WorldWideScience

Sample records for projecting hospital bed

  1. Practice Hospital Bed Safety

    Science.gov (United States)

    ... Home For Consumers Consumer Updates Practice Hospital Bed Safety Share Tweet Linkedin Pin it More sharing options ... It depends on the complexity of the bed." Safety Tips CDRH offers the following safety tips for ...

  2. The Safety of Hospital Beds

    Science.gov (United States)

    Gervais, Pierre; Pooler, Charlotte; Merryweather, Andrew; Doig, Alexa K.; Bloswick, Donald

    2015-01-01

    To explore the safety of the standard and the low hospital bed, we report on a microanalysis of 15 patients’ ability to ingress, move about the bed, and egress. The 15 participants were purposefully selected with various disabilities. Bed conditions were randomized with side rails up or down and one low bed with side rails down. We explored the patients’ use of the side rails, bed height, ability to lift their legs onto the mattress, and ability to turn, egress, and walk back to the chair. The standard bed was too high for some participants, both for ingress and egress. Side rails were used by most participants when entering, turning in bed, and exiting. We recommend that side rails be reconsidered as a means to facilitate in-bed movement, ingress, and egress. Furthermore, single deck height settings for all patients are not optimal. Low beds as a safety measure must be re-evaluated. PMID:28462302

  3. The NASA Bed Rest Project

    Science.gov (United States)

    Rhodes, Bradley; Meck, Janice

    2005-01-01

    NASA s National Vision for Space Exploration includes human travel beyond low earth orbit and the ultimate safe return of the crews. Crucial to fulfilling the vision is the successful and timely development of countermeasures for the adverse physiological effects on human systems caused by long term exposure to the microgravity environment. Limited access to in-flight resources for the foreseeable future increases NASA s reliance on ground-based analogs to simulate these effects of microgravity. The primary analog for human based research will be head-down bed rest. By this approach NASA will be able to evaluate countermeasures in large sample sizes, perform preliminary evaluations of proposed in-flight protocols and assess the utility of individual or combined strategies before flight resources are requested. In response to this critical need, NASA has created the Bed Rest Project at the Johnson Space Center. The Project establishes the infrastructure and processes to provide a long term capability for standardized domestic bed rest studies and countermeasure development. The Bed Rest Project design takes a comprehensive, interdisciplinary, integrated approach that reduces the resource overhead of one investigator for one campaign. In addition to integrating studies operationally relevant for exploration, the Project addresses other new Vision objectives, namely: 1) interagency cooperation with the NIH allows for Clinical Research Center (CRC) facility sharing to the benefit of both agencies, 2) collaboration with our International Partners expands countermeasure development opportunities for foreign and domestic investigators as well as promotes consistency in approach and results, 3) to the greatest degree possible, the Project also advances research by clinicians and academia alike to encourage return to earth benefits. This paper will describe the Project s top level goals, organization and relationship to other Exploration Vision Projects, implementation

  4. MIT pebble bed reactor project

    Energy Technology Data Exchange (ETDEWEB)

    Kadak, Andrew C. [Massachusetts Institute of Technology, Cambridge (United States)

    2007-03-15

    The conceptual design of the MIT modular pebble bed reactor is described. This reactor plant is a 250 Mwth, 120 Mwe indirect cycle plant that is designed to be deployed in the near term using demonstrated helium system components. The primary system is a conventional pebble bed reactor with a dynamic central column with an outlet temperature of 900 C providing helium to an intermediate helium to helium heat exchanger (IHX). The outlet of the IHX is input to a three shaft horizontal Brayton Cycle power conversion system. The design constraint used in sizing the plant is based on a factory modularity principle which allows the plant to be assembled 'Lego' style instead of constructed piece by piece. This principle employs space frames which contain the power conversion system that permits the Lego-like modules to be shipped by truck or train to sites. This paper also describes the research that has been conducted at MIT since 1998 on fuel modeling, silver leakage from coated fuel particles, dynamic simulation, MCNP reactor physics modeling and air ingress analysis.

  5. MIT pebble bed reactor project

    International Nuclear Information System (INIS)

    Kadak, Andrew C.

    2007-01-01

    The conceptual design of the MIT modular pebble bed reactor is described. This reactor plant is a 250 Mwth, 120 Mwe indirect cycle plant that is designed to be deployed in the near term using demonstrated helium system components. The primary system is a conventional pebble bed reactor with a dynamic central column with an outlet temperature of 900 C providing helium to an intermediate helium to helium heat exchanger (IHX). The outlet of the IHX is input to a three shaft horizontal Brayton Cycle power conversion system. The design constraint used in sizing the plant is based on a factory modularity principle which allows the plant to be assembled 'Lego' style instead of constructed piece by piece. This principle employs space frames which contain the power conversion system that permits the Lego-like modules to be shipped by truck or train to sites. This paper also describes the research that has been conducted at MIT since 1998 on fuel modeling, silver leakage from coated fuel particles, dynamic simulation, MCNP reactor physics modeling and air ingress analysis

  6. Using technology for bed management in public hospitals - A strategic analysis and change management plan

    OpenAIRE

    Brayan, Daniel Joseph

    2005-01-01

    As healthcare organisations in New South Wales, Australia, are facing the increased demands of an aging population, new approaches to improving access to services are being sought. This project explores the potential of applying information technology to the management of beds in a large Sydney public hospital. More specifically, this project addresses the cultural and organizational aspects of hospital environments and factors them into a change management plan for implementing bed managemen...

  7. Public hospital bed crisis: too few or too misused?

    Science.gov (United States)

    Scott, Ian A

    2010-08-01

    * Increasing demand on public hospital beds has led to what many see as a hospital bed crisis requiring substantial increases in bed numbers. By 2050, if current bed use trends persist and as the numbers of frail older patients rise exponentially, a 62% increase in hospital beds will be required to meet expected demand, at a cost almost equal to the entire current Australian healthcare budget. * This article provides an overview of the effectiveness of different strategies for reducing hospital demand that may be viewed as primarily (although not exclusively) targeting the hospital sector - increasing capacity and throughput and reducing readmissions - or the non-hospital sector - facilitating early discharge or reducing presentations and admissions to hospital. Evidence of effectiveness was retrieved from a literature search of randomised trials and observational studies using broad search terms. * The principal findings were as follows: (1) within the hospital sector, throughput could be substantially improved by outsourcing public hospital clinical services to the private sector, undertaking whole-of-hospital reform of care processes and patient flow that address both access and exit block, separating acute from elective beds and services, increasing rates of day-only or short stay admissions, and curtailing ineffective or marginally effective clinical interventions; (2) in regards to the non-hospital sector, potentially the biggest gains in reducing hospital demand will come from improved access to residential care, rehabilitation services, and domiciliary support as patients awaiting such services currently account for 70% of acute hospital bed-days. More widespread use of acute care and advance care planning within residential care facilities and population-based chronic disease management programs can also assist. * This overview concludes that, in reducing hospital bed demand, clinical process redesign within hospitals and capacity enhancement of non-hospital

  8. IEN project - Fluidized bed burner

    International Nuclear Information System (INIS)

    1985-08-01

    Due to difficulties inherent to the organic waste storage from laboratories and institutes which use radioactive materials for scientific researches, the Nuclear Facilities Division (DIN/CNEN); elaborated a project for constructing a fluidized burner, in laboratory scale, for burning the low level organic radioactive wastes. The burning system of organic wastes is described. (M.C.K.) [pt

  9. The Safety of Hospital Beds: Ingress, Egress, and In-Bed Mobility.

    Science.gov (United States)

    Morse, Janice M; Gervais, Pierre; Pooler, Charlotte; Merryweather, Andrew; Doig, Alexa K; Bloswick, Donald

    2015-01-01

    To explore the safety of the standard and the low hospital bed, we report on a microanalysis of 15 patients' ability to ingress, move about the bed, and egress. The 15 participants were purposefully selected with various disabilities. Bed conditions were randomized with side rails up or down and one low bed with side rails down. We explored the patients' use of the side rails, bed height, ability to lift their legs onto the mattress, and ability to turn, egress, and walk back to the chair. The standard bed was too high for some participants, both for ingress and egress. Side rails were used by most participants when entering, turning in bed, and exiting. We recommend that side rails be reconsidered as a means to facilitate in-bed movement, ingress, and egress. Furthermore, single deck height settings for all patients are not optimal. Low beds as a safety measure must be re-evaluated.

  10. NUCLA Circulating Atmospheric Fluidized Bed Demonstration Project

    Energy Technology Data Exchange (ETDEWEB)

    1992-02-01

    The objective of this DOE Cooperative Agreement is to conduct a cost-shared clean coal technology project to demonstrate the feasibility of circulating fluidized bed combustion technology and to evaluate economic, environmental, and operational benefits of CFB steam generators on a utility scale. At the conclusion of the Phase 2 program, testing related to satisfying these objectives was completed. Data analysis and reporting are scheduled for completion by October 1991. (VC)

  11. 21 CFR 880.5110 - Hydraulic adjustable hospital bed.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Hydraulic adjustable hospital bed. 880.5110 Section 880.5110 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL HOSPITAL AND PERSONAL USE DEVICES General Hospital and Personal Use...

  12. 21 CFR 880.5140 - Pediatric hospital bed.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Pediatric hospital bed. 880.5140 Section 880.5140 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL HOSPITAL AND PERSONAL USE DEVICES General Hospital and Personal Use Therapeutic...

  13. 21 CFR 880.5120 - Manual adjustable hospital bed.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Manual adjustable hospital bed. 880.5120 Section 880.5120 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL HOSPITAL AND PERSONAL USE DEVICES General Hospital and Personal Use...

  14. Between two beds: inappropriately delayed discharges from hospitals.

    Science.gov (United States)

    Holmås, Tor Helge; Islam, Mohammad Kamrul; Kjerstad, Egil

    2013-12-01

    Acknowledging the necessity of a division of labour between hospitals and social care services regarding treatment and care of patients with chronic and complex conditions, is to acknowledge the potential conflict of interests between health care providers. A potentially important conflict is that hospitals prefer comparatively short length of stay (LOS) at hospital, while social care services prefer longer LOS all else equal. Furthermore, inappropriately delayed discharges from hospital, i.e. bed blocking, is costly for society. Our aim is to discuss which factors that may influence bed blocking and to quantify bed blocking costs using individual Norwegian patient data, merged with social care and hospital data. The data allow us to divide hospital LOS into length of appropriate stay (LAS) and length of delay (LOD), the bed blocking period. We find that additional resources allocated to social care services contribute to shorten LOD indicating that social care services may exploit hospital resources as a buffer for insufficient capacity. LAS increases as medical complexity increases indicating hospitals incentives to reduce LOS are softened by considerations related to patients’ medical needs. Bed blocking costs constitute a relatively large share of the total costs of inpatient care.

  15. Nucla circulating atmospheric fluidized bed demonstration project

    Energy Technology Data Exchange (ETDEWEB)

    Keith, Raymond E.

    1991-10-01

    Colorado-Ute Electric Association began a study to evaluate options for upgrading and extending the life of its Nucla power station in 1982. Located in southwestern Colorado near the town of Nucla, this station was commissioned in 1959 with a local bituminous coal as its design fuel for three identical stoker-fired units, each rated at 12.6 MW(e). Poor station efficiency, high fuel costs, and spiraling boiler maintenance costs forced the Nucla Station into low priority in the CUEA dispatch order as early as 1981. Among the options CUEA considered was to serve as a host utility to demonstrate Atmospheric Fluidized Bed Combustion (AFBC) technology. The anticipated environmental benefits and apparent attractive economics of a circulating AFBC led to Colorado-Ute's decision to proceed with the design and construction of a demonstration project in 1984 at the Nucla facility.

  16. Bed blocking by elderly patients in general-hospital wards.

    Science.gov (United States)

    Rubin, S G; Davies, G H

    1975-08-01

    A point prevalence survey, using a questionnaire, was performed in three general hospitals to investigate the problem of elderly patients blocking acute-hospital beds. A total of 1010 occupied general beds were surveyed and all patients, over the age of 60 years, who had been in hospital more than four weeks, and who, in the opinion of medical and nursing staff, were no longer in need of the facilities of a general hospital, were investigated. Forty-eight patients (4.8 per cent of the total) were found to be genuinely in bed inappropriate to their needs. Rehabilitation, together with assessment of these patients, appeared disorganized and lacked consistency, and decisions regarding suitable 'disposal' appeared to be made without sufficient consultation and conformed to no detectable pattern. The main reason for the continuing bed occupancy of the patients was the length of the waiting lists for alternative residential accommodation and the main single medical factor preventing discharge home or to a hostel was the problem of mobility. By interviewing staff and patients and scrutinizing the questionnaires, it was found that 23 patients (48 per cent) were only suitable for transfer to a long-stay hospital. Of these, however, 15 (31 per cent) could be placed in specialized accommodation if some degree of nursing care, at present not available, was provided.

  17. Optimization Model for Capacity Management and Bed Scheduling for Hospital

    Science.gov (United States)

    Sitepu, Suryati; Mawengkang, Herman; Husein, Ismail

    2018-01-01

    Hospital is a very important institution to provide health care for people. It is not surprising that nowadays the people’s demands for hospital is increasing.. However, due to the rising cost of healthcare services, hospitals need to consider efficiencies in order to overcome these two problems. This paper deals with an integrated strategy of staff capacity management and bed allocation planning to tackle these problems. Mathematically, the strategy can be modeled as an integer linear programming problem. We solve the model using a direct neighborhood search approach, based on the notion of superbasic variables.

  18. Art in Hospitals Project

    DEFF Research Database (Denmark)

    Baceviciute, Sarune; Bruni, Luis Emilio; Burelli, Paolo

    studies of the “Art in Hospitals” project challenged this perspective by investigating the positive or negative effects of “lower-level” specific features (e.g.: bright colors vs. darker, contrast, predominant shapes) independent of whether they were present in abstract or figurative art, which...... as such could not be said to have universal positive or negative effects respectively. In this sense it was retained necessary to assess whether significant differences can be detected in cognitive processes when processing figurative or abstract art that has been manifestly reported as pleasant or unpleasant...

  19. Novel bed integrated ventilation method for hospital patient rooms

    DEFF Research Database (Denmark)

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

    2014-01-01

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

  20. The relationship between bed size and profitability in South Carolina hospitals.

    Science.gov (United States)

    Kim, Yang K; Glover, Saundra H; Stoskopf, Carleen H; Boyd, Suzan D

    2002-01-01

    The purpose of the study is to identify factors affecting hospital profitability and to find the optimal hospital bed size that assures maximum profit. This is a cross-sectional study using survey data obtained from acute care hospitals in South Carolina in 1997. The relationship of hospital profitability and hospital bed size revealed that when bed size increases, hospital profitability increases, decreases, and then increases again. For the patient profit proportion, the turning points in bed size are 238.22 and 560.08. For the total profit proportion, the turning points in bed size are 223.31 and 503.86. The results on the relationship between bed size and hospital profitability indicate that medium-size hospitals have less profitability.

  1. NUCLA Circulating Atmospheric Fluidized Bed Demonstration Project

    Energy Technology Data Exchange (ETDEWEB)

    Keith, Raymond E.; Heller, Thomas J.; Bush, Stuart A.

    1991-01-01

    This Annual Report on Colorado-Ute Electric Association's NUCLA Circulating Fluidized Bed (CFB) Demonstration Program covers the period from February 1987 through December 1988. The outline for presentation in this report includes a summary of unit operations along with individual sections covering progress in study plan areas that commenced during this reporting period. These include cold-mode shakedown and calibration, plant commercial performance statistics, unit start-up (cold), coal and limestone preparation and handling, ash handling system performance and operating experience, tubular air heater, baghouse operation and performance, materials monitoring, and reliability monitoring. During this reporting period, the coal-mode shakedown and calibration plan was completed. (VC)

  2. Exposure measurement in the neighboring hospital beds during an x-ray procedure in hospitalization unit

    Energy Technology Data Exchange (ETDEWEB)

    Goto, Rafael E.; Capeleti, Felipe F.; Cabete, Henrique V., E-mail: rafael.goto@fcmsantacasasp.edu.br, E-mail: felipe.capeleti@fcmsantacasasp.edu.br, E-mail: henrique@gmpbrasil.com.br [Faculdade de Ciencias Medicas da Santa Casa Sao Paulo, SP (Brazil); GMP Consultoria em Radioprotecao e Fisica Medica e Assessoria LTDA, Sao Paulo, SP (Brazil)

    2017-11-01

    There are lots of discussion about the exposure in hospitalization units in Brazil, especially around labor legislation and economic advantages of unhealthiness. With the attention focused on hospitalized patients, there were measured the exposure in neighboring beds of the patient submitted to an X-ray procedure with a mobile X-ray system that could be used to illustrate the discussion with consistent values. The most common X-ray procedure made in hospitalization units are chests images with techniques between 70 to 120 kV and 5 to 20 mAs. The measurement was made during routine exposure and simulations using a scattering phantom with Radcal AccuPro electrometer and 1800cc ionization chamber in a private hospital and a philanthropic hospital, both in Sao Paulo, Brazil. The ionization chambers are placed at 2 meters distance of the patient exposed of both sides during the routine procedure. During the simulation, a nylon phantom of 20 centimeters thick and 30 x 30 cm² size was placed on the bed, a typical exposure technique was used and the exposure was measured surrounding the phantom at 0.6, 1.0 and 2.0 meters distance for scattered radiation characterization. Initial results showed that the neighboring exposure at about 2 meters distance from the exposed patient bed have low values, even when exposure is integrated during the length of hospital stay. Therefore, the exposure in hospitalization units are very low compared to the exams doses. (author). (author)

  3. Global hospital bed utilization crisis. A different approach.

    Science.gov (United States)

    Waness, Abdelkarim; Akbar, Jalal U; Kharal, Mubashar; BinSalih, Salih; Harakati, Mohammed

    2010-04-01

    To test the effect of improved physician availability on hospital bed utilization. A prospective cohort study was conducted from 1st January 2009 to 31st March 2009 in the Division of Internal Medicine (DIM), King Abdul-Aziz Medical City (KAMC), Riyadh, Kingdom of Saudi Arabia. Two clinical teaching units (CTU) were compared head-to-head. Each CTU has 3 consultants. The CTU-control provides standard care, while the CTU-intervention was designed to provide better physician-consultant availability. Three outcomes were evaluated: patient outsourcing to another hospital, patient discharge during weekends, and overall admissions. Statistical analysis was carried out by electronic statistics calculator from the Center for Evidence-Based Medicine. Three hundred and thirty-four patients were evaluated for admission at the Emergency Room by both CTU's. One hundred and eighty-three patients were seen by the CTU-control, 6 patients were outsourced, and 177 were admitted. One hundred fifty-one patients were seen by the CTU-intervention: 39 of them were outsourced, and 112 were admitted. Forty-eight weekend patient discharges occurred during this period of time: 21 by CTU-control, and 27 by CTU-intervention. Analysis for odds ratio in both the rate of outsourcing, and weekend discharges, showed statistical significance in favor of the intervention group. The continuous availability of a physician-consultant for patient admission evaluation, outsourcing, or discharge during regular weekdays and weekends at DIM, KAMC proved to have a positive impact on bed utilization.

  4. The SSM/PMAD automated test bed project

    Science.gov (United States)

    Lollar, Louis F.

    1991-01-01

    The Space Station Module/Power Management and Distribution (SSM/PMAD) autonomous subsystem project was initiated in 1984. The project's goal has been to design and develop an autonomous, user-supportive PMAD test bed simulating the SSF Hab/Lab module(s). An eighteen kilowatt SSM/PMAD test bed model with a high degree of automated operation has been developed. This advanced automation test bed contains three expert/knowledge based systems that interact with one another and with other more conventional software residing in up to eight distributed 386-based microcomputers to perform the necessary tasks of real-time and near real-time load scheduling, dynamic load prioritizing, and fault detection, isolation, and recovery (FDIR).

  5. Subjective Evaluation of the Microenvironment Generated by a Hospital Bed with Localized Ventilation System

    DEFF Research Database (Denmark)

    Kehayova, Nushka; Bolashikov, Zhecho Dimitrov; Melikov, Arsen Krikor

    2016-01-01

    A novel method for local hospital bed ventilation, called HBIVCU (Hospital Bed with Integrated Ventilation and Cleansing Unit), was studied in a human subject experiment. The goal of this study was to identify human response to the microenvironment generated by a hospital bed with installed HBIVC...... and the LTS acceptability votes between the two conditions could be found only for some body parts and time intervals. No draught was reported....

  6. Bedding, not boarding. Psychiatric patients boarded in hospital EDs create crisis for patient care and hospital finances.

    Science.gov (United States)

    Kutscher, Beth

    2013-11-18

    As the supply of psychiatric beds dwindles, hospitals are devising innovative ways handle psych patients who come through the emergency department. Some collaborate with other hospitals, use separate pysch EDs or refer patients to residential treatment centers.

  7. Do More Hospital Beds Lead to Higher Hospitalization Rates? A Spatial Examination of Roemer’s Law

    Science.gov (United States)

    Delamater, Paul L.; Messina, Joseph P.; Grady, Sue C.; WinklerPrins, Vince; Shortridge, Ashton M.

    2013-01-01

    Background Roemer’s Law, a widely cited principle in health care policy, states that hospital beds that are built tend to be used. This simple but powerful expression has been invoked to justify Certificate of Need regulation of hospital beds in an effort to contain health care costs. Despite its influence, a surprisingly small body of empirical evidence supports its content. Furthermore, known geographic factors influencing health services use and the spatial structure of the relationship between hospital bed availability and hospitalization rates have not been sufficiently explored in past examinations of Roemer’s Law. We pose the question, “Accounting for space in health care access and use, is there an observable association between the availability of hospital beds and hospital utilization?” Methods We employ an ecological research design based upon the Anderson behavioral model of health care utilization. This conceptual model is implemented in an explicitly spatial context. The effect of hospital bed availability on the utilization of hospital services is evaluated, accounting for spatial structure and controlling for other known determinants of hospital utilization. The stability of this relationship is explored by testing across numerous geographic scales of analysis. The case study comprises an entire state system of hospitals and population, evaluating over one million inpatient admissions. Results We find compelling evidence that a positive, statistically significant relationship exists between hospital bed availability and inpatient hospitalization rates. Additionally, the observed relationship is invariant with changes in the geographic scale of analysis. Conclusions This study provides evidence for the effects of Roemer’s Law, thus suggesting that variations in hospitalization rates have origins in the availability of hospital beds. This relationship is found to be robust across geographic scales of analysis. These findings suggest

  8. Hospital bed ventilation: impact of operation mode on exposure

    DEFF Research Database (Denmark)

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

    2014-01-01

    a second patient lying in the other bed. The doctor stood up 0.55 m from the bed facing the sick patient. Two pairs of localized ventilation units were attached near the heads of both patients alongside the beds to capture, clean and release the captured exhaled air from the lying patients. When the bed...

  9. Effect of a powered drive on pushing and pulling forces when transporting bariatric hospital beds.

    Science.gov (United States)

    Wiggermann, Neal

    2017-01-01

    Powered drives designed to assist with moving hospital beds are commercially available but no studies have evaluated whether they reduce the push and pull forces likely contributing to injury in caregivers. This study measured hand forces of 10 caregivers maneuvering a manual and powered bariatric bed through simulated hospital environments (hallway, elevator, and ramp). Peak push and pull forces exceeded previously established psychophysical limits for all activities with the manual bed. For the powered bed, peak forces were significantly (p pushing did not differ between beds. Powered drive may reduce the risk of injury or the number of caregivers needed for transport. Copyright © 2016 Elsevier Ltd. All rights reserved.

  10. 21 CFR 880.5100 - AC-powered adjustable hospital bed.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false AC-powered adjustable hospital bed. 880.5100 Section 880.5100 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES... Therapeutic Devices § 880.5100 AC-powered adjustable hospital bed. (a) Identification. An AC-powered...

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

    DEFF Research Database (Denmark)

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

    2012-01-01

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

  12. [Prediction model of health workforce and beds in county hospitals of Hunan by multiple linear regression].

    Science.gov (United States)

    Ling, Ru; Liu, Jiawang

    2011-12-01

    To construct prediction model for health workforce and hospital beds in county hospitals of Hunan by multiple linear regression. We surveyed 16 counties in Hunan with stratified random sampling according to uniform questionnaires,and multiple linear regression analysis with 20 quotas selected by literature view was done. Independent variables in the multiple linear regression model on medical personnels in county hospitals included the counties' urban residents' income, crude death rate, medical beds, business occupancy, professional equipment value, the number of devices valued above 10 000 yuan, fixed assets, long-term debt, medical income, medical expenses, outpatient and emergency visits, hospital visits, actual available bed days, and utilization rate of hospital beds. Independent variables in the multiple linear regression model on county hospital beds included the the population of aged 65 and above in the counties, disposable income of urban residents, medical personnel of medical institutions in county area, business occupancy, the total value of professional equipment, fixed assets, long-term debt, medical income, medical expenses, outpatient and emergency visits, hospital visits, actual available bed days, utilization rate of hospital beds, and length of hospitalization. The prediction model shows good explanatory and fitting, and may be used for short- and mid-term forecasting.

  13. NUCLA Circulating Atmospheric Fluidized Bed Demonstration Project. 1990 Annual report

    Energy Technology Data Exchange (ETDEWEB)

    1992-02-01

    The objective of this DOE Cooperative Agreement is to conduct a cost-shared clean coal technology project to demonstrate the feasibility of circulating fluidized bed combustion technology and to evaluate economic, environmental, and operational benefits of CFB steam generators on a utility scale. At the conclusion of the Phase 2 program, testing related to satisfying these objectives was completed. Data analysis and reporting are scheduled for completion by October 1991. (VC)

  14. Experimental evaluation of a novel robotic hospital bed mover with omni-directional mobility.

    Science.gov (United States)

    Guo, Zhao; Yee, Rachael Bei; Mun, Kyung-Ryoul; Yu, Haoyong

    2017-11-01

    Bed pushing during patient transfer is one of the most physically demanding and yet common tasks in the hospital setting. Powered bed movers have been increasingly introduced to hospitals to reduce physiological strains on the users. This study introduces and quantifies the manpower efficiency and health benefits of a novel robotic-assisted omni-directional hospital bed transporter (SESTO Bed Mover) in comparison with a conventional manual transport stretcher (Stryker Trauma Stretcher 1037) and a powered transport stretcher (HOSPIMEK HMPT 740), which has a fifth powered wheel providing power assistance only in the forward direction. A total of 14 subjects were recruited (7 porters and 7 students) and were tasked to complete a course within a controlled lab environment. It is concluded that the robotic bed mover is able to halve the required manpower to push hospital beds as compared to conventional bed pushing without any additional physiological strain, potentially improving efficiency by two-fold. Electromyography (EMG) patterns showed that users relied on the shoulder and back muscles in a fashion similar to conventional pushing, further confirming the intuitive drive of the robotic bed mover. Overall, the robotic bed mover shows reduced physical demands, less manpower required for patient transport and reduced back muscle activities, which strongly suggest health benefits for workers in the hospital. Copyright © 2017 Elsevier Ltd. All rights reserved.

  15. [Hospital efficiency measured by bed space use in a secondary care hospital].

    Science.gov (United States)

    Moreno-Martínez, Roberto; Martínez-Cruz, Rocío Alejandra

    2015-01-01

    In recognition that the availability of resources in the medical facility forms part of the factors that influence the quality of healthcare, it is of vital importance to measure their outcome. The aim of this study was determine the efficiency of the medical facility through the use of beds in a secondary level hospital. Through the Health Information Management System (HIMS), we examined statistical reports from July 2012 to June 2013 including variables such as expenses, patient days, occupancy rate, average length of stay by specialty and medical division, results were obtained for each strategic indicator, and these results were related assumptions proposing to assess hospital efficiency. Overall, we identified optimal efficiency of the medical facility without analysis of services, leads to deteriorating and low efficiency. The overall outcome of the five indicators applied overlooked saturation of services within the medical unit. However, the overall analysis shows the problem, noting the advantage of evaluating the same scenario from different perspectives. The include indicators measuring hospital efficiency resource based bed, allows considering deficiencies identified, so that decision making is strengthened the decision making health.

  16. Atmospheric fluidized-bed combustion (AFBC) co-firing of coal and hospital waste

    International Nuclear Information System (INIS)

    1993-02-01

    The proposed project involves co-firing of coal and medical waste (including infectious medical waste) in an atmospheric fluidized-bed combustor (AFBC) to safely dispose of medical waste and produce steam for hospital needs. Combustion at the design temperature and residence time (duration) in the AFBC has been proven to render infectious medical waste free of disease producing organisms. The project would be located at the Veterans Affairs (VA) Medical Center in Lebanon, Pennsylvania. The estimated cost of the proposed AFBC facility is nearly $4 million. It would be jointly funded by DOE, Veterans Affairs, and Donlee Technologies, Inc., of York, Pennsylvania, under a cooperative agreement between DOE and Donlee. Under the terms of this agreement, $3.708 million in cost-shared financial assistance would be jointly provided by DOE and the Veterans Affairs (50/50), with $278,000 provided by Donlee. The purposes of the proposed project are to: (1) provide the VA Medical Center and the Good Samaritan Hospital (GSH), also of Lebanon, Pennsylvania, with a solution for disposal of their medical waste; and (2) demonstrate that a new coal-burning technology can safely incinerate infectious medical waste, produce steam to meet hospital needs, and comply with environmental regulations

  17. Electric versus hydraulic hospital beds: differences in use during basic nursing tasks.

    Science.gov (United States)

    Capodaglio, Edda Maria

    2013-01-01

    Biomechanical, postural and ergonomic aspects during real patient-assisting tasks performed by nurses using an electric versus a hydraulic hospital bed were observed. While there were no differences in the flexed postures the nurses adopted, longer performance times were recorded when electric beds were used. Subjective effort, force exertion and lumbar shear forces exceeding safety limits proved electric beds were superior. Patients' dependency level seemed to influence the type of nurses' intervention (duration and force actions), irrespective of the bed used. The nurses greatly appreciated the electric bed. Its use seemed to reduce the level of effort perceived during care giving and the postural load during critical subtasks. Ergonomics and organizational problems related to adopting electric beds in hospital wards should be addressed further to make their use more efficient.

  18. CERTS Microgrid Laboratory Test Bed - PIER Final Project Report

    Energy Technology Data Exchange (ETDEWEB)

    Eto, Joseph H.; Eto, Joseph H.; Lasseter, Robert; Schenkman, Ben; Klapp, Dave; Linton, Ed; Hurtado, Hector; Roy, Jean; Lewis, Nancy Jo; Stevens, John; Volkommer, Harry

    2008-07-25

    The objective of the CERTS Microgrid Laboratory Test Bed project was to enhance the ease of integrating small energy sources into a microgrid. The project accomplished this objective by developing and demonstrating three advanced techniques, collectively referred to as the CERTS Microgrid concept, that significantly reduce the level of custom field engineering needed to operate microgrids consisting of small generating sources. The techniques comprising the CERTS Microgrid concept are: 1) a method for effecting automatic and seamless transitions between grid-connected and islanded modes of operation; 2) an approach to electrical protection within the microgrid that does not depend on high fault currents; and 3) a method for microgrid control that achieves voltage and frequency stability under islanded conditions without requiring high-speed communications. The techniques were demonstrated at a full-scale test bed built near Columbus, Ohio and operated by American Electric Power. The testing fully confirmed earlier research that had been conducted initially through analytical simulations, then through laboratory emulations, and finally through factory acceptance testing of individual microgrid components. The islanding and resychronization method met all Institute of Electrical and Electronics Engineers 1547 and power quality requirements. The electrical protections system was able to distinguish between normal and faulted operation. The controls were found to be robust and under all conditions, including difficult motor starts. The results from these test are expected to lead to additional testing of enhancements to the basic techniques at the test bed to improve the business case for microgrid technologies, as well to field demonstrations involving microgrids that involve one or mroe of the CERTS Microgrid concepts.

  19. Nucla circulating atmospheric fluidized bed demonstration project. Final report

    Energy Technology Data Exchange (ETDEWEB)

    1991-10-01

    Colorado-Ute Electric Association began a study to evaluate options for upgrading and extending the life of its Nucla power station in 1982. Located in southwestern Colorado near the town of Nucla, this station was commissioned in 1959 with a local bituminous coal as its design fuel for three identical stoker-fired units, each rated at 12.6 MW(e). Poor station efficiency, high fuel costs, and spiraling boiler maintenance costs forced the Nucla Station into low priority in the CUEA dispatch order as early as 1981. Among the options CUEA considered was to serve as a host utility to demonstrate Atmospheric Fluidized Bed Combustion (AFBC) technology. The anticipated environmental benefits and apparent attractive economics of a circulating AFBC led to Colorado-Ute`s decision to proceed with the design and construction of a demonstration project in 1984 at the Nucla facility.

  20. Introducing DRG-based financing in Hungary : a study into the relationship between supply of hospital beds and use of these beds under changing institutional circumstances

    NARCIS (Netherlands)

    Kroneman, Madelon W.; Nagy, Júlia

    2001-01-01

    Most hospital reforms carried out in Europe over the past few decades concern the supply of hospital beds and hospital financing systems. In Hungary, financing was not tied to hospital input or output until a Diagnosis-Related-Group system was introduced. This change provided an opportunity to study

  1. Distribution of physicians and hospital beds based on Gini coefficient and Lorenz curve: A national survey

    Directory of Open Access Journals (Sweden)

    Satar Rezaei

    2016-06-01

    Full Text Available Introduction: Inequality is prevalent in all sectors, particularly in distribution of and access to resources in the health sector. The aim of current study was to investigate the distribution of physicians and hospital beds in Iran in 2001, 2006 and 2011. Methods: This retrospective, cross-sectional study evaluated the distribution of physicians and hospital beds in 2001, 2006 and 2011 using Gini coefficient and Lorenz curve. The required data, including the number of physicians (general practitioners and specialists, number of hospital beds and number of hospitalized patients were obtained from the statistical yearbook of Iranian Statistical Center (ISC. The data analysis was performed by DASP software. Results: The Gini Coefficients for physicians and hospital beds based on population in 2001 were 0.19 and 0.16, and based on hospitalized patients, were 0.48 and 0.37, respectively. In 2006, these values were found to be 0.18 and 0.15 based on population, and 0.21 and 0.21 based on hospitalized patients, respectively. In 2011, however, the Gini coefficients were reported to be 0.16 and 0.13 based on population, and 0.47 and 0.37 based on hospitalized patients, respectively. Although distribution status had improved in 2011compared with 2001 in terms of population and number of hospitalized patients, there was more inequality in distribution based on the number of hospitalized patients than based on population. Conclusion: This study indicated that inequality in distribution of physicians and hospital beds was declined in 2011 compared with 2001. This distribution was based on the population, so it is suggested that, in allocation of resource, the health policymakers consider such need indices as the pattern of diseases and illness-prone areas, number of inpatients, and mortality.

  2. The Hospital Building as Project and Matter of Concern

    DEFF Research Database (Denmark)

    Harty, Chris; Tryggestad, Kjell

    2015-01-01

    the building design and project, including the exposition and resolution of controversy concerning size of spaces and bodies. The paper compares the use of two different forms of representation of the same imagined space—a single-bed room in a hospital, and produced for similar purposes—to ascertain what...... of matters of concern and matters of fact, we compare these two cases to provide insights into the way different media produce specific senses of the design or imagined space, with consequences for on-going design work, and for the settling of controversy over the sizes of spaces and bodies....

  3. Analysis of Information Security Management Systems at 5 Domestic Hospitals with More than 500 Beds

    OpenAIRE

    Park, Woo-Sung; Seo, Sun-Won; Son, Seung-Sik; Lee, Mee-Jeong; Kim, Shin-Hyo; Choi, Eun-Mi; Bang, Ji-Eon; Kim, Yea-Eun; Kim, Ok-Nam

    2010-01-01

    Objectives The information security management systems (ISMS) of 5 hospitals with more than 500 beds were evaluated with regards to the level of information security, management, and physical and technical aspects so that we might make recommendations on information security and security countermeasures which meet both international standards and the needs of individual hospitals. Methods The ISMS check-list derived from international/domestic standards was distributed to each hospital to com...

  4. Co-firing coal and hospital waste in a circulating fluidized bed boiler

    International Nuclear Information System (INIS)

    Coulthard, E.J.; Korenberg, J.; Oswald, K.D.

    1991-01-01

    The Department of Energy - Morgantown Energy Technology Center and the Pennsylvania Energy Development Authority are co-funding a project which will demonstrate the reduction of infectious hospital waste to an environmentally safe disposable ash by cofiring the waste with coal in a circulating fluidized bed (CFB). The main objective of this paper is increased utilization of coal but the project also provides a solution to a problem which has grown rapidly and become very visible in recent years (e.g., hospital waste washed up on beaches). The application of CFB boilers in hospitals introduces an economical clean coal technology into a size range and market dominated by gas and oil combustion systems. The use of CFB represents the utilization of state-of-the-art technology for burning coal in an environmentally benign manner. SO 2 , NO x , CO and particulate emissions lower than the latest New Source Performance Standards have proven to be achievable in CFB combustion systems. By processing the infectious waste in a steam generation system which operates continuously, the problem of creating excessive gaseous emissions during repeated start-ups (as is the case with current incinerator technology) is avoided. The operating conditions with respect to residence time, temperature and turbulence that are inherent to a CFB combustion system, provide an excellent environment for complete combustion and destruction of potentially hazardous solid and gaseous emissions (e.g., dioxins). The limestone, which is injected into the combustion system to reduce SO 2 emissions, will also react with chlorine. Thus chlorine compound emissions and the corrosive nature of the flue gas are reduced. The work efforts to date indicate that infectious waste thermal processing in a coal-fired CFB is a technically and economically viable on-site disposal option

  5. Geographic distribution of hospital beds throughout China: a county-level econometric analysis.

    Science.gov (United States)

    Pan, Jay; Shallcross, David

    2016-11-08

    Geographical distribution of healthcare resources is an important dimension of healthcare access. Little work has been published on healthcare resource allocation patterns in China, despite public equity concerns. Using national data from 2043 counties, this paper investigates the geographic distribution of hospital beds at the county level in China. We performed Gini coefficient analysis to measure inequalities and ordinary least squares regression with fixed provincial effects and additional spatial specifications to assess key determinants. We found that provinces in west China have the least equitable resource distribution. We also found that the distribution of hospital beds is highly spatially clustered. Finally, we found that both county-level savings and government revenue show a strong positive relationship with county level hospital bed density. We argue for more widespread use of disaggregated, geographical data in health policy-making in China to support the rational allocation of healthcare resources, thus promoting efficiency and equity.

  6. Estimating the financial savings from maintaining the level of acute services with fewer hospital beds.

    Science.gov (United States)

    Beech, R; Larkinson, J

    1990-01-01

    All district health authorities are obliged to use resources most efficiently. One approach to increasing efficiency is to identify measures which allow service levels, in terms of patients treated and standards of care, to be maintained at a lower cost. This could be achieved by maintaining service levels with fewer hospital beds. Reducing lengths of stay by removing organizational delays and expansions of day-case care, are policies which can increase patient caseload per bed. This paper puts forward an approach for estimating the resources released by such policies and assesses the savings achieved by realizing efficiency gains identified in a previous study by Beech et al. (1987). That study identified significant potential for maintaining services with fewer beds, with the expansion of day-case care being a key mechanism. However this paper concludes that when services are maintained with fewer beds, the vast majority of hospital costs remain fixed. It also reaches the alarming conclusion that as a vehicle for reducing costs, day-case care is much less effective than previous studies have implied. However, increasing hospital throughput per bed does release capacity to treat more patients. The proposed reforms of the NHS (Secretaries of State, 1989) envisage an internal market for health care, allowing hospitals to enter into contracts with purchasers of health care. The approach to costing described in this paper is applicable to assessing the increased costs associated with such developments. These extra costs can then be compared with expected income.

  7. Expected hazards and hospital beds in host cities of the 2014 FIFA World Cup in Brazil

    Directory of Open Access Journals (Sweden)

    Elaine Silva Miranda

    Full Text Available Planning for mass gatherings involves health system preparedness based on an understanding of natural and technological hazards identified through prior risk assessment. We present the expected hazards reported by health administrators of the host cities for the 2014 FIFA World Cup in Brazil and discuss the hazards considering minimal available public hospital beds in the 12 cities at the time of the event. Four different groups of respondents were interviewed: pharmaceutical service administrators and overall health administrators at both the municipal and hospital levels. The hospital bed occupancy rate was calculated, based on the Brazilian Health Informatics Department (DATASUS. The number of surplus beds was calculated using parameters from the literature regarding surge and mass casualty needs and number of unoccupied beds. In all groups, physical injuries ranked first, followed by emerging and endemic diseases. Baseline occupancy rates were high (95%CI: 0.93-2.19 in all 12 cities. Total shortage, considering all the cities, ranged from -47,670 (for surges to -60,569 beds (for mass casualties. The study can contribute to discussions on mass-gathering preparedness.

  8. Psychiatric hospital beds and prison populations in South America since 1990: does the Penrose hypothesis apply?

    Science.gov (United States)

    Mundt, Adrian P; Chow, Winnie S; Arduino, Margarita; Barrionuevo, Hugo; Fritsch, Rosemarie; Girala, Nestor; Minoletti, Alberto; Mitkiewicz, Flávia; Rivera, Guillermo; Tavares, María; Priebe, Stefan

    2015-02-01

    In 1939, English mathematician, geneticist, and psychiatrist Lionel Sharples Penrose hypothesized that the numbers of psychiatric hospital beds and the sizes of prison populations were inversely related; 75 years later, the question arises as to whether the hypothesis applies to recent developments in South America. To explore the possible association of changes in the numbers of psychiatric hospital beds with changes in the sizes of prison populations in South America since 1990. We searched primary sources for the numbers of psychiatric hospital beds in South American countries since 1990 (the year that the Latin American countries signed the Caracas Declaration) and compared these changes against the sizes of prison populations. The associations between the numbers of psychiatric beds and the sizes of prison populations were tested using fixed-effects regression of panel data. Economic variables were considered as covariates. Sufficiently reliable and complete data were obtained from 6 countries: Argentina, Bolivia, Brazil, Chile, Paraguay, and Uruguay. The numbers of psychiatric beds and the sizes of prison populations. Since 1990, the numbers of psychiatric beds decreased in all 6 countries (ranging from -2.0% to -71.9%), while the sizes of prison populations increased substantially (ranging from 16.1% to 273.0%). Panel data regression analysis across the 6 countries showed a significant inverse relationship between numbers of psychiatric beds and sizes of prison populations. On average, the removal of 1 bed was associated with 5.18 more prisoners (95% CI, 3.10-7.26; P = .001), which was reduced to 2.78 prisoners (95% CI, 2.59-2.97; P prison populations remained practically unchanged when income inequality was considered as a covariate (-4.28 [95% CI, -5.21 to -3.36]; P prison populations have increased against a background of strong economic growth. The changes appear to be associated because the numbers of beds decreased more extensively when and

  9. High Levels Of Bed Occupancy Associated With Increased Inpatient And Thirty-Day Hospital Mortality In Denmark

    DEFF Research Database (Denmark)

    Madsen, Flemming; Ladelund, Steen; Linneberg, Allan

    2014-01-01

    to low bed occupancy rates. Being admitted to a hospital outside of normal working hours or on a weekend or holiday was also significantly associated with increased mortality. The health risks of bed shortages, including mortality, could be better documented as a priority health issue. Resources should......High bed occupancy rates have been considered a matter of reduced patient comfort and privacy and an indicator of high productivity for hospitals. Hospitals with bed occupancy rates of above 85 percent are generally considered to have bed shortages. Little attention has been paid to the impact...... be allocated to researching the causes and effects of bed shortages, with the aim of creating greater interest in exploring new methods to avoid or reduce bed shortages....

  10. A bacteriological study of hospital beds before and after disinfection with phenolic disinfectant

    OpenAIRE

    Denise de Andrade; Emília L. S. Angerami; Carlos Roberto Padovani

    2000-01-01

    In hospitals, one of the ways to control microbial contamination is by disinfecting the furniture used by patients. This study's main objective was to evaluate the microbiological condition of hospital mattresses before and after such disinfection, in order to identify bacteria that are epidemiologically important in nosocomial infection, such as Staphylococcus aureus and Pseudomonas aeruginosa. RODAC plates with two different culture media were used to collect specimens. Patient beds were se...

  11. Hospitalization of nursing home residents: the effects of states' Medicaid payment and bed-hold policies.

    Science.gov (United States)

    Intrator, Orna; Grabowski, David C; Zinn, Jacqueline; Schleinitz, Mark; Feng, Zhanlian; Miller, Susan; Mor, Vince

    2007-08-01

    Hospitalizations of nursing home residents are costly and expose residents to iatrogenic disease and social and psychological harm. Economic constraints imposed by payers of care, predominantly Medicaid policies, are hypothesized to impact hospitalizations. Federally mandated resident assessments were merged with Medicare claims and eligibility files to determine hospitalizations and death within 150 days of baseline assessment. Nursing home and market characteristics were obtained from the Online Survey Certification and Reporting, and the Area Resource File, respectively. States' average daily Medicaid nursing home payments and bed-hold policies were obtained independently. Prospective cohort study of 570,614 older (> or =65-year-old), non-MCO (Medicare Managed Care), long-stay (> or =90 days) residents in 8,997 urban, freestanding nursing homes assessed between April and June 2000, using multilevel models to test the impact of state policies on hospitalizations controlling for resident, nursing home, and market characteristics. Overall, 99,379 (17.4 percent) residents were hospitalized with rates varying from 8.4 percent in Utah to 24.9 percent in Louisiana. Higher Medicaid per diem was associated with lower odds of hospitalizations (5 percent lower for each $10 above average $103.5, confidence intervals [CI] 0.91-0.99). Hospitalization odds were higher by 36 percent in states with bed-hold policies (CI: 1.12-1.63). State Medicaid bed-hold policy and per-diem payment have important implications for nursing home hospitalizations, which are predominantly financed by Medicare. This study emphasizes the importance of properly aligning state Medicaid and federal Medicare policies in regards to the subsidy of acute, maintenance, and preventive care in the nursing home setting.

  12. The Factors Influencing Economic Efficiency of the Hospital Bed Care in Terms of the Regional Allowance Organizations

    Directory of Open Access Journals (Sweden)

    Vaňková Ivana

    2014-09-01

    Full Text Available This paper aims to provide an efficiency evaluation of selected hospital bed care providers during years 2010 -2012 with respect to selected factors: The size of the hospital establishment according to number of beds, number of hospitalized patients, the average length of stay per a patient in care, total staff cost calculated per bed, total revenues calculated per bed, and total costs calculated per bed. For this purpose, hospitals providing primarily acute bed care were chosen. From the legal point of view, they are allowance organizations of a particular region. The evaluation concerns both allocative efficiency and technical efficiency. The allocative efficiency is treated from the proper algorithm point of view and it compares total costs calculated per bed with total revenues calculated per bed. A method denominated Data Envelopment Analysis was applied for the calculation of the technical efficiency of units. To be more specific, it was input-oriented model with constant returns to scale (CCR. The input parameters involve the number of beds, the average length of stay and costs per day of stay. Output parameters were as follows: Bed occupancy in days and the number of hospitalized patients. The data published by the Institute of Health Information and Statistic of the Czech Republic and by ÚFIS system (the Data Base of Ministry of Finance of the Czech Republic were used as the source of data. The evaluation implies that only three hospitals were economically-effective: Silesian Hospital in Opava, Hospital Jihlava, and TGM Hospital Hodonín. The most significant factor influencing the efficiency was determined - the average length of stay.

  13. Bed blockers: A study on the elderly patients in a teaching hospital in India

    Directory of Open Access Journals (Sweden)

    Praveen Kumar N

    2010-07-01

    Full Text Available A cross-sectional study of in-patients over the age of 60 years was conducted at district McGann Hospital, Shimoga on patients who were classified as bed blockers. Level of dependency and cognitive function of these patients were assessed using Barthel scale and Abbreviated mental test (AMT respectively. Median age of the study population was 67 years; majority of them were men. Most of them were admitted in the medical ward and the median time to be labeled as bed blocker was 32 days. These bed blockers were a weak group of patients with an average 3.1 pathology per case. Majority of them suffered from neurological disorders and cardiovascular disease. High level of dependence was noted with a mean Barthel score of 29.68 (Range 0 -100. Low levels of cognitive function was also noted among these patients with a mean AMT of 4.76 (Range 0 -10.These findings demonstrate that the bed blockers in McGann hospital suffer not only from genuine health problems but also have a high dependency level in activities of daily living which hamper their discharge to the community. Community based rehabilitation using an intersectoral approach may help at least the less dependent to return home.

  14. Inside 'bed management': ethnographic insights from the vantage point of UK hospital nurses.

    Science.gov (United States)

    Allen, Davina

    2015-03-01

    In the face of unprecedented financial and demographic challenges, optimising acute bed utilisation by the proactive management of patient flows is a pressing policy concern in high-income countries. Despite the growing literature on this topic, bed management has received scant sociological attention. Drawing on practice-based approaches, this article deploys ethnographic data to examine bed management from the perspective of UK hospital nurses. While the nursing contribution to bed management is recognised formally in their widespread employment in patient access and discharge liaison roles, nurses at all levels in the study site were enrolled in this organisational priority. Rather than the rational, centrally controlled processes promulgated by policymakers, bed management emerges as a predominantly distributed activity, described here as match-making. An example of micro-level rationing, for the most part, match-making was not informed by explicit criteria nor did it hinge on clearly identifiable decisions to grant or deny access. Rather it was embedded in the everyday practices and situated rationalities through which nurses accomplished the accommodations necessary to balance demand with resources. © 2014 Foundation for the Sociology of Health & Illness.

  15. A Model for the Development of Hospital Beds Using Fuzzy Analytical Hierarchy Process (Fuzzy AHP).

    Science.gov (United States)

    Ravangard, Ramin; Bahadori, Mohammadkarim; Raadabadi, Mehdi; Teymourzadeh, Ehsan; Alimomohammadzadeh, Khalil; Mehrabian, Fardin

    2017-11-01

    This study aimed to identify and prioritize factors affecting the development of military hospital beds and provide a model using fuzzy analytical hierarchy process (Fuzzy AHP). This applied study was conducted in 2016 in Iran using a mixed method. The sample included experts in the field of military health care system. The MAXQDA 10.0 and Expert Choice 10.0 software were used for analyzing the collected data. Geographic situation, demographic status, economic status, health status, health care centers and organizations, financial and human resources, laws and regulations and by-laws, and the military nature of service recipients had effects on the development of military hospital beds. The military nature of service recipients (S=0.249) and economic status (S=0.040) received the highest and lowest priorities, respectively. Providing direct health care services to the military forces in order to maintain their dignity, and according to its effects in the crisis, as well as the necessity for maintaining the security of the armed forces, and the hospital beds per capita based on the existing laws, regulations and bylaws are of utmost importance.

  16. Bed, Breakfast and Friendship: Intimacy and Distance in Small-Scale Hospitality Businesses

    Directory of Open Access Journals (Sweden)

    Johan Hultman

    2010-09-01

    Full Text Available Through an analysis of the narrative of a Bed and Breakfast (B & B and art gal-lery owner, the emergence of intimacy as a commercial value in the hospitality industry is illustrated. This is a formation of economic value where economic ra-tionality as a motive for commercial activity is rejected. Simultaneously though, a different set of market attitudes are performed by hospitality practitioners in the course of everyday interactions with customers, and a tension between emotional, spatial and temporal intimacy and distance is uncovered and discussed. It is con-cluded that commercial friendship is a more complex issue than what has been acknowledged so far in the hospitality literature. A continued discussion of inti-macy in hospitality will therefore affect the cultural understanding of emotions, identity and lifestyle values on the one hand, and business strategy, value creation and markets on the other.

  17. Analysis of information security management systems at 5 domestic hospitals with more than 500 beds.

    Science.gov (United States)

    Park, Woo-Sung; Seo, Sun-Won; Son, Seung-Sik; Lee, Mee-Jeong; Kim, Shin-Hyo; Choi, Eun-Mi; Bang, Ji-Eon; Kim, Yea-Eun; Kim, Ok-Nam

    2010-06-01

    The information security management systems (ISMS) of 5 hospitals with more than 500 beds were evaluated with regards to the level of information security, management, and physical and technical aspects so that we might make recommendations on information security and security countermeasures which meet both international standards and the needs of individual hospitals. The ISMS check-list derived from international/domestic standards was distributed to each hospital to complete and the staff of each hospital was interviewed. Information Security Indicator and Information Security Values were used to estimate the present security levels and evaluate the application of each hospital's current system. With regard to the moderate clause of the ISMS, the hospitals were determined to be in compliance. The most vulnerable clause was asset management, in particular, information asset classification guidelines. The clauses of information security incident management and business continuity management were deemed necessary for the establishment of successful ISMS. The level of current ISMS in the hospitals evaluated was determined to be insufficient. Establishment of adequate ISMS is necessary to ensure patient privacy and the safe use of medical records for various purposes. Implementation of ISMS which meet international standards with a long-term and comprehensive perspective is of prime importance. To reflect the requirements of the varied interests of medical staff, consumers, and institutions, the establishment of political support is essential to create suitable hospital ISMS.

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

    DEFF Research Database (Denmark)

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

    2016-01-01

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

  19. NUCLA Circulating Atmospheric Fluidized Bed Demonstration Project. Annual report, 1988

    Energy Technology Data Exchange (ETDEWEB)

    1991-01-01

    This Annual Report on Colorado-Ute Electric Association`s NUCLA Circulating Fluidized Bed (CFB) Demonstration Program covers the period from February 1987 through December 1988. The outline for presentation in this report includes a summary of unit operations along with individual sections covering progress in study plan areas that commenced during this reporting period. These include cold-mode shakedown and calibration, plant commercial performance statistics, unit start-up (cold), coal and limestone preparation and handling, ash handling system performance and operating experience, tubular air heater, baghouse operation and performance, materials monitoring, and reliability monitoring. During this reporting period, the coal-mode shakedown and calibration plan was completed. (VC)

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

    Science.gov (United States)

    Persson, Eva; Määttä, Sylvia

    2012-12-01

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

  1. Reducing serious fall-related injuries in acute hospitals: are low-low beds a critical success factor?

    Science.gov (United States)

    Barker, Anna; Kamar, Jeannette; Tyndall, Tamara; Hill, Keith

    2013-01-01

    This article is a report of a study of associations between occurrence of serious fall-related injuries and implementation of low-low beds at The Northern Hospital, Victoria, Australia. A 9-year evaluation at The Northern Hospital found an important reduction in fall-related injuries after the 6-PACK falls prevention program was implemented. Low-low beds are a key component of the 6-PACK that aims to decrease fall-related injuries. A retrospective cohort study. Retrospective audit of The Northern Hospital inpatients admitted between 1999-2009. Changes in serious fall-related injuries throughout the period and associations with available low-low beds were analysed using Poisson regression. During the observation of 356,158 inpatients, there were 3946 falls and 1005 fall-related injuries of which 60 (5·9%) were serious (55 fractures and five subdural haematomas). Serious fall-related injuries declined significantly throughout the period. When there was one low-low bed to nine or more standard beds there was no statistically significant decrease in serious fall-related injuries. An important reduction only occurred when there was one low-low bed to three standard beds. The 6-PACK program has been in place since 2002 at The Northern Hospital. Throughout this time serious fall-related injuries have decreased. There appears to be an association between serious fall-related injuries and the number of available low-low beds. Threshold numbers of these beds may be required to achieve optimal usability and effectiveness. A randomized controlled trial is required to give additional evidence for use of low-low beds for injury prevention in hospitals. © 2012 Blackwell Publishing Ltd.

  2. Women's experience of hospitalized bed rest during high-risk pregnancy.

    Science.gov (United States)

    Rubarth, Lori Baas; Schoening, Anne M; Cosimano, Amy; Sandhurst, Holly

    2012-01-01

    To describe the lived experience of the hospitalized pregnant woman on bed rest. A qualitative, phenomenological design. Three high-risk antepartum units in the midwestern United States. A self-selected, convenience sample of 11 high-risk pregnant women. Phenomenological study using thematic analysis of completed handwritten journals and/or online blogs. Women described the battles that they fought each day for the lives of their unborn children. Using an imagery of war, three categories emerged: (a) the war within, (b) fighting each battle, and (c) bringing in reinforcements. Women experience many different emotions and stressors during restricted bed rest. A nurse's understanding of this experience is essential to provide adequate care and coping strategies for women at this time. © 2012 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses.

  3. The Design and Simulation of Natural Personalised Ventilation (NPV System for Multi-Bed Hospital Wards

    Directory of Open Access Journals (Sweden)

    Zulfikar A. Adamu

    2015-05-01

    Full Text Available Adequate ventilation is necessary for thermal comfort and reducing risks from infectious bio-aerosols in hospital wards, but achieving this with mechanical ventilation has carbon and energy implications. Natural ventilation is often limited to window-based designs whose dilution/mixing effectiveness are subject to constraints of wind speed, cross ventilation, and in the case of hospital wards, proximity of patients to external walls. A buoyancy-driven natural ventilation system capable of achieving dilution/mixing was shown to be feasible in a preceding study of novel system called natural personalised ventilation (NPV. This system combined both architecture and airflow engineering principles of space design and buoyancy and was tested and validated (salt-bath experiment for a single bed ward. This research extends the previous work and is proof-of-concept on the feasibility of NPV system for multi-bed wards. Two different four-bed ward types were investigated of using computational fluid dynamics (CFD simulations under wind-neutral conditions. Results predict that NPV system could deliver fresh air to multiple patients, including those located 10 m away from external wall, with absolute flow rates of between 32 L·s−1 and 54 L·s−1 for each patient/bed. Compared to same wards simulated using window design, ingress of airborne contaminants into patients’ breathing zone and summer overheating potential were minimised, while overall ward dilution was maximised. Findings suggest the NPV has potentials for enabling architects and building service engineers to decouple airflow delivery from the visualisation and illumination responsibilities placed upon windows.

  4. Analysis of the Internal Bed Regulation Committees from hospitals of a Southern Brazilian city

    Science.gov (United States)

    Soares, Vinícius Sabedot

    2017-01-01

    ABSTRACT Objective To evaluate the composition of the Internal Regulation Committees created in hospitals of a capital city. Methods A cross-sectional descriptive study assessing the structure, processes and results of each Committee. Results The main reasons for implementing the committees were legal issues and overcrowding in the emergency department. The most monitored indicators were the occupancy rate and the mean length of stay, and the most observed results were reductions in the latter. Institutional protocols were developed in 70% of cases, and the degree of support that the Internal Regulation Committee received from the hospital managers was high, despite being only average the support received from the medical teams. Promoting the efficient use of beds seemed to be the main goal. To achieve it, the Internal Regulation Committee had to control hospital capacity at levels that allowed proper and safe bed turnover for patients. The strategies for this were varied and needed to integrate administrative and care issues. Conclusion The Internal Regulation Committees were a management tool with great potential and promising results in the experiences evaluated. PMID:29091157

  5. [Project financing in public hospital trusts].

    Science.gov (United States)

    Contarino, F; Grosso, G; Mistretta, A

    2009-01-01

    The growing debate in recent years over how to finance public works through private capital has progressively highlighted the role of project finance (PF) and publicprivate partnerships (PPP) in general. More and more European countries are turning to PF to finance their public infrastructure development. The UK, which pioneered the adoption of project finance in this field, has been followed by Italy, Spain, France, Portugal and Germany and more recently by Greece, Czech Republic and Poland. Beginning in the late 1990's, Italy has steadily amplified its use of PF and PPPs in key sectors such as healthcare as an alternative way of funding the modernisation of its health facilities and hospitals. The trend reveal an average annual growth of 10.9% since 2002 with peaks of varying intensity over the five year period. Project finance and PPPs represent an effective response to the country's infrastructure gap and support the competitiveness of local systems and the quality of public services. None of this will transpire, however without energetic new planning efforts and adequate policy at the centre.

  6. Assessment of service delays and impact on bed utilisation in a major teaching hospital.

    LENUS (Irish Health Repository)

    Conway, R

    2010-12-14

    BACKGROUND: Increasing economic pressures coupled with an expanding and ageing population and a hostile economic climate have led to growing interest in the optimisation of bed usage within hospitals. There are many causes for delay in a patient\\'s discharge. METHODS: This prospective observational study assessed consecutive patients admitted and discharged from hospital within a 52-day period for waiting times in the provision of requested diagnostic tests and services. RESULTS: Seventy patients were included in the study. There were median delays of 2 and 3 days for an MRI and colonoscopy, a delay of 3 days for a Holter monitor report, and 9 days for an occupational therapy referral. The median wait for consults was 1 day across all three services. CONCLUSIONS: Significant remediable delays exist during the course of many acute medical admissions. Addressing these factors will enable the provision of a faster and more cost-efficient service.

  7. Unit cost of healthcare services at 200-bed public hospitals in Myanmar: what plays an important role of hospital budgeting?

    Science.gov (United States)

    Than, Thet Mon; Saw, Yu Mon; Khaing, Moe; Win, Ei Mon; Cho, Su Myat; Kariya, Tetsuyoshi; Yamamoto, Eiko; Hamajima, Nobuyuki

    2017-09-19

    Cost information is important for efficient allocation of healthcare expenditure, estimating future budget allocation, and setting user fees to start new financing systems. Myanmar is in political transition, and trying to achieve universal health coverage by 2030. This study assessed the unit cost of healthcare services at two public hospitals in the country from the provider perspective. The study also analyzed the cost structure of the hospitals to allocate and manage the budgets appropriately. A hospital-based cross-sectional study was conducted at 200-bed Magway Teaching Hospital (MTH) and Pyinmanar General Hospital (PMN GH), in Myanmar, for the financial year 2015-2016. The step-down costing method was applied to calculate unit cost per inpatient day and per outpatient visit. The costs were calculated by using Microsoft Excel 2010. The unit costs per inpatient day varied largely from unit to unit in both hospitals. At PMN GH, unit cost per inpatient day was 28,374 Kyats (27.60 USD) for pediatric unit and 1,961,806 Kyats (1908.37 USD) for ear, nose, and throat unit. At MTH, the unit costs per inpatient day were 19,704 Kyats (19.17 USD) for medicine unit and 168,835 Kyats (164.24 USD) for eye unit. The unit cost of outpatient visit was 14,882 Kyats (14.48 USD) at PMN GH, while 23,059 Kyats (22.43 USD) at MTH. Regarding cost structure, medicines and medical supplies was the largest component at MTH, and the equipment was the largest component at PMN GH. The surgery unit of MTH and the eye unit of PMN GH consumed most of the total cost of the hospitals. The unit costs were influenced by the utilization of hospital services by the patients, the efficiency of available resources, type of medical services provided, and medical practice of the physicians. The cost structures variation was also found between MTH and PMN GH. The findings provided the basic information regarding the healthcare cost of public hospitals which can apply the efficient utilization of the

  8. Dispersion of exhaled droplet nuclei in a two-bed hospital ward with three different ventilation systems

    DEFF Research Database (Denmark)

    Qian, H.; Li, Y.; Nielsen, Peter V.

    2006-01-01

    hospital ward with three ventilation systems, i.e. mixing, downward and displacement ventilation. Two life-size breathing thermal manikins were used to simulate a source patient and a receiving patient. The exhalation jet from a bed-lying manikin was visualized using smoke. N2O was used as tracer gas...... are well mixed in the ward. Bed distance does not affect the personal exposure of the receiving patient. For displacement ventilation, the exhaled jet can penetrate a long distance. A high concentration layer of exhaled droplet nuclei because of thermal stratification locking has also been observed...

  9. Advantages of a Web-Based Real-Time Bed-Management System for Hospital Admission Monitoring in Iran.

    Science.gov (United States)

    Abedian, Somayeh; Bitaraf, Ehsan; Askari, Marjan

    2018-01-01

    Lack of up-to-date information of hospitals beds, specifically in emergencies, is a significant problem in many large countries; The Ministry of Health and Medical Education of Iran (MOHME) designed and implemented a dynamic system that reports the status of beds in 2012. This system created great opportunities for national bed management, including real-time hospital admission monitoring, especially for emergency departments, ICUs and CCUs. Therefore, an additional online system was planned to be implemented for monitoring hospital admissions, including a national alert system. Prior to the design of this system, a study was done using literature study and expert opinion to investigate the advantages and features that this monitoring system was required to have. We used the MoSCoW method to prioritize the requirements of the system. This system was designed to have the following advantages, among other things: the hospitals as well as government should be able to track the patients, manage patient distribution in healthcare centers, and make policy for supplying extra beds. It should also be possible for the hospitals executive board, as well as the government, to monitor the performance of the hospitals regarding patient admissions (i.e., the rate of rejection of patients with severe conditions).

