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Sample records for baylor operating room

  1. Trends in operating room devices.

    PubMed

    Laufman, H

    1976-01-01

    Although trends in the use of operating room devices have generally followed advances in technology, the trends are not always influenced as much by surgical need as they are by industrial expediency and commercial promotion. Nonetheless, a broad view of trends in OR devices definitely points to efforts at greater compatibility between devices made by different manufacturers. To mention a few examples, operating tables are being made more compatible with OR X-ray equipment; surgical lighting is being designed for greater compatibility with air-handling systems and video equipment; power consoles have reduced the clutter of tubes, hoses, and wires in complicated operations, and have become more functional in keeping with the trend away from electrical power and toward nitrogen power for driving surgical tools; cabinetry is being designed to employ clean-air principles; and surgical apparel and barrier materials are undergoing close scrutiny for their effectiveness against moist bacterial strike-through in lengthy wet operations. Operating room devices form an important segment of the devices classified by the FDA, and are expected to benefit by the application of standards in performance and safety. This trend will affect not only the devices themselves, but all other facets of operating room design and engineering.

  2. 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

  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 SOUTHEAST - 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. 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

  5. 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

  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. 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.

  8. Rethinking theatre in modern operating rooms.

    PubMed

    Riley, Robin; Manias, Elizabeth

    2005-03-01

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

  9. The Baylor pediatric nutrition handbook for residents

    Technology Transfer Automated Retrieval System (TEKTRAN)

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

  10. What Happens in the Operating Room? (For Kids)

    MedlinePlus

    ... Quizzes Kids' Dictionary of Medical Words En Español What Other Kids Are Reading Video: Am I Normal? ( ... Emergency Room? What Happens in the Operating Room? What Happens in the Operating Room? KidsHealth > For Kids > ...

  11. [The endoscopic operating room OR 1].

    PubMed

    Dubuisson, J B; Chapron, C

    2003-04-01

    During the last few years, the development of surgical laparoscopy has been the major turning point, and the most important progress in the field of surgery. The specific installation requirements of surgical laparoscopy, as well as the technological progress proper to this surgical technique, justify the need of a new organization of the operating theatre. The new operating room OR 1 is especially designed to fit and satisfy the requirements of a modern operating theatre, where surgical laparoscopy plays a major role. The organization and the design of this new operating room (OR 1) rely on 2 main concepts: architectural, and computerized, through 2 PC systems SCB and AIDA. The main objectives of this new concept are: allowing the surgeon to control and command all the functions and the instruments, as well as the lighting of the room and the operating field; managing the surgical data and images required for medical files; establishing a communication network either from the inside or outside the sterile zone.

  12. 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.

  13. 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

  14. Local anaesthesia outside the operating room.

    PubMed

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

    2002-04-01

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

  15. The dedicated orthopedic trauma operating room.

    PubMed

    Min, William; Wolinsky, Philip R

    2011-08-01

    The development and implementation of a dedicated orthopedic trauma operating room (OTOR) that is used for the treatment of orthopedic trauma patients has changed and improved the practice of orthopedic trauma surgery. Advantages noted with OTOR implementation include improvements in morbidity and complication rates, enhancements in the professional and personal lifestyles of the on-call surgeon, and increased physician recruitment and retention in orthopedic traumatology. However, the inappropriate use of the OTOR, which can waste valuable resources and delay the treatment of emergent cases, must be monitored and avoided.

  16. 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.

  17. [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.

  18. Footwear practices and operating room contamination.

    PubMed

    Copp, G; Slezak, L; Dudley, N; Mailhot, C B

    1987-01-01

    The extent of bacterial transfer into the clean confines of the operating room (OR) was studied by comparing the use of protective footwear (i.e., polypropylene shoe covers and OR restricted shoes) with unprotected street shoes over a 5-week period. The study was divided into two experimental times: (a) early morning (disinfected floor) and (b) midmorning (dirty floor). Data obtained from the early morning experiment showed that OR restricted shoes and shoe covers transferred fewer bacteria onto the disinfected study area than unprotected street shoes; similar findings were obtained from the midmorning experiment for shoe covers, but not for OR restricted shoes. A comparison of changes in bacterial counts obtained from OR restricted shoes and shoe covers worn from the changing room through a common corridor to the disinfected study area did not differ significantly from OR restricted shoes and shoe covers that were put on immediately before walking through the study area at both experimental times. Overall results indicated that protective footwear may act to reduce bacterial contamination on OR floors.

  19. An Ethogram to Quantify Operating Room Behavior

    PubMed Central

    Jones, Laura K.; Jennings, Bonnie Mowinski; Goelz, Ryan M.; Haythorn, Kent W.; Zivot, Joel B.; de Waal, Frans B. M.

    2017-01-01

    Background The operating room (OR) is a highly social and hierarchical setting where interprofessional team members must work interdependently under pressure. Due primarily to methodological challenges, the social and behavioral sciences have had trouble offering insight into OR dynamics. Purpose We adopted a method from the field of ethology for observing and quantifying the interpersonal interactions of OR team members. Methods We created and refined an ethogram, a catalog of all our subjects’ observable social behaviors. The ethogram was then assessed for its feasibility and interobserver reliability. Results It was feasible to use an ethogram to gather data in the OR. The high interobserver reliability (Cohen’s Kappa coefficients of 81 % and higher) indicates its utility for yielding largely objective, descriptive, quantitative data on OR behavior. Conclusions The method we propose has potential for social research conducted in healthcare settings as complex as the OR. PMID:26813263

  20. 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.

  1. Science Support Room Operations During Desert RATS 2009

    NASA Astrophysics Data System (ADS)

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

    2010-03-01

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

  2. 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.

  3. A Learning Needs Assessment of Operating Room Nurses.

    ERIC Educational Resources Information Center

    Pounds, Elizabeth; Littlefield, John H.

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

  4. The operating room of the future: a view from Europe.

    PubMed

    Feussner, H

    2003-09-01

    The Operating Room of the Future will be characterized by meticulous preoperative planning, full integration of the operating room into the general flow of information, more comprehensive intraoperative diagnostic imaging procedures, and the use of sophisticated visualization processes including augmented reality. Mechatronic support (partially autonomous robots) enhances safety and allows reduction of staff. Integrated operating room systems will allow the wide spectrum of new devices and functionalities to be easily controlled by the operating team. The Operating Room of the Future will no longer be isolated from the rest of the clinical endeavor. Intraoperative teleconsultation and telepresence will help to promote and teach safer evidence-based endoscopic therapeutic surgery. Traditional surgical intervention will expand its definitions by procedures via an interdisciplinary, cooperative approach that will replace the sequential therapeutic process of today.

  5. 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

  6. 6. INTERIOR VIEW OF TYPICAL OPERATING ROOM; NOTE APPARATUS SUSPENDED ...

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

    6. INTERIOR VIEW OF TYPICAL OPERATING ROOM; NOTE APPARATUS SUSPENDED FROM CEILING & REMAINING COPPER STRIPS IN FLOOR - Fort McCoy, Building No. T-1032, North side of South Tenth Avenue, Block 10, Sparta, Monroe County, WI

  7. Noise Levels in the Operating Room

    DTIC Science & Technology

    2001-10-01

    59-63. Hodge, B., & Thompson , J . F . (1990). Noise pollution in the operating theatre. The Lancet, 335, 891-894. Noise Levels 41...Kam, P. C. A., Kam A. C., & Thompson , J . F . (1994). Noise pollution in the anaesthetic and intensive care environment. Anaesthesia, 49, 982-986

  8. 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.

  9. 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.

  10. Managing transition to a hybrid operating room.

    PubMed

    Odle, Teresa G

    2011-01-01

    Managers of interventional radiology departments and medical imaging personnel who work in surgical suites deal with regular technical innovations in their work, but large-scale innovations seldom come along that transform markets and require massive architectural, training, and technological changes. The hybrid interventional/operating suite is one such massive change. This article presents an overview of the transition to hybrid procedures and designs, the benefits and challenges of the new delivery method, and change management issues for managers of cardiovascular and vascular interventional departments.

  11. Baylor, Univ. of North Texas Students Win EPA Fellowship Grant

    EPA Pesticide Factsheets

    DALLAS - (April 1, 2015) One undergraduate student at Baylor University and another at the University of North Texas were both awarded research fellowship grants by the U.S. Environmental Protection Agency (EPA). The grants were given to students pu

  12. Environmental control: operating room air quality.

    PubMed

    Bartley, J M

    1993-01-01

    1. OR staff members should familiarize themselves with basic air handling system terminology to better manage their own environment (eg, HVAC, air changes, air balancing, HEPA filtration). A working relationship with building engineers is an important skill for the OR nurse. 2. Knowledge of the standards on which air quality in the OR is based should assist in the process of planning for improved design--as well as in monitoring existing air quality. 3. Current standards balance energy savings with air changes and high levels of filtration to achieve optimum outcomes. Recommendations from design and engineering authorities (even for implant surgery) are based on average air changes and HEPA filtration, not laminar air flow. 4. The daily, operational role of the OR staff in maintaining high air quality includes managing traffic, using low-lint barrier materials, monitoring air quality indicators, and investigating unusual variances with the engineering staff for appropriate follow-up (eg, filter changes).

  13. 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

  14. 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.

  15. 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

  16. 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

  17. 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

  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. 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.

  20. 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.

  1. 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

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

    SciTech Connect

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

    1982-09-01

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

  3. 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

  4. 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

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

    PubMed Central

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

    2016-01-01

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

  6. Delays in the operating room: signs of an imperfect system

    PubMed Central

    Wong, Janice; Khu, Kathleen Joy; Kaderali, Zul; Bernstein, Mark

    2010-01-01

    Background Delays in the operating room have a negative effect on its efficiency and the working environment. In this prospective study, we analyzed data on perioperative system delays. Methods One neurosurgeon prospectively recorded all errors, including perioperative delays, for consecutive patients undergoing elective procedures from May 2000 to February 2009. We analyzed the prevalence, causes and impact of perioperative system delays that occurred in one neurosurgeon’s practice. Results A total of 1531 elective surgical cases were performed during the study period. Delays were the most common type of error (33.6%), and more than half (51.4%) of all cases had at least 1 delay. The most common cause of delay was equipment failure. The first cases of the day and cranial cases had more delays than subsequent cases and spinal cases, respectively. A delay in starting the first case was associated with subsequent delays. Conclusion Delays frequently occur in the operating room and have a major effect on patient flow and resource utilization. Thorough documentation of perioperative delays provides a basis for the development of solutions for improving operating room efficiency and illustrates the principles underlying the causes of operating room delays across surgical disciplines. PMID:20507792

  7. 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.

  8. Control of the Environment in the Operating Room.

    PubMed

    Katz, Jonathan D

    2016-09-23

    There is a direct relationship between the quality of the environment of a workplace and the productivity and efficiency of the work accomplished. Components such as temperature, humidity, ventilation, drafts, lighting, and noise each contribute to the quality of the overall environment and the sense of well-being of those who work there.The modern operating room is a unique workplace with specific, and frequently conflicting, environmental requirements for each of the inhabitants. Even minor disturbances in the internal environment of the operating room can have serious ramifications on the comfort, effectiveness, and safety of each of the inhabitants. A cool, well-ventilated, and dry climate is optimal for many members of the surgical team. Any significant deviation from these objectives raises the risk of decreased efficiency and productivity and adverse surgical outcomes. A warmer, more humid, and quieter environment is necessary for the patient. If these requirements are not met, the risk of surgical morbidity and mortality is increased. An important task for the surgical team is to find the correct balance between these 2 opposed requirements. Several of the components of the operating room environment, especially room temperature and airflow patterns, are easily manipulated by the members of the surgical team. In the following discussion, we will examine these elements to better understand the clinical ramifications of adjustments and accommodations that are frequently made to meet the requirements of both the surgical staff and the patient.

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

    SciTech Connect

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

    1998-07-01

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

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

    SciTech Connect

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

    2006-07-01

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

  11. 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.

  12. Economic and quality scheduling for effective utilization of operating rooms.

    PubMed

    Jeang, Angus; Chiang, An-Jen

    2012-06-01

    Under the constraints of limited medical resources and severe competition among hospitals, administrators have begun to pay attention to the opportunities of cost reduction and quality improvement in hospital management, in order to find methods to increase hospital revenue and improve service quality. The operating room should be one of the most important sources of hospital income, yet it is both costly to run and constrictive to inpatient flow. Successful hospital management necessitates the construction of cost-effective and quality operating room scheduling. This paper attempts to model the scheduling problem in the form of mathematical programming with the objective being to minimize the deviation between the total operation time and the total available time in operating rooms. Urgent revisions to the model in consideration of such factors as doctor's availability, outpatient consulting hours and unfavorable surgery hours can be achieved in a timely manner. With the present approach, surgical procedures can start punctually, inpatient waiting time for surgery and length of stay can be reduced, and staff morale can be enhanced. These improvements will result in cost reduction, and increased hospital revenue without sacrificing the quality of medical care.

  13. 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.

  14. Management of a fire in the operating room.

    PubMed

    Kaye, Alan David; Kolinsky, Daniel; Urman, Richard D

    2014-04-01

    Operating room (OR) fires remain a significant source of liability for anesthesia providers and injury for patients, despite existing practice guidelines and other improvements in operating room safety. Factors contributing to OR fires are well understood and these occurrences are generally preventable. OR personnel must be familiar with the fire triad which consists of a fuel supply, an oxidizing agent, and an ignition source. Existing evidence shows that OR-related fires can result in significant patient complications and malpractice claims. Steps to reduce fires include taking appropriate safety measures before a patient is brought to the OR, taking proper preventive measures during surgery, and effectively managing fire and patient complications when they occur. Decreasing the incidence of fires should be a team effort involving the entire OR personnel, including surgeons, anesthesia providers, nurses, scrub technologists, and administrators. Communication and coordination among members of the OR team is essential to creating a culture of safety.

  15. [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.

  16. 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.

  17. Operating Room of the Future: Advanced Technologies in Safe and Efficient Operating Rooms

    DTIC Science & Technology

    2008-10-01

    follows: Objective 1. Dose reduction strategy: High dose-Low dose. (Algorithmic developments; phantom and animal model study; validation) One of...this camera orientation. The participants will experience control 36 of the camera location by manipulation of the 3-d stylus of a Phantom desktop...Imaging and Communications in Medicine ( DICOM ) data sets. Such imaging could provide the surgeon with real-time “x-ray vision” during the operation

  18. Initial clinical experience with the Baylor-Nikkiso centrifugal pump.

    PubMed

    Ohtsubo, S; Naito, K; Matsuura, M; Kawahito, K; Shimono, T; Makinouchi, K; Tasai, K; Ohara, Y; Damm, G; Glueck, J

    1995-07-01

    Recently, a newly developed centrifugal pump, the Baylor-Nikkiso pump, was approved for clinical use in the United States. This pump is the most compact centrifugal pump with a priming volume of only 25 ml. Although it is small, this pump can provide a flow of 4 L/min against a total pressure head of 300 mm Hg at 3,000 rpm. In vitro and in vivo validation of the Baylor-Nikkiso pump has proved that this pump could effectively reduce blood trauma even under high total head pressure. In addition, 48-h durability tests with biventricular bypass using calves verified the reliability of shaft sealing and antithrombogenicity. Clinical trials of the Baylor-Nikkiso pumps have been initiated in our department. This pump provides flows of 60-70 ml/kg/min with stable hemodynamic conditions. No leakage of thrombus formation was observed. The results of the initial clinical experience of the Baylor-Nikkiso pump suggest that it is suitable for cardiopulmonary bypass surgery.

  19. Common Bibliographic Standards for Baylor University Libraries. Revised.

    ERIC Educational Resources Information Center

    Scott, Sharon; And Others

    Developed by a Baylor University (Texas) Task Force, the revised policies of bibliographic standards for the university libraries provide formats for: (1) archives and manuscript control; (2) audiovisual media; (3) books; (4) machine-readable data files; (5) maps; (6) music scores; (7) serials; and (8) sound recordings. The task force assumptions…

  20. 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.

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

    PubMed

    Cleary, Kevin

    2005-01-01

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

  2. Bacterial dispersion in relation to operating room clothing.

    PubMed Central

    Whyte, W.; Vesley, D.; Hodgson, R.

    1976-01-01

    The effect of operating clothing on the dispersal of bacterial particles from the wearers was studied in a dispersal chamber. A comparison was made of six gowns as well as four types of trousers. The gowns were of three basic types, namely a conventional cotton type, disposable types made of non-woven fabric and those of the total-body exhaust system (Charnley type). The dispersal chamber could simulate conditions as expected both in down-flow unidirectional ultra-clean systems and in a conventional turbulent plenum-ventilated system. It was found that the disposable gowns would reduce the dispersal rate by about 30% in the simulated conventionally ventilated system and about 65% in the laminar flow system. The total-body exhaust system (Charnley) would reduce the count by 10-fold in the conventional ventilated system and by 66-fold in the laminar-flow system. The poor performance of the gowns in conventionally ventilated systems was caused by the dispersal of bacterial particles from underneath the gown (about 80%). This was not reduced by the disposable gown and only partially by the Charnley type. This small drop would be further decreased in a conventionally ventilated operating-room as only scrubbed staff would wear the gown. In order to overcome this poor performance in conventionally ventilated operating-rooms impervious trousers would be required. Four types were studied and it was demonstrated that those made either from Ventile or non-woven fabric would reduce the bacterial dispersion fourfold. As these tests had been carried out in an artificial environment checks were carried out in the unidirectional-flow operating-room during total-hip arthroplasty. This was done by comparing conventional cotton gowns with non-woven gowns and total-body exhaust gowns. The results showed good correlation between the operating room and the chamber with the non-woven fabric gown but the total-body exhaust system did not perform as well in the operating room (12-fold

  3. Surgical Cost Disclosure May Reduce Operating Room Expenditures.

    PubMed

    Austin, Luke S; Tjoumakaris, Fotios P; Ong, Alvin C; Lombardi, Nicholas J; Wowkanech, Charles D; Mehnert, Michael J

    2017-03-01

    Health care expenditures are rising in the United States. Recent policy changes are attempting to reduce spending through the development of value-based payment systems that rely heavily on cost transparency. This study was conducted to investigate whether cost disclosure influences surgeons to reduce operating room expenditures. Beginning in 2012, surgeon scorecards were distributed at a regional health care system. The scorecard reported the actual direct supply cost per case for a specific procedure and compared each surgeon's data with those of other surgeons in the same subspecialty. Rotator cuff repair was chosen for analysis. Actual direct supply cost per case was calculated quarterly and collected over a 2-year period. Surgeons were given a questionnaire to determine their interest in the scorecard. Actual direct supply cost per rotator cuff repair procedure decreased by $269 during the study period. A strong correlation (R(2)=0.77) between introduction of the scorecards and cost containment was observed. During the study period, a total of $39,831 was saved. Of the surgeons who were queried, 89% were interested in the scorecard and 56% altered their practice as a result. Disclosure of surgical costs may be an effective way to control operating room spending. The findings suggest that providing physicians with knowledge about their surgical charges can alter per-case expenditures. [Orthopedics. 2017; 40(2):e269-e274.].

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

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 2 2013-04-01 2013-04-01 false Operations in the thermal processing room. 113.87... CONTAINERS Production and Process Controls § 113.87 Operations in the thermal processing room. (a) Operating... Food and Drug Administration. (b) A system for product traffic control in the retort room shall...

  5. 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... Food and Drug Administration. (b) A system for product traffic control in the retort room shall...

  6. 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... Food and Drug Administration. (b) A system for product traffic control in the retort room shall...

  7. How do strategic decisions and operative practices affect operating room productivity?

    PubMed

    Peltokorpi, Antti

    2011-12-01

    Surgical operating rooms are cost-intensive parts of health service production. Managing operating units efficiently is essential when hospitals and healthcare systems aim to maximize health outcomes with limited resources. Previous research about operating room management has focused on studying the effect of management practices and decisions on efficiency by utilizing mainly modeling approach or before-after analysis in single hospital case. The purpose of this research is to analyze the synergic effect of strategic decisions and operative management practices on operating room productivity and to use a multiple case study method enabling statistical hypothesis testing with empirical data. 11 hypotheses that propose connections between the use of strategic and operative practices and productivity were tested in a multi-hospital study that included 26 units. The results indicate that operative practices, such as personnel management, case scheduling and performance measurement, affect productivity more remarkably than do strategic decisions that relate to, e.g., units' size, scope or academic status. Units with different strategic positions should apply different operative practices: Focused hospital units benefit most from sophisticated case scheduling and parallel processing whereas central and ambulatory units should apply flexible working hours, incentives and multi-skilled personnel. Operating units should be more active in applying management practices which are adequate for their strategic orientation.

  8. 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.

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

    PubMed

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

    2000-12-01

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

  10. 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.

  11. 9 CFR 590.508 - Candling and transfer-room operations.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 9 Animals and Animal Products 2 2010-01-01 2010-01-01 false Candling and transfer-room operations..., Processing, and Facility Requirements § 590.508 Candling and transfer-room operations. (a) Candling and transfer rooms and equipment shall be kept clean, free from cobwebs, dust, objectionable odors, and...

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

    DTIC Science & Technology

    2002-05-01

    instance, frequent hand washing has been shown to significantly lessen the incidence of nosocomial infections . In addition, improved operating room...Room Nurse : A registered nurse who works in an operating room. Responsible for the clinical and technical knowledge of both scrub and circulating...risk management. 26 Criteria included the following: noise exposure, nosocomial infections , environmental controls, air exchanges, and electrical

  13. [Does ultraclean air in the operating room provide greater safety?].

    PubMed

    van Tiel, Frank H; Buiting, Anton G; Meessen, Nico E L; Voss, Andreas; Vos, Margreet C

    2010-01-01

    The Dutch quality control plan for climatisation of the operating room (OR), which was published in 2005, describes the management and maintenance of the air conditioning system. This management plan proposes a standard for air quality in class 1 ORs. This has been adopted by the Dutch Orthopaedic Society, but not by other surgical societies. The British study which underlies the proposed norm for air quality in class 1 ORs, a study on the infection preventive effect of ultraclean air, dates from 1982 and is inadequately controlled for prophylactic use of antibiotics. Antibiotic prophylaxis in itself already reduces the number of surgical site infections.-More recent studies fail to show an infection preventive effect of ultraclean air in the OR. The Dutch Working Party for Infection Prevention (WIP) ought to take the initiative, together with the medical Scientific Societies and the Society of Infection Prevention and Control in the health care setting (VHIG), to establish enforceable norms for microbiological air quality and to set criteria as to which types of operations are allowed to be performed in which class of OR.

  14. Potential Operating Room Fire Hazard of Bone Cement.

    PubMed

    Sibia, Udai S; Connors, Kevin; Dyckman, Sarah; Zahiri, Hamid R; George, Ivan; Park, Adrian E; MacDonald, James H

    Approximately 600 cases of operating room (OR) fires are reported annually. Despite extensive fire safety education and training, complete elimination of OR fires still has not been achieved. Each fire requires an ignition source, a fuel source, and an oxidizer. In this case report, we describe the potential fire hazard of bone cement in the OR. A total knee arthroplasty was performed with a standard medial parapatellar arthrotomy. Tourniquet control was used. After bone cement was applied to the prepared tibial surface, the surgeon used an electrocautery device to resect residual lateral meniscus tissue-and started a fire in the operative field. The surgeon suffocated the fire with a dry towel and prevented injury to the patient. We performed a PubMed search with a cross-reference search for relevant papers and found no case reports outlining bone cement as a potential fire hazard in the OR. To our knowledge, this is the first case report identifying bone cement as a fire hazard. OR fires related to bone cement can be eliminated by correctly assessing the setting time of the cement and avoiding application sites during electrocautery.

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

    NASA Technical Reports Server (NTRS)

    1981-01-01

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

  16. [Hybrid operating rooms: only for advanced endovascular procedures?].

