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Sample records for baylor operating room

  1. 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

  2. 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

  3. 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

  4. 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

  5. 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.

  6. 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.

  7. [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

  8. [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.

  9. 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.

  10. Accelerating best care at baylor dallas.

    PubMed

    Haydar, Ziad; Cox, Marsha; Stafford, Pam; Rodriguez, Vera; Ballard, David J

    2009-10-01

    A culture of quality improvement (QI) is needed to bridge the gap between possible STEEEP (safe, timely, effective, efficient, equitable, and patient-centered) care and actual usual care. Baylor Health Care System (BHCS) developed Accelerating Best Care at Baylor (ABC Baylor), an innovative educational program that teaches health care leaders the theory and techniques of rapid-cycle QI. Course participants learn general principles of continuous QI, as well as health care-specific QI techniques, and finish the course by designing and implementing their own QI project. ABC Baylor has been employed in a variety of settings and has spread its success to other organizations, especially small and rural hospitals. These hospitals, like BHCS, have demonstrated sustained improvements that are due in part to the use of ABC Baylor and its reliance on specific modules that focus on health care safety, service, equity, and chronic disease management. The role of ABC Baylor training and consulting is part of the overall culture and infrastructure that have allowed BHCS to achieve success in its improvement journey, including the receipt of several national awards and the achievement of high reliability in compliance with Centers for Medicare and Medicaid Services core measures of processes of care related to heart failure, acute myocardial infarction, community-acquired pneumonia, and surgical care. The culture of rapid-cycle QI facilitated by ABC Baylor serves to link BHCS's vision and goals to practical execution. PMID:19865500

  11. 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…

  12. 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 > ...

  13. 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

  14. IAIMS development at Baylor College of Medicine.

    PubMed

    Gorry, G A

    1992-07-01

    At Baylor College of Medicine, we are developing the technical and intellectual resources needed to realize the Integrated Academic Information Management System (IAIMS) concept fully. The substantial technical, organizational, and financial commitments involved demand that we align our efforts with the strategic purposes of the college. The support of science, therefore, has become the principal, but not exclusive, focus of Baylor's IAIMS effort. Even so, the information technology architecture we have created for biomedical research is proving valuable in other settings as well. And the infrastructure we are creating--the communications architecture and the linkages to information resources--serves many purposes in addition to those of research. The architecture accommodates a diversity of workstations, networks, and informational and computational servers. This will be the greatest possible chance of transferring the fruits of our Phase III development to other academic medical centers.

  15. 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.

  16. Surgeons and operating rooms: underutilized resources.

    PubMed Central

    Gil, A V; Galarza, M T; Guerrero, R; de Velez, G P; Peterson, O L; Bloom, B L

    1983-01-01

    A classification of surgical procedures, based on degree of complexity and the need for facilities and personnel, was applied to all 50,782 surgical interventions performed in the Valle del Cauca, Colombia during 1974. Three-fourths of all operations were of low levels of complexity, and most could be performed on an ambulatory basis with immediate discharge after recovery from anesthesia. Mean numbers of operations per year for surgical specialists and other physicians were 119.7 and 18.1, respectively. The 76 existing operating rooms were utilized only 41.6 per cent of the time. The implications of underutilization of personnel and facilities and low productivity of surgeons are discussed. PMID:6638228

  17. 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

  18. 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.

  19. 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

  20. 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.

  1. [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

  2. [The operating room of the future].

    PubMed

    Broeders, I A; Niessen, W; van der Werken, C; van Vroonhoven, T J

    2000-01-29

    Advances in computer technology will revolutionize surgical techniques in the next decade. The operating room (OR) of the future will be connected with a laboratory where clinical specialists and researchers prepare image-guided interventions and explore the possibilities of these techniques. The virtual reality is linked to the actual situation in the OR with the aid of navigation instruments. During complicated operations the images prepared preoperatively will be corrected during the operation on the basis of the information obtained peroperatively. MRI currently offers maximal possibilities for image-guided surgery of soft tissues. Simpler techniques such as fluoroscopy and echography will become increasingly integrated in computer-assisted peroperative navigation. The development of medical robot systems will make possible microsurgical procedures by the endoscopic route. Tele-manipulation systems will also play a part in the training of surgeons. Design and construction of the OR will be adapted to the surgical technology, and include an information and control unit where preoperative and peroperative data come together and from where the surgeon operates the instruments. Concepts for the future OR should be regularly adjusted to allow for new surgical technology. PMID:10682646

  3. 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.

  4. 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

  5. Comparison of Microbial Contamination Levels Among Hospital Operating Rooms and Industrial Clean Rooms

    PubMed Central

    Favero, Martin S.; Puleo, John R.; Marshall, James H.; Oxborrow, Gordon S.

    1968-01-01

    Microbial contamination in industrial clean rooms was compared quantitatively and qualitatively with that of hospital operating rooms. The number of aerobic mesophilic microorganisms which accumulated on stainless-steel strips exposed for periods up to 21 weeks to the intramural air of four operating rooms was at least 1 log higher than the accumulation on strips exposed in four clean rooms, and was essentially the same as that found in two factory areas. Volumetric air samplings showed that there were significantly higher numbers of airborne viable particles per cubic foot of air in operating rooms than in industrial clean rooms. In contrast to clean rooms, where most of the airborne contaminants were those associated with human hair, skin, and respiratory tract, the hospital operating rooms showed a very high level of microorganisms associated with dust and soil. Images Fig. 4 PMID:5649862

  6. 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.

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

    SciTech Connect

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

    1982-02-01

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

  8. [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

  9. Conflict and its resolution in the operating room.

    PubMed

    Katz, Jonathan D

    2007-03-01

    The operating room is a high-stress and volatile workplace where interpersonal conflict can be frequent and at times intense. This article explores some of the common sources of conflict and suggests some remedies.

  10. Simulating environmental and psychological acoustic factors of the operating room.

    PubMed

    Bennett, Christopher L; Dudaryk, Roman; Ayers, Andrew L; McNeer, Richard R

    2015-12-01

    In this study, an operating room simulation environment was adapted to include quadraphonic speakers, which were used to recreate a composed clinical soundscape. To assess validity of the composed soundscape, several acoustic parameters of this simulated environment were acquired in the presence of alarms only, background noise only, or both. These parameters were also measured for comparison from size-matched operating rooms at Jackson Memorial Hospital. The parameters examined included sound level, reverberation time, and predictive metrics of speech intelligibility in quiet and noise. It was found that the sound levels and acoustic parameters were comparable between the simulated environment and the actual operating rooms. The impact of the background noise on the perception of medical alarms was then examined, and was found to have little impact on the audibility of the alarms. This study is a first in kind report of a comparison between the environmental and psychological acoustical parameters of a hospital simulation environment and actual operating rooms.

  11. 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

  12. Interior view of operating room on third floor of west ...

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

    Interior view of operating room on third floor of west wing; camera facing north. - Mare Island Naval Shipyard, Hospital Wards, Cedar Avenue, eat side between Fourteenth Avenue & Cossey Street, Vallejo, Solano County, CA

  13. 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.

  14. 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.

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

    PubMed

    Moszczynski, Alice

    2010-09-01

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

  16. Noise in the operating rooms of Greek hospitals.

    PubMed

    Tsiou, Chrisoula; Efthymiatos, Gerasimos; Katostaras, Theophanis

    2008-02-01

    This study is an evaluation of the problem of noise pollution in operating rooms. The high sound pressure level of noise in the operating theatre has a negative impact on communication between operating room personnel. The research took place at nine Greek public hospitals with more than 400 beds. The objective evaluation consisted of sound pressure level measurements in terms of L(eq), as well as peak sound pressure levels in recordings during 43 surgeries in order to identify sources of noise. The subjective evaluation consisted of a questionnaire answered by 684 operating room personnel. The views of operating room personnel were studied using Pearson's X(2) Test and Fisher's Exact Test (SPSS Version 10.00), a t-test comparison was made of mean sound pressure levels, and the relationship of measurement duration and sound pressure level was examined using linear regression analysis (SPSS Version 13.00). The sound pressure levels of noise per operation and the sources of noise varied. The maximum measured level of noise during the main procedure of an operation was measured at L(eq)=71.9 dB(A), L(1)=84.7 dB(A), L(10)=76.2 dB(A), and L(99)=56.7 dB(A). The hospital building, machinery, tools, and people in the operating room were the main noise factors. In order to eliminate excess noise in the operating room it may be necessary to adopt a multidisciplinary approach. An improvement in environment (background noise levels), the implementation of effective standards, and the focusing of the surgical team on noise matters are considered necessary changes.

  17. 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

  18. 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

  19. 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

  20. 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

  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. Risk of blood contamination and injury to operating room personnel.

    PubMed Central

    Quebbeman, E J; Telford, G L; Hubbard, S; Wadsworth, K; Hardman, B; Goodman, H; Gottlieb, M S

    1991-01-01

    The potential for transmission of deadly viral diseases to health care workers exists when contaminated blood is inoculated through injury or when blood comes in contact with nonintact skin. Operating room personnel are at particularly high risk for injury and blood contamination, but data on the specifics of which personnel are at greater risk and which practices change risk in this environment are almost nonexistent. To define these risk factors, experienced operating room nurses were employed solely to observe and record the injuries and blood contaminations that occurred during 234 operations involving 1763 personnel. Overall 118 of the operations (50%) resulted in at least one person becoming contaminated with blood. Cuts or needlestick injuries occurred in 15% of the operations. Several factors were found to significantly alter the risk of blood contamination or injury: surgical specialty, role of each person, duration of the procedure, amount of blood loss, number of needles used, and volume of irrigation fluid used. Risk calculations that use average values to include all personnel in the operating room or all operations performed substantially underestimate risk for surgeons and first assistants, who accounted for 81% of all body contamination and 65% of the injuries. The area of the body contaminated also changed with the surgical specialty. These data should help define more appropriate protection for individuals in the operating room and should allow refinements of practices and techniques to decrease injury. Images Fig. 1. PMID:1953115

  3. High-tech tools transform the operating room.

    PubMed

    Haugh, Richard

    2005-01-01

    This installment of our quarterly Clinical Management series examines how the hospital operating room is becoming a safer place for patients. Thanks to such technological breakthroughs as 3-D images, virtual patients and robots, surgeons can operate with more accuracy and efficiency.

  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. 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

  6. 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.

  7. Eyewear contamination levels in the operating room: infection risk.

    PubMed

    Lange, Victor R

    2014-04-01

    We investigated eyewear contamination levels in the operating room to assess infection risk and inform protocol development. Microbial contamination after use was found in 37.7% of disposable and 94.9% of reusable eyewear pieces. After disinfection, 74.4% of reusable eyewear also cultured positive. Disposable eyewear may reduce intercase contamination risk. Reusable eyewear may carry ongoing bioburden and, thus, contribute to operating room environment risk. Eyewear with antimicrobial material or components could reduce risk. Alternative decontamination methods for reusable eyewear should be evaluated.

  8. Arterial oxygen saturation in anaesthetised patients during transfer from induction room to operating room.

    PubMed

    Riley, R H; Davis, N J; Finucane, K E; Christmas, P

    1988-05-01

    There is no published study that examines oxygenation of anaesthetised patients during transport from anaesthesia induction room to operating room. Arterial oxygen saturation (SaO2) was measured in twenty-five anaesthetised patients before and during transfer to an adjacent operating room and continuously recorded on a calibrated chart recorder. A telemetry ECG recorder was used to detect cardiac dysrhythmias. All anaesthetists followed their usual anaesthetic practice. Patients ventilated via face-mask and via endotracheal tube were studied. During transfer patients were either apnoeic (n = 8) or breathing room air spontaneously (n = 17). Mean SaO2 before induction was 95.4 (SD 2.5)%, was higher after induction of anaesthesia, 98.5 (SD 1.4)% and fell after transfer, 95.7 (SD 2.6)%. A fall in SaO2 was recorded for 21 patients. No SaO2 value below 90% was seen. The decrease in SaO2 was related to the time taken to transfer the patients and spontaneous ventilation (Multiple regression analysis); it was not related to the body mass index although two of the greatest decreases were seen in obese patients. Transfer time averaged 51 seconds (range: 24-97 s). No changes in cardiac rhythm were seen. Transfer of anaesthetised patients was accompanied by variable falls in SaO2 which related to duration of transfer and spontaneous breathing of room air and which were not associated with new dysrhythmias.

  9. Transport of surgically produced aerosols in an operating room.

    PubMed

    Buchanan, C R; Dunn-Rankin, D

    1998-06-01

    The particle transport characteristics of two ventilation configurations commonly used in hospital operating rooms (ORs), cross-flow and impinging-flow ventilation, were investigated. The computational fluid dynamics software FLUENT was used to simulate turbulent airflow with mixed convection in a three-dimensional, rectangular OR. Two OR personnel, a patient, OR spotlights, an anesthetics cart, and an operating table were represented in the room. Heat loads from the personnel, patient, and lights affected the airflow through buoyancy. Particles produced at the operation site with various sizes and initial conditions were tracked through the room. A stochastic model was used to include the random effects of turbulence on particle trajectories. Simulation results show that heat loads from the personnel, patient, and OR spotlights had an important effect on the airflow through natural convection. Particle trajectories were influenced greatly by the flow field structure, particle launch position, and turbulence in the flow, and somewhat by particle size. However, particle paths were insensitive to the launch velocity. Virtually identical trajectories were obtained for particles with launch velocities ranging from 0 to 1 m/sec in magnitude. Changes in ventilation configuration dramatically affected particle transport. The cross-flow ventilation configuration performed better, based on the criteria of removing particles from the breathing zone of room occupants. Proper flow field design and contaminant source placement can be used to control particle transport. Numerical simulations allow quick and inexpensive comparisons between room designs and provide details about airflow and contaminant transport.

  10. Continued cost justification of an operating room satellite pharmacy.

    PubMed

    Fiala, D; Grady, K P; Smigla, R

    1993-03-01

    Cost justification for the establishment and continued operation of an operating room satellite pharmacy is described. Establishment of an operating room satellite pharmacy can be justified based on the need to recover lost revenue, regulate controlled substances, monitor inventory, and enhance communication between operating room personnel and the department of pharmacy. At a 510-bed community hospital, an internal audit performed before the satellite pharmacy was opened revealed an average loss of $14.53 in drug charges per surgical procedure; 16 months after the pharmacy opened, changes in the way drugs are distributed to the departments of surgery and anesthesia has resulted in a decrease in this loss to $9.61, or a 34% improvement. To regulate controlled substances, the pharmacy attaches a drug-use log to each dispensing kit, which has resulted in 98% agreement between recorded administration of controlled substances and actual amounts signed out and ultimately returned. Recommendations made by the department of pharmacy regarding the use of high-cost drugs during surgery has resulted in an annual savings of more than $100,000, and improvements in drug packaging reduced, and in some cases eliminated, wastage. Direct contact between operating room personnel and pharmacists has fostered discussions regarding cost-effective application of pharmacotherapy, and the potential for cost savings is substantial. Although the remaining loss of $9.61 per case must still be addressed, considerable progress has been made in a relatively short period of time. The satellite pharmacy in the operating room has led to increased revenue recovery, improved regulation of controlled substances and monitoring of drug inventory, and better communication among the involved personnel.

  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. 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

  13. Elements of the employee selection process: interviewing operating room staff.

    PubMed

    Coleman, J

    1996-07-01

    Selecting the right staff for employment in an operating room (OR) is critical to the success of any OR manager. Legal considerations limit the ability to gather certain information. However, by applying the correct skills and techniques, the manager can develop an information base that will lead to better decisions when selecting employees who can contribute to an efficiently run department.

  14. 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

  15. 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.

  16. 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

  17. 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.

  18. 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

  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. 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

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

    PubMed

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

    2011-01-01

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

  2. 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.

  3. 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

  4. Advanced visualization platform for surgical operating room coordination: distributed video board system.

    PubMed

    Hu, Peter F; Xiao, Yan; Ho, Danny; Mackenzie, Colin F; Hu, Hao; Voigt, Roger; Martz, Douglas

    2006-06-01

    One of the major challenges for day-of-surgery operating room coordination is accurate and timely situation awareness. Distributed and secure real-time status information is key to addressing these challenges. This article reports on the design and implementation of a passive status monitoring system in a 19-room surgical suite of a major academic medical center. Key design requirements considered included integrated real-time operating room status display, access control, security, and network impact. The system used live operating room video images and patient vital signs obtained through monitors to automatically update events and operating room status. Images were presented on a "need-to-know" basis, and access was controlled by identification badge authorization. The system delivered reliable real-time operating room images and status with acceptable network impact. Operating room status was visualized at 4 separate locations and was used continuously by clinicians and operating room service providers to coordinate operating room activities. PMID:17012154

  5. [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

  6. [Occupational exposure to enflurane and laughing gas in operating rooms].

    PubMed

    Hoerauf, K; Mayer, T; Hobbhahn, J

    1996-02-01

    Current scientific evidence suggests that chronic exposure to trace concentrations of anaesthetic gases may result in various forms of untoward health responses in operating room personnel. Although there are no clear dose-effect-relationships, in Germany threshold values (MAK-values) exist for nitrous oxide of 100 ppm and for enflurane of 20 ppm. Aim of this investigation was, to determine the exposure of the operating room personnel under modern working conditions using a standardized anaesthetic procedure. By means of a direct-reading, high sensitive gas monitor trace concentrations of nitrous oxide and enflurane were measured at three personnel-related (surgeon, anaesthetist, auxiliary nurse) and a potential leakage source (patient's mouth). The calculation and assessment of the measured concentrations followed the prescriptions of the technical rules for hazardous substances 402 and 403 (TRGS 402 and 403). The personnel-related concentrations were clearly under the MAK-values of 100 ppm nitrous oxide and/or 20 ppm enflurane. The time weighted averages were for the personnel-related measurement points, indicated in ppm for nitrous oxide and enflurane, respectively: "surgeon" 28.3/0.25, "anaesthetist" 39.3/0.34 and "auxiliary nurse" 64.6/0.57. At the leakage source "patient's mouth" time weighted averages of 317 ppm nitrous oxide and 3.79 ppm enflurane were measured. Under air-conditioning with a high air change rate, a central scavenging system and low leakage anaesthesia machine low trace concentrations of anaesthetic gases were measured. Despite an average contamination of approx. 300 ppm nitrous oxide at the "patient's mouth" personnel-related values remained clearly under the MAK-values. Outside the mainstream of the air-conditioning system the group "auxiliary nurse" had an approximately 30% higher exposure than the other groups. Under the described conditions, the working environment "operating room" can be classified as a low exposure working area. PMID

  7. 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

  8. A mother's journey from the roadside to the operating room.

    PubMed

    Hoy, Leontia

    2013-01-01

    Sometimes I wonder why I wandered into the nursing profession, but in the past few years it has become clear--I became a nurse to look after my son. As we journey through life we try to predict and plan our future. Life twists and turns in so many ways just like my son's life when one fateful day those plans and predictions were smashed. I recount, as a mother my son's journey into your hands ... the operating room. Some names have been changed. PMID:24245058

  9. The humanity of a Baylor surgeon: a tribute to Zeck Lieberman

    PubMed Central

    2008-01-01

    Editor's note: On March 25, 2008, Zelig (“Zeck”) Lieberman, MD, was recognized at a reception at the Crescent Club marking his 50th anniversary at Baylor University Medical Center. More than 115 friends, family members, and associates gathered to pay tribute to Dr. Lieberman for his commitment to the surgical oncology profession as well as his dedication to Baylor. Dr. Fordtran delivered the following tribute during the event. Culminating the evening's celebrations, Rowland K. Robinson, president of the Baylor Health Care System Foundation, and Joel Allison, president and chief executive officer of the Baylor Health Care System, presented Dr. Lieberman with a plaque for his extraordinary service.

  10. 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

  11. Dedicated operating room for emergency surgery improves access and efficiency

    PubMed Central

    Heng, Marilyn; Wright, James G.

    2013-01-01

    Background Scheduling emergency cases among elective surgeries often results in prolonged waits for emergency surgery and delays or cancellation of elective cases. We evaluated the benefits of a dedicated operating room (OR) for emergency procedures available to all surgical services at a large children’s hospital. Methods We compared a 6-month period (January 2009 to June 2009) preimplementation with a 6-month period (January 2010 to June 2010) postimplementation of a dedicated OR. We evaluated OR use, wait times, percentage of cases done within and outside of access targets, off-hours surgery, cancellations, overruns and length of stay. Results Preimplementation, 1069 of the 5500 surgeries performed were emergency cases. Postimplementation, 1084 of the 5358 surgeries performed were emergency cases. Overall use of the dedicated OR was 53% (standard deviation 25%) postimplementation. Excluding outliers, the average wait time for priority 3 emergency patients decreased from 11 hours 8 minutes to 10 hours 5 minutes (p = 0.004). An increased proportion of priority 3 patients, from 52% to 58%, received surgery within 12 hours (p = 0.020). There was a 9% decrease in the proportion of priority 3 cases completed during the evening and night (p < 0.001). The elective surgical schedule benefited from the dedicated OR, with a significant decrease in cancellations (1.5% v. 0.7%, p < 0.001) and an accumulated decrease of 5211 minutes in overrun minutes in elective rooms. The average hospital stay after emergency surgery decreased from 16.0 days to 14.7 days (p = 0.12) following implementation of the dedicated OR. Conclusion A dedicated OR for emergency cases improved quality of care by decreasing cancellations and overruns in elective rooms and increasing the proportion of priority 3 patients who accessed care within the targeted time. PMID:23706847

  12. 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

  13. 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.

