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Sample records for baylor operating room

  1. Optimizing Operating Room Scheduling.

    PubMed

    Levine, Wilton C; Dunn, Peter F

    2015-12-01

    This article reviews the management of an operating room (OR) schedule and use of the schedule to add value to an organization. We review the methodology of an OR block schedule, daily OR schedule management, and post anesthesia care unit patient flow. We discuss the importance of a well-managed OR schedule to ensure smooth patient care, not only in the OR, but throughout the entire hospital. PMID:26610624

  2. Improving operating room schedules.

    PubMed

    Li, Fei; Gupta, Diwakar; Potthoff, Sandra

    2016-09-01

    Operating rooms (ORs) in US hospitals are costly to staff, generate about 70 % of a hospital's revenues, and operate at a staffed-capacity utilization of 60-70 %. Many hospitals allocate blocks of OR time to individual or groups of surgeons as guaranteed allocation, who book surgeries one at a time in their blocks. The booking procedure frequently results in unused time between surgeries. Realizing that this presents an opportunity to improve OR utilization, hospitals manually reschedule surgery start times one or two days before each day of surgical operations. The purpose of rescheduling is to decrease OR staffing costs, which are determined by the number of concurrently staffed ORs. We formulate the rescheduling problem as a variant of the bin-packing problem with interrelated items, which are the surgeries performed by the same surgeon. We develop a lower bound (LB) construction algorithm and prove that the LB is at least (2/3) of the optimal staffing cost. A key feature of our approach is that we allow hospitals to have two shift lengths. Our analytical results form the basis of a branch-and-bound algorithm, which we test on data obtained from three hospitals. Experiments show that rescheduling saves significant staffing costs. PMID:25687390

  3. [Cleanliness in the operating room].

    PubMed

    Suzuki, Toshiyasu

    2010-05-01

    With regard to recent findings in the cleanliness of the operating room, concerning handwashing and performing operations, the traditional method of excessive scrubbing using a brush is not effective, and handwashing using only an alcohol-containing antiseptic hand rub (rubbing method) has become common practice. Use of a brush has already been abolished in some medical institutions. In addition, sterilized water used for handwashing when performing operations has no scientific basis and use of tap water is considered sufficient. Furthermore, the concept of operating room zoning has also undergone a dramatic change. It was discovered that a layout focusing on work efficiency is more desirable than the one that follows an excessively rigid zoning pattern. One-footwear System not requiring change of shoes also has various advantages in improving the efficiency of the operation room, and this is thought to become commonplace in the future. PMID:20486565

  4. DETAIL VIEW OF OPERATIONS MANAGEMENT ROOM, FIRING ROOM NO. 3, ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    DETAIL VIEW OF OPERATIONS MANAGEMENT ROOM, FIRING ROOM NO. 3, FACING SOUTHEAST - Cape Canaveral Air Force Station, Launch Complex 39, Launch Control Center, LCC Road, East of Kennedy Parkway North, Cape Canaveral, Brevard County, FL

  5. DETAIL VIEW OF OPERATIONS MANAGEMENT ROOM, FIRING ROOM NO. 4, ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    DETAIL VIEW OF OPERATIONS MANAGEMENT ROOM, FIRING ROOM NO. 4, FACING WEST - Cape Canaveral Air Force Station, Launch Complex 39, Launch Control Center, LCC Road, East of Kennedy Parkway North, Cape Canaveral, Brevard County, FL

  6. DETAIL VIEW OF OPERATIONS MANAGEMENT ROOM, FIRING ROOM NO. 3, ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    DETAIL VIEW OF OPERATIONS MANAGEMENT ROOM, FIRING ROOM NO. 3, FACING NORTH - Cape Canaveral Air Force Station, Launch Complex 39, Launch Control Center, LCC Road, East of Kennedy Parkway North, Cape Canaveral, Brevard County, FL

  7. DETAIL VIEW OF OPERATIONS MANAGEMENT ROOM, FIRING ROOM NO. 3, ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    DETAIL VIEW OF OPERATIONS MANAGEMENT ROOM, FIRING ROOM NO. 3, FACING EAST - Cape Canaveral Air Force Station, Launch Complex 39, Launch Control Center, LCC Road, East of Kennedy Parkway North, Cape Canaveral, Brevard County, FL

  8. Operating room of the future.

    PubMed

    Bharathan, Rasiah; Aggarwal, Rajesh; Darzi, Ara

    2013-06-01

    Development of surgical care in the 21st century is increasingly dependent on demonstrating safety, efficacy and cost effectiveness. Over the past 2 decades, the potential role of simulation in surgery has been explored with encouraging results; this can now be linked to direct improvement in the quality of care provision. Computer-assisted surgical platforms, such as robotic surgery, offer us the versatility to embrace a host of technical and technological developments. Rapid development in nanomedicine will expand the limits of operative performance through improved navigation and surgical precision. Integration of the multiple functions of the future operating room will be essential in optimising resource management. The key to bringing about the necessary paradigm shift in the design and delivery of modern surgical care is to appreciate that we now function in an information age, where the integrity of processes is driven by apt data management. PMID:23266083

  9. Development of the NASA/Baylor VAD

    NASA Technical Reports Server (NTRS)

    Aber, G. S.; Akkerman, J. W.; Bozeman, R. J., Jr.; Saucler, D. R.; Bacak, J. W.; Svejkovsky, P. A.; Damm, G. A.; Mizuguchi, K.; Noon, G. P.; Nose, Y.

    1994-01-01

    A cooperative effort between the NASA/Johnson Space Center (JSC) and the Baylor College of Medicine (BCM) has been underway since 1988 to develop a long-term implantable Ventricular Assist Device (VAD). The VAD is intended to boost the cardiac output of patients with deteriorated cardiac function. For many of these patients, the best alternative is heart transplantation. Heart transplantation is a complex and expensive procedure and usually requires a long waiting period for a donor heart. The condition of the patient often deteriorates during this waiting period which complicates the pre and post-operative care. Because of these factors, the need for a long-term implantable VAD for use as a bridge-to-transplant device or as a permanent assist device has become the focus of much research. The need for a VAD has been estimated at 50,000 to 60,000 patients per year in the United States alone. A device which satisfies all the system performance and reliability requirements has yet to be achieved. However, the development of the NASA/Baylor VAD has progressed to a state in which commercial viability can being to be considered. The device is small, simple, efficient and reliable which meets all requirements for a totally implantable VAD.

  10. [Management for the operating room].

    PubMed

    Tschudi, O; Schüpfer, G

    2015-03-01

    Business companies, which in the current times also includes hospitals, must create customer benefits and as a prerequisite for this must sustainably generate profits. Management in the world of business means the formation and directing of a company or parts of a company on a permanent basis, whereby management in this context is not exercising power but function. This concept of management is exemplary developed in this article for the important services sector of the operating room (OR) and individual functions, such as resource control, capacity planning and materials administration are presented in detail. Some OR-specific management challenges are worked out. From this it becomes clear that the economic logic of the most efficient implementation possible is not a contradiction of medical ethics, enabling the most effective treatment possible for patients while safeguarding the highest possible levels of safety and quality. The article aims to build a bridge for medical specialists to the language and world of commerce, emphasizing the profession-based competence and hopefully to arouse interest to go into more detail. PMID:25782780

  11. Elementary Particle Physics at Baylor (Final Report)

    SciTech Connect

    Dittmann, J.R.

    2012-08-25

    This report summarizes the activities of the Baylor University Experimental High Energy Physics (HEP) group on the Collider Detector at Fermilab (CDF) experiment from August 15, 2005 to May 31, 2012. Led by the Principal Investigator (Dr. Jay R. Dittmann), the Baylor HEP group has actively pursued a variety of cutting-edge measurements from proton-antiproton collisions at the energy frontier.

  12. Operating Room Technology. Post Secondary Curriculum Guide.

    ERIC Educational Resources Information Center

    Simpson, Bruce; And Others

    This curriculum guide was designed for use in postsecondary operating room technology education programs in Georgia. Its purpose is to provide for development of entry level skills in operating room technology in the areas of knowledge, theoretical structure, tool usage, diagnostic ability, related supportive skills, and occupational survival…

  13. The Baylor pediatric nutrition handbook for residents

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The Baylor Pediatric Nutrition Handbook for Residents provides basic resource information about the assessment of growth, the nutritional status assessment and feeding guidelines, biochemical evaluation of nutritional status, infant nutrition, enteral nutrition, parenteral nutrition, nutritional man...

  14. What Happens in the Operating Room?

    MedlinePlus

    ... Quizzes Kids' Dictionary of Medical Words En Español What Other Kids Are Reading Back-to-School Butterflies? ... Got Homework? Here's Help White House Lunch Recipes What Happens in the Operating Room? KidsHealth > For Kids > ...

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

    PubMed

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

    2010-09-01

    The last two decades have seen a paradigm shift in the treatment of vascular related diseases from once traditional open surgical repairs to the entire vascular tree being amenable to percutaneous interventions. Neither the classic operating room nor the conventional angiography suite is optimal for both open surgery and endovascular procedures. Important issues for the vascular hybrid operating room include quality of the imaging equipment, radiation burden, ease of use of the equipment, need for specially trained personnel, ergonomics, ability to perform both open and percutaneous procedures, sterile environments, as well as quality and efficiency of patient care. The most important feature of working in a dedicated hybrid vascular suite should be the ability to attain best treatment of vascular patients. Whether the interventional radiologist or the vascular surgeon uses the facilities is of less importance. Establishment of an endovascular operating room suite has the benefit of a sterile environment, and the possibility of performing hybrid procedures and conversions when necessary. Moreover, angiography immediately before treatment gives contemporary anatomical information, and after treatment provides quality control. Consequently, better quality and service can be provided to the individual patient. These changes in the treatment of vascular disease require that a new type of vascular specialist, named 'vascular hybrid surgeon', trained to perform both endovascular and open surgical procedures in this highly complex patient group. PMID:21462818

  16. 27. View east of operator's room, west operator's house, showing ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    27. View east of operator's room, west operator's house, showing bascule control panel center and gate control panel left. - Yellow Mill Bridge, Spanning Yellow Mill Channel at Stratford Avenue, Bridgeport, Fairfield County, CT

  17. Operating room management: operative suite considerations, infection control.

    PubMed

    Allo, Maria D; Tedesco, Maureen

    2005-12-01

    An operating room's condition is rarely directly implicated in dis-ease transmission. Even so, to prevent such rare transmissions,hospitals must be thoughtful in designing operating rooms as important adjuncts to infection control. Proper ventilation in and near the operating room is the single most important component in establishing an environment that stops the spread of infection. Other considerations include attention to traffic control, equipment maintenance and storage, and construction materials that enhance the ability to maintain clean rooms. Hospitals can avert potential infectious problems through preventive maintenance and the use of infection control risk assessments (ICRAs) for preemptive consideration of infectious risks before renovations, repairs and new construction. Guidelines should be consulted and incorporated into each operating room's policies and procedures. PMID:16326209

  18. Pharmacy practice in an operating room complex.

    PubMed

    Evans, D M; Guenther, A M; Keith, T D; Lazarus, H L

    1979-10-01

    The steps involved in establishing a comprehensive pharmaceutical service in an operating and recovery room complex is described. Objectives of the operating room pharmaceutical satellite were to: (1) improve control of distribution, storage and charging for all drugs, especially Schedule II controlled substances; (2) reduce inventory costs and loss of revenue; (3) improve compliance with the drug formulary; and (4) establish patient-oriented pharmaceutical services. The pharmacy satellite improved inventory control and patient charging, assured continual access to all drugs and appropriate security for controlled substances, and expanded the pharmacy department's clinical, drug information and research activities. PMID:507076

  19. Integrating robotic technology into the operating room.

    PubMed

    Coon, Thomas M

    2009-02-01

    Integration of any highly complex technology into the operating room is challenging but can be accomplished with dedicated engineers, trained surgical team members, a streamlined surgical setup, and efficient surgical technique. Early results suggest a short learning curve and excellent radiographic outcomes (2.5 times improvement in tibial alignment, lower SD). The robotic arm is a valuable tool in modern orthopedics. PMID:19340376

  20. Advance Directives and Operating: Room for Improvement?

    PubMed

    Hadler, Rachel A; Neuman, Mark D; Raper, Steven; Fleisher, Lee A

    2016-04-01

    Anesthesiologists and surgeons are frequently called on to perform procedures on critically ill patients with advanced directives. We assessed the attitudes of attending and resident surgeons and anesthesiologists at our institution regarding their understanding of and practice around the application of consenting critically ill patients with advance directives in the operating room. To do so, we deployed a survey after interdepartmental grand rounds, featuring a panel discussion of ethically complex cases featuring end-of-life issues. PMID:26599738

  1. Fighting drug abuse in operating rooms.

    PubMed

    Nemes, J

    1991-07-29

    A growing problem of drug addicts working in operating rooms is mobilizing hospitals to make it more difficult for staff members to steal drugs for their own use or for sale to others. Monitoring devices and tighter drug distribution security are among measures being used to deter theft by anesthesiologists, technicians or nurses who are addicted to one of many potent narcotics readily available to them. PMID:10170762

  2. Stress, performance, and control room operations

    SciTech Connect

    Fontaine, C.W.

    1990-01-01

    The notion of control room operator performance being detrimentally affected by stress has long been the focus of considerable conjecture. It is important to gain a better understanding of the validity of this concern for the development of effective severe-accident management approaches. This paper illustrates the undeniable negative impact of stress on a wide variety of tasks. A computer-controlled simulated work environment was designed in which both male and female operators were closely monitored during the course of the study for both stress level (using the excretion of the urine catecholamines epinephrine and norepinephrine as an index) and job performance. The experimental parameters employed by the study when coupled with the subsequent statistical analyses of the results allow one to make some rather striking comments with respect to how a given operator might respond to a situation that he or she perceives to be psychologically stressful (whether the stress be externally or internally generated). The findings of this study clearly indicated that stress does impact operator performance on tasks similar in nature to those conducted by control room operators and hence should be seriously considered in the development of severe-accident management strategies.

  3. Tritium Room Air Monitor Operating Experience Review

    SciTech Connect

    L. C. Cadwallader; B. J. Denny

    2008-09-01

    Monitoring the breathing air in tritium facility rooms for airborne tritium is a radiological safety requirement and a best practice for personnel safety. Besides audible alarms for room evacuation, these monitors often send signals for process shutdown, ventilation isolation, and cleanup system actuation to mitigate releases and prevent tritium spread to the environment. Therefore, these monitors are important not only to personnel safety but also to public safety and environmental protection. This paper presents an operating experience review of tritium monitor performance on demand during small (1 mCi to 1 Ci) operational releases, and intentional airborne inroom tritium release tests. The tritium tests provide monitor operation data to allow calculation of a statistical estimate for the reliability of monitors annunciating in actual tritium gas airborne release situations. The data show a failure to operate rate of 3.5E-06/monitor-hr with an upper bound of 4.7E-06, a failure to alarm on demand rate of 1.4E-02/demand with an upper bound of 4.4E-02, and a spurious alarm rate of 0.1 to 0.2/monitor-yr.

  4. Lean Strategies in the Operating Room.

    PubMed

    Robinson, Stephen T; Kirsch, Jeffrey R

    2015-12-01

    Lean strategies can be readily applied to health care in general and operating rooms specifically. The emphasis is on the patient as the customer, respect and engagement of all providers, and leadership from management. The strategy of lean is to use continuous improvement to eliminate waste from the care process, leaving only value-added activities. This iterative process progressively adds the steps of identifying the 7 common forms of waste (transportation, inventory, motion, waiting, overproduction, overprocessing, and defects), 5S (sort, simplify, sweep, standardize, sustain), visual controls, just-in-time processing, level-loaded work, and built-in quality to achieve the highest quality of patient care. PMID:26610625

  5. Designing an Alternate Mission Operations Control Room

    NASA Technical Reports Server (NTRS)

    Montgomery, Patty; Reeves, A. Scott

    2014-01-01

    The Huntsville Operations Support Center (HOSC) is a multi-project facility that is responsible for 24x7 real-time International Space Station (ISS) payload operations management, integration, and control and has the capability to support small satellite projects and will provide real-time support for SLS launches. The HOSC is a service-oriented/ highly available operations center for ISS payloads-directly supporting science teams across the world responsible for the payloads. The HOSC is required to endure an annual 2-day power outage event for facility preventive maintenance and safety inspection of the core electro-mechanical systems. While complete system shut-downs are against the grain of a highly available sub-system, the entire facility must be powered down for a weekend for environmental and safety purposes. The consequence of this ground system outage is far reaching: any science performed on ISS during this outage weekend is lost. Engineering efforts were focused to maximize the ISS investment by engineering a suitable solution capable of continuing HOSC services while supporting safety requirements. The HOSC Power Outage Contingency (HPOC) System is a physically diversified compliment of systems capable of providing identified real-time services for the duration of a planned power outage condition from an alternate control room. HPOC was designed to maintain ISS payload operations for approximately three continuous days during planned HOSC power outages and support a local Payload Operations Team, International Partners, as well as remote users from the alternate control room located in another building.

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

    PubMed

    Salassa, Tiare E; Swiontkowski, Marc F

    2014-09-01

    ➤ Although there is some evidence that scrubs, masks, and head coverings reduce bacterial counts in the operating room, there is no evidence that these measures reduce the prevalence of surgical site infection.➤ The use of gloves and impervious surgical gowns in the operating room reduces the prevalence of surgical site infection.➤ Operating-room ventilation plays an unclear role in the prevention of surgical site infection.➤ Exposure of fluids and surgical instruments to the operating-room environment can lead to contamination. Room traffic increases levels of bacteria in the operating room, although the role of this contamination in surgical site infection is unclear. PMID:25187588

  7. Implementing a computerized operating room management system.

    PubMed

    Choy, M

    1991-01-01

    The Queen's Medical Center implemented a computerized operating room management system in 1987 that includes surgery scheduling, intraoperative recording, and resource tracking. In addition to the important functional components, the system provides management with a better tool for decision-making. The purpose of this article is to describe this implementation. Background is provided to identify the manual system's deficiencies followed by the anticipated benefits of the computer system. The paper concentrates on Queen's implementation experiences in coding the surgical procedure information, confronting staff anxiety, managing the changing roles of the staff and providing adequate resources. Minimum requirements for a successful implementation include designating an effective project leader, assigning system responsibilities to the user, relieving all operational responsibilities from key members of the project team and providing adequate resources to support the system. PMID:1760543

  8. [Controlling systems for operating room managers].

    PubMed

    Schüpfer, G; Bauer, M; Scherzinger, B; Schleppers, A

    2005-08-01

    Management means developing, shaping and controlling of complex, productive and social systems. Therefore, operating room managers also need to develop basic skills in financial and managerial accounting as a basis for operative and strategic controlling which is an essential part of their work. A good measurement system should include financial and strategic concepts for market position, innovation performance, productivity, attractiveness, liquidity/cash flow and profitability. Since hospitals need to implement a strategy to reach their business objectives, the performance measurement system has to be individually adapted to the strategy of the hospital. In this respect the navigation system developed by Gälweiler is compared to the "balanced score card" system of Kaplan and Norton. PMID:15959742

  9. Physician communication in the operating room.

    PubMed

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

    2015-01-01

    In this study, communication research was conducted with multidisciplinary groups of operating-room physicians. Theoretical frameworks from intercultural communication and rhetoric were used to (a) measure latent cultural communication variables and (b) conduct communication training with the physicians. A six-step protocol guided the research with teams of physicians from different surgical specialties: anesthesiologists, general surgeons, and obstetrician-gynecologists (n = 85). Latent cultural communication variables were measured by surveys administered to physicians before and after completion of the protocol. The centerpiece of the 2-hour research protocol was an instructional session that informed the surgical physicians about rhetorical choices that support participatory communication. Post-training results demonstrated scores increased on communication variables that contribute to collaborative communication and teamwork among the physicians. This study expands health communication research through application of combined intercultural and rhetorical frameworks, and establishes new ways communication theory can contribute to medical education. PMID:24885399

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

    PubMed

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

    2015-11-01

    Many resources are expended to ensure a sterile operating room environment. Efforts are made to prevent exposure of patients to personnel and to achieve positive room pressure to keep out airborne contaminants. Foot traffic into and out of the operating room during surgery can undermine these efforts. The authors investigated the number and duration of operating room door openings during hip and knee arthroplasty procedures and the effect of the door openings on room pressure. They tested the hypothesis that door openings defeat positive pressure, permitting air flow into the room. Room pressure and door status were monitored electronically during 191 hip and knee arthroplasty procedures. Operating room staff were unaware that data were being collected. The authors evaluated the data with regression analysis to determine whether the number and duration of door openings had an effect on room pressure. Significance was set at P<.05. Doors were open, on average, 9.5 minutes per case. In 77 of 191 cases, positive pressure was defeated, allowing air flow to reverse into the operating room. Total time with the door open significantly affected the minimum pressure recorded in the room (P<.02), but did not significantly affect average room pressure (P=.7). This finding suggested that the loss of positive pressure was a transient event from which the room recovered. The number and duration of door openings showed a significant association with length of surgery. Door openings threaten positive pressure, potentially jeopardizing operating room sterility. The causes of excessive operating room traffic must be evaluated to identify ways to reduce this traffic and the associated risks. PMID:26558679

  11. Science Support Room Operations During Desert RATS 2009

    NASA Astrophysics Data System (ADS)

    Lofgren, G. E.; Hörz, F.; D-Rats Ssr; Bell, M. S.; Cohen, B. A.; Eppler, D. B.; Evans, C. A.; Hodges, K. V.; Hynek, B. M.; Gruener, J. E.; Kring, D. A.; Hurtado, J. M.; Lee, P.; Ming, D. W.; Rice, J. W.

    2010-03-01

    The DRATS 2009 field exercise provided operational experience that will help define science requirements for a science support room for future lunar surface operations. Lessons learned emphasize the continued collaboration between science, engineering, and operations.

  12. A Learning Needs Assessment of Operating Room Nurses.

    ERIC Educational Resources Information Center

    Pounds, Elizabeth; Littlefield, John H.

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

  13. Improving on-time surgical starts in an operating room

    PubMed Central

    Wright, James G.; Roche, Ann; Khoury, Antoine E.

    2010-01-01

    Background Operating rooms are expensive to run, and hospitals strive to be efficient. The purpose of this study was to evaluate an initiative to improve starting on time in the operating room in an academic pediatric hospital. Methods We used an 8-step approach to transforming an organization. A multidisciplinary team defined on-time starts, identified reasons for delays and instituted changes, including improving the same-day admission process, instituting a huddle of operating room staff each morning and providing feedback about on-time starts to staff. Results The most common reasons for delay were surgeon and anesthesiologist unavailability and lack of preparedness of patients. The percentage of operations that began on time, defined as the patient being in the room, increased from about 6% to 60% over a 9-month period. Conclusion A targeted, multifaceted and multidisciplinary approach can increase the percentage of operations that begin on time in a pediatric hospital. PMID:20507788

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

    PubMed

    Waeschle, R M; Sliwa, B; Jipp, M; Pütz, H; Hinz, J; Bauer, M

    2016-08-01

    The difficult financial situation in German hospitals requires measures for improvement in process quality. Associated increases in revenues in the high income field "operating room (OR) area" are increasingly the responsibility of OR management but it has not been shown that the introduction of an efficiency-oriented management leads to an increase in process quality and revenues in the operating theatre. Therefore the performance in the operating theatre of the University Medical Center Göttingen was analyzed for working days in the core operating time from 7.45 a.m. to 3.30 p.m. from 2009 to 2014. The achievement of process target times for the morning surgery start time and the turnover times of anesthesia and OR-nurses were calculated as indicators of process quality. The number of operations and cumulative incision-suture time were also analyzed as aggregated performance indicators. In order to assess the development of revenues in the operating theatre, the revenues from diagnosis-related groups (DRG) in all inpatient and occupational accident cases, adjusted for the regional basic case value from 2009, were calculated for each year. The development of revenues was also analyzed after deduction of revenues resulting from altered economic case weighting. It could be shown that the achievement of process target values for the morning surgery start time could be improved by 40 %, the turnover times for anesthesia reduced by 50 % and for the OR-nurses by 36 %. Together with the introduction of central planning for reallocation, an increase in operation numbers of 21 % and cumulative incision-suture times of 12% could be realized. Due to these additional operations the DRG revenues in 2014 could be increased to 132 % compared to 2009 or 127 % if the revenues caused by economic case weighting were excluded. The personnel complement in anesthesia (-1.7 %) and OR-nurses (+2.6 %) as well as anesthetists (+6.7 %) increased less compared to the

  15. 19. VIEW OF PROCESSING ROOM. AFTER 1957, BUILDING 771 OPERATIONS ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    19. VIEW OF PROCESSING ROOM. AFTER 1957, BUILDING 771 OPERATIONS CONSISTED PRIMARILY OF AQUEOUS PLUTONIUM RECOVERY FROM SCRAP METAL. (6/20/60) - Rocky Flats Plant, Plutonium Recovery & Fabrication Facility, North-central section of plant, Golden, Jefferson County, CO

  16. A Basic Communication Workshop for Operating Room Nurses.

    ERIC Educational Resources Information Center

    Darou, Wes G.

    1982-01-01

    Describes a workshop presented to operating room nurses in a small children's hospital and the evaluation of the program. The approach chosen was an empathy and self-disclosure training workshop empirically known to reduce some aspects of stress. (PAS)

  17. Buoyancy driven acceleration in a hospital operating room indoor environment

    NASA Astrophysics Data System (ADS)

    McNeill, James; Hertzberg, Jean; Zhai, John

    2011-11-01

    In hospital operating rooms, centrally located non-isothermal ceiling jets provide sterile air for protecting the surgical site from infectious particles in the room air as well as room cooling. Modern operating rooms are requiring larger temperature differences to accommodate increasing cooling loads for heat gains from medical equipment. This trend may lead to significant changes in the room air distribution patterns that may sacrifice the sterile air field across the surgical table. Quantitative flow visualization experiments using laser sheet illumination and RANS modeling of the indoor environment were conducted to demonstrate the impact of the indoor environment thermal conditions on the room air distribution. The angle of the jet shear layer was studied as function of the area of the vena contracta of the jet, which is in turn dependent upon the Archimedes number of the jet. Increases in the buoyancy forces cause greater air velocities in the vicinity of the surgical site increasing the likelihood of deposition of contaminants in the flow field. The outcome of this study shows the Archimedes number should be used as the design parameter for hospital operating room air distribution in order to maintain a proper supply air jet for covering the sterile region. This work is supported by ASHRAE.

  18. Photodynamic research at Baylor University Medical Center Dallas, Texas

    NASA Astrophysics Data System (ADS)

    Gulliya, Kirpal S.; Matthews, James Lester; Sogandares-Bernal, Franklin M.; Aronoff, Billie L.; Judy, Millard M.

    1993-03-01

    We received our first CO2 laser at Baylor University Medical Center in December 1974, following a trip to Israel in January of that year. Discussion with the customs office of the propriety of charging an 18% import tax lasted for nine months. We lost that argument. Baylor has been using lasers of many types for many procedures since that time. About ten years ago, through the kindness of Tom Dougherty and Roswell Park, we started working with photodynamic therapy, first with hematoporphyrin I and later with dihematoporphyrin ether (II). In February 1984, we were invited to a conference at Los Alamos, New Mexico, U.S.A. on medical applications of the free electron laser as part of the Star Wars Program. A grant application from Baylor was approved that November, but funding did not start for many months. This funding contributed to the development of a new research center as part of Baylor Research Institute. Many of the projects investigated at Baylor dealt with applications of the free electron laser (FEL), after it became available. A staff was assembled and many projects are still ongoing. I would like to outline those which are in some way related to photodynamic therapy.

  19. Anesthesia and sedation outside of the operating room

    PubMed Central

    Youn, Ann Misun; Kim, Yoon-Hee

    2015-01-01

    Due to rapid evolution and technological advancements, medical personnel now require special training outside of their safe zones. Anesthesiologists face challenges in practicing in locations beyond the operating room. New locations, inadequate monitoring devices, poor assisting staff, unfamiliarity of procedures, insufficient knowledge of basic standards, and lack of experience compromise the quality of patient care. Therefore, anesthesiologists must recognize possible risk factors during anesthesia in nonoperating rooms and familiarize themselves with standards to improve safe practice. This review article emphasizes the need for standardizing hospitals and facilities requiring nonoperating room anesthesia, and encourages anesthesiologists to take the lead in applying these practice guidelines to improve patient outcomes and reduce adverse events. PMID:26257843

  20. 12. VIEW OF OPERATING ROOMRCA COMMUNICATION REC STATION (THIS ROOM ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    12. VIEW OF OPERATING ROOM-RCA COMMUNICATION REC STATION (THIS ROOM WAS ORIGINALLY A MOTOR GENERATOR FACILITY AND SUPPLIED DC POWER TO AN EARLIER GENERATION OF POINT-TO-POINT RECEIVERS ON SECOND FLOOR). VIEW SHOWS TRANSMITTER CONTROL STATION AND AUDIO CONTROL STATION (LEFT, WATKINS-JOHNSON WJ-8718-23. HP RECEIVERS AND KENWOOD R-5000 COMMUNICATIONS RECEIVERS (220 DEGREES). - Marconi Radio Sites, Receiving, Point Reyes Station, Marin County, CA

  1. 76. MEDICAL DEPARTMENT OPERATING ROOM STARBOARD LOOKING TO ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    76. MEDICAL DEPARTMENT - OPERATING ROOM - STARBOARD LOOKING TO PORT FORWARD TO AFT SHOWING OPERATING TABLE, CABINETS, LOCKERS, X-RAY VIEWING SCREEN, LIGHTS AND EMERGENCY LIGHTING. - U.S.S. HORNET, Puget Sound Naval Shipyard, Sinclair Inlet, Bremerton, Kitsap County, WA

  2. 12. INTERIOR VIEW OF GATE OPERATOR ROOM, SHOWING SLIDES GATE ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    12. INTERIOR VIEW OF GATE OPERATOR ROOM, SHOWING SLIDES GATE OPERATORS, LOOKING NORTHWEST. - Sacramento River Water Treatment Plant Intake Pier & Access Bridge, Spanning Sacramento River approximately 175 feet west of eastern levee on river; roughly .5 mile downstream from confluence of Sacramento & American Rivers, Sacramento, Sacramento County, CA

  3. 13. INTERIOR VIEW OF GATE OPERATOR ROOM, SHOWING UNFINISHED CONCRETE ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    13. INTERIOR VIEW OF GATE OPERATOR ROOM, SHOWING UNFINISHED CONCRETE WALLS AND SLIDE GATE OPERATORS, LOOKING NORTH. - Sacramento River Water Treatment Plant Intake Pier & Access Bridge, Spanning Sacramento River approximately 175 feet west of eastern levee on river; roughly .5 mile downstream from confluence of Sacramento & American Rivers, Sacramento, Sacramento County, CA

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

    NASA Astrophysics Data System (ADS)

    Faeghi, Shiva; Lennerts, Kunibert

    2016-06-01

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

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

    PubMed

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

    2016-07-01

    New technologies and innovations are common in the delivery of modern health care. Google Glass is one such device gaining increased attention in medical specialties. The authors surveyed residents and attending physicians in the Department of Plastic Surgery, MedStar Georgetown University Hospital, on their experience using Google Glass in the operating room. Ease of use, quality of images, gaze disruption, and distraction during surgery were measured. Overall, subjects found the device to be comfortable and satisfying to wear and use during surgery to capture images of good quality. Despite some identified weaknesses, Google Glass is a unique technology with a promising plastic surgical application in the operating room. PMID:27348661

  6. The operating room charge nurse: coordinator and communicator.

    PubMed Central

    Moss, J.; Xiao, Y.; Zubaidah, S.

    2001-01-01

    To achieve the potential inherent in the use of computer applications in distributed environments, we need to understand the information needs of users. The purpose of this descriptive study was to document the communication of an operating room charge nurse to inform the design of technological communication applications for operating room coordination. A data collection tool was developed to record: 1) the purpose of the communication, 2) mode of communication, 3) the target individual, and 4) the length of time taken for each occurrence. The chosen data collection categories provided a functional structure for data collection and analysis involving communication. Study findings are discussed within the context of application design. PMID:11825234

  7. Control Room operations: an investigation of the task of the operator in a Colliery Control Room. Final report

    SciTech Connect

    Simpson, G.C.; Best, C.F.; Ferguson, C.A.; Graveling, R.A.; Nicholl, A.G.M.

    1982-09-01

    A detailed study of the ergonomics aspects of four representative Colliery Control Rooms was carried out. Numerous ergonomics limitations, many common to each of the control rooms studied, were identified particularly in relation to workspace dimensions, console layout and lighting. In order to overcome these limitations in future designs, a report detailing the Ergonomics Principles of Colliery Control Room design and Layout was prepared on the basis of the information obtained. Task analysis carried out during the studies revealed that control room operators could have a direct effect on production and that ergonomics aspects were involved in these situations. Indications of potential ergonomics problems in the wider sphere of job design were also identified particularly in relation to information handling.

  8. 42. View of CSMR room equipment status board and operators ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    42. View of CSMR room equipment status board and operators console with two phone links to MWOC in transmitter building no. 102. - Clear Air Force Station, Ballistic Missile Early Warning System Site II, One mile west of mile marker 293.5 on Parks Highway, 5 miles southwest of Anderson, Anderson, Denali Borough, AK

  9. Working posture and its predictors in hospital operating room nurses

    PubMed Central

    Abdollahzade, Farahnaz; Mohammadi, Fariba; Dianat, Iman; Asghari, Elnaz; Asghari-Jafarabadi, Mohammad; Sokhanvar, Zahra

    2016-01-01

    Background: This study was conducted to evaluate working posture of operating room nurses and its relationship with demographic and job details of this group. Methods: This cross-sectional study was conducted among 147 operating room nurses in Tabriz, Iran using a questionnaire and the Rapid Entire Body Assessment (REBA) checklist. The data were analyzed with SPSS.16 using t test, Pearson correlation coefficient and analysis of variance (ANOVA) tests for univariate analysis and the linear regression test for multivariate analysis. Results: The mean (SD) of REBA score was 7.7 (1.9), which means a high risk level and highlights an urgent need to change the working postures of the studied nurses. There was significant relationship between working posture and age (P = 0.003), gender (P = 0.003), regular daily exercise (P = 0.048), work experience (P = 0.003), number of shifts per month (P = 0.006) and type of operating rooms (P < 0.001) in univariate analyses. Gender and type of operating room were the predictors of working posture of nurses in multivariate analysis. Conclusion: The findings highlight the need for ergonomic interventions and educational programs to improve working posture of this study population, which can consequently lead to promotion of health and well-being of this group. PMID:27123432

  10. 40. DRAW CONTROL PLAN OF OPERATING ROOM, CONTROLS, SIGNALS ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    40. DRAW CONTROL - PLAN OF OPERATING ROOM, CONTROLS, SIGNALS With draw tender's and gateman's instructions Courtesy of John E. Carty, Division Engineer, Boston Department of Public Works, 1929. - Congress Street Bascule Bridge, Spanning Fort Point Channel at Congress Street, Boston, Suffolk County, MA

  11. 101. ARAIII. View of control room with operators during attempted ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    101. ARA-III. View of control room with operators during attempted 500-hour run of ML-1 reactor. April 21, 1964. Ineel photo no. 64-2185. Photographer: Benson. - Idaho National Engineering Laboratory, Army Reactors Experimental Area, Scoville, Butte County, ID

  12. SECOND FLOOR OF OPERATOR'S ROOM, WITH THROTTLE LEVER ABOVE TORQUE ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    SECOND FLOOR OF OPERATOR'S ROOM, WITH THROTTLE LEVER ABOVE TORQUE CONVERTER SWITCH, AT LEFT. MAGNETIC SOLENOID IS IN CENTER, HYDRAULIC BRAKE PUMP IS IN UPPER RIGHT, LOOKING WEST. - Mad River Glen, Single Chair Ski Lift, 62 Mad River Glen Resort Road, Fayston, Washington County, VT

  13. 9 CFR 590.522 - Breaking room operations.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 9 Animals and Animal Products 2 2014-01-01 2014-01-01 false Breaking room operations. 590.522 Section 590.522 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE EGG PRODUCTS INSPECTION INSPECTION OF EGGS AND EGG PRODUCTS (EGG PRODUCTS INSPECTION ACT) Sanitary, Processing, and Facility Requirements §...

  14. Mission Operations Control Room (MOCR) activities during STS-6 mission

    NASA Technical Reports Server (NTRS)

    1983-01-01

    Vice President George Bush talks to the STS-6 astronauts from the spacecraft communicators (CAPCOM) console in the mission operations control room (MOCR) of JSC's mission control center. Astronauts Bryan D. O'Connor, second left and Roy D. Bridges, center, are the on-duty CAPCOMS. Standing near the console are (left) JSC Director Gerald D. Griffin and NASA Administrator James Beggs. Eugene F. Kranz, Director of Mission Operations, is at the back console near the glass.

  15. Nuclear power plant control room operator control and monitoring tasks

    SciTech Connect

    Bovell, C.R.; Beck, M.G.; Carter, R.J.

    1998-07-01

    Oak Ridge National Laboratory is conducting a research project the purpose of which is to develop the technical bases for regulatory review criteria for use in evaluating the safety implications of human factors associated with the use of artificial intelligence and expert systems, and with advanced instrumentation and control (I and C) systems in nuclear power plants (NPP). This report documents the results from Task 8 of that project. The primary objectives of the task was to identify the scope and type of control and monitoring tasks now performed by control-room operators. Another purpose was to address the types of controls and safety systems needed to operate the nuclear plant. The final objective of Task 8 was to identify and categorize the type of information and displays/indicators required to monitor the performance of the control and safety systems. This report also discusses state-of-the-art controls and advanced display devices which will be available for use in control-room retrofits and in control room of future plants. The fundamental types of control and monitoring tasks currently conducted by operators can be divided into four classifications: function monitoring tasks, control manipulation tasks, fault diagnostic tasks, and administrative tasks. There are three general types of controls used in today`s NPPs, switches, pushbuttons, and analog controllers. Plant I and C systems include components to achieve a number of safety-related functions: measuring critical plant parameters, controlling critical plant parameters within safety limits, and automatically actuating protective devices if safe limits are exceeded. The types of information monitored by the control-room operators consist of the following parameters: pressure, fluid flow and level, neutron flux, temperature, component status, water chemistry, electrical, and process and area radiation. The basic types of monitoring devices common to nearly all NPP control rooms include: analog meters

  16. Operator experiences on working in screen-based control rooms

    SciTech Connect

    Salo, L.; Laarni, J.; Savioja, P.

    2006-07-01

    This paper introduces the results of two interview studies carried out in Finland in four conventional power plants and one nuclear power plant. The aim of the studies was to gather data on user experiences on the effects of control room modernization and digital control room technology on operator work Since the number of completed digitalization projects in nuclear power plants is small supplementary information was gathered by interviewing operators in conventional power plants. Our results suggest that even though the modernization processes have been success stories, they have created new challenges for operator personnel. Examples of these challenges are increased requirements for competence and collaboration, problems in trust calibration and development of awareness of the process state. Some major differences in the digitalization of human-system interfaces between conventional and nuclear power plants were discussed. (authors)

  17. Radiation safety for anaesthesia providers in the orthopaedic operating room.

    PubMed

    Rhea, E B; Rogers, T H; Riehl, J T

    2016-04-01

    In many orthopaedic operating rooms, anaesthesia providers routinely wear lead aprons for protection from radiation, but some studies have questioned whether this is needed. We conducted a systematic review to identify studies that measured the amount of radiation that anaesthetists were exposed to in the orthopaedic operating room. Multiple studies have shown that at 1.5 m from the source of radiation, anaesthetists received no radiation, or amounts so small that a person would have to be present in an unreasonable number of operations to receive cumulative doses of any significance. Radiation doses at this distance were often at the limits of the sensitivity of the measuring dosimeter. We question the need to wear lead protection for anaesthesia providers who are routinely at 1.5 m or a greater distance from standard fluoroscopy units. PMID:26874074

  18. Operating Room Delays: Meaningful Use in Electronic Health Record.

    PubMed

    Van Winkle, Rachelle A; Champagne, Mary T; Gilman-Mays, Meri; Aucoin, Julia

    2016-06-01

    Perioperative areas are the most costly to operate and account for more than 40% of expenses. The high costs prompted one organization to analyze surgical delays through a retrospective review of their new electronic health record. Electronic health records have made it easier to access and aggregate clinical data; 2123 operating room cases were analyzed. Implementing a new electronic health record system is complex; inaccurate data and poor implementation can introduce new problems. Validating the electronic health record development processes determines the ease of use and the user interface, specifically related to user compliance with the intent of the electronic health record development. The revalidation process after implementation determines if the intent of the design was fulfilled and data can be meaningfully used. In this organization, the data fields completed through automation provided quantifiable, meaningful data. However, data fields completed by staff that required subjective decision making resulted in incomplete data nearly 24% of the time. The ease of use was further complicated by 490 permutations (combinations of delay types and reasons) that were built into the electronic health record. Operating room delay themes emerged notwithstanding the significant complexity of the electronic health record build; however, improved accuracy could improve meaningful data collection and a more accurate root cause analysis of operating room delays. Accurate and meaningful use of data affords a more reliable approach in quality, safety, and cost-effective initiatives. PMID:27046388

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

    PubMed

    Fuji, Kumiko; Mizuno, Ju

    2011-11-01

    In order to maintain air cleanliness in the operating room (OR) permanently, air exchange rate in the OR should be more than 15 times x hr(-1), the laminar air flow should be kept, and the numbers of the persons in the OR and the numbers of opening and closing OR door should be limited. High efficiency particulate air (HEPA) filter is effective in collection and removal of airborne microbes, and is used in the biological clean room. We need to design, equip, and manage the OR environment according to Guideline for Design and Operation of Hospital HVAC Systems HEAS-02-2004 established by Healthcare Engineering Association of Japan and Guideline for Prevention of Surgical Site Infection (SSI) established by the Center for Disease Control and Prevention (CDC) in the USA. PMID:22175178

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

    PubMed

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

    2016-08-01

    In 2010, our department instituted a nonclinical, administrative rotation in operating room management for anesthesiology residents. Subsequently, we mandated the rotation for all senior anesthesiology residents in 2013. In 2014, under the auspices of the American Society of Anesthesiologists, we developed a web-based module covering the basics of finance, accounting, and operating room management. A multiple-choice test was given to residents at the beginning and end of the rotation, and we compared the mean scores between residents who took the traditional course and residents who took the web-based module. We found no significant difference between the groups of residents, suggesting that the web-based module is as effective as traditional didactics. PMID:27258181

  1. Reduction of Gas Contamination in The Operating Room

    PubMed Central

    Shykoff, Henry J.

    1977-01-01

    The level of anesthetic gas considered to be hazardous for operating room personnel is as yet unknown, but the least possible contamination is desirable. This paper discusses methods of reducing contamination from several sources — the anesthetic machine, high pressure leaks, low pressure leaks, and from anesthetists' poor habits. ImagesFig. 1Fig. 2Fig. 3Fig. 4Fig. 5Fig. 6Fig. 7 & 8Fig. 9Fig. 10 PMID:20469279

  2. The July Spike in Operating Room Management: Reality or Perception?

    PubMed

    Sanford, Joseph A; Tsai, Mitchell H; Kadry, Bassam; Mayhew, Christopher R; Adams, David C

    2016-05-01

    Background Some research has found increased incidence of medical errors in teaching hospitals at the beginning of the academic year and have termed this the "July Phenomenon." Objective Our primary hypothesis was that the "July Phenomenon" for anesthesiology and surgical residents might manifest itself as operational inefficiency, measured by monthly total operating room (OR) minutes. Secondary measures were monthly elective overutilized minutes (OR workload minus OR allocated time, after 5:30 pm at our institution), 80th percentile number of ORs running at 7:00 pm, and mean last room end time. Methods Data were collected retrospectively from a 525-bed academic tertiary care hospital from January 2010 to September 2014 and were deconstructed to assess for a seasonal component using local regression (Loess). Variable month length was addressed by transforming the monthly totals to average daily minutes and overutilized minutes. Linear regression quantified significance for all primary and secondary analyses. Results In the regressions, monthly average minutes showed no significant difference in July (P = .65) compared to the baseline month of April. There were no significant differences for any month for overutilized minutes or 80th percentile number ORs working at 7:00 pm. Only August was significant (P = .005) for mean last room end time. Conclusions Data from a single institution study did not show a "July Phenomenon" in the number of operating minutes, overutilized minutes, or the number of ORs working late in July. PMID:27168896

  3. Non-Operating Room Anesthesia in the Endoscopy Unit.

    PubMed

    Bhavani, Sekar

    2016-07-01

    The term, non-operating room anesthesia, describes a location remote from the main operating suites and closer to the patient, including areas that offer specialized procedures, like endoscopy suites, cardiac catheterization laboratories, bronchoscopy suites, and invasive radiology suites. There has been an exponential growth in such procedures and they present challenges in both organizational aspects and administration of anesthesia. This article explores the requirements for the location, preoperative evaluation and patient selection, monitoring, anesthesia technique, and postoperative management at these sites. There is a need to better define the role of the anesthesia personnel at these remote sites. PMID:27372771

  4. Auditing Operating Room Recycling: A Management Case Report.

    PubMed

    McGain, Forbes; Jarosz, Katherine Maria; Nguyen, Martin Ngoc Hoai Huong; Bates, Samantha; O'Shea, Catherine Jane

    2015-08-01

    Much waste arises from operating rooms (ORs). We estimated the practical and financial feasibility of an OR recycling program, weighing all waste from 6 ORs in Melbourne, Australia. Over 1 week, 237 operations produced 1265 kg in total: general waste 570 kg (45%), infectious waste 410 kg (32%), and recyclables 285 kg (23%). The achieved recycling had no infectious contamination. The achieved recycling/potential recycling rate was 285 kg/517 kg (55%). The average waste disposal costs were similar for general waste and recycling. OR recycling rates of 20%-25% total waste were achievable without compromising infection control or financial constraints. PMID:26230308

  5. Monitored anesthesia care in and outside the operating room

    PubMed Central

    Sohn, Hye-min

    2016-01-01

    Monitored anesthesia care (MAC) is an anesthesia technique combining local anesthesia with parenteral drugs for sedation and analgesia. The use of MAC is increasing for a variety of diagnostic and therapeutic procedures in and outside of the operating room due to the rapid postoperative recovery with the use of relatively small amounts of sedatives and analgesics compared to general anesthesia. The purposes of MAC are providing patients with safe sedation, comfort, pain control and satisfaction. Preoperative evaluation for patients with MAC is similar to those of general or regional anesthesia in that patients should be comprehensively assessed. Additionally, patient cooperation with comprehension of the procedure is an essential component during MAC. In addition to local anesthesia by operators or anesthesiologists, systemic sedatives and analgesics are administered to provide patients with comfort during procedures performed with MAC. The discretion and judgment of an experienced anesthesiologist are required for the safety and efficacy profiles because the airway of the patients is not secured. The infusion of sedatives and analgesics should be individualized during MAC. Many procedures in and outside of the operating room, including eye surgery, otolaryngologic surgery, cardiovascular procedures, pain procedures, and endoscopy are performed with MAC to increase patient and operator satisfaction. PMID:27482307

  6. Computed tomographic coronary angiography: experience at Baylor University Medical Center/Baylor Jack and Jane Hamilton Heart and Vascular Hospital

    PubMed Central

    2005-01-01

    Noninvasive cardiac computed tomographic imaging using multislice or electron beam technology has been shown to be highly specific and sensitive in diagnosing coronary heart disease. It is about a fifth of the cost of coronary angiography and is particularly well suited for evaluating patients with a low or low to moderate probability of having obstructive coronary atherosclerosis. In addition, it offers more information than calcium scoring: because of the intravenous contrast used, it temporarily increases the density of the lumen and allows differentiation of soft plaque from calcified plaque. The Baylor Hamilton Heart and Vascular Hospital now uses this modality to define coronary atherosclerosis in patients who would otherwise have needed invasive coronary angiography; several research protocols with the technique are also under way. Baylor has recently upgraded to the 64-slice scanner. It is expected that computed tomographic coronary angiography will replace a significant percentage of invasive cardiac catheterizations. PMID:16200178

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

    NASA Technical Reports Server (NTRS)

    1981-01-01

    Mission Operations Control Room (MOCR) activities during STS-2 mission. President Ronald Reagan and Dr. Christopher C. Kraft, Jr., look toward the orbiter spotter on the projection plotter at the front of the MOCR. Also present are Astronaut Daniel C. Brandenstein, seated left, and NASA Administrator James M. Beggs standing left of center. In the foreground, Dr. Hans Mark, Deputy NASA Administrator, briefs Michael Deaver, Special Assistant to President Reagan (39504); President Reagan speaks to the STS-2 crew during the second day of their mission. On hand in MOCR were NASA Administrator James M. Beggs and Deputy Administrator Hans Mark (standing behind the president but mostly out of frame) and Dr. Kraft on the right. Eugene F. Kranz, Deputy Director of Flight Operations can be seen in the background seated at the Flight Operations Directorate (FOD) console. Also present is Astronaut Daniel C. Brandenstein, seated left, who turned the communications over to Mr. Reagan (39505).

  8. Virtual reality in the operating room of the future.

    PubMed

    Müller, W; Grosskopf, S; Hildebrand, A; Malkewitz, R; Ziegler, R

    1997-01-01

    In cooperation with the Max-Delbrück-Centrum/Robert-Rössle-Klinik (MDC/RRK) in Berlin, the Fraunhofer Institute for Computer Graphics is currently designing and developing a scenario for the operating room of the future. The goal of this project is to integrate new analysis, visualization and interaction tools in order to optimize and refine tumor diagnostics and therapy in combination with laser technology and remote stereoscopic video transfer. Hence, a human 3-D reference model is reconstructed using CT, MR, and anatomical cryosection images from the National Library of Medicine's Visible Human Project. Applying segmentation algorithms and surface-polygonization methods a 3-D representation is obtained. In addition, a "fly-through" the virtual patient is realized using 3-D input devices (data glove, tracking system, 6-DOF mouse). In this way, the surgeon can experience really new perspectives of the human anatomy. Moreover, using a virtual cutting plane any cut of the CT volume can be interactively placed and visualized in realtime. In conclusion, this project delivers visions for the application of effective visualization and VR systems. Commonly known as Virtual Prototyping and applied by the automotive industry long ago, this project shows, that the use of VR techniques can also prototype an operating room. After evaluating design and functionality of the virtual operating room, MDC plans to build real ORs in the near future. The use of VR techniques provides a more natural interface for the surgeon in the OR (e.g., controlling interactions by voice input). Besides preoperative planning future work will focus on supporting the surgeon in performing surgical interventions. An optimal synthesis of real and synthetic data, and the inclusion of visual, aural, and tactile senses in virtual environments can meet these requirements. This Augmented Reality could represent the environment for the surgeons of tomorrow. PMID:10173059

  9. Applying science and strategy to operating room workforce management.

    PubMed

    Butler, Victoria; Clinton, Christopher; Sagi, Harsha K; Kenney, Robert; Barsoum, Wael K

    2012-01-01

    The traditional means of planning nurse staffing for operating rooms are either poorly translated to the setting or do not provide decision makers with a platform to defend their needs, especially in an era of health care reform. The surgical operations department of the Cleveland Clinic initiated a quality improvement project aimed at applying a scientific method to operating room staffing. One goal was to provide a defensible plan for allocating direct caregiver positions. A second goal was to provide a quick and easy way for nurse managers and directors to track positions and graphically depict the effect of vacancies and orientation on their staffing budgets. Using an objective, scientific method allows position requests to be approved quickly and allows managers to feel much more comfortable functioning in a "lean" mode because they know needed positions will be approved quickly. Managers and directors also have found that graphically depicting numbers of vacant positions, as well as staff in orientation, could quickly relate a story visually rather than getting "bogged down" in narrative (often losing finance administrators along the way). PMID:23198610

  10. [Computerized barcode operational system for package of surgical instruments in operating room].

