9 CFR 590.522 - Breaking room operations.

Science.gov (United States)

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].

Science.gov (United States)

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.

Flooding PSA with Plant Specific Operating Experiences of Korean PWRs

International Nuclear Information System (INIS)

Choi, Sun Yeong; Yang, Joon Yull

2006-01-01

The purpose of this paper is to update the flooding PSA with Korean plant specific operating experience data and the appropriate estimation method for the flooding frequency to improve the PSA quality. The existing flooding PSA used the NPE (Nuclear Power Experience) database up to 1985 for the flooding frequency. They are all USA plant operating experiences. So an upgraded flooding frequency with Korean specific plant operation experience is required. We also propose a method of only using the PWR (Pressurized Water Reactor) data for the flooding frequency estimation in the case of the flooding area in the primary building even though the existing flooding PSA used both PWR and BWR (Boiled Water Reactor) data for all kinds of plant areas. We evaluate the CDF (Core Damage Frequency) with the modified flooding frequency and compare the results with that of the existing flooding PSA method

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.

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)

Smart home design and operation preferences of Americans and Koreans.

Science.gov (United States)

Jeong, Kyeong-Ah; Salvendy, Gavriel; Proctor, Robert W

2010-05-01

The purpose of the present study was to generate both culture-specific and universal design and operational guidelines for smart homes. Questionnaire surveys were performed in the USA and South Korea to collect data on preferences for various aspects of the design and operation of smart homes. The factors that the survey participants considered most important were derived through factor analyses of the survey data and the responses of Americans and Koreans were compared to generate culture-specific guidelines. The five factors derived were: 1) environmental connection and control; 2) smart devices (appliances) and their control; 3) physical safety and security concerns; 4) comfort and relaxation issues; 5) control restriction issues. The two cultures showed different preference structures with statistical significance for all five factors. Prediction capability of the derived factors was also examined through multiple regressions for buying intention, interest, self-vision of living, moving intention, living satisfaction and perceived time and effort savings. 'Environmental connection and control' and 'smart devices (appliances) and their control' seemed to be the most influential factors for Americans and Koreans, respectively. STATEMENT OF RELEVANCE: Analysis of a survey of design and operational preferences for smart homes yielded five factors on which US and South Korean respondents differed. These factors form the basis for culture-specific guidelines, which, along with universal guidelines, should be followed in design of user-centred smart homes.

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

[Comprehensive system integration and networking in operating rooms].

Science.gov (United States)

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.

How do strategic decisions and operative practices affect operating room productivity?

Science.gov (United States)

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.

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

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)

Cultural differences in room size perception.

Science.gov (United States)

Saulton, Aurelie; Bülthoff, Heinrich H; de la Rosa, Stephan; Dodds, Trevor J

2017-01-01

Cultural differences in spatial perception have been little investigated, which gives rise to the impression that spatial cognitive processes might be universal. Contrary to this idea, we demonstrate cultural differences in spatial volume perception of computer generated rooms between Germans and South Koreans. We used a psychophysical task in which participants had to judge whether a rectangular room was larger or smaller than a square room of reference. We systematically varied the room rectangularity (depth to width aspect ratio) and the viewpoint (middle of the short wall vs. long wall) from which the room was viewed. South Koreans were significantly less biased by room rectangularity and viewpoint than their German counterparts. These results are in line with previous notions of general cognitive processing strategies being more context dependent in East Asian societies than Western ones. We point to the necessity of considering culturally-specific cognitive processing strategies in visual spatial cognition research.

Cultural differences in room size perception.

Directory of Open Access Journals (Sweden)

Aurelie Saulton

Full Text Available Cultural differences in spatial perception have been little investigated, which gives rise to the impression that spatial cognitive processes might be universal. Contrary to this idea, we demonstrate cultural differences in spatial volume perception of computer generated rooms between Germans and South Koreans. We used a psychophysical task in which participants had to judge whether a rectangular room was larger or smaller than a square room of reference. We systematically varied the room rectangularity (depth to width aspect ratio and the viewpoint (middle of the short wall vs. long wall from which the room was viewed. South Koreans were significantly less biased by room rectangularity and viewpoint than their German counterparts. These results are in line with previous notions of general cognitive processing strategies being more context dependent in East Asian societies than Western ones. We point to the necessity of considering culturally-specific cognitive processing strategies in visual spatial cognition research.

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.

Study on the Correlation between PSR and Korean Stress Test for Continued Operation of Aging NPP

International Nuclear Information System (INIS)

Chung, June Ho; Kim, Tae Ryong

2013-01-01

Nuclear Safety and Security Commission (NSSC), Korean nuclear regulatory authority established the stress test guideline based on the EU stress test, and KHNP prepared the execution plan in response to the guideline for the CO of Kori Unit 1 and Wolsong Unit 1. PSR is a comprehensive safety review program for long term operation of NPP, which was developed by IAEA. Korea adopted PSR in 1999 as the regulatory requirement for CO of NPP. The IAEA standard guideline for PSR program was updated in 2003. However, the Korean PSR has not been revised yet to apply the new IAEA guidelines. Additionally, national legal systems and guidelines associated with the adoption of stress tests are urgently required as well. These revisions are imperative in order to ensure the reliability of NPPs, and to promote public acceptance and understanding. This study presents the technical basis and proposals for review actions necessary to address the issues and controversies surrounding the continued operation and decommissioning of aging NPPs in Korea. As discussed earlier in characteristics of Korean Stress Test, it is more comprehensive than the EU Stress Test in terms of its multilateral evaluation which includes equipment durability, plant operation, human factors, and safety margins, hence substantially raising the significance and value of the evaluation process. Thus, the addition of Korean Stress Test to the existing Korean Evaluation of CO is expected to greatly increase the quality of safety assessment of aging NPPs in Korea due to its stricter safety policies, hence providing a more meaningful evaluation process. However, a one-time application of the Korean Stress Test to only Kori Unit 1 and Wolsong Unit 1 would be a waste of the great effort that has been done thus far to improve the Korean Evaluation of CO and develop the Korean Stress Test. By extending the Korean Stress Test to all NPPs in Korea would maintain and ensure the reliability of NPPs as well as public

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.

Science.gov (United States)

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...

Overutilization and underutilization of operating rooms - insights from behavioral health care operations management.

Science.gov (United States)

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.

Science.gov (United States)

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

2012-11-01

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

Attitudes to teamwork and safety among Italian surgeons and operating room nurses.

Science.gov (United States)

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.

[Handling modern imaging procedures in a high-tech operating room].

Science.gov (United States)

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.

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].

Science.gov (United States)

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.

Science.gov (United States)

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

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

Review of operating room ventilation standards

NARCIS (Netherlands)

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

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.

Korean Clinic Based Outcome Measure Studies

OpenAIRE

Jongbae Park

2003-01-01

Background: Evidence based medicine has become main tools for medical practice. However, conducting a highly ranked in the evidence hierarchy pyramid is not easy or feasible at all times and places. There remains a room for descriptive clinical outcome measure studies with admitting the limit of the intepretation. Aims: Presents three Korean clinic based outcome measure studies with a view to encouraging Korean clinicians to conduct similar studies. Methods: Three studies are presented...

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)

Engineering Process Monitoring for Control Room Operation

OpenAIRE

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...

Control of the Environment in the Operating Room.

Science.gov (United States)

Katz, Jonathan D

2017-10-01

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

The association of subjective stress, urinary catecholamine concentrations and PC game room use and musculoskeletal disorders of the upper limbs in young male Koreans.

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Kang, Jong-Won; Kim, Heon; Cho, Soo-Hun; Lee, Myung-Koo; Kim, Yong-Dae; Nan, Hong-Mei; Lee, Chul-Ho

2003-06-01

The use of PCs can cause health problems, including musculoskeletal disorders (MSDs) of the upper limbs. This study was performed to investigate whether using PCs in PC game rooms may induce MSDs of the upper limbs. 284 young male Koreans were included. A self-administered, structured questionnaire was used to gather information about game room use, perceived subjective stress, and the symptoms related to MSDs. Urinary concentrations of epinephrine, norepinephrine, and dopamine were measured in spot urine. The symptom prevalence of MSDs of the upper limbs increased according to the increase of the duration of game room use. The intensity of perceived subjective stress showed a significant dose-response relationship with the frequency of MSDs symptoms in neck and shoulder areas. However, the urinary level of catecholamines was not significantly correlated with the symptom prevalence of MSDs in the upper limbs. These findings suggest that using PCs in game rooms produce physical stress on the upper limbs, strong enough to induce MSDs.

Delays in the operating room: signs of an imperfect system.

Science.gov (United States)

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

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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.

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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

NARCIS (Netherlands)

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

Air quality monitoring of the post-operative recovery room and locations surrounding operating theaters in a medical center in Taiwan.

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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.

Air quality monitoring of the post-operative recovery room and locations surrounding operating theaters in a medical center in Taiwan.

Science.gov (United States)

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.

A Study on the Korean Medicine Education and the Changes in the Traditional Korean Medicine during the Japanese Colonial Era: Focused on the Korean Medicine Training Schools.

Science.gov (United States)

Huang, Yongyuan

2018-04-01

The modern education institutes play an important role in fostering professional talents, reproducing knowledge and studies, and forming the identities of certain academic fields and vocational communities. It is a matter of common knowledge that the absence of an official Korean medicine medical school during the Japanese colonial era was a severely disadvantageous factor in the aspects of academic progress, fostering follow-up personnel, and establishment of social capability. Therefore, the then Korean medicine circle put emphasis on inadequate official education institutes as the main factor behind oppression. Furthermore, as the measure to promote the continuance of Korean medicine, the circle regarded establishing civilian Korean medicine training schools as their long-cherished wish and strived to accomplish the mission even after liberation. This study looked into how the Korean medicine circle during the Japanese colonial era utilized civilian training schools to conduct the Korean medicine education conforming to modern medical school and examined how the operation of these training schools influenced the changes in the traditional Korean medicine. After the introduction of the Western medical science, the Korean medicine circle aimed to improve the quality of Korean medicine doctors by establishing modern Korean medicine medical schools. However, after the annexation of Korea and Japan, official Korean medicine medical schools were not established since policies were organized centered on the Western medical science. In this light, the Korean medicine circle strived to nurture the younger generation of Korean medicine by establishing and operating the civilian Korean medicine training schools after the annexation between Korea and Japan. The schools were limited in terms of scale and status but possessed the forms conforming to the modern medical schools in terms of education system. In other words, the civilian training schools not only adhered to the

Start time delays in operating room: Different perspectives

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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

NARCIS (Netherlands)

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.

Science.gov (United States)

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.

Science.gov (United States)

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.

Determination of Anger Expression and Anger Management Styles and an Application on Operating Room Nurses

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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

NARCIS (Netherlands)

Does, R.J.M.M.; Vermaat, T.M.B.; Verver, J.P.S.; Bisgaard, S.; van den Heuvel, J.

2009-01-01

Problem: Health care today is facing serious problems: quality of care does not meet patients’ needs and costs are exploding. Inefficient utilization of expensive operating rooms is one of the major problems in many hospitals worldwide. A benchmark study of 13 hospitals in the Netherlands and

Status of operation of radionuclides assay system in Korean nuclear power plant

International Nuclear Information System (INIS)

Hwang, K.H.; Lee, K.J.; Jeong, C.W.; Ahn, S.M.

2003-01-01

In Korea, 17 nuclear power plants composed of 13 pressurized water reactors and 4 CANDU reactors are currently in operation. The cumulative amounts of low and intermediate level radioactive waste in nuclear power plant reached 58,718 drums (unit: 200 liter) in 2001. Efforts to construct LILW disposal facility are continued and its first operation is planned in the year 2008. Its first stage capacity is assumed to be 100,000 drums and total capacity will reach to 800,000 drums. Radwaste disposal site selection is an urgent national project at present time. Regulations and guidelines require detailed information about the radioactive waste package and its contents prior to the transport to the disposal sites. The Enforcement Decree of the Korean Atomic Energy Act (articles 234-17) requires the Minister of Science and Technology (MOST) of Korea to establish regulation for the waste acceptance (MOST notice. 1196-10). It requires detailed information about the radioactive waste package and its contents such as activity of radionuclides, total activities, types and characteristics of waste. For the measurement of the concentrations and activities of radionuclides in radwaste drum, a radionuclides assay system is installed at Korean nuclear power plant (KORI site) in 1996. The waste drum can be measured in the vertical direction with eight vertical segments while in the radial direction also with eight segments. Using this measurement method, homogeneous and non-homogeneous waste drum can be measured. Scaling factor methods have been played a dominant role in the determination of the radionuclides concentration in this system. For corrosion product, generic scaling factors were used due to the similarity and better-characterized properties of Korean analyzed data as compared with the worldwide data base of PWR industry. For fission product and TRU nuclides, it is not easy to determine the generic scaling factors. Thus simple model reflecting the operation history of power

Factors related to teamwork performance and stress of operating room nurses.

Science.gov (United States)

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.

Science.gov (United States)

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.

Science.gov (United States)

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

Science.gov (United States)

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

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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.

Science.gov (United States)

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

Clinical Experience of Auditory Brainstem Response Testing on Pediatric Patients in the Operating Room

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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.

