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Sample records for operating room safety

  1. Safety status system for operating room devices.

    Science.gov (United States)

    Guédon, Annetje C P; Wauben, Linda S G L; Overvelde, Marlies; Blok, Joleen H; van der Elst, Maarten; Dankelman, Jenny; van den Dobbelsteen, John J

    2014-01-01

    Since the increase of the number of technological aids in the operating room (OR), equipment-related incidents have come to be a common kind of adverse events. This underlines the importance of adequate equipment management to improve the safety in the OR. A system was developed to monitor the safety status (periodic maintenance and registered malfunctions) of OR devices and to facilitate the notification of malfunctions. The objective was to assess whether the system is suitable for use in an busy OR setting and to analyse its effect on the notification of malfunctions. The system checks automatically the safety status of OR devices through constant communication with the technical facility management system, informs the OR staff real-time and facilitates notification of malfunctions. The system was tested for a pilot period of six months in four ORs of a Dutch teaching hospital and 17 users were interviewed on the usability of the system. The users provided positive feedback on the usability. For 86.6% of total time, the localisation of OR devices was accurate. 62 malfunctions of OR devices were reported, an increase of 12 notifications compared to the previous year. The safety status system was suitable for an OR complex, both from a usability and technical point of view, and an increase of reported malfunctions was observed. The system eases monitoring the safety status of equipment and is a promising tool to improve the safety related to OR devices.

  2. 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.

  3. Attitudes and behavior towards patient safety in an operating room

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    María del Pilar Sánchez Moreno

    2013-09-01

    Full Text Available Patient´s safety is a priority line of action in the Quality of Health Care. Adequate patient safety culture is one of the important pillars in the health care. Also the World Health Organization reports that 7 million people, of 234 million of major surgeries, suffer complications and this can be reduced by half with a system that decreases the possibility of error. Objectives: To determinate the attitude and behavior of professionals in the operating room unit in Hospital Virgen de la Salud of Toledo towards patient safety. Material and method: The type of study is a descriptive and transversal. Population: medical and nursing staff of the theatre with over 1 year in service. Measurement of variables will be made by a validated test and adapted to Spanish territory by the Agency for Healthcare Research and Quality of the United States. We intend to identify the strengths and weaknesses in matter of operating room safety, to know the starting point for the implementation of the surgical safety checklist and to develop a safety culture in the operating room with standardized tools and regular quality controls.

  4. 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.

  5. [Patient safety recommendations for out of operating room procedure sedation].

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    Arnal Velasco, D; Romero García, E; Martínez Palli, G; Muñoz Corsini, L; Rey Martínez, M; Postigo Morales, S

    There is an increasing and more complex demand for sedation for procedures out of the operating room. For different reasons, nowadays the administration of sedation varies considerably. We believe that a patient safety approach rather an approach out of corporate or economic interests is desirable. We created a working group of experts within the Spanish Anaesthesia and Reanimation Incident Reporting System (SENSAR) to prepare a series of recommendations through a non-systematic review. These recommendations were validated by an expert panel of 31 anaesthesiologists through two rounds of an adaptation of the Delphi Method where more than 70% agreement was required. The resulting recommendations include previous evaluation, material and staffing needs for sedation for procedures, post-sedation recommendations and activity and quality control advice. We present patient centred recommendations for the safe use of sedation for out of the operating room procedures from the point of view of the professionals with the most experience in its administration. We believe that these can be used as a guide to reduce variability and increase patient safety in the organisation of healthcare. Copyright © 2016 SECA. Publicado por Elsevier España, S.L.U. All rights reserved.

  6. Patient safety recommendations for out of operating room procedure sedation.

    Science.gov (United States)

    Arnal Velasco, D; Romero García, E; Martínez Palli, G; Muñoz Corsini, L; Rey Martínez, M; Postigo Morales, S

    2016-12-01

    There is an increasing and more complex demand for sedation for procedures out of the operating room. For different reasons, nowadays the administration of sedation varies considerably. We believe that a patient safety approach rather an approach out of corporate or economic interests is desirable. We created a working group of experts within the Spanish Anaesthesia and Reanimation Incident Reporting System (SENSAR) to prepare a series of recommendations through a non-systematic review. These recommendations were validated by an expert panel of 31 anaesthesiologists through two rounds of an adaptation of the Delphi Method where more than 70% agreement was required. The resulting recommendations include previous evaluation, material and staffing needs for sedation for procedures, post-sedation recommendations and activity and quality control advice. We present patient centred recommendations for the safe use of sedation for out of the operating room procedures from the point of view of the professionals with the most experience in its administration. We believe that these can be used as a guide to reduce variability and increase patient safety in the organisation of healthcare. Copyright © 2016 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Publicado por Elsevier España, S.L.U. All rights reserved.

  7. Music in the operating room: is it a safety hazard?

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    Shambo, Lyda; Umadhay, Tony; Pedoto, Alessia

    2015-02-01

    Noise is a health hazard and a source of stress, and it impairs concentration and communication. Since 1960, hospital noise levels have risen around the world. Nowhere in the healthcare setting is noise more prevalent than in the operating room (OR). The genetic makeup of humans does not evolve at the rate of technology. Noise exposure, sensory overload, and the capacity to adapt without physical and psychological consequences are absent from the human condition. The World Health Organization has recognized environmental noise as harmful pollution that causesadverse effects on health. Although noise in the OR is unavoidable, music is a choice. The purpose of this literature review is to provide further insight into the ramifications of the presence of music in the OR, evaluate its appropriateness in relation to care and safety for the patient and staff, and provide information for future research.

  8. Changing Operating Room Culture: Implementation of a Post-Operative Debrief and Improved Safety Culture.

    Science.gov (United States)

    Magill, Stephen T; Wang, Doris D; Rutledge, W Caleb; Lau, Darryl; Berger, Mitchel S; Sankaran, Sujatha; Lau, Catherine Y; Imershein, Sarah G

    2017-08-23

    Patient safety is foundational to neurosurgical care. Post-procedural "debrief" checklists have been proposed to improve patient safety, but there is limited data about their use in neurosurgery. Here, we implemented an initiative to routinely perform post-operative debriefs and evaluated the impact of debriefing on operating room (OR) safety culture. A 10-question safety attitude questionnaire (SAQ) was sent to neurosurgical operating room staff at a major academic medical center before and 18-months after implementation of a post-operative debriefing initiative. Rates of debrief compliance and changes in attitudes before and after the survey were evaluated. The survey utilized a Likert scale and analyzed with standard statistical methods. After the debrief initiative, the rate of debriefing increased from 51% to 86% of cases for the neurosurgery service. Baseline SAQ responses found that neurosurgeons had a more favorable perception of OR safety than anesthesiologists and nurses. Following implementation of the post-operative debriefing process, perceptions of OR safety significantly improved for neurosurgeons, anesthesiologists and nurses. Furthermore, the disparity between nurses and surgeons was no longer significant. After debrief implementation, neurosurgical OR staff had improved perceptions of patient safety compared to surgical services that did not commonly perform debriefing. Debriefing identified OR efficiency concerns in 26.9% of cases and prevention of potential adverse events/near misses were reported in 8% of cases. Post-operative debriefing can be effectively introduced into the operating room and improves the safety culture after implementation. Debriefing is an effective tool to identify OR inefficiencies and potential adverse events. Copyright © 2017 Elsevier Inc. All rights reserved.

  9. Crew resource management improved perception of patient safety in the operating room.

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    Gore, Dennis C; Powell, Jennifer M; Baer, Jennifer G; Sexton, Karen H; Richardson, C Joan; Marshall, David R; Chinkes, David L; Townsend, Courtney M

    2010-01-01

    To improve safety in the operating theater, a company of aviation pilots was employed to guide implementation of preprocedural briefings. A 5-point Likert scale survey that assessed the attitudes of operating room personnel toward patient safety was distributed before and 6 months following implementation of the briefings. Using Mann-Whitney analysis, the survey showed a significant (P perception of patient safety, which was largely demonstrated by nursing personnel.

  10. Patient safety in the operating room: an intervention study on latent risk factors

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    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

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

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    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.

  13. 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.

  14. Surgical safety checklist is associated with improved operating room safety culture, reduced wound complications, and unplanned readmissions in a pilot study in neurosurgery.

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    Lepänluoma, M; Takala, R; Kotkansalo, A; Rahi, M; Ikonen, T S

    2014-03-01

    The World Health Organization's surgical safety checklist is designed to improve adherence to operating room safety standards, and its use has been shown to reduce complications among surgical patients. The objective of our study was to assess the impact of the implementation of the checklist on safety-related issues in the operating room and on postoperative adverse events in neurosurgery. From structured questionnaires delivered to operating room personnel, answers were analyzed to evaluate communication and safety-related issues during 89 and 73 neurosurgical operations before and after the checklist implementation, respectively. From the analyzed operations, 83 and 67 patients, respectively, were included in a retrospective analysis of electronic patient records to compare the length of hospital stay, reported adverse events, and readmissions. In addition, the consistency of operating room documentation and patient records was assessed. Communication between the surgeon and the anesthesiologist was enhanced, and safety-related issues were better covered when the checklist was used. Unplanned readmissions fell from 25% to 10% after the checklist implementation (p = 0.02). Wound complications decreased from 19% to 8% (p = 0.04). The consistency of documentation of the diagnosis and the procedure improved. The use of the checklist improved safety-related performance and, contemporarily, reduced numbers of wound complications, and readmissions were observed.

  15. Thinking in three's: Changing surgical patient safety practices in the complex modern operating room

    Institute of Scientific and Technical Information of China (English)

    Verna C Gibbs

    2012-01-01

    The three surgical patient safety events,wrong site surgery,retained surgical items (RSI) and surgical fires are rare occurrences and thus their effects on the complex modern operating room (OR) are difficult to study.The likelihood of occurrence and the magnitude of risk for each of these surgical safety events are undefined.Many providers may never have a personal experience with one of these events and training and education on these topics are sparse.These circumstances lead to faulty thinking that a provider won't ever have an event or if one does occur the provider will intuitively know what to do.Surgeons are not preoccupied with failure and tend to usually consider good outcomes,which leads them to ignore or diminish the importance of implementing and following simple safety practices.These circumstances contribute to the persistent low level occurrence of these three events and to the difficulty in generating sufficient interest to resource solutions.Individual facilities rarely have the time or talent to understand these events and develop lasting solutions.More often than not,even the most well meaning internal review results in a new line to a policy and some rigorous enforcement mandate.This approach routinely fails and is another reason why these problems are so persistent.Vigilance actions alone have been unsuccessful so hospitals now have to take a systematic approach to implementing safer processes and providing the resources for surgeons and other stakeholders to optimize the OR environment.This article discusses standardized processes of care for mitigation of injury or outright prevention of wrong site surgery,RSI and surgical fires in an action-oriented framework illustrating the strategic elements important in each event and focusing on the responsibilities for each of the three major OR agents-anesthesiologists,surgeons and nurses.A Surgical Patient Safety Checklist is discussed that incorporates the necessary elements to bring these team

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

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    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 teamwork and surgeon buy-in related positively to completing more conversation prompts; none related significantly to procedural checks (estimates from 0.10, p 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 teamwork for promoting checklist use and ensuring a safe surgical environment. Copyright © 2016 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

  17. A methodology for Living Probabilistic Safety Assessment (LPSA) based on Advanced Control Room Operator Support System (ACROSS)

    Energy Technology Data Exchange (ETDEWEB)

    Zubair, Muhammad, E-mail: zubairheu@gmail.com [College of Nuclear Science and Technology, Harbin Engineering University, 145 Nantong Street, Nangang District, Harbin, Heilongjiang 150001 (China); Zhang Zhijian, E-mail: zhangzhijian@hrbeu.edu.cn [College of Nuclear Science and Technology, Harbin Engineering University, 145 Nantong Street, Nangang District, Harbin, Heilongjiang 150001 (China); Khan, Salah Ud-din, E-mail: khanheu@gmail.com [College of Nuclear Science and Technology, Harbin Engineering University, 145 Nantong Street, Nangang District, Harbin, Heilongjiang 150001 (China)

    2011-06-15

    Highlights: > In this study we have introduced a methodology for Living Probabilistic Safety Assessment (LPSA). > Now the paper is focus on LPSA methodology for this purpose we introduced Advanced Control Room Operator Support System (ACROSS). > The ACROSS concept is new technique in LPSA and it's a part of our research project. > Detail is present in Section of paper. > We have also added to provide more detail about methodology. > We have remove Risk monitor portion from our paper and give more attention to LPSA methodology. - Abstract: In Probabilistic Safety Assessment (PSA) all attention is paid to analyze a system which is a time consuming effort so there is a need to develop a system network to support the analyst and to reduce manpower. To handle the physical, operational and organizational changes and to utilize the PSA information effectively the development of living Probabilistic Safety Assessment (LPSA) is essential. This paper presents a detailed methodology for LPSA. One part of this methodology is Advanced Control Room Operator Support System (ACROSS) which is helpful for updating the LPSA model. This methodology also provides help to make the control rooms in Nuclear Power Plants (NPPs) more advanced and user friendly. The study also makes recommendations for further use and development of this technique in the present and future NPPs.

  18. Operating room manager game

    NARCIS (Netherlands)

    Hans, Erwin W.; Nieberg, Tim

    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 cont

  19. 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.

  20. Operating room of the future.

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    Bharathan, Rasiah; Aggarwal, Rajesh; Darzi, Ara

    2013-06-01

    Development of surgical care in the 21st century is increasingly dependent on demonstrating safety, efficacy and cost effectiveness. Over the past 2 decades, the potential role of simulation in surgery has been explored with encouraging results; this can now be linked to direct improvement in the quality of care provision. Computer-assisted surgical platforms, such as robotic surgery, offer us the versatility to embrace a host of technical and technological developments. Rapid development in nanomedicine will expand the limits of operative performance through improved navigation and surgical precision. Integration of the multiple functions of the future operating room will be essential in optimising resource management. The key to bringing about the necessary paradigm shift in the design and delivery of modern surgical care is to appreciate that we now function in an information age, where the integrity of processes is driven by apt data management.

  1. 手术室护理安全隐患与安全管理对策%Nursing safety hazard and safety management in operation room

    Institute of Scientific and Technical Information of China (English)

    刘显莲

    2015-01-01

    目的:了解手术室护理过程中存在的安全隐患,根据分析结果制定对应的安全管理对策。方法:本院自2012年始在手术室护理管理中应用风险管理,随机抽取本院2012年后接受护理风险管理的患者50例为观察组,另随机抽取本院2010年1月-2011年12月收治接受常规护理管理患者50例为对照组。对比2组发生安全事故概率和患者对护理服务的满意程度。结果:观察组发生风险事故与投诉率等相对对照组患者有明显优越性,差异有统计学价值(P<0.05);观察组患者对护理服务满意程度为98.0%,对照组患者对护理服务满意率为84.0%,两者对比具有统计学价值(P<0.05)。结论:在手术室护理中应用风险管理有利于降低护理过程中发生事故的概率,提升患者对护理服务的满意程度,更有利于构建和谐护患关系,对于医院和患者均有重要价值,值得临床重视推广。%Objective: to understand the security hidden trouble in the process of nursing in operation room, and to formulate the corresponding safety management countermeasures according to the analysis results.Methods: the hospital from 2012 in the operation room nursing management in the application of risk management, a random sample of 50 cases of nursing risk management in our hospital in 2012, the observation group, and randomly selected 50 cases of patients treated in our hospital from January 2010 -2011 to December. Comparison of 2 groups of patients with safety accident probability and the degree of satisfaction of patients to nursing service. Results: in the observation group, there were significant differences in risk accident and complaint rate, the difference was statistically significant (P < 0.05); the satisfaction rate of nursing care in the observation group was 98%, and the satisfaction rate was 84% in the control group (P <0.05).Conclusion:application of risk management in operation

  2. [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.

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

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    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.

  4. The Operating Room Nursing Safety Hazard and Prevention%手术室护理安全隐患与防范

    Institute of Scientific and Technical Information of China (English)

    俞静

    2014-01-01

    目的:手术室护理人员科学安全护理可以有效提高护理质量,保证患者以及医护人员自身的安全。方法2012年7月~2013年11月对190例普外科肝包虫手术患者进行术前访视,术后随访调查进行总结,列出下列护理安全隐患,列出内容分析原因,针对性地制定措施。结果确保安全护理操作,保证了患者的安全,此案例中无一列护理差错事故和护理纠纷的发生。结论加强和重视手术室护理安全操作,减少差错事故及医疗纠纷的发生,也是确保护理工作质量的重要措施。%Objective To the operating room nurses scientific safety nursing can ef ectively improve the quality of nursing,ensure the safety of patients and medical staf itself. Method -July,2012 in November 2013,190 cases of general surgery of liver hydatid surgery preoperative visits to patients,postoperative fol ow-up survey summary, list the fol owing nursing safety,lists the content analysis,targeted measures. Results to ensure safe nursing operation,ensure the safety of patients,this case there is no list of nursing error accident and the occurrence of nursing dispute. Conclusion to strengthen and at ach importance to the operating room nursing safety operation,reduce mistakes accidents and the occurrence of medical disputes,it is also an important measures to ensure the quality of nursing work.

  5. HFMEA模式在手术室安全管理中的应用%Application of HFMEA Model in Safety Management of Operation Room

    Institute of Scientific and Technical Information of China (English)

    马玲飞; 王美珍; 马玲平; 潘卫星

    2015-01-01

    Objective To explore the application of Healthcare Failure Mode and Effect Analysis Using (HFMEA) Model in safety management of operation room and its effect.Methods We set up a HFMEA Model team in January 2013 which aimed at assessing causes of failure in the process of operation with the application of HFMEA Model and finding out corresponding methods to resolve these problems so as to take rectification measures to prevent the occurrence of failure mode. The incidence of adverse events of nursing in operation room, RPN of failure mode and patients' satisfaction rate before and after the application of HFMEA model were compared.Results After the application of HFMEA Model, the incidence of all kinds of adverse events of nursing in operation room reduced obviously. RPN of failure mode which influenced nursing safety of operation reduced from 2014 to 474 with statistically significant (P<0.05). Patients' satisfaction rate increased from 80.20% to 92.12% with statistically significant (P<0.05). Conclusion With the application of HFMEA Model, the failure of nursing in the process of operation can be predicted, the major target for improving safety of operation room can be determined and the nursing safety of operation can be ensured with the implementation of corresponding measures.%目的探讨医疗失效模式和效果分析模式(Healthcare Failure Mode and Effect Analysis,HFMEA)在手术室护理安全管理中的应用效果。方法本院手术室2013年1月成立HFMEA管理小组,运用HFMEA模式评估手术患者手术过程中易发生失效的原因,找出亟待解决的失效环节,进而分析整改措施并实施,以预防失效模式的再次发生。比较实施前后手术室护理不良事件发生情况、失效模式RPN值及患者满意度。结果应用HFMEA模式后,手术室各种护理不良事件发生情况均有明显下降;影响手术护理安全的失效模式RPN值由2104分下降到474分,

  6. Local anaesthesia outside the operating room.

    Science.gov (United States)

    Chan, S K; Karmakar, M K; Chui, P T

    2002-04-01

    An increasing number of minor surgical procedures are performed under local anaesthesia in clinical settings outside the operating room, where monitoring and resuscitation equipment--as well as personnel skilled in resuscitation--may not be readily available. Serious adverse effects and even fatalities may result from the use of local anaesthetic agents, arising from a variety of causes such as systemic toxicity, allergy, vasovagal syncope, and reaction to additives present in the local anaesthetic. This article briefly reviews the pharmacology of local anaesthetic agents, and describes various techniques commonly used for local anaesthesia, with special emphasis on safety. Clinical features of toxicity, and its differential diagnosis and management, are also discussed.

  7. Clinical efficacy of nursing safety intervention mechanism in the operation room safety management%手术室实施护理安全管理的效果分析

    Institute of Scientific and Technical Information of China (English)

    冉俊辉

    2014-01-01

    Objective:To observe the clinical efficacy of nursing safety intervention mechanism in the operation room safety management. Methods:A total of 1280 patients who received nursing safety management were selected into the observation group,another 1000 patients before the implementation of nursing safe-ty management were selected into the control group,the nursing qualities of the two groups were compared. Results:The score of nursing quality,the satisfaction degree of nursing job of the patients and doctors in the observation group were significantly higher than that in the control group (P<0. 05 ). The incidence of nursing errors in the observation group were shorter than that in the control group (P<0. 05 ). Conclusions:Nursing safety intervention mechanism can effective-ly reduce the incidence rate of safety risk and medical errors accident in operating room and can raise the satisfaction of patients.%目的:分析研究手术室实施护理安全管理的临床效果。方法:将我院实施护理安全管理的1280例手术的患者作为观察组,另选实施护理安全管理以前的1000例患者作为对照组,比较两组患者的手术室护理质量。结果:与对照组比较,观察组护理质量评分、患者和医生对护理工作的满意度明显增高(P<0.05);观察组护理差错发生率少于对照组,两组比较差异有统计学意义(P<0.05)。结论:在手术室的安全管理中,有效应用护理干预机制,可对手术室护理的安全质量起到提高效果,预防和减少风险事件的发生,提高手术配合质量。

  8. 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.

  9. New heuristics for planning operating rooms.

    NARCIS (Netherlands)

    Molina-Pariente, J.M.; Hans, E.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 t

  10. Principles of operating room organization.

    Science.gov (United States)

    Watkins, W D

    1997-01-01

    The importance of the changing health care climate has triggered important changes in the management of high-cost components of acute care facilities. By integrating and better managing various elements of the surgical process, health care institutions are able to rationally trim costs while maintaining high-quality services. The leadership that physicians can provide is crucial to the success of this undertaking (1). The importance of the use of primary data related to patient throughput and related resources should be strongly emphasized, for only when such data are converted to INFORMATION of functional value can participating healthcare personnel be reasonably expected to anticipate and respond to varying clinical demands with ever-limited resources. Despite the claims of specific commercial vendors, no single product will likely be sufficient to significantly change the perioperative process to the degree or for the duration demanded by healthcare reform. The most effective approach to achieving safety, cost-effectiveness, and predictable process in the realm of Surgical Services will occur by appropriate application of the "best of breed" contributions of: (a) medical/patient safety practice/oversight; (b) information technology; (c) contemporary management; and (d) innovative and functional cost-accounting methodology. S "modified activity-based cost accounting method" can serve as the basis for acquiring true direct-cost information related to the perioperative process. The proposed overall management strategy emphasizes process and feedback, rather than specific product, and although imposing initial demands and change on the traditional hospital setting, can advance the strongest competitive position in perioperative services. This comprehensive approach comprises a functional basis for important bench-marking activities among multiple surgical services. An active, comparative process of this type is of paramount importance in emphasizing patient care and

  11. 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.

  12. The vascular hybrid room--operating room of the future.

    Science.gov (United States)

    Hudorović, Narcis; Rogan, Suncica Andreja; Lovricević, Ivo; Zovak, Mario; Schmidt, Sasa

    2010-09-01

    The last two decades have seen a paradigm shift in the treatment of vascular related diseases from once traditional open surgical repairs to the entire vascular tree being amenable to percutaneous interventions. Neither the classic operating room nor the conventional angiography suite is optimal for both open surgery and endovascular procedures. Important issues for the vascular hybrid operating room include quality of the imaging equipment, radiation burden, ease of use of the equipment, need for specially trained personnel, ergonomics, ability to perform both open and percutaneous procedures, sterile environments, as well as quality and efficiency of patient care. The most important feature of working in a dedicated hybrid vascular suite should be the ability to attain best treatment of vascular patients. Whether the interventional radiologist or the vascular surgeon uses the facilities is of less importance. Establishment of an endovascular operating room suite has the benefit of a sterile environment, and the possibility of performing hybrid procedures and conversions when necessary. Moreover, angiography immediately before treatment gives contemporary anatomical information, and after treatment provides quality control. Consequently, better quality and service can be provided to the individual patient. These changes in the treatment of vascular disease require that a new type of vascular specialist, named 'vascular hybrid surgeon', trained to perform both endovascular and open surgical procedures in this highly complex patient group.

  13. Operating Room Telephone Microbial Flora

    Science.gov (United States)

    2007-11-02

    beta-lactamase expressing multi-resistant Acinetobacter baumannii transmitted in the operation area. J Hosp Infect, 2004. 57(4): p. 308-15. 63...Goodman, J. E., Volk, H. M., and Sood, R., Direct costs of multidrug-resistant Acinetobacter baumannii in the burn unit of a public teaching hospital...Scerpella, E.G., Wanger, A. R., Armitige, L., Anderlini, P., & Ericsson, C. D., Nosocomial outbreak caused by a multiresistant clone of Acinetobacter

  14. HFE safety reviews of advanced nuclear power plant control rooms

    Science.gov (United States)

    Ohara, John

    1994-01-01

    Advanced control rooms (ACR's) will utilize human-system interface (HSI) technologies that may have significant implications for plant safety in that they will affect the operator's overall role and means of interacting with the system. The Nuclear Regulatory Commission (NRC) reviews the human factors engineering (HFE) aspects of HSI's to ensure that they are designed to good HFE principles and support performance and reliability in order to protect public health and safety. However, the only available NRC guidance was developed more than ten years ago, and does not adequately address the human performance issues and technology changes associated with ACR's. Accordingly, a new approach to ACR safety reviews was developed based upon the concept of 'convergent validity'. This approach to ACR safety reviews is described.

  15. Effectiveness of Surgical Safety Check List applied in operation room%《手术安全核查表》在手术室的应用效果分析

    Institute of Scientific and Technical Information of China (English)

    王地萍

    2013-01-01

    Objective To investigate the effectiveness of Surgical Safety Check List applied during operation . Methods Relative information of patients ,receiving operation ,were checked by anesthesiologists ,nurse in opera-tion room and operation doctors before anesthesia ,operation and after operation .Results After the practice of opera-tion safety verification ,104 cases with hidden danger were discovered and treated in time ,and the operations were successfully completed .Conclusion Implementation of Surgical Safety Check List could effectively reduce the opera-tion risks ,improve the quality of nursing management ,promote team cooperation and ensure operation safety .%目的探讨《手术安全核查表》在手术过程中的应用效果。方法采取患者入手术室后,由麻醉医生、手术室护士、手术医生在麻醉实施前、手术切皮前、患者离室前3个时刻共同对手术患者相关信息进行核查。结果在实施手术安全核查后,及时发现隐患104例,并给予及时处理,顺利完成了手术。结论《手术安全核查表》的实施可有效降低手术风险、提高护理管理质量、密切团队协作、保障患者手术安全。

  16. RCA(Analysis Root Cause)Application in Operation Room Nursing Buried in Safety Management%RCA(根因分析法)在手术室护理安全管理中的应用

    Institute of Scientific and Technical Information of China (English)

    陈杏秀

    2015-01-01

    Objective:To explore the application effect of RCA in the whole course nursing in operation room. Method:2013 August to 2014 August in our hospital 12 000 elective operation patients were selected as research objects, the application of RCA and the effect of nursing safety management in operation room was observed. Result:The root cause analysis method of fishbone diagram clearly found operation room nursing problems and solutions. Conclusion:The related concept of combined application of RCA conclusion of whole nursing in operation room,help to improve the nursing effect, enhance the operation side effect,which is worth promoting.%目的:探讨RCA在手术室全程护理中的应用效果。方法:选择2013年8月-2014年8月本院开展的12000例择期手术患者作为研究对象,应用RCA观察对手术室护理安全管理中的影响。结果:经根因分析法的鱼骨图可清晰发现手术室护理存在的问题及解决方法。结论:手术室全程护理中联合应用RCA相关理念,有助于提升护理效果,侧面提升手术效果,值得推广。

  17. Implementation of a risk management plan in a hospital operating room

    Directory of Open Access Journals (Sweden)

    Li Guo

    2015-12-01

    Full Text Available A risk management program based on AS–NZS4360 risk management standards was developed and implemented in the operating room of Peking University Third Hospital. To accomplish this task, we developed a risk quantification matrix and a risk register form to identify potential risks in the operating room, and then implemented operating room policies designed to reduce or eliminate those risks. We also established a consultation mechanism and risk monitoring system designed to minimize risks to operation room nurses. Finally, we continuously seek to improve our operating room risk management capabilities, so we can continue to improve the quality of service provided and guarantee the safety of surgical patients.

  18. 安全文化在手术室护理管理中的应用探析%Application analysis of the safety culture in the operating room nursing management

    Institute of Scientific and Technical Information of China (English)

    曾慕阳

    2013-01-01

    目的探讨安全文化在手术室护理管理中的应用效果。方法选取实施安全文化的我院手术室,全面加强安全文化在护理管理中的应用,对实施安全文化前后医生、患者满意度和危急患者抢救情况以及护理差错和护理纠纷发生率分别予以统计分析。结果实施安全文化后,医生、患者满意度和危急患者抢救成功率均明显提高,护理差错及护理纠纷发生率明显降低,差异均具有统计学意义(P<0.05)。结论手术室通过实施安全文化教育和管理后,医疗服务质量明显提高,值得临床推广应用。%Objective To analyze the application effect of the safety culture in the operating room nursing management. Methods Select the operating room of our hospital enforced the safety culture, comprehensively strengthen the application of safety culture in nursing management, the satisfaction degree of the doctors and patients, the salvage condition of the critical patients, and the incidence of nursing errors and disputes before and after the implementation of safety culture were statistically analyzed respectively. Results After the implementation of the safety culture, the satisfaction degree of the doctors and patients, the rescue success rate of the critical patients were improved obviously, the incidence of nursing error and disputes were significantly reduced, the differences were all statistically significant (P<0.05). Conclusion By implementing safety culture education and management, medical service quality of the operating room improved obviously, worth of clinical popularization and application.

  19. Laminar flow operation room air quality on intraoperative equipment safety study%层流手术室动态空气质量对术中器械安全性的研究

    Institute of Scientific and Technical Information of China (English)

    白晓霞

    2013-01-01

    objective:Analyze the effect of laminar flow operation room air quality change on intraoperative equipment of bacterial colony growth ,take effective measures to ensure the air quality of laminar flow operation room , prevent intraoperative equipment pollution, improve the quality and safety of operation. Methods:Choose the area of 30M2, air cleanliness class of 100 laminar flow operation room to take 40 operations, operation time are more than 6 hours, the 40 operations were randomly divided into intervention group and control group. By monitoring the surface colony number of two groups of instruments, compare the bacterial colony number and intraoperative air colony number. Results:There is no bacterial growth in the intervention group or bacterial number was minimal, and no correlation with operation time. The gloves and intraoperative equipment of control group in 2 hours have bacterial growth, equipment covered have no bacterial growth. Conclusion:In the laminar flow purification air conditioning equipment running under good conditions, if we strictly control the operation flow and reduce the times of opening number in operation process ,we can ensure the air quality,and prevent equipment pollution.%目的:分析手术过程中细菌生长繁殖数量与手术时间的变化规律,采取有效措施减少各种感染因素,提高手术质量与安全。方法:通过空气培养监测手术过程中细菌菌落数,将细菌菌落数量与手术时间进行统计分析,得出两者之间的关系。结果:细菌数量与手术时间呈非线性关系,菌落数先增长后下降。结论:了解手术时间与细菌繁殖数量之间的规律对控制手术感染有较好的参考意义。

  20. Analysis and Countermeasures of Safety Hazards Reason in Operation Room%手术室用药中安全隐患的原因分析及对策

    Institute of Scientific and Technical Information of China (English)

    巫菊仙

    2015-01-01

    目的:探究手术室用药中安全隐患的原因及对策。方法对我院手术室发生安全隐患原因进行分析,并提出对策。结果护理执行制度不严,护理人员本身欠缺,相关人员沟通不到位,都是手术室用药安全隐患的因素。结论采取严格的管理制度,要求所有护理人员做好交接班工作,认真执行查对制度,同时加强医生、护理人员、麻醉师三者之间的沟通,明确抗生素过敏反应和麻醉不良反应的区别,将抗生素输注时间与麻醉时间错开。%ObjectiveExplore the operating room medication safety risks and the countermeasures.MethodsHospital operating room for analysis of the causes of safety problems, and proposed a solution. Results No strict implementation of the system of care, lack of nurses themselves, communication al relevant person in place, al the factors caused safety risks.Conclusion Taking strict management system, requiring al nurses to do shift work, earnestly implementing the check system, and strengthening communication between doctors, nurses and anesthesiologists.To clearer antibiotic alergic reactions and side effects of narcotic difference and make the antibiotic infusion time and anesthesia time staggered.

  1. Control of the Environment in the Operating Room.

    Science.gov (United States)

    Katz, Jonathan D

    2016-09-23

    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.

  2. Teamwork in the operating room: frontline perspectives among hospitals and operating room personnel.

    Science.gov (United States)

    Sexton, J Bryan; Makary, Martin A; Tersigni, Anthony R; Pryor, David; Hendrich, Ann; Thomas, Eric J; Holzmueller, Christine G; Knight, Andrew P; Wu, Yun; Pronovost, Peter J

    2006-11-01

    The Joint Commission on Accreditation of Healthcare Organizations is proposing that hospitals measure culture beginning in 2007. However, a reliable and widely used measurement tool for the operating room (OR) setting does not currently exist. OR personnel in 60 US hospitals were surveyed using the Safety Attitudes Questionnaire. The teamwork climate domain of the survey uses six items about difficulty speaking up, conflict resolution, physician-nurse collaboration, feeling supported by others, asking questions, and heeding nurse input. To justify grouping individual-level responses to a single score at each hospital OR level, the authors used a multilevel confirmatory factor analysis, intraclass correlations, within-group interrater reliability, and Cronbach's alpha. To detect differences at the hospital OR level and by caregiver type, the authors used multivariate analysis of variance (items) and analysis of variance (scale). The response rate was 77.1%. There was robust evidence for grouping individual-level respondents to the hospital OR level using the diverse set of statistical tests, e.g., Comparative Fit Index = 0.99, root mean squared error of approximation = 0.05, and acceptable intraclasss correlations, within-group interrater reliability values, and Cronbach's alpha = 0.79. Teamwork climate differed significantly by hospital (F59, 1,911 = 4.06, P teamwork climate is possible using this psychometrically sound teamwork climate scale. This tool and initial benchmarks allow others to compare their teamwork climate to national means, in an effort to focus more on what excellent surgical teams do well.

  3. 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

  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 quali

  5. The utilization of magnetic resonance imaging in the operating room.

    Science.gov (United States)

    Ménard, C; Pambrun, J-F; Kadoury, S

    Online image guidance in the operating room using ultrasound imaging led to the resurgence of prostate brachytherapy in the 1980s. Here we describe the evolution of integrating MRI technology in the brachytherapy suite or operating room. Given the complexity, cost, and inherent safety issues associated with MRI system integration, first steps focused on the computational integration of images rather than systems. This approach has broad appeal given minimal infrastructure costs and efficiencies comparable with standard care workflows. However, many concerns remain regarding accuracy of registration through the course of a brachytherapy procedure. In selected academic institutions, MRI systems have been integrated in or near the brachytherapy suite in varied configurations to improve the precision and quality of treatments. Navigation toolsets specifically adapted to prostate brachytherapy are in development and are reviewed. Copyright © 2017 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

  6. 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.

  7. Surgical attire and the operating room: role in infection prevention.

    Science.gov (United States)

    Salassa, Tiare E; Swiontkowski, Marc F

    2014-09-01

    ➤ Although there is some evidence that scrubs, masks, and head coverings reduce bacterial counts in the operating room, there is no evidence that these measures reduce the prevalence of surgical site infection.➤ The use of gloves and impervious surgical gowns in the operating room reduces the prevalence of surgical site infection.➤ Operating-room ventilation plays an unclear role in the prevention of surgical site infection.➤ Exposure of fluids and surgical instruments to the operating-room environment can lead to contamination. Room traffic increases levels of bacteria in the operating room, although the role of this contamination in surgical site infection is unclear.

  8. Fire in the Operating Room During Hypospadias Repair.

    Science.gov (United States)

    Boscarelli, Alessandro; Frediani, Simone; Ceccanti, Silvia; Cervellone, Alice; Pesce, Maria Vittoria; Cozzi, Denis A

    2017-11-01

    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.

  9. 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)

  10. Physician communication in the operating room.

    Science.gov (United States)

    Kirschbaum, Kristin A; Rask, John P; Fortner, Sally A; Kulesher, Robert; Nelson, Michael T; Yen, Tony; Brennan, Matthew

    2015-01-01

    In this study, communication research was conducted with multidisciplinary groups of operating-room physicians. Theoretical frameworks from intercultural communication and rhetoric were used to (a) measure latent cultural communication variables and (b) conduct communication training with the physicians. A six-step protocol guided the research with teams of physicians from different surgical specialties: anesthesiologists, general surgeons, and obstetrician-gynecologists (n = 85). Latent cultural communication variables were measured by surveys administered to physicians before and after completion of the protocol. The centerpiece of the 2-hour research protocol was an instructional session that informed the surgical physicians about rhetorical choices that support participatory communication. Post-training results demonstrated scores increased on communication variables that contribute to collaborative communication and teamwork among the physicians. This study expands health communication research through application of combined intercultural and rhetorical frameworks, and establishes new ways communication theory can contribute to medical education.

  11. HEMATOLOGIC FINDINGS IN OPERATING ROOM STAFFS

    Directory of Open Access Journals (Sweden)

    H SOLTANI

    2000-03-01

    Full Text Available Introduction. Long term exposure to trace amounts of anesthetic vapors and gases may produce hematologic and hepatic disorders in human. Since operating room (OR staffs are exposed to these agents, we decided to study their hematopoietic and hepatic systems in comparison with ordinary ward staffs. Methods. Seventy staffs from OR were compared with a matched similar number of ward staffs about their hematologic and hepatic laboratory findings in a historical cohort study. Findings. Mean of leukocyte and platelet counts were significantly lower in OR staffs, but in normal range. Mean of monocyte count was significantly higher in OR staffs. No significant differences were found between two groups for other hepatic and hematologic tests. Fatigue and headache were reported in OR staffs more than others. Conclusion. These findings may warn a risk to OR staffs but, it is not clear and requires further controlled studies.

  12. 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)

  13. Door Opening Affects Operating Room Pressure During Joint Arthroplasty.

    Science.gov (United States)

    Mears, Simon C; Blanding, Renee; Belkoff, Stephen M

    2015-11-01

    Many resources are expended to ensure a sterile operating room environment. Efforts are made to prevent exposure of patients to personnel and to achieve positive room pressure to keep out airborne contaminants. Foot traffic into and out of the operating room during surgery can undermine these efforts. The authors investigated the number and duration of operating room door openings during hip and knee arthroplasty procedures and the effect of the door openings on room pressure. They tested the hypothesis that door openings defeat positive pressure, permitting air flow into the room. Room pressure and door status were monitored electronically during 191 hip and knee arthroplasty procedures. Operating room staff were unaware that data were being collected. The authors evaluated the data with regression analysis to determine whether the number and duration of door openings had an effect on room pressure. Significance was set at Poperating room. Total time with the door open significantly affected the minimum pressure recorded in the room (Poperating room sterility. The causes of excessive operating room traffic must be evaluated to identify ways to reduce this traffic and the associated risks.

  14. 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.

  15. Implementing an operating room pharmacy satellite.

    Science.gov (United States)

    Powell, P J; Maland, L; Bair, J N; McCall, J D; Wong, K C

    1983-07-01

    Implementation of an operating room (OR) pharmacy satellite is described, and its impact on cost-effectiveness and efficiency of drug distribution is analyzed. The OR satellite provided pharmacy coverage for 30-35 patients per day in 10 centralized surgical suites, 2 obstetric suites, and 1 burn-unit suite in a 401-bed teaching hospital. Objectives of the satellite were to consolidate accountability for drug distribution and control, reduce controlled substance loss and waste, reduce inventory costs, and improve recording of patient charges. Stock on the OR supply cart was reduced, controlled substances were dispensed to anesthesiologists from the satellite, and a system of standardized anesthesiology exchange trays was developed. A new billing form served as both the charging document and replacement list. Reduction in the medication cart stock resulted in smaller discrepancies in patient charges. For the five most commonly used controlled substances, accounting discrepancies were reduced. Inventory turnover increased and inventory dollar value and cost per patient were reduced. The percent of nurses who believed that a pharmacist should work in the area increased from 31% before implementation of the satellite to 95% after. The pilot OR pharmacy satellite was a financial success. Efficiency and effectiveness in drug distribution and control were improved, and communication between pharmacists and other medical personnel working in the OR areas was enhanced.

  16. A Learning Needs Assessment of Operating Room Nurses.

    Science.gov (United States)

    Pounds, Elizabeth; Littlefield, John H.

    Operating room nursing is not a formal part of the generic nursing curriculum. A learning needs assessment can serve to identify inservice education needs of operating nurses. In this study, a factor analysis was performed on the responses of 1,201 practicing operating room nurses to a list of 24 behaviorally-stated learning needs. Four factors,…

  17. 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.

  18. 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.

  19. Effects of Intervention and Team Culture on Operating Room Traffic.

    Science.gov (United States)

    Pulido, Ricardo W; Kester, Benjamin; Schwarzkopf, Ran

    How changes in the surgical team's culture can potentially reduce operating room (OR) traffic. Excessive OR traffic during surgical procedures can present a risk to the patient's safety and recovery. Data suggest that limiting the number of OR personnel during the intraoperative period can reduce excessive OR traffic. However, it is unclear whether the surgeon's verbal intervention can also successfully reduce intraoperative OR traffic. This study compares traffic rates in hip and knee arthroplasty cases against traffic rates during nonarthroplasty cases to examine the effects of verbal interventions implemented by the surgeon to reduce intraoperative traffic. The study consisted of 16 orthopedic surgeons in a noninterventional group and 1 orthopedic surgeon in the interventional group. The surgeon in the interventional group implemented verbal protocols to OR staff to limit excessive intraoperative traffic. Operating room traffic was monitored for 3 consecutive months (January-March 2015) with the use of infrared automated door counters that tracked door openings when someone entered or left the OR. A total of 50 hip and knee arthroplasties cases and 157 nonarthroplasty cases were tracked during the study period. A total of 134 hours and 4482 movements were collected for the hip and knee arthroplasty cases. A total of 498 hours and 22 902 movements were collected for the nonarthroplasty cases. Comparing the 2 groups, the interventional group averaged 33 movements per hour while the noninterventional group averaged 46 movements per hour (P traffic can be reduced through simple verbal protocols established by the surgical team.

  20. Composite Operators in Asymptotic Safety

    CERN Document Server

    Pagani, Carlo

    2016-01-01

    We study the role of composite operators in the Asymptotic Safety program for quantum gravity. By including in the effective average action an explicit dependence on new sources we are able to keep track of operators which do not belong to the exact theory space and/or are normally discarded in a truncation. Typical examples are geometric operators such as volumes, lengths, or geodesic distances. We show that this set-up allows to investigate the scaling properties of various interesting operators via a suitable exact renormalization group equation. We test our framework in several settings, including Quantum Einstein Gravity, the conformally reduced Einstein-Hilbert truncation, and two dimensional quantum gravity. Finally, we briefly argue that our construction paves the way to approach observables in the Asymptotic Safety program.

  1. 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...

  2. Concentrations of methoxyflurane and nitrous oxide in veterinary operating rooms

    Energy Technology Data Exchange (ETDEWEB)

    Ward, G.S.; Byland, R.R.

    1982-02-01

    The surgical rooms of 14 private veterinary practices were monitored to determined methoxyflurane (MOF) concentrations during surgical procedure under routine working conditions. The average room volume for these 14 rooms was 29 m3. The average MOF value for all rooms was 2.3 ppm, with a range of 0.7 to 7.4 ppm. Four of the 14 rooms exceeded the maximum recommended concentration of 2 ppm. Six rooms which had 6 or more air changes/hr averaged 1.1 ppm, whereas 8 rooms with less than 6 measurable air changes/hr averaged 3.2 ppm. Operating rooms that had oxygen flows of more than 1,000 cm3/min averaged 4.4 ppm, whereas those with flows of less than 1,000 cm3/min averaged 1.5 ppm. The average time spent during a surgical procedure using MOF, for all 14 facilities, was 2 hours. Nitrous oxide (N/sub 2/O) concentrations were determined in 4 veterinary surgical rooms. The average N/sub 2/O concentration for 3 rooms without waste anesthetic gas scavenging was 138 ppm. Concentration of N/sub 2/O in the waste anesthetic gas-scavenged surgical room was 14 ppm, which was below the maximum recommended concentration of 25 ppm.

  3. [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

  4. 75 FR 5536 - Pipeline Safety: Control Room Management/Human Factors, Correction

    Science.gov (United States)

    2010-02-03

    ... Safety: Control Room Management/Human Factors, Correction AGENCY: Pipeline and Hazardous Materials Safety... Regulations to address human factors and other aspects of control room management for pipelines where... 63310) entitled ``Pipeline Safety: Control Room Management/Human Factors.'' This final rule...

  5. Operating room metrics score card-creating a prototype for individualized feedback.

    Science.gov (United States)

    Gabriel, Rodney A; Gimlich, Robert; Ehrenfeld, Jesse M; Urman, Richard D

    2014-11-01

    The balance between reducing costs and inefficiencies with that of patient safety is a challenging problem faced in the operating room suite. An ongoing challenge is the creation of effective strategies that reduce these inefficiencies and provide real-time personalized metrics and electronic feedback to anesthesia practitioners. We created a sample report card structure, utilizing existing informatics systems. This system allows to gather and analyze operating room metrics for each anesthesia provider and offer personalized feedback. To accomplish this task, we identified key metrics that represented time and quality parameters. We collected these data for individual anesthesiologists and compared performance to the overall group average. Data were presented as an electronic score card and made available to individual clinicians on a real-time basis in an effort to provide effective feedback. These metrics included number of cancelled cases, average turnover time, average time to operating room ready and patient in room, number of delayed first case starts, average induction time, average extubation time, average time to recovery room arrival to discharge, performance feedback from other providers, compliance to various protocols, and total anesthetic costs. The concept we propose can easily be generalized to a variety of operating room settings, types of facilities and OR health care professionals. Such a scorecard can be created using content that is important for operating room efficiency, research, and practice improvement for anesthesia providers.

  6. The operating room: architectural conditions and potential hazards.

    Science.gov (United States)

    Koneczny, Sonja

    2009-01-01

    Ergonomics is still not fully implemented in the design of operation rooms (ORs). The OR staff has to deal with various ergonomic deficiencies which may be associated with potential hazards for the patient and/or the OR team.Three surveys were conducted among German OR staff at major conferences. Two of them dealt with the working conditions in the OR and were conducted among surgeons and OR nurses. The third survey queried OR nurses about the electrical safety in the OR.In addition, a specially developed checklist was used to evaluate the work place OR in five German OR units and the staff of these OR units were queried with questionnaires adapted from the surveys. For this article a few of the deficiencies found in the ORs were chosen to serve as examples for the plethora of results gathered.Findings showed that there was a high potential for ergonomic improvement and therefore an increase in safety and comfort. Many of these deficiencies may be eased by simple means such as the reduction of the number of different devices and mandatory training in the use of the devices since device operation is one of the main causes leading to potential hazards in the OR. Other deficiencies, such as the cable routing in the OR, require more extensive intervention and/or the implementation of new techniques, for example the "wireless" OR. All these deficiencies demonstrate the need for better implementation of ergonomics into the OR and for individual solutions, as there is no such thing as an 'one-size-fits-all' solution for OR units.

  7. [Annual study of anesthesia-related mortality and morbidity in the year 2000 in Japan: the outlines--report of Japanese Society of Anesthesiologists Committee on Operating Room Safety].

    Science.gov (United States)

    Kawashima, Yasuo; Seo, Norimasa; Morita, Kiyoshi; Iwao, Yasuhide; Irita, Kazuo; Tsuzaki, Koichi; Tanaka, Yoshifumi; Shiraishi, Yoshito; Nakao, Yasuo; Tosaki, Youko; Goto, Yasuyuki; Kobayashi, Tsutomu; Dohi, Shuji; Obara, Hidefumi

    2002-09-01

    This report contains anesthesia-related mortality and morbidity in Japanese Society of Anesthesiologists Certified Training Hospitals (JSACTH) in the year 2000, as a part of the second series of annual studies started in 1999. JSA Committee on Operating Room Safety (CORS) sent confidential questionnaires to 794 JSACTH and received effective answers from 65.5% of hospitals. A total number of 941,217 anesthetics were documented. The respondents were asked to report all cases of cardiac arrests and other critical incidents (serious hypotension, serious hypoxemia and others), and their outcomes (death in operating room, death within 7 days, transfer to vegetative state and rescue without sequelae) as well as one principal cause for each incident from the list of 52 items. They were also requested to submit the tabulation of patients by ASA physical status, age distribution, surgery sites and anesthetic methods. Analysis was made by total incidents under anesthesia/surgery, and also by incidents totally attributable to anesthetic management (AM), due to preoperative complications (PC), due to intraoperative pathological events (IP) and due to surgery (SG). This paper focused analysis on entire patients, since analyses with special reference to ASA physical status, age distribution, surgery sites and anesthetic methods were reported previously. Total incidence of cardiac arrest under anesthesia/surgery was 6.52 per 10,000 anesthetics. PC, IP and SG occupied 46.4%, 19.1% and 23.0% of principal causes of total cardiac arrest, respectively. AM occupied only 8.1% of the principal causes and the incidence was 0.53 per 10,000. The most frequent cause of cardiac arrest in 52 more detailed classification of principal causes was preoperative hemorrhagic shock that occupied 23.3% of all cardiac arrests. The second was massive hemorrhage and/or hypovolemia due to surgical procedures (10.6%), and the third was surgery itself (9.5%). Prognosis of the cardiac arrest was worst in that

  8. [Annual study of anesthesia-related mortality and morbidity in the year 2001 in Japan: the outlines--report of Japanese Society of Anesthesiologists Committee on Operating Room Safety].

    Science.gov (United States)

    Kawashima, Yasuo; Seo, Norimasa; Tsuzaki, Koichi; Iwao, Yasuhide; Morita, Kiyoshi; Irita, Kazuo; Obara, Hidefumi

    2003-06-01

    We reported anesthesia-related mortality and morbidity in Japanese Society of Anesthesiologists Certified Training Hospitals (JSACTH) in the year 2001, as a part of the second series of annual studies in the identical questionnaires form started in 1999. JSA Committee on Operating Room Safety sent confidential questionnaires to 813 JSACTH and received effective answers from 87.9% of the hospitals. A total number of 1,284,957 anesthetics were documented. The respondents were asked to report all cases of cardiac arrests and other critical incidents (serious hypotension, serious hypoxemia and others) during anesthesia and surgery, and their outcomes (death in operating room, death within 7 days, transfer to vegetative state and rescue without sequelae) as well as one principal cause for each incident from the list of 52 items. Definition of serious hypotension, serious hypoxemia and others was those events suggesting the possibility of impending cardiac arrest or permanent disability of the central nervous system or myocardium. The respondents were also requested to submit the tabulation of patients by ASA physical status, age distribution, surgery sites and anesthetic methods. Analysis was made by total incidents under anesthesia/surgery, and also by incidents totally attributable to anesthetic management (AM), due to preoperative complications (PC), due to intraoperative pathological events (IP) and due to surgery (SG). This paper focused on analysis of entire patients, as other later papers will report analyses with special reference to ASA physical status, age distribution, surgery sites and anesthetic methods. Total incidence of cardiac arrest under anesthesia/surgery was 6.12 per 10,000 anesthetics. PC, IP and SG occupied 47.2%, 21.1% and 24.2% of principal causes of total cardiac arrest, respectively. AM occupied only 6.4% of the principal causes and the incidence was 0.39 per 10,000. The most frequent cause of cardiac arrest in 52 more detailed classifications

  9. Preoperative planning and designing of a fluorocompatible endourology operating room.

    Science.gov (United States)

    Sabnis, Ravindra B; Mishra, Shashikant; Sharma, Rajan; Desai, Mahesh R

    2009-10-01

    A dedicated fluoroscopic-compatible operating room (OR) for endourologic procedures, such as percutaneous nephrolithotomy and ureteroscopy, is structurally and functionally different from the general OR. Publications with practical details are scarce, imposing a challenge in construction of such an OR. We outline a practical approach for the design and construction of a modern flourocompatible endourology OR. There were no publications related to a dedicated endourology OR in Medline. A search was then performed for English language articles on OR designing, fluoroscopy in the OR, data archiving, and data relay. We also surveyed the existing endourology OR in different hospitals and analyzed the available technology for audiovisual capture and relay in surgery. This article was then prepared, covering the relevant areas on designing a dedicated flourocompatible endourology OR. Close cooperation and interaction between an architect and expert construction manager for designing, development, and construction of an OR are necessary. Strategic equipment placement with booms is essential to increase the efficiency and safety within the surgical space. Distinct features of an endourology OR are thickness of the walls for radiation protection, wide OR gate, central floor water exit drain, flourocompatible rotatable OR table, C-arm unit, minimum three hanging thin-film transistor (TFT) screen monitors, and endoscopic equipment supported on a boom. The anesthetic boom should be retractable and movable from one end of the OR table to other. The OR should have an electronic workstation strategically located at one corner for data capture, archiving, and telementoring. Data relay of the OR procedure is facilitated by a control room located in the vicinity of the OR. Designing the layout of the OR is extremely important, necessitating thoughtful planning to provide hassle-free movement, comfort to the surgeon, and efficient data archiving and transmission during a surgical

  10. Before operating room nursing journals: operating room nursing in the pages of the Canadian Nurse 1940-1960.

    Science.gov (United States)

    Moszczynski, Alice

    2010-09-01

    The Canadian Nurses Association (CNA) values learning from nursing history to provide a contextual perspective in understanding how past events have shaped current nursing practice. Until the publication of operating room nursing journals, Canada's national nursing journal, The Canadian Nurse, served as an educational and professional resource for those nurses working in the operating room and for nurses whose work was related to, or connected with, the operating room. A historical review of early issues of The Canadian Nurse (first published in 1905) reveals a substantial amount of content related to operating room nursing in the twenty year period, beginning in the 1940s, that predated the existence of OR specialty journals. The content was, for the time, both detailed and informative. It was through this journal that operating room nurses, indeed all Canadian nurses, learned about new advances, employment opportunities, educational programs, professional associations, and the achievements of those in the profession. Operating Room Nursing, as an isolated and quickly emerging specialty, was introduced to other nurses via items in The Canadian Nurse journal.