    PubMed

    Wu, Su-Lan; Liu, Yu-Chu; Shih, Whie-Mei; Wu, Shu-Chu; Lee, Hsiu-Fang; Lin, Chau-Tzu

    2008-10-01

    About 8,000 people die every year in Taiwan as a result of nosocomial infection. Clinically, there is a high possibility for patients to contract nosocomial infection if medical equipment is not completely sterilized. In order to provide care and safety to patients in the operating room, increase management effectiveness and efficiency, and to reduce equipment operating costs, a project was developed to improve operating room management through data collection and analysis. A computerized barcode operational system for packages of surgical instruments was developed and executed throughout an entire operating room. The results showed that average time spent searching for surgical instruments decreased by 2,872 minutes (47.8hrs/month), 150% of the target figure; computerized monitoring of equipment expiration dates reduced total cost by 29.2% abnormal recognition of equipment tags was reduced to 0%. This project is the first one of its kind in the world. PMID:18836975

  11. Nuclear power plant control room operators' performance research

    SciTech Connect

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

    1984-01-01

    A research program is being conducted to provide information on the performance of nuclear power plant control room operators when responding to abnormal/emergency events in the plants and in full-scope training simulators. The initial impetus for this program was the need for data to assess proposed design criteria for the choice of manual versus automatic action for accomplishing safety-related functions during design basis accidents. The program also included studies of training simulator capabilities, of procedures and data for specifying and verifying simulator performance, and of methods and applications of task analysis.

  12. Medical robotics and the operating room of the future.

    PubMed

    Cleary, Kevin

    2005-01-01

    Medical robotics is an evolving field with a relatively short history and limited market penetration, although some recent systems have shown some commercial success. Nevertheless, medical robotics shows great promise for improving patient care and may become a key component in the Operating Room of the Future (ORF), where high technology equipment will be integrated with medical imaging. This paper gives an overview of the medical robotics field and summarizes a recent ORF workshop in which participants concluded that standards are critical for an integrated approach. PMID:17281953

  13. Monitoring operating room turnaround time: a retrospective analysis.

    PubMed

    Scagliarini, Michele; Apreda, Mariarosaria; Wienand, Ulrich; Valpiani, Giorgia

    2016-04-18

    Purpose - Operating room (OR) turnaround time is a key process indicator for hospital business management: delays lead to a reduced surgical interventions per day with a consequent increase in costs and decrease in efficiency. The purpose of this paper is to increase understanding by assessing the process' steady-state behaviour and identifying changes that indicate either improvement or deterioration in quality. Design/methodology/approach - With this purpose, the authors retrospectively applied Shewhart control charts and exponentially weighted moving average control charts to data extracted from an hospital information system. Findings - The results showed that statistical process control is able to identify steady-state behaviour process and to detect positive or negative changes in process performance. In particular the authors detected a deterioration in the process performance coinciding with the change in the operating room patient transfer staff. Practical implications - This study showed that statistical quality control is a valuable tool for monitoring performance indicators. Currently, hospital managers are designing an OR dashboard which also includes the control charts. Originality/value - The paper highlights the control chart application to organizational indicators allowing an objective OR system performance assessment. PMID:27120511

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

    NASA Technical Reports Server (NTRS)

    1981-01-01

    Mission Operations Control Room (MOCR) activities during STS-2 mission. President Ronald Reagan is briefed by Dr. Christopher C. Kraft, Jr., JSC Director, who points toward the orbiter spotter on the projection plotter at the front of the MOCR (39499); President Reagan joking with STS-2 astronauts during space to ground conversation (39500); Mission Specialist/Astronaut Sally K. Ride communicates with the STS-2 crew from the spacecraft communicator console (39501); Charles R. Lewis, bronze team Flight Director, monitors activity from the STS-2 crew. He is seated at the flight director console in MOCR (39502); Eugene F. Kranz, Deputy Director of Flight Operations at JSC answers a question during a press conference on Nov. 13, 1981. He is flanked by Glynn S. Lunney, Manager, Space Shuttle Program Office, JSC; and Dr. Christopher C. Kraft, Jr., Director of JSC (39503).

  15. Primary standard of optical power operating at room temperature

    NASA Astrophysics Data System (ADS)

    Dönsberg, Timo; Sildoja, Meelis; Manoocheri, Farshid; Merimaa, Mikko; Petroff, Leo; Ikonen, Erkki

    2014-08-01

    The Predictable Quantum Efficient Detector (PQED) is evaluated as a new primary standard of optical power. Design and characterization results are presented for a new compact room temperature PQED that consists of two custom-made induced junction photodiodes mounted in a wedged trap configuration. The detector assembly includes a window aligned in Brewster angle in front of the photodiodes for high transmission of p polarized light. The detector can also be operated without the window, in which case a dry nitrogen flow system is utilized to prevent dust contamination of the photodiodes. Measurements of individual detectors at the wavelength of 488 nm indicate that reflectance and internal quantum efficiency are consistent within 14 ppm and 10 ppm (ppm = part per million), respectively, and agree with the predicted values. The measured photocurrent ratio of the two photodiodes confirms the predicted value for s and p polarized light, and the spatial variation in the photocurrent ratio can be used to estimate the uniformity in the thickness of the silicon dioxide layer on the surface of the photodiodes. In addition, the spatial non-uniformity of the responsivity of the PQED is an order of magnitude lower than that of single photodiodes. Such data provide evidence that the room temperature PQED may replace the cryogenic radiometer as a primary standard of optical power in the visible wavelength range.

  16. CONVENIENT SAMPLING OF AIR BACTERIA IN OPERATING ROOMS.

    PubMed

    WARNER, P; GLASSCO, A; KROEKER, J

    1964-02-22

    A convenient arrangement for sampling air bacteria in operating rooms with a slit sampler (the Fort Detrick sampler) is described. Its purpose is to contribute as far as possible to the convenience of the surgical staff and thereby to the safety of the patient. It has the advantages of recording minute-to-minute changes in bacterial air count; it is unobtrusive and yet can be continually observed by a technician; it is not noisy and avoids the dangers of explosion and static electricity; it is inexpensive, and parts are easily replaced; and finally it provides a means of keeping permanent photographic records of bacterial counts. Results of a preliminary trial of this method appeared to be satisfactory. PMID:14118695

  17. Operating room fire: Should we mistrust alcoholic antiseptics?

    PubMed

    Bonnet, A; Devienne, M; De Broucker, V; Duquennoy-Martinot, V; Guerreschi, P

    2015-08-01

    Surgical site infections are a challenge for public health. One of the keystones of prevention is the skin preparation of the patient. Alcoholic antiseptics are presented as the best solution. But the adverse effects attributed to them must not be overshadowed by the exclusive benefit of their microbiological performance. The authors report four cases of severe burn having occurred in the operating room after skin antisepsis performed with an alcoholic antiseptic. The mechanisms of these accidents and preventive measures are reviewed. It concerns the restriction of ignition factors during use and the strict conformity to drying time. These potentially dramatic complications can and should be avoided. Probably underestimated, burns due to ignition of alcoholic antiseptics should appear more clearly in the evaluation of the risk-benefit balance. PMID:26066854

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

    PubMed

    Shambo, Lyda; Umadhay, Tony; Pedoto, Alessia

    2015-02-01

    Noise is a health hazard and a source of stress, and it impairs concentration and communication. Since 1960, hospital noise levels have risen around the world. Nowhere in the healthcare setting is noise more prevalent than in the operating room (OR). The genetic makeup of humans does not evolve at the rate of technology. Noise exposure, sensory overload, and the capacity to adapt without physical and psychological consequences are absent from the human condition. The World Health Organization has recognized environmental noise as harmful pollution that causesadverse effects on health. Although noise in the OR is unavoidable, music is a choice. The purpose of this literature review is to provide further insight into the ramifications of the presence of music in the OR, evaluate its appropriateness in relation to care and safety for the patient and staff, and provide information for future research. PMID:25842633

  19. One hundred human pancreatic islet isolations at Baylor Research Institute.

    PubMed

    Takita, Morihito; Matsumoto, Shinichi; Noguchi, Hirofumi; Shimoda, Masayuki; Chujo, Daisuke; Sugimoto, Koji; Itoh, Takeshi; Lamont, Jeffrey P; Lara, Luis F; Onaca, Nicholas; Naziruddin, Bashoo; Klintmalm, Goran B; Levy, Marlon F

    2010-10-01

    The effectiveness of pancreatic islet isolation must be maximized to make islet cell transplantation (ICT) a standard therapy. We have performed 100 human islet isolations at Baylor Research Institute including islet isolations for research, for clinical allogeneic transplantation, and for autologous islet transplantation. In this study, we analyzed the results of these isolations. First, we assessed 79 islet isolations using brain-dead donors to determine variables associated with successful islet isolation. Univariate logistic regression analysis revealed that seven variables influenced the success of islet isolation for allogeneic ICT: cause of death, mechanism of death, techniques for pancreas procurement and preservation, heavy fatty infiltration, collagenase type, dilution time, and islet purification method. Multivariate regression analysis revealed that only the current isolation protocol, the Baylor Islet Isolation Method (BIIM)-with its four required elements of pancreas procurement by the team, pancreatic ductal injection, the two-layer method with perfluorocarbon, and density-adjusted density gradient purification-had a significant positive impact on successful islet isolation (P = 0.02). Second, we compared allogeneic and autologous ICT using the BIIM. There were no significant differences in islet yields between allogeneic and autologous ICT using the BIIM; total islet yield after purification was 628 ± 84 × 10(3) IE in allogeneic ICT vs. 576 ± 49 × 10(3) IE in autologous ICT (P = 0.59). This retrospective study revealed that the BIIM provided favorable outcomes for both autologous and allogeneic ICT. PMID:20944753

  20. Theatre personnel's perception of operating room resource allocation.

    PubMed

    Adejumo, A O; Adejumo, P O

    2009-06-01

    Operating rooms (OR) in hospitals represent big investments and must be utilized efficiently. Inaccurate scheduling of OR resources often results in delays of surgery or cancellations of procedures. These are costly to the patient, surgical team and hospital. Existing literatures in the OR management lack consensus on the method of evaluating management decisions from the perspectives of personnel or those affected by management decision-making processes. Eight key informant interviews were conducted. Also, 50 Operating Theatre Personnel (OTP), i.e., Surgeons, OR Nurses, Anaesthetists, and Executive Officers in the Nigeria's premier University Teaching Hospital were asked to complete a survey questionnaire concerning operating theatre resource allocation in the hospital. Five close-ended and 10 open-ended questions were used. (For example, how are the decisions to allocate OR resources in this hospital made?) Thematic analysis and descriptive statistics were done. The theoretical framework, accountability for reasonableness was applied. Forty-eight percent of the participants were ignorant of the framework guiding OR resource allocation. 54% of the respondents admitted the current mechanism for publicizing management decisions on OR resource allocation is ineffective. Another 50% of the respondents knew little about the mode of appealing against unfavourable allocation decisions. Participants' open ended responses revealed that hospital executives and a few consultant surgeons control the allocation of OR resources, with little recourse to OR personnel's concerns. If operating theatre stake holders are excluded in the planning, allocation and evaluation of OR resources, the efficiency required in surgical services would never be realized irrespective of the dexterity of the surgical team. PMID:20175420

  1. Prevention of meconium aspiration syndrome: an update and the Baylor experience

    PubMed Central

    Charsha, Dianne S.; Chiruvolu, Arpitha

    2009-01-01

    The approach to preventing meconium aspiration syndrome (MAS) in the newborn has changed markedly over the last 30 years. In the late 1970s, all infants born through meconium-stained amniotic fluid (MSAf) had upper-airway suctioning before delivery of the shoulders and then had tracheal intubation and suctioning in the delivery room. Now suctioning of the upper airway is no longer recommended, and only “depressed” infants are intubated for tracheal suctioning. The incidence of MAS and the associated high mortality rate have both declined significantly over time. This is due to improved antepartum and intrapartum obstetrical management as well as the postdelivery resuscitation of the neonate born through MSAf. MAS is no longer considered to be solely a postnatal disorder that is preventable with routine delivery room suctioning of the trachea; rather, it is considered a complex and multifactorial disorder with antenatal as well as intrapartum factors. The incidence and severity of MAS have been positively affected by a combined obstetrical and neonatal approach to the infant born through MSAf. In this article, we detail our experience at Baylor University Medical Center with MAS and its prevention and review the current literature. PMID:19381312

  2. Why crystalloids will do the job in the operating room.

    PubMed

    Hahn, Robert G

    2014-01-01

    The current trend in anaesthesia is to choose crystalloid over colloid fluids for volume replacement in the operating room. Outcome-oriented studies and kinetic analyses have recently provided more insight into how crystalloid infusions should be managed. These fluids have a much better short-term effect on the plasma volume than previously believed. Their efficiency (i.e. the plasma volume expansion divided by the infused volume) is 50-80% as long as an infusion continues, while this fraction increases to 100% when the arterial pressure has dropped. Elimination is very slow during surgery, and amounts to only 10% of that recorded in conscious volunteers. Capillary refill further reduces the need for crystalloid fluid when bleeding occurs. These four factors limit the need for large volumes of crystalloid fluid during surgery. Adverse effects associated with crystalloid fluids mainly include prolonged gastrointestinal recovery time, which occurs when > 3 L has been infused. Clinicians who do not want to prolong the length of the hospital stay by 1-2 days due to such problems may use colloid fluid selectively, but calculations show that the therapeutic window for colloids is quite narrow. Inflammation is likely to decrease the fluid efficiency of colloid fluids, while its effect on crystalloids is unclear. However, some recent evidence suggests that inflammation accelerates the turnover of crystalloid fluid as well. PMID:25432554

  3. The operating room of the future: white paper summation.

    PubMed

    Moses, Gerald R; Farr, James O

    2003-01-01

    On November 8 and 9, 2001, leading experts in patient safety, medical informatics, advanced surgical devices, telesurgery, and surgical facilities met to formulate strategic directions for the "OR of the Future" in both military and civilian healthcare. The meeting was co-hosted by the Telemedicine and Advanced Technology Research Center (TATRC) part of the U.S. Army Medical Research and Materiel Command at Fort Detrick, and the University of Maryland Medical Center. Researchers, surgeons, and experts in the field of operating room (OR) technology addressed the current state of research and technological developments. Experts in (1) patient safety, (2) medical informatics, (3) advanced surgical devices, (4) telesurgery, and (5) surgical facilities met in focused work groups to develop a proposed research agenda for each content area. Afterwards, each focused group agreed to develop a 'White Paper' on each specific area, addressing the current and future prospectus. In addition, they attempted to provide a recommended research roadmap for the 'OR of the Future.' PMID:15455898

  4. Identifying workflow disruptions in the cardiovascular operating room.

    PubMed

    Cohen, T N; Cabrera, J S; Sisk, O D; Welsh, K L; Abernathy, J H; Reeves, S T; Wiegmann, D A; Shappell, S A; Boquet, A J

    2016-08-01

    The objectives of this study were to identify the frequency and nature of flow disruptions in the operating room with respect to three cardiac surgical team members: anaesthetists; circulating nurses; and perfusionists. Data collected from 15 cases and coded using a human factors taxonomy identified 878 disruptions. Significant differences were identified in frequency relative to discipline type. Circulating nurses experienced more coordination disruptions (χ(2) (2, N = 110) = 7.136, p < 0.028) and interruptions (χ(2) (2, N = 427) = 29.743, p = 0.001) than anaesthetists and perfusionists, whereas anaesthetists and perfusionists experienced more layout issues than circulating nurses (χ(2) (2, N = 153) = 48.558, p = 0.001). Time to resolve disruptions also varied among disciplines (λ (12, 878) = 5.186, p = 0.000). Although most investigations take a one-size fits all approach in addressing disruptions to flow, this study demonstrates that targeted interventions must focus on differences with respect to individual role. PMID:27396248

  5. Thermal cycling can extend tool life in orthopaedic operating rooms.

    PubMed

    Katchky, Ryan N; McLachlin, Stewart D; Wong, Edwin K Y; Finkelstein, Joel; Kreder, Hans J; Whyne, Cari M

    2016-03-01

    Thermal cycling is a temperature modulation process developed to improve the performance, durability and longevity of materials. This process has been successfully utilized in the automotive, aeronautic and manufacturing industries. Surgical cutting tools undergo cyclical loading and generally fail by dulling, suggesting that thermal cycling may improve their performance and longevity. Ten 2.5 mm orthopaedic drill bits were randomized, with five undergoing thermal cycling within their sterile packaging and five serving as untreated controls. Using a servohydraulic testing machine, 100 drilling cycles were performed with each drill bit into the diaphyseal region of bovine femurs. After every 25 cycles, data was collected by performing identical drilling cycles into simulated human cortical bone material. Maximum force, maximum normalized torque and drilling work were measured, and a scanning electron microscope was used to measure outer corner wear. After 100 drilling cycles, the maximum drilling force, maximum normalized torque, drilling work and microscopic outer corner wear were all significantly lower for the treated drill bits (p < 0.05). Thermal cycling has the potential to decrease operating room costs and thermal necrosis associated with dull cutting tools. Application of this technology may also be relevant to surgical cutting tools such as saw blades, burrs and reamers. PMID:26296244

  6. Damage control resuscitation: from emergency department to the operating room.

    PubMed

    Duchesne, Juan C; Barbeau, James M; Islam, Tareq M; Wahl, Georgia; Greiffenstein, Patrick; McSwain, Norman E

    2011-02-01

    Damage control surgery emphasizes limited operations with control of bleeding and contamination. Traditional management centered upon correction of acidosis and hypotension with crystalloids. Damage control resuscitation (DCR) is permissive hypotension and early hemostatic resuscitation combined identified and corrects coagulopathy with fresh-frozen plasma (FFP), restricting use of crystalloids. We hypothesize a survival advantage in patients managed with DCR when compared with a historical cohort of patients. During the 2-year retrospective review, a 1-year period after institution of DCR was compared with a historical control. Resuscitation strategies were analyzed and stratified into emergency department (ED) resuscitation and intraoperative resuscitation. Univariate analysis of continuous data was done with Student's t test followed by multiple logistic regression. Fifty-seven and 61 patients were managed during the NonDCR and DCR periods respectively. Baseline demographic patient characteristics and physiologic variables were similar between groups. ED DCR patients received less crystalloids: 1.1 versus 4.7 liters (P = 0.0001), more FFP: 1.8 versus 0.5 (P = 0.001). NonDCR had a lower initial systolic pressure in the operating room when compared with DCR: 81 mm Hg versus 95 mm Hg (P = 0.03). DCR patients received less intraoperative crystalloids: 5.7 versus 15.8 liters (P = 0.0001) and more FFP: 15.1 versus 6.2 (P = 0.0001). DCR conveyed a survival benefit (Odds Ratio; 95% confidence interval: 0.40 (0.18-0.90), P = 0.024). NonDCR group had 13.2 days longer hospital length of stay. Damage control resuscitation, beginning in the ED, used more packed red blood cells and FFP minimizing crystalloids. DCR was associated with a survival advantage and shorter length of stay in patients with severe hemorrhage. PMID:21337881

  7. Factors determining the smooth flow and the non-operative time in a one-induction room to one-operating room setting

    PubMed Central

    Mulier, Jan P; De Boeck, Liesje; Meulders, Michel; Beliën, Jeroen; Colpaert, Jan; Sels, Annabel

    2015-01-01

    Rationale, aims and objectives What factors determine the use of an anaesthesia preparation room and shorten non-operative time? Methods A logistic regression is applied to 18 751 surgery records from AZ Sint-Jan Brugge AV, Belgium, where each operating room has its own anaesthesia preparation room. Surgeries, in which the patient's induction has already started when the preceding patient's surgery has ended, belong to a first group where the preparation room is used as an induction room. Surgeries not fulfilling this property belong to a second group. A logistic regression model tries to predict the probability that a surgery will be classified into a specific group. Non-operative time is calculated as the time between end of the previous surgery and incision of the next surgery. A log-linear regression of this non-operative time is performed. Results It was found that switches in surgeons, being a non-elective surgery as well as the previous surgery being non-elective, increase the probability of being classified into the second group. Only a few surgery types, anaesthesiologists and operating rooms can be found exclusively in one of the two groups. Analysis of variance demonstrates that the first group has significantly lower non-operative times. Switches in surgeons, anaesthesiologists and longer scheduled durations of the previous surgery increases the non-operative time. A switch in both surgeon and anaesthesiologist strengthens this negative effect. Only a few operating rooms and surgery types influence the non-operative time. Conclusion The use of the anaesthesia preparation room shortens the non-operative time and is determined by several human and structural factors. PMID:25496600

  8. Healthcare personnel attire in non-operating-room settings.

    PubMed

    Bearman, Gonzalo; Bryant, Kristina; Leekha, Surbhi; Mayer, Jeanmarie; Munoz-Price, L Silvia; Murthy, Rekha; Palmore, Tara; Rupp, Mark E; White, Joshua

    2014-02-01

    Healthcare personnel (HCP) attire is an aspect of the medical profession steeped in culture and tradition. The role of attire in cross-transmission remains poorly established, and until more definitive information exists priority should be placed on evidence-based measures to prevent healthcare-associated infections (HAIs). This article aims to provide general guidance to the medical community regarding HCP attire outside the operating room. In addition to the initial guidance statement, the article has 3 major components: (1) a review and interpretation of the medical literature regarding (a) perceptions of HCP attire (from both HCP and patients) and (b) evidence for contamination of attire and its potential contribution to cross-transmission; (2) a review of hospital policies related to HCP attire, as submitted by members of the Society for Healthcare Epidemiology of America (SHEA) Guidelines Committee; and (3) a survey of SHEA and SHEA Research Network members that assessed both institutional HCP attire policies and perceptions of HCP attire in the cross-transmission of pathogens. Recommendations for HCP attire should attempt to balance professional appearance, comfort, and practicality with the potential role of apparel in the cross-transmission of pathogens. Although the optimal choice of HCP attire for inpatient care remains undefined, we provide recommendations on the use of white coats, neckties, footwear, the bare-below-the-elbows strategy, and laundering. Institutions considering these optional measures should introduce them with a well-organized communication and education effort directed at both HCP and patients. Appropriately designed studies are needed to better define the relationship between HCP attire and HAIs. PMID:24442071

  9. Allocating operating room block time using historical caseload variability.

    PubMed

    Hosseini, Narges; Taaffe, Kevin M

    2015-12-01

    Operating room (OR) allocation and planning is one of the most important strategic decisions that OR managers face. The number of ORs that a hospital opens depends on the number of blocks that are allocated to the surgical groups, services, or individual surgeons, combined with the amount of open posting time (i.e., first come, first serve posting) that the hospital wants to provide. By allocating too few ORs, a hospital may turn away surgery demand whereas opening too many ORs could prove to be a costly decision. The traditional method of determining block frequency and size considers the average historical surgery demand for each group. However, given that there are penalties to the system for having too much or too little OR time allocated to a group, demand variability should play a role in determining the real OR requirement. In this paper we present an algorithm that allocates block time based on this demand variability, specifically accounting for both over-utilized time (time used beyond the block) and under-utilized time (time unused within the block). This algorithm provides a solution to the situation in which total caseload demand can be accommodated by the total OR resource set, in other words not in a capacity-constrained situation. We have found this scenario to be common among several regional healthcare providers with large OR suites and excess capacity. This algorithm could be used to adjust existing blocks or to assign new blocks to surgeons that did not previously have a block. We also have studied the effect of turnover time on the number of ORs that needs to be allocated. Numerical experiments based on real data from a large health-care provider indicate the opportunity to achieve over 2,900 hours of OR time savings through improved block allocations. PMID:24590259

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

    PubMed

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

    2014-06-01

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

  11. Impact of changed management policies on operating room efficiency

    PubMed Central

    2014-01-01

    Background To increase operating room (OR) efficiency, a new resource allocation strategy, a new policy for patient urgency classification, and a new system for OR booking was implemented at a tertiary referral hospital. We investigated the impact of these interventions. Methods We carried out a before-and-after study using OR data. A total of 23 515 elective (planned) and non-elective (unplanned) orthopaedic and general surgeries were conducted during calendar year 2007 (period 1) and July 2008 to July 2009 (period 2). The Wilcoxon–Mann–Whitney test was used to calculate statistical significance. Results An increased amount of case time (7.1%, p < 0.05) was conducted without any increase in out-of-hours case time. Despite having three fewer ORs for electives, slightly more elective case time was handled with 26% less use of overtime (p < 0.05). Mean OR utilization was 56% for the 17 mixed ORs, 60% for the 14 elective ORs, and 62% for the 3 dedicated ORs. A 20% growth (p < 0.05) of non-elective case time was primarily absorbed through enhanced daytime surgery, which increased over 48% (p < 0.05). As a result, the proportions of case time on evenings and nights decreased. Specifically, case time at night decreased by 26% (p < 0.05), and the number of nights without surgery increased from 55 to 112 (out of 315 and 316, respectively). Median waiting time for the middle urgencies increased with 1.2 hours, but over 90% received treatment within maximum acceptable waiting time (MAWT) in both periods. Median waiting time for the lowest urgencies was reduced with 12 hours, and the proportion of cases treated within MAWT increased from 70% to 89%. The proportion of high urgency patients (as a proportion of the total) was reduced from 20% to 12%. Consequently, almost 90% of the operations could be planned at least 24 hours in advance. Conclusions The redesign facilitated effective daytime surgery and a more selective use of the ORs for high urgency

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

    PubMed Central

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

    2010-01-01

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

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

    ERIC Educational Resources Information Center

    Environmental Protection Agency, Research Triangle Park, NC. Air Pollution Training Inst.

    This Operator's Manual is a supplement to a self-instructional course prepared for the United States Environmental Protection Agency. This publication is the Boiler Room Handbook for operating and maintaining the boiler and the boiler room. As the student completes this handbook, he is putting together a manual for running his own boiler. The…

  14. Construction of a high-tech operating room for image-guided surgery using VR.

    PubMed

    Suzuki, Naoki; Hattori, Asaki; Suzuki, Shigeyuki; Otake, Yoshito; Hayashibe, Mitsuhiro; Kobayashi, Susumu; Nezu, Takehiko; Sakai, Haruo; Umezawa, Yuji

    2005-01-01

    This project aimed to construct an operating room to implement high dimensional (3D, 4D) medical imaging and medical virtual reality techniques that would enable clinical tests for new surgical procedures. We designed and constructed such an operating room at Dai-san Hospital, the Jikei Univ. School of Medicine, Tokyo, Japan. The room was equipped with various facilities for image-guided, robot and tele- surgery. In this report, we describe an outline of our "high-tech operating room" and future plans. PMID:15718793

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

    ERIC Educational Resources Information Center

    Heiner, Jeremy S.

    2013-01-01

    Student registered nurse anesthetists are an important part of an operating room team, yet little research has investigated how they perceive teamwork or approach team related issues specific to the operating room. This mixed methods study evaluated junior and senior student registered nurse anesthetists' attitudes toward and perceptions of…

  16. Flashlamp Pumped, Room Temperature, Nd:YAG Laser Operating at 0.946 Micrometers

    NASA Technical Reports Server (NTRS)

    Barnes, Norman P.; Murray, Keith E.; Walsh, Brian M.

    1998-01-01

    Room temperature operation of flashlamp pumped Nd:YAG at 0.946 micrometers was achieved with a laser rod having undoped ends. Performance was characterized and compared with 1.064 micrometer operation and other quasi four level lasers.

  17. The effect of increasing operating room capacity on day-of-surgery cancellation.

    PubMed

    Yoon, S-Z; Lee, S I; Lee, H W; Lim, H J; Yoon, S M; Chang, S H

    2009-03-01

    Several studies have been conducted to evaluate the utilisation of the operating room, a fixed resource, in terms of conditions that prevent day-of-surgery cancellation due to deficient operative capacity. In this study, we surveyed the causes and overall rates of elective surgery cancellation and then compared the number of cancellations that occurred before and after the installation of additional operating rooms. We surveyed all patients undergoing elective surgery for 100 days prior to and after the installation of additional operating rooms. The causes for cancellations were divided into six categories: departmental issues, abnormal laboratory results, patient denial, inadequate preparation, over-booking and other issues. The departmental causes were further divided into four categories: ward overflow, scheduling date errors, unavailable surgeons and other issues. The number of overall cancelled cases and scheduled cases increased following the increase in operating room capacity, although this increase was not statistically significant. However; the cancellation ratio rose significantly after the operating room capacity was increased. The primary reasons for cancellation prior to the increase in operating room capacity were departmental issues, over-booking and abnormal laboratory data, in that order. After the operating room capacity was increased, the primary reasons for cancellation were departmental issues, abnormal laboratory data and over-booking, in that order Taken together the results of this study indicate that increased operating room capacity can prevent cancellation due to over-booking. However; the numbers of cancellations due to ward overflow exceeded the numbers of cancellations that occurred as a result of over-booking. In conclusion, increasing the operating room capacity is not an appropriate option for preventing the cancellation of operations. PMID:19400490

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

    PubMed

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

    2016-05-01

    Students undertake their clinical placement in various clinical settings for the exposure to and acquisition of skills related to that particular context. The operating room is a context that offers the opportunity to develop critical skills related to the perioperative care of the patient. Despite numerous studies that have been undertaken in this field, few have investigated the operating room as a clinical learning environment in the South African private healthcare context. The aim of this study was to determine nursing students' perceptions of the operating room as a clinical learning environment. An exploratory, interpretive and descriptive design generating qualitative data was utilized. Eight nursing students completed an open-ended questionnaire, and twelve nursing students participated in the focus group discussion. Four themes emerged, namely, 'interpersonal factors', 'educational factors', 'private operating room context', and 'recommendations'. The opinion that the operating room offers an opportunity to gain skills unique to this context was expressed. However, despite the potential learning opportunities, the key findings of this study reveal negative perceptions of nursing students regarding learning experiences in the operating room. Exploration into the preparatory needs of students specific to learning outcomes before operating room placement should be considered. It will also be necessary to improve collaboration between lecturers, mentors and theatre managers. PMID:27235567

  19. Science Support Room Operations During Desert RATS 2009

    NASA Technical Reports Server (NTRS)

    Lofgren, G. E.; Horz, F.; Bell, M. S.; Cohen, B. A.; Eppler,D. B.; Evans, C. a.; Hodges, K. V.; Hynek, B. M.; Gruener, J. E.; Kring, D. A.; Hurtado, J. M.; Lee, P.; Ming, D. W.; Rice, J. W.

    2010-01-01

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

  20. Science Support Room Operations During Desert RATS 2009

    NASA Technical Reports Server (NTRS)

    Lofgren, Gary E.; Hoerz, F.; Bell, M. S.; Cohen, B. A.; Eppler, D. B.; Evans,C. A.; Hodges, K. V.; Hynek, B. M.; Gruener, J. E.; Kring, D. A.; Hurtado, J. M.; Lee, P.; Ming, D. W.; Rice, J. W.

    2009-01-01

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

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

    PubMed

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

    2014-11-01

    The balance between reducing costs and inefficiencies with that of patient safety is a challenging problem faced in the operating room suite. An ongoing challenge is the creation of effective strategies that reduce these inefficiencies and provide real-time personalized metrics and electronic feedback to anesthesia practitioners. We created a sample report card structure, utilizing existing informatics systems. This system allows to gather and analyze operating room metrics for each anesthesia provider and offer personalized feedback. To accomplish this task, we identified key metrics that represented time and quality parameters. We collected these data for individual anesthesiologists and compared performance to the overall group average. Data were presented as an electronic score card and made available to individual clinicians on a real-time basis in an effort to provide effective feedback. These metrics included number of cancelled cases, average turnover time, average time to operating room ready and patient in room, number of delayed first case starts, average induction time, average extubation time, average time to recovery room arrival to discharge, performance feedback from other providers, compliance to various protocols, and total anesthetic costs. The concept we propose can easily be generalized to a variety of operating room settings, types of facilities and OR health care professionals. Such a scorecard can be created using content that is important for operating room efficiency, research, and practice improvement for anesthesia providers. PMID:25315824

  2. Silicene field-effect transistors operating at room temperature

    NASA Astrophysics Data System (ADS)

    Tao, Li; Cinquanta, Eugenio; Chiappe, Daniele; Grazianetti, Carlo; Fanciulli, Marco; Dubey, Madan; Molle, Alessandro; Akinwande, Deji

    2015-03-01

    Free-standing silicene, a silicon analogue of graphene, has a buckled honeycomb lattice and, because of its Dirac bandstructure combined with its sensitive surface, offers the potential for a widely tunable two-dimensional monolayer, where external fields and interface interactions can be exploited to influence fundamental properties such as bandgap and band character for future nanoelectronic devices. The quantum spin Hall effect, chiral superconductivity, giant magnetoresistance and various exotic field-dependent states have been predicted in monolayer silicene. Despite recent progress regarding the epitaxial synthesis of silicene and investigation of its electronic properties, to date there has been no report of experimental silicene devices because of its air stability issue. Here, we report a silicene field-effect transistor, corroborating theoretical expectations regarding its ambipolar Dirac charge transport, with a measured room-temperature mobility of ˜100 cm2 V-1 s-1 attributed to acoustic phonon-limited transport and grain boundary scattering. These results are enabled by a growth-transfer-fabrication process that we have devised—silicene encapsulated delamination with native electrodes. This approach addresses a major challenge for material preservation of silicene during transfer and device fabrication and is applicable to other air-sensitive two-dimensional materials such as germanene and phosphorene. Silicene's allotropic affinity with bulk silicon and its low-temperature synthesis compared with graphene or alternative two-dimensional semiconductors suggest a more direct integration with ubiquitous semiconductor technology.

  3. The use of a novel technology to study dynamics of pathogen transmission in the operating room.

    PubMed

    Birnbach, David J; Rosen, Lisa F; Fitzpatrick, Maureen; Carling, Philip; Munoz-Price, L Silvia

    2015-04-01

    Pathogenic organisms have been found in the intraoperative environment, potentially posing a risk of infection that could cause morbidity and mortality. In an effort to understand how a patient's bacteria can be spread throughout the operating room with the anesthesia provider as a vector, we conducted a study using recently developed experimental technology in a simulated operating room environment with a high-fidelity human patient simulator. PMID:24810261

  4. Sports hernia: the experience of Baylor University Medical Center at Dallas.

    PubMed

    Preskitt, John T

    2011-04-01

    Groin injuries in high-performance athletes are common, occurring in 5% to 28% of athletes. Athletic pubalgia syndrome, or so-called sports hernia, is one such injury that can be debilitating and sport ending in some athletes. It is a clinical diagnosis of chronic, painful musculotendinous injury to the medial inguinal floor occurring with athletic activity. Over the past 12 years, we have operated on >100 patients with this injury at Baylor University Medical Center at Dallas. These patients have included professional athletes, collegiate athletes, competitive recreational athletes, and the occasional "weekend warrior." The repair used is an open technique using a lightweight polypropylene mesh. Patient selection is important, as is collaboration with other experienced and engaged sports health care professionals, including team trainers, physical therapists, team physicians, and sports medicine and orthopedic surgeons. Of the athletes who underwent surgery, 98% have returned to competition. After a minimum of 6 weeks for recovery and rehabilitation, they have usually returned to competition within 3 months. PMID:21566750

  5. Sports hernia: the experience of Baylor University Medical Center at Dallas

    PubMed Central

    2011-01-01

    Groin injuries in high-performance athletes are common, occurring in 5% to 28% of athletes. Athletic pubalgia syndrome, or so-called sports hernia, is one such injury that can be debilitating and sport ending in some athletes. It is a clinical diagnosis of chronic, painful musculotendinous injury to the medial inguinal floor occurring with athletic activity. Over the past 12 years, we have operated on >100 patients with this injury at Baylor University Medical Center at Dallas. These patients have included professional athletes, collegiate athletes, competitive recreational athletes, and the occasional “weekend warrior.” The repair used is an open technique using a lightweight polypropylene mesh. Patient selection is important, as is collaboration with other experienced and engaged sports health care professionals, including team trainers, physical therapists, team physicians, and sports medicine and orthopedic surgeons. Of the athletes who underwent surgery, 98% have returned to competition. After a minimum of 6 weeks for recovery and rehabilitation, they have usually returned to competition within 3 months. PMID:21566750

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

    PubMed Central

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

    2015-01-01

    The operation theater (OT) environment is the most complex and volatile workplace where two coequal physicians share responsibility of one patient. Difference in information, opinion, values, experience and interests between a surgeon and anesthesiologist may arise while working in high-pressure environments like OT, which may trigger conflict. Quality of patient care depends on effective teamwork for which multidisciplinary communication is an essential part. Troubled relationships leads to conflicts and conflicts leads to stressful work environment which hinders the safe discharge of patient care. Unresolved conflicts can harm the relationship but when handled in a positive way it provides an opportunity for growth and ultimately strengthening the bond between two people. By learning the skills to resolve conflict, we can keep our professional relationship healthy and strong which is an important component of good patient care. PMID:26543468

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

    PubMed

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

    2015-01-01

    The operation theater (OT) environment is the most complex and volatile workplace where two coequal physicians share responsibility of one patient. Difference in information, opinion, values, experience and interests between a surgeon and anesthesiologist may arise while working in high-pressure environments like OT, which may trigger conflict. Quality of patient care depends on effective teamwork for which multidisciplinary communication is an essential part. Troubled relationships leads to conflicts and conflicts leads to stressful work environment which hinders the safe discharge of patient care. Unresolved conflicts can harm the relationship but when handled in a positive way it provides an opportunity for growth and ultimately strengthening the bond between two people. By learning the skills to resolve conflict, we can keep our professional relationship healthy and strong which is an important component of good patient care. PMID:26543468

  8. History of the biomedical studies PhD program: a joint graduate program of the Baylor Health Care system and Baylor University

    PubMed Central

    Morel, Christine R.; Horton, Joshua M.; Peng, Han; Xu, Kangling; Batra, Sushil K.; Miles, Jonathan P.

    2008-01-01

    On a sweltering summer morning, throngs of people filed into Jones Theatre at Baylor University in Waco for the graduate student orientation. One could look around and notice the diversity of not only the student population, but also the disciplines being represented. Many students had stepped off planes only hours prior, but even those who had been traveling for days could not contain their excitement. As for me, I was nowhere near any of this. I was still 40 miles north of Waco in Waxahachie, having been pulled over for speeding. After 4 days of traveling with my life in my Volkswagon Jetta, all the way from San Francisco, on one of the most important days of my life, I was late. When I finally arrived at the Hooper Schafer Fine Arts Auditorium, out of breath from running all the way from the parking structure, all of the graduate students were quietly listening to the first introductory speech. I snuck into the back and sat down. My mind was racing, as I knew very little about Waco and Baylor University except for the growing accomplishments of the biomedical studies program. What little I did know about Baylor seemed so different from my very liberal upbringing in California. What would this experience be like for me? But, as I listened to the talks, met with other students, and finally met the entire biomedical studies entering class of 2007, I knew that I had made the right decision in coming to Baylor. This would be an experience unlike any other, and I was wholeheartedly open to embracing it. —Christine Morel, PhD candidate, Institute of Biomedical Studies PMID:18982085

  9. Staff planning for operating rooms with different surgical services lines.

    PubMed

    Villarreal, Monica C; Keskinocak, Pinar

    2016-06-01

    We present a two-phase model for a staff planning problem in a surgical department. We consider the setting where staff, in particular nurse circulators and surgical scrub technicians, are assigned to one of different service lines, and while they can be 'pooled' and temporally assigned to other service line if needed, these re-assignments should belimited. In Phase I, we decide on the number of staff hours to budget for each service line, considering policies limiting staff pooling and overtime, and different demand scenarios. In Phase II, we determine how these budgeted staff hours should be allocated across potential work days and shifts, given estimated staff requirements and shift-related scheduling restrictions. We propose a heuristic to speed the model's Phase II solution time. We implement the model using a hospital's surgical data and compare the model's results with the hospital's current practices. Using a simulation model for the surgical operations, we find that our two-phase model reduces the delays caused by staff unavailability as well as staff pooling, without increasing the workforce size. Finally, we briefly describe a decision-support tool we developed with the objective of fine-tuning staff planning decisions. PMID:25366968

  10. Ergonomic design in the operating room: information technologies

    NASA Astrophysics Data System (ADS)

    Morita, Mark M.; Ratib, Osman

    2005-04-01

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

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

    ERIC Educational Resources Information Center

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

    2010-01-01

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

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

    NASA Technical Reports Server (NTRS)

    Kressel, H.; Hawrylo, F. Z.

    1976-01-01

    Heterojunction laser diodes of AlGaAs have been prepared with threshold current densities substantially below those previously achieved at room temperature in the 7200-8000-A spectral range. These devices operate continuously with simple oxide-isolated stripe contacts to 7400 A, which extends CW operation into the visible (red) portion of the spectrum.

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

    PubMed

    Wachtel, Ruth E; Dexter, Franklin

    2010-06-01

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

  14. From the operating room of the present to the operating room of the future. Human-factors lessons learned from the minimally invasive surgery revolution.

    PubMed

    Gallagher, Anthony G; Smith, C Daniel

    2003-09-01

    The minimally invasive surgical revolution has changed the way surgery is practiced. It has also helped surgical innovators to break the tethers that anchored the practice of surgery in an early 20th century operating room environment. To some in surgery, the Operating Room of the Future will be seen as a revolution but to others, an inevitable evolution of the changes ushered in by the adoption of minimally invasive surgery. Although minimally invasive surgery has conferred considerable advantages on the patient, it has imposed significant difficulties on the surgeon, which in turn, have impacted outcomes. These difficulties were primarily human factor in nature and were poorly understood by critical groups such as device manufacturers, surgeons, and surgery educators and trainers. This article details what these human factors were, how they related to the practice of minimally invasive surgery, and how they will impact on the practice of surgery in the Operating Room of the Future. Much of the technology for the Operating Room of the Future currently exists (eg, surgical robotics, virtual reality, and telemedicine). However, for it to function optimally it must be integrated in a fashion that takes on board the human factor strengths and limitations of the surgeon. These advanced technologies should then be harnessed to optimize surgical practice. In some cases, this will involve rethinking existing technologies (ie, three-dimensional camera systems), applying technologies that currently exist in a manner that is more systematic and better managed (ie, surgical robots and virtual reality), and a reconsideration of who should be applying these technologies for the practice of surgery in the 21st century. In all cases, there will be education and training implications for the practitioner. Lastly, there must be unequivocal demonstration that these changes bring about positive benefits for patients in terms of better outcomes and for surgeons in terms of ability and

  15. Understanding stress in the operating room: a step toward improving the work environment.

    PubMed

    Vowels, Anthony; Topp, Robert; Berger, Jill

    2012-01-01

    Job-related stress is an important factor predicting staff satisfaction and position turnover among nursing staff, particularly in the operating room. The purpose of this study was to examine the perceived amount of stress elicited by events in the perioperative environment, the frequency of those events, and the impact of those events on the perceived stress of operating room nurses (ORNs) and operating room technologists (ORTs). The Survey on Stress in the OR instrument, which was used to query the subjects, exhibited high internal consistency of all items. The findings indicated that the ORNs and the ORTs exhibited remarkable similarities between stressful events perceived as high and low impact. The two groups agreed that the highest impact stressful event was "pressure to work more quickly." Using the results of this study, OR administrators may be able to redesign the OR environment to minimize the impact of stressful events and thereby improve job satisfaction and minimize nursing staff turnover. PMID:22545480

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

    PubMed

    Liu, Baozhen; Liu, Zhiguo; Wang, Xianwen

    2015-06-01

    A mobile operating room information management system with electronic medical record (EMR) is designed to improve work efficiency and to enhance the patient information sharing. In the operating room, this system acquires the information from various medical devices through the Client/Server (C/S) pattern, and automatically generates XML-based EMR. Outside the operating room, this system provides information access service by using the Browser/Server (B/S) pattern. Software test shows that this system can correctly collect medical information from equipment and clearly display the real-time waveform. By achieving surgery records with higher quality and sharing the information among mobile medical units, this system can effectively reduce doctors' workload and promote the information construction of the field hospital. PMID:26485982

  17. [Present status of critical hemorrhage and its management in the operating room].

    PubMed

    Irita, Kazuo

    2014-12-01

    Hemorrhage is a major cause of cardiac arrest in the operating room. Many human factors, including surgical procedures, transfusion practices, blood supply, and anesthetic management, are involved in the process that leads to hemorrhage developing into a critical situation. It is desirable for hospital transfusion committees to prepare hospital-based regulations on 'actions to be taken to manage critical hemorrhage', and practice the implementation of these regulations with simulated drills. If intraoperative hemorrhage may become critical, a state of emergency should immediately be declared to the operating room staff, the blood transfusion service staff, and blood bank staff in order to organize a systematic approach to the ongoing problem and keep all responsible staff working outside the operating room informed of events developing in the room. To rapidly deal with critical hemorrhage, not only cooperation between anesthesiologists and surgeons but also linkage of operating rooms with blood transfusion services and a blood bank are important. When time is short, cross-matching tests are omitted, and ABO-identical red blood cells are used. When supplies of ABO-identical red blood cells are not available, ABO-compatible, non-identical red blood cells are used. Because a systematic, not individual, approach is required to prevent and manage critical hemorrhage, whether or not a hospital can establish a procedure to deal with it depends on the overall capability of critical and crisis management of the hospital. (Review). PMID:25823246

  18. Baylor SBIRT Medical Residency Training Program: Model Description and Initial Evaluation

    ERIC Educational Resources Information Center

    Bray, James H.; Kowalchuk, Alicia; Waters, Vicki; Laufman, Larry; Shilling, Elizabeth H.

    2012-01-01

    The Baylor College of Medicine SBIRT Medical Residency Training Program is a multilevel project that trains residents and faculty in evidenced-based screening, brief intervention, and referral to treatment (SBIRT) methods for alcohol and substance use problems. This paper describes the training program and provides initial evaluation after the…

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

    PubMed Central

    2012-01-01

    Background Patient safety is one of the greatest challenges in healthcare. In the operating room errors are frequent and often consequential. This article describes an approach to a successful implementation of a patient safety program in the operating room, focussing on latent risk factors that influence patient safety. We performed an intervention to improve these latent risk factors (LRFs) and increase awareness of patient safety issues amongst OR staff. Methods Latent risk factors were studied using a validated questionnaire applied to the OR staff before and after an intervention. A pre-test/post-test control group design with repeated measures was used to evaluate the effects of the interventions. The staff from one operating room of an university hospital acted as the intervention group. Controls consisted of the staff of the operating room in another university hospital. The outcomes were the changes in LRF scores, perceived incident rate, and changes in incident reports between pre- and post-intervention. Results Based on pre-test scores and participants’ key concerns about organizational factors affecting patient safety in their department the intervention focused on the following LRFs: Material Resources, Training and Staffing Recourses. After the intervention, the intervention operating room - compared to the control operating room - reported significantly fewer problems on Material Resources and Staffing Resources and a significantly lower score on perceived incident rate. The contribution of technical factors to incident causation decreased significantly in the intervention group after the intervention. Conclusion The change of state of latent risk factors can be measured using a patient safety questionnaire aimed at these factors. The change of the relevant risk factors (Material and Staffing resources) concurred with a decrease in perceived and reported incident rates in the relevant categories. We conclude that interventions aimed at unfavourable

  20. Case reports: response to a partial power failure in the operating room.

    PubMed

    Carpenter, Tammy; Robinson, Stephen T

    2010-06-01

    Failure of the power supply to the operating suites is a rare event. When it happens, it is critical that the care team responds in a way that optimizes patient safety. In the event we describe in this case report, only the emergency (red) power outlets failed. The anesthesia care team and other staff in the 8 affected rooms with anesthetized patients generally responded appropriately. The optimal response to these events is not necessarily intuitive. It is important to have advanced planning both within the immediate work area and beyond the operating room all the way into the hospital infrastructure. PMID:20008912

  1. Executive competencies in healthcare administration: preceptors of the Army-Baylor University Graduate Program.

    PubMed

    Finstuen, Kenn; Mangelsdorff, A David

    2006-01-01

    The purpose of this research was to identify the mentoring and executive competencies required among preceptors of the Army-Baylor University Graduate Program in Health and Business Administration, and to specify the requisite skills, knowledge, and abilities (SKAs) needed to achieve those competencies. In the first wave of inquiry, a list of 123 competencies and associated SKAs was elicited from a network of 80 current and past preceptor executives employing a Delphi methodology using e-mail. An expert panel, which consisted of seven past program directors, examined and sorted the list into four preceptor content domains, viz., Health Systems Management (HS Management), Leadership, Residency Administration, and Community Involvement. Frequency analyses showed that the HS Management domain constituted over half of the competencies, with particular emphasis on strategic thinking, planning, billing, finance, manpower, and contracting. In the second wave, the preceptor Delphi network reviewed the expertpanel list and made 7-pointSKA importance ratings on an 80-item structured questionnaire representative of the four domains. Findings indicated thataverage SKA ratings were reliable and agreed upon to a high degree among preceptors. Results, rank ordered by SKA item means within preceptor content domains and overall, suggested that the most important rated items centered on teamwork, negotiation, interpersonal skills, communication, leadership vision, and customer and healthcare business operations. Outcomes from the competency list are expected to be useful for preceptor mentoring, self-assessment, and for professional development. Additionally, specific SKAs can provide a means for developing job requirements and career performance criteria at a behavioral task level, and can contribute information for identifying continuing education and conference topical needs. PMID:16700444

  2. Room-temperature operation of a Co:MgF2 laser

    NASA Technical Reports Server (NTRS)

    Welford, D.; Moulton, P. F.

    1988-01-01

    A normal-mode, pulsed Co:MgF2 laser has been operated at room temperature for the first time. Continuous tuning from 1750 to 2500 nm with pulse energies up to 70 mJ and 46-percent slope efficiency was obtained with a 1338-nm Nd:YAG pump laser.

  3. Health Occupations--Operating Room Technician. Kit No. 63. Instructor's Manual [and] Student Learning Activity Guide.

    ERIC Educational Resources Information Center

    Jackson, Janette

    An instructor's manual and student activity guide on the operating room technician are provided in this set of prevocational education materials which focuses on the vocational area of health occupations. (This set of materials is one of ninety-two prevocational education sets arranged around a cluster of seven vocational offerings: agriculture,…

  4. An Analysis of the National Certifying Examination for Operating Room Technicians.

    ERIC Educational Resources Information Center

    Olsen, Claire

    This analysis of the National Certifying Examination for Operating Room Technicians revealed that examinee's performance was related to their educational preparation. Utilizing test results from 2,841 candidates, the performance of first time candidates was compared to the performance of graduates of one or two-year programs and of technicians who…

  5. 62. (Credit CBF) Operating floor of filter room, c1912. The ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    62. (Credit CBF) Operating floor of filter room, c1912. The remodeled New York horizontal pressure filters (now gravity filters) are in the foreground; the remodelled Hyatt tub filters are in the background. - McNeil Street Pumping Station, McNeil Street & Cross Bayou, Shreveport, Caddo Parish, LA

  6. 21 CFR 113.87 - Operations in the thermal processing room.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 2 2011-04-01 2011-04-01 false Operations in the thermal processing room. 113.87 Section 113.87 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) FOOD FOR HUMAN CONSUMPTION THERMALLY PROCESSED LOW-ACID FOODS PACKAGED IN HERMETICALLY SEALED CONTAINERS Production and Process Controls...

  7. Crisis Checklists May Substantially Reduce the Likelihood of Critical Missed Steps in the Operating Room

    MedlinePlus

    ... the likelihood of critical missed steps in the operating room Previous Page Next Page Table of Contents Research Activities, July 2013 Care of Oklahoma tornado victims helped by AHRQ-supported information system From the Director Certain therapies and medications improve ...