  10. A bacteriological study of hospital beds before and after disinfection with phenolic disinfectant

    Directory of Open Access Journals (Sweden)

    Andrade Denise de

    2000-01-01

    Full Text Available In hospitals, one of the ways to control microbial contamination is by disinfecting the furniture used by patients. This study's main objective was to evaluate the microbiological condition of hospital mattresses before and after such disinfection, in order to identify bacteria that are epidemiologically important in nosocomial infection, such as Staphylococcus aureus and Pseudomonas aeruginosa. RODAC plates with two different culture media were used to collect specimens. Patient beds were selected according to previously established criteria, and surface areas on the mattresses were chosen at random. From the total of 1 040 plate cultures from 52 mattresses, positive results were obtained from 500 of them (48.1%, 263 before disinfection and 237 after disinfection. Considering the selectivity of the culture media, the positivity rate was high. There were high prevalences of S. aureus both before and after mattress disinfection. The study results suggest that the usual disinfection procedures, instead of diminishing the number of microbes, merely displace them from one part of the mattress to another, and the number of microorganisms remains the same.

  11. A bacteriological study of hospital beds before and after disinfection with phenolic disinfectant

    Directory of Open Access Journals (Sweden)

    Denise de Andrade

    2000-03-01

    Full Text Available In hospitals, one of the ways to control microbial contamination is by disinfecting the furniture used by patients. This study's main objective was to evaluate the microbiological condition of hospital mattresses before and after such disinfection, in order to identify bacteria that are epidemiologically important in nosocomial infection, such as Staphylococcus aureus and Pseudomonas aeruginosa. RODAC plates with two different culture media were used to collect specimens. Patient beds were selected according to previously established criteria, and surface areas on the mattresses were chosen at random. From the total of 1 040 plate cultures from 52 mattresses, positive results were obtained from 500 of them (48.1%, 263 before disinfection and 237 after disinfection. Considering the selectivity of the culture media, the positivity rate was high. There were high prevalences of S. aureus both before and after mattress disinfection. The study results suggest that the usual disinfection procedures, instead of diminishing the number of microbes, merely displace them from one part of the mattress to another, and the number of microorganisms remains the same.

  12. Use of in-patient hospital beds by people living in residential care.

    Science.gov (United States)

    Finucane, P; Wundke, R; Whitehead, C; Williamson, L; Baggoley, C

    2000-01-01

    There is concern that people living in residential care in Australia make significant and often inappropriate use of acute in-patient hospital services. To date, no factual information has been collected in Australia and its absence may allow myths and negative stereotypes to proliferate. To determine how and why people living in residential care in Australia use in-patient hospital beds. To determine the outcome of hospitalisation and functional status at 3 months following discharge. Prospective study of 184 consecutive admissions to hospital following Emergency Department (ED) attendance involving people aged over 65 years and living in residential care in southern Adelaide, South Australia. Information was obtained from the facilities' transfer letters, and where these were inadequate or absent, telephone interviews were held with residential care staff. 153 people accounted for the 184 admissions. They had a mean age of 84 years and 69% were female. 61% came from hostels and 35% from nursing homes. They had a wide range of clinical problems and twice as many were admitted to medical than to surgical units. Their mean length of hospital stay was 7.9 days, 2.3 days higher than for non-same-day patients and was higher for hostel than for nursing home residents. All but two admissions were considered unavoidable though the provision of specialised care within residential care could have prevented a further 19 (10%) admissions. 96% of admissions resulted in survival to leave hospital and in 74%, people returned directly to their place of origin. At 3 months follow-up, a further 20% of the group had died while 5% were in hospital. In all, 14% of the original group were in a different long-term care facility while 56% were living at their former residence. People living in residential care are often hospitalised because of acute illness. In the vast majority of cases hospitalisation is both appropriate and unavoidable. Most did not require prolonged hospitalisation

  13. Design and development of an intelligent nursing bed - a pilot project of "joint assignment".

    Science.gov (United States)

    Jiehui Jiang; Tingwei Liu; Yuting Zhang; Yu Song; Mi Zhou; Xiaosong Zheng; Zhuangzhi Yan

    2017-07-01

    The "joint assignment" is a creative bachelor education project for Biomedical Engineering (BME) in Shanghai University (SHU), China. The objective of this project is to improve students' capabilities in design thinking and teamwork through practices in the process of the design and development of complex medical product. As the first step, a pilot project "design and development of intelligent nursing bed" was set up in May 2015. This paper describes details of how project organization and management, various teaching methods and scientific evaluation approaches were achieved in this pilot project. For example, a method containing one main line and four branches is taken to manage the project and "prototyping model" was used as the main research approach. As a result a multi-win situation was achieved. The results showed, firstly, 62 bachelor students including 16 BME students were well trained. They improved themselves in use of practical tools, communication skills and scientific writing; Secondly, commercial companies received a nice product design on intelligent nursing bed, and have been working on industrializing it; Thirdly, the university and associated schools obtained an excellent practical education experience to supplement traditional class education; Fourthly and most importantly, requirements from end-users will be met. The results also showed that the "joint assignment" task could become a significant component in BME bachelor education.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2017-09-15

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

  15. Cross Infection in Hospital Wards with Downward Ventilation - Different Locations of Return Openings without and with Partitions between Beds

    DEFF Research Database (Denmark)

    Nielsen, Peter V.; Li, Yuguo; Buus, Morten

    2009-01-01

    A two-bed hospital ward with one standing healthcare assistant and a ceiling-mounted low-impulse semicircular inlet diffuser is simulated in a full-scale room. Tracer gas is used for simulating gaseous contaminants, and the concentration is measured at different air change rates and different pos...

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

    Science.gov (United States)

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

    2015-06-01

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

  17. Using a Medical Intranet of Things System to Prevent Bed Falls in an Acute Care Hospital: A Pilot Study

    Science.gov (United States)

    Wise, Diana; Ng, Chun Yin; Tso, Han-Wen; Chiang, Wan-Lin; Hutchinson, Aimee M; Galvin, Tracy; Hilborne, Lee; Hoffman, Cathy; Huang, Chi-Cheng; Wang, C Jason

    2017-01-01

    Background Hospitalized patients in the United States experience falls at a rate of 2.6 to 17.1 per 1000 patient-days, with the majority occurring when a patient is moving to, from, and around the bed. Each fall with injury costs an average of US $14,000. Objective The aim was to conduct a technology evaluation, including feasibility, usability, and user experience, of a medical sensor-based Intranet of things (IoT) system in facilitating nursing response to bed exits in an acute care hospital. Methods Patients 18 years and older with a Morse fall score of 45 or greater were recruited from a 35-bed medical-surgical ward in a 317-bed Massachusetts teaching hospital. Eligible patients were recruited between August 4, 2015 and July 31, 2016. Participants received a sensor pad placed between the top of their mattress and bed sheet. The sensor pad was positioned to monitor movement from patients’ shoulders to their thighs. The SensableCare System was evaluated for monitoring patient movement and delivering timely alerts to nursing staff via mobile devices when there appeared to be a bed-exit attempt. Sensor pad data were collected automatically from the system. The primary outcomes included number of falls, time to turn off bed-exit alerts, and the number of attempted bed-exit events. Data on patient falls were collected by clinical research assistants and confirmed with the unit nurse manager. Explanatory variables included room locations (zones 1-3), day of the week, nursing shift, and Morse Fall Scale (ie, positive fall history, positive secondary diagnosis, positive ambulatory aid, weak impaired gait/transfer, positive IV/saline lock, mentally forgets limitations). We also assessed user experience via nurse focus groups. Qualitative data regarding staff interactions with the system were collected during two focus groups with 25 total nurses, each lasting approximately 1.5 hours. Results A total of 91 patients used the system for 234.0 patient-days and experienced

  18. Using Simulation to Model Improvements in Pediatric Bed Placement in an Acute Care Hospital.

    Science.gov (United States)

    Lambton, Judith; Roeder, Theresa; Saltzman, Robert; Param, Lila; Fernandes, Roxanne

    2017-02-01

    The objective of this project was to use an interdisciplinary approach to analyze strategies through simulation technology for improving patient flow in a pediatric hospital. Various statistics have been offered on the number of children admitted annually to hospitals. For administrators, particularly in smaller systems, the financial burden of equipping and staffing pediatric units often outweighs the moral desire to maintain a pediatric unit as a viable option for patients and pediatricians. Discrete event simulation was used to model current operations of a pediatric unit. Cost analysis was conducted using simulation reflecting various percentages of patients being referred to a discharge holding area (DHA) upon discharge and of the use of all private rooms. Both DHA and private rooms resulted in increased patient volumes. Administrators should consider the use of a DHA and/or private rooms to ease the census strains of pediatric units and the resultant revenue of this service.

  19. Peripherally Inserted Central Catheters (PICCs) and Potential Cost Savings and Shortened Bed Stays In an Acute Hospital Setting.

    LENUS (Irish Health Repository)

    O’Brien, C

    2018-01-01

    Peripheral inserted central catheters (PICCs) have increasingly become the mainstay of patients requiring prolonged treatment with antibiotics, transfusions, oncologic IV therapy and total parental nutrition. They may also be used in delivering a number of other medications to patients. In recent years, bed occupancy rates have become hugely pressurized in many hospitals and any potential solutions to free up beds is welcome. Recent introductions of doctor or nurse led intravenous (IV) outpatient based treatment teams has been having a direct effect on early discharge of patients and in some cases avoiding admission completely. The ability to deliver outpatient intravenous treatment is facilitated by the placement of PICCs allowing safe and targeted treatment of patients over a prolonged period of time. We carried out a retrospective study of 2,404 patients referred for PICCs from 2009 to 2015 in a university teaching hospital. There was an exponential increase in the number of PICCs requested from 2011 to 2015 with a 64% increase from 2012 to 2013. The clear increase in demand for PICCs in our institution is directly linked to the advent of outpatient intravenous antibiotic services. In this paper, we assess the impact that the use of PICCs combined with intravenous outpatient treatment may have on cost and hospital bed demand. We advocate that a more widespread implementation of this service throughout Ireland may result in significant cost savings as well as decreasing the number of patients on hospital trollies.

  20. Literature Review for Texas Department of Transportation Research Project 0-4695: Guidance for Design in Areas of Extreme Bed-Load Mobility, Edwards Plateau, Texas

    National Research Council Canada - National Science Library

    Heitmuller, Franklin T; Asquith, William H; Fang, Xing; Thompson, David B; Wang, Keh-Han

    2005-01-01

    A review of the literature addressing sediment transport in gravel-bed river systems and structures designed to control bed-load mobility is provided as part of Texas Department of Transportation research project 0-4695...

  1. In Situ Fringe Projection Profilometry for Laser Power Bed Fusion Process

    Science.gov (United States)

    Zhang, Bin

    Additive manufacturing (AM) offers an industrial solution to produce parts with complex geometries and internal structures that conventional manufacturing techniques cannot produce. However, current metal additive process, particularly the laser powder bed fusion (LPBF) process, suffers from poor surface finish and various material defects which hinder its wide applications. One way to solve this problem is by adding in situ metrology sensor onto the machine chamber. Matured manufacturing processes are tightly monitored and controlled, and instrumentation advances are needed to realize this same advantage for metal additive process. This encourages us to develop an in situ fringe projection system for the LPBF process. The development of such a system and the measurement capability are demonstrated in this dissertation. We show that this system can measure various powder bed signatures including powder layer variations, the average height drop between fused metal and unfused powder, and the height variations on the fused surfaces. The ability to measure textured surface is also evaluated through the instrument transfer function (ITF). We analyze the mathematical model of the proposed fringe projection system, and prove the linearity of the system through simulations. A practical ITF measurement technique using a stepped surface is also demonstrated. The measurement results are compared with theoretical predictions generated through the ITF simulations.

  2. HHARP: The Historical Hospital Admission Records Project – a review

    Directory of Open Access Journals (Sweden)

    Cara Hirst

    2018-04-01

    Full Text Available Hospital records have frequently been used in epidemiological research (Kilgore et al. 2017; Rushton 2016, and in some cases palaeopathological research. However, the availability of data is problematic, with written records requiring considerable time to interpret, digitise and analyse. In 2001, the Historical Hospital Records Project (HHARP began digitising over 140,000 hospital admission records from four hospitals in London and Glasgow, providing researchers with an online data base of hospital records (Figure 1. I review the data available in the HHARP database, as well as make a preliminary analysis of the hospital records from London and Glasgow between c.1852-1921 which illustrates the value of the HHARP database in understanding disease and medical care during this period.

  3. Identification of critical factors affecting flexibility in hospital construction projects.

    Science.gov (United States)

    Olsson, Nils E O; Hansen, Geir K

    2010-01-01

    This paper analyzes the dynamics relating to flexibility in a hospital project context. Three research questions are addressed: (1) When is flexibility used in the life cycle of a project? (2) What are the stakeholders' perspectives on project flexibility? And (3) What is the nature of the interaction between flexibility in the process of a project and flexibility in terms of the characteristics of a building? Flexibility is discussed from both a project management point of view and from a hospital architecture perspective. Flexibility in project life cycle and from a stakeholder perspective is examined, and the interaction between flexibility in scope lock-in and building flexibility is investigated. The results are based on case studies of four Norwegian hospital projects. Information relating to the projects has been obtained from evaluation reports, other relevant documents, and interviews. Observations were codified and analyzed based on selected parameters that represent different aspects of flexibility. One of the cases illustrates how late changes can have a significant negative impact on the project itself, contributing to delays and cost overruns. Another case illustrates that late scope lock-in on a limited part of the project, in this case related to medical equipment, can be done in a controlled manner. Project owners and users appear to have given flexibility high priority. Project management teams are less likely to embrace changes and late scope lock-in. Architects and consultants are important for translating program requirements into physical design. A highly flexible building did not stop some stakeholders from pushing for significant changes and extensions during construction.

  4. Performance analysis and pilot plant test results for the Komorany fluidized bed retrofit project

    Energy Technology Data Exchange (ETDEWEB)

    Snow, G.C. [POWER International, Inc., Coeur d`Alene, ID (United States)

    1995-12-01

    Detailed heat and mass balance calculations and emission performance projections are presented for an atmospheric fluidized bed boiler bottom retrofit at the 927 MWt (steam output) Komorany power station and district heating plant in the Czech Republic. Each of the ten existing boilers are traveling grate stoker units firing a local, low-rank brown coal. This fuel, considered to be representative of much of the coal deposits in Central Europe, is characterized by an average gross calorific value of 10.5 MJ/kg (4,530 Btu/lb), an average dry basis ash content of 47 %, and a maximum dry basis sulfur content of 1.8 % (3.4 % on a dry, ash free basis). The same fuel supply, together with limestone supplied from the region will be utilized in the retrofit fluidized bed boilers. The primary objectives of this retrofit program are, (1) reduce emissions to a level at or below the new Czech Clean Air Act, and (2) restore plant capacity to the original specification. As a result of the AFBC retrofit and plant upgrade, the particulate matter emissions will be reduced by over 98 percent, SO{sub 2} emissions will be reduced by 88 percent, and NO{sub x} emissions will be reduced by 38 percent compared to the present grate-fired configuration. The decrease in SO{sub 2} emissions resulting from the fluidized bed retrofit was initially predicted based on fuel sulfur content, including the distribution among organic, pyritic, and sulfate forms; the ash alkalinity; and the estimated limestone calcium utilization efficiency. The methodology and the results of this prediction were confirmed and extended by pilot scale combustion trials at a 1.0 MWt (fuel input), variable configuration test facility in France.

  5. Project reconversion Service Hospital Radiation Oncology Clinics-Medical School

    International Nuclear Information System (INIS)

    Quarneti, A.; Levaggi, G.

    2004-01-01

    Introduction: The Health Sector operates within the framework of Social Policy and it is therefore one of the ways of distribution of public benefit, like Housing, Education and Social Security. While public spending on health has grown in recent years, its distribution has been uneven and the sector faces funding and management problems. The Service Hospital Radiation Oncology has reduced its health care liavility , lack technological development and unsufficient human resources and training. Aim: developing an inclusive reform bill Service Hospital Radiation Oncology .Material and Methods: This project tends to form a network institutional, introducing concepts of evidence-based medicine, risk models, cost analysis, coding systems, system implementation of quality management (ISO-9000 Standards). Proposes redefining radiotherapy centers and their potential participation in training resource development goals humanos.Promueve scientific research of national interest. Separate strictly administrative function, management and teaching. The project takes into account the characteristics of demand, the need to order it and organize around her, institutional network system and within the Hospital das Clinicas own related services related to Service Hospital Radiation Oncology , Encourages freedom of choice, and confers greater equity in care. The project would managed by the Hospital Clínicas. Conclusions: We believe this proposal identifies problems and opportunities, Service Hospital Radiation Oncology proposes the development of institutional network under one management model

  6. Burden, duration and costs of hospital bed closures due to acute gastroenteritis in England per winter, 2010/11-2015/16.

    Science.gov (United States)

    Sandmann, F G; Jit, M; Robotham, J V; Deeny, S R

    2017-09-01

    Bed closures due to acute gastroenteritis put hospitals under pressure each winter. In England, the National Health Service (NHS) has monitored the winter situation for all acute trusts since 2010/11. To estimate the burden, duration and costs of hospital bed closures due to acute gastroenteritis in winter. A retrospective analysis of routinely collected time-series data of bed closures due to diarrhoea and vomiting was conducted for the winters 2010/11 to 2015/16. Two key issues were addressed by imputing non-randomly missing values at provider level, and filtering observations to a range of dates recorded in all six winters. The lowest and highest values imputed were taken to represent the best- and worst-case scenarios. Bed-days were costed using NHS reference costs, and potential staff absence costs were based on previous studies. In the best-to-worst case, a median of 88,000-113,000 beds were closed due to gastroenteritis each winter. Of these, 19.6-20.4% were unoccupied. On average, 80% of providers were affected, and had closed beds for a median of 15-21 days each winter. Hospital costs of closed beds were £5.7-£7.5 million, which increased to £6.9-£10.0 million when including staff absence costs due to illness. The median number of hospital beds closed due to acute gastroenteritis per winter was equivalent to all general and acute hospital beds in England being unavailable for a median of 0.88-1.12 days. Costs for hospitals are high but vary with closures each winter. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  7. Hospitality Occupational Skills Training Cooperative. Project HOST Final Report.

    Science.gov (United States)

    Northwest Educational Cooperative, Des Plaines, IL.

    Project HOST (Hospitality Occupational Skills Training) provided vocational training and employment opportunities in the hotel industry to disadvantaged adult minority populations in Chicago. It demonstrated a model for successful cooperation between the business sector and a public vocational education agency and developed and piloted a…

  8. Radiological incident preparedness for community hospitals: a demonstration project.

    Science.gov (United States)

    Jafari, Mary Ellen

    2010-08-01

    In November 2007, the Wisconsin Division of Public Health Hospital Disaster Preparedness Program State Expert Panel on Radiation Emergencies issued a report titled The Management of Patients in a Radiological Incident. Gundersen Lutheran Health System was selected to conduct a demonstration project to implement the recommendations in that report. A comprehensive radiological incident response plan was developed and implemented in the hospital's Trauma and Emergency Center, including the purchase and installation of radiation detection and identification equipment, staff education and training, a tabletop exercise, and three mock incident test exercises. The project demonstrated that the State Expert Panel report provides a flexible template that can be implemented at community hospitals using existing staff for an approximate cost of $25,000.

  9. Primary Hyperparathyroidism. Statistical Study about Patient to bed in Imam Khomeiny and Shariaty Hospitals (67-1376 Years)

    OpenAIRE

    Kafie N; Eshghyar N

    1998-01-01

    In this study we try to clear the prevalance of age and sex and clinical and radiographic"nmanifestations of primary hyperparathyroidism. In this duration 47 patients with primary"nhyperparathyroidism that bed in two important hospitals in Tehran were studied."nThe ratio between women to men was 7 to 1 and most prevalance of disease were in fouyth decade. The pain boon was the cheif complain of patients and osteopenia was the most radiographic findings."nIn addition a case...

  10. Spatio-temporal dependencies between hospital beds, physicians and health expenditure using visual variables and data classification in statistical table

    Science.gov (United States)

    Medyńska-Gulij, Beata; Cybulski, Paweł

    2016-06-01

    This paper analyses the use of table visual variables of statistical data of hospital beds as an important tool for revealing spatio-temporal dependencies. It is argued that some of conclusions from the data about public health and public expenditure on health have a spatio-temporal reference. Different from previous studies, this article adopts combination of cartographic pragmatics and spatial visualization with previous conclusions made in public health literature. While the significant conclusions about health care and economic factors has been highlighted in research papers, this article is the first to apply visual analysis to statistical table together with maps which is called previsualisation.

  11. Spatio-temporal dependencies between hospital beds, physicians and health expenditure using visual variables and data classification in statistical table

    Directory of Open Access Journals (Sweden)

    Medyńska-Gulij Beata

    2016-06-01

    Full Text Available This paper analyses the use of table visual variables of statistical data of hospital beds as an important tool for revealing spatio-temporal dependencies. It is argued that some of conclusions from the data about public health and public expenditure on health have a spatio-temporal reference. Different from previous studies, this article adopts combination of cartographic pragmatics and spatial visualization with previous conclusions made in public health literature. While the significant conclusions about health care and economic factors has been highlighted in research papers, this article is the first to apply visual analysis to statistical table together with maps which is called previsualisation.

  12. Using autoregressive integrated moving average (ARIMA) models to predict and monitor the number of beds occupied during a SARS outbreak in a tertiary hospital in Singapore.

    Science.gov (United States)

    Earnest, Arul; Chen, Mark I; Ng, Donald; Sin, Leo Yee

    2005-05-11

    The main objective of this study is to apply autoregressive integrated moving average (ARIMA) models to make real-time predictions on the number of beds occupied in Tan Tock Seng Hospital, during the recent SARS outbreak. This is a retrospective study design. Hospital admission and occupancy data for isolation beds was collected from Tan Tock Seng hospital for the period 14th March 2003 to 31st May 2003. The main outcome measure was daily number of isolation beds occupied by SARS patients. Among the covariates considered were daily number of people screened, daily number of people admitted (including observation, suspect and probable cases) and days from the most recent significant event discovery. We utilized the following strategy for the analysis. Firstly, we split the outbreak data into two. Data from 14th March to 21st April 2003 was used for model development. We used structural ARIMA models in an attempt to model the number of beds occupied. Estimation is via the maximum likelihood method using the Kalman filter. For the ARIMA model parameters, we considered the simplest parsimonious lowest order model. We found that the ARIMA (1,0,3) model was able to describe and predict the number of beds occupied during the SARS outbreak well. The mean absolute percentage error (MAPE) for the training set and validation set were 5.7% and 8.6% respectively, which we found was reasonable for use in the hospital setting. Furthermore, the model also provided three-day forecasts of the number of beds required. Total number of admissions and probable cases admitted on the previous day were also found to be independent prognostic factors of bed occupancy. ARIMA models provide useful tools for administrators and clinicians in planning for real-time bed capacity during an outbreak of an infectious disease such as SARS. The model could well be used in planning for bed-capacity during outbreaks of other infectious diseases as well.

  13. Implementation of an antimicrobial stewardship program on the medical-surgical service of a 100-bed community hospital

    Directory of Open Access Journals (Sweden)

    Storey Donald F

    2012-10-01

    Full Text Available Abstract Background Antimicrobial stewardship has been promoted as a key strategy for coping with the problems of antimicrobial resistance and Clostridium difficile. Despite the current call for stewardship in community hospitals, including smaller community hospitals, practical examples of stewardship programs are scarce in the reported literature. The purpose of the current report is to describe the implementation of an antimicrobial stewardship program on the medical-surgical service of a 100-bed community hospital employing a core strategy of post-prescriptive audit with intervention and feedback. Methods For one hour twice weekly, an infectious diseases physician and a clinical pharmacist audited medical records of inpatients receiving systemic antimicrobial therapy and made non-binding, written recommendations that were subsequently scored for implementation. Defined daily doses (DDDs; World Health Organization Center for Drug Statistics Methodology and acquisition costs per admission and per patient-day were calculated monthly for all administered antimicrobial agents. Results The antimicrobial stewardship team (AST made one or more recommendations for 313 of 367 audits during a 16-month intervention period (September 2009 – December 2010. Physicians implemented recommendation(s from each of 234 (75% audits, including from 85 of 115 for which discontinuation of all antimicrobial therapy was recommended. In comparison to an 8-month baseline period (January 2009 – August 2009, there was a 22% decrease in defined daily doses per 100 admissions (P = .006 and a 16% reduction per 1000 patient-days (P = .013. There was a 32% reduction in antimicrobial acquisition cost per admission (P = .013 and a 25% acquisition cost reduction per patient-day (P = .022. Conclusions An effective antimicrobial stewardship program was implemented with limited resources on the medical-surgical service of a 100-bed community hospital.

  14. The Artificial Gravity Bed Rest Pilot Project: Effects on Knee Extensor and Plantar Flexor Muscle Groups

    Science.gov (United States)

    Caiozzo, V. J.; Haddad, F.; Lee, S.; Baker, M.; Baldwin, K. M.

    2007-01-01

    The goal of this project was to examine the effects of artificial gravity (2.5 g) on skeletal muscle strength and key anabolic/catabolic markers known to regulate muscle mass. Two groups of subjects were selected for study: 1) a 21 day-bed rest (BR) control (C) group (N=7); and 2) an AG group (N=8), which was exposed to 21 days of bed-rest plus daily 1 hr exposures to AG (2.5 g). This particular experiment was part of an integrated AG Pilot Project sponsored by NASA/Johnson Space Center. The in vivo torque-velocity relationships of the knee extensors and plantar flexors of the ankle were determined pre and post treatment. Also, pre- and post treatment biopsy samples were obtained from both the vastus lateralis and soleus muscles and were used, in part, for a series of analyses on gene expression (mRNA abundance) of key factors implicated in the anabolic versus catabolic state of the muscle. Post/Pre toque-velocity determinations revealed greater decrements in knee extensor performance in the C versus AG group (P less than 0.04). The plantar flexor muscle group of the AG subjects actually demonstrated a net gain in torque-velocity relationship; whereas, in the C group the overall post/pre responses declined (AG vs C; P less than 0.001). Measurements of muscle fiber cross-sectional area (for both muscles) demonstrated a loss of approx. 20% in the C group while no losses were evident in the AG group. RT-PCR analyses of muscle biopsy specimens demonstrated that markers of growth and cytoskeletal integrity (IGF-1, IGF-1 BP4, mechano growth factor, total RNA, and pro-collagen 3a) were higher in the AG group, whereas catabolic markers (myostatin and atrogen) were elevated in the C group. Importantly, these patterns were seen in both muscles. Based on these observations we conclude that paradigms of AG have the potential to maintain the functional, biochemical, and structural homeostasis of skeletal muscle in the face of chronic unloading states. These findings also

  15. Promoting mobility and reducing length of stay in hospitalized general medicine patients: A quality-improvement project.

    Science.gov (United States)

    Hoyer, Erik H; Friedman, Michael; Lavezza, Annette; Wagner-Kosmakos, Kathleen; Lewis-Cherry, Robin; Skolnik, Judy L; Byers, Sherrie P; Atanelov, Levan; Colantuoni, Elizabeth; Brotman, Daniel J; Needham, Dale M

    2016-05-01

    To determine whether a multidisciplinary mobility promotion quality-improvement (QI) project would increase patient mobility and reduce hospital length of stay (LOS). Implemented using a structured QI model, the project took place between March 1, 2013 and March 1, 2014 on 2 general medicine units in a large academic medical center. There were 3352 patients admitted during the QI project period. The Johns Hopkins Highest Level of Mobility (JH-HLM) scale, an 8-point ordinal scale ranging from bed rest (score = 1) to ambulating ≥250 feet (score = 8), was used to quantify mobility. Changes in JH-HLM scores were compared for the first 4 months of the project (ramp-up phase) versus 4 months after project completion (post-QI phase) using generalized estimating equations. We compared the relative change in median LOS for the project months versus 12 months prior among the QI units, using multivariable linear regression analysis adjusting for 7 demographic and clinically relevant variables. Comparing the ramp-up versus post-QI phases, patients reaching JH-HLM's ambulation status increased from 43% to 70% (P mobility scores between admission and discharge increased from 32% to 45% (P 7 days), were associated with a significantly greater adjusted median reduction in LOS of 1.11 (95% CI: -1.53 to -0.65, P mobility was not associated with an increase in injurious falls compared to 12 months prior on the QI units (P = 0.73). Active prevention of a decline in physical function that commonly occurs during hospitalization may be achieved with a structured QI approach. In an adult medicine population, our QI project was associated with improved mobility, and this may have contributed to a reduction in LOS, particularly for more complex patients with longer expected hospital stay. Journal of Hospital Medicine 2016. © 2016 Society of Hospital Medicine. © 2016 Society of Hospital Medicine.

  16. Reasons for cancellation of operation on the day of intended surgery in a multidisciplinary 500 bedded hospital

    Directory of Open Access Journals (Sweden)

    Rajender Kumar

    2012-01-01

    Full Text Available Background: Cancellation of operations in hospitals is a significant problem with far reaching consequences. This study was planned to evaluate reasons for cancellation of elective surgical operation on the day of surgery in a 500 bedded Government hospital. Materials and Methods: The medical records of all the patients, from December 2009 to November 2010, who had their operations cancelled on the day of surgery in all surgical units of the hospital, were audited prospectively. The number of operation cancelled and reasons for cancellation were documented. Results: 7272 patients were scheduled for elective surgical procedures during study period; 1286 (17.6 % of these were cancelled on the day of surgery. The highest number of cancellation occurred in the discipline of general surgery (7.1% and the least (0.35% occurred in Ear-Nose-Throat surgery. The most common cause of cancellation was the lack of availability of theater time 809 (63% and patients not turning up 244 (19% patients. 149 cancellations (11.6% were because of medical reasons; 16 (1.2% were cancelled by the surgeon due to a change in the surgical plan; 28 (2.1% were cancelled as patients were not ready for surgery; and 40 (3.1% were cancelled due to equipment failure.]. Conclusion: Most causes of cancellations of operations are preventable.

  17. Management of HAPE with bed rest and supplemental oxygen in hospital setting at high altitude (11,500 ft): A review of 43 cases

    OpenAIRE

    Sanjay Singhal; Srinivasa A Bhattachar; Sumit Rungta

    2017-01-01

    Objectives: To evaluate the safety and efficacy of treating high-altitude pulmonary edema (HAPE) by bed rest and supplemental oxygen in hospital setting at high altitude. Materials and Methods: In a prospective case series, all patients who were diagnosed clinically with HAPE on admission to our hospital located at a height of 11,500 ft were evaluated and managed with bed rest and oxygen supplementation. Results: A total of 43 patients of HAPE with mean age of 31 years (range 20–48 years) wer...

  18. Final Environmental Impact Statement for the JEA Circulating Fluidized Bed Combustor Project

    Energy Technology Data Exchange (ETDEWEB)

    N/A

    2000-06-30

    This EIS assesses environmental issues associated with constructing and demonstrating a project that would be cost-shared by DOE and JEA (formerly the Jacksonville Electric Authority) under the Clean Coal Technology Program. The project would demonstrate circulating fluidized bed (CFB) combustion technology at JEA's existing Northside Generating Station in Jacksonville, Florida, about 9 miles northeast of the downtown area of Jacksonville. The new CFB combustor would use coal and petroleum coke to generate nearly 300 MW of electricity by repowering the existing Unit 2 steam turbine, a 297.5-MW unit that has been out of service since 1983. The proposed project is expected to demonstrate emission levels of sulfur dioxide (SO{sub 2}), oxides of nitrogen (NO{sub x}), and particulate matter that would be lower than Clean Air Act limits while at the same time producing power more efficiently and at less cost than conventional coal utilization technologies. At their own risk, JEA has begun initial construction activities without DOE funding. Construction would take approximately two years and, consistent with the original JEA schedule, would be completed in December 2001. Demonstration of the proposed project would be conducted during a 2-year period from March 2002 until March 2004. In addition, JEA plans to repower the currently operating Unit 1 steam turbine about 6 to 12 months after the Unit 2 repowering without cost-shared funding from DOE. Although the proposed project consists of only the Unit 2 repowering, this EIS analyzes the Unit 1 repowering as a related action. The EIS also considers three reasonably foreseeable scenarios that could result from the no-action alternative in which DOE would not provide cost-shared funding for the proposed project. The proposed action, in which DOE would provide cost-shared finding for the proposed project, is DOE's preferred alternative. The EIS evaluates the principal environmental issues, including air quality

  19. First results of the Test-Bed Telescopes (TBT) project: Cebreros telescope commissioning

    Science.gov (United States)

    Ocaña, Francisco; Ibarra, Aitor; Racero, Elena; Montero, Ángel; Doubek, Jirí; Ruiz, Vicente

    2016-07-01

    The TBT project is being developed under ESA's General Studies and Technology Programme (GSTP), and shall implement a test-bed for the validation of an autonomous optical observing system in a realistic scenario within the Space Situational Awareness (SSA) programme of the European Space Agency (ESA). The goal of the project is to provide two fully robotic telescopes, which will serve as prototypes for development of a future network. The system consists of two telescopes, one in Spain and the second one in the Southern Hemisphere. The telescope is a fast astrograph with a large Field of View (FoV) of 2.5 x 2.5 square-degrees and a plate scale of 2.2 arcsec/pixel. The tube is mounted on a fast direct-drive mount moving with speed up to 20 degrees per second. The focal plane hosts a 2-port 4K x 4K back-illuminated CCD with readout speeds up to 1MHz per port. All these characteristics ensure good survey performance for transients and fast moving objects. Detection software and hardware are optimised for the detection of NEOs and objects in high Earth orbits (objects moving from 0.1-40 arcsec/second). Nominal exposures are in the range from 2 to 30 seconds, depending on the observational strategy. Part of the validation scenario involves the scheduling concept integrated in the robotic operations for both sensors. Every night it takes all the input needed and prepares a schedule following predefined rules allocating tasks for the telescopes. Telescopes are managed by RTS2 control software, that performs the real-time scheduling of the observation and manages all the devices at the observatory.1 At the end of the night the observing systems report astrometric positions and photometry of the objects detected. The first telescope was installed in Cebreros Satellite Tracking Station in mid-2015. It is currently in the commissioning phase and we present here the first results of the telescope. We evaluate the site characteristics and the performance of the TBT Cebreros

  20. High-cost users of hospital beds in Western Australia: a population-based record linkage study.

    Science.gov (United States)

    Calver, Janine; Brameld, Kate J; Preen, David B; Alexia, Stoney J; Boldy, Duncan P; McCaul, Kieran A

    2006-04-17

    To describe how high-cost users of inpatient care in Western Australia differ from other users in age, health problems and resource use. Secondary analysis of hospital data and linked mortality data from the WA Data Linkage System for 2002, with cost data from the National Hospital Cost Data Collection (2001-02 financial year). Comparison of high-cost users and other users of inpatient care in terms of age, health profile (major diagnostic category) and resource use (annualised costs, separations and bed days). Older high-cost users (> or = 65 years) were not more expensive to treat than younger high-cost users (at the patient level), but were costlier as a group overall because of their disproportionate representation (n = 8466; 55.9%). Chronic stable and unstable conditions were a key feature of high-cost users, and included end stage renal disease, angina, depression and secondary malignant neoplasms. High-cost users accounted for 38% of both inpatient costs and inpatient days, and 26% of inpatient separations. Ageing of the population is associated with an increase in the proportion of high-cost users of inpatient care. High costs appear to be needs-driven. Constraining high-cost inpatient use requires more focus on preventing the onset and progression of chronic disease, and reducing surgical complications and injuries in vulnerable groups.

  1. Comparision between bed side testing of blood glucose by glucometer vs centralized testing in a tertiary care hospital.

    Science.gov (United States)

    Baig, Ayaz; Siddiqui, Imran; Jabbar, Abdul; Azam, Syed Iqbal; Sabir, Salman; Alam, Shahryar; Ghani, Farooq

    2007-01-01

    To determine the accuracy, turnaround time and cost effectiveness of bedside monitoring of blood glucose levels by non-laboratory health care workers and centralized testing of blood glucose by automated analyzer in a tertiary care hospital. The study was conducted in Section of Chemical Pathology, Department of Pathology and Microbiology and Section of Endocrinology Department of Medicine, Aga Khan University and Hospital Karachi, from April 2005 to March 2006. One hundred and ten patients were included in the study. The blood glucose levels were analyzed on glucometer (Precision Abbott) by finger stick, using Biosensor Technology. At the same time venous blood was obtained to analyze glucose in clinical laboratory on automated analyzer (SYNCHRON CX7) by glucose oxidase method. We observed good correlation between bed side glucometer and laboratory automated analyzer for glucose values between 3.3 mmol/L (60 mg/dl) and 16.7 (300 mg/dl). A significant difference was observed for glucose values less than 3.3 mmol/L (p = 0.002) and glucose values more than 16.67 mmol/l (p = 0.049). Mean Turnaround time for glucometer and automated analyzer were 0.08 hours and 2.49 hours respectively. The cost of glucose testing with glucometer was 48.8% lower than centralized lab based testing. Bedside glucometer testing, though less expensive does not have good accuracy in acutely ill patient with either very high or very low blood glucose levels.

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

    DEFF Research Database (Denmark)

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

    2012-01-01

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

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

    DEFF Research Database (Denmark)

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

    2013-01-01

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

  4. Management of HAPE with bed rest and supplemental oxygen in hospital setting at high altitude (11,500 ft: A review of 43 cases

    Directory of Open Access Journals (Sweden)

    Sanjay Singhal

    2017-01-01

    Full Text Available Objectives: To evaluate the safety and efficacy of treating high-altitude pulmonary edema (HAPE by bed rest and supplemental oxygen in hospital setting at high altitude. Materials and Methods: In a prospective case series, all patients who were diagnosed clinically with HAPE on admission to our hospital located at a height of 11,500 ft were evaluated and managed with bed rest and oxygen supplementation. Results: A total of 43 patients of HAPE with mean age of 31 years (range 20–48 years were admitted to our hospital. Infections followed by unaccustomed physical exertion were the predominant risk factors. 95.35% of the patients improved successfully with oxygen and bed rest alone with mean hospital stay of 2.67 ± 1.06 (1–6 days. Two patients (4.65% required nifedipine and evacuation to lower altitude. Of this, one patient suffering from concomitant viral infection expired 4 days after evacuation to near sea level. Conclusion: Majority of the patients with HAPE where medical facilities are available can be safely treated with bed rest and oxygen supplementation at moderate high altitude without descent.

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

    DEFF Research Database (Denmark)

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

    2010-01-01

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

  6. Assessment Approach for Identifying Compatibility of Restoration Projects with Geomorphic and Flooding Processes in Gravel Bed Rivers.

    Science.gov (United States)

    DeVries, Paul; Aldrich, Robert

    2015-08-01

    A critical requirement for a successful river restoration project in a dynamic gravel bed river is that it be compatible with natural hydraulic and sediment transport processes operating at the reach scale. The potential for failure is greater at locations where the influence of natural processes is inconsistent with intended project function and performance. We present an approach using practical GIS, hydrologic, hydraulic, and sediment transport analyses to identify locations where specific restoration project types have the greatest likelihood of working as intended because their function and design are matched with flooding and morphologic processes. The key premise is to identify whether a specific river analysis segment (length ~1-10 bankfull widths) within a longer reach is geomorphically active or inactive in the context of vertical and lateral stabilities, and hydrologically active for floodplain connectivity. Analyses involve empirical channel geometry relations, aerial photographic time series, LiDAR data, HEC-RAS hydraulic modeling, and a time-integrated sediment transport budget to evaluate trapping efficiency within each segment. The analysis segments are defined by HEC-RAS model cross sections. The results have been used effectively to identify feasible projects in a variety of alluvial gravel bed river reaches with lengths between 11 and 80 km and 2-year flood magnitudes between ~350 and 1330 m(3)/s. Projects constructed based on the results have all performed as planned. In addition, the results provide key criteria for formulating erosion and flood management plans.

  7. Assessment Approach for Identifying Compatibility of Restoration Projects with Geomorphic and Flooding Processes in Gravel Bed Rivers

    Science.gov (United States)

    DeVries, Paul; Aldrich, Robert

    2015-08-01

    A critical requirement for a successful river restoration project in a dynamic gravel bed river is that it be compatible with natural hydraulic and sediment transport processes operating at the reach scale. The potential for failure is greater at locations where the influence of natural processes is inconsistent with intended project function and performance. We present an approach using practical GIS, hydrologic, hydraulic, and sediment transport analyses to identify locations where specific restoration project types have the greatest likelihood of working as intended because their function and design are matched with flooding and morphologic processes. The key premise is to identify whether a specific river analysis segment (length ~1-10 bankfull widths) within a longer reach is geomorphically active or inactive in the context of vertical and lateral stabilities, and hydrologically active for floodplain connectivity. Analyses involve empirical channel geometry relations, aerial photographic time series, LiDAR data, HEC-RAS hydraulic modeling, and a time-integrated sediment transport budget to evaluate trapping efficiency within each segment. The analysis segments are defined by HEC-RAS model cross sections. The results have been used effectively to identify feasible projects in a variety of alluvial gravel bed river reaches with lengths between 11 and 80 km and 2-year flood magnitudes between ~350 and 1330 m3/s. Projects constructed based on the results have all performed as planned. In addition, the results provide key criteria for formulating erosion and flood management plans.

  8. Using autoregressive integrated moving average (ARIMA models to predict and monitor the number of beds occupied during a SARS outbreak in a tertiary hospital in Singapore

    Directory of Open Access Journals (Sweden)

    Earnest Arul

    2005-05-01

    Full Text Available Abstract Background The main objective of this study is to apply autoregressive integrated moving average (ARIMA models to make real-time predictions on the number of beds occupied in Tan Tock Seng Hospital, during the recent SARS outbreak. Methods This is a retrospective study design. Hospital admission and occupancy data for isolation beds was collected from Tan Tock Seng hospital for the period 14th March 2003 to 31st May 2003. The main outcome measure was daily number of isolation beds occupied by SARS patients. Among the covariates considered were daily number of people screened, daily number of people admitted (including observation, suspect and probable cases and days from the most recent significant event discovery. We utilized the following strategy for the analysis. Firstly, we split the outbreak data into two. Data from 14th March to 21st April 2003 was used for model development. We used structural ARIMA models in an attempt to model the number of beds occupied. Estimation is via the maximum likelihood method using the Kalman filter. For the ARIMA model parameters, we considered the simplest parsimonious lowest order model. Results We found that the ARIMA (1,0,3 model was able to describe and predict the number of beds occupied during the SARS outbreak well. The mean absolute percentage error (MAPE for the training set and validation set were 5.7% and 8.6% respectively, which we found was reasonable for use in the hospital setting. Furthermore, the model also provided three-day forecasts of the number of beds required. Total number of admissions and probable cases admitted on the previous day were also found to be independent prognostic factors of bed occupancy. Conclusion ARIMA models provide useful tools for administrators and clinicians in planning for real-time bed capacity during an outbreak of an infectious disease such as SARS. The model could well be used in planning for bed-capacity during outbreaks of other infectious

  9. Back to Bed: From Hospital to Home Obstetrics in the City of Chicago.

    Science.gov (United States)

    Kline, Wendy

    2018-01-01

    This article analyzes the role of doctors and activists in Chicago who successfully redefined the practice and politics of childbirth both locally and ultimately nationwide. It begins with the story of Joseph DeLee's Chicago Maternity Center, responsible for supervising over 100,000 home births between 1932 and 1972. Most of the mothers cared for by the Center were nonwhite, poor, and had little or no access to prenatal care, yet their babies had a far higher survival rate than the nationwide average. Thousands of medical students from all over the Midwest experienced their first deliveries not in hospitals, but in these homes. The article then addresses a very different demographic: a rising number of middle-class white families in the suburbs of Chicago who, beginning in the 1950s, opted for out-of-hospital births. Many of them learned about home birth through their involvement in La Leche League, the breastfeeding organization formed in a Chicago suburb in 1956. Seemingly separated by class, race, and locale, the link between these two groups of home birthers was the philosophy and training in place at the Chicago Maternity Center. © The Author 2017. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  10. Proper target depth of an accelerometer-based feedback device during CPR performed on a hospital bed: a randomized simulation study.

    Science.gov (United States)

    Lee, Sanghyun; Oh, Jaehoon; Kang, Hyunggoo; Lim, Taeho; Kim, Wonhee; Chee, Youngjoon; Song, Yeongtak; Ahn, Chiwon; Cho, Jun Hwi

    2015-10-01

    Feedback devices are used to improve chest compression (CC) quality related to survival rates in cardiac arrest. However, several studies have shown that feedback devices are not sufficiently reliable to ensure adequate CC depth on soft surfaces. Here, we determined the proper target depth of feedback (TDF) using an accelerometer during cardiopulmonary resuscitation in hospital beds. In prospective randomized crossover study, 19 emergency physicians performed CCs for 2 minutes continuously on a manikin in 2 different beds with 3 TDFs (5, 6, and 7 cm). We measured CC depth, the proportion of accurate compression depths, CC rate, the proportion of incomplete chest decompressions, the velocity of CC (CC velocity), the proportion of time spent in CC relative to compression plus decompression (duty cycle), and the time spent in CC (CC time). Mean (SD) CC depths at TDF 5, 6, and 7 were 45.42 (5.79), 52.68 (4.18), and 58.47 (2.48) on one bed and 46.26 (4.49), 53.58 (3.15), and 58.74 (2.10) mm on the other bed (all P.05). The duty cycle differed significantly on only B2. The target depth of the real-time feedback device should be at least 6 cm but should not exceed 7 cm for optimal CC on patients on hospital beds. Copyright © 2015 Elsevier Inc. All rights reserved.

  11. Industrial Scale Synthesis of Carbon Nanotubes Via Fluidized Bed Chemical Vapor Deposition: A Senior Design Project

    Science.gov (United States)

    Smith, York R.; Fuchs, Alan; Meyyappan, M.

    2010-01-01

    Senior year chemical engineering students designed a process to produce 10 000 tonnes per annum of single wall carbon nanotubes (SWNT) and also conducted bench-top experiments to synthesize SWNTs via fluidized bed chemical vapor deposition techniques. This was an excellent pedagogical experience because it related to the type of real world design…

  12. Intrinsic bacterial burden associated with intensive care unit hospital beds: effects of disinfection on population recovery and mitigation of potential infection risk.

    Science.gov (United States)

    Attaway, Hubert H; Fairey, Sarah; Steed, Lisa L; Salgado, Cassandra D; Michels, Harold T; Schmidt, Michael G

    2012-12-01

    Commonly touched items are likely reservoirs from which patients, health care workers, and visitors may encounter and transfer microbes. A quantitative assessment was conducted of the risk represented by the intrinsic bacterial burden associated with bed rails in a medical intensive care unit (MICU), and how disinfection might mitigate this risk. Bacteria present on the rails from 36 patient beds in the MICU were sampled immediately before cleaning and at 0.5, 2.5, 4.5, and 6.5 hours after cleaning. Beds were sanitized with either a bottled disinfectant (BD; CaviCide) or an automated bulk-diluted disinfectant (ABDD; Virex II 256). The majority of bacteria recovered from the bed rails in the MICU were staphylococci, but not methicillin-resistant Staphylococcus aureus. Vancomycin-resistant enterococci were recovered from 3 beds. Bottled disinfectant reduced the average bacterial burden on the rails by 99%. However, the burden rebounded to 30% of that found before disinfection by 6.5 hours after disinfection. ABDD reduced the burden by an average of 45%, but levels rebounded within 2.5 hours. The effectiveness of both disinfectants was reflected in median reductions to burden of 98% for BD and 95% for ABDD. Cleaning with hospital-approved disinfectants reduced the intrinsic bacterial burden on bed rail surfaces by up to 99%, although the population, principally staphylococci, rebounded quickly to predisinfection levels. Copyright © 2012 Association for Professionals in Infection Control and Epidemiology, Inc. All rights reserved.

  13. Using Information and Communication Technologies in Hospital Classrooms: SAVEH Project

    Directory of Open Access Journals (Sweden)

    Dolores Meneses

    2011-03-01

    Full Text Available Children suffering a serious illness, experience enormous changes in their daily lives. Not only does the direct consequences of the disease affect the child, but also the fact of being at a hospital, or at home and not being allowed to go to school. Frequently, connections with classmates, neighbors, and sometimes even some with his relatives are lost. Furthermore, the responsibility of the state, to continue his schooling process is much harder, since different communities (family, school teachers, hospital teachers, medical doctors, psychologists… have to be coordinated. Last but not least, entertainment and enjoyment should be provided to avoid boredom and to improve their affective state. At the same time, with the development of Information and Communication Technologies, a large number of solutions have arisen that allow people to enhance their communication, education and entertainment possibilities. These technologies seem perfectly suitable to be used to tackle the problems described above. In this article, some of the special necessities of children suffering from a serious illness are pointed out, technologies available to be facilitated are described and some initiatives taking place in Spain mentioned. The SAVEH project will be described in detail.

  14. Pervasive Computing Support for Hospitals: An Overview of the Activity-Based Computing Project

    DEFF Research Database (Denmark)

    Christensen, Henrik Bærbak; Bardram, Jakob E

    2007-01-01

    The activity-based computing project researched pervasive computing support for clinical hospital work. Such technologies have potential for supporting the mobile, collaborative, and disruptive use of heterogeneous embedded devices in a hospital......The activity-based computing project researched pervasive computing support for clinical hospital work. Such technologies have potential for supporting the mobile, collaborative, and disruptive use of heterogeneous embedded devices in a hospital...

  15. The effectiveness of bed bathing practices on skin integrity and hospital-acquired infections among adult patients

    DEFF Research Database (Denmark)

    Veje, Pia; Larsen, Palle

    2014-01-01

    is: What is the effectiveness of traditional towel bed bath practice compared to other innovate bed bath practices on maintaining skin integrity, skin barrier function and reduction of pathogen microbial counts on skin among adult patients in all settings? Inclusion criteria: Types of participants...... practices, including all bag bath interventions, not limited to any specific type or brand. For the purpose of this systematic review, bag bath interventions include bathing patients with pre-packaged disposal washcloths by use of a different cloth to wash each part of the patient's body. The washcloths...... typically comprise rayon/polyester cloth pre-moistened with an evaporating no-rinse cleanser and emollients. Comparator: The comparator is the traditional bed bath (towel bed bath) intervention, regardless of type and frequency. For the purposes of this systematic review, traditional bed bath refers...

  16. Effects of two hospital bed design features on physical demands and usability during brake engagement and patient transportation: a repeated measures experimental study.

    Science.gov (United States)

    Kim, Sunwook; Barker, Linsey M; Jia, Bochen; Agnew, Michael J; Nussbaum, Maury A

    2009-03-01

    Work-related musculoskeletal disorders (WMSDs) are prevalent among healthcare workers worldwide. While existing research has focused on patient-handling techniques during activities which require direct patient contact (e.g., patient transfer), nursing tasks also involve other patient-handling activities, such as engaging bed brakes and transporting patients in beds, which could render healthcare workers at risk of developing WMSDs. Effectiveness of hospital bed design features (brake pedal location and steering-assistance) was evaluated in terms of physical demands and usability during brake engagement and patient transportation tasks. Two laboratory-based studies were conducted. In simulated brake engagement tasks, three brake pedal locations (head-end vs. foot-end vs. side of a bed) and two hands conditions (hands-free vs. hands-occupied) were manipulated. Additionally, both in-room and corridor patient transportation tasks were simulated, in which activation of steering-assistance features (5th wheel and/or front wheel caster lock) and two patient masses were manipulated. Nine novice participants were recruited from the local student population and community for each study. During brake engagement, trunk flexion angle, task completion time, and questionnaires were used to quantify postural comfort and usability. For patient transportation, dependent measures were hand forces and questionnaire responses. Brake pedal locations and steering-assistance features in hospital beds had significant effects on physical demands and usability during brake engagement and patient transportation tasks. Specifically, a brake pedal at the head-end of a bed increased trunk flexion by 74-224% and completion time by 53-74%, compared to other pedal locations. Participants reported greater overall perceived difficulty and less postural comfort with the brake pedal at the head-end. During in-room transportation, participants generally reported "Neither Low nor High" physical demands

  17. Development of clinical pharmacy in Belgian hospitals through pilot projects funded by the government.

    Science.gov (United States)

    Somers, A; Spinewine, A; Spriet, I; Steurbaut, S; Tulkens, P; Hecq, J D; Willems, L; Robays, H; Dhoore, M; Yaras, H; Vanden Bremt, I; Haelterman, M

    2018-04-30

    Objectives The goal is to develop clinical pharmacy in the Belgian hospitals to improve drug efficacy and to reduce drug-related problems. Methods From 2007 to 2014, financial support was provided by the Belgian federal government for the development of clinical pharmacy in Belgian hospitals. This project was guided by a national Advisory Working Group. Each funded hospital was obliged to describe yearly its clinical pharmacy activities. Results In 2007, 20 pharmacists were funded in 28 pilot hospitals; this number was doubled in 2009 to 40 pharmacists over 54 institutions, representing more than half of all acute Belgian hospitals. Most projects (72%) considered patient-related activities, whereas some projects (28%) had a hospital-wide approach. The projects targeted patients at admission (30%), during hospital stay (52%) or at discharge (18%). During hospital stay, actions were mainly focused on geriatric patients (20%), surgical patients (15%), and oncology patients (9%). Experiences, methods, and tools were shared during meetings and workshops. Structure, process, and outcome indicators were reported and strengths, weaknesses, opportunities, and threats were described. The yearly reports revealed that the hospital board was engaged in the project in 87% of the cases, and developed a vision on clinical pharmacy in 75% of the hospitals. In 2014, the pilot phase was replaced by structural financing for clinical pharmacy in all acute Belgian hospitals. Conclusion The pilot projects in clinical pharmacy funded by the federal government provided a unique opportunity to launch clinical pharmacy activities on a broad scale in Belgium. The results of the pilot projects showed clear implementation through case reports, time registrations, and indicators. Tools for clinical pharmacy activities were developed to overcome identified barriers. The engagement of hospital boards and the results of clinical pharmacy activities persuaded the government to start structural

  18. Looking after Lawns and Bedding. Youth Training Scheme. Core Exemplar Work Based Project.

    Science.gov (United States)

    Further Education Staff Coll., Blagdon (England).

    This trainer's guide is intended to assist supervisors of work-based career training projects in teaching students about lawn care. The guide is one in a series of core curriculum modules that is intended for use in combination on- and off-the-job programs to familiarize youth with the skills, knowledge, and attitudes necessary for success in the…

  19. The rationale for sitting elderly patients in hospital out of bed for long periods is medically unsubstantiated and detrimental to their recovery.

    Science.gov (United States)

    Bliss, Mary Rose

    2004-01-01

    The notorious statement by Asher about the dangers of bed rest [Brit Med J 1947; ii: 967-8] which continues to be quoted out of context in leading medical journals today is inapplicable to modern short stay elderly hospital patients and has little medical foundation. 'Blood clotting in the veins' is more likely to result from venous stasis during sitting than from lying down. 'Lime draining from the bones' refers to subjects' spending weeks, not hours, in the horizontal position and similar losses have been shown to occur in healthy people immobilised in chairs for long periods during the day. Constipation is common in sick old people and there is no evidence that 'scybala stacking up the colon' is more likely to occur in bed than in a chair. The 'flesh rotting from the seat', or pressure sores, occur as frequently or more frequently, in sick patients nursed in chairs as in bed. 'Urine leaking from the distended bladder' may be reduced in very debilitated old people sitting in chairs, but at the expense of impaired renal function associated with reduced perfusion in the upright posture and exacerbated incontinence due to a compensatory diuresis at night. The 'spirit evaporating from the soul' today is more likely to afflict old patients who are exhausted by prolonged chair nursing and orthostatic hypotension due to age or illness. Recent studies in intensive care patients have highlighted the hypotension due to vasodilatation which can occur in infection and trauma. There is no evidence that nosocomial pneumonia is reduced by sitting patients out of bed, and lack of sleep is likely to exacerbate infection and delay recovery. Preventing patients from lying down when they feel the need is a violation of their rights and has been shown to be probably as injurious as the Victorian practice of preventing healthy patients from getting up. Physiotherapy is obviously important but patients should be allowed to decide for themselves how long they spend in or out of bed.

  20. Banho No Leito: o Discurso do Sujeito Coletivo de Pacientes Hospitalizados / Bath In Bed: the Collective Subject Discourse of Hospitalized Patients

    Directory of Open Access Journals (Sweden)

    Bruna Coelho Nepomuceno

    2014-03-01

    Full Text Available Objetivo: conhecer os significados e os sentimentos dos pacientes quanto ao fato de tomar banho no leito. Materiais e métodos: estudo de abordagem qualitativa e exploratória, tendo sido entrevistados 20 pacientes hospitalizados. Para a coleta de dados utilizou-se um roteiro de entrevista semiestruturada, gravada e transcrita na íntegra. Foi utilizado o método do Discurso do Sujeito Coletivo para análise dos dados. Resultados: para os pacientes hospitalizados, banho no leito significa “impossibilidade de locomover” e “seguro”. Os sentimentos dos pacientes hospitalizados variaram entre “vergonha” e “incapacidade”. Conclusão: os discursos encontrados podem cooperar para a melhoria da abordagem da equipe de enfermagem ao realizar um cuidado cotidiano e básico da vida diária. Objective: to identify the meanings and feelings of patients considering the action of to take a bath in bed. Materials and methods: qualitative and exploratory study, 20 patients hospitalized were interviewed. To collect data, we used semi-structured interviews, recorded and transcribed in full. We used the method of the Collective Subject Discourse for data analysis. Results: for hospitalized patients, bathing in bed means "inability to move" and "safe". The feelings of hospitalized patients ranged from "shame" and "disability." Conclusion: the discourses found can cooperate to improve the approach of the nursing staff by performing a basic daily care and daily life.

  1. CFD applications in the Pebble Bed Modular Reactor Project: A decade of progress

    International Nuclear Information System (INIS)

    Janse van Rensburg, J.J.; Kleingeld, M.

    2011-01-01

    Highlights: → This paper evaluates the evolution of Gas Cooled Reactor CFD analysis over the last decade. → It discusses the influence of advances in hardware and software on the evolution of capabilities. → The advances in mesh generation and the physics that can be included is also discussed. → The focus was on the capabilities rather than improving the assumptions and correlations. - Abstract: Of all the systems and components that have to be designed for a nuclear plant, the Reactor Unit is the most significant since it is at the very heart of the plant. At Pebble Bed Modular Reactor (Pty) Ltd. (PBMR), the design of the Reactor Unit is conducted with the aid of extensive analysis work. Due to the rapid computational improvements, the analysis capabilities have had to evolve rather significantly over the last decade. This paper evaluates the evolution of RU Computational Fluid Dynamics (CFD) analysis in particular and presents a historical timeline of the analyses conducted at PBMR. The influence of advances in the hardware and software applications on the evolution of the analysis capabilities is also discussed. When evaluating the evolution of analysis, it is important to look not only at the advances in mesh generation and the representation of the geometry, but also at the improvements regarding the physics that were included in the models. The discussion evaluates the improvements from the pre-conceptual analyses, the concept design, the basic design and finally, the detail design. It is however important to note that the focus of this research was on establishing a methodology for the integrated CFD analysis of High Temperature Reactors. It is recognized however that results from this research can currently only be used to investigate and understand trends and behaviors rather than absolute values. It was therefore required to also launch an extensive V and V program of which the focus was to verify the approach and validate the methodology that

  2. Projected lifetime risks and hospital care expenditure for traumatic injury.

    Science.gov (United States)

    Chang, David C; Anderson, Jamie E; Kobayashi, Leslie; Coimbra, Raul; Bickler, Stephen W

    2012-08-01

    The lifetime risk and expected cost of trauma care would be valuable for health policy planners, but this information is currently unavailable. The cumulative incidence rates methodology, based on a cross-sectional population analysis, offers an alternative approach to prohibitively costly prospective cohort studies. Retrospective analysis of the California Office of Statewide Health Planning and Development (OSHPD) database was performed for 2008. Trauma admissions were identified by ICD-9 primary diagnosis codes 800-959, with certain exclusions. Cumulative incidence rates were calculated as the cumulative summation of incidence risks sequentially across age groups. A total of 2.2 million admissions were identified, with mean age of 63.8 y, 49.6% men, 82.8% Whites, 5.7% Blacks, 11.3% Hispanics, and 3.1% Asians. The cumulative incidence rate for patients older than age 85 y was 1119 per 10,000 people, with the majority of risk in the elderly, compared with 24,325 per 10,000 people for all-cause hospitalizations. The rates were 946 for men, 1079 for women, 999 for non-Hispanic Whites, 568 for Blacks, 577 for Hispanics, and 395 for Asians, per 10,000 population. The cumulative expected hospital charge was $6538, compared with $81,257 for all-cause hospitalizations. The cumulative lifetime risk of trauma/injury requiring hospitalization for a person living to age 85 y in California is 11.2%, accounting for 4.6% of expected lifetime hospitalizations, but accounting for 8.0% of expected lifetime hospital expenditures. Risk of trauma is significant in the elderly. The total expenditure for all trauma hospitalizations in California was $7.62 billion in 2008. Copyright © 2012 Elsevier Inc. All rights reserved.

  3. The Hospital Building as Project and Matter of Concern

    DEFF Research Database (Denmark)

    Harty, Chris; Tryggestad, Kjell

    , and which can be explored or navigated using head-tracker technology and a joystick controller. The second is a physical mock up of a single room for a Danish hospital where actual medical procedures are simulated using real equipment and real people. Drawing on Latour’s concepts of matters of concern...

  4. Web Based Projects Enhancing English Language and Generic Skills Development for Asian Hospitality Industry Students

    Science.gov (United States)

    Wang, Mei-jung

    2009-01-01

    This study investigated hospitality students' responses toward their learning experiences from undertaking group projects based upon a College web platform, the "Ubiquitous Hospitality English Learning Platform" (U-HELP). Twenty-six students in the Department of Applied Foreign Languages participated in this study. Their attitudes toward…

  5. [Loyal frequent users of hospital emergency departments: the FIDUR project].

    Science.gov (United States)

    Fernández Alonso, Cesáreo; Romero Pareja, Rodolfo; Rivas García, Aristides; Jiménez Gallego, Rosa; Majo Carbajo, Yolanda; Aguilar Mulet, Juan Mariano

    2016-02-01

    To describe the characteristics of frequent users of hospital emergency departments and analyze whether characteristics varied in relation to how revisits were distributed over the course of the year studied. Retrospective study of patients over the age of 14 years who were treated in a hospital emergency department at least 10 times in 2013. Patients were identified in 17 public hospitals in the Spanish autonomous community of Madrid. Data related to the first and successive visits were gathered and analyzed by quarter year. We included 2340 patients with a mean (SD) age of 54 (21) years. A total of 1361 (58.%) were women, 1160 (50%) had no concomitant diseases, 1366 (58.2%) were substance abusers, and 25 (1.1%) were homeless. During the first visit, 2038 (87.1%) complained of a recent health problem, and 289 (12.4%) were admitted. Sixty (2.6%) patients concentrated their revisits in a single quarters 335 (14.3%) in 2 quarters, 914 (39.1%) in 3, and 1005 (42.9%) in 4. Patients whose revisits were distributed over more quarters were older (> 65 years), had more concomitant conditions, were on more medications (P women (P = .012) and more likely to have a specific diagnosis (P loyally comes to the same emergency department over the course of a year. Patients whose revisits are dispersed over a longer period have more complex problems and use more resources during their initial visit.

  6. Total quality management in a 300-bed community hospital: the quality improvement process translated to health care.

    Science.gov (United States)

    Hughes, J M

    1992-09-01

    Winter Park Memorial Hospital (Winter Park, Florida) began implementation of a well-strategized plan for total quality management (TQM) in 1987. Having no guidelines for applying TQM to health care but using the industrial quality management techniques of Philip Crosby Associates, Inc, the hospital made the transition and saved thousands of dollars in the process. This article describes the transition, especially the integral part played by the Medical Staff Quality Council in changing the hospital's culture.