Surgical team turnover and operative time: An evaluation of operating room efficiency during pulmonary resection.

Science.gov (United States)

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.

Game theoretic approaches to operating room management.

Science.gov (United States)

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.

Evaluating Operating Room Turnaround Times and Cancellations at Dwight D. Eisenhower Army Medical Center

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...

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)

Application of Operational Research Techniques in Operating Room Scheduling Problems: Literature Overview

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.

Science.gov (United States)

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].

Science.gov (United States)

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...

Operator's Manual, Boiler Room Operations and Maintenance. Supplement A, Air Pollution Training Institute Self-Instructional Course SI-466.

Science.gov (United States)

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…

Development of Emergency Operating Strategies for Beyond Design Basis External Event(BDBEE)s in Korean WH Nuclear Power Plants

Energy Technology Data Exchange (ETDEWEB)

Yoon, Duk-Joo; Lee, Seung-Chan; Sung, Je-Joong; Ha, Sang-Jun [KHNP CRI, Daejeon (Korea, Republic of); Hong, Soon-Joon; Hwang, Su-Hyun; Lee, Byung-Chul; Park, Kang-Min [FNC Tech. Co., Yongin (Korea, Republic of)

2015-10-15

Westinghouse developed and connected emergency operating procedures into a set of FLEX Support Guidelines(FSGs). This paper explains that Korean WH(Westinghouse) type nuclear power plants develop emergency operating strategies for ELAP(extended loss of all AC power), which include guidelines to use permanent and portable equipment as necessary to prevent core damage until AC power is restored from a reliable alternate source of AC power. The Korean emergency operating response strategies were developed to cope with a ELAP such as Fukushima event. The strategies include guidelines to prevent fuel damage using the FLEX equipment. Operators should take actions to prepare FLEX equipment within license basis SBO coping time. The loss of all AC power has been analyzed to identify the behavior of major NSSS process variables using RELAP computer code. The accident analysis showed that the plant does not result in fuel damage in 72 hours after an ELAP if operators take actions to cool RCS with opening of SG ADV in 5 gpm seal leak case. In this scenario, because ELAP is in process and all power cannot be used, operator should operate the FLEX equipment in order to actuate active equipment using the EOP fo SBO response. This strategy will prevent entering SAMG because this actions result in core cooling and stay in core exit temperature less than 650 .deg. C. Korean emergency operating guidelines(EOGs) will be developed using this strategies for response to the BDBEE.

Sister chromatid exchanges and structural chromosome aberrations in lymphocytes in operating room personnel

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.

Can efficient supply management in the operating room save millions?

Science.gov (United States)

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.

Science.gov (United States)

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

NARCIS (Netherlands)

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

NARCIS (Netherlands)

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

Essays on Korean online game communities: A sense of place: Media and motivation in Korea by the Wang-tta effect; Order and chaos in an ethnography of Korean online game communities

OpenAIRE

Chee, Florence

2005-01-01

Essay 1 : This paper presents an ethnographic analysis of the different ways Korean game players establish community. I look at Korean PC game rooms as "third places,", and peer relations associated with online video gaming activities. A synthesis of the Korean concept "Wang-tta" and application of the TEDA Ethos protocol provides extra insight into the motivations to excel at digital games and one of the strong drivers of such community membership. Essay 2: This paper explores the dichotomy ...

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...

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

Foundations for teaching surgeons to address the contributions of systems to operating room team conflict.

Science.gov (United States)

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.

Detection of Irradiated Korean Wheat Flour by Viscosity and Pulsed Photostimulated Luminescence (PPSL) Methods

International Nuclear Information System (INIS)

Yi, S.D.; Chang, K.S.; Oh, M.J.

2005-01-01

This study was carried out to establish methods for irradiation detection of irradiation in Korean wheat flour by pulsed photostimulated luminescence (PPSL) and viscometric methods. The photon counts of the irradiated Korean wheat flour measured by PPSL immediately after irradiation increased with increasing irradiation dose. The photon counts in the irradiated Korean wheat flour almost disappeared with lapse of time after storage in normal room conditions, but irradiation detection was still possible after 6 months in darkroom conditions

A novel interactive educational system in the operating room--the IE system.

Science.gov (United States)

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.

Have it your way. A modular approach to custom compact control rooms

International Nuclear Information System (INIS)

Harmon, Daryl; Scarola, Ken

2003-01-01

In spite of the recent lack of growth in the nuclear power industry, a transition is taking place to compact main control rooms as the design of choice for power generating facilities. This is evident in the design and construction of new facilities, including Advanced Light Water Reactors such as the Korean Shin Kori 3 and 4 units, as well as Generation IV reactors. Also, compact control rooms are increasingly preferred for the modernization of current generation plants. This shift reflects that compact control rooms combine cost savings through equipment reduction and standardization with operability improvements through increased functionality and flexibility and improved presentation. Though compact control rooms feature significantly fewer Human Machine Interface (HMI) devices than their conventional counterparts, customers still require a wide variety of different configurations to accommodate their individual operations philosophies, cultural norms, licensing regulations and physical constraints. To meet this need, Westinghouse Electric Company has developed an innovative, modular approach to designing compact control rooms for nuclear power plants. This approach features a small set of standard HMI devices serving as building blocks for all compact control room functions. The building blocks include qualified and non-safety video devices for implementing displays, alarms, multi-channel soft controls, computerized procedures, etc. These building blocks can be used for (1) large screen overview displays, (2) console-based control and monitoring and (3) HMI devices for conventional, benchboard-style control panels. Their modular design allows these building blocks to be arranged in various physical configurations to meet a wide variety of customer's control room preferences and constraints. For example, a compact control room could use the qualified building blocks (1) to configure a dedicated safety panel independent of the normal operational consoles, or (2

Improving operating room first start efficiency - value of both checklist and a pre-operative facilitator.

Science.gov (United States)

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.

Facets of operational performance in an emergency room (ER)

NARCIS (Netherlands)

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

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)

Crew resource management: using aviation techniques to improve operating room safety.

Science.gov (United States)

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.

Student Registered Nurse Anesthetists' Atittudes toward and Perceptions of Teamwork in the Operating Room

Science.gov (United States)

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.

Science.gov (United States)

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.

Red-light-emitting laser diodes operating CW at room temperature

Science.gov (United States)

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

A study on associations of Korean sample group for colors applied to the nuclear power plant control room

Energy Technology Data Exchange (ETDEWEB)

Oh, In Seok; Lee, Jung Woon; Lee, Yong Hee; Lee, Hyun Chul [Korea Atomic Energy Research Institute, Taejeon (Korea); Lee, Dhong Ha [Suwon University, Whasung (Korea)

2002-05-01

Colors are widely used to warn risk levels and to attract attention of the public. Korea Standard Nuclear Reactor Control Room (KSNRCR) also uses several colors to differentiate warnings, priorities, status, borders, and messages based on the HF010 guideline. However the previous studies showed that the general public not engaged in a specific job domain had different associations of colors as regulated in the standards or the guidelines. It is also expected that the general public not engaged in nuclear power plant industry will have different color association system from the color coding system applied to the KSNRCR. So, this study was performed to show whether there is any difference between color association of a sample Korean group and the color meanings specified in the HF010 guideline. The general public not engaged in the nuclear power plant industry have no idea of the color usage in the nuclear control room. So we converted the specific color usage situation into similar but general situations. In questionnaire, we gave subjects the general situation where color coding is appled and alternative colors which were applied to the HF010 guidelines. And we asked the subjects to choose the colors proper to the situation and to rank the colors according to the degree of suitability. A hundred college students participated in the experiment. 10 refs., 7 tabs. (Author)

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

Resident Autonomy in the Operating Room: Expectations Versus Reality.

Science.gov (United States)

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.

Laparoscopic assistance by operating room nurses: Results of a virtual-reality study.

Science.gov (United States)

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.

A model for generating master surgical schedules to allow cyclic scheduling in operating room departments

NARCIS (Netherlands)

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

Flooding PSA by considering the operating experience data of Korean PWRs

International Nuclear Information System (INIS)

Choi, Sun Yeong; Yang, Joon Eon

2007-01-01

The existing flooding Probabilistic Safety Analysis (PSA) was updated to reflect the Korean plant specific operating experience data into the flooding frequency to improve the PSA quality. Both the Nuclear Power Experience (NPE) database and the Korea Nuclear PIPE Failure Database (NuPIPE) databases were used in this study, and from these databases, only the Pressurized Water Reactor (PWR) data were used for the flooding frequencies of the flooding areas in the primary auxiliary building. With these databases and a Bayesian method, the flooding frequencies for the flooding areas were estimated. Subsequently, the Core Damage Frequency (CDF) for the flooding PSA of the UlChiN (UCN) unit 3 and 4 plants based on the Korean Standard Nuclear power Plant (KSNP) internal full-power PSA model was recalculated. The evaluation results showed that sixteen flooding events are potentially significant according to the screening criterion, while there were two flooding events exceeding the screening criterion of the existing UCN 3 and 4 flooding PSA. The result was compared with two kinds of cases: 1) the flooding frequency and CDF from the method of the existing flooding PSA with the PWR and Boiled Water Reactor (BWR) data of the NPE database and the Maximum Likelihood Estimate (MLE) method and 2) the flooding frequency and CDF with the NPE database (PWR and BWR data), NuPIPE database, and a Bayesian method. From the comparison, a difference in CDF results was revealed more clearly between the CDF from this study and case 2) than between case 1) and case 2). That is, the number of flooding events exceeding the screen criterion further increased when only the PWR data were used for the primary auxiliary building than when the Korean specific data were used

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

Directory of Open Access Journals (Sweden)

2012-09-01

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

Korean Clinic Based Outcome Measure Studies

Directory of Open Access Journals (Sweden)

Jongbae Park

2003-02-01

Full Text Available Background: Evidence based medicine has become main tools for medical practice. However, conducting a highly ranked in the evidence hierarchy pyramid is not easy or feasible at all times and places. There remains a room for descriptive clinical outcome measure studies with admitting the limit of the intepretation. Aims: Presents three Korean clinic based outcome measure studies with a view to encouraging Korean clinicians to conduct similar studies. Methods: Three studies are presented briefly here including 1 Quality of Life of liver cancer patients after 8 Constitutional acupuncture; 2 Developing a Korean version of Measuring yourself Medical Outcome profile (MYMOP; and 3 Survey on 5 Shu points: a pilot In the first study, we have included 4 primary or secondary liver cancer patients collecting their diagnostic X-ray film and clinical data f개m their hospital, and asked them to fill in the European Organization Research and Treatment of Cancer, Quality of Life Questionnaire before the commencement of the treatment. The acupuncture treatment is set up format but not disclosed yet. The translation and developing a Korean version of outcome measures that is Korean clinician friendly has been sought for MYMOP is one of the most appropriate one. The permission was granted, the translation into Korean was done, then back translated into English only based on the Korean translation by the researcher who is bilingual in both languages. The back translation was compared by the original developer of MYMOP and confirmed usable. In order to test the existence of acupoints and meridians through popular forms of Korean acupuncture regimes, we aim at collecting opinions from 101 Korean clinicians that have used those forms. The questions asked include most effective symptoms, 5 Shu points, points those are least likely to use due to either adverse events or the lack of effectiveness, theoretical reasons for the above proposals, proposing outcome measures

The normalized administration of hybrid operating room: its practical application in managing multiple injuries

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)

Auditing Operating Room Recycling: A Management Case Report.

Science.gov (United States)

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.

Device- and system-independent personal touchless user interface for operating rooms : One personal UI to control all displays in an operating room.

Science.gov (United States)

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)

Operating room teamwork among physicians and nurses: teamwork in the eye of the beholder.

Science.gov (United States)

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.

Human-machine interface aspects and use of computer-based operator support systems in control room upgrades and new control room designs for nuclear power plants

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

Human-machine interface aspects and use of computer-based operator support systems in control room upgrades and new control room designs for nuclear power plants

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.

Assessing Nurse Anaesthetists' Non-Technical Skills in the operating room.

Science.gov (United States)

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.

Use of an operating microscope during spine surgery is associated with minor increases in operating room times and no increased risk of infection.

Science.gov (United States)

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.

A comprehensive operating room information system using the Kinect sensors and RFID.

Science.gov (United States)

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.

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)

Virtual reality in the operating room of the future.

Science.gov (United States)

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.

Gynaecological surgical training in the operating room : an exploratory study

NARCIS (Netherlands)

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.

Science.gov (United States)

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.