  8. 9 CFR 590.508 - Candling and transfer-room operations.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 9 Animals and Animal Products 2 2010-01-01 2010-01-01 false Candling and transfer-room operations. 590.508 Section 590.508 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE EGG PRODUCTS INSPECTION INSPECTION OF EGGS AND EGG PRODUCTS (EGG PRODUCTS INSPECTION ACT)...

  9. 9 CFR 590.508 - Candling and transfer-room operations.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 9 Animals and Animal Products 2 2011-01-01 2011-01-01 false Candling and transfer-room operations. 590.508 Section 590.508 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE EGG PRODUCTS INSPECTION INSPECTION OF EGGS AND EGG PRODUCTS (EGG PRODUCTS INSPECTION ACT)...

  10. Integrating medical devices in the operating room using service-oriented architectures.

    PubMed

    Ibach, Bastian; Benzko, Julia; Schlichting, Stefan; Zimolong, Andreas; Radermacher, Klaus

    2012-08-01

    Abstract With the increasing documentation requirements and communication capabilities of medical devices in the operating room, the integration and modular networking of these devices have become more and more important. Commercial integrated operating room systems are mainly proprietary developments using usually proprietary communication standards and interfaces, which reduce the possibility of integrating devices from different vendors. To overcome these limitations, there is a need for an open standardized architecture that is based on standard protocols and interfaces enabling the integration of devices from different vendors based on heterogeneous software and hardware components. Starting with an analysis of the requirements for device integration in the operating room and the techniques used for integrating devices in other industrial domains, a new concept for an integration architecture for the operating room based on the paradigm of a service-oriented architecture is developed. Standardized communication protocols and interface descriptions are used. As risk management is an important factor in the field of medical engineering, a risk analysis of the developed concept has been carried out and the first prototypes have been implemented. PMID:22718585

  11. A Portable Fluorescence Camera for Testing Surgical Specimens in the Operating Room: Description and Early Evaluation

    PubMed Central

    Kakareka, John W.; McCann, Thomas E.; Kosaka, Nobuyuki; Mitsunaga, Makoto; Morgan, Nicole Y.; Pohida, Thomas J.; Choyke, Peter L.; Kobayashi, Hisataka

    2011-01-01

    Purpose Clinical translation of novel optical probes requires testing of human specimens ex vivo to ensure efficacy. However, it may be difficult to remove human tissue from the operating room due to regulatory/privacy issues. Therefore, we designed a portable fluorescence camera to test targeted optical imaging probes on human specimens in the operating room. Procedures A compact benchtop fluorescence camera was designed and built in-house. A mouse xenograft model of ovarian cancer with an activatable imaging probe based on rhodamine green was used to test the device. Comparison was made to commercially available imaging systems. Results The prototype camera produced images comparable to images acquired with commercially available, non-portable imaging systems. Conclusion We demonstrate the feasibility of a specimen-based portable fluorescence camera for use in the operating room. Its small size ensures that tissue excised from patients can be tested promptly for fluorescence within the operating room environment, thus expediting the testing of novel imaging probes. PMID:20960235

  12. 21 CFR 878.5070 - Air-handling apparatus for a surgical operating room.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Air-handling apparatus for a surgical operating room. 878.5070 Section 878.5070 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Therapeutic Devices §...

  13. 21 CFR 878.5070 - Air-handling apparatus for a surgical operating room.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Air-handling apparatus for a surgical operating room. 878.5070 Section 878.5070 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Therapeutic Devices §...

  14. 21 CFR 878.5070 - Air-handling apparatus for a surgical operating room.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Air-handling apparatus for a surgical operating room. 878.5070 Section 878.5070 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Therapeutic Devices §...

  15. 21 CFR 878.5070 - Air-handling apparatus for a surgical operating room.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Air-handling apparatus for a surgical operating room. 878.5070 Section 878.5070 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Therapeutic Devices §...

  16. 21 CFR 878.5070 - Air-handling apparatus for a surgical operating room.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Air-handling apparatus for a surgical operating room. 878.5070 Section 878.5070 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Therapeutic Devices §...

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

    PubMed

    Baker, J J; Boyd, G F

    1997-01-01

    This article presents an example of how one hospital reports the results of activity-based costing (ABC). It examines the composition and supporting assumptions of an ABC report for a particular procedure in the operating room (OR). It describes management uses of the information generated. It comments upon how the continuous quality improvement (CQI) is synchronized with the ABC reporting. PMID:9327354

  18. 61. (Credit CBF) Operating floor of filter room, c1912. A ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    61. (Credit CBF) Operating floor of filter room, c1912. A remodeled Hyatt pressure filter, now operating as a tub, gravity, rapid sand filter, is in the foreground (the remodeling took place c1908-1909). The remodeled New York horizontal pressure filters (installed 01900, remodeled c1908-1909) are in the background. - McNeil Street Pumping Station, McNeil Street & Cross Bayou, Shreveport, Caddo Parish, LA

  19. Room temperature operational single electron transistor fabricated by focused ion beam deposition

    NASA Astrophysics Data System (ADS)

    Karre, P. Santosh Kumar; Bergstrom, Paul L.; Mallick, Govind; Karna, Shashi P.

    2007-07-01

    We present the fabrication and room temperature operation of single electron transistors using 8nm tungsten islands deposited by focused ion beam deposition technique. The tunnel junctions are fabricated using oxidation of tungsten in peracetic acid. Clear Coulomb oscillations, showing charging and discharging of the nanoislands, are seen at room temperature. The device consists of an array of tunnel junctions; the tunnel resistance of individual tunnel junction of the device is calculated to be as high as 25.13GΩ. The effective capacitance of the array of tunnel junctions was found to be 0.499aF, giving a charging energy of 160.6meV.

  20. A novel NO2 gas sensor based on Hall effect operating at room temperature

    NASA Astrophysics Data System (ADS)

    Lin, J. Y.; Xie, W. M.; He, X. L.; Wang, H. C.

    2016-09-01

    Tungsten trioxide nanoparticles were obtained by a simple thermal oxidation approach. The structural and morphological properties of these nanoparticles are investigated using XRD, SEM and TEM. A WO3 thick film was deposited on the four Au electrodes to be a WO3 Hall effect sensor. The sensor was tested between magnetic field in a plastic test chamber. Room-temperature nitrogen dioxide sensing characteristics of Hall effect sensor were studied for various concentration levels of nitrogen dioxide at dry air and humidity conditions. A typical room-temperature response of 3.27 was achieved at 40 ppm of NO2 with a response and recovery times of 36 and 45 s, respectively. NO2 gas sensing mechanism of Hall effect sensor was also studied. The room-temperature operation, with the low deposition cost of the sensor, suggests suitability for developing a low-power cost-effective nitrogen dioxide sensor.

  1. HYBRID ALARM SYSTEMS: COMBINING SPATIAL ALARMS AND ALARM LISTS FOR OPTIMIZED CONTROL ROOM OPERATION

    SciTech Connect

    Ronald L. Boring; J.J. Persensky

    2012-07-01

    The US Department of Energy (DOE) is sponsoring research, development, and deployment on Light Water Reactor Sustainability (LWRS), in which the Idaho National Laboratory (INL) is working closely with nuclear utilities to develop technologies and solutions to help ensure the safe operational life extension of current nuclear power plants. One of the main areas of focus is control room modernization. Within control room modernization, alarm system upgrades present opportunities to meet the broader goals of the LWRS project in demonstrating the use and safety of the advanced instrumentation and control (I&C) technologies and the short-term and longer term objectives of the plant. In this paper, we review approaches for and human factors issues behind upgrading alarms in the main control room of nuclear power plants.

  2. Baylor's program to attract minority students and others to science and medicine.

    PubMed

    Butler, W T; Thomson, W A; Morrissey, C T; Miller, L M; Smith, Q W

    1991-06-01

    To attract minority students and others to careers in medical practice and biomedical research and to prepare them for such careers, Baylor College of Medicine conducts a variety of summer enrichment programs and other programs to improve how science is presented to students in their preprofessional years from elementary grades through college. These efforts aim to increase the number of competitive candidates for medical school, particularly those from minority groups underrepresented in medicine. They entail close collaboration between the Baylor administration and faculty from Texas public schools and two-year and four-year colleges and universities. The authors discuss the rationale for these programs and comment about the need for institutional commitments of faculty and financial support. They note that these programs are an investment in the future and that longitudinal assessment is needed to determine their ultimate success. PMID:2069648

  3. Delivering images to the operating room: a web-based solution.

    PubMed

    Bennett, W F; Tunstall, K M; Skinner, P W; Spigos, D G

    2002-01-01

    As radiology departments become filmless, they are discovering that some areas are particularly difficult to deliver images. Many departments have found that the operating room is one such area. There are space constraints and difficulty in manipulating the images by a sterile surgeon. This report describes one method to overcome this obstacle. The author's institution has been using picture archiving and communication system (PACS) for approximately 3 years, and it has been a filmless department for 1 year. The PACS transfers images to a webserver for distribution throughout the hospital. It is accessed by Internet Explorer without any additional software. The authors recently started a pilot program in which they installed dual panel flat screen monitors in 6 operating rooms. The computers are connected to the hospital backbone by ethernet. Graphic cards installed in the computers allow the use of dual monitors. Because the surgeons were experienced in viewing cases on the enterprise web system, they had little difficulty in adapting to the operating room (OR) system. Initial reception of the system is positive. The use of the web system was found to be superior by the surgeons because of the flexibility and manipulation of the images compared with film. Images can be magnified to facilitate viewing from across the room. The ultimate goal of electronic radiology is to replace hardcopy film in all aspects. One area that PACS has difficulty in accomplishing this goal is in the operating room. Most institutions have continued to print film for the OR. The authors have initiated a project that may allow web viewing in the OR. Because of limited space in the OR, an additional computer was undesirable. The CPU tower, keyboard, and mouse were mounted on a frame on the wall. The images were displayed on 2 flat screen monitors, which simulated the viewboxes traditionally used by the surgeons. Interviews with the surgeons have found both positive and negative aspects of

  4. [Prevention of catheter-related bloodstream infections in the operation room].

    PubMed

    Ema, Yoshiaki; Nishiwaki, Kimitoshi

    2010-05-01

    Catheter-related bloodstream infections (CRBSIs) are recognized as an important and serious problem, especially in an intensive care unit (ICU), since they have far higher infection rates compared to those for other type of intravascular devices. However, in the operation room, there seems to be little concern among anesthesiologists regarding this problem. It is important for anesthesiologists to understand that CRBSIs can be prevented or reduced by evidence-based interventions such as hand hygiene, education in hand washing and alcohol-based hand rubbing, sterile catheter care techniques, proper skin disinfection, maximal barrier precautions during catheter insertion, choice of subclavian vein placement, avoidance of femoral vein placement, and removal of an unnecessary catheter. This evidence is based mainly on findings in ICU patients, but introduction of these interventions into operation rooms may be very useful for reducing perioperative CRBSIs. PMID:20486568

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

    PubMed Central

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

    2011-01-01

    The main bottlenecks limiting the practical applications of current magnetoresistive random access memory (MRAM) technology are its low storage density and high writing energy consumption. Although a number of proposals have been reported for voltage-controlled memory device in recent years, none of them simultaneously satisfy the important device attributes: high storage capacity, low power consumption and room temperature operation. Here we present, using phase-field simulations, a simple and new pathway towards high-performance MRAMs that display significant improvements over existing MRAM technologies or proposed concepts. The proposed nanoscale MRAM device simultaneously exhibits ultrahigh storage capacity of up to 88 Gb inch−2, ultralow power dissipation as low as 0.16 fJ per bit and room temperature high-speed operation below 10 ns. PMID:22109527

  6. Statistical method using operating room information system data to determine anesthetist weekend call requirements.

    PubMed

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

    2000-02-01

    We present a statistical method that uses data from surgical services information systems to determine the minimum number of anesthetists to be scheduled for weekend call in an operating room suite. The staffing coverage is predicted that provides for sufficient anesthetists to cover each hour of a 24-hour weekend period, while satisfying a specified risk for being understaffed. The statistical method incorporates shifts of varying start times and durations, as well as historical weekend operating room caseload data. By using this method to schedule weekend staff, an anesthesia group can assure as few anesthetists are on call as possible, and for as few hours as possible, while maintaining the level of risk of understaffing that the anesthesia group is willing to accept. An anesthesia group also can use the method to calculate its risk of being understaffed in the surgical suite based on its existing weekend staffing plan. PMID:10876448

  7. The modern brain tumor operating room: from standard essentials to current state-of-the-art.

    PubMed

    Barnett, Gene H; Nathoo, Narendra

    2004-01-01

    It is just over a century since successful brain tumor resection. Since then the diagnosis, imaging, and management of brain tumors have improved, in large part due to technological advances. Similarly, the operating room (OR) for brain tumor surgery has increased in complexity and specificity with multiple forms of equipment now considered necessary as technical adjuncts. It is evident that the theme of minimalism in combination with advanced image-guidance techniques and a cohort of sophisticated technologies (e.g., robotics and nanotechnology) will drive changes in the current OR environment for the foreseeable future. In this report we describe what may be regarded today as standard essentials in an operating room for the surgical management of brain tumors and what we believe to be the current 'state-of-the-art' brain tumor OR. Also, we speculate on the additional capabilities of the brain tumor OR of the near future. PMID:15527078

  8. Do-not-resuscitate orders in the operating room: required reconsideration.

    PubMed

    Smith, K A

    2000-07-01

    Advances in medical technology are giving health care providers the tools with which to keep patients alive for longer and longer periods of time. However, in our struggle to keep patients alive, we must not forget that the patient is the one who controls his or her own destiny. Advance directives and do-not-resuscitate orders are becoming more commonplace as patients strive to make their wishes known to all who care for them. The use of such orders in the operating room has historically been a hotbed of controversy because it appears contrary to the necessity of surgery in the first place. Surgeons, anesthetists, operating room nurses, and others all have concerns regarding this issue, and they will be discussed here. The answer to the dilemma lies in a policy of "required reconsideration" to examine all factors of the do-not-resuscitate order and its applicability to the situation at hand. PMID:10920651

  9. Common Intra-Cluster Competencies Needed in Selected Occupational Clusters. Final Report. Supplemental Volume XIII: Operating Room Technician.

    ERIC Educational Resources Information Center

    McClurg, Ronald B.

    An analysis of survey responses from a sample of operating room technicians on competency characteristics for their occupation is presented in this document. (Operating room technician is one of seventeen occupation groups included in this research.) The competencies are reported in five categories: (1) those competencies selected by the…

  10. Follow-up Study of Operating Room Technician Graduates. Vol. VIII, No. 9.

    ERIC Educational Resources Information Center

    Phillips, Shirley C.; Lucas, John A.

    A follow-up survey on the employment of the 55 recent (1973-1976) graduates of the Operating Room Technician (ORT) program at William Rainey Harper College revealed that 51.2% of the 41 respondents had some college work prior to Harper enrollment; 63.5% were currently employed full-time, 14.5% part-time, 17% were voluntarily unemployed, and 5%…

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

    PubMed

    Nouei, Mahyar Taghizadeh; Kamyad, Ali Vahidian; Soroush, Ahmad Reza; Ghazalbash, Somayeh

    2015-04-01

    Occasionally, surgeons do need various types of information to be available rapidly, efficiently and safely during surgical procedures. Meanwhile, they need to free up hands throughout the surgery to necessarily access the mouse to control any application in the sterility mode. In addition, they are required to record audio as well as video files, and enter and save some data. This is an attempt to develop a comprehensive operating room information system called "Medinav" to tackle all mentioned issues. An integrated and comprehensive operating room information system is introduced to be compatible with Health Level 7 (HL7) and digital imaging and communications in medicine (DICOM). DICOM is a standard for handling, storing, printing, and transmitting information in medical imaging. Besides, a natural user interface (NUI) is designed specifically for operating rooms where touch-less interactions with finger and hand tracking are in use. Further, the system could both record procedural data automatically, and view acquired information from multiple perspectives graphically. A prototype system is tested in a live operating room environment at an Iranian teaching hospital. There are also contextual interviews and usability satisfaction questionnaires conducted with the "MediNav" system to investigate how useful the proposed system could be. The results reveal that integration of these systems into a complete solution is the key to not only stream up data and workflow but maximize surgical team usefulness as well. It is now possible to comprehensively collect and visualize medical information, and access a management tool with a touch-less NUI in a rather quick, practical, and harmless manner. PMID:25017016

  12. Fine needle aspiration of head and neck masses in the operating room: accuracy and potential benefits.

    PubMed

    Arabi, Haitham; Yousef, Nida; Bandyopadhyay, Sudeshna; Feng, Jining; Yoo, George H; Al-Abbadi, Mousa A

    2008-06-01

    Fine needle aspiration (FNA) in the operating room is a convenient optional diagnostic approach. Our objective of this study was to evaluate the accuracy and study the potential benefits of fine needle aspiration in the operating room. Retrospective review of all intraoperative FNA that were requested and performed by pathologists over 20-month period was carried out. Immediate smears were interpreted by the cytopathology team after staining with Diff Quik stain. All cases were reviewed and correlation with subsequent tissue diagnosis was done. Accuracy was calculated and potential benefits were discussed. The number of aspirates was 32. Adequate material for immediate and final interpretation was achieved in 31 cases (sensitivity 97%). In 20 cases (63%), malignancy was diagnosed while a benign diagnosis was rendered in 12 (37%). All cases had a follow up tissue diagnosis. No false-positive cases were identified (specificity 100%). The information gained from this approach was considered helpful to the surgeons. We concluded that FNA of head and neck masses in the operating room is an accurate and sensitive diagnostic approach. The service provides helpful information to surgeons and is an additional optional diagnostic approach. PMID:18478613

  13. [Surgical safety cheklist at the management of the hybrid operating room].

    PubMed

    Cherkashin, M A; Berezina, N A; Kuplevatsky, V I; Serov, A V; Mefodovsky, A A

    2016-01-01

    An essential aspect of the work of the operating room is the provision of safety of both the patient and staff. The organization of the activity of the surgical service requires serious elaboration of each of its stage, as well as standardization in using various validated instruments. When speaking of a hybrid operating room with the use of intraoperative magnetic resonance tomography, such an approach becomes not merely a recommendation but rather forced and justified necessity. Simultaneous use of various technologies of imaging and treatment with the engagement of physicians of various specialties requires especially thorough control. A generally accepted international standard of the work of the operating block is the use of checklists, and since 2008 the initiative of the World Health Organization "Safe Surgery Saves Lives" has globally been working to promote implementation of the WHO Surgical Safety Checklists (SSCL) to the real clinical practice. The intraoperative MR-diagnostic stage dictates rigid requirements for proper inventory of ferromagnetic and nonmagnetic surgical tools, verified logistics, and routing of the patient in the conditions of high and extremely high (1.5-3.0 T) magnetic field. A separate and not less important problem is anaesthesiological support during MRT. In order to optimise the patient's movements and adequate monitoring of his/her safety inside the operating department, the authors have modified the standard WHO Surgical Safety Checklist. Implementation of the modified checklist for the MRT-equipped hybrid operating room should improve the control over the processes, as well as increase safety of both the patient and personnel. PMID:27336334

  14. Recognizing/accepting futility: prehospital, emergency center, operating room, and intensive care unit.

    PubMed

    Coimbra, Raul; Lee, Jeanne; Bansal, Vishal; Hollingsworth-Fridlund, Peggy

    2007-01-01

    Trauma has been perceived by the public as occurring as an isolated event, always resulting in favorable outcomes. There has therefore been a lack of discussion of futility of care and termination of care when dealing with the sick trauma patient. Several stages exist where issues of futility and early termination of care must be considered. These include the prehospital setting and involve the emergency medical service system in recognizing those patients who are nonsurvivors. Next is in the emergency room, where heroic measures may not benefit the very sick patient. In the operating room, the surgeon must always reassess and recognize when massive resuscitation will not benefit a particular trauma patient. Lastly, the intensivist must recognize those patients who may or may not benefit from continued efforts to sustain life. PMID:17579324

  15. Human factors in surgery: from Three Mile Island to the operating room.

    PubMed

    D'Addessi, Alessandro; Bongiovanni, Luca; Volpe, Andrea; Pinto, Francesco; Bassi, PierFrancesco

    2009-01-01

    Human factors is a definition that includes the science of understanding the properties of human capability, the application of this understanding to the design and development of systems and services, the art of ensuring their successful applications to a program. The field of human factors traces its origins to the Second World War, but Three Mile Island has been the best example of how groups of people react and make decisions under stress: this nuclear accident was exacerbated by wrong decisions made because the operators were overwhelmed with irrelevant, misleading or incorrect information. Errors and their nature are the same in all human activities. The predisposition for error is so intrinsic to human nature that scientifically it is best considered as inherently biologic. The causes of error in medical care may not be easily generalized. Surgery differs in important ways: most errors occur in the operating room and are technical in nature. Commonly, surgical error has been thought of as the consequence of lack of skill or ability, and is the result of thoughtless actions. Moreover the 'operating theatre' has a unique set of team dynamics: professionals from multiple disciplines are required to work in a closely coordinated fashion. This complex environment provides multiple opportunities for unclear communication, clashing motivations, errors arising not from technical incompetence but from poor interpersonal skills. Surgeons have to work closely with human factors specialists in future studies. By improving processes already in place in many operating rooms, safety will be enhanced and quality increased. PMID:19829020

  16. Views of the Mission Operations Control room (MOCR) during STS-5

    NASA Technical Reports Server (NTRS)

    1983-01-01

    Hans Mark, NASA Deputy Administrator, and Daniel M. Germany, Assistant Manager, Orbiter Project Office, monitor activity from STS-5 in the mission operations control room (MOCR) of JSC's mission control center. Arnold D. Aldrich, Manager of the Orbiter Project Office, can be seen at left background (27153); Gerald D. Griffin, JSC Director, stands near the flight director console in the MOCR. Astronaut Robert L. Stewart, STS-5 spacecraft communicator, mans the CAPCOM console at left. Others in the background include M.P. Frank, Chief of the Flight Operations Integration Office (back row); Eugene F. Kranz, Deputy Director of Flight Operations; Tommy W. Holloway, flight director (right of Griffin) (27154); Flight directors during STS-5 posed at the flight directors console are from left to right: Lawrence S. Bourgeois, Brock R. Stone, Jay H. Greene, Tommy W. Holloway, John T. Cox and Gary E. Coen. Other flight controllers are pictured in the background of the MOCR (27155).

  17. Difficulties and challenges associated with literature searches in operating room management, complete with recommendations.

    PubMed

    Wachtel, Ruth E; Dexter, Franklin

    2013-12-01

    The purpose of this article is to teach operating room managers, financial analysts, and those with a limited knowledge of search engines, including PubMed, how to locate articles they need in the areas of operating room and anesthesia group management. Many physicians are unaware of current literature in their field and evidence-based practices. The most common source of information is colleagues. Many people making management decisions do not read published scientific articles. Databases such as PubMed are available to search for such articles. Other databases, such as citation indices and Google Scholar, can be used to uncover additional articles. Nevertheless, most people who do not know how to use these databases are reluctant to utilize help resources when they do not know how to accomplish a task. Most people are especially reluctant to use on-line help files. Help files and search databases are often difficult to use because they have been designed for users already familiar with the field. The help files and databases have specialized vocabularies unique to the application. MeSH terms in PubMed are not useful alternatives for operating room management, an important limitation, because MeSH is the default when search terms are entered in PubMed. Librarians or those trained in informatics can be valuable assets for searching unusual databases, but they must possess the domain knowledge relative to the subject they are searching. The search methods we review are especially important when the subject area (e.g., anesthesia group management) is so specific that only 1 or 2 articles address the topic of interest. The materials are presented broadly enough that the reader can extrapolate the findings to other areas of clinical and management issues in anesthesiology. PMID:24257396

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

    PubMed Central

    Albrecht, Mark; Gauthier, Robert; Leaper, David

    2009-01-01

    Forced-air-warming (FAW) is an effective and widely used means for maintaining surgical normothermia, but FAW also has the potential to generate and mobilize airborne contamination in the operating room. We measured the emission of viable and non-viable forms of airborne contamination from an arbitrary selection of FAW blowers (n=25) in the operating room. A laser particle counter measured particulate concentrations of the air near the intake filter and in the distal hose airstream. Filtration efficiency was calculated as the reduction in particulate concentration in the distal hose airstream relative to that of the intake. Microbial colonization of the FAW blower's internal hose surfaces was assessed by culturing the microorganisms recovered through swabbing (n=17) and rinsing (n=9) techniques. Particle counting revealed that 24% of FAW blowers were emitting significant levels of internally generated airborne contamination in the 0.5 to 5.0 µm size range, evidenced by a steep decrease in FAW blower filtration efficiency for particles 0.5 to 5.0 µm in size. The particle size-range-specific reduction in efficiency could not be explained by the filtration properties of the intake filter. Instead, the reduction was found to be caused by size-range-specific particle generation within the FAW blowers. Microorganisms were detected on the internal air path surfaces of 94% of FAW blowers. The design of FAW blowers was found to be questionable for preventing the build-up of internal contamination and the emission of airborne contamination into the operating room. Although we did not evaluate the link between FAW and surgical site infection rates, a significant percentage of FAW blowers with positive microbial cultures were emitting internally generated airborne contamination within the size range of free floating bacteria and fungi (<4 µm) that could, conceivably, settle onto the surgical site. PMID:21808690

  19. 9 CFR 355.15 - Inedible material operating and storage rooms; outer premises, docks, driveways, etc.; fly...

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... storage rooms; outer premises, docks, driveways, etc.; fly-breeding material; nuisances. 355.15 Section....15 Inedible material operating and storage rooms; outer premises, docks, driveways, etc.; fly... any material in which flies may breed, or the maintenance of any nuisance on the premises shall not...

  20. 9 CFR 355.15 - Inedible material operating and storage rooms; outer premises, docks, driveways, etc.; fly...

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... storage rooms; outer premises, docks, driveways, etc.; fly-breeding material; nuisances. 355.15 Section....15 Inedible material operating and storage rooms; outer premises, docks, driveways, etc.; fly... any material in which flies may breed, or the maintenance of any nuisance on the premises shall not...

  1. 9 CFR 355.15 - Inedible material operating and storage rooms; outer premises, docks, driveways, etc.; fly...

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... storage rooms; outer premises, docks, driveways, etc.; fly-breeding material; nuisances. 355.15 Section...-breeding material; nuisances. All operating and storage rooms and departments of inspected plants used for... any material in which flies may breed, or the maintenance of any nuisance on the premises shall not...

  2. 9 CFR 355.15 - Inedible material operating and storage rooms; outer premises, docks, driveways, etc.; fly...

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... storage rooms; outer premises, docks, driveways, etc.; fly-breeding material; nuisances. 355.15 Section...-breeding material; nuisances. All operating and storage rooms and departments of inspected plants used for... any material in which flies may breed, or the maintenance of any nuisance on the premises shall not...

  3. 9 CFR 355.15 - Inedible material operating and storage rooms; outer premises, docks, driveways, etc.; fly...

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... storage rooms; outer premises, docks, driveways, etc.; fly-breeding material; nuisances. 355.15 Section...-breeding material; nuisances. All operating and storage rooms and departments of inspected plants used for... any material in which flies may breed, or the maintenance of any nuisance on the premises shall not...

  4. Operating-room venting of trace concentrations of inhalation anesthetic agents.

    PubMed Central

    Oulton, J. L.

    1977-01-01

    Operating-room personnel exposed over a long period to trace concentrations of anesthetic gases may acquire both organic disturbances and impairment of cerebral function, though this has not been proven. However, the dangers of miscalculations due to disturbances of cerebral function and the fact that all working personnel should be breathing unpolluted air are sufficient indications to make scavenging of anesthetic gases mandatory. Scavenging has been carried out in many hospitals. At Vancouver General Hospital venting of the gases has decreased the nitrous oxide pollution to what is considered an acceptable level. Images FIG. 1 FIG. 5 PMID:861867

  5. Experimental Demonstration of xor Operation in Graphene Magnetologic Gates at Room Temperature

    NASA Astrophysics Data System (ADS)

    Wen, Hua; Dery, Hanan; Amamou, Walid; Zhu, Tiancong; Lin, Zhisheng; Shi, Jing; Žutić, Igor; Krivorotov, Ilya; Sham, L. J.; Kawakami, Roland K.

    2016-04-01

    We report the experimental demonstration of a magnetologic gate built on graphene at room temperature. This magnetologic gate consists of three ferromagnetic electrodes contacting a single-layer graphene spin channel and relies on spin injection and spin transport in the graphene. We utilize electrical bias tuning of spin injection to balance the inputs and achieve "exclusive or" (xor) logic operation. Furthermore, a simulation of the device performance shows that substantial improvement towards spintronic applications can be achieved by optimizing the device parameters such as the device dimensions. This advance holds promise as a basic building block for spin-based information processing.

  6. Non-operating Room Anesthesia: The Principles of Patient Assessment and Preparation.

    PubMed

    Chang, Beverly; Urman, Richard D

    2016-03-01

    A significant number of anesthetics are performed outside of the operating room (OR). Despite the increased requirement for anesthesia services, the framework to perform the necessary preprocedural anesthesia assessments to optimize patients has not been uniformly developed. Performing anesthesia in non-OR locations poses significant and distinct challenges compared with the procedures in the OR. Anesthesiologists are faced with patients with increasingly complicated comorbidities undergoing novel, complex interventional procedures. With unique training in preoperative triaging, and an expertise in intraoperative and postoperative management of complex patients, anesthesiologists can contribute to greater efficiency and patient safety in the non-OR setting. PMID:26927750

  7. Human factors analysis of workstation design: Earth Radiation Budget Satellite Mission Operations Room

    NASA Technical Reports Server (NTRS)

    Stewart, L. J.; Murphy, E. D.; Mitchell, C. M.

    1982-01-01

    A human factors analysis addressed three related yet distinct issues within the area of workstation design for the Earth Radiation Budget Satellite (ERBS) mission operation room (MOR). The first issue, physical layout of the MOR, received the most intensive effort. It involved the positioning of clusters of equipment within the physical dimensions of the ERBS MOR. The second issue for analysis was comprised of several environmental concerns, such as lighting, furniture, and heating and ventilation systems. The third issue was component arrangement, involving the physical arrangement of individual components within clusters of consoles, e.g., a communications panel.

  8. From the operating room to the office: paradigm shift in the economics of surgical practice.

    PubMed

    Baum, Neil

    2012-01-01

    In the past decade, there has been a trend from doing procedures in the hospital operating room and the ambulatory treatment center to performing procedures in the doctor's office. This trend is becoming more prevalent as doctors have recognized that they have more control over their practices by working in the office rather than at a hospital or ambulatory treatment center. This article will focus on the trend and provide financial examples of this movement and why doctors need to be cognizant of their increased productivity in the office. PMID:22413590

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

    PubMed

    Bilyk, Candis

    2008-09-01

    Management of supplies within the operating room (OR) has considerable implications for decreasing healthcare costs while maintaining high-quality patient care. This area of healthcare therefore requires more monitoring by end-users including OR management, physicians, and nursing staff. This article is based on understanding supply chain management in the OR setting. Information provided throughout the article can be applied to small or large health care centers. It defines supply chain management and contains a brief overview of supply chain processes. It reviews the benefits of following these processes. The article also includes recommendations for improving the supply chain in the OR. PMID:18980068

  10. Pulsed, room-temperature operation of a tunable NaCl color-center laser

    SciTech Connect

    Culpepper, C.F.; Carrig, T.J.; Pinto, J.F.; Georgiou, E.; Pollock, C.R.

    1987-11-01

    A room-temperature, pulsed, color-center laser using OH/sup : /-doped NaCl crystals is reported. Crystals were transversely pumped by a Q-switched Nd:YAG laser at 1.06 ..mu..m and produced output energies of 8.6 mJ in 20-nsec pulses. The tuning range extended from 1.37 to 1.77 ..mu..m. During 40 h of operation (>10/sup 6/ pulses), a gradual power fading was observed. Laser action is tentatively ascribed to F/sub 2//sup //sup +/ centers.

  11. Cross-industry benchmarking: is it applicable to the operating room?

    PubMed

    Marco, A P; Hart, S

    2001-01-01

    The use of benchmarking has been growing in nonmedical industries. This concept is being increasingly applied to medicine as the industry strives to improve quality and improve financial performance. Benchmarks can be either internal (set by the institution) or external (use other's performance as a goal). In some industries, benchmarking has crossed industry lines to identify breakthroughs in thinking. In this article, we examine whether the airline industry can be used as a source of external process benchmarking for the operating room. PMID:14598625

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

    PubMed Central

    Tok, Adem; Akbas, Alparslan; Aytan, Nimet; Aliskan, Tamer; Cicekbilek, Izzet; Kaba, Mehmet; Tepeler, Abdulkadir

    2015-01-01

    ABSTRACT Purpose: We assessed and evaluated attitudes and knowledge regarding ionizing radiation of urology surgery room staff. Materials and Methods: A questionnaire was sent by e-mail to urology surgery room personnel in Turkey, between June and August 2013. The questionnaire included demographic questions and questions regarding radiation exposure and protection. Results: In total, 127 questionnaires were answered. Of them, 62 (48.8%) were nurses, 51 (40.2%) were other personnel, and 14 (11%) were radiological technicians. In total, 113 (89%) participants had some knowledge of radiation, but only 56 (44.1%) had received specific education or training regarding the harmful effects of radiation. In total, 92 (72.4%) participants indicated that they used a lead apron and a thyroid shield. In the subgroup that had received education about the harmful effects of radiation, the use ratio for all protective procedures was 21.4% (n=12); this ratio was only 2.8% (n=2) for those with no specific training; the difference was statistically significant (p=0.004). Regarding dosimeters, the use rates were 100% for radiology technicians, 46.8% for nurses, and 31.4% for other hospital personnel; these differences were statistically significant (p<0.001). No significant relationship between working period in the surgery room, number of daily fluoroscopy procedures, education, task, and use of radiation protection measures was found. Conclusions: It is clear that operating room-allied health personnel exposed to radiation do not have sufficient knowledge of ionizing radiation and they do not take sufficient protective measures. PMID:26689525

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

    PubMed

    White, Mark J; Thornton, John S; Hawkes, David J; Hill, Derek L G; Kitchen, Neil; Mancini, Laura; McEvoy, Andrew W; Razavi, Reza; Wilson, Sally; Yousry, Tarek; Keevil, Stephen F

    2015-01-01

    The design and operation of a facility in which a magnetic resonance imaging (MRI) scanner is incorporated into a room used for surgical or endovascular cardiac interventions presents several challenges. MR safety must be maintained in the presence of a much wider variety of equipment than is found in a diagnostic unit, and of staff unfamiliar with the MRI environment, without compromising the safety and practicality of the interventional procedure. Both the MR-guided cardiac interventional unit at Kings College London and the intraoperative imaging suite at the National Hospital for Neurology and Neurosurgery are single-room interventional facilities incorporating 1.5 T cylindrical-bore MRI scanners. The two units employ similar strategies to maintain MR safety, both in original design and day-to-day operational workflows, and between them over a decade of incident-free practice has been accumulated. This article outlines these strategies, highlighting both similarities and differences between the units, as well as some lessons learned and resulting procedural changes made in both units since installation. PMID:24497105

  14. Occupational hazards for pregnant or lactating women in the orthopaedic operating room.

    PubMed

    Downes, Jessica; Rauk, Philip N; Vanheest, Ann E

    2014-05-01

    Pregnant or lactating staff working in the orthopaedic operating room may be at risk of occupational exposure to several hazards, including blood-borne pathogens, anesthetic gases, methylmethacrylate, physical stress, and radiation. Because the use of proper personal protective equipment is mandatory, the risk of contamination with blood-borne pathogens such as hepatitis B, hepatitis C, and HIV is low. Moreover, effective postexposure prophylactic regimens are available for hepatitis B and HIV. In the 1960s, concerns were raised about occupational exposure to harmful chemicals in the operating room such as anesthetic gases and methylmethacrylate. Guidelines on safe levels of exposure to these chemicals and the use of personal protective equipment have helped to minimize the risks to pregnant or lactating staff. Short periods of moderate physical activity are beneficial for pregnant women, but prolonged strenuous activity can lead to increased pregnancy complications. The risk of prenatal radiation exposure during orthopaedic procedures is of concern, as well. However, proper lead protection and contamination control can minimize the risk of occupational exposure to radiation. PMID:24788448

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

    PubMed

    2014-05-01

    A real case reported to the SENSAR database of incidents is presented. In a patient scheduled for nose fracture repair surgery an unexpected atrial fibrillation was found when monitored in the operating room. The operation was not delayed. After induction of general anaesthesia heart rate suddenly increased and hemodinamic situation was impaired. Cardioversion was required. Two electric countershocks were given but sinus rhythm was not restored. Heart rate was controlled with amiodarone infusion. Optimal defibrillation characteristics are described in these cases. Increased risk of thromboembolism (1-2%) following cardioversion is present even if atrial thrombi are ruled out. The mainstay therapies of are rhythm and rate control and prevention of thromboembolic complications. We describe recommendations on the management of these critical situations with emphasis in learning through the creation of protocols and training practice in simulation. PMID:24287084

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

    SciTech Connect

    R. Fink, D. Hill, J. O'Hara

    2004-11-30

    Nuclear plant operators face a significant challenge designing and modifying control rooms. This report provides guidance on planning, designing, implementing and operating modernized control rooms and digital human-system interfaces.

  17. U.S. Army-Baylor University Health Care Administration Program: evidenced-based outcomes in the military health system.

    PubMed

    Mangelsdorff, A David; Rogers, Jody; Finstuen, Kenn; Pryor, Rene

    2004-01-01

    The purpose of this research is to assess the impact of an educational program on the Military Health System on some of the evidence-based educational outcomes for the Individual (student) and the Society (all Army Medical Treatment Facilities). The U.S. Army-Baylor University HCA program provides a unique opportunity to assess the impact of an educational program on the Military Health System (MHS). Since the majority of the graduate students are military officers who serve in military medical treatment facilities (MTFs), tracking their career progression allows assessing the value added of the U.S. Army-Baylor University HCA experience from 1951 to 2001 (n = 2234). The context of Society outcomes includes all the Army MTFs where U.S. Army-Baylor University HCA graduates execute their leadership skills. During the time from 1994 to 2001, all of the Army MTFs in the MHS (n = 38) were examined by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO). In a similar but shorter time frame (1997-2001), DoD patient satisfaction assessments were conducted. The Individual outcomes (career advancement, increase in status, higher professional association membership) demonstrate that the selection criteria used for program admission appear to be successful. The Society outcomes showed higher JCAHO scores and satisfied consumers in Army facilities with Baylor graduates as the Deputy Commander for Administration (DCA). Continued internal program assessments (curriculum reviews) and external reviews (Accrediting Commission on Education for Health Services Administration accreditations of 5 years in 1987, 8 years in 1993 and 7 years in 2001, and 7 ACHE student chapter awards) attest to the strengths of the U.S. Army-Baylor University HCA program. Educating the MHS shareholders (patients, beneficiaries, professional and support staff, senior leaders) and leveraging technology to. share best practices for all administrators (including non-Baylor graduates) will

  18. The Math You Need at Baylor University: Improving Quantitative Skills in an Introductory Geology Lab Course

    NASA Astrophysics Data System (ADS)

    Browning, S.

    2014-12-01

    The Math You Need (TMYN) modules were introduced at Baylor University in fall 2012 to address issues of math anxiety common among freshmen non-majors completing their lab science requirement, and to reduce lab time spent reviewing basic math concepts. Modules and associated assessment questions commonly use geoscience examples to illustrate the mathematical principles involved, reinforcing topics addressed in lab. Large enrollments in the course selected for these modules necessitate multiple graduate teaching assistants in the lab, making the online nature of the modules and minimal required involvement of the teaching assistants even more valuable. Students completed three selected modules before encountering associated topics in lab, as well as a pre and post-test to gauge improvement. This presentation will review lessons learned and changes made in the first two years of TMYN at Baylor. Results indicate continued increases in mean pre to post test scores (e.g. 3.2% in fall 2012 to 11.9% in spring 2014), percentage of student pre to post- test improvement (59% in fall 2012 to 72% in spring 2014) and student participation (95 in fall 2012 to 186 in spring 2014). Continued use of these modules is anticipated.

  19. The evidence-based dentistry initiative at Baylor College of Dentistry.

    PubMed

    Jones, Daniel L; Hinton, Robert J; Dechow, Paul C; Abdellatif, Hoda; McCann, Ann L; Schneiderman, Emet D; D'Souza, Rena

    2011-02-01

    This report describes the impact of an R25 Oral Health Research Education Grant awarded to the Texas A&M Health Science Center-Baylor College of Dentistry (BCD) to promote the application of basic and clinical research findings to clinical training and encourage students to pursue careers in oral health research. At Baylor, the R25 grant supports a multi-pronged initiative that employs clinical research as a vehicle for acquainting both students and faculty with the tools of evidence-based dentistry (EBD). New coursework and experiences in all 4 years of the curriculum plus a variety of faculty development offerings are being used to achieve this goal. Progress on these fronts is reflected in a nascent "EBD culture" characterized by increasing participation and buy-in by students and faculty. The production of a new generation of dental graduates equipped with the EBD skill set as well as a growing nucleus of faculty who can model the importance of evidence-based practice is of paramount importance for the future of dentistry. PMID:21473244

  20. Human Error in Medicine: Change in Cardiac Operating Rooms through the FOCUS Initiative

    PubMed Central

    Spiess, Bruce D.

    2011-01-01

    Abstract: Human error in medicine is a significant cause of patient mortality. While there has been increased attention to safety in medicine since the Institute of Medicine publication To Err is Human, the profession at large has not progressed to the same degree as other highly complex industries such as aviation and nuclear power. The Flawless Operative Cardiovascular Unified Systems initiative (FOCUS) is a multi-year study/intervention to learn about and to improve human error in cardiac surgery. FOCUS has developed into an ongoing re-focusing through prospective interventional research schemes designed to effect positive change for improved patient care in cardiac surgery. The program was developed in conjunction with the Johns Hopkins University Quality and Safety Research Group using an approach termed Locating Errors through Network Surveillance (LENS). The LENS process was undertaken at Johns Hopkins University and another five centers where three major areas were examined observationally: interactions (communication) between operating room cardiac team members, clinical performance of known quality and safety dependent processes, and ergonomics/safety or human-machine interfaces. While collected data is currently being analyzed, preliminary results reveal over 800 human errors noted in the 40 cases observed. The errors observed are being categorized and taxonomy of errors is being created. Categories used in the FOCUS analysis include: teamwork and communication, compliance with existing protocols, knowledge or supervision, vigilance or situational awareness, equipment failure/design, poor operating room design/ergonomics, handoffs and transport problems, lack of professionalism, and ambiguity of responsibility. FOCUS is an initiative to change practice driven by science. Interventions based upon the observations already underway include efforts to decrease infection, adoption of the aviation concept of the “sterile cockpit”, briefing and debriefing

  1. STS-35 Mission Manager Actions Room at the Marshall Space Flight Center Spacelab Payload Operations

    NASA Technical Reports Server (NTRS)

    1990-01-01

    The primary objective of the STS-35 mission was round the clock observation of the celestial sphere in ultraviolet and X-Ray astronomy with the Astro-1 observatory which consisted of four telescopes: the Hopkins Ultraviolet Telescope (HUT); the Wisconsin Ultraviolet Photo-Polarimeter Experiment (WUPPE); the Ultraviolet Imaging Telescope (UIT); and the Broad Band X-Ray Telescope (BBXRT). The Huntsville Operations Support Center (HOSC) Spacelab Payload Operations Control Center (SL POCC) at the Marshall Space Flight Center (MSFC) was the air/ground communication channel used between the astronauts and ground control teams during the Spacelab missions. Teams of controllers and researchers directed on-orbit science operations, sent commands to the spacecraft, received data from experiments aboard the Space Shuttle, adjusted mission schedules to take advantage of unexpected science opportunities or unexpected results, and worked with crew members to resolve problems with their experiments. Due to loss of data used for pointing and operating the ultraviolet telescopes, MSFC ground teams were forced to aim the telescopes with fine tuning by the flight crew. This photo captures the activities at the Mission Manager Actions Room during the mission.

  2. Spacelab Payload Operations Control Center (POCC) Control Room During STS-35 Mission

    NASA Technical Reports Server (NTRS)

    1990-01-01

    The primary objective of the STS-35 mission was round the clock observation of the celestial sphere in ultraviolet and X-Ray astronomy with the Astro-1 observatory which consisted of four telescopes: the Hopkins Ultraviolet Telescope (HUT); the Wisconsin Ultraviolet Photo-Polarimeter Experiment (WUPPE); the Ultraviolet Imaging Telescope (UIT); and the Broad Band X-Ray Telescope (BBXRT). The Huntsville Operations Support Center (HOSC) Spacelab Payload Operations Control Center (SL POCC) at the Marshall Space Flight Center (MSFC) was the air/ground communication channel used between the astronauts and ground control teams during the Spacelab missions. Teams of controllers and researchers directed on-orbit science operations, sent commands to the spacecraft, received data from experiments aboard the Space Shuttle, adjusted mission schedules to take advantage of unexpected science opportunities or unexpected results, and worked with crew members to resolve problems with their experiments. Due to loss of data used for pointing and operating the ultraviolet telescopes, MSFC ground teams were forced to aim the telescopes with fine tuning by the flight crew. This photo is an overview of the MSFC Payload Control Room (PCR).

  3. [Possible Instrument Contamination in the Operating Room During Implantation of Knee and Hip Arthroplasty].

    PubMed

    Quint, U; Benen, T

    2016-04-01

    Integrated ventilation systems with low turbulence displacement flow (TAV) are generally legally required in the architectural structure of operating theatres. However, it seems that the instruments laid out on sterile covered tables do not have the best possible protection from bacteria. Within an operating theatre, different bacteria counts are possible on the instruments. This prospective controlled study was conducted to demonstrate the influence of instrument tables with integrated horizontal flow on contamination with pathogens in comparison with conventional tables. In an operating theatre (OT) with a ceiling legally appropriate for TAV (2.40 m × 1.20 m), microbiological samples were placed on a table with integrated TAV flow (n = 100) and on a conventional instrument table (n = 100). The routine qualification of the OT was on an ongoing basis and was in accordance with DIN 1946-4: 1999 standards (in accordance with DIN measurement of recovery time 1946-4: 12-2008). This corresponds to the OT of the room class Ib. The results show significant differences between the two tables. The bacteria count and the percentage of contamination were many times higher on the conventional table. It is important to understand that the instruments are not completely protected against contamination after opening the pack and during the operation. Remedial measures are possible to optimise the sterility the instrument table. PMID:26844853

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

    PubMed

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

    2011-05-01

    Observations of surgical teams in the operating room (OR) and interviews with surgeons, circulating registered nurses (RNs), anaesthesiologists and surgical technicians reveal the importance of leadership, team member competencies and an enacted environment that encourages feelings of competence and cooperation. Surgical teams are more loosely coupled than intact and bounded. Team members tend to rely on expected role behaviours to bridge lack of familiarity. While members of the surgical team identified technical competence and preparation as critical factors affecting team performance, they had differing views over the role behaviours of other members of the surgical team that lead to surgical team performance. Observations revealed that the work climate in the OR can shape interpersonal relations and begins to be established when the room is being set up for the surgical case, and evolves as the surgical procedure progresses. The leadership and supervisory competencies of the circulating RNs establish the initial work environment. Both influenced the degree of cooperation and support that was observed, which had an effect on the interactions and relationships between other members of the surgical team. As the surgery unfolds, the surgeon's behaviours and interpersonal relations modify this environment and ultimately influence the degree of team work, team satisfaction and team performance. PMID:21471578

  5. A waterjet mining machine for use in room and pillar mining operations

    SciTech Connect

    Summers, D.A.

    1990-06-01

    A new mining machine is constructed for use in room and pillar mining operations. This machine uses the action of computer controlled, centrally located high pressure cutting lances to cut deep slots in a coal face. These slots stress relieve the coal ahead of the machine and outline blocks of coal. The movement forward of the machine then wedges up the lower block of coal. This wedging action is assisted by the gathering arms of the loader section of the machine, and by underlying oscillating waterjets which create a slot ahead of the loading wedge as it advances. Finally the top section of coal is brought down by the sequential advance of wedge faced roof support members, again assisted by the waterjet action from the central cutting arms. The machine is designed to overcome major disadvantages of existing room and pillar mining machines in regard to a reduction in respirable dust, the creation of an immediate roof support, and an increase in product size, with concomitant reduction in cleaning costs.

  6. A waterjet mining machine for use in room and pillar mining operations. [Final report

    SciTech Connect

    Summers, D.A.

    1990-06-01

    A new mining machine is constructed for use in room and pillar mining operations. This machine uses the action of computer controlled, centrally located high pressure cutting lances to cut deep slots in a coal face. These slots stress relieve the coal ahead of the machine and outline blocks of coal. The movement forward of the machine then wedges up the lower block of coal. This wedging action is assisted by the gathering arms of the loader section of the machine, and by underlying oscillating waterjets which create a slot ahead of the loading wedge as it advances. Finally the top section of coal is brought down by the sequential advance of wedge faced roof support members, again assisted by the waterjet action from the central cutting arms. The machine is designed to overcome major disadvantages of existing room and pillar mining machines in regard to a reduction in respirable dust, the creation of an immediate roof support, and an increase in product size, with concomitant reduction in cleaning costs.

  7. High-frequency operation of a mid-infrared interband cascade system at room temperature

    NASA Astrophysics Data System (ADS)

    Lotfi, Hossein; Li, Lu; Lei, Lin; Ye, Hao; Shazzad Rassel, S. M.; Jiang, Yuchao; Yang, Rui Q.; Mishima, Tetsuya D.; Santos, Michael B.; Gupta, James A.; Johnson, Matthew B.

    2016-05-01

    The high-frequency operation of a mid-infrared interband cascade system that consists of a type-I interband cascade laser and an uncooled interband cascade infrared photodetector (ICIP) is demonstrated at room temperature. The 3-dB bandwidth of this system under direct frequency modulation was ˜850 MHz. A circuit model was developed to analyze the high-frequency characteristics. The extracted 3-dB bandwidth for an uncooled ICIP was ˜1.3 GHz, signifying the great potential of interband cascade structures for high-speed applications. The normalized Johnson-noise-limited detectivity of these ICIPs exceeded 109 cm Hz1/2/W at 300 K. These results validate the advantage of ICIPs to achieve both high speed and high sensitivity at high temperatures.