  14. 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.

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

    PubMed

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

    2015-10-01

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

  16. Operation room management in Korea: results of a survey

    PubMed Central

    Lim, Hyong Hwan; Bae, Goeun

    2016-01-01

    Background The current state of general hospital operation room (OR) in Korea and how these ORs are being operated remain unclear. Therefore, the aim of this study was to investigate and assess the current state of OR management and surgical scheduling in general hospitals of Korea. Methods A total of 92 anesthesiology training hospitals and 2 equivalent hospitals in Korea were targeted for the survey. Anesthesiologists in hospitals received questionnaires for OR, anesthetic managements and surgical scheduling directly or by phone from the beginning of October 2015 to the end of December 2015. Results Of the 94 hospitals that were targeted, 59 hospitals (62.7%) responded to the survey. Of the 59 hospitals, 40 (67.8%) had 500–1,000 beds, 36 (61.0%) had 11–20 ORs. Most OR arrangements were made by residents and specialists in Anesthesiology Department (90%). Most hospitals (47.4%) in the response set performed total surgeries in the range of 10,000 to 20,000 annually. The proportion of emergency surgeries in the total surgeries was 2.8–55.0%. Methods for predicting expected surgery time were arbitrarily decided by surgeons (61%), anesthesiologist's experience (20%), or by analyzing historical data using software (5%). Conclusions This survey study could trigger active operational researches for OR efficiency. It might help hospital policy makers manage OR resources more efficiently. PMID:27703630

  17. Planning and Development of the Computer Resource at Baylor College of Medicine.

    ERIC Educational Resources Information Center

    And Others; Ogilvie, W. Buckner, Jr.

    1979-01-01

    Describes the development and implementation of a plan at Baylor College of Medicine for providing computer support for both the administrative and scientific/ research needs of the Baylor community. The cost-effectiveness of this plan is also examined. (Author/CMV)

  18. High-power room-temperature-operated CO laser

    NASA Astrophysics Data System (ADS)

    Shimizu, Kouki; Taniwaki, Manabu; Sato, Shunichi; Kumagai, Mikio; Takashima, Yoich; Naito, Yasuhiro; Nagano, Hiroshi; Hasuike, Toru

    2000-04-01

    The objectives of this study are to achieve high-power, efficient operation of a room-temperature CO laser and to collect data for designing the CO laser system for nuclear reactor decommissioning. The influence of the H2O concentration in the laser gas on the output performance was investigated, and it was found that the H2O concentration should be kept as low as possible (less than 260 ppm) to obtain stable, high-power outputs. To improve output performance, the rf frequency was increased from 13.56 MHz to 27.12 MHz. The output power for the 27.12 MHz excitation was increased by 10 to 20% compared with that for the 13.56 MHz excitation. The laser output was scaled by extending the discharge tube inner diameter from 19 mm to 30 mm. By optimizing the air gap length and the curvature radius of the outer metallic electrode, the operating gas conditions, and the reflectivity of the output coupler, a maximum output of 830 W was obtained at a laser efficiency of 12.2% with adding neither Kr nor Xe. The addition of Kr was more effective for increasing the output than the addition of Xe. A maximum output of 910 W was obtained at a laser efficiency of 14.8% with Kr addition, and a maximum output of 810 W was obtained at a laser efficiency of 16.2% with Xe addition.

  19. Anaesthetists' role in computer keyboard contamination in an operating room.

    PubMed

    Fukada, T; Iwakiri, H; Ozaki, M

    2008-10-01

    To store anaesthetic records in computers, anaesthetists usually input data while still wearing dirty wet gloves. No studies have explored computer contamination in the operating room (OR) or anaesthetists' awareness of the importance of handwashing or hand hygiene. We investigated four components of keyboard contamination: (1) degree of contamination, (2) effect of cleaning with ethyl alcohol, (3) bacterial transmission between gloves and keyboards by tapping keys, and (4) frequency of anaesthetists' performing hand hygiene. Most of the bacteria on keyboards were coagulase-negative staphylococci and Bacillus spp.; however, meticillin-resistant Staphylococcus aureus was also found. Cleaning keyboards with ethyl alcohol effectively reduced bacterial counts. Wet contaminated gloves and keyboards transmitted meticillin-susceptible Staphylococcus epidermidis from one to the other more readily than dry contaminated gloves and keyboards. Only 17% of anaesthetists performed hand hygiene before anaesthesia, although 64% or 69% of anaesthetists performed hand hygiene after anaesthesia or before lunch. To prevent cross-contamination, keyboards should be routinely cleaned according to the manufacturer's instructions and disinfected once daily, or, when visibly soiled with blood or secretions. Moreover, anaesthetists should be aware that they could spread microbes that might cause healthcare-associated infection in the OR. Anaesthetists should perform hand hygiene before and after anaesthesia and remove gloves after each procedure and before using the computer. PMID:18701192

  20. 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.

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

    PubMed

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

    2012-12-01

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

  2. 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

  3. 21 CFR 113.87 - Operations in the thermal processing room.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 2 2014-04-01 2014-04-01 false Operations in the thermal processing room. 113.87... CONTAINERS Production and Process Controls § 113.87 Operations in the thermal processing room. (a) Operating... by other effective means that will indicate visually, to thermal processing personnel, those...

  4. 21 CFR 113.87 - Operations in the thermal processing room.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 2 2010-04-01 2010-04-01 false Operations in the thermal processing room. 113.87... CONTAINERS Production and Process Controls § 113.87 Operations in the thermal processing room. (a) Operating... by other effective means that will indicate visually, to thermal processing personnel, those...

  5. 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…

  6. 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

  7. 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

  8. 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…

  9. 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.

  10. Microbial surface contamination after standard operating room cleaning practices following surgical treatment of infection.

    PubMed

    Balkissoon, Rishi; Nayfeh, Tariq; Adams, Kerri L; Belkoff, Stephen M; Riedel, Stefan; Mears, Simon C

    2014-04-01

    At the authors' institution, some joint arthroplasty surgeons require the operating room to be terminally cleaned before using the room after infected cases, in theory to decrease exposure to excessive microbial contamination for the subsequent patient. The authors found no guidance in the literature to support this practice. To test this theory, the authors measured microbial surface contamination from 9 surfaces in operating rooms after standard operating room turnover following 14 infected cases vs 16 noninfected cases. A check was made for an association between organisms isolated intraoperatively from infected surgical patients immediately preceding standard cleaning and organisms isolated from common operating room surfaces. Colony counts were made at 24 and 48 hours, and organisms were identified. No significant difference was noted in colony counts between infected and noninfected cases, and no relationship was found between organisms isolated from infected cases and those from operating room surfaces. Furthermore, the largest colony count from both groups (0.08 cfu/cm(2)) was an order of magnitude less than the recently proposed 5 cfu/cm(2) threshold for surface hygiene in hospitals. This finding indicates that standard operating room turnover results in minimal surface contamination, regardless of the previous case's infection status, and that there is no need for a more extensive terminal cleaning after an infected case.

  11. 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.

  12. 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.

  13. 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.

  14. 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

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

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ....5070 Air-handling apparatus for a surgical operating room. (a) Identification. Air-handling apparatus... that has been filtered to remove particulate matter and microorganisms to provide an area free...

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

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ....5070 Air-handling apparatus for a surgical operating room. (a) Identification. Air-handling apparatus... that has been filtered to remove particulate matter and microorganisms to provide an area free...

  17. 21 CFR 878.5070 - Air-handling apparatus for a surgical operating room.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ....5070 Air-handling apparatus for a surgical operating room. (a) Identification. Air-handling apparatus... that has been filtered to remove particulate matter and microorganisms to provide an area free...

  18. 21 CFR 878.5070 - Air-handling apparatus for a surgical operating room.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ....5070 Air-handling apparatus for a surgical operating room. (a) Identification. Air-handling apparatus... that has been filtered to remove particulate matter and microorganisms to provide an area free...

  19. 21 CFR 878.5070 - Air-handling apparatus for a surgical operating room.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ....5070 Air-handling apparatus for a surgical operating room. (a) Identification. Air-handling apparatus... that has been filtered to remove particulate matter and microorganisms to provide an area free...

  20. [A ten-year risk evaluation study in Catania hospital operating rooms].

    PubMed

    Ferrante, Margherita; Fiore, Maria; Fallico, Giuseppe; Mazza, Angelo; Fallico, Roberto; Biondi, Marisa; Mirone, Lucia; Sciacca, Salvatore

    2004-01-01

    Previous studies conducted in Catania hospitals have revealed a high burden of contamination in the air of operating rooms and have recommended measures to improve air quality. In this study we verified the effectiveness of the undertaken measures. Furthermore we evaluated the possibility of using microclimatic parameters as "markers" of operating room contamination. Changes made to ventilation systems and to waste gas scavenging systems in the monitored operating rooms were remarkably effective. Microclimatic conditions and degree of chemical contamination improved over time; nevertheless airflow velocity values were found to be insufficient and nitrous oxide values, in some cases, remained slightly elevated. A significant correlation was observed only between some nitrous oxide values and relative humidity. Monitoring important marker levels is useful for correctly evaluating operating room thermal, chemical and microbiological air quality.

  1. Wavelet analysis application for remote control room operation

    NASA Astrophysics Data System (ADS)

    Semenov, Oleg I.; Semenov, Igor B.

    2003-03-01

    Compression algorithm for data transfer from tokamak installation to remote control room was developed on the basis of wavelet analyses. The algorithm is useful in the case of low speed Internet channel (˜20 kbytes/s) for real time express analysis of row noisy data between shots (i.e., ˜5-10 times compression of the initial row data array (˜50-100 Mbytes), transmission, restoration, and analysis in time interval ˜15 min). The developed algorithm is based on some amount of data losses so that the amplitude and phase difference between the initial and restored data were less then 5% to signal amplitude. The algorithm was tested for Mirnov signal transmission in the case of disruption instability. It was shown that the error of restoration does not depend on form of the signal, i.e., applied method has good characteristics both in the case of the spikes and smooth functions. Experiments show that the coefficient of compression 5-15 could be achieved if the errors are in 0.5%-5%.

  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. Silicene field-effect transistors operating at room temperature.

    PubMed

    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 cm(2) 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.

  4. 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

  5. Conflict in the operating room: fight and flight or growth and communication.

    PubMed

    Stella, Cheryl

    2010-06-01

    Conflict is partial to no one. It ranges from within an individual and spirals in a ripple effect to others. Conflict among Registered Nurses (RNs) and Operating Room Technicians (ORTs) and between fellow RNs is prevalent in the operation room. The OR environment is filled with a number of personalities, each possessing varying methods for the implementation of patient care. Effective communication is key to preventing, and resolving, conflict situations.

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

    PubMed

    Feng, Jingyi; Chen, Hua; Liu, Jiquan

    2011-10-01

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

  7. How to evaluate whether a new technology in the operating room is cost-effective from society's viewpoint.

    PubMed

    Tan, Jonathan M; Macario, Alex

    2008-12-01

    The hospital operating room is one of the most important and costly environments in health care. Given the current reductions in reimbursement and limited resources, hospital administrators and operating room managers have to be careful about adopting new technologies into the operating room. Operating rooms must balance the improved care a new technology can provide with its additional costs. Economic analysis provides systematic methods to guide decisions by quantitatively assessing the value of a new technology.

  8. Is it safe to allow smoke in our operating room?

    PubMed

    Dikes, C N

    1999-01-01

    Researchers have shown that the plume produced during electrosurgery is twice as harmful as laser plume. The smoke produced by ESUs is not routinely evacuated and rises into the air to dissipate haphazardly. Smoke evacuators remove surgical smoke from the operating suite in an efficient and safe manner.

  9. [Stimulation of medical personnel work in operating rooms].

    PubMed

    Privalov, V A; Rozenfel'd, L G; Red'kin, G A; Vasiunin, V G

    1999-01-01

    Preliminary results of experimental trial on stimulation of medical staff's labour in the operation unit, held in medical institutions of Chelyabinsk, has been analysed. As a basis for calculation of the payments for the work, the labour expenditures of each member of surgical team (surgeon, assistant, anesthesiologist, surgical nurse, anesthesist, litter bearer nurse) and the cost of 1 hour work were assessed, the degree of the difficulty of each operation, as well as the total cost of the procedure was determined. Registration of the work of all members of the surgical team and its payment, according to the quantity and the quality of the performed operations, demonstrates the stage of transition to the system of payment for the labour, i.e.--for the concrete work, done by somebody of the staff (for the treatment of some patient, etc.). The evaluation of the work according to the number of treated patients (operations being done) and to the quality of the treatment provides the conditions for personal financial incentive of surgical staff to intensification of their work and contributes to the achievements of favourable final results and in the same time--it provides decrease of the terms for patients' stay in the hospital, saving money and material resources. PMID:10533376

  10. 9 CFR 590.522 - Breaking room operations.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... in a dust-free clean condition and free from flies, insects, and rodents. The floor shall be kept clean and reasonably dry during breaking operations and free of egg meat and shells. (b) All breaking...) Breakers shall use a complete set of clean equipment when starting work and after lunch periods. All...

  11. 9 CFR 590.522 - Breaking room operations.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... in a dust-free clean condition and free from flies, insects, and rodents. The floor shall be kept clean and reasonably dry during breaking operations and free of egg meat and shells. (b) All breaking...) Breakers shall use a complete set of clean equipment when starting work and after lunch periods. All...

  12. 9 CFR 590.522 - Breaking room operations.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... in a dust-free clean condition and free from flies, insects, and rodents. The floor shall be kept clean and reasonably dry during breaking operations and free of egg meat and shells. (b) All breaking...) Breakers shall use a complete set of clean equipment when starting work and after lunch periods. All...

  13. 9 CFR 590.522 - Breaking room operations.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... in a dust-free clean condition and free from flies, insects, and rodents. The floor shall be kept clean and reasonably dry during breaking operations and free of egg meat and shells. (b) All breaking...) Breakers shall use a complete set of clean equipment when starting work and after lunch periods. All...

  14. 9 CFR 590.522 - Breaking room operations.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... in a dust-free clean condition and free from flies, insects, and rodents. The floor shall be kept clean and reasonably dry during breaking operations and free of egg meat and shells. (b) All breaking...) Breakers shall use a complete set of clean equipment when starting work and after lunch periods. All...

  15. [Legal aspects of video registration during operations--the digital operating room assistant: opportunity or threat?].

    PubMed

    Blaauw, Claire B; van den Dobbelsteen, John J; Hubben, Joep H

    2011-01-01

    Video registration in hospitals is becoming increasingly frequent and an increasing number of surgical procedures are performed with the help of video imaging. The Technical University of Delft is developing a safety system that will use video images to directly inform medical staff of technical problems during surgery so that necessary adjustments can be made in time: the digital operating room assistant. However, the saving of video images is legally considered to be processing of personal data. Dutch privacy legislation requires that certain legal demands are taken into consideration. From legal point of view three situations can be distinguished where video images are being used: (a) as an essential part of treatment (endoscopic surgery, for example), (b) to enhance the quality of the procedure, and (c) for the purposes of peer assessment or education. To whom and in which way consent has to be asked, differs per situation. We recommend that video recordings of crucial points in the operation are included in the patient file. The same counts for incidental findings or complications if, according to the standard of a good caregiver, this is necessary for the further treatment of the patient. In addition to the doctor and the patient, in certain circumstances, access to the video recordings may also be granted to the Health Care Inspectorate and, to the Public Prosecutor. Covert video recording of an employee is a breach of privacy and essentially punishable by law. Video recordings may not themselves be used to assess the performance of the surgeon involved.

  16. [New operating rooms: problems related with ventilation and air quality].

    PubMed

    Sabbadini, M; Verga, M; Boglioni, R; Zotti, A

    2002-01-01

    Realizing the project of the new operating theatres, We bring out the importance of creating bright environments, rational and wide ways, a good indoor air quality, thermal comfort and occupational hygiene. Therefore for the first time We've installed an automatic system for permanent monitoring of gases, vapours and particles, associated with the study of ventilation, to evaluate the real condition of the mantenance and of staff behaviour.

  17. [A study on job satisfaction and its depressive factors in human relations among operating room nursing].

    PubMed

    Cho, M J

    1993-01-01

    This study was done for the purpose of analyzing the job-satisfaction and its depressive factors in human relation of operating room nurses of university hospital. Therefore, it makes an offer the basic data to help the resolution and prevention of the problems in operating room nurses. Furthermore, this study was conducted in order to find out some kinds of scientific data for the better control of depressive factors of job-satisfaction expressed by the operating room nurses. The structured questionnaire reports of 246 operating room nurses who were employed in 5 different university hospitals which have over 1,000 beds located in Seoul, Korea were used, which wer collected from August 24th to August 30th of 1992. The author visited supervisors of operating room in each university hospital and explained the aim of this study. The most of them (90.0%) answered to the questionnaires. Analysis of the collected data were done by mean, standard deviation, percentage, t-test, F-test, Q-test, correlation analysis, one-way ANOVA, and stepwise multiple regression analysis. Major findings of this study were as follows: 1. The job of the operating room nurses were remarkably related with the satisfaction in human relation, which was defined as the behavioral job with thoughtful action rather than with mechanical action. However, the degree of satisfaction in human relation with personnel in other departments was found to be the lowest and its the main depressive factors were appeared due to the absence of interaction and uncooperative attitudes. Therefore, it was required that the members of other job need more cooperative attitude to the actual works in the operating room nurses. 2. The depressive factors in the satisfaction degree of human relation with official seniors wer significantly related with their irresponsibility and partialness. Moreover, the job attitude of the operating room nurses is abundantly required to be improved. 3. The depressive factors in the

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

    PubMed

    Testi, Angela; Tànfani, Elena

    2009-12-01

    In this paper, we evaluate the impact on welfare implications of a 0-1 linear programming model to solve the Operating Room (OR) planning problem, taking a patient perspective. In particular, given a General Surgery Department made up of different surgical sub-specialties sharing a given number of OR block times, the model determines, during a given planning period, the allocation of those blocks to surgical sub-specialties, i.e. the so called Master Surgical Schedule Problem (MSSP), together with the subsets of elective patients to be operated on in each block time, i.e. the so called Surgical Case Assignment Problem (SCAP). The innovation of the model is two-fold. The first is that OR allocation is "optimal" if the available OR blocks are scheduled simultaneously to the proper subspecialty, at the proper time to the proper patient. The second is defining what "proper" means and include that in the objective function. In our approach what is important is not number of patients who can be treated in a given period but how much welfare loss, due to clinical deterioration or other negative consequences related to excessive waiting, can be prevented. In other words we assume a societal perspective in that we focus on "outcome" (health improving or preventing from worsening) rather than on "output" (delivered procedures). The model can be used both to develop weekly OR planning with given resources (operational decision), and to perform "what if" scenario analysis regarding how to increase the amount of OR time available for the entire department (tactical decision). The model performance is verified by applying it to a real scenario, the elective admissions of the General Surgery Department of the San Martino University Hospital in Genova (Italy). Despite the complexity of this NP-hard combinatorial optimization problem, computational results indicate that the model can solve all test problems within 600 s and an average optimality tolerance of less than 0.01%.

  19. 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

  20. Gestalt operating room display design for perioperative team situation awareness.

    PubMed

    Lai, Fuji; Spitz, Gabriel; Brzezinski, Philip

    2006-01-01

    The perioperative environment is a complex, high risk environment that requires real-time coordination by all perioperative team members and accurate, up-to-date information for situation assessment and decision-making. There is the need for a "Gestalt" holistic awareness of the perioperative environment to enable synthesis and contextualization of the salient information such as: patient information, case and procedure information, staff information, operative site view, physiological data, resource availability. One potential approach is to augment the medical toolkit with a large screen wall display that integrates and makes accessible information that currently resides in different data systems and care providers. The objectives are to promote safe workflows, team coordination and communication, and to enable diagnosis, anticipation of events, and information flow from upstream to downstream care providers. We used the human factors engineering design process to design and develop a display that provides a common operational picture for shared virtual perioperative team situation awareness to enhance patient safety. PMID:16404062

  1. 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

  2. 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

  3. Strategies to maintain operating room functionality following the complete loss of the recovery room due to an internal disaster.

    PubMed

    Metzler, Elise C; Kodali, Bhavani S; Urman, Richard D; Flanagan, Hugh L; Rego, Monica Sa; Vacanti, Joshua C

    2015-01-01

    The post-anesthesia care unit (PACU) is a major contributor to the operating room (OR) process flow and efficiency. A sudden failure of hospital facility infrastructure due to a burst pipe resulted in the complete loss of a 66-bed combined preoperative and PACU facility of a major academic medical center. The OR suites were undamaged. The clinical and administrative challenges of caring for surgical patients without the usual preoperative and postoperative care areas are discussed. Our strategy for maintaining OR functions and management of patient flow, OR personnel, case prioritization, and equipment needs are detailed from the time of initial crisis until restoration of these clinical care areas. Utilization of the hospital disaster Incident Command Structure and the activation and decision support provided by the hospital Emergency Operations Center (EOC) for the week immediately following the crisis, helped maintain OR functionality.

  4. Strategies to maintain operating room functionality following the complete loss of the recovery room due to an internal disaster.