  7. Bed Bugs

    Science.gov (United States)

    Prevent, identify, and treat bed bug infestations using EPA’s step-by-step guides, based on IPM principles. Find pesticides approved for bed bug control, check out the information clearinghouse, and dispel bed bug myths.

  8. [PACS: from project to reality. Report of experiences on full digitalisation of the radiology department of a major hospital].

    Science.gov (United States)

    Gross-Fengels, W; Miedeck, C; Siemens, P; Appel, R; Mückner, K; Finsterbusch, J; Bonas, H

    2002-02-01

    To assess the time needed and the resulting effects of a complete digitalisation of a radiological department of a major hospital (856 beds, 28,000 in-patients, 35,000 out-patients/year) a pilot study was performed. This had to be done without interrupting routine services. After intensive preparations were performed and the hospital-network was completed, within a two year period all radiological functions (mammography excluded), reporting stations and archives were changed to a complete digital workflow. All modalities (provided by 3 different companies) are now connected by DICOM-work lists. The picture-files (4 GB/day) are automatically routed to the work-stations (n = 10), where the reporting and file shows are performed, to the digital archive and to the peripheral viewing-stations (n = 44). The distribution of the digital pictures takes place all over the hospital including the ORs and special units. We accomplished, to connect electronically the report and the image data. The clinical file shows are also performed completely digitally. The access to the data of the deep archive is possible by the dept. of radiology without any manual interaction. The film consumption was reduced to an amount of less than 10%, as compared to the prior PACS situation. Since PACS has been introduced the radiological productivity increased by more than 15% and throughput-time was clearly reduced. The complete digitalisation increases productivity and attractiveness of a hospital-radiology and helps to shorten diagnostic and therapeutic decision-making. The transfer from a conventional to a digital workflow is possible without interrupting the clinical services. Extensive preparations and ongoing assistance of such projects though are clearly needed.

  9. Recovery Act Hospital Alteration Project at Naval Air Station Jacksonville

    Science.gov (United States)

    2010-12-07

    QMAD Quantitative Methods and Analysis Division RLF Rogers Lovelock & Fritz, Incorporated SE Southeast SF Square Feet SOW Statement of Work TMA TRICARE...Finally, the contractor, Rogers Lovelock & Fritz, Incorporated, reported the recipient information required by the Recovery Act. What We Recommend...contractor, Rogers Lovelock & Fritz, Incorporated (RLF), reported the recipient information required by the Recovery Act. Planning: Initially, Project

  10. An Empirical Study of Hospitality Management Student Attitudes toward Group Projects: Instructional Factors and Team Problems

    Science.gov (United States)

    Choi, Youngsoo; Ro, Heejung

    2012-01-01

    The development of positive attitudes in team-based work is important in management education. This study investigates hospitality students' attitudes toward group projects by examining instructional factors and team problems. Specifically, we examine how the students' perceptions of project appropriateness, instructors' support, and evaluation…

  11. Wind power integration in island-based smart grid projects : A comparative study between Jeju Smart Grid Test-bed and Smart Grid Gotland

    OpenAIRE

    Piehl, Hampus

    2014-01-01

    Smart grids seem to be the solution to use energy from renewable and intermittent energy sources in an efficient manner. There are many research projects around the world and two of them are Jeju Smart Grid Test-bed and Smart Grid Gotland. They have in common that they are both island-based projects and connected to the Powergrid on the mainland by HVDC-link. The purpose of this thesis is to compare the two projects and find out what challenges and strategies they have related to wind power i...

  12. Literature review for Texas Department of Transportation Research Project 0-4695: Guidance for design in areas of extreme bed-load mobility, Edwards Plateau, Texas

    Science.gov (United States)

    Heitmuller, Franklin T.; Asquith, William H.; Fang, Xing; Thompson, David B.; Wang, Keh-Han

    2005-01-01

    A review of the literature addressing sediment transport in gravel-bed river systems and structures designed to control bed-load mobility is provided as part of Texas Department of Transportation research project 0–4695: Guidance for Design in Areas of Extreme Bed-Load Mobility. The study area comprises the western half of the Edwards Plateau in central Texas. Three primary foci of the literature review are journal articles, edited volumes, and government publications. Major themes within the body of literature include deterministic sediment transport theory and equations, development of methods to measure and analyze fluvial sediment, applications and development of theory in natural channels and flume experiments, and recommendations for river management and structural design. The literature review provides an outline and foundation for the research project to characterize extreme bed-load mobility in rivers and streams across the study area. The literature review also provides a basis upon which potential modifications to low-water stream-crossing design in the study area can be made.

  13. Ubiquitous-severance hospital project: implementation and results.

    Science.gov (United States)

    Chang, Bung-Chul; Kim, Nam-Hyun; Kim, Young-A; Kim, Jee Hea; Jung, Hae Kyung; Kang, Eun Hae; Kang, Hee Suk; Lee, Hyung Il; Kim, Yong Ook; Yoo, Sun Kook; Sunwoo, Ilnam; An, Seo Yong; Jeong, Hye Jeong

    2010-03-01

    The purpose of this study was to review an implementation of u-Severance information system with focus on electronic hospital records (EHR) and to suggest future improvements. Clinical Data Repository (CDR) of u-Severance involved implementing electronic medical records (EMR) as the basis of EHR and the management of individual health records. EHR were implemented with service enhancements extending to the clinical decision support system (CDSS) and expanding the knowledge base for research with a repository for clinical data and medical care information. The EMR system of Yonsei University Health Systems (YUHS) consists of HP integrity superdome servers using MS SQL as a database management system and MS Windows as its operating system. YUHS is a high-performing medical institution with regards to efficient management and customer satisfaction; however, after 5 years of implementation of u-Severance system, several limitations with regards to expandability and security have been identified.

  14. Fluidised bed combustion system

    International Nuclear Information System (INIS)

    McKenzie, E.C.

    1976-01-01

    Fluidized bed combustion systems that facilitates the maintenance of the depth of the bed are described. A discharge pipe projects upwardly into the bed so that bed material can flow into its upper end and escape downwardly. The end of the pipe is surrounded by an enclosure and air is discharged into the enclosure so that material will enter the pipe from within the enclosure and have been cooled in the enclosure by the air discharged into it. The walls of the enclosure may themselves be cooled

  15. Bed-side inferior vena cava diameter and mean arterial pressure predict long-term mortality in hospitalized patients with heart failure: 36 months of follow-up.

    Science.gov (United States)

    Torres, Daniele; Cuttitta, Francesco; Paterna, Salvatore; Garofano, Alessandro; Conti, Giosafat; Pinto, Antonio; Parrinello, Gaspare

    2016-03-01

    In discharged patients with heart failure (HF), diverse conditions can intervene to worsen outcome. We would investigate whether such factors present on hospital admission can affect long-term mortality in subjects hospitalized for acute HF. One hundred twenty-three consecutive patients hospitalized for acute HF (mean age 74.8 years; 57% female) were recruited and followed for 36 months after hospitalization. At multivariate Cox model, only inferior vena cava (IVC) diameter and mean arterial pressure (MAP) registered bed-side on admission, resulted, after correction for all confounders factors, the sole factors significantly associated with a higher risk of all-cause mortality in long-term (HR 1.06, p=0.0057; HR 0.97, p=0.0218; respectively). Study population was subdivided according to median values of IVC diameter (23 mm) and MAP (93.3 mm Hg). The Kaplan–Meier curve showed that HF patients with both IVC ≥ 23 mm and MAP b93.3 mm Hg on admission had reduced probability of survival free from all-cause death (log rank p = 0.0070 and log rank p = 0.0028, respectively). In patients hospitalized for acute HF, IVC diameter, measured by hand-carried ultrasound (HCU), and MAP detected on admission are strong predictors of long-term all-cause mortality. The data suggest the need for a careful clinical-therapeutic surveillance on these patients during the post-discharge period. IVC diameter and MAP can be utilized as parameters to stratify prognosis on admission and to be supervised during follow-up. Copyright © 2015 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

  16. Relationship between healthcare worker surface contacts, care type and hand hygiene: an observational study in a single-bed hospital ward.

    Science.gov (United States)

    King, M-F; Noakes, C J; Sleigh, P A; Bale, S; Waters, L

    2016-09-01

    This study quantifies the relationship between hand hygiene and the frequency with which healthcare workers (HCWs) touch surfaces in patient rooms. Surface contacts and hand hygiene were recorded in a single-bed UK hospital ward for six care types. Surface contacts often formed non-random patterns, but hygiene before or after patient contact depends significantly on care type (P=0.001). The likelihood of hygiene correlated with the number of surface contacts (95% confidence interval 1.1-5.8, P=0.002), but not with time spent in the room. This highlights that a potential subconscious need for hand hygiene may have developed in HCWs, which may support and help focus future hygiene education programmes. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

  17. Educational intervention together with an on-line quality control program achieve recommended analytical goals for bedside blood glucose monitoring in a 1200-bed university hospital.

    Science.gov (United States)

    Sánchez-Margalet, Víctor; Rodriguez-Oliva, Manuel; Sánchez-Pozo, Cristina; Fernández-Gallardo, María Francisca; Goberna, Raimundo

    2005-01-01

    Portable meters for blood glucose concentrations are used at the patients bedside, as well as by patients for self-monitoring of blood glucose. Even though most devices have important technological advances that decrease operator error, the analytical goals proposed for the performance of glucose meters have been recently changed by the American Diabetes Association (ADA) to reach nurses in a 1200-bed University Hospital to achieve recommended analytical goals, so that we could improve the quality of diabetes care. We used portable glucose meters connected on-line to the laboratory after an educational program for nurses with responsibilities in point-of-care testing. We evaluated the system by assessing total error of the glucometers using high- and low-level glucose control solutions. In a period of 6 months, we collected data from 5642 control samples obtained by 14 devices (Precision PCx) directly from the control program (QC manager). The average total error for the low-level glucose control (2.77 mmol/l) was 6.3% (range 5.5-7.6%), and even lower for the high-level glucose control (16.66 mmol/l), at 4.8% (range 4.1-6.5%). In conclusion, the performance of glucose meters used in our University Hospital with more than 1000 beds not only improved after the intervention, but the meters achieved the analytical goals of the suggested ADA/National Academy of Clinical Biochemistry criteria for total error (<7.9% in the range 2.77-16.66 mmol/l glucose) and optimal total error for high glucose concentrations of <5%, which will improve the quality of care of our patients.

  18. The WAMI Rural Hospital Project. Part 3: Building health care leadership in rural communities.

    Science.gov (United States)

    Elder, W G; Amundson, B A

    1991-01-01

    The WAMI Rural Hospital Project (RHP) intervention combined aspects of community development, strategic planning and organizational development to address the leadership issues in six Northwest rural hospitals. Hospitals and physicians, other community health care providers and local townspeople were involved in this intervention, which was accomplished in three phases. In the first phase, extensive information about organizational effectiveness was collected at each site. Phase two consisted of 30 hours of education for the physician, board, and hospital administrator community representatives covering management, hospital board governance, and scope of service planning. In the third phase, each community worked with a facilitator to complete a strategic plan and to resolve conflicts addressed in the management analyses. The results of the evaluation demonstrated that the greatest change noted among RHP hospitals was improvement in the effectiveness of their governing boards. All boards adopted some or all of the project's model governance plan and had successfully completed considerable portions of their strategic plans by 1989. Teamwork among the management triad (hospital, board, and medical staff) was also substantially improved. Other improvements included the development of marketing plans for the three hospitals that did not initially have them and more effective use of outside consultants. The project had less impact on improving the functioning of the medical chief of staff, although this was not a primary target of the intervention. There was also relatively less community interest in joining regional health care associations. The authors conclude that an intervention program tailored to address specific community needs and clearly identified leadership deficiencies can have a positive effect on rural health care systems.

  19. The Healthy Skin Project: changing nursing practice to prevent and treat hospital-acquired pressure ulcers.

    Science.gov (United States)

    Armour-Burton, Teri; Fields, Willa; Outlaw, Lanie; Deleon, Elvira

    2013-06-01

    Hospital-acquired pressure ulcers are serious clinical complications that can lead to increased length of stay, pain, infection, and, potentially, death. The surgical progressive care unit at Sharp Grossmont Hospital, San Diego, California, developed the multidisciplinary Healthy Skin Project to decrease the prevalence of hospital-acquired pressure ulcers. The previous treatment plan was reviewed and modified according to current evidence-based practice. The project consisted of 3 components: creation of a position for a unit-based wound liaison nurse, staff education, and involvement of the nursing assistants. The wound liaison nurse developed and conducted bimonthly skin audits, which revealed inconsistencies in clinical practice and documentation. Education for the staff was accomplished via a self-learning module, case presentations, and 1-on-1 training. In addition, a pressure ulcer algorithm tool was developed to demonstrate step-by-step wound management and documentation. From Spring 2003 through Summer 2006, the prevalence of hospital-acquired pressure ulcers ranged from 0.0% to 18.92%, with a mean of 4.85%. After implementation of the project, the prevalence decreased to 0.0% for 17 of 20 quarters, through 2011. Prevention and a multidisciplinary approach are effective in reducing the occurrence of hospital-acquired pressure ulcers.

  20. Frederick National Lab Aids Liberian Hospitals Through Project C.U.R.E. | FNLCR Staging

    Science.gov (United States)

    When Project C.U.R.E.'s much-needed medical supplies and equipment arrive in Liberia, the Frederick National Lab’s Kathryn Kynvin is there to receive and distribute the donations to hospitals who continue to treat survivors of the most recent Ebola

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

    Directory of Open Access Journals (Sweden)

    Juan-Carlos Fraile

    2014-05-01

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

  2. Agency problems in hospitals participating in self-management project under global budget system in Taiwan.

    Science.gov (United States)

    Yan, Yu-Hua; Hsu, Shuofen; Yang, Chen-Wei; Fang, Shih-Chieh

    2010-02-01

    The main purposes of this study are to clarify the agency problems in the hospitals participating in self-management project within the context of Global Budgeting Payment System regulated by Taiwan government, and also to provide some suggestions for hospital administrator and health policy maker in reducing the waste of healthcare resources resulting from agency problems. For the purposes above, this study examines the relationships between two agency problems (ex ante moral hazard and ex post moral hazard) aroused among the hospitals and Bureau of National Health Insurance in Taiwan's health care sector. This study empirically tested the theoretical model at organization level. The findings suggest that the hospital's ex ante moral hazards before participating the self-management project do have some influence on its ex post moral hazards after participating the self-management project. This study concludes that the goal conflict between the agents and the principal certainly exist. The principal tries hard to control the expenditure escalation and keep the financial balance, but the agents have to subsist within limited healthcare resources. Therefore, the agency cost would definitely occur due to the conflicts between both parties. According to the results of the research, some suggestions and related management concepts were proposed at the end of the paper.

  3. Fiscal 1995 survey report on the environmentally friendly type coal utilization system introduction support project. Verification project on the circulating fluidized bed boiler; Kankyo chowagata sekitan riyo system donyu shien jigyo. Junkan ryudosho boiler ni kakawaru jissho jigyo

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1996-12-01

    In relation to the circulating fluidized bed boiler which reduces the amount of sulfur oxides emitted in coal utilization, a verification project was carried out on installation of the equipment and spread activity in China and the Philippines contributing to the control of environmental pollutant associated with coal utilization and the effective use of energy. At the Fanshan area, installed was a 10t/h internal circulating fluidized bed boiler. At the performance test, coal includes around 7% of impurities such as stone, and the impurities should be excluded continuously at the time of actual run. Therefore, the boiler efficiency had to be changed from 89.5% to 85.8%. Further, power generation facilities have not yet been finished, and the overall operation of boiler turbine has not been executed. At the Zibo area, a 30t/h external circulating fluidized bed boiler was installed. The boiler efficiency reached 86.1%, over the targeted value. At the Batangas area in the Philippines, a 10t/h internal circulating fluidized bed boiler was installed. The boiler efficiency reached 85.8%, over the designed value. About the coal produced in the Philippines, slagging was feared, but the combustion state was favorable. 82 figs., 21 tabs.

  4. Computer literacy enhancement in the Teaching Hospital Olomouc. Part I: project management techniques. Short communication.

    Science.gov (United States)

    Sedlár, Drahomír; Potomková, Jarmila; Rehorová, Jarmila; Seckár, Pavel; Sukopová, Vera

    2003-11-01

    Information explosion and globalization make great demands on keeping pace with the new trends in the healthcare sector. The contemporary level of computer and information literacy among most health care professionals in the Teaching Hospital Olomouc (Czech Republic) is not satisfactory for efficient exploitation of modern information technology in diagnostics, therapy and nursing. The present contribution describes the application of two basic problem solving techniques (brainstorming, SWOT analysis) to develop a project aimed at information literacy enhancement.

  5. Decision making and senior management: the implementation of change projects covering clinical management in SUS hospitals.

    Science.gov (United States)

    Pacheco, José Márcio da Cunha; Gomes, Romeu

    2016-08-01

    This paper analyses the decision making process for senior management in public hospitals that are a part of the National Health Service in Brazil (hereafter SUS) in relation to projects aimed at changing clinical management. The methodological design of this study is qualitative in nature taking a hermeneutics-dialectics perspective in terms of results. Hospital directors noted that clinical management projects changed the state of hospitals through: improving their organizations, mobilizing their staff in order to increase a sense of order and systemizing actions and available resources. Technical rationality was the principal basis used in the decision making process for managers. Due to the reality of many hospitals having fragmented organizations, this fact impeded the use of aspects related to rationality, such as economic and financial factors in the decision making process. The incremental model and general politics also play a role in this area. We concluded that the decision making process embraces a large array of factors including rational aspects such as the use of management techniques and the ability to analyze, interpret and summarize. It also incorporates subjective elements such as how to select values and dealing with people's working experiences. We recognized that management problems are wide in scope, ambiguous, complex and do not come with a lot of structure in practice.

  6. Peer-to-peer nursing rounds and hospital-acquired pressure ulcer prevalence in a surgical intensive care unit: a quality improvement project.

    Science.gov (United States)

    Kelleher, Alyson Dare; Moorer, Amanda; Makic, MaryBeth Flynn

    2012-01-01

    We conducted a quality improvement project in order to evaluate the effect of nurse-to-nurse bedside "rounding" as a strategy to decrease hospital-acquired pressure ulcers (HAPU) in a surgical intensive care unit. We instituted weekly peer-to-peer bedside skin rounds in a 17-bed surgical intensive care unit. Two nurses were identified as skin champions and trained by the hospital's certified WOC nurse to conduct skin rounds. The skin champion nurses conducted weekly peer-to-peer rounds that included discussions about key elements of our patients' skin status including current Braden Scale for Pressure Sore Risk score, and implementation of specific interventions related to subscale risk assessment. If a pressure ulcer was present, the current action plan was reevaluated for effectiveness. Quarterly HAPU prevalence studies were conducted from January 2008 to December 2010. Nineteen patients experienced a HAPU: 17 were located on the coccyx and 2 on the heel. Ten ulcers were classified as stage II, 3 PU were stage IV, 5 were deemed unstageable, and 1 was classified as a deep tissue injury. The frequency of preventive interventions rose during our quality improvement project. Specifically, the use of prevention surfaces increased 92%, repositioning increased 30%, nutrition interventions increased 77%, and moisture management increased 100%. Prior to focused nursing rounds, the highest HAPU prevalence rate was 27%. After implementing focused nursing rounds, HAPU rates trended down and were 0% for 3 consecutive quarters.

  7. Hospitals

    Data.gov (United States)

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

  8. Process Evaluation of a Quality Improvement Project to Decrease Hospital Readmissions From Skilled Nursing Facilities.

    Science.gov (United States)

    Meehan, Thomas P; Qazi, Daniel J; Van Hoof, Thomas J; Ho, Shih-Yieh; Eckenrode, Sheila; Spenard, Ann; Pandolfi, Michelle; Johnson, Florence; Quetti, Deborah

    2015-08-01

    To describe and evaluate the impact of quality improvement (QI) support provided to skilled nursing facilities (SNFs) by a Quality Improvement Organization (QIO). Retrospective, mixed-method, process evaluation of a QI project intended to decrease preventable hospital readmissions from SNFs. Five SNFs in Connecticut. SNF Administrators, Directors of Nursing, Assistant Directors of Nursing, Admissions Coordinators, Registered Nurses, Certified Nursing Assistants, Receptionists, QIO Quality Improvement Consultant. QIO staff provided training and technical assistance to SNF administrative and clinical staff to establish or enhance QI infrastructure and implement an established set of QI tools [Interventions to Reduce Acute Care Transfers (INTERACT) tools]. Baseline SNF demographic, staffing, and hospital readmission data; baseline and follow-up SNF QI structure (QI Committee), processes (general and use of INTERACT tools), and outcome (30-day all-cause hospital readmission rates); details of QIO-provided training and technical assistance; QIO-perceived barriers to quality improvement; SNF leadership-perceived barriers, accomplishments, and suggestions for improvement of QIO support. Success occurred in establishing QI Committees and targeting preventable hospital readmissions, as well as implementing INTERACT tools in all SNFs; however, hospital readmission rates decreased in only 2 facilities. QIO staff and SNF leaders noted the ongoing challenge of engaging already busy SNF staff and leadership in QI activities. SNF leaders reported that they appreciated the training and technical assistance that their institutions received, although most noted that additional support was needed to bring about improvement in readmission rates. This process evaluation documented mixed clinical results but successfully identified opportunities to improve recruitment of and provision of technical support to participating SNFs. Recommendations are offered for others who wish to conduct

  9. Downsizing of acute inpatient beds associated with private finance initiative: Scotland's case study

    Science.gov (United States)

    Dunnigan, Matthew G; Pollock, Allyson M

    2003-01-01

    Objectives To evaluate whether the projected 24% reduction in acute bed numbers in Lothian hospitals, which formed part of the private finance initiative (PFI) plans for the replacement Royal Infirmary of Edinburgh, is being compensated for by improvements in efficiency and greater use of community facilities, and to ascertain whether there is an independent PFI effect by comparing clinical activity and performance in acute specialties in Lothian hospitals with other NHS hospitals in Scotland. Design Comparison of projected and actual trends in acute bed capacity and inpatient and day case admissions in the first five years (1995-6 to 2000-1) of Lothian Health Board's integrated healthcare plan. Population study of trends in bed rate, hospital activity, length of stay, and throughput in Lothian hospitals compared with the rest of Scotland from 1990-1 to 2000-1. Main outcome measures Staffed bed rates, admission rates, mean lengths of stay, occupancy, and throughput in four adult acute specialty groups in 1990-1, 1995-6, and 2000-1. Results By 2000-1, rates for inpatient admission in all acute, medical, surgical, and intensive therapy specialties in Lothian hospitals were respectively 20%, 6%, 28%, and 38% below those in the rest of Scotland. Day case rates in all acute and acute surgical specialties were 13% and 33% lower. The proportion of delayed discharges in staffed acute and post-acute NHS beds in Lothian hospitals exceeded the Scottish average (15% and 12% respectively; Pfinance initiative (PFI) hospitals in England and Scotland projected reductions in acute beds of about 30% in the five years before the opening of the new replacement hospitalsThe new PFI Royal Infirmary of Edinburgh, which will fully open in 2003, is the cornerstone of Lothian Health Board's healthcare plan for its acute hospitalsWhat this study addsCompared with other Scottish NHS hospitals, service delivery has been reduced across Lothian associated with PFI developmentThe planning targets

  10. Intensidade de ruído em hospital de 222 leitos na 18ª Regional de Saúde - PR Noise level in a 222 bed hospital in the 18th health region - PR

    Directory of Open Access Journals (Sweden)

    Marcelo Henrique Otenio

    2007-04-01

    Full Text Available A poluição sonora ambiental torna-se hoje onipresente e beira o intolerável. Nos hospitais, os avanços tecnológicos trazem, como conseqüência, níveis de ruído potencialmente danosos. Muito do ruído no hospital provém mais de dentro, do que de fora desse ambiente, sendo as principais causas de ruído em Unidade de Terapia Intensiva, por exemplo, os equipamentos e a conversação entre a equipe hospitalar. O objetivo deste trabalho foi avaliar o nível de ruído nos diversos ambientes hospitalares, em Hospital de 222 leitos na 18ª RS de Saúde - PR. MATERIAIS E MÉTODOS: Conduziu-se, em março de 2005 no período de 24 horas, em dez setores. Forma de Estudo: Aferição do nível de ruído ambiental utilizando um Decibelímetro modelo 1350. RESULTADOS: O nível de ruído encontrado em nosso estudo apresentou média total de 63,7 dB(A, que excede os valores máximos permitidos de 45 dB recomendados pela Associação Brasileira de Normas Técnicas (1987. CONCLUSÃO: Nos setores analisados, o nível de ruído encontrado neste está consideravelmente acima do recomendado. A equipe hospitalar deve estar consciente do ruído e dos efeitos deste, para que possa atuar de maneira mais efetiva na redução da poluição sonora, beneficiando assim a função laborativa dos profissionais e recuperação dos pacientes.Environment noise pollution is common place today, at intolerable levels. In hospitals, technological developments have, as a consequence, potentially harmful noise levels. Much of the hospital noise comes from inside, rather than outside, and the major source of such noise is the Intensive Care Unit, for example equipment and hospital staff talk. Our goal with the present study was to investigate the noise level present in the different hospital environments, within a 222 bed hospital located at the 18th health zone, PR. MATERIALS AND METHODS: The study was carried out in March, 2005, during a period of 24 hours, in tem different

  11. [Predicting spread of new pandemic swine-origin influenza A (H1N1) in local mid-size city: evaluation of hospital bed shortage and effectiveness of vaccination].

    Science.gov (United States)

    Takeuchi, Shouhei; Kuroda, Yoshiki

    2010-01-01

    On April 24th, 2009, a new swine-origin influenza A (H1N1) was first reported in Mexico. Japan confirmed cases of the flu on May 9th, and the pandemic in Japan has become full-scale. The Ministry of Health, Labor and Welfare of Japan announced that the first peak of this pandemic was predicted to occur in October, 2009. Therefore, it is most important to predict the progress of this pandemic to be able to use medical resources effectively in Japan. We used a modified susceptible-exposed-infected-recovered (SEIR) model to calculate the number of infected people and hospital bed shortage during this pandemic. In this model, available medical resources were investigated on the basis of four vaccination scenarios. Our model showed that it would take a further six months for the pandemic to peak than was predicted by the Ministry of Health, Labor and Welfare of Japan. Without vaccination, at the peak of the pandemic 23,689 out of 400,000 people would be infected and the hospital bed shortage would reach 7,349 in total. We suggest that mathematical models are strong tools to predict the spread of infectious diseases. According to our model, it is possible to prevent hospital bed shortage by vaccination.

  12. Determination of risk identification process employed by NHS for a PFI hospital project in the UK

    Directory of Open Access Journals (Sweden)

    F. E. Mohamed Ghazali

    2009-12-01

    Full Text Available Long-term concession contracts associated with Private Finance Initiative (PFI projects, such as National Health Service (NHS hospitals, are subject to substantial risks, which may not only emerge from project activities such as design and construction, but also from global issues beyond the control of project parties, such as commercial, legal and political risks. Therefore, the principal parties involved must manage risks effectively and efficiently, as early as the project initiation stage, in order to ensure a successful delivery. The aim of this paper is to examine the risk identification process of the NHS PFI hospital in the UK, as a case study, in order to determine the techniques used in risk identification, and their significance, based on estimated probabilities of occurrence. These objectives were achieved through interviews with key personnel within the NHS Trust involved. Results found the sole technique used in risk identification to be brainstorming, through which more than thirty risks were identified and classified under six risk categories: planning, pre-commissioning, design, land purchasing, construction and operation. Thirteen risks were identified as significant based on their estimated probability of occurrence had the project been developed via public procurement. The results of this research will enable public sector clients like the NHS Trust to not only identify the significant risks, which will allow them to focus more attention on developing appropriate mitigation strategies and contingency plans, but also to improve its risk identification process through the use of other techniques in order to support findings from the brainstorming process.

  13. Comparison of the Wymark CO2 Reservoir with the Midale Beds at the Weyburn CO2 Injection Project

    International Nuclear Information System (INIS)

    Ryerson, F.; Johnson, J.

    2010-01-01

    The Devonian carbonates of the Duperow Formation on the western flank of the Williston Basin in southwest Saskatchewan contain natural accumulations of CO 2 , and may have done so for as long as 50 m.y. in the views of some investigations. These carbonate sediments are characterized by a succession of carbonate cycles capped by anhydrite-rich evaporites that are thought to act as seals to fluid migration. The Weyburn CO 2 injection site lies 400 km to the east in a series of Mississippian carbonates that were deposited in a similar depositional environment. That natural CO 2 can be stored long-term within carbonate strata has motivated the investigation of the Duperow rocks as a potential natural analogue to storage of anthropogenic CO 2 that may ultimately provide additional confidence for CO 2 sequestration in carbonate lithologies. For the Duperow strata to represent a legitimate analog for Midale injection and storage, the similarity in lithofacies, whole rock compositions, mineral compositions and porosity with the Midale Beds must be established. Previous workers have demonstrated the similarity of the lithofacies at both sites. Here we compare the whole rock compositions, mineralogy and mineral compositions. The major mineral phases at both locales are calcite, dolomite and anhydrite. In addition, accessory pyrite, fluorite and celestine are also observed. The distribution of porosity in the Midale Vuggy units is virtually identical to that of the Duperow Formation, but the Marly units of the Midale have significantly higher porosity. The Duperow Formation is topped by the Dinesmore evaporite that is particularly rich in anhydrite, and often contains authigenic K-feldspar. The chemistry of dolomite and calcite from the two localities also overlaps. Silicate minerals are in low abundance within the analyzed Duperow samples, < 3 wt% on a normative basis, with quartz the only phase identifiable in x-ray diffraction patterns. The Midale Beds contain

  14. Consensus on the leadership of hospital CEOs and its impact on the participation of physicians in improvement projects

    NARCIS (Netherlands)

    Dückers, Michel L.A.; Stegeman, Inge; Spreeuwenberg, Peter; Wagner, Cordula; Sanders, Karin; Groenewegen, Peter P.

    2009-01-01

    Objectives: The success of a Dutch program to disseminate quality improvement projects depends on the participation of physicians working in program hospitals. The leadership of hospital executives (CEOs) is considered an important explanation. This study aims to determine whether the relation,

  15. Consensus on the leadership of hospital CEOs and its impact on the participation of clinicians in improvement projects.

    NARCIS (Netherlands)

    Dückers, M.L.A.; Stegeman, I.; Spreeuwenberg, P.; Wagner, C.; Sanders, K.; Groenewegen, P.P.

    2009-01-01

    Objectives: The success of a Dutch program to disseminate quality improvement projects depends on the participation of physicians working in program hospitals. The leadership of hospital executives (CEOs) is considered an important explanation. This study aims to determine whether the relation,

  16. Consensus on the leadership of hospital CEOs and its impact on the participation of physicians in improvement projects

    NARCIS (Netherlands)

    Duckers, M.L.A.; Stegeman, I.; Spreeuwenberg, P.; Wagner, C.; Sanders, K.; Groenewegen, P.P.

    2009-01-01

    OBJECTIVES: The success of a Dutch program to disseminate quality improvement projects depends on the participation of physicians working in program hospitals. The leadership of hospital executives (CEOs) is considered an important explanation. This study aims to determine whether the relation,

  17. Consensus on the leadership of hospital CEO's and its impact on the participation of physicians in improvement projects

    NARCIS (Netherlands)

    Dückers, M.L.A.; Stegeman, I.; Spreeuwenberg, P.; Wagner, C.; Sanders, K.; Groenewegen, P.P.

    2009-01-01

    Objectives: The success of a Dutch program to disseminate quality improvement projects depends on the participation of physicians working in program hospitals. The leadership of hospital executives (CEOs) is considered an important explanation. This study aims to determine whether the relation,

  18. Condição microbiológica dos leitos hospitalares antes e depois de sua limpeza Microbiological condition of hospital beds before and after terminal cleaning

    Directory of Open Access Journals (Sweden)

    Denise de Andrade

    2000-04-01

    Full Text Available INTRODUÇÃO: O meio ambiente hospitalar guarda uma íntima relação com as infecções hospitalares, podendo proporcionar focos de contato e de transmissão. Como a higiene representa uma das formas de controlar a contaminação ambiental, realizou-se estudo para avaliar as condições microbiológicas dos colchões hospitalares antes e depois de sua limpeza. MÉTODOS: Utilizaram-se, para a colheita dos espécimes, placas de contato -- Rodac-plate ¾ preparadas com meio de cultura ágar-sangue. Selecionaram-se os leitos de acordo com critérios previamente estabelecidos, e os locais de colheita sob o colchão foram escolhidos por sorteio aleatório. Aplicou-se o teste estatístico de Goodman para o estudo das alterações numéricas quanto a positividade das placas. RESULTADOS: Foram investigados 52 colchões, totalizando 520 placas, das quais 514 (98,8% resultaram em culturas positivas, sendo que 259 corresponderam ao período anterior à limpeza e 255 ao período posterior ao procedimento. Houve redução de culturas positivas em apenas 4 placas. CONCLUSÕES: Os resultados obtidos sugerem que a limpeza, da forma como vem sendo conduzida, provoca o deslocamento da carga microbiana para outros pontos do colchão em vez de diminuí-la, resultando na manutenção da quantidade de microorganismos que existia anteriormente à limpeza.INTRODUCTION: The hospital's environment keeps a close relationship with hospital infection, which may promote focus of contact and transmission. The terminal cleaning of patient unit represents one way to control microbiological environmental contamination. The study has as its main objective to evaluate the microbiological conditions of hospital mattresses before and after cleaning. METHODS: Rodac plates were utilized for specimen collection with culture medium - blood agar plate. The patients beds were chosen by criteria established before hand and the places for specimen collection in the mattress were chosen by

  19. Challenges in the delivery of nutrition services to hospital discharged older adults: the community connections demonstration project.

    Science.gov (United States)

    Sahyoun, Nadine R; Akobundu, Ucheoma; Coray, Kevin; Netterville, Linda

    2009-04-01

    The objective of this project was to explore the effort necessary to transform the Older Americans Act Nutrition Program (OAANP) into core programs within an integrated health care delivery system that serves hospital-discharged older adults in order to assist them in reintegrating into the community. Six OAANPs in six states were funded and provided technical assistance to develop coalitions with hospitals and community organizations. Each demonstration site was unique and faced many challenges in reaching out to a hospitalized vulnerable population. This project also provided opportunities to try out new initiatives and examine their sustainability within the community.

  20. Hospitals

    DEFF Research Database (Denmark)

    Mullins, Michael

    2013-01-01

    The challenge could be briefly seen in these terms: hospitals as places for treatment where there’s a technology focus and hospitals for healing where there’s a human focus. In the 60s - 70s wave of new hospital building, an emphasis on technology can be seen. It’s time to move from the technology...... focus. It is not enough to consider only the factors of function within architecture, hygiene, economy and logistics. We also need to look at aspects of aesthetics, bringing nature into the building, art, color, acoustics, volume and space as we perceive them. Contemporary methods and advances...... placed, accessible, provided with plenty of greenery, and maximize sensory impressions, providing sounds, smells, sight and the possibility to be touched. This is a very well documented area I can say. Hygiene, in terms of architecture can give attention to hand wash facilities and their positioning...

  1. Influence to the financial situation of hospitals for projects financed from the EU structural funds

    Directory of Open Access Journals (Sweden)

    Aleksandra ŁĘGA

    2015-05-01

    Full Text Available The European Union gives many opportunities for development to member countries, including raising founds for its funds. This money could be sought in many sectors of the economy. One of them is health care. The goal of this study is to assess the impact of the financial situation of hospitals in the Kuyavian-Pomeranian for projects financed by the Structural Funds European Union (EU in programming period 2007-2013. The money from the European Regional Development Fund and European Social Fund provided an opportunity to introduce the latest technology and equipment in medical entities, as well as allowed skilled in the art. Of medicine to acquire knowledge and skills to develop their potential. The paper discusses issues related to the possibilities of support by EU funding to health care. Based on the data contained in the financial statements of an analysis of data from the balance sheet, characterized projects in hospitals as part of financing from the EU and the influence of the material in the therapeutic entities for their implementation through the analyses of correlation. The possibility of providing health services requires appropriate  regulations in law, system and organization. This is necessary in order to achieve the main goal of any entity that is take care of the welfare of the patient. Health and its protection is the highest value for the individual and for society, so Poland and the European Union is committed to the protection of the priority objective through enhanced organizational and legal actions and investments in the health sector.

  2. The Hospital Microbiome Project: Meeting Report for the 1st Hospital Microbiome Project Workshop on sampling design and building science measurements, Chicago, USA, June 7th-8th 2012.

    Science.gov (United States)

    Smith, Daniel; Alverdy, John; An, Gary; Coleman, Maureen; Garcia-Houchins, Sylvia; Green, Jessica; Keegan, Kevin; Kelley, Scott T; Kirkup, Benjamin C; Kociolek, Larry; Levin, Hal; Landon, Emily; Olsiewski, Paula; Knight, Rob; Siegel, Jeffrey; Weber, Stephen; Gilbert, Jack

    2013-04-15

    This report details the outcome of the 1st Hospital Microbiome Project workshop held on June 7th-8th, 2012 at the University of Chicago, USA. The workshop was arranged to determine the most appropriate sampling strategy and approach to building science measurement to characterize the development of a microbial community within a new hospital pavilion being built at the University of Chicago Medical Center. The workshop made several recommendations and led to the development of a full proposal to the Alfred P. Sloan Foundation as well as to the creation of the Hospital Microbiome Consortium.

  3. [Hospital variation in anastomotic leakage after rectal cancer surgery in the Spanish Association of Surgeons project: The contribution of hospital volume].

    Science.gov (United States)

    Ortiz, Héctor; Biondo, Sebastiano; Codina, Antonio; Ciga, Miguel Á; Enríquez-Navascués, José; Espín, Eloy; García-Granero, Eduardo; Roig, José Vicente

    2016-04-01

    This multicentre observational study aimed to determine the anastomotic leak rate in the hospitals included in the Rectal Cancer Project of the Spanish Society of Surgeons and examine whether hospital volume may contribute to any variation between hospitals. Hospital variation was quantified using a multilevel approach on prospective data derived from the multicentre database of all adenocarcinomas of the rectum operated by an anterior resection at 84 surgical departments from 2006 to 2013. The following variables were included in the analysis; demographics, American Society of Anaesthesiologists classification, use of defunctioning stoma, tumour location and stage, administration of neoadjuvant treatment, and annual volume of elective surgical procedures. A total of 7231 consecutive patients were included. The rate of anastomotic leak was 10.0%. Stratified by annual surgical volume hospitals varied from 9.9 to 11.3%. In multilevel regression analysis, the risk of anastomotic leak increased in male patients, in patients with tumours located below 12 cm from the anal verge, and advanced tumour stages. However, a defunctioning stoma seemed to prevent this complication. Hospital surgical volume was not associated with anastomotic leak (OR: 0.852, [0.487-1.518]; P=.577). Furthermore, there was a statistically significant variation in anastomotic leak between all departments (MOR: 1.475; [1.321-1.681]; P<0.001). Anastomotic leak varies significantly among hospitals included in the project and this difference cannot be attributed to the annual surgical volume. Copyright © 2015 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.

  4. K Basin Sludge Conditioning Process Testing Project. Results from Test 4, ''Acid Digestion of Mixed-Bed Ion Exchange Resin''

    International Nuclear Information System (INIS)

    Pool, K.H.; Delegard, C.H.; Schmidt, A.J.; Thornton, B.M.; Silvers, K.L.

    1998-06-01

    Approximately 73 m 3 of heterogeneous solid material, ''sludge,'' (upper bound estimate, Packer 1997) have accumulated at the bottom of the K Basins in the 100 K Area of the Hanford Site. This sludge is a mixture of spent fuel element corrosion products, ion exchange materials (organic and inorganic), graphite-based gasket materials, iron and aluminum metal corrosion products, sand, and debris (Makenas et al. 1996, 1997). In addition, small amounts of polychlorinated biphenyls (PCBs) have been found. Ultimately, it is planned to transfer the K Basins sludge to the Hanford double shell tanks (DSTs). The Hanford Spent Nuclear Fuel (HSNF) project has conducted a number of evaluations to examine technology and processing alternatives to pretreat K Basin sludge to meet storage and disposal requirements. From these evaluations, chemical pretreatment has been selected to address criticality issues, reactivity, and the destruction or removal of PCBs before the K Basin sludge can be transferred to the DSTs. Chemical pretreatment, referred to as the K Basin sludge conditioning process, includes nitric acid dissolution of the sludge (with removal of acid insoluble solids), neutrons absorber addition, neutralization, and reprecipitation. Laboratory testing is being conducted by the Pacific Northwest National Laboratory (PNNL) to provide data necessary to develop the sludge conditioning process

  5. Early data from project engage: a program to identify and transition medically hospitalized patients into addictions treatment

    OpenAIRE

    Pecoraro, Anna; Horton, Terry; Ewen, Edward; Becher, Julie; Wright, Patricia A; Silverman, Basha; McGraw, Patty; Woody, George E

    2012-01-01

    Background Patients with untreated substance use disorders (SUDs) are at risk for frequent emergency department visits and repeated hospitalizations. Project Engage, a US pilot program at Wilmington Hospital in Delaware, was conducted to facilitate entry of these patients to SUD treatment after discharge. Patients identified as having hazardous or harmful alcohol consumption based on results of the Alcohol Use Disorders Identification Test-Primary Care (AUDIT-PC), administered to all patients...

  6. Napping on the Night Shift: A Two-Hospital Implementation Project

    Science.gov (United States)

    Brown, Jeanne Geiger; Sagherian, Knar; Zhu, Shijun; Wieroniey, Margaret; Blair, Lori; Warren, Joan; Hinds, Pamela; Szeles, Rose

    2015-01-01

    Some nurses who work the night shift experience high levels of sleepiness. Napping has been adopted as an effective countermeasure to sleepiness and fatigue in other safety-sensitive industries but has not had widespread acceptance in nursing. In this two-hospital implementation project, napping was offered to six nursing units where nurse executives had previously approved nap implementation for the night shift as a pilot project. Successful implementation occurred in only one of the six units with partial success in a second unit. Barriers primarily occurred at the point of seeking unit-based nursing leadership approval. On the successful unit, one hundred fifty three 30-minutes naps were taken during the 3-month pilot period. A Nap Experience Survey measured sleepiness prior to the nap, the nap duration and perceived sleep, sleep inertia after the nap, and the perceived helpfulness of the nap. A high level of sleepiness was present at the beginning of 44% of naps. For over half of naps, nurses reported sleeping slightly (43%) or deeply (14%). Sleep inertia was rare (very groggy or sluggish on arising, 1.3%). The average score of helpfulness of napping was high (7.3 on a 1–10 scale). Nurses who napped reported being less drowsy while driving home after their shift. These data suggest that when barriers to napping are overcome, napping on the nightshift is feasible and can reduce sleepiness and drowsy driving in nurses. PMID:27082421

  7. Effects of salinity and particle concentration on sediment hydrodynamics and critical bed-shear-stress for erosion of fine grained sediments used in wetland restoration projects

    Science.gov (United States)

    Ghose-Hajra, M.; McCorquodale, A.; Mattson, G.; Jerolleman, D.; Filostrat, J.

    2015-03-01

    Sea-level rise, the increasing number and intensity of storms, oil and groundwater extraction, and coastal land subsidence are putting people and property at risk along Louisiana's coast, with major implications for human safety and economic health of coastal areas. A major goal towards re-establishing a healthy and sustainable coastal ecosystem has been to rebuild Louisiana's disappearing wetlands with fine grained sediments that are dredged or diverted from nearby rivers, channels and lakes to build land in open water areas. A thorough geo-hydrodynamic characterization of the deposited sediments is important in the correct design and a more realistic outcome assessment of the long-term performance measures for ongoing coastal restoration projects. This paper evaluates the effects of salinity and solid particle concentration on the re-suspension characteristics of fine-grained dredged sediments obtained from multiple geographic locations along the Gulf coast. The critical bed-shear-stress for erosion has been evaluated as a function of sedimentation time. The sediment hydrodynamic properties obtained from the laboratory testing were used in a numerical coastal sediment distribution model to aid in evaluating sediment diversions from the Mississippi River into Breton Sound and Barataria Bay.

  8. Effects of salinity and particle concentration on sediment hydrodynamics and critical bed-shear-stress for erosion of fine grained sediments used in wetland restoration projects

    Directory of Open Access Journals (Sweden)

    M. Ghose-Hajra

    2015-03-01

    Full Text Available Sea-level rise, the increasing number and intensity of storms, oil and groundwater extraction, and coastal land subsidence are putting people and property at risk along Louisiana’s coast, with major implications for human safety and economic health of coastal areas. A major goal towards re-establishing a healthy and sustainable coastal ecosystem has been to rebuild Louisiana’s disappearing wetlands with fine grained sediments that are dredged or diverted from nearby rivers, channels and lakes to build land in open water areas. A thorough geo-hydrodynamic characterization of the deposited sediments is important in the correct design and a more realistic outcome assessment of the long-term performance measures for ongoing coastal restoration projects. This paper evaluates the effects of salinity and solid particle concentration on the re-suspension characteristics of fine-grained dredged sediments obtained from multiple geographic locations along the Gulf coast. The critical bed-shear-stress for erosion has been evaluated as a function of sedimentation time. The sediment hydrodynamic properties obtained from the laboratory testing were used in a numerical coastal sediment distribution model to aid in evaluating sediment diversions from the Mississippi River into Breton Sound and Barataria Bay.

  9. Hospital variability in postoperative mortality after rectal cancer surgery in the Spanish Association of Surgeons project: The impact of hospital volume.

    Science.gov (United States)

    Ortiz, Héctor; Biondo, Sebastiano; Codina, Antonio; Ciga, Miguel Á; Enríquez-Navascués, José M; Espín, Eloy; García-Granero, Eduardo; Roig, José Vicente

    2016-01-01

    This multicentre observational study examines variation between hospitals in postoperative mortality after elective surgery in the Rectal Cancer Project of the Spanish Society of Surgeons and explores whether hospital volume and patient characteristics contribute to any variation between hospitals. Hospital variation was quantified using a multilevel approach on prospective data derived from the multicentre database of all rectal adenocarcinomas operated by an anterior resection or an abdominoperineal excision at 84 surgical departments from 2006 to 2013. The following variables were included in the analysis; demographics, American Society of Anaesthesiologists classification, tumour location and stage, administration of neoadjuvant treatment, and annual volume of surgical procedures. A total of 9809 consecutive patients were included. The rate of 30-day postoperative mortality was 1.8% Stratified by annual surgical volume hospitals varied from 1.4 to 2.0 in 30-day mortality. In the multilevel regression analysis, male gender (OR 1.623 [1.143; 2.348]; P<.008), increased age (OR: 5.811 [3.479; 10.087]; P<.001), and ASA score (OR 10.046 [3.390; 43.185]; P<.001) were associated with 30-day mortality. However, annual surgical volume was not associated with mortality (OR 1.309 [0.483; 4.238]; P=.619). Besides, there was a statistically significant variation in mortality between all departments (MOR 1.588 [1.293; 2.015]; P<.001). Postoperative mortality varies significantly among hospitals included in the project and this difference cannot be attributed to the annual surgical volume. Copyright © 2015 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.

  10. Continuous Improvement Implementation in the Nottingham University Hospitals NHS Trust: A Case Study of a Continuous Improvement Programme & Project

    OpenAIRE

    Velzen, Jeena

    2012-01-01

    This paper aims at identifying the extent to which the Nottingham University Hospitals NHS Trust has fulfilled literature requirements for successful continuous improvement as exemplified by its Better for You programme and chemotherapy service improvement project. Both the theory and ideals of the continuous improvement programme, along with the actualization of these philosophies and methodologies in the context of the particular project,were compared against a framework for the enabling...

  11. TOWARD A CONTINGENCY MODEL FOR HOSPITAL-BASED HEALTH TECHNOLOGY ASSESSMENT: EVIDENCE FROM ADHOPHTA PROJECT.

    Science.gov (United States)

    Cicchetti, Americo; Iacopino, Valentina; Coretti, Silvia; Fiore, Alessandra; Marchetti, Marco; Sampietro-Colom, Laura; Kidholm, Kristian; Wasserfallen, Jean-Blaise; Kahveci, Rabia; Halmesmäki, Esa; Rosenmöller, Magdalene; Wild, Claudia; Kivet, Raul-Allan

    2018-01-01

    Hospital-based health technology assessment (HB-HTA) is becoming increasingly relevant because of its role in managing the introduction and withdrawal of health technologies. The organizational arrangement in which HB-HTA activities are conducted depends on several contextual factors, although the dominant models have several similarities. The aims of this study were to explore, describe, interpret, and explain seven cases of the application of HB-HTA logic and to propose a classification for HB-HTA organizational models which may be beneficial for policy makers and HTA professionals. The study was part of the AdHopHTA Project, granted under the European 7th Framework Research Programme. A case study methodology was applied to analyze seven HB-HTA initiatives in seven countries, with collection of qualitative and quantitative data. Cross-case analysis was performed within the framework of contingent organizational theory. Evidence showed that some organizational or "structural" variables, namely the level of procedure formalization/structuration and the level of integration with other HTA bodies at the national, regional, and provincial levels, predominantly shape the HB-HTA approach, determining a contingency model of HB-HTA. Crossing the two variables, four options have emerged: integrated specialized HTA unit, stand-alone HTA unit, integrated-essential HTA, independent group unit. No one-best-way approach can be used for HTA at the hospital level. Rather, the characteristics of HTA models depend on many contextual factors. Such conceptualization may aid the diffusion of HB-HTA to inform managerial decision making and clinical practice.

  12. HAD 2020 Project: A proposal to consolidate hospital-based home care in Spain

    Directory of Open Access Journals (Sweden)

    Oriol Estrada Cuxart

    2017-04-01

    Full Text Available Hospital at home (HAH appeared in Spain 36 years ago with the opening of several units. The initial push was truncated by the lack of political leadership and sometimes clinical as well. The current reality offers an irregular implementation with a wide disparity of assistance and resource models. The Sociedad Española de Hospitalización a Domicilio (SEHAD has not played either the expected scientific or professional leadership roles. The “Plan HAD2020: key of the future” was designed as revulsive. This is an ambitious 4-year project to consolidate HAH as a care modality. Its deployment consists of five phases. Preparation: the foundations of the strategic plan (EP were established. Situation analysis: a national survey was carried out on the 106 operational units (data 2014. Validation of the EP: contributions and proposals of action of the members of SEHAD. National Congress 2016: presentation and approval of EP conclusions and proposals. EP deployment phase: it will be extended until 2020 and will be executed by various teams of referents spread over five lines of work. The final objective set for the year 2020 is: to come up with a more homogenous care model; to promote the training and professional recognition of those who work in the HAD; that each hospital in Spain has a HAH unit; recognition and empowerment by the national health system. HAD2020 has marked an inflection point in the SEHAD. The traced path and the effort of all the HAH professionals will allow reaching the vision which the pioneers of the HAH in Spain pursued.

  13. Hospital cultural competency as a systematic organizational intervention: Key findings from the national center for healthcare leadership diversity demonstration project.

    Science.gov (United States)

    Weech-Maldonado, Robert; Dreachslin, Janice L; Epané, Josué Patien; Gail, Judith; Gupta, Shivani; Wainio, Joyce Anne

    Cultural competency or the ongoing capacity of health care systems to provide for high-quality care to diverse patient populations (National Quality Forum, 2008) has been proposed as an organizational strategy to address disparities in quality of care, patient experience, and workforce representation. But far too many health care organizations still do not treat cultural competency as a business imperative and driver of strategy. The aim of the study was to examine the impact of a systematic, multifaceted, and organizational level cultural competency initiative on hospital performance metrics at the organizational and individual levels. This demonstration project employs a pre-post control group design. Two hospital systems participated in the study. Within each system, two hospitals were selected to serve as the intervention and control hospitals. Executive leadership (C-suite) and all staff at one general medical/surgical nursing unit at the intervention hospitals experienced a systematic, planned cultural competency intervention. Assessments and interventions focused on three organizational level competencies of cultural competency (diversity leadership, strategic human resource management, and patient cultural competency) and three individual level competencies (diversity attitudes, implicit bias, and racial/ethnic identity status). In addition, we evaluated the impact of the intervention on diversity climate and workforce diversity. Overall performance improvement was greater in each of the two intervention hospitals than in the control hospital within the same health care system. Both intervention hospitals experienced improvements in the organizational level competencies of diversity leadership and strategic human resource management. Similarly, improvements were observed in the individual level competencies for diversity attitudes and implicit bias for Blacks among the intervention hospitals. Furthermore, intervention hospitals outperformed their respective

  14. Model of rough bed for numerical simulation of saltation

    Czech Academy of Sciences Publication Activity Database

    Kharlamova, Irina; Vlasák, Pavel

    2015-01-01

    Roč. 19, č. 3 (2015), s. 366-385 ISSN 1964-8189 R&D Projects: GA ČR GA103/09/1718; GA ČR GAP105/10/1574 Institutional support: RVO:67985874 Keywords : saltation * bed load transport * rough bed * armoured bed * bed roughness Subject RIV: BK - Fluid Dynamics Impact factor: 0.636, year: 2015

  15. Frederick National Lab Aids Liberian Hospitals Through Project C.U.R.E. | Frederick National Laboratory for Cancer Research

    Science.gov (United States)

    When Project C.U.R.E.'s much-needed medical supplies and equipment arrive in Liberia, the Frederick National Lab’s Kathryn Kynvin is there to receive and distribute the donations to hospitals who continue to treat survivors of the most recent Ebola

  16. IBRD sonar scour monitoring project : real-time river channel-bed monitoring at the Chariton and Mississippi Rivers in Missouri, 2007-09, final report, January 2010.

    Science.gov (United States)

    2010-01-01

    Scour and depositional responses to hydrologic events have been important to the scientific community studying sediment transport as well as potential effects on bridges and other hydraulic structures within riverine systems. A river channel-bed moni...

  17. Targeted individual exercise programmes for older medical patients are feasible, and may change hospital and patient outcomes: a service improvement project

    Directory of Open Access Journals (Sweden)

    Thomas Susie

    2008-12-01

    Full Text Available Abstract Background The aim of this project was primarily to assess the feasibility of individual exercise programs for older hospitalised patients at risk of functional decline, and secondarily to evaluate impact on discharge outcomes. Methods Design: Cohort service improvement project Setting: 500 bed acute metropolitan hospital Subjects: Patients aged 70 and older admitted to Flinders Medical Centre under the general medical, aged care and respiratory units from June to November 2006, at intermediate or high risk of functional decline, and able to commence exercise within 48 hours of admission Intervention: Functional Maintenance Program (FMP; an individually tailored exercise program to maintain functional mobility, prescribed and progressed by a physiotherapist, and supervised by an Allied Health Assistant (AHA, provided in addition to usual physiotherapy care Outcome measures: Feasibility (number of admissions suitable, commencing and complying with FMP. Impact (length of hospital stay (LOS, Aged Care Assessment Team (ACAT referrals and approvals, hospital readmissions within 28 days, and functional mobility (Elderly Mobility Scale Data Analysis: Descriptive and logistic regression analysis Results Of 1021 admissions of patients aged 70 or older to general medical, aged care and respiratory units, 22% (n = 220 were identified within 48 hours as suitable for FMP: 196 (89% commenced FMP within 48 hours of admission (FMP patients; 24 (11% received usual physiotherapy (usual care patients. Feasibility of individually tailored exercise programs for older medical patients was supported by high uptake (89%, low withdrawal (17% shown by those who commenced FMP, and good compliance with exercise sessions (70%. Logistic regression analysis showed a statistically significant decreased likelihood of referral for nursing home admission (OR = 0.228, 95% CI 0.088–0.587 and decreased likelihood of approval for admission to residential care (OR = 0

  18. Hotel architecture from the perspective of sustainability and space hospitality : a study on the application of the concepts of sustainability and hospitality space in hotel projects

    Directory of Open Access Journals (Sweden)

    Josildete Pereira Oliveira

    2016-03-01

    Full Text Available This present study aims to discuss the concept of both sustainability and hospitality into the context of city contemporary architecture which, in a certain way had been reinterpreted or asked in what is concerned to the concept of environmental sustainability. In this sense, the main goal of the research was to analyze two hotel projects in Santa Catarina, Brazil, been one of them configured as a small sized one and the other as a big hotel, where all the mentioned conditions had been manifested in a tight way and even had not been systematized into one of the hotel architecture samples, as a reference of sustainable and hospitable architecture. The methodology characterized by an initial bibliographic study, as well as documentary study, followed by a field research characterized by an intensive direct observation, as well as a group and systematic one, also considered both observation and questionnaires application (Marconi & Lakatos, 2006 and it tried to rescue the history of hotel architecture in order to identify environmental sustainability contents, as well as hospitality ones, concerned to the constructed spaces, so that it would be possible, in a following moment, to analyze the hotel samples selected, which do manifest all the mentioned conditions. It was realized that considering its realities and sizes, both studied hotels do count with actions and elements that may be considered sustainable, as well as friendly environmental actions, what, doubtless, do provide hospitality in a certain way. Similarly, both hotels still have potentialities to be developed.

  19. Consensus on the leadership of hospital CEOs and its impact on the participation of physicians in improvement projects.

    Science.gov (United States)

    Dückers, Michel L A; Stegeman, Inge; Spreeuwenberg, Peter; Wagner, Cordula; Sanders, Karin; Groenewegen, Peter P

    2009-08-01

    The success of a Dutch program to disseminate quality improvement projects depends on the participation of physicians working in program hospitals. The leadership of hospital executives (CEOs) is considered an important explanation. This study aims to determine whether the relation, between the extent to which physicians notice their CEOs stimulate improvement initiatives and the number of projects joined by physicians, is moderated by the consensus among physicians working in the same hospital. Multilevel analyses are applied on data of 286 physicians from eight hospitals to: (1) estimate whether participation depends on noticing if CEOs stimulate improvement, (2) test if an individual's participation differs when more colleagues have the same opinion (effect modification). Significant moderator effects are found. The participation of physicians, noticing that CEOs stimulate improvement is higher when more colleagues share this opinion. For physicians not knowing whether improvement is encouraged, higher consensus coincides with lower participation. Project involvement of physicians depends on their consensus about encouragement by CEOs. This confirms the importance of strategic leaders in dissemination programs. Further research is recommended into causes of CEO leadership visibility and methods to strengthen leadership climate.

  20. The definition, selection and implementation of a new Clinical Information System to prepare the hospital for the electronic future : an example of project-based education

    NARCIS (Netherlands)

    Spil, Antonius A.M.; van de Meeberg, Henk J.; Sikkel, Nicolaas

    The software supplier of a large hospital has been taken over. The hospital gets notice that the central hospital information system (HIS) will no longer be maintained, starting next year. This problem, not uncommon in business today, is used as a real-life case in a project-based course for first

  1. Plan to Have No Unplanned: A Collaborative, Hospital-Based Quality-Improvement Project to Reduce the Rate of Unplanned Extubations in the Pediatric ICU.

    Science.gov (United States)

    Tripathi, Sandeep; Nunez, Denise J; Katyal, Chaavi; Ushay, H Michael

    2015-08-01

    Although under-reported and understudied, unplanned extubations carry a significant risk of patient harm and even death. They are an important yardstick of quality control of care of intubated patients in the ICU. A unit-based risk assessment and multidisciplinary approach is required to decrease the incidence of unplanned extubations. As part of a quality-improvement initiative of Children's Hospital at Montefiore, all planned and unplanned extubations in a multidisciplinary 20-bed pediatric ICU were evaluated over a 12-month period (January to December 2010). At the end of 6 months, an interim analysis was performed, and high-risk patient groups and patient care factors were identified. These factors were targeted in the second phase of the project. Over this period, there were a total of 267 extubations, of which 231 (87%) were planned extubations and 36 (13%) were unplanned. A patient care policy targeting the risk factors was instituted, along with extensive nursing and other personnel education in the second phase. As a result of this intervention, the unplanned extubation rate in the pediatric ICU decreased from 3.55 to 2.59/100 intubation days. All subjects who had an unplanned extubation during nursing procedures or transport required re-intubation, whereas none of the unplanned extubations during ventilator weaning required re-intubation. A targeted approach based on unit-specific risk factors is most effective in quality-improvement projects. A specific policy for sedation and weaning can be very helpful in managing intubated patients and preventing unintended harm. Copyright © 2015 by Daedalus Enterprises.

  2. Smart use of data, information and communication: the INFORM-ed Best Local Practice Project--Grafton Base Hospital.

    Science.gov (United States)

    Lloyd, Sheree; Collie, Jean; McInnes, Alastair; King, Kevin; Lollback, Alison; Garland, Angie

    This paper describes current progress for an information management project in a medium-sized rural hospital after the first four months of the one-year project. In particular, the article examines some of the project outcomes to date as these relate to the National Hospitals and Health Reform recommendations for the smart use of data, information and communication. The paper identifies a number of important challenges and issues that have been addressed by the project and proposes that the project findings may be used to inform similar projects in other settings. These findings relate to clinician requirements for reports, investment in human resources, development, and time for information management activities. An understanding of data collected, information systems, and presentation of clinician data are also important. The benefits of information sharing in assisting quality improvement activities are particularly relevant but, more importantly, they can engage and involve clinicians in the use of information. The importance of local data, information, and knowledge is described. Finally, issues for the health information management profession, such as working collegially and sharing knowledge and expertise, are outlined.

  3. FY 1975 Report on results of Sunshine Project. Development of techniques of digging high-temperature beds (Conceptual designs of automatic digging systems); 1975 nendo koon chiso kussaku gijutsu no kaihatsu seika hokokusho. Jido kussaku system no gainen sekkei

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1976-03-31

    This project is aimed at development of automatic rotary table type digging apparatus capable of digging high-temperature beds of 3,000 to 5,000 m in depth, 400 degrees C and 500 kg/cm{sup 2}. The automatic excavation apparatus is designed based on the concept that the driller is separated from the running drawworks side for other works. However, it is operated manually in a traditional manner, when the bed for which it is to be used is under complex conditions, or when the bed properties require frequent changes in digging conditions with respect to bit load and speed of rotation. The apparatus works, when the bed is considered to be under essentially constant conditions at a fairly high depth, in such a way that a combination of bit load and speed of rotation is set by the driller, and the work line wound on the drawworks drum is let out to keep the bit load constant. It is equipped with, e.g., a controller, converter and brake operating device, detecting suspension load by the controller, when it increases, increasing speed of air motor after comparing the load with the reference level, and relaxing the brake, to keep the suspension load at the set level. When the suspension load decreases, on the other hand, the air motor is decelerated to tighten the brake. (NEDO)

  4. CE: Original Research: Napping on the Night Shift: A Two-Hospital Implementation Project.

    Science.gov (United States)

    Geiger-Brown, Jeanne; Sagherian, Knar; Zhu, Shijun; Wieroniey, Margaret Ann; Blair, Lori; Warren, Joan; Hinds, Pamela S; Szeles, Rose

    2016-05-01

    : Nurses who work the night shift often experience high levels of sleepiness. Napping has been adopted as an effective countermeasure to sleepiness and fatigue in other safety-sensitive industries, but has not had widespread acceptance in nursing. To assess the barriers to successful implementation of night-shift naps and to describe the nap experiences of night-shift nurses who took naps. In this two-hospital pilot implementation project, napping on the night shift was offered to six nursing units for which the executive nursing leadership had given approval. Unit nurse managers' approval was sought, and where granted, further explanation was given to the unit's staff nurses. A nap experience form, which included the Karolinska Sleepiness Scale, was used to assess pre-nap sleepiness level, nap duration and perceived sleep experience, post-nap sleep inertia, and the perceived helpfulness of the nap. Nurse managers and staff nurses were also interviewed at the end of the three-month study period. Successful implementation occurred on only one of the six units, with partial success seen on a second unit. Barriers primarily occurred at the point of seeking the unit nurse managers' approval. On the successful unit, 153 30-minutes naps were taken during the study period. A high level of sleepiness was present at the beginning of 44% of the naps. For more than half the naps, nurses reported achieving either light (43%) or deep (14%) sleep. Sleep inertia was rare. The average score of helpfulness of napping was high (7.3 on a 1-to-10 scale). Nurses who napped reported being less drowsy while driving home after their shift. These data suggest that when barriers to napping are overcome, napping on the night shift is feasible and can reduce nurses' workplace sleepiness and drowsy driving on the way home. Addressing nurse managers' perceptions of and concerns about napping may be essential to successful implementation.

