declined at temperatures increasingly below or above room temperature, roughly corresponding to the change in 6H-SiC n-channel resistance arising from incomplete carrier ionization at low temperature and decreased electron mobility at high temperature. In addition to very broad temperature functionality, these simple digital and analog demonstration integrated circuits successfully operated with little change in functional characteristics over the course of thousands of hours at 500 C before experiencing interconnect-related failures. With appropriate further development, these initial results establish a new technology foundation for realizing durable 500 C ICs for combustion engine sensing and control, deep-well drilling, and other harsh-environment applications.
Operating room fire prevention: creating an electrosurgical unit fire safety device.
Culp, William C; Kimbrough, Bradly A; Luna, Sarah; Maguddayao, Aris J
2014-08-01
To reduce the incidence of surgical fires. Operating room fires represent a potentially life-threatening hazard and are triggered by the electrosurgical unit (ESU) pencil. Carbon dioxide is a fire suppressant and is a routinely used medical gas. We hypothesize that a shroud of protective carbon dioxide covering the tip of the ESU pencil displaces oxygen, thereby preventing fire ignition. Using 3-dimensional modeling techniques, a polymer sleeve was created and attached to an ESU pencil. This sleeve was connected to a carbon dioxide source and directed the gas through multiple precisely angled ports, generating a cone of fire-suppressive carbon dioxide surrounding the active pencil tip. This device was evaluated in a flammability test chamber containing 21%, 50%, and 100% oxygen with sustained ESU activation. The sleeve was tested with and without carbon dioxide (control) until a fuel was ignited or 30 seconds elapsed. Time to ignition was measured by high-speed videography. Fires were ignited with each control trial (15/15 trials). The control group median ± SD ignition time in 21% oxygen was 3.0 ± 2.4 seconds, in 50% oxygen was 0.1 ± 1.8 seconds, and in 100% oxygen was 0.03 ± 0.1 seconds. No fire was observed when the fire safety device was used in all concentrations of oxygen (0/15 trials; P fire ignition was 76% to 100%. A sleeve creating a cone of protective carbon dioxide gas enshrouding the sparks from an ESU pencil effectively prevents fire in a high-flammability model. Clinical application of this device may reduce the incidence of operating room fires.
Univalence Conditions Related to a General Integral Operator
Directory of Open Access Journals (Sweden)
Nicoleta Breaz
2012-01-01
Full Text Available We consider a general integral operator based on two types of analytic functions, namely, regular functions and, respectively, functions having a positive real part. Some univalence conditions for this integral operator are obtained.
Holloran-Schwartz, M Brigid; Gavard, Jeffrey A; Martin, Jared C; Blaskiewicz, Robert J; Yeung, Patrick P
2016-01-01
To compare the intraoperative direct costs of a single-use energy device with reusable energy devices during laparoscopic hysterectomy. A randomized controlled trial (Canadian Task Force Classification I). An academic hospital. Forty-six women who underwent laparoscopic hysterectomy from March 2013 to September 2013. Each patient served as her own control. One side of the uterine attachments was desiccated and transected with the single-use device (Ligasure 5-mm Blunt Tip LF1537 with the Force Triad generator). The other side was desiccated and transected with reusable bipolar forceps (RoBi 5 mm), and transected with monopolar scissors using the same Covidien Force Triad generator. The instrument approach used was randomized to the attending physician who was always on the patient's left side. Resident physicians always operated on the patient's right side and used the converse instruments of the attending physician. Start time was recorded at the utero-ovarian pedicle and end time was recorded after transection of the uterine artery on the same side. Costs included the single-use device; amortized costs of the generator, reusable instruments, and cords; cleaning and packaging of reusable instruments; and disposal of the single-use device. Operating room time was $94.14/min. We estimated that our single use-device cost $630.14 and had a total time savings of 6.7 min per case, or 3.35 min per side, which could justify the expense of the device. The single-use energy device had significant median time savings (-4.7 min per side, p energy device that both desiccates and cuts significantly reduced operating room time to justify its own cost, and it also reduced total intraoperative direct costs during laparoscopic hysterectomy in our institution. Operating room cost per minute varies between institutions and must be considered before generalizing our results. Copyright © 2016 AAGL. Published by Elsevier Inc. All rights reserved.
Human error mode identification for NPP main control room operations using soft controls
International Nuclear Information System (INIS)
Lee, Seung Jun; Kim, Jaewhan; Jang, Seung-Cheol
2011-01-01
The operation environment of main control rooms (MCRs) in modern nuclear power plants (NPPs) has considerably changed over the years. Advanced MCRs, which have been designed by adapting digital and computer technologies, have simpler interfaces using large display panels, computerized displays, soft controls, computerized procedure systems, and so on. The actions for the NPP operations are performed using soft controls in advanced MCRs. Soft controls have different features from conventional controls. Operators need to navigate the screens to find indicators and controls and manipulate controls using a mouse, touch screens, and so on. Due to these different interfaces, different human errors should be considered in the human reliability analysis (HRA) for advanced MCRs. In this work, human errors that could occur during operation executions using soft controls were analyzed. This work classified the human errors in soft controls into six types, and the reasons that affect the occurrence of the human errors were also analyzed. (author)
The keys to CERN conference rooms - Managing local collaboration facilities in large organisations
International Nuclear Information System (INIS)
Baron, T; Domaracky, M; Duran, G; Fernandes, J; Ferreira, P; Lopez, J B Gonzalez; Jouberjean, F; Lavrut, L; Tarocco, N
2014-01-01
For a long time HEP has been ahead of the curve in its usage of remote collaboration tools, like videoconference and webcast, while the local CERN collaboration facilities were somewhat behind the expected quality standards for various reasons. This time is now over with the creation by the CERN IT department in 2012 of an integrated conference room service which provides guidance and installation services for new rooms (either equipped for videoconference or not), as well as maintenance and local support. Managing now nearly half of the 246 meeting rooms available on the CERN sites, this service has been built to cope with the management of all CERN rooms with limited human resources. This has been made possible by the intensive use of professional software to manage and monitor all the room equipment, maintenance and activity. This paper focuses on presenting these packages, either off-the-shelf commercial products (asset and maintenance management tool, remote audio-visual equipment monitoring systems, local automation devices, new generation touch screen interfaces for interacting with the room) when available or locally developed integration and operational layers (generic audio-visual control and monitoring framework) and how they help overcoming the challenges presented by such a service. The aim is to minimise local human interventions while preserving the highest service quality and placing the end user back in the centre of this collaboration platform.
Job satisfaction among control room operators of electrical systems.
Macaia, Amanda A Silva; Marqueze, Elaine C; Rotenberg, Lúcia; Fischer, Frida Marina; Moreno, Claudia R C
2012-01-01
Shift workers from control centers of electrical systems are a group that has received little attention in Brazil. This study aimed to compare workers' job satisfaction at five control centers of a Brazilian company electrical system, and according to their job titles. The Organization Satisfaction Index (OSI) questionnaire to assess job satisfaction was used. ANOVA was used to compare OSI means, according to job title and control center. The results showed that there is no difference in job satisfaction among job titles, but a significant difference was found according to the control center. A single organizational culture cannot be applied to several branches. It is required to implement actions that would result in job satisfaction improvements among workers of all studied control rooms centers. The high level of education of operators working in all centers might have contributed to the similar values of perceived satisfaction among distinct job titles.
Guidelines for control room systems design. Working material. Report
International Nuclear Information System (INIS)
1993-01-01
This report contains comprehensive technical and methodological information and recommendations for the benefit of Member States for advice and assistance in ''NPP control room systems'' design backfitting existing nuclear power plants and design for future stations. The term ''Control Room Systems'' refers to the entire human/machine interface for the nuclear stations - including the main control room, back-ups control room and the emergency control rooms, local panels, technical support centres, operating staff, operating procedures, operating training programs, communications, etc. Refs, figs and tabs
Assessment of control room habitability and unfiltered air inleakage test of the OPR 1000 NPP
International Nuclear Information System (INIS)
Song, Dong Soo; Lee, Jong Beom; Ha, Sang Jun; Huh, Seong Cheol
2015-01-01
The assessment of control room habitability for Hanbit unit 5 was performed based on GL 2003-01 and Regulatory Guide 1.197. The integrated control room envelope (CRE) test was performed utilizing ASTM E741. Four tests were performed using each of the control room HVAC subtrains. The control room heating, ventilating, and air conditioning (HVAC) system lineup of pressurization mode test was based upon a lineup that encompassed the design basis radiological analyses. The other control room HVAC system lineup of isolation mode test was based on an operation mode that considers toxic gas. The measured inleakage for the isolation test mode remains within the toxicity limit. Radiation effect analysis showed that the measured inleakage satisfied the regulatory criteria, and the inleakage would not result in control room operator dose exceeding 50 mSv whole body and 500 mSv thyroid except train A pressurization test mode. The thyroid dose due to maximum measured unfiltered inleakage of 8976 lpm for train A is corresponding to 700 mSv. Modifications to the CRE boundary and control room HVAC system should be done to demonstrate that the measured unfiltered inleakage for train A pressurization test mode is bounded by the regulatory criteria assumed in the design basis radiological analyses. (author)
International Nuclear Information System (INIS)
Bintu Khoiriyyah; Budi Purnama; Tri Cahyo Laksono
2016-01-01
The monitoring of surface contamination should be conducted to determine the safety of work areas. Surface contamination at the TRIGA 2000 reactor room which is on PSTNT-BATAN Bandung remain to be implemented although reactor not operating. In this research monitoring of surface contamination when TRIGA 2000 in operation of the first time after several years not operating aims to determine the influence on the results of monitoring. The monitoring of surface contamination has been done using smear test method at some predetermined in TRIGA 2000 reactor room. The highest surface contamination activities is obtained 0.32 Bq/cm 2 and there are some points that are not detected. Based on keputusan kepala BAPETEN No.1/Ka BAPETEN/ V/99 the work showed that the TRIGA 2000 reactor in the category of low area contamination, that is <3.7 Bq/cm 2 to gross beta. (author)
Consequences and potential problems of operating room outbursts and temper tantrums by surgeons
Jacobs, George B.; Wille, Rosanne L.
2012-01-01
Background: Anecdotal tales of colorful temper tantrums and outbursts by surgeons directed at operating room nurses and at times other health care providers, like residents and fellows, are part of the history of surgery and include not only verbal abuse but also instrument throwing and real harassment. Our Editor-in-Chief, Dr. Nancy Epstein, has made the literature review of “Are there truly any risks and consequences when spine surgeons mistreat their predominantly female OR nursing staff/c...
International Nuclear Information System (INIS)
Vaidya, V.V.; Iwasa-Madge, K.M.; Howard, B.; Willson, R.B.
1984-01-01
Operators at a Heavy Water Plant in Ontario, Canada complained about lighting-related difficulties in the control room. The Human Factors Engineering Unit was requested to perform a lighting survey and make recommendations to improve the control centre lighting conditions. This paper describes the control room, the operator tasks, the procedures used for the lighting survey, the findings, and the changes recommended
Work Analysis of the nuclear power plant control room operators (II): The classes of situation
International Nuclear Information System (INIS)
Alengry, P.
1989-03-01
This report presents a work analysis of nuclear power plant control room operators focused on the classes of situation they can meet during their job. Each class of situation is first described in terms of the process variables states. We then describe the goals of the operators and the variables they process in each class of situation. We report some of the most representative difficulties encountered by the operators in each class of situation. Finally, we conclude on different topics: the nature of the mental representations, the temporal dimension, the monitoring activity, and the role of the context in the work of controlling a nuclear power plant [fr
White, Mark J; Thornton, John S; Hawkes, David J; Hill, Derek L G; Kitchen, Neil; Mancini, Laura; McEvoy, Andrew W; Razavi, Reza; Wilson, Sally; Yousry, Tarek; Keevil, Stephen F
2015-01-01
The design and operation of a facility in which a magnetic resonance imaging (MRI) scanner is incorporated into a room used for surgical or endovascular cardiac interventions presents several challenges. MR safety must be maintained in the presence of a much wider variety of equipment than is found in a diagnostic unit, and of staff unfamiliar with the MRI environment, without compromising the safety and practicality of the interventional procedure. Both the MR-guided cardiac interventional unit at Kings College London and the intraoperative imaging suite at the National Hospital for Neurology and Neurosurgery are single-room interventional facilities incorporating 1.5 T cylindrical-bore MRI scanners. The two units employ similar strategies to maintain MR safety, both in original design and day-to-day operational workflows, and between them over a decade of incident-free practice has been accumulated. This article outlines these strategies, highlighting both similarities and differences between the units, as well as some lessons learned and resulting procedural changes made in both units since installation. © 2014 Wiley Periodicals, Inc.
Operating room scheduling and surgeon assignment problem under surgery durations uncertainty.
Liu, Hongwei; Zhang, Tianyi; Luo, Shuai; Xu, Dan
2017-12-29
Scientific management methods are urgently needed to balance the demand and supply of heath care services in Chinese hospitals. Operating theatre is the bottleneck and costliest department. Therefore, the surgery scheduling is crucial to hospital management. To increase the utilization and reduce the cost of operating theatre, and to improve surgeons' satisfaction in the meantime, a practical surgery scheduling which could assign the operating room (OR) and surgeon for the surgery and sequence surgeries in each OR was provided for hospital managers. Surgery durations were predicted by fitting the distributions. A two-step mixed integer programming model considering surgery duration uncertainty was proposed, and sample average approximation (SAA) method was applied to solve the model. Durations of various surgeries were log-normal distributed respectively. Numerical experiments showed the model and method could get good solutions with different sample sizes. Real-life constraints and duration uncertainty were considered in the study, and the model was also very applicable in practice. Average overtime of each OR was reducing and tending to be stable with the number of surgeons increasing, which is a discipline for OR management.
On Univalence Criteria for a General Integral Operator
Directory of Open Access Journals (Sweden)
Vasile Marius Macarie
2012-01-01
Full Text Available We consider a new general integral operator, and we give sufficient conditions for the univalence of this integral operator in the open unit disk of the complex plane. Several consequences of the main results are also shown.
Containment long-term operational integrity
International Nuclear Information System (INIS)
Sammataro, R.F.
1990-01-01
Periodic integrated leak rate tests are required to assure that containments continue to meet allowable leakage limits. Although overall performance has been quite good to date, several major containment aging and degradation mechanisms have been identified. Two pilot plant life extension (PLEX) studies serve as models for extending the operational integrity of present containments for light-water cooled nuclear power plants in the United States. One study is for a Boiling-Water Reactor (BWR) and the second is for a Pressurized-Water Reactor (PWR). Research and testing programs for determining the ultimate pressure capacity and failure mechanisms for containments under severe loading conditions and studies for extending the life of current plants beyond the present 40-year licensed lifetime are under way. This paper presents an overview of containment designs in the United States. Also presented are a discussion of the American Society of Mechanical Engineers Boiler and Pressure Vessel Code (ASME Code) and regulatory authority requirements for the design, construction, inservice inspection, leakage testing and repair of steel and concrete containments. Findings for containments from the pilot PLEX studies and continuing containment integrity research and testing programs are discussed. The ASME Code and regulatory requirements together with recommendations from the PLEX studies and containment integrity research and testing provide a basis for continued containment long-term operational integrity. (orig./GL)
Real-time observations of stressful events in the operating room
Directory of Open Access Journals (Sweden)
AlNassar Sami
2012-01-01
Full Text Available Aim: To identify and quantify factors causing stress in the operating room (OR and evaluate the relationship between these factors and surgeons′ stress level. Methods: This is a prospective observational study from 32 elective surgical procedures conducted in the OR of King Khalid University Hospital, Riyadh, Saudi Arabia. Before each operation, each surgeon was asked of stressors. Two interns observed 16 surgeries each, separately. The interns watched and took notes during the entire surgical procedure. During each operation, the observer recorded anxiety-inducing activities and events that occurred in real time by means of a checklist of 8 potential stressors: technical, patient problems, teamwork problems, time and management issues, distractions and interruptions, equipment problems, personal problems, and teaching. After each operation, surgeons were asked to answer the validated State-Trait Anxiety Inventory questionnaire and self-report on their stress level from the 8 sources using a scale of 1-8 (1: stress free, 8: extremely stressful. The observer also recorded perceived stress levels experienced by the surgeons during the operation. Results: One hundred ten stressors were identified. Technical problems most frequently caused stress (16.4% and personal issues the least often (6.4%. Frequently encountered stressors (teaching and distractions/interruptions caused less stress to the surgeons. Technical factors, teamwork, and equipment problems occurred frequently and were also a major contributor to OR stress. All patients were discharged in good health and within 1 week of surgery. Conclusion: Certain stressful factors do occur among surgeons in the OR and can increase the potential for errors. Further research is required to determine the impact of stress on performance and the outcome of surgery.
Operations strategy for workload balancing of crews in an advanced main control room
International Nuclear Information System (INIS)
Kim, Seunghwan; Kim, Yochan; Jung, Wondea
2016-01-01
The advanced main control room (advanced-MCR) is the one that allows for reactor operations based on digital instrumentation and control (I and C) technology. Thus, the operators of an advanced-MCR operate the plant through digital I and C interfaces, and for this purpose, an additional digital manipulation task for the operating equipment should be performed that cannot be observed in a conventional-MCR. As a prior study proposing the cognitive, communicative, and operational activity measurement approach (COCOA), COCOA enables an evaluation of the operator's workload in an advanced-MCR,which includes newly generated tasks for Man-Machine Interface System based secondary operation under a digital environment, which does not exist in a conventional-MCR. As a result of observations on the workload level by utilizing COCOA for a reference plant with an advanced-MCR when conducting an emergency operating procedure, it was observed that the workload of the shift supervisor is about two times greater than that of other operators. This is because operators therein stuck to the old guidelines customized to a conventional-MCR and failed to accomplish load balancing in consideration of the operation environment that an advanced-MCR provides. In this context, it would be imperative to develop and apply an operations strategy for an advanced-MCR operation. This study proposes an operations strategy in an attempt to make a balanced workload of operators in an advanced-MCR. (author)
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...
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.
Palmer, Gary; Abernathy, James H; Swinton, Greg; Allison, David; Greenstein, Joel; Shappell, Scott; Juang, Kevin; Reeves, Scott T
2013-11-01
Human factors engineering has allowed a systematic approach to the evaluation of adverse events in a multitude of high-stake industries. This study sought to develop an initial methodology for identifying and classifying flow disruptions in the cardiac operating room (OR). Two industrial engineers with expertise in human factors workflow disruptions observed 10 cardiac operations from the moment the patient entered the OR to the time they left for the intensive care unit. Each disruption was fully documented on an architectural layout of the OR suite and time-stamped during each phase of surgery (preoperative [before incision], operative [incision to skin closure], and postoperative [skin closure until the patient leaves the OR]) to synchronize flow disruptions between the two observers. These disruptions were then categorized. The two observers made a total of 1,158 observations. After the elimination of duplicate observations, a total of 1,080 observations remained to be analyzed. These disruptions were distributed into six categories such as communication, usability, physical layout, environmental hazards, general interruptions, and equipment failures. They were further organized into 33 subcategories. The most common disruptions were related to OR layout and design (33%). By using the detailed architectural diagrams, the authors were able to clearly demonstrate for the first time the unique role that OR design and equipment layout has on the generation of physical layout flow disruptions. Most importantly, the authors have developed a robust taxonomy to describe the flow disruptions encountered in a cardiac OR, which can be used for future research and patient safety improvements.