  11. Design and Implementation of Air Conditioning System in Operating Room

    Directory of Open Access Journals (Sweden)

    Htet Htet Aung

    2014-10-01

    Full Text Available The system is air conditioning system in operating room. The main objective of the system was implemented to provide air balance and temperature necessary conditions and to control airflow system for ventilation units in operating room. The operation room can be controlled with fuzzy expert system and describes the desired outputs. Input parameters such as temperature, humidity, oxygen and particle are used and output parameters are chosen as air conditioning motor speed and exhaust motor speed. Input parameters of the system are taken into account optimal conditions based on oxygen as medium and other parameters are chosen minimum condition for operating room. The airflow control system is determined the two components: the airflow block and the thermal block for ventilation units in operating room. The mathematical modeling of each such system based on a computational procedure and to combine them together in an efficient manner. Whether it supports to the most suitable control for the system prototype was determined by simulating the operation with varying the number of personnel and duration of time. Finally, according to the combination of temperature and airflow regulations with PI controller, the results of simulation of the entire ventilation unit control system is obtained.

  12. Central waste complex interim operational safety requirements

    Energy Technology Data Exchange (ETDEWEB)

    Bendixsen, R.B.; Ames, R.R., Fluor Daniel Hanford

    1997-03-20

    This Interim Operational Safety Requirements document supports the authorization basis for interim operations and identifies restrictions on interim operations for the disposal and storage of solid waste in the Central Waste Complex. The Central Waste Complex Interim Operational Safety Requirements provide the necessary controls on operations in the Central Waste Complex to ensure the radiological and hazardous material exposure will be acceptable from an overall health and safety standpoint to the worker, the onsite personnel, 1327 the public and the environment.

  13. 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.

  14. 75 FR 69912 - Pipeline Safety: Control Room Management/Human Factors

    Science.gov (United States)

    2010-11-16

    ... Safety: Control Room Management/Human Factors AGENCY: Pipeline and Hazardous Materials Safety..., 2010, PHMSA published a Control Room Management/Human Factors notice of proposed rulemaking (NPRM... to expedite the program implementation deadlines of the Control Room Management/Human Factors rule...

  15. 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.

  16. Flow analysis of airborne particles in a hospital operating room

    Science.gov (United States)

    Faeghi, Shiva; Lennerts, Kunibert

    2016-06-01

    Preventing airborne infections during a surgery has been always an important issue to deliver effective and high quality medical care to the patient. One of the important sources of infection is particles that are distributed through airborne routes. Factors influencing infection rates caused by airborne particles, among others, are efficient ventilation and the arrangement of surgical facilities inside the operating room. The paper studies the ventilation airflow pattern in an operating room in a hospital located in Tehran, Iran, and seeks to find the efficient configurations with respect to the ventilation system and layout of facilities. This study uses computational fluid dynamics (CFD) and investigates the effects of different inflow velocities for inlets, two pressurization scenarios (equal and excess pressure) and two arrangements of surgical facilities in room while the door is completely open. The results show that system does not perform adequately when the door is open in the operating room under the current conditions, and excess pressure adjustments should be employed to achieve efficient results. The findings of this research can be discussed in the context of design and controlling of the ventilation facilities of operating rooms.

  17. Google Glass in the Operating Room: The Plastic Surgeon's Perspective.

    Science.gov (United States)

    Sinkin, Jeremy C; Rahman, Omar F; Nahabedian, Maurice Y

    2016-07-01

    New technologies and innovations are common in the delivery of modern health care. Google Glass is one such device gaining increased attention in medical specialties. The authors surveyed residents and attending physicians in the Department of Plastic Surgery, MedStar Georgetown University Hospital, on their experience using Google Glass in the operating room. Ease of use, quality of images, gaze disruption, and distraction during surgery were measured. Overall, subjects found the device to be comfortable and satisfying to wear and use during surgery to capture images of good quality. Despite some identified weaknesses, Google Glass is a unique technology with a promising plastic surgical application in the operating room.

  18. [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.

  19. 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

  20. 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

  1. Silence, power and communication in the operating room

    Science.gov (United States)

    Gardezi, Fauzia; Lingard, Lorelei; Espin, Sherry; Whyte, Sarah; Orser, Beverley; Baker, G Ross

    2009-01-01

    Title. Silence, power and communication in the operating room Aim This paper is a report of a study conducted to explore whether a 1- to 3-minute preoperative interprofessional team briefing with a structured checklist was an effective way to support communication in the operating room. Background Previous research suggests that nurses often feel constrained in their ability to communicate with physicians. Previous research on silence and power suggests that silence is not only a reflection of powerlessness or passivity, and that silence and speech are not opposites, but closely interrelated. Methods We conducted a retrospective study of silences observed in communication between nurses and surgeons in a multi-site observational study of interprofessional communication in the operating room. Over 700 surgical procedures were observed from 2005–2007. Instances of communication characterized by unresolved or unarticulated issues were identified in field notes and analysed from a critical ethnography perspective. Findings We identified three forms of recurring ‘silences’: absence of communication; not responding to queries or requests; and speaking quietly. These silences may be defensive or strategic, and they may be influenced by larger institutional and structural power dynamics as well as by the immediate situational context. Conclusions There is no single answer to the question of why ‘nobody said anything’. Exploring silences in relation to power suggests that there are multiple and complex ways that constrained communication is produced in the operating room, which are essential to understand in order to improve interprofessional communication and collaboration.

  2. Improving the Interdisciplinary Team Work in the Operating Room

    DEFF Research Database (Denmark)

    Tørring, Birgitte

    2016-01-01

    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...

  3. 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.

  4. Facets of operational performance in an emergency room (ER)

    NARCIS (Netherlands)

    van der Vaart, Taco; Vastag, Gyula; Wijngaard, Jacob

    2011-01-01

    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 opera

  5. Decision support system for the operating room rescheduling problem

    NARCIS (Netherlands)

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

    2012-01-01

    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 in

  6. 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

    2011-01-01

    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 tr

  7. 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.

  8. [Perioperative mortality and morbidity for the year of 1999 in 466 Japanese Certified Anesthesia-training Hospitals: with special reference to ASA-physical status--report of Committee on Operating Room Safety of Japan Society of Anesthesiologists].

    Science.gov (United States)

    Irita, K; Kawashima, Y; Kobayashi, T; Goto, Y; Morita, K; Iwao, Y; Seo, N; Tsuzaki, K; Dohi, S

    2001-06-01

    Perioperative mortality and morbidity in Japan for the year 1999 were studied retrospectively. Committee on Operating Room Safety of the Japan Society of Anesthesiologists (JSA) sent confidential questionnaires to 774 Certified Training Hospitals of JSA and received answers from 60.2% of the hospitals. We analyzed their answers with special reference to ASA physical status (ASA-PS). The total number of anesthetics analyzed was 655, 644. Mortality and morbidity due to all kinds of causes including anesthetic management, intraoperative events, co-existing diseases, and operation were as follows. The incidence of cardiac arrest (per 10,000 anesthetics) was 0.68, 3.76, 14.37, 67.03, 0.36, 4.68, 27.96, 206.30 in patients with ASA-PS of I, II, III, IV, I E, II E, III E, and IV E, respectively. The incidences of critical events including cardiac arrest, severe hypotension, and severe hypoxemia were 8.93, 26.99, 71.30, 188.52, 8.68, 31.27, 136.16, and 790.92 in patients with ASA-PS of I, II, III, IV, I E, II E, III E, and IV E, respectively. The mortality rates (death during anesthesia and within 7th postoperative day) after cardiac arrest were 0.16, 0.94, 5.71, 33.51, 0.00, 1.46, 16.41 and 167.76 per 10,000 anesthetics in patients with ASA-PS of I, II, III, IV, I E, II E, III E, and IV E, respectively. The overall mortality rates were 0.24, 1.66, 12.16, 67.03, 0.00, 3.51, 34.65 and 417.14 in patients with ASA-PS of I, II, III, IV, I E, II E, III E, and IV E, respectively. Overall mortality and morbidity were higher in emergency anesthetics than in elective anesthetics. ASA-PS correlated well with overall mortality and with morbidity, regardless of etiology. The incidences of cardiac arrest totally attributable to anesthesia were 0.24, 0.45, 1.47, 8.38, 0.36, 1.75, 2.43 and 11.34 in patients with ASA-PS of I, II, III, IV, I E, II E, III E, and IV E, respectively. The incidences of all critical events totally attributable to anesthesia were 4.92, 8.81, 14.74, 20.95, 4

  9. [Perioperative mortality and morbidity in the year 2000 in 502 Japanese certified anesthesia-training hospitals: with a special reference to ASA-physical status--report of the Japan Society of Anesthesiologists Committee on Operating Room Safety].

    Science.gov (United States)

    Irita, Kazuo; Kawashima, Yasuo; Tsuzaki, Koichi; Iwao, Yasuhide; Kobayashi, Tsutomu; Seo, Norimasa; Goto, Yasuyuki; Morita, Kiyoshi; Shiraishi, Yoshito; Nakao, Yasuo; Tanaka, Yoshifumi; Tosaki, Youko; Dohi, Shuji; Obara, Hidefumi

    2002-01-01

    Perioperative mortality and morbidity in Japan from Jan. 1 to Dec. 31, 2000 were studied retrospectively. Committee on Operating Room Safety in Japanese Society of Anesthesiologists (JSA) sent confidential questionnaires to 794 certified training hospitals of JSA and received answers from 67.6% of the hospitals. We analyzed their answers with a special reference to ASA physical status (ASA-PS). The total number of anesthesia available for this analysis was 897,733. The percentages of patients with ASA-PS of I, II, III, IV, I E, II E, III E, and IV E are 38.0, 40.3, 8.5, 0.4, 4.3, 5.3, 2.5, and 0.7%, respectively. Mortality and morbidity from all kinds of causes including anesthetic management, intraoperative events, co-existing diseases, and surgical problems were as follows. The incidences of cardiac arrest (per 10,000 cases of anesthesia) were 1.11, 3.26, 12.25, 54.60, 0.77, 4.46, 21.08 and 217.75 in patients with ASA-PS of I, II, III, IV, I E, II E, III E, and IV E, respectively. The incidences of critical events including cardiac arrest, severe hypotension, and severe hypoxemia were 6.89, 20.22, 62.18, 148.21, 6.71, 20.38, 106.72 and 592.21 in patients with ASA-PS of I, II, III, IV, I E, II E, III E, and IV E, respectively. The mortality rates (death during anesthesia and within 7 postoperative days) after cardiac arrest were 0.26, 0.77, 3.69, 41.60, 0.00, 1.06, 9.42 and 163.31 per 10,000 cases of anesthesia in patients with ASA-PS of I, II, III, IV, I E, II E, III E, and IV E, respectively. The overall mortality rates were 0.32, 1.38, 9.75, 70.20, 0.26, 2.12, 29.15 and 353.02 in patients with ASA-PS of I, II, III, IV, I E, II E, III E, and IV E, respectively. Overall mortality and morbidity were higher in emergency anesthesia than in elective anesthesia. ASA-PS correlated well with overall mortality and morbidity, regardless of etiology. The incidences of cardiac arrest totally attributable to anesthesia were 0.23, 0.50, 1.32, 0.00, 0.00, 0.85, 2.69 and 4

  10. 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.

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

    Science.gov (United States)

    Sonoda, Yukio; Onozuka, Daisuke; Hagihara, Akihito

    2017-07-25

    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.

  12. Sedation of infants and children outside of the operating room.

    Science.gov (United States)

    Tobias, Joseph D

    2015-08-01

    Although adults may be able to tolerate procedures without sedation, developmental and cognitive issues often mandate the use of sedation in infants and children. There has been a shift in the philosophy regarding sedation with an increasing recognition of the negative psychological and physiological aspects of inadequate sedation. The expansion of our technology continues to result in an increasing number of techniques, which require sedation outside of the operating room environment. These factors have contributed to an ever growing number of pediatric patients presenting themselves for procedural sedation. This chapter will discuss issues regarding the provision of anesthesia outside of the operating room for pediatric patients including current guidelines for patient assessment prior to procedural, monitoring during sedation, and a discussion of some of the more commonly utilized sedative and analgesic agents within the pediatric population.

  13. A Web-Based Operating Room Management Educational Tool.

    Science.gov (United States)

    Tsai, Mitchell H; Haddad, Daniel J; Friend, Alexander F; Bender, S Patrick; Davidson, Melissa L

    2016-08-01

    In 2010, our department instituted a nonclinical, administrative rotation in operating room management for anesthesiology residents. Subsequently, we mandated the rotation for all senior anesthesiology residents in 2013. In 2014, under the auspices of the American Society of Anesthesiologists, we developed a web-based module covering the basics of finance, accounting, and operating room management. A multiple-choice test was given to residents at the beginning and end of the rotation, and we compared the mean scores between residents who took the traditional course and residents who took the web-based module. We found no significant difference between the groups of residents, suggesting that the web-based module is as effective as traditional didactics.

  14. [Design, equipment, and management for air conditioning in operating room].

    Science.gov (United States)

    Fuji, Kumiko; Mizuno, Ju

    2011-11-01

    In order to maintain air cleanliness in the operating room (OR) permanently, air exchange rate in the OR should be more than 15 times x hr(-1), the laminar air flow should be kept, and the numbers of the persons in the OR and the numbers of opening and closing OR door should be limited. High efficiency particulate air (HEPA) filter is effective in collection and removal of airborne microbes, and is used in the biological clean room. We need to design, equip, and manage the OR environment according to Guideline for Design and Operation of Hospital HVAC Systems HEAS-02-2004 established by Healthcare Engineering Association of Japan and Guideline for Prevention of Surgical Site Infection (SSI) established by the Center for Disease Control and Prevention (CDC) in the USA.

  15. Response Times of Operators in a Control Room

    DEFF Research Database (Denmark)

    Platz, O.; Rasmussen, J.; 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 ...... response times. Lognormal distributions are found to provide the best fit of the day and the night response times....

  16. Advanced Technologies in Safe and Efficient Operating Rooms

    Science.gov (United States)

    2006-02-01

    area of Informatics, a Meta analysis of commercially available positioning technolgies has been completed. A sampling of these technologies was...intense care provided for many patients. The operating room forms the nucleus of mobile military hospitals. Whether found in civilian or military...encompasses systems consisting of mobile transmitters and fixed or semi-fixed receivers used wirelessly and without human intervention to identify the

  17. Surgical site infection prevention: the operating room environment.

    Science.gov (United States)

    Clyburn, Terry A; Evans, Richard P; Moucha, Calin S; Prokuski, Laura

    2011-01-01

    Surgical site infections can complicate orthopaedic procedures and contribute to morbidity, mortality, and health care costs. Extensive literature has been published on this topic; however, the quality of data using standards of evidence-based medicine is variable with a lack of well-controlled studies. A review of the literature concerning measures to prevent surgical site infections in the operating room environment may be helpful in preventing such infections.

  18. 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 Video-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.

  19. 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.

  20. Safety management of complex research operations

    Science.gov (United States)

    Brown, W. J.

    1981-01-01

    Complex research and technology operations present many varied potential hazards which must be addressed in a disciplined independent safety review and approval process. The research and technology effort at the Lewis Research Center is divided into programmatic areas of aeronautics, space and energy. Potential hazards vary from high energy fuels to hydrocarbon fuels, high pressure systems to high voltage systems, toxic chemicals to radioactive materials and high speed rotating machinery to high powered lasers. A Safety Permit System presently covers about 600 potentially hazardous operations. The Safety Management Program described in this paper is believed to be a major factor in maintaining an excellent safety record at the Lewis Research Center.

  1. 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.

  2. 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.

  3. Safety of collieries blasting operations

    Energy Technology Data Exchange (ETDEWEB)

    Carbonel, P. (Cerchar, 75 - Paris (France))

    1984-01-01

    The slight increase in periodicity of blasting incidents and their nature have led to remind one of the basic safety principles: to reduce the probability of dust and methane ignition by the explosive used or by the shotfiring line; to carefully select the explosive in accordance to the work to be carried out. It is reminded that using an anti-gassy explosive does not necessarily mean that no ignition will occur.

  4. 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.

  5. Diagnostic hysteroscopy in a procedure room setting compared to diagnostic hysteroscopy in the operating room

    Directory of Open Access Journals (Sweden)

    Ayman Oraif

    2016-12-01

    Conclusions: Diagnostic hysteroscopy is currently considered a valuable investigational tool for endometrial abnormalities and abnormal uterine bleeding. Most of these procedures can be performed in a procedure room setting without I.V. sedation or pre-operative narcotics. In our experience, a utero-sacral block using lidocaine is quite effective in controlling discomfort while passing various instruments through the internal cervical os. These techniques result in good visualization of the endometrial cavity, adequate and appropriate endometrial sampling with tolerable discomfort. The patients spend less time in the hospital, experience a much faster recovery and have less pre-operative restrictions. [Int J Reprod Contracept Obstet Gynecol 2016; 5(12.000: 4164-4173

  6. Feasibility and safety of Reveal LINQ insertion in a sterile procedure room versus electrophysiology laboratory.

    Science.gov (United States)

    Wong, Geoffrey R; Lau, Dennis H; Middeldorp, Melissa E; Harrington, Judith A; Stolcman, Simon; Wilson, Lauren; Twomey, Darragh J; Kumar, Sharath; Munawar, Dian A; Khokhar, Kashif B; Mahajan, Rajiv; Sanders, Prashanthan

    2016-11-15

    Insertable cardiac monitors (ICMs) are increasingly utilized for diagnosis of unexplained syncope and arrhythmia monitoring. The Reveal LINQ is a novel miniaturized ICM with improved algorithms. The feasibility and safety of insertion outside the traditional electrophysiology laboratory is unknown. Here we compare outcomes of Reveal LINQ insertion in different environments. We report on a prospective, single-centre, non-randomized, observational experience of consecutive Reveal LINQ implantation in the electrophysiology laboratory or a procedure room between October 2013 and October 2015. Of 178 consecutive patients who underwent LINQ device insertion, 80 were implanted in the electrophysiology laboratory and 98 in a procedure room. There were no significant differences in baseline patient characteristics. All implants were performed in the recommended manufacturer method with the exception of 1 which required suture closure. Only a minority received peri-procedural antibiotics with a greater number in the electrophysiology laboratory group (11 [14%] versus 1 [1%], p=0.007). Overall, there were 3 (1.7%) complications with no significant difference between the electrophysiology laboratory and the procedure room groups (2 [3%] versus 1 [1%], p=0.45). There was 1 superficial infection in the procedure room group and 1 superficial infection with device extrusion and 1 traumatic extrusion in the electrophysiology laboratory group. Procedure room implantation subjectively improved laboratory efficiency and patient flow. Reveal LINQ insertion can be safely performed outside of the cardiac laboratory provided a sterile technique is followed by the operator using manufacturer recommendations for insertion. These findings have significant resource implications for hospitals undertaking such procedures. Crown Copyright © 2016. Published by Elsevier Ireland Ltd. All rights reserved.

  7. Psychological and Physical Stress in Surgeons Operating in a Standard or Modern Operating Room

    DEFF Research Database (Denmark)

    Klein, M.; Andersen, L.P.H.; Gögenür, Ismayil

    2010-01-01

    Purpose: There have been no studies examining the effect of optimized ergonomic and technical environment on the psychological and physiological stress of the surgeon. The aim of this study was to examine whether optimized ergonomics and technical aids within a modern operating room (OR) affect...... psychological and physiological stress in experienced laparoscopic surgeons. Methods: This was a prospective case-controlled study including 10 experienced surgeons. Surgery was performed in 2 different ORs: a standard room and a modern room (OR1-suite, Karl Storz). The surgeons filled out questionnaires...

  8. Effective management strategy for establishing an operating room satellite pharmacy.

    Science.gov (United States)

    Brakebill, J I; Schoeneman, P F; Buchanan, B

    1988-11-01

    The steps involved in justifying and implementing an operating room (OR) pharmacy satellite are described. A hospital administrator's viewpoint on the project is included. Objectives of the satellite were to reduce inventory costs, improve control of distribution, reduce loss of revenue and improve patient charging, improve IV compounding and labeling, and significantly improve narcotic control and accountability. The satellite provides comprehensive services 12 hours a day, five days a week. Effective after-hours procedures have been developed to provide efficient drug distribution when the pharmacy is closed. Achieved benefits of the satellite include decreased drug inventory, improved patient charging, accurate labeling, improved IV compounding, and improved pharmacy/surgery relations. The OR pharmacy satellite is a successful cost-effective operation.

  9. 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.

  10. 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.

  11. Utilization of operating room time in a cancer hospital

    Directory of Open Access Journals (Sweden)

    P Ranganathan

    2013-01-01

    Full Text Available Background: Appropriate usage of operating room (OR time can improve efficiency of utilization of resources and help to decrease surgical waiting lists. Aims: This study was conducted to evaluate the pattern of usage of OR time in a tertiary referral cancer hospital. Setting and Design: This was a prospective audit carried out over 2 months in 11 major ORs in a cancer hospital. Materials and Methods: OR anesthesiologists filled a standard form for all patients undergoing elective surgery and documented the following times: entry into OR, start of anesthesia, handover to surgeon, incision, start of reversal, end of anesthesia, and shifting out of patient. Statistical Analysis: Median time utilized for various OR processes was calculated. Results: An average of two surgeries were performed per OR session (828 surgeries in 407 OR sessions. Anesthesia and surgery-related processes contributed to 17% and 79%, respectively, of total OR time, with turnover time between cases accounting for the remaining 4%. Fifteen percent (60 out of 407 OR sessions started more than 10 min later than the planned start time, and 17% (70 of 407 of OR sessions ended more than 2 h after the scheduled finish time. An anesthesia procedure room was utilized in only 15% of cases where it could potentially have been used. Conclusion: This audit identified patterns of OR usage in a cancer hospital and helped to detect areas of inefficient utilization. Anesthesia-related processes contributed to 17% of the total OR time.

  12. 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.

  13. Gender, patient comfort and the neurosurgical operating room.

    Science.gov (United States)

    Zener, Rebecca; Bernstein, Mark

    2011-01-01

    Neurosurgical patients may be unaware of components of their intra-operative care. The relationship between patient gender and comfort level in the neurosurgical operating room (OR) has not been previously studied. Our objective was to gain insight into patients' perspective of the OR environment, including staffing and observers, the role of medical students, catheterization, exposure, and verbiage, using a qualitative needs assessment. Face-to-face semi-structured interviews were conducted with 20 patients (14 female, six male) who had a neurosurgical operation under general anesthetic within the previous two years. The majority underwent craniotomy for benign tumours. Interviews were transcribed and subjected to modified thematic analysis. Nine themes emerged: 1) perception of the intra-operative environment varies between men and women; 2) lacking awareness about observers is anxiety-provoking for women; 3) being unaware of the hands-on involvement of students is a concern for all patients; 4) disclosure of implantation of foreign and permanent materials into patients is important; 5) catheterization is anxiety provoking for women; 6) pre-operative menstruation screening may minimize embarrassment for women; 7) patients perceive extraneous conversation as a distraction for surgeons; 8) patients trust their surgeon; 9) a relationship exists between interviewer gender and patient comfort in the interview. Although most male and female patients are unaware of OR activities, they are generally not fearful since they trust their surgeon. Women appear to have greater information needs. Patients' information needs must be met without provoking anxiety and yet preserving their personal sense of modesty in the intra-operative environment.

  14. To the point: teaching the obstetrics and gynecology medical student in the operating room.

    Science.gov (United States)

    Hampton, Brittany S; Craig, LaTasha B; Abbott, Jodi F; Buery-Joyner, Samantha D; Dalrymple, John L; Forstein, David A; Hopkins, Laura; McKenzie, Margaret L; Page-Ramsey, Sarah M; Pradhan, Archana; Wolf, Abigail; Graziano, Scott C

    2015-10-01

    This article, from the "To the Point" series that is prepared by the Association of Professors of Gynecology and Obstetrics Undergraduate Medical Education Committee, is a review of considerations for teaching the medical student in the operating room during the obstetrics/gynecology clerkship. The importance of the medical student operating room experience and barriers to learning in the operating room are discussed. Specific considerations for the improvement of medical student learning and operating room experience, which include the development of operating room objectives and specific curricula, an increasing awareness regarding role modeling, and faculty development, are reviewed.

  15. Improving pharmacy supply-chain management in the operating room.

    Science.gov (United States)

    Thomas, J A; Martin, V; Frank, S

    2000-12-01

    Anesthesia services can account for a significant portion of a healthcare organization's costs. Deaconess Hospital of Evansville, Indiana, used a collaborative, multidisciplinary effort to implement process improvements that yielded significant cost savings while improving patient care. Shifting responsibility for drug distribution from the operating room (OR) nurses to a pharmacist, the hospital established a satellite pharmacy service for the OR. As a result, the hospital was able to improve control of drug distribution and record-keeping, reduce turnaround time for medication preparation, lower its medication charge error rate, and increase the percentage of surgeries that start on time. The success of the OR satellite pharmacy led the hospital to expand satellite pharmacy services to labor and delivery, the cardiac cath laboratory, and the intensive care units.

  16. The Line Operations Safety Audit Program: Transitioning From Flight Operations to Maintenance and Ramp Operations

    Science.gov (United States)

    2011-09-01

    A Line Operations Safety Audit ( LOSA ) is a voluntary safety program that collects safety data during normal airline operations and was originally...maintenance and ramp operations. This report provides a review of the use of LOSA , discusses LOSA’s essential operating characteristics, lessons learned on...the flight deck, and describes the extension of LOSA to maintenance and ramp operations. The research team developed tools for airlines and

  17. Operational reliability of standby safety systems

    Energy Technology Data Exchange (ETDEWEB)

    Grant, G.M.; Atwood, C.L.; Gentillon, C.D. [Idaho National Engineering Lab., Idaho Falls, ID (United States)] [and others

    1995-04-01

    The Idaho National Engineering Laboratory (INEL) is evaluating the operational reliability of several risk-significant standby safety systems based on the operating experience at US commercial nuclear power plants from 1987 through 1993. The reliability assessed is the probability that the system will perform its Probabilistic Risk Assessment (PRA) defined safety function. The quantitative estimates of system reliability are expected to be useful in risk-based regulation. This paper is an overview of the analysis methods and the results of the high pressure coolant injection (HPCI) system reliability study. Key characteristics include (1) descriptions of the data collection and analysis methods, (2) the statistical methods employed to estimate operational unreliability, (3) a description of how the operational unreliability estimates were compared with typical PRA results, both overall and for each dominant failure mode, and (4) a summary of results of the study.

  18. 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.

  19. 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)

  20. Mission Operations Control Room Activities during STS-2 mission

    Science.gov (United States)

    1981-01-01

    Mission Operations Control Room (MOCR) activities during STS-2 mission. Overall view of the MOCR in the Johnson Space Center's Mission Control Center. At far right is Eugene F. Kranz, Deputy Director of Flight Operations. At the flight director console in front of Kranz's FOD console are Flight Directors M.P. Frank, Neil B. Hutchinson and Donald R. Puddy as well as others (39506); Wide-angle view of flight controllers in the MOCR. Clifford E. Charlesworth, JSC Deputy Director, huddles with several flight directors for STS-2 at the flight director console. Kranz, is at far right of frame (39507); Dr. Christopher C. Kraft, Jr., JSC Director, center, celebrates successful flight and landing of STS-2 with a cigar in the MOCR. He is flanked by Dr. Maxime A Faget, left, Director of Engineering and Development, and Thomas L. Moser, of the Structures and Mechanics Division (39508); Flight Director Donald R. Puddy, near right, holds replica of the STS-2 insignia. Insignias on the opposite wall

  1. Tracheotomy in Pediatric Patients: In Operating Room or Intensive Care Unit?

    Directory of Open Access Journals (Sweden)

    Umut Kaygusuz

    2014-08-01

    Full Text Available Introduction: The morbidity and mortality rates of tracheotomy are higher in the pediatric population because the incision is small and the trachea is more prone to surgical trauma. Tracheotomy procedure is mostly performed in operating room in most institutions. The aim of the study is to compare the outcomes of tracheotomy procedures between intensive care unit (ICU and operating room (OR in terms of pitfalls, complications and family preferences. Materials and Methods: In between June 2012 and July 2013, at a single institution, 39 patients were prospectively analyzed for age, gender, primary pathology, tracheotomy indications, location of operation, the duration of family consent, perioperative complications and presence of decanulation. Results: Male/female ratio was 20/19. Mean age was 49.9±52.5 (4-204 months. Tracheotomy procedure was performed in OR in 19 patients (45% and in ICU in 20 (54.5% patients. There was no statistically significant difference between groups in terms of complications (OR-48.7%, ICU-51.3%. The time of informed consent was significantly shorter in ICU patients. Conclusions: There is no significant difference in terms of safety for tracheotomy procedure in ICU or OR. Parents give approval to a bedside invasive procedure faster. The words ‘Surgery’ and ‘Operating room’ can easily confuse the parents, extend the duration for endolaryngeal intubation, and increase the cost and labour loss.

  2. Association Between Surgeon Scorecard Use and Operating Room Costs.

    Science.gov (United States)

    Zygourakis, Corinna C; Valencia, Victoria; Moriates, Christopher; Boscardin, Christy K; Catschegn, Sereina; Rajkomar, Alvin; Bozic, Kevin J; Soo Hoo, Kent; Goldberg, Andrew N; Pitts, Lawrence; Lawton, Michael T; Dudley, R Adams; Gonzales, Ralph

    2017-03-01

    Despite the significant contribution of surgical spending to health care costs, most surgeons are unaware of their operating room costs. To examine the association between providing surgeons with individualized cost feedback and surgical supply costs in the operating room. The OR Surgical Cost Reduction (OR SCORE) project was a single-health system, multihospital, multidepartmental prospective controlled study in an urban academic setting. Intervention participants were attending surgeons in orthopedic surgery, otolaryngology-head and neck surgery, and neurological surgery (n = 63). Control participants were attending surgeons in cardiothoracic surgery, general surgery, vascular surgery, pediatric surgery, obstetrics/gynecology, ophthalmology, and urology (n = 186). From January 1 to December 31, 2015, each surgeon in the intervention group received standardized monthly scorecards showing the median surgical supply direct cost for each procedure type performed in the prior month compared with the surgeon's baseline (July 1, 2012, to November 30, 2014) and compared with all surgeons at the institution performing the same procedure at baseline. All surgical departments were eligible for a financial incentive if they met a 5% cost reduction goal. The primary outcome was each group's median surgical supply cost per case. Secondary outcome measures included total departmental surgical supply costs, case mix index-adjusted median surgical supply costs, patient outcomes (30-day readmission, 30-day mortality, and discharge status), and surgeon responses to a postintervention study-specific health care value survey. The median surgical supply direct costs per case decreased 6.54% in the intervention group, from $1398 (interquartile range [IQR], $316-$5181) (10 637 cases) in 2014 to $1307 (IQR, $319-$5037) (11 820 cases) in 2015. In contrast, the median surgical supply direct cost increased 7.42% in the control group, from $712 (IQR, $202-$1602) (16 441 cases

  3. 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.

  4. 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.

  5. POST OPERATIVE PROBLEMS IN ORTOPEDICS PATIENTS IN THE RECOVERY ROOM

    Directory of Open Access Journals (Sweden)

    Regiane Aparecida dos Santos Soares Barreto

    2002-12-01

    Full Text Available This study aimed at providing related problems in patients who had undergone orthopedic surgery through theevaluation of the following variables: sex, age, surgery type and anesthesia type. Two hundred and twenty patientswere studied. They had been submitted to an elective orthopedic surgical procedure from July to December 1998and their medical records were used for retrospective data collection. With regard to sex, 58% were males and42% were females. As to age, middle-aged patients - 35 to 65 years old - comprised 48%, young adults - 18 to 35years old - were 38% and elderly adults - over 66 years old - were 14%. The frequency of results were as follows:surgery on the upper limbs/shoulder, 27%, knee/leg, 32%, spinal cord, 17%, femur/hips, 15%, ankle/foot, 9%,regional anesthesia, 48%, general anesthesia, 38%, regional associated with general, 6% and blocking, 8%.Occurred 306 post-operative problems were observed as follows: pain, 45%, nausea/vomiting, 16%, blooding,11%, cardiovascular alterations, 10%, hypothermia, 9%, urinary retention, 5%, respiratory problems, 1% andhiperthermia, 0,6%. In this way, there was an attempt at making a profile of orthopedic surgery patients in POI as asource of data for planning nursing care. It is believed that the study has contributed to nursing care in postanesthesiarecovery room which is based on scientific data and not only on every-day practice.

  6. 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.

  7. 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.

  8. Technologies and solutions for data display in the operating room.

    Science.gov (United States)

    Bitterman, Noemi

    2006-06-01

    Recent advances in technology have led to the introduction of a variety of innovative devices, each with their own platform for data display, into the operating room (OR). While these innovative applications are expanding the traditional boundaries of the surgical space and enhancing treatment capabilities, the introduction of additional screens and displays is placing an ever-increasing load on the OR team. This review describes the main data display platforms currently available in ORs: computer monitors with CRT (cathode ray tube) or LCD (liquid crystal display) screens, suspended imaging displays, wearable computers (WC), auditory displays and tactile (haptic) displays. The different display platforms are evaluated according to their compatibility with the characteristics of the working environment (OR), the monitoring task, and the users (the surgical team). No single display configuration provides an ultimate solution for presenting patient data in the OR. A multi-sensory data display including visual, acoustic and haptic manipulation is suggested as a promising configuration for data display in the OR.

  9. Operational Safety Performance Indicators and Balanced Scorecard in HANARO

    Energy Technology Data Exchange (ETDEWEB)

    Wu, Jong-Sup; Jung, Hoan-Sung; Ahn, Guk-Hoon; Lee, Kye-Hong; Lim, In-Cheol; Kim, Hark-Rho [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)

    2007-07-01

    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.

  10. 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.)

  11. 75 FR 67450 - Pipeline Safety: Control Room Management Implementation Workshop

    Science.gov (United States)

    2010-11-02

    ... associated with fatigue management and maximum hours of service, alarm management, and adequate information... Specifics. (3) Fatigue and Maximum Hours of Service (panel). (4) Alarm Management (panel). (5) Roles and... risk associated with controller fatigue. In addition, certain operators must define the roles and...

  12. [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.

  13. Operating room waste reduction in plastic and hand surgery

    Science.gov (United States)

    Albert, Mark G; Rothkopf, Douglas M

    2015-01-01

    BACKGROUND: 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. OBJECTIVE: To propose a method of decreasing cost through judicious selection of instruments and supplies, and initiation of recycling in plastic and hand surgery. METHODS: 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. RESULTS: 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. DISCUSSION: 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. CONCLUSIONS: Significant financial savings and environmental benefit can result from this judicious supply and instrument selection, as well as implementation of recycling. PMID:26665137

  14. Operating room waste: disposable supply utilization in neurosurgical procedures.

    Science.gov (United States)

    Zygourakis, Corinna C; Yoon, Seungwon; Valencia, Victoria; Boscardin, Christy; Moriates, Christopher; Gonzales, Ralph; Lawton, Michael T

    2017-02-01

    OBJECTIVE Disposable supplies constitute a large portion of operating room (OR) costs and are often left over at the end of a surgical case. Despite financial and environmental implications of such waste, there has been little evaluation of OR supply utilization. The goal of this study was to quantify the utilization of disposable supplies and the costs associated with opened but unused items (i.e., "waste") in neurosurgical procedures. METHODS Every disposable supply that was unused at the end of surgery was quantified through direct observation of 58 neurosurgical cases at the University of California, San Francisco, in August 2015. Item costs (in US dollars) were determined from the authors' supply catalog, and statistical analyses were performed. RESULTS Across 58 procedures (36 cranial, 22 spinal), the average cost of unused supplies was $653 (range $89-$3640, median $448, interquartile range $230-$810), or 13.1% of total surgical supply cost. Univariate analyses revealed that case type (cranial versus spinal), case category (vascular, tumor, functional, instrumented, and noninstrumented spine), and surgeon were important predictors of the percentage of unused surgical supply cost. Case length and years of surgical training did not affect the percentage of unused supply cost. Accounting for the different case distribution in the 58 selected cases, the authors estimate approximately $968 of OR waste per case, $242,968 per month, and $2.9 million per year, for their neurosurgical department. CONCLUSIONS This study shows a large variation and significant magnitude of OR waste in neurosurgical procedures. At the authors' institution, they recommend price transparency, education about OR waste to surgeons and nurses, preference card reviews, and clarification of supplies that should be opened versus available as needed to reduce waste.

  15. 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…

  16. Operator's Influence on the Safety of the Controlled Process

    Directory of Open Access Journals (Sweden)

    Peter Nagy

    2015-01-01

    Full Text Available An analysis of risks related to controlled process and related hazards identification is an important activity during the development of the safety related control system (SRCS. The mistake of the operational staff during the execution of the safety relevant operations related to controlled process can be the cause of hazard. Influence of the operator on controlled process safety depends on operation mode of the SRCS and on technical safety of the SRCS. This contribution deals with the issue of the safety assessment of the operator effect on the safety of the controlled process.

  17. Operating Room Traffic: Is There Any Role of Monitoring It?

    Science.gov (United States)

    Parikh, Shital N.; Grice, Salih S.; Schnell, Beverly M.; Salisbury, Shelia R.

    2010-01-01

    Background Operating room (OR) human traffic has been implicated as a cause of surgical site infection. We first observed the normal human traffic pattern in our Pediatric Orthopaedic ORs, then examined the effect of surveillance on that traffic pattern. Methods This study consisted of two phases: phase I sought to observe the OR traffic pattern (number of door swings, maximum and minimum number of OR personnel, number of OR personnel at 30 minute intervals, or changes in nursing, anesthesia or surgeon staff) during surgical cases without OR personnel being notified, and for phase II, the same traffic pattern was monitored with their knowledge. Results 2442 minutes of surgical time were observed in phase I, and 1908 minutes were observed in phase II. There was no difference (p=0.06) in the time between door swings between phase I (1.39 minutes) and phase II (1.70), no difference (p=1.000) in the maximum number of people in the OR between phase I (11.5 people, range: 7–15 people) and phase II (11.5 people, range: 8–20 people), no difference (p=1.000) in the minimum number of people in the OR between phase I (4.67 people, range: 4–6 people) and phase II (4.71 people, range: 3–6 people). There was a difference in the time between door swings (p=0.03) and maximum number of people in the OR (p=0.005) based on length of surgery (less or more than120 minutes). There was no difference in the time between door swings (p=0.11), but there was a difference in the maximum number of people in the OR (p=0.002) based on type of surgery (spine vs. others). Conclusion There was no role of surveillance of human traffic in the OR. To achieve any change in the OR traffic pattern, monitoring alone may not be sufficient; other novel techniques or incentives may need to be considered. PMID:20733430

  18. Operating room clinicians' ratings of workload: a vignette simulation study.

    Science.gov (United States)

    Wallston, Kenneth A; Slagle, Jason M; Speroff, Ted; Nwosu, Sam; Crimin, Kimberly; Feurer, Irene D; Boettcher, Brent; Weinger, Matthew B

    2014-06-01

    Increased clinician workload is associated with medical errors and patient harm. The Quality and Workload Assessment Tool (QWAT) measures anticipated (pre-case) and perceived (post-case) clinical workload during actual surgical procedures using ratings of individual and team case difficulty from every operating room (OR) team member. The purpose of this study was to examine the QWAT ratings of OR clinicians who were not present in the OR but who read vignettes compiled from actual case documentation to assess interrater reliability and agreement with ratings made by clinicians involved in the actual cases. Thirty-six OR clinicians (13 anesthesia providers, 11 surgeons, and 12 nurses) used the QWAT to rate 6 cases varying from easy to moderately difficult based on actual ratings made by clinicians involved with the cases. Cases were presented and rated in random order. Before rating anticipated individual and team difficulty, the raters read prepared clinical vignettes containing case synopses and much of the same written case information that was available to the actual clinicians before the onset of each case. Then, before rating perceived individual and team difficulty, they read part 2 of the vignette consisting of detailed role-specific intraoperative data regarding the anesthetic and surgical course, unusual events, and other relevant contextual factors. Surgeons had higher interrater reliability on the QWAT than did OR nurses or anesthesia providers. For the anticipated individual and team workload ratings, there were no statistically significant differences between the actual ratings and the ratings obtained from the vignettes. There were differences for the 3 provider types in perceived individual workload for the median difficulty cases and in the perceived team workload for the median and more difficult cases. The case difficulty items on the QWAT seem to be sufficiently reliable and valid to be used in other studies of anticipated and perceived clinical

  19. 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…

  20. 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…

  1. CdZnTe room-temperature semiconductor operation in liquid scintillator

    CERN Document Server

    Stewart, D Y

    2008-01-01

    We demonstrate the first operation of CdZnTe room-temperature detectors in a liquid scintillator environment. This work follows conceptually the Heusser-type detector method of operating HPGe detectors in liquid nitrogen and liquid argon but instead for a far more practical room-temperature ensemble with the aim of achieving ultra-low background levels for radiation detection.

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

    NARCIS (Netherlands)

    Oostrum, van J.M.; Houdenhoven, van M.; Hurink, J.L.; Hans, E.W.; Wullink, G.; 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 t

  3. 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

  4. Ge-on-Si laser operating at room temperature.

    Science.gov (United States)

    Liu, Jifeng; Sun, Xiaochen; Camacho-Aguilera, Rodolfo; Kimerling, Lionel C; Michel, Jurgen

    2010-03-01

    Monolithic lasers on Si are ideal for high-volume and large-scale electronic-photonic integration. Ge is an interesting candidate owing to its pseudodirect gap properties and compatibility with Si complementary metal oxide semiconductor technology. Recently we have demonstrated room-temperature photoluminescence, electroluminescence, and optical gain from the direct gap transition of band-engineered Ge-on-Si using tensile strain and n-type doping. Here we report what we believe to be the first experimental observation of lasing from the direct gap transition of Ge-on-Si at room temperature using an edge-emitting waveguide device. The emission exhibited a gain spectrum of 1590-1610 nm, line narrowing and polarization evolution from a mixed TE/TM to predominantly TE with increasing gain, and a clear threshold behavior.

  5. 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

  6. 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.

  7. 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.

  8. 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.

  9. The operating room as a clinical learning environment: An exploratory study.

    Science.gov (United States)

    Meyer, Rhoda; Van Schalkwyk, Susan C; Prakaschandra, Rosaley

    2016-05-01

    Students undertake their clinical placement in various clinical settings for the exposure to and acquisition of skills related to that particular context. The operating room is a context that offers the opportunity to develop critical skills related to the perioperative care of the patient. Despite numerous studies that have been undertaken in this field, few have investigated the operating room as a clinical learning environment in the South African private healthcare context. The aim of this study was to determine nursing students' perceptions of the operating room as a clinical learning environment. An exploratory, interpretive and descriptive design generating qualitative data was utilized. Eight nursing students completed an open-ended questionnaire, and twelve nursing students participated in the focus group discussion. Four themes emerged, namely, 'interpersonal factors', 'educational factors', 'private operating room context', and 'recommendations'. The opinion that the operating room offers an opportunity to gain skills unique to this context was expressed. However, despite the potential learning opportunities, the key findings of this study reveal negative perceptions of nursing students regarding learning experiences in the operating room. Exploration into the preparatory needs of students specific to learning outcomes before operating room placement should be considered. It will also be necessary to improve collaboration between lecturers, mentors and theatre managers.

  10. The effects of surgeons and anesthesiologists on operating room efficiency

    Directory of Open Access Journals (Sweden)

    Nessa Timoney

    2016-09-01

    Conclusion: In some procedures types a significant part of the variability in operative time is due to the interaction between the surgeon and anesthesiologist. Reviewing operative records should allow identification of efficient/inefficient combinations.

  11. 78 FR 54510 - New Entrant Safety Assurance Program Operational Test

    Science.gov (United States)

    2013-09-04

    ... demonstrating basic safety management controls in the areas of driver qualifications, hours of service, vehicle... Agency to better utilize its resources for on-site safety audits of higher-risk (e.g., passenger and HM... TRANSPORTATION Federal Motor Carrier Safety Administration New Entrant Safety Assurance Program Operational Test...

  12. Workflow in the operating room: review of Arrowhead 2004 seminar on imaging and informatics (Invited Paper)

    Science.gov (United States)

    Lemke, Heinz U.; Ratib, Osman M.; Horii, Steven C.

    2005-04-01

    This review paper is based on the 2004 UCLA Seminar on Imaging and Informatics (http://www.radnet.ucla.edu/Arrowhead2004/) which is a joint endeavour between the UCLA and the CARS organization, focussing on workflow analysis tools and the digital operating room. Eleven specific presentations of the Arrowhead Seminar have been summarized in this review referring to redesigning perioperative care for a high velocity OR, intraoperative ultrasound process and model, surgical workflow and surgical PACS, an integrated view , interactions in the surgical OR, workflow automation strategies and target applications, visualisation solutions for the operating room, navigating the fifth dimension, and design of digital operating rooms and interventional suites

  13. Psychological and Physical Stress in Surgeons Operating in a Standard or Modern Operating Room

    DEFF Research Database (Denmark)

    Klein, M.; Andersen, L.P.H.; Alamili, M.

    2010-01-01

    concerning physical and psychological wellbeing before and after surgery and had their heart rate variability registered during surgery. Results: Preoperative to postoperative physical strain and pain measurements revealed a systematical difference with 14 of 15 parameters favoring the modern OR. Two...... of these parameters reached statistical significance. We did not find any significant differences in the subjective parameters of surgeon satisfaction or the measured heart rate variability parameters. Conclusions: Physical strain on the surgeon was reduced when performing laparoscopic cholecystectomy in a modern......Purpose: There have been no studies examining the effect of optimized ergonomic and technical environment on the psychological and physiological stress of the surgeon. The aim of this study was to examine whether optimized ergonomics and technical aids within a modern operating room (OR) affect...

  14. Allocation of surgeries to operating rooms by goal programing.

    Science.gov (United States)

    Ozkarahan, I

    2000-12-01

    High usage rate in a surgical suite is extremely important in meeting the increasing demand for health care services and reducing costs to improve quality of care. In this paper a goal programming model which can produce schedules that best serve the needs of the hospital, i.e., by minimizing idle time and overtime, and increasing satisfaction of surgeons, patients, and staff, is described. The approach involves sorting the requests for a particular day on the basis of block restrictions, room utilization, surgeon preferences and intensive care capabilities. The model is tested using the data obtained during field studies at Dokuz Eylul University Hospital. The model is also tested for alternative achievement functions to examine the model's ability to satisfy abstract goals.

  15. Predicting Correct Body Posture based on Theory of Planned Behavior in Iranian Operating Room Nurses

    National Research Council Canada - National Science Library

    BAHAREH ABEDI; RABIOLLAH FARMANBAR1; SAEED OMIDI; MAHDI JAHANGIR BLOURCHIAN

    2015-01-01

    Due to the importance of correct posture for preventing musculoskeletal disorders, the purpose of this study was to evaluate Theory of Planned Behavior in Predicting correct Body Posture in operating room...

  16. Mean sound level in operation rooms in a referral hospital: a brief report

    Directory of Open Access Journals (Sweden)

    Ahmad Joneidi Jafari

    2014-02-01

    Conclusion: Overall total noise dose during all types of surgeries was measured as twice of permitted dose and also orthopedic and general operation rooms experience brief periods of noise exposure in excess.

  17. Science Support Room Operations During Desert RATS 2009

    Science.gov (United States)

    Lofgren, G. E.; Horz, F.; Bell, M. S.; Cohen, B. A.; Eppler,D. B.; Evans, C. a.; Hodges, K. V.; Hynek, B. M.; Gruener, J. E.; Kring, D. A.; hide

    2010-01-01

    NASA's Desert Research and Technology Studies (D-RATS) field test is a demonstration that combines operations development, technology advances and science in analog planetary surface conditions. The focus is testing preliminary operational concepts for extravehicular activity (EVA) systems by providing hands-on experience with simulated surface operations and EVA hardware and procedures. The DRATS activities also develop technical skills and experience for the engineers, scientists, technicians, and astronauts responsible for realizing the goals of the Lunar Surface Systems Program. The 2009 test is the twelfth for the D-RATS team.

  18. Operating room team members' views of workload, case difficulty, and nonroutine events.

    Science.gov (United States)

    Minnick, Ann F; Donaghey, Beth; Slagle, Jason; Weinger, Matthew B

    2012-01-01

    Interventions such as mandatory "time-outs" have contributed to intraoperative safety but improvements are still necessary. We present data provided by 3 professions always present in the intraoperative setting that suggest next steps in the quest for improvements. We describe the differences and similarities in operating room (OR) nurses', anesthesia providers', and surgeons' beliefs about team function, case difficulty, nonroutine event (NRE), and error causation using a qualitative design at 3 Veterans' Administration hospitals. Intraoperative errors are costly in lives, suffering, and dollars. A quality improvement tenet states that workers are a rich information source regarding the context within which quality can be improved. Identifying and describing OR providers' beliefs are necessary steps in devising novel approaches to quality improvement. Intraoperative NRE and error prevention opportunities exist within and outside of the OR. There may be "cascade" and "perfect storm conditions" before and during operative procedures that increase the likelihood of NREs. Confirmation of these phenomena could improve prediction and prevention of NREs. Exploration of differences in team definition and team performance ratings by provider type may also identify avenues for improvement.

  19. [Interface interconnection and data integration in implementing of digital operating room].

    Science.gov (United States)

    Feng, Jingyi; Chen, Hua; Liu, Jiquan

    2011-10-01

    The digital operating-room, with highly integrated clinical information, is very important for rescuing lives of patients and improving quality of operations. Since equipments in domestic operating-rooms have diversified interface and nonstandard communication protocols, designing and implementing an integrated data sharing program for different kinds of diagnosing, monitoring, and treatment equipments become a key point in construction of digital operating room. This paper addresses interface interconnection and data integration for commonly used clinical equipments from aspects of hardware interface, interface connection and communication protocol, and offers a solution for interconnection and integration of clinical equipments in heterogeneous environment. Based on the solution, a case of an optimal digital operating-room is presented in this paper. Comparing with the international solution for digital operating-room, the solution proposed in this paper is more economical and effective. And finally, this paper provides a proposal for the platform construction of digital perating-room as well as a viewpoint for standardization of domestic clinical equipments.

  20. Rule-based medical device adaptation for the digital operating room.

    Science.gov (United States)

    Franke, Stefan; Neumuth, Thomas

    2015-08-01

    A workflow-driven cooperative operating room needs to be established in order to successfully unburden the surgeon and the operating room staff very time-consuming information-seeking and configuration tasks. We propose an approach towards the integration of intraoperative surgical workflow management and integration technologies. The concept of rule-based behavior is adapted to situation-aware medical devices. A prototype was implemented and experiments with sixty recorded brain tumor removal procedures were conducted to test the proposed approach. An analysis of the recordings indicated numerous applications, such as automatic display configuration, room light adaptation and pre-configuration of medical devices and systems.

  1. Improving the Interdisciplinary Team Work in the Operating Room

    DEFF Research Database (Denmark)

    Tørring, Birgitte

    2016-01-01

    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...... 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...... with the purpose of identifying different ways of communicating and managing relationship in contexts of variable complexity and to develop an intervention program. An ethnographic field study where data are collected through participant observations (35 teams) and semi-structured interviews (15), over a 10-months...

  2. Operational experience with room temperature continuous wave accelerator structures

    Science.gov (United States)

    Alimov, A. S.; Ishkhanov, B. S.; Piskarev, I. M.; Shvedunov, V. I.; Tiunov, A. V.

    1993-05-01

    The paper reports the results of the computer simulation of parameters of the on-axis coupled accelerator structure for the continuous wave racetrack microtron. The operational experience with the accelerating sections on the basis of the on-axis coupled structure is described.

  3. 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.

  4. Fuel Supply Shutdown Facility Interim Operational Safety Requirements

    Energy Technology Data Exchange (ETDEWEB)

    BENECKE, M.W.

    2000-09-06

    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.

