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Sample records for operating room safety

  1. Improving operating room safety

    Directory of Open Access Journals (Sweden)

    Garrett Jill

    2009-11-01

    Full Text Available Abstract Despite the introduction of the Universal Protocol, patient safety in surgery remains a daily challenge in the operating room. This present study describes one community health system's efforts to improve operating room safety through human factors training and ultimately the development of a surgical checklist. Using a combination of formal training, local studies documenting operating room safety issues and peer to peer mentoring we were able to substantially change the culture of our operating room. Our efforts have prepared us for successfully implementing a standardized checklist to improve operating room safety throughout our entire system. Based on these findings we recommend a multimodal approach to improving operating room safety.

  2. Safety status system for operating room devices.

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    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.

  3. The Patient Safety Attitudes among the Operating Room Personnel

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    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.

  4. [Operating Room Nurses' Experiences of Securing for Patient Safety].

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    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.

  5. Safety culture in the gynecology robotics operating room.

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    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.

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

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    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.

  7. 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

  8. 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

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

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    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.

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

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    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.

  11. [Nursing professionals and health care assistants' perception of patient safety culture in the operating room].

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    Bernalte-Martí, Vicente; Orts-Cortés, María Isabel; Maciá-Soler, Loreto

    2015-01-01

    To assess nursing professionals and health care assistants' perceptions, opinions and behaviours on patient safety culture in the operating room of a public hospital of the Spanish National Health Service. To describe strengths and weaknesses or opportunities for improvement according to the Agency for Healthcare Research and Quality criteria, as well as to determine the number of events reported. A descriptive, cross-sectional study was conducted using the Spanish version of the questionnaire Hospital Survey on Patient Safety Culture. The sample consisted of nursing professionals, who agreed to participate voluntarily in this study and met the selection criteria. A descriptive and inferential analysis was performed depending on the nature of the variables and the application conditions of statistical tests. Significance if p < .05. In total, 74 nursing professionals responded (63.2%). No strengths were found in the operating theatre, and improvements are needed concerning staffing (64.0%), and hospital management support for patient safety (52.9%). A total of 52.3% (n = 65) gave patient safety a score from 7 to 8.99 (on a 10 point scale); 79.7% (n = 72) reported no events last year. The total variance explained by the regression model was 0.56 for "Frequency of incident reporting" and 0.26 for "Overall perception of safety". There was a more positive perception of patient safety culture at unit level. Weaknesses have been identified, and they can be used to design specific intervention activities to improve patient safety culture in other nearby operating theatres. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

  12. Enhancing operational safety

    Energy Technology Data Exchange (ETDEWEB)

    Wiebe, J S

    1997-09-01

    The presentation briefly considers the following aspects concerning enhancing operational safety of NPP: licensed control room supervision, reactivity changes, personnel access to control room, simulator training.

  13. Durable improvements in efficiency, safety, and satisfaction in the operating room.

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    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

  14. Using human factors engineering to improve patient safety in the cardiovascular operating room.

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    Gurses, Ayse P; Martinez, Elizabeth A; Bauer, Laura; Kim, George; Lubomski, Lisa H; Marsteller, Jill A; Pennathur, Priyadarshini R; Goeschel, Chris; Pronovost, Peter J; Thompson, David

    2012-01-01

    Despite significant medical advances, cardiac surgery remains a high risk procedure. Sub-optimal work system design characteristics can contribute to the risks associated with cardiac surgery. However, hazards due to work system characteristics have not been identified in the cardiovascular operating room (CVOR) in sufficient detail to guide improvement efforts. The purpose of this study was to identify and categorize hazards (anything that has the potential to cause a preventable adverse patient safety event) in the CVOR. An interdisciplinary research team used prospective hazard identification methods including direct observations, contextual inquiry, and photographing to collect data in 5 hospitals for a total 22 cardiac surgeries. We performed thematic analysis of the qualitative data guided by a work system model. 60 categories of hazards such as practice variations, high workload, non-compliance with evidence-based guidelines, not including clinicians' in medical device purchasing decisions were found. Results indicated that hazards are common in cardiac surgery and should be eliminated or mitigated to improve patient safety. To improve patient safety in the CVOR, efforts should focus on creating a culture of safety, increasing compliance with evidence based infection control practices, improving communication and teamwork, and designing better tools and technologies through partnership among all stakeholders.

  15. Learning from Aviation to Improve Safety in the Operating Room - a Systematic Literature Review

    Directory of Open Access Journals (Sweden)

    Linda S. G. L. Wauben

    2012-01-01

    Full Text Available Lessons 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 and Scopus databases were systematically searched for relevant articles written in the English language published between 2000 and 2011. In total, 25 articles were included, all within the medical domain focusing on the comparison between surgery and aviation. In order to improve safety in the OR, multiple interventions have to be implemented. Additionally, the healthcare organization has to become a ‘learning organization’ and the OR team has to become a team with shared responsibilities and flat hierarchies. Interpersonal and technical skills can be trained by means of simulation and can be supported by implementing team briefings, debriefings and cross-checks. However, further development and research is needed to prove if these solutions are useful, practical, and actually increase safety.

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

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    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.

  17. Do safety checklists improve teamwork and communication in the operating room? A systematic review.

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    Russ, Stephanie; Rout, Shantanu; Sevdalis, Nick; Moorthy, Krishna; Darzi, Ara; Vincent, Charles

    2013-12-01

    The aim of this systematic review was to assess the impact of surgical safety checklists on the quality of teamwork and communication in the operating room (OR). Safety checklists have been shown to impact positively on patient morbidity and mortality following surgery, but it is unclear whether this clinical improvement is related to an improvement in OR teamwork and communication. A systematic search strategy of MEDLINE, EMBASE, PsycINFO, Google Scholar, and the Cochrane Database for Systematic Reviews was undertaken to obtain relevant articles. After de-duplication and the addition of limits, 315 articles were screened for inclusion by 2 researchers and all articles meeting a set of prespecified inclusion criteria were retained. Information regarding the type of checklist, study design, assessment tools used, outcomes, and study limitations was extracted. Twenty articles formed the basis of this systematic review. All articles described an empirical study relating to a case-specific safety checklist for surgery as the primary intervention, with some measure of change/improvement in teamwork and/or communication relating to its use. The methods for assessing teamwork and communication varied greatly, including surveys, observations, interviews, and 360° assessments. The evidence suggests that safety checklists improve the perceived quality of OR teamwork and communication and reduce observable errors relating to poor team skills. This is likely to function through establishing an open platform for communication at the start of a procedure: encouraging the sharing of critical case-related information, promoting team coordination and decision making, flagging knowledge gaps, and enhancing team cohesion. However, the evidence would also suggest that when used suboptimally or when individuals have not bought in to the process, checklists may conversely have a negative impact on the function of the team. Safety checklists are beneficial for OR teamwork and

  18. Safety in the operating room during orthopedic trauma surgery-incidence of adverse events related to technical equipment and logistics

    NARCIS (Netherlands)

    van Delft, E. A. K.; Schepers, T.; Bonjer, H. J.; Kerkhoffs, G. M. M. J.; Goslings, J. C.; Schep, N. W. L.

    2017-01-01

    Safety in the operating room is widely debated. Adverse events during surgery are potentially dangerous for the patient and staff. The incidence of adverse events during orthopedic trauma surgery is unknown. Therefore, we performed a study to quantify the incidence of these adverse events. Primary

  19. Risk and safety of pediatric sedation/anesthesia for procedures outside the operating room.

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    Cravero, Joseph P

    2009-08-01

    Sedation and anesthesia outside the operating room represents a rapidly growing field of practice that involves a number of different specialty providers including anesthesiology. The literature surrounding this work is found in a variety of journals - many outside anesthesiology. This review is intended to inform readers about the current status of risk and safety involving sedation/anesthesia for tests and minor procedures utilizing a wide range of sources. Two large database studies have helped to define the frequency and nature of adverse events in pediatric sedation/anesthesia practice from a multispecialty perspective. A number of papers describing respiratory and hemodynamic aspects of dexmedetomidine sedation have also been published. Finally, a number of studies relating to training sedation providers, reporting of sedation adverse events, sedation for vulnerable populations, and (in particular) ketamine sedation adverse respiratory events have also come to light. The latest publications continue to document a relatively low risk to pediatric sedation yet also warn us about the potential adverse events in this field. The results help to define competencies required to deliver pediatric sedation and make this practice even safer. Particularly interesting are new jargon and methodologies for defining adverse events and the use of new methods for training sedation providers.

  20. 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

  1. Operating room manager game

    NARCIS (Netherlands)

    Hans, Elias W.; Nieberg, T.

    2007-01-01

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

  2. Relationship Between Operating Room Teamwork, Contextual Factors, and Safety Checklist Performance.

    Science.gov (United States)

    Singer, Sara J; Molina, George; Li, Zhonghe; Jiang, Wei; Nurudeen, Suliat; Kite, Julia G; Edmondson, Lizabeth; Foster, Richard; Haynes, Alex B; Berry, William R

    2016-10-01

    Studies show that using surgical safety checklists (SSCs) reduces complications. Many believe SSCs accomplish this by enhancing teamwork, but evidence is limited. Our study sought to relate teamwork to checklist performance, understand how they relate, and determine conditions that affect this relationship. Using 2 validated tools for observing and coaching operating room teams, we evaluated the association between checklist performance with surgeon buy-in and 4 domains of surgical teamwork: clinical leadership, communication, coordination, and respect. Hospital staff in 10 South Carolina hospitals observed 207 procedures between April 2011 and January 2013. We calculated levels of checklist performance, buy-in, and measures of teamwork, and evaluated their relationship, controlling for patient and case characteristics. Few teams completed most or all SSC items. Teams more often completed items considered procedural "checks" than conversation "prompts." Surgeon buy-in, clinical leadership, communication, a summary measure of teamwork overall, and observers' teamwork ratings positively related to overall checklist completion (multivariable model estimates from 0.04, p < 0.05 for communication to 0.17, p < 0.01 for surgeon buy-in). All measures of teamwork and surgeon buy-in related positively to completing more conversation prompts; none related significantly to procedural checks (estimates from 0.10, p < 0.01 for communication to 0.27, p < 0.001 for surgeon buy-in). Patient age was significantly associated with completing the checklist and prompts (p < 0.05); only case duration was positively associated with performing more checks (p < 0.10). Surgeon buy-in and surgical teamwork characterized by shared clinical leadership, open communication, active coordination, and mutual respect were critical in prompting case-related conversations, but not in completing procedural checks. Findings highlight the importance of surgeon engagement and high-quality, consistent

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

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    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.

  4. Safety measures in exposure room

    International Nuclear Information System (INIS)

    Muhammad Jamal Md Isa

    2004-01-01

    The contents of this chapter are follows - The exposure room: location and dimension, material and thickness, windows, doors and other openings; Position of the Irradiating Apparatus, Use of Space Adjoining the Room, Warning Signs/Light, Dark Room. Materials and Apparatus: Classification of Areas, Local Rules, Other General Safety Requirements

  5. Operating room data management: improving efficiency and safety in a surgical block.

    Science.gov (United States)

    Agnoletti, Vanni; Buccioli, Matteo; Padovani, Emanuele; Corso, Ruggero M; Perger, Peter; Piraccini, Emanuele; Orelli, Rebecca Levy; Maitan, Stefano; Dell'amore, Davide; Garcea, Domenico; Vicini, Claudio; Montella, Teresa Maria; Gambale, Giorgio

    2013-03-11

    European Healthcare Systems are facing a difficult period characterized by increasing costs and spending cuts due to economic problems. There is the urgent need for new tools which sustain Hospitals decision makers work. This project aimed to develop a data recording system of the surgical process of every patient within the operating theatre. The primary goal was to create a practical and easy data processing tool to give hospital managers, anesthesiologists and surgeons the information basis to increase operating theaters efficiency and patient safety. The developed data analysis tool is embedded in an Oracle Business Intelligence Environment, which processes data to simple and understandable performance tachometers and tables. The underlying data analysis is based on scientific literature and the projects teams experience with tracked data. The system login is layered and different users have access to different data outputs depending on their professional needs. The system is divided in the tree profile types Manager, Anesthesiologist and Surgeon. Every profile includes subcategories where operators can access more detailed data analyses. The first data output screen shows general information and guides the user towards more detailed data analysis. The data recording system enabled the registration of 14.675 surgical operations performed from 2009 to 2011. Raw utilization increased from 44% in 2009 to 52% in 2011. The number of high complexity surgical procedures (≥120 minutes) has increased in certain units while decreased in others. The number of unscheduled procedures performed has been reduced (from 25% in 2009 to 14% in 2011) while maintaining the same percentage of surgical procedures. The number of overtime events decreased in 2010 (23%) and in 2011 (21%) compared to 2009 (28%) and the delays expressed in minutes are almost the same (mean 78 min). The direct link found between the complexity of surgical procedures, the number of unscheduled procedures

  6. FOCUS: the Society of Cardiovascular Anesthesiologists' initiative to improve quality and safety in the cardiovascular operating room.

    Science.gov (United States)

    Barbeito, Atilio; Lau, William Travis; Weitzel, Nathaen; Abernathy, James H; Wahr, Joyce; Mark, Jonathan B

    2014-10-01

    The Society of Cardiovascular Anesthesiologists (SCA) introduced the FOCUS initiative (Flawless Operative Cardiovascular Unified Systems) in 2005 in response to the need for a rigorous scientific approach to improve quality and safety in the cardiovascular operating room (CVOR). The goal of the project, which is supported by the SCA Foundation, is to identify hazards and develop evidence-based protocols to improve cardiac surgery safety. A hazard is anything that has the potential to cause a preventable adverse event. Specifically, the strategic plan of FOCUS includes 3 goals: (1) identifying hazards in the CVOR, (2) prioritizing hazards and developing risk-reduction interventions, and (3) disseminating these interventions. Collectively, the FOCUS initiative, through the work of several groups composed of members from different disciplines such as clinical medicine, human factors engineering, industrial psychology, and organizational sociology, has identified and documented significant hazards occurring daily in our CVORs. Some examples of frequent occurrences that contribute to reduce the safety and quality of care provided to cardiac surgery patients include deficiencies in teamwork, poor OR design, incompatible technologies, and failure to adhere to best practices. Several projects are currently under way that are aimed at better understanding these hazards and developing interventions to mitigate them. The SCA, through the FOCUS initiative, has begun this journey of science-driven improvement in quality and safety. There is a long and arduous road ahead, but one we need to continue to travel.

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

    Science.gov (United States)

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

    2013-01-01

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

  8. 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.

  9. Assessing the similarity of mental models of operating room team members and implications for patient safety: a prospective, replicated study.

    Science.gov (United States)

    Nakarada-Kordic, Ivana; Weller, Jennifer M; Webster, Craig S; Cumin, David; Frampton, Christopher; Boyd, Matt; Merry, Alan F

    2016-08-31

    Patient safety depends on effective teamwork. The similarity of team members' mental models - or their shared understanding-regarding clinical tasks is likely to influence the effectiveness of teamwork. Mental models have not been measured in the complex, high-acuity environment of the operating room (OR), where professionals of different backgrounds must work together to achieve the best surgical outcome for each patient. Therefore, we aimed to explore the similarity of mental models of task sequence and of responsibility for task within multidisciplinary OR teams. We developed a computer-based card sorting tool (Momento) to capture the information on mental models in 20 six-person surgical teams, each comprised of three subteams (anaesthesia, surgery, and nursing) for two simulated laparotomies. Team members sorted 20 cards depicting key tasks according to when in the procedure each task should be performed, and which subteam was primarily responsible for each task. Within each OR team and subteam, we conducted pairwise comparisons of scores to arrive at mean similarity scores for each task. Mean similarity score for task sequence was 87 % (range 57-97 %). Mean score for responsibility for task was 70 % (range = 38-100 %), but for half of the tasks was only 51 % (range = 38-69 %). Participants believed their own subteam was primarily responsible for approximately half the tasks in each procedure. We found differences in the mental models of some OR team members about responsibility for and order of certain tasks in an emergency laparotomy. Momento is a tool that could help elucidate and better align the mental models of OR team members about surgical procedures and thereby improve teamwork and outcomes for patients.

  10. [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.

  11. Revisiting the Operating Room Basics

    Directory of Open Access Journals (Sweden)

    Tushar Chakravorty

    2015-12-01

    Full Text Available Young doctors walking into the operating room are eager to develop their skills to become efficient and knowledgeable professionals in future. But precious little is done to actively develop the basic practical skills of the budding doctors. They remain unaware about the layout of the operating room, the OR etiquette and often do not have sound scientific understanding and importance of meticulous execution of the basic operating room protocols. This article stresses the need to develop the basics of OR protocol and to improve the confidence of the young doctor by strengthening his foundation by showing him that attention to the basics of medical care and empathy for the patient can really make a difference to the outcome of a treatment.

  12. Va-Room: Motorcycle Safety.

    Science.gov (United States)

    Keller, Rosanne

    One of a series of instructional materials produced by the Literacy Council of Alaska, this booklet provides information about motorcycle safety. Using a simplified vocabulary and shorter sentences, it offers statistics concerning motorcycle accidents; information on how to choose the proper machine; basic information about the operation of the…

  13. Briefing and debriefing in the cardiac operating room. Analysis of impact on theatre team attitude and patient safety.

    Science.gov (United States)

    Papaspyros, Sotiris C; Javangula, Kalyana C; Adluri, Rajeshwara Krishna Prasad; O'Regan, David J

    2010-01-01

    Error in health services delivery has long been recognised as a significant cause of inpatient morbidity and mortality. Root-cause analyses have cited communication failure as one of the contributing factors in adverse events. The formalised fighter pilot mission brief and debrief formed the basis of the National Aeronautics and Space Administration (NASA) crew resource management (CRM) concept produced in 1979. This is a qualitative analysis of our experience with the briefing-debriefing process applied to cardiac theatres. We instituted a policy of formal operating room (OR) briefing and debriefing in all cardiac theatre sessions. The first 118 cases were reviewed. A trouble-free operation was noted in only 28 (23.7%) cases. We experienced multiple problems in 38 (32.2%) cases. A gap was identified in the second order problem solving in relation to instrument repair and maintenance. Theatre team members were interviewed and their comments were subjected to qualitative analysis. The collaborative feeling is that communication has improved. The health industry may benefit from embracing the briefing-debriefing technique as an adjunct to continuous improvement through reflective learning, deliberate practice and immediate feedback. This may be the initial step toward a substantive and sustainable organizational transformation.

  14. 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.

  15. Operational safety

    International Nuclear Information System (INIS)

    Anon.

    1977-01-01

    The PNL Safety, Standards and Compliance Program contributed to the development and issuance of safety policies, standards, and criteria; for projects in the nuclear and nonnuclear areas. During 1976 the major emphasis was on developing criteria, instruments and methods to assure that radiation exposure to occupational personnel and to people in the environs of nuclear-related facilities is maintained at the lowest level technically and economically practicable. Progress in 1976 is reported on the preparation of guidelines for radiation exposure; Pu dosimetry studies; the preparation of an environmental monitoring handbook; and emergency instrumentation preparedness

  16. Operating Room Utilization at Frederick Memorial Hospital

    National Research Council Canada - National Science Library

    Edwards, Jonathan A

    2007-01-01

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

  17. 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

  18. Operating room management and operating room productivity: the case of Germany.

    Science.gov (United States)

    Berry, Maresi; Berry-Stölzle, Thomas; Schleppers, Alexander

    2008-09-01

    We examine operating room productivity on the example of hospitals in Germany with independent anesthesiology departments. Linked to anesthesiology group literature, we use the ln(Total Surgical Time/Total Anesthesiologists Salary) as a proxy for operating room productivity. We test the association between operating room productivity and different structural, organizational and management characteristics based on survey data from 87 hospitals. Our empirical analysis links improved operating room productivity to greater operating room capacity, appropriate scheduling behavior and management methods to realign interests. From this analysis, the enforcing jurisdiction and avoiding advance over-scheduling appear to be the implementable tools for improving operating room productivity.

  19. 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)

  20. New heuristics for planning operating rooms.

    NARCIS (Netherlands)

    Molina-Pariente, J.M.; Hans, Elias W.; Framinan, J.M.; Gomez-Cia, T.

    2015-01-01

    We tackle the operating room planning problem of the Plastic Surgery and Major Burns Specialty of the University Hospital “Virgen del Rocio” in Seville (Spain). The decision problem is to assign an intervention date and an operating room to a set of surgeries on the waiting list, minimizing access

  1. Operating room fires in periocular surgery.

    Science.gov (United States)

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

    2018-06-01

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

  2. Preliminary considerations on safety of computerized control rooms

    International Nuclear Information System (INIS)

    Vittet, J.

    1983-02-01

    Safety problems are analyzed in this report by the study of the interaction: ''human behavior in a rigid environment/information overload in perturbed situation''. For pedagogy the study is presented as a research of factors influencing operator performance in a control room and a dialogue between an analyst and a conceiving engineer. Danger of all control room where the strategy for data acquisition is too rigid and without spatial reference is stressed in conclusion. Orientations for an advanced control room are outlined [fr

  3. Radiation protection in the operating room

    International Nuclear Information System (INIS)

    Kunz, B.; Stargardt, A.

    1978-01-01

    On the basis of legally provided area dose measurements and time records of fluoroscopic examinations during the operation, radiation doses to medical personnel and patients are evaluated. Adequate radiation protection measures and a careful behaviour in the operating room keep the radiation exposure to the personnel below the maximum permissible exposure. Taking into account the continuous personnel radiation monitoring and medical supervision, radiation hazards in the operating room can be considered low

  4. 76 FR 35130 - Pipeline Safety: Control Room Management/Human Factors

    Science.gov (United States)

    2011-06-16

    ...: Control Room Management/Human Factors AGENCY: Pipeline and Hazardous Materials Safety Administration... the Control Room Management/Human Factors regulations in order to realize the safety benefits sooner... FR 5536). By this amendment to the Control Room Management/Human Factors (CRM) rule, an operator must...

  5. Safety by design: effects of operating room floor marking on the position of surgical devices to promote clean air flow compliance and minimise infection risks

    NARCIS (Netherlands)

    de Korne, Dirk F.; van Wijngaarden, Jeroen D. H.; van Rooij, Jeroen; Wauben, Linda S. G. L.; Hiddema, U. Frans; Klazinga, Niek S.

    2012-01-01

    To evaluate the use of floor marking on the positioning of surgical devices within the clean air flow in an operating room (OR) to minimise infection risk. Laminar flow clean air systems are important in preventing infection in ORs but, for optimal results, surgical devices must be correctly

  6. Rethinking theatre in modern operating rooms.

    Science.gov (United States)

    Riley, Robin; Manias, Elizabeth

    2005-03-01

    Metaphor is a means through which a widely accepted meaning of a word is used in a different context to add understanding that would otherwise be difficult to conceive. Through etymological and metaphorical associations, we contend that aspects of "theatre" are still relevant in the modern operating rooms and that the use of dramaturgical metaphors can add another layer of understanding about the social reality in this setting. We begin by exploring the historical roots and derivation of the word theatre as it applied to anatomical dissection and surgery. Briefly, we touch on the work of Erving Goffman and examine how his work has been used by others to explore aspects of operating room nursing. Then, drawing on data from a postmodern ethnographic study that has been used to examine communication in operating room nursing, four dramaturgical metaphors are used to illustrate the argument. They are drama, the script and learning the lines, the show must go on, and changing between back stage and front stage. To conclude, the small amount of previously published literature on this topic is compared and contrasted, and the relevance of using dramaturgical metaphors to understand modern operating rooms is discussed. Being able to distinguish between the inherent drama in operating room work and the dramatic realisation of individuals who work within, can help operating room nurses to think differently about, and perhaps re-evaluate their social situation and how they function within it.

  7. 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

  8. Noise in the operating room

    DEFF Research Database (Denmark)

    Hasfeldt-Hansen, Dorthe; Lærkner, Eva Ann; Birkelund, Regner

    2010-01-01

    Because noise is a general stressor, noise in the OR should be avoided whenever possible. This article presents the results of a review of the research literature on the topic of noise in the OR. A systematic literature search was conducted. Eighteen relevant articles were identified...... and categorized as follows: noise levels, noise sources, staff performances, and patient’s perception of noise. Each study was assessed according to the strength of the evidence and the quality of the study. Noise levels in the OR in general exceed recommended levels, and the noise sources are related...... to equipment and staff behavior. The main effect of noise on staff performances is related to impaired communication, resulting in a negative effect on patient safety. The literature on patients’ perception of noise is both limited and inconsistent, and more research on this topic is needed....

  9. Engineering Process Monitoring for Control Room Operation

    CERN Document Server

    Bätz, M

    2001-01-01

    A major challenge in process operation is to reduce costs and increase system efficiency whereas the complexity of automated process engineering, control and monitoring systems increases continuously. To cope with this challenge the design, implementation and operation of process monitoring systems for control room operation have to be treated as an ensemble. This is only possible if the engineering of the monitoring information is focused on the production objective and is lead in close collaboration of control room teams, exploitation personnel and process specialists. In this paper some principles for the engineering of monitoring information for control room operation are developed at the example of the exploitation of a particle accelerator at the European Laboratory for Nuclear Research (CERN).

  10. 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

  11. 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...

  12. 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

  13. Enhancing operational nuclear safety

    International Nuclear Information System (INIS)

    Sengoku, Katsuhisa

    2008-01-01

    's safety standards and program which provides the safety objective following the 10 fundamental safety principles. The safety requirements defines the functional conditions required for safety and the safety guides provides user-friendly and up-to-date practical guidance representing good/best practices to fulfill the requirements. The IAEA provides safety review services and fields safety review teams upon request of member states for the regulatory, the International Regulatory Review Team (IRRT) and Operational Safety Review Team (OSART) and Peer Review of the Operational and Safety Performance Experience Review (PROSPER). The OSART programme's purpose is to assist member states in enhancing the operational safety of individual nuclear power plants and to promote the continuous development of operational safety within all member states by the dissemination of information on good practice. The OSART Mission Results (OSMIR) database contains the results from 73 OSART missions and 54 follow up visits from 1991 and its continually updated. The Asian Nuclear Safety Network (ANSN) was established to pool and share existing and new technical knowledge and practical experience to further improve the safety of nuclear installation in Asia. In summary, the enhancement of the GNSR is anchored in the recognition that all the states are in the same boat and the increasing importance of sharing and mutual learning, sharing knowledge and experience through regional and global networking. It requires joint and coordinated strategy by all states. The IAEA is willing and ready to support the GNSR through the establishment and application of safety standards, and safety review and advisory services and international instruments. (Author)

  14. 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

  15. 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)

  16. 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

  17. 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

  18. Operating experience: safety perspective

    International Nuclear Information System (INIS)

    Piplani, Vivek; Krishnamurthy, P.R.; Kumar, Neeraj; Upadhyay, Devendra

    2015-01-01

    Operating Experience (OE) provides valuable information for improving NPP safety. This may include events, precursors, deviations, deficiencies, problems, new insights to safety, good practices, lessons and corrective actions. As per INSAG-10, an OE program caters as a fundamental means for enhancing the defence-in-depth at NPPs and hence should be viewed as ‘Continuous Safety Performance Improvement Tool’. The ‘Convention on Nuclear Safety’ also recognizes the OE as a tool of high importance for enhancing the NPP safety and its Article 19 mandates each contracting party to establish an effective OE program at operating NPPs. The lessons drawn from major accidents at Three Mile Island, Chernobyl and Fukushima Daiichi NPPs had prompted nuclear stalwarts to change their safety perspective towards NPPs and to frame sound policies on issues like safety culture, severe accident prevention and mitigation. An effective OE program, besides correcting current/potential problems, help in proactively improving the NPP design, operating and maintenance procedures, practices, training, etc., and thus plays vital role in ensuring safe and efficient operation of NPPs. Further it enhances knowledge with regard to equipment operating characteristics, system performance trends and provides data for quantitative and qualitative safety analysis. Besides all above, an OE program inculcates a learning culture in the organisation and thus helps in continuously enhancing the expertise, technical competency and knowledge base of its staff. Nuclear and Radiation Facilities in India are regulated by Atomic Energy Regulatory Board (AERB). Operating Plants Safety Division (OPSD) of AERB is involved in managing operating experience activities. This paper provides insights about the operating experience program of OPSD, AERB (including its on-line data base namely OPSD STAR) and its utilisation in improving the regulations and safety at Indian NPPs/projects. (author)

  19. Operational safety reliability research

    International Nuclear Information System (INIS)

    Hall, R.E.; Boccio, J.L.

    1986-01-01

    Operating reactor events such as the TMI accident and the Salem automatic-trip failures raised the concern that during a plant's operating lifetime the reliability of systems could degrade from the design level that was considered in the licensing process. To address this concern, NRC is sponsoring the Operational Safety Reliability Research project. The objectives of this project are to identify the essential tasks of a reliability program and to evaluate the effectiveness and attributes of such a reliability program applicable to maintaining an acceptable level of safety during the operating lifetime at the plant

  20. 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.

  1. Operational and environmental safety

    International Nuclear Information System (INIS)

    Anon.

    1978-01-01

    The responsibility of the DOE Office of Operational and Environmental Safety is to assure that DOE-controlled activities are conducted in a manner that will minimize risks to the public and employees and will provide protection for property and the environment. The program supports the various energy technologies by identifying and resolving safety problems; developing and issuing safety policies, standards, and criteria; assuring compliance with DOE, Federal, and state safety regulations; and establishing procedures for reporting and investigating accidents in DOE operations. Guidelines for the radiation protection of personnel; radiation monitoring at nuclear facilities; an assessment of criticality accidents by fault tree analysis; and the preparation of environmental, safety, and health standards applicable to geothermal energy development are discussed

  2. Criteria for safety-related operator actions

    International Nuclear Information System (INIS)

    Gray, L.H.; Haas, P.M.

    1983-01-01

    The Safety-Related Operator Actions (SROA) Program was designed to provide information and data for use by NRC in assessing the performance of nuclear power plant (NPP) control room operators in responding to abnormal/emergency events. The primary effort involved collection and assessment of data from simulator training exercises and from historical records of abnormal/emergency events that have occurred in operating plants (field data). These data can be used to develop criteria for acceptability of the use of manual operator action for safety-related functions. Development of criteria for safety-related operator actions are considered

  3. 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

  4. The radiation dose dilemma in the hybrid operating room

    NARCIS (Netherlands)

    de Ruiter, QMB

    2016-01-01

    The of the hybrid Operation room (an operation room combined with advanced radiological X-ray equipment) is gaining popularity, as it is now the preferred room to perform (complex) endovascular aortic procedures. The fixed C-arms equipped in these rooms make it possible to gain very high image

  5. New technologies for information retrieval to achieve situational awareness and higher patient safety in the surgical operating room: the MRI institutional approach and review of the literature.