Development of Safety Culture Assessment Strategy for Korean NPP

International Nuclear Information System (INIS)

Park, Jung Hwan; Kim, Jong Hyun

2014-01-01

This paper aims at developing the requirements for a method to evaluate the operational safety culture, evaluating currently available methods based on the requirements, and suggesting a method to evaluate and improve the operational safety culture for Korean nuclear power plants. This paper reviews the widely-used methods to assess safety culture for NPPs and their basis. Then, this paper develops the requirements for the method to evaluate operational safety culture for Korean NPPs. Based on these requirements, Korean Safety Culture Indicators (KSCI) and evaluation measures are also suggested. Finally this paper proposes the guidelines to develop improvements to safety culture from the evaluation results

Development of Safety Culture Assessment Strategy for Korean NPP

Energy Technology Data Exchange (ETDEWEB)

Park, Jung Hwan; Kim, Jong Hyun [KEPCO, Ulsan (Korea, Republic of)

2014-08-15

This paper aims at developing the requirements for a method to evaluate the operational safety culture, evaluating currently available methods based on the requirements, and suggesting a method to evaluate and improve the operational safety culture for Korean nuclear power plants. This paper reviews the widely-used methods to assess safety culture for NPPs and their basis. Then, this paper develops the requirements for the method to evaluate operational safety culture for Korean NPPs. Based on these requirements, Korean Safety Culture Indicators (KSCI) and evaluation measures are also suggested. Finally this paper proposes the guidelines to develop improvements to safety culture from the evaluation results.

Lean Strategies in the Operating Room.

Science.gov (United States)

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.

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.

Implications of Perioperative Team Setups for Operating Room Management Decisions.

Science.gov (United States)

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.

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

NARCIS (Netherlands)

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

2007-01-01

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

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.

Cognitive requirements in the redesign of a TRIGA RC-1 control room: The role of the operators' evaluations

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

NARCIS (Netherlands)

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

NARCIS (Netherlands)

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

NARCIS (Netherlands)

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.

Science.gov (United States)

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

Role Allocations and Communications of Operators during Emergency Operation in Advanced Main Control Rooms

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)

Korean ESL Parents' Perspectives and Maintenance of Mother Tongue: A Case Study of Two Korean Mothers

Science.gov (United States)

Yang, Jaeseok

2017-01-01

This case study explores the language attitudes and perceptions of Korean parents, with regard to their children's native language maintenance and ESL education in the US. The primary focuses are on (1) what aspects are held by Korean parents toward the maintenance of the native language in the US, and (2) how these perspectives operate in their…

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

Science.gov (United States)

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

2017-06-01

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

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.

Operating room nursing directors' influence on anesthesia group operating room productivity.

Science.gov (United States)

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

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.)

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.

Science.gov (United States)

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.

Control Room Tasks During Refueling in Ringhals 1 Nuclear Power Plant - Operator performance during refuelling outages

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.

Science.gov (United States)

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.

Undergraduate surgical nursing preparation and guided operating room experience: A quantitative analysis.

Science.gov (United States)

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.

[Performance development of a university operating room after implementation of a central operating room management].

Science.gov (United States)

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)

The internationalization of the Korean radiological society

International Nuclear Information System (INIS)

Choi, Byung Ihn; Kim, Seung Hyup; Han, Man Chung; Kim, Young Goo; Kim, Kun Sang

1995-01-01

Toward the beginning of the twenty-first century, the world experiences the dramatic changes in politics, economics and culture, and it is evident that the Korean medical field will not be able to survive provided it doesn't prepare ourselves to adapt to those changes. The Korean Medical Society held a forum for the active operation of the medical society, inviting several leading affiliated societies, to meet the needs of the times. This review describes the summary of the presentation that the authors made on behalf of the Korean Radiological Society in the forum, including the organization, current status of academic activity, current status of international communication, and problems encountered in the internationalization of the Korean Radiological Society

Operational Intelligence Failures of the Korean War

Science.gov (United States)

2014-05-22

debrief of General (ret.) James H. Polk by Lieutenant Colonel Tausch, U.S. Army Heritage and Education Center, “General James H. Polk Papers,” U.S. Army...highly politicized, childish , and ultimately, prone to creating false alarms.52 Conflicting information and intelligence provided to the Far East...the United States Air Force Education Division, Korean War 1950-1953: Teacher Resource Guide, National Museum of the United States Air Force, http

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.

Science.gov (United States)

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.

A Development Method of Mobile Computerized Procedure System for the Cooperation among Field Workers and Main Control Room Operators in Korean Nuclear Power Plants

International Nuclear Information System (INIS)

Lee, Sun Jin; Seong, No Kyu; Jung, Yeon Sub

2014-01-01

Human errors can occur during the test and maintenance of steam generator, safety injection system and other various systems and devices in nuclear power plants (NPPs). Most of human errors can be improved by the human error prevention techniques such as self-check, peer-check, concurrent verification and etc. Another important technique is to share work information among main control room (MCR) operators and field workers. Various field service automation tools have been developed with recent information technology in many countries. APR1400 computerized procedure system (CPS) has been developed for the MCR operators of Shin-Kori 3 and 4 units. Especially, the concurrent verification support design is applied in the construction project of Shin-Hanul 1 and 2 CPS. It is expected that the proposed mobile CPS can enhance the reduction of human errors by supporting human error prevention techniques and information sharing. This paper describes the technical issues of the mobile CPS (mobile CPS) in the initial development stage. Based on the design of APR1400, CRI CPS has been developed and operated for SKN 3 and 4 HFE V and V and license test for the MCR operating staff. Therefore the mobile CPS will be developed by upgrading the CRI CPS with improved features

A Development Method of Mobile Computerized Procedure System for the Cooperation among Field Workers and Main Control Room Operators in Korean Nuclear Power Plants

Energy Technology Data Exchange (ETDEWEB)

Lee, Sun Jin; Seong, No Kyu; Jung, Yeon Sub [KHNP ,Daejeon (Korea, Republic of)

2014-08-15

Human errors can occur during the test and maintenance of steam generator, safety injection system and other various systems and devices in nuclear power plants (NPPs). Most of human errors can be improved by the human error prevention techniques such as self-check, peer-check, concurrent verification and etc. Another important technique is to share work information among main control room (MCR) operators and field workers. Various field service automation tools have been developed with recent information technology in many countries. APR1400 computerized procedure system (CPS) has been developed for the MCR operators of Shin-Kori 3 and 4 units. Especially, the concurrent verification support design is applied in the construction project of Shin-Hanul 1 and 2 CPS. It is expected that the proposed mobile CPS can enhance the reduction of human errors by supporting human error prevention techniques and information sharing. This paper describes the technical issues of the mobile CPS (mobile CPS) in the initial development stage. Based on the design of APR1400, CRI CPS has been developed and operated for SKN 3 and 4 HFE V and V and license test for the MCR operating staff. Therefore the mobile CPS will be developed by upgrading the CRI CPS with improved features.

Ergonomics in the operating room: protecting the surgeon.

Science.gov (United States)

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.

[Design and Implementation of a Mobile Operating Room Information Management System Based on Electronic Medical Record].

Science.gov (United States)

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

[Management for the operating room].

Science.gov (United States)

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

NARCIS (Netherlands)

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

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.

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

[The hybrid operating room. Home of high-end intraoperative imaging].

Science.gov (United States)

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.

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

Things Korean.

Science.gov (United States)

Chang, Roberta

Presented in this booklet are brief descriptions of items and activities that are symbolic of Korean culture. Some of the items and activities described include traditional Korean clothing and accessories, dolls, fans, a Korean game called "yut," tape recordings of Korean music, a "buhk" (drum), and brass eating utensils. A map of Korea, some…

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

Science.gov (United States)

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

2011-01-01

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

Scheduling elective surgeries: the tradeoff among bed capacity, waiting patients and operating room utilization using goal programming.

Science.gov (United States)

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

The BWR [Boiling Water Reactor] Emergency Operating Procedures Tracking System (EOPTS): Evaluation by control-room operating crews

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

Cost and morbidity analysis of chest port insertion in adults: Outpatient clinic versus operating room placement.

Science.gov (United States)

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.

Science.gov (United States)

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.

Factors Affecting Acoustics and Speech Intelligibility in the Operating Room: Size Matters.

Science.gov (United States)

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)

Management of immune thrombocytopenia: Korean experts recommendation in 2017.

Science.gov (United States)

Jang, Jun Ho; Kim, Ji Yoon; Mun, Yeung-Chul; Bang, Soo-Mee; Lim, Yeon Jung; Shin, Dong-Yeop; Choi, Young Bae; Yhim, Ho-Young; Lee, Jong Wook; Kook, Hoon

2017-12-01

Management options for patients with immune thrombocytopenia (ITP) have evolved substantially over the past decades. The American Society of Hematology published a treatment guideline for clinicians referring to the management of ITP in 2011. This evidence-based practice guideline for ITP enables the appropriate treatment of a larger proportion of patients and the maintenance of normal platelet counts. Korean authority operates a unified mandatory national health insurance system. Even though we have a uniform standard guideline enforced by insurance reimbursement, there are several unsolved issues in real practice in ITP treatment. To optimize the management of Korean ITP patients, the Korean Society of Hematology Aplastic Anemia Working Party (KSHAAWP) reviewed the consensus and the Korean data on the clinical practices of ITP therapy. Here, we report a Korean expert recommendation guide for the management of ITP.

The installation and operation of the seismic instrumentation in Korean NPPs

International Nuclear Information System (INIS)

Lee, Kye Hyun; Baek, Yong Lak; Chung, Yun Suk

1994-01-01

Including the 7 October, 1978, Hongsung earthquake, many earthquakes have occurred in our country. The Korean peninsular is no longer a safety zone against earthquakes, and there are possibilities of the damage they cause. So therefore, it is essential to verify the safety of the safety-related facilities in the event of an earthquake. If an earthquake occurs, seismic instrumentation provides information on the vibratory ground motion and resultant vibratory responses of representative safety-related structures and equipment so that an evaluation can be made immediately as to whether or not the design response spectra have been exceeded. In this paper, general descriptions of the seismic instrumentation installed in domestic NPPs will be discussed; this includes instrument type and location, the Operating Basis Earthquake (OBE) exceedance criteria, and processing and evaluation of earthquake response data, and items to be studied for further enhancement of post-earthquake evaluation techniques are presented

Evaluation of Knowledge, Attitude and Practice of Personnel in Operating Room, ERCP, and ESWL Towards Radiation Hazards and Protection

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

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?

Science.gov (United States)

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.

Early Extubation in the Operating Room after Congenital Open-Heart Surgery.

Science.gov (United States)

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.

Science.gov (United States)

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.

The use of operator surveys by the CEGB to evaluate nuclear control room design and initiatives in the design of alarm systems and control room operating procedures

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

Present and future of Korean nuclear power

International Nuclear Information System (INIS)

Min, K-H

2014-01-01

'Full text:' The Korean nuclear power industry has devoted itself to technological development and self-reliance over the last 30 years since Kori unit 1, the first nuclear power plant commenced its commercial operation in 1978. As a result of such efforts and accumulated experiences, the Korean nuclear power industry has developed the OPR 1000 and APR 1400 units and is almost completing the development of the APR+ as a 1,500MW class reactor with its own technologies of design and manufacturing. Also, the Korean nuclear power industry has been able to build a strong supply chain from engineering, manufacturing, construction, and fuel supply, to operation and maintenance. At present, Korea is operating 23 commercial power reactors with a total installed capacity of 20,716 MW, accounting for 25 percent of the installed capacity and one third of the nation's total electricity generation. Also, the share of nuclear power generation capacity will be 29 percent by 2035 in the Long Term Energy Development Plan and 43 GW of nuclear energy capacity will be needed. Thanks to nuclear power generation as an essential driving force, Korea has been able to supply cheap and stable electricity. However, amid the growing public concerns about nuclear safety after the Fukushima accident, the Korean government and related organizations are exerting its utmost effort in all areas, for example, enhancing nuclear safety and safety culture, carrying out management innovation, and communicating with the public in order to enhance transparency. Also, the Korean government launched the Public Engagement Commission on spent nuclear fuel (SNF) management in 2013, which is tasked to initiate public consultation & discussion and submit recommendation to government after in-depth review and analysis on SNF management options by the end of 2014. Nuclear power has become very essential part of national economy in Korea because Korea has virtually no indigenous energy resources and

Present and future of Korean nuclear power

Energy Technology Data Exchange (ETDEWEB)

Min, K-H [Korea Atomic Industrial Forum, Inc., Seoul (Korea, Republic of)

2014-07-01

'Full text:' The Korean nuclear power industry has devoted itself to technological development and self-reliance over the last 30 years since Kori unit 1, the first nuclear power plant commenced its commercial operation in 1978. As a result of such efforts and accumulated experiences, the Korean nuclear power industry has developed the OPR 1000 and APR 1400 units and is almost completing the development of the APR+ as a 1,500MW class reactor with its own technologies of design and manufacturing. Also, the Korean nuclear power industry has been able to build a strong supply chain from engineering, manufacturing, construction, and fuel supply, to operation and maintenance. At present, Korea is operating 23 commercial power reactors with a total installed capacity of 20,716 MW, accounting for 25 percent of the installed capacity and one third of the nation's total electricity generation. Also, the share of nuclear power generation capacity will be 29 percent by 2035 in the Long Term Energy Development Plan and 43 GW of nuclear energy capacity will be needed. Thanks to nuclear power generation as an essential driving force, Korea has been able to supply cheap and stable electricity. However, amid the growing public concerns about nuclear safety after the Fukushima accident, the Korean government and related organizations are exerting its utmost effort in all areas, for example, enhancing nuclear safety and safety culture, carrying out management innovation, and communicating with the public in order to enhance transparency. Also, the Korean government launched the Public Engagement Commission on spent nuclear fuel (SNF) management in 2013, which is tasked to initiate public consultation & discussion and submit recommendation to government after in-depth review and analysis on SNF management options by the end of 2014. Nuclear power has become very essential part of national economy in Korea because Korea has virtually no indigenous energy resources and

Development of Korean EDMG

Energy Technology Data Exchange (ETDEWEB)

Kim, Yunjung; Jee, Moonhak; Kim, Inhwan; Park, Munhee [Nuclear Safety Technology Research Laboratory, Daejeon (Korea, Republic of); Kim, Moonoh [Atomic Creative Technology, Seoul (Korea, Republic of)

2014-05-15

Safety feature is also needed to more effectively cope with site-wide events affecting multiple units. In this study, the accident mitigation approaches in US are reviewed. The most effective ways to strengthen the defense-in-depth of nuclear power installations are presented as EDMG(Extensive Damage Mitigation Guideline) and FLEX against extreme hazards such as a beyond-design-basis external event (BDBEE) that took place at Fukushima. A combination of the US EDMG and FLEX is applied to develop Korean EDMG, which will be developed to have two different types of EDMGs : 'Site EDMG' to be used for effective technical support to activated TSCs and management of corporate emergency response resources in coordination with the EOF as necessary; and 'Plant-Specific EDMG (for Extreme Event)' to be used by the Technical Support Center (TSC) of a unit where a total loss of control has occurred or plant control cannot be established from the Control Room and Remote Shutdown Panel. The development of Korean EDMG is expected to further enhance mitigation and coping capabilities against site-wide extreme hazard in Korea where a relatively large number of units are assembled on each nuclear power plant site.

