Evaluation of the disruptive behaviors among treatment teams and its reflection on the therapy process of patients in the operating room: The impact of personal conflicts.

PubMed

Maddineshat, Maryam; Hashemi, Mitra; Tabatabaeichehr, Mahbubeh

2017-01-01

Understanding the development and distribution of disruptive behaviour among members of a health-care team is critical to the safety and quality of patient care in high-risk environments such as operating rooms. The present study identified disruptive behaviour and its effect on the treatment of patients in the operating room environment. This cross-sectional study used the convenience sampling method to select 144 operating room physicians and nurses (91 women and 53 men). The study was conducted in the operating rooms of four academic hospitals with different specialties in North Khorasan province in Iran from December 2013 to September 2014. The data were collected using a translated, modified, and validated questionnaire to investigate the prevalence and consequences of disruptive behaviour, the response of the health care system to the behaviour, factors affecting the creation of conflict and the spread of disruptive behaviour. Statistical analysis of the data was performed using SPSS 18. Disruptive behaviour was reported by 82.95% physicians and nurses. On average, 39% of physicians and 21% of operating room nurses exhibited disruptive behaviour. Disruptive behaviour is associated with psychological and clinical consequences. Factors such as fear of retaliation (8%), lack of change (43.8%), lack of security (18.1%) and attitude of the organization (14.6%) are significant reasons for the failure to report these behaviours. The findings suggest that disruptive behaviour occurs and affects treatment and workflow of treatment teams in the operating room. Interpersonal conflict contributes to the growth of such behaviour; thus, more research should focus on this subject in the future.

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.

Auto identification technology and its impact on patient safety in the Operating Room of the Future.

PubMed

Egan, Marie T; Sandberg, Warren S

2007-03-01

Automatic identification technologies, such as bar coding and radio frequency identification, are ubiquitous in everyday life but virtually nonexistent in the operating room. User expectations, based on everyday experience with automatic identification technologies, have generated much anticipation that these systems will improve readiness, workflow, and safety in the operating room, with minimal training requirements. We report, in narrative form, a multi-year experience with various automatic identification technologies in the Operating Room of the Future Project at Massachusetts General Hospital. In each case, the additional human labor required to make these ;labor-saving' technologies function in the medical environment has proved to be their undoing. We conclude that while automatic identification technologies show promise, significant barriers to realizing their potential still exist. Nevertheless, overcoming these obstacles is necessary if the vision of an operating room of the future in which all processes are monitored, controlled, and optimized is to be achieved.

Operating room fires in periocular surgery.

PubMed

Connor, Michael A; Menke, Anne M; Vrcek, Ivan; Shore, John W

2018-06-01

A survey of ophthalmic plastic and reconstructive surgeons as well as seven-year data regarding claims made to the Ophthalmic Mutual Insurance Company (OMIC) is used to discuss operating room fires in periocular surgery. A retrospective review of all closed claim operating room fires submitted to OMIC was performed. A survey soliciting personal experiences with operating room fires was distributed to all American Society of Oculoplastic and Reconstructive Surgeons. Over the last 2 decades, OMIC managed 7 lawsuits resulting from an operating room fire during periocular surgery. The mean settlement per lawsuit was $145,285 (range $10,000-474,994). All six patients suffered burns to the face, and three required admission to a burn unit. One hundred and sixty-eight surgeons participated in the online survey. Approximately 44% of survey respondents have experienced at least one operating room fire. Supplemental oxygen was administered in 88% of these cases. Most surgical fires reported occurred in a hospital-based operating room (59%) under monitored anesthesia care (79%). Monopolar cautery (41%) and thermal, high-temperature cautery (41%) were most commonly reported as the inciting agents. Almost half of the patients involved in a surgical fire experienced a complication from the fire (48%). Sixty-nine percent of hospital operating rooms and 66% of ambulatory surgery centers maintain an operating room fire prevention policy. An intraoperative fire can be costly for both the patient and the surgeon. Ophthalmic surgeons operate in an oxygen rich and therefore flammable environment. Proactive measures can be undertaken to reduce the incidence of surgical fires periocular surgery; however, a fire can occur at any time and the entire operating room team must be constantly vigilant to prevent and manage operating room fires.

Touchless interaction with software in interventional radiology and surgery: a systematic literature review.

PubMed

Mewes, André; Hensen, Bennet; Wacker, Frank; Hansen, Christian

2017-02-01

In this article, we systematically examine the current state of research of systems that focus on touchless human-computer interaction in operating rooms and interventional radiology suites. We further discuss the drawbacks of current solutions and underline promising technologies for future development. A systematic literature search of scientific papers that deal with touchless control of medical software in the immediate environment of the operation room and interventional radiology suite was performed. This includes methods for touchless gesture interaction, voice control and eye tracking. Fifty-five research papers were identified and analyzed in detail including 33 journal publications. Most of the identified literature (62 %) deals with the control of medical image viewers. The others present interaction techniques for laparoscopic assistance (13 %), telerobotic assistance and operating room control (9 % each) as well as for robotic operating room assistance and intraoperative registration (3.5 % each). Only 8 systems (14.5 %) were tested in a real clinical environment, and 7 (12.7 %) were not evaluated at all. In the last 10 years, many advancements have led to robust touchless interaction approaches. However, only a few have been systematically evaluated in real operating room settings. Further research is required to cope with current limitations of touchless software interfaces in clinical environments. The main challenges for future research are the improvement and evaluation of usability and intuitiveness of touchless human-computer interaction and the full integration into productive systems as well as the reduction of necessary interaction steps and further development of hands-free interaction.

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…

A patient who was burned in the operative field: a case report.

PubMed

Chung, Soo Ho; Lee, Hae Hyeog; Kim, Tae Hee; Kim, Jeong Sig

2012-05-01

Operating room fires occur very rarely. Nevertheless, a disaster can complicate almost any kind of surgery. The majority of operating room fires result from the use of alcohol- based surgical preparation solutions, electro-surgical equipment, or flammable drapes in an oxygen-rich environment. We report a patient with an ovarian cyst and uterine myomas who suffered a flame burn while undergoing gynecological surgery.

Full immersion simulation: validation of a distributed simulation environment for technical and non-technical skills training in Urology.

PubMed

Brewin, James; Tang, Jessica; Dasgupta, Prokar; Khan, Muhammad S; Ahmed, Kamran; Bello, Fernando; Kneebone, Roger; Jaye, Peter

2015-07-01

To evaluate the face, content and construct validity of the distributed simulation (DS) environment for technical and non-technical skills training in endourology. To evaluate the educational impact of DS for urology training. DS offers a portable, low-cost simulated operating room environment that can be set up in any open space. A prospective mixed methods design using established validation methodology was conducted in this simulated environment with 10 experienced and 10 trainee urologists. All participants performed a simulated prostate resection in the DS environment. Outcome measures included surveys to evaluate the DS, as well as comparative analyses of experienced and trainee urologist's performance using real-time and 'blinded' video analysis and validated performance metrics. Non-parametric statistical methods were used to compare differences between groups. The DS environment demonstrated face, content and construct validity for both non-technical and technical skills. Kirkpatrick level 1 evidence for the educational impact of the DS environment was shown. Further studies are needed to evaluate the effect of simulated operating room training on real operating room performance. This study has shown the validity of the DS environment for non-technical, as well as technical skills training. DS-based simulation appears to be a valuable addition to traditional classroom-based simulation training. © 2014 The Authors BJU International © 2014 BJU International Published by John Wiley & Sons Ltd.

Temperature-controlled airflow ventilation in operating rooms compared with laminar airflow and turbulent mixed airflow.

PubMed

Alsved, M; Civilis, A; Ekolind, P; Tammelin, A; Andersson, A Erichsen; Jakobsson, J; Svensson, T; Ramstorp, M; Sadrizadeh, S; Larsson, P-A; Bohgard, M; Šantl-Temkiv, T; Löndahl, J

2018-02-01

To evaluate three types of ventilation systems for operating rooms with respect to air cleanliness [in colony-forming units (cfu/m 3 )], energy consumption and comfort of working environment (noise and draught) as reported by surgical team members. Two commonly used ventilation systems, vertical laminar airflow (LAF) and turbulent mixed airflow (TMA), were compared with a newly developed ventilation technique, temperature-controlled airflow (T c AF). The cfu concentrations were measured at three locations in an operating room during 45 orthopaedic procedures: close to the wound (<40cm), at the instrument table and peripherally in the room. The operating team evaluated the comfort of the working environment by answering a questionnaire. LAF and T c AF, but not TMA, resulted in less than 10cfu/m 3 at all measurement locations in the room during surgery. Median values of cfu/m 3 close to the wound (250 samples) were 0 for LAF, 1 for T c AF and 10 for TMA. Peripherally in the room, the cfu concentrations were lowest for T c AF. The cfu concentrations did not scale proportionally with airflow rates. Compared with LAF, the power consumption of T c AF was 28% lower and there was significantly less disturbance from noise and draught. T c AF and LAF remove bacteria more efficiently from the air than TMA, especially close to the wound and at the instrument table. Like LAF, the new T c AF ventilation system maintained very low levels of cfu in the air, but T c AF used substantially less energy and provided a more comfortable working environment than LAF. This enables energy savings with preserved air quality. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

Microbiological aspects of clean room technology as applied to surgery, with special reference to unidirectional airflow systems

NASA Technical Reports Server (NTRS)

Wardle, M. D.

1974-01-01

The microbiological aspects of clean room technology as applied to surgery were reviewed. The following pertinent subject areas were examined: (1) clean room technology per se and its utilization for surgery, (2) microbiological monitoring of the clean room surgical environment, (3) clean rooms and their impact on operating room environmental microbiology, and (4) the effect of the technology on surgical wound infection rates. Conclusions were drawn for each topic investigated.

Virtual environment for training in microsurgery

NASA Astrophysics Data System (ADS)

Montgomery, Kevin N.; Stephanides, Michael; Brown, Joel; Latombe, Jean-Claude; Schendel, Stephen A.

1999-05-01

Microsurgery is a well-established medical field, and involves repair of approximately 1mm vessels and nerves under an operating microscope in order to reattach severed fingers or transfer tissue for reconstruction. Initial skill sin microvascular surgery are usually developed in the animal lab and subsequently in the operating room. Development of these skills typically requires about 6 months of animal based training before additional learning takes place in the operating room.

[A project to improve the validity rate for nursing staff operating single door autoclave sterilizers].

PubMed

Chen, Chun-Hung; Li, Cheng-Chang; Chou, Chuan-Yu; Chen, Shu-Hwa

2009-08-01

This project was designed to improve the low validity rate for nurses responsible to operate single door autoclave sterilizers in the operating room. By investigating the current status, we found that the nursing staff validity rate of cognition on the autoclave sterilizer was 85%, and the practice operating check validity rate was only 80%. Such was due to a lack of in-service education. Problems with operation included: 1. Unsafe behaviors - not following standard procedure, lacking relevant operating knowledge and absence of a check form; 2. Unsafe environment - the conveying steam piping was typically not covered and lacked operation marks. Recommended improvement measures included: 1. holding in-service education; 2. generating an operation procedure flow chart; 3. implementing obstacle eliminating procedures; 4. covering piping to prevent fire and burns; 5. performing regular checks to ensure all procedures are followed. Following intervention, nursing staff cognition rose from 85% to 100%, while the operation validity rate rose from 80% to 100%. These changes ensure a safer operating room environment, and helps facilities move toward a zero accident rate in the healthcare environment.

Human factors aspects of control room design: Guidelines and annotated bibliography

NASA Technical Reports Server (NTRS)

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

1982-01-01

A human factors analysis of the workstation design for the Earth Radiation Budget Satellite mission operation room is discussed. The relevance of anthropometry, design rules, environmental design goals, and the social-psychological environment are discussed.

Operating room myths: what is the evidence for common practices.

PubMed

Pada, Surinder; Perl, Trish M

2015-08-01

In order to ensure patient safety and prevent surgical site infections (SSIs), operating theaters/rooms have evolved into complex, highly technical environments. Prevention of healthcare-associated infections, and strategies to limit patient harm, have gained momentum over the last decade. This article aims to examine and dispute some commonly held beliefs with specific reference to: laminar airflow, noise and operating theater door openings and how these impact SSI. Laminar airflow may not be necessary for prosthetic implant surgery. Some recent data suggest that there may be patient harm. With the development of better surgical techniques and perioperative care, such costly systems may not be needed. Operating rooms with a high number of door openings have also been shown to experience higher SSI rates, as have operating rooms with high noise levels. These may serve as surrogate markers for operating room discipline. Initiatives which target these areas may be worth considering when devising strategies to reduce SSIs. Improved surveillance systems for SSIs are needed and should include operating theater airflow type. This will allow further analysis of the effect of laminar air flow on SSIs and provide evidence for a decisive recommendation. Cultivating a culture of good operating theater discipline may also reduce SSIs.

The RoboConsultant: telementoring and remote presence in the operating room during minimally invasive urologic surgeries using a novel mobile robotic interface.

PubMed

Agarwal, Rahul; Levinson, Adam W; Allaf, Mohamad; Makarov, Danil; Nason, Alex; Su, Li-Ming

2007-11-01

Remote presence is the ability of an individual to project himself from one location to another to see, hear, roam, talk, and interact just as if that individual were actually there. The objective of this study was to evaluate the efficacy and functionality of a novel mobile robotic telementoring system controlled by a portable laptop control station linked via broadband Internet connection. RoboConsultant (RemotePresence-7; InTouch Health, Sunnyvale, CA) was employed for the purpose of intraoperative telementoring and consultation during five laparoscopic and endoscopic urologic procedures. Robot functionality including navigation, zoom capability, examination of external and internal endoscopic camera views, and telestration were evaluated. The robot was controlled by a senior surgeon from various locations ranging from an adjacent operating room to an affiliated hospital 5 miles away. The RoboConsultant performed without connection failure or interruption in each case, allowing the consulting surgeon to immerse himself and navigate within the operating room environment and provide effective communication, mentoring, telestration, and consultation. RoboConsultant provided clear, real-time, and effective telementoring and telestration and allowed the operator to experience remote presence in the operating room environment as a surgical consultant. The portable laptop control station and wireless connectivity allowed the consultant to be mobile and interact with the operating room team from virtually any location. In the future, the remote presence provided by the RoboConsultant may provide useful and effective intraoperative consultation by expert surgeons located in remote sites.

Exposure of hospital operating room personnel to potentially harmful environmental agents

DOE Office of Scientific and Technical Information (OSTI.GOV)

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

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, typemore » 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.« less

Noise in the operating rooms of Greek hospitals.

PubMed

Tsiou, Chrisoula; Efthymiatos, Gerasimos; Katostaras, Theophanis

2008-02-01

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

Clean Room in the Zero Gravity Research Facility

NASA Image and Video Library

1968-07-21

A technician prepares a test sample in the Zero Gravity Research Facility clean room at the National Aeronautics and Space Administration (NASA) Lewis Research Center. The Zero Gravity Research Facility contained a drop tower which provided five seconds of microgravity during freefall in its 450-foot deep vacuum chamber. The facility has been used for a variety of studies relating to the behavior of fluids and flames in microgravity. During normal operations, a cylindrical 3-foot diameter and 11-foot long vehicle was used to house the experiments, instrumentation, and high speed cameras. The 4.5-foot long and 1.5-foot wide rectangular vehicle, seen in this photograph, was used less frequently. A 3-foot diameter orb was used for the special ten-second drops in which the package was pneumatically shot to the top of the tower then dropped. The facility also contained a control room, shop offices, tool and equipment rooms, and this clean room. The 242.5-foot long and 19.5-foot wide clean room was equipped with specialized cleaning equipment. In the 1960s the room was rated as a class 10,000 clean room, but I was capable of meeting the class 100 requirements. The room included a fume hood, ultrasonic cleaner, and a laminar flow station which operated as a class 100 environment. The environment in the clean room was maintained at 71° F and a relative humidity of 45- percent.

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

DTIC Science & Technology

2008-10-01

fit” or compatibility with different tasks. Ideally, the optimal match between tasks and well-designed display alternatives will be self -apparent...hierarchical display environment. The FARO robot arm is used as an accurate and reliable tracker to control a virtual camera. The virtual camera pose is...in learning outcomes due to self -feedback, improvements in learning outcomes due to instructor feedback and synchronous versus asynchronous

Performance analysis of air conditioning system and airflow simulation in an operating theater

NASA Astrophysics Data System (ADS)

Alhamid, Muhammad Idrus; Budihardjo, Rahmat

2018-02-01

The importance of maintaining performance of a hospital operating theater is to establish an adequate circulation of clean air within the room. The parameter of air distribution in a space should be based on Air Changes per Hour (ACH) to maintain a positive room pressure. The dispersion of airborne particles in the operating theater was governed by regulating the air distribution so that the operating theater meets clean room standards ie ISO 14664 and ASHRAE 170. Here, we introduced several input parameters in a simulation environment to observe the pressure distribution in the room. Input parameters were air temperature, air velocity and volumetric flow rate entering and leaving room for existing and designed condition. In the existing operating theatre, several observations were found. It was found that the outlet air velocity at the HEPA filter above the operating table was too high thus causing a turbulent airflow pattern. Moreover, the setting temperature at 19°C was found to be too low. The supply of air into the room was observed at lower than 20 ACH which is under the standard requirement. Our simulation using FloVent 8.2™ program showed that not only airflow turbulence could be reduced but also the amount of particle contamination could also be minimized.

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

System having unmodulated flux locked loop for measuring magnetic fields

DOEpatents

Ganther, Jr., Kenneth R.; Snapp, Lowell D [Blue Springs, MO

2006-08-15

A system (10) for measuring magnetic fields, wherein the system (10) comprises an unmodulated or direct-feedback flux locked loop (12) connected by first and second unbalanced RF coaxial transmission lines (16a, 16b) to a superconducting quantum interference device (14). The FLL (12) operates for the most part in a room-temperature or non-cryogenic environment, while the SQUID (14) operates in a cryogenic environment, with the first and second lines (16a, 16b) extending between these two operating environments.

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

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.

Psychomotor performance measured in a virtual environment correlates with technical skills in the operating room.

PubMed

Kundhal, Pavi S; Grantcharov, Teodor P

2009-03-01

This study was conducted to validate the role of virtual reality computer simulation as an objective method for assessing laparoscopic technical skills. The authors aimed to investigate whether performance in the operating room, assessed using a modified Objective Structured Assessment of Technical Skill (OSATS), correlated with the performance parameters registered by a virtual reality laparoscopic trainer (LapSim). The study enrolled 10 surgical residents (3 females) with a median of 5.5 years (range, 2-6 years) since graduation who had similar limited experience in laparoscopic surgery (median, 5; range, 1-16 laparoscopic cholecystectomies). All the participants performed three repetitions of seven basic skills tasks on the LapSim laparoscopic trainer and one laparoscopic cholecystectomy in the operating room. The operating room procedure was video recorded and blindly assessed by two independent observers using a modified OSATS rating scale. Assessment in the operating room was based on three parameters: time used, error score, and economy of motion score. During the tasks on the LapSim, time, error (tissue damage and millimeters of tissue damage [tasks 2-6], error score [incomplete target areas, badly placed clips, and dropped clips [task 7]), and economy of movement parameters (path length and angular path) were registered. The correlation between time, economy, and error parameters during the simulated tasks and the operating room procedure was statistically assessed using Spearman's test. Significant correlations were demonstrated between the time used to complete the operating room procedure and time used for task 7 (r (s) = 0.74; p = 0.015). The error score demonstrated during the laparoscopic cholecystectomy correlated well with the tissue damage in three of the seven tasks (p < 0.05), the millimeters of tissue damage during two of the tasks, and the error score in task 7 (r (s) = 0.67; p = 0.034). Furthermore, statistically significant correlations were observed between the economy of motion score from the operative procedure and LapSim's economy parameters (path length and angular path in six of the tasks) (p < 0.05). The current study demonstrated significant correlations between operative performance in the operating room (assessed using a well-validated rating scale) and psychomotor performance in virtual environment assessed by a computer simulator. This provides strong evidence for the validity of the simulator system as an objective tool for assessing laparoscopic skills. Virtual reality simulation can be used in practice to assess technical skills relevant for minimally invasive surgery.

Process simulation during the design process makes the difference: process simulations applied to a traditional design.

PubMed

Traversari, Roberto; Goedhart, Rien; Schraagen, Jan Maarten

2013-01-01

The objective is evaluation of a traditionally designed operating room using simulation of various surgical workflows. A literature search showed that there is no evidence for an optimal operating room layout regarding the position and size of an ultraclean ventilation (UCV) canopy with a separate preparation room for laying out instruments and in which patients are induced in the operating room itself. Neither was literature found reporting on process simulation being used for this application. Many technical guidelines and designs have mainly evolved over time, and there is no evidence on whether the proposed measures are also effective for the optimization of the layout for workflows. The study was conducted by applying observational techniques to simulated typical surgical procedures. Process simulations which included complete surgical teams and equipment required for the intervention were carried out for four typical interventions. Four observers used a form to record conflicts with the clean area boundaries and the height of the supply bridge. Preferences for particular layouts were discussed with the surgical team after each simulated procedure. We established that a clean area measuring 3 × 3 m and a supply bridge height of 2.05 m was satisfactory for most situations, provided a movable operation table is used. The only cases in which conflicts with the supply bridge were observed were during the use of a surgical robot (Da Vinci) and a surgical microscope. During multiple trauma interventions, bottlenecks regarding the dimensions of the clean area will probably arise. The process simulation of four typical interventions has led to significantly different operating room layouts than were arrived at through the traditional design process. Evidence-based design, human factors, work environment, operating room, traditional design, process simulation, surgical workflowsPreferred Citation: Traversari, R., Goedhart, R., & Schraagen, J. M. (2013). Process simulation during the design process makes the difference: Process simulations applied to a traditional design. Health Environments Research & Design Journal 6(2), pp 58-76.

Metal oxide gas sensors on the nanoscale

NASA Astrophysics Data System (ADS)

Plecenik, A.; Haidry, A. A.; Plecenik, T.; Durina, P.; Truchly, M.; Mosko, M.; Grancic, B.; Gregor, M.; Roch, T.; Satrapinskyy, L.; Moskova, A.; Mikula, M.; Kus, P.

2014-06-01

Low cost, low power and highly sensitive gas sensors operating at room temperature are very important devices for controlled hydrogen gas production and storage. One of the disadvantages of chemosensors is their high operating temperature (usually 200 - 400 °C), which excludes such type of sensors from usage in explosive environment. In this report, a new concept of gas chemosensors operating at room temperature based on TiO2 thin films is discussed. Integration of such sensor is fully compatible with sub-100 nm semiconductor technology and could be transferred directly from labor to commercial sphere.

The genesis of neurosurgery and the evolution of the neurosurgical operative environment: part I-prehistory to 2003.

PubMed

Liu, Charles Y; Apuzzo, Michael L J

2003-01-01

Despite its singular importance, little attention has been given to the neurosurgical operative environment in the scientific and medical literature. This article focuses attention on the development of neurosurgery and the parallel emergence of its operative setting. The operative environment has, to a large extent, defined the "state of the art and science" of neurosurgery, which is now undergoing rapid reinvention. During the course of its initial invention, major milestones in the development of neurosurgery have included the definition of anatomy, consolidation of a scientific basis, and incorporation of the practicalities of anesthesia and antisepsis and later operative technical adjuvants for further refinement of action and minimalism. The progress, previously long and laborious in emergence, is currently undergoing rapid evolution. Throughout its evolution, the discipline has assimilated the most effective tools of modernity into the operative environment, leading eventually to the entity known as the operating room. In the decades leading to the present, progressive minimalization of manipulation and the emergence of more refined operative definition with increasing precision are evident, with concurrent miniaturization of attendant computerized support systems, sensors, robotic interfaces, and imaging devices. These developments over time have led to the invention of neurosurgery and the establishment of the current state-of-the-art neurosurgical operating room as we understand it, and indeed, to a broader definition of the entity itself. To remain current, each neurosurgeon should periodically reconsider his or her personal operative environment and its functional design with reference to modernity of practice as currently defined.

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

PubMed

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

2010-06-01

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

Integrated intelligent systems in advanced reactor control rooms

DOE Office of Scientific and Technical Information (OSTI.GOV)

Beckmeyer, R.R.

1989-01-01

An intelligent, reactor control room, information system is designed to be an integral part of an advanced control room and will assist the reactor operator's decision making process by continuously monitoring the current plant state and providing recommended operator actions to improve that state. This intelligent system is an integral part of, as well as an extension to, the plant protection and control systems. This paper describes the interaction of several functional components (intelligent information data display, technical specifications monitoring, and dynamic procedures) of the overall system and the artificial intelligence laboratory environment assembled for testing the prototype. 10 refs.,more » 5 figs.« less

Role of Ultraviolet Disinfection in the Prevention of Surgical Site Infections.

PubMed

Simmons, Sarah; Dale, Charles; Holt, James; Velasquez, Katie; Stibich, Mark

2017-01-01

The role of the environment in surgical site infections is surprisingly understudied. UV disinfection holds promise for reducing the level of contamination in operating rooms and thereby lowering the risk of infection for patients. Issues such as the frequency, amount and locations for UV disinfection to have an impact on the risk of surgical site infection are recently emerging in the literature. As technologies and knowledge improve, UV disinfection will have a role to play in operating rooms in the future.

Air-conditioning vs. presence of pathogenic fungi in hospital operating theatre environment.

PubMed

Gniadek, Agnieszka; Macura, Anna B

2011-01-01

Infections related to modern surgical procedures present a difficult problem for contemporary medicine. Infections acquired during surgery represent a risk factor related to therapeutical interventions. Eradication of microorganisms from hospital operating theatre environment may contribute to reduction of infections as the laminar flow air-conditioning considerably reduces the number of microorganisms in the hospital environment. The objective of the study was to evaluate the occurrence of fungi in air-conditioned operating theatre rooms. The study was carried out in one of the hospitals in Krak6w during December 2009. Indoor air samples and imprints from the walls were collected from five operating theatre rooms. A total of fifty indoor air samples were collected with a MAS-100 device, and twenty five imprints from the walls were collected using a Count Tact method. Fungal growth was observed in 48 air samples; the average numbers of fungi were within the range of 5-100 c.f.u. in one cubic metre of the air. Fungi were detected only in four samples of the wall imprints; the number of fungi was 0.01 c.f.u. per one square centimetre of the surface. The mould genus Aspergillus was most frequently isolated, and the species A. fumigatus and A. versicolor were the dominating ones. To ensure microbiological cleanness of hospital operating theatre, the air-conditioning system should be properly maintained. Domination of the Aspergillus fungi in indoor air as well as increase in the number of moulds in the samples taken in evenings (p < 0.05) may suggest that the room decontamination procedures were neglected.

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

Decreasing airborne contamination levels in high-risk hospital areas using a novel mobile air-treatment unit.

PubMed

Bergeron, V; Reboux, G; Poirot, J L; Laudinet, N

2007-10-01

To evaluate the performance of a new mobile air-treatment unit that uses nonthermal-plasma reactors for lowering the airborne bioburden in critical hospital environments and reducing the risk of nosocomial infection due to opportunistic airborne pathogens, such as Aspergillus fumigatus. Tests were conducted in 2 different high-risk hospital areas: an operating room under simulated conditions and rooms hosting patients in a pediatric hematology ward. Operating room testing provided performance evaluations of removal rates for airborne contamination (ie, particles larger than 0.5 microm) and overall lowering of the airborne bioburden (ie, colony-forming units of total mesophilic flora and fungal flora per cubic meter of air). In the hematology service, opportunistic and nonpathogenic airborne fungal levels in a patient's room equipped with an air-treatment unit were compared to those in a control room. In an operating room with a volume of 118 m(3), the time required to lower the concentration of airborne particles larger than 0.5 microm by 90% was decreased from 12 minutes with the existing high-efficiency particulate air filtration system to less than 2 minutes with the units tested, with a 2-log decrease in the steady-state levels of such particles (P<.01). Concurrently, total airborne mesophilic flora concentrations dropped by a factor of 2, and the concentrations of fungal species were reduced to undetectable levels (P<.01). The 12-day test period in the hematology ward revealed a significant reduction in airborne fungus levels (P<.01), with average reductions of 75% for opportunistic species and 82% for nonpathogenic species. Our data indicate that the mobile, nonthermal-plasma air treatment unit tested in this study can rapidly reduce the levels of airborne particles and significantly lower the airborne bioburden in high-risk hospital environments.

The empty OR-process analysis and a new concept for flexible and modular use in minimal invasive surgery.

PubMed

Eckmann, Christian; Olbrich, Guenter; Shekarriz, Hodjat; Bruch, Hans-Peter

2003-01-01

The reproducible advantages of minimal invasive surgery have led to a worldwide spread of these techniques. Nevertheless, the increasing use of technology causes problems in the operating room (OR). The workstation environment and workflow are handicapped by a great number of isolated solutions that demand a large amount of space. The Center of Excellence in Medical Technology (CEMET) was established in 2001 as an institution for a close cooperation between users, science, and manufacturers of medical devices in the State of Schleswig-Holstein, Germany. The future OR, as a major project, began with a detailed process analysis, which disclosed a large number of medical devices with different interfaces and poor standardisation as main problems. Smaller and more flexible devices are necessary, as well as functional modules located outside the OR. Only actuators should be positioned near the operation area. The future OR should include a flexible-room concept and less equipment than is in use currently. A uniform human-user interface is needed to control the OR environment. This article addresses the need for a clear workspace environment, intelligent-user interfaces, and flexible-room concept to improve the potentials in use of minimal invasive surgery.

Consultation, communication, and conflict management by out-of-operating room anesthesiologists: strangers in a strange land.

PubMed

Caplan, Jason P; Querques, John; Epstein, Lucy A; Stern, Theodore A

2009-03-01

With anesthesiology increasingly practiced outside the operating room (OR) environment, it is important that anesthesiologists begin to identify and to teach the communication skills required for practice in non-OR general hospital settings. The "one back" position of the consultant, and the associated diminished sense of immediate control, can generate discomfort for many clinicians. This article discusses the literature regarding practice as a consultant and the navigation of conflict with an emphasis on how anesthesiologists might apply the findings to out-of-OR practice.

Special Operations Forces Language and Culture Needs Assessment Project: Defense Language Aptitude Battery (DLAB): Perspectives from the Field

DTIC Science & Technology

2010-09-29

facilities (the room was 100 degrees in the middle of a hot North Carolina summer) and because our drill sergeants did not let us get enough sleep the...inadquate facilities (the room was 100 degrees in the middle of a hot North Carolina summer) and because our drill sergeants did not let us get enough ...environment was too hot. Furthermore, some operators reported they did not receive adequate sleep the night before the test due to other training

Trace anesthetic vapors in hospital operating-room environments

DOE Office of Scientific and Technical Information (OSTI.GOV)

Choi-Lao, A.T.

1981-05-01

This study investigated concentrations of halothane anesthetic vapors in the operating rooms of two hospitals in the Ottawa, Ontario, Canada, area. Air samples, taken by active charcoal tubes and dosimeter badges, were analyzed by a gas chromatographic technique. Readings of 71 samples taken from hospital A and 65 samples from hospital B ranged from 1.0 to 29.4 parts per billion (ppb) for the active period and 0.1 to 3.8 ppb for the inactive period. All samples showed trace concentrations of halothane, but were well below the recommended maximal level.

The ergonomic conundrum for technology integration.

PubMed

Ahearn, David

2006-01-01

In the operatory of today, the opportunities are great. Space is at a premium and integration is a must. By consolidating the operator's primary supplies, which formerly were spread around the room, performance improves and space is gained for the successful introduction of high technology. Room cost decreases, permitting more networked rooms in less space at a lower cost. The productive potential of today's practice is greater than ever before; however, to gain the most from these opportunities, a change must occur in our perception of the treatment environment. When designing an office for the coming decades, it is vitally important to create a space for the future, not the past. Dentists must be willing to look objectively at their clinical environment and be willing to gain a clear sense of future needs. Your new treatment room can become a tool for future growth and prosperity or a museum about dentistry's past. Opportunity knocks.

Operating room environment and surgical site infections in arthroplasty procedures.

PubMed

Cristina, M L; Sartini, M; Schinca, E; Ottria, G; Spagnolo, A M

2016-09-01

The rate of surgical site infections (SSI) is strongly influenced by operating room quality, which is determined by the structural features of the facility and its systems and by the management and behavior of healthcare workers. The aim of the present study was to assess microbial contamination in the operating room during hip- and knee-replacement procedures, the behavior of operating room staff and the incidence of SSI through postdischarge surveillance. Microbial contamination was evaluated by active and passive sampling at rest and in operating conditions. Organizational and behavioral characteristics were collected through observational assessment. The incidence of SSI was evaluated in 255 patients, and follow-up examinations were carried out 30 and 365 days after the procedure. The mean values of the airborne and sedimenting microbial loads were 12.90 CFU/m 3 and 0.02 CFU/cm2/h, respectively. With regard to outcome, the infection rate proved to be 0.89% and was associated with knee-replacement procedures. The microorganism responsible for this superficial infection was Staphylococcus aureus. Clinical outcomes proved to be satisfactory, owing to the limited microbial load (in both at-rest and operating conditions), the appropriate behavior of the staff, compliance with the guidelines on preoperative antibiotic prophylaxis, and efficient management of the ventilation system.

Acoustic facilities for human factors research at NASA Langley Research Center: Description and operational capabilities

NASA Astrophysics Data System (ADS)

Hubbard, H. H.; Powell, C. A.

1981-06-01

A number of facilities were developed which provide a unique test capability for psychoacoustics and related human factors research. The design philosophy, physical layouts, dimensions, construction features, operating capabilities, and example applications for these facilities are described. In the exterior effects room, human subjects are exposed to the types of noises that are experienced outdoors, and in the interior effects room, subjects are exposed to the types of noises and noise-induced vibrations that are experience indoors. Subjects are also exposed to noises in an echo-free environment in the anechoic listening room. An aircraft noise synthesis system, which simulates aircraft flyover noise at an observer position on the ground, is used in conjunction with these three rooms. The passenger ride quality apparatus, a device for studying passenger response to noise and vibration in aircraft, or in other vehicles, is described.

Acoustic facilities for human factors research at NASA Langley Research Center: Description and operational capabilities

NASA Technical Reports Server (NTRS)

Hubbard, H. H.; Powell, C. A.

1981-01-01

A number of facilities were developed which provide a unique test capability for psychoacoustics and related human factors research. The design philosophy, physical layouts, dimensions, construction features, operating capabilities, and example applications for these facilities are described. In the exterior effects room, human subjects are exposed to the types of noises that are experienced outdoors, and in the interior effects room, subjects are exposed to the types of noises and noise-induced vibrations that are experience indoors. Subjects are also exposed to noises in an echo-free environment in the anechoic listening room. An aircraft noise synthesis system, which simulates aircraft flyover noise at an observer position on the ground, is used in conjunction with these three rooms. The passenger ride quality apparatus, a device for studying passenger response to noise and vibration in aircraft, or in other vehicles, is described.

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

PubMed

Barnett, Gene H; Nathoo, Narendra

2004-01-01

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

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

NASA Astrophysics Data System (ADS)

Hosaka, Ryosuke

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

Microbial diversity in European and South American spacecraft assembly clean rooms

NASA Astrophysics Data System (ADS)

Moissl-Eichinger, Christine; Stieglmeier, Michaela; Schwendner, Petra

Spacecraft assembly clean rooms are unique environments for microbes: Due to low nutri-ent levels, desiccated, clean conditions, constant control of humidity and temperature, these environments are quite inhospitable to microbial life and even considered "extreme". Many procedures keep the contamination as low as possible, but these conditions are also highly se-lective for indigenous microbial communities. For space missions under planetary protection requirements, it is crucial to control the contaminating bioburden as much as possible; but for the development of novel cleaning/sterilization methods it is also important to identify and characterize (understand) the present microbial community of spacecraft clean rooms. In prepa-ration for the recently approved ESA ExoMars mission, two European and one South American spacecraft assembly clean rooms were analyzed with respect to their microbial diversity, using standard procedures, new cultivation approaches and molecular methods, that should shed light onto the presence of planetary protection relevant microorganisms. For this study, the Her-schel Space Observatory (launched in May 2009) and its housing clean rooms in Friedrichshafen (Germany), at ESTEC (The Netherlands) and CSG, Kourou (French Guyana) were sampled during assembly, test and launch operations. Although Herschel does not demand planetary protection requirements, all clean rooms were in a fully operating state during sampling. This gave us the opportunity to sample the microbial diversity under strict particulate and molecular contamination-control. Samples were collected from spacecraft and selected clean room surface areas and were subjected to cultivation assays (32 different media), molecular studies (based on 16S rRNA gene sequence analysis) and quantitative PCR. The results from different strategies will be compared and critically discussed, showing the advantages and limits of the selected methodologies. This talk will sum up the lessons learned from this microbial diversity project.

Disparities in Ammonia, Temperature, Humidity, and Airborne Particulate Matter between the Micro-and Macroenvironments of Mice in Individually Ventilated Caging

PubMed Central

Rosenbaum, Matthew D; VandeWoude, Susan; Volckens, John; Johnson, Thomas E

2010-01-01

Animal room environmental parameters typically are monitored with the assumption that the environment within the cage closely mirrors the room environment. This study evaluated that premise by examining macro- (room) and microenvironmental (cage) parameters in individually ventilated cages housing mice with variable amounts of bedding over a period of 17 d without cage changes. Intracage ammonia levels remained within recommended human guidelines but were higher than room levels, confirming that microisolation caging is efficient at preventing ammonia generated from animal waste from escaping into the room. Humidity and temperature within cages were consistently higher than room levels. Particles in the room predominantly consisted of fine particles (diameter less than 2.5 µm), presumably from the ambient atmosphere; some of these particles were found in the cage microenvironment. In addition, mouse activity within cages produced larger particles, and these particles contributed to substantially higher aerosol mass concentrations within the cage. These findings demonstrate that, although cage and room environmental parameters differ, knowledge of room environmental conditions can be used to predict certain conditions within the cage. This association is relevant in that typical animal care standard operating procedures rely on room measurements, not intracage measurements, which arguably are more important for assessing animal welfare. Further, location and ambient climate can influence particle concentrations in the room, and consequently within the animal cage, suggesting local weather patterns and air quality may account for variability among studies conducted at sites that are geographically divergent. PMID:20353692

Summer Biomedical Engineering Institute 1972

NASA Technical Reports Server (NTRS)

Deloatch, E. M.

1973-01-01

The five problems studied for biomedical applications of NASA technology are reported. The studies reported are: design modification of electrophoretic equipment, operating room environment control, hematological viscometry, handling system for iridium, and indirect blood pressure measuring device.

Virtual reality in the operating room of the future.