Energy Technology Data Exchange (ETDEWEB)
HIGGINS,J.C.; OHARA,J.M.; ALMEIDA,P.
2002-09-19
THE JOSE CABRERA NUCLEAR POWER PLANT IS A ONE LOOP WESTINGHOUSE PRESSURIZED WATER REACTOR. IN THE CONTROL ROOM, THE DISPLAYS AND CONTROLS USED BY OPERATORS FOR THE EMERGENCY OPERATING PROCEDURES ARE DISTRIBUTED ON FRONT AND BACK PANELS. THIS CONFIGURATION CONTRIBUTED TO RISK IN THE PROBABILISTIC SAFETY ASSESSMENT WHERE IMPORTANT OPERATOR ACTIONS ARE REQUIRED. THIS STUDY WAS UNDERTAKEN TO EVALUATE THE IMPACT OF THE DESIGN ON CREW PERFORMANCE AND PLANT SAFETY AND TO DEVELOP DESIGN IMPROVEMENTS.FIVE POTENTIAL EFFECTS WERE IDENTIFIED. THEN NUREG-0711 [1], PROGRAMMATIC, HUMAN FACTORS, ANALYSES WERE CONDUCTED TO SYSTEMATICALLY EVALUATE THE CR-LA YOUT TO DETERMINE IF THERE WAS EVIDENCE OF THE POTENTIAL EFFECTS. THESE ANALYSES INCLUDED OPERATING EXPERIENCE REVIEW, PSA REVIEW, TASK ANALYSES, AND WALKTHROUGH SIMULATIONS. BASED ON THE RESULTS OF THESE ANALYSES, A VARIETY OF CONTROL ROOM MODIFICATIONS WERE IDENTIFIED. FROM THE ALTERNATIVES, A SELECTION WAS MADE THAT PROVIDED A REASONABLEBALANCE BE TWEEN PERFORMANCE, RISK AND ECONOMICS, AND MODIFICATIONS WERE MADE TO THE PLANT.
International Nuclear Information System (INIS)
Sendin, P.
2005-01-01
During the month of July 2005 the physical renovation works and technological updating of the basic infrastructures of the CSN Emergency Room (SALEM) were finished, allowing the Room to now have greater functionality and a broader technical capacity. Nevertheless, the technological improvement process of SALEM will reach its full potential within the next few years, once the installation currently underway of the new information integration and monitoring systems and the decision making support systems have been completed. This article describes the improvements introduced to the Room and the objectives pursued in this renovation project to convert the SALEM into a new generation room in accordance with its current technological context. (Author) 4 refs
Anesthetic drug wastage in the operation room: A cause for concern
Directory of Open Access Journals (Sweden)
Kapil Chaudhary
2012-01-01
Full Text Available Context: The cost of anesthetic technique has three main components, i.e., disposable supplies, equipments, and anesthetic drugs. Drug budgets are an easily identifiable area for short-term savings. Aim: To assess and estimate the amount of anesthetic drug wastage in the general surgical operation room. Also, to analyze the financial implications to the hospital due to drug wastage and suggest appropriate steps to prevent or minimize this wastage. Settings and Design: A prospective observational study conducted in the general surgical operation room of a tertiary care hospital. Materials and Methods: Drug wastage was considered as the amount of drug left unutilized in the syringes/vials after completion of a case and any ampoule or vial broken while loading. An estimation of the cost of wasted drug was made. Results: Maximal wastage was associated with adrenaline and lignocaine (100% and 93.63%, respectively. The drugs which accounted for maximum wastage due to not being used after loading into a syringe were adrenaline (95.24%, succinylcholine (92.63%, lignocaine (92.51%, mephentermine (83.80%, and atropine (81.82%. The cost of wasted drugs for the study duration was 46.57% (Rs. 16,044.01 of the total cost of drugs issued/loaded (Rs. 34,449.44. Of this, the cost of wastage of propofol was maximum being 56.27% (Rs. 9028.16 of the total wastage cost, followed by rocuronium 17.80% (Rs. 2856, vecuronium 5.23% (Rs. 840, and neostigmine 4.12% (Rs. 661.50. Conclusions: Drug wastage and the ensuing financial loss can be significant during the anesthetic management of surgical cases. Propofol, rocuronium, vecuronium, and neostigmine are the drugs which contribute maximally to the total wastage cost. Judicious use of these and other drugs and appropriate prudent measures as suggested can effectively decrease this cost.
Variables influencing medical student learning in the operating room.
Schwind, Cathy J; Boehler, Margaret L; Rogers, David A; Williams, Reed G; Dunnington, Gary; Folse, Roland; Markwell, Stephen J
2004-02-01
The operating room (OR) is an important venue where surgeons do much of medical student teaching and yet there has been little work evaluating variables that influence learning in this unique environment. We designed this study to identify variables that affected medical student learning in the OR. We developed a questionnaire based on surgery faculty observations of learning in the OR. The medical students completed the questionnaire on 114 learning episodes in the OR. Pearson correlation coefficient was used to establish the strength of association between various variables and the student's overall perception of learning. The students evaluated 27 variables that might impact their learning in the OR. Strong correlations were identified between the attending physician's attitude, interactions and teaching ability in the OR and the environment being conducive to learning. Surgical faculty behavior is a powerful determinant of student perceptions of what provides for a favorable learning environment in the OR.
Control room and ergonomic design
International Nuclear Information System (INIS)
Hinz, W.
1984-01-01
The important basis for the configuration of the control room of a nuclear power station is the concept for controlling a fault and that for controlling normal operation. The tasks resulting from this for the control room personnel are decided by the control room concept. In this configuration process (from the division of process control tasks between the system components operators and control technology to the configuration of individual means of operation) the characteristics and capabilities of the personnel, which are subject to special requirements as regards their qualifications, are observed. New concepts which are only now technically feasible are therefore being developed for information processing and display, in order to give the personnel a better oversight of the state and trends of the plant. (orig./DG) [de
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...
Blom, E M; Verdaasdonk, E G G; Stassen, L P S; Stassen, H G; Wieringa, P A; Dankelman, J
2007-09-01
Verbal communication in the operating room during surgical procedures affects team performance, reflects individual skills, and is related to the complexity of the operation process. During the procedural training of surgeons (residents), feedback and guidance is given through verbal communication. A classification method based on structural analysis of the contents was developed to analyze verbal communication. This study aimed to evaluate whether a classification method for the contents of verbal communication in the operating room could provide insight into the teaching processes. Eight laparoscopic cholecystectomies were videotaped. Two entire cholecystectomies and the dissection phase of six additional procedures were analyzed by categorization of the communication in terms of type (4 categories: commanding, explaining, questioning, and miscellaneous) and content (9 categories: operation method, location, direction, instrument handling, visualization, anatomy and pathology, general, private, undefinable). The operation was divided into six phases: start, dissection, clipping, separating, control, closing. Classification of the communication during two entire procedures showed that each phase of the operation was dominated by different kinds of communication. A high percentage of explaining anatomy and pathology was found throughout the whole procedure except for the control and closing phases. In the dissection phases, 60% of verbal communication concerned explaining. These explaining communication events were divided as follows: 27% operation method, 19% anatomy and pathology, 25% location (positioning of the instrument-tissue interaction), 15% direction (direction of tissue manipulation), 11% instrument handling, and 3% other nonclassified instructions. The proposed classification method is feasible for analyzing verbal communication during surgical procedures. Communication content objectively reflects the interaction between surgeon and resident. This
Sistani, Masiar; Staudinger, Philipp; Greil, Johannes; Holzbauer, Martin; Detz, Hermann; Bertagnolli, Emmerich; Lugstein, Alois
2017-08-09
Conductance quantization at room temperature is a key requirement for the utilizing of ballistic transport for, e.g., high-performance, low-power dissipating transistors operating at the upper limit of "on"-state conductance or multivalued logic gates. So far, studying conductance quantization has been restricted to high-mobility materials at ultralow temperatures and requires sophisticated nanostructure formation techniques and precise lithography for contact formation. Utilizing a thermally induced exchange reaction between single-crystalline Ge nanowires and Al pads, we achieved monolithic Al-Ge-Al NW heterostructures with ultrasmall Ge segments contacted by self-aligned quasi one-dimensional crystalline Al leads. By integration in electrostatically modulated back-gated field-effect transistors, we demonstrate the first experimental observation of room temperature quantum ballistic transport in Ge, favorable for integration in complementary metal-oxide-semiconductor platform technology.
Energy Technology Data Exchange (ETDEWEB)
1981-12-01
This document defines an integrated plan for the operation of the Lawrence Livermore National Laboratory (LLNL) Mirror Fusion Test Facility (MFTF-B). The plan fulfills and further delineates LLNL policies and provides for accomplishing the functions required by the program. This plan specifies the management, operations, maintenance, and engineering support responsibilities. It covers phasing into sustained operations as well as the sustained operations themselves. Administrative and Plant Engineering support, which are now being performed satisfactorily, are not part of this plan unless there are unique needs.
International Nuclear Information System (INIS)
1981-12-01
This document defines an integrated plan for the operation of the Lawrence Livermore National Laboratory (LLNL) Mirror Fusion Test Facility (MFTF-B). The plan fulfills and further delineates LLNL policies and provides for accomplishing the functions required by the program. This plan specifies the management, operations, maintenance, and engineering support responsibilities. It covers phasing into sustained operations as well as the sustained operations themselves. Administrative and Plant Engineering support, which are now being performed satisfactorily, are not part of this plan unless there are unique needs
Integrated Ground Operations Demonstration Units Testing Plans and Status
Johnson, Robert G.; Notardonato, William U.; Currin, Kelly M.; Orozco-Smith, Evelyn M.
2012-01-01
Cryogenic propellant loading operations with their associated flight and ground systems are some of the most complex, critical activities in launch operations. Consequently, these systems and operations account for a sizeable portion of the life cycle costs of any launch program. NASA operations for handling cryogens in ground support equipment have not changed substantially in 50 years, despite advances in cryogenics, system health management and command and control technologies. This project was developed to mature, integrate and demonstrate advancement in the current state of the art in these areas using two distinct integrated ground operations demonstration units (GODU): GODU Integrated Refrigeration and Storage (IRAS) and GODU Autonomous Control
International Nuclear Information System (INIS)
Seminara, J.L.; Parsons, S.O.
1979-11-01
An earlier review of the control rooms of operating nuclear power plants identified many design problems having potential for degrading operator performance. As a result, the formal application of human factors principles was found to be needed. This report demonstrates the use of human factors in the design of power plant control rooms. The approaches shown in the report can be applied to operating power plants, as well as to those in the design stage. This study documents human factors techniques required to provide a sustained concern for the man-machine interface from control room concept definition to system implementation
Design of a wireless, standard-based patient monitoring system for operating rooms
Energy Technology Data Exchange (ETDEWEB)
Villalobos Cervantes, A.; Alamo Ramiro, J.M. del
2016-07-01
In the last decades, IT has brought several successful innovations into the healthcare field, such as wearable devices or hospital information systems. However, IT adoption in surgical environments has followed a slower pace. In this kind of interventions, the large number of wired monitoring equipment limits the efficiency and movements of surgical staff in the room. Therefore, wireless intercommunication between these devices has become a priority. This paper proposes a solution to these needs, and describes the design of a system that uses wireless technologies to collect data from different monitors and display physicians an integrated vision of the patient’s status. Finally, a functional prototype was developed to validate the proposed design. (Author)
Tactical and operational decisions for operating room planning: efficiency and welfare implications.
Testi, Angela; Tànfani, Elena
2009-12-01
In this paper, we evaluate the impact on welfare implications of a 0-1 linear programming model to solve the Operating Room (OR) planning problem, taking a patient perspective. In particular, given a General Surgery Department made up of different surgical sub-specialties sharing a given number of OR block times, the model determines, during a given planning period, the allocation of those blocks to surgical sub-specialties, i.e. the so called Master Surgical Schedule Problem (MSSP), together with the subsets of elective patients to be operated on in each block time, i.e. the so called Surgical Case Assignment Problem (SCAP). The innovation of the model is two-fold. The first is that OR allocation is "optimal" if the available OR blocks are scheduled simultaneously to the proper subspecialty, at the proper time to the proper patient. The second is defining what "proper" means and include that in the objective function. In our approach what is important is not number of patients who can be treated in a given period but how much welfare loss, due to clinical deterioration or other negative consequences related to excessive waiting, can be prevented. In other words we assume a societal perspective in that we focus on "outcome" (health improving or preventing from worsening) rather than on "output" (delivered procedures). The model can be used both to develop weekly OR planning with given resources (operational decision), and to perform "what if" scenario analysis regarding how to increase the amount of OR time available for the entire department (tactical decision). The model performance is verified by applying it to a real scenario, the elective admissions of the General Surgery Department of the San Martino University Hospital in Genova (Italy). Despite the complexity of this NP-hard combinatorial optimization problem, computational results indicate that the model can solve all test problems within 600 s and an average optimality tolerance of less than 0.01%.
Elements of an advanced integrated operator control station
International Nuclear Information System (INIS)
Clarke, M.M.; Kreifeldt, J.G.
1984-01-01
One of the critical determinants of peformance for any remotely operated maintenance system is the compatibility achieved between elements of the man/machine interface (e.g., master manipulator controller, controls, displays, etc.) and the human operator. In the Remote Control Engineering task of the Consolidated Fuel Reprocessing Program, considerable attention has been devoted to optimizing the man/machine interface of the operator control station. This system must be considered an integral element of the overall maintenance work system which includes transporters, manipulators, remote viewing, and other parts. The control station must reflect the integration of the operator team, control/display panels, manipulator master controllers, and remote viewing monitors. Human factors principles and experimentation have been used in the development of an advanced integrated operator control station designed for the advance servomanipulator. Key features of this next-generation design are summarized in this presentation. 7 references, 4 figures
Elements of an advanced integrated operator control station
International Nuclear Information System (INIS)
Clarke, M.M.; Kreifeldt, J.G.
1984-01-01
One of the critical determinants of performance for any remotely operated maintenance system is the compatibility achieved between elements of the man/machine interface (e.g., master manipulator controller, controls, displays) and the human operator. In the remote control engineering task of the Consolidated Fuel Reprocessing Program, considerable attention has been devoted to optimizing the man/machine interface of the operator control station. This system must be considered an integral element of the overall maintenance work system which includes transporters, manipulators, remote viewing, and other parts. The control station must reflect the integration of the operator team, control/display panels, manipulator master controllers, and remote viewing monitors. Human factors principles and experimentation have been used in the development of an advanced integrated operator control station designed for the advance servomanipulator. Key features of this next-generation design are summarized in this presentation. 7 references, 4 figures
Discussion on control room habitability assessment
International Nuclear Information System (INIS)
Li Bing; Chen Yingying; Xiao Jun; Yang Duanjie; Cui Hao
2014-01-01
The discussion on control room envelope integrity, source term analysis in habitability assessments and other impact factors for dose consequence is provided combined with regulatory requirements and the current status of domestic NPPs. Considering that the infiltration is an important factor for control room habitability assessment, CRE integrity test should be performed to demonstrate the CRE's infiltration characteristics. The consequence assessment should be performed based on different DBAs and different pathways, such as pathways internal to the plant. (authors)
Teamwork and error in the operating room: analysis of skills and roles.
Catchpole, K; Mishra, A; Handa, A; McCulloch, P
2008-04-01
To analyze the effects of surgical, anesthetic, and nursing teamwork skills on technical outcomes. The value of team skills in reducing adverse events in the operating room is presently receiving considerable attention. Current work has not yet identified in detail how the teamwork and communication skills of surgeons, anesthetists, and nurses affect the course of an operation. Twenty-six laparoscopic cholecystectomies and 22 carotid endarterectomies were studied using direct observation methods. For each operation, teams' skills were scored for the whole team, and for nursing, surgical, and anesthetic subteams on 4 dimensions (leadership and management [LM]; teamwork and cooperation; problem solving and decision making; and situation awareness). Operating time, errors in surgical technique, and other procedural problems and errors were measured as outcome parameters for each operation. The relationships between teamwork scores and these outcome parameters within each operation were examined using analysis of variance and linear regression. Surgical (F(2,42) = 3.32, P = 0.046) and anesthetic (F(2,42) = 3.26, P = 0.048) LM had significant but opposite relationships with operating time in each operation: operating time increased significantly with higher anesthetic but decreased with higher surgical LM scores. Errors in surgical technique had a strong association with surgical situation awareness (F(2,42) = 7.93, P skills of the nurses (F(5,1) = 3.96, P = 0.027). Detailed analysis of team interactions and dimensions is feasible and valuable, yielding important insights into relationships between nontechnical skills, technical performance, and operative duration. These results support the concept that interventions designed to improve teamwork and communication may have beneficial effects on technical performance and patient outcome.
洁净手术室的医院感染管理环节控制%Control of nosocomial infections in laminar airflow operating rooms
Institute of Scientific and Technical Information of China (English)
江才秀; 李晓花
2013-01-01
OBJECTIVE To study the impact factors of surgical site infections (SSIs) in laminar airflow (LAF) operating rooms (OR) and ensure the air quality of the operating rooms so as to decrease the incidence of SSIs.METHODS The key point of the hospital infection control combined humanization management and mandatory management was implemented strictly in the work process of laminar airflow operating rooms.RESULTS The difficulties in the control of nosocomial infections in the operating rooms have been effectively overcome,the air quality of the clean operating rooms has been ensured,and the incidence of SSIs has been reduced.CONCLUSION It is the key point to overcome the difficulties in the control of nosocomial infections in the cleaning operating rooms through enhancement of the study and training,implementation of the system,and strict management.%目的 加强洁净手术室医院感染管理环节控制,确保洁净手术室空气质量,以降低手术切口感染率.方法 针对难以控制的环节,以学习、训练为基础,实行人性化管理与强制性管理相结合.结果 有效克服了洁净手术室医院感染管理环节控制难点,确保了洁净手术室的空气质量,降低了手术切口感染率.结论 加强学习、强化训练、制度落实、严格管理是克服洁净手术室医院感染管理环节控制难点的关键.
Directory of Open Access Journals (Sweden)
Mojtaba Raji
2016-07-01
Full Text Available Background and Objective: Nursing students are exposed to clinical environmental stresses in addition to educational environmental stresses. The aim of this study was to assessment of clinical stressful factors among Academic Students of Nursing and Operating Room of Dezful University of Medical Sciences in 2015.Materials and Methods: This study was a description-analytical study with 234 students of nursing and operation room up to two semesters for enrolled. Data was using a self-made researcher Questionnaire consisted of demographic information and clinical stressful factors. Data analysis was performed by descriptive and inferential statistics using SPSS-PC (v.20.Results: The findings showed that the main stressors in students of nursing and operation room were unpleasant emotions and least stressful areas were interpersonal communication in a clinical environment. The results showed that the average score of the field of education and humiliating experiences using Spearman correlation test (P=0/045 (r=0/16.Conclusion: Study showed, the mean stress is the moderate level. Stressful areas obtained in the four areas of personal communication, clinical practice stressful, unpleasant feelings and humiliating experience that fortunately, in many cases reform and change.
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
Surgeons' Leadership Styles and Team Behavior in the Operating Room.