  5. Hospital staffing and hospital costs.

    Science.gov (United States)

    Andrew, R R

    1976-08-07

    A comparative study of costs per bed per day in teaching hospitals affiliated with Monash University compared with large non-teaching metropolitan hospitals (1964 to 1974) shows they are much higher in teaching hospitals. There is no evidence that this is due to the additional costs arising from the clinical schools. Research in the teaching hospitals and the accompanying high professional standards and demands on services are major factors accounting for the difference. Over the decade studied, the resident staff have increased by 77% and other salaried staff by 24%. The index of expenditure for the three teaching hospitals in the decade has increased by 386%.

  6. Coal Bed Methane Primer

    Energy Technology Data Exchange (ETDEWEB)

    Dan Arthur; Bruce Langhus; Jon Seekins

    2005-05-25

    During the second half of the 1990's Coal Bed Methane (CBM) production increased dramatically nationwide to represent a significant new source of income and natural gas for many independent and established producers. Matching these soaring production rates during this period was a heightened public awareness of environmental concerns. These concerns left unexplained and under-addressed have created a significant growth in public involvement generating literally thousands of unfocused project comments for various regional NEPA efforts resulting in the delayed development of public and fee lands. The accelerating interest in CBM development coupled to the growth in public involvement has prompted the conceptualization of this project for the development of a CBM Primer. The Primer is designed to serve as a summary document, which introduces and encapsulates information pertinent to the development of Coal Bed Methane (CBM), including focused discussions of coal deposits, methane as a natural formed gas, split mineral estates, development techniques, operational issues, producing methods, applicable regulatory frameworks, land and resource management, mitigation measures, preparation of project plans, data availability, Indian Trust issues and relevant environmental technologies. An important aspect of gaining access to federal, state, tribal, or fee lands involves education of a broad array of stakeholders, including land and mineral owners, regulators, conservationists, tribal governments, special interest groups, and numerous others that could be impacted by the development of coal bed methane. Perhaps the most crucial aspect of successfully developing CBM resources is stakeholder education. Currently, an inconsistent picture of CBM exists. There is a significant lack of understanding on the parts of nearly all stakeholders, including industry, government, special interest groups, and land owners. It is envisioned the Primer would being used by a variety of

  7. Hospital Job Skills Enhancement Program: A Workplace Literacy Project. Final Evaluation Report.

    Science.gov (United States)

    Nurss, Joanne R.

    A workplace literacy program was designed to improve the literacy skills of entry-level workers in the housekeeping, food service, and laundry departments of Grady Memorial Hospital in Atlanta. Classes were held twice per week for 36 weeks at the hospital on job time. Literacy was defined as reading, writing, oral communication, and problem…

  8. Project Octo-Pills - A practice model engaging community pharmacists in the care of patients from a tertiary hospital.

    Science.gov (United States)

    Ong, Kheng Yong; Chung, Wing Lam; Mamun, Kaysar; Chen, Li Li

    2017-10-13

    Even while pharmacy practice evolves to a more patient-centric mode of practice, local hospitals, due to high patient load as well as space and resource constraints, find it challenging to conduct thorough medication review and physical medication reconciliation for all patients. In light of this, optimizing the local current healthcare system to involve community pharmacists in the care of patients from public hospitals could potentially better cater to the healthcare needs of the older population. Due to easy accessibility, community pharmacies are often the first point of contact in the healthcare system. Project Octo-Pills aims to engage community pharmacists in the collaborative care of patients from a tertiary hospital, providing patients with quality medication reconciliation and review services from a more convenient location within their neighborhood. This paper describes the model for this pilot initiative. Copyright © 2017 Elsevier Inc. All rights reserved.

  9. Problematic of the implantation of quality control in the radiodiagnostic service of a hospital with more than 5000 beds with a urgency service

    International Nuclear Information System (INIS)

    Castell, A.; Lizuain, M.C.; Cinos, C.; Linero, D.

    1992-01-01

    The quality control of the x-ray equipment is not normal in the Hospitals. This technique has very difficulties. In this report we show the methodology in order to implant the quality control in radiodiagnostic service : data acquisition and format of communication

  10. A Clinical Nurse Specialist-Led Interprofessional Quality Improvement Project to Reduce Hospital-Acquired Pressure Ulcers.

    Science.gov (United States)

    Fabbruzzo-Cota, Christina; Frecea, Monica; Kozell, Kathryn; Pere, Katalin; Thompson, Tamara; Tjan Thomas, Julie; Wong, Angela

    2016-01-01

    The purpose of this clinical nurse specialist-led interprofessional quality improvement project was to reduce hospital-acquired pressure ulcers (HAPUs) using evidence-based practice. Hospital-acquired pressure ulcers (PUs) have been linked to morbidity, poor quality of life, and increasing costs. Pressure ulcer prevention and management remain a challenge for interprofessional teams in acute care settings. Hospital-acquired PU rate is a critical nursing quality indicator for healthcare organizations and ties directly with Mount Sinai Hospital's (MSH's) mission and vision, which mandates providing the highest quality care to patients and families. This quality improvement project, guided by the Donabedian model, was based on the Registered Nurses' Association of Ontario Best Practice Guideline Risk Assessment & Prevention of Pressure Ulcers. A working group was established to promote evidence-based practice for PU prevention. Initiatives such as documentation standardization, development of staff education and patient and family educational resources, initiation of a hospital-wide inventory for support surfaces, and procurement of equipment were implemented to improve PU prevention and management across the organization. An 80% decrease in HAPUs has been achieved since the implementation of best practices by the Best Practice Guideline Pressure Ulcer working group. The implementation of PU prevention strategies led to a reduction in HAPU rates. The working group will continue to work on building interprofessional awareness and collaboration in order to prevent HAPUs and promote an organizational culture that supports staff development, teamwork and communication. This quality improvement project is a successful example of an interprofessional clinical nurse specialist-led initiative that impacts patient/family and organization outcomes through the identification and implementation of evidence-based nursing practice.

  11. [Consequences of a Failed Project: Introduction and Management of a Hospitalization-Substituting Treatment Model].

    Science.gov (United States)

    Peters, Uwe

    2018-01-01

    This article is a report on a psychiatric project introducing services that substitute in-patient treatment and a new control and management system. The implementation of the project was a failure. Nevertheless, the project has made a contribution to further development of community-based psychiatry. Design, organization and course of the project are described and analyzed from the point of view of the communal actors involved. Effects going beyond the time course of the project have been taken into consideration. The results show that the contracting authority, project developer and local actors involved had differing ideas on the weight attached to different parts of the project as well as on the project goal and resources for carrying out the project. © Georg Thieme Verlag KG Stuttgart · New York.

  12. Continuous austempering fluidized bed furnace. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Srinivasan, M.N. [Lamar Univ., Beaumont, TX (United States). Dept. of Mechanical Engineering

    1997-09-23

    The intended objective of this project was to show the benefits of using a fluidized bed furnace for austenitizing and austempering of steel castings in a continuous manner. The division of responsibilities was as follows: (1) design of the fluidized bed furnace--Kemp Development Corporation; (2) fabrication of the fluidized bed furnace--Quality Electric Steel, Inc.; (3) procedure for austempering of steel castings, analysis of the results after austempering--Texas A and M University (Texas Engineering Experiment Station). The Department of Energy provided funding to Texas A and M University and Kemp Development Corporation. The responsibility of Quality Electric Steel was to fabricate the fluidized bed, make test castings and perform austempering of the steel castings in the fluidized bed, at their own expense. The project goals had to be reviewed several times due to financial constraints and technical difficulties encountered during the course of the project. The modifications made and the associated events are listed in chronological order.

  13. Improving Emergency Department flow through optimized bed utilization.

    Science.gov (United States)

    Chartier, Lucas Brien; Simoes, Licinia; Kuipers, Meredith; McGovern, Barb

    2016-01-01

    Over the last decade, patient volumes in the emergency department (ED) have grown disproportionately compared to the increase in staffing and resources at the Toronto Western Hospital, an academic tertiary care centre in Toronto, Canada. The resultant congestion has spilled over to the ED waiting room, where medically undifferentiated and potentially unstable patients must wait until a bed becomes available. The aim of this quality improvement project was to decrease the 90th percentile of wait time between triage and bed assignment (time-to-bed) by half, from 120 to 60 minutes, for our highest acuity patients. We engaged key stakeholders to identify barriers and potential strategies to achieve optimal flow of patients into the ED. We first identified multiple flow-interrupting challenges, including operational bottlenecks and cultural issues. We then generated change ideas to address two main underlying causes of ED congestion: unnecessary patient utilization of ED beds and communication breakdown causing bed turnaround delays. We subsequently performed seven tests of change through sequential plan-do-study-act (PDSA) cycles. The most significant gains were made by improving communication strategies: small gains were achieved through the optimization of in-house digital information management systems, while significant improvements were achieved through the implementation of a low-tech direct contact mechanism (a two-way radio or walkie-talkie). In the post-intervention phase, time-to-bed for the 90th percentile of high-acuity patients decreased from 120 minutes to 66 minutes, with special cause variation showing a significant shift in the weekly measurements.

  14. Designs that make a difference: the Cardiac Universal Bed model.

    Science.gov (United States)

    Johnson, Jackie; Brown, Katherine Kay; Neal, Kelly

    2003-01-01

    Information contained in this article includes some of the findings from a joint research project conducted by Corazon Consulting and Ohio State University Medical Center on national trends in Cardiac Universal Bed (CUB) utilization. This article outlines current findings and "best practice" standards related to the benefits of developing care delivery models to differentiate an organization with a competitive advantage in the highly dynamic marketplace of cardiovascular care. (OSUMC, a Corazon client, is incorporating the CUB into their Ross Heart Hospital slated to open this spring.)

  15. Evaluation of the medical records system in an upcoming teaching hospital-a project for improvisation.

    Science.gov (United States)

    Kumar, B Deepak; Kumari, C M Vinaya; Sharada, M S; Mangala, M S

    2012-08-01

    The medical records system of an upcoming teaching hospital in a developing nation was evaluated for its accessibility, completeness, physician satisfaction, presence of any lacunae, suggestion of necessary steps for improvisation and to emphasize the importance of Medical records system in education and research work. The salient aspects of the medical records department were evaluated based on a questionnaire which was evaluated by a team of 40 participants-30 doctors, 5 personnel from Medical Records Department and 5 from staff of Hospital administration. Most of the physicians (65%) were partly satisfied with the existing medical record system. 92.5% were of the opinion that upgradation of the present system is necessary. The need of the hour in the present teaching hospital is the implementation of a hospital-wide patient registration and medical records re-engineering process in the form of electronic medical records system and regular review by the audit commission.

  16. Review of acute cancer beds.

    LENUS (Irish Health Repository)

    Evans, D S

    2012-01-01

    A review of admissions to cancer services at University Hospital Galway (UHG) was undertaken to assess the appropriateness of hospital usage. All cancer specialty patients admitted from 26-28 May 2009 were reviewed (n = 82). Chi square tests, Exact tests, and One-way ANOVA were utilised to analyse key issues emerging from the data. Fifty (61%) were classified as emergencies. Twenty three (67%) occupied a designated cancer bed with 24 (30%) in outlying non-oncology wards. The mean length of stay was 29.3 days. Possible alternatives to admission were identified for 15 (19%) patients. There was no evidence of discharge planning for 50 (60%) admissions. There is considerable potential to make more appropriate utilisation of UHG for cancer patients, particularly in terms of reducing bed days and length of stay and the proportion of emergency cancer admissions, and further developing integrated systems of discharge planning.

  17. Evacuation of Bed-bound Patients-STEPS Simulations

    DEFF Research Database (Denmark)

    Madsen, Anne; Dederichs, Anne Simone

    2016-01-01

    Fires in hospitals occur, and evacuation of bed-bound patients might be necessary in case of emergency. The current study concerns the evacuation of bed-bound patients from a fire section in a hospital using hospital porters. The simulations are performed using the STEPS program. The aim...... of the study is to investigate the evacuation time of bed-bound hospital patients using different walking speeds from the literature, and the influence of the number of hospital porters on the total evacuation times of bed-bound patients. Different scenarios were carried out with varying staff......-to-patient ratios that simulate the horizontal evacuation of 40 bed-bound patients into a different fire section. It was found that the staff-to-patient-ratio affects the total evacuation times. However, the total evacuation times do not decrease linearly and a saturation effect is seen at a staff-to-patient ratio...

  18. Gum-compliant uncertainty propagations for Pu and U concentration measurements using the 1st-prototype XOS/LANL hiRX instrument; an SRNL H-Canyon Test Bed performance evaluation project

    Energy Technology Data Exchange (ETDEWEB)

    Holland, Michael K. [Savannah River Site (SRS), Aiken, SC (United States). Savannah River National Lab. (SRNL); O' Rourke, Patrick E. [Savannah River Site (SRS), Aiken, SC (United States). Savannah River National Lab. (SRNL)

    2016-05-04

    An SRNL H-Canyon Test Bed performance evaluation project was completed jointly by SRNL and LANL on a prototype monochromatic energy dispersive x-ray fluorescence instrument, the hiRX. A series of uncertainty propagations were generated based upon plutonium and uranium measurements performed using the alpha-prototype hiRX instrument. Data reduction and uncertainty modeling provided in this report were performed by the SRNL authors. Observations and lessons learned from this evaluation were also used to predict the expected uncertainties that should be achievable at multiple plutonium and uranium concentration levels provided instrument hardware and software upgrades being recommended by LANL and SRNL are performed.

  19. Attitudes of Registered and Licensed Practical Nurses About the Importance of Families in Surgical Hospital Units: Findings From the Landspitali University Hospital Family Nursing Implementation Project.

    Science.gov (United States)

    Blöndal, Katrin; Zoëga, Sigridur; Hafsteinsdottir, Jorunn E; Olafsdottir, Olof Asdis; Thorvardardottir, Audur B; Hafsteinsdottir, Sigrun A; Sveinsdóttir, Herdis

    2014-08-01

    The purpose of this study was to examine attitudes of registered nurses and licensed practical nurses about the importance of the family in surgical hospital units before (T1) and after (T2) implementation of a Family Systems Nursing educational intervention based on the Calgary Family Assessment and Intervention Models. This study was part of the Landspitali University Hospital Family Nursing Implementation Project and used a nonrandomized, quasi-experimental design with nonequivalent group before and after and without a control group. There were 181 participants at T1 and 130 at T2. No difference was found in nurses' attitudes as measured by the Families Importance in Nursing Care-Nurses' Attitudes (FINC-NA) questionnaire, before and after the educational intervention. Attitudes toward families were favorable at both times. Analysis of demographic variables showed that age, work experience, and workplace (inpatient vs. outpatient units) had an effect on the nurses' attitudes toward families. The influence of work experience on attitudes toward family care warrants further exploration. © The Author(s) 2014.

  20. Assessment of Lean Construction Principles: A Case Study at Semarang Medical Centre Hospital Project

    Directory of Open Access Journals (Sweden)

    Matias Roy Adi Wijaya

    2016-06-01

    Full Text Available The lean construction frameworks have been developed for years to enhance the poor performance of Indonesian project delivery system which influenced by the waste of non-value adding activities. Never the less most of the developments were limited on working process and lack in people empowerment. Toyota Way which integrate working process optimization and people empowerment, was developed as a lean construction frame works. This paper aimed to assess the implementation of Toyota Way principles in project delivery system by observing project’s delivery current state (status quo. The assessment began by conducting a questionnaire survey about Toyota Way implementation which then validated by interview with involved stakeholders and field observation. The assessment showed that project’s stakeholders were still unfamiliar with Toyota Way concept. Although some Toyota Way guidelines have been used in projects completion process such as visual management and training program, it found that those guidelines had not fully implemented. The project delivery system was lack of process focus and concerns more on relationship inter-parties. It also found thatToyota Way implementation will constrained by the difficulties to change the status quo of project delivery. Moreover, it seems that construction projects need practical guidelines to simplify the Toyota Way implementation in project delivery system such as project flow evaluation and system of reflection.

  1. Community-based management of multiple drug resistant tuberculosis in a tertiary hospital in Tanzania: a best practice implementation project.

    Science.gov (United States)

    Jelly, Isaya; Peters, Micah D J

    2017-12-01

    The World Health Organization (WHO) has prioritized collaboration with communities in its 2016 "End TB" implementation strategy. Acknowledging the difficulties that some communities face in gaining access to health facilities due to barriers such as stigma, discrimination, healthcare expenditure, transport and income loss, partnering with communities in the roll-out of community-based TB management activities is vital. The aim of this project was to make a contribution to promoting evidence-based practice with regards to the community-based management of multidrug-resistant tuberculosis (MDR-TB) at Kibong'oto National Infectious Disease Hospital, Tanzania, and thereby supporting improvements in patient outcomes and resource utilization. The project utilized the Joanna Briggs Institute Practical Application of Clinical Evidence System (JBI PACES) program to facilitate the collection of pre- and post-audit data. The Getting Research into Practice (GRiP) module was also used to analyze the potential barriers and for designing the final action plan. This project was conducted in three phases over a three-month period at the MDR-TB unit in a referral hospital in Northern Tanzania. The project showed that there were significant improvements in compliance rates in staff education and documentation of patients' suitability and preferences in receiving community-based care for MDR-TB. The compliance rate of criterion 2, which was already 100% at baseline, was slightly lower at follow-up. The project achieved significant improvements in the delivery of evidence-based practice with regards to community-based management of MDR-TB.

  2. What impedes and what facilitates a quality improvement project for older hospitalized patients?

    NARCIS (Netherlands)

    Ijkema, R.; Langelaan, M.; van de Steeg, L.; Wagner, C.

    2014-01-01

    Objective: To gain insight into which factors impede, and which facilitate, the implementation of a complex multi-component improvement initiative in hospitalized older patients. Design: A qualitative study based on semi-structured interviews. The three dimensions of Pettigrew and Whipp's

  3. Early data from Project Engage: a program to identify and transition medically hospitalized patients into addictions treatment.

    Science.gov (United States)

    Pecoraro, Anna; Horton, Terry; Ewen, Edward; Becher, Julie; Wright, Patricia A; Silverman, Basha; McGraw, Patty; Woody, George E

    2012-09-25

    Patients with untreated substance use disorders (SUDs) are at risk for frequent emergency department visits and repeated hospitalizations. Project Engage, a US pilot program at Wilmington Hospital in Delaware, was conducted to facilitate entry of these patients to SUD treatment after discharge. Patients identified as having hazardous or harmful alcohol consumption based on results of the Alcohol Use Disorders Identification Test-Primary Care (AUDIT-PC), administered to all patients at admission, received bedside assessment with motivational interviewing and facilitated referral to treatment by a patient engagement specialist (PES). This program evaluation provides descriptive information on self-reported rates of SUD treatment initiation of all patients and health-care utilization and costs for a subset of patients. Program-level data on treatment entry after discharge were examined retrospectively. Insurance claims data for two small cohorts who entered treatment after discharge (2009, n = 18, and 2010, n = 25) were reviewed over a six-month period in 2009 (three months pre- and post-Project Engage), or over a 12-month period in 2010 (six months pre- and post-Project Engage). These data provided descriptive information on health-care utilization and costs. (Data on those who participated in Project Engage but did not enter treatment were unavailable). Between September 1, 2008, and December 30, 2010, 415 patients participated in Project Engage, and 180 (43%) were admitted for SUD treatment. For a small cohort who participated between June 1, 2009, and November 30, 2009 (n = 18), insurance claims demonstrated a 33% ($35,938) decrease in inpatient medical admissions, a 38% ($4,248) decrease in emergency department visits, a 42% ($1,579) increase in behavioral health/substance abuse (BH/SA) inpatient admissions, and a 33% ($847) increase in outpatient BH/SA admissions, for an overall decrease of $37,760. For a small cohort who participated between June 1

  4. Development and piloting of the Fiji Injury Surveillance in Hospitals System (TRIP Project-1).

    Science.gov (United States)

    Wainiqolo, I; Kafoa, B; McCaig, E; Kool, B; McIntyre, R; Ameratunga, S

    2013-01-01

    Whilst more than 90% of injury related deaths are estimated to occur in low-and-middle-income countries (LMICs), the epidemiology of fatal and hospitalised injuries in Pacific Island Countries has received scant attention. This study describes the development and piloting of a population-based trauma registry in Fiji to address this gap in knowledge. The Fiji Injury Surveillance in Hospitals (FISH) system was an active surveillance system designed to identify injuries resulting in death or a hospital admission in Viti Levu, Fiji. During the pilot conducted over five months in 2005, Accident and Emergency registers, admission folders and morgue registers from 8 of Viti Levu's 12 hospitals, and an additional 3 hospitals in other parts of the country were reviewed by hospital staff and medical students to identify cases and extract a minimum data set that included demographic factors; the mechanism, nature and context of injury; substance use; and discharge outcomes. The system was audited to identify and redress difficulties with data quality in a manner that also supported local capacity development and training in injury surveillance and data management. This pilot study demonstrated the potential to collect high quality data on injuries that can pose a significant threat to life in Fiji using a mechanism that also increased the capability of health professionals to recognise the significance of injury as a public health issue. The injury surveillance system piloted provides the opportunity to inform national injury control strategies in Fiji and increase the capacity for injury prevention and more focused research addressing risk factors in the local context. Copyright © 2011 Elsevier Ltd. All rights reserved.

  5. Direct medical costs of hospitalizations for cardiovascular diseases in Shanghai, China: trends and projections.

    Science.gov (United States)

    Wang, Shengnan; Petzold, Max; Cao, Junshan; Zhang, Yue; Wang, Weibing

    2015-05-01

    Few studies in China have focused on direct expenditures for cardiovascular diseases (CVDs), making cost trends for CVDs uncertain. Epidemic modeling and forecasting may be essential for health workers and policy makers to reduce the cost burden of CVDs.To develop a time series model using Box-Jenkins methodology for a 15-year forecasting of CVD hospitalization costs in Shanghai.Daily visits and medical expenditures for CVD hospitalizations between January 1, 2008 and December 31, 2012 were analyzed. Data from 2012 were used for further analyses, including yearly total health expenditures and expenditures per visit for each disease, as well as per-visit-per-year medical costs of each service for CVD hospitalizations. Time series analyses were performed to determine the long-time trend of total direct medical expenditures for CVDs and specific expenditures for each disease, which were used to forecast expenditures until December 31, 2030.From 2008 to 2012, there were increased yearly trends for both hospitalizations (from 250,354 to 322,676) and total costs (from US $ 388.52 to 721.58 million per year in 2014 currency) in Shanghai. Cost per CVD hospitalization in 2012 averaged US $ 2236.29, with the highest being for chronic rheumatic heart diseases (US $ 4710.78). Most direct medical costs were spent on medication. By the end of 2030, the average cost per visit per month for all CVDs was estimated to be US $ 4042.68 (95% CI: US $ 3795.04-4290.31) for all CVDs, and the total health expenditure for CVDs would reach over US $1.12 billion (95% CI: US $ 1.05-1.19 billion) without additional government interventions.Total health expenditures for CVDs in Shanghai are estimated to be higher in the future. These results should be a valuable future resource for both researchers on the economic effects of CVDs and for policy makers.

  6. The impacts of smart cards on hospital information systems--an investigation of the first phase of the national health insurance smart card project in Taiwan.

    Science.gov (United States)

    Liu, Chien-Tsai; Yang, Pei-Tun; Yeh, Yu-Ting; Wang, Bin-Long

    2006-02-01

    To investigate the impacts of the first phase of Taiwan's Bureau of National Health Insurance (TBNHI) smart card project on existing hospital information systems. TBNHI has launched a nationwide project for replacement of its paper-based health insurance cards by smart cards (or NHI-IC cards) since November 1999. The NHI-IC cards have been used since 1 July 2003, and they have fully replaced the paper-based cards since 1 January 2004. Hospitals must support the cards in order to provide medical services for insured patients. We made a comprehensive study of the current phase of the NHI-IC card system, and conducted a questionnaire survey (from 1 October to 30 November, 2003) to investigate the impacts of NHI-IC cards on the existing hospital information systems. A questionnaire was distributed by mail to 479 hospitals, including 23 medical centers, 71 regional hospitals, and 355 district hospitals. The returned questionnaires were also collected by prepaid mail. The questionnaire return rates of the medical centers, regional hospitals and district hospitals were 39.1, 29.6 and 20.9%, respectively. In phase 1 of the project, the average number of card readers purchased per medical center, regional hospital, and district hospital were 202, 45 and 10, respectively. The average person-days for the enhancement of existing information systems of a medical center, regional hospital and district hospital were 175, 74 and 58, respectively. Three months after using the NHI-IC cards most hospitals (60.6%) experienced prolonged service time for their patients due to more interruptions caused mainly by: (1) impairment of the NHI-IC cards (31.2%), (2) failure in authentication of the SAMs (17.0%), (3) malfunction in card readers (15.3%) and (4) problems with interfaces between the card readers and hospital information systems (15.8%). The overall hospital satisfaction on the 5-point Likert scale was 2.86. Although most hospitals were OK with the project, there was about 22

  7. Open source challenges for hospital information system (HIS in developing countries: a pilot project in Mali

    Directory of Open Access Journals (Sweden)

    Chaacho Saad

    2010-04-01

    Full Text Available Abstract Background We are currently witnessing a significant increase in use of Open Source tools in the field of health. Our study aims to research the potential of these software packages for developing countries. Our experiment was conducted at the Centre Hospitalier Mere Enfant in Mali. Methods After reviewing several Open Source tools in the field of hospital information systems, Mediboard software was chosen for our study. To ensure the completeness of Mediboard in relation to the functionality required for a hospital information system, its features were compared to those of a well-defined comprehensive record management tool set up at the University Hospital "La Timone" of Marseilles in France. It was then installed on two Linux servers: a first server for testing and validation of different modules, and a second one for the deployed full implementation. After several months of use, we have evaluated the usability aspects of the system including feedback from end-users through a questionnaire. Results Initial results showed the potential of Open Source in the field of health IT for developing countries like Mali. Five main modules have been fully implemented: patient administrative and medical records management of hospital activities, tracking of practitioners' activities, infrastructure management and the billing system. This last component of the system has been fully developed by the local Mali team. The evaluation showed that the system is broadly accepted by all the users who participated in the study. 77% of the participants found the system useful; 85% found it easy; 100% of them believe the system increases the reliability of data. The same proportion encourages the continuation of the experiment and its expansion throughout the hospital. Conclusions In light of the results, we can conclude that the objective of our study was reached. However, it is important to take into account the recommendations and the challenges discussed

  8. The effect of a resident-led quality improvement project on improving communication between hospital-based and outpatient physicians.

    Science.gov (United States)

    Kalanithi, Lucy; Coffey, Charles E; Mourad, Michelle; Vidyarthi, Arpana R; Hollander, Harry; Ranji, Sumant R

    2013-01-01

    This article reports on a resident-led quality improvement program to improve communication between inpatient internal medicine residents and their patients' primary care physicians (PCPs). The program included education on care transitions, standardization of documentation, audit and feedback of documented PCP communication rates with public reporting of performance, rapid-cycle data analysis and improvement projects, and a financial incentive. At baseline, PCP communication was documented in 55% of patients; after implementation of the intervention, communication was documented in 89.3% (2477 of 2772) of discharges during the program period. The program was associated with a significant increase in referring PCP satisfaction with communication at hospital admission (baseline, 27.7% "satisfied" or "very satisfied"; postintervention, 58.2%; P communication for patient care and audit and feedback of their performance as the principal drivers of their engagement in the project.

  9. Design and Simulation of an Air Conditioning Project in a Hospital Based on Computational Fluid Dynamics

    OpenAIRE

    Ding X. R.; Guo Y. Y.; Chen Y. Y.

    2017-01-01

    This study aims to design a novel air cleaning facility which conforms to the current situation in China, and moreover can satisfy our demand on air purification under the condition of poor air quality, as well as discuss the development means of a prototype product. Air conditions in the operating room of a hospital were measured as the research subject of this study. First, a suitable turbulence model and boundary conditions were selected and computational fluid dynamics (CFD) software was ...

  10. Baby Boomers and Beds: a Demographic Challenge for the Ages.

    Science.gov (United States)

    Song, Zirui; Ferris, Timothy G

    2018-03-01

    The United States is facing a significant demographic transition, with about 10,000 baby boomers turning age 65 each day. At the same time, the nation is experiencing a similarly striking transition in hospital capacity, as the supply of hospital beds has declined in recent decades. The juxtaposition of population aging and hospital capacity portends a potentially widening divergence between supply and demand for hospital care. We provide a closer look at current hospital capacity and a rethinking of the future role of hospital beds in meeting the needs of an aging population.

  11. Assessment and management of burn pain at the Komfo Anokye Teaching Hospital: a best practice implementation project.

    Science.gov (United States)

    Bayuo, Jonathan; Munn, Zachary; Campbell, Jared

    2017-09-01

    Pain management is a significant issue in health facilities in Ghana. For burn patients, this is even more challenging as burn pain has varied facets. Despite the existence of pharmacological agents for pain management, complaints of pain still persist. The aim of this project was to identify pain management practices in the burns units of Komfo Anokye Teaching Hospital, compare these approaches to best practice, and implement strategies to enhance compliance to standards. Ten evidence-based audit criteria were developed from evidence summaries. Using the Joanna Briggs Institute Practical Application of Clinical Evidence Software (PACES), a baseline audit was undertaken on a convenience sample of ten patients from the day of admission to the seventh day. Thereafter, the Getting Research into Practice (GRiP) component of PACES was used to identify barriers, strategies, resources and outcomes. After implementation of the strategies, a follow-up audit was undertaken using the same sample size and audit criteria. The baseline results showed poor adherence to best practice. However, following implementation of strategies, including ongoing professional education and provision of assessment tools and protocols, compliance rates improved significantly. Atlhough the success of this project was almost disrupted by an industrial action, collaboration with external bodies enabled the successful completion of the project. Pain management practices in the burns unit improved at the end of the project which reflects the importance of an audit process, education, providing feedback, group efforts and effective collaboration.

  12. Dependence of saltation characteristics on bed organisation in numerical simulation

    Czech Academy of Sciences Publication Activity Database

    Kharlamova, Irina; Vlasák, Pavel

    2015-01-01

    Roč. 19, č. 1 (2015), s. 177-184 ISSN 1226-4806 R&D Projects: GA ČR GA103/09/1718; GA ČR GAP105/10/1574 Institutional support: RVO:67985874 Keywords : saltation parameters * bed roughness * bed structure * bed load transport * armoured bed Subject RIV: BK - Fluid Dynamics Impact factor: 0.922, year: 2015 http://link.springer.com/content/pdf/10.1007%2Fs12303-014-0029-3.pdf

  13. Gonad protection for the antero-posterior projection of the pelvis in diagnostic radiography in Dublin hospitals

    Energy Technology Data Exchange (ETDEWEB)

    Doolan, Aoife; Brennan, Patrick C. E-mail: patrick.brennan@ucd.ie; Rainford, Louise A.; Healy, Jan

    2004-02-01

    Gonad shielding during diagnostic X-ray procedures is an effective way of reducing radiation dose to patients' reproductive organs and reduces the risk of genetic effects in future generations. The utilisation of gonad shielding, the availability of shields and the existence of written protocols for the use of radiation shielding for antero-posterior projections of the male and female pelvis were examined in four major Dublin hospitals. A retrospective study of 198 pelvic radiographs revealed that only 2% (n=4) of images had evidence of gonad shielding. All four images that demonstrated shielding showed that the shield was malpositioned with either important bony anatomy obscured or gonads not sufficiently protected. Some of the hospitals surveyed had inadequate supplies of gonad shields in the general radiography rooms and no written protocols were available. The results of this study indicate that patients in the hospitals investigated are receiving avoidable gonad irradiation due to the omission, or malpositioning of gonad shields during pelvis examinations. In line with recent EC recommendations appropriate shielding of the gonads during pelvis AP examinations should be encouraged.

  14. Gonad protection for the antero-posterior projection of the pelvis in diagnostic radiography in Dublin hospitals

    International Nuclear Information System (INIS)

    Doolan, Aoife; Brennan, Patrick C.; Rainford, Louise A.; Healy, Jan

    2004-01-01

    Gonad shielding during diagnostic X-ray procedures is an effective way of reducing radiation dose to patients' reproductive organs and reduces the risk of genetic effects in future generations. The utilisation of gonad shielding, the availability of shields and the existence of written protocols for the use of radiation shielding for antero-posterior projections of the male and female pelvis were examined in four major Dublin hospitals. A retrospective study of 198 pelvic radiographs revealed that only 2% (n=4) of images had evidence of gonad shielding. All four images that demonstrated shielding showed that the shield was malpositioned with either important bony anatomy obscured or gonads not sufficiently protected. Some of the hospitals surveyed had inadequate supplies of gonad shields in the general radiography rooms and no written protocols were available. The results of this study indicate that patients in the hospitals investigated are receiving avoidable gonad irradiation due to the omission, or malpositioning of gonad shields during pelvis examinations. In line with recent EC recommendations appropriate shielding of the gonads during pelvis AP examinations should be encouraged

  15. Increasing patient mobility through an individualized goal-centered hospital mobility program: A quasi-experimental quality improvement project.

    Science.gov (United States)

    Klein, Lisa M; Young, Daniel; Feng, Du; Lavezza, Annette; Hiser, Stephanie; Daley, Kelly N; Hoyer, Erik H

    2018-02-27

    Hospital-acquired functional decline due to decreased mobility has negative impacts on patient outcomes. Current nurse-directed mobility programs lack a standardized approach to set achievable mobility goals. We aimed to describe implementation and outcomes from a nurse-directed patient mobility program. The quality improvement mobility program on the project unit was compared to a similar control unit providing usual care. The Johns Hopkins Mobility Goal Calculator was created to guide a daily patient mobility goal based on the level of mobility impairment. On the project unit, patient mobility increased from 5.2 to 5.8 on the Johns Hopkins Highest Level of Mobility score, mobility goal attainment went from 54.2% to 64.2%, and patients exceeding the goal went from 23.3% to 33.5%. All results were significantly higher than the control unit. An individualized, nurse-directed, patient mobility program using daily mobility goals is a successful strategy to improve daily patient mobility in the hospital. Copyright © 2018 Elsevier Inc. All rights reserved.

  16. [Gender-inclusive care of victims of violence : The model project "Gender Gewaltkonzept" at the University Hospital Aachen].

    Science.gov (United States)

    Evler, A; Scheller, M; Wagels, L; Bergs, R; Clemens, B; Kohn, N; Pütz, A; Voss, B; Schneider, F; Habel, U

    2016-07-01

    Violence is a topic of great social relevance, frequently causing tremendous health consequences for those affected and high consequential costs for health care and the national economy. The established consulting and assistance services are usually restricted to offers for ambulant supply, mainly from private agencies or societies. As a result, there is no identification and care for patients who have experienced violence and who are treated in hospital. Another deficiency is the identification and care of male victims of violence. Despite wide-ranging offers of assistance, only very few gender-specific consulting and support services have been available to date.Therefore, the model project "Gender Gewaltkonzept" was initiated at Aachen University Hospital to assess the prevalence of violence and the potential consequences of the violence experienced on the patients' health. In addition, we investigated whether males and females are in need of different supply requirements.Based on the results of the project "Gender Gewaltkonzept" so far, and on prevalence estimates proving that there is a high rate of violent experiences in both males and females, this overview is aimed at presenting the aid and protection concepts available for victims of violence, in addition to the existing deficiencies of the care system. We present approaches to resolving these deficiencies to be able to establish all-encompassing gender-appropriate support for victims of violence.

  17. FY 1974 Report on results of Sunshine Project. Feasibility study on digging high-temperature beds; 1974 nendo koon chiso kussaku ni kansuru feasibility study

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1975-03-31

    The desired target geothermal conditions for which the digging equipment is to be developed are 3,000 to 5,000 m as depth, 400 degrees C as temperature and 500 kg/cm{sup 2} as pressure. As the first phase, the study is conducted on feasibility of development of techniques for digging high-temperature beds under a temperature condition of 250 degrees C, where the rotary table type digger is mainly studied. It is most widely used for digging oil wells as well as geothermal wells. The current rotary table B type digger is studied as the equipment serviceable at 250 degrees C as the target temperature level for the moment for digging high-temperature beds. The studied items include the problems involved in the digger body, pipes, bits and other members, and also measures to expand its possibility. Also studied/surveyed are applicability of the new digging techniques now under development to geothermal wells, and techniques for fracturing high-temperature rocks. This report summarizes to help select the methods desired to be developed in the future, and plan development of the digging systems. (NEDO)

  18. 2D numerical model of particle-bed collision in fluid-particle flows over bed

    Czech Academy of Sciences Publication Activity Database

    Lukerchenko, Nikolay; Chára, Zdeněk; Vlasák, Pavel

    2006-01-01

    Roč. 44, č. 1 (2006), s. 70-78 ISSN 0022-1686 R&D Projects: GA AV ČR IAA2060201 Institutional research plan: CEZ:AV0Z20600510 Keywords : saltation * particle-bed collision * collision angle * bed roughness Subject RIV: BK - Fluid Dynamics Impact factor: 0.527, year: 2006

  19. Geothermal heating project at St. Mary's Hospital, Pierre, South Dakota. Final report

    Energy Technology Data Exchange (ETDEWEB)

    1984-12-01

    St. Mary's Hospital, Pierre, South Dakota, with the assistance of the US Department of Energy, drilled a 2176 ft well into the Madison Aquifer ot secure 108/sup 0/F artesian flow water at 385 gpm (475 psig shut-in pressure). The objective was to provide heat for domestic hot water and to space heat 163,768 sq. ft. Cost savings for the first three years were significant and, with the exception of a shutdown to replace some corroded pipe, the system has operated reliably and continuously for the last four years.

  20. Occupational Analysis: Hospital Radiologic Technologist. The UCLA Allied Health Professions Project.

    Science.gov (United States)

    Reeder, Glenn D.; And Others

    In an effort to meet the growing demand for skilled radiologic technologists and other supportive personnel educated through the associate degree level, a national survey was conducted as part of the UCLA Allied Health Professions Project to determine the tasks performed by personnel in the field and lay the groundwork for development of…

  1. Bed Bugs and Schools

    Science.gov (United States)

    Bed bugs have long been a pest – feeding on blood, causing itchy bites and generally irritating their human hosts. They are successful hitchhikers, and can move from an infested site to furniture, bedding, baggage, boxes, and clothing.

  2. Population-based characteristics of fatal and hospital admissions for poisoning in Fiji: TRIP Project-11

    Science.gov (United States)

    Peiris-John, Roshini; Kafoa, Berlin; Wainiqolo, Iris; Reddy, Ravi Krishnan; McCaig, Eddie; Ameratunga, Shanthi N

    2013-01-01

    This study investigated the incidence and characteristics of poisoning fatalities and hospital admissions among indigenous Fijians and Indians in Viti Levu, Fiji. Individuals with a mechanism of injury classified as poisoning were identified using the Fiji injury surveillance in hospitals system, a population-based registry established for 12 months in Viti Levu, and analysed using population-based denominators. The mean annual rates of fatalities and hospitalisations were 2.3 and 26.0 per 100 000, respectively. Over two-thirds of poisonings occurred among people of Indian ethnicity. Most intentional poisoning admissions occurred among women (58.3%) and in 15–29-year-old individuals (73.8%). Unintentional poisoning admission rates were highest among Indian boys aged 0–14 years. While over 75% of events occurred at home, the substances involved were not systematically identified. The findings indicate the need for a strategy that addresses the differing contexts across age group, gender and ethnicity, and a lead agency responsible for implementing and monitoring its effectiveness. PMID:23353079

  3. Bed management team with Kanban web-based application.

    Science.gov (United States)

    Rocha, Hermano Alexandre Lima; Santos, Ana Kelly Lima da Cruz; Alcântara, Antônia Celia de Castro; Lima, Carmen Sulinete Suliano da Costa; Rocha, Sabrina Gabriele Maia Oliveira; Cardoso, Roberto Melo; Cremonin, Jair Rodrigues

    2018-05-15

    To measure the effectiveness of the bed management process that uses a web-based application with Kanban methodology to reduce hospitalization time of hospitalized patients. Before-after study was performed. The study was conducted between July 2013 and July 2017, at the Unimed Regional Hospital of Fortaleza, which has 300 beds, of which 60 are in the intensive care unit (ICU). It is accredited by International Society for Quality in Healthcare. Patients hospitalized in the referred period. Bed management with an application that uses color logic to signal at which stage of high flow the patients meet, in which each patient is interpreted as a card of the classical Kanban theory. It has an automatic user signaling system for process movement, and a system for monitoring and analyzing discharge forecasts. Length of hospital stay, number of customer complaints related to bed availability. After the intervention, the hospital's overall hospital stay time was reduced from 5.6 days to 4.9 days (P = 0.001). The units with the greatest reduction were the ICUs, with reduction from 6.0 days to 2.0 (P = 0.001). The relative percentage of complaints regarding bed availability in the hospital fell from 27% to 0%. We conclude that the use of an electronic tool based on Kanban methodology and accessed via the web by a bed management team is effective in reducing patients' hospital stay time.

  4. Comparative analysis of the current payment system for hospital services in Serbia and projected payments under diagnostic related groups system in urology.

    Science.gov (United States)

    Babić, Uroš; Soldatović, Ivan; Vuković, Dejana; Milićević, Milena Šantrić; Stjepanović, Mihailo; Kojić, Dejan; Argirović, Aleksandar; Vukotić, Vinka

    2015-03-01

    Global budget per calendar year is a traditional method of funding hospitals in Serbia. Diagnose related groups (DGR) is a method of hospital payment based on classification of patients into groups with clinically similar problems and similar utilization of hospital resources. The aim of this study was to compare current methods of hospital services payment with the projected costs by DRG payment method in urology. The data were obtained from the information system used in the Clinical Hospital Center "Dr. Dragiša Mišović"--Dedinje in Belgrade, Serbia. The implemented hospital information system was the main criterion for selection of healthcare institutions. The study included 994 randomly selected patients treated surgically and conservatively in 2012. Average costs under the current payment method were slightly higher than those projected by DRG, however, the variability was twice as high (54,111 ± 69,789 compared to 53,434 ± 32,509, p payment method as well as with the projected one by DRG was observed in relation to the number of days of hospitalization (ρ = 0.842, p payment system (β = 0.843, p payment system (β = 0.737, p payment method and the pro- jected DRG payment methods (β = 0.501, p Payment under the DRG system is administratively more complex because it requires detailed and standardized coding of diagnoses and procedures, as well as the information on the average consumption of resources (costs) per DRG. Given that aggregate costs of treatment under two hospital payment methods compared in the study are not significantly different, the focus on minor surgeries both under the current hospital payment method and under the introduced DRG system would be far more cost-effective for a hospital as great variations in treatment performance (reductions of days of hospitalization and complications), and consequently invoiced amounts would be reduced.

  5. Waste Treatment And Immobilization Plant U. S. Department Of Energy Office Of River Protection Submerged Bed Scrubber Condensate Disposition Project - Abstract no. 13460

    International Nuclear Information System (INIS)

    Yanochko, Ronald M; Corcoran, Connie

    2012-01-01

    The Hanford Waste Treatment and Immobilization Plant (WTP) will generate an off-gas treatment system secondary liquid waste stream [submerged bed scrubber (SBS) condensate], which is currently planned for recycle back to the WTP Low Activity Waste (LAW) melter. This SBS condensate waste stream is high in Tc-99, which is not efficiently captured in the vitrified glass matrix. A pre-conceptual engineering study was prepared in fiscal year 2012 to evaluate alternate flow paths for melter off-gas secondary liquid waste generated by the WTP LAW facility. This study evaluated alternatives for direct off-site disposal of this SBS without pre-treatment, which mitigates potential issues associated with recycling

  6. Waste Treatment And Immobilization Plant U. S. Department Of Energy Office Of River Protection Submerged Bed Scrubber Condensate Disposition Project - Abstract # 13460

    Energy Technology Data Exchange (ETDEWEB)

    Yanochko, Ronald M [Washington River Protection Solutions, Richland, WA (United States); Corcoran, Connie [AEM Consulting, LLC, Richland, WA (United States)

    2012-11-15

    The Hanford Waste Treatment and Immobilization Plant (WTP) will generate an off-gas treatment system secondary liquid waste stream [submerged bed scrubber (SBS) condensate], which is currently planned for recycle back to the WTP Low Activity Waste (LAW) melter. This SBS condensate waste stream is high in Tc-99, which is not efficiently captured in the vitrified glass matrix. A pre-conceptual engineering study was prepared in fiscal year 2012 to evaluate alternate flow paths for melter off-gas secondary liquid waste generated by the WTP LAW facility. This study evaluated alternatives for direct off-site disposal of this SBS without pre-treatment, which mitigates potential issues associated with recycling.

  7. Using business process redesign to reduce wait times at a university hospital in the Netherlands

    NARCIS (Netherlands)

    Elkhuizen, Sylvia G.; Burger, Matthe P. M.; Jonkers, Rene E.; Limburg, Martien; Klazinga, Niek; Bakker, Piet J. M.

    2007-01-01

    BACKGROUND: Business process redesign (BPR) has been applied to implement more customer-focused and cost-effective care. In 2002, two pilot projects to improve patient care processes for two specific patient groups were conducted at the Academic Medical Center, a 1,000-bed university hospital in

  8. Determinants of the cost of capital for privately financed hospital projects in the UK.

    Science.gov (United States)

    Colla, Paolo; Hellowell, Mark; Vecchi, Veronica; Gatti, Stefano

    2015-11-01

    Many governments make use of private finance contracts to deliver healthcare infrastructure. Previous work has shown that the rate of return to investors in these markets often exceeds the efficient level. Our focus is on the factors that influence that return. We examine the effect of macroeconomic, project- and firm-level variables using a detailed sample of 84 UK private finance initiative (PFI) contracts signed between 1997 and 2010. Of the above variables, macroeconomic conditions and lead sponsor size are related to the investor return. However, our results show a remarkable degree of stability in the return to investors over the 14-year period. We find evidence of a 'prevailing norm' that is robust to project- and firm-level variation. The sustainability of excess returns over a long period is indicative of a concentrated market structure. We argue that policymakers should consider new mechanisms for increasing competition in the equity market, while ensuring that authorities have the specialist resources required to negotiate efficient contract prices. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  9. [Patient satisfaction survey and the place of users in the Oran university hospital quality project].

    Science.gov (United States)

    Chougrani, Saada; Ouhadj, Salah

    2014-01-01

    Quality of care is a strategic priority of any management approach in order to meet users' expectations of health care systems. This study tried to define the role of patient satisfaction surveys and the place of user in the quality of care project. The results of patient satisfaction surveys conducted between 2010 and 2012 and the draft quality of care project were analysed. Patient satisfaction surveys from 2010 to 2012 focused on logistic shortcomings. No comment was formulated about health care. Comments and suggestions did not provide any contribution in terms of patient involvement in the health care process. The multiple perspectives of quality of care include clinical care and other social objectives of respect for the individual and attention to the patient. User satisfaction as assessed by patient satisfaction surveys or patients' experiences only reflect the health professionals' representation. However, the objective is to measure what the user perceives and feels and his/her representation of the attention provided. These approaches, conducted outside of the quality of care strategic plan, only provide a basis for actions with limited or no effectiveness.

  10. Comparative analysis of current payment system for hospital services in Serbia and projected payments under diagnostic related groups system in urology

    Directory of Open Access Journals (Sweden)

    Babić Uroš

    2015-01-01

    Full Text Available Background/Aim. Global budget per calendar year is a traditional method of funding hospitals in Serbia. Diagnose related groups (DGR is a method of hospital payment based on classification of patients into groups with clinically similar problems and similar utilization of hospital resources. The aim of this study was to compare current methods of hospital services payment with the projected costs by DRG payment method in urology. Methods. The data were obtained from the information system used in the Clinical Hospital Center “Dr. Dragiša Mišović” - Dedinje in Belgrade, Serbia. The implemented hospital information system was the main criterion for selection of healthcare institutions. The study included 994 randomly selected patients treated surgically and conservatively in 2012. Results. Average costs under the current payment method were slightly higher than those projected by DRG, however, the variability was twice as high (54,111 ± 69,789 compared to 53,434 ± 32,509, p < 0,001 respectively. The univariate analysis showed that the highest correlation with the current payment method as well as with the projected one by DRG was observed in relation to the number of days of hospitalization (ρ = 0.842, p < 0.001, and ρ = 0.637, p < 0.001, respectively. Multivariate regression models confirmed the influence of the number of hospitalization days to costs under the current payment system (β = 0.843, p < 0.001 as well as under the projected DRG payment system (β = 0.737, p < 0.001. The same predictor was crucial for the difference in the current payment method and the projected DRG payment methods (β = 0.501, p <0.001. Conclusion. Payment under the DRG system is administratively more complex because it requires detailed and standardized coding of diagnoses and procedures, as well as the information on the average consumption of resources (costs per DRG. Given that aggregate costs of treatment under two hospital payment methods compared

  11. Fluidised-bed combustion of gasification residue

    Energy Technology Data Exchange (ETDEWEB)

    Korpela, T.; Kudjoi, A.; Hippinen, I.; Heinolainen, A.; Suominen, M.; Lu Yong [Helsinki Univ. of Technology (Finland). Lab of Energy Economics and Power Plant Engineering

    1996-12-01

    Partial gasification processes have been presented as possibilities for future power production. In the processes, the solid materials removed from a gasifier (i.e. fly ash and bed material) contain unburnt fuel and the fuel conversion is increased by burning this gasification residue either in an atmospheric or a pressurised fluidised-bed. In this project, which is a part of European JOULE 2 EXTENSION research programme, the main research objectives are the behaviour of calcium and sulphur compounds in solids and the emissions of sulphur dioxide and nitrogen oxides (NO{sub x} and N{sub 2}O) in pressurised fluidised-bed combustion of gasification residues. (author)

  12. The consequences upon patient care of moving Brits Hospital: A ...

    African Journals Online (AJOL)

    Background. In 2001, North West Province took the decision to increase bed capacity at Brits Hospital from 66 beds to 267 beds. After careful consideration of costs and an assessment of available land, it was decided to demolish the existing hospital and rebuild the new hospital on the same site. It was planned that during ...

  13. Design and Simulation of an Air Conditioning Project in a Hospital Based on Computational Fluid Dynamics

    Directory of Open Access Journals (Sweden)

    Ding X. R.

    2017-06-01

    Full Text Available This study aims to design a novel air cleaning facility which conforms to the current situation in China, and moreover can satisfy our demand on air purification under the condition of poor air quality, as well as discuss the development means of a prototype product. Air conditions in the operating room of a hospital were measured as the research subject of this study. First, a suitable turbulence model and boundary conditions were selected and computational fluid dynamics (CFD software was used to simulate indoor air distribution. The analysis and comparison of the simulation results suggested that increasing the area of air supply outlets and the number of return air inlets would not only increase the area of unidirectional flow region in main flow region, but also avoid an indoor vortex and turbulivity of the operating area. Based on the summary of heat and humidity management methods, the system operation mode and relevant parameter technologies as well as the characteristics of the thermal-humidity load of the operating room were analyzed and compiled. According to the load value and parameters of indoor design obtained after our calculations, the airflow distribution of purifying the air-conditioning system in a clean operating room was designed and checked. The research results suggested that the application of a secondary return air system in the summer could reduce energy consumption and be consistent with the concept of primaiy humidity control. This study analyzed the feasibility and energy conservation properties of cleaning air-conditioning technology in operating rooms, proposed some solutions to the problem, and performed a feasible simulation, which provides a reference for practical engineering.

  14. Inpatient capacity at children's hospitals during pandemic (H1N1) 2009 outbreak, United States.

    Science.gov (United States)

    Sills, Marion R; Hall, Matthew; Fieldston, Evan S; Hain, Paul D; Simon, Harold K; Brogan, Thomas V; Fagbuyi, Daniel B; Mundorff, Michael B; Shah, Samir S

    2011-09-01

    Quantifying how close hospitals came to exhausting capacity during the outbreak of pandemic influenza A (H1N1) 2009 can help the health care system plan for more virulent pandemics. This ecologic analysis used emergency department (ED) and inpatient data from 34 US children's hospitals. For the 11-week pandemic (H1N1) 2009 period during fall 2009, inpatient occupancy reached 95%, which was lower than the 101% occupancy during the 2008-09 seasonal influenza period. Fewer than 1 additional admission per 10 inpatient beds would have caused hospitals to reach 100% occupancy. Using parameters based on historical precedent, we built 5 models projecting inpatient occupancy, varying the ED visit numbers and admission rate for influenza-related ED visits. The 5 scenarios projected median occupancy as high as 132% of capacity. The pandemic did not exhaust inpatient bed capacity, but a more virulent pandemic has the potential to push children's hospitals past their maximum inpatient capacity.

  15. Waste Treatment and Immobilization Plant U. S. Department of Energy Office of River Protection Submerged Bed Scrubber Condensate Disposition Project - 13460

    Energy Technology Data Exchange (ETDEWEB)

    Yanochko, Ronald M. [Washington River Protection Solutions, P.O. Box 850, Richland, Washington 99352 (United States); Corcoran, Connie [AEM Consulting, LLC, 1201 Jadwin Avenue, Richland, Washington 99352 (United States)

    2013-07-01

    The Hanford Waste Treatment and Immobilization Plant (WTP) will generate an off-gas treatment system secondary liquid waste stream [submerged bed scrubber (SBS) condensate], which is currently planned for recycle back to the WTP Low Activity Waste (LAW) melter. This SBS condensate waste stream is high in Tc-99, which is not efficiently captured in the vitrified glass matrix [1]. A pre-conceptual engineering study was prepared in fiscal year 2012 to evaluate alternate flow paths for melter off-gas secondary liquid waste generated by the WTP LAW facility [2]. This study evaluated alternatives for direct off-site disposal of this SBS without pre-treatment, which mitigates potential issues associated with recycling. This study [2] concluded that SBS direct disposal is a viable option to the WTP baseline. The results show: - Off-site transportation and disposal of the SBS condensate is achievable and cost effective. - Reduction of approximately 4,325 vitrified WTP Low Activity Waste canisters could be realized. - Positive WTP operational impacts; minimal WTP construction impacts are realized. - Reduction of mass flow from the LAW Facility to the Pretreatment Facility by 66%. - Improved Double Shell Tank (DST) space management is a benefit. (authors)

  16. Research report of FY 1997 on the environmentally acceptable coal utilization system introduction support project. Follow-up project on circulating fluidized bed boiler introduction (Calaca Batangas Thermal Power Station); 1997 nendo chosa hokokusho. Kankyo chowagata sekitan riyo system donyu shien jigyo (junkan ryudosho boiler ni kakawaru follow up jigyo (Calaca Batangas karyoku hatsudensho))

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1998-03-01

    For the follow-up project, to promote the diffusion of results of the clean coal technology (CCT) model projects, experts of circulating fluidized bed boilers were dispatched, to guide and advise for the operation of facilities introduced in these projects. The purpose of these projects is to diffuse the CCTs, and to support the promotion of environmental measures. Some guidance and advice about operation processes, data processing, operation regulation, maintenance, and boiler maintenance works were provided to the Ministry of Energy and Electric Power Corporation of the Philippines. Semirara, Malangas, and Samar coals in the Philippines were used for the tests. The boiler facilities could be operated by Philippine operators themselves. Based on the guidance and advice about operation processes, combustion tests using various Philippine coals were also planned and conducted by themselves. The maintenance techniques were transferred to Philippine operators through the inspection, repair and advice. The Philippine side understood the technologies well, and the circulating fluidized bed boiler technology was independently educated in the Philippines. 23 figs., 16 tabs.

  17. Evaluation of conducting a screening assessment of nutritional status of hospitalized patients. Presentation of main goals and objectives of the global health project "NutritionDay".

    Science.gov (United States)

    Jeznach-Steinhagen, Anna; Ostrowska, Joanna; Czerwonogrodzka-Senczyna, Aneta

    2016-01-01

    European Society for Clinical Nutrition and Metabolism (ESPEN) commenced in 2004 a global health project named "NutritionDay" aiming to promote awareness of proper nutritional status of hospitalized patients and to draw attention to the need for early detection of malnutrition among patients. Under the Polish law--pursunat to the regulation of the Minister of Health dated September 15, 2011 (amendment as of 27.12.2013)--a nutritional status of each patient should be assessed at the time of a hospital admission. of this study was to analyze the fulfilment of the mandatory questionnaire assessment of nutritional status at selected wards of one of Warsaw's clinical hospitals. The study included an analysis of medical records of patients hospitalized within 6 months (n = 26375). The correct fulfilment of screening questionnaire assessing nutritional status (NRS 2002 survey) and the information about patients' body weight as well as the results assessment of nutritional status were subject to the analysis. NRS 2002 questionnaire was present in only 67,14% medical records of patients, however 49.24% of them were unfilled. The obtained results confirming low degree of NRS 2002 questionnaires' fulfilment in one of the Warsaw clinical hospitals draws attention to the need for education of hospital personnel in the field of significance of screening of nutritional assessment and its regulations. The "NutritionDay" project is an interesting form to attract attention of the aforementioned problem and its global extent additionally encourage medical units to participate in the project.

  18. Types of treatment collaboration between conventional and alternative practitioners – results from a research project at a Danish MS hospital

    Directory of Open Access Journals (Sweden)

    Lasse Skovgaard

    2010-12-01

    Full Text Available Introduction: More than 50% of the People with Multiple Sclerosis (PwMS in Denmark use alternative treatment. Most of them combine alternative and conventional treatment, but PwMS often find that there is no dialogue, coordination or synergy between the parallel courses of treatment offered. For this reason the Danish Multiple Sclerosis Society conducted a research project to develop and examine different models for collaboration between conventional and alternative treatment providers. Materials and methods: Empirical material consist of individual interviews with practitioners, a group interview with practitioners, a group interview with professional staff at the Danish MS hospital that provided the organisational framework for the project, interviews with patients as well as written responses from participating treatment providers in connection with practitioner-researcher seminars held. Results: Collaboration between researchers and the treatment team resulted in the development examination of several models which describe the strengths and weaknesses of various types of collaboration. The models also show that the various types of collaboration place different requirements on the degree of 1 mutual acknowledgement and understanding among practitioners, 2 flexibility and resources in the organizational framework, and 3 patients' activities and own efforts, respectively.    Perspectives: The relationship between integration and pluralism can contribute to a fruitful discussion in regards to the value of treatment collaboration. In addition to the many positive perspectives the characterise integration of different treatment modalities the project points to the importance of not overlooking the opportunities, values and potential inherent in a pluralistic ideal in the form of patients' own active efforts and the dynamism that can arise when the patient becomes a co-informant, co-coordinator and/or co-integrator. 

  19. Types of treatment collaboration between conventional and alternative practitioners – results from a research project at a Danish MS hospital

    Directory of Open Access Journals (Sweden)

    Lasse Skovgaard

    2010-12-01

    Full Text Available Introduction: More than 50% of the People with Multiple Sclerosis (PwMS in Denmark use alternative treatment. Most of them combine alternative and conventional treatment, but PwMS often find that there is no dialogue, coordination or synergy between the parallel courses of treatment offered. For this reason the Danish Multiple Sclerosis Society conducted a research project to develop and examine different models for collaboration between conventional and alternative treatment providers. Materials and methods: Empirical material consist of individual interviews with practitioners, a group interview with practitioners, a group interview with professional staff at the Danish MS hospital that provided the organisational framework for the project, interviews with patients as well as written responses from participating treatment providers in connection with practitioner-researcher seminars held. Results: Collaboration between researchers and the treatment team resulted in the development examination of several models which describe the strengths and weaknesses of various types of collaboration. The models also show that the various types of collaboration place different requirements on the degree of 1 mutual acknowledgement and understanding among practitioners, 2 flexibility and resources in the organizational framework, and 3 patients' activities and own efforts, respectively.    Perspectives: The relationship between integration and pluralism can contribute to a fruitful discussion in regards to the value of treatment collaboration. In addition to the many positive perspectives the characterise integration of different treatment modalities the project points to the importance of not overlooking the opportunities, values and potential inherent in a pluralistic ideal in the form of patients' own active efforts and the dynamism that can arise when the patient becomes a co-informant, co-coordinator and/or co-integrator.

  20. Types of treatment collaboration between conventional and alternative practitioners-results from a research project at a Danish MS hospital.

    Science.gov (United States)

    Skovgaard, Lasse; Haahr, Niels; Bjerre, Liv; Launsø, Laila

    2010-12-23

    More than 50% of People with Multiple Sclerosis (PwMS) in Denmark use alternative treatment. Most of them combine alternative and conventional treatment, but PwMS often find that they engage in parallel courses of treatment between which there is no dialogue, coordination or synergy. For this reason the Danish Multiple Sclerosis Society conducted a research project to develop and examine different models for collaboration between conventional and alternative treatment providers. The empirical material consisted of 10 individual interviews with practitioners, a group interview with practitioners, a group interview with professional staff at the Danish Multiple Sclerosis hospital that provided the organisational framework for the project, interviews with 59 patients and written responses from participating treatment providers in connection with 29 practitioner-researcher seminars held during the period 2004-2010. Collaboration between researchers and the treatment team resulted in the development and examination of several models which describe the strengths and weaknesses of various types of collaboration. The models show that the various types of collaboration place different requirements on the degree of 1) mutual acknowledgement and understanding among practitioners and 2) flexibility and resources in the organizational framework. The analyses also point to the fact that the degree of patient activity must be considered in relation to a given type of collaboration. The relationship between integration and pluralism can contribute to a fruitful discussion in regards to the value of treatment collaboration. In addition to the many positive perspectives that characterise integration of different treatment modalities the project points to the importance of not overlooking the opportunities, values and potential inherent in a pluralistic ideal in the form of patients' own active efforts and the dynamism that can arise when the patient becomes a co-informant, co

  1. Fluid-bed combustion

    Energy Technology Data Exchange (ETDEWEB)

    Hunt, G.; Schoebotham, N.

    1981-02-01

    In Energy Equipment Company's two-stage fluidized bed system, partial combustion in a fluidized bed is followed by burn-off of the generated gases above the bed. The system can be retrofitted to existing boilers, and can burn small, high ash coal efficiently. It has advantages when used as a hot gas generator for process drying. Tests on a boiler at a Cadbury Schweppes plant are reported.

  2. Investigation of Fuel Chemistry and Bed Performance in a Fluidized Bed Black Liquor Steam Reformer

    Energy Technology Data Exchange (ETDEWEB)

    Kevin Whitty

    2007-06-30

    University of Utah's project entitled 'Investigation of Fuel Chemistry and Bed Performance in a Fluidized Bed Black Liquor Steam Reformer' (DOE Cooperative Agreement DE-FC26-02NT41490) was developed in response to a solicitation released by the U.S. Department of Energy in December 2001, requesting proposals for projects targeted towards black liquor/biomass gasification technology support research and development. Specifically, the solicitation was seeking projects that would provide technical support for Department of Energy supported black liquor and biomass gasification demonstration projects under development at the time.

  3. The effect of hospital organizational characteristics on postoperative complications.

    Science.gov (United States)

    Knight, Margaret

    2013-12-01

    To determine if there is a relationship between the risk of postoperative complications and the nonclinical hospital characteristics of bed size, ownership structure, relative urbanicity, regional location, teaching status, and area income status. This study involved a secondary analysis of 2006 administrative hospital data from a number of U.S. states. This data, gathered annually by the Agency for Healthcare Research and Quality (AHRQ) via the National Inpatient Sample (NIS) Healthcare Utilization Project (HCUP), was analyzed using probit regressions to measure the effects of several nonclinical hospital categories on seven diagnostic groupings. The study model included postoperative complications as well as additional potentially confounding variables. The results showed mixed outcomes for each of the hospital characteristic groupings. Subdividing these groupings to correspond with the HCUP data analysis allowed a greater understanding of how hospital characteristics' may affect postoperative outcomes. Nonclinical hospital characteristics do affect the various postoperative complications, but they do so inconsistently.