PubMed

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

1997-01-01

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

Surgical Theatre (Operating Room) Measure STEEM (OREEM) Scoring Overestimates Educational Environment: The 1-to-L Bias

ERIC Educational Resources Information Center

Dimoliatis, Ioannis D. K.; Jelastopulu, Eleni

2013-01-01

The surgical theatre educational environment measures STEEM, OREEM and mini-STEEM for students (student-STEEM) comprise an up to now disregarded systematic overestimation (OE) due to inaccurate percentage calculation. The aim of the present study was to investigate the magnitude of and suggest a correction for this systematic bias. After an…

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

PubMed

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

2017-08-01

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

SU-F-P-18: Development of the Technical Training System for Patient Set-Up Considering Rotational Correction in the Virtual Environment Using Three-Dimensional Computer Graphic Engine

DOE Office of Scientific and Technical Information (OSTI.GOV)

Imura, K; Fujibuchi, T; Hirata, H

Purpose: Patient set-up skills in radiotherapy treatment room have a great influence on treatment effect for image guided radiotherapy. In this study, we have developed the training system for improving practical set-up skills considering rotational correction in the virtual environment away from the pressure of actual treatment room by using three-dimensional computer graphic (3DCG) engine. Methods: The treatment room for external beam radiotherapy was reproduced in the virtual environment by using 3DCG engine (Unity). The viewpoints to perform patient set-up in the virtual treatment room were arranged in both sides of the virtual operable treatment couch to assume actual performancemore » by two clinical staffs. The position errors to mechanical isocenter considering alignment between skin marker and laser on the virtual patient model were displayed by utilizing numerical values expressed in SI units and the directions of arrow marks. The rotational errors calculated with a point on the virtual body axis as the center of each rotation axis for the virtual environment were corrected by adjusting rotational position of the body phantom wound the belt with gyroscope preparing on table in a real space. These rotational errors were evaluated by describing vector outer product operations and trigonometric functions in the script for patient set-up technique. Results: The viewpoints in the virtual environment allowed individual user to visually recognize the position discrepancy to mechanical isocenter until eliminating the positional errors of several millimeters. The rotational errors between the two points calculated with the center point could be efficiently corrected to display the minimum technique mathematically by utilizing the script. Conclusion: By utilizing the script to correct the rotational errors as well as accurate positional recognition for patient set-up technique, the training system developed for improving patient set-up skills enabled individual user to indicate efficient positional correction methods easily.« less

Medical Team Training Improves Team Performance: AOA Critical Issues.

PubMed

Carpenter, James E; Bagian, James P; Snider, Rebecca G; Jeray, Kyle J

2017-09-20

Effective teamwork and communication can decrease medical errors in environments where the culture of safety is enhanced. Health care can benefit from programs that are based on teamwork, as in other high-stress industries (e.g., aviation), with crew resource management programs, simulator use, and utilization of checklists. Medical team training (MTT) with a strong leadership commitment was used at our institution to focus specifically on creating open, yet structured, communication in operating rooms. Training included the 3 phases of the World Health Organization protocol to organize communication and briefings: preoperative verification, preincision briefing, and debriefing at or near the end of the surgical case. This training program led to measured improvements in job satisfaction and compliance with checklist tasks, and identified opportunities to improve training sessions. MTT provides the potential for sustainable change and a positive impact on the environment of the operating room.

Study About Ceiling Design for Main Control Room of NPP with HFE

NASA Astrophysics Data System (ADS)

Gu, Pengfei; Ni, Ying; Chen, Weihua; Chen, Bo; Zhang, Jianbo; Liang, Huihui

Recently since human factor engineering (HFE) has been used in control room design of nuclear power plant (NPP), the human-machine interface (HMI) has been gradual to develop harmoniously, especially the use of the digital technology. Comparing with the analog technology which was used to human-machine interface in the past, human-machine interaction has been more enhanced. HFE and the main control room (MCR) design engineering of NPP is a combination of multidisciplinary cross, mainly related to electrical and instrument control, reactor, machinery, systems engineering and management disciplines. However, MCR is not only equipped with HMI provided by the equipments, but also more important for the operator to provide a work environment, such as the main control room ceiling. The ceiling design of main control room related to HFE which influences the performance of staff should also be considered in the design of the environment and aesthetic factors, especially the introduction of professional design experience and evaluation method. Based on Ling Ao phase II and Hong Yanhe project implementation experience, the study analyzes lighting effect, space partition, vision load about the ceiling of main control room of NPP. Combining with the requirements of standards, the advantages and disadvantages of the main control room ceiling design has been discussed, and considering the requirements of lightweight, noise reduction, fire prevention, moisture protection, the ceiling design solution of the main control room also has been discussed.

Mars mission science operations facilities design

NASA Technical Reports Server (NTRS)

Norris, Jeffrey S.; Wales, Roxana; Powell, Mark W.; Backes, Paul G.; Steinke, Robert C.

2002-01-01

A variety of designs for Mars rover and lander science operations centers are discussed in this paper, beginning with a brief description of the Pathfinder science operations facility and its strengths and limitations. Particular attention is then paid to lessons learned in the design and use of operations facilities for a series of mission-like field tests of the FIDO prototype Mars rover. These lessons are then applied to a proposed science operations facilities design for the 2003 Mars Exploration Rover (MER) mission. Issues discussed include equipment selection, facilities layout, collaborative interfaces, scalability, and dual-purpose environments. The paper concludes with a discussion of advanced concepts for future mission operations centers, including collaborative immersive interfaces and distributed operations. This paper's intended audience includes operations facility and situation room designers and the users of these environments.

Double gloves: a randomized trial to evaluate a simple strategy to reduce contamination in the operating room.

PubMed

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

2015-04-01

Oral flora, blood-borne pathogens, and bacterial contamination pose a direct risk of infection to patients and health care workers. We conducted a study in a simulated operating room using a newly validated technology to determine whether the use of 2 sets of gloves, with the outer set removed immediately after endotracheal intubation, may reduce this risk. Forty-one anesthesiology residents (PGY 2-4) were enrolled in a study consisting of individual or group simulation sessions. On entry to the simulated operating room, the residents were asked to perform an anesthetic induction and tracheal intubation timed to approximately 6 minutes; they were unaware of the study design. Of the 22 simulation sessions, 11 were conducted with the intubating resident wearing single gloves, and 11 with the intubating resident using double gloves with the outer pair removed after verified intubation. Before the start of the scenario, we coated the lips and inside of the mouth of the mannequin with a fluorescent marking gel as a surrogate pathogen. After the simulation, an observer examined 40 different sites using a handheld ultraviolet light in the operating room to determine the transfer of surrogate pathogens to the patient and the patient's environment. Residents who wore double gloves were instructed by a confederate nurse to remove the outer set immediately after completion of the intubation. Forty sites of potential intraoperative pathogen spread were identified and assigned a score. The difference in the rate of contamination between anesthesiology residents who wore single gloves versus those with double gloves was clinically and statistically significant. The number of sites that were contaminated in the operating room when the intubating resident wore single gloves was 20.3 ± 1.4 (mean ± SE); the number of contaminated sites when residents wore double gloves was 5.0 ± 0.7 (P < 0.001). The results of this study suggest that when an anesthesiologist wears 2 sets of gloves during laryngoscopy and intubation and then removes the outer set immediately after intubation, the contamination of the intraoperative environment is dramatically reduced.

Impact of indoor environment on path loss in body area networks.

PubMed

Hausman, Sławomir; Januszkiewicz, Łukasz

2014-10-20

In this paper the influence of an example indoor environment on narrowband radio channel path loss for body area networks operating around 2.4 GHz is investigated using computer simulations and on-site measurements. In contrast to other similar studies, the simulation model included both a numerical human body phantom and its environment-room walls, floor and ceiling. As an example, radio signal attenuation between two different configurations of transceivers with dipole antennas placed in a direct vicinity of a human body (on-body scenario) is analyzed by computer simulations for several types of reflecting environments. In the analyzed case the propagation environments comprised a human body and office room walls. As a reference environment for comparison, free space with only a conducting ground plane, modelling a steel mesh reinforced concrete floor, was chosen. The transmitting and receiving antennas were placed in two on-body configurations chest-back and chest-arm. Path loss vs. frequency simulation results obtained using Finite Difference Time Domain (FDTD) method and a multi-tissue anthropomorphic phantom were compared to results of measurements taken with a vector network analyzer with a human subject located in an average-size empty cuboidal office room. A comparison of path loss values in different environments variants gives some qualitative and quantitative insight into the adequacy of simplified indoor environment model for the indoor body area network channel representation.

Piezo-based motion stages for heavy duty operation in clean environments

NASA Astrophysics Data System (ADS)

Karasikov, Nir; Peled, Gal; Yasinov, Roman; Gissin, Michael; Feinstein, Alan

2018-02-01

A range of heavy duty, ultra-precise motion stages had been developed for precise positioning in semiconductor manufacturing and metrology, for use in a clean room and high vacuum (HV and UHV) environments, to meet the precision requirements for 7, 5 nm nodes and beyond. These stages are powered by L1B2 direct drive ultrasonic motors, which allows combining long motion range, sub-nanometer positioning accuracy, high stiffness (in the direction of motion), low power consumption and active compensation of thermal and structural drift while holding position. The mechanical design, material selection for clean room and high vacuum preparation techniques are reviewed. Test results in a clean room are reported for a two-axis (X-Y) stage, having a load capacity of 30 kg, a motion range of 450 mm, a positioning accuracy of < 1 nm, a maximum motion speed of > 200 mm/s and a < 2 nm position stability (3 sigma). Long term drift compensation to sub-nm level, against thermal drift, has been validated for more than 10 hours. Heavy duty operation in a high vacuum is exemplified via a single axis stage operating at 5E-7 Torr, having a moving mass of 0.96 kg, oriented against gravity. The stage is operated periodically (up and down) over a travel length of 45 mm. The motion profile has a trapezoidal shape with an acceleration of 1m/s2 and a constant velocity of 100 mm/s. The operational parameters (average absolute position error during constant velocity, motor force, dead zone level) remain stable over more than 370000 passes (experiment duration).

The influence of personal characteristics on the resilience of operating room nurses: a predictor study.

PubMed

Gillespie, Brigid M; Chaboyer, Wendy; Wallis, Marianne

2009-07-01

Resilience in the workplace has been described as a means of facilitating adaptation in stressful environments, and therefore has application in nursing contexts. However, little research has examined how personal characteristics such as age, nursing experience and education contribute to resilience in clinical environments such as the operating room (OR). First to identify the level of resilience, and second, investigate whether age, experience and education contribute to resilience in an Australian sample of OR nurses. A predictive survey design was used. A random sample of 1430 nurses who were members of the Australian College of Operating Room Nurses association were surveyed. The survey included the 25-item Connor-Davidson Resilience Scale, and demographic questions. A standard regression model tested the hypothesis that age, years of OR experience and education contributed to resilience in OR nurses. A total of 735 (51.4%) completed, usable surveys were returned. Pearson's correlations demonstrated modest but statistically significant associations between age (p<0.001), and years of OR experience (p<0.0001), and resilience. In the multiple regression model, only years of OR experience predicted resilience (p<0.0001) and explained a small 3.1% of the variance in resilience. In OR nurses, resilience appears to be predicted by other attributes and is not necessarily dependent on an individual's personal characteristics. Thus, recruitment to the OR should not be based on the conventional notion that an older nursing workforce will have greater longevity and hence be more stable. If younger, less experienced nurses are adequately supported, they may thrive in the OR environment.

[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).

Crew resource management: using aviation techniques to improve operating room safety.

PubMed

Ricci, Michael A; Brumsted, John R

2012-04-01

Since the publication of the Institute of Medicine report estimating nearly 100,000 deaths per year from medical errors, hospitals and physicians have a renewed focus upon error reduction. We implemented a surgical crew resource management (CRM) program for all operating room (OR) personnel. In our academic medical center, 19,000 procedures per year are performed in 27 operating rooms. Mandatory CRM training was implemented for all peri-operative personnel. Aviation techniques introduced included a pre-operative checklist and brief, post-operative debrief, read and initial files, and various other aviation-based techniques. Compliance with conduct of the brief/debrief was monitored as well as wrong-site surgeries and retained foreign body events. The malpractice insurance database for claims was also queried for the period prior to and after training. Initial training was accomplished for 517 people, including all anesthesiologists, surgeons, nurses, technicians, and OR assistants. Pre-operative briefing increased from 6.7 to 99% within 4 mo. Wrong site surgeries and retained foreign bodies decreased from a high of seven in 2007 to none in 2008, but, after 14 mo without additional training, these rose to five in 2009. Malpractice expenses (payouts and legal fees) totaled $793,000 (2003-2007), but have been zero since 2008. CRM training and implementation had an impact on reducing the incidence of wrong site surgery and retained foreign bodies in our operating rooms. However, constant reinforcement and refresher training is necessary for sustained results. Though no one technique can prevent all errors, CRM can effect culture change, producing a safer environment.

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.

Toward realizing high power semiconductor terahertz laser sources at room temperature

NASA Astrophysics Data System (ADS)

Razeghi, Manijeh

2011-05-01

The terahertz (THz) spectral range offers promising applications in science, industry, and military. THz penetration through nonconductors (fabrics, wood, plastic) enables a more efficient way of performing security checks (for example at airports), as illegal drugs and explosives could be detected. Being a non-ionizing radiation, THz radiation is environment-friendly enabling a safer analysis environment than conventional X-ray based techniques. However, the lack of a compact room temperature THz laser source greatly hinders mass deployment of THz systems in security check points and medical centers. In the past decade, tremendous development has been made in GaAs/AlGaAs based THz Quantum Cascade Laser (QCLs), with maximum operating temperatures close to 200 K (without magnetic field). However, higher temperature operation is severely limited by a small LO-phonon energy (~ 36 meV) in this material system. With a much larger LO-phonon energy of ~ 90 meV, III-Nitrides are promising candidates for room temperature THz lasers. However, realizing high quality material for GaN-based intersubband devices presents a significant challenge. Advances with this approach will be presented. Alternatively, recent demonstration of InP based mid-infrared QCLs with extremely high peak power of 120 W at room temperature opens up the possibility of producing high power THz emission with difference frequency generation through two mid-infrared wavelengths.

Durable improvements in efficiency, safety, and satisfaction in the operating room.

PubMed

Heslin, Martin J; Doster, Barbara E; Daily, Sandra L; Waldrum, Michael R; Boudreaux, Arthur M; Smith, A Blair; Peters, Glenn; Ragan, Debbie B; Buchalter, Scott; Bland, Kirby I; Rue, Loring W

2008-05-01

Enhanced productivity and efficiency in the operating room must be balanced with patient safety and staff satisfaction. In December 2004, transition to an expanded replacement hospital resulted in mandatory overtime, unpredictable work hours, and poor morale among operating room (OR) staff. A staff-retention crisis resulted, which threatened the viability of the OR and the institution. We report the changes implemented to efficiently deliver safe patient care in a supportive environment for surgeons and OR staff. University of Alabama at Birmingham University Hospital OR data were evaluated for fiscal year 2004 and compared with fiscal years 2005 and 2006. Case volumes, number of operational ORs, and on-time case starts were evaluated. OR adverse events were tabulated. Percentage of registered nurse hires and staff departures served as a proxy for staff satisfaction. Short, intermediate, and longterm strategies were implemented by an engaged OR management committee with the guidance of surgical, anesthesia, and hospital leadership. These included new block time release policies; use of traveling nurses until new staff could be hired and trained; and incentive-based, voluntary, employee-scheduled overtime. Mandatory nursing education time was blocked weekly. Enforcement of the National Patient Safety Goals were implemented and adjudicated with a "surgeon-of-the-day" system providing backup for nurse management. We demonstrated an increase in operations per year, on-time starts, and registered nurse hires in fiscal years 2005 and 2006. During this same time, we were able to markedly decrease the number of adverse events, admitting delays, and staff departures. Change is difficult to accept but essential when vital clinical activities are impaired and at risk. To maintain important clinical environments like the OR in an academic center, we developed and implemented effective, data-driven changes. This allowed us to retain critical human resources and restore a supportive environment for the patients, the doctors, and the staff.

Architectural design influences the diversity and structure of the built environment microbiome

PubMed Central

Kembel, Steven W; Jones, Evan; Kline, Jeff; Northcutt, Dale; Stenson, Jason; Womack, Ann M; Bohannan, Brendan JM; Brown, G Z; Green, Jessica L

2012-01-01

Buildings are complex ecosystems that house trillions of microorganisms interacting with each other, with humans and with their environment. Understanding the ecological and evolutionary processes that determine the diversity and composition of the built environment microbiome—the community of microorganisms that live indoors—is important for understanding the relationship between building design, biodiversity and human health. In this study, we used high-throughput sequencing of the bacterial 16S rRNA gene to quantify relationships between building attributes and airborne bacterial communities at a health-care facility. We quantified airborne bacterial community structure and environmental conditions in patient rooms exposed to mechanical or window ventilation and in outdoor air. The phylogenetic diversity of airborne bacterial communities was lower indoors than outdoors, and mechanically ventilated rooms contained less diverse microbial communities than did window-ventilated rooms. Bacterial communities in indoor environments contained many taxa that are absent or rare outdoors, including taxa closely related to potential human pathogens. Building attributes, specifically the source of ventilation air, airflow rates, relative humidity and temperature, were correlated with the diversity and composition of indoor bacterial communities. The relative abundance of bacteria closely related to human pathogens was higher indoors than outdoors, and higher in rooms with lower airflow rates and lower relative humidity. The observed relationship between building design and airborne bacterial diversity suggests that we can manage indoor environments, altering through building design and operation the community of microbial species that potentially colonize the human microbiome during our time indoors. PMID:22278670

Implementation of the Vocera Communication System in a Quaternary Perioperative Environment.

PubMed

Friend, Tynan H; Jennings, Samantha J; Copenhaver, Martin S; Levine, Wilton C

2017-01-01

In the hospital, fast and efficient communication among clinicians and other employees is paramount to ensure optimal patient care, workflow efficiency, patient safety and patient comfort. The implementation of the wireless Vocera® Badge, a hands-free wearable device distributed to perioperative team members, has increased communication efficiency across the perioperative environment at Massachusetts General Hospital (MGH). This quality improvement project, based upon identical pre- and post-implementation surveys, used qualitative and quantitative analysis to determine if and how the Vocera system affected the timeliness of information flow, ease of communication, and operating room noise levels throughout the perioperative environment. Overall, the system increased the speed of information flow and eased communication between coworkers yet was perceived to have raised the overall noise level in and around the operating rooms (ORs). The perceived increase in noise was outweighed by the closed-loop communication between clinicians. Further education of the system's features in regard to speech recognition and privacy along with expected conversation protocol are necessary to ensure hassle-free communication for all staff.

Airborne particle dispersion to an operating room environment during sliding and hinged door opening.

PubMed

Sadrizadeh, Sasan; Pantelic, Jovan; Sherman, Max; Clark, Jordan; Abouali, Omid

2018-03-08

Operating rooms (ORs) are usually over-pressurized in order to prevent the penetration of contaminated air and the consequent risk of surgical site infection. However, a door-opening can result in the rapid disappearance of pressure and contaminants can then easily penetrate into the surgical zone. Therefore, a broad knowledge and understanding of OR ventilation systems and their protective potential is essential for optimizing the surgical environment. This study investigated the air quality and level of airborne particles during a single and multiple door-opening cycles in an operating room supplied by a turbulent-mixing ventilation system. The exploration was carried out numerically using computational fluid dynamics. Model validation was performed to ensure the validity of the achieved results. The OR was initially over-pressurized by approximately 15Pa, relative to the adjacent corridors. Both sliding and hinged doors were simulated and compared. Penetration of bacteria carrying particles from the corridors to the OR can be successfully restricted by using a positive-pressure system. However, the results clearly indicate that frequent door opening can interfere with airflow ventilation systems, alter the pressure gradient, and increase the infection risk for the patient undergoing surgical intervention. Door-opening disturbs the airflow field and could result in containment failure. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

Integration of trans-esophageal echocardiography with magnetic tracking technology for cardiac interventions

NASA Astrophysics Data System (ADS)

Moore, John T.; Wiles, Andrew D.; Wedlake, Chris; Bainbridge, Daniel; Kiaii, Bob; Trejos, Ana Luisa; Patel, Rajni; Peters, Terry M.

2010-02-01

Trans-esophageal echocardiography (TEE) is a standard component of patient monitoring during most cardiac surgeries. In recent years magnetic tracking systems (MTS) have become sufficiently robust to function effectively in appropriately structured operating room environments. The ability to track a conventional multiplanar 2D TEE transducer in 3D space offers incredible potential by greatly expanding the cumulative field of view of cardiac anatomy beyond the limited field of view provided by 2D and 3D TEE technology. However, there is currently no TEE probe manufactured with MTS technology embedded in the transducer, which means sensors must be attached to the outer surface of the TEE. This leads to potential safety issues for patients, as well as potential damage to the sensor during procedures. This paper presents a standard 2D TEE probe fully integrated with MTS technology. The system is evaluated in an environment free of magnetic and electromagnetic disturbances, as well as a clinical operating room in the presence of a da Vinci robotic system. Our first integrated TEE device is currently being used in animal studies for virtual reality-enhanced ultrasound guidance of intracardiac surgeries, while the "second generation" TEE is in use in a clinical operating room as part of a project to measure perioperative heart shift and optimal port placement for robotic cardiac surgery. We demonstrate excellent system accuracy for both applications.

Impact of Indoor Environment on Path Loss in Body Area Networks

PubMed Central

Hausman, Sławomir; Januszkiewicz, Łukasz

2014-01-01

In this paper the influence of an example indoor environment on narrowband radio channel path loss for body area networks operating around 2.4 GHz is investigated using computer simulations and on-site measurements. In contrast to other similar studies, the simulation model included both a numerical human body phantom and its environment—room walls, floor and ceiling. As an example, radio signal attenuation between two different configurations of transceivers with dipole antennas placed in a direct vicinity of a human body (on-body scenario) is analyzed by computer simulations for several types of reflecting environments. In the analyzed case the propagation environments comprised a human body and office room walls. As a reference environment for comparison, free space with only a conducting ground plane, modelling a steel mesh reinforced concrete floor, was chosen. The transmitting and receiving antennas were placed in two on-body configurations chest–back and chest–arm. Path loss vs. frequency simulation results obtained using Finite Difference Time Domain (FDTD) method and a multi-tissue anthropomorphic phantom were compared to results of measurements taken with a vector network analyzer with a human subject located in an average-size empty cuboidal office room. A comparison of path loss values in different environments variants gives some qualitative and quantitative insight into the adequacy of simplified indoor environment model for the indoor body area network channel representation. PMID:25333289

[Quantitative analysis of factors to influence the environment of the clean room and clean bench during preparation of intravenous hyperalimentation (IVH) admixtures].

PubMed

Hotoda, S; Aoyama, T; Sato, A; Yamamura, Y; Nakajima, K; Nakamura, K; Sato, H; Iga, T

1999-12-01

We quantitatively studied factors influencing the environment cleanliness for intravenous hyperalimentation (IVH) admixing. The environment cleanliness was evaluated by measuring the counts of particles (> 0.5 micron) and bacteria floating in 1 ft3 of the air inside the clean room (23.6 m3) and in the clean bench built in the department of pharmacy, The University of Tokyo Hospital in 1998. The number of particles at the center of the clean room during IVH admixing by 4 pharmacists was higher than that at the medicine passing area (150 +/- 50/ft3 vs. 260 +/- 60/ft3; mean +/- S.D., n = 12). The cleanliness inside the clean room was improved as the measurement point became higher from the floor (600 +/- 180/ft3, 150 +/- 50/ft3, and 35 +/- 15/ft3 at 50, 100, and 150 cm height, respectively) and the number of persons working inside the room decreased. The changes in the counts of floating bacteria were similar to that of floating particles under the same conditions. In addition the effect of disinfection on the counts of bacteria was clearly observed. When the cleanliness of the room became lower by turning off the air conditioning, the particle counts inside the clean bench became lower along with the distance from the front glass becoming deeper (i.e., 1400 +/- 550/ft3, 140 +/- 70/ft3, and 40 +/- 30/ft3 at 0, 5, and 15 cm, respectively). From these lines of evidence, the following items were suggested in order to maintain the environment cleanliness for IVH admixing. First, the number of persons residing in the clean room should be kept to be minimum. Second, the clean bench should be set up in the center of the clean room. Finally IVH admixing operation should be performed at more than 15 cm depth inside the front glass surface of the clean bench. Moreover, the effect of mopping-up of the clean room with 0.1% benzethonium chloride clearly demonstrated the importance of disinfection on a routine basis.

Improving operating room first start efficiency - value of both checklist and a pre-operative facilitator.

PubMed

Panni, M K; Shah, S J; Chavarro, C; Rawl, M; Wojnarwsky, P K; Panni, J K

2013-10-01

There are multiple components leading to improved operating room efficiency. We undertook a project focusing on first case starts; accounting for each delay component on a global basis. Our hypothesis was there would be a reduction in first start delays after we implemented strategies to address the issues identified through this accounting process. An orange sheet checklist was implemented, with specific items that needed to be clear prior to roll back to the operating room (OR), and an OR facilitator was employed to intervene whenever there were any missing items needed for a specific patient. We present the data from this quality improvement project over an 18-month period. Initially, 10.07 (± 0.73) delayed first starts occurred per day but declined steadily over time to a low of 4.95 (± 0.38) per day after 6 months (-49.2 %, P < 0.001). By the end of the project, the most common reasons for delay still included late surgical attending (19%), schedule changes (14%) as well as 'other reasons' (13%), but with an overall reduction per day of each. Total anaesthesia delay initially totalled 11% of the first start delays, but was negligible (< 1%) at the project's completion. While we have a challenging operating room environment based on our patient population, multiple trainees in both the surgery and anaesthesiology teams: an orange sheet - pre-operative checklist in addition to a dedicated pre-operative facilitator; allowed us to make a substantial improvement in our first start on time starts. © 2013 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

Self-Protective Measures to Enhance Airlift Operations in Hostile Environments

DTIC Science & Technology

1989-09-01

developed theater may be so disorganized that category 2 threats may be less precisely defined and maybe found throughout the area. It is ironic that in...microns, a heat-seeker 80 TABLE 13 Infrared Sensitive Photoconductors 52 Photoconductor Wavelength Sensitivity Lead Sulfide , -60°F 1 to 3.5 microns Lead... Sulfide , Room Temperature 1 to 2.8 microns Telluride, -320°F i to 5 microns Indium Antimonide, -320°F 1 to 6 microns Germanium, Doped, Room

Alcaligenes xylosoxidans endophthalmitis following phacoemulsification and intraocular lens implantation.

PubMed

Robert, Pierre-Yves; Chainier, Delphine; Garnier, Fabien; Ploy, Marie-Cécile; Parneix, Pierre; Adenis, Jean-Paul; Martin, Christian

2008-01-01

Five consecutive cases of endophthalmitis that developed after cataract extraction by a single surgeon using the same operating room during one morning session are described. Following preoperative topical administration of ciprofloxacin, surgery consisted of phacoemulsification with peristaltic pump and fluid venting, polymethylmethacrylate intraocular lens implantation, and corneal suture. No complications occurred during surgery. All five patients developed endophthalmitis caused by infection with Alcaligenes xylosoxidans in less than 24 hours. Pulsed-field gel electrophoresis was used to prove similarity between strains. Bacterial inquiry on contamination of the operating room environment revealed massive colonization of phacoemulsifier irrigation channels by Pseudomonas fluorescens bacteria from an unestablished source. Four of the five patients ultimately recovered visual acuity better than 20/60.

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.

Large-eddy simulation of human-induced contaminant transport in room compartments.

PubMed

Choi, J-I; Edwards, J R

2012-02-01

A large-eddy simulation is used to investigate contaminant transport owing to complex human and door motions and vent-system activity in room compartments where a contaminated and clean room are connected by a vestibule. Human and door motions are simulated with an immersed boundary procedure. We demonstrate the details of contaminant transport owing to human- and door-motion-induced wake development during a short-duration event involving the movement of a person (or persons) from a contaminated room, through a vestibule, into a clean room. Parametric studies that capture the effects of human walking pattern, door operation, over-pressure level, and vestibule size are systematically conducted. A faster walking speed results in less mass transport from the contaminated room into the clean room. The net effect of increasing the volume of the vestibule is to reduce the contaminant transport. The results show that swinging-door motion is the dominant transport mechanism and that human-induced wake motion enhances compartment-to-compartment transport. The effect of human activity on contaminant transport may be important in design and operation of clean or isolation rooms in chemical or pharmaceutical industries and intensive care units for airborne infectious disease control in a hospital. The present simulations demonstrate details of contaminant transport in such indoor environments during human motion events and show that simulation-based sensitivity analysis can be utilized for the diagnosis of contaminant infiltration and for better environmental protection. © 2011 John Wiley & Sons A/S.

Operating room management and operating room productivity: the case of Germany.

PubMed

Berry, Maresi; Berry-Stölzle, Thomas; Schleppers, Alexander

2008-09-01

We examine operating room productivity on the example of hospitals in Germany with independent anesthesiology departments. Linked to anesthesiology group literature, we use the ln(Total Surgical Time/Total Anesthesiologists Salary) as a proxy for operating room productivity. We test the association between operating room productivity and different structural, organizational and management characteristics based on survey data from 87 hospitals. Our empirical analysis links improved operating room productivity to greater operating room capacity, appropriate scheduling behavior and management methods to realign interests. From this analysis, the enforcing jurisdiction and avoiding advance over-scheduling appear to be the implementable tools for improving operating room productivity.

Pre-use anesthesia machine check; certified anesthesia technician based quality improvement audit.

PubMed

Al Suhaibani, Mazen; Al Malki, Assaf; Al Dosary, Saad; Al Barmawi, Hanan; Pogoku, Mahdhav

2014-01-01

Quality assurance of providing a work ready machine in multiple theatre operating rooms in a tertiary modern medical center in Riyadh. The aim of the following study is to keep high quality environment for workers and patients in surgical operating rooms. Technicians based audit by using key performance indicators to assure inspection, passing test of machine worthiness for use daily and in between cases and in case of unexpected failure to provide quick replacement by ready to use another anesthetic machine. The anesthetic machines in all operating rooms are daily and continuously inspected and passed as ready by technicians and verified by anesthesiologist consultant or assistant consultant. The daily records of each machines were collected then inspected for data analysis by quality improvement committee department for descriptive analysis and report the degree of staff compliance to daily inspection as "met" items. Replaced machine during use and overall compliance. Distractive statistic using Microsoft Excel 2003 tables and graphs of sums and percentages of item studied in this audit. Audit obtained highest compliance percentage and low rate of replacement of machine which indicate unexpected machine state of use and quick machine switch. The authors are able to conclude that following regular inspection and running self-check recommended by the manufacturers can contribute to abort any possibility of hazard of anesthesia machine failure during operation. Furthermore in case of unexpected reason to replace the anesthesia machine in quick maneuver contributes to high assured operative utilization of man machine inter-phase in modern surgical operating rooms.

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.

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

PubMed

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

2015-01-01

The design and operation of a facility in which a magnetic resonance imaging (MRI) scanner is incorporated into a room used for surgical or endovascular cardiac interventions presents several challenges. MR safety must be maintained in the presence of a much wider variety of equipment than is found in a diagnostic unit, and of staff unfamiliar with the MRI environment, without compromising the safety and practicality of the interventional procedure. Both the MR-guided cardiac interventional unit at Kings College London and the intraoperative imaging suite at the National Hospital for Neurology and Neurosurgery are single-room interventional facilities incorporating 1.5 T cylindrical-bore MRI scanners. The two units employ similar strategies to maintain MR safety, both in original design and day-to-day operational workflows, and between them over a decade of incident-free practice has been accumulated. This article outlines these strategies, highlighting both similarities and differences between the units, as well as some lessons learned and resulting procedural changes made in both units since installation. © 2014 Wiley Periodicals, Inc.

Gigabit free-space multi-level signal transmission with a mid-infrared quantum cascade laser operating at room temperature.

PubMed

Pang, Xiaodan; Ozolins, Oskars; Schatz, Richard; Storck, Joakim; Udalcovs, Aleksejs; Navarro, Jaime Rodrigo; Kakkar, Aditya; Maisons, Gregory; Carras, Mathieu; Jacobsen, Gunnar; Popov, Sergei; Lourdudoss, Sebastian

2017-09-15

Gigabit free-space transmissions are experimentally demonstrated with a quantum cascaded laser (QCL) emitting at mid-wavelength infrared of 4.65 μm, and a commercial infrared photovoltaic detector. The QCL operating at room temperature is directly modulated using on-off keying and, for the first time, to the best of our knowledge, four- and eight-level pulse amplitude modulations (PAM-4, PAM-8). By applying pre- and post-digital equalizations, we achieve up to 3  Gbit/s line data rate in all three modulation configurations with a bit error rate performance of below the 7% overhead hard decision forward error correction limit of 3.8×10 -3 . The proposed transmission link also shows a stable operational performance in the lab environment.

Utilizing Diffusion Theory to predict carbon dioxide concentration in an indoor environment

NASA Astrophysics Data System (ADS)

Kramer, Andrew R.

This research details a new method of relating sources of carbon dioxide to carbon dioxide concentration in a room operating in a reduced ventilation mode by utilizing Diffusion Theory. The theoretical basis of this research involved solving Fick's Second Law of Diffusion in spherical coordinates for a source of carbon dioxide flowing at a constant rate and located in the center of an impermeable spherical boundary. The solution was developed using a Laplace Transformation. A spherical diffusion test chamber was constructed and used to validate and benchmark the developed theory. The method was benchmarked by using Dispersion Coefficients for large carbon dioxide flow rates due to diffusion induced convection. The theoretical model was adapted to model a room operating with restricted ventilation in the presence of a known, constant source of carbon dioxide. The room was modeled as a sphere of volume equal to the room and utilized a Dispersion Coefficient that is consistent with published values. The developed Diffusion Model successfully predicted the spatial concentration of carbon dioxide in a room operating in a reduced ventilation mode in the presence of a source of carbon dioxide. The flow rates of carbon dioxide that were used in the room are comparable to the average flow rate of carbon dioxide from a person during quiet breathing, also known as the Tidal Breathing. This indicates the Diffusion Model developed from this research has the potential to correlate carbon dioxide concentration with static occupancy levels which can lead to energy savings through a reduction in air exchange rates when low occupancy is detected.

[Team training and assessment in mixed reality-based simulated operating room : Current state of research in the field of simulation in spine surgery exemplified by the ATMEOS project].

PubMed

Stefan, P; Pfandler, M; Wucherer, P; Habert, S; Fürmetz, J; Weidert, S; Euler, E; Eck, U; Lazarovici, M; Weigl, M; Navab, N

2018-04-01

Surgical simulators are being increasingly used as an attractive alternative to clinical training in addition to conventional animal models and human specimens. Typically, surgical simulation technology is designed for the purpose of teaching technical surgical skills (so-called task trainers). Simulator training in surgery is therefore in general limited to the individual training of the surgeon and disregards the participation of the rest of the surgical team. The objective of the project Assessment and Training of Medical Experts based on Objective Standards (ATMEOS) is to develop an immersive simulated operating room environment that enables the training and assessment of multidisciplinary surgical teams under various conditions. Using a mixed reality approach, a synthetic patient model, real surgical instruments and radiation-free virtual X‑ray imaging are combined into a simulation of spinal surgery. In previous research studies, the concept was evaluated in terms of realism, plausibility and immersiveness. In the current research, assessment measurements for technical and non-technical skills are developed and evaluated. The aim is to observe multidisciplinary surgical teams in the simulated operating room during minimally invasive spinal surgery and objectively assess the performance of the individual team members and the entire team. Moreover, the effectiveness of training methods and surgical techniques or success critical factors, e. g. management of crisis situations, can be captured and objectively assessed in the controlled environment.

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 demonstrated in a flammability model effectively reduced the risk of fire. CO2 3-dimensional spatial mapping suggests effective fire reduction at least 1 cm away from the tip of the ESU pencil at 8 L/min CO2 flow. Future testing should determine optimum CO2 flow rates and ideal nozzle shapes. Use of this device may substantially reduce the risk of patient injury due to operating room fires.

Impact of imaging room environment: staff job stress and satisfaction, patient satisfaction, and willingness to recommend.

PubMed

Quan, Xiaobo; Joseph, Anjali; Ensign, Janet C

2012-01-01

The built environment significantly affects the healthcare experiences of patients and staff. Healthcare administrators and building designers face the opportunity and challenge of improving healthcare experience and satisfaction through better environmental design. The purpose of the study was to evaluate how a novel environmental intervention for imaging rooms, which integrated multiple elements of healing environments including positive distractions and personal control over environment, affects the perceptions and satisfactions of its primary users-patients and staff. Anonymous questionnaire surveys were conducted to compare patient and staff perceptions of the physical environment, satisfaction, and stress in two types of imaging rooms: imaging rooms with the intervention installed (intervention rooms) and traditionally designed rooms without the intervention (comparison rooms). Imaging technologists and patients perceived the intervention rooms to be significantly more pleasant-looking. Patients in the intervention rooms reported significantly higher levels of environmental control and were significantly more willing to recommend the intervention rooms to others. The environmental intervention was effective in improving certain aspects of the imaging environment: pleasantness and environmental control. Further improvement of the imaging environment is needed to address problematic areas such as noise.

Concept and design engineering: endourology operating room.

PubMed

Sabnis, Ravindra; Ganesamoni, Raguram; Mishra, Shashikant; Sinha, Lokesh; Desai, Mahesh R

2013-03-01

A dedicated operating room with fluoroscopic imaging capability and adequate data connectivity is important to the success of any endourology program. Proper understanding of the recent developments in technology in relation to operating room is necessary before planning an endourology operating room. An endourology operating room is a fluorocompatible operating room with enough space to accommodate equipment like multiple flat monitors to display video, C-arm with its monitor, ultrasonography machine, laser machine, intracorporeal lithotripsy unit, irrigation pumps and two large trolleys with instruments. This operating room is integrated with devices to continuously record and archive data from endovision and surface cameras, ultrasound and fluoroscopy. Moreover, advances made in data relay systems have created seamless two-way communication between the operating room and electronic medical records, radiological picture archiving and communication system, classroom, auditorium and literally anywhere in the world. A dedicated endourology operating room is required for any hospital, which has a significant amount of endourology procedures. A custom-made integrated endourology operating room will facilitate endourology procedures, smoothen the workflow in operating room and improve patient outcomes. Meticulous planning and involving experts in the field are critical for the success of the project.

Hippocampus, Retrosplenial and Parahippocampal Cortices Encode Multicompartment 3D Space in a Hierarchical Manner.

PubMed

Kim, Misun; Maguire, Eleanor A

2018-05-01

Humans commonly operate within 3D environments such as multifloor buildings and yet there is a surprising dearth of studies that have examined how these spaces are represented in the brain. Here, we had participants learn the locations of paintings within a virtual multilevel gallery building and then used behavioral tests and fMRI repetition suppression analyses to investigate how this 3D multicompartment space was represented, and whether there was a bias in encoding vertical and horizontal information. We found faster response times for within-room egocentric spatial judgments and behavioral priming effects of visiting the same room, providing evidence for a compartmentalized representation of space. At the neural level, we observed a hierarchical encoding of 3D spatial information, with left anterior hippocampus representing local information within a room, while retrosplenial cortex, parahippocampal cortex, and posterior hippocampus represented room information within the wider building. Of note, both our behavioral and neural findings showed that vertical and horizontal location information was similarly encoded, suggesting an isotropic representation of 3D space even in the context of a multicompartment environment. These findings provide much-needed information about how the human brain supports spatial memory and navigation in buildings with numerous levels and rooms.