Hu, Yue-Yung; Parker, Sarah Henrickson; Lipsitz, Stuart R; Arriaga, Alexander F; Peyre, Sarah E; Corso, Katherine A; Roth, Emilie M; Yule, Steven J; Greenberg, Caprice C
2016-01-01
The importance of leadership is recognized in surgery, but the specific impact of leadership style on team behavior is not well understood. In other industries, leadership is a well-characterized construct. One dominant theory proposes that transactional (task-focused) leaders achieve minimum standards and transformational (team-oriented) leaders inspire performance beyond expectations. We videorecorded 5 surgeons performing complex operations. Each surgeon was scored on the Multifactor Leadership Questionnaire, a validated method for scoring transformational and transactional leadership style, by an organizational psychologist and a surgeon researcher. Independent coders assessed surgeons' leadership behaviors according to the Surgical Leadership Inventory and team behaviors (information sharing, cooperative, and voice behaviors). All coders were blinded. Leadership style (Multifactor Leadership Questionnaire) was correlated with surgeon behavior (Surgical Leadership Inventory) and team behavior using Poisson regression, controlling for time and the total number of behaviors, respectively. All surgeons scored similarly on transactional leadership (range 2.38 to 2.69), but varied more widely on transformational leadership (range 1.98 to 3.60). Each 1-point increase in transformational score corresponded to 3 times more information-sharing behaviors (p leadership and its impact on team performance in the operating room. As in other fields, our data suggest that transformational leadership is associated with improved team behavior. Surgeon leadership development, therefore, has the potential to improve the efficiency and safety of operative care. Copyright © 2016 American College of Surgeons. Published by Elsevier Inc. All rights reserved.
4.5 μm wavelength vertical external cavity surface emitting laser operating above room temperature
Rahim, M.; Khiar, A.; Felder, F.; Fill, M.; Zogg, H.
2009-05-01
A midinfrared vertical external cavity surface emitting laser with 4.5 μm emission wavelength and operating above room temperature has been realized. The active part consists of a single 850 nm thick epitaxial PbSe gain layer. It is followed by a 2 1/2 pair Pb1-yEuyTe/BaF2 Bragg mirror. No microstructural processing is needed. Excitation is done optically with a 1.5 μm wavelength laser. The device operates up to 45 °C with 100 ns pulses and delivers 6 mW output power at 27 °C heat-sink temperature.
Residents' reluctance to challenge negative hierarchy in the operating room: a qualitative study.
Bould, M Dylan; Sutherland, Stephanie; Sydor, Devin T; Naik, Viren; Friedman, Zeev
2015-06-01
Our aim was to clarify how hierarchy influences residents' reluctance to challenge authority with respect to clearly erroneous medical decision-making. After research ethics approval, we recruited 44 anesthesia residents for a high-fidelity simulation scenario at two Ontario universities. During the scenario, an actor, whom the residents were told was an actual new staff anesthesiologist at their university, asked the trainees to give blood to a Jehovah's Witness in contradiction to the patient's explicitly stated wishes. Following the case, the trainees were debriefed and were interviewed for 30-40 min. The interviews were audio recorded and transcribed verbatim, and the text was coded using a qualitative approach informed by grounded theory. Qualitative analysis of the participants' interviews yielded rich descriptive accounts of hierarchical influences often characterized by fear and intimidation. Residents spoke about their coping strategies, which included adaptability, avoiding conflict, using inquiry as a method for patient advocacy, and relying on a diffusion of responsibility within the larger operating room team. Study results showed that hierarchy played a dominant role in the functioning of the operating room. Participants spoke of both the positive and negative effects of such a hierarchical learning environment. The majority of participants described a negative perception of hierarchy as the norm, and they employed many coping strategies. This study provides insight into how a negative hierarchical culture can adversely impact patient safety, resident learning, and team functioning. We propose a theoretical model to describe challenging authority in this context.
Erestam, Sofia; Haglind, Eva; Bock, David; Andersson, Annette Erichsen; Angenete, Eva
2017-01-01
Inter-professional teamwork in the operating room is important for patient safety. The World Health Organization (WHO) checklist was introduced to improve intraoperative teamwork. The aim of this study was to evaluate the safety climate in a Swedish operating room setting before and after an intervention, using a revised version of the WHO checklist to improve teamwork. This study is a single center prospective interventional study. Participants were personnel working in operating room teams including surgeons, anesthesiologists, scrub nurses, nurse anaesthetists and nurse assistants. The study started with pre-interventional observations of the WHO checklist use followed by education on safety climate, the WHO checklist, and non-technical skills in the operating room. Thereafter a revised version of the WHO checklist was introduced. Post-interventional observations regarding the performance of the WHO checklist were carried out. The Safety Attitude Questionnaire was used to assess safety climate at baseline and post-intervention. At baseline we discovered a need for improved teamwork and communication. The participants considered teamwork to be important for patient safety, but had different perceptions of good teamwork between professions. The intervention, a revised version of the WHO checklist, did not affect teamwork climate. Adherence to the revision of the checklist was insufficient, dominated by a lack of structure. There was no significant change in teamwork climate by use of the revised WHO checklist, which may be due to insufficient implementation, as a lack of adherence to the WHO checklist was detected. We found deficiencies in teamwork and communication. Further studies exploring how to improve safety climate are needed. NCT02329691.
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.
International Nuclear Information System (INIS)
Santiago Lucas Soriano, A.
2002-01-01
The experience, explained below, is based on the latest works carried out in TECNATOM, to improve the behaviour of the control room personnel, by an effective involvement of the operators in their own improvement, in which they create their own expectations and the instructors are only guides and advisors in a working place very close to the reality, that is, the simulator. The experience mainly deals with aspects such as: Teamwork, effective communications, use of procedures, self-checking, decision making, diagnose, motivation and other aspects that are present in the control room. (author)
Direct to Operating Room Trauma Resuscitation Decreases Mortality Among Severely Injured Children.
Wieck, Minna M; Cunningham, Aaron J; Behrens, Brandon; Ohm, Erika T; Maxwell, Bryan G; Hamilton, Nicholas A; Adams, M Christopher; Cole, Frederick J; Jafri, Mubeen A
2018-03-16
Expediting evaluation and intervention for severely injured patients has remained a mainstay of advanced trauma care. One technique, direct to operating room (DOR) resuscitation, for selective adult patients has demonstrated decreased mortality. We sought to investigate the application of this protocol in children. All DOR pediatric patients from 2009-2016 at a pediatric Level I Trauma Center were identified. DOR criteria included penetrating injury, chest injuries, amputations, significant blood loss, cardiopulmonary resuscitation, and surgeon discretion. Demographics, injury patterns, interventions, and outcomes were analyzed. Observed mortality was compared to expected mortality, calculated using Trauma Injury Severity Score (TRISS) methodology, with two-tailed t-tests and a p-value 15, 33% had GCS≤8, and 9% were hypotensive. The most commonly injured body regions were external (66%), head (34%), chest (30%), and abdomen (27%). Sixty-seven patients (82%) required emergent procedural intervention, most commonly wound exploration/repair (35%), central venous access (22%), tube thoracostomy (19%) and laparotomy (18%). Predictors of intervention were ISS>15 (odds ratio=14, p=0.013) and GCS<9 (odds ratio=8.5, p=0.044). The survival rate to discharge for DOR patients was 84% compared with an expected survival of 79% (TRISS) (p=0.4). The greatest improvement relative to expected mortality was seen in the subgroup with penetrating trauma (84.5% vs. 74.4%, p=0.002). A selective policy of resuscitating the most severely injured children in the operating room can decrease mortality. Patients suffering penetrating trauma with the highest ISS and diminished GCS have the greatest benefit. Trauma centers with appropriate resources should evaluate implementing similar policies. Level II. Diagnostic tests or criteria.
Directory of Open Access Journals (Sweden)
Sönke Pelzer
2014-04-01
Full Text Available For architects, real-time 3D visual rendering of CAD-models is a valuable tool. The architect usually perceives the visual appearance of the building interior in a natural and realistic way during the design process. Unfortunately this only emphasizes the role of the visual appearance of a building, while the acoustics often remain disregarded. Controlling the room acoustics is not integrated into most architects’ workflows—due to a lack of tools. The present contribution describes a newly developed plug-in for adding an adequate 3D-acoustics feedback to the architect. To present intuitively the acoustical effect of the current design project, the plug-in uses real-time audio rendering and 3D-reproduction. The room acoustics of the design can be varied by modifying structural shapes as well as by changing the material selection. In addition to the audio feedback, also a visualization of important room acoustics qualities is provided by displaying color-coded maps inside the CAD software.
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.
Screening Criteria for Loss of Room Cooling Failure
Energy Technology Data Exchange (ETDEWEB)
Hwang, Mee Jeong; Yang, Joon Eon; Yoon, Churl
2007-01-15
In this report, we estimated the temperature of the pump rooms and reviewed the operability of the components under the loss of the HVAC (Heating, Ventilation, and Air Condition) system. The issues relevant to the HVAC system in the PSA (Probabilistic Safety Assessment) FT (Fault Tree) model are as follows: (1) Does the loss of the HVAC system bring about a function failure of other components? (2) Can the operator take action to reduce the temperature of the room in case of a HVAC function failure? At present, we do not know whether a component will lose its function or not under the loss of the HVAC. ASME Standard describes that a recovery action can be credited if the related recovery action is included in the procedure or there are similar recovery experiences in the plant. However, there is no description about the recovery action of the HVAC in the EOP (Emergency Operation Procedure) of the UCN3, 4 under the situation of a loss of the HVAC. Even though we consider this assumption positively, it would be limited to the rooms such as the Switchgear Room, Inverter Room, and Main Control Room etc. where a real recovery action can be performed easily. However, if we consider the HVAC failure in the PSA FT model according to the above background, the problem is that the unavailability induced from the loss of a HVAC is highly unrealistically. From a viewpoint of the PSA, it is not true that the related system always fails even though the HVAC system fails. Therefore, we reviewed the necessity of the HVAC model through the identification of the operable temperature of the components' within the pump room and the change of the temperature of the pump room under the situation of a loss of the HVAC system. In this paper, we performed a heat up calculation for the Auxiliary Feedwater Motor Operated Pump (AFW MDP) room, PAB-077-11A with CFX 10 and RATT when the HVAC system is failed. We also reviewed the operability of the components under a loss of the HVAC. Room
Screening Criteria for Loss of Room Cooling Failure
International Nuclear Information System (INIS)
Hwang, Mee Jeong; Yang, Joon Eon; Yoon, Churl
2007-01-01
In this report, we estimated the temperature of the pump rooms and reviewed the operability of the components under the loss of the HVAC (Heating, Ventilation, and Air Condition) system. The issues relevant to the HVAC system in the PSA (Probabilistic Safety Assessment) FT (Fault Tree) model are as follows: (1) Does the loss of the HVAC system bring about a function failure of other components? (2) Can the operator take action to reduce the temperature of the room in case of a HVAC function failure? At present, we do not know whether a component will lose its function or not under the loss of the HVAC. ASME Standard describes that a recovery action can be credited if the related recovery action is included in the procedure or there are similar recovery experiences in the plant. However, there is no description about the recovery action of the HVAC in the EOP (Emergency Operation Procedure) of the UCN3, 4 under the situation of a loss of the HVAC. Even though we consider this assumption positively, it would be limited to the rooms such as the Switchgear Room, Inverter Room, and Main Control Room etc. where a real recovery action can be performed easily. However, if we consider the HVAC failure in the PSA FT model according to the above background, the problem is that the unavailability induced from the loss of a HVAC is highly unrealistically. From a viewpoint of the PSA, it is not true that the related system always fails even though the HVAC system fails. Therefore, we reviewed the necessity of the HVAC model through the identification of the operable temperature of the components' within the pump room and the change of the temperature of the pump room under the situation of a loss of the HVAC system. In this paper, we performed a heat up calculation for the Auxiliary Feedwater Motor Operated Pump (AFW MDP) room, PAB-077-11A with CFX 10 and RATT when the HVAC system is failed. We also reviewed the operability of the components under a loss of the HVAC. Room
Evaluation of potential distractors in the urology operating room.
Lee, Jason Y; Lantz, Andrea G; McDougall, Elspeth M; Landman, Jaime; Gettman, Matthew; Sweet, Robert; Sundaram, Chandru P; Zorn, Kevin C
2013-09-01
Surgical outcomes depend on patient and disease-related factors, as well as the technical skill of the surgeon. Various distractions in the operating room (OR) environment have been shown to negatively impact a surgeon's performance. A survey was conducted with the objective to evaluate and characterize distractions during urologic surgery. An Internet-based survey was distributed to 2057 international urologists via email between April and October 2011; questions focused on a variety of disruptive factors postulated to have a negative impact on surgical performance. Of the 523 (25%) respondents, 58% practiced in North America, 42% were from an academic institution, and 68% had completed a clinical fellowship. In an average year, 83% reported having operated at least once while sleep deprived, 84% when significantly ill, 55% with a musculoskeletal injury, and 65% under significant social stress. Up to 38% reported that on at least one occasion, such "internal distractions" had significantly affected surgical performance and 14% perceived that at least one surgical complication was caused mainly by an internal distraction. Less than 50% had ever cancelled surgery because of an internal distraction. Music was routinely played in the OR by 57% of respondents, >67% reported answering pages and discussing consults while operating, and 25% reported "commonly" working with scrub nurses/techs that were unfamiliar with the procedure and/or instruments. Only 44% had consistent individual(s) assisting, and 27% reported that the scrub nurse/tech would "commonly" scrub out during a critical portion of the procedure. Overall, 14.5% reported that at least one complication had occurred mainly because of such "external" or "interactive" distractions. Urologists face various distractions in the OR that can negatively impact surgical performance, potentially compromising patient outcomes and safety. Further studies are needed to elucidate the true impact of such distractions and to
[Unexpected atrial fibrillation when monitoring in operating room. Case of the trimester].
2014-05-01
A real case reported to the SENSAR database of incidents is presented. In a patient scheduled for nose fracture repair surgery an unexpected atrial fibrillation was found when monitored in the operating room. The operation was not delayed. After induction of general anaesthesia heart rate suddenly increased and hemodinamic situation was impaired. Cardioversion was required. Two electric countershocks were given but sinus rhythm was not restored. Heart rate was controlled with amiodarone infusion. Optimal defibrillation characteristics are described in these cases. Increased risk of thromboembolism (1-2%) following cardioversion is present even if atrial thrombi are ruled out. The mainstay therapies of are rhythm and rate control and prevention of thromboembolic complications. We describe recommendations on the management of these critical situations with emphasis in learning through the creation of protocols and training practice in simulation. Copyright © 2013 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Published by Elsevier España. All rights reserved.
Working conditions of a radiodiagnostic room
International Nuclear Information System (INIS)
Chikirdin, Eh.G.
1983-01-01
The concept of ''operating load'' of an X-ray diagnostic room is explained. The concept includes the calculation of the Week's maximum exposure calculation and monitoring of stationary radiation shielding, measurements of exposure dose rate at working places. In this case the substitution of the actual repeated short-time regime of emitter operation for the calculated continuous regime is performed. The data on the ''operating load'' of X-ray diagnostic room are presented taking into account the method of X-ray investigation
Safety status system for operating room devices.
Guédon, Annetje C P; Wauben, Linda S G L; Overvelde, Marlies; Blok, Joleen H; van der Elst, Maarten; Dankelman, Jenny; van den Dobbelsteen, John J
2014-01-01
Since the increase of the number of technological aids in the operating room (OR), equipment-related incidents have come to be a common kind of adverse events. This underlines the importance of adequate equipment management to improve the safety in the OR. A system was developed to monitor the safety status (periodic maintenance and registered malfunctions) of OR devices and to facilitate the notification of malfunctions. The objective was to assess whether the system is suitable for use in an busy OR setting and to analyse its effect on the notification of malfunctions. The system checks automatically the safety status of OR devices through constant communication with the technical facility management system, informs the OR staff real-time and facilitates notification of malfunctions. The system was tested for a pilot period of six months in four ORs of a Dutch teaching hospital and 17 users were interviewed on the usability of the system. The users provided positive feedback on the usability. For 86.6% of total time, the localisation of OR devices was accurate. 62 malfunctions of OR devices were reported, an increase of 12 notifications compared to the previous year. The safety status system was suitable for an OR complex, both from a usability and technical point of view, and an increase of reported malfunctions was observed. The system eases monitoring the safety status of equipment and is a promising tool to improve the safety related to OR devices.
To compare methods used in our operating room for alleviating tourniquet pain
International Nuclear Information System (INIS)
Ali, M. A.; Siddiqui, S.
2013-01-01
Objective: To compare the efficacy of different methods used to alleviate tourniquet pain in operating rooms as well as assess their effect on post-operative pain. Methods: The study was conducted at the Aga Khan University Hospital, Karachi from June to August 2010. All patients who came for elective orthopaedic surgery in whom a tourniquet application was planned were included in the study. Information was collected through a pre-designed data form. Qualitative data was expressed as mean standard deviation, while qualitative data was presented as frequency and percentage. Results: In the 106 patients studied, opioids were administered in 90 (85%) cases, paracetamol in 73 (69%) and non-steroidal anti-inflammatory drugs in 11 (10.4%) cases. Efficacy was determined by means of the effect on the blood pressure and heart rate of the patient before and after the drug administration. Intravenous paracetamol was found to be the most effective in reducing both blood pressure and heart rate (p<0.001). The effect on post-operative pain was insignificant. Conclusions: Intravenous paracetamol is a cost-effective and safe analgesic, especially when combined with a multi-modal regimen, and has potential effect on the alleviation of tourniquet pain. (author)
Directory of Open Access Journals (Sweden)
Kelkar Uday
2003-01-01
Full Text Available Purpose: Postoperative infections can be caused by a contaminated environment, unsterile equipment, contaminated surfaces, and infected personnel as well as contaminated disinfectants. In order to establish guidelines for microbiological monitoring, a detailed microbiological surveillance was carried out in an ophthalmic hospital. Method: Over a period of 21 months, we assessed environmental Bacteria Carrying Particle (BCP load and surface samples weekly (n=276; the autoclaving system once a month and repeated whenever the process failed (n= 24; the air conditioning filters for fungal growth once in four months (n = 15, and the disinfectant solution for contamination once in two months (n = 10. Additionally, the personnel involved directly in surgery were screened for potential pathogens such as Staphylococcus aureus and β haemolytic streptococci. Result: On 14 (5.07% occasions the environment in the operating rooms had a significant risk of airborne infections. Sterilisation of instruments in the autoclaves was unsatisfactory on 4 (16.66 % occasions. Samples from the filters of the air-conditioning units yielded potentially pathogenic fungi on 3 (20% occasions. Personnel sampling revealed that 5 (8.77% individuals harboured β haemolytic Streptococci in the throat and 4 (7.01 % harboured S. aureus in the nasal cavity. The samples of disinfectant in use were not contaminated. Conclusion: There is a need to standardise microbiological evaluation protocols for operating rooms.
Certain Inequalities Involving the Fractional q-Integral Operators
Directory of Open Access Journals (Sweden)
Dumitru Baleanu
2014-01-01
Full Text Available We establish some inequalities involving Saigo fractional q-integral operator in the theory of quantum calculus by using the two parameters of deformation, q1 and q2, whose special cases are shown to yield corresponding inequalities associated with Riemann-Liouville and Kober fractional q-integral operators, respectively. Furthermore, we also consider their relevance with other related known results.