    PubMed

    Verhoeven, E; Katsargyris, A; Töpel, I; Steinbauer, M

    2013-10-01

    The evolution of endovascular techniques has led to the concept of the "hybrid operating room" (hybrid OR). A hybrid OR combines the sterility of an OR in an operating theatre environment with a high-quality fixed imaging system. On the basis of these advantages it would be desirable that an angio-hybrid OR becomes a standard requirement for endovascular surgery. In Great Britain guidelines have already been published that require a hybrid OR even for normal endovascular management of the infrarenal aorta. However, in Germany there are no guidelines from professional societies or formal rules from the federal joint committee, thus in this article a classification of endovascular procedures according to their complexity and the necessary infrastructures are proposed in order to define particular procedures that should only be performed in an angio-hybrid OR. According to our experience, endovascular procedures can be classified into four categories based on their complexity and the requirements regarding fluoroscopy: level 1: standard EVAR, TEVAR, iliac and popliteal artery procedures; level 2: iliac branched (IBD) and standard (2 fenestrations for the renal arteries and a scallop for the superior mesenteric artery) fenestrated stent-grafting; level 3: more complex fenestrated procedures (three or four fenestrations); and level 4: branched stent-grafting for TAAA. At this moment it is still acceptable to perform level 1 and level 2 procedures outside of a hybrid OR. In our opinion, it is not recommended to perform level 3 and level 4 endovascular procedures without a hybrid OR.

  17. Overutilization and underutilization of operating rooms - insights from behavioral health care operations management.

    PubMed

    Fügener, Andreas; Schiffels, Sebastian; Kolisch, Rainer

    2017-03-01

    The planning of surgery durations is crucial for efficient usage of operating theaters. Both planning too long and too short durations for surgeries lead to undesirable consequences, e.g. idle time, overtime, or rescheduling of surgeries. We define these consequences as operating room inefficiency. The overall objective of planning surgery durations is to minimize expected operating room inefficiency, since surgery durations are stochastic. While most health care studies assume economically rational behavior of decision makers, experimental studies have shown that decision makers often do not act according to economic incentives. Based on insights from health care operations management, medical decision making, behavioral operations management, as well as empirical observations, we derive hypotheses that surgeons' behavior deviates from economically rational behavior. To investigate this, we undertake an experimental study where experienced surgeons are asked to plan surgeries with uncertain durations. We discover systematic deviations from optimal decision making and offer behavioral explanations for the observed biases. Our research provides new insights to tackle a major problem in hospitals, i.e. low operating room utilization going along with staff overtime.

  18. One year orthopaedic trauma experience using an advanced interdisciplinary hybrid operating room.

    PubMed

    Richter, Peter H; Yarboro, Seth; Kraus, Michael; Gebhard, Florian

    2015-10-01

    Hybrid operating rooms have been used successfully in several surgical specialties, but no data have been published for orthopaedic trauma. We present our one-year orthopaedic trauma experience using a hybrid operating room, which incorporates 3D fluoroscopic imaging as well as navigation capabilities. Data were compiled for a series of 92 cases performed in an advanced hybrid operating room at the level one trauma center in Ulm, Germany. All patients who had surgery performed using this operating room during the first year were included. Setup time and surgical complications using hybrid operating room were recorded and analysed. The hybrid operating room resulted in no higher rate of complication than expected from the same cases in a conventional operating room. The hybrid room did however allow the surgeon to confidently place implants for orthopaedic trauma cases, and was most advantageous for spine and pelvis cases, both minimally invasive and conventional. Further, appropriate reduction and implant position was confirmed with 3D imaging prior to leaving the operating room and obviated the need for postoperative CT scan. Based on our one-year experience, the hybrid operating room is a useful and safe tool for orthopaedic trauma surgery.

  19. A Miracle That Accelerates Operating Room Functionality: Sugammadex

    PubMed Central

    Dogan, Erdal; Akdemir, Mehmet Salim; Guzel, Abdulmenap; Yildirim, Mehmet Besir; Baysal Yildirim, Zeynep; Kuyumcu, Mahir; Gümüş, Abdurrahman; Akelma, Hakan

    2014-01-01

    Background. Sugammadex offers a good alternative to the conventional decurarisation process currently performed with cholinesterase inhibitors. Sugammadex, which was developed specifically for the aminosteroid-structured rocuronium and vecuronium neuromuscular blockers, is a modified cyclodextrin made up of 8 glucose monomers arranged in a cylindrical shape. Methods. In this study, the goal was to investigate the efficacy of sugammadex. Sugammadex was used when there was insufficient decurarisation following neostigmine. This study was performed on 14 patients who experienced insufficient decurarisation (TOF <0.9) with neostigmine after general anaesthesia in the operating rooms of a university and a state hospital between June, 2012, and January, 2014. A dose of 2 mg/kg of sugammadex was administered. Results. Time elapsed until sugammadex administration following neostigmine 37 ± 6 min, following sugammadex it took 2.1 ± 0.9 min to reach TOF ≥0.9, and the extubation time was 3.2 ± 1.4 min. No statistically significant differences were detected in the hemodynamic parameters before and after sugammadex application. From the time of administration of sugammadex to the second postoperative hour, no side effects or complications occurred. None of the patients experienced acute respiratory failure or residual block during this time period. Conclusion. Sugammadex was successfully used to reverse rocuronium-induced neuromuscular block in patients where neostigmine was insufficient. PMID:25202709

  20. 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.

  1. Learning about teamwork in operating room clinical placement.

    PubMed

    Silén-Lipponen, Marja; Tossavainen, Kerttu; Turunen, Hannele; Smith, Ann

    The aim of nursing students' operating room (OR) clinical practice is to gain experience of the perioperative nursing process and to develop skills related to the practice within OR teams in a variety of situations. However, it has previously been problematic to get enough practical experience within OR teams because of the general urgency, e.g. rapid turnover and flow of emergency cases, and preceptors' multiple responsibilities related to their simultaneous need to work as team members. This study describes how Finnish, British and American nursing students (n = 30) experienced learning about teamwork during their OR placement period. The critical incident technique was used for data collection, and data were analysed using a descriptive phenomenological method. Three types of teamwork emerged based on the students' perceptions: functional manifestation of OR teamwork, gaining OR team membership and technical orientation of OR teamwork. The findings are discussed in relation to OR practice, education and research on ways to improve teamwork while maintaining a satisfactory OR learning context and stimulating interest in perioperative nursing.

  2. Control room crew operations research project. Final report

    SciTech Connect

    Parry, G.W.; Mosleh, A.

    1995-12-01

    This report presents an assessment of the current state of the art in human reliability analysis (HRA) and highlights the principal shortcomings of current approaches. Issues that should be addressed in an improved HRA approach as well as the constraints imposed by current methodologies used to perform Probabilistic Safety Assessment (PSAs) are identified. A generalized conceptual model for estimating the probabilities of the human failure events that are included in a PSA logic model is presented. The model is expressed as a sum over error modes and error causes. The report emphasizes the importance of understanding the causality of error and suggests one approach to the representation of error causes. An example approach to the qualitative screening of errors of commission is presented. The second part of the report describes an alternative approach to modeling accident scenarios that explicitly considers the dynamic interactions of the various elements and provides the needed environment for implementation of advanced human reliability models. This approach has been incorporated into the Accident Dynamic Simulator (ADS), a computer tool that removes the main roadblock to implementation of this methodology by handling the computational complexities of an integrated model of a large system, its physical processes, and the human behavior of the control room operators. ADS runs on a personal computer and is designed to facilitate the PSA of nuclear power plants. The application of the code to a SGTR initiating event at a Westinghouse PWR is presented.

  3. 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.

  4. 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.

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

    PubMed

    Bitterman, Noemi

    2006-06-01

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

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

    PubMed

    Koneczny, Sonja

    2009-01-01

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

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

    PubMed Central

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

    2015-01-01

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

  8. Improving operating room turnover time: a systems based approach.

    PubMed

    Bhatt, Ankeet S; Carlson, Grant W; Deckers, Peter J

    2014-12-01

    Operating room (OR) turnover time (TT) has a broad and significant impact on hospital administrators, providers, staff and patients. Our objective was to identify current problems in TT management and implement a consistent, reproducible process to reduce average TT and process variability. Initial observations of TT were made to document the existing process at a 511 bed, 24 OR, academic medical center. Three control groups, including one consisting of Orthopedic and Vascular Surgery, were used to limit potential confounders such as case acuity/duration and equipment needs. A redesigned process based on observed issues, focusing on a horizontally structured, systems-based approach has three major interventions: developing consistent criteria for OR readiness, utilizing parallel processing for patient and room readiness, and enhancing perioperative communication. Process redesign was implemented in Orthopedics and Vascular Surgery. Comparisons of mean and standard deviation of TT were made using an independent 2-tailed t-test. Using all surgical specialties as controls (n = 237), mean TT (hh:mm:ss) was reduced by 0:20:48 min (95 % CI, 0:10:46-0:30:50), from 0:44:23 to 0:23:25, a 46.9 % reduction. Standard deviation of TT was reduced by 0:10:32 min, from 0:16:24 to 0:05:52 and frequency of TT≥30 min was reduced from 72.5to 11.7 %. P < 0.001 for each. Using Vascular and Orthopedic surgical specialties as controls (n = 13), mean TT was reduced by 0:15:16 min (95 % CI, 0:07:18-0:23:14), from 0:38:51 to 0:23:35, a 39.4 % reduction. Standard deviation of TT reduced by 0:08:47, from 0:14:39 to 0:05:52 and frequency of TT≥30 min reduced from 69.2 to 11.7 %. P < 0.001 for each. Reductions in mean TT present major efficiency, quality improvement, and cost-reduction opportunities. An OR redesign process focusing on parallel processing and enhanced communication resulted in greater than 35 % reduction in TT. A systems-based focus should drive OR TT design.

  9. Burn center management of operating room fire injuries.

    PubMed

    Haith, Linwood R; Santavasi, Wil; Shapiro, Tyler K; Reigart, Cynthia L; Patton, Mary Lou; Guilday, Robert E; Ackerman, Bruce H

    2012-01-01

    Approximately 100 operating room (OR) fires occur per year in the United States, with 15% resulting in serious injuries. Intraoperative cautery was frequently associated with OR fires before 1994; however, use of supplemental oxygen (O(2)), ethanol-based products, and disposable drapes have been more frequently associated with OR fires. Fires resulting from cosmetic and other small procedures involving use of nasal canula O(2) and electrocautery have been described in six published reports. We report five thermal injury cases admitted to our burn treatment center because of fires during surgical procedures over a 5-year period. Two patients undergoing supraorbital excision experienced 2.5 and 3% TBSA involvement burns; in a third patient surgical excision of a nasal polyp resulted in a 1% TBSA burn; in a fourth patient an excisional biopsy of a lymph node resulted in a 2.75% TBSA burn; and the last patient was burned during placement of a pacemaker, with resulting TBSA of 10.5%. Two of the five patients required intubation for inhalational injury. Two patients required tangential excision and grafting of their thermal injuries. All patients had received local or parenteral anesthesia with supplemental O(2)/nitrous oxide (N(2)O) for surgical procedure. There are a number of ignition sources in the OR, including electrocautery, lasers, and faulty OR equipment. The risk of OR fires increases with surgical procedures involving the face and neck, including tracheostomy and tracheobronchial surgery. The common use of O(2)/N(2)O mixtures or enriched O(2) for minimally complex surgical procedures and disposable drapes adds to the risk of an OR fire: the O(2)/N(2)O provides a fuel source, and the disposable drapes trap thedelivered gas. Electrocautery near an O(2)/N(2)O source resulted in the five thermal injuries and warrants careful reconsideration of technique for surgical procedures.

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

    PubMed

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

    2014-02-01

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

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

    PubMed

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

    2014-06-01

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

  12. The pivot wash in two impeller modes for the Baylor/Miwatec centrifugal blood pump.

    PubMed

    Yamane, Takashi; Kodama, Takayuki; Nishida, Masahiro; Maruyama, Osamu; Yamamoto, Yoshiro; Shinohara, Toshiyuki; Motomura, Tadashi; Nosé, Yukihiko

    2006-01-01

    A centrifugal blood pump with a double pivot impeller and an eccentric inlet port is being developed as an implantable artificial heart by the Baylor College of Medicine and Miwatec Co. Ltd. Flow visualization measurements were conducted to compare the flow around the pivot for two impeller operational modes: the top and the bottom contact modes. In the top contact mode, one-way flow in the pivot gap due to the eccentric vortex was observed, and sufficient wall shear rate to prevent thrombus formation was attained around the bottom pivot for over 1,400 rpm. Computational fluid dynamic analyses confirmed that the causes of the eccentric vortex were the inlet eccentricity and the pressure imbalance in the volute.

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

    ERIC Educational Resources Information Center

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

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

  14. 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

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

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Air-handling apparatus for a surgical operating room. 878.5070 Section 878.5070 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND....5070 Air-handling apparatus for a surgical operating room. (a) Identification. Air-handling...

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

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Air-handling apparatus for a surgical operating room. 878.5070 Section 878.5070 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND....5070 Air-handling apparatus for a surgical operating room. (a) Identification. Air-handling...

  17. 9 CFR 590.508 - Candling and transfer-room operations.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 9 Animals and Animal Products 2 2012-01-01 2012-01-01 false Candling and transfer-room operations. 590.508 Section 590.508 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE, DEPARTMENT OF..., Processing, and Facility Requirements § 590.508 Candling and transfer-room operations. (a) Candling...

  18. 9 CFR 590.508 - Candling and transfer-room operations.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 9 Animals and Animal Products 2 2014-01-01 2014-01-01 false Candling and transfer-room operations. 590.508 Section 590.508 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE, DEPARTMENT OF..., Processing, and Facility Requirements § 590.508 Candling and transfer-room operations. (a) Candling...

  19. 9 CFR 590.508 - Candling and transfer-room operations.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 9 Animals and Animal Products 2 2011-01-01 2011-01-01 false Candling and transfer-room operations. 590.508 Section 590.508 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE, DEPARTMENT OF..., Processing, and Facility Requirements § 590.508 Candling and transfer-room operations. (a) Candling...

  20. 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…

  1. [Standard operating procedures and operating room management: Improvement of patient safety and the efficiency of processes].

    PubMed

    Bleyl, Jörg U; Heller, Axel R

    2008-01-01

    Financial pressures have led the way more efficiency in health care management. To decrease hospital costs a more proficient use of personal resources is required. The drive to increase efficiency with the concomitant increase in workload can cause a reduction in quality of patient care and of patient security. A professional operating room (OR) management and the introduction of standard operating procedures (SOP) have helped to optimise workflow in and around the OR. OR management can control an efficient workflow and generate data concerning performance, costs and quality. SOPs lead to a standardisation of workflow in the OR and in patient treatment modalities. This guaranties a high quality in patient care and more safety despite an increase in work-load.

  2. 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.

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

    NASA Astrophysics Data System (ADS)

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

    2005-04-01

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

  4. Nursing in a technological environment: nursing care in the operating room.

    PubMed

    Bull, Rosalind; FitzGerald, Mary

    2006-02-01

    Operating room nurses continue to draw criticism regarding the appropriateness of a nursing presence in the operating room. The technological focus of the theatre and the ways in which nurses in the theatre have shaped and reshaped their practice in response to technological change have caused people within and outside the nursing profession to question whether operating room nursing is a technological rather than nursing undertaking. This paper reports findings from an ethnographic study that was conducted in an Australian operating department. The study examined the contribution of nurses to the work of the operating room through intensive observation and ethnographic interviews. This paper uses selected findings from the study to explore the ways in which nurses in theatre interpret their role in terms of caring in a technological environment.

  5. 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.

  6. Computerized control of the procedure for detecting and removing airborne particles in operating rooms.

    PubMed

    Bay, Omer Faruk; Ergül, Nesip

    2004-04-01

    Surgical-site infections are still a major problem in modern medicine. Normal skin fora of patients or healthcare workers causes more than half of all infections following clean surgery, but the importance of airborne particles in this setting remains controversial. The use of ultraclean air in operating rooms has been shown to reduce infection rates significantly. High efficiency particlulate air (HEPA) filters are used in some modern operating rooms. Although the uses of HEPA filters, the air quality should be controlled by another device to make safe the air in operating rooms and intensive care units. In this study, a computerized system was established to control the cleanliness of the air by measuring the presence of airborne particles of varying sizes and numbers in operating rooms. When the maximum values are exceeded, the system warns the authorized people by phone, sound, or displays.

  7. 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.

  8. 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.

  9. Estimation of Blood Loss: Comparing the Accuracy of Operating Room Personnel

    DTIC Science & Technology

    1991-02-01

    Operating Room Services to reserve an unutilized room for the day of the experiment . The experimental period was on June 14, 1990, from 8:30 AM to 12:00...moderate loss he may experience a decrease in pulse pressure, tachycardia, tachypnea, and postural hypotension. A major blood loss may constitute...during the procedure. In discussing his experience with 3,000 transfusions, Blain (1929) emphasized that the amount of blood lost during operations

  10. 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.

  11. [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.

  12. Operational experience with room temperature continuous wave accelerator structures

    NASA Astrophysics Data System (ADS)

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

    1993-05-01

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

  13. [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.

  14. 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.

  15. Towards communication requirements in the operating room and clinic IT.

    PubMed

    Pahontu, Raluca; Will, Armin; Bergh, Björn

    2015-01-01

    Today, connecting medical devices to the hospital network becomes a priority for many hospitals. User and operator requirements for communication must be considered in order to develop an adequate interoperable integration approach. This paper conducts a requirement study using questionnaires and working groups investigating 16 clinical communication requirements for connecting medical devices with each other and with clinical IT systems. Six German Hospitals order the communication requirements by their clinical relevance and categorize those into four main clusters. Communication requirements regarding accurate data transfer and processing for patients and devices have top priority, while communication requirements regarding remote manipulation of medical devices have low rank. Connecting medical devices to clinical IT systems improves clinical documentation and with it patient care processes.

  16. 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.

  17. Surgeons' Leadership Styles and Team Behavior in the Operating Room

    PubMed Central

    Hu, Yue-Yung; Parker, Sarah Henrickson; Lipsitz, Stuart R; Arriaga, Alexander F; Peyre, Sarah E; Corso, Katherine A; Roth, Emilie M; Yule, Steven J; Greenberg, Caprice C

    2016-01-01

    Background The importance of leadership is recognized in surgery, but the specific impact of leadership style on team behavior is not well understood. In other industries, leadership is a well-characterized construct. One dominant theory proposes that transactional (task-focused) leaders achieve minimum standards, whereas transformational (team-oriented) leaders inspire performance beyond expectations. Study Design We video-recorded 5 surgeons performing complex operations. Each surgeon was scored on the Multifactor Leadership Questionnaire, a validated method for scoring transformational and transactional leadership style, by an organizational psychologist and a surgeon-researcher. Independent coders assessed surgeons' leadership behaviors according to the Surgical Leadership Inventory and team behaviors (information-sharing, cooperative, and voice behaviors). All coders were blinded. Leadership style (MLQ) was correlated with surgeon behavior (SLI) and team behavior using Poisson regression, controlling for time and the total number of behaviors, respectively. Results All surgeons scored similarly on transactional leadership (2.38-2.69), but varied more widely on transformational leadership (1.98-3.60). Each 1-point increase in transformational score corresponded to 3× more information-sharing behaviors (p<0.0001) and 5.4× more voice behaviors (p=0.0005) amongst the team. With each 1-point increase in transformational score, leaders displayed 10× more supportive behaviors (p<0.0001) and 12.5× less frequently displayed poor behaviors (p<0.0001). Excerpts of representative dialogue are included for illustration. Conclusions We provide a framework for evaluating surgeons' leadership and its impact on team performance in the OR. As in other fields, our data suggest that transformational leadership is associated with improved team behavior. Surgeon leadership development therefore has the potential to improve the efficiency and safety of operative care. PMID

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

    PubMed

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

    2016-12-01

    This article reports the results of a case study of the consequences of mobile device use for the work practices of operating room nurses. The study identifies different patterns of mobile technology use by operating room nurses, including both work-related and non-work-related use. These patterns have multiple consequences for nurses, such as improvements in information access, e-learning and work-related communication, as well as a perceived increase in distractions from the collaborative work. We conceptualize these consequences in terms of three level effects and explain how we find both positive and negative consequences on the third level. On the positive side, improvements were found in how nurses spent their unoccupied time during the stable parts of operations, contributing to their well-being and job satisfaction. A negative consequence was the perceived increase in distraction from the collaborative operating room work practices.

  19. 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…

  20. [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.

  1. [The role of the pharmacist in the management of the operating room].

    PubMed

    Kihira, Kenji

    2012-03-01

    Pharmacy services have traditionally consisted of dispensing, provision of drug information and inventory management practices. Pharmacist's impact on the implementation of medication safety standards, drug therapy optimization, and other clinical interventions has been adequately reviewed in settings of general wards and considered as standard practice; however, these activities in the operating room have not become the standard practice. In this article, we reviewed the clinical interventions by pharmacists working in the operating room. The five main duties or obligations required of the pharmacists are appropriate drug management, achieving medical economic benefits, mixing injectable drugs, risk management, and provision of drug information. The major information provided to physicians and nurses is on usage, dosage, stability, incompatibility, pharmacological effects and adverse effects. Physicians and nurses require the drug information provided by the pharmacist in the operating room. Furthermore, their requirement for the stationing of pharmacist is extremely high. It is suggested that these services might be quite important in optimizing drug therapy and preventing adverse effects. Additionally, pharmacist can contribute on rational use of drug, safety management, reduction of works of other medical staff, and also the medical economics through pharmaceutical care in operating room as well as in general wards. It is suggested that stationing pharmacists in the operating room might be indispensable for hospital administration in view of the medication safety and cost reduction.

  2. Quality of inguinal hernia operative reports: room for improvement

    PubMed Central

    Ma, Grace W.; Pooni, Amandeep; Forbes, Shawn S.; Eskicioglu, Cagla; Pearsall, Emily; Brenneman, Fred D.; McLeod, Robin S.

    2013-01-01

    Background Operative reports (ORs) serve as the official documentation of surgical procedures. They are essential for optimal patient care, physician accountability and billing, and direction for clinical research and auditing. Nonstandardized narrative reports are often of poor quality and lacking in detail. We sought to audit the completeness of narrative inguinal hernia ORs. Methods A standardized checklist for inguinal hernia repair (IHR) comprising 33 variables was developed by consensus of 4 surgeons. Five high-volume IHR surgeons categorized items as essential, preferable or nonessential. We audited ORs for open IHR at 6 academic hospitals. Results We audited 213 ORs, and we excluded 7 femoral hernia ORs. Tension-free repairs were the most common (82.5%), and the plug-and-patch technique was the most frequent (52.9%). Residents dictated 59% of ORs. Of 33 variables, 15 were considered essential and, on average, 10.8 ± 1.3 were included. Poorly reported elements included first occurrence versus recurrent repair (8.3%), small bowel viability in incarcerated hernias (10.7%) and occurrence of intraoperative complications (32.5%). Of 18 nonessential elements, deep vein thrombosis prophylaxis, preoperative antibiotics and urgency were reported in 1.9%, 11.7% and 24.3% of ORs, respectively. Repair-specific details were reported in 0 to 97.1% of ORs, including patch sutured to tubercle (55.1%) and location of plug (67.0%). Conclusion Completeness of IHR ORs varied with regards to essential and nonessential items but were generally incomplete, suggesting there is opportunity for improvement, including implementation of a standardized synoptic OR. PMID:24284146

  3. Modes of mechanical ventilation for the operating room.

    PubMed

    Ball, Lorenzo; Dameri, Maddalena; Pelosi, Paolo

    2015-09-01

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

  4. Ergonomic design in the operating room: information technologies

    NASA Astrophysics Data System (ADS)

    Morita, Mark M.; Ratib, Osman

    2005-04-01

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

  5. [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.

  6. [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).

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

    PubMed

    Preskitt, John T

    2011-04-01

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

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

    PubMed Central

    2011-01-01

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

  9. Room temperature operation of GaSb-based resonant tunneling diodes by prewell injection

    NASA Astrophysics Data System (ADS)

    Pfenning, Andreas; Knebl, Georg; Hartmann, Fabian; Weih, Robert; Bader, Andreas; Emmerling, Monika; Kamp, Martin; Höfling, Sven; Worschech, Lukas

    2017-01-01

    We present room temperature resonant tunneling of GaSb/AlAsSb double barrier resonant tunneling diodes with pseudomorphically grown prewell emitter structures comprising the ternary compound semiconductors GaInSb and GaAsSb. At room temperature, resonant tunneling is absent for diode structures without prewell emitters. The incorporation of Ga0.84In0.16Sb and GaAs0.05Sb0.95 prewell emitters leads to room temperature resonant tunneling with peak-to-valley current ratios of 1.45 and 1.36 , respectively. The room temperature operation is attributed to the enhanced Γ-L-valley energy separation and consequently depopulation of L-valley states in the conduction band of the ternary compound emitter prewell with respect to bulk GaSb.