Virtual reality in surgical skills training.

PubMed

Palter, Vanessa N; Grantcharov, Teodor P

2010-06-01

With recent concerns regarding patient safety, and legislation regarding resident work hours, it is accepted that a certain amount of surgical skills training will transition to the surgical skills laboratory. Virtual reality offers enormous potential to enhance technical and non-technical skills training outside the operating room. Virtual-reality systems range from basic low-fidelity devices to highly complex virtual environments. These systems can act as training and assessment tools, with the learned skills effectively transferring to an analogous clinical situation. Recent developments include expanding the role of virtual reality to allow for holistic, multidisciplinary team training in simulated operating rooms, and focusing on the role of virtual reality in evidence-based surgical curriculum design. Copyright 2010 Elsevier Inc. All rights reserved.

Status quo and current trends of operating room management in Germany.

PubMed

Baumgart, André; Schüpfer, Guido; Welker, Andreas; Bender, Hans-Joachim; Schleppers, Alexander

2010-04-01

Ongoing healthcare reforms in Germany have required strenuous efforts to adapt hospital and operating room organizations to the needs of patients, new technological developments, and social and economic demands. This review addresses the major developments in German operating room management research and current practice. The introduction of the diagnosis-related group system in 2003 has changed the incentive structure of German hospitals to redesign their operating room units. The role of operating room managers has been gradually changing in hospitals in response to the change in the reimbursement system. Operating room managers are today specifically qualified and increasingly externally hired staff. They are more and more empowered with authority to plan and control operating rooms as profit centers. For measuring performance, common perioperative performance indicators are still scarcely implemented in German hospitals. In 2008, a concerted time glossary was established to enable consistent monitoring of operating room performance with generally accepted process indicators. These key performance indicators are a consistent way to make a procedure or case - and also the effectiveness of the operating room management - more transparent. In the presence of increasing financial pressure, a hospital's executives need to empower an independent operating room management function to achieve the hospital's economic goals. Operating room managers need to adopt evidence-based methods also from other scientific fields, for example management science and information technology, to further sustain operating room performance.

Improving operating room safety

PubMed Central

2009-01-01

Despite the introduction of the Universal Protocol, patient safety in surgery remains a daily challenge in the operating room. This present study describes one community health system's efforts to improve operating room safety through human factors training and ultimately the development of a surgical checklist. Using a combination of formal training, local studies documenting operating room safety issues and peer to peer mentoring we were able to substantially change the culture of our operating room. Our efforts have prepared us for successfully implementing a standardized checklist to improve operating room safety throughout our entire system. Based on these findings we recommend a multimodal approach to improving operating room safety. PMID:19930577

Los Alamos National Lab: National Security Science

Science.gov Websites

SKIP TO PAGE CONTENT Los Alamos National Laboratory Delivering science and technology to protect Permit for Storm Water Public Reading Room Environment Home News Los Alamos National Lab: National deposition operations for the Center for Integrated Nanotechnologies at Los Alamos. Innovation drives his

18. DETAIL OF NORTH END OF ATLAS CONTROL CONSOLE NEAR ...

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

18. DETAIL OF NORTH END OF ATLAS CONTROL CONSOLE NEAR WEST WALL OF SLC-3W CONTROL ROOM SHOWING PAYLOAD ENVIRONMENT CONTROL AND MONITORING PANELS (LABELED 'PECMP') - Vandenberg Air Force Base, Space Launch Complex 3, Launch Operations Building, Napa & Alden Roads, Lompoc, Santa Barbara County, CA

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

DTIC Science & Technology

2005-01-01

The surgical hand scrub plays a significant role in preventing nosocomial and surgical site infections . After approval from the Infection Control...stressful conditions in a time- constrained environment. As a result, they are more comfortable with the hands - on aspects of patient care within the...amount of dust, organic debris, and microbial load in surgical environments. Proper cleaning of surfaces can greatly reduce the risk of nosocomial

Specialized operating room for cesarean section in the perinatal care unit: a review of the opening process and operating room management.

PubMed

Kasagi, Yoshihiro; Okutani, Ryu; Oda, Yutaka

2015-02-01

We have opened an operating room in the perinatal care unit (PNCU), separate from our existing central operating rooms, to be used exclusively for cesarean sections. The purpose is to meet the increasing need for both emergency cesarean sections and non-obstetric surgeries. It is equipped with the same surgical instruments, anesthesia machine, monitoring system, rapid infusion system and airway devices as the central operating rooms. An anesthesiologist and a nurse from the central operating rooms trained the nurses working in the new operating room, and discussed solutions to numerous problems that arose before and after its opening. Currently most of the elective and emergency cesarean sections carried out during the daytime on weekdays are performed in the PNCU operating room. A total of 328 and 347 cesarean sections were performed in our hospital during 2011 and 2012, respectively, of which 192 (55.5 %) and 254 (73.2 %) were performed in the PNCU operating room. The mean occupancy rate of the central operating rooms also increased from 81 % in 2011 to 90 % in 2012. The PNCU operating room was built with the support of motivated personnel and multidisciplinary teamwork, and has been found to be beneficial for both surgeons and anesthesiologists, while it also contributes to hospital revenue.

Human factors dimensions in the evolution of increasingly automated control rooms for near-earth satellites

NASA Technical Reports Server (NTRS)

Mitchell, C. M.

1982-01-01

The NASA-Goddard Space Flight Center is responsible for the control and ground support for all of NASA's unmanned near-earth satellites. Traditionally, each satellite had its own dedicated mission operations room. In the mid-seventies, an integration of some of these dedicated facilities was begun with the primary objective to reduce costs. In this connection, the Multi-Satellite Operations Control Center (MSOCC) was designed. MSOCC represents currently a labor intensive operation. Recently, Goddard has become increasingly aware of human factors and human-machine interface issues. A summary is provided of some of the attempts to apply human factors considerations in the design of command and control environments. Current and future activities with respect to human factors and systems design are discussed, giving attention to the allocation of tasks between human and computer, and the interface for the human-computer dialogue.

Towards a model of surgeons' leadership in the operating room.

PubMed

Henrickson Parker, Sarah; Yule, Steven; Flin, Rhona; McKinley, Aileen

2011-07-01

There is widespread recognition that leadership skills are essential for effective performance in the workplace, but the evidence detailing effective leadership behaviours for surgeons during operations is unclear. Boolean searches of four on-line databases and detailed hand search of relevant references were conducted. A four stage screening process was adopted stipulating that articles presented empirical data on surgeons' intraoperative leadership behaviours. Ten relevant articles were identified and organised by method of investigation into (i) observation, (ii) questionnaire and (iii) interview studies. This review summarises the limited literature on surgeons' intraoperative leadership, and proposes a preliminary theoretically based structure for intraoperative leadership behaviours. This structure comprises seven categories with corresponding leadership components and covers two overarching themes related to task- and team-focus. Selected leadership theories which may be applicable to the operating room environment are also discussed. Further research is required to determine effective intraoperative leadership behaviours for safe surgical practice.

Magnetocardiography measurements with 4He vector optically pumped magnetometers at room temperature

NASA Astrophysics Data System (ADS)

Morales, S.; Corsi, M. C.; Fourcault, W.; Bertrand, F.; Cauffet, G.; Gobbo, C.; Alcouffe, F.; Lenouvel, F.; Le Prado, M.; Berger, F.; Vanzetto, G.; Labyt, E.

2017-09-01

In this paper, we present a proof of concept study which demonstrates for the first time the possibility of recording magnetocardiography (MCG) signals with 4He vector optically pumped magnetometers (OPM) operated in a gradiometer mode. Resulting from a compromise between sensitivity, size and operability in a clinical environment, the developed magnetometers are based on the parametric resonance of helium in a zero magnetic field. Sensors are operated at room temperature and provide a tri-axis vector measurement of the magnetic field. Measured sensitivity is around 210 f T (√Hz)-1 in the bandwidth (2 Hz; 300 Hz). MCG signals from a phantom and two healthy subjects are successfully recorded. Human MCG data obtained with the OPMs are compared to reference electrocardiogram recordings: similar heart rates, shapes of the main patterns of the cardiac cycle (P/T waves, QRS complex) and QRS widths are obtained with both techniques.

A novel method of personnel cooling in an operating theatre environment.

PubMed

Casha, Aaron R; Manché, Alexander; Camilleri, Liberato; Gauci, Marilyn; Grima, Joseph N; Borg, Michael A

2014-10-01

An optimized theatre environment, including personal temperature regulation, can help maintain concentration, extend work times and may improve surgical outcomes. However, devices, such as cooling vests, are bulky and may impair the surgeon's mobility. We describe the use of a low-cost, low-energy 'bladeless fan' as a personal cooling device. The safety profile of this device was investigated by testing air quality using 0.5- and 5-µm particle counts as well as airborne bacterial counts on an operating table simulating a wound in a thoracic operation in a busy theatre environment. Particle and bacterial counts were obtained with both an empty and full theatre, with and without the 'bladeless fan'. The use of the 'bladeless fan' within the operating theatre during the simulated operation led to a minor, not statistically significant, lowering of both the particle and bacterial counts. In conclusion, the 'bladeless fan' is a safe, effective, low-cost and low-energy consumption solution for personnel cooling in a theatre environment that maintains the clean room conditions of the operating theatre. © The Author 2014. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

Prepare to protect: Operating and maintaining a tornado safe room.

PubMed

Herseth, Andrew; Goldsmith-Grinspoon, Jennifer; Scott, Pataya

2017-06-01

Operating and maintaining a tornado safe room can be critical to the effective continuity of business operations because a firm's most valuable asset is its people. This paper describes aspects of operations and maintenance (O&M) for existing tornado safe rooms as well as a few planning and design aspects that affect the ultimate operation of a safe room for situations where a safe room is planned, but not yet constructed. The information is based on several Federal Emergency Management Agency safe room publications that provide guidance on emergency management and operations, as well as the design and construction of tornado safe rooms.

Physical design correlates of efficiency and safety in emergency departments: a qualitative examination.

PubMed

Pati, Debajyoti; Harvey, Thomas E; Pati, Sipra

2014-01-01

The objective of this study was to explore and identify physical design correlates of safety and efficiency in emergency department (ED) operations. This study adopted an exploratory, multimeasure approach to (1) examine the interactions between ED operations and physical design at 4 sites and (2) identify domains of physical design decision-making that potentially influence efficiency and safety. Multidisciplinary gaming and semistructured interviews were conducted with stakeholders at each site. Study data suggest that 16 domains of physical design decisions influence safety, efficiency, or both. These include (1) entrance and patient waiting, (2) traffic management, (3) subwaiting or internal waiting areas, (4) triage, (5) examination/treatment area configuration, (6) examination/treatment area centralization versus decentralization, (7) examination/treatment room standardization, (8) adequate space, (9) nurse work space, (10) physician work space, (11) adjacencies and access, (12) equipment room, (13) psych room, (14) staff de-stressing room, (15) hallway width, and (16) results waiting area. Safety and efficiency from a physical environment perspective in ED design are mutually reinforcing concepts--enhancing efficiency bears positive implications for safety. Furthermore, safety and security emerged as correlated concepts, with security issues bearing implications for safety, thereby suggesting important associations between safety, security, and efficiency.

Birth wind and fire: raising awareness to operating room fires during delivery.

PubMed

Wolf, Omer; Weissman, Oren; Harats, Moti; Farber, Nimrod; Stavrou, Demetris; Tessone, Ariel; Zilinsky, Isaac; Winkler, Eyal; Haik, Josef

2013-09-01

We researched whether the obstetric operating room (OR) qualified as a fire-risk environment so as to take preventive measures accordingly. We analyzed a series of iatrogenic burns inflicted during birth by collecting clinical data and comparing it with known OR fire risk factors and with other factors that repeated in all cases in search of unique characteristics of the obstetric OR. All three cases shared in common the same type of oxygen-rich open ventilation system, alcohol-based prepping solution, and the hastiness of cesarean delivery while spontaneous vaginal delivery was already in progress. The obstetric OR is, as suspected, a fire-prone zone in more ways than the regular OR. Therefore, preventive measures should be undertaken and awareness for the possibility for such occurrences should be raised.

The challenges of clinical education in a baccalaureate surgical technology students in Iran: a qualitative study.

PubMed

Zardosht, Roghayeh; Moonaghi, Hossein Karimi; Razavi, Mohammad Etezad; Ahmady, Soleiman

2018-02-01

Clinical education is an integral part of the surgical technology curriculum, in which students combine and integrate knowledge, skills, attitudes, values and philosophies of the profession. It is difficult to learn and adapt to different types of skills and roles in the operating room environment. This qualitative study examines the difference between the clinical education of Surgical Technology and other clinical settings, and the challenges faced by students in the field, within the course. This was a qualitative content analysis study conducted in 2016. The participants in this study were 16 baccalaureate surgical technology students of the University for Medical Sciences in Khorasan Razavi province. A semi-structured interview method was run to collect the required data. The sampling was initially purposive, then in the snowball method which continued until data saturation. All interviews were recorded, then transcribed, and analyzed using a continuous comparative method and conventional qualitative content analysis method. From the deep and rich descriptions of the participants, three themes including "stressful environment", "controversy between anticipation of role and reality", and "humiliating experiences" as well as a general theme of "bitter education" were obtained. Students' orientation before attending the operating room, accompanying, supporting, and a full-time attendance of the specialist instructor, strengthening the prerequisite knowledge and skills for the students in this field, teaching ethics, and professional interactions, play an important role in the student's acceptance of the operating room, in the surgery team and the improvement of the quality of clinical education of these students.

Development and experimental evaluation of an alarm concept for an integrated surgical workstation.

PubMed

Zeißig, Eva-Maria; Janß, Armin; Dell'Anna-Pudlik, Jasmin; Ziefle, Martina; Radermacher, Klaus

2016-04-01

Alarm conditions of the technical equipment in operating rooms represent a prevalent cause for interruptions of surgeons and scrub nurses, resulting in an increase of workload and potential reduction of patient safety. In this work, an alarm concept for an integrated operating room system based on open communication standards is developed and tested. In a laboratory experiment, the reactions of surgeons were analysed, comparing the displaying of alarms on an integrated workstation and on single devices: disruptive effects of alarm handling on primary task (ratings of perceived distraction, resumption lag, deterioration of speed, accuracy, and prospective memory), efficiency and effectiveness of identification of alarms, as well as perceived workload were included. The identification of the alarm cause is significantly more efficient and effective with the integrated alarm concept. Moreover, a slightly lower deterioration of performance of the primary task due to the interruption of alarm handling was observed. Displaying alarms on an integrated workstation supports alarm handling and consequently reduces disruptive effects on the primary task. The findings show that even small changes can reduce workload in a complex work environment like the operating room, resulting in improved patient safety.

Application of an engineering problem-solving methodology to address persistent problems in patient safety: a case study on retained surgical sponges after surgery.

PubMed

Anderson, Devon E; Watts, Bradley V

2013-09-01

Despite innumerable attempts to eliminate the postoperative retention of surgical sponges, the medical error persists in operating rooms worldwide and places significant burden on patient safety, quality of care, financial resources, and hospital/physician reputation. The failure of countless solutions, from new sponge counting methods to radio labeled sponges, to truly eliminate the event in the operating room requires that the emerging field of health-care delivery science find innovative ways to approach the problem. Accordingly, the VA National Center for Patient Safety formed a unique collaboration with a team at the Thayer School of Engineering at Dartmouth College to evaluate the retention of surgical sponges after surgery and find a solution. The team used an engineering problem solving methodology to develop the best solution. To make the operating room a safe environment for patients, the team identified a need to make the sponge itself safe for use as opposed to resolving the relatively innocuous counting methods. In evaluation of this case study, the need for systematic engineering evaluation to resolve problems in health-care delivery becomes clear.

Maintaining a Class M 5.5 environment in a Class M 6.5 cleanroom

NASA Astrophysics Data System (ADS)

Hughes, David W.; Hedgeland, Randy J.; Geer, Wayne C.; Greenberg, Barry N.

1994-10-01

During Kennedy Space Center processing of the Hubble Space Telescope First Servicing Mission, critical optical components were integrated in a Class 100,000 (M 6.5 at 0.5 micrometers and 5.0 micrometers , per Fed-Std 209E) cleanroom. A Class 10,000 (M 5.5) environment was mandated by the 400B (per Mil-Std 1246B) surface cleanliness requirement of the Scientific Instruments. To maintain a Class M 5.5 environment, a contamination control plan was implemented which addressed personnel constraints, operations, and site management. This plan limited personnel access, imposed strict gowning requirements, and increased cleanroom janitorial operations, prohibited operations known to generate contamination while sensitive hardware was exposed to the environment, and controlled roadwork, insecticide spraying, and similar activities. Facility preparations included a ceiling to floor cleaning, sealing of vents and doors, and revising the garment change room entry patterns. The cleanroom was successfully run below Class 5000 while the instruments were present; certain operations, however, were observed to cause local contamination levels to increase above Class M 5.5.

Operating room efficiency improvement after implementation of a postoperative team assessment.

PubMed

Porta, Christopher R; Foster, Andrew; Causey, Marlin W; Cordier, Patricia; Ozbirn, Roger; Bolt, Stephen; Allison, Dennis; Rush, Robert

2013-03-01

Operating room time is highly resource intensive, and delays can be a source of lost revenue and surgeon frustration. Methods to decrease these delays are important not only for patient care, but to maximize operating room resource utilization. The purpose of this study was to determine the root cause of operating room delays in a standardized manner to help improve overall operating room efficiency. We performed a single-center prospective observational study analyzing operating room utilization and efficiency after implementing an executive-driven standardized postoperative team debriefing system from January 2010 to December 2010. A total of 11,342 procedures were performed over the 1-y study period (elective 86%, urgent 11%, and emergent 3%), with 1.3 million min of operating room time, 865,864 min of surgeon operative time (62.5%), and 162,958 min of anesthesia time (11.8%). Overall, the average operating room delay was 18 min and varied greatly based on the surgical specialty. The longest delays were due to need for radiology (40 min); other significant delays were due to supply issues (22.7 min), surgeon issues (18 min), nursing issues (14 min), and room turnover (14 min). Over the 1-y period, there was a decrease in mean delay duration, averaging a decrease in delay of 0.147 min/mo with an overall 9% decrease in the mean delay times. With regard to overall operating room utilization, there was a 39% decrease in overall un-utilized available OR time that was due to delays, improving efficiency by 2334 min (212 min/mo). During this study interval no sentinel events occurred in the operating room. A standardized postoperative debrief tracking system is highly beneficial in identifying and reducing overall operative delays and improving operating room utilization. Published by Elsevier Inc.

Predictors of operating room extubation in adult cardiac surgery.

PubMed

Subramaniam, Kathirvel; DeAndrade, Diana S; Mandell, Daniel R; Althouse, Andrew D; Manmohan, Rajan; Esper, Stephen A; Varga, Jeffrey M; Badhwar, Vinay

2017-11-01

The primary objective of the study was to identify perioperative factors associated with successful immediate extubation in the operating room after adult cardiac surgery. The secondary objective was to derive a simplified predictive scoring system to guide clinicians in operating room extubation. All 1518 patients in this retrospective cohort study underwent standardized fast-track cardiac anesthetic protocol during adult cardiac surgery. Perioperative variables between patients who had successful extubation in the operating room versus in the intensive care unit were retrospectively analyzed using both univariate and multivariable logistic regression analyses. A predictive score of successful operating room extubation was constructed from the multivariable results of 800 patients (derivation set), and the scoring system was further tested using a validation set of 398 patients. Younger age, lower body mass index, higher preoperative serum albumin, absence of chronic lung disease and diabetes, less-invasive surgical approach, isolated coronary bypass surgery, elective surgery, and lower doses of intraoperative intravenous fentanyl were independently associated with higher probability of operating room extubation. The extubation prediction score created in a derivation set of patients performed well in the validation set. Patient scores less than 0 had a minimal probability of successful operating room extubation. Operating room extubation was highly predicted with scores of 5 or greater. Perioperative factors that are independently associated with successful operating room extubation after adult cardiac operations were identified, and an operating room extubation prediction scoring system was validated. This scoring system may be used to guide safe operating room extubation after cardiac operations. Copyright © 2017 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

Microbial contamination of syringes during preparation: the direct influence of environmental cleanliness and risk manipulations on end-product quality.

PubMed

Stucki, Cyril; Sautter, Anna-Maria; Favet, Jocelyne; Bonnabry, Pascal

2009-11-15

The direct influence of environmental cleanliness and risk manipulations on prepared syringes was evaluated. Media-fill testing was used to estimate potential microbial contamination. Syringes were prepared in three different environments using four different uncontrolled high-risk manipulations. The three environments included an International Organization for Standardization (ISO) class 5 horizontal laminar-airflow hood in an ISO class 6 cleanroom (in accordance with United States Pharmacopeia [USP] chapter 797), an ISO class 7 drug preparation area of an operating room, and an uncontrolled decentralized pharmacy in a ward. For each combination of environment and manipulation, 100 syringes were filled by a single operator. The four high-risk manipulations used included simple filling of syringes with trypticase soy broth, three-second contact by the ungloved fingers of the operator with the hub of the syringe, three-second contact between an object and the hub of the syringe, and exposure of the filled syringes to ambient air for 10 minutes. Of the 1500 syringes prepared in three different environments, none produced within the cleanroom contained microorganisms, 6% were contaminated in the operating room, and 16% were contaminated in the ward (p < 0.0001). Certain high-risk manipulations were associated with a significant increase in the contamination of the surrogate syringes, including exposure to nonsterile ambient air and nonsterile objects or fingers (p < 0.0001). High contamination rates were measured when the hub of syringes touched nonsterile environmental surfaces and fingers, whereas the drawn-air manipulation was associated with a lower risk of contamination. Working within a properly operating unidirectional airflow primary engineering control in an ISO class 5 cleanroom in accordance with USP chapter 797 requirements was demonstrated to be the best way to avoid bacterial or fungal contamination of injectable drugs directly resulting in patient infections.

Polymer Electrolyte-Based Ambient Temperature Oxygen Microsensors for Environmental Monitoring

NASA Technical Reports Server (NTRS)

Hunter, Gary W.; Xu, Jennifer C.; Liu, Chung-Chiun

2011-01-01

An ambient temperature oxygen microsensor, based on a Nafion polymer electrolyte, has been developed and was microfabricated using thin-film technologies. A challenge in the operation of Nafion-based sensor systems is that the conductivity of Nafion film depends on the humidity in the film. Nafion film loses conductivity when the moisture content in the film is too low, which can affect sensor operation. The advancement here is the identification of a method to retain the operation of the Nafion films in lower humidity environments. Certain salts can hold water molecules in the Nafion film structure at room temperature. By mixing salts with the Nafion solution, water molecules can be homogeneously distributed in the Nafion film increasing the film s hydration to prevent Nafion film from being dried out in low-humidity environment. The presence of organics provides extra sites in the Nafion film to promote proton (H+) mobility and thus improving Nafion film conductivity and sensor performance. The fabrication of ambient temperature oxygen microsensors includes depositing basic electrodes using noble metals, and metal oxides layer on one of the electrode as a reference electrode. The use of noble metals for electrodes is due to their strong catalytic properties for oxygen reduction. A conducting polymer Nafion, doped with water-retaining components and extra sites facilitating proton movement, was used as the electrolyte material, making the design adequate for low humidity environment applications. The Nafion solution was coated on the electrodes and air-dried. The sensor operates at room temperature in potentiometric mode, which measures voltage differences between working and reference electrodes in different gases. Repeat able responses to 21-percent oxygen in nitrogen were achieved using nitrogen as a baseline gas. Detection of oxygen from 7 to 21 percent has also been demonstrated. The room-temperature oxygen micro sensor developed has extremely low power consumption (no heating for operation, no voltage applied to the sensor, only a voltmeter is needed to measure the output), is small in size, is simple to batch-fabricate, and is high in sensor yield. It is applicable in a wide humidity range, with improved operation in low humidity after the additives were added to the Nafion film. Through further improvement and development, the sensor can be used for aerospace applications such as fuel leak detection, fire detection, and environmental monitoring.

Analysis, design, fabrication and testing of an optical tip clearance sensor. [turbocompressor blade tips

NASA Technical Reports Server (NTRS)

Poppel, G. L.; Marple, D. T. F.; Kingsley, J. D.

1981-01-01

Analyses and the design, fabrication, and testing of an optical tip clearance sensor with intended application in aircraft propulsion control systems are reported. The design of a sensor test rig, evaluation of optical sensor components at elevated temperatures, sensor design principles, sensor test results at room temperature, and estimations of sensor accuracy at temperatures of an aircraft engine environment are discussed. Room temperature testing indicated possible measurement accuracies of less than 12.7 microns (0.5 mils). Ways to improve performance at engine operating temperatures are recommended. The potential of this tip clearance sensor is assessed.

Environments predicting intermittent shortening access reduce operant performance but not home cage binge size in rats

PubMed Central

Wojnicki, F.H.E.; Babbs, R.K.; Corwin, R.L.W

2013-01-01

When non-food-deprived rats are given brief access to vegetable shortening (a semi-solid fat used in baked products) on an intermittent basis (Monday, Wednesday, Friday), they consume significantly more and emit more operant responses for shortening than a separate group of rats given brief access to shortening every day. Since both groups are traditionally housed in the same room, it is possible that the environmental cues associated with placing shortening in the cages (e.g., investigator in room, cages opening and closing, etc.) provide predictable cues to the daily group, but unpredictable cues to the intermittent group. The present study examined the effects of providing predictable environmental cues to an isolated intermittent group in order to examine the independent contributions of intermittency and predictability on intake and operant performance. Two groups of rats were housed in the same room, with one group provided 30-min intermittent (INT) access and the second group provided 30-min daily access (D) to shortening. A third group (ISO) of rats was housed in a room by themselves in which all environmental cues associated with intermittent shortening availability were highly predictable. After five weeks of home cage shortening access, all rats were then exposed to several different operant schedules of reinforcement. The INT and ISO groups consumed significantly more shortening in the home cage than the D group. In contrast, the INT group earned significantly more reinforcers than both the ISO and D groups under all but one of the reinforcement schedules, while ISO and D did not differ. These data indicate that intermittent access will generate binge-type eating in the home cage independent of cue predictability. However, predictable cues in the home cage reduce operant responding independent of intermittent access. PMID:23535243

Laparoscopic Skills Are Improved With LapMentor™ Training

PubMed Central

Andreatta, Pamela B.; Woodrum, Derek T.; Birkmeyer, John D.; Yellamanchilli, Rajani K.; Doherty, Gerard M.; Gauger, Paul G.; Minter, Rebecca M.

2006-01-01

Objective: To determine if prior training on the LapMentor™ laparoscopic simulator leads to improved performance of basic laparoscopic skills in the animate operating room environment. Summary Background Data: Numerous influences have led to the development of computer-aided laparoscopic simulators: a need for greater efficiency in training, the unique and complex nature of laparoscopic surgery, and the increasing demand that surgeons demonstrate competence before proceeding to the operating room. The LapMentor™ simulator is expensive, however, and its use must be validated and justified prior to implementation into surgical training programs. Methods: Nineteen surgical interns were randomized to training on the LapMentor™ laparoscopic simulator (n = 10) or to a control group (no simulator training, n = 9). Subjects randomized to the LapMentor™ trained to expert criterion levels 2 consecutive times on 6 designated basic skills modules. All subjects then completed a series of laparoscopic exercises in a live porcine model, and performance was assessed independently by 2 blinded reviewers. Time, accuracy rates, and global assessments of performance were recorded with an interrater reliability between reviewers of 0.99. Results: LapMentor™ trained interns completed the 30° camera navigation exercise in significantly less time than control interns (166 ± 52 vs. 220 ± 39 seconds, P < 0.05); they also achieved higher accuracy rates in identifying the required objects with the laparoscope (96% ± 8% vs. 82% ± 15%, P < 0.05). Similarly, on the two-handed object transfer exercise, task completion time for LapMentor™ trained versus control interns was 130 ± 23 versus 184 ± 43 seconds (P < 0.01) with an accuracy rate of 98% ± 5% versus 80% ± 13% (P < 0.001). Additionally, LapMentor™ trained interns outperformed control subjects with regard to camera navigation skills, efficiency of motion, optimal instrument handling, perceptual ability, and performance of safe electrocautery. Conclusions: This study demonstrates that prior training on the LapMentor™ laparoscopic simulator leads to improved resident performance of basic skills in the animate operating room environment. This work marks the first prospective, randomized evaluation of the LapMentor™ simulator, and provides evidence that LapMentor™ training may lead to improved operating room performance. PMID:16772789

Nurses' Perceptions of Pediatric Intensive Care Unit Environment and Work Experience After Transition to Single-Patient Rooms.

PubMed

Kudchadkar, Sapna R; Beers, M Claire; Ascenzi, Judith A; Jastaniah, Ebaa; Punjabi, Naresh M

2016-09-01

The architectural design of the pediatric intensive care unit may play a major role in optimizing the environment to promote patients' sleep while improving stress levels and the work experience of critical care nurses. To examine changes in nurses' perceptions of the environment of a pediatric critical care unit for promotion of patients' sleep and the nurses' work experience after a transition from multipatient rooms to single-patient rooms. A cross-sectional survey of nurses was conducted before and after the move to a new hospital building in which all rooms in the pediatric critical care unit were single-patient rooms. Nurses reported that compared with multipatient rooms, single-patient private rooms were more conducive to patients sleeping well at night and promoted a more normal sleep-wake cycle (P < .001). Monitors/alarms and staff conversations were the biggest factors that adversely influenced the environment for sleep promotion in both settings. Nurses were less annoyed by noise in single-patient rooms (33%) than in multipatient rooms (79%; P < .001) and reported improved exposure to sunlight. Use of single-patient rooms rather than multipatient rooms improved nurses' perceptions of the pediatric intensive care unit environment for promoting patients' sleep and the nurses' own work experience. ©2016 American Association of Critical-Care Nurses.

Foucault could have been an operating room nurse.

PubMed

Riley, Robin; Manias, Elizabeth

2002-08-01

Operating room nursing is an under-researched area of nursing practice. The stereotypical image of operating room nursing is one of task- and technically-orientated aspects of practice, where nurses work in a medical model and are dominated by constraints from outside their sphere of influence. This paper explores the possibility of understanding operating room nursing in a different way. Using the work of Michel Foucault to analyse the work of operating room nursing, this paper argues the relevance of the framework for a more in-depth analysis of this specialty area of practice. The concepts of power, discipline and subjectivity are used to demonstrate how operating room nursing is constructed as a discipline and how operating room nurses act to govern and construct the specialty. Exemplars are drawn from extensive professional experience, from guidelines of professional operating room nursing associations, as well as published texts. The focus is predominantly on the regulation of space and time to maintain the integrity of the sterile surgical field and issues of management, as well as the use of the ethical concept of the 'surgical conscience'. This form of analysis provides a level and depth of inquiry that has rarely been undertaken in operating room nursing. As such, it has the potential to provide a much needed, different view of operation room nursing that can only help to strengthen its professional foundations and development.

[Hygienic relevance of devices for indoor air treatment].

PubMed

Wegner, J

1982-01-01

Shortcomings regarding design, construction, operation (including emissions), maintenance/repair and control of buildings with rooms for the accommodation of persons may be the reason to install air conditioning devices. According to manufacturers' data, such devices may be applied for various purposes, e.g. the creation of a defined air temperature or humidity, an increase of the supply of outdoor air, the cleaning and deodorization of indoor air or the alteration of the so-called electric climate of a room. The hygienic health evaluation of the different types of air conditioning devices should establish whether --there are aspects of health necessitating alterations of the microclimate of a room; --such alterations could be brought about in a more economic way by purely constructional or individual measures; --the function of individual apparatuses could be accomplished in a better way by replacing them by a larger device serving several rooms; --the operation of such devices may produce adverse health effects such as nuisance by noise, formation of undesirable gases (ozone), danger owing to non-adherence to electric safety rules; --there will be no damage to rooms and furniture, e.g. by water droplets. A look at a number of commercially available devices shows that they are generally dispensable. There are, however, special rare cases where the use of such devices may result in an improvement of the quality of indoor environments.

Cultivation of anaerobic and facultatively anaerobic bacteria from spacecraft-associated clean rooms.

PubMed

Stieglmeier, Michaela; Wirth, Reinhard; Kminek, Gerhard; Moissl-Eichinger, Christine

2009-06-01

In the course of this biodiversity study, the cultivable microbial community of European spacecraft-associated clean rooms and the Herschel Space Observatory located therein were analyzed during routine assembly operations. Here, we focused on microorganisms capable of growing without oxygen. Anaerobes play a significant role in planetary protection considerations since extraterrestrial environments like Mars probably do not provide enough oxygen for fully aerobic microbial growth. A broad assortment of anaerobic media was used in our cultivation strategies, which focused on microorganisms with special metabolic skills. The majority of the isolated strains grew on anaerobic, complex, nutrient-rich media. Autotrophic microorganisms or microbes capable of fixing nitrogen were also cultivated. A broad range of facultatively anaerobic bacteria was detected during this study and also, for the first time, some strictly anaerobic bacteria (Clostridium and Propionibacterium) were isolated from spacecraft-associated clean rooms. The multiassay cultivation approach was the basis for the detection of several bacteria that had not been cultivated from these special environments before and also led to the discovery of two novel microbial species of Pseudomonas and Paenibacillus.

Effects of Forced Air Warming on Airflow around the Operating Table.

PubMed

Shirozu, Kazuhiro; Kai, Tetsuya; Setoguchi, Hidekazu; Ayagaki, Nobuyasu; Hoka, Sumio

2018-01-01

Forced air warming systems are used to maintain body temperature during surgery. Benefits of forced air warming have been established, but the possibility that it may disturb the operating room environment and contribute to surgical site contamination is debated. The direction and speed of forced air warming airflow and the influence of laminar airflow in the operating room have not been reported. In one institutional operating room, we examined changes in airflow speed and direction from a lower-body forced air warming device with sterile drapes mimicking abdominal surgery or total knee arthroplasty, and effects of laminar airflow, using a three-dimensional ultrasonic anemometer. Airflow from forced air warming and effects of laminar airflow were visualized using special smoke and laser light. Forced air warming caused upward airflow (39 cm/s) in the patient head area and a unidirectional convection flow (9 to 14 cm/s) along the ceiling from head to foot. No convection flows were observed around the sides of the operating table. Downward laminar airflow of approximately 40 cm/s counteracted the upward airflow caused by forced air warming and formed downward airflow at 36 to 45 cm/s. Downward airflows (34 to 56 cm/s) flowing diagonally away from the operating table were detected at operating table height in both sides. Airflow caused by forced air warming is well counteracted by downward laminar airflow from the ceiling. Thus it would be less likely to cause surgical field contamination in the presence of sufficient laminar airflow.

Calculation of Appropriate Minimum Size of Isolation Rooms based on Questionnaire Survey of Experts and Analysis on Conditions of Isolation Room Use

NASA Astrophysics Data System (ADS)

Won, An-Na; Song, Hae-Eun; Yang, Young-Kwon; Park, Jin-Chul; Hwang, Jung-Ha

2017-07-01

After the outbreak of the MERS (Middle East Respiratory Syndrome) epidemic, issues were raised regarding response capabilities of medical institutions, including the lack of isolation rooms at hospitals. Since then, the government of Korea has been revising regulations to enforce medical laws in order to expand the operation of isolation rooms and to strengthen standards regarding their mandatory installation at hospitals. Among general and tertiary hospitals in Korea, a total of 159 are estimated to be required to install isolation rooms to meet minimum standards. For the purpose of contributing to hospital construction plans in the future, this study conducted a questionnaire survey of experts and analysed the environment and devices necessary in isolation rooms, to determine their appropriate minimum size to treat patients. The result of the analysis is as follows: First, isolation rooms at hospitals are required to have a minimum 3,300mm minor axis and a minimum 5,000mm major axis for the isolation room itself, and a minimum 1,800mm minor axis for the antechamber where personal protective equipment is donned and removed. Second, the 15 ㎡-or-larger standard for the floor area of isolation rooms will have to be reviewed and standards for the minimum width of isolation rooms will have to be established.

Effect of ventilation rate on air cleanliness and energy consumption in operation rooms at rest.

PubMed

Lee, Shih-Tseng; Liang, Ching-Chieh; Chien, Tsung-Yi; Wu, Feng-Jen; Fan, Kuang-Chung; Wan, Gwo-Hwa

2018-02-27

The interrelationships between ventilation rate, indoor air quality, and energy consumption in operation rooms at rest are yet to be understood. We investigate the effect of ventilation rate on indoor air quality indices and energy consumption in ORs at rest. The study investigates the air temperature, relative humidity, concentrations of carbon dioxide, particulate matter (PM), and airborne bacteria at different ventilation rates in operation rooms at rest of a medical center. The energy consumption and cost analysis of the heating, ventilating, and air conditioning (HVAC) system in the operation rooms at rest were also evaluated for all ventilation rates. No air-conditioned operation rooms had very highest PM and airborne bacterial concentrations in the operation areas. The bacterial concentration in the operation areas with 6-30 air changes per hour (ACH) was below the suggested level set by the United Kingdom (UK) for an empty operation room. A 70% of reduction in annual energy cost by reducing the ventilation rate from 30 to 6 ACH was found in the operation rooms at rest. Maintenance of operation rooms at ventilation rate of 6 ACH could save considerable amounts of energy and achieve the goal of air cleanliness.

Performance analysis of multiple Indoor Positioning Systems in a healthcare environment.

PubMed

Van Haute, Tom; De Poorter, Eli; Crombez, Pieter; Lemic, Filip; Handziski, Vlado; Wirström, Niklas; Wolisz, Adam; Voigt, Thiemo; Moerman, Ingrid

2016-02-03

The combination of an aging population and nursing staff shortages implies the need for more advanced systems in the healthcare industry. Many key enablers for the optimization of healthcare systems require provisioning of location awareness for patients (e.g. with dementia), nurses, doctors, assets, etc. Therefore, many Indoor Positioning Systems (IPSs) will be indispensable in healthcare systems. However, although many IPSs have been proposed in literature, most of these have been evaluated in non-representative environments such as office buildings rather than in a hospital. To remedy this, the paper evaluates the performance of existing IPSs in an operational modern healthcare environment: the "Sint-Jozefs kliniek Izegem" hospital in Belgium. The evaluation (data-collecting and data-processing) is executed using a standardized methodology and evaluates the point accuracy, room accuracy and latency of multiple IPSs. To evaluate the solutions, the position of a stationary device was requested at 73 evaluation locations. By using the same evaluation locations for all IPSs the performance of all systems could objectively be compared. Several trends can be identified such as the fact that Wi-Fi based fingerprinting solutions have the best accuracy result (point accuracy of 1.21 m and room accuracy of 98%) however it requires calibration before use and needs 5.43 s to estimate the location. On the other hand, proximity based solutions (based on sensor nodes) are significantly cheaper to install, do not require calibration and still obtain acceptable room accuracy results. As a conclusion of this paper, Wi-Fi based solutions have the most potential for an indoor positioning service in case when accuracy is the most important metric. Applying the fingerprinting approach with an anchor installed in every two rooms is the preferred solution for a hospital environment.