Ergonomic evaluation model of operational room based on team performance
Directory of Open Access Journals (Sweden)
YANG Zhiyi
2017-05-01
Full Text Available A theoretical calculation model based on the ergonomic evaluation of team performance was proposed in order to carry out the ergonomic evaluation of the layout design schemes of the action station in a multitasking operational room. This model was constructed in order to calculate and compare the theoretical value of team performance in multiple layout schemes by considering such substantial influential factors as frequency of communication, distance, angle, importance, human cognitive characteristics and so on. An experiment was finally conducted to verify the proposed model under the criteria of completion time and accuracy rating. As illustrated by the experiment results,the proposed approach is conductive to the prediction and ergonomic evaluation of the layout design schemes of the action station during early design stages,and provides a new theoretical method for the ergonomic evaluation,selection and optimization design of layout design schemes.
Space station operations task force. Panel 4 report: Management integration
1987-01-01
The Management Integration Panel of the Space Station Operations Task Force was chartered to provide a structure and ground rules for integrating the efforts of the other three panels and to address a number of cross cutting issues that affect all areas of space station operations. Issues addressed include operations concept implementation, alternatives development and integration process, strategic policy issues and options, and program management emphasis areas.
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
Verbal Communication in the APR1400 Advanced Control Room
International Nuclear Information System (INIS)
Kim, Jong Hyun; Shin, Young Cheol
2007-01-01
This paper introduces the characteristics of communication in advanced main controlghd rooms (MCRs) and some observations from a case study performed for APR1400 MCR. In advanced MCRs, operators need not maintain the same communication patterns as they do in conventional ones. For example, a senior reactor operator (SRO) does not have to rely on board operators for information acquisition and can get any information from his/her own workstation. This situation may also bring about new problems in MCRs such as lack of shared situation awareness and collaboration between MCR operators. To cope with these problems, the APR1400 MCR adapts several approaches in design and training for encouraging operators to communicate with each other. This paper introduces the possible changes of communication patterns and the countermeasures in design and training. Some findings from an integrated system validation for Shin Kori Units 3 and 4 are also presented
A Study of Interpersonal Conflict Among Operating Room Nurses.
Chang, Tsui-Fen; Chen, Chung-Kuang; Chen, Ming-Jia
2017-12-01
Team collaboration is an important factor that affects the performance of the operating room (OR). Therefore, the ability of OR nurses to adapt to and manage interpersonal conflict incidents properly is very important. The aims of this study were to investigate the interpersonal conflict management capabilities of OR nursing staffs and to find the relationships among the demographics of OR nurses and the following: work-related variables, interpersonal conflict management style, and target of interpersonal conflict. This study investigated 201 OR nurses who had worked for more than 6 months at the target hospitals, which were located in the three counties of Changhua, Yunlin, and Chiayi. The questionnaire that was used to collect data included three components: a demographic and work-related variables survey, interpersonal conflict management factor analysis scale, and interpersonal conflict parties and frequency scale. Data were analyzed using independent t test, analysis of variance, Scheffe's test, and Pearson's correlation coefficient. The main findings were as follows: (a) Integration and arbitration were the major interpersonal conflict management strategies adopted by the participants; (b) medical doctor, OR nurses, and anesthetists were the primary targets of conflict for the participants; (c) the factors of educational background, job position, experience in other departments, seniority, attending courses in conflict management, and level of hospital significantly affected the strategies that participants used to manage interpersonal conflict; and (d) license level, experience in other departments, seniority, and inclination toward serving in the OR were each found to relate significantly to the target of interpersonal conflict and the frequency of interpersonal conflict incidents. The main implications of this study are as follows: (a) The environment for communication in the OR should be made more friendly to encourage junior OR nurses to adopt
Integrating surgical robots into the next medical toolkit.
Lai, Fuji; Entin, Eileen
2006-01-01
Surgical robots hold much promise for revolutionizing the field of surgery and improving surgical care. However, despite the potential advantages they offer, there are multiple barriers to adoption and integration into practice that may prevent these systems from realizing their full potential benefit. This study elucidated some of the most salient considerations that need to be addressed for integration of new technologies such as robotic systems into the operating room of the future as it evolves into a complex system of systems. We conducted in-depth interviews with operating room team members and other stakeholders to identify potential barriers in areas of workflow, teamwork, training, clinical acceptance, and human-system interaction. The findings of this study will inform an approach for the design and integration of robotics and related computer-assisted technologies into the next medical toolkit for "computer-enhanced surgery" to improve patient safety and healthcare quality.
Some criteria for two new integral operators
Directory of Open Access Journals (Sweden)
Laura Stanciu
2012-12-01
Full Text Available Using the Hadamard product, we define two new integral operators. The main object of the present paper is to discuss some univalence conditions for these operators. Several corollaries of the main results are also considered.
Projection operator and propagator for an arbitrary integral spin
Huang Shi Zhong; Wu Ning; Zheng Zhi Peng
2002-01-01
Based on the solution of the Bargmann-Wigner equation for an arbitrary integral spin, a direct derivation of the projection operator and propagator for an arbitrary integral spin is presented. The explicit form for the spin projection operators constructed by Behrends and Fronsdal is confirmed. The commutation rules and a general expression for the Feynman propagator for a free particle of arbitrary integral spin are deduced
International Nuclear Information System (INIS)
Petkov, M.; Petkov, G.
2006-01-01
The paper presents an investigation results for Main Control Room operators' reliability by Performance Evaluation of Teamwork method, based on FSS-1000 training archives in KNPP in case of Steam Generator Tube Rupture accident. The advantages of operators' teamwork are shown: a) group decision-making vs. individual one: b) positive influence of crew initiated communication consisting of orders and reports that are required by instruction. (authors)
Application of process computers and colour CRT displays in the plant control room of a BWR
International Nuclear Information System (INIS)
Itoh, M.; Hayakawa, H.; Kawahara, H.; Neda, T.; Wakabayashi, Y.
1983-01-01
The recent application of a CRT display system in an 1100-MW(e) BWR plant control room and the design features of a new control room whose installation is planned for the next generation are discussed. As reactor unit capacity and the need for plant safety and reliability continue to increase, instrumentation and control equipment is growing in number and complexity. In consequence, control and supervision of plant operations require improvement. Thus, because of recent progress in the field of process computers and display equipment (colour CRTs), efficient improvements of the control room are under way in the Japanese BWR plant. In the recently constructed BWR plant (1100 MW(e)), five CRTs on the bench board and two process computers were additionally installed in the control room during the construction stage to improve plant control and supervisory functions by implementing the lessons learned from the Three Mile Island incident. The major functions of the new computers and display systems are to show integrated graphic displays of the plant status, to monitor the standby condition of the safety system, to show the condition of the integrated alarm system, etc. In practice, in the actual plant, this newly installed system performs well. On the basis of the experience gained in these activities, a new computerized control and monitoring system is now being designed for subsequent domestic BWR plants. This advanced system will incorporate not only the functions already mentioned, but also a surveillance guide system and plant automation. For future plants, a diagnostic system and an instructional system that can analyse a disturbance and give operational guidance to the plant operator are being developed in a government-sponsored programme. (author)
Bos, Ellen; Krol, Boudien; van der Star, Lex; Groothoff, Johan
Objectives: To gain more insight into the prevalence rates of musculoskeletal complaints of neck-shoulder and low back and to determine the relation between physical and psychosocial work-related risk factors and the complaints mentioned in non-specialized nurses, operation room nurses, Intensive
Integration of operational research and environmental management
Bloemhof - Ruwaard, J.M.
1996-01-01
The subject of this thesis is the integration of Operational Research and Environmental Management. Both sciences play an important role in the research of environmental issues. Part I describes a framework for the interactions between Operational Research and Environmental Management.
Modern control room design experience and speculation
International Nuclear Information System (INIS)
Smith, J.E.
1993-01-01
Can operators trained to use conventional control panels readily adapt to CRT based control rooms? Does automation make the design of good man-machine interfaces more or less difficult? In a conventional, hard-wired control room is the operator's peripheral vision always an asset and how can one do better in a CRT based control room? Are Expert System assisted man-machine interfaces a boon or a bust? This paper explores these questions in the light of actual experience with advanced power plant control environments. This paper discusses how automation has in fact simplified the problem of ensuring that the operator has at all times a clear understanding of the plant state. The author contends that conventional hard-wired control rooms are very poor at providing the operator with a good overview of the plant status particularly under startup, or upset conditions and that CRT-based control rooms offer an opportunity for improvement. Experience with some early attempts at this are discussed together with some interesting proposals from other authors. Finally the paper discusses the experience to date with expert system assisted man-machine interfaces. Although promising for the future progress has been slow. The amount of knowledge research required is often formidable and consequently costly. Often when an adequate knowledge base is finally acquired it turns out to be better to use it to increase the level of automation and thus simplify the operator's task. The risks are not any greater and automation offers more consistent operation. It is important also to carefully distinguish between expert system assisted display selection and expert system operator guidance. The first is intended to help the operator in his quest for information. The second attempts to guide the operator actions. The good and the bad points of each of these approaches is discussed
Completely integrable operator evolutionary equations
International Nuclear Information System (INIS)
Chudnovsky, D.V.
1979-01-01
The authors present natural generalizations of classical completely integrable equations where the functions are replaced by arbitrary operators. Among these equations are the non-linear Schroedinger, the Korteweg-de Vries, and the modified KdV equations. The Lax representation and the Baecklund transformations are presented. (Auth.)
Verbal Communication Quality Analysis of Human Operators in Main Control Room
International Nuclear Information System (INIS)
Kim, Seung Hwan; Park, Jin kyun
2012-01-01
Verbal communication problems have been one of the major human factors causing serious problems in many industries. The results of existing researches have revealed that keeping good communication quality is essential to ensure the safety of a large-sized and highly advanced industrial process system. Communication Quality is ensured only when both parties involved in a communication process understand and comprehend each other correctly, and it can be decided based on the correctness of the messages communicated between them. In this paper, we suggested a method to measure the quality of communication during off-normal situation in main control room of nuclear power plants. It evaluates the cosine similarity that is a measure of sentence similarity between two operators by finding the cosine of the angle between them
A Review of the Ergonomic Issues in the Laparoscopic Operating Room
Directory of Open Access Journals (Sweden)
Sang D. Choi
2012-01-01
Full Text Available This review paper discusses the ergonomic challenges associated with laparoscopy in the operating room (OR and summarizes the practical ergonomic solutions. The literature search was conducted in the fields of laparoscopy and applied ergonomics. Findings indicated that laparoscopic OR staff (surgeons, perioperative nurses and technicians commonly experienced physical and mental ergonomic risks while working in prolonged static and awkward body positions. This study highlighted the need for more ergonomic interventions in OR environment in order to improve the efficiency of laparoscopy. Ergonomic solutions included utilizing adjustable equipment, placing computer peripherals in optimal locations, providing ergonomic instruments, and improving communication. Understanding the job- or task-related ergonomic risks and hazards could help identify intervention requirements to meet the challenges associated with increased dependency on advanced high technology in the OR.
Effect of Room Ventilation Rates in Rodent Rooms with Direct-Exhaust IVC Systems.
Geertsema, Roger S; Lindsell, Claire E
2015-09-01
When IVC are directly exhausted from a rodent housing room, the air quality of the room can become independent of the intracage air quality and may reduce the need for high room ventilation rates. This study assessed the effect of decreasing the ventilation rate in rodent rooms using direct-exhaust IVC systems. The study was conducted over 16 wk and compared conditions in 8 rodent rooms that had ventilation rates of 5 to 6 air changes per hour (ACH) with those in rooms at 10 to 12 ACH. At the low ventilation rate, rooms had higher CO₂ concentrations, higher dew point temperature, and lower particulate levels and spent a greater percentage of time above the temperature set point than did rooms at the high rate. The levels of allergens and endotoxins in room air were the same regardless of the ventilation rate. Differences seen in parameters within cages at the 2 ventilation rates were operationally irrelevant. We detected no total volatile organic compounds in the room that were attributable to ammonia, regardless of the ventilation rate. Clearing the air of ethanol after a spill took longer at the low compared with high rate. However, ethanol clearance was faster at the low rate when the demand-control system was activated than at the high ventilation rate alone. Air quality in the room and in the cages were acceptable with room ventilation rates of 5 to 6 ACH in rodent rooms that use direct-exhaust IVC systems.
Information Foraging in Nuclear Power Plant Control Rooms
International Nuclear Information System (INIS)
Boring, R.L.
2011-01-01
nformation foraging theory articulates the role of the human as an 'informavore' that seeks information and follows optimal foraging strategies (i.e., the 'information scent') to find meaningful information. This paper briefly reviews the findings from information foraging theory outside the nuclear domain and then discusses the types of information foraging strategies operators employ for normal and off-normal operations in the control room. For example, operators may employ a predatory 'wolf' strategy of hunting for information in the face of a plant upset. However, during routine operations, the operators may employ a trapping 'spider' strategy of waiting for relevant indicators to appear. This delineation corresponds to information pull and push strategies, respectively. No studies have been conducted to determine explicitly the characteristics of a control room interface that is optimized for both push and pull information foraging strategies, nor has there been empirical work to validate operator performance when transitioning between push and pull strategies. This paper explores examples of control room operators as wolves vs. spiders and con- cludes by proposing a set of research questions to investigate information foraging in control room settings.
Information Foraging in Nuclear Power Plant Control Rooms
Energy Technology Data Exchange (ETDEWEB)
R.L. Boring
2011-09-01
nformation foraging theory articulates the role of the human as an 'informavore' that seeks information and follows optimal foraging strategies (i.e., the 'information scent') to find meaningful information. This paper briefly reviews the findings from information foraging theory outside the nuclear domain and then discusses the types of information foraging strategies operators employ for normal and off-normal operations in the control room. For example, operators may employ a predatory 'wolf' strategy of hunting for information in the face of a plant upset. However, during routine operations, the operators may employ a trapping 'spider' strategy of waiting for relevant indicators to appear. This delineation corresponds to information pull and push strategies, respectively. No studies have been conducted to determine explicitly the characteristics of a control room interface that is optimized for both push and pull information foraging strategies, nor has there been empirical work to validate operator performance when transitioning between push and pull strategies. This paper explores examples of control room operators as wolves vs. spiders and con- cludes by proposing a set of research questions to investigate information foraging in control room settings.
International Nuclear Information System (INIS)
Zhang Li; Li Linfeng; Li Pengcheng; Lu Changshen; Huang Weigang; Dai Zhonghua; Huang Yuanzheng; Chen Qingqing
2013-01-01
In the digital main control room of nuclear power plants, monitoring the operating status of the system of reactor is not only one of the most important tasks of the operators, but also the basis and premise of controlling the system of reactor running correctly. After analyzing, inducing, summarizing the data obtained, we found the operators' monitor behavior could be classified as procedure transfer, abnormal transfer, and exchange transfer. The times of exchange transfer is 29% of the total transfer times, abnormal transfer is 14%, regulation transfer is 36%, and others are 21%. (authors)
Advanced Neutron Source operating philosophy
International Nuclear Information System (INIS)
Houser, M.M.
1993-01-01
An operating philosophy and operations cost estimate were prepared to support the Conceptual Design Report for the Advanced Neutron Source (ANS), a new research reactor planned for the Oak Ridge National Laboratory (ORNL). The operating philosophy was part of the initial effort of the ANS Human Factors Program, was integrated into the conceptual design, and addressed operational issues such as remote vs local operation; control room layout and responsibility issues; role of the operator; simulation and training; staffing levels; and plant computer systems. This paper will report on the overall plans and purpose for the operations work, the results of the work done for conceptual design, and plans for future effort
A model of a control-room crew
International Nuclear Information System (INIS)
Spurgin, A.J.; Beveridge, R.L.
1986-01-01
This paper discusses the development of a model of a control-room crew based on observations of crews and concepts developed by cognitive psychologists. The model can help define, among other things, the requirements for SPDS or other operator aids. The paper discusses the relationship of the shift supervisor, the control board operators, the control and instrumentation systems and the written procedures in the control of the plant during normal and abnormal plant transients. These relationships cover the communications between crew members, use of the control equipment by the board operators, use of information, such as the SPDS, by the shift supervisor and integration of crew actions by the use of the procedures. Also discussed are the potential causes of erroneous actions by the crew in accident situations. The model is at this time purely qualitative, but it can be considered to be the basis for the development of a mathematical model
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
Threats to safety during sedation outside of the operating room and the death of Michael Jackson.
Webster, Craig S; Mason, Keira P; Shafer, Steven L
2016-03-01
From an understanding of human psychology and the reliability of high-technology systems, this review considers critical threats to the safety of patients undergoing sedation outside of the operating room, and will stratify these threats along what we define as the 'Patient Risk Continuum'. We then consider interventions suitable for addressing identified risks. The technology, organization and delivery of healthcare continue to become more complex, highlighting the importance of maintaining the safety of patients. Sedation outside of the operating room is known to be associated with higher rates of adverse events. However, a number of recent safety initiatives have shown benefit in improving patient safety. The following threats to patients undergoing sedation, in increasing order of risk, are discussed: equipment and environmental factors, known patient risks, poor team performance, combinatorial problems and egregious violations. To address these threats, we discuss a number of approaches consistent with the systems approach to safety, namely: encouraging functions, forcing functions, cognitive safety nets, information sharing, recovery strategies and regulatory change. Demonstrating improvement with any safety initiative relies critically on quality data collected on the problem area in question.
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.
Knowledge representation for integrated plant operation and maintenance
DEFF Research Database (Denmark)
Lind, Morten
2010-01-01
Integrated operation and maintenance of process plants has many advantages. One advantage is the improved economy obtained by reducing the number of plant shutdowns. Another is to increase reliability of operation by monitoring of risk levels during on-line maintenance. Integrated plant operation...... and maintenance require knowledge bases which can capture the interactions between the two plant activities. As an example, taking out a component or a subsystem for maintenance during operation will require a knowledge base representing the interactions between plant structure, functions, operating states...... and goals and incorporate knowledge about redundancy and reliability data. Multilevel Flow Modeling can be used build knowledge bases representing plant goals and functions and has been applied for fault diagnosis and supervisory control but currently it does not take into account structural information...
J-integral flaw resistance curves of Incoloy 800H at room temperature
International Nuclear Information System (INIS)
Krompholz, K.; Ullrich, G.
1985-08-01
J-integral experiments at room temperature were performed on three point bend type specimens of the iron-nickel base alloy Incoloy 800H with a/w-ratios of 0.3 and 0.5. These experiments are performed within the frame of a round robin test in cooperation with German- and US-partners. The tests were performed in stroke control as well as in load control. Three different evaluation procedures were applied: -The signal of the dc potential drop technique -The partial unloading procedure and -The multiple specimen technique. Evaluating the dc potential drop technique and the multiple specimen method delivered reasonable results while the partial unloading procedure failed. The different methods are discussed and fractographic results support these results under discussion. (author)
Operating room fires: a closed claims analysis.
Mehta, Sonya P; Bhananker, Sanjay M; Posner, Karen L; Domino, Karen B
2013-05-01
To assess patterns of injury and liability associated with operating room (OR) fires, closed malpractice claims in the American Society of Anesthesiologists Closed Claims Database since 1985 were reviewed. All claims related to fires in the OR were compared with nonfire-related surgical anesthesia claims. An analysis of fire-related claims was performed to identify causative factors. There were 103 OR fire claims (1.9% of 5,297 surgical claims). Electrocautery was the ignition source in 90% of fire claims. OR fire claims more frequently involved older outpatients compared with other surgical anesthesia claims (P fire claims (P fires (n = 93) increased over time (P fires occurred during head, neck, or upper chest procedures (high-fire-risk procedures). Oxygen served as the oxidizer in 95% of electrocautery-induced OR fires (84% with open delivery system). Most electrocautery-induced fires (n = 75, 81%) occurred during monitored anesthesia care. Oxygen was administered via an open delivery system in all high-risk procedures during monitored anesthesia care. In contrast, alcohol-containing prep solutions and volatile compounds were present in only 15% of OR fires during monitored anesthesia care. Electrocautery-induced fires during monitored anesthesia care were the most common cause of OR fires claims. Recognition of the fire triad (oxidizer, fuel, and ignition source), particularly the critical role of supplemental oxygen by an open delivery system during use of the electrocautery, is crucial to prevent OR fires. Continuing education and communication among OR personnel along with fire prevention protocols in high-fire-risk procedures may reduce the occurrence of OR fires.