Single-use surgical clothing system for reduction of airborne bacteria in the operating room.

Science.gov (United States)

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.

Job satisfaction or production? How staff and leadership understand operating room efficiency: a qualitative study.

Science.gov (United States)

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.

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)

Measuring quality indicators in the operating room: cleaning and turnover time.

Science.gov (United States)

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.

Comparison of the inspection practices in relation to the control room operator and shift supervisor licenses

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.

Science.gov (United States)

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.

Clinical Efficacy of Simulated Vitreoretinal Surgery to Prepare Surgeons for the Upcoming Intervention in the Operating Room.

Science.gov (United States)

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.

Clinical Efficacy of Simulated Vitreoretinal Surgery to Prepare Surgeons for the Upcoming Intervention in the Operating Room.

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

Development of the Korean Reference Vertical Disposal System Concept for Spent Fuels

International Nuclear Information System (INIS)

Lee, J.Y.; Cho, D.K.; Kim, S.G.; Choi, H.J.; Choi, J.W.; Hahn, P.S.

2006-01-01

The development of a deep geologic disposal system for the spent fuel from nuclear power plants has been carried out since this program was launched at 1997 in Korea. In ' this paper, a pre-conceptual design of the Korean Reference HLW Vertical disposal System (KRS-V1) is presented. Though no site for the underground repository has yet been specified in Korea, a generic site with granitic rock is considered for reference HLW repository design. Depth of the repository is assumed to be 500 meters. The repository consists of the disposal area, technical rooms with four shafts to connect them to the ground level in the controlled area and technical rooms with an access tunnel and three shafts to connect them to the ground level in the uncontrolled area. Disposal area consists of disposal tunnels, panel tunnels and a central tunnel. The repository will be excavated, operated and backfilled in several phases including an Underground Research Laboratory (URL) phase. The result of this preliminary conceptual design will be used for an evaluation of the feasibility, analyses of the long term safety, information for public communication and a cost estimation etc. (authors)

Shaping the operating room and perioperative systems of the future: innovating for improved competitiveness.

Science.gov (United States)

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

Comprehensive Surgical Coaching Enhances Surgical Skill in the Operating Room: A Randomized Controlled Trial.

Science.gov (United States)

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?

Science.gov (United States)

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.

Color Perception in Pediatric Patient Room Design: American versus Korean Pediatric Patients.

Science.gov (United States)

Phillip Park, Jin Gyu; Park, Changbae

2013-01-01

This study simultaneously addresses the issues of the scarcity of information about pediatric patient color preferences, conflicting findings about the impact of culture on color preferences, and limitations of previous research instruments. Effects of culture and gender on color preferences were investigated using American and Korean pediatric patients. Much of the existing research in environmental design has focused on environments for healthy children and adults, but those findings cannot be confidently applied to environments for pediatric patients. In previous studies, the impact of culture on color preferences has been suggested, though the effects appear to vary. Moreover, the results of previous studies were typically based on perceptions of small color chips, which are different from seeing a color on wall surfaces. Previous studies also failed to control for confounding variables such as color attributes and light sources. Instead of using color chips, this study used physical model simulation to investigate environmental color preferences in real contexts. Cultural difference was found in white. Other than white, no significant cultural difference was found. Gender differences were found across both of the groups. Korean pediatric patients showed significantly higher preference scores for white than Americans did. Other than white, both groups reported blue and green as their most preferred colors; white was the least preferred. Both groups reported similar gender effects. Overall, male patients reported significantly lower preference scores for red and purple than female patients did. These results can help healthcare providers and professionals better understand appropriate colors for pediatric populations. Evidence-based design, healing environment, patients, pediatric, satisfaction.

Major NSSS design features of the Korean next generation reactor

International Nuclear Information System (INIS)

Kim, Insk; Kim, Dong-Su

1999-01-01

In order to meet national needs for increasing electric power generation in the Republic of Korea in the 2000s, the Korean nuclear development group (KNDG) is developing a standardized evolutionary advanced light water reactor (ALWR), the Korean Next Generation Reactor (KNGR). It is an advanced version of the successful Korean Standard Nuclear Power Plant (KSNP) design, which meets utility needs for safety enhancement, performance improvement and ease of operation and maintenance. The KNGR design starts fro the proven design concept of the currently operating KSNPs with uprated power and advanced design features required by the utility. The KNGR design is currently in the final stage of the basic design, and the paper describes the major nuclear steam supply system (NSSS) design features of the KNGR together with introduction of the KNGR development program. (author)

OR.NET: multi-perspective qualitative evaluation of an integrated operating room based on IEEE 11073 SDC.

Science.gov (United States)

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.

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

Science.gov (United States)

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

2013-08-01

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

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.

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.)

Korean/Korean American Adolescents' Responses to Young Adult Fiction and Media Created by Korean/Korean Americans

Science.gov (United States)

Kim, Eunhyun

2010-01-01

Multicultural children's and young adult literature provides readers with various opportunities: to mirror their lives and reflect the meanings of their own experiences; to gain insight on social issues as well as personal issues; and to enhance cross-cultural awareness. How might Korean/Korean American youth cope with everyday life as a minority…

Operating Room Environment Control. Part A: a Valve Cannister System for Anesthetic Gas Adsorption. Part B: a State-of-the-art Survey of Laminar Flow Operating Rooms. Part C: Three Laminar Flow Experiments

Science.gov (United States)

Meyer, J. S.; Kosovich, J.

1973-01-01

An anesthetic gas flow pop-off valve canister is described that is airtight and permits the patient to breath freely. Once its release mechanism is activated, the exhaust gases are collected at a hose adapter and passed through activated coal for adsorption. A survey of laminar air flow clean rooms is presented and the installation of laminar cross flow air systems in operating rooms is recommended. Laminar flow ventilation experiments determine drying period evaporation rates for chicken intestines, sponges, and sections of pig stomach.

Uncovering the History of Operating Room Attire through Photographs.

Science.gov (United States)

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.

Mitigating operating room fires: development of a carbon dioxide fire prevention device.

Science.gov (United States)

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.

Science.gov (United States)

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.

Observation of behavioural markers of non-technical skills in the operating room and their relationship to intra-operative incidents.

Science.gov (United States)

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.

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.

Science.gov (United States)

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.

Adaptation in South Korean Society of North Korean Elite Defectors

Directory of Open Access Journals (Sweden)

Levi Nicolas

2017-10-01

Full Text Available This paper aims to explain the adaptation of North Korean elite defectors who fled from North Korea. Data used for the purpose of this article came from surveys of North Korean defectors conducted in the late 2000’s. Findings of the realized research indicate that the majority of senior defectors are experiencing less psychological and material issues when adjusting to society than regular North Korean defectors. The paper will proceed in three steps: explaining the notion of defectors, outlining their background, and focusing on their adaptation in South. Although defectors as a whole has emerged as of the most research group as a minority in South Korea, the so-called senior defectors have hardly been spotlighted. Basically North Korean senior defectors are supposed to strengthen the anti-Kim movement and legitimize the power of the South Korean government and the image of South Korea abroad. What has to be enlightened upon is the fact that North Korean senior defectors partially disagree with the integration policy of South Korean authorities. A major research question emerges: How are the experience of elite defectors localized in South Korea? How do their specific identities impact their opinion within the South Korean society? The aim of the article is also to categorize senior defectors and to provide in a single document a list of senior North Korea defectors based abroad. This kind of information is only available for Korean speaking readers. I wanted to make it accessible to the Englishspeaking community.

The operating room case-mix problem under uncertainty and nurses capacity constraints.

Science.gov (United States)

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.

Mental workload measurement in operator control room using NASA-TLX

Science.gov (United States)

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

History of Korean Neurosurgery.

Science.gov (United States)

Hwang, Sung-nam

2015-08-01

The year 2012 was the 50th anniversary of the Korean Neurosurgical Society, and in 2013, the 15th World Congress of Neurosurgery took place in Seoul, Korea. Thus, it is an appropriate occasion to introduce the world to the history of the Korean Neurosurgical Society and the foundation, development, and growth of Korean neurosurgery. Historical materials and pictures were collected and reviewed from the history book and photo albums of the Korean Neurosurgical Society. During the last 50 years, the Korean Neurosurgical Society and Korean neurosurgery have developed and grown enormously not only in quantity but also in quality. In every aspect, the turning point from the old to the new era of the Korean Neurosurgical Society and Korean neurosurgery was the year 1980. Copyright © 2015. Published by Elsevier Inc.

Guidelines for control room design reviews

International Nuclear Information System (INIS)

1981-09-01

The control room design review is part of a broad program being undertaken by the nuclear industry and the government to ensure consideration of human factors in nuclear power plant design and operation. The purpose of the control room design review described by these guidelines is to (1) review and evaluate the control room workspace, instrumentation, controls, and other equipment from a human factors engineering point of view that takes into account both system demands and operator capabilities; and (2) to identify, assess, and implement control room design modifications that correct inadequate or unsuitable items. The scope of the control room design review described by these guidelines covers the human engineering review of completed control rooms; i.e., operational control rooms or those at that stage of the licensing process where control room design and equipment selection are committed. These guidelines should also be of use during the design process for new control rooms. However, additional analyses to optimize the allocation of functions to man and machine, and further examination of advanced control system technology, are recommended for new control rooms. Guidelines and references for comprehensive system analyses designed to incorporate human factors considerations into the design and development of new control rooms are presented in Appendix B. Where possible, a generic approach to the control room design review process is encouraged; for example, when control room designs are replicated wholly or in part in two or more units. Even when designs are not replicated exactly, generic reviews which can be modified to account for specific differences in particular control rooms should be considered. Industry organizations and owners groups are encouraged to coordinate joint efforts and share data to develop generic approaches to the design review process. The control room design review should accomplish the following specific objectives. To determine

LOW ENDOPHTHALMITIS RATES AFTER INTRAVITREAL ANTI-VASCULAR ENDOTHELIAL GROWTH FACTOR INJECTIONS IN AN OPERATION ROOM

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.

Science.gov (United States)

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.

Science.gov (United States)

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.

Applying cost accounting to operating room staffing in otolaryngology: time-driven activity-based costing and outpatient adenotonsillectomy.

Science.gov (United States)

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.

Control room design

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)

Towards a performance assessment methodology using computational simulation for air distribution system designs in operating rooms

NARCIS (Netherlands)

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

What Orthopaedic Operating Room Surfaces Are Contaminated With Bioburden? A Study Using the ATP Bioluminescence Assay.

Science.gov (United States)

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.

Science.gov (United States)

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.

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.

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

Science.gov (United States)

2009-06-28

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

Use of a Hybrid Operating Room to Improve Reduction of Syndesmotic Injuries in Ankle Fractures: A Case Report.

Science.gov (United States)

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.

Simulated versus realistic intra operative radiation therapy (I.O.R.T.) treatment in operating room: from knowledge of stray radiation to action

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

Modern control room for AHWR

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.

Science.gov (United States)

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.

Learning from aviation to improve safety in the operating room - a systematic literature review

NARCIS (Netherlands)

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

Reliability analysis of operator's monitoring behavior in digital main control room of nuclear power plants and its application

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)

Workplace culture among operating room nurses.