    Science.gov (United States)

    Kranzfelder, Michael; Schneider, Armin; Gillen, Sonja; Feussner, Hubertus

    2011-03-01

    Technical progress in the operating room (OR) increases constantly, but advanced techniques for error prevention are lacking. It has been the vision to create intelligent OR systems ("autopilot") that not only collect intraoperative data but also interpret whether the course of the operation is normal or deviating from the schedule ("situation awareness"), to recommend the adequate next steps of the intervention, and to identify imminent risky situations. Recently introduced technologies in health care for real-time data acquisition (bar code, radiofrequency identification [RFID], voice and emotion recognition) may have the potential to meet these demands. This report aims to identify, based on the authors' institutional experience and a review of the literature (MEDLINE search 2000-2010), which technologies are currently most promising for providing the required data and to describe their fields of application and potential limitations. Retrieval of information on the functional state of the peripheral devices in the OR is technically feasible by continuous sensor-based data acquisition and online analysis. Using bar code technologies, automatic instrument identification seems conceivable, with information given about the actual part of the procedure and indication of any change in the routine workflow. The dynamics of human activities also comprise key information. A promising technology for continuous personnel tracking is data acquisition with RFID. Emotional data capture and analysis in the OR are difficult. Although technically feasible, nonverbal emotion recognition is difficult to assess. In contrast, emotion recognition by speech seems to be a promising technology for further workflow prediction. The presented technologies are a first step to achieving an increased situational awareness in the OR. However, workflow definition in surgery is feasible only if the procedure is standardized, the peculiarities of the individual patient are taken into account

  6. 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.

  7. 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)

  8. 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.

  9. Prepare to protect: Operating and maintaining a tornado safe room.

    Science.gov (United States)

    Herseth, Andrew; Goldsmith-Grinspoon, Jennifer; Scott, Pataya

    2017-06-01

    Operating and maintaining a tornado safe room can be critical to the effective continuity of business operations because a firm's most valuable asset is its people. This paper describes aspects of operations and maintenance (O&M) for existing tornado safe rooms as well as a few planning and design aspects that affect the ultimate operation of a safe room for situations where a safe room is planned, but not yet constructed. The information is based on several Federal Emergency Management Agency safe room publications that provide guidance on emergency management and operations, as well as the design and construction of tornado safe rooms.

  10. 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.

  11. [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.

  12. 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.

  13. 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)

  14. 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.

  15. 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.

  16. 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

  17. 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

  18. 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.

  19. Operation safety at Ignalina NPP

    International Nuclear Information System (INIS)

    Zheltobriukh, G.

    1999-01-01

    An improvement of operational safety at Ignalina NPP covers: improvement of management structure and safety culture; symptom-based emergency operating procedures; staff training and full scope simulator; program of components ageing; metal inspection; improvement of fire safety. The first plan of Ignalina NPP Safety culture development for 1997 purposed to the SAR recommendation implementation was prepared and approved by the General Director

  20. The operating room of the future: observations and commentary.

    Science.gov (United States)

    Satava, Richard M

    2003-09-01

    The Operating Room of the Future is a construct upon which to develop the next generation of operating environments for the patient, surgeon, and operating team. Analysis of the suite of visions for the Operating Room of the Future reveals a broad set of goals, with a clear overall solution to create a safe environment for high-quality healthcare. The vision, although planned for the future, is based upon iteratively improving and integrating current systems, both technology and process. This must become the Operating Room of Today, which will require the enormous efforts described. An alternative future of the operating room, based upon emergence of disruptive technologies, is also presented.

  1. Operation Aspect of the Main Control Room of NPP

    International Nuclear Information System (INIS)

    Sahala M Lumbanraja

    2009-01-01

    The main control room of Nuclear Power Plant (NPP) is operational centre to control all of the operation activity of NPP. NPP must be operated carefully and safely. Many aspect that contributed to operation of NPP, such as man power whose operated, technology type used, ergonomic of main control room, operational management, etc. The disturbances of communication in control room must be anticipated so the high availability of NPP can be achieved. The ergonomic of the NPP control room that will be used in Indonesia must be designed suitable to anthropometric of Indonesia society. (author)

  2. Dam safety operating guidelines

    International Nuclear Information System (INIS)

    Elsayed, E.; Leung, T.; Kirkham, A.; Lum, D.

    1990-01-01

    As part of Ontario Hydro's dam structure assessment program, the hydraulic design review of several river systems has revealed that many existing dam sites, under current operating procedures, would not have sufficient discharge capacity to pass the Inflow Design Flood (IDF) without compromising the integrity of the associated structures. Typical mitigative measures usually considered in dealing with these dam sites include structural alterations, emergency action plans and/or special operating procedures designed for extreme floods. A pilot study was carried out for the Madawaska River system in eastern Ontario, which has seven Ontario Hydro dam sites in series, to develop and evaluate the effectiveness of the Dam Safety Operating Guidelines (DSOG). The DSOG consist of two components: the flood routing schedules and the minimum discharge schedules, the former of which would apply in the case of severe spring flood conditions when the maximum observed snowpack water content and the forecast rainfall depth exceed threshold values. The flood routing schedules would identify to the operator the optimal timing and/or extent of utilizing the discharge facilities at each dam site to minimize the potential for dam failures cased by overtopping anywhere in the system. It was found that the DSOG reduced the number of structures overtopped during probable maximum flood from thirteen to four, while the number of structures that could fail would be reduced from seven to two. 8 refs., 4 figs., 3 tabs

  3. Operational safety at the FFTF

    International Nuclear Information System (INIS)

    Baird, Q.L.; Hagan, J.W.; Seeman, S.E.; Baker, S.M.

    1981-02-01

    An extensive operational nuclear safety program has been an integral part of the design, startup, and initial operating phases of the Fast Flux Test Facility (FFTF). During the design and construction of the facility, a program of independent safety overviews and analyses assured the provision of responsible safety margins within the plant, protective systems, and engineered safety features for protection of the public, operating staff, and the facility. The program is continuing through surveillance of operations to verify continued adherence to the established operating envelope and for timely identification of any trends potentially adverse to those margins. Experience from operation of FFTF is being utilized in the development of enhanced operational nuclear safety aids for application in follow-on breeder reactor power systems. The commendable plant and personnel safety experiences of FFTF through its startup and ascension to full power demonstrate the overall effectiveness of the FFTF operational nuclear safety program

  4. The Operating Room of the Future Versus the Future of the Operating Room.

    Science.gov (United States)

    Kassam, Amin B; Rovin, Richard A; Walia, Sarika; Chakravarthi, Srikant; Celix, Juanita; Jennings, Jonathan; Khalili, Sammy; Gonen, Lior; Monroy-Sosa, Alejandro; Fukui, Melanie B

    2017-06-01

    Technological advancement in the operating room is evolving into a dynamic system mirroring that of the aeronautics industry. Through data visualization, information is continuously being captured, collected, and stored on a scalable informatics platform for rapid, intuitive, iterative learning. The authors believe this philosophy (paradigm) will feed into an intelligent informatics domain fully accessible to all and geared toward precision, cell-based therapy in which tissue can be targeted and interrogated in situ. In the future, the operating room will be a venue that facilitates this real-time tissue interrogation, which will guide in situ therapeutics to restore the state of health. Copyright © 2017 Elsevier Inc. All rights reserved.

  5. 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.

  6. 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)

  7. Foucault could have been an operating room nurse.

    Science.gov (United States)

    Riley, Robin; Manias, Elizabeth

    2002-08-01

    Operating room nursing is an under-researched area of nursing practice. The stereotypical image of operating room nursing is one of task- and technically-orientated aspects of practice, where nurses work in a medical model and are dominated by constraints from outside their sphere of influence. This paper explores the possibility of understanding operating room nursing in a different way. Using the work of Michel Foucault to analyse the work of operating room nursing, this paper argues the relevance of the framework for a more in-depth analysis of this specialty area of practice. The concepts of power, discipline and subjectivity are used to demonstrate how operating room nursing is constructed as a discipline and how operating room nurses act to govern and construct the specialty. Exemplars are drawn from extensive professional experience, from guidelines of professional operating room nursing associations, as well as published texts. The focus is predominantly on the regulation of space and time to maintain the integrity of the sterile surgical field and issues of management, as well as the use of the ethical concept of the 'surgical conscience'. This form of analysis provides a level and depth of inquiry that has rarely been undertaken in operating room nursing. As such, it has the potential to provide a much needed, different view of operation room nursing that can only help to strengthen its professional foundations and development.

  8. 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.

  9. Control room human engineering influences on operator performance

    International Nuclear Information System (INIS)

    Finlayson, F.C.

    1977-01-01

    Three general groups of factors influence operator performance in fulfilling their responsibilities in the control room: (1) control room and control system design, informational data displays (operator inputs) as well as control board design (for operator output); (2) operator characteristics, including those skills, mental, physical, and emotional qualities which are functions of operator selection, training, and motivation; (3) job performance guides, the prescribed operating procedures for normal and emergency operations. This paper presents some of the major results of an evaluation of the effect of human engineering on operator performance in the control room. Primary attention is given to discussion of control room and control system design influence on the operator. Brief observations on the influences of operator characteristics and job performance guides (operating procedures) on performance in the control room are also given. Under the objectives of the study, special emphasis was placed on the evaluation of the control room-operator relationships for severe emergency conditions in the power plant. Consequently, this presentation is restricted largely to material related to emergency conditions in the control room, though it is recognized that human engineering of control systems is of equal (or greater) importance for many other aspects of plant operation

  10. A BWR Safety and Operability Improvements

    International Nuclear Information System (INIS)

    Sawyer, Craig D.

    1993-01-01

    The A BWR is the culmination of 30 years of design, development and operating experience of BWRs around the world. It represents across the board improvements is safety, operation and maintenance practices (O and M), economics, radiation exposure and rad waste generation. More than ten years and $20m5 went into the design and development of its new features, and it is now under construction in Japan. This paper concentrates on the safety and operability improvements. In the safety area, more than a decade improvement in core damage frequency (CDFR) has been assessed by formal PIRA techniques, with CDFR less than 10 -6 /year. Severe accident mitigation has also been formally addressed in the design. Plant operations were simplified by incorporation of better materials, optimum use of redundancy in mechanical and electrical equipment so that on-line maintenance can be performed, by better arrangements which account for required maintenance practices, and by an advanced control room

  11. The investigation of the design of hybrid operating room

    International Nuclear Information System (INIS)

    Jiang Weihao; Li Jun

    2011-01-01

    Objective: To investigate the design of the interventional operating room that can meet the needs of modern DSA operation, and the overall arrangement of the hybrid operating room should be reasonable, practical and perspective. Methods: The experience and understanding obtained from the designing and planning of the new Building of Radiology and Surgery in authors' hospital were summarized. In order to meet the requirements of aseptic surgical practices and a full-featured hybrid operating room the following factors should be carefully and synthetically taken into account: the room size, the functional sub-areas, the operational procedures, the aseptic specification, etc. Results: The sufficient verification and scientific design were the important link for building a hybrid operating room. It could provide the surgeons and interventional physicians with more alternative operating methods and it could represent the development trend of medical technology. Conclusion: When planning and designing a new DSA operating room, various factors related to the interventional procedures, such as the room size, the functional sub-areas, the operational procedures and the aseptic specification, should be carefully and synthetically taken into account. The standard of aseptic procedure must be strictly complied with and the various functional sub-areas need to be rationally distributed. The design of hybrid operating room, which joins the functions of both open surgery and interventional management together, should be scientific, practical and perspective. (authors)

  12. 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...

  13. Building a collaborative culture in cardiothoracic operating rooms: pre and postintervention study protocol for evaluation of the implementation of teamSTEPPS training and the impact on perceived psychological safety.

    Science.gov (United States)

    Dahl, Aaron Benjamin; Ben Abdallah, Arbi; Maniar, Hersh; Avidan, Michael Simon; Bollini, Mara L; Patterson, George Alexander; Steinberg, Aaron; Scaggs, Katie; Dribin, Brenda V; Ridley, Clare H

    2017-09-27

    The importance of effective communication, a key component of teamwork, is well recognised in the healthcare setting. Establishing a culture that encourages and empowers team members to speak openly in the cardiothoracic (CT) operating room (OR) is necessary to improve patient safety in this high-risk environment. This study will take place at Barnes-Jewish Hospital, an academic hospital in affiliation with Washington University School of Medicine located in the USA. All team members participating in cardiac and thoracic OR cases during this 17-month study period will be identified by the primary surgical staff attending on the OR schedule.TeamSTEPPS (Team Strategies and Tools to Enhance Performance and Patient Safety) training course will be taught to all CT OR staff. Before TeamSTEPPS training, staff will respond to a 39-item questionnaire that includes constructs from the Agency for Healthcare Research and Quality Hospital Survey on Patient Safety Culture, Edmondson's 'Measure of psychological safety' questionnaire, and questionnaires on turnover intentions, job satisfaction and 'burnout'. The questionnaires will be readministered at 6 and 12 months.The primary outcomes to be assessed include the perceived psychological safety of CT OR team members, the overall effect of TeamSTEPPS on burnout and job satisfaction, and observed turnover rate among the OR nurses. As secondary outcomes, we will be assessing self-reported rates of medical error and near misses in the ORs with a questionnaire at the end of each case. Ethics approval is not indicated as this project does not meet the federal definitions of research requiring the oversight of the Institutional Review Board (IRB). Patient health information (PHI) will not be generated during the implementation of this project. Results of the trial will be made accessible to the public when published in a peer-reviewed journal following the completion of the study. © Article author(s) (or their employer(s) unless

  14. 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...

  15. 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.

  16. 75 FR 67450 - Pipeline Safety: Control Room Management Implementation Workshop

    Science.gov (United States)

    2010-11-02

    ... regulations to address human factors and other aspects of control room management for certain pipelines where controllers use supervisory control and data acquisition (SCADA) systems. Under the final rule, pipeline... Washington, DC on October 22, 2010. Jeffrey D. Wiese, Associate Administrator for Pipeline Safety. [FR Doc...

  17. Ventilation of nuclear rooms and operators' protection

    International Nuclear Information System (INIS)

    Vavasseur, C.

    1985-01-01

    Ventilation systems are designed to guarantee air replacement in rooms so as to evacuate gases, odors and aerosols liable to be produced therein. This air is conditioned, filtered, heated, and the relative humidity checked. At the outlet, a filtration system adapted to the type of effluent prevents the external dispersion of toxic substances. Ventilation is defined by the air change time. A comfort rule recommends reducing the velocities reaching the person present in less than 0.2 m/sec. This reduction is achieved by adjusting the natural property of the jets, induction, by means of diffusers placed at the vents

  18. 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...

  19. ITER safety and operational scenario

    International Nuclear Information System (INIS)

    Shimomura, Y.; Saji, G.

    1998-01-01

    The safety and environmental characteristics of ITER and its operational scenario are described. Fusion has built-in safety characteristics without depending on layers of safety protection systems. Safety considerations are integrated in the design by making use of the intrinsic safety characteristics of fusion adequate to the moderate hazard inventories. In addition to this, a systematic nuclear safety approach has been applied to the design of ITER. The safety assessment of the design shows how ITER will safely accommodate uncertainties, flexibility of plasma operations, and experimental components, which is fundamental in ITER, the first experimental fusion reactor. The operation of ITER will progress step by step from hydrogen plasma operation with low plasma current, low magnetic field, short pulse and low duty factor without fusion power to deuterium-tritium plasma operation with full plasma current, full magnetic field, long pulse and high duty factor with full fusion power. In each step, characteristics of plasma and optimization of plasma operation will be studied which will significantly reduce uncertainties and frequency/severity of plasma transient events in the next step. This approach enhances reliability of ITER operation. (orig.)

  20. [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

  1. 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.

  2. Operational safety - the IAEA response

    International Nuclear Information System (INIS)

    Rosen, M.

    1984-01-01

    Nuclear safety is an international issue. The role of the International Atomic Energy Agency is growing because it offers a centre for contact and exchange between East and West, North and South. New initiatives are under way to intensify international co-operative safety efforts through exchange of information on abnormal events at nuclear power plants, and through greater sharing of safety research results. Emergency preparedness also lends itself to international co-operation. A report has been prepared on the need for establishing mutual emergency assistance. By analysing possible constraints to bilateral or multinational efforts in advance, a basis for agreement at the time of an emergency is being worked out. Safety standards have been developed in several areas. The NUSS Codes and Guides, now almost complete, make available to countries starting a nuclear power programme a coherent set of nuclear safety standards. A revised set of Basic Safety Standards for Radiation Protection has been issued in 1982. (author)

  3. 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.

  4. 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

  5. Reactor operation safety information document

    Energy Technology Data Exchange (ETDEWEB)

    1990-01-01

    The report contains a reactor facility description which includes K, P, and L reactor sites, structures, operating systems, engineered safety systems, support systems, and process and effluent monitoring systems; an accident analysis section which includes cooling system anomalies, radioactive materials releases, and anticipated transients without scram; a summary of onsite doses from design basis accidents; severe accident analysis (reactor core disruption); a description of operating contractor organization and emergency planning; and a summary of reactor safety evolution. (MB)

  6. 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

  7. Intelligent systems supporting the control room operators

    International Nuclear Information System (INIS)

    Berger, E.

    1997-01-01

    The operational experience obtained with the various applications of the systems discussed in this paper shows that more consequent use of the systems will make detection and management of disturbances still more efficient and faster. This holds true both for a low level of process automation and for power plants with a high level of automation. As for conventional power plants, the trend clearly is towards higher degrees of automation and consequent application of supporting systems. Thus, higher availability and rapid failure management are achieved, at low effects on normal operation. These systems are monitoring and process control systems, expert systems, and systems for optimal use of the equipment, or systems for post-incident analyses and computer-assisted on-shift protocols, or operating manuals. (orig./CB) [de

  8. 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

  9. Operating procedures and safety culture

    International Nuclear Information System (INIS)

    Carnino, A.

    1993-01-01

    The development of new technologies in recent years has led to a tremendous increase in the information to be mastered by operators in industrial processes. The information at operators disposal both in routine situations and accidental ones needs to be well prepared and organized to ensure reliability and safety. The man-machine interface should give operators all the necessary and clear indications on the process status and evolution so that the operators can operate the installation through adequate procedures. Procedures represent the real interface and mode of action of the operators on the machine, and they are of prime importance. Although they are by essence quite different, the routine, accident, and emergency procedures have in common one attribute: They all require a good safety culture both in their development and their implementation. From the definition given by the members of the International Nuclear Safety Advisory Group (INSAG), open-quotes Safety culture is that assembly of characteristics and attitudes in organizations and individuals which establishes that, as an overriding priority, nuclear plant safety issues receive the attention warranted by their significance,close quotes one can see that two aspects are embedded, a collective attitude that in fact is reflected in the managerial framework and an individual one that is linked to personnel behavior and work practices

  10. 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.

  11. 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.

  12. 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)

  13. 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

  14. 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...

  15. [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.

  16. 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.

  17. 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.

  18. 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...

  19. 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

  20. 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

  1. 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

  2. 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

  3. 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

  4. 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.

  5. Operating plant safety analysis needs

    International Nuclear Information System (INIS)

    Young, M.Y.; Love, D.S.

    1992-01-01

    The primary objective for nuclear power station owners is to operate and manage their plants safely. However, there is also a need to provide economical electric power, which requires that the unit be operated as efficiently as possible, consistent with the safety requirements. The objectives cited above can be achieved through the identification and use of available margins inherent in the plant design. As a result of conservative licensing and analytical approaches taken in the past, many of these margins may be found in the safety analysis limits within which plants currently operate. Improvements in the accuracy of the safety analysis, and a more realistic treatment of plant initial and boundary conditions, can make this margin available for a variety of uses which enhance plant performance, help to reduce O and M costs, and may help to extend licensed operation. Opportunities for improvement exist in several areas in the accident analysis normally performed for Chapter 15 of the FSAR. For example, recent modifications to the ECCS rule, 10CFR50.46 and Appendix K, allow use of margins previously unavailable in the analysis of the Loss of Coolant Accident (LOCA). To take advantage of this regulatory change, new methods are being developed to analyze both the large and small break loss of coolant accident (LOCA). As this margin is used, enhancements in the analysis of other transients will become necessary. The paper discusses accident analysis methods, future development needs, and analysis margin utilization in specific accident scenarios

  6. 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.

  7. Improving safety margins for control room habitability, through heating/ventilation/air conditioning modifications

    International Nuclear Information System (INIS)

    Beach, D.R.; Fillingim, W.; Bell, G.; Eurich, R.G.

    1989-01-01

    The Fort Calhoun power station began operation in September 1973. Since that time, modifications to the plant have required the addition of a substantial number of electrical and control components in the control room, which has resulted in an increased heat load in this area. Additionally, NUREG-0737, Item III.D.3.4, imposed requirements on the ventilating system related to protection of personnel from the effects of toxic and radioactive gas releases, which were not considered in the original design. Omaha Public Power District (OPPD) has recently undertaken a major modification to the Fort Calhoun station control room ventilating system to improve the safety margins for control room habitability. The goals of the modification were to achieve adequate cooling capacity with fully redundant equipment, improve habitability under accident conditions, and eliminate several potential problems related to steam line break and equipment qualification. Additionally, the scope of the project grew as design problems emerged

  8. 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

  9. 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)

  10. 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)

  11. 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)

  12. 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.

  13. 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.

  14. 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.

  15. 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.

  16. 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)

  17. Complementing Operating Room Teaching With Video-Based Coaching.

    Science.gov (United States)

    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.

  18. Start time delays in operating room: Different perspectives

    Directory of Open Access Journals (Sweden)

    Babita Gupta

    2011-01-01

    Full Text Available Background: Healthcare expenditure is a serious concern, with escalating costs failing to meet the expectations of quality care. The treatment capacities are limited in a hospital setting and the operating rooms (ORs. Their optimal utilization is vital in efficient hospital management. Starting late means considerable wait time for staff, patients and waste of resources. We planned an audit to assess different perspectives of the residents in surgical specialities and anesthesia and OR staff nurses so as to know the causative factors of operative delay. This can help develop a practical model to decrease start time delays in operating room (ORs. Aims: An audit to assess different perspectives of the Operating room (OR staff with respect to the varied causative factors of operative delay in the OR. To aid in the development of a practical model to decrease start time delays in ORs and facilitate on-time starts at Jai Prakash Narayan Apex Trauma centre (JPNATC, All India Institute of Medical Sciences (AIIMS, New Delhi. Methods: We prepared a questionnaire seeking the five main reasons of delay as per their perspective. Results: The available data was analysed. Analysis of the data demonstrated the common causative factors in start time operative delays as: a lack of proper planning, deficiencies in team work, communication gap and limited availability of trained supporting staff. Conclusions: The preparation of the equipment and required material for the OR cases must be done well in advance. Utilization of newer technology enables timely booking and scheduling of cases. Improved inter-departmental coordination and compliance with preanesthetic instructions needs to be ensured. It is essential that the anesthesiologists perform their work promptly, well in time . and supervise the proceedings as the OR manager. This audit is a step forward in defining the need of effective OR planning for continuous quality improvement.

  19. 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.

  20. 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.

  1. Operational safety of nuclear power plants

    International Nuclear Information System (INIS)

    Tanguy, P.

    1987-01-01

    The operational safety of nuclear power plants has become an important safety issue since the Chernobyl accident. A description is given of the various aspects of operational safety, including the importance of human factors, responsibility, the role and training of the operator, the operator-machine interface, commissioning and operating procedures, experience feedback, and maintenance. The lessons to be learnt from Chernobyl are considered with respect to operator errors and the management of severe accidents. Training of personnel, operating experience feedback, actions to be taken in case of severe accidents, and international cooperation in the field of operational safety, are also discussed. (U.K.)

  2. 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

  3. 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.

  4. 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.

  5. 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)

  6. 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.

  7. 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.

  8. 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

  9. 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.

  10. 75 FR 5536 - Pipeline Safety: Control Room Management/Human Factors, Correction

    Science.gov (United States)

    2010-02-03

    ... DEPARTMENT OF TRANSPORTATION Pipeline and Hazardous Materials Safety Administration 49 CFR Parts...: Control Room Management/Human Factors, Correction AGENCY: Pipeline and Hazardous Materials Safety... following correcting amendments: PART 192--TRANSPORTATION OF NATURAL AND OTHER GAS BY PIPELINE: MINIMUM...

  11. 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

  12. Operator Actions Within a Safety Instrumented Function

    International Nuclear Information System (INIS)

    Suttinger, L.T.

    2002-01-01

    This paper presents an overview of the factors that should be considered when crediting operator action for performing a safety function or being a part of the process of enabling a safety function. Criteria for evaluating operator action, such as required time response and operator training among others, are discussed. The paper will address these and other factors that should be considered when determining the reliability of the operator to respond and perform his/her part of the safety function. The entire safety function includes the operator and the reliability of the instrumented system that provides the alarm or indication, the final control element, and support systems. The integration of the operator performance with the hardware safety availability, including the effects of the supporting systems is discussed. The analysis of these factors will provide the justification for the amount of risk reduction or safety integrity level that can be credited for the Safety Instrumented Function (SIF), including operator action

  13. Operation safety of complex industrial systems

    International Nuclear Information System (INIS)

    Zwingelstein, G.

    1999-01-01

    Zero fault or zero risk is an unreachable goal in industrial activities like nuclear activities. However, methods and techniques exist to reduce the risks to the lowest possible and acceptable level. The operation safety consists in the recognition, evaluation, prediction, measurement and mastery of technological and human faults. This paper analyses each of these points successively: 1 - evolution of operation safety; 2 - definitions and basic concepts: failure, missions and functions of a system and of its components, basic concepts and operation safety; 3 - forecasting analysis of operation safety: reliability data, data-banks, precautions for the use of experience feedback data; realization of an operation safety study: management of operation safety, quality assurance, critical review and audit of operation safety studies; 6 - conclusions. (J.S.)

  14. 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.

  15. 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.

  16. 75 FR 69912 - Pipeline Safety: Control Room Management/Human Factors

    Science.gov (United States)

    2010-11-16

    ... 192 and 195 [Docket ID PHMSA-2007-27954] RIN 2137-AE64 Pipeline Safety: Control Room Management/Human... Control Room Management/Human Factors rule at 49 CFR 192.631 and 195.446. The NPRM proposes to expedite... rule and to engage in open discussions with the agency at PHMSA's Control Room Management...

  17. Safety aspects of cryochamber operation

    Science.gov (United States)

    Chorowski, M.; Piotrowska, A.; Sieron, A.; Stanek, A.

    2014-01-01

    Local and whole body cryotherapy is well recognized, developed and appreciated both from medical and technical point of view. Poland is a country with a highest number of medical cryochambers in operation (above 200) and more than 3 millions of whole body cryotherapeutic sessions have been performed since 1989. Cryogenic temperatures applied for whole-body apart from medical effects have also significant influence on patient's psyche. A number of cryochambers is constantly increasing in hospitals, sport centers and spas. A temperature inside a cryochamber should be below 150 K. To achieve and stabilize such low temperature, either cascade compressor unit or liquid cryogens evaporation (N2 or synthetic air) are used. This paper presents safety oriented review of cryochamber design and constructions.

  18. Safety aspects of cryochamber operation

    Energy Technology Data Exchange (ETDEWEB)

    Chorowski, M.; Piotrowska, A. [Wroclaw University of Technology, Institute of Aviation, Processing and Power Machines Engineering, Process Control and Cryogenics Group, Wybrzeze Wyspianskiego 27, 50-370 Wroclaw (Poland); Sieron, A.; Stanek, A. [Medical University of Silesia, Department and Clinic of Internal Diseases, Angiology and Physiacal Medicine in Bytom (Poland)

    2014-01-29

    Local and whole body cryotherapy is well recognized, developed and appreciated both from medical and technical point of view. Poland is a country with a highest number of medical cryochambers in operation (above 200) and more than 3 millions of whole body cryotherapeutic sessions have been performed since 1989. Cryogenic temperatures applied for whole-body apart from medical effects have also significant influence on patient's psyche. A number of cryochambers is constantly increasing in hospitals, sport centers and spas. A temperature inside a cryochamber should be below 150 K. To achieve and stabilize such low temperature, either cascade compressor unit or liquid cryogens evaporation (N{sub 2} or synthetic air) are used. This paper presents safety oriented review of cryochamber design and constructions.

  19. Safety aspects of cryochamber operation

    International Nuclear Information System (INIS)

    Chorowski, M.; Piotrowska, A.; Sieron, A.; Stanek, A.

    2014-01-01

    Local and whole body cryotherapy is well recognized, developed and appreciated both from medical and technical point of view. Poland is a country with a highest number of medical cryochambers in operation (above 200) and more than 3 millions of whole body cryotherapeutic sessions have been performed since 1989. Cryogenic temperatures applied for whole-body apart from medical effects have also significant influence on patient's psyche. A number of cryochambers is constantly increasing in hospitals, sport centers and spas. A temperature inside a cryochamber should be below 150 K. To achieve and stabilize such low temperature, either cascade compressor unit or liquid cryogens evaporation (N 2 or synthetic air) are used. This paper presents safety oriented review of cryochamber design and constructions

  20. 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

  1. 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

  2. Safety of nuclear power plants: Operation. Safety requirements

    International Nuclear Information System (INIS)

    2004-01-01

    The safety of a nuclear power plant is ensured by means of its proper siting, design, construction and commissioning, followed by the proper management and operation of the plant. In a later phase, proper decommissioning is required. This Safety Requirements publication supersedes the Code on the Safety of Nuclear Power Plants: Operation, which was issued in 1988 as Safety Series No. 50-C-O (Rev. 1). The purpose of this revision was: to restructure Safety Series No. 50-C-O (Rev. 1) in the light of the basic objectives, concepts and principles in the Safety Fundamentals publication The Safety of Nuclear Installations. To be consistent with the requirements of the International Basic Safety Standards for Protection against Ionizing Radiation and for the Safety of Radiation Sources. And to reflect current practice and new concepts and technical developments. Guidance on fulfillment of these Safety Requirements may be found in the appropriate Safety Guides relating to plant operation. The objective of this publication is to establish the requirements which, in the light of experience and the present state of technology, must be satisfied to ensure the safe operation of nuclear power plants. These requirements are governed by the basic objectives, concepts and principles that are presented in the Safety Fundamentals publication The Safety of Nuclear Installations. This publication deals with matters specific to the safe operation of land based stationary thermal neutron nuclear power plants, and also covers their commissioning and subsequent decommissioning

  3. Safety of nuclear power plants: Operation. Safety requirements

    International Nuclear Information System (INIS)

    2003-01-01

    The safety of a nuclear power plant is ensured by means of its proper siting, design, construction and commissioning, followed by the proper management and operation of the plant. In a later phase, proper decommissioning is required. This Safety Requirements publication supersedes the Code on the Safety of Nuclear Power Plants: Operation, which was issued in 1988 as Safety Series No. 50-C-O (Rev. 1). The purpose of this revision was: to restructure Safety Series No. 50-C-O (Rev. 1) in the light of the basic objectives, concepts and principles in the Safety Fundamentals publication The Safety of Nuclear Installations. To be consistent with the requirements of the International Basic Safety Standards for Protection against Ionizing Radiation and for the Safety of Radiation Sources. And to reflect current practice and new concepts and technical developments. Guidance on fulfillment of these Safety Requirements may be found in the appropriate Safety Guides relating to plant operation. The objective of this publication is to establish the requirements which, in the light of experience and the present state of technology, must be satisfied to ensure the safe operation of nuclear power plants. These requirements are governed by the basic objectives, concepts and principles that are presented in the Safety Fundamentals publication The Safety of Nuclear Installations. This publication deals with matters specific to the safe operation of land based stationary thermal neutron nuclear power plants, and also covers their commissioning and subsequent decommissioning

  4. Safety of nuclear power plants: Operation. Safety requirements

    International Nuclear Information System (INIS)

    2000-01-01

    The safety of a nuclear power plant is ensured by means of its proper siting, design, construction and commissioning, followed by the proper management and operation of the plant. In a later phase, proper decommissioning is required. This Safety Requirements publication supersedes the Code on the Safety of Nuclear Power Plants: Operation, which was issued in 1988 as Safety Series No. 50-C-O (Rev. 1). The purpose of this revision was: to restructure Safety Series No. 50-C-O (Rev. 1) in the light of the basic objectives, concepts and principles in the Safety Fundamentals publication The Safety of Nuclear Installations; to be consistent with the requirements of the International Basic Safety Standards for Protection against Ionizing Radiation and for the Safety of Radiation Sources; and to reflect current practice and new concepts and technical developments. Guidance on fulfillment of these Safety Requirements may be found in the appropriate Safety Guides relating to plant operation. The objective of this publication is to establish the requirements which, in the light of experience and the present state of technology, must be satisfied to ensure the safe operation of nuclear power plants. These requirements are governed by the basic objectives, concepts and principles that are presented in the Safety Fundamentals publication The Safety of Nuclear Installations. This publication deals with matters specific to the safe operation of land based stationary thermal neutron nuclear power plants, and also covers their commissioning and subsequent decommissioning

  5. Improving safety through an integrated approach for advanced control room development

    International Nuclear Information System (INIS)

    Haugset, K.; Berg, O.; Foerdestroemmen, N.T.; Kvalem, J.; Nelson, W.R.