Control room habitability in Spanish Nuclear Power Plants
International Nuclear Information System (INIS)
Mediavilla, F.; Sierra, J. J.
2007-01-01
Since the NRC published in 2003 the Generic Letter 2003-01 Control room Habitability and the Regulatory guide 1.197 Demonstrating Control Room Envelope Integrity at Nuclear Power Reactors, where it is emphasized the importance of verifying the control room habitability by means of alternative methods, Spanish Nuclear Power Plants are undertaking the different necessary activities to fulfill the requirements of the regulatory commission. This paper describes the main mechanisms included in NEI 99-03 Nuclear Energy Institute publication Control room Habitability Assessment guidance, to demonstrate and maintain Control room Habitability. In addition, in this article it Ds shown the theoretical principle of the test used to quantify air in-leakage in a control room envelope by using tracer gas techniques. The necessary activities to perform the initial in leakage testing are also put forward. Since 2006 Tecnatom, S. A. has performed the baseline testing in four Spanish Units, all of them with successful results. The rest of the Plants are scheduled to perform the tests during the second half of this year. Finally, this document summarises the more important aspects to be taken into account in the development of control room Habitability Programs, which are expected to ensure the integral maintenance of the Control room Envelope during the life a plant. (Author)
Schmeck, J; Schmeck, S B; Kohnen, W; Werner, C; Schäfer, M; Gervais, H
2008-08-01
The implementation of diagnosis-related groups (DRGs) sharply increased economic pressure on hospitals. Hence, process optimization was focussed on cost-intensive areas, namely the operation room (OR) departments. Work-flow in the OR is characterized by a mandatory interlocking of the job functions of many different occupational groups and the availability of a variety of different materials. Alternatives for staff assignment optimization have been published in numerous publications dealing with the importance of OR management. In this connection the issue of material logistics in the context of OR management has not been frequently addressed. In order to perform a surgical procedure according to plan, one depends on personnel and on timely availability of the materials needed. Supply of sterilized materials is of utmost importance, because in most hospitals sterilized surgical devices constitute a critical resource. In order to coordinate the OR process with the production flow of sterilized materials, an organizational connection to the OR management makes sense. Hence, in a German university hospital the Department of Hospital Sterile Supplies was integrated into the OR management of the Department of Anesthesiology. This led to a close coordination of work-flow processes, and concomitantly a significant reduction of production costs of sterile supplies could be achieved by direct interaction with the OR. Thus, hospital sterile supplies can reasonably be integrated into an OR management representing a new interesting business area for OR organization.
Operator role definition and human-system integration
International Nuclear Information System (INIS)
Knee, H.E.; Schryver, J.C.
1989-01-01
This paper discusses operator role definition and human-system integration from a perspective of systems engineering and allocation of functions. Current and traditional allocation of tasks/functions can no longer by applied to systems that are significantly more sophisticated and dynamic than current system designs. For such advanced and automated designs, explicit attention must be given to the role of the operator in order to facilitate efficient system performance. Furthermore, such systems will include intelligent automated systems which will support the cognitive activities of the operator. If such systems share responsibility and control with the human operator, these computer-based assistants/associates should be viewed as intelligent team members. As such, factors such as trust, intentions, and expectancies, among team members must be considered by the systems designer. Such design considerations are discussed in this paper. This paper also discusses the area of dynamic allocation of functions, and the need for models of the human operator in support of machine forecast of human performance. The Integrated Reactor Operator/System (INTEROPS) model is discussed as an example of a cognitive model capable of functioning beyond a rule-based behavioral structure
Ground Operations Autonomous Control and Integrated Health Management
Daniels, James
2014-01-01
The Ground Operations Autonomous Control and Integrated Health Management plays a key role for future ground operations at NASA. The software that is integrated into this system is called G2 2011 Gensym. The purpose of this report is to describe the Ground Operations Autonomous Control and Integrated Health Management with the use of the G2 Gensym software and the G2 NASA toolkit for Integrated System Health Management (ISHM) which is a Computer Software Configuration Item (CSCI). The decision rationale for the use of the G2 platform is to develop a modular capability for ISHM and AC. Toolkit modules include knowledge bases that are generic and can be applied in any application domain module. That way, there's a maximization of reusability, maintainability, and systematic evolution, portability, and scalability. Engine modules are generic, while application modules represent the domain model of a specific application. Furthermore, the NASA toolkit, developed since 2006 (a set of modules), makes it possible to create application domain models quickly, using pre-defined objects that include sensors and components libraries for typical fluid, electrical, and mechanical systems.
Alsved, M; Civilis, A; Ekolind, P; Tammelin, A; Andersson, A Erichsen; Jakobsson, J; Svensson, T; Ramstorp, M; Sadrizadeh, S; Larsson, P-A; Bohgard, M; Šantl-Temkiv, T; Löndahl, J
2018-02-01
To evaluate three types of ventilation systems for operating rooms with respect to air cleanliness [in colony-forming units (cfu/m 3 )], energy consumption and comfort of working environment (noise and draught) as reported by surgical team members. Two commonly used ventilation systems, vertical laminar airflow (LAF) and turbulent mixed airflow (TMA), were compared with a newly developed ventilation technique, temperature-controlled airflow (T c AF). The cfu concentrations were measured at three locations in an operating room during 45 orthopaedic procedures: close to the wound (draught. T c AF and LAF remove bacteria more efficiently from the air than TMA, especially close to the wound and at the instrument table. Like LAF, the new T c AF ventilation system maintained very low levels of cfu in the air, but T c AF used substantially less energy and provided a more comfortable working environment than LAF. This enables energy savings with preserved air quality. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.
Use of task analysis in control room evaluations
International Nuclear Information System (INIS)
Ross, K.C.
1981-01-01
Responding to recently formulated regulatory requirements, the BWR Owners' Group, working in conjunction with General Electric, has formulated a method for performing human factors design reviews of nuclear power plant control rooms. This process incorporates task analyses to analyze operational aspects of panel layout and design. Correlation of operator functions defined by emergency procedures against required controls and displays has proven successful in identifying instrumentation required in the control room to adequately respond to transient conditions, and in evaluating the effectiveness of panel design and physical arrangement. Extensions of the analysis have provided information on operator response paths, frequency of use of instruments, and control room layout. The techniques used were based on a need to identify primary controls and indications required by the operator in performing each step of the applicable procedure. The relative locations of these instruments were then analyzed for information on the adequacy of the control room design for those conditions
Design of a multisystem remote maintenance control room
International Nuclear Information System (INIS)
Draper, J.V.; Handel, S.J.; Kring, C.T.; Kawatsuma, S.
1988-01-01
The Remote Systems Development Section of the Consolidated Fuel Reprocessing Program at the Oak Ridge National Laboratory (ORNL) and Japan's Power Reactor and Nuclear Fuel Development Corporation (PNC) recently collaborated in the development of a control room concept for remote operations. This report describes design methods and the resulting control room concept. The design project included five stages. The first was compilation of a complete function list; functions are tasks performed by operators in the control room while operating equipment located in the remote area. The second step was organization of the function list into ''function groups;'' function groups are sets of functions that operate one piece of equipment. The third stage was determination of crew size and requirements for supervision. The fourth stage was development of conceptual designs of displays and controls. The fifth stage was development of plans for placement of crew stations within the control room. 5 figs., 1 tab
Survey of licensee control room habitability practices
International Nuclear Information System (INIS)
Boland, J.F.; Brookshire, R.L.; Danielson, W.F.; Driscoll, J.W.; Graham, E.D.; McConnell, R.J.; Thompson, V.N.
1985-04-01
This document presents the results of a survey of Licensee control-room-habitability practices. The survey is part of a comprehensive program plan instituted in August 1983 by the NRC to respond to ongoing questions from the Advisory Committee on Reactor Safeguards (ACRS). The emphasis of this survey was to determine by field review the control-room habitability practices at three different plants, one of which is still under construction and scheduled to receive an operating license in 1986. The other two plants are currently operating, having received operating licenses in the mid-1970's and early 1980's. The major finding of this survey is that despite the fact that the latest control-room-habitability systems have become larger and more complex than earlier systems surveyed, the latest systems do not appear to be functionally superior. The major recommendation of this report is to consolidate into a single NRC document, based upon a comprehensive systems engineering approach, the pertinent criteria for control-room-habitability design
Tale of two sites: capillary versus arterial blood glucose testing in the operating room.
Akinbami, Felix; Segal, Scott; Schnipper, Jeffrey L; Stopfkuchen-Evans, Matthias; Mills, Jonathan; Rogers, Selwyn O
2012-04-01
Pre- and intraoperative glycemic control has been identified as a putative target to improve outcomes of surgical patients. Glycemic control requires frequent monitoring of blood glucose levels with appropriate adjustments. However, monitoring standards have been called into question, especially in cases in which capillary samples are used. Point-of-care testing (POCT) using capillary samples and glucometers has been noted to give relatively accurate results for critically ill patients. However, the package inserts of most glucometers warn that they should not be used for patients in shock. This has led clinicians to doubt their accuracy in the operating room. The accuracy of capillary samples when tested in patients undergoing surgical procedures has not been proven. This study aims to determine the accuracy of intraoperative blood glucose values using capillary samples relative to arterial samples. A prospective study was conducted by collecting paired capillary and arterial samples of patients undergoing major operations at a tertiary medical center from August 2009 to May 2011. Subjects were a convenience sample of patients who had arterial lines and needed glucose testing while undergoing the procedure. Precision Xceed Pro (Abbott) handheld glucometers were used to obtain the blood glucose values. Our primary outcome of interest was the degree of correlation between capillary and arterial blood glucose values or the degree to which arterial glucose levels can be predicted by capillary glucose samples. We used linear regression and the Student t tests for statistical analyses. Seventy-two-paired samples were collected. Of the cases, 54% were major abdominal operations, whereas 24% were vascular operations. The mean values ± standard deviation for glucose levels were 146 ± 35 mg/dL (capillary) and 147 ± 36 mg/dL (arterial). The mean time ± standard deviation between the collection of both samples was 3.5 ± 1.3 minutes. The regression coefficient showed a
Some classes of analytic functions involving Noor integral operator
Patel, J.; Cho, N. E.
2005-12-01
The object of the present paper is to investigate some inclusion properties of certain subclasses of analytic functions defined by using the Noor integral operator. The integral preserving properties in connection with the operator are also considered. Relevant connections of the results presented here with those obtained in earlier works are pointed out.
HuRECA: Human Reliability Evaluator for Computer-based Control Room Actions
International Nuclear Information System (INIS)
Kim, Jae Whan; Lee, Seung Jun; Jang, Seung Cheol
2011-01-01
As computer-based design features such as computer-based procedures (CBP), soft controls (SCs), and integrated information systems are being adopted in main control rooms (MCR) of nuclear power plants, a human reliability analysis (HRA) method capable of dealing with the effects of these design features on human reliability is needed. From the observations of human factors engineering verification and validation experiments, we have drawn some major important characteristics on operator behaviors and design-related influencing factors (DIFs) from the perspective of human reliability. Firstly, there are new DIFs that should be considered in developing an HRA method for computer-based control rooms including especially CBP and SCs. In the case of the computer-based procedure rather than the paper-based procedure, the structural and managerial elements should be considered as important PSFs in addition to the procedural contents. In the case of the soft controllers, the so-called interface management tasks (or secondary tasks) should be reflected in the assessment of human error probability. Secondly, computer-based control rooms can provide more effective error recovery features than conventional control rooms. Major error recovery features for computer-based control rooms include the automatic logic checking function of the computer-based procedure and the information sharing feature of the general computer-based designs
[Role-specific targets and teamwork in the operating room].
Hoeper, K; Kriependorf, M; Felix, C; Nyhuis, P; Tecklenburg, A
2017-12-01
The primary goal of a surgical team is the successful performance of an operation on a patien; however, this primary goal can show discrepancies from the goals of individual team members. The main causes for differences of interests can be variations in subjective preferences and organizational differences. Subjective preferences are due to the values held by those involved. These values are of an intrinsic nature and therefore difficult to change. Another reason for individual goals is that hospitals and universities are professional bureaucracies. Experts working in professional bureaucracies are known to identify themselves to a greater extent with their respective profession than with their institution; however, teams in the operating room (OR) have to work together in multidisciplinary teams. The main goal of this analysis is to document role-specific targets and motivations within teams. This was a case study at a university hospital with 40 operating rooms. The data collection resulted from the three pillars of the goal documentation instrument, which includes expert interviews, a utility analysis and card placement as a basis for communicative validation. The results were analyzed with a systematic method as a qualitative content analysis. The four-pillar success model, which maps aspects of a successful hospital, was used as a deductive coding scheme. The four pillars represent the level of medical quality (process, structure and outcome quality), economy and efficiency, client satisfaction (patients and referring physicians) and employee satisfaction. At a university hospital an additional focus is on research and teaching. In addition to the four pillar success model as a deductive coding scheme, an inductive coding scheme was introduced. Approximately 10% of the employees from each professional group (surgeons, anesthesiologists, OR nurses, nurse anesthetists) were interviewed resulting in 65 interviews overall. The interviews were conducted
Integrating Sustainable Development into Operations Management Courses
Fredriksson, Peter; Persson, Magnus
2011-01-01
Purpose: It is widely acknowledged that aspects of sustainable development (SD) should be integrated into higher level operations management (OM) education. The aim of the paper is to outline the experiences gained at Chalmers University of Technology in Sweden from integrating aspects of SD into OM courses. Design/methodology/approach: The paper…
Directory of Open Access Journals (Sweden)
Hasibe Baytan Yildiz
2016-09-01
Full Text Available Aim: The aim of this randomized, single-blinded study was to evaluate the effects of noise on hemodynamic and neuroendocrine stress response by measuring the level of noise in the surgery rooms of patients undergoing knee operations under neuroaxial anesthesia. Gerec ve Yontem: We compared patient responses from two groups of patients: those undergoing knee operations in a surgery room where the noise level (measured in decibels is high, and those undergoing meniscus operations in a surgery room with lower noise levels. The STAI, the State-Trait Anxiety Inventory (STAI-1, and the anxiety test (STAI-2wereperformed at preoperative and postoperative periods. 20 ml of blood sample was taken for basal, intraoperative 30th minute, and postoperative 1st hour measurements. Systolic, diastolic, and mean arterial blood pressures were found to be higher in the high noise level group. ACTH levels were increased during the early postoperative period and became normal during the late postoperative period in the high noise level group whereas ACTH levels were significantly decreased in the low-noise level group. Basal cortisol levels were significantly higher in the high noise level group. HCRP, an inflammatory response mediator was found to be decreased in both groups. Early and late blood glucose levels were significantly higher in the high noise group. There was a greater increase in early and late blood glucose levels in the high noise group. In the postoperative period, although the state-trait anxiety inventory (STAI-2 levels being higher in patients subject to noisier environment determines how people feel independent of the conditions and state they are in, this result made us consider that the noise the patients were subjected to in the intraoperative period may cause a stress response. Discussion: As a result we believe that standard noise levels should be achieved by reducing the factors causing high noise levels in the operating room. This will
A Miracle That Accelerates Operating Room Functionality: Sugammadex
Directory of Open Access Journals (Sweden)
Erdal Dogan
2014-01-01
Full Text Available Background. Sugammadex offers a good alternative to the conventional decurarisation process currently performed with cholinesterase inhibitors. Sugammadex, which was developed specifically for the aminosteroid-structured rocuronium and vecuronium neuromuscular blockers, is a modified cyclodextrin made up of 8 glucose monomers arranged in a cylindrical shape. Methods. In this study, the goal was to investigate the efficacy of sugammadex. Sugammadex was used when there was insufficient decurarisation following neostigmine. This study was performed on 14 patients who experienced insufficient decurarisation (TOF <0.9 with neostigmine after general anaesthesia in the operating rooms of a university and a state hospital between June, 2012, and January, 2014. A dose of 2 mg/kg of sugammadex was administered. Results. Time elapsed until sugammadex administration following neostigmine 37 ± 6 min, following sugammadex it took 2.1 ± 0.9 min to reach TOF ≥ 0.9, and the extubation time was 3.2 ± 1.4 min. No statistically significant differences were detected in the hemodynamic parameters before and after sugammadex application. From the time of administration of sugammadex to the second postoperative hour, no side effects or complications occurred. None of the patients experienced acute respiratory failure or residual block during this time period. Conclusion. Sugammadex was successfully used to reverse rocuronium-induced neuromuscular block in patients where neostigmine was insufficient.
Perception of tomorrow's nuclear power plant control rooms
International Nuclear Information System (INIS)
Meyer, O.R.
1986-01-01
Major development programs are upgrading today's light water reactor nuclear power plant (NPP) control rooms. These programs involve displays, control panel architecture, procedures, staffing, and training, and are supported by analytical efforts to refine the definitions of the dynamics and the functional requirements of NPP operation. These programs demonstrate that the NPP control room is the visible command/control/communications center of the complex man/machine system that operates the plant. These development programs are primarily plant specific, although the owners' groups and the Institute of Nuclear Power Operations (INPO) do provide some standardization. The Idaho National Engineering Laboratory recently completed a project to categorize control room changes and estimate the degree of change. That project, plus related studies, provides the basis for this image of the next generation of NPP control rooms. The next generation of NPP control rooms is envisioned as being dominated by three current trends: (1) application of state-of-the-art computer hardware and software; (2) use of NPP dynamic analyses to provide the basis for the control room man/machine system design; and (3) application of empirical principles of human performance
Bouhenguel, Jason T; Preiss, David A; Urman, Richard D
2017-12-01
Non-operating room anesthesia (NORA) encounters comprise a significant fraction of contemporary anesthesia practice. With the implemention of an aneshtesia information management system (AIMS), anesthesia practitioners can better streamline preoperative assessment, intraoperative automated documentation, real-time decision support, and remote surveillance. Despite the large personal and financial commitments involved in adoption and implementation of AIMS and other electronic health records in these settings, the benefits to safety, efficacy, and efficiency are far too great to be ignored. Continued future innovation of AIMS technology only promises to further improve on our NORA experience and improve care quality and safety. Copyright © 2017 Elsevier Inc. All rights reserved.
Integrated solution for field operations
Energy Technology Data Exchange (ETDEWEB)
Aubin, Renaud; Dionis, Francois [EDF, Chatou (France)
2014-08-15
This document presents our approach to design and to implement mobile applications for field operations. Internal on-field studies yield to the fact that the value added by mobile solutions is correlated with the easiness of their integration with each other and with the underlying information systems. Moreover, the fast-growing mobile market brings new concepts to the mass and industrial applications design can benefit from these. As a consequence, a simple components-based approach has been applied to design and develop mobile applications for field operations and on-site experiments of the resulting applications have been conducted.