  5. Cost-benefit analysis of different air change rates in an operating room environment.

    Science.gov (United States)

    Gormley, Thomas; Markel, Troy A; Jones, Howard; Greeley, Damon; Ostojic, John; Clarke, James H; Abkowitz, Mark; Wagner, Jennifer

    2017-09-08

    Hospitals face growing pressure to meet the dual but often competing goals of providing a safe environment while controlling operating costs. Evidence-based data are needed to provide insight for facility management practices to support these goals. The quality of the air in 3 operating rooms was measured at different ventilation rates. The energy cost to provide the heating, ventilation, and air conditioning to the rooms was estimated to provide a cost-benefit comparison of the effectiveness of different ventilation rates currently used in the health care industry. Simply increasing air change rates in the operating rooms tested did not necessarily provide an overall cleaner environment, but did substantially increase energy consumption and costs. Additionally, and unexpectedly, significant differences in microbial load and air velocity were detected between the sterile fields and back instrument tables. Increasing the ventilation rates in operating rooms in an effort to improve clinical outcomes and potentially reduce surgical site infections does not necessarily provide cleaner air, but does typically increase operating costs. Efficient distribution or management of the air can improve quality indicators and potentially reduce the number of air changes required. Measurable environmental quality indicators could be used in lieu of or in addition to air change rate requirements to optimize cost and quality for an operating room and other critical environments. Copyright © 2017 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  6. 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.

  7. 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.

  8. Agricultural Safety. FMO: Fundamentals of Machine Operation. Second Edition.

    Science.gov (United States)

    John Deere Co., Moline, IL.

    This manual is intended to provide students with basic information on the safe operation of farm machinery. The following topics are covered in the individual chapters: safe farm machinery operation (the importance of safety, the role of communication in safety, and types of farm accidents); human factors (human limitations and capabilities;…

  9. 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.

  10. Mobile devices in the operating room: Intended and unintended consequences for nurses' work.

    Science.gov (United States)

    Sergeeva, Anastasia; Aij, Kjeld; van den Hooff, Bart; Huysman, Marleen

    2016-12-01

    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 have multiple consequences for nurses, such as improvements in information access, e-learning and work-related communication, as well as a perceived increase in distractions from the collaborative work. We conceptualize these consequences in terms of three level effects and explain how we find both positive and negative consequences on the third level. On the positive side, improvements were found in how nurses spent their unoccupied time during the stable parts of operations, contributing to their well-being and job satisfaction. A negative consequence was the perceived increase in distraction from the collaborative operating room work practices.

  11. Application of an Online Reference for Reviewing Basic Statistical Principles of Operating Room Management

    Science.gov (United States)

    Dexter, Franklin; Masursky, Danielle; Wachtel, Ruth E.; Nussmeier, Nancy A.

    2010-01-01

    Operating room (OR) management differs from clinical anesthesia in that statistical literacy is needed daily to make good decisions. Two of the authors teach a course in operations research for surgical services to anesthesiologists, anesthesia residents, OR nursing directors, hospital administration students, and analysts to provide them with the…

  12. In-office vs. operating room procedures for recurrent respiratory papillomatosis.

    Science.gov (United States)

    Miller, Anya J; Gardner, Glendon M

    2017-01-01

    We conducted a study to analyze hospital and patient costs, outcomes, and patient satisfaction among adults undergoing in-office and operating room procedures for the treatment of recurrent respiratory papillomatosis. Our final study population was made up of 17 patients-1 man and 16 women, aged 30 to 86 years (mean: 62). The mean number of in-office laser procedures per patient was 4.2, and the mean interval between procedures was 5.4 months (although 10 patients underwent only 1 office procedure); the mean number of operating room procedures was 13.5, and the mean interval between procedures was 14.3 months. An equal number of patients reported complications or adverse events with the two types of procedures-5 each. The difference in cost between the office procedure (mean: $3,413.00) and the operating room procedure (mean: $12,382.59) was almost $9,000, but these savings were offset by the fact that the office procedures needed to be performed three times as often. Patients reported slightly more anxiety and discomfort during the office procedures and, overall, they appeared to prefer the operating room procedure. We conclude that office procedures are significantly more cost-effective than operating room procedures, but their use may be limited by patient tolerance and the increased frequency of the procedure.

  13. 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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1994-05-01

    This report addresses concerns about the consequences of valve mispositioning which were brought to the forefront following an event at Davis Besse in 1985 (NRC, 1985a). The concern related to the ability to reposition ``position changeable`` motor operated valves (MOVs) in the event of their inadvertent operation from the control room and was documented in Nuclear Regulatory Commission (NRC) Bulletin 85-03 (NRC, 1985b) and Generic Letter (GL) 89-10 (NRC, 1989). The mispositioned MOVs may not be able to be returned to their required position due to high differential pressure (dP) or high flow conditions across the valves. The inability to reposition such valves may have significant 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 which would justify licensee costs. As a response, Brookhaven National Laboratory (BNL) 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 utilized 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 (CDF) 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 judgement determination of the risk significance of the MOV mispositioning issue for BWRs and PWRS.

  15. 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.

  16. Review article: review of behavioral operations experimental studies of newsvendor problems for operating room management.

    Science.gov (United States)

    Wachtel, Ruth E; Dexter, Franklin

    2010-06-01

    Operating room (OR) managers must plan staffing in the face of uncertain demand for OR time. Planning too much staffing results in underutilized OR time. Planning too little staffing causes overutilized time, which is approximately twice as expensive as underutilized time. Deciding how much staffing to plan for an OR is analogous to the classic newsvendor problem in operations research. A newsvendor must decide how much product to order based on its cost c and sales price p, plus estimates of the uncertain future demand for the product. The newsvendor problem has a simple mathematical solution. The correct amount of product to order is the (p - c)/p quantile of the demand for the product. This optimal order quantity is analogous mathematically to the number of hours of OR time for which staffing should be planned. We performed a systematic review of the behavioral operations experimental literature on newsvendor problems relevant to OR management. Student volunteers participating in experimental studies have great difficulty knowing how much product to order, given c, p, and the demand distribution. Decision making is only modestly improved by more frequent feedback. Even scores of rounds of ordering are insufficient for much learning to occur. Suboptimal decisions result from innate psychological biases. Students anchor on mean demand, make insufficient adjustments, and rely disproportionately on the most recent demand values. The behavior of OR managers who plan staffing for the OR is analogous to that of students participating in a newsvendor experiment. Month after month, an OR manager will plan too little staffing for the surgeon who consistently ends the day late and too much staffing for the surgeon who consistently does not fill an OR. Experimental studies of the newsvendor problem provide mechanistic insights into the reasons that OR managers make poor decisions when planning OR staffing. The students face no organizational factors or personality issues

  17. A study on room design and radiation safety around room for Co-60 after loading HDR brachytherapy unit converted from room for Ir-192 after loading HDR brachytherapy unit

    Directory of Open Access Journals (Sweden)

    Om Prakash Gurjar

    2015-01-01

    Full Text Available Context: Use of Co-60 source in place of Ir-192 in high dose rate brachytherapy unit (HDR unit has come for discussion in recent publications. Co-60 based system has been advocated for centers which have fewer brachytherapy procedures as it has comparative economically and administrative advantage. This study has direct practical application for such institutions, which are at the cusp of moving from Ir-192 to Co-60 based brachytherapy. Aims: Conversion of Ir-192 HDR room to Co-60 HDR room and to analyze radiation safety around the room. Materials and Methods: Uniform thickness of 15 cm concrete was added to all walls (except one wall adjoining to linear accelerator bunker to convert existing room forIr-192 HDR unit to suitable room for Co-60 HDR unit. Radiation survey around room was done. Actual and calculated wall thicknesses were compared. Results: Radiation survey data indicates that modified room is suitable for Co-60 HDR unit and all values are in full conformity to annual dose limits mentioned in Safety Code for Radiation Therapy Sources (SCRTS, Atomic Energy Regulatory Body (AERB; the regulatory body in India. Also, modified wall thicknesses are appropriate for annual design dose limits mentioned in Safety Report Series No. 47 of International Atomic Energy Agency (IAEA. However, console wall thickness (0.45 m is less than the calculated thickness (0.53 m for instantaneous dose rate (IDR design dose limit (7.5 ΅Sv/h as perabove safety report of IAEA. Conclusions: The modified wall thicknesses are appropriate for annual design dose limits. However, console wall thickness is less than the required thickness for IDR design dose limit. It has been suggested to add 2.64 cm steel on console wall. It has been found that design dose limits should be considered while making room layout plan and regulatory body should add these constraints inSCRTS.

  18. Room temperature aging to guarantee microbiological safety of Brazilian artisan Canastra cheese

    Directory of Open Access Journals (Sweden)

    Milene Therezinha das Dores

    2013-03-01

    Full Text Available Canastra cheese is one of the oldest and most traditional cheeses made from raw milk in Brazil. However, this type of practice may have severe consequences for human health. According to the current legislation, any cheese made from raw milk must be aged for at least 60 days. Traditionally, Canastra cheese is consumed after different ripening periods, but consumers usually prefer those that are aged less than eight days. This study aimed to evaluate the effects of physicochemical and microbiological parameters, with emphasis on the pathogenic microbiota regulated by law, on cheese aged at room temperature and under refrigeration. Cheese samples were collected from eight different cheese producers located in the Serra da Canastra region twice a year (rainy and dry seasons and analyzed with 8, 15, 22, 29, 36, and 64 days of ripening. Room temperature aging effectively reduced pathogens, reaching the total count established by law in 22 days, regardless of the season. However, ripening under refrigeration, it was ineffective in reducing the Staphylococcus aureus counts to the legislation limits, even after 64 days. Therefore, Canastra cheese should be ripened for at least 22 days at room temperature in order to fulfill the safety regulatory limits.

  19. [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.

  20. 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.

  1. Development of an operating room pharmacy substation on a restricted budget.

    Science.gov (United States)

    Buchanan, E C; Gaither, M W

    1986-07-01

    Pharmaceutical services implemented in an operating room (OR) pharmacy substation without addition of staff in a 764-bed teaching hospital with 22 operating rooms are described. In 1984 an interdepartmental task force recommended that pharmacy take control of responsibility for controlled drugs used in anesthesia. The anesthesia department contributed space for a pharmacy substation and some of the necessary equipment. Two technicians staff the substation (1.5 full-time equivalent positions); pharmacy contributed 0.5 FTE and the additional FTE was obtained through staffing adjustments in other departments. Anesthesiologists and nurse anesthetists obtain controlled drugs directly from the technicians, and records of drug disposition are compared with inventory twice daily. The substation also handles exchange carts for noncontrolled drugs for anesthesia and for other drugs used in the operating rooms. Total cost (additional cost to pharmacy and other departments) for operating the substation for its first year was +2161, and there were no unresolved discrepancies in controlled drug accounting. Undocumented use of noncontrolled drugs has been reduced by 67%, and cooperation and communication between the pharmacy and anesthesia departments has improved. Substation personnel do not prepare intravenous admixtures or provide clinical services. An operating room substation staffed by technicians 10.5 hours daily Monday through Friday provided cost-effective pharmacy control of drugs used in the OR.

  2. Fuel supply shutdown facility interim operational safety requirements

    Energy Technology Data Exchange (ETDEWEB)

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

    1995-05-23

    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).

  3. Shielding considerations for an operating room based intraoperative electron radiotherapy unit.

    Science.gov (United States)

    Mills, M D; Almond, P R; Boyer, A L; Ochran, T G; Madigan, W; Rich, T A; Dally, E B

    1990-05-01

    The leakage radiation characteristics of a dedicated intraoperative radiotherapy linear accelerator have been measured on a machine designed to minimize the shielding required to allow it to be placed in an operating room suite. The scattering foil design was optimized to produce a flat beam for the field sizes employed while generating minimal bremsstrahlung contamination over the available energy range. More lead shielding was used in the treatment head than is used in conventional accelerators. A small amount of borated polyethylene shielding was also employed since neutron production was present at measurable levels. The room shielding installed in the operating room was demonstrated to be adequate to treat at least 20 patients each month to an average dose of 20 Gy. The worst case exposure was found to be 73% maximum permissible exposure. Administrative control was required for adjoining areas when calibrations and maintenance were performed.

  4. Method of Evidence-Based Intervention for Nosocomial Infection in Operation Room%手术室医院感染循证干预方法

    Institute of Scientific and Technical Information of China (English)

    张雯璟

    2015-01-01

    目的:降低手术室医院感染的危险,保障医疗护理安全。方法对手术室存在的医院感染危险因素及原因进行分析。结果通过对手术室的空气、物体表面、医护人员的手、麻醉用具进行细菌监测,手术器械集中管理,合理使用抗菌药物及加强职业安全防护等,可有效控制手术室医院感染。结论实施手术室医院感染循证干预,重视每一个环节,实施规范化的综合预防措施,才能保证手术患者及手术人员的安全。%Objective To reduce the risk of operating room of hospital infection,to ensure the safety of medical care.Methods The hospital infection risk factors existing in the operating room and the reasons were analyzed.Results Through to the operating room air,surfaces,medical personnel hand,bacteria monitoring anesthesia equipment,surgical instruments centralized management and rational use of antimicrobial agents and strengthening occupational safety protection,etc.,which can ef ectively control the operating room of hospital infection.Conclusion The implementation of the operating room of hospital infection of evidence-based interventions,at ach importance to every link,the implementation of standardized comprehensive prevention measures,to ensure the safety of surgery patients and staf .

  5. 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.

  6. A norm utilisation for scarce hospital resources: Evidence from operating rooms in a Dutch university hospital

    NARCIS (Netherlands)

    van Houdenhoven, Mark; Hans, Elias W.; Klein, Jan; Wullink, Gerhard; Kazemier, Geert

    2007-01-01

    Background: Utilisation of operating rooms is high on the agenda of hospital managers and researchers. Many efforts in the area of maximising the utilisation have been focussed on finding the holy grail of 100% utilisation. The utilisation that can be realised, however, depends on the patient mix an

  7. Improving operating room efficiency by applying bin-packing and portfolio techniques to surgical case scheduling

    NARCIS (Netherlands)

    Houdenhoven, van M.; Oostrum, van J.M.; Hans, E.W.; Wullink, G.; Kazemier, G.

    2013-01-01

    BACKGROUND: An operating room (OR) department has adopted an efficient business model and subsequently investigated how efficiency could be further improved. The aim of this study is to show the efficiency improvement of lowering organizational barriers and applying advanced mathematical techniques.

  8. Emotional intelligence in the operating room: analysis from the Boston Marathon bombing.

    Science.gov (United States)

    Chang, Beverly P; Vacanti, Joshua C; Michaud, Yvonne; Flanagan, Hugh; Urman, Richard D

    2014-01-01

    The Boston Marathon terrorist bombing that occurred on April 15, 2013 illustrates the importance of a cohesive, efficient management for the operating room and perioperative services. Conceptually, emotional intelligence (EI) is a form of social intelligence used by individuals in leadership positions to monitor the feelings and emotions of their team while implementing a strategic plan. To describe the experience of caring for victims of the bombing at a large tertiary care center and provide examples demonstrating the importance of EI and its role in the management of patient flow and overall care. A retrospective review of trauma data was performed. Data regarding patient flow, treatment types, treatment times, and outcomes were gathered from the hospital's electronic tracking system and subsequently analyzed. Analyses were performed to aggregate the data, identify trends, and describe the medical care. Immediately following the bombing, a total of 35 patients were brought to the emergency department (ED) with injuries requiring immediate medical attention. 10 of these patients went directly to the operating room on arrival to the hospital. The first victim was in an operating room within 21 minutes after arrival to the ED. The application of EI in managerial decisions helped to ensure smooth transitions for victims throughout all stages of their perioperative care. EI provided the fundamental groundwork that allowed the operating room manager and nurse leaders to establish the calm and coordinated leadership that facilitated patient care and teamwork.

  9. Are operating room nurses at higher risk of severe persistent asthma? The Nurses' Health Study.

    NARCIS (Netherlands)

    Moual, N. le; Varraso, R.; Zock, J.P.; Henneberger, P.; Speizer, F.E.; Kauffmann, F.; Camargo, C.A.

    2013-01-01

    Objective: To assess the associations between operating room (OR) nursing, a category of health care workers at high risk of exposure to various inhaled agents, and asthma severity/control among women with asthma. Methods: The level of severity/control in nurses with prevalent doctor-diagnosed asthm

  10. Activity-based costing in the operating room at Valley View Hospital.

    Science.gov (United States)

    Baker, J J; Boyd, G F

    1997-01-01

    This article presents an example of how one hospital reports the results of activity-based costing (ABC). It examines the composition and supporting assumptions of an ABC report for a particular procedure in the operating room (OR). It describes management uses of the information generated. It comments upon how the continuous quality improvement (CQI) is synchronized with the ABC reporting.

  11. Room Temperature Operation of a Buried Heterostructure Photonic Crystal Quantum Cascade Laser

    CERN Document Server

    Peretti, R; Wolf, J M; Bonzon, C; Süess, M J; Lourdudoss, S; Metaferia, W; Beck, M; Faist, J

    2015-01-01

    We demonstrated room temperature operation of deep etched photonic crystal quantum cascade laser emitting around 8.5 micron. We fabricated buried heterostructure photonic crystals, resulting in single mode laser emission on a high order slow Bloch modes of the photonic crystal, between high symmetry points of the Brillouin.

  12. Feasibility Assessment of Performing Surgery in a Deployable Medical System Operating Room

    Science.gov (United States)

    2002-05-01

    Nosocomial infections are easily prevented if the hospital and its staff follow well-recognized sanitation and hygiene protocols. The Guidelines for...instance, frequent hand washing has been shown to significantly lessen the incidence of nosocomial infections . In addition, improved operating room...risk management. 26 Criteria included the following: noise exposure, nosocomial infections , environmental controls, air exchanges, and electrical

  13. Improving operating room efficiency by applying bin-packing and portfolio techniques to surgical case scheduling

    NARCIS (Netherlands)

    van Houdenhoven, M.; van Oostrum, J.M.; Hans, Elias W.; Wullink, Gerhard; Kazemier, G.

    2013-01-01

    BACKGROUND: An operating room (OR) department has adopted an efficient business model and subsequently investigated how efficiency could be further improved. The aim of this study is to show the efficiency improvement of lowering organizational barriers and applying advanced mathematical techniques.

  14. Natural Rubber Latex Hypersensitivity with Skin Prick Test in Operating Room Personnel

    Directory of Open Access Journals (Sweden)

    Seyed Hessamedin Nabavizadeh

    2009-12-01

    Full Text Available Hypersensitivity reactions to natural rubber latex have increased recently, especially among people with high exposure to latex allergens. Hypersensitivity reactions to latex are related to many conditions like occupational asthma. Our study was performed to determine the prevalence of hypersensitivity to natural rubber latex and potential food cross reactions in operation room personnel in Shiraz hospitals. In this cross-sectional, descriptive study, 580 operation room personnel filled out our questionnaire which included data about their personal history, symptoms of latex hypersensitivity, and other related allergies such as food hypersensitivity. An informed consent was obtained and skin prick tests were performed for natural rubber latex and potential food cross reactions (kiwi, banana, and potato. The obtained data were analyzed by SPSS and Chi-square test.Results: 104 (17.9% of the operating room personnel showed positive latex skin tests. We revealed a significant correlation between those with positive skin tests to latex with atopia, urthicaria, and food hypersensitivity. The prevalence did not vary by sex, age, education, surgical and non-surgical gloves users, or history of contact dermatitis. Latex hypersensitivity is common among operation room personnel. Evaluation of symptoms and prediction of future diseases necessitate screening tests in individuals at risk.

  15. The current status of procedural sedation for pediatric patients in out-of-operating room locations.

    Science.gov (United States)

    Havidich, Jeana E; Cravero, Joseph P

    2012-08-01

    To illustrate the changes that are occurring in the rapidly growing field of pediatric sedation. In the USA and throughout the world, children receive sedation from a multitude of specialists with varying levels of training. The current pediatric sedation literature reflects a growing body of sedation literature by medical specialists other than anesthesiologists. This article will review the controversial use of propofol by nonanesthesiologists and the manner in which this varied group of providers along with government entities, regulatory agencies, and national organizations contribute to the continuing evolution of sedation practices. The number of diagnostic and therapeutic procedures performed on children outside of the operating room continues to increase. The growing body of pediatric sedation literature suggests anesthesiologists are no longer at the forefront of pediatric sedation training, education, and research. Articles published by nonanesthesiologists describe pediatric sedation services, safety, and quality initiatives, drugs, and original sedation research. Medications that were considered under the realm of anesthesiologists are utilized by nonanesthesiologists to provide sedation to children. Regulating and government agencies, including the Joint Commission and the Center for Medicaid and Medicare Services have recently issued statements on the oversight and practice of sedation. The direction of pediatric sedation is no longer solely under the leadership of anesthesiologists. The use of anesthetic agents, including propofol, have been administered by nonanesthesiologists and reported as safe and effective agents. Nonanesthesiologists and governmental and regulatory agencies influence the delivery of sedation services. The future direction of pediatric sedation will ultimately depend upon the ability of anesthesiologists to collaborate with specialists, hospital administrators, credentialing committees, and oversight agencies in order to

  16. Clinical experience with desflurane for paediatric anaesthesia outside the operating room.

    Science.gov (United States)

    Alonso, M; Builes, L; Morán, P; Ortega, A; Fernández, E; Reinoso-Barbero, F

    2017-01-01

    Desflurane has been used in paediatric patients for several surgical indications. This article analyses the efficacy and safety of desflurane for diagnostic-therapeutic procedures in remote areas far from operating room in a group of selected patients with no known associated respiratory disease. A retrospective analysis was performed on 2,072 general anaesthesia procedures stored in a computer database, in which desflurane was used in a Paediatric Pain Unit during the years 2013 and 2014. An analysis was also performed using the patient demographics, type of procedure, anaesthetic technique, type of airway management, patient cooperation, and incidence of anaesthetic complications. The study included 876 patients, with a mean age of 8.8 years. The main procedures were bone marrow aspirates (23%), lumbar punctures (20%), panendoscopies (15%), and colonoscopies (5%). Induction was intravenous with propofol (26%) or inhalation with sevoflurane in the remaining 74%. Maintenance consisted of remifentanil and desflurane at mean end tidal concentrations of 6.2±2.1%. The airway was managed through a nasal cannula or face mask in spontaneous ventilation. The effectiveness was 98%, and the incidence of side effects was 15%, which included agitation (6%), headache (4%), nausea-vomiting (3%), and laryngospasm (2%). The maintenance with desflurane (at concentrations close to the hypnotic-MAC in spontaneous ventilation) was effective, with a rapid recovery, and with a low incidence of adverse effects. Copyright © 2016 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Publicado por Elsevier España, S.L.U. All rights reserved.

  17. Control, Operator Support and Safety System of PVC-reactors

    Directory of Open Access Journals (Sweden)

    Jens I. Ytreeide

    1997-01-01

    Full Text Available In modern petrochemical plants the corporate and societal demands to plant safety and minimum environmental effects are high. These demands rise high performance requirements to the technical systems, specially the process control and safety systems including an effective operator support system with fault detection capability. The systems must have high reliability also against erroneous operations which may cause shutdown situations or quality deviations.

  18. Methodology for analyzing environmental quality indicators in a dynamic operating room environment.

    Science.gov (United States)

    Gormley, Thomas; Markel, Troy A; Jones, Howard W; Wagner, Jennifer; Greeley, Damon; Clarke, James H; Abkowitz, Mark; Ostojic, John

    2017-04-01

    Sufficient quantities of quality air and controlled, unidirectional flow are important elements in providing a safe building environment for operating rooms. To make dynamic assessments of an operating room environment, a validated method of testing the multiple factors influencing the air quality in health care settings needed to be constructed. These include the following: temperature, humidity, particle load, number of microbial contaminants, pressurization, air velocity, and air distribution. The team developed the name environmental quality indicators (EQIs) to describe the overall air quality based on the actual measurements of these properties taken during the mock surgical procedures. These indicators were measured at 3 different hospitals during mock surgical procedures to simulate actual operating room conditions. EQIs included microbial assessments at the operating table and the back instrument table and real-time analysis of particle counts at 9 different defined locations in the operating suites. Air velocities were measured at the face of the supply diffusers, at the sterile field, at the back table, and at a return grille. The testing protocol provided consistent and comparable measurements of air quality indicators between institutions. At 20 air changes per hour (ACH), and an average temperature of 66.3°F, the median of the microbial contaminants for the 3 operating room sites ranged from 3-22 colony forming units (CFU)/m(3) at the sterile field and 5-27 CFU/m(3) at the back table. At 20 ACH, the median levels of the 0.5-µm particles at the 3 sites were 85,079, 85,325, and 912,232 in particles per cubic meter, with a predictable increase in particle load in the non-high-efficiency particulate air-filtered operating room site. Using a comparison with cleanroom standards, the microbial and particle counts in all 3 operating rooms were equivalent to International Organization for Standardization classifications 7 and 8 during the mock surgical

  19. [Implementation of a rational standard of hygiene for preparation of operating rooms].

    Science.gov (United States)

    Bauer, M; Scheithauer, S; Moerer, O; Pütz, H; Sliwa, B; Schmidt, C E; Russo, S G; Waeschle, R M

    2015-10-01

    The assurance of high standards of care is a major requirement in German hospitals while cost reduction and efficient use of resources are mandatory. These requirements are particularly evident in the high-risk and cost-intensive operating theatre field with multiple process steps. The cleaning of operating rooms (OR) between surgical procedures is of major relevance for patient safety and requires time and human resources. The hygiene procedure plan for OR cleaning between operations at the university hospital in Göttingen was revised and optimized according to the plan-do-check-act principle due to not clearly defined specifications of responsibilities, use of resources, prolonged process times and increased staff engagement. The current status was evaluated in 2012 as part of the first step "plan". The subsequent step "do" included an expert symposium with external consultants, interdisciplinary consensus conferences with an actualization of the former hygiene procedure plan and the implementation process. All staff members involved were integrated into this management change process. The penetration rate of the training and information measures as well as the acceptance and compliance with the new hygiene procedure plan were reviewed within step "check". The rates of positive swabs and air sampling as well as of postoperative wound infections were analyzed for quality control and no evidence for a reduced effectiveness of the new hygiene plan was found. After the successful implementation of these measures the next improvement cycle ("act") was performed in 2014 which led to a simplification of the hygiene plan by reduction of the number of defined cleaning and disinfection programs for preparation of the OR. The reorganization measures described led to a comprehensive commitment of the hygiene procedure plan by distinct specifications for responsibilities, for the course of action and for the use of resources. Furthermore, a simplification of the plan, a

  20. Behavior based safety in drilling operations

    Energy Technology Data Exchange (ETDEWEB)

    Miessner, D.J.; Fleming, E.; Loafmann, B.

    1996-12-31

    Drilling rig safety was enhanced dramatically by partnering with our drilling contractor to implement a behavior based safety process with emphasis on positive reinforcement. By identifying and targeting specific safe behaviors, we have reduced the number of acts that expose rig workers to the possibility of injury. The process focuses on only three behaviors at a time. We observe these three behaviors and record the number of times that a behavior is done correctly in relationship to the total number of instances of the behavior. Observations are recorded daily on a graph in the work place. The graph gives the employees an opportunity to receive daily feedback on their progress. Emphasis is placed on using social positive reinforcers to increase the occurrence of the desired behavior. The frequency of the desired behavior increases until the behaviors are consistently done correctly and declared to be at {open_quotes}habit strength{close_quotes}. The success of the process can be measured by the number of safe behaviors at habit strength.

  1. 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.

  2. CONTROL COMMAND SYSTEMS IMPACT ON THE RAILWAY OPERATIONAL SAFETY

    Directory of Open Access Journals (Sweden)

    Marek Pawlik

    2015-04-01

    Full Text Available Purpose. Safety is seen as a must, for railway transport market. However it is not so obvious what does safety exactly mean as it means different things for different experts. Showing safety ensured by control command systems as a component of the railway operational safety and pointing associated challenges especially those arising from subdivision of the national railway system into different entities. Methodology. To achieve this purpose control command and signalling systems keeping safe distances between trains, preventing setting conflicting train routs, locking of the mobile elements of the switches, protecting the level crossings, enabling safe incorporation of additional trains were analyzed. Findings. Article analyses how control command system influence operational safety taking into account safety of the control-command system itself, interfaces on one side between signalling systems and control command system and on the other side between control command system and vehicle control systems, transmission, maintenance, and operation in degraded modes of running. Originality. New and high-effective scope of tests which are necessary for putting new control command installation into service both track-side and on-board are proposed. Practical value. Control command implementations will significantly improve operational safety, however it is possible only when recommendations defined in this article are taken into account. This means that all the components including interfaces have to meet acceptable hazard rate 10E-9 and have to be properly design, constructed, assembled and maintained, all taking into account whole chain of functions performed and supervised by different railway entities.

  3. 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.

  4. Obesity increases operating room time for lobectomy in the society of thoracic surgeons database.

    Science.gov (United States)

    St Julien, Jamii B; Aldrich, Melinda C; Sheng, Shubin; Deppen, Stephen A; Burfeind, William R; Putnam, Joe B; Lambright, Eric S; Nesbitt, Jonathan C; Grogan, Eric L

    2012-12-01

    Obesity has become a major epidemic in the United States. Although research suggests obesity does not increase major morbidity or mortality after thoracic operations, it likely results in greater use of health care resources. We examined all patients in The Society of Thoracic Surgeons General Thoracic Surgery database with primary lung cancer who underwent lobectomy from 2006 to 2010. We investigated the impact of body mass index (BMI) on total operating room time using a linear mixed-effects regression model and multiple imputations to account for missing data. Secondary outcomes included postoperative length of stay and 30-day mortality. Covariates included age, sex, race, forced expiratory volume, smoking status, Zubrod score, prior chemotherapy or radiation, steroid use, number of comorbidities, surgical approach, hospital lobectomy volume, hospital percent obesity, and the addition of mediastinoscopy or wedge resection. A total of 19,337 patients were included. The mean BMI was 27.3 kg/m2, with 4,898 patients (25.3%) having a BMI of 30 kg/m2 or greater. The mean total operating room time, length of stay, and 30-day mortality were 240 minutes, 6.7 days, and 1.8%, respectively. For every 10-unit increase in BMI, mean operating room time increased by 7.2 minutes (range, 4.8 to 8.4 minutes; pobese patients did not affect the association between BMI and operative time. Body mass index was not associated with 30-day mortality or increased length of stay. Increased BMI is associated with increased total operating room time, regardless of institutional experience with obese patients. Copyright © 2012 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  5. [Anesthetic management of patients with mental retardation during autologous transplantation of peripheral blood mononuclear cells outside the operating room].

    Science.gov (United States)

    Li, Meng-meng; Zhang, Qing-hong; Liu, Ying-hui; Yue, Li; Liu, Zhi-hui; Hao, Jian-hua

    2011-06-01

    To observe the anesthetic effect and safety of differential airway management in patients with mental retardation (MR) during autologous peripheral blood mononuclear cell transplantation (APBMCT) outside the operating room. In this prospective study, 30 uncooperative patients with MR receiving total intravenous anesthesia (TIVA) with propofol for APBMCT were randomized into 3 groups with monitored anesthesia care (MAC group), inserted classic laryngeal mask airway under general anesthesia (LMA group), or endotracheal tube placement (ETT group). The blood pressure (BP), heart rate (HR), SpO(2) and pH, PaCO(2), and HCO(3)(-) were monitored at 5 min and 1 h after anesthesia, before completion of the operation and at 1 h after the operation. The total operative time, dosage of propofol, awake time and body movement during the procedure were recorded. Compared with LMA and ETT groups, the MAC groups showed a significantly increased total dosage of propofol (66.07±5.41, 35.83±5.80, and 34.61±3.68 g·kg(-1)·min(-1), respectively, Pawake time (16.82±7.60, 4.31±1.32, and 3.73±1.33 min, P0.05). At 1 h after anesthesia, the pH in MAC group decreased markedly compared with that in LMA and ETT groups (PMAC group and remained so till the end of the surgery (P<0.05). Endotracheal tube placement is safer than laryngeal mask airway placement and monitored anesthesia care in patients with MR during APBMCT, and allows rapid onset of sedation with minimal cardiovascular responses, body movement and recovery, therefore is more suitable in the setting outside the operating room.

  6. Changing Safety Priorities from Payload Development to Onboard Payload Operations

    Science.gov (United States)

    Kreimer, J.; Biemann, W.; Festa, F.

    2012-01-01

    Safety Analyses for Payload development phases are typically based o n well defined fixed configurations. From safety point of view the main focus during the development phase is on t he design features that will ensure inherent safe launch, on-board installation and usage of the payload in the planned configuration. The complete payload verification including the safety verification and the flight certification is based on that expected scenario. Once the payload is launched and installed on-orbit the focus moves to safe operations in constantly changing configurations over the life-time due t o upgrades, preventive, and corrective maintenance activities. A broader assessment and preparation for recovery procedures would help to streamline this aspect. It would also support the new extended ISS utilization scenario and the changes of the logistic fleet available to the ISS. The challenge to move the safety focus from payload development and design safety features to permanently modified configurations, different upload capabilities and extending life-cycles/time during the operations phase of the payloads can be supported by early definition of operational envelops and resulting safety approval of wider operational flexibility.

  7. [Simulation-based analysis of novel therapy principles. Effects on the efficiency of operating room processes].

    Science.gov (United States)

    Baumgart, A; Denz, C; Bender, H; Bauer, M; Hunziker, S; Schüpfer, G; Schleppers, A

    2009-02-01

    The introduction of innovative drugs in anesthesiological treatment has the potential to improve perioperative efficiency. This article examines the impact of the new muscle relaxant encapsulator Bridion on emergence from anesthesia and on the efficiency of the perioperative organization. To analyze the effects of medical innovations, computer simulation was used as an experimental frame. The simulation was based on a realistic model of an operating room setting and used historical data to study the effect of innovation on the operational performance and the economic outcomes. The use of medical innovations in anesthesiological emergence yields new potentials for a hospital under certain conditions. Due to shorter block times and anesthesia-controlled times, additional benefits for the operating room could be realized. This results in an increase of up to 2.4% additional cases during similar working hours and planning periods. The introduction of innovative medicines may reveal more efficient and economical conditions in operating rooms. The overall result depends, for example, on the rate of application of the patient's portfolio or the organization and access rules of the surgical suite. Based on the anesthesia-controlled time no general a priori statement about the economic potentials can be confirmed. Future empirical studies should investigate the impact on quality and economic benefits for the entire patient pathway.

  8. 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 < 0.001). Graduates with guided operating theatre experience as undergraduates or graduate nurses achieved a 100% pass rate compared to 53% with non-guided or no experience (p < 0.001). The 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.

  9. High-density magnetoresistive random access memory operating at ultralow voltage at room temperature.

    Science.gov (United States)

    Hu, Jia-Mian; Li, Zheng; Chen, Long-Qing; Nan, Ce-Wen

    2011-11-22

    The main bottlenecks limiting the practical applications of current magnetoresistive random access memory (MRAM) technology are its low storage density and high writing energy consumption. Although a number of proposals have been reported for voltage-controlled memory device in recent years, none of them simultaneously satisfy the important device attributes: high storage capacity, low power consumption and room temperature operation. Here we present, using phase-field simulations, a simple and new pathway towards high-performance MRAMs that display significant improvements over existing MRAM technologies or proposed concepts. The proposed nanoscale MRAM device simultaneously exhibits ultrahigh storage capacity of up to 88 Gb inch(-2), ultralow power dissipation as low as 0.16 fJ per bit and room temperature high-speed operation below 10 ns.

  10. 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.......0074% per injection (95% CI: 0.0070-0.0078%). Positive cultures were found in 4 out of 10 presumed endophthalmitis cases. CONCLUSION: The standardized sterile technique in an operation room with laminar airflow showed very low rates of endophthalmitis at three European sites....

  11. 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.

  12. [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.

  13. NCRP Program Area Committee 2: Operational Radiation Safety.

    Science.gov (United States)

    Goldin, Eric M; Pryor, Kathryn H

    2016-02-01

    Program Area Committee 2 of the National Council on Radiation Protection and Measurements provides guidance for radiation safety in occupational settings in a variety of industries and activities. The Committee completed three reports in recent years covering recommendations for the development and administration of radiation safety programs for smaller educational institutions, requirements for self-assessment programs that improve radiation safety and identify and correct deficiencies, and a comprehensive process for effective investigation of radiological incidents. Ongoing work includes a report on sealed radioactive source controls and oversight of a report on radioactive nanomaterials focusing on gaps within current radiation safety programs. Future efforts may deal with operational radiation safety programs in fields such as the safe use of handheld and portable x-ray fluorescence analyzers, occupational airborne radioactive contamination, unsealed radioactive sources, or industrial accelerators.

  14. NCRP Program Area Committee 2: Operational Radiation Safety

    Energy Technology Data Exchange (ETDEWEB)

    Pryor, Kathryn H.; Goldin, Eric M.

    2016-02-29

    Program Area Committee 2 of the National Council on Radiation Protection and Measurements provides guidance for radiation safety in occupational settings in a variety of industries and activities. The committee completed three reports in recent years covering recommendations for the development and administration of radiation safety programs for smaller educational institutions, requirements for self-assessment programs that improve radiation safety and identify and correct deficiencies, and a comprehensive process for effective investigation of radiological incidents. Ongoing work includes a report on sealed radioactive source controls and oversight of a report on radioactive nanomaterials focusing on gaps within current radiation safety programs. Future efforts may deal with operational radiation safety programs in fields such as the safe use of handheld and portable X-Ray fluorescence analyzers, occupational airborne radioactive contamination, unsealed radioactive sources, or industrial accelerators.

  15. [Surgery training of gynecologic residents: master and student in the operating room].

    Science.gov (United States)

    Rathat, G; Hoa, D; Gagnayre, R; Hoffet, M; Mares, P

    2008-02-01

    Describe the surgical training of gynecologic residents in the operating room, by collecting the opinion of French gynecologists. A questionnaire investigating this subject was put on a web site. Every French gynecologist could answer the questionnaire from a duration of six months. The data of the inquiry were studied by comparing five groups: residents (group 1), fellows (group 2), seniors of public hospital (group 3), and seniors of private hospitals (group 4), or, groups 2, 3 and 4 together, as Group A. Six hundred and fifty-seven gynecologists answered the inquiry. For the residents, lack of time and senior's weak educational motivation are the explanations most frequently retained in order to explain that residents do not operate. For group A, it is rather the residents' skills which is the most important fact to have residents operate. Residents more often practice surgery in general public hospital that in faculty hospital. For 31% of all the referees, heads of departments do not incite their teams to have residents operate. Nearly 25% of all the investigated believe that a man operates more than a woman in resident curriculum. Besides, by analyzing the answers of groups 1 and 2, we were able to correlate resident seniority at their first practice of 13 surgical operations. For 26% of the group A, residents operate less than they do during their own studies. Finally, all the investigated confirm the lack of surgical assessment in the resident curriculum. Decision to let the resident operate remains too dependent on senior personal appreciation and does not seem to join a strategy of training. Opinions of surgical training in the operating room is different between residents and seniors. Operating time increases when residents operate but there is no effect on quality of care. These results show again the necessity of a formal teaching and assessment, in a resident program with objectives, collecting every resident's surgery volume. These educational

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

    Science.gov (United States)

    2009-06-28

    the MTF does not receive any performance earnings from workload generated under the Dental inpatient and outpatient codes (CAA5 and ABFA). Also OR...increasing nursing staffing to permit completion of more cases: A case study. Anesthesia & Analgesia , 94(1), 138 - 142. Dexter, F., & Macario, A. (2002...as possible. Anesthesia & Analgesia , 94(5), 1272 - 1279. OR Metrics 54 Dexter, F., Macario, A., Traub, R.D., & Lubarsky, D.A. (2003). Operating room

  17. Implications of Surgical Training on Operating Room Throughput at Wilford Hall Medical Center

    Science.gov (United States)

    2008-06-26

    its physician specialists, 85 percent of dental specialists, and a full spectrum of other training. The medical center’s fourth mission is clinical...dedicated to training dental officers of the three services in one facility. The medical center’s support of San Antonio’s emergency medicine structure...P. (2006). Resident teaching versus the operating room schedule: An independent observer- based study of 1558 cases. Anesthesia and Analgesia , 103

  18. Predicting Correct Body Posture based on Theory of Planned Behavior in Iranian Operating Room Nurses

    OpenAIRE

    BAHAREH ABEDI; RABIOLLAH FARMANBAR1; SAEED OMIDI; MAHDI JAHANGIR BLOURCHIAN

    2015-01-01

    Due to the importance of correct posture for preventing musculoskeletal disorders, the purpose of this study was to evaluate Theory of Planned Behavior in Predicting correct Body Posture in operating room nurses.In this cross-sectional study, participants (n=100) were nurses from five hospitals located in northern Iran. Participants completed demographic data and theory of planned behavior construct Questionnaires. In addition, the researcher checked the Body Posture of nurses by Rapid Entire...

  19. Continuous-wave operation of a room-temperature Tm: YAP-pumped Ho: YAG laser

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    We report a continuous-wave (CW) 2.1-μm Ho:YAG laser operating at room temperature pumped by a diode-pumped 1.94-?m Tm:YAP laser.The maximum output power of 1.5 W is obtained from Ho:YAG laser,corresponding to Tm-to-Ho slope efficiency of 17.9% and diode-to-He conversion efficiency of 5.6%.

  20. Mirror thermal noise in laser interferometer gravitational wave detectors operating at room and cryogenic temperature

    CERN Document Server

    Franc, Janyce; Flaminio, Raffaele; Nawrodt, Ronny; Martin, Iain; Cunningham, Liam; Cumming, Alan; Rowan, Sheila; Hough, James

    2009-01-01

    Mirror thermal noise is and will remain one of the main limitations to the sensitivity of gravitational wave detectors based on laser interferometers. We report about projected mirror thermal noise due to losses in the mirror coatings and substrates. The evaluation includes all kind of thermal noises presently known. Several of the envisaged substrate and coating materials are considered. The results for mirrors operated at room temperature and at cryogenic temperature are reported.

  1. Case Study: Review of Operating Room Utilization at Mayo Clinic Arizona (MCA)

    Science.gov (United States)

    2008-05-01

    offers. The premier programs of the hospital are cancer treatment and solid organ /bone marrow transplant . (Mayo Clinic, 2007) Problem Statement In...improve revenue streams (Overdyl, Harvey, Fishman , & Shippey, 1998). Organizations have seen reduced revenues from operating room care because of lower...TASK NUMBER 5f. WORK UNIT NUMBER 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) RESIDENCY SITE ADDRESS Mayo Clinic Arizona 5777 East Mayo

  2. The effects of Chamomile tea on antioxidative biomarkers in operating room staff

    Directory of Open Access Journals (Sweden)

    Sami Ghazal

    2015-07-01

    Full Text Available Introduction: Chamomile tea (CT is an herbal tea and is served as a beneficial herbal infusion all over the world. Its major polyphenols constituents and tea-catechins have been shown to have health benefits. Operating room staff are commonly exposed to damaging factors, such as radiation, waste anesthetic gases and psychological stress. One of the most important qualities of CT is its antioxidant property. The aim of this study was to evaluate the effects of CT in reducing the oxidative stress of operative room staff that are chronically exposed to damaging factors. Methods: In this study we approached to 20 operating room personnel. The subjects drank 2 cups of CT (every cup contained 1.8730 g of chamomile and 300 ml of water daily, one cup in the morning and another in the afternoon for 21 days. A questionnaire that contained personal information was filled by each subject. Oxidative stress parameters such as total antioxidant capacity (TAC, catalase (CAT and total thiol molecules (TTG were measured 2 times: first before drinking CT at the first day and the next time after the 21st day. Results: Consumption of CT by subjects caused a significant induction in TAC (6.62 ± 0.77 vs 4.81± 0.39 ųmol/ml, P < .05 of saliva. There was not any statistically significant change in saliva TTG and CAT after 21 days of drinking CT. Conclusion: In the end we came to conclusion that CT can be a useful additional food to remove the oxidative damage that happens to operating room staff.

  3. 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.

  4. A generic operational strategy to qualify translational safety biomarkers.

    Science.gov (United States)

    Matheis, Katja; Laurie, David; Andriamandroso, Christiane; Arber, Nadir; Badimon, Lina; Benain, Xavier; Bendjama, Kaïdre; Clavier, Isabelle; Colman, Peter; Firat, Hüseyin; Goepfert, Jens; Hall, Steve; Joos, Thomas; Kraus, Sarah; Kretschmer, Axel; Merz, Michael; Padro, Teresa; Planatscher, Hannes; Rossi, Annamaria; Schneiderhan-Marra, Nicole; Schuppe-Koistinen, Ina; Thomann, Peter; Vidal, Jean-Marc; Molac, Béatrice

    2011-07-01

    The importance of using translational safety biomarkers that can predict, detect and monitor drug-induced toxicity during human trials is becoming increasingly recognized. However, suitable processes to qualify biomarkers in clinical studies have not yet been established. There is a need to define clear scientific guidelines to link biomarkers to clinical processes and clinical endpoints. To help define the operational approach for the qualification of safety biomarkers the IMI SAFE-T consortium has established a generic qualification strategy for new translational safety biomarkers that will allow early identification, assessment and management of drug-induced injuries throughout R&D. Copyright © 2011 Elsevier Ltd. All rights reserved.

  5. Reducing operating costs while protecting safety and the environment

    Energy Technology Data Exchange (ETDEWEB)

    Lund, R. [Transocean Drilling ASA, (Norway)

    1996-12-31

    The paper deals with the change process by reducing the operating costs in the petroleum industry while protecting safety and the environment. The author`s intention is to examine some of these cost reduction initiatives and see if they have affected the HSE (Health, Safety and Environment) parameters and subsequently how HSE has been managed during the change process. The examination will be from a contractor`s point of view. Topics are: organisational change; safety, environment and change; reduction of profit margins; changing contract strategy; restructuring of the drilling industry; technological development; environment

  6. How do the top 12 pharmaceutical companies operate safety pharmacology?

    Science.gov (United States)

    Ewart, Lorna; Gallacher, David J; Gintant, Gary; Guillon, Jean-Michel; Leishman, Derek; Levesque, Paul; McMahon, Nick; Mylecraine, Lou; Sanders, Martin; Suter, Willi; Wallis, Rob; Valentin, Jean-Pierre

    2012-09-01

    How does safety pharmacology operate in large pharmaceutical companies today? By understanding our current position, can we prepare safety pharmacology to successfully navigate the complex process of drug discovery and development? A short anonymous survey was conducted, by invitation, to safety pharmacology representatives of the top 12 pharmaceutical companies, as defined by 2009 revenue figures. A series of multiple choice questions was designed to explore group size, accountabilities, roles and responsibilities of group members, outsourcing policy and publication record. A 92% response rate was obtained. Six out of 11 companies have 10 to 30 full time equivalents in safety pharmacology, who hold similar roles and responsibilities; although the majority of members are not qualified at PhD level or equivalent. Accountabilities were similar across companies and all groups have accountability for core battery in vivo studies and problem solving activities but differences do exist for example with in vitro safety screening and pharmacodynamic/pharmokinetic modeling (PK/PD). The majority of companies outsource less than 25% of studies, with in vitro profiling being the most commonly outsourced activity. Finally, safety pharmacology groups are publishing 1 to 4 articles each year. This short survey has highlighted areas of similarity and differences in the way large pharmaceutical companies operate safety pharmacology. Copyright © 2012 Elsevier Inc. All rights reserved.

  7. Assessment of nursing students' stress levels and coping strategies in operating room practice.

    Science.gov (United States)

    Yildiz Findik, Ummu; Ozbas, Ayfer; Cavdar, Ikbal; Yildizeli Topcu, Sacide; Onler, Ebru

    2015-05-01

    The aim of this study was to evaluate the stress levels and stress coping strategies of nursing students in their first operating room experience. This descriptive study was done with 126 nursing students who were having an experience in an operating room for the first time. Data were collected by using Personal Information Form, Clinical Stress Questionnaire, and Styles of Coping Inventory. The nursing students mostly had low clinical stress levels (M = 27.56, SD = 10.76) and adopted a self-confident approach in coping with stress (M = 14.3, SD = 3.58). The nursing students generally employed a helpless/self-accusatory approach among passive patterns as their clinical stress levels increased, used a self-confident and optimistic approach among active patterns as their average age increased, and those who had never been to an operating room previously used a submissive approach among passive patterns. The results showed that low levels of stress caused the nursing students to use active patterns in coping with stress, whereas increasing levels of stress resulted in employing passive patterns in stress coping. The nursing students should be ensured to maintain low levels of stress and use active patterns in stress coping.

  8. 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.

  9. The Development and Deployment of a Maintenance Operations Safety Survey.

    Science.gov (United States)

    Langer, Marie; Braithwaite, Graham R

    2016-11-01

    Based on the line operations safety audit (LOSA), two studies were conducted to develop and deploy an equivalent tool for aircraft maintenance: the maintenance operations safety survey (MOSS). Safety in aircraft maintenance is currently measured reactively, based on the number of audit findings, reportable events, incidents, or accidents. Proactive safety tools designed for monitoring routine operations, such as flight data monitoring and LOSA, have been developed predominantly for flight operations. In Study 1, development of MOSS, 12 test peer-to-peer observations were collected to investigate the practicalities of this approach. In Study 2, deployment of MOSS, seven expert observers collected 56 peer-to-peer observations of line maintenance checks at four stations. Narrative data were coded and analyzed according to the threat and error management (TEM) framework. In Study 1, a line check was identified as a suitable unit of observation. Communication and third-party data management were the key factors in gaining maintainer trust. Study 2 identified that on average, maintainers experienced 7.8 threats (operational complexities) and committed 2.5 errors per observation. The majority of threats and errors were inconsequential. Links between specific threats and errors leading to 36 undesired states were established. This research demonstrates that observations of routine maintenance operations are feasible. TEM-based results highlight successful management strategies that maintainers employ on a day-to-day basis. MOSS is a novel approach for safety data collection and analysis. It helps practitioners understand the nature of maintenance errors, promote an informed culture, and support safety management systems in the maintenance domain. © 2016, Human Factors and Ergonomics Society.

  10. Room-temperature operation of mid-infrared surface-plasmon quantum cascade lasers

    Science.gov (United States)

    Bahriz, M.; Moreau, V.; Palomo, J.; Krysa, A. B.; Austin, D.; Cockburn, J. W.; Roberts, J. S.; Wilson, L. R.; Julien, F.; Colombelli, R.

    2007-04-01

    We report the pulsed, room-temperature operation of an InGaAs/AllnAs quantum cascade laser at an operating wavelength of ≈ 7.5 μm in which the optical mode is a surface-plasmon polariton excitation. The use of a silver-based electrical contact with reduced optical losses at the laser emission wavelength allows for a reduction of the laser threshold current by a factor of two relative to samples with a gold-based contact layer.

  11. Failure analysis for JNK Boracic acid Tank Room of NPP

    Institute of Scientific and Technical Information of China (English)

    2011-01-01

    The JNK Boracic acid Tank Room is important safety equipment for Nuclear Power Plant. Corrosion,crack and leaked Boracic acid were found on the some welding area of the liners of the JNK Tank Room during operation.

  12. Nuclear electric power safety, operation, and control aspects

    CERN Document Server

    Knowles, J Brian

    2013-01-01

    Assesses the engineering of renewable sources for commercial power generation and discusses the safety, operation, and control aspects of nuclear electric power From an expert who advised the European Commission and UK government in the aftermath of Three Mile Island and Chernobyl comes a book that contains experienced engineering assessments of the options for replacing the existing, aged, fossil-fired power stations with renewable, gas-fired, or nuclear plants. From geothermal, solar, and wind to tidal and hydro generation, Nuclear Electric Power: Safety, Operation, and Control Aspects ass

  13. 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.

  14. Safety-related operator actions: methodology for developing criteria

    Energy Technology Data Exchange (ETDEWEB)

    Kozinsky, E.J.; Gray, L.H.; Beare, A.N.; Barks, D.B.; Gomer, F.E.

    1984-03-01

    This report presents a methodology for developing criteria for design evaluation of safety-related actions by nuclear power plant reactor operators, and identifies a supporting data base. It is the eleventh and final NUREG/CR Report on the Safety-Related Operator Actions Program, conducted by Oak Ridge National Laboratory for the US Nuclear Regulatory Commission. The operator performance data were developed from training simulator experiments involving operator responses to simulated scenarios of plant disturbances; from field data on events with similar scenarios; and from task analytic data. A conceptual model to integrate the data was developed and a computer simulation of the model was run, using the SAINT modeling language. Proposed is a quantitative predictive model of operator performance, the Operator Personnel Performance Simulation (OPPS) Model, driven by task requirements, information presentation, and system dynamics. The model output, a probability distribution of predicted time to correctly complete safety-related operator actions, provides data for objective evaluation of quantitative design criteria.

  15. Evolution of the future plants operation for a better safety

    Energy Technology Data Exchange (ETDEWEB)

    Papin, B.; Malvache, P.