Planning for patient privacy and hospitability: a must do in oncology care.

PubMed

Easter, James G

2003-01-01

The number one design challenge in the healthcare environment is the patient room. This space is one of the primary functional areas impacting hospital design and, quite often, the place of greatest controversy. This controversy is due to the length of time the patient spends in the room (compared to other areas), the amount of overall space required and the time dedicated to patient room utilization, maintenance, general arrangement and overall efficiency. In addition, there is a growing list of room types to be considered, many are of the ambulatory care, short stay and observation category. Other room types beyond the routine medical/surgical room include Intensive Care, Coronary Care, Surgical Intensive Care, Skilled Nursing, Rehabilitation and Oncology Care as well as more intensive Bone Marrow Transplantation, for example. Major features of the traditional acute care patient room require the space to be flexible, convertible, expandable and, most importantly, hospitable. For many, many years the patient room was considered a shared space with multiple beds and multiple users. The term semi-private has been used to describe the traditional two-bed and, sometimes 4-bed patient room. This article will address the programmatic elements of an inpatient area, the room and its functional components along with some examples for comparative purposes. For the oncology patient, the development of a family-focused, private room is mandatory. The private room is more flexible, less expensive to operate, safer and environmentally more appealing for the patient, family and staff.

Computer based guidance in the modern operating room: a historical perspective.

PubMed

Bova, Frank

2010-01-01

The past few decades have seen the introduction of many different and innovative approaches aimed at enhancing surgical technique. As microprocessors have decreased in size and increased in processing power, more sophisticated systems have been developed. Some systems have attempted to provide enhanced instrument control while others have attempted to provide tools for surgical guidance. These systems include robotics, image enhancements, and frame-based and frameless guidance procedures. In almost every case the system's design goals were achieved and surgical outcomes were enhanced, yet a vast majority of today's surgical procedures are conducted without the aid of these advances. As new tools are developed and existing tools refined, special attention to the systems interface and integration into the operating room environment will be required before increased utilization of these technologies can be realized.

[Implementation of modern operating room management -- experiences made at an university hospital].

PubMed

Hensel, M; Wauer, H; Bloch, A; Volk, T; Kox, W J; Spies, C

2005-07-01

Caused by structural changes in health care the general need for cost control is evident for all hospitals. As operating room is one of the most cost-intensive sectors in a hospital, optimisation of workflow processes in this area is of particular interest for health care providers. While modern operating room management is established in several clinics yet, others are less prepared for economic challenges. Therefore, the operating room statute of the Charité university hospital useful for other hospitals to develop an own concept is presented. In addition, experiences made with implementation of new management structures are described and results obtained over the last 5 years are reported. Whereas the total number of operation procedures increased by 15 %, the operating room utilization increased more markedly in terms of time and cases. Summarizing the results, central operating room management has been proved to be an effective tool to increase the efficiency of workflow processes in the operating room.

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.

Distributed optical fibre temperature measurements in a low dose rate radiation environment based on Rayleigh backscattering

NASA Astrophysics Data System (ADS)

Faustov, A.; Gussarov, A.; Wuilpart, M.; Fotiadi, A. A.; Liokumovich, L. B.; Kotov, O. I.; Zolotovskiy, I. O.; Tomashuk, A. L.; Deschoutheete, T.; Mégret, P.

2012-04-01

On-line monitoring of environmental conditions in nuclear facilities is becoming a more and more important problem. Standard electronic sensors are not the ideal solution due to radiation sensitivity and difficulties in installation of multiple sensors. In contrast, radiation-hard optical fibres can sustain very high radiation doses and also naturally offer multi-point or distributed monitoring of external perturbations. Multiple local electro-mechanical sensors can be replaced by just one measuring fibre. At present, there are over four hundred operational nuclear power plants (NPPs) in the world 1. Operating experience has shown that ineffective control of the ageing degradation of major NPP components can threaten plant safety and also plant life. Among those elements, cables are vital components of I&C systems in NPPs. To ensure their safe operation and predict remaining life, environmental monitoring is necessary. In particular, temperature and radiation dose are considered to be the two most important parameters. The aim of this paper is to assess experimentally the feasibility of optical fibre temperature measurements in a low doserate radiation environment, using a commercially available reflectometer based on Rayleigh backscattering. Four different fibres were installed in the Sub-Pile Room of the BR2 Material testing nuclear reactor in Mol, Belgium. This place is man-accessible during the reactor shut-down, allowing easy fibre installation. When the reactor operates, the dose-rates in the room are in a range 0.005-5 Gy/h with temperatures of 40-60 °C, depending on the location. Such a surrounding is not much different to some "hot" environments in NPPs, where I&C cables are located.

PT-SAFE: a software tool for development and annunciation of medical audible alarms.

PubMed

Bennett, Christopher L; McNeer, Richard R

2012-03-01

Recent reports by The Joint Commission as well as the Anesthesia Patient Safety Foundation have indicated that medical audible alarm effectiveness needs to be improved. Several recent studies have explored various approaches to improving the audible alarms, motivating the authors to develop real-time software capable of comparing such alarms. We sought to devise software that would allow for the development of a variety of audible alarm designs that could also integrate into existing operating room equipment configurations. The software is meant to be used as a tool for alarm researchers to quickly evaluate novel alarm designs. A software tool was developed for the purpose of creating and annunciating audible alarms. The alarms consisted of annunciators that were mapped to vital sign data received from a patient monitor. An object-oriented approach to software design was used to create a tool that is flexible and modular at run-time, can annunciate wave-files from disk, and can be programmed with MATLAB by the user to create custom alarm algorithms. The software was tested in a simulated operating room to measure technical performance and to validate the time-to-annunciation against existing equipment alarms. The software tool showed efficacy in a simulated operating room environment by providing alarm annunciation in response to physiologic and ventilator signals generated by a human patient simulator, on average 6.2 seconds faster than existing equipment alarms. Performance analysis showed that the software was capable of supporting up to 15 audible alarms on a mid-grade laptop computer before audio dropouts occurred. These results suggest that this software tool provides a foundation for rapidly staging multiple audible alarm sets from the laboratory to a simulation environment for the purpose of evaluating novel alarm designs, thus producing valuable findings for medical audible alarm standardization.

Time Management in the Operating Room: An Analysis of the Dedicated Minimally Invasive Surgery Suite

PubMed Central

Hsiao, Kenneth C.; Machaidze, Zurab

2004-01-01

Background: Dedicated minimally invasive surgery suites are available that contain specialized equipment to facilitate endoscopic surgery. Laparoscopy performed in a general operating room is hampered by the multitude of additional equipment that must be transported into the room. The objective of this study was to compare the preparation times between procedures performed in traditional operating rooms versus dedicated minimally invasive surgery suites to see whether operating room efficiency is improved in the specialized room. Methods: The records of 50 patients who underwent laparoscopic procedures between September 2000 and April 2002 were retrospectively reviewed. Twenty-three patients underwent surgery in a general operating room and 18 patients in an minimally invasive surgery suite. Nine patients were excluded because of cystoscopic procedures undergone prior to laparoscopy. Various time points were recorded from which various time intervals were derived, such as preanesthesia time, anesthesia induction time, and total preparation time. A 2-tailed, unpaired Student t test was used for statistical analysis. Results: The mean preanesthesia time was significantly faster in the minimally invasive surgery suite (12.2 minutes) compared with that in the traditional operating room (17.8 minutes) (P=0.013). Mean anesthesia induction time in the minimally invasive surgery suite (47.5 minutes) was similar to time in the traditional operating room (45.7 minutes) (P=0.734). The average total preparation time for the minimally invasive surgery suite (59.6 minutes) was not significantly faster than that in the general operating room (63.5 minutes) (P=0.481). Conclusion: The amount of time that elapses between the patient entering the room and anesthesia induction is statically shorter in a dedicated minimally invasive surgery suite. Laparoscopic surgery is performed more efficiently in a dedicated minimally invasive surgery suite versus a traditional operating room. PMID:15554269

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

Attitudes to teamwork and safety among Italian surgeons and operating room nurses.

PubMed

Prati, Gabriele; Pietrantoni, Luca

2014-01-01

Previous studies have shown that surgical team members' attitudes about safety and teamwork in the operating theatre may play a role in patient safety. The aim of this study was to assess attitudes about teamwork and safety among Italian surgeons and operating room nurses. Fifty-five surgeons and 48 operating room nurses working in operating theatres at one hospital in Italy completed the Operating Room Management Attitudes Questionnaire (ORMAQ). Results showed several discrepancies in attitudes about teamwork and safety between surgeons and operating room nurses. Surgeons had more positive views on the quality of surgical leadership, communication, teamwork, and organizational climate in the theatre than operating room nurses. Operating room nurses reported that safety rules and procedures were more frequently disregarded than the surgeons. The results are only partially aligned with previous ORMAQ surveys of surgical teams in other countries. The differences emphasize the influence of national culture, as well as the particular healthcare system. This study shows discrepancies on many aspects in attitudes to teamwork and safety between surgeons and operating room nurses. The findings support implementation and use of team interventions and human factor training. Finally, attitude surveys provide a method for assessing safety culture in surgery, for evaluating the effectiveness of training initiatives, and for collecting data for a hospital's quality assurance programme.

Molecular Functionalization of Graphene Oxide for Next-Generation Wearable Electronics.

PubMed

Zarrin, Hadis; Sy, Serubbabel; Fu, Jing; Jiang, Gaopeng; Kang, Keunwoo; Jun, Yun-Seok; Yu, Aiping; Fowler, Michael; Chen, Zhongwei

2016-09-28

Acquiring reliable and efficient wearable electronics requires the development of flexible electrolyte membranes (EMs) for energy storage systems with high performance and minimum dependency on the operating conditions. Herein, a freestanding graphene oxide (GO) EM is functionalized with 1-hexyl-3-methylimidazolium chloride (HMIM) molecules via both covalent and noncovalent bonds induced by esterification reactions and electrostatic πcation-π stacking, respectively. Compared to the commercial polymeric membrane, the thin HMIM/GO membrane demonstrates not only slightest performance sensitivity to the operating conditions but also a superior hydroxide conductivity of 0.064 ± 0.0021 S cm(-1) at 30% RH and room temperature, which was 3.8 times higher than that of the commercial membrane at the same conditions. To study the practical application of the HMIM/GO membranes in wearable electronics, a fully solid-state, thin, flexible zinc-air battery and supercapacitor are made exhibiting high battery performance and capacitance at low humidified and room temperature environment, respectively, favored by the bonded HMIM molecules on the surface of GO nanosheets. The results of this study disclose the strong potential of manipulating the chemical structure of GO to work as a lightweight membrane in wearable energy storage devices, possessing highly stable performance at different operating conditions, especially at low relative humidity and room temperature.

Computational intelligence for target assessment in Parkinson's disease

NASA Astrophysics Data System (ADS)

Micheli-Tzanakou, Evangelia; Hamilton, J. L.; Zheng, J.; Lehman, Richard M.

2001-11-01

Recent advances in image and signal processing have created a new challenging environment for biomedical engineers. Methods that were developed for different fields are now finding a fertile ground in biomedicine, especially in the analysis of bio-signals and in the understanding of images. More and more, these methods are used in the operating room, helping surgeons, and in the physician's office as aids for diagnostic purposes. Neural Network (NN) research on the other hand, has gone a long way in the past decade. NNs now consist of many thousands of highly interconnected processing elements that can encode, store and recall relationships between different patterns by altering the weighting coefficients of inputs in a systematic way. Although they can generate reasonable outputs from unknown input patterns, and can tolerate a great deal of noise, they are very slow when run on a serial machine. We have used advanced signal processing and innovative image processing methods that are used along with computational intelligence for diagnostic purposes and as visualization aids inside and outside the operating room. Applications to be discussed include EEGs and field potentials in Parkinson's disease along with 3D reconstruction of MR or fMR brain images in Parkinson's patients, are currently used in the operating room for Pallidotomies and Deep Brain Stimulation (DBS).

Improved scores for observed teamwork in the clinical environment following a multidisciplinary operating room simulation intervention.

PubMed

Weller, Jennifer M; Cumin, David; Civil, Ian D; Torrie, Jane; Garden, Alexander; MacCormick, Andrew D; Gurusinghe, Nishanthi; Boyd, Matthew J; Frampton, Christopher; Cokorilo, Martina; Tranvik, Magnus; Carlsson, Lisa; Lee, Tracey; Ng, Wai Leap; Crossan, Michael; Merry, Alan F

2016-08-05

We ran a Multidisciplinary Operating Room Simulation (MORSim) course for 20 complete general surgical teams from two large metropolitan hospitals. Our goal was to improve teamwork and communication in the operating room (OR). We hypothesised that scores for teamwork and communication in the OR would improve back in the workplace following MORSim. We used an extended Behavioural Marker Risk Index (BMRI) to measure teamwork and communication, because a relationship has previously been documented between BMRI scores and surgical patient outcomes. Trained observers scored general surgical teams in the OR at the two study hospitals before and after MORSim, using the BMRI. Analysis of BMRI scores for the 224 general surgical cases before and 213 cases after MORSim showed BMRI scores improved by more than 20% (0.41 v 0.32, p<0.001). Previous research suggests that this improved teamwork score would translate into a clinically important reduction in complications and mortality in surgical patients. We demonstrated an improvement in scores for teamwork and communication in general surgical ORs following our intervention. These results support the use of simulation-based multidisciplinary team training for OR staff to promote better teamwork and communication, and potentially improve outcomes for general surgical patients.

Conflicts in operating room: Focus on causes and resolution

PubMed Central

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

2015-01-01

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

An assessment of the quality indicators of operative and non-operative times in a public university hospital.

PubMed

Costa, Altair da Silva; Leão, Luiz Eduardo Villaça; Novais, Maykon Anderson Pires de; Zucchi, Paola

2015-01-01

To assess the operative time indicators in a public university hospital. A descriptive cross-sectional study was conducted using data from operating room database. The sample was obtained from January 2011 to January 2012. The operations performed in sequence in the same operating room, between 7:00 am and 5:00 pm, elective or emergency, were included. The procedures with incomplete data in the system were excluded, as well as the operations performed after 5:00 pm or on weekends or holidays. We measured the operative and non-operative time of 8,420 operations. The operative time (mean and standard deviation) of anesthesias and operations were 177.6 ± 110 and 129.8 ± 97.1 minutes, respectively. The total time of the patient in operative room (mean and standard deviation) was 196.8 ± 113.2. The non-operative time, e.g., between the arrival of the patient and the onset of anesthesia was 14.3 ± 17.3 minutes. The time to set the next patient in operating room was 119.8 ± 79.6 minutes. Our total non-operative time was 155 minutes. Delays frequently occurred in our operating room and had a major effect on patient flow and resource utilization. The non-operative time was longer than the operative time. It is possible to increase the operating room capacity by management and training of the professionals involved. The indicators provided a tool to improve operating room efficiency.

Applying a Wearable Voice-Activated Computer to Instructional Applications in Clean Room Environments

NASA Technical Reports Server (NTRS)

Graves, Corey A.; Lupisella, Mark L.

2004-01-01

The use of wearable computing technology in restrictive environments related to space applications offers promise in a number of domains. The clean room environment is one such domain in which hands-free, heads-up, wearable computing is particularly attractive for education and training because of the nature of clean room work We have developed and tested a Wearable Voice-Activated Computing (WEVAC) system based on clean room applications. Results of this initial proof-of-concept work indicate that there is a strong potential for WEVAC to enhance clean room activities.

Research status and evaluation system of heat source evaluation method for central heating

NASA Astrophysics Data System (ADS)

Sun, Yutong; Qi, Junfeng; Cao, Yi

2018-02-01

The central heating boiler room is a regional heat source heating center. It is also a kind of the urban environment pollution, it is an important section of building energy efficiency. This article through to the evaluation method of central heating boiler room and overviews of the researches during domestic and overseas, summarized the main influence factors affecting energy consumption of industrial boiler under the condition of stable operation. According to the principle of establishing evaluation index system. We can find that is great significance in energy saving and environmental protection for the content of the evaluation index system of the centralized heating system.

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

PubMed

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

2005-01-01

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

Operating room scheduling using hybrid clustering priority rule and genetic algorithm

NASA Astrophysics Data System (ADS)

Santoso, Linda Wahyuni; Sinawan, Aisyah Ashrinawati; Wijaya, Andi Rahadiyan; Sudiarso, Andi; Masruroh, Nur Aini; Herliansyah, Muhammad Kusumawan

2017-11-01

Operating room is a bottleneck resource in most hospitals so that operating room scheduling system will influence the whole performance of the hospitals. This research develops a mathematical model of operating room scheduling for elective patients which considers patient priority with limit number of surgeons, operating rooms, and nurse team. Clustering analysis was conducted to the data of surgery durations using hierarchical and non-hierarchical methods. The priority rule of each resulting cluster was determined using Shortest Processing Time method. Genetic Algorithm was used to generate daily operating room schedule which resulted in the lowest values of patient waiting time and nurse overtime. The computational results show that this proposed model reduced patient waiting time by approximately 32.22% and nurse overtime by approximately 32.74% when compared to actual schedule.

Alpha-ray spectrometry at high temperature by using a compound semiconductor detector.

PubMed

Ha, Jang Ho; Kim, Han Soo

2013-11-01

The use of conventional radiation detectors in harsh environments is limited by radiation damage to detector materials and by temperature constraints. We fabricated a wide-band gap semiconductor radiation detector based on silicon carbide. All the detector components were considered for an application in a high temperature environment like a nuclear reactor core. The radiation response, especially to alpha particles, was measured using an (241)Am source at variable operating voltages at room temperature in the air. The temperature on detector was controlled from 30°C to 250°C. The alpha-particle spectra were measured at zero bias operation. Even though the detector is operated at high temperature, the energy resolution as a function of temperature is almost constant within 3.5% deviation. Copyright © 2013 Elsevier Ltd. All rights reserved.

9 CFR 590.508 - Candling and transfer-room operations.

Code of Federal Regulations, 2011 CFR

2011-01-01

..., 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 excess... 9 Animals and Animal Products 2 2011-01-01 2011-01-01 false Candling and transfer-room operations...

9 CFR 590.508 - Candling and transfer-room operations.

Code of Federal Regulations, 2013 CFR

2013-01-01

..., 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 excess... 9 Animals and Animal Products 2 2013-01-01 2013-01-01 false Candling and transfer-room operations...

9 CFR 590.508 - Candling and transfer-room operations.

Code of Federal Regulations, 2010 CFR

2010-01-01

..., 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 excess... 9 Animals and Animal Products 2 2010-01-01 2010-01-01 false Candling and transfer-room operations...

9 CFR 590.508 - Candling and transfer-room operations.

Code of Federal Regulations, 2014 CFR

2014-01-01

..., 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 excess... 9 Animals and Animal Products 2 2014-01-01 2014-01-01 false Candling and transfer-room operations...

9 CFR 590.508 - Candling and transfer-room operations.

Code of Federal Regulations, 2012 CFR

2012-01-01

..., 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 excess... 9 Animals and Animal Products 2 2012-01-01 2012-01-01 false Candling and transfer-room operations...

Medical robotics: the impact on perioperative nursing practice.

PubMed

Francis, Paula; Winfield, Howard N

2006-04-01

Robotic technology and the increased use of minimally invasive surgery approaches is altering the environment in which operating room personnel work and affecting how nurses must care for patients. An understanding of the history of robotics, current applications of the technology, and perioperative nursing responsibilities is needed to assure quality patient care in the wake of continued advances in technology.

Analysis of C3 Counterinsurgency-Inspired Policing and the Flip Side of the Coin

DTIC Science & Technology

2014-12-01

Massachusetts, Massachusetts 15. NUMBER OF State Police, ten·orist, C3, Counter Criminal Continmuu, tmancy, delinquency , crime, graffiti, litter, PAGES...47 b. Delinquency in Schools by North End Students ....................52 c. After School Programs...Compliant Statistics CORE Common Operational Research Environment DOJ Department of Justice ER emergency room FBI Federal Bureau of Investigation

Workplace culture among operating room nurses.

PubMed

Eskola, Suvi; Roos, Mervi; McCormack, Brendan; Slater, Paul; Hahtela, Nina; Suominen, Tarja

2016-09-01

To investigate the workplace culture in the Operating Room (OR) environment and the factors associated with it. In health care, the workplace culture affects the delivery and experience of care. The OR can be a stressful practice environment, where nurses might have occasionally either job stress or job satisfaction based on their competence. A quantitative cross-sectional approach was used. The study consisted of 96 Finnish OR nurses. A Nursing Context Index instrument was used to obtain data by way of an electronic questionnaire. The primary role and working unit of respondents were the main components relating to workplace culture, and especially to job stress. Nurse anaesthetists were found to be slightly more stressed than scrub nurses. In local hospitals, job stress related to workload was perceived less than in university hospitals (P = 0.001). In addition, OR nurses in local hospitals were more satisfied with their profession (P = 0.007), particularly around issues concerning adequate staffing and resources (P = 0.001). It is essential that nurse managers learn to recognise the different expressions of workplace culture. In particular, this study raises a need to recognise the factors that cause job stress to nurse anaesthetists. © 2016 John Wiley & Sons Ltd.

Allocation of surgical procedures to operating rooms.

PubMed

Ozkarahan, I

1995-08-01

Reduction of health care costs is of paramount importance in our time. This paper is a part of the research which proposes an expert hospital decision support system for resource scheduling. The proposed system combines mathematical programming, knowledge base, and database technologies, and what is more, its friendly interface is suitable for any novice user. Operating rooms in hospitals represent big investments and must be utilized efficiently. In this paper, first a mathematical model similar to job shop scheduling models is developed. The model loads surgical cases to operating rooms by maximizing room utilization and minimizing overtime in a multiple operating room setting. Then a prototype expert system which replaces the expertise of the operations research analyst for the model, drives the modelbase, database, and manages the user dialog is developed. Finally, an overview of the sequencing procedures for operations within an operating room is also presented.

[Operating Room Nurses' Experiences of Securing for Patient Safety].

PubMed

Park, Kwang Ok; Kim, Jong Kyung; Kim, Myoung Sook

2015-10-01

This study was done to evaluate the experience of securing patient safety in hospital operating rooms. Experiential data were collected from 15 operating room nurses through in-depth interviews. The main question was "Could you describe your experience with patient safety in the operating room?". Qualitative data from the field and transcribed notes were analyzed using Strauss and Corbin's grounded theory methodology. The core category of experience with patient safety in the operating room was 'trying to maintain principles of patient safety during high-risk surgical procedures'. The participants used two interactional strategies: 'attempt continuous improvement', 'immersion in operation with sharing issues of patient safety'. The results indicate that the important factors for ensuring the safety of patients in the operating room are manpower, education, and a system for patient safety. Successful and safe surgery requires communication, teamwork and recognition of the importance of patient safety by the surgical team.

Intraoperative radiation therapy using mobile electron linear accelerators: report of AAPM Radiation Therapy Committee Task Group No. 72.

PubMed

Beddar, A Sam; Biggs, Peter J; Chang, Sha; Ezzell, Gary A; Faddegon, Bruce A; Hensley, Frank W; Mills, Michael D

2006-05-01

Intraoperative radiation therapy (IORT) has been customarily performed either in a shielded operating suite located in the operating room (OR) or in a shielded treatment room located within the Department of Radiation Oncology. In both cases, this cancer treatment modality uses stationary linear accelerators. With the development of new technology, mobile linear accelerators have recently become available for IORT. Mobility offers flexibility in treatment location and is leading to a renewed interest in IORT. These mobile accelerator units, which can be transported any day of use to almost any location within a hospital setting, are assembled in a nondedicated environment and used to deliver IORT. Numerous aspects of the design of these new units differ from that of conventional linear accelerators. The scope of this Task Group (TG-72) will focus on items that particularly apply to mobile IORT electron systems. More specifically, the charges to this Task Group are to (i) identify the key differences between stationary and mobile electron linear accelerators used for IORT, (ii) describe and recommend the implementation of an IORT program within the OR environment, (iii) present and discuss radiation protection issues and consequences of working within a nondedicated radiotherapy environment, (iv) describe and recommend the acceptance and machine commissioning of items that are specific to mobile electron linear accelerators, and (v) design and recommend an efficient quality assurance program for mobile systems.

An assessment of the quality indicators of operative and non-operative times in a public university hospital

PubMed Central

Costa, Altair da Silva; Leão, Luiz Eduardo Villaça; de Novais, Maykon Anderson Pires; Zucchi, Paola

2015-01-01

ABSTRACT Objective To assess the operative time indicators in a public university hospital. Methods A descriptive cross-sectional study was conducted using data from operating room database. The sample was obtained from January 2011 to January 2012. The operations performed in sequence in the same operating room, between 7:00 am and 5:00 pm, elective or emergency, were included. The procedures with incomplete data in the system were excluded, as well as the operations performed after 5:00 pm or on weekends or holidays. Results We measured the operative and non-operative time of 8,420 operations. The operative time (mean and standard deviation) of anesthesias and operations were 177.6±110 and 129.8±97.1 minutes, respectively. The total time of the patient in operative room (mean and standard deviation) was 196.8±113.2. The non-operative time, e.g., between the arrival of the patient and the onset of anesthesia was 14.3±17.3 minutes. The time to set the next patient in operating room was 119.8±79.6 minutes. Our total non-operative time was 155 minutes. Conclusion Delays frequently occurred in our operating room and had a major effect on patient flow and resource utilization. The non-operative time was longer than the operative time. It is possible to increase the operating room capacity by management and training of the professionals involved. The indicators provided a tool to improve operating room efficiency. PMID:26761557

Mixed Reality with HoloLens: Where Virtual Reality Meets Augmented Reality in the Operating Room.

PubMed

Tepper, Oren M; Rudy, Hayeem L; Lefkowitz, Aaron; Weimer, Katie A; Marks, Shelby M; Stern, Carrie S; Garfein, Evan S

2017-11-01

Virtual reality and augmented reality devices have recently been described in the surgical literature. The authors have previously explored various iterations of these devices, and although they show promise, it has become clear that virtual reality and/or augmented reality devices alone do not adequately meet the demands of surgeons. The solution may lie in a hybrid technology known as mixed reality, which merges many virtual reality and augmented realty features. Microsoft's HoloLens, the first commercially available mixed reality device, provides surgeons intraoperative hands-free access to complex data, the real environment, and bidirectional communication. This report describes the use of HoloLens in the operating room to improve decision-making and surgical workflow. The pace of mixed reality-related technological development will undoubtedly be rapid in the coming years, and plastic surgeons are ideally suited to both lead and benefit from this advance.

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.

Titanium alloy 5111 brings intermediate strength, excellent toughness, and corrosion resistance to naval operating environments

DOE Office of Scientific and Technical Information (OSTI.GOV)

Been, J.

1999-07-01

Ti-5Al-1Sn-1Zr-1V-O.8M0 is a near alpha titanium alloy of intermediate strength, designed for high toughness, good weldability, stress-corrosion cracking resistance, and room temperature creep resistance. Ideally suited for marine environments, Ti 5111 offers the means to aid the navy in fulfilling their goals of reducing maintenance and life cycle costs, reducing topside and overall weight, improve survivability and increase reliability. The alloy was recently included in the ASTM bar and plate specifications as ASTM Grade 32.

40 CFR 1601.12 - Public reading room.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 34 2013-07-01 2013-07-01 false Public reading room. 1601.12 Section 1601.12 Protection of Environment CHEMICAL SAFETY AND HAZARD INVESTIGATION BOARD PROCEDURES FOR DISCLOSURE OF RECORDS UNDER THE FREEDOM OF INFORMATION ACT Administration § 1601.12 Public reading room. (a) The CSB maintains a public reading room that...

40 CFR 1601.12 - Public reading room.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 33 2011-07-01 2011-07-01 false Public reading room. 1601.12 Section 1601.12 Protection of Environment CHEMICAL SAFETY AND HAZARD INVESTIGATION BOARD PROCEDURES FOR DISCLOSURE OF RECORDS UNDER THE FREEDOM OF INFORMATION ACT Administration § 1601.12 Public reading room. (a) The CSB maintains a public reading room that...

40 CFR 1601.12 - Public reading room.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 32 2010-07-01 2010-07-01 false Public reading room. 1601.12 Section 1601.12 Protection of Environment CHEMICAL SAFETY AND HAZARD INVESTIGATION BOARD PROCEDURES FOR DISCLOSURE OF RECORDS UNDER THE FREEDOM OF INFORMATION ACT Administration § 1601.12 Public reading room. (a) The CSB maintains a public reading room that...

40 CFR 1601.12 - Public reading room.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 33 2014-07-01 2014-07-01 false Public reading room. 1601.12 Section 1601.12 Protection of Environment CHEMICAL SAFETY AND HAZARD INVESTIGATION BOARD PROCEDURES FOR DISCLOSURE OF RECORDS UNDER THE FREEDOM OF INFORMATION ACT Administration § 1601.12 Public reading room. (a) The CSB maintains a public reading room that...

40 CFR 1601.12 - Public reading room.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 34 2012-07-01 2012-07-01 false Public reading room. 1601.12 Section 1601.12 Protection of Environment CHEMICAL SAFETY AND HAZARD INVESTIGATION BOARD PROCEDURES FOR DISCLOSURE OF RECORDS UNDER THE FREEDOM OF INFORMATION ACT Administration § 1601.12 Public reading room. (a) The CSB maintains a public reading room that...

Perceptions, training experiences, and preferences of surgical residents toward laparoscopic simulation training: a resident survey.

PubMed

Shetty, Shohan; Zevin, Boris; Grantcharov, Teodor P; Roberts, Kurt E; Duffy, Andrew J

2014-01-01

Simulation training for surgical residents can shorten learning curves, improve technical skills, and expedite competency. Several studies have shown that skills learned in the simulated environment are transferable to the operating room. Residency programs are trying to incorporate simulation into the resident training curriculum to supplement the hands-on experience gained in the operating room. Despite the availability and proven utility of surgical simulators and simulation laboratories, they are still widely underutilized by surgical trainees. Studies have shown that voluntary use leads to minimal participation in a training curriculum. Although there are several simulation tools, there is no clear evidence of the superiority of one tool over the other in skill acquisition. The purpose of this study was to explore resident perceptions, training experiences, and preferences regarding laparoscopic simulation training. Our goal was to profile resident participation in surgical skills simulation, recognize potential barriers to voluntary simulator use, and identify simulation tools and tasks preferred by residents. Furthermore, this study may help to inform whether mandatory/protected training time, as part of the residents' curriculum is essential to enhance participation in the simulation laboratory. A cross-sectional study on general surgery residents (postgraduate years 1-5) at Yale University School of Medicine and the University of Toronto via an online questionnaire was conducted. Overall, 67 residents completed the survey. The institutional review board approved the methods of the study. Overall, 95.5% of the participants believed that simulation training improved their laparoscopic skills. Most respondents (92.5%) perceived that skills learned during simulation training were transferrable to the operating room. Overall, 56.7% of participants agreed that proficiency in a simulation curriculum should be mandatory before operating room experience. The simulation laboratory was most commonly used during work hours; lack of free time during work hours was most commonly cited as a reason for underutilization. Factors influencing use of the simulation laboratory in order of importance were the need for skill development, an interest in minimally invasive surgery, mandatory/protected time in a simulation environment as part of the residency program curriculum, a recommendation by an attending surgeon, and proximity of the simulation center. The most preferred simulation tool was the live animal model followed by cadaveric tissue. Virtual reality simulators were among the least-preferred (25%) simulation tools. Most residents (91.0%) felt that mandatory/protected time in a simulation environment should be introduced into resident training protocols. Mandatory and protected time in a simulation environment as part of the resident training curriculum may improve participation in simulation training. A comprehensive curriculum, which includes the use of live animals, cadaveric tissue, and virtual reality simulators, may enhance the laparoscopic training experience and interest level of surgical trainees. Copyright © 2014 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Porting and refurbishment of the WSS TNG control software

NASA Astrophysics Data System (ADS)

Caproni, Alessandro; Zacchei, Andrea; Vuerli, Claudio; Pucillo, Mauro

2004-09-01

The Workstation Software Sytem (WSS) is the high level control software of the Italian Galileo Galilei Telescope settled in La Palma Canary Island developed at the beginning of '90 for HP-UX workstations. WSS may be seen as a middle layer software system that manages the communications between the real time systems (VME), different workstations and high level applications providing a uniform distributed environment. The project to port the control software from the HP workstation to Linux environment started at the end of 2001. It is aimed to refurbish the control software introducing some of the new software technologies and languages, available for free in the Linux operating system. The project was realized by gradually substituting each HP workstation with a Linux PC with the goal to avoid main changes in the original software running under HP-UX. Three main phases characterized the project: creation of a simulated control room with several Linux PCs running WSS (to check all the functionality); insertion in the simulated control room of some HPs (to check the mixed environment); substitution of HP workstation in the real control room. From a software point of view, the project introduces some new technologies, like multi-threading, and the possibility to develop high level WSS applications with almost every programming language that implements the Berkley sockets. A library to develop java applications has also been created and tested.

Active listening room compensation for massive multichannel sound reproduction systems using wave-domain adaptive filtering.

PubMed

Spors, Sascha; Buchner, Herbert; Rabenstein, Rudolf; Herbordt, Wolfgang

2007-07-01

The acoustic theory for multichannel sound reproduction systems usually assumes free-field conditions for the listening environment. However, their performance in real-world listening environments may be impaired by reflections at the walls. This impairment can be reduced by suitable compensation measures. For systems with many channels, active compensation is an option, since the compensating waves can be created by the reproduction loudspeakers. Due to the time-varying nature of room acoustics, the compensation signals have to be determined by an adaptive system. The problems associated with the successful operation of multichannel adaptive systems are addressed in this contribution. First, a method for decoupling the adaptation problem is introduced. It is based on a generalized singular value decomposition and is called eigenspace adaptive filtering. Unfortunately, it cannot be implemented in its pure form, since the continuous adaptation of the generalized singular value decomposition matrices to the variable room acoustics is numerically very demanding. However, a combination of this mathematical technique with the physical description of wave propagation yields a realizable multichannel adaptation method with good decoupling properties. It is called wave domain adaptive filtering and is discussed here in the context of wave field synthesis.

Editorial: Challenges for the usability of AR and VR for clinical neurosurgical procedures.

PubMed

de Ribaupierre, Sandrine; Eagleson, Roy

2017-10-01

There are a number of challenges that must be faced when trying to develop AR and VR-based Neurosurgical simulators, Surgical Navigation Platforms, and "Smart OR" systems. Trying to simulate an operating room environment and surgical tasks in Augmented and Virtual Reality is a challenge many are attempting to solve, in order to train surgeons or help them operate. What are some of the needs of the surgeon, and what are the challenges encountered (human computer interface, perception, workflow, etc). We discuss these tradeoffs and conclude with critical remarks.

Virtual and augmented medical imaging environments: enabling technology for minimally invasive cardiac interventional guidance.

PubMed

Linte, Cristian A; White, James; Eagleson, Roy; Guiraudon, Gérard M; Peters, Terry M

2010-01-01

Virtual and augmented reality environments have been adopted in medicine as a means to enhance the clinician's view of the anatomy and facilitate the performance of minimally invasive procedures. Their value is truly appreciated during interventions where the surgeon cannot directly visualize the targets to be treated, such as during cardiac procedures performed on the beating heart. These environments must accurately represent the real surgical field and require seamless integration of pre- and intra-operative imaging, surgical tracking, and visualization technology in a common framework centered around the patient. This review begins with an overview of minimally invasive cardiac interventions, describes the architecture of a typical surgical guidance platform including imaging, tracking, registration and visualization, highlights both clinical and engineering accuracy limitations in cardiac image guidance, and discusses the translation of the work from the laboratory into the operating room together with typically encountered challenges.

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

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

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

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

Switching the JLab Accelerator Operations Environment from an HP-UX Unix-based to a PC/Linux-based environment

DOE Office of Scientific and Technical Information (OSTI.GOV)

Mcguckin, Theodore

2008-10-01

The Jefferson Lab Accelerator Controls Environment (ACE) was predominantly based on the HP-UX Unix platform from 1987 through the summer of 2004. During this period the Accelerator Machine Control Center (MCC) underwent a major renovation which included introducing Redhat Enterprise Linux machines, first as specialized process servers and then gradually as general login servers. As computer programs and scripts required to run the accelerator were modified, and inherent problems with the HP-UX platform compounded, more development tools became available for use with Linux and the MCC began to be converted over. In May 2008 the last HP-UX Unix login machinemore » was removed from the MCC, leaving only a few Unix-based remote-login servers still available. This presentation will explore the process of converting an operational Control Room environment from the HP-UX to Linux platform as well as the many hurdles that had to be overcome throughout the transition period (including a discussion of« less

Technical Assessment: Autonomy

DTIC Science & Technology

2015-02-01

and video games . If DoD develops CONOPS for lower- performance systems, there is an opportunity to leverage a large amount of private investment, as the...originally designed for the Xbox video game platform, it is now being used or developed for retail environments, operating rooms, and physical therapy...approaches that render artificial intelligence less susceptible to intelligent influence. One area worthy of consideration is applied game theory, which

Air Quality Monitoring of the Post-Operative Recovery Room and Locations Surrounding Operating Theaters in a Medical Center in Taiwan

PubMed Central

Tang, Chin-Sheng; Wan, Gwo-Hwa

2013-01-01

To prevent surgical site infection (SSI), the airborne microbial concentration in operating theaters must be reduced. The air quality in operating theaters and nearby areas is also important to healthcare workers. Therefore, this study assessed air quality in the post-operative recovery room, locations surrounding the operating theater area, and operating theaters in a medical center. Temperature, relative humidity (RH), and carbon dioxide (CO2), suspended particulate matter (PM), and bacterial concentrations were monitored weekly over one year. Measurement results reveal clear differences in air quality in different operating theater areas. The post-operative recovery room had significantly higher CO2 and bacterial concentrations than other locations. Bacillus spp., Micrococcus spp., and Staphylococcus spp. bacteria often existed in the operating theater area. Furthermore, Acinetobacter spp. was the main pathogen in the post-operative recovery room (18%) and traumatic surgery room (8%). The mixed effect models reveal a strong correlation between number of people in a space and high CO2 concentration after adjusting for sampling locations. In conclusion, air quality in the post-operative recovery room and operating theaters warrants attention, and merits long-term surveillance to protect both surgical patients and healthcare workers. PMID:23573296

Governing time in operating rooms.