Integrated solution for field operations
International Nuclear Information System (INIS)
Aubin, Renaud; Dionis, Francois
2014-01-01
This document presents our approach to design and to implement mobile applications for field operations. Internal on-field studies yield to the fact that the value added by mobile solutions is correlated with the easiness of their integration with each other and with the underlying information systems. Moreover, the fast-growing mobile market brings new concepts to the mass and industrial applications design can benefit from these. As a consequence, a simple components-based approach has been applied to design and develop mobile applications for field operations and on-site experiments of the resulting applications have been conducted
Integrated solution for field operations
International Nuclear Information System (INIS)
Aubin, Renaud; Dionis, Francois
2014-01-01
This paper presents the authors' approach to design and to implement mobile applications for field operations. Internal on-field studies can yield the fact that the value-added by mobile solutions is correlated with the easiness of their integration with each other and with the underlying information systems. Moreover, the fast-growing mobile market brings new concepts to the mass and industrial applications design can benefit from these. As a consequence, a simple components-based approach has been applied to design and develop mobile applications for field operations and on-site experiments of the resulting applications have been conducted. (author)
Gas sensor based on photoconductive electrospun titania nanofibres operating at room temperature
Energy Technology Data Exchange (ETDEWEB)
Zampetti, E., E-mail: emiliano.zampetti@artov.imm.cnr.it; Macagnano, A.; Bearzotti, A. [Consiglio Nazionale delle Ricerche, Istituto per la Microelettronica e Microsistemi (CNR IMM) (Italy)
2013-04-15
An important drawback of semiconductor gas sensors is their operating temperature that needs the use of heaters. To overcome this problem a prototyping sensor using titania nanofibres (with an average diameter of 50 nm) as sensitive membrane were fabricated by electrospinning directly on the transducer of the sensor. Exploiting the effect of titania photoconductivity, resistance variations upon gas interaction under continuous irradiation of ultra violet light were measured at room temperature. The resistive sensor response was evaluated towards ammonia, nitrogen dioxide and humidity. The sensor exhibited a higher response to ammonia than to nitrogen dioxide, especially for concentrations larger than 100 ppb. For 200 ppb of ammonia and nitrogen dioxide, the responses were {approx}2.8 and 1.5 %, respectively.
DEFF Research Database (Denmark)
Thomsen, Ann Sofia Skou; Bach-Holm, Daniella; Kjærbo, Hadi
2017-01-01
PURPOSE: To investigate the effect of virtual reality proficiency-based training on actual cataract surgery performance. The secondary purpose of the study was to define which surgeons benefit from virtual reality training. DESIGN: Multicenter masked clinical trial. PARTICIPANTS: Eighteen cataract...... surgeons with different levels of experience. METHODS: Cataract surgical training on a virtual reality simulator (EyeSi) until a proficiency-based test was passed. MAIN OUTCOME MEASURES: Technical performance in the operating room (OR) assessed by 3 independent, masked raters using a previously validated...... task-specific assessment tool for cataract surgery (Objective Structured Assessment of Cataract Surgical Skill). Three surgeries before and 3 surgeries after the virtual reality training were video-recorded, anonymized, and presented to the raters in random order. RESULTS: Novices (non...
Research on Integration of NPP Operational Safety Management Performance Systems
International Nuclear Information System (INIS)
Chi, Miao; Shi, Liping
2014-01-01
The operational safety management of Nuclear Power Plants demands systematic planning and integrated control. NPPs are following the well-developed safety indicator systems proposed by IAEA Operational Safety Performance Indicator Programme, NRC Reactor Oversight Process or the other institutions. Integration of the systems is proposed to benefiting from the advantages of both systems and avoiding improper application into the real world. The authors analyzed the possibility and necessity for system integration, and propose an indicator system integrating method
Bridging the gap: adapting advanced display technologies for use in hybrid control rooms
International Nuclear Information System (INIS)
Jokstad, Håkon; Boring, Ronald
2015-01-01
The Institute for Energy Technology (IFE), runs the OECD Halden Reactor Project (HRP), featuring a state-of-the-art research simulator facility in Halden, Norway, called HAMMLAB. HAMMLAB serves two main purposes: the study of human behaviour in interaction with complex process systems; and the development, test and evaluation of prototype control centres and their individual systems. By studying operator performance in HAMMLAB and integrating the knowledge gained into new designs, the HRP contributes to improving operational safety, reliability, efficiency and productivity. The U.S. Department of Energy's (DOE) Light Water Reactor Sustainability (LWRS) Program has contracted IFE to assist DOE national laboratory staff at Idaho National Laboratory (INL) in adapting HAMMLAB design concepts for the purpose of control room modernization at nuclear power plants in the U.S. In support of this effort, the DOE has built a simulator research facility at INL called the Human Systems Simulation Laboratory (HSSL). The HSSL is centered on control room modernization, in which industry provided plant instrumentation and controls are modified for upgrade opportunities. The HSSL houses the LWRS simulator, which is a reconfigurable full-scale and full-scope control room simulator. Consisting of 45 large touchscreens on 15 panels, the LWRS simulator is currently using this glass top technology to digitally represent and replicate the functionality of the analog I&C systems in existing control rooms. The LWRS simulator is reconfigurable in that different plant training simulator models obtained from the utilities can be run on the panels, and the panels can be physically moved and arranged to mimic the layout of those control rooms. The glass top technology and reconfigurability capabilities allow the LWRS simulator to be the research platform that is necessary to design, prototype, and validate human-system interface (HSI) technologies that can replace existing analog I&C. IFE
Bridging the gap: adapting advanced display technologies for use in hybrid control rooms
Energy Technology Data Exchange (ETDEWEB)
Jokstad, Håkon [Inst. for Energy Technology, Halden (Norway); Boring, Ronald [Idaho National Lab. (INL), Idaho Falls, ID (United States)
2015-02-01
The Institute for Energy Technology (IFE), runs the OECD Halden Reactor Project (HRP), featuring a state-of-the-art research simulator facility in Halden, Norway, called HAMMLAB. HAMMLAB serves two main purposes: the study of human behaviour in interaction with complex process systems; and the development, test and evaluation of prototype control centres and their individual systems. By studying operator performance in HAMMLAB and integrating the knowledge gained into new designs, the HRP contributes to improving operational safety, reliability, efficiency and productivity. The U.S. Department of Energy’s (DOE) Light Water Reactor Sustainability (LWRS) Program has contracted IFE to assist DOE national laboratory staff at Idaho National Laboratory (INL) in adapting HAMMLAB design concepts for the purpose of control room modernization at nuclear power plants in the U.S. In support of this effort, the DOE has built a simulator research facility at INL called the Human Systems Simulation Laboratory (HSSL). The HSSL is centered on control room modernization, in which industry provided plant instrumentation and controls are modified for upgrade opportunities. The HSSL houses the LWRS simulator, which is a reconfigurable full-scale and full-scope control room simulator. Consisting of 45 large touchscreens on 15 panels, the LWRS simulator is currently using this glass top technology to digitally represent and replicate the functionality of the analog I&C systems in existing control rooms. The LWRS simulator is reconfigurable in that different plant training simulator models obtained from the utilities can be run on the panels, and the panels can be physically moved and arranged to mimic the layout of those control rooms. The glass top technology and reconfigurability capabilities allow the LWRS simulator to be the research platform that is necessary to design, prototype, and validate human-system interface (HSI) technologies that can replace existing analog I&C. IFE has
CERN PhotoLab
1983-01-01
View into the control room of the Low Energy Antiproton Ring (LEAR). Edgar Asseo (sitting) and Dieter Möhl and Georges Carron reflecting upon some beam dynamics (or hardware?) problem. Vassilis Agoritsas, in the background, leaning over a plan or a keyboard. LEAR in its early years (1982 to about 1990) was run from this local control room in building 363 close to the end of the PS South Hall, where the ring was installed. Later-on the operation was surveyed from the PS main control room.
Brown, Allan C.D.; Schmidt, Nancy M.
1984-01-01
The development of a micro-computer application for the on-line prediction of surgeon-specific operating room time using an IBM - PCXT is described. The reasons leading to the project, together with an assessment of the Condor 20 relational database management system as the basis for the application are discussed.
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.
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)
Directory of Open Access Journals (Sweden)
Tomasz Jankowski
2016-11-01
Full Text Available Ventilation and air conditioning systems are necessary for developing proper parameters of indoor envi-ronment in operating rooms. The main task of ventilation and air conditioning in those specific areas consists in creating desirable temperature, reducing the number of microorganisms and the concen-trations of hazardous gases and substances in the air, as well as ensuring the proper direction of airflow. In Poland, indoor environment in operating rooms has to comply with the requirements set out in three regulations (Journal of Laws of 2002 No. 75, item 690, as amended, Journal of Laws of 2002 No. 217, item 1833, Journal of Laws of 2011 No. 31, item 158, as amended and the document entitled "Guidelines for the design of general hospitals". Given insufficient accuracy of the abovementioned national documents, it is a common practice to use foreign standards, i.e. ASHRAE Standard 170-2013, DIN 1946-4: 2008 and FprCEN TR 16244: 2011. When considering the conditions for thermal comfort, it is important to bear in mind a close link between air flow velocity and air temperature. Air in the zone occupied by patients and medical staff must not cause the sensation of draft. Furthermore, air velocity should be sufficient to eliminate interference caused by the presence of people and other sources of heat. It should also reduce the turbulence level in the air in the operating room. Efficient functioning of ventilation and air conditioning was tested during treatments and operations carried out on three wards of a Warsaw hospital. Tests were performed with the participation of medical staff from various surgical units. They were asked to perform minor manual tasks to simulate work on the op-erating table, and to complete a questionnaire on subjective thermal sensation. The applied methodology is widely used during testing of general and local ventilation in public buildings. Air temperature, relative humidity, air flow supply and exhaust air from the
Essay on Fractional Riemann-Liouville Integral Operator versus Mikusinski’s
Directory of Open Access Journals (Sweden)
Ming Li
2013-01-01
Full Text Available This paper presents the representation of the fractional Riemann-Liouville integral by using the Mikusinski operators. The Mikusinski operators discussed in the paper may yet provide a new view to describe and study the fractional Riemann-Liouville integral operator. The present result may be useful for applying the Mikusinski operational calculus to the study of fractional calculus in mathematics and to the theory of filters of fractional order in engineering.
Eigenvalue estimates of positive integral operators with analytic ...
Indian Academy of Sciences (India)
Eigenvalue estimates of positive integral operators. 337 will be used to denote, respectively, the complex line integral of f along γ and the integral of f with respect to arc-length measure. In the first case we assume γ has an orientation. The notation Lp(γ ) will denote the Lp space of normalized arc length measure on γ with.
Erichsen Andersson, Annette; Petzold, Max; Bergh, Ingrid; Karlsson, Jón; Eriksson, Bengt I; Nilsson, Kerstin
2014-06-01
The importance of laminar airflow systems in operating rooms as protection from surgical site infections has been questioned. The aim of our study was to explore the differences in air contamination rates between displacement ventilation and laminar airflow systems during planned and acute orthopedic implant surgery. A second aim was to compare the influence of the number of people present, the reasons for traffic flow, and the door-opening rates between the 2 systems. Active air sampling and observations were made during 63 orthopedic implant operations. The laminar airflow system resulted in a reduction of 89% in colony forming units in comparison with the displacement system (P operating rooms offer high-quality air during surgery, with very low levels of colony forming units close to the surgical wound. The continuous maintenance of laminar air flow and other technical systems are crucial, because minor failures in complex systems like those in operating rooms can result in a detrimental effect on air quality and jeopardize the safety of patients. The technical ventilation solutions are important, but they do not guarantee clean air, because many other factors, such as the organization of the work and staff behavior, influence air cleanliness. Copyright © 2014 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.
Analysis of Optimal Operation of an Energy Integrated Distillation Plant
DEFF Research Database (Denmark)
Li, Hong Wen; Hansen, C.A.; Gani, Rafiqul
2003-01-01
The efficiency of manufacturing systems can be significantly increased through diligent application of control based on mathematical models thereby enabling more tight integration of decision making with systems operation. In the present paper analysis of optimal operation of an energy integrated...
Augmented reality in neurovascular surgery: feasibility and first uses in the operating room.
Kersten-Oertel, Marta; Gerard, Ian; Drouin, Simon; Mok, Kelvin; Sirhan, Denis; Sinclair, David S; Collins, D Louis
2015-11-01
The aim of this report is to present a prototype augmented reality (AR) intra-operative brain imaging system. We present our experience of using this new neuronavigation system in neurovascular surgery and discuss the feasibility of this technology for aneurysms, arteriovenous malformations (AVMs), and arteriovenous fistulae (AVFs). We developed an augmented reality system that uses an external camera to capture the live view of the patient on the operating room table and to merge this view with pre-operative volume-rendered vessels. We have extensively tested the system in the laboratory and have used the system in four surgical cases: one aneurysm, two AVMs and one AVF case. The developed AR neuronavigation system allows for precise patient-to-image registration and calibration of the camera, resulting in a well-aligned augmented reality view. Initial results suggest that augmented reality is useful for tailoring craniotomies, localizing vessels of interest, and planning resection corridors. Augmented reality is a promising technology for neurovascular surgery. However, for more complex anomalies such as AVMs and AVFs, better visualization techniques that allow one to distinguish between arteries and veins and determine the absolute depth of a vessel of interest are needed.
The technology of integrated surveillance and control system for the advanced control room
International Nuclear Information System (INIS)
Song, Soon Ja; Kim, Jung Taek; Hwang, Inn Koo; Kwon, Kee Choon; Ham, Chang Sik
1998-05-01
The size and complexity of nuclear power plants have increased significantly in recent. It has important to take both operator's experience and plants for maintaining safety. The role of this system is to gather each computerized operating support system (COSS) having the certain functions, to integrate the summary of high level information through COSS and process, and to display information on the MMI. This kind of functions is requested to develop its own modules in Korea as their events and tasks is run through the intelligent coordinator. Therefore, this survey is suggested to develop the prototype which is integrated with several developed subsystems in KAERI even though a standard guideline and requirement is not existed yet, after reviewing the similar system to be implemented and integrated several hetero subsystems. (author). 24 refs., 5 tabs., 22 figs
Spherical and plane integral operators for PDEs construction, analysis, and applications
Sabelfeld, Karl K
2013-01-01
The book presents integral formulations for partial differential equations, with the focus on spherical and plane integral operators. The integral relations are obtained for different elliptic and parabolic equations, and both direct and inverse mean value relations are studied. The derived integral equations are used to construct new numerical methods for solving relevant boundary value problems, both deterministic and stochastic based on probabilistic interpretation of the spherical and plane integral operators.
Computer aids for plant operators
International Nuclear Information System (INIS)
Joly, J.P.
1992-01-01
For some time, particularly since the TMI accident, nuclear power plant operators have been aware of the difficulties involved in diagnosing accidents and returning plants to their stable, safe operating mode. There are various possible solutions to these problems: improve control organization during accident situations, rewrite control procedures, integrate safety engineers in shifts, improve control rooms, and implement additional computer aids. The purpose of this presentation is to describe the efforts undertaken by EDF over the last few years in this field
International Nuclear Information System (INIS)
Park, Jooyoung; Lee, Daeil; Jung, Wondea; Kim, Jonghyun
2017-01-01
Highlights: • The relationship between performance shaping factors and operator performances are experimentally investigated. • The experiment includes features of digital main control room. • The result indicates that the operator’s experience level is the most effective on the performance. - Abstract: This study designs an experiment to investigate the relationship between performance shaping factors (PSFs) and operator performances. This study involves selecting three PSFs that are controllable in the experiments: (1) experience, (2) complexity, and (3) urgency. Six scenarios are developed to reflect the PSFs. The experiment involves the participation of licensed operators and the use of an APR1400 simulator. During the experiment, operator performances, such as completion time, error, secondary task, workload, and situation awareness, are measured and collected. The experimental result indicates that the operator’s experience is most effective on the overall performances. The task complexity influences the secondary tasks and situation awareness.
El Haddad, Lynn; Ghantoji, Shashank S; Stibich, Mark; Fleming, Jason B; Segal, Cindy; Ware, Kathy M; Chemaly, Roy F
2017-10-10
Environmental cleanliness is one of the contributing factors for surgical site infections in the operating rooms (ORs). To decrease environmental contamination, pulsed xenon ultraviolet (PX-UV), an easy and safe no-touch disinfection system, is employed in several hospital environments. The positive effect of this technology on environmental decontamination has been observed in patient rooms and ORs during the end-of-day cleaning but so far, no study explored its feasibility between surgical cases in the OR. In this study, 5 high-touch surfaces in 30 ORs were sampled after manual cleaning and after PX-UV intervention mimicking between-case cleaning to avoid the disruption of the ORs' normal flow. The efficacy of a 1-min, 2-min, and 8-min cycle were tested by measuring the surfaces' contaminants by quantitative cultures using Tryptic Soy Agar contact plates. We showed that combining standard between-case manual cleaning of surfaces with a 2-min cycle of disinfection using a portable xenon pulsed ultraviolet light germicidal device eliminated at least 70% more bacterial load after manual cleaning. This study showed the proof of efficacy of a 2-min cycle of PX-UV in ORs in eliminating bacterial contaminants. This method will allow a short time for room turnover and a potential reduction of pathogen transmission to patients and possibly surgical site infections.
Virtual reality applied in the ergonomic evaluation of nuclear power plant control room
International Nuclear Information System (INIS)
Gatto, Leandro Barbosa da Silveira
2012-01-01
A nuclear power plant control room is a complex system that controls a nuclear and thermodynamic process used to produce electrical energy. The operators interact with the control room through interfaces that have significant implications to nuclear power plant safety and influence the operator activity. The operator activity presents complexity features and shows a series of mechanisms absents from the human factors guidelines, important to the evaluation and update of control rooms. The ergonomics approach considers the operation strategies, the interaction between the operators, the operator-system interaction, and interaction between operators and support groups. The main objective of this paper is propose the modeling of a nuclear control room, with the support of a game engine core. This tool will be used in the ergonomic evaluation of nuclear control room, generating information and data that will make possible the adequacy of control rooms features to the legal requirements of the regulating agency, assisting the nuclear licensing. (author)
van Delft, E. A. K.; Schepers, T.; Bonjer, H. J.; Kerkhoffs, G. M. M. J.; Goslings, J. C.; Schep, N. W. L.
2017-01-01
Safety in the operating room is widely debated. Adverse events during surgery are potentially dangerous for the patient and staff. The incidence of adverse events during orthopedic trauma surgery is unknown. Therefore, we performed a study to quantify the incidence of these adverse events. Primary
Room-temperature-deposited dielectrics and superconductors for integrated photonics.
Shainline, Jeffrey M; Buckley, Sonia M; Nader, Nima; Gentry, Cale M; Cossel, Kevin C; Cleary, Justin W; Popović, Miloš; Newbury, Nathan R; Nam, Sae Woo; Mirin, Richard P
2017-05-01
We present an approach to fabrication and packaging of integrated photonic devices that utilizes waveguide and detector layers deposited at near-ambient temperature. All lithography is performed with a 365 nm i-line stepper, facilitating low cost and high scalability. We have shown low-loss SiN waveguides, high-Q ring resonators, critically coupled ring resonators, 50/50 beam splitters, Mach-Zehnder interferometers (MZIs) and a process-agnostic fiber packaging scheme. We have further explored the utility of this process for applications in nonlinear optics and quantum photonics. We demonstrate spectral tailoring and octave-spanning supercontinuum generation as well as the integration of superconducting nanowire single photon detectors with MZIs and channel-dropping filters. The packaging approach is suitable for operation up to 160 °C as well as below 1 K. The process is well suited for augmentation of existing foundry capabilities or as a stand-alone process.