  4. MARKETING MIX BY BED OCCUPANCY RATIO (BOR

    Directory of Open Access Journals (Sweden)

    Abdul Muhith

    2017-04-01

    Full Text Available Introduction: Bed Occupancy Ratio (BOR in RSI Arafah Mojosari during the last three years are at under ideal rate and the lowest of the three existing hospitals in the area of Mojosari. The purpose of this study was to determine the relationship marketing mix with Bed Occupancy Ratio in RSI Arafah Mojosari. Methods: This research uses analytic methods with crossectional approach. Variables in the study is marketing mix and Bed Occupancy Ratio (BOR. The population in this study were all patients hospitalized in the RSI Arafah Mojosari. Samples amounted 44 respondents taken by the Stratified random sampling technique. Data were collected using the questionnaire and analyzed using Fisher's Exact test. Result: The results obtained more than 50% of respondents (59.1% rate well against the marketing mix is developed by the hospital management and the majority of respondents (79.5% are in the treatment room that has a number BOR is not ideal. Fisher Exact test test results obtained probabililty value=0.02<0.05 so that H0 is rejected, which means there is a relationship marketing mix with the Bed Occupancy Ratio in RSI Arafah Mojosari. Discussion: Hospitals which able to develop the marketing mix very well, can attract consumers to use inpatient services at the hospital, with that BOR value will increase as the increased use of inpatient services. Hospital management must be able to formulate a good marketing mix strategy that hospital marketing objectives can be achieved. Conformity between service quality and service rates must be addressed, otherwise it extent of media promotions can attract patients to inpatient services.

  5. Research report of FY 1997 on the environmentally acceptable coal utilization system introduction support project. Demonstration project of circulating fluidized bed boiler (Jinzhou Coal-Thermal Power Corporation); 1997 nendo seika hokokusho (kankyo chowagata sekitan riyo system donyu shien jigyo). Junkan ryudosho boiler ni kakawaru jissho jigyo (Jinzhou netsuden sokoji)

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1998-03-01

    To verify the clean coal technology to be diffused in China and consolidate its diffusion basis, demonstration project of circulating fluidized bed boiler was conducted through the cooperation with China which is positive in its introduction. This report describes its characteristics. Coal and limestone are supplied in a lower part of combustion chamber, and are mixed with circulating ash by fluidized air for combustion. Densely fluidized bed the same as the bubbling fluidized bed is formed in the lower part of combustion chamber, which provides excellent stability in ignition and combustion. Particles including ash, char and limestone formed during the combustion are discharged into the cyclone through the convection heat transfer part at the outlet of combustion chamber with the combustion gas flow. Since the gas temperature is lowered to 400 to 500degC at the convection heat transfer part, troubles of the ash circulating system can be prevented. The combustion gas separated from ash at the cyclone is discharged through the heat exchanger and precipitator, and the collected ash is returned to the lower part of combustion chamber. In FY 1997, design, fabrication, procurement/inspection, field survey/meeting, survey of visitors/meeting, and education were carried out. 4 figs., 4 tabs.

  6. A community hospital's journey into Lean Six Sigma.

    Science.gov (United States)

    Stuenkel, Kurt; Faulkner, Taunya

    2009-01-01

    The implementation of Lean Six Sigma and 100-day workouts throughout the 304-bed Floyd Medical Center community hospital organization has led to sustainable results and a marked change in culture. The organization-wide learning of such an effort is deep and intehse, and to remain focused and successful it must be a priority of top management. The workout methodology can assist the organization to carry projects to completion and to achieve rapid implementation of desired improvements.

  7. Fluidized bed incinerator development

    International Nuclear Information System (INIS)

    Ziegler, D.L.; Johnson, A.J.

    1976-01-01

    A fluidized bed incinerator is being developed for burning rad contaminated solid and liquid waste materials. In situ neutralization of acid gases by the bed material, catalytic afterburning, and gas filtration are used to produce a clean flue gas without the use of aqueous scrubbing

  8. The project of the technological line of the electronic-beam drains disinfection in the infected hospitals' divisions and tubercular centres

    International Nuclear Information System (INIS)

    Shlapatska, V.V.; Volkonsky, V.G.; Sakhno, V.I.; Tomchaj, S.P.

    1999-01-01

    The purpose of the project was to create the electrophysical facility for the environmental protection from contamination by drains of the infected hospitals' divisions and tubercular centres and prevention of open water reservoirs. Development of the economically approved methods of the radiative disinfection of contaminated drains; development of the inexpensive compact facility for the electron-beam disinfection of small volume drains

  9. Radiotherapy and Nuclear Medicine Project for an Integral Oncology Center at the Oaxaca High Specialization Regional Hospital

    International Nuclear Information System (INIS)

    De Jesus, M.; Trujillo-Zamudio, F. E.

    2010-01-01

    A building project of Radiotherapy and Nuclear Medicine services (diagnostic and therapy), within an Integral Oncology Center (IOC), requires interdisciplinary participation of architects, biomedical engineers, radiation oncologists and medical physicists. This report focus on the medical physicist role in designing, building and commissioning stages, for the final clinical use of an IOC at the Oaxaca High Specialization Regional Hospital (HRAEO). As a first step, during design stage, the medical physicist participates in discussions about radiation safety and regulatory requirements for the National Regulatory Agency (called CNSNS in Mexico). Medical physicists propose solutions to clinical needs and take decisions about installing medical equipment, in order to fulfill technical and medical requirements. As a second step, during the construction stage, medical physicists keep an eye on building materials and structural specifications. Meanwhile, regulatory documentation must be sent to CNSNS. This documentation compiles information about medical equipment, radioactivity facility, radiation workers and nuclear material data, in order to obtain the license for the linear accelerator, brachytherapy and nuclear medicine facilities. As a final step, after equipment installation, the commissioning stage takes place. As the conclusion, we show that medical physicists are essentials in order to fulfill with Mexican regulatory requirements in medical facilities.

  10. The "El Alamo" project (1990-1997): two consecutive hospital-based studies of breast cancer outcomes in Spain.

    Science.gov (United States)

    Martín, M; Mahillo, E; Llombart-Cussac, A; Lluch, A; Munarriz, B; Pastor, M; Alba, E; Ruiz, A; Antón, A; Bermejo, B

    2006-07-01

    The "Alamo" project is a retrospective analysis of 14,854 patients diagnosed of breast cancer between 1990 and 1997 in 50 Spanish hospitals. Alamo I (AI) consisted of 4,532 patients diagnosed with breast cancer between 1990 and 1993. Data were collected in 2000. Alamo II (AII) consisted of 10,322 patients diagnosed between 1994 and 1997. Data were collected in 2003. At presentation, there were (AI vs. AII) 17.6% vs. 24.3% at stage I; 55.5% vs. 53.1% at stage II; 18.7% vs. 15% at stage III; 7.2% vs. 5.9 at stage IV. Median age was 57 (AI) vs. 58 years (AII) and 65.9% vs. 67.2% (AI vs. AII) were post-menopausal. Firstline treatment for disease stages I, II and III was surgery in 91% of patients in both studies. Breast conserving surgery rate increased from 20.2% (AI) to 32.7% (AII). Adjuvant systemic treatments were administered to 87.6% (AI) and 92.8% (AII) of patients. Recurrence rate diminished from 36.6% (AI) to 22.5% (AII) and the 9-year survival rate increased from 63.2% (95% CI: 61.5-64.9) to 70.1% (95% CI: 68.5-71.8). Breast cancer outcomes in Spain have improved from 1990-1993 to 1994-1997, likely because of breast cancer screening program implementation and new therapies.

  11. A European benchmarking system to evaluate in-hospital mortality rates in acute coronary syndrome: the EURHOBOP project.

    Science.gov (United States)

    Dégano, Irene R; Subirana, Isaac; Torre, Marina; Grau, María; Vila, Joan; Fusco, Danilo; Kirchberger, Inge; Ferrières, Jean; Malmivaara, Antti; Azevedo, Ana; Meisinger, Christa; Bongard, Vanina; Farmakis, Dimitros; Davoli, Marina; Häkkinen, Unto; Araújo, Carla; Lekakis, John; Elosua, Roberto; Marrugat, Jaume

    2015-03-01

    Hospital performance models in acute myocardial infarction (AMI) are useful to assess patient management. While models are available for individual countries, mainly US, cross-European performance models are lacking. Thus, we aimed to develop a system to benchmark European hospitals in AMI and percutaneous coronary intervention (PCI), based on predicted in-hospital mortality. We used the EURopean HOspital Benchmarking by Outcomes in ACS Processes (EURHOBOP) cohort to develop the models, which included 11,631 AMI patients and 8276 acute coronary syndrome (ACS) patients who underwent PCI. Models were validated with a cohort of 55,955 European ACS patients. Multilevel logistic regression was used to predict in-hospital mortality in European hospitals for AMI and PCI. Administrative and clinical models were constructed with patient- and hospital-level covariates, as well as hospital- and country-based random effects. Internal cross-validation and external validation showed good discrimination at the patient level and good calibration at the hospital level, based on the C-index (0.736-0.819) and the concordance correlation coefficient (55.4%-80.3%). Mortality ratios (MRs) showed excellent concordance between administrative and clinical models (97.5% for AMI and 91.6% for PCI). Exclusion of transfers and hospital stays ≤1day did not affect in-hospital mortality prediction in sensitivity analyses, as shown by MR concordance (80.9%-85.4%). Models were used to develop a benchmarking system to compare in-hospital mortality rates of European hospitals with similar characteristics. The developed system, based on the EURHOBOP models, is a simple and reliable tool to compare in-hospital mortality rates between European hospitals in AMI and PCI. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  12. Managing prices for hospital pharmaceuticals: a successful strategy for New Zealand?

    Science.gov (United States)

    Tordoff, June M; Norris, Pauline T; Reith, David M

    2005-01-01

    In 2002, as part of a National Hospital Pharmaceutical Strategy, the New Zealand (NZ) government agency PHARMAC commenced a 3-year period of negotiating prices for 90% of hospital pharmaceuticals on behalf of all NZ public hospitals. The present study was undertaken to determine the effects of this first year of "pooled procurement." Using price changes and volume data for each of their top 150 pharmaceutical items, chief pharmacists at 11 public hospitals calculated projected cost savings for the financial year July 2003 to June 2004. Researchers calculated total projected savings for all 11 hospitals, and for three types of hospitals. Estimates of projected savings were made for all 29 major public hospitals by using savings per bed and savings per bed-day. A sensitivity analysis was undertaken. Items showing savings were categorized by using the Anatomical Therapeutic Chemical classification system. For the 11 hospitals, the top 150 items comprised 612 different items. Projected savings for 2003 to 2004 were NZ dollar 2,652,814, NZ dollar 658,984, and NZ dollar 127,952 for tertiary, secondary, and rural/special hospitals, respectively. Percentage savings as a median (range) of the total top 150 expenditure were: tertiary 5.28% (3.09-16.05%), secondary 7.41% (4.67-12.85%), and rural/special 9.55% (6.27-10.09%). For all 29 hospitals, estimated projected savings were NZ dollar 5,234,919 (NZ dollar 3,304,606-NZ dollar 8,044,482) by savings per bed, and NZ dollar 5,255,781 (NZ dollar 2,936,850-NZ dollar 8,693,239) by savings per bed-day. The main contributors to savings were: agents for infections, the nervous system, musculoskeletal system, and blood/blood-forming organs. The first year of pooled procurement under the National Hospital Pharmaceutical Strategy (2002-2003) has resulted in moderate savings. For all 29 major public hospitals, savings of around NZ dollar 5.2 million (dollar 2.9 million-dollar 8.7 million) or 3.7% were projected for 2003 to 2004. Longer

  13. FY 2000 report on the survey project on potentiality of the environmental harmony coal utilization system. Potential study of the circulating fluidized bed boiler model project in Vietnam; 2000 nendo kankyo chowagata sekitan riyo system kanosei chosa jigyo hokokusho. Vietnam ni okeru junkan ryudosho boiler model jigyo jisshi kanosei chosa

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2001-03-01

    In Vietnam, survey was conducted of the project in which the adoption of circulating fluidized bed boiler (CFB) makes energy conservation and greenhouse effect gas reduction possible. CFB makes a marked decrease in SOx emission possible by using limestone as combustion bed material. As a result of the survey, the thermal power plant was not suitable for the model project due to its large size. However, it was found that two cement plants and one fiber plant having coal-fired boiler were suitable for survey. Nghi Son and Bim Son cement plants are typical cement plants in Vietnam. As a result of the hearing, they were eager to adopt CFB equipment. As to environmental improvement effects, in the thermal power plant with power source loads, emissions of SOx and NOx can be reduced by 79.0% and 72.5%, respectively. Further, in Nam Dinh Textile Company, emissions of SOx and NOx can be reduced by 79.8% and 84.6%, respectively, in case of converting boiler from the existing stoker boiler to CFB boiler. (NEDO)

  14. Introducing DRG-based financing in Hungary: a study into the relationship between supply of hopsital beds and use of these beds under changing instituonal circumstances.

    NARCIS (Netherlands)

    Kroneman, M.; Nagy, J.

    2001-01-01

    Most hospital reforms carried out in Europe over the past few decades concern the supply of hospital beds and hospital financing systems. In Hungary, financing was not tied to hospital input or output until a Diagnosis-Related-Group system was introduced. This change provided an opportunity to study

  15. Joyful and serious intentions in the work of hospital clowns: A meta-analysis based on a 7-year research project conducted in three parts

    Directory of Open Access Journals (Sweden)

    Lotta Linge

    2013-01-01

    Full Text Available The present meta-analysis focuses on a 7-year research project entitled “Hospital clowns—in encounters with ailing children” and funded by the Swedish Childhood Cancer Foundation. The aim of the meta-analysis, which is based on the project's three studies, was to attempt to achieve a deeper psychological and more nuanced understanding of the unique encounters taking place between the hospital clowns and ailing children in the study. The methodological procedures were qualitative and included 51 interviews with four informant groups: the clowns, staff, children, and their parents. The meta-analysis revealed the unique aspects of hospital clowns’ work with respect to: a a quality of care that transcends boundaries, that is, a magical safe area where demands and adjustment were temporarily set aside and where the lighter side of life took precedence; b a non-demanding quality of care, where joy could be experienced without requiring something in return, where the child's terms mattered and where the child perspective was clearly in focus; and c a defusing quality of care, which is expressed as a positive counterweight that was otherwise lacking in medical care, where the hospital clowns used different solutions that bypassed regular hospital routines by temporarily distracting and making things easier for the children, parents, and staff in various care situations. Finally, the aim of the theoretical framework, in its synthesizing form, was to promote further psychological understanding of the area of humor that exists between fantasy and reality—an intermediate or transitional area that the hospital clowns created together with the children. In this transitional area, the hospital clowns’ unique contribution can be interpreted, in psychological terms, as being available as a vicarious therapeutic clown figure in a magical world that parallels reality.

  16. Bed Bugs FAQs

    Science.gov (United States)

    ... Europe. Bed bugs have been found in five-star hotels and resorts and their presence is not ... Health – Division of Parasitic Diseases Email Recommend Tweet YouTube Instagram Listen Watch RSS ABOUT About CDC Jobs ...

  17. Bed Bug Information Clearinghouse

    Science.gov (United States)

    Its purpose is to help states, communities, and consumers in efforts to prevent and control bed bug infestations. Currently includes only reviewed material from federal/state/local government agencies, extension services, and universities.

  18. Particle fuel bed tests

    International Nuclear Information System (INIS)

    Horn, F.L.; Powell, J.R.; Savino, J.M.

    1985-01-01

    Gas-cooled reactors, using packed beds of small diameter coated fuel particles have been proposed for compact, high-power systems. The particulate fuel used in the tests was 800 microns in diameter, consisting of a thoria kernel coated with 200 microns of pyrocarbon. Typically, the bed of fuel particles was contained in a ceramic cylinder with porous metallic frits at each end. A dc voltage was applied to the metallic frits and the resulting electric current heated the bed. Heat was removed by passing coolant (helium or hydrogen) through the bed. Candidate frit materials, rhenium, nickel, zirconium carbide, and zirconium oxide were unaffected, while tungsten and tungsten-rhenium lost weight and strength. Zirconium-carbide particles were tested at 2000 K in H 2 for 12 hours with no visible reaction or weight loss

  19. [Project for the Creation of a Medical or Hospital Ethical Committee at a Local Level in the San Miguel Arcangel Hospital, District of San Miguelito, Province of Panama. Year 2013].

    Science.gov (United States)

    Díaz Rivera, Yashiro A

    2015-01-01

    The next project was based on the design on the creation of a medical ethical Committee at a hospital. It was developed at the San Miguel Arcangel Hospital, District of San Miguelito, Province of Panama, in 2013. Insomuch as the creation of social projects requires unified international parameters, format is taken from the Unesco's guides for the establishing and working of bioethics committees; adapted to the socio-economic, political and cultural context of the San Miguelito District, Panama Province. Furthermore to adapting to socio-ecological aspect where the research project is carried out, the theoretical aspect includes from the ontological personalistic bioethics, where the cornerstone is the dignity of the human person. A study of perceptions of medical staff and nursing was developed on the management of the most common ethical dilemmas in the Hospital San Miguel Arcángel. The instrument used was a previously validated perception survey through a pilot test. Reliability was measured using Cronbach's alpha coefficient, and validity was obtained from the content. Satisfactory statistical results, that verify the working hypotheses on the recognition of the importance of autonomy, confidentiality, protection of vulnerable population, occupational health staff welfare and integration of bioethics at the institutional agenda, were obtained. However, there were particular aspects that indicate some doubt as to the management of some realities that are presented in the context of health care.

  20. How dynamic are ice-stream beds?

    Science.gov (United States)

    Davies, Damon; Bingham, Robert G.; King, Edward C.; Smith, Andrew M.; Brisbourne, Alex M.; Spagnolo, Matteo; Graham, Alastair G. C.; Hogg, Anna E.; Vaughan, David G.

    2018-05-01

    Projections of sea-level rise contributions from West Antarctica's dynamically thinning ice streams contain high uncertainty because some of the key processes involved are extremely challenging to observe. An especially poorly observed parameter is sub-decadal stability of ice-stream beds, which may be important for subglacial traction, till continuity and landform development. Only two previous studies have made repeated geophysical measurements of ice-stream beds at the same locations in different years, but both studies were limited in spatial extent. Here, we present the results from repeat radar measurements of the bed of Pine Island Glacier, West Antarctica, conducted 3-6 years apart, along a cumulative ˜ 60 km of profiles. Analysis of the correlation of bed picks between repeat surveys shows that 90 % of the bed displays no significant change despite the glacier increasing in speed by up to 40 % over the last decade. We attribute the negligible detection of morphological change at the bed of Pine Island Glacier to the ubiquitous presence of a deforming till layer, wherein sediment transport is in steady state, such that sediment is transported along the basal interface without inducing morphological change to the radar-sounded basal interface. Given the precision of our measurements, the upper limit of subglacial erosion observed here is 500 mm a-1, far exceeding erosion rates reported for glacial settings from proglacial sediment yields, but substantially below subglacial erosion rates of 1.0 m a-1 previously reported from repeat geophysical surveys in West Antarctica.

  1. Increasing podiatry referrals for patients with inflammatory arthritis at a tertiary hospital in Singapore: A quality improvement project.

    Science.gov (United States)

    Carter, K; Cheung, P P; Rome, K; Santosa, A; Lahiri, M

    2017-06-01

    Foot disease is highly prevalent in people with inflammatory arthritis and is often under-recognized. Podiatry intervention can significantly reduce foot pain and disability, with timely access being the key factor. The aim of this study was to plan and implement a quality improvement project to identify the barriers to, and improve, uptake of podiatry services among patients with inflammatory arthritis-related foot problems seen at a tertiary hospital in Singapore. A 6-month quality improvement program was conducted by a team of key stakeholders using quality improvement tools to identify, implement and test several interventions designed to improve uptake of podiatry services. The number of patients referred for podiatry assessment was recorded on a weekly basis by an experienced podiatrist. The criterion for appropriate referral to podiatry was those patients with current or previous foot problems such as foot pain, swelling and deformity. Interventions included education initiatives, revised workflow, development of national guidelines for inflammatory arthritis, local podiatry guidelines for the management of foot and ankle problems, routine use of outcome measures, and introduction of a fully integrated rheumatology-podiatry service with reduced cost package. Referral rates increased from 8% to 11%, and were sustained beyond the study period. Complete incorporation of podiatry into the rheumatology consultation as part of the multidisciplinary team package further increased referrals to achieve the target of full uptake of the podiatry service. Through a structured quality improvement program, referrals to podiatry increased and improved the uptake and acceptance of rheumatology-podiatry services. Copyright © 2016 Elsevier Ltd. All rights reserved.

  2. Basic survey project for joint implementation. Feasibility study for the diffusion of fluidized bed cement kiln system in China; 1998 nendo kyodo jisshi nado suishin kiso chosa. Chugoku ni okeru ryudosho cement kirun fukyu chosa

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1999-03-01

    Discussions were given on conversion of shaft kilns mainly used at Tianjin Cement and Huaxin Cement to the fluidized bed cement kiln of the most advanced type. Possibility of energy conservation in China, that is reduction of carbon dioxide emission, was evaluated. This system has been developed by the Center for Coal Utilization, Japan. The system is characterized by reduction of greenhouse effect gas emission, elimination of the problem of dust scattering from sintering facilities, stabilized production of high-quality clinker, capability of using low-grade coal and anthracite, and reduction of cement production cost. As a result of the discussions, the reduction rate of greenhouse effect gases was found about 17 to 33%. The cost effect may be calculated as 2 to 5 thousand yen per ton of CO2 reduction amount assuming the system life of 20 years. If this process has been diffused into China, the quantity of CO2 to be reduced will reach about four million tons annually assuming a diffusion rate of 10%. This project shows as high profitability as about 20% at IRR, and the system is more advantageous economically than the shaft kiln. (NEDO)

  3. Bubble Swarm Rise Velocity in Fluidized Beds.

    Czech Academy of Sciences Publication Activity Database

    Punčochář, Miroslav; Růžička, Marek; Šimčík, Miroslav

    2016-01-01

    Roč. 152, OCT 2 (2016), s. 84-94 ISSN 0009-2509 R&D Projects: GA ČR(CZ) GA15-05534S Institutional support: RVO:67985858 Keywords : bubbling fluidized bed * gas-solid * bubble swarm velocity Subject RIV: CI - Industrial Chemistry, Chemical Engineering Impact factor: 2.895, year: 2016

  4. Experimental Study of the Flooding and Appearance of a Bubble Bed on Top of a Countercurrent Packed-Bed Column

    Czech Academy of Sciences Publication Activity Database

    Jiřičný, Vladimír; Staněk, Vladimír; Svoboda, Petr; Ondráček, Jakub

    2001-01-01

    Roč. 40, č. 1 (2001), s. 407-412 ISSN 0888-5885 R&D Projects: GA ČR GA203/97/1174 Institutional research plan: CEZ:AV0Z4072921 Keywords : appearance * bubble-bed * packed bed column Subject RIV: CI - Industrial Chemistry, Chemical Engineering Impact factor: 1.351, year: 2001

  5. A Hospital Nursing Adverse Events Reporting System Project: An Approach Based on the Systems Development Life Cycle.

    Science.gov (United States)

    Cao, Yingjuan; Ball, Marion

    2017-01-01

    Based on the System Development Life Cycle, a hospital based nursing adverse event reporting system was developed and implemented which integrated with the current Hospital Information System (HIS). Besides the potitive outcomes in terms of timeliness and efficiency, this approach has brought an enormous change in how the nurses report, analyze and respond to the adverse events.

  6. Energy Saving by Novel Bed-Integrated Local Exhaust Ventilation

    DEFF Research Database (Denmark)

    Bivolarova, Mariya Petrova; Kehayova, Nushka; Melikov, Arsen Krikor

    2016-01-01

    High quality indoor environment in hospitals is important for patients’ healing and performance of the personnel. A novel method for minimizing spread of bio-effluents generated from hospitalized patients lying in bed was developed. The method consists of ventilated mattress (VM) which is able...... respectively with 55%, 71.1% and 85.9% and in the double room with 39.3%, 60.0%, and 80.4%. The use of the VM with reduced background CAV ventilation is an effective energy saving strategy for both double and single patient hospital rooms.......-bed hospital patient room (1.3 air changes per hour (ACH)) and double-bed patient room (1.6 ACH) was assessed by means of dynamic computer simulations. The estimated annual energy consumption for the rooms using the VM combined with CAV was compared to the annual energy consumption when the CAV ventilation...

  7. Risk analysis using AS/NZS 4360:2004, Bow-Tie diagram and ALARP on construction projects of Banyumanik Hospital

    Science.gov (United States)

    Sari, Diana Puspita; Pujotomo, Darminto; Wardani, Nadira Kusuma

    2017-11-01

    The Determination of risk is an uncertain event. Risks can have negative or positive impacts on project objectives. A project was defined as a series of activities and tasks that have a purpose, specifications, and limits of cost. Banyumanik Hospital Development Project is one of the construction projects in Semarang which have experienced some problems. The first problem is project delays on building stake. The second problem is delay of material supply. Finally, the problem that occurs is less management attention to health safety as evidenced by the unavailability of PPE for the workers. These problems will pose a risk to be a very important risk management performed by contractors at the Banyumanik Hospital Development Project to reduce the impact that would be caused by the risk borne by the provider of construction services. This research aim to risk identification, risk assessment and risk mitigation. Project risk management begins with the identification of risks based on the project life cycle. The risk assessment carried out by AS I NZS 4360: 2004 to the impacts of cost, time and quality. The results obtained from the method of AS I NZS 4360: 2004 is the risk that requires the handling of mitigation. Mitigated risk is the risk that had significant and high level. There are four risks that require risk mitigation with Bow-Tie diagrams which is work accidents, contract delays, material delays and design changes. Bow-Tie diagram method is a method for identifying causal and preventive action and recovery of a risk. Results obtained from Bow-Tie diagram method is a preventive action and recovery. This action is used as input to the ALARP method. ALARP method is used to determine the priority of the strategy proposed in the category broadly acceptable, tolerable, and unacceptable.

  8. Discussion on the environmental protection acceptance method and the critical issues of the completion of projects about radiation usage in the hospitals

    International Nuclear Information System (INIS)

    Wang Wei

    2014-01-01

    It is widely used in the world that the hospitals take advantages of radiation technology. Practically it is involved radioactive isotope, sealed source and the usage of ray device. Based on the environmental protection acceptance of the finished projects, this article is aimed at the actual characteristics of the medical practice and differentiating the major factors of environmental effects, choosing the monitoring criteria and method of environmental protection acceptance and exploring the critical issues in the course of acceptance. Finally this essay is intended to provide theory evidence and technical support in the acceptance of the above projects. (author)

  9. Effect of bed particles to combustion of gases in fluidized bed

    Energy Technology Data Exchange (ETDEWEB)

    Raiko, R.; Wallen, V.; Etelaeaho, R.; Correia, S. [Tampere Univ. of Technology (Finland). Energy and Process Engineering

    1997-10-01

    The objective of this project was to obtain experimental data on effects of sand particles to the combustion of gases. The effect of the surface area of the particles was tested using different sized particles. The fluidized bed reactor used in these experiments was a stainless-steel tube with an internal diameter of 42 mm surrounded by an electric heater. The test rig was built in the Laboratory of Energy and Process Engineering at Tampere University of Technology. In order to elucidate the possible changes of particle surface, microscopic and porosimetric studies were conducted with both fresh bed particles and used bed particles. These measurements indicate that carbon monoxide significantly reacts with oxygen in the particulate or emulsion phase of a fluidized bed, if the residence time is long enough. The reaction rate depends mainly on temperature, air coefficient, residence time and particle size of the solids. It seems that the combustion enhances if the average particle size increases. Whether this is caused by increased free path length or reduced specific surface area of the bed is yet unknown. The first might be more probable cause because the majority of reactions often took place in the freeboard right above the bed. It was clear that the bed hindered proper combustion in several cases. (orig.)

  10. Projectables

    DEFF Research Database (Denmark)

    Rasmussen, Troels A.; Merritt, Timothy R.

    2017-01-01

    CNC cutting machines have become essential tools for designers and architects enabling rapid prototyping, model-building and production of high quality components. Designers often cut from new materials, discarding the irregularly shaped remains. We introduce ProjecTables, a visual augmented...... reality system for interactive packing of model parts onto sheet materials. ProjecTables enables designers to (re)use scrap materials for CNC cutting that would have been previously thrown away, at the same time supporting aesthetic choices related to wood grain, avoiding surface blemishes, and other...... relevant material properties. We conducted evaluations of ProjecTables with design students from Aarhus School of Architecture, demonstrating that participants could quickly and easily place and orient model parts reducing material waste. Contextual interviews and ideation sessions led to a deeper...

  11. Hospitals, The featured data collection is the USGS-LAGIC Coastal Parishes Structures Project. This ongoing project was started in 2009 with the intent to map critical infrastructure in the Coastal Zone. The initial four parishes included Lafourche, Plaquemine, St. , Published in 2011, 1:12000 (1in=1000ft) scale, LSU Louisiana Geographic Information Center (LAGIC).

    Data.gov (United States)

    NSGIC Education | GIS Inventory — Hospitals dataset current as of 2011. The featured data collection is the USGS-LAGIC Coastal Parishes Structures Project. This ongoing project was started in 2009...

  12. Hospitals, The featured data collection is the USGS-LAGIC Coastal Parishes Structures Project. This ongoing project was started in 2009 with the intent to map critical infrastructure in the Coastal Zone. The initial four parishes included Lafourche, Plaquemine, St., Published in 2011, 1:12000 (1in=1000ft) scale, LSU Louisiana Geographic Information Center (LAGIC).

    Data.gov (United States)

    NSGIC Education | GIS Inventory — Hospitals dataset current as of 2011. The featured data collection is the USGS-LAGIC Coastal Parishes Structures Project. This ongoing project was started in 2009...

  13. [Work setting, satisfaction and burnout of the nurses in critical care units and hospitalization units. RN4CAST-Spain project].

    Science.gov (United States)

    Fuentelsaz-Gallego, C; Moreno-Casbas, T; Gómez-García, T; González-María, E

    2013-01-01

    To know if there are differences between the critical care units and the medical-surgical care units regarding the perception of the nurses working in National Health System hospitals about their work environment, burnout level and job satisfaction. A cross-sectional study was conducted with 6,417 nurses from the medical-surgical care units and with 1,122 nurses from critical care units of 59 Spanish hospitals with more than 150 beds. Socio-demographic, job satisfaction, perception of work environment (Practice Environment Scale of the Nursing Work Index [PES-NWI questionnaire]) and burnout measured with the Maslach Burnout Inventory (MBI) data were collected. The PES-NWI showed differences in 4 out of its 5 factors. It showed better values in medical-surgical units in all the factors, except for Staffing and resource adequacy (P<.001), where critical care units showed a mean level of agreement of 2.41 versus 2.19 for the medical-surgical units. Regarding burnout, this was higher in the medical-surgical care units (P=.039) where 23% (952) of the nurses had high levels. Job satisfaction was lower in the critical care units (P=.044) with 70% (578) of nurses being very or strongly satisfied. The opinion of the nurses, working in critical care units about their hospital is unfavorable. They showed lower levels of burnout than those working in medical-surgical units. Copyright © 2013 Elsevier España, S.L. y SEEIUC. All rights reserved.

  14. Pebble-bed reactor

    International Nuclear Information System (INIS)

    Lohnert, G.; Mueller-Frank, U.; Heil, J.

    1976-01-01

    A pebble-bed nuclear reactor of large power rating comprises a container having a funnel-shaped bottom forming a pebble run-out having a centrally positioned outlet. A bed of downwardly-flowing substantially spherical nuclear fuel pebbles is positioned in the container and forms a reactive nuclear core maintained by feeding unused pebbles to the bed's top surface while used or burned-out pebbles run out and discharge through the outlet. A substantially conical body with its apex pointing upwardly and its periphery spaced from the periphery of the container spreads the bottom of the bed outwardly to provide an annular flow down the funnel-shaped bottom forming the runout, to the discharge outlet. This provides a largely constant downward velocity of the spheres throughout the diameter of the bed throughout a substantial portion of the down travel, so that all spheres reach about the same burned-out condition when they leave the core, after a single pass through the core area

  15. Fluidised bed heat exchangers

    International Nuclear Information System (INIS)

    Elliott, D.E.; Healey, E.M.; Roberts, A.G.

    1974-01-01

    Problems that have arisen during the initial stages of development of fluidised bed boilers in which heat transfer surfaces are immersed in fluidised solids are discussed. The very high heat transfer coefficients that are obtained under these conditions can be exploited to reduce the total heat transfer surface to a fraction of that in normal boilers. However, with the high heat flux levels involved, tube stressing becomes more important and it is advantageous to use smaller diameter tubes. One of the initial problems was that the pumping power absorbed by the fluidised bed appeared to be high. The relative influence of the fluidising velocity (and the corresponding bed area), tube diameter, tube spacing, heat transfer coefficient and bed temperature on pumping power and overall cost was determined. This showed the importance of close tube packing and research was undertaken to see if this would adversely affect the heat transfer coefficient. Pressure operation also reduces the pumping power. Fouling and corrosion tests in beds burning coal suggest that higher temperatures could be reached reliably and cost studies show that, provided the better refractory metals are used, the cost of achieving higher temperatures is not unduly high. It now remains to demonstrate at large scale that the proposed systems are viable and that the methods incorporated to overcome start up and part lead running problems are satisfactory. The promising role of these heat transfer techniques in other applications is briefly discussed

  16. Obstacles to implementation of an intervention to improve surgical services in an Ethiopian hospital: a qualitative study of an international health partnership project.

    Science.gov (United States)

    Aveling, Emma-Louise; Zegeye, Desalegn Tegabu; Silverman, Michael

    2016-08-17

    Access to safe surgical care represents a critical gap in healthcare delivery and development in many low- and middle-income countries, including Ethiopia. Quality improvement (QI) initiatives at hospital level may contribute to closing this gap. Many such quality improvement initiatives are carried out through international health partnerships. Better understanding of how to optimise quality improvement in low-income settings is needed, including through partnership-based approaches. Drawing on a process evaluation of an intervention to improve surgical services in an Ethiopian hospital, this paper offers lessons to help meet this need. We conducted a qualitative process evaluation of a quality improvement project which aimed to improve access to surgical services in an Ethiopian referral hospital through better management. Data was collected longitudinally and included: 66 in-depth interviews with surgical staff and project team members; observation (135 h) in the surgery department and of project meetings; project-related documentation. Thematic analysis, guided by theoretical constructs, focused on identifying obstacles to implementation. The project largely failed to achieve its goals. Key barriers related to project design, partnership working and the implementation context, and included: confusion over project objectives and project and partner roles and responsibilities; logistical challenges concerning overseas visits; difficulties in communication; gaps between the time and authority team members had and that needed to implement and engage other staff; limited strategies for addressing adaptive-as opposed to technical-challenges; effects of hierarchy and resource scarcity on QI efforts. While many of the obstacles identified are common to diverse settings, our findings highlight ways in which some features of low-income country contexts amplify these common challenges. We identify lessons for optimising the design and planning of quality improvement

  17. A Study to Determine if Ethics Committees Should be a Decision-Making and Review Mechanism for Matters Relating to No-Code Orders in the Continental United States Army Medical Department Hospitals with over One Hundred Total Operating Beds

    Science.gov (United States)

    1984-08-01

    their role in the hospital. The book Megatrends points out that there are six States which set the pace for national trends. One of these is California...care hospitals but two. Again, one must recall what the book Megatrends says about California and national trends. Another key according to this study...Catholic Hospitals," Ethics Committees Newsletter, Vol 1, No. 2, November 1983, p. 2. 7. R. Veatch, Death, PyiLn and the Biological Revolution, New Haven

  18. Comparison of tissue plasminogen activator administration management between Telestroke Network hospitals and academic stroke centers: the Telemedical Pilot Project for Integrative Stroke Care in Bavaria/Germany.

    Science.gov (United States)

    Audebert, Heinrich J; Kukla, Christian; Vatankhah, Bijan; Gotzler, Berthold; Schenkel, Johannes; Hofer, Stephan; Fürst, Andrea; Haberl, Roman L

    2006-07-01

    Systemic thrombolysis is the only therapy proven to be effective for ischemic stroke. Telemedicine may help to extend its use. However, concerns remain whether management and safety of tissue plasminogen activator (tPA) administration after telemedical consultation are equivalent in less experienced hospitals compared with tPA administration in academic stroke centers. During the second year of the ongoing Telemedical Pilot Project for Integrative Stroke Care, all systemic thrombolyses in stroke patients of the 12 regional clinics and the 2 stroke centers were recorded prospectively. Patients' demographics, stroke severity (National Institutes of Health Stroke Scale), frequency of administration, time management, protocol violations, and safety were included in the analysis. In 2004, 115 of 4727 stroke or transient ischemic attack patients (2.4%) in the community hospitals and 110 of 1889 patients in the stroke centers (5.8%) received systemic thrombolysis. Prehospital latencies were shorter in the regional hospitals despite longer distances. Door to needle times were shorter in the stroke centers. Although blood pressure was controlled more strictly in community hospitals, symptomatic intracerebral hemorrhage rate (7.8%) was higher (P=0.14) than in stroke centers (2.7%) but still within the range of the National Institute of Neurological Disorders and Stroke trial. In-hospital mortality rate was low in community hospitals (3.5%) and in stroke centers (4.5%). Although with a lower rate of systemic thrombolysis, there was no evidence of lower treatment quality in the remote hospitals. With increasing numbers of tPA administration and growing training effects, the telestroke concept promises better coverage of systemic thrombolysis in nonurban areas.

  19. Graduate Management Project: The Capital Equipment Acquisition Process at The Johns Hopkins Hospital Evaluating Acquisition Strategies Through Financial Analysis

    National Research Council Canada - National Science Library

    McGowan, Colleen

    1999-01-01

    .... The purpose of this paper is to first develop an equipment evaluation process at The Johns Hopkins Hospital which considers both clinical and financial factors when allocating capital dollars to acquire equipment...

  20. Thermal Protection Test Bed Pathfinder Development Project

    Science.gov (United States)

    Snapp, Cooper

    2015-01-01

    In order to increase thermal protection capabilities for future reentry vehicles, a method to obtain relevant test data is required. Although arc jet testing can be used to obtain some data on materials, the best method to obtain these data is to actually expose them to an atmospheric reentry. The overprediction of the Orion EFT-1 flight data is an example of how the ground test to flight traceability is not fully understood. The RED-Data small reentry capsule developed by Terminal Velocity Aerospace is critical to understanding this traceability. In order to begin to utilize this technology, ES3 needs to be ready to build and integrate heat shields onto the RED-Data vehicle. Using a heritage Shuttle tile material for the heat shield will both allow valuable insight into the environment that the RED-Data vehicle can provide and give ES3 the knowledge and capability to build and integrate future heat shields for this vehicle.

  1. The Iowa Disinfection Cleaning Project: Opportunities, Successes, and Challenges of a Structured Intervention Program in 56 Hospitals.

    Science.gov (United States)

    Carling, Philip; Herwaldt, Loreen A

    2017-08-01

    OBJECTIVE A diverse group of hospitals in Iowa implemented a program to objectively evaluate and improve the thoroughness of disinfection cleaning of near-patient surfaces. Administrative benefits of, challenges of, and impediments to the program were also evaluated. METHODS We conducted a prospective, quasi-experimental pre-/postintervention trial to improve the thoroughness of terminal room disinfection cleaning. Infection preventionists utilized an objective cleaning performance monitoring system (DAZO) to evaluate the thoroughness of disinfection cleaning (TDC) expressed as a proportion of objects confirmed to have been cleaned (numerator) to objects to be cleaned per hospital policy (denominator)×100. Data analysis, educational interventions, and objective performance feedback were modeled on previously published studies using the same monitoring tool. Programmatic analysis utilized unstructured and structured information from participants irrespective of whether they participated in the process improvement aspects to the program. RESULTS Initially, the overall TDC was 61% in 56 hospitals. Hospitals completing 1 or 2 feedback cycles improved their TDC percentages significantly (P90% for at least 38 months. A survey of infection preventionists found that lack of time and staff turnover were the most common reasons for terminating the study early. CONCLUSION The study confirmed that hospitals using this program can improve their TDC percentages significantly. Hospitals must invest resources to improve cleaning and to sustain their gains. Infect Control Hosp Epidemiol 2017;38:960-965.

  2. in Spouted Bed

    Directory of Open Access Journals (Sweden)

    Bronislaw Buczek

    2013-01-01

    Full Text Available Samples of active coke, fresh and spent after cleaning flue gases from communal waste incinerators, were investigated. The outer layers of both coke particles were separately removed by comminution in a spouted bed. The samples of both active cokes were analysed by means of densities, mercury porosimetry, and adsorption technique. Remaining cores were examined to determine the degree of consumption of coke by the sorption of hazardous emissions (SO2, HCl, and heavy metals through its bed. Differences in contamination levels within the porous structure of the particles were estimated. The study demonstrated the effectiveness of commercial active coke in the cleaning of flue gases.

  3. Multi-bed patient room architectural evaluation

    Directory of Open Access Journals (Sweden)

    Evangelia Sklavou

    2016-12-01

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

  4. Apparatus for controlling fluidized beds

    Science.gov (United States)

    Rehmat, A.G.; Patel, J.G.

    1987-05-12

    An apparatus and process are disclosed for control and maintenance of fluidized beds under non-steady state conditions. An ash removal conduit is provided for removing solid particulates from a fluidized bed separate from an ash discharge conduit in the lower portion of the grate supporting such a bed. The apparatus and process of this invention is particularly suitable for use in ash agglomerating fluidized beds and provides control of the fluidized bed before ash agglomeration is initiated and during upset conditions resulting in stable, sinter-free fluidized bed maintenance. 2 figs.

  5. Fluidized bed calciner

    International Nuclear Information System (INIS)

    Sheely, W.F.

    1986-01-01

    A unique way to convert radioactive scrap into useful nuclear fuel products was developed for the Department of Energy at Hanford. An advanced, fluidized bed calciner is used to convert metallic nitrate scrap or waste solutions into benign, solid and gaseous products. There are broad potential applications of this concept beyond those in the nuclear industry

  6. Nail Bed Injuries

    Science.gov (United States)

    ... All Topics A-Z Videos Infographics Symptom Picker Anatomy Bones Joints Muscles Nerves Vessels Tendons About Hand Surgery What is a Hand Surgeon? What is a Hand Therapist? Media Find a Hand Surgeon Home Anatomy Nail Bed Injuries Email to a friend * required ...

  7. Bed Bug Myths

    Science.gov (United States)

    Learn the truth about bed bugs, such as how easy they are to see with the naked eye, their preferred habitat, whether they transmit diseases, their public health effects, and whether pesticides are the best way to deal with an infestation.

  8. What Bed Size Does a Patient Need? The Relationship Between Body Mass Index and Space Required to Turn in Bed

    OpenAIRE

    Wiggermann, Neal; Smith, Kathryn; Kumpar, Dee

    2017-01-01

    Background A bed that is too small to allow patients to turn from supine to side lying increases the difficulty of mobilizing patients, which can increase risk of musculoskeletal injury to caregivers, increase risk of pressure injuries to patients, and reduce patient comfort. Currently, no guidance is available for what patient sizes are accommodated by the standard 91cm (36 in.)-wide hospital bed, and no studies have evaluated the relationship between anthropometric attributes and space requ...

  9. High participation rate among 25 721 patients with broad age range in a hospital-based research project involving whole-genome sequencing - the Lausanne Institutional Biobank.

    Science.gov (United States)

    Bochud, Murielle; Currat, Christine; Chapatte, Laurence; Roth, Cindy; Mooser, Vincent

    2017-10-24

    We aimed to evaluate the interest of adult inpatients and selected outpatients in engaging in a large, real-life, hospital-based, genomic medicine research project and in receiving clinically actionable incidental findings. Within the framework of the cross-sectional Institutional Biobank of Lausanne, Switzerland, a total of 25721 patients of the CHUV University Hospital were systematically invited to grant researchers access to their biomedical data and to donate blood for future analyses, including whole-genome sequencing. Multivariable logistic regression analysis was used to identify personal factors, including age, gender, religion, ethnicity, citizenship, education level and mode of admission, associated with willingness to participate in this genomic research project and with interest in receiving clinically actionable incidental findings. The overall participation rate was 79% (20343/25721). Participation rate declined progressively with age, averaging 83%, 75%, 67% and 62% in patients aged rate, but not with higher willingness to receive incidental findings within the population who had agreed to participate. A large proportion of adult patients, even among the elderly, are willing to actively participate and receive incidental findings in this systematic hospital-based precision and genomic medicine research program with broad consent.

  10. 7 CFR 2902.15 - Bedding, bed linens, and towels.

    Science.gov (United States)

    2010-01-01

    ... PROCUREMENT Designated Items § 2902.15 Bedding, bed linens, and towels. (a) Definition. (1) Bedding is that... minimum biobased content is 12 percent and shall be based on the amount of qualifying biobased carbon in..., and silk are not qualifying biobased feedstocks for the purpose of determining the biobased content of...

  11. VA National Bed Control System

    Data.gov (United States)

    Department of Veterans Affairs — The VA National Bed Control System records the levels of operating, unavailable and authorized beds at each VAMC, and it tracks requests for changes in these levels....

  12. Getting Rid of Bed Bugs

    Science.gov (United States)

    ... Directory Planning, Budget and Results Jobs and Internships Headquarters Offices Regional Offices Labs and Research Centers Bed ... to be careful in how you select a company. Related Information Collaborative Strategy on Bed Bugs - highlights ...

  13. Rate of spontaneous voiding recovery after acute urinary retention due to bed rest in the hospital setting in a non-urological population clinical study of the relationship between lower limbs and bladder function

    Directory of Open Access Journals (Sweden)

    Paulo Rodrigues

    Full Text Available Abstract Objectives To understand the clinical relationship between lower limbs functions and the recovery of spontaneous voiding after an acute urinary retention (AUR in older patients admitted to hospitals for non-urological causes using clinical parameters. Materials and Methods 56 adult patients (32 men; mean age: 77.9 ± 8.3 and 24 women; mean age 82.1 ± 4.6 with AUR were prospectively followed with validated Physical Performance Mobility Exam (PPME instrument to evaluate the relationship between the recovery of mobility capacity and spontaneous voiding. After a short period of permanent bladder drainage patients started CIC along evaluation by PPME during hospitalization and at 7, 15, 30 60, 90, and 180 days of discharge. Mann-Whitney U, chi-square test and ANOVA tests were used. Results All patients were hospitalized for at least 15 days (Median 26.3 ± 4.1 days. Progressive improvement on mobility scale measured by PPME was observed after leaving ICU and along the initial 7 days of hospitalization but with a deterioration if hospitalization extends beyond 15 days (p<0.03. Prolonged hospital stay impairs mobility in all domains (p<0.05 except step-up and transfer skills (p<0.02 although a recovery rate on spontaneous voiding persistented. Restoration of spontaneous voiding was accompanied by improvement on mobility scale (p<0.02. Recovery of spontaneous voiding was markedly observed after discharging the hospital. All patients recovered spontaneous voiding until 6 months of follow-up. Conclusions Recovery to spontaneous voiding after acute urinary retention in the hospital setting may be anticipated by evaluation of lower limbs function measured by validated instruments.

  14. Using HL7 in hospital staff assignments.

    Science.gov (United States)

    Unluturk, Mehmet S

    2014-02-01

    Hospital staff assignments are the instructions that allocate the hospital staff members to the hospital beds. Currently, hospital administrators make the assignments without accessing the information regarding the occupancy of the hospital beds and the acuity of the patient. As a result, administrators cannot distinguish between occupied and unoccupied beds, and may therefore assign staff to unoccupied beds. This gives rise to uneven and inefficient staff assignments. In this paper, the hospital admission-discharge-transfer (ADT) system is employed both as a data source and an assignment device to create staff assignments. When the patient data is newly added or modified, the ADT system updates the assignment software client with the relevant data. Based on the relevant data, the assignment software client is able to construct staff assignments in a more efficient way. © 2013 Elsevier Ltd. All rights reserved.

  15. Hospitalizations in Pediatric and Adult Patients for All Cancer Type in Italy: The EPIKIT Study under the E.U. COHEIRS Project on Environment and Health

    Directory of Open Access Journals (Sweden)

    Prisco Piscitelli

    2017-05-01

    Full Text Available Background: Cancer Registries (CRs remain the gold standard for providing official epidemiological estimations. However, due to CRs’ partial population coverage, hospitalization records might represent a valuable tool to provide additional information on cancer occurrence and expenditures at national/regional level for research purposes. The Epidemiology of Cancer in Italy (EPIKIT study group has been built up, within the framework of the Civic Observers for Health and Environment: Initiative of Responsibility and Sustainability (COHEIRS project under the auspices of the Europe for Citizens Program, to assess population health indicators. Objective: To assess the burden of all cancers in Italian children and adults. Methods: We analyzed National Hospitalization Records from 2001 to 2011. Based on social security numbers (anonymously treated, we have excluded from our analyses all re-hospitalizations of the same patients (n = 1,878,109 over the entire 11-year period in order to minimize the overlap between prevalent and incident cancer cases. To be more conservative, only data concerning the last five years (2007–2011 have been taken into account for final analyses. The absolute number of hospitalizations and standardized hospitalization rates (SHR were computed for each Italian province by sex and age-groups (0–19 and 20–49. Results: The EPIKIT database included a total of 4,113,169 first hospital admissions due to main diagnoses of all tumors. The annual average number of hospital admissions due to cancer in Italy has been computed in 2362 and 43,141 hospitalizations in pediatric patients (0–19 years old and adults (20–49 years old, respectively. Women accounted for the majority of cancer cases in adults aged 20–49. As expected, the big city of Rome presented the highest average annual number of pediatric cancers (n = 392, SHR = 9.9, followed by Naples (n = 378; SHR = 9.9 and Milan (n = 212; SHR = 7.3. However, when we look at SHR

  16. Improvement of a multi-stage model for the modeling of a functionalized nursing bed as support for the sensor-assisted function-alization of furniture in the hospital and care sector

    Directory of Open Access Journals (Sweden)

    Kitzig Andreas

    2017-09-01

    Full Text Available Development of preparation-free functionalized furniture based patient monitoring systems for use in the area of home- or stationary- care is often empirically driven. In particular, functionalization of furniture by means of different sensors is strongly affected by this development methodology. As a result, the systems are often not extensive-ly extendable or cannot be optimized because basic mechanisms are not comprehensible. In order to support development or optimization, a modelling approach is often useful. Thus, using a more comprehensive approach the required sensitivity of the sensors as well as their position in the system can be derived from a simulation model. In order to solve this problem, a multi-stage model was introduced at the BMT conference in 2014 by the authors, which allows the designer to model the entire system. The model has been extended and improved in the meantime and the achieved progress is presented in this work. The presented modelling approach can be divided into three main components. These are the person under supervision, the furniture (in our case a nursing bed and the sensors (force measuring cells which are modelled separately. In this work the main focus will be on improving the modelling of the human movement process and its implementation. Furthermore, the modelling of the sensor behavior in the nursing bed is described in detail with regard to their oscillation behavior and the influence on the model.

  17. Geomechanics of bedded salt

    International Nuclear Information System (INIS)

    Serata, S.; Milnor, S.W.

    1979-01-01

    Creep data from the literature search is reinterpreted by SGI, resulting in a better understanding of the temperature and stress state dependence of the octahedral creep rate and the octahedral shear strength. The concept of a transition strength between the elastic and the plastic states is in agreement with the data. The elastic and rheological properties of salt are described, and a set of constitutive equations is presented. The dependence of material properties on parameters such as temperature is considered. Findings on the permeability of salt are summarized, and the in-situ behavior of openings in bedded salt is described based on extensive engineering experience. A stress measuring system utilizing a finite element computer code is discussed. Geological factors affecting the stability of salt openings are considered, and the Stress Control Technique for designing stable openings in bedded salt formations is explained

  18. Community Hospital Telehealth Consortium

    National Research Council Canada - National Science Library

    Williams, Elton

    2004-01-01

    The Community Hospital Telehealth Consortium is a unique, forward-thinking, community-based healthcare service project organized around 5 not-for-profit community hospitals located throughout Louisiana and Mississippi...

  19. Community Hospital Telehealth Consortium

    National Research Council Canada - National Science Library

    Williams, Elton

    2003-01-01

    The Community Hospital Telehealth Consortium is a unique, forward-thinking, community-based healthcare service project organized around 5 not-for-profit community hospitals located throughout Louisiana and Mississippi...

  20. Community Hospital Telehealth Consortium

    National Research Council Canada - National Science Library

    Williams, Jr, Elton L

    2007-01-01

    The Community Hospital Telehealth Consortium is a unique, forward-thinking, community-based healthcare service project organized around 5 not-for-profit community hospitals located throughout Louisiana and Mississippi...

  1. Avaliação da presença de Staphylococcus aureus nos leitos do Centro de Terapia Intensiva do Hospital Escola da Faculdade de Medicina do Triângulo Mineiro, em relação à posição no colchão antes e após a limpeza Evaluation of presence of Staphylococcus aureus on the beds of Hospital Escola's Intensive Care Unit, concerning the position on the mattress, before and after cleaning

    Directory of Open Access Journals (Sweden)

    Guilhermo Justino Mundim

    2003-12-01

    Full Text Available Através de meios de cultura, foi pesquisada a posição de colônias de Staphylococcus aureus em colchões, visando avaliar a eficácia do procedimento de limpeza e desinfecção dos leitos do Hospital Escola da Faculdade de Medicina do Triângulo Mineiro (Uberaba. Foram analisadas amostras de 50 colchões no período de 22 de outubro de 2000 a 16 de janeiro de 2001. As amostras foram coletadas e semeadas, pela técnica de esgotamento, em dois meios de cultivo (ágar sangue e manitol com posterior realização de provas de catalase e coagulase . Na análise estatística, foram utilizados os testes não paramétricos Mann-Whitney, Kruswkal- Wallis e Wilcoxon Matched Pairs Test com nível de significância p 0,05. Os resultados apontam e alertam para falhas no procedimento de limpeza e desinfecção dos leitos hospitalares por nós estudados.By means of culture medium, it was researched the position of the colony of Staphylococcus aureus on the mattress, to evaluate the efficciuoness of the methods of cleaning and disinfection of the river bed in the Faculdade de Medicina do Triângulo Mineiro's School Hospital (Uberaba. It were evaluated fifty mattresses on the period of October 22th (2000 to January 16th (2001. The samples were collected and grown, the exhaustion techinique draining, on two different nutrient bases (blood agar and mannitol salt agar followed by catalase and coagulase tests. For the statistical analysis, were used non-parametrics tests Mann-Whitney, Kruskal-Wallis, Wilcoxon Matched Pairs Test with significance level p < 0,05 were used. Six hundred dishes of culture medium have been used. There was growing in 94 (15,6%, being 82 (87,2% before and 12 (12,8% after cleaning and disinfection. Concerning the position on the bed, the samples obtained from mannitol salt agar medium showed significant retention on the lower position of bed. The results alert to flaws in the procedure for cleaning and disinfection from the mattresses

  2. Characteristics of fatal and hospital admissions for burns in Fiji: a population-based study (TRIP Project-2).

    Science.gov (United States)

    Taoi, Mable; Wainiqolo, Iris; Kafoa, Berlin; Kool, Bridget; Naisaki, Asilika; McCaig, Eddie; Ameratunga, Shanthi

    2012-08-01

    Over 95% of burn deaths are estimated to occur in low-and-middle-income countries. However, the epidemiology of burn-related injuries in Pacific Island Countries is unclear. This study investigated the incidence and demographic characteristics associated with fatal and hospitalised burns in Fiji. This cross-sectional study utilised the Fiji Injury Surveillance in Hospital database to estimate the population-based incidence and contextual characteristics associated with burns resulting in death or hospital admission (≥12h) during a 12-month period commencing 1st October 2005. 116 people were admitted to hospital or died as a result of burns during the study period accounting for an overall annual incidence of 17.8/100,000 population, and mortality rate of 3.4/100,000. Most (92.2%) burns occurred at home, and 85.3% were recorded as unintentional. Burns were disproportionately higher among Fijian children compared with Fijian-Indian children with the converse occurring in adulthood. In adults, Indian women were at particularly high risk of death from self-inflicted burns as a consequence of 'conflict situations'. Burns are a significant public health burden in Fiji requiring prevention and management strategies informed by important differences in the context of these injuries among the major ethic groups of the country. Copyright © 2011 Elsevier Ltd and ISBI. All rights reserved.

  3. Hospital evacuation : Exercise versus reality

    NARCIS (Netherlands)

    Haverkort, J. J Mark; Biesheuvel, Tessa H.; Bloemers, Frank W.; de Jong, MB; Hietbrink, Falco; van Spengler, Lukas L.; Leenen, Luke P H

    Introduction: The Dutch Major Incident Hospital (MIH) is a standby, highly prepared, 200-bed hospital strictly reserved to provide immediate, large-scale, and emergency care for victims of disasters and major incidents. It has long-standing experience training for various major incident scenarios,

  4. Case study: improving efficiency in a large hospital laboratory.

    Science.gov (United States)

    Bartel, Marilynn

    2004-01-01

    Saint Francis Health System (SFHS) consists of three hospitals and one clinic: Saint Francis Hospital (SFH); Broken Arrow Medical Center; Laureate Psychiatric Hospital; and Warren Clinic. SFHS has 670 physicians on staff and serves medical (oncology, orthopedic, neurology, and renal), surgical, cardiac, women and infant, pediatric, transplant, and trauma patients in Tulsa County, Oklahoma, which has a population of 660,000. SFH incorporates 706 staffed beds, including 126 pediatric beds and 119 critical care beds. Each year, the health system averages 38,000 admissions, 70,000 emergency department visits, 25,000 surgeries, and 3,500 births. Saint Francis Laboratory is located within the main hospital facility (SFH) and functions as a core lab for the health system. The lab also coordinates lab services with Saint Francis Heart Hospital, a physician-system joint venture. The Optimal Equipment Configuration (OEC) Project was designed by the Clinical Laboratory Services division of Premier, a group purchasing organization, with the goal of determining whether laboratories could improve efficiency and decrease unit cost by using a single-source vendor. Participants included seven business partners (Abbott, Bayer, Beckman/Coulter, Dade/Behring, J&J/ Ortho, Olympus, and Roche) and 21 laboratory sites (a small, mid-sized, and large site for each vendor). SFH laboratory staff embraced Premier's concept and viewed the OEC project as an opportunity to "energize" laboratory operations. SFH partnered with Abbott, their primary equipment vendor, for the project. Using resources and tools made available through the project, the laboratory was re-engineered to simplify workflow, increase productivity, and decrease costs by adding automation and changing to centralized specimen processing. Abbott and SFH shared a common vision for the project and enhanced their partnership through increased communication and problem solving. Abbott's area representatives provided for third

  5. INEDITHOS: a Hospital Pedagogy project devoted to improving the quality of life of children and young people with rare diseases from the intervention, and research with university volunteering.

    Directory of Open Access Journals (Sweden)

    Francisca NEGRE BENNASAR

    2018-01-01

    Full Text Available This paper presents an experience in Hospital Pedagogy organized by the University of the Balearic Islands. This project is called INEDITHOS and its main objective is to work into improve the quality of life of children and youth with Rare Diseases. The project works in three lines of intervention: psycho-pedagogical support to patients and their families, research to respond to the needs that are detected in this area and the training of university students who collaborates in the project, using the Service Learning methodology. The long trajectory of the project that began in 2003 has made it possible to consolidate the three interventions resulting in a non-profit association with the same name. This result is complemented by the growing involvement of other Associations such as ABAIMAR and FEDER with which close collaboration is maintained. It is also worth noting the increase in the number of volunteers, which allows to offer attention to a higher number of affected while improving the quality of the interventions made thanks to the collaboration and involvement of students and teachers who, through the methodology of Learning and Service, carry out activities and elaborate end-of-degree and master’s work based on the needs identified in the volunteer interventions. INEDITHOS has introduced Rare Diseases in the university context sensitizing a large part of the Educational Community.

  6. Biosystem of seaweed beds coexisting with power plants; Denryoku hatsudensho to kyoseisuru moba no seitaikei

    Energy Technology Data Exchange (ETDEWEB)

    Ono, M. [Kochi Univ., Kochi (Japan)

    1996-03-05

    Recently, seaweed beds on the coasts of Japan are decreasing rapidly, and it has been demanded that they should be restored. As one of the restoring methods, plans are investigated to utilize coast structures near power plants and wave absorbing dykes, which are artificial seaweed beds with dense seaweed forests and offer favorable areas for living creatures, for the purpose of building new seaweed beds and marine pastures. For seaweed bed building projects, it is necessary to show the economical effect of seaweed beds. Recently, absorption of carbon dioxide, nitrogen, and phosphoric acid dissolved in the sea has been attracting attention as a role of seaweed beds. Creation of Zostera beds is a difficult enterprise. The mound creation of the seaweed bed at Ikata, Aichi Prefecture, Japan is successful because there is a good seaweed bed in the periphery which can supply sufficient seeds (spores) to the bed. With the development of the seaweed bed, a concrete block rocky beach reef was developed which is provided with a function of dwelling places for shells and lobsters. The Fishery Ministry is promoting a large scale ocean pasture plan on the coast of Japan with the target period of the 21st century, and extension of seaweed bed areas is considered to be the major project. 8 refs., 7 figs.

  7. In-hospital fall-risk screening in 4,735 geriatric patients from the LUCAS project.

    Science.gov (United States)

    Neumann, L; Hoffmann, V S; Golgert, S; Hasford, J; Von Renteln-Kruse, W

    2013-03-01

    In-hospital falls in older patients are frequent, but the identification of patients at risk of falling is challenging. Aim of this study was to improve the identification of high-risk patients. Therefore, a simplified screening-tool was developed, validated, and compared to the STRATIFY predictive accuracy. Retrospective analysis of 4,735 patients; evaluation of predictive accuracy of STRATIFY and its single risk factors, as well as age, gender and psychotropic medication; splitting the dataset into a learning and a validation sample for modelling fall-risk screening and independent, temporal validation. Geriatric clinic at an academic teaching hospital in Hamburg, Germany. 4,735 hospitalised patients ≥65 years. Sensitivity, specificity, positive and negative predictive value, Odds Ratios, Youden-Index and the rates of falls and fallers were calculated. There were 10.7% fallers, and the fall rate was 7.9/1,000 hospital days. In the learning sample, mental alteration (OR 2.9), fall history (OR 2.1), and insecure mobility (Barthel-Index items 'transfer' + 'walking' score = 5, 10 or 15) (OR 2.3) had the most strongest association to falls. The LUCAS Fall-Risk Screening uses these risk factors, and patients with ≥2 risk factors contributed to the high-risk group (30.9%). In the validation sample, STRATIFY SENS was 56.8, SPEC 59.6, PPV 13.5 and NPV 92.6 vs. LUCAS Fall-Risk Screening was SENS 46.0, SPEC 71.1, PPV 14.9 and NPV 92.3. Both the STRATIFY and the LUCAS Fall-Risk Screening showed comparable results in defining a high-risk group. Impaired mobility and cognitive status were closely associated to falls. The results do underscore the importance of functional status as essential fall-risk factor in older hospitalised patients.

  8. Bed Utilisation in an Irish Regional Paediatric Unit A Cross-Sectional Study Using the Paediatric Appropriateness Evaluation Protocol (PAEP)

    LENUS (Irish Health Repository)

    Ó hAiseadha, Coilín

    2016-05-01

    Increasing demand for limited healthcare resources raises questions about appropriate use of inpatient beds. In the first paediatric bed utilisation study at a regional university centre in Ireland, we conducted a cross-sectional study to audit the utilisation of inpatient beds at the Regional Paediatric Unit (RPU) in University Hospital Limerick (UHL), Limerick, Ireland and also examined hospital activity data, to make recommendations for optimal use of inpatient resources.