PubMed

Riley, Robin; Manias, Elizabeth

2006-05-01

This paper examines how time is controlled and governed in operating rooms through interpersonal communication between nurses and doctors. Time is a valuable commodity in organizations with improvements often directed towards maximizing efficiencies. As a consequence, time can be a source of tension and interpersonal conflict as individuals compete for control of its use. The data in this paper emanate from an ethnographic study that explored a range of communication practices in operating room nursing. Participants comprised 11 operating room nurses. Data were collected over two years in three different institutional settings and involved participant observation, interviews and the keeping of a personal diary. A deconstructive analysis of the data was undertaken. Results are discussed in terms of the practices, in which clinicians are engaged in, to govern and control their use of time. The four practices presented in this paper include; questioning judgment and timing, controlling speed, estimating surgeons' use of time and coping with different perceptions of time. Time and speed were hotly contested by nurses. They used their personal knowledge of individual surgeon's habits of time to govern and control practice. Nurses thought about surgeons in terms of time and developed commonly accepted understandings about the length of surgical procedures. They used this knowledge to manage the scheduling of operations in the departments and to control the workflow in individual operating rooms. Knowledge of individual surgeons was a source of power for operating room nurses. Nurses have more power in the operating room than might be imagined but they exercise this power in subtle ways. If operating rooms are to work effectively, the operating room team must understand each others' work better.

Ventilating Air-Conditioner

NASA Technical Reports Server (NTRS)

Dinh, Khanh

1994-01-01

Air-conditioner provides ventilation designed to be used alone or incorporated into cooling or heating system operates efficiently only by recirculating stale air within building. Energy needed to operate overall ventilating cooling or heating system slightly greater than operating nonventilating cooling or heating system. Helps to preserve energy efficiency while satisfying need for increased forced ventilation to prevent accumulation of undesired gases like radon and formaldehyde. Provides fresh treated air to variety of confined spaces: hospital surgeries, laboratories, clean rooms, and printing shops and other places where solvents used. In mobile homes and portable classrooms, eliminates irritant chemicals exuded by carpets, panels, and other materials, ensuring healthy indoor environment for occupants.

Evaluation of a pulsed xenon ultraviolet disinfection system to decrease bacterial contamination in operating rooms.

PubMed

El Haddad, Lynn; Ghantoji, Shashank S; Stibich, Mark; Fleming, Jason B; Segal, Cindy; Ware, Kathy M; Chemaly, Roy F

2017-10-10

Environmental cleanliness is one of the contributing factors for surgical site infections in the operating rooms (ORs). To decrease environmental contamination, pulsed xenon ultraviolet (PX-UV), an easy and safe no-touch disinfection system, is employed in several hospital environments. The positive effect of this technology on environmental decontamination has been observed in patient rooms and ORs during the end-of-day cleaning but so far, no study explored its feasibility between surgical cases in the OR. In this study, 5 high-touch surfaces in 30 ORs were sampled after manual cleaning and after PX-UV intervention mimicking between-case cleaning to avoid the disruption of the ORs' normal flow. The efficacy of a 1-min, 2-min, and 8-min cycle were tested by measuring the surfaces' contaminants by quantitative cultures using Tryptic Soy Agar contact plates. We showed that combining standard between-case manual cleaning of surfaces with a 2-min cycle of disinfection using a portable xenon pulsed ultraviolet light germicidal device eliminated at least 70% more bacterial load after manual cleaning. This study showed the proof of efficacy of a 2-min cycle of PX-UV in ORs in eliminating bacterial contaminants. This method will allow a short time for room turnover and a potential reduction of pathogen transmission to patients and possibly surgical site infections.

Overview of an Indoor Sonic Boom Simulator at NASA Langley Research Center

NASA Technical Reports Server (NTRS)

Klos, Jacob

2012-01-01

A facility has been constructed at NASA Langley Research Center to simulate the soundscape inside residential houses that are exposed to environmental noise from aircraft. This controllable indoor listening environment, the Interior Effects Room, enables systematic study of parameters that affect psychoacoustic response. The single-room facility, built using typical residential construction methods and materials, is surrounded on adjacent sides by two arrays of loudspeakers in close proximity to the exterior walls. The arrays, containing 52 subwoofers and 52 mid-range speakers, have a usable bandwidth of 3 Hz to 5 kHz and sufficient output to allow study of sonic boom noise. In addition to these exterior arrays, satellite speakers placed inside the room are used to augment the transmitted sound with rattle and other audible contact ]induced noise that can result from low frequency excitation of a residential house. The layout of the facility, operational characteristics, acoustic characteristics and equalization approaches are summarized.

Experimental system, and its evaluation for the control of surgically inducted infections

NASA Technical Reports Server (NTRS)

Tevebaugh, M. D.; Nelson, J. P.

1972-01-01

The effect is reported to design, fabricate, test and evaluate a prototype experimental system for the control of surgically induced infections. The purpose is to provide the cleanest possible environment within a hospital surgery room and eliminate contamination sources that could cause infections during surgery. The system design is described. The system provides for a portable laminar flow clean room, a full bubble helmet system with associated communications and ventilation subsystems for operating room personnel, and surgical gowns that minimize the migration of bacteria. The development test results consisting of portability, laminar flowrate, air flow pattern, electrostatic buildup, noise level, ventilation, human factors, electrical and material compatibility tests are summarized. The conclusions are that the experimental system is effective in reducing the airborne and wound contamination although the helmets and gowns may not be a significant part of this reduction. Definitive conclusions with regard to the infection rate cannot be made at this time.

Healing Environments: What Design Factors Really Matter According to Patients? An Exploratory Analysis.

PubMed

Schreuder, Eliane; Lebesque, Layla; Bottenheft, Charelle

2016-10-01

The main aim of this research was to identify the impact of design characteristics (DCs) of a patient room on self-reported patient well-being. This knowledge enables the construction of healing environments focusing on DCs that maximize well-being. Six themes were identified in literature that create healing environments: spatial comfort, safety and security, autonomy, sensory comfort, privacy, and social comfort. We wondered what themes and associated DCs should be prioritized if needed to maximize well-being. The physical environment of patient rooms in four hospital locations was measured and patients who stayed in these rooms were asked to evaluate the room design on above mentioned themes and its contribution to their well-being. We used a machine-learning technique and regression analysis to find relations between the physical environment of a patient room and patient well-being. We found that spatial comfort, safety and security, autonomy, and associated DCs have the strongest ability to influence patient's self-reported well-being in a patient room. Privacy appears to have the smallest influence. © The Author(s) 2016.

Nickel release from surgical instruments and operating room equipment.

PubMed

Boyd, Anne H; Hylwa, Sara A

2018-04-15

Background There has been no systematic study assessing nickel release from surgical instruments and equipment used within the operating suite. This equipment represents important potential sources of exposure for nickel-sensitive patients and hospital staff. To investigate nickel release from commonly used surgical instruments and operating room equipment. Using the dimethylglyoxime nickel spot test, a variety of surgical instruments and operating room equipment were tested for nickel release at our institution. Of the 128 surgical instruments tested, only 1 was positive for nickel release. Of the 43 operating room items tested, 19 were positive for nickel release, 7 of which have the potential for direct contact with patients and/or hospital staff. Hospital systems should be aware of surgical instruments and operating room equipment as potential sources of nickel exposure.

Ergonomics in the operating room: protecting the surgeon.

PubMed

Rosenblatt, Peter L; McKinney, Jessica; Adams, Sonia R

2013-01-01

To review elements of an ergonomic operating room environment and describe common ergonomic errors in surgeon posture during laparoscopic and robotic surgery. Descriptive video based on clinical experience and a review of the literature (Canadian Task Force classification III). Community teaching hospital affiliated with a major teaching hospital. Gynecologic surgeons. Demonstration of surgical ergonomic principles and common errors in surgical ergonomics by a physical therapist and surgeon. The physical nature of surgery necessitates awareness of ergonomic principles. The literature has identified ergonomic awareness to be grossly lacking among practicing surgeons, and video has not been documented as a teaching tool for this population. Taking this into account, we created a video that demonstrates proper positioning of monitors and equipment, and incorrect and correct ergonomic positions during surgery. Also presented are 3 common ergonomic errors in surgeon posture: forward head position, improper shoulder elevation, and pelvic girdle asymmetry. Postural reset and motion strategies are demonstrated to help the surgeon learn techniques to counterbalance the sustained and awkward positions common during surgery that lead to muscle fatigue, pain, and degenerative changes. Correct ergonomics is a learned and practiced behavior. We believe that video is a useful way to facilitate improvement in ergonomic behaviors. We suggest that consideration of operating room setup, proper posture, and practice of postural resets are necessary components for a longer, healthier, and pain-free surgical career. Copyright © 2013 AAGL. Published by Elsevier Inc. All rights reserved.

Assessment of operative times of multiple surgical specialties in a public university hospital

PubMed Central

Costa, Altair da Silva

2017-01-01

ABSTRACT Objective To evaluate the indicators duration of anesthesia, operative time and time patients stay in the operating rooms of different surgical specialties at a public university hospital. Methods It was done by a descriptive cross-sectional study based on the operating room database. The following stages were measured: duration of anesthesia, procedure time and patient length of stay in the room of the various specialties. We included surgeries carried out in sequence in the same room, between 7:00 a.m. and 5 p.m., either elective or emergency. We calculated the 80th percentile of the stages, where 80% of procedures were below this value. Results The study measured 8,337 operations of 12 surgical specialties performed within one year. The overall mean duration of anesthesia of all specialties was 178.12±110.46 minutes, and the 80th percentile was 252 minutes. The mean operative time was 130.45±97.23 minutes, and the 80th percentile was 195 minutes. The mean total time of the patient in the operating room was 197.30±113.71 minutes, and the 80th percentile was 285 minutes. Thus, the variation of the overall mean compared to the 80th percentile was 41% for anesthesia, 49% for surgeries and 44% for operating room time. In average, anesthesia took up 88% of the operating room period, and surgery, 61%. Conclusion This study identified patterns in the duration of surgery stages. The mean values of the specialties can assist with operating room planning and reduce delays. PMID:28767919

The risk for syncope and presyncope during surgery in surgeons and nurses.

PubMed

Rudnicki, Jerzy; Zyśko, Dorota; Gajek, Jacek; Kuliczkowski, Wiktor; Rosińczuk-Tonderys, Joanna; Zielińska, Dominika; Terpiłowski, Łukasz; Agrawal, Anil Kumar

2011-11-01

Surgeons and nurses are exposed to orthostatic stress. To assess the lifetime incidence of syncopal and presyncopal events during surgery in operation room staff and reveal the predicting factors. The study included 317 subjects (161 F, 156 M) aged 43.9 ± 9.6; 216 surgeons and 101 instrumenters. The study included filling of an anonymous questionnaire on the syncope and presyncope history. At least one syncopal event during operation was reported by 4.7% and presyncope by 14.8% of the studied population. All but one subject reported prodromal symptoms before syncope. In the medical history, syncope outside the operating room was reported by 11% of the studied group. Syncope and presyncope during operation was related to syncope in the medical history outside the operation room, respectively: odds ratio (OR) 20.2 95% confidence interval (CI): 2.0-70.5 and OR 10.8; CI: 5.0-23.4 and to presyncope in the medical history, respectively: OR 23.5; CI: 7.4-74.4 OR 8.9; CI: 3.6-11.2 (P < 0.001). (1) Syncope and presyncope may occur during surgery in the staff of the operating room. (2) Syncope in the operating room is usually preceded by prodromal symptoms and has vasovagal origin. (3) Both lower then expected occurrence of syncope in the operating room staff and absence of any difference between genders in this regard indicate preselection in the process of choosing profession and specialization. (4) Syncope and presyncope outside the operating room in medical history increases the risk of syncope and presyncope inside the operation room.

High-quality remote interactive imaging in the operating theatre

NASA Astrophysics Data System (ADS)

Grimstead, Ian J.; Avis, Nick J.; Evans, Peter L.; Bocca, Alan

2009-02-01

We present a high-quality display system that enables the remote access within an operating theatre of high-end medical imaging and surgical planning software. Currently, surgeons often use printouts from such software for reference during surgery; our system enables surgeons to access and review patient data in a sterile environment, viewing real-time renderings of MRI & CT data as required. Once calibrated, our system displays shades of grey in Operating Room lighting conditions (removing any gamma correction artefacts). Our system does not require any expensive display hardware, is unobtrusive to the remote workstation and works with any application without requiring additional software licenses. To extend the native 256 levels of grey supported by a standard LCD monitor, we have used the concept of "PseudoGrey" where slightly off-white shades of grey are used to extend the intensity range from 256 to 1,785 shades of grey. Remote access is facilitated by a customized version of UltraVNC, which corrects remote shades of grey for display in the Operating Room. The system is successfully deployed at Morriston Hospital, Swansea, UK, and is in daily use during Maxillofacial surgery. More formal user trials and quantitative assessments are being planned for the future.

The Space Operations Simulation Center (SOSC) and Closed-loop Hardware Testing for Orion Rendezvous System Design

NASA Technical Reports Server (NTRS)

D'Souza, Christopher; Milenkovich, Zoran; Wilson, Zachary; Huich, David; Bendle, John; Kibler, Angela

2011-01-01

The Space Operations Simulation Center (SOSC) at the Lockheed Martin (LM) Waterton Campus in Littleton, Colorado is a dynamic test environment focused on Autonomous Rendezvous and Docking (AR&D) development testing and risk reduction activities. The SOSC supports multiple program pursuits and accommodates testing Guidance, Navigation, and Control (GN&C) algorithms for relative navigation, hardware testing and characterization, as well as software and test process development. The SOSC consists of a high bay (60 meters long by 15.2 meters wide by 15.2 meters tall) with dual six degree-of-freedom (6DOF) motion simulators and a single fixed base 6DOF robot. The large testing area (maximum sensor-to-target effective range of 60 meters) allows for large-scale, flight-like simulations of proximity maneuvers and docking events. The facility also has two apertures for access to external extended-range outdoor target test operations. In addition, the facility contains four Mission Operations Centers (MOCs) with connectivity to dual high bay control rooms and a data/video interface room. The high bay is rated at Class 300,000 (. 0.5 m maximum particles/m3) cleanliness and includes orbital lighting simulation capabilities.

Teaching the Surgical Craft: Surgery Residents Perception of the Operating Theater Educational Environment in a Tertiary Institution in Nigeria

PubMed Central

Ibrahim, Abdulrasheed; Delia, Ibrahim Z; Edaigbini, Sunday A; Abubakar, Amina; Dahiru, Ismail L; Lawal, Zakari Y

2013-01-01

Background: The transformation of a surgical trainee into a surgeon is strongly influenced by the quality of teaching in the operating theater. This study investigates the perceptions of residents about the educational environment of the operating theater and identifies variables that may improve the operating theater education of our trainees. Materials and Methods: Residents in the department of surgery anonymously evaluated teaching in the operating room using the operating theater education environment measure. The residents evaluated 33 variables that might have an impact on their surgical skills within the operating theater. The variables were grouped into four subscales; teaching and training, learning opportunities, operating theater atmosphere and workload/supervision/support. Differences between male and female residents and junior and senior registrars were assessed using Mann-Whitney test. Statistical analysis was completed with the statistics package for the social sciences version 17. Results: A total of 33 residents were participated in this study. Twenty nine (88%) males and 4 (12%) females. 30 (90%) were junior registrars. The mean total score was 67.5%. Operating theater atmosphere subscale had the highest score of 79.2% while workload/supervision/support subscale had the least score of 48.3%. There were significant differences between male and female resident's perception of workload/supervision/support P < 0.05; however, there was no significant differences in junior registrar versus senior registrar's perception of the education environment in all the subscales P > 0.05. Conclusion: This study has shown a satisfactory teaching environment based on the existing local realities of means, resources and tools and highlighted the need for improvement in workload/supervision/support in our institution. An acceptable learning environment in the operating theatre will produce surgeons that are technically competent to bridge the gap in the enormous unmet need for surgical care in Nigeria. PMID:24497753

Students’ perceptions of the academic learning environment in seven medical sciences courses based on DREEM

PubMed Central

Bakhshialiabad, Hamid; Bakhshi, Mohammadhosien; Hassanshahi, Gholamhossein

2015-01-01

Objective Learning environment has a significant role in determining students’ academic achievement and learning. The aim of this study is to investigate the viewpoints of undergraduate medical sciences students on the learning environment using the Dundee Ready Education Environment Measure (DREEM) at Rafsanjan University of Medical Sciences (RUMS). Methods The descriptive cross-sectional study was performed on 493 medical sciences students in the following majors: nursing, midwifery, radiology, operating room nursing, laboratory sciences, medical emergency, and anesthesia. The DREEM questionnaire was used as a standard tool. Data were analyzed using SPSS (v17) software. Student’s t-tests and analysis of variance (ANOVA) statistical tests were used. Results The mean of the achieved scores in the five domains was 113.5 out of 200 (56.74%), which was considered to be more positive than negative. The total mean scores for perception of learning, teaching, and atmosphere were 27.4/48 (57.24%), 24.60/44 (55.91%), and 26.8/48 (55.89%), respectively. Academic and social self-perceptions were 20.5/32 (64.11%) and 15.7/28 (56.36%), respectively. The total DREEM scores varied significantly between courses (P<0.01). The total scores of the students of operating room nursing, anesthesia, and laboratory sciences, first year students, and females were significantly higher than the other students (P<0.01). Conclusion The results have suggested that the students of medical sciences courses at RUMS generally hold positive perceptions toward their course environment. The differences between courses and their study pathway should be further investigated by analysis of specific items. Our results showed that it is essential for faculty members and course managers to make more efforts toward observing principles of instructional designs, to create an appropriate educational environment, and to reduce deficits in order to provide a better learning environment with more facilities and supportive systems for the students. PMID:25848331

The Influence of Modulated Signal Risetime in Flight Electronics Radiated Immunity Testing with a Mode-Stirred Chamber

NASA Technical Reports Server (NTRS)

Ely, Jay J.; Nguyen, Truong X.; Scearce, Stephen A.

2000-01-01

For electromagnetic immunity testing of an electronic system, it is desirable to demonstrate its functional integrity when exposed to the full range and intensity of environmental electromagnetic threats that may be encountered over its operational life. As part of this, it is necessary to show proper system operation when exposed to representative threat signal modulations. Modulated signal transition time is easily overlooked, but can be highly significant to system susceptibility. Radiated electromagnetic field immunity testing is increasingly being performed in Mode Stirred Chambers. Because the peak field vs. time relationship is affected by the operation of a reverberating room, it is important to understand how the room may influence any input signal modulation characteristics. This paper will provide insight into the field intensity vs. time relationship within the test environment of a mode stirred chamber. An understanding of this relationship is important to EMC engineers in determining what input signal modulation characteristics will be transferred to the equipment under test. References will be given for the development of this topic, and experimental data will be presented

Surgical simulation in orthopaedic skills training.

PubMed

Atesok, Kivanc; Mabrey, Jay D; Jazrawi, Laith M; Egol, Kenneth A

2012-07-01

Mastering rapidly evolving orthopaedic surgical techniques requires a lengthy period of training. Current work-hour restrictions and cost pressures force trainees to face the challenge of acquiring more complex surgical skills in a shorter amount of time. As a result, alternative methods to improve the surgical skills of orthopaedic trainees outside the operating room have been developed. These methods include hands-on training in a laboratory setting using synthetic bones or cadaver models as well as software tools and computerized simulators that enable trainees to plan and simulate orthopaedic operations in a three-dimensional virtual environment. Laboratory-based training offers potential benefits in the development of basic surgical skills, such as using surgical tools and implants appropriately, achieving competency in procedures that have a steep learning curve, and assessing already acquired skills while minimizing concerns for patient safety, operating room time, and financial constraints. Current evidence supporting the educational advantages of surgical simulation in orthopaedic skills training is limited. Despite this, positive effects on the overall education of orthopaedic residents, and on maintaining the proficiency of practicing orthopaedic surgeons, are anticipated.

Intrahospital teleradiology from the emergency room

NASA Astrophysics Data System (ADS)

Fuhrman, Carl R.; Slasky, B. S.; Gur, David; Lattner, Stefanie; Herron, John M.; Plunkett, Michael B.; Towers, Jeffrey D.; Thaete, F. Leland

1993-09-01

Off-hour operations of the modern emergency room presents a challenge to conventional image management systems. To assess the utility of intrahospital teleradiology systems from the emergency room (ER), we installed a high-resolution film digitizer which was interfaced to a central archive and to a workstation at the main reading room. The system was designed to allow for digitization of images as soon as the films were processed. Digitized images were autorouted to both destinations, and digitized images could be laser printed (if desired). Almost real time interpretations of nonselected cases were performed at both locations (conventional film in the ER and a workstation in the main reading room), and an analysis of disagreements was performed. Our results demonstrate that in spite of a `significant' difference in reporting, `clinically significant differences' were found in less than 5% of cases. Folder management issues, preprocessing, image orientation, and setting reasonable lookup tables for display were identified as the main limitations to the systems' routine use in a busy environment. The main limitation of the conventional film was the identification of subtle abnormalities in the bright regions of the film. Once identified on either system (conventional film or soft display), all abnormalities were visible and detectable on both display modalities.

[Operating room during natural disaster: lessons from the 2011 Tohoku earthquake].

PubMed

Fukuda, Ikuo; Hashimoto, Hiroshi; Suzuki, Yasuyuki; Satomi, Susumu; Unno, Michiaki; Ohuchi, Noriaki; Nakaji, Shigeyuki

2012-03-01

Objective of this study is to clarify damages in operating rooms after the 2011 Tohoku Earthquake. To survey structural and non-structural damage in operating theaters, we sent questionnaires to 155 acute care hospitals in Tohoku area. Questionnaires were sent back from 105 hospitals (70.3%). Total of 280 patients were undergoing any kinds of operations during the earthquake and severe seismic tremor greater than JMA Seismic Intensity 6 hit 49 hospitals. Operating room staffs experienced life-threatening tremor in 41 hospitals. Blackout occurred but emergency electronic supply unit worked immediately in 81 out of 90 hospitals. However, emergency power plant did not work in 9 hospitals. During earthquake some materials fell from shelves in 44 hospitals and medical instruments fell down in 14 hospitals. In 5 hospitals, they experienced collapse of operating room wall or ceiling causing inability to maintain sterile operative field. Damage in electric power and water supply plus damage in logistics made many operating rooms difficult to perform routine surgery for several days. The 2011 Tohoku earthquake affected medical supply in wide area of Tohoku district and induced dysfunction of operating room. Supply-chain management of medical goods should be reconsidered to prepare severe natural disaster.

Traffic flow in the operating room: an explorative and descriptive study on air quality during orthopedic trauma implant surgery.

PubMed

Andersson, Annette Erichsen; Bergh, Ingrid; Karlsson, Jón; Eriksson, Bengt I; Nilsson, Kerstin

2012-10-01

Understanding the protective potential of operating room (OR) ventilation under different conditions is crucial to optimizing the surgical environment. This study investigated the air quality, expressed as colony-forming units (CFU)/m(3), during orthopedic trauma surgery in a displacement-ventilated OR; explored how traffic flow and the number of persons present in the OR affects the air contamination rate in the vicinity of surgical wounds; and identified reasons for door openings in the OR. Data collection, consisting of active air sampling and observations, was performed during 30 orthopedic procedures. In 52 of the 91 air samples collected (57%), the CFU/m(3) values exceeded the recommended level of <10 CFU/m(3). In addition, the data showed a strongly positive correlation between the total CFU/m(3) per operation and total traffic flow per operation (r = 0.74; P = .001; n = 24), after controlling for duration of surgery. A weaker, yet still positive correlation between CFU/m(3) and the number of persons present in the OR (r = 0.22; P = .04; n = 82) was also found. Traffic flow, number of persons present, and duration of surgery explained 68% of the variance in total CFU/m(3) (P = .001). Traffic flow has a strong negative impact on the OR environment. The results of this study support interventions aimed at preventing surgical site infections by reducing traffic flow in the OR. Copyright © 2012 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

Effectiveness of the surgical safety checklist in a high standard care environment.

PubMed

Lübbeke, Anne; Hovaguimian, Frederique; Wickboldt, Nadine; Barea, Christophe; Clergue, François; Hoffmeyer, Pierre; Walder, Bernhard

2013-05-01

Use of surgical safety checklists has been associated with significant reduction in postoperative surgical site infection (SSI), morbidity, and mortality. To evaluate the effectiveness of an intraoperative checklist in high-risk surgical patients in a high standard care environment with long-standing regular perioperative safety control programs. Quasi-experiment pre-post checklist implementation. Surgical patients above 16 years with an American Society of Anesthesiologists (ASA) score 3-5 operated upon at a large tertiary hospital. Unplanned return to operating room for any reason, reoperation for SSI, unplanned admission to intensive care unit, and in-hospital death within 30 days. A total of 609 patients (53% elective, 85% ASA 3, mean age 70 y) were included before and 1818 after implementation (52% elective, 87% ASA 3, mean age 69 y), the latter with 552, 558, and 708 in period I, II, and III, respectively. Comparing preimplementation to postimplementation periods: unplanned return to operating room occurred in 45/609 (7.4%) versus 109/1818 (6.0%) interventions [adjusted risk ratios (RR) 0.82; 95% confidence interval (CI), 0.59-1.14]; reoperation for SSI in 18/609 (3.0%) versus 109/1818 (1.7%) interventions (adjusted RR 0.56; 95% CI, 0.32-1.00); unplanned admission to intensive care unit in 17 (2.8%) versus 48 (2.6%) interventions (adjusted RR 0.90; 95% CI, 0.52-1.55); and in-hospital death occurred in 26 (4.3%) versus 108 (5.9%) patients (adjusted RR 1.44; 95% CI, 0.97-2.14). Checklist use during 77 interventions prevented 1 reoperation for SSI. A trend toward reduced reoperation rates for SSI was observed after checklist implementation in this high standard care environment; no influence on other outcome measures was observed.

TeamSTEPPS Improves Operating Room Efficiency and Patient Safety.

PubMed

Weld, Lancaster R; Stringer, Matthew T; Ebertowski, James S; Baumgartner, Timothy S; Kasprenski, Matthew C; Kelley, Jeremy C; Cho, Doug S; Tieva, Erwin A; Novak, Thomas E

2016-09-01

The objective was to evaluate the effect of TeamSTEPPS on operating room efficiency and patient safety. TeamSTEPPS consisted of briefings attended by all health care personnel assigned to the specific operating room to discuss issues unique to each case scheduled for that day. The operative times, on-time start rates, and turnover times of all cases performed by the urology service during the initial year with TeamSTEPPS were compared to the prior year. Patient safety issues identified during postoperative briefings were analyzed. The mean case time was 12.7 minutes less with TeamSTEPPS (P < .001). The on-time first-start rate improved by 21% with TeamSTEPPS (P < .001). The mean room turnover time did not change. Patient safety issues declined from an initial rate of 16% to 6% at midyear and remained stable (P < 0.001). TeamSTEPPS was associated with improved operating room efficiency and diminished patient safety issues in the operating room. © The Author(s) 2015.

Physical order produces healthy choices, generosity, and conventionality, whereas disorder produces creativity.

PubMed

Vohs, Kathleen D; Redden, Joseph P; Rahinel, Ryan

2013-09-01

Order and disorder are prevalent in both nature and culture, which suggests that each environ confers advantages for different outcomes. Three experiments tested the novel hypotheses that orderly environments lead people toward tradition and convention, whereas disorderly environments encourage breaking with tradition and convention-and that both settings can alter preferences, choice, and behavior. Experiment 1 showed that relative to participants in a disorderly room, participants in an orderly room chose healthier snacks and donated more money. Experiment 2 showed that participants in a disorderly room were more creative than participants in an orderly room. Experiment 3 showed a predicted crossover effect: Participants in an orderly room preferred an option labeled as classic, but those in a disorderly room preferred an option labeled as new. Whereas prior research on physical settings has shown that orderly settings encourage better behavior than disorderly ones, the current research tells a nuanced story of how different environments suit different outcomes.

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 compared to 66-fold) the difference being possibly due to the contribution from the patient. However, as this comparison was that which would be most open to influence from other variables confidence could be placed on the chamber test results. Values were also obtained for the total number of bacterial particles dispersed by persons during a standard exercise wearing different clothing. This count was dependent on the clothing worn but a median count of between 1000 and 1500 bacterial particles/min. would be expected when conventional clothing was worn, with a range of between 300 and 19,000. This count could be reduced to about 100/min. if a total-body exhaust suit was worn (range 30-400). PMID:778258

Perceptions of Recent Graduates of the Adequacy of Anesthesia Training Programs.

ERIC Educational Resources Information Center

Spielman, Fred J.; Bowe, Edwin A.

1983-01-01

A survey examined physician attitudes toward operating room, nonoperating room, and nonpatient care responsibilities in their residencies. Training for operating room responsibilities was deemed adequate by most, and nonoperating room training inadequate. Recommendations include: hospital cooperation, more effective sessions, and supplementary…

Efficiency of endoscopy units can be improved with use of discrete event simulation modeling.

PubMed

Sauer, Bryan G; Singh, Kanwar P; Wagner, Barry L; Vanden Hoek, Matthew S; Twilley, Katherine; Cohn, Steven M; Shami, Vanessa M; Wang, Andrew Y

2016-11-01

Background and study aims: The projected increased demand for health services obligates healthcare organizations to operate efficiently. Discrete event simulation (DES) is a modeling method that allows for optimization of systems through virtual testing of different configurations before implementation. The objective of this study was to identify strategies to improve the daily efficiencies of an endoscopy center with the use of DES. Methods: We built a DES model of a five procedure room endoscopy unit at a tertiary-care university medical center. After validating the baseline model, we tested alternate configurations to run the endoscopy suite and evaluated outcomes associated with each change. The main outcome measures included adequate number of preparation and recovery rooms, blocked inflow, delay times, blocked outflows, and patient cycle time. Results: Based on a sensitivity analysis, the adequate number of preparation rooms is eight and recovery rooms is nine for a five procedure room unit (total 3.4 preparation and recovery rooms per procedure room). Simple changes to procedure scheduling and patient arrival times led to a modest improvement in efficiency. Increasing the preparation/recovery rooms based on the sensitivity analysis led to significant improvements in efficiency. Conclusions: By applying tools such as DES, we can model changes in an environment with complex interactions and find ways to improve the medical care we provide. DES is applicable to any endoscopy unit and would be particularly valuable to those who are trying to improve on the efficiency of care and patient experience.

Efficiency of endoscopy units can be improved with use of discrete event simulation modeling

PubMed Central

Sauer, Bryan G.; Singh, Kanwar P.; Wagner, Barry L.; Vanden Hoek, Matthew S.; Twilley, Katherine; Cohn, Steven M.; Shami, Vanessa M.; Wang, Andrew Y.

2016-01-01

Background and study aims: The projected increased demand for health services obligates healthcare organizations to operate efficiently. Discrete event simulation (DES) is a modeling method that allows for optimization of systems through virtual testing of different configurations before implementation. The objective of this study was to identify strategies to improve the daily efficiencies of an endoscopy center with the use of DES. Methods: We built a DES model of a five procedure room endoscopy unit at a tertiary-care university medical center. After validating the baseline model, we tested alternate configurations to run the endoscopy suite and evaluated outcomes associated with each change. The main outcome measures included adequate number of preparation and recovery rooms, blocked inflow, delay times, blocked outflows, and patient cycle time. Results: Based on a sensitivity analysis, the adequate number of preparation rooms is eight and recovery rooms is nine for a five procedure room unit (total 3.4 preparation and recovery rooms per procedure room). Simple changes to procedure scheduling and patient arrival times led to a modest improvement in efficiency. Increasing the preparation/recovery rooms based on the sensitivity analysis led to significant improvements in efficiency. Conclusions: By applying tools such as DES, we can model changes in an environment with complex interactions and find ways to improve the medical care we provide. DES is applicable to any endoscopy unit and would be particularly valuable to those who are trying to improve on the efficiency of care and patient experience. PMID:27853739

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

DOE Office of Scientific and Technical Information (OSTI.GOV)

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.

Operating Room Technology. Post Secondary Curriculum Guide.

ERIC Educational Resources Information Center

Simpson, Bruce; And Others

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

[Fire in the operating room].

PubMed

Koljonen, Virve; Mäkisalo, Heikki

2013-01-01

This article reviews the recent literature on operating room fires. Most of the reported cases have occurred from a spark from an ignition source in an oxygen-enriched atmosphere. Fire requires the presence of three components which all are ample in the operating room: heat, flammable materials or flammable gases.

Medical Gas Analyzer

NASA Technical Reports Server (NTRS)

1983-01-01

The Remote Monitoring System (RMS) is manufactured by Perkin Elmer Corporation. The principal component of the RMS was originally developed for spacecraft use to monitor astronaut's respiratory gases in NASA's Gemini and Apollo program. At Wishard Memorial Hospital in Indianapolis, IN, the RMS is used in operating rooms for analysis of anesthetic gases and measurement of oxygen, carbon dioxide and nitrogen concentrations. It assures that the patient undergoing surgery has the proper breathing environment.

Encapsulated monoclinic sulfur for stable cycling of li-s rechargeable batteries.

PubMed

Moon, San; Jung, Young Hwa; Jung, Wook Ki; Jung, Dae Soo; Choi, Jang Wook; Kim, Do Kyung

2013-12-03

Monoclinic S8 , an uncommon allotrope of sulfur at room temperature, can be formed when common orthorhombic S8 is heat-treated under enclosed environments in nanometer dimensions. Monoclinic S8 prevents the formation of soluble polysulfides during battery operation, resulting in unprecedented cycling performance over 1000 cycles under the highest sulfur content to date. © 2013 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

The Effect of Intravenous Catheter Diameter on the Temperature of Fluids Warmed by the Level 1(TM) Fluid Warmer

DTIC Science & Technology

1990-08-01

9 Pathophysiology of hypothermia............ 11 Hypothermia and anesthesia................ 16 Causes of hypothermia...Various causes exist for the development of hypothermia and many are intrinsic to the surgical environment. Cool operating room temperatures, cold skin...slower infusion rates (< 20 ml/min) cause heat loss from fluids warmed by conventional warmers (Baker, 1985), similar loss may occur using rapid infusion

Advanced Technologies in Safe and Efficient Operating Rooms

DTIC Science & Technology

2009-10-01

focused on the video, not (initially) any other sensors and ii) tried to capture using machine learning techniques the ability of an expert surgeon to...plant (with humans playing the role of team leader) o a learning environment (where humans play the role of students ). As can be seen, this work...increased cognitive demands associated with the one-handed technique occur because the surgeon is providing instructions to the assistant performing

A High Frequency (HF) Inductive Power Transfer Circuit for High Temperature Applications Using SiC Schottky Diodes

NASA Technical Reports Server (NTRS)

Jordan, Jennifer L.; Ponchak, George E.; Spry, David J.; Neudeck, Philip G.

2018-01-01

Wireless sensors placed in high temperature environments, such as aircraft engines, are desirable to reduce the mass and complexity of routing wires. While communication with the sensors is straight forward, providing power wirelessly is still a challenge. This paper introduces an inductive wireless power transfer circuit incorporating SiC Schottky diodes and its operation from room temperature (25 C) to 500 C.

Synthesis and humidity sensing analysis of ZnS nanowires

NASA Astrophysics Data System (ADS)

Okur, Salih; Üzar, Neslihan; Tekgüzel, Nesli; Erol, Ayşe; Çetin Arıkan, M.

2012-03-01

ZnS nanowires synthesized by the vapor-liquid-solid (VLS) method and humidity sensing properties of obtained ZnS nanowires were investigated by quartz crystal microbalance (QCM) method and electrical measurements. The synthesized nanowires were exposed to relative humidity (RH) between 22% and 97% under controlled environment. Our experimental results show that ZnS nanowires have a great potential for humidity sensing applications in room temperature operations.

KENNEDY SPACE CENTER, FLA. - In the high bay clean room at the Astrotech Space Operations processing facilities near KSC, workers remove the protective cover from NASA’s MESSENGER spacecraft. Employees of the Johns Hopkins University Applied Physics Laboratory, builders of the spacecraft, will perform an initial state-of-health check. Then processing for launch can begin, including checkout of the power systems, communications systems and control systems. The thermal blankets will also be attached for flight. MESSENGER - short for MErcury Surface, Space ENvironment, GEochemistry and Ranging - will be launched May 11 on a six-year mission aboard a Boeing Delta II rocket. Liftoff is targeted for 2:26 a.m. EDT on Tuesday, May 11.

NASA Image and Video Library

2004-03-10

KENNEDY SPACE CENTER, FLA. - In the high bay clean room at the Astrotech Space Operations processing facilities near KSC, workers remove the protective cover from NASA’s MESSENGER spacecraft. Employees of the Johns Hopkins University Applied Physics Laboratory, builders of the spacecraft, will perform an initial state-of-health check. Then processing for launch can begin, including checkout of the power systems, communications systems and control systems. The thermal blankets will also be attached for flight. MESSENGER - short for MErcury Surface, Space ENvironment, GEochemistry and Ranging - will be launched May 11 on a six-year mission aboard a Boeing Delta II rocket. Liftoff is targeted for 2:26 a.m. EDT on Tuesday, May 11.

KENNEDY SPACE CENTER, FLA. - At the Astrotech Space Operations processing facilities near KSC, workers move NASA’s MESSENGER spacecraft into a high bay clean room. Employees of the Johns Hopkins University Applied Physics Laboratory, builders of the spacecraft, will perform an initial state-of-health check. Then processing for launch can begin, including checkout of the power systems, communications systems and control systems. The thermal blankets will also be attached for flight. MESSENGER - short for MErcury Surface, Space ENvironment, GEochemistry and Ranging - will be launched May 11 on a six-year mission aboard a Boeing Delta II rocket. Liftoff is targeted for 2:26 a.m. EDT on Tuesday, May 11.

NASA Image and Video Library

2004-03-10

KENNEDY SPACE CENTER, FLA. - At the Astrotech Space Operations processing facilities near KSC, workers move NASA’s MESSENGER spacecraft into a high bay clean room. Employees of the Johns Hopkins University Applied Physics Laboratory, builders of the spacecraft, will perform an initial state-of-health check. Then processing for launch can begin, including checkout of the power systems, communications systems and control systems. The thermal blankets will also be attached for flight. MESSENGER - short for MErcury Surface, Space ENvironment, GEochemistry and Ranging - will be launched May 11 on a six-year mission aboard a Boeing Delta II rocket. Liftoff is targeted for 2:26 a.m. EDT on Tuesday, May 11.

KENNEDY SPACE CENTER, FLA. - In the high bay clean room at the Astrotech Space Operations processing facilities near KSC, NASA’s MESSENGER spacecraft is revealed. Employees of the Johns Hopkins University Applied Physics Laboratory, builders of the spacecraft, will perform an initial state-of-health check. Then processing for launch can begin, including checkout of the power systems, communications systems and control systems. The thermal blankets will also be attached for flight. MESSENGER - short for MErcury Surface, Space ENvironment, GEochemistry and Ranging - will be launched May 11 on a six-year mission aboard a Boeing Delta II rocket. Liftoff is targeted for 2:26 a.m. EDT on Tuesday, May 11.

NASA Image and Video Library

2004-03-10

KENNEDY SPACE CENTER, FLA. - In the high bay clean room at the Astrotech Space Operations processing facilities near KSC, NASA’s MESSENGER spacecraft is revealed. Employees of the Johns Hopkins University Applied Physics Laboratory, builders of the spacecraft, will perform an initial state-of-health check. Then processing for launch can begin, including checkout of the power systems, communications systems and control systems. The thermal blankets will also be attached for flight. MESSENGER - short for MErcury Surface, Space ENvironment, GEochemistry and Ranging - will be launched May 11 on a six-year mission aboard a Boeing Delta II rocket. Liftoff is targeted for 2:26 a.m. EDT on Tuesday, May 11.