Directory of Open Access Journals (Sweden)
Shahabaldin Zand
2017-05-01
Full Text Available Background and Objectives: Staphylococcus aureus is one of the five causes of nosocomial infections. Presence of this bacterium in operating rooms is one of the most important causes of nosocomial infections. This study was performed to investigate the contamination rate of S. aureus in the nose of personnel of operating rooms and its related antibiotic resistance. Methods: In this study, samples were taken from the nasal entrance of the personnel using a sterile swab on Mueller-Hinton agar medium. Then, the obtained samples were transferred to mannitol salt agar, and catalase- and coagulase-positive Staphylococci, were separated. Finally, agar disk diffusion method was used to determine antibiotic susceptibility. Data analysis was performed using Chi square and t-test. Results: In this research, 47 males (60.25 and 31 females (39.75 were studied. Twenty-two subjects (28.20% {9 (40.90% females and 13 (59.09% males}, were nasal carriers of Staphylococcus aureus. Five experimental bacteria carrier groups included 3 (13.63% surgeons, 7 (83.31% scrubs, 4 (18.18% circulars, 4 (18.18% anesthesias, 4 (18/18% services working in operating room. Most antibiotic resistance in the nose was against penicillin and piperacillin with resistance of 20 samples (90% and the lowest resistance was against vancomycin with resistance of 4 samples (18.18% and cefotaxime with 5 samples (22.72%. Of five occupational categories, scrub staff were the highest and surgeons were the lowest nasal carriers. 31.83% and 13.63%, respectively. There was a significant relationship between occupational category and nasal staphylococcus. Conclusion: According to the results of this study, limited number of operating room staff were resistant to cefotaxime and vancomycin antibiotics. Therefore, more attention can be paid to adoption of therapeutic and some preventive methods by these two antibiotics and also recommended of excessive prescription of antibiotics is prevention.
Considerations concerning the ergonomics of power plant control rooms
International Nuclear Information System (INIS)
Herbst, L.; Hinz, W.
1981-01-01
Modern control rooms for the monitoring and control of large power plants have a high degree of automation. However, it is the responsibility of the control room personnel to ensure optimum process control during all operational states. The proper ergonomic design of a control room is one of the prerequisites to ensure that the operators are able to perceive the often large flow of current information and, after processing, to respond properly. (orig.) [de
Hoffmann, Clement; Falzone, Elisabeth; Verret, Catherine; Pasquier, Pierre; Leclerc, Thomas; Donat, Nicolas; Jost, Daniel; Mérat, Stephane; Maurice, Guillaume de Saint; Lenoir, Bernard; Auroy, Yves; Tourtier, Jean-Pierre
2013-09-01
We compared the subjective quality of pulmonary auscultation between 2 acoustic stethoscopes (Holtex Ideal® and Littmann Cardiology III®) and an electronic stethoscope (Littmann 3200®) in the operating room. A prospective double-blind randomized study with an evaluation during mechanical ventilation was performed in 100 patients. After each examination, the listeners using a numeric scale (0-10) rated the quality of auscultation. Auscultation quality was compared in patients among stethoscopes with a multilevel mixed-effects linear regression with random intercept (operator effect), adjusted on significant factors in univariate analysis. A significant difference was defined as P auscultation were performed. The quality of auscultation was rated 8.2 ± 1.6 for the electronic stethoscope, 7.4 ± 1.8 for the Littmann Cardiology III, and 4.6 ± 1.8 for the Holtex Ideal. Compared with Holtex Ideal, auscultation quality was significantly higher with other stethoscopes (P auscultation quality was significantly higher with Littmann 3200 electronic stethoscope (β = 0.9 [95% confidence interval, 0.5-1.3]). An electronic stethoscope can provide a better quality of pulmonary auscultation than acoustic stethoscopes in the operating room, yet with a magnitude of improvement marginally higher than that provided with a high performance acoustic stethoscope. Whether this can translate into a clinically relevant benefit requires further studies.
The next step: intelligent digital assistance for clinical operating rooms
Directory of Open Access Journals (Sweden)
Miehle Juliana
2017-08-01
Full Text Available With the emergence of new technologies, the surgical working environment becomes increasingly complex and comprises many medical devices that have to be taken cared of. However, the goal is to reduce the workload of the surgical team to allow them to fully focus on the actual surgical procedure. Therefore, new strategies are needed to keep the working environment manageable. Existing research projects in the field of intelligent medical environments mostly concentrate on workflow modeling or single smart features rather than building up a complete intelligent environment. In this article, we present the concept of intelligent digital assistance for clinical operating rooms (IDACO, providing the surgeon assistance in many different situations before and during an ongoing procedure using natural spoken language. The speech interface enables the surgeon to concentrate on the surgery and control the technical environment at the same time, without taking care of how to interact with the system. Furthermore, the system observes the context of the surgery and controls several devices autonomously at the appropriate time during the procedure.
The Decoration Operator: A Foundation for On-Line Dimensional Data Integration
DEFF Research Database (Denmark)
Pedersen, Dennis; Pedersen, Torben Bach; Riis, Karsten
2004-01-01
The changing data requirements of today's dynamic business environments are not handled well by current On-Line Analytical Processing (OLAP) systems. Physically integrating unexpected, external data into OLAP cubes, i.e., the data warehousing approach, is a long and time-consuming process, making...... logical, on-the-fly, integration the better choice in many situations. However, OLAP systems have no operations for integrating existing multidimensional cube data with external data. In this paper we present a novel multidimensional algebra operator, the decoration operator, which allows external data...... to be integrated in OLAP cubes as new dimensions, i.e., the cube is ``decorated'' with new dimensions which can subsequently be used just as the regular dimensions. We formally specify the semantics of the decoration operator, ensuring that semantic problems do not occur in the data integration process. We also...
Wubben, I.; van Manen, Jeanette Gabrielle; van den Akker, B.J.; Vaartjes, S.R.; van Harten, Willem H.
2010-01-01
Background: Equipment-related incidents in the operating room (OR) can affect quality of care. In this study, the authors determined the occurrence and effects on the care process in a large teaching hospital. - Methods: During a 4-week period, OR nurses reported equipment-related incidents during
Integral type operators from normal weighted Bloch spaces to QT,S spaces
Directory of Open Access Journals (Sweden)
Yongyi GU
2016-08-01
Full Text Available Operator theory is an important research content of the analytic function space theory. The discussion of simultaneous operator and function space is an effective way to study operator and function space. Assuming that is an analytic self map on the unit disk Δ, and the normal weighted bloch space μ-B is a Banach space on the unit disk Δ, defining a composition operator C∶C(f=f on μ-B for all f∈μ-B, integral type operator JhC and CJh are generalized by integral operator and composition operator. The boundeness and compactness of the integral type operator JhC acting from normal weighted Bloch spaces to QT,S spaces are discussed, as well as the boundeness of the integral type operators CJh acting from normal weighted Bloch spaces to QT,S spaces. The related sufficient and necessary conditions are given.
Microbial Load in Septic and Aseptic Procedure Rooms.
Harnoss, Julian-Camill; Assadian, Ojan; Diener, Markus Karl; Müller, Thomas; Baguhl, Romy; Dettenkofer, Markus; Scheerer, Lukas; Kohlmann, Thomas; Heidecke, Claus-Dieter; Gessner, Stephan; Büchler, Markus Wolfgang; Kramer, Axel
2017-07-10
Highly effective measures to prevent surgical wound infections have been established over the last two decades. We studied whether the strict separation of septic and aseptic procedure rooms is still necessary. In an exploratory, prospective observational study, the microbial concentration in an operating room without a room ventilating system (RVS) was analyzed during 16 septic and 14 aseptic operations with the aid of an air sampler (50 cm and 1 m from the operative field) and sedimentation plates (1 m from the operative field, and contact culture on the walls). The means and standard deviations of the microbial loads were compared with the aid of GEE models (generalized estimation equations). In the comparison of septic and aseptic operations, no relevant differences were found with respect to the overall microbial concentration in the room air (401.7 ± 176.3 versus 388.2 ± 178.3 CFU/m 3 ; p = 0.692 [CFU, colony-forming units]) or sedimentation 1 m from the operative field (45.3 ± 22.0 versus 48.7 ± 18.5 CFU/m 2 /min; p = 0.603) and on the walls (35.7 ± 43.7 versus 29.0 ± 49.4 CFU/m 2 /min; p = 0.685). The only relevant differences between the microbial spectra associated with the two types of procedure were a small amount of sedimentation of Escherichia coli and Enterococcus faecalis in septic operations, and of staphylococcus aureus and pseudomonas stutzeri in aseptic operations, up to 30 minutes after the end of the procedure. These data do not suggest that septic and aseptic procedure rooms need to be separated. In interpreting the findings, one should recall that the study was not planned as an equivalence or non-inferiority study. Wherever patient safety is concerned, high-level safety concepts should only be demoted to lower levels if new and convincing evidence becomes available.
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.
Nosal, Eva-Marie; Hodgson, Murray; Ashdown, Ian
2004-08-01
This paper explores acoustical (or time-dependent) radiosity-a geometrical-acoustics sound-field prediction method that assumes diffuse surface reflection. The literature of acoustical radiosity is briefly reviewed and the advantages and disadvantages of the method are discussed. A discrete form of the integral equation that results from meshing the enclosure boundaries into patches is presented and used in a discrete-time algorithm. Furthermore, an averaging technique is used to reduce computational requirements. To generalize to nonrectangular rooms, a spherical-triangle method is proposed as a means of evaluating the integrals over solid angles that appear in the discrete form of the integral equation. The evaluation of form factors, which also appear in the numerical solution, is discussed for rectangular and nonrectangular rooms. This algorithm and associated methods are validated by comparison of the steady-state predictions for a spherical enclosure to analytical solutions.
Ergonomics in the licensing and evaluation of nuclear reactors control room
International Nuclear Information System (INIS)
Santos, Isaac Jose Antonio Luquetti dos; Vidal, Mario Cesar Rodriguez
2002-01-01
A nuclear control room is a complex system that controls a thermodynamic process used to produce electrical energy. The operators interact with the control room through interfaces that have significant implications to nuclear plant safety and influence the operator activity. The TMI (Three Mile Island) accident demonstrated that only the anthropometric aspects were not enough for an adequate nuclear control room design. The studies showed that the accident was aggravated because the designers had not considered adequately human factor aspects. After TMI accident, the designers introduce in the nuclear control room development only human factors standards and human factors guidelines. The ergonomics approaches was not considered. Our objective is introduce in nuclear control room design and nuclear control room evaluation, a methodology that. includes human factors standards, human factors guidelines and ergonomic approaches, the operator activity analysis. (author)
Gillespie, Brigid M; Chaboyer, Wendy; Wallis, Marianne
2009-07-01
Resilience in the workplace has been described as a means of facilitating adaptation in stressful environments, and therefore has application in nursing contexts. However, little research has examined how personal characteristics such as age, nursing experience and education contribute to resilience in clinical environments such as the operating room (OR). First to identify the level of resilience, and second, investigate whether age, experience and education contribute to resilience in an Australian sample of OR nurses. A predictive survey design was used. A random sample of 1430 nurses who were members of the Australian College of Operating Room Nurses association were surveyed. The survey included the 25-item Connor-Davidson Resilience Scale, and demographic questions. A standard regression model tested the hypothesis that age, years of OR experience and education contributed to resilience in OR nurses. A total of 735 (51.4%) completed, usable surveys were returned. Pearson's correlations demonstrated modest but statistically significant associations between age (presilience. In the multiple regression model, only years of OR experience predicted resilience (presilience. In OR nurses, resilience appears to be predicted by other attributes and is not necessarily dependent on an individual's personal characteristics. Thus, recruitment to the OR should not be based on the conventional notion that an older nursing workforce will have greater longevity and hence be more stable. If younger, less experienced nurses are adequately supported, they may thrive in the OR environment.
Non-local electrical spin injection and detection in germanium at room temperature
Rortais, F.; Vergnaud, C.; Marty, A.; Vila, L.; Attané, J.-P.; Widiez, J.; Zucchetti, C.; Bottegoni, F.; Jaffrès, H.; George, J.-M.; Jamet, M.
2017-10-01
Non-local carrier injection/detection schemes lie at the very foundation of information manipulation in integrated systems. This paradigm consists in controlling with an external signal the channel where charge carriers flow between a "source" and a well separated "drain." The next generation electronics may operate on the spin of carriers in addition to their charge and germanium appears as the best hosting material to develop such a platform for its compatibility with mainstream silicon technology and the predicted long electron spin lifetime at room temperature. In this letter, we demonstrate injection of pure spin currents (i.e., with no associated transport of electric charges) in germanium, combined with non-local spin detection at 10 K and room temperature. For this purpose, we used a lateral spin valve with epitaxially grown magnetic tunnel junctions as spin injector and spin detector. The non-local magnetoresistance signal is clearly visible and reaches ≈15 mΩ at room temperature. The electron spin lifetime and diffusion length are 500 ps and 1 μm, respectively, the spin injection efficiency being as high as 27%. This result paves the way for the realization of full germanium spintronic devices at room temperature.
Achieving High Reliability Operations Through Multi-Program Integration
Energy Technology Data Exchange (ETDEWEB)
Holly M. Ashley; Ronald K. Farris; Robert E. Richards
2009-04-01
Over the last 20 years the Idaho National Laboratory (INL) has adopted a number of operations and safety-related programs which has each periodically taken its turn in the limelight. As new programs have come along there has been natural competition for resources, focus and commitment. In the last few years, the INL has made real progress in integrating all these programs and are starting to realize important synergies. Contributing to this integration are both collaborative individuals and an emerging shared vision and goal of the INL fully maturing in its high reliability operations. This goal is so powerful because the concept of high reliability operations (and the resulting organizations) is a masterful amalgam and orchestrator of the best of all the participating programs (i.e. conduct of operations, behavior based safety, human performance, voluntary protection, quality assurance, and integrated safety management). This paper is a brief recounting of the lessons learned, thus far, at the INL in bringing previously competing programs into harmony under the goal (umbrella) of seeking to perform regularly as a high reliability organization. In addition to a brief diagram-illustrated historical review, the authors will share the INL’s primary successes (things already effectively stopped or started) and the gaps yet to be bridged.
Development concepts of a Smart Cyber Operating Theater (SCOT) using ORiN technology.
Okamoto, Jun; Masamune, Ken; Iseki, Hiroshi; Muragaki, Yoshihiro
2018-02-23
Currently, networking has not progressed in the treatment room. Almost every medical device in the treatment room operates as a stand-alone device. In this project, we aim to develop a networked operating room called "Smart Cyber Operating Theater (SCOT)". Medical devices are connected using Open Resource interface for the Network (ORiN) technology. In this paper, we describe the concept of the SCOT project. SCOT is integrated using the communication interface ORiN, which was originally developed for industry. One feature of ORiN is that the system can be constructed flexibly. ORiN creates abstracts of the same type of devices and increases the robustness of the system for device exchange. By using ORiN technology, we are developing new applications, such as decision-making navigation or a precision guided treatment system.
Perceptions of communication in the operating room: a pilot survey study.
Wyche, Melville Q; Lemay, Allyson C; Tiemann, Dawn D; Billeaud, Craig B; Ma, John G; Elhassan, Amir O; Fox, Mary E; Diaz, James H; Bell, Laura J; Beutler, Sascha S; Urman, Richard D; Kaye, Alan David
2015-01-01
An operating room (OR) environment is challenging and complicated. At any given time, several vital tasks are being performed by skilled individuals, including physicians, nurses, and ancillary staff. There is a potential for multifactorial mistakes; many arise because of communication issues. To evaluate the current state of perceptions of interdisciplinary communication in an OR setting, a survey was developed and administered to four academic residency training departments of anesthesiology in a single U.S. state. The results of this survey show that perceived poor communication within the OR leads to a lack of emphasis on a multidisciplinary approach to patient care in the OR. Survey data can be used internally to identify shortcomings in communication at a facility, to stress the importance of communication, and to serve as a powerful education tool to potentially improve patient care. Through this type of survey, which emphasizes communication in the OR, stakeholders can work more effectively to improve patient care and decrease adverse outcomes in the hospital environment.
Intelligent cooperation: A framework of pedagogic practice in the operating room.
Sutkin, Gary; Littleton, Eliza B; Kanter, Steven L
2018-04-01
Surgeons who work with trainees must address their learning needs without compromising patient safety. We used a constructivist grounded theory approach to examine videos of five teaching surgeries. Attending surgeons were interviewed afterward while watching cued videos of their cases. Codes were iteratively refined into major themes, and then constructed into a larger framework. We present a novel framework, Intelligent Cooperation, which accounts for the highly adaptive, iterative features of surgical teaching in the operating room. Specifically, we define Intelligent Cooperation as a sequence of coordinated exchanges between attending and trainee that accomplishes small surgical steps while simultaneously uncovering the trainee's learning needs. Intelligent Cooperation requires the attending to accurately determine learning needs, perform real-time needs assessment, provide critical scaffolding, and work with the learner to accomplish the next step in the surgery. This is achieved through intense, coordinated verbal and physical cooperation. Copyright © 2017 Elsevier Inc. All rights reserved.
Using a Research Simulator for Validating Control Room Modernization Concepts
International Nuclear Information System (INIS)
Boring, Ronald L.; Agarwal, Vivek; Persensky, Julius J.; Joe, Jeffrey C.
2012-01-01
The Light Water Reactor Sustainability Program is a research, development, and deployment program sponsored by the United States Department of Energy. The program is operated in close collaboration with industry research and development programs to provide the technical foundations for licensing and managing the long-term, safe, and economical operation of nuclear power plants that are currently in operation. Advanced instrumentation and control (I and C) technologies are needed to support the continued safe and reliable production of power from nuclear energy systems during sustained periods of operation up to and beyond their expected licensed lifetime. This requires that new capabilities to achieve process control be developed and eventually implemented in existing nuclear control rooms. It also requires that approaches be developed and proven to achieve sustainability of I and C systems throughout the period of extended operation. Idaho National Laboratory (INL) is working closely with nuclear utilities to develop technologies and solutions to help ensure the safe life extension of current reactors. One of the main areas of focus is control room modernization. Current analog control rooms are growing obsolete, and it is difficult for utilities to maintain them. Using its reconfigurable control room simulator adapted from a training simulator, INL serves as a neutral test bed for implementing new control room system technologies and assisting in control room modernization efforts across. (author)
Using a Research Simulator for Validating Control Room Modernization Concepts
Energy Technology Data Exchange (ETDEWEB)
Ronald L. Boring; Vivek Agarwal; Julius J. Persensky; Jeffrey C. Joe
2012-05-01
The Light Water Reactor Sustainability Program is a research, development, and deployment program sponsored by the United States Department of Energy. The program is operated in close collaboration with industry research and development programs to provide the technical foundations for licensing and managing the long-term, safe, and economical operation of nuclear power plants that are currently in operation. Advanced instrumentation and control (I&C) technologies are needed to support the continued safe and reliable production of power from nuclear energy systems during sustained periods of operation up to and beyond their expected licensed lifetime. This requires that new capabilities to achieve process control be developed and eventually implemented in existing nuclear control rooms. It also requires that approaches be developed and proven to achieve sustainability of I&C systems throughout the period of extended operation. Idaho National Laboratory (INL) is working closely with nuclear utilities to develop technologies and solutions to help ensure the safe life extension of current reactors. One of the main areas of focus is control room modernization. Current analog control rooms are growing obsolete, and it is difficult for utilities to maintain them. Using its reconfigurable control room simulator adapted from a training simulator, INL serves as a neutral test bed for implementing new control room system technologies and assisting in control room modernization efforts across.