  8. Pro: early extubation in the operating room following cardiac surgery in adults.

    PubMed

    Singh, Karen E; Baum, Victor C

    2012-12-01

    There is growing evidence that the general current approach in many centers of continued mechanical ventilation following cardiac surgery has evolved through historical experience rather than having a strong physiological basis in current practice. There is evidence going back several decades supporting very early (in the operating room [OR]) extubation in pediatric cardiac anesthesia. The authors provide evidence from numerous sources showing that extubation in the OR or shortly after arrival in the ICU is safe and cost-effective and is not prevented by the type of cardiac surgery or the use of cardiopulmonary bypass. They query if the paradigm should not be reversed and very early extubation be the routine unless contraindicated. Like any anesthetic technique, appropriate patient selection is called for, but this technique is widely appropriate. PMID:22798230

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

    PubMed Central

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

    2013-01-01

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

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

    NASA Astrophysics Data System (ADS)

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

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

  11. How to implement information technology in the operating room and the intensive care unit.

    PubMed

    Meyfroidt, Geert

    2009-03-01

    The number of operating rooms and intensive care units looking for a data management system to perform their increasingly complex tasks is rising. Although at this time only a minority is computerized, within the next few years many centres will start implementing information technology. The transition towards a computerized system is a major venture, which will have a major impact on workflow. This chapter reviews the present literature. Published papers on this subject are predominantly single- or multi-centre implementation reports. The general principles that should guide such a process are described. For healthcare institutions or individual practitioners that plan to undertake this venture, the implementation process is described in a practical, nine-step overview. PMID:19449612

  12. Leadership in surgery for public sector hospitals in Jamaica: strategies for the operating room.

    PubMed

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

    2013-01-01

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

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

    PubMed

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

    2006-01-01

    For better integration of surgical assist systems into the operating room, a common communication and processing plattform that is based on the users needs is needed. The development of such a system, a Surgical Picture Aquisition and Communication System (S-PACS), according the systems engineering cycle is oulined in this paper. The first two steps (concept and specification) for the engineering of the S-PACS are discussed.A method for the systematic integration of the users needs', the Quality Function Deployment (QFD), is presented. The properties of QFD for the underlying problem and first results are discussed. Finally, this leads to a first definition of an S-PACS system. PMID:16404059

  14. [Chemical risk in operating rooms and technical progress: the obligations and responsibilities of law].

    PubMed

    Oddo, Antonio

    2013-01-01

    We are going to consider the specific applications of the new legal system and of the most recent body of laws to those work environments of particular risk, such as healthcare facilities and in particular operating rooms. In such environments, volatile chemicals classified as "dangerous" are used with consequent exposure to "chemical risk", both of those persons professionally involved, depending on the type of activity, and of the patients to whom such activities are addressed in the same environment. Once the chemical risk is framed in the existing regulatory system, it must be specifically evaluated the application of the same principle to the particular chemical risk arising from the use of anesthetic agents in the operating room, for example sevoflurane and desflurane, being careful to test wether and how much this risk can be eliminated or reduced to minimum in relation to the new achievements of the technical progress. So, as soon as the quality of "dangerous chemical agent" of the "volatile chemicals" and of the "volatile liquid anesthetic" (sevoflurane and desflurane) as well--which are characterized by a lower degree of toxicity and for this reason are mostly used in current chemical practice, preferable to some anesthetic gases such as nitrous oxide--is legally verified, it is necessary to relate the scientific and technical data which result from the current "state of art" also to the other binding regulations that are imposed for the "prevention and protection from chemical agents", according to the relative Title IX of the TUSL (Unique text for Safety and Health at Work). PMID:24640081

  15. The green operating room: simple changes to reduce cost and our carbon footprint.

    PubMed

    Wormer, Blair A; Augenstein, Vedra A; Carpenter, Christin L; Burton, Patrick V; Yokeley, William T; Prabhu, Ajita S; Harris, Beth; Norton, Sujatha; Klima, David A; Lincourt, Amy E; Heniford, B Todd

    2013-07-01

    Generating over four billion pounds of waste each year, the healthcare system in the United States is the second largest contributor of trash with one-third produced by operating rooms. Our objective is to assess improvement in waste reduction and recycling after implementation of a Green Operating Room Committee (GORC) at our institution. A surgeon and nurse-initiated GORC was formed with members from corporate leadership, nursing, anesthesia, and OR staff. Initiatives for recycling opportunities, reduction of energy and water use as well as solid waste were implemented and the results were recorded. Since formation of GORC in 2008, our OR has diverted 6.5 tons of medical waste. An effort to recycle all single-use devices was implemented with annual solid waste reduction of approximately 12,860 lbs. Disposable OR foam padding was replaced with reusable gel pads at greater than $50,000 per year savings. Over 500 lbs of previously discarded batteries were salvaged from the OR and donated to charity or redistributed in the hospital ($9,000 annual savings). A "Power Down" initiative to turn off all anesthesia and OR lights and equipment not in use resulted in saving $33,000 and 234.3 metric tons of CO2 emissions reduced per year. Converting from soap to alcohol-based waterless scrub demonstrated a potential saving of 2.7 million liters of water annually. Formation of an OR committee dedicated to ecological initiatives can provide a significant opportunity to improve health care's impact on the environment and save money. PMID:23815997

  16. Spacelab Operations Support Room Space Engineering Support Team in the SL POCC During the IML-1

    NASA Technical Reports Server (NTRS)

    1992-01-01

    The primary payload for Space Shuttle Mission STS-42, launched January 22, 1992, was the International Microgravity Laboratory-1 (IML-1), a pressurized manned Spacelab module. The goal of IML-1 was to explore in depth the complex effects of weightlessness of living organisms and materials processing. Around-the-clock research was performed on the human nervous system's adaptation to low gravity and effects of microgravity on other life forms such as shrimp eggs, lentil seedlings, fruit fly eggs, and bacteria. Materials processing experiments were also conducted, including crystal growth from a variety of substances such as enzymes, mercury iodide, and a virus. The Huntsville Operations Support Center (HOSC) Spacelab Payload Operations Control Center (SL POCC) at the Marshall Space Flight Center (MSFC) was the air/ground communication channel used between the astronauts and ground control teams during the Spacelab missions. Featured is the Spacelab Operations Support Room Space Engineering Support team in the SL POCC during STS-42, IML-1 mission.

  17. Tactical increases in operating room block time for capacity planning should not be based on utilization.

    PubMed

    Wachtel, Ruth E; Dexter, Franklin

    2008-01-01

    When a decision has been made to expand operating room (OR) capacity, the choice of surgical subspecialties to receive additional block time and fill the additional OR capacity is a tactical decision. Such decisions are made approximately once a year. Afterwards, typically a few months before the day of surgery, a second stage occurs in which operational decisions allocate OR time and determine the hours of staffing for each specialty based on its expected workload. In practice, cases are not scheduled into block time that has been planned tactically, but instead are scheduled during the second stage into the staffed time that is allocated operationally. This article reviews the literature on tactical decision-making for expansion of OR capacity. When additional OR capacity is available, it should be planned for those subspecialties that have the greatest contribution margin per OR hour, that have the potential for growth, and that have minimal need for limited resources such as intensive care unit beds. Numerous reasons are presented to explain why tactical planning of additional block time should not be based on current or past utilization of block time. PMID:18165581

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

    PubMed

    Wachs, Juan P; Gomez, Gerardo

    2013-01-01

    This paper discusses the challenges and innovations related to the use of telementoring systems in the operating room. Most of the systems presented leverage on three types of interaction channels: audio, visual and physical. The audio channel enables the mentor to verbally instruct the trainee, and allows the trainee to ask questions. The visual channel is used to deliver annotations, alerts and other messages graphically to the trainee during the surgery. These visual representations are often displayed through a telestrator. The physical channel has been used in laparoscopic procedures by partially controlling the laparoscope through force-feedback. While in face to face instruction, the mentor produces gestures to convey certain aspects of the surgical instruction, there is not equivalent of this form of physical interaction between the mentor and trainee in open surgical procedures in telementoring systems. Even that the trend is to perform more minimally invasive surgery (MIS), trauma surgeries are still necessary, where initial resuscitation and stabilization of the patient in a timely manner is crucial. This paper presents a preliminary study conducted at the Indiana University Medical School and Purdue University, where initial lexicons of surgical instructive gestures (SIGs) were determined through systematic observation when mentor and trainee operate together. The paper concludes with potential ways to convey gestural information through surgical robots. PMID:24356263

  19. The impact of in-house surgeons and operating room resuscitation on outcome of traumatic injuries.

    PubMed

    Hoyt, D B; Shackford, S R; McGill, T; Mackersie, R; Davis, J; Hansbrough, J

    1989-08-01

    As trauma systems develop, more patients can potentially benefit from immediate surgery. With in-house surgeons available, enthusiasm for direct transfer from the scene to the operating room (OR) has developed in many institutions. The purpose of this study was to define precisely which patients should be taken to the OR for resuscitation. Three hundred twenty-three patients were taken to the OR directly from the field during a 4-year period (6.9% of trauma activations). Indications included the following: (1) cardiac arrest--one vital sign present, (2) persistent hypotension despite field intravenous fluid, and (3) uncontrolled external hemorrhage. A board-certified surgeon and resuscitation team met the field transport team in the OR in all cases. Cardiopulmonary resuscitation for patients with blunt trauma was not accompanied by survival even with immediate surgery by a trained surgeon and it wastes valuable OR resources. Patients with prehospital hypotension unresponsive to fluid resuscitation indicate the need for rapid surgery. Patients with blunt injuries even with hypotension infrequently undergo operations in less than 20 minutes and can be resuscitated in traditional areas where better roentgenograms are obtained. Penetrating injuries to the chest and abdomen with hypotension are the primary indications for OR resuscitation. It can be anticipated with field communication and accompanied by enhanced survival. PMID:2757502

  20. Central Venous Line Placement prior to Gastric Bypass Improves Operating Room Efficiency

    PubMed Central

    Overby, D. Wayne; Kohn, Geoffrey P.; Colton, Karen J.; Stavas, Joseph M.; Dixon, Robert G.; Passannante, Anthony; Farrell, Timothy M.

    2012-01-01

    Background. Bariatric surgery has increased across America. Venous access is difficult in these patients. Anesthesiologists often utilize valuable operating room (OR) time acquiring reliable intravenous lines. Our objective was to determine if outpatient central venous line (CVL) placement improves OR efficiency and professional reimbursement for CVL insertion. Methods. In our bariatric practice, selected surgery patients have outpatient CVLs placed during prophylactic vena cava filter placement. In a cohort of 268 gastric bypass patients operated between 1/01 and 11/06, we compared time-to-incision between 106 with pre-established CVLs and 162 without. In addition, we determined professional compensation rates for CVLs placed outpatient versus CVLs inserted in the OR. Results. Patients with preoperative (outpatient) CVLs required 35.6 ± 12.5 minutes to skin incision compared with 42.5 ± 13.9 minutes for controls (P < 0.0001), and 34.9% had skin incision in <30 minutes compared with 16.4% of controls. Radiologists collected 28.2% of outpatient billings for CPT code 36556, compared with anesthesiologists who collected <1% when placing CVLs in the OR. Conclusions. Outpatient CVLs prior to gastric bypass improve efficiency in the OR with earlier skin incision. Professional reimbursement is better for outpatient CVLs than intraoperative inpatient CVLs. PMID:22830049

  1. Time-Motion Analysis of Clinical Nursing Documentation During Implementation of an Electronic Operating Room Management System for Ophthalmic Surgery

    PubMed Central

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

    2013-01-01

    Efficiency and quality of documentation are critical in surgical settings because operating rooms are a major source of revenue, and because adverse events may have enormous consequences. Electronic health records (EHRs) have potential to impact surgical volume, quality, and documentation time. Ophthalmology is an ideal domain to examine these issues because procedures are high-throughput and demand efficient documentation. This time-motion study examines nursing documentation during implementation of an EHR operating room management system in an ophthalmology department. Key findings are: (1) EHR nursing documentation time was significantly worse during early implementation, but improved to a level near but slightly worse than paper baseline, (2) Mean documentation time varied significantly among nurses during early implementation, and (3) There was no decrease in operating room turnover time or surgical volume after implementation. These findings have important implications for ambulatory surgery departments planning EHR implementation, and for research in system design. PMID:24551402

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

    PubMed Central

    Gonzalez, Tyler A.; Bluman, Eric M.; Palms, David; Smith, Jeremy T.; Chiodo, Christopher P.

    2016-01-01

    Background: The most expensive variable in the operating room (OR) is time. Lean Process Management is being used in the medical field to improve efficiency in the OR. Streamlining individual processes within the OR is crucial to a comprehensive time saving and cost-cutting health care strategy. At our institution, one hour of OR time costs approximately $500, exclusive of supply and personnel costs. Commercially prepared splint packs (SP) contain all components necessary for plaster-of-Paris short-leg splint application and have the potential to decrease splint application time and overall costs by making it a more lean process. We conducted a randomized controlled trial comparing OR time savings between SP use and bulk supply (BS) splint application. Methods: Fifty consecutive adult operative patients on whom post-operative short-leg splint immobilization was indicated were randomized to either a control group using BS or an experimental group using SP. One orthopaedic surgeon (EMB) prepared and applied all of the splints in a standardized fashion. Retrieval time, preparation time, splint application time, and total splinting time for both groups were measured and statistically analyzed. Results: The retrieval time, preparation time and total splinting time were significantly less (p<0.001) in the SP group compared with the BS group. There was no significant difference in application time between the SP group and BS group. Conclusion: The use of SP made the process of splinting more lean. This has resulted in an average of 2 minutes 52 seconds saved in total splinting time compared to BS, making it an effective cost-cutting and time saving technique. For high volume ORs, use of splint packs may contribute to substantial time and cost savings without impacting patient safety. PMID:26894212

  3. Traffic in the operating room during joint replacement is a multidisciplinary problem

    PubMed Central

    Bédard, Martin; Pelletier-Roy, Rémi; Angers-Goulet, Mathieu; Leblanc, Pierre-Alexandre; Pelet, Stéphane

    2015-01-01

    Background Door openings disrupt the laminar air flow and increase the bacterial count in the operating room (OR). We aimed to define the incidence of door openings in the OR during primary total joint arthroplasty (TJA) surgeries and determine whether measures were needed and/or possible to reduce OR staff traffic. Methods We recorded the number of door openings during 100 primary elective TJA surgeries; the OR personnel were unaware of the observer’s intention. Operating time was divided into the preincision period, defined as the time from the opening of surgical trays to skin incision, and the postincision period, defined as time from incision to dressing application. Results The mean number of door openings during primary TJA was 71.1 (range 35–176) with a mean operative time of 111.9 (range 53–220) minutes, for an average of 0.64 (range 0.36–1.05) door openings/min. Nursing staff were responsible for 52.2% of total door openings, followed by anesthesia staff at 23.9% and orthopedic staff at 12.7%. In the preincision period, we observed an average of 0.84 door openings/min, with nursing and orthopedic personnel responsible for most of the door openings. The postincision period yielded an average of 0.54 door openings/min, with nursing and anesthesia personnel being responsible for most of the door openings. Conclusion There is a high incidence of door openings during TJA. Because we observed a range in the number of door openings per surgery, we believe it is possible to reduce this number during TJA. PMID:26022153

  4. Consequences and potential problems of operating room outbursts and temper tantrums by surgeons

    PubMed Central

    Jacobs, George B.; Wille, Rosanne L.

    2012-01-01

    Background: Anecdotal tales of colorful temper tantrums and outbursts by surgeons directed at operating room nurses and at times other health care providers, like residents and fellows, are part of the history of surgery and include not only verbal abuse but also instrument throwing and real harassment. Our Editor-in-Chief, Dr. Nancy Epstein, has made the literature review of “Are there truly any risks and consequences when spine surgeons mistreat their predominantly female OR nursing staff/colleagues, and what can we do about it?,” an assigned topic for members of the editorial board as part of a new category entitled Ethical Note for our journal. This is a topic long overdue and I chose to research it. Methods: There is no medical literature to review dealing with nurse abuse. To research this topic, one has to involve business, industry, educational institutions, compliance standards and practices, and existing state and federal laws. I asked Dr. Rosanne Wille to co-author this paper since, as the former Dean of Nursing and then Provost and Senior Vice President for Academic Affairs at a major higher educational institution, she had personal experience with compliance regulations and both sexual harassment and employment discrimination complaints, to make this review meaningful. Results: A review of the existing business practices and both state and federal laws strongly suggests that although there has not been any specific legal complaint that is part of the public record, any surgeon who chooses to act out his or her frustration and nervous energy demands by abusing co-workers on the health care team, and in this case specifically operating room personnel, is taking a chance of making legal history with financial outcomes which only an actual trial can predict or determine. Even more serious outcomes of an out-of-control temper tantrum and disruptive behavior can terminate, after multiple hearings and appeals, in adverse decisions affecting hospital

  5. Assessment of an innovative antimicrobial surface disinfectant in the operating room environment using adenosine triphosphate bioluminescence assay.

    PubMed

    Lewis, Brian D; Spencer, Maureen; Rossi, Peter J; Lee, Cheong J; Brown, Kellie R; Malinowski, Michael; Seabrook, Gary R; Edmiston, Charles E

    2015-03-01

    Terminal cleaning in the operating room is a critical step in preventing the transmission of health care-associated pathogens. The persistent disinfectant activity of a novel isopropyl alcohol/organofunctional silane solution (ISO) was evaluated in 4 operating rooms after terminal cleaning. Adenosine triphosphate bioluminescence documented a significant difference (P < .048) in surface bioburden on IOS-treated surfaces versus controls. RODAC plate cultures revealed a significant (P < .001) reduction in microbial contamination on IOS-treated surfaces compared with controls. Further studies are warranted to validate the persistent disinfectant activity of ISO within selective health care settings. PMID:25728155

  6. [Microbiological pollution of operating rooms: critical analysis of two decades of surveillance].

    PubMed

    D'Alessandro, D; Fabiani, M; Pallottino, O A; Semeraro, V; Orsi, G B; Fara, G M

    2011-01-01

    The objective of this study was to analyze the results of microbiological air sampling of operating rooms (OR) over the last two decades at the Sapienza University Hospital of Rome, in order to describe the time trends of contamination levels and to assess any significant changes. Microbiological air sampling carried out in 14 surgical units between 1992 and 2010 were examined. The sampling results have been aggregated into four time periods (prior to 1996, 1996-2000, 2001-2005, 2006-2010) and the time trend of sampling results was analyzed in comparison with the standard reported by ISPESL for OR at-rest (< or = 35 CFU/mc). The same analysis was repeated after stratification by risk level of the OR (high risk (AR) and low risk (BR)). To verify the significance level of the temporal variations in the distribution of results x2 test for trend was performed. There was a significant downward trend in the number of OR with contamination levels higher of the standard (x2 for trend = 8.94, P < 0.025). This reduction mainly regards AR-OR (x2 for trend = 7.33, P < 0.05). The results suggest that the preventive measures performed in AR-OR have been effective. More attention must be given to BR-OR. PMID:22013705

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

    PubMed

    Schieble, Thomas M

    2008-01-01

    The present study aimed to identify firms supplying products to our university operating room (OR) that promote sustainable manufacturing methods. Results show that 72% of our suppliers, or 152 of 211 companies, do not promote sustainability practices in a salient manner. Multi-national firms document sustainability methods significantly more than U.S. divisions of multi-nationals or U.S. firms with chi-square = 157.93 (p < 0.001). Although the current study did not evaluate real manufacturing methods, sustainability promotion is an important marketing tool through which purchasers may begin the process of due diligence for product selection. Lack of sustainability information among suppliers in this study suggests that hospital procurement departments likely focus solely on issues like price or quality when making purchase decisions. These results also suggest an opportunity for healthcare administrators to evaluate more fully the products involved in the healthcare supply chain; the intrinsic, intangible value added to hospital products through sustainable manufacturing is consistent with responsible patient care and has the potential to create marketing and public relations value. PMID:19042865

  8. The Effects of Workload and Working Conditions on Operating Room Nurses and Technicians.

    PubMed

    Uğurlu, Ziyafet; Karahan, Azize; Ünlü, Hayriye; Abbasoğlu, Aysel; Özhan Elbaş, Nalan; Avcı Işık, Sevcan; Tepe, Aylin

    2015-09-01

    This study was conducted between August 15 and September 20, 2013, to determine the effects of workload and working conditions on operating room (OR) nurses and technicians. The study sample included 74 OR nurses and technicians working in a private university's six hospitals. The Individual Workload Perception Scale and a questionnaire that collected data on risk and environmental factors were used. The mean age of study participants was 29.3 ± 6.7 years, and 62.2% of the participants were female. More than 90% of the nurses and technicians had experienced spills or splashing of blood or other body fluids; anesthetic gases and radiation had affected 63.5% and 71.6% of nurses and technicians, respectively; 63.5% reported lumbar pain; and 46.6% defined the work environment as very stressful. The average workload scale score was 32.4 ± 6.2 (min = 11, max = 55). OR nurses and technicians are exposed to many occupational risks. PMID:26206853

  9. Time accuracy of a radio frequency identification patient tracking system for recording operating room timestamps.

    PubMed

    Marjamaa, Riitta A; Torkki, Paulus M; Torkki, Markus I; Kirvelä, Olli A

    2006-04-01

    A patient tracking system is a promising tool for managing patient flow and improving efficiency in the operating room. Wireless location systems, using infrared or radio frequency transmitters, can automatically timestamp key events, thereby decreasing the need for manual data input. In this study, we measured the accuracy and precision of automatically documented timestamps compared with manual recording. Each patient scheduled for urgent surgery was given an active radio frequency/infrared transmitter. The prototype software tracked the patient throughout the perioperative process, automatically documenting the timestamps. Both automatic and traditional data entry were compared with the reference data. The absolute value of median error was 64% smaller (P < 0.01), and the average quartile deviation of error was 69% smaller in automatic documentation. The average delay between an activity and the documentation was 80 seconds in automatic documentation and 735 seconds in manual documentation. Both the accuracy and the precision were better in automatic documentation and the data were immediately available. Automatic documentation with the Indoor Positioning System can help in managing patient flow and in increasing transparency with faster availability and better accuracy of data. PMID:16551921

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

    PubMed

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

    2015-12-01

    In recent years, aortic aneurysm treatment with stent graft grafting in the X-ray fluoroscopy is increasing. This is an endovascular therapy, because it is a treatment which includes the risk of radiation damage, having to deal with radiation damage, to know in advance is important. In this study, in order to grasp the trend of exposure stent graft implantation in a hybrid operating room (OR) system, focusing on clinical data (entrance skin dose and fluoroscopy time), was to count the total. In TEVAR and EVAR, fluoroscopy time became 13.40 ± 7.27 minutes, 23.67 ± 11.76 minutes, ESD became 0.87 ± 0.41 mGy, 1.11 ± 0.57 mGy. (fluoroscopy time of EVAR was 2.0 times than TEVAR. DAP of EVAR was 1.2 times than TEVAR.) When using the device, adapted lesions and usage are different. This means that care changes in exposure-related factors. In this study, exposure trends of the stent graft implantation was able to grasp. It can be a helpful way to reduce/optimize the radiation dose in a hybrid OR system. PMID:26685833

  11. Applied patent RFID systems for building reacting HEPA air ventilation system in hospital operation rooms.

    PubMed

    Lin, Jesun; Pai, Jar-Yuan; Chen, Chih-Cheng

    2012-12-01

    RFID technology, an automatic identification and data capture technology to provide identification, tracing, security and so on, was widely applied to healthcare industry in these years. Employing HEPA ventilation system in hospital is a way to ensure healthful indoor air quality to protect patients and healthcare workers against hospital-acquired infections. However, the system consumes lots of electricity which cost a lot. This study aims to apply the RFID technology to offer a unique medical staff and patient identification, and reacting HEPA air ventilation system in order to reduce the cost, save energy and prevent the prevalence of hospital-acquired infection. The system, reacting HEPA air ventilation system, contains RFID tags (for medical staffs and patients), sensor, and reacting system which receives the information regarding the number of medical staff and the status of the surgery, and controls the air volume of the HEPA air ventilation system accordingly. A pilot program was carried out in a unit of operation rooms of a medical center with 1,500 beds located in central Taiwan from Jan to Aug 2010. The results found the air ventilation system was able to function much more efficiently with less energy consumed. Furthermore, the indoor air quality could still keep qualified and hospital-acquired infection or other occupational diseases could be prevented. PMID:22081235

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

    PubMed

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

    2005-05-01

    Previous studies have indicated that music decreases intraoperative sedative requirements in patients undergoing surgical procedures under regional anesthesia. In this study we sought to determine whether this decrease in sedative requirements results from music or from eliminating operating room (OR) noise. A secondary aim of the study was to examine the relationship of response to intraoperative music and participants' culture (i.e., American versus Lebanese). Eighty adults (36 American and 54 Lebanese) undergoing urological procedures with spinal anesthesia and patient-controlled IV propofol sedation were randomly assigned to intraoperative music, white noise, or OR noise. We found that, controlling for ambient OR noise, intraoperative music decreases propofol requirements (0.004 +/- 0.002 mg . kg(-1) . min(-1) versus 0.014 +/- 0.004 mg . kg(-1) . min(-1) versus 0.012 +/- 0.002 mg . kg(-1) . min(-1); P = 0.026). We also found that, regardless of group assignment, Lebanese patients used less propofol as compared with American patients (0.005 +/- 0.001 mg . kg(-1) . min(-1) versus 0.017 +/- 0.003 mg . kg(-1) . min(-1); P = 0.001) and that, in both sites, patients in the music group required less propofol (P < 0.05). We conclude that when controlling for ambient OR noise, intraoperative music decreases propofol requirements of both Lebanese and American patients who undergo urological surgery under spinal anesthesia. PMID:15845676

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

    PubMed

    Schüpfer, G; Bauer, M

    2011-03-01

    Operation room (OR) management is not an end in itself. The challenge is more to organize the complex, inhomogeneous and interference-prone machinery of intraoperative service provision according to business objectives. Although business objectives may differ in some details the ultimate consequence is always to assure the quality of medical care along with adhering to the general economic conditions. The narrower the economic framework the smaller the company's tolerance to unprofessional OR management. Consequently, it can be noticed that OR management has become of age. An internal socialization as frontline leader is no longer sufficient for taking over a job profile which, regarding the risks of revenues and costs belongs to the top management of a company. Prior to looking for a future OR manager it is mandatory to develop a profile of qualifications tailored to the company. In the following selection process the important thing is to identify the candidate who fits best to the developed profile. This paper sees itself as an assistance in the development of such a company-specific qualification profile for an OR manager. On the basis of knowledge, skills and characteristics, different manager typologies are developed, facilitating the successful evaluation in a selection process for both the company and the candidate. PMID:21311852

  14. Plasma transfusion for bedside, radiologically guided, and operating room invasive procedures.

    PubMed

    Desborough, Michael; Stanworth, Simon

    2012-05-01

    Frozen plasma (FP) is commonly used in an attempt to correct coagulation defects before performing bedside, radiologically guided, or operating room procedures. Use of FP prophylactically is closely linked to results for standard coagulation tests in the laboratory, including prothrombin time, but there is a general lack of evidence supporting the predictive value of abnormalities of these tests for bleeding. Use of FP has little effect on correcting abnormal coagulation tests when mild and moderate results are recorded. There is no support for evidence of effectiveness for the prophylactic use of FP when reviewing the wider randomized controlled trial literature. When the lack of clinical effectiveness is combined with the risks of FP transfusion, such as transfusion-related acute lung injury and transfusion-associated circulatory overload, the need to challenge continued preprocedure prophylactic use of FP becomes pressing. In clinical practice, abnormalities of standard coagulation tests should not be interpreted in isolation, but alongside review of clinical bleeding history and other hemostatic markers such as platelet count. A more appropriate transfusion strategy may be one that emphasizes the therapeutic use of FP. PMID:22578367

  15. Monitor height ergonomics: A comparison of operating room video display terminals.

    PubMed

    Kelts, Gregory I; McMains, Kevin C; Chen, Phillip G; Weitzel, Erik K

    2015-01-01

    A surgeon's eyes should be positioned 1 meter (m) distant and no more than 15° below the top of an operating monitor (0.27 m). We sought to determine which operating room video display terminal can best accommodate ergonomically optimized gaze during surgery. Floor to eye height was measured for surgeons in seated, perched, and standing positions. These ranges were then compared to vertical displacement ranges for monitors measured from floor to top of the screen. Eye height was measured for standing (1.56-1.80 m), perched (1.40-1.65 m), and seated (1.10-1.32 m) positions. The minimum distance (min) between the floor and the top of the monitor and the vertical mobility range (VR) of the monitor were measured throughout a tertiary medical center including towers with boom arms (TcB) (min: 1.58 m, VR: 0.37 m), towers without booms (TsB) (min: 1.82 m, VR: 0.025 m), ceiling mounted booms (CMB) (min: 1.34 m:, VR: 1.04 m), and portable monitors (PM) (min: 1.73 m, VR: 0.04 m). The tangent of 15° declination was used to calculate a correction factor to determine the minimum optimal ergonomic display height. The correction factor was subtracted from the eye height at each position to determine the lowest target height and the highest target floor to eye distance for each position. Analysis of variance with least significant difference post hoc testing identified all minimum distances and vertical ranges to be statistically different (p < 0.001). Monitor vertical displacement varied between styles of carts. CMB video display terminal systems can accommodate standing, perched and the tallest seated surgeons. TcB, TsB and PM systems cannot adequately accommodate all standing, perched or seated surgeons. PMID:25860168

  16. Basement utility room (room 24; air handling room), near the ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Basement utility room (room 24; air handling room), near the west end of the combat operations center, looking southwest towards fan system one, air ducts, and walk-in filter rooms. The exterior equipment well is visible at the left - March Air Force Base, Strategic Air Command, Combat Operations Center, 5220 Riverside Drive, Moreno Valley, Riverside County, CA

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

    SciTech Connect

    Ronald Boring; Roger Lew; Thomas Ulrich; Jeffrey Joe

    2014-03-01

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

  18. Room temperature continuous-wave operation of GaInNAs long wavelength VCSELs

    SciTech Connect

    Larson, M C; Coldren, C W; Spruytte, S G; Peterson, H E; Harris, J S

    2000-06-22

    Vertical cavity surface-emitting lasers (VCSELs) are becoming increasingly important for short-haul optical fiber transmission systems. Given the commercial success of GaAs-based 850nm VCSELs, dramatic enhancements in transmission bandwidth and distance can be achieved in conventional single- and multi-mode fiber by extending the emission wavelength to the 1300nm-1550nm range. GaInNAs is a promising active layer material grown on GaAs that can achieve 1300nm emission [l], and electrically pulsed broad-area GaInNAs VCSELs [2,3] have been realized. Here we take advantage of the properties of GaAs-based materials-thermally-conductive high contrast mirrors and AlAs-oxide current apertures-to demonstrate for the first time low-threshold ({approx}1 mA) GaInNAs VCSELs emitting at a wavelength of 1200 nm under continuous-wave room temperature operation. The device structure is shown schematically in figure 1. The bottom mirror consists of a 22.5-period n-doped GaAs/AlAs distributed Bragg reflector (DBR) designed for a center wavelength {lambda} near 1200nm, the top mirror is a 22-period p-doped DBR whose reflectance is enhanced by a Ti/Au contact electrode, and the GaAs {lambda} cavity contains three 70{angstrom}, Ga{sub 0.3}In{sub 0.7}N{sub 0.02}As{sub 0.98} quantum wells (QWs) separated by 200{angstrom} GaAs barriers. The epilayers were grown by molecular beam epitaxy using solid-source arsenic and a rf nitrogen plasma source. After growth, the first 17 mirror periods of the top mirror were dry etched and subsequently capped with SiO{sub 2}, and the remaining three periods were etched to expose the AlAs for lateral oxidation, which formed square unoxidized apertures as small as 3.6 {micro}m on a side. After the top contact metalization, devices were mounted without heat sinking on a glass slide for optical emission through the substrate, which was contacted electrically with indium solder. The output power and voltage vs. injection current for a 5{micro}m x 5{micro

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

    NASA Technical Reports Server (NTRS)

    Meyer, J. S.; Kosovich, J.

    1973-01-01

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

  20. AuPd/polyaniline as the anode in an ethylene glycol microfluidic fuel cell operated at room temperature.

    PubMed

    Arjona, N; Palacios, A; Moreno-Zuria, A; Guerra-Balcázar, M; Ledesma-García, J; Arriaga, L G

    2014-08-01

    AuPd/polyaniline was used for the first time, for ethylene glycol (EG) electrooxidation in a novel microfluidic fuel cell (MFC) operated at room temperature. The device exhibits high electrocatalytic performance and stability for the conversion of cheap and fully available EG as fuel. PMID:24923468

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

    ERIC Educational Resources Information Center

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

    2015-01-01

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

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

    SciTech Connect

    HIGGINS,J.C.; OHARA,J.M.; ALMEIDA,P.

    2002-09-19

    THE JOSE CABRERA NUCLEAR POWER PLANT IS A ONE LOOP WESTINGHOUSE PRESSURIZED WATER REACTOR. IN THE CONTROL ROOM, THE DISPLAYS AND CONTROLS USED BY OPERATORS FOR THE EMERGENCY OPERATING PROCEDURES ARE DISTRIBUTED ON FRONT AND BACK PANELS. THIS CONFIGURATION CONTRIBUTED TO RISK IN THE PROBABILISTIC SAFETY ASSESSMENT WHERE IMPORTANT OPERATOR ACTIONS ARE REQUIRED. THIS STUDY WAS UNDERTAKEN TO EVALUATE THE IMPACT OF THE DESIGN ON CREW PERFORMANCE AND PLANT SAFETY AND TO DEVELOP DESIGN IMPROVEMENTS.FIVE POTENTIAL EFFECTS WERE IDENTIFIED. THEN NUREG-0711 [1], PROGRAMMATIC, HUMAN FACTORS, ANALYSES WERE CONDUCTED TO SYSTEMATICALLY EVALUATE THE CR-LA YOUT TO DETERMINE IF THERE WAS EVIDENCE OF THE POTENTIAL EFFECTS. THESE ANALYSES INCLUDED OPERATING EXPERIENCE REVIEW, PSA REVIEW, TASK ANALYSES, AND WALKTHROUGH SIMULATIONS. BASED ON THE RESULTS OF THESE ANALYSES, A VARIETY OF CONTROL ROOM MODIFICATIONS WERE IDENTIFIED. FROM THE ALTERNATIVES, A SELECTION WAS MADE THAT PROVIDED A REASONABLEBALANCE BE TWEEN PERFORMANCE, RISK AND ECONOMICS, AND MODIFICATIONS WERE MADE TO THE PLANT.

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

    PubMed Central

    Deuchler, Svenja; Wagner, Clemens; Singh, Pankaj; Müller, Michael; Al-Dwairi, Rami; Benjilali, Rachid; Schill, Markus; Ackermann, Hanns; Bon, Dimitra; Kohnen, Thomas; Schoene, Benjamin; Koss, Michael; Koch, Frank

    2016-01-01

    Purpose To evaluate the efficacy of the virtual reality training simulator Eyesi to prepare surgeons for performing pars plana vitrectomies and its potential to predict the surgeons’ performance. Methods In a preparation phase, four participating vitreoretinal surgeons performed repeated simulator training with predefined tasks. If a surgeon was assigned to perform a vitrectomy for the management of complex retinal detachment after a surgical break of at least 60 hours it was randomly decided whether a warmup training on the simulator was required (n = 9) or not (n = 12). Performance at the simulator was measured using the built-in scoring metrics. The surgical performance was determined by two blinded observers who analyzed the video-recorded interventions. One of them repeated the analysis to check for intra-observer consistency. The surgical performance of the interventions with and without simulator training was compared. In addition, for the surgeries with simulator training, the simulator performance was compared to the performance in the operating room. Results Comparing each surgeon’s performance with and without warmup trainingshowed a significant effect of warmup training onto the final outcome in the operating room. For the surgeries that were preceeded by the warmup procedure, the performance at the simulator was compared with the operating room performance. We found that there is a significant relation. The governing factor of low scores in the simulator were iatrogenic retinal holes, bleedings and lens damage. Surgeons who caused minor damage in the simulation also performed well in the operating room. Conclusions Despite the large variation of conditions, the effect of a warmup training as well as a relation between the performance at the simulator and in the operating room was found with statistical significance. Simulator training is able to serve as a warmup to increase the average performance. PMID:26964040

  4. Infection Control Practice in the Operating Room: Staff Adherence to Existing Policies in a Developing Country

    PubMed Central

    Cawich, Shamir O; Tennant, Ingrid A; McGaw, Clarence D; Harding, Hyacinth; Walters, Christine A; Crandon, Ivor W

    2013-01-01

    Context: Infection control interventions are important for containing surgery-related infections. For this reason, the modern operating room (OR) should have well-developed infection control policies. The efficacy of these policies depends on how well the OR staff adhere to them. There is a lack of available data documenting adherence to infection control policies. Objective: To evaluate OR staff adherence to existing infection control policies in Jamaica. Methods: We administered a questionnaire to all OR staff to assess their training, knowledge of local infection control protocols, and practice with regard to 8 randomly selected guidelines. Adherence to each guideline was rated with fixed-choice items on a 4-point Likert scale. The sum of points determined the adherence score. Two respondent groups were defined: adherent (score > 26) and nonadherent (score ≤ 26). We evaluated the relationship between respondent group and age, sex, occupational rank, and time since completion of basic medical training. We used χ2 and Fisher exact tests to assess associations and t tests to compare means between variables of interest. Results: The sample comprised 132 participants (90 physicians and 42 nurses) with a mean age of 36 (standard deviation ± 9.5) years. Overall, 40.1% were adherent to existing protocols. There was no significant association between the distribution of adherence scores and sex (p = 0.319), time since completion of basic training (p = 0.595), occupational rank (p = 0.461), or age (p = 0.949). Overall, 19% felt their knowledge of infection control practices was inadequate. Those with working knowledge of infection control practices attained it mostly through informal communication (80.4%) and self-directed research (62.6%). Conclusion: New approaches to the problem of nonadherence to infection control guidelines are needed in the Caribbean. Several unique cultural, financial, and environmental factors influence adherence in this region, in contrast to

  5. Expert Guidance: Healthcare Personnel Attire in Non-Operating Room Settings

    PubMed Central

    Bearman, Gonzalo; Bryant, Kristina; Leekha, Surbhi; Mayer, Jeanmarie; Munoz-Price, L. Silvia; Murthy, Rekha; Palmore, Tara; Rupp, Mark E.; White, Joshua

    2016-01-01

    Healthcare personnel (HCP) attire is an aspect of the medical profession steeped in culture and tradition. The role of attire in cross-transmission remains poorly established and until more definitive information exists, priority should be placed on evidence-based measures to prevent hospital acquired infections (HAI). This paper aims to provide a general guidance to the medical community regarding HCP attire outside the operating room. In addition to the initial guidance statement, the manuscript has three major components: 1. A review and interpretation of the medical literature regarding a) perceptions of HCP attire (from both HCP and patients) and b) evidence for contamination of attire and its potential contribution to cross-transmission; 2. A review of hospital policies related to HCP attire, as submitted by members of the SHEA Guidelines Committee; 3. A survey of SHEA and SHEA Research Network members, which assessed both institutional HCP attire policies and perceptions of HCP attire in the cross-transmission of pathogens. Recommendations for HCP attire should attempt to balance professional appearance, comfort, and practicality with the potential role of apparel in the cross-transmission of pathogens. Although the optimal choice of HCP attire for inpatient care remains undefined, we provide recommendations on the use of white coats, neck ties, footwear, the bare-below-the-elbows strategy, and laundering. Institutions considering these optional measures should introduce them with a well-organized communication and education effort directed at both HCP and patients. Appropriately designed studies are needed to better define the relationship between HCP attire and HAIs. PMID:24442071

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

    PubMed

    Gibbs, Verna C

    2012-12-14

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

  7. [Business organization theory: its potential use in the organization of the operating room].

    PubMed

    Bartz, H-J

    2005-07-01

    The paradigm of patient care in the German health system is changing. The introduction of German Diagnosis Related Groups (G-DRGs), a diagnosis-related coding system, has made process-oriented thinking increasingly important. The treatment process is viewed and managed as a whole from the admission to the discharge of the patient. The interfaces of departments and sectors are diminished. A main objective of these measures is to render patient care more cost efficient. Within the hospital, the operating room (OR) is the most expensive factor accounting for 25 - 50 % of the costs of a surgical patient and is also a bottleneck in the surgical patient care. Therefore, controlling of the perioperative treatment process is getting more and more important. Here, the business organisation theory can be a very useful tool. Especially the concepts of process organisation and process management can be applied to hospitals. Process-oriented thinking uncovers and solves typical organisational problems. Competences, responsibilities and tasks are reorganised by process orientation and the enterprise is gradually transformed to a process-oriented system. Process management includes objective-oriented controlling of the value chain of an enterprise with regard to quality, time, costs and customer satisfaction. The quality of the process is continuously improved using process-management techniques. The main advantage of process management is consistent customer orientation. Customer orientation means to be aware of the customer's needs at any time during the daily routine. The performance is therefore always directed towards current market requirements. This paper presents the basics of business organisation theory and to point out its potential use in the organisation of the OR. PMID:16001317

  8. Minimally Invasive Catheter Procedures to Assist Complicated Pacemaker Lead Extraction and Implantation in the Operating Room

    SciTech Connect

    Kroepil, Patric; Lanzman, Rotem S. Miese, Falk R.; Blondin, Dirk; Winter, Joachim; Scherer, Axel; Fuerst, Guenter

    2011-04-15

    We report on percutaneous catheter procedures in the operating room (OR) to assist complicated manual extraction or insertion of pacemaker (PM) and implantable cardioverter defibrillator leads. We retrospectively reviewed complicated PM revisions and implantations performed between 2004 and 2009 that required percutaneous catheter procedures performed in the OR. The type of interventional procedure, catheter and retrieval system used, venous access, success rates, and procedural complications were analyzed. In 41 (12 female and 29 male [mean age 62 {+-} 17 years]) of 3021 (1.4%) patients, standard manual retrieval of old leads or insertion of new leads was not achievable and thus required percutaneous catheter intervention for retrieval of misplaced leads and/or recanalisation of occluded central veins. Thirteen of 18 (72.2%) catheter-guided retrieval procedures for misplaced (right atrium [RA] or ventricle [RV; n = 3], superior vena cava [n = 2], brachiocephalic vein [n = 5], and subclavian vein [n = 3]) lead fragments in 16 patients were successful. Percutaneous catheter retrieval failed in five patients because there were extremely fixed or adhered lead fragments. Percutaneous transluminal angiography (PTA) of central veins for occlusion or high-grade stenosis was performed in 25 patients. In 22 of 25 patients (88%), recanalization of central veins was successful, thus enabling subsequent lead replacement. Major periprocedural complications were not observed. In the case of complicated manual PM lead implantation or revision, percutaneous catheter-guided extraction of misplaced lead fragments or recanalisation of central veins can be performed safely in the OR, thus enabling subsequent implantation or revision of PM systems in the majority of patients.

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

    PubMed Central

    Gibbs, Verna C

    2012-01-01

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

  10. Factitious disease: clinical lessons from case studies at Baylor University Medical Center

    PubMed Central

    Savino, Adria C.; Fordtran, John S.

    2006-01-01

    Factitious disease is defined as the intentional production (or feigning) of disease in oneself to relieve emotional distress by assuming the role of a sick person. Although the self-induction of disease is a conscious act, the underlying motivation is usually unconscious. It has been estimated that 3% to 5% of physician-patient encounters involve factitious disease. This article presents 6 case studies from Baylor University Medical Center that highlight various clinical aspects of factitious disease. Patients with factitious diseases are extremely difficult to recognize because they do not appear different from patients with authentic causes of similar symptoms, because their psychiatric abnormalities are not appreciated, and because doctors and nurses have alowindex of suspicion. Since patients with factitious disease present a false medicalhistory, their physicians prescribe unnecessary procedures and therapies that may result in iatrogenic disease. In many cases, damage to these patients from doctors' actions exceeds the harm resulting from the patients' self-induced illness. The clues that should suggest factitious disease, the diagnostic roles of the clinician and a consulting psychiatrist, and the ethical conflicts that confront doctors taking care of such patients are discussed. To help keep factitious disease in clinical perspective, one of the case studies involves the antithesis of factitious disease, where a patient was mistakenly diagnosed as having psychogenic pain when in fact the symptoms were caused by an overlooked physical disease. Better knowledge of the clinical features of factitious disease might have prevented the disastrous outcome. PMID:17252033

  11. Creating an Evidence-Based Dentistry Culture at Baylor College of Dentistry: The Winds of Change

    PubMed Central

    Hinton, Robert J.; Dechow, Paul C.; Abdellatif, Hoda; Jones, Daniel L.; McCann, Ann L.; Schneiderman, Emet D.; D’Souza, Rena

    2011-01-01

    In the early years of the new millennium, the National Institute of Dental and Craniofacial Research of the National Institutes of Health began funding Oral Health Research Education Grants using the R25 mechanism to promote the application of basic and clinical research findings to clinical training and to encourage students to pursue careers in oral health research. This report describes the impact of an R25 grant awarded to the Texas A&M Health Science Center’s Baylor College of Dentistry (BCD) on its curriculum and faculty development efforts. At BCD, the R25 grant supports a multipronged initiative that employs clinical research as a vehicle for acquainting both students and faculty with the tools of evidence-based dentistry (EBD). New coursework and experiences in all four years of the curriculum plus a variety of faculty development offerings are being used to achieve this goal. Progress on these fronts is reflected in a nascent EBD culture characterized by increasing participation and buy-in by students and faculty. The production of a new generation of dental graduates equipped with the EBD skill set as well as a growing nucleus of faculty members who can model the importance of evidence-based practice is of paramount importance for the future of dentistry. PMID:21368252

  12. Thoracic outlet syndrome: a 50-year experience at Baylor University Medical Center

    PubMed Central

    Kourlis, Harry

    2007-01-01

    During the past 5 decades, the recognition and management of thoracic outlet syndrome (TOS) have evolved. This article elucidates these changes and improvements in the diagnosis and management of TOS at Baylor University Medical Center. The most remarkable change over the past 50 years is the use of nerve conduction velocity to diagnose and monitor patients with nerve compression. Recognition that procedures such as breast implantation and median sternotomy may produce TOS has been revealing. Prompt thrombolysis followed by surgical venous decompression for Paget-Schroetter syndrome has markedly improved results compared with the conservative anticoagulation approach; thrombolysis and prompt first rib resection is the optimal treatment for most patients with Paget-Schroetter syndrome. Complete first rib extirpation at the initial procedure markedly reduces the incidence of recurrent neurologic symptoms or the need for a second procedure. Chest pain or pseudoangina can be caused by TOS. Dorsal sympathectomy is helpful for patients with sympathetic maintained pain syndrome or causalgia and patients with recurrent TOS symptoms who need a second procedure. PMID:17431445

  13. Review of behavioral health integration in primary care at Baylor Scott and White Healthcare, Central Region

    PubMed Central

    Fluet, Norman R.; Reis, Michael D.; Stern, Charles H.; Thompson, Alexander W.; Jolly, Gillian A.

    2016-01-01

    The integration of behavioral health services in primary care has been referred to in many ways, but ultimately refers to common structures and processes. Behavioral health is integrated into primary care because it increases the effectiveness and efficiency of providing care and reduces costs in the care of primary care patients. Reimbursement is one factor, if not the main factor, that determines the level of integration that can be achieved. The federal health reform agenda supports changes that will eventually permit behavioral health to be fully integrated and will allow the health of the population to be the primary target of intervention. In an effort to develop more integrated services at Baylor Scott and White Healthcare, models of integration are reviewed and the advantages and disadvantages of each model are discussed. Recommendations to increase integration include adopting a disease management model with care management, planned guideline-based stepped care, follow-up, and treatment monitoring. Population-based interventions can be completed at the pace of the development of alternative reimbursement methods. The program should be based upon patient-centered medical home standards, and research is needed throughout the program development process. PMID:27034543

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

    PubMed

    Dexter, Franklin; Epstein, Richard H

    2015-12-01

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

  15. Metal-Based Room-Temperature Operating Single Electron Devices Using Scanning Probe Oxidation

    NASA Astrophysics Data System (ADS)

    Matsumoto, Kazuhiko; Gotoh, Yoshitaka; TatsuroMaeda, TatsuroMaeda; Dagata, John; Harris, JamesS.

    1999-01-01

    Coulomb oscillation was clearly observed at room temperature in the singleelectron transistor fabricated by atomic force microscopy (AFM) nano-oxidationprocess. In order to obtain a clear Coulomb oscillation at room temperature, newand improved fabrication processes and measurement systems such as a pulse-modeAFM nano-oxidation process and a triaxial active feedback measurement system areintroduced. The Coulomb oscillation peaks appear with the period of 1.9 V at thedrain bias conditions of 0.25 V and 0.3 V. The current modulation rate ranges from20% to 30%.

  16. 21 CFR 113.87 - Operations in the thermal processing room.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... Section 113.87 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) FOOD FOR HUMAN CONSUMPTION THERMALLY PROCESSED LOW-ACID FOODS PACKAGED IN HERMETICALLY SEALED... Food and Drug Administration. (b) A system for product traffic control in the retort room shall...

  17. 21 CFR 113.87 - Operations in the thermal processing room.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... Section 113.87 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) FOOD FOR HUMAN CONSUMPTION THERMALLY PROCESSED LOW-ACID FOODS PACKAGED IN HERMETICALLY SEALED... Food and Drug Administration. (b) A system for product traffic control in the retort room shall...

  18. 21 CFR 113.87 - Operations in the thermal processing room.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... Section 113.87 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) FOOD FOR HUMAN CONSUMPTION THERMALLY PROCESSED LOW-ACID FOODS PACKAGED IN HERMETICALLY SEALED... Food and Drug Administration. (b) A system for product traffic control in the retort room shall...

  19. 21 CFR 113.87 - Operations in the thermal processing room.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... Section 113.87 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) FOOD FOR HUMAN CONSUMPTION THERMALLY PROCESSED LOW-ACID FOODS PACKAGED IN HERMETICALLY SEALED... Food and Drug Administration. (b) A system for product traffic control in the retort room shall...

  20. Room-temperature repositioning of individual C60 molecules at Cu steps: Operation of a molecular counting device

    NASA Astrophysics Data System (ADS)

    Cuberes, M. T.; Schlittler, R. R.; Gimzewski, J. K.

    1996-11-01

    C60 molecules absorbed on a monoatomic Cu step have been reversibly repositioned at room temperature with the tip of a scanning tunneling microscope by performing controlled displacements along the step direction. We demonstrate the feasibility of building an abacus on the nanometer scale using single molecules as ``counters,'' Cu monoatomic steps as ``rods'' that constrain the molecular motion to one dimension, and the scanning tunneling microscope as an ``actuator'' for counting operations.

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

    PubMed Central

    Rosen, A.C.; Dexter, F.