Microbes in the neonatal intensive care unit resemble those found in the gut of premature infants

PubMed Central

2014-01-01

Background The source inoculum of gastrointestinal tract (GIT) microbes is largely influenced by delivery mode in full-term infants, but these influences may be decoupled in very low birth weight (VLBW, <1,500 g) neonates via conventional broad-spectrum antibiotic treatment. We hypothesize the built environment (BE), specifically room surfaces frequently touched by humans, is a predominant source of colonizing microbes in the gut of premature VLBW infants. Here, we present the first matched fecal-BE time series analysis of two preterm VLBW neonates housed in a neonatal intensive care unit (NICU) over the first month of life. Results Fresh fecal samples were collected every 3 days and metagenomes sequenced on an Illumina HiSeq2000 device. For each fecal sample, approximately 33 swabs were collected from each NICU room from 6 specified areas: sink, feeding and intubation tubing, hands of healthcare providers and parents, general surfaces, and nurse station electronics (keyboard, mouse, and cell phone). Swabs were processed using a recently developed ‘expectation maximization iterative reconstruction of genes from the environment’ (EMIRGE) amplicon pipeline in which full-length 16S rRNA amplicons were sheared and sequenced using an Illumina platform, and short reads reassembled into full-length genes. Over 24,000 full-length 16S rRNA sequences were produced, generating an average of approximately 12,000 operational taxonomic units (OTUs) (clustered at 97% nucleotide identity) per room-infant pair. Dominant gut taxa, including Staphylococcus epidermidis, Klebsiella pneumoniae, Bacteroides fragilis, and Escherichia coli, were widely distributed throughout the room environment with many gut colonizers detected in more than half of samples. Reconstructed genomes from infant gut colonizers revealed a suite of genes that confer resistance to antibiotics (for example, tetracycline, fluoroquinolone, and aminoglycoside) and sterilizing agents, which likely offer a competitive advantage in the NICU environment. Conclusions We have developed a high-throughput culture-independent approach that integrates room surveys based on full-length 16S rRNA gene sequences with metagenomic analysis of fecal samples collected from infants in the room. The approach enabled identification of discrete ICU reservoirs of microbes that also colonized the infant gut and provided evidence for the presence of certain organisms in the room prior to their detection in the gut. PMID:24468033

Design of the environment of care for safety of patients and personnel: does form follow function or vice versa in the intensive care unit?

PubMed

Bartley, Judene; Streifel, Andrew J

2010-08-01

We review the context of the environment of care in the intensive care unit setting in relation to patient safety and quality, specifically addressing healthcare-associated infection issues and solutions involving interdisciplinary teams. Issues addressed include current and future architectural design and layout trends, construction trends affecting intensive care units, and prevention of construction-associated healthcare-associated infections related to airborne and waterborne risks and design solutions. Specific elements include single-occupancy, acuity-scalable intensive care unit rooms; environmental aspects of hand hygiene, such as water risks, sink design/location, human waste management, surface selection (floor covering, countertops, furniture, and equipment) and cleaning, antimicrobial-treated or similar materials, ultraviolet germicidal irradiation, specialized rooms (airborne infection isolation and protective environments), and water system design and strategies for safe use of potable water and mitigation of water intrusion. Effective design and operational use of the intensive care unit environment of care must engage critical care personnel from initial planning and design through occupancy of the new/renovated intensive care unit as part of the infection control risk assessment team. The interdisciplinary infection control risk assessment team can address key environment of care design features to enhance the safety of intensive care unit patients, personnel, and visitors. This perspective will ensure the environment of care supports human factors and behavioral aspects of the interaction between the environment of care and its occupants.

Spatial Hearing with Incongruent Visual or Auditory Room Cues

PubMed Central

Gil-Carvajal, Juan C.; Cubick, Jens; Santurette, Sébastien; Dau, Torsten

2016-01-01

In day-to-day life, humans usually perceive the location of sound sources as outside their heads. This externalized auditory spatial perception can be reproduced through headphones by recreating the sound pressure generated by the source at the listener’s eardrums. This requires the acoustical features of the recording environment and listener’s anatomy to be recorded at the listener’s ear canals. Although the resulting auditory images can be indistinguishable from real-world sources, their externalization may be less robust when the playback and recording environments differ. Here we tested whether a mismatch between playback and recording room reduces perceived distance, azimuthal direction, and compactness of the auditory image, and whether this is mostly due to incongruent auditory cues or to expectations generated from the visual impression of the room. Perceived distance ratings decreased significantly when collected in a more reverberant environment than the recording room, whereas azimuthal direction and compactness remained room independent. Moreover, modifying visual room-related cues had no effect on these three attributes, while incongruent auditory room-related cues between the recording and playback room did affect distance perception. Consequently, the external perception of virtual sounds depends on the degree of congruency between the acoustical features of the environment and the stimuli. PMID:27853290

Aberration-Corrected STEM Imaging Through Off-Site Remote Operation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Jarvis, Karalee; Allard Jr, Lawrence Frederick; Jerome, Timothy Y

2010-01-01

Recent advances in aberration-corrected electron microscopy have allowed researchers to image materials at sub- ngstr m resolution. Many of these modern instruments are designed to be operated from separate 'control' rooms, removing the effect of the operator on the instrument s physical environment. This capability also allows operation from suitable workstations, over internet connections, from literally anywhere in the world [1]. Researchers at the University of Texas at Austin (UTA) have collaborated with Oak Ridge National Laboratory (ORNL) and JEOL Ltd. to routinely conduct research sessions in which high-resolution images and X-ray microanalytical data are acquired during after-hours research sessions,more » utilizing the JEOL 2200FS aberration-corrected STEM/TEM at ORNL from their lab in Austin. Details of the remote operation are presented here.« less

The costs and quality of operative training for residents in tympanoplasty type I.

PubMed

Wang, Mao-Che; Yu, Eric Chen-Hua; Shiao, An-Suey; Liao, Wen-Huei; Liu, Chia-Yu

2009-05-01

A teaching hospital would incur more operation room costs on training surgical residents. To evaluate the increased operation time and the increased operation room costs of operations performed by surgical residents. As a model we used a very common surgical otology procedure -- tympanoplasty type I. From January 1, 2004 to December 31, 2004, we included in this study 100 patients who received tympanoplasty type I in Taipei Veterans General Hospital. Fifty-six procedures were performed by a single board-certified surgeon and 44 procedures were performed by residents. We analyzed the operation time and surgical outcomes in these two groups of patients. The operation room cost per minute was obtained by dividing the total operation room expenses by total operation time in the year 2004. The average operation time of residents was 116.47 min, which was significantly longer (p<0.0001) than that of the board-certified surgeon (average 81.07 min). It cost USD $40.36 more for each operation performed by residents in terms of operation room costs. The surgical success rate of residents was 81.82%, which was significantly lower (p=0.016) than that of the board-certified surgeon (96.43%).

Alcohol based surgical prep solution and the risk of fire in the operating room: a case report

PubMed Central

Batra, Sumit; Gupta, Rajiv

2008-01-01

A few cases of fire in the operating room are reported in the literature. The factors that may initiate these fires are many and include alcohol based surgical prep solutions, electrosurgical equipment, flammable drapes etc. We are reporting a case of fire in the operating room while operating on a patient with burst fracture C6 vertebra with quadriplegia. The cause of the fire was due to incomplete drying of the covering drapes with an alcohol based surgical prep solution. This paper discusses potential preventive measures to minimize the incidence of fire in the operating room. PMID:18439304

Wearing long sleeves while prepping a patient in the operating room decreases airborne contaminants.

PubMed

Markel, Troy A; Gormley, Thomas; Greeley, Damon; Ostojic, John; Wagner, Jennifer

2018-04-01

The use of long sleeves by nonscrubbed personnel in the operating room has been called into question. We hypothesized that wearing long sleeves and gloves, compared with having bare arms without gloves, while applying the skin preparation solution would decrease particulate and microbial contamination. A mock patient skin prep was performed in 3 different operating rooms. A long-sleeved gown and gloves, or bare arms, were used to perform the procedure. Particle counters were used to assess airborne particulate contamination, and active and passive microbial assessment was achieved through air samplers and settle plate analysis. Data were compared with Student's t-test or Mann-Whitney U, and P < .05 was considered to be significant. Operating room B demonstrated decreased 5.0- µm particle sizes with the use of sleeves, while operating rooms A and C showed decreased total microbes only with the use of sleeves. Despite there being no difference in the average number of total microbes for all operating rooms assessed, the use of sleeves specifically appeared to decrease the shed of Micrococcus. The use of long sleeves and gloves while applying the skin preparation solution decreased particulate and microbial shedding in several of the operating rooms tested. Although long sleeves may not be necessary for all operating room personnel, they may decrease airborne contamination while the skin prep is applied, which may lead to decreased surgical site infections. Copyright © 2018 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

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…

Macro-mechanics controls quantum mechanics: mechanically controllable quantum conductance switching of an electrochemically fabricated atomic-scale point contact.

PubMed

Staiger, Torben; Wertz, Florian; Xie, Fangqing; Heinze, Marcel; Schmieder, Philipp; Lutzweiler, Christian; Schimmel, Thomas

2018-01-12

Here, we present a silver atomic-scale device fabricated and operated by a combined technique of electrochemical control (EC) and mechanically controllable break junction (MCBJ). With this EC-MCBJ technique, we can perform mechanically controllable bistable quantum conductance switching of a silver quantum point contact (QPC) in an electrochemical environment at room temperature. Furthermore, the silver QPC of the device can be controlled both mechanically and electrochemically, and the operating mode can be changed from 'electrochemical' to 'mechanical', which expands the operating mode for controlling QPCs. These experimental results offer the perspective that a silver QPC may be used as a contact for a nanoelectromechanical relay.

Macro-mechanics controls quantum mechanics: mechanically controllable quantum conductance switching of an electrochemically fabricated atomic-scale point contact

NASA Astrophysics Data System (ADS)

Staiger, Torben; Wertz, Florian; Xie, Fangqing; Heinze, Marcel; Schmieder, Philipp; Lutzweiler, Christian; Schimmel, Thomas

2018-01-01

Here, we present a silver atomic-scale device fabricated and operated by a combined technique of electrochemical control (EC) and mechanically controllable break junction (MCBJ). With this EC-MCBJ technique, we can perform mechanically controllable bistable quantum conductance switching of a silver quantum point contact (QPC) in an electrochemical environment at room temperature. Furthermore, the silver QPC of the device can be controlled both mechanically and electrochemically, and the operating mode can be changed from ‘electrochemical’ to ‘mechanical’, which expands the operating mode for controlling QPCs. These experimental results offer the perspective that a silver QPC may be used as a contact for a nanoelectromechanical relay.

CAVE2: a hybrid reality environment for immersive simulation and information analysis

NASA Astrophysics Data System (ADS)

Febretti, Alessandro; Nishimoto, Arthur; Thigpen, Terrance; Talandis, Jonas; Long, Lance; Pirtle, J. D.; Peterka, Tom; Verlo, Alan; Brown, Maxine; Plepys, Dana; Sandin, Dan; Renambot, Luc; Johnson, Andrew; Leigh, Jason

2013-03-01

Hybrid Reality Environments represent a new kind of visualization spaces that blur the line between virtual environments and high resolution tiled display walls. This paper outlines the design and implementation of the CAVE2TM Hybrid Reality Environment. CAVE2 is the world's first near-seamless flat-panel-based, surround-screen immersive system. Unique to CAVE2 is that it will enable users to simultaneously view both 2D and 3D information, providing more flexibility for mixed media applications. CAVE2 is a cylindrical system of 24 feet in diameter and 8 feet tall, and consists of 72 near-seamless, off-axisoptimized passive stereo LCD panels, creating an approximately 320 degree panoramic environment for displaying information at 37 Megapixels (in stereoscopic 3D) or 74 Megapixels in 2D and at a horizontal visual acuity of 20/20. Custom LCD panels with shifted polarizers were built so the images in the top and bottom rows of LCDs are optimized for vertical off-center viewing- allowing viewers to come closer to the displays while minimizing ghosting. CAVE2 is designed to support multiple operating modes. In the Fully Immersive mode, the entire room can be dedicated to one virtual simulation. In 2D model, the room can operate like a traditional tiled display wall enabling users to work with large numbers of documents at the same time. In the Hybrid mode, a mixture of both 2D and 3D applications can be simultaneously supported. The ability to treat immersive work spaces in this Hybrid way has never been achieved before, and leverages the special abilities of CAVE2 to enable researchers to seamlessly interact with large collections of 2D and 3D data. To realize this hybrid ability, we merged the Scalable Adaptive Graphics Environment (SAGE) - a system for supporting 2D tiled displays, with Omegalib - a virtual reality middleware supporting OpenGL, OpenSceneGraph and Vtk applications.

Prospective Evaluation of Operating Room Inefficiency.

PubMed

Madni, Tarik D; Imran, Jonathan B; Clark, Audra T; Cunningham, Holly B; Taveras, Luis; Arnoldo, Brett D; Phelan, Herb A; Wolf, Steven E

2018-04-06

Previously, we identified that 60% of our facility's total operative time is nonoperative. We performed a review of our operating room to determine where inefficiencies exist in nonoperative time. Live video of operations performed in a burn operating room from 6/23/17 to 8/16/17 were prospectively reviewed. Preparation (end of induction to procedure start) and turnover (patient out of room to next patient in room) were divided into the following activities: 1) Preparation: remove dressing, position patient, clean patient, drape patient, and 2) Turnover: clean operating room, scrub tray set-up, anesthesia set-up. Ideal preparation time was calculated as the sum of time needed to perform preparation activities consecutively. Ideal turnover time was calculated as the sum of time needed to clean the operating room and to set up either the scrub tray or anesthesia (the larger of the two times as these can be done in parallel). We reviewed 101 consecutive operations. An average of 2.4±0.8 cases/day were performed. Ideal preparation and turnover time were 16.6 and 30.1 minutes, a 38.3% and 32.5% reduction compared to actual times. Attending surgeon presence in the operating room within 10 minutes of a patient's arrival was found to significantly decrease time to incision by 33% (52.7±14.3 minutes down to 35.7±20.4, p<0.0001). A reduction in preparation and turnover time could save $1.02 million and generate $1.76 million in additional revenue annually. Reducing preparation and turnover to ideal times could increase caseload to 4/day, leading to millions of dollars of savings annually.

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…

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 apparatus...

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 apparatus...

Foundations for teaching surgeons to address the contributions of systems to operating room team conflict.

PubMed

Rogers, David A; Lingard, Lorelei; Boehler, Margaret L; Espin, Sherry; Schindler, Nancy; Klingensmith, Mary; Mellinger, John D

2013-09-01

Prior research has shown that surgeons who effectively manage operating room conflict engage in a problem-solving stage devoted to modifying systems that contribute to team conflict. The purpose of this study was to clarify how systems contributed to operating room team conflict and clarify what surgeons do to modify them. Focus groups of circulating nurses and surgeons were conducted at 5 academic medical centers. Narratives describing the contributions of systems to operating room conflict and behaviors used by surgeons to address those systems were analyzed using the constant comparative approach associated with a constructivist grounded theory approach. Operating room team conflict was affected by 4 systems-related factors: team features, procedural-specific staff training, equipment management systems, and the administrative leadership itself. Effective systems problem solving included advocating for change based on patient safety concerns. The results of this study provide clarity about how systems contribute to operating room conflict and what surgeons can do to effectively modify these systems. This information is foundational material for a conflict management educational program for surgeons. Copyright © 2013 Elsevier Inc. All rights reserved.

High Sensitivity Gas Detection Using a Macroscopic Three-Dimensional Graphene Foam Network

PubMed Central

Yavari, Fazel; Chen, Zongping; Thomas, Abhay V.; Ren, Wencai; Cheng, Hui-Ming; Koratkar, Nikhil

2011-01-01

Nanostructures are known to be exquisitely sensitive to the chemical environment and offer ultra-high sensitivity for gas-sensing. However, the fabrication and operation of devices that use individual nanostructures for sensing is complex, expensive and suffers from poor reliability due to contamination and large variability from sample-to-sample. By contrast, conventional solid-state and conducting-polymer sensors offer excellent reliability but suffer from reduced sensitivity at room-temperature. Here we report a macro graphene foam-like three-dimensional network which combines the best of both worlds. The walls of the foam are comprised of few-layer graphene sheets resulting in high sensitivity; we demonstrate parts-per-million level detection of NH3 and NO2 in air at room-temperature. Further, the foam is a mechanically robust and flexible macro-scale network that is easy to contact (without Lithography) and can rival the durability and affordability of traditional sensors. Moreover, Joule-heating expels chemisorbed molecules from the foam's surface leading to fully-reversible and low-power operation. PMID:22355681

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

PubMed

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

2015-09-01

This study was conducted between August 15 and September 20, 2013, to determine the effects of workload and working conditions on operating room (OR) nurses and technicians. The study sample included 74 OR nurses and technicians working in a private university's six hospitals. The Individual Workload Perception Scale and a questionnaire that collected data on risk and environmental factors were used. The mean age of study participants was 29.3 ± 6.7 years, and 62.2% of the participants were female. More than 90% of the nurses and technicians had experienced spills or splashing of blood or other body fluids; anesthetic gases and radiation had affected 63.5% and 71.6% of nurses and technicians, respectively; 63.5% reported lumbar pain; and 46.6% defined the work environment as very stressful. The average workload scale score was 32.4 ± 6.2 (min = 11, max = 55). OR nurses and technicians are exposed to many occupational risks. © 2015 The Author(s).

[Progress in imaging techniques].

PubMed

Mishima, Kazuaki; Otsuka, Tsukasa

2013-05-01

Today it is common to perform real-time diagnosis and treatment via live broadcast as a method of education and to spread new technology for diagnosis and therapy in medical fields. Live medical broadcasts have developed along with broadcast technology. In the early days, live video feeds were sent from operating rooms to classrooms and lecture halls in universities and hospitals. However, the development of imaging techniques and communication networks enabled live broadcasts that bi-directionally link operating rooms and meeting halls during scientific meetings and live demonstration courses. Live broadcasts therefore became an important method for education and the dissemination of new medical technologies. The development of imaging techniques has contributed to more realistic live broadcasts through such innovative techniques as three-dimensional viewing and higher-definition 4K technology. In the future, live broadcasts will be transmitted on personal computers using regular Internet connections. In addition to the enhancement of image delivery technology, it will also be necessary to examine the entire image delivery environment carefully, including issues of security and privacy of personal information.

Electrospun amplified fiber optics.

PubMed

Morello, Giovanni; Camposeo, Andrea; Moffa, Maria; Pisignano, Dario

2015-03-11

All-optical signal processing is the focus of much research aiming to obtain effective alternatives to existing data transmission platforms. Amplification of light in fiber optics, such as in Erbium-doped fiber amplifiers, is especially important for efficient signal transmission. However, the complex fabrication methods involving high-temperature processes performed in a highly pure environment slow the fabrication process and make amplified components expensive with respect to an ideal, high-throughput, room temperature production. Here, we report on near-infrared polymer fiber amplifiers working over a band of ∼20 nm. The fibers are cheap, spun with a process entirely carried out at room temperature, and shown to have amplified spontaneous emission with good gain coefficients and low levels of optical losses (a few cm(-1)). The amplification process is favored by high fiber quality and low self-absorption. The found performance metrics appear to be suitable for short-distance operations, and the large variety of commercially available doping dyes might allow for effective multiwavelength operations by electrospun amplified fiber optics.

Room temperature single-photon detectors for high bit rate quantum key distribution

DOE Office of Scientific and Technical Information (OSTI.GOV)

Comandar, L. C.; Patel, K. A.; Engineering Department, Cambridge University, 9 J J Thomson Ave., Cambridge CB3 0FA

We report room temperature operation of telecom wavelength single-photon detectors for high bit rate quantum key distribution (QKD). Room temperature operation is achieved using InGaAs avalanche photodiodes integrated with electronics based on the self-differencing technique that increases avalanche discrimination sensitivity. Despite using room temperature detectors, we demonstrate QKD with record secure bit rates over a range of fiber lengths (e.g., 1.26 Mbit/s over 50 km). Furthermore, our results indicate that operating the detectors at room temperature increases the secure bit rate for short distances.

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.

10 CFR 36.67 - Entering and leaving the radiation room.

Code of Federal Regulations, 2011 CFR

2011-01-01

... radiation room of a panoramic irradiator after an irradiation, the irradiator operator shall use a survey... irradiation, the irradiator operator shall: (1) Visually inspect the entire radiation room to verify that no...

10 CFR 36.67 - Entering and leaving the radiation room.

Code of Federal Regulations, 2010 CFR

2010-01-01

... radiation room of a panoramic irradiator after an irradiation, the irradiator operator shall use a survey... irradiation, the irradiator operator shall: (1) Visually inspect the entire radiation room to verify that no...

10 CFR 36.67 - Entering and leaving the radiation room.

Code of Federal Regulations, 2014 CFR

2014-01-01

... radiation room of a panoramic irradiator after an irradiation, the irradiator operator shall use a survey... irradiation, the irradiator operator shall: (1) Visually inspect the entire radiation room to verify that no...

10 CFR 36.67 - Entering and leaving the radiation room.

Code of Federal Regulations, 2012 CFR

2012-01-01

... radiation room of a panoramic irradiator after an irradiation, the irradiator operator shall use a survey... irradiation, the irradiator operator shall: (1) Visually inspect the entire radiation room to verify that no...

10 CFR 36.67 - Entering and leaving the radiation room.

Code of Federal Regulations, 2013 CFR

2013-01-01

... radiation room of a panoramic irradiator after an irradiation, the irradiator operator shall use a survey... irradiation, the irradiator operator shall: (1) Visually inspect the entire radiation room to verify that no...

Microenvironments in swine farrowing rooms: the thermal, lighting and acoustic environments of sows and piglets

USDA-ARS?s Scientific Manuscript database

The present research hypothesized that the thermal, lighting and acoustic environments in commercial swine farrowing rooms vary over time and among crates. The study was conducted in 27 replicates in two commercial farrowing rooms in North Central Indiana, each equipped with 60 farrowing crates. Tem...

Multisensory environments for leisure: promoting well-being in nursing home residents with dementia.

PubMed

Cox, Helen; Burns, Ian; Savage, Sally

2004-02-01

Multisensory environments such as Snoezelen rooms are becoming increasingly popular in health care facilities for older individuals. There is limited reliable evidence of the benefits of such innovations, and the effect they have on residents, caregivers, and visitors in these facilities. This two-stage project examined how effective two types of multisensory environments were in improving the well-being of older individuals with dementia. The two multisensory environments were a Snoezelen room and a landscaped garden. These environments were compared to the experience of the normal living environment. The observed response of 24 residents with dementia in a nursing home was measured during time spent in the Snoezelen room, in the garden, and in the living room. In the second part of the project, face-to-face interviews were conducted with six caregivers and six visitors to obtain their responses to the multisensory environments. These interviews identified the components of the environments most used and enjoyed by residents and the ways in which they could be improved to maximize well-being.

Radiation protection measures: Implications on the design of neurosurgery operating rooms.

PubMed

Delgado-López, Pedro David; Sánchez-Jiménez, Javier; Herrero-Gutiérrez, Ana Isabel; Inclán-Cuesta, María Teresa; Corrales-García, Eva María; Martín-Alonso, Javier; Galacho-Harriero, Ana María; Rodríguez-Salazar, Antonio

To describe pros and cons of some radiation protection measures and the implications on the design of a neurosurgery operating room. Concurring with the acquisition and use of an O-arm device, a structural remodeling of our neurosurgery operating room was carried out. The theater was enlarged, the shielding was reinforced and a foldable leaded screen was installed inside the operating room. Radiation doses were measured in front of and behind the screen. The screen provides whole-body radiation protection for all the personnel inside the theater (effective dose <5μSv at 2,5 m from the gantry per O-arm exploration; 0,0μSv received behind the screen per O-arm exploration; and undetectable cumulative annual radiation dose behind the screen), obviates the need for leaded aprons and personal dosimeters, and minimizes the circulation of personnel. Enlarging the size of the operating room allows storing the equipment inside and minimizes the risk of collision and contamination. Rectangular rooms provide greater distance from the source of radiation. Floor, ceiling and walls shielding, a rectangular-shaped and large enough theater, the presence of a foldable leaded screen, and the security systems precluding an unexpected irruption into the operating room during irradiation are relevant issues to consider when designing a neurosurgery operating theater. Copyright © 2018 Sociedad Española de Neurocirugía. Publicado por Elsevier España, S.L.U. All rights reserved.

The social computing room: a multi-purpose collaborative visualization environment

NASA Astrophysics Data System (ADS)

Borland, David; Conway, Michael; Coposky, Jason; Ginn, Warren; Idaszak, Ray

2010-01-01

The Social Computing Room (SCR) is a novel collaborative visualization environment for viewing and interacting with large amounts of visual data. The SCR consists of a square room with 12 projectors (3 per wall) used to display a single 360-degree desktop environment that provides a large physical real estate for arranging visual information. The SCR was designed to be cost-effective, collaborative, configurable, widely applicable, and approachable for naive users. Because the SCR displays a single desktop, a wide range of applications is easily supported, making it possible for a variety of disciplines to take advantage of the room. We provide a technical overview of the room and highlight its application to scientific visualization, arts and humanities projects, research group meetings, and virtual worlds, among other uses.

Advanced Technologies in Safe and Efficient Operating Rooms

DTIC Science & Technology

2008-02-01

of team leader) o a learning environment (where humans play the role of students ). As can be seen, this work is at the confluence of several lines... Abstract Routine clinical information systems now have the ability to gather large amounts of data that surgical managers can access to create a...project is to create a computer system for teaching medical students cognitive skills of an attending physician related to diagnosing and treating

Residents' reluctance to challenge negative hierarchy in the operating room: a qualitative study.

PubMed

Bould, M Dylan; Sutherland, Stephanie; Sydor, Devin T; Naik, Viren; Friedman, Zeev

2015-06-01

Our aim was to clarify how hierarchy influences residents' reluctance to challenge authority with respect to clearly erroneous medical decision-making. After research ethics approval, we recruited 44 anesthesia residents for a high-fidelity simulation scenario at two Ontario universities. During the scenario, an actor, whom the residents were told was an actual new staff anesthesiologist at their university, asked the trainees to give blood to a Jehovah's Witness in contradiction to the patient's explicitly stated wishes. Following the case, the trainees were debriefed and were interviewed for 30-40 min. The interviews were audio recorded and transcribed verbatim, and the text was coded using a qualitative approach informed by grounded theory. Qualitative analysis of the participants' interviews yielded rich descriptive accounts of hierarchical influences often characterized by fear and intimidation. Residents spoke about their coping strategies, which included adaptability, avoiding conflict, using inquiry as a method for patient advocacy, and relying on a diffusion of responsibility within the larger operating room team. Study results showed that hierarchy played a dominant role in the functioning of the operating room. Participants spoke of both the positive and negative effects of such a hierarchical learning environment. The majority of participants described a negative perception of hierarchy as the norm, and they employed many coping strategies. This study provides insight into how a negative hierarchical culture can adversely impact patient safety, resident learning, and team functioning. We propose a theoretical model to describe challenging authority in this context.

Ergonomics perspective for identifying and reducing internal operative flow disruption for laparoscopic urological surgery.

PubMed

Al-Hakim, Latif; Xiao, Jiaquan; Sengupta, Shomik

2017-12-01

The aim of this study is to examine operative flow disruption that occurs inside the surgical field, (internal operative flow disruption (OFD)), during urological laparoscopies, and to relate those events to external ergonomics environment in terms of monitor location, level of instruments' handles, and location of surgical team members. According to the our best knowledge, this is the first study of its kind. A combination of real and video-aided observational study was conducted in the operating rooms at hospitals in Australia and China. Brain storming sessions were first conducted to identify the main internal OFD events, and the observable reasons, potential external, and latent ergonomic factors were listed. A prospective observational study was then conducted. The observer's records and the related video records of internal surgical fields were analysed. Procedures were categorised into groups based on similarity in ergonomics environment. The mapping process revealed 39 types of internal OFD events resulted from six reasons. A total of 24 procedures were selected and arranged into two groups, each with twelve procedures. Group A was carried out under satisfactory ergonomics environment, while Group B was conducted under unsatisfactory ergonomics environment. A total of 1178 OFD events were detected delaying the total observed operative times (2966 min) by 220 min (7.43%). Average OFD/h in group A was less than 15, while in group B about 29 OFD/h. There are two main latent ergonomics factors affecting the surgeon's performance; non-physiological posture and long-period static posture. The delays and number of internal OFD were nearly doubled where procedures were conducted under unsatisfactory external ergonomics environment. Some events such as stopping operation and irrelevant conversations during long procedures may have a positive influence on the surgeon's performance.

KSC-2009-5248

NASA Image and Video Library

2009-09-25

CAPE CANAVERAL, Fla. – This ribbon cutting officially turns over NASA Kennedy Space Center's Launch Control Center Firing Room 1 from the Space Shuttle Program to the Constellation Program. Participating are (from left) Pepper Phillips, director of the Constellation Project Office at Kennedy; Bob Cabana, Kennedy's director; Robert Crippen, former astronaut; Jeff Hanley, manager of the Constellation Program at NASA's Johnson Space Center; and Nancy Bray, deputy director of Center Operations at Kennedy. The room has undergone demolition and construction and been outfitted with consoles for the upcoming Ares I-X rocket flight test targeted for launch on Oct. 27. As the center of launch operations at Kennedy since the Apollo Program, the Launch Control Center, or LCC, has played a central role in NASA's human spaceflight programs. Firing Room 1 was the first operational firing room constructed. From this room, controllers launched the first Saturn V, the first crewed flight of Saturn V, the first crewed mission to the moon and the first space shuttle. Firing Room 1 will continue this tradition of firsts when controllers launch the Constellation Program's first flight test. Also, this firing room will be the center of operations for the upcoming Ares I and Orion operations. Photo credit: NASA/Kim Shiflett

Design and Development of Functionally Effective Human-Machine Interfaces for Firing Room Displays

NASA Technical Reports Server (NTRS)

Cho, Henry

2013-01-01

This project involves creating software for support equipment used on the Space Launch System (SLS). The goal is to create applications and displays that will be used to remotely operate equipment from the firing room and will continue to support the SLS launch vehicle to the extent of its program. These displays include design practices that help to convey information effectively, such as minimizing distractions at normal operating state and displaying intentional distractions during a warning or alarm state. The general practice for creating an operator display is to reduce the detail of unimportant aspects of the display and promote focus on data and dynamic information. These practices include using minimalist design, using muted tones for background colors, using a standard font at a readable text size, displaying alarms visible for immediate attention, grouping data logically, and displaying data appropriately varying on the type of data. Users of these displays are more likely to stay focused on operating for longer periods by using design practices that reduce eye strain and fatigue. Effective operator displays will improve safety by reducing human errors during operation, which will help prevent catastrophic accidents. This report entails the details of my work on developing remote displays for the Hypergolic fuel servicing system. Before developing a prototype display, the design and requirements of the system are outlined and compiled into a document. Then each subsystem has schematic representations drawn that meet the specifications detailed in the document. The schematics are then used as the outline to create display representations of each subsystem. Each display is first tested individually. Then the displays are integrated with a prototype of the master system, and they are tested in a simulated environment then retested in the real environment. Extensive testing is important to ensure the displays function reliably as intended.

Design and Development of Functionally Effective Human-Machine Interfaces for Firing Room Displays

NASA Technical Reports Server (NTRS)

Cho, Henry

2013-01-01

This project involves creating software for support equipment used on the Space l aunch System (SLS). The goal is to create applications and displays that will be used to remotely operate equipment from the firing room and will continue to support the SLS launch vehicle to the extent of its program. These displays include design practices that help to convey information effectively, such as minimizing distractions at normal operating state and displaying intentional distractions during a warning or alarm state. The general practice for creating an operator display is to reduce the detail of unimportant aspects of the display and promote focus on data and dynamic information. These practices include using minimalist design, using muted tones for background colors, using a standard font at a readable text size, displaying alarms visible for Immediate attention, grouping data logically, and displaying data appropriately varying on the type of data. Users of these displays are more likely to stay focused on operating for longer periods by using design practices that reduce eye strain and fatigue. Effective operator displays will improve safety by reducing human errors during operation, which will help prevent catastrophic accidents. This report entails the details of my work on developing remote displays for the Hypergolics ground system. Before developing a prototype display, the design and requirements of the system are outlined and compiled into a document. Then each subsystem has schematic representations drawn tha.t meet the specifications detailed in the document. The schematics are then used as the outline to create display representations of each subsystem. Each display is first tested individually. Then the displays are integrated with a prototype of the master system, and they are tested in a simulated environment then retested in the real environment. Extensive testing is important to ensure the displays function reliably as intended.

[Comprehensive system integration and networking in operating rooms].

PubMed

Feußner, H; Ostler, D; Kohn, N; Vogel, T; Wilhelm, D; Koller, S; Kranzfelder, M

2016-12-01

A comprehensive surveillance and control system integrating all devices and functions is a precondition for realization of the operating room of the future. Multiple proprietary integrated operation room systems are currently available with a central user interface; however, they only cover a relatively small part of all functionalities. Internationally, there are at least three different initiatives to promote a comprehensive systems integration and networking in the operating room: the Japanese smart cyber operating theater (SCOT), the American medical device plug-and-play interoperability program (MDPnP) and the German secure and dynamic networking in operating room and hospital (OR.NET) project supported by the Federal Ministry of Education and Research. Within the framework of the internationally advanced OR.NET project, prototype solution approaches were realized, which make short-term and mid-term comprehensive data retrieval systems probable. An active and even autonomous control of the medical devices by the surveillance and control system (closed loop) is expected only in the long run due to strict regulatory barriers.

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

NASA Astrophysics Data System (ADS)

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

2010-02-01

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

Immersive virtual reality used as a platform for perioperative training for surgical residents.

PubMed

Witzke, D B; Hoskins, J D; Mastrangelo, M J; Witzke, W O; Chu, U B; Pande, S; Park, A E

2001-01-01

Perioperative preparations such as operating room setup, patient and equipment positioning, and operating port placement are essential to operative success in minimally invasive surgery. We developed an immersive virtual reality-based training system (REMIS) to provide residents (and other health professionals) with training and evaluation in these perioperative skills. Our program uses the qualities of immersive VR that are available today for inclusion in an ongoing training curriculum for surgical residents. The current application consists of a primary platform for patient positioning for a laparoscopic cholecystectomy. Having completed this module we can create many different simulated problems for other procedures. As a part of the simulation, we have devised a computer-driven real-time data collection system to help us in evaluating trainees and providing feedback during the simulation. The REMIS program trains and evaluates surgical residents and obviates the need to use expensive operating room and surgeon time. It also allows residents to train based on their schedule and does not put patients at increased risk. The method is standardized, allows for repetition if needed, evaluates individual performance, provides the possible complications of incorrect choices, provides training in 3-D environment, and has the capability of being used for various scenarios and professions.

Collection and analysis of NASA clean room air samples

NASA Technical Reports Server (NTRS)

Sheldon, L. S.; Keever, J.

1985-01-01

The environment of the HALOE assembly clean room at NASA Langley Research Center is analyzed to determine the background levels of airborne organic compounds. Sampling is accomplished by pumping the clean room air through absorbing cartridges. For volatile organics, cartridges are thermally desorbed and then analyzed by gas chromatography and mass spectrometry, compounds are identified by searching the EPA/NIH data base using an interactive operator INCOS computer search algorithm. For semivolatile organics, cartridges are solvent entracted and concentrated extracts are analyzed by gas chromatography-electron capture detection, compound identification is made by matching gas chromatogram retention times with known standards. The detection limits for the semivolatile organics are; 0.89 ng cu m for dioctylphlhalate (DOP) and 1.6 ng cu m for polychlorinated biphenyls (PCB). The detection limit for volatile organics ranges from 1 to 50 parts per trillion. Only trace quantities of organics are detected, the DOP levels do not exceed 2.5 ng cu m and the PCB levels do not exceed 454 ng cu m.

Toward an Improved Hypersonic Engine Seal

NASA Technical Reports Server (NTRS)

Dunlap, Patrick H., Jr.; Steinetz, Bruce M.; DeMange,Jeffrey J.; Taylor, Shawn C.

2003-01-01

High temperature, dynamic seals are required in advanced engines to seal the perimeters of movable engine ramps for efficient, safe operation in high heat flux environments at temperatures from 2000 to 2500 F. Current seal designs do not meet the demanding requirements for future engines, so NASA s Glenn Research Center (GRC) is developing advanced seals to overcome these shortfalls. Two seal designs and two types of seal preloading devices were evaluated in a series of compression tests at room temperature and 2000 F and flow tests at room temperature. Both seals lost resiliency with repeated load cycling at room temperature and 2000 F, but seals with braided cores were significantly more flexible than those with cores composed of uniaxial ceramic fibers. Flow rates for the seals with cores of uniaxial fibers were lower than those for the seals with braided cores. Canted coil springs and silicon nitride compression springs showed promise conceptually as potential seal preloading devices to help maintain seal resiliency.

[Newly developed monitor for IVR: liquid crystal display (LCD) replaced with cathode ray tube (CRT)].

PubMed

Ichida, Takao; Hosogai, Minoru; Yokoyama, Kouji; Ogawa, Takayoshi; Okusako, Kenji; Shougaki, Masachika; Masai, Hironao; Yamada, Eiji; Okuyama, Kazuo; Hatagawa, Masakatsu

2004-09-01

For physicians who monitor images during interventional radiology (VR), we have built and been using a system that employs a liquid crystal display (LCD) instead of the conventional cathode ray tube (CRT). The system incorporates a ceiling-suspension-type monitor (three-display monitor) with an LCD on each of the three displays for the head and abdominal regions and another ceiling-suspension-type monitor (5-display monitor) with an LCD on each display for the cardiac region. As these monitors are made to be thin and light in weight, they can be placed in a high position in the room, thereby saving space and allowing for more effective use of space in the X-ray room. The system has also improved the efficiency of operators in the IVR room. The three-display folding mechanism allows the displays to be viewed from multiple directions, thereby improving the environment so that the performance of IVR can be observed.