  10. Abstracts from the First Annual Baylor Scott and White Surgery Research Day

    PubMed Central

    2014-01-01

    The First Annual Baylor Scott and White Surgery Research Day was held on May 2, 2014, in Temple, Texas. The program built on the tradition of eight previous research days for the Texas A&M Health Science Center College of Medicine and Scott & White Memorial Hospital and this year included the Department of Surgery at Baylor University Medical Center at Dallas. The forum is open to all Baylor Scott and White surgery fellows, residents, and medical students and includes a variety of basic science, clinical, and educational research projects with a focus on trainees’ research. The 2014 forum was organized by Dr. J. Scott Thomas and Dr. Raman C. Mahabir, under the guidance of Dr. Harry T. Papaconstantinou. This article highlights the top 16 abstracts selected from the submissions for presentation from the podium. PMID:25484497

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

    PubMed

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

    1990-05-01

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

  12. 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

  13. 21 CFR 113.87 - Operations in the thermal processing room.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 2 2012-04-01 2012-04-01 false Operations in the thermal processing room. 113.87 Section 113.87 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) FOOD FOR HUMAN CONSUMPTION THERMALLY PROCESSED LOW-ACID FOODS PACKAGED IN HERMETICALLY...

  14. 21 CFR 113.87 - Operations in the thermal processing room.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

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

  15. Exposure of hospital operating room personnel to potentially harmful environmental agents

    SciTech Connect

    Sass-Kortsak, A.M.; Purdham, J.T.; Bozek, P.R.; Murphy, J.H. )

    1992-03-01

    Epidemiologic studies of risk to reproductive health arising from the operating room environment have been inconclusive and lack quantitative exposure information. This study was undertaken to quantify exposure of operating room (OR) personnel to anesthetic agents, x-radiation, methyl methacrylate, and ethylene oxide and to determine how exposure varies with different operating room factors. Exposures of anesthetists and nurses to these agents were determined in selected operating rooms over three consecutive days. Each subject was asked to wear an x-radiation dosimeter for 1 month. Exposure to anesthetic agents was found to be influenced by the age of the OR facility, type of surgical service, number of procedures carried out during the day, type of anesthetic circuitry, and method of anesthesia delivery. Anesthetists were found to have significantly greater exposures than OR nurses. Exposure of OR personnel to ethylene oxide, methyl methacrylate, and x-radiation were well within existing standards. Exposure of anesthetists and nurses to anesthetic agents, at times, was in excess of Ontario exposure guidelines, despite improvements in the control of anesthetic pollution.

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

    DTIC Science & Technology

    2008-06-26

    the same (Cromwell, Adamache, & Drozd, 2006; Laszewski , 2003). In this cost-conscious, competitive environment, the operating room (OR) is...is_3_26/ai_nl3478910. Laszewski , R. (1993). Conditions for consensus. Health Management Quarterly 15, 2-7. Manchikanti, L. (2008). Health care reform in

  17. Interactions between anesthesiologists and the environment while providing anesthesia care in the operating room.

    PubMed

    Munoz-Price, L Silvia; Lubarsky, David A; Arheart, Kristopher L; Prado, Guillermo; Cleary, Timothy; Fajardo-Aquino, Yovanit; Depascale, Dennise; Eber, Scott; Carling, Philip; Birnbach, David J

    2013-10-01

    We describe 1,132 contacts between anesthesiologists and the operating room. Objects most commonly touched included anesthesia machines and keyboards. Only 13 hand hygiene events were witnessed during 8 hours of observations. Line insertions, bronchoscopies, or blood exposures were not followed by hand hygiene. Stopcocks were accessed 66 times and only disinfected on 10 (15%) of these occasions.

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

    PubMed Central

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

    2011-01-01

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

  19. Bacterial contamination of floors and other surfaces in operating rooms: a five-year survey.

    PubMed

    Suzuki, A; Namba, Y; Matsuura, M; Horisawa, A

    1984-12-01

    Bacterial contamination of floors and other surfaces in the operating suite has been investigated by contact impression plates during the past five years. Colony counts of the floors of operating rooms, cleaned with disinfectant, were 3.3 c.f.u./10 cm2; on the floors of semi-clean and dirty areas, cleaned with detergent, colony counts were 44.8 and 71.4 c.f.u./10 cm2 respectively. The highest colony counts of 487.4 c.f.u./10 cm2 were found in the dressing rooms, the floors of which were covered with carpets, cleaned with a vacuum cleaner. Mean bacterial numbers on surfaces of various equipment in operating rooms, cleaned with disinfectant, were 2.8 c.f.u./10 cm2. Bacterial numbers on surfaces decreased markedly from 253.2 to 11.9 c.f.u./10 cm2 following the use of disinfectant. Bacterial species found from various surfaces were mainly coagulase-negative staphylococci, derived from human beings. In the light of these findings the regular use of disinfectant for cleaning of the floors and other surfaces in operating rooms is advisable.

  20. 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.

  1. 21 CFR 878.5070 - Air-handling apparatus for a surgical operating room.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

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

  2. 21 CFR 878.5070 - Air-handling apparatus for a surgical operating room.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

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

  3. 21 CFR 878.5070 - Air-handling apparatus for a surgical operating room.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

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

  4. 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

  5. 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

  6. 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.

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

    SciTech Connect

    Ronald L. Boring; J.J. Persensky

    2012-07-01

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

  8. 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.

  9. Improving environmental quality in an operating room: clinical outcomes and economic implications.

    PubMed

    Sartini, M; Spagnolo, A M; Panatto, D; Perdelli, F; Cristina, M L

    2013-06-01

    An experimental study was conducted in a hospital in Liguria (northern Italy) on two groups of patients with the same disease severity who were undergoing the same type of surgery (primary hemiarthroplasty). Our aim was to assessing the results of a quality-improvement scheme implemented in the operating room. The quality-improvement protocol involved analyzing a set of parameters concerning the operating team's behavior and environmental conditions that could be attributed to the operating team itself A program of training and sanitary education was carried to rectify any improper behavior of the operating staff Two hundred and six hip-joint replacement operations (primary hip hemiarthroplasty--ICD9-CM 81.51) all conducted in the same operating room were studied: 103 patients, i.e. operations performed before the quality-improvement scheme and 103 patients, i.e. operations performed after the quality improvement scheme; all were comparable in terms of type of surgery and severity. The scheme resulted in an improvement in both behavioral and environmental parameters and an 80% reduction in the level of microbial air contamination (p < 0.001). Patient outcomes improved in terms of average postoperative hospitalization time, the occurrence and duration of fever (> 37.5 degrees C) and microbiological contamination of surgical wounds. From an economic point of view, facility efficiency increased by 28.57%, average hospitalization time decreased (p < 0.001) and a theoretical increase of Euro 1,441,373.58 a year in revenues was achieved.

  10. 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…

  11. 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…

  12. Undergraduate surgical nursing preparation and guided operating room experience: A quantitative analysis.

    PubMed

    Foran, Paula

    2016-01-01

    The aim of this research was to determine if guided operating theatre experience in the undergraduate nursing curricula enhanced surgical knowledge and understanding of nursing care provided outside this specialist area in the pre- and post-operative surgical wards. Using quantitative analyses, undergraduate nurses were knowledge tested on areas of pre- and post-operative surgical nursing in their final semester of study. As much learning occurs in nurses' first year of practice, participants were re-tested again after their Graduate Nurse Program/Preceptorship year. Participants' results were compared to the model of operating room education they had participated in to determine if there was a relationship between the type of theatre education they experienced (if any) and their knowledge of surgical ward nursing. Findings revealed undergraduates nurses receiving guided operating theatre experience had a 76% pass rate compared to 56% with non-guided or no experience (p < 0.001). Graduates with guided operating theatre experience as undergraduates or graduate nurses achieved a 100% pass rate compared to 53% with non-guided or no experience (p < 0.001). The research informs us that undergraduate nurses achieve greater learning about surgical ward nursing via guided operating room experience as opposed to surgical ward nursing experience alone.

  13. 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.

  14. 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.

  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. 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

  17. Traffic in the operating room: a review of factors influencing air flow and surgical wound contamination.

    PubMed

    Pokrywka, Marian; Byers, Karin

    2013-06-01

    Surgical wound contamination leading to surgical site infection can result from disruption of the intended airflow in the operating room (OR). When personnel enter and exit the OR, or create unnecessary movement and traffic during the procedure, the intended airflow in the vicinity of the open wound becomes disrupted and does not adequately remove airborne contaminants from the sterile field. An increase in the bacterial counts of airborne microorganisms is noted during increased activity levels within the OR. Researchers have studied OR traffic and door openings as a determinant of air contamination. During a surgical procedure the door to the operating room may be open as long as 20 minutes out of each surgical hour during critical procedures involving implants. Interventions into limiting excessive movement and traffic in the OR may lead to reductions in surgical site infections in select populations.

  18. 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.

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

    DTIC Science & Technology

    2008-05-01

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

  20. Application of Hierarchical Goal Analysis to the Halifax Class Frigate Operations Room: A Case Study

    DTIC Science & Technology

    2007-11-01

    Application of hierarchical goal analysis to the Halifax Class frigate operations room: A case study Renee Chow DRDC Toronto Jacquelyn M.Crebolder...Defence Research and Development Canada Recherche et développement pour la défense Canada DEFENCE DÉFENSE & Application of hierarchical goal...This paper reports on the first application of Hierarchical Goal Analysis (HGA) [1], a relatively new approach to requirements analysis for

  1. Application of Lean Methodology for Improved Quality and Efficiency in Operating Room Instrument Availability.

    PubMed

    Farrokhi, Farrokh R; Gunther, Maria; Williams, Barbara; Blackmore, Christopher Craig

    2015-01-01

    Advances in surgical instrumentation allow surgeons to treat patients with less morbidity and shorter recovery time. However, the increasing complexity also adds to surgical risk, and to operating room supply chain burden. To improve the quality and efficiency of operating room instrument availability, we developed and validated a Lean 5S approach consisting of sort (determining instrument usage and waste), simplify (removing unnecessary instruments), sweep (confirm availability of needed instruments), standardize (all trays the same for a given procedure), and self-discipline (monitor success). The primary outcome was reduction in unnecessary instruments delivered to the operating room. As a secondary analysis, we evaluated the effect of the Lean instrument intervention on surgery times. We reduced the number of instruments for minimally invasive spine surgery by 70% (from 197 to 58), and setup time decreased 37% (13.1-8.2 min, p = .0015). We also report subsequent validation of the approach on deep brain stimulator cases. We conclude that complex surgical procedures offer opportunities for substantial waste reduction, simplification, and quality improvement, with potential institutional annual cost savings of $2.8 million. We demonstrate that Lean methodology can improve quality at lower cost.

  2. 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.

  3. Transfer of bacteria between biomaterials surfaces in the operating room--an experimental study.

    PubMed

    Knobben, Bas A S; van der Mei, Henny C; van Horn, Jim R; Busscher, Henk J

    2007-03-15

    Bacterial adhesion to and transfer between surfaces is a complicated process. With regard to the success of biomaterials implants, studies on bacterial adhesion and transfer should not be confined to biomaterials surfaces in the human body, but also encompass surfaces in the operating room, where the origin of many biomaterials related infections is found. The purpose of this study was to quantify the transfer of Staphylococcus aureus, Staphylococcus epidermidis, and Propionibacterium acnes from one operating room material to another, while accounting for surface hydrophobicity and roughness, moistness and application of friction during transfer. The tested operating room materials were gloves, broaches (orthopaedic drills), theatre gowns, and light handles. As a possible clinical intervention method to prevent transfer, it was investigated whether dipping the gloves in a chlorhexidine splash-basin affected the viability of the transferred bacteria. Transfer (moist and without friction) was demonstrated to some extent with all bacterial strains and with every material, ranging from 17% to 71%, and was influenced by the bacterial strain, moistness of the inoculum, the application of friction, and the characteristics of both the donating and the receiving surface. Dipping the glove material in 4% or 0.4% chlorhexidine solutions killed all bacteria present, regardless of whether surfaces were dried or moist and thus prevented transfer.

  4. Multi-color tunneling quantum dot infrared photodetectors operating at room temperature

    NASA Astrophysics Data System (ADS)

    Ariyawansa, G.; Perera, A. G. U.; Su, X. H.; Chakrabarti, S.; Bhattacharya, P.

    2007-04-01

    Quantum dot structures designed for multi-color infrared detection and high temperature (or room temperature) operation are demonstrated. A novel approach, tunneling quantum dot (T-QD), was successfully demonstrated with a detector that can be operated at room temperature due to the reduction of the dark current by blocking barriers incorporated into the structure. Photoexcited carriers are selectively collected from InGaAs quantum dots by resonant tunneling, while the dark current is blocked by AlGaAs/InGaAs tunneling barriers placed in the structure. A two-color tunneling-quantum dot infrared photodetector (T-QDIP) with photoresponse peaks at 6 μm and 17 μm operating at room temperature will be discussed. Furthermore, the idea can be used to develop terahertz T-QD detectors operating at high temperatures. Successful results obtained for a T-QDIP designed for THz operations are presented. Another approach, bi-layer quantum dot, uses two layers of InAs quantum dots (QDs) with different sizes separated by a thin GaAs layer. The detector response was observed at three distinct wavelengths in short-, mid-, and far-infrared regions (5.6, 8.0, and 23.0 μm). Based on theoretical calculations, photoluminescence and infrared spectral measurements, the 5.6 and 23.0 μm peaks are connected to the states in smaller QDs in the structure. The narrow peaks emphasize the uniform size distribution of QDs grown by molecular beam epitaxy. These detectors can be employed in numerous applications such as environmental monitoring, spectroscopy, medical diagnosis, battlefield-imaging, space astronomy applications, mine detection, and remote-sensing.

  5. [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.

  6. 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.

  7. 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.

  8. 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.

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

    NASA Technical Reports Server (NTRS)

    1983-01-01

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

  10. 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...

  11. 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...

  12. 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...

  13. 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...

  14. 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...

  15. Marine Corps Operational Medicine: An Analysis of Medical Supply Requirements for the Surgical Company Operating Room

    DTIC Science & Technology

    2004-06-18

    6515003669200 Forceps Bone Cutting Bethune 13.5" Lg Cupped Screw Lock Crs 1 EA 6515003333700 Forceps Dressing 10" Lg Straight & Serrated Rd Tip Heavy...34 Jaw 2 EA 6515003352900 Forceps Intestinal Babcock 7.75" O/A Lg Straight Box Lock Crs 4 EA 6515003355800 Forceps Kidney Pedicle Guyon-Pean...6515012045394 Resuscitator Hand Operated Ipp High O2 Small & Med Adult Face Masks W/Case 1 EA 6515012080576 Stimulator Nerve High/Low Output

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

    PubMed

    Wachtel, Ruth E; Dexter, Franklin

    2013-12-01

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

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

    PubMed

    Albrecht, Mark; Gauthier, Robert; Leaper, David

    2009-10-10

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

  18. Facilitating skin-to-skin contact in the operating room after cesarean birth.

    PubMed

    Stone, Susan; Prater, Lyn; Spencer, Rebecca

    2014-12-01

    We implemented an evidence-based practice change to provide early skin-to-skin contact (SSC) in non-emergent, full-term cesarean surgical births among low-risk healthy women. There were three aims of this project: (1) To develop a protocol for health care professionals' roles in providing SSC in the operating room; (2) To implement the protocol; and (3) To evaluate the process of implementation of the evidence-based intervention. The "champion team" concept was crucial to the project's success.

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

    DTIC Science & Technology

    1981-08-01

    predicting procedure times. Literature Review The problem of operating room scheduling has long been recognized as a critical one in the health care field, and...1978), p. 193. 1 8Ibid., p. 194. 19Priest, p. 81. 2 0Richard Bendix et al, "Computer Scheduling for the O.R.," Modern Health Care 5 (June 1976), p. 16n...48+. Bendix, Richard; Bhargara, V.; Griffith, W.; Walsh, C.; and Berland, T. "Computer Scheduling for the OR." Modern Health Care 5 (June 1976): 16m

  20. A room-temperature semiconductor spaser operating near 1.5 μm.

    PubMed

    Flynn, R A; Kim, C S; Vurgaftman, I; Kim, M; Meyer, J R; Mäkinen, A J; Bussmann, K; Cheng, L; Choa, F-S; Long, J P

    2011-04-25

    Room temperature spasing of surface plasmon polaritons at 1.46 μm wavelength has been demonstrated by sandwiching a gold-film plasmonic waveguide between optically pumped InGaAs quantum-well gain media. The spaser exhibits gain narrowing, the expected transverse-magnetic polarization, and mirror feedback provided by cleaved facets in a 1-mm long cavity fabricated with a flip-chip approach. The 1.06-μm pump-threshold of ~60 kW/cm2 is in good agreement with calculations. The architecture is readily adaptable to all-electrical operation on an integrated microchip.

  1. 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.

  2. 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.

  3. 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.

  4. 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.

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

    PubMed

    Tang, Chin-Sheng; Wan, Gwo-Hwa

    2013-01-01

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

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

    PubMed

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

    2007-06-01

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

  7. 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.

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

    NASA Astrophysics Data System (ADS)

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

    2014-05-01

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

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

    PubMed

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

    2010-01-01

    To improve safety in the operating theater, a company of aviation pilots was employed to guide implementation of preprocedural briefings. A 5-point Likert scale survey that assessed the attitudes of operating room personnel toward patient safety was distributed before and 6 months following implementation of the briefings. Using Mann-Whitney analysis, the survey showed a significant (P < .05) improvement in 2 questions (of 13) involving reporting error and 2 questions (of 11) involving patient safety climate. When analyzed by occupation, there were no significant changes for faculty physicians; for resident physicians, there was a significant improvement in 1 question (of 13) regarding error reporting. For nurses, there were significant improvements in 3 questions (of 4) involving teamwork, 1 question (of 13) involving reporting error, and 3 questions (of 11) regarding patient safety climate. These results suggest that aviation-based crew resource management initiatives lead to an improved perception of patient safety, which was largely demonstrated by nursing personnel.

  10. [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.

  11. 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

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

    PubMed Central

    Spiess, Bruce D.

    2011-01-01

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

  13. Application of Mathematical Models in Combination with Monte Carlo Simulation for Prediction of Isoflurane Concentration in an Operation Room Theater

    PubMed Central

    ZARE SAKHVIDI, Mohammad Javad; BARKHORDARI, Abolfazl; SALEHI, Maryam; BEHDAD, Shekoofeh; FALLAHZADEH, Hossein

    2013-01-01

    Applicability of two mathematical models in inhalation exposure prediction (well mixed room and near field-far field model) were validated against standard sampling method in one operation room for isoflurane. Ninety six air samples were collected from near and far field of the room and quantified by gas chromatography-flame ionization detector. Isoflurane concentration was also predicted by the models. Monte Carlo simulation was used to incorporate the role of parameters variability. The models relatively gave more conservative results than the measurements. There was no significant difference between the models and direct measurements results. There was no difference between the concentration prediction of well mixed room model and near field far field model. It suggests that the dispersion regime in room was close to well mixed situation. Direct sampling showed that the exposure in the same room for same type of operation could be up to 17 times variable which can be incorporated by Monte Carlo simulation. Mathematical models are valuable option for prediction of exposure in operation rooms. Our results also suggest that incorporating the role of parameters variability by conducting Monte Carlo simulation can enhance the strength of prediction in occupational hygiene decision making. PMID:23912206

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

    NASA Technical Reports Server (NTRS)

    1990-01-01

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

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

    NASA Technical Reports Server (NTRS)

    1990-01-01

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

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

    PubMed

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

    2016-12-01

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

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

    PubMed

    Quint, U; Benen, T

    2016-04-01

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

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

    PubMed

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

    2011-05-01

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

  19. Fundamental Use of Surgical Energy (FUSE): An Essential Educational Program for Operating Room Safety

    PubMed Central

    Jones, Stephanie B; Munro, Malcolm G; Feldman, Liane S; Robinson, Thomas N; Brunt, L Michael; Schwaitzberg, Steven D; Jones, Daniel B; Fuchshuber, Pascal R

    2017-01-01

    Operating room (OR) safety has become a major concern in patient safety since the 1990s. Improvement of team communication and behavior is a popular target for safety programming at the institutional level. Despite these efforts, essential safety gaps remain in the OR and procedure rooms. A prime example is the use of energy-based devices in ORs and procedural areas. The lack of fundamental understanding of energy device function, design, and application contributes to avoidable injury and harm at a rate of approximately 1 to 2 per 1000 patients in the US. Hundreds of OR fires occur each year in the US, some causing severe injury and even death. Most of these fires are associated with the use of energy-based surgical devices. In response to this safety issue, the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) developed the Fundamental Use of Surgical Energy (FUSE) program. This program includes a standardized curriculum targeted to surgeons, other physicians, and allied health care professionals and a psychometrically designed and validated certification test. A successful FUSE certification documents acquisition of the basic knowledge needed to safely use energy-based devices in the OR. By design FUSE fills a void in the curriculum and competency assessment for surgeons and other procedural specialists in the use of energy-based devices in patients. PMID:28241913

  20. Fundamental Use of Surgical Energy (FUSE): An Essential Educational Program for Operating Room Safety.

    PubMed

    Jones, Stephanie B; Munro, Malcolm G; Feldman, Liane S; Robinson, Thomas N; Brunt, L Michael; Schwaitzberg, Steven D; Jones, Daniel B; Fuchshuber, Pascal R

    2017-01-01

    Operating room (OR) safety has become a major concern in patient safety since the 1990s. Improvement of team communication and behavior is a popular target for safety programming at the institutional level. Despite these efforts, essential safety gaps remain in the OR and procedure rooms. A prime example is the use of energy-based devices in ORs and procedural areas. The lack of fundamental understanding of energy device function, design, and application contributes to avoidable injury and harm at a rate of approximately 1 to 2 per 1000 patients in the US. Hundreds of OR fires occur each year in the US, some causing severe injury and even death. Most of these fires are associated with the use of energy-based surgical devices.In response to this safety issue, the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) developed the Fundamental Use of Surgical Energy (FUSE) program. This program includes a standardized curriculum targeted to surgeons, other physicians, and allied health care professionals and a psychometrically designed and validated certification test. A successful FUSE certification documents acquisition of the basic knowledge needed to safely use energy-based devices in the OR. By design FUSE fills a void in the curriculum and competency assessment for surgeons and other procedural specialists in the use of energy-based devices in patients.

  1. 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.

  2. 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.

  3. Investigation of room ventilation for improved operation of a downdraft table

    SciTech Connect

    Jayaraman, B.; Kristoffersen, A.; Finlayson, E.; Gadgil, A.

    2004-05-01

    We report a computational fluid dynamics (CFD) study on containment of airborne hazardous materials in a ventilated room containing a downdraft table. Specifically, we investigate the containment of hazardous airborne material obtainable under a range of ventilation configurations. The desirable ventilation configuration should ensure excellent containment of the hazardous material released from the workspace above the downdraft table. However, increased airflow raises operation costs, so the airflow should be as low as feasible without compromising containment. The airflow is modeled using Reynolds Averaged Navier Stokes equations with a high Reynolds number k-epsilon turbulence model. CFD predictions are examined for several ventilation configurations. Based on this study, we find that substantial improvements in containment are possible concurrent with a significant reduction in airflow, compared to the existing design of ventilation configuration.