    2009-01-01

    Foglia et al. (in press) describe tension in two veteran's hospitals among managers, clinicians, and patients over allocating appropriate resources to support care and inefficiencies in care delivery. Ultimately ethical healthcare in a system which is committed to caring for an entire population of patients must use its limited resources effectively while not compromising patient safety. This discussion gives examples from operating room management in which systematic analyses of existing data can guide more efficient care delivery. PMID:19326313

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

    PubMed

    Kirschbaum, Kristin

    2012-01-01

    Communication variables that are associated with face-negotiation theory were examined in a sample of operating-room physicians. A survey was administered to anesthesiologists and surgeons at a teaching hospital in the southwestern United States to measure three variables commonly associated with face-negotiation theory: conflict-management style, face concern, and self-construal. The survey instrument that was administered to physicians includes items that measured these three variables in previous face-negotiation research with slight modification of item wording for relevance in the medical setting. The physician data were analyzed using confirmatory factor analysis, Pearson's correlations, and t-tests. Results of this initial investigation showed that variables associated with face-negotiation theory were evident in the sample physician population. In addition, the correlations were similar among variables in the medical sample as those found in previous face-negotiation research. Finally, t-tests suggest variance between anesthesiologists and surgeons on specific communication variables. These findings suggest three implications that warrant further investigation with expanded sample size: (1) An intercultural communication theory and instrument can be utilized for health communication research; (2) as applied in a medical context, face-negotiation theory can be expanded beyond traditional intercultural communication boundaries; and (3) theoretically based communication structures applied in a medical context could help explain physician miscommunication in the operating room to assist future design of communication training programs for operating-room physicians. PMID:21899403

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

    PubMed

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

    2012-01-01

    Currently, there is a trend in nuclear power plants (NPPs) toward introducing digital and computer technologies into main control rooms (MCRs). Safe generation of electric power in NPPs requires reliable performance of cognitive tasks such as fault detection, diagnosis, and response planning. The digitalization of MCRs has dramatically changed the whole operating environment, and the ways operators interact with the plant systems. If the design and implementation of the digital technology is incompatible with operators' cognitive characteristics, it may have negative effects on operators' cognitive reliability. Firstly, on the basis of three essential prerequisites for successful cognitive tasks, a causal model is constructed to reveal the typical human performance issues arising from digitalization. The cognitive mechanisms which they impact cognitive reliability are analyzed in detail. Then, Bayesian inference is used to quantify and prioritize the influences of these factors. It suggests that interface management and unbalanced workload distribution have more significant impacts on operators' cognitive reliability. PMID:22316806

  4. Surgeon's satisfaction on the use of invented needle magnet in reducing the risk of sharp injuries in the operating room

    PubMed Central

    Rahmati, Hashem; Sharif, Farkhondeh; Davarpanah, Mohammad Ali

    2014-01-01

    Background: Healthcare workers, especially operating room personnel, are at increased risk for sharps injury and transmission of blood-borne pathogens as a result of their occupation. Infection with these pathogens occurs mainly by percutaneous or mucocutaneous exposure to blood-borne pathogens. This study evaluated the effectiveness of using invented needle magnet in reducing the risk of sharp injuries in the operating room. Materials and Methods: The needle magnet device is consisted of three parts: a cap, a magnet and a metal container. It was invented by the authors for the first time in Iran. The average weight of this device is 200 g and it can be easily placed near the surgery field or on the myostand. It has magnetic properties that attracts the sharp pointed particles during surgery and preserve them in a protected space. The device was used in surgical field by 33 surgeons during 90 surgical operations. Then, the satisfaction of participants and effectiveness of the device in protection against sharps injury was evaluated by a questionnaire. Results: Thirty-one surgeons (94%) believed that needle magnet reduces dispersion of sharp instruments; 79% of the participants suggested that our device reduces sharps injury during operation; 29 surgeons (88%) intended to use this device during operation. Thus, the use of needle magnet within surgical field may reduce the chances of sharps injury during surgery. Conclusion: The use of needle magnet within surgical field reduces the chance of sharp injury during surgery and the surgeons were satisfied with its use. PMID:25013253

  5. Long-term and room temperature operable bioactuator powered by insect dorsal vessel tissue.

    PubMed

    Akiyama, Yoshitake; Iwabuchi, Kikuo; Furukawa, Yuji; Morishima, Keisuke

    2009-01-01

    We present a bioactuator powered by insect dorsal vessel tissue which can work for a long time at room temperature without maintenance. Previously reported bioactuators which exploit contracting ability of mammalian heart muscle cell have required precise environmental control to keep the cell alive and contracting. To overcome this problem, we propose a bioactuator using dorsal vessel tissue. The insect tissue which can grow at room temperature is generally robust over a range of culture conditions compared to mammalian tissues and cells. First, we confirm that a dorsal vessel tissue of lepidoptera larva Ctenoplusia agnata contracts spontaneously for at least 30 days without medium replacement at 25 degrees C. Using the dorsal vessel tissue cultured under the same conditions, we succeed in driving micropillars 100 microm in diameter and 1000 microm in height for more than 90 days. The strongest displacement of the micropillar top occurs on the 42(nd) day and is 23 microm. Based on these results, the contracting force is roughly estimated as 4.7 microN which is larger than that by a few mammalian cardiomyocytes (3.4 microN). Definite displacements of more than 10 microm are observed for 58 days from the 15(th) to the 72(nd) days. The number of life cycles can be roughly calculated as 7.5 x 10(5) times for the average frequency of about 0.15 Hz, which is no less than that of conventional mechanical actuators. These results suggest that the insect dorsal vessel tissue is a more promising material for bioactuators used at room temperature than other biological cell-based materials. PMID:19209346

  6. Impact of assembly, testing and launch operations on the airborne bacterial diversity within a spacecraft assembly facility clean-room

    NASA Astrophysics Data System (ADS)

    Newcombe, David A.; La Duc, Myron T.; Vaishampayan, Parag; Venkateswaran, Kasthuri

    2008-10-01

    In an effort to minimize the probability of forward contamination of pristine extraterrestrial environments, the National Aeronautics and Space Administration requires that all US robotic spacecraft undergo assembly, testing and launch operations (ATLO) in controlled clean-room environments. This study examines the impact of ATLO activity on the microbial diversity and overall bioburden contained within the air of the clean-room facility in which the Mars Exploration Rovers (MERs) underwent final preparations for launch. Air samples were collected from several facility locations and traditional culture-based and molecular methodologies were used to measure microbial burden and diversity. Surprisingly, the greatest estimates of airborne bioburden, as derived from ATP content and cultivation assays, were observed prior to the commencement of MER ATLO activities. Furthermore, airborne microbial diversity gradually declined from the initiation of ATLO on through to launch. Proteobacterial sequences were common in 16S rDNA clone libraries. Conspicuously absent were members of the Firmicutes phylum, which includes the genus Bacillus. In previous studies, species of this genus were repeatedly isolated from the surfaces of spacecraft and clean-room assembly facilities. Increased cleaning and maintenance initiated immediately prior to the start of ATLO activity could explain the observed declines in both airborne bioburden and microbial diversity.

  7. Team interaction skills evaluation criteria for nuclear power plant control room operators

    SciTech Connect

    Montgomery, J.C.; Toquam, J.; Gaddy, C.

    1991-09-01

    Previous research has shown the value of good team interaction skills to group performance, yet little progress has been made on in terms of how such skills can be measured. In this study rating scales developed previously (Montgomery, et al., 1990) were extensively revised and cast into a Behaviorally Anchored Rating Scale (BARS) and a Behavioral Frequency format. Rating data were collected using 13 training instructors at the Diablo Canyon Nuclear Plant, who rated three videotapes of simulator scenario performance during a day-long training session and later evaluated control room crews during requalification training. High levels of interrater agreement on both rating scales were found. However, the factor structure of the ratings was generally inconsistent with that hypothesized. Analysis of training ratings using Cronbach`s components of accuracy (Cronbach, 1955) indicated that BARS ratings generally exhibited less error than did the Behavioral Frequency ratings. The results are discussed in terms of both field and research implications.

  8. Liquid Phase Chemical-Enhanced Oxidation for GaAs Operated Near Room Temperature

    NASA Astrophysics Data System (ADS)

    Wang, Hwei-Heng; Huang, Chien-Jung; Wang, Yeong-Her; Houng, Mau-Phon

    1998-01-01

    A new chemical enhanced oxidation method for gallium arsenide (GaAs) in liquid phase near room temperature (40°C 70°C) is proposed and investigated. Featureless oxide layers with good uniformity and reliability can be grown efficiently on GaAs without any extra energy source. A relatively high oxidation rate (≃1000 Å/h), about 50 times higher than that obtained during oxidation in boiling water has been realized. Based on the results of X-ray photoelectron spectroscopy (XPS), excellent chemical stability after thermal annealing as well as good chemical stoichiometry have been realized. The oxide was determined to be composed of Ga2O3 and As2O3.

  9. A novel technique for identifying opportunities to improve environmental hygiene in the operating room.

    PubMed

    Jefferson, Julie; Whelan, Rita; Dick, Brian; Carling, Philip

    2011-03-01

    Environmental cleaning and disinfection is essential for optimizing safe patient care in the OR; however, perioperative staff members have not had an easy-to-use, objective method for determining whether high-touch, potentially contaminated surfaces have been cleaned during terminal room cleaning. To address this issue, members of the Healthcare Environmental Hygiene Study Group used a transparent, removable, environmentally stable disclosing agent and handheld ultraviolet light to determine whether potentially contaminated surfaces had been contacted by a wet disinfection cleaning cloth during terminal cleaning of ORs. Results from the project showed that 237 of 946 targeted surfaces (25%) had the disclosing agent removed (ie, were cleaned). The use of the disclosing agent for staff education and process monitoring has led to significant improvements in the disinfection cleaning process. PMID:21353808

  10. Submilliampere continuous-wave room-temperature lasing operation of a GaAs mushroom structure surface-emitting laser

    SciTech Connect

    Yang, Y.J.; Dziura, T.G.; Wang, S.C. ); Hsin, W.; Wang, S. Electronics Research Laboratory, University of California, Berkeley, California 94720 )

    1990-05-07

    We report a GaAs mushroom structure surface-emitting laser at 900 nm with submilliampere (0.2--0.5 mA) threshold under room-temperature cw operation for the first time. The very low threshold current was achieved on devices which consisted of a 2--4 {mu}m diameter active region formed by chemical selective etching, and sandwiched between two Al{sub 0.05}Ga{sub 0.95} As/ Al{sub 0.53}Ga{sub 0.47} As distributed Bragg reflectors of very high reflectivity (98--99%) grown by metalorganic chemical vapor deposition.

  11. The gender of authors in the Baylor Proceedings: a reflection of both current staff composition and lesser number of publications by female physicians

    PubMed Central

    Paul, Ashley; Thakur, Richa; Bass, Kyle; East, Cara

    2015-01-01

    Gender parity has been achieved in entrance to medical school, but women still constitute only 32% of the physicians licensed to practice in the state of Texas. Similarly, female physicians lag behind in scholarly publications. This gender imbalance appears to be improving, although parity has yet to be achieved in many journals. We could reliably obtain the gender of both the physician staff of the North Division of Baylor Scott & White Health and of the authors in Baylor University Medical Center Proceedings. Of the Baylor authors, 19% were female physicians, while 65% were male physicians (others were nonphysicians). The gender makeup of the total staff was 27% female and 73% male physicians. Thus, female authorship is only 70% as great as the number of female staff physicians. We suggest ways to encourage more women to submit publications. PMID:26424940

  12. Design and Development of Functionally Operative and Visually Appealing Remote Firing Room Displays

    NASA Technical Reports Server (NTRS)

    Quaranto, Kristy

    2014-01-01

    This internship provided an opportunity for an intern to work with NASA's Ground Support Equipment (GSE) for the Spaceport Command and Control System (SCCS) at Kennedy Space Center as a remote display developer, under NASA mentor Kurt Leucht. The main focus was on creating remote displays for the hypergolic and high pressure helium subsystem team to help control the filling of the respective tanks. As a remote display developer for the GSE hypergolic and high pressure helium subsystem team the intern was responsible for creating and testing graphical remote displays to be used in the Launch Control Center (LCC) on the Firing Room's computer monitors. To become more familiar with the subsystem, the individual attended multiple project meetings and acquired their specific requirements regarding what needed to be included in the remote displays. After receiving the requirements, the next step was to create a display that had both visual appeal and logical order using the Display Editor, on the Virtual Machine (VM). In doing so, all Compact Unique Identifiers (CUI), which are associated with specific components within the subsystem, will need to be included in each respective display for the system to run properly. Then, once the display was created it needed to be tested to ensure that the display runs as intended by using the Test Driver, also found on the VM. This Test Driver is a specific application that checks to make sure all the CUIs in the display are running properly and returning the correct form of information. After creating and locally testing the display it will need to go through further testing and evaluation before deemed suitable for actual use. By the end of the semester long experience at NASA's Kennedy Space Center, the individual should have gained great knowledge and experience in various areas of display development and testing. They were able to demonstrate this new knowledge obtained by creating multiple successful remote displays that will

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

    PubMed

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

    2001-01-01

    This prospective randomized study compares the effects of rocuronium (R) and vecuronium (V) on the early postoperative period in infants. Forty-eight infants between the ages of three and six, scheduled for elective ENT procedures, were studied after prior approval of local ethics committee and informed parental consent. All children were premedicated with chlorprotixene and belladonna. Anaesthesia was induced with 5 mg/kg thiopentone and 1 vol.-% halothane. Subsequently, 0.4 mg/kg rocuronium or 0.075 mg/kg vecuronium were administered, respectively. Anaesthesia and post-operative care were conducted by independent anaesthetists, who were unaware of the drug used and of the relaxometric data obtained. All children were monitored in the recovery room by pulse oximetry until they reached a Steward Score of 6. Demographic data did not differ between the groups. No differences were recorded between the non-depolarizing relaxants regarding intubation time (R: 24.1 +/- 4.2 min, V: 25.8 +/- 6.8 min) and the time interval from end extubation to leaving the operating theatre (R: 2.3 +/- 0.8 min, V: 2.6 +/- 1.2 min), respectively. Similarly, no differences in SaO2 were noted during the recovery period in the recovery room. Significant differences between the non-depolarizing relaxants were found in the TOF-ratios at extubation (R: 0.73 +/- 0.31 min, V: 0.48 +/- 0.34 min) and arrival in the recovery room (R: 0.88 +/- 0.21 min, V: 0.69 +/- 0.26 min). 0.4 mg/kg Rocuronium and 0.075 mg/kg vecuronium can be used for intubation during short operations on pre-school children. Rocuronium may be the better alternative, due to its faster neuromuscular recovery properties. PMID:11455866

  14. Efficient operation of a room-temperature Nd:YAG 946-nm laser pumped with multiple diode arrays

    SciTech Connect

    Hanson, F.

    1995-01-15

    Efficient pulsed room-temperature laser operation at 946 nm is reported for Nd:YAG pumped with multiple diode array bars. We achieved high pump brightness by collimating the outputs from individual bars and focusing them onto the end of a short 3-mm-diameter rod. An average power of 470 mW at 100 Hz was obtained with an optical slope efficiency of 15% based on incident pump power, and greater than 1 W of output was obtained at 300 Hz. Intracavity frequency doubling with KNbO{sub 3} resulted in 40--70-mW output at 473 nm. {ital Q}-switched operation is also reported.

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

    PubMed

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

    2016-01-01

    Shift work is associated with both sleepiness and reduced performance. The aim of this study was to examine cognitive performance, sleepiness, and sleep quality among petrochemical control room shift workers. Sixty shift workers participated in this study. Cognitive performance was evaluated using a number of objective tests, including continuous performance test, n-back test, and simple reaction time test; sleepiness was measured using the subjective Karolinska Sleepiness Scale (KSS); and sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI) questionnaire. ANCOVA, t-test, and repeated-measures ANOVA were applied for statistical analyses, and the significance level was set at p < 0.05. All variables related to cognitive performance, except for omission error, significantly decreased at the end of both day and night shifts (p < 0.0001). There were also significant differences between the day and night shifts in terms of the variables of omission error (p < 0.027) and commission error (p < 0.036). A significant difference was also observed between daily and nightly trends of sleepiness (p < 0.0001) so that sleepiness was higher for the night shift. Participants had low sleep quality on both day and night shifts, and there were significant differences between the day and night shifts in terms of subjective sleep quality and quantity (p < 0.01). Long working hours per shift result in fatigue, irregularities in the circadian rhythm and the cycle of sleep, induced cognitive performance decline at the end of both day and night shifts, and increased sleepiness in night shift. It, thus, seems necessary to take ergonomic measures such as planning for more appropriate shift work and reducing working hours. PMID:27103934

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

    PubMed Central

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

    2016-01-01

    Shift work is associated with both sleepiness and reduced performance. The aim of this study was to examine cognitive performance, sleepiness, and sleep quality among petrochemical control room shift workers. Sixty shift workers participated in this study. Cognitive performance was evaluated using a number of objective tests, including continuous performance test, n-back test, and simple reaction time test; sleepiness was measured using the subjective Karolinska Sleepiness Scale (KSS); and sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI) questionnaire. ANCOVA, t-test, and repeated-measures ANOVA were applied for statistical analyses, and the significance level was set at p < 0.05. All variables related to cognitive performance, except for omission error, significantly decreased at the end of both day and night shifts (p < 0.0001). There were also significant differences between the day and night shifts in terms of the variables of omission error (p < 0.027) and commission error (p < 0.036). A significant difference was also observed between daily and nightly trends of sleepiness (p < 0.0001) so that sleepiness was higher for the night shift. Participants had low sleep quality on both day and night shifts, and there were significant differences between the day and night shifts in terms of subjective sleep quality and quantity (p < 0.01). Long working hours per shift result in fatigue, irregularities in the circadian rhythm and the cycle of sleep, induced cognitive performance decline at the end of both day and night shifts, and increased sleepiness in night shift. It, thus, seems necessary to take ergonomic measures such as planning for more appropriate shift work and reducing working hours. PMID:27103934

  17. Room temperature Dy:YLF laser operation at 4.34 micron

    NASA Technical Reports Server (NTRS)

    Barnes, Norman P.; Allen, Roger E.

    1991-01-01

    A Dy:YLF laser operating on the 6H11/2 to 6H13/2 transition at 4.34 micron and using a laser pumping scheme is reported. This pumping scheme is necessitated by the short upper-laser-level lifetime and the small effective stimulated-emission cross section. A suitable laser for this application is the Er:YLF laser operating at 1.73 micron. A simple model that approximates Dy:YLF laser performance well is presented. Results on laser performance, including a determination of the slope efficiency and threshold as a function of the output mirror reflectivity and a correlation of the pulse length with the laser output energy, are reported. Overall laser efficiency is found to be limited primarily by the ratio of the pump wavelength to laser output wavelength and the terminated four-level laser operation. Spectroscopic results, including the measurement of the absorption spectra and the lifetimes of both the upper- and lower-laser manifolds, are given.

  18. A new sensor for ammonia based on cyanidin-sensitized titanium dioxide film operating at room temperature.

    PubMed

    Huang, Xiao-wei; Zou, Xiao-bo; Shi, Ji-yong; Zhao, Jie-wen; Li, Yanxiao; Hao, Limin; Zhang, Jianchun

    2013-07-17

    Design and fabrication of an ammonia sensor operating at room temperature based on pigment-sensitized TiO2 films was described. TiO2 was prepared by sol-gel method and deposited on glass slides containing gold electrodes. Then, the film immersed in a 2.5×10(-4)M ethanol solution of cyanidin to absorb the pigment. The hybrid organic-inorganic formed film here can detect ammonia reversibly at room temperature. The relative change resistance of the films at a potential difference of 1.5V is determined when the films are exposed to atmospheres containing ammonia vapors with concentrations over the range 10-50 ppm. The relative change resistance, S, of the films increased almost linearly with increasing concentrations of ammonia (r=0.92). The response time to increasing concentrations of the ammonia is about 180-220 s, and the corresponding values for decreasing concentrations 240-270 s. At low humidity, ammonia could be ionized by the cyanidin on the TiO2 film and thereby decrease in the proton concentration at the surface. Consequently, more positively charged holes at the surface of the TiO2 have to be extracted to neutralize the adsorbed cyanidin and water film. The resistance response to ammonia of the sensors was nearly independent on temperature from 10 to 50°C. These results are not actually as good as those reported in the literature, but this preliminary work proposes simpler and cheaper processes to realize NH3 sensor for room temperature applications. PMID:23830444

  19. A 5-year observational study of cancellations in the operating room: Does the introduction of preoperative preparation have an impact?

    PubMed Central

    McKendrick, Douglas R. A.; Cumming, Grant P.; Lee, Amanda J.

    2014-01-01

    Background: Preoperative preparation (assessment) of patients reduces cancellations on the day of surgery. A Center for Reviews and Dissemination review (2007) concluded “the evidence was weak and it was uncertain that preassessment reduced cancellations.” The aim of this study was to observe the impact of a preoperative preparation clinic on cancellations of operating room cases on the day of surgery, and in particular on those causes of cancellation on the day of surgery which were expected to be affected by preoperative preparation. Materials and Methods: Observational study conducted in a 194 bed District General Hospital in the United Kingdom from April 1, 2006 to March 31, 2011. 42,082 operating room cases were scheduled for operation during this period. Surgical sessions which did not require anesthetic input were excluded. Contemporaneous data were collected and analyzed on a monthly basis, and also grouped by year over a 5-year period. The cancellations on the day of surgery were divided into two groups: Those considered to be affected by preoperative preparation and those which were not. Comparisons were made between these two groups and between individual reasons for cancellation. Results: A total of 28,928 cases met the inclusion criteria. The clinic introduction reduced cancellations considered to be affected by preoperative preparation from 462 to 177 (78% and 42% total cancellations, respectively) (P < 0.001). There was a decrease in cancellations due to patients who did not arrive (P < 0.001) and medical reasons (P < 0.001), but an increase in the number of cancellations by the patients themselves (P = 0.002). Cancellations due to lack of beds and “other” reasons both increased (P < 0.001) across the study period. Conclusions: This study suggests that the introduction of preoperative preparation clinics for patients reduces cancellations on the day of surgery. PMID:25538529

  20. [Optimization of working in the operating room by minimizing losses and improving flow].

    PubMed

    Leppikangas, Heli; Puolakka, Pia; Korppi, Anssi; Heikki-Jussi, Laine

    2015-01-01

    The need for development of practices within the Finnish healthcare system is immense. Economic threats will force the system to streamline treatment processes without sacrificing quality. Surgical operations bind resources and represent one of the most expensive units in the hospital. By developing the respective procedures it is possible to achieve significant changes in the patient's entire care pathway. Lean is a practical management philosophy involving fairly expedient and structured methods of work development. On the basis of available research results and practical experiences Lean is very well suited for a method of development of practices within healthcare. PMID:26638349

  1. Effect of Temperature on the Aging rate of Li Ion Battery Operating above Room Temperature

    NASA Astrophysics Data System (ADS)

    Leng, Feng; Tan, Cher Ming; Pecht, Michael

    2015-08-01

    Temperature is known to have a significant impact on the performance, safety, and cycle lifetime of lithium-ion batteries (LiB). However, the comprehensive effects of temperature on the cyclic aging rate of LiB have yet to be found. We use an electrochemistry-based model (ECBE) here to measure the effects on the aging behavior of cycled LiB operating within the temperature range of 25 °C to 55 °C. The increasing degradation rate of the maximum charge storage of LiB during cycling at elevated temperature is found to relate mainly to the degradations at the electrodes, and that the degradation of LCO cathode is larger than graphite anode at elevated temperature. In particular, the formation and modification of the surface films on the electrodes as well as structural/phase changes of the LCO electrode, as reported in the literatures, are found to be the main contributors to the increasing degradation rate of the maximum charge storage of LiB with temperature for the specific operating temperature range. Larger increases in the Warburg elements and cell impedance are also found with cycling at higher temperature, but they do not seriously affect the state of health (SoH) of LiB as shown in this work.

  2. Effect of Temperature on the Aging rate of Li Ion Battery Operating above Room Temperature

    PubMed Central

    Leng, Feng; Tan, Cher Ming; Pecht, Michael

    2015-01-01

    Temperature is known to have a significant impact on the performance, safety, and cycle lifetime of lithium-ion batteries (LiB). However, the comprehensive effects of temperature on the cyclic aging rate of LiB have yet to be found. We use an electrochemistry-based model (ECBE) here to measure the effects on the aging behavior of cycled LiB operating within the temperature range of 25 °C to 55 °C. The increasing degradation rate of the maximum charge storage of LiB during cycling at elevated temperature is found to relate mainly to the degradations at the electrodes, and that the degradation of LCO cathode is larger than graphite anode at elevated temperature. In particular, the formation and modification of the surface films on the electrodes as well as structural/phase changes of the LCO electrode, as reported in the literatures, are found to be the main contributors to the increasing degradation rate of the maximum charge storage of LiB with temperature for the specific operating temperature range. Larger increases in the Warburg elements and cell impedance are also found with cycling at higher temperature, but they do not seriously affect the state of health (SoH) of LiB as shown in this work. PMID:26245922

  3. [Evaluation of the risk of anesthetic gases to exposed subjects with different tasks in operating rooms].

    PubMed

    Bolzoni, G; Somenzi, V; Cirla, A M

    1992-01-01

    A research was carried out on risk evaluation of workers with different tasks in operating theatre. The airborne concentrations were determined by an IR analyzer with two distinct sampling lines: the first was placed in surgical zone and the second one in anesthesiological zone. The anesthetists resulted more at risk than surgical team. Nevertheless when the evaluation was based on N2O urinary concentration and data were stratified according to task a prevalent inhalation absorption resulted for non medical staff (instrumentist and professional nurse). Our data concerning N2O ranged between 95-764 ppm indoor and between 3-92 mcg/l in the urines of exposed subjects. PMID:1345720

  4. The evolution of a purpose designed hybrid trauma operating room from the trauma service perspective: the RAPTOR (Resuscitation with Angiography Percutaneous Treatments and Operative Resuscitations).

    PubMed

    Kirkpatrick, Andrew W; Vis, Christine; Dubé, Mirette; Biesbroek, Susan; Ball, Chad G; Laberge, Jason; Shultz, Jonas; Rea, Ken; Sadler, David; Holcomb, John B; Kortbeek, John

    2014-09-01

    Traumatic injury is the leading cause of potentially preventable lost years of life in the Western world and exsanguination is the most potentially preventable cause of post-traumatic death. With mature trauma systems and experienced trauma centres, extra-abdominal sites, such as the pelvis, constitute the most frequent anatomic site of exsanguination. Haemorrhage control for such bleeding often requires surgical adjuncts most notably interventional radiology (IR). With the usual paradigm of surgery conducted within an operating room and IR procedures within distant angiography suites, responsible clinicians are faced with making difficult decisions regarding where to transport the most physiologically unstable patients for haemorrhage control. If such a critical patient is transported to the wrong suite, they may die unnecessarily despite having potentially salvageable injuries. Thus, it seems only logical that the resuscitative operating room of the future would have IR capabilities making it the obvious geographic destination for critically unstable patients, especially those who are exsanguinating. Our trauma programme recently had the opportunity to conceive, design, build, and operationalise a purpose-designed hybrid trauma operating room, designated as the resuscitation with angiographic percutaneous techniques and operative resuscitation (RAPTOR) suite, which we believe to be the first such resource designed primarily to serve the exsanguinating trauma patient. The project was initiated after consultations between the trauma programme and private philanthropists regarding the greatest potential impacts on regional trauma care. The initial capital construction costs were thus privately generated but coincided with a new hospital wing construction allowing the RAPTOR to be purpose-designed for the exsanguinating patient. Many trauma programmes around the world are now starting to navigate the complex process of building new facilities, or else retrofitting

  5. Evaluation of fungal contamination in operating rooms using a dusting cloth pad: comparison among different sampling methods.

    PubMed

    D'Alessandro, Daniela; Cerquetani, Franco; Deriu, Maria Grazia; Montagna, Maria Teresa; Mura, Ida; Napoli, Christian; Vescia, Nicoletta

    2013-07-01

    To evaluate microbial contamination in hospitals environments, several methods are available, each one having its limitations. Therefore, the choice of system to use is open. This study compares the ability of a dusting cloth pad (DC pad) with 2 other methods (Rodac contact plate and air sampling) to detect contamination because of filamentous fungi in operating rooms, performing 110 sampling campaigns in hospitals of 3 Italian cities. Overall, 96% of the DC pad samples were positive compared with 51% of Rodac plates (P < .0001) and 35% of air samples (P < .0001). Authors conclude that the DC pad improves the ability to detect an environmental contamination of filamentous fungi. PMID:23380381

  6. Evaluation of the physical activity of anesthesiologists in the operating room during daily work using a triaxial accelerometer.

    PubMed

    Tanaka, Hidenori; Kawamata, Tomoyuki; Gen-No, Hirokazu; Nose, Hiroshi; Kawamata, Mikito

    2015-01-01

    Appropriate daily exercise is recommended to remain healthy for adults, including medical professionals. In this study, the authors quantified daily physical activity of anesthesiologists in the operating room using a newly developed triaxial accelerometer, Jukudai Mate. During daily work, mean±SD energy expenditure of staff was 576±181 kcal and was significantly higher than that of residents (400±95 kcal; p=007). The mean intensities of hourly physical activity of the staff and residents were estimated to be approximately 1.9 and 1.7 metabolic equivalents (METs), respectively. None of the anesthesiologists had more than 3 METs in intensity of physical activity. We concluded that the physical activity of anesthesiologists during daily work can be classified as light intensity. To promote and maintain health, anesthesiologists need physical activity of moderate or vigorous intensity off the job. PMID:24965320

  7. Establishment of the USDA/ARS Children's Nutrition Research Center at Baylor College of Medicine and Texas Children's Hospital in 1978

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The Children's Nutrition Research Center (CNRC) is a unique cooperative venture among Baylor College of Medicine, Texas Children's Hospital, and the USDA/Agricultural Research Service. The CNRC is dedicated to defining the nutrient needs of children, from conception through adolescence, and the need...

  8. Short-wavelength interband cascade infrared photodetectors operating above room temperature

    DOE PAGESBeta

    Lotfi, Hossein; Li, Lu; Lei, Lin; Jiang, Yuchao; Yang, Rui Q.; Klem, John F.; Johnson, Matthew B.

    2016-01-13

    High temperature operation (250–340 K) of short-wavelength interband cascade infrared photodetectors (ICIPs) with InAs/GaSb/Al0.2In0.8Sb/GaSb superlattice absorbers has been demonstrated with a 50% cutoff wavelength of 2.9 μm at 300 K. Two ICIP structures, one with two and the other with three stages, were designed and grown to explore this multiple-stage architecture. At λ = 2.1 μm, the two- and three-stage ICIPs had Johnson-noise-limited detectivities of 5.1 × 109 and 5.8 ×109 cm Hz1/2/W, respectively, at 300 K. The better device performance of the three-stage ICIP over the two-stage ICIP confirmed the advantage of more stages for this cascade architecture. Furthermore,more » an Arrhenius activation energy of 450 meV is extracted for the bulk resistance-area product, which indicates the dominance of the diffusion current at these high temperatures.« less

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

    PubMed

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

    2014-01-01

    Effective teamwork is one of the essentials in conducting successful and safe surgical procedures in the operating theatre (OT). The present paper aims to provide a selective review of various approaches describing effective interdisciplinary teamwork in the OT. Furthermore, it covers observational methods to assess OT teamwork with particular focus on Germany. Our definition of successful surgical teamwork is based on an already established classification system considering five criteria for effective and safe OT teams: coordination, communication, cooperation, leadership, and team monitoring. Well-defined and reliable measures are necessary to examine the quality of OT teamwork. Those methods should entail the special characteristics of the OT team. They should include all phases of the surgical procedure and incorporate all the professions involved (surgeons, surgical nurses, and anaesthetic staff). We conclude that research into methods for the assessment of OTs in Germany needs to be undertaken as a prerequisite to investigating the relationship between OT teamwork and its effects on patient safety and surgical quality. PMID:25066348

  10. Do radio frequencies of medical instruments common in the operating room interfere with near-infrared spectroscopy signals?

    NASA Astrophysics Data System (ADS)

    Shadgan, Babak; Molavi, Behnam; Reid, W. D.; Dumont, Guy; Macnab, Andrew J.

    2010-02-01

    Background: Medical and diagnostic applications of near infrared spectroscopy (NIRS) are increasing, especially in operating rooms (OR). Since NIRS is an optical technique, radio frequency (RF) interference from other instruments is unlikely to affect the raw optical data, however, NIRS data processing and signal output could be affected. Methods: We investigated the potential for three common OR instruments: an electrical cautery, an orthopaedic drill and an imaging system, to generate electromagnetic interference (EMI) that could potentially influence NIRS signals. The time of onset and duration of every operation of each device was recorded during surgery. To remove the effects of slow changing physiological variables, we first used a lowpass filter and then selected 2 windows with variable lengths around the moment of device onset. For each instant, variances (energy) and means of the signals in the 2 windows were compared. Results: Twenty patients were studied during ankle surgery. Analysis shows no statistically significant difference in the means and variance of the NIRS signals (p < 0.01) during operation of any of the three devices for all surgeries. Conclusion: This method confirms the instruments evaluated caused no significant interference. NIRS can potentially be used without EMI in clinical environments such as the OR.

  11. Prevalence and Religious Predictors of Healing Prayer Use in the USA: Findings from the Baylor Religion Survey.

    PubMed

    Levin, Jeff

    2016-08-01

    Using data from the 2010 Baylor Religion Survey (N = 1714), this study investigates the prevalence and religious predictors of healing prayer use among US adults. Indicators include prayed for self (lifetime prevalence = 78.8 %), prayed for others (87.4 %), asked for prayer (54.1 %), laying-on-of-hands (26.1 %), and participated in a prayer group (53.0 %). Each was regressed onto eight religious measures, and then again controlling for sociodemographic variables and health. While all religious measures had net effects on at least one healing prayer indicator, the one consistent predictor was a four-item scale assessing a loving relationship with God. Higher scores were associated with more frequent healing prayer use according to every measure, after controlling for all other religious variables and covariates. PMID:27075199

  12. A room temperature operating cryogenic cell for in vivo monitoring of dry snow metamorphism by X-ray microtomography

    NASA Astrophysics Data System (ADS)

    Calonne, N.; Flin, F.; Lesaffre, B.; Dufour, A.; Roulle, J.; Puglièse, P.; Philip, A.; Lahoucine, F.; Rolland du Roscoat, S.; Geindreau, C.

    2013-12-01

    Three-dimensional (3D) images of snow offer the possibility of studying snow metamorphism at the grain scale by analysing the time evolution of its complex microstructure. Such images are also particularly useful for providing physical effective properties of snow arising in macroscopic models. In the last 15 years, several experiments have been developed in order to get 3D images of snow by X-ray microtomography. Up to now, two different approaches have been used: a static and an in vivo approach. The static method consists in imaging a snow sample whose structural evolution has been stopped by impregnation and/or very cold temperature conditions. The sample is placed in a cryogenic cell that can operate at the ambient temperature of the tomograph room (e.g. Brzoska et al., 1999, Coléou et al., 2001). The in vivo technique uses a non impregnated sample which continues to undergo structural evolutions and is put in a cell that controls the temperature conditions at the boundaries of the sample. This kind of cell requires a cold environnement and the whole tomographic acquisition process takes place in a cold room (e.g. Schneebeli and Sokratov, 2004, Pinzer and Schneebeli, 2009). The 2nd approach has the major advantage to provide the time evolution of the microstructure of a same snow sample but requires a dedicated cold-room tomographic scanner, whereas the static method can be used with any tomographic scanner operating at ambient conditions. We developed a new in vivo cryogenic cell which benefits from the advantages of each of the above methods: it (1) allows to follow the evolution of the same sample with time and (2) is usable with a wide panel of tomographic scanners provided with large cabin sizes, which has many advantages in terms of speed, resolution, and availability of new technologies. The thermal insulation between the snow sample and the outside is ensured by a double wall vacuum system of thermal conductivity of about 0.0015 Wm-1K-1. An air

  13. Attitudes, risk of infection and behaviours in the operating room (the ARIBO Project): a prospective, cross-sectional study

    PubMed Central

    Birgand, Gabriel; Azevedo, Christine; Toupet, Gaelle; Pissard-Gibollet, Roger; Grandbastien, Bruno; Fleury, Eric; Lucet, Jean-Christophe

    2014-01-01

    Introduction Inappropriate staff behaviours can lead to environmental contamination in the operating room (OR) and subsequent surgical site infection (SSI). This study will focus on the continued assessment of OR staff behaviours using a motion tracking system and their impact on the SSI risk during surgical procedures. Methods and analysis This multicentre prospective cross-sectional study will include 10 ORs of cardiac and orthopaedic surgery in 12 healthcare facilities (HCFs). The staff behaviour will be assessed by an objective, continued and prolonged quantification of movements within the OR. A motion tracking system including eight optical cameras (VICON-Bonita) will record the movements of reflective markers placed on the surgical caps/hoods of each person entering the room. Different configurations of markers positioning will be used to distinguish between the staff category. Doors opening will be observed by means of wireless inertial sensors fixed on the doors and synchronised with the motion tracking system. We will collect information on the OR staff, surgical procedures and surgical environment characteristics. The behavioural data obtained will be compared (1) to the ‘best behaviour rules’ in the OR, pre-established using a Delphi method and (2) to surrogates of the infectious risk represented by microbiological air counts, particle counts, and a bacteriological sample of the wound at closing. Statistics will be performed using univariate and multivariate analysis to adjust on the aerolic and architectural characteristics of the OR. A multilevel model will allow including surgical specialty and HCFs effects. Through this study, we will develop an original approach using high technology tools associated to data processing techniques to evaluate ‘automatically’ the behavioural dynamics of the OR staff and their impact on the SSI risk. Ethics and dissemination Approbation of the Institutional Review Board of Paris North Hospitals, Paris 7

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

    PubMed

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

    2014-10-01

    The Society of Cardiovascular Anesthesiologists (SCA) introduced the FOCUS initiative (Flawless Operative Cardiovascular Unified Systems) in 2005 in response to the need for a rigorous scientific approach to improve quality and safety in the cardiovascular operating room (CVOR). The goal of the project, which is supported by the SCA Foundation, is to identify hazards and develop evidence-based protocols to improve cardiac surgery safety. A hazard is anything that has the potential to cause a preventable adverse event. Specifically, the strategic plan of FOCUS includes 3 goals: (1) identifying hazards in the CVOR, (2) prioritizing hazards and developing risk-reduction interventions, and (3) disseminating these interventions. Collectively, the FOCUS initiative, through the work of several groups composed of members from different disciplines such as clinical medicine, human factors engineering, industrial psychology, and organizational sociology, has identified and documented significant hazards occurring daily in our CVORs. Some examples of frequent occurrences that contribute to reduce the safety and quality of care provided to cardiac surgery patients include deficiencies in teamwork, poor OR design, incompatible technologies, and failure to adhere to best practices. Several projects are currently under way that are aimed at better understanding these hazards and developing interventions to mitigate them. The SCA, through the FOCUS initiative, has begun this journey of science-driven improvement in quality and safety. There is a long and arduous road ahead, but one we need to continue to travel. PMID:25232690

  15. Radiation exposure and associated risks to operating-room personnel during use of fluoroscopic guidance for selected orthopaedic surgical procedures

    SciTech Connect

    Miller, M.E.; Davis, M.L.; MacClean, C.R.; Davis, J.G.; Smith, B.L.; Humphries, J.R.

    1983-01-01

    Because of the increased use of fluoroscopic guidance techniques in certain orthopaedic surgical procedures, surgeons and other operating-room personnel who are involved in these procedures are voicing growing concern over possible associated radiation health hazards. Using thin-layer lithium fluoride chips for thermoluminescence dosimetry, we directly measured the radiation exposure encountered by the primary surgeon during seven operative procedures that were done utilizing fluoroscopic guidance techniques. Dosimetry studies were also carried out using a tissue-equivalent phantom model to determine the directions of maximum scatter radiation. These studies indicated that the standard protective apron that is commonly worn during the use of fluoroscopy provides adequate protection to most of the body; however, the surgeon is exposed to significant levels of scatter radiation to the head, neck, and hands, Dosimetry studies showed that positioning the fluoroscopic beam vertically to the fracture site of the supine patient, with the x-ray source posterior to the patient, provided the lowest levels of scatter radiation to the surgeon in the normal working position.

  16. Sister chromatid exchanges and micronuclei in lymphocytes of operating room personnel occupationally exposed to enfluorane and nitrous oxide.

    PubMed

    Pasquini, R; Scassellati-Sforzolini, G; Fatigoni, C; Marcarelli, M; Monarca, S; Donato, F; Cencetti, S; Cerami, F M

    2001-01-01

    The objective of this article is to assess whether occupational exposure to anesthetics increases genotoxic risk. We investigated two cytogenetic biomarkers, sister chromatid exchanges (SCE) and micronuclei (MN), in the peripheral blood lymphocytes of 46 anesthesiologists (24 men), working in operating rooms and mostly exposed to enfluorane and nitrous oxide, and 66 controls (35 men), not exposed to chemicals and living in the same area. Contrary to what was expected, a lower frequency of SCE was found in male anesthesiologists than in controls. Smoking status was found to be positively associated with SCE frequency in each group, while no relation to age was evident. On the contrary, MN frequency was significantly higher in female, but not male, anesthesiologists than in controls. Age and smoking status did not modify the association. No relationship between MN frequency and duration of employment was found in anesthesiologists. Smoking status and mean number of cigarettes smoked per day in smokers were not associated with MN frequency in either anesthesiologists or in controls. MN analysis seems to be a sensitive index of possible genotoxic effects of occupational exposure to anesthesiologists, and women appear to be more susceptible to these effects than men. PMID:11394710

  17. Safety culture in the operating room of a public hospital in the perception of healthcare professionals1

    PubMed Central

    Carvalho, Paloma Aparecida; Göttems, Leila Bernarda Donato; Pires, Maria Raquel Gomes Maia; de Oliveira, Maria Liz Cunha

    2015-01-01

    Objective: to evaluate the perception of healthcare professionals about the safety culture in the operating room of a public hospital, large-sized, according to the domains of the Safety Attitudes Questionnaire (SAQ). Method: descriptive, cross-sectional and quantitative research, with the application of the SAQ to 226 professionals. Descriptive data analysis, instrument consistency and exploratory factor analysis. Results: participants were distributed homogeneously between females (49.6%) and males (50.4%); mean age of 39.6 (SD±9.9) years and length of professional experience of 9.9 (SD±9.2) years. And Cronbach's ( of 0.84. It was identified six domains proposed in the questionnaire: stress perception (74.5) and job satisfaction (70.7) showed satisfactory results; teamwork environment (59.1) and climate of security (48.9) presented scores below the minimum recommended (75); unit's management perceptions (44.5), hospital management perceptions (34.9) and working conditions (41.9) presented the lowest averages. Conclusions: the results showed that, from the perspective of the professionals, there is weakness in the values, attitudes, skills and behaviors that determine the safety culture in a healthcare organization. PMID:26625994

  18. One-dimensional carbon-sulfur composite fibers for Na-S rechargeable batteries operating at room temperature.

    PubMed

    Hwang, Tae Hoon; Jung, Dae Soo; Kim, Joo-Seong; Kim, Byung Gon; Choi, Jang Wook

    2013-09-11

    Na-S batteries are one type of molten salt battery and have been used to support stationary energy storage systems for several decades. Despite their successful applications based on long cycle lives and low cost of raw materials, Na-S cells require high temperatures above 300 °C for their operations, limiting their propagation into a wide range of applications. Herein, we demonstrate that Na-S cells with solid state active materials can perform well even at room temperature when sulfur-containing carbon composites generated from a simple thermal reaction were used as sulfur positive electrodes. Furthermore, this structure turned out to be robust during repeated (de)sodiation for ~500 cycles and enabled extraordinarily high rate performance when one-dimensional morphology is adopted using scalable electrospinning processes. The current study suggests that solid-state Na-S cells with appropriate atomic configurations of sulfur active materials could cover diverse battery applications where cost of raw materials is critical. PMID:23981085

  19. Development and Testing of Screen-Based and Psychometric Instruments for Assessing Resident Performance in an Operating Room Simulator.

    PubMed

    McNeer, Richard R; Dudaryk, Roman; Nedeff, Nicholas B; Bennett, Christopher L

    2016-01-01

    Introduction. Medical simulators are used for assessing clinical skills and increasingly for testing hypotheses. We developed and tested an approach for assessing performance in anesthesia residents using screen-based simulation that ensures expert raters remain blinded to subject identity and experimental condition. Methods. Twenty anesthesia residents managed emergencies in an operating room simulator by logging actions through a custom graphical user interface. Two expert raters rated performance based on these entries using custom Global Rating Scale (GRS) and Crisis Management Checklist (CMC) instruments. Interrater reliability was measured by calculating intraclass correlation coefficients (ICC), and internal consistency of the instruments was assessed with Cronbach's alpha. Agreement between GRS and CMC was measured using Spearman rank correlation (SRC). Results. Interrater agreement (GRS: ICC = 0.825, CMC: ICC = 0.878) and internal consistency (GRS: alpha = 0.838, CMC: alpha = 0.886) were good for both instruments. Subscale analysis indicated that several instrument items can be discarded. GRS and CMC scores were highly correlated (SRC = 0.948). Conclusions. In this pilot study, we demonstrated that screen-based simulation can allow blinded assessment of performance. GRS and CMC instruments demonstrated good rater agreement and internal consistency. We plan to further test construct validity of our instruments by measuring performance in our simulator as a function of training level. PMID:27293430

  20. Development and Testing of Screen-Based and Psychometric Instruments for Assessing Resident Performance in an Operating Room Simulator

    PubMed Central

    McNeer, Richard R.; Dudaryk, Roman; Nedeff, Nicholas B.; Bennett, Christopher L.

    2016-01-01

    Introduction. Medical simulators are used for assessing clinical skills and increasingly for testing hypotheses. We developed and tested an approach for assessing performance in anesthesia residents using screen-based simulation that ensures expert raters remain blinded to subject identity and experimental condition. Methods. Twenty anesthesia residents managed emergencies in an operating room simulator by logging actions through a custom graphical user interface. Two expert raters rated performance based on these entries using custom Global Rating Scale (GRS) and Crisis Management Checklist (CMC) instruments. Interrater reliability was measured by calculating intraclass correlation coefficients (ICC), and internal consistency of the instruments was assessed with Cronbach's alpha. Agreement between GRS and CMC was measured using Spearman rank correlation (SRC). Results. Interrater agreement (GRS: ICC = 0.825, CMC: ICC = 0.878) and internal consistency (GRS: alpha = 0.838, CMC: alpha = 0.886) were good for both instruments. Subscale analysis indicated that several instrument items can be discarded. GRS and CMC scores were highly correlated (SRC = 0.948). Conclusions. In this pilot study, we demonstrated that screen-based simulation can allow blinded assessment of performance. GRS and CMC instruments demonstrated good rater agreement and internal consistency. We plan to further test construct validity of our instruments by measuring performance in our simulator as a function of training level. PMID:27293430

  1. Work–Family Conflict, Task Interruptions, and Influence at Work Predict Musculoskeletal Pain in Operating Room Nurses

    PubMed Central

    Nützi, Marina; Koch, Patricia; Baur, Heiner; Elfering, Achim

    2015-01-01

    Background The aim of this study is to examine the prevalence of musculoskeletal complaints in Swiss operating room (OR) nurses, and to investigate how work–family conflict, work interruptions, and influence at work are related to lumbar and cervical back pain. Methods Participants in this correlational questionnaire study included 116 OR nurses from eight different hospitals in Switzerland. Results We found that 66% of the OR staff suffered from musculoskeletal problems. The most prevalent musculoskeletal complaints were lumbar (52.7%) and cervical pain (38.4%). Furthermore, 20.5% reported pain in the mid spine region, 20.5% in the knees and legs, and 9.8% in the hands and feet. Multiple linear regression analyses showed that work–family conflict (p < 0.05) and interruptions (p < 0.05) significantly predicted lumbar and cervical pain in OR nurses, while influence at work (p < 0.05) only predicted lumbar pain. Conclusion These results suggest that reducing the work–family conflict and interruptions at work, as well as offering opportunities to influence one's workplace, help to promote OR nurses' health. PMID:26929846

  2. Using Goal Setting, Task Clarification, and Feedback to Increase the Use of the Hands-Free Technique by Hospital Operating Room Staff

    ERIC Educational Resources Information Center

    Cunningham, Thomas R.; Austin, John

    2007-01-01

    We evaluated the effects of a behavioral treatment on the safe passing of sharp instruments using the hands-free technique among hospital operating room personnel during surgical procedures. Treatment consisted of participative goal setting, task clarification, and feedback. The average percentage of sharp instruments passed safely increased from…

  3. Continuous-wave operation of InAsSb/InP quantum - dot lasers near 2 (mu)m at room temperature

    NASA Technical Reports Server (NTRS)

    Qiu, Yueming; Uhl, David; Keo, Sam

    2004-01-01

    InAsSb quantum-dot lasers near 2 pm were demonstrated in cw operation at room temperature with a threshold current density of below 1 kA/cm, output power of 3 mW/facet and a differential quantum efficiency of 13%.

  4. [Ultrafast-track Anesthesia (UFTA) in the Operating Room and the Anesthetic Management for Off-pump Coronary Artery Bypass (OPCAB)].

    PubMed

    Shimosaka, Mika; Inoue, Motoki; Takahashi, Hisato; Takahashi, Masao; Miyajima, Keisuke; Ishikawa, Toshihiro; Hatada, Kazuyoshi

    2016-04-01

    Currently, the immediate extubation in the operating room is necessary for the patients undergoing off-pump coronary artery bypass (OPCAB). To achieve UFTA, anesthesiologists should control general anesthesia. We report the case series of UFTA for the patients undergone OPCAB at our hospital. Forty patients receiving OPCAB between April 2012 and April 2014 were retrospectively analyzed. We divided the patients into those extubated in the operating room (Extubation group) and those not (Intubation group). The extubation criteria included adequate revascularization, adequate hemostasis, ratio between Pa(O2) and FI(O2) more than 250, body temperature above 36 degrees C, stable hemodynamics without noradrenaline, without IABP, and normal postoperative chest X-ray. Twenty-three patients (70% of the scheduled and 20% of the emergency patients) were included in our criteria and could be extubated in the operating room. One patient was re-intubated due to asthma attack following extubation in the operating room. The sucess rate of immediate extubation was 95.7% by our criteria. There were no significant differences in age, sex, BMI, duration of anesthesia, and amount of hemorrhage between the 2 groups. We believe that UFTA for OPCAB patients may be possible under carefull decision by extubation criteria. PMID:27188100

  5. NHEXAS PHASE I ARIZONA STUDY--STANDARD OPERATING PROCEDURE FOR WEIGHT ROOM OPERATION AND MAINTENANCE (UA-L-2.1)

    EPA Science Inventory

    The purpose of this SOP is to identify the steps in the upkeep of the weighing room during the Arizona NHEXAS project and the "Border" study. Keywords: lab; equipment; weighing room.

    The National Human Exposure Assessment Survey (NHEXAS) is a federal interagency research effort...

  6. U.S.-MEXICO BORDER PROGRAM ARIZONA BORDER STUDY--STANDARD OPERATING PROCEDURE FOR WEIGHING ROOM OPERATION AND MAINTENANCE (UA-L-2.1)

    EPA Science Inventory

    The purpose of this SOP is to identify the steps in the upkeep of the weighing room during the Arizona NHEXAS project and the Border study. Keywords: lab; equipment; weighing room.

    The U.S.-Mexico Border Program is sponsored by the Environmental Health Workgroup of the Border 2...

  7. Use of safety scalpels and other safety practices to reduce sharps injury in the operating room: What is the evidence?

    PubMed Central

    DeGirolamo, Kristin M.; Courtemanche, Douglas J.; Hill, Warren D.; Kennedy, Angie; Skarsgard, Erik D.

    2013-01-01

    Background The occupational hazard associated with percutaneous injury in the operating room (OR) has encouraged harm reduction through behaviour change and the use of safety-engineered surgical sharps. Some Canadian regulatory agencies have mandated the use of “safety scalpels.” Our primary objective was to determine whether safety scalpels reduce the risk of percutaneous injury in the OR, while a secondary objective was to evaluate risk reduction associated with other safety practices. Methods We used evidence review methods described by the International Liaison Committee on Resuscitation and conducted a systematic, English-language search of Ovid, MEDLINE and EMBASE using the following search terms: “safety-engineered scalpel,” “mistake proofing device,” “retractable/removable blade/scalpel,” “pass tray,” “hands free passing,” “neutral zone,” “sharpless surgery,” “double/cutproof gloving” and “blunt suture needles.” Included articles were scored according to level of evidence; quality; and whether they were supportive, opposed or neutral to the study question(s). Results Of 72 included citations, none was supportive of the use of safety scalpels. There was high-level/quality evidence (Cochrane reviews) in support of risk reduction through double-gloving and use of blunt suture needles, with additional evidence supporting a pass tray/neutral zone for sharps handling (4 of 5 articles supportive) and use of suturing adjuncts (1 article supportive). Conclusion There is insufficient evidence to support regulated use of safety scalpels. Injury-reduction strategies should emphasize proven methods, including double-gloving, blunt suture needles and use of hands-free sharps transfer. PMID:23883497

  8. Influence of Data and Formulas on Trust in Information from Journal Articles in an Operating Room Management Course.

    PubMed

    Dexter, Franklin; Van Swol, Lyn M

    2016-06-01

    To make good decisions, operating room (OR) managers often act autocratically after obtaining expert advice. When such advice is provided by e-mail, attachments of research articles can be included. We performed a quasi-experimental study using an evaluation of 4 articles used in a 50-hour OR management course to assess how their content influences trust in the article's content, including its quality, usefulness, and reliability. There were (a) 2 articles containing data with specific examples of application for health systems and 2 without and (b) 2 articles containing appendices of formulas and 2 without. Some of the formulas in the readings were relatively complicated (e.g., stochastic optimization using the Lagrange method) and unlikely to be used by the subjects (i.e., they show what does not need to be done). Content complexity (±data, ±formulas) served both as sources of limitation in understanding the content and potentially as peripheral cues influencing perception of the content. The 2-page evaluation forms were generated with random sequences of articles and response items. The N = 17 subjects each completed 9 items about each of the 4 articles (i.e., answered 36 questions). The 9-item assessment of trust provided a unidimensional construct (Cronbach α, 0.94). Formulas in the articles significantly increased trust in the information (P = 0.0019). Presence of data did not significantly influence trust (P = 0.15). Therefore, when an expert sends e-mail to a manager who has completed this basic OR management science and asks a question, choosing a paper with formulas has no disadvantage. PMID:27166745

  9. Inactivation of a 25.5 µm Enterococcus faecalis biofilm by a room-temperature, battery-operated, handheld air plasma jet

    NASA Astrophysics Data System (ADS)

    Pei, X.; Lu, X.; Liu, J.; Liu, D.; Yang, Y.; Ostrikov, K.; Chu, Paul K.; Pan, Y.