    PubMed

    Metzler, Elise C; Kodali, Bhavani S; Urman, Richard D; Flanagan, Hugh L; Rego, Monica Sa; Vacanti, Joshua C

    2015-01-01

    The post-anesthesia care unit (PACU) is a major contributor to the operating room (OR) process flow and efficiency. A sudden failure of hospital facility infrastructure due to a burst pipe resulted in the complete loss of a 66-bed combined preoperative and PACU facility of a major academic medical center. The OR suites were undamaged. The clinical and administrative challenges of caring for surgical patients without the usual preoperative and postoperative care areas are discussed. Our strategy for maintaining OR functions and management of patient flow, OR personnel, case prioritization, and equipment needs are detailed from the time of initial crisis until restoration of these clinical care areas. Utilization of the hospital disaster Incident Command Structure and the activation and decision support provided by the hospital Emergency Operations Center (EOC) for the week immediately following the crisis, helped maintain OR functionality. PMID:26102040

  5. 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…

  6. A Stochastic Model for Infective Events in Operating Room Caused by Air Contamination

    NASA Astrophysics Data System (ADS)

    Abundo, Paolo; Rosato, Nicola; Abundo, Mario

    2008-07-01

    We propose a simple stochastic model for the movement of a potentially infective particle in operating room in which the local air contamination level is reduced by using a double laminar flow. Numerical simulation is used to obtain qualitative scenario analysis, in order to prevent infection, i.e. impact of the infective particle with the surgical wound, during the operation.

  7. 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.

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

    PubMed

    Hüfner, T; Citak, M; Imrecke, J; Krettek, C; Stübig, T

    2012-03-01

    Operating rooms are the central unit in the hospital network in trauma centers. In this area, high costs but also high revenues are generated. Modern operating theater concepts as an integrated model have been offered by different companies since the early 2000s. Our hypothesis is that integrative concepts for operating rooms, in addition to improved operating room ergonomics, have the potential for measurable time and cost savings. In our clinic, an integrated operating room concept (I-Suite, Stryker, Duisburg) was implemented after analysis of the problems. In addition to the ceiling-mounted arrangement, the system includes an endoscopy unit, a navigation system, and a voice control system. In the first 6 months (9/2005 to 2/2006), 112 procedures were performed in the integrated operating room: 34 total knee arthroplasties, 12 endoscopic spine surgeries, and 66 inpatient arthroscopic procedures (28 shoulder and 38 knee reconstructions). The analysis showed a daily saving of 22-45 min, corresponding to 15-30% of the daily changeover times, calculated to account for potential savings in the internal cost allocation of 225-450 EUR. A commercial operating room concept was evaluated in a pilot phase in terms of hard data, including time and cost factors. Besides the described effects further savings might be achieved through the effective use of voice control and the benefit of the sterile handle on the navigation camera, since waiting times for an additional nurse are minimized. The time of the procedure of intraoperative imaging is also reduced due to the ceiling-mounted concept, as the C-arm can be moved freely in the operating theater without hindering cables. By these measures and ensuing improved efficiency, the initial high costs for the implementation of the system may be cushioned over time.

  9. Advances in the care of head and neck cancer patients at Baylor University Medical Center.

    PubMed

    O'Brien, John C

    2008-01-01

    Editor's note: The Society of Baylor Surgeons held a meeting on August 10 to 11, 2007: "Advances in Surgery and Surgical Education: The Past 20 Years," in honor of Dr. Ronald C. Jones' 20th year as chairman of the Department of Surgery at Baylor University Medical Center. This society was founded in 1981 by Dr. Robert Sparkman, past chief of the department, as a way to reunite former Baylor surgery residents and provide continuing surgical education for residents and members of the medical staff.Under the direction of program director John Preskitt, MD, the 2007 CME-accredited meeting included presentations from four prominent guest speakers: Edward M. Copeland, MD, president of the American College of Surgeons; R. Scott Jones, MD, professor and chairman of surgery emeritus for the University of Virginia Health System; Kirby I. Bland, MD, chairman of the Department of Surgery at the University of Alabama; and Stanley Dudrick, MD, chairman of the Department of Surgery at St. Mary's Hospital, Waterbury, Connecticut. In addition, 12 physicians from Baylor made presentations at this meeting, and some provided summaries, which are reproduced in this issue of Proceedings.

  10. 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…

  11. The Core Course in Medical Microbiology at Baylor College of Medicine

    ERIC Educational Resources Information Center

    Knight, Vernon; And Others

    1978-01-01

    Principal features of Baylor's course are annually-revised lecture handouts, medically-oriented laboratory sessions with a manual written especially for the course, and clinical demonstrations of infectious disease. Improvement in student performance seems to be related to the course format, increased teaching proficiency, and allocations of hours…

  12. Lessons Learned from the Competency-Based Curriculum Initiative at Baylor College of Dentistry.

    ERIC Educational Resources Information Center

    McCann, Ann L.; Babler, William J.; Cohen, Peter A.

    1998-01-01

    Chronicles development of the Baylor College of Dentistry (Texas) competency-based curriculum and outlines 11 lessons learned concerning strategic planning, external accountability, value of significant and continuing faculty participation, administrative support structures, linking planning and assessment, using multiple assessment methods,…

  13. 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

  14. [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

  15. Developing a culture of collaboration in the operating room: more than effective communication.

    PubMed

    Wade, Patricia

    2014-12-01

    The purpose of this literature review was to examine the current state of knowledge on successful collaborative practice in the operating room. Using the determinants of successful collaborative practice, developed by San-Martin-Rodriguez, Beaulieu, D'Amour, & Ferrada-Videla, the current literature on collaboration in the operating room was reviewed in order to identify the gaps in knowledge and identify future research avenues. The review highlighted that communication patterns among operating room team members was the most extensively researched aspect of teamwork. Other aspects, such as the willingness to engage in collaborative practice, trust, respect, societal factors, and cultural factors, were absent from the literature. Future research will need to focus on these gaps in knowledge in order to maximize our limited research resources and improve patient safety.

  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.

  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).

  18. 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.

  19. 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

  20. Bacteriology of Air-Conditioning Ducts with Special Reference to Operating Rooms

    PubMed Central

    Warner, Peter; Doherty, Jane

    1963-01-01

    The number of bacteria in air, before filtration with five different easily available filters in the low positive-pressure type of airconditioning system of the Winnipeg General Hospital, was between 3 and 4/cu. ft., and after filtration between 1 and 2/cu. ft. with all types of filters. Cl. welchii contributed about 1% and Staph. pyogenes about 0.1% of this total. Sampling the exhaust air from an operating room during an operation showed that the bacterial count fluctuated with the degree of activity in the room and was from two to 10 times as high as in the air delivered to the room. Atlhough every reasonable attempt should be made to diminish the bacterial count of air in hospitals, if much energy and money is to be spent it would probably be wiser to investigate sources of hospital infection other than the type of air-conditioning system described in this report. PMID:13998955

  1. 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 ...

  2. 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

  3. 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.

  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. 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.

  6. 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

  7. An automated information system for families of patients in the operation room based on EMR data.

    PubMed

    Jo, Eun-mi

    2013-01-01

    When children undergo surgery, the parents waiting for them outside the room feel extreme anxiety. SNUH was a full EMR hospital. But nurses had to manually operate an electronic display board which provided information regarding the progresses of the operations. The parents had to be located in front of the board. It was a unilateral and passive system. Therefore, we were about to improve the system to provide efficient information satisfying both parents and nurses. This service, which connected to the EMR system to provide real time location of patients undergoing operations, provide information through an electronic display board outside the operating room and SMS messages. We could reduce uneasiness of patients' families, increase satisfactions, and further, not only contribute to establishing the improved service of SNUH but also lessening unnecessary duties of nurses.

  8. 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

  9. 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.

  10. Room-Temperature Continuous-Wave Operation of a Tunable External Cavity Quantum Cascade Laser

    NASA Astrophysics Data System (ADS)

    Zhang, Jin-Chuan; Wang, Li-Jun; Liu, Wan-Feng; Liu, Feng-Qi; Yin, Wen; Liu, Jun-Qi; Li, Lu; Wang, Zhan-Guo

    2011-07-01

    A room-temperature cw operation of a tunable external cavity (EC) quantum cascade laser (QCL) at an emitting wavelength of 4.6 μm is presented. Strain-compensation combined with two-phonon resonance in an active region design promises low threshold current density. A very low threshold current density of 1.47kA/cm2 for an EC-QCL operated in cw mode is realized. Single-mode cw operation with a side-mode suppression ratio of 20 dB and a wide tuning range of over 110cm-1 are achieved. Moreover, an even wider tuning range of over 135cm-1 is obtained in pulsed mode at room temperature.

  11. 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.

  12. Context dependent memory in two learning environments: the tutorial room and the operating theatre

    PubMed Central

    2013-01-01

    Background Psychologists have previously demonstrated that information recall is context dependent. However, how this influences the way we deliver medical education is unclear. This study aimed to determine if changing the recall context from the learning context affects the ability of medical students to recall information. Methods Using a free recall experimental model, fourteen medical student participants were administered audio lists of 30 words in two separate learning environments, a tutorial room and an operating theatre. They were then asked to recall the words in both environments. While in the operating theatre participants wore appropriate surgical clothing and assembled around an operating table. While in the tutorial room, participants dressed casually and were seated around a table. Students experienced the same duration (15 minutes) and disruption in both environments. Results The mean recall score from the 28 tests performed in the same environment was 12.96 +/− 3.93 (mean, SD). The mean recall score from the 28 tests performed in an alternative environment to the learning episode was 13.5 +/− 5.31(mean, SD), indicating that changing the recall environment from the learning environment does not cause any statistical difference (p=0.58). The average recall score of participants who learned and recalled in the tutorial room was 13.0 +/− 3.84 (mean, SD). The average recall score of participants who learnt and recalled in the operating theatre was 12.92 +/− 4.18 (mean, SD), representing no significant difference between the two environments for learning (p=0.4792). Conclusions The results support the continued use of tutorial rooms and operating theatres as appropriate environments in which to teach medical students, with no significant difference in information recall seen either due to a same context effect or specific context effect. PMID:24127650

  13. 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

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

    PubMed

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

    2013-08-01

    We have designed a mobile operating room information management system. The system is composed of a client and a server. A client, consisting of a PC, medical equipments, PLC and sensors, provides the acquisition and processing of anesthesia and micro-environment data. A server is a powerful computer that stores the data of the system. The client gathers the medical device data by using the C/S mode, and analyzes the obtained HL7 messages through the class library call. The client collects the micro-environment information with PLC, and finishes the data reading with the OPC technology. Experiment results showed that the designed system could manage the patient anesthesia and micro-environment information well, and improve the efficiency of the doctors' works and the digital level of the mobile operating room. PMID:24059052

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

    PubMed

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

    2013-08-01

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

  16. Learning gestures for customizable human-computer interaction in the operating room.

    PubMed

    Schwarz, Loren Arthur; Bigdelou, Ali; Navab, Nassir

    2011-01-01

    Interaction with computer-based medical devices in the operating room is often challenging for surgeons due to sterility requirements and the complexity of interventional procedures. Typical solutions, such as delegating the interaction task to an assistant, can be inefficient. We propose a method for gesture-based interaction in the operating room that surgeons can customize to personal requirements and interventional workflow. Given training examples for each desired gesture, our system learns low-dimensional manifold models that enable recognizing gestures and tracking particular poses for fine-grained control. By capturing the surgeon's movements with a few wireless body-worn inertial sensors, we avoid issues of camera-based systems, such as sensitivity to illumination and occlusions. Using a component-based framework implementation, our method can easily be connected to different medical devices. Our experiments show that the approach is able to robustly recognize learned gestures and to distinguish these from other movements. PMID:22003609

  17. 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

  18. Room temperature continuous wave operation of InAs-based quantum cascade lasers at 15 µm.

    PubMed

    Baranov, Alexei N; Bahriz, Michael; Teissier, Roland

    2016-08-01

    We report low threshold InAs/AlSb quantum cascade lasers emitting near 15 µm. The devices are based on a vertical design similar to those employed previously in far infrared InAs-based QCLs, whereas the doping level of the active core is considerably decreased. The lasers exhibit a threshold current density as low as 730 A/cm2 in pulsed mode at room temperature and can operate in this regime up to 410K. The continuous wave regime of operation has been achieved in these devices at temperatures up to 20°C. The cw regime is demonstrated for InAs-based QCLs for the first time at room temperature.

  19. 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

  20. 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.

  1. 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

  2. Influence of staff behavior on infectious risk in operating rooms: what is the evidence?

    PubMed

    Birgand, Gabriel; Saliou, Philippe; Lucet, Jean-Christophe

    2015-01-01

    SUMMARY A systematic literature review was performed to assess the impact of surgical-staff behaviors on the risk of surgical site infections. Published data are limited, heterogeneous, and weakened by several methodological flaws, underlying the need for more studies with accurate tools. OBJECTIVE To assess the current literature regarding the impact of surgical-staff behaviors on the risk of surgical-site infection (SSI). DESIGN Systematic literature review. METHODS We searched the Medline, EMBASE, Ovid, Web of Science, and Cochrane databases for original articles about the impact of intraoperative behaviors on the risk of SSI published in English before September 2013. RESULTS We retrieved 27 original articles reporting data on number of people in the operating room (n=14), door openings (n=14; number [n=6], frequency [n=7], reasons [n=4], or duration [n=3]), surgical-team discipline (evidence of distraction; n=4), compliance with traffic measures (n=6), or simulated behaviors (n=3). Most (59%) articles were published in 2009-2013. End points were the 30-day SSI rate (n=8), air-particle count (n=2), or microbiological air counts (n=6); 11 studies were only descriptive. Number of people in the operating room and SSI rate or airborne contaminants (particle/bacteria) were correlated in 2 studies. Door openings and airborne bacteria counts were correlated in 2 observational studies and 1 experimental study. Two cohort studies showed a significant association between surgeon interruptions/distraction or noise and SSI rate. The level of evidence was low in all studies. CONCLUSIONS Published data about the impact of operating-room behaviors on the risk of infection are limited and heterogeneous. All studies exhibit major methodological flaws. More studies with accurate tools should be performed to address the influence of operating room behaviors on the infectious risk. PMID:25627767

  3. Influence of staff behavior on infectious risk in operating rooms: what is the evidence?

    PubMed

    Birgand, Gabriel; Saliou, Philippe; Lucet, Jean-Christophe

    2015-01-01

    SUMMARY A systematic literature review was performed to assess the impact of surgical-staff behaviors on the risk of surgical site infections. Published data are limited, heterogeneous, and weakened by several methodological flaws, underlying the need for more studies with accurate tools. OBJECTIVE To assess the current literature regarding the impact of surgical-staff behaviors on the risk of surgical-site infection (SSI). DESIGN Systematic literature review. METHODS We searched the Medline, EMBASE, Ovid, Web of Science, and Cochrane databases for original articles about the impact of intraoperative behaviors on the risk of SSI published in English before September 2013. RESULTS We retrieved 27 original articles reporting data on number of people in the operating room (n=14), door openings (n=14; number [n=6], frequency [n=7], reasons [n=4], or duration [n=3]), surgical-team discipline (evidence of distraction; n=4), compliance with traffic measures (n=6), or simulated behaviors (n=3). Most (59%) articles were published in 2009-2013. End points were the 30-day SSI rate (n=8), air-particle count (n=2), or microbiological air counts (n=6); 11 studies were only descriptive. Number of people in the operating room and SSI rate or airborne contaminants (particle/bacteria) were correlated in 2 studies. Door openings and airborne bacteria counts were correlated in 2 observational studies and 1 experimental study. Two cohort studies showed a significant association between surgeon interruptions/distraction or noise and SSI rate. The level of evidence was low in all studies. CONCLUSIONS Published data about the impact of operating-room behaviors on the risk of infection are limited and heterogeneous. All studies exhibit major methodological flaws. More studies with accurate tools should be performed to address the influence of operating room behaviors on the infectious risk.

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

    PubMed

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

    2015-05-01

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

  5. Epidemiologic observations of operating room infections resulting from variations in ventilation and temperature.

    PubMed

    Everett, W D; Kipp, H

    1991-12-01

    Over a period of years the ventilation system of a community hospital progressively deteriorated until it no longer met regulatory guidelines. The hospital, a publicly funded military facility, requested funding to repair the ventilation system, but funds were not forthcoming because of budget austerity. When an increase in infections was documented, high-risk operations were curtailed and funding was expedited. With the new improved ventilation system the operating rooms once again met regulatory guidelines and infections returned to baseline rates. Throughout the period infections remained below recognized national levels. PMID:1763823

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

    NASA Astrophysics Data System (ADS)

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

    2007-04-01

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

  7. [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.

  8. [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

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

    PubMed

    Kerwat, Klaus; Piechowiak, Karolin; Wulf, Hinnerk

    2013-01-01

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

  10. [On-line data management system using a portable blood gas analyzer in the operating room].

    PubMed

    Shimosato, G; Ibuki, T; Hirata, M; Shigemi, K; Tanaka, Y

    2000-03-01

    It is very important to establish a clinical testing system which is not only prompt, simple and accurate but also safe for the patients and medical staff in the operating room, emergency room and intensive care unit. In our institution an i-STAT portable blood gas analyser has been widely used for point of care testing in all the operating rooms. This clinical testing system has been upgraded by adding an i-STAT communication protocol to our online data management system. The analysed data transmitted by the i-STAT as an infrared signal is transformed to an electronic signal through the IR link and sent to the central data station (CDS) via RS232C. The data received by the CDS is then sent to the upper grade computer system where the data is recorded on the hard disk. One advantage of this system is that it is connected to the hospital computer system. Not only does this new system meet the need for accurate, safe, effective and economical laboratory testing, but also retrospective and multifactorial analysis of intraoperative events can be easily carried out. In the future this system can be applied to telemedicine through the Internet and contribute to the treatment of critically ill patients.

  11. 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

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

    PubMed

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

    1992-01-01

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

  13. Two loose screws: near-miss fall of a morbidly obese patient after an operating room table failure.

    PubMed

    McAllister, Russell K; Booth, Robert T; Bittenbinder, Timothy M

    2016-09-01

    Operating room surgical table failure is a rare event but can lead to a dangerous situation when it does occur. The dangers can be compounded in the presence of obesity, especially in the anesthetized or sedated patient. We present a case of a near-miss fall of a morbidly obese patient while turning the patient in preparation to transfer from the operating room table to the hospital bed when 2 fractured bolts in the tilt cylinder mechanism led to an operating room table failure.

  14. [Working conditions in the operating room: surgeons surveyed during the annual meeting of the German society of surgery 2004].

    PubMed

    Matern, U; Koneczny, S

    2006-10-01

    For the evaluation of working place conditions in the operating room a survey was conducted among the surgeons working in German hospitals. Questions regarded the personal profile, the architectural situation, the devices and instruments as well as the working posture. The answers to the 60 questions display a high potential for improvement within all fields. Every single group working in the operating room, as well as their professional organizations are asked to work on the optimization of the working place conditions in the operating room in terms of improvement of quality and efficiency. PMID:17089288

  15. 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...

  16. 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...-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...

  17. 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...-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...

  18. 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...

  19. 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...

  20. Remotely operated MR-guided neurosurgical device in MR operating room

    NASA Astrophysics Data System (ADS)

    Liu, Haiying; Hall, Walter A.; Truwit, Charles L.

    2001-05-01

    A robust near real-time MRI based surgical guidance and navigation scheme has been developed, validated and used. The key concept of the method is to use intra-operative MRI to facilitate the trajectory alignment process of a biopsy needle in neurobiopsy. Since the trajectory corresponding to the biopsy needle pivoted at an entry point on patient skull has two degrees of freedom, the orientation of the needle can be tracked using a 2D imaging plane placed perpendicular to the desired trajectory. Using a near real- time visual feedback during the adjustment of an alignment guidance device, the required trajectory alignment was translated into a simple in-plane targeting task on computer monitor. The orientation adjustment was achieved remotely via a set of MR-compatible strings, which were connected to a joystick. The concept of MR-guided targeting was successfully validated on a phantom set-up. This MR based guidance technique has practically allowed neurosurgeons to accomplish the required needle alignment to an arbitrary trajectory remotely in a straight forward procedure on any conventional MR scanner. Before needle insertion, the trajectory can be validated. Two successful biopsy cases using the new methodology and device have shown that the remotely operated device under MR-guidance is both effective and accurate for neurosurgery.

  1. 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.

  2. 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

  3. 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

  4. 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.

  5. Room temperature continuous wave operation of quantum cascade lasers with 12.5% wall plug efficiency

    SciTech Connect

    Bai, Y.; Slivken, S.; Darvish, S. R.; Razeghi, M.

    2008-07-14

    An InP based quantum cascade laser heterostructure emitting at 4.6 {mu}m was grown with gas-source molecular beam epitaxy. The wafer was processed into a conventional double-channel ridge waveguide geometry with ridge widths of 19.7 and 10.6 {mu}m without semi-insulating InP regrowth. An uncoated, narrow ridge device with a 4.8 mm cavity length was epilayer down bonded to a diamond submount and exhibits 2.5 W maximum output power with a wall plug efficiency of 12.5% at room temperature in continuous wave operation.