Virtual reality conditioned place preference using monetary reward

PubMed Central

Childs, Emma; Astur, Robert S.; de Wit, Harriet

2017-01-01

Computerized tasks based on conditioned place preference (CPP) methodology offer the opportunity to study learning mechanisms involved in conditioned reward in humans. In this study, we examined acquisition and extinction of a CPP for virtual environments associated with monetary reward ($). Healthy men and women (N=57) completed a computerized CPP task in which they controlled an avatar within a virtual environment. On day 1, subjects completed 6 conditioning trials in which one room was paired with high $ and another with low $. Acquisition of place conditioning was assessed by measuring the time spent in each room during an exploration test of the virtual environments and using self-reported ratings of room liking and preference. Twenty-four hours later, retention and extinction of CPP were assessed during 4 successive exploration tests of the virtual environments. Participants exhibited a place preference for (spent significantly more time in) the virtual room paired with high $ over the one paired with low $ (p=0.015). They also reported that they preferred the high $ room (p<0.001) and liked it significantly more than the low $ room (p<0.001). However, these preferences were short-lived: 24h later subjects did not exhibit a behavioral or subjective preference for the high $ room. These findings show that individuals exhibit transient behavioral and subjective preferences for a virtual environment paired with monetary reward. Variations on this task may be useful to study mechanisms and brain substrates involved in conditioned reward and to examine the influence of drugs upon appetitive conditioning. PMID:28108321

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

PubMed

Matern, U; Koneczny, S

2006-10-01

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

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

PubMed

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

2014-10-15

Retrospective database review. To evaluate whether microscope use during spine procedures is associated with increased operating room times or increased risk of infection. Operating microscopes are commonly used in spine procedures. It is debated whether the use of an operating microscope increases operating room time or confers increased risk of infection. The American College of Surgeons National Surgical Quality Improvement Program database, which includes data from more than 370 participating hospitals, was used to identify patients undergoing elective spinal procedures with and without the use of an operating microscope for the years 2011 and 2012. Bivariate and multivariate linear regressions were used to test the association between microscope use and operating room times. Bivariate and multivariate logistic regressions were similarly conducted to test the association between microscope use and infection occurrence within 30 days of surgery. A total of 23,670 elective spine procedures were identified, of which 2226 (9.4%) used an operating microscope. The average patient age was 55.1±14.4 years. The average operative time (incision to closure) was 125.7±82.0 minutes.Microscope use was associated with minor increases in preoperative room time (+2.9 min, P=0.013), operative time (+13.2 min, P<0.001), and total room time (+18.6 min, 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 nonmicroscope groups for occurrence of any infection, superficial surgical site infection, deep surgical site infection, organ space infection, or sepsis/septic shock, regardless of surgery type. We did not find operating room times or infection risk to be significant deterrents for use of an operating microscope during spine surgery. 3.

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

Shuttle optical environment; Proceedings of the Meeting, Washington, DC, April 23, 24, 1981

NASA Technical Reports Server (NTRS)

Miller, E. R. (Editor); Fazio, G. G.

1982-01-01

The numerical modeling, instrumentation, identification, and procedures to characterize and/or control contamination hazards to equipment used on the Shuttle are discussed. On-orbit pollutants include molecular offgassing and outgassing, particulate material, and substances from thrusters, vents, and leaks. Clean-rooms are being implemented in ground assembly and integration facilities. Attention is given to an upgraded SPACE program for numerically modeling contamination pathways and appropriate procedures to protect instrumentation from film and particulate deposition. Finally, attention is given to military cryogenic IR detectors being employed to quantify the Shuttle thermal and solid pollutant environment on-orbit as a prelude to future operational IR sensors.

Information Foraging in Nuclear Power Plant Control Rooms

DOE Office of Scientific and Technical Information (OSTI.GOV)

R.L. Boring

2011-09-01

nformation foraging theory articulates the role of the human as an 'informavore' that seeks information and follows optimal foraging strategies (i.e., the 'information scent') to find meaningful information. This paper briefly reviews the findings from information foraging theory outside the nuclear domain and then discusses the types of information foraging strategies operators employ for normal and off-normal operations in the control room. For example, operators may employ a predatory 'wolf' strategy of hunting for information in the face of a plant upset. However, during routine operations, the operators may employ a trapping 'spider' strategy of waiting for relevant indicators tomore » appear. This delineation corresponds to information pull and push strategies, respectively. No studies have been conducted to determine explicitly the characteristics of a control room interface that is optimized for both push and pull information foraging strategies, nor has there been empirical work to validate operator performance when transitioning between push and pull strategies. This paper explores examples of control room operators as wolves vs. spiders and con- cludes by proposing a set of research questions to investigate information foraging in control room settings.« less

Explicit crystal host effects on excited state properties of linear polyacenes: towards a room-temperature maser

NASA Astrophysics Data System (ADS)

Charlton, Robert; Bogatko, Stuart; Zuehlsdorff, Tim; Hine, Nicholas; Horsfield, Andrew; Haynes, Peter

Maser technology has been held back for decades by the impracticality of the operating conditions of traditional masing devices, such as cryogenic freezing and strong magnetic fields. Recently it has been experimentally demonstrated that pentacene in p-terphenyl can act as a viable solid-state room-temperature maser by exploiting the alignment of the low-lying singlet and triplet excited states of pentacene. To understand the operation of this device from first principles, an ab initio study of the excitonic properties of pentacene in p-terphenyl has been carried out using time-dependent density functional theory (TDDFT), implemented in the linear-scaling ONETEP software (www.onetep.org). In particular, we focus on the impact that the wider crystal has on the localised pentacene excitations by performing an explicit DFT treatment of the p-terphenyl environment. We demonstrate the importance of explicit crystal host effects in calculating the excitation energies of pentacene in p-terphenyl, providing important information for the operation of the maser. We then use this same approach to test the viability of other linear polyacenes as maser candidates as a screening step before experimental testing.

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.

Packaging Technology Developed for High-Temperature Silicon Carbide Microsystems

NASA Technical Reports Server (NTRS)

Chen, Liang-Yu; Hunter, Gary W.; Neudeck, Philip G.

2001-01-01

High-temperature electronics and sensors are necessary for harsh-environment space and aeronautical applications, such as sensors and electronics for space missions to the inner solar system, sensors for in situ combustion and emission monitoring, and electronics for combustion control for aeronautical and automotive engines. However, these devices cannot be used until they can be packaged in appropriate forms for specific applications. Suitable packaging technology for operation temperatures up to 500 C and beyond is not commercially available. Thus, the development of a systematic high-temperature packaging technology for SiC-based microsystems is essential for both in situ testing and commercializing high-temperature SiC sensors and electronics. In response to these needs, researchers at Glenn innovatively designed, fabricated, and assembled a new prototype electronic package for high-temperature electronic microsystems using ceramic substrates (aluminum nitride and aluminum oxide) and gold (Au) thick-film metallization. Packaging components include a ceramic packaging frame, thick-film metallization-based interconnection system, and a low electrical resistance SiC die-attachment scheme. Both the materials and fabrication process of the basic packaging components have been tested with an in-house-fabricated SiC semiconductor test chip in an oxidizing environment at temperatures from room temperature to 500 C for more than 1000 hr. These test results set lifetime records for both high-temperature electronic packaging and high-temperature electronic device testing. As required, the thick-film-based interconnection system demonstrated low (2.5 times of the room-temperature resistance of the Au conductor) and stable (decreased 3 percent in 1500 hr of continuous testing) electrical resistance at 500 C in an oxidizing environment. Also as required, the electrical isolation impedance between printed wires that were not electrically joined by a wire bond remained high (greater than 0.4 GW) at 500 C in air. The attached SiC diode demonstrated low (less than 3.8 W/mm2) and relatively consistent dynamic resistance from room temperature to 500 C. These results indicate that the prototype package and the compatible die-attach scheme meet the initial design standards for high-temperature, low-power, and long-term operation. This technology will be further developed and evaluated, especially with more mechanical tests of each packaging element for operation at higher temperatures and longer lifetimes.

A simulator-based nuclear reactor emergency response training exercise.

PubMed

Waller, Edward; Bereznai, George; Shaw, John; Chaput, Joseph; Lafortune, Jean-Francois

Training offsite emergency response personnel basic awareness of onsite control room operations during nuclear power plant emergency conditions was the primary objective of a week-long workshop conducted on a CANDU® virtual nuclear reactor simulator available at the University of Ontario Institute of Technology, Oshawa, Canada. The workshop was designed to examine both normal and abnormal reactor operating conditions, and to observe the conditions in the control room that may have impact on the subsequent offsite emergency response. The workshop was attended by participants from a number of countries encompassing diverse job functions related to nuclear emergency response. Objectives of the workshop were to provide opportunities for participants to act in the roles of control room personnel under different reactor operating scenarios, providing a unique experience for participants to interact with the simulator in real-time, and providing increased awareness of control room operations during accident conditions. The ability to "pause" the simulator during exercises allowed the instructors to evaluate and critique the performance of participants, and to provide context with respect to potential offsite emergency actions. Feedback from the participants highlighted (i) advantages of observing and participating "hands-on" with operational exercises, (ii) their general unfamiliarity with control room operational procedures and arrangements prior to the workshop, (iii) awareness of the vast quantity of detailed control room procedures for both normal and transient conditions, and (iv) appreciation of the increased workload for the operators in the control room during a transient from normal operations. Based upon participant feedback, it was determined that the objectives of the training had been met, and that future workshops should be conducted.

Designing Facilities for Collaborative Operations

NASA Technical Reports Server (NTRS)

Norris, Jeffrey; Powell, Mark; Backes, Paul; Steinke, Robert; Tso, Kam; Wales, Roxana

2003-01-01

A methodology for designing operational facilities for collaboration by multiple experts has begun to take shape as an outgrowth of a project to design such facilities for scientific operations of the planned 2003 Mars Exploration Rover (MER) mission. The methodology could also be applicable to the design of military "situation rooms" and other facilities for terrestrial missions. It was recognized in this project that modern mission operations depend heavily upon the collaborative use of computers. It was further recognized that tests have shown that layout of a facility exerts a dramatic effect on the efficiency and endurance of the operations staff. The facility designs (for example, see figure) and the methodology developed during the project reflect this recognition. One element of the methodology is a metric, called effective capacity, that was created for use in evaluating proposed MER operational facilities and may also be useful for evaluating other collaboration spaces, including meeting rooms and military situation rooms. The effective capacity of a facility is defined as the number of people in the facility who can be meaningfully engaged in its operations. A person is considered to be meaningfully engaged if the person can (1) see, hear, and communicate with everyone else present; (2) see the material under discussion (typically data on a piece of paper, computer monitor, or projection screen); and (3) provide input to the product under development by the group. The effective capacity of a facility is less than the number of people that can physically fit in the facility. For example, a typical office that contains a desktop computer has an effective capacity of .4, while a small conference room that contains a projection screen has an effective capacity of around 10. Little or no benefit would be derived from allowing the number of persons in an operational facility to exceed its effective capacity: At best, the operations staff would be underutilized; at worst, operational performance would deteriorate. Elements of this methodology were applied to the design of three operations facilities for a series of rover field tests. These tests were observed by human-factors researchers and their conclusions are being used to refine and extend the methodology to be used in the final design of the MER operations facility. Further work is underway to evaluate the use of personal digital assistant (PDA) units as portable input interfaces and communication devices in future mission operations facilities. A PDA equipped for wireless communication and Ethernet, Bluetooth, or another networking technology would cost less than a complete computer system, and would enable a collaborator to communicate electronically with computers and with other collaborators while moving freely within the virtual environment created by a shared immersive graphical display.

Protective environment for hematopoietic cell transplant (HSCT) recipients: The Infectious Diseases Working Party EBMT analysis of global recommendations on health-care facilities.

PubMed

Styczynski, Jan; Tridello, Gloria; Donnelly, J Peter; Iacobelli, Simona; Hoek, Jennifer; Mikulska, Malgorzata; Aljurf, Mahmoud; Gil, Lidia; Cesaro, Simone

2018-03-13

International guidelines on protective environment for HSCT recipients proposed a set of 10 global recommendations in 2009 on protective environment (GRPE) concerning hospital room design and ventilation. The EBMT Infectious Diseases Working Party undertook a survey on the status on protective environment for HSCT recipients with the aim of surveying current practices and their agreement with GRPE recommendations. The questionnaire consisted of 37 questions divided into 5 sections about filtration, air changes, maintenance, and the protective environment in rooms and the surrounding unit. Overall, 177 centres (response rate 33%) from 36 countries responded, indicating that 99.4% of patient rooms were equipped with HEPA filters, but only 48.6% of the centre's staff were aware of, and could confirm, regular replacement of filters based on manufacturers' recommendations. Well-sealed rooms were used in terms of windows (70.6%), ceilings (35%), and plumbing pipes (51.4%). The sensor monitors in the patient room used to determine when the HEPA filters require changing were installed only in 18.1% of centres. Only 1 centre fulfilled all 10 GRPE recommendations, while 62 centres fulfilled the 3 level "A" recommendations. In conclusion, HEPA-filtered rooms are available in almost all centres, while fewer centres fulfilled other requirements. Knowledge on the details and maintenance of protective environments in the HSCT setting was inadequate, reflecting a lack of communication between the health personnel involved, hospital infection control and the hospital maintenance services.

Comparison of three distinct clean air suits to decrease the bacterial load in the operating room: an observational study.

PubMed

Kasina, Piotr; Tammelin, Ann; Blomfeldt, Anne-Marie; Ljungqvist, Bengt; Reinmüller, Berit; Ottosson, Carin

2016-01-01

Lowering air-borne bacteria counts in the operating room is essential in prevention of surgical site infections in orthopaedic joint replacement surgery. This is mainly achieved by decreasing bacteria counts through dilution, with appropriate ventilation and by limiting the bacteria carrying skin particles, predominantly shed by the personnel. The aim of this study was to investigate if a single use polypropylene clothing system or a reusable polyester clothing system could offer similar air quality in the operating room as a mobile laminar airflow device-assisted reusable cotton/polyester clothing system. Prospective observational study design, comparing the performance of three Clean Air Suits by measuring Colony Forming Units (CFU)/m(3) of air during elective hip and knee arthroplasties, performed at a large university-affiliated hospital. The amount of CFU/m(3) of air was measured during 37 operations of which 13 were performed with staff dressed in scrub suits made of a reusable mixed material (69 % cotton, 30 % polyester, 1 % carbon fibre) accompanied by two mobile laminar airflow units. During 24 procedures no mobile laminar airflow units were used, 13 with staff using a reusable olefin fabric clothing (woven polypropylene) and 11 with staff dressed in single-use suits (non-woven spunbonded polypropylene). Air from the operating field was sampled through a filter, by a Sartorius MD8, and bacterial colonies were counted after incubation. There were 6-8 measurements from each procedure, in total 244 measurements. Statistical analysis was performed by Mann-Whitney U-test. The single-use polypropylene suit reduced the amount of CFU/m(3) to a significantly lower level than both other clothing systems. Single-use polypropylene clothing systems can replace mobile laminar airflow unit-assisted reusable mixed material-clothing systems. Measurements in standardized laboratory settings can only serve as guidelines as environments in real operation settings present a much more difficult challenge.

Impact of the reduction of anaesthesia turnover time on operating room efficiency.

PubMed

Sokolovic, E; Biro, P; Wyss, P; Werthemann, C; Haller, U; Spahn, D; Szucs, T

2002-08-01

We investigated whether an increase in anaesthesia staffing to permit induction of anaesthesia before the previous case had ended ('overlapping') would increase overall efficiency in the operating room. Hitherto, the average duration of operating sessions was too long, thus impeding the timely commencement of physicians' ward duties. The investigation was designed as a prospective, non-randomized, interrupted time-series analysis divided into three phases: (a) a baseline of 3.5 months, (b) a 2.5 month intervention phase, in which anaesthesia staffing was increased by one attending physician and one nurse, and (c) a further 2 months under baseline conditions. Data focussed on process management were collected from operating room staff, anaesthesia personnel and surgeons using a structured questionnaire collected daily during the entire study. Turnover time between consecutive operations decreased from 65 to 52 min per operation (95% CI: 9; 17; P = 0.0001). Operating room occupancy increased from 4:28 to 5:27 h day-1 (95% CI: 50; 68; P = 0.005). The surgeons began their work on the ward 35 min (95% CI: 30; 40) later than before the intervention and their overtime increased from 22:36 to 139:50 h. The time between surgical operations decreased significantly. Increased operating room efficiency owing to overlapping induction of anaesthesia allows more intense scheduling of operations. Thus, physicians and nurses can be released to spend more time with their patients in the ward. Improving the efficiency of the operating room alone is insufficient to improve human resource management at all levels of a surgical clinic.

[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.

Impact of Operating Room Environment on Postoperative Central Nervous System Infection in a Resource-Limited Neurosurgical Center in South Asia.

PubMed

Chidambaram, Swathi; Vasudevan, Madabushi Chakravarthy; Nair, Mani Nathan; Joyce, Cara; Germanwala, Anand V

2018-02-01

Postoperative central nervous system infections (PCNSIs) are serious complications following neurosurgical intervention. We previously investigated the incidence and causative pathogens of PCNSIs at a resource-limited, neurosurgical center in south Asia. This follow-up study was conducted to analyze differences in PCNSIs at the same institution following only one apparent change: the operating room air filtration system. This was a retrospective study of all neurosurgical cases performed between December 1, 2013, and March 31, 2016 at our center. Providers, patient demographic data, case types, perioperative care, rate of PCNSI, and rates of other complications were reviewed. These results were then compared with the findings of our previous study of neurosurgical cases between June 1, 2012, and June 30, 2013. All 623 neurosurgical operative cases over the study period were reviewed. Four patients (0.6%) had a PCNSI, and no patients had a positive cerebrospinal fluid (CSF) culture. In the previous study, among 363 cases, 71 patients (19.6%) had a PCNSI and 7 (1.9%) had a positive CSF culture (all Gram-negative organisms). The differences in both parameters are statistically significant (P < 0.001). Between the 2 studies, there was no change in treatment providers, case types, case durations, antibiotic administration practices, and patient demographics. The rates of PCNSI and positive CSF culture were significantly lower in our present cohort compared with the cohort in our previous study. The sole apparent change involves the air filtration system inside the neurosurgical operating rooms; this environmental change occurred during the 5 months between the 2 studies. This study demonstrates the impact of environmental factors in reducing infections. Copyright © 2017 Elsevier Inc. All rights reserved.

In situ antimicrobial behavior of materials with copper-based additives in a hospital environment.

PubMed

Palza, Humberto; Nuñez, Mauricio; Bastías, Roberto; Delgado, Katherine

2018-06-01

Copper and its alloys are effective antimicrobial surface materials in the laboratory and in clinical trials. Copper has been used in the healthcare setting to reduce environmental contamination, and thus prevent healthcare-associated infections, complementing traditional protocols. The addition of copper nanoparticles to polymer/plastic matrices can also produce antimicrobial materials, as confirmed under laboratory conditions. However, there is a lack of studies validating the antimicrobial effects of these nanocomposite materials in clinical trials. To satisfy this issue, plastic waiting room chairs with embedded metal copper nanoparticles, and metal hospital IV pools coated with an organic paint with nanostructured zeolite/copper particles were produced and tested in a hospital environment. These prototypes were sampled once weekly for 10 weeks and the viable microorganisms were analysed and compared with the copper-free materials. In the waiting rooms, chairs with copper reduced by around 73% the total viable microorganisms present, showing activity regardless of the microorganism tested. Although there were only low levels of microorganisms in the IV pools installed in operating rooms because of rigorous hygiene protocols, samples with copper presented lower total viable microorganisms than unfilled materials. Some results did not have statistical significance because of the low load of microorganisms; however, during at least three weeks the IV pools with copper had reduced levels of microorganisms by a statistically significant 50%. These findings show for the first time the feasibility of utilizing the antimicrobial property of copper by adding nanosized fillers to other materials in a hospital environment. Copyright © 2018 Elsevier B.V. and International Society of Chemotherapy. All rights reserved.

Cognitive Task Analysis of the HALIFAX-Class Operations Room Officer

DTIC Science & Technology

1999-03-10

Image Cover Sheet CLASSIFICATION SYSTEM NUMBER 510918 UNCLASSIFIED llllllllllllllllllllllllllllllllllllllll TITLE COGNITIVE TASK ANALYSIS OF THE...DATES COVERED 00-00-1999 to 00-00-1999 4. TITLE AND SUBTITLE Cognitive Task Analysis of the HALIFAX-Class Operations Room Officer 5a. CONTRACT...Ontario . ~ -- . ’ c ... - Incorporated Cognitive Task Analysis of the HALIFAX-Class Operations Room Officer: PWGSC Contract No. W7711-7-7404/001/SV

[Cleanliness in the operating room].

PubMed

Suzuki, Toshiyasu

2010-05-01

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

Multichannel System Based on a High Sensitivity Superconductive Sensor for Magnetoencephalography

PubMed Central

Rombetto, Sara; Granata, Carmine; Vettoliere, Antonio; Russo, Maurizio

2014-01-01

We developed a multichannel system based on superconducting quantum interference devices (SQUIDs) for magnetoencephalography measurements. Our system consists of 163 fully-integrated SQUID magnetometers, 154 channels and 9 references, and all of the operations are performed inside a magnetically-shielded room. The system exhibits a magnetic field noise spectral density of approximatively 5 fT/Hz1/2. The presented magnetoencephalography is the first system working in a clinical environment in Italy. PMID:25006995

KENNEDY SPACE CENTER, FLA. - In the high bay clean room at the Astrotech Space Operations processing facilities near KSC, workers prepare NASA’s MESSENGER spacecraft for transfer to a work stand. There employees of the Johns Hopkins University Applied Physics Laboratory, builders of the spacecraft, will perform an initial state-of-health check. Then processing for launch can begin, including checkout of the power systems, communications systems and control systems. The thermal blankets will also be attached for flight. MESSENGER - short for MErcury Surface, Space ENvironment, GEochemistry and Ranging - will be launched May 11 on a six-year mission aboard a Boeing Delta II rocket. Liftoff is targeted for 2:26 a.m. EDT on Tuesday, May 11.

NASA Image and Video Library

2004-03-10

KENNEDY SPACE CENTER, FLA. - In the high bay clean room at the Astrotech Space Operations processing facilities near KSC, workers prepare NASA’s MESSENGER spacecraft for transfer to a work stand. There employees of the Johns Hopkins University Applied Physics Laboratory, builders of the spacecraft, will perform an initial state-of-health check. Then processing for launch can begin, including checkout of the power systems, communications systems and control systems. The thermal blankets will also be attached for flight. MESSENGER - short for MErcury Surface, Space ENvironment, GEochemistry and Ranging - will be launched May 11 on a six-year mission aboard a Boeing Delta II rocket. Liftoff is targeted for 2:26 a.m. EDT on Tuesday, May 11.

KENNEDY SPACE CENTER, FLA. - At the Astrotech Space Operations processing facilities near KSC, workers begin moving NASA’s MESSENGER spacecraft into the building MESSENGER - short for MErcury Surface, Space ENvironment, GEochemistry and Ranging - is being taken into a high bay clean room where employees of the Johns Hopkins University Applied Physics Laboratory, builders of the spacecraft, will perform an initial state-of-health check. Then processing for launch can begin, including checkout of the power systems, communications systems and control systems. The thermal blankets will also be attached for flight. MESSENGER will be launched May 11 on a six-year mission aboard a Boeing Delta II rocket. Liftoff is targeted for 2:26 a.m. EDT on Tuesday, May 11.

NASA Image and Video Library

2004-03-10

KENNEDY SPACE CENTER, FLA. - At the Astrotech Space Operations processing facilities near KSC, workers begin moving NASA’s MESSENGER spacecraft into the building MESSENGER - short for MErcury Surface, Space ENvironment, GEochemistry and Ranging - is being taken into a high bay clean room where employees of the Johns Hopkins University Applied Physics Laboratory, builders of the spacecraft, will perform an initial state-of-health check. Then processing for launch can begin, including checkout of the power systems, communications systems and control systems. The thermal blankets will also be attached for flight. MESSENGER will be launched May 11 on a six-year mission aboard a Boeing Delta II rocket. Liftoff is targeted for 2:26 a.m. EDT on Tuesday, May 11.

KENNEDY SPACE CENTER, FLA. - At the Astrotech Space Operations processing facilities near KSC, a lift begins lowering NASA’s MESSENGER spacecraft onto the ground. MESSENGER - short for MErcury Surface, Space ENvironment, GEochemistry and Ranging - will be taken into a high bay clean room and employees of the Johns Hopkins University Applied Physics Laboratory, builders of the spacecraft, will perform an initial state-of-health check. Then processing for launch can begin, including checkout of the power systems, communications systems and control systems. The thermal blankets will also be attached for flight. MESSENGER will be launched May 11 on a six-year mission aboard a Boeing Delta II rocket. Liftoff is targeted for 2:26 a.m. EDT on Tuesday, May 11.

NASA Image and Video Library

2004-03-10

KENNEDY SPACE CENTER, FLA. - At the Astrotech Space Operations processing facilities near KSC, a lift begins lowering NASA’s MESSENGER spacecraft onto the ground. MESSENGER - short for MErcury Surface, Space ENvironment, GEochemistry and Ranging - will be taken into a high bay clean room and employees of the Johns Hopkins University Applied Physics Laboratory, builders of the spacecraft, will perform an initial state-of-health check. Then processing for launch can begin, including checkout of the power systems, communications systems and control systems. The thermal blankets will also be attached for flight. MESSENGER will be launched May 11 on a six-year mission aboard a Boeing Delta II rocket. Liftoff is targeted for 2:26 a.m. EDT on Tuesday, May 11.

KENNEDY SPACE CENTER, FLA. - In the high bay clean room at the Astrotech Space Operations processing facilities near KSC, workers get ready to remove the protective cover from NASA’s MESSENGER spacecraft. Employees of the Johns Hopkins University Applied Physics Laboratory, builders of the spacecraft, will perform an initial state-of-health check. Then processing for launch can begin, including checkout of the power systems, communications systems and control systems. The thermal blankets will also be attached for flight. MESSENGER - short for MErcury Surface, Space ENvironment, GEochemistry and Ranging - will be launched May 11 on a six-year mission aboard a Boeing Delta II rocket. Liftoff is targeted for 2:26 a.m. EDT on Tuesday, May 11.

NASA Image and Video Library

2004-03-10

KENNEDY SPACE CENTER, FLA. - In the high bay clean room at the Astrotech Space Operations processing facilities near KSC, workers get ready to remove the protective cover from NASA’s MESSENGER spacecraft. Employees of the Johns Hopkins University Applied Physics Laboratory, builders of the spacecraft, will perform an initial state-of-health check. Then processing for launch can begin, including checkout of the power systems, communications systems and control systems. The thermal blankets will also be attached for flight. MESSENGER - short for MErcury Surface, Space ENvironment, GEochemistry and Ranging - will be launched May 11 on a six-year mission aboard a Boeing Delta II rocket. Liftoff is targeted for 2:26 a.m. EDT on Tuesday, May 11.

KENNEDY SPACE CENTER, FLA. - At the Astrotech Space Operations processing facilities near KSC, workers check the moveable pallet holding NASA’s MESSENGER spacecraft. MESSENGER - short for MErcury Surface, Space ENvironment, GEochemistry and Ranging - will be taken into a high bay clean room and employees of the Johns Hopkins University Applied Physics Laboratory, builders of the spacecraft, will perform an initial state-of-health check. Then processing for launch can begin, including checkout of the power systems, communications systems and control systems. The thermal blankets will also be attached for flight. MESSENGER will be launched May 11 on a six-year mission aboard a Boeing Delta II rocket. Liftoff is targeted for 2:26 a.m. EDT on Tuesday, May 11.

NASA Image and Video Library

2004-03-10

KENNEDY SPACE CENTER, FLA. - At the Astrotech Space Operations processing facilities near KSC, workers check the moveable pallet holding NASA’s MESSENGER spacecraft. MESSENGER - short for MErcury Surface, Space ENvironment, GEochemistry and Ranging - will be taken into a high bay clean room and employees of the Johns Hopkins University Applied Physics Laboratory, builders of the spacecraft, will perform an initial state-of-health check. Then processing for launch can begin, including checkout of the power systems, communications systems and control systems. The thermal blankets will also be attached for flight. MESSENGER will be launched May 11 on a six-year mission aboard a Boeing Delta II rocket. Liftoff is targeted for 2:26 a.m. EDT on Tuesday, May 11.

Operator Support System Design forthe Operation of RSG-GAS Research Reactor

NASA Astrophysics Data System (ADS)

Santoso, S.; Situmorang, J.; Bakhri, S.; Subekti, M.; Sunaryo, G. R.

2018-02-01

The components of RSG-GAS main control room are facing the problem of material ageing and technology obsolescence as well, and therefore the need for modernization and refurbishment are essential. The modernization in control room can be applied on the operator support system which bears the function in providing information for assisting the operator in conducting diagnosis and actions. The research purpose is to design an operator support system for RSG-GAS control room. The design was developed based on the operator requirement in conducting task operation scenarios and the reactor operation characteristics. These scenarios include power operation, low power operation and shutdown/scram reactor. The operator support system design is presented in a single computer display which contains structure and support system elements e.g. operation procedure, status of safety related components and operational requirements, operation limit condition of parameters, alarm information, and prognosis function. The prototype was developed using LabView software and consisted of components structure and features of the operator support system. Information of each component in the operator support system need to be completed before it can be applied and integrated in the RSG-GAS main control room.

Study of a dry room in a battery manufacturing plant using a process model

NASA Astrophysics Data System (ADS)

Ahmed, Shabbir; Nelson, Paul A.; Dees, Dennis W.

2016-09-01

The manufacture of lithium ion batteries requires some processing steps to be carried out in a dry room, where the moisture content should remain below 100 parts per million. The design and operation of such a dry room adds to the cost of the battery. This paper studied the humidity management of the air to and from the dry room to understand the impact of design and operating parameters on the energy demand and the cost contribution towards the battery manufacturing cost. The study was conducted with the help of a process model for a dry room with a volume of 16,000 cubic meters. For a defined base case scenario it was found that the dry room operation has an energy demand of approximately 400 kW. The paper explores some tradeoffs in design and operating parameters by looking at the humidity reduction by quenching the make-up air vs. at the desiccant wheel, and the impact of the heat recovery from the desiccant regeneration cycle.

Motion sickness and development of synergy within the spatial orientation system. A hypothetical unifying concept

NASA Technical Reports Server (NTRS)

Guedry, F. E.; Rupert, A. R.; Reschke, M. F.

1998-01-01

Adaptation to research paradigms such as rotating rooms and optical alteration of visual feedback during movement results in development of perceptual-motor programs that provide the reflexive assistance that is necessary to skilled control of movement and balance. The discomfort and stomach awareness that occur during the adaptation process has been attributed to conflicting sensory information about the state of motion. Vestibular signals depend on the kinematics of head movements irrespective of the presence or absence of signals from other senses. We propose that sensory conflict when vestibular signals are at least one component of the conflict are innately disturbing and unpleasant. This innate reaction is part of a continuum that operates early in life to prevent development of inefficient perceptual-motor programs. This reaction operates irrespective of and in addition to reward and punishment from parental guidance or goal attainment to yield efficient control of whole body movement in the operating environment of the individual. The same mechanism is involved in adapting the spatial orientation system to strange environments. This conceptual model "explains" why motion sickness is associated with adaptation to novel environments and is in general consistent with motion sickness literature.

The Operating Room of the Future Versus the Future of the Operating Room.

PubMed

Kassam, Amin B; Rovin, Richard A; Walia, Sarika; Chakravarthi, Srikant; Celix, Juanita; Jennings, Jonathan; Khalili, Sammy; Gonen, Lior; Monroy-Sosa, Alejandro; Fukui, Melanie B

2017-06-01

Technological advancement in the operating room is evolving into a dynamic system mirroring that of the aeronautics industry. Through data visualization, information is continuously being captured, collected, and stored on a scalable informatics platform for rapid, intuitive, iterative learning. The authors believe this philosophy (paradigm) will feed into an intelligent informatics domain fully accessible to all and geared toward precision, cell-based therapy in which tissue can be targeted and interrogated in situ. In the future, the operating room will be a venue that facilitates this real-time tissue interrogation, which will guide in situ therapeutics to restore the state of health. Copyright © 2017 Elsevier Inc. All rights reserved.

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

Code of Federal Regulations, 2011 CFR

2011-07-01

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

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

Code of Federal Regulations, 2010 CFR

2010-07-01

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

SiC-based neutron detector in quasi-realistic working conditions: efficiency and stability at room and high temperature under fast neutron irradiations

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ferone, Raffaello; Issa, Fatima; Ottaviani, Laurent

In the framework of the European I SMART project, we have designed and made new SiC-based nuclear radiation detectors able to operate in harsh environments and to detect both fast and thermal neutrons. In this paper, we report experimental results of fast neutron irradiation campaign at high temperature (106 deg. C) in quasi-realistic working conditions. Our device does not suffer from high temperature, and spectra do show strong stability, preserving features. These experiments, as well as others in progress, show the I SMART SiC-based device skills to operate in harsh environments, whereas other materials would strongly suffer from degradation. Workmore » is still demanded to test our device at higher temperatures and to enhance efficiency in order to make our device fully exploitable from an industrial point of view. (authors)« less

Indoor air bacterial load and antibiotic susceptibility pattern of isolates in operating rooms and surgical wards at jimma university specialized hospital, southwest ethiopia.

PubMed

Genet, Chalachew; Kibru, Gebre; Tsegaye, Wondewosen

2011-03-01

Surgical site infection is the second most common health care associated infection. One of the risk factors for such infection is bacterial contamination of operating rooms' and surgical wards' indoor air. In view of that, the microbiological quality of air can be considered as a mirror of the hygienic condition of these rooms. Thus, the objective of this study was to determine the bacterial load and antibiotic susceptibility pattern of isolates in operating rooms' and surgical wards' indoor air of Jimma University Specialized Hospital. A cross sectional study was conducted to measure indoor air microbial quality of operating rooms and surgical wards from October to January 2009/2010 on 108 indoor air samples collected in twelve rounds using purposive sampling technique by Settle Plate Method (Passive Air Sampling following 1/1/1 Schedule). Sample processing and antimicrobial susceptibility testing were done following standard bacteriological techniques. The data was analyzed using SPSS version 16 and interpreted according to scientifically determined baseline values initially suggested by Fisher. The mean aerobic colony counts obtained in OR-1(46cfu/hr) and OR-2(28cfu/hr) was far beyond the set 5-8cfu/hr acceptable standards for passive room. Similarly the highest mean aerobic colony counts of 465cfu/hr and 461cfu/hr were observed in Female room-1 and room-2 respectively when compared to the acceptable range of 250-450cfu/hr. In this study only 3 isolates of S. pyogenes and 48 isolates of S. aureus were identified. Over 66% of S. aureus was identified in Critical Zone of Operating rooms. All isolates of S. aureus showed 100% and 82.8% resistance to methicillin and ampicillin respectively. Higher degree of aerobic bacterial load was measured from operating rooms' and surgical wards' indoor air. Reducing foot trafficking, improving the ventilation system and routine cleaning has to be made to maintain the aerobic bacteria load with in optimal level.

Thermal responses from repeated exposures to severe cold with intermittent warmer temperatures.

PubMed

Ozaki, H; Enomoto-Koshimizu, H; Tochihara, Y; Nakamura, K

1998-09-01

This study was conducted to evaluate physiological reaction and manual performance during exposure to warm (30 degrees C) and cool (10 degrees C) environments after exposure to very low temperatures (-25 degrees C). Furthermore, this experiment was conducted to study whether it is desirable to remove cold-protective jackets in warmer rooms after severe cold exposure. Eight male students remained in an extremely cold room for 20 min, after which they transferred into either the warm room or the cool room for 20 min. This pattern was repeated three times, and the total cold exposure time was 60 min. In the warm and cool rooms, the subjects either removed their cold-protective jackets (Condition A), or wore them continuously (Condition B). Rectal temperature, skin temperatures, manual performance, blood pressure, thermal, comfort and pain sensations were measured during the experiment. The effects of severe cold on almost all measurements in the cool (10 degrees C) environment were greater than those in the warm (30 degrees C) environment under both clothing conditions. The effects of severe cold on all measurements under Condition A except rectal temperature and toe skin temperature were significantly greater than those under Condition B in the cool environment but, not at all differences between Condition A and Condition B in the warm environments were significant. It was recognized that to remove cold-protective jackets in the cool room (10 degrees C) after severe cold exposure promoted the effects of severe cold. When rewarming in the warm resting room (30 degrees C), the physiological and psychological responses and manual performance were not influenced by the presence or absence of cold-protective clothing. These results suggest that it is necessary for workers to make sure to rewarm in the warm room outside of the cold storage and continue to wear cold-protective clothing in the cool room.

Prevention of 3 "never events" in the operating room: fires, gossypiboma, and wrong-site surgery.

PubMed

Zahiri, Hamid R; Stromberg, Jeffrey; Skupsky, Hadas; Knepp, Erin K; Folstein, Matthew; Silverman, Ronald; Singh, Devinder

2011-03-01

This study sought to identify and provide preventative recommendations for potentially devastating safety violations in the operating room. A Medline database search from 1950 to current using the terms patient safety and operating room was conducted. All topics identified were reviewed. Three patient safety violations with potential for immediate and devastating outcomes were selected for discussion using evidence-based literature. The search identified 2851 articles, 807 of which were directly related to patient safety in the operating room. Topics addressed by these 807 included infectious complications (26%), fires (11%), communication/teamwork (6%), retained foreign objects (3%), safety checklists (1%), and wrong-site surgery (1%). Fires, gossypiboma, and wrong-site surgery were selected for discussion. Although fire, gossypiboma, and wrong-site surgery should be "never events" in the operating room, they continue to persist as 3 common patient safety violations. This study provides the epidemiology, common etiologies, and evidence-based preventative recommendations for each.

Retrospective Chart Review of Skin-to-Skin Contact in the Operating Room and Administration of Analgesic and Anxiolytic Medication to Women After Cesarean Birth.

PubMed

Wagner, Debra L; Lawrence, Stephen; Xu, Jing; Melsom, Janice

2018-04-01

Transporting a newborn out of the operating room after cesarean birth can contribute to maternal awareness of discomfort, anxiety, and the need for administration of analgesics and anxiolytics for relief. This retrospective study analyzed the association between skin-to-skin contact in the operating room and administration of analgesics and anxiolytics to women in the operating and recovery rooms after cesarean birth. Our results indicated a trend toward decreased medication administration for women who experienced skin-to-skin contact and add to evidence supporting the incorporation of skin-to-skin contact in the operating room as the standard of care for cesarean birth. This practice has the potential to enhance the birth experience, promote breastfeeding, and provide greater safety with less exposure to opioids and benzodiazepines for women and their newborns. © 2018 AWHONN, the Association of Women’s Health, Obstetric and Neonatal Nurses.

Wayfinding and Glaucoma: A Virtual Reality Experiment.

PubMed

Daga, Fábio B; Macagno, Eduardo; Stevenson, Cory; Elhosseiny, Ahmed; Diniz-Filho, Alberto; Boer, Erwin R; Schulze, Jürgen; Medeiros, Felipe A

2017-07-01

Wayfinding, the process of determining and following a route between an origin and a destination, is an integral part of everyday tasks. The purpose of this study was to investigate the impact of glaucomatous visual field loss on wayfinding behavior using an immersive virtual reality (VR) environment. This cross-sectional study included 31 glaucomatous patients and 20 healthy subjects without evidence of overall cognitive impairment. Wayfinding experiments were modeled after the Morris water maze navigation task and conducted in an immersive VR environment. Two rooms were built varying only in the complexity of the visual scene in order to promote allocentric-based (room A, with multiple visual cues) versus egocentric-based (room B, with single visual cue) spatial representations of the environment. Wayfinding tasks in each room consisted of revisiting previously visible targets that subsequently became invisible. For room A, glaucoma patients spent on average 35.0 seconds to perform the wayfinding task, whereas healthy subjects spent an average of 24.4 seconds (P = 0.001). For room B, no statistically significant difference was seen on average time to complete the task (26.2 seconds versus 23.4 seconds, respectively; P = 0.514). For room A, each 1-dB worse binocular mean sensitivity was associated with 3.4% (P = 0.001) increase in time to complete the task. Glaucoma patients performed significantly worse on allocentric-based wayfinding tasks conducted in a VR environment, suggesting visual field loss may affect the construction of spatial cognitive maps relevant to successful wayfinding. VR environments may represent a useful approach for assessing functional vision endpoints for clinical trials of emerging therapies in ophthalmology.