    1990-01-01

    With the fast development of computer technology, the potential exists for improving operational safety of nuclear plants by using advanced operator tools in the control room. Specific systems are being introduced, such as systems for alarm handling, failure detection, disturbance diagnosis, procedural advice and others, often based on process modeling techniques or expert system technology. To ensure a maximum benefit from the new technology, a careful integration of the various systems must, however, take place, resulting in a well coordinated interface between the operator and the process. The OECD Halden Reactor Project has started the development of an Integrated Surveillance And Control System (ISACS). The basis for the activity is the experience at Halden in developing specific Computerized Operator Support Systems (COSSs), and the activity around the experimental control room HAMMLAB where detailed validations of operator tools have been performed for a number of years. The first goal in the ISACS project is to have a first, limited prototype in operation at the end of 1990. Validation experiments will follow

  6. Improving safety through an integrated approach for advanced control room development

    International Nuclear Information System (INIS)

    Haugset, K.; Berg, O.; Bologna, S.; Foerdestroemmen, N.T.; Kvalem, J.; Nelson, W.R.; Yamane, N.

    1992-01-01

    With the fast development of computer technology, the potential exists for improving operational safety of nuclear plants by using advanced operator tools in the control room. Specific systems are being introduced, such as systems for alarm handling, failure detection, disturbance diagnosis, procedural advice and others, often based on process modeling techniques or expert system technology. To ensure a maximum benefit from the new technology, a careful integration of the various systems must, however, take place, resulting in a well coordinated interface between the operator and the process. The OECD Halden Reactor Project has started the development of an Integrated Surveillance And Control System (ISACS). The basis for the activity is the experience at Halden in developing specific Computerized Operator Support Systems (COSSs), and the activity around the experimental control room HAMMLAB where detailed validations of operator tools have been performed for a number of years. The first goal in the ISACS project is to have a first, limited prototype in operation at the end of 1990. Validation experiments will follow. (orig.)

  7. Operational safety improvement in OPR 1000

    International Nuclear Information System (INIS)

    Jung, Y.-E.

    2005-01-01

    Nuclear power operating experience management might be an important factor for the operational safety improvement. KHNP's nuclear information management system, called KONIS receives, distributes and manages all nuclear information from domestic and foreign, especially operating experience. Ulchin 3 and 4, the first units of OPR 1000 series operates several organizations regarding management of operating experience e.g. specialist group program, various task forces, equipment specialist system for operator, etc. Peer review is another contribution for nuclear safety. (author)

  8. 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.

  9. 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)

  10. 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.

  11. 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.

  12. 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.

  13. 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

  14. Operations and maintenance - Safety challenges

    Energy Technology Data Exchange (ETDEWEB)

    Nielsen, Liv [Oljedirektoratet, Stavanger (Norway)

    1999-07-01

    With the unsteady oil prices and the possible consequences of the deregulation of the European energy markets one may expect further optimization of operating and maintenance costs. One may also expect extended use of various risk-based optimization techniques such as RCM (Reliability Centered Maintenance) and RBI (Risk Based Inspection). This presentation addresses the need for further research and development in this area. Maintenance work is necessary, but it can also create risk. The accident statistics show many examples of this. The Norwegian petroleum industry's ability to learn from previous incidents is questioned. Maintenance staff must be well trained and possess the necessary routines. Technical documentation must be updated. Uncertainties with respect to future oil and gas prices combined with the effect of the deregulation of the European energy markets will lead to even more focus on cost-effective operations and maintenance. The need for long-term research and development is stressed. Risk based techniques such as RCM and RBI are extensively used in the defence industry and the nuclear industry, but applying them to the petroleum industry requires improved risk models. Ageing effects such as corrosion, erosion, fatigue etc. can be expected, but the capability to predict, monitor and control them should be improved. At present, not even the most sophisticated risk analysis can model ageing effects. The importance of efficient use of information technology (IT) is stressed. Improving the product quality and safety often requires new technology and so research and development is important. Close cooperation with the industry is required.

  15. 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

  16. 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.

  17. 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.

  18. 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.

  19. 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.

  20. 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.

  1. 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.

  2. 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.

  3. The operator's role and safety functions

    International Nuclear Information System (INIS)

    Corcoran, W.R.; Finnicum, D.J.; Hubbard, F.R.; Musick, C.R.; Walzer, R.F.

    1980-01-01

    A nuclear power plant can be thought of as a single system with two major subsystems: equipment and people. Both play important roles in nuclear safety. Whereas, in the past, the role of equipment had been emphasized in nuclear safety, the accident at Three Mile Island and its subsequent investigations point out the vital role of the operator. This paper outlines the operator's roles in nuclear safety and suggests how the concept of safety functions can be used to reduce economic losses and increase safety margins. (auth)

  4. The critical safety functions and plant operation

    International Nuclear Information System (INIS)

    Corcoran, W.R.; Church, J.F.; Cross, M.T.; Guinn, W.M.; Porter, N.J.

    1981-01-01

    The operator's role in nuclear safety is outlined and the concept of ''safety functions'' introduced. Safety functions are a group of actions that prevent core melt or minimize radiation releases to the general public. They can be used to provide a hierarchy of practical plant protection that an operator should use. The plant safety evaluation uses four inputs in predicting the results of an event: the event initiator, the plant design, the initial plant conditions and setup, and the operator actions. If any of these inputs are not as assumed in the evaluation, confidence that the consequences will be as predicted is reduced. Based on the safety evaluation, the operator has three roles in assuring that the consequences of an event will be no worse than the predicted acceptable results: Maintain plant setup in readiness to properly respond. Operate the plant in a manner such that fewer, milder events minimize the frequency and the severity of adverse events. Monitor the plant to verify that the safety functions are accomplished. The operator needs a systematic approach to mitigating the consequences of an event. The concept of safety functions introduces this systematic approach and presents a hierarchy of protection. If the operator has difficulty identifying an event for any reason, the systematic safety function approach allows accomplishing the overall path of mitigating consequences. Ten functions designed to protect against core melt, preserve containment integrity, prevent indirect release of radioactivity, and maintain vital auxiliaries needed to support the other safety functions are identified

  5. Nuclear safety: an operational constraint or necessity

    International Nuclear Information System (INIS)

    Gauvenet, A.

    1983-01-01

    Different aspects of the nuclear safety in the operation of power stations are analysed. There is always a danger that safety is considered as a constraint at operator level, but it is essential that human factors and working conditions be taken into consideration [fr

  6. 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)

  7. International cooperation for operating safety

    International Nuclear Information System (INIS)

    Dupuis, M.C.

    1989-03-01

    The international-cooperation organization in nuclear safety domain is discussed. The nuclear energy Direction Committee is helped by the Security Committee for Nuclear Power Plants in the cooperation between security organizations of member countries and in the safety and nuclear activity regulations. The importance of the cooperation between experts in human being and engine problems is underlined. The applied methods, exchange activities and activity analysis, and the cooperation of the Nuclear Energy Agency and international organizations is analysed [fr

  8. Improving the safety of room air pneumoperitoneum for diagnostic laparoscopy.

    Science.gov (United States)

    Ikechebelu, J I; Okeke, C A F

    2008-06-01

    Laparoscopic examination is a useful investigation in the evaluation of infertile women. To perform this test, pneumoperitoneum is required to distend the abdomen, improve visibility and displace the intestines out of the pelvis. Several gases have been used to achieve this purpose including Nitrous Oxide (N2O), Carbondioxide (CO2), Helium, Xenon andAir. This was a prospective study in a private fertility centre in Nnewi, Nigeria aimed at reducing the morbidities inherent in the use Room Air pneumoperitoneum for diagnostic laparoscopy. This was sequel to an earlier study, which revealed that women who had Room Air pneumoperitoneum had a higher port wound infection rate, abdominal discomfort (feeling of retained gas in the abdomen) and shoulder pain with resultant delayed return to normal activity than women who had Co2 pneumoperitoneum. This study demonstrated that the use of soda lime to purify the Room Air and a low pressure suction pump to evacuate the air after the procedure significantly reduced the wound infection rate and virtually eliminated the abdominal discomfort and shoulder pain associated with Room Air pneumoperitoneum. This was followed by early return to normal activity. Therefore, use of Room Air for pneumoperitoneum is safe and affordable. It is recommended for low resource settings.

  9. The critical safety functions and plant operation

    International Nuclear Information System (INIS)

    Corcoran, W.R.; Church, J.F.; Porter, N.J.; Cross, M.T.; Guinn, W.M.

    1981-01-01

    The paper outlines the operator's role in nuclear safety and introduces the concept of ''safety functions''. Safety functions are a group of actions that prevent core melt or minimize radiation releases to the general public. They can be used to provide a hierarchy of practical plant protection that an operator should use. ''An accident identical to that at Three Mile Island is not going to happen again'', said the Rogovin investigators. The concepts put forward in this paper are intended to help the operator avoid serious consequence from the next unexpected threat. On the basis of the safety evaluation, the operator has three roles in assuring that the consequences of an event will be no worse than the predicted acceptable results. These three operator roles are: first, maintain plant setup in readiness to properly respond; second, operate the plant in a manner such that fewer, milder events minimize the frequency and the severity of adverse events; third, the operator needs to monitor the plant to verify that the safety functions are accomplished. The operator needs a systematic approach to mitigating the consequences of an event. The concept of ''safety function'' introduces that systematic approach and prevents a hierarchy of protection. If the operator has difficulty in identifying an event for any reason, the systematic safety function approach allows ones to accomplish the overall path of mitigating consequences. There are ten identified functions designed to protect against core melt, preserve containment integrity, prevent indirect release of radioactivity, and maintain vital auxiliaries needed to support the other safety functions. The paper describes in detail the operator's role and the safety functions, and provides many examples of the use of alternative success paths to accomplish the safety function

  10. 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.

  11. 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.

  12. 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.

  13. 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.)

  14. Indicators to monitor NPP operational safety performance

    International Nuclear Information System (INIS)

    Gomez-Cobo, Ana

    2002-01-01

    Since December 1995 the IAEA activities on safety performance indicators focused on the elaboration of a framework for the establishment of an operational safety performance indicator programme. The development of this framework began with the consideration of the concept of NPP operational safety performance and the identification of operational safety attributes. For each operational safety attribute, overall indicators, envisioned as providing an overall evaluation of relevant aspects of safety performance, were established. Associated with each overall indicator is a level of strategic indicators intended to provide a bridge from overall to specific indicators. Finally each strategic indicator was supported by a set of specific indicators, which represent quantifiable measures of performance. The programme development was enhanced by pilot plant studies, conducted over a 15 month period from January 1998 to March 1999. The result of all this work is compiled in the IAEA-TECDOC-1141, to be published shortly. This paper presents a summary of this IAEA TECDOC. It describes the operational safety performance indicator framework proposed and discusses the results of and lessons learned from the pilot studies. Despite the efforts described, it is clear that additional research is still necessary in areas such as plant-specific adaptation of proposed frameworks in order to suit individual data collection systems and plant characteristics, indicator selection, indicator definition, goal setting, action thresholds, analysis of trends, indicator display systems, analysis of overall safety performance (i.e., aggregation or combination of indicators), safety culture indicators, qualitative indicators, and use of additional indicators to address issues such as industrial safety attitude and performance, staff welfare, and environmental compliance. This is the rationale for a new IAEA Coordinated Research Project on 'Development and application of indicators to monitor NPP

  15. 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.

  16. Safety aspects on the Asea-Atom BWR 75 control room design

    International Nuclear Information System (INIS)

    Gemst, Paul van; Pedersen, Tor.

    1978-01-01

    The control room is an integrated part of the total plant layout and is located in a special building, known as the control building. The problems of designing a control room meeting all safety requirements and at the same time allowing for modifications to meet special customer specifications are described. (author)

  17. Psychophysical workload in the operating room: primary surgeon versus assistant.

    Science.gov (United States)

    Rieger, Annika; Fenger, Sebastian; Neubert, Sebastian; Weippert, Matthias; Kreuzfeld, Steffi; Stoll, Regina

    2015-07-01

    Working in the operating room is characterized by high demands and overall workload of the surgical team. Surgeons often report that they feel more stressed when operating as a primary surgeon than in the function as an assistant which has been confirmed in recent studies. In this study, intra-individual workload was assessed in both intraoperative functions using a multidimensional approach that combined objective and subjective measures in a realistic work setting. Surgeons' intraoperative psychophysiologic workload was assessed through a mobile health system. 25 surgeons agreed to take part in the 24-hour monitoring by giving their written informed consent. The mobile health system contained a sensor electronic module integrated in a chest belt and measuring physiological parameters such as heart rate (HR), breathing rate (BR), and skin temperature. Subjective workload was assessed pre- and postoperatively using an electronic version of the NASA-TLX on a smartphone. The smartphone served as a communication unit and transferred objective and subjective measures to a communication server where data were stored and analyzed. Working as a primary surgeon did not result in higher workload. Neither NASA-TLX ratings nor physiological workload indicators were related to intraoperative function. In contrast, length of surgeries had a significant impact on intraoperative physical demands (p NASA-TLX sum score (p < 0.01; η(2) = 0.287). Intra-individual workload differences do not relate to intraoperative role of surgeons when length of surgery is considered as covariate. An intelligent operating management that considers the length of surgeries by implementing short breaks could contribute to the optimization of intraoperative workload and the preservation of surgeons' health, respectively. The value of mobile health systems for continuous psychophysiologic workload assessment was shown.

  18. Safety review for human factors engineering and control rooms of nuclear power plants

    International Nuclear Information System (INIS)

    Yang Mengzhuo

    1998-01-01

    Safety review for human factors engineering and control rooms of nuclear power plants (NPP) is in a forward position of science and technology, which began at American TMI severe accident and had been implemented in China. The importance and the significance of the safety review are expounded, the requirements of its scope and profundity are explained in detail. In addition, the situation of the technical document system for nuclear safety regulation on human factors engineering and control rooms of NPP in China is introduced briefly, on which the safety review is based

  19. Improving The Safety Of Room Air Pneumoperitoneum For ...

    African Journals Online (AJOL)

    N2O), Carbondioxide (CO2), Helium, Xenon and Air. Study Design and Method: This was a prospective study in a private fertility centre in Nnewi, Nigeria aimed at reducing the morbidities inherent in the use Room Air pneumoperitoneum for ...

  20. Decision support system for the operating room rescheduling problem.

    Science.gov (United States)

    van Essen, J Theresia; Hurink, Johann L; Hartholt, Woutske; van den Akker, Bernd J

    2012-12-01

    Due to surgery duration variability and arrivals of emergency surgeries, the planned Operating Room (OR) schedule is disrupted throughout the day which may lead to a change in the start time of the elective surgeries. These changes may result in undesirable situations for patients, wards or other involved departments, and therefore, the OR schedule has to be adjusted. In this paper, we develop a decision support system (DSS) which assists the OR manager in this decision by providing the three best adjusted OR schedules. The system considers the preferences of all involved stakeholders and only evaluates the OR schedules that satisfy the imposed resource constraints. The decision rules used for this system are based on a thorough analysis of the OR rescheduling problem. We model this problem as an Integer Linear Program (ILP) which objective is to minimize the deviation from the preferences of the considered stakeholders. By applying this ILP to instances from practice, we determined that the given preferences mainly lead to (i) shifting a surgery and (ii) scheduling a break between two surgeries. By using these changes in the DSS, the performed simulation study shows that less surgeries are canceled and patients and wards are more satisfied, but also that the perceived workload of several departments increases to compensate this. The system can also be used to judge the acceptability of a proposed initial OR schedule.

  1. A Miracle That Accelerates Operating Room Functionality: Sugammadex

    Directory of Open Access Journals (Sweden)

    Erdal Dogan

    2014-01-01

    Full Text Available Background. Sugammadex offers a good alternative to the conventional decurarisation process currently performed with cholinesterase inhibitors. Sugammadex, which was developed specifically for the aminosteroid-structured rocuronium and vecuronium neuromuscular blockers, is a modified cyclodextrin made up of 8 glucose monomers arranged in a cylindrical shape. Methods. In this study, the goal was to investigate the efficacy of sugammadex. Sugammadex was used when there was insufficient decurarisation following neostigmine. This study was performed on 14 patients who experienced insufficient decurarisation (TOF <0.9 with neostigmine after general anaesthesia in the operating rooms of a university and a state hospital between June, 2012, and January, 2014. A dose of 2 mg/kg of sugammadex was administered. Results. Time elapsed until sugammadex administration following neostigmine 37 ± 6 min, following sugammadex it took 2.1 ± 0.9 min to reach TOF ≥ 0.9, and the extubation time was 3.2 ± 1.4 min. No statistically significant differences were detected in the hemodynamic parameters before and after sugammadex application. From the time of administration of sugammadex to the second postoperative hour, no side effects or complications occurred. None of the patients experienced acute respiratory failure or residual block during this time period. Conclusion. Sugammadex was successfully used to reverse rocuronium-induced neuromuscular block in patients where neostigmine was insufficient.

  2. Robotic digital subtraction angiography systems within the hybrid operating room.

    Science.gov (United States)

    Murayama, Yuichi; Irie, Koreaki; Saguchi, Takayuki; Ishibashi, Toshihiro; Ebara, Masaki; Nagashima, Hiroyasu; Isoshima, Akira; Arakawa, Hideki; Takao, Hiroyuki; Ohashi, Hiroki; Joki, Tatsuhiro; Kato, Masataka; Tani, Satoshi; Ikeuchi, Satoshi; Abe, Toshiaki

    2011-05-01

    Fully equipped high-end digital subtraction angiography (DSA) within the operating room (OR) environment has emerged as a new trend in the fields of neurosurgery and vascular surgery. To describe initial clinical experience with a robotic DSA system in the hybrid OR. A newly designed robotic DSA system (Artis zeego; Siemens AG, Forchheim, Germany) was installed in the hybrid OR. The system consists of a multiaxis robotic C arm and surgical OR table. In addition to conventional neuroendovascular procedures, the system was used as an intraoperative imaging tool for various neurosurgical procedures such as aneurysm clipping and spine instrumentation. Five hundred one neurosurgical procedures were successfully conducted in the hybrid OR with the robotic DSA. During surgical procedures such as aneurysm clipping and arteriovenous fistula treatment, intraoperative 2-/3-dimensional angiography and C-arm-based computed tomographic images (DynaCT) were easily performed without moving the OR table. Newly developed virtual navigation software (syngo iGuide; Siemens AG) can be used in frameless navigation and in access to deep-seated intracranial lesions or needle placement. This newly developed robotic DSA system provides safe and precise treatment in the fields of endovascular treatment and neurosurgery.

  3. An ethnographic study of differentiated practice in an operating room.

    Science.gov (United States)

    Graff, C; Roberts, K; Thornton, K

    1999-01-01

    An ethnographic study was conducted to investigate implementation of the clinical nurse III or team leader (TL) role as part of a newly executed nursing differentiated practice model. The six TLs studied were employed in the operating room (OR). Through participant observation, interviews, and document analysis, the TL role--as well as perceptions of the role by the TLs and OR staff--were studied. Problems related to performance of the role and its evolutionary process were delineated. Data analysis involved identifying categories and subcategories of data and developing a coding system to identify themes. Salient themes were related to the culture of the OR. Because of the OR's highly technical environment, the TLs defined their roles in relation to the organizational and technical needs of their surgical service. Refinement of surgeon "preference cards" and "instrument count sheets" was considered the initial priority for the TLs. Various controllable and uncontrollable factors were identified that affected implementation of the new TL role. Findings suggest that introduction of the role requires insight into setting and an emphasis on staging and orientation of employees to the new role.

  4. The next step: intelligent digital assistance for clinical operating rooms

    Directory of Open Access Journals (Sweden)

    Miehle Juliana

    2017-08-01

    Full Text Available With the emergence of new technologies, the surgical working environment becomes increasingly complex and comprises many medical devices that have to be taken cared of. However, the goal is to reduce the workload of the surgical team to allow them to fully focus on the actual surgical procedure. Therefore, new strategies are needed to keep the working environment manageable. Existing research projects in the field of intelligent medical environments mostly concentrate on workflow modeling or single smart features rather than building up a complete intelligent environment. In this article, we present the concept of intelligent digital assistance for clinical operating rooms (IDACO, providing the surgeon assistance in many different situations before and during an ongoing procedure using natural spoken language. The speech interface enables the surgeon to concentrate on the surgery and control the technical environment at the same time, without taking care of how to interact with the system. Furthermore, the system observes the context of the surgery and controls several devices autonomously at the appropriate time during the procedure.

  5. Psychology of NPP operation safety

    International Nuclear Information System (INIS)

    Tret'yakov, V.P.

    1993-01-01

    The book is devoted to psychologic investigations into different aspects of NPP operative personnel activities. The whole set of conditions on which successful and accident-free personnel operation depends, is analysed. Based on original engineering and socio-psychologic investigations complex psychologic support for NPP personnel and a system of training and upkeep of operative personnel skills are developed. The methods proposed have undergone a practical examination and proved their efficiency. 154 refs., 12 figs., 9 tabs

  6. 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.

  7. [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

  8. Managing Safety and Operations: The Effect of Joint Management System Practices on Safety and Operational Outcomes.

    Science.gov (United States)

    Tompa, Emile; Robson, Lynda; Sarnocinska-Hart, Anna; Klassen, Robert; Shevchenko, Anton; Sharma, Sharvani; Hogg-Johnson, Sheilah; Amick, Benjamin C; Johnston, David A; Veltri, Anthony; Pagell, Mark

    2016-03-01

    The aim of this study was to determine whether management system practices directed at both occupational health and safety (OHS) and operations (joint management system [JMS] practices) result in better outcomes in both areas than in alternative practices. Separate regressions were estimated for OHS and operational outcomes using data from a survey along with administrative records on injuries and illnesses. Organizations with JMS practices had better operational and safety outcomes than organizations without these practices. They had similar OHS outcomes as those with operations-weak practices, and in some cases, better outcomes than organizations with safety-weak practices. They had similar operational outcomes as those with safety-weak practices, and better outcomes than those with operations-weak practices. Safety and operations appear complementary in organizations with JMS practices in that there is no penalty for either safety or operational outcomes.

  9. Experience in the review of utility control room design review and safety parameter display system programs

    International Nuclear Information System (INIS)

    Moore, V.A.

    1985-01-01

    The Detailed Control Room Design Review (DCRDR) and the Safety Parameter Display System (SPDS) had their origins in the studies and investigations conducted as the result of the TMI-2 accident. The President's Commission (Kemeny Commission) critized NRC for not examining the man-machine interface, over-emphasizing equipment, ignoring human beings, and tolerating outdated technology in control rooms. The Commission's Special Inquiry Group (Rogovin Report) recommended greater application of human factors engineering including better instrumentation displays and improved control room design. The NRC Lessons Learned Task Force concluded that licensees should review and improve control rooms using NRC Human engineering guidelines, and install safety parameter display systems (then called the safety staff vector). The TMI Action Plan Item I.D.1 and I.D.2 were based on these recommendations

  10. 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.

  11. 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

    Background 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, whereas transformational (team-oriented) leaders inspire performance beyond expectations. Study Design We video-recorded 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 (MLQ) was correlated with surgeon behavior (SLI) and team behavior using Poisson regression, controlling for time and the total number of behaviors, respectively. Results All surgeons scored similarly on transactional leadership (2.38-2.69), but varied more widely on transformational leadership (1.98-3.60). Each 1-point increase in transformational score corresponded to 3× more information-sharing behaviors (psupportive behaviors (pleadership and its impact on team performance in the OR. 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. PMID:26481409

  12. Safety valve opening and closing operation monitor

    International Nuclear Information System (INIS)

    Kodama, Kunio; Takeshima, Ikuo; Takahashi, Kiyokazu.

    1981-01-01

    Purpose: To enable the detection of the closing of a safety valve when the internal pressure in a BWR type reactor is a value which will close the safety valve, by inputting signals from a pressure detecting device mounted directly at a reactor vessel and a safety valve discharge pressure detecting device to an AND logic circuit. Constitution: A safety valve monitor is formed of a pressure switch mounted at a reactor pressure vessel, a pressure switch mounted at the exhaust pipe of the escape safety valve and a logic circuit and the lide. When the input pressure of the safety valve is raised so that the valve and the pressure switch mounted at the exhaust pipe are operated, an alarm is indicated, and the operation of the pressure switch mounted at a pressure vessel is eliminated. If the safety valve is not reclosed when the vessel pressure is decreased lower than the pressure at which it is to be reclosed after the safety valve is operated, an alarm is generated by the logic circuit since both the pressure switches are operated. (Sekiya, K.)

  13. 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.

  14. 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

  15. Protective lung ventilation in operating room: a systematic review.

    Science.gov (United States)

    Futier, E; Constantin, J M; Jaber, S

    2014-06-01

    Postoperative pulmonary and extrapulmonary complications adversely affect clinical outcomes and healthcare utilization, so that prevention has become a measure of the quality of perioperative care. Mechanical ventilation is an essential support therapy to maintain adequate gas exchange during general anesthesia for surgery. Mechanical ventilation using high tidal volume (VT) (between 10 and 15 mL/kg) has been historically encouraged to prevent hypoxemia and atelectasis formation in anesthetized patients undergoing abdominal and thoracic surgery. However, there is accumulating evidence from both experimental and clinical studies that mechanical ventilation, especially the use of high VT and plateau pressure, may potentially aggravate or even initiate lung injury. Ventilator-associated lung injury can result from cyclic alveolar overdistension of non-dependent lung tissue, and repetitive opening and closing of dependent lung tissue resulting in ultrastructural damage at the junction of closed and open alveoli. Lung-protective ventilation, which refers to the use of lower VT and limited plateau pressure to minimize overdistension, and positive end-expiratory pressure to prevent alveolar collapse at end-expiration, was shown to improve outcome in critically ill patients with acute respiratory distress syndrome (ARDS). It has been recently suggested that this approach might also be beneficial in a broader population, especially in critically ill patients without ARDS at the onset of mechanical ventilation. There is, however, little evidence regarding a potential beneficial effect of lung protective ventilation during surgery, especially in patients with healthy lungs. Although surgical patients are frequently exposed to much shorter periods of mechanical ventilation, this is an important gap in knowledge given the number of patients receiving mechanical ventilation in the operating room. This review developed the benefits of lung protective ventilation during surgery

  16. Operating room waste reduction in plastic and hand surgery.

    Science.gov (United States)

    Albert, Mark G; Rothkopf, Douglas M

    2015-01-01

    Operating rooms (ORs), combined with labour and delivery suites, account for approximately 70% of hospital waste. Previous studies have reported that recycling can have a considerable financial impact on a hospital-wide basis; however, its importance in the OR has not been demonstrated. To propose a method of decreasing cost through judicious selection of instruments and supplies, and initiation of recycling in plastic and hand surgery. The authors identified disposable supplies and instruments that are routinely opened and wasted in common plastic and hand surgery procedures, and calculated the savings that can result from eliminating extraneous items. A cost analysis was performed, which compared the expense of OR waste versus single-stream recycling and the benefit of recycling HIPAA documents and blue wrap. Fifteen total items were removed from disposable plastic packs and seven total items from hand packs. A total of US$17,381.05 could be saved per year from these changes alone. Since initiating single-stream recycling, the authors' institution has saved, on average, US$3,487 per month at the three campuses. After extrapolating at the current savings rate, one would expect to save a minimum of US$41,844 per year. OR waste reduction is an effective method of decreasing cost in the surgical setting. By revising the contents of current disposable packs and instrument sets designated for plastic and hand surgery, hospitals can reduce the amount of opened and unused material. Significant financial savings and environmental benefit can result from this judicious supply and instrument selection, as well as implementation of recycling.

  17. [Conflict matrix : Risk management tool in the operating room].

    Science.gov (United States)

    Andel, D; Markstaller, K; Andel, H

    2017-05-01

    In business conflicts have long been known to have a negative effect on costs and team performance. In medicine this aspect has been widely neglected, especially when optimizing processes for operating room (OR) management. In the multidisciplinary setting of OR management, shortcomings in rules for decision making and lack of communication result in members perceiving themselves as competitors in the patient's environment rather than acting as art of a multiprofessional team. This inevitably leads to the emergence and escalation of conflicts. We developed a conflict matrix to provide an inexpensive and objective way for evaluating the level of escalation of conflicts in a multiprofessional working environment, such as an OR. The senior members of all involved disciplines were asked to estimate the level of conflict escalation between the individual professional groups on a scale of 0-9. By aggregating the response data, an overview of the conflict matrix within this OR section was created. No feedback was received from 1 of the 11 contacted occupational groups. By color coding the median, minimum and maximum values of the retrieved data, an intuitive overview of the escalation levels of conflict could be provided. The value range of all feedbacks was between 0 and 6. Estimation of the escalation levels differed widely within one category, showing a range of up to 6 (out of 6) levels. The presented assessment using a conflict matrix is a simple and cost-effective method to assess the conflict landscape, especially in multidisciplinary environments, such as OR management. The chance of conflict prevention or the early recognition of existing conflicts represents an enormous potential for cost and risk saving and might have positive long-term effects by building a culture of conflict prevention at the workplace and a positive influence on interdisciplinary cooperation in this working environment.