    1994-12-31

    This paper describes a coordinated research project of the french CEA, addressing to the evolutions in plant operation apt to bring perceptible and assessable improvement in the operational safety. This program has been scheduled for the 1992-1996 period, with a global 40 men/year effort. The present status of the two main parts of the project is presented: ESCRIME (program aiming at defining the optimal share of tasks between humans and computers in plant operation), IMAGIN (research in the domain of plant information management, in order to ensure the global coherence of the image of the plant, used by the different actors in plant operation). (authors). 3 refs., 4 figs.

  16. [Air conditioning units and warm air blankets in the operating room].

    Science.gov (United States)

    Kerwat, Klaus; Piechowiak, Karolin; Wulf, Hinnerk

    2013-01-01

    Nowadays almost all operating rooms are equipped with air conditioning (AC units). Their main purpose is climatization, like ventilation, moisturizing, cooling and also the warming of the room in large buildings. In operating rooms they have an additional function in the prevention of infections, especially the avoidance of postoperative wound infections. This is achieved by special filtration systems and by the creation of specific air currents. Since hypothermia is known to be an unambiguous factor for the development of postoperative wound infections, patients are often actively warmed intraoperatively using warm air blankets (forced-air warming units). In such cases it is frequently discussed whether such warm air blankets affect the performance of AC units by changing the air currents or whether, in contrast, have exactly the opposite effect. However, it has been demonstrated in numerous studies that warm air blankets do not have any relevant effect on the functioning of AC units. Also there are no indications that their use increases the rate of postoperative wound infections. By preventing the patient from experiencing hypothermia, the rate of postoperative wound infections can even be decreased thereby. © Georg Thieme Verlag Stuttgart · New York.

  17. Safety and health hazard observations in Hmong farming operations.

    Science.gov (United States)

    Neitzel, R L; Krenz, J; de Castro, A B

    2014-01-01

    Agricultural workers have a high risk of occupational injuries, illnesses, and fatalities. However, there are very few standardized tools available to assess safety and health in agricultural operations. Additionally, there are a number of groups of agricultural workers, including Hmong refugees and immigrants, for which virtually no information on safety and health conditions is available. This study developed an observation-based methodology for systematically evaluating occupational health and safety hazards in agriculture, and pilot-tested this on several small-scale Hmong farming operations. Each observation assessed of range of safety and health hazards (e.g., musculoskeletal hazards, dust and pollen, noise, and mechanical hazards), as well as on factors such as type of work area, presence of personal protective equipment, and weather conditions. Thirty-six observations were collected on nine farms. The most common hazards observed were bending at the back and lifting 50 pounds were also common. The farming activities observed involved almost no power equipment, and no pesticide or chemical handling was observed. The use of personal protective equipment was uncommon. The results of this assessment agreed well with a parallel study of perceived safety and health hazards among Hmong agricultural workers. This study suggests that small-scale Hmong farming operations involve a variety of hazards, and that occupational health interventions may be warranted in this community. The study also demonstrates the utility of standardized assessment tools and mixed-method approaches to hazard evaluation.

  18. Substitute safety rods: Physics of operation and irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Baumann, N.P.

    1991-11-18

    Under certain assumed accidents, an SRS reactor may lose most of its bulk moderator while maintaining flow to fuel assemblies. If this occurs immediately after operation at power, components normally dependent on convective heat transfer to the moderator will heat up with the possibility of melting that component. One component at risk is the currently used cadmium safety rod. A substitute safety rod consisting solely of sintered B{sub 4}C and stainless steel has been designed which is capable of withstanding much higher temperatures. This memorandum provides the physics basis for the adequacy of the rod for reactor shutdown and provides a set of criteria for acceptance in the NTG tests. This memorandum provides physics data for other aspects of operation. These include: Heat production and helium production, along with related phenomena, resulting from inadvertent irradiation at power. Gamma heat input under drained tank conditions. An equivalent rod design suitable for charge design and safety analyses. Degradation under normal operation. Thermal flux ripple in adjacent fuel due to axial striping of alternate B{sub 4}C and steel pellets. Possible effect on safety analyses. Safety rod withdrawal during reactor startup.

  19. Safety and emergency preparedness considerations for geotechnical field operations

    Energy Technology Data Exchange (ETDEWEB)

    Wemple, R.P.

    1989-04-01

    The GEO Energy Technology Department at Sandia National Laboratories is involved in several remote-site drilling and/or experimental operations each year. In 1987, the Geothermal Research Division of the Department developed a general set of Safe Operating Procedures (SOPs) that could be applied to a variety of projects. This general set is supplemented by site-specific SOPs as needed. Effective field operations require: integration of safety and emergency preparedness planning with overall project planning, training of field personnel and inventorying of local emergency support resources, and, developing a clear line of responsibility and authority to enforce the safety requirements. Copies of SOPs used in recent operations are included as examples of working documents for the reader.

  20. Green monolithic II-VI vertical-cavity surface-emitting laser operating at room temperature

    Science.gov (United States)

    Kruse, C.; Ulrich, S. M.; Alexe, G.; Roventa, E.; Kröger, R.; Brendemühl, B.; Michler, P.; Gutowski, J.; Hommel, D.

    2004-02-01

    The realization of a monolithic all II-VI-based vertical cavity surface emitting laser (VCSEL) for the green spectral region is reported. Optically pumped lasing operation was achieved up to room temperature using a planar VCSEL structure. Taking advantage of distributed Bragg-reflectors based on MgS/Zn(Cd)Se superlattices as the low-refractive index material and ZnS0.06Se0.94 layers as the high-index material with a refractive index contrast of n = 0.6, a quality factor exceeding Q = 2000 is reached by using only 18 Bragg periods for the bottom DBR and 15 Bragg periods for the top DBR. The threshold power density is 0.32 MW/cm2 at a temperature of 10 K (emission wavelength 498.5 nm) and 1.9 MW/cm2 at room temperature (emission wavelength 502.3 nm).

  1. Operational Safety Requirements and Operating Specification Documentation compliance instrumentation matrices: 200 East Area Tank Farms

    Energy Technology Data Exchange (ETDEWEB)

    Story, D.R.

    1995-03-01

    This document contains information about matrices complied of instrumentation used to comply with the existing Operational Safety Requirements from Safety Analysis Reports and Operating, Specification Documentation requirements for 200 East Area Tank Farms. These matrices contain the primary instrumentation needed to comply with each OSR and/or OSD requirement as well as any backup instrumentation that may be used should the primary device be out of service. The referenced matrices are provided as attachments to this document.

  2. Dry lab practice leads to improved laparoscopic performance in the operating room.

    Science.gov (United States)

    Stelzer, Marie K; Abdel, Matthew P; Sloan, Michael P; Gould, Jon C

    2009-06-01

    Research has demonstrated that practice in surgical simulators leads to improved performance in that simulator. Our hypothesis is that skills acquired in simulators are transferable to the operating room. Twenty-three laparoscopically naïve surgical interns performed two standardized tasks in a simulator: pegboard transfer and intracorporeal knot tying. Performance was measured using a validated scoring system. On the same day as this initial assessment, subjects were videotaped performing two tasks in a live porcine model: running the small bowel and intracorporeal knot tying. Performance in the porcine model was measured using a modified version of a validated skills assessment tool by two blinded experts. Following a 6-wk proficiency-based dry lab laparoscopic training course, task performance was re-evaluated. No interval live operative laparoscopic experience occurred between the first and second assessment. After training, mean pegboard transfer scores increased from 118.7 to 181.8 (theoretical maximum = 300; P operative model. We believe that this is evidence that laparoscopic skills developed in a dry laboratory setting are transferable to the operating room.

  3. A survey of static and dynamic work postures of operating room staff.

    Science.gov (United States)

    Kant, I J; de Jong, L C; van Rijssen-Moll, M; Borm, P J

    1992-01-01

    Work in health care units is associated with considerable physical strain and many musculoskeletal complaints. Most investigations have concentrated on the work of general hospital nurses; little is known about the physical stress load on other health care workers. We therefore carried out an ergonomic study amongst operating room staff in order to (i) determine the work (posture) stress load on this particular group of health care workers and the effect of static posture on this stress, (ii) identify activities involving poor work postures, and (iii) determine differences between specialties in regard to work posture stress load. The work postures and related work activities of four different groups of staff in operating rooms (surgeons, assistant anaesthesists, instrumentation nurses and circulating nurses) were recorded and evaluated using the specified Ovako Working posture Analysing System (OWAS). Observation during the course of 18 daily surgical programmes (total number of observations: 3714) in the specialties general surgery and ear-nose-throat (ENT) surgery revealed that the work-load according to OWAS for circulating nurses and assistant anaesthesists was not harmful. Some work postures seen among instrumentation nurses and surgeons, however, need improvement. The work posture stress load in these groups is mainly due to the high prevalence of static work postures during the activities "surgery" (surgeons) and "assisting surgery" (instrumentation nurses). Significant differences in ergonomic stress load were observed between general surgeons and ENT surgeons. This survey in operating theatres relates work postures to basic activities and can be used as a starting point from which to improve work conditions in order to reduce or eliminate physical complaints among operating room staff.

  4. Safety Signals as Instrumental Reinforcers during Free-Operant Avoidance

    Science.gov (United States)

    Fernando, Anushka B. P.; Urcelay, Gonzalo P.; Mar, Adam C.; Dickinson, Anthony; Robbins, Trevor W.

    2014-01-01

    Safety signals provide "relief" through predicting the absence of an aversive event. At issue is whether these signals also act as instrumental reinforcers. Four experiments were conducted using a free-operant lever-press avoidance paradigm in which each press avoided shock and was followed by the presentation of a 5-sec auditory safety…

  5. 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

  6. 浅谈手术室的整体护理%Operating Room Holistic Nursing

    Institute of Scientific and Technical Information of China (English)

    王丽娜

    2015-01-01

    This paper discusses the operation room nursing work not only with technical operation, simple operation, should also pay attention to humanistic care operation patients. Master the communication skills. In the process of nursing operation should take the patient as the center to respect the rights of people to serve patients. Caring patients is all care as the starting point and destination, to realize the whole process of operation of holistic nursing. The effective implementation of holistic nursing operation room will improve patient's satisfaction to our work to change from passive to active nursing care.%本文论述了手术室的护理工作不能仅限于配合手术等单纯的技术操作,也应该注重手术患者的人文关怀,掌握沟通技巧。在进行各项护理操作过程中,都要以患者为中心开展,尊重患者的权利,服务于患者。把对患者的关怀作为一切护理工作的出发点和归宿,真正实现手术全过程整体化护理。手术室整体护理模式的有效实施将会提高患者就医满意度,把我们的工作由被动护理转变为主动护理。

  7. Factors predicting the increased risk for return to the operating room in bariatric patients: a NSQIP database study.

    Science.gov (United States)

    Nandipati, Kalyana; Lin, Edward; Husain, Farah; Perez, Sebastian; Srinivasan, Jahnavi; Sweeney, John F; Davis, S Scott

    2013-04-01

    The objective of the study was to assess the risk factors associated with return to the operating room in bariatric surgery patients. Using the American College of Surgeons-National Surgical Quality Improvement Project's participant-use file, patients who underwent laparoscopic gastric bypass (LRYGB) and adjustable gastric band (LAGB) procedures for morbid obesity were identified. Several pre-, peri-, and postoperative variables, including 30 day morbidity and mortality, were collected. The study population was divided into two groups: patients returning to the operating room (group 1), and patients not returning to the operating room (group 2). Variables analyzed included postoperative complications, overall morbidity, and mortality. Relationships between preoperative and perioperative factors leading to the return to the operating room also were analyzed. Of 28,241 (LRYGB = 18,671, LAGB = 9,570) patients included in the study, 644 (2.3 %) patients returned to the operating room. Of the study population, 30 day mortality rate was 0.13 % (37/28,241) and morbidity was 4.1 % (1,155/28,241). Patients returning to the operating room had a higher mortality [14/644 (2.2 %) vs. 23/27,597 (0.01 %); P return to the operating room. Postoperative complications (superficial wound infection, deep surgical site infection, organ space infection, pneumonia, pulmonary embolism, renal insufficiency, renal failure, septic shock, and length of stay) were significantly higher for patients who required reoperation. On multivariate logistic regression analysis, the bypass operation, bleeding disorder, patients on dialysis, preoperative hematocrit, preoperative low albumin, and length of operation were associated with increased risk of return to the operating room. In the bariatric population, return to the operating room is associated with significantly higher morbidity and mortality. Patients who are on dialysis, have a low preoperative serum albumin, and a history of bleeding disorders

  8. A study on scattered dose in operation room by C-arm unit

    Energy Technology Data Exchange (ETDEWEB)

    An, Sung Min; Oh, Jung Hwan; Kim, Sung Chul [Gachon Gil College, Incheon (Korea, Republic of)

    2000-04-15

    This paper studied a C-arm's exposure condition and measured scatter rays by thickness and distance. This study reached the following conclusion. Approximately exposure dose for a patient using fluoroscopy is as follows: Mostly, an operating room was not shielding by lead and operator put on only apron without thyroid and facial part protection. 0.5 mmPb equivalent's apron shielded about 99% of scattered rays at 60 cm from x-ray tube. Scattered rays are depended on distance and thickness so operators are should be careful when using fluoroscopy by C-arm and if possible use high frequency equipment that has a large output.

  9. Cyber Safety and Security for Reduced Crew Operations (RCO)

    Science.gov (United States)

    Driscoll, Kevin

    2017-01-01

    NASA and the Aviation Industry is looking into reduced crew operations (RCO) that would cut today's required two-person flight crews down to a single pilot with support from ground-based crews. Shared responsibility across air and ground personnel will require highly reliable and secure data communication and supporting automation, which will be safety-critical for passenger and cargo aircraft. This paper looks at the different types and degrees of authority delegation given from the air to the ground and the ramifications of each, including the safety and security hazards introduced, the mitigation mechanisms for these hazards, and other demands on an RCO system architecture which would be highly invasive into (almost) all safety-critical avionics. The adjacent fields of unmanned aerial systems and autonomous ground vehicles are viewed to find problems that RCO may face and related aviation accident scenarios are described. The paper explores possible data communication architectures to meet stringent performance and information security (INFOSEC) requirements of RCO. Subsequently, potential challenges for RCO data communication authentication, encryption and non-repudiation are identified. The approach includes a comprehensive safety-hazard analysis of the RCO system to determine top level INFOSEC requirements for RCO and proposes an option for effective RCO implementation. This paper concludes with questioning the economic viability of RCO in light of the expense of overcoming the operational safety and security hazards it would introduce.

  10. Forced-air warming: a source of airborne contamination in the operating room?

    Directory of Open Access Journals (Sweden)

    David Leaper

    2009-12-01

    Full Text Available 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 mm size range, evidenced by a steep decrease in FAW blower filtration efficiency for particles 0.5 to 5.0 mm 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 mm that could, conceivably, settle onto the surgical site.

  11. 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.

  12. Teaching techniques in the operating room: the importance of perceptual motor teaching.

    Science.gov (United States)

    Skoczylas, Laura C; Littleton, Eliza B; Kanter, Steven L; Sutkin, Gary

    2012-03-01

    To identify sucessful teaching techniques in the operating room environment through examining the teaching of the midurethral sling (MUS) surgery. The authors distributed questionnaires with open-ended questions about teaching and learning MUS to 5 urogynecology attendings and 16 obstetrics-gynecology residents in spring 2010. In an effort to identify qualities of an effective sling teacher, the authors used grounded theory to determine common themes and to code participant responses for examples. Of 21 potential respondents, 14 (67%) returned questionnaires. The authors analyzed these and identified seven commonalities among effective sling teachers: they (1) emphasize anatomical landmarks (as determined by 64 total comments); (2) use perceptual-motor teaching (PMT; 38 comments); (3) encourage repetition (28); (4) promote early independence (34); (5) demonstrate confident competence (23); (6) maintain a calm demeanor in the operating room (20); and (7) exhibit a willingness to accept responsibility for mistakes and consequences (9). The second-most common attribute, using PMT, requires the teaching attending to emphasize the motor and tactile aspects of operating and involves incorporating not only what learners see but also what they feel. The authors report seven qualities or techniques fundamental to good teaching practice in a high-stress, high-technology surgical environment, and they have identified the use of PMT, which to their knowledge has not been previously described. Teachers and learners in this study characterized PMT, which is likely generalizable to surgical procedures other than the MUS, as important. Future research should focus on exploring this technique in other surgeries.

  13. 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

  14. The safety experience of New Zealand adventure tourism operators.

    Science.gov (United States)

    Bentley, Tim A; Page, Stephen; Walker, Linda

    2004-01-01

    This survey examined parameters of the New Zealand adventure tourism industry client injury risk. The research also sought to establish priorities for intervention to reduce adventure tourism risk, and identify client injury control measures currently in place (or absent) in the New Zealand adventure tourism industry, with a view to establishing guidelines for the development of effective adventure tourism safety management systems. This 2003 survey builds upon an exploratory study of New Zealand adventure tourism safety conducted by us during 1999. A postal questionnaire was used to survey all identifiable New Zealand adventure tourism operators. The questionnaire asked respondents about their recorded client injury experience, perceptions of client injury risk factors, safety management practices, and barriers to safety. Some 27 adventure tourism activities were represented among the responding sample (n=96). The highest client injury risk was reported in the snow sports, bungee jumping and horse riding sectors, although serious underreporting of minor injuries was evident across the industry. Slips, trips and falls (STF) were the major client injury mechanisms, and a range of risk factors for client injuries were identified. Safety management measures were inconsistently applied across the industry. The industry should consider the implications of poor injury reporting standards and safety management practices generally. Specifically, the industry should consider risk management that focuses on minor (e.g., STF) as well as catastrophic events.

  15. 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.

  16. Are the urology operating room personnel aware about the ionizing radiation?

    Directory of Open Access Journals (Sweden)

    Adem Tok

    2015-10-01

    Full Text Available ABSTRACT Purpose: We assessed and evaluated attitudes and knowledge regarding ionizing radiation of urology surgery room staff. Materials and Methods: A questionnaire was sent by e-mail to urology surgery room personnel in Turkey, between June and August 2013. The questionnaire included demographic questions and questions regarding radiation exposure and protection. Results: In total, 127 questionnaires were answered. Of them, 62 (48.8% were nurses, 51 (40.2% were other personnel, and 14 (11% were radiological technicians. In total, 113 (89% participants had some knowledge of radiation, but only 56 (44.1% had received specific education or training regarding the harmful effects of radiation. In total, 92 (72.4% participants indicated that they used a lead apron and a thyroid shield. In the subgroup that had received education about the harmful effects of radiation, the use ratio for all protective procedures was 21.4% (n=12; this ratio was only 2.8% (n=2 for those with no specific training; the difference was statistically significant (p=0.004. Regarding dosimeters, the use rates were 100% for radiology technicians, 46.8% for nurses, and 31.4% for other hospital personnel; these differences were statistically significant (p<0.001. No significant relationship between working period in the surgery room, number of daily fluoroscopy procedures, education, task, and use of radiation protection measures was found. Conclusions: It is clear that operating room-allied health personnel exposed to radiation do not have sufficient knowledge of ionizing radiation and they do not take sufficient protective measures.

  17. Stage Right operational safety analysis and evaluation of Pantex personnel operations

    Energy Technology Data Exchange (ETDEWEB)

    Rountree, S.L.K.; Whitehurst, H.O.; Tomlin, E.H.; Restrepo, L.F. [Sandia National Labs., Albuquerque, NM (United States); White, J. [Sandia National Labs., Albuquerque, NM (United States)]|[Intera, Albuquerque, NM (United States)

    1995-01-01

    This report documents a study (Stage Right Operational Safety Analysis) that was performed to evaluate the effects of new Stage Right operations on the safety of Pantex personnel who perform the operations and maintain the equipment. The primary concern of the evaluation was for personnel safety during Stage Right operations, but operations equipment damage and degradation also were taken into account. This analysis evaluates safety of the work process in the staging of dismantled nuclear weapon pits within the modified Richmond magazines only. This Stage Right Process and Operational Safety Analysis includes the following processes: moving the pelletized drums from the pallet trailer to the pallet turner, staging of pallets and removal of pallets from the magazine, recovery from an incident in a magazine, setting up, opening, and closing a Zone 4 magazine, inventory of pelletized drums in the magazines, transporting pelletized drums from Zone 12 to Zone 4, and maintenance on the shielded lift truck that involves removal of the cab shielding. The analysis includes the following undesirable consequences: injury to personnel, breach of an AL-R8 container, drop of a loaded pallet, damage to equipment, and equipment unreliability.

  18. 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.

  19. Your Lung Operation: After Your Operation

    Medline Plus

    Full Text Available ... Safety Resources About the Patient Education Program The Recovery Room Choosing Wisely Educational Programs Educational Programs Educational ... Lung Operation After Your Operation Your Discharge and Recovery Complete Video After Your Operation Guidance for after ...

  20. 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.

  1. 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.

  2. 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.

  3. 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. PMID:23573296

  4. A professional and cost effective digital video editing and image storage system for the operating room.

    Science.gov (United States)

    Scollato, A; Perrini, P; Benedetto, N; Di Lorenzo, N

    2007-06-01

    We propose an easy-to-construct digital video editing system ideal to produce video documentation and still images. A digital video editing system applicable to many video sources in the operating room is described in detail. The proposed system has proved easy to use and permits one to obtain videography quickly and easily. Mixing different streams of video input from all the devices in use in the operating room, the application of filters and effects produces a final, professional end-product. Recording on a DVD provides an inexpensive, portable and easy-to-use medium to store or re-edit or tape at a later time. From stored videography it is easy to extract high-quality, still images useful for teaching, presentations and publications. In conclusion digital videography and still photography can easily be recorded by the proposed system, producing high-quality video recording. The use of firewire ports provides good compatibility with next-generation hardware and software. The high standard of quality makes the proposed system one of the lowest priced products available today.

  5. Health risks associated with exposure to surgical smoke for surgeons and operation room personnel.

    Science.gov (United States)

    Okoshi, Kae; Kobayashi, Katsutoshi; Kinoshita, Koichi; Tomizawa, Yasuko; Hasegawa, Suguru; Sakai, Yoshiharu

    2015-08-01

    Although surgical smoke contains potentially hazardous substances, such as cellular material, blood fragments, microorganisms, toxic gases and vapors, many operating rooms (ORs) do not provide protection from exposure to it. This article reviews the hazards of surgical smoke and the means of protecting OR personnel. Our objectives are to promote surgeons' acceptance to adopt measures to minimize the hazards. Depending on its components, surgical smoke can increase the risk of acute and chronic pulmonary conditions, cause acute headaches; irritation and soreness of the eyes, nose and throat; dermatitis and colic. Transmission of infectious disease may occur if bacterial or viral fragments present in the smoke are inhaled. The presence of carcinogens in surgical smoke and their mutagenic effects are also of concern. This review summarizes previously published reports and data regarding the toxic components of surgical smoke, the possible adverse effects on the health of operating room personnel and measures that can be used to minimize exposure to prevent respiratory problems. To reduce the hazards, surgical smoke should be removed by an evacuation system. Surgeons should assess the potential dangers of surgical smoke and encourage the use of evacuation devices to minimize potential health hazards to both themselves and other OR personnel.

  6. 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.

  7. 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.

  8. Room-temperature operation of a titanium supersaturated silicon-based infrared photodetector

    Science.gov (United States)

    García-Hemme, E.; García-Hernansanz, R.; Olea, J.; Pastor, D.; del Prado, A.; Mártil, I.; González-Díaz, G.

    2014-05-01

    We report room-temperature operation of 1 × 1 cm2 infrared photoconductive photodetectors based on silicon supersaturated with titanium. We have fabricated these Si-based infrared photodetectors devices by means of ion implantation followed by a pulsed laser melting process. A high sub-band gap responsivity of 34 mV W-1 has been obtained operating at the useful telecommunication applications wavelength of 1.55 μm (0.8 eV). The sub-band gap responsivity shows a cut-off frequency as high as 1.9 kHz. These Si-based devices exhibit a non-previous reported specific detectivity of 1.7 × 104 cm Hz1/2 W-1 at 660 Hz, under a 1.55 μm wavelength light. This work shows the potential of Ti supersaturated Si as a fully CMOS-compatible material for the infrared photodetection technology.

  9. [The application of operating room quality backward system in instrument place management].

    Science.gov (United States)

    Du, Hui; He, Anjie; Zeng, Leilei

    2010-09-01

    Improvement of the surgery instrument's clean quality, the optimized preparation way, reasonable arrangement in groups, raising the working efficiency. We use the quality backward system into the instrument clean, the pack and the preparation way's question, carry on the analysis and the optimization, and appraise the effect after trying out 6 months. After finally the way optimized, instrument clean quality distinct enhancement; The flaws in the instrument clean, the pack way and the total operating time reduce; the contradictory between nurses and the cleans arising from the unclear connection reduces, the satisfaction degree of nurse and doctor to the instrument enhances. Using of operating room quality backward system in the management of the instrument clean, the pack and the preparation way optimized, may reduce flaws in the work and the waste of human resources, raise the working efficiency.

  10. Operational design for safety of minimum operators; Shoninka no tameno opereshon anzen sekkei

    Energy Technology Data Exchange (ETDEWEB)

    Yamamuro, N. [Nippon Zeon Co., Ltd., Tokyo (Japan)

    2000-07-05

    One of the keywords of the chemical plant in the twenty-first century is the minimum operators. It requires the plant with the more advanced reliability it maintains the safe level along the convention in little personnel. Here, it limits the target to automation and computerization design, which are a key point of minimum operators plant design, and on the design strategy of new operation safety design, it introduces the outline. (NEDO)

  11. Control, operator support and safety system of PVC reactors

    Energy Technology Data Exchange (ETDEWEB)

    Ytreeide, J.I.; Aaker, O.; Kristoffersen, V.; Moe, G.; Naustdal, C.

    1997-06-01

    In modern petrochemical plants the corporate and societal demands to plant safety and minimum environmental effects are high. These demands rise high performance requirements to the technical systems, specially the process control and safety systems including an effective operator support system with fault detection capability. PVC producing plants have high inherent hazard potentials, and the studied reaction in this publication is exothermic and non-linear and open-loop unstable, and the plant is equipped with two independent cooling systems to keep the reaction under control. A system to solve the stability problem of parallel control is suggested, showing the simulation of real process data. The publication describes an operator support system for monitoring the heat of reaction in the autoclave consisting of a model based estimator. The system is tested on-line, and the results of simulations and on-line estimates are presented. 6 refs., 13 figs.

  12. 49 CFR 192.631 - Control room management.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 3 2010-10-01 2010-10-01 false Control room management. 192.631 Section 192.631... BY PIPELINE: MINIMUM FEDERAL SAFETY STANDARDS Operations § 192.631 Control room management. (a... operator must have and follow written control room management procedures that implement the requirements...

  13. Which algorithm for scheduling add-on elective cases maximizes operating room utilization? Use of bin packing algorithms and fuzzy constraints in operating room management.

    Science.gov (United States)

    Dexter, F; Macario, A; Traub, R D

    1999-11-01

    The algorithm to schedule add-on elective cases that maximizes operating room (OR) suite utilization is unknown. The goal of this study was to use computer simulation to evaluate 10 scheduling algorithms described in the management sciences literature to determine their relative performance at scheduling as many hours of add-on elective cases as possible into open OR time. From a surgical services information system for two separate surgical suites, the authors collected these data: (1) hours of open OR time available for add-on cases in each OR each day and (2) duration of each add-on case. These empirical data were used in computer simulations of case scheduling to compare algorithms appropriate for "variable-sized bin packing with bounded space." "Variable size" refers to differing amounts of open time in each "bin," or OR. The end point of the simulations was OR utilization (time an OR was used divided by the time the OR was available). Each day there were 0.24 +/- 0.11 and 0.28 +/- 0.23 simulated cases (mean +/- SD) scheduled to each OR in each of the two surgical suites. The algorithm that maximized OR utilization, Best Fit Descending with fuzzy constraints, achieved OR utilizations 4% larger than the algorithm with poorest performance. We identified the algorithm for scheduling add-on elective cases that maximizes OR utilization for surgical suites that usually have zero or one add-on elective case in each OR. The ease of implementation of the algorithm, either manually or in an OR information system, needs to be studied.

  14. Multidisciplinary teamwork improves use of the operating room: a multicenter study.

    Science.gov (United States)

    van Veen-Berkx, Elizabeth; Bitter, Justin; Kazemier, Geert; Scheffer, Gert J; Gooszen, Hein G

    2015-06-01

    Poor inter-professional collaboration might negatively influence adequate planning of operative procedures. Interventions capable of improving inter-professional collaboration will positively impact professional practice and health care outcomes. Radboud University Medical Center (UMC) redesigned their operating room (OR) scheduling method by implementing cross-functional teams (CFTs). In this center, positive effects of CFTs were already demonstrated in a mono-center study. This study aims to confirm these effects by comparing the Radboud data with data from 6 other similar centers using a nationwide OR benchmark collaborative. The effect of CFTs was measured by the performance indicator "raw utilization." The Kruskal-Wallis one-way ANOVA was applied to compare OR performance among all 7 centers. The Wilcoxon-Mann-Whitney test was used to determine differences in OR performance between Radboud UMC and the control group. Operating room performance differed significantly among all 7 centers (p<0.0005). Radboud UMC demonstrated the highest median raw utilization of 94% vs 85% in the control group (p<0.0005). Box-and-whisker plots validated the reduced variation during the years, indicating an organizational learning effect. Therefore, not only a better performance than the control group, but also a gradual improvement of this performance during the years. This study shows that multidisciplinary collaboration in CFTs during the perioperative phase has a positive influence on OR scheduling and use of OR time. Other national databases considering mortality rates also support the idea that introducing CFTs is not only an important condition for improving OR performance, but also for improving quality of care. Copyright © 2015 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

  15. Operating Room Efficiency: Benefits of an Orthopaedic Traumatologist at a Level II Trauma Center.

    Science.gov (United States)

    Althausen, Peter L; Kauk, Justin R; Shannon, Steven; Lu, Minggen; O'Mara, Timothy J; Bray, Timothy J

    2016-12-01

    Fellowship-trained orthopaedic traumatologists are presumably taught skill sets leading to "best practice" outcomes and more efficient use of hospital resources. This should result in more favorable economic opportunities when compared with general orthopaedic surgeons (GOSs) providing similar clinical services. The purpose of our study was to compare the operating room utilization and financial data of traumatologists versus GOSs at a level II trauma center. Retrospective review. Level II community-based trauma hospital. Patients who presented to the emergency room at our institution with fractures and orthopaedic conditions requiring surgical intervention from January 1, 2010, to December 31, 2011. Operative fracture fixation by members of our orthopaedic trauma panel, including fellowship and nontrauma fellowship-trained orthopaedic surgeons. Our institutional database was queried to determine operative times, surgical supply and implant costs, and surgery labor expenses. Patients were stratified according to those treated by our trauma panel's 3 traumatologists and those treated by the 15 GOSs on our trauma panel. These 2 groups were then compared using standard statistical methods. A total of 6449 orthopedic cases were identified and 2076 of these involved fracture care. One thousand one hundred ninety-nine patients were treated by traumatologists and 877 by GOSs. There was no statistical difference detected in American Society of Anesthesiologists score between trauma and nontrauma groups. Overall, the traumatologist group demonstrated significantly decreased procedure times when compared with the GOS group (55.6 vs. 75.8 minutes, P , 0.0001). In 16 of 18 most common procedure types, traumatologists were more efficient. This led to significantly decreased surgical labor costs ($381.4 vs. $484.8; P Economic Level IV. See Instructions for Authors for a complete description of levels of evidence.

  16. Microbiological performance of a food safety management system in a food service operation.

    Science.gov (United States)

    Lahou, E; Jacxsens, L; Daelman, J; Van Landeghem, F; Uyttendaele, M

    2012-04-01

    The microbiological performance of a food safety management system in a food service operation was measured using a microbiological assessment scheme as a vertical sampling plan throughout the production process, from raw materials to final product. The assessment scheme can give insight into the microbiological contamination and the variability of a production process and pinpoint bottlenecks in the food safety management system. Three production processes were evaluated: a high-risk sandwich production process (involving raw meat preparation), a medium-risk hot meal production process (starting from undercooked raw materials), and a low-risk hot meal production process (reheating in a bag). Microbial quality parameters, hygiene indicators, and relevant pathogens (Listeria monocytogenes, Salmonella, Bacillus cereus, and Escherichia coli O157) were in accordance with legal criteria and/or microbiological guidelines, suggesting that the food safety management system was effective. High levels of total aerobic bacteria (>3.9 log CFU/50 cm(2)) were noted occasionally on gloves of food handlers and on food contact surfaces, especially in high contamination areas (e.g., during handling of raw material, preparation room). Core control activities such as hand hygiene of personnel and cleaning and disinfection (especially in highly contaminated areas) were considered points of attention. The present sampling plan was used to produce an overall microbiological profile (snapshot) to validate the food safety management system in place.

  17. [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.

  18. A study to assess the influence of interprofessional point of care simulation training on safety culture in the operating theatre environment of a university teaching hospital.

    Science.gov (United States)

    Hinde, Theresa; Gale, Thomas; Anderson, Ian; Roberts, Martin; Sice, Paul

    2016-01-01

    Interprofessional point of care or in situ simulation is used as a training tool in our operating theatre directorate with the aim of improving crisis behaviours. This study aimed to assess the impact of interprofessional point of care simulation on the safety culture of operating theatres. A validated Safety Attitude Questionnaire was administered to staff members before each simulation scenario and then re-administered to the same staff members after 6-12 months. Pre- and post-training Safety Attitude Questionnaire-Operating Room (SAQ-OR) scores were compared using paired sample t-tests. Analysis revealed a statistically significant perceived improvement in both safety (p culture) 6-12 months after interprofessional simulation training. A growing body of literature suggests that a positive safety culture is associated with improved patient outcomes. Our study supports the implementation of point of care simulation as a useful intervention to improve safety culture in theatres.

  19. InSb Mid-Infrared Photon Detector for Room-Temperature Operation

    Science.gov (United States)

    Ueno, Koichiro; Gomes Camargo, Edson; Katsumata, Takashi; Goto, Hiromasa; Kuze, Naohiro; Kangawa, Yoshihiro; Kakimoto, Koichi

    2013-09-01

    We developed a small InSb mid-infrared (2-7 µm wavelength range) photon detector that operates at room temperature. The photodiode was made from (hetero epitaxial) InSb layers that were grown on a semi-insulating GaAs substrate by molecular beam epitaxy. To suppress the effects of the diffusion current of the p-i-n photodiode, we used an AlInSb barrier layer that raises the resistance of the photodiode. We also optimized the device's doping concentration and the infrared incidence window structure. These optimization steps realized high photoelectric current output in a room-temperature environment. We also increased the signal-to-noise ratio of the detector by connecting multiple photodiodes in series. The size of this detector is 1.9×2.7×0.4 mm3 and the detectivity is 2.8×108 cm Hz1/2/W at 300 K. This is a practical IR detector that can be used in general signal amplification ICs.

  20. Nitrous Oxide Levels In Operating and Recovery Rooms of Iranian Hospitals

    Directory of Open Access Journals (Sweden)

    Sh Sadigh Maroufi

    2011-06-01

    Full Text Available "nBackground: Nitrous oxide (N2O 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."nMethods: During a 6-month period, we have measured the shift-long time weighted average concentration of N2O in 43 op­erating and 12 recovery rooms of teaching hospitals of Tehran University of Medical Sciences."nResults: 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."nConclusion: 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.

  1. Surgical teams: role perspectives and role dynamics in the operating room.

    Science.gov (United States)

    Leach, Linda Searle; Myrtle, Robert C; Weaver, Fred A

    2011-05-01

    Observations of surgical teams in the operating room (OR) and interviews with surgeons, circulating registered nurses (RNs), anaesthesiologists and surgical technicians reveal the importance of leadership, team member competencies and an enacted environment that encourages feelings of competence and cooperation. Surgical teams are more loosely coupled than intact and bounded. Team members tend to rely on expected role behaviours to bridge lack of familiarity. While members of the surgical team identified technical competence and preparation as critical factors affecting team performance, they had differing views over the role behaviours of other members of the surgical team that lead to surgical team performance. Observations revealed that the work climate in the OR can shape interpersonal relations and begins to be established when the room is being set up for the surgical case, and evolves as the surgical procedure progresses. The leadership and supervisory competencies of the circulating RNs establish the initial work environment. Both influenced the degree of cooperation and support that was observed, which had an effect on the interactions and relationships between other members of the surgical team. As the surgery unfolds, the surgeon's behaviours and interpersonal relations modify this environment and ultimately influence the degree of team work, team satisfaction and team performance.

  2. Fabrication of room temperature continuous-wave operation GaN-based ultraviolet laser diodes

    Science.gov (United States)

    Zhao, Degang; Yang, Jing; Liu, Zongshun; Chen, Ping; Zhu, Jianjun; Jiang, Desheng; Shi, Yongsheng; Wang, Hai; Duan, Lihong; Zhang, Liqun; Yang, Hui

    2017-06-01

    Two kinds of continuous-wave GaN-based ultraviolet laser diodes (LDs) operated at room temperature and with different emission wavelengths are demonstrated. The LDs epitaxial layers are grown on GaN substrate by metalorganic chemical vapor deposition, with a 10 × 600 μm2 ridge waveguide structure. The electrical and optical characteristics of the ultraviolet LDs are investigated under direct-current injection at room temperature. The stimulated emission peak wavelength of first LD is 392.9 nm, the threshold current density and voltage is 1.5 kA/cm2 and 5.0 V, respectively. The output light power is 80 mW under the 4.0 kA/cm2 injection current density. The stimulated emission peak wavelength of second LD is 381.9 nm, the threshold current density the voltage is 2.8 kA/cm2 and 5.5 V, respectively. The output light power is 14 mW under a 4.0 kA/cm2 injection current density. Projects the supported by the National Key R&D Program of China (Nos. 2016YFB0401801, 2016YFB0400803), the National Natural Science Foundation of China (Nos. 61674138, 61674139, 61604145, 61574135, 61574134, 61474142, 61474110, 61377020, 61376089), the Science Challenge Project (No. JCKY2016212A503), and the One Hundred Person Project of the Chinese Academy of Sciences.

  3. THE MANAGEMENT MEASURES FOR THE OPERATION QUALITY OF LAMINAR FLOW OPERATING ROOM SYSTEMS SECURITY IN OPERATING ROOM OF THE HOSPITAL%医院手术部层流洁净系统运行质量安全管理措施

    Institute of Scientific and Technical Information of China (English)

    林彬; 李文霞; 李晓花

    2012-01-01

    Objective To observe the operation quality of laminar flow clean system in operating room so as to enhance safety management measures. Methods Through the instrumental analysis and detection methods on the field, the running quality of laminar flow clean system in operating room of this hospital was monitored. Results After the laminar flow system of each level of the operating room and ancillary rooms running for 30 min, the average pass rate of micro - climate of all parts of the indoor environment was more than 98% ; that of precipitating bacterial indicators in the surgical area and the surrounding area of one thousand purification surgery air was more than 97% and that of the subsidence bacteria indicators in the 100 000 - 300 000 clean regional area was 100%. Conclusion The operation quality of laminar flow clean system in operating room of this hospital is reliable and the management is normative. The operating manual should be stricdy executed.%目的 观察医院手术部层流洁净系统运行质量,加强安全管理措施.方法 通过现场仪器分析检测方法,对某医院手术部层流洁净系统运行质量进行了监测.结果 各级别手术室和辅助用房在层流洁净系统运行30min后,所有部位室内环境微小气候平均合格率达到98%以上.1000级手术区和周边区空气中沉降菌指标有97%以上达标;10万至30万级洁净区域沉降菌指标合格率均达到100%.结论 该医院手术部层流洁净系统运行质量可靠,管理规范,主要靠严格执行操作规程.

  4. Advances in operational safety and severe accident research

    Energy Technology Data Exchange (ETDEWEB)

    Simola, K. [VTT Automation (Finland)

    2002-02-01

    A project on reactor safety was carried out as a part of the NKS programme during 1999-2001. The objective of the project was to obtain a shared Nordic view of certain key safety issues related to the operating nuclear power plants in Finland and Sweden. The focus of the project was on selected central aspects of nuclear reactor safety that are of common interest for the Nordic nuclear authorities, utilities and research bodies. The project consisted of three sub-projects. One of them concentrated on the problems related to risk-informed deci- sion making, especially on the uncertainties and incompleteness of probabilistic safety assessments and their impact on the possibilities to use the PSA results in decision making. Another sub-project dealt with questions related to maintenance, such as human and organisational factors in maintenance and maintenance management. The focus of the third sub-project was on severe accidents. This sub-project concentrated on phenomenological studies of hydrogen combustion, formation of organic iodine, and core re-criticality due to molten core coolant interaction in the lower head of reactor vessel. Moreover, the current status of severe accident research and management was reviewed. (au)

  5. 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.

  6. Designing User Interfaces for Smart-Applications for Operating Rooms and Intensive Care Units

    Science.gov (United States)

    Kindsmüller, Martin Christof; Haar, Maral; Schulz, Hannes; Herczeg, Michael

    Today’s physicians and nurses working in operating rooms and intensive care units have to deal with an ever increasing amount of data. More and more medical devices are delivering information, which has to be perceived and interpreted in regard to patient status and the necessity to adjust therapy. The combination of high information load and insufficient usability creates a severe challenge for the health personnel with respect to proper monitoring of these devices respective to acknowledging alarms and timely reaction to critical incidents. Smart Applications are a new kind of decision support systems that incorporate medical expertise in order to help health personnel in regard to diagnosis and therapy. By means of a User Centered Design process of two Smart Applications (anaesthesia monitor display, diagnosis display), we illustrate which approach should be followed and which processes and methods have been successfully applied in fostering the design of usable medical devices.

  7. Augmented-reality visualization in iMRI operating room: system description and preclinical testing

    Science.gov (United States)

    Sauer, Frank; Khamene, Ali; Bascle, Benedicte; Vogt, Sebastian; Rubino, Gregory

    2002-05-01

    We developed an augmented reality system targeting image guidance for surgical procedures. The surgeon wears a video- see-through head mounted display that provides him with a stereo video view of the patient. The live video images are augmented with graphical representations of anatomical structures that are segmented from medical image data. The surgeon can see, e.g., a tumor in its actual location inside the patient. This in-situ visualization, where the computer maps the image information onto the patient, promises the most direct, intuitive guidance for surgical procedures. In this paper, we describe technical details of the system and its installation in UCLA's iMRI operating room. We added instrument tracking to the capabilities of our system to prepare it for minimally invasive procedures. We discuss several pre-clinical phantom experiments that support the potential clinical usefulness of augmented reality guidance.

  8. 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...

  9. Impact of computerized information systems on workload in operating room and intensive care unit.

    Science.gov (United States)

    Bosman, R J

    2009-03-01

    The number of operating rooms and intensive care departments equipped with a clinical information system (CIS) is rapidly expanding. Amongst the putative advantages of such an installation, reduction in workload for the clinician is one of the most appealing. The scarce studies looking at workload variations associated with the implementation of a CIS, only focus on direct workload discarding indirect changes in workload. Descriptions of the various methods to quantify workload are provided. The hypothesis that a third generation CIS can reduce documentation time for ICU nurses and increase time they spend on patient care, is supported by recent literature. Though it seems obvious to extrapolate these advantages of a CIS to the anesthesiology department or physicians in the intensive care, studies examining this assumption are scarce.

  10. Risk Factors for Return to the Operating Room after Resident-Performed Cataract Surgery.

    Science.gov (United States)

    Menda, Shivali A; Driver, Todd H; Neiman, Alexandra E; Blumberg, Seth; Naseri, Ayman; Stewart, Jay M

    2016-09-29

    Investigate risk factors for unplanned return to the operating room after resident-performed cataract surgery. Retrospective case-control study. Institutional. Study population: All patients with reoperation within 90 days of resident-performed phacoemulsification were matched to four control eyes which had surgery within 30 days of the reoperation at the same institution. Billing codes were used to identify all patients who underwent resident-performed intended phacoemulsification with intraocular lens placement from January 2005 to December 2010. Investigated risk factors for reoperation included cataract characteristics and preexisting ocular co-morbidities, including diabetic retinopathy, retinal detachment history, glaucoma, corneal pathology, and uveitis. Additional preoperative risk factors studied included resident training year, history of tamsulosin use, phacodonesis, pupillary dilation, presence of pseudoexfoliation, myopia, history of trauma, visual acuity, and monocular status. Intraoperative variables were the use of iris expansion devices, use of capsular stain, attending type, incision type, use of sutures, vitreous loss, anesthesia type, and phacoemulsification technique. There were 67 returns to the operating room (i.e., cases) over five years that were assigned to 268 control eyes. In preoperative multivariate analysis, phacoemulsification done by a first- or second-year resident (OR 3.2, 95% CI: 1.7-6.0, p risk of reoperation. In postoperative multivariate analysis, only the use of the divide-and-conquer technique (OR 4.0, 95% CI:1.7-9.2, p = 0.001) was associated with an increased risk of reoperation. Phacoemulsification done by a junior resident or using the divide-and-conquer technique had the highest risk of reoperation.

  11. Wearing lead aprons in surgical operating rooms: ergonomic injuries evidenced by infrared thermography.

    Science.gov (United States)

    Alexandre, Dominique; Prieto, Marc; Beaumont, Fabien; Taiar, Redha; Polidori, Guillaume

    2017-03-01

    The purpose of this study is to quantify the impact of the weight of radiation protection lead aprons on the discomfort and the fatigue of the medical staff within an operating room of interventional gastroenterology. To quantify this fatigue, we analyzed variations of the physiological parameters, including heart rate, blood pressure, and cutaneous temperature; we compared two situations: the first within the classic endoscopy department (without apron) and the second within the operating room with apron. A follow-up study with lighter lead aprons was also conducted. We used infrared thermography as the principal method of analysis in our study. This technique permits us to obtain data, without body contact, of the spatial and temporal orientation of temperatures on subject skin. This method proves to be beneficial in the evaluation of the posture of users. The symmetry of the temperature evolution among the different body zones can contribute to the body balance analysis. Our results of the cutaneous temperatures obtained by infrared camera show significant differences in the muscular activity. All the muscular groups studied were revealed significant temperature increases. The temperature curve T2-T1 reveals the actual influence of carrying heavy apron loads. Regardless of the muscular group, this temperature increase varies on the range between 0.55°C and 0.95°C. The muscular groups most recruited are the trapezoids and pectorals. The muscles least recruited are those of the lower limbs. The study shows the impact of load bearing on the body mechanics of medical staff during work. It will be beneficial to develop this study to predict changes in skin temperature because of the various types of aprons and to determine the possible correlation between the thermal distribution and users' sense of comfort. Copyright © 2016 Elsevier Inc. All rights reserved.

  12. 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.

  13. 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.

  14. Influence of the operating room schedule on tardiness from scheduled start times.

    Science.gov (United States)

    Wachtel, Ruth E; Dexter, Franklin

    2009-06-01

    Tardiness from scheduled start times in a surgical suite is a common source of frustration for both operating room personnel and patients. Data from two surgical suites were used to investigate the relative importance of various factors that contribute to tardiness, including average case duration, time of day, prolonged turnovers, whether a surgeon follows himself or another surgeon, the potential for starting cases early, concurrency (e.g., number of residents supervised simultaneously), expected under-utilized or over-utilized time, and case duration bias. Average tardiness per case did not depend on the individual durations of preceding cases or on the relative numbers of long and short cases. In contrast, the total duration of preceding cases was important in determining tardiness. Tardiness per case grew larger as the day progressed because the total duration of preceding cases increased, but began to decline for cases scheduled to commence 6 h after the start of the workday. Tardiness was not affected by prolonged turnovers, differences in average case duration among services, or whether a surgeon followed himself or another surgeon in the same operating room. Tardiness was affected by expected under-utilized or over-utilized time at the end of the workday and by case duration bias. Factors associated with the largest numbers of cases had the biggest influence on tardiness. Greater understanding of these factors aided in the development of several mathematical interventions to reduce tardiness in the two surgical suites. These interventions and their applicability for reducing tardiness are described in a companion article. At two surgical suites, tardiness from scheduled start times did not depend on average case duration or prolonged turnovers. Tardiness did depend on the total duration of preceding cases, expected under-utilized or over-utilized time at the end of the day, and case duration bias.

  15. [Operational units for health risk management (patient safety)].

    Science.gov (United States)

    Pardo Hernández, A; Claveria Fontán, A; García Urbaneja, M; López Barba, J

    2008-12-01

    In 1995 INSALUD began to develop performance measures in the field of risk management, and following transfer of powers to the regions, these led to the development of operational units in individual healthcare centres. These units, which consist of a group of health professionals, including managers, aim to identify, evaluate, analyse and deal with health risks, to enhance patient safety. Their organisational structure can vary in accordance with the needs, resources and philosophy of each individual organisation. This paper presents the experience of the risk management units developed in four Spanish regions: Madrid, the Basque Country, Galicia and INGESA (Ceuta and Melilla). It also includes reflections on assessment of their impact and on their future role in improving safety in healthcare services.

  16. Effects of divided attention and operating room noise on perception of pulse oximeter pitch changes: A laboratory study

    Science.gov (United States)

    Stevenson, Ryan A.; Fellow, Postdoctoral; Schlesinger, Joseph J.; Physician, Resident; Wallace, Mark T.

    2012-01-01

    Background Anesthesiology requires performing visually-oriented procedures while monitoring auditory information about a patient’s vital signs. A concern in operating rooms environments is the amount of competing information and the effects that divided attention have on patient monitoring, such as detecting auditory changes in arterial oxygen saturation via pulse oximetry. Methods We measured the impact of visual attentional load and auditory background noise on the ability of anesthesia residents to monitor the pulse oximeter auditory display in a laboratory setting. Accuracies and response times were recorded reflecting anesthesiologists’ abilities to detect changes in oxygen saturation across three levels of visual attention in quiet and with noise. Results Results show that visual attentional load substantially impacts the ability to detect changes in oxygen saturation levels conveyed by auditory cues signaling 99 and 98% saturation. These effects are compounded by auditory noise, with up to a 17% decline in performance. These deficits are seen in the ability to accurately detect a change in oxygen saturation and in speed of response. Conclusions Most anesthesia accidents are initiated by small errors that cascade into serious events. Lack of monitor vigilance and inattention are two of the more commonly cited factors. Reducing such errors is thus a priority for improving patient safety. Specifically, efforts to reduce distractors and lower background noise should be considered during induction and emergence, periods of especially high risk, when anesthesiologists must attend to many tasks and are thus susceptible to error. PMID:23263015

  17. Operating Room Time Savings with the Use of Splint Packs: A Randomized Controlled Trial

    Directory of Open Access Journals (Sweden)

    Tyler Gonzalez

    2016-01-01

    Full Text Available Background: The most expensive variable in the operating room (OR is time. Lean Process Management is being used in the medical field to improve efficiency in the OR. Streamlining individual processes within the OR is crucial to a comprehensive time saving and cost-cutting health care strategy. At our institution, one hour of OR time costs approximately $500, exclusive of supply and personnel costs. Commercially prepared splint packs (SP contain all components necessary for plaster-of-Paris short-leg splint application and have the potential to decrease splint application time and overall costs by making it a more lean process. We conducted a randomized controlled trial comparing OR time savings between SP use and bulk supply (BS splint application. Methods: Fifty consecutive adult operative patients on whom post-operative short-leg splint immobilization was indicated were randomized to either a control group using BS or an experimental group using SP. One orthopaedic surgeon (EMB prepared and applied all of the splints in a standardized fashion. Retrieval time, preparation time, splint application time, and total splinting time for both groups were measured and statistically analyzed. Results: The retrieval time, preparation time and total splinting time were significantly less (p

  18. Creating impact with operations research in health: making room for practice in academia.

    Science.gov (United States)

    Brandeau, Margaret L

    2016-12-01

    Operations research (OR)-based analyses have the potential to improve decision making for many important, real-world health care problems. However, junior scholars often avoid working on practical applications in health because promotion and tenure processes tend to value theoretical studies more highly than applied studies. This paper discusses the author's experiences in using OR to inform and influence decisions in health and provides a blueprint for junior researchers who wish to find success by taking a similar path. This involves selecting good problems to study, forming productive collaborations with domain experts, developing appropriate models, identifying the most salient results from an analysis, and effectively disseminating findings to decision makers. The paper then suggests how journals, funding agencies, and senior academics can encourage such work by taking a broader and more informed view of the potential role and contributions of OR to solving health care problems. Making room in academia for the application of OR in health follows in the tradition begun by the founders of operations research: to work on important real-world problems where operations research can contribute to better decision making.

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

    Science.gov (United States)

    Kersten-Oertel, Marta; Gerard, Ian; Drouin, Simon; Mok, Kelvin; Sirhan, Denis; Sinclair, David S; Collins, D Louis

    2015-11-01

    The aim of this report is to present a prototype augmented reality (AR) intra-operative brain imaging system. We present our experience of using this new neuronavigation system in neurovascular surgery and discuss the feasibility of this technology for aneurysms, arteriovenous malformations (AVMs), and arteriovenous fistulae (AVFs). We developed an augmented reality system that uses an external camera to capture the live view of the patient on the operating room table and to merge this view with pre-operative volume-rendered vessels. We have extensively tested the system in the laboratory and have used the system in four surgical cases: one aneurysm, two AVMs and one AVF case. The developed AR neuronavigation system allows for precise patient-to-image registration and calibration of the camera, resulting in a well-aligned augmented reality view. Initial results suggest that augmented reality is useful for tailoring craniotomies, localizing vessels of interest, and planning resection corridors. Augmented reality is a promising technology for neurovascular surgery. However, for more complex anomalies such as AVMs and AVFs, better visualization techniques that allow one to distinguish between arteries and veins and determine the absolute depth of a vessel of interest are needed.