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

    NASA Astrophysics Data System (ADS)

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

    2002-05-01

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

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

    PubMed

    Bosman, R J

    2009-03-01

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

  6. The effect of surgical handwashing routines on the microbial counts of operating room nurses.

    PubMed

    Pereira, L J; Lee, G M; Wade, K J

    1990-12-01

    Many factors may affect the efficiency of handwashing techniques. This study examined two interdependent factors: the time taken to wash the hands and the type of antiseptic solution used. A 3-minute initial scrub and 30-second consecutive scrub regimen was compared with a current standard regimen of a 5-minute initial scrub and a 3-minute consecutive scrub. Chlorhexidine gluconate 4% and povidone-iodine 7.5% were the antiseptics used in the two regimens. The sample (n = 34) was drawn from nurses employed in the operating room suite of a 950-bed hospital. Chlorhexidine gluconate was found to be responsible for lower numbers of colony-forming units of bacteria than povidone-iodine. The duration of the scrub had no significant effect on the numbers of bacteria when povidone-iodine was used. The optimal regimen was found to be the 5-minute initial and 3-minute consecutive scrubs with chlorhexidine gluconate.

  7. Nitrous oxide pollution in the operating room. A comparison of two modes of ventilation.

    PubMed

    Noorddin, Y; Raha, A R; Jaafar, M Z; Rozaidi, S H W; Muraly, S; Marlizan, M Y

    2007-06-01

    The use of laryngeal mask airway (LMA) as an alternative to the endotracheal tube (ETT) is becoming more popular in the practice of anesthesia. It is undeniable that this device has numerous advantages over endotracheal tube, however it does not provide an airtight seal between the airway and atmospheric gases. This may lead to pollution of the operating room environment with nitrous oxide. One hundreds adult patients undergoing general anaesthesia were divided into two groups. The airway in Group I was maintained with LMA with spontaneous ventilation and ETT with intermittent positive pressure ventilation (IPPV) was used for Group II. The result demonstrated that the ETT group recorded concentrations of nitrous oxide that were well above the NIOSH recommended eight hour time weighted average of 25ppm throughout the duration of surgery when compared to patients using LMA.

  8. 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

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

    PubMed

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

    2013-01-01

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

  11. A Case Report of Malignant Hyperthermia in a Dental Clinic Operating Room

    PubMed Central

    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

  12. [Rules of decontamination and disinfection of medicosurgical instruments in the operating room].

    PubMed

    Dumartin, C; Brücker, G

    1995-01-01

    Nosocomial infections may result from the reuse of surgical devices if adequate disinfection or sterilization measures are not employed. The first step of reprocessing occurs immediately after use in the operating room. This consists of cleaning and decontamination to eliminate organic material and to reduce the number of microorganisms, in order to protect personnel who subsequently manipulate these instruments and to facilitate the ultimate process of sterilization or disinfection. Instruments that cannot be sterilized must be submitted to "high level disinfection" to remove undesirable microorganisms. In order to guarantee the desired results of disinfection, it is very important to adopt reliable and effective protocols, chemical products with good germicidal properties and with minimal adverse effects on the personnel and the environment. The personnel involved in this delicate and important task must be thoroughly trained. If the above conditions are met, the infectious risk associated with reuse of surgical devices can be controlled.

  13. [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).

  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.

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

    PubMed Central

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

    2014-01-01

    Study Design Retrospective database review. Objective To evaluate whether microscope use during spine procedures is associated with increased operating room times or increased risk of infection. Summary of Background Data Operating microscopes are commonly used in spine procedures. It is debated whether the use of an operating microscope increases operating room time or confers increased risk of infection. Methods The American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database, which includes data from over 370 participating hospitals, was used to identify patients undergoing elective spinal procedures with and without an operating microscope for the years 2011 and 2012. Bivariate and multivariate linear regressions were used to test the association between microscope use and operating room times. Bivariate and multivariate logistic regressions were similarly conducted to test the association between microscope use and infection occurrence within 30 days of surgery. Results A total of 23,670 elective spine procedures were identified, of which 2,226 (9.4%) used an operating microscope. The average patient age was 55.1 ± 14.4 years. The average operative time (incision to closure) was 125.7 ± 82.0 minutes. Microscope use was associated with minor increases in preoperative room time (+2.9 minutes, p=0.013), operative time (+13.2 minutes, p<0.001), and total room time (+18.6 minutes, p<0.001) on multivariate analysis. A total of 328 (1.4%) patients had an infection within 30 days of surgery. Multivariate analysis revealed no significant difference between the microscope and non-microscope groups for occurrence of any infection, superficial surgical site infection (SSI), deep SSI, organ space infection, or sepsis/septic shock, regardless of surgery type. Conclusions We did not find operating room times or infection risk to be significant deterrents for use of an operating microscope during spine surgery. PMID:25188600

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

    NASA Technical Reports Server (NTRS)

    1992-01-01

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

  17. [Operation room management in quality control certification of a mainstream hospital].

    PubMed

    Leidinger, W; Meierhofer, J N; Schüpfer, G

    2006-11-01

    We report the results of our study concerning the organisation of operating room (OR) capacity planned 1 year in advance. The use of OR is controlled using 2 global controlling numbers: a) the actual time difference between the expected optimal and previously calculated OR running time and b) the punctuality of starting the first operation in each OR. The focal point of the presented OR management concept is a consensus-oriented decision-making and steering process led by a coordinator who achieves a high degree of acceptance by means of comprehensive transparency. Based on the accepted running time, the optimal productivity of OR's (OP_A(%) can be calculated. In this way an increase of the overall capacity (actual running time) of ORs was from 40% to over 55% was achieved. Nevertheless, enthusiasm and teamwork from all persons involved in the system are vital for success as well as a completely independent operating theatre manager. Using this concept over 90% of the requirements for the new certification catalogue for hospitals in Germany was achieved.

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

    PubMed

    Brandeau, Margaret L

    2016-12-01

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

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

    PubMed

    Wachtel, Ruth E; Dexter, Franklin

    2008-01-01

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

  20. Use of a Hybrid Operating Room to Improve Reduction of Syndesmotic Injuries in Ankle Fractures: A Case Report.

    PubMed

    Cancienne, Jourdan M; Crosen, Matelin P; Yarboro, Seth R

    2016-01-01

    Ankle fractures are one of the most common orthopedic injuries requiring operative treatment, and approximately 1 in 4 ankle fractures will have an associated distal tibiofibular syndesmosis disruption. Syndesmotic reduction is crucial to restoring ankle function and preventing the development of arthritis. The hybrid operating room provides 3-dimensional intraoperative imaging capabilities that can enable the surgeon to ensure the syndesmosis is appropriately reduced, particularly by comparing it with the contralateral ankle. By confirming the syndesmosis reduction intraoperatively, the risk of a return to the operating room for revision surgery is decreased.

  1. Late Operating Room Start Times Impact Mortality and Cost for Nonemergent Cardiac Surgery

    PubMed Central

    Yount, Kenan W; Lau, Christine L; Yarboro, Leora T; Ghanta, Ravi K; Kron, Irving L; Kern, John A; Ailawadi, Gorav

    2015-01-01

    Background There is growing concern over the effect of starting non-emergent cardiac surgery later in the day on clinical outcomes and resource utilization. Our objective was to determine the differences in patient outcomes for starting non-emergent cardiac surgery after 3pm. Methods All non-emergent cardiac operations performed at a single institution from July 2008 to 2013 were reviewed. Cases were stratified based on “early start” or “late start,” defined by incision time before or after 3pm. Rates of observed and risk-adjusted mortality, major complications, and costs were compared on a univariate basis for all patients and via multivariable linear and logistic regression for patients with a valid Society of Thoracic Surgeons (STS) Predicted Risk of Mortality (PROM). Results A total of 3,395 non-emergent cardiac operations were reviewed, including 368 late start cases. Compared to cases starting earlier, mortality was significantly higher for patients undergoing late operations (5.2% vs. 3.5%, p=0.046) despite similar preoperative risk (STS PROM 3.8% vs. 3.3%) and major complication rates (18.2% vs. 18.3%). Costs were 8% higher with late start cases ($51,576 vs. $47,641, p<0.001). After controlling for case type, surgeon, year, and risk, late cases resulted in higher mortality (odds ratio 2.04, p=0.041) despite shorter operative duration (16 min, p<0.001). Conclusions Starting non-emergent cardiac cases later in the day is associated with 2× higher absolute and risk-adjusted mortality. These data should be carefully considered—not only by surgeons and patients but also in the context of the operating room system—when scheduling non-emergent cardiac cases. PMID:26209491

  2. 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.

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

    NASA Astrophysics Data System (ADS)

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

    2016-11-01

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

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

    PubMed

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

    2013-01-01

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

  5. [The importance of the airborne microorganisms evaluation in the operating rooms: the biological risk for health care workers].

    PubMed

    Gioffrè, A; Dragone, M; Ammoscato, I; Iannò, A; Marramao, A; Samele, P; Sorrentino, D

    2007-01-01

    The operating room is a complex environment, traditionally considered at high infectious risk, for both the patients and the health care workers, they can contract diseases, because of the exposure for relatively long times to various dangerous chemical, physical and biological factors. The biological contamination in the operating rooms is mostly imputable to airborne and bloodborne microorganisms, whose primary source represent the staff: patients and operating team, while either secondary sources are the contaminate air introduced from the VCCC system and the use of the infect instruments. About 10% of the hospital infections are determined by airborne bacteria and a variable fraction of these, not only in immunocompromised patients but also in healthy people, may cause the respirators pathologies. The aim of this paper was to estimate the microbial contamination, in 20 hospitals located in three regions of the South Italy, for a total 81 operating rooms. The results show that 17 of the 20 operating units and 45 out of 81 operating rooms examined are contaminated. Periodic inspections should be carried out in order to control and lower the biological risk for both the patients and the health care workers.

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

    PubMed

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

    2004-01-01

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

  7. [Impact of The Netherlands Health Care Inspectorate report on patient safety in operating rooms: teamwork is better than bureaucracy].

    PubMed

    Lange, J F

    2008-10-18

    The Netherlands Health Care Inpectorate recently concluded that patient safety in operating rooms should improve. One example of improvement is the implementation of the time out procedure, which consists of a preoperative briefing and a postoperative debriefing in the operating room. There is, however, a risk of bureaucray and pro forma procedures, due to the time pressure the inspectorate has imposed. Sustainable improvement in patient safety requires teamwork and training of all members of surgical teams in non-technical skills such as communication. Crew resource management has been implemented in the intensive care departments in The Netherlands and is now being adapted for the training of integrated surgical teams.

  8. The endovascular operating room as an extension of the intensive care unit: changing strategies in the management of neurovascular disease.

    PubMed

    Bell, Randy S; Vo, Alexander H; Veznedaroglu, Erol; Armonda, Rocco A

    2006-11-01

    Technological advances within the field of endovascular neurosurgery have influenced the management of the neurovascular patient within the intensive care unit (ICU). The endovascular operating room has, in fact, become an extension of the ICU in certain cases. Given the rapid development of new endovascular technologies, it is more important than ever for neurosurgeons to remain intimately involved with the care of their patients within the ICU. This article offers an overview of the evolution in ICU management of neurovascular disease and provides a framework for the incorporation of the endovascular operating room in the intensive care management of patients with this disease.

  9. 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.

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

    PubMed Central

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

    2015-01-01

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

  11. 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

  12. 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

  13. 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.

  14. 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

  15. 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.

  16. Gestonurse: a robotic surgical nurse for handling surgical instruments in the operating room.

    PubMed

    Jacob, Mithun; Li, Yu-Ting; Akingba, George; Wachs, Juan P

    2012-03-01

    While surgeon-scrub nurse collaboration provides a fast, straightforward and inexpensive method of delivering surgical instruments to the surgeon, it often results in "mistakes" (e.g. missing information, ambiguity of instructions and delays). It has been shown that these errors can have a negative impact on the outcome of the surgery. These errors could potentially be reduced or eliminated by introducing robotics into the operating room. Gesture control is a natural and fundamentally sound alternative that allows interaction without disturbing the normal flow of surgery. This paper describes the development of a robotic scrub nurse Gestonurse to support surgeons by passing surgical instruments during surgery as required. The robot responds to recognized hand signals detected through sophisticated computer vision and pattern recognition techniques. Experimental results show that 95% of the gestures were recognized correctly. The gesture recognition algorithm presented is robust to changes in scale and rotation of the hand gestures. The system was compared to human task performance and was found to be only 0.83 s slower on average.

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

    PubMed

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

    2012-01-01

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

  18. [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.

  19. 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.

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

    PubMed

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

    2005-05-01

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

  1. Segregation for reduction of regulated medical waste in the operating room: a case report

    PubMed Central

    Shinn, Helen Ki; Kim, Byung-Gun; Yang, Chunwoo; Na, WonJu; Song, Jang-Ho

    2017-01-01

    One-third of all hospital-regulated medical waste (RMW) comes from the operating room (OR), and it considerably consists of disposable packaging and wrapping materials for the sterilization of surgical instruments. This study sought to identify the amount and type of waste produced by ORs in order to reduce the RMW so as to achieve environmentally-friendly waste management in the OR. We performed an initial waste segregation of 4 total knee replacement arthroplasties (TKRAs) and 1 total hip replacement arthroplasty, and later of 1 extra TKRA, 1 laparoscopic anterior resection of the colon, and 1 pelviscopy (with radical vaginal hysterectomy), performed at our OR. The total mass of non-regulated medical waste (non-RMW) and blue wrap amounted to 30.5 kg (24.9%), and that of RMW to 92.1 kg (75.1%). In the course of the study, we noted that the non-RMW included recyclables, such as papers, plastics, cardboards, and various wrapping materials. The study showed that a reduction in RMW generation can be achieved through the systematic segregation of OR waste. PMID:28184276

  2. Costs and Utilization of Operating Rooms in a Public Hospital in Trinidad, West Indies

    PubMed Central

    Hariharan, Seetharaman; Chen, Deryk

    2015-01-01

    Context: A top-down evaluation of the costs of operating rooms (ORs) is not commonly done because it is relevant mostly in a publicly funded system. Objective: This study was conducted to determine the costs and utilization of ORs in a public hospital in Trinidad, West Indies, for two one-year periods using a top-down model. Design: Quantitative observational study. Main Outcome Measures: A “cost-block” model suggested for evaluation of intensive care unit costs was adapted to suit ORs. Data were obtained from personal interviews, records, and surveys from the appropriate hospital departments. Adjusted OR utilization times also were recorded for both years. Results: The total annual costs of 4 ORs for the years 2006 and 2009 were approximately US $2.2 and $3.2 million, respectively. Capital expenditure contributed to 70% of the costs, followed by consumables (15%) and medical staff salary (8%). The daily cost of running the ORs was US $6242 in 2006, which rose to $8873 in 2009. The cost of unutilized OR time was approximately US $298,342 in 2006 and was reduced to $198,315 during 2009. Conclusion: The adapted cost-block model was useful to evaluate the costs of ORs in a public hospital in Trinidad and can be used from the government’s expenditure perspective. Because the cost of running the ORs was high, efficiency must be improved to minimize waste. PMID:26828072

  3. 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.

  4. Segregation for reduction of regulated medical waste in the operating room: a case report.

    PubMed

    Shinn, Helen Ki; Hwang, Youngyoen; Kim, Byung-Gun; Yang, Chunwoo; Na, WonJu; Song, Jang-Ho; Lim, Hyun Kyoung

    2017-02-01

    One-third of all hospital-regulated medical waste (RMW) comes from the operating room (OR), and it considerably consists of disposable packaging and wrapping materials for the sterilization of surgical instruments. This study sought to identify the amount and type of waste produced by ORs in order to reduce the RMW so as to achieve environmentally-friendly waste management in the OR. We performed an initial waste segregation of 4 total knee replacement arthroplasties (TKRAs) and 1 total hip replacement arthroplasty, and later of 1 extra TKRA, 1 laparoscopic anterior resection of the colon, and 1 pelviscopy (with radical vaginal hysterectomy), performed at our OR. The total mass of non-regulated medical waste (non-RMW) and blue wrap amounted to 30.5 kg (24.9%), and that of RMW to 92.1 kg (75.1%). In the course of the study, we noted that the non-RMW included recyclables, such as papers, plastics, cardboards, and various wrapping materials. The study showed that a reduction in RMW generation can be achieved through the systematic segregation of OR waste.

  5. 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.

  6. A Comparison of Two Fat Grafting Methods on Operating Room Efficiency and Costs

    PubMed Central

    Gabriel, Allen; Maxwell, G. Patrick; Griffin, Leah; Champaneria, Manish C.; Parekh, Mousam; Macarios, David

    2017-01-01

    Background Centrifugation (Cf) is a common method of fat processing but may be time consuming, especially when processing large volumes. Objectives To determine the effects on fat grafting time, volume efficiency, reoperations, and complication rates of Cf vs an autologous fat processing system (Rv) that incorporates fat harvesting and processing in a single unit. Methods We performed a retrospective cohort study of consecutive patients who underwent autologous fat grafting during reconstructive breast surgery with Rv or Cf. Endpoints measured were volume of fat harvested (lipoaspirate) and volume injected after processing, time to complete processing, reoperations, and complications. A budget impact model was used to estimate cost of Rv vs Cf. Results Ninety-eight patients underwent fat grafting with Rv, and 96 patients received Cf. Mean volumes of lipoaspirate (506.0 vs 126.1 mL) and fat injected (177.3 vs 79.2 mL) were significantly higher (P < .0001) in the Rv vs Cf group, respectively. Mean time to complete fat grafting was significantly shorter in the Rv vs Cf group (34.6 vs 90.1 minutes, respectively; P < .0001). Proportions of patients with nodule and cyst formation and/or who received reoperations were significantly less in the Rv vs Cf group. Based on these outcomes and an assumed per minute operating room cost, an average per patient cost savings of $2,870.08 was estimated with Rv vs Cf. Conclusions Compared to Cf, the Rv fat processing system allowed for a larger volume of fat to be processed for injection and decreased operative time in these patients, potentially translating to cost savings. Level of Evidence: 3 PMID:27733351

  7. Image-guided thoracoscopic surgery with dye localization in a hybrid operating room

    PubMed Central

    Yang, Shun-Mao; Ko, Wei-Chun; Lin, Mong-Wei; Chan, Chih-Yang; Wu, I-Hui; Chang, Yeun-Chung

    2016-01-01

    Background The rate of detection of small pulmonary nodules (SPNs) has increased. Thoracoscopic resection following image-guided localization had been a reliable alternative in their treatment. We present our experience with image-guided dye localization using robotic C-arm computed tomography (CT) followed by immediate video-assisted thoracoscopic surgery (VATS) for SPNs in a hybrid operating room (OR). Methods From July 2015 to July 2016, 25 consecutive patients with SPNs smaller than 2 cm underwent robotic C-arm CT-guided blue dye tattooing followed by immediate VATS in a hybrid OR. Their medical records were retrospectively reviewed to evaluate the feasibility and safety of this novel procedure. Results Robotic C-arm CT-guided dye localization was successfully performed in 23 patients (92%). Wound extension was required for nodule identification in the remaining two patients. The median size of the nodules was 1.0 cm (range, 0.6–2.0 cm). The median needle localization time and surgery time were 46 and 109 min, respectively. All 25 patients had successful resection of their lesions. The pathological diagnoses were primary lung adenocarcinoma in 18 (72%), benign tumors in 5 (20%), and metastatic lesions in 2 (8%). There was no operative mortality. The median length of the postoperative stay was 3 days (range, 2–8 days). Complications were noted in two patients (8%). One patient had a penetrating injury of the diaphragm during needle localization. The other had pneumonia postoperatively. Both patients were managed conservatively. Conclusions Our experience showed that robotic C-arm CT-guided dye localization followed by immediate thoracoscopic surgery in a hybrid OR is safe and feasible. It may become an effective and attractive alternative in managing SPNs. PMID:28066670

  8. Sensitive Infrared Photodetectors: Optimized Electron Kinetics for Room-Temperature Operation

    DTIC Science & Technology

    2010-12-20

    photoelectron lifetime (the capture time of photoelectrons) and improve the device responsivity, photoconductive gain, and sensitivity. Combining QD...parameter for improving the efficiency of room-temperature semiconductor optoelectronic devices, such as mid- and far infrared detectors, solar cells... improving the room- temperature optoelectronic devices due to expected slow relaxation between discrete QD levels. These expectations were based on the

  9. 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.

  10. 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

    2014-08-04

    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.

  11. 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…

  12. 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.

  13. 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

  14. Fox-Kemper and Willis receive Ocean Sciences Early Career Awards: Citation for Baylor Fox-Kemper

    NASA Astrophysics Data System (ADS)

    Pedlosky, Joseph

    2012-06-01

    Baylor Fox-Kemper and Josh K. Willis each received the 2011 Ocean Sciences Early Career Award at the 2011 AGU Fall Meeting, held 5-9 December in San Francisco, Calif. The award recognizes "significant contributions to and promise in the ocean sciences."

  15. Fox-Kemper and Willis receive Ocean Sciences Early Career Awards: Response from Baylor Fox-Kemper

    NASA Astrophysics Data System (ADS)

    Fox-Kemper, Baylorti

    2012-06-01

    Baylor Fox-Kemper and Josh K. Willis each received the 2011 Ocean Sciences Early Career Award at the 2011 AGU Fall Meeting, held 5-9 December in San Francisco, Calif. The award recognizes "significant contributions to and promise in the ocean sciences."

  16. 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

  17. 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

  18. The effect of distractions in the operating room during endourological procedures

    PubMed Central

    Broos, Hans J. H. P.; Witjes, J. Alfred; Hendrikx, Ad. J. M.; Scherpbier, Albert J. J. M.

    2010-01-01

    Background Professionals working in the operating room (OR) are subject to various distractions that can be detrimental to their task performance and the quality of their work. This study aimed to quantify the frequency, nature, and effect on performance of (potentially) distracting events occurring during endourological procedures and additionally explored urologists’ and residents’ perspectives on experienced ill effects due to distracting factors. Methods First, observational data were collected prospectively during endourological procedures in one OR of a teaching hospital. A seven-point ordinal scale was used to measure the level of observed interference with the main task of the surgical team. Second, semistructured interviews were conducted with eight urologists and seven urology residents in two hospitals to obtain their perspectives on the impact of distracting factors. Results Seventy-eight procedures were observed. A median of 20 distracting events occurred per procedure, which corresponds to an overall rate of one distracting event every 1.8 min. Equipment problems and procedure-related and medically irrelevant communication were the most frequently observed causes of interruptions and identified as the most distracting factors in the interviews. Occurrence of distracting factors in difficult situations requiring high levels of concentration was perceived by all interviewees as disturbing and negatively impacting performance. The majority of interviewees (13/15) thought distracting factors impacted more strongly on residents’ compared to urologists’ performance due to their different levels of experience. Conclusion Distracting events occur frequently in the OR. Equipment problems and communication, the latter both procedure-related and medically irrelevant, have the largest impact on the sterile team and regularly interrupt procedures. Distracting stimuli can influence performance negatively and should therefore be minimized. Further research

  19. 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

  20. How to preoxygenate in operative room: healthy subjects and situations "at risk".

    PubMed

    De Jong, A; Futier, E; Millot, A; Coisel, Y; Jung, B; Chanques, G; Baillard, C; Jaber, S

    2014-01-01

    Intubation is one of the most common procedures performed in operative rooms. It can be associated with life-threatening complications when difficult airway access occurs, in patients who cannot tolerate even a slight hypoxemia or when performed in patients at risk of oxygen desaturation during intubation, as obese, critically-ill and pregnant patients. To improve intubation safety, preoxygenation is a major technique, extending the duration of safe apnoea, defined as the time until a patient reaches an arterial saturation level of 88% to 90%, to allow for placement of a definitive airway. Preoxygenation consists in increasing the lung stores of oxygen, located in the functional residual capacity, and helps preventing hypoxia that may occur during intubation attempts. Obese, critically-ill and pregnant patients are especially at risk of reduced effectiveness of preoxygenation because of pathophysiological modifications (reduced functional residual capacity (FRC), increased risk of atelectasis, shunt). Three minutes tidal volume breathing or 3-8 vital capacities are recommended in general population, mostly allowing achieving a 90% end-tidal oxygen level. Recent studies have indicated that in order to maximize the value of preoxygenation (i.e, oxygenation stores) obese and critically-ill patients can benefit from the combination of breathing 100% oxygen and non-invasive positive pressure ventilation (NIV) with end-expiratory positive pressure (PEEP) in the proclive position (Trendelenburg reverse). Recruitment manoeuvres may be of interest immediately after intubation to limit the risk of lung derecruitment. Further studies are needed in the field of preoxygenation in pregnant women.