  18. Operating room fires in otolaryngology: risk factors and prevention.

    Science.gov (United States)

    Smith, Lee P; Roy, Soham

    2011-01-01

    The aim of the study was to characterize the causes of operating room (OR) fires in otolaryngology. A questionnaire was designed to elicit the characteristics of OR fires experienced by otolaryngologists. The survey was advertised to 8523 members of the American Academy of Otolaryngology-Head and Neck Surgery. Three hundred forty-nine questionnaires were completed. Eighty-eight surgeons (25.2%) witnessed at least one OR fire in their career, 10 experienced 2 fires each, and 2 reported 5 fires each. Of 106 reported fires, details were available for 100. The most common ignition sources were an electrosurgical unit (59%), a laser (32%), and a light cord (7%). Twenty-seven percent of fires occurred during endoscopic airway surgery, 24% during oropharyngeal surgery, 23% during cutaneous or transcutaneous surgery of the head and neck, and 18% during tracheostomy; 7% were related to a light cord, and 1% was related to an anesthesia machine. Eighty-one percent of fires occurred while supplemental oxygen was in use. Common fuels included an endotracheal tube (31%), OR drapes/towels (18%), and flash fire (where no substrate burned) (11%). Less common fuels included alcohol-based preparation solution, gauze sponges, patient's hair or skin, electrosurgical unit with retrofitted insulation over the tip, tracheostomy tube, tonsil sponge, suction tubing, a cottonoid pledget, and a red rubber catheter. OR fire may occur in a wide variety of clinical settings; endoscopic airway surgery, oropharyngeal surgery, cutaneous surgery, and tracheostomy present the highest risk for otolaryngologists. Electrosurgical devices and lasers are the most likely to produce ignition. Copyright © 2011 Elsevier Inc. All rights reserved.

  19. 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

  20. 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

  1. Evaluation of operating experience with safety values

    International Nuclear Information System (INIS)

    Bung, W.; Hoemke, P.; Oberender, W.; Paul, H.; Rueter, W.

    1985-01-01

    This report describes statistical investigations of 2076 functional tests carried out on power operated safety valves in conventional power plants in 1972 until 1983 with special regard to Common Mode-Failures. The results clearly show that Common Mode-Failures play an important part of non-availability for the controlled safety valves, especially in the control system. The 'Deutsche Risikostudie' does not consider any Common Mode-Failures of the primary safety valves. However there is no significant increase of the risk resulted by the primary safety valves in the 'Referenzanlage' if the calculated Common Mode-Failures probabilities are considered. (orig.) [de

  2. A simple intervention to improve patient safety, save time and improve staff experience in the AMU procedure room.

    Science.gov (United States)

    Misselbrook, Gary Peter; Kause, Juliane; Yeoh, Su-Ann

    2016-01-01

    Over the last decade, operating theatres and Intensive Care Units (ICUs) have established systematic methods for performing procedures on patients that have been shown to reduce complications and improve patient safety. Whilst the use of procedure rooms on Acute Medicine Units (AMUs) is highly recommended by patient safety groups and Royal College publications, they are not universally available or appropriately utilised. In this article we discuss a quality improvement project that was undertaken on an AMU at a large university teaching hospital in the United Kingdom, highlighting its successes and challenges.

  3. 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.

  4. Operator’s cognitive, communicative and operative activities based workload measurement of advanced main control room

    International Nuclear Information System (INIS)

    Kim, Seunghwan; Kim, Yochan; Jung, Wondea

    2014-01-01

    Highlights: • An advanced MMIS in the advanced MCR requires new roles and tasks of operators. • A new workload evaluation framework is needed for a new MMIS environment. • This work suggests a new workload measurement approach (COCOA) for an advanced MCR. • COCOA enables 3-dimensional measurement of cognition, communication and operation. • COCOA workload evaluation of the reference plant through simulation was performed. - Abstract: An advanced man–machine interface system (MMIS) with a computer-based procedure system and high-tech control/alarm system is installed in the advanced main control room (MCR) of a nuclear power plant. Accordingly, though the task of the operators has been changed a great deal, owing to a lack of appropriate guidelines on the role allocation or communication method of the operators, operators should follow the operating strategies of conventional MCR and the problem of an unbalanced workload for each operator can be raised. Thus, it is necessary to enhance the operation capability and improve the plant safety by developing guidelines on the role definition and communication of operators in an advanced MCR. To resolve this problem, however, a method for measuring the workload according to the work execution of the operators is needed, but an applicable method is not available. In this research, we propose a COgnitive, Communicative and Operational Activities measurement approach (COCOA) to measure and evaluate the workload of operators in an advanced MCR. This paper presents the taxonomy for additional operation activities of the operators to use the computerized procedures and soft control added to an advanced MCR, which enables an integrated measurement of the operator workload in various dimensions of cognition, communication, and operation. To check the applicability of COCOA, we evaluated the operator workload of an advanced MCR of a reference power plant through simulation training experiments. As a result, the amount

  5. 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…

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

    Directory of Open Access Journals (Sweden)

    Seung Woo Lee

    2016-02-01

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

  7. Relation between water chemistry and operational safety

    International Nuclear Information System (INIS)

    Oliveira, M.F. de.

    1991-01-01

    This report describes the relation between chemistry/radiochemistry and operational safety, the technics bases for chemical and radiochemical parameters and an analysis of the Annual Report of Angra I Operation and OSRAT Mission report to 1989 in this area too. Furthermore it contains the transcription of the technical Specifications related to the chemistry and radiochemistry for Angra I. (author)

  8. A Study of Interpersonal Conflict Among Operating Room Nurses.

    Science.gov (United States)

    Chang, Tsui-Fen; Chen, Chung-Kuang; Chen, Ming-Jia

    2017-12-01

    Team collaboration is an important factor that affects the performance of the operating room (OR). Therefore, the ability of OR nurses to adapt to and manage interpersonal conflict incidents properly is very important. The aims of this study were to investigate the interpersonal conflict management capabilities of OR nursing staffs and to find the relationships among the demographics of OR nurses and the following: work-related variables, interpersonal conflict management style, and target of interpersonal conflict. This study investigated 201 OR nurses who had worked for more than 6 months at the target hospitals, which were located in the three counties of Changhua, Yunlin, and Chiayi. The questionnaire that was used to collect data included three components: a demographic and work-related variables survey, interpersonal conflict management factor analysis scale, and interpersonal conflict parties and frequency scale. Data were analyzed using independent t test, analysis of variance, Scheffe's test, and Pearson's correlation coefficient. The main findings were as follows: (a) Integration and arbitration were the major interpersonal conflict management strategies adopted by the participants; (b) medical doctor, OR nurses, and anesthetists were the primary targets of conflict for the participants; (c) the factors of educational background, job position, experience in other departments, seniority, attending courses in conflict management, and level of hospital significantly affected the strategies that participants used to manage interpersonal conflict; and (d) license level, experience in other departments, seniority, and inclination toward serving in the OR were each found to relate significantly to the target of interpersonal conflict and the frequency of interpersonal conflict incidents. The main implications of this study are as follows: (a) The environment for communication in the OR should be made more friendly to encourage junior OR nurses to adopt

  9. Recommendations to Improve the Implementation Compliance of Surgical Safety Checklist in Surgery Rooms

    Directory of Open Access Journals (Sweden)

    Juliana Sandrawati

    2014-11-01

    Full Text Available Background: Surgical Safety Checklist has been adopted in surgery room as a tool to improve safe surgery. Its implementation during 2012 was low (33.9% so was the completeness of filling it (57.3%. Objective: To increase the implementation of Surgical Safety Checklist (SSC through analyzing the effect of policy, procedures, patient safety culture, and individual factors on compliance SSC implementation in the surgery room. Methods: Cross-sectional study with descriptive observational approach was done to find influencing factors of health care personnels’ compliance to fill SSC. Sample consisted of all surgery room nurses (45 nurses, 10 surgeons and 4 anesthesists. Data collection was made use of questionnaires, surgical medical records and SSC form. Results:The compliance to fill SSC in April 2013 was still low (55.9%. Written policy on patient safety was absent and awareness of respondents about the procedure was low. Respondents’ assessment showed that patient safety culture in surgery room was good, except management and stress recognition dimensions. Likewise, the respondents’ knowledge about SSC was low (61.0%. Conclusion: The study conclude that influencing factors of compliance implementation SSC is absence of the written policy in patient safety, lack of socialization of Standar Prosedur Operasional to health care personnels, lack of knowledge about SSC, lack awareness about the importance of SSC, shortage of surgery room nurses, and innappropriate perception about filling SSC as workload. Recomendation:The study will be making of written policy in patient safety and SSC, followed by socialization to health care personnels, training about SSC implementation, empowering and advocating surgery room nurses and use of reminders.

  10. 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.

  11. Operational characteristics of nuclear power plants - modelling of operational safety

    International Nuclear Information System (INIS)

    Studovic, M.

    1984-01-01

    By operational experience of nuclear power plants and realize dlevel of availability of plant, systems and componenst reliabiliuty, operational safety and public protection, as a source on nature of distrurbances in power plant systems and lessons drawn by the TMI-2, in th epaper are discussed: examination of design safety for ultimate ensuring of safe operational conditions of the nuclear power plant; significance of the adequate action for keeping proess parameters in prescribed limits and reactor cooling rquirements; developed systems for measurements detection and monitoring all critical parameters in the nuclear steam supply system; contents of theoretical investigation and mathematical modeling of the physical phenomena and process in nuclear power plant system and components as software, supporting for ensuring of operational safety and new access in staff education process; program and progress of the investigation of some physical phenomena and mathematical modeling of nuclear plant transients, prepared at faculty of mechanical Engineering in Belgrade. (author)

  12. 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

  13. 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…

  14. 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

  15. 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

  16. 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

  17. Lessons from Evidence-Based Operating Room Management in Balancing the Needs for Efficient, Effective and Ethical Healthcare

    OpenAIRE

    Rosen, A.C.; Dexter, F.

    2009-01-01

    Foglia et al. (in press) describe tension in two veteran's hospitals among managers, clinicians, and patients over allocating appropriate resources to support care and inefficiencies in care delivery. Ultimately ethical healthcare in a system which is committed to caring for an entire population of patients must use its limited resources effectively while not compromising patient safety. This discussion gives examples from operating room management in which systematic analyses of existing dat...

  18. Enhancing Safety at Airline Operations Control Centre

    Directory of Open Access Journals (Sweden)

    Lukáš Řasa

    2015-04-01

    Full Text Available In recent years a new term of Safety Management System (SMS has been introduced into aviation legislation. This system is being adopted by airline operators. One of the groundbased actors of everyday operations is Operations Control Centre (OCC. The goal of this article has been to identify and assess risks and dangers which occur at OCC and create a template for OCC implementation into SMS.

  19. 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

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

    Directory of Open Access Journals (Sweden)

    Guangwei Zhou

    2012-01-01

    Full Text Available Objectives. To review our experience of conducting auditory brainstem response (ABR test on children in the operating room and discuss the benefits versus limitations of this practice. Methods. Retrospective review study conducted in a pediatric tertiary care facility. A total of 267 patients identified with usable data, including ABR results, medical and surgical notes, and follow-up evaluation. Results. Hearing status successfully determined in all patients based on the ABR results form the operating room. The degrees and the types of hearing loss also documented in most of the cases. In addition, multiple factors that may affect the outcomes of ABR in the operating room identified. Conclusions. Hearing loss in children with complicated medical issues can be accurately evaluated via ABR testing in the operating room. Efforts should be made to eliminate adverse factors to ABR recording, and caution should be taken when interpreting ABR results from the operating room.

  1. Environmental Health and Safety Hazards Experienced by Home Health Care Providers: A Room-by-Room Analysis.

    Science.gov (United States)

    Polivka, Barbara J; Wills, Celia E; Darragh, Amy; Lavender, Steven; Sommerich, Carolyn; Stredney, Donald

    2015-11-01

    The number of personnel providing in-home health care services is increasing substantially. The unique configuration of environmental hazards in individual client homes has a significant impact on the safety and health of home health care providers (HHPs). This mixed-methods study used data from a standardized questionnaire, focus groups, and individual interviews to explore environmental health and safety hazards encountered by HHPs in client homes. The participant sample (N = 68) included nurses, aides, therapists, and owners/managers from a variety of geographic locations. The most often-reported hazards were trip/slip/lift hazards, biohazards, and hazards from poor air quality, allergens, pests and rodents, and fire and burns. Frequency of identified key hazards varied by room, that is, kitchen (e.g., throw rugs, water on floor), bathroom (e.g., tight spaces for client handling), bedroom (e.g., bed too low), living room (e.g., animal waste), and hallway (e.g., clutter). Findings indicate the need for broader training to enable HHPs to identify and address hazards they encounter in client homes. © 2015 The Author(s).

  2. International co-operation in the field of operational safety

    International Nuclear Information System (INIS)

    Dupuis, M.C.

    1988-10-01

    Operational safety in nuclear power plants is without doubt a field where international co-operation is in constant progress. Accounting for over 80 per cent of the 400 reactors in service throughout the world, the menber countries of the OECD Nuclear Energy Agency (NEA) are constantly striving to improve the exchange and use of the wealth of information to be gained not just from power plant accidents and incidents but from the routine operation of these facilities. The Committee on the Safety of Nuclear Installations (CSNI) helps the Steering Committee for Nuclear Energy to meet the NEA's objectives in the safety field, namely: - to promote co-operation between the safety bodies of member countries - to contribute to the safety and regulation of nuclear activities. The CSNI relies on the technical back-up of several different working groups made up of experts appointed by the member countries. For the past three years I have had the honour of chairing Principal Working Group 1 (PWG 1), which deals with operating experience and human factor. It is in this capacity that I will attempt to outline the group's various activities and its findings illustrated by a few examples

  3. 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

  4. Intelligent cooperation: A framework of pedagogic practice in the operating room.

    Science.gov (United States)

    Sutkin, Gary; Littleton, Eliza B; Kanter, Steven L

    2018-04-01

    Surgeons who work with trainees must address their learning needs without compromising patient safety. We used a constructivist grounded theory approach to examine videos of five teaching surgeries. Attending surgeons were interviewed afterward while watching cued videos of their cases. Codes were iteratively refined into major themes, and then constructed into a larger framework. We present a novel framework, Intelligent Cooperation, which accounts for the highly adaptive, iterative features of surgical teaching in the operating room. Specifically, we define Intelligent Cooperation as a sequence of coordinated exchanges between attending and trainee that accomplishes small surgical steps while simultaneously uncovering the trainee's learning needs. Intelligent Cooperation requires the attending to accurately determine learning needs, perform real-time needs assessment, provide critical scaffolding, and work with the learner to accomplish the next step in the surgery. This is achieved through intense, coordinated verbal and physical cooperation. Copyright © 2017 Elsevier Inc. All rights reserved.

  5. 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

  6. Implementation of an Electronic Checklist to Improve Patient Handover From Ward to Operating Room

    DEFF Research Database (Denmark)

    Münter, Kristine H; Møller, Thea P; Østergaard, Doris

    2017-01-01

    risk factors. The aim of this study was to describe the implementation process and completion rate of a new preoperative, ward-to-OR checklist. Our goal was a 90% fulfillment. METHOD: This study is a prospective, observational study in a Danish University Hospital including all patients undergoing......OBJECTIVE: Research has identified numerous safety risks in perioperative patient handover. In handover from ward to operating room (OR), patients are often transferred by a third person. This adds to the risk of loss of important information and of caregivers in the OR not identifying possible...... surgery in 2013. The checklist was a screen page with 27 checkboxes of information relevant for a safe handover. The checklist should be completed in the ward before handover to the OR and should be checked in the OR before receiving the patient. The Plan-Do-Study-Act (PDSA) cycle method was used...

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

    Science.gov (United States)

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

    2013-01-01

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

  8. 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.

  9. Operational safety evaluation for minor reactor accidents

    International Nuclear Information System (INIS)

    Wang, O.S.

    1981-01-01

    The purpose of this paper is to address a concern of applying conservatism in analysing minor reactor incidents. A so-called ''conservative'' safety analysis may exaggerate the system responses and result in a reactor scram tripped by the reactor protective system (RPS). In reality, a minor incident may lead the reactor to a new thermal hydraulic steady-state without scram, and the mitigation or termination of the incident may entirely depend on operator actions. An example on a small steamline break evaluation for a pressurized water reactor recently investigated by the staff at the Washington Public Power Supply System is presented to illustrate this point. A safety evaluation using mainly the safety-related systems to be consistent with the conservative assumptions used in the Safety Analysis Report was conducted. For comparison, a realistic analysis was also performed using both the safety- and control-related systems. The analyses were performed using the RETRAN plant simulation computer code. The ''conservative'' safety analysis predicts that the incident can be turned over by the RPS scram trips without operator intervention. However, the realistic analysis concludes that the reactor will reach a new steady-state at a different plant thermal hydraulic condition. As a result, the termination of the incident at this stage depends entirely on proper operator action. On the basis of this investigation it is concluded that, for minor incidents, ''conservative'' assumptions are not necessary, sometimes not justifiable. A realistic investigation from the operational safety point of view is more appropriate. It is essential to highlight the key transient indications for specific incident recognition in the operator training program

  10. 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)

  11. 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.

  12. Understanding Costs of Care in the Operating Room.

    Science.gov (United States)

    Childers, Christopher P; Maggard-Gibbons, Melinda

    2018-04-18

    Increasing value requires improving quality or decreasing costs. In surgery, estimates for the cost of 1 minute of operating room (OR) time vary widely. No benchmark exists for the cost of OR time, nor has there been a comprehensive assessment of what contributes to OR cost. To calculate the cost of 1 minute of OR time, assess cost by setting and facility characteristics, and ascertain the proportion of costs that are direct and indirect. This cross-sectional and longitudinal analysis examined annual financial disclosure documents from all comparable short-term general and specialty care hospitals in California from fiscal year (FY) 2005 to FY2014 (N = 3044; FY2014, n = 302). The analysis focused on 2 revenue centers: (1) surgery and recovery and (2) ambulatory surgery. Mean cost of 1 minute of OR time, stratified by setting (inpatient vs ambulatory), teaching status, and hospital ownership. The proportion of cost attributable to indirect and direct expenses was identified; direct expenses were further divided into salary, benefits, supplies, and other direct expenses. In FY2014, a total of 175 of 302 facilities (57.9%) were not for profit, 78 (25.8%) were for profit, and 49 (16.2%) were government owned. Thirty facilities (9.9%) were teaching hospitals. The mean (SD) cost for 1 minute of OR time across California hospitals was $37.45 ($16.04) in the inpatient setting and $36.14 ($19.53) in the ambulatory setting (P = .65). There were no differences in mean expenditures when stratifying by ownership or teaching status except that teaching hospitals had lower mean (SD) expenditures than nonteaching hospitals in the inpatient setting ($29.88 [$9.06] vs $38.29 [$16.43]; P = .006). Direct expenses accounted for 54.6% of total expenses ($20.40 of $37.37) in the inpatient setting and 59.1% of total expenses ($20.90 of $35.39) in the ambulatory setting. Wages and benefits accounted for approximately two-thirds of direct expenses (inpatient, $14.00 of $20

  13. Safety assessment for TA-48 radiochemical operations

    International Nuclear Information System (INIS)

    1994-08-01

    The purpose of this report is to document an assessment performed to evaluate the safety of the radiochemical operations conducted at the Los Alamos National Laboratory operations area designated as TA-48. This Safety Assessment for the TA-48 radiochemical operations was prepared to fulfill the requirements of US Department of Energy (DOE) Order 5481.1B, ''Safety Analysis and Review System.'' The area designated as TA-48 is operated by the Chemical Science and Technology (CST) Division and is involved with radiochemical operations associated with nuclear weapons testing, evaluation of samples collected from a variety of environmental sources, and nuclear medicine activities. This report documents a systematic evaluation of the hazards associated with the radiochemical operations that are conducted at TA-48. The accident analyses are limited to evaluation of the expected consequences associated with a few bounding accident scenarios that are selected as part of the hazard analysis. Section 2 of this report presents an executive summary and conclusions, Section 3 presents pertinent information concerning the TA-48 site and surrounding area, Section 4 presents a description of the TA-48 radiochemical operations, and Section 5 presents a description of the individual facilities. Section 6 of the report presents an evaluation of the hazards that are associated with the TA-48 operations and Section 7 presents a detailed analysis of selected accident scenarios

  14. Semiconductor terahertz technology devices and systems at room temperature operation

    CERN Document Server

    Carpintero, G; Hartnagel, H; Preu, S; Raisanen, A

    2015-01-01

    Key advances in Semiconductor Terahertz (THz) Technology now promises important new applications enabling scientists and engineers to overcome the challenges of accessing the so-called "terahertz gap".  This pioneering reference explains the fundamental methods and surveys innovative techniques in the generation, detection and processing of THz waves with solid-state devices, as well as illustrating their potential applications in security and telecommunications, among other fields. With contributions from leading experts, Semiconductor Terahertz Technology: Devices and Systems at Room Tempe

  15. Transportation Safety Excellence in Operations Through Improved Transportation Safety Document

    International Nuclear Information System (INIS)

    Dr. Michael A. Lehto; MAL

    2007-01-01

    A recent accomplishment of the Idaho National Laboratory (INL) Materials and Fuels Complex (MFC) Nuclear Safety analysis group was to obtain DOE-ID approval for the inter-facility transfer of greater-than-Hazard-Category-3 quantity radioactive/fissionable waste in Department of Transportation (DOT) Type A drums at MFC. This accomplishment supported excellence in operations through safety analysis by better integrating nuclear safety requirements with waste requirements in the Transportation Safety Document (TSD); reducing container and transport costs; and making facility operations more efficient. The MFC TSD governs and controls the inter-facility transfer of greater-than-Hazard-Category-3 radioactive and/or fissionable materials in non-DOT approved containers. Previously, the TSD did not include the capability to transfer payloads of greater-than-Hazard-Category-3 radioactive and/or fissionable materials using DOT Type A drums. Previous practice was to package the waste materials to less-than-Hazard-Category-3 quantities when loading DOT Type A drums for transfer out of facilities to reduce facility waste accumulations. This practice allowed operations to proceed, but resulted in drums being loaded to less than the Waste Isolation Pilot Plant (WIPP) waste acceptance criteria (WAC) waste limits, which was not cost effective or operations friendly. An improved and revised safety analysis was used to gain DOE-ID approval for adding this container configuration to the MFC TSD safety basis. In the process of obtaining approval of the revised safety basis, safety analysis practices were used effectively to directly support excellence in operations. Several factors contributed to the success of MFC's effort to obtain approval for the use of DOT Type A drums, including two practices that could help in future safety basis changes at other facilities. (1) The process of incorporating the DOT Type A drums into the TSD at MFC helped to better integrate nuclear safety

  16. Hand washing in operating room: a procedural comparison

    Directory of Open Access Journals (Sweden)

    Alessia Stilo

    2016-09-01

    Full Text Available BACKGROUND Hand washing has been considered a measure of personal hygiene for centuries and it is known that an improper hand hygiene by healthcare workers is responsible for about 40% of nosocomial infections. Therefore, surgical hand preparation is a critical element for healthcare safety in order to reduce microbial contamination of  surgical wound in case of non detected break of the gloves. The aim of our study is to evaluate the efficacy three antiseptics: Povi-iodine scrub; EPG (Ethanol, Hydrogen Peroxide, Glycerol, recommended by WHO, and common marseille soap type in a liquid formulation. METHODS It was designed a randomized, double-blind, single-center study conducted in the University Hospital of Messina, from January to June 2013. We asked operators to put the fingertips of their right hand (if not left-handed for one minute on the PCA medium, before washing with the three types of antiseptics, and after washing and drying. Drying was made using sterile gauzes or disposable wipes. Then, we measured the number of colony forming units per mL (CFU/mL and calculated the percentage of microbial load reduction. RESULTS 211 samples have been considered for statistical analysis: in 42 samples, in fact, initial microbial load was lower than after washing. Washing with EPG reduced CFU/ml from  a mean of 38,9 to 4,1 (86,5% reduction, washing with povi-iodine scrub from 59,55 to 12,9 (75,9% reduction and washing with Marseille soap from 47,26 to 12,7 (64,3% reduction. CONCLUSIONS Our study shows that washing with EPG has superior efficacy in CFU reduction. Antiseptic hand washing, however, cannot be considered the only measure to reduce infections: the anomaly of some results (initial microbial load lower than after washing  demonstrates that drying is an essential phase in the presurgical preparation. Therefore, hand hygiene must be part of a more complex strategy of surveillance and control of nosocomial infections

  17. Optimization of recirculating laminar air flow in operating room air conditioning systems

    Directory of Open Access Journals (Sweden)

    Enver Yalcin

    2016-04-01

    Full Text Available The laminar flow air-conditioning system with 100% fresh air is used in almost all operating rooms without discrimination in Turkey. The laminar flow device which is working with 100% fresh air should be absolutely used in Type 1A operating rooms. However, there is not mandatory to use of 100% fresh air for Type 1B defined as places performed simpler operation. Compared with recirculating laminar flow, energy needs of the laminar flow with 100 % fresh air has been emerged about 40% more than re-circulated air flow. Therefore, when a recirculating laminar flow device is operated instead of laminar flow system with 100% fresh air in the Type 1B operating room, annual energy consumption will be reduced. In this study, in an operating room with recirculating laminar flow, optimal conditions have been investigated in order to obtain laminar flow form by analyzing velocity distributions at various supply velocities by using computational fluid dynamics method (CFD.

  18. 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)

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

    Directory of Open Access Journals (Sweden)

    Hülya Aslan

    2016-12-01

    Full Text Available This research has been carried out in order to determine anger expression and anger management styles in operating room nurses. By applying an in-depth interview technique on operating room nurses working in a private hospital, a qualitative study has been performed in order to determine anger expression and anger management styles in operating room nurses. The interview consisted of ten questions such as demographic questions addressing the workers’ age, sex, education level and duration of employment in the organization they work, aiming to determine their anger expression and anger management styles. Since operating room environments contain various risk factors, and require active team work in a stressful dynamic setting under excessive workload, , it has been found that operating room nurses display their anger through loud speaking, fail to settle their anger positively, fail to control their anger in a behavioural pattern despite their cognitive awareness in anger management. Thus, it has been suggested that operating room nurses should be trained on anger management methods so that they can manage their anger in a stressful operating room environment.

  20. Evaluation of BOR-60 operation safety

    International Nuclear Information System (INIS)

    Minakov, A.A.; Antipin, G.K.; Efimov, V.N.; Kuzin, G.G.; Eschenko, L.V.; Eschenko, S.N.

    1987-12-01

    In this communication, BOR-60 reactor operation anomalies capable to produce a dangerous overheating of the core (SDC) is examined. On bases of calculations and reactor operation experience an event tree for SDC is built. Evaluations of probable anomalies entering in the event tree and reactor parameters modifications in case of anomalies are presented. In conclusion BOR-60 agree with the sovietic nuclear safety [fr

  1. Safety parameter display systems' effect on operator performance

    International Nuclear Information System (INIS)

    Cerven, F.; Ford, R.E.; Blackman, H.S.

    1983-01-01

    Computer generated displays are a powerful and flexible tool for presenting data to the operators of nuclear power plants. Such displays are currently being developed in industry for use as safety parameter displays and for use in advanced control rooms. There exists a need for methods to objectively evaluate the effect of these displays, positive or negative, on the performance of control room personnel. Results of developing one such method, noninteractive simulation, and the two experiments that were performed to determine if it can be used as a method for evaluating computer displays are presented. This method is more objective and powerful than pencil and paper methods because it measures human performance rather than opinion or perference, has excellent control of the experimental variables, and has a higher fidelity to the control room environment. The results of these experiments indicates that the present methodology does not differentiate among the display types tested at a statistically significant level. In other words, all display types tested worked equally well in providing operators needed information

  2. Planning of Operating Rooms at the Danish National Hospital

    OpenAIRE

    Taltavull Mercadal, Ignasi

    2016-01-01

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

  3. Sedation for procedures outside the operating room in children

    International Nuclear Information System (INIS)

    Molina Rodriguez, Ericka

    2014-01-01

    Sedation is defined in the pediatric population. An adequate preoperative assessment is established in patients subjected to a sedation. Fundamental characteristics of drugs used during a sedation are determined. Recommendations about surveillance and monitoring are established in a patient sedated. Principal characteristics of sedation are defined in patients exposed to radiological diagnostic and therapeutic procedures. Considerations in sedation are identified for procedures in the laboratory of digestive endoscopy. Alternatives of sedation are mentioned for oncological patients subjected to invasive procedures. Working conditions and specifications of anesthesia are determined in the cardiac catheterization room [es

  4. Summary of the nuclear safety in operation

    International Nuclear Information System (INIS)

    2004-01-01

    This summary is a collection of general information about nuclear safety of PWR type reactors exploited by EDF. Teaching aid, this work has been conceived by operators for operators, it must not be considered nor used as a doctrine document with a regulatory or prescriptive characteristic. it summarizes the great principles of nuclear safety, places them in a global approach and shows their coherence. It consists in 6 chapters and 6 annexes. The news of this edition are the chapter 2 devoted to the safety management and the annexe 6 devoted to the principal teaching coming from the feedback. At the end a glossary explains the signs and abbreviations and an index allows to find themes in the memento text from keywords. (N.C.)

  5. Improving nuclear power plant safety through operator aids

    International Nuclear Information System (INIS)

    1987-12-01

    In October 1986, the IAEA convened a one-week Technical Committee Meeting on Improving Nuclear Power Plant Safety Through Operator Aids. The term ''operator aid'' or more formally ''operator support system'' refers to a class of devices designed to be added to a nuclear power plant control station to assist an operator in performing his job and thereby decrease the probability of operator error. The addition of a carefully planned and designed operator aid should result in an increase in nuclear power plant safety and reliability. Operator aids encompass a wide range of devices from the very simple, such as color coding a display to distinguish it out of a group of similar displays, to the very complex, such as a computer-generated video display which concentrates a number of scattered indicator readings located around a control room into a concise display in front of the operator. This report provides guidelines and information to help make a decision as to whether an operator aid is needed, what kinds of operator aids are available and whether it should be purchased or developed by the utility. In addition, a discussion is presented on advanced operator aids to provide information on what may become available in the future. The broad scope of these guidelines makes it most suitable for use by a multi-disciplinary team. The document consists of two parts. The recommendations and results of the meeting discussions are given in the first part. The second part is the annex where the papers presented at the Technical Committee Meeting are printed. A separate abstract was prepared for each of the 10 papers. Refs, figs and tabs

  6. Safety indicators as a tool for operational safety evaluation of nuclear power plants

    International Nuclear Information System (INIS)

    Araujo, Jefferson Borges; Melo, Paulo Fernando Ferreira Frutuoso e; Schirru, Roberto

    2009-01-01

    also identify eventual room for improvements by generating suggestions and recommendations, as a complement for regulatory actions and inspections, focusing resources in eventual existing weaknesses, in order to increase or maintain a high pattern of operational safety. (author)

  7. Regulatory Safety Requirements for Operating Nuclear Installations

    International Nuclear Information System (INIS)

    Gubela, W.