  9. Hospital pharmacy workforce in Brazil.

    Science.gov (United States)

    Santos, Thiago R; Penm, Jonathan; Baldoni, André O; Ayres, Lorena Rocha; Moles, Rebekah; Sanches, Cristina

    2018-01-04

    This study aims to describe the distribution of the hospital pharmacy workforce in Brazil. Data were acquired, during 2016, through the Brazilian National Database of Healthcare Facilities (CNES). The following variables were extracted: hospital name, registry number, telephone, e-mail, state, type of institution, subtype, management nature, ownership, presence of research/teaching activities, complexity level, number of hospital beds, presence of pharmacists, number of pharmacists, pharmacist specialization. All statistical analyses were performed by IBM SPSS v.19. The number of hospitals with a complete registry in the national database was 4790. The majority were general hospitals (77.9%), managed by municipalities (66.1%), under public administration (44.0%), had no research/teaching activities (90.5%), classified as medium complexity (71.6%), and had no pharmacist in their team (50.6%). Furthermore, almost 60.0% of hospitals did not comply with the minimum recommendations of having a pharmacist per 50 hospital beds. The Southeast region had the highest prevalence of pharmacists, with 64.4% of hospitals having a pharmaceutical professional. This may have occurred as this region had the highest population to hospital ratio. Non-profit hospitals were more likely to have pharmacists compared to those under public administration and private hospitals. This study mapped the hospital pharmacy workforce in Brazil, showing a higher prevalence of hospital pharmacists in the Southeast region, and in non-profit specialized hospitals.

  10. Infant's bed climate and bedding in the Japanese home.

    Science.gov (United States)

    Nakamura Ikeda, Rie; Fukai, Kiyoko; Okamoto Mizuno, Kazue

    2012-06-01

    to assess the bed climate of infants in their homes in Japan. descriptive, exploratory, non-experimental research design. the data were collected at the participants' homes under normal circumstances. nineteen healthy infants between the ages of two and five months. Their mothers, who joined a parenting class organised by a maternity clinic in Okayama, Japan, consented to participate in this study. we visited the infants' homes and interviewed their mothers concerning the types and use of bedding. The temperature and relative humidity of the bed climate at the back and foot of the bedding, and in the room were measured every minute for four consecutive days. Differences among the bed climates measured during three seasons (spring, summer, and autumn) were assessed by one-way analysis of variance. The bed temperature was higher for infants than for adults. No significant difference in temperature was noted among the three seasons. The bed temperature was about 36.0°C when waterproof sheets and futon mattresses for children or adult were used. The average relative humidity of the bed climate at the back was highest in summer, followed by that in spring and autumn; the differences were significant. The use of waterproof sheets and futon mattresses for children in summer increased the relative humidity to 80% or more. The use of infant beds, sunoko drainboards, and cotton futon mattresses in summer was effective in reducing the bed humidity. these results suggest that nurse-midwives should advise the parents on comfortable bed climates for their infants, as well as how to select and use bedding for them. Copyright © 2010 Elsevier Ltd. All rights reserved.

  11. Particle bed reactor modeling

    Science.gov (United States)

    Sapyta, Joe; Reid, Hank; Walton, Lew

    The topics are presented in viewgraph form and include the following: particle bed reactor (PBR) core cross section; PBR bleed cycle; fuel and moderator flow paths; PBR modeling requirements; characteristics of PBR and nuclear thermal propulsion (NTP) modeling; challenges for PBR and NTP modeling; thermal hydraulic computer codes; capabilities for PBR/reactor application; thermal/hydralic codes; limitations; physical correlations; comparison of predicted friction factor and experimental data; frit pressure drop testing; cold frit mask factor; decay heat flow rate; startup transient simulation; and philosophy of systems modeling.

  12. Fluidised bed cereal cooking

    International Nuclear Information System (INIS)

    Jenkins, Simon Anthony

    2002-01-01

    Man has been cooking food for thousands of years for a number of reasons: to improve flavour and palatability, sterilise, increase digestibility, improve texture and colour. Increasingly more advanced techniques are employed today in food production plants to engineer foods with many different properties. With this in mind manufacturers are constantly seeking to improve processing techniques and apply new or different technologies (such as microwaves, RF and extrusion) to develop foods with new properties (like puffed texture starches) and to increase process efficiencies (energy efficiency, water reduction). This thesis reports on work undertaken to demonstrate the potential to achieve high temperature starch conversion of whole wheat grains in a fluidised bed, thereby reducing the amount of water required and processing time. Specifically, wheat from the farm at 14% water content is cooked in a fluidised bed. The fluidised bed heats the wheat quickly by convective heating. In addition, energy can be delivered directly to the grain by microwave heating during fluidisation. Degree of starch conversion is determined by measuring the reduction in size of endotherm of reaction as observed by Differential Scanning Calorimetry. The fluidising gas, processing temperature and starting moisture content were varied in order to investigate their effect on the cooking process. A mathematical model based on energy and species concentration equations was developed to help understand the internal grain processes. The model coupled the thermal energy equation with water diffusion. The effect of water evaporation was represented as a thermal sink in the energy equation. Popular kinetic models from literature were adapted to predict the degree of starch conversion. The model gives solutions consistent with experimental data and physical intuition. A commercial computational fluid dynamics package was used to study simple airflow and particle tracks in the fluidisation column. A

  13. The effect of patient migration in bed on torso elevation.

    Science.gov (United States)

    Wiggermann, Neal; Kotowski, Susan; Davis, Kermit; VanGilder, Catherine

    2015-01-01

    Elevating the hospital head of bed (HOB) to at least 30° is recommended practice to reduce the risk of ventilator-associated pneumonia (VAP) in mechanically ventilated patients. However, this common practice prescribes the position of the bed and not of the patient, which could be significantly different. The aim of this research was to determine the relationship between patient migration in bed and anatomic torso angle. Ten healthy participants were positioned in a hospital bed that was raised from flat to 30° and 45° HOB elevations. Prior to bed movement, participants were aligned to different locations along the length of the bed to represent different amounts of migration. A motion capture system was used to measure torso angle and migration toward the foot of the bed. The relationship between torso angle and migration was estimated by linear regression. Patient migration resulted in lower torso angles for both 30° and 45° HOB articulations. A migration of 10 cm resulted in a loss of 9.1° and 13.0° of torso angle for HOB articulations of 30° and 45°, respectively (for 30° articulations: (Equation is included in full-text article.)= -0.91, R = .96; for 45° articulations: (Equation is included in full-text article.)= -1.30, R = .98). Migration toward the foot of the bed flattens the torso. To maintain a torso angle that is likely to protect against VAP, healthcare providers need to manage both HOB angle and migration. Protocols and equipment that minimize patient migration will help support effective clinical practice. Future research on patient migration, as it relates to VAP or other outcomes, should measure patient torso angle to allow accurate translation of the results to care practice.

  14. Special report. Twin Cities hospital breaks down ambulatory care, overcomes fears of outpatient care.

    Science.gov (United States)

    1995-01-06

    With payers pushing for shorter hospital stays and outpatient services generating growing shares of hospitals' revenues, experts everywhere are projecting the end of the traditional inpatient-oriented hospital. Those predictions have triggered a scramble by many hospital managers to adapt their organizations and empty beds to the expected predominance of same-day services. One Minnesota facility that surveyed the outpatient trend, however, found that its strategic options weren't limited to becoming a jumbo-sized outpatient clinic, explain David Allen, a partner with The Chancellor Group, Bloomington, Minn., and Daniel Weber, vice president of Fairview Southdale Hospital, Edina, Minn., in this special report. By understanding the multidimensional nature of ambulatory services and focusing its efforts on becoming a regional hub of healthcare services, Fairview Southdale has carved its own niche in a changing provider market.

  15. Building the future of healthcare. Part III: managing the build. Hospital leaders are moving forward using specialized IT tools to help them manage today's complex new-construction projects.

    Science.gov (United States)

    Lawrence, Daphne

    2010-05-01

    Hospital leaders are increasing making use of project management information systems (PMIS), which are built around documentation and communication of project-specific information. PMIS solutions are being applied to the daunting challenge of managing the large volumes of information involved in new construction projects. Project management tools usually utilize a portal. These tools can interface with administrative systems for best effect. CIOs and other senior executives emphasize that good leadership and execution are fundamental to success, and that automated project management tools are supports, not substitutes for good strategic planning and execution.

  16. Short-term Associations between Fine and Coarse Particulate Matter and Hospitalizations in Southern Europe: Results from the MED-PARTICLES Project

    Science.gov (United States)

    Samoli, Evangelia; Alessandrini, Ester; Cadum, Ennio; Ostro, Bart; Berti, Giovanna; Faustini, Annunziata; Jacquemin, Benedicte; Linares, Cristina; Pascal, Mathilde; Randi, Giorgia; Ranzi, Andrea; Stivanello, Elisa; Forastiere, Francesco

    2013-01-01

    Background: Evidence on the short-term effects of fine and coarse particles on morbidity in Europe is scarce and inconsistent. Objectives: We aimed to estimate the association between daily concentrations of fine and coarse particles with hospitalizations for cardiovascular and respiratory conditions in eight Southern European cities, within the MED-PARTICLES project. Methods: City-specific Poisson models were fitted to estimate associations of daily concentrations of particulate matter with aerodynamic diameter ≤ 2.5 μm (PM2.5), ≤ 10 μm (PM10), and their difference (PM2.5–10) with daily counts of emergency hospitalizations for cardiovascular and respiratory diseases. We derived pooled estimates from random-effects meta-analysis and evaluated the robustness of results to co-pollutant exposure adjustment and model specification. Pooled concentration–response curves were estimated using a meta-smoothing approach. Results: We found significant associations between all PM fractions and cardiovascular admissions. Increases of 10 μg/m3 in PM2.5, 6.3 μg/m3 in PM2.5–10, and 14.4 μg/m3 in PM10 (lag 0–1 days) were associated with increases in cardiovascular admissions of 0.51% (95% CI: 0.12, 0.90%), 0.46% (95% CI: 0.10, 0.82%), and 0.53% (95% CI: 0.06, 1.00%), respectively. Stronger associations were estimated for respiratory hospitalizations, ranging from 1.15% (95% CI: 0.21, 2.11%) for PM10 to 1.36% (95% CI: 0.23, 2.49) for PM2.5 (lag 0–5 days). Conclusions: PM2.5 and PM2.5–10 were positively associated with cardiovascular and respiratory admissions in eight Mediterranean cities. Information on the short-term effects of different PM fractions on morbidity in Southern Europe will be useful to inform European policies on air quality standards. Citation: Stafoggia M, Samoli E, Alessandrini E, Cadum E, Ostro B, Berti G, Faustini A, Jacquemin B, Linares C, Pascal M, Randi G, Ranzi A, Stivanello E, Forastiere F, the MED-PARTICLES Study Group. 2013. Short

  17. Fluidized bed boiler feed system

    Science.gov (United States)

    Jones, Brian C.

    1981-01-01

    A fluidized bed boiler feed system for the combustion of pulverized coal. Coal is first screened to separate large from small particles. Large particles of coal are fed directly to the top of the fluidized bed while fine particles are first mixed with recycled char, preheated, and then fed into the interior of the fluidized bed to promote char burnout and to avoid elutriation and carryover.

  18. Disposable products in the hospital waste stream.

    OpenAIRE

    Gilden, D. J.; Scissors, K. N.; Reuler, J. B.

    1992-01-01

    Use of disposable products in hospitals continues to increase despite limited landfill space and dwindling natural resources. We analyzed the use and disposal patterns of disposable hospital products to identify means of reducing noninfectious, nonhazardous hospital waste. In a 385-bed private teaching hospital, the 20 disposable products of which the greatest amounts (by weight) were purchased, were identified, and total hospital waste was tabulated. Samples of trash from three areas were so...

  19. Awareness campaign. Orthopedic Hospital of Oklahoma launches awareness campaign.

    Science.gov (United States)

    2007-01-01

    The Orthopedic Hospital of Oklahoma is a 25-bed inpatient and outpatient center with one focus: Orthopedics. To acquaint people with its services and build brand awareness to drive market share, the hospital launched a print campaign featuring actual patients.

  20. Creating a Culture of Patient Safety through Innovative Hospital Design

    National Research Council Canada - National Science Library

    Reiling, John G

    2005-01-01

    When SynergyHealth, St. Joseph's Hospital of West Bend, Wisconsin, decided to relocate and build an 82-bed acute care facility, they recognized the opportunity to design a hospital that focused on patient safety...

  1. [Anesthesia practice in Catalan hospitals and other health care facilities].

    Science.gov (United States)

    Villalonga, Antonio; Sabaté, Sergi; Campos, Juan Manuel; Fornaguera, Joan; Hernández, Carmen; Sistac, José María

    2006-05-24

    The aim of this arm of the ANESCAT study was to characterize anesthesia practice in the various types of health care facilities of Catalonia, Spain, in 2003. We analyzed data from the survey according to a) source of a facility's funding: public hospitals financed by the Catalan Public Health Authority (ICS), the network of subsidized hospitals for public use (XHUP), or private hospitals; b) size: facilities without hospital beds, hospitals with fewer than 250 beds, those with 251 to 500, and those with over 500; and c) training accreditation status: whether or not a facility gave medical resident training. A total of 131 facilities participated (11 under the ICS, 47 from the XHUP, and 73 private hospitals). Twenty-six clinics had no hospital beds, 78 facilities had fewer than 250, 21 had 251 to 500, and 6 had more than 500. Seventeen hospitals trained medical residents. XHUP hospitals performed 44.3% of all anesthetic procedures, private hospitals 36.7%, and ICS facilities 18.5%. Five percent of procedures were performed in clinics without beds, 42.9% in facilities with fewer than 250 beds, 35% in hospitals with 251 to 500, and 17.1% in hospitals with over 500. Anesthetists in teaching hospitals performed 35.5% of all procedures. The mean age of patients was lower in private hospitals, facilities with fewer than 250 beds, and hospitals that did not train medical residents. The physical status of patients was worse in ICS hospitals, in facilities with over 500 beds, and in teaching hospitals. It was noteworthy that 25% of anesthetic procedures were performed on an emergency basis in XHUP and ICS hospitals, in facilities with more than 250 beds, and in teaching hospitals. Anesthesia for outpatient procedures accounted for 40% of the total in private hospitals and 31% of the practice in ICS and XHUP hospitals. The duration of anesthesia and postanesthetic recovery was longer in ICS hospitals, in facilities with over 500 beds, and in those with medical resident

  2. Supervisors' perspective on medical thesis projects and dropout rates: survey among thesis supervisors at a large German university hospital.

    Science.gov (United States)

    Can, Elif; Richter, Felicitas; Valchanova, Ralitsa; Dewey, Marc

    2016-10-14

    To identify underlying causes for failure of medical thesis projects and the constantly high drop-out rate in Germany from the supervisors' perspective and to compare the results with the students' perspective. Cross-sectional survey. Online questionnaire for survey of medical thesis supervisors among the staff of Charité-Universitätsmedizin Berlin, Germany. Published, earlier longitudinal survey among students for comparison. 1069 thesis supervisors participated. Data are presented using descriptive statistics, and the χ 2 test served to compare the results among supervisors with the earlier data from the longitudinal survey of doctoral students. Not applicable. This survey is an observational study. Of 3653 potential participants, 1069 (29.3%) supervising 3744 doctoral candidates participated in the study. Supervisors considered themselves to be highly motivated and to offer adequate supervision. On the other hand, 87% stated that they did not feel well prepared for thesis supervision. Supervisors gave lack of timeliness of doctoral students and personal differences (p=0.024 and p=0.001) as the main reasons for terminating thesis projects. Doctoral students predominantly mentioned methodological problems and difficult subjects as critical issues (p=0.001 and pthesis supervisors and medical students feel ill prepared for their roles in the process of a medical dissertation. Contradictory reasons for terminating medical thesis projects based on supervisors' and students' self-assessment suggest a lack of communication and true scientific collaboration between supervisors and doctoral students as the major underlying issue that requires resolution. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  3. Duration of patients’ visits to the hospital emergency department

    Directory of Open Access Journals (Sweden)

    Karaca Zeynal

    2012-11-01

    Full Text Available Abstract Background Length of stay is an important indicator of quality of care in Emergency Departments (ED. This study explores the duration of patients’ visits to the ED for which they are treated and released (T&R. Methods Retrospective data analysis and multivariate regression analysis were conducted to investigate the duration of T&R ED visits. Duration for each visit was computed by taking the difference between admission and discharge times. The Healthcare Cost and Utilization Project (HCUP State Emergency Department Databases (SEDD for 2008 were used in the analysis. Results The mean duration of T&R ED visit was 195.7 minutes. The average duration of ED visits increased from 8 a.m. until noon, then decreased until midnight at which we observed an approximately 70-minute spike in average duration. We found a substantial difference in mean duration of ED visits (over 90 minutes between Mondays and other weekdays during the transition time from the evening of the day before to the early morning hours. Black / African American patients had a 21.4-minute longer mean duration of visits compared to white patients. The mean duration of visits at teaching hospitals was substantially longer than at non-teaching hospitals (243.8 versus 175.6 minutes. Hospitals with large bed size were associated with longer duration of visits (222.2 minutes when compared to hospitals with small bed size (172.4 minutes or those with medium bed size (166.5 minutes. The risk-adjusted results show that mean duration of visits on Mondays are longer by about 4 and 9 percents when compared to mean duration of visits on non-Monday workdays and weekends, respectively. Conclusions The duration of T&R ED visits varied significantly by admission hour, day of the week, patient volume, patient characteristics, hospital characteristics and area characteristics.

  4. Management bedding : vrijloopstal met composterende bedding van houtsnippers

    NARCIS (Netherlands)

    Boer, de H.C.; Wiersma, M.; Galama, P.J.; Szanto, G.L.

    2015-01-01

    In de vrijloopstal liggen de koeien meestal op een organische bedding en scheiden daar mest (feces en urine) uit. Om de bedding voldoende droog en schoon te houden wordt er regelmatig nieuw strooisel aangevoerd en wordt de toplaag bewerkt. Op basis van onderzoek- en praktijkervaringen tot nu toe

  5. The heat transfer mechanisms in fluidized beds; Laemmoensiirtomekanismit leijukerroksessa

    Energy Technology Data Exchange (ETDEWEB)

    Fogelholm, C.J.; Blomster, A.M.; Kojola, H. [Helsinki Univ. of Technology, Espoo (Finland)

    1996-12-01

    The goal of the research project is to improve the accuracy of the heat transfer correlation in circulating fluidized beds and to define how the heat transfer is distributed in radiation and convection in the different parts of the fluidized bed. This will be carried out by studying the behaviour and heat transfer of the fluidized bed in the boundary layer near the wall. The total and radiative heat transfer as well as the particle concentration will be measured. Based on the data a correlation will be created. Two different measurement systems are used. The particle concentration is measured by a image-analysis system. A video camera and a Super VHS recorder are used to capture live images from the bed. The images are digitized and stored on a PC. The system has been used in previous research projects at our laboratory. In earlier projects all measurements have been carried out in cold environments. In this project the system will be modified for hot environments. The radiative heat transfer is measured by a radiative heat transfer probe connected to a PC via an A/D converter. The probe consists of a heat flow detector which is isolated from the bed by a sapphire window so that only the radiative part of the heat transfer is detected. The probe will be calibrated in a black body oven so that the effect of the conduction and the sapphire window can be separated. (author)

  6. [Assessment of the announcement procedure in 29 cancer-accredited hospitals in the Aquitaine region: the EVADA project].

    Science.gov (United States)

    Rongère-Casteigt, Julie; Pinon, Elodie; Domecq, Sandrine; Hoppe, Stéphanie; Bousser, Véronique; Vimard, Edwige; Saillour-Glenisson, Florence

    2015-01-01

    An announcement procedure is mandatory to obtain accreditation to treat cancer patients. Health care professionals in the Aquitaine region evaluated the organization of this announcement procedure in their institutions and the patients' perception, in order to initiate actions to improve the structure and traceability of this procedure. Self-assessment approach based on a retrospective study plan comprising three concomitant steps: organizational audit, medical records audit and patient experience survey. 29 institutions participated in the study. Heterogeneous organizations were observed, although progress had been made in the deployment of the announcement procedure in terms of personnel training,formal organization and the resources devoted to this procedure, but there remains considerable room for improvement in terms of traceability, coordination between doctors and nursing staff, and referral of patients to supportive care. This evaluation triggered active mobilization of hospital teams concerning the announcement procedure in the Aquitaine region and a better awareness of the patient's perception. The regional dynamic allowed exchanges between institutions, facilitating the implementation of improvement actions.

  7. Management of radiodiagnostic equipment: Implementation of self-maintenance project of the conventional x-ray equipment of Hospital Universitario Clementino Fraga Filho - HUCFF-UFRJ

    International Nuclear Information System (INIS)

    Couto, N.F. do; Azevedo, A.C.P.; Koch, H.A.

    2001-01-01

    The project aims the implantation of a management program, for the maintenance of the conventional X-ray equipment at HUCFF. It has been implemented through the training of the electronic technicians who work at the Hospital. Essential courses were organized such as: Basics of Radioprotection, Radiographs Techniques, and Maintenance of equipment of X-Rays. Equipment: a library with the schemes of the equipment is being assembled in collaboration with UNICAMP. In order to manage the process, a software was created using the tools of the total quality for control of the maintenance. Preliminary tests: the equipment and their working conditions were evaluated, as well as the level of the employees' satisfaction with their use. The creation of a new routine for maintenance seeks to assist the demands of the new legislation in Brazil 5, and also reduce the costs to improve the quality of the images in the Radiodiagnostic Service. (author)

  8. Hospital waste management in nonteaching hospitals of Lucknow City, India

    Directory of Open Access Journals (Sweden)

    Manish Kumar Manar

    2014-01-01

    Full Text Available Objective: To assess hospital waste management in nonteaching hospitals of Lucknow city. Materials and Methods: A cross-sectional, descriptive study was conducted on the staffs of nonteaching hospitals of Lucknow from September 2012 to March 2013. A total of eight hospitals were chosen as the study sample size. Simple random sampling technique was used for the selection of the nonteaching hospitals. A pre-structured and pre-tested interview questionnaire was used to collect necessary information regarding the hospitals and biomedical waste (BMW management of the hospitals. The general information about the selected hospitals/employees of the hospitals was collected. Results: Mean hospital waste generated in the eight nonteaching hospitals of Lucknow was 0.56 kg/bed/day. About 50.5% of the hospitals did not have BMW department and colored dustbins. In 37.5% of the hospitals, there were no BMW records and segregation at source. Incinerator was used only by hospital A for treatment of BMW. Hospital G and hospital H had no facilities for BMW treatment. Conclusion: There is a need for appropriate training of staffs, strict implementation of rules, and continuous surveillance of the hospitals of Lucknow to improve the BMW management and handling practices.

  9. Using linked data to evaluate hospital charges for motor vehicle crash victims in Pennsylvania : Crash Outcome Data Evaluation System (CODES) linked data demonstration project

    Science.gov (United States)

    1998-10-01

    The report uses police-reported crash data that have been linked to hospital discharge data to evaluate charges for hospital care provided to motor vehicle crash victims in Pennsylvania. Approximately 17,000 crash victims were hospitalized in Pennsyl...

  10. Design of the DISCovery project: tailored work-oriented interventions to improve employee health, well-being, and performance-related outcomes in hospital care.

    Science.gov (United States)

    Niks, Irene M W; de Jonge, Jan; Gevers, Josette M P; Houtman, Irene L D

    2013-02-19

    It is well-known that health care workers in today's general hospitals have to deal with high levels of job demands, which could have negative effects on their health, well-being, and job performance. A way to reduce job-related stress reactions and to optimize positive work-related outcomes is to raise the level of specific job resources and opportunities to recover from work. However, the question remains how to translate the optimization of the balance between job demands, job resources, and recovery opportunities into effective workplace interventions. The aim of the DISCovery project is to develop and implement tailored work-oriented interventions to improve health, well-being, and performance of health care personnel. A quasi-experimental field study with a non-equivalent control group pretest-posttest design will be conducted in a top general hospital. Four existing organizational departments will provide both an intervention and a comparison group. Two types of research methods are used: (1) a longitudinal web-based survey study, and (2) a longitudinal daily diary study. After base-line measures of both methods, existing and yet to be developed interventions will be implemented within the experimental groups. Follow-up measurements will be taken one and two years after the base-line measures to analyze short-term and long-term effects of the interventions. Additionally, a process evaluation and a cost-effectiveness analysis will be carried out. The DISCovery project fulfills a strong need for theory-driven and scientifically well-performed research on job stress and performance interventions. It will provide insight into (1) how a balance between job demands, job resources, and recovery from work can be optimized, (2) the short-term and long-term effects of tailored work-oriented effects, and (3) indicators for successful or unsuccessful implementation of interventions.

  11. Design of the DISCovery project: tailored work-oriented interventions to improve employee health, well-being, and performance-related outcomes in hospital care

    Directory of Open Access Journals (Sweden)

    Niks Irene MW

    2013-02-01

    Full Text Available Abstract Background It is well-known that health care workers in today’s general hospitals have to deal with high levels of job demands, which could have negative effects on their health, well-being, and job performance. A way to reduce job-related stress reactions and to optimize positive work-related outcomes is to raise the level of specific job resources and opportunities to recover from work. However, the question remains how to translate the optimization of the balance between job demands, job resources, and recovery opportunities into effective workplace interventions. The aim of the DISCovery project is to develop and implement tailored work-oriented interventions to improve health, well-being, and performance of health care personnel. Methods/Design A quasi-experimental field study with a non-equivalent control group pretest-posttest design will be conducted in a top general hospital. Four existing organizational departments will provide both an intervention and a comparison group. Two types of research methods are used: (1 a longitudinal web-based survey study, and (2 a longitudinal daily diary study. After base-line measures of both methods, existing and yet to be developed interventions will be implemented within the experimental groups. Follow-up measurements will be taken one and two years after the base-line measures to analyze short-term and long-term effects of the interventions. Additionally, a process evaluation and a cost-effectiveness analysis will be carried out. Discussion The DISCovery project fulfills a strong need for theory-driven and scientifically well-performed research on job stress and performance interventions. It will provide insight into (1 how a balance between job demands, job resources, and recovery from work can be optimized, (2 the short-term and long-term effects of tailored work-oriented effects, and (3 indicators for successful or unsuccessful implementation of interventions.

  12. Performance of Sandy Dry Beds for sludge dewatering

    International Nuclear Information System (INIS)

    Al-Muzaini, S.

    2003-01-01

    Sludge produced by the Jahra treatment plant was assessed. The assessment was directed at determining the performance of sand drying beds. The assessment of quality of the sludge produced was based on the standards for land application of sewage sludge. Analyses were carried out for trace heavy metals and bacteria. The results of analyses showed that the sludge produced was high in organic matter and sand content but low in heavy metals. The collected data indicated that the sand drying beds at the Jahra treatment plant are at present inadequate to handle the projected sludge production. The investigation showed that the sand drying beds are fully used and the plant will require 3-4 times the capacity of the existing drying beds when the plant becomes fully operational. In addition, these sand drying beds are subjected to uncontrollable conditions such as temperature, rainfall and sludge drainage rate. Thus, sand drying beds have become less popular as a dewatering system. This paper evaluates the performance of the existing sand drying beds and suggests the most appropriate technology to alleviate the above mentioned problems. (author)

  13. Tanning beds: A call to action for further educational and legislative efforts.

    Science.gov (United States)

    Farley, Clara; Alimi, Yewande; Espinosa, Lauren R; Perez, Sebastian; Knechtle, William; Hestley, Andrea; Carlson, Grant W; Russell, Maria C; Delman, Keith A; Rizzo, Monica

    2015-08-01

    Melanoma is steadily increasing over the past decade. Recent studies confirmed a link between tanning bed use and melanoma. We sought to determine the prevalence and frequency of tanning bed among young patients with melanoma. We retrospectively analyzed tanning bed use among young melanoma patients compared to controls selected from the hospital medical records. A telephone survey investigated family history of melanoma or skin cancer, hair color, eye color, skin type, tanning bed use, and patient awareness of dangers of tanning bed use. A total of 601 melanoma cases were identified; 265 (44%) completed the telephone survey as did 195 (31%) controls. Of these 460 subjects, 260 were female. Females were 3.0 times more likely to have used a tanning bed. Melanoma patients had natural light color hair, blue-green eyes, and 2.0 times more likely to use a tanning bed than controls. Among the tanning bed users, 90% were aware of danger of tanning bed. Our study found that tanning beds were more likely to be used by young women, the majority of whom are aware of the associated risks. Eliminating the use of tanning beds should be considered to decrease the incidence of melanoma. © 2015 Wiley Periodicals, Inc.

  14. Falls prevention in hospitals and mental health units: an extended evaluation of the FallSafe quality improvement project.

    Science.gov (United States)

    Healey, Frances; Lowe, Derek; Darowski, Adam; Windsor, Julie; Treml, Jonathan; Byrne, Lisa; Husk, Janet; Phipps, Jill

    2014-07-01

    inpatient falls are a major patient safety issue causing distress, injury and death. Systematic review suggests multifactorial assessment and intervention can reduce falls by 20-30%, but large-scale studies of implementation are few. This paper describes an extended evaluation of the FallSafe quality improvement project, which presented key components of multifactorial assessment and intervention as a care bundle. : data on delivery of falls prevention processes were collected at baseline and for 18 months from nine FallSafe units and nine control units. Data on falls were collected from local risk management systems for 24 months, and data on under-reporting through staff surveys. : in FallSafe units, delivery of seven care bundle components significantly improved; most improvements were sustained after active project support was withdrawn. Twelve-month moving average of reported fall rates showed a consistent downward trend in FallSafe units but not controls. Significant reductions in reported fall rate were found in FallSafe units (adjusted rate ratio (ARR) 0.75, 95% confidence interval (CI) 0.68-0.84 P control units (ARR 0.91, 95% CI 0.81-1.03 P = 0.13). No significant changes in injurious fall rate were found in FallSafe units (ARR 0.86, 95% CI 0.71-1.03 P = 0.11), or controls (ARR 0.88, 95% CI 0.72-1.08 P = 0.13). In FallSafe units, staff certain falls had been reported increased from 60 to 77%. : introducing evidence-based care bundles of multifactorial assessment and intervention using a quality improvement approach resulted in improved delivery of multifactorial assessment and intervention and significant reductions in fall rates, but not in injurious fall rates. © The Author 2013. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  15. MARKETING STRATEGY TO INCREASE BED OCCUPANCY RATE

    Directory of Open Access Journals (Sweden)

    Purwaningsih Purwaningsih

    2017-07-01

    Full Text Available Introduction: A hospital is an institution for health care providing treatment by specialized staff and equipment, more often but not always providing for longer-term patient stays. Today, hospitals are very complex institution, not only survive in dynamic environment but also make a profit based on their services. The aimed of this research was to know marketing mix concept (product, price, place, promotion, people, process and provision of customer service in formulating marketing strategy to increased Bed Occupancy Rate of Obstetric Gynecology Ward 2. Method: The population are health care personnel including midwife, midwife associate, administrator and also client or consumer. The variable were product, price, place, promotion, people, process and provision of customer service. Data were collected by using structured questionnaire. Result: The result showed that product (type of services, infrastructure and facility, relative price, comfortable and safe place, targeted promotion, trained human resources, standard process and provision of customer service are an important aspect to implement strategy marketing to increase Bed Occupancy Rate. Analysis: The result of this study has enlightened the importance of strategy marketing in health care services based on seven principle of marketing mix. Discussion: Implementation of marketing mix in obstetric gynecology ward 2 need to be considered.

  16. Using Six Sigma methodology to reduce patient transfer times from floor to critical-care beds.

    Science.gov (United States)

    Silich, Stephan J; Wetz, Robert V; Riebling, Nancy; Coleman, Christine; Khoueiry, Georges; Abi Rafeh, Nidal; Bagon, Emma; Szerszen, Anita

    2012-01-01

    In response to concerns regarding delays in transferring critically ill patients to intensive care units (ICU), a quality improvement project, using the Six Sigma process, was undertaken to correct issues leading to transfer delay. To test the efficacy of a Six Sigma intervention to reduce transfer time and establish a patient transfer process that would effectively enhance communication between hospital caregivers and improve the continuum of care for patients. The project was conducted at a 714-bed tertiary care hospital in Staten Island, New York. A Six Sigma multidisciplinary team was assembled to assess areas that needed improvement, manage the intervention, and analyze the results. The Six Sigma process identified eight key steps in the transfer of patients from general medical floors to critical care areas. Preintervention data and a root-cause analysis helped to establish the goal transfer-time limits of 3 h for any individual transfer and 90 min for the average of all transfers. The Six Sigma approach is a problem-solving methodology that resulted in almost a 60% reduction in patient transfer time from a general medical floor to a critical care area. The Six Sigma process is a feasible method for implementing healthcare related quality of care projects, especially those that are complex. © 2011 National Association for Healthcare Quality.

  17. Effectiveness of Bed Bug Pesticides

    Science.gov (United States)

    Before EPA allows a bed bug claim on a label, the product must be supported by data showing it will kill bed bugs when applied according to the label. Also consider factors such as extent of infestation, site preparation, and insect life stages.

  18. Estimating ICU bed capacity using discrete event simulation.

    Science.gov (United States)

    Zhu, Zhecheng; Hen, Bee Hoon; Teow, Kiok Liang

    2012-01-01

    The intensive care unit (ICU) in a hospital caters for critically ill patients. The number of the ICU beds has a direct impact on many aspects of hospital performance. Lack of the ICU beds may cause ambulance diversion and surgery cancellation, while an excess of ICU beds may cause a waste of resources. This paper aims to develop a discrete event simulation (DES) model to help the healthcare service providers determine the proper ICU bed capacity which strikes the balance between service level and cost effectiveness. The DES model is developed to reflect the complex patient flow of the ICU system. Actual operational data, including emergency arrivals, elective arrivals and length of stay, are directly fed into the DES model to capture the variations in the system. The DES model is validated by open box test and black box test. The validated model is used to test two what-if scenarios which the healthcare service providers are interested in: the proper number of the ICU beds in service to meet the target rejection rate and the extra ICU beds in service needed to meet the demand growth. A 12-month period of actual operational data was collected from an ICU department with 13 ICU beds in service. Comparison between the simulation results and the actual situation shows that the DES model accurately captures the variations in the system, and the DES model is flexible to simulate various what-if scenarios. DES helps the healthcare service providers describe the current situation, and simulate the what-if scenarios for future planning.

  19. FY 2000 report on the potential survey of the environmental friendly type coal utilization system. Survey for digging up items for the model project on spread type circulating fluid bed boilers in China; 2000 nendo chosa hokokusho. Kankyo chowagata sekitan riyo system kanosei chosa. Chugoku ni okeru fukyugata junkan ryudo yukaboira setsubi model jigyo no anken hakkutsu chosa

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2000-09-01

    For the purpose of spreading/promoting circulating fluidized bed boilers in China, survey was conducted on the confirmation of effectiveness of implementation of the model project on spread type circulating fluidized bed boilers and the appropriateness of the sites proposed for implementation. As to the model of spread type 35t/h-CFB boilers, local products are more integrated into it, taking cost reduction of equipment and secure performance/quality into consideration, and the wider-ranging technical guidance/transfer are conducted also in design/production. In China, where environmental regulations are not strict, and there are many restrictions on funds, the size of the initial investment is an important element for selection of type. Further, the market is very big, about 200 units/year. It is highly possible to realize the competitive cost level by the quantity production effect by increasing local production. Two companies, Southeast Electrochemical Co. and Fujian Prime Pharmaceutical Group Co., which were proposed as sites are financially good and are achieving substantial results. Both companies are located in the urban area, and therefore, environmental measures should urgently be taken, and PR activities for spread are highly effective. It was confirmed that the companies were fully appropriate as sites proposed for the spread type model project. (NEDO)

  20. Mega-Project Construction Management: The Corps of Engineers and Bechtel Group in Saudi Arabia

    Science.gov (United States)

    1991-02-01

    waste-to-energy project in Massachusetts, an international airport for greater Hong Kong, decontamination of Three Mile Island Unit 2 reactor , the...available and when; even if committed may come in an uncertain trickle . 3. Desired Completion Date - Also interim dates; schedules tight or ample. 4. Time...Dental. Free routine dental work and 100 bed hospital at KKMC. - Schools. Kindergarden through 9th grade American school at KKMC. Free tuition for high

  1. Status of the fluidized bed unit

    International Nuclear Information System (INIS)

    Williams, P.M.; Wade, J.F.

    1994-01-01

    Rocky Flats has a serious mixed waste problem. No technology or company has a license and available facilities to remedy this dilemma. One solution under study is to use a catalytic fluidized bed unit to destroy the combustible portion of the mixed waste. The fluidized bed thermal treatment program at Rocky Flats is building on knowledge gained over twenty years of successful development activity. The FBU has numerous technical advantages over other thermal technologies to treat Rocky Flats' mixed waste, the largest being the lower temperature (700 degrees C versus 1000 degrees C) which reduces acid corrosion and mechanical failures and obviates the need for ceramic lining. Successful demonstrations have taken place on bench, pilot, and full-scale tests using radioactive mixed wastes. The program is approaching implementation and licensing of a production-scale fluidized bed system for the safe treatment of mixed waste. The measure for success on this project is the ability to work closely with the community to jointly solve problems and respond to concerns of mixed waste treatment at Rocky Flats

  2. Tracking the daily availability of burn beds for national emergencies.

    Science.gov (United States)

    Barillo, David J; Jordan, Marion H; Jocz, Richard J; Nye, Donna; Cancio, Leopoldo C; Holcomb, John B

    2005-01-01

    Medical planning for Operation Iraqi Freedom included predictive models of expected number of burn casualties. In all but the best-case scenario, casualty estimates exceeded the capacity of the only Department of Defense burn center. Examination of existing federal-civilian disaster plans for military hospital augmentation revealed that bed availability data were neither timely nor accurate. Recognizing the need for accurate knowledge of burn bed availability, the Department of Defense requested assistance from the American Burn Association (ABA). Directors of burn centers in the United States were queried for interest in participation in a mass casualty plan to provide overflow burn bed capacity. A list of 70 participating burn centers was devised based upon proximity to planned military embarkation points. A computer tracking program was developed. Daily automated e-mail messages requesting bed status were sent to burn center directors at 6 am Central time with responses requested before 11 am. The collated list of national overflow burn bed capacity was e-mailed each day to the ABA Central Office and to federal and military agencies involved with burn patient triage and transportation. Once automated, this task required only 1-2 hours a day. Available burn-bed lists were generated daily between March 17 and May 2, 2003 and then every other day until May 9, 2003. A total of 2151 responses were received (mean, 43 burn centers per day). A system to track daily nationwide burn bed availability was successfully implemented. Although intended for military conflict, this system is equally applicable to civilian mass casualty situations. We advocate adoption of this or a similar bed tracking system by the ABA for use during burn mass casualty incidents.

  3. Protecting Your Home from Bed Bugs

    Science.gov (United States)

    ... your home: Inspect the luggage rack in your hotel room for bed bugs. Check secondhand furniture, beds, ... with Bed Bug Problems Discover. Accessibility EPA Administrator Budget & Performance Contracting Grants January 19, 2017 Web Snapshot ...

  4. Saccharomyces boulardii for the prevention of hospital onset Clostridium difficile infection.

    Science.gov (United States)

    Flatley, Elizabeth A; Wilde, Ashley M; Nailor, Michael D

    2015-03-01

    Probiotics, including Saccharomyces boulardii, have been advocated for the prevention of Clostridium difficile infection. The aim of this project was to evaluate the effects of the removal of S. boulardii from an automatic antibiotic order set and hospital formulary on hospital onset C. difficile infection rates. A retrospective chart review was performed on all patients with hospital onset C. difficile infection during the 13 months prior (control group) and the 13 months after (study group) removal of an automatic order set linking S. boulardii capsules to certain broad spectrum antibiotics. A large 800+ bed tertiary hospital. Among all hospitalized patients, the rate of hospital onset C. difficile infection was 0.99 per 1000 patient days while the S. boulardii protocol was active compared with 1.04 per 1000 patient days (p=0.10) after S. boulardii was removed from the formulary. No difference in the rate of hospital onset C. difficile infection was detected in patients receiving the linked broad spectrum antibiotics during and after the removal of the protocol (1.25% vs. 1.51%, respectively; p=0.70). Removal of S. boulardii administration to patients receiving broad spectrum antibiotics and the hospital formulary did not impact the rate of hospital onset C. difficile infection in either the hospital population or patients receiving broad spectrum antibiotics.

  5. Gas fluidized bed reactor

    International Nuclear Information System (INIS)

    Bernardelli, H. da C.

    1976-03-01

    The equations of motion for both gas and particles in a gas fluidised system are stablished through general assumptions which are generally accepted on physical grounds. The resulting model is used to study the velocity fields of each phase in the case of an isolated bubble rising close to the flat distributor plate. A well posed problem results for the solution of Laplace's equation of the potential flow of the particles when consideration is given to the presence of the distributor as a boundary condition. The corresponding stream functions are also obtained which enable the drawing of the motion patterns using numerical techniques. The following two dimensional cases are analysed: S/b=1; S/b=1,5; S/b=2,5; S/b=5 and the limiting case S/b→αinfinite. The results for the interphase exchange between bubbles and particulate phases are applied to a gas fluidised bed reactor and its effect on the chemical conversion is studied for the simplest cases of piston flow and perfect mixing in the particulate phase [pt

  6. Chaotic hydrodynamics of fluidized beds

    Energy Technology Data Exchange (ETDEWEB)

    Van der Stappen, M.L.M. [Unit Process and Systems Engineering, Advanced Manufacturing Technology Group, Unilever Research Laboratorium, Vlaardingen (Netherlands)

    1996-12-31

    The major goals of this thesis are: (1) to develop and evaluate an analysis method based on techniques from non-linear chaos theory to characterize the nonlinear hydrodynamics of gas-solids fluidized beds quantitatively; and (2) to determine the dependence of the chaotic invariants on the operating conditions and investigate how the chaos analysis method can be profitably applied to improve scale-up and design of gas-solids fluidized bed reactors. Chaos theory is introduced in chapter 2 with emphasis on analysis techniques for (experimental) time series, known from literature at the start of this work (1990-1991). In chapter 3, the testing of existing and newly developed techniques on both model and fluidized bed data is described. This leads to the development of the chaos analysis method to analyze measured pressure fluctuations time series of a fluidized bed. Following, in chapter 4, this method is tested and all choices for the parameters are evaluated. The influence of the experimental parameters and external disturbances on the measurements and analysis results is discussed and quantified. The result is a chaos measurement and analysis protocol, which is further used in this work. In chapter 5, the applications to fluidized beds are discussed. It is shown that the entropy is a good measure for the characterization of the dynamical behavior of gas-solids bubbling/slugging fluidized beds. Entropy is applied to characterize the influence of the operating conditions, to assess regime transitions and to analyze dimensionless similar beds of different scale. Quantitative design correlations that relate entropy to the operating parameters (including the bed diameter) are described. Finally, it is discussed how the results of this work might be used in scaling up the chaotic dynamics of fluidized beds. The overall conclusions and outlook from this work are presented in chapter 6. 182 refs.

  7. Bed retained products in swept fixed bed (SFB) coal hydropyrolysis

    Energy Technology Data Exchange (ETDEWEB)

    Mastral, A.M.; Perez-Surio, M.J. [CSIC, Zaragosa (Spain). Inst. de Carboquimica

    1997-12-31

    The hydropyrolysis of a low rank coal in a swept fixed bed (SFB) reactor is carried out by fixing the hydrogen pressure (40 kg/cm{sup 2}), the hydrogen flow (2 l/min) and the residence time (10 min) at increasing temperatures (400 C, 500 C and 600 C) and coal bed heights (h, 1.5h, 2h, 2.5h and 3h). It is shown that the percentages of tars and char directly depend on the coal bed height and that there is not only a quantitative dependence, but also the height of the coal bed is very important and plays a relevant role on the nature of the conversion products. (orig.)

  8. Bed diameter effects and incipient slugging in gas fluidized beds

    International Nuclear Information System (INIS)

    Agarwal, P.K.

    1986-01-01

    The coalescence and growth of bubble swarms formed at the distributor of a fluidized bed gives rise to lateral as well as vertical distributions of bubble properties. However, existing models employ average bubble properties obtained largely from semi-empirical considerations. In a recent Paper, the author developed a bubble growth model based on a population balance approach. Analytical expressions were derived for the bubble characteristic distributions and averages. However, the model, developed for unconstrained growth, did not take into account the effect of the bed diameter and the possibility of slugging. In this Paper, the model is extended to take these aspects into account. A slugging criterion is also developed which is expected to be valid for the regime where incipient slugging depends on the bed height as well as the region where bed height does not significantly affect minimum slugging conditions

  9. Unit cost of medical services at different hospitals in India.

    Directory of Open Access Journals (Sweden)

    Susmita Chatterjee

    Full Text Available Institutional care is a growing component of health care costs in low- and middle-income countries, but local health planners in these countries have inadequate knowledge of the costs of different medical services. In India, greater utilisation of hospital services is driven both by rising incomes and by government insurance programmes that cover the cost of inpatient services; however, there is still a paucity of unit cost information from Indian hospitals. In this study, we estimated operating costs and cost per outpatient visit, cost per inpatient stay, cost per emergency room visit, and cost per surgery for five hospitals of different types across India: a 57-bed charitable hospital, a 200-bed private hospital, a 400-bed government district hospital, a 655-bed private teaching hospital, and a 778-bed government tertiary care hospital for the financial year 2010-11. The major cost component varied among human resources, capital costs, and material costs, by hospital type. The outpatient visit cost ranged from Rs. 94 (district hospital to Rs. 2,213 (private hospital (USD 1 = INR 52. The inpatient stay cost was Rs. 345 in the private teaching hospital, Rs. 394 in the district hospital, Rs. 614 in the tertiary care hospital, Rs. 1,959 in the charitable hospital, and Rs. 6,996 in the private hospital. Our study results can help hospital administrators understand their cost structures and run their facilities more efficiently, and we identify areas where improvements in efficiency might significantly lower unit costs. The study also demonstrates that detailed costing of Indian hospital operations is both feasible and essential, given the significant variation in the country's hospital types. Because of the size and diversity of the country and variations across hospitals, a large-scale study should be undertaken to refine hospital costing for different types of hospitals so that the results can be used for policy purposes, such as revising

  10. Unit Cost of Medical Services at Different Hospitals in India

    Science.gov (United States)

    Chatterjee, Susmita; Levin, Carol; Laxminarayan, Ramanan

    2013-01-01

    Institutional care is a growing component of health care costs in low- and middle-income countries, but local health planners in these countries have inadequate knowledge of the costs of different medical services. In India, greater utilisation of hospital services is driven both by rising incomes and by government insurance programmes that cover the cost of inpatient services; however, there is still a paucity of unit cost information from Indian hospitals. In this study, we estimated operating costs and cost per outpatient visit, cost per inpatient stay, cost per emergency room visit, and cost per surgery for five hospitals of different types across India: a 57-bed charitable hospital, a 200-bed private hospital, a 400-bed government district hospital, a 655-bed private teaching hospital, and a 778-bed government tertiary care hospital for the financial year 2010–11. The major cost component varied among human resources, capital costs, and material costs, by hospital type. The outpatient visit cost ranged from Rs. 94 (district hospital) to Rs. 2,213 (private hospital) (USD 1 = INR 52). The inpatient stay cost was Rs. 345 in the private teaching hospital, Rs. 394 in the district hospital, Rs. 614 in the tertiary care hospital, Rs. 1,959 in the charitable hospital, and Rs. 6,996 in the private hospital. Our study results can help hospital administrators understand their cost structures and run their facilities more efficiently, and we identify areas where improvements in efficiency might significantly lower unit costs. The study also demonstrates that detailed costing of Indian hospital operations is both feasible and essential, given the significant variation in the country’s hospital types. Because of the size and diversity of the country and variations across hospitals, a large-scale study should be undertaken to refine hospital costing for different types of hospitals so that the results can be used for policy purposes, such as revising payment rates

  11. Using multiple bed load measurements: Toward the identification of bed dilation and contraction in gravel-bed rivers

    Science.gov (United States)

    Marquis, G. A.; Roy, A. G.

    2012-02-01

    This study examines bed load transport processes in a small gravel-bed river (Béard Creek, Québec) using three complementary methods: bed elevation changes between successive floods, bed activity surveys using tags inserted into the bed, and bed load transport rates from bed load traps. The analysis of 20 flood events capable of mobilizing bed material led to the identification of divergent results among the methods. In particular, bed elevation changes were not consistent with the bed activity surveys. In many cases, bed elevation changes were significant (1 to 2 times the D50) even if the bed surface had not been activated during the flood, leading to the identification of processes of bed dilation and contraction that occurred over 10% to 40% of the bed surface. These dynamics of the river bed prevent accurate derivation of bed load transport rates from topographic changes, especially for low magnitude floods. This paper discusses the mechanisms that could explain the dilation and contraction of particles within the bed and their implications in fluvial dynamics. Bed contraction seems to be the result of the winnowing of the fine sediments under very low gravel transport. Bed dilation seems to occur on patches of the bed at the threshold of motion where various processes such as fine sediment infiltration lead to the maintenance of a larger sediment framework volume. Both processes are also influenced by flood history and the initial local bed state and in turn may have a significant impact on sediment transport and morphological changes in gravel-bed rivers.

  12. The Introduction of a Full Medication Review Process in a Local Hospital: Successes and Barriers of a Pilot Project in the Geriatric Ward

    Directory of Open Access Journals (Sweden)

    Lies De Bock

    2018-02-01

    Full Text Available For the majority of Belgian hospitals, a pharmacist-led full medication review process is not standard care and, therefore, challenging to introduce. With this study, we aimed to evaluate the successes and barriers of the implementation of a pharmacist-led full medication review process in the geriatric ward at a local Belgian hospital. To this end, we carried out an interventional study, performing a full medication review on older patients (≥70 years with polypharmacy (≥5 drugs who had an unplanned admission to the geriatric ward. The process consisted of 3 steps: (1 medication reconciliation upon admission; (2 medication review using an explicit reviewing tool (STOPP/START criteria or GheOP3S tool, followed by a discussion between the pharmacist and the geriatrician; and (3 medication reconciliation upon discharge. Ethical approval was obtained from the Ethical Commission of the Ghent University Hospital. Outcomes included objective data on the interventions (e.g., number of drug discrepancies; number of potentially inappropriate prescriptions (PIP; as well as subjective experiences (e.g., satisfaction with service; opinion on inter-professional communication. There was a special focus on communication aspects within the introduction of this process. In total, 52 patients were included in the study, taking a median of 10 drugs (IQR 8–12. Upon admission, 122 drug discrepancies were detected. During medication review, 254 PIPs were detected and discussed, leading to an improvement in the appropriateness of medication use. The satisfaction of community pharmacists concerning additional communication and the satisfaction of the patients after counselling at discharge were positive. However, several barriers were encountered, such as the time-consuming process to gather necessary information from different sources, the non-continuity of the service due to the lack of trained personnel or the lack of safe, electronic platforms to share

  13. Gaze interaction from bed

    DEFF Research Database (Denmark)

    Hansen, John Paulin; San Agustin, Javier; Jensen, Henrik Tomra Skovsgaard Hegner

    2011-01-01

    This paper presents a low-cost gaze tracking solution for bedbound people composed of free-ware tracking software and commodity hardware. Gaze interaction is done on a large wall-projected image, visible to all people present in the room. The hardware equipment leaves physical space free to assis...

  14. Better backs by better beds?

    DEFF Research Database (Denmark)

    Bergholdt, Kim; Fabricius, Rasmus N; Bendix, Tom

    2008-01-01

    mattresses have a positive effect on LBP, and especially a hard mattress is commonly believed to have a positive effect. METHODS: One hundred sixty CLBP patients were randomized to 1 of 3 groups, having a mattress/bed mounted in their sleeping room for 1 month. The beds were: (1) waterbed (Akva), (2) body......-conforming foam mattress (Tempur), and (3) a hard mattress (Innovation Futon). At baseline and after 4 weeks, a blinded observer interviewed the patients on LBP levels (0-10), daily function (activities of daily living, 0-30), and on the amount of sleeping hours/night. RESULTS: Because of dropout of 19 patients...... using the probably most relevant "worst case" data. There were no relevant difference between the effects of the water bed and the foam bed. CONCLUSION: The Waterbed and foam mattress' did influence back symptoms, function and sleep more positively as apposed to the hard mattress, but the differences...

  15. Top Ten Bed Bug Tips

    Science.gov (United States)

    ... Directory Planning, Budget and Results Jobs and Internships Headquarters Offices Regional Offices Labs and Research Centers Bed ... you hire an expert, be sure it’s a company with a good reputation and request that it ...

  16. Torsion testing of bed joints

    DEFF Research Database (Denmark)

    Hansen, Klavs Feilberg; Pedersen, Carsten Mørk

    2008-01-01

    This paper describes a simple test method for determining the torsion strength of a single bed joint between two bricks and presents results from testing using this test method. The setup for the torsion test is well defined, require minimal preparation of the test specimen and the test can...... be carried out directly in a normal testing machine. The torsion strength is believed to be the most important parameter in out-of-plane resistance of masonry walls subjected to bending about an axis perpendicular to the bed joints. The paper also contains a few test results from bending of small walls about...... an axis perpendicular to the bed joints, which indicate the close connection between these results and results from torsion tests. These characteristics make the torsion strength well suited to act as substitute parameter for the bending strength of masonry about an axis perpendicular to the bed joints....

  17. Sea bed mapping and inspection

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2006-07-01

    The conference has 24 presentations on the topics: Sea bed mapping, inspection, positioning, hydrography, marine archaeology, remote operation vehicles and computerized simulation technologies, oil field activities and plans, technological experiences and problems. (tk)

  18. Fluid-bed methane proposed

    Energy Technology Data Exchange (ETDEWEB)

    1981-05-01

    The first full scale plant for the production of methane from organic waste could be built in the next few years believes M.J. Nyns of the University of Louvain, Belgium, utilizing either expanded bed or fluidised bed systems, with more than one stage, in a continuous flow arrangement. Up to 8.0 m cubed gas/m cubed digester/day could be produced with residence times reduced to 34 hours.

  19. Dispersion of Bed Load Particles

    OpenAIRE

    SAWAI, Kenji

    1987-01-01

    The motion of bed load particles is so irregular that they disperse remarkably with time.In this study, some flume tests using painted tracer particles were carried out, in which thedispersive property of tracers changed variously with sediment feed rate.In analysing this process, a stochastic simulation model is proposed where it is discussedabout the degree of exposure of individual particle near the bed surface and about the variationof its pick up rate. The exponential distribution of ste...

  20. Interaction of slurry pipe flow with a stationary bed

    Czech Academy of Sciences Publication Activity Database

    Matoušek, Václav

    2007-01-01

    Roč. 107, č. 6 (2007), s. 365-372 ISSN 0038-223X R&D Projects: GA ČR GA103/06/0428 Institutional research plan: CEZ:AV0Z20600510 Keywords : sheet flow * particle dispersion * suspension * concentration profile * bed shear stress Subject RIV: BK - Fluid Dynamics Impact factor: 0.108, year: 2007

  1. Minimum Energy Dissipation under Cocurrent Flow in Packed Beds

    Czech Academy of Sciences Publication Activity Database

    Akramov, T.A.; Stavárek, Petr; Jiřičný, Vladimír; Staněk, Vladimír

    2011-01-01

    Roč. 50, č. 18 (2011), s. 10824-10832 ISSN 0888-5885 R&D Projects: GA ČR GA104/09/0880 Institutional research plan: CEZ:AV0Z40720504 Keywords : energy dissipation * current flow * packed bed Subject RIV: CI - Industrial Chemistry, Chemical Engineering Impact factor: 2.237, year: 2011

  2. Developing and evaluating a meeting assistant test bed

    NARCIS (Netherlands)

    Post, W.M.; Lincoln, M.

    2008-01-01

    A test bed has been developed in which participants are tasked to work in simulated, scenario based, projects in which face-to-face and remote meetings of about 45 minutes have to be held. Measures on performance, team factors and remote aspects are automatically collected with electronic

  3. Trickle Bed Reactor Operation under Forced Liquid Feed Rate Modulation

    Czech Academy of Sciences Publication Activity Database

    Hanika, Jiří; Jiřičný, Vladimír; Karnetová, P.; Kolena, J.; Lederer, J.; Skála, D.; Staněk, Vladimír; Tukač, V.

    2007-01-01

    Roč. 13, č. 4 (2007), s. 192-198 ISSN 1451-9372 R&D Projects: GA MPO(CZ) FT-TA/039 Institutional research plan: CEZ:AV0Z40720504 Keywords : trickle -bed reactor * period * feed rate Subject RIV: CI - Industrial Chemistry, Chemical Engineering

  4. Dicyclopentadiene Hydrogenation in Trickle Bed Reactor under Forced Periodic Control

    Czech Academy of Sciences Publication Activity Database

    Skála, D.; Hanika, Jiří

    2008-01-01

    Roč. 62, č. 2 (2008), s. 215-218 ISSN 1336-7242 R&D Projects: GA MPO(CZ) FT-TA/039 Institutional research plan: CEZ:AV0Z40720504 Keywords : periodic control * trickle -bed reactor * dicyclopentadiene Subject RIV: CI - Industrial Chemistry, Chemical Engineering

  5. Gasification of Coal and PET in Fluidized Bed Reactor

    Czech Academy of Sciences Publication Activity Database

    Pohořelý, Michael; Vosecký, Martin; Kameníková, Petra; Punčochář, Miroslav; Skoblia, Sergej; Staf, M.; Vošta, J.; Koutský, B.; Svoboda, Karel

    2006-01-01

    Roč. 85, 17-18 (2006), s. 2458-2468 ISSN 0016-2361 R&D Projects: GA ČR(CZ) GA104/04/0829 Institutional research plan: CEZ:AV0Z40720504 Keywords : fludized bed * gasification * plastic waste Subject RIV: CI - Industrial Chemistry, Chemical Engineering Impact factor: 1.358, year: 2006

  6. On equivalent roughness of mobile bed at high shear stress

    Czech Academy of Sciences Publication Activity Database

    Matoušek, Václav; Krupička, Jan

    2009-01-01

    Roč. 57, č. 3 (2009), s. 191-199 ISSN 0042-790X R&D Projects: GA ČR GA103/06/0428 Institutional research plan: CEZ:AV0Z20600510 Keywords : bed shear * experiment * hydraulic transport * sediment transport Subject RIV: BK - Fluid Dynamics Impact factor: 1.000, year: 2009

  7. Feasibility Study of a Lunar Analog Bed Rest Model

    Science.gov (United States)

    Cromwell, Ronita L.; Platts, Steven H.; Yarbough, Patrice; Buccello-Stout, Regina

    2010-01-01

    The purpose of this study was to determine the feasibility of using a 9.5deg head-up tilt bed rest model to simulate the effects of the 1/6 g load to the human body that exists on the lunar surface. The lunar analog bed rest model utilized a modified hospital bed. The modifications included mounting the mattress on a sled that rolled on bearings to provide freedom of movement. The weight of the sled was off-loaded using a counterweight system to insure that 1/6 body weight was applied along the long axis (z-axis) of the body. Force was verified through use of a force plate mounted at the foot of the bed. A seating assembly was added to the bed to permit periods of sitting. Subjects alternated between standing and sitting positions throughout the day. A total of 35% of the day was spent in the standing position and 65% was spent sitting. In an effort to achieve physiologic fluid shifts expected for a 1/6 G environment, subjects wore compression stockings and performed unloaded foot and ankle exercises. Eight subjects (3 females and 5 males) participated in this study. Subjects spent 13 days in the pre-bed rest phase, 6 days in bed rest and 3 days post bed rest. Subjects consumed a standardized diet throughout the study. To determine feasibility, measures of subject comfort, force and plasma volume were collected. Subject comfort was assessed using a Likert scale. Subjects were asked to assess level of comfort (0-100) for 11 body regions and provide an overall rating. Results indicated minimal to no discomfort as most subjects reported scores of zero. Force measures were performed for each standing position and were validated against subject s calculated 1/6 body weight (r(sup 2) = 0.993). The carbon monoxide rebreathing technique was used to assess plasma volume during pre-bed rest and on the last day of bed rest. Plasma volume results indicated a significant decrease (p = 0.001) from pre to post bed rest values. Subjects lost on average 8.3% (sd = 6.1%) during the

  8. Bed mixing dryer for high moisture content fuels

    Energy Technology Data Exchange (ETDEWEB)

    Hulkkonen, S; Heinonen, O. [Imatran Voima Oy, Vantaa (Finland)

    1998-12-31

    Bed mixing dryer is a new type of fuel drying technology for fluidized bed combustion. The idea is to extract hot bed material from the fluidized bed and use it as a heat source for drying the fuel. Drying occurs at steam atmosphere which makes it possible to recover the latent heat of evaporation to process. This improves the thermal efficiency of the power plant process considerably, especially in combined heat and power applications. Imatran Voima Oy (IVO) has developed the Bed Mixing Dryer technology since early 1990s. The first pilot plant was built in 1994 to IVO`s Kuusamo peat and wood fired power plant. The capacity of the plant is 6 MW{sub e} and 20 MW of district heat. In Kuusamo the dryer is connected to a bubbling fluidized bed. Since it`s commissioning the dryer has been used successfully for about 3000 hours during the heating season in wintertime. The second application of the technology will be a demonstration project in Oerebro (S). IVO Power Engineering Ltd will supply in 1997 a dryer to Oerebro Energi`s peat, wood and coal fired CHP plant equipped with circulating fluidized bed boiler. The fuel to be dried is sawdust with fuel input of about 60 MW. In Kuusamo the dryer produces 3 MW of additional district heat and in Oerebro 6 MW. The fuels in Kuusamo are peat, saw dust and bark. In addition to the municipal heat production this type of drying technology has its benefits in pulp and paper industry processes. Disposal of paper mill sludges is becoming more difficult and costly which has resulted in need of alternative treatment. Drying of the sludge before combustion in a boiler for power production is an attractive option. At the moment IVO is carrying out several studies to apply the Bed Mixing Dryer in pulp and paper industry processes. Economy of drying the sludge looks promising

  9. Bed mixing dryer for high moisture content fuels

    Energy Technology Data Exchange (ETDEWEB)

    Hulkkonen, S.; Heinonen, O. [Imatran Voima Oy, Vantaa (Finland)

    1997-12-31

    Bed mixing dryer is a new type of fuel drying technology for fluidized bed combustion. The idea is to extract hot bed material from the fluidized bed and use it as a heat source for drying the fuel. Drying occurs at steam atmosphere which makes it possible to recover the latent heat of evaporation to process. This improves the thermal efficiency of the power plant process considerably, especially in combined heat and power applications. Imatran Voima Oy (IVO) has developed the Bed Mixing Dryer technology since early 1990s. The first pilot plant was built in 1994 to IVO`s Kuusamo peat and wood fired power plant. The capacity of the plant is 6 MW{sub e} and 20 MW of district heat. In Kuusamo the dryer is connected to a bubbling fluidized bed. Since it`s commissioning the dryer has been used successfully for about 3000 hours during the heating season in wintertime. The second application of the technology will be a demonstration project in Oerebro (S). IVO Power Engineering Ltd will supply in 1997 a dryer to Oerebro Energi`s peat, wood and coal fired CHP plant equipped with circulating fluidized bed boiler. The fuel to be dried is sawdust with fuel input of about 60 MW. In Kuusamo the dryer produces 3 MW of additional district heat and in Oerebro 6 MW. The fuels in Kuusamo are peat, saw dust and bark. In addition to the municipal heat production this type of drying technology has its benefits in pulp and paper industry processes. Disposal of paper mill sludges is becoming more difficult and costly which has resulted in need of alternative treatment. Drying of the sludge before combustion in a boiler for power production is an attractive option. At the moment IVO is carrying out several studies to apply the Bed Mixing Dryer in pulp and paper industry processes. Economy of drying the sludge looks promising

  10. Report on research and development achievements in fiscal 1980 in Sunshine Project. Development of a high-temperature bed drilling technology (Feasibility study on high-temperature bed drilling); 1980 nendo koon chiso kusaku gijutsu no kaihatsu seika hokokusho. Koon chiso kussaku ni kansuru feasibility study

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1981-03-01

    Discussions were given on feasibility of a technology to drill efficiently a high-temperature bed (350 degrees C and 400 kg/cm{sup 2}) to 3 to 5 km. This paper summarizes the bit items for development (bearings, cutters, blade tips, sealing materials, a tip retaining method and structures). The roller cutter bit had the retaining power of the mother cutter material strengthened by using improved carbonized steel and heat treatment. A bit bearing using heat resistant material showed a life of 40 hours or longer at 350 degrees C. The solid bit using a two-layered ultra hard blade tip achieved a drilling rate of 0.84 m/h without any breakage. Studies were also advanced on the air friction drilling method. This paper also dwelled on heat and corrosion resistant blade tips, materials, enhancement of heat resistance in powder sintered cutters, and studies on the bit sealing. In addition to discussions on the percussion drilling as a new drilling method, discussions were given on slanted drilling, air drilling and multi-leg drilling. The paper summarizes these discussions together with development problems to be solved in the future. Research and development works were carried out also on an explosion preventing device, a roll packer, and a rotating head prevent device. (NEDO)

  11. FY 1975 Report on results of Sunshine Project. Development of techniques of digging high-temperature beds (Feasibility study on digging high-temperature beds); 1975 nendo koon chiso kussaku gijutsu no kaihatsu seika hokokusho. Koon chiso kussaku ni kansuru feasibility study

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1976-03-31

    The environmental conditions for which the digging techniques are to be developed have been set at 3,000 to 5,000 m as depth, 400 degrees C as temperature and 500 kg/cm{sup 2} as pressure. The environmental temperature was set at 250 degrees C as the first phase in the previous year. In this year, the temperature level is increased to 400 degrees C for the feasibility study on technological development. For development of the high-temperature bed digging apparatuses, masts, sub-structures, drawworks, slurry pumps, and pipe addition handling are studied as the problems involved in the rotary table method. Also studied are the related themes, e.g., drill pipes, drill collars, casing pipes, slurry, cementing and instruments to be installed in geothermal wells. For development of the bits, various problems to be solved are studied, including slurry circulation systems, bit diameter and speed of rotation, and bit configurations as those involved in the digging systems; heat-resistant materials, bit tooth forms, hardening of the edges, bearing configurations and cooling mechanisms as those involved in the bit structures; and optimum service conditions and selective use standards for roller cutter and solid bits. Other items studied include structures of the apparatuses for geothermal well mouth, and wear of digging tools for the air drilling method. (NEDO)

  12. Status of the in-pile test of HCPB pebble-bed assemblies in the HFR Petten

    Energy Technology Data Exchange (ETDEWEB)

    Laan, J.G. van der; Fokkens, J.H.; Hofmans, H.E.; Jong, M.; Magielsen, A.J.; Pijlgroms, B.J.; Stijkel, M.P. [NRG, Petten (Netherlands); Conrad, R. [JRC, Inst. for Energy, Petten (Netherlands); Malang, S.; Reimann, J. [FZK, Karlsruhe (Germany); Roux, N. [CEA Saclay (France)

    2002-06-01

    In the framework of developing the helium cooled pebble-bed (HCPB) blanket an irradiation test of pebble-bed assemblies is prepared at the HFR Petten. The test objective is to concentrate on the effect of neutron irradiation on the thermal-mechanical behaviour of the HCPB breeder pebble-bed at DEMO representative levels of temperature and defined thermal-mechanical loads. The basic test elements are EUROFER-97 cylinders with a horizontal bed of ceramic breeder pebbles sandwiched between two beryllium beds. The pebble beds are separated by EUROFER-97 steel plates. The heat flow is managed such as to have a radial temperature distribution in the ceramic breeder pebble-bed as flat as reasonably possible. The paper reports on the project status, and presents the results of pre-tests, material characteristics, the manufacturing of the pebble-bed assemblies, and the nuclear and thermo-mechanical loading parameters. (orig.)