  20. Real-time observations of stressful events in the operating room

    Directory of Open Access Journals (Sweden)

    AlNassar Sami

    2012-01-01

    Full Text Available Aim: To identify and quantify factors causing stress in the operating room (OR and evaluate the relationship between these factors and surgeons′ stress level. Methods: This is a prospective observational study from 32 elective surgical procedures conducted in the OR of King Khalid University Hospital, Riyadh, Saudi Arabia. Before each operation, each surgeon was asked of stressors. Two interns observed 16 surgeries each, separately. The interns watched and took notes during the entire surgical procedure. During each operation, the observer recorded anxiety-inducing activities and events that occurred in real time by means of a checklist of 8 potential stressors: technical, patient problems, teamwork problems, time and management issues, distractions and interruptions, equipment problems, personal problems, and teaching. After each operation, surgeons were asked to answer the validated State-Trait Anxiety Inventory questionnaire and self-report on their stress level from the 8 sources using a scale of 1-8 (1: stress free, 8: extremely stressful. The observer also recorded perceived stress levels experienced by the surgeons during the operation. Results: One hundred ten stressors were identified. Technical problems most frequently caused stress (16.4% and personal issues the least often (6.4%. Frequently encountered stressors (teaching and distractions/interruptions caused less stress to the surgeons. Technical factors, teamwork, and equipment problems occurred frequently and were also a major contributor to OR stress. All patients were discharged in good health and within 1 week of surgery. Conclusion: Certain stressful factors do occur among surgeons in the OR and can increase the potential for errors. Further research is required to determine the impact of stress on performance and the outcome of surgery.

  1. Real-time observations of stressful events in the operating room.

    Science.gov (United States)

    Sami, Alnassar; Waseem, Hajjar; Nourah, Alsubaie; Areej, Alhummaid; Afnan, Almarshedi; Ghadeer, Al-Shaikh; Abdulaziz, Alsaif; Arthur, Isnani

    2012-04-01

    To identify and quantify factors causing stress in the operating room (OR) and evaluate the relationship between these factors and surgeons' stress level. This is a prospective observational study from 32 elective surgical procedures conducted in the OR of King Khalid University Hospital, Riyadh, Saudi Arabia. Before each operation, each surgeon was asked of stressors. Two interns observed 16 surgeries each, separately. The interns watched and took notes during the entire surgical procedure. During each operation, the observer recorded anxiety-inducing activities and events that occurred in real time by means of a checklist of 8 potential stressors: technical, patient problems, teamwork problems, time and management issues, distractions and interruptions, equipment problems, personal problems, and teaching. After each operation, surgeons were asked to answer the validated State-Trait Anxiety Inventory questionnaire and self-report on their stress level from the 8 sources using a scale of 1-8 (1: stress free, 8: extremely stressful). The observer also recorded perceived stress levels experienced by the surgeons during the operation. One hundred ten stressors were identified. Technical problems most frequently caused stress (16.4%) and personal issues the least often (6.4%). Frequently encountered stressors (teaching and distractions/interruptions) caused less stress to the surgeons. Technical factors, teamwork, and equipment problems occurred frequently and were also a major contributor to OR stress. All patients were discharged in good health and within 1 week of surgery. Certain stressful factors do occur among surgeons in the OR and can increase the potential for errors. Further research is required to determine the impact of stress on performance and the outcome of surgery.

  2. Room-temperature continuous-wave operation of Ti:sapphire buried channel-waveguide lasers fabricated via proton implantation

    NARCIS (Netherlands)

    Grivas, C.; Shepherd, D.P.; Eason, R.W.; Laversenne, L.; Moretti, P.; Borca, C.N.; Pollnau, M.

    2006-01-01

    Fabrication and laser operation of proton-implanted Ti:sapphire buried channel waveguides is reported for the first time to our knowledge. Without any postimplantation annealing of the structures, continuous laser operation near 780 nm was demonstrated at room temperature at an absorbed pump power t

  3. Defining the optimal time to the operating room may salvage early trauma deaths.

    Science.gov (United States)

    Remick, Kyle N; Schwab, C William; Smith, Brian P; Monshizadeh, Amir; Kim, Patrick K; Reilly, Patrick M

    2014-05-01

    Early trauma deaths have the potential for salvage with immediate surgery. We studied time from injury to death in this group to qualify characteristics and quantify time to the operating room, yielding the greatest opportunity for salvage. The Pennsylvania Trauma Outcomes Study (PTOS) is a comprehensive registry including all Pennsylvania trauma centers. PTOS was queried for adult trauma patients from 1999 to 2010 dying within 4 hours of injury. The distribution of time to death (TD) was examined for subgroups according to mechanism of injury, hypotension (defined as systolic blood pressure ≤ 90 mm Hg), and operation required. The 5th percentile (TD5) and the 50th percentile (TD50) were calculated from the distributions and compared using the Mann-Whitney U-test. The PTOS yielded 6,547 deaths within 4 hours of injury. The overall TD5 and TD50 were 0:23 (hour:minute) and 0:59, respectively. Median penetrating injury times were significantly shorter than blunt injury times (TD5/TD50, 0:19/0:43 vs. 0:29/1:10). Median time was significantly shorter for hypotensive versus normotensive patients (TD5/TD50, 0:22/0:52 vs. 0:43/2:18). Operative subgroups had different TD5/TD50 (abdominal surgery [n = 607], 1:07/2:26; thoracic surgery [n = 756] 0:25/1:25; vascular surgery [n = 156], 0:35/2:15; and cranial surgery [n = 18], 1:20/2:42). Early trauma deaths have the potential for salvage with immediate surgery. We found TD to vary based on mechanism of injury, presence of hypotension, and type of surgery needed. With the use of TD5 and TD50 benchmarks in these subgroups, a trauma system may determine if decreased time to the operating room decreases mortality. Trauma systems can use these data to further improve prehospital and initial hospital phases of care for this subset of early death trauma patients. Epidemiologic study, level III.

  4. 75 FR 56972 - Pipeline Safety: Control Room Management/Human Factors

    Science.gov (United States)

    2010-09-17

    ..., except for certain provisions regarding adequate information and alarm management, which would have a... must implement methods to reduce the risk associated with controller fatigue. In addition, certain... also manage alarms, assure control room considerations are taken into account when changing pipeline...

  5. Cyber Safety and Security for Reduced Crew Operations (RCO)

    Science.gov (United States)

    Driscoll, Kevin R.; Roy, Aloke; Ponchak, Denise S.; Downey, Alan N.

    2017-01-01

    NASA and the Aviation Industry is looking into reduced crew operations (RCO) that would cut today's required two-person flight crews down to a single pilot with support from ground-based crews. Shared responsibility across air and ground personnel will require highly reliable and secure data communication and supporting automation, which will be safety-critical for passenger and cargo aircraft. This paper looks at the different types and degrees of authority delegation given from the air to the ground and the ramifications of each, including the safety and security hazards introduced, the mitigation mechanisms for these hazards, and other demands on an RCO system architecture which would be highly invasive into (almost) all safety-critical avionics. The adjacent fields of unmanned aerial systems and autonomous ground vehicles are viewed to find problems that RCO may face and related aviation accident scenarios are described. The paper explores possible data communication architectures to meet stringent performance and information security (INFOSEC) requirements of RCO. Subsequently, potential challenges for RCO data communication authentication, encryption and non-repudiation are identified.

  6. Safety analysis, 200 Area, Savannah River Plant: Separations area operations

    Energy Technology Data Exchange (ETDEWEB)

    Perkins, W.C.; Lee, R.; Allen, P.M.; Gouge, A.P.

    1991-07-01

    The nev HB-Line, located on the fifth and sixth levels of Building 221-H, is designed to replace the aging existing HB-Line production facility. The nev HB-Line consists of three separate facilities: the Scrap Recovery Facility, the Neptunium Oxide Facility, and the Plutonium Oxide Facility. There are three separate safety analyses for the nev HB-Line, one for each of the three facilities. These are issued as supplements to the 200-Area Safety Analysis (DPSTSA-200-10). These supplements are numbered as Sup 2A, Scrap Recovery Facility, Sup 2B, Neptunium Oxide Facility, Sup 2C, Plutonium Oxide Facility. The subject of this safety analysis, the, Plutonium Oxide Facility, will convert nitrate solutions of {sup 238}Pu to plutonium oxide (PuO{sub 2}) powder. All these new facilities incorporate improvements in: (1) engineered barriers to contain contamination, (2) barriers to minimize personnel exposure to airborne contamination, (3) shielding and remote operations to decrease radiation exposure, and (4) equipment and ventilation design to provide flexibility and improved process performance.

  7. Development of efficiency indicators of operating room management for multi-institutional comparisons.

    Science.gov (United States)

    Tanaka, Masayuki; Lee, Jason; Ikai, Hiroshi; Imanaka, Yuichi

    2013-04-01

    The efficiency of a hospital's operating room (OR) management can affect its overall profitability. However, existing indicators that assess OR management efficiency do not take into account differences in hospital size, manpower and functional characteristics, thereby rendering them unsuitable for multi-institutional comparisons. The aim of this study was to develop indicators of OR management efficiency that would take into account differences in hospital size and manpower, which may then be applied to multi-institutional comparisons. Using administrative data from 224 hospitals in Japan from 2008 to 2010, we performed four multiple linear regression analyses at the hospital level, in which the dependent variables were the number of operations per OR per month, procedural fees per OR per month, total utilization times per OR per month and total fees per OR per month for each of the models. The expected values of these four indicators were produced using multiple regression analysis results, adjusting for differences in hospital size and manpower, which are beyond the control of process owners' management. However, more than half of the variations in three of these four indicators were shown to be explained by differences in hospital size and manpower. Using the ratio of observed to expected values (OE ratio), as well as the difference between the two values (OE difference) allows hospitals to identify weaknesses in efficiency with more validity when compared to unadjusted indicators. The new indicators may support the improvement and sustainment of a high-quality health care system. © 2012 Blackwell Publishing Ltd.

  8. [Unexpected atrial fibrillation when monitoring in operating room. Case of the trimester].

    Science.gov (United States)

    2014-05-01

    A real case reported to the SENSAR database of incidents is presented. In a patient scheduled for nose fracture repair surgery an unexpected atrial fibrillation was found when monitored in the operating room. The operation was not delayed. After induction of general anaesthesia heart rate suddenly increased and hemodinamic situation was impaired. Cardioversion was required. Two electric countershocks were given but sinus rhythm was not restored. Heart rate was controlled with amiodarone infusion. Optimal defibrillation characteristics are described in these cases. Increased risk of thromboembolism (1-2%) following cardioversion is present even if atrial thrombi are ruled out. The mainstay therapies of are rhythm and rate control and prevention of thromboembolic complications. We describe recommendations on the management of these critical situations with emphasis in learning through the creation of protocols and training practice in simulation. Copyright © 2013 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Published by Elsevier España. All rights reserved.

  9. Telementoring systems in the operating room: a new approach in medical training

    Directory of Open Access Journals (Sweden)

    Juan P. Wachs

    2013-12-01

    Full Text Available This paper discusses the challenges and innovations related to the use of telementoring systems in the operating room. Most of the systems presented leverage on three types of interaction channels: audio, visual and physical. The audio channel enables the mentor to verbally instruct the trainee, and allows the trainee to ask questions. The visual channel is used to deliver annotations, alerts and other messages graphically to the trainee during the surgery. These visual representations are often displayed through a telestrator. The physical channel has been used in laparoscopic procedures by partially controlling the laparoscope through force-feedback. While in face to face instruction, the mentor produces gestures to convey certain aspects of the surgical instruction, there is not equivalent of this form of physical interaction between the mentor and trainee in open surgical procedures in telementoring systems. Even that the trend is to perform more minimally invasive surgery (MIS, trauma surgeries are still necessary, where initial resuscitation and stabilization of the patient in a timely manner is crucial. This paper presents a preliminary study conducted at the Indiana University Medical School and Purdue University, where initial lexicons of surgical instructive gestures (SIGs were determined through systematic observation when mentor and trainee operate together. The paper concludes with potential ways to convey gestural information through surgical robots.

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

    Science.gov (United States)

    Thomsen, Ann Sofia Skou; Bach-Holm, Daniella; Kjærbo, Hadi; Højgaard-Olsen, Klavs; Subhi, Yousif; Saleh, George M; Park, Yoon Soo; la Cour, Morten; Konge, Lars

    2017-04-01

    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. Multicenter masked clinical trial. Eighteen cataract surgeons with different levels of experience. Cataract surgical training on a virtual reality simulator (EyeSi) until a proficiency-based test was passed. 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. Novices (non-independently operating surgeons) and surgeons having performed fewer than 75 independent cataract surgeries showed significant improvements in the OR-32% and 38%, respectively-after virtual reality training (P = 0.008 and P = 0.018). More experienced cataract surgeons did not benefit from simulator training. The reliability of the assessments was high with a generalizability coefficient of 0.92 and 0.86 before and after the virtual reality training, respectively. Clinically relevant cataract surgical skills can be improved by proficiency-based training on a virtual reality simulator. Novices as well as surgeons with an intermediate level of experience showed improvement in OR performance score. Copyright © 2017 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

  11. Telementoring systems in the operating room: a new approach in medical training.

    Science.gov (United States)

    Wachs, Juan P; Gomez, Gerardo

    2013-01-01

    This paper discusses the challenges and innovations related to the use of telementoring systems in the operating room. Most of the systems presented leverage on three types of interaction channels: audio, visual and physical. The audio channel enables the mentor to verbally instruct the trainee, and allows the trainee to ask questions. The visual channel is used to deliver annotations, alerts and other messages graphically to the trainee during the surgery. These visual representations are often displayed through a telestrator. The physical channel has been used in laparoscopic procedures by partially controlling the laparoscope through force-feedback. While in face to face instruction, the mentor produces gestures to convey certain aspects of the surgical instruction, there is not equivalent of this form of physical interaction between the mentor and trainee in open surgical procedures in telementoring systems. Even that the trend is to perform more minimally invasive surgery (MIS), trauma surgeries are still necessary, where initial resuscitation and stabilization of the patient in a timely manner is crucial. This paper presents a preliminary study conducted at the Indiana University Medical School and Purdue University, where initial lexicons of surgical instructive gestures (SIGs) were determined through systematic observation when mentor and trainee operate together. The paper concludes with potential ways to convey gestural information through surgical robots.

  12. Above room temperature continuous wave operation of a broad-area quantum-cascade laser

    Science.gov (United States)

    Semtsiv, M. P.; Masselink, W. T.

    2016-11-01

    We describe the design and implementation of a broad-area (w ≈ 30 μm) quantum-cascade laser operating in a continuous wave mode up to heat-sink temperatures beyond +100 °C. The room-temperature emission wavelength is 4.6 μm. The temperature gradient in the active region of such a wide laser stripe is essentially perpendicular to the epitaxial layers and the resulting steady-state active region temperature offset scales approximately with the square of the number of cascades. With only 10 cascades in the active region, the threshold electrical power density in the current quantum-cascade laser in the continuous-wave mode is as low as Vth × Ith = 3.8 V × 0.9 kA/cm2 = 3.4 kW/cm2 at room temperature for 2 mm-long two-side high-reflectivity coated laser stripe. A 4 mm-long one-side high-reflectivity coated laser stripe delivers in continuous-wave mode above 0.6 W at +20 °C and above 1.3 W at -27 °C (cooled with a single-stage Peltier element). A 2 mm-long two-side high-reflectivity coated laser stripe demonstrates continuous-wave lasing up to at least +102 °C (375 K). The thermal conductance, Gth, ranges between 235 W/K cm2 and 140 W/K cm2 for temperatures between -33 °C and +102 °C. This demonstration opens the route for continuous-wave power scaling of quantum-cascade lasers via broad-area laser ridges.

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

    Science.gov (United States)

    Read-Brown, Sarah; Sanders, David S; Brown, Anna S; Yackel, Thomas R; Choi, Dongseok; Tu, Daniel C; Chiang, Michael F

    2013-01-01

    Efficiency and quality of documentation are critical in surgical settings because operating rooms are a major source of revenue, and because adverse events may have enormous consequences. Electronic health records (EHRs) have potential to impact surgical volume, quality, and documentation time. Ophthalmology is an ideal domain to examine these issues because procedures are high-throughput and demand efficient documentation. This time-motion study examines nursing documentation during implementation of an EHR operating room management system in an ophthalmology department. Key findings are: (1) EHR nursing documentation time was significantly worse during early implementation, but improved to a level near but slightly worse than paper baseline, (2) Mean documentation time varied significantly among nurses during early implementation, and (3) There was no decrease in operating room turnover time or surgical volume after implementation. These findings have important implications for ambulatory surgery departments planning EHR implementation, and for research in system design.

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

    Science.gov (United States)

    Basques, Bryce A; Golinvaux, Nicholas S; Bohl, Daniel D; Yacob, Alem; Toy, Jason O; Varthi, Arya G; Grauer, Jonathan N

    2014-10-15

    Retrospective database review. To evaluate whether microscope use during spine procedures is associated with increased operating room times or increased risk of infection. Operating microscopes are commonly used in spine procedures. It is debated whether the use of an operating microscope increases operating room time or confers increased risk of infection. The American College of Surgeons National Surgical Quality Improvement Program database, which includes data from more than 370 participating hospitals, was used to identify patients undergoing elective spinal procedures with and without the use of an operating microscope for the years 2011 and 2012. Bivariate and multivariate linear regressions were used to test the association between microscope use and operating room times. Bivariate and multivariate logistic regressions were similarly conducted to test the association between microscope use and infection occurrence within 30 days of surgery. A total of 23,670 elective spine procedures were identified, of which 2226 (9.4%) used an operating microscope. The average patient age was 55.1±14.4 years. The average operative time (incision to closure) was 125.7±82.0 minutes.Microscope use was associated with minor increases in preoperative room time (+2.9 min, P=0.013), operative time (+13.2 min, Pmicroscope and nonmicroscope groups for occurrence of any infection, superficial surgical site infection, deep surgical site infection, organ space infection, or sepsis/septic shock, regardless of surgery type. We did not find operating room times or infection risk to be significant deterrents for use of an operating microscope during spine surgery. 3.

  15. Impact of an electronic health record operating room management system in ophthalmology on documentation time, surgical volume, and staffing.

    Science.gov (United States)

    Sanders, David S; Read-Brown, Sarah; Tu, Daniel C; Lambert, William E; Choi, Dongseok; Almario, Bella M; Yackel, Thomas R; Brown, Anna S; Chiang, Michael F

    2014-05-01

    Although electronic health record (EHR) systems have potential benefits, such as improved safety and quality of care, most ophthalmology practices in the United States have not adopted these systems. Concerns persist regarding potential negative impacts on clinical workflow. In particular, the impact of EHR operating room (OR) management systems on clinical efficiency in the ophthalmic surgery setting is unknown. To determine the impact of an EHR OR management system on intraoperative nursing documentation time, surgical volume, and staffing requirements. For documentation time and circulating nurses per procedure, a prospective cohort design was used between January 10, 2012, and January 10, 2013. For surgical volume and overall staffing requirements, a case series design was used between January 29, 2011, and January 28, 2013. This study involved ophthalmic OR nurses (n = 13) and surgeons (n = 25) at an academic medical center. Electronic health record OR management system implementation. (1) Documentation time (percentage of operating time documenting [POTD], absolute documentation time in minutes), (2) surgical volume (procedures/time), and (3) staffing requirements (full-time equivalents, circulating nurses/procedure). Outcomes were measured during a baseline period when paper documentation was used and during the early (first 3 months) and late (4-12 months) periods after EHR implementation. There was a worsening in total POTD in the early EHR period (83%) vs paper baseline (41%) (P system implementation was associated with worsening of intraoperative nursing documentation time especially in shorter procedures. However, it is possible to implement an EHR OR management system without serious negative impacts on surgical volume and staffing requirements.

  16. Safety approaches for high power modular laser operation

    Science.gov (United States)

    Handren, R. T.

    1993-03-01

    Approximately 20 years ago, a program was initiated at the Lawrence Livermore National Laboratory (LLNL) to study the feasibility of using lasers to separate isotopes of uranium and other materials. Of particular interest was the development of a uranium enrichment method for the production of commercial nuclear power reactor fuel to replace current more expensive methods. The Uranium Atomic Vapor Laser Isotope Separation (U-AVLIS) Program progressed to the point where a plant-scale facility to demonstrate commercial feasibility was built and is being tested. The U-AVLIS Program uses copper vapor lasers which pump frequency selective dye lasers to photoionize uranium vapor produced by an electron beam. The selectively ionized isotopes are electrostatically collected. The copper lasers are arranged in oscillator/amplifier chains. The current configuration consists of 12 chains, each with a nominal output of 800 W for a system output in excess of 9 kW. The system requirements are for continuous operation (24 h a day, 7 days a week) and high availability. To meet these requirements, the lasers are designed in a modular form allowing for rapid change-out of the lasers requiring maintenance. Since beginning operation in early 1985, the copper lasers have accumulated over 2 million unit hours at a greater than 90% availability. The dye laser system provides approximately 2.5 kW average power in the visible wavelength range. This large-scale laser system has many safety considerations, including high-power laser beams, high voltage, and large quantities (approximately 3000 gal) of ethanol dye solutions. The Laboratory's safety policy requires that safety controls be designed into any process, equipment, or apparatus in the form of engineering controls. Administrative controls further reduce the risk to an acceptable level. Selected examples of engineering and administrative controls currently being used in the U-AVLIS Program are described.

  17. Framework for Integrating Safety, Operations, Security, and Safeguards in the Design and Operation of Nuclear Facilities

    Energy Technology Data Exchange (ETDEWEB)

    Darby, John L. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Horak, Karl Emanuel [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); LaChance, Jeffrey L. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Tolk, Keith Michael [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Whitehead, Donnie Wayne [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    2007-10-01

    The US is currently on the brink of a nuclear renaissance that will result in near-term construction of new nuclear power plants. In addition, the Department of Energy’s (DOE) ambitious new Global Nuclear Energy Partnership (GNEP) program includes facilities for reprocessing spent nuclear fuel and reactors for transmuting safeguards material. The use of nuclear power and material has inherent safety, security, and safeguards (SSS) concerns that can impact the operation of the facilities. Recent concern over terrorist attacks and nuclear proliferation led to an increased emphasis on security and safeguard issues as well as the more traditional safety emphasis. To meet both domestic and international requirements, nuclear facilities include specific SSS measures that are identified and evaluated through the use of detailed analysis techniques. In the past, these individual assessments have not been integrated, which led to inefficient and costly design and operational requirements. This report provides a framework for a new paradigm where safety, operations, security, and safeguards (SOSS) are integrated into the design and operation of a new facility to decrease cost and increase effectiveness. Although the focus of this framework is on new nuclear facilities, most of the concepts could be applied to any new, high-risk facility.

  18. JET-ISX-B beryllium limiter experiment safety analysis report and operational safety requirements

    Energy Technology Data Exchange (ETDEWEB)

    Edmonds, P.H.

    1985-09-01

    An experiment to evaluate the suitability of beryllium as a limiter material has been completed on the ISX-B tokamak. The experiment consisted of two phases: (1) the initial operation and characterization in the ISX experiment, and a period of continued operation to the specified surface fluence (10/sup 22/ atoms/cm/sup 2/) of hydrogen ions; and (2) the disassembly, decontamination, or disposal of the ISX facility. During these two phases of the project, the possibility existed for beryllium and/or beryllium oxide powder to be produced inside the vacuum vessel. Beryllium dust is a highly toxic material, and extensive precautions are required to prevent the release of the beryllium into the experimental work area and to prevent the contamination of personnel working on the device. Details of the health hazards associated with beryllium and the appropriate precautions are presented. Also described in appendixes to this report are the various operational safety requirements for the project.

  19. 手术室巡回护士的护理工作%Operating Room Nurses Tour of Nursing Work

    Institute of Scientific and Technical Information of China (English)

    李安祥

    2015-01-01

    the operating room is the place that provide patients with surgery and rescue,is an important technology of the hospital departments.operating room should have with different surgery department,but also with the guard room,anesthesia recovery room in the blood bank,etc.Pays special attention to the incision infection management of four ways, namely:the operating room air, the items needed for the operation,the ifngers of the doctors and nurses and the patient’s skin,prevent infection,to ensure the success rate of surgery.request reasonable design, equipment is well-found,the nurses work is responsive,quick,efifcient work efifciency.Patients into the operating room nursing work to be done by a visiting nurse.%手术室是为病人提供手术及抢救的场所,是医院的重要技术部门。手术室应与手术科室相接连,还要与血库、临护室、麻醉复苏室等临近。抓好手术切口感染四条途径的环节管理,即:手术室的空气、手术所需的物品、医生护士的手指及病人的皮肤,防止感染,确保手术成功率。要求设计合理,设备齐全,护士工作反应灵敏、快捷,有高效的工作效率。患者进入手术室的护理工作由巡回护士完成。

  20. Photodetector development at Fraunhofer IAF: From LWIR to SWIR operating from cryogenic close to room temperature

    Science.gov (United States)

    Daumer, V.; Gramich, V.; Müller, R.; Schmidt, J.; Rutz, F.; Stadelmann, T.; Wörl, A.; Rehm, R.

    2017-02-01

    Photodetectors in the non-visible region of the electromagnetic spectrum are essential for security, defense and space science as well as industrial and scientific applications. The research activities at Fraunhofer IAF cover a broad range in the infrared (IR) regime. Whereas short-wavelength IR (SWIR, <1.7 μm) detectors are realized by InGaAs/InP structures, InAs/GaSb type-II superlattice (T2SL) infrared detectors are developed for the spectral bands from mid- (MWIR, 3-5 μm) to long-wavelength IR (LWIR, 8-12 μm). We report on the extension of the superlattice empirical pseudopotential method (SEPM) to 300 K for the design of LWIR heterostructures for operation near room temperature. Recently, we have also adapted heterostructure concepts to our well established bi-spectral T2SL MWIR detector resulting in a dark current density below 2 × 10-9 A/cm2 for a cut-off wavelength close to 5 μm. Finally, we present first results obtained with a gated viewing system based on our InGaAs/InAlAs/InP avalanche photodiode arrays.

  1. Implementation of a preoperative briefing protocol improves accuracy of teamwork assessment in the operating room.

    Science.gov (United States)

    Paige, John T; Aaron, Deborah L; Yang, Tong; Howell, D Shannon; Hilton, Charles W; Cohn, Isidore; Chauvin, Sheila W

    2008-09-01

    This study examined the effect of implementing a new preoperative briefing protocol on self- and peer-assessments of individual operating room (OR) teamwork behaviors. From July 2006 to February 2007, OR teamwork performance at a rural community hospital was evaluated before and after training and implementation of the protocol. After each case, every member on the team completed a 360-degree type teamwork behavior evaluation containing both self- and peer-assessments using a six-point Likert type scale (1 = definitely no to 6 = definitely yes). Individual behavior change was measured using the mean scale score of pre and postprotocol assessments. Statistical analysis included t test for both pre/post and self/peer differences. Data were available for one general surgeon and nine OR staff (pre = 20 cases, post = 16 cases). The preprotocol self-assessment mean score was significantly higher than peer-assessment (5.63 vs 5.29, P teamwork behaviors. No difference was observed in postassessment mean scores for self- and peer-assessments. Individuals overestimated their teamwork behaviors before protocol implementation. Using a preoperative protocol seems to improve OR staff teamwork behaviors and self-assessment accuracy. The use of a 360-degree assessment method targeting specific, observable behaviors may be useful in evaluating team-based interventions and enhancing teamwork effectiveness.

  2. Obesity increases operating room times in patients undergoing primary hip arthroplasty: a retrospective cohort analysis.

    Science.gov (United States)

    Kadry, Bassam; Press, Christopher D; Alosh, Hassan; Opper, Isaac M; Orsini, Joe; Popov, Igor A; Brodsky, Jay B; Macario, Alex

    2014-01-01

    Background. Obesity impacts utilization of healthcare resources. The goal of this study was to measure the relationship between increasing body mass index (BMI) in patients undergoing total hip arthroplasty (THA) with different components of operating room (OR) time. Methods. The Stanford Translational Research Integrated Database Environment (STRIDE) was utilized to identify all ASA PS 2 or 3 patients who underwent primary THA at Stanford Medical Center from February 1, 2008 through January 1, 2013. Patients were divided into five groups based on the BMI weight classification. Regression analysis was used to quantify relationships between BMI and the different components of total OR time. Results. 1,332 patients were included in the study. There were no statistically significant differences in age, gender, height, and ASA PS classification between the BMI groups. Normal-weight patients had a total OR time of 138.9 min compared 167.9 min (P 35 kg/m(2) each incremental BMI unit increase was associated with greater incremental total OR time increases. Conclusion. Morbidly obese patients required significantly more total OR time than normal-weight patients undergoing a THA procedure. This increase in time is relevant when scheduling obese patients for surgery and has an important impact on health resource utilization.

  3. Obesity increases operating room times in patients undergoing primary hip arthroplasty: a retrospective cohort analysis

    Directory of Open Access Journals (Sweden)

    Bassam Kadry

    2014-08-01

    Full Text Available Background. Obesity impacts utilization of healthcare resources. The goal of this study was to measure the relationship between increasing body mass index (BMI in patients undergoing total hip arthroplasty (THA with different components of operating room (OR time. Methods. The Stanford Translational Research Integrated Database Environment (STRIDE was utilized to identify all ASA PS 2 or 3 patients who underwent primary THA at Stanford Medical Center from February 1, 2008 through January 1, 2013. Patients were divided into five groups based on the BMI weight classification. Regression analysis was used to quantify relationships between BMI and the different components of total OR time. Results. 1,332 patients were included in the study. There were no statistically significant differences in age, gender, height, and ASA PS classification between the BMI groups. Normal-weight patients had a total OR time of 138.9 min compared 167.9 min (P 35 kg/m2 each incremental BMI unit increase was associated with greater incremental total OR time increases. Conclusion. Morbidly obese patients required significantly more total OR time than normal-weight patients undergoing a THA procedure. This increase in time is relevant when scheduling obese patients for surgery and has an important impact on health resource utilization.

  4. [Evaluation of Radiation Dose during Stent-graft Treatment Using a Hybrid Operating Room System].

    Science.gov (United States)

    Haga, Yoshihiro; Chida, Kouichi; Kaga, Yuji; Saitou, Kazuhisa; Arai, Takeshi; Suzuki, Shinichi; Iwaya, Yoshimi; Kumasaka, Eriko; Kataoka, Nozomi; Satou, Naoto; Abe, Mitsuya

    2015-12-01

    In recent years, aortic aneurysm treatment with stent graft grafting in the X-ray fluoroscopy is increasing. This is an endovascular therapy, because it is a treatment which includes the risk of radiation damage, having to deal with radiation damage, to know in advance is important. In this study, in order to grasp the trend of exposure stent graft implantation in a hybrid operating room (OR) system, focusing on clinical data (entrance skin dose and fluoroscopy time), was to count the total. In TEVAR and EVAR, fluoroscopy time became 13.40 ± 7.27 minutes, 23.67 ± 11.76 minutes, ESD became 0.87 ± 0.41 mGy, 1.11 ± 0.57 mGy. (fluoroscopy time of EVAR was 2.0 times than TEVAR. DAP of EVAR was 1.2 times than TEVAR.) When using the device, adapted lesions and usage are different. This means that care changes in exposure-related factors. In this study, exposure trends of the stent graft implantation was able to grasp. It can be a helpful way to reduce/optimize the radiation dose in a hybrid OR system.

  5. The effects of general anesthesia legislation on operating room visits by preschool children undergoing dental treatment.

    Science.gov (United States)

    White, Halley R; Lee, Jessica Y; Rozier, R Gary

    2008-01-01

    The purpose of this study was to examine the impact of state-level general anesthesia (GA) legislation on operating room visits for the treatment of dental caries on preschool-aged children. The North Carolina Ambulatory Surgery Discharge Database was used to observe GA visits for fiscal years (FY) 1997 to 2001. A pretest/post-test design with concurrent comparison groups was used for 2 analyses: (1) all children treated for dental caries were compared to those treated for otitis media; and (2) those whose treatment for dental caries was reimbursed by Medicaid were compared to those whose treatment for dental caries was not reimbursed by Medicaid. In the prelegislation period (FY 1997 and 1998), there were 3,857 GA visits for dental core and 21,038 for otitis media. Postlegislation (FY 2000 and 2001) dental visits increased to 5,511(43%), and otitis media visits increased to 22,279 (6%)-a statistically significant difference (Pdental visits and 2,487 Medicaid dental visits. Non-Medicaid and Medicaid dental visits postlegislation increased to 2,195 (60%) and 3,316 (33%), respectively. This difference was significant (Panesthesia legislation resulted in an increase in access to care for children needing dental care in North Carolina.

  6. [Who is suited as operation room manager? Evaluation process for hospitals and candidates].

    Science.gov (United States)

    Schüpfer, G; Bauer, M

    2011-03-01

    Operation room (OR) management is not an end in itself. The challenge is more to organize the complex, inhomogeneous and interference-prone machinery of intraoperative service provision according to business objectives. Although business objectives may differ in some details the ultimate consequence is always to assure the quality of medical care along with adhering to the general economic conditions. The narrower the economic framework the smaller the company's tolerance to unprofessional OR management. Consequently, it can be noticed that OR management has become of age. An internal socialization as frontline leader is no longer sufficient for taking over a job profile which, regarding the risks of revenues and costs belongs to the top management of a company. Prior to looking for a future OR manager it is mandatory to develop a profile of qualifications tailored to the company. In the following selection process the important thing is to identify the candidate who fits best to the developed profile. This paper sees itself as an assistance in the development of such a company-specific qualification profile for an OR manager. On the basis of knowledge, skills and characteristics, different manager typologies are developed, facilitating the successful evaluation in a selection process for both the company and the candidate.

  7. Improving operating room efficiency by applying bin-packing and portfolio techniques to surgical case scheduling.

    Science.gov (United States)

    Van Houdenhoven, Mark; van Oostrum, Jeroen M; Hans, Erwin W; Wullink, Gerhard; Kazemier, Geert

    2007-09-01

    An operating room (OR) department has adopted an efficient business model and subsequently investigated how efficiency could be further improved. The aim of this study is to show the efficiency improvement of lowering organizational barriers and applying advanced mathematical techniques. We applied advanced mathematical algorithms in combination with scenarios that model relaxation of various organizational barriers using prospectively collected data. The setting is the main inpatient OR department of a university hospital, which sets its surgical case schedules 2 wk in advance using a block planning method. The main outcome measures are the number of freed OR blocks and OR utilization. Lowering organizational barriers and applying mathematical algorithms can yield a 4.5% point increase in OR utilization (95% confidence interval 4.0%-5.0%). This is obtained by reducing the total required OR time. Efficient OR departments can further improve their efficiency. The paper shows that a radical cultural change that comprises the use of mathematical algorithms and lowering organizational barriers improves OR utilization.

  8. The Effect of Instructional Supervision by an Operating Room Assistant on First-Case Starts.

    Science.gov (United States)

    Pan, Xiaohua; Zhang, Jun; Dai, Chen; Si, Yibing

    2017-02-01

    Delays in starting first cases of the day are a common topic associated with high economic costs. This study aimed to determine if an operating room (OR) assistant using an instructional supervision program could reduce the tardiness of first-case starts. A prospective study was conducted. Data from four ORs were used to compare the effectiveness of an instructional intervention to reduce delays in starting first cases of the day. The first cases in two ORs received instructional supervision by an OR. The primary endpoint was the percentage of first cases that started on time. Other endpoints were the percentage of the team work score of OR staff and the percentage of patient satisfaction score. Over 48 weeks, the effect of instructional supervision was evaluated in 960 first-case starts. In the instructional supervision group (n = 480), the percentage of first cases that started on time increased significantly (92.1% vs 71.7%; P < .001), and there was a higher percentage of the team work score (84.4% vs 76.7%; P < .01) and patient satisfaction score (88.3% vs 79.4%; P < .001). Instructional supervision by an OR assistant can make a potential improvement in our on-time first-case starts per day. Copyright © 2016 American Society of PeriAnesthesia Nurses. Published by Elsevier Inc. All rights reserved.

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

    Science.gov (United States)

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

    2017-08-23

    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 process data in Germany. Panel regression modelling was applied. Results revealed no clear and univocal trend of participation in a benchmarking and reporting program for surgical process data. The largest trend was observed for first-case tardiness. In contrast to expectations, turnover times showed a generally increasing trend during participation. For raw utilization no clear and statistically significant trend could be evidenced. Subgroup analyses revealed differences in effects across different hospital types and department specialties. Participation in a benchmarking and reporting program and thus 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 of OR efficiency in German hospitals and could have meaningful consequences for the medium- and long-run capacity planning in the OR.

  10. Music and ambient operating room noise in patients undergoing spinal anesthesia.

    Science.gov (United States)

    Ayoub, Chakib M; Rizk, Laudi B; Yaacoub, Chadi I; Gaal, Dorothy; Kain, Zeev N

    2005-05-01

    Previous studies have indicated that music decreases intraoperative sedative requirements in patients undergoing surgical procedures under regional anesthesia. In this study we sought to determine whether this decrease in sedative requirements results from music or from eliminating operating room (OR) noise. A secondary aim of the study was to examine the relationship of response to intraoperative music and participants' culture (i.e., American versus Lebanese). Eighty adults (36 American and 54 Lebanese) undergoing urological procedures with spinal anesthesia and patient-controlled IV propofol sedation were randomly assigned to intraoperative music, white noise, or OR noise. We found that, controlling for ambient OR noise, intraoperative music decreases propofol requirements (0.004 +/- 0.002 mg . kg(-1) . min(-1) versus 0.014 +/- 0.004 mg . kg(-1) . min(-1) versus 0.012 +/- 0.002 mg . kg(-1) . min(-1); P = 0.026). We also found that, regardless of group assignment, Lebanese patients used less propofol as compared with American patients (0.005 +/- 0.001 mg . kg(-1) . min(-1) versus 0.017 +/- 0.003 mg . kg(-1) . min(-1); P = 0.001) and that, in both sites, patients in the music group required less propofol (P noise, intraoperative music decreases propofol requirements of both Lebanese and American patients who undergo urological surgery under spinal anesthesia.

  11. Surgical clothing systems in laminar airflow operating room: a numerical assessment.

    Science.gov (United States)

    Sadrizadeh, Sasan; Holmberg, Sture

    2014-01-01

    This study compared two different laminar airflow distribution strategies - horizontal and vertical - and investigated the effectiveness of both ventilation systems in terms of reducing the sedimentation and distribution of bacteria-carrying particles. Three different staff clothing systems, which resulted in source strengths of 1.5, 4 and 5 CFU/s per person, were considered. The exploration was conducted numerically using a computational fluid dynamics technique. Active and passive air sampling methods were simulated in addition to recovery tests, and the results were compared. Model validation was performed through comparisons with measurement data from the published literature. The recovery test yielded a value of 8.1 min for the horizontal ventilation scenario and 11.9 min for the vertical ventilation system. Fewer particles were captured by the slit sampler and in sedimentation areas with the horizontal ventilation system. The simulated results revealed that under identical conditions in the examined operating room, the horizontal laminar ventilation system performed better than the vertical option. The internal constellation of lamps, the surgical team and objects could have a serious effect on the movement of infectious particles and therefore on postoperative surgical site infections.

  12. Advertised sustainability practices among suppliers to a university hospital operating room.

    Science.gov (United States)

    Schieble, Thomas M

    2008-01-01

    The present study aimed to identify firms supplying products to our university operating room (OR) that promote sustainable manufacturing methods. Results show that 72% of our suppliers, or 152 of 211 companies, do not promote sustainability practices in a salient manner. Multi-national firms document sustainability methods significantly more than U.S. divisions of multi-nationals or U.S. firms with chi-square = 157.93 (p sustainability promotion is an important marketing tool through which purchasers may begin the process of due diligence for product selection. Lack of sustainability information among suppliers in this study suggests that hospital procurement departments likely focus solely on issues like price or quality when making purchase decisions. These results also suggest an opportunity for healthcare administrators to evaluate more fully the products involved in the healthcare supply chain; the intrinsic, intangible value added to hospital products through sustainable manufacturing is consistent with responsible patient care and has the potential to create marketing and public relations value.

  13. LNG Bunkering Operations: Establish probabilistic safety distances for LNG bunkering operations.

    OpenAIRE

    Arnet, Nora Marie Lundevall

    2014-01-01

    The environmental and economical advantages of using LNG as marine fuel have been recognized by the industry. In response to increasing demand, construction of LNG bunkering infrastructure is under rapid development. Several ports are preparing to supply LNG, but uncertainties concerning the bunkering process and operational safety still exist. Recently, much work has been done to standardize LNG bunkering solutions, including a launch of an ISO guideline and a Recommended Practice (RP) by DN...

  14. LNG Bunkering Operations: Establish probabilistic safety distances for LNG bunkering operations.

    OpenAIRE

    2014-01-01

    The environmental and economical advantages of using LNG as marine fuel have been recognized by the industry. In response to increasing demand, construction of LNG bunkering infrastructure is under rapid development. Several ports are preparing to supply LNG, but uncertainties concerning the bunkering process and operational safety still exist. Recently, much work has been done to standardize LNG bunkering solutions, including a launch of an ISO guideline and a Recommended Practice (RP) by DN...

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

    Energy Technology Data Exchange (ETDEWEB)

    Ronald Boring; Roger Lew; Thomas Ulrich; Jeffrey Joe

    2014-03-01

    As control rooms are modernized with new digital systems at nuclear power plants, it is necessary to evaluate the operator performance using these systems as part of a verification and validation process. There are no standard, predefined metrics available for assessing what is satisfactory operator interaction with new systems, especially during the early design stages of a new system. This report identifies the process and metrics for evaluating human system interfaces as part of control room modernization. The report includes background information on design and evaluation, a thorough discussion of human performance measures, and a practical example of how the process and metrics have been used as part of a turbine control system upgrade during the formative stages of design. The process and metrics are geared toward generalizability to other applications and serve as a template for utilities undertaking their own control room modernization activities.

  16. 76 FR 35130 - Pipeline Safety: Control Room Management/Human Factors

    Science.gov (United States)

    2011-06-16

    ... assessments, and safety policies for natural gas pipelines and for hazardous liquid pipelines. Both committees... advise PHMSA on technical feasibility, practicability, and cost-effectiveness of each proposed pipeline... only recommended improvements, rather than Notices of Probable Violation and monetary penalties...

  17. Safety Learning From Drugs of the Same Class : Room for Improvement

    NARCIS (Netherlands)

    Stefansdottir, G.; Knol, M. J.; Arnardottir, A. H.; van der Elst, M. E.; Grobbee, D. E.; Leufkens, H. G. M.; De Bruin, M. L.

    This study was aimed at assessing the extent of safety learning from data pertaining to other drugs of the same class. We studied drug classes for which the first and second drugs were centrally registered in the European Union from 1995 to 2008. We assessed whether adverse drug reactions (ADRs)

  18. Development of an evaluation methodology for operator`s moving distance workload for the assessment of the layout and arrangement of nuclear power plant control rooms

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jeong Un; Seo, Sang Moon; Lee, Yong Hee; Cheon, Se Woo [Korea Atomic Energy Research Institute, Taejon (Korea, Republic of)

    1995-07-01

    In this report, link analysis is discussed for the assessment of control room layout and arrangement, among the workload assessment methodologies using SACOM. A methodology developed for estimating operator`s moving distances based on modified link analysis is described, including its detail algorithm. This methodology was developed with the type and content of SACOM input information in consideration of not only software aspects but also easiness when the designer use this for control room layout and arrangement. 1 tab., 7 figs., 8 refs. (Author) .new.

  19. Proceedings of the High Consequence Operations Safety Symposium

    Energy Technology Data Exchange (ETDEWEB)

    1994-12-01

    Many organizations face high consequence safety situations where unwanted stimuli due to accidents, catastrophes, or inadvertent human actions can cause disasters. In order to improve interaction among such organizations and to build on each others` experience, preventive approaches, and assessment techniques, the High Consequence Operations Safety Symposium was held July 12--14, 1994 at Sandia National Laboratories, Albuquerque, New Mexico. The symposium was conceived by Dick Schwoebel, Director of the SNL Surety Assessment Center. Stan Spray, Manager of the SNL System Studies Department, planned strategy and made many of the decisions necessary to bring the concept to fruition on a short time scale. Angela Campos and about 60 people worked on the nearly limitless implementation and administrative details. The initial symposium (future symposia are planned) was structured around 21 plenary presentations in five methodology-oriented sessions, along with a welcome address, a keynote address, and a banquet address. Poster papers addressing the individual session themes were available before and after the plenary sessions and during breaks.

  20. Reducing tardiness from scheduled start times by making adjustments to the operating room schedule.

    Science.gov (United States)

    Wachtel, Ruth E; Dexter, Franklin

    2009-06-01

    Tardiness from scheduled start times is a common source of frustration for both operating room (OR) personnel and patients. Factors that influence tardiness were quantified in a companion paper and have been used to develop interventions that have the potential for reducing tardiness. Data from two surgical suites were used to compare the effectiveness of several interventions to reduce tardiness, including i) moving cases to different ORs on the afternoon of surgery, ii) recalculating the OR schedule when it is published to correct for average lateness in first cases of the day, iii) recalculating the OR schedule when it is published to correct for average service-specific case duration bias, and iv) scheduling a gap (time buffer) before the cases of a "to follow" surgeon if the day is expected to end early. These last three interventions involve creation of a modified schedule with revised start times that are more accurate for both patient and "to follow" surgeon. The surgeon performing the first case of the day would not be affected. Moving cases to different ORs when a room was running late produced a 50%-70% reduction in the tardiness for those cases that were moved. However, overall tardiness in each suite was reduced by only 6%-9%, because few cases were moved. Scheduling a gap between surgeons if the day was expected to end early reduced tardiness by more than 50% for those cases that were preceded by gaps. However, overall tardiness in each suite was reduced by only 4%-8%, because few gaps could be scheduled. In contrast, correcting for the combination of lateness in first cases of the day and service-specific case duration bias reduced overall tardiness in each suite by 30%-35%. Interventions which involve small numbers of cases have little potential to reduce overall tardiness. Generating a modified or auxiliary OR schedule that compensates for known causes of tardiness can significantly reduce patient and "to follow" surgeon waiting times. Modifying

  1. Retained foreign bodies: a serious threat in the Indian operation room.

    Science.gov (United States)

    Sharma, G; Bigelow, Jc

    2014-01-01

    Retained foreign bodies (RFBs) are a surgical complication resulting from foreign materials accidently left in a patient's body. This review attempts to give an overview of different types of RFBs, problems related to them and their management after the surgical operation. The internet was searched using the Google and Google scholar. In addition, relevant electronic journals from the University's library such as Entrez (including PubMed and PubMed central), Since Direct, Scirus, NIH.gov, Medknow.com, Medscape.com, Scopus, MedHelp.org, Cochrane library, WebMD.com, and World Health Organization Hinari. It shows that the major reasons of RFBs are emergency surgical operation with unplanned changes, patient high body mass index, and poor communication. To prevent this textile material should be radiopaque marked and must be counted once at the start and twice at the conclusion of all surgical procedures. If the count is incorrect, then radiography or manually re-exploration should be performed. Ultrasonography, computerized tomography, magnetic resonance imaging and radio frequency identification are also used in the proper identification of RFBs. Safety practice should be robust and simple enough to protect patient under the most chaotic of circumstances. Proper communication among the personnel participating in surgery aimed at preventing this medical negligence would help in mitigating such errors. Finally, the surgeon should not only follow the standard recommended procedure, but also report cases of RFBs.

  2. Design And Implementation Of Smart Living Room Wireless Control For Safety Purpose

    Directory of Open Access Journals (Sweden)

    Aeindra Myint Lwin

    2015-07-01

    Full Text Available Abstract This research presents the microcontroller controlled smart living room system using Bluetooth wireless technology from mobile phone.An android apk is created in mobile for controlling the living room system. A 16F877A microcontroller is interfaced serially to a bluetooth module transceiver. It is used for controlling fan speed control dim light control lighting ONOFF and window angle control. An arduino controller is used for keypad control door security. It is connected to DC motor control circuit and switching circuit for opening and closing of the door keypad for entering password and serial LCD for displaying the update status of the door.User can control the home appliances by using bluetooth connection from mobile phone in its range. User can adjust the dim light fan speed window angle and light bulbs from android apk. An internal EEPROM is built in 16F877A microcontroller and it stores the last requested data of the appliances. If userwants to recover the former conditions of the appliances he can recall them from android apk.

  3. Equipment-related incidents in the operating room: an analysis of occurrence, underlying causes and consequences for the clinical process

    NARCIS (Netherlands)

    Wubben, I.; van Manen, Jeanette Gabrielle; van den Akker, B.J.; Vaartjes, S.R.; van Harten, Willem H.

    2010-01-01

    Background: Equipment-related incidents in the operating room (OR) can affect quality of care. In this study, the authors determined the occurrence and effects on the care process in a large teaching hospital. - Methods: During a 4-week period, OR nurses reported equipment-related incidents during

  4. Practice Brief: Accommodating Deaf and Hard of Hearing Students in Operating Room Environments--A Case Study

    Science.gov (United States)

    Meeks, Lisa M.; Laird-Metke, Elisa; Rollins, Mark; Gandhi, Seema; Stechert, Martin; Jain, Neera R.

    2015-01-01

    Increasing numbers of deaf students in the health professions require accommodations in the clinical setting to ensure effective learning and accurate communication. Although classroom learning barriers have long been identified and addressed, barriers to clinical education have been far less analyzed. Operating room clerkships, which include many…

  5. Countermeasures for nursing errors in operation room%手术室护理差错的防范对策

    Institute of Scientific and Technical Information of China (English)

    李淑文

    2015-01-01

    本文分析手术室护理差错的原因及防范对策,最大限度防止护理差错的发生。%this paper analyzes the causes of nursing errors in operation room and its preventive measures,and can prevent the occurrence of nursing errors..

  6. 75 FR 50009 - Babcock & Wilcox Nuclear Operations Group, Inc.; Establishment of Atomic Safety and Licensing Board

    Science.gov (United States)

    2010-08-16

    ... COMMISSION Babcock & Wilcox Nuclear Operations Group, Inc.; Establishment of Atomic Safety and Licensing... & Wilcox Nuclear Operations Group, Inc. (Lynchburg, VA Facility). This proceeding concerns an Order Imposing Civil Monetary Penalty served upon the Licensee, Babcock & Wilcox Nuclear Operations Group,...

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

    Science.gov (United States)

    Rockstroh, M; Franke, S; Hofer, M; Will, A; Kasparick, M; Andersen, B; Neumuth, T

    2017-08-01

    Clinical working environments have become very complex imposing many different tasks in diagnosis, medical treatment, and care procedures. During the German flagship project OR.NET, more than 50 partners developed technologies for an open integration of medical devices and IT systems in the operating room. The aim of the present work was to evaluate a large set of the proposed concepts from the perspectives of various stakeholders. The demonstration OR is focused on interventions from the head and neck surgery and was developed in close cooperation with surgeons and numerous colleagues of the project partners. The demonstration OR was qualitatively evaluated including technical as well as clinical aspects. In the evaluation, a questionnaire was used to obtain feedback from hospital operators. The clinical implications were covered by structured interviews with surgeons, anesthesiologists and OR staff. In the present work, we qualitatively evaluate a subset of the proposed concepts from the perspectives of various stakeholders. The feedback of the clinicians indicates that there is a need for a flexible data and control integration. The hospital operators stress the need for tools to simplify risk management in openly integrated operating rooms. The implementation of openly integrated operating rooms will positively affect the surgeons, the anesthesiologists, the surgical nursing staff, as well as the technical personnel and the hospital operators. The evaluation demonstrated the need for OR integration technologies and identified the missing tools to support risk management and approval as the main barriers for future installments.

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

    Directory of Open Access Journals (Sweden)

    H Nabavizade

    2007-07-01

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

  9. The Association Between Operating Room Personnel and Turnover With Surgical Site Infection in More Than 12 000 Neurosurgical Cases.