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

    PubMed Central

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

    2013-01-01

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

  2. [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.

  3. 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.

  4. Swedish translation and psychometric testing of the safety attitudes questionnaire (operating room version)

    PubMed Central

    2013-01-01

    Background Tens of millions of patients worldwide suffer from avoidable disabling injuries and death every year. Measuring the safety climate in health care is an important step in improving patient safety. The most commonly used instrument to measure safety climate is the Safety Attitudes Questionnaire (SAQ). The aim of the present study was to establish the validity and reliability of the translated version of the SAQ. Methods The SAQ was translated and adapted to the Swedish context. The survey was then carried out with 374 respondents in the operating room (OR) setting. Data was received from three hospitals, a total of 237 responses. Cronbach’s alpha and confirmatory factor analysis (CFA) was used to evaluate the reliability and validity of the instrument. Results The Cronbach’s alpha values for each of the factors of the SAQ ranged between 0.59 and 0.83. The CFA and its goodness-of-fit indices (SRMR 0.055, RMSEA 0.043, CFI 0.98) showed good model fit. Intercorrelations between the factors safety climate, teamwork climate, job satisfaction, perceptions of management, and working conditions showed moderate to high correlation with each other. The factor stress recognition had no significant correlation with teamwork climate, perception of management, or job satisfaction. Conclusions Therefore, the Swedish translation and psychometric testing of the SAQ (OR version) has good construct validity. However, the reliability analysis suggested that some of the items need further refinement to establish sound internal consistency. As suggested by previous research, the SAQ is potentially a useful tool for evaluating safety climate. However, further psychometric testing is required with larger samples to establish the psychometric properties of the instrument for use in Sweden. PMID:23506044

  5. Minimally invasive catheter procedures to assist complicated pacemaker lead extraction and implantation in the operating room.

    PubMed

    Kröpil, Patric; Lanzman, Rotem S; Miese, Falk R; Blondin, Dirk; Winter, Joachim; Scherer, Axel; Fürst, Günter

    2011-04-01

    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.

  6. 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

  7. [Education in postgraduate surgical schools: the role of the surgical tutor as supervisor in the operating room].

    PubMed

    Alloni, Rossana; Binetti, Paola; Coppola, Roberto; Arullani, Augusto

    2005-01-01

    The Postgraduate Surgical education is in an era of transition, in order to create physicians with skills and attitudes needed by modern health care. Many studies have examined the impact of surgical tutoring in surgical residency programs in USA Medical Schools, while few experiences are reported from European Universities. The new Italian guidelines for post-graduate education require a structured clinical learning with the supervision of a tutor ("attending surgeon" for surgical residency); it is a challenge to describe the role of this teacher and educator, and to implement an effective evaluation of operating room teachers. Confidential survey was administered to 14 surgical residents of the Authors' University. Questions were related to their surgical activity and their perception of educational role of tutors in operating room and tutors' teaching behaviors. Residents pointed out five behaviors they perceive as signs of tutor excellence in clinical and operating room setting. According with studies from other Universities, residents need a tutor with competency but also with good teaching skills and a mature self-perception as educator. Faculty would provide training programs for surgeons in order to improve their teaching skills and behaviors.

  8. [Operating rooms during the second half of the 20th century and its change with surgical advances].

    PubMed

    Steimle, Raoul H

    2011-01-01

    With the rise of new specialities after the World War, the number of OP rooms increases. They became gathered on the basement of buildings near the central sterilisation. To enter the OP room, everyone passes through the dressing "sas". "Slippers", uniforms, gloves and many supplies are now for single-use. Electrified operating tables with their own accessories became very useful. Air conditioning is appreciated too in our countries. The operating microscope for ORL, ophthalmology and neurosurgery is used by every one. In cardiology the coronary revascularisation being common stuff, cardiac transplantation (1967) and open-heart surgery received special attention. Vascular surgeons are dedicated to arteritiden, implants, and aortic aneurysms. Urology is focused on renal transplants (since 1959), and more recently on lithotrity and coelioscopic prostatectomy. The coeliosurgery conquered the abdominal pathology and the endoscopic techniques became current. In neurosurgery, stereotaxy to treat parkinson's disease is not used so often since Levodopa exists. But it is still useful to implant brain-stimulating electrodes for refractory parkinson's cases, some other dyskinesias, mental troubles or epilepsies. The neuronavigation brought new possibilities. At century's end, ambulatory surgery reduces surgical costs. Bigger and multidisciplinary theatres are now preferred. The open-heart surgery assisted by computer and robotics is evolving. Finally, we recall OP room accidents, which are not directly dealing with the operation.

  9. 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.

  10. 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.

  11. Ultrasensitive Room-Temperature Operable Gas Sensors Using p-Type Na:ZnO Nanoflowers for Diabetes Detection.

    PubMed

    Jaisutti, Rawat; Lee, Minkyung; Kim, Jaeyoung; Choi, Seungbeom; Ha, Tae-Jun; Kim, Jaekyun; Kim, Hyoungsub; Park, Sung Kyu; Kim, Yong-Hoon

    2017-03-15

    Ultrasensitive room-temperature operable gas sensors utilizing the photocatalytic activity of Na-doped p-type ZnO (Na:ZnO) nanoflowers (NFs) are demonstrated as a promising candidate for diabetes detection. The flowerlike Na:ZnO nanoparticles possessing ultrathin hierarchical nanosheets were synthesized by a facile solution route at a low processing temperature of 40 °C. It was found that the Na element acting as a p-type dopant was successfully incorporated in the ZnO lattice. On the basis of the synthesized p-type Na:ZnO NFs, room-temperature operable chemiresistive-type gas sensors were realized, activated by ultraviolet (UV) illumination. The Na:ZnO NF gas sensors exhibited high gas response (S of 3.35) and fast response time (∼18 s) and recovery time (∼63 s) to acetone gas (100 ppm, UV intensity of 5 mW cm(-2)), and furthermore, subppm level (0.2 ppm) detection was achieved at room temperature, which enables the diagnosis of various diseases including diabetes from exhaled breath.

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

    PubMed

    Savino, Adria C; Fordtran, John S

    2006-07-01

    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.

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

    PubMed Central

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

    2011-01-01

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

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

    PubMed Central

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

    2016-01-01

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

  15. 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.

  16. 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.

  17. [Introduction of operating room checklists as a part of clinical risk management: are there hard facts on complication prevention available?].

    PubMed

    Busemann, A; Schreiber, A; Heidecke, C-D

    2012-11-01

    For approximately the past 10 years the aspects of quality and risk management have spread widely not only into the realm of hospitals but also into overall general medicine, which is viewed by many physicians as a paradigmatic change. The required use of the WHO operating room (OR) checklist has in the meantime become routine procedure in many hospitals but with varying degrees of acceptance. Current data reaffirm the positive effect of the checklist in lowering complication and mortality rates. This effect can be directly traced to a higher level for safety culture in the OR.

  18. [Introduction of operating room checklists as a part of clinical risk management : are there hard facts on complication prevention available?].

    PubMed

    Busemann, A; Schreiber, A; Heidecke, C-D

    2012-07-01

    For approximately the past 10 years the aspects of quality and risk management have spread widely not only into the realm of hospitals but also into overall general medicine, which is viewed by many physicians as a paradigmatic change. The required use of the WHO operating room (OR) checklist has in the meantime become routine procedure in many hospitals but with varying degrees of acceptance. Current data reaffirm the positive effect of the checklist in lowering complication and mortality rates. This effect can be directly traced to a higher level for safety culture in the OR.

  19. 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.

  20. Effects of reflected CO2 laser energy on operative field materials: risks to patients and operating room personnel.

    PubMed

    Hammons, Matthew A; Ramey, Nicholas A; Stinnett, Sandra; Woodward, Julie A

    2010-01-01

    This study investigates the effects of specularly and diffusely reflected CO2 laser energy on operative field materials. The CO2 laser was reflected off the sandblasted and polished surfaces of an eyelid plate and a wet cotton gauze pad. The laser was aimed at a surgical glove, operative gown, laser safety goggles, and endotracheal tube, each positioned 5 cm, 10 cm, and 15 cm from the plate. Primary outcomes were time to initial effect and description of result. There was no reflection off wet gauze and no effect on the gauze itself. When reflected off sandblasted and polished surfaces, the laser created a hole in the glove and a flame in the surgical gown. When targeting safety goggles and an endotracheal tube, the laser created a surface divot at short distances and surface irregularity at 15 cm. While the CO2 laser is an excellent surgical instrument, reflected laser energy can affect operative field materials.

  1. Man’s Place in Spaceplane Flight Operations: Cockpit, Cargo Bay, or Control Room?

    DTIC Science & Technology

    1998-04-01

    may remain an unresolved question for a long time.1 — Maxime Faget Background These words, written by one of NASA’s founding fathers and a driving force...of how man will ultimately be integrated into a MSP system configuration. . Notes 1 Maxime Faget , Manned Spacecraft: Engineering Design and Operation...College of the Armed Forces, 1995. Faget , Maxime . Manned Spacecraft: Engineering Design and Operation. New York NY: Fairchild Publications, Inc., 1964

  2. Performance Evaluation of Conventional Sb-based Multiquantum Well Lasers operating above 3μm at Room Temperature

    NASA Astrophysics Data System (ADS)

    Kadri, A.; Zitouni, K.; Rouillard, Y.; Christol, P.

    We present the results of a theoretical performance evaluation of conventional type I Sb-based Quinary Multiple Quantum Well Lasers operating in cw at λ>3μm at Room Temperature. In this purpose, we use a k.P band structure model to calculate the optical properties of these new Quinary Sb-based heterostructures. Our calculations show that for optimized laser structures emitting near 3.3μm, modal gain value GmodalM =50cm-1 and threshold current densities Jth = 2-3 kA/cm2 are expected. Thanks to the valence band offset enhancement, hole lifetime are shown to increase by one order of magnitude in Quinary laser with respect to Quaternary counterpart. Our results show that this kind of Quinary Sb-based type I laser structures are quite convenient for cw RT Laser operation at λ>3μm.

  3. Is "intra-operating room" thromboelastometry useful in liver transplantation? A case-control study in 303 patients.

    PubMed

    Alamo, J-M; León, A; Mellado, P; Bernal, C; Marín, L M; Cepeda, C; Suárez, G; Serrano, J; Padillo, J; Gómez, M-Á

    2013-01-01

    Coagulation monitoring during liver transplantation (LT) is, even today, fundamental to reduce blood loss during surgery. Thromboelastometry (TEM) is a proven technique for controlling the various parameters that influence coagulation. However, there are no studies linking "intra-operating room" TEM (orTEM) with LT outcomes. We describe a case-control study in 303 liver graft recipients analyzing variables associated with operative complications and long-term LT outcomes. The results showed that orTEM reduced the use of blood products in patients with Model for End-Stage Liver Disease scores of ≥ 21, retransplantation, and high surgical difficulty and important intraoperative bleeding. In addition, results in survival and postoperative complications were better when orTEM was used. In conclusion, we confirm that use of orTEM is associated with less use of blood products and a lower rate of complications after LT.

  4. 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

  5. Iron overload detection in rats by means of a susceptometer operating at room temperature

    NASA Astrophysics Data System (ADS)

    Marinelli, M.; Gianesin, B.; Avignolo, C.; Minganti, V.; Parodi, S.

    2008-12-01

    Biosusceptometry is a non-invasive procedure for determination of iron overload in a human body; it is essentially an assessment of the diamagnetic (water) and paramagnetic (iron) properties of tissues. We measured in vivo iron overload in the liver region of 12 rats by a room temperature susceptometer. The rats had been injected with sub-toxic doses of iron dextran. A quantitative relationship has been observed between the measurements and the number of treatments. The assessment of iron overload requires evaluating the magnetic signal corresponding to the same rat ideally without the overload. This background value was extrapolated on the basis of the signal measured in control rats versus body weight (R2 = 0.73). The mean iron overload values for the treated rats, obtained after each iron injection, were significantly different from the means of the corresponding control rats (p < 0.01). The in vivo measurements have been complemented by chemical analysis on excised livers and other organs (R2 = 0.89). The magnetic moment of iron atoms in liver tissues was measured to be 3.6 Bohr magneton. Evaluation of the background signal is the limit to the measure; the error corresponds to about 30 mg (1 SD) of iron while the instrument sensitivity is more than a factor of 10 better.

  6. [Comparative economic evaluation of nonwoven and traditional woven textiles in operating rooms].

    PubMed

    Vincent-Ballereau, F; Trevidic, J; Lafleuriel, M T; Merville, C

    1989-01-01

    The nonwoven textiles do not let oneself unconcerned, but are often considered with reserve in the operating theatre, at least for the "noble" textiles, such as the surgical drapes or the surgeon's gowns. Their part is to set barriers to prevent against microbial contamination. Now, it is proved that these nonwoven textiles qualities rise above that of the woven materials. What are the reasons for this reserve? A survey carried out in 1986 at the Angers hospital, compared with other similar studies, have shown a cost decreased by 20 per cent on an average, when the nonwoven textiles are used for a surgical operation, except the gowns. On the other hand, the cost increases by 20 per cent when nonwoven textiles gowns are also used. The features of the traditional textiles versus nonwoven ones in an operating theatre are described and show the interest of the nonwoven textiles.

  7. Development of the Baylor Gyro permanently implantable centrifugal blood pump as a biventricular assist device.

    PubMed

    Nonaka, K; Linneweber, J; Ichikawa, S; Yoshikawa, M; Kawahito, S; Mikami, M; Motomura, T; Ishitoya, H; Nishimura, I; Oestmann, D; Glueck, J; Schima, H; Wolner, E; Shinohara, T; Nosé, Y

    2001-09-01

    The Baylor Gyro permanently implantable centrifugal blood pump (Gyro PI pump) has been under development since 1995 at Baylor College of Medicine. Excellent results were achieved as a left ventricular assist device (LVAD) with survival up to 284 days. Based on these results, we are now focusing on the development of a biventricular assist device (BVAD) system, which requires 2 pumps to be implanted simultaneously in the preperitoneal space. Our hypothesis was that the Gyro PI pump would be an appropriate device for an implantable BVAD system. The Gyro PI 700 pump is fabricated from titanium alloy and has a 25 ml priming volume, pump weight of 204 g, height of 45 mm, and pump diameter of 65 mm. This pump can provide 5 L/min against 100 mm Hg at 2,000 rpm. In this study, 6 half-Dexter healthy calves have been used as the experimental model. The right pump was applied between the infundibular of the right ventricle and the main pulmonary artery. The left pump was applied between the apex of the left ventricle and the thoracic descending aorta. As for anticoagulation, heparin was administered at the first postoperative week and then converted to warfarin sodium from the second week after surgery. Both pump flow rates were controlled maintaining a pulmonary arterial flow of less than 160 ml/kg/min for the sake of avoidance of pulmonary congestion. Blood sampling was done to assess visceral organ function, and the data regarding pump performance were collected. After encountering the endpoint, which the study could not keep for any reasons, necropsy and histopathological examinations were performed. The first 2 cases were terminated within 1 week. Deterioration of the pump flow due to suction phenomenon was recognized in both cases. To avoid the suction phenomenon, a flexible conduit attached on the inlet conduit was designed and implanted. After using the flexible inflow conduit, the required power and the rotational speed were reduced. Furthermore, the suction

  8. An interdisciplinary national program developed at Baylor to make science exciting for all K-5 students.

    PubMed

    Moreno, N P; Tharp, B Z

    1999-04-01

    The achievement gap in science begins in elementary school, where many students lose interest in science-related studies, particularly students from traditionally underrepresented groups. The "My Health My World" Project (hereafter, "the Project"), developed at Baylor College of Medicine with the assistance of federal funds, is a national effort to address this problem. The Project's goals are to make science appealing and relevant for elementary school students (i.e., kindergarten through grade five), including those from underrepresented minorities (URMs), and easy to teach for teachers and parents. It is achieving this goal by the development of interdisciplinary instructional materials that use environmental health issues as a unifying theme. The Project provides its materials (including take-home materials for parents) and training for teachers at seven dissemination centers across the country, established in 1997. Workshops are also held to train facilitators, chosen from among local science education leaders, who in turn hold workshops to train other teachers. Each center receives a mini-grant to cover costs related to the training it provides, and all coordinate their training to offer comparable experiences for all participants. Field tests in 1995, 1996, and 1997 involving culturally, racially, and ethnically diverse students and teachers in two sites indicate that the participating teachers found that the Project's materials promote science learning and enthusiasm for science and are easy to use and engaging for teachers. Ratings for workshops in 1998 were also high for all characteristics evaluated. All signs after the Project's first full year of dissemination activities (1998) indicate that it will continue to reach more teachers and students across the nation and will eventually help more students from all backgrounds achieve in science-related studies.

  9. 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…

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

    PubMed

    Matern, Ulrich

    2009-01-01

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

  11. [The risk of infection with patients with multi-drug resistant bacteria in the operating room].

    PubMed

    Latroche, Marie-France; Roche, Géraldine; Velardo, Danielle

    2015-01-01

    The risk of infection in the operating theatre is constant and multifactorial. It can be contained through a prevention process. The organisation, implementation, monitoring and the results of the patient pathway are all sources for the analysis of practices, quality and professional progress in order to limit the risks of transmitting multi-drug or highly resistant bacteria.

  12. 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

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

    PubMed

    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.

  14. 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

  15. 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.

  16. Room temperature operating InAsSb-based photovoltaic infrared sensors grown by metalorganic vapor phase epitaxy

    NASA Astrophysics Data System (ADS)

    Hasegawa, Ryosuke; Yoshikawa, Akira; Morishita, Tomohiro; Moriyasu, Yoshitaka; Nagase, Kazuhiro; Kuze, Naohiro

    2017-04-01

    We have developed InAsxSb1-x-based photovoltaic infrared sensors (PVS) for room temperature operation by metalorganic vapor phase epitaxy (MOVPE). To obtain high performance, we improved the crystallinity of the InAs0.12Sb0.88 absorber layer and utilized a Ga0.33In0.67Sb electron barrier layer. An investigation of InAs0.12Sb0.88 growth conditions using a high-quality InSb buffer layer showed that we were able to obtain the smallest full-width at half-maximum (FWHM) of the X-ray diffraction omega rocking curve, 560 arcsec, for a growth temperature of 520°C for a 1 μm thick layer. Moreover, we successfully grew a Ga0.33In0.67Sb barrier layer coherently on an InAs0.12Sb0.88 absorber layer, which is the first report of GayIn1-ySb growth on Sb-rich InAsxSb1-x. An InAsxSb1-x PVS with a responsivity at wavelengths of 8-12 μm was obtained, and estimated detectivity peak at room temperature was approximately 7×107 cm Hz1/2 W-1, which is 1.3 times higher than without a Ga0.33In0.67Sb electron barrier. These results demonstrate that our InAsxSb1-x PVS is a promising device for the 8-12 μm wavelength range at room temperature.

  17. [Anesthesia and safety of procedures outside the operating room: "everyone's responsibility"].

    PubMed

    Jastrowicz, J; Hallet, C; Roediger, L; Brichant, J F

    2011-01-01

    Due to important technological improvements, anesthesiological activity outside the operating theatre is increasing. Most of these procedures are performed for gastroenterology procedures; other procedures include medical imaging, electroconvulsive therapy or cardioversion. The practice of anesthesia at alternative sites is associated with logistical difficulties with many constraints. Anesthesia will be requested if the procedure is likely to be unpleasant or painful, if the patient is not cooperative, or if the patient's hemodynamic condition is unstable. The pre-anesthesia assessment, an adequate monitoring and an appropriate choice of the anesthetic technique and drugs will be helpful in managing an anesthetic procedure too frequently neglected despite it is associated with risks similar to procedures performed in the operating theatre.

  18. Linguistic analysis of verbal and non-verbal communication in the operating room.

    PubMed

    Moore, Alison; Butt, David; Ellis-Clarke, Jodie; Cartmill, John

    2010-12-01

    Surgery can be a triumph of co-operation, the procedure evolving as a result of joint action between multiple participants. The communication that mediates the joint action of surgery is conveyed by verbal but particularly by non-verbal signals. Competing priorities superimposed by surgical learning must also be negotiated within this context and this paper draws on techniques of systemic functional linguistics to observe and analyse the flow of information during such a phase of surgery.

  19. Behind the Scenes: Patient Safety in the Operating Room and Central Materiel Service During Deployments

    DTIC Science & Technology

    2005-01-01

    masks are worn. The work flow of people, supplies, and equipment needs to travel from dirty to clean areas in such a way that contaminated items are...standard. The OR staff used what they had to create the best dirty to clean traffic pattern possible. Training and education were paramount to their...Resistant Organism standard operating procedure was created to provide the best possible care for the patients. War wounds are notoriously dirty , and

  20. 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.

  1. 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

  2. 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.

  3. 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

  4. 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

  5. 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

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

    PubMed

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

    2015-08-06

    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.

  7. Neural networks improve brain cancer detection with Raman spectroscopy in the presence of operating room light artifacts

    NASA Astrophysics Data System (ADS)

    Jermyn, Michael; Desroches, Joannie; Mercier, Jeanne; Tremblay, Marie-Andrée; St-Arnaud, Karl; Guiot, Marie-Christine; Petrecca, Kevin; Leblond, Frederic

    2016-09-01

    Invasive brain cancer cells cannot be visualized during surgery and so they are often not removed. These residual cancer cells give rise to recurrences. In vivo Raman spectroscopy can detect these invasive cancer cells in patients with grade 2 to 4 gliomas. The robustness of this Raman signal can be dampened by spectral artifacts generated by lights in the operating room. We found that artificial neural networks (ANNs) can overcome these spectral artifacts using nonparametric and adaptive models to detect complex nonlinear spectral characteristics. Coupling ANN with Raman spectroscopy simplifies the intraoperative use of Raman spectroscopy by limiting changes required to the standard neurosurgical workflow. The ability to detect invasive brain cancer under these conditions may reduce residual cancer remaining after surgery and improve patient survival.

  8. Low threshold laser operation at room temperature in GaAs/(Al,Ga)As structures grown directly on (100)Si

    SciTech Connect

    Fischer, R.; Kopp, W.; Morkoc, H.; Pion, M.; Specht, A.; Burkhart, G.; Appelman, H.; McGougan, D.; Rice, R.

    1986-05-19

    We report the room-temperature pulsed operation of GaAs/(Al,Ga)As double heterojunction laser structures grown directly on (100)Si. Current thresholds of as low as 170 mA in 10-..mu..m-wide stripe lasers have been achieved at 280 K. Power output as high as 44 mW per facet was also obtained. Assuming no current spreading, the corresponding current threshold density is 6.9 kA/cm/sup 2/. Slope efficiencies and T/sub 0/ values of 0.18 W/A and 165 K, respectively, have also been obtained. These results are directly attributable to the reduction of dislocations by choosing growth conditions and step density on the surface.

  9. Relationship between time in the operating room and incident pressure ulcers: a matched case-control study.

    PubMed

    Hayes, Rachel M; Spear, Marcia E; Lee, Sheree I; Krauser Lupear, Buffy E; Benoit, Richard A; Valerio, Rainy; Dmochowski, Roger R

    2015-01-01

    The objective was to determine the relationship between time in the operating room (OR) and hospital-acquired pressure ulcers (HAPUs), controlling for temporality. The research team identified 931 HAPUs among surgical patients and matched them to 4 controls by hospital length of stay at the time the pressure ulcer (PU) was documented. A regression model estimated the relationship between OR time and HAPU after controlling for matching, age, sex, admission and current Braden score, weight, year, and American Society of Anesthesiologists physical status score. OR time in the 24 hours prior to PU documentation was associated with PUs. Only 5% of HAPUs occurred within 24 hours of extended (>4 hours) surgery and 58% occurred after hospital day 5. Extended surgery is confirmed as a risk factor for PU development. Most PUs do not appear in the immediate postoperative period, and prevention efforts should focus on postoperative patient care, when most HAPUs develop.

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

    DOE PAGES

    Lotfi, Hossein; Li, Lu; Lei, Lin; ...