  13. The work experience of a patient affected by Williams Syndrome: a pilot project at the Bambino Gesù Children's Hospital.

    Science.gov (United States)

    De Lorenzo, Francesca; Macchiaiolo, Marina; Carlevaris, Carla Maria; Bartuli, Andrea

    2017-05-31

    A new approach has been designed at the Bambino Gesù Children's Hospital in Rome aimed at increasing empowerment in Williams Syndrome individuals through tutor-assisted work activities. Williams Syndrome is characterized by a combination of distinguishing physical traits, congenital anomalies, intellectual disabilities, and a specific developmental profile.This manuscript describes the case of a Williams Syndrome patient.There are only few papers in the scientific literature describing interventions targeting improvement in the quality of life of adult Williams Syndrome individuals. Therefore, this experience may prove useful to several patients, their families, and the experts helping them.We described an example of intervention aimed at guiding and facilitating a Williams Syndrome patient within a work environment, taking into consideration the peaks and valleys of these individuals' specific abilities.Based on our results, we also stressed the need to promote a set of projects and initiatives aimed at enhancing as much as possible self-sufficiency and psycho-affective balance in Williams Syndrome individuals, in order to protect their dignity and self-esteem.

  14. Volatiles combustion in fluidized beds. Technical progress report, 4 March 1993--3 June 1993

    Energy Technology Data Exchange (ETDEWEB)

    Hesketh, R.P.

    1993-09-01

    The goal of this project is to investigate the conditions in which volatiles will burn within both the dense and freeboard regions of fluidized beds. Experiments using a fluidized bed operated at incipient fluidization will be performed to characterize the effect of particle surface area, initial fuel concentration, and particle type on the inhibition of volatiles within a fluidized bed. The work conducted during the period 4 March, 1993 through 3 June, 1993 is reported in this technical progress report. The work during this time period consists primarily of the startup and trouble shooting of the fluidized bed reactor and gas phase modeling of methane and propane.

  15. Components of Hospital Perioperative Infrastructure Can Overcome the Weekend Effect in Urgent General Surgery Procedures.

    Science.gov (United States)

    Kothari, Anai N; Zapf, Matthew A C; Blackwell, Robert H; Markossian, Talar; Chang, Victor; Mi, Zhiyong; Gupta, Gopal N; Kuo, Paul C

    2015-10-01

    We hypothesized that perioperative hospital resources could overcome the "weekend effect" (WE) in patients undergoing emergent/urgent surgeries. The WE is the observation that surgeon-independent patient outcomes are worse on the weekend compared with weekdays. The WE is often explained by differences in staffing and resources resulting in variation in care between the week and weekend. Emergent/urgent surgeries were identified using the Healthcare Cost and Utilization Project State Inpatient Database (Florida) from 2007 to 2011 and linked to the American Hospital Association (AHA) Annual Survey Database to determine hospital level characteristics. Extended median length of stay (LOS) on the weekend compared with the weekdays (after controlling for hospital, year, and procedure type) was selected as a surrogate for WE. Included were 126,666 patients at 166 hospitals. A total of 17 hospitals overcame the WE during the study period. Logistic regression, controlling for patient characteristics, identified full adoption of electronic medical records (OR 4.74), home health program (OR 2.37), pain management program [odds ratio (OR) 1.48)], increased registered nurse-to-bed ratio (OR 1.44), and inpatient physical rehabilitation (OR 1.03) as resources that were predictors for overcoming the WE. The prevalence of these factors in hospitals exhibiting the WE for all 5 years of the study period were compared with those hospitals that overcame the WE (P surgery procedures. Improved hospital perioperative infrastructure represents an important target for overcoming disparities in surgical care.

  16. What Bed Size Does a Patient Need? The Relationship Between Body Mass Index and Space Required to Turn in Bed.

    Science.gov (United States)

    Wiggermann, Neal; Smith, Kathryn; Kumpar, Dee

    A bed that is too small to allow patients to turn from supine to side lying increases the difficulty of mobilizing patients, which can increase risk of musculoskeletal injury to caregivers, increase risk of pressure injuries to patients, and reduce patient comfort. Currently, no guidance is available for what patient sizes are accommodated by the standard 91cm (36 in.)-wide hospital bed, and no studies have evaluated the relationship between anthropometric attributes and space required to turn in bed. The purpose of this research was to determine how much space individuals occupy when turning from supine to side lying as predicted by their anthropometry (i.e., body dimensions) to establish guidance on selecting the appropriate bed size. Forty-seven adult participants (24 female) with body mass index (BMI) from 20 to 76 kg/m participated in a laboratory study. Body dimensions were measured, and the envelope of space required to turn was determined using motion capture. Linear regressions estimated the relationship between anthropometric attributes and space occupied when turning. BMI was strongly correlated (R = .88) with the space required to turn. Based on the linear regressions, individuals with BMI up to 35 kg/m could turn left and right within 91 cm and individuals with BMI up to 45 kg/m could turn one direction within 91 cm. BMI is a good predictor of the space required to turn from supine to lateral. Nurses should consider placing patients that are unable to laterally reposition themselves on a wider bed when BMI is greater than 35 kg/m and should consider placing all patients greater than 45 kg/m on a wider bed regardless of mobility. Hospital administrators can use historical demographic information about the BMI of their patient populations to plan facility-level equipment procurement for equipment that accommodates their patients.

  17. [A hospital stay without bedsores].

    Science.gov (United States)

    Papas, Anne; Dérémience, Virginie; Tettiravou, Lucia; De Poix, Alix Tyrel

    2013-10-01

    A hospital stay without bedsores. The skin of elderly people is thin and fragile. After extended bed-rest, the skin's resources are rapidly depleted. The risk of bedsores becomes imminent. But a high-quality multi-disciplinary partnership can prevent bedsores in elderly patients with multiple illnesses. Example around a clinical case.

  18. Avaliação de intervenções de gestão da clínica na qualificação do cuidado e na oferta de leitos em um hospital público de grande porte = Evaluation of clinical governance interventions on qualification of care and supply of beds in a large public hospital

    Directory of Open Access Journals (Sweden)

    Anschau, Fernando

    2017-01-01

    CONCLUSÕES: A implantação da Gestão da Clínica no contexto do trabalho assistencial na unidade dos leitos de retaguarda do hospital em estudo associou-se a melhorias nos processos de cuidado, proporcionando maior oferta de leitos aos usuários

  19. Utility of Recycled Bedding for Laboratory Rodents

    OpenAIRE

    Miyamoto, Toru; Li, Zhixia; Kibushi, Tomomi; Okano, Shinya; Yamasaki, Nakamichi; Kasai, Noriyuki

    2009-01-01

    Animal facilities generate a large amount of used bedding containing excrement as medical waste. We developed a recycling system for used bedding that involves soft hydrothermal processing. In this study, we examined the effects of bedding type on growth, hematologic and serum biochemical values, and organ weights of female and male mice reared on either recycled or fresh bedding from 3 to 33 wk of age. Neither growth nor physiology differed between mice housed on recycled bedding compared wi...

  20. Oxy-fuel combustion on circulating fluidized bed. Chapter 5

    Energy Technology Data Exchange (ETDEWEB)

    Anthony, E.J. [Canmet, Natural Resources Canada (Canada); Hack, H. [Foster Wheeler North America Corporation (United States)

    2011-07-01

    This paper explores the developments and field tests carried out with oxy-fuel fluidized bed combustion. This method has the advantage over the other options of emitting a pure stream of CO2 which thus does not need to be concentrated to be liquefied, transported and stored. In addition, pilot scale tests have shown that oxy-fired circulating fluidized bed combustion (CFBC) results in low emission and fuel flexibility. This paper highlighted that oxy-fired CFBC might be a good option for CCS but tests performed so far have been on a small scale. To confirm the promising results of pilot tests, demonstration projects are underway and are presented herein.

  1. Fluid bed porosity equation for an inverse fluidized bed bioreactor with particles growing biofilm

    International Nuclear Information System (INIS)

    Campos-Diaz, K. E.; Limas-Ballesteros, R.

    2009-01-01

    Fluid Bed Bioreactor performance is strongly affected by bed void fraction or bed porosity fluctuations. Particle size enlargement due to biofilm growth is an important factor that is involved in these variations and until now there are no mathematical equations that consider biofilm growth. In this work a mathematical equation is proposed to calculate bed void fraction in an inverse fluid bed bioreactor. (Author)

  2. The effect of insecticide-treated bed net on malarial parasitaemia ...

    African Journals Online (AJOL)

    AFRICAN JOURNALS ONLINE (AJOL) · Journals · Advanced Search ... nets sold by a social marketing project were used as the intervention group. ... Keywords: Insecticide-treated bed net, Effectiveness, Malaria control, South-South Nigeria.

  3. Effects of Drawdown and Structures on Bed-Load Transport in Pool 8 Navigation Channel

    National Research Council Canada - National Science Library

    Abraham, David; Hendrickson, Jon

    2003-01-01

    ... of a pool drawdown and structures on bed-load transport in the Pool 8 navigation channel. Work was conducted as part of the Monitoring of Completed Navigation Projects (MCNP) program. BACKGROUND...

  4. Feasibility study - Lowered bed temperature in Fluidised Bed boilers for waste; Foerstudie - Saenkt baeddtemperatur i FB-pannor foer avfallsfoerbraenning

    Energy Technology Data Exchange (ETDEWEB)

    Niklasson, Fredrik

    2009-01-15

    Waste incineration generally serves two purposes; 1) dispose of waste and 2) generation of heat and power. In the process of power production from waste fuels, the steam temperatures in super heaters are generally limited by the severe fouling and corrosion that occurs at elevated material temperatures, caused by high concentrations of alkali metals and chloride in the flue gas and fly ash. The overall aim of a continuation of present project is to determine if a reduced temperature of the bed zone in a fluidized bed waste incinerator reduces the amount of alkali chlorides in the flue gas. If so, a reduced bed temperature might enable increased steam temperature in super heaters, or, at unchanged steam temperature, improve the lifespan of the super heaters. The results from the project are of interest for plant owners wishing to improve performance of existing plants. The results may also be used to modify the design of future plants by boiler manufacturers. The aim of present pre-study was to determine how far the bed temperature can be reduced in a waste fired fluidized bed boiler in Boraas while maintaining a stable operation with sufficient combustion temperature in the freeboard to fulfil the directives of waste incineration. A continuation of the project will be based on the results from present study. The work is based on experiments at the test boiler. During the present study, no other measurements were performed apart from some sampling of bed material and ashes at different modes of operation. The experiments show that it is possible to alter the air and recycled flue gas in such a manner that the bed temperature is reduced from about 870 deg C to 700 deg C at 100% load and normal fuel mixture, while fulfilling the directive of 850 deg C at 2 seconds. Within normal variations of the fuel properties, however, the bed temperature increases to somewhat above 700 deg C if the fuel turns dry, while it falls below 650 deg C when the fuel turns wet. With

  5. Clinical physiology of bed rest

    Science.gov (United States)

    Greenleaf, John E.

    1993-01-01

    Maintenance of optimal health in humans requires the proper balance between exercise, rest, and sleep as well as time in the upright position. About one-third of a lifetime is spent sleeping; and it is no coincidence that sleeping is performed in the horizontal position, the position in which gravitational influence on the body is minimal. Although enforced bed rest is necessary for the treatment of some ailments, in some cases it has probably been used unwisely. In addition to the lower hydrostatic pressure with the normally dependent regions of the cardiovascular system, body fuid compartments during bed rest in the horizontal body position, and virtual elimination of compression on the long bones of the skeletal system during bed rest (hypogravia), there is often reduction in energy metabolism due to the relative confinement (hypodynamia) and alteration of ambulatory circadian variations in metabolism, body temperature, and many hormonal systems. If patients are also moved to unfamiliar surroundings, they probably experience some feelings of anxiety and some sociopsychological problems. Adaptive physiological responses during bed rest are normal for that environment. They are attempts by the body to reduce unnecessary energy expenditure, to optimize its function, and to enhance its survival potential. Many of the deconditioning responses begin within the first day or two of bed rest; these early responses have prompted physicians to insist upon early resumption of the upright posture and ambulation of bedridden patients.

  6. [Management characteristics in charity hospitals in Brazil].

    Science.gov (United States)

    Lima, Sheyla Maria Lemos; Barbosa, Pedro Ribeiro; Portela, Margareth C; Ugá, Maria Alicia Dominguez; Vasconcellos, Miguel Murat; Gerschman, Silvia

    2004-01-01

    This paper presents the management characteristics of charity hospitals in Brazil, based on data from a national survey developed in 2001. The sample accounted for the random inclusion of 66 Brazilian Unified Health System (SUS) inpatient care providers with less than 599 beds and all 26 hospitals with at least 599 beds. It also included 10 institutions assumed as non-providers of services to the SUS. The analyses are descriptive, focusing on the classification of the hospitals according to their managerial development level, as well as selected issues regarding the utilization of specific managerial technologies, human resources, technical services, and services contracting. Distinct managerial levels were identified, but it is important to note that 83% of the SUS providers with less than 599 beds were classified as having incipient management. The authors discuss implications of the findings for inpatient care policies, considering the importance of charity hospitals for the Brazilian Health System.

  7. Premier Hospital Historical Data

    Data.gov (United States)

    U.S. Department of Health & Human Services — To provide a historical overview of the participating hospitals, before the first project report, Premier Healthcare Informatics has used data already available for...

  8. Particle Bed Reactor scaling relationships

    International Nuclear Information System (INIS)

    Slovik, G.; Araj, K.; Horn, F.L.; Ludewig, H.; Benenati, R.

    1987-01-01

    Scaling relationships for Particle Bed Reactors (PBRs) are discussed. The particular applications are short duration systems, i.e., for propulsion or burst power. Particle Bed Reactors can use a wide selection of different moderators and reflectors and be designed for such a wide range of power and bed power densities. Additional design considerations include the effect of varying the number of fuel elements, outlet Mach number in hot gas channel, etc. All of these variables and options result in a wide range of reactor weights and performance. Extremely light weight reactors (approximately 1 kg/MW) are possible with the appropriate choice of moderator/reflector and power density. Such systems are very attractive for propulsion systems where parasitic weight has to be minimized

  9. Fluidized-bed nuclear reactor

    International Nuclear Information System (INIS)

    Grimmett, E.S.; Kunze, J.F.

    1975-01-01

    A reactor vessel containing a fluidized-bed region of particulate material including both a neutron-moderating and a fertile substance is described. A gas flow including fissile material passes through the vessel at a sufficient rate to fluidize the particulate material and at a sufficient density to support a thermal fission reaction within the fluidized-bed region. The high-temperature portion of a heat transfer system is located within the fluidized-bed region of the reactor vessel in direct contact with the fluidized particles. Heat released by fission is thereby transferred at an enhanced rate to a coolant circulating within the heat transfer system. Fission products are continuously removed from the gas flow and supplemental fissile material added during the reactor operation. (U.S.)

  10. Hospital Management Software Development

    OpenAIRE

    sobogunGod, olawale

    2012-01-01

    The purpose of this thesis was to implement a hospital management software which is suitable for small private hospitals in Nigeria, especially for the ones that use a file based system for storing information rather than having it stored in a more efficient and safer environment like databases or excel programming software. The software developed within this thesis project was specifically designed for the Rainbow specialist hospital which is based in Lagos, the commercial neurological cente...

  11. Activation of Hypocretin-1/Orexin-A Neurons Projecting to the Bed Nucleus of the Stria Terminalis and Paraventricular Nucleus Is Critical for Reinstatement of Alcohol Seeking by Neuropeptide S.

    Science.gov (United States)

    Ubaldi, Massimo; Giordano, Antonio; Severi, Ilenia; Li, Hongwu; Kallupi, Marsida; de Guglielmo, Giordano; Ruggeri, Barbara; Stopponi, Serena; Ciccocioppo, Roberto; Cannella, Nazzareno

    2016-03-15

    Environmental conditioning is a major trigger for relapse in abstinent addicts. We showed that activation of the neuropeptide S (NPS) system exacerbates reinstatement vulnerability to cocaine and alcohol via stimulation of the hypocretin-1/orexin-A (Hcrt-1/Ox-A) system. Combining pharmacologic manipulations with immunohistochemistry techniques, we sought to determine how NPS and Hcrt-1/Ox-A systems interact to modulate reinstatement of alcohol seeking in rats. Intrahypothalamic injection of NPS facilitated discriminative cue-induced reinstatement of alcohol seeking. This effect was blocked by the selective Hcrt-1/Ox-A antagonist SB334867 microinjected into the hypothalamic paraventricular nucleus (PVN) or into the bed nucleus of the stria terminalis (BNST) but not into the ventral tegmental area or the locus coeruleus. Combining double labeling and confocal microscopy analyses, we found that NPS-containing axons are in close apposition to hypothalamic Hcrt-1/Ox-A positive neurons, a significant proportion of which express NPS receptors, suggesting a direct interaction between the two systems. Retrograde tracing experiments showed that intra-PVN or intra-BNST red fluorobead unilateral injection labeled bilaterally Hcrt-1/Ox-A somata, suggesting that NPS could recruit two distinct neuronal pathways. Confirming this assumption, intra-BNST or PVN Hcrt-1/Ox-A injection enhanced alcohol seeking similarly to hypothalamic NPS injection but to a lesser degree. Results suggest that the Hcrt-1/Ox-A neurocircuitry mediating the facilitation of cue-induced reinstatement by NPS involves structures critically involved in stress regulation such as the PVN and the BNST. These findings open to the tempting hypothesis of a role of the NPS system in modulating the interactions between stress and environmental conditioning factors in drug relapse. Copyright © 2016. Published by Elsevier Inc.

  12. Prediction of bed level variations in nonuniform sediment bed channel

    Indian Academy of Sciences (India)

    B R Andharia

    2018-04-12

    Apr 12, 2018 ... A fully-coupled 1D mobile-bed model (CAR-. ICHAR) was introduced ...... for sediment trap, water level sensor, tail gate operated by lever arm at .... materials were brought back to upstream to feed the same through sediment ...

  13. The relationship of fluidized bed technology to the U.S. Clean Coal Technology demonstration program

    International Nuclear Information System (INIS)

    Weth, G.; Geffken, J.; Huber, D.A.

    1991-01-01

    Fluidized Bed Combustion projects (both AFBCs and PFBCs) have a prominent role in the US DOE Clean Coal Technology (CCT) Program. This program has the successful commercialization of these technologies as its primary objective and this is the basic criterion for government funding and participation in the development and demonstration of the technologies. Under the CCT program the US DOE is actively involved in the development and operation of three Fluidized Bed Technology projects, NUCLA, TIDD, and SPORN, and is in the negotiation stage on others, Dairyland, Nichols and Tallahassee. All of these projects, along with the operating information on fluidized beds in the industrial sector, will provide a basis for evaluating future utilization of Fluidized Bed Technology in the market place. Impacting upon further utilization will be the time-frame and the Clean Air Act Amendments of 1990. This paper presents the results of a study to ascertain the commercial readiness of Fluidized Bed Technology to meet the emissions and time-frame requirements of the Clean Air Act Amendments of 1990. Specifically addressed are: Commercialization criteria/factors which candidate and/or existing CCTs must achieve in order to gain market acceptance. The status of Fluidized Bed Technology in achieving these commercialization criteria for market acceptance (industrial and utility) consistent with the time frame of the Clean Air Act Amendments of 1990. Recommendations of commercialization criteria for future fluidized bed CCT demonstration projects

  14. Design requirements for the supercritical water oxidation test bed

    International Nuclear Information System (INIS)

    Svoboda, J.M.; Valentich, D.J.

    1994-05-01

    This report describes the design requirements for the supercritical water oxidation (SCWO) test bed that will be located at the Idaho National Engineering Laboratory (INEL). The test bed will process a maximum of 50 gph of waste plus the required volume of cooling water. The test bed will evaluate the performance of a number of SCWO reactor designs. The goal of the project is to select a reactor that can be scaled up for use in a full-size waste treatment facility to process US Department of Energy mixed wastes. EG ampersand G Idaho, Inc. will design and construct the SCWO test bed at the Water Reactor Research Test Facility (WRRTF), located in the northern region of the INEL. Private industry partners will develop and provide SCWO reactors to interface with the test bed. A number of reactor designs will be tested, including a transpiring wall, tube, and vessel-type reactor. The initial SCWO reactor evaluated will be a transpiring wall design. This design requirements report identifies parameters needed to proceed with preliminary and final design work for the SCWO test bed. A flow sheet and Process and Instrumentation Diagrams define the overall process and conditions of service and delineate equipment, piping, and instrumentation sizes and configuration Codes and standards that govern the safe engineering and design of systems and guidance that locates and interfaces test bed hardware are provided. Detailed technical requirements are addressed for design of piping, valves, instrumentation and control, vessels, tanks, pumps, electrical systems, and structural steel. The approach for conducting the preliminary and final designs and environmental and quality issues influencing the design are provided

  15. The association between number of doctors per bed and readmission of elderly patients with pneumonia in South Korea.

    Science.gov (United States)

    Lee, Joo Eun; Kim, Tae Hyun; Cho, Kyoung Hee; Han, Kyu-Tae; Park, Eun-Cheol

    2017-06-08

    There is an urgent need to reduce readmission of patients with pneumonia and improve quality of care. To assess the association between hospital resources and quality of care, we examined the effect of number of doctors per bed on 30-day readmission and investigated the combined effect of number of doctors per bed and number of beds. We used nationwide cohort sample data of health insurance claims by the National Health Insurance Service (NHIS) from 2002 to 2013. Pneumonia admissions to acute care hospitals among 7446 inpatients older than 65 were examined. We conducted a multivariate Cox proportional hazard model to analyze the association between the number of doctors per bed and 30-day readmission, as well as that of pneumonia-specific 30-day readmission with the combined effects of number of doctors per bed and number of beds. Overall, 1421 (19.1%) patients were readmitted within 30 days and 756 (11.2%) patients were readmitted for pneumonia within 30 days. Patients with pneumonia treated by very low or low number of doctors per bed showed higher readmission (pneumonia-specific readmission: hazard ratio [HR] = 1. 406, 95% confidence interval [CI] = 1.072-1.843 for low number of doctors per bed; all-cause readmissions: HR = 1.276, 95% CI = 1.026-1.587 for very low number of doctors per bed, and HR = 1.280, 95% CI = 1.064-1.540 for low number of doctors per bed). This empirical study showed that patients with pneumonia cared for in hospitals with more doctors were less likely to be readmitted. Pneumonia-specific 30-day readmission was also significantly associated with the combined effect of the number of doctors and the number of hospital beds.

  16. Economies of scale and optimal size of hospitals: Empirical results for Danish public hospitals

    DEFF Research Database (Denmark)

    Kristensen, Troels

    number of beds per hospital is estimated to be 275 beds per site. Sensitivity analysis to partial changes in model parameters yields a joint 95% confidence interval in the range 130 - 585 beds per site. Conclusions: The results indicate that it may be appropriate to consolidate the production of small...... the current configuration of Danish hospitals is subject to scale economies that may justify such plans and to estimate an optimal hospital size. Methods: We estimate cost functions using panel data on total costs, DRG-weighted casemix, and number : We estimate cost functions using panel data on total costs......, DRG-weighted casemix, and number of beds for three years from 2004-2006. A short-run cost function is used to derive estimates of long-run scale economies by applying the envelope condition. Results: We identify moderate to significant long-run economies of scale when applying two alternative We...

  17. Hospitals; hospitals13

    Data.gov (United States)

    University of Rhode Island Geospatial Extension Program — Hospital Facilities information was compiled from several various sources. Main source was the RI Department of Health Facilities Regulation database, License 2000....

  18. Bed system performance in helium circulation mode

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Yean Jin; Jung, Kwang Jin; Ahn, Do Hee; Chung, Hong Suk [UST, Daejeon (Korea, Republic of); Kang, Hee Suk [KAERI, Daejeon (Korea, Republic of); Yun, Sei Hun [NFRI, Deajeon (Korea, Republic of)

    2016-05-15

    As a part of the International Thermonuclear Experimental Reactor (ITER) Project, We have conducted an experiment for storing hydrogen to depleted uranium and zirconium cobalt. The helium blanket effect has been observed in experiments using metal hydrides. The collapse of the hydrogen isotopes are accompanied by the decay heat and helium-3. Helium-3 dramatically reduces the hydrogen isotope storage capacity by surrounding the metal. This phenomenon is called a helium blanket effect. In addition the authors are working on the recovery and removal techniques of helium-3. In this paper, we discuss the equipment used to test the helium blanket effect and the results of a helium circulation experiment. The helium-3 produced surrounds the storage material surface and thus disturbs the reaction of the storage material and the hydrogen isotope. Even if the amount of helium-3 is small, the storage capacity of the SDS bed significantly drops. This phenomenon is the helium blanket effect. To resolve this phenomenon, a circulating loop was introduced. Using a circulating system, helium can be separated from the storage material. We made a helium loop that includes a ZrCo bed. Then using a metal bellows pump, we tested the helium circulation.

  19. The Pebble Bed Modular Reactor: An obituary

    Energy Technology Data Exchange (ETDEWEB)

    Thomas, Steve, E-mail: stephen.thomas@gre.ac.u [Public Services International Research Unit (PSIRU), Business School, University of Greenwich, 30 Park Row, London SE10 9LS (United Kingdom)

    2011-05-15

    The High Temperature Gas-cooled Reactor (HTGR) has exerted a peculiar attraction over nuclear engineers. Despite many unsuccessful attempts over half a century to develop it as a commercial power reactor, there is still a strong belief amongst many nuclear advocates that a highly successful HTGR technology will emerge. The most recent attempt to commercialize an HTGR design, the Pebble Bed Modular Reactor (PBMR), was abandoned in 2010 after 12 years of effort and the expenditure of a large amount of South African public money. This article reviews this latest attempt to commercialize an HTGR design and attempts to identify which issues have led to its failure and what lessons can be learnt from this experience. It concludes that any further attempts to develop HTGRs using Pebble Bed technology should only be undertaken if there is a clear understanding of why earlier attempts have failed and a high level of confidence that earlier problems have been overcome. It argues that the PBMR project has exposed serious weaknesses in accountability mechanisms for the expenditure of South African public money. - Research highlights: {yields} In this study we examine the reasons behind the failure of the South African PBMR programme. {yields} The study reviews the technical issues that have arisen and lessons for future reactor developments. {yields} The study also identifies weaknesses in the accountability mechanisms for public spending.

  20. Fluidized bed combustion: mixing and pollutant limitation

    Energy Technology Data Exchange (ETDEWEB)

    Leckner, B. [Chalmers Univ. of Technology, Goeteborg (Sweden). Dept. of Energy Conversion

    1997-10-01

    Fluidized bed combustion (FBC) has been applied commercially during a few decades, and sufficient knowledge is gained to design boilers with sizes of up to several hundreds of megawatt thermal power (MW{sub th}). The knowledge of what goes on inside a large combustion chamber is still limited, however, and this impedes further optimization and efficient solution of problems that might occur. Despite this lack of knowledge the present survey deals with combustion chamber processes and discusses mixing and distribution of fuel and air in the combustion chamber and its importance for sulphur capture and reduction of emissions of nitrogen oxides. It is desirable to present the material in a general way and to cover the entire field of FBC. However, the scarce openly published information deals mostly with coal combustion in atmospheric circulating fluidized bed (CFB) combustors, and therefore this application will receive most attention, but reference is also made to pressurized combustion and to other fuels than coal. In this context the important work made in the LIEKKI project on the analysis of different fuels and on the influence of pressure should be especially pointed out. (orig.)

  1. Service Robots for Hospitals

    DEFF Research Database (Denmark)

    Özkil, Ali Gürcan

    services to maintain the quality of healthcare provided. This thesis and the Industrial PhD project aim to address logistics, which is the most resource demanding service in a hospital. The scale of the transportation tasks is huge and the material flow in a hospital is comparable to that of a factory. We......Hospitals are complex and dynamic organisms that are vital to the well-being of societies. Providing good quality healthcare is the ultimate goal of a hospital, and it is what most of us are only concerned with. A hospital, on the other hand, has to orchestrate a great deal of supplementary...... believe that these transportation tasks, to a great extent, can be and will be automated using mobile robots. This thesis consequently addresses the key technical issues of implementing service robots in hospitals. In simple terms, a robotic system for automating hospital logistics has to be reliable...

  2. Apparatus and process for controlling fluidized beds

    Science.gov (United States)

    Rehmat, Amirali G.; Patel, Jitendra G.

    1985-10-01

    An apparatus and process for control and maintenance of fluidized beds under non-steady state conditions. An ash removal conduit is provided for removing solid particulates from a fluidized bed separate from an ash discharge conduit in the lower portion of the grate supporting such a bed. The apparatus and process of this invention is particularly suitable for use in ash agglomerating fluidized beds and provides control of the fluidized bed before ash agglomeration is initiated and during upset conditions resulting in stable, sinter-free fluidized bed maintenance.

  3. Problems facing Korean hospitals and possible countermeasures.

    Science.gov (United States)

    Kim, Kwang-Tae

    2004-07-01

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

  4. CIRCULATING MOVING BED COMBUSTION PROOF OF CONCEPT

    Energy Technology Data Exchange (ETDEWEB)

    Jukkola, Glen

    2010-06-30

    Circulating Moving Bed (CMB) combustion technology has its roots in traditional circulating fluidized bed technology and involves a novel method of solid fuel combustion and heat transfer. CMB technology represents a step change in improved performance and cost relative to conventional PC and FBC boilers. The CMB heat exchanger preheats the energy cycle working fluid, steam or air, to the high temperature levels required in systems for advanced power generation. Unique features of the CMB are the reduction of the heat transfer surfaces by about 60% as a result of the enhanced heat transfer rates, flexibility of operation, and about 30% lower cost over existing technology. The CMB Phase I project ran from July 2001 through March 2003. Its objective was to continue development of the CMB technology with a series of proof of concept tests. The tests were conducted at a scale that provided design data for scale up to a demonstration plant. These objectives were met by conducting a series of experiments in ALSTOM Power’s Multi-use Test Facility (MTF). The MTF was modified to operate under CMB conditions of commercial interest. The objective of the tests were to evaluate gas-to-solids heat transfer in the upper furnace, assess agglomeration in the high temperature CMB bubbling bed, and evaluate solids-to-tube heat transfer in the moving bed heat exchanger. The Phase I program results showed that there are still some significant technical uncertainties that needed to be resolved before the technology can be confidently scaled up for a successful demonstration plant design. Work remained in three primary areas: • scale up of gas to solid heat transfer • high temperature finned surface design • the overall requirements of mechanical and process design. The CMB Phase II workscope built upon the results of Phase I and specifically addressed the remaining technical uncertainties. It included a scaled MTF heat transfer test to provide the necessary data to scale up gas

  5. Hybrid Molten Bed Gasifier for High Hydrogen Syngas Production

    Energy Technology Data Exchange (ETDEWEB)

    Rue, David [Gas Technology Institute, Des Plaines, IL (United States)

    2017-05-23

    The techno-economic analyses of the hybrid molten bed gasification technology and laboratory testing of the HMB process were carried out in this project by the Gas Technology Institute and partner Nexant, Inc. under contract with the US Department of Energy’s National Energy Technology Laboratory. This report includes the results of two complete IGCC and Fischer-Tropsch TEA analyses comparing HMB gasification with the Shell slagging gasification process as a base case. Also included are the results of the laboratory simulation tests of the HMB process using Illinois #6 coal fed along with natural gas, two different syngases, and steam. Work in this 18-month project was carried out in three main Tasks. Task 2 was completed first and involved modeling, mass and energy balances, and gasification process design. The results of this work were provided to Nexant as input to the TEA IGCC and FT configurations studied in detail in Task 3. The results of Task 2 were also used to guide the design of the laboratory-scale testing of the HMB concept in the submerged combustion melting test facility in GTI’s industrial combustion laboratory. All project work was completed on time and budget. A project close-out meeting reviewing project results was conducted on April 1, 2015 at GTI in Des Plaines, IL. The hybrid molten bed gasification process techno-economic analyses found that the HMB process is both technically and economically attractive compared with the Shell entrained flow gasification process. In IGCC configuration, HMB gasification provides both efficiency and cost benefits. In Fischer-Tropsch configuration, HMB shows small benefits, primarily because even at current low natural gas prices, natural gas is more expensive than coal on an energy cost basis. HMB gasification was found in the TEA to improve the overall IGCC economics as compared to the coal only Shell gasification process. Operationally, the HMB process proved to be robust and easy to operate. The burner

  6. Physiology Of Prolonged Bed Rest

    Science.gov (United States)

    Greenleaf, John E.

    1991-01-01

    Report describes physiological effects of prolonged bed rest. Rest for periods of 24 hours or longer deconditions body to some extent; healing proceeds simultaneously with deconditioning. Report provides details on shifts in fluid electrolytes and loss of lean body mass, which comprises everything in body besides fat - that is, water, muscle, and bone. Based on published research.

  7. How to Find Bed Bugs

    Science.gov (United States)

    Find and correctly identify an infestation early before it becomes widespread. Look for rusty or reddish stains and pinpoint dark spots on bed sheets or mattresses, and search for bugs near the piping, seams and tags of the mattress and box spring.

  8. The heat transfer mechanisms in fluidized beds; Laemmoensiirtomekanismit leijukerroksessa

    Energy Technology Data Exchange (ETDEWEB)

    Fogelholm, C.J.; Blomster, A.M.; Kojola, H. [Helsinki Univ. of Technology, Otaniemi (Finland). Lab. of Energy Technology and Environmental Protection

    1997-10-01

    The goal of the research project is to improve the accuracy of the heat transfer correlation in circulating fluidized beds and to define how the heat transfer is distributed in radiation and convection in the different parts of the fluidized bed. This will be carried out by studying the behaviour and the heat transfer of the fluidized bed in the boundary layer near the wall. During the project the concentration and the velocity of the sand particles are measured. The particle concentration and the particle velocity are measured by an image analysis system. A video camera and a Super VHS recorder are used to capture live images from the bed. The images are digitized and stored on a PC. The measured particle concentration was at highest slightly over 20 % on the straight wall. As expected, the velocity of the fluidizing gas had the most important role on the particle concentration. The experimental studies of the particle velocity were started last autumn 1996. The velocities of the particles were measured by using a multiple exposure technique. Afterwards the images captured were analyzed by performing a Fourier transform analysis. So far the results have been encouraging and the analyzing work will be ended this spring. (orig.)

  9. ADVANCES IN CLOG STATE MONITORING FOR USE IN AUTOMATED REED BED INSTALLATIONS

    Directory of Open Access Journals (Sweden)

    Theodore HUGHES-RILEY

    2014-06-01

    Full Text Available Constructed wetlands are a popular form of waste-water treatment that have proliferated across Europe and the rest of the world in recent years as an environmentally conscious form of waste water treatment. The ability to monitor the conditions in the bed and control input factors such as heating and aeration may extend the lifetime of the reed bed substantially beyond the ten year lifetime normally reached. The Autonomous Reed Bed Installation (ARBI project is an EU FP7 initiative to develop a reed bed with automated control over input parameters based on readings taken from embedded sensors. Automated remedial action may improve bed treatment efficiency, and prolong the life of the bed and avoiding the need to refurbish the bed, which is both time consuming and costly. One critical parameter to observe is the clog state of the reed bed, as this can severely impact on the efficiency of water treatment to the point of the bed becoming non-operable. Magnetic resonance (MR sensors can be a powerful tool in determining clogging levels, and has previously been explored in the literature. This work is based on a conference paper (2nd International Conference "Water resources and wetlands", 2014 and details magnetic sensors suitable for long-term embedding into a constructed wetland. Unlike previous studies this work examines a probe embedded into a wetland.

  10. Report on investigations in fiscal 2000 on the basic investigation on promotion of joint implementation. Project to utilize coal bed methane gas for power generation in Poland; 2000 nendo kyodo jisshi nado suishin kiso chosa hokokusho. Poland tanko methane gas hatsuden riyo keikaku

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2001-03-01

    Having the Mining Industry Restructuring Public Corporation located in the city of Katowice, Poland as the counterpart, a feasibility study has been executed on a project to utilize coal bed gas for power generation. Selected for the study are the 'Budryk coal mine' owned by KWK 'Budryk' Coal Company and the 'Pniowek coal mine' owned by Jastrzebie Coal Company. Since the Pniowek coal mine can utilize the whole quantity of recovered methane by 2001, the Budryk coal mine was selected as the object of the project. As a result of the trial calculation on the economy when the new gas power plant is installed in the Budryk coal mine, the energy substitution effect was found to equal to a power amount at transmission terminal of 6 MWh/year. Furthermore, when proliferation effect is taken into consideration, an enormous effect can be expected if new coal mines are developed and the existing cola mines will go further deeper, because the Silesian coal mine presently has the coal resource quantity of 57 billion tons and the annual gas discharge quantity of 750 million m{sup 3}. Therefore, if the technologies to recover, manage and utilize the gas are established at the Budryk coal mine, a large effect leading to an aspiration would be expected under the current situation of the structural reorganization under which the Polish coal companies are placed. (NEDO)

  11. The effect of hydraulic bed movement on the quality of chest compressions.

    Science.gov (United States)

    Park, Maeng Real; Lee, Dae Sup; In Kim, Yong; Ryu, Ji Ho; Cho, Young Mo; Kim, Hyung Bin; Yeom, Seok Ran; Min, Mun Ki

    2017-08-01

    The hydraulic height control systems of hospital beds provide convenience and shock absorption. However, movements in a hydraulic bed may reduce the effectiveness of chest compressions. This study investigated the effects of hydraulic bed movement on chest compressions. Twenty-eight participants were recruited for this study. All participants performed chest compressions for 2min on a manikin and three surfaces: the floor (Day 1), a firm plywood bed (Day 2), and a hydraulic bed (Day 3). We considered 28 participants of Day 1 as control and each 28 participants of Day 2 and Day 3 as study subjects. The compression rates, depths, and good compression ratios (>5-cm compressions/all compressions) were compared between the three surfaces. When we compared the three surfaces, we did not detect a significant difference in the speed of chest compressions (p=0.582). However, significantly lower values were observed on the hydraulic bed in terms of compression depth (p=0.001) and the good compression ratio (p=0.003) compared to floor compressions. When we compared the plywood and hydraulic beds, we did not detect significant differences in compression depth (p=0.351) and the good compression ratio (p=0.391). These results indicate that the movements in our hydraulic bed were associated with a non-statistically significant trend towards lower-quality chest compressions. Copyright © 2017 Elsevier Inc. All rights reserved.

  12. Adult Bed-Wetting: A Concern?

    Science.gov (United States)

    Adult bed-wetting: A concern? My 24-year-old husband has started to wet the bed at ... of Privacy Practices Notice of Nondiscrimination Manage Cookies Advertising Mayo Clinic is a not-for-profit organization ...

  13. Find a Bed Bug Pesticide Product

    Science.gov (United States)

    Introduces the Bed Bug Product Search Tool, to help consumers find EPA-registered pesticides for bed bug infestation control. Inclusion in this database is not an endorsement. Always follow label directions carefully.

  14. EPA-Registered Bed Bug Products

    Science.gov (United States)

    ... rest or hide in hampers, bed frames, even furniture); Failing to treat adjacent areas where bed bugs ... to work (some pesticides, such as desiccators or growth regulators, may be very effective but take some ...

  15. Bed Bug Guidance for School Nurses

    Science.gov (United States)

    School nurses are often called upon to provide vital information to students, parents, teachers, and administrators. These tips on identifying, managing and preventing bed bugs will help you to effectively respond if bed bugs appear in your school.

  16. INCOME PER BED AS A DETERMINANT OF HOSPITAL’S FINANCIAL LIQUIDITY

    Directory of Open Access Journals (Sweden)

    Agnieszka Bem

    2014-10-01

    Full Text Available Hospitals’ financial condition is very important, in terms of availability and quality of inpatient health care services. Inpatient’s services consume, in Poland, an important part (about 50% of National Health Fund resources, but financial situation of hospitals is difficult and many hospitals report problems with liquidity and solvency. The purpose of this research is to study the relationship between the intensity of care, measured by the annual income per bed, and the static liquidity ratios (current ratio and quick ratio. The research has been conducted on the sample of 138 Polish hospitals, using data covering the period 2009-2011. In order to test research hypotheses, statistical tools have been used (T-Student distribution. The study has shown, that, during analyzed period, liquidity ratios have lowered and the level of financial liquidity is, in case of Polish hospitals, lower than recommended in the literature. The authors also confirmed the existence of the relationship between annual income per bed and liquidity ratios. However, the most important finding is that the relationship between the hospital’s income per bed and financial liquidity ratios is positive only up to a certain level, which has been estimated at about 60,000-70,000 EUR per bed. Above this level further increase in income per bed decreases liquidity ratios. This finding seems to be extremely important for health care managers, which usually strive for the income maximization.

  17. Drawing Hospital Foodscapes

    DEFF Research Database (Denmark)

    Tvedebrink, Tenna Doktor Olsen; Fisker, Anna Marie; Kirkegaard, Poul Henning

    This poster presents a series of drawings depicting the initial considerations made with the Ph.D. project for an improved ‘Interior Design for Food’ in a Danish hospital ward. The project concerns a study on the ontological and symbolic interrelationship possibly existing between food...

  18. Study of recent and future trends in place of death in Belgium using death certificate data: a shift from hospitals to care homes

    Directory of Open Access Journals (Sweden)

    Deliens Luc

    2011-04-01

    Full Text Available Abstract Background Since most patients prefer out-of-hospital death, place of death can be considered an indicator of end-of-life care quality. The study of trends in place of death is necessary to examine causes of shifts, to evaluate efforts to alter place of death and develop future policies. This study aims to examine past trends and future projections of place of death. Methods Analysis of death certificates (decedents aged ≥ 1 year in Belgium (Flanders and Brussels Capital region 1998-2007. Trends in place of death were adjusted for cause of death, sociodemographic characteristics, environmental factors, numbers of hospital beds, and residential and skilled nursing beds in care homes. Future trends were based on age- and sex-specific mortality prognoses. Results Hospital deaths decreased from 55.1% to 51.7% and care home deaths rose from 18.3% to 22.6%. The percentage of home deaths remained stable. The odds of dying in a care home versus hospital increased steadily and was 1.65 (95%CI:1.53-1.78 in 2007 compared to 1998. This increase could be attributed to the replacement of residential beds by skilled nursing beds. Continuation of these trends would result in the more than doubling of deaths in care homes and a decrease in deaths at home and in hospital by 2040. Conclusions Additional end-of-life care resources in care homes largely explain the decrease in hospital deaths. Care homes will become the main locus of end-of-life care in the future. Governments should provide sufficient skilled nursing resources in care homes to fulfil the end-of-life care preferences and needs of patients.

  19. Bacillus cereus in free-stall bedding.

    Science.gov (United States)

    Magnusson, M; Svensson, B; Kolstrup, C; Christiansson, A

    2007-12-01

    To increase the understanding of how different factors affect the bacterial growth in deep sawdust beds for dairy cattle, the microbiological status of Bacillus cereus and coliforms in deep sawdust-bedded free stalls was investigated over two 14-d periods on one farm. High counts of B. cereus and coliforms were found in the entire beds. On average, 4.1 log(10) B. cereus spores, 5.5 log(10) B. cereus, and 6.7 log(10) coliforms per gram of bedding could be found in the upper layers of the sawdust likely to be in contact with the cows' udders. The highest counts of B. cereus spores, B. cereus, and coliforms were found in the bedding before fresh bedding was added, and the lowest immediately afterwards. Different factors of importance for the growth of B. cereus in the bedding material were explored in laboratory tests. These were found to be the type of bedding, pH, and the type and availability of nutrients. Alternative bedding material such as peat and mixtures of peat and sawdust inhibited the bacterial growth of B. cereus. The extent of growth of B. cereus in the sawdust was increased in a dose-dependent manner by the availability of feces. Urine added to different bedding material raised the pH and also led to bacterial growth of B. cereus in the peat. In sawdust, a dry matter content greater than 70% was needed to lower the water activity to 0.95, which is needed to inhibit the growth of B. cereus. In an attempt to reduce the bacterial growth of B. cereus and coliforms in deep sawdust beds on the farm, the effect of giving bedding daily or a full replacement of the beds was studied. The spore count of B. cereus in the back part of the free stalls before fresh bedding was added was 0.9 log units lower in stalls given daily bedding than in stalls given bedding twice weekly. No effect on coliform counts was found. Replacement of the entire sawdust bedding had an effect for a short period, but by 1 to 2 mo after replacement, the counts of B. cereus spores in the

  20. FY 1975 Report on results of Sunshine Project. Development of techniques of digging high-temperature beds (Researches on roller cutter bits); 1975 nendo koon chiso kussaku gijutsu no kaihatsu. Roller cutter bit no kenkyu

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1976-03-31

    It is necessary to establish the techniques for digging bedrocks under elevated temperature and pressure for development and utilization of geothermal energy. This project is aimed at development of heat- and wear-resistant bit cutters, which have efficient tooth edge forms and arrangements. Another factor that determines bit serviceability is the bearing built in a cutter, and this project is also aimed at development of long-serviceable bit bearings by improving their resistance to heat. Four types of bits were developed, on a trial basis, and tested (size: 8.625 inches, two types of tooth forms, different shapes and arrangements of insert tips). They were tested for, e.g., their excavation rate, under the conditions of 5 tons as load and 100 rpm. It is found that their excavation rate vary with load, speed of rotation, tooth height and tooth form. Excavation torque increases in almost proportion to load. The sliding bearings of silver and its alloy were tested, to confirm the effects of silver. It is necessary to conduct the field tests in an actual geothermal area of high rock temperature and the ground tests with test machines to dig heated rocks in and after FY 1975, for overall evaluation of the bits developed. (NEDO)

  1. Evaluation of AFBC co-firing of coal and hospital wastes

    Energy Technology Data Exchange (ETDEWEB)

    1991-02-01

    The purpose of this program is to expand the use of coal by utilizing CFB (circulating fluidized bed) technology to provide an environmentally safe method for disposing of waste materials. Hospitals are currently experiencing a waste management crisis. In many instances, they are no longer permitted to burn pathological and infectious wastes in incinerators. Older hospital incinerators are not capable of maintaining the stable temperatures and residence times necessary in order to completely destroy toxic substances before release into the atmosphere. In addition, the number of available landfills which can safely handle these substances is decreasing each year. The purpose of this project is to conduct necessary research investigating whether the combustion of the hospital wastes in a coal-fired circulating fluidized bed boiler will effectively destroy dioxins and other hazardous substances before release into the atmosphere. If this is proven feasible, in light of the quantity of hospital wastes generated each year, it would create a new market for coal -- possibly 50 million tons/year.

  2. Multiple intra-hospital transports during relocation to a new critical care unit.

    Science.gov (United States)

    O'Leary, R-A; Conrick-Martin, I; O'Loughlin, C; Curran, M-R; Marsh, B

    2017-11-01

    Intra-hospital transport (IHT) of critically ill patients is associated with morbidity and mortality. Mass transfer of patients, as happens with unit relocation, is poorly described. We outline the process and adverse events associated with the relocation of a critical care unit. Extensive planning of the relocation targeted patient and equipment transfer, reduction in clinical pressure prior to the event and patient care during the relocation phase. The setting was a 30-bed, tertiary referral, combined medical and surgical critical care unit, located in a 570-bed hospital that serves as the national referral centre for cardiothoracic surgery and spinal injuries. All stakeholders relevant to the critical care unit relocation were involved, including nursing and medical staff, porters, information technology services, laboratory staff, project development managers, pharmacy staff and building contractors. Mortality at discharge from critical care unit and discharge from hospital were the main outcome measures. A wide range of adverse events were prospectively recorded, as were transfer times. Twenty-one patients underwent IHT, with a median transfer time of 10 min. Two transfers were complicated by equipment failure and three patients experienced an episode of hypotension requiring intervention. There were no cases of central venous or arterial catheter or endotracheal tube dislodgement, and hospital mortality at 30 days was 14%. Although IHT is associated with morbidity and mortality, careful logistical planning allows for efficient transfer with low complication rates.

  3. Improving hand hygiene in a paediatric hospital: a multimodal quality improvement approach.

    Science.gov (United States)

    Jamal, Ahmed; O'Grady, G; Harnett, E; Dalton, D; Andresen, D

    2012-02-01

    Effective hand hygiene has long been recognised as an important way to reduce the transmission of bacterial and viral pathogens in healthcare settings. However, many studies have shown that adherence to hand hygiene remains low, and improvement efforts have often not delivered sustainable results. The Children's Hospital at Westmead is the largest tertiary paediatric hospital in Sydney, Australia. The hospital participated in a state-wide 'Clean hands save lives' campaign which was initiated in 2006. Strong leadership, good stakeholder engagement, readily accessible alcohol-based hand rub at the point of patient care, a multifaceted education programme, monitoring of staff, adherence to recommended hand hygiene practices and contemporaneous feedback of performance data have significantly improved and maintained compliance with hand hygiene. Hand hygiene compliance has increased from 23% in 2006 to 87% in 2011 (phand hygiene has been evident in the last 4 years. A decline in a set of hospital-acquired infections (including rotavirus, multiresistant organism transmission, and nosocomial bacteraemia) has also been noted as hand hygiene rates have improved. Monthly usage of alcohol-based hand rub has increased from 16 litres/1000 bed days to 51 litres/1000 bed days during this same period. This project has delivered sustained improvement in hand hygiene compliance by establishing a framework of multimodal evidence-based strategies.

  4. Fluidization quality analyzer for fluidized beds

    Science.gov (United States)

    Daw, C.S.; Hawk, J.A.

    1995-07-25

    A control loop and fluidization quality analyzer for a fluidized bed utilizes time varying pressure drop measurements. A fast-response pressure transducer measures the overall bed pressure drop, or over some segment of the bed, and the pressure drop signal is processed to produce an output voltage which changes with the degree of fluidization turbulence. 9 figs.

  5. Fluidized bed dry dense medium coal beneficiation

    CSIR Research Space (South Africa)

    North, Brian C

    2017-10-01

    Full Text Available medium beneficiation using a fluidized bed was investigated. Bed materials of sand, magnetite and ilmenite were used in a laboratory sized cylindrical fluidized bed. The materials were individually tested, as were mixes of sand and heavy minerals. Coal...

  6. Short term effects of air pollution on emergency hospital admissions for respiratory disease : Results of the APHEA project in two major cities in The Netherlands, 1977-89

    NARCIS (Netherlands)

    Schouten, JP; Vonk, JM; deGraaf, A

    Study objective - To assess the short term relationship between air pollution and the daily number of emergency hospital admissions for respiratory disease. Design - Data were analysed using autoregressive Poisson regression allowing for overdispersion and controlling for possible confounding

  7. The O3-Vet project: integration of a standard nomenclature of clinical terms in a veterinary electronic medical record for veterinary hospitals.

    Science.gov (United States)

    Zaninelli, M; Campagnoli, A; Reyes, M; Rojas, V

    2012-11-01

    In order to improve the hospital information system of the Chilean University Hospital, the Veterinary Medicine School of Universidad de Chile made a research cooperation with Università San Raffaele Roma to develop and test a new release of the O3-Vet software application. O3-Vet was selected by the Chilean University mainly for two reasons: (1) it uses human medicine standardized technologies such as "Health Level 7" (HL7) and "Integrating the Healthcare Enterprise" (IHE), which allow a good level of data sharing and hospital management; (2) it is open source, which means it can be adapted to specific hospital needs. In the new release, a subset of diagnostic terms was added from the "Systematized Nomenclature of Medicine Clinical Terms" (SNOMED CT), selected by the "American Animal Hospital Association" (AAHA) to standardize the filing of clinical data and its retrieval. Results from a limited survey of veterinarians of the University (n=9) show that the new release improved the management of the Chilean University Hospital and the ability to retrieve useful clinical data. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  8. Designing a CR Test bed

    DEFF Research Database (Denmark)

    Cattoni, Andrea Fabio; Buthler, Jakob Lindbjerg; Tonelli, Oscar

    2014-01-01

    with their own set up, since the potential costs and efforts could not pay back in term of expected research results. Software Defined Radio solutions offer an easy way to communication researchers for the development of customized research test beds. While several hardware products are commercially available......, an overview on common research-oriented software products for SDR development, namely GNU Radio, Iris, and ASGARD, will be provided, including how to practically start the software development of simple applications. Finally, best practices and examples of all the software platforms will be provided, giving...... they are up and running in generating results. With this chapter we would like to provide a tutorial guide, based on direct experience, on how to enter in the world of test bed-based research, providing both insight on the issues encountered in every day development, and practical solutions. Finally...

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

    DEFF Research Database (Denmark)

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

    2010-01-01

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

  10. Design and simulation of a circulating fluidized bed to clean the products of biomass gasification

    Energy Technology Data Exchange (ETDEWEB)

    Uchoa Neto, Moises; Carvalho, Yuri de Araujo [Dept. de Engenharia Mecanica. Faculdade de Tecnologia. Universidade de Brasilia, DF (Brazil); Oliveira, Taygoara Felamingo de; Barcelos, Manuel [Faculdade do Gama. Universidade de Brasilia, Gama, DF (Brazil)], e-mail: taygoara@unb.br

    2010-07-01

    The main goal of this work is to design a workbench circulating fluidized bed to study the cracking of tar in gases from the processes of biomass gasification. For this, a design methodology based on analytical results and empirical correlations for fluidized beds was employed. In parallel, a numerical code of open source technology (MFIX) for the solution of the transport equations of the multiphase flow in the column of a fluidized bed was used to give support to the choice of the design elements. The whole project of the workbench fluidized bed was completely developed, whose operation parameters such as bed geometry, gas velocity, circulating ratio and void fraction characterize a fast fluidization process. A preliminary mesh convergence study was executed with the numerical tool, that was validated comparing with analytical results. Among the most important results, the code computed the predicted value for the minimum fluidization. (author)

  11. Integrated drying and incineration of wet sewage sludge in combined bubbling and circulating fluidized bed units.

    Science.gov (United States)

    Li, Shiyuan; Li, Yunyu; Lu, Qinggang; Zhu, Jianguo; Yao, Yao; Bao, Shaolin

    2014-12-01

    An original integrated drying and incineration technique is proposed to dispose of sewage sludge with moisture content of about 80% in a circulating fluidized bed. This system combines a bubbling fluidized bed dryer with a circulating fluidized bed incinerator. After drying, sewage sludge with moisture less than 20% is transported directly and continuously from the fluidized bed dryer into a circulating fluidized bed incinerator. Pilot plant results showed that integrated drying and incineration is feasible in a unique single system. A 100 t/d Sewage Sludge Incineration Demonstration Project was constructed at the Qige sewage treatment plant in Hangzhou City in China. The operational performance showed that the main operation results conformed to the design values, from which it can be concluded that the scale-up of this technique is deemed both feasible and successful. Copyright © 2014 Elsevier Ltd. All rights reserved.

  12. THE BAUXITES AND JELAR - BEDS

    Directory of Open Access Journals (Sweden)

    Krešimir Sakač

    1993-12-01

    Full Text Available Minor bauxite deposits and occurrences were formed in technically disturbed environments in the middle part of the Adriatic geotectonic unit in Dinarides, contemporary with the clastic Jelar-beds in the Late Lutetian time. Uneven chemical composition of these Eocene bauxites, their sporadic occurrences in developed paleorelief as well as characteristic petrographic composition of the immediate overlying rocks point out at different genetical conditions (the paper is published in Croatian.

  13. Trends in epidemiology and hospitalization utilization for myelomeningocele repair from 2000 to 2009.

    Science.gov (United States)

    Harris, Dominic A; Cherian, Jacob; LoPresti, Melissa; Jea, Andrew; Lam, Sandi

    2016-07-01

    Although the incidence of myelomeningocele (MMC) has declined over the past decades with folic acid supplementation and prenatal screening, neural tube defects remain the most common birth defect in the USA. A majority of affected neonates require surgical repair. To characterize US trends in the epidemiology and hospital utilization of MMC repair over the past decade, we analyzed a nationally representative database. We queried the Healthcare Cost and Utilization Project (HCUP) Kid's Inpatient Database (KID) for all discharges with procedure code for MMC repair for the years 2000, 2003, 2006, and 2009. The cohorts from these time points were compared for their demographic and in-hospital variables. Results are reported as estimated frequencies and means with 95 % confidence intervals (CI). Sex, race, insurance status, family income level, and mortality of affected infants have not changed significantly over the decade. A majority of neonatal MMC repairs occur in larger hospital bed size and more specialized children's hospital centers. Of patients, 52.3 to 60 % receive VPS placement during the same admission as the primary MMC repair. Total hospital costs for the MMC hospitalizations have remained relatively stable from 42,843 dollars in 2003 to 46,749 dollars in 2009 (adjusted to 2009 dollars). Demographics of children having MMC repair have not changed significantly over the past decade, while these surgeries have become more concentrated in pediatric-specialized centers. There appears to be a plateau in public health and access advances with relatively stable cost of MMC hospital care.

  14. Hospital Compare

    Data.gov (United States)

    U.S. Department of Health & Human Services — Hospital Compare has information about the quality of care at over 4,000 Medicare-certified hospitals across the country. You can use Hospital Compare to find...

  15. HCAHPS - Hospital

    Data.gov (United States)

    U.S. Department of Health & Human Services — A list of hospital ratings for the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS). HCAHPS is a national, standardized survey of hospital...

  16. Advances in fluidized bed technologies

    International Nuclear Information System (INIS)

    Mutanen, K.