Taking account of human factors in control-room design
International Nuclear Information System (INIS)
Dien, Y.; Montmayeul, R.
1995-07-01
Since the Three Mile Island accident two ways for improving the Human-Machine Interface have mainly been followed: the development of computerized operator aids in existing control-rooms and the design of advanced control-rooms. Insufficient attention paid to human factors in the design of operator aids has generally led to these aids being neglected or unused by their potential users. While for the design of advanced control-rooms efforts have been made for dealing with human factors in more extensive way. Based upon this experience, a general method for taking account of human factors in a control-room design has been devised and is described in this paper. (author)
Optimizing integrated airport surface and terminal airspace operations under uncertainty
Bosson, Christabelle S.
In airports and surrounding terminal airspaces, the integration of surface, arrival and departure scheduling and routing have the potential to improve the operations efficiency. Moreover, because both the airport surface and the terminal airspace are often altered by random perturbations, the consideration of uncertainty in flight schedules is crucial to improve the design of robust flight schedules. Previous research mainly focused on independently solving arrival scheduling problems, departure scheduling problems and surface management scheduling problems and most of the developed models are deterministic. This dissertation presents an alternate method to model the integrated operations by using a machine job-shop scheduling formulation. A multistage stochastic programming approach is chosen to formulate the problem in the presence of uncertainty and candidate solutions are obtained by solving sample average approximation problems with finite sample size. The developed mixed-integer-linear-programming algorithm-based scheduler is capable of computing optimal aircraft schedules and routings that reflect the integration of air and ground operations. The assembled methodology is applied to a Los Angeles case study. To show the benefits of integrated operations over First-Come-First-Served, a preliminary proof-of-concept is conducted for a set of fourteen aircraft evolving under deterministic conditions in a model of the Los Angeles International Airport surface and surrounding terminal areas. Using historical data, a representative 30-minute traffic schedule and aircraft mix scenario is constructed. The results of the Los Angeles application show that the integration of air and ground operations and the use of a time-based separation strategy enable both significant surface and air time savings. The solution computed by the optimization provides a more efficient routing and scheduling than the First-Come-First-Served solution. Additionally, a data driven analysis is
Zhou, Yong; Mu, Haiying; Jiang, Jianjun; Zhang, Li
2012-01-01
Currently, there is a trend in nuclear power plants (NPPs) toward introducing digital and computer technologies into main control rooms (MCRs). Safe generation of electric power in NPPs requires reliable performance of cognitive tasks such as fault detection, diagnosis, and response planning. The digitalization of MCRs has dramatically changed the whole operating environment, and the ways operators interact with the plant systems. If the design and implementation of the digital technology is incompatible with operators' cognitive characteristics, it may have negative effects on operators' cognitive reliability. Firstly, on the basis of three essential prerequisites for successful cognitive tasks, a causal model is constructed to reveal the typical human performance issues arising from digitalization. The cognitive mechanisms which they impact cognitive reliability are analyzed in detail. Then, Bayesian inference is used to quantify and prioritize the influences of these factors. It suggests that interface management and unbalanced workload distribution have more significant impacts on operators' cognitive reliability.
Integrated System Health Management: Pilot Operational Implementation in a Rocket Engine Test Stand
Figueroa, Fernando; Schmalzel, John L.; Morris, Jonathan A.; Turowski, Mark P.; Franzl, Richard
2010-01-01
This paper describes a credible implementation of integrated system health management (ISHM) capability, as a pilot operational system. Important core elements that make possible fielding and evolution of ISHM capability have been validated in a rocket engine test stand, encompassing all phases of operation: stand-by, pre-test, test, and post-test. The core elements include an architecture (hardware/software) for ISHM, gateways for streaming real-time data from the data acquisition system into the ISHM system, automated configuration management employing transducer electronic data sheets (TEDS?s) adhering to the IEEE 1451.4 Standard for Smart Sensors and Actuators, broadcasting and capture of sensor measurements and health information adhering to the IEEE 1451.1 Standard for Smart Sensors and Actuators, user interfaces for management of redlines/bluelines, and establishment of a health assessment database system (HADS) and browser for extensive post-test analysis. The ISHM system was installed in the Test Control Room, where test operators were exposed to the capability. All functionalities of the pilot implementation were validated during testing and in post-test data streaming through the ISHM system. The implementation enabled significant improvements in awareness about the status of the test stand, and events and their causes/consequences. The architecture and software elements embody a systems engineering, knowledge-based approach; in conjunction with object-oriented environments. These qualities are permitting systematic augmentation of the capability and scaling to encompass other subsystems.
Error analysis of nuclear power plant operator cognitive behavior
International Nuclear Information System (INIS)
He Xuhong; Zhao Bingquan; Chen Yulong
2001-01-01
Nuclear power plant is a complex human-machine system integrated with many advanced machines, electron devices and automatic controls. It demands operators to have high cognitive ability and correct analysis skill. The author divides operator's cognitive process into five stages to analysis. With this cognitive model, operator's cognitive error is analysed to get the root causes and stages that error happens. The results of the analysis serve as a basis in design of control rooms and training and evaluation of operators
Rosen, A.C.; Dexter, F.
2009-01-01
Foglia et al. (in press) describe tension in two veteran's hospitals among managers, clinicians, and patients over allocating appropriate resources to support care and inefficiencies in care delivery. Ultimately ethical healthcare in a system which is committed to caring for an entire population of patients must use its limited resources effectively while not compromising patient safety. This discussion gives examples from operating room management in which systematic analyses of existing dat...
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.
Energy Technology Data Exchange (ETDEWEB)
Oskarsson, Per-Anders; Johansson, Bjoern J.E.; Gonzalez, Natalia (Swedish Defence Research Agency, Information Systems, Linkoeping (Sweden))
2010-02-15
The frame of reference for this work was existing recommendations and instructions from the NPP area, experiences from the review of the Turbic Validation and experiences from system validations performed at the Swedish Armed Forces, e.g. concerning military control rooms and fighter pilots. These enterprises are characterized by complex systems in extreme environments, often with high risks, where human error can lead to serious consequences. A focus group has been performed with representatives responsible for Human Factors issues from all Swedish NPP:s. The questions that were discussed were, among other things, for whom an integrated validation (IV) is performed and its purpose, what should be included in an IV, the comparison with baseline measures, the design process, the role of SSM, which methods of measurement should be used, and how the methods are affected of changes in the control room. The report brings different questions to discussion concerning the validation process. Supplementary methods of measurement for integrated validation are discussed, e.g. dynamic, psychophysiological, and qualitative methods for identification of problems. Supplementary methods for statistical analysis are presented. The study points out a number of deficiencies in the validation process, e.g. the need of common guidelines for validation and design, criteria for different types of measurements, clarification of the role of SSM, and recommendations for the responsibility of external participants in the validation process. The authors propose 12 measures for taking care of the identified problems
Energy Technology Data Exchange (ETDEWEB)
2007-07-01
In Norway Integrated Operations (IO) is a concept which in the first phase (G1) has been used to describe how to integrate processes and people onshore and offshore using ICT solutions and facilities that improve onshore's ability to support offshore operationally. The second generation (G2) Integrated Operations aims to help operators utilize vendors' core competencies and services more efficiently. Utilizing digital services and vendor products, operators will be able to update reservoir models, drilling targets and well trajectories as wells are drilled, manage well completions remotely, optimize production from reservoir to export lines, and implement condition-based maintenance concepts. The total impact on production, recovery rates, costs and safety will be profound. When the international petroleum business moves to the Arctic region the setting is very different from what is the case on the Norwegian Continental Shelf (NCS) and new challenges will arise. The Norwegian Ministry of Environment has recently issued an Integrated Management Plan for the Barents Sea where one focus is on 'Monitoring of the Marine Environment in the North'. The Government aims to establish a new and more coordinated system for monitoring the marine ecosystems in the north. A representative group consisting of the major Operators, the Service Industry, Academia and the Authorities have developed the enclosed strategy for the OG21 Integrated Operations and Real Time Reservoir Management (IO and RTRM) Technology Target Area (TTA). Major technology and work process research and development gaps have been identified in several areas: Bandwidth down-hole to surface; Sensor development including Nano-technology; Cross discipline use of Visualisation, Simulation and model development particularly in Drilling and Reservoir management areas; Software development in terms of data handling, model updating and calculation speed; Enabling reliable and robust communications particularly for
Energy Technology Data Exchange (ETDEWEB)
2007-07-01
In Norway Integrated Operations (IO) is a concept which in the first phase (G1) has been used to describe how to integrate processes and people onshore and offshore using ICT solutions and facilities that improve onshore's ability to support offshore operationally. The second generation (G2) Integrated Operations aims to help operators utilize vendors' core competencies and services more efficiently. Utilizing digital services and vendor products, operators will be able to update reservoir models, drilling targets and well trajectories as wells are drilled, manage well completions remotely, optimize production from reservoir to export lines, and implement condition-based maintenance concepts. The total impact on production, recovery rates, costs and safety will be profound. When the international petroleum business moves to the Arctic region the setting is very different from what is the case on the Norwegian Continental Shelf (NCS) and new challenges will arise. The Norwegian Ministry of Environment has recently issued an Integrated Management Plan for the Barents Sea where one focus is on 'Monitoring of the Marine Environment in the North'. The Government aims to establish a new and more coordinated system for monitoring the marine ecosystems in the north. A representative group consisting of the major Operators, the Service Industry, Academia and the Authorities have developed the enclosed strategy for the OG21 Integrated Operations and Real Time Reservoir Management (IO and RTRM) Technology Target Area (TTA). Major technology and work process research and development gaps have been identified in several areas: Bandwidth down-hole to surface; Sensor development including Nano-technology; Cross discipline use of Visualisation, Simulation and model development particularly in Drilling and Reservoir management areas; Software development in terms of data handling, model updating and calculation speed; Enabling reliable and robust communications
Control Room Habitability for Accidental Sulfuric Acid Release
International Nuclear Information System (INIS)
Cho, Sungmin; Lee, Heedo; Song, Dongsoo
2006-01-01
The 10 CFR 50 Appendix A Criterion 19, 'Control Room', requires that a control room be provided from which actions can be taken to operate the nuclear power unit safely under normal conditions and to maintain it in a safe condition under accident conditions. For compliance with the requirement, the control room of a nuclear power plant should be appropriately protected from hazardous chemicals that may be discharged as a result of equipment failures, operator errors, or events and conditions outside the control of the nuclear power plant. We have excluded sulfuric acid from a target of estimation for control room habitability merely because its boiling point is too high; qualitative analysis in this paper shows that we can exclude sulfuric acid from the target of habitability estimation
Tsai, Mitchell H; Huynh, Tinh T; Breidenstein, Max W; O'Donnell, Stephen E; Ehrenfeld, Jesse M; Urman, Richard D
2017-07-01
There has been little in the development or application of operating room (OR) management metrics to non-operating room anesthesia (NORA) sites. This is in contrast to the well-developed management framework for the OR management. We hypothesized that by adopting the concept of physician efficiency, we could determine the applicability of this clinical productivity benchmark for physicians providing services for NORA cases at a tertiary care center. We conducted a retrospective data analysis of NORA sites at an academic, rural hospital, including both adult and pediatric patients. Using the time stamps from WiseOR® (Palo Alto, CA), we calculated site utilization and physician efficiency for each day. We defined scheduling efficiency (SE) as the number of staffed anesthesiologists divided by the number of staffed sites and stratified the data into three categories (SE 1). The mean physician efficiency was 0.293 (95% CI, [0.281, 0.305]), and the mean site utilization was 0.328 (95% CI, [0.314, 0.343]). When days were stratified by scheduling efficiency (SE 1), we found differences between physician efficiency and site utilization. On days where scheduling efficiency was less than 1, that is, there are more sites than physicians, mean physician efficiency (95% CI, [0.326, 0.402]) was higher than mean site utilization (95% CI, [0.250, 0.296]). We demonstrate that scheduling efficiency vis-à-vis physician efficiency as an OR management metric diverge when anesthesiologists travel between NORA sites. When the opportunity to scale operational efficiencies is limited, increasing scheduling efficiency by incorporating different NORA sites into a "block" allocation on any given day may be the only suitable tactical alternative.
Fractional quantum integral operator with general kernels and applications
Babakhani, Azizollah; Neamaty, Abdolali; Yadollahzadeh, Milad; Agahi, Hamzeh
In this paper, we first introduce the concept of fractional quantum integral with general kernels, which generalizes several types of fractional integrals known from the literature. Then we give more general versions of some integral inequalities for this operator, thus generalizing some previous results obtained by many researchers.2,8,25,29,30,36
Chen, Xiaodong Phoenix; Williams, Reed G; Smink, Douglas S
2015-01-01
The amount of guidance provided by the attending surgeon in the operating room (OR) is a key element in developing residents' autonomy. The purpose of this study is to explore factors that affect attending surgeons' decision making regarding OR guidance provided to the resident. We used video-stimulated recall interviews (VSRI) throughout this 2-phase study. In Phase 1, 3 attending surgeons were invited to review separately 30 to 45 minute video segments of their prerecorded surgical operations to explore factors that influenced their OR guidance decision making. In Phase 2, 3 attending surgeons were observed and documented in the OR (4 operations, 341min). Each operating surgeon reviewed their videotaped surgical performance within 5 days of the operation to reflect on factors that affected their decision making during the targeted guidance events. All VSRI were recorded. Thematic analysis and manual coding were used to synthesize and analyze data from VSRI transcripts, OR observation documents, and field notes. A total of 255 minutes of VSRI involving 6 surgeons and 7 surgical operations from 5 different procedures were conducted. A total of 13 guidance decision-making influence factors from 4 categories were identified (Cohen's κ = 0.674): Setting (case schedule and patient morbidity), content (procedure attributes and case progress), resident (current competency level, trustworthiness, self-confidence, and personal traits), and attending surgeon (level of experience, level of comfort, preferred surgical technique, OR training philosophy, and responsibility as surgeon). A total of 5 factors (case schedule, patient morbidity, procedure attributes, resident current competency level, and trustworthiness) influenced attending surgeons' pre-OR guidance plans. "OR training philosophy" and "responsibility as surgeon" were anchor factors that affected attending surgeons' OR guidance decision-making patterns. Surgeons' OR guidance decision making is a dynamic process
Integrating Nuclear Energy to Oilfield Operations - Two Case Studies
International Nuclear Information System (INIS)
Robertson, Eric P.; Nelson, Lee O.; McKellar, Michael G.; Gandrik, Anastasia M.; Patterson, Mike W.
2011-01-01
Fossil fuel resources that require large energy inputs for extraction, such as the Canadian oil sands and the Green River oil shale resource in the western USA, could benefit from the use of nuclear power instead of power generated by natural gas combustion. This paper discusses the technical and economic aspects of integrating nuclear energy with oil sands operations and the development of oil shale resources. A high temperature gas reactor (HTGR) that produces heat in the form of high pressure steam (no electricity production) was selected as the nuclear power source for both fossil fuel resources. Both cases were based on 50,000 bbl/day output. The oil sands case was a steam-assisted, gravity-drainage (SAGD) operation located in the Canadian oil sands belt. The oil shale development was an in-situ oil shale retorting operation located in western Colorado, USA. The technical feasibility of the integrating nuclear power was assessed. The economic feasibility of each case was evaluated using a discounted cash flow, rate of return analysis. Integrating an HTGR to both the SAGD oil sands operation and the oil shale development was found to be technically feasible for both cases. In the oil sands case, integrating an HTGR eliminated natural gas combustion and associated CO2 emissions, although there were still some emissions associated with imported electrical power. In the in situ oil shale case, integrating an HTGR reduced CO2 emissions by 88% and increased natural gas production by 100%. Economic viabilities of both nuclear integrated cases were poorer than the non-nuclear-integrated cases when CO2 emissions were not taxed. However, taxing the CO2 emissions had a significant effect on the economics of the non-nuclear base cases, bringing them in line with the economics of the nuclear-integrated cases. As we move toward limiting CO2 emissions, integrating non-CO2-emitting energy sources to the development of energy-intense fossil fuel resources is becoming
International Nuclear Information System (INIS)
Boring, Ronald; Persensky, Julius; Thomas, Kenneth
2011-01-01
The INL operates the HSSL to conduct research in the design and evaluation of advanced reactor control rooms, integration of intelligent support systems to assist operators, development and assessment of advanced human performance models, and visualizations to assess advanced operational concepts across various infrastructures. This advanced facility consists of a reconfigurable simulator and a virtual reality capability (known as the Computer-Aided Virtual Environment (CAVE)) (Figure 2). It supports human factors research, including human-in-the-loop performance, HSI, and analog and digital hybrid control displays. It can be applied to the development and evaluation of control systems and displays for complex systems such as existing and advanced NPP control rooms, command and control systems, and advance emergency operations centers. The HSSL incorporates a reconfigurable control room simulator, which is currently housed in the Center for Advanced Energy Studies (CAES), a joint venture of the DOE and the Idaho University System. The simulator is a platform- and plant-neutral environment intended for full-scope and part-task testing of operator performance in various control room configurations. The simulator is not limited to a particular plant or even simulator architecture. It can support engineering simulator platforms from multiple vendors using digital interfaces. Due to its ability to be reconfigured, it is possible to switch the HSI - not just to digital panels but also to different control modalities such as those using greater plant automation or intelligent alarm filtering. The simulator currently includes three operator workstations, each capable of driving up to eight 30-inch monitors. The size and number of monitors varies depending on the particular front-end simulator deployed for a simulator study. These operator workstations would typically be used for the shift supervisor or senior reactor operator, reactor operator, and assistant reactor
Energy Technology Data Exchange (ETDEWEB)
Ronald Boring; Julius Persensky; Kenneth Thomas
2011-09-01
The INL operates the HSSL to conduct research in the design and evaluation of advanced reactor control rooms, integration of intelligent support systems to assist operators, development and assessment of advanced human performance models, and visualizations to assess advanced operational concepts across various infrastructures. This advanced facility consists of a reconfigurable simulator and a virtual reality capability (known as the Computer-Aided Virtual Environment (CAVE)) (Figure 2). It supports human factors research, including human-in-the-loop performance, HSI, and analog and digital hybrid control displays. It can be applied to the development and evaluation of control systems and displays for complex systems such as existing and advanced NPP control rooms, command and control systems, and advance emergency operations centers. The HSSL incorporates a reconfigurable control room simulator, which is currently housed in the Center for Advanced Energy Studies (CAES), a joint venture of the DOE and the Idaho University System. The simulator is a platform- and plant-neutral environment intended for full-scope and part-task testing of operator performance in various control room configurations. The simulator is not limited to a particular plant or even simulator architecture. It can support engineering simulator platforms from multiple vendors using digital interfaces. Due to its ability to be reconfigured, it is possible to switch the HSI - not just to digital panels but also to different control modalities such as those using greater plant automation or intelligent alarm filtering. The simulator currently includes three operator workstations, each capable of driving up to eight 30-inch monitors. The size and number of monitors varies depending on the particular front-end simulator deployed for a simulator study. These operator workstations would typically be used for the shift supervisor or senior reactor operator, reactor operator, and assistant reactor