  6. Implementation of an innovation in the ophthalmic operating room: the Memory lens.

    PubMed

    Errico, B

    1999-01-01

    I have participated in the evolution of the cataract procedure for the last 23 years. This year, as nursing director for an eye surgery center, I was responsible for the implementation of a new prerolled intraocular lens: The Memory lens. I review 5 implementation strategies, which are: Be open to recently approved products Utilize all company resources Introduce, train, train, train Evaluate, review, review, review Enjoy the questions and attention from others considering the innovation The implementation of this innovation confirmed both my and the operating room staff's ability to change and reaffirmed their commitment to achieve the resultant patient benefits.

  7. 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.

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

    PubMed

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

    2015-08-01

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

  9. 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

  10. 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.

  11. 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.

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

    PubMed

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

    2015-08-01

    Although surgical smoke contains potentially hazardous substances, such as cellular material, blood fragments, microorganisms, toxic gases and vapors, many operating rooms (ORs) do not provide protection from exposure to it. This article reviews the hazards of surgical smoke and the means of protecting OR personnel. Our objectives are to promote surgeons' acceptance to adopt measures to minimize the hazards. Depending on its components, surgical smoke can increase the risk of acute and chronic pulmonary conditions, cause acute headaches; irritation and soreness of the eyes, nose and throat; dermatitis and colic. Transmission of infectious disease may occur if bacterial or viral fragments present in the smoke are inhaled. The presence of carcinogens in surgical smoke and their mutagenic effects are also of concern. This review summarizes previously published reports and data regarding the toxic components of surgical smoke, the possible adverse effects on the health of operating room personnel and measures that can be used to minimize exposure to prevent respiratory problems. To reduce the hazards, surgical smoke should be removed by an evacuation system. Surgeons should assess the potential dangers of surgical smoke and encourage the use of evacuation devices to minimize potential health hazards to both themselves and other OR personnel. PMID:25421864

  13. [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.

  14. [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

  15. 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.

  16. 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.

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

    PubMed

    Culp, William C; Kimbrough, Bradly A; Luna, Sarah; Maguddayao, Aris J

    2014-04-01

    Operating room fires are sentinel events that present a real danger to surgical patients and occur at least as frequently as wrong-sided surgery. For fire to occur, the 3 points of the fire triad must be present: an oxidizer, an ignition source, and fuel source. The electrosurgical unit (ESU) pencil triggers most operating room fires. Carbon dioxide (CO2) is a gas that prevents ignition and suppresses fire by displacing oxygen. We hypothesize that a device can be created to reduce operating room fires by generating a cone of CO2 around the ESU pencil tip. One such device was created by fabricating a divergent nozzle and connecting it to a CO2 source. This device was then placed over the ESU pencil, allowing the tip to be encased in a cone of CO2 gas. The device was then tested in 21%, 50%, and 100% oxygen environments. The ESU was activated at 50 W cut mode while placing the ESU pencil tip on a laparotomy sponge resting on an aluminum test plate for up to 30 seconds or until the sponge ignited. High-speed videography was used to identify time of ignition. Each test was performed in each oxygen environment 5 times with the device activated (CO2 flow 8 L/min) and with the device deactivated (no CO2 flow-control). In addition, 3-dimensional spatial mapping of CO2 concentrations was performed with a CO2 sampling device. The median ± SD [range] ignition time of the control group in 21% oxygen was 2.9 s ± 0.44 [2.3-3.0], in 50% oxygen 0.58 s ± 0.12 [0.47-0.73], and in 100% oxygen 0.48 s ± 0.50 [0.03-1.27]. Fires were ignited with each control trial (15/15); no fires ignited when the device was used (0/15, P < 0.0001). The CO2 concentration at the end of the ESU pencil tip was 95%, while the average CO2 concentration 1 to 1.4 cm away from the pencil tip on the bottom plane was 64%. In conclusion, an operating room fire prevention device can be created by using a divergent nozzle design through which CO2 passes, creating a cone of fire suppressant. This device as

  18. Human error in medicine: change in cardiac operating rooms through the FOCUS initiative.

    PubMed

    Spiess, Bruce D

    2011-03-01

    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, reduction of

  19. Optically Pumped Two-Dimensional MoS2 Lasers Operating at Room-Temperature.

    PubMed

    Salehzadeh, Omid; Djavid, Mehrdad; Tran, Nhung Hong; Shih, Ishiang; Mi, Zetian

    2015-08-12

    The discovery of direct bandgap semiconducting two-dimensional (2D) transition metal dichalcogenides (TMDCs) has opened a new era in flexible optoelectronic devices. Critical to this development is the realization of a semiconductor laser using the emerging 2D TMDCs. Here, by embedding 2D MoS2 at the interface between a free-standing microdisk and microsphere, we have demonstrated, for the first time, room-temperature lasing from 2D TMDCs. The devices exhibit multiple lasing peaks in the wavelength range of ∼600 to 800 nm. The threshold is measured to be ∼5 μW under continuous wave operation at room temperature. No saturation in the output power is measured for pump powers more than 2 orders of magnitude larger than the threshold. The superior performance is attributed to the large gain of 2D TMDCs and the strong coupling between the 2D MoS2 gain medium and optical modes in the unique optical cavity. PMID:26214363

  20. 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.

  1. 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.

  2. A case report of malignant hyperthermia in a dental clinic operating room.

    PubMed

    Fukami, M Cynthia; Ganzberg, Steven I

    2005-01-01

    A healthy 5-year-old boy presented for arch bar placement under general anesthesia in an operating room in a dental school. The patient had previously undergone general anesthesia without complication, and no family history of anesthetic problems were reported. Halothane mask induction, intravenous catheter placement, and nasal intubation proceeded uneventfully without the aid of a muscle relaxant. Halfway through the procedure, signs and symptoms of malignant hyperthermia, including muscle rigidity, hypercarbia, tachypnea, and tachycardia were noted. Immediate treatment, including discontinuation of the triggering agent, dantrolene administration, and cooling measures were applied, and once stable, the child was transferred to Columbus Children's Hospital for further management. The patient experienced no postoperative complications. Further discussion regarding the pathophysiology and management of malignant hyperthermia is provided. PMID:15859446

  3. 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

  4. 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

  5. Continuous operation of a monolithic semiconductor terahertz source at room temperature

    SciTech Connect

    Lu, Q. Y.; Bandyopadhyay, N.; Slivken, S.; Bai, Y.; Razeghi, M.

    2014-06-02

    We demonstrate room temperature continuous wave THz sources based on intracavity difference-frequency generation from mid-infrared quantum cascade lasers. Buried ridge, buried composite distributed-feedback waveguide with Čerenkov phase-matching scheme is used to reduce the waveguide loss and enhance the heat dissipation for continuous wave operation. Continuous emission at 3.6 THz with a side-mode suppression ratio of 20 dB and output power up to 3 μW are achieved, respectively. THz peak power is further scaled up to 1.4 mW in pulsed mode by increasing the mid-infrared power through increasing the active region doping and device area.

  6. Room-temperature continuous-wave operation of an external-cavity quantum cascade laser.

    PubMed

    Mohan, Arun; Wittmann, Andreas; Hugi, Andreas; Blaser, Stéphane; Giovannini, Marcella; Faist, Jérôme

    2007-10-01

    Room-temperature, continuous-wave operation of an external-cavity quantum cascade laser (EC-QCL) is reported. Single-mode tuning range of 120 cm(-1) was achieved, from 7.96 to 8.84 microm. The gain chips utilized are based on the bound to continuum design and were fabricated as buried heterostructure lasers. Gap-free tuning (mode hops only on the external-cavity modes) is demonstrated for an antireflection-coated laser, just by grating rotation. The EC-QCL was implemented in a Littrow setup and an average power of 1.5 mW was obtained at 20 degrees C, while a peak power of 20 mW was obtained for a modified Littrow setup with the back extraction of light.

  7. 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

  8. Patient Monitoring in the Operating Room: Validation of Instrument Readings by Artificial Intelligence Methods

    PubMed Central

    Garfinkel, D.; Matsiras, P.V.; Mavrides, T.; McAdams, J.; Aukburg, S.J.

    1989-01-01

    Physiological monitoring in the operating room is needed to follow the patient's state of ventilation, circulation, etc. Parameters such as heart rate, blood pressure, and respiratory gas content are observed with devices of uncertain reliability. These provide speedy information in the form of cautions and alarms, which may indicate that corrective action is needed. In practice the large number of alarms when there is no hazard to the patient (false alarms) is a considerable problem. We describe a method of comparing and validating instrument readings in this situation involving a knowledge base whose core is a set of 36 rules. This was applied to 7803 warnings (6287 cautions and 1516 alarms) from 68 day surgery patients undergoing 115 hours of surgery. Most of the cautions were validated by our analysis, but 734 of the 1516 alarms were invalidated while 419 were validated and 363 left indeterminate. This translates to a potential reduction from one alarm every 4 minutes to one every 16 minutes.

  9. 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.

  10. Evaluation of preoperative and perioperative operating room briefings at the Hospital for Sick Children

    PubMed Central

    Khoshbin, Amir; Lingard, Lorelei; Wright, James G.

    2009-01-01

    Background Wrong-site, wrong-procedure and wrong-patient surgeries are catastrophic events for patients, medical caregivers and institutions. Operating room (OR) briefings are intended to reduce the risk of wrong-site surgeries and promote collaboration among OR personnel. The purpose of our study was to evaluate 2 OR briefing safety initiatives, “07:35 huddles” (preoperative OR briefing) and “surgical time-outs” (perioperative OR briefing), at the Hospital for Sick Children in Toronto, Ont. Methods First, we evaluated the completion and components of the 07:35 huddles and surgical time-outs briefings using direct observations. We then evaluated the attitudes of the OR staff regarding safety in the OR using the “Safety Attitudes Questionnaire, Operating Room version.” Finally, we conducted personal interviews with OR personnel. Results Based on direct observations, 102 of 159 (64.1%) 07:35 huddles and 230 of 232 (99.1%) surgical time-outs briefings were completed. The perception of safety in the OR improved, but only among nurses. Regarding difficulty discussing errors in the OR, the nurses’ mean scores improved from 3.5 (95% confidence interval [CI] 3.2–3.8) prebriefing to 2.8 (95% CI 2.5–3.2) postbriefing on a 5-point Likert scale (p < 0.05). Personal interviews confirmed that, mainly among the nursing staff, pre-and perioperative briefing tools increase the perception of communication within the OR, such that discussions regarding errors within the OR are more encouraged. Conclusion Structured communication tools, such as 07:35 huddles and surgical time-outs briefings, especially for the nursing personnel, change the notion of individual advocacy to one of teamwork and being proactive about patient safety. PMID:19680516

  11. [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).

  12. [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

  13. 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.

  14. 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

  15. 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.

  16. [Spectrophotometric evaluation of nitrous oxide pollution in the work place of the anesthesiologic personnel in operating rooms].

    PubMed

    Lukaszewski, Marceli; Kübler, Andrzej; Durek, Grazyna

    2004-11-01

    Chronic exposure to nitrous oxide and volatile anaesthetics can threat the health of the operation theatre personnel. In Poland there are no regulations determining the maximum concentration of anaesthetic gases in the air. The results of measurement of N2O pollution of theatre atmosphere presented in the article exceed European and North American standards. Lack of appropriate technical facilities in operation rooms is aggravated by incompetence of the technical supervision staff and negligence of the anaesthesiological personnel. It is important to enforce European law and standards of work safety in operation rooms. It is of double impact, health protecting and ecological. The authors suggest introducing activities aiming toward the improvement of work conditions in operation rooms and the reduction of uncontrolled release of harmful anaesthetics.

  17. An evaluation of a partial-walled laminar-flow operating room

    PubMed Central

    Whyte, W.; Shaw, B. H.; Freeman, M. A. R.

    1974-01-01

    This paper contains an assessment of the physical performance of a permanently installed down-flow laminar-flow operating room at the London Hospital. This system employs partial walls extending 0·76 m (2·5 ft.) from the ceiling, from which the air is allowed to issue freely downwards at an initial velocity of about 0·4 m./sec. (80 ft./min.). The usefulness of the partial wall, as compared with a free issuing system, was demonstrated and a comparison made with a fully walled system. It was shown that a fully walled system would be more efficient than a partial-walled system as there was a loss in air velocity of about 20-25% with the partial wall due to the nonconstrained flow of air. This loss would be reflected in an increase in airborne bacterial count and would mean that an increase of 20-25% in the air volume would be required to obtain the same conditions as with the full-walled system. Entrainment of contaminated air was demonstrated but it was concluded that this would be of little consequence in the centre of the clean area, i.e. at the wound site. Sterile instruments, etc., however, on the outside of the clean area, would be more liable to airborne contamination. Bacterial and dust airborne counts taken during total hip operations gave a very low average figure (0·3 bacteria/ft.3 or 10·5/m.3) from which we conclude that the system was about 30 times cleaner in terms of airborne bacteria than a well ventilated conventional operating-room. We concluded that although the partial-walled system was slightly less efficacious than a normal full-walled system, the freedom of movement and of communication for the operating team could in some circumstances outweigh this disadvantage. Sound levels were such that normal conversation was possible with little or no awareness of background noise. ImagesFig. 2Fig. 3Plate 2Plate 2Plate 3Plate 3Plate 1 PMID:4529595

  18. Operating room practices for the control of infection in U. S. hospitals, October 1976 to July 1977.

    PubMed

    Garner, J S; Emori, T G; Haley, R W

    1982-12-01

    We estimated the frequency of selected infection control practices in the operating room from a nationwide survey of hospitals. Our survey confirmed that, in many hospitals, practices which have not received scientific or budgetary scrutiny have become part of the perioperative routine. Almost half of the hospitals reported using nonrecommended tacky, or disinfectant, mats at the entrance to operating rooms, and more than three-fourths were performing nonrecommended environmental cultures in the operating room at a cost ranging from $2,000 to $20,000 per year. When routine nose and throat cultures were taken of operating room personnel, we found an obvious pecking order, rather than a scientific rationale for culturing. In almost all instances, we found wide variations in practice among hospitals. This nonuniformity may be due to such factors as lack of a convincing scientific basis for evaluating the relative efficacy of alternative practices, the strong influence of industry marketing, the individual preferences of surgeons and operating room supervisors and the lack of completeness and agreement of statements from various scientific and professional organizations.

  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. 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

  1. 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.

  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. 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

  4. 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

  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.

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

    PubMed

    Sadrizadeh, Sasan; Holmberg, Sture

    2014-01-01

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

  7. 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.

  8. Financial Implications of Different Interpretations of ACGME Anesthesiology Program Requirements for Rotations in the Operating Room

    PubMed Central

    Backeris, Mark E.; Forte, Patrick J.; Beaman, Shawn T.; Metro, David G.

    2013-01-01

    Background The Accreditation Council for Graduate Medical Education (ACGME) standards for resident education in anesthesiology mandate required rotations including rotations inside the operating room (OR). When residents complete rotations outside the OR, other providers must be used to maintain the OR's clinical productivity. Objective We quantified and compared the costs of replacing residents by using two different working patterns that are compliant with the ACGME anesthesiology program requirements: (1) the minimum amount of time in the OR, and (2) working the maximum amount of time permitted in the OR. Methods We calculated resident replacement costs over a 36-month residency period in both a minimum and maximum OR time model. We used a range of Certified Registered Nurse Anesthetist (CRNA) pay scales determined by a local market analysis for cost comparisons. Results Depending on CRNA pay rates, the cost differentials to replace a resident in the OR between the minimum and maximum OR time models ranged from $236,000 to $581,876, assuming a 50-hour resident work week, and $373,400 to $931,001, assuming an 80-hour resident work week. This cost was per resident over the entire 3 years of their residency. Conclusions Varying the amount of time residents work in the OR (as allowed under ACGME program requirements) has significant financial implications over a 36-month anesthesiology residency. The larger the residency, the more significant will be the impact on the department and sponsoring institution. PMID:24404280

  9. [The environmental monitoring of the exposure to chemical contamination in operating rooms].

    PubMed

    Desogus, G F

    2007-01-01

    The medical staff which works in an operating room is exposed to danger due to the chemical contamination found in the air. The results of this research depend to hormonal and haematochemical variations. The chemical contamination can be the cause of pathologies of the respiratory organs, the skin, the mucosa and the immune system. After a preventive evaluation of the production processes and the working procedures, some researchers have estimated the environmental risk caused by low concentrations of chemical products. In order to control the levels of the chemical agents, they have used an integrated system set up by a gaschromatography-mass spectrometer that has found some levels of chemical agents peculiar to a low pollution, characterized by the low concentration under the levels of the so-called ACGIH (2006) of hesane, toluene, ethylbenzene, o-xylene and naphthalene. According to the latest studies is very important to develop working methods and scientific knowledges direct to environmental, medical and toxicological problems. They are necessary to guarantee a greater protection of the human health and the safety at work.

  10. Monolithically integrated mid-IR interband cascade laser and photodetector operating at room temperature

    NASA Astrophysics Data System (ADS)

    Lotfi, Hossein; Li, Lu; Shazzad Rassel, S. M.; Yang, Rui Q.; Corrége, Cédric J.; Johnson, Matthew B.; Larson, Preston R.; Gupta, James A.

    2016-10-01

    We report on the demonstration of a monolithically integrated mid-IR interband cascade (IC) laser and photodetector operating at room temperature. The base structure for the integrated laser and detector is a six-stage type-I IC laser with GaInAsSb quantum well active regions. The laser/detector pair was defined using focused ion beam milling. The laser section lased in cw mode with an emission wavelength of ˜3.1 μm at 20 °C and top-illuminated photodetectors fabricated from the same wafer had Johnson-noise-limited detectivity of 1.05 × 109 cm Hz1/2/W at this wavelength and temperature. Under the same condition, the detectivity for the edge illumination configuration for the monolithically integrated laser/photodetector pairs is projected to be as high as 1.85 × 1010 cm Hz1/2/W, as supported by experimentally observed high photocurrent and open-circuit voltage. These high performance characteristics for monolithically integrated IC devices show great prospects for on-chip integration of mid-IR photonic devices for miniaturized sensors and on-chip optical communication systems.

  11. 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.

  12. [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.

  13. 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.

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

    PubMed

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

    2014-01-01

    Background. Obesity impacts utilization of healthcare resources. The goal of this study was to measure the relationship between increasing body mass index (BMI) in patients undergoing total hip arthroplasty (THA) with different components of operating room (OR) time. Methods. The Stanford Translational Research Integrated Database Environment (STRIDE) was utilized to identify all ASA PS 2 or 3 patients who underwent primary THA at Stanford Medical Center from February 1, 2008 through January 1, 2013. Patients were divided into five groups based on the BMI weight classification. Regression analysis was used to quantify relationships between BMI and the different components of total OR time. Results. 1,332 patients were included in the study. There were no statistically significant differences in age, gender, height, and ASA PS classification between the BMI groups. Normal-weight patients had a total OR time of 138.9 min compared 167.9 min (P < 0.001) for morbidly obese patients. At a BMI > 35 kg/m(2) each incremental BMI unit increase was associated with greater incremental total OR time increases. Conclusion. Morbidly obese patients required significantly more total OR time than normal-weight patients undergoing a THA procedure. This increase in time is relevant when scheduling obese patients for surgery and has an important impact on health resource utilization.

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

    PubMed Central

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

    2014-01-01

    Background. Obesity impacts utilization of healthcare resources. The goal of this study was to measure the relationship between increasing body mass index (BMI) in patients undergoing total hip arthroplasty (THA) with different components of operating room (OR) time. Methods. The Stanford Translational Research Integrated Database Environment (STRIDE) was utilized to identify all ASA PS 2 or 3 patients who underwent primary THA at Stanford Medical Center from February 1, 2008 through January 1, 2013. Patients were divided into five groups based on the BMI weight classification. Regression analysis was used to quantify relationships between BMI and the different components of total OR time. Results. 1,332 patients were included in the study. There were no statistically significant differences in age, gender, height, and ASA PS classification between the BMI groups. Normal-weight patients had a total OR time of 138.9 min compared 167.9 min (P < 0.001) for morbidly obese patients. At a BMI > 35 kg/m2 each incremental BMI unit increase was associated with greater incremental total OR time increases. Conclusion. Morbidly obese patients required significantly more total OR time than normal-weight patients undergoing a THA procedure. This increase in time is relevant when scheduling obese patients for surgery and has an important impact on health resource utilization. PMID:25210656

  16. [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.

  17. [The environmental monitoring of the exposure to chemical contamination in operating rooms].