    Science.gov (United States)

    Wathen, Connor; Kshettry, Varun R; Krishnaney, Ajit; Gordon, Steven M; Fraser, Thomas; Benzel, Edward C; Modic, Michael T; Butler, Sam; Machado, Andre G

    2016-12-01

    Surgical site infection (SSI) contributes significantly to postoperative morbidity and mortality and greatly increases the cost of care. To identify the impact of workflow and personnel-related risk factors contributing to the incidence of SSIs in a large sample of neurological surgeries. Data were obtained using an enterprisewide electronic health record system, operating room, and anesthesia records for neurological procedures conducted between January 1, 2009, and November 30, 2012. SSI data were obtained from prospective surveillance by infection preventionists using Centers for Disease Control and Prevention definitions. A multivariate model was constructed and refined using backward elimination logistic regression methods. The analysis included 12 528 procedures. Most cases were elective (94.5%), and the average procedure length was 4.8 hours. The average number of people present in the operating room at any time during the procedure was 10.0. The overall infection rate was 2.3%. Patient body mass index (odds ratio, 1.03; 95% confidence interval [CI], 1.01-1.04) and sex (odds ratio, 1.36; 95% CI, 1.07-1.72) as well as procedure length (odds ratio, 1.19 per additional hour; 95% CI, 1.15-1.23) and nursing staff turnovers (odds ratio, 1.095 per additional turnover; 95% CI, 1.02-1.21) were significantly correlated with the risk of SSI. This study found that patient body mass index and male sex were associated with an increased risk of SSI. Operating room personnel turnover, a modifiable, work flow-related factor, was an independent variable positively correlated with SSI. This study suggests that efforts to reduce operating room turnover may be effective in preventing SSI. OR, operating roomSSI, surgical site infection.

  10. Room-temperature cw operation of an efficient miniaturized Nd:YAG laser end-pumped by a superluminescent diode

    Energy Technology Data Exchange (ETDEWEB)

    Washio, K.; Iwamoto, K.; Inoue, K.; Hino, I.; Matsumoto, S.; Saito, F.

    1976-12-01

    A miniaturized Nd:YAG laser is described, in which a 3-mm-diam x 5.4-mm-long laser rod is end-pumped by a single Al/sub x/Ga/sub 1-x/As superluminescent diode (SLD) having 20-..mu..m x 1.4-nm stripe geometry. A 4.5-mW laser power was obtained at room temperature in a 1-ms pulse operation. Emitted power from the SLD was 50 mW with 1.7% external power efficiency. When continuously pumped, a 1.5-mW laser power was obtained at room temperature. (AIP)

  11. The Role of the Operating Room in Medical Student Education: Differing Perspectives of Learners and Educators.

    Science.gov (United States)

    O'Neill, Rebecca; Shapiro, Michael; Merchant, Aziz

    2017-07-13

    The surgical clerkship is an integral part of third-year medical student education. The operating room (OR) is a heavily used setting, but it is unclear whether this setting is as effective as possible. To determine the role of the OR and potential improvements, it is necessary to analyze the perspectives of those involved, including surgeons, residents, and medical students. An electronic survey was distributed to the surgeons, surgical residents, and third-year medical students associated with Rutgers New Jersey Medical School. The questions were a combination of 5-point Likert scale questions and qualitative responses. The questions assessed the role of the OR, the information taught in the OR, the quality of the teaching and environment, and potential improvements. Attending surgeons and residents generally rated the OR more positively than medical students did. Medical students desired more hands-on participation and a greater focus on learning technical skills. In addition, most medical students rated the feedback and direct instruction in the OR as "poor." Furthermore, the attending surgeons and medical students disagreed about the main roles of the OR as well as the effectiveness of teaching in the OR. The medical students reported experiencing anxiety and intimidation in the OR and suggested several improvements, such as decreasing the length of the surgical clerkship. There is significant disagreement between the surgeons and residents and the medical students regarding the roles and effectiveness of learning in the OR. This may help explain the reported medical student dissatisfaction and frustrations with the surgical clerkship. Copyright © 2017 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  12. Brain Tumor Interface Dissection Technique with Surgical Blade from Laboratory to Neurosurgical Operating Room.

    Science.gov (United States)

    Rai, Survendra Kumar R; Mancarella, Cristina; Goel, Atul H

    2017-04-01

    Ideal tumor resection requires brain/spinal cord tumor interface separation in perfect and precise surgical planes within a few micrometers for radical tumor resection and maximum normal tissue preservation. Despite the availability of several dissection techniques, the search for additional alternatives and an ideal technique continues. We evaluated the feasibility and advantages of dissection using a No. 15-blade scalpel in special brain tumor surgery situations. We developed a leaf model wherein its outer layer is progressively dissected from its inner skeleton using a scalpel. An additional model used was a tomato wherein its skin was peeled off its pulp using the same technique. We developed an inexpensive leaf model. A scalpel knife was used in a microneurosurgical setting, and the leaf's outer layer is peeled off. The technique is then used in an operating room setup where surgery on extra-axial tumors like meningiomas and intra-axial brain and spinal cord tumors is done. A No. 15 scalpel was used for dissection between the layers of the Peltophorum pterocarpum leaf model. This dissection method was compared with other neurosurgical dissecting tools. We dissected 120-μm thick leaves into 2 layers with removal of an 18- to 55-μm thick layer. Leaving behind a transparent layer was possible using a No. 15 blade scalpel. Similarly, it was possible to preserve a 35- to 40-μm thick arachnoid layer that separated a meningioma from the underlying brain parenchyma. A scalpel with a sharp edge could be used to perform precise and fine dissection. The scalpel deserves to occupy a place of pride as a dissecting tool in neurosurgery. Copyright © 2017 Elsevier Inc. All rights reserved.

  13. Evaluating The Operation Of Three Air Cleaners Working Individually In A Clean Room

    DEFF Research Database (Denmark)

    Ardkapan, Siamak Rahimi; Afshari, Alireza; Bergsøe, Niels Christian

    2011-01-01

    The use of portable air cleaners is becoming increasingly popular in many countries including Denmark. Portable air cleaners are known for not only removing but also generating particles and gases. To clarify this, three air cleaning technologies were evaluated. They were nonthermal plasma......, photochemical air purifier and corona discharge ionizer. The concentrations of ultrafine particles, ozone and total volatile organic compounds were measured both in a duct and in a clean room. It was found that the studied air cleaning technologies increased the ozone level in the clean room and the duct....... The increase of ozone level in the clean room was more than that was measured in the duct. Additionally, it was found that the number of ultrafine particles in the room increased due to the generated ozone. The number of generated particles changed with the season. The study leads to the recommendation...

  14. Overlying strata movement rules and safety mining technology for the shallow depth seam proximity beneath a room mining goaf

    Institute of Scientific and Technical Information of China (English)

    Wang Fangtian; Zhang Cun; Zhang Xiaogang; Song Qi

    2015-01-01

    Aiming at the shallow depth seam proximity beneath a room mining goaf, due to that the shallow depth seam is exploited using the longwall mining and overlain by thin bedrock and thick loose sands, many accidents are likely to occur, including roof structure instability, roof step subsidence, damages of shield supports, and the face bumps triggered by the large area roof weighting, resulting in serious threats to the safety of underground miners and equipment. This paper analyses the overlying strata movement rules for the shallow seams using the physical simulation, the 3DEC numerical simulation and the field mea-surements. The results show that, in shallow seam mining, the overburden movement forms caved zone and fractured zone, the cracks develop continuously and reach the surface with the face advancing, and the development of surface cracks generally goes through four stages. With the application of loose blast-ing of residual pillars, reasonable mining height, and roof support and management, the safe, efficient and high recovery rate mining has been achieved in the shallow depth seam proximity beneath a room min-ing goaf.

  15. Safety management of a complex R and D ground operating system

    Science.gov (United States)

    Connors, J. F.; Maurer, R. A.

    1975-01-01

    A perspective on safety program management was developed for a complex R&D operating system, such as the NASA-Lewis Research Center. Using a systems approach, hazardous operations are subjected to third-party reviews by designated-area safety committees and are maintained under safety permit controls. To insure personnel alertness, emergency containment forces and employees are trained in dry-run emergency simulation exercises. The keys to real safety effectiveness are top management support and visibility of residual risks.

  16. Safety management of a complex R&D ground operating system

    Science.gov (United States)

    Connors, J. F.; Maurer, R. A.

    1975-01-01

    A perspective on safety program management has been developed for a complex R&D operating system, such as the NASA-Lewis Research Center. Using a systems approach, hazardous operations are subjected to third-party reviews by designated area safety committees and are maintained under safety permit controls. To insure personnel alertness, emergency containment forces and employees are trained in dry-run emergency simulation exercises. The keys to real safety effectiveness are top management support and visibility of residual risks.

  17. Data-driven spatio-temporal RGBD feature encoding for action recognition in operating rooms.

    Science.gov (United States)

    Twinanda, Andru P; Alkan, Emre O; Gangi, Afshin; de Mathelin, Michel; Padoy, Nicolas

    2015-06-01

    Context-aware systems for the operating room (OR) provide the possibility to significantly improve surgical workflow through various applications such as efficient OR scheduling, context-sensitive user interfaces, and automatic transcription of medical procedures. Being an essential element of such a system, surgical action recognition is thus an important research area. In this paper, we tackle the problem of classifying surgical actions from video clips that capture the activities taking place in the OR. We acquire recordings using a multi-view RGBD camera system mounted on the ceiling of a hybrid OR dedicated to X-ray-based procedures and annotate clips of the recordings with the corresponding actions. To recognize the surgical actions from the video clips, we use a classification pipeline based on the bag-of-words (BoW) approach. We propose a novel feature encoding method that extends the classical BoW approach. Instead of using the typical rigid grid layout to divide the space of the feature locations, we propose to learn the layout from the actual 4D spatio-temporal locations of the visual features. This results in a data-driven and non-rigid layout which retains more spatio-temporal information compared to the rigid counterpart. We classify multi-view video clips from a new dataset generated from 11-day recordings of real operations. This dataset is composed of 1734 video clips of 15 actions. These include generic actions (e.g., moving patient to the OR bed) and actions specific to the vertebroplasty procedure (e.g., hammering). The experiments show that the proposed non-rigid feature encoding method performs better than the rigid encoding one. The classifier's accuracy is increased by over 4 %, from 81.08 to 85.53 %. The combination of both intensity and depth information from the RGBD data provides more discriminative power in carrying out the surgical action recognition task as compared to using either one of them alone. Furthermore, the proposed non

  18. Low-threshold room-temperature continuous-wave operation of a terahertz difference-frequency quantum cascade laser source

    Science.gov (United States)

    Fujita, Kazuue; Ito, Akio; Hitaka, Masahiro; Dougakiuchi, Tatsuo; Edamura, Tadataka

    2017-08-01

    The performance of a room-temperature continuous-wave (CW) terahertz source based on intracavity difference-frequency generation in a mid-infrared (λ ∼ 6.8 µm) quantum cascade laser with a dual-upper-state active region is reported. The fabricated buried heterostructure device, with a two-section buried distributed feedback grating, operates at two mid-infrared wavelengths and demonstrates a terahertz output of 2.92 THz with a very low threshold current density of 0.89 kA/cm2 in pulsed operation. Consequently, despite an epitaxial-side-up mounting configuration, the device achieves CW operation at room temperature in which a low CW threshold current density of 1.3 kA/cm2 is obtained.

  19. Three distinct surgical clothing systems in a turbulent mixing operating room equipped with mobile ultraclean laminar airflow screen

    DEFF Research Database (Denmark)

    Sadrizadeh, Sasan; Holmberg, Sture; Nielsen, Peter Vilhelm

    2016-01-01

    Two types of mobile screens producing ultraclean local laminar airflow were investigated as an addition to turbulent mixing operating room ventilation. The exploration was carried out numerically using computational fluid dynamics. Surface and volumetric particle counts were simulated on the oper......Two types of mobile screens producing ultraclean local laminar airflow were investigated as an addition to turbulent mixing operating room ventilation. The exploration was carried out numerically using computational fluid dynamics. Surface and volumetric particle counts were simulated...... on the operating and instrument tables with and without the additional mobile airflow screen. Three different source strengths (the mean bacteria-carrying particle value emitted from one person per second) due to staff clothing variety were considered. Model validation was performed through result comparisons...... with experimental data from the literature. Results confirmed that the mobile screen units reduced the airborne bacteria to an acceptable level for infection-prone surgeries. No significant particle concentration differences existed in the periphery of the operating room. Lower source strength resulting from...

  20. SAFETY

    CERN Document Server

    Niels Dupont

    2013-01-01

    CERN Safety rules and Radiation Protection at CMS The CERN Safety rules are defined by the Occupational Health & Safety and Environmental Protection Unit (HSE Unit), CERN’s institutional authority and central Safety organ attached to the Director General. In particular the Radiation Protection group (DGS-RP1) ensures that personnel on the CERN sites and the public are protected from potentially harmful effects of ionising radiation linked to CERN activities. The RP Group fulfils its mandate in collaboration with the CERN departments owning or operating sources of ionising radiation and having the responsibility for Radiation Safety of these sources. The specific responsibilities concerning "Radiation Safety" and "Radiation Protection" are delegated as follows: Radiation Safety is the responsibility of every CERN Department owning radiation sources or using radiation sources put at its disposition. These Departments are in charge of implementing the requi...

  1. [Interdisciplinary teamwork in the OR: Identification and measurement of teamwork in the operating room].

    Science.gov (United States)

    Passauer-Baierl, Stefanie; Baschnegger, Heiko; Bruns, Christiane; Weigl, Matthias

    2014-01-01

    Effective teamwork is one of the essentials in conducting successful and safe surgical procedures in the operating theatre (OT). The present paper aims to provide a selective review of various approaches describing effective interdisciplinary teamwork in the OT. Furthermore, it covers observational methods to assess OT teamwork with particular focus on Germany. Our definition of successful surgical teamwork is based on an already established classification system considering five criteria for effective and safe OT teams: coordination, communication, cooperation, leadership, and team monitoring. Well-defined and reliable measures are necessary to examine the quality of OT teamwork. Those methods should entail the special characteristics of the OT team. They should include all phases of the surgical procedure and incorporate all the professions involved (surgeons, surgical nurses, and anaesthetic staff). We conclude that research into methods for the assessment of OTs in Germany needs to be undertaken as a prerequisite to investigating the relationship between OT teamwork and its effects on patient safety and surgical quality. Copyright © 2013. Published by Elsevier GmbH.

  2. 14 CFR 417.411 - Safety clear zones for hazardous operations.

    Science.gov (United States)

    2010-01-01

    ... 14 Aeronautics and Space 4 2010-01-01 2010-01-01 false Safety clear zones for hazardous operations. 417.411 Section 417.411 Aeronautics and Space COMMERCIAL SPACE TRANSPORTATION, FEDERAL AVIATION... for hazardous operations. (a) A launch operator must define a safety clear zone that confines...

  3. The relationship of the emotional climate of work and threat to patient outcome in a high-volume thoracic surgery operating room team.

    Science.gov (United States)

    Nurok, Michael; Evans, Linda A; Lipsitz, Stuart; Satwicz, Paul; Kelly, Andrea; Frankel, Allan

    2011-03-01

    It is widely believed that the emotional climate of surgical team's work may affect patient outcome. To analyse the relationship between the emotional climate of work and indices of threat to patient outcome. Interventional study. Operating rooms in a high-volume thoracic surgery centre from September 2007 to June 2008. Thoracic surgery operating room teams. Two 90 min team-skills training sessions focused on findings from a standardised safety-culture survey administered to all participants and highlighting positive and problematic aspects of team skills, communication and leadership. Relationship of functional or less functional emotional climates of work to indices of threat to patient outcome. A less functional emotional climate corresponded to more threat to outcome in the sterile surgical environment in the pre-intervention period (pwork in the sterile surgical environment appeared to be related to threat to patient outcome prior to, but not after, a team-training intervention. Further study of the relationship between the emotional climate of work and threat to patient outcome using reproducible methods is required.

  4. Achieving shift work excellence: maximizing health, safety and operating efficiency in round-the-clock operations

    Energy Technology Data Exchange (ETDEWEB)

    Sirois, W. G. (circadian Technologies Ltd., Cambridge, MA (United States))

    1999-01-01

    Alertness Assurance techniques, Lifestyle Training and Shift Scheduling practices are described as weapons in the fight against the consequences of sleep deprivation and fatigue, higher operating risks , the adverse health, safety and quality of life effects on workers. Fatigue is a fundamental problem for all round-the-clock industries. The central message of this paper is that by making appropriate interventions and taking counter-measures to fatigue, the risks and liabilities of human error can be dramatically minimized through increased employee alertness, vigilance and cognitive reasoning skills around-the-clock. 12 refs., 1 fig.

  5. 手术室护理管理中安全文化的运用%A Research on Application of Safety Culture in Nursing Management in Surgery Room

    Institute of Scientific and Technical Information of China (English)

    王会平

    2015-01-01

    目的::在手术室中实施安全文化管理,能提高医护人员的安全意识,有效减少手术室的护理风险,降低手术室的护理缺陷,保证手术安全。方法:在某院的手术室实施安全文化的护理管理,全面开展安全文化在护理管理中的应用,主要是体现在安全文化护理管理的实施前以及实施后患者、医护人员的满意度、危急患者的抢救成功率、护理差错发生率及护理纠纷发生率做统计学分析。结果:通过运用护理安全文化可使护理差错的发生率降低很大,1年来没有发生严重护理差错及纠纷事件,一般差错由2009年的150起下降到2010年的56起。在实施安全文化管理后,患者、医护人员的满意度、危急患者的抢救成功的机率都有显著的提高,护理差错发生率以及护理纠纷发生率都有大幅度的降低,相比较存在差异性,有统计学意义(P <0.05)。结论:将安全文化管理运用到手术室中,可有效的降低护理缺陷的发生,保证护理质量。%Objective:The implementation of safety culture management in operation room,can help to enhance the safety awareness of medical personnel,effectively reduce nursing risk in operating room ,reduce nursing defects in operation room,and ensure the safety of operation.Methods:Implementation nursing management on safety culture in operation room in some hospital ,comprehensively develop the application of safety culture in nursing management ,and make statistical analysis on the satisfaction of patients and medi-cal personnel,and the rescue of successful rescue of patients in danger and occurrence of nursing mistake be-fore and after the implementation of safety culture nursing management.Results:The application of nursing safety education can significantly reduce the incidence of nursing mistakes,in the 1 year,there was no seri-ous nursing errors and disputes in our hospital,the number of general error has been reduced from 150

  6. Application of Digital Operating Room%浅谈数字化手术室的应用

    Institute of Scientific and Technical Information of China (English)

    韩雪峰; 雍维林

    2012-01-01

    介绍了数字化手术室的概念和具体功能,分析了数字化手术室在安全的手术环境、医院系统集成、教学及学术交流等方面的应用,并从提升医疗安全和质量、提高工作效率、监控医疗过程、提高医院信息化管理水平等方面详细阐述了数字化手术室应用效果,指出了数字化手术室是医院数字化建设的重要组成部分,为医院带来直接的经济效益和社会效益,提高了医院的核心竞争力,是医院数字化的必然趋势.%Hie concept and specific functions of digital operating room are introduced, and the application of digital operating room in safe operation environment, hospital system integration, teaching and academic exchanges is analyzed. The application effect of digital operating room is expounded from upgrading medical security and quality, improving work efficiency, monitoring medical process, and heightening hospital information management level, etc. It is pointed out that the digital operating room is an important part for the construction of digital hospital, which can bring direct economic and social benefits for hospital, enhance the core competitiveness of hospital, and is the inevitable trend of digital hospital. [Chinese Medical Equipment Journal,2012,33(4):101-103

  7. Safety of the French reactors in operation; Surete des reacteurs francais en service

    Energy Technology Data Exchange (ETDEWEB)

    Libmann, J. [CEA/Fontenay-aux-Roses, Inst. de Protection et de Surete Nucleaire (IPSN), 92 (France)]|[Agence Internationale pour l' Energie Atomique, AIEA, Vienne (Austria)

    1999-10-01

    The French nuclear reactors still in operation at the end of the 1990's are all of PWR type. This paper focusses on the technical aspects of the safety of these reactors which depends on the original design and on the quality of the realization, on the ageing of the facilities, on the improvements added with time, and on the conditions of operation (incidents, periodical inspections, maintenance). The experience feedback, the reexamination of safety rules and the use of probabilistic evaluations have permitted to reach a satisfactory level of safety so far. The following aspects are presented successively: 1 - design and expected safety: design basis, defense-in-depth concept, postulated accidents and methods of accidents analysis, safety systems and principles of materials classification, complementary accidental conditions, preparation to the management of serious accidents, relative safety differences between the different units; 2 - expected safety during operation: general operation rules, periodical safety tests, preventive maintenance, training of personnel, safety culture; 3 - probabilistic evaluation of safety: interest of probabilistic safety studies, main results, evolutions; 4 - safety verifications: detection and analysis of incidents, global behaviour of the electronuclear park, presentation of some serious French incidents, importance of human factors, monitoring of the ageing of installations, the international nuclear events scale (INES); 5 - the periodical reexamination of safety: principles and practice, main results. (J.S.)

  8. Arianespace Launch Service Operator Policy for Space Safety (Regulations and Standards for Safety)

    Science.gov (United States)

    Jourdainne, Laurent

    2013-09-01

    Since December 10, 2010, the French Space Act has entered into force. This French Law, referenced as LOS N°2008-518 ("Loi relative aux Opérations Spatiales"), is compliant with international rules. This French Space Act (LOS) is now applicable for any French private company whose business is dealing with rocket launch or in orbit satellites operations. Under CNES leadership, Arianespace contributed to the consolidation of technical regulation applicable to launch service operators.Now for each launch operation, the operator Arianespace has to apply for an authorization to proceed to the French ministry in charge of space activities. In the files issued for this purpose, the operator is able to justify a high level of warranties in the management of risks through robust processes in relation with the qualification maintenance, the configuration management, the treatment of technical facts and relevant conclusions and risks reduction implementation when needed.Thanks to the historic success of Ariane launch systems through its more than 30 years of exploitation experience (54 successes in a row for latest Ariane 5 launches), Arianespace as well as European public and industrial partners developed key experiences and knowledge as well as competences in space security and safety. Soyuz-ST and Vega launch systems are now in operation from Guiana Space Center with identical and proved risks management processes. Already existing processes have been slightly adapted to cope with the new roles and responsibilities of each actor contributing to the launch preparation and additional requirements like potential collision avoidance with inhabited space objects.Up to now, more than 12 Ariane 5 launches and 4 Soyuz-ST launches have been authorized under the French Space Act regulations. Ariane 5 and Soyuz- ST generic demonstration of conformity have been issued, including exhaustive danger and impact studies for each launch system.This article will detail how Arianespace

  9. Resident Physicians Improve Nontechnical Skills When on Operating Room Management and Leadership Rotation.

    Science.gov (United States)

    Cole, Devon C; Giordano, Christopher R; Vasilopoulos, Terrie; Fahy, Brenda G

    2017-01-01

    Anesthesiology residency primarily emphasizes the development of medical knowledge and technical skills. Yet, nontechnical skills (NTS) are also vital to successful clinical practice. Elements of NTS are communication, teamwork, situational awareness, and decision making. The first 10 consecutive senior residents who chose to participate in this 2-week elective rotation of operating room (OR) management and leadership training were enrolled in this study, which spanned from March 2013 to March 2015. Each resident served as the anesthesiology officer of the day (AOD) and was tasked with coordinating OR assignments, managing care for 2 to 4 ORs, and being on call for the trauma OR; all residents were supervised by an attending AOD. Leadership and NTS techniques were taught via a standardized curriculum consisting of leadership and team training articles, crisis management text, and daily debriefings. Resident self-ratings and attending AOD and charge nurse raters used the Anaesthetists' Non-Technical Skills (ANTS) scoring system, which involved task management, situational awareness, teamwork, and decision making. For each of the 10 residents in their third year of clinical anesthesiology training (CA-3) who participated in this elective rotation, there were 14 items that required feedback from resident self-assessment and OR raters, including the daily attending AOD and charge nurse. Results for each of the items on the questionnaire were compared between the beginning and the end of the rotation with the Wilcoxon signed-rank test for matched samples. Comparisons were run separately for attending AOD and charge nurse assessments and resident self-assessments. Scaled rankings were analyzed for the Kendall coefficient of concordance (ω) for rater agreement with associated χ and P value. Common themes identified by the residents during debriefings were recurrence of challenging situations and the skills residents needed to instruct and manage clinical teams. For

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

    Science.gov (United States)

    Dexter, Franklin; Epstein, Richard H

    2015-12-01

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

  11. A System Approach to Navy Medical Education and Training. Appendix 36. Competency Curriculum for Operating Room Assistant and Operating Room Technician.

    Science.gov (United States)

    1974-08-31

    101 2. Peripheral-Vascular Procedures . . . .. .. . .102 3. Abdominal-Vascular Procedures . . . . . . . . . . 103 XII : Scrubbing for Cardiac...ORP) Unit XII : Scr’boing fcr Ca- iac Procadures 2MO D𔃼 1: CLOSED C*.". .C Pp-r .... TASYS a. Scrub for naricardiocto:iy b. Scrub for comiissurotomy...dona for and to him, transfar patient to operating tabla and taka any nece3sary naures to pzovida for patie3nt’ 3 aafety und co-mfort (Crit~azia

  12. A Novel Grid-Wide Transient Stability Assessment and Visualization Method for Increasing Situation Awareness of Control Room Operators

    DEFF Research Database (Denmark)

    Pertl, Michael; Rezkalla, Michel M.N.; Marinelli, Mattia

    2016-01-01

    The aim of the paper is to introduce a grid-wide assessment method to determine the transient stability margin and visualize it effectively to increase the situation awareness of control room operators. Critical area(s) with insufficient transient stability margin have to be identified in order...... to be able to take appropriate preventive actions. The introduced method evaluates the transient stability margin with a time-domain approach by using the voltage angle of several buses across the power system. Information about the severity of a contingency and the location of the most critical buses...... is derived. Moreover, it is shown that the method facilitates the visual examination of transient stability. It provides control room operators with essential information about the state of the system and enables them to take appropriate preventive actions if insufficient transient stability margins...

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

    Directory of Open Access Journals (Sweden)

    Hasibe Baytan Yildiz

    2016-09-01

    Full Text Available Aim: The aim of this randomized, single-blinded study was to evaluate the effects of noise on hemodynamic and neuroendocrine stress response by measuring the level of noise in the surgery rooms of patients undergoing knee operations under neuroaxial anesthesia. Gerec ve Yontem: We compared patient responses from two groups of patients: those undergoing knee operations in a surgery room where the noise level (measured in decibels is high, and those undergoing meniscus operations in a surgery room with lower noise levels. The STAI, the State-Trait Anxiety Inventory (STAI-1, and the anxiety test (STAI-2wereperformed at preoperative and postoperative periods. 20 ml of blood sample was taken for basal, intraoperative 30th minute, and postoperative 1st hour measurements. Systolic, diastolic, and mean arterial blood pressures were found to be higher in the high noise level group. ACTH levels were increased during the early postoperative period and became normal during the late postoperative period in the high noise level group whereas ACTH levels were significantly decreased in the low-noise level group. Basal cortisol levels were significantly higher in the high noise level group. HCRP, an inflammatory response mediator was found to be decreased in both groups. Early and late blood glucose levels were significantly higher in the high noise group. There was a greater increase in early and late blood glucose levels in the high noise group. In the postoperative period, although the state-trait anxiety inventory (STAI-2 levels being higher in patients subject to noisier environment determines how people feel independent of the conditions and state they are in, this result made us consider that the noise the patients were subjected to in the intraoperative period may cause a stress response. Discussion: As a result we believe that standard noise levels should be achieved by reducing the factors causing high noise levels in the operating room. This will

  14. Contamination of the operating room by anesthetic gases and vapors. II. Gas chromatographic analysis of nitrous oxide

    Energy Technology Data Exchange (ETDEWEB)

    Cattaneo, A.D.; Ferraiolo, G.; Rovatti, M.; Zattoni, J.; Donato, A.

    1981-12-01

    The contamination by nitrous oxide of an operating room atmosphere was studied in a number of experiments, in the absence of personnel and using a gaschromatographic method. The evacuating device of the anesthesia machine proved to be ineffective to overcome the hazard of leaks in the breathing system, whereas the air conditioning flow rates (12 outside air changes per hour) minimized waste anesthetic gas concentrations.

  15. Private Hospital La Clinique de La Qiataigneraie Deployed Wi-Fi Network to Optimize the Management of its Operating Rooms

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    Symbol Technologies, Inc. (NYSE:SBL), The Enterprise Mobility Company, and Ekahau, one of the leading suppliers of Wi-Fi positioning solutions, today announced that the La Chataigneraie private clinic implemented the Ekahau Real Time Location System (RTLS) solution. The wireless solution incorporates two Symbol WS5100 wireless switches and 30 AP300 access ports, and is used to improve communications in and between its 16 operating rooms.

  16. Full scope simulator of a nuclear power plant control room using 3D stereo virtual reality techniques for operators training

    Energy Technology Data Exchange (ETDEWEB)

    Aghina, Mauricio A.C.; Mol, Antonio Carlos A.; Almeida, Adino Americo A.; Pereira, Claudio M.N.A. [Instituto de Engenharia Nuclear (IEN-CNEN/RJ), Rio de Janeiro, RJ (Brazil)]. E-mails: mag@ien.gov.br; mol@ien.gov.br; adino@ien.gov.br; cmnap@ien.gov.br; Varela, Thiago F.B. [Universidade Federal do Rio de Janeiro (UFRJ), RJ (Brazil). Coordenacao dos Programas de Pos-graduacao de Engenharia (COPPE). Programa de Engenharia Eletrica]. E-mail: phillips.rj@terra.com.br; Cunha, Gerson G. [Universidade Federal do Rio de Janeiro (UFRJ), RJ (Brazil). Coordenacao dos Programas de Pos-graduacao de Engenharia (COPPE). Lab. de Metodos Computacionais em Engenharia (LAMCE)]. E-mail: gerson@lance.ufrj.br

    2007-07-01

    Practical training of nuclear power plants operators are partially performed by means of simulators. Usually these simulators are physical copies of the original control roam, needing a large space on a facility being also very expensive. In this way, the proposal of this paper is to implement the use of Virtual Reality techniques to design a full scope control room simulator, in a manner to reduce costs and physical space usage. (author)

  17. Investigation of the impact of main control room digitalization on operators cognitive reliability in nuclear power plants.

    Science.gov (United States)

    Zhou, Yong; Mu, Haiying; Jiang, Jianjun; Zhang, Li

    2012-01-01

    Currently, there is a trend in nuclear power plants (NPPs) toward introducing digital and computer technologies into main control rooms (MCRs). Safe generation of electric power in NPPs requires reliable performance of cognitive tasks such as fault detection, diagnosis, and response planning. The digitalization of MCRs has dramatically changed the whole operating environment, and the ways operators interact with the plant systems. If the design and implementation of the digital technology is incompatible with operators' cognitive characteristics, it may have negative effects on operators' cognitive reliability. Firstly, on the basis of three essential prerequisites for successful cognitive tasks, a causal model is constructed to reveal the typical human performance issues arising from digitalization. The cognitive mechanisms which they impact cognitive reliability are analyzed in detail. Then, Bayesian inference is used to quantify and prioritize the influences of these factors. It suggests that interface management and unbalanced workload distribution have more significant impacts on operators' cognitive reliability.

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

    Directory of Open Access Journals (Sweden)

    Mojtaba Raji

    2016-07-01

    Full Text Available Background and Objective: Nursing students are exposed to clinical environmental stresses in addition to educational environmental stresses. The aim of this study was to assessment of clinical stressful factors among Academic Students of Nursing and Operating Room of Dezful University of Medical Sciences in 2015.Materials and Methods: This study was a description-analytical study with 234 students of nursing and operation room up to two semesters for enrolled. Data was using a self-made researcher Questionnaire consisted of demographic information and clinical stressful factors. Data analysis was performed by descriptive and inferential statistics using SPSS-PC (v.20.Results: The findings showed that the main stressors in students of nursing and operation room were unpleasant emotions and least stressful areas were interpersonal communication in a clinical environment. The results showed that the average score of the field of education and humiliating experiences using Spearman correlation test (P=0/045 (r=0/16.Conclusion: Study showed, the mean stress is the moderate level. Stressful areas obtained in the four areas of personal communication, clinical practice stressful, unpleasant feelings and humiliating experience that fortunately, in many cases reform and change.

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

    Science.gov (United States)

    Kirschbaum, Kristin

    2012-01-01

    Communication variables that are associated with face-negotiation theory were examined in a sample of operating-room physicians. A survey was administered to anesthesiologists and surgeons at a teaching hospital in the southwestern United States to measure three variables commonly associated with face-negotiation theory: conflict-management style, face concern, and self-construal. The survey instrument that was administered to physicians includes items that measured these three variables in previous face-negotiation research with slight modification of item wording for relevance in the medical setting. The physician data were analyzed using confirmatory factor analysis, Pearson's correlations, and t-tests. Results of this initial investigation showed that variables associated with face-negotiation theory were evident in the sample physician population. In addition, the correlations were similar among variables in the medical sample as those found in previous face-negotiation research. Finally, t-tests suggest variance between anesthesiologists and surgeons on specific communication variables. These findings suggest three implications that warrant further investigation with expanded sample size: (1) An intercultural communication theory and instrument can be utilized for health communication research; (2) as applied in a medical context, face-negotiation theory can be expanded beyond traditional intercultural communication boundaries; and (3) theoretically based communication structures applied in a medical context could help explain physician miscommunication in the operating room to assist future design of communication training programs for operating-room physicians.

  20. Economic analysis of linking operating room scheduling and hospital material management information systems for just-in-time inventory control.

    Science.gov (United States)

    Epstein, R H; Dexter, F

    2000-08-01

    Operating room (OR) scheduling information systems can decrease perioperative labor costs. Material management information systems can decrease perioperative inventory costs. We used computer simulation to investigate whether using the OR schedule to trigger purchasing of perioperative supplies is likely to further decrease perioperative inventory costs, as compared with using sophisticated, stand-alone material management inventory control. Although we designed the simulations to favor financially linking the information systems, we found that this strategy would be expected to decrease inventory costs substantively only for items of high price ($1000 each) and volume (>1000 used each year). Because expensive items typically have different models and sizes, each of which is used by a hospital less often than this, for almost all items there will be no benefit to making daily adjustments to the order volume based on booked cases. We conclude that, in a hospital with a sophisticated material management information system, OR managers will probably achieve greater cost reductions from focusing on negotiating less expensive purchase prices for items than on trying to link the OR information system with the hospital's material management information system to achieve just-in-time inventory control. In a hospital with a sophisticated material management information system, operating room managers will probably achieve greater cost reductions from focusing on negotiating less expensive purchase prices for items than on trying to link the operating room information system with the hospital's material management information system to achieve just-in-time inventory control.

  1. Justification of Financial Safety Analysis Approach in Cargo-and-Passenger Ferry Operations Management

    National Research Council Canada - National Science Library

    Yelena V. Kirillova; Yekaterina S. Meleshenko

    2014-01-01

    .... At the same time, when managing the production activity of the ferry operators and, in particular, when analysing the ferry operation the indicator of its financial safety factor is of great importance...

  2. Safety, feasibility, and results of exercise testing for stratifying patients with chest pain in the emergency room

    Directory of Open Access Journals (Sweden)

    Renato Machado Macaciel

    2003-08-01

    Full Text Available OBJECTIVE: To assess safety, feasibility, and the results of early exercise testing in patients with chest pain admitted to the emergency room of the chest pain unit, in whom acute myocardial infarction and high-risk unstable angina had been ruled out. METHODS: A study including 1060 consecutive patients with chest pain admitted to the emergency room of the chest pain unit was carried out. Of them, 677 (64% patients were eligible for exercise testing, but only 268 (40% underwent the test. RESULTS: The mean age of the patients studied was 51.7±12.1 years, and 188 (70% were males. Twenty-eight (10% patients had a previous history of coronary artery disease, 244 (91% had a normal or unspecific electrocardiogram, and 150 (56% underwent exercise testing within a 12-hour interval. The results of the exercise test in the latter group were as follows: 34 (13% were positive, 191 (71% were negative, and 43 (16% were inconclusive. In the group of patients with a positive exercise test, 21 (62% underwent coronary angiography, 11 underwent angioplasty, and 2 underwent myocardial revascularization. In a univariate analysis, type A/B chest pain (definitely/probably anginal (p<0.0001, previous coronary artery disease (p<0.0001, and route 2 (patients at higher risk correlated with a positive or inconclusive test (p<0.0001. CONCLUSION: In patients with chest pain and in whom acute myocardial infarction and high-risk unstable angina had been ruled out, the exercise test proved to be feasible, safe, and well tolerated.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2014-08-15

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

  4. Report of the aviation safety review of Department of Energy helicopter operations

    Energy Technology Data Exchange (ETDEWEB)

    1992-02-01

    In a memorandum dated November 27, 1991, the Secretary of Energy directed the Office of Environment, Safety and Health (EH) to lead, with Program Secretarial Office participation, an aviation safety review of the safe operation of the Department`s helicopter program. The Aviation Safety Review Team comprised of aviation experts from the US Army, the Federal Aviation Administration, private consulting organizations, and Department of Energy (DOE) staff was assembled. The scope of the Aviation Safety Review Team`s appraisals included the following as applicable: policy; operations; maintenance; crew training; previous appraisals; contract requirements; aviation safety analysis reports; refueling facilities and management; night vision goggle (NVG) operations; helicopter limited standdown initiative; Secretary of Energy Notice (SEN) -6D-91 Compliance; and, DOE/contractor organizational structures and responsibilities. The appraisals at each site included a review of aviation policy, manuals, procedures, facilities, and documentation pertaining to management, safety, operations, maintenance, and quality control.

  5. Report of the aviation safety review of Department of Energy helicopter operations

    Energy Technology Data Exchange (ETDEWEB)

    1992-02-01

    In a memorandum dated November 27, 1991, the Secretary of Energy directed the Office of Environment, Safety and Health (EH) to lead, with Program Secretarial Office participation, an aviation safety review of the safe operation of the Department's helicopter program. The Aviation Safety Review Team comprised of aviation experts from the US Army, the Federal Aviation Administration, private consulting organizations, and Department of Energy (DOE) staff was assembled. The scope of the Aviation Safety Review Team's appraisals included the following as applicable: policy; operations; maintenance; crew training; previous appraisals; contract requirements; aviation safety analysis reports; refueling facilities and management; night vision goggle (NVG) operations; helicopter limited standdown initiative; Secretary of Energy Notice (SEN) -6D-91 Compliance; and, DOE/contractor organizational structures and responsibilities. The appraisals at each site included a review of aviation policy, manuals, procedures, facilities, and documentation pertaining to management, safety, operations, maintenance, and quality control.

  6. Experience of Interview Before and After Operation in Operating Room%手术室术前术后访视体会

    Institute of Scientific and Technical Information of China (English)

    陈保清

    2015-01-01

    Objective: To explore the effect of interview before and after operation on nursing works in operating room. Methods: Full-time interviewing nurses were appointed to the operating room to read the medical records of patients who were going to receive operation on the next day. Preoperative directions were given to the patients according to their conditions. The psychological characteristics of the patients were analyzed and right psychological counselings were given to the patients. Results: The interview before and after operation can improve the nursing quality in operating room and the preoperative psychological condition of the patients. It is good for the performance of the operation and increase the comfort of the patients in hospital.%目的:探讨术前、术后访视在手术室护理工作中的护理体会。方法:手术室指定专职的访视护士,在手术前1 d查阅第2 d需要手术的患者病历,根据情况对患者进行术前指导,了解患者心理特点,及时给患者提供正确的心理疏导。结果:通过术前、术后访视提高了手术室护理质量,有利于患者术前心理状态的改善,有助于手术的顺利进行,提高了患者在医院的舒适度。

  7. 14 CFR 437.51 - Rest rules for vehicle safety operations personnel.

    Science.gov (United States)

    2010-01-01

    ... 14 Aeronautics and Space 4 2010-01-01 2010-01-01 false Rest rules for vehicle safety operations... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION LICENSING EXPERIMENTAL PERMITS Safety Requirements § 437.51 Rest... operations personnel adhere to the work and rest standards in this section during permitted activities. (a...

  8. 78 FR 67086 - Safety Zone, Submarine Cable Replacement Operations, Kent Island Narrows; Queen Anne's County, MD

    Science.gov (United States)

    2013-11-08

    ... SECURITY Coast Guard 33 CFR Part 165 RIN 1625-AA00 Safety Zone, Submarine Cable Replacement Operations... safety of mariners and their vessels on navigable waters during submarine cable replacement operations at... installation of a submarine cable within a federal navigation channel requiring divers, a barge, and...

  9. Surgical Safety Checklists in Operative Medicine in Switzerland

    Directory of Open Access Journals (Sweden)

    Reto Kaderli

    2012-06-01

    Conclusions: There is still room for improvement in the use of surgical checklists, which impresses, in regard to the time needed for data collection per patient, and which is not excessively time-consuming. However, acceptance problems of the majority of respondents during the introduction phase of surgical checklists vanished over time. [Arch Clin Exp Surg 2012; 1(3.000: 158-167

  10. Operation Room Infection Factors and Control%手术室感染因素及控制

    Institute of Scientific and Technical Information of China (English)

    姜丽; 周静

    2014-01-01

    The postoperative infection of patients means that the threat to life, so to prevent postoperative infection has become the guarantee of human life, an important task to promote the rehabilitation of patients and medical development. In order to reduce the infection rate of operation, improve the quality of medical treatment, the operation infection factors analysis. The results show that: the infection factors although many, but in general the main or operation contact and air bacteria through various means of land caused by operation wound infection in operation room, so is the key to control [1] infection, so the scientific management of operation room, take comprehensive measures and dynamic bacteriological monitoring is the fundamental way to reduce operation incision infection. Ensure work quality is the key to operation room infection reduce all kinds of operation after operation.%术后感染对患者意味着生命的威胁,因此防止术后感染已经成为当今保障人类生命,促进患者康复和医学发展的一个重大课题。为降低手术感染率,提高医疗质量,对手术感染因素进行分析。结果表明:感染因素虽然很多,但总的来说主要还是手术的接触传播和空气浮游菌通过各种途径降落于手术创面而引起的感染,所以手术室是控制切口感染的关键[1],因此对手术室进行科学管理,采取综合预防措施和动态细菌学监测是降低手术切口感染的根本途径。保证手术室工作质量是减少各类手术术后感染的关键。

  11. 论手术室护士伦理素养的培养%Discussion on the Cultivation of Ethic Quality of Operation Room Nurses

    Institute of Scientific and Technical Information of China (English)

    吴秀婷; 郭瑞娟; 袁晓艳

    2016-01-01

    Under the new medical situation, operating room nurses should pay attention to improving their pro-fessional proficiency, but also to cultivating theethic quality. During the whole nursing process in operating room, nurses should carry forward Nightingale Spirit,practice the nursing conceptof integrationand humanization,conscien-tiously do a good job in every job,ensure the safety of the operation,closely collaborate with the medical team at the same time, reassure the teammates, satisfy the patients, and improve the quality of medicaltogether. It helpsculti-vate nurses′sense of responsibility and honor, make the nurses to establish the sense of responsibility, and develop their empathy, thus to provide more qualityservice to patients.%在新的医疗形势下,手术室护士不仅要注重自身业务能力的提高,更要注重伦理素养的培养。在手术室护理全过程中,护士要发扬南丁格尔精神,践行整体化、人性化的护理理念,认真做好每一项工作,保证手术的安全,同时与医疗团队密切协作,使队友放心,使患者满意,共同提高医疗质量。这样,有助于培养护士自身的荣誉感与责任感,使护士树立起责任心、培养起同理心,能够更好地为患者提供更加优质的服务。

  12. Operating personnel safety during the administration of Hyperthermic Intraperitoneal Chemotherapy (HIPEC).

    Science.gov (United States)

    Kyriazanos, Ioannis; Kalles, Vasileios; Stefanopoulos, Anastasios; Spiliotis, John; Mohamed, Faheez

    2016-09-01

    Cytoreductive surgery (CRS) and Hyperthermic Intraperitoneal Chemotherapy (HIPEC) is increasingly used in the treatment of peritoneal malignancies. The administration of HIPEC after complete cytoreduction offers the combination of the pharmacokinetic advantages inherent to the intraperitoneal delivery of cytotoxic chemotherapy, with the direct cytotoxic effects of hyperthermia, and has been reported to offer significantly improved patient outcomes. As a result, this novel method disseminates rapidly, with many surgical teams having developed peritoneal malignancy treatment programs. Protocols are needed for the introduction, handling, and management of chemotherapeutic agents in the operating room to minimize risk to the staff involved in the procedure. The personnel exposure during CRS and HIPEC may arise from different routes, such as air contamination, direct contact, manipulation of perfusates or chemotherapy solutions, and manipulation of objects/tissues exposed to chemotherapeutics. Guidelines for safe administration of HIPEC including environmental contamination risk management, personal protective equipment, and occupational health issues are yet to be established. This review summarizes the existing evidence regarding the safety considerations of HIPEC administration.

  13. A RFID specific participatory design approach to support design and implementation of real-time location systems in the operating room.

    Science.gov (United States)

    Guédon, A C P; Wauben, L S G L; de Korne, D F; Overvelde, M; Dankelman, J; van den Dobbelsteen, J J

    2015-01-01

    Information technology, such as real-time location (RTL) systems using Radio Frequency IDentification (RFID) may contribute to overcome patient safety issues and high costs in healthcare. The aim of this work is to study if a RFID specific Participatory Design (PD) approach supports the design and the implementation of RTL systems in the Operating Room (OR). A RFID specific PD approach was used to design and implement two RFID based modules. The Device Module monitors the safety status of OR devices and the Patient Module tracks the patients' locations during their hospital stay. The PD principles 'multidisciplinary team', 'participation users (active involvement)' and 'early adopters' were used to include users from the RFID company, the university and the hospital. The design and implementation process consisted of two 'structured cycles' ('iterations'). The effectiveness of this approach was assessed by the acceptance in terms of level of use, continuity of the project and purchase. The Device Module included eight strategic and twelve tactical actions and the Patient Module included six strategic and twelve tactical actions. Both modules are now used on a daily basis and are purchased by the hospitals for continued use. The RFID specific PD approach was effective in guiding and supporting the design and implementation process of RFID technology in the OR. The multidisciplinary teams and their active participation provided insights in the social and the organizational context of the hospitals making it possible to better fit the technology to the hospitals' (future) needs.

  14. Fuel cells using ionic liquids as electrolyte and operating at room temperature; Celulas de combustivel utilizando como eletrolito liquidos ionicos e operando a temperatura ambiente

    Energy Technology Data Exchange (ETDEWEB)

    Botton, Janine Padilha; Souza, Roberto Fernando de; Goncalves, Reinaldo Simoes; Dupont, Jairton [Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS (Brazil). Inst. de Quimica], e-mail: janine@iq.ufrgs.br

    2004-07-01

    The room temperature imidazolium based ionic liquids, such as 1-n-butyl-3-methylimidazolium tetrafluoroborate (BMI.BF4) are outstanding electrolytes for fuel cells. A 67% overall cell efficiency is achieve using these liquids as supporting electrolytes for a commercially available alkaline fuel cell (AFC) at room temperature operating with air and hydrogen at atmospheric pressure. (author)

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

    Energy Technology Data Exchange (ETDEWEB)

    Andreoli, S.; Moretti, R. [USC Fisica Sanitaria - Ospedali Riuniti di Bergamo (Italy); Catalano, M.; Locatelli, F. [Degli Studi di Milano Univ., Scuola di Specializzazione in Fisica Sanitaria (Italy)

    2006-07-01

    Intra-Operative Radiation Therapy (I.O.R.T.) is carried out with electron beams produced by a Linac (Linear Accelerator) generally used for conventional radiotherapy with external beam, or by dedicated accelerators that can be employed directly into an operating room. I.O.R.T. refers to the application of radiation during a surgical intervention, after the removal of a neoplastic mass. I.O.R.T. uses on the tumour area a direct irradiation, for the possible localisation of sub-clinic illness or macroscopic residue in the case of non-radical resection. Intra-Operative Radiotherapy foresees a single session only, generally preceded or followed by radiotherapy with external beam. It allows the achievement of a selective radiation boost on the tumour volume. In some cases, it can also be used as a one-time/stand alone treatment in initial cancer of small volume, or in unresectable malignancies for palliative purpose. The technical advantages of I.O.R.T. consist in the direct visual control of the target volume, and in the possibility to protect the healthy tissues by moving them away from the path of the radiation beam. The use of electron beams allows the administration of a homogeneous dose to a selected layer of tissues surrounding the tumour. The following professional staff forms the Operative Group: radiation oncologist, surgeon, anaesthetist, medical physicist, radiation technologist, nurse.The choice of a simulation geometry very similar to the clinical situation allows to evaluate radioprotection data very close to the real situation. For a fixed layout, an anthropomorphic phantom was positioned on the operating bed and a breast I.O.R.T. treatment was simulated positioning all the accessories of the operating room in their typical positions. A detailed dose mapping was performed with a Victoreen 450P ionisation chamber and with environment film-dosimeter on the walls of the operating room during the simulation of the clinical treatment. The simulation appears

  16. 循证护理在手术室的应用%Evidence-based nursing application in operation room

    Institute of Scientific and Technical Information of China (English)

    车南飞

    2011-01-01

    Objective To investigate the model of evidence - based nursing application in operation room. Methods Based on the model of evidence - based nursing, hypothermia, pressure ulcer in perioperative and postoperative cervicobrachialgia pain after laparoscopic operation were all clinically analyzed. Results Following the model of evidence- based nursing, compared with the common practice, hypothermia, pressure ulcer in the perioperative and postoperative cervicobrachialgia after laparoscopic all achieved significant results. Conclusion The model of evidence -based nursing application in operation room could obtain better effects.%目的 探讨循证护理模式在手术室的应用.方法根据循证护理模式,对手术常见的压疮、低体温、腹腔镜手术后引起的颈肩痛进行循证护理研究.结果遵循循证护理模式后,手术常见的压疮、低体温、腹腔镜手术后引起的颈肩痛与既往所采取常规措施比较,均取得良好效果.结论在手术室工作中遵循循证护理模式,可取得良好效果,值得推广.

  17. A fuel cell operating between room temperature and 250 C based on a new phosphoric acid based composite electrolyte

    Energy Technology Data Exchange (ETDEWEB)

    Lan, Rong [Department of Chemistry, Heriot-Watt University, Edinburgh EH14 4AS (United Kingdom); Xu, Xiaoxiang; Irvine, John T.S. [School of Chemistry, University of St Andrews, St Andrews, Fife KY16 9ST (United Kingdom); Tao, Shanwen [Department of Chemistry, Heriot-Watt University, Edinburgh EH14 4AS (United Kingdom); School of Chemistry, University of St Andrews, St Andrews, Fife KY16 9ST (United Kingdom)

    2010-10-15

    A phosphoric acid based composite material with core-shell microstructure has been developed to be used as a new electrolyte for fuel cells. A fuel cell based on this electrolyte can operate at room temperature indicating leaching of H{sub 3}PO{sub 4} with liquid water is insignificant at room temperature. This will help to improve the thermal cyclability of phosphoric acid based electrolyte to make it easier for practical use. The conductivity of this H{sub 3}PO{sub 4}-based electrolyte is stable at 250 C with addition of the hydrophilic inorganic compound BPO{sub 4} forming a core-shell microstructure which makes it possible to run a PAFC at a temperature above 200 C. The core-shell microstructure retains after the fuel cell measurements. A power density of 350 mW/cm{sup 2} for a H{sub 2}/O{sub 2} fuel cell has been achieved at 200 C. The increase in operating temperature does not have significant benefit to the performance of a H{sub 2}/O{sub 2} fuel cell. For the first time, a composite electrolyte material for phosphoric acid fuel cells which can operate in a wide range of temperature has been evaluated but certainly further investigation is required. (author)

  18. The incidence and nature of adverse events during pediatric sedation/anesthesia with propofol for procedures outside the operating room: a report from the Pediatric Sedation Research Consortium.

    Science.gov (United States)

    Cravero, Joseph P; Beach, Michael L; Blike, George T; Gallagher, Susan M; Hertzog, James H

    2009-03-01

    pulmonary adverse events was not different for anesthesiologists versus other providers. We report the largest series of pediatric propofol sedation/anesthesia for procedures outside the operating room. The data indicate that propofol sedation/anesthesia is unlikely to yield serious adverse outcomes in a collection of institutions with highly motivated and organized sedation/anesthesia services. However, the safety of this practice is dependent on a system's ability to manage less serious events. We propose that our data suggest variables for training and credentialing providers of propofol sedation/anesthesia and the system characteristics that promote safe use of this drug.

  19. Manufacture use and invention of protected transport carts for pollutants in operating rooms%手术室污染物品密闭转运车的使用与管理

    Institute of Scientific and Technical Information of China (English)

    田继红

    2012-01-01

    OBJECTIVE To solve the problems of the collection and protected transport of the postoperative pollutants in asepsis area of the operating rooms with single aisle. METHODS A cart was designed for protecting transport of the pollutants in the operating room. RESULTS The effectiveness of the cart has been well proved by applying it in asepsis area in the operating room. It could reduce the risks of infection environment in operating area,ameliorate the OR management and save the operation cost and improve the nursing quality and efficiency. CONCLUSION We conclude that because of its advantages of safety, simple operation and less cost, the protected transport cart is a necessary medical facility in the operating room with single aisle.%目的 解决单走廊洁净手术部术后污染物品的收集与密闭转运的问题.方法 自行设计手术室污染物品与废弃物品密闭转运车.结果 自2006年10月-2011年5月临床使用效果证明其实现了单走廊洁净手术部术后污染物品的快速收集与密闭转运;规避了单走廊洁净手术部环境污染的风险;促进了护理管理的持续改进;节省了手术运营成本,提高了护理工作的质量和效率.结论 因其安全可靠、操作简单、方便快捷、经济实用,而成为单走廊洁净手术部感染控制之必备的医疗用品.