    2017-01-01

    The National Nuclear Regulator (NNR) is established in terms of the National Nuclear Regulator Act (Act No 47 of 1999) and its mandate and authority are conferred through sections 5 and 7 of this Act, setting out the NNR's objectives and functions, which include exercising regulatory control over siting, design, construction etc of nuclear installations through the granting of nuclear authorisations. The NNR's responsibilities embrace all those actions aimed at providing the public with confidence and assurance that the risks arising from the production of nuclear energy remain within acceptable safety limits -> Therefore: Set fundamental safety standards, conducting pro-active safety assessments, determining licence conditions and obtaining assurance of compliance. The promotional aspects of nuclear activities in South Africa are legislated by the Nuclear Energy Act (Act No 46 of 1999). The NNR approach to regulations of nuclear safety and security take into consideration, amongst others, the potential hazards associated with the facility or activity, safety related programmes, the importance of the authorisation holder's safety related processes as well as the need to exercise regulatory control over the technical aspects such as of the design and operation of a nuclear facility in ensuring nuclear safety and security. South Africa does not have national nuclear industry codes and standards. The NNR is therefore non-prescriptive as it comes to the use of industry codes and standards. Regulatory framework (current) provide for the protection of persons, property, and environment against nuclear damage, through Licensing Process: Safety standards; Safety assessment; Authorisation and conditions of authorisation; Public participation process; Compliance assurance; Enforcement

  8. 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.

  9. A reliability program approach to operational safety

    International Nuclear Information System (INIS)

    Mueller, C.J.; Bezella, W.A.

    1985-01-01

    A Reliability Program (RP) model based on proven reliability techniques is being formulated for potential application in the nuclear power industry. Methods employed under NASA and military direction, commercial airline and related FAA programs were surveyed and a review of current nuclear risk-dominant issues conducted. The need for a reliability approach to address dependent system failures, operating and emergency procedures and human performance, and develop a plant-specific performance data base for safety decision making is demonstrated. Current research has concentrated on developing a Reliability Program approach for the operating phase of a nuclear plant's lifecycle. The approach incorporates performance monitoring and evaluation activities with dedicated tasks that integrate these activities with operation, surveillance, and maintenance of the plant. The detection, root-cause evaluation and before-the-fact correction of incipient or actual systems failures as a mechanism for maintaining plant safety is a major objective of the Reliability Program. (orig./HP)

  10. Safety of research reactors (Design and Operation)

    International Nuclear Information System (INIS)

    Dirar, H. M.

    2012-06-01

    The primary objective of this thesis is to conduct a comprehensive up-to-date literature review on the current status of safety of research reactor both in design and operation providing the future trends in safety of research reactors. Data and technical information of variety selected historical research reactors were thoroughly reviewed and evaluated, furthermore illustrations of the material of fuel, control rods, shielding, moderators and coolants used were discussed. Insight study of some historical research reactors was carried with considering sample cases such as Chicago Pile-1, F-1 reactor, Chalk River Laboratories,. The National Research Experimental Reactor and others. The current status of research reactors and their geographical distribution, reactor category and utilization is also covered. Examples of some recent advanced reactors were studied like safety barriers of HANARO of Korea including safety doors of the hall and building entrance and finger print identification which prevent the reactor from sabotage. On the basis of the results of this research, it is apparent that a high quality of safety of nuclear reactors can be attained by achieving enough robust construction, designing components of high levels of efficiency, replacing the compounds of the reactor in order to avoid corrosion and degradation with age, coupled with experienced scientists and technical staffs to operate nuclear research facilities.(Author)

  11. Data collection on the unit control room simulator as a method of operator reliability analysis

    International Nuclear Information System (INIS)

    Holy, J.

    1998-01-01

    The report consists of the following chapters: (1) Probabilistic assessment of nuclear power plant operation safety and human factor reliability analysis; (2) Simulators and simulations as human reliability analysis tools; (3) DOE project for using the collection and analysis of data from the unit control room simulator in human factor reliability analysis at the Paks nuclear power plant; (4) General requirements for the organization of the simulator data collection project; (5) Full-scale simulator at the Nuclear Power Plants Research Institute in Trnava, Slovakia, used as a training means for operators of the Dukovany NPP; (6) Assessment of the feasibility of quantification of important human actions modelled within a PSA study by employing simulator data analysis; (7) Assessment of the feasibility of using the various exercise topics for the quantification of the PSA model; (8) Assessment of the feasibility of employing the simulator in the analysis of the individual factors affecting the operator's activity; and (9) Examples of application of statistical methods in the analysis of the human reliability factor. (P.A.)

  12. The Design and Research of the Operation Status Detector for Marine Engine Room Power Plant Based on Noise

    Directory of Open Access Journals (Sweden)

    Li Hang

    2016-01-01

    Full Text Available Designed in this paper, based on the noise of ship engine room power plant running status of detector, is mainly used in the operation of the power plant of acoustic shell size to determine when the machine running state, this device is composed of signal disposal and alarm display adjustment part of two parts. Detector that can show the size of the voice, if exceed the set limit alarm value, the detector can sound an alarm, to remind staff equipment fails, it shall timely inspection maintenance, improve the safety of the operation of the ship.

  13. Description of the tasks of control room operators in German nuclear power plants and support possibilities by advanced computer systems

    International Nuclear Information System (INIS)

    Buettner, W.E.

    1984-01-01

    In course of the development of nuclear power plants the instrumentation and control systems and the information in the control room have been increasing substantially. With this background it is described which operator tasks might be supported by advanced computer aid systems with main emphasis to safety related information and diagnose facilities. Nevertheless, some of this systems under development may be helpful for normal operation modes too. As far as possible recommendations for the realization and test of such systems are made. (orig.) [de

  14. Updated requirements for control room annunciation: an operations perspective

    International Nuclear Information System (INIS)

    Davey, E.; Lane, L.

    2001-01-01

    The purpose of this paper is to describe the results of updating and aligning requirements for annunciation functionality and performance with current expectations for operational excellence. This redefinition of annunciation requirements was undertaken as one component of a project to characterize improvement priorities, establish the operational and economic basis for improvement, and identify preferred implementation options for Ontario Power Generation plants. The updated requirements express the kinds of information support annunciation should provide to Operations staff to support the detection, recognition and response to changes in plant conditions. The updated requirements were developed using several types of information: management and industry expectations for operations excellence, previous definitions of user needs for annunciation, and operational and ergonomic principles. Operations and engineering staff at several stations have helped refine and complete the initial requirements definition. Application of these updated requirements is expected to lead to more effective and task relevant annunciation system improvements that better serve plant operation needs. The paper outlines the project rationale, reviews development objectives, discusses the approaches applied for requirements definition and organization, describes key requirements findings in relation to current operations experience, and discusses the proposed application of these requirements for guiding future annunciation system improvements. (author)

  15. One size fits all? Mixed methods evaluation of the impact of 100% single-room accommodation on staff and patient experience, safety and costs

    Science.gov (United States)

    Maben, Jill; Penfold, Clarissa; Simon, Michael; Anderson, Janet E; Robert, Glenn; Pizzo, Elena; Hughes, Jane; Murrells, Trevor; Barlow, James

    2016-01-01

    Background and objectives There is little strong evidence relating to the impact of single-room accommodation on healthcare quality and safety. We explore the impact of all single rooms on staff and patient experience; safety outcomes; and costs. Methods Mixed methods pre/post ‘move’ comparison within four nested case study wards in a single acute hospital with 100% single rooms; quasi-experimental before-and-after study with two control hospitals; analysis of capital and operational costs associated with single rooms. Results Two-thirds of patients expressed a preference for single rooms with comfort and control outweighing any disadvantages (sense of isolation) felt by some. Patients appreciated privacy, confidentiality and flexibility for visitors afforded by single rooms. Staff perceived improvements (patient comfort and confidentiality), but single rooms were worse for visibility, surveillance, teamwork, monitoring and keeping patients safe. Staff walking distances increased significantly post move. A temporary increase of falls and medication errors in one ward was likely to be associated with the need to adjust work patterns rather than associated with single rooms per se. We found no evidence that single rooms reduced infection rates. Building an all single-room hospital can cost 5% more with higher housekeeping and cleaning costs but the difference is marginal over time. Conclusions Staff needed to adapt their working practices significantly and felt unprepared for new ways of working with potentially significant implications for the nature of teamwork in the longer term. Staff preference remained for a mix of single rooms and bays. Patients preferred single rooms. PMID:26408568

  16. 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.

  17. Leadership: briefing and debriefing in the operating room.

    Science.gov (United States)

    Donnelly, Teresa

    2017-07-01

    Steelman (2014) stated that the concept of briefing and debriefing used in operating theatres derived from the airline industry in the 1970s. There had been a series of devastating air crashes and the airline industry had come under severe public scrutiny. Investigations identified that, while the crews operating these aircrafts were very skilled and knowledgeable, they lacked competence in their ability to perform as part of a team. Copyright the Association for Perioperative Practice.

  18. Safety of Running Two Rooms: A Systematic Review and Meta-Analysis of Overlapping Neurosurgical Procedures.

    Science.gov (United States)

    Self, D Mitchell; Ilyas, Adeel; Stetler, William R

    2018-04-27

    Overlapping surgery, a long-standing practice within academic neurosurgery centers nationwide, has recently come under scrutiny from the government and media as potentially harmful to patients. Therefore, the objective of this systematic review and meta-analysis is to determine the safety of overlapping neurosurgical procedures. The authors performed a systematic review and meta-analysis in accordance with PRISMA guidelines. A review of PubMed and Medline databases was undertaken with the search phrase "overlapping surgery AND neurosurgery AND outcomes." Data regarding patient demographics, type of neurosurgical procedure, and outcomes and complications were extracted from each study. The principle summary measure was odds ratio (OR) of the association of overlapping versus non-overlapping surgery with outcomes. The literature search yielded a total of 36 studies, of which 5 studies met inclusion criteria and were included in this study. These studies included a total of 25,764 patients undergoing neurosurgical procedures. Overlapping surgery was associated with an increased likelihood of being discharged home (OR = 1.32; 95% CI 1.20 to 1.44; P < 0.001) and a reduced 30-day unexpected return to the operating room (OR = 0.79; 95% CI 0.72 to 0.87; P < 0.001). Overlapping surgery did not significantly affect OR of length of surgery, 30-day mortality, or 30-day readmission. Overlapping neurosurgical procedures were not associated with worse patient outcomes. Additional, prospective studies are needed to further assess the safety overlapping procedures. Copyright © 2018. Published by Elsevier Inc.

  19. 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

  20. Development of a Novel Nuclear Safety Culture Evaluation Method for an Operating Team Using Probabilistic Safety Analysis

    Energy Technology Data Exchange (ETDEWEB)

    Han, Sangmin; Lee, Seung Min; Seong, Poong Hyun [KAIST, Daejeon (Korea, Republic of)

    2015-05-15

    IAEA defined safety culture as follows: 'Safety Culture is that assembly of characteristics and attitudes in organizations and individuals which establishes that, as an overriding priority, nuclear plant safety issues receive the attention warranted by their significance'. Also, celebrated behavioral scientist, Cooper, defined safety culture as,'safety culture is that observable degree of effort by which all organizational members direct their attention and actions toward improving safety on a daily basis' with his internal psychological, situational, and behavioral context model. With these various definitions and criteria of safety culture, several safety culture assessment methods have been developed to improve and manage safety culture. To develop a new quantitative safety culture evaluation method for an operating team, we unified and redefined safety culture assessment items. Then we modeled a new safety culture evaluation by adopting level 1 PSA concept. Finally, we suggested the criteria to obtain nominal success probabilities of assessment items by using 'operational definition'. To validate the suggested evaluation method, we analyzed the collected audio-visual recording data collected from a full scope main control room simulator of a NPP in Korea.

  1. Development of a Novel Nuclear Safety Culture Evaluation Method for an Operating Team Using Probabilistic Safety Analysis

    International Nuclear Information System (INIS)

    Han, Sangmin; Lee, Seung Min; Seong, Poong Hyun

    2015-01-01

    IAEA defined safety culture as follows: 'Safety Culture is that assembly of characteristics and attitudes in organizations and individuals which establishes that, as an overriding priority, nuclear plant safety issues receive the attention warranted by their significance'. Also, celebrated behavioral scientist, Cooper, defined safety culture as,'safety culture is that observable degree of effort by which all organizational members direct their attention and actions toward improving safety on a daily basis' with his internal psychological, situational, and behavioral context model. With these various definitions and criteria of safety culture, several safety culture assessment methods have been developed to improve and manage safety culture. To develop a new quantitative safety culture evaluation method for an operating team, we unified and redefined safety culture assessment items. Then we modeled a new safety culture evaluation by adopting level 1 PSA concept. Finally, we suggested the criteria to obtain nominal success probabilities of assessment items by using 'operational definition'. To validate the suggested evaluation method, we analyzed the collected audio-visual recording data collected from a full scope main control room simulator of a NPP in Korea

  2. Risk based limits for Operational Safety Requirements

    International Nuclear Information System (INIS)

    Cappucci, A.J. Jr.

    1993-01-01

    OSR limits are designed to protect the assumptions made in the facility safety analysis in order to preserve the safety envelope during facility operation. Normally, limits are set based on ''worst case conditions'' without regard to the likelihood (frequency) of a credible event occurring. In special cases where the accident analyses are based on ''time at risk'' arguments, it may be desirable to control the time at which the facility is at risk. A methodology has been developed to use OSR limits to control the source terms and the times these source terms would be available, thus controlling the acceptable risk to a nuclear process facility. The methodology defines a new term ''gram-days''. This term represents the area under a source term (inventory) vs time curve which represents the risk to the facility. Using the concept of gram-days (normalized to one year) allows the use of an accounting scheme to control the risk under the inventory vs time curve. The methodology results in at least three OSR limits: (1) control of the maximum inventory or source term, (2) control of the maximum gram-days for the period based on a source term weighted average, and (3) control of the maximum gram-days at the individual source term levels. Basing OSR limits on risk based safety analysis is feasible, and a basis for development of risk based limits is defensible. However, monitoring inventories and the frequencies required to maintain facility operation within the safety envelope may be complex and time consuming

  3. Supporting Control Room Operators in Highly Automated Future Power Networks

    DEFF Research Database (Denmark)

    Chen, Minjiang; Catterson, Victoria; Syed, Mazheruddin

    2017-01-01

    Operating power systems is an extremely challenging task, not least because power systems have become highly interconnected, as well as the range of network issues that can occur. It is therefore a necessity to develop decision support systems and visualisation that can effectively support the hu...... the human operators for decisionmaking in the complex and dynamic environment of future highly automated power system. This paper aims to investigate the decision support functions associated with frequency deviation events for the proposed Web of Cells concept....

  4. CloudSat Safety Operations at Vandenberg AFB

    Science.gov (United States)

    Greenberg, Steve

    2006-01-01

    CloudSat safety operations at Vendenberg AFB is given. The topics include: 1) CloudSat Project Overview; 2) Vandenberg Ground Operations; 3) Delta II Launch Vehicle; 4) The A-Train; 5) System Safety Management; 6) CALIPSO Hazards Assessment; 7) CALIPSO Supplemental Safeguards; 8) Joint System Safety Operations; 9) Extended Stand-down; 10) Launch Delay Safety Concerns; and 11) Lessons Learned.

  5. Discovery of high-level tasks in the operating room

    NARCIS (Netherlands)

    Bouarfa, L.; Jonker, P.P.; Dankelman, J.

    2010-01-01

    Recognizing and understanding surgical high-level tasks from sensor readings is important for surgical workflow analysis. Surgical high-level task recognition is also a challenging task in ubiquitous computing because of the inherent uncertainty of sensor data and the complexity of the operating

  6. [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.

  7. Safety in Liquefied Natural Gas (LNG) Operations

    Energy Technology Data Exchange (ETDEWEB)

    Buhrow, C. [Technische Univ. Bergakademie, Freiberg (Germany). Lehrstuhl Bergbau/Tiefbau; Niemann-Delius, C.; Okafor, E. [Technische Hochschule Aachen (Germany). Lehrstuhl und Inst. fuer Bergbaukunde 3

    2005-07-01

    Germany needs an LNG receiving terminal to import LNG and supplement expected future gas supply shortages. Enormous economic benefits also abound if Germany is to install an LNG receiving terminal. Jobs will be created for several hundred people. New tax revenues will be generated for state and local governments and this will further enhance the economic competitiveness of Germany. Additionally, it will provide Germany with a reliable source of clean-burning energy. Any proposed LNG receiving terminal should incorporate safety right from the start. These safety requirements will: ensure that certain public land uses, people, and structures outside the LNG facility boundaries are protected in the event of LNG fire, prevent vapour clouds associated with an LNG spill from reaching a property line that can be built upon, prevent severe burns resulting from thermal radiation, specify requirements for design, construction and use of LNG facilities and other equipments, and promote safe, secure and reliable LNG operations. The German future LNG business will not be complete without the evolution of both local and international standards that can apply to LNG operations. Currently existing European standards also appear inadequate. With an OHSAS 18001 management system integrated with other existing standards we can better control our LNG occupational health and safety risks, and improve performance in the process. Additionally, an OHSAS 18001 System will help future German LNG contractors and operators safeguard their most important assets - their employees. (orig.)

  8. Operational Safety Performance Indicators and Balanced Scorecard in HANARO

    International Nuclear Information System (INIS)

    Wu, Jong-Sup; Jung, Hoan-Sung; Ahn, Guk-Hoon; Lee, Kye-Hong; Lim, In-Cheol; Kim, Hark-Rho

    2007-01-01

    Research reactors need an extensive basis for ensuring their safety. The importance of a safety management in nuclear facilities and activities has been emphasized. The safety activities in HANARO have been continuously conducted to enhance its safe operation. Last year, HANARO prepared two indicator sets to measure and assess the safety status of the reactor's operation and utilization. One is Safety Performance Indicators (SPI) and the other is Balanced Scorecard (BSC). Through reviewing these indicators, we can obtain the following information; - Plant safety status - Safety parameter trends - Safety information, for example, reactor operation status and radiation safety HANARO will continuously pursue the trends of SPI and BSC

  9. 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...

  10. Coaching Non-technical Skills Improves Surgical Residents' Performance in a Simulated Operating Room.

    Science.gov (United States)

    Yule, Steven; Parker, Sarah Henrickson; Wilkinson, Jill; McKinley, Aileen; MacDonald, Jamie; Neill, Adrian; McAdam, Tim

    2015-01-01

    To investigate the effect of coaching on non-technical skills and performance during laparoscopic cholecystectomy in a simulated operating room (OR). Non-technical skills (situation awareness, decision making, teamwork, and leadership) underpin technical ability and are critical to the success of operations and the safety of patients in the OR. The rate of developing assessment tools in this area has outpaced development of workable interventions to improve non-technical skills in surgical training and beyond. A randomized trial was conducted with senior surgical residents (n = 16). Participants were randomized to receive either non-technical skills coaching (intervention) or to self-reflect (control) after each of 5 simulated operations. Coaching was based on the Non-Technical Skills For Surgeons (NOTSS) behavior observation system. Surgeon-coaches trained in this method coached participants in the intervention group for 10 minutes after each simulation. Primary outcome measure was non-technical skills, assessed from video by a surgeon using the NOTSS system. Secondary outcomes were time to call for help during bleeding, operative time, and path length of laparoscopic instruments. Non-technical skills improved in the intervention group from scenario 1 to scenario 5 compared with those in the control group (p = 0.04). The intervention group was faster to call for help when faced with unstoppable bleeding in the final scenario (no. 5; p = 0.03). Coaching improved residents' non-technical skills in the simulated OR compared with those in the control group. Important next steps are to implement non-technical skills coaching in the real OR and assess effect on clinically important process measures and patient outcomes. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  11. 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%.

  12. Conflicts in operating room: Focus on causes and resolution

    Directory of Open Access Journals (Sweden)

    Joginder Pal Attri

    2015-01-01

    Full Text Available The operation theater (OT environment is the most complex and volatile workplace where two coequal physicians share responsibility of one patient. Difference in information, opinion, values, experience and interests between a surgeon and anesthesiologist may arise while working in high-pressure environments like OT, which may trigger conflict. Quality of patient care depends on effective teamwork for which multidisciplinary communication is an essential part. Troubled relationships leads to conflicts and conflicts leads to stressful work environment which hinders the safe discharge of patient care. Unresolved conflicts can harm the relationship but when handled in a positive way it provides an opportunity for growth and ultimately strengthening the bond between two people. By learning the skills to resolve conflict, we can keep our professional relationship healthy and strong which is an important component of good patient care.

  13. Operating room use of hypertonic solutions: a clinical review

    Directory of Open Access Journals (Sweden)

    Gustavo Azoubel

    2008-01-01

    Full Text Available Hyperosmotic-hyperoncotic solutions have been widely used during prehospital care of trauma patients and have shown positive hemodynamic effects. Recently, there has been a growing interest in intra-operative use of hypertonic solutions. We reviewed 30 clinical studies on the use of hypertonic saline solutions during surgeries, with the majority being cardiac surgeries. Reduced positive fluid balance, increased cardiac index, and decreased systemic vascular resistance were the main beneficial effects of using hypertonic solutions in this population. Well-designed clinical trials are highly needed, particularly in aortic aneurysm repair surgeries, where hypertonic solutions have shown many beneficial effects. Examining the immunomodulatory effects of hypertonic solutions should also be a priority in future studies.

  14. Conflicts in operating room: Focus on causes and resolution.

    Science.gov (United States)

    Attri, Joginder Pal; Sandhu, Gagandeep Kaur; Mohan, Brij; Bala, Neeru; Sandhu, Kulwinder Singh; Bansal, Lipsy

    2015-01-01

    The operation theater (OT) environment is the most complex and volatile workplace where two coequal physicians share responsibility of one patient. Difference in information, opinion, values, experience and interests between a surgeon and anesthesiologist may arise while working in high-pressure environments like OT, which may trigger conflict. Quality of patient care depends on effective teamwork for which multidisciplinary communication is an essential part. Troubled relationships leads to conflicts and conflicts leads to stressful work environment which hinders the safe discharge of patient care. Unresolved conflicts can harm the relationship but when handled in a positive way it provides an opportunity for growth and ultimately strengthening the bond between two people. By learning the skills to resolve conflict, we can keep our professional relationship healthy and strong which is an important component of good patient care.

  15. Oswer integrated health and safety standard operating practices. Directive

    International Nuclear Information System (INIS)

    1993-02-01

    The directive implements the OSWER (Office of Solid Waste and Emergency Response) Integrated Health and Safety Standards Operating Practices in conjunction with the OSHA (Occupational Safety and Health Act) Worker Protection Standards, replacing the OSWER Integrated Health and Safety Policy

  16. Safety of nuclear operation and maintenance

    International Nuclear Information System (INIS)

    Mori, M.; Nitta, T.; Sakai, K.

    1994-01-01

    The Kansai Electric Power Co. Inc.(Kansai EPC) aims to pursue a high quality and highly reliable operation in nuclear power generation in order to ensure safety by reducing the risk of accidents and win the confidence from the society and the public. It is emphasised that in order to realize this aim manufacturers and contractors cooperate with each other in performing high quality maintenance through plant lifetime maintenance system. TQC (Total Quality Control) activity enhances the motivation for each individual to have a quality-oriented mind and cultivate the safety culture. Under the lifetime employment practice, Kansai EPC and maintenance contractors can conduct systematic education and training, and the Maintenance Training Center helps to make it effective. 6 figs

  17. Safety goals for nuclear power plant operation

    International Nuclear Information System (INIS)

    1983-05-01

    This report presents and discusses the Nuclear Regulatory Commission's, Policy Statement on Safety Goals for the Operation of Nuclear Power Plants. The safety goals have been formulated in terms of qualitative goals and quantitative design objectives. The qualitative goals state that the risk to any individual member of the public from nuclear power plant operation should not be a significant contributor to that individual's risk of accidental death or injury and that the societal risks should be comparable to or less than those of viable competing technologies. The quantitative design objectives state that the average risks to individual and the societal risks of nuclear power plant operation should not exceed 0.1% of certain other risks to which members of the US population are exposed. A subsidiary quantitative design objective is established for the frequency of large-scale core melt. The significance of the goals and objectives, their bases and rationale, and the plan to evaluate the goals are provided. In addition, public comments on the 1982 proposed policy statement and responses to a series of questions that accompanied the 1982 statement are summarized

  18. 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.

  19. 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

  20. 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.

  1. 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)

  2. 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.

  3. 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

  4. [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.

  5. 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)

  6. 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.

  7. 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

  8. Modes of mechanical ventilation for the operating room.

    Science.gov (United States)

    Ball, Lorenzo; Dameri, Maddalena; Pelosi, Paolo

    2015-09-01

    Most patients undergoing surgical procedures need to be mechanically ventilated, because of the impact of several drugs administered at induction and during maintenance of general anaesthesia on respiratory function. Optimization of intraoperative mechanical ventilation can reduce the incidence of post-operative pulmonary complications and improve the patient's outcome. Preoxygenation at induction of general anaesthesia prolongs the time window for safe intubation, reducing the risk of hypoxia and overweighs the potential risk of reabsorption atelectasis. Non-invasive positive pressure ventilation delivered through different interfaces should be considered at the induction of anaesthesia morbidly obese patients. Anaesthesia ventilators are becoming increasingly sophisticated, integrating many functions that were once exclusive to intensive care. Modern anaesthesia machines provide high performances in delivering the desired volumes and pressures accurately and precisely, including assisted ventilation modes. Therefore, the physicians should be familiar with the potential and pitfalls of the most commonly used intraoperative ventilation modes: volume-controlled, pressure-controlled, dual-controlled and assisted ventilation. Although there is no clear evidence to support the advantage of any one of these ventilation modes over the others, protective mechanical ventilation with low tidal volume and low levels of positive end-expiratory pressure (PEEP) should be considered in patients undergoing surgery. The target tidal volume should be calculated based on the predicted or ideal body weight rather than on the actual body weight. To optimize ventilation monitoring, anaesthesia machines should include end-inspiratory and end-expiratory pause as well as flow-volume loop curves. The routine administration of high PEEP levels should be avoided, as this may lead to haemodynamic impairment and fluid overload. Higher PEEP might be considered during surgery longer than 3 h

  9. Ergonomic design in the operating room: information technologies

    Science.gov (United States)

    Morita, Mark M.; Ratib, Osman

    2005-04-01

    The ergonomic design in the Surgical OR of information technology systems has been and continues to be a large problem. Numerous disparate information systems with unique hardware and display configurations create an environment similar to the chaotic environments of air traffic control. Patient information systems tend to show all available statistics making it difficult to isolate the key, relevant vitals for the patient. Interactions in this sterile environment are still being done with the traditional keyboard and mouse designed for cubicle office workflows. This presentation will address the shortcomings of the current design paradigm in the Surgical OR that relate to Information Technology systems. It will offer a perspective that addresses the ergonomic deficiencies and predicts how future technological innovations will integrate into this vision. Part of this vision includes a Surgical OR PACS prototype, developed by GE Healthcare Technologies, that addresses ergonomic challenges of PACS in the OR that include lack of portability, sterile field integrity, and UI targeted for diagnostic radiologists. GWindows (gesture control) developed by Microsoft Research and Voice command will allow for the surgeons to navigate and review diagnostic imagery without using the conventional keyboard and mouse that disrupt the integrity of the sterile field. This prototype also demonstrates how a wireless, battery powered, self contained mobile PACS workstation can be optimally positioned for a surgeon to reference images during an intervention as opposed to the current pre-operative review. Lessons learned from the creation of the Surgical OR PACS Prototype have demonstrated that PACS alone is not the end all solution in the OR. Integration of other disparate information systems and presentation of this information in simple, easy to navigate information packets will enable smoother interactions for the surgeons and other healthcare professionals in the OR. More intuitive

  10. Aviation safety and operation problems research and technology

    Science.gov (United States)

    Enders, J. H.; Strickle, J. W.

    1977-01-01

    Aircraft operating problems are described for aviation safety. It is shown that as aircraft technology improves, the knowledge and understanding of operating problems must also improve for economics, reliability and safety.

  11. Psychological factors of professional success of nuclear power plant main control room operators

    Directory of Open Access Journals (Sweden)

    Kosenkov A.A.

    2014-12-01

    Full Text Available Aim: to conduct a comparative analysis of the psychological characteristics of the most and least successful main control room operators. Material and Methods. Two NPP staff groups: the most and least successful main control room operators, who worked in routine operating conditions, were surveyed. Expert evaluation method has been applied to identify the groups. The subjects were administered the Minnesota Multiphasic Personality Inventory (MMPI, Cattell's Sixteen Personality Factor Questionnaire (16PF form A and Raven's Progressive Matrices test. Results. Numerous significant psychological differences between the groups of most and least successful control room operators were obtained: the best operators were significantly more introverted and correctly solved more logical tasks with smaller percentage of mistakes under time pressure than worst ones. Conclusions: 1. The psychodiagnostic methods used in the study were adequate to meet research objective 2. Tendency to introversion, as well as developed the ability to solve logic problems undertime pressure, apparently, are important professional qualities for control room operators. These indicators should be considered in the process of psychological selection and professional guidance of nuclear power plant operators.

  12. 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)

  13. Operational and safety status of Krsko NPP

    International Nuclear Information System (INIS)

    Sirola, P.; Kavsek, D.

    1998-01-01

    Nuclear Power Plants Krsko (NEK) is producing electricity with the high level of reliability, safety and at acceptable price for 17 years. Energy is shared between both Slovenian and Croatian grid. The specifics of sharing the initial investment costs, later covering the operations costs and energy supply between Croatia and Slovenia is causing specific decision making problems about energy cost and future investments, however not influencing the plant safety, by now. NEK is continuously following the international nuclear technology practices, standards' changes and improvements and introducing them into the processes and equipment upgrades. As the member of the most important international integration, NEK is having the possibility of sharing its experience with others. Slovenian Energy Consumption and Supply Strategy is recognizing the NEK as a long term supply of energy in Slovenia being a strong decision making base for the future. According to the above mentioned Slovenian Energy Consumption and Supply Strategy the plant is obliged to keep all the radioactive waste, produced during the plant life, on site. The extensive efforts are taking place to reduce the radioactive waste production and save the area available for temporary waste deposition. The plant is licensed for the period of 40 years of commercial operation which started in 1983, so the Life Time Management is getting more and more important, including the performance tracing of the essential components, their maintenance and surveillance programs and also replacement plans of critical equipment. The major problems the NEK is confronted with at the moment are the Steam Generators which are reaching their and of life, and a very limited radioactive waste storage area. They are excerting influence on the plant availability and operations and maintenance costs. At the moment the process of Modernization is in progress, covering the Steam Generators replacement and a Plant Specific Simulators supply

  14. [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.