Science.gov (United States)

Eskola, Suvi; Roos, Mervi; McCormack, Brendan; Slater, Paul; Hahtela, Nina; Suominen, Tarja

2016-09-01

To investigate the workplace culture in the Operating Room (OR) environment and the factors associated with it. In health care, the workplace culture affects the delivery and experience of care. The OR can be a stressful practice environment, where nurses might have occasionally either job stress or job satisfaction based on their competence. A quantitative cross-sectional approach was used. The study consisted of 96 Finnish OR nurses. A Nursing Context Index instrument was used to obtain data by way of an electronic questionnaire. The primary role and working unit of respondents were the main components relating to workplace culture, and especially to job stress. Nurse anaesthetists were found to be slightly more stressed than scrub nurses. In local hospitals, job stress related to workload was perceived less than in university hospitals (P = 0.001). In addition, OR nurses in local hospitals were more satisfied with their profession (P = 0.007), particularly around issues concerning adequate staffing and resources (P = 0.001). It is essential that nurse managers learn to recognise the different expressions of workplace culture. In particular, this study raises a need to recognise the factors that cause job stress to nurse anaesthetists. © 2016 John Wiley & Sons Ltd.

Time-motion analysis of clinical nursing documentation during implementation of an electronic operating room management system for ophthalmic surgery.

Science.gov (United States)

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.)

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)

Summary of component reliability data for probabilistic safety analysis of Korean standard nuclear power plant

International Nuclear Information System (INIS)

Choi, S. Y.; Han, S. H.

2004-01-01

The reliability data of Korean NPP that reflects the plant specific characteristics is necessary for PSA of Korean nuclear power plants. We have performed a study to develop the component reliability DB and S/W for component reliability analysis. Based on the system, we had have collected the component operation data and failure/repair data during plant operation data to 1998/2000 for YGN 3,4/UCN 3,4 respectively. Recently, we have upgraded the database by collecting additional data by 2002 for Korean standard nuclear power plants and performed component reliability analysis and Bayesian analysis again. In this paper, we supply the summary of component reliability data for probabilistic safety analysis of Korean standard nuclear power plant and describe the plant specific characteristics compared to the generic data

Validation of the Korean Addenbrooke's Cognitive Examination for diagnosing Alzheimer's dementia and mild cognitive impairment in the Korean elderly.

Science.gov (United States)

Heo, Jae-Hyeok; Lee, Kyoung-Min; Park, Tai-Hwan; Ahn, Jin-Young; Kim, Min-Ky

2012-01-01

The Addenbrooke's Cognitive Examination (ACE) is a valid dementia-screening test that is a simple and effective instrument. We aimed to assess the diagnostic accuracy of the Korean version of the ACE (K-ACE) in a Korean population. A total of 115 subjects (50 with Alzheimer's dementia [AD], 26 with mild cognitive impairment [MCI], and 39 controls) who visited the Neurology Outpatient Clinic of Seoul Medical Center were included. The ACE was translated and modified to create the K-ACE. The sensitivity, specificity, area under the curve, reliability, and Verbal-Language/Orientation-Memory ratio were evaluated. The receiver-operating characteristic (ROC) curve was used to determine the optimal cutoff score in screening for dementia. The ROC curves showed the superiority of the K-ACE over the Korean Mini-Mental Status Examination in the diagnosis of AD and MCI. The optimal cutoff of the K-ACE for the identification of AD was 68/69, which had a sensitivity of 90% and a specificity of 84%. The K-ACE is a short, reliable, and valid neuropsychological test battery used to screen for dementia in the Korean elderly.

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)

The Role of the Institutional Environment in the Relationship between CSR and Operational Performance: An Empirical Study in Korean Manufacturing Industries

Directory of Open Access Journals (Sweden)

Antonio K. W. Lau

2018-03-01

Full Text Available Few studies have been conducted to explore the role of the institutional environment on the relationship between corporate social responsibility (CSR and operational performance in Korea’s manufacturing industry. Therefore, this study investigates the moderating effects of four institutional uncertainties—law enforcement, regulatory uncertainty, market turbulence and competition intensity—on the relationship between CSR and operational performance. Empirical survey data from 209 Korean manufacturers was collected online and then analyzed through moderated multiple regression analyses. The results show that CSR can significantly affect operational performance, positively moderated by law enforcement and competition intensity, but not by regulatory uncertainty and market turbulence. These results advise that the different institutional environments in which CSR is implemented are particularly important to consider for optimal business operations.

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

Directory of Open Access Journals (Sweden)

H Nabavizade

2007-07-01

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

On Being There: Korean in Japan.

Science.gov (United States)

Maher, John C.; Kawanishi, Yumiko

1995-01-01

Examines the experiences of ethnic Koreans and the Korean language in Japan since 1945, focusing on Japanese attitudes toward Koreans and the Korean language, provisions for Korean and bilingual education, and the increasing influence of Koreans in Japanese society. (18 references) (MDM)

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

Control room lay-out

International Nuclear Information System (INIS)

Toma, Violeta

2004-01-01

TRIUMF (Tri-University Meson Facility) is Canada's national laboratory for particle and nuclear physics. There are 6 accelerators and 3 Control Rooms at TRIUMF. The main control room serves the big cyclotron, the 500 MeV, and the adjacent experiment. The 42 MeV and two 32 MeV ones are production dedicated. These cyclotrons belong to a private company but are operated by TRIUMF staff from ATG (Applied Technology Group) Control Room. The last is ISAC (Isotope Acceleration and Separation) Control Room, from which the LINAC is controlled. Research areas cover theoretical (2 subjects), pure (5 subjects) and applied (8 subjects) physics. In the early '70s, as the 500 MeV was being completed, the first Control Room was built in the main accelerator building. The recent topics covered by this paper are proton and pion therapy, what are the operator's duties?, the CP42, TR30 and TR13 cyclotron control rooms, the ISAC control systems including control room modification. Due to the nature of an operator's job, the Control Room layout is pretty important. This is true for any work environment, but when working shifts it becomes essential. Lots of time and effort, not to mention money, were spent to figure out the optimum configuration. It seems to me that the key factor in the control room layout is versatility, and this is because it has to keep happy a group of people with different inclinations, which have a tendency to become quite moody after the second night shift. No matter what, there will still be unhappy people, but we are trying our best. (Y. Tanaka)

Strategies of modeling the cognitive tasks of human operators for accident scenarios in nuclear power plant control rooms

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)

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

International Nuclear Information System (INIS)

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

2017-01-01

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

Towards a model of surgeons' leadership in the operating room.

Science.gov (United States)

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.

Implementation and evaluation of an interprofessional simulation-based education program for undergraduate nursing students in operating room nursing education: a randomized controlled trial.

Science.gov (United States)

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.

Room temperature continuous wave mid-infrared VCSEL operating at 3.35 μm

Science.gov (United States)

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.

Human Factors Guidance for Control Room and Digital Human-System Interface Design and Modification, Guidelines for Planning, Specification, Design, Licensing, Implementation, Training, Operation and Maintenance

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.

Human Factors Guidance for Control Room and Digital Human-System Interface Design and Modification. Guidelines for Planning, Specification, Design, Licensing, Implementation, Training, Operation and Maintenance

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

North Korean nuclear negotiation drama

International Nuclear Information System (INIS)

Kim, Jai Bok

1995-06-01

This book reports negotiation on North Korean nuclear among South Korea, North Korea and U. S. It includes an account about international issues on North Korean nuclear activities, a new aspect on the problems of North Korean nuclear, pressure on North Korea and startup for dialogue trying to solve problems by communication, investigation by IAEA, IAEA resolution and high tension on Korean peninsula with North Korean nuclear.

North Korean nuclear negotiation drama

Energy Technology Data Exchange (ETDEWEB)

Kim, Jai Bok

1995-06-15

This book reports negotiation on North Korean nuclear among South Korea, North Korea and U. S. It includes an account about international issues on North Korean nuclear activities, a new aspect on the problems of North Korean nuclear, pressure on North Korea and startup for dialogue trying to solve problems by communication, investigation by IAEA, IAEA resolution and high tension on Korean peninsula with North Korean nuclear.

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

Science.gov (United States)

Genet, Chalachew; Kibru, Gebre; Tsegaye, Wondewosen

2011-03-01

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

Effects of Economic Factors on Demand for Luxury Hotel Rooms in the U.S.

Directory of Open Access Journals (Sweden)

Xuan V. TRAN

2015-06-01

Full Text Available The purpose of this study is to estimate the effects of economic factors on the demand for luxury hotel rooms in the United States during the 16-year period (1998 - 2013. The average daily rate of six types of hotel rooms, gross domestic product and two recessions (2001 and 2007-2009 are considered as independent variables in the sample of the time series data set of 192 points to predict luxury room night stays of customers by ex-post data. Autoregressive Distributed Lag Model is employed to select the best model of luxury hotel demand on its determinants in the short and long run relationships. Findings indicate that in the long run, (1 the US residents would stay more nights in luxury hotels when their income increases; (2 the Canadian and UK might not visit or stay in the luxury hotels in the U.S. when their income or luxury hotel price increases; and (3 the German, Japanese, Korean and Chinese visitors would stay in the luxury hotels in the U.S. when their incomes increase no matter what the luxury hotel price increases. In the short run, the Chinese, Japanese, and Korean might not stay in the luxury hotels in the U.S. when their income or hotel price increases. The English would stay in the luxury hotels when their income or luxury hotel price increases. Finally, the two US economy recessions in 2001 and 2007-2009 do not affect the demand for luxury hotel rooms in the long run.

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

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

Improving operating room turnover time: a systems based approach.

Science.gov (United States)

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.

The Korean Peninsula Energy Development Organization : implications for Northeast Asian regional security co-operation?

International Nuclear Information System (INIS)

Snyder, S.

2000-01-01

This paper identifies opportunities for co-operation on regional development and security in the North Pacific region. The Korean Peninsula Energy Development Organization (KEDO) was created in 1993 during bilateral negotiations between the United States and the Democratic People's Republic of Korea (US-DPRK) over North Korea's alleged nuclear weapons program. The negotiations resulted in an agreement to freeze North Korea's known nuclear weapons program in return for the construction of two proliferation-resistant 100 MWe light water reactors (LWR) in North Korea, and the provision of 500,000 tons of heavy fuel oil per year until the completion of the LWR construction as compensation for lost energy production capacity resulting from the shutting down of North Korea's nuclear reactors. The author described the activities of KEDO and examined its internal dynamics. The unique circumstances that produced the Agreed Framework and KEDO in response to a major international crisis of the nuclear program in the DPRK were also highlighted along with the US-DPRK bilateral agreement and the multilateral institution involving the United States, South Korea, Japan and the European Union. Financial support from Australia and Canada was discussed along with the mechanism for engaging North Korea in regularized interaction and technical cooperation. It was concluded that KEDO's record of successes and failures is mixed. The energy security issue has been identified as an area that could result in conflict among Northeast Asian countries which are increasingly dependent on oil supplies from the Middle East. In response, numerous multilateral financing mechanisms have been developed to promote joint business opportunities that exploit natural gas resources in the Russian Far East to address Japanese, Korean and Chinese energy needs. 35 refs

A Satellite Based Fog Study of the Korean Peninsula

National Research Council Canada - National Science Library

McDonald, David K

2007-01-01

Fog has always been a difficult phenomenon to forecast. Its unpredictable nature and propensity to quickly decrease visibilities have had adverse effects on military operations for many years across the Korean peninsula...

Korean Adoptee Identity: Adoptive and Ethnic Identity Profiles of Adopted Korean Americans

Science.gov (United States)

Beaupre, Adam J.; Reichwald, Reed; Zhou, Xiang; Raleigh, Elizabeth; Lee, Richard M.

2015-01-01

Adopted Korean adolescents face the task of grappling with their identity as Koreans and coming to terms with their adoptive status. In order to explore these dual identities, the authors conducted a person-centered study of the identity profiles of 189 adopted Korean American adolescents. Using cluster analytic procedures, the study examined…

[Effect of dexmedetomidine on emergence agitation after general anesthesia in children undergoing odontotherapy in day-surgery operating room].

Science.gov (United States)

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.

Retrospective Chart Review of Skin-to-Skin Contact in the Operating Room and Administration of Analgesic and Anxiolytic Medication to Women After Cesarean Birth.

Science.gov (United States)

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.

Understanding Korean food culture from Korean paintings

OpenAIRE

Hae Kyung Chung; Kyung Rhan Chung; Hung Ju Kim

2016-01-01

Background: In Korea, there are many traditional foods that have developed along with the country's rich history. In addition, various food cultures have developed through agricultural traditions, ritual ceremonies, and the sharing of affection. Paintings, works of calligraphy, and music demonstrate some of these cultural characteristics of Korean foods. Further research and analysis of Korean food culture using these data sources is currently underway. Methods: This paper focuses on the c...

Future control room design (modernization of control room systems); Zukuenftiges Wartendesign (Modernisierung von Warteneinrichtungen)

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.

Operating Experience Review(OER) and development of Issues Tracking System(ITS) for Jordan Research and Training Reactor(JRTR)

International Nuclear Information System (INIS)

Kim, Yong Jun; Lee, Hyun Chul

2011-01-01

The operation of the Jordan Research and Training Reactor which Korean consortium designs will start in March 2015. Though the power level of JRTR is different from the one of HANARO, a Korean research reactor, experience and expertise gained from the successful operation of the multipurpose research reactor, HANARO, would be applied for the design of JRTR because the basic operation principles of two reactors are almost same. From the point of human factors view, Operating Experience Review (OER) has the accurate purpose of reflecting accumulated knowledge to a new design and this activity are required to perform in the beginning stage of the control room designs in nuclear facilities. OER is to identify human factors engineering (HFE) issues related to safety. The issues from operating experience provide a basis for improving the plant design in a timely way. Identified issues are reported to an issues tracking system (ITS) so as to manage and resolve issues. HFE related safety issues are to be extracted from OER. The purpose of this paper is to present the scope and methods of OER for the JRTR design. In addition, a new ITS is proposed. The ITS is effective for issue management and has simplified states for issue development and small numbers of steps for issue control

Traffic in the operating room: a review of factors influencing air flow and surgical wound contamination.