    2012-04-01

    Effective biofilm inactivation using a handheld, mobile plasma jet powered by a 12 V dc battery and operated in open air without any external gas supply is reported. This cold, room-temperature plasma is produced in self-repetitive nanosecond discharges with current pulses of ˜100 ns duration, current peak amplitude of ˜6 mA and repetition rate of ˜20 kHz. It is shown that the reactive plasma species penetrate to the bottom layer of a 25.5 µm-thick Enterococcus faecalis biofilm and produce a strong bactericidal effect. This is the thickest reported biofilm inactivated using room-temperature air plasmas.

  10. Underrepresented minority students' experiences at Baylor College of Dentistry: perceptions of cultural climate and reasons for choosing to attend.

    PubMed

    McCann, Ann L; Lacy, Ernestine S; Miller, Barbara H

    2014-03-01

    A study was conducted at Texas A&M University Baylor College of Dentistry (TAMBCD) in fall 2011 to identify the reasons underrepresented minority (URM) students chose to attend TAMBCD, the factors that supported their success as enrolled students, and their perceptions of the institution's cultural climate. A survey distributed online to all URM students received a 79 percent response rate (129/164). The respondents were primarily Hispanic (62 percent Mexican American and other Hispanic) and African American (33 percent) and had attended a college pipeline program (53 percent). The top reasons these students chose TAMBCD were reputation, location, and automatic acceptance or familiarity from being in a predental program. Alumni had most influenced them to attend. Regarding support services, the largest percentage reported not using any (44 percent); personal advising and tutoring were reported to be the most commonly used. In terms of climate, discrimination was reported by 22 percent (n=29), mostly from classmates and clinical faculty. The majority (87 percent) reported their cultural competence program was "effective" and agreed that faculty (83 percent), staff (85 percent), and students (75 percent) were culturally competent. Overall, the students were "satisfied" with how they were treated (88 percent), their education (91 percent), and the services/resources (92 percent). This information is being used to continue to improve the school's cultural climate and to conduct a broader assessment of all students. PMID:24609343

  11. Impact and Challenges of a Policy Change to Early Track Extubation in the Operating Room for Fontan.

    PubMed

    Kawaguchi, Atsushi; Liu, Qi; Coquet, Sean; Yasui, Yutaka; Cave, Dominic

    2016-08-01

    While policy changes toward early extubation in the operating room (OR) have been commonly seen in palliative surgeries in single ventricle anatomy, no systematic assessment of their impact on patient outcome has been reported. All patients aged 0-17 years admitted to a PICU in a quaternary children's hospital for post-operative management following a primary Fontan procedure between 2005 and 2011 were included. Patients for revision of Fontan or patients admitted to adult Cardiovascular Intensive Care Unit were excluded. Practice policy was changed from routine extubation in the PICU to early extubation in OR in January 2008. Data were compared between the pre-policy-change era (2005-2007) and the post-policy-change era (2008-2011) to assess the impact of the change on patient outcomes. Generalized linear regression (GLM) and interrupted time series (ITS) analysis were used to access the effect of policy change on PICU length of stay and post-operative fluid balance, adjusting for potential confounders using propensity scores. Root cause analysis (RCA) was conducted to describe causes of failed extubation and challenges of this policy change. One hundred twenty-seven children met inclusion criteria. Average body weight was 14.7 kg [standard deviation (SD) 3.9], and age was 3.5 years (SD 1.9). A clear change in extubation practice occurred between the pre- versus post-policy-change eras: 97.5 % were extubated in the PICU in the pre-policy-change era, as compared to 15.0 % in the post-policy-change era. The average PICU length of stay was shortened by 4.1 days from the pre-policy-change era to the post-policy-change era [95 % CI -1.2 to -6.9, p < 0.01] in the GLM, whereas the ITS analysis did not show a statistically significant difference [95 % CI 1.8 to -2.5] (p = 0.23). No statistically significant difference was observed in the fluid balance in the 24 h post-operation in both analyses. Sixteen patients (16/127, 12.6 %) were reintubated mainly for

  12. Mutagenicity of inhalation anaesthetics studied by the sister chromatid exchange test in lymphocytes of patients and operating room personnel.

    PubMed

    Husum, B

    1987-06-01

    Retrospective studies have indicated that operating room personnel may have increased risks of spontaneous abortion, congenital malformations in offspring, and cancer (Cohen et al 1980, Buring et al 1985). Occupational exposure to waste anaesthetic gases may be responsible for these possible adverse health effects, but a cause-effect relationship has never been proved. Induction of changes in the DNA in the chromosomes leading to mutations may play a role in teratogenicity and carcinogenicity. Along with an increasing concern in society regarding occupational diseases and working and living environment in general, cytogenetic methods have been developed for rapid detection of potential mutagenicity in vitro of chemical agents. One such method is the SCE test, which is based on examination of sister chromatid exchanges (SCEs), i.e. exchanges of chromatid-segments between the two chromatids in a chromosome, during cell replication. SCEs are not mutations, but an increased frequency of SCE is a sensitive indicator of exposure to agents that are capable of producing damage to the DNA and thus possibly mutations. In vitro tests like the SCE test are very useful for evaluation of specific chemical agents, which may be added to the culture in known concentrations. In studies of possible hazards from chemical agents in the working or living environment, the exposure is often poorly defined. Also, biotransformation may be different in different species, and the duration and the level of the exposure may play a role. Examination of SCEs is, therefore, increasingly performed directly on human lymphocytes from peripheral blood. Thus, although the examination of SCEs is still performed in vitro, the exposure has taken place in vivo. Increased SCE levels are then regarded as a non-specific indicator that the donor has been exposed to potentially mutagenic agents in the environment. The author and his associates used the SCE test to investigate the possible mutagenicity of

  13. Event-based knowledge elicitation of operating room management decision-making using scenarios adapted from information systems data

    PubMed Central

    2011-01-01

    Background No systematic process has previously been described for a needs assessment that identifies the operating room (OR) management decisions made by the anesthesiologists and nurse managers at a facility that do not maximize the efficiency of use of OR time. We evaluated whether event-based knowledge elicitation can be used practically for rapid assessment of OR management decision-making at facilities, whether scenarios can be adapted automatically from information systems data, and the usefulness of the approach. Methods A process of event-based knowledge elicitation was developed to assess OR management decision-making that may reduce the efficiency of use of OR time. Hypothetical scenarios addressing every OR management decision influencing OR efficiency were created from published examples. Scenarios are adapted, so that cues about conditions are accurate and appropriate for each facility (e.g., if OR 1 is used as an example in a scenario, the listed procedure is a type of procedure performed at the facility in OR 1). Adaptation is performed automatically using the facility's OR information system or anesthesia information management system (AIMS) data for most scenarios (43 of 45). Performing the needs assessment takes approximately 1 hour of local managers' time while they decide if their decisions are consistent with the described scenarios. A table of contents of the indexed scenarios is created automatically, providing a simple version of problem solving using case-based reasoning. For example, a new OR manager wanting to know the best way to decide whether to move a case can look in the chapter on "Moving Cases on the Day of Surgery" to find a scenario that describes the situation being encountered. Results Scenarios have been adapted and used at 22 hospitals. Few changes in decisions were needed to increase the efficiency of use of OR time. The few changes were heterogeneous among hospitals, showing the usefulness of individualized assessments

  14. An Estimation for Availability of Battery less LF Band RFID Tag to Identify Patients in Operation Room from Viewpoint of Engineering

    NASA Astrophysics Data System (ADS)

    Hosaka, Ryosuke

    Nowadays, medical accidents increase in Japanese patient environment. Especially, misidentification of the patients occurred in operation room of higher level hospitals. It is considered that the great deals of accidents are due to mistakes by nurse. However, the accidents are prevented by management of patients. If a suitable patient identification system is developed, the accidents are prevented. In this study, new patient identification system using battery less LF band RFID(Radio Frequency Identification) is proposed. In the method, battery less RFID tag is attached to patient. In operation room, patient is identified before operation using the proposed system. However, identification distance of RFID is small. It is important that extension of the distance. In this study, antennas of RFID tag and sensor are designed. Two types of tag are proposed. One of them is set on wristband. An antenna for the tag is designed as a circular shape with 30mm in diameter. The other one is shaped like a necklace. The antenna is also designed 220mm, 240mm and 260mm in diameter. Using necklace type new antenna, sufficient identification distance for detection of the tag in the operation room is realized. The patient identification is realized using the proposed system

  15. Design and Room-Temperature Operation of GaAs/AlGaAs Multiple Quantum Well Nanowire Lasers.

    PubMed

    Saxena, Dhruv; Jiang, Nian; Yuan, Xiaoming; Mokkapati, Sudha; Guo, Yanan; Tan, Hark Hoe; Jagadish, Chennupati

    2016-08-10

    We present the design and room-temperature lasing characteristics of single nanowires containing coaxial GaAs/AlGaAs multiple quantum well (MQW) active regions. The TE01 mode, which has a doughnut-shaped intensity profile and is polarized predominantly in-plane to the MQWs, is predicted to lase in these nanowire heterostructures and is thus chosen for the cavity design. Through gain and loss calculations, we determine the nanowire dimensions required to minimize loss for the TE01 mode and determine the optimal thickness and number of QWs for minimizing the threshold sheet carrier density. In particular, we show that there is a limit to the minimum and maximum number of QWs that are required for room-temperature lasing. Based on our design, we grew nanowires of a suitable diameter containing eight uniform coaxial GaAs/AlGaAs MQWs. Lasing was observed at room temperature from optically pumped single nanowires and was verified to be from TE01 mode by polarization measurements. The GaAs MQW nanowire lasers have a threshold fluence that is a factor of 2 lower than that previously demonstrated for room-temperature GaAs nanowire lasers. PMID:27459233

  16. Gesture-Controlled Interface for Contactless Control of Various Computer Programs with a Hooking-Based Keyboard and Mouse-Mapping Technique in the Operating Room

    PubMed Central

    Park, Ben Joonyeon; Jang, Taekjin; Choi, Jong Woo; Kim, Namkug

    2016-01-01

    We developed a contactless interface that exploits hand gestures to effectively control medical images in the operating room. We developed an in-house program called GestureHook that exploits message hooking techniques to convert gestures into specific functions. For quantitative evaluation of this program, we used gestures to control images of a dynamic biliary CT study and compared the results with those of a mouse (8.54 ± 1.77 s to 5.29 ± 1.00 s; p < 0.001) and measured the recognition rates of specific gestures and the success rates of tasks based on clinical scenarios. For clinical applications, this program was set up in the operating room to browse images for plastic surgery. A surgeon browsed images from three different programs: CT images from a PACS program, volume-rendered images from a 3D PACS program, and surgical planning photographs from a basic image viewing program. All programs could be seamlessly controlled by gestures and motions. This approach can control all operating room programs without source code modification and provide surgeons with a new way to safely browse through images and easily switch applications during surgical procedures. PMID:26981146

  17. Gesture-Controlled Interface for Contactless Control of Various Computer Programs with a Hooking-Based Keyboard and Mouse-Mapping Technique in the Operating Room.

    PubMed

    Park, Ben Joonyeon; Jang, Taekjin; Choi, Jong Woo; Kim, Namkug

    2016-01-01

    We developed a contactless interface that exploits hand gestures to effectively control medical images in the operating room. We developed an in-house program called GestureHook that exploits message hooking techniques to convert gestures into specific functions. For quantitative evaluation of this program, we used gestures to control images of a dynamic biliary CT study and compared the results with those of a mouse (8.54 ± 1.77 s to 5.29 ± 1.00 s; p < 0.001) and measured the recognition rates of specific gestures and the success rates of tasks based on clinical scenarios. For clinical applications, this program was set up in the operating room to browse images for plastic surgery. A surgeon browsed images from three different programs: CT images from a PACS program, volume-rendered images from a 3D PACS program, and surgical planning photographs from a basic image viewing program. All programs could be seamlessly controlled by gestures and motions. This approach can control all operating room programs without source code modification and provide surgeons with a new way to safely browse through images and easily switch applications during surgical procedures. PMID:26981146

  18. Genetic Similarity among One Aspergillus flavus Strain Isolated from a Patient Who Underwent Heart Surgery and Two Environmental Strains Obtained from the Operating Room

    PubMed Central

    Diaz-Guerra, Teresa M.; Mellado, Emilia; Cuenca-Estrella, Manuel; Gaztelurrutia, Lourdes; Navarro, Jose Ignacio Villate; Tudela, Juan L. Rodríguez

    2000-01-01

    We report the simultaneous isolation of one Aspergillus flavus strain from the aortic prosthesis of a heart surgery patient and another two isolates recovered from a dual-reservoir cooler-heater used in the operating room where this patient was operated on. Genetic typing of these three isolates by randomly amplified polymorphic DNA (RAPD) revealed identical genotypes. Eight unrelated control strains of A. flavus had eight different genotypes. These results clearly indicated the nosocomial origin of the A. flavus strain isolated from the patient. We suggest that the RAPD technique is a rapid and reliable tool to ascertain the epidemiology of infections caused by A. flavus. PMID:10835021

  19. A primary standard of optical power based on induced-junction silicon photodiodes operated at room temperature

    NASA Astrophysics Data System (ADS)

    Dönsberg, Timo; Sildoja, Meelis; Manoocheri, Farshid; Merimaa, Mikko; Petroff, Leo; Ikonen, Erkki

    2014-06-01

    We present the design and construction of a new compact room temperature predictable quantum efficient detector (PQED). It consists of two custom-made induced-junction photodiodes mounted in a wedge trap configuration and a window aligned at Brewster's angle for high transmission of p polarized light. The window can also be removed, in which case a dry nitrogen flow system is utilized to prevent dust contamination of the photodiodes. Measurements of individual detectors at the wavelength of 488 nm indicate that reflectance and spectral responsivity are consistent within 4 ppm and 13 ppm peak-to-peak variation, respectively, and agree with the predicted values. The spatial non-uniformity of the responsivity of the PQED is an order of magnitude lower than that of single photodiodes. The internal quantum efficiency of the photodiodes is concluded to be spatially uniform within 50 ppm. These measurement results—together with the responsivity predictable by fundamental laws of physics—provide evidence that the room temperature PQED may replace the cryogenic radiometer as a primary standard of optical power in the visible wavelength range of 380 nm to 780 nm.

  20. [Work strain by anaesthetic gas and surgical smoke due to tissue coagulation as well as safety measures in surgical operating rooms - what the surgeon needs to know].

    PubMed

    Boeckelmann, I; Sammito, S; Meyer, F

    2013-02-01

    Exposure of the respiratory tract during surgical interventions is an important topic of occupational medicine, which has only rarely been investigated. Based on a literature search, relevant information on the possible health risk is summarised. Within the operating room, an exposure of the respiratory tract to gas (volatile anaesthetics) and aerosols (smoking gas by coagulation) can occur. This exposure needs to be considered as a potential health risk if safety measures are not sufficient. Health risks comprise possible disturbances of gravidity and fertility, neurotoxicity and cancer generation. Such health risks can be prevented with primary preventive measures and can be early recognised/diagnosed by preventive investigations of occupational medicine (secondary prevention). Safety measures are developed according to the STOP principle (substitution, technical, organisatory and personal measures). Assessment of the potential danger begins with an appropriate description of the working procedure and detection of the toxic features of the drugs and medical products, which helps to determine individual exposure and to estimate risk potential. Required occupational safety measures can be derived from this and, subsequently, the work organisation can be optimised. In addition, employees in the operating room are to be instructed about the indicated preventive mode of behaviour. Due to better implementation of the above-mentioned basic principles, introduction of novel narcotics and technological developments, potential exposure of the respiratory tract within the operating room has been reduced over the last 10 years. Thus, risks for gravidity and possible disturbances of fertility by exposure to volatile narcotics are currently assessed to be low. However, available data on health risks of the chronic exposure to smoking gases are still deficient although toxic and cancerogenic organic pyrolysis products are generated. The protection effect of modern air

  1. Room Acoustics

    NASA Astrophysics Data System (ADS)

    Kuttruff, Heinrich; Mommertz, Eckard

    The traditional task of room acoustics is to create or formulate conditions which ensure the best possible propagation of sound in a room from a sound source to a listener. Thus, objects of room acoustics are in particular assembly halls of all kinds, such as auditoria and lecture halls, conference rooms, theaters, concert halls or churches. Already at this point, it has to be pointed out that these conditions essentially depend on the question if speech or music should be transmitted; in the first case, the criterion for transmission quality is good speech intelligibility, in the other case, however, the success of room-acoustical efforts depends on other factors that cannot be quantified that easily, not least it also depends on the hearing habits of the listeners. In any case, absolutely "good acoustics" of a room do not exist.

  2. Commander's conference room (room 202), closet and hallway to bathroom ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Commander's conference room (room 202), closet and hallway to bathroom and bedroom, leading to conference room 211. Viewing windows look down on the display area. View to north - March Air Force Base, Strategic Air Command, Combat Operations Center, 5220 Riverside Drive, Moreno Valley, Riverside County, CA

  3. Assessment of DICOM Viewers Capable of Loading Patient-specific 3D Models Obtained by Different Segmentation Platforms in the Operating Room.

    PubMed

    Lo Presti, Giuseppe; Carbone, Marina; Ciriaci, Damiano; Aramini, Daniele; Ferrari, Mauro; Ferrari, Vincenzo

    2015-10-01

    Patient-specific 3D models obtained by the segmentation of volumetric diagnostic images play an increasingly important role in surgical planning. Surgeons use the virtual models reconstructed through segmentation to plan challenging surgeries. Many solutions exist for the different anatomical districts and surgical interventions. The possibility to bring the 3D virtual reconstructions with native radiological images in the operating room is essential for fostering the use of intraoperative planning. To the best of our knowledge, current DICOM viewers are not able to simultaneously connect to the picture archiving and communication system (PACS) and import 3D models generated by external platforms to allow a straight integration in the operating room. A total of 26 DICOM viewers were evaluated: 22 open source and four commercial. Two DICOM viewers can connect to PACS and import segmentations achieved by other applications: Synapse 3D® by Fujifilm and OsiriX by University of Geneva. We developed a software network that converts diffuse visual tool kit (VTK) format 3D model segmentations, obtained by any software platform, to a DICOM format that can be displayed using OsiriX or Synapse 3D. Both OsiriX and Synapse 3D were suitable for our purposes and had comparable performance. Although Synapse 3D loads native images and segmentations faster, the main benefits of OsiriX are its user-friendly loading of elaborated images and it being both free of charge and open source. PMID:25739346

  4. Room-Temperature Continuous-Wave Operation of InGaN-Based Blue-Violet Laser Diodes with a Lifetime of 15.6 Hours

    NASA Astrophysics Data System (ADS)

    Zeng, Chang; Zhang, Shu-Ming; Ji, Lian; Wang, Huai-Bing; Zhao, De-Gang; Zhu, Jian-Jun; Liu, Zong-Shun; Jiang, De-Sheng; Cao, Qing; Chong, Ming; Duan, Li-Hong; Wang, Hai; Shi, Yong-Sheng; Liu, Su-Ying; Yang, Hui; Chen, Liang-Hui

    2010-11-01

    We report our recent progress of investigations on InGaN-based blue-violet laser diodes (LDs). The room-temperature (RT) cw operation lifetime of LDs has extended to longer than 15.6 h. The LD structure was grown on a c-plane free-standing (FS) GaN substrate by metal organic chemical vapor deposition (MOCVD). The typical threshold current and voltage of LD under RT cw operation are 78 mA and 6.8 V, respectively. The experimental analysis of degradation of LD performances suggests that after aging treatment, the increase of series resistance and threshold current can be mainly attributed to the deterioration of p-type ohmic contact and the decrease of internal quantum efficiency of multiple quantum well (MQW), respectively.

  5. Small-Scale Mechanical Testing on Proton Beam-Irradiated 304 SS from Room Temperature to Reactor Operation Temperature

    NASA Astrophysics Data System (ADS)

    Vo, H.; Reichardt, A.; Howard, C.; Abad, M. D.; Kaoumi, D.; Chou, P.; Hosemann, P.

    2015-12-01

    Austenitic stainless steels are common structural components in light water reactors. Because reactor components are subjected to harsh conditions such as high operating temperatures and neutron radiation, they can undergo irradiation-induced embrittlement and related failure, which compromises reliable operation. Small-scale mechanical testing has seen widespread use as a testing method for both ion- and reactor-irradiated materials because it allows access to the mechanical properties of the ion beam-irradiated region, and for safe handling of a small amount of activated material. In this study, nanoindentation and microcompression testing were performed on unirradiated and 10 dpa proton-irradiated 304 SS, from 25°C to 300°C. Increases in yield stress (YS), critical resolved shear stress (CRSS) and hardness ( H) were seen in the irradiated region relative to the unirradiated region. Relationships between H, YS, and CRSS of irradiated and unirradiated materials are discussed over this temperature range.

  6. Simulation and experimental studies of operators` decision styles and crew composition while using an ecological and traditional user interface for the control room of a nuclear power plant

    SciTech Connect

    Meshkati, N.; Buller, B.J.; Azadeh, M.A.

    1995-04-01

    The goal of this research is threefold: (1) use of the Skill-, Rule-, and Knowledge-based levels of cognitive control -- the SRK framework -- to develop an integrated information processing conceptual framework (for integration of workstation, job, and team design); (2) to evaluate the user interface component of this framework -- the Ecological display; and (3) to analyze the effect of operators` individual information processing behavior and decision styles on handling plant disturbances plus their performance on, and preference for, Traditional and Ecological user interfaces. A series of studies were conducted. In Part I, a computer simulation model and a mathematical model were developed. In Part II, an experiment was designed and conducted at the EBR-II plant of the Argonne National Laboratory-West in Idaho Falls, Idaho. It is concluded that: the integrated SRK-based information processing model for control room operations is superior to the conventional rule-based model; operators` individual decision styles and the combination of their styles play a significant role in effective handling of nuclear power plant disturbances; use of the Ecological interface results in significantly more accurate event diagnosis and recall of various plant parameters, faster response to plant transients, and higher ratings of subject preference; and operators` decision styles affect on both their performance and preference for the Ecological interface.

  7. Continuous-wave operation of a room-temperature, diode-laser-pumped, 946-nm Nd:YAG laser

    NASA Technical Reports Server (NTRS)

    Fan, T. Y.; Byer, Robert L.

    1987-01-01

    Single-stripe diode-laser-pumped operation of a continuous-wave 946-nm Nd:YAG laser with less than 10-mW threshold has been demonstrated. A slope efficiency of 16 percent near threshold was shown with a projected slope efficiency well above a threshold of 34 percent based on results under Rhodamine 6G dye-laser pumping. Nonlinear crystals for second-harmonic generation of this source were evaluated. KNbO3 and periodically poled LiNbO3 appear to be the most promising.

  8. Automated Air Traffic Control Operations with Weather and Time-Constraints: A First Look at (Simulated) Far-Term Control Room Operations

    NASA Technical Reports Server (NTRS)

    Prevot, Thomas; Homola, Jeffrey R.; Martin, Lynne H.; Mercer, Joey S.; Cabrall, Christopher C.

    2011-01-01

    In this paper we discuss results from a recent high fidelity simulation of air traffic control operations with automated separation assurance in the presence of weather and time-constraints. We report findings from a human-in-the-loop study conducted in the Airspace Operations Laboratory (AOL) at the NASA Ames Research Center. During four afternoons in early 2010, fifteen active and recently retired air traffic controllers and supervisors controlled high levels of traffic in a highly automated environment during three-hour long scenarios, For each scenario, twelve air traffic controllers operated eight sector positions in two air traffic control areas and were supervised by three front line managers, Controllers worked one-hour shifts, were relieved by other controllers, took a 3D-minute break, and worked another one-hour shift. On average, twice today's traffic density was simulated with more than 2200 aircraft per traffic scenario. The scenarios were designed to create peaks and valleys in traffic density, growing and decaying convective weather areas, and expose controllers to heavy and light metering conditions. This design enabled an initial look at a broad spectrum of workload, challenge, boredom, and fatigue in an otherwise uncharted territory of future operations. In this paper we report human/system integration aspects, safety and efficiency results as well as airspace throughput, workload, and operational acceptability. We conclude that, with further refinements. air traffic control operations with ground-based automated separation assurance can be an effective and acceptable means to routinely provide very high traffic throughput in the en route airspace.

  9. Room temperature plasmonic lasing in a continuous wave operation mode from an InGaN/GaN single nanorod with a low threshold

    PubMed Central

    Hou, Y.; Renwick, P.; Liu, B.; Bai, J.; Wang, T.

    2014-01-01

    It is crucial to fabricate nano photonic devices such as nanolasers in order to meet the requirements for the integration of photonic and electronic circuits on the nanometre scale. The great difficulty is to break down a bottleneck as a result of the diffraction limit of light. Nanolasers on a subwavelength scale could potentially be fabricated based on the principle of surface plasmon amplification by stimulated emission of radiation (SPASER). However, a number of technological challenges will have to be overcome in order to achieve a SPASER with a low threshold, allowing for a continuous wave (cw) operation at room temperature. We report a nano-SPASER with a record low threshold at room temperature, optically pumped by using a cw diode laser. Our nano-SPASER consists of a single InGaN/GaN nanorod on a thin SiO2 spacer layer on a silver film. The nanorod containing InGaN/GaN multi-quantum-wells is fabricated by means of a cost-effective post-growth fabrication approach. The geometry of the nanorod/dielectric spacer/plasmonic metal composite allows us to have accurate control of the surface plasmon coupling, offering an opportunity to determine the optimal thickness of the dielectric spacer. This approach will open up a route for further fabrication of electrically injected plasmonic lasers. PMID:24852881

  10. Actual Performance Prediction of Split-type Room Air Conditioner which Considered Unsteady Operation Concerning Heat Island Problem

    NASA Astrophysics Data System (ADS)

    Shinomiya, Naruaki; Nishimura, Nobuya; Iyota, Hiroyuki; Nomura, Tomohiro

    Split type air conditioners are operated actually in the situation unlike the condition that was described in a product catalog. On the other hand, exhaust heat from air conditioner is considered as one of the causes of heat island problem in urban area, and the air conditioner performance and heat load affect exhaust heat amount. In this study, air conditioner performances in both standard summer day and severe hot day were examined by dynamic simulation which considered outdoor weather changes. As a result, actual performances of the air conditioner were demonstrated as a function of outdoor temperature, heat load and indoor temperature. The higher the outdoor temperature and heat load rise, the smaller influences of indoor temperature against COP became. In standard summer day, relative performance exceeded by 15 to 45% than that of JIS operating condition. Also, COP in severe hot day decreased about 6% at the peak time than that of standard day. As a result, the air conditioner exhaust heat during one day which was predicted by the proposed simulation model became about 16% smaller than the conventional prediction model.

  11. Single Spatial-Mode Room-Temperature-Operated 3.0 to 3.4 micrometer Diode Lasers

    NASA Technical Reports Server (NTRS)

    Frez, Clifford F.; Soibel, Alexander; Belenky, Gregory; Shterengas, Leon; Kipshidze, Gela

    2010-01-01

    Compact, highly efficient, 3.0 to 3.4 m light emitters are in demand for spectroscopic analysis and identification of chemical substances (including methane and formaldehyde), infrared countermeasures technologies, and development of advanced infrared scene projectors. The need for these light emitters can be currently addressed either by bulky solid-state light emitters with limited power conversion efficiency, or cooled Interband Cascade (IC) semiconductor lasers. Researchers here have developed a breakthrough approach to fabrication of diode mid-IR lasers that have several advantages over IC lasers used for the Mars 2009 mission. This breakthrough is due to a novel design utilizing the strain-engineered quantum-well (QW) active region and quinternary barriers, and due to optimization of device material composition and growth conditions (growth temperatures and rates). However, in their present form, these GaSb-based laser diodes cannot be directly used as a part of sensor systems. The device spectrum is too broad to perform spectroscopic analysis of gas species, and operating currents and voltages are too high. In the current work, the emitters were fabricated as narrow-ridge waveguide index-guided lasers rather than broad stripe-gain guided multimode Fabry-Perot (FP) lasers as was done previously. These narrow-ridge waveguide mid-IR lasers exhibit much lower power consumptions, and can operate in a single spatial mode that is necessary for demonstration of single-mode distributed feedback (DBF) devices for spectroscopic applications. These lasers will enable a new generation of compact, tunable diode laser spectrometers with lower power consumption, reduced complexity, and significantly reduced development costs. These lasers can be used for the detection of HCN, C2H2, methane, and ethane.

  12. End of life care in the operating room for non-heart-beating donors: organization at the University Hospital of Liège.

    PubMed

    Joris, J; Kaba, A; Lauwick, S; Lamy, M; Brichant, J-F; Damas, P; Ledoux, D; Damas, F; Lambermont, B; Morimont, P; Devos, P; Delbouille, M-H; Monard, J; Hans, M-F; DeRoover, A; Honoré, P; Squifflet, J-P; Meurisse, M; Detry, O

    2011-11-01

    Non-heart-beating (NHB) organ donation has become an alternative source to increase organ supply for transplantation. A NHB donation program was implemented in our institution in 2002. As in many institutions the end of life care of the NHB donor (NHBD) is terminated in the operating room (OR) to reduce warm ischemia time. Herein we have described the organization of end of life care for these patients in our institution, including the problems addressed, the solution proposed, and the remaining issues. Emphasis is given to our protocol elaborated with the different contributors of the chain of the NHB donation program. This protocol specifies the information mandatory in the medical records, the end of life care procedure, the determination of death, and the issue of organ preservation measures before NHBD death. The persisting malaise associated with NHB donation reported by OR nurses is finally documented using an anonymous questionnaire. PMID:22099816

  13. Room-temperature continuous operation of InAsSb quantum-dot lasers near 2 mu m based on (100) InP substrate

    NASA Technical Reports Server (NTRS)

    Qui, Y.; Uhl, D.; Keo, S.

    2003-01-01

    Single-stack InAsSb self-assembled quantum-dot lasers based on (001) InP substrate have been grown by metalorganic vapor-phase epitaxy. The narrow ridge waveguide lasers lased at wavelengths near 2 mu m up to 25 degrees C in continuous-wave operation. At room temperature, a differential quantum efficiency of 13 percent is obtained and the maximum output optical power reaches 3 mW per facet with a threshold current density of 730 A/cm(sup 2). With increasing temperature the emission wavelength is extremely temperature stable, and a very low wavelength temperature sensitivity of 0.05 nm/degrees C is measured, which is even lower than that caused by the refractive index change.

  14. Room-temperature continuous operation of GaAs/AlGaS lasers grown on Si by organometallic vapor-phase epitaxy

    SciTech Connect

    Choi, H.K.; Wang, C.A.; Fan, J.C.

    1990-08-15

    Graded-index separate-confinement heterostructure single-quantum-well GaAs/AlGaAs diode lasers exhibiting continuous (cw) operation at room temperature have been grown on a Si substrate by organometallic vapor-phase epitaxy, without the use of molecular-beam epitaxy. To improve the quality of the laser structure, a defect-filtering layer was incorporated between this structure and a GaAs buffer layer about 1.5 micron thick grown on the substrate. Of four types of defect-filtering layers investigated, the most effective was one grown with thermal cycling, which made it possible to obtain pulsed threshold current densities as low as 350 A/cm2 for broad-stripe lasers with a cavity length of 500 microns. Ridge-waveguide lasers with this type of defect-filtering layer have exhibited cw threshold currents as low as 25 mA and a differential quantum efficiency of 55%.

  15. Growth and layer structure optimization of 2.26 μm (AlGaIn)(AsSb) diode lasers for room temperature operation

    NASA Astrophysics Data System (ADS)

    Simanowski, S.; Mermelstein, C.; Walther, M.; Herres, N.; Kiefer, R.; Rattunde, M.; Schmitz, J.; Wagner, J.; Weimann, G.

    2001-07-01

    The optimization of MBE growth conditions and layer structures for room temperature operation of 2.26 μm AlGaAsSb/GaInAsSb laser structures is investigated. Index guided triple quantum well large optical cavity diode lasers with 64 μm×1000 μm cavities and high reflection/antireflection coated facets reveal a cw output power of 350 mW at T=280 K. An internal quantum efficiency ηi of 69%, internal losses αi of 7.7 cm -1 and a threshold current density for infinite cavity length of j ∞=144 A/cm 2 are obtained for this structure.

  16. Surgeon point-of-view recording: Using a high-definition head-mounted video camera in the operating room

    PubMed Central

    Nair, Akshay Gopinathan; Kamal, Saurabh; Dave, Tarjani Vivek; Mishra, Kapil; Reddy, Harsha S; Rocca, David Della; Rocca, Robert C Della; Andron, Aleza; Jain, Vandana

    2015-01-01

    Objective: To study the utility of a commercially available small, portable ultra-high definition (HD) camera (GoPro Hero 4) for intraoperative recording. Methods: A head mount was used to fix the camera on the operating surgeon's head. Due care was taken to protect the patient's identity. The recorded video was subsequently edited and used as a teaching tool. This retrospective, noncomparative study was conducted at three tertiary eye care centers. The surgeries recorded were ptosis correction, ectropion correction, dacryocystorhinostomy, angular dermoid excision, enucleation, blepharoplasty and lid tear repair surgery (one each). The recorded videos were reviewed, edited, and checked for clarity, resolution, and reproducibility. Results: The recorded videos were found to be high quality, which allowed for zooming and visualization of the surgical anatomy clearly. Minimal distortion is a drawback that can be effectively addressed during postproduction. The camera, owing to its lightweight and small size, can be mounted on the surgeon's head, thus offering a unique surgeon point-of-view. In our experience, the results were of good quality and reproducible. Conclusions: A head-mounted ultra-HD video recording system is a cheap, high quality, and unobtrusive technique to record surgery and can be a useful teaching tool in external facial and ophthalmic plastic surgery. PMID:26655001

  17. 49. Machinery rooms on north tower. Facing north. Machinery rooms ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    49. Machinery rooms on north tower. Facing north. Machinery rooms contain all motors, motor controllers, and gears for operating one span, in this case, the north span. Note bell with continuous operating clapper for use as fog signals. - Henry Ford Bridge, Spanning Cerritos Channel, Los Angeles-Long Beach Harbor, Los Angeles, Los Angeles County, CA

  18. The impact of a preloaded intraocular lens delivery system on operating room efficiency in routine cataract surgery

    PubMed Central

    Jones, Jason J; Chu, Jeffrey; Graham, Jacob; Zaluski, Serge; Rocha, Guillermo

    2016-01-01

    Purpose The aim of this study was to evaluate the operational impact of using preloaded intraocular lens (IOL) delivery systems compared with manually loaded IOL delivery processes during routine cataract surgeries. Methods Time and motion data, staff and surgery schedules, and cost accounting reports were collected across three sites located in the US, France, and Canada. Time and motion data were collected for manually loaded IOL processes and preloaded IOL delivery systems over four surgery days. Staff and surgery schedules and cost accounting reports were collected during the 2 months prior and after introduction of the preloaded IOL delivery system. Results The study included a total of 154 routine cataract surgeries across all three sites. Of these, 77 surgeries were performed using a preloaded IOL delivery system, and the remaining 77 surgeries were performed using a manual IOL delivery process. Across all three sites, use of the preloaded IOL delivery system significantly decreased mean total case time by 6.2%–12.0% (P<0.001 for data from Canada and the US and P<0.05 for data from France). Use of the preloaded delivery system also decreased surgeon lens time, surgeon delays, and eliminated lens touches during IOL preparation. Conclusion Compared to a manual IOL delivery process, use of a preloaded IOL delivery system for cataract surgery reduced total case time, total surgeon lens time, surgeon delays, and eliminated IOL touches. The time savings provided by the preloaded IOL delivery system provide an opportunity for sites to improve routine cataract surgery throughput without impacting surgeon or staff capacity. PMID:27382245

  19. Comparison of subcutaneous and intravenous continuous glucose monitoring accuracy in an operating room and an intensive care unit.

    PubMed

    Munekage, Masaya; Yatabe, Tomoaki; Sakaguchi, Masahiko; Kitagawa, Hiroyuki; Tamura, Takahiko; Namikawa, Tsutomu; Hanazaki, Kazuhiro

    2016-06-01

    Although we have used an intravenous continuous glucose monitor for blood glucose management, a previous study reported that a subcutaneous continuous glucose monitor was also reliable for use in critically ill patients. The aim of this study was to compare the subcutaneous and intravenous continuous glucose monitors. This was an observational trial (UMIN-CTR, ID:000013338). We included patients who were admitted to our intensive care units (ICU) after hepato-biliary pancreatic surgery. Continuous blood glucose measurement was performed from the beginning of the operation to ICU discharge using the intravenous continuous monitor STG-55 (Nikkiso, Tokyo, Japan) and the subcutaneous continuous monitor iPro2 (Medtronic Japan, Tokyo, Japan). The STG-55 measured the glucose level in real time, and the iPro2 measured this every 5 min. We compared glucose levels obtained using the two devices every 5 min using a Bland-Altman plot and a regression analyses. A total of 3592 comparative samples in 15 cases were analyzed. The mean glucose level measured using the STG-55 was 139 ± 21 mg/dl, and that measured using the iPro2 was 144 ± 31 mg/dl. A linear regression line had the equation of the form y = 0.225x + 106. The coefficient of determination was 0.11, and the F-test significance level was set as p < 0.01. The mean of the differences was -5.2 mg/dl, with a 95 % agreement limit of -67 to + 57 mg/dL. The percent error was 44 %. In conclusion, the current study suggests that subcutaneous and intravenous continuous glucose monitoring was not highly correlated during either surgery or ICU stay. PMID:26721825

  20. Room-temperature CW operation of a nitride-based vertical-cavity surface-emitting laser using thick GaInN quantum wells

    NASA Astrophysics Data System (ADS)

    Furuta, Takashi; Matsui, Kenjo; Horikawa, Kosuke; Ikeyama, Kazuki; Kozuka, Yugo; Yoshida, Shotaro; Akagi, Takanobu; Takeuchi, Tetsuya; Kamiyama, Satoshi; Iwaya, Motoaki; Akasaki, Isamu

    2016-05-01

    We demonstrated a room-temperature (RT) continuous-wave (CW) operation of a GaN-based vertical-cavity surface-emitting laser (VCSEL) using a thick GaInN quantum well (QW) active region and an AlInN/GaN distributed Bragg reflector. We first investigated the following two characteristics of a 6 nm GaInN 5 QWs active region in light-emitting diode (LED) structures. The light output power at a high current density (∼10 kA/cm2) from the 6 nm GaInN 5 QWs was the same or even higher than that from standard 3 nm 5 QWs. In addition, we found that hole injection into the farthest QW from a p-layer was sufficient. We then demonstrated a GaN-based VCSEL with the 6 nm 5 QWs, resulting in the optical confinement factor of 3.5%. The threshold current density under CW operation at RT was 7.5 kA/cm2 with a narrow (0.4 nm) emission spectrum of 413.5 nm peak wavelength.

  1. Memory's Room.

    ERIC Educational Resources Information Center

    Carruthers, Mary

    1999-01-01

    Describes the Liberal Arts Studiolo from the Ducal Palace at Guibbio, Italy. Discusses how the room's design and decoration mirrors its educational uses. Notes that the object of education was to provide the young person with a kind of mental library of materials that could be drawn upon quickly. (RS)

  2. Principles of operating room organization.

    PubMed

    Watkins, W D

    1997-01-01

    The importance of the changing health care climate has triggered important changes in the management of high-cost components of acute care facilities. By integrating and better managing various elements of the surgical process, health care institutions are able to rationally trim costs while maintaining high-quality services. The leadership that physicians can provide is crucial to the success of this undertaking (1). The importance of the use of primary data related to patient throughput and related resources should be strongly emphasized, for only when such data are converted to INFORMATION of functional value can participating healthcare personnel be reasonably expected to anticipate and respond to varying clinical demands with ever-limited resources. Despite the claims of specific commercial vendors, no single product will likely be sufficient to significantly change the perioperative process to the degree or for the duration demanded by healthcare reform. The most effective approach to achieving safety, cost-effectiveness, and predictable process in the realm of Surgical Services will occur by appropriate application of the "best of breed" contributions of: (a) medical/patient safety practice/oversight; (b) information technology; (c) contemporary management; and (d) innovative and functional cost-accounting methodology. S "modified activity-based cost accounting method" can serve as the basis for acquiring true direct-cost information related to the perioperative process. The proposed overall management strategy emphasizes process and feedback, rather than specific product, and although imposing initial demands and change on the traditional hospital setting, can advance the strongest competitive position in perioperative services. This comprehensive approach comprises a functional basis for important bench-marking activities among multiple surgical services. An active, comparative process of this type is of paramount importance in emphasizing patient care and safety as the highest priority while changing the process and cost of perioperative care. Additionally, this approach objectively defines the surgical process in terms by which the impact of new treatments, drugs, devices and process changes can be assessed rationally. PMID:9420979

  3. Effect of an Ergonomics-Based Educational Intervention Based on Transtheoretical Model in Adopting Correct Body Posture Among Operating Room Nurses

    PubMed Central

    Moazzami, Zeinab; Dehdari, Tahere; Taghdisi, Mohammad Hosein; Soltanian, Alireza

    2016-01-01

    Background: One of the preventive strategies for chronic low back pain among operating room nurses is instructing proper body mechanics and postural behavior, for which the use of the Transtheoretical Model (TTM) has been recommended. Methods: Eighty two nurses who were in the contemplation and preparation stages for adopting correct body posture were randomly selected (control group = 40, intervention group = 42). TTM variables and body posture were measured at baseline and again after 1 and 6 months after the intervention. A four-week ergonomics educational intervention based on TTM variables was designed and conducted for the nurses in the intervention group. Results: Following the intervention, a higher proportion of nurses in the intervention group moved into the action stage (p < 0.05). Mean scores of self-efficacy, pros, experimental processes and correct body posture were also significantly higher in the intervention group (p < 0.05). No significant differences were found in the cons and behavioral processes, except for self-liberation, between the two groups (p > 0.05) after the intervention. Conclusions: The TTM provides a suitable framework for developing stage-based ergonomics interventions for postural behavior.

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

    PubMed

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

    2015-01-01

    Information technology, such as real-time location (RTL) systems using Radio Frequency IDentification (RFID) may contribute to overcome patient safety issues and high costs in healthcare. The aim of this work is to study if a RFID specific Participatory Design (PD) approach supports the design and the implementation of RTL systems in the Operating Room (OR). A RFID specific PD approach was used to design and implement two RFID based modules. The Device Module monitors the safety status of OR devices and the Patient Module tracks the patients' locations during their hospital stay. The PD principles 'multidisciplinary team', 'participation users (active involvement)' and 'early adopters' were used to include users from the RFID company, the university and the hospital. The design and implementation process consisted of two 'structured cycles' ('iterations'). The effectiveness of this approach was assessed by the acceptance in terms of level of use, continuity of the project and purchase. The Device Module included eight strategic and twelve tactical actions and the Patient Module included six strategic and twelve tactical actions. Both modules are now used on a daily basis and are purchased by the hospitals for continued use. The RFID specific PD approach was effective in guiding and supporting the design and implementation process of RFID technology in the OR. The multidisciplinary teams and their active participation provided insights in the social and the organizational context of the hospitals making it possible to better fit the technology to the hospitals' (future) needs. PMID:25503417

  5. CellDyM: A room temperature operating cryogenic cell for the dynamic monitoring of snow metamorphism by time-lapse X-ray microtomography

    NASA Astrophysics Data System (ADS)

    Calonne, N.; Flin, F.; Lesaffre, B.; Dufour, A.; Roulle, J.; Puglièse, P.; Philip, A.; Lahoucine, F.; Geindreau, C.; Panel, J.-M.; Roscoat, S. Rolland; Charrier, P.

    2015-05-01

    Monitoring the time evolution of snow microstructure in 3-D is crucial for a better understanding of snow metamorphism. We, therefore, designed a cryogenic cell that precisely controls the experimental conditions of a sample while it is scanned by X-ray tomography. Based on a thermoelectrical regulation and a vacuum insulation, the cell operates at room temperature. It is, thus, adaptable to diverse scanners, offering advantages in terms of imaging techniques, resolution, and speed. Three-dimensional time-lapse series were obtained under equitemperature and temperature gradient conditions at a 7.8 μm precision. The typical features of each metamorphism and the anisotropic faceting behavior between the basal and prismatic planes, known to occur close to -2°C, were observed in less than 30 h. These results are consistent with the temperature fields expected from heat conduction simulations through the cell. They confirm the cell's accuracy and the interest of relatively short periods to study snow metamorphism.

  6. Decreasing the Hours That Anesthesiologists and Nurse Anesthetists Work Late by Making Decisions to Reduce the Hours of Over-Utilized Operating Room Time.

    PubMed

    Dexter, Franklin; Wachtel, Ruth E; Epstein, Richard H

    2016-03-01

    In this special article, we evaluate how to reduce the number of hours that anesthesiologists and nurse anesthetists work beyond the end of their scheduled shifts. We limit consideration to surgical suites where the hours of cases in each operating room (OR) average 8 hours or more per day. Let "allocated hours" refer to the hours into which cases are scheduled, calculated months in advance for each combination of service and day of the week. Over-Utilized time is the OR workload exceeding allocated time. Reducing Over-Utilized time is the key to reducing the hours that anesthesia providers work late. Certain decisions that reduce Over-Utilized time and reduce the hours that anesthesiologists and nurse anesthetists work late are made by the surgical committee or perioperative medical director months in advance. Such decisions include increasing the number of first case starts and planning staffing for turnovers and lunch breaks during the busiest times of the day. However, most decisions substantively influencing Over-Utilized OR time are made within 1 workday before the day of surgery and on the day of surgery, because only then are ORs sufficiently full that changes can be made to minimize Over-Utilized time. Decisions to reduce Over-Utilized time on the day of surgery include targeting ORs with expected Over-Utilized time and taking steps to reduce it, including making effective staff assignments and appropriately scheduling add-on cases. PMID:26891395

  7. Surgical Management of Combined Intramedullary Arteriovenous Malformation and Perimedullary Arteriovenous Fistula within the Hybrid Operating Room after Five Years of Performing Focus Fractionated Radiotherapy: Case Report

    PubMed Central

    GEKKA, Masayuki; SEKI, Toshitaka; HIDA, Kazutoshi; OSANAI, Toshiya; HOUKIN, Kiyohiro

    2014-01-01

    Perimedullary arteriovenous fistula (AVF) shunts occur on the spinal cord surface and can be treated surgically or by endovascular embolization. In contrast, the nidus of an intramedullary arteriovenous malformation (AVM) is located in the spinal cord and is difficult to treat surgically or by endovascular techniques. The benefits of radiotherapy for treating intramedullary AVM have been published, but are anecdotal and consist largely of case reports. We present a case of combined cervical intramedullary AVM and perimedullary AVF which received surgical treatment within a hybrid operating room (OR) after 5 years of focus fractionated radiotherapy. A 37-year-old male presented with stepwise worsening myelopathy. Magnetic resonance imaging and spinal angiography revealed intramedullary AVM and perimedullary AVF at the C3 to C5 levels. In order to reduce nidus size and blood flow, we first performed focal fractionated radiotherapy. Five years later, the lesion volume was reduced. Following this, direct surgery was performed by an anterior approach using corpectomy in the hybrid OR. The spinal cord was monitored by motor-evoked potential throughout the surgery. Complete obliteration of the fistulous connection was confirmed by intraoperative indocyanine green video-angiography and intraoperative angiography, preserving the anterior spinal artery. We conclude that surgical treatment following focal fractionated radiotherapy may become one strategy for patients who are initially deemed ineligible for endovascular embolization and surgical treatment. Furthermore, the hybrid OR enables safe and precise treatment for spinal vascular disorders in the fields of endovascular treatment and neurosurgery. PMID:25367581

  8. Review of experimental studies in social psychology of small groups when an optimal choice exists and application to operating room management decision-making.

    PubMed

    Prahl, Andrew; Dexter, Franklin; Braun, Michael T; Van Swol, Lyn

    2013-11-01

    Because operating room (OR) management decisions with optimal choices are made with ubiquitous biases, decisions are improved with decision-support systems. We reviewed experimental social-psychology studies to explore what an OR leader can do when working with stakeholders lacking interest in learning the OR management science but expressing opinions about decisions, nonetheless. We considered shared information to include the rules-of-thumb (heuristics) that make intuitive sense and often seem "close enough" (e.g., staffing is planned based on the average workload). We considered unshared information to include the relevant mathematics (e.g., staffing calculations). Multiple studies have shown that group discussions focus more on shared than unshared information. Quality decisions are more likely when all group participants share knowledge (e.g., have taken a course in OR management science). Several biases in OR management are caused by humans' limited abilities to estimate tails of probability distributions in their heads. Groups are more susceptible to analogous biases than are educated individuals. Since optimal solutions are not demonstrable without groups sharing common language, only with education of most group members can a knowledgeable individual influence the group. The appropriate model of decision-making is autocratic, with information obtained from stakeholders. Although such decisions are good quality, the leaders often are disliked and the decisions considered unjust. In conclusion, leaders will find the most success if they do not bring OR management operational decisions to groups, but instead act autocratically while obtaining necessary information in 1:1 conversations. The only known route for the leader making such decisions to be considered likable and for the decisions to be considered fair is through colleagues and subordinates learning the management science. PMID:24108254

  9. Looking west in the basement utility room, room 24, overview ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Looking west in the basement utility room, room 24, overview of air handling system, large walk-in filter, large ducts, pipes, and gauges - March Air Force Base, Strategic Air Command, Combat Operations Center, 5220 Riverside Drive, Moreno Valley, Riverside County, CA

  10. 35. VIEW OF TELEMETRY ROOM (ROOM 106) FROM ITS NORTHWEST ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    35. VIEW OF TELEMETRY ROOM (ROOM 106) FROM ITS NORTHWEST CORNER SHOWING TM-ISE-3 TELEMETRY CHECKOUT SYSTEM AND HONEYWELL TAPE RECORDER - Vandenberg Air Force Base, Space Launch Complex 3, Launch Operations Building, Napa & Alden Roads, Lompoc, Santa Barbara County, CA

  11. Room temperature operation of 2.67 mJ pulse LD end pumped Q-switched Tm:YAG laser

    NASA Astrophysics Data System (ADS)

    Song, Xuedi; Wu, Chunting; Chen, Xinyu; Yu, Kai; Jin, Guangyong

    2014-12-01

    Due to 2 μm band in the absorption of water and CO2, the diode pumped solid state lasers with wavelength around 2 μm have important applications in laser medicine and remote sensing, such as it can be used as a scalpe or a light source of Coherent Doppler Wind Lidar and Differential Absorption Lidar. In the recently years, scientists have done much work on the development of such lasers. There're many reports on continuous Tm:YAG laser. However, the study on Q-switched Tm:YAG laser, which is more useful in applications, was very rare. As the light source of Coherent Doppler Wind Lidar, large energy and wide pulse width is desired. Current reports mostly adopted CW pumped source, but it would make a mount of heat. Pulse pumping method could reduce the heat accumulation and improve the heat stability of the laser. How to improve the single pulse energy was the focus of current study. In this paper, a single end bonding Tm:YAG crystal with Tm3+ doping concentration of 3.5at.% was used. Acousto-optic (AO) Q-switched (GOOCH and HOUSEGO QS041-10M-HI8) operation was adopted in our experiment. In the repetition frequency of 100Hz, a maximum single energy of 2.67 mJ (measured by Ophir 30A-BB) and the narrowest pulse width of 149 ns (measured by Vigo PCI-3TE-12 detector) were achieved at room temperature. The M2x was 1.31 and the M2y was 1.35 (measured by Spiricon Pyrocam-III). Tm:YAG laser was developed by using a pulse diode pumped L shape resonant cavity. The transmittance of the curve output mirror was 4% and the curvature radius of which was 300 mm. The output center wavelength of the laser was measured to be 2013.5 nm (measured by YOKOGAWA AQ6375).