    1992-01-01

    Atmospheric fluidized bed combustion (AFBC) has advanced into industrial cogeneration and utility-scale electric generation. During the 1980's AFBC became the dominant technology in the United States for power generation systems fired with solid fuels. Development of pressurized fluidized bed combustion/gasification (PFB/G) has grown rapidly from small bench-scale rigs to large pilot and demonstration plants. AFBC as large as 160 MWe in capacity are now in operation, while pressurized combustion systems generating 80 MWe have started up two years ago. The major driving forces behind development of fluidized bed technologies are all the time strictening emission control regulations, need for fuel flexibility, repowering of older power plants and need for higher efficiency in electricity generation. Independent power producers (IPP) and cogenerators were the first ones in the United States who accepted AFBC for wide commercial use. Their role will be dominant in the markets of the 1990's also. Developers of AFBC systems are working on designs that reduce investment costs, decrease emissions and offer even higher reliability and availability in utility-scale applications while developers of PFBC/G work on designs that increase plant efficiencies, allow modular construction, decrease emissions further and reduce the cost of generating power. This paper presents technological background, commercial status, boiler performance, emissions and future developments for both AFBC and PFBC/G systems

  17. Organ Donation European Quality System: ODEQUS project methodology.

    Science.gov (United States)

    Manyalich, M; Guasch, X; Gomez, M P; Páez, G; Teixeira, L

    2013-01-01

    Differences in the number of organ donors among hospitals cannot be explained only by the number of intensive care unit beds used or neurologic patients treated. The figures obtained are influenced by the organizational structure of the donation process and how efficient it is. The Organ Donation European Quality System (ODEQUS) is a 3-year project (from October 2010 to September 2013) co-financed by the European Agency for Health and Consumers (EAHC20091108) which aims to define a methodology to evaluate organ procurement performance at the hospital level. ODEQUS's specific objectives are to identify quality criteria and to develop quality indicators in three types of organ donation (after brain death, after cardiac death, and living donation). Those tools will be useful for hospitals' self-assessment as well as for developing an international auditing model. A consortium has been established involving 14 associated partners from Austria, Croatia, France, Germany, Italy, Poland, Portugal, Romania, Spain, Sweden, and the United Kingdom, as well as five collaborating partners from Greece, Hungary, Malta, Slovenia, and Turkey. The project has been established in three steps: 1) Design of a survey about the use of quality tools in a wide sample of European hospitals; 2) Development of quality criteria and quality indicators by the project experts. The main fields considered have been organizational structures, clinical procedures, and outcomes; and 3) Elaboration of an evaluation system to test the quality indicators in 11 European hospitals. Two types of training have been designed and performed: one concerns the development of quality criteria and quality indicators, whereas another is focused on how to use evaluation tools. Following this methodology, the project has so far identified 131 quality criteria and developed 31 quality indicators. Currently, the quality indicators are being tested in 11 selected hospitals. Copyright © 2013 Elsevier Inc. All rights

  18. Evaluation of an institutional project to improve venous thromboembolism prevention.

    Science.gov (United States)

    Minami, Christina A; Yang, Anthony D; Ju, Mila; Culver, Eckford; Seifert, Kathryn; Kreutzer, Lindsey; Halverson, Terri; O'Leary, Kevin J; Bilimoria, Karl Y

    2016-12-01

    Northwestern Memorial Hospital (NMH) was historically a poor performer on the venous thromboembolism (VTE) outcome measure. As this measure has been shown to be flawed by surveillance bias, NMH embraced process-of-care measures to ensure appropriate VTE prophylaxis to assess healthcare-associated VTE prevention efforts. To evaluate the impact of an institution-wide project aimed at improving hospital performance on VTE prophylaxis measures. A retrospective observational study. NMH, an 885-bed academic medical center in Chicago, Illinois PATIENTS: Inpatients admitted to NMH from January 1, 2013 to May 1, 2013 and from October 1, 2014 to April 1, 2015 were eligible for evaluation. Using the define-measure-analyze-improve-control (DMAIC) process-improvement methodology, a multidisciplinary team implemented and iteratively improved 15 data-driven interventions in 4 broad areas: (1) electronic medical record (EMR) alerts, (2) education initiatives, (3) new EMR order sets, and (4) other EMR changes. The Joint Commission's 6 core measures and the Surgical Care Improvement Project (SCIP) SCIP-VTE-2 measure. Based on 3103 observations (1679 from January 1, 2013 to May 1, 2013, and 1424 from October 1, 2014 to April 1, 2015), performance on the core measures improved. Performance on measure 1 (chemoprophylaxis) improved from 82.5% to 90.2% on medicine services, and from 94.4% to 97.6% on surgical services. The largest improvements were seen in measure 4 (platelet monitoring), with a performance increase from 76.7% adherence to 100%, and measure 5 (warfarin discharge instructions), with a performance increase from 27.4% to 88.8%. A systematic hospital-wide DMAIC project improved VTE prophylaxis measure performance. Sustained performance has been observed, and novel control mechanisms for continued performance surveillance have been embedded in the hospital system. Journal of Hospital Medicine 2016;11:S29-S37. © 2016 Society of Hospital Medicine. © 2016 Society of Hospital

  19. Bed agglomeration characteristics of palm shell and corncob combustion in fluidized bed

    International Nuclear Information System (INIS)

    Chaivatamaset, Pawin; Sricharoon, Panchan; Tia, Suvit

    2011-01-01

    Bed particle agglomeration was studied experimentally in an atmospheric laboratory scale fluidized bed combustor using quartz sand as bed material. Palm shell and corncob were tested. The objectives of the study were (i) to describe the contributions of the biomass ash properties and the operating conditions on the bed agglomeration tendency in term of the bed defluidization time (t def ) and the extent of potassium accumulation in the bed (K/Bed) and (ii) to further elucidate the ash inorganic behaviors and the governing bed agglomeration mechanisms. Defluidization caused by the bed agglomeration was experienced in all experiments during combustion of these biomasses, as a consequence of the presence of potassium in biomass. The experimental results indicated that biomass ash characteristics were the significant influence on the bed agglomeration. The increasing bed temperature, bed particle size and static bed height and the decreasing fluidizing air velocity enhanced the bed agglomeration tendency. The SEM/EDS analyses on the agglomerates confirmed that the agglomeration was attributed to the formation of potassium silicate liquid enriched on the surface of quartz sand particles in conjunction with the high surface temperature of the burning biomass char particles. Thermodynamic examination based on the phase diagram analysis confirmed that the molten phase formation was responsible for the agglomeration. In this study, the high molten ash fraction resulting from the high potassium content in biomass promoted the agglomeration and thus defluidization. - Highlights: → Palm shell and corncob of Thailand are tested their bed agglomeration behaviors during fluidized bed combustion. → The increase of bed temperature, bed particle size and static bed height and the decrease of air velocity enhance bed agglomeration. → The formation of ash derived potassium silicate melts enriched on sand surface is the key process. → The collision between char and sand

  20. The characteristics of bed agglomeration during fluidized bed combustion of eucalyptus bark

    International Nuclear Information System (INIS)

    Chaivatamaset, Pawin; Tia, Suvit

    2015-01-01

    The bed agglomeration behaviors were investigated experimentally when eucalyptus bark was burning tested in a laboratory scale fluidized bed reactor. The focuses of this work were the influences of operating conditions and bed materials on the bed agglomeration tendency and the elucidation in the behaviors of fuel inorganic elements and the governing mode of the agglomeration. It was found that the defluidization caused by the bed agglomeration was clearly detectable from the decrease in measured bed pressure. The growth of bed particle and accumulation of agglomerates during combustion provided the partial to complete defluidization. The defluidization was promoted by the increase of bed temperature and bed particle size, and the decrease of fluidizing air velocity. The SEM-EDS analyses revealed that the bed agglomeration was mainly attributed to the formation of potassium silicate compounds as liquid phase during the combustion. This was initiated by the chemical reaction between the bed particle and the released ash constituents. In this study, the inorganic migration from fuel particle to bed particle was likely dominated by the condensation/reaction. The thermodynamic examination by ternary phase diagram analysis corroborated that the liquid phase formation of the ash derived materials controlled the agglomeration. The alumina sand prevented the bed agglomeration since it was inactive in the formation of viscous molten substances during combustion at the observed temperatures. - Highlights: • The behaviors of bed agglomeration were studied during the fluidized bed combustion of eucalyptus bark. • The increase in bed temperature and sand size, and the decrease of air velocity promoted bed defluidization. • The formation of molten potassium silicate compounds conduced to the bed agglomeration. • Condensation/reaction was the dominant inorganic migration mechanism from fuel particle to bed particle. • The alumina sand prevented effectively the bed

  1. Method and apparatus for a combination moving bed thermal treatment reactor and moving bed filter

    Energy Technology Data Exchange (ETDEWEB)

    Badger, Phillip C.; Dunn, Jr., Kenneth J.

    2015-09-01

    A moving bed gasification/thermal treatment reactor includes a geometry in which moving bed reactor particles serve as both a moving bed filter and a heat carrier to provide thermal energy for thermal treatment reactions, such that the moving bed filter and the heat carrier are one and the same to remove solid particulates or droplets generated by thermal treatment processes or injected into the moving bed filter from other sources.

  2. Tests for evaluation of pellets as foundation bed material KBP1003 - ASKAR

    International Nuclear Information System (INIS)

    Johnsson, Anna

    2011-12-01

    The reference design for the backfill of deposition tunnels, described in SKB (2010), include bentonite blocks, bentonite pellets and a foundation bed of bentonite pellets or granulate. The tunnel floor needs to be flat and have sufficient bearing capacity to make it possible to stack the backfill blocks according to the reference design. To achieve a flat foundation the tunnel floor will be covered with a bed of pellets or granulate made of bentonite clay. The bed can be either compacted or non compacted. Bed tests have been performed as a part of the project KBP1003 DP1 Design, which is a subproject of KBP1003 ASKAR. The main objectives for KBP1003 DP1 is to define all requirements for the backfill and its production and installation prior to start of the large scale tests, based on given perquisites. KBP1003 is based on the reference design for the backfill of deposition tunnels which was developed in 2010 (SKB 2010). The concept for installation and block design has been further developed during the project. A new dimension of the backfill blocks has been developed; the chosen dimension makes it possible to gain overlapping joints between the blocks by block stacking. The further developed concept is hereinafter referred to as the ASKAR-concept. The purpose of the performed bed tests was to define the bed requirements in the backfill installation to enable stable stacking of backfill blocks. The tests included stacking of blocks on different bed materials, on blasted and wire sawn floor, with and without concurrent water inflow. The bed tests was subdivided into four main parts: - block stacking on different bed compositions - block stacking on bed during water inflow - block stacking in a realistic test tunnel - block stacking on the upper part of the deposition hole and bevel

  3. Tests for evaluation of pellets as foundation bed material KBP1003 - ASKAR

    Energy Technology Data Exchange (ETDEWEB)

    Johnsson, Anna (ES-Konsult AB (Sweden))

    2011-12-15

    The reference design for the backfill of deposition tunnels, described in SKB (2010), include bentonite blocks, bentonite pellets and a foundation bed of bentonite pellets or granulate. The tunnel floor needs to be flat and have sufficient bearing capacity to make it possible to stack the backfill blocks according to the reference design. To achieve a flat foundation the tunnel floor will be covered with a bed of pellets or granulate made of bentonite clay. The bed can be either compacted or non compacted. Bed tests have been performed as a part of the project KBP1003 DP1 Design, which is a subproject of KBP1003 ASKAR. The main objectives for KBP1003 DP1 is to define all requirements for the backfill and its production and installation prior to start of the large scale tests, based on given perquisites. KBP1003 is based on the reference design for the backfill of deposition tunnels which was developed in 2010 (SKB 2010). The concept for installation and block design has been further developed during the project. A new dimension of the backfill blocks has been developed; the chosen dimension makes it possible to gain overlapping joints between the blocks by block stacking. The further developed concept is hereinafter referred to as the ASKAR-concept. The purpose of the performed bed tests was to define the bed requirements in the backfill installation to enable stable stacking of backfill blocks. The tests included stacking of blocks on different bed materials, on blasted and wire sawn floor, with and without concurrent water inflow. The bed tests was subdivided into four main parts: - block stacking on different bed compositions - block stacking on bed during water inflow - block stacking in a realistic test tunnel - block stacking on the upper part of the deposition hole and bevel

  4. Challenges of rehabilitation case mix measurement in Ontario hospitals.

    Science.gov (United States)

    Sutherland, Jason Murray; Walker, Jan

    2008-03-01

    Case mix classification systems have been adopted in many countries as a method to manage and finance healthcare in acute care settings; the most popular systems are based on diagnosis related groups. The most successful of those case mix systems differentiate patient types by reflecting both the intensity of resources consumed and patient acuity. Case mix systems for use with non-acute hospital activity have not been as wide-spread; other than in the United States, little attention has been directed towards case mix classification for rehabilitation activity. In a province with over 13 million inhabitants with 2496 rehabilitation beds, inpatient rehabilitation is an important component of hospital care in Ontario, Canada, and consists of the spectrum of intensive rehabilitation activities intended to restore function. Although case mix adjusted activity has been the currency in Ontario's Integrated Population Based Allocation hospital funding formula, rehabilitation activity has not been subjected to case mix measurement. A project to examine case mix classification for adult inpatient rehabilitation activity was initiated by the Ontario Ministry of Health and Long-Term Care whose outcome was a case mix system and associated cost weights that would result in rehabilitation activity being incorporated into the hospital funding formula. The process described in this study provides Ontario's provincial government with a case mix classification system for adult inpatient rehabilitation activity although there remain areas for improvement.

  5. Clinical evaluation of an automated turning bed.

    Science.gov (United States)

    Melland, H I; Langemo, D; Hanson, D; Olson, B; Hunter, S

    1999-01-01

    The purposes of this study were to assess client comfort and sleep quality, client physiologic response (skin and respiratory status), the effect on the need for caregiver assistance, and cost when using an automated turning bed. Nonexperimental, evaluative study. Twenty-four adult home or long-term care resident subjects who had a degenerative disease, spinal cord injury, stroke, cerebral palsy, or back surgery. Each subject agreed to use the automated turning bed for four weeks. Researchers completed a demographic survey and skin assessment, and assessed each subject for pressure ulcer risk and for the need of assistance of a care giver for turning before and after the four weeks of using the turning bed. Subjects rated the turning bed in terms of comfort and sleep quality. Subjects rated the turning bed as more comfortable than their own bed and expressed satisfaction at the pain relief attained when on the turning bed. While using the turning bed, there was a significant improvement in sleep quality. No skin breakdown or deterioration in respiratory status occurred. Fewer subjects required the assistance of a caregiver for turning when on the turning bed. This automated turning bed shows great promise in meeting a need for patients with limited mobility whether they are homebound or in a residential community. Future studies that further investigate use of the turning bed for postoperative back patients while still in the acute care setting are indicated. Replicative studies with a larger sample size are also indicated.

  6. 38 CFR 59.40 - Maximum number of nursing home care and domiciliary care beds for veterans by State.

    Science.gov (United States)

    2010-07-01

    ... home care and domiciliary care beds for veterans by State. 59.40 Section 59.40 Pensions, Bonuses, and... ACQUISITION OF STATE HOMES § 59.40 Maximum number of nursing home care and domiciliary care beds for veterans... projection of demand for nursing home and domiciliary care by veterans who at such time are 65 years of age...

  7. The potential carcinogenic risk of tanning beds: clinical guidelines and patient safety advice

    Directory of Open Access Journals (Sweden)

    Mette Mogensen

    2010-10-01

    Full Text Available Mette Mogensen1, Gregor BE Jemec21Department of Dermatology, Gentofte Hospital, Hellerup, Denmark; 2Department of Dermatology, Roskilde Hospital, Health Sciences Faculty, University of Copenhagen, Roskilde, DenmarkIntroduction: In 2009, the WHO listed ultraviolet (UV radiation as a group 1 carcinogen. In spite of this, each year, millions of people tan indoor in Western countries. The aim of this review is to summarize evidence of tanning bed carcinogenesis and to present guidelines for use of tanning beds and patient safety advice.Methods: A narrative review of the literature was conducted based on both PubMed and Medline searches and on literature review of the retrieved papers.Results: Use of indoor tanning beds represents a significant and avoidable risk factor for the development of both melanoma and nonmelanoma skin cancers. Frequent tanners are more often adolescent females. Tanning beds have additional potential adverse effects such as burns, solar skin damage, infection, and possibly also addictive behavior.Discussion: The effort in preventing UV light-induced carcinogenesis should currently be aimed at developing new strategies for public health information. Tanning beds are one preventable source of UV radiation. In the majority of people solar UV radiation continues to be the major factor and therefore anti-tanning campaigns must always include sunbathers.Keywords: tanning beds, skin cancers, melanoma, nonmelanoma

  8. Knowledge, opinions and compliance related to the 100% smoke-free law in hospitality venues in Kampala, Uganda: cross-sectional results from the KOMPLY Project.

    Science.gov (United States)

    Gravely, Shannon; Nyamurungi, Kellen Namusisi; Kabwama, Steven Ndugwa; Okello, Gabriel; Robertson, Lindsay; Heng, Kelvin Khow Chuan; Ndikum, Achiri Elvis; Oginni, Adeniyi Samuel; Rusatira, Jean Christophe; Kakoulides, Socrates; Huffman, Mark D; Yusuf, Salim; Bianco, Eduardo

    2018-01-05

    This study evaluated knowledge, opinions and compliance related to Uganda's comprehensive smoke-free law among hospitality venues in Kampala Uganda. This multi-method study presents cross-sectional findings of the extent of compliance in the early phase of Uganda's comprehensive smoke-free law (2 months postimplementation; pre-enforcement). Bars, pubs and restaurants in Kampala Uganda. A two-stage stratified cluster sampling procedure was used to select hospitality sites stratified by all five divisions in Kampala. A total of 222 establishments were selected for the study. One hospitality representative from each of the visited sites agreed to take part in a face-to-face administered questionnaire. A subsample of hospitality venues were randomly selected for tobacco air quality testing (n=108). Data were collected between June and August 2016. Knowledge and opinions of the smoke-free law among hospitality venue staff and owners. The level of compliance with the smoke-free law in hospitality venues through: (1) systematic objective observations (eg, active smoking, the presence of designated smoking areas, 'no smoking' signage) and (2) air quality by measuring the levels of tobacco particulate matter (PM 2.5 ) in both indoor and outdoor venues. Active smoking was observed in 18% of venues, 31% had visible 'no smoking' signage and 47% had visible cigarette remains. Among interviewed respondents, 57% agreed that they had not been adequately informed about the smoke-free law; however, 90% were supportive of the ban. Nearly all respondents (97%) agreed that the law will protect workers' health, but 32% believed that the law would cause financial losses at their establishment. Indoor PM 2.5 levels were hazardous (267.6 µg/m 3 ) in venues that allowed smoking and moderate (29.6 µg/m 3 ) in smoke-free establishments. In the early phase of Uganda's smoke-free law, the level of compliance in hospitality venues settings in Kampala was suboptimal. Civil society and the

  9. Developing a strategic marketing plan for physical and occupational therapy services: a collaborative project between a critical access hospital and a graduate program in health care management.

    Science.gov (United States)

    Kash, Bita A; Deshmukh, A A

    2013-01-01

    The purpose of this study was to develop a marketing plan for the Physical and Occupational Therapy (PT/OT) department at a Critical Access Hospital (CAH). We took the approach of understanding and analyzing the rural community and health care environment, problems faced by the PT/OT department, and developing a strategic marketing plan to resolve those problems. We used hospital admissions data, public and physician surveys, a SWOT analysis, and tools to evaluate alternative strategies. Lack of awareness and negative perception were key issues. Recommended strategies included building relationships with physicians, partnering with the school district, and enhancing the wellness program.

  10. Graphite waste incineration in a fluidized bed

    International Nuclear Information System (INIS)

    Guiroy, J.J.

    1996-01-01

    French gas-cooled reactors belonging to the Atomic Energy Commission (CEA), Electricite de France (EDF), Hifrensa (Spain), etc., commissioned between the 1950s and 1970s, have generated large quantities of graphite wastes, mainly in the form of spent fuel sleeves. Furthermore, some of these reactors scheduled for dismantling in the near future (such as the G2 and G3 reactors at Marcoule) have cores consisting of graphite blocks. Consequently, a fraction of the contaminated graphite, amounting to 6000 t in France for example, must be processed in the coming years. For this processing, incineration using a circulating fluidized bed combustor has been selected as a possible solution and validated. However, the first operation to be performed involves recovering this graphite waste, and particularly, first of all, the spent fuel sleeves that were stored in silos during the years of reactor operation. Subsequent to the final shutdown of the Spanish gas-cooled reactor unit, Vandellos 1, the operating utility Hifrensa awarded contracts to a Framatome Iberica SA/ENSA consortium for removing, sorting, and prepackaging of the waste stored in three silos on the Vandellos site, essentially graphite sleeves. On the other hand, a program to validate the Framatome fluidized bed incineration process was carried out using a prototype incinerator installed at Le Creusot, France. The validation program included 22 twelve-hour tests and one 120-hour test. Particular attention was paid to the safety aspects of this project. During the performance of the validation program, a preliminary safety assessment was carried out. An impact assessment was performed with the help of the French Institute for Protection and Nuclear Safety, taking into account the preliminary spectra supplied by the CEA and EDF, and the activities of the radionuclides susceptible of being released into the atmosphere during the incineration. (author). 4 refs, 11 figs, 1 tab

  11. Hospital Presbiteriano Valley

    Directory of Open Access Journals (Sweden)

    Luckman, Charles

    1964-12-01

    Full Text Available This hospital is built on the circular system. This arrangement has economic and functional advantages. The nurses walk 40 % less distance than in a hospital of similar size, of conventional layout. The rooms are situated along the external perimeter and the beds are orientated towards the corridor, rather than towards the window. However, the patients can see out of doors by turning on their side. The hospital is most carefully fitted out, and is very comfortable. There is air conditioning, and patients can control their own TV sets. There are also curtains separating each bed form the rest, thus providing maximum independence. Warm colours have been adopted in the decoration of rooms facing north, whilst those facing south are painted in cooler tones. The circular design arrangement makes the distribution far more flexible, and it will be easier to include further units later on; by adding small adjustments to the central building. To reduce external noise, and to improve the surrounding landscape, small sand hills have been provided in the garden, and the parking site also serves to partially absorb the noise.Presenta esta solución de unidades circulares numerosas ventajas de tipo económico, ahorra espacio y da eficiencia a la circulación— las enfermeras recorren un 40 por 100 menos de camino que en otro hospital de dimensiones similares—. Las habitaciones están distribuidas a lo largo del perímetro exterior y tienen las camas orientadas hacia los corredores, en lugar de hacia las ventanas, pero de tal modo que los pacientes puedan contemplar el exterior al volverse sobre uno de sus costados. Están cuidadosamente diseñadas y dotadas de las máximas comodidades: aire acondicionado y aparatos de televisión controlados por el paciente; así como cortinas divisorias que le proporcionan el grado de aislamiento deseado.

  12. FY 1975 Report on results of Sunshine Project. Development of techniques of digging high-temperature beds (Development of solid bits and air-friction bearings); 1975 nendo koon chiso kussaku gijutsu no kaihatsu. Solid bit oyobi air friction bearing no kaihatsu

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1976-03-31

    A combination of superhard alloy and diamond powder has been widely used as the solid type edge. The solid type with only a superhard alloy edge is no better than the traditional metal bit. It is ironical to admit that one of the most important items in the development of solid bits for digging high-temperature beds is not related to high temperature itself but development of highly efficient, long serviceable bits, growing out of the inefficient digging mechanisms for the conventional solid bits. It is considered that use of a superhard alloy edge is disadvantageous for digging hard rocks in the so-called scratching manner, for the two major reasons: (1) a superhard alloy is certainly resistant to wear, but nothing to that of diamond, and (2) it is homogeneous and lacks directional properties, such as the cleavage plane of diamond, which is effective for cutting. This project is aimed at development, on a trial basis, and eventual commercialization of new types of solid bits serviceable for extended periods by drastically improving suerhard alloys to provide them with new structures, e.g., those corresponding to the crystal axes of diamond, and also introducing a concept of crushing. (NEDO)

  13. FY 1999 Feasibility study on the environmentally-friendly coal utilization systems. Green Helmet Project (Circulating fluidized bed boiler Zaozhuang, Shangdong Province, China); 1999 nendo kankyo chowagata sekitan riyo system kanosei chosa jigyo seika hokokusho. Green helmet jigyo (junkan ryudosho boiler Chugoku Shangdong sho Zaozhuang)

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2001-03-01

    The demonstration project is carried out in at Chaili coal mine in Shangdong Province, China for installation of and dissemination activities for circulating fluidized bed boilers to abate sulfur oxide emissions associated with utilization of coal, and the FY 1999 results are reported. The operating conditions were reviewed, and some recommendations were made for improving the operation procedures. Limestone was not used for desulfurization, and furnace temperature tended to increase due to increased size of the fluidizing particles. Therefore, it was recommended to use limestone at the design rate. The boiler was operated at a load exceeding the design level, and it was recommended to limit the load viewed from extending serviceability. The boiler start-up procedure was concretely proposed to use a mixed fuel of wood and coal instead of distillate oil, in order to reduce the start-up cost. The recommendations and design support activities for improving facilities included early stage repair of the damaged refractories. For build up of the ashes in the horizontal heat transfer section, the investigated design charts for improvement by installation of ash-discharging hopper were drawn and proposed. Maintenance-related information was given, including Chinese agencies for obtaining auxiliary facilities. (NEDO)

  14. Test-element assembly and loading parameters for the in-pile test of HCPB ceramic pebble beds

    Energy Technology Data Exchange (ETDEWEB)

    Laan, J.G. van der E-mail: vanderlaan@nrg-nl.com; Boccaccini, L.V.; Conrad, R.; Fokkens, J.H.; Jong, M.; Magielsen, A.J.; Pijlgroms, B.J.; Reimann, J.; Stijkel, M.P.; Malang, S

    2002-11-01

    In the framework of developing the helium cooled pebble-bed (HCPB) blanket an irradiation test of pebble-bed assemblies is prepared at the HFR Petten. The test objective is to concentrate on the effect of neutron irradiation on the thermal-mechanical behaviour of the HCPB breeder pebble-bed at DEMO representative levels of temperature and defined thermal-mechanical loads. The paper reports on the project status, and presents the results of pre-tests, material characteristics, the manufacturing of the pebble-bed assemblies, and the nuclear and thermo-mechanical loading parameters.

  15. Gaseous emissions in pressurized fluidized-bed combustion: Analysis and summary of the pilot experiments

    International Nuclear Information System (INIS)

    Korpela, T.; Hippinen, I.

    1995-01-01

    The project connects the experimental data from the projects of pressurised fluidized-bed technology by HUT/EVO. The research objectives are behaviour of sulphur absorbents and reduction of sulphur dioxide emissions, reduction of nitrogen oxide emissions, release of vapour-phase alkali metals and carbon monoxide emissions. Optimal process conditions in relation to minimising the emissions are clarified

  16. Design of the DISCovery project: Tailored work-oriented interventions to improve employee health, well-being, and performance-related outcomes in hospital care

    NARCIS (Netherlands)

    Niks, I.M.W.; Jonge, J. de; Gevers, J.M.P; Houtman, I.L.D.

    2013-01-01

    Background: It is well-known that health care workers in today's general hospitals have to deal with high levels of job demands, which could have negative effects on their health, well-being, and job performance. A way to reduce job-related stress reactions and to optimize positive work-related

  17. Design of the DISCovery project : tailored work-oriented interventions to improve employee health, well-being and performance-related outcomes in hospital care.

    NARCIS (Netherlands)

    Niks, I.M.W.; Jonge, de J.; Gevers, J.M.P.; Houtman, I.L.D.

    2013-01-01

    Background It is well-known that health care workers in today’s general hospitals have to deal with high levels of job demands, which could have negative effects on their health, well-being, and job performance. A way to reduce job-related stress reactions and to optimize positive work-related

  18. Hospital waste management in Lebanon

    International Nuclear Information System (INIS)

    Chaker, Alissar

    1999-01-01

    Hospital wastes comprises approximately 80% domestic waste components, also known as non-risk waste and 20% hazardous or risk waste. The 20% of the hospital waste stream or the risk waste (also known as infectious, medical, clinical wastes) comprises components which could be potentially contaminated with infections, chemical or radioactive agents. Therefore, it should be handled and disposed of in such a manner as to minimize potential human exposure and cross-contamination. Hospital risk waste and be subdivided into seven general categories as follows: infections, anatomical/pathological, chemical, pharmaceutical, radioactive waste, sharps and pressurised containers. These waste categories are generated by many types of health care establishments, including hospitals, clinics, infirmaries.... The document presents also tables of number of hospitals and estimated bed number in different regions in Lebanon; estimated hospital risk and non-risk waste generation per tonnes per day for the years 1998 until 2010 and finally sensitivity analysis of estimated generation of hospital risk waste in Lebanon per tonnes per day for the years 1998 until 2010. The management, treatment and disposal of hospital risk waste constitute important environmental and public safety issues. It is recognised that there is alack of infrastructure for the safe and environmentally acceptable disposal of hospital waste in Lebanon

  19. [Special beds. Pulmonary therapy system].

    Science.gov (United States)

    Calixto Rodríguez, Joaquín; Rodríguez Martínez, Xavier; Marín i Vivó, Gemma; Paunellas Albert, Josep

    2008-10-01

    To be bedridden reduces one's capacity to move and produces muscular debility that affects the respiratory system leading to a decreased effectiveness in expectoration, the ability to spit up sputum. The pulmonary therapy system integrated in a bed is the result of applying motorized elements to the articulation points of the bad in order to achieve safe positions at therapeutic angles, which improve the breathing-perfusion (blood flow) relationship. This system also makes it possible to apply vibration waves to the patient which favor the elimination of bronchial-pulmonary secretions, the rehabilitation of the bedridden patient and decrease the work load for nursing personnel.

  20. Particle bed reactor scaling relationships

    Science.gov (United States)

    Slovik, G.; Araj, K.; Horn, F. L.; Ludewig, H.; Benenati, R.

    The Particle Bed Reactor (PBR) concept can be used in several applications both as part of a power generating system or as a direct propulsion unit. In order to carry out optimization studies of systems involving a PBR, it is necessary to know the variation of the critical mass with pertinent system parameters such as weight, size, power level and thrust level. A parametric study is presented for all the practical combinations of fuel and moderating material. The PBR is described, the practical combinations of materials and dimensions are discussed, and an example is presented.

  1. Indirect costs of teaching in Canadian hospitals.

    Science.gov (United States)

    MacKenzie, T A; Willan, A R; Cox, M A; Green, A

    1991-01-01

    We sought to determine whether there are indirect costs of teaching in Canadian hospitals. To examine cost differences between teaching and nonteaching hospitals we estimated two cost functions: cost per case and cost per patient-day (dependent variables). The independent variables were number of beds, occupancy rate, teaching ratio (number of residents and interns per 100 beds), province, urbanicity (the population density of the county in which the hospital was situated) and wage index. Within each hospital we categorized a random sample of patient discharges according to case mix and severity of illness using age and standard diagnosis and procedure codes. Teaching ratio and case severity were each highly correlated positively with the dependent variables. The other variables that led to higher costs in teaching hospitals were wage rates and number of beds. Our regression model could serve as the basis of a reimbursement system, adjusted for severity and teaching status, particularly in provinces moving toward introducing case-weighting mechanisms into their payment model. Even if teaching hospitals were paid more than nonteaching hospitals because of the difference in the severity of illness there should be an additional allowance to cover the indirect costs of teaching. PMID:1898870

  2. The Space Station Module Power Management and Distribution automation test bed

    Science.gov (United States)

    Lollar, Louis F.

    1991-01-01

    The Space Station Module Power Management And Distribution (SSM/PMAD) automation test bed project was begun at NASA/Marshall Space Flight Center (MSFC) in the mid-1980s to develop an autonomous, user-supportive power management and distribution test bed simulating the Space Station Freedom Hab/Lab modules. As the test bed has matured, many new technologies and projects have been added. The author focuses on three primary areas. The first area is the overall accomplishments of the test bed itself. These include a much-improved user interface, a more efficient expert system scheduler, improved communication among the three expert systems, and initial work on adding intermediate levels of autonomy. The second area is the addition of a more realistic power source to the SSM/PMAD test bed; this project is called the Large Autonomous Spacecraft Electrical Power System (LASEPS). The third area is the completion of a virtual link between the SSM/PMAD test bed at MSFC and the Autonomous Power Expert at Lewis Research Center.

  3. Electromyographic evaluation of high-intensity elastic resistance exercises for lower extremity muscles during bed rest

    DEFF Research Database (Denmark)

    Vinstrup, Jonas; Skals, Sebastian; Calatayud, Joaquin

    2017-01-01

    PURPOSE: Prolonged hospital bed rest after severe injury or disease leads to rapid muscle atrophy and strength loss. Therefore, the main aim of this study was to evaluate the efficacy of lower extremity strengthening exercises using elastic resistance that can be performed while lying in a hospit......, the present study has the potential to provide a reference table of exercises to select from when individualizing and progressing strengthening exercises during the early rehabilitation of bedridden individuals....

  4. Hospitals' vertical integration into skilled nursing: a rational approach to controlling transaction costs.

    Science.gov (United States)

    Lehrman, S; Shore, K K

    1998-01-01

    Using 1985 and 1988 American Hospital Association data, this study examines 1,523 hospitals nationwide and concludes that hospitals' ownership of skilled nursing facilities helps minimize the transaction costs associated with post-acute patient transfers while productively using empty hospital beds. Unfortunately, such ownership creates complex cost, quality, and accessibility trade-offs in terms of the skilled nursing care provided.

  5. Adherence to hospital drug formularies and cost of drugs in hospitals in Denmark

    DEFF Research Database (Denmark)

    Plet, H. T.; Hallas, J.; Kjeldsen, L. J.

    2013-01-01

    PURPOSE: To investigate adherence rates to hospital drug formularies (HDFs) and cost of drugs in hospitals. METHODS: Data on drugs used during 2010 were analyzed for ten hospitals (two hospitals from each of the five regions), constituting 30 % of hospitals and 45 % of hospital beds in Denmark....... Drug use data from individual hospitals were retrieved from the hospital pharmacies. Adherence to the HDFs was analyzed for selected substances characterised by extensive use both in primary and secondary sectors (ATC codes A10, B03, C03, C07, C08, C09, C10, J01, N02, N05 and R03). Within each group......, we also identified the drugs constituting 90 % of the volume (= DU90%) and the adherence to the HDF in this segment (Index of Adherence). RESULTS: Substances used by hospitals varied between 598 and 1,093. The proportion of used substances that were on the HDF varied between 14 % and 44 %. University...

  6. Estimating the Hospital Burden of Norovirus-Associated Gastroenteritis in England and its Opportunity Costs for Non-Admitted Patients.

    Science.gov (United States)

    Sandmann, Frank G; Shallcross, Laura; Adams, Natalie; Allen, David J; Coen, Pietro G; Jeanes, Annette; Kozlakidis, Zisis; Larkin, Lesley; Wurie, Fatima; Robotham, Julie V; Jit, Mark; Deeny, Sarah R

    2018-02-26

    Norovirus places a substantial burden on healthcare systems, arising from infected patients, disease outbreaks, beds kept unoccupied for infection control, and staff absences due to infection. In settings with high rates of bed occupancy, opportunity costs arise from patients who cannot be admitted due to beds being unavailable. With several treatments and vaccines against norovirus in development, quantifying the expected economic burden is timely. The number of inpatients with norovirus-associated gastroenteritis in England were modelled using infectious and non-infectious gastrointestinal Hospital Episode Statistics codes and laboratory reports of gastrointestinal pathogens collected at Public Health England. The excess length of stay from norovirus was estimated with a multi-state model and local outbreak data. Unoccupied bed-days and staff absences were estimated from national outbreak surveillance. The burden was valued conventionally using accounting expenditures and wages, which we contrasted to the opportunity costs from forgone patients using a novel methodology. Between July 2013 and June 2016, 17.7% (95%-confidence interval: 15.6%‒21.6%) of primary and 23.8% (20.6%‒29.9%) of secondary gastrointestinal diagnoses were norovirus-attributable. Annually, the estimated median 290,000 (interquartile range: 282,000‒297,000) occupied and unoccupied bed-days used for norovirus displaced 57,800 patients. Conventional costs for the National Health Service reached £107.6 million; the economic burden approximated to £297.7 million and a loss of 6,300 quality-adjusted life years annually. In England, norovirus is now the second-largest contributor of the gastrointestinal hospital burden. With the projected impact being greater than previously estimated, improved capture of relevant opportunity costs seems imperative for diseases like norovirus.

  7. Geographic Information System (GIS) characterization of historical extent of seagrass beds in Tampa Bay, Florida (NODC Accession 0000613)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The coverage is the historical extent of seagrass beds in Tampa Bay. Vector coverage was rasterized using ELAS software. The project was completed by US Fish and...

  8. On spaces of hospitality

    DEFF Research Database (Denmark)

    Greve, Anni

    Although specialists in hospitality have worked extensively on hospitality with respect to relations between different nations or between nations and individuals of a different nationality, for instance when they seek asylum, Jacques Derrida preferred to focus instead upon the relationship between...... the guest and the host. This has provided a much-needed rethinking of how to understand hospitality as a way of relating, as an ethics and as a politics. Within this work, there have often appeared discussions of ‘spaces of hospitality’, but these spaces have remained largely abstract. This is where...... this paper comes in: It will re open discussions of spaces of hospitality with an introduction into an on-going research project that studies the performative, structural and social dynamics of cultural encounters focusing on forms of hospitality that are related to particular sites in the city, namely...

  9. Hospital Waste Management - Case Study

    Directory of Open Access Journals (Sweden)

    Beatriz Edra

    2017-07-01

    Full Text Available The importance of waste management in hospitals is indisputable in preserving the environment and protecting public health, but management models are rarely discussed. This study presents the legal and conceptual frameworks of good waste management practices applicable to hospitals and associated indicators. As a case study, the overall performance of Hospital Centre of São João, in Porto, was analysed based on published reports. Data on the production of waste in their different typologies were collected from 2010 to 2016, enabling a correlation of the waste production with the kg/bed/day indicator. The aim of this study was to gather data and discuss trends in a real scenario of evolution over a six-year period in order to contribute to a future research proposal on indicators that can be used as reference for benchmarking the construction of methodological guides for hospital waste management.

  10. Fluid-bed process for SYNROC production

    International Nuclear Information System (INIS)

    Ackerman, F.J.; Grens, J.Z.; Ryerson, F.J.; Hoenig, C.L.; Bazan, F.; Peters, P.E.; Smith, R.; Campbell, J.H.

    1983-01-01

    SYNROC is a titanate-based ceramic waste developed for the immobilization of high-level nuclear reactor waste. Lawrence Livermore National Laboratory (LLNL) has investigated a fluid-bed technique for the large-scale production of SYNROC precursor powders. Making SYNROC in a fluid bed permits slurry drying, calcination and reduction-oxidation reactions to be carried out in a single unit. We present the results of SYNROC fluid-bed studies from two fluid-bed units 10 cm in diameter: an internally heated fluid-bed unit developed by Exxon Idaho and an externally heated unit constructed at LLNL. Bed operation over a range of temperatures, feed rates, fluidizing rates, and redox conditions indicate that SYNROC powders of a high density and a uniform particle size can be produced. These powders facilitate the densification step and yield dense ceramics (greater than 95% theoretical density) with well-developed phases and low leaching rates

  11. On partial fluidization in rotating fluidized beds

    International Nuclear Information System (INIS)

    Kao, J.; Pfeffer, R.; Tardos, G.I.

    1987-01-01

    In a rotating fluidized bed, unlike in a conventional fluidized bed, the granules are fluidized layer by layer from the (inner) free surface outward at increasing radius as the gas velocity is increased. This is a very significant and interesting phenomenon and is extremely important in the design of these fluidized beds. The phenomenon was first suggested in a theoretical analysis and recently verified experimentally in the authors' laboratory. However, in the first paper, the equations presented are too cumbersome and the influence of bed thickness is not clearly stated. In this note the authors present simplified equations, based on that paper, for the pressure drop and the minimum fluidizing velocities in a rotating fluidized bed. Experimental data are also shown and compared with the theoretical model, and the effect of bed thickness is shown. Furthermore, an explanation for the observation of a maximum in the pressure drop vs. velocity curve instead of the plateau derived by Chen is proposed

  12. Simulation Facilities and Test Beds for Galileo

    Science.gov (United States)

    Schlarmann, Bernhard Kl.; Leonard, Arian

    2002-01-01

    Galileo is the European satellite navigation system, financed by the European Space Agency (ESA) and the European Commission (EC). The Galileo System, currently under definition phase, will offer seamless global coverage, providing state-of-the-art positioning and timing services. Galileo services will include a standard service targeted at mass market users, an augmented integrity service, providing integrity warnings when fault occur and Public Regulated Services (ensuring a continuity of service for the public users). Other services are under consideration (SAR and integrated communications). Galileo will be interoperable with GPS, and will be complemented by local elements that will enhance the services for specific local users. In the frame of the Galileo definition phase, several system design and simulation facilities and test beds have been defined and developed for the coming phases of the project, respectively they are currently under development. These are mainly the following tools: Galileo Mission Analysis Simulator to design the Space Segment, especially to support constellation design, deployment and replacement. Galileo Service Volume Simulator to analyse the global performance requirements based on a coverage analysis for different service levels and degrades modes. Galileo System Simulation Facility is a sophisticated end-to-end simulation tool to assess the navigation performances for a complete variety of users under different operating conditions and different modes. Galileo Signal Validation Facility to evaluate signal and message structures for Galileo. Galileo System Test Bed (Version 1) to assess and refine the Orbit Determination &Time Synchronisation and Integrity algorithms, through experiments relying on GPS space infrastructure. This paper presents an overview on the so called "G-Facilities" and describes the use of the different system design tools during the project life cycle in order to design the system with respect to

  13. Effects of Speech Therapy in Hospitalized Patients with Post-Stroke Dysphagia: A Systematic Review of Observational Studies

    Directory of Open Access Journals (Sweden)

    Joice Santos Andrade

    2017-12-01

    Conclusion: Speech therapy in hospital bed in post-stroke hospitalized patients with dysphagia seems to bring satisfactory results in the short-term, revealing the importance of diagnosis and early intervention in these cases.

  14. Intensive Exercise Training During Bed Rest Attenuates Deconditioning

    Science.gov (United States)

    Greenleaf, John E.

    1997-01-01

    Intensive exercise training during bed rest attenuates deconditioning. Med. Sci. Sports Exerc., Vol. 29, No. 2, pp. 207-215, 1997. A 30-d 6 deg head-down bed rest project was conducted to evaluate variable high-intensity, short-duration, isotonic cycle ergometer exercise (ITE) training and high-intensity intermittent resistive isokinetic exercise (IKE) training regimens designed to maintain peak VO2 and muscle mass, strength, and endurance at ambulatory control levels throughout prolonged bed rest. Other elements of the deconditioning (adaptive) syndrome, such as proprioception, psychological performance, hypovolemia, water balance, body composition, and orthostatic tolerance, were also measured. Major findings are summarized in this paper. Compared with response during bed rest of the no exercise (NOE) control group: the ITE training regimen (a) maintained work capacity (peak VO2), (b) maintained plasma and red cell volumes, (c) induced positive body water balance, (d) decreased quality of sleep and mental concentration, and (e) had no effect on the decrease in orthostatic tolerance; the IKE training regimen (f) attenuated the decrease in peak VO2 by 50%, (g) attenuated loss of red cell volume by 40% but had no effect on loss of plasma volume, (b) induced positive body water balance, (i) had no adverse effect on quality of sleep or concentration, and 0) had no effect on the decrease in orthostatic tolerance. These findings suggest that various elements of the deconditioning syndrome can be manipulated by duration and intensity of ITE or IKE training regimens and that several different training protocols will be required to maintain or restore physiological and psychological performance of individuals confined to prolonged bed rest.

  15. Gas distributor for fluidized bed coal gasifier

    Science.gov (United States)

    Worley, Arthur C.; Zboray, James A.

    1980-01-01

    A gas distributor for distributing high temperature reaction gases to a fluidized bed of coal particles in a coal gasification process. The distributor includes a pipe with a refractory reinforced lining and a plurality of openings in the lining through which gas is fed into the bed. These feed openings have an expanding tapered shape in the downstream or exhaust direction which aids in reducing the velocity of the gas jets as they enter the bed.

  16. The emergency to home project: impact of an emergency department care coordinator on hospital admission and emergency department utilization among seniors.

    Science.gov (United States)

    Bond, Christopher Matthew; Freiheit, Elizabeth A; Podruzny, Lesley; Kingsly, Alianu Akawakun; Wang, Dongmei; Davenport, Jamie; Gutscher, Abram; Askin, Cathy; Taylor, Allison; Lee, Vivian; Choo, Queenie; Lang, Eddy Samuel

    2014-01-01

    Seniors comprise 14% to 21% of all emergency department (ED) visits, yet are disproportionately larger users of ED and inpatient resources. ED care coordinators (EDCCs) target seniors at risk for functional decline and connect them to home care and other community services in hopes of avoiding hospitalization. The goal of this study was to measure the association between the presence of EDCCs and admission rates for seniors aged ≥ 65. Secondary outcomes included length of stay, recidivism at 30 days, and revisit resulting in admission at 30 days. This was a matched pairs study using administrative data from eight EDs in six Alberta cities. Four of these hospitals were intervention sites, in which patients were seen by an EDCC, while the other four sites had no EDCC presence. All seniors aged ≥ 65 with a discharge diagnosis of fall or musculoskeletal pathology were included. Cases were matched by CTAS category, age, gender, mode of arrival, and home living environment. McNemar's test for matched pairs was used to compare admission and recidivism rates at EDCC and non-EDCC hospitals. A paired t-test was used to compare length of stay between groups. There were no statistically significant differences for baseline admission rate, revisit rate at 30 days, and readmission rate at 30 days between EDCC and non-EDCC patients. This study showed no reduction in senior patients' admission rates, recidivism at 30 days, or hospital length of stay when comparing seniors seen by an EDCC with those not seen by an EDCC.

  17. Knowledge, opinions and compliance related to the 100% smoke-free law in hospitality venues in Kampala, Uganda: cross-sectional results from the KOMPLY Project

    OpenAIRE

    Gravely, Shannon; Nyamurungi, Kellen Namusisi; Kabwama, Steven Ndugwa; Okello, Gabriel; Robertson, Lindsay; Heng, Kelvin Khow Chuan; Ndikum, Achiri Elvis; Oginni, Adeniyi Samuel; Rusatira, Jean Christophe; Kakoulides, Socrates; Huffman, Mark D; Yusuf, Salim; Bianco, Eduardo

    2018-01-01

    Objective This study evaluated knowledge, opinions and compliance related to Uganda’s comprehensive smoke-free law among hospitality venues in Kampala Uganda. Design This multi-method study presents cross-sectional findings of the extent of compliance in the early phase of Uganda’s comprehensive smoke-free law (2 months postimplementation; pre-enforcement). Setting Bars, pubs and restaurants in Kampala Uganda. Procedure and participants A two-stage stratified cluster sampling procedure was us...

  18. Reducing hospital admissions and improving the diagnosis of COPD in Southampton City: methods and results of a 12-month service improvement project.

    Science.gov (United States)

    Wilkinson, Tom; North, Mal; Bourne, Simon C

    2014-08-21

    The British Lung Foundation highlighted Southampton City as a hotspot for patients at future risk of chronic obstructive pulmonary disease (COPD) exacerbations due to severe deprivation levels and a high undiagnosed level of disease based on health economic modelling. We developed a strategy spanning primary and secondary care to reduce emergency admissions of patients with acute exacerbations of COPD and increase the diagnosed prevalence of COPD on general practitioner (GP) registers closer to that predicted from local modelling. A comprehensive 3-year audit of admissions was performed. Patients who had been admitted with an exacerbation to University Hospital Southampton three or more times in the previous 12 months were cohorted and cared for in a consultant-led, but community based, COPD service. Within primary care, a programme of education and case-based finding was delivered to most practices within the city. Thirty-four patients were found to be responsible for 176 admissions (22% of total COPD admissions) to the hospital. These 34 patients required 185 active interventions during the 12-month period but only 39 hospital admissions. The 30-day readmission rate dropped from 13.4 to 1.9% (Pmodel.

  19. [The structural functional analysis of beds stock of curative preventive organizations of the state public health system of the Russian Federation].

    Science.gov (United States)

    Schepin, V O

    2014-01-01

    The article presents the results of comprehensive scientific analysis of size and structure of beds stock of medical curative preventive organizations of state and municipal health care systems of the Russian Federation. The issues of beds support of population on national, federal okrugs and federation subjects' levels including differentiation on different medical specialties are considered. The main indicators of functioning of hospitals, per capita consumption of hospital medical care and territorial characteristics and differences of these indicators are analyzed In conditions of on-going decrease of size of beds stock and amount of medical care in hospitals and against the background of stability of main indicators of beds use the expressed but not always objectively conditioned differences continue to be present concerning both population support with beds stock and indicators of consumption of medical care in hospitals. All these occurrences undoubtedly impact accessibility of this type of medical care to population and its resource capacity for the government. In 2012, beds support of population decreased from 85.7 to 84.1 beds per 10 000 of population. The value of indicator in federal subjects differs up to 2.9 times. In the structure of beds stock are prevailing specialized beds or groups of beds on such medical specialties as psychiatry, surgery, obstetrics and gynecology and therapy. The per capita use of medical care in hospitals decreased up to 2.609 beds-per-day that is 6.2% lower than standard value from the program of state guarantees of free-of-charge medical care support of citizen. The end values of indicator in federal subjects differ in 2.7 times. In federal subjects indicators of mean number of work of bed per year differ up to 1.2 times, of mean duration of treatment--up to 1.6 times, turn-over of bed--up to 1.6 times, hospital lethality--up to 5.9 times. The results of study confirm necessity of structural functional optimization of

  20. Fluidized Bed Reactor as Solid State Fermenter

    Directory of Open Access Journals (Sweden)

    Krishnaiah, K.

    2005-01-01

    Full Text Available Various reactors such as tray, packed bed, rotating drum can be used for solid-state fermentation. In this paper the possibility of fluidized bed reactor as solid-state fermenter is considered. The design parameters, which affect the performances are identified and discussed. This information, in general can be used in the design and the development of an efficient fluidized bed solid-state fermenter. However, the objective here is to develop fluidized bed solid-state fermenter for palm kernel cake conversion into enriched animal and poultry feed.

  1. Fungi solubilisation of low rank coal: performances of stirred tank, fluidised bed and packed bed reactors

    CSIR Research Space (South Africa)

    Oboirien, BO

    2013-02-01

    Full Text Available Coal biosolubilisation was investigated in stirred tank reactor, fluidised bed and fixed bed bioreactors with a view to highlight the advantages and shortcomings of each of these reactor configurations. The stirred aerated bioreactor and fluidised...

  2. Visualization of bed material movement in a simulated fluidized bed heat exchanger by neutron radiography

    International Nuclear Information System (INIS)

    Umekawa, Hisashi; Ozawa, Mamoru; Takenaka, Nobuyuki; Matsubayashi, Masahito

    1999-01-01

    The bulk movement of fluidized bed material was visualized by neutron radiography by introducing tracers into the bed materials. The simulated fluidized bed consisted of aluminum plates, and the bed material was sand of 99.7% SiO 2 (mean diameter: 0.218 mm, density: 2555 kg/m 3 ). Both materials were almost transparent to neutrons. Then the sand was colored by the contamination of the sand coated by CdSO 4 . Tracer particles of about 2 mm diameter were made by the B 4 C, bonded by the vinyl resin. The tracer was about ten times as large as the particle of fluidized bed material, but the traceability was enough to observe the bed-material bulk movement owing to the large effective viscosity of the fluidized bed. The visualized images indicated that the bubbles and/or wakes were important mechanism of the behavior of the fluidized bed movement

  3. [Long-term psychiatric hospitalizations].

    Science.gov (United States)

    Plancke, L; Amariei, A

    2017-02-01

    Long-term hospitalizations in psychiatry raise the question of desocialisation of the patients and the inherent costs. Individual indicators were extracted from a medical administrative database containing full-time psychiatric hospitalizations for the period 2011-2013 of people over 16 years old living in the French region of Nord-Pas-de-Calais. We calculated the proportion of people who had experienced a hospitalization with a duration of 292 days or more during the study period. A bivariate analysis was conducted, then ecological data (level of health-care offer, the deprivation index and the size of the municipalities of residence) were included into a multilevel regression model in order to identify the factors significantly related to variability of long-term hospitalization rates. Among hospitalized individuals in psychiatry, 2.6% had had at least one hospitalization of 292 days or more during the observation period; the number of days in long-term hospitalization represented 22.5% of the total of days of full-time hospitalization in psychiatry. The bivariate analysis revealed that seniority in the psychiatric system was strongly correlated with long hospitalization rates. In the multivariate analysis, the individual indicators the most related to an increased risk of long-term hospitalization were: total lack of autonomy (OR=9.0; 95% CI: 6.7-12.2; P<001); diagnoses of psychological development disorders (OR=9.7; CI95%: 4.5-20.6; P<.001); mental retardation (OR=4.5; CI95%: 2.5-8.2; P<.001): schizophrenia (OR=3.0; CI95%: 1.7-5.2; P<.001); compulsory hospitalization (OR=1.7; CI95%: 1.4-2.1; P<.001); having experienced therapeutic isolation (OR=1.8; CI95%: 1.5-2.1; P<.001). Variations of long-term hospitalization rates depending on the type of establishment were very high, but the density of hospital beds or intensity of ambulatory activity services were not significantly linked to long-term hospitalization. The inhabitants of small urban units had

  4. Evaluation of AFBC co-firing of coal and hospital wastes. Technical report, January 1989--August 1990

    Energy Technology Data Exchange (ETDEWEB)

    1991-02-01

    The purpose of this program is to expand the use of coal by utilizing CFB (circulating fluidized bed) technology to provide an environmentally safe method for disposing of waste materials. Hospitals are currently experiencing a waste management crisis. In many instances, they are no longer permitted to burn pathological and infectious wastes in incinerators. Older hospital incinerators are not capable of maintaining the stable temperatures and residence times necessary in order to completely destroy toxic substances before release into the atmosphere. In addition, the number of available landfills which can safely handle these substances is decreasing each year. The purpose of this project is to conduct necessary research investigating whether the combustion of the hospital wastes in a coal-fired circulating fluidized bed boiler will effectively destroy dioxins and other hazardous substances before release into the atmosphere. If this is proven feasible, in light of the quantity of hospital wastes generated each year, it would create a new market for coal -- possibly 50 million tons/year.

  5. Combustion of cork waste in a circulating fluidized bed combustor

    Energy Technology Data Exchange (ETDEWEB)

    Gulyurtlu, I.; Boavida, D.; Miranda, M.; Cabrita, I. [Dept. de Tecnologias de Combustao, ITE-INETI, Lisboa (Portugal); Abelha, P. [Coaltec e Ambiente, Lisboa (Portugal)

    1999-07-01

    There is currently an ongoing joint project between Portugal and Spain, which is being funded by the FAIR programme. The principal objective of the FAIR project is to investigate the application of the fluidised bed combustion (FBC) technology to burn cork wastes with the aim of overcoming the difficulties currently experienced in the cork processing industries. The combustion studies at INETI were carried out using the 300 kW{sub th} circulating fluidised bed facility. The combustor is square in cross section with each side being 0.3 m long. The combustor height is 5 m. The temperatures in the bed, the riser and that of the flue gases leaving the reactor were continuously monitored. The combustion gases leaving the reactor passed through the recycling cyclone first to capture most of particulates elutriated out of the combustor. The solid particles were intermittently collected for analysis to determine the amount of carbon present, which helped the combustion efficiency to be calculated. Instantaneous measurements of O{sub 2}, CO, CO{sub 2}, NO{sub x}, N{sub 2}O and SO{sub 2} present levels in the flue gases were also carried out. The combustion tests were done with both the cork waste dust and granular virgin cork. The difference is that cork dust gets contaminated during the process due to the use of various additives. Most of the combustion took place in the riser where the temperature was at times up to 523 K above that of the bed. The unburned carbon level was low ranging from about 1.5 to 2.% suggesting that most of the particles burned to completion in the riser. (orig.)

  6. Accessing hospital packaged foods and beverages : the importance of a seated posture when eating

    OpenAIRE

    Bell, Alison; Tapsell, Linda; Walton, Karen; Yoxall, Alaster

    2017-01-01

    Background: Hospitalised and community dwelling older people (65 years and over), have difficulties opening food and beverage items such as cheese portions and tetra packs served in public hospitals. Previously, the role of hand strength on successful pack opening has been explored in a seated position. However, as many people in hospital eat in bed, this laboratory study examined the differences between participants opening a selection of products both in a hospital bed and a chair.\\ud Metho...

  7. Metabolic Resistance in Bed Bugs

    Directory of Open Access Journals (Sweden)

    Omprakash Mittapalli

    2011-03-01

    Full Text Available Blood-feeding insects have evolved resistance to various insecticides (organochlorines, pyrethroids, carbamates, etc. through gene mutations and increased metabolism. Bed bugs (Cimex lectularius are hematophagous ectoparasites that are poised to become one of the major pests in households throughout the United States. Currently, C. lectularius has attained a high global impact status due to its sudden and rampant resurgence. Resistance to pesticides is one factor implicated in this phenomenon. Although much emphasis has been placed on target sensitivity, little to no knowledge is available on the role of key metabolic players (e.g., cytochrome P450s and glutathione S-transferases towards pesticide resistance in C. lectularius. In this review, we discuss different modes of resistance (target sensitivity, penetration resistance, behavioral resistance, and metabolic resistance with more emphasis on metabolic resistance.

  8. Debridement and wound bed preparation.

    Science.gov (United States)

    Falabella, Anna F

    2006-01-01

    Debridement can play a vital role in wound bed preparation and the removal of barriers that impair wound healing. In accordance with the TIME principles, debridement can help remove nonviable tissue, control inflammation or infection, decrease excess moisture, and stimulate a nonadvancing wound edge. There are many types of debridement, each with a set of advantages and disadvantages that must be clearly understood by the healthcare team. Failure to use the correct debridement method for a given type of wound may lead to further delays in healing, increase patient suffering, and unnecessarily increase the cost of care. This review article discusses the various methods of debridement, describes currently available debriding agents, evaluates the clinical data regarding their efficacy and safety, and describes strategies for the management of problematic nonhealing wounds.

  9. Particle Bed Reactor engine technology

    Science.gov (United States)

    Sandler, S.; Feddersen, R.

    1992-03-01

    This paper discusses the Particle Bed Reactor (PBR) based propulsion system being developed under the Space Nuclear Thermal Propulsion (SNTP) program. A PBR engine is a light weight, compact propulsion system which offers significant improvement over current technology systems. Current performance goals are a system thrust of 75,000 pounds at an Isp of 1000 sec. A target thrust to weight ratio (T/W) of 30 has been established for an unshielded engine. The functionality of the PBR, its pertinent technology issues and the systems required to make up a propulsion system are described herein. Accomplishments to date which include hardware development and tests for the PBR engine are also discussed. This paper is intended to provide information on and describe the current state-of-the-art of PBR technology.

  10. Particle Bed Reactor engine technology

    International Nuclear Information System (INIS)

    Sandler, S.; Feddersen, R.

    1992-01-01

    This paper discusses the Particle Bed Reactor (PBR) based propulsion system being developed under the Space Nuclear Thermal Propulsion (SNTP) program. A PBR engine is a light weight, compact propulsion system which offers significant improvement over current technology systems. Current performance goals are a system thrust of 75,000 pounds at an Isp of 1000 sec. A target thrust to weight ratio (T/W) of 30 has been established for an unshielded engine. The functionality of the PBR, its pertinent technology issues and the systems required to make up a propulsion system are described herein. Accomplishments to date which include hardware development and tests for the PBR engine are also discussed. This paper is intended to provide information on and describe the current state-of-the-art of PBR technology. 4 refs

  11. Pulsed atmospheric fluidized bed combustion

    Energy Technology Data Exchange (ETDEWEB)

    1989-11-01

    In order to verify the technical feasibility of the MTCI Pulsed Atmospheric Fluidized Bed Combustor technology, a laboratory-scale system was designed, built and tested. Important aspects of the operational and performance parameters of the system were established experimentally. A considerable amount of the effort was invested in the initial task of constructing an AFBC that would represent a reasonable baseline against which the performance of the PAFBC could be compared. A summary comparison of the performance and emissions data from the MTCI 2 ft {times} 2 ft facility (AFBC and PAFBC modes) with those from conventional BFBC (taller freeboard and recycle operation) and circulating fluidized bed combustion (CFBC) units is given in Table ES-1. The comparison is for typical high-volatile bituminous coals and sorbents of average reactivity. The values indicated for BFBC and CFBC were based on published information. The AFBC unit that was designed to act as a baseline for the comparison was indeed representative of the larger units even at the smaller scale for which it was designed. The PAFBC mode exhibited superior performance in relation to the AFBC mode. The higher combustion efficiency translates into reduced coal consumption and lower system operating cost; the improvement in sulfur capture implies less sorbent requirement and waste generation and in turn lower operating cost; lower NO{sub x} and CO emissions mean ease of site permitting; and greater steam-generation rate translates into less heat exchange surface area and reduced capital cost. Also, the PAFBC performance generally surpasses those of conventional BFBC, is comparable to CFBC in combustion and NO{sub x} emissions, and is better than CFBC in sulfur capture and CO emissions even at the scaled-down size used for the experimental feasibility tests.

  12. Volatiles combustion in fluidized beds. Final technical report, 4 September 1992--4 June 1995

    Energy Technology Data Exchange (ETDEWEB)

    Pendergrass, R.A. II; Raffensperger, C.; Hesketh, R.P.

    1996-02-29

    The goal of this project is to investigate the conditions in which volatiles will burn within both the dense and freeboard regions of fluidized beds. Experiments using a fluidized bed operated at incipient fluidization are being conducted to characterize the effect of particle surface area, initial fuel concentration, and particle type on the inhibition of volatiles within a fluidized bed. A review of the work conducted under this grant is presented in this Final Technical Report. Both experimental and theoretical work have been conducted to examine the inhibition of the combustion by the fluidized bed material, sand. It has been shown that particulate phase at incipient fluidization inhibits the combustion of propane by free radical destruction at the surface of sand particles within the particulate phase. The implications of these findings is that at bed temperatures lower than the critical temperatures, gas combustion can only occur in the bubble phase or at the top surface of a bubbling fluidized bed. In modeling fluidized bed combustion this inhibition by the particulate phase should be included.

  13. Design of the DISCovery project: tailored work-oriented interventions to improve employee health, well-being, and performance-related outcomes in hospital care

    OpenAIRE

    Niks Irene MW; de Jonge Jan; Gevers Josette MP; Houtman Irene LD

    2013-01-01

    Abstract Background It is well-known that health care workers in today’s general hospitals have to deal with high levels of job demands, which could have negative effects on their health, well-being, and job performance. A way to reduce job-related stress reactions and to optimize positive work-related outcomes is to raise the level of specific job resources and opportunities to recover from work. However, the question remains how to translate the optimization of the balance between job deman...

  14. Overall Hospital Cost Estimates in Children with Congenital Heart Disease: Analysis of the 2012 Kid's Inpatient Database.

    Science.gov (United States)

    Faraoni, David; Nasr, Viviane G; DiNardo, James A

    2016-01-01

    This study sought to determine overall hospital cost in children with congenital heart disease (CHD) and to compare cost associated with cardiac surgical procedures, cardiac catheterizations, non-cardiac surgical procedures, and medical admissions. The 2012 Healthcare Cost and Utilization Project Kid's Inpatient Database was used to evaluate hospital cost in neonates and children with CHD undergoing cardiac surgery, cardiac catheterization, non-cardiac surgical procedures, and medical treatments. Multivariable logistic regression was applied to determine independent predictors for increased hospital cost. In 2012, total hospital cost was 28,900 M$, while hospital cost in children with CHD represented 23% of this total and accounted for only 4.4% of hospital discharges. The median cost was $51,302 ($32,088-$100,058) in children who underwent cardiac surgery, $21,920 ($13,068-$51,609) in children who underwent cardiac catheterization, $4134 ($1771-$10,253) in children who underwent non-cardiac surgery, and $23,062 ($5529-$71,887) in children admitted for medical treatments. Independent predictors for increased cost were hospital bed size cost in children with CHD represented 23% of global cost while accounting for only 4.4% of discharges. This study identified factors associated with increased cost of cardiac surgical procedures, cardiac catheterizations, non-cardiac surgical procedures, and medical management in children with CHD.

  15. A cost sensitive inpatient bed reservation approach to reduce emergency department boarding times.

    Science.gov (United States)

    Qiu, Shanshan; Chinnam, Ratna Babu; Murat, Alper; Batarse, Bassam; Neemuchwala, Hakimuddin; Jordan, Will

    2015-03-01

    Emergency departments (ED) in hospitals are experiencing severe crowding and prolonged patient waiting times. A significant contributing factor is boarding delays where admitted patients are held in ED (occupying critical resources) until an inpatient bed is identified and readied in the admit wards. Recent research has suggested that if the hospital admissions of ED patients can be predicted during triage or soon after, then bed requests and preparations can be triggered early on to reduce patient boarding time. We propose a cost sensitive bed reservation policy that recommends optimal bed reservation times for patients. The policy relies on a classifier that estimates the probability that the ED patient will be admitted using the patient information collected and readily available at triage or right after. The policy is cost sensitive in that it accounts for costs associated with patient admission prediction misclassification as well as costs associated with incorrectly selecting the reservation time. Results from testing the proposed bed reservation policy using data from a VA Medical Center are very promising and suggest significant cost saving opportunities and reduced patient boarding times.

  16. Reducing the number of obstetrical beds by challenging traditions.

    Science.gov (United States)

    Salvig, Camilla Dalby; Storkholm, Marie Højriis; Salvig, Jannie Dalby; Uldbjerg, Niels

    2018-05-19

    The aim of this commentary is to describe changes in women care at an obstetric department that made it possible to reduce the number of beds from 40 to 29. Patient pathways were reviewed and revised using lean methodology. The mean length of stay was reduced from 70 to 59 hours and the mean numbers of hospitalizations per woman from 1.26 to 1.20. At the organizational level, we introduced a Family Department, home management of newborns, home monitoring of the women with cardiotocography and blood samples, and intrapartum Group B Streptococcus-PCR. Additionally, an After Birth Clinic and network meetings for vulnerable women were established. In patient pathway, we reduced the hospitalization indicated by preterm premature rupture of membranes, preeclampsia and observation after birth laceration. According to National Patient Satisfaction surveys, there was no decrease in women's satisfaction after reducing the number of beds. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  17. Bedømmelsesformer inden for AMU

    DEFF Research Database (Denmark)

    Helms, Niels Henrik; Løfgreen, Lars Bo

    Sigtet med denne rapport om bedømmelse i AMU-regi er dels at indsamle dokumentation fra praksiserfaringer baseret på udvalgte TUP-projekter, og dels at beskrive national og international forskning på bedømmelses- og evalueringsområdet. Denne indsamling og beskrivelse vil lægge op til en diskussio...

  18. Bed-levelling experiments with suspended load

    NARCIS (Netherlands)

    Talmon, A.M.; De Graaff, J.

    1991-01-01

    Bed-levelling experiments are conducted in a straight laboratory channel. The experiments involve a significant fraction of suspended sediment transport. The purpose of the experiments is to provide data for modelling of the direction of sediment transport on a transverse sloping alluvial river bed,

  19. Flue Gas Emissions from Fluidized Bed Combustion

    NARCIS (Netherlands)

    Bramer, E.A.; Valk, M.

    1995-01-01

    During the past decades fluidized bed coal combustion was developed as a technology for burning coal in an effective way meeting the standards for pollution control. During the earlier years of research on fluidized bed combustion, the potential for limiting the S02 emission by adding limestone to

  20. Multiphase flow in spout fluidized bed granulators

    NARCIS (Netherlands)

    Buijtenen, van M.S.

    2011-01-01

    Spout fluidized beds are frequently used for the production of granules or particles through granulation, which are widely applied, for example, in the production of detergents, pharmaceuticals, food and fertilizers (M¨orl et al. 2007). Spout fluidized beds have a number of advantageous properties,