Science.gov (United States)

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.

Korean Version of Inventory of Complicated Grief Scale: Psychometric Properties in Korean Adolescents.

Science.gov (United States)

Han, Doug Hyun; Lee, Jung Jae; Moon, Duk-Soo; Cha, Myoung-Jin; Kim, Min A; Min, Seonyeong; Yang, Ji Hoon; Lee, Eun Jeong; Yoo, Seo Koo; Chung, Un-Sun

2016-01-01

We aimed to validate the Inventory of Complicated Grief (ICG)-Korean version among 1,138 Korean adolescents, representing a response rate of 57% of 1,997 students. Participants completed a set of questionnaires including demographic variables (age, sex, years of education, experience of grief), the ICG, the Children's Depression Inventory (CDI) and the Lifetime Incidence of Traumatic Events-Child (LITE-C). Exploratory factor analysis was performed to determine whether the ICG items indicated complicated grief in Korean adolescents. The internal consistency of the ICG-Korean version was Cronbach's α=0.87. The test-retest reliability for a randomly selected sample of 314 participants in 2 weeks was r=0.75 (PKaiser-Meyer-Olkin Measure of Sampling Adequacy=0.911; Bartlett's Test of Sphericity, χ(2)=13,144.7, P<0.001). After omission of 3 items, the value of Cronbach's α increased from 0.87 for the 19-item ICG-Korean version to 0.93 for the 16-item ICG-Korean version. These results suggest that the ICG is a useful tool in assessing for complicated grief in Korean adolescents. However, the 16-item version of the ICG appeared to be more valid compared to the 19-item version of the ICG. We suggest that the 16-item version of the ICG be used to screen for complicated grief in Korean adolescents.

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...

Current status and future prospects of Korean standardized nuclear power plant design

International Nuclear Information System (INIS)

Rieh, C.-H.; Park, S.-K.; Lee, B.-R.

1992-01-01

The authors reviewed a brief history of Korean nuclear industry since the first Kori-1 plant operation in 1978 with special emphasis on the NSSS and BOP design and engineering, and the design approaches for nuclear power plants in the future. Continued effort to enhance plant economy and operational safety has been made by increasing plant size, and improving safety features, systems and component reliability in various design aspects. Korean nuclear industry is now trying to be one of the major contributors to the world nuclear field in sharing nuclear technology gained from past experience and developed through internation technical cooperation programs

Koreans in Japan: Their Influence on Korean-Japanese Relations.

Science.gov (United States)

1979-09-01

1963. 31. The Republic of Korea National Red Cross, The Dispersed Families in Korea, Seoul, 1977. 32. Sato , Shoki, Koreans in Japan - The...1975. 34. Sumiya, Mikio , Kankoku no Keizai (The Korean Economy), Iwanami Shoten, Tokyo, Japan, 1974. 35. U.S. Government Printing Office, U.S. Army Area

Physician communication in the operating room: expanding application of face-negotiation theory to the health communication context.

Science.gov (United States)

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 analysis of auditory cues for inclusion in a close quarters battle room clearing operation

OpenAIRE

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...

A Comparison of Adaptation to Childhood Disability in Korean Immigrant and Korean Mothers.

Science.gov (United States)

Cho, Su-Je; Singer, George H. S.; Brenner, Betsy (Mary)

2003-01-01

A study examined the variables that exacerbated or buffered the impact of child problem behaviors and/or physical differences on 16 Korean mothers and 16 Korean American mothers of children with disabilities. Overall findings from data analyses were consistent with qualitative findings that Korean mothers experienced more difficulties than their…

Light Water Reactor Sustainability Program Operator Performance Metrics for Control Room Modernization: A Practical Guide for Early Design Evaluation

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.

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

Consideration on HRA implementation during LPSD operation

International Nuclear Information System (INIS)

Kim, Ar Ryum; Kim, Jae Whan; Jang, In Seok; Seong, Poong Hyun

2014-01-01

During low power and shutdown operation, it has been pointed out that the important of human actions is significantly increased. Because automatic control may be disabled, most control room annunciation titles indicate alarm status, and procedures are insufficient, human operators plays a much larger role during outages and in lower power state. In this regards, in order to reduce human errors and secure nuclear power plant safety, it is necessary to identify and estimate human errors during LPSD operations. However, many researchers have argued that there is no comprehensive LPSD human reliability analysis (HRA) method so far. In this study, we reviewed and implemented the existing HRA methods during LPSD operations: Korean standard HRA (K-HRA), Simplified plant analysis risk HRA (SPAR-H), Caused based decision tree (CBDT), and human cognitive reliability/ operator reliability experiments (HCR/ORE). We reviewed HRA methods based on several reports related to the unique aspects of human operator during LPSD operation and HRA requirements. In addition, the existing HRA methods were implemented during various plant operating states (POS) of LPSD operation. Loss of shutdown cooling system (SCS) was selected as initiating event. As a result of review and implementation of HRA methods, we derived the some limitations of the existing HRA methods and related procedure during loss of SCS event

Operating room fire prevention: creating an electrosurgical unit fire safety device.

Science.gov (United States)

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.

Single-Use Energy Sources and Operating Room Time for Laparoscopic Hysterectomy: A Randomized Controlled Trial.

Science.gov (United States)

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)

Job satisfaction among control room operators of electrical systems.

Science.gov (United States)

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

The influence of Triga 2000 reactor operation on the surface contamination at reactor room using smear test method

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

OpenAIRE

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...

A control room lighting study

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

Design, operation, and safety of single-room interventional MRI suites: practical experience from two centers.

Science.gov (United States)

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.

Science.gov (United States)

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.

Korean Screen Cultures

DEFF Research Database (Denmark)

Screen Cultures sets out to redress this imbalance with a broad selection of essays spanning both North and South as well as different methodological approaches, from ethnographic and audience studies to cultural materialist readings. The first section of the book, «The South», highlights popular media...... new approaches to Korean popular culture beyond national borders and includes work on K-pop and Korean television drama. This book is a vital addition to existing scholarship on Korean popular culture, offering a unique view by providing an imaginary unification of the two Koreas negotiated through...

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)

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

DEFF Research Database (Denmark)

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

2018-01-01

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

Organizational factors in Korean NPPs

International Nuclear Information System (INIS)

Jang, D. J.; Kim, Y. I.; Jeong, C. H.; Kim, J. W.

2003-01-01

Organizational factors are referred to as the factors that influence the achievement of a goal of an organization. Latent problems of an organization could contribute to causing human errors in such stages as design, operation and maintenance, and furthermore, leading to an severe accident. In order to evaluate an organization from the safety viewpoint, it is necessary to identify the organizational factors in a systematic fashion. In this paper, some efforts to identify the organizational factors in Korean NPPs are presented. The study was performed in the following steps: 1) Reviewing the definitions and range of the organizational factors used by the previous 13 researches, 2) Structuring the organizational factors by screening and collating factors, 3) Analysing the organizational factors that is considered to have contributed to the trip events based on the trip report of Korean NPPs, 4) Suggesting a more reliable taxonomy of organizational factors for event analysis by applying the Onion Structure Model to the selected factors

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

Science.gov (United States)

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

2017-06-01

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

Realizing improved patient care through human-centered operating room design: a human factors methodology for observing flow disruptions in the cardiothoracic operating room.

Science.gov (United States)

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.

IMPROVING CONTROL ROOM DESIGN AND OPERATIONS BASED ON HUMAN FACTORS ANALYSES OR HOW MUCH HUMAN FACTORS UPGRADE IS ENOUGH ?

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.

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.

Design of Korean nuclear reliability data-base network using a two-stage Bayesian concept

International Nuclear Information System (INIS)

Kim, T.W.; Jeong, K.S.; Chae, S.K.

1987-01-01

In an analysis of probabilistic risk, safety, and reliability of a nuclear power plant, the reliability data base (DB) must be established first. As the importance of the reliability data base increases, event reporting systems such as the US Nuclear Regulatory Commission's Licensee Event Report and the International Atomic Energy Agency's Incident Reporting System have been developed. In Korea, however, the systematic reliability data base is not yet available. Therefore, foreign data bases have been directly quoted in reliability analyses of Korean plants. In order to develop a reliability data base for Korean plants, the problem is which methodology is to be used, and the application limits of the selected method must be solved and clarified. After starting the commercial operation of Korea Nuclear Unit-1 (KNU-1) in 1978, six nuclear power plants have begun operation. Of these, only KNU-3 is a Canada Deuterium Uranium pressurized heavy-water reactor, and the others are all pressurized water reactors. This paper describes the proposed reliability data-base network (KNRDS) for Korean nuclear power plants in the context of two-stage Bayesian (TSB) procedure of Kaplan. It describes the concept of TSB to obtain the Korean-specific plant reliability data base, which is updated with the incorporation of both the reported generic reliability data and the operation experiences of similar plants

Variables influencing medical student learning in the operating room.

Science.gov (United States)

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

Analysis of verbal communication during teaching in the operating room and the potentials for surgical training.

Science.gov (United States)

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

Human factors methods for nuclear control room design. Volume 2. Human factors survey of control room design practices

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

Using an integrative mock-up simulation approach for evidence-based evaluation of operating room design prototypes.

Science.gov (United States)

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.

Tactical and operational decisions for operating room planning: efficiency and welfare implications.

Science.gov (United States)

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%.

Teamwork and error in the operating room: analysis of skills and roles.

Science.gov (United States)

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.

Korean Textile Firms' FDI in China: An Empirical Analysis on the Management Practices

Directory of Open Access Journals (Sweden)

Hyun-jun Cho

2005-12-01

Full Text Available China is top FDI destination for Korean Textile firms. This paper, using survey data for 41 Korean textile firms invested in China, measured their performance and analysed its determinants. Regression results show that localization of the business management, level of wages, the investment-to-employee ratio, ratio of raw materials sourced from Korea, and export ratio of the parent company have positive relations with the firm's performance. On the contrary, domestic sales (i.e. sales within China ratio is not significantly related with the performance. This survey also reveals some difficulties which Korean-invested textile firms in China usually face in the operation stages of investment. The biggest trouble is the rapid rise of production cost, and many firms feel growing competition from local competitors and have difficulties with entering local market. They also suffer from lack of skilled workers and high ratio of labor turnover. Besides, they have trouble financing operation funds in China. Meanwhile, according to the survey result, the ratio of local procurement of raw materials continues to rise rapidly, being expected to amount 77 percent within the next few years. This indicates that the export induction effect of FDI would be in a sharp decline, possibly resulting in enlargement of Korean textile industry's trade deficit with China.

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.

Assessment of Clinical Stressful Factors Among Academic Students of Nursing and Operating Room of Dezful University of Medical Sciences (2015

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.

Historic Factors Influencing Korean Higher Education. Korean Studies Series, No. 17.

Science.gov (United States)

Jeong-kyu, Lee

This book examines the religious and philosophical factors historically affecting Korean higher education, and the characteristics of contemporary Korean higher education in relation to organizational structure, leadership, and organizational culture. The book is organized into 4 parts, with 11 chapters. Part One focuses on identifying the problem…

Attitude of the Korean dentists towards radiation safety and selection criteria

International Nuclear Information System (INIS)

Lee, Byung Do; Ludlow, John B.

2013-01-01

X-ray exposure should be clinically justified and each exposure should be expected to give patients benefits. Since dental radiographic examination is one of the most frequent radiological procedures, radiation hazard becomes an important public health concern. The purpose of this study was to investigate the attitude of Korean dentists about radiation safety and use of criteria for selecting the frequency and type of radiographic examinations. The study included 267 Korean dentists. Five questions related to radiation safety were asked of each of them. These questions were about factors associated with radiation protection of patients and operators including the use of radiographic selection criteria for intraoral radiographic procedures. The frequency of prescription of routine radiographic examination (an example is a panoramic radiograph for screening process for occult disease) was 34.1%, while that of selective radiography was 64.0%. Dentists' discussion of radiation risk and benefit with patients was infrequent. More than half of the operators held the image receptor by themselves during intraoral radiographic examinations. Lead apron/thyroid collars for patient protection were used by fewer than 22% of dental offices. Rectangular collimation was utilized by fewer than 15% of dental offices. The majority of Korean dentists in the study did not practice radiation protection procedures which would be required to minimize exposure to unnecessary radiation for patients and dental professionals. Mandatory continuing professional education in radiation safety and development of Korean radiographic selection criteria is recommended.