  20. Operational readiness verification, phase 1: A study on safety during outage and restart of nuclear power plants

    Energy Technology Data Exchange (ETDEWEB)

    Hollnagel, E. [Linkoeping Univ. (Sweden). Dept. of Computer and Information Science; Gauthereau, V. [Linkoeping Univ. (Sweden). Dept. of Industrial Engineering

    2001-06-01

    interviews were conducted with technical staff at most of the Swedish NPPs. It focused on which solutions the various NPPs had developed to cope with the problem, and which steps had been taken specifically to improve the efficiency of ORV. It was soon found that ORV could not be separated from the rest of the work done in a NPP during outages since many of the proposed solutions have a broad scope. An analysis of the nine Swedish ORV cases had found weaknesses in four main areas: administration processes, management, human performance, and control room layout. Relative to these, the Swedish NPPs have implemented several technical and organisational solutions. Among the former are an overall re-qualification scheme, blocked safety functions, computerised operational position control, and central indications in the control room. Most of the technical solutions have been part of the design of the newer plants, since to implement them in older plants requires essential changes both in the station and in the control room. The organisational solutions comprised operational readiness plans, systematic ways of working, new instructions, co-ordinated testing, and the use of redundant or independent controls. Special emphasis was put on how the NPPs planned their outages, how the plans were implemented, and how deviations were handled. Issues related to learning from experience were also investigated. It was found that although all the NPPs approached the ORV issues in a serious and efficient manner, the solutions could be different corresponding to the characteristics of the organisation. Finally a number of questions, which still need answers, were identified. One is how new procedures or new barriers are accepted and assimilated into the safety culture. A second concerns the demarcation of systems for which ORV is required, i.e., the boundary between safety and non-safety systems. A third is how complex technical solutions influence the operators' work. Finally, it is

  1. Multidisciplinary teamwork improves use of the operating room: a multicenter study

    NARCIS (Netherlands)

    Veen-Berkx, E. van; Bitter, J.; Kazemier, G.; Scheffer, G.J.; Gooszen, H.G.

    2015-01-01

    BACKGROUND: Poor inter-professional collaboration might negatively influence adequate planning of operative procedures. Interventions capable of improving inter-professional collaboration will positively impact professional practice and health care outcomes. Radboud University Medical Center (UMC)

  2. Robotic nurse duties in the urology operative room: 11 years of experience

    Directory of Open Access Journals (Sweden)

    Ali Abdel Raheem

    2017-04-01

    Full Text Available The robotic nurse plays an essential role in a successful robotic surgery. As part of the robotic surgical team, the robotic nurse must demonstrate a high level of professional knowledge, and be an expert in robotic technology and dealing with robotic malfunctions. Each one of the robotic nursing team “nurse coordinator, scrub-nurse and circulating-nurse” has a certain job description to ensure maximum patient's safety and robotic surgical efficiency. Well-structured training programs should be offered to the robotic nurse to be well prepared, feel confident, and maintain high-quality of care.

  3. Development of an expert system for abnormal operating procedures in a main control room.

    Science.gov (United States)

    Hsieh, Min-Han; Hwang, Sheue-Ling; Liu, Kang-Hong; Liang, Sheau-Farn Max; Chuang, Chang-Fu

    2012-01-01

    The study was conducted from the perspective of human factors engineering in order to compare the process that operators originally used to diagnose potential and actual faults with a process that included an expert system for diagnosing faults. The results of the study indicated that the existence of an expert system for fault diagnosis makes the task of fault diagnosis easier and reduces errors by quickly suggesting likely Abnormal Operating Procedures (AOPs).

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

    OpenAIRE

    Tomasz Jankowski; Magdalena Młynarczyk

    2016-01-01

    Ventilation and air conditioning systems are necessary for developing proper parameters of indoor envi-ronment in operating rooms. The main task of ventilation and air conditioning in those specific areas consists in creating desirable temperature, reducing the number of microorganisms and the concen-trations of hazardous gases and substances in the air, as well as ensuring the proper direction of airflow. In Poland, indoor environment in operating rooms has to comply with the requirements se...

  5. [Rocuronium or vecuronium for intubation for short operations in the preschool age? Effects on time in the operating room and postoperative phase].

    Science.gov (United States)

    Pestel, G; Uhlig, T; Unrein, H; Rothhammer, A

    2001-01-01

    This prospective randomized study compares the effects of rocuronium (R) and vecuronium (V) on the early postoperative period in infants. Forty-eight infants between the ages of three and six, scheduled for elective ENT procedures, were studied after prior approval of local ethics committee and informed parental consent. All children were premedicated with chlorprotixene and belladonna. Anaesthesia was induced with 5 mg/kg thiopentone and 1 vol.-% halothane. Subsequently, 0.4 mg/kg rocuronium or 0.075 mg/kg vecuronium were administered, respectively. Anaesthesia and post-operative care were conducted by independent anaesthetists, who were unaware of the drug used and of the relaxometric data obtained. All children were monitored in the recovery room by pulse oximetry until they reached a Steward Score of 6. Demographic data did not differ between the groups. No differences were recorded between the non-depolarizing relaxants regarding intubation time (R: 24.1 +/- 4.2 min, V: 25.8 +/- 6.8 min) and the time interval from end extubation to leaving the operating theatre (R: 2.3 +/- 0.8 min, V: 2.6 +/- 1.2 min), respectively. Similarly, no differences in SaO2 were noted during the recovery period in the recovery room. Significant differences between the non-depolarizing relaxants were found in the TOF-ratios at extubation (R: 0.73 +/- 0.31 min, V: 0.48 +/- 0.34 min) and arrival in the recovery room (R: 0.88 +/- 0.21 min, V: 0.69 +/- 0.26 min). 0.4 mg/kg Rocuronium and 0.075 mg/kg vecuronium can be used for intubation during short operations on pre-school children. Rocuronium may be the better alternative, due to its faster neuromuscular recovery properties.

  6. Safety methodology for the operation of a continuous intensified reactor

    OpenAIRE

    BENAISSA, Wassila; Elgue, Sébastien; Gabas, Nadine; Cabassud, Michel; Carson, Douglas; Demissy, Michel

    2007-01-01

    International audience; Today the chemical industry has to deal with new challenges. In addition to producing more and faster we must produce safer and cleaner. Thusly, new perspectives have emerged to improve production processes. Green chemistry is certainly one of the most relevant examples but not the only: process intensification and safety also focus on finding creative ways to reduce the use of toxic chemicals and minimize the human and environmental impact. Indeed significant progress...

  7. Implementation Guideline for Maintenance Line Operations Safety Assessment (M-LOSA) and Ramp LOSA (R-LOSA) Programs

    Science.gov (United States)

    2012-08-01

    airlines and Maintenance Repair & Overhaul ( MROs ) communities. 53 Appendix A. Organizational Change Management – Stakeholder Strategy...Maintenance Line Operations Safety Audit MRO – Maintenance, Repair & Overhaul NOSS – Normal Operations Safety Survey QA – Quality Assurance RACI

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

    Directory of Open Access Journals (Sweden)

    MR Khajeh Aminian

    2012-08-01

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

  9. Nursing Work in Operation Room%浅谈手术室护理工作职业

    Institute of Scientific and Technical Information of China (English)

    赵凤凤

    2015-01-01

    本文的主要目的在于研究在临床工作的过程中,手术室护理工作职业存在的一些危害因素,以及研究产生这些危害因素的内在原因是什么,以及我们如何解决这些危险性因素,从而保障护理人员的健康。促使护理人员在手术室护理工作中能够实现自我保护。减少在护理过程中引发的一系列职业病,保障手术室护理人员的身体健康。%The main purpose of this paper is to study some harmful factors in the course of clinical work, and to study the inherent causes of these harmful factors, and how to solve these risk factors, so as to ensure the health of nursing staf . To promote the nursing staf in operation room nursing work to achieve self protection. Reduce a series of occupational diseases caused by the nursing process, ensure the health of nursing staf in operation room.

  10. Study on safety operation for large hydroelectric generator unit

    Science.gov (United States)

    Yan, Z. G.; Cui, T.; Zhou, L. J.; Zhi, F. L.; Wang, Z. W.

    2012-11-01

    Hydroelectric generator unit is a complex mechanical system which is composed of hydraulic turbine and electric generator. Rotary system is supported by the bearing bracket and the reinforced concrete structures, and vibration problem can't be avoided in the process of operating. Many large-scale hydroelectric units have been damaged because of the vibration problem in recent years. As the increase of the hydraulic turbine unit capacity and water head, the safe operation of hydraulic turbine has become a focus research in many countries. The operating characteristics of the hydraulic turbine have obvious differences at different working conditions. Based on the combination of field measurement and theoretical calculation, this paper shows a deep research on the safe operation of a large-scale Francis turbine unit. Firstly, the measurements of vibration, swing, pressure fluctuation and noise were carried out at 4 different heads. And also the relationships between vibrations and pressure fluctuations at different heads and working conditions were analysed deeply. Then the scientific prediction of safe operation for the unit at high head were done based on the CFD numerical calculation. Finally, this paper shows the division of the operating zone for the hydroelectric unit. According to the experimental results (vibrations, swings, pressure fluctuations and noise) as well as the theoretical results, the operating zone of the unit has been divided into three sections: prohibited operating zone, transition operating zone and safe operating zone. After this research was applied in the hydropower station, the security and economic efficiency of unit increased greatly, and enormous economic benefits and social benefits have been obtained.

  11. 76 FR 7107 - Quarterly Listings; Safety Zones, Security Zones, Special Local Regulations, Drawbridge Operation...

    Science.gov (United States)

    2011-02-09

    ... changes to drawbridge schedules to accommodate bridge repairs, seasonal vessel traffic, and local public... Bridge.... Safety Zones (Part 165)...... 11/9/2009 USCG-2008-0700 Portland, OR Safety Zones (Part 165.../4/2009 USCG-2009-0640 Brooklyn/Queens, NY...... Drawbridge Operations 8/1/2009 Regulation (Part 117...

  12. Numerical Study on Effects of Door-Opening on Airflow Patterns and Dynamic Cross-Contamination in an ISO Class 5 Operating Room

    Institute of Scientific and Technical Information of China (English)

    DONG Shuyun; TU Guangbei; CAO Rongguang; YU Zhenfeng

    2009-01-01

    The contamination diffusion to the operating room when the door is open was simulated with a computational fluid dynamic (CFD) method,to give the extent of the contamination diffusion.The influence of the door-opening procedure was ignored since the door of the operating room is normally a sliding one.The flow field in the case of the 16 s course of opening the door was simulated.The simulated and the experimental results demonstrate that the extent of the contamination diffusion is around 1.5 m when there is no temperature difference between indoor and outdoor,and there is hardly any contamination diffusion when the temperature difference is 1 ℃.It can be concluded that the positive pressure difference in the operating room lost its function in preventing the contamination when the door is open.That the temperature of corridor is lower than that of operating room contributes to contamination control.Keeping 1 ℃ temperature difference between corridor and operating room and increasing positive pressure and air flow are suggested.It is more secure to set up an anteroom if persons come in or out of the operation room at the course of surgery.

  13. Assessment of a short hypnosis in a paediatric operating room in reducing postoperative pain and anxiety: A randomised study.

    Science.gov (United States)

    Duparc-Alegria, Nathalie; Tiberghien, Karine; Abdoul, Hendy; Dahmani, Souhayl; Alberti, Corinne; Thiollier, Anne-Francoise

    2017-04-12

    To assess the impact of a short hypnotic session on postoperative anxiety and pain in major orthopaedic surgery. Despite specific information given before a scheduled paediatric surgery, perioperative anxiety can become important. Randomised Clinical Study. The study is an open single-centre randomised clinical study comparing a "control" group versus a "hypnosis" group receiving a short hypnosis pre-induction session as additional experimental analgesic procedure. The primary endpoint was the postoperative anxiety, blindly assessed using a visual analogue scale. The study involved 120 children (age 10-18 years). The results showed no difference between control group versus hypnosis group. Twenty-four hours after surgery (Day+1), the patient's anxiety score was not different between control and hypnosis groups (median [Q1-Q3]: 1 [0; 3] vs. 0 [0; 3], respectively, p = .17). Each group experienced a significant decrease in anxiety level between the day before surgery (Day-1) and the day after surgery (Day+1) (median ([Q1-Q3]) difference of the anxiety score: 2 [4; 0] and 2 [4; 0], respectively, p < .0001 in each group). The postoperative pain scores were low and not different between groups (median [Q1-Q3]: 2 [0; 3] in control group vs. 3 [1; 3] in hypnosis group, p = .57). This randomised study on a short hypnosis session performed in the operating room prior to a major surgery showed no difference in postoperative anxiety and pain levels. The decrease in anxiety and pain levels may be due to the addition of nurse pre-operative interviews and optimisation in communication in the operating room. As postoperative anxiety level was low in both control and hypnosis groups, nurse pre-operative interviews and nurse training in hypnosis may contribute to the optimisation of global management and decrease the postoperative anxiety level. © 2017 John Wiley & Sons Ltd.

  14. Safety management of a complex R&D ground operating system

    Science.gov (United States)

    Connors, J.; Mauer, R. A.

    1975-01-01

    Report discusses safety program implementation for large R&D operating system. Analytical techniques are defined and suggested as tools for identifying potential hazards and determining means to effectively control or eliminate hazards.

  15. Analytical Chemistry Laboratory (ACL) procedure compendium. Volume 7, Safety operation procedure for hot cell

    Energy Technology Data Exchange (ETDEWEB)

    1993-08-01

    This volume contains the interim change notice for the safety operation procedure for hot cell. It covers the master-slave manipulators, dry waste removal, cell transfers, hoists, cask handling, liquid waste system, and physical characterization of fluids.

  16. Effects of Shift Work on Cognitive Performance, Sleep Quality, and Sleepiness among Petrochemical Control Room Operators.

    Science.gov (United States)

    Kazemi, Reza; Haidarimoghadam, Rashid; Motamedzadeh, Majid; Golmohamadi, Rostam; Soltanian, Alireza; Zoghipaydar, Mohamad Reza

    2016-02-03

    Shift work is associated with both sleepiness and reduced performance. The aim of this study was to examine cognitive performance, sleepiness, and sleep quality among petrochemical control room shift workers. Sixty shift workers participated in this study. Cognitive performance was evaluated using a number of objective tests, including continuous performance test, n-back test, and simple reaction time test; sleepiness was measured using the subjective Karolinska Sleepiness Scale (KSS); and sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI) questionnaire. ANCOVA, t-test, and repeated-measures ANOVA were applied for statistical analyses, and the significance level was set at p sleep quality on both day and night shifts, and there were significant differences between the day and night shifts in terms of subjective sleep quality and quantity (p sleep, induced cognitive performance decline at the end of both day and night shifts, and increased sleepiness in night shift. It, thus, seems necessary to take ergonomic measures such as planning for more appropriate shift work and reducing working hours.

  17. Novel, Web-based, information-exploration approach for improving operating room logistics and system processes.

    Science.gov (United States)

    Nagy, Paul G; Konewko, Ramon; Warnock, Max; Bernstein, Wendy; Seagull, Jacob; Xiao, Yan; George, Ivan; Park, Adrian

    2008-03-01

    Routine clinical information systems now have the ability to gather large amounts of data that surgical managers can access to create a seamless and proactive approach to streamlining operations and minimizing delays. The challenge lies in aggregating and displaying these data in an easily accessible format that provides useful, timely information on current operations. A Web-based, graphical dashboard is described in this study, which can be used to interpret clinical operational data, allow managers to see trends in data, and help identify inefficiencies that were not apparent with more traditional, paper-based approaches. The dashboard provides a visual decision support tool that assists managers in pinpointing areas for continuous quality improvement. The limitations of paper-based techniques, the development of the automated display system, and key performance indicators in analyzing aggregate delays, time, specialties, and teamwork are reviewed. Strengths, weaknesses, opportunities, and threats associated with implementing such a program in the perioperative environment are summarized.

  18. Analysis of electricity distribution network operation business models and capitalization of control room functions with DMS

    Energy Technology Data Exchange (ETDEWEB)

    Tanskanen, A.

    2010-07-01

    Electricity distribution network operation (NO) models are challenged as they are expected to continue to undergo changes during the coming decades in the fairly developed and regulated Nordic electricity market. Network asset managers are to adapt to competitive technoeconomical business models regarding the operation of increasingly intelligent distribution networks. Factors driving the changes for new business models within network operation include: increased investments in distributed automation (DA), regulative frameworks for annual profit limits and quality through outage cost, increasing end-customer demands, climatic changes and increasing use of data system tools, such as Distribution Management System (DMS). The doctoral thesis addresses the questions a) whether there exist conditions and qualifications for competitive markets within electricity distribution network operation and b) if so, identification of limitations and required business mechanisms. This doctoral thesis aims to provide an analytical business framework, primarily for electric utilities, for evaluation and development purposes of dedicated network operation models to meet future market dynamics within network operation. In the thesis, the generic build-up of a business model has been addressed through the use of the strategic business hierarchy levels of mission, vision and strategy for definition of the strategic direction of the business followed by the planning, management and process execution levels of enterprise strategy execution. Research questions within electricity distribution network operation are addressed at the specified hierarchy levels. The results of the research represent interdisciplinary findings in the areas of electrical engineering and production economics. The main scientific contributions include further development of the extended transaction cost economics (TCE) for government decisions within electricity networks and validation of the usability of the

  19. Development of NPP control room operators`s mental workload measurement system using bioelectric signals

    Energy Technology Data Exchange (ETDEWEB)

    Shim, Bong Sik; Oh, In Seok; Lee, Hyun Cheol; Cha, Kyung Ho [Korea Atomic Energy Research Institute, Taejon (Korea, Republic of); Lee, Dong Ha [Suwon Univ., Suwon (Korea, Republic of)

    1996-09-01

    This study developed mentalload measurement system based on the relations between mentalload and physiological responses of the human operators. The measurement system was composed of the telemetry system for EEG, EOG, ECG and respiration pattern of the subjects, A/D converter, the physiological signal processing programs (compiled by the Labview). The signal processing programs transformed the physiological signal into the scores indicating mentalload status of the subjects and recorded the mentalload scores in the form of the table of a database. The acqknowledge and the labview programs additionally transformed the mentalload score database and the operator behavior database so that both database were consolidated into one. 94 figs., 57 refs. (Author).

  20. 76 FR 1504 - Pipeline Safety: Establishing Maximum Allowable Operating Pressure or Maximum Operating Pressure...

    Science.gov (United States)

    2011-01-10

    ...: Establishing Maximum Allowable Operating Pressure or Maximum Operating Pressure Using Record Evidence, and... facilities of their responsibilities, under Federal integrity management (IM) regulations, to perform... system, especially when calculating Maximum Allowable Operating Pressure (MAOP) or Maximum Operating...

  1. Facility Safety Plan B360 Complex Biohazardous Operations CMLS-412r0

    Energy Technology Data Exchange (ETDEWEB)

    Cooper, G

    2007-01-08

    This Addendum to the Facility Safety Plan (FSP) 360 Complex describes the safety requirements for the safe conduct of all biohazardous research operations in all buildings within the 360 complex program areas. These requirements include all the responsibilities and authorities of building personnel, operational hazards, and environmental concerns and their controls. In addition, this Addendum prescribes facility-specific training requirements and emergency controls, as well as maintenance and quality assurance requirements for ES&H-related building systems.

  2. Safety Enhancement Technologies for Airport Ramp Area Operations Project

    Data.gov (United States)

    National Aeronautics and Space Administration — NASA has been involved in developing advanced automation systems for improving the efficiency of air-traffic operations, reducing controller workload and enhancing...

  3. 75 FR 23589 - Safety Zones; Blasting Operations and Movement of Explosives, St. Marys River, Sault Sainte Marie...

    Science.gov (United States)

    2010-05-04

    ... SECURITY Coast Guard 33 CFR Part 165 RIN 1625-AA00 Safety Zones; Blasting Operations and Movement of... ensure the safety of the maritime community during blasting and dredging operations. DATES: Effective... action is needed to ensure the public's safety during blasting and dredging operations. Delaying...

  4. Emergency Management Operations Process Mapping: Public Safety Technical Program Study

    Science.gov (United States)

    2011-02-01

    DRDC CSS CR 2011-09 i Emergency Management Operations Process Mapping : Public Security Technical Program Study Anet Greenley ...processus/outils). DRDC CSS CR 2011-09 iii Executive summary Emergency Management Operations Process Mapping PSTP Study [ Greenley , A...technique de sécurité publique – Etude DSTP [ Greenley , A.; Poursina, S.]; DRDC CSS CR 2011-09 L’objectif principal du Programme technique de sécurité

  5. Ergonomic deficiencies in the operating room: examples from minimally invasive surgery.

    Science.gov (United States)

    Matern, Ulrich

    2009-01-01

    The importance of minimally invasive surgery (MIS) has constantly increased in the last 20 years. Laparoscopic removal of the gallbladder has become the gold standard with advantages for patients. However, in laparoscopy, the surgeon loses direct contact with the surgical site. Rather than seeing the entire surgical field including adjacent organs, the surgeon's vision is restricted by an optic and camera system. Pictures of the surgical site in the abdomen are presented on a monitor. Hand eye coordination is decreasing because the operating team is not able to position the monitor at an ergonomically preferable position given that operation tables, constructed for open surgery where surgeons use short instruments, are too high for laparoscopic procedures where surgeons use long-shafted instruments. Additionally the degrees of freedom for camera movements and the instruments are limited, tactile feedback given in open surgery is lost. The typical design of instrument handles leads to pressure areas and nerve lesions. All these aspects force the surgeon into unnatural and uncomfortable body postures that can affect the outcome of the operation. An ideal posture for laparoscopic surgeons is described and ergonomic requirements for an optimal height of operation tables, monitor positions and man-machine interfaces are discussed.

  6. A Study of the Operating Room Scheduling System at Tripler Army Medical Center, Hawaii

    Science.gov (United States)

    1981-08-01

    operating theatre are many, and the benefits to the patients and staff great . However, there would also be some disadvantages which need to be...Standard Mean Standard Average Standard Deviation ’ Devid -ion E_ irror Cataract Extraction 1:49 32 1:14 39 1:40 28 W/.IOL Cataract Extraction 1:33 29 58 25 1

  7. Microorganisms in Confined Habitats: Microbial Monitoring and Control of Intensive Care Units, Operating Rooms, Cleanrooms and the International Space Station.

    Science.gov (United States)

    Mora, Maximilian; Mahnert, Alexander; Koskinen, Kaisa; Pausan, Manuela R; Oberauner-Wappis, Lisa; Krause, Robert; Perras, Alexandra K; Gorkiewicz, Gregor; Berg, Gabriele; Moissl-Eichinger, Christine

    2016-01-01

    Indoor environments, where people spend most of their time, are characterized by a specific microbial community, the indoor microbiome. Most indoor environments are connected to the natural environment by high ventilation, but some habitats are more confined: intensive care units, operating rooms, cleanrooms and the international space station (ISS) are extraordinary living and working areas for humans, with a limited exchange with the environment. The purposes for confinement are different: a patient has to be protected from infections (intensive care unit, operating room), product quality has to be assured (cleanrooms), or confinement is necessary due to extreme, health-threatening outer conditions, as on the ISS. The ISS represents the most secluded man-made habitat, constantly inhabited by humans since November 2000 - and, inevitably, also by microorganisms. All of these man-made confined habitats need to be microbiologically monitored and controlled, by e.g., microbial cleaning and disinfection. However, these measures apply constant selective pressures, which support microbes with resistance capacities against antibiotics or chemical and physical stresses and thus facilitate the rise of survival specialists and multi-resistant strains. In this article, we summarize the available data on the microbiome of aforementioned confined habitats. By comparing the different operating, maintenance and monitoring procedures as well as microbial communities therein, we emphasize the importance to properly understand the effects of confinement on the microbial diversity, the possible risks represented by some of these microorganisms and by the evolution of (antibiotic) resistances in such environments - and the need to reassess the current hygiene standards.

  8. Microorganisms in confined habitats: Microbial monitoring and control of intensive care units, operating rooms, cleanrooms and the International Space Station

    Directory of Open Access Journals (Sweden)

    Maximilian Mora

    2016-10-01

    Full Text Available Indoor environments, where people spend most of their time, are characterized by a specific microbial community, the indoor microbiome. Most indoor environments are connected to the natural environment by high ventilation, but some habitats are more confined: intensive care units, operating rooms, cleanrooms and the international space station (ISS are extraordinary living and working areas for humans, with a limited exchange with the environment. The purposes for confinement are different: a patient has to be protected from infections (intensive care unit, operating room, product quality has to be assured (cleanrooms, or confinement is necessary due to extreme, health-threatening outer conditions, as on the ISS. The ISS represents the most secluded man-made habitat, constantly inhabited by humans since November 2000 – and, inevitably, also by microorganisms. All of these man-made confined habitats need to be microbiologically monitored and controlled, by e.g. microbial cleaning and disinfection. However, these measures apply constant selective pressures, which support microbes with resistance capacities against antibiotics or chemical and physical stresses and thus facilitate the rise of survival specialists and multi-resistant strains. In this article, we summarize the available data on the microbiome of aforementioned confined habitats. By comparing the different operating, maintenance and monitoring procedures as well as microbial communities therein, we emphasize the importance to properly understand the effects of confinement on the microbial diversity, the possible risks represented by some of these microorganisms and by the evolution of (antibiotic resistances in such environments - and the need to reassess the current hygiene standards.

  9. Room temperature CW and QCW operation of Ho:CaF2 laser pumped by Tm:fiber laser

    Science.gov (United States)

    Jelínek, Michal; Cvrček, Jan; Kubeček, Václav; Zhao, Beibei; Ma, Weiwei; Jiang, Dapeng; Su, Liangbi

    2017-05-01

    Laser radiation in the wavelength range around 2 μm is required for its specific properties - it is very suitable for medical applications, remote sensing, or pumping of optical parametric oscillators to generate ultrafast pulses in the mid-IR region further exploited in nonlinear optics. Crystals as YLF, YAG, LLF, and GdVO4 doped by holmium were already investigated and found suitable for the tunable laser generation around 2.1 mμ. Only a few works are devoted to the laser operation of holmium-doped fluorides as CaF2. In this work, pulsed and continuous-wave laser operation of a modified- Bridgman-grown Ho:CaF2 active crystal at room temperature is reported. A commercial 50 W 1940 nm Tm-fiber laser was used to pump a laser oscillator based on a novel 10 mm long 0.5 at.% Ho:CaF2 active crystal placed in the Peltiercooled holder. In the pulsed regime (10 ms, 10 Hz), the laser slope efficiency of 53 % with respect to the absorbed pump power was achieved. The laser generated at the central wavelength of 2085 nm with the maximum mean output power of 365 mW corresponding to the power amplitude of 3.65 W. In the continuous wave regime, the maximum output power was 1.11 W with the slope efficiency of 41 % with respect to the absorbed pump power. To our best knowledge this is the first demonstration of this laser active material operating in the CW regime at room temperature. The tuning range over 60 nm from 2034 to 2094 nm was achieved using a birefringent filter showing the possibility to develop a mode-locked laser system generating pulses in the sub-picosecond range.

  10. A System-Wide Approach to Physician Efficiency and Utilization Rates for Non-Operating Room Anesthesia Sites.

    Science.gov (United States)

    Tsai, Mitchell H; Huynh, Tinh T; Breidenstein, Max W; O'Donnell, Stephen E; Ehrenfeld, Jesse M; Urman, Richard D

    2017-07-01

    There has been little in the development or application of operating room (OR) management metrics to non-operating room anesthesia (NORA) sites. This is in contrast to the well-developed management framework for the OR management. We hypothesized that by adopting the concept of physician efficiency, we could determine the applicability of this clinical productivity benchmark for physicians providing services for NORA cases at a tertiary care center. We conducted a retrospective data analysis of NORA sites at an academic, rural hospital, including both adult and pediatric patients. Using the time stamps from WiseOR® (Palo Alto, CA), we calculated site utilization and physician efficiency for each day. We defined scheduling efficiency (SE) as the number of staffed anesthesiologists divided by the number of staffed sites and stratified the data into three categories (SE 1). The mean physician efficiency was 0.293 (95% CI, [0.281, 0.305]), and the mean site utilization was 0.328 (95% CI, [0.314, 0.343]). When days were stratified by scheduling efficiency (SE 1), we found differences between physician efficiency and site utilization. On days where scheduling efficiency was less than 1, that is, there are more sites than physicians, mean physician efficiency (95% CI, [0.326, 0.402]) was higher than mean site utilization (95% CI, [0.250, 0.296]). We demonstrate that scheduling efficiency vis-à-vis physician efficiency as an OR management metric diverge when anesthesiologists travel between NORA sites. When the opportunity to scale operational efficiencies is limited, increasing scheduling efficiency by incorporating different NORA sites into a "block" allocation on any given day may be the only suitable tactical alternative.

  11. Possible fire hazard caused by mismatching electrical chargers with the incorrect device within the operating room.

    LENUS (Irish Health Repository)

    Hargrove, Martin

    2012-02-03

    It has come to our attention that numerous devices that need charging adaptors during cardiopulmonary bypass (CPB) have similar charging sockets but different voltage requirements. This has caused one of our devices in the operating theater to overheat and completely shut down when connected to an incorrect higher-voltage charger. The possibility of fire, device destruction, or patient harm in such circumstances is of serious concern.

  12. A marker-less technique for measuring kinematics in the operating room.

    Science.gov (United States)

    Frasier, Lane L; Azari, David P; Ma, Yue; Pavuluri Quamme, Sudha R; Radwin, Robert G; Pugh, Carla M; Yen, Thomas Y; Chen, Chia-Hsiung; Greenberg, Caprice C

    2016-11-01

    Often in simulated settings, quantitative analysis of technical skill relies largely on specially tagged instruments or tracers on surgeons' hands. We investigated a novel, marker-less technique for evaluating technical skill during open operations and for differentiating tasks and surgeon experience level. We recorded the operative field via in-light camera for open operations. Sixteen cases yielded 138 video clips of suturing and tying tasks ≥5 seconds in duration. Video clips were categorized based on surgeon role (attending, resident) and task subtype (suturing tasks: body wall, bowel anastomosis, complex anastomosis; tying tasks: body wall, superficial tying, deep tying). We tracked a region of interest on the hand to generate kinematic data. Nested, multilevel modeling addressed the nonindependence of clips obtained from the same surgeon. Interaction effects for suturing tasks were seen between role and task categories for average speed (P = .04), standard deviation of speed (P = .05), and average acceleration (P = .03). There were significant differences across task categories for standard deviation of acceleration (P = .02). Significant differences for tying tasks across task categories were observed for maximum speed (P = .02); standard deviation of speed (P = .04); and average (P = .02), maximum (P < .01), and standard deviation (P = .03) of acceleration. We demonstrated the ability to detect kinematic differences in performance using marker-less tracking during open operative cases. Suturing task evaluation was most sensitive to differences in surgeon role and task category and may represent a scalable approach for providing quantitative feedback to surgeons about technical skill. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. Linguistic analysis of verbal and non-verbal communication in the operating room.

    Science.gov (United States)

    Moore, Alison; Butt, David; Ellis-Clarke, Jodie; Cartmill, John

    2010-12-01

    Surgery can be a triumph of co-operation, the procedure evolving as a result of joint action between multiple participants. The communication that mediates the joint action of surgery is conveyed by verbal but particularly by non-verbal signals. Competing priorities superimposed by surgical learning must also be negotiated within this context and this paper draws on techniques of systemic functional linguistics to observe and analyse the flow of information during such a phase of surgery.

  14. War stories: a qualitative analysis of narrative teaching strategies in the operating room

    Science.gov (United States)

    Hu, Yue-Yung; Peyre, Sarah E.; Arriaga, Alexander F.; Roth, Emilie M.; Corso, Katherine A.; Greenberg, Caprice C.

    2015-01-01

    BACKGROUND “War stories” are commonplace in surgical education, yet little is known about their purpose, construct, or use in the education of trainees. METHODS Ten complex operations were videotaped and audiotaped. Narrative stories were analyzed using grounded theory to identify emergent themes in both the types of stories being told and the teaching objectives they illustrated. RESULTS Twenty-four stories were identified in 9 of the 10 cases (mean, 2.4/case). They were brief (mean, 58 seconds), illustrative of multiple teaching points (mean, 1.5/story), and appeared throughout the operations. Anchored in personal experience, these stories taught both clinical (eg, operative technique, decision making, error identification) and programmatic (eg, resource management, professionalism) topics. CONCLUSIONS Narrative stories are used frequently and intuitively by physicians to emphasize a variety of intraoperative teaching points. They socialize trainees in the culture of surgery and may represent an underrecognized approach to teaching the core competencies. More understanding is needed to maximize their potential. PMID:22088266

  15. War stories: a qualitative analysis of narrative teaching strategies in the operating room.

    Science.gov (United States)

    Hu, Yue-Yung; Peyre, Sarah E; Arriaga, Alexander F; Roth, Emilie M; Corso, Katherine A; Greenberg, Caprice C

    2012-01-01

    "War stories" are commonplace in surgical education, yet little is known about their purpose, construct, or use in the education of trainees. Ten complex operations were videotaped and audiotaped. Narrative stories were analyzed using grounded theory to identify emergent themes in both the types of stories being told and the teaching objectives they illustrated. Twenty-four stories were identified in 9 of the 10 cases (mean, 2.4/case). They were brief (mean, 58 seconds), illustrative of multiple teaching points (mean, 1.5/story), and appeared throughout the operations. Anchored in personal experience, these stories taught both clinical (eg, operative technique, decision making, error identification) and programmatic (eg, resource management, professionalism) topics. Narrative stories are used frequently and intuitively by physicians to emphasize a variety of intraoperative teaching points. They socialize trainees in the culture of surgery and may represent an underrecognized approach to teaching the core competencies. More understanding is needed to maximize their potential. Copyright © 2012 Elsevier Inc. All rights reserved.

  16. 加强医院整形美容门诊手术室管理控制医院感染%Improving management of cosmetic surgery outpatient operating room to control nosocomial infection

    Institute of Scientific and Technical Information of China (English)

    王艳; 董薪; 张金凤; 孙建荷

    2011-01-01

    目的 探讨医院整形美容门诊手术室安全有效的管理措施,加强整形美容手术各个环节管理,预防和控制医院感染. 方法 通过加强组织领导,规范手术室环境、手术物品、手术人员等各个环节管理, 建立健全整形美容手术室医院感染控制体系. 结果 加强了整形美容手术室医院感染的管理体系,有效地预防和控制了医院感染,提高了手术室医疗护理质量. 结论 采取严格规范系统的整形美容手术管理措施,可以有效控制医院感染的发生,对加强医院规范化管理,控制医院感染具有积极重要的意义.%OBJECTIVE To discuss the effective measures for the safety of cosmetic surgery in outpatient operating room and strengthen the management of every links of cosmetic surgery to prevent and control the incidence of nosocomial infection. METHODS By means of reinforcing the administrative performance, the links to the operating room management, such as the environment of operating room, supervision of operation materials and surgical staff, were regulated to establish and perfect the control system of hospital infection in cosmetic surgery operating room. RESULTS The administrative system of nosocomial infection, the effective prevention and control of nosocomial infection in cosmetic surgery operation room and the quality of medical care in cosmetic surgery operation room had been improved. CONCLUSION Adopting the strict, standard and systemic management in cosmetic surgery can effectively control the occurrence of hospital infection and improve the quality of medical nursing and ensure the medical security, which has the positive significance to the standardized management and control of nosocomial infection.

  17. Operational safety practices as determinants of machinery-related injury on Saskatchewan farms.

    Science.gov (United States)

    Narasimhan, Gopinath R; Peng, Yingwei; Crowe, Trever G; Hagel, Louise; Dosman, James; Pickett, William

    2010-07-01

    Agricultural machinery is a major source of injury on farms. The importance of machinery safety practices as potential determinants of injury remains incompletely understood. We examined two such safety practices as risk factors for injury: (1) the presence of safety devices on machinery and (2) low levels of routine machinery maintenance. Our data source was the Saskatchewan Farm Injury Cohort baseline survey (n=2390 farms). Factor analysis was used to create measures of the two operational safety practices. The farm was the unit for all analyses and associations were evaluated using multiple Poisson regression models. Limited presence of safety devices on machinery during farm operations was associated with higher risks for injury (RR 1.94; 95% CI 1.13-3.33; p(trend)=0.02). Lower routine maintenance scores were associated with significantly reduced risks for injury (RR 0.54; 95% CI 0.29-0.98; p(trend)=0.05). The first finding implies that injury prevention programs require continued focus on the use of safety devices on machinery. The second finding could indicate that maintenance itself is a risk factor or that more modern equipment that requires less maintenance places the operator at lower risk. These findings provide etiological data that confirms the practical importance of operational safety practices as components of injury control strategies on farms. Copyright 2010 Elsevier Ltd. All rights reserved.

  18. MANAGEMENT OF POWER NETWORK OPERATION SAFETY IN MINING

    Directory of Open Access Journals (Sweden)

    Sergiusz BORON

    2015-04-01

    Full Text Available The paper characterizes hazards resulting from the use of power networks in underground workings of mines, with particular emphasis placed on electric shock and explosion hazards. Protection measures that mitigate hazards caused by network failures are presented. These measures are related to the proper design of equipment and cable lines, network arrangement and principles of selecting adequate protection equipment. The vast majority of electrical accidents are caused by the incorrect behaviour of people, mostly intentional (resulting from not respecting the rules. For this reason, particular attention should be paid to the level of skills and awareness of the risks of electrical personnel, especially for junior employees. The article presents selected safety rules when working on electrical equipment.

  19. Design, Operations, and Safety Report for the MERIT Target System

    Energy Technology Data Exchange (ETDEWEB)

    Graves, Van B [ORNL; Spampinato, Philip Thomas [ORNL

    2007-09-01

    The Mercury Intense Target Project (MERIT) is a proof-of-principal experiment to determine the feasibility of using a free-jet of Hg as a spallation target in a Neutrino Factory or a Muon Collider facility. The 1-cm-diameter, 20-m/sec jet will be generated inside a 15-Tesla magnetic field, and high-speed optical diagnostics will be used to photograph the interaction between the Hg jet and a 24-GeV proton beam.The experiment is scheduled to be conducted at CERN in 2007. ORNL is responsible for the design, fabrication, and testing of a system to deliver the Hg jet within the confines of the 15-cm magnet bore. This report documents the functional and safety requirements of the Hg system along with descriptions of its interfaces to the other experimental equipment.

  20. Human factor as operating safety dominant of ATM navigation support

    Directory of Open Access Journals (Sweden)

    Ю.В. Зайцев

    2004-04-01

    Full Text Available  The method of specifying individual psychophysical characteristics of the human higher nervous activity has been studied to match professional fitness. Information processing rate is being estimated considering peculiarities of the nervous system of the operators working in extreme situations, and providing fluent knowledge of Ukrainian, Russian and English.

  1. Surgical outcomes and transfusion of minimal amounts of blood in the operating room.

    Science.gov (United States)

    Ferraris, Victor A; Davenport, Daniel L; Saha, Sibu P; Austin, Peter C; Zwischenberger, Joseph B

    2012-01-01

    To examine outcomes in patients who receive small amounts of intraoperative blood transfusion. Longitudinal, uncontrolled observational study evaluating results of intraoperative transfusion in patients entered into the American College of Surgeons National Surgical Quality Improvement Program database. We made propensity-matched comparisons between patients who received and did not receive intraoperative transfusion to minimize confounding when estimating the effect of intraoperative transfusion on postoperative outcomes. We queried the American College of Surgeons National Surgical Quality Improvement Program database for patients undergoing operations between January 1, 2005, and December 31, 2009. A large sample of surgical patients from 173 hospitals throughout the United States. Operative mortality and serious perioperative morbidity (≥1 of 20 complications). After exclusions, 941,496 operations were analyzed in patients from 173 hospitals. Most patients (893,205 patients [94.9%]) did not receive intraoperative transfusions. Patients who received intraoperative infusion of 1 unit of packed red blood cells (15,186 patients [1.6%]) had higher unadjusted rates of mortality and more serious morbidity. These rates further increased with intraoperative transfusion of more than 1 unit of packed red blood cells in a dose-dependent manner. After propensity matching to adjust for multiple preoperative risks, transfusion of a single unit of packed red blood cells increased the multivariate risk of mortality, wound problems, pulmonary complications, postoperative renal dysfunction, systemic sepsis, composite morbidity, and postoperative length of stay compared with propensity-matched patients who did not receive intraoperative transfusion. There is a dose-dependent adverse effect of intraoperative blood transfusion. It is likely that a small, possibly discretionary amount of intraoperative transfusion leads to increased mortality, morbidity, and resource use

  2. Room Temperature Operation of a Radiofrequency Diamond Magnetometer near the Shot Noise Limit

    CERN Document Server

    Shin, Chang S; Butler, Mark C; Trease, David R; Seltzer, Scott J; Mustonen, J Peter; Kennedy, Daniel J; Acosta, Victor M; Budker, Dmitry; Pines, Alexander; Bajaj, Vikram S

    2012-01-01

    We operate a nitrogen vacancy (NV-) diamond magnetometer at ambient temperatures and study the dependence of its bandwidth on experimental parameters including optical and microwave excitation powers. We introduce an analytical theory that yields an explicit formula for the response of an ensemble of NV- spins to an oscillating magnetic field, such as in NMR applications. We measure a detection bandwidth of 1.6 MHz and a sensitivity of 4.6 nT/Hz^(1/2), unprecedented in a detector with this active volume and close to the photon shot noise limit of our experiment.

  3. Application of Hierarchical Goal Analysis to the Halifax Class Frigate Operations Room: A Case Study

    Science.gov (United States)

    2007-11-01

    HGA and a software tool for performing all phases of HGA would reduce the time and effort required, improve the usability of the outputs, and improve... organisationnelle de la sécurité maritime. Malgré la taille et la complexité de la salle des opérations, l’AOH a permis de cerner les conflits potentiels...approaches have used either tasks, defined as activities performed by human operators (cf., [2], [3], [4]) or functions, defined as capabilities

  4. [Optimization of working in the operating room by minimizing losses and improving flow].

    Science.gov (United States)

    Leppikangas, Heli; Puolakka, Pia; Korppi, Anssi; Heikki-Jussi, Laine

    2015-01-01

    The need for development of practices within the Finnish healthcare system is immense. Economic threats will force the system to streamline treatment processes without sacrificing quality. Surgical operations bind resources and represent one of the most expensive units in the hospital. By developing the respective procedures it is possible to achieve significant changes in the patient's entire care pathway. Lean is a practical management philosophy involving fairly expedient and structured methods of work development. On the basis of available research results and practical experiences Lean is very well suited for a method of development of practices within healthcare.

  5. The evolution of a purpose designed hybrid trauma operating room from the trauma service perspective: the RAPTOR (Resuscitation with Angiography Percutaneous Treatments and Operative Resuscitations).

    Science.gov (United States)

    Kirkpatrick, Andrew W; Vis, Christine; Dubé, Mirette; Biesbroek, Susan; Ball, Chad G; Laberge, Jason; Shultz, Jonas; Rea, Ken; Sadler, David; Holcomb, John B; Kortbeek, John

    2014-09-01

    Traumatic injury is the leading cause of potentially preventable lost years of life in the Western world and exsanguination is the most potentially preventable cause of post-traumatic death. With mature trauma systems and experienced trauma centres, extra-abdominal sites, such as the pelvis, constitute the most frequent anatomic site of exsanguination. Haemorrhage control for such bleeding often requires surgical adjuncts most notably interventional radiology (IR). With the usual paradigm of surgery conducted within an operating room and IR procedures within distant angiography suites, responsible clinicians are faced with making difficult decisions regarding where to transport the most physiologically unstable patients for haemorrhage control. If such a critical patient is transported to the wrong suite, they may die unnecessarily despite having potentially salvageable injuries. Thus, it seems only logical that the resuscitative operating room of the future would have IR capabilities making it the obvious geographic destination for critically unstable patients, especially those who are exsanguinating. Our trauma programme recently had the opportunity to conceive, design, build, and operationalise a purpose-designed hybrid trauma operating room, designated as the resuscitation with angiographic percutaneous techniques and operative resuscitation (RAPTOR) suite, which we believe to be the first such resource designed primarily to serve the exsanguinating trauma patient. The project was initiated after consultations between the trauma programme and private philanthropists regarding the greatest potential impacts on regional trauma care. The initial capital construction costs were thus privately generated but coincided with a new hospital wing construction allowing the RAPTOR to be purpose-designed for the exsanguinating patient. Many trauma programmes around the world are now starting to navigate the complex process of building new facilities, or else retrofitting

  6. A new sensor for ammonia based on cyanidin-sensitized titanium dioxide film operating at room temperature

    Energy Technology Data Exchange (ETDEWEB)

    Xiao-wei, Huang [School of Food and Biological Engineering, Jiangsu University, 301 Xuefu Road, 212013 Zhenjiang, Jiangsu (China); Xiao-bo, Zou, E-mail: zou_xiaobo@ujs.edu.cn [School of Food and Biological Engineering, Jiangsu University, 301 Xuefu Road, 212013 Zhenjiang, Jiangsu (China); Key Laboratory of Modern Agricultural Equipment and Technology, 301 Xuefu Road, 212013 Zhenjiang, Jiangsu (China); Ji-yong, Shi; Jie-wen, Zhao; Yanxiao, Li [School of Food and Biological Engineering, Jiangsu University, 301 Xuefu Road, 212013 Zhenjiang, Jiangsu (China); Limin, Hao; Jianchun, Zhang [The Research Center of China Hemp Materials, Beijing (China)

    2013-07-17

    Graphical abstract: -- Highlights: •TiO{sub 2} was prepared by sol–gel method film and then functionalized with the cyanidin dye. •The morphology and the absorption spectra of films were examined. •The hybrid organic–inorganic formed film here can detect ammonia reversibly at room temperature. •The low humidity could promote the sensitivity of the sensors. -- Abstract: Design and fabrication of an ammonia sensor operating at room temperature based on pigment-sensitized TiO{sub 2} films was described. TiO{sub 2} was prepared by sol–gel method and deposited on glass slides containing gold electrodes. Then, the film immersed in a 2.5 × 10{sup −4} M ethanol solution of cyanidin to absorb the pigment. The hybrid organic–inorganic formed film here can detect ammonia reversibly at room temperature. The relative change resistance of the films at a potential difference of 1.5 V is determined when the films are exposed to atmospheres containing ammonia vapors with concentrations over the range 10–50 ppm. The relative change resistance, S, of the films increased almost linearly with increasing concentrations of ammonia (r = 0.92). The response time to increasing concentrations of the ammonia is about 180–220 s, and the corresponding values for decreasing concentrations 240–270 s. At low humidity, ammonia could be ionized by the cyanidin on the TiO{sub 2} film and thereby decrease in the proton concentration at the surface. Consequently, more positively charged holes at the surface of the TiO{sub 2} have to be extracted to neutralize the adsorbed cyanidin and water film. The resistance response to ammonia of the sensors was nearly independent on temperature from 10 to 50 °C. These results are not actually as good as those reported in the literature, but this preliminary work proposes simpler and cheaper processes to realize NH{sub 3} sensor for room temperature applications.

  7. Neural networks improve brain cancer detection with Raman spectroscopy in the presence of operating room light artifacts

    Science.gov (United States)

    Jermyn, Michael; Desroches, Joannie; Mercier, Jeanne; Tremblay, Marie-Andrée; St-Arnaud, Karl; Guiot, Marie-Christine; Petrecca, Kevin; Leblond, Frederic

    2016-09-01

    Invasive brain cancer cells cannot be visualized during surgery and so they are often not removed. These residual cancer cells give rise to recurrences. In vivo Raman spectroscopy can detect these invasive cancer cells in patients with grade 2 to 4 gliomas. The robustness of this Raman signal can be dampened by spectral artifacts generated by lights in the operating room. We found that artificial neural networks (ANNs) can overcome these spectral artifacts using nonparametric and adaptive models to detect complex nonlinear spectral characteristics. Coupling ANN with Raman spectroscopy simplifies the intraoperative use of Raman spectroscopy by limiting changes required to the standard neurosurgical workflow. The ability to detect invasive brain cancer under these conditions may reduce residual cancer remaining after surgery and improve patient survival.

  8. Simulator platform for fast reactor operation and safety technology demonstration

    Energy Technology Data Exchange (ETDEWEB)

    Vilim, R. B.; Park, Y. S.; Grandy, C.; Belch, H.; Dworzanski, P.; Misterka, J. (Nuclear Engineering Division)

    2012-07-30

    A simulator platform for visualization and demonstration of innovative concepts in fast reactor technology is described. The objective is to make more accessible the workings of fast reactor technology innovations and to do so in a human factors environment that uses state-of-the art visualization technologies. In this work the computer codes in use at Argonne National Laboratory (ANL) for the design of fast reactor systems are being integrated to run on this platform. This includes linking reactor systems codes with mechanical structures codes and using advanced graphics to depict the thermo-hydraulic-structure interactions that give rise to an inherently safe response to upsets. It also includes visualization of mechanical systems operation including advanced concepts that make use of robotics for operations, in-service inspection, and maintenance.

  9. Use of operating room information system data to predict the impact of reducing turnover times on staffing costs.

    Science.gov (United States)

    Dexter, Franklin; Abouleish, Amr E; Epstein, Richard H; Whitten, Charles W; Lubarsky, David A

    2003-10-01

    Potential benefits to reducing turnover times are both quantitative (e.g., complete more cases and reduce staffing costs) and qualitative (e.g., improve professional satisfaction). Analyses have shown the quantitative arguments to be unsound except for reducing staffing costs. We describe a methodology by which each surgical suite can use its own numbers to calculate its individual potential reduction in staffing costs from reducing its turnover times. Calculations estimate optimal allocated operating room (OR) time (based on maximizing OR efficiency) before and after reducing the maximum and average turnover times. At four academic tertiary hospitals, reductions in average turnover times of 3 to 9 min would result in 0.8% to 1.8% reductions in staffing cost. Reductions in average turnover times of 10 to 19 min would result in 2.5% to 4.0% reductions in staffing costs. These reductions in staffing cost are achieved predominantly by reducing allocated OR time, not by reducing the hours that staff work late. Heads of anesthesiology groups often serve on OR committees that are fixated on turnover times. Rather than having to argue based on scientific studies, this methodology provides the ability to show the specific quantitative effects (small decreases in staffing costs and allocated OR time) of reducing turnover time using a surgical suite's own data. Many anesthesiologists work at hospitals where surgeons and/or operating room (OR) committees focus repeatedly on turnover time reduction. We developed a methodology by which the reductions in staffing cost as a result of turnover time reduction can be calculated for each facility using its own data. Staffing cost reductions are generally very small and would be achieved predominantly by reducing allocated OR time to the surgeons.

  10. Safety in the Operating Theatre | a Multi Factor Approach for Patients and Teams

    NARCIS (Netherlands)

    Wauben, L.S.G.L.

    2010-01-01

    Due to the advances in high-tech technology in the operating theatre, the increased number of persons involved, and the increased complexity of surgical procedures, medical errors are inflicted. To answer the main question: How to improve patient safety in the operating theatre during surgery? this

  11. 4-H Tractor Operator Program Teaches Employability Skills and Safety to Youth

    Science.gov (United States)

    Barrett, Debra K.

    2013-01-01

    For Michigan State University Extension, the Berrien County 4-H Tractor Operator Program has provided tractor safety education to teens for over 30 years. The certification training satisfies current requirements for operation of a 20 PTO HP or greater agricultural tractor by 14- and 15-year-old youth employed on property "not" owned,…

  12. Safety in the Operating Theatre | a Multi Factor Approach for Patients and Teams

    NARCIS (Netherlands)

    Wauben, L.S.G.L.

    2010-01-01

    Due to the advances in high-tech technology in the operating theatre, the increased number of persons involved, and the increased complexity of surgical procedures, medical errors are inflicted. To answer the main question: How to improve patient safety in the operating theatre during surgery? this

  13. ENVIRONMENTAL AND SAFETY ACCIDENTS RELATED TO BLASTING OPERATION

    Directory of Open Access Journals (Sweden)

    Lazar Kricak

    2012-01-01

    Full Text Available The blasting process remains a potential source of numerous environmental and safety accidents. The majority of these accidents were contributed to the flyrock and lack of blast area security. A field-scale investigation related to flyrock accident was conducted in an andesite quarry where rocks up to 50 cm in diameter were propelled almost 300 m from the center of blasting field causing extensive damages to the surrounding objects. The study revealed that accident occurred due to the existence of andesite alteration in one section of the blast field. The existence of this alteration caused a sliding of rock masses along the subsistent joint planes and thereby reduced burden for the second row of blastholes. Alterations involved small area of andesite masses that were not detected by previous geological exploration or visually observed prior to initiation of blastholes. The result of this filed investigation should have a positive impact on hazard awareness, prevention and safe blasting practices in mining and construction industries."