    PubMed

    Desogus, G F

    2007-01-01

    The medical staff which works in an operating room is exposed to danger due to the chemical contamination found in the air. The results of this research depend to hormonal and haematochemical variations. The chemical contamination can be the cause of pathologies of the respiratory organs, the skin, the mucosa and the immune system. After a preventive evaluation of the production processes and the working procedures, some researchers have estimated the environmental risk caused by low concentrations of chemical products. In order to control the levels of the chemical agents, they have used an integrated system set up by a gaschromatography-mass spectrometer that has found some levels of chemical agents peculiar to a low pollution, characterized by the low concentration under the levels of the so-called ACGIH (2006) of hesane, toluene, ethylbenzene, o-xylene and naphthalene. According to the latest studies is very important to develop working methods and scientific knowledges direct to environmental, medical and toxicological problems. They are necessary to guarantee a greater protection of the human health and the safety at work. PMID:18409754

  18. Assessment of genotoxicity risk in operation room personnel by the alkaline comet assay.

    PubMed

    El-Ebiary, A A; Abuelfadl, A A; Sarhan, N I; Othman, M M

    2013-06-01

    This study was conducted to evaluate the possible genotoxic effects of waste anesthetic gases. Comet assay was performed on peripheral blood lymphocytes of 60 volunteers: 20 healthy unexposed office workers and 40 operation room (OR) personnel at Tanta University Hospital (Egypt). The exposed personnel were anesthetists (6 females and 7 males), surgeons (10 males), nurses (9 females), and technicians (8 males). The study revealed significantly increased comet parameters (mean comet tail length and mean percentage of DNA in the tail) in peripheral blood lymphocytes of OR personnel in comparison with control individuals. The maximum DNA damage was observed in anesthesia technicians, whereas the nurses showed the least DNA damage. Furthermore, significant difference was observed between smoker and nonsmokerOR personnel in relation to mean comet tail length. However, no significant difference was seen due to age, gender, or duration of exposure. Also, significant increase in mean percentage of tail DNA was observed in smoker individuals of both exposed and control groups. As a conclusion, this study points to the risk of DNA damage in personnel who are exposed to waste anesthetic gases.

  19. 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.

  20. 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

  1. 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.

  2. 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…

  3. 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

  4. 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.

  5. 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

  6. Operating Room to Intensive Care Unit Handoffs and the Risks of Patient Harm

    PubMed Central

    McElroy, Lisa M.; Collins, Kelly M.; Koller, Felicitas L.; Khorzad, Rebeca; Abecassis, Michael M.; Holl, Jane L.; Ladner, Daniela P.

    2015-01-01

    Background The goal of this study was to assess systems and processes involved in the operating room (OR) to intensive care unit (ICU) handoff in an attempt to understand the criticality of specific steps of the handoff. Methods We performed a failure modes, effects and criticality analysis (FMECA) of the OR to ICU handoff of deceased donor liver transplant recipients using in-person observations and descriptions of the handoff process from a multidisciplinary group of clinicians. For each step in the process, failures were identified along with frequency of occurrence, causes, potential effects and safeguards. A risk priority number (RPN) was calculated for each failure (Frequency x Potential effect x Safeguard; range 1-least risk to 1000-most risk). Results The FMECA identified 37 individual steps in the OR to ICU handoff process. In total, 81 process failures were identified, 22 of which were determined to be critical and 36 of which relied on weak safeguards such as informal human verification. Process failures with the highest risk of harm were lack of preliminary OR to ICU communication (RPN 504), team member absence during handoff communication (RPN 480) and transport equipment malfunction (RPN 448). Conclusions Based on the analysis, recommendations were made to reduce potential for patient harm during OR to ICU handoffs. These included automated transfer of OR data to ICU clinicians, enhanced ICU team member notification processes and revision of the postoperative order sets. The FMECA revealed steps in the OR to ICU handoff that are high risk for patient harm and are currently being targeted for process improvement. PMID:26067459

  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.

  8. 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

  9. 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.

  10. 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

  11. [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

  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. 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

  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. 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

  16. 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%.

  17. Design and first implementation of business process visualization for a task manager supporting the workflow in an operating room

    NASA Astrophysics Data System (ADS)

    Fink, E.; Wiemuth, M.; Burgert, O.

    2015-03-01

    An operating room is a stressful work environment. Nevertheless, all involved persons have to work safely as there is no space for mistakes. To ensure a high level of concentration and seamless interaction, all involved persons have to know their own tasks and the tasks of their colleagues. The entire team must work synchronously at all times. To optimize the overall workflow, a task manager supporting the team was developed. In parallel, a common conceptual design of a business process visualization was developed, which makes all relevant information accessible in real-time during a surgery. In this context an overview of all processes in the operating room was created and different concepts for the graphical representation of these user-dependent processes were developed. This paper describes the concept of the task manager as well as the general concept in the field of surgery.

  18. Continuous-Wave Operation of GaN Based Multi-Quantum-Well Laser Diode at Room Temperature

    NASA Astrophysics Data System (ADS)

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

    2008-04-01

    Room-temperature operation of cw GaN based multi-quantum-well laser diodes (LDs) is demonstrated. The LD structure is grown on a sapphire (0001) substrate by metalorganic chemical vapour deposition. A 2.5μm × 800μm ridge waveguide structure is fabricated. The electrical and optical characteristics of the laser diode under direct current injection at room temperature are investigated. The threshold current and voltage of the LD under cw operation are 110 mA and 10.5 V, respectively. Thermal induced series resistance decrease and emission wavelength red-shift are observed as the injection current is increased. The full width at half maximum for the parallel and perpendicular far field pattern (FFP) are 12° and 32°, respectively.

  19. 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.

  20. 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.

  1. 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

  2. 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.

  3. 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

  4. [The necessity for alternative methods of hygienic testing of air technical designs for operating rooms].

    PubMed

    Seipp, H M; Barth, U

    1994-06-01

    The performance assessment of technical systems for the supply of clean air is fraught with problems which are caused by the present assessment procedures and norms. Until now the distribution of germs in a clean room has been considered as stationary and has been tested as though it was independent of the measuring time. Accordingly the quality of clean air rooms has to date been determined by measurements of particle or germ concentrations (Federal Standard 209; European Standard 209-WG-1; VDI 2083/1). By contrast different methods demonstrate that the contaminations introduced into a clean air room as particles or as particle-bound bacteria are eliminated according to an exponential function in a time-dependent manner. Therefore the measurements of single concentrations without the consideration of the time-dependence of concentration changes must needs lead to extremely faulty results. Furthermore the influence of disturbing factors (test persons, properties of different air supply ceilings, measuring instruments). As a consequence of the poor reliability and lacking validity of presently valid assessment methods, there is a discrepancy between the seemingly high performance of the clean air supply systems under laboratory conditions (DIN 4799) on the one hand, and the frequently unsatisfactory functioning of the same systems under practical conditions. This discrepancy has caused a significant loss of confidence towards the whole clean air technique, especially among the users. Therefore critical test and evaluation methods should be immediately set up for comprehensive testing of technical clean air systems, methods which include the time-dependence of particle or germ elimination as well as test-dependent disturbing factors. PMID:7916866

  5. Fabrication and evaluation of room temperature operated radiation detectors processed from undoped LEC bulk gallium arsenide material

    SciTech Connect

    McGregor, D.S.; Knoll, G.F.; Eisen, Y.; Brake, R.

    1994-09-01

    Semi-insulating undoped bulk LEC GaAs was investigated as a possible detector material for room temperature operated charged particle and gamma ray spectrometers. GaAs Schottky based diode detectors were fabricated with thicknesses of 45 microns, 100 microns, 250 microns, and 750 microns. Pulse height analysis utilizing an alpha particle source disclosed non-constant electric field distributions that decreased rapidly from the Schottky contact into the bulk of the detectors. Results from pulsed X-ray analysis and the alpha particle pulse height analysis indicate an active region width voltage dependence that strongly deviates from {radical}{bar V} behavior. Resolution at room temperature for {sup 241}Am alpha particles ranged from 2.2% to 3.1% FWHM for different detectors with a typical resolution of 2.5% FWHM. Room temperature measurements of 60 keV gamma rays ({sup 24l}Am) and 122 keV gamma rays ({sup 57}Co) resulted in observed full energy peaks with FWHM`s of 22 keV and 40 keV, respectively.

  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. 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.

  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. 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.

  10. 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

  11. [Differentiation of allotments for occupationally necessary and hygiene relevant costs of air technology designs for operating rooms].

    PubMed

    Seipp, H M; Sprengel, M; Wagner, K H

    1994-06-01

    The aeration of operation theatres serves multiple purposes. It is necessary for the regulation of room temperature (waste heat generated by the operation team and technical appliances), air exchange for oxygen supply, removal of narcotic gases and of smells (occupational limit values) as well the elimination of germs and particles emitted during operations by staff and from instruments (avoidance of germ transfer by air). This paper tries on the one hand to estimate the investment and running costs of different indoor air supplies according to the specifications given by DIN 1946, parts 2 and 4) and on the other hand to differentiate the hygienically relevant expenses of turbulent and laminar flow air supply systems. It can be seen that, due to the high heat production generated during operations, no cost can be saved through decreases in air flow volume. Depending on the operation frequency (e.g. 4 operations daily, 200-300 days per year) a hygienically relevant cost of DM 2.8-6.7 per patient is calculated for laminar flow supplies and DM 4.5-6.7 per patient for the turbulent air supply systems ("Stützstrahl"). Thus laminar flow systems are also cost-saving in comparison to turbulent air supply systems in addition to their significant technical and hygienic advantages. PMID:7916867

  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. Continuous wave operation of a mid-infrared semiconductor laser at room temperature.

    PubMed

    Beck, Mattias; Hofstetter, Daniel; Aellen, Thierry; Faist, Jérôme; Oesterle, Ursula; Ilegems, Marc; Gini, Emilio; Melchior, Hans

    2002-01-11

    Continuous wave operation of quantum cascade lasers is reported up to a temperature of 312 kelvin. The devices were fabricated as buried heterostructure lasers with high-reflection coatings on both laser facets, resulting in continuous wave operation with optical output power ranging from 17 milliwatts at 292 kelvin to 3 milliwatts at 312 kelvin, at an emission wavelength of 9.1 micrometers. The results demonstrate the potential of quantum cascade lasers as continuous wave mid-infrared light sources for high-resolution spectroscopy, chemical sensing applications, and free-space optical communication systems.

  14. Government Documents Departmental Operations Guide.

    ERIC Educational Resources Information Center

    Wilson, John S.; And Others

    This manual for the operation and maintenance of the Government Documents Department at Baylor University's Moody Memorial Library is divided into 13 topical sections. The guide opens with the collection development policy statement, which covers the general collection, the maps division, and weeding government documents. Technical processing…

  15. 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

  16. 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

  17. 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

    2016-02-03

    Shift work is associated with both sleepiness and reduced performance. The aim of this study was to examine cognitive performance, sleepiness, and sleep quality among petrochemical control room shift workers. Sixty shift workers participated in this study. Cognitive performance was evaluated using a number of objective tests, including continuous performance test, n-back test, and simple reaction time test; sleepiness was measured using the subjective Karolinska Sleepiness Scale (KSS); and sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI) questionnaire. ANCOVA, t-test, and repeated-measures ANOVA were applied for statistical analyses, and the significance level was set at p < 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.

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

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... initial temperature of the contents of the containers to be processed shall be determined and recorded with sufficient frequency to ensure that the temperature of the product is no lower than the minimum initial temperature specified in the scheduled process. For those operations that use water during...

  19. 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.

  20. War stories: a qualitative analysis of narrative teaching strategies in the operating room

    PubMed Central

    Hu, Yue-Yung; Peyre, Sarah E.; Arriaga, Alexander F.; Roth, Emilie M.; Corso, Katherine A.; Greenberg, Caprice C.

    2015-01-01

    BACKGROUND “War stories” are commonplace in surgical education, yet little is known about their purpose, construct, or use in the education of trainees. METHODS Ten complex operations were videotaped and audiotaped. Narrative stories were analyzed using grounded theory to identify emergent themes in both the types of stories being told and the teaching objectives they illustrated. RESULTS Twenty-four stories were identified in 9 of the 10 cases (mean, 2.4/case). They were brief (mean, 58 seconds), illustrative of multiple teaching points (mean, 1.5/story), and appeared throughout the operations. Anchored in personal experience, these stories taught both clinical (eg, operative technique, decision making, error identification) and programmatic (eg, resource management, professionalism) topics. CONCLUSIONS Narrative stories are used frequently and intuitively by physicians to emphasize a variety of intraoperative teaching points. They socialize trainees in the culture of surgery and may represent an underrecognized approach to teaching the core competencies. More understanding is needed to maximize their potential. PMID:22088266

  1. Reliable assessment of laparoscopic performance in the operating room using videotape analysis.

    PubMed

    Chang, Lily; Hogle, Nancy J; Moore, Brianna B; Graham, Mark J; Sinanan, Mika N; Bailey, Robert; Fowler, Dennis L

    2007-06-01

    The Global Operative Assessment of Laparoscopic Skills (GOALS) is a valid assessment tool for objectively evaluating the technical performance of laparoscopic skills in surgery residents. We hypothesized that GOALS would reliably differentiate between an experienced (expert) and an inexperienced (novice) laparoscopic surgeon (construct validity) based on a blinded videotape review of a laparoscopic cholecystectomy procedure. Ten board-certified surgeons actively engaged in the practice and teaching of laparoscopy reviewed and evaluated the videotaped operative performance of one novice and one expert laparoscopic surgeon using GOALS. Each reviewer recorded a score for both the expert and the novice videotape reviews in each of the 5 domains in GOALS (depth perception, bimanual dexterity, efficiency, tissue handling, and overall competence). The scores for the expert and the novice were compared and statistically analyzed using single-factor analysis of variance (ANOVA). The expert scored significantly higher than the novice did in the domains of depth perception (p = .005), bimanual dexterity (p = .001), efficiency (p = .001), and overall competence ( p = .001). Interrater reliability for the reviewers of the novice tape was Cronbach alpha = .93 and the expert tape was Cronbach alpha = .87. There was no difference between the two for tissue handling. The Global Operative Assessment of Laparoscopic Skills is a valid, objective assessment tool for evaluating technical surgical performance when used to blindly evaluate an intraoperative videotape recording of a laparoscopic procedure.

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

    PubMed Central

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

    2016-01-01

    Indoor environments, where people spend most of their time, are characterized by a specific microbial community, the indoor microbiome. Most indoor environments are connected to the natural environment by high ventilation, but some habitats are more confined: intensive care units, operating rooms, cleanrooms and the international space station (ISS) are extraordinary living and working areas for humans, with a limited exchange with the environment. The purposes for confinement are different: a patient has to be protected from infections (intensive care unit, operating room), product quality has to be assured (cleanrooms), or confinement is necessary due to extreme, health-threatening outer conditions, as on the ISS. The ISS represents the most secluded man-made habitat, constantly inhabited by humans since November 2000 – and, inevitably, also by microorganisms. All of these man-made confined habitats need to be microbiologically monitored and controlled, by e.g., microbial cleaning and disinfection. However, these measures apply constant selective pressures, which support microbes with resistance capacities against antibiotics or chemical and physical stresses and thus facilitate the rise of survival specialists and multi-resistant strains. In this article, we summarize the available data on the microbiome of aforementioned confined habitats. By comparing the different operating, maintenance and monitoring procedures as well as microbial communities therein, we emphasize the importance to properly understand the effects of confinement on the microbial diversity, the possible risks represented by some of these microorganisms and by the evolution of (antibiotic) resistances in such environments – and the need to reassess the current hygiene standards. PMID:27790191

  3. 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.

  4. [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.

  5. [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

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

    PubMed Central

    2013-01-01

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

  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. 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

  9. Retained Foreign Bodies: A Serious Threat in the Indian Operation Room

    PubMed Central

    Sharma, G; Bigelow, JC

    2014-01-01

    Retained foreign bodies (RFBs) are a surgical complication resulting from foreign materials accidently left in a patient's body. This review attempts to give an overview of different types of RFBs, problems related to them and their management after the surgical operation. The internet was searched using the Google and Google scholar. In addition, relevant electronic journals from the University's library such as Entrez (including PubMed and PubMed central), Since Direct, Scirus, NIH.gov, Medknow.com, Medscape.com, Scopus, MedHelp.org, Cochrane library, WebMD.com, and World Health Organization Hinari. It shows that the major reasons of RFBs are emergency surgical operation with unplanned changes, patient high body mass index, and poor communication. To prevent this textile material should be radiopaque marked and must be counted once at the start and twice at the conclusion of all surgical procedures. If the count is incorrect, then radiography or manually re-exploration should be performed. Ultrasonography, computerized tomography, magnetic resonance imaging and radio frequency identification are also used in the proper identification of RFBs. Safety practice should be robust and simple enough to protect patient under the most chaotic of circumstances. Proper communication among the personnel participating in surgery aimed at preventing this medical negligence would help in mitigating such errors. Finally, the surgeon should not only follow the standard recommended procedure, but also report cases of RFBs. PMID:24669327

  10. 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

  11. 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

  12. Application of a Hand-Held Computer for Data Capture in the Operating Room

    PubMed Central

    Maruschak, Gary F.; Mack, Stephen S.; Rosenfeld, Gilbert I.; Blanck, Thomas J.J.

    1983-01-01

    In this paper, the use of a battery-powered, handheld computer system (HHC) for the capture of drug and events (D&E) during anesthesia and surgery is described. The advantages of the HHC system are small size, non-volatile memory, flexible keyboard configuration-every key can be a special function key labeled with custom overlays, fast entry of D&E with accurate time of day and provision of a pulse signal to external trend recorders logging each real-time entry. Disadvantages are limited processing speed that can inhibit complex operations such as long searches for a particular drug entry and some training is required to become a proficient user. ImagesFigure 1Figure 1

  13. Continuous-wave diode-pumped operation of an Yb:NaLa(WO 4) 2 laser at room temperature

    NASA Astrophysics Data System (ADS)

    Liu, Junhai; María Cano-Torres, José; Esteban-Betegón, Fátima; Dolores Serrano, María; Cascales, Concepción; Zaldo, Carlos; Rico, Mauricio; Griebner, Uwe; Petrov, Valentin

    2007-04-01

    Room-temperature continuous-wave (cw) laser operation is demonstrated with the newly developed Yb:NaLa(WO 4) 2 disordered crystal by end-pumping with a fiber-coupled diode laser. A maximum output power of 330 mW is obtained with an optical efficiency of 4.9% and a slope efficiency of 6.3% with respect to the incident pump power. The efficiencies in terms of the absorbed pump power are roughly three times higher. Sellmeier dispersion curves for the ordinary and extraordinary refractive indices of the NaLa(WO 4) 2 host are reported along with crystallographic and spectroscopic properties related to the Yb 3+-doping.

  14. Clinician Perceptions of Operating Room to Intensive Care Unit Handoffs and Implications for Patient Safety: A Qualitative Study

    PubMed Central

    McElroy, Lisa M.; Macapagal, Kathryn R.; Collins, Kelly M.; Abecassis, Michael M.; Holl, Jane L.; Ladner, Daniela P.; Gordon, Elisa J.

    2015-01-01

    Background Operating room (OR) to the intensive care unit (ICU) handoffs are known sources of medical error, yet little is known about the relationship between process failures and patient harm. Materials and Methods Interviews were conducted with clinicians involved in the OR-to-ICU handoff to characterize the relationship between handoff process failures and patient harm. Thematic analysis was used to inductively identify key themes. Results A total of 38 interviews were conducted. Dominant themes included early communication from the OR to the ICU, team member participation in the handoff, and relationships between clinicians; clinician perspectives varied depending substantially on role within the team. Conclusions The findings suggest that ambiguous roles and conflicting expectations of team members during the OR-to-ICU handoff can increase risk of patient harm. Future studies should investigate early postoperative ICU care as outcome markers of handoff quality and the effect of inter-professional education on clinician adherence to interventions. PMID:26198333

  15. An audit of operating room time utilization in a teaching hospital: is there a place for improvement?

    PubMed

    Stavrou, George; Panidis, Stavros; Tsouskas, John; Tsaousi, Georgia; Kotzampassi, Katerina

    2014-01-01

    Aim. To perform a thorough and step-by-step assessment of operating room (OR) time utilization, with a view to assess the efficacy of our practice and to identify areas of further improvement. Materials and Methods. We retrospectively analyzed the most ordinary general surgery procedures, in terms of five intervals of OR time utilization: anaesthesia induction, surgery preparation, duration of operation, recovery from anaesthesia, and transfer to postanaesthesia care unit (PACU) or intensive care unit (ICU). According to their surgical impact, the procedures were defined as minor, moderate, and major. Results. A total of 548 operations were analyzed. The mean (SD) time in minutes for anaesthesia induction was 19 (9), for surgery preparation 13 (8), for surgery 115 (64), for recovery from anaesthesia 12 (8), and for transfer to PACU/ICU 12 (9). The time spent in each step presented an ascending escalation pattern proportional to the surgical impact (P = 0.000), which was less pronounced in the transfer to PACU/ICU (P = 0.006). Conclusions. Albeit, our study was conducted in a teaching hospital, the recorded time estimates ranged within acceptable limits. Efficient OR time usage and outliers elimination could be accomplished by a better organized transfer personnel service, greater availability of anaesthesia providers, and interdisciplinary collaboration.

  16. [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.

  17. 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

  18. Dichotomy of rhinoplasty practice: from the conference floor to the operating room.

    PubMed

    Palma, Pietro; Khodaei, Iman

    2014-04-01

    Advancements in surgical techniques and improvements in clinical practice inevitably lag behind scientific progress and peer-led opinion. The rapid rise and fall in the popularity of rhinoplasty techniques makes scientific evidence-gathering and education a daunting task. Students of rhinoplasty face a long and steep learning curve, and need to acquire sound analytical tools to critically evaluate both literature contributions and operative reports shown in conferences. Such a complex learning process requires continuous self-examination, and must account for the increasingly sophisticated and intricate wishes of rhinoplasty patients whose desires do not always coincide with what surgeons have been taught and practiced. In contemporary practice, the developing rhinoplasty surgeon must be also familiar with the range of racial features, as the broad variety of nasal anatomies and beauty canons are truly staggering, and one formula does not fit all cases.The complex set of circumstances that lead to disharmony between scientific progress and clinical practice is addressed, and a utilitarian plan to remedy this awkward dichotomy is suggested. PMID:24810121

  19. 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

  20. 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

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

    PubMed

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

    2010-01-01

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

  2. 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

  3. Risk factors for and circumstances of needlestick and sharps injuries of doctors in operating rooms: A study focusing on surgeries using general anesthesia at Kurume University Hospital, Japan.