Attitude of the Korean dentists towards radiation safety and selection criteria

Energy Technology Data Exchange (ETDEWEB)

Lee, Byung Do [Dept. of Oral and Maxillofacial Radiology and Wonkwang Dental Research Institute, College of Dentistry, Wonkwang University, Iksan (Korea, Republic of); Ludlow, John B. [Graduate Program in Oral and Maxillofacial Radiology, School of Dentistry, University of North Carolina, Chapel Hill (United States)

2013-09-15

X-ray exposure should be clinically justified and each exposure should be expected to give patients benefits. Since dental radiographic examination is one of the most frequent radiological procedures, radiation hazard becomes an important public health concern. The purpose of this study was to investigate the attitude of Korean dentists about radiation safety and use of criteria for selecting the frequency and type of radiographic examinations. The study included 267 Korean dentists. Five questions related to radiation safety were asked of each of them. These questions were about factors associated with radiation protection of patients and operators including the use of radiographic selection criteria for intraoral radiographic procedures. The frequency of prescription of routine radiographic examination (an example is a panoramic radiograph for screening process for occult disease) was 34.1%, while that of selective radiography was 64.0%. Dentists' discussion of radiation risk and benefit with patients was infrequent. More than half of the operators held the image receptor by themselves during intraoral radiographic examinations. Lead apron/thyroid collars for patient protection were used by fewer than 22% of dental offices. Rectangular collimation was utilized by fewer than 15% of dental offices. The majority of Korean dentists in the study did not practice radiation protection procedures which would be required to minimize exposure to unnecessary radiation for patients and dental professionals. Mandatory continuing professional education in radiation safety and development of Korean radiographic selection criteria is recommended.

The status of AOA and the CRUD deposition in Korean PWR

International Nuclear Information System (INIS)

Maeng, Wan Young; Choi, Byung Seon; Min, Duck Kee; Kwon, Hyung Moon; Choi, In Kyu; Yeon, Je Won; Kim, Jae Ik; Woo, Hae Seuk; Kim, Young Koo; Park, Jong Youl

2009-01-01

Korean nuclear power plants have experienced several times of AOA (Axial Offset Anomaly). AOA in Korean plants seems to be the consequence of high burn-up and long term cycle of the nuclear fuel as experienced in the foreign plants. The root cause of AOA is not clearly understood until now. Even though plants which have similar operation condition (similar thermo-hydraulic condition, water chemistry and structural materials), the AOA behavior of each plant is different from other plants. To have an understanding of the plant specific behavior of each plant and to have the countermeasures to AOA, the mechanism of CRUD deposition should be clarified. The purpose of this study is to investigate the AOA status and the CRUD characteristics in Korean power utilities. We surveyed the current AOA occurrence history and collected the Korean CRUD data which are scattered in various sources. To have some understanding on the key variables of AOA, we built experimental apparatus for CRUD deposition in simulated PWR environment. The status and the investigation plans of our experimental study are introduced in the paper

The Effect of Gender on Resident Autonomy in the Operating room.

Science.gov (United States)

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.

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

NARCIS (Netherlands)

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

2005-01-01

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

Surgeons' Leadership Styles and Team Behavior in the Operating Room.

Science.gov (United States)

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

Science.gov (United States)

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.

Science.gov (United States)

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.

Aesthetics of Korean foods: The symbol of Korean culture

Directory of Open Access Journals (Sweden)

Hae-Kyung Chung

2016-09-01

Full Text Available Advances in transportation and communication have broken down critical barriers within the global economy, pushing us towards a more unified world. In keeping with this trend, processes of communication, transportation, and production are becoming increasingly standardized, mechanized, and automated. Yet as this global era of uniformity progresses, people and individuals will inevitably encounter identity confusion. Numerous individuals, ethnicities, nationalities, and countries around the world are working to counteract such identity confusion. As globalization progresses, groups and nationalities that fail to preserve their identities will dwindle and become absorbed by stronger entities. Therefore, many societies are investing great efforts into rediscovering and revamping their indigenous traditions, cultures, and customs. When travelers visit another country, one of the simplest avenues for them to experience the local culture is food. Unlike other cultural elements, many of which have become diluted because of globalization, native cuisines are still perceived as retaining the traditions, uniqueness, and diversity of individual cultures. It is more important than ever for people and countries to expand and preserve their respective cultural currencies. In this respect, taking a cultural approach to Korean cuisine is a fascinating and meaningful endeavor. In light of the recent publication of a few articles dealing with the symbolic significance and meaning behind Korean cuisine, an effort to compile a list of the distinctive cultural properties of Korean food seems vital. Furthermore, presenting the aesthetics of Korean food through a method that integrates science and culture is a very significant task. The authors of this paper firmly believe in its potential to advance the globalization of Korean food.

Changes in safety climate and teamwork in the operating room after implementation of a revised WHO checklist: a prospective interventional study.

Science.gov (United States)

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.

Korean Variant Archive (KOVA): a reference database of genetic variations in the Korean population.

Science.gov (United States)

Lee, Sangmoon; Seo, Jihae; Park, Jinman; Nam, Jae-Yong; Choi, Ahyoung; Ignatius, Jason S; Bjornson, Robert D; Chae, Jong-Hee; Jang, In-Jin; Lee, Sanghyuk; Park, Woong-Yang; Baek, Daehyun; Choi, Murim

2017-06-27

Despite efforts to interrogate human genome variation through large-scale databases, systematic preference toward populations of Caucasian descendants has resulted in unintended reduction of power in studying non-Caucasians. Here we report a compilation of coding variants from 1,055 healthy Korean individuals (KOVA; Korean Variant Archive). The samples were sequenced to a mean depth of 75x, yielding 101 singleton variants per individual. Population genetics analysis demonstrates that the Korean population is a distinct ethnic group comparable to other discrete ethnic groups in Africa and Europe, providing a rationale for such independent genomic datasets. Indeed, KOVA conferred 22.8% increased variant filtering power in addition to Exome Aggregation Consortium (ExAC) when used on Korean exomes. Functional assessment of nonsynonymous variant supported the presence of purifying selection in Koreans. Analysis of copy number variants detected 5.2 deletions and 10.3 amplifications per individual with an increased fraction of novel variants among smaller and rarer copy number variable segments. We also report a list of germline variants that are associated with increased tumor susceptibility. This catalog can function as a critical addition to the pre-existing variant databases in pursuing genetic studies of Korean individuals.

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

Science.gov (United States)

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

2018-07-01

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

2014 Korean guidelines for appropriate utilization of cardiovascular magnetic resonance imaging: A joint report of the Korean Society of Cardiology and the Korean Society of Radiology

Energy Technology Data Exchange (ETDEWEB)

Yoon, Yeon Yee E. [Dept. of Cardiology, Cardiovascular Center, Seoul National University Bundang Hospital, Seoul (Korea, Republic of); Hong, Yoo Jin; Choi, Eui Young [Dept. of Radiology, Severance Hospital, Yonsei University College of Medicine, Seoul (Korea, Republic of); and others

2015-04-15

The use of cardiac magnetic resonance (CMR) imaging is increasing for the assessment of certain cardiovascular diseases, due to recent technical developments. CMR can give physicians information that cannot be found with other imaging modalities. However, there has been no guideline for the use of CMR in Korean people. Therefore, we have prepared a Korean guideline for the appropriate utilization of CMR to guide Korean physicians, imaging specialists, medical associates, and patients to improve the overall performances in medical system. By addressing CMR usage and creating these guidelines, we hope to contribute to the promotion of public health. This guideline is a joint report of the Korean Society of Cardiology and the Korean Society of Radiology.

2014 Korean Guidelines for Appropriate Utilization of Cardiovascular Magnetic Resonance Imaging: A Joint Report of the Korean Society of Cardiology and the Korean Society of Radiology

Energy Technology Data Exchange (ETDEWEB)

Yoon, Yeonyee E. [Department of Cardiology, Cardiovascular Center, Seoul National University Bundang Hospital, Seongnam 463-707 (Korea, Republic of); Hong, Yoo Jin [Department of Radiology, Severance Hospital, Yonsei University College of Medicine, Seoul 120-752 (Korea, Republic of); Kim, Hyung-Kwan [Division of Cardiology, Department of Internal Medicine, Cardiovascular Center, Seoul National University College of Medicine, Seoul National University Hospital, Seoul 110-744 (Korea, Republic of); Kim, Jeong A [Department of Radiology, Ilsan Paik Hospital, Inje University College of Medicine, Goyang 411-706 (Korea, Republic of); Na, Jin Oh [Cardiovascular Center, Korea University Guro Hospital, Korea University College of Medicine, Seoul 152-703 (Korea, Republic of); Yang, Dong Hyun [Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 138-736 (Korea, Republic of); Kim, Young Jin [Department of Radiology, Severance Hospital, Yonsei University College of Medicine, Seoul 120-752 (Korea, Republic of); Choi, Eui-Young [Division of Cardiology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul 135-720 (Korea, Republic of)

2014-07-01

Cardiac magnetic resonance (CMR) imaging is now widely used in several fields of cardiovascular disease assessment due to recent technical developments. CMR can give physicians information that cannot be found with other imaging modalities. However, there is no guideline which is suitable for Korean people for the use of CMR. Therefore, we have prepared a Korean guideline for the appropriate utilization of CMR to guide Korean physicians, imaging specialists, medical associates and patients to improve the overall medical system performances. By addressing CMR usage and creating these guidelines we hope to contribute towards the promotion of public health. This guideline is a joint report of the Korean Society of Cardiology and the Korean Society of Radiology.

2014 Korean guidelines for appropriate utilization of cardiovascular magnetic resonance imaging: A joint report of the Korean Society of Cardiology and the Korean Society of Radiology

International Nuclear Information System (INIS)

Yoon, Yeon Yee E.; Hong, Yoo Jin; Choi, Eui Young

2015-01-01

The use of cardiac magnetic resonance (CMR) imaging is increasing for the assessment of certain cardiovascular diseases, due to recent technical developments. CMR can give physicians information that cannot be found with other imaging modalities. However, there has been no guideline for the use of CMR in Korean people. Therefore, we have prepared a Korean guideline for the appropriate utilization of CMR to guide Korean physicians, imaging specialists, medical associates, and patients to improve the overall performances in medical system. By addressing CMR usage and creating these guidelines, we hope to contribute to the promotion of public health. This guideline is a joint report of the Korean Society of Cardiology and the Korean Society of Radiology.

Training experience to improve and reinforce associated aspects to the control room operators' behaviour in the simulator setting

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.

Science.gov (United States)

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.

Recovery Room

African Journals Online (AJOL)

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

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)

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.

Science.gov (United States)

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].

Science.gov (United States)

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.

Science.gov (United States)

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.

Problems facing Korean hospitals and possible countermeasures.

Science.gov (United States)

Kim, Kwang-Tae

2004-07-01

Korea has a unique health care system, of which the private sector comprises most of the country's health resources: 88% of the beds and 91% of specialists in Korea, but are funded by public financing, such as national health insurance and the national aid program. However, the public financing pays only 50% of actual costs and the patient's co-payment is still high. Healthcare organizations in Korea are categorized into four types; tertiary care hospitals, general hospitals, hospitals and clinics by scale of operator: number of beds. General hospitals must have 100 beds and over, and compulsorily specialties in internal medicine, surgery, obstetrics-gynecology, pediatrics, dental service, other ancillary service units and an emergency care unit. General hospitals with 300 beds and more must operate an intensive care unit. There are many challenges facing the Korean healthcare system, such as reformation of primary healthcare system, enhancing hospitals' competitiveness, and permission of for-profit hospital, introduction of private health insurance, enhancement of geriatric care. These challenges can be resolved with long-term vision, willingness and strategies of the Korean government to ensure equitable financing and access to healthcare, combined with the active participation and utilization of the private sector.

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)

Microbiological evaluation of various parameters in ophthalmic operating rooms. The need to establish guidelines.

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.

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.

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

Science.gov (United States)

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

2017-01-01

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

Analysis of Communication between Main Control Room Operators in Decision-making Process in Steam Generator Tube Rupture Accident

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)

Negotiating Colonial Korean Cinema in the Japanese Empire: From the Silent Era to the Talkies, 1923-1939

Directory of Open Access Journals (Sweden)

Chonghwa Chung

2012-12-01

Full Text Available This article examines what I call a “system of cooperation” (K. hyŏp’ŏp, J. kyōgyō, 協業 in the colonial Korean film industry from 1923, when silent films appeared, to the late 1930s, when colonial cinema was restructured within an imperial wartime system. In other words, this article examines the interworking of colonial Korean and imperial Japanese cinema from Yun Hae-dong’s “colonial modern” perspective in order to go beyond the long established lens on colonial Korean film and film historiography that merely focused on the contributions of colonial Korean filmmakers. Here the author rather focuses on the cooperation or collaboration between Japan and Korea: Japanese directors and cinematographers working in Korea, Korean filmmakers with experience in the Japanese apprenticeship system, and filmmakers working together and independently during the silent film era. During the transition from the silent to the early talkie eras, second-generation filmmakers, especially those who trained in film studios in Japan, were significant. They dreamed of the corporatization of the colonial Korean film industry and took the lead in coproductions between Japanese film companies and their colonial Korean counterparts. Korean filmmakers were not unilaterally suppressed by imperial Japan, nor did they independently operate within the Korean film industry during the colonial period. The Japanese in colonial Korea did not take the lead in forming the colonial Korean film scene, either. The core formation of colonial Korean / Korean film was a process of Korean and Japanese filmmakers in competition and negotiation with one another within a complex film sphere launched with Japanese capital and technology.