  15. 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.

  16. 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.

  17. Predicting safety culture: the roles of employer, operations manager and safety professional.

    Science.gov (United States)

    Wu, Tsung-Chih; Lin, Chia-Hung; Shiau, Sen-Yu

    2010-10-01

    This study explores predictive factors in safety culture. In 2008, a sample 939 employees was drawn from 22 departments of a telecoms firm in five regions in central Taiwan. The sample completed a questionnaire containing four scales: the employer safety leadership scale, the operations manager safety leadership scale, the safety professional safety leadership scale, and the safety culture scale. The sample was then randomly split into two subsamples. One subsample was used for measures development, one for the empirical study. A stepwise regression analysis found four factors with a significant impact on safety culture (R²=0.337): safety informing by operations managers; safety caring by employers; and safety coordination and safety regulation by safety professionals. Safety informing by operations managers (ß=0.213) was by far the most significant predictive factor. The findings of this study provide a framework for promoting a positive safety culture at the group level. Crown Copyright © 2010. Published by Elsevier Ltd. All rights reserved.

  18. 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.

  19. 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)

  20. ILK statement about the regulatory authorities' perception of operators' self-assessment of safety culture

    International Nuclear Information System (INIS)

    2005-01-01

    Over the past few years, German licensing and supervisory authorities have devoted increasing attention to safety management and safety culture issues. At present, German plant operators are introducing systems for self-assessment of the safety culture in their plants, such as the Safety Culture Assessment System developed by VGB Power Tech (VGB-SBS). In its statement, the International Committee on Nuclear Technology (ILK) addresses an effective approach of the authorities in evaluating the self-assessment of safety culture conducted by operators. ILK proposes a total of ten recommendations for evaluating the self-assessment system of the operators by the authority. The regulatory authorities should see to it that the operators establish a self-assessment system for aspects of organization and personnel, and use it continuously. The measures derived from this self-assessment by the operators, and the reasons underlying them, should be discussed with the authorities. In addition to the operators, also the regulatory authorities and the technical expert organizations commissioned by them should carry out self-assessments of their respective supervisory activities, taking into account also special events, such as changes in government, and develop appropriate programs of measures to be taken. In evaluating safety culture, the regulatory authorities should strive to support the activities of operators in improving their safety culture. A spirit of mutual confidence and cooperation should exist between operators and authorities. The recommendations expressed in the statement deliberately leave room for detailed implementation by the parties concerned. (orig.)

  1. Safety Climate of Commercial Vehicle Operation

    Science.gov (United States)

    2010-03-01

    Enhancing the safety culture within trucking and motor coach industries has become a key area of concern given the potential impact it has on crashes and overall safety. Many organizations recognize that safety is compromised if the culture within th...

  2. The enhancement of Ignalina NPP in design and operational safety

    International Nuclear Information System (INIS)

    Negrivoda, G.

    1999-01-01

    Enhancement of Ignalina NPP design include: core design improvements; fuel channel integrity (multiple pressure tube rupture); improvements of shutdown systems; improvements of instrumentation and control devices; containment strength and tightness; design basis accident analysis; improvements of safety and support systems; seismic safety enhancement; Year 2000 project; cracks in pipes. Enhancement of operational safety includes: quality assurance; configuration management; safety management and safety culture; emergency operating procedures; training and full scope simulator; in-service inspection; fire protection and ageing monitoring and management

  3. 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)

  4. 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.

  5. 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

  6. Operational and safety requirement of radiation facility

    International Nuclear Information System (INIS)

    Zulkafli Ghazali

    2007-01-01

    Gamma and electron irradiation facilities are the most common industrial sources of ionizing radiation. They have been used for medical, industrial and research purposes since the 1950s. Currently there are more than 160 gamma irradiation facilities and over 600 electron beam facilities in operation worldwide. These facilities are either used for the sterilization of medical and pharmaceutical products, the preservation of foodstuffs, polymer synthesis and modification, or the eradication of insect infestation. Irradiation with electron beam, gamma ray or ultra violet light can also destroy complex organic contaminants in both liquid and gaseous waste. EB systems are replacing traditional chemical sterilization methods in the medical supply industry. The ultra-violet curing facility, however, has found more industrial application in printing and furniture industries. Gamma and electron beam facilities produce very high dose rates during irradiation, and thus there is a potential of accidental exposure in the irradiation chamber which can be lethal within minutes. Although, the safety record of this industry has been relatively very good, there have been fatalities recorded in Italy (1975), Norway (1982), El Salvador (1989) and Israel (1990). Precautions against uncontrolled entry into irradiation chamber must therefore be taken. This is especially so in the case of gamma irradiation facilities those contain large amounts of radioactivity. If the mechanism for retracting the source is damaged, the source may remain exposed. This paper will, to certain extent, describe safety procedure and system being installed at ALURTRON, Nuclear Malaysia to eliminate accidental exposure of electron beam irradiation. (author)

  7. 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.

  8. 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...

  9. 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.

  10. 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

  11. 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.

  12. 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

  13. 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)

  14. Safety evaluation of the Dalat research reactor operation

    International Nuclear Information System (INIS)

    Long, V.H.; Lam, P.V.; An, T.K.

    1989-01-01

    After an introduction presenting the essential characteristics of the Dalat Nuclear Research Reactor, the document presents i) The safety assurance condition of the reactor, ii) Its safety behaviour after 5 years of operation, iii) Safety research being realized on the reactor. Following is questionnaire of safety evaluation and a list of attachments, which concern the reactor

  15. 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...

  16. [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

  17. Conduct of Operations at Nuclear Power Plants. Safety Guide (Spanish Edition)

    International Nuclear Information System (INIS)

    2012-01-01

    This Safety Guide identifies the main responsibilities and practices of nuclear power plant (NPP) operations departments in relation to their responsibility for the safe functioning of the plant. The guide presents the factors to be considered in structuring the operations department of an NPP; setting high standards of performance; making safety related decisions in an effective manner; conducting control room and field activities in a thorough and professional manner; and maintaining an NPP within established operational limits and conditions. Contents: 1. Introduction; 2. Management and organization of plant operations; 3. Shift complement and functions; 4. Shift routines and operating practices; 5. Control of equipment and plant status; 6. Operations equipment and operator aids; 7. Work control and authorization.

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

    Science.gov (United States)

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

    2013-09-01

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

  19. Research on station management in subway operation safety

    Science.gov (United States)

    Li, Yiman

    2017-10-01

    The management of subway station is an important part of the safe operation of urban subway. In order to ensure the safety of subway operation, it is necessary to study the relevant factors that affect station management. In the protection of subway safety operations on the basis of improving the quality of service, to promote the sustained and healthy development of subway stations. This paper discusses the influencing factors of subway operation accident and station management, and analyzes the specific contents of station management security for subway operation, and develops effective suppression measures. It is desirable to improve the operational quality and safety factor for subway operations.

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

    Directory of Open Access Journals (Sweden)

    Callie M. Cox Bauer

    2016-08-01

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

  1. Safety Evakuation Of Triga-2000 Reactor Operation Viewed From Safety Culture

    International Nuclear Information System (INIS)

    Karliana, Itjeu

    2001-01-01

    The safety evaluation activities of TRIGA-2000 operation viewed from safety culture performed by questioners data collected from the operators and supervisor site of TRIGA-2000 P3TN, Bandung. There are 9 activity aspects surveyed, for instant to avail the policy of safety from their chairman, safety management, education and training, emergency aids planning, safety consultancy, accident information, safety analysis, safety devices, safety and occupational health. The surveying undertaken by filling the questioner that containing of 9 activity aspects and 20 samples of employees. The safety evaluation results' of the operation personnel in TRIGA-2000 P3TN are good implemented by both the operators and supervisors should be improve and attention need to provide the equipment's. The education and training especially for safety refreshment must be performing

  2. 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.

  3. Modelling operator cognitive interactions in nuclear power plant safety evaluation

    International Nuclear Information System (INIS)

    Senders, J.W.; Moray, N.; Smiley, A.; Sellen, A.

    1985-08-01

    The overall objectives of the study were to review methods which are applicable to the analysis of control room operator cognitive interactions in nuclear plant safety evaluations and to indicate where future research effort in this area should be directed. This report is based on an exhaustive search and review of the literature on NPP (Nuclear Power Plant) operator error, human error, human cognitive function, and on human performance. A number of methods which have been proposed for the estimation of data for probabilistic risk analysis have been examined and have been found wanting. None addresses the problem of diagnosis error per se. Virtually all are concerned with the more easily detected and identified errors of action. None addresses underlying cause and mechanism. It is these mechanisms which must be understood if diagnosis errors and other cognitive errors are to be controlled and predicted. We have attempted to overcome the deficiencies of earlier work and have constructed a model/taxonomy, EXHUME, which we consider to be exhaustive. This construct has proved to be fruitful in organizing our thinking about the kinds of error that can occur and the nature of self-correcting mechanisms, and has guided our thinking in suggesting a research program which can provide the data needed for quantification of cognitive error rates and of the effects of mitigating efforts. In addition a preliminary outline of EMBED, a causal model of error, is given based on general behavioural research into perception, attention, memory, and decision making. 184 refs

  4. 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)

  5. Upgraded safety analysis document including operations policies, operational safety limits and policy changes. Revision 2

    International Nuclear Information System (INIS)

    Batchelor, K.

    1996-03-01

    The National Synchrotron Light Source Safety Analysis Reports (1), (2), (3), BNL reports number-sign 51584, number-sign 52205 and number-sign 52205 (addendum) describe the basic Environmental Safety and Health issues associated with the department's operations. They include the operating envelope for the Storage Rings and also the rest of the facility. These documents contain the operational limits as perceived prior or during construction of the facility, much of which still are appropriate for current operations. However, as the machine has matured, the experimental program has grown in size, requiring more supervision in that area. Also, machine studies have either verified or modified knowledge of beam loss modes and/or radiation loss patterns around the facility. This document is written to allow for these changes in procedure or standards resulting from their current mode of operation and shall be used in conjunction with the above reports. These changes have been reviewed by NSLS and BNL ES and H committee and approved by BNL management

  6. Supplement to safety analysis report. 306-W building operations safety requirement

    International Nuclear Information System (INIS)

    Richey, C.R.

    1979-08-01

    The operations safety requirements (OSRs) presented in this report define the conditions, safe boundaries, and management control needed for safely conducting operations with radioactive materials in the Pacific Northwest Laboratory (PNL) 306-W building. The safety requirements are organized in five sections. Safety limits are safety-related process variables that are observable and measurable. Limiting conditions cover: equipment and technical conditions and characteristics of the facility and operations necessary for continued safe operation. Surveillance requirements prescribe the requirements for checking systems and components that are essential to safety. Equipment design controls require that changes to process equipment and systems be independently checked and approved to assure that the changes will have no adverse effect on safety. Administrative controls describe and discuss the organization and administrative systems and procedures to be used for safe operation of the facility. Details of the implementation of the operations safety requirements are prescribed by internal PNL documents such as criticality safety specifications and radiation work procedures

  7. Implementation of an operator model with error mechanisms for nuclear power plant control room operation

    International Nuclear Information System (INIS)

    Suh, Sang Moon; Cheon, Se Woo; Lee, Yong Hee; Lee, Jung Woon; Park, Young Taek

    1996-01-01

    SACOM(Simulation Analyser with Cognitive Operator Model) is being developed at Korea Atomic Energy Research Institute to simulate human operator's cognitive characteristics during the emergency situations of nuclear power plans. An operator model with error mechanisms has been developed and combined into SACOM to simulate human operator's cognitive information process based on the Rasmussen's decision ladder model. The operational logic for five different cognitive activities (Agents), operator's attentional control (Controller), short-term memory (Blackboard), and long-term memory (Knowledge Base) have been developed and implemented on blackboard architecture. A trial simulation with a scenario for emergency operation has been performed to verify the operational logic. It was found that the operator model with error mechanisms is suitable for the simulation of operator's cognitive behavior in emergency situation

  8. Operation safety of complex industrial systems. Main concepts

    International Nuclear Information System (INIS)

    Zwingelstein, G.

    2009-01-01

    Operation safety consists in knowing, evaluating, foreseeing, measuring and mastering the technological system and human failures in order to avoid their impacts on health and people's safety, on productivity, and on the environment, and to preserve the Earth's resources. This article recalls the main concepts of operation safety: 1 - evolutions in the domain; 2 - failures, missions and functions of a system and of its components: functional failure, missions and functions, industrial processes, notions of probability; 3 - basic concepts and operation safety: reliability, unreliability, failure density, failure rate, relations between them, availability, maintainability, safety. (J.S.)

  9. Safety of Nuclear Power Plants: Commissioning and Operation

    International Nuclear Information System (INIS)

    2011-01-01

    This publication is a revision of Safety Requirements No. NS-R-2, Safety of Nuclear Power Plants: Operation, and has been extended to cover the commissioning stage. It describes the requirements to be met to ensure the safe operation of nuclear power plants. Over recent years there have been developments in areas such as long term operation, plant ageing, periodic safety review, probabilistic safety analysis and risk informed decision making processes. It became necessary to revise the IAEA's safety requirements in these areas and to correct and/or improve the publication on the basis of feedback from its application by both the IAEA and its Member States. In addition, the requirements are governed by, and must apply, the safety objective and safety principles that are established in the Fundamental Safety Principles. Contents: 1. Introduction; 2. Safety objectives and principles; 3. The management and organizational structure of the operating organization; 4. Management of operational safety; 5. Operational safety programmes; 6. Plant commissioning; 7. Plant operations; 8. Maintenance, testing, surveillance and inspection; 9. Preparation for decommissioning.

  10. Safety of Nuclear Power Plants: Commissioning and Operation (French Edition)

    International Nuclear Information System (INIS)

    2012-01-01

    This publication is a revision of Safety Requirements No. NS-R-2, Safety of Nuclear Power Plants: Operation, and has been extended to cover the commissioning stage. It describes the requirements to be met to ensure the safe operation of nuclear power plants. Over recent years there have been developments in areas such as long term operation, plant ageing, periodic safety review, probabilistic safety analysis and risk informed decision making processes. It became necessary to revise the IAEA's safety requirements in these areas and to correct and/or improve the publication on the basis of feedback from its application by both the IAEA and its Member States. In addition, the requirements are governed by, and must apply, the safety objective and safety principles that are established in the Fundamental Safety Principles. Contents: 1. Introduction; 2. Safety objectives and principles; 3. The management and organizational structure of the operating organization; 4. Management of operational safety; 5. Operational safety programmes; 6. Plant commissioning; 7. Plant operations; 8. Maintenance, testing, surveillance and inspection; 9. Preparation for decommissioning.

  11. Safety of Nuclear Power Plants: Commissioning and Operation. Arabic Edition

    International Nuclear Information System (INIS)

    2011-01-01

    This publication is a revision of Safety Requirements No. NS-R-2, Safety of Nuclear Power Plants: Operation, and has been extended to cover the commissioning stage. It describes the requirements to be met to ensure the safe operation of nuclear power plants. Over recent years there have been developments in areas such as long term operation, plant ageing, periodic safety review, probabilistic safety analysis and risk informed decision making processes. It became necessary to revise the IAEA's safety requirements in these areas and to correct and/or improve the publication on the basis of feedback from its application by both the IAEA and its Member States. In addition, the requirements are governed by, and must apply, the safety objective and safety principles that are established in the Fundamental Safety Principles. Contents: 1. Introduction; 2. Safety objectives and principles; 3. The management and organizational structure of the operating organization; 4. Management of operational safety; 5. Operational safety programmes; 6. Plant commissioning; 7. Plant operations; 8. Maintenance, testing, surveillance and inspection; 9. Preparation for decommissioning.

  12. Safety of Nuclear Power Plants: Commissioning and Operation (Spanish Edition)

    International Nuclear Information System (INIS)

    2012-01-01

    This publication is a revision of Safety Requirements No. NS-R-2, Safety of Nuclear Power Plants: Operation, and has been extended to cover the commissioning stage. It describes the requirements to be met to ensure the safe operation of nuclear power plants. Over recent years there have been developments in areas such as long term operation, plant ageing, periodic safety review, probabilistic safety analysis and risk informed decision making processes. It became necessary to revise the IAEA's safety requirements in these areas and to correct and/or improve the publication on the basis of feedback from its application by both the IAEA and its Member States. In addition, the requirements are governed by, and must apply, the safety objective and safety principles that are established in the Fundamental Safety Principles. Contents: 1. Introduction; 2. Safety objectives and principles; 3. The management and organizational structure of the operating organization; 4. Management of operational safety; 5. Operational safety programmes; 6. Plant commissioning; 7. Plant operations; 8. Maintenance, testing, surveillance and inspection; 9. Preparation for decommissioning.

  13. The operating organization for nuclear power plants. Safety guide

    International Nuclear Information System (INIS)

    2001-01-01

    This Safety Guide was prepared under the IAEA programme for safety standards for nuclear power plants. The present publication is a revision of the IAEA Safety Guide on Management of Nuclear Power Plants for Safe Operation issued in 1984. It supplements Section 2 of the Safety Requirements publication on Safety of Nuclear Power Plants: Operation. Nuclear power technology is different from the customary technology of power generation from fossil fuel and by hydroelectric means. One major difference between the management of nuclear power plants and that of conventional generating plants is the emphasis that should be placed on nuclear safety, quality assurance, the management of radioactive waste and radiological protection, and the accompanying national regulatory requirements. This Safety Guide highlights the important elements of effective management in relation to these aspects of safety. The attention to be paid to safety requires that the management recognize that personnel involved in the nuclear power programme should understand, respond effectively to, and continuously search for ways to enhance safety in the light of any additional requirements socially and legally demanded of nuclear energy. This will help to ensure that safety policies that result in the safe operation of nuclear power plants are implemented and that margins of safety are always maintained. The structure of the organization, management standards and administrative controls should be such that there is a high degree of assurance that safety policies and decisions are implemented, safety is continuously enhanced and a strong safety culture is promoted and supported. The objective of this publication is to guide Member States in setting up an operating organization which facilitates the safe operation of nuclear power plants to a high level internationally. The second objective is to provide guidance on the most important organizational elements in order to contribute to a strong safety

  14. The operating organization for nuclear power plants. Safety guide

    International Nuclear Information System (INIS)

    2005-01-01

    This Safety Guide was prepared under the IAEA programme for safety standards for nuclear power plants. The present publication is a revision of the IAEA Safety Guide on Management of Nuclear Power Plants for Safe Operation issued in 1984. It supplements Section 2 of the Safety Requirements publication on Safety of Nuclear Power Plants: Operation. Nuclear power technology is different from the customary technology of power generation from fossil fuel and by hydroelectric means. One major difference between the management of nuclear power plants and that of conventional generating plants is the emphasis that should be placed on nuclear safety, quality assurance, the management of radioactive waste and radiological protection, and the accompanying national regulatory requirements. This Safety Guide highlights the important elements of effective management in relation to these aspects of safety. The attention to be paid to safety requires that the management recognize that personnel involved in the nuclear power programme should understand, respond effectively to, and continuously search for ways to enhance safety in the light of any additional requirements socially and legally demanded of nuclear energy. This will help to ensure that safety policies that result in the safe operation of nuclear power plants are implemented and that margins of safety are always maintained. The structure of the organization, management standards and administrative controls should be such that there is a high degree of assurance that safety policies and decisions are implemented, safety is continuously enhanced and a strong safety culture is promoted and supported. The objective of this publication is to guide Member States in setting up an operating organization which facilitates the safe operation of nuclear power plants to a high level internationally. The second objective is to provide guidance on the most important organizational elements in order to contribute to a strong safety

  15. The operating organization for nuclear power plants. Safety guide

    International Nuclear Information System (INIS)

    2004-01-01

    This Safety Guide was prepared under the IAEA programme for safety standards for nuclear power plants. The present publication is a revision of the IAEA Safety Guide on Management of Nuclear Power Plants for Safe Operation issued in 1984. It supplements Section 2 of the Safety Requirements publication on Safety of Nuclear Power Plants: Operation. Nuclear power technology is different from the customary technology of power generation from fossil fuel and by hydroelectric means. One major difference between the management of nuclear power plants and that of conventional generating plants is the emphasis that should be placed on nuclear safety, quality assurance, the management of radioactive waste and radiological protection, and the accompanying national regulatory requirements. This Safety Guide highlights the important elements of effective management in relation to these aspects of safety. The attention to be paid to safety requires that the management recognize that personnel involved in the nuclear power programme should understand, respond effectively to, and continuously search for ways to enhance safety in the light of any additional requirements socially and legally demanded of nuclear energy. This will help to ensure that safety policies that result in the safe operation of nuclear power plants are implemented and that margins of safety are always maintained. The structure of the organization, management standards and administrative controls should be such that there is a high degree of assurance that safety policies and decisions are implemented, safety is continuously enhanced and a strong safety culture is promoted and supported. The objective of this publication is to guide Member States in setting up an operating organization which facilitates the safe operation of nuclear power plants to a high level internationally. The second objective is to provide guidance on the most important organizational elements in order to contribute to a strong safety

  16. Evaluating the influence of perceived organizational learning capability on user acceptance of information technology among operating room nurse staff.

    Science.gov (United States)

    Lee, Chien-Ching; Lin, Shih-Pin; Yang, Shu-Ling; Tsou, Mei-Yung; Chang, Kuang-Yi

    2013-03-01

    Medical institutions are eager to introduce new information technology to improve patient safety and clinical efficiency. However, the acceptance of new information technology by medical personnel plays a key role in its adoption and application. This study aims to investigate whether perceived organizational learning capability (OLC) is associated with user acceptance of information technology among operating room nurse staff. Nurse anesthetists and operating room nurses were recruited in this questionnaire survey. A pilot study was performed to ensure the reliability and validity of the translated questionnaire, which consisted of 14 items from the four dimensions of OLC, and 16 items from the four constructs of user acceptance of information technology, including performance expectancy, effort expectancy, social influence, and behavioral intention. Confirmatory factor analysis was applied in the main survey to evaluate the construct validity of the questionnaire. Structural equation modeling was used to test the hypothetical relationships between the four dimensions of user acceptance of information technology and the second-ordered OLC. Goodness of fit of the hypothetic model was also assessed. Performance expectancy, effort expectancy, and social influence positively influenced behavioral intention of users of the clinical information system (all p < 0.001) and accounted for 75% of its variation. The second-ordered OLC was positively associated with performance expectancy, effort expectancy, and social influence (all p < 0.001). However, the hypothetic relationship between perceived OLC and behavioral intention was not significant (p = 0.87). The fit statistical analysis indicated reasonable model fit to data (root mean square error of approximation = 0.07 and comparative fit index = 0.91). Perceived OLC indirectly affects user behavioral intention through the mediation of performance expectancy, effort expectancy, and social influence in the operating room

  17. Bayesian approach and application to operation safety

    International Nuclear Information System (INIS)

    Procaccia, H.; Suhner, M.Ch.

    2003-01-01

    The management of industrial risks requires the development of statistical and probabilistic analyses which use all the available convenient information in order to compensate the insufficient experience feedback in a domain where accidents and incidents remain too scarce to perform a classical statistical frequency analysis. The Bayesian decision approach is well adapted to this problem because it integrates both the expertise and the experience feedback. The domain of knowledge is widen, the forecasting study becomes possible and the decisions-remedial actions are strengthen thanks to risk-cost-benefit optimization analyzes. This book presents the bases of the Bayesian approach and its concrete applications in various industrial domains. After a mathematical presentation of the industrial operation safety concepts and of the Bayesian approach principles, this book treats of some of the problems that can be solved thanks to this approach: softwares reliability, controls linked with the equipments warranty, dynamical updating of databases, expertise modeling and weighting, Bayesian optimization in the domains of maintenance, quality control, tests and design of new equipments. A synthesis of the mathematical formulae used in this approach is given in conclusion. (J.S.)

  18. 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

  19. Development, initial reliability and validity testing of an observational tool for assessing technical skills of operating room nurses.

    Science.gov (United States)

    Sevdalis, Nick; Undre, Shabnam; Henry, Janet; Sydney, Elaine; Koutantji, Mary; Darzi, Ara; Vincent, Charles A

    2009-09-01

    The recent emergence of the Systems Approach to the safety and quality of surgical care has triggered individual and team skills training modules for surgeons and anaesthetists and relevant observational assessment tools have been developed. To develop an observational tool that captures operating room (OR) nurses' technical skill and can be used for assessment and training. The Imperial College Assessment of Technical Skills for Nurses (ICATS-N) assesses (i) gowning and gloving, (ii) setting up instrumentation, (iii) draping, and (iv) maintaining sterility. Three to five observable behaviours have been identified for each skill and are rated on 1-6 scales. Feasibility and aspects of reliability and validity were assessed in 20 simulation-based crisis management training modules for trainee nurses and doctors, carried out in a Simulated Operating Room. The tool was feasible to use in the context of simulation-based training. Satisfactory reliability (Cronbach alpha) was obtained across trainers' and trainees' scores (analysed jointly and separately). Moreover, trainer nurse's ratings of the four skills correlated positively, thus indicating adequate content validity. Trainer's and trainees' ratings did not correlate. Assessment of OR nurses' technical skill is becoming a training priority. The present evidence suggests that the ICATS-N could be considered for use as an assessment/training tool for junior OR nurses.

  20. [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.

  1. 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.

  2. 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...

  3. 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.

  4. 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.

  5. Enhanced operational safety of BWRs by advanced computer technology and human engineering

    International Nuclear Information System (INIS)

    Tomizawa, T.; Fukumoto, A.; Neda, T.; Toda, Y.; Takizawa, Y.

    1984-01-01

    In BWR nuclear power plants, where unit capacity is increasing and the demand for assured safety is growing, it has become important for the information interface between man and machine to work smoothly. Efforts to improve man-machine communication have been going on for the past ten years in Japan. Computer facilities and colour CRT display systems are amongst the most useful new methods. Advanced computer technology has been applied to operating plants and found to be very helpful for safe operation. A display monitoring system (DMS) is in operation in a 1100 MW(e) BWR plant. A total combination test was successfully completed on the 'plant operation by displayed information and automation' system (PODIA) in February 1983 before shipment to the site. The objective of this test was to verify the improved qualification of the newly developed advanced PODIA man-machine system by this enlarged fabrication test concept. In addition, the development of special graphics displays for the main control room and technical support centre to assist operators in assessing plant safety and diagnosing problems is required to meet post-TMI regulations. For this purpose, a prototype safety parameter display system (called Toshiba SPDS) with two colour CRT displays and a computer (TOSBAC-7/70) was developed in 1981 as an independent safety monitoring system. The PODIA and SPDS are now independent systems, but their combination has been found to be more useful and valuable for nuclear power plant safety. The paper discusses supervisory and operational concepts in the advanced main control room including SPDS, and describes the PODIA and SPDS verification tests including the valuable experience obtained after improvements in the qualification of these systems had been made to satisfactory operational safety levels. (author)

  6. 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.

  7. Safety analysis of ventilation and inspection operations on barrels in which spent fuel elements are stored

    International Nuclear Information System (INIS)

    Pavlovic, R.; Todorovic, D.; Plecas, I.

    2000-01-01

    Safety analysis of possible accident during performing ventilation and inspection operations on barrels in which spent fuel elements are stored has been proposed. Investigation is confined to a case when primary contamination is localized to the disposal room and controlled release of gaseous effluents to the atmosphere. 85 Kr is the most important radionuclide considered risk estimation due to release of gaseous fission products (author) [sr

  8. Time Based Workload Analysis Method for Safety-Related Operator Actions in Safety Analysis

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Yun Goo; Oh, Eung Se [Korea Hydro and Nuclear Power Co., Daejeon (Korea, Republic of)

    2016-05-15

    During the design basis event, the safety system performs safety functions to mitigate the event. The most of safety system is actuated by automatic system however, there are operator manual actions that are needed for the plant safety. These operator actions are classified as important human actions in human factors engineering design. The human factors engineering analysis and evaluation is needed for these important human actions to assure that operator successfully perform their tasks for plant safety and operational goals. The work load analysis is one of the required analysis for the important human actions.

  9. Time Based Workload Analysis Method for Safety-Related Operator Actions in Safety Analysis

    International Nuclear Information System (INIS)

    Kim, Yun Goo; Oh, Eung Se

    2016-01-01

    During the design basis event, the safety system performs safety functions to mitigate the event. The most of safety system is actuated by automatic system however, there are operator manual actions that are needed for the plant safety. These operator actions are classified as important human actions in human factors engineering design. The human factors engineering analysis and evaluation is needed for these important human actions to assure that operator successfully perform their tasks for plant safety and operational goals. The work load analysis is one of the required analysis for the important human actions.

  10. Evaluating X-ray absorption of nano-bismuth oxide ointment for decreasing risks associated with X-ray exposure among operating room personnel and radiology experts

    Directory of Open Access Journals (Sweden)

    M. Rashidi

    2015-12-01

      Conclusion: It seems that due to higher atomic number and lower toxicity, Bi2O3 nanoparticles have better efficiency in X-ray absorbtion, comparing to the lead. Cream and ointment of bismuth oxide nanoparticles can be used as X-ray absorbant for different professions such as physicians, dentists, radiology experts, and operating room staff and consequently increase health and safety of these employees.

  11. 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...

  12. 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.

  13. 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

  14. Safety of Nuclear Power Plants: Commissioning and Operation

    International Nuclear Information System (INIS)

    2011-01-01

    The safety of a nuclear power plant is ensured by means of proper site selection, design, construction and commissioning, and the evaluation of these, followed by proper management, operation and maintenance of the plant. In a later phase, a proper transition to decommissioning is required. The organization and management of plant operations ensures that a high level of safety is achieved through the effective management and control of operational activities. This publication is a revision of the Safety Requirements publication Safety of Nuclear Power Plants: Operation, which was issued in 2000 as IAEA Safety Standards Series No. NS-R-2. The purpose of this revision was to restructure Safety Standards Series No. NS-R-2 in the light of new operating experience and new trends in the nuclear industry; to introduce new requirements that were not included in Safety Standards Series No. NS-R-2 on the operation of nuclear power plants; and to reflect current practices, new concepts and technical developments. This update also reflects feedback on the use of the standards, both from Member States and from the IAEA's safety related activities. The publication is presented in the new format for Safety Requirements publications. The present publication reflects the safety principles of the Fundamental Safety Principles. It has been harmonized with IAEA Safety Standards Series No. GS-R-3 on The Management System for Facilities and Activities. Guidance on the fulfilment of the safety requirements is provided in supporting Safety Guides. The terminology used in this publication is defined and explained in the IAEA Safety Glossary. The objective of this publication is to establish the requirements which, in the light of experience and the present state of technology, must be satisfied to ensure the safe operation of nuclear power plants. These requirements are governed by the safety objective and safety principles that are established in the Fundamental Safety Principles. This

  15. 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

  16. Fuel Supply Shutdown Facility Interim Operational Safety Requirements

    International Nuclear Information System (INIS)

    BENECKE, M.W.