    PubMed

    Yonezawa, Yuko; Yahara, Koji; Miura, Miho; Hieda, Fumiyo; Yamakawa, Ryoji; Masunaga, Kenji; Mishima, Yasunori; Watanabe, Hiroshi

    2015-12-01

    Healthcare workers are exposed to serious infectious diseases via needlestick and sharps injuries. The operating room is a particularly important environment in which the risk for needlestick injuries is increased for surgical doctors. According to national surveillance studies, the proportion of needlestick and sharps injuries in operating rooms has been increasing for unknown reasons. In this study, we examined risk factors for and circumstances of injuries in operating rooms by combining and analyzing incidence reports and electronic records of every surgery in Kurume University Hospital (Kurume, Japan). The annual injury rate (reflecting the reporting rate) rose continuously from fiscal years 2007-2012. We conducted analyses focusing on surgeries that used general anesthesia, which accounted for 88.1% of the injuries. An analysis of the time of injury found that the number of injuries increased toward the end of the surgical procedure. A comparative analysis of surgeries by doctors who had experienced injury revealed risk for the injury increased when a procedure ended after 20:00. In addition, a comparative analysis of doctors with and without injury experience who had similar level of operating time per year revealed that the number of working years was not lower in the injured doctors. Although the data analyzed in this study were confined to one university hospital, our approach and these results will form a basis on which to consider more effective measures to prevent injury in operating rooms. PMID:26462957

  4. Risk factors for and circumstances of needlestick and sharps injuries of doctors in operating rooms: A study focusing on surgeries using general anesthesia at Kurume University Hospital, Japan.

    PubMed

    Yonezawa, Yuko; Yahara, Koji; Miura, Miho; Hieda, Fumiyo; Yamakawa, Ryoji; Masunaga, Kenji; Mishima, Yasunori; Watanabe, Hiroshi

    2015-12-01

    Healthcare workers are exposed to serious infectious diseases via needlestick and sharps injuries. The operating room is a particularly important environment in which the risk for needlestick injuries is increased for surgical doctors. According to national surveillance studies, the proportion of needlestick and sharps injuries in operating rooms has been increasing for unknown reasons. In this study, we examined risk factors for and circumstances of injuries in operating rooms by combining and analyzing incidence reports and electronic records of every surgery in Kurume University Hospital (Kurume, Japan). The annual injury rate (reflecting the reporting rate) rose continuously from fiscal years 2007-2012. We conducted analyses focusing on surgeries that used general anesthesia, which accounted for 88.1% of the injuries. An analysis of the time of injury found that the number of injuries increased toward the end of the surgical procedure. A comparative analysis of surgeries by doctors who had experienced injury revealed risk for the injury increased when a procedure ended after 20:00. In addition, a comparative analysis of doctors with and without injury experience who had similar level of operating time per year revealed that the number of working years was not lower in the injured doctors. Although the data analyzed in this study were confined to one university hospital, our approach and these results will form a basis on which to consider more effective measures to prevent injury in operating rooms.

  5. 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

  6. 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

  7. 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

  8. 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

  9. Establishment of an operating room committee and a training program to improve aseptic techniques for rodent and large animal surgery.

    PubMed

    Héon, Hélène; Rousseau, Nathalie; Montgomery, Jane; Beauregard, Gilles; Choiniére, Manon

    2006-11-01

    Investigators of our research facility generally accept the concept of asepsis as an important component of adequate surgical care for animals. However, they experience difficulties putting it into practice, especially in the case of rodents. The reasons for this are inconvenience, cost, and lack of training. To better assist investigators in the implementation of aseptic surgical techniques in their laboratories, we have created an Operating Room (OR) Committee modeled after OR committees found in human hospitals. A reconstructive surgeon, a veterinarian, a research scientist, a nurse involved in the training of OR personnel, interns, graduate students, and an animal health technician were chosen as committee members in light of their OR and animal care expertise. The first task of the OR Committee was to establish institutional guidelines for aseptic surgery, taking into account the costs imposed on research budgets by these procedures. The OR Committee also supports a complete training program in aseptic surgery techniques, which consists of lectures, a training manual, videos, and a practical course. Furthermore, when experimental procedures require specialized equipment, the OR Committee collaborates with researchers to develop strategies to achieve asepsis. This OR Committee and the training program proved to be important tools to promote and improve the quality of animal care during surgery.

  10. 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

  11. 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…

  12. [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

  13. Analysis of operation of filters for post-accident decontamination of pressurized rooms of a nuclear power plants with a type VVER-440 reactor

    NASA Astrophysics Data System (ADS)

    Zaichik, L. I.; Zeigarnik, Yu. A.; Rotinov, A. G.; Sidorov, A. S.; Silina, N. N.; Chalyi, R. F.

    2007-05-01

    Operation of filters of postaccident decontamination of pressurized rooms of a nuclear power plant with a type-VVER-440 reactor is analyzed. The distribution of radioactive nuclides over filter stages, the time variation of the thermal state of filter, and the characteristic features of the processes of sorption in the section of fine cleaning are considered.

  14. 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%.

  15. [Importance of material logistics in the interface management of operation departments: is the supply of sterile equipment a new business area of operation room organization?].

    PubMed

    Schmeck, J; Schmeck, S B; Kohnen, W; Werner, C; Schäfer, M; Gervais, H

    2008-08-01

    The implementation of diagnosis-related groups (DRGs) sharply increased economic pressure on hospitals. Hence, process optimization was focussed on cost-intensive areas, namely the operation room (OR) departments. Work-flow in the OR is characterized by a mandatory interlocking of the job functions of many different occupational groups and the availability of a variety of different materials. Alternatives for staff assignment optimization have been published in numerous publications dealing with the importance of OR management. In this connection the issue of material logistics in the context of OR management has not been frequently addressed. In order to perform a surgical procedure according to plan, one depends on personnel and on timely availability of the materials needed. Supply of sterilized materials is of utmost importance, because in most hospitals sterilized surgical devices constitute a critical resource. In order to coordinate the OR process with the production flow of sterilized materials, an organizational connection to the OR management makes sense. Hence, in a German university hospital the Department of Hospital Sterile Supplies was integrated into the OR management of the Department of Anesthesiology. This led to a close coordination of work-flow processes, and concomitantly a significant reduction of production costs of sterile supplies could be achieved by direct interaction with the OR. Thus, hospital sterile supplies can reasonably be integrated into an OR management representing a new interesting business area for OR organization.

  16. A seal-less centrifugal pump (Baylor Gyro Pump) for application to long-term circulatory support.

    PubMed

    Minato, N; Sakuma, I; Sasaki, T; Shiono, M; Ohara, Y; Takatani, S; Noon, G P; Nosé, Y

    1993-01-01

    We are developing a new centrifugal pump, the Baylor Gyro Centrifugal Pump (Gyro Pump), which can function for more than 2 weeks. The concept of the Gyro Pump is that a one-piece rotor-impeller with embedded permanent magnets, driven directly by a brushless direct current motor stator placed outside, rotates like a "gyroscope," and the rotor-impeller is supported by one pivot bearing at the bottom in accordance with the gyroscopic principle. This concept enables us to eliminate a driving shaft and a seal between the driving shaft and the blood chamber, which results in extending the life of the centrifugal pump. The blood passes through the space between the motor stator and the rotor to the impeller portion. In this preliminary phase, two pivot bearings were applied to support the rotor-impeller at the top and the bottom inside the blood chamber. Both pivot bearings showed less blood trauma and less thrombogenicity in in vitro and in vivo studies. The Gyro Pump is a promising second-generation centrifugal pump for long-term circulatory support in the near future. PMID:8422233

  17. Development and testing of Baylor Scott & White Health's “Attitudes and Practices of Patient Safety Survey”

    PubMed Central

    Compton, Jan; Saldaña, Margaret; Tecson, Kristen M.; Hastings, Chizuko; Kennerly, Donald A.

    2016-01-01

    Improving the quality of patient care requires a culture attuned to safety. We describe the development, implementation, and psychometric evaluation of the Attitudes and Practices of Patient Safety Survey (APPSS) within the Baylor Scott & White Health system. The APPSS was designed to enable safety culture data to be collected and aggregated at the unit level to identify high-priority needs. The survey, with 27 Likert-scale core questions divided into 4 concept domains and 2 open-ended questions, was administered electronically to employees with direct patient care responsibilities (n = 16,950). The 2015 response rate was 50.4%. The Cronbach's α values for the four domains ranged from 0.78 to 0.90, indicating strong internal consistency. Confirmatory factor analysis results were mixed but were comparable to those of established safety culture surveys. Over the years, the adaptability of the APPSS has proven helpful to administrative and clinical leaders alike, and the survey responses have led to the creation of programs to improve the organization's patient safety culture. In conclusion, the APPSS provides a reliable measure of patient safety culture and may be useful to other health care organizations seeking to improve the quality and safety of the care they provide. PMID:27695163

  18. Development and testing of Baylor Scott & White Health's “Attitudes and Practices of Patient Safety Survey”

    PubMed Central

    Compton, Jan; Saldaña, Margaret; Tecson, Kristen M.; Hastings, Chizuko; Kennerly, Donald A.

    2016-01-01

    Improving the quality of patient care requires a culture attuned to safety. We describe the development, implementation, and psychometric evaluation of the Attitudes and Practices of Patient Safety Survey (APPSS) within the Baylor Scott & White Health system. The APPSS was designed to enable safety culture data to be collected and aggregated at the unit level to identify high-priority needs. The survey, with 27 Likert-scale core questions divided into 4 concept domains and 2 open-ended questions, was administered electronically to employees with direct patient care responsibilities (n = 16,950). The 2015 response rate was 50.4%. The Cronbach's α values for the four domains ranged from 0.78 to 0.90, indicating strong internal consistency. Confirmatory factor analysis results were mixed but were comparable to those of established safety culture surveys. Over the years, the adaptability of the APPSS has proven helpful to administrative and clinical leaders alike, and the survey responses have led to the creation of programs to improve the organization's patient safety culture. In conclusion, the APPSS provides a reliable measure of patient safety culture and may be useful to other health care organizations seeking to improve the quality and safety of the care they provide.

  19. 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.

  20. 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.

  1. 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

  2. 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

  3. 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.

  4. Single-use instruments, cutting blocks, and trials increase efficiency in the operating room during total knee arthroplasty: a prospective comparison of navigated and non-navigated cases.

    PubMed

    Mont, Michael A; McElroy, Mark J; Johnson, Aaron J; Pivec, Robert

    2013-08-01

    The purpose of this prospective controlled trial was to determine if efficiency increases could be achieved in non-navigated and navigated total knee arthroplasties by replacing traditional saws, cutting blocks, and trials with specialized saws and single-use cutting blocks and trials. Various timing metrics during total knee arthroplasty, including operating room preparation times and specific intra-operative times, were measured in 400 procedures performed by eight different surgeons at 6 institutions. Efficiency increases were the result of statistically significant reductions in combined instrument setup and cleanup times as well as in adjusted surgical episode times in navigated total knee arthroplasties. Single-use instruments show promising benefits, but adequate patient follow-up is needed to confirm safety and efficacy before they can be widely adopted. Nevertheless, the authors believe that the use of single-use instruments, cutting guides, and trial implants for total knee arthroplasty will play an increasing role in improving operating room efficiency.

  5. 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

  6. Room-temperature operation of npn- AlGaInAs/InP multiple quantum well transistor laser emitting at 1.3-µm wavelength.

    PubMed

    Shirao, Mizuki; Sato, Takashi; Sato, Noriaki; Nishiyama, Nobuhiko; Arai, Shigehisa

    2012-02-13

    Room-temperature pulsed operation of a 1.3-µm wavelength transistor laser (TL), consisting of a buried heterostructure (BH) with an npn configuration and an AlGaInAs/InP multiple-quantum-well (MQW) active region, was successfully attained. A threshold base current of 18 mA (threshold emitter current of 150 mA) was obtained with a stripe width of 1.3 µm and a cavity length of 500 µm. The transistor activity as well as the lasing operation were achieved at the same time, which is essential for the high-speed operation of TLs. PMID:22418155

  7. [Occupational exposure to sevoflurane in pediatric operating rooms: the multi-point sampling method for risk assessment].

    PubMed

    Zaffina, S; Camisa, V; Poscia, A; Tucci, M G; Montaldi, V; Cerabona, V; Wachocka, M; Moscato, U

    2012-01-01

    Several studies have shown that occupational exposure to anesthetic gases might be higher during pediatric surgery, probably due to the increased use of inhalational induction techniques. Our study aims to assess the level of exposure to sevoflurane in two rooms of pediatric surgery, using multi-point sampling method for environmental monitoring. The gas concentrations as well as its dispersion were measured in strategic points in the rooms for a total of 44 surgical interventions. Although the average of these concentrations has been rather low (1.32, SD +/- 1:55 ppm), the results obtained have documented a significant distribution kinetics difference inside the rooms as function of multiple factors among which there were the anesthetic technique used and the team involved. Therefore the method described allows to correctly analyze the spread of anesthetic gases and suggests a different risk stratification which may be dependent on the professional work.

  8. 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

  9. 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

  10. 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.

  11. Room temperature continuous wave operation in a photonic crystal microcavity laser with a single layer of InAs/InP self-assembled quantum wires.

    PubMed

    Martínez, Luis Javier; Alén, Benito; Prieto, Ivan; Fuster, David; González, Luisa; González, Yolanda; Dotor, María Luisa; Postigo, Pablo Aitor

    2009-08-17

    We present continuous wave laser emission in a photonic crystal microcavity operating at 1.5 microm at room temperature. The structures have been fabricated in an InP slab including a single layer of self-assembled InAs/InP quantum wires (QWrs) as active material. Laser emission in air suspended membranes with thresholds of effective optical pump power of 22 microW and quality factors up to 55000 have been measured.

  12. 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

  13. Obvious and Hidden Anxiety and the Related Factors in Operating Room Nurses Employed in General Hospital, Qazvin, Iran: A Cross-Sectional Study

    PubMed Central

    Kayalha, Hamid; Yazdi, Zohreh; Rastak, Shahram; Dizaniha, Mojtaba

    2013-01-01

    Background: Health promotion and security of manpower in a society is one of the pillars to progress a society. Anxiety, is the most common psychological disorder in societies and occupations like nursing, anesthesia technicians and operation room technicians. The aim of this study was to investigate prevalence of anxiety, and its severity in Iranian nurses working in operation room. Also, we determined the most important associated factors with anxiety. Methods: In this cross sectional study, 152 nurses working in operating room participated. The tool to gather the data was a questionnaire, that included three parts; demographic information, obvious anxiety questions and hidden anxiety questions of Spielburger. Obtained data was analysed with SPSS 16 software. Results: The majority of participants were females (94.7%) with experience at work less than 10 years (84.9%). The average scores of participants in obvious and hidden anxiety were 41.9±39.4 (range 20 to 75) and 39.4±8.2 (range 20 to 70), respectively. Anxiety level was significantly higher in females than males (P=0.04). The most prevalent cause of anxiety, was contact with infected biological factors (23% of nurses). The less important cause was concern about retirement (42.8% of nurses). Conclusion: Our results suggest that, anxiety disorders is prevalent in Iranian nurses working in public city hospitals, which warrants immediate programs for intervention to improve working situations in work place. PMID:24171889

  14. CW room temperature operation of praseodymium-doped fluorozirconate glass fibre lasers in the blue-green, green and red spectral regions

    NASA Astrophysics Data System (ADS)

    Smart, R. G.; Carter, J. N.; Tropper, A. C.; Hanna, D. C.; Davey, S. T.; Carter, S. F.; Szebesta, D.

    1991-11-01

    We report room temperature, continuous-wave oscillation of Pr 3+-doped fluorozirconate fibre lasers at around 491 nm, 520 nm, 605 nm, 635 nm and 715 nm. An output power of 250 mW has been obtained 635 nm for 800 mW of pump power from an argon ion laser operating at 476.5 nm. Tunable operation of the red transitions has been investigated, with output powers in excess of 30 mW being obtained. Q-switched pulses of 75 ns (fwhm) and 20 W peak power at 635 nm have also been generated.

  15. Room temperature continuous wave operation of InAs/GaAs quantum dot photonic crystal nanocavity laser on silicon substrate.

    PubMed

    Tanabe, Katsuaki; Nomura, Masahiro; Guimard, Denis; Iwamoto, Satoshi; Arakawa, Yasuhiko

    2009-04-27

    Room temperature, continuous-wave lasing in a quantum dot photonic crystal nanocavity on a Si substrate has been demonstrated by optical pumping. The laser was an air-bridge structure of a two-dimensional photonic crystal GaAs slab with InAs quantum dots inside on a Si substrate fabricated through wafer bonding and layer transfer. This surface-emitting laser exhibited emission at 1.3 microm with a threshold absorbed power of 2 microW, the lowest out of any type of lasers on silicon.

  16. Multiwavelength erbium-doped fiber ring laser employing Fabry-Perot etalon inside cavity operating in room temperature

    NASA Astrophysics Data System (ADS)

    Yeh, C. H.; Chow, C. W.; Wu, Y. F.; Shih, F. Y.; Wang, C. H.; Chi, S.

    2009-08-01

    In this investigation, we propose and demonstrate a simple and cost-effective erbium-doped fiber (EDF) ring laser using a Fabry-Perot etalon inside a linear cavity and employing the accurate fiber cavity length to satisfy the least common multiple number for generating multiwavelength in C-band at room temperature. Furthermore, the center wavelength of the lasing wavelength bands can be adjusted to 1541.02, 1551.32, and 1562.03 nm, respectively. The wavelength separation in each wavelength band is 0.34 nm. Moreover, the output stability of the multiwavelength laser has also been discussed and analyzed.

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

    NASA Astrophysics Data System (ADS)

    Lan, Rong; Xu, Xiaoxiang; Tao, Shanwen; Irvine, John T. S.

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

  18. Role of hybrid operating room in surgery for the right atrial thrombus, pulmonary thrombi, and ventricular septal rupture after myocardial infarction

    PubMed Central

    Singh, Ajmer; Mehta, Yatin; Parakh, Rajiv; Kohli, Vijay; Trehan, Naresh

    2016-01-01

    Free-floating right heart thrombi are uncommon and need emergency treatment in view of their tendency to dislodge and cause pulmonary embolism. We report a successful surgical management of a patient who had large mobile right atrial thrombus, bilateral pulmonary thrombi, coronary artery disease, and postmyocardial infarction ventricular septal rupture (VSR). The patient underwent coronary angiography, inferior vena cava filter placement, removal of thrombi from the right atrium and pulmonary arteries, repair of VSR, and coronary artery bypass graft surgery in a hybrid operating room. PMID:27716704

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

    PubMed Central

    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 32% to 64% and 31% to 70% between baseline and treatment phases in the inpatient and outpatient surgery units, respectively. Five-month follow-up data suggested maintenance of treatment effects. These findings suggest the utility of organizational behavior management strategies in reducing risky behavior in hospital settings. PMID:18189098

  20. 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.

  1. 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.

  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. 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.

  4. 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.

  5. 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

  6. 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.

  7. High-Sensitivity InAsSb Photoconductors with a Response Wavelength Range of 2-9 μm Operated at Room Temperature

    NASA Astrophysics Data System (ADS)

    Gao, Yu Zhu; Gong, Xiu Ying; Fang, Wei Zheng; Wu, Guang Hui; Feng, Yan Bin

    2009-08-01

    InAsSb immersion photoconductors with a response wavelength range of 2-9 μm operated at room temperature were reported. The detectors are based on InAsSb single crystals grown on InAs substrates by melt epitaxy (ME). Van der Pauw measurements showed that the 300 K electron mobilities of InAsSb materials are higher than 5× 104 cm2 V-1 s-1 with carrier densities of (1--3)× 1016 cm-3. The photoconductors were measured using a standard blackbody source at a temperature of 500 K and a modulation frequency of 800 Hz under an applied bias current of 10 mA. At 293 K, the blackbody detectivity Dbb{}* (500 K, 800) reaches (2--6)× 108 cm Hz1/2 W-1, indicating the high sensitivity of the detectors and their potential detection applications.

  8. 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.

  9. 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.