    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

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

    SciTech Connect

    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, 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.

  12. [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.

  13. The new ACS/APDS Skills Curriculum: moving the learning curve out of the operating room.

    PubMed

    Scott, Daniel J; Dunnington, Gary L

    2008-02-01

    Surgical education has dramatically changed in response to numerous constraints placed on residency programs, but a substantial gap in uniform practices exist, especially in the area of skills laboratory availability and usage. Simulation-based training has gained significant momentum and will be a requirement for residencies in the near future. In response, the American College of Surgeons and the Association of Program Directors in Surgery have formed a Surgical Skills Curriculum Task Force with the aim of establishing a National Skills Curriculum. The first of three phases will undergo implementation in 2007, with subsequent phases scheduled for launch in 2008. The curriculum has been carefully structured and designed by content experts to enhance resident training through reproducible simulations, with verification of proficiency before operative experience. Free-of-charge distribution is planned through a web-based platform, and widespread adoption is encouraged. In the future, these simulation-based strategies may be useful in assuring the competency of practicing surgeons and for credentialing purposes.

  14. [Improvement of team competence in the operating room : Training programs from aviation].

    PubMed

    Schmidt, C E; Hardt, F; Möller, J; Malchow, B; Schmidt, K; Bauer, M

    2010-08-01

    Growing attention has been drawn to patient safety during recent months due to media reports of clinical errors. To date only clinical incident reporting systems have been implemented in acute care hospitals as instruments of risk management. However, these systems only have a limited impact on human factors which account for the majority of all errors in medicine. Crew resource management (CRM) starts here. For the commissioning of a new hospital in Minden, training programs were installed in order to maintain patient safety in a new complex environment. The training was planned in three parts: All relevant processes were defined as standard operating procedures (SOP), visualized and then simulated in the new building. In addition, staff members (trainers) in leading positions were trained in CRM in order to train the complete staff. The training programs were analyzed by questionnaires. Selection of topics, relevance for practice and mode of presentation were rated as very good by 73% of the participants. The staff members ranked the topics communication in crisis situations, individual errors and compensating measures as most important followed by case studies and teamwork. Employees improved in compliance to the SOP, team competence and communication. In high technology environments with escalating workloads and interdisciplinary organization, staff members are confronted with increasing demands in knowledge and skills. To reduce errors under such working conditions relevant processes should be standardized and trained for the emergency situation. Human performance can be supported by well-trained interpersonal skills which are evolved in CRM training. In combination these training programs make a significant contribution to maintaining patient safety.

  15. 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

  16. 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.

  17. 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.

  18. Structure-oriented versus process-oriented approach to enhance efficiency for emergency room operations: what lessons can we learn?

    PubMed

    Hwang, Taik Gun; Lee, Younsuk; Shin, Hojung

    2011-01-01

    The efficiency and quality of a healthcare system can be defined as interactions among the system structure, processes, and outcome. This article examines the effect of structural adjustment (change in floor plan or layout) and process improvement (critical pathway implementation) on performance of emergency room (ER) operations for acute cerebral infarction patients. Two large teaching hospitals participated in this study: Korea University (KU) Guro Hospital and KU Anam Hospital. The administration of Guro adopted a structure-oriented approach in improving its ER operations while the administration of Anam employed a process-oriented approach, facilitating critical pathways and protocols. To calibrate improvements, the data for time interval, length of stay, and hospital charges were collected, before and after the planned changes were implemented at each hospital. In particular, time interval is the most essential measure for handling acute stroke patients because patients' survival and recovery are affected by the promptness of diagnosis and treatment. Statistical analyses indicated that both redesign of layout at Guro and implementation of critical pathways at Anam had a positive influence on most of the performance measures. However, reduction in time interval was not consistent at Guro, demonstrating delays in processing time for a few processes. The adoption of critical pathways at Anam appeared more effective in reducing time intervals than the structural rearrangement at Guro, mainly as a result of the extensive employee training required for a critical pathway implementation. Thus, hospital managers should combine structure-oriented and process-oriented strategies to maximize effectiveness of improvement efforts.

  19. 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

  20. Applications for a hybrid operating room in thoracic surgery: from multidisciplinary procedures to ­­image-guided video-assisted thoracoscopic surgery

    PubMed Central

    Terra, Ricardo Mingarini; Andrade, Juliano Ribeiro; Mariani, Alessandro Wasum; Garcia, Rodrigo Gobbo; Succi, Jose Ernesto; Soares, Andrey; Zimmer, Paulo Marcelo

    2016-01-01

    ABSTRACT The concept of a hybrid operating room represents the union of a high-complexity surgical apparatus with state-of-the-art radiological tools (ultrasound, CT, fluoroscopy, or magnetic resonance imaging), in order to perform highly effective, minimally invasive procedures. Although the use of a hybrid operating room is well established in specialties such as neurosurgery and cardiovascular surgery, it has rarely been explored in thoracic surgery. Our objective was to discuss the possible applications of this technology in thoracic surgery, through the reporting of three cases. PMID:27812640

  1. Rui Liao's work on patient-specific 3-D model guidance for interventional and hybrid-operating-room applications.

    PubMed

    Liao, Rui

    2011-06-28

    Compared to surgery, interventional and hybrid-operating-room (OR) approaches diagnose or treat pathology with the most minimally invasive techniques possible. By minimizing the physical trauma to the patient, peripheral or hybrid approaches can reduce infection rates and recovery time as well as shorten hospital stays. Minimally invasive approaches therefore are the trend and often the preferred choice, and may even be the only option for the patients associated with high surgery risks. Common interventional imaging modalities include 2-D X-ray fluoroscopy and ultrasound. However, fluoroscopic images do not display the anatomic structures without a contrast agent, which on the other hand, needs to be minimized for patients' safety. Ultrasound images suffer from relatively low image quality and tissue contrast problems. To augment the doctor's view of the patient's anatomy and help doctors navigate the devices to the targeted area with more confidence and a higher accuracy, high-resolution pre-operative volumetric data such as computed tomography and/or magnetic resonance can be fused with intra-operative 2-D images during interventions. A seamless workflow and accurate 2-D/3-D registration as well as cardiac and/or respiratory motion compensation are the key components for a successful image guidance system using a patient-specific 3-D model. Dr. Liao's research has been focused on developing methods and systems of 3-D model guidance for various interventions and hybrid-OR applications. Dr. Liao's work has led to several Siemens products with high clinical and/or market impact and a good number of scientific publications in leading journals/conferences on medical imaging.

  2. 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...

  3. Collaborative Cultural Studies over The Internet: Learning Cultures with Virtual Partners. A Project between Baylor University and Tokyo Institute of Polytechnics.

    ERIC Educational Resources Information Center

    Okubo, Masamichi; Kumahata, Hajime

    Since the fall semester of 1995, students at Baylor University (Waco, Texas) taking Japanese and students at Tokyo Institute of Polytechnics have had opportunities to communicate with each other and learn together in a real-world situation. Until the fall of 2000, the format limited them to e-mail communication; however other Internet tools are…

  4. Persistence of unsafe practice in everyday work: an exploration of organizational and psychological factors constraining safety in the operating room.

    PubMed

    Espin, S; Lingard, L; Baker, G R; Regehr, G

    2006-06-01

    This paper explores the factors that influence the persistence of unsafe practice in an interprofessional team setting in health care, towards the development of a descriptive theoretical model for analyzing problematic practice routines. Using data collected during a mixed method interview study of 28 members of an operating room team, participants' approaches to unsafe practice were analyzed using the following three theoretical models from organizational and cognitive psychology: Reason's theory of "vulnerable system syndrome", Tucker and Edmondson's concept of first and second order problem solving, and Amalberti's model of practice migration. These three theoretical approaches provide a critical insight into key trends in the interview data, including team members' definition of error as the breaching of standards of practice, nurses' sense of scope of practice as a constraint on their reporting behaviours, and participants' reports of the forces influencing tacit agreements to work around safety regulations. However, the relational factors underlying unsafe practice routines are poorly accounted for in these theoretical approaches. Incorporating an additional theoretical construct such as "relational coordination" to account for the emotional human features of team practice would provide a more comprehensive theoretical approach for use in exploring unsafe practice routines and the forces that sustain them in healthcare team settings.

  5. How work context affects operating room processes: using data mining and computer simulation to analyze facility and process design.

    PubMed

    Baumgart, André; Denz, Christof; Bender, Hans-Joachim; Schleppers, Alexander

    2009-01-01

    The complexity of the operating room (OR) requires that both structural (eg, department layout) and behavioral (eg, staff interactions) patterns of work be considered when developing quality improvement strategies. In our study, we investigated how these contextual factors influence outpatient OR processes and the quality of care delivered. The study setting was a German university-affiliated hospital performing approximately 6000 outpatient surgeries annually. During the 3-year-study period, the hospital significantly changed its outpatient OR facility layout from a decentralized (ie, ORs in adjacent areas of the building) to a centralized (ie, ORs in immediate vicinity of each other) design. To study the impact of the facility change on OR processes, we used a mixed methods approach, including process analysis, process modeling, and social network analysis of staff interactions. The change in facility layout was seen to influence OR processes in ways that could substantially affect patient outcomes. For example, we found a potential for more errors during handovers in the new centralized design due to greater interdependency between tasks and staff. Utilization of the mixed methods approach in our analysis, as compared with that of a single assessment method, enabled a deeper understanding of the OR work context and its influence on outpatient OR processes.

  6. 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

  7. 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…

  8. 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%.

  9. [Management of the operating room at the time of emergency outbreak--the experience of the 2011 Off the Pacific Coast of Tohoku Earthquake].

    PubMed

    Isosu, Tsuyoshi; Murakawa, Masahiro

    2012-03-01

    This article introduces the operating room disaster manual of our hospital. When "The 2011 Off the Pacific Coast of Tohoku Earthquake of magnitude 9" occurred, the 9 operations were being performed in our hospital. Among these, general and regional anesthesia had been induced in 8 cases, and as for one, patient was just leaving the operation room. General anesthesia was stopped in 6 cases. In our manual, all operations should be stopped, and then immediately finished if it is possible. There was no patient injured in our hospital. This was the first time we experienced such a large scale earthquake. It seemed closer cooperation between anesthesiologists, surgeons and the other co-medical staffs are very important to manage the unusual situation.

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

    PubMed

    Levin, Jeff

    2016-08-01

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

  11. Prevalence of type I allergy to natural rubber latex and type IV allergy to latex and rubber additives in operating room staff with glove-related symptoms.

    PubMed

    Miri, Sara; Pourpak, Zahra; Zarinara, Alireza; Zarinara, Alam; Heidarzade, Marzieh; Kazemnejad, Anoushirvan; Kardar, Gholamali; Firooz, Alireza; Moin, Athar

    2007-01-01

    There is lack of data on the prevalence of latex allergy in the health care setting in Iran. This study was performed to determine the prevalence of type I latex allergy and type IV allergy to latex and rubber additives among the operating room staff with glove-related symptoms in 13 general hospitals in Tehran. Skin-prick tests with commercial latex extract, patch tests with latex and 25 rubber additive series, and total and latex-specific IgE detection were performed on the operating room staff who reported latex glove-related symptoms. Five hundred twelve self-administered questionnaires (100%) were completed by all operating room staff and latex glove-related symptoms were reported by 59 (11.5%) employees. Among all symptomatic operating room staff tested, the prevalence of type I latex allergy was 30.5% and the prevalence rates of type IV allergy to latex and rubber additives were 16.7 and 14.6%, respectively. The most positive patch test result with rubber additives was related to tetramethylthiuram monosulfide (38.5%). The risk factors for type I latex allergy were female sex (p = 0.009) and positive patch test with rubber additives (p = 0.012). Subjects who had positive patch test with latex were significantly more likely to have positive patch test with rubber additives (p < 0.0001). Our results showed a high prevalence of type I latex allergy and type IV allergy to latex and rubber additives. Based on this study, we recommend eliminating powdered latex gloves from the operating rooms of the 13 studied general hospitals and support the substitution of powder-free latex gloves.

  12. [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.

  13. 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.

  14. 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

  15. Planning for operating room efficiency and faster anesthesia wake-up time in open major upper abdominal surgery

    PubMed Central

    Lai, Hou-Chuan; Chan, Shun-Ming; Lu, Chueng-He; Wong, Chih-Shung; Cherng, Chen-Hwan; Wu, Zhi-Fu

    2017-01-01

    Abstract Reducing anesthesia-controlled time (ACT) may improve operation room (OR) efficiency result from different anesthetic techniques. However, the information about the difference in ACT between desflurane (DES) anesthesia and propofol-based total intravenous anesthesia (TIVA) techniques for open major upper abdominal surgery under general anesthesia (GA) is not available in the literature. This retrospective study uses our hospital database to analyze the ACT of open major upper abdominal surgery without liver resection after either desflurane/fentanyl-based anesthesia or TIVA via target-controlled infusion with fentanyl/propofol from January 2010 to December 2011. The various time intervals including waiting for anesthesia time, anesthesia time, surgical time, extubation time, exit from OR after extubation, total OR time, and postanesthetic care unit (PACU) stay time and percentage of prolonged extubation (≥15 minutes) were compared between these 2 anesthetic techniques. We included data from 343 patients, with 159 patients receiving TIVA and 184 patients receiving DES. The only significant difference is extubation time, TIVA was faster than the DES group (8.5 ± 3.8 vs 9.4 ± 3.7 minutes; P = 0.04). The factors contributed to prolonged extubation were age, gender, body mass index, DES anesthesia, and anesthesia time. In our hospital, propofol-based TIVA by target-controlled infusion provides faster emergence compared with DES anesthesia; however, it did not improve OR efficiency in open major abdominal surgery. Older, male gender, higher body mass index, DES anesthesia, and lengthy anesthesia time were factors that contribute to extubation time. PMID:28207547

  16. 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.

  17. 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.

  18. A Study to Determine the Impact of the PRIMUS Clinic on Patient Workload in the General Outpatient Clinic, the Emergency Room, the GYN Clinic, the Pediatric Clinic, and the Family Practice Clinic at Martin Army Community Hospital

    DTIC Science & Technology

    1989-07-07

    as obstetrics and pediatrics will be honed to a fine edge. Cherkov further suggests that construction of medical facilities outside of the hospital...ROOM, m THE OB GYN CLINIC, THE PEDIATRIC CLINIC, AND THE FAMILY o 0c C PRACTICE CLINIC AT MARTIN ARMY COMMUNITY HOSPITAL 0 0 m M xz z Baylor...Clinic on patien workload in the Outpatient, Family Practice, and Pediatrics Clinics and The Emergency Room at Martin Army Commnity Hospital. 12. PERSONAL

  19. Continuous glucose monitoring system in the operating room and intensive care unit: any difference according to measurement sites?

    PubMed

    Song, In-Kyung; Lee, Ji-Hyun; Kang, Joo-Eun; Park, Yang-Hyo; Kim, Hee-Soo; Kim, Jin-Tae

    2017-02-01

    Given the benefit of glucose control in the perioperative period, we evaluated the accuracy and performance of the continuous glucose monitoring system (CGMS) depending on different measurement sites in the operating room (OR) and in the intensive care unit (ICU). Patients over 18 years of age scheduled for elective surgery and ICU admission were enrolled prospectively. Two CGMS sensors were inserted into the subcutaneous tissue of the proximal lateral thigh and the lateral abdomen. The rate of successful measurements from thigh and abdomen in the OR and in the ICU were calculated separately. Each CGMS values were compared with the time-matched arterial blood glucose measurements. CGMS values from both measurement sites were also compared. A total of 22 patients undergoing cardiac surgeries were studied. The rate of successful measurements was higher in the ICU (73.2 %) than in the OR (66.0 %) (P = 0.01); however, that from thigh (72.9 %) and from abdomen (58.7 %) showed statistically significant difference only in the OR (P = 0.04). The Pearson correlation coefficient of thigh and abdomen versus arterial values was 0.67 and 0.60, respectively (P < 0.001). In Clarke error grid analysis, 94.6 % (89.3 % in the OR and 96.1 % in the ICU) of values from thigh fell into clinically acceptable zones compared to 93.7 % (89.0 % in the OR and 95.4 % in the ICU) from abdomen. There were no statistically significant differences in the accuracy according to measurement sites. The CGMS showed high measurement failure rate, especially in the OR. In the OR, the rate of successful measurement was higher from thigh than from abdomen. The CGMS showed low accuracy compared to arterial reference values. Nevertheless, there was no difference in the accuracy of the CGMS between two measurement sites. Perioperative performance of the CGMS still needs to be improved considering relatively low successful measurement rates.

  20. Comparison of Anesthesia-Controlled Operating Room Time between Propofol-Based Total Intravenous Anesthesia and Desflurane Anesthesia in Open Colorectal Surgery: A Retrospective Study

    PubMed Central

    Chan, Wei-Hung; Lee, Meei-Shyuan; Lin, Chin; Wu, Chang-Chieh; Lai, Hou-Chuan; Chan, Shun-Ming; Lu, Chueng-He; Cherng, Chen-Hwan

    2016-01-01

    We conducted a retrospective study to investigate the anesthesia-controlled time and factors that contribute to prolonged extubation in open colorectal surgery. Using our hospital database, demographic data, various time intervals (waiting for anesthesia time, anesthesia time, surgical time, emergence time, exit from operating room after extubation, total operating room time, and post-anesthesia care unit stay time), and incidence of prolonged extubation (≥ 15 mins), were compared between patients who received desflurane/fentanyl-based anesthesia and total intravenous anesthesia via target-controlled infusion with fentanyl/propofol. Logistic regression analyses were performed to assess the association between variables that contributed to prolonged extubation. In conclusion, the anesthesia-controlled time was similar in desflurane anesthesia and propofol-based total intravenous anesthesia for open colorectal surgery in our hospital. Surgical time greater than 210 minutes, as well as age, contributed to prolonged extubation. PMID:27780241

  1. The Effect of Inspired Oxygen Concentration and Transportation Time on Arterial Hemoglobin Oxygen Saturation During Transport from the Operating Room to the Postanesthesia Care UnitCare Unit

    DTIC Science & Technology

    1996-08-14

    during the transfer from the operating room to the postanesthesia care unit (Pullerits, Burrows, & Roy , 1987). This study focused on ASA Class I, II...was significantly higher than the mean for the cannula group. 10 Conceptual Framework The theoretical base for this research was the Roy ...adaptation model (Galbreath, 1985). The most basic premise of the Roy model is that the patient or individual is considered an adaptive system. The

  2. 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.

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

    PubMed

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

    2016-01-01

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

  4. 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

  5. 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.

  6. 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.

  7. 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

  8. 3.5-μm radius race-track microlasers operating at room temperature with 1.3-μm quantum dot active region

    NASA Astrophysics Data System (ADS)

    Kryzhanovskaya, N. V.; Polubavkina, Yu. S.; Scherbak, S. A.; Moiseev, E. I.; Zhurikhina, V. V.; Zubov, F. I.; Lipovskii, A. A.; Kulagina, M. M.; Troshkov, S. I.; Zadiranov, Yu. M.; Maximov, M. V.; Zhukov, A. E.

    2017-01-01

    We present detailed studies of optically pumped InAs/InGaAs quantum dot based racetrack microlasers with 3.5-μm bend radius operating at room temperature. Q factor over 8000 and room temperature threshold power in the mW-range were achieved in the racetrack microlasers with straight section length ranging from 0 to 4 μm. A systematic investigation of the influence of the racetrack straight section length on spatial distribution of optical modes is presented. The microcavity eigenmodes and electromagnetic field distribution calculated by means of three-dimensional numerical simulation demonstrate a good agreement with the experimental results obtained by micro-photoluminescence and scanning near-field optical microscopy. The racetracks demonstrate zigzagging behavior of the modes inside the cavity and the energy switching between the radial maxima in second-order modes. Higher-order modes are found to be suppressed in micro-photoluminescence spectra.

  9. Characteristics control of room-temperature operating single electron transistor with floating gate by charge pump circuit

    NASA Astrophysics Data System (ADS)

    Nozue, Motoki; Suzuki, Ryota; Nomura, Hirotoshi; Saraya, Takuya; Hiramoto, Toshiro

    2013-10-01

    A single electron transistor (SET) with floating gate, which has a non-volatile memory effect, is successfully integrated with a charge pump circuit that consists of conventional MOS circuits on the same chip. By applying high voltage generated by the charge pump circuit to SET with floating gate, characteristics control of the Coulomb blockade oscillation is demonstrated at room temperature for the first time. This attempt will open a new path of adding new functionality to conventional MOS circuits by integration with so-called "Beyond CMOS" devices.

  10. 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.

  11. Comparative study of tunable room-temperature laser operation in the 900-1100-nm range: LiF:F2+ and Ti3+:sapphire.

    PubMed

    Rawle, C B; McKinnie, I T; Ter-Mikirtychev, V V; Sandle, W J

    2000-08-20

    We report on a comparative evaluation of efficient room-temperature solid-state lasers based on Ti:sapphire and LiF:F(2)(+) operating in the 900-1100-nm range. LiF:F(2)(+) lasers are shown to operate with substantially lower threshold, broader tuning, and higher output pulse energies. The shorter fluorescence lifetime in LiF:F(2)(+) leads to higher peak output powers and a considerable reduction in buildup-time fluctuations. The main limitations on LiF:F(2)(+) laser operation are identified as amplified spontaneous emission (ASE) and long-term thermal degradation of the color centers. ASE restricts the tuning range, slope efficiency, and bandwidth of the LiF:F(2)(+) laser for high pump intensity, but broader tuning is achieved with longer pump pulses. The beam quality of the LiF:F(2)(+) laser is comparable with that of the Ti:sapphire laser.

  12. 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

  13. Room-temperature continuous-wave operation of GaN-based vertical-cavity surface-emitting lasers fabricated using epitaxial lateral overgrowth

    NASA Astrophysics Data System (ADS)

    Izumi, Shouichiro; Fuutagawa, Noriyuki; Hamaguchi, Tatsushi; Murayama, Masahiro; Kuramoto, Masaru; Narui, Hironobu

    2015-06-01

    We have successfully demonstrated the room-temperature continuous-wave operation of GaN-based vertical-cavity surface-emitting lasers (VCSELs) with all-dielectric reflectors, which were fabricated using epitaxial lateral overgrowth. The VCSELs exhibited a threshold current of 8 mA and a threshold voltage of 4.5 V at a lasing wavelength of 446 nm. The maximum output power was 0.9 mW for an 8-µm-diameter current aperture, which was made possible because of the high thermal conductivity of the GaN substrate.

  14. Comparison of two single-use scrub suits in terms of effect on air-borne bacteria in the operating room.

    PubMed

    Tammelin, A; Blomfeldt, A-M

    2017-03-01

    A low level of air-borne bacteria in the operating room air can be achieved if all staff wear clothes made of low-permeability material (i.e. clean air suits). This study investigated if there was a difference in protective efficacy between two single-use scrubs made of polypropylene by testing them during routinely performed orthopaedic surgical procedures. No significant difference in the colony-forming unit count/m(3) air was found between the two scrubs, so the choice can be based on which scrub type is more comfortable for staff.

  15. Room-temperature-operated sensitive hybrid gas sensor based on amorphous indium gallium zinc oxide thin-film transistors

    NASA Astrophysics Data System (ADS)

    Zan, Hsiao-Wen; Li, Chang-Hung; Yeh, Chun-Cheng; Dai, Ming-Zhi; Meng, Hsin-Fei; Tsai, Chuang-Chuang

    2011-06-01

    An organic sensing layer is capped onto an amorphous indium gallium zinc oxide (a-IGZO) thin-film transistor (TFT) to form a hybrid sensor. The organic layer, served as a second gate, forms a p-n junction with the a-IGZO film. Oxidizing or reducing vapor molecules act like electron acceptors or electron donors to change the potential of the organic layer and the current of a-IGZO TFT. A sensitive and reversible response to 100 ppb ammonia and 100 ppb acetone is obtained at room temperature. This letter opens a route to develop low-cost large-area bio/chemical sensor arrays based on the emerging a-IGZO TFT technology.