  14. An audit of operating room time utilization in a teaching hospital: is there a place for improvement?

    Science.gov (United States)

    Stavrou, George; Panidis, Stavros; Tsouskas, John; Tsaousi, Georgia; Kotzampassi, Katerina

    2014-01-01

    Aim. To perform a thorough and step-by-step assessment of operating room (OR) time utilization, with a view to assess the efficacy of our practice and to identify areas of further improvement. Materials and Methods. We retrospectively analyzed the most ordinary general surgery procedures, in terms of five intervals of OR time utilization: anaesthesia induction, surgery preparation, duration of operation, recovery from anaesthesia, and transfer to postanaesthesia care unit (PACU) or intensive care unit (ICU). According to their surgical impact, the procedures were defined as minor, moderate, and major. Results. A total of 548 operations were analyzed. The mean (SD) time in minutes for anaesthesia induction was 19 (9), for surgery preparation 13 (8), for surgery 115 (64), for recovery from anaesthesia 12 (8), and for transfer to PACU/ICU 12 (9). The time spent in each step presented an ascending escalation pattern proportional to the surgical impact (P = 0.000), which was less pronounced in the transfer to PACU/ICU (P = 0.006). Conclusions. Albeit, our study was conducted in a teaching hospital, the recorded time estimates ranged within acceptable limits. Efficient OR time usage and outliers elimination could be accomplished by a better organized transfer personnel service, greater availability of anaesthesia providers, and interdisciplinary collaboration.

  15. Formal safety assessment and application of the navigation simulators for preventing human error in ship operations

    Institute of Scientific and Technical Information of China (English)

    2005-01-01

    The International Maritime Organization (IMO) has encouraged its member countries to introduce Formal Safety Assessment (FSA) for ship operations since the end of the last century. FSA can be used through certain formal assessing steps to generate effective recommendations and cautions to control marine risks and improve the safety of ships. On the basis of the brief introduction of FSA, this paper describes the ideas of applying FSA to the prevention of human error in ship operations. It especially discusses the investigation and analysis of the information and data using navigation simulators and puts forward some suggestions for the introduction and development of the FSA research work for safer ship operations.

  16. Application Analysis of Evidence-based Operation Room Nursing in the Operation Room Emergency Patient Care%循证手术室护理在手术室急诊患者护理中的应用分析

    Institute of Scientific and Technical Information of China (English)

    张梅; 喻瑛; 龚俊仙

    2015-01-01

    Objective:To investigate the clinical application effect of evidence-based operation room nursing in the operation room emergency patient care,and provide a theoretical basis for improving the level of care for emergency patients.Method:100 emergency surgical patients in operation room of our hospital from February 2013 to March 2014 were retrospectively analyzed,they were randomly divided into the control group and the experimental group according to the different ways of surgical care,50 cases in each group.The patients in the control group were treated with routine care,while the patients in the experimental group were treated with routine care added evidence-based care.The clinical effects of the two groups were compared and analyzed.Result:The operative time and postoperative recovery time of the experimental group were (50.65±3.48)min,(5.47±1.62)d,which were significantly shorter than (69.47±3.62)min and (8.26±1.48)d of the control group,the differences were statistically significant(P<0.05).The nursing satisfaction of the experimental group was 96.0%(48/50),which was significantly higher than 72.0%(36/50) of the control group, the incidence of adverse reactions in the experimental group was 4.0%(2/50),which significantly lower than 26.0%(13/50) in the control group,the differences were statistically significant(P<0.05).The scores of depression,anxiety, hostility,fear in the experimental group were significantly lower than those in the control group,the differences were statistically significant(P<0.05).Conclusion:Application of evidence-based operation room nursing in the operation room emergency patient care can improve the quality of nursing care,decrease the postoperative recovery time,increase the satisfaction of emergency surgical patients,lower the incidence of adverse reactions,with obvious clinical practice value,it is worthy of further promotion and application.%目的:探讨循证手术护理在手术室急诊患者护理中的临床应用

  17. Application of Safety Culture in Nursing Operation in Elderly Patients%安全文化在老年患者手术护理中的应用

    Institute of Scientific and Technical Information of China (English)

    刘雪春; 俞莉; 赵杉杉; 齐瑞芳

    2014-01-01

    Objective To the concept of safety culture goes through in elderly patients with surgical nursing management, to improve the nursing quality of elderly patients with surgery. Methods To summarize 2012 years, 200 cases of elderly surgical patients safety culture nursing methods, standardized work processes. Results Through creating a safety culture, improve the safety awareness of the operating room nurses and reduce the potential safety hazard for elderly patients with surgery. Conclusion The implementation of safety culture of every detail to prevent the nursing safety problems in the elderly patients with surgery.%目的将安全文化理念贯穿于老年手术患者的护理管理,提高老年手术患者的护理质量。方法总结2012年1年中200例老年手术患者实施安全文化护理方法,制定标准化工作流程。结果通过营造安全文化,提高了手术室护士的安全意识,减少了老年患者手术的安全隐患。结论实施安全文化的每一个细节预防了老年患者手术中的护理安全隐患。

  18. Operational Safety Analysis of CEFR Main Feed Pump

    Institute of Scientific and Technical Information of China (English)

    DING; Tong-wei; ZHANG; Huan-qi

    2012-01-01

    <正>China Experimental Fast Reactor (CEFR) use three main feed pumps, two parallel running and one standby at full power. During CEFR operation, the pressure of deaerator is maintained at (1.16±0.01) MPa. Combined with the actual condition of the single feed pump carried out the NPSH analysis of full flow range calculation, the results are listed in Table 1. The actual measured mounting height of feed water pump is -19.2 m. The analysis results that the main feed pumps running condition cavitation does not

  19. Outside the operating room: How a robotics program changed resource utilization on the inpatient Ward.

    Science.gov (United States)

    Leung, Annie; Abitbol, Jeremie; Ramana-Kumar, Agnihotram V; Fadlallah, Bassam; Kessous, Roy; Cohen, Sabine; Lau, Susie; Salvador, Shannon; Gotlieb, Walter H

    2017-04-01

    To analyze the changes in the composition of the gynecologic oncology inpatient ward following the implementation of a robotic surgery program and its impact on inpatient resource utilization and costs. Retrospective review of the medical charts of patients admitted onto the gynecologic oncology ward the year prior to and five years after the implementation of robotics. The following variables were collected: patient characteristics, hospitalization details (reason for admission and length of hospital stay), and resource utilization (number of hospitalization days, consultations, and imaging). Following the introduction of robotic surgery, there were more admissions for elective surgery yet these accounted for only 21% of the inpatient ward in terms of number of hospital days, compared to 36% prior to the robotic program. This coincided with a sharp increase in the overall number of patients operated on by a minimally invasive approach (15% to 76%, probotics era. The robotics program contributed to a ward with higher proportion of patients with complex comorbidities (Charlson≥5: RR 1.06), Stage IV disease (RR 1.30), and recurrent disease (RR 1.99). Introduction of robotic surgery allowed for more patients to be treated surgically while simultaneously decreasing inpatient resource use. With more patients with non-surgical oncological issues and greater medical complexity, the gynecologic oncology ward functions more like a medical rather than surgical ward after the introduction of robotics, which has implications for hospital-wide resource planning. Copyright © 2017 Elsevier Inc. All rights reserved.

  20. Multi-wavelength Operation of an Er3+-doped Fiber Laser at Room Temperature with a Novel Optical Fiber Mach-Zehnder Interferometer

    Institute of Scientific and Technical Information of China (English)

    AN Hong-Lin; LIN Xiang-Zhi; LIU Hong-Du

    2000-01-01

    A novel multi-wavelength erbium-doped fiber laser with a double-pass Mach-Zehnder fiber interferometer acting both as a comb filter and as a reflection mirror is demonstrated. The spatial hole burning effect introduced by the standing wave cavity configuration enables the simultaneous operation of multiple wavelengths in the homogeneously broadened erbium-doped fiber at room temperature. In the experiment, simultaneous oscillation of four wavelengths at room temperature has been obtained.

  1. 在导管室管理中手术室管理模式的可行性探讨%Feasibility study of management mode of operation room in the management of catheter room

    Institute of Scientific and Technical Information of China (English)

    丁小云; 周鹏飞; 王晓玉; 黄永丽

    2015-01-01

    Using operating room management mode gives independent management for catheter room,the department management is more standardized,the resource utilization is efficiency,the work team is professionalization,and the benefit is improved obviously.The catheter room is constructed into the second operation room of hospital,as an open and comprehensive platform which is characterized by interventional operation to manage.It is a kind of effective management mode.%目的:运用手术室管理模式对导管室进行独立管理,科室管理更加规范化,资源利用高效化,工作队伍专业化,效益明显提高。将导管室建设成医院的第二手术室,作为一个以介入手术为特色的开放性、综合性平台来管理,是一种行之有效的管理模式。

  2. Application of Time Management in Operation Room Nursing%时间管理在手术室护理管理中的应用

    Institute of Scientific and Technical Information of China (English)

    王光明; 陈佐彩

    2015-01-01

    目的:探讨时间管理对提高手术室工作效率的效果。方法我院2013年制定并实施手术室时间管理,通过成立质量管理小组、建立手术室时间质量管理制度、严格控制第一台手术开台时间、缩短手术室台间间隔时间、节假日适当安排择期手术等方式方法,提高手术室工作效率。结果2013年共实施手术2469台,日均手术6.8台,第一台手术准时开台率达83%,高于2012年的27%。2013年各科室人员对手术室护理工作满意度明显提高。结论在手术室实施时间管理,可有效提升手术室工作效率、医护人员工作满意度,而且提高了医院经济效益。%Objective To investigate the effect of time management to improve the work efifciency of the operation room.MethodsIn our hospital in 2013 to develop and implement operation room, time management, through the establishment of quality management team, the establishment of operation room time quality management system, strictly control the ifrst surgery founding time, shorten the operation room table time interval, holidays elective surgery way methods appropriate to improve the working efifciency of the operation room.Results A total of 2469 units in 2013 to implement the operation, the daily operation of 6.8 units. In 2013 the ifrst operation time of founding rate of 83%, higher than the 27% in 2012.In 2013 the Department staff on operation room nursing satisfaction improved signiifcantly.ConclusionThe implementation of time management in the operation room, operation room can effectively improve work efifciency, job satisfaction of medical staff, and improve the economic benefit of hospital.

  3. US Department of Energy DOE Nevada Operations Office, Nevada Test Site: Underground safety and health standards

    Energy Technology Data Exchange (ETDEWEB)

    1993-05-01

    The Nevada Test Site Underground Safety and Health Standards Working Group was formed at the direction of John D. Stewart, Director, Nevada Test Site Office in April, 1990. The objective of the Working Group was to compile a safety and health standard from the California Tunnel Safety Orders and OSHA for the underground operations at the NTS, (excluding Yucca Mountain). These standards are called the NTS U/G Safety and Health Standards. The Working Group submits these standards as a RECOMMENDATION to the Director, NTSO. Although the Working Group considers these standards to be the most integrated and comprehensive standards that could be developed for NTS Underground Operations, the intent is not to supersede or replace any relevant DOE orders. Rather the intent is to collate the multiple safety and health references contained in DOE Order 5480.4 that have applicability to NTS Underground Operations into a single safety and heath standard to be used in the underground operations at the NTS. Each portion of the standard was included only after careful consideration by the Working Group and is judged to be both effective and appropriate. The specific methods and rationale used by the Working Group are outlined as follows: The letter from DOE/HQ, dated September 28, 1990 cited OSHA and the CTSO as the safety and health codes applicable to underground operations at the NTS. These mandated codes were each originally developed to be comprehensive, i.e., all underground operations of a particular type (e.g., tunnels in the case of the CTSO) were intended to be adequately regulated by the appropriate code. However, this is not true; the Working Group found extensive and confusing overlap in the codes in numerous areas. Other subjects and activities were addressed by the various codes in cursory fashion or not at all.

  4. 78 FR 59632 - Oil and Gas and Sulphur Operations on the Outer Continental Shelf-Oil and Gas Production Safety...

    Science.gov (United States)

    2013-09-27

    ... proposed rulemaking on production safety systems on August 22, 2013 (78 FR 52240). The proposed rule would... Bureau of Safety and Environmental Enforcement 30 CFR Part 250 RIN 1014-AA10 Oil and Gas and Sulphur Operations on the Outer Continental Shelf--Oil and Gas Production Safety Systems AGENCY: Bureau of Safety...

  5. A Study on the Construct Validity of Safety Culture Oversight Model for Nuclear Power Operating Organization

    Energy Technology Data Exchange (ETDEWEB)

    Jung, Su Jin; Choi, Young Sung; Oh, Jang Jin [Korea Institute of Nuclear Safety, Daejeon (Korea, Republic of)

    2015-05-15

    In Korea, the safety policy statement declared in 1994 by government stressed the importance of safety culture and licensees were encouraged to manage and conduct their self-assessments. A change in regulatory position about safety culture oversight was made after the event of SBO cover-up in Kori unit 1 and several subsequent falsification events. Since then KINS has been developing licensee's safety culture oversight system including conceptual framework of oversight, prime focus area for oversight, and specific details on regulatory expectations, all of which are based on defence-in-depth (DiD) safety enhancement approach. Development and gathering of performance data which is related to actual 'safety' of nuclear power plant are needed to identify the relationship between safety culture and safety performance. Authors consider this study as pilot which has a contribution on verifying the construct validity of the model and the effectiveness of survey based research. This is the first attempt that the validity of safety culture oversight model has been investigated with empirical data obtained from Korean nuclear power operating organization.

  6. Preliminary Assessment of Operational Hazards and Safety Requirements for Airborne Trajectory Management (ABTM) Roadmap Applications

    Science.gov (United States)

    Cotton, William B.; Hilb, Robert; Koczo, Stefan, Jr.; Wing, David J.

    2016-01-01

    A set of five developmental steps building from the NASA TASAR (Traffic Aware Strategic Aircrew Requests) concept are described, each providing incrementally more efficiency and capacity benefits to airspace system users and service providers, culminating in a Full Airborne Trajectory Management capability. For each of these steps, the incremental Operational Hazards and Safety Requirements are identified for later use in future formal safety assessments intended to lead to certification and operational approval of the equipment and the associated procedures. Two established safety assessment methodologies that are compliant with the FAA's Safety Management System were used leading to Failure Effects Classifications (FEC) for each of the steps. The most likely FEC for the first three steps, Basic TASAR, Digital TASAR, and 4D TASAR, is "No effect". For step four, Strategic Airborne Trajectory Management, the likely FEC is "Minor". For Full Airborne Trajectory Management (Step 5), the most likely FEC is "Major".

  7. Safety rules during operation in sewage networks; Procedure di sicurezza sul lavoro per interventi in fognatura

    Energy Technology Data Exchange (ETDEWEB)

    Bonvicini, V.; Cervi, G.; Lastrico, G.; Siri, R. [Azienda Municipalizzata Gas e Acqua, A.M.G.A., Genoa (Italy)

    1998-04-01

    The paper describes the risks evaluation and the safety rules for operations of detecting of sewage networks. There are also described the possibility of gas formation in the network and the safety rules in this particularly work conditions. [Italiano] L`articolo espone la valutazione dei rischi e le relative procedure di sicurezza durante le operazioni di ispezione dei condotti fognari. Siconsidera inoltre la possibilita` di formazione di gas pericolosi e le procedure di sicurezza da adottare in questi casi.

  8. 手术室护工职业暴露的危险因素及防护对策%Risk factors for occupational exposure to care workers in operating rooms and protective countermeasures

    Institute of Scientific and Technical Information of China (English)

    祝惠琴

    2012-01-01

    目的 探讨手术室护工职业暴露的危险因素,针对性地制定对策,加强手术室护工的职业安全防护意识.方法 根据手术室护工职业暴露的危险因素,制定规范化的防护措施,对护工进行职业安全防护知识的培训,使其熟练应用防护技术.结果 进行防护教育后,手术室护工职业暴露自我防护意识和防护方法明显提高.结论 切实关注护工弱势群体,重视护工职业暴露防护,确保护工身心健康,防止医院感染的发生.%OBJECTIVE To discuss the risk factors for occupational exposure to the care workers in the operating rooms so as to develop countermeasures and strengthen the awareness of occupational safety protection of the care workers in the operating rooms. METHODS According to the risk factors for occupational exposures to the care workers in the operating rooms, the standardized measures of protection "were developed, the training of safety protection knowledge for the care workers was conducted to make the care workers skillfully use protection technologies. RESULTS After the care workers were educated, their self-protection awareness of occupational exposure and protection methods have been improved significantly. CONCLUSION To attach sufficient importance to vulnerable workers and the prevention of occupational exposure and ensure the physical and mental health of the care workers can prevent nosocomial infections.

  9. 妇产科手术室的护理管理%Nursing Management of operation room of Obstetrics and Gynecology

    Institute of Scientific and Technical Information of China (English)

    陈慧; 周芸羊

    2015-01-01

    Objective To analyze the nursing management measures and effect of operation room of Obstetrics and Gynecology, and to improve the safety of operation.Methods Selected 10 nursing staff of operation room of Obstetrics and Gynecology in our hospital, and compared the nursing quality and awareness of risk protection of them before and after nursing care. Selected 72 cases of patients in Obstetrics and Gynecology from April 2012 to April 2013 and May 2013 to May 2014, and then compared the nursing satisfaction before and after nursing care. Results Only 4 had awareness of risk before nursing management, accounting for 40%, while 9 had awareness of risk after nursing management, accounting for 90%. The occurrence of nursing events of the control group was 16.7%, and nursing satisfaction was only 77.8%, but nursing events of the observation group was 2.8%, and nursing satisfaction was only 97.2% after the nursing management, which was significantly higher than the control group, it had significant differences between groups (P<0.05).Conclusion Nursing management in Obstetrics and Gynecology operation room can enhance awareness of risk effectively and improve nursing satisfaction and quality of care of patients and reduce the incidence of nursing event, which has positive clinical value.%目的:对妇产科手术室的护理管理措施与效果进行分析,为提高妇产科手术安全提供可靠保障。方法抽取本院10例妇产科手术室护理人员参与本次研究,对护理管理前后,妇科手术室的护理质量及护理人员的风险防控意识予以比较;分别于2012年4月~2013年4月、2013年5月~2014年5月选取本院妇产科接诊患者72例,对其进行临床护理,比较两组患者护理管理前后护理满意度。结果在进行护理管理之前,只有4例具有一定的风险意识,占40%,而护理管理之后,9例护理人员提高了风险意识,占90%;在护理管理之前对照

  10. Structure-oriented versus process-oriented approach to enhance efficiency for emergency room operations: what lessons can we learn?

    Science.gov (United States)

    Hwang, Taik Gun; Lee, Younsuk; Shin, Hojung

    2011-01-01

    The efficiency and quality of a healthcare system can be defined as interactions among the system structure, processes, and outcome. This article examines the effect of structural adjustment (change in floor plan or layout) and process improvement (critical pathway implementation) on performance of emergency room (ER) operations for acute cerebral infarction patients. Two large teaching hospitals participated in this study: Korea University (KU) Guro Hospital and KU Anam Hospital. The administration of Guro adopted a structure-oriented approach in improving its ER operations while the administration of Anam employed a process-oriented approach, facilitating critical pathways and protocols. To calibrate improvements, the data for time interval, length of stay, and hospital charges were collected, before and after the planned changes were implemented at each hospital. In particular, time interval is the most essential measure for handling acute stroke patients because patients' survival and recovery are affected by the promptness of diagnosis and treatment. Statistical analyses indicated that both redesign of layout at Guro and implementation of critical pathways at Anam had a positive influence on most of the performance measures. However, reduction in time interval was not consistent at Guro, demonstrating delays in processing time for a few processes. The adoption of critical pathways at Anam appeared more effective in reducing time intervals than the structural rearrangement at Guro, mainly as a result of the extensive employee training required for a critical pathway implementation. Thus, hospital managers should combine structure-oriented and process-oriented strategies to maximize effectiveness of improvement efforts.

  11. Attitudes, risk of infection and behaviours in the operating room (the ARIBO Project): a prospective, cross-sectional study.

    Science.gov (United States)

    Birgand, Gabriel; Azevedo, Christine; Toupet, Gaelle; Pissard-Gibollet, Roger; Grandbastien, Bruno; Fleury, Eric; Lucet, Jean-Christophe

    2014-01-02

    Inappropriate staff behaviours can lead to environmental contamination in the operating room (OR) and subsequent surgical site infection (SSI). This study will focus on the continued assessment of OR staff behaviours using a motion tracking system and their impact on the SSI risk during surgical procedures. This multicentre prospective cross-sectional study will include 10 ORs of cardiac and orthopaedic surgery in 12 healthcare facilities (HCFs). The staff behaviour will be assessed by an objective, continued and prolonged quantification of movements within the OR. A motion tracking system including eight optical cameras (VICON-Bonita) will record the movements of reflective markers placed on the surgical caps/hoods of each person entering the room. Different configurations of markers positioning will be used to distinguish between the staff category. Doors opening will be observed by means of wireless inertial sensors fixed on the doors and synchronised with the motion tracking system. We will collect information on the OR staff, surgical procedures and surgical environment characteristics. The behavioural data obtained will be compared (1) to the 'best behaviour rules' in the OR, pre-established using a Delphi method and (2) to surrogates of the infectious risk represented by microbiological air counts, particle counts, and a bacteriological sample of the wound at closing. Statistics will be performed using univariate and multivariate analysis to adjust on the aerolic and architectural characteristics of the OR. A multilevel model will allow including surgical specialty and HCFs effects. Through this study, we will develop an original approach using high technology tools associated to data processing techniques to evaluate 'automatically' the behavioural dynamics of the OR staff and their impact on the SSI risk. Approbation of the Institutional Review Board of Paris North Hospitals, Paris 7 University, AP-HP (no 11-113, 6 April 2012). The findings will be

  12. Attitudes, risk of infection and behaviours in the operating room (the ARIBO Project): a prospective, cross-sectional study

    Science.gov (United States)

    Birgand, Gabriel; Azevedo, Christine; Toupet, Gaelle; Pissard-Gibollet, Roger; Grandbastien, Bruno; Fleury, Eric; Lucet, Jean-Christophe

    2014-01-01

    Introduction Inappropriate staff behaviours can lead to environmental contamination in the operating room (OR) and subsequent surgical site infection (SSI). This study will focus on the continued assessment of OR staff behaviours using a motion tracking system and their impact on the SSI risk during surgical procedures. Methods and analysis This multicentre prospective cross-sectional study will include 10 ORs of cardiac and orthopaedic surgery in 12 healthcare facilities (HCFs). The staff behaviour will be assessed by an objective, continued and prolonged quantification of movements within the OR. A motion tracking system including eight optical cameras (VICON-Bonita) will record the movements of reflective markers placed on the surgical caps/hoods of each person entering the room. Different configurations of markers positioning will be used to distinguish between the staff category. Doors opening will be observed by means of wireless inertial sensors fixed on the doors and synchronised with the motion tracking system. We will collect information on the OR staff, surgical procedures and surgical environment characteristics. The behavioural data obtained will be compared (1) to the ‘best behaviour rules’ in the OR, pre-established using a Delphi method and (2) to surrogates of the infectious risk represented by microbiological air counts, particle counts, and a bacteriological sample of the wound at closing. Statistics will be performed using univariate and multivariate analysis to adjust on the aerolic and architectural characteristics of the OR. A multilevel model will allow including surgical specialty and HCFs effects. Through this study, we will develop an original approach using high technology tools associated to data processing techniques to evaluate ‘automatically’ the behavioural dynamics of the OR staff and their impact on the SSI risk. Ethics and dissemination Approbation of the Institutional Review Board of Paris North Hospitals, Paris 7

  13. National Ignition Facility start-up/operations engineering and special equipment construction health and safety plan

    Energy Technology Data Exchange (ETDEWEB)

    Huddleston, P C

    1998-05-08

    This document sets forth the responsibilities, interfaces, guidelines, rules, policy, and regulations for all workers involved in the S/O and SE construction, installation, and acceptance testing. This document is enforced from the first day that S/O and SE workers set foot on the NIF construction site until the end of the Project at Critical Decision 4. This document is applicable only to site activities, which are defined as those that occur within the perimeter of the fenced-off NIF construction zone and the Target Chamber Assembly Area (Helipad). The associated Special Equipment laydown and construction support areas listed in Appendix B are not under this plan; their safety provisions are discussed in the Appendix. Prototype and other support activities, such as the Amplifier Laboratory and Frame Assembly Unit assembly area, are not included in this plan. After completion of the Operational Readiness Review, the Facility Safety Procedure, Operational Safety Requirements, and Operational Safety Procedures are the governing safety documents for the operating facility. The S/O and SE project elements are required to implement measures that create a universal awareness of and promote safe job practices at the site. This includes all Lawrence Livermore National Laboratory (LLNL), Los Alamos National Laboratory, Sandia National Laboratories, University of Rochester, supplement labor organization, and subcontractor employees; visitors; and guests serving the S/O and SE effort.

  14. National Ignition Facility start-up/operations engineering and special equipment construction health and safety plan

    Energy Technology Data Exchange (ETDEWEB)

    Huddleston, P C

    1998-05-08

    This document sets forth the responsibilities, interfaces, guidelines, rules, policy, and regulations for all workers involved in the S/O and SE construction, installation, and acceptance testing. This document is enforced from the first day that S/O and SE workers set foot on the NIF construction site until the end of the Project at Critical Decision 4. This document is applicable only to site activities, which are defined as those that occur within the perimeter of the fenced-off NIF construction zone and the Target Chamber Assembly Area (Helipad). The associated Special Equipment laydown and construction support areas listed in Appendix B are not under this plan; their safety provisions are discussed in the Appendix. Prototype and other support activities, such as the Amplifier Laboratory and Frame Assembly Unit assembly area, are not included in this plan. After completion of the Operational Readiness Review, the Facility Safety Procedure, Operational Safety Requirements, and Operational Safety Procedures are the governing safety documents for the operating facility. The S/O and SE project elements are required to implement measures that create a universal awareness of and promote safe job practices at the site. This includes all Lawrence Livermore National Laboratory (LLNL), Los Alamos National Laboratory, Sandia National Laboratories, University of Rochester, supplement labor organization, and subcontractor employees; visitors; and guests serving the S/O and SE effort.

  15. 手术室扁平化管理之实践%Practice and exploration of the flat management in the operating room

    Institute of Scientific and Technical Information of China (English)

    李胜云; 程慧敏; 屈清荣; 张增梅; 潘芦翎

    2012-01-01

    目的:探讨扁平化管理在手术室的应用.方法:根据手术室工作特点,建立扁平化组织结构,通过工作流程再造、绩效考核和人力资源重组等措施,逐步实现扁平化管理.结果:手术室工作流程趋向合理,人力资源紧张得到缓解,工作效率得到提高;患者和医生对手术室护士的工作满意度由扁平化管理之前的82.8%和93.4%分别提高到94.6%和98.9%.结论:扁平化管理使手术室管理更加科学、合理和高效,有利于手术室管理工作健康发展.%Objective:To explore the application of flat management in the operating room. Methods:According to the characteristics of the operating room, the flat organizational structure was established, and the reform of flat management was realized gradually through process reengineering, performance evaluation and human resources reorganization, etc. Results:Workflow of the operating room tended to rationalization. Human resources got more effective utilization and work efficiency improved. Patients' satisfaction and doctors' satisfaction with the operating room increased from 82.8%, 93.4% to 94.6% and 98.9%, respectively. Conclusion:Flat management could make the operating room management more scientific, reasonable and effective, and contributed to healthy and rapid development of the operating room.

  16. Evaluating North Carolina Food Pantry Food Safety-Related Operating Procedures.

    Science.gov (United States)

    Chaifetz, Ashley; Chapman, Benjamin

    2015-11-01

    Almost one in seven American households were food insecure in 2012, experiencing difficulty in providing enough food for all family members due to a lack of resources. Food pantries assist a food-insecure population through emergency food provision, but there is a paucity of information on the food safety-related operating procedures used in the pantries. Food pantries operate in a variable regulatory landscape; in some jurisdictions, they are treated equivalent to restaurants, while in others, they operate outside of inspection regimes. By using a mixed methods approach to catalog the standard operating procedures related to food in 105 food pantries from 12 North Carolina counties, we evaluated their potential impact on food safety. Data collected through interviews with pantry managers were supplemented with observed food safety practices scored against a modified version of the North Carolina Food Establishment Inspection Report. Pantries partnered with organized food bank networks were compared with those that operated independently. In this exploratory research, additional comparisons were examined for pantries in metropolitan areas versus nonmetropolitan areas and pantries with managers who had received food safety training versus managers who had not. The results provide a snapshot of how North Carolina food pantries operate and document risk mitigation strategies for foodborne illness for the vulnerable populations they serve. Data analysis reveals gaps in food safety knowledge and practice, indicating that pantries would benefit from more effective food safety training, especially focusing on formalizing risk management strategies. In addition, new tools, procedures, or policy interventions might improve information actualization by food pantry personnel.

  17. Safety requirements to the operation of hydropower plants; Sicherheit beim Betrieb von Wasserkraftwerken

    Energy Technology Data Exchange (ETDEWEB)

    Lux, Reinhard [Berufsgenossenschaft Energie Textil Elektro Medienerzeugnisse (BG ETEM), Koeln (Germany)

    2011-07-01

    Employers have to take into account various safety and health requirements relating to the design, construction, operation and maintenance of hydropower plants. Especially the diversity of the hydropower plant components requires the consideration of different safety and health aspects. In 2011 the ''Fachausschuss Elektrotechnik'' (expert committee electro-technics) of the institution for statutory accident insurance and prevention presented a new ''BG-Information'' dealing with ''Safe methods operating hydropower plants''. The following article gives an introduction into the conception and the essential requirements of this new BG-Information. (orig.)

  18. System Coordination of Survivability and Safety of Complex Engineering Objects Operation

    Directory of Open Access Journals (Sweden)

    Nataliya Pankratova

    2014-11-01

    Full Text Available A system strategy to estimation the guaranteed survivability and safety of complex engineering objects (CEO operation is proposed. The principles that underlie the strategy of the guaranteed safety of CEO operation provide a flexible approach to timely detection, recognition, forecast, and system diagnostics of risk factors and situations, to formulation and implementation of a rational decision in a practicable time within an unremovable time constraint. Implementation of the proposed strategy is shown on example of diagnostics of electromobile-refrigerator functioning in real mode.

  19. Impact and Challenges of a Policy Change to Early Track Extubation in the Operating Room for Fontan.

    Science.gov (United States)

    Kawaguchi, Atsushi; Liu, Qi; Coquet, Sean; Yasui, Yutaka; Cave, Dominic

    2016-08-01

    While policy changes toward early extubation in the operating room (OR) have been commonly seen in palliative surgeries in single ventricle anatomy, no systematic assessment of their impact on patient outcome has been reported. All patients aged 0-17 years admitted to a PICU in a quaternary children's hospital for post-operative management following a primary Fontan procedure between 2005 and 2011 were included. Patients for revision of Fontan or patients admitted to adult Cardiovascular Intensive Care Unit were excluded. Practice policy was changed from routine extubation in the PICU to early extubation in OR in January 2008. Data were compared between the pre-policy-change era (2005-2007) and the post-policy-change era (2008-2011) to assess the impact of the change on patient outcomes. Generalized linear regression (GLM) and interrupted time series (ITS) analysis were used to access the effect of policy change on PICU length of stay and post-operative fluid balance, adjusting for potential confounders using propensity scores. Root cause analysis (RCA) was conducted to describe causes of failed extubation and challenges of this policy change. One hundred twenty-seven children met inclusion criteria. Average body weight was 14.7 kg [standard deviation (SD) 3.9], and age was 3.5 years (SD 1.9). A clear change in extubation practice occurred between the pre- versus post-policy-change eras: 97.5 % were extubated in the PICU in the pre-policy-change era, as compared to 15.0 % in the post-policy-change era. The average PICU length of stay was shortened by 4.1 days from the pre-policy-change era to the post-policy-change era [95 % CI -1.2 to -6.9, p extubation in the current practice.

  20. A STUDY OF MICROBIOLOGICAL CONTAMINATION OF MOBILE PHONES IN OPERATING ROOM PERSONNEL AND EFFICACY OF DECONTAMINATION WITH 2% ISOPROPYL ALCOHOL

    Directory of Open Access Journals (Sweden)

    Shivakumar M

    2016-02-01

    Full Text Available BACKGROUND The objective of this study was to determine the contamination rate of the healthcare workers’ (HCWs’ mobile phones in operating room and identify strategies for their safe use within clinical areas. This study also to determine whether a standardized disinfecting protocol decreased the rate of bacterial contamination. METHODS This is a cross-sectional study that included all Health care workers with mobile phones in operation theatre. Samples for culture were collected from mobile phones with swab stick before and after disinfection of mobile phones with 2% isopropyl alcohol swab and transported for microbiological identification using Amies medium. Quantification of bacteria was performed using both surface spread isolated bacterial agents were identified using standard microbiological methods. RESULTS Total of 92 samples studied from 46 mobiles, out of 46 mobile phones tested (89% 41 were contaminated with either single or mixed bacterial agents. The most prevalent bacterial contaminants were Coagulase-Negative Staphylococci (CONS and E. coli representing 36% and 23%, respectively. After cleaning of mobile phone with 2% isopropyl alcohol decreases contamination to 50%. The mean bacterial count was 357 CFU/ml, while the median was 13 CFU/ml using the pour plate method. The corresponding figures were 2,192 and 1,720 organisms/phone using the surface spread method. CONCLUSION It is important to be conscious of the fact that mobile phone usage in Operation Theater is easily contaminated. Because cleaning with alcohol swabs prevents the contamination of the mobile phones. Mobile communication devices have an invaluable feature of communication within hospital health care providers should take standard precautions to minimize the contamination of mobile phones.

  1. Applications for a hybrid operating room in thoracic surgery: from multidisciplinary procedures to ­­image-guided video-assisted thoracoscopic surgery

    Science.gov (United States)

    Terra, Ricardo Mingarini; Andrade, Juliano Ribeiro; Mariani, Alessandro Wasum; Garcia, Rodrigo Gobbo; Succi, Jose Ernesto; Soares, Andrey; Zimmer, Paulo Marcelo

    2016-01-01

    ABSTRACT The concept of a hybrid operating room represents the union of a high-complexity surgical apparatus with state-of-the-art radiological tools (ultrasound, CT, fluoroscopy, or magnetic resonance imaging), in order to perform highly effective, minimally invasive procedures. Although the use of a hybrid operating room is well established in specialties such as neurosurgery and cardiovascular surgery, it has rarely been explored in thoracic surgery. Our objective was to discuss the possible applications of this technology in thoracic surgery, through the reporting of three cases. PMID:27812640

  2. Safety in the operating theatre--part 1: interpersonal relationships and team performance

    Science.gov (United States)

    Schaefer, H. G.; Helmreich, R. L.; Scheidegger, D.

    1995-01-01

    The authors examine the application of interpersonal human factors training on operating room (OR) personnel. Mortality studies of OR deaths and critical incident studies of anesthesia are examined to determine the role of human error in OR incidents. Theoretical models of system vulnerability to accidents are presented with emphasis on a systems approach to OR performance. Input, process, and outcome factors are discussed in detail.

  3. The influence of individual and team cognitive ability on operators' task and safety performance: a multilevel field study in nuclear power plants.

    Science.gov (United States)

    Zhang, Jingyu; Li, Yongjuan; Wu, Changxu

    2013-01-01

    While much research has investigated the predictors of operators' performance such as personality, attitudes and motivation in high-risk industries, its cognitive antecedents and boundary conditions have not been fully investigated. Based on a multilevel investigation of 312 nuclear power plant main control room operators from 50 shift teams, the present study investigated how general mental ability (GMA) at both individual and team level can influence task and safety performance. At the individual level, operators' GMA was predictive of their task and safety performance and this trend became more significant as they accumulated more experience. At the team level, we found team GMA had positive influences on all three performance criteria. However, we also found a "big-fish-little-pond" effect insofar as team GMA had a relatively smaller effect and inhibited the contribution of individual GMA to workers' extra-role behaviors (safety participation) compared to its clear beneficial influence on in-role behaviors (task performance and safety compliance). The possible mechanisms related to learning and social comparison processes are discussed.

  4. Automated Air Traffic Control Operations with Weather and Time-Constraints: A First Look at (Simulated) Far-Term Control Room Operations

    Science.gov (United States)

    Prevot, Thomas; Homola, Jeffrey R.; Martin, Lynne H.; Mercer, Joey S.; Cabrall, Christopher C.

    2011-01-01

    In this paper we discuss results from a recent high fidelity simulation of air traffic control operations with automated separation assurance in the presence of weather and time-constraints. We report findings from a human-in-the-loop study conducted in the Airspace Operations Laboratory (AOL) at the NASA Ames Research Center. During four afternoons in early 2010, fifteen active and recently retired air traffic controllers and supervisors controlled high levels of traffic in a highly automated environment during three-hour long scenarios, For each scenario, twelve air traffic controllers operated eight sector positions in two air traffic control areas and were supervised by three front line managers, Controllers worked one-hour shifts, were relieved by other controllers, took a 3D-minute break, and worked another one-hour shift. On average, twice today's traffic density was simulated with more than 2200 aircraft per traffic scenario. The scenarios were designed to create peaks and valleys in traffic density, growing and decaying convective weather areas, and expose controllers to heavy and light metering conditions. This design enabled an initial look at a broad spectrum of workload, challenge, boredom, and fatigue in an otherwise uncharted territory of future operations. In this paper we report human/system integration aspects, safety and efficiency results as well as airspace throughput, workload, and operational acceptability. We conclude that, with further refinements. air traffic control operations with ground-based automated separation assurance can be an effective and acceptable means to routinely provide very high traffic throughput in the en route airspace.

  5. Operation safety of complex industrial systems. Main concepts; Surete de fonctionnement des systemes industriels complexes. Principaux concepts

    Energy Technology Data Exchange (ETDEWEB)

    Zwingelstein, G

    2009-06-15

    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.)

  6. Carry Out the Nursing Quality of Operation Room%深入开展手术室优质护理体会

    Institute of Scientific and Technical Information of China (English)

    郭颖

    2014-01-01

    Objective To explore the further improvement of nursing in operation room, operation room nursing method to improve the quality of service level. Methods Nursing care, seamless, comfortable nursing, pain nursing methods through the humanization of the in-depth development of operation room nursing quality. Results The nursing measures for patients undergoing selective operation implement standard nursing service, make patients at admission to the whole process of discharge are enjoy humanized, standardization, quality care. Conclusion High quality of nursing care in operation room, to enhance the satisfaction degree of nursing service object.%目的:探讨进一步改进手术室护理工作,提升手术室优质护理服务水平的方法。方法通过人性化的护理、无缝护理、舒适护理、疼痛护理等方法深入开展手术室优质护理。结果通过上述护理措施为择期手术患者实施规范化护理服务,使患者在入院到出院的全过程中都享受到人性化、系统化、规范化的优质护理服务。结论手术室优质护理,提升了护理服务对象满意度。

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

    Directory of Open Access Journals (Sweden)

    A Rostaminejad

    2011-04-01

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

  8. Resolving plant operational issues related to pressurizer safety relief valve piping

    Energy Technology Data Exchange (ETDEWEB)

    Bain, R.A. [Stone and Webster Engineering Corp., Boston, MA (United States). Mechanical Engineering Div.; Testa, M.F. [Duquesne Light Co., Shippingport, PA (United States). Mechanical Engineering Dept.

    1995-11-01

    Pressurizer safety and relief valve (PSARV) piping has many technical issues related to the qualification and operation of the system that have been addressed at Beaver Valley Unit 2. The PSARV piping is part of a system that must meet Code requirements while being subjected to very significant fluid transient loadings. Valve components include safety valves, power operated relief valves (PORVs), and motor operated block valves. Fluid slugs upstream of these valves can be steam or can be hot or cold water, resulting in a significant variance in possible slug densities. Problems with design options and hardware installed to decrease slug density such as heat tracing, and the susceptibility of the PORVs to leak are issues that affect plant operation, efficiency and cost effectiveness.

  9. Operational readiness verification, phase 1: A study on safety during outage and restart of nuclear power plants

    Energy Technology Data Exchange (ETDEWEB)

    Hollnagel, E. [Linkoeping Univ. (Sweden). Dept. of Computer and Information Science; Gauthereau, V. [Linkoeping Univ. (Sweden). Dept. of Industrial Engineering

    2001-06-01

    interviews were conducted with technical staff at most of the Swedish NPPs. It focused on which solutions the various NPPs had developed to cope with the problem, and which steps had been taken specifically to improve the efficiency of ORV. It was soon found that ORV could not be separated from the rest of the work done in a NPP during outages since many of the proposed solutions have a broad scope. An analysis of the nine Swedish ORV cases had found weaknesses in four main areas: administration processes, management, human performance, and control room layout. Relative to these, the Swedish NPPs have implemented several technical and organisational solutions. Among the former are an overall re-qualification scheme, blocked safety functions, computerised operational position control, and central indications in the control room. Most of the technical solutions have been part of the design of the newer plants, since to implement them in older plants requires essential changes both in the station and in the control room. The organisational solutions comprised operational readiness plans, systematic ways of working, new instructions, co-ordinated testing, and the use of redundant or independent controls. Special emphasis was put on how the NPPs planned their outages, how the plans were implemented, and how deviations were handled. Issues related to learning from experience were also investigated. It was found that although all the NPPs approached the ORV issues in a serious and efficient manner, the solutions could be different corresponding to the characteristics of the organisation. Finally a number of questions, which still need answers, were identified. One is how new procedures or new barriers are accepted and assimilated into the safety culture. A second concerns the demarcation of systems for which ORV is required, i.e., the boundary between safety and non-safety systems. A third is how complex technical solutions influence the operators' work. Finally, it is

  10. Nanostructured ZrO2 Thick Film Resistors as H2-Gas Sensors Operable at Room Temperature

    Directory of Open Access Journals (Sweden)

    K. M. GARADKAR

    2009-11-01

    Full Text Available Nanostructured ZrO2 powder was synthesized by microwave assisted sol-gel method. The material was characterized by XRD and SEM techniques. X-Ray diffraction studies confirm that a combination of tetragonal and monoclinic zirconia nanoparticles is obtained by using microwave-assisted method. The nanopowder was calcined at an optimized temperature of 400 °C for 3 h. The prepared powder had crystalline size about 25 nm. Thick films of synthesized ZrO2 powder were prepared by screen printing technique. The gas sensing performances of these films for various gases were tested. Films showed highest response to H2 (50 ppm gas at room temperature with poor responses to others (1000 ppm. The quick response and fast recovery are the main features of this sensor. The effects of microstructure, operating temperature and gas concentration on the gas response, selectivity, response time and recovery time of the sensor in the presence of H2 gas and others were studied and discussed.

  11. Establishment of an operating room committee and a training program to improve aseptic techniques for rodent and large animal surgery.

    Science.gov (United States)

    Héon, Hélène; Rousseau, Nathalie; Montgomery, Jane; Beauregard, Gilles; Choiniére, Manon

    2006-11-01

    Investigators of our research facility generally accept the concept of asepsis as an important component of adequate surgical care for animals. However, they experience difficulties putting it into practice, especially in the case of rodents. The reasons for this are inconvenience, cost, and lack of training. To better assist investigators in the implementation of aseptic surgical techniques in their laboratories, we have created an Operating Room (OR) Committee modeled after OR committees found in human hospitals. A reconstructive surgeon, a veterinarian, a research scientist, a nurse involved in the training of OR personnel, interns, graduate students, and an animal health technician were chosen as committee members in light of their OR and animal care expertise. The first task of the OR Committee was to establish institutional guidelines for aseptic surgery, taking into account the costs imposed on research budgets by these procedures. The OR Committee also supports a complete training program in aseptic surgery techniques, which consists of lectures, a training manual, videos, and a practical course. Furthermore, when experimental procedures require specialized equipment, the OR Committee collaborates with researchers to develop strategies to achieve asepsis. This OR Committee and the training program proved to be important tools to promote and improve the quality of animal care during surgery.

  12. A Coordinated Patient Transport System for ICU Patients Requiring Surgery: Impact on Operating Room Efficiency and ICU Workflow.

    Science.gov (United States)

    Brown, Michael J; Kor, Daryl J; Curry, Timothy B; Marmor, Yariv; Rohleder, Thomas R

    2015-01-01

    Transfer of intensive care unit (ICU) patients to the operating room (OR) is a resource-intensive, time-consuming process that often results in patient throughput inefficiencies, deficiencies in information transfer, and suboptimal nurse to patient ratios. This study evaluates the implementation of a coordinated patient transport system (CPTS) designed to address these issues. Using data from 1,557 patient transfers covering the 2006-2010 period, interrupted time series and before and after designs were used to analyze the effect of implementing a CPTS at Mayo Clinic, Rochester. Using a segmented regression for the interrupted time series, on-time OR start time deviations were found to be significantly lower after the implementation of CPTS (p < .0001). The implementation resulted in a fourfold improvement in on-time OR starts (p < .01) while significantly reducing idle OR time (p < .01). A coordinated patient transfer process for moving patient from ICUs to ORs can significantly improve OR efficiency, reduce nonvalue added time, and ensure quality of care by preserving appropriate care provider to patient ratios.

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

    Science.gov (United States)

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

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

  14. Device Sales Representatives in the Operating Room: Do We Really Need or Want Them? A Survey of Orthopaedic Trauma Surgeons.

    Science.gov (United States)

    Moed, Berton R; Israel, Heidi A

    2017-09-01

    The purposes of this study were to determine the current attitude of orthopaedic trauma surgeons toward device sales representatives (DSRs), especially regarding their presence in the operating room (OR), and to establish the existence of any surgeon generational differences. A survey was created using a 5-point Likert response scale, related to conflict of interest (COI) and attitudes toward DSRs. Participants were solicited from the Orthopaedic Trauma Association database of 384 active members and 127 (33%) completed the survey. Respondents were divided into 2 subcategories (Generation X vs. Baby Boomers). Overall, respondents viewed their DSRs favorably without any perception of COI. However, they perceived their peers as being at risk for COI (P ≤ 0.004). Generation X responders feel that DSRs should be in the OR for all cases, whereas Baby Boomers do not (P < 0.01). With one striking generational difference, most orthopaedic trauma surgeons feel that they need DSRs in the OR. Similar to other physician groups, they also feel that they are not subject to COI from salesman contact that affects their peers. Reasons for this perceived need and any related COI risk, and the opportunities to address both, require further study.

  15. 手术室护士的护理体会%Nursing experience of nurses in operation room

    Institute of Scientific and Technical Information of China (English)

    王瑞霞

    2015-01-01

    With the continuous development of medical model, nursing mode has changed fundamentally, from the treatment of disease as the center to the recovery of the body and mind as the center. Which requires nursing staff should continue to enhance their quality of care, especially in the operating room nurses, to do a good job in the comprehensive preoperative, intraoperative and postoperative nursing, take the initiative and enthusiasm to contact with the patient, in-depth understanding of patient physiological and psychological characteristics, in order to enable the patient to security successfully survive the surgery, and improve the postoperative quality of life.%随着医学模式的不断发展,护理模式发生了根本性的改变,从以治疗疾病为中心转变为以病人的身心恢复为中心。这就要求护理人员应不断提升自身的护理素质,尤其是手术室护士,要做好术前、术中、术后全面的护理,主动热情地接触病人,深入了解病人的生理、心理特点,以使病人能够安全顺利地度过手术关,提高术后生活质量。

  16. How many operating rooms are needed to manage non-elective surgical cases? A Monte Carlo simulation study.

    Science.gov (United States)

    Antognini, Joseph M O'Brien; Antognini, Joseph F; Khatri, Vijay

    2015-10-28

    Patients often wait to have urgent or emergency surgery. The number of operating rooms (ORs) needed to minimize waiting time while optimizing resources can be determined using queuing theory and computer simulation. We developed a computer program using Monte Carlo simulation to determine the number of ORs needed to minimize patient wait times while optimizing resources. We used patient arrival data and surgical procedure length from our institution, a tertiary-care academic medical center that serves a large diverse population. With ~4800 patients/year requiring non-elective surgery, and mean procedure length 185 min (median 150 min) we determined the number of ORs needed during the day and evening (0600-2200) and during the night (2200-0600) that resulted in acceptable wait times. Simulation of 4 ORs at day/evening and 3 ORs at night resulted in median wait time = 0 min (mean = 19 min) for emergency cases requiring surgery within 2 h, with wait time at the 95th percentile = 109 min. Median wait time for urgent cases needing surgery within 8-12 h was 34 min (mean = 136 min), with wait time at the 95th percentile = 474 min. The effect of changes in surgical length and volume on wait times was determined with sensitivity analysis. Monte Carlo simulation can guide decisions on how to balance resources for elective and non-elective surgical procedures.

  17. Changes in Stroke Volume Induced by Lung Recruitment Maneuver Predict Fluid Responsiveness in Mechanically Ventilated Patients in the Operating Room.

    Science.gov (United States)

    Biais, Matthieu; Lanchon, Romain; Sesay, Musa; Le Gall, Lisa; Pereira, Bruno; Futier, Emmanuel; Nouette-Gaulain, Karine

    2017-02-01

    Lung recruitment maneuver induces a decrease in stroke volume, which is more pronounced in hypovolemic patients. The authors hypothesized that the magnitude of stroke volume reduction through lung recruitment maneuver could predict preload responsiveness. Twenty-eight mechanically ventilated patients with low tidal volume during general anesthesia were included. Heart rate, mean arterial pressure, stroke volume, and pulse pressure variations were recorded before lung recruitment maneuver (application of continuous positive airway pressure of 30 cm H2O for 30 s), during lung recruitment maneuver when stroke volume reached its minimal value, and before and after volume expansion (250 ml saline, 0.9%, infused during 10 min). Patients were considered as responders to fluid administration if stroke volume increased greater than or equal to 10%. Sixteen patients were responders. Lung recruitment maneuver induced a significant decrease in mean arterial pressure and stroke volume in both responders and nonresponders. Changes in stroke volume induced by lung recruitment maneuver were correlated with those induced by volume expansion (r = 0.56; P recruitment maneuver predicted fluid responsiveness with a sensitivity of 88% (95% CI, 62 to 98) and a specificity of 92% (95% CI, 62 to 99). Pulse pressure variations more than 6% before lung recruitment maneuver discriminated responders with a sensitivity of 69% (95% CI, 41 to 89) and a specificity of 75% (95% CI, 42 to 95). The area under receiver operating curves generated for changes in stroke volume induced by lung recruitment maneuver (0.96; 95% CI, 0.81 to 0.99) was significantly higher than that for pulse pressure variations (0.72; 95% CI, 0.52 to 0.88; P recruitment maneuver could predict preload responsiveness in mechanically ventilated patients in the operating room.

  18. Concepts and techniques: Active electronics and computers in safety-critical accelerator operation

    Energy Technology Data Exchange (ETDEWEB)

    Frankel, R.S.

    1995-12-31

    The Relativistic Heavy Ion Collider (RHIC) under construction at Brookhaven National Laboratory, requires an extensive Access Control System to protect personnel from Radiation, Oxygen Deficiency and Electrical hazards. In addition, the complicated nature of operation of the Collider as part of a complex of other Accelerators necessitates the use of active electronic measurement circuitry to ensure compliance with established Operational Safety Limits. Solutions were devised which permit the use of modern computer and interconnections technology for Safety-Critical applications, while preserving and enhancing, tried and proven protection methods. In addition a set of Guidelines, regarding required performance for Accelerator Safety Systems and a Handbook of design criteria and rules were developed to assist future system designers and to provide a framework for internal review and regulation.

  19. Safety testing and operational procedures for self-developed radiofrequency coils.

    Science.gov (United States)

    Hoffmann, Jens; Henning, Anke; Giapitzakis, Ioannis A; Scheffler, Klaus; Shajan, G; Pohmann, Rolf; Avdievich, Nikolai I

    2016-09-01

    The development of novel radiofrequency (RF) coils for human ultrahigh-field (≥7 T), non-proton and body applications is an active field of research in many MR groups. Any RF coil must meet the strict requirements for safe application on humans with respect to mechanical and electrical safety, as well as the specific absorption rate (SAR) limits. For this purpose, regulations such as the International Electrotechnical Commission (IEC) standard for medical electrical equipment, vendor-suggested test specifications for third party coils and custom-developed test procedures exist. However, for higher frequencies and shorter wavelengths in ultrahigh-field MR, the RF fields may become extremely inhomogeneous in biological tissue and the risk of localized areas with elevated power deposition increases, which is usually not considered by existing safety testing and operational procedures. In addition, important aspects, such as risk analysis and comprehensive electrical performance and safety tests, are often neglected. In this article, we describe the guidelines used in our institution for electrical and mechanical safety tests, SAR simulation and verification, risk analysis and operational procedures, including coil documentation, user training and regular quality assurance testing, which help to recognize and eliminate safety issues during coil design and operation. Although the procedure is generally applicable to all field strengths, specific requirements with regard to SAR-related safety and electrical performance at ultrahigh-field are considered. The protocol describes an internal procedure and does not reflect consensus among a large number of research groups, but rather aims to stimulate further discussion related to minimum coil safety standards. Furthermore, it may help other research groups to establish their own procedures. Copyright © 2015 John Wiley & Sons, Ltd.