  10. Adjusting team involvement: a grounded theory study of challenges in utilizing a surgical safety checklist as experienced by nurses in the operating room

    PubMed Central

    2012-01-01

    Background Even though the use of perioperative checklists have resulted in significant reduction in postoperative mortality and morbidity, as well as improvements of important information communication, the utilization of checklists seems to vary, and perceived barriers are likely to influence compliance. In this grounded theory study we aimed to explore the challenges and strategies of performing the WHO’s Safe Surgical Checklist as experienced by the nurses appointed as checklist coordinators. Methods Grounded theory was used in gathering and analyzing data from observations of the checklist used in the operating room, in conjunction with single and focus group interviews. A purposeful sample of 14 nurse-anesthetists and operating room nurses as surgical team members in a tertiary teaching hospital participated in the study. Results The nurses’ main concern regarding checklist utilization was identified as “how to obtain professional and social acceptance within the team”. The emergent grounded theory of “adjusting team involvement” consisted of three strategies; distancing, moderating and engaging team involvement. The use of these strategies explains how they resolved their challenges. Each strategy had corresponding conditions and consequences, determining checklist compliance, and how the checklist was used. Conclusion Even though nurses seem to have a loyal attitude towards the WHO’s checklist regarding their task work, they adjusted their surgical team involvement according to practical, social and professional conditions in their work environment. This might have resulted in the incomplete use of the checklist and therefore a low compliance rate. Findings also emphasized the importance of: a) management support when implementing WHO’s Safe Surgical Checklist, and b) interprofessional education approach to local adaptation of the checklists use. PMID:22958326

  11. [X-ray in trauma and orthopedic surgery. Physical and biological impact, reasonable use, and radiation protection in the operating room].

    PubMed

    Dresing, K

    2011-02-01

    Orthopedic and especially trauma surgeons' use of x-rays during operations vary extensively, especially in minimally invasive osteosynthesis procedures. Radiation hazards often are neglected. In this paper, a short overview of physical and biological effects of radiation are given. In addition, practical information about how to lower radiation exposure in the daily work in the operating room (OR) is given. The operating team is exposed mainly to scattered radiation. The radiation exposure is 10 times higher on the tube side than on the amplifier side. The distance between tube and surgeon must be as great as possible. The tube should be positioned under the OR table, and the distance between tube and patient should be as short as possible. The positioning of the C-arm device without radiation is important. The use of patient landmarks is used to position the C-arm over the region of interest, but the preoperative training of surgeons and team with virtual learning tools, e.g., virtX, is very effective in reducing radiation hazards.

  12. 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

  13. 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

  14. 7. VIEW OF SLC3W CONTROL ROOM (ROOM 105) FROM ITS ...

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

    7. VIEW OF SLC-3W CONTROL ROOM (ROOM 105) FROM ITS SOUTHWEST CORNER. NOTE RAISED FLATFORM IN CENTER OF ROOM. - Vandenberg Air Force Base, Space Launch Complex 3, Launch Operations Building, Napa & Alden Roads, Lompoc, Santa Barbara County, CA

  15. 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

  16. 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

  17. 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.

  18. 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)

  19. Locker-Room Talk.

    ERIC Educational Resources Information Center

    Lowe, Jason; Noyes, Brad

    1999-01-01

    Explains how proper athletic facility locker-room design can save time and money. Design factors that address who will be using the facility are discussed as are user requirements, such as preparation areas, total storage area per user, grooming area, and security areas. Final comments address maintenance and operations issues. (GR)

  20. The use of a virtual reality surgical simulator for cataract surgical skill assessment with 6 months of intervening operating room experience

    PubMed Central

    Sikder, Shameema; Luo, Jia; Banerjee, P Pat; Luciano, Cristian; Kania, Patrick; Song, Jonathan C; Kahtani, Eman S; Edward, Deepak P; Towerki, Abdul-Elah Al

    2015-01-01

    Purpose To evaluate a haptic-based simulator, MicroVisTouch™, as an assessment tool for capsulorhexis performance in cataract surgery. The study is a prospective, unmasked, nonrandomized dual academic institution study conducted at the Wilmer Eye Institute at Johns Hopkins Medical Center (Baltimore, MD, USA) and King Khaled Eye Specialist Hospital (Riyadh, Saudi Arabia). Methods This prospective study evaluated capsulorhexis simulator performance in 78 ophthalmology residents in the US and Saudi Arabia in the first round of testing and 40 residents in a second round for follow-up. Results Four variables (circularity, accuracy, fluency, and overall) were tested by the simulator and graded on a 0–100 scale. Circularity (42%), accuracy (55%), and fluency (3%) were compiled to give an overall score. Capsulorhexis performance was retested in the original cohort 6 months after baseline assessment. Average scores in all measured metrics demonstrated statistically significant improvement (except for circularity, which trended toward improvement) after baseline assessment. A reduction in standard deviation and improvement in process capability indices over the 6-month period was also observed. Conclusion An interval objective improvement in capsulorhexis skill on a haptic-enabled cataract surgery simulator was associated with intervening operating room experience. Further work investigating the role of formalized simulator training programs requiring independent simulator use must be studied to determine its usefulness as an evaluation tool. PMID:25653496

  1. Theoretical and experimental investigations of a diode-pumped high-power continuous-wave 912 nm Nd:GdVO 4 laser operation at room temperature

    NASA Astrophysics Data System (ADS)

    Chen, Fei; Yu, Xin; Li, Xudong; Yan, Renpeng; Wang, Cheng; Luo, Ming; Peng, Jiangbo; Zhang, Zhonghua; Yu, Junhua

    2010-10-01

    Based on the rate equation of Nd 3+-doped quasi-three-level lasers, a theoretical model of diode-end-pumped continuous-wave 912 nm Nd:GdVO 4 laser is presented. Lasing threshold and slope efficiency considering reabsorption effect are calculated and analyzed. It is found that the output performance of 912 nm laser operating at room temperature is influenced remarkably by the reabsorption loss and spatial distribution of the pump beam and laser beam. In experiments, the output power and average slope efficiency of 912 nm laser were investigated under different conditions. After optimization at the parameters of laser medium, working temperature and spatial distribution of the pump beam, up to 16.2 W continuous-wave 912 nm laser output was obtained at incident pump power of 67.0 W, with an average slope efficiency of 41.7%, to the best of our knowledge, this is the highest output power of diode-pumped 912 nm Nd:GdVO 4 laser by far.

  2. 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.

  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. PMID:26925897

  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.

  5. 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

    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.

  6. 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

  7. 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.

  8. Schottky junctions on semi-insulating LEC gallium arsenide for X- and {gamma}-ray spectrometers operated at and below room temperature

    SciTech Connect

    Bertuccio, G.; Pullia, A. |; Canali, C. |; Nava, F. |; Lanzieri

    1997-04-01

    This work deals with the study of a Schottky junction used as an X- and {gamma}-ray detector in a spectrometer operated in the temperature range from {minus}30 C to +22 C. The device, fabricated on liquid encapsulated Czochralski (LEC) semi-insulating Gallium Arsenide, is designed with a noninjecting ohmic contact which allows biasing voltages up to 550 V. At room temperature (22 C) the energy resolution is found to be relatively poor (15.5-keV full-width at half-maximum (FWHM) at 59.5 keV) due to the large junction reverse current, whose density is within the typical values for Schottky junctions on SI LEC GaAs. By cooling of the detector to {minus}30 C, the noise of the reverse current is drastically lowered, thus achieving electronic noise levels around 160--180 rms electrons. At 500-V bias, the {sup 241}Am spectrum has been resolved down to an energy of 4 keV with charge collection efficiency of cce = 97% and a resolution of about 2-keV FWHM for the Np L lines and 2.4-keV FWHM for the 59.5-keV {gamma} photons. The linearity of the detector has been measured to be better than {+-}0.6% within the explored energy range (14--59 keV). From the experimental spectra, it has been analyzed how either the electronic noise or the trapping of the signal charge contribute to the energy resolution of the spectrometer. The result is that despite the high measured cce, the trapping gives a contribution higher than 1.5 keV FWHM for the 59.5-keV spectral line. A comparison between the experimental results and Monte Carlo simulations, based on the Hecht model of charge trapping in detectors, is shown to give a satisfactory justification of the observed phenomena.

  9. Decision support using anesthesia information management system records and accreditation council for graduate medical education case logs for resident operating room assignments.

    PubMed

    Wanderer, Jonathan P; Charnin, Jonathan; Driscoll, William D; Bailin, Michael T; Baker, Keith

    2013-08-01

    Our goal in this study was to develop decision support systems for resident operating room (OR) assignments using anesthesia information management system (AIMS) records and Accreditation Council for Graduate Medical Education (ACGME) case logs and evaluate the implementations. We developed 2 Web-based systems: an ACGME case-log visualization tool, and Residents Helping in Navigating OR Scheduling (Rhinos), an interactive system that solicits OR assignment requests from residents and creates resident profiles. Resident profiles are snapshots of the cases and procedures each resident has done and were derived from AIMS records and ACGME case logs. A Rhinos pilot was performed for 6 weeks on 2 clinical services. One hundred sixty-five requests were entered and used in OR assignment decisions by a single attending anesthesiologist. Each request consisted of a rank ordered list of up to 3 ORs. Residents had access to detailed information about these cases including surgeon and patient name, age, procedure type, and admission status. Success rates at matching resident requests were determined by comparing requests with AIMS records. Of the 165 requests, 87 first-choice matches (52.7%), 27 second-choice matches (16.4%), and 8 third-choice matches (4.8%) were made. Forty-three requests were unmatched (26.1%). Thirty-nine first-choice requests overlapped (23.6%). Full implementation followed on 8 clinical services for 8 weeks. Seven hundred fifty-four requests were reviewed by 15 attending anesthesiologists, with 339 first-choice matches (45.0%), 122 second-choice matches (16.2%), 55 third-choice matches (7.3%), and 238 unmatched (31.5%). There were 279 overlapping first-choice requests (37.0%). The overall combined match success rate was 69.4%. Separately, we developed an ACGME case-log visualization tool that allows individual resident experiences to be compared against case minimums as well as resident peer groups. We conclude that it is feasible to use ACGME case

  10. An investigation on occupational stress of the operating room staffs in hospitals affiliated to Isfahan University of Medical Sciences and its association with some factors

    PubMed Central

    Bakhtiari, Soheila; Mehrabi, Tayebeh; Hasanzadeh, Akbar

    2013-01-01

    Background: Stress is a nonspecific reaction to everything the body needs. Although occupational stress exists in every occupation, it is seen with more frequency and intensity amongst those occupations related to human health. In this study, we aimed to investigate the level of occupational stress in operating room staffs working in the hospitals affiliated to Isfahan University of Medical Sciences and its association with some factors. Materials and Methods: This is a descriptive co-relational study conducted in summer 2010. The population studied comprised 100 OP staffs working in hospitals affiliated to Isfahan University of Medical Sciences. The data were collected by a questionnaire including two sections of personal information and Toft-Anderson Standard occupational stress inventory. The first section contained 13 questions and the second included 34 questions on stressful factors, measured through Likert's scale in which the scores of 0-33 indicated mild stress, 34-66 indicated moderate stress, and 67-100 indicated acute stress. The data were analyzed through SPSS. The statistical tests of Pearson correlation, variance analysis, and independent t-test were employed to analyze the data (P < 0 0.05 was considered significant). Results: Based on the findings, mean score of staffs’ stress (out of 100) was 32.3 (12.9) and was in the range of 1-65. The highest frequencies were for mild stress (57.4%) and moderate stress (42.6). In addition, mean score of stress was not the same in different domains. There was a significant inverse association between the score of stress and monthly working hours (r = -0.21, P = 0.049). Mean score of stress was 28.1 (12.3) among those with average income and 33.8 (12.8) for the low-income subjects, showing a significant difference (P = 0.048). Discussion and Conclusion: The present study showed that most of the subjects suffer from mild stress. Since the highest level of stress was for work overload, it is suggested to reduce

  11. Decision support using anesthesia information management system records and accreditation council for graduate medical education case logs for resident operating room assignments.

    PubMed

    Wanderer, Jonathan P; Charnin, Jonathan; Driscoll, William D; Bailin, Michael T; Baker, Keith

    2013-08-01

    Our goal in this study was to develop decision support systems for resident operating room (OR) assignments using anesthesia information management system (AIMS) records and Accreditation Council for Graduate Medical Education (ACGME) case logs and evaluate the implementations. We developed 2 Web-based systems: an ACGME case-log visualization tool, and Residents Helping in Navigating OR Scheduling (Rhinos), an interactive system that solicits OR assignment requests from residents and creates resident profiles. Resident profiles are snapshots of the cases and procedures each resident has done and were derived from AIMS records and ACGME case logs. A Rhinos pilot was performed for 6 weeks on 2 clinical services. One hundred sixty-five requests were entered and used in OR assignment decisions by a single attending anesthesiologist. Each request consisted of a rank ordered list of up to 3 ORs. Residents had access to detailed information about these cases including surgeon and patient name, age, procedure type, and admission status. Success rates at matching resident requests were determined by comparing requests with AIMS records. Of the 165 requests, 87 first-choice matches (52.7%), 27 second-choice matches (16.4%), and 8 third-choice matches (4.8%) were made. Forty-three requests were unmatched (26.1%). Thirty-nine first-choice requests overlapped (23.6%). Full implementation followed on 8 clinical services for 8 weeks. Seven hundred fifty-four requests were reviewed by 15 attending anesthesiologists, with 339 first-choice matches (45.0%), 122 second-choice matches (16.2%), 55 third-choice matches (7.3%), and 238 unmatched (31.5%). There were 279 overlapping first-choice requests (37.0%). The overall combined match success rate was 69.4%. Separately, we developed an ACGME case-log visualization tool that allows individual resident experiences to be compared against case minimums as well as resident peer groups. We conclude that it is feasible to use ACGME case

  12. Initial experience in the treatment of thoracic aortic aneurysmal disease with a thoracic aortic endograft at Baylor University Medical Center

    PubMed Central

    Apple, Jeffrey; McQuade, Karen L.; Hamman, Baron L.; Hebeler, Robert F.; Shutze, William P.

    2008-01-01

    A retrospective review of 27 patients who underwent endovascular repair of thoracic aneurysms and of other thoracic aortic pathology with the thoracic aortic endograft (Gore Medical, Flagstaff, AZ) from June 2005 to July 2007 was performed. The mean follow-up period was 13.5 months (range, 2–25 months). Indications for thoracic endografting included descending thoracic aneurysms (n = 18), thoracoabdominal aneurysms (n = 3), traumatic aortic injuries (n = 3), penetrating aortic ulcers (n = 2), and contained rupture of a type B dissection (n = 1). One patient died during the procedure, for an overall mortality rate of 3.7%. The average length of stay was 8.1 days, with an average stay in the intensive care unit of 4.2 days. If patients with traumatic aortic injuries were excluded, the average overall and intensive care unit length of stay were 5.6 and 1.8 days, respectively. There was one incident of spinal cord ischemia (3.7%). There were five type I or type III endoleaks, three of which required revision (11.1%). In conclusion, thoracic endografting is a safe and viable option for the repair of descending thoracic aneurysms and other aortic pathologies. We have found it to be less invasive, even in conjunction with preoperative debranching procedures, with a shorter recovery time, decreased perioperative morbidity and blood loss, and decreased peri-operative mortality compared with standard open repair. PMID:18382748

  13. 6. VIEW OF SLC3W CONTROL ROOM (ROOM 105) FROM ITS ...

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

    6. VIEW OF SLC-3W CONTROL ROOM (ROOM 105) FROM ITS SOUTHEAST CORNER - Vandenberg Air Force Base, Space Launch Complex 3, Launch Operations Building, Napa & Alden Roads, Lompoc, Santa Barbara County, CA

  14. 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

  15. 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.

  16. 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

  17. Room-temperature continuous-wave operation of GaN-based vertical-cavity surface-emitting lasers with n-type conducting AlInN/GaN distributed Bragg reflectors

    NASA Astrophysics Data System (ADS)

    Ikeyama, Kazuki; Kozuka, Yugo; Matsui, Kenjo; Yoshida, Shotaro; Akagi, Takanobu; Akatsuka, Yasuto; Koide, Norikatsu; Takeuchi, Tetsuya; Kamiyama, Satoshi; Iwaya, Motoaki; Akasaki, Isamu

    2016-10-01

    The room-temperature continuous-wave operation of a 1.5λ-cavity GaN-based vertical-cavity surface-emitting laser with an n-type conducting AlInN/GaN distributed Bragg reflector (DBR) was achieved. A peak reflectivity of over 99.9% was obtained in the n-type conducting AlInN/GaN DBR so that the current was injected through the DBR for the operation. The threshold current was 2.6 mA, corresponding to the threshold current density of 5.2 kA/cm2, and the operating voltage was 4.7 V. A lasing spectrum with a peak wavelength of 405.1 nm and a full-width at half maximum of 0.08 nm was also observed.

  18. 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

  19. 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

  20. 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.

  1. A charge-density-wave oscillator based on an integrated tantalum disulfide–boron nitride–graphene device operating at room temperature

    NASA Astrophysics Data System (ADS)

    Liu, Guanxiong; Debnath, Bishwajit; Pope, Timothy R.; Salguero, Tina T.; Lake, Roger K.; Balandin, Alexander A.

    2016-10-01

    The charge-density-wave (CDW) phase is a macroscopic quantum state consisting of a periodic modulation of the electronic charge density accompanied by a periodic distortion of the atomic lattice in quasi-1D or layered 2D metallic crystals. Several layered transition metal dichalcogenides, including 1T-TaSe2, 1T-TaS2 and 1T-TiSe2 exhibit unusually high transition temperatures to different CDW symmetry-reducing phases. These transitions can be affected by the environmental conditions, film thickness and applied electric bias. However, device applications of these intriguing systems at room temperature or their integration with other 2D materials have not been explored. Here, we demonstrate room-temperature current switching driven by a voltage-controlled phase transition between CDW states in films of 1T-TaS2 less than 10 nm thick. We exploit the transition between the nearly commensurate and the incommensurate CDW phases, which has a transition temperature of 350 K and gives an abrupt change in current accompanied by hysteresis. An integrated graphene transistor provides a voltage-tunable, matched, low-resistance load enabling precise voltage control of the circuit. The 1T-TaS2 film is capped with hexagonal boron nitride to provide protection from oxidation. The integration of these three disparate 2D materials in a way that exploits the unique properties of each yields a simple, miniaturized, voltage-controlled oscillator suitable for a variety of practical applications.

  2. 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.

  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. 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.

  5. 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.

  6. 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.

  7. 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.

  8. 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.

  9. 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

  10. 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.

  11. Intra-operative 3.0 T magnetic resonance imaging using a dual-independent room: long-term evaluation of time-cost, problems, and learning-curve effect.

    PubMed

    Martin, X Pablos; Vaz, G; Fomekong, E; Cosnard, G; Raftopoulos, C

    2011-01-01

    We present a short and comprehensive report of our 39-month experience using a 3.0 T intra-operative magnetic resonance imaging (ioMRI) neurosurgical-MR twin room, including a description of the problems encountered and the associated time-delays. Forty-seven problems were experienced during the 189 ioMRI procedures (two ioMRI were performed in five of the 184 surgical procedures) performed in the 39-month period, including a blocked transfer table, failure of anesthetic monitoring material, and specific MRI-related problems, such as head and coil positioning difficulties, artefacts, coil malfunctions and other technical difficulties. None of these problems prevented the ioMRI procedure from taking place or affected image interpretation, but they sometimes caused a significant delay. Fifteen (32%) of these problems occurred during the initial learning curve period. The mean duration of the ioMRI procedure was 75 min, which decreased slightly with experience, although an average waiting-for-access time of 24 min could not be avoided. These results illustrate that although performing ioMRI at 3.0 T with the dual room is a challenging procedure, it remains safe and feasible and associated with only minor dysfunctions while offering optimal image quality and standard surgical conditions.

  12. Locker Room Design Trends.

    ERIC Educational Resources Information Center

    Wiens, Janet

    2001-01-01

    Examines how today's college and university athletic locker rooms have become sophisticated recruiting tools that rival many professional facilities. Locker room design and location and their level of furniture, finishes, and equipment are discussed as is the trend for more environmentally friendly locker rooms. (GR)

  13. 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

  14. 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

  15. 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.

  16. Multi-step interrupted-growth MBE technology for GaAs/AlGaAs (˜9.4 μm) room temperature operating quantum-cascade lasers

    NASA Astrophysics Data System (ADS)

    Kosiel, K.; Kubacka-Traczyk, J.; Sankowska, I.; Szerling, A.; Gutowski, P.; Bugajski, M.

    2012-09-01

    In order to adjust the highly controllable and optimum growth conditions, the multi-step interrupted-growth MBE processes were performed to deposit a series of GaAs/Al0.45Ga0.55As QCL structures. The additional calibrations of MBE system were carried out during the designed growth interruptions. This solution was combined with a relatively low growth rate of active region layers, in order to suppress the negative effects of elemental flux instabilities. As a result, the fabricated QCL structures have yielded devices operating with peak optical power of ˜12 mW at room temperature. That is a better result than was obtained for comparable structures deposited with a growth rate kept constant, and with the only initial calibrations performed just before the epitaxy of the overall structure.

  17. Development of a spectrometer using a continuous wave distributed feedback quantum cascade laser operating at room temperature for the simultaneous analysis of N2O and CH4 in the Earth's atmosphere.

    PubMed

    Joly, Lilian; Robert, Claude; Parvitte, Bertrand; Catoire, Valery; Durry, Georges; Richard, Guy; Nicoullaud, Bernard; Zéninari, Virginie

    2008-03-20

    We report on the development and performance of a gas sensor based on a distributed feedback quantum cascade laser operating in continuous wave at room temperature for simultaneous measurement of nitrous oxide (N(2)O) and methane (CH(4)) concentrations at ground level. The concentrations of the gases are determined by a long path infrared diode laser absorption spectroscopy. The long-term stability of the instrument is evaluated using the Allan variance technique. A preliminary evaluation of the instrument performance is realized by in situ measurements of N(2)O and CH(4) concentrations at ground level during 1 day. The sensor has also been applied to study the time response of N(2)O concentrations to a fertilizer addition in a soil sample and for the comparison between various types of soils.