  12. 55. VIEW OF SLC3E CONTROL ROOM (ROOM 107) FROM ITS ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    55. VIEW OF SLC-3E CONTROL ROOM (ROOM 107) FROM ITS NORTHEAST CORNER - Vandenberg Air Force Base, Space Launch Complex 3, Launch Operations Building, Napa & Alden Roads, Lompoc, Santa Barbara County, CA

  13. Field Test of Room-to-Room Uniformity of Ventilation Air Distribution in Two New Houses

    SciTech Connect

    Hendron, Robert; Anderson, Ren; Barley, Dennis; Rudd, Armin; Townsend, Aaron; Hancock, Ed

    2006-12-01

    This report describes a field test to characterize the uniformity of room-to-room ventilation air distribution under various operating conditions by examining multi-zone tracer gas decay curves and calculating local age-of-air.

  14. How to Conduct Multimethod Field Studies in the Operating Room: The iPad Combined With a Survey App as a Valid and Reliable Data Collection Tool

    PubMed Central

    Tscholl, David W; Weiss, Mona; Spahn, Donat R

    2016-01-01

    Background Tablet computers such as the Apple iPad are progressively replacing traditional paper-and-pencil-based data collection. We combined the iPad with the ready-to-use survey software, iSurvey (from Harvestyourdata), to create a straightforward tool for data collection during the Anesthesia Pre-Induction Checklist (APIC) study, a hospital-wide multimethod intervention study involving observation of team performance and team member surveys in the operating room (OR). Objective We aimed to provide an analysis of the factors that led to the use of the iPad- and iSurvey-based tool for data collection, illustrate our experiences with the use of this data collection tool, and report the results of an expert survey about user experience with this tool. Methods We used an iPad- and iSurvey-based tool to observe anesthesia inductions conducted by 205 teams (N=557 team members) in the OR. In Phase 1, expert raters used the iPad- and iSurvey-based tool to rate team performance during anesthesia inductions, and anesthesia team members were asked to indicate their perceptions after the inductions. In Phase 2, we surveyed the expert raters about their perceptions regarding the use of the iPad- and iSurvey-based tool to observe, rate, and survey teams in the ORs. Results The results of Phase 1 showed that training data collectors on the iPad- and iSurvey-based data collection tool was effortless and there were no serious problems during data collection, upload, download, and export. Interrater agreement of the combined data collection tool was found to be very high for the team observations (median Fleiss’ kappa=0.88, 95% CI 0.78-1.00). The results of the follow-up expert rater survey (Phase 2) showed that the raters did not prefer a paper-and-pencil-based data collection method they had used during other earlier studies over the iPad- and iSurvey-based tool (median response 1, IQR 1-1; 1=do not agree, 2=somewhat disagree, 3=neutral, 4=somewhat agree, 5=fully agree). They

  15. The 'Room within a Room' Concept for Monitored Warhead Dismantlement

    SciTech Connect

    Tanner, Jennifer E.; Benz, Jacob M.; White, Helen; McOmish, Sarah; Allen, Keir; Tolk, Keith; Weeks, George E.

    2014-12-01

    Over the past 10 years, US and UK experts have engaged in a technical collaboration with the aim of improving scientific and technological abilities in support of potential future nuclear arms control and non-proliferation agreements. In 2011 a monitored dismantlement exercise provided an opportunity to develop and test potential monitoring technologies and approaches. The exercise followed a simulated nuclear object through a dismantlement process and looked to explore, with a level of realism, issues surrounding device and material monitoring, chain of custody, authentication and certification of equipment, data management and managed access. This paper focuses on the development and deployment of the ‘room-within-a-room’ system, which was designed to maintain chain of custody during disassembly operations. A key challenge for any verification regime operating within a nuclear weapon complex is to provide the monitoring party with the opportunity to gather sufficient evidence, whilst protecting sensitive or proliferative information held by the host. The requirement to address both monitoring and host party concerns led to a dual function design which: • Created a controlled boundary around the disassembly process area which could provide evidence of unauthorised diversion activities. • Shielded sensitive disassembly operations from monitoring party observation. The deployed room-within-a-room was an integrated system which combined a number of chain of custody technologies (i.e. cameras, tamper indicating panels and enclosures, seals, unique identifiers and radiation portals) and supporting deployment procedures. This paper discusses the bounding aims and constraints identified by the monitoring and host parties with respect to the disassembly phase, the design of the room-within-a-room system, lessons learned during deployment, conclusions and potential areas of future work. Overall it was agreed that the room-within-a-room approach was effective but

  16. 8. VIEW OF SLC3W CONTROL ROOM (ROOM 105) FROM ITS ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    8. VIEW OF SLC-3W CONTROL ROOM (ROOM 105) FROM ITS NORTHEAST CORNER. TELEMETRY ROOM VISIBLE THROUGH WINDOWS IN SOUTH WALL. - Vandenberg Air Force Base, Space Launch Complex 3, Launch Operations Building, Napa & Alden Roads, Lompoc, Santa Barbara County, CA

  17. Strain-Compensated InGaAs/InAlAs Quantum Cascade Detector of 4.5 μm Operating at Room Temperature

    NASA Astrophysics Data System (ADS)

    Kong, Ning; Liu, Jun-Qi; Li, Lu; Liu, Feng-Qi; Wang, Li-Jun; Wang, Zhan-Guo

    2010-03-01

    We present a strain-compensated InP-based InGaAs/InAlAs photovoltaic quantum cascade detector grown by solid source molecular beam epitaxy. The detector is based on a vertical intersubband transition and electron transfer on a cascade of quantum levels which is designed to provide longitudinal optical phonon extraction stairs. By careful structure design and growth, the whole epilayer has a residual strain toward InP substrate of only -2.8 × 10-4. A clear narrow band detection spectrum centered at 4.5 μm has been observed above room temperature for a device with 200 × 200 μm2 square mesa.

  18. Room-temperature continuous-wave operation of lateral current injection wavelength-scale embedded active-region photonic-crystal laser.

    PubMed

    Matsuo, Shinji; Takeda, Koji; Sato, Tomonari; Notomi, Masaya; Shinya, Akihiko; Nozaki, Kengo; Taniyama, Hideaki; Hasebe, Koichi; Kakitsuka, Takaaki

    2012-02-13

    We have developed a wavelength-scale embedded active-region photonic-crystal laser using lateral p-i-n structure. Zn diffusion and Si ion implantation are used for p- and n-type doping. Room-temperature continuous-wave lasing behavior is clearly observed from the injection current dependence of the output power, 3dB-bandwidth of the peak, and lasing wavelength. The threshold current is 390 μA and the estimated effective threshold current is 9.4 μA. The output power in output waveguide is 1.82 μW for a 2.0-mA current injection. These results indicate that the embedded active-region structure effectively reduce the thermal resistance. Ultrasmall electrically driven lasers are an important step towards on-chip photonic network applications. PMID:22418134

  19. Room-temperature operation of GaInAsP lasers epitaxially grown on wafer-bonded InP/Si substrate

    NASA Astrophysics Data System (ADS)

    Matsumoto, Keiichi; Kishikawa, Junya; Nishiyama, Tetsuo; Kanke, Tomokazu; Onuki, Yuya; Shimomura, Kazuhiko

    2016-06-01

    An epitaxially grown GaInAsP/InP double-hetero laser diode (LD) has been demonstrated on a wafer-bonded InP/Si substrate for the first time. The as-grown structure was optically active and exhibited a photoluminescence intensity comparable to that grown on an InP wafer as a reference. Electrodes were formed on both the p-side contact layer and the n-Si underside to fabricate Fabry–Perot LD chips. During these processes, the InP layer remained bonded to the underlying Si substrate. Electrically pumped lasing emission was observed at room temperature under a pulse regime. These results indicate the potential for the high-density integration of InP-based LDs as a light source for optical interconnections.

  20. Electrically pumped room-temperature operation of GaAs1-xBix laser diodes with low-temperature dependence of oscillation wavelength

    NASA Astrophysics Data System (ADS)

    Fuyuki, Takuma; Yoshida, Kenji; Yoshioka, Ryo; Yoshimoto, Masahiro

    2014-08-01

    Lasing oscillation at wavelengths up to 1045 nm at room temperature has been realized from GaAs1-xBix Fabry-Perot laser diodes (FP-LDs) by electrical injection, and the temperature characteristics of GaAs1-xBix FP-LDs are revealed for the first time. The characteristic temperature T0 of the GaAs0.97Bi0.03 FP-LD in the temperature range between 15 and 40 °C (T0 = 125 K) is similar to that reported for typical 0.98 µm InGaAs/GaAs LDs. The temperature coefficient of the lasing wavelength in GaAs0.97Bi0.03 FP-LDs is reduced to 0.17 nm/K, which is only 45% of that of GaAs FP-LDs.

  1. CEBAF Control Room Renovation

    SciTech Connect

    Michael Spata; Anthony Cuffe; Thomas Oren

    2005-03-22

    The Machine Control Center (MCC) at Jefferson Lab's Continuous Electron Beam Accelerator Facility (CEBAF) was constructed in the early 1990s and based on proven technology of that era. Through our experience over the last 15 years and in our planning for the facilities 12 GeV upgrade we reevaluated the control room environment to capitalize on emerging visualization and display technologies and improve on work-flow processes and ergonomic attributes. The renovation was performed in two phases during the summer of 2004, with one phase occurring during machine operations and the latter, more extensive phase, occurring during our semi-annual shutdown period. The new facility takes advantage of advances in display technology, analog and video signal management, server technology, ergonomic workspace design, lighting engineering, acoustic ceilings and raised flooring solutions to provide a marked improvement in the overall environment of machine operations.

  2. Effect of Embedded Pd Microstructures on the Flat-Band-Voltage Operation of Room Temperature ZnO-Based Liquid Petroleum Gas Sensors

    PubMed Central

    Ali, Ghusoon M.; Thompson, Cody V.; Jasim, Ali K.; Abdulbaqi, Isam M.; Moore, James C.

    2013-01-01

    Three methods were used to fabricate ZnO-based room temperature liquid petroleum gas (LPG) sensors having interdigitated metal-semiconductor-metal (MSM) structures. Specifically, devices with Pd Schottky contacts were fabricated with: (1) un-doped ZnO active layers; (2) Pd-doped ZnO active layers; and (3) un-doped ZnO layers on top of Pd microstructure arrays. All ZnO films were grown on p-type Si(111) substrates by the sol-gel method. For devices incorporating a microstructure array, Pd islands were first grown on the substrate by thermal evaporation using a 100 μm mesh shadow mask. We have estimated the sensitivity of the sensors for applied voltage from –5 to 5 V in air ambient, as well as with exposure to LPG in concentrations from 500 to 3,500 ppm at room temperature (300 K). The current-voltage characteristics were studied and parameters such as leakage current, barrier height, reach-through voltage, and flat-band voltage were extracted. We include contributions due to the barrier height dependence on the electric field and tunneling through the barrier for the studied MSM devices. The Pd-enhanced devices demonstrated a maximum gas response at flat-band voltages. The study also revealed that active layers consisting of Pd microstructure embedded ZnO films resulted in devices exhibiting greater gas-response as compared to those using Pd-doped ZnO thin films or un-doped active layers.

  3. Individual room temperature control: A peaceful solution to thermostat wars

    SciTech Connect

    Pieper, C.A. )

    1994-01-01

    This article addresses the problem of maintaining thermal comfort in individual rooms using an individual room temperature control concept to provide greater occupant comfort and potentially reduce energy consumption. The topics of the article include occupant temperature control methods, multi-room zone control, HVAC system operation, computer simulation, and the results of using individual room temperature control.

  4. Virus diffusion in isolation rooms.

    PubMed

    Kao, P H; Yang, R J

    2006-03-01

    In hospitals, the ventilation of isolation rooms operating under closed-door conditions is vital if the spread of viruses and infection is to be contained. Engineering simulation, which employs computational fluid dynamics, provides a convenient means of investigating airflow behaviour in isolation rooms for various ventilation arrangements. A cough model was constructed to permit the numerical simulation of virus diffusion inside an isolation room for different ventilation system configurations. An analysis of the region of droplet fallout and the dilution time of virus diffusion of coughed gas in the isolation room was also performed for each ventilation arrangement. The numerical results presented in this paper indicate that the parallel-directional airflow pattern is the most effective means of controlling flows containing virus droplets. Additionally, staggering the positions of the supply vents at the door end of the room relative to the exhaust vents on the wall behind the bed head provides effective infection control and containment. These results suggest that this particular ventilation arrangement enhances the safety of staff when performing medical treatments within isolation rooms. PMID:16359753

  5. BeZnCdSe quantum-well ridge-waveguide laser diodes under low threshold room-temperature continuous-wave operation

    NASA Astrophysics Data System (ADS)

    Feng, Jijun; Akimoto, Ryoichi

    2015-10-01

    Low threshold current ridge-waveguide BeZnCdSe quantum-well laser diodes (LDs) have been developed by completely etching away the top p-type BeMgZnSe/ZnSe:N short-period superlattice cladding layer, which can suppress the leakage current that flows laterally outside of the electrode. The waveguide LDs are covered with a thick SiO2 layer and planarized with chemical-mechanical polishing and a reactive ion etching process. Room-temperature lasing under continuous-wave condition is achieved with the laser cavity formed by the cleaved waveguide facets coated with high-reflectivity dielectric films. For a 4 μm-wide green LD lasing around a wavelength of 535 nm, threshold current and voltage of 7.07 mA and 7.89 V are achieved for a cavity length of 300 μm, and the internal differential quantum efficiency, internal absorption loss, gain constant, and nominal transparency current density are estimated to be 27%, 4.09 cm-1, 29.92 (cm × μm)/kA and 6.35 kA/(cm2 × μm), respectively. This compact device can realize a significantly improved performance with much lower threshold power consumption, which would benefit the potential application for ZnSe-based green LDs as light sources in full-color display and projector devices installed in consumer products such as pocket projectors.

  6. Smartphones in the Operating Room: Distraction or Diagnostic Aid? A Case of Newly Diagnosed Wolff-Parkinson White in a Pediatric Patient Having Bronchoscopy Under General Anesthesia.

    PubMed

    Esenther, Brandon; Ko, Riva

    2015-08-01

    A 4-year-old boy presented for elective bronchoscopy after years of pharmacologically unresponsive reactive airway disease that limited physical activity. After mask induction with nitrous oxide and sevoflurane, the patient was noted to be intermittently in a hemodynamically stable tachyarrhythmia. The anesthesia machine, though equipped with electrocardiogram (ECG) recording capabilities, malfunctioned during the case and was not able to print a rhythm strip. As a substitute, a smartphone picture and video were recorded. In the recovery room, initial 12-lead ECG showed sinus tachycardia. Shortly after, a presumptive diagnosis of Wolff-Parkinson White was given upon review of the smartphone recordings by the pediatric cardiologist on service. Twelve lead ECG was repeated which showed intermittent Wolff-Parkinson White. This case highlights 2 points. First, any prolonged or sustained pediatric dysrhythmia revealed during anesthesia warrants further investigation and should not be assumed secondary to an anesthetic drug. Second, ubiquitous smartphones are an excellent tool for capturing data that the monitor is unable to capture. PMID:26230306

  7. BeZnCdSe quantum-well ridge-waveguide laser diodes under low threshold room-temperature continuous-wave operation

    SciTech Connect

    Feng, Jijun; Akimoto, Ryoichi

    2015-10-19

    Low threshold current ridge-waveguide BeZnCdSe quantum-well laser diodes (LDs) have been developed by completely etching away the top p-type BeMgZnSe/ZnSe:N short-period superlattice cladding layer, which can suppress the leakage current that flows laterally outside of the electrode. The waveguide LDs are covered with a thick SiO{sub 2} layer and planarized with chemical-mechanical polishing and a reactive ion etching process. Room-temperature lasing under continuous-wave condition is achieved with the laser cavity formed by the cleaved waveguide facets coated with high-reflectivity dielectric films. For a 4 μm-wide green LD lasing around a wavelength of 535 nm, threshold current and voltage of 7.07 mA and 7.89 V are achieved for a cavity length of 300 μm, and the internal differential quantum efficiency, internal absorption loss, gain constant, and nominal transparency current density are estimated to be 27%, 4.09 cm{sup −1}, 29.92 (cm × μm)/kA and 6.35 kA/(cm{sup 2 }× μm), respectively. This compact device can realize a significantly improved performance with much lower threshold power consumption, which would benefit the potential application for ZnSe-based green LDs as light sources in full-color display and projector devices installed in consumer products such as pocket projectors.

  8. Room temperature terahertz polariton emitter

    SciTech Connect

    Geiser, Markus; Scalari, Giacomo; Castellano, Fabrizio; Beck, Mattias; Faist, Jerome

    2012-10-01

    Terahertz (THz) range electroluminescence from intersubband polariton states is observed in the ultra strong coupling regime, where the interaction energy between the collective excitation of a dense electron gas and a photonic mode is a significant portion of the uncoupled excitation energy. The polariton's increased emission efficiency along with a parabolic electron confinement potential allows operation up to room temperature in a nonresonant pumping scheme. This observation of room temperature electroluminescence of an intersubband device in the THz range is a promising proof of concept for more powerful THz sources.

  9. CEBAF Control Room Renovation

    SciTech Connect

    Michael Spata; Thomas Oren

    2005-05-01

    The Machine Control Center (MCC) at Jefferson Lab's Continuous Electron Beam Accelerator Facility (CEBAF) was initially constructed in the early 1990s and based on proven technology of that era. Through our experience over the last 15 years and in our planning for the facility's 12 GeV upgrade we reevaluated the control room environment to capitalize on emerging visualization and display technologies and improve workflow processes and ergonomic attributes. This effort also sets the foundation for the redevelopment of the accelerator's control system to deliver high reliability performance with improvements in beam specifications management and information flow. The complete renovation was performed over a three-week maintenance period with no interruption to beam operations. We present the results of this effort.

  10. CEBAF Control Room Renovation

    SciTech Connect

    Michael Spata; Thomas Oren

    2005-05-01

    The Machine Control Center at Jefferson Lab's Continuous Electron Beam Accelerator Facility was initially constructed in the early 1990s and based on proven technology of that era. Through our experience over the last 15 years and in our planning for the facilities 12 GeV upgrade we reevaluated the control room environment to capitalize on emerging visualization and display technologies and improve on workflow processes and ergonomic attributes. This effort also sets the foundation for the redevelopment of the accelerator's control system to deliver high reliability performance with improvements in beam specifications management and information flow. The complete renovation was performed over a three-week period with no interruption to beam operations. We present the results of this effort.

  11. Comparative investigations on continuous wave operation of a-cut and b-cut Tm,Ho:YAlO3 lasers at room temperature.

    PubMed

    Bromberger, H; Yang, K J; Heinecke, D; Dekorsy, T; Zheng, L H; Xu, J; Zhao, G J

    2011-03-28

    The Tm,Ho:YAlO3 laser performance for two crystal orientations pumped by a wavelength tunable Ti:Sapphire laser is presented in this paper. An experimental investigation comparing a- and b-oriented Tm,Ho:YAlO3 crystals laser performance is demonstrated and discussed. Single- and multi-wavelength operations of Tm,Ho:YAlO3 lasers have been investigated in detail. The maximum output powers of 890 mW at 2119 nm for a-oriented Tm,Ho:YAlO3 crystal and 946 mW at 2103 nm for b-oriented Tm,Ho:YAlO3 crystal have been obtained, respectively. The two crystals show very similar performance in terms of output power and conversion efficiency, only that the b-cut Tm,Ho:YAP crystal demonstrates more regimes of multi-wavelength operations. PMID:21451679

  12. 49 CFR 195.446 - Control room management.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 3 2010-10-01 2010-10-01 false Control room management. 195.446 Section 195.446... PIPELINE Operation and Maintenance § 195.446 Control room management. (a) General. This section applies to each operator of a pipeline facility with a controller working in a control room who monitors...

  13. Effect of Room Ventilation Rates in Rodent Rooms with Direct-Exhaust IVC Systems.

    PubMed

    Geertsema, Roger S; Lindsell, Claire E

    2015-09-01

    When IVC are directly exhausted from a rodent housing room, the air quality of the room can become independent of the intracage air quality and may reduce the need for high room ventilation rates. This study assessed the effect of decreasing the ventilation rate in rodent rooms using direct-exhaust IVC systems. The study was conducted over 16 wk and compared conditions in 8 rodent rooms that had ventilation rates of 5 to 6 air changes per hour (ACH) with those in rooms at 10 to 12 ACH. At the low ventilation rate, rooms had higher CO₂ concentrations, higher dew point temperature, and lower particulate levels and spent a greater percentage of time above the temperature set point than did rooms at the high rate. The levels of allergens and endotoxins in room air were the same regardless of the ventilation rate. Differences seen in parameters within cages at the 2 ventilation rates were operationally irrelevant. We detected no total volatile organic compounds in the room that were attributable to ammonia, regardless of the ventilation rate. Clearing the air of ethanol after a spill took longer at the low compared with high rate. However, ethanol clearance was faster at the low rate when the demand-control system was activated than at the high ventilation rate alone. Air quality in the room and in the cages were acceptable with room ventilation rates of 5 to 6 ACH in rodent rooms that use direct-exhaust IVC systems. PMID:26424250

  14. Effect of Room Ventilation Rates in Rodent Rooms with Direct-Exhaust IVC Systems

    PubMed Central

    Geertsema, Roger S; Lindsell, Claire E

    2015-01-01

    When IVC are directly exhausted from a rodent housing room, the air quality of the room can become independent of the intracage air quality and may reduce the need for high room ventilation rates. This study assessed the effect of decreasing the ventilation rate in rodent rooms using direct-exhaust IVC systems. The study was conducted over 16 wk and compared conditions in 8 rodent rooms that had ventilation rates of 5 to 6 air changes per hour (ACH) with those in rooms at 10 to 12 ACH. At the low ventilation rate, rooms had higher CO2 concentrations, higher dew point temperature, and lower particulate levels and spent a greater percentage of time above the temperature set point than did rooms at the high rate. The levels of allergens and endotoxins in room air were the same regardless of the ventilation rate. Differences seen in parameters within cages at the 2 ventilation rates were operationally irrelevant. We detected no total volatile organic compounds in the room that were attributable to ammonia, regardless of the ventilation rate. Clearing the air of ethanol after a spill took longer at the low compared with high rate. However, ethanol clearance was faster at the low rate when the demand-control system was activated than at the high ventilation rate alone. Air quality in the room and in the cages were acceptable with room ventilation rates of 5 to 6 ACH in rodent rooms that use direct-exhaust IVC systems. PMID:26424250

  15. Alertness, performance and off-duty sleep on 8-hour and 12-hour night shifts in a simulated continuous operations control room setting

    SciTech Connect

    Baker, T.L.

    1995-04-01

    A growing number of nuclear power plants in the United States have adopted routine 12-hr shift schedules. Because of the potential impact that extended work shifts could have on safe and efficient power plant operation, the U.S. Nuclear Regulatory Commission funded research on 8-hr and 12-hr shifts at the Human Alertness Research Center (HARC) in Boston, Massachusetts. This report describes the research undertaken: a study of simulated 8-hr and 12-hr work shifts that compares alertness, speed, and accuracy at responding to simulator alarms, and relative cognitive performance, self-rated mood and vigor, and sleep-wake patterns of 8-hr versus 12-hr shift workers.

  16. Operations

    ERIC Educational Resources Information Center

    Wilkins, Jesse L. M.; Norton, Anderson; Boyce, Steven J.

    2013-01-01

    Previous research has documented schemes and operations that undergird students' understanding of fractions. This prior research was based, in large part, on small-group teaching experiments. However, written assessments are needed in order for teachers and researchers to assess students' ways of operating on a whole-class scale. In this…

  17. Fe(II) Spin Transition Materials Including an Amino-Ester 1,2,4-Triazole Derivative, Operating at, below, and above Room Temperature.

    PubMed

    Dîrtu, Marinela M; Naik, Anil D; Rotaru, Aurelian; Spinu, Leonard; Poelman, Dirk; Garcia, Yann

    2016-05-01

    A new family of one-dimensional Fe(II) 1,2,4-triazole spin transition coordination polymers for which a modification of anion and crystallization solvent can tune the switching temperature over a wide range, including the room temperature region, is reported. This series of materials was prepared as powders after reaction of ethyl-4H-1,2,4-triazol-4-yl-acetate (αEtGlytrz) with an iron salt from a MeOH/H2O medium affording: [Fe(αEtGlytrz)3](ClO4)2 (1); [Fe(αEtGlytrz)3](ClO4)2·CH3OH (2); [Fe(αEtGlytrz)3](NO3)2·H2O (3); [Fe(αEtGlytrz)3](NO3)2 (4); [Fe(αEtGlytrz)3](BF4)2·0.5H2O (5); [Fe(αEtGlytrz)3](BF4)2 (6); and [Fe(αEtGlytrz)3](CF3SO3)2·2H2O (7). Their spin transition properties were investigated by (57)Fe Mossbauer spectroscopy, superconducting quantum interference device (SQUID) magnetometry, and differential scanning calorimetry (DSC). The temperature dependence of the high-spin molar fraction derived from (57)Fe Mössbauer spectroscopy in 1 reveals an abrupt single step transition between low-spin and high-spin states with a hysteresis loop of width 5 K (Tc(↑) = 296 K and Tc(↓) = 291 K). The properties drastically change with modification of anion and/or lattice solvent. The transition temperatures, deduced by SQUID magnetometry, shift to Tc(↑) = 273 K and Tc(↓) = 263 K for (2), Tc(↑) = 353 K and Tc(↓) = 333 K for (3), Tc(↑) = 338 K and Tc(↓) = 278 K for (4), T(↑) = 320 K and T(↓) = 305 K for (5), Tc(↑) = 106 K and Tc(↓) = 92 K for (6), and T(↑) = 325 K and T(↓) = 322 K for (7). Annealing experiments of 3 lead to a change of the morphology, texture, and magnetic properties of the sample. A dehydration/rehydration process associated with a spin state change was analyzed by a mean-field macroscopic master equation using a two-level Hamiltonian Ising-like model for 3. A new structural-property relationship was also identified for this series of materials [Fe(αEtGlytrz)3](anion)2·nSolvent based on Mössbauer and DSC

  18. 16. DINING ROOM INTERIOR SHOWING DOUBLE DOOR ARCHWAY INTO LIVING ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    16. DINING ROOM INTERIOR SHOWING DOUBLE DOOR ARCHWAY INTO LIVING ROOM AND DOUBLE FRENCH DOORS INTO SOUTH END SCREENED PORCH. VIEW TO SOUTHWEST. - Big Creek Hydroelectric System, Powerhouse 8, Operator Cottage, Big Creek, Big Creek, Fresno County, CA

  19. Improved semi-conductor laser device, operating, at room temperature, with an array of three lasers in the spatially coherent, free running mode

    NASA Technical Reports Server (NTRS)

    Rutz, E. M.

    1975-01-01

    The peak pulse power was increased by operating an array of three homostructure Ga As lasers in the laser device. A spatial filter in the laser device selects the spatially coherent, free running, mode. The optical peak power is 5 watts, which is three times the peak power of a single laser in the array. The far-field distribution of the three laser array is a single Gaussian beam of spatial coherence without sidelobes or grating lobes. The length of the optical pulses of spatial coherence was increased to 200 ns by improved heat transfer from the p-n junctions of the lasers to the metal housing of the pulse transformer, and by doubling the core area and increasing the turns of the primary windings of the pulse transformer. The mechanical stability of the laser device was improved and the transition from mechanical alignment to electro-mechanical alignment control, was facilitated.

  20. The virtual gamma camera room.

    PubMed

    Penrose, J M; Trowbridge, E A; Tindale, W B

    1996-05-01

    The installation of a gamma camera is time-consuming and costly and, once installed, the camera position is unlikely to be altered during its working life. Poor choice of camera position therefore has long-term consequences. Additional equipment such as collimators and carts, the operator's workstation and wall-mounted display monitors must also be situated to maximize access and ease of use. The layout of a gamma camera room can be optimized prior to installation by creating a virtual environment. Super-Scape VRT software running on an upgraded 486 PC microprocessor was used to create a 'virtual camera room'. The simulation included an operator's viewpoint and a controlled tour of the room. Equipment could be repositioned as required, allowing potential problems to be identified at the design stage. Access for bed-ridden patients, operator ergonomics, operator and patient visibility were addressed. The display can also be used for patient education. Creation of a virtual environment is a valuable tool which allows different camera systems to be compared interactively in terms of dimensions, extent of movement and use of a defined space. Such a system also has applications in radiopharmacy design and simulation. PMID:8736511

  1. The Upstairs Room - Room for Controversy?

    ERIC Educational Resources Information Center

    Poole, Mary F.

    1973-01-01

    Doubtless everyone is tired of the subject of censorship; but I do have to give vent to my feelings when they are as intense as they are over the selection of a book as full of profanity as a Newbery honor book ( The Upstairs Room''). (Author/SM)

  2. Clean room wiping liquids

    SciTech Connect

    Harding, W.B.

    1991-12-01

    A water-based liquid containing isopropyl alcohol, ammonium hydroxide, and surfactants was developed to replace 1,1,2-trichlorotrifluoroethane for the dampening of clean room wiping cloths used to wipe clean benches, clean room equipment, and latex finger cots and gloves.

  3. Unlocking the Locker Room.

    ERIC Educational Resources Information Center

    St. Clair, Dean

    1996-01-01

    Discusses locker-room design standards and common challenges when complying with the Americans with Disabilities Act. Accessibility and safety considerations for shower, toilet, and locker areas are addressed, as are entrance vestibules, drying and grooming areas, and private dressing rooms. (GR)

  4. Legal accountability in the operating room.

    PubMed

    Furay, C J

    1989-06-01

    Malpractice implies misconduct and refers to a lack of skill or fidelity in the performance of professional duties. Health-care providers are not absolute guarantors of a favorable result; they are merely required to possess and exercise the knowledge and skill necessary to perform their tasks. The buyer of a product may assume liability by failing to exercise recommended precautions or by failing to relay the manufacturer's warning. Hospitals have the duty to furnish adequate equipment for diagnosis and treatment; if proper and safe products and equipment are not provided, the hospital can be found liable. PMID:2734816

  5. Contrast media use in the operating room.

    PubMed

    Bickham, Peggy; Golembiewski, Julie

    2010-04-01

    Iodinated contrast media is frequently used in the OR, but often is not well understood by health care providers who are administering it. Although used for diagnosis rather than treatment, contrast media is classified as a drug by the FDA, and has indications, contraindications, adverse effects, drug interactions, disease interactions, and laboratory interference issues related to its use. Iodinated contrast media is classified according to osmolarity and ionicity, and these characteristics contribute to potential for adverse effects and choice of agent. Financial and safety concerns are factors to be considered when selecting an appropriate agent. Adverse effects can range from mild and self-limited to severe and life threatening; potentially the most serious of these are anaphylactoid reactions and contrast-induced acute renal failure. Knowledge of risk factors and preventive strategies is vital, as are issues related to substitution of gadolinium-based contrast, an off-label use. It is important for the perianesthesia nurse to become familiar with these commonly used imaging medications. PMID:20359644

  6. Interior of display area (room 101), looking south towards TV ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Interior of display area (room 101), looking south towards TV control panel room (room 139) at far left corner. The stairway leads to the commander's quarters and the senior battle viewing bridge at top right. Control and communication consoles at the right - March Air Force Base, Strategic Air Command, Combat Operations Center, 5220 Riverside Drive, Moreno Valley, Riverside County, CA

  7. 49 CFR 192.631 - Control room management.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... must be reported pursuant to 49 CFR part 191 to determine if control room actions contributed to the... 49 Transportation 3 2013-10-01 2013-10-01 false Control room management. 192.631 Section 192.631... BY PIPELINE: MINIMUM FEDERAL SAFETY STANDARDS Operations § 192.631 Control room management....

  8. 49 CFR 195.446 - Control room management.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 3 2011-10-01 2011-10-01 false Control room management. 195.446 Section 195.446... PIPELINE Operation and Maintenance § 195.446 Control room management. (a) General. This section applies to... written control room management procedures that implement the requirements of this section. The...

  9. 49 CFR 195.446 - Control room management.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 49 Transportation 3 2012-10-01 2012-10-01 false Control room management. 195.446 Section 195.446... PIPELINE Operation and Maintenance § 195.446 Control room management. (a) General. This section applies to... written control room management procedures that implement the requirements of this section. The...

  10. 49 CFR 192.631 - Control room management.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... must be reported pursuant to 49 CFR part 191 to determine if control room actions contributed to the... 49 Transportation 3 2011-10-01 2011-10-01 false Control room management. 192.631 Section 192.631... BY PIPELINE: MINIMUM FEDERAL SAFETY STANDARDS Operations § 192.631 Control room management....

  11. 49 CFR 192.631 - Control room management.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... must be reported pursuant to 49 CFR part 191 to determine if control room actions contributed to the... 49 Transportation 3 2012-10-01 2012-10-01 false Control room management. 192.631 Section 192.631... BY PIPELINE: MINIMUM FEDERAL SAFETY STANDARDS Operations § 192.631 Control room management....

  12. 49 CFR 195.446 - Control room management.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 49 Transportation 3 2013-10-01 2013-10-01 false Control room management. 195.446 Section 195.446... PIPELINE Operation and Maintenance § 195.446 Control room management. (a) General. This section applies to... written control room management procedures that implement the requirements of this section. The...

  13. West wall, display area (room 101), view 1 of 4: ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    West wall, display area (room 101), view 1 of 4: southwest corner, showing stairs to commander's quarters and viewing bridge, windows to controller's room (room 102), south end of control consoles, and holes in pedestal floor for computer equipment cables (tape drive I/O?) - March Air Force Base, Strategic Air Command, Combat Operations Center, 5220 Riverside Drive, Moreno Valley, Riverside County, CA

  14. Telco maintenance (room 228) looking south into the telephone equipment ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Telco maintenance (room 228) looking south into the telephone equipment room (room 227). Note workbench in left corner, lighting fixtures, and air handling ducts - March Air Force Base, Strategic Air Command, Combat Operations Center, 5220 Riverside Drive, Moreno Valley, Riverside County, CA

  15. 49 CFR 192.631 - Control room management.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... must be reported pursuant to 49 CFR part 191 to determine if control room actions contributed to the... 49 Transportation 3 2010-10-01 2010-10-01 false Control room management. 192.631 Section 192.631... BY PIPELINE: MINIMUM FEDERAL SAFETY STANDARDS Operations § 192.631 Control room management....

  16. Software Support during a Control Room Upgrade

    SciTech Connect

    Michele Joyce; Michael Spata; Thomas Oren; Anthony Cuffe; Theo McGuckin; Isadoro Carlino; C. Higgins; Harry Fanning; Matthew Bickley; Brian Bevins

    2005-09-21

    In 2004, after 14 years of accelerator operations and commissioning, Jefferson Lab renovated its main control room. Changes in technology and lessons learned during those 14 years drove the control room redesign in a new direction, one that optimizes workflow and makes critical information and controls available to everyone in the control room. Fundamental changes in a variety of software applications were required to facilitate the new operating paradigm. A critical component of the new control room design is a large-format video wall that is used to make a variety of operating information available to everyone in the room. Analog devices such as oscilloscopes and function generators are now displayed on the video wall through two crosspoint switchers: one for analog signals and another for video signals. A new software GUI replaces manual configuration of the oscilloscopes and function generators and helps automate setup. Monitoring screens, customized for the video wall, now make important operating information visible to everyone, not just a single operator. New alarm handler software gives any operator, on any workstation, access to all alarm handler functionality, and multiple users can now contribute to a single electronic logbook entry. To further support the shift to distributed access and control, many applications have been redesigned to run on servers instead of on individual workstations.

  17. Interior. Balance room for chemistry laboratory. Storage room for glassware ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Interior. Balance room for chemistry laboratory. Storage room for glassware and reference room with frequently used chemistry and chemical engineering texts. - Thomas A. Edison Laboratories, Building No. 2, Main Street & Lakeside Avenue, West Orange, Essex County, NJ

  18. Central room (delivery room on plan) between the east and ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Central room (delivery room on plan) between the east and west reading rooms, showing built-in card catalog drawers. View to south. - Sacramento Junior College, Library, 3835 Freeport Boulevard, Sacramento, Sacramento County, CA

  19. 15. Readiness Crew Building interior, Room 105, former briefing room, ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    15. Readiness Crew Building interior, Room 105, former briefing room, looking northwest. Projection room in at the back wall. Thalheimer - Whiteman Air Force Base, Bomber Alert Facility S-6, 1300 Alert Road, Knob Noster, Johnson County, MO

  20. NCI Grant Resources Room

    Cancer.gov

    If you’re interested in information about NCI grants, visit the Grant Resources Room. You can talk to NCI staff about grant application and review processes, and even schedule a one-on-one consultation.

  1. 'How To' Clean Room Video

    NASA Technical Reports Server (NTRS)

    McCarty, Kaley Corinne

    2013-01-01

    One of the projects that I am completing this summer is a Launch Services Program intern 'How to' set up a clean room informational video. The purpose of this video is to go along with a clean room kit that can be checked out by employees at the Kennedy Space Center and to be taken to classrooms to help educate students and intrigue them about NASA. The video will include 'how to' set up and operate a clean room at NASA. This is a group project so we will be acting as a team and contributing our own input and ideas. We will include various activities for children in classrooms to complete, while learning and having fun. Activities that we will explain and film include: helping children understand the proper way to wear a bunny suit, a brief background on cleanrooms, and the importance of maintaining the cleanliness of a space craft. This project will be shown to LSP management and co-workers; we will be presenting the video once it is completed.

  2. 9 CFR 354.221 - Rooms and compartments.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 9 Animals and Animal Products 2 2012-01-01 2012-01-01 false Rooms and compartments. 354.221 Section 354.221 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE... live rabbits or killing operations be permitted in rooms in which eviscerating operations are...

  3. 9 CFR 354.221 - Rooms and compartments.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 9 Animals and Animal Products 2 2014-01-01 2014-01-01 false Rooms and compartments. 354.221 Section 354.221 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE... live rabbits or killing operations be permitted in rooms in which eviscerating operations are...

  4. 9 CFR 354.221 - Rooms and compartments.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 9 Animals and Animal Products 2 2013-01-01 2013-01-01 false Rooms and compartments. 354.221 Section 354.221 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE... live rabbits or killing operations be permitted in rooms in which eviscerating operations are...

  5. 9 CFR 354.221 - Rooms and compartments.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 9 Animals and Animal Products 2 2010-01-01 2010-01-01 false Rooms and compartments. 354.221 Section 354.221 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE... live rabbits or killing operations be permitted in rooms in which eviscerating operations are...

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

    PubMed

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

    2003-06-01

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

  7. Wash room, bunkhouse, first floor interior. This room is a ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Wash room, bunkhouse, first floor interior. This room is a screened porch with the original sinks extant. Light and ventilation was borrowed from the wash room into the toilets and bathing rooms. - Sespe Ranch, Bunkhouse, 2896 Telegraph Road, Fillmore, Ventura County, CA

  8. Cerebral monitoring in the operating room and the intensive care unit: an introductory for the clinician and a guide for the novice wanting to open a window to the brain. Part I: The electroencephalogram.

    PubMed

    Freye, Enno; Levy, Joseph V

    2005-04-01

    While there is an increasing body of knowledge in regard to central nervous system function and/or the mode of action of centrally active agents on neuronal function, little is done to develop new techniques on how to measure such changes. Also, monitoring of the cardiovascular system in the past has made extensive progress especially when it comes to evaluate the failing heart. In contrast monitoring of the central nervous system is only done in rare cases where operative procedures likely impede nervous function integrity. Since in the past decade the aging population undergoing operation has rise considerably, the risk of cerebral malperfusion or minute signs of degradation of the aging central nervous system (CNS) to anesthetics and agents being used in the operation room (OR) or the intensive care unit (ICU), needs continuous monitoring of an organ which presents the highest vulnerability and is likely to deteriorate faster than the cardiovascular system. In spite the rapid improvement in technology regarding the electroencephalogram (EEG) and evoked potential monitoring, physicians still are reluctant to use a technology on a routine base, which will give them insight information into brain function and activity. Such "windows to the brain" now not just are reserved to specialists working in the area of neurology and/or psychiatry. More so, cerebral monitoring is getting an integrated part in the overall therapy in patients undergoing operation or who need ventilatory support in the ICU as it effects the well-being and the outcome. The present book therefore, is intended for the practitioners who work with the patient, guide the clinician in his decision making and outlining those situations where cerebral monitoring presents an integrated part in the diagnosis and therapy of patient care. Without going too much into the technical details, representative cases underline the potential use of cerebral monitoring in the underlying clinical situation where either

  9. Technology Equipment Rooms.

    ERIC Educational Resources Information Center

    Day, C. William

    2001-01-01

    Examines telecommunications equipment room design features that allow for growth and can accommodate numerous equipment replacements and upgrades with minimal service disruption and with minimal cost. Considerations involving the central hub, power and lighting needs, air conditioning, and fire protection are discussed. (GR)

  10. Visiting Room 501

    ERIC Educational Resources Information Center

    Curwen, Margaret Sauceda

    2009-01-01

    Students in Room 501 were exploring and negotiating their lives as transnational citizens. In a globalized world of instantaneous information and communication, Latino students are shaping, morphing, and evolving into a new generation. This study highlights one group of students who were aspiring toward middle class, which is not the typical…

  11. Rooms with a View

    ERIC Educational Resources Information Center

    Hourihan, Peter; Berry, Millard, III

    2006-01-01

    When well-designed and integrated into a campus living or learning space, an atrium can function as the heart and spirit of a building, connecting interior rooms and public spaces with the outside environment. However, schools and universities should seek technological and HVAC solutions that maximize energy efficiency. This article discusses how…

  12. Detention Room Counseling

    ERIC Educational Resources Information Center

    Salem, Terry

    1973-01-01

    This article describes how the detention room in one school system was changed in favor of group counseling sessions. In the counseling sessions, the counselors could aid students in identifying the problems which disturb them in order to improve self-understanding and status in school. (JC)

  13. Guidelines on ergonomic aspects of control rooms

    NASA Technical Reports Server (NTRS)

    Mitchell, C. M.; Bocast, A. K.; Stewart, L. J.

    1983-01-01

    The anthropometry, workstation design, and environmental design of control rooms are outlined. The automated interface and VDTs and displays and various modes of communication between the system and the human operator using VDTs are discussed. The man in the loop is examined, the single controller single task framework and multiple controller multiple tasks issues are considered.

  14. Clean room wiping cloths

    SciTech Connect

    Harding, W.B.

    1981-01-01

    The suitability of various fabrics for use as clean room wiping cloths was investigated. These fabrics included knit polyester, knit nylon, urethane foam, woven cotton, nonwoven polyester, nonwoven rayon, nonwoven polyethylene and polypropylene, and woven nylon. These materials were tested for detachable lint and fibers, deterioration, and oil content which could leave contaminating films on wiped surfaces. Well-laundered nylon and polyester cloths knitted from filamentary yarn, with hems, were found to be suitable. (LCL)

  15. [Virtual room of gastroenterology].

    PubMed

    Spinelli, Osvaldo Mateo; Fittipaldi, Mónica Elsa; Henderson, Eduardo; Krabshuis, Justus Hendrik

    2010-12-01

    The amount of published information and its continuing growth can no longer be managed by an individual searcher. One of today's great challenges for the academic researcher and clinician is to find a relevant scientific article using bibliographic search strategies. We aimed to design and build a Virtual Room of Gastroenterology (VRG) generating real-time automated search strategies and producing bibliographic and full text search results. These results update and complement with the latest evidence the Clinical Guideline Program of the World Gastroenterology Organisation. The HTML driven interface provides a series of pre-formulated MeSH based search strategies for each Aula. For each topic between 10 and 20 specific terms, qualifiers and subheadings are identified. The functionality of the VRG is based on the PubMed's characteristic that allows a search strategy to be captured as a web address. The VRG is available in Spanish and English, and the access is free. There are 28 rooms currently available. All together these rooms provide an advanced bibliographic access using more than 900 pre-programmed MeSH driven strategies. In a further very recent development some of the topics of VRG now allow cascade based searches. These searches look at resource sensitive options and possible ethnic difference per topic. The VRG allows significant reductions in time required to design and carry out complex bibliographic searches in the areas of gastroenterology, hepatology and endoscopy. The system updates automatically in real-time thus ensuring the currency of the results. PMID:21381412

  16. 175. STORAGE ROOM, SOUTH WALL OF STORAGE ROOM, ADDED WITH ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    175. STORAGE ROOM, SOUTH WALL OF STORAGE ROOM, ADDED WITH ELEVATOR ADDITION OF 1905. WALL IS EXTERIOR OF ORIGINAL WAGON WORKS OF 1883. - Gruber Wagon Works, Pennsylvania Route 183 & State Hill Road at Red Bridge Park, Bernville, Berks County, PA

  17. INTERIOR VIEW OF THE LIVING ROOM. DINING ROOM AND PANTRY ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    INTERIOR VIEW OF THE LIVING ROOM. DINING ROOM AND PANTRY IN THE BACKGROUND. VIEW FACING NORTHEAST. - Hickam Field, Fort Kamehameha Officers' Housing Type Z, 19 Worchester Avenue, Honolulu, Honolulu County, HI

  18. 21. Perimeter acquisition radar building room #200, electrical equipment room ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    21. Perimeter acquisition radar building room #200, electrical equipment room - Stanley R. Mickelsen Safeguard Complex, Perimeter Acquisition Radar Building, Limited Access Area, between Limited Access Patrol Road & Service Road A, Nekoma, Cavalier County, ND

  19. Interior. Storage room for glassware and reference room with frequentlyused ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Interior. Storage room for glassware and reference room with frequently-used chemistry and chemical engineering texts. - Thomas A. Edison Laboratories, Building No. 2, Main Street & Lakeside Avenue, West Orange, Essex County, NJ

  20. Supreme Court Room (room 573), looking westsouthwest (bearing 250). Not ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Supreme Court Room (room 573), looking west-southwest (bearing 250). Not that missing scones are to be returned and presently obscured ceiling is proposed for restoration. - California State Library & Courts Building, 914 Capitol Mall, Sacramento, Sacramento County, CA

  1. 11. FIRST FLOOR, EAST ROOM, DOORWAY TO WEST ROOM ON ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    11. FIRST FLOOR, EAST ROOM, DOORWAY TO WEST ROOM ON LEFT AND BOTTOM OF STAIRWAY ON RIGHT - Whitcomb Cabin, BZ Corners, Glenwood County Road (Conboy Lake National Wildlife Refuge), Glenwood, Klickitat County, WA

  2. 16. Readiness Crew Building interior, Room 105, former briefing room, ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    16. Readiness Crew Building interior, Room 105, former briefing room, looking southeast. Thalheimer - Whiteman Air Force Base, Bomber Alert Facility S-6, 1300 Alert Road, Knob Noster, Johnson County, MO

  3. 24. Perimeter acquisition radar building room #203, communications room ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    24. Perimeter acquisition radar building room #203, communications room - Stanley R. Mickelsen Safeguard Complex, Perimeter Acquisition Radar Building, Limited Access Area, between Limited Access Patrol Road & Service Road A, Nekoma, Cavalier County, ND

  4. MACHINE ROOM FROM DOORWAY TO COMMUNICATIONS ROOM, VIEW FACING SOUTHWEST. ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    MACHINE ROOM FROM DOORWAY TO COMMUNICATIONS ROOM, VIEW FACING SOUTHWEST. - Naval Air Station Barbers Point, World War II Command Center, Midway Street east of Lexington Avenue, Ewa, Honolulu County, HI

  5. View from window of southeast room (bed room no. 1), ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    View from window of southeast room (bed room no. 1), second floor, commandant's house, looking east across parade ground. - Fort Simcoe, Commandant's House & Blockhouse, Fort Simcoe Road, White Swan, Yakima County, WA

  6. Entry area from living room with dining room beyond and ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Entry area from living room with dining room beyond and stairs to second floor through doorway to the right (southern unit) - Fitzsimons General Hospital, Officers' Quarters, West Charlie Kelly Boulevard & South Hutton Street, Southwest Corner, Aurora, Adams County, CO

  7. INTERIOR VIEW OF A TYPICAL ROOM (ROOM NO. 209), FACING ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    INTERIOR VIEW OF A TYPICAL ROOM (ROOM NO. 209), FACING NORTH. THE SINK AND MIRROR MAY HAVE BEEN FROM THE ORIGINAL CONSTRUCTION. - U.S. Naval Base, Pearl Harbor, Bachelor Officer Quarters, Dealy Circle, Pearl City, Honolulu County, HI

  8. 8. VIEW OF ROOM 101 (ASSEMBLY ROOM) FROM NORTHEAST CORNER ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    8. VIEW OF ROOM 101 (ASSEMBLY ROOM) FROM NORTHEAST CORNER SHOWING FLEXIBLE AIR-CONDITIONING DUCT - Vandenberg Air Force Base, Space Launch Complex 3, Vehicle Support Building, Napa & Alden Roads, Lompoc, Santa Barbara County, CA

  9. 14. Door leading from Boiler Room to Pattern Room. ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    14. Door leading from Boiler Room to Pattern Room. - Central of Georgia Railway, Savannah Repair Shops & Terminal Facilities, Engine Boiler & Pattern Building, Bounded by West Broad, Jones, West Boundary & Hull Streets, Savannah, Chatham County, GA

  10. 13. Interior view of conference room looking into break room ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    13. Interior view of conference room looking into break room beyond; along west side of upper level; view to southwest. - Ellsworth Air Force Base, Mess Hall & Administration Building, 1301 Ellsworth Street, Blackhawk, Meade County, SD

  11. How much sense do room occupancy sensor controls make

    SciTech Connect

    Becker, H.P.

    1986-01-01

    Hotel operators are faced with a confusing array of both remote and local guest room energy control devices. A wide variety of decentralized electronic room controllers, each with its own control logic and vendor claims are in competition with remote front desk microprocessor controls which are essentially ''blind'' to actual occupancy. This paper is a review of the characteristics of various controllers, their behaviour with different in-room environmental equipment, and guest reactions to the potpourri of available devices.