Risk-sensitive events during laparoscopic cholecystectomy : The influence of the integrated operating room and a preoperative checklist tool

NARCIS (Netherlands)

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

Risk factors and musculoskeletal complaints in non-specialized nurses, IC nurses, operation room nurses, and X-ray technologists

NARCIS (Netherlands)

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

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

50-year-old history of the Korean physical society

International Nuclear Information System (INIS)

2002-12-01

This book introduces the root of Korean physics, the dawning of Korean physics, foundation and childhood of Korean physics society, growth of Korean physics society, revival of Korean physics society, corporation Korean physics society, leap of Korean physics society and challenges towards future. It also deals with 50-year-old history of the Korean physical society according to committees, special interest groups, branches in cities and provinces, branches in universities, laboratories, society bureau, and commemoration business to celebrate 50th anniversary.

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.

Science.gov (United States)

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.

Research on transfer rule of the monitoring of operator in digital main control room of nuclear power plant

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)

General MacArthur’s Strategic Success During the Early Months of the Korean War

Science.gov (United States)

2012-05-17

Korean advance. On the evening of 30 June, Colonel Richard W. Stephens the commanding officer of the Twenty First Infantry Division woke up Lieutenant...the Fifth Regimental Combat Team arrived from Hawaii with fourteen additional Pershing tanks and the Five Fifty-Fifth Field Artillery Battalion, the...staff not pay attention to the clear indicators of a pending North Korean invasion? Today, the operational planning team leverages the collective

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

Energy Technology Data Exchange (ETDEWEB)

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

2005-07-01

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

Threats to safety during sedation outside of the operating room and the death of Michael Jackson.

Science.gov (United States)

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.

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

Science.gov (United States)

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

2016-08-05

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

Operating room fires: a closed claims analysis.

Science.gov (United States)

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.

Temperature-controlled airflow ventilation in operating rooms compared with laminar airflow and turbulent mixed airflow.

Science.gov (United States)

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

Language-specific dysgraphia in Korean stroke patients.

Science.gov (United States)

Yoon, Ji Hye; Suh, Mee Kyung; Kim, HyangHee

2010-12-01

We investigated how changes in the writing of 14 Korean stroke patients reflect the unique features of the Korean writing system. The Korean writing system, Han-geul, has both linguistic and visuospatial/constructive characteristics. In the visuospatial construction of a syllable, the component consonant(s) and vowel(s) must be arranged from top-to-bottom and/or left-to-right within the form of a square. This syllabic organization, unique to Korean writing, may distinguish dysgraphia in Korean patients from the disorder in other languages, and reveal the effects of stroke on visuospatial/constructive abilities. We compared 2 groups of patients affected by stroke, 1 group with left hemisphere (LH) lesions and the other with right hemisphere (RH) lesions. We instructed them to write from a dictation of 90 monosyllabic stimuli, each presented with a real word cue. Patients had to repeat a target syllable and a word cue, and then to write the target syllable only. Patients with LH and RH lesions produced qualitatively different error patterns. While the LH lesion group produced primarily linguistic errors, visuospatial/constructive errors predominated in the group with RH lesions. With regard to language-specific features, these Korean patients with RH lesions produced diverse visuospatial/constructive errors not commonly observed in dysgraphia of the English language. Language-specific writing errors by Korean stroke patients reflect the unique characteristics of Korean writing, which include the arrangement of strokes and graphemes within a square syllabic form by dimensional and spatial rules. These findings support the notion that the Korean writing system possesses a language-specific nature with both linguistic and visuospatial/constructive processes. Distinctive patterns of dysgraphia in the Korean language also suggest interactivity between linguistic and visuospatial/constructive levels of processing. This study is noteworthy for its systematic description of

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.

Science.gov (United States)

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

A Korean perspective on megachurches as missional churches

Directory of Open Access Journals (Sweden)

Cornelius J.P. Niemandt

2015-03-01

Full Text Available Both the megachurch and the missional church are on-going global phenomena. Working from the premise that the church has to be missional, this article operates from a Korean perspective and researches whether a megachurch can be missional. The megachurch is not simply a very large church in terms of membership or the physical size of its building(s � because of the influence of the interaction between socio-cultural, historical, and theological backgrounds, the megachurch has its own missiological and ecclesiological perspectives. The megachurch understands that the growth of an individual church implies the expansion of the kingdom of God, which means that the individual church has a responsibility to be both functionally and structurally sound, in order to ensure the efficient growth of the kingdom. This is an influential tendency that is found not only in larger size churches, but in all churches who are trying to achieve the quantitative growth of the church by way of evangelisation. The Korean megachurches, represented by the Poongsunghan Church, display these characteristics. The missional church is not simply a mission-driven church, sending many missionaries to other countries; the missional church believes that all churches are sent to the world by God, who wants to reconcile the whole universe with himself. The implication of this is that the church has to restore its missional essence in order to be able to participate in the mission of God. Thus, the missional church is a reforming movement that witnesses to God�s rule by recovering its apostolic nature. The characteristics of this movement are clearly visible in one of the case studies � the Bundang Woori Church. The importance of the missional movement for Korean churches is emphasised.Interdisciplinary and/or interdisciplinary implications: The research is a case study of Korean megachurches from a missional perspective. The research represents a critique of practises in

[Role-specific targets and teamwork in the operating room].

Science.gov (United States)

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

Female visibility through Korean literature: Feminist theological critique

Directory of Open Access Journals (Sweden)

Eun Ok Jeong

2003-10-01

Full Text Available This article introduces Korean women’s experience as seen through the lense of social and cultural backgrounds, from the premodern through to the postmodern era. Korean literature is used as a source to investigate Korean women’s experiences and perspectives. By means of feminist critique this article explores men-centered influences in Korean literature. It aims to illustrate the importance of the issue of female visibility through Korean literature from a Korean woman’s perspective. Two texts are analyzed and critiqued: the first is the myth of Korean origin. The second is a story of Gasi Gogi (a thorny fish. The article is intended to stimulate debate on gender, voices, and authority from a feminist perspective, in order to transcend the more traditional interpretations.

Comparison of the Effect of Noise Levels on Stress Response in Two Different Operation Groups in an Orthopedic Surgery Room

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

Korean Culture and Autism Spectrum Disorders

Science.gov (United States)

Kang-Yi, Christina D.; Grinker, Roy R.; Mandell, David S.

2013-01-01

This paper reviews the literature on early child development among Koreans, with a focus on autism spectrum disorders (ASD). The literature review of 951 abstracts in English, 101 abstracts in Korean and 27 full articles published from 1994 to 2011 was performed to understand the presentation of and response to ASD in Korean culture. Based on…

A Miracle That Accelerates Operating Room Functionality: Sugammadex

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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.

Acculturative Stress and Coping: Gender Differences among Korean and Korean American University Students

Science.gov (United States)

Lee, Diane Sookyoung; Padilla, Amado M.

2014-01-01

In this study we examined acculturative stress and coping among 86 students of Korean heritage at an American university. Participants indicated their stress levels on 3 scales of cultural adaptation: discrimination, language and cultural ties, and social distance. Findings show that self-identified Korean students displayed higher levels of…

Korean War Veterans by State

Data.gov (United States)

Department of Veterans Affairs — The spreadsheet of Korean War Veterans by State includes the total Korean War Veteran population for each state and broken out by age and gender. It also includes...

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

Korean Affairs Report

Science.gov (United States)

1985-09-20

Pyongyang station, the South Korean delegation boarded 16 Mercedes Benz sedans and seven buses, then headed for the Koryo Hotel. The South Korean...money-making, loudly advertising "relief of hungry children, "relief of the destitute" and "programme for the rebirth of narcotic addicts. It was with... market are twin pains these days. When they convert what they earned on the bearish stock exchange into dol- lars, their returns show minus gains

History of Korean gochu, gochujang, and kimchi

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Dae Young Kwon

2014-12-01

Full Text Available The gochu (Korean red pepper that goes into Korean traditional fermented foods such as kimchi (fermented cabbage and gochujang (spicy red pepper paste should have a mild spiciness and its Scoville heat unit (the unit that measures spiciness is <1,000. The kimchi and gochujang that are fermented only with Korean gochu can be eaten. Kimchi and gochujang cannot be prepared even with cheongyangkochu (Scoville heat unit is approximately 3,000, which is a hybrid of Korean gochu and Thai gochu. When these foods are prepared with other spicier gochu, such as Thai pepper, Southern Asian red pepper, Central American red pepper, or Mexico's aji (which is 500 times spicier than Korean gochu, they will be too spicy to consume. Biologically, Korean gochu is different from the red peppers of Central American countries (such as Mexico and Colombia, Indonesia, India, and Thailand. Therefore, the statement that the Central American red pepper came to Korea during the Japanese invasion of Korea in 1592 is not true. We can refer to a research paper in the magazine “Nature” that Korea's gochu arrived at the Korean peninsula millions of years ago, having been spread by birds. It states that gochu has evolved for millions of years, therefore, we can infer that Korean gochu existed as a completely different variety. In addition, gochujang and kimchi can be made using gochu only, which proves that people in Korea cultivated gochu thousands of years ago and have been eating it since then. Furthermore, many old Korean documents support the fact that Koreans have been planting and harvesting gochu for the last 1,500 years.

Implementation and Use of Anesthesia Information Management Systems for Non-operating Room Locations.

Science.gov (United States)

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.

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.

Operating Room Performance Improves after Proficiency-Based Virtual Reality Cataract Surgery Training

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...

In the LEAR control room

CERN Multimedia

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.

Component reliability analysis for development of component reliability DB of Korean standard NPPs

International Nuclear Information System (INIS)

Choi, S. Y.; Han, S. H.; Kim, S. H.

2002-01-01

The reliability data of Korean NPP that reflects the plant specific characteristics is necessary for PSA and Risk Informed Application. We have performed a project to develop the component reliability DB and calculate the component reliability such as failure rate and unavailability. We have collected the component operation data and failure/repair data of Korean standard NPPs. We have analyzed failure data by developing a data analysis method which incorporates the domestic data situation. And then we have compared the reliability results with the generic data for the foreign NPPs

The early Korean Protestant Churches’ impact on Korea’s democratisation: With special reference to the Korean Presbyterian Church

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Jae-Buhm Hwang

2014-06-01

Full Text Available This study examines the significant influence of the early Korean Protestant churches in general and the Korean Presbyterian Church in particular on the early phases of Korea’s democratisation. Firstly, the Western Protestant mission works in general were visibly conducive for dissemination and cultivation of egalitarian and democratic ideals, with the mission churches becoming sites of do-it-yourself democracy. Secondly, the Nevius (Mission Methods of the Korean Presbyterian Church came to foster the democratic spirit of self-support and self-government, resulting in its rapid growth. Thirdly, with the implementation of a nationwide, representative and democratic polity (presbytery with a constitution, the church even facilitated law-binding and institutional democracy for Koreans in general and Korean Christians in particular. Fourthly, the church’s democratic working deeply inspired Korean democratic politicians, especially Mr Changho Ahn, who had an important influence on the making of the Provisional Government of Korea and its Constitution.

Development of an On-Line Surgeon-Specific Operating Room Time Prediction System (Experience with the Michigan Surgical Monitors)

OpenAIRE

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.

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

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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)

AN IMPACT OF THE EFFICIENT FUNCTIONING OF THE VENTILATION AND AIR-CONDITIONING SYSTEM ON THERMAL COMFORT OF THE MEDICAL STAFF IN THE OPERATING ROOM

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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

Comparison between mixed and laminar airflow systems in operating rooms and the influence of human factors: experiences from a Swedish orthopedic center.

Science.gov (United States)

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.

“Breaking the Dam to Reunify our Country”: Alternate Histories of the Korean War in Contemporary South Korean Cinema

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Kristen Sun

2015-08-01

Full Text Available This article analyzes three contemporary South Korean films that (represent alternate histories of the Korean War: 2009 Lost Memories (2009 Rosŭt’ŭmemorichŭ (Lee Simyung (I Simyŏng, 2002, Welcome to Dongmakgol (Welk’ŏm t’u Tongmakkol (Park Kwang-hyun (Pak Kwanghyŏn, 2005, and Joint Security Area (Park Chan-wook, 2000. Despite focusing on different eras of history, I argue that they rewrite dominant narratives of the Korean War (Cold War logics of anticommunism v. communism and instead focus on North Korean- South Korean friendships/collaborations. Each film also presents similar situations in which a group of disparate “heroes” (made up of unified Koreans band together to circumvent the circumstances of division. This article analyzes historical conditions that influence the emergence of these similarly-themed films as well as film content in order to further think through memorial legacies of the Korean War, as well as to take seriously the radical possibilities of a different future that each film presents.

Augmented reality in neurovascular surgery: feasibility and first uses in the operating room.

Science.gov (United States)

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.

An experimental investigation on relationship between PSFs and operator performances in the digital main control room

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.

Evaluation of a pulsed xenon ultraviolet disinfection system to decrease bacterial contamination in operating rooms.

Science.gov (United States)

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.