  18. 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)

  19. 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

  20. 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

  1. 9 CFR 354.241 - Cleaning of rooms and compartments.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... skinning room shall be kept clean and free from offensive odors at all times. (g) The walls, floors, 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...

  2. 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

  3. 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... written control room management procedures that implement the requirements of this section. The...

  4. Virtual Reality Simulation for the Operating Room

    PubMed Central

    Gallagher, Anthony G.; Ritter, E Matt; Champion, Howard; Higgins, Gerald; Fried, Marvin P.; Moses, Gerald; Smith, C Daniel; Satava, Richard M.

    2005-01-01

    Summary Background Data: To inform surgeons about the practical issues to be considered for successful integration of virtual reality simulation into a surgical training program. The learning and practice of minimally invasive surgery (MIS) makes unique demands on surgical training programs. A decade ago Satava proposed virtual reality (VR) surgical simulation as a solution for this problem. Only recently have robust scientific studies supported that vision Methods: A review of the surgical education, human-factor, and psychology literature to identify important factors which will impinge on the successful integration of VR training into a surgical training program. Results: VR is more likely to be successful if it is systematically integrated into a well-thought-out education and training program which objectively assesses technical skills improvement proximate to the learning experience. Validated performance metrics should be relevant to the surgical task being trained but in general will require trainees to reach an objectively determined proficiency criterion, based on tightly defined metrics and perform at this level consistently. VR training is more likely to be successful if the training schedule takes place on an interval basis rather than massed into a short period of extensive practice. High-fidelity VR simulations will confer the greatest skills transfer to the in vivo surgical situation, but less expensive VR trainers will also lead to considerably improved skills generalizations. Conclusions: VR for improved performance of MIS is now a reality. However, VR is only a training tool that must be thoughtfully introduced into a surgical training curriculum for it to successfully improve surgical technical skills. PMID:15650649

  5. Bullet retrieval in the operating room.

    PubMed

    Hanshaw, S L

    1994-10-01

    Valuable trace evidence is often lost or destroyed because of faulty collection and preservation techniques during surgical management of gunshot wounds. An experiment was conducted to show the importance of proper collection techniques and preservation of forensic evidence. Results are noted, a discussion is given, and a protocol for the surgical retrieval of bullets is presented.

  6. MEDISIGN: Educating designers for the operating room.

    PubMed

    Goossens; Lange; Kleinrensink

    2004-06-01

    One of the interesting things about medical technology is that it addresses so many diverse subjects, which is indeed the case in all departments of a hospital, in general practice and in other care agencies. Medical technology contributes to the diagnosis, treatment and prevention of disease and disorders. Designing for medical applications demands a high level of creativity and inventivity, both in low-tech and in high-tech applications. In over 200 projects with hospitals and companies in the medical field the Delft industrial designer has therefore played an important part in designing innovative products [1]. In the new program Medisign the expertise and networks that have been built up in this area over the past 20 years are being passed on to students. The program is based upon the idea that education of engineers in human anatomy, physiology, medical technoloy, health care systems and even basic surgical techniques will lead to better communication with the medical professionals and to better design solutions in this area. To our knowledge this is the first initiative in Europe in which structural education in anatomy is offered to industrial design engineers.

  7. 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)

  8. 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.

  9. Music practice rooms

    NASA Astrophysics Data System (ADS)

    Lamberty, D. C.

    1980-03-01

    A study of users, requirements and preferences for music practice rooms is described. Analysis of the subjective and objective information obtained provides guide lines for the design of such rooms. The study has shown that, ideally, the requirements for different users and different instruments vary, but there are broad areas of agreement so that satisfactory designs are often possible.

  10. 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.

  11. 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

  12. 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

  13. Men's toilet (room 207, representing rooms 306, 406, and 506; ...

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

    Men's toilet (room 207, representing rooms 306, 406, and 506; also women's toilets, rooms 102, 104, 204, 204A, 303, 403, and 503), looking north. - California State Office Building No. 1, 915 Capitol Mall, Sacramento, Sacramento County, CA

  14. Secondary entrance corridor (room 120, representing room 121), looking west ...

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

    Secondary entrance corridor (room 120, representing room 121), looking west (bearing 270) from elevator lobby - California State Office Building No. 1, 915 Capitol Mall, Sacramento, Sacramento County, CA

  15. Polariton condensates at room temperature

    NASA Astrophysics Data System (ADS)

    Guillet, Thierry; Brimont, Christelle

    2016-10-01

    We review the recent developments of the polariton physics in microcavities featuring the exciton-photon strong coupling at room temperature, and leading to the achievement of room-temperature polariton condensates. Such cavities embed active layers with robust excitons that present a large binding energy and a large oscillator strength, i.e. wide bandgap inorganic or organic semiconductors, or organic molecules. These various systems are compared, in terms of figures of merit and of common features related to their strong oscillator strength. The various demonstrations of polariton laser are compared, as well as their condensation phase diagrams. The room-temperature operation indeed allows a detailed investigation of the thermodynamic and out-of-equilibrium regimes of the condensation process. The crucial role of the spatial dynamics of the condensate formation is discussed, as well as the debated issue of the mechanism of stimulated relaxation from the reservoir to the condensate under non-resonant excitation. Finally the prospects of polariton devices are presented.

  16. '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.

  17. 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...

  18. Room-temperature continuous-wave operation of the In(Ga)As/GaAs quantum-dot VCSELs for the 1.3 µm optical-fibre communication

    NASA Astrophysics Data System (ADS)

    Xu, Dawei; Tong, Cunzhu; Yoon, Soon Fatt; Fan, Weijun; Zhang, Dao Hua; Wasiak, Michał; Piskorski, Łukasz; Gutowski, Krzysztof; Sarzała, Robert P.; Nakwaski, Włodzimierz

    2009-05-01

    Efficient room-temperature (RT) continuous-wave (CW) lasing operation of the 1.3 µm MBE (molecular-beam epitaxy) In(Ga)As/GaAs quantum-dot (QD) top-emitting oxide-confined vertical-cavity surface-emitting diode lasers (VCSELs) for the second-generation optical-fibre communication has been achieved. In their design, a concept of a QD inside a quantum well (QW) has been utilized. The proposed In(Ga)As/GaAs QD active region is composed of five groups of three 8 nm In0.15Ga0.85As QWs, each containing one InAs QD sheet layer. In each group located close to successive anti-node positions of the optical standing wave within the 3λ cavity, QWs are separated by 32 nm GaAs barriers. Besides, at both active-region edges, additional single InGaAs QWs are located containing single QD layers. For the 10 µm diameter QD VCSELs, the RT CW threshold current of only 6.2 mA (7.9 kA cm-2), differential efficiency of 0.11 W A-1 and the maximal output power of 0.85 mW have been recorded. The experimental characteristics are in excellent agreement with theoretical ones obtained using the optical-electrical-thermal-recombination self-consistent computer model. According to this, for the 10 µm devices, the fundamental linearly polarized LP01 mode remains the dominating one up to the current of 9.1 mA. The lowest RT CW lasing threshold below 5 mA is expected for 6 µm devices.

  19. Test Room Stability Plan

    SciTech Connect

    Not Available

    1993-01-01

    This plan documents the combination of designs, installations, programs, and activities that ensures that the underground excavations at the Waste Isolation Pilot Plant (WIPP), in which transuranic (TRU) waste may be emplaced during the Test Phase, will remain sufficiently stable and safe during that time. The current ground support systems installed at the WIPP are the result of over ten years of data collection from hundreds of geomechanical instruments and thousands of hours of direct observation of the changing conditions of the openings. In addition, some of the world's most respected experts on salt rock mechanics have provided input in the design process and concurrence on the suitability of the final design. The general mine rockbolt pattern and the ground support system for the test rooms are designed to specifically address the fracture and deformation geometries observed today at the WIPP. After an introductory chapter, this plan describes the general underground design, then proceeds to an account of general ground support performance, and finally focuses on the details of the special test room ground support systems. One such system already installed in Room 1, Panel 1, is described in comprehensive detail. Other test rooms in Panel 1, whether full-size or smaller, will be equipped with systems that ensure stability to the same or equivalent extent. They will benefit from the experience gained in the first test room, which in turn benefitted from the data and knowledge accumulated during previous stages (e.g., the Site and Preliminary Design Validation program) of the project.

  20. Staff corridor (room 206, representing rooms 301, 305, 401, 405, ...

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

    Staff corridor (room 206, representing rooms 301, 305, 401, 405, 501, and 505), looking south towards the staff corridor vestibule (room 206A, representing rooms 305A, 405A, and 505A). - California State Office Building No. 1, 915 Capitol Mall, Sacramento, Sacramento County, CA

  1. 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

  2. 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)

  3. 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…

  4. Making Room for One

    ERIC Educational Resources Information Center

    Silva, Peggy

    2006-01-01

    In this article, the author shares the lesson she learned from her young friend, Mirabel, whose mother was dying. By following the daily path of support taken by Mirabel, she learned that it does not matter whether schools have a hundred kids, a thousand kids, or several thousand kids. Teachers must make sure that they can make room for each one.…

  5. 21 CFR 20.120 - Records available in Food and Drug Administration Public Reading Rooms.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... Public Reading Rooms. 20.120 Section 20.120 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF....120 Records available in Food and Drug Administration Public Reading Rooms. (a) The Food and Drug Administration operates two public reading rooms. The Division of Freedom of Information Public Reading Room...

  6. 21 CFR 20.120 - Records available in Food and Drug Administration Public Reading Rooms.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... Public Reading Rooms. 20.120 Section 20.120 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF....120 Records available in Food and Drug Administration Public Reading Rooms. (a) The Food and Drug Administration operates two public reading rooms. The Division of Freedom of Information Public Reading Room...

  7. 21 CFR 20.120 - Records available in Food and Drug Administration Public Reading Rooms.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... Public Reading Rooms. 20.120 Section 20.120 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF....120 Records available in Food and Drug Administration Public Reading Rooms. (a) The Food and Drug Administration operates two public reading rooms. The Freedom of Information Staff's Public Reading Room...

  8. 21 CFR 20.120 - Records available in Food and Drug Administration Public Reading Rooms.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... Public Reading Rooms. 20.120 Section 20.120 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF....120 Records available in Food and Drug Administration Public Reading Rooms. (a) The Food and Drug Administration operates two public reading rooms. The Division of Freedom of Information Public Reading Room...

  9. 21 CFR 20.120 - Records available in Food and Drug Administration Public Reading Rooms.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... Public Reading Rooms. 20.120 Section 20.120 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF....120 Records available in Food and Drug Administration Public Reading Rooms. (a) The Food and Drug Administration operates two public reading rooms. The Freedom of Information Staff's Public Reading Room...

  10. Test Room Stability Plan

    SciTech Connect

    Not Available

    1993-03-01

    This plan documents the combination of designs, installations, programs, and activities that ensures that the underground excavations at the Waste Isolation Pilot Plant (WIPP), in which transuranic (TRU) waste may be emplaced during the Test Phase, will remain sufficiently stable and safe during that time. The current ground support systems installed at the WIPP are the result of over ten years of data collection from hundreds of geomechanical instruments and thousands of hours of direct observation of the changing conditions of the openings. In addition, some of the world`s most respected experts on salt rock mechanics have provided input in the design process and concurrence on the suitability of the final design. The general mine rockbolt pattern and the ground support system for the test rooms are designed to specifically address the fracture and deformation geometries observed today at the WIPP. After an introductory chapter, this plan describes the general underground design, then proceeds to an account of general ground support performance, and finally focuses on the details of the special test room ground support systems. One such system already installed in Room 1, Panel 1, is described in comprehensive detail. Other test rooms in Panel 1, whether full-size or smaller, will be equipped with systems that ensure stability to the same or equivalent extent. They will benefit from the experience gained in the first test room, which in turn benefitted from the data and knowledge accumulated during previous stages (e.g., the Site and Preliminary Design Validation program) of the project.

  11. 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.

  12. The Technique of the Film Cutting Room.

    ERIC Educational Resources Information Center

    Walter, Ernest

    This book is more concerned with the "physical" in contrast to the "artistic" problems of the editing process. The functions of the editor and his assistants in relation to each stage in the production of a large-scale film are described in detail. All the routine operations of the editing room are discussed, from the receipt and documentation of…

  13. Priority coding for control room alarms

    DOEpatents

    Scarola, Kenneth; Jamison, David S.; Manazir, Richard M.; Rescorl, Robert L.; Harmon, Daryl L.

    1994-01-01

    Indicating the priority of a spatially fixed, activated alarm tile on an alarm tile array by a shape coding at the tile, and preferably using the same shape coding wherever the same alarm condition is indicated elsewhere in the control room. The status of an alarm tile can change automatically or by operator acknowledgement, but tones and/or flashing cues continue to provide status information to the operator.

  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. 23. Perimeter acquisition radar building room #202, mechanical equipment room ...

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

    23. Perimeter acquisition radar building room #202, mechanical equipment room no. 2 - Stanley R. Mickelsen Safeguard Complex, Perimeter Acquisition Radar Building, Limited Access Area, between Limited Access Patrol Road & Service Road A, Nekoma, Cavalier County, ND

  16. 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

  17. 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

  18. 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

  19. 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

  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. Console Room, looking southwesterly into Highbay Generator Room Beale ...

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

    Console Room, looking southwesterly into Highbay Generator Room - Beale Air Force Base, Perimeter Acquisition Vehicle Entry Phased-Array Warning System, Power Plant, End of Spencer Paul Road, north of Warren Shingle Road (14th Street), Marysville, Yuba County, CA

  2. 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

  3. 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

  4. LOOKING NORTHWEST FROM LIVING ROOM TOWARD DINING ROOM AT LEFT ...

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

    LOOKING NORTHWEST FROM LIVING ROOM TOWARD DINING ROOM AT LEFT AND FOYER AT RIGHT - Hamilton Field, Double Non-Commmissioned Officers' Quarters Type C, San Jose & Crescent Drives, Novato, Marin County, CA

  5. FACILITY 809, DINING ROOM WITH LIVING ROOM ON RIGHT, VIEW ...

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

    FACILITY 809, DINING ROOM WITH LIVING ROOM ON RIGHT, VIEW FACING NORTH-NORTHWEST. - Schofield Barracks Military Reservation, Corner-Entry Single-Family Housing Type, Between Hamilton & Tidball Streets, & between Williston & Ayres Avenues, Wahiawa, Honolulu County, HI

  6. FACILITY 713, DINING ROOM WITH LIVING ROOM IN LEFT BACKGROUND, ...

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

    FACILITY 713, DINING ROOM WITH LIVING ROOM IN LEFT BACKGROUND, VIEW FACING EAST. - Schofield Barracks Military Reservation, Central-Entry Single-Family Housing Type, Between Bragg & Grime Streets near Ayres Avenue, Wahiawa, Honolulu County, HI

  7. FACILITY 728, LIVING ROOM FROM DINING ROOM, OBLIQUE VIEW FACING ...

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

    FACILITY 728, LIVING ROOM FROM DINING ROOM, OBLIQUE VIEW FACING SOUTH. - Schofield Barracks Military Reservation, Corner-Entry Single-Family Housing Type, Between Bragg & Grime Streets near Williston Avenue, Wahiawa, Honolulu County, HI

  8. 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

  9. 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

  10. Living room toward dining room, bath, and bedroom of south ...

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

    Living room toward dining room, bath, and bedroom 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

  11. 7. October 1969 SOUTHWEST ROOM, FIRST FLOOR, 'CAPTAINS' ROOM' (Note: ...

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

    7. October 1969 SOUTHWEST ROOM, FIRST FLOOR, 'CAPTAINS' ROOM' (Note: Furnace has replaced pot-bellied stove, cribbage board on table) - William Rotch Warehouse, Main & South Water Streets, Nantucket, Nantucket County, MA

  12. [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

  13. [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.

  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. 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…

  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. 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

  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. 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.

  1. [Interdisciplinary emergency room - key to success?].

    PubMed

    Kirsch, M; Zahn, P; Happel, D; Gries, A

    2014-09-01

    In Germany, which is also faced with a scarcity of resources, the concept of central, interdisciplinary emergency rooms ("Zentrale Notfallaufnahme", ZNA) is being developed as an answer to the complex demands of modern emergency medicine with increasing numbers of patients and complexity of the medical conditions. This autonomous institution is the first point of contact for all emergency patients. The central tasks of the ZNA are triage and the interdisciplinary primary treatment of patients. The establishment of the ZNA includes specific facilities (treatment rooms, short stay units, resuscitation rooms, triage and management areas, integration of the premises on site) as well as specific processes (triage systems, specific standard operating procedures) and training for the staff (European Curriculum for Emergency Medicine). It could be shown that by establishing a ZNA along with all its structures the satisfaction of the patients (including shorter waiting times), resource management (intensive care capacity), and patient outcome could be significantly improved.

  2. 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…

  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. 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.

  5. 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

  6. 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

  7. 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

  8. 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

  9. 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

  10. Basement, room 23, looking southwest into two adjacent offices with ...

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

    Basement, room 23, looking southwest into two adjacent offices with soundproof walls and pedestal flooring - March Air Force Base, Strategic Air Command, Combat Operations Center, 5220 Riverside Drive, Moreno Valley, Riverside County, CA

  11. 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

  12. 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.

  13. 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.

  14. [Pollution of room air].

    PubMed

    Schlatter, J

    1986-01-01

    In the last decade the significance of indoor air pollution to human health has increased because of improved thermal insulation of buildings to save energy: air turnover is reduced and air quality is impaired. The most frequent air pollutants are tobacco smoke, radioactive radon gas emanating from the soil, formaldehyde from furniture and insulation material, nitrogen oxides from gas stoves, as well as solvents from cleaning agents. The most important pollutants leading to health hazards are tobacco smoke and air pollutants which are emitted continuously from building materials and furniture. Such pollutants have to be eliminated by reducing the emission rate. A fresh air supply is necessary to reduce the pollutants resulting from the inhabitants and their activities, the amount depending on the number of inhabitants and the usage of the room. The carbon dioxide level should not exceed 1500 ppm.

  15. 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.

  16. 40 CFR 62.15105 - Who must complete the operator training course? By when?

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... supervisors, and control room operators who have obtained full certification from the American Society of... supervisors, and control room operators who have obtained provisional certification from the American...

  17. 40 CFR 62.15105 - Who must complete the operator training course? By when?

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... supervisors, and control room operators who have obtained full certification from the American Society of... supervisors, and control room operators who have obtained provisional certification from the American...

  18. 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.

  19. 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

  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. 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

  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. 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

  4. 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

  5. 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

  6. 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

  7. 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

  8. Room temperature polyesterification

    SciTech Connect

    Moore, J.S.; Stupp, S.I. . Dept. of Materials Science and Engineering)

    1990-01-01

    A new room temperature polymerization method has been developed for the synthesis of high molecular weight polyesters directly from carboxylic acids and phenols. The solution polymerization reaction proceeds under mild conditions, near neutral pH, and also avoids the use of preactivated acid derivatives for esterification. The reaction is useful in the preparation of isoregic ordered chains with translational polar symmetry and also in the polymerization of functionalized or chiral monomers. The conditions required for polymerization in the carbodiimide-based reaction included catalysis by the 1:1 molecular complex formed by 4-(dimethylamino)pyridine and p-toluenesulfonic acid. These conditions were established through studies on a model system involving esterification of p-toluic acid and p-cresol. Self-condensation of several hydroxy acid monomers by this reaction has produced routinely good yields of polyesters with molecular weights greater than 15,000. It is believed that the high extents of reaction required for significant degrees of polymerization result from suppression of the side reaction leading to N-acylurea. The utility of this reaction in the formation of polar chains from sensitive monomers is demonstrated hereby the polycondensation of a chiral hydroxy acid.

  9. 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.

  10. 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.

  11. Display Developer for Firing Room Applications

    NASA Technical Reports Server (NTRS)

    Bowman, Elizabeth A.

    2013-01-01

    The firing room at Kennedy Space Center (KSC) is responsible for all NASA human spaceflight launch operations, therefore it is vital that all displays within the firing room be properly tested, up-to-date, and user-friendly during a launch. The Ground Main Propulsion System (GMPS) requires a number of remote displays for Vehicle Integration and Launch (VIL) Operations at KSC. My project is to develop remote displays for the GMPS using the Display Services and Framework (DSF) editor. These remote displays will be based on model images provided by GMPS through PowerPoint. Using the DSF editor, the PowerPoint images can be recreated with active buttons associated with the correct Compact Unique Identifiers (CUIs). These displays will be documented in the Software Requirements and Design Specifications (SRDS) at the 90% GMPS Design Review. In the future, these remote displays will be available for other developers to improve, edit, or add on to so that the display may be incorporated into the firing room to be used for launches.

  12. 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.

  13. 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

  14. 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

  15. 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

  16. 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.

  17. 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.

  18. 32 CFR 518.9 - Reading room.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 32 National Defense 3 2012-07-01 2009-07-01 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...

  19. 32 CFR 518.9 - Reading room.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 32 National Defense 3 2014-07-01 2014-07-01 false 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...

  20. 32 CFR 518.9 - Reading room.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 32 National Defense 3 2013-07-01 2013-07-01 false 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...