  16. Schottky Diode Based 1.2 THz Receivers Operating at Room-Temperature and Below for Planetary Atmospheric Sounding

    NASA Astrophysics Data System (ADS)

    Schlecht, Erich; Siles, Jose V.; Lee, Choonsup; Lin, Robert; Thomas, Bertrand; Chattopadhyay, Goutam; Mehdi, Imran

    2014-11-01

    In this paper, we report on the design, fabrication and test of two designs for all-solid-state planar Schottky diode based receivers working in the 1.2 THz range. At room temperature, a double side-band (DSB) mixer noise temperature of 2800 K and a conversion loss of 10.5 dB have been measured at 1134 GHz. When the mixers are cooled down to 120 K, they exhibit DSB noise temperatures as low as about 2000 K and conversion loss of 12 dB. The compact local oscillator source (LO) is based on a x2x3 chain and sufficiently pumps the sub-harmonic mixer with 1.5-2.5 mW of power. The receivers provide around 15% RF bandwidth and are well suited for planetary missions to investigate methane and other key lines.

  17. 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

  18. 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.

  19. 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.

  20. Applications for a hybrid operating room in thoracic surgery: from multidisciplinary procedures to --image-guided video-assisted thoracoscopic surgery.

    PubMed

    Terra, Ricardo Mingarini; Andrade, Juliano Ribeiro; Mariani, Alessandro Wasum; Garcia, Rodrigo Gobbo; Succi, Jose Ernesto; Soares, Andrey; Zimmer, Paulo Marcelo

    2016-01-01

    The concept of a hybrid operating room represents the union of a high-complexity surgical apparatus with state-of-the-art radiological tools (ultrasound, CT, fluoroscopy, or magnetic resonance imaging), in order to perform highly effective, minimally invasive procedures. Although the use of a hybrid operating room is well established in specialties such as neurosurgery and cardiovascular surgery, it has rarely been explored in thoracic surgery. Our objective was to discuss the possible applications of this technology in thoracic surgery, through the reporting of three cases. RESUMO O conceito de sala híbrida traduz a união de um aparato cirúrgico de alta complexidade com recursos radiológicos de última geração (ultrassom, TC, radioscopia e/ou ressonância magnética), visando a realização de procedimentos minimamente invasivos e altamente eficazes. Apesar de bem estabelecido em outras especialidades, como neurocirurgia e cirurgia cardiovascular, o uso da sala hibrida ainda é pouco explorado na cirurgia torácica. Nosso objetivo foi discutir as aplicações e as possibilidades abertas por essa tecnologia na cirurgia torácica através do relato de três casos.

  1. Dual gas-diffusion membrane- and mediatorless dihydrogen/air-breathing biofuel cell operating at room temperature

    NASA Astrophysics Data System (ADS)

    Xia, Hong-qi; So, Keisei; Kitazumi, Yuki; Shirai, Osamu; Nishikawa, Koji; Higuchi, Yoshiki; Kano, Kenji

    2016-12-01

    A membraneless direct electron transfer (DET)-type dihydrogen (H2)/air-breathing biofuel cell without any mediator was constructed wherein bilirubin oxidase from Myrothecium verrucaria (BOD) and membrane-bound [NiFe] hydrogenase from Desulfovibrio vulgaris Miyazaki F (MBH) were used as biocatalysts for the cathode and the anode, respectively, and Ketjen black-modified water proof carbon paper (KB/WPCC) was used as an electrode material. The KB/WPCC surface was modified with 2-aminobenzoic acid and p-phenylenediamine, respectively, to face the positively charged electron-accepting site of BOD and the negatively charged electron-donating site of MBH to the electrode surface. A gas-diffusion system was employed for the electrodes to realize high-speed substrate supply. As result, great improvement in the current density of O2 reduction with BOD and H2 reduction with MBH were realized at negatively and postively charged surfaces, respectively. Gas diffusion system also suppressed the oxidative inactivation of MBH at high electrode potentials. Finally, based on the improved bioanode and biocathode, a dual gas-diffusion membrane- and mediatorless H2/air-breathing biofuel cell was constructed. The maximum power density reached 6.1 mW cm-2 (at 0.72 V), and the open circuit voltage was 1.12 V using 1 atm of H2 gas as a fuel at room temperature and under passive and quiescent conditions.

  2. Ammonia gas sensors based on In2O3/PANI hetero-nanofibers operating at room temperature.

    PubMed

    Nie, Qingxin; Pang, Zengyuan; Lu, Hangyi; Cai, Yibing; Wei, Qufu

    2016-01-01

    Indium nitrate/polyvinyl pyrrolidone (In(NO3)3/PVP) composite nanofibers were synthesized via electrospinning, and then hollow structure indium oxide (In2O3) nanofibers were obtained through calcination with PVP as template material. In situ polymerization was used to prepare indium oxide/polyaniline (In2O3/PANI) composite nanofibers with different mass ratios of In2O3 to aniline. The structure and morphology of In(NO3)3/PVP, In2O3/PANI composite nanofibers and pure PANI were investigated by scanning electron microscopy (SEM), Fourier transform infrared spectroscopy (FTIR), X-ray diffraction (XRD), transmission electron microscopy (TEM) and current-voltage (I-V) measurements. The gas sensing properties of these materials towards NH3 vapor (100 to 1000 ppm) were measured at room temperature. The results revealed that the gas sensing abilities of In2O3/PANI composite nanofibers were better than pure PANI. In addition, the mass ratio of In2O3 to aniline and the p-n heterostructure between In2O3 and PANI influences the sensing performance of the In2O3/PANI composite nanofibers. In this paper, In2O3/PANI composite nanofibers with a mass ratio of 1:2 exhibited the highest response values, excellent selectivity, good repeatability and reversibility.

  3. Ammonia gas sensors based on In2O3/PANI hetero-nanofibers operating at room temperature

    PubMed Central

    Nie, Qingxin; Pang, Zengyuan; Lu, Hangyi; Cai, Yibing

    2016-01-01

    Summary Indium nitrate/polyvinyl pyrrolidone (In(NO3)3/PVP) composite nanofibers were synthesized via electrospinning, and then hollow structure indium oxide (In2O3) nanofibers were obtained through calcination with PVP as template material. In situ polymerization was used to prepare indium oxide/polyaniline (In2O3/PANI) composite nanofibers with different mass ratios of In2O3 to aniline. The structure and morphology of In(NO3)3/PVP, In2O3/PANI composite nanofibers and pure PANI were investigated by scanning electron microscopy (SEM), Fourier transform infrared spectroscopy (FTIR), X-ray diffraction (XRD), transmission electron microscopy (TEM) and current–voltage (I–V) measurements. The gas sensing properties of these materials towards NH3 vapor (100 to 1000 ppm) were measured at room temperature. The results revealed that the gas sensing abilities of In2O3/PANI composite nanofibers were better than pure PANI. In addition, the mass ratio of In2O3 to aniline and the p–n heterostructure between In2O3 and PANI influences the sensing performance of the In2O3/PANI composite nanofibers. In this paper, In2O3/PANI composite nanofibers with a mass ratio of 1:2 exhibited the highest response values, excellent selectivity, good repeatability and reversibility. PMID:27826505

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

    PubMed

    Nichols, Buford L

    2009-01-01

    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 needs of pregnant women and nursing mothers. Scientific data from the Center enable healthcare providers and policy advisors to make dietary recommendations that improve the health of today's children and that of generations to come. CNRC research has already impacted feeding guidelines for normal U.S. children and all children of the world.

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

    NASA Astrophysics Data System (ADS)

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

    2015-12-01

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

  6. Transformer room fire tests

    NASA Astrophysics Data System (ADS)

    Fustich, C. D.

    1980-03-01

    A series of transformer room fire tests are reported to demonstate the shock hazard present when automatic sprinklers operate over energized electrical equipment. Fire protection was provided by standard 0.5 inch pendent automatic sprinklers temperature rated at 135 F and installed to give approximately 150 sq ft per head coverage. A 480 v dry transformer was used in the room to provide a three phase, four wire distribution system. It is shown that the induced currents in the test room during the various tests are relatively small and pose no appreciable personnel shock hazard.

  7. 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.

  8. [Biological risk in the operating room: microbiological monitoring of the environment and analysis of the associated variables].

    PubMed

    Liguori, G; Spagnoli, G; Agozzino, E; Marinelli, A; Signoriello, G; Lucariello, A; Albano, L; Di Onofrio, V; Cammarota, B; Capozza, G; Lombardi, R; Marinelli, P

    2005-01-01

    The authors present an environmental microbiological monitoring programme carried out over a period of 15 months in 16 operating theatres performing specific types of surgery. The levels of microbial contamination of the air and of four of the most representative surfaces of the clean area were determined at 3 different times for each theatre, both before and during surgery. For the air assessment, the results obtained with three different samplers, Sed-3 Unit, SAS and RCS, were compared. The results were on the whole acceptable, but some poor conditions were detected during the theatres in use, especially in general surgery theatres; in some of these the floors showed levels of contamination consistently exceeding the reference limits. As the monitoring programme proceeded, the microbiological quality of the air and of the surfaces in the theatres notably improved. The three air samplers showed different conditions expressed with units of measure not always readily comparable. For active samplers, the bacterial load determined by RCS, although less variable, were always higher (even 2-3 fold) than those obtained with the SAS. Passive sampling takes longer but determines the real risk of infection for the patients; contemporary determination of the fall-out and the CFU/m3 helps to identify the occupational risks. Since the limit values established by the ISPESL guidelines for the operating theatres have been defined only for active samplers, there is urgent need for more exhaustive national guidelines to define similar values also for passive sampling. The Authors conclude stressing the importance of promoting continuing information-education programmes to heighten the awareness of all those involved in operating theatre activities.

  9. 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.

  10. 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

  11. 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.

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

    PubMed

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

    2011-11-01

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

  13. 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.

  14. Quality and operations of portable X-ray examination procedures in the emergency room: queuing theory at work.

    PubMed

    Abujudeh, Hani; Vuong, Bill; Baker, Stephen R

    2005-07-01

    The objective of this study was to evaluate the operation of the portable X-ray machine in relation to examinations ordered by the Emergency Department at the University of Medicine and Dentistry of New Jersey, as well as to identify any bottlenecks hindering the performance of the aforementioned system. To do so, the activity of the portable X-ray was monitored in the period from 8 June 2004 to 24 June 2004, as well as from 6 July 2004 to 12 July 2004, yielding 11 days of data and 116 individual X-ray examinations. During observation times was noted for various checkpoints in the procedure. Using the data gathered, the average input, output, processing times, and variance were calculated. In turn, these values were used to calculate the response times for the Ordering Phase (5.502 min), traveling (2.483 min), Examination Phase (4.453 min), returning (3.855 min), Order Processing Phase (2.962 min), and the Development Phase (3.437 min). These phases were combined for a total of 22.721 min from the time the examination was placed to the time the X-ray films were uploaded to the PACS computer network. Based on these calculations, the Ordering Phase was determined to be the single largest bottleneck in the portable X-ray system. The Examination Phase also represented the second largest bottleneck for a combined total of 44% of the total response time.

  15. 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.

  16. 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)

  17. 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)

  18. Operating Room Telephone Microbial Flora

    DTIC Science & Technology

    2005-06-02

    from telephones to hands and from hands to other skin surfaces. Rusin et al. demonstrated that Micrococcus luteus (M. luteus ) can be transferred from...Micrococcus luteus endocarditis: case report and review of the literature. Zentralbl Bakteriol, 1995. 282(4): p. 431-5. 69. Oudiz, R.J., et al

  19. Operating Room Telephone Microbial Flora

    DTIC Science & Technology

    2007-11-02

    Rusin et al. demonstrated that Micrococcus luteus (M. luteus ) can be transferred from telephones to hands with approximately 41% efficiency and from...p. 385. "M. luteus is the most common micrococcal species found in nature and in clinical specimens" [43] p.385. Micrococci are considered to be...Kaltheuner, and F. Perdreau-Remington, Micrococcus luteus endocarditis: case report and review of the literature. Zentralbl Bakteriol, 1995. 282(4): p. 431-5

  20. 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.

  1. Looking west in the basement utility room, room 24, overview ...

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

    Looking west in the basement utility room, room 24, overview of air handling system, large walk-in filter, large ducts, pipes, and gauges - March Air Force Base, Strategic Air Command, Combat Operations Center, 5220 Riverside Drive, Moreno Valley, Riverside County, CA

  2. Surgical Management of Combined Intramedullary Arteriovenous Malformation and Perimedullary Arteriovenous Fistula within the Hybrid Operating Room after Five Years of Performing Focus Fractionated Radiotherapy: Case Report

    PubMed Central

    GEKKA, Masayuki; SEKI, Toshitaka; HIDA, Kazutoshi; OSANAI, Toshiya; HOUKIN, Kiyohiro

    2014-01-01

    Perimedullary arteriovenous fistula (AVF) shunts occur on the spinal cord surface and can be treated surgically or by endovascular embolization. In contrast, the nidus of an intramedullary arteriovenous malformation (AVM) is located in the spinal cord and is difficult to treat surgically or by endovascular techniques. The benefits of radiotherapy for treating intramedullary AVM have been published, but are anecdotal and consist largely of case reports. We present a case of combined cervical intramedullary AVM and perimedullary AVF which received surgical treatment within a hybrid operating room (OR) after 5 years of focus fractionated radiotherapy. A 37-year-old male presented with stepwise worsening myelopathy. Magnetic resonance imaging and spinal angiography revealed intramedullary AVM and perimedullary AVF at the C3 to C5 levels. In order to reduce nidus size and blood flow, we first performed focal fractionated radiotherapy. Five years later, the lesion volume was reduced. Following this, direct surgery was performed by an anterior approach using corpectomy in the hybrid OR. The spinal cord was monitored by motor-evoked potential throughout the surgery. Complete obliteration of the fistulous connection was confirmed by intraoperative indocyanine green video-angiography and intraoperative angiography, preserving the anterior spinal artery. We conclude that surgical treatment following focal fractionated radiotherapy may become one strategy for patients who are initially deemed ineligible for endovascular embolization and surgical treatment. Furthermore, the hybrid OR enables safe and precise treatment for spinal vascular disorders in the fields of endovascular treatment and neurosurgery. PMID:25367581

  3. 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.

  4. Decreasing the Hours That Anesthesiologists and Nurse Anesthetists Work Late by Making Decisions to Reduce the Hours of Over-Utilized Operating Room Time.

    PubMed

    Dexter, Franklin; Wachtel, Ruth E; Epstein, Richard H

    2016-03-01

    In this special article, we evaluate how to reduce the number of hours that anesthesiologists and nurse anesthetists work beyond the end of their scheduled shifts. We limit consideration to surgical suites where the hours of cases in each operating room (OR) average 8 hours or more per day. Let "allocated hours" refer to the hours into which cases are scheduled, calculated months in advance for each combination of service and day of the week. Over-Utilized time is the OR workload exceeding allocated time. Reducing Over-Utilized time is the key to reducing the hours that anesthesia providers work late. Certain decisions that reduce Over-Utilized time and reduce the hours that anesthesiologists and nurse anesthetists work late are made by the surgical committee or perioperative medical director months in advance. Such decisions include increasing the number of first case starts and planning staffing for turnovers and lunch breaks during the busiest times of the day. However, most decisions substantively influencing Over-Utilized OR time are made within 1 workday before the day of surgery and on the day of surgery, because only then are ORs sufficiently full that changes can be made to minimize Over-Utilized time. Decisions to reduce Over-Utilized time on the day of surgery include targeting ORs with expected Over-Utilized time and taking steps to reduce it, including making effective staff assignments and appropriately scheduling add-on cases.

  5. Development of simulation-based learning program for improving adherence to time-out protocol on high-risk invasive procedures outside of operating room.

    PubMed

    Jeong, Eun Ju; Chung, Hyun Soo; Choi, Jeong Yun; Kim, In Sook; Hong, Seong Hee; Yoo, Kyung Sook; Kim, Mi Kyoung; Won, Mi Yeol; Eum, So Yeon; Cho, Young Soon

    2017-02-07

    The aim of this study was to develop a simulation-based time-out learning program targeted to nurses participating in high-risk invasive procedures and to figure out the effects of application of the new program on acceptance of nurses. This study was performed using a simulation-based learning predesign and postdesign to figure out the effects of implementation of this program. It was targeted to 48 registered nurses working in the general ward and the emergency department in a tertiary teaching hospital. Difference between acceptance and performance rates has been figured out by using mean, standard deviation, and Wilcoxon-signed rank test. The perception survey and score sheet have been validated through content validation index, and the reliability of evaluator has been verified by using intraclass correlation coefficient. Results showed high level of acceptance of high-risk invasive procedure (P<.01). Further, improvement was consistent regardless of clinical experience, workplace, or experience in simulation-based learning. The face validity of the program showed over 4.0 out of 5.0. This simulation-based learning program was effective in improving the recognition of time-out protocol and has given the participants the opportunity to become proactive in cases of high-risk invasive procedures performed outside of operating room.

  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.

  7. A survey of the appropriate use of antiseptic agents in the operating room of several key health care facilities. A comparison between surveys in 2000 and 2004.

    PubMed

    Shiraishi, T; Nakagawa, Y; Matsubara, H; Takada, Y; Arai, Y; Okada, S; Harada, Y

    2006-01-01

    Since 2000, new hand and environmental hygiene guidelines have been published by the Center for Disease Control and Prevention (CDC) based on scientific evidence. Accordingly, we expected that the use of disinfectants in clinical settings had been changed. To compare the use and amount of disinfectants before and after the publication of these guidelines, we conducted a questionnaire-based survey on the use of antiseptic agents in operating rooms (ORs) in 6 key hospitals over a period of a month in 2000 and 2004. As a result, the amount of disinfectants used in ORs was reduced in all hospitals in 2004. Especially, amphoteric detergents and glutaral products showed significant reductions in the total amount used in the 6 hospitals, by 94.8 and 96.8%, respectively. The use of povidone-iodine (PVP-I) was decreased by 23.4% overall, although it was increased in 3 hospitals by 11.0-58.6%. The number of applications of PVP-I on the surgical site did not change; however, the site was left to dry without wiping after PVP-I application more frequently in 2004 than in 2000. The time for surgical scrubbing was shortened in 2004, but brush scrubbing was still used as often as in 2000. Many of the hospitals used brush scrubbing in conjunction with alcohol-based rubs. These results indicated changes in infection control measures in hospital settings after publication of the new CDC guidelines; environmental disinfection had been limited and excessive use of disinfectants reevaluated.

  8. Room temperature operation of 2.67 mJ pulse LD end pumped Q-switched Tm:YAG laser

    NASA Astrophysics Data System (ADS)

    Song, Xuedi; Wu, Chunting; Chen, Xinyu; Yu, Kai; Jin, Guangyong

    2014-12-01

    Due to 2 μm band in the absorption of water and CO2, the diode pumped solid state lasers with wavelength around 2 μm have important applications in laser medicine and remote sensing, such as it can be used as a scalpe or a light source of Coherent Doppler Wind Lidar and Differential Absorption Lidar. In the recently years, scientists have done much work on the development of such lasers. There're many reports on continuous Tm:YAG laser. However, the study on Q-switched Tm:YAG laser, which is more useful in applications, was very rare. As the light source of Coherent Doppler Wind Lidar, large energy and wide pulse width is desired. Current reports mostly adopted CW pumped source, but it would make a mount of heat. Pulse pumping method could reduce the heat accumulation and improve the heat stability of the laser. How to improve the single pulse energy was the focus of current study. In this paper, a single end bonding Tm:YAG crystal with Tm3+ doping concentration of 3.5at.% was used. Acousto-optic (AO) Q-switched (GOOCH and HOUSEGO QS041-10M-HI8) operation was adopted in our experiment. In the repetition frequency of 100Hz, a maximum single energy of 2.67 mJ (measured by Ophir 30A-BB) and the narrowest pulse width of 149 ns (measured by Vigo PCI-3TE-12 detector) were achieved at room temperature. The M2x was 1.31 and the M2y was 1.35 (measured by Spiricon Pyrocam-III). Tm:YAG laser was developed by using a pulse diode pumped L shape resonant cavity. The transmittance of the curve output mirror was 4% and the curvature radius of which was 300 mm. The output center wavelength of the laser was measured to be 2013.5 nm (measured by YOKOGAWA AQ6375).

  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. 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.

  11. 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

  12. 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

  13. 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.

  14. Locker Room Talk.

    ERIC Educational Resources Information Center

    Fickes, Michael

    1999-01-01

    Examines the trends in college and university sports and recreation center locker rooms as envisioned by a specialist. Features of the modern locker room and the different levels of locker room design are explained. Final comments discuss whether college and university facility managers are inclined to move to high-end locker rooms. (GR)

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

    PubMed

    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.

  16. 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.

  17. 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.

  18. CIMIT/TATRC Symposium on Developing a Plug-and-Play Open Networking Standard for the Operating Room of the Future

    DTIC Science & Technology

    2005-05-01

    Secours Health System dards that would facilitate safe, reliable, medical device inter- Premier Inc. Randy Libros , CBET Inside Certification Community...Rick Schrenker has worked in clinical engineering at Johns research operations for a Digital / Compaq / Hewlett Packard Hopkins Hospital and

  19. 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.

  20. 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.

  1. 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.

  2. Effect of Room Ventilation Rates in Rodent Rooms with Direct-Exhaust IVC Systems.

    PubMed

    Geertsema, Roger S; Lindsell, Claire E

    2015-09-01

    When IVC are directly exhausted from a rodent housing room, the air quality of the room can become independent of the intracage air quality and may reduce the need for high room ventilation rates. This study assessed the effect of decreasing the ventilation rate in rodent rooms using direct-exhaust IVC systems. The study was conducted over 16 wk and compared conditions in 8 rodent rooms that had ventilation rates of 5 to 6 air changes per hour (ACH) with those in rooms at 10 to 12 ACH. At the low ventilation rate, rooms had higher CO₂ concentrations, higher dew point temperature, and lower particulate levels and spent a greater percentage of time above the temperature set point than did rooms at the high rate. The levels of allergens and endotoxins in room air were the same regardless of the ventilation rate. Differences seen in parameters within cages at the 2 ventilation rates were operationally irrelevant. We detected no total volatile organic compounds in the room that were attributable to ammonia, regardless of the ventilation rate. Clearing the air of ethanol after a spill took longer at the low compared with high rate. However, ethanol clearance was faster at the low rate when the demand-control system was activated than at the high ventilation rate alone. Air quality in the room and in the cages were acceptable with room ventilation rates of 5 to 6 ACH in rodent rooms that use direct-exhaust IVC systems.

  3. 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

  4. 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)

  5. Operations

    ERIC Educational Resources Information Center

    Wilkins, Jesse L. M.; Norton, Anderson; Boyce, Steven J.

    2013-01-01

    Previous research has documented schemes and operations that undergird students' understanding of fractions. This prior research was based, in large part, on small-group teaching experiments. However, written assessments are needed in order for teachers and researchers to assess students' ways of operating on a whole-class scale. In this study,…

  6. 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.

  7. Nuclear power station main control room habitability

    SciTech Connect

    Paschal, W.B.; Knous, W.S. )

    1989-01-01

    The main control room at a nuclear power station must remain habitable during a variety of plant conditions and postulated events. The control room habitability requirement and the function of the heating, ventilating, air-conditioning, and air treatment system are to control environmental factors, such as temperature, pressure, humidity, radiation, and toxic gas. Habitability requirements provide for the safety of personnel and enable operation of equipment required to function in the main control room. Habitability as an issue has been gaining prominence with the Advisor Committee of Reactor Safeguards and the Nuclear Regulatory Commission since the incident at Three Mile Island. Their concern is the ability of the presently installed habitability systems to control the main control room environment after an accident. This paper discusses main control room HVAC systems; the concern, requirements, and results of NRC surveys and notices; and an approach to control room habitability reviews.