    2000-01-01

    The Interim Operational Safety Requirements for the Fuel Supply Shutdown (FSS) Facility define acceptable conditions, safe boundaries, bases thereof, and management of administrative controls to ensure safe operation of the facility

  17. 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.

  18. 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.

  19. 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.

  20. Use of hands-free technique among operating room nurses in the Republic of Korea.

    Science.gov (United States)

    Jeong, Ihn Sook; Park, Sunmi

    2009-03-01

    The recently introduced concept of hands-free technique (HFT) currently has no recommendations or formal educational program for use in the Republic of Korea. This study evaluated the level of HFT use and investigated factors related to HFT use among Korean operating room nurses. Data were obtained through a self-administered questionnaire from 158 operating room nurses in 7 general hospitals in Busan, Republic of Korea, in April and May 2006. The questionnaire elicited information on demographics, exposure to education on HFT, attitude toward the need for HFT, concerns about exposure to bloodborne pathogens, and experience with HTF use. Multilevel multiple logistic regression analysis with generalized estimating equations was used, and adjusted odds ratios (ORs) and their 95% confidence intervals (CIs) were calculated. We found that 56% of the participants had used HFT, and 50% had received education on HFT. The use of HFT had a significant association with both education on HFT (OR = 12.02; 95% CI = 7.50 to 19.25) and attitude toward the need for HFT (OR = 4.22; 95% CI = 2.43 to 7.35). Increasing education about HFT could be the most important approach to increasing the use of HFT among Korean operating room nurses. Thus, routine teaching about HFT should be provided to these nurses.

  1. 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

  2. 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.

  3. 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

  4. AMNT 2014. Key Topic: Reactor operation, safety - report. Pt. 1

    International Nuclear Information System (INIS)

    Schaffrath, Andreas

    2014-01-01

    Summary report on one session of the Annual Conference on Nuclear Technology held in Frankfurt, 6 to 8 May 2014: - Safety of Nuclear Installations - Methods, Analysis, Results: Backfittings for the Improvement of Safety and Efficiency. The other Sessions of the Key Topics 'Reactor Operation, Safety', 'Competence, Innovation, Regulation' and 'Fuel, Decommissioning and Disposal' will be covered in further issues of atw.

  5. Operating safety requirements for the intermediate level liquid waste system

    International Nuclear Information System (INIS)

    1980-07-01

    The operation of the Intermediate Level Liquid Waste (ILW) System, which is described in the Final Safety Analysis, consists of two types of operations, namely: (1) the operation of a tank farm which involves the storage and transportation through pipelines of various radioactive liquids; and (2) concentration of the radioactive liquids by evaporation including rejection of the decontaminated condensate to the Waste Treatment Plant and retention of the concentrate. The following safety requirements in regard to these operations are presented: safety limits and limiting control settings; limiting conditions for operation; and surveillance requirements. Staffing requirements, reporting requirements, and steps to be taken in the event of an abnormal occurrence are also described

  6. Safety significance of inadvertent operation of motor-operated valves in nuclear power plants

    International Nuclear Information System (INIS)

    Ruger, C.J.; Higgins, J.C.; Carbonaro, J.F.; Hall, R.E.

    1994-01-01

    Concerns about the consequences of valve mispositioning were brought to the forefront following an event at Davis Besse in 1985. The concern related to the ability to reposition open-quotes position-changeableclose quotes motor-operated valves (MOVs) from the control room in the event of their inadvertent operation and was documented in U.S. Nuclear Regulatory Commission (USNRC) Bulletin 85-03 and Generic Letter (GL) 89-10. The mispositioned MOVs may not be able to be returned to their required position due to high differential pressure or high flow conditions across the valves. The inability to reposition such valves may have significantly safety consequences, as in the Davis Besse event. However, full consideration of such mispositioning in safety analyses and in MOV test programs can be labor intensive and expensive. Industry raised concerns that consideration of position-changeable valves under GL 89-10 would not decrease the probability of core damage to an extent that would justify licensee costs. As a response, Brookhaven National Laboratory has conducted separate scoping studies for both boiling water reactors (BWRs) and pressurized water reactors (PWRs) using probabilistic risk assessment (PRA) techniques to determine if such valve mispositioning by itself is significant to safety. The approach used internal events PRA models to survey the order of magnitude of the risk-significance of valve mispositioning by considering the failure of selected position-changeable MOVs. The change in core damage frequency was determined for each valve considered, and the results were presented as a risk increase ratio for each of four assumed MOV failure rates. The risk increase ratios resulting from this failure rate sensitivity study can be used as a basis for a determination of the risk-significance of the MOV mispositioning issues for BWRs and PWRs

  7. [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.

  8. Pharmacologic Considerations for Pediatric Sedation and Anesthesia Outside the Operating Room: A Review for Anesthesia and Non-Anesthesia Providers.

    Science.gov (United States)

    Khurmi, Narjeet; Patel, Perene; Kraus, Molly; Trentman, Terrence

    2017-10-01

    Understanding the pharmacologic options for pediatric sedation outside the operating room will allow practitioners to formulate an ideal anesthetic plan, allaying anxiety and achieving optimal immobilization while ensuring rapid and efficient recovery. The authors identified relevant medical literature by searching PubMed, MEDLINE, Embase, Scopus, Web of Science, and Google Scholar databases for English language publications covering a period from 1984 to 2017. Search terms included pediatric anesthesia, pediatric sedation, non-operating room sedation, sedation safety, and pharmacology. As a narrative review of common sedation/anesthesia options, the authors elected to focus on studies, reviews, and case reports that show clinical relevance to modern day sedation/anesthesia practice. A variety of pharmacologic agents are available for sedation/anesthesia in pediatrics, including midazolam, fentanyl, ketamine, dexmedetomidine, etomidate, and propofol. Dosing ranges reported are a combination of what is discussed in the reviewed literature and text books along with personal recommendations based on our own practice. Several reports reveal that ketofol (a combination of ketamine and propofol) is quite popular for short, painful procedures. Fospropofol is a newer-generation propofol that may confer advantages over regular propofol. Remimazolam combines the pharmacologic effects of remifentanil and midazolam. A variety of etomidate derivatives such as methoxycarbonyl-etomidate, carboetomidate, methoxycarbonyl-carboetomidate, and cyclopropyl-methoxycarbonyl metomidate are in development stages. The use of nitrous oxide as a mild sedative, analgesic, and amnestic agent is gaining popularity, especially in the ambulatory setting. Utilizing a dedicated and experienced team to provide sedation enhances safety. Furthermore, limiting sedation plans to single-agent pharmacy appears to be safer than using multi-agent plans.

  9. Operational safety performance of Slovak NPPs in 2005

    International Nuclear Information System (INIS)

    Tomek, J.

    2006-01-01

    In this presentation author presents operational safety performance of Slovak NPPs in 2005. Operation of Slovak NPPs in 2005 was safe and reliable, with: - high level of performance low risk; - minimal impact on the personnel, environment and public; - positive attitude to safety.

  10. 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.

  11. LMFBR operational safety: the EBR-II experience

    International Nuclear Information System (INIS)

    Sackett, J.I.; Allen, N.L.; Dean, E.M.; Fryer, R.M.; Larson, H.A.; Lehto, W.K.

    1978-01-01

    The mission of the Experimental Breeder Reactor II (EBR-II) has evolved from that of a small LMFBR demonstration plant to a major irradiation-test facility. Because of that evolution, many operational-safety issues have been encountered. The paper describes the EBR-II operational-safety experience in four areas: protection-system design, safety-document preparation, tests of off-normal reactor conditions, and tests of elements with breached cladding

  12. Waste Encapsulation and Storage Facility interim operational safety requirements

    CERN Document Server

    Covey, L I

    2000-01-01

    The Interim Operational Safety Requirements (IOSRs) for the Waste Encapsulation and Storage Facility (WESF) define acceptable conditions, safe boundaries, bases thereof, and management or administrative controls required to ensure safe operation during receipt and inspection of cesium and strontium capsules from private irradiators; decontamination of the capsules and equipment; surveillance of the stored capsules; and maintenance activities. Controls required for public safety, significant defense-in-depth, significant worker safety, and for maintaining radiological consequences below risk evaluation guidelines (EGs) are included.

  13. Research on Integration of NPP Operational Safety Management Performance Systems

    International Nuclear Information System (INIS)

    Chi, Miao; Shi, Liping

    2014-01-01

    The operational safety management of Nuclear Power Plants demands systematic planning and integrated control. NPPs are following the well-developed safety indicator systems proposed by IAEA Operational Safety Performance Indicator Programme, NRC Reactor Oversight Process or the other institutions. Integration of the systems is proposed to benefiting from the advantages of both systems and avoiding improper application into the real world. The authors analyzed the possibility and necessity for system integration, and propose an indicator system integrating method

  14. Safety parameter display system: an operator support system for enhancement of safety in Indian PHWRs

    International Nuclear Information System (INIS)

    Subramaniam, K.; Biswas, T.

    1994-01-01

    Ensuring operational safety in nuclear power plants is important as operator errors are observed to contribute significantly to the occurrence of accidents. Computerized operator support systems, which process and structure information, can help operators during both normal and transient conditions, and thereby enhance safety and aid effective response to emergency conditions. An important operator aid being developed and described in this paper, is the safety parameter display system (SPDS). The SPDS is an event-independent, symptom-based operator aid for safety monitoring. Knowledge-based systems can provide operators with an improved quality of information. An information processing model of a knowledge based operator support system (KBOSS) developed for emergency conditions using an expert system shell is also presented. The paper concludes with a discussion of the design issues involved in the use of a knowledge based systems for real time safety monitoring and fault diagnosis. (author). 8 refs., 4 figs., 1 tab

  15. 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.

  16. 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)

  17. 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.

  18. 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.

  19. 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

  20. 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)

  1. 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.

  2. 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

  3. 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.

  4. 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.

  5. 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.

  6. 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.

  7. 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.

  8. 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

  9. 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.

  10. 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.

  11. Don't break the chain: importance of supply chain management in the operating room setting.

    Science.gov (United States)

    Bilyk, Candis

    2008-09-01

    Management of supplies within the operating room (OR) has considerable implications for decreasing healthcare costs while maintaining high-quality patient care. This area of healthcare therefore requires more monitoring by end-users including OR management, physicians, and nursing staff. This article is based on understanding supply chain management in the OR setting. Information provided throughout the article can be applied to small or large health care centers. It defines supply chain management and contains a brief overview of supply chain processes. It reviews the benefits of following these processes. The article also includes recommendations for improving the supply chain in the OR.

  12. 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

  13. Surgical PACS for the digital operating room. Systems engineering and specification of user requirements.

    Science.gov (United States)

    Korb, Werner; Bohn, Stefan; Burgert, Oliver; Dietz, Andreas; Jacobs, Stephan; Falk, Volkmar; Meixensberger, Jürgen; Strauss, Gero; Trantakis, Christos; Lemke, Heinz U

    2006-01-01

    For better integration of surgical assist systems into the operating room, a common communication and processing plattform that is based on the users needs is needed. The development of such a system, a Surgical Picture Aquisition and Communication System (S-PACS), according the systems engineering cycle is oulined in this paper. The first two steps (concept and specification) for the engineering of the S-PACS are discussed.A method for the systematic integration of the users needs', the Quality Function Deployment (QFD), is presented. The properties of QFD for the underlying problem and first results are discussed. Finally, this leads to a first definition of an S-PACS system.

  14. JET Tokamak, preparation of a safety case for tritium operations

    Energy Technology Data Exchange (ETDEWEB)

    Boyer, Helen, E-mail: helen.boyer@ccfe.ac.uk [CCFE, Culham Science Centre (United Kingdom); Plummer, David; Johnston, Jane [CCFE, Culham Science Centre (United Kingdom)

    2016-11-01

    Highlights: • A safety case incorporating technical and ITER related upgrades. • Hazard analysis reworked to include new modelling assessments. • Fitness for purpose assessment of safety controls. - Abstract: A new Safety Case is required to permit tritium operations on JET during the forthcoming DTE2 campaign. The outputs, benefits and lessons learned associated with the production of this Safety Case are presented. The changes that have occurred to the Safety Case methodology since the last JET tritium Safety Case are reviewed. Consideration is given to the effects of modifications, particularly ITER related changes, made to the JET and the impact these have on the hazard assessments as well as normal operations. Several specialized assessments, including recent MELCOR modelling, have been undertaken to support the production of this Safety Case and the impact of these assessments is outlined. Discussion of the preliminary actions being taken to progress implementation of this Safety Case is provided, highlighting new methods to improve the dissemination of the key Safety Case results to the plant operators. Finally, the work required to complete this Safety Case, before the next tritium campaign, is summarized.

  15. Contribution of operating feedback to probabilistic safety studies

    International Nuclear Information System (INIS)

    Guio, J.M. de; Lannoy, A.

    1992-03-01

    This paper presents the method used for PWR unit operation feedback analysis and its contribution to probabilistic safety studies. The targets were as follows: - use of failure data banks to assess reliability parameters, - use of event data banks to identify and quantify main system initiating events, - determination of a standard operating profile. These studies, performed in the context of nuclear power plant safety programs, prove useful not only to safety engineers but also to equipment experts, designers, operators and maintenance specialists. They constitute basic data for studies in all these areas or the departure point for new investigations. (authors). 3 figs., 3 tabs., 3 refs

  16. 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

  17. Operational limits and conditions and operating procedures for nuclear power plants. Safety guide

    International Nuclear Information System (INIS)

    2005-01-01

    This Safety Guide was prepared as part of the Agency's programme for establishing safety standards relating to nuclear power plants. The present Safety Guide supersedes the IAEA Safety Guide on Operational Limits and Conditions for Nuclear Power Plants which was issued in 1979 as Safety Series No. 50-SG-O3. For a nuclear power plant to be operated in a safe manner, the provisions made in the final design and subsequent modifications shall be reflected in limitations on plant operating parameters and in the requirements on plant equipment and personnel. Under the responsibility of the operating organization, these shall be developed during the design safety evaluation as a set of operational limits and conditions (OLCs). A major contribution to compliance with the OLCs is made by the development and utilization of operating procedures (OPs) that are consistent with and fully implement the OLCs. The requirements for the OLCs and OPs are established in Section 5 of the IAEA Safety Requirements publication Safety of Nuclear Power Plants: Operation, which this Safety Guide supplements. The purpose of this Safety Guide is to provide guidance on the development, content and implementation of OLCs and OPs. The Safety Guide is directed at both regulators and owners/operators. This Safety Guide covers the concept of OLCs, their content as applicable to land based stationary power plants with thermal neutron reactors, and the responsibilities of the operating organization regarding their establishment, modification, compliance and documentation. The OPs to support the implementation of the OLCs and to ensure their observance are also within the scope of this Safety Guide. The particular aspects of the procedures for maintenance, surveillance, in-service inspection and other safety related activities in connection with the safe operation of nuclear power plants are outside the scope of this Safety Guide but can be found in other IAEA Safety Guides. Section 2 indicates the

  18. Operational limits and conditions and operating procedures for nuclear power plants. Safety guide

    International Nuclear Information System (INIS)

    2000-01-01

    This Safety Guide was prepared as part of the Agency's programme for establishing safety standards relating to nuclear power plants. The present Safety Guide supersedes the IAEA Safety Guide on Operational Limits and Conditions for Nuclear Power Plants which was issued in 1979 as Safety Series No. 50-SG-O3. For a nuclear power plant to be operated in a safe manner, the provisions made in the final design and subsequent modifications shall be reflected in limitations on plant operating parameters and in the requirements on plant equipment and personnel. Under the responsibility of the operating organization, these shall be developed during the design safety evaluation as a set of operational limits and conditions (OLCs). A major contribution to compliance with the OLCs is made by the development and utilization of operating procedures (OPs) that are consistent with and fully implement the OLCs. The requirements for the OLCs and OPs are established in Section 5 of the IAEA Safety Requirements publication Safety of Nuclear Power Plants: Operation, which this Safety Guide supplements. The purpose of this Safety Guide is to provide guidance on the development, content and implementation of OLCs and OPs. The Safety Guide is directed at both regulators and owners/operators. This Safety Guide covers the concept of OLCs, their content as applicable to land based stationary power plants with thermal neutron reactors, and the responsibilities of the operating organization regarding their establishment, modification, compliance and documentation. The OPs to support the implementation of the OLCs and to ensure their observance are also within the scope of this Safety Guide. The particular aspects of the procedures for maintenance, surveillance, in-service inspection and other safety related activities in connection with the safe operation of nuclear power plants are outside the scope of this Safety Guide but can be found in other IAEA Safety Guides. Section 2 indicates the

  19. Mobile Computerized Procedure System for the Improved Situation Awareness among Field Workers and Main Control Room Operators

    International Nuclear Information System (INIS)

    Lee, Sungjin; Seong, Nokyu; Jung, Yeonsub

    2013-01-01

    This paper explains the technical issues of the mobile CPS (m-CPS) in the conceptual development stage. The proposed m-CPS can be developed with many recent technologies in the various industry fields based on CRI CPS. Performance and stability of CRI CPS have been tested several times until now. It is expected that more human errors can be reduced by the m-CPS through improved situation awareness and human performance tools for local workers and MCR operators. Some considerations as well as mentioned ones will be reflected in the m-CPS development. Human errors can occur during the test and maintenance of the generator, safety injection system and reactor coolant inventory in nuclear power plants (NPPs). Most of human errors have been occurred by the omission of the prevention techniques such as the self-check, the peer-check, the concurrent verification and etc. Another important reason is the insufficient information sharing 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. KHNP central research institute (CRI) expects that the extended application of CPS including the field activity, that is a kind of mobile CPS, can enhance the reduction of human errors

  20. Development of a web based monitoring system for safety and activity analysis in operating theatres.

    Science.gov (United States)

    Frosini, Francesco; Miniati, Roberto; Avezzano, Paolo; Cecconi, Giulio; Dori, Fabrizio; Gentili, Guido Biffi; Belardinelli, Andrea

    2016-01-01

    The management and the monitoring of the operating rooms on the part of the general management have the objective of optimizing their use and maximizing the internal safety. The expenses owed to their safe use represent, besides reimbursements coming from the surgical activity, important factors for the analysis of the medical facility. Given that it is not possible to reduce the safety, it is necessary to develop supporting systems with the aim to enhance and optimize the use of the rooms. The developed analysis model of the operating rooms in this study is based on the specific performance indicators and allows the effective monitoring of both the parameters that influence the safety (environmental, microbiological parameters) and those that influence the efficiency of the usage (employment rate, delays, necessary formalities, etc.). This allows you to have a systematic dashboard on hand for all of the OTs and, thus, organize the intervention schedules and more appropriate improvements. A monitoring dashboard has been achieved, accessible from any platform and any device, capable of aggregating hospital information. The undertaken organizational modifications, through the use of the dashboard, have allowed for an average annual savings of 29.52 minutes per intervention and increase the use of the ORs of 5%. The increment of the employment rate and the optimization of the operating room have allowed for savings of around $299,88 for every intervention carried out in 2013, corresponding to an annual savings of $343,362,60. Integration dashboards, as the one proposed in this study as a prototype, represent a governance model of economically sustainable healthcare systems capable of guiding the hospital management in the choices and in the implementation of the most efficient organizational modifications.

  1. Fuel supply shutdown facility interim operational safety requirements

    International Nuclear Information System (INIS)

    Besser, R.L.; Brehm, J.R.; Benecke, M.W.; Remaize, J.A.

    1995-01-01

    These Interim Operational Safety Requirements (IOSR) for the Fuel Supply Shutdown (FSS) facility define acceptable conditions, safe boundaries, bases thereof, and management or administrative controls to ensure safe operation. The IOSRs apply to the fuel material storage buildings in various modes (operation, storage, surveillance)

  2. 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.

  3. AMNT 2014. Key Topic: Reactor operation, safety - report. Pt. 1

    Energy Technology Data Exchange (ETDEWEB)

    Schaffrath, Andreas [Gesellschaft fuer Anlagen- und Reaktorsicherheit mbH (GRS), Garching (Germany). Forschungszentrum

    2014-10-15

    Summary report on one session of the Annual Conference on Nuclear Technology held in Frankfurt, 6 to 8 May 2014: - Safety of Nuclear Installations - Methods, Analysis, Results: Backfittings for the Improvement of Safety and Efficiency. The other Sessions of the Key Topics 'Reactor Operation, Safety', 'Competence, Innovation, Regulation' and 'Fuel, Decommissioning and Disposal' will be covered in further issues of atw.

  4. Development of Alarm System link Drawing for Operation Support for APR1400 Digital Main Control Room

    International Nuclear Information System (INIS)

    Kim, Ki-Hwan

    2016-01-01

    Digitalized MMI(Man-Machine Interface) including Digital Main Control Room(MCR) and digital I and C system was being applied for SKN 3 and 4 Nuclear Power Plant(NPP) and subsequent APR1400 NPP type. But, operators can not easily find instrument for alarm immediately. Therefore, Alarm system is required to easily find instrument for Alarm. For this implementation, we will plan system design considering design feature without affecting network load and CPU load. We have developed Alarm system link drawing for digital MCR. Operators of the digitalized MCR navigates from their consoles to the drawings related to the plant alarms and their instruments or the operation status. Such method gives cognitive load to the operators having to travel to different locations in finding the related information. Screen Sharing System, which is the fundamental technique for Drawing Interconnection Alarm System is close to completion, and it should be functionally tested and verified by the human factor engineering. For the actual application to the operating plants, the drawings to be interconnected to the alarms and the opinions from the operators/maintenance departments for designating alarm number should be surveyed, Also, another function that allows the access to the alarm related drawings not only from the MCR but also from the other offices

  5. Development of Alarm System link Drawing for Operation Support for APR1400 Digital Main Control Room

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Ki-Hwan [KHNP CRI, Daejeon (Korea, Republic of)

    2016-10-15

    Digitalized MMI(Man-Machine Interface) including Digital Main Control Room(MCR) and digital I and C system was being applied for SKN 3 and 4 Nuclear Power Plant(NPP) and subsequent APR1400 NPP type. But, operators can not easily find instrument for alarm immediately. Therefore, Alarm system is required to easily find instrument for Alarm. For this implementation, we will plan system design considering design feature without affecting network load and CPU load. We have developed Alarm system link drawing for digital MCR. Operators of the digitalized MCR navigates from their consoles to the drawings related to the plant alarms and their instruments or the operation status. Such method gives cognitive load to the operators having to travel to different locations in finding the related information. Screen Sharing System, which is the fundamental technique for Drawing Interconnection Alarm System is close to completion, and it should be functionally tested and verified by the human factor engineering. For the actual application to the operating plants, the drawings to be interconnected to the alarms and the opinions from the operators/maintenance departments for designating alarm number should be surveyed, Also, another function that allows the access to the alarm related drawings not only from the MCR but also from the other offices.

  6. Operational Risk Management and Military Aviation Safety

    National Research Council Canada - National Science Library

    Ashley, Park

    1999-01-01

    .... The Army's Class A aviation mishap rate declined after it implemented risk management (RM) principles in 1987. This reduction caught the attention of Air Force leadership who have since stated that the application of operational risk management...

  7. 78 FR 54510 - New Entrant Safety Assurance Program Operational Test

    Science.gov (United States)

    2013-09-04

    ... safety management controls; (2) consider their effects on small businesses; and (3) consider establishing alternate locations where such reviews may be conducted for the convenience of small businesses. In response... safety review within 18 months of starting interstate operations. [49 U.S.C. 31144(g)]. In issuing these...

  8. 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.

  9. 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

  10. Feedback of safety - related operational experience: Lessons learned

    Energy Technology Data Exchange (ETDEWEB)

    Elias, D [Commonwealth Edison Co. (United States)

    1997-09-01

    The presentation considers the following aspects of feedback of safety-related operational experience: lessons learned program, objectives, personnel characteristics; three types of documents for transmitting lessons learned issues.

  11. Feedback of safety - related operational experience: Lessons learned

    International Nuclear Information System (INIS)

    Elias, D.

    1997-01-01

    The presentation considers the following aspects of feedback of safety-related operational experience: lessons learned program, objectives, personnel characteristics; three types of documents for transmitting lessons learned issues

  12. Research on asset management for safety and operations.

    Science.gov (United States)

    2011-11-01

    The Texas Department of Transportation (TxDOT) is challenged with managing a wide range of : transportation safety and operations assets in order to respond to public and other outside interests. These : assets include, but are not limited to pavemen...

  13. RATU2, research for safety and operability

    International Nuclear Information System (INIS)

    Solin, J.

    1998-01-01

    The Finnish research programme on the structural integrity of nuclear power plants, RATU2 was launched in 1995 for four years to coordinate the independent national research and development work aiming for structural safety in NPP's. The general planning and goal setting of the programme was based on the research need assessment and evaluation of the previous RATU programme. The research plans have been updated and refined annually on the basis of available funding. The RATU2 programme is briefly introduced in this paper. The role of RATU2 in the national nuclear energy research field, the research areas, administrative data, main objectives and future plans are reported in this paper

  14. 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.

  15. 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.

  16. The influence of personal characteristics on the resilience of operating room nurses: a predictor study.

    Science.gov (United States)

    Gillespie, Brigid M; Chaboyer, Wendy; Wallis, Marianne

    2009-07-01

    Resilience in the workplace has been described as a means of facilitating adaptation in stressful environments, and therefore has application in nursing contexts. However, little research has examined how personal characteristics such as age, nursing experience and education contribute to resilience in clinical environments such as the operating room (OR). First to identify the level of resilience, and second, investigate whether age, experience and education contribute to resilience in an Australian sample of OR nurses. A predictive survey design was used. A random sample of 1430 nurses who were members of the Australian College of Operating Room Nurses association were surveyed. The survey included the 25-item Connor-Davidson Resilience Scale, and demographic questions. A standard regression model tested the hypothesis that age, years of OR experience and education contributed to resilience in OR nurses. A total of 735 (51.4%) completed, usable surveys were returned. Pearson's correlations demonstrated modest but statistically significant associations between age (presilience. In the multiple regression model, only years of OR experience predicted resilience (presilience. In OR nurses, resilience appears to be predicted by other attributes and is not necessarily dependent on an individual's personal characteristics. Thus, recruitment to the OR should not be based on the conventional notion that an older nursing workforce will have greater longevity and hence be more stable. If younger, less experienced nurses are adequately supported, they may thrive in the OR environment.

  17. 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.

  18. 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.

  19. 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.

  20. Safety operation of training reactor VR-1

    International Nuclear Information System (INIS)

    Matejka, K.

    2001-01-01

    There are three nuclear research reactors in the Czech Republic in operation now: light water reactor LVR-15, maximum reactor power 10 MW t , owner and operator Nuclear Research Institute Rez; light water zero power reactor LR-0, maximum reactor power 5 kW t , owner and operator Nuclear Research Institute Rez and training reactor VR-1 Sparrow, maximum reactor power 5 kW t , owner and operate Faculty of Nuclear Sciences and Physical Engineering, CTU in Prague. The training reactor VR-1 Vrabec 'Sparrow', operated at the Faculty of Nuclear Sciences and Physical Engineering, Czech Technical University in Prague, was started up on December 3, 1990. Particularly it is designed for training the students of Czech universities, preparing the experts for the Czech nuclear programme, as well as for certain research work, and for information programmes in the nuclear programme, as well as for certain research work, and for information programmes in sphere of using the nuclear energy (public relations). (author)

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

    Directory of Open Access Journals (Sweden)

    Chin-Sheng Tang

    Full Text Available To prevent surgical site infection (SSI, the airborne microbial concentration in operating theaters must be reduced. The air quality in operating theaters and nearby areas is also important to healthcare workers. Therefore, this study assessed air quality in the post-operative recovery room, locations surrounding the operating theater area, and operating theaters in a medical center. Temperature, relative humidity (RH, and carbon dioxide (CO2, suspended particulate matter (PM, and bacterial concentrations were monitored weekly over one year. Measurement results reveal clear differences in air quality in different operating theater areas. The post-operative recovery room had significantly higher CO2 and bacterial concentrations than other locations. Bacillus spp., Micrococcus spp., and Staphylococcus spp. bacteria often existed in the operating theater area. Furthermore, Acinetobacter spp. was the main pathogen in the post-operative recovery room (18% and traumatic surgery room (8%. The mixed effect models reveal a strong correlation between number of people in a space and high CO2 concentration after adjusting for sampling locations. In conclusion, air quality in the post-operative recovery room and operating theaters warrants attention, and merits long-term surveillance to protect both surgical patients and healthcare workers.

  2. 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.

  3. Improvements in operational safety performance of the Magnox power stations

    Energy Technology Data Exchange (ETDEWEB)

    Marchese, C.J. [BNFL Magnox Generation, Berkeley (United Kingdom)

    2000-10-01

    In the 43 years since commencement of operation of Calder Hall, the first Magnox power station, there remain eight Magnox stations and 20 reactors still in operation, owned by BNFL Magnox Generation. This paper describes how the operational safety performance of these stations has significantly improved over the last ten years. This has been achieved against a background of commercial competition introduced by privatization and despite the fact that the Magnox base design belongs to the past. Finally, the company's future plans for continued improvements in operational safety performance are discussed. (author)

  4. 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)

  5. Statistical process control as a tool for controlling operating room performance: retrospective analysis and benchmarking.

    Science.gov (United States)

    Chen, Tsung-Tai; Chang, Yun-Jau; Ku, Shei-Ling; Chung, Kuo-Piao

    2010-10-01

    There is much research using statistical process control (SPC) to monitor surgical performance, including comparisons among groups to detect small process shifts, but few of these studies have included a stabilization process. This study aimed to analyse the performance of surgeons in operating room (OR) and set a benchmark by SPC after stabilized process. The OR profile of 499 patients who underwent laparoscopic cholecystectomy performed by 16 surgeons at a tertiary hospital in Taiwan during 2005 and 2006 were recorded. SPC was applied to analyse operative and non-operative times using the following five steps: first, the times were divided into two segments; second, they were normalized; third, they were evaluated as individual processes; fourth, the ARL(0) was calculated;, and fifth, the different groups (surgeons) were compared. Outliers were excluded to ensure stability for each group and to facilitate inter-group comparison. The results showed that in the stabilized process, only one surgeon exhibited a significantly shorter total process time (including operative time and non-operative time). In this study, we use five steps to demonstrate how to control surgical and non-surgical time in phase I. There are some measures that can be taken to prevent skew and instability in the process. Also, using SPC, one surgeon can be shown to be a real benchmark. © 2010 Blackwell Publishing Ltd.

  6. The Safety Prevention in the Theater Management and Operation

    Institute of Scientific and Technical Information of China (English)

    WU Sheng

    2015-01-01

    Take the operation and management experience as examples, the author discussed how to formulate a set of complete and effective equipment management system, operating rules, procedures and standards, as well as the safety prevention and control measures, according to the national or trade related laws and regulations and combining the operation and performance characteristics of theatre management, in order to ensure the safe operation of theatre and stage equipment.