  12. Room with a View: Ethical Encounters in Room 13

    ERIC Educational Resources Information Center

    Grube, Vicky

    2012-01-01

    In this article, the author describes ethical encounters in Room 13, a schoolroom where children made what they wanted, posed their own questions, and ran an art room like a small business. In Room 13 children had the responsibility to maintain all aspects of the art studio. Specific decisions fell to an annually elected management team, a small…

  13. 45. 1915 CLOTH ROOM ADJACENT TO PICKER ROOM, SECOND FLOOR, ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    45. 1915 CLOTH ROOM ADJACENT TO PICKER ROOM, SECOND FLOOR, NORTH END OF MILL NO. 2, WALL ON LEFT DIVIDING CLOTH ROOM ADDED LATER (PROBABLY C. 1970s). - Prattville Manufacturing Company, Number One, 242 South Court Street, Prattville, Autauga County, AL

  14. Control room habitability system review models

    SciTech Connect

    Gilpin, H. )

    1990-12-01

    This report provides a method of calculating control room operator doses from postulated reactor accidents and chemical spills as part of the resolution of TMI Action Plan III.D.3.4. The computer codes contained in this report use source concentrations calculated by either TACT5, FPFP, or EXTRAN, and transport them via user-defined flow rates to the control room envelope. The codes compute doses to six organs from up to 150 radionuclides (or 1 toxic chemical) for time steps as short as one second. Supporting codes written in Clipper assist in data entry and manipulation, and graphically display the results of the FORTRAN calculations. 7 refs., 22 figs.

  15. Apparel for Cleaner Clean Rooms

    NASA Technical Reports Server (NTRS)

    1983-01-01

    In the 1960s NASA pioneered contamination control technology, providing a base from which aerospace contractors could develop control measures. NASA conducted special courses for clean room technicians and supervisors, and published a series of handbooks with input from various NASA field centers. These handbooks extended aerospace experience to the medical, pharmaceutical, electronics, and other industries where extreme cleanliness is important. American Hospital Supply Company (AHSC) felt that high technology products with increasingly stringent operating requirements in aerospace, electronics, pharmaceuticals and medical equipment manufacturing demanded improvement in contamination control techniques. After studying the NASA handbooks and visiting NASA facilities, the wealth of information gathered resulted in Micro-clean non-woven garments and testing equipment and procedures for evaluating effectiveness.

  16. 11. Historic view of Building 100 control room, showing personnel ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    11. Historic view of Building 100 control room, showing personnel operating rocket engine test controls and observer watching activity from observation room. May 27, 1957. On file at NASA Plumbrook Research Center, Sandusky, Ohio. NASA photo number C-45020. - Rocket Engine Testing Facility, GRC Building No. 100, NASA Glenn Research Center, Cleveland, Cuyahoga County, OH

  17. 86. VIEW OF AUTOPILOT ROOM LOOKING WEST FROM CENTER OF ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    86. VIEW OF AUTOPILOT ROOM LOOKING WEST FROM CENTER OF ROOM. IBM PERSONAL COMPUTER FOR SLC-3W AUTOPILOT FUNCTIONS IN SOUTHWEST CORNER (LEFT). - Vandenberg Air Force Base, Space Launch Complex 3, Launch Operations Building, Napa & Alden Roads, Lompoc, Santa Barbara County, CA

  18. 9 CFR 354.241 - Cleaning of rooms and compartments.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... such regularity as may be necessary to maintain them in a sanitary condition. (f) The killing and... all equipment and utensils used in the killing and skinning room shall be thoroughly washed and cleaned after each day's operation. (h) The floor in the killing and skinning rooms shall be...

  19. West wall, display area (room 101), view 2 of 4: ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    West wall, display area (room 101), view 2 of 4: south part, showing commander's quarters and viewing bridge on second floor, controller's room, console, and projection booth on main floor - March Air Force Base, Strategic Air Command, Combat Operations Center, 5220 Riverside Drive, Moreno Valley, Riverside County, CA

  20. West wall, display area (room 101), view 4 of 4: ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    West wall, display area (room 101), view 4 of 4: northwest corner, with D.M. logistics office below (room 137), and D.O./D.D.O. offices above. Lower stairs lead to entry shown in view 13 - March Air Force Base, Strategic Air Command, Combat Operations Center, 5220 Riverside Drive, Moreno Valley, Riverside County, CA

  1. One Room Schools in Iowa.

    ERIC Educational Resources Information Center

    Ruth, Amy, Ed.

    1994-01-01

    This issue focuses on one-room school houses in Iowa. At one time, almost 14,000 one-room schools dotted Iowa's rural landscape. Articles explore Native American schools of the past and present, segregation of black students, and Amish schools. An article remembering one-room schools describes the early schools from 1830 to 1858, township schools…

  2. A New Control Room for SLAC Accelerators

    SciTech Connect

    Erickson, Roger; Guerra, E.; Stanek, M.; Hoover, Z.Van; Warren, J.; /SLAC

    2012-06-04

    We are planning to construct a new control room at SLAC to unify and improve the operation of the LCLS, SPEAR3, and FACET accelerator facilities, and to provide the space and flexibility needed to support the LCLS-II and proposed new test beam facilities. The existing control rooms for the linac and SPEAR3 have been upgraded in various ways over the last decade, but their basic features have remained unchanged. We propose to build a larger modern Accelerator Control Room (ACR) in the new Research Support Building (RSB) which is currently under construction at SLAC. Shifting the center of control for the accelerator facilities entails both technical and administrative challenges. In this paper, we describe the history, concept, and status of this project.

  3. 10. LIVING ROOM INTERIOR SHOWING 1 OVER 1 LIGHT, DOUBLEHUNG, ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    10. LIVING ROOM INTERIOR SHOWING 1 OVER 1 LIGHT, DOUBLEHUNG, WOOD-FRAME WINDOWS FLANKING FRONT ENTRANCE DOOR AND SOUTH END DOOR TO ENCLOSED SLEEPING PORCH/STAIR ACCESS TO ATTIC. CEILING AND WALLS IN THIS ROOM AND THROUGHOUT THE HOUSE ARE COVERED WITH ORIGINAL FIBERBOARD. THE FLOOR IN THIS ROOM AND ALL OTHERS EXCEPT THE BATHROOM, KITCHEN AND DINING ROOM ARE HARDWOOD. VIEW TO SOUTHEAST. - Big Creek Hydroelectric System, Big Creek Town, Operator House, Orchard Avenue south of Huntington Lake Road, Big Creek, Fresno County, CA

  4. 12. VIEW OF ELEVATOR MACHINE ROOM, SHOWING LOW CABINET TEAT ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    12. VIEW OF ELEVATOR MACHINE ROOM, SHOWING LOW CABINET TEAT HOUSES HYDRAULIC CYLINDER AND CLOSET AT LEFT THAT HOUSES OPERATING VALVE, LOOKING NORTHEAST - 72 Marlborough Street, Residential Hydraulic Elevator, Boston, Suffolk County, MA

  5. 17. DINING ROOM INTERIOR SHOWING GROUP OF THREE 1 LIGHT ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    17. DINING ROOM INTERIOR SHOWING GROUP OF THREE 1 LIGHT OVER 1 LIGHT WINDOWS, AND DOORWAY INTO KITCHEN. VIEW TO EAST. - Big Creek Hydroelectric System, Powerhouse 8, Operator Cottage, Big Creek, Big Creek, Fresno County, CA

  6. 102. STEERING GEAR ROOM FORWARD LOOKING AFT ON STARBOARD ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    102. STEERING GEAR ROOM - FORWARD LOOKING AFT ON STARBOARD SIDE SHOWING RUDDER POST, HYDRAULIC RAM, EMERGENCY STEERING PUMP PIPING AND REMOTE OPERATING LINKAGE. - U.S.S. HORNET, Puget Sound Naval Shipyard, Sinclair Inlet, Bremerton, Kitsap County, WA

  7. DETAIL OF ELECTRICAL PANEL, ROOM 112, FACING EAST Cape ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    DETAIL OF ELECTRICAL PANEL, ROOM 112, FACING EAST - Cape Canaveral Air Force Station, Launch Complex 34, Operations Support Building, Freedom Road, Southwest of Launch Stand CX-34, Cape Canaveral, Brevard County, FL

  8. 32. SITE BUILDING 002 SCANNER BUILDING MECHANICAL ROOM ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    32. SITE BUILDING 002 - SCANNER BUILDING - MECHANICAL ROOM 105, VIEW OF OPERATIONAL SCHEMATIC OF COOLING SYSTEM LOOPS. - Cape Cod Air Station, Technical Facility-Scanner Building & Power Plant, Massachusetts Military Reservation, Sandwich, Barnstable County, MA

  9. Design of a multisystem remote maintenance control room

    SciTech Connect

    Draper, J.V.; Handel, S.J.; Kring, C.T.; Kawatsuma, S.

    1988-01-01

    The Remote Systems Development Section of the Consolidated Fuel Reprocessing Program at the Oak Ridge National Laboratory (ORNL) and Japan's Power Reactor and Nuclear Fuel Development Corporation (PNC) recently collaborated in the development of a control room concept for remote operations. This report describes design methods and the resulting control room concept. The design project included five stages. The first was compilation of a complete function list; functions are tasks performed by operators in the control room while operating equipment located in the remote area. The second step was organization of the function list into ''function groups;'' function groups are sets of functions that operate one piece of equipment. The third stage was determination of crew size and requirements for supervision. The fourth stage was development of conceptual designs of displays and controls. The fifth stage was development of plans for placement of crew stations within the control room. 5 figs., 1 tab.

  10. 101. STARBOARD AIRPLANE ELEVATOR MACHINERY ROOM AFT LOOKING FORWARD ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    101. STARBOARD AIRPLANE ELEVATOR MACHINERY ROOM - AFT LOOKING FORWARD PORT TO STARBOARD SHOWING ELEVATOR ENGINE, LIFTING WIRES, HYDRAULIC PIPING WITH REMOTE OPERATOR. - U.S.S. HORNET, Puget Sound Naval Shipyard, Sinclair Inlet, Bremerton, Kitsap County, WA

  11. Interior view to the southwest of Computer Room 157 ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Interior view to the southwest of Computer Room 157 - Over-the-Horizon Backscatter Radar Network, Mountain Home Air Force Operations Building, On Desert Street at 9th Avenue Mountain Home Air Force Base, Mountain Home, Elmore County, ID

  12. Telephone equipment room, showing channel terminal bank with vacuum tubes. ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Telephone equipment room, showing channel terminal bank with vacuum tubes. View to east - March Air Force Base, Strategic Air Command, Combat Operations Center, 5220 Riverside Drive, Moreno Valley, Riverside County, CA

  13. 14. LIVING ROOM INTERIOR SHOWING WEST SIDE AND SOUTH END ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    14. LIVING ROOM INTERIOR SHOWING WEST SIDE AND SOUTH END DOUBLE FRENCH DOORS, AND FIBERBOARD WALLS. VIEW TO SOUTHWEST. - Big Creek Hydroelectric System, Powerhouse 8, Operator Cottage, Big Creek, Big Creek, Fresno County, CA

  14. EXTERIOR OF LOCKER ROOM PROJECTION, FACING SOUTHEAST Cape Canaveral ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    EXTERIOR OF LOCKER ROOM PROJECTION, FACING SOUTHEAST - Cape Canaveral Air Force Station, Launch Complex 34, Operations Support Building, Freedom Road, Southwest of Launch Stand CX-34, Cape Canaveral, Brevard County, FL

  15. VIEW OF ROOM 136, FACING SOUTHWEST Cape Canaveral Air ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    VIEW OF ROOM 136, FACING SOUTHWEST - Cape Canaveral Air Force Station, Launch Complex 34, Operations Support Building, Freedom Road, Southwest of Launch Stand CX-34, Cape Canaveral, Brevard County, FL

  16. Binaural room simulation

    NASA Technical Reports Server (NTRS)

    Lehnert, H.; Blauert, Jens; Pompetzki, W.

    1991-01-01

    In every-day listening the auditory event perceived by a listener is determined not only by the sound signal that a sound emits but also by a variety of environmental parameters. These parameters are the position, orientation and directional characteristics of the sound source, the listener's position and orientation, the geometrical and acoustical properties of surfaces which affect the sound field and the sound propagation properties of the surrounding fluid. A complete set of these parameters can be called an Acoustic Environment. If the auditory event perceived by a listener is manipulated in such a way that the listener is shifted acoustically into a different acoustic environment without moving himself physically, a Virtual Acoustic Environment has been created. Here, we deal with a special technique to set up nearly arbitrary Virtual Acoustic Environments, the Binaural Room Simulation. The purpose of the Binaural Room Simulation is to compute the binaural impulse response related to a virtual acoustic environment taking into account all parameters mentioned above. One possible way to describe a Virtual Acoustic Environment is the concept of the virtual sound sources. Each of the virtual sources emits a certain signal which is correlated but not necessarily identical with the signal emitted by the direct sound source. If source and receiver are non moving, the acoustic environment becomes a linear time-invariant system. Then, the Binaural Impulse Response from the source to a listener' s eardrums contains all relevant auditory information related to the Virtual Acoustic Environment. Listening into the simulated environment can easily be achieved by convolving the Binaural Impulse Response with dry signals and representing the results via headphones.

  17. Control room concept for remote maintenance in high radiation areas

    SciTech Connect

    Clarke, M.M.; Kreifeldt, J.G.

    1984-01-01

    This paper summarizes the design of a control room concept for an operator interface with remote maintenance equipment consisting of force-reflecting manipulators, tools, hoists, cranes, cameras, and lights. The design development involved two major activities. First, detailed requirements were defined for foreseeable functions that will be performed by the control room operators. Second, concepts were developed, tested, and refined to meet these requirements. Each of these activities is summarized below. 6 references, 3 figures.

  18. Control room concept for remote maintenance in high radiation areas

    SciTech Connect

    Clarke, M.M.; Kreifeldt, J.G.

    1984-01-01

    This paper summarizes the design of a control room concept for an operator interface with remote maintenance equipment consisting of force-reflecting manipulators, tools, hoists, cranes, cameras, and lights. The design development involved two major activities. First, detailed requirements were defined for foreseeable functions that will be performed by the control room operators. Second, concepts were developed, tested, and refined to meet these requirements. 6 references, 3 figures.

  19. Acoustic echoes reveal room shape.

    PubMed

    Dokmanic, Ivan; Parhizkar, Reza; Walther, Andreas; Lu, Yue M; Vetterli, Martin

    2013-07-23

    Imagine that you are blindfolded inside an unknown room. You snap your fingers and listen to the room's response. Can you hear the shape of the room? Some people can do it naturally, but can we design computer algorithms that hear rooms? We show how to compute the shape of a convex polyhedral room from its response to a known sound, recorded by a few microphones. Geometric relationships between the arrival times of echoes enable us to "blindfoldedly" estimate the room geometry. This is achieved by exploiting the properties of Euclidean distance matrices. Furthermore, we show that under mild conditions, first-order echoes provide a unique description of convex polyhedral rooms. Our algorithm starts from the recorded impulse responses and proceeds by learning the correct assignment of echoes to walls. In contrast to earlier methods, the proposed algorithm reconstructs the full 3D geometry of the room from a single sound emission, and with an arbitrary geometry of the microphone array. As long as the microphones can hear the echoes, we can position them as we want. Besides answering a basic question about the inverse problem of room acoustics, our results find applications in areas such as architectural acoustics, indoor localization, virtual reality, and audio forensics. PMID:23776236

  20. 37. DINING ROOM FROM BALCONY. THE DINING ROOM ROOF IS ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    37. DINING ROOM FROM BALCONY. THE DINING ROOM ROOF IS SUPPORTED BY A SCISSOR TRUSS SYSTEM REINFORCED WITH TURNBUCKLE IRON RODS AND GUSSET PLATES (NOTE: THIS SYSTEM DIFFERS FROM THE LOBBY). - Old Faithful Inn, 900' northeast of Snowlodge & 1050' west of Old Faithful Lodge, Lake, Teton County, WY

  1. 12. INTERIOR OF LIVING ROOM FROM DINING ROOM SHOWING OPEN ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    12. INTERIOR OF LIVING ROOM FROM DINING ROOM SHOWING OPEN FRONT DOOR AT PHOTO CENTER AND OPEN DOOR TO BEDROOM NO. 1 AT PHOTO LEFT. VIEW TO NORTH. - Bishop Creek Hydroelectric System, Plant 4, Worker Cottage, Bishop Creek, Bishop, Inyo County, CA

  2. 2. ENGINE ROOM AND CHIPPY ENGINE ROOM OF THE DIAMOND ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    2. ENGINE ROOM AND CHIPPY ENGINE ROOM OF THE DIAMOND MINE, LOOKING NORTH. THE MAIN HOIST USED A FLAT CABLE, WHICH WAS SCRAPPED IN THE 1950s. THE ORIGINAL DIXON CABLE STILL EXISTS IN THE CHIPPY HOIST HOUSE. - Butte Mineyards, Diamond Mine, Butte, Silver Bow County, MT

  3. 17. Perimeter acquisition radar building room #105, mechanical equipment room ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    17. Perimeter acquisition radar building room #105, mechanical equipment room no. 1; sign reads: Heat exchangers (shell and tube type). Provide precise temperature control of water for cooling critical electronic equipment - Stanley R. Mickelsen Safeguard Complex, Perimeter Acquisition Radar Building, Limited Access Area, between Limited Access Patrol Road & Service Road A, Nekoma, Cavalier County, ND

  4. 10. CONTROL ROOM INTERIOR. Looking into southwest corner. CONTROL ROOM ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    10. CONTROL ROOM INTERIOR. Looking into southwest corner. CONTROL ROOM INTERIOR, SHOWING ESCAPE HATCH. Looking north along east wall. - Edwards Air Force Base, Air Force Rocket Propulsion Laboratory, Instrumentation & Control Building, Test Area 1-115, northwest end of Saturn Boulevard, Boron, Kern County, CA

  5. LIVING ROOM WITH THE SLIDING DOORS TO DINING ROOM ON ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    LIVING ROOM WITH THE SLIDING DOORS TO DINING ROOM ON THE LEFT. SHOWING THE WOOD GRILLE TO THE FOYER. VIEW FACING SOUTHEAST - Camp H.M. Smith and Navy Public Works Center Manana Title VII (Capehart) Housing, U-Shaped Two-Bedroom Duplex Type 1, Acacia Road, Birch Circle, and Cedar Drive, Pearl City, Honolulu County, HI

  6. 16. Perimeter acquisition radar building room #102, electrical equipment room; ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    16. Perimeter acquisition radar building room #102, electrical equipment room; the prime power distribution system. Excellent example of endulum-types shock isolation. The grey cabinet and barrel assemble is part of the polychlorinated biphenyl (PCB) retrofill project - Stanley R. Mickelsen Safeguard Complex, Perimeter Acquisition Radar Building, Limited Access Area, between Limited Access Patrol Road & Service Road A, Nekoma, Cavalier County, ND

  7. From living room through french doors toward room in southeast ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    From living room through french doors toward room in southeast corner of south unit - Fitzsimons General Hospital, Civilian Employees' Quarters, North Hickey Street, West side, 150 feet North of intersection of North Hickey Street & West Loosley Avenue, Aurora, Adams County, CO

  8. 16. Bus Room (also known as Switch Gear Room), view ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    16. Bus Room (also known as Switch Gear Room), view to the southeast. An air circuit breaker compressor (visible in photograph number 2) was once attached to the main bus relay visible in the background of the photograph. - Washington Water Power Clark Fork River Cabinet Gorge Hydroelectric Development, Powerhouse, North Bank of Clark Fork River at Cabinet Gorge, Cabinet, Bonner County, ID

  9. 38. NORTHEAST ROOM, SECOND FLOOR, SOUTH WALL. ROOM COMPLETELY WALLED ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    38. NORTHEAST ROOM, SECOND FLOOR, SOUTH WALL. ROOM COMPLETELY WALLED WITH RANDOM WIDTH BOARDS WHICH WERE PAPERED OR PLASTERED OVER. THIS WAS TYPICAL THROUGHOUT HOUSE EXCEPT FOR WOOD PANELED WALLS - John Mark Verdier House, 801 Bay & Scott Streets, Beaufort, Beaufort County, SC

  10. Using a Research Simulator for Validating Control Room Modernization Concepts

    SciTech Connect

    Ronald L. Boring; Vivek Agarwal; Julius J. Persensky; Jeffrey C. Joe

    2012-05-01

    The Light Water Reactor Sustainability Program is a research, development, and deployment program sponsored by the United States Department of Energy. The program is operated in close collaboration with industry research and development programs to provide the technical foundations for licensing and managing the long-term, safe, and economical operation of nuclear power plants that are currently in operation. Advanced instrumentation and control (I&C) technologies are needed to support the continued safe and reliable production of power from nuclear energy systems during sustained periods of operation up to and beyond their expected licensed lifetime. This requires that new capabilities to achieve process control be developed and eventually implemented in existing nuclear control rooms. It also requires that approaches be developed and proven to achieve sustainability of I&C systems throughout the period of extended operation. Idaho National Laboratory (INL) is working closely with nuclear utilities to develop technologies and solutions to help ensure the safe life extension of current reactors. One of the main areas of focus is control room modernization. Current analog control rooms are growing obsolete, and it is difficult for utilities to maintain them. Using its reconfigurable control room simulator adapted from a training simulator, INL serves as a neutral test bed for implementing new control room system technologies and assisting in control room modernization efforts across.

  11. Advanced nuclear plant control room complex

    DOEpatents

    Scarola, Kenneth; Jamison, David S.; Manazir, Richard M.; Rescorl, Robert L.; Harmon, Daryl L.

    1993-01-01

    An advanced control room complex for a nuclear power plant, including a discrete indicator and alarm system (72) which is nuclear qualified for rapid response to changes in plant parameters and a component control system (64) which together provide a discrete monitoring and control capability at a panel (14-22, 26, 28) in the control room (10). A separate data processing system (70), which need not be nuclear qualified, provides integrated and overview information to the control room and to each panel, through CRTs (84) and a large, overhead integrated process status overview board (24). The discrete indicator and alarm system (72) and the data processing system (70) receive inputs from common plant sensors and validate the sensor outputs to arrive at a representative value of the parameter for use by the operator during both normal and accident conditions, thereby avoiding the need for him to assimilate data from each sensor individually. The integrated process status board (24) is at the apex of an information hierarchy that extends through four levels and provides access at each panel to the full display hierarchy. The control room panels are preferably of a modular construction, permitting the definition of inputs and outputs, the man machine interface, and the plant specific algorithms, to proceed in parallel with the fabrication of the panels, the installation of the equipment and the generic testing thereof.

  12. 10 CFR 36.67 - Entering and leaving the radiation room.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 10 Energy 1 2011-01-01 2011-01-01 false Entering and leaving the radiation room. 36.67 Section 36.67 Energy NUCLEAR REGULATORY COMMISSION LICENSES AND RADIATION SAFETY REQUIREMENTS FOR IRRADIATORS Operation of Irradiators § 36.67 Entering and leaving the radiation room. (a) Upon first entering the radiation room of a panoramic irradiator after...

  13. FRAMEWORK AND APPLICATION FOR MODELING CONTROL ROOM CREW PERFORMANCE AT NUCLEAR POWER PLANTS

    SciTech Connect

    Ronald L Boring; David I Gertman; Tuan Q Tran; Brian F Gore

    2008-09-01

    This paper summarizes an emerging project regarding the utilization of high-fidelity MIDAS simulations for visualizing and modeling control room crew performance at nuclear power plants. The key envisioned uses for MIDAS-based control room simulations are: (i) the estimation of human error associated with advanced control room equipment and configurations, (ii) the investigative determination of contributory cognitive factors for risk significant scenarios involving control room operating crews, and (iii) the certification of reduced staffing levels in advanced control rooms. It is proposed that MIDAS serves as a key component for the effective modeling of cognition, elements of situation awareness, and risk associated with human performance in next generation control rooms.

  14. Local public document room directory. Revision 7

    SciTech Connect

    1998-04-01

    This directory (NUREG/BR-0088, Revision 7) lists local public document rooms (LPDRs) for commercial nuclear power plants with operating or possession-only licenses or under construction, plus the LPDRs for potential high-level radioactive waste repository sites, gaseous diffusion plants, certain fuel cycle facilities, certain low-level waste disposal facilities, and any temporary LPDRs established for the duration of licensing proceedings. In some instances, the LPDR libraries maintain document collections for more than one licensed facility. The library staff members listed are the persons most familiar with the LPDR collections. Reference librarians in the NRC Headquarters Public Document Room (PDR) are also available to assist the public in locating NRC documents.

  15. 33. ROOM A (WEST ROOM) LOOKING SOUTHWEST. The windows above ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    33. ROOM A (WEST ROOM) LOOKING SOUTHWEST. The windows above the original Ministers' Gallery were raised in 1888 when inside toilet facilities were added on the other side of the west wall. Note the sloped window sills which provided more light. Also at the rear of the Meeting House a caretaker's apartment was added in 1908. - Twelfth Street Meeting House, 20 South Twelfth Street, Philadelphia, Philadelphia County, PA

  16. Conference room 211, adjacent to commander's quarters, with vault door ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Conference room 211, adjacent to commander's quarters, with vault door at right. Projection area at center is equipped with automatic security drapes. Projection room uses a 45 degree mirror to reflect the image onto the frosted glass screen. Door on far left leads to display area senior battle staff viewing bridge, and the commander's quarters - March Air Force Base, Strategic Air Command, Combat Operations Center, 5220 Riverside Drive, Moreno Valley, Riverside County, CA

  17. 8. VIEW OF THE SWITCHGEAR AND ELECTRICAL SUPPLY ROOM IN ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    8. VIEW OF THE SWITCHGEAR AND ELECTRICAL SUPPLY ROOM IN BETWEEN SIDES A AND B OF BUILDING 883. EQUIPMENT WITHIN THE BUILDING REQUIRED AN EXTENSIVE AMOUNT OF POWER. THE ELECTRICAL SUPPLY ROOM IS ESSENTIALLY AN ELECTRICAL SUBSTATION. (1/23/57) - Rocky Flats Plant, Uranium Rolling & Forming Operations, Southeast section of plant, southeast quadrant of intersection of Central Avenue & Eighth Street, Golden, Jefferson County, CO

  18. A new main control room for the AGS complex

    SciTech Connect

    Ingrassia, P.F.; Zaharatos, R.M.; Dyling, O.H.

    1991-01-01

    A new Main Control Room (MCR) has been built to control the accelerators of the AGS Complex. A new physical environment was produced to better control light, sound, temperature, and traffic. New control consoles were built around the work-stations that make up the distributed control system. Equipment placement within consoles and console placement within the room reflect attention to the human factors'' needs of the operator. 1 ref., 2 figs.

  19. 26. VIEW OF SOUTHERN PORTION OF EAST BOILER ROOM LOOKING ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    26. VIEW OF SOUTHERN PORTION OF EAST BOILER ROOM LOOKING EAST AT BOILER 904. BOILER 904 WAS MANUFACTURED BY RILEY STOKER AND INSTALLED IN 1944. ORIGINALLY FUELED BY PULVERIZED COAL, IT WAS CONVERTED TO GAS/OIL OPERATION IN 1978 AND OPERATED UNTIL THE PLANT CLOSED. - New York, New Haven & Hartford Railroad, Cos Cob Power Plant, Sound Shore Drive, Greenwich, Fairfield County, CT

  20. 9 CFR 354.221 - Rooms and compartments.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... INSPECTION AND CERTIFICATION VOLUNTARY INSPECTION OF RABBITS AND EDIBLE PRODUCTS THEREOF Buildings and Plant... separate operation. The official plant should have separate rooms for each of the following operations... needs of the inspection in the plant may require. They shall be equipped with locks and keys and...

  1. 32 CFR 518.9 - Reading room.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 32 National Defense 3 2010-07-01 2010-07-01 true Reading room. 518.9 Section 518.9 National... RELATIONS THE FREEDOM OF INFORMATION ACT PROGRAM FOIA Reading Rooms § 518.9 Reading room. (a) Reading room... the records described, DA may elect to place other records in their reading room, and also make...

  2. Microbiological aspects of clean room technology as applied to surgery, with special reference to unidirectional airflow systems

    NASA Technical Reports Server (NTRS)

    Wardle, M. D.

    1974-01-01

    The microbiological aspects of clean room technology as applied to surgery were reviewed. The following pertinent subject areas were examined: (1) clean room technology per se and its utilization for surgery, (2) microbiological monitoring of the clean room surgical environment, (3) clean rooms and their impact on operating room environmental microbiology, and (4) the effect of the technology on surgical wound infection rates. Conclusions were drawn for each topic investigated.

  3. Human factors engineering control-room-design review/audit report: Palo Verde Nuclear Generating Station, Arizona Public Service Company

    SciTech Connect

    Savage, J.W.; Lappa, D.A.

    1981-10-09

    A human factors engineering design review of the Palo Verde control room simulator was performed at the site on September 15 through September 17, 1981. Observed human factors design discrepancies were given priority ratings. This report summarizes the team's observations of the control room design and layout and of the control room operators' interface with the control room environment. A list of the human factors strengths observed in the Palo Verde control room simulator is given.

  4. Nuclear reactor control room construction

    DOEpatents

    Lamuro, Robert C.; Orr, Richard

    1993-01-01

    A control room 10 for a nuclear plant is disclosed. In the control room, objects 12, 20, 22, 26, 30 are no less than four inches from walls 10.2. A ceiling 32 contains cooling fins 35 that extend downwards toward the floor from metal plates 34. A concrete slab 33 is poured over the plates. Studs 36 are welded to the plates and are encased in the concrete.

  5. Nuclear reactor control room construction

    DOEpatents

    Lamuro, R.C.; Orr, R.

    1993-11-16

    A control room for a nuclear plant is disclosed. In the control room, objects labelled 12, 20, 22, 26, 30 in the drawing are no less than four inches from walls labelled 10.2. A ceiling contains cooling fins that extend downwards toward the floor from metal plates. A concrete slab is poured over the plates. Studs are welded to the plates and are encased in the concrete. 6 figures.

  6. Room-temperature continuous-wave operation of BeZnCdSe quantum-well green-to-yellow laser diodes with sub-10 mA threshold current

    NASA Astrophysics Data System (ADS)

    Feng, Jijun; Akimoto, Ryoichi

    2016-03-01

    Low threshold current BeZnCdSe single quantum-well (SQW) laser diodes (LDs) have been developed. The waveguide was formed of a ridge structure with etching away the top p-type BeMgZnSe/ZnSe:N short-period superlattice cladding layer, and then covered with a thick SiO2 layer and planarized with chemical-mechanical polishing and reactive ion etching process. Three type LDs with different SQW thickness and Cd content were developed and compared at varying waveguide width and length. Lasing wavelength of 535, 563, and 567 nm were realized respectively, at room-temperature continuous-wave condition with the laser cavity formed by the cleaved waveguide facets coated with high-reflectivity dielectric films. Compared with our previously developed gain-guided diode structure for a 5-μm-wide, 800- μm-long gain-guided green laser with a threshold current and voltage of 68 mA and 10.4 V, a 535-nm green laser with 7- nm-thick SQW can realize a threshold current and voltage of 7.07 mA and 7.89 V, respectively, for a cavity width of 4 μm and length of 300 μm. A 563-nm yellow LD with 4-nm-thick SQW was also developed with 7.4-mA and 8.48-V threshold current and voltage for a 3-μm-wide, 300-μm-long cavity. A 567-nm yellow LD with 7-nm-thick SQW can achieve a threshold current and voltage of 10.8 mA and 8.4 V, respectively, for a cavity length of 300 μm and width of 7 μm. The threshold current and voltage were decreased due to the reinforced confinement of carriers in cavities. The device performance can be significantly improved with much lower power consumption. The threshold current and power consumption is also sufficiently low compared with that of InGaN/GaN green LDs, which will benefit the potential application for ZnSe-based LDs as light sources in full-color display as well as some biomedical devices.

  7. Information Foraging in Nuclear Power Plant Control Rooms

    SciTech Connect

    R.L. Boring

    2011-09-01

    nformation foraging theory articulates the role of the human as an 'informavore' that seeks information and follows optimal foraging strategies (i.e., the 'information scent') to find meaningful information. This paper briefly reviews the findings from information foraging theory outside the nuclear domain and then discusses the types of information foraging strategies operators employ for normal and off-normal operations in the control room. For example, operators may employ a predatory 'wolf' strategy of hunting for information in the face of a plant upset. However, during routine operations, the operators may employ a trapping 'spider' strategy of waiting for relevant indicators to appear. This delineation corresponds to information pull and push strategies, respectively. No studies have been conducted to determine explicitly the characteristics of a control room interface that is optimized for both push and pull information foraging strategies, nor has there been empirical work to validate operator performance when transitioning between push and pull strategies. This paper explores examples of control room operators as wolves vs. spiders and con- cludes by proposing a set of research questions to investigate information foraging in control room settings.

  8. Room temperature single-photon detectors for high bit rate quantum key distribution

    SciTech Connect

    Comandar, L. C.; Patel, K. A.; Fröhlich, B. Lucamarini, M.; Sharpe, A. W.; Dynes, J. F.; Yuan, Z. L.; Shields, A. J.; Penty, R. V.

    2014-01-13

    We report room temperature operation of telecom wavelength single-photon detectors for high bit rate quantum key distribution (QKD). Room temperature operation is achieved using InGaAs avalanche photodiodes integrated with electronics based on the self-differencing technique that increases avalanche discrimination sensitivity. Despite using room temperature detectors, we demonstrate QKD with record secure bit rates over a range of fiber lengths (e.g., 1.26 Mbit/s over 50 km). Furthermore, our results indicate that operating the detectors at room temperature increases the secure bit rate for short distances.

  9. Room-temperature semiconductor heterostructure refrigeration

    NASA Astrophysics Data System (ADS)

    Chao, K. A.; Larsson, Magnus; Mal'shukov, A. G.

    2005-07-01

    With the proper design of semiconductor tunneling barrier structures, we can inject low-energy electrons via resonant tunneling, and take out high-energy electrons via a thermionic process. This is the operation principle of our semiconductor heterostructure refrigerator (SHR) without the need of applying a temperature gradient across the device. Even for the bad thermoelectric material AlGaAs, our calculation shows that at room temperature, the SHR can easily lower the temperature by 5-7K. Such devices can be fabricated with the present semiconductor technology. Besides its use as a kitchen refrigerator, the SHR can efficiently cool microelectronic devices.

  10. 14. NBS REMOTE MANIPULATOR SIMULATOR (RMS) CONTROL ROOM. THE RMS ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    14. NBS REMOTE MANIPULATOR SIMULATOR (RMS) CONTROL ROOM. THE RMS CONTROL PANEL IS IDENTICAL TO THE SHUTTLE ORBITER AFT FLIGHT DECK WITH ALL RMS SWITCHES AND CONTROL KNOBS FOR INVOKING ANY POSSIBLE FLIGHT OPERATIONAL MODE. THIS INCLUDES ALL COMPUTER AIDED OPERATIONAL MODES, AS WELL AS FULL MANUAL MODE. THE MONITORS IN THE AFT FLIGHT DECK WINDOWS AND THE GLASSES THE OPERATOR WEARS PROVIDE A 3-D VIDEO PICTURE TO AID THE OPERATOR WITH DEPTH PERCEPTION WHILE OPERATING THE ARM. THIS IS REQUIRED BECAUSE THE RMS OPERATOR CANNOT VIEW RMS MOVEMENTS IN THE WATER WHILE AT THE CONTROL PANEL. - Marshall Space Flight Center, Neutral Buoyancy Simulator Facility, Rideout Road, Huntsville, Madison County, AL

  11. 26. A typical outer rod room, or rack room, showing ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    26. A typical outer rod room, or rack room, showing the racks for the nine horizontal control rods (HCRs) that would be inserted or withdrawn from the pile to control the rate of reaction. In this case, it is the 105-F Reactor in February 1945. The view is looking away from the pile, which is out of the picture on the left. Several of the cooling water hose reels for the rods can be seen at the end of the racks near the wall. D-8323 - B Reactor, Richland, Benton County, WA

  12. 77 FR 55813 - Transition of DOE-ID Public Reading Room

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-09-11

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF ENERGY Transition of DOE-ID Public Reading Room AGENCY: Idaho Operations Office, Department of Energy. ACTION... Department of Energy Idaho Operations Office Public Reading Room has been relocated to the INL...

  13. Bridging a few terahertz to tens of terahertz: Inspection on a cost-effective, room-temperature operated measurement system based on frequency conversion via 4-dimethylamino-N'-methyl-4'-stilbazolium tosylate crystal

    NASA Astrophysics Data System (ADS)

    Qi, Feng; Nawata, Kouji; Hayashi, Shin'ichiro; Notake, Takashi; Matsukawa, Takeshi; Minamide, Hiroaki

    2014-01-01

    Based on experimental studies, we inspected the feasibility of a frequency conversion system, including both terahertz (THz) generation and detection, by using 4-dimethylamino-N'-methy-4'-stilbazolium tosylate crystal for wideband measurement. At 27 THz, more than five orders dynamic range in power have been obtained. Compared with typical pyroelectric detectors, it is four orders better in terms of sensitivity. Power calibration has been implemented and the minimum detectable pulse energy is 3 fJ, with a corresponding noise equivalent power of 22 pW/Hz1/2. For broadband operation, we have achieved good signal level downwards to 2.5 THz. Such a system can be an excellent complement to classical time-domain spectroscopy systems.

  14. Brief history of laminar flow clean room systems

    SciTech Connect

    Whitfield, W J

    1981-01-01

    This paper reviews the development and evolution of laminar flow clean rooms and hoods and describes the underlying principles and rationales associated with development of this type of clean room system and Federal Standard No. 209. By the mid 1970's, over a thousand hospitals in the US had installed laminar flow equipment in operating rooms. During the past several years a great deal of attention has been focused on conserving energy in clean rooms. Some gains in energy conservation have been achieved by improved design, off hours shutdown, and closer evaluation of requirements for clean rooms. By the early 1970's, the laminar flow principle had been carried from the Laboratory and applied to production hardware to create a mature industry producing and marketing a variety of laminar flow equipment in less than 10 years time. This achievement was made possible by literally dozens of persons in industry, government, military, and private individuals who developed hardware, added numerous innovations, and had the foresight to apply the technology to many fields other than industrial clean rooms. Now, with laminar flow devices available, class 100 levels are readily achievable and maintained, and at the same time require fewer operating restrictions than previously possible.

  15. Corneal storage at room temperature.

    PubMed

    Sachs, U; Goldman, K; Valenti, J; Kaufman, H E

    1978-06-01

    Short-term eye banking is based mainly on moist chamber and McCarey-Kaufman medium (M-K medium) preservation. Both involve a controlled 4 C temperature for storage. Warming the cornea to room temperature, however, drastically affects the endothelial viability. On enzymatic staining and histological study, the M-K medium-stored rabbit corneas had more normal endothelium than did "moist chamber" eyes when storage was prolonged for seven days at room temperature. In human corneas that were kept at 4 C for 24 hours and then exposed to a temperature of 25 C, destruction of organelles had occurred by six hours and was increased by 12 hours. Corneas that were kept in M-K medium had relatively intact endothelium after four days, but cell disruption and vacuolation was present by the seventh day. The M-K medium, therefore, affords protection to tissue warmed to room temperature, where metabolic activity is resumed. PMID:350203

  16. Room-temperature low-threshold low-loss continuous-wave operation of 2.26 μm GaInAsSb/AlGaAsSb quantum-well laser diodes

    NASA Astrophysics Data System (ADS)

    Mermelstein, C.; Simanowski, S.; Mayer, M.; Kiefer, R.; Schmitz, J.; Walther, M.; Wagner, J.

    2000-09-01

    Strained single- and triple-quantum-well (SQW and TQW), large optical cavity GaInAsSb/AlGaAsSb/GaSb laser diodes emitting at 2.26 μm are investigated. Internal loss coefficients as low as 5 and 7.7 cm-1 for the SQW and TQW, respectively, and relatively high internal quantum efficiencies of 65% (SQW) and 69% (TQW) were obtained. Extrapolated threshold current densities for infinite cavity lengths of 55 and 150 A/cm2 have been deduced for the SQW and TQW, respectively. These values scale very well with the number of QWs and are among the lowest reported for diode lasers in this wavelength range. A differential quantum efficiency as high as 50% and a total power efficiency of 23% were achieved at 280 K. The temperature dependence of the threshold current density revealed a high characteristic temperature of 110 K. Single-ended output powers of 240 mW in continuous-wave mode and exceeding 0.5 W in pulsed operation were obtained for a TQW laser with high-reflection/antireflection coated facets at 280 K, mounted substrate-side down.

  17. 39 CFR 3004.12 - Reading room.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 39 Postal Service 1 2011-07-01 2011-07-01 false Reading room. 3004.12 Section 3004.12 Postal... Reading room. (a) The Commission maintains a public reading room at its offices (901 New York Avenue, NW., Suite 200, Washington, DC 20268-0001) and an electronic reading room at http://www.prc.gov. The...

  18. 32 CFR 296.6 - Reading room.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 32 National Defense 2 2011-07-01 2011-07-01 false Reading room. 296.6 Section 296.6 National... Reading room. (a) The NRO shall provide a reading room equipped with hard copy and electronic records as required in the “Electronic Freedom of Information Act Amendments of 1996”. The NRO Reading Room is...

  19. 32 CFR 296.6 - Reading room.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 32 National Defense 2 2010-07-01 2010-07-01 false Reading room. 296.6 Section 296.6 National... Reading room. (a) The NRO shall provide a reading room equipped with hard copy and electronic records as required in the “Electronic Freedom of Information Act Amendments of 1996”. The NRO Reading Room is...

  20. 39 CFR 3004.12 - Reading room.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 39 Postal Service 1 2010-07-01 2010-07-01 false Reading room. 3004.12 Section 3004.12 Postal... Reading room. (a) The Commission maintains a public reading room at its offices (901 New York Avenue, NW., Suite 200, Washington, DC 20268-0001) and an electronic reading room at http://www.prc.gov. The...

  1. Energy Efficiency in Small Server Rooms: Field Surveys and Findings

    SciTech Connect

    Cheung, Iris; Greenberg, Steve; Mahdavi, Roozbeh; Brown, Richard; Tschudi, William

    2014-08-11

    Fifty-seven percent of US servers are housed in server closets, server rooms, and localized data centers, in what are commonly referred to as small server rooms, which comprise 99percent of all server spaces in the US. While many mid-tier and enterprise-class data centers are owned by large corporations that consider energy efficiency a goal to minimize business operating costs, small server rooms typically are not similarly motivated. They are characterized by decentralized ownership and management and come in many configurations, which creates a unique set of efficiency challenges. To develop energy efficiency strategies for these spaces, we surveyed 30 small server rooms across eight institutions, and selected four of them for detailed assessments. The four rooms had Power Usage Effectiveness (PUE) values ranging from 1.5 to 2.1. Energy saving opportunities ranged from no- to low-cost measures such as raising cooling set points and better airflow management, to more involved but cost-effective measures including server consolidation and virtualization, and dedicated cooling with economizers. We found that inefficiencies mainly resulted from organizational rather than technical issues. Because of the inherent space and resource limitations, the most effective measure is to operate servers through energy-efficient cloud-based services or well-managed larger data centers, rather than server rooms. Backup power requirement, and IT and cooling efficiency should be evaluated to minimize energy waste in the server space. Utility programs are instrumental in raising awareness and spreading technical knowledge on server operation, and the implementation of energy efficiency measures in small server rooms.

  2. Room-Maid in Hotel

    ERIC Educational Resources Information Center

    Hotel and Catering Industry Training Board, Wembley (England).

    This syllabus is intended for the use of training personnel in drawing up training programs for room-maids in hotels. Its main objective is to produce fully trained maids, thereby maintaining and raising standards. The syllabus is divided into three sections: Introducing to Housekeeping, Basic Tasks Performed by the Majority of Housekeeping…

  3. Locker Room Maintenance Made Easy.

    ERIC Educational Resources Information Center

    Theel, James

    1998-01-01

    Provides examples on ways to make locker room maintenance easier and their use more student-friendly. Improvements include use of indoor-outdoor carpeting with numerous floor drains to cut mildew buildup, adequate ventilation to reduce musty smells, better hot water management, ceramic tiles to reduce water-damage repair and painting needs, and…

  4. Hotels Make Room for Fitness.

    ERIC Educational Resources Information Center

    Koszuta, Laurie Einstein

    1986-01-01

    Hotels, in hopes of gaining a competitive edge, are offering workout rooms, exercise equipment, fitness trails, and jogging tracks, but no standards have been set for safety of the facilities or staff preparedness in exercise screening, equipment use, injury prevention, or first aid. (MT)

  5. Room Density and User Satisfaction

    ERIC Educational Resources Information Center

    Sommer, Robert; Becker, Franklin D.

    1971-01-01

    Over a four-year period, different sized classes were asked to rate the physical environment in a college classroom. Class size was found to be related to the proportion of complaints, satisfaction with ventilation, and room size for both students and faculty. It is necessary to develop theories of people-in-environments rather than of people and…

  6. 10 CFR 429.15 - Room air conditioners.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 10 Energy 3 2012-01-01 2012-01-01 false Room air conditioners. 429.15 Section 429.15 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION CERTIFICATION, COMPLIANCE, AND ENFORCEMENT FOR CONSUMER PRODUCTS AND... selected and tested to ensure that— (i) Any represented value of estimated annual operating cost,...

  7. 10. VIEW OF ELEVATOR MACHINE ROOM IN BASEMENT BELOW SHAFT, ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    10. VIEW OF ELEVATOR MACHINE ROOM IN BASEMENT BELOW SHAFT, SHOWING LOW CABINET THAT HOUSES HYDRAULIC CYLINDER AND CLOSET THAT HOUSES TRAVELING SHEAVES AT RIGHT; OPERATING CABLE SHEAVE AT TOP OF PICTURE, LOOKING SOUTHEAST - 72 Marlborough Street, Residential Hydraulic Elevator, Boston, Suffolk County, MA

  8. 12. Historic view of Building 100 control room, showing television ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    12. Historic view of Building 100 control room, showing television monitoring of tests and personnel operating rocket engine test controls. May 27, 1957. On file at NASA Plumbrook Research Facility, Sandusky, Ohio. NASA photo number C-45021. - Rocket Engine Testing Facility, GRC Building No. 100, NASA Glenn Research Center, Cleveland, Cuyahoga County, OH

  9. Control Room - 10ft x 10ft Wind Tunnel

    NASA Technical Reports Server (NTRS)

    1955-01-01

    One of three control panels in the control room of the Lewis Unitary Plan Wind Tunnel. The tunnel model (top center) shows position of the valves that control the operating cycle of the tunnel. The TV monitor screens can be connected to any of 3 closed-circuit TV cameras used to monitor tunnel components.

  10. 11. LIVING ROOM INTERIOR SHOWING BUILTIN CUPBOARD AND OPEN DOOR ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    11. LIVING ROOM INTERIOR SHOWING BUILT-IN CUPBOARD AND OPEN DOOR TO KITCHEN ON THE NORTH WALL AT PHOTO CENTER. OPEN DOOR ON WEST WALL AT PHOTO LEFT ENTERS NORTH BEDROOM. VIEW TO NORTH. - Big Creek Hydroelectric System, Big Creek Town, Operator House, Orchard Avenue south of Huntington Lake Road, Big Creek, Fresno County, CA

  11. Looking southwest in the service bay area, pump room level, ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Looking southwest in the service bay area, pump room level, at the ventilation fan ducts associated with the evaporative cooling system. Stairs to the operating deck above the intakes are at the far left - Wellton-Mohawk Irrigation System, Pumping Plant No. 2, Bounded by Interstate 8 to south, Wellton, Yuma County, AZ

  12. 29. Perimeter acquisition radar building room #318, data processing system ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    29. Perimeter acquisition radar building room #318, data processing system area; data processor maintenance and operations center, showing data processing consoles - Stanley R. Mickelsen Safeguard Complex, Perimeter Acquisition Radar Building, Limited Access Area, between Limited Access Patrol Road & Service Road A, Nekoma, Cavalier County, ND

  13. 20. VIEW OF WASTE TREATMENT CONTROL ROOM IN BUILDING 374. ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    20. VIEW OF WASTE TREATMENT CONTROL ROOM IN BUILDING 374. THE BUILDING 371/374 COMPLEX WAS DESIGNED TO EMPHASIZE AUTOMATICALLY CONTROLLED, REMOTELY OPERATED PROCESSES. (1/80) - Rocky Flats Plant, Plutonium Recovery Facility, Northwest portion of Rocky Flats Plant, Golden, Jefferson County, CO

  14. 18. The west end of the dining room contains four ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    18. The west end of the dining room contains four windows that overlook Central Avenue. As other millwork in the restaurant, these windows were originally finished with stain and varnish. Transoms retain their original operators. Credit GADA/MRM. - Stroud Building, 31-33 North Central Avenue, Phoenix, Maricopa County, AZ

  15. Wiring repair area, southwest corner of room 227, looking east. ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Wiring repair area, southwest corner of room 227, looking east. Repair area includes soldering equipment and wire dispensing reels hanging from the ceiling - March Air Force Base, Strategic Air Command, Combat Operations Center, 5220 Riverside Drive, Moreno Valley, Riverside County, CA

  16. 106. VIEW OF NORTHEAST QUADRANT OF COMMUNICATIONS ROOM FROM SOUTHEAST ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    106. VIEW OF NORTHEAST QUADRANT OF COMMUNICATIONS ROOM FROM SOUTHEAST QUADRANT. Three rows of equipment cabinets west of (behind) those visible here are not accessible for photography. - Vandenberg Air Force Base, Space Launch Complex 3, Launch Operations Building, Napa & Alden Roads, Lompoc, Santa Barbara County, CA

  17. Interior, equipment room, weather support area (from July, 1968 drawing) ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Interior, equipment room, weather support area (from July, 1968 drawing) at north end of display area, looking west. Window looks south towards the main console - March Air Force Base, Strategic Air Command, Combat Operations Center, 5220 Riverside Drive, Moreno Valley, Riverside County, CA

  18. VIEW OF HISTORIC SLATE SWITCHBOARD IN THE CONTROL ROOM OF ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    VIEW OF HISTORIC SLATE SWITCHBOARD IN THE CONTROL ROOM OF THE ELWHA POWERHOUSE, INCLUDING: METERS, PROTECTIVE RELAYS, AND SWITCHES. NOTE ADDITION OF PERSONAL COMPUTERS FOR POWER METERING AND OPERATIONS. PHOTO BY JET LOWE, HAER, 1995. - Elwha River Hydroelectric System, Elwha Hydroelectric Dam & Plant, Port Angeles, Clallam County, WA

  19. CONTROL ROOM WITH SPRINKLER SYSTEM CONTROLS, INCLUDING MANUAL CONTROL BOXES ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    CONTROL ROOM WITH SPRINKLER SYSTEM CONTROLS, INCLUDING MANUAL CONTROL BOXES FOR THE VENTILATION SYSTEM AND A PLC SWITCH FOR AUTOMATIC CO (CARBON MONOXIDE) SYSTEM. THE AIR TESTING SYSTEM IS FREE STANDING AND THE FANS ARE COMPUTER-OPERATED. - Alaskan Way Viaduct and Battery Street Tunnel, Seattle, King County, WA

  20. 33. Perimeter acquisition radar building room #320, perimeter acquisition radar ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    33. Perimeter acquisition radar building room #320, perimeter acquisition radar operations center (PAROC), contains the tactical command and control group equipment required to control the par site. Showing spacetrack monitor console - Stanley R. Mickelsen Safeguard Complex, Perimeter Acquisition Radar Building, Limited Access Area, between Limited Access Patrol Road & Service Road A, Nekoma, Cavalier County, ND