  8. 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

    2016-05-02

    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

  9. The virtual gamma camera room.

    PubMed

    Penrose, J M; Trowbridge, E A; Tindale, W B

    1996-05-01

    The installation of a gamma camera is time-consuming and costly and, once installed, the camera position is unlikely to be altered during its working life. Poor choice of camera position therefore has long-term consequences. Additional equipment such as collimators and carts, the operator's workstation and wall-mounted display monitors must also be situated to maximize access and ease of use. The layout of a gamma camera room can be optimized prior to installation by creating a virtual environment. Super-Scape VRT software running on an upgraded 486 PC microprocessor was used to create a 'virtual camera room'. The simulation included an operator's viewpoint and a controlled tour of the room. Equipment could be repositioned as required, allowing potential problems to be identified at the design stage. Access for bed-ridden patients, operator ergonomics, operator and patient visibility were addressed. The display can also be used for patient education. Creation of a virtual environment is a valuable tool which allows different camera systems to be compared interactively in terms of dimensions, extent of movement and use of a defined space. Such a system also has applications in radiopharmacy design and simulation.

  10. Treatment of chronic subdural hematomas with subdural evacuating port system placement in the intensive care unit: evolution of practice and comparison with bur hole evacuation in the operating room.

    PubMed

    Flint, Alexander C; Chan, Sheila L; Rao, Vivek A; Efron, Allen D; Kalani, Maziyar A; Sheridan, William F

    2017-01-20

    OBJECTIVE The aims of this study were to evaluate a multiyear experience with subdural evacuating port system (SEPS) placement for chronic subdural hematoma (cSDH) in the intensive care unit at a tertiary neurosurgical center and to compare SEPS placement with bur hole evacuation in the operating room. METHODS All cases of cSDH evacuation were captured over a 7-year period at a tertiary neurosurgical center within an integrated health care delivery system. The authors compared the performance characteristics of SEPS and bur hole placement with respect to recurrence rates, change in recurrence rates over time, complications, length of stay, discharge disposition, and mortality rates. RESULTS A total of 371 SEPS cases and 659 bur hole cases were performed (n = 1030). The use of bedside SEPS placement for cSDH treatment increased over the 7-year period, from 14% to 80% of cases. Reoperation within 6 months was higher for the SEPS (15.6%) than for bur hole drainage (9.1%) across the full 7-year period (p = 0.002). This observed overall difference was due to a higher rate of reoperation during the same hospitalization (7.0% for SEPS vs 3.2% for bur hole; p = 0.008). Over time, as the SEPS procedure became more common and modifications of the SEPS technique were introduced, the rate of in-hospital reoperation after SEPS decreased to 3.3% (p = 0.02 for trend), and the difference between SEPS and bur hole recurrence was no longer significant (p = 0.70). Complications were uncommon and were similar between the groups. CONCLUSIONS Overall performance characteristics of bedside SEPS and bur hole drainage in the operating room were similar. Modifications to the SEPS technique over time were associated with a reduced reoperation rate.

  11. 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.

  12. 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

  13. 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

  14. Telco maintenance (room 228) looking south into the telephone equipment ...

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

    Telco maintenance (room 228) looking south into the telephone equipment room (room 227). Note workbench in left corner, lighting fixtures, and air handling ducts - March Air Force Base, Strategic Air Command, Combat Operations Center, 5220 Riverside Drive, Moreno Valley, Riverside County, CA

  15. 49 CFR 195.446 - Control room management.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... of paragraphs (e)(1) through (e)(5) of this section. (f) Change management. Each operator must assure... reference, see § 195.3) for control room management change and require coordination between control room... 49 Transportation 3 2010-10-01 2010-10-01 false Control room management. 195.446 Section...

  16. 49 CFR 195.446 - Control room management.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... of paragraphs (e)(1) through (e)(5) of this section. (f) Change management. Each operator must assure... reference, see § 195.3) for control room management change and require coordination between control room... 49 Transportation 3 2011-10-01 2011-10-01 false Control room management. 195.446 Section...

  17. 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...

  18. 9 CFR 354.241 - Cleaning of rooms and compartments.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 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...

  19. 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)

  20. Controller's office (room 102), looking northeast into the display area ...

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

    Controller's office (room 102), looking northeast into the display area - March Air Force Base, Strategic Air Command, Combat Operations Center, 5220 Riverside Drive, Moreno Valley, Riverside County, CA

  1. 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)

  2. Strengthening Weight Rooms.

    ERIC Educational Resources Information Center

    Sherman, Rachel M.

    1997-01-01

    Examines ways of giving an existing weight-training room new life without spending a lot of time and money. Tips include adding rubber floor coverings; using indirect lighting; adding windows, art work, or mirrors to open up the room; using more aesthetically pleasing ceiling tiles; upgrading ventilation; repadding or painting the equipment; and…

  3. 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.

  4. Computer Room Water Protection.

    ERIC Educational Resources Information Center

    Price, Bennett J.

    1990-01-01

    Addresses the protection of computer rooms from water. Sources of water and potentially vulnerable areas in computer rooms are described. Water detection is then discussed, and several detection systems are detailed. Prices and manufacturers' telephone numbers for some of the systems are included. Water cleanup is also briefly considered. (MES)

  5. Noise Levels in the Operating Room

    DTIC Science & Technology

    2001-10-01

    CRNA vigilance is crucial to the well-being of patients, and if the cause of the noise can be identified and corrected , CRNAs in the future...64.6 52.2 85.5 107.0 56.2 23 Open shoulder GETA 64.3 48.3 88.9 112.6 54.6 24 Cancelled (before induction) 66.8 50.6 95.0 117.2 53.9 25 Osteotomy ...acromioplasty Knee arthroscopy Knee arthroscopy Knee arthroscopy Finger pinning Wrist pinning Open shoulder Cancelled before inducing Osteotomy ACL

  6. Military Operating Room of the Future

    DTIC Science & Technology

    2013-10-01

    Co-op Comm Workspace SA 6 11 16 21 26 0% 20% 40% 60% 80% 100% To ta l T e am w o rk S co re ( 6 -3 0 ) Total Information Transfer /21 items...following the detailed data collection and root cause analysis. Intervention 1: Smart Phone Application Originating from our work in phase 1, we...which our teamwork, communication and patient management interventions could be supported and sustained with well designed smart phone technology

  7. Military Operating Room of the Future

    DTIC Science & Technology

    2012-10-01

    behind this assumption, we will focus on four different types of surgical care: cardiac, orthopedic, robotic and trauma surgery . SIGNIFICANCE...management (Catchpole et al. 2007). Task, Technology and Teamwork in Robotic Surgery We have also been conducting new studies examining robotic surgery ...identify those flow disruptions and communication failures in care which inhibit early recognition and treatment of complications and other subtle barriers

  8. Military Operating Room of the Future

    DTIC Science & Technology

    2011-10-01

    Administer Methylpredisolone  Burn?  Blunt Thoracic Aortic Injury?  Diagnostic Peritoneal Lavage Needed?  Pelvic  fracture ?  Blunt Trauma in Elderly...Proceed  to OR  Angiogram may be requested  by Thoracic Surgeon Includes mediastinal  hematoma  that does not  involve the aorta Mediastinal... Hematoma   present and  in contact  with aorta? Yes Angiography for  Definitive Diagnosis No Blunt Trauma and the Elderly Trauma Patient Initiate ATLS

  9. Military Operating Room of the Future

    DTIC Science & Technology

    2012-10-01

    ric ar di...um Ca rd ia c  Ac tiv ity ? Co nt ro l C ar di ac   Bl ee di ng O pe n  Pe ric ar di um Ye s N o Ta m po na de   Pr es en t? Ye s N o P at ie nt   Pr...2007;142:658e65. 14. Parker SE, Laviana AA, Wadhera RK, et al. Development and evaluation of an observational tool for assessing surgical flow

  10. Military Operating Room of the Future

    DTIC Science & Technology

    2014-12-01

    Human Factors; Handoffs; Handover; Communication; Teamwork; Trauma; Cardiac Surgery; Patient Safety ; Improvement; Systems Analysis 16. SECURITY...INTRODUCTION Effective handoffs of care are critical for maintaining safety and avoiding communication problems in acute care. This program of work...Trauma; Cardiac Surgery; Patient Safety ; Improvement; Systems Analysis; 3. OVERALL PROJECT SUMMARY General Introduction They serve several purposes

  11. Human factors and operating room safety.

    PubMed

    ElBardissi, Andrew W; Sundt, Thoralf M

    2012-02-01

    A human factors model is used to highlight the nature of many systems factors that affect surgical performance, including the OR environment, teamwork and communication, technology and equipment, tasks and workload factors, and organizational variables. If further improvements in the success rate and reliability of cardiac surgery are to be realized, interventions need to be developed to reduce the negative impact that work system failures can have on surgical performance. Some recommendations are proposed here; however, several challenges remain.

  12. High-power and low-loss room temperature operation of 2.4μm GaInAsSb/AlGaAsSb type-I strained quantum-well laser diodes

    NASA Astrophysics Data System (ADS)

    Song, Yuzhi; Song, Jiakun; Zhang, Yu; Li, Kangwen; Xu, Yun; Song, Guofeng; Chen, Lianghui

    2015-10-01

    High power GaSb based type-I GaInAsSb/AlGaAsSb three quantum wells laser diodes emitting at 2.4 μm were optimized and fabricated. The laser wafer was grown with solid source Molecular Beam Epitaxy System. With optimizations of the epitaxial structure design and the ohmic contact, the operation voltage and the internal loss decreased; the internal quantum efficiency and output power increased. The internal quantum efficiency was determined about 80.1% and the internal loss was 12 cm-1 by measuring laser diodes with different cavity lengths. An uncoated 2-mm-long laser diode with 90-μm-wide aperture exhibited a threshold current density of 222 A/cm2 (74 A/cm2 per quantum well), a continuous wave output power of 232 mW and a quasi-continuous wave (1 kHz, 10 μs) output power of 1 W at room temperature.

  13. 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

  14. Carpenter in White Room

    NASA Technical Reports Server (NTRS)

    1962-01-01

    Inside Hangar S at the White Room Facility at Cape Canaveral, Florida, Mercury astronaut M. Scott Carpenter examines the honeycomb protective material on the main pressure bulkhead (heat shield) of his Mercury capsule nicknamed 'Aurora 7.'

  15. '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.

  16. 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.

  17. 49 CFR 192.631 - Control room management.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... implementation of paragraphs (e)(1) through (e)(5) of this section. (f) Change management. Each operator must... 49 Transportation 3 2011-10-01 2011-10-01 false Control room management. 192.631 Section 192.631... BY PIPELINE: MINIMUM FEDERAL SAFETY STANDARDS Operations § 192.631 Control room management....

  18. 49 CFR 192.631 - Control room management.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... implementation of paragraphs (e)(1) through (e)(5) of this section. (f) Change management. Each operator must... 49 Transportation 3 2010-10-01 2010-10-01 false Control room management. 192.631 Section 192.631... BY PIPELINE: MINIMUM FEDERAL SAFETY STANDARDS Operations § 192.631 Control room management....

  19. A room-temperature-operated Si LED with β-FeSi2 nanocrystals in the active layer: μW emission power at 1.5 μm

    NASA Astrophysics Data System (ADS)

    Shevlyagin, A. V.; Goroshko, D. L.; Chusovitin, E. A.; Balagan, S. A.; Dotsenko, S. A.; Galkin, K. N.; Galkin, N. G.; Shamirzaev, T. S.; Gutakovskii, A. K.; Latyshev, A. V.; Iinuma, M.; Terai, Y.

    2017-03-01

    This article describes the development of an Si-based light-emitting diode with β-FeSi2 nanocrystals embedded in the active layer. Favorable epitaxial conditions allow us to obtain a direct band gap type-I band alignment Si/β-FeSi2 nanocrystals/Si heterostructure with optical transition at a wavelength range of 1500-1550 nm at room temperature. Transmission electron microscopy data reveal strained, defect-free β-FeSi2 nanocrystals of diameter 6 and 25 nm embedded in the Si matrix. Intense electroluminescence was observed at a pumping current density as low as 0.7 A/cm2. The device reached an optical emission power of up to 25 μW at 9 A/cm2 with an external quantum efficiency of 0.009%. Watt-Ampere characteristic linearity suggests that the optical power margin of the light-emitting diode has not been exhausted. Band structure calculations explain the luminescence as being mainly due to radiative recombination in the large β-FeSi2 nanocrystals resulting from the realization of an indirect-to-direct band gap electronic configuration transformation arising from a favorable deformation of nanocrystals. The direct band gap structure and the measured short decay time of the luminescence of several tens of ns give rise to a fast operation speed for the device. Thus a method for developing a silicon-based photonic integrated circuit, combining complementary metal-oxide-semiconductor technology functionality and near-infrared light emission, is reported here.

  20. 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

  1. 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

  2. Clean-room robot implementation

    SciTech Connect

    Comeau, J.L.

    1982-07-14

    A robot has been incorporated in a clean room operation in which vacuum tube parts are cleaned just prior to final assembly with a 60 lb/in/sup 2/ blast of argon gas. The robot is programmed to pick up the parts, manipulate/rotate them as necessary in the jet pattern and deposit them in a tray precleaned by the robot. A carefully studied implementation plan was followed in the procurement, installation, modification and programming of the robot facility. An unusual configuration of one tube part required a unique gripper design. A study indicated that the tube parts processed by the robot are 12% cleaner than those manually cleaned by an experienced operator.

  3. 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)

  4. 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…

  5. Visiting Room 501

    ERIC Educational Resources Information Center

    Curwen, Margaret Sauceda

    2009-01-01

    Students in Room 501 were exploring and negotiating their lives as transnational citizens. In a globalized world of instantaneous information and communication, Latino students are shaping, morphing, and evolving into a new generation. This study highlights one group of students who were aspiring toward middle class, which is not the typical…

  6. 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.

  7. 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.

  8. 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)

  9. 44. Launch Control Equipment Room, taken from rear of room. ...

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

    44. Launch Control Equipment Room, taken from rear of room. Lyon - Whiteman Air Force Base, Oscar O-1 Minuteman Missile Alert Facility, Southeast corner of Twelfth & Vendenberg Avenues, Knob Noster, Johnson County, MO

  10. 42. Launch Control Equipment Room, rear of room. Lyon ...

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

    42. Launch Control Equipment Room, rear of room. Lyon - Whiteman Air Force Base, Oscar O-1 Minuteman Missile Alert Facility, Southeast corner of Twelfth & Vendenberg Avenues, Knob Noster, Johnson County, MO

  11. 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

  12. 8. GROUND FLOOR, NORTH ROOM, NORTH WALL, VIEW OF ROOM ...

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

    8. GROUND FLOOR, NORTH ROOM, NORTH WALL, VIEW OF ROOM LOOKING TOWARDS FIREPLACE, SHOWING PROJECTING CHIMNEY, WINDOW EMBRASURES ON EITHER SIDE AND PANELING - Ocean Hall, Bushwood, St. Mary's County, MD

  13. 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

  14. 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

  15. 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

  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. 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

  18. 21. Perimeter acquisition radar building room #200, electrical equipment room ...

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

    21. Perimeter acquisition radar building room #200, electrical equipment room - Stanley R. Mickelsen Safeguard Complex, Perimeter Acquisition Radar Building, Limited Access Area, between Limited Access Patrol Road & Service Road A, Nekoma, Cavalier County, ND

  19. 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. 34. Perimeter acquisition radar building room #325, tape handler room ...

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

    34. Perimeter acquisition radar building room #325, tape handler 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

  1. 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

  2. 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

  3. 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

  4. 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.

  5. [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.

  6. On Air Shutter for Cold Storage Room

    NASA Astrophysics Data System (ADS)

    Fukuhara, Isamu; Tsuji, Katsuhiko

    Air curtains are frequently placed at doorway of cold storage room or freezing chamber. As an opening of jet flow in these air curtains is relatively narrow and speed of jet flow is fast, air entrained from surroundings increases in quantity. Therefore, we consider that jet flow with narrow opening can not effectively isolate inside air from the external atmosphere, but the one with relatively wide opening can decrease air entrained from surroundings. Then, when air curtain which has a wide opening (we call it air shutter) is installed at cold storage room, and isolating performances of air shutter are compared with the air curtain. First, as various conditions can be easily changed in numerical calculation, we compare a velocity and temperature field in cold storage room under these conditions when velocity of jet flow is changed by using numerical method. Second, we measure a temperature and velocity distribution in an actual cold storage room under three conditions (air shutter operates, air curtain operates and no operation). From these results, it was found that air shutter is more efficient than air curtain.

  7. Apparel for Cleaner Clean Rooms

    NASA Technical Reports Server (NTRS)

    1983-01-01

    In the 1960s NASA pioneered contamination control technology, providing a base from which aerospace contractors could develop control measures. NASA conducted special courses for clean room technicians and supervisors, and published a series of handbooks with input from various NASA field centers. These handbooks extended aerospace experience to the medical, pharmaceutical, electronics, and other industries where extreme cleanliness is important. American Hospital Supply Company (AHSC) felt that high technology products with increasingly stringent operating requirements in aerospace, electronics, pharmaceuticals and medical equipment manufacturing demanded improvement in contamination control techniques. After studying the NASA handbooks and visiting NASA facilities, the wealth of information gathered resulted in Micro-clean non-woven garments and testing equipment and procedures for evaluating effectiveness.

  8. Operating Room of the Future: Advanced Technologies in Safe and Efficient Operating Rooms

    DTIC Science & Technology

    2010-10-01

    Pareja CR, Shekhar R,"FPGA-based Reconfigurable 3D  Image Pre-processing for Image Guided Interventions. Journal of Real-Time  Image Processing...34 IEEE Transactions on Biomedical Circuits and Systems, vol. 1(2), pp. 116-127, 2007.  Dandekar, C. Castro- Pareja , and R. Shekhar, "FPGA-based real-time...3rd IEEE International Symposium on Biomedical Imaging: Nano to Macro, 2006, pp. 502-505. Dandekar O., C. Castro- Pareja , and R. Shekhar, "FPGA

  9. 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

  10. 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

  11. 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

  12. 9 CFR 354.241 - Cleaning of rooms and compartments.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... such regularity as may be necessary to maintain them in a sanitary condition. (f) The killing and... all equipment and utensils used in the killing and skinning room shall be thoroughly washed and cleaned after each day's operation. (h) The floor in the killing and skinning rooms shall be...

  13. 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

  14. 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…

  15. 45. 1915 CLOTH ROOM ADJACENT TO PICKER ROOM, SECOND FLOOR, ...

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

    45. 1915 CLOTH ROOM ADJACENT TO PICKER ROOM, SECOND FLOOR, NORTH END OF MILL NO. 2, WALL ON LEFT DIVIDING CLOTH ROOM ADDED LATER (PROBABLY C. 1970s). - Prattville Manufacturing Company, Number One, 242 South Court Street, Prattville, Autauga County, AL

  16. 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.

  17. 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

  18. 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…

  19. 7 CFR 58.510 - Rooms and compartments.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ....510 Rooms and compartments. (a) Processing operations with open cheese vats should be separated from... ingredients supplies or finished products are handled, processed, packaged or stored shall be designed...

  20. 12. VIEW OF ELEVATOR MACHINE ROOM, SHOWING LOW CABINET TEAT ...

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

    12. VIEW OF ELEVATOR MACHINE ROOM, SHOWING LOW CABINET TEAT HOUSES HYDRAULIC CYLINDER AND CLOSET AT LEFT THAT HOUSES OPERATING VALVE, LOOKING NORTHEAST - 72 Marlborough Street, Residential Hydraulic Elevator, Boston, Suffolk County, MA

  1. 49 CFR 192.631 - Control room management.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... field equipment or SCADA displays; (3) Test and verify an internal communication plan to provide... personnel by performing each of the following: (1) Establish communications between control room... controllers on their responsibilities for communication under the operator's emergency response procedures;...

  2. 49 CFR 192.631 - Control room management.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... field equipment or SCADA displays; (3) Test and verify an internal communication plan to provide... personnel by performing each of the following: (1) Establish communications between control room... controllers on their responsibilities for communication under the operator's emergency response procedures;...

  3. 49 CFR 192.631 - Control room management.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... field equipment or SCADA displays; (3) Test and verify an internal communication plan to provide... personnel by performing each of the following: (1) Establish communications between control room... controllers on their responsibilities for communication under the operator's emergency response procedures;...

  4. 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

  5. 17. DINING ROOM INTERIOR SHOWING GROUP OF THREE 1 LIGHT ...

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

    17. DINING ROOM INTERIOR SHOWING GROUP OF THREE 1 LIGHT OVER 1 LIGHT WINDOWS, AND DOORWAY INTO KITCHEN. VIEW TO EAST. - Big Creek Hydroelectric System, Powerhouse 8, Operator Cottage, Big Creek, Big Creek, Fresno County, CA

  6. 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

  7. 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

  8. 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

  9. VIEW OF EASTERN PARTITION OF FRONT BAY ROOM, FACING SOUTH ...

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

    VIEW OF EASTERN PARTITION OF FRONT BAY ROOM, FACING SOUTH - Cape Canaveral Air Force Station, Launch Complex 34, Operations Support Building, Freedom Road, Southwest of Launch Stand CX-34, Cape Canaveral, Brevard County, FL

  10. VIEW OF EASTERN PARTITION OF FRONT BAY ROOM, FACING NORTHWEST ...

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

    VIEW OF EASTERN PARTITION OF FRONT BAY ROOM, FACING NORTHWEST - Cape Canaveral Air Force Station, Launch Complex 34, Operations Support Building, Freedom Road, Southwest of Launch Stand CX-34, Cape Canaveral, Brevard County, FL

  11. DETAIL OF ELECTRICAL PANEL, ROOM 112, FACING EAST Cape ...

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

    DETAIL OF ELECTRICAL PANEL, ROOM 112, FACING EAST - Cape Canaveral Air Force Station, Launch Complex 34, Operations Support Building, Freedom Road, Southwest of Launch Stand CX-34, Cape Canaveral, Brevard County, FL

  12. VIEW OF ROOM 112, FACING NORTHEAST Cape Canaveral Air ...

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

    VIEW OF ROOM 112, FACING NORTHEAST - Cape Canaveral Air Force Station, Launch Complex 34, Operations Support Building, Freedom Road, Southwest of Launch Stand CX-34, Cape Canaveral, Brevard County, FL

  13. EXTERIOR OF LOCKER ROOM PROJECTION, FACING SOUTHEAST Cape Canaveral ...

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

    EXTERIOR OF LOCKER ROOM PROJECTION, FACING SOUTHEAST - Cape Canaveral Air Force Station, Launch Complex 34, Operations Support Building, Freedom Road, Southwest of Launch Stand CX-34, Cape Canaveral, Brevard County, FL

  14. VIEW OF ROOM 136, FACING SOUTHWEST Cape Canaveral Air ...

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

    VIEW OF ROOM 136, FACING SOUTHWEST - Cape Canaveral Air Force Station, Launch Complex 34, Operations Support Building, Freedom Road, Southwest of Launch Stand CX-34, Cape Canaveral, Brevard County, FL

  15. VIEW OF WESTERN PARTITION OF FRONT BAY ROOM, FACING NORTHWEST ...

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

    VIEW OF WESTERN PARTITION OF FRONT BAY ROOM, FACING NORTHWEST - Cape Canaveral Air Force Station, Launch Complex 34, Operations Support Building, Freedom Road, Southwest of Launch Stand CX-34, Cape Canaveral, Brevard County, FL

  16. VIEW OF WESTERN PARTITION OF FRONT BAY ROOM, FACING SOUTH ...

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

    VIEW OF WESTERN PARTITION OF FRONT BAY ROOM, FACING SOUTH - Cape Canaveral Air Force Station, Launch Complex 34, Operations Support Building, Freedom Road, Southwest of Launch Stand CX-34, Cape Canaveral, Brevard County, FL

  17. VIEW OF GROUND SUPPORT EQUIPMENT SHOP, ROOM 104, FACING NORTH ...

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

    VIEW OF GROUND SUPPORT EQUIPMENT SHOP, ROOM 104, FACING NORTH - Cape Canaveral Air Force Station, Launch Complex 34, Operations Support Building, Freedom Road, Southwest of Launch Stand CX-34, Cape Canaveral, Brevard County, FL

  18. 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.

  19. 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

  20. 2. AXIAL VIEW OF THE MAIN EQUIPMENT ROOM IN BUILDING ...

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

    2. AXIAL VIEW OF THE MAIN EQUIPMENT ROOM IN BUILDING 408, LOOKING WEST-SOUTHWEST. - Mill Valley Air Force Station, Operations Building & Annex, East Ridgecrest Boulevard, Mount Tamalpais, Mill Valley, Marin County, CA