  7. Safety of Nuclear Power Plants: Commissioning and Operation. Specific Safety Requirements (Arabic Edition)

    International Nuclear Information System (INIS)

    2017-01-01

    This publication is a revision of IAEA Safety Standards Series No. NS-R-2, Safety of Nuclear Power Plants: Operation, and has been extended to cover the commissioning stage. It describes the requirements to be met to ensure the safe commissioning, operation, and transition from operation to decommissioning of nuclear power plants. Over recent years there have been developments in areas such as long term operation of nuclear power plants, plant ageing, periodic safety review, probabilistic safety analysis review and risk informed decision making processes. It became necessary to revise the IAEA’s Safety Requirements in these areas and to correct and/or improve the publication on the basis of feedback from its application by both the IAEA and its Member States. In addition, the requirements are governed by, and must apply, the safety objective and safety principles that are established in the IAEA Safety Standards Series No. SF-1, Fundamental Safety Principles. A review of Safety Requirements publications, initiated in 2011 following the accident in the Fukushima Daiichi nuclear power plant in Japan, revealed no significant areas of weakness but resulted in a small set of amendments to strengthen the requirements and facilitate their implementation. These are contained in the present publication.

  8. Safety of Nuclear Power Plants: Commissioning and Operation. Specific Safety Requirements

    International Nuclear Information System (INIS)

    2017-01-01

    This publication is a revision of IAEA Safety Standards Series No. NS-R-2, Safety of Nuclear Power Plants: Operation, and has been extended to cover the commissioning stage. It describes the requirements to be met to ensure the safe commissioning, operation, and transition from operation to decommissioning of nuclear power plants. Over recent years there have been developments in areas such as long term operation of nuclear power plants, plant ageing, periodic safety review, probabilistic safety analysis review and risk informed decision making processes. It became necessary to revise the IAEA’s Safety Requirements in these areas and to correct and/or improve the publication on the basis of feedback from its application by both the IAEA and its Member States. In addition, the requirements are governed by, and must apply, the safety objective and safety principles that are established in the IAEA Safety Standards Series No. SF-1, Fundamental Safety Principles. A review of Safety Requirements publications, initiated in 2011 following the accident in the Fukushima Daiichi nuclear power plant in Japan, revealed no significant areas of weakness but resulted in a small set of amendments to strengthen the requirements and facilitate their implementation. These are contained in the present publication.

  9. Safety of Nuclear Power Plants: Commissioning and Operation. Specific Safety Requirements (French Edition)

    International Nuclear Information System (INIS)

    2016-01-01

    This publication describes the requirements to be met to ensure the safe operation of nuclear power plants. It takes into account developments in areas such as long term operation of nuclear power plants, plant ageing, periodic safety review, probabilistic safety analysis and risk informed decision making processes. In addition, the requirements are governed by, and must apply, the safety objective and safety principles that are established in the IAEA Safety Standards Series No. SF-1, Fundamental Safety Principles. A review of Safety Requirements publications was commenced in 2011 following the accident in the Fukushima Daiichi nuclear power plant in Japan. The review revealed no significant areas of weakness and resulted in just a small set of amendments to strengthen the requirements and facilitate their implementation, which are contained in the present publication.

  10. Safety of Nuclear Power Plants: Commissioning and Operation. Specific Safety Requirements

    International Nuclear Information System (INIS)

    2016-01-01

    This publication describes the requirements to be met to ensure the safe operation of nuclear power plants. It takes into account developments in areas such as long term operation of nuclear power plants, plant ageing, periodic safety review, probabilistic safety analysis and risk informed decision making processes. In addition, the requirements are governed by, and must apply, the safety objective and safety principles that are established in the IAEA Safety Standards Series No. SF-1, Fundamental Safety Principles. A review of Safety Requirements publications was commenced in 2011 following the accident in the Fukushima Daiichi nuclear power plant in Japan. The review revealed no significant areas of weakness and resulted in just a small set of amendments to strengthen the requirements and facilitate their implementation, which are contained in the present publication

  11. 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.

  12. 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

  13. AMNT 2014. Key topic: Reactor operation, safety - report. Pt. 2

    International Nuclear Information System (INIS)

    Fischer, Klaus-Christian; Willschuetz, Hans-Georg; Wortmann, Birgit

    2014-01-01

    Summary report on the following sessions of the Annual Conference on Nuclear Technology held in Frankfurt, 6 to 8 May 2014: - Thermo Dynamics and Fluid Dynamics: Experiments and Backfittings for the Improvement of Safety and Efficiency; - Safety of Nuclear Installations - Methods, Analyses, Results: In-Vessel Phenomena; Ex-Vessel Phenomena; - Standards and Regulations; Hazard and Safety Analysis; and Validation and Uncertainty Analysis. The other Sessions of the Key Topics 'Reactor Operation, Safety', 'Competence, Innovation, Regulation' and 'Fuel, Decommissioning and Disposal' have been covered in atw 10 (2014) and will be covered in further issues of atw.

  14. Operational safety analysis status of Novi Han repository

    International Nuclear Information System (INIS)

    Boiadjiev, A.

    2000-01-01

    This article presents the status of the safety studies and activities related to Novi Han repository. The case of this facility is such that no clear boundary exists between post-closure safety assessment and operational safety assessment. The major findings of these activities are given. The Safety Analysis Report (SAR) for Novi Han repository is developed by Risk Engineering Ltd. under a contract with the Committee on the Use of Atomic Energy for Peaceful Purposes. The general structure and main conclusions and recommendations of the SAR are presented. (author)

  15. Improving plant state information for better operational safety

    International Nuclear Information System (INIS)

    Girard, C.; Olivier, E.; Grimaldi, X.

    1994-01-01

    Nuclear Power Plant (NPP) safety is strongly dependent on components' reliability and particularly on plant state information reliability. This information, used by the plant operators in order to produce appropriate actions, have to be of a high degree of confidence, especially in accidental conditions where safety is threatened. In this perspective, FRAMATOME, EDF and CEA have started a joint research program to prospect different solutions aiming at a better reliability for critical information needed to safety operate the plant. This paper gives the main results of this program and describes the developments that have been made in order to assess reliability of different information systems used in a Nuclear Power Plant. (Author)

  16. Human and organization factors: engineering operating safety into offshore structures

    International Nuclear Information System (INIS)

    Bea, Robert G.

    1998-01-01

    History indicates clearly that the safety of offshore structures is determined primarily by the humans and organizations responsible for these structures during their design, construction, operation, maintenance, and decommissioning. If the safety of offshore structures is to be preserved and improved, then attention of engineers should focus on to how to improve the reliability of the offshore structure 'system,' including the people that come into contact with the structure during its life-cycle. This article reviews and discusss concepts and engineering approaches that can be used in such efforts. Two specific human factor issues are addressed: (1) real-time management of safety during operations, and (2) development of a Safety Management Assessment System to help improve the safety of offshore structures

  17. Safety review of experiments at Albuquerque Operations Office

    International Nuclear Information System (INIS)

    Elliott, K.

    1984-01-01

    The Department of Energy (DOE) Albuquerque Operations Office is responsible for the safety overview of nuclear reactor and critical assembly facilities at Sandia National Laboratories, Los Alamos National Laboratory, and the Rocky Flats Plant. The important safety concerns with these facilities involve the complex experiments that are performed, and that is the area emphasized. A determination is made by the Albuquerque Office (AL) with assistance from DOE/OMA whether or not a proposed experiment is an unreviewed safety question. Meetings are held with the contractor to resolve and clarify questions that are generated during the review of the proposed experiment. The AL safety evaluation report is completed and any recommendations are discussed. Prior to the experiment a preoperational appraisal is performed to assure that personnel, procedures, and equipment are in readiness for operations. During the experiment, any abnormal condition is reviewed in detail to determine any safety concerns

  18. 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.

  19. Operating experience feedback from safety significant events at research reactors

    Energy Technology Data Exchange (ETDEWEB)

    Shokr, A.M. [Atomic Energy Authority, Abouzabal (Egypt). Egypt Second Research Reactor; Rao, D. [Bhabha Atomic Research Centre, Mumbai (India)

    2015-05-15

    Operating experience feedback is an effective mechanism to provide lessons learned from the events and the associated corrective actions to prevent recurrence of events, resulting in improving safety in the nuclear installations. This paper analyzes the events of safety significance that have been occurred at research reactors and discusses the root causes and lessons learned from these events. Insights from literature on events at research reactors and feedback from events at nuclear power plants that are relevant to research reactors are also presented along with discussions. The results of the analysis showed the importance of communication of safety information and exchange of operating experience are vital to prevent reoccurrences of events. The analysis showed also the need for continued attention to human factors and training of operating personnel, and the need for establishing systematic ageing management programmes of reactor facilities, and programmes for safety management of handling of nuclear fuel, core components, and experimental devices.

  20. Operating experience feedback from safety significant events at research reactors

    International Nuclear Information System (INIS)

    Shokr, A.M.

    2015-01-01

    Operating experience feedback is an effective mechanism to provide lessons learned from the events and the associated corrective actions to prevent recurrence of events, resulting in improving safety in the nuclear installations. This paper analyzes the events of safety significance that have been occurred at research reactors and discusses the root causes and lessons learned from these events. Insights from literature on events at research reactors and feedback from events at nuclear power plants that are relevant to research reactors are also presented along with discussions. The results of the analysis showed the importance of communication of safety information and exchange of operating experience are vital to prevent reoccurrences of events. The analysis showed also the need for continued attention to human factors and training of operating personnel, and the need for establishing systematic ageing management programmes of reactor facilities, and programmes for safety management of handling of nuclear fuel, core components, and experimental devices.

  1. [Intelligent operating room suite : From passive medical devices to the self-thinking cognitive surgical assistant].

    Science.gov (United States)

    Kenngott, H G; Wagner, M; Preukschas, A A; Müller-Stich, B P

    2016-12-01

    Modern operating room (OR) suites are mostly digitally connected but until now the primary focus was on the presentation, transfer and distribution of images. Device information and processes within the operating theaters are barely considered. Cognitive assistance systems have triggered a fundamental rethinking in the automotive industry as well as in logistics. In principle, tasks in the OR, some of which are highly repetitive, also have great potential to be supported by automated cognitive assistance via a self-thinking system. This includes the coordination of the entire workflow in the perioperative process in both the operating theater and the whole hospital. With corresponding data from hospital information systems, medical devices and appropriate models of the surgical process, intelligent systems could optimize the workflow in the operating theater in the near future and support the surgeon. Preliminary results on the use of device information and automatically controlled OR suites are already available. Such systems include, for example the guidance of laparoscopic camera systems. Nevertheless, cognitive assistance systems that make use of knowledge about patients, processes and other pieces of information to improve surgical treatment are not yet available in the clinical routine but are urgently needed in order to automatically assist the surgeon in situation-related activities and thus substantially improve patient care.

  2. 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

  3. Lessons from feedback of safety operating experience for reactor physics

    International Nuclear Information System (INIS)

    Suchomel, J.; Rapavy, S.

    1999-01-01

    Analyses of events in WWER operations as a part of safety experience feedback provide a valuable source of lessons for reactor physics. Examples of events from Bohunice operation will be shown such as events with inadequate approach to criticality, positive reactivity insertions, expulsion of a control rod from shut-down reactor, problems with reactor protection system and control rods. (Authors)

  4. 14 CFR 417.121 - Safety critical preflight operations.

    Science.gov (United States)

    2010-01-01

    ... 14 Aeronautics and Space 4 2010-01-01 2010-01-01 false Safety critical preflight operations. 417.121 Section 417.121 Aeronautics and Space COMMERCIAL SPACE TRANSPORTATION, FEDERAL AVIATION... surveillance. A launch operator must implement its hazard area surveillance and clearance plan, of § 417.111(j...

  5. Operational safety experience feedback by means of unusual event reports

    International Nuclear Information System (INIS)

    1996-07-01

    Operational experience of nuclear power plants can be used to great advantage to enhance safety performance provided adequate measures are in place to collect and analyse it and to ensure that the conclusions drawn are acted upon. Feedback of operating experience is thus an extremely important tool to ensure high standards of safety in operational nuclear power plants and to improve the capability to prevent serious accidents and to learn from minor deviations and equipment failures - which can serve as early warnings -to prevent even minor events from occurring. Mechanisms also need to be developed to ensure that operating experience is shared both nationally as well as internationally. The operating experience feedback process needs to be fully and effectively established within the nuclear power plant, the utility, the regulatory organization as well as in other institutions such as technical support organizations and designers. The main purpose of this publication is to reflect the international consensus as to the general principles and practices in the operational safety experience feedback process. The examples of national practices for the whole or for particular parts of the process are given in annexes. The publication complements the IAEA Safety Series No.93 ''Systems for Reporting Unusual Events in Nuclear Power Plants'' (1989) and may also give a general guidance for Member States in fulfilling their obligations stipulated in the Nuclear Safety Convention. Figs, tabs

  6. Operational safety experience feedback by means of unusual event reports

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1996-07-01

    Operational experience of nuclear power plants can be used to great advantage to enhance safety performance provided adequate measures are in place to collect and analyse it and to ensure that the conclusions drawn are acted upon. Feedback of operating experience is thus an extremely important tool to ensure high standards of safety in operational nuclear power plants and to improve the capability to prevent serious accidents and to learn from minor deviations and equipment failures - which can serve as early warnings -to prevent even minor events from occurring. Mechanisms also need to be developed to ensure that operating experience is shared both nationally as well as internationally. The operating experience feedback process needs to be fully and effectively established within the nuclear power plant, the utility, the regulatory organization as well as in other institutions such as technical support organizations and designers. The main purpose of this publication is to reflect the international consensus as to the general principles and practices in the operational safety experience feedback process. The examples of national practices for the whole or for particular parts of the process are given in annexes. The publication complements the IAEA Safety Series No.93 ``Systems for Reporting Unusual Events in Nuclear Power Plants`` (1989) and may also give a general guidance for Member States in fulfilling their obligations stipulated in the Nuclear Safety Convention. Figs, tabs.

  7. Safety evaluation by living probabilistic safety assessment. Procedures and applications for planning of operational activities and analysis of operating experience

    International Nuclear Information System (INIS)

    Johanson, Gunnar; Holmberg, J.

    1994-01-01

    Living Probabilistic Safety Assessment (PSA) is a daily safety management system and it is based on a plant-specific PSA and supporting information systems. In the living use of PSA, plant status knowledge is used to represent actual plant safety status in monitoring or follow-up perspective. The PSA model must be able to express the risk at a given time and plant configuration. The process, to update the PSA model to represent the current or planned configuration and to use the model to evaluate and direct the changes in the configuration, is called living PSA programme. The main purposes to develop and increase the usefulness of living PSA are: Long term safety planning: To continue the risk assessment process started with the basic PSA by extending and improving the basic models and data to provide a general risk evaluation tool for analyzing the safety effects of changes in plant design and procedures. Risk planning of operational activities: To support the operational management by providing means for searching optimal operational maintenance and testing strategies from the safety point of view. The results provide support for risk decision making in the short term or in a planning mode. The operational limits and conditions given by technical specifications can be analyzed by evaluating the risk effects of alternative requirements in order to balance the requirements with respect to operational flexibility and plant economy. Risk analysis of operating experience: To provide a general risk evaluation tool for analyzing the safety effects of incidents and plant status changes. The analyses are used to: identify possible high risk situations, rank the occurred events from safety point of view, and get feedback from operational events for the identification of risk contributors. This report describes the methods, models and applications required to continue the process towards a living use of PSA. 19 tabs, 20 figs

  8. Code on the safety of nuclear research reactors: Operation

    International Nuclear Information System (INIS)

    1992-01-01

    The purpose of this publication is to provide the essential requirements and recommendations for the safe operation of research reactors, with emphasis on the supervisory and managerial aspects. However, the publication also provides some guidance and information on topics concerning all the organizations involved in operation. These objectives are expressed in terms of requirements and recommendations for the safe operation of research reactors. Emphasis is placed on the safety requirements that shall be met rather than on the ways in which they can be met. The requirements and recommendations may form the foundation necessary for a Member State to develop regulations and safety criteria for its research reactor programme.

  9. Safety and operation of the Stade nuclear power plant

    International Nuclear Information System (INIS)

    Salcher, H.

    1991-01-01

    The concept of PreussenElektra is to continuously increase the existing safety standard of the Stade nuclear power station using experience gained from faults and operation in nuclear power stations and the progressive state of the art. Modifications to achieve the most gentle operation of the plant have been completed and other are on-going. To do so instruments were attached to those components which are susceptible to fatigue to record the transients and extensive calculatory records were kept. Although the plant has almost 20 years successful operation behind it, it can still stand up well to comparisons with more recent plants as far as safety aspects are concerned. 6 figs

  10. Applying lessons from commercial aviation safety and operations to resuscitation.

    Science.gov (United States)

    Ornato, Joseph P; Peberdy, Mary Ann

    2014-02-01

    Both commercial aviation and resuscitation are complex activities in which team members must respond to unexpected emergencies in a consistent, high quality manner. Lives are at stake in both activities and the two disciplines have similar leadership structures, standard setting processes, training methods, and operational tools. Commercial aviation crews operate with remarkable consistency and safety, while resuscitation team performance and outcomes are highly variable. This commentary provides the perspective of two physician-pilots showing how commercial aviation training, operations, and safety principles can be adapted to resuscitation team training and performance. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  11. 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.

  12. The work of the Operational Safety Review Team (OSART)

    International Nuclear Information System (INIS)

    Hide, K.W.

    1996-01-01

    The Operational Safety Review Team (OSART) programme was set up by the IAEA in 1982 to assist Member States to enhance the operational safety of nuclear power plants. Each team is staffed by senior experts in the relevant fields. The review team discusses with plant staff the existing operational programmes for plant which may be under construction, being commissioned or already operating. Following a detailed examination of a safety programme, the OSART team lists strengths and weaknesses and makes recommendations on how to overcome the latter. Since their conclusions are based on the best prevailing international practice, they may be more stringent than those based on national criteria. The results of the 77 missions conducted at 62 plants in 28 countries by the end of 1994 are summarised. (UK)

  13. Operation safety of control systems. Principles and methods

    International Nuclear Information System (INIS)

    Aubry, J.F.; Chatelet, E.

    2008-01-01

    This article presents the main operation safety methods that can be implemented to design safe control systems taking into account the behaviour of the different components with each other (binary 'operation/failure' behaviours, non-consistent behaviours and 'hidden' failures, dynamical behaviours and temporal aspects etc). To take into account these different behaviours, advanced qualitative and quantitative methods have to be used which are described in this article: 1 - qualitative methods of analysis: functional analysis, preliminary risk analysis, failure mode and failure effects analyses; 2 - quantitative study of systems operation safety: binary representation models, state space-based methods, event space-based methods; 3 - application to the design of control systems: safe specifications of a control system, qualitative analysis of operation safety, quantitative analysis, example of application; 4 - conclusion. (J.S.)

  14. Teamwork and communication in the operating room: relationship to discrete outcomes and research challenges.

    Science.gov (United States)

    Nurok, Michael; Sundt, Thoralf M; Frankel, Allan

    2011-03-01

    The literature defining and addressing teamwork and communication is abundant; however, few studies have analyzed the relationship between measures of teamwork and communication and quantifiable outcomes. The objectives of this review are: (1) to identify studies addressing teamwork and communication in the operating room in relation to discrete measures of outcome, (2) to create a classification of studies of the relationship between teamwork and communication and outcomes, (3) to assess the implications of these studies, (4) to explore the methodological challenges of teamwork and communication studies in the perioperative setting, and (5) to suggest future research directions.studies in the perioperative setting, and (5) to suggest future research directions. Copyright © 2011 Elsevier Inc. All rights reserved.

  15. Mixed Reality with HoloLens: Where Virtual Reality Meets Augmented Reality in the Operating Room.

    Science.gov (United States)

    Tepper, Oren M; Rudy, Hayeem L; Lefkowitz, Aaron; Weimer, Katie A; Marks, Shelby M; Stern, Carrie S; Garfein, Evan S

    2017-11-01

    Virtual reality and augmented reality devices have recently been described in the surgical literature. The authors have previously explored various iterations of these devices, and although they show promise, it has become clear that virtual reality and/or augmented reality devices alone do not adequately meet the demands of surgeons. The solution may lie in a hybrid technology known as mixed reality, which merges many virtual reality and augmented realty features. Microsoft's HoloLens, the first commercially available mixed reality device, provides surgeons intraoperative hands-free access to complex data, the real environment, and bidirectional communication. This report describes the use of HoloLens in the operating room to improve decision-making and surgical workflow. The pace of mixed reality-related technological development will undoubtedly be rapid in the coming years, and plastic surgeons are ideally suited to both lead and benefit from this advance.

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

    Directory of Open Access Journals (Sweden)

    Jéssica Helena Dantas de Oliveira

    2017-05-01

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

  17. Operating Room Efficiency before and after Entrance in a Benchmarking Program for Surgical Process Data

    DEFF Research Database (Denmark)

    Pedron, Sara; Winter, Vera; Oppel, Eva-Maria

    2017-01-01

    Operating room (OR) efficiency continues to be a high priority for hospitals. In this context the concept of benchmarking has gained increasing importance as a means to improve OR performance. The aim of this study was to investigate whether and how participation in a benchmarking and reporting...... program for surgical process data was associated with a change in OR efficiency, measured through raw utilization, turnover times, and first-case tardiness. The main analysis is based on panel data from 202 surgical departments in German hospitals, which were derived from the largest database for surgical...... the availability of reliable, timely and detailed analysis tools to support the OR management seemed to be correlated especially with an increase in the timeliness of staff members regarding first-case starts. The increasing trend in turnover time revealed the absence of effective strategies to improve this aspect...

  18. 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.

  19. 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.

  20. Concept of polymer alloy electrolytes: towards room temperature operation of lithium-polymer batteries

    International Nuclear Information System (INIS)

    Noda, Kazuhiro; Yasuda, Toshikazu; Nishi, Yoshio

    2004-01-01

    Polymer alloy technique is very powerful tool to tune the ionic conductivity and mechanical strength of polymer electrolyte. A semi-interpenetrating polymer network (semi-IPN) polymer alloy electrolyte, composed of non-cross-linkable siloxane-based polymer and cross-linked 3D network polymer, was prepared. Such polymer alloy electrolyte has quite high ionic conductivity (more than 10 -4 Scm -1 at 25 o C and 10 -5 Scm -1 at -10 o C) and mechanical strength as a separator film with a wide electrochemical stability window. A lithium metal/semi-IPN polymer alloy solid state electrolyte/LiCoO 2 cell demonstrated promising cycle performance with room temperature operation of the energy density of 300Wh/L and better rate performance than conventional PEO based lithium polymer battery ever reported

  1. 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...

  2. 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

  3. Joint road safety operations in tunnels and open roads

    Science.gov (United States)

    Adesiyun, Adewole; Avenoso, Antonio; Dionelis, Kallistratos; Cela, Liljana; Nicodème, Christophe; Goger, Thierry; Polidori, Carlo

    2017-09-01

    The objective of the ECOROADS project is to overcome the barrier established by the formal interpretation of the two Directives 2008/96/EC and 2004/54/EC, which in practice do not allow the same Road Safety Audits/Inspections to be performed inside tunnels. The projects aims at the establishment of a common enhanced approach to road infrastructure and tunnel safety management by using the concepts and criteria of the Directive 2008/96/CE on road infrastructure safety management and the results of related European Commission (EC) funded projects. ECOROADS has already implemented an analysis of national practices regarding Road Safety Inspections (RSI), two Workshops with the stakeholders, and an exchange of best practices between European tunnel experts and road safety professionals, which led to the definition of common agreed safety procedures. In the second phase of the project, different groups of experts and observers applied the above common procedures by inspecting five European road sections featuring both open roads and tunnels in Belgium, Albania, Germany, Serbia and Former Yugoslav Republic of Macedonia. This paper shows the feedback of the 5 joint safety operations and how they are being used for a set of - recommendations and guidelines for the application of the RSA and RSI concepts within the tunnel safety operations.

  4. Review of safety related control room function research based on experience from nuclear power plants in Finland

    International Nuclear Information System (INIS)

    Juslin, K.; Wahlstroem, B.; Rinttilae, E.

    1985-01-01

    A comprehensive human engineering research programme was established in the second half of the 1970's at the Technical Research Centre of Finland (VTT). The research is performed in cooperation with the utility companies Imatran Voima Oy (IVO) and Teollisuuden Voima Oy (TVO) and includes topics such as Handling of alarm information, Disturbance analysis systems, Assessment of control rooms and Validation of safety parameter display systems. Reference is also made to the Finnish contribution to the OECD Halden Reactor Project (Halden) and the Nordic Liaison Committee for Atomic Energy (NKA) research projects. In this paper feasible realization alternatives of safety related control room functions are discussed on the basis of experience from the nuclear power plants in Finland, which at present are equipped with extensive process computer systems. A proposal for future power plant information systems is described. It is intended that this proposal will serve as the basis for future computer systems at nuclear power plants in Finland. (author)

  5. Self-assessment of operational safety for nuclear power plants

    International Nuclear Information System (INIS)

    1999-12-01

    Self-assessment processes have been continuously developed by nuclear organizations, including nuclear power plants. Currently, the nuclear industry and governmental organizations are showing an increasing interest in the implementation of this process as an effective way for improving safety performance. Self-assessment involves the use of different types of tools and mechanisms to assist the organizations in assessing their own safety performance against given standards. This helps to enhance the understanding of the need for improvements, the feeling of ownership in achieving them and the safety culture as a whole. Although the primary beneficiaries of the self-assessment process are the plant and operating organization, the results of the self-assessments are also used, for example, to increase the confidence of the regulator in the safe operation of an installation, and could be used to assist in meeting obligations under the Convention on Nuclear Safety. Such considerations influence the form of assessment, as well as the type and detail of the results. The concepts developed in this report present the basic approach to self-assessment, taking into consideration experience gained during Operational Safety Review Team (OSART) missions, from organizations and utilities which have successfully implemented parts of a self-assessment programme and from meetings organized to discuss the subject. This report will be used in IAEA sponsored workshops and seminars on operational safety that include the topic of self-assessment

  6. Ensuring the operational safety of finnish nuclear power plants

    International Nuclear Information System (INIS)

    Vuorinen, A.

    1991-01-01

    The Finnish nuclear energy programme has been successful both from the safety and economical point of view. These achievements are based on different factors which are discussed in the paper. Finnish Centre for Radiation and Nuclear Safety (STUK) has specified the technical requirements and procedures to be followed in the design, construction, commissioning and operation of NPPs in a series of guides. The guides are quite demanding and latest results of safety research and technical development are taken into account. Regulatory supervision of Finnish NPPs is comprehensive. As an example of this the regulatory inspection program for operational phase is presented. An important way to ensure operational safety of a NPP is to define a set of limits and conditions to identify limiting safety envelope for plant operation. Practices in Finland are reviewed in the paper. The strategy of Defence in Depth is amongst the fundamental principles of nuclear safety. Two corollary principles of defence of depth are accident prevention and accident mitigation. Means used in following these principles are discussed. (author)

  7. Global public health impact of recovered supplies from operating rooms: a critical analysis with national implications.

    Science.gov (United States)

    Wan, Eric L; Xie, Li; Barrett, Miceile; Baltodano, Pablo A; Rivadeneira, Andres F; Noboa, Jonathan; Silver, Maya; Zhou, Richard; Cho, Suzy; Tam, Tammie; Yurter, Alp; Gentry, Carol; Palacios, Jorge; Rosson, Gedge D; Redett, Richard J

    2015-01-01

    In modern operating rooms, clean and unused medical supplies are routinely discarded and can be effectively recovered and redistributed abroad to alleviate the environmental burden of donor hospitals and to generate substantial health benefits at resource-poor recipient institutions. We established a recovery and donation program to collect clean and unused supplies for healthcare institutions in developing nations. We analyzed items donated over a 3-year period (September 2010-November 2013) by quantity and weight, and estimated the projected value of the program under potential nationwide participation. To capture the health benefits attributable to the donated supplies at recipient institutions, we partnered with two tertiary-care centers in Guayaquil, Ecuador and conducted a pilot study on the utility of the donated supplies at the recipient institutions (October 2013). We determined the disability-adjusted life years (DALY) averted for all patients undergoing procedures involving donated items and estimated the annual attributable DALY as well as the cost per DALY averted both by supply and by procedure. Approximately, 2 million lbs (907,185 kg) per year of medical supplies are recoverable from large non-rural US academic medical centers. Of these supplies, 19 common categories represent a potential for donation worth US $15 million per year, at a cost-utility of US $2.14 per DALY averted. Hospital operating rooms continue to represent a large source of recoverable surgical supplies that have demonstrable health benefits in the recipient communities. Cost-effective recovery and need-based donation programs can significantly alleviate the global burden of surgical diseases.

  8. Cost and Morbidity Analysis of Chest Port Insertion: Interventional Radiology Suite Versus Operating Room.

    Science.gov (United States)

    LaRoy, Jennifer R; White, Sarah B; Jayakrishnan, Thejus; Dybul, Stephanie; Ungerer, Dirk; Turaga, Kiran; Patel, Parag J

    2015-06-01

    To compare complications and cost, from a hospital perspective, of chest port insertions performed in an interventional radiology (IR) suite versus in surgery in an operating room (OR). This study was approved by an institutional review board and is HIPAA compliant. Medical records were retrospectively searched on consecutive chest port placement procedures, in the IR suite and the OR, between October 22, 2010 and February 26, 2013, to determine patients' demographic information and chest port-related complications and/or infections. A total of 478 charts were reviewed (age range: 21-85 years; 309 women, 169 men). Univariate and bivariate analyses were performed to identify risk factors associated with an increased complication rate. Cost data on 149 consecutive Medicare outpatients (100 treated in the IR suite; 49 treated in the OR) who had isolated chest port insertions between March 2012 and February 2013 were obtained for both the operative services and pharmacy. Nonparametric tests for heterogeneity were performed using the Kruskal-Wallis method. Early complications occurred in 9.2% (22 of 239) of the IR patients versus 13.4% (32 of 239) of the OR patients. Of the 478 implanted chest ports, 9 placed in IR and 18 placed in surgery required early removal. Infections from the ports placed in IR versus the OR were 0.25 versus 0.18 infections per 1000 catheters, respectively. Overall mean costs for chest port insertion were significantly higher in the OR, for both room and pharmacy costs (P chest ports in an OR setting was almost twice that of placement in the IR suite. Hospital costs to place a chest port were significantly lower in the IR suite than in the OR, whereas radiology and surgery patients did not show a significantly different rate of complications and/or infections. Copyright © 2015 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  9. 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.

  10. 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.

  11. A cost and time analysis of laryngology procedures in the endoscopy suite versus the operating room.

    Science.gov (United States)

    Hillel, Alexander T; Ochsner, Matthew C; Johns, Michael M; Klein, Adam M

    2016-06-01

    To assess the costs, charges, reimbursement, and efficiency of performing awake laryngology procedures in an endoscopy suite (ES) compared with like procedures performed in the operating room (OR). Retr