Virtual reality conditioned place preference using monetary reward.

PubMed

Childs, Emma; Astur, Robert S; de Wit, Harriet

2017-03-30

Computerized tasks based on conditioned place preference (CPP) methodology offer the opportunity to study learning mechanisms involved in conditioned reward in humans. In this study, we examined acquisition and extinction of a CPP for virtual environments associated with monetary reward ($). Healthy men and women (N=57) completed a computerized CPP task in which they controlled an avatar within a virtual environment. On day 1, subjects completed 6 conditioning trials in which one room was paired with high $ and another with low $. Acquisition of place conditioning was assessed by measuring the time spent in each room during an exploration test of the virtual environments and using self-reported ratings of room liking and preference. Twenty-four hours later, retention and extinction of CPP were assessed during 4 successive exploration tests of the virtual environments. Participants exhibited a place preference for (spent significantly more time in) the virtual room paired with high $ over the one paired with low $ (p=0.015). They also reported that they preferred the high $ room (p<0.001) and liked it significantly more than the low $ room (p<0.001). However, these preferences were short-lived: 24h later subjects did not exhibit a behavioral or subjective preference for the high $ room. These findings show that individuals exhibit transient behavioral and subjective preferences for a virtual environment paired with monetary reward. Variations on this task may be useful to study mechanisms and brain substrates involved in conditioned reward and to examine the influence of drugs upon appetitive conditioning. Copyright © 2017 Elsevier B.V. All rights reserved.

Cultivation of Anaerobic and Facultatively Anaerobic Bacteria from Spacecraft-Associated Clean Rooms▿

PubMed Central

Stieglmeier, Michaela; Wirth, Reinhard; Kminek, Gerhard; Moissl-Eichinger, Christine

2009-01-01

In the course of this biodiversity study, the cultivable microbial community of European spacecraft-associated clean rooms and the Herschel Space Observatory located therein were analyzed during routine assembly operations. Here, we focused on microorganisms capable of growing without oxygen. Anaerobes play a significant role in planetary protection considerations since extraterrestrial environments like Mars probably do not provide enough oxygen for fully aerobic microbial growth. A broad assortment of anaerobic media was used in our cultivation strategies, which focused on microorganisms with special metabolic skills. The majority of the isolated strains grew on anaerobic, complex, nutrient-rich media. Autotrophic microorganisms or microbes capable of fixing nitrogen were also cultivated. A broad range of facultatively anaerobic bacteria was detected during this study and also, for the first time, some strictly anaerobic bacteria (Clostridium and Propionibacterium) were isolated from spacecraft-associated clean rooms. The multiassay cultivation approach was the basis for the detection of several bacteria that had not been cultivated from these special environments before and also led to the discovery of two novel microbial species of Pseudomonas and Paenibacillus. PMID:19363082

Software Support during a Control Room Upgrade

DOE Office of Scientific and Technical Information (OSTI.GOV)

Michele Joyce; Michael Spata; Thomas Oren

2005-09-21

In 2004, after 14 years of accelerator operations and commissioning, Jefferson Lab renovated its main control room. Changes in technology and lessons learned during those 14 years drove the control room redesign in a new direction, one that optimizes workflow and makes critical information and controls available to everyone in the control room. Fundamental changes in a variety of software applications were required to facilitate the new operating paradigm. A critical component of the new control room design is a large-format video wall that is used to make a variety of operating information available to everyone in the room. Analogmore » devices such as oscilloscopes and function generators are now displayed on the video wall through two crosspoint switchers: one for analog signals and another for video signals. A new software GUI replaces manual configuration of the oscilloscopes and function generators and helps automate setup. Monitoring screens, customized for the video wall, now make important operating information visible to everyone, not just a single operator. New alarm handler software gives any operator, on any workstation, access to all alarm handler functionality, and multiple users can now contribute to a single electronic logbook entry. To further support the shift to distributed access and control, many applications have been redesigned to run on servers instead of on individual workstations.« less

Implementation and evaluation of an interprofessional simulation-based education program for undergraduate nursing students in operating room nursing education: a randomized controlled trial.

PubMed

Wang, Rongmei; Shi, Nianke; Bai, Jinbing; Zheng, Yaguang; Zhao, Yue

2015-07-09

The present study was designed to implement an interprofessional simulation-based education program for nursing students and evaluate the influence of this program on nursing students' attitudes toward interprofessional education and knowledge about operating room nursing. Nursing students were randomly assigned to either the interprofessional simulation-based education or traditional course group. A before-and-after study of nursing students' attitudes toward the program was conducted using the Readiness for Interprofessional Learning Scale. Responses to an open-ended question were categorized using thematic content analysis. Nursing students' knowledge about operating room nursing was measured. Nursing students from the interprofessional simulation-based education group showed statistically different responses to four of the nineteen questions in the Readiness for Interprofessional Learning Scale, reflecting a more positive attitude toward interprofessional learning. This was also supported by thematic content analysis of the open-ended responses. Furthermore, nursing students in the simulation-based education group had a significant improvement in knowledge about operating room nursing. The integrated course with interprofessional education and simulation provided a positive impact on undergraduate nursing students' perceptions toward interprofessional learning and knowledge about operating room nursing. Our study demonstrated that this course may be a valuable elective option for undergraduate nursing students in operating room nursing education.

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

PubMed

Miller, Anya J; Gardner, Glendon M

2017-01-01

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

What Orthopaedic Operating Room Surfaces Are Contaminated With Bioburden? A Study Using the ATP Bioluminescence Assay.

PubMed

Richard, Raveesh Daniel; Bowen, Thomas R

2017-07-01

Contaminated operating room surfaces can increase the risk of orthopaedic infections, particularly after procedures in which hardware implantation and instrumentation are used. The question arises as to how surgeons can measure surface cleanliness to detect increased levels of bioburden. This study aims to highlight the utility of adenosine triphosphate (ATP) bioluminescence technology as a novel technique in detecting the degree of contamination within the sterile operating room environment. What orthopaedic operating room surfaces are contaminated with bioburden? When energy is required for cellular work, ATP breaks down into adenosine biphosphate (ADP) and phosphate (P) and in that process releases energy. This process is inherent to all living things and can be detected as light emission with the use of bioluminescence assays. On a given day, six different orthopaedic surgery operating rooms (two adult reconstruction, two trauma, two spine) were tested before surgery with an ATP bioluminescence assay kit. All of the cases were considered clean surgery without infection, and this included the previously performed cases in each sampled room. These rooms had been cleaned and prepped for surgery but the patients had not been physically brought into the room. A total of 13 different surfaces were sampled once in each room: the operating room (OR) preparation table (both pre- and postdraping), OR light handles, Bovie machine buttons, supply closet countertops, the inside of the Bair Hugger™ hose, Bair Hugger™ buttons, right side of the OR table headboard, tourniquet machine buttons, the Clark-socket attachment, and patient positioners used for total hip and spine positioning. The relative light units (RLUs) obtained from each sample were recorded and data were compiled and averaged for analysis. These values were compared with previously published ATP benchmark values of 250 to 500 RLUs to define cleanliness in both the hospital and restaurant industries. All surfaces had bioburden. The ATP RLUs (mean ± SD) are reported for each surface in ascending order: the OR preparation table (postdraping; 8.3 ± 3.4), inside the sterilized pan (9.2 ± 5.5), the inside of the Bair Hugger™ hose (212.5 ± 155.7), supply closet countertops (281.7 ± 236.7), OR light handles (647.8 ± 903.7), the OR preparation table (predraping; 1054 ± 387.5), the Clark-socket attachment (1135.7 ± 705.3), patient positioners used for total hip and spine positioning (1201.7 ± 1144.9), Bovie machine buttons (1264.5 ± 638.8), Bair Hugger™ buttons (1340.8 ± 1064.1), tourniquet machine buttons (1666.5 ± 2144.9), computer keyboard (1810.8 ± 929.6), and the right side of the OR table headboard (2539 ± 5635.8). ATP bioluminescence is a novel method to measure cleanliness within the orthopaedic OR and can help identify environmental trouble spots that can potentially lead to increased infection rates. Future studies correlating ATP bioluminescence findings with microbiology cultures could add to the clinical utility of this technology. Surfaces such as the undersurface of the OR table headboard, Bair Hugger™ buttons, and tourniquet machine buttons should be routinely cleansed as part of an institutional protocol. Although correlation between ATP bioluminescence and clinical infection was not evaluated in this study, it is the subject of future research. Specifically, evaluating microbiology samples taken from these environmental surfaces and correlating them with increased bioburden found with ATP bioluminescence technology can help promote improved surgical cleaning practices.

The Attitudes and Behaviors of Anaesthesiology and Reanimation Specialists in Anaesthesia Care Applications Outside the Operating Room in Turkey: A Survey Study

PubMed Central

Yıldız, Mehmet; İyilikçi, Leyla; Duru, Seden; Hancı, Volkan

2014-01-01

Objective We aimed to investigate the attitudes and behaviors of anaesthesiologists in “non-operating room anaesthesia” applications, which can be described as anaesthesia applications performed outside the operating room, and their reflection on practice all over Turkey. Methods Our study was conducted between November 5, 2012 and January 7, 2013 with the approval of the Research Ethics Board. Survey data were obtained through distributing printed questionnaires to be completed either by hand or via the web. The questionnaire consisted of 38 questions. The data obtained were analyzed with the Statistical Package for Social Sciences (SPSS) program. Results A total of 500 anaesthesiologists replied to our survey; 93% of anaesthesia specialists reported that there was a request that the anaesthesia and anaesthesia outside the operating room was given in their institution. Among anaesthesiologists, 56% reported that there were other sections that can provide sedation other than the anaesthesiology department in their institutions. Anaesthesia care team members; equipment; anaesthetic techniques; monitoring methods; and hypnotic, analgesic, and antagonist agents had statistically significant differences according to the participants’ institutions. Equipment used in the anaesthesia practice outside the operating room, anaesthesia, and monitoring methods had statistically significant differences according to geographical distribution (p<0.05). Conclusion Outside the operating room, anaesthesia practices and security measures are compliant with the standards set by the guidelines, the key to the prevention of complications. In our study, the current status of anaesthetic procedures outside the operating room in our country have been analyzed. PMID:27366420

Bacteria killing nanotechnology Bio-Kil effectively reduces bacterial burden in intensive care units.

PubMed

Hsueh, P-R; Huang, H-C; Young, T-G; Su, C-Y; Liu, C-S; Yen, M-Y

2014-04-01

A contaminated hospital environment has been identified as an important reservoir of pathogens causing healthcare-associated infections. This study is to evaluate the efficacy of bacteria killing nanotechnology Bio-Kil on reducing bacterial counts in an intensive care unit (ICU). Two single-bed rooms (S-19 and S-20) in the ICU were selected from 7 April to 27 May 2011. Ten sets of new textiles (pillow cases, bed sheets, duvet cover, and patient clothing) used by patients in the two single-bed rooms were provided by the sponsors. In the room S-20, the 10 sets of new textiles were washed with Bio-Kil; the room walls, ceiling, and air-conditioning filters were treated with Bio-Kil; and the surfaces of instruments (respirator, telephone, and computer) were covered with Bio-Kil-embedded silicon pads. Room S-19 served as the control. We compared the bacterial count on textiles and environment surfaces as well as air samples between the two rooms. A total of 1,364 samples from 22 different sites in each room were collected. The mean bacterial count on textiles and environmental surfaces in room S-20 was significantly lower than that in room S-19 (10.4 vs 49.6 colony-forming units [CFU]/100 cm(2); P < 0.001). Room S-20 had lower bacterial counts in air samples than room S-19 (33.4-37.6 vs 21.6-25.7 CFU/hour/plate; P < 0.001). The density of microbial isolations was significantly greater among patients admitted to room S-19 than those to room S-20 (9.15 vs 5.88 isolates per 100 patient-days, P < 0.05). Bio-Kil can significantly reduce bacterial burden in the environment of the ICU.

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....15 Inedible material operating and storage rooms; outer premises, docks, driveways, etc.; fly... departments where certified products are prepared, handled, or stored. Docks and areas where cars and vehicles...

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....15 Inedible material operating and storage rooms; outer premises, docks, driveways, etc.; fly... departments where certified products are prepared, handled, or stored. Docks and areas where cars and vehicles...

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....15 Inedible material operating and storage rooms; outer premises, docks, driveways, etc.; fly... departments where certified products are prepared, handled, or stored. Docks and areas where cars and vehicles...

How does the environment impact on the quality of life of advanced cancer patients? A qualitative study with implications for ward design.

PubMed

Rowlands, J; Noble, S

2008-09-01

It is well recognized that the ward environment has an effect on patients' quality of life and may, therefore, impact on the quality of end of life care. The body of evidence that informs ward design policy recommends single-bedded rooms on grounds of reduced infection risk, noise and versatility. Considering the majority of anticipated patient deaths occurring in hospitals, the quality of life aspects of ward design should also be considered. The aim of this study is to explore the views of patients with advanced cancer on the effect the ward environment has on their overall well-being. Semi-structured interviews exploring the experiences of 12 inpatients at a regional cancer centre were recorded and transcribed verbatim. Transcripts were analysed for emerging themes until theoretical saturation. Four major themes emerged: staff behaviours, the immediate environment, single vs. multi-bedded rooms and contact with the outside environment. The attitude, competence and helpfulness of the staff creates the atmosphere of the ward regardless of layout, furnishings, equipment and décor. The majority of the patients in this study expressed a strong preference for a multi-bedded room when they were well enough to interact and a single cubicle when they were very ill or dying, which opposes the current advice for building new hospitals with all single rooms. Although the current policy recommends the use of single-bedded rooms, this study suggests the need for a mix of multi-bedded wards and single rooms with respect to the impact of the environment on patient quality of life.

The radiologist's workflow environment: evaluation of disruptors and potential implications.

PubMed

Yu, John-Paul J; Kansagra, Akash P; Mongan, John

2014-06-01

Workflow interruptions in the health care delivery environment are a major contributor to medical errors and have been extensively studied within numerous hospital settings, including the nursing environment and the operating room, along with their effects on physician workflow. Less understood, though, is the role of interruptions in other highly specialized clinical domains and subspecialty services, such as diagnostic radiology. The workflow of the on-call radiologist, in particular, is especially susceptible to disruption by telephone calls and other modes of physician-to-physician communication. Herein, the authors describe their initial efforts to quantify the degree of interruption experienced by on-call radiologists and examine its potential implications in patient safety and overall clinical care. Copyright © 2014 American College of Radiology. Published by Elsevier Inc. All rights reserved.

RF Exposure Analysis for Multiple Wi-Fi Devices In Enclosed Environment

NASA Technical Reports Server (NTRS)

Hwu, Shian U.; Rhodes, Bryan A.; deSilva, B. Kanishka; Sham, Catherine C.; Keiser, James R.

2013-01-01

Wi-Fi devices operated inside a metallic enclosure have been investigation in the recent years. A motivation for this study is to investigate wave propagation inside an enclosed environment such as elevator, car, aircraft, and spacecraft. There are performances and safety concerned that when the RF transmitters are used in the metallic enclosed environments. In this paper, the field distributions inside a confined room were investigated with multiple portable Wi-Fi devices. Computer simulations were performed using the rigorous computational electromagnetics (CEM). The method of moments (MoM) was used to model the mutual coupling among antennas. The geometrical theory of diffraction (GTD) was applied for the multiple reflections off the ground and walls. The prediction of the field distribution inside such environment is useful for the planning and deployment of a wireless radio and sensor system. Factors that affect the field strengths and distributions of radio waves in confined space were analyzed. The results could be used to evaluate the RF exposure safety in confined environment. By comparing the field distributions for various scenarios, it was observed that the Wi-Fi device counts, spacing and relative locations in the room are important factors in such environments. The RF Keep Out Zone (KOZ), where the electric field strengths exceed the permissible RF exposure limit, could be used to assess the RF human exposure compliance. As shown in this study, it s possible to maximize or minimize field intensity in specific area by arranging the Wi-Fi devices as a function of the relative location and spacing in a calculated manner.

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.

The challenges of clinical education in a baccalaureate surgical technology students in Iran: a qualitative study

PubMed Central

Zardosht, Roghayeh; Razavi, Mohammad Etezad; Ahmady, Soleiman

2018-01-01

Background Clinical education is an integral part of the surgical technology curriculum, in which students combine and integrate knowledge, skills, attitudes, values and philosophies of the profession. It is difficult to learn and adapt to different types of skills and roles in the operating room environment. Objective This qualitative study examines the difference between the clinical education of Surgical Technology and other clinical settings, and the challenges faced by students in the field, within the course. Methods This was a qualitative content analysis study conducted in 2016. The participants in this study were 16 baccalaureate surgical technology students of the University for Medical Sciences in Khorasan Razavi province. A semi-structured interview method was run to collect the required data. The sampling was initially purposive, then in the snowball method which continued until data saturation. All interviews were recorded, then transcribed, and analyzed using a continuous comparative method and conventional qualitative content analysis method. Results From the deep and rich descriptions of the participants, three themes including “stressful environment”, “controversy between anticipation of role and reality”, and “humiliating experiences” as well as a general theme of “bitter education” were obtained. Conclusion Students’ orientation before attending the operating room, accompanying, supporting, and a full-time attendance of the specialist instructor, strengthening the prerequisite knowledge and skills for the students in this field, teaching ethics, and professional interactions, play an important role in the student’s acceptance of the operating room, in the surgery team and the improvement of the quality of clinical education of these students. PMID:29629066

The Doctrinal Basis for Medical Stability Operations

DTIC Science & Technology

2010-01-01

lead actor, preferably a HN agency, but sometimes the military must take the lead in medical stability operations when overwhelming violence prevents...34 Assessment Tasks Administration of hospital Communications Obstetrics , Pediatrics, Emergency room. Operating room Nursing procedures Medical supply

Oximeter reliability in a subzero environment.

PubMed

Macnab, A J; Smith, M; Phillips, N; Smart, P

1996-11-01

Pulse oximeters optimize care in the pre-hospital setting. As British Columbia ambulance teams often provide care in subzero temperatures, we conducted a study to determine the reliability of 3 commercially-available portable oximeters in a subzero environment. We hypothesized that there is no significant difference between SaO2 readings obtained using a pulse oximeter at room temperature and a pulse oximeter operating at sub-zero temperatures. Subjects were stable normothermic children in intensive care on Hewlett Packard monitors (control unit) at room temperature. The test units were packed in dry ice in an insulated bin (temperature - 15 degrees C to -30 degrees C) and their sensors placed on the subjects, contralateral to the control sensors. Data were collected simultaneously from test and control units immediately following validation of control unit values by co-oximetry (blood gas). No data were unacceptable. Two units (Propaq 106EC and Nonin 8500N) functioned well to < -15 degrees C, providing data comparable to those obtained from the control unit (p < 0.001). The Siemens Micro O2 did not function at the temperatures tested. Monitor users who require equipment to function in subzero environments (military, Coast Guard, Mountain Rescue) should ensure that function is reliable, and could test units using this method.

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

Impact of Hospital-Employed Physician Assistants on a Level II Community-Based Orthopaedic Trauma System.

PubMed

Althausen, Peter L; Shannon, Steven; Owens, Brianne; Coll, Daniel; Cvitash, Michael; Lu, Minggen; O'Mara, Timothy J; Bray, Timothy J

2016-12-01

The American Academy of Orthopedic Surgeons and the Orthopedic Trauma Association have released guidelines for the provision of orthopedic trauma services such as adequate stipends, designated operating rooms, ancillary staff, and guaranteed reimbursement for indigent care. One recommendation included a provision for hospital-based physician assistants (PAs). Given current reimbursement arrangements, PA collections for billable services may not meet their salary and benefit expenses. However, their actions may indirectly affect emergency room, operating room, and hospital reimbursement and patient care itself. The purpose of our study is to define the true impact of hospitalbased PAs on orthopaedic trauma care at a level II community hospital. Retrospective case series. Level II trauma center. One thousand one hundred four trauma patients with orthopaedic injuries. PA involvement. Emergency room data such as triage time, time until seen by the orthopedic service, and total emergency room time was recorded. Operating room data such as time to surgery, set-up time, total operating time, and out of room time was entered as well. Charts were reviewed to determine if patients were given postoperative antibiotics and Deep Venous Thrombosis (DVT) prophylaxis. Intraoperative and postoperative complications were noted, and lengths of stay were calculated for all patients. At our institution, PA collections from patient care cover only 50% of their costs for salary and benefits. However, with PA involvement, trauma patients with orthopedic injuries were seen 205 minutes faster (P = 0.006), total Emergency Room (ER) time decreased 175 minutes (P = 0.0001), and time to surgery improved 360 minutes (P . 0.03). Operating room parameters were minimally improved, but postoperative DVT prophylaxis increased by a mean of 6.73% (P = 0.0084), postoperative antibiotic administration increased by 2.88% (P = 0.0302), and there was a 4.67% decrease in postoperative complications (P = 0.0034). Average length of stay decreased by 0.61 days (P = 0.27). Although the PA's collections do not cover their costs, the indirect economic and patient care impacts are clear. By increasing emergency room pull through and decreasing times to Operating Room (OR), operative times, lengths of stay, and complications, their existence is clearly beneficial to hospitals, physicians, and patients as well. Economic Level IV. See Instructions for Authors for a complete description of levels of evidence.

Perceptual effects in auralization of virtual rooms

NASA Astrophysics Data System (ADS)

Kleiner, Mendel; Larsson, Pontus; Vastfjall, Daniel; Torres, Rendell R.

2002-05-01

By using various types of binaural simulation (or ``auralization'') of physical environments, it is now possible to study basic perceptual issues relevant to room acoustics, as well to simulate the acoustic conditions found in concert halls and other auditoria. Binaural simulation of physical spaces in general is also important to virtual reality systems. This presentation will begin with an overview of the issues encountered in the auralization of room and other environments. We will then discuss the influence of various approximations in room modeling, in particular, edge- and surface scattering, on the perceived room response. Finally, we will discuss cross-modal effects, such as the influence of visual cues on the perception of auditory cues, and the influence of cross-modal effects on the judgement of ``perceived presence'' and the rating of room acoustic quality.

An ethnographic study of differentiated practice in an operating room.

PubMed

Graff, C; Roberts, K; Thornton, K

1999-01-01

An ethnographic study was conducted to investigate implementation of the clinical nurse III or team leader (TL) role as part of a newly executed nursing differentiated practice model. The six TLs studied were employed in the operating room (OR). Through participant observation, interviews, and document analysis, the TL role--as well as perceptions of the role by the TLs and OR staff--were studied. Problems related to performance of the role and its evolutionary process were delineated. Data analysis involved identifying categories and subcategories of data and developing a coding system to identify themes. Salient themes were related to the culture of the OR. Because of the OR's highly technical environment, the TLs defined their roles in relation to the organizational and technical needs of their surgical service. Refinement of surgeon "preference cards" and "instrument count sheets" was considered the initial priority for the TLs. Various controllable and uncontrollable factors were identified that affected implementation of the new TL role. Findings suggest that introduction of the role requires insight into setting and an emphasis on staging and orientation of employees to the new role.

Auditory environmental context affects visual distance perception.

PubMed

Etchemendy, Pablo E; Abregú, Ezequiel; Calcagno, Esteban R; Eguia, Manuel C; Vechiatti, Nilda; Iasi, Federico; Vergara, Ramiro O

2017-08-03

In this article, we show that visual distance perception (VDP) is influenced by the auditory environmental context through reverberation-related cues. We performed two VDP experiments in two dark rooms with extremely different reverberation times: an anechoic chamber and a reverberant room. Subjects assigned to the reverberant room perceived the targets farther than subjects assigned to the anechoic chamber. Also, we found a positive correlation between the maximum perceived distance and the auditorily perceived room size. We next performed a second experiment in which the same subjects of Experiment 1 were interchanged between rooms. We found that subjects preserved the responses from the previous experiment provided they were compatible with the present perception of the environment; if not, perceived distance was biased towards the auditorily perceived boundaries of the room. Results of both experiments show that the auditory environment can influence VDP, presumably through reverberation cues related to the perception of room size.

Sensitive and Selective NH₃ Monitoring at Room Temperature Using ZnO Ceramic Nanofibers Decorated with Poly(styrene sulfonate).

PubMed

Andre, Rafaela S; Kwak, Dongwook; Dong, Qiuchen; Zhong, Wei; Correa, Daniel S; Mattoso, Luiz H C; Lei, Yu

2018-04-01

Ammonia (NH₃) gas is a prominent air pollutant that is frequently found in industrial and livestock production environments. Due to the importance in controlling pollution and protecting public health, the development of new platforms for sensing NH₃ at room temperature has attracted great attention. In this study, a sensitive NH₃ gas device with enhanced selectivity is developed based on zinc oxide nanofibers (ZnO NFs) decorated with poly(styrene sulfonate) (PSS) and operated at room temperature. ZnO NFs were prepared by electrospinning followed by calcination at 500 °C for 3 h. The electrospun ZnO NFs are characterized to evaluate the properties of the as-prepared sensing materials. The loading of PSS to prepare ZnO NFs/PSS composite is also optimized based on the best sensing performance. Under the optimal composition, ZnO NFs/PSS displays rapid, reversible, and sensitive response upon NH₃ exposure at room temperature. The device shows a dynamic linear range up to 100 ppm and a limit of detection of 3.22 ppm and enhanced selectivity toward NH₃ in synthetic air, against NO₂ and CO, compared to pure ZnO NFs. Additionally, a sensing mechanism is proposed to illustrate the sensing performance using ZnO NFs/PSS composite. Therefore, this study provides a simple methodology to design a sensitive platform for NH₃ monitoring at room temperature.

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

...-breeding material; nuisances. All operating and storage rooms and departments of inspected plants used for... storage rooms; outer premises, docks, driveways, etc.; fly-breeding material; nuisances. 355.15 Section... premises of every inspected plant shall be kept in clean and orderly condition. All catchbasins on the...

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

...-breeding material; nuisances. All operating and storage rooms and departments of inspected plants used for... storage rooms; outer premises, docks, driveways, etc.; fly-breeding material; nuisances. 355.15 Section... premises of every inspected plant shall be kept in clean and orderly condition. All catchbasins on the...

Study of a dry room in a battery manufacturing plant using a process model

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ahmed, Shabbir; Nelson, Paul A.; Dees, Dennis W.

The manufacture of lithium ion batteries requires some processing steps to be carried out in a dry room, where the moisture content should remain below 100 parts per million. The design and operation of such a dry room adds to the cost of the battery. This paper studies the humidity management of the air to and from the dry room to understand the impact of design and operating parameters on the energy demand and the cost contribution towards the battery manufacturing cost. The study is conducted with the help of a process model for a dry room with a volumemore » of 16000 cubic meters. For a defined base case scenario it is found that the dry room operation has an energy demand of approximately 400 kW. The paper explores some tradeoffs in design and operating parameters by looking at the humidity reduction by quenching the make-up air vs. at the desiccant wheel, and the impact of the heat recovery from the desiccant regeneration cycle.« less

Lighting, sleep and circadian rhythm: An intervention study in the intensive care unit.

PubMed

Engwall, Marie; Fridh, Isabell; Johansson, Lotta; Bergbom, Ingegerd; Lindahl, Berit

2015-12-01

Patients in an intensive care unit (ICU) may risk disruption of their circadian rhythm. In an intervention research project a cycled lighting system was set up in an ICU room to support patients' circadian rhythm. Part I aimed to compare experiences of the lighting environment in two rooms with different lighting environments by lighting experiences questionnaire. The results indicated differences in advantage for the patients in the intervention room (n=48), in perception of daytime brightness (p=0.004). In nighttime, greater lighting variation (p=0.005) was found in the ordinary room (n=52). Part II aimed to describe experiences of lighting in the room equipped with the cycled lighting environment. Patients (n=19) were interviewed and the results were presented in categories: "A dynamic lighting environment", "Impact of lighting on patients' sleep", "The impact of lighting/lights on circadian rhythm" and "The lighting calms". Most had experiences from sleep disorders and half had nightmares/sights and circadian rhythm disruption. Nearly all were pleased with the cycled lighting environment, which together with daylight supported their circadian rhythm. In night's actual lighting levels helped patients and staff to connect which engendered feelings of calm. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

Nursing staff's experiences of working in an evidence-based designed ICU patient room-An interview study.

PubMed

Sundberg, Fredrika; Olausson, Sepideh; Fridh, Isabell; Lindahl, Berit

2017-12-01

It has been known for centuries that environment in healthcare has an impact, but despite this, environment has been overshadowed by technological and medical progress, especially in intensive care. Evidence-based design is a concept concerning integrating knowledge from various research disciplines and its application to healing environments. The aim was to explore the experiences of nursing staff of working in an evidence-based designed ICU patient room. Interviews were carried out with eight critical care nurses and five assistant nurses and then subjected to qualitative content analysis. The experience of working in an evidence-based designed intensive care unit patient room was that the room stimulates alertness and promotes wellbeing in the nursing staff, fostering their caring activities but also that the interior design of the medical and technical equipment challenges nursing actions. The room explored in this study had been rebuilt in order to create and evaluate a healing environment. This study showed that the new environment had a great impact on the caring staffs' wellbeing and their caring behaviour. At a time when turnover in nurses is high and sick leave is increasing, these findings show the importance of interior design ofintensive care units. Copyright © 2017 Elsevier Ltd. All rights reserved.

Proton Tolerance of SiGe Precision Voltage References for Extreme Temperature Range Electronics

NASA Astrophysics Data System (ADS)

Najafizadeh, Laleh; Bellini, Marco; Prakash, A. P. Gnana; Espinel, Gustavo A.; Cressler, John D.; Marshall, Paul W.; Marshall, Cheryl J.

2006-12-01

A comprehensive investigation of the effects of proton irradiation on the performance of SiGe BiCMOS precision voltage references intended for extreme environment operational conditions is presented. The voltage reference circuits were designed in two distinct SiGe BiCMOS technology platforms (first generation (50 GHz) and third generation (200 GHz)) in order to investigate the effect of technology scaling. The circuits were irradiated at both room temperature and at 77 K. Measurement results from the experiments indicate that the proton-induced changes in the SiGe bandgap references are minor, even down to cryogenic temperatures, clearly good news for the potential application of SiGe mixed-signal circuits in emerging extreme environments

High-resolution real-time optical studies of radiological air sample filtration processes in an environmental continuous air monitor

NASA Astrophysics Data System (ADS)

Rodgers, John C.; Wasiolek, Piotr T.; Schery, Stephen D.; Alcantara, Raul E.

1999-01-01

The need for a continuous air monitor capable of quick and accurate measurements of airborne radioactivity in close proximity to the work environment during waste management, site restoration, and D&D operations led to the Los Alamos National Laboratory development of an environmental continuous air monitor (ECAM). Monitoring the hostile work environment of waste recovery, for example, presents unique challenges for detector design for detectors previously used for the clean room conditions of the typical plutonium laboratory. The environmental and atmospheric conditions (dust, high wind, etc.) influence aerosol particle penetration into the ECAM sampling head as well as the build-up of deposits on the ECAM filter.

Quality Detection of Litchi Stored in Different Environments Using an Electronic Nose

PubMed Central

Xu, Sai; Lü, Enli; Lu, Huazhong; Zhou, Zhiyan; Wang, Yu; Yang, Jing; Wang, Yajuan

2016-01-01

The purpose of this paper was to explore the utility of an electronic nose to detect the quality of litchi fruit stored in different environments. In this study, a PEN3 electronic nose was adopted to test the storage time and hardness of litchi that were stored in three different types of environment (room temperature, refrigerator and controlled-atmosphere). After acquiring data about the hardness of the sample and from the electronic nose, linear discriminant analysis (LDA), canonical correlation analysis (CCA), BP neural network (BPNN) and BP neural network-partial least squares regression (BPNN-PLSR), were employed for data processing. The experimental results showed that the hardness of litchi fruits stored in all three environments decreased during storage. The litchi stored at room temperature had the fastest rate of decrease in hardness, followed by those stored in a refrigerator environment and under a controlled-atmosphere. LDA has a poor ability to classify the storage time of the three environments in which litchi was stored. BPNN can effectively recognize the storage time of litchi stored in a refrigerator and a controlled-atmosphere environment. However, the BPNN classification of the effect of room temperature storage on litchi was poor. CCA results show a significant correlation between electronic nose data and hardness data under the room temperature, and the correlation is more obvious for those under the refrigerator environment and controlled-atmosphere environment. The BPNN-PLSR can effectively predict the hardness of litchi under refrigerator storage conditions and a controlled-atmosphere environment. However, the BPNN-PLSR prediction of the effect of room temperature storage on litchi and global environment storage on litchi were poor. Thus, this experiment proved that an electronic nose can detect the quality of litchi under refrigeratored storage and a controlled-atmosphere environment. These results provide a useful reference for future studies on nondestructive and intelligent monitoring of fruit quality. PMID:27338391

Lean management in academic surgery.

PubMed

Collar, Ryan M; Shuman, Andrew G; Feiner, Sandra; McGonegal, Amy K; Heidel, Natalie; Duck, Mary; McLean, Scott A; Billi, John E; Healy, David W; Bradford, Carol R

2012-06-01

Lean is a management system designed to enhance productivity by eliminating waste. Surgical practice offers many opportunities for improving efficiency. Our objective was to determine whether systematic implementation of lean thinking in an academic otolaryngology operating room improves efficiency and profitability and preserves team morale and educational opportunities. In an 18-month prospective quasi-experimental study, a multidisciplinary task force systematically implemented lean thinking within an otolaryngology operating room of an academic health system. Operating room turnover time and turnaround time were measured during a baseline period; an observer-effect period in which workers were made aware that their efficiency was being measured but before implementing lean changes; and an intervention period after redesign principles had been used. The impact on teamwork, morale, and surgical resident education were measured during the baseline and intervention periods through validated surveys. A profit model was applied to estimate the financial implications of the study. There was no difference between the baseline and observer-effect periods of the study for turnover time (p = 0.98) or turnaround time (p = 0.20). During the intervention period, the mean turnover time and turnaround time were significantly shorter than during the baseline period (29 vs 38 minutes; p < 0.001 and 69 vs 89 minutes; p < 0.001, respectively). The composite morale score suggested improved morale after implementation (p = 0.011). Educational metrics were unchanged before and after implementation. The annual opportunity revenue for the involved operating room is $330,000; when extrapolated throughout the operating rooms, lean thinking could create 6,500 hours of capacity annually. Application of lean management techniques to a single operating room and surgical service improved operating room efficiency and morale, sustained resident education, and can provide considerable financial gains when scaled to an entire academic surgical suite. Copyright © 2012. Published by Elsevier Inc.

Individual and workplace monitoring measurements made after a 240Pu incident and during the clean-up operations.

PubMed

Hochmann, R; Eisenwagner, H; Benesch, T; Hunt, J; Cruz-Suarez, R; Bulyha, S; Schmitzer, C

2011-03-01

On 3 August 2008, five glass vials containing around 7 GBq of (240)Pu in nitric acid solution burst in a laboratory operated by the IAEA in Seibersdorf, Austria. The vials were located in a fire-proof safe in the IAEA Safeguards Analytical Laboratory, and the release of the (240)Pu caused an air contamination in the room and in adjoining rooms. Immediate emergency work was carried out, which was then followed by a long period of clean-up operations. A large number of conventional individual and workplace monitoring measurements were carried out immediately after the incident and during the clean-up work. In addition, due to the fact that (240)Pu has a very low background presence in the environment, and that the IAEA laboratories operate an inductively coupled plasma mass spectrometry system capable of very low levels of detection of this radionuclide, a number of non-conventional measurements were made to detect (240)Pu on, for example, the photographic camera used to document the incident, on nasal swabs from the first responders, etc. Plastic beakers were left in the corridor of the controlled area to accumulate (240)Pu from precipitation to see whether it was possible to detect traces of the radionuclide. This paper presents the measurements obtained, and discusses their relevance to occupational radiation protection.

The Effects of Scavenging on Waste Methoxyflurane Concentrations in Veterinary Operating Room Air

DTIC Science & Technology

1981-01-01

Afl-AO5 572 AIR FORCE OCCUPATIONAL AND ENVIRONMENTAL H4EALTH LAS -ETC F/S 6120 TIE EFFECTS OF SCAVENGING ON WASTE METHOXYFLURANE CONCENTRATIOH-ETC...REPRINT The Effects of Scavenging on Waste Methoxyflurane Concentrations in Veterinary Operating Room Air Approved for public release; distribution...Waste Methoxyflurane Fnal y t Concentrations ir Veterinary Operating Room Air, 6.PROMN _6._PERFORMIN oIG. REPORT NUMBER 7. AUTOR~s)B. CONTRACT OR GRANT

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

PubMed

Sonoda, Yukio; Onozuka, Daisuke; Hagihara, Akihito

2018-01-01

To evaluate operating room nurses' perception of teamwork performance and their level of mental stress and to identify related factors. Little is known about the factors affecting teamwork and the mental stress of surgical nurses, although the performance of the surgical team is essential for patient safety. The questionnaire survey for operation room nurses consisted of simple questions about teamwork performance and mental stress. Multivariate analyses were used to identify factors causing a sense of teamwork performance or mental stress. A large number of surgical nurses had a sense of teamwork performance, but 30-40% of operation room nurses were mentally stressed during surgery. Neither the patient nor the operation factors were related to the sense of teamwork performance in both types of nurses. Among scrub nurses, endoscopic and abdominal surgery, body mass index, blood loss and the American Society of Anesthesiologists physical status class were related to their mental stress. Conversely, circulating nurses were stressed about teamwork performance. The factors related to teamwork performance and mental stress during surgery differed between scrub and circulating nurses. Increased support for operation room nurses is necessary. The increased support leads to safer surgical procedures and better patient outcomes. © 2017 John Wiley & Sons Ltd.

Model for Team Training Using the Advanced Trauma Operative Management Course: Pilot Study Analysis.

PubMed

Perkins, R Serene; Lehner, Kathryn A; Armstrong, Randy; Gardiner, Stuart K; Karmy-Jones, Riyad C; Izenberg, Seth D; Long, William B; Wackym, P Ashley

2015-01-01

Education and training of surgeons has traditionally focused on the development of individual knowledge, technical skills, and decision making. Team training with the surgeon's operating room staff has not been prioritized in existing educational paradigms, particularly in trauma surgery. We aimed to determine whether a pilot curriculum for surgical technicians and nurses, based on the American College of Surgeons' Advanced Trauma Operative Management (ATOM) course, would improve staff knowledge if conducted in a team-training environment. Between December 2012 and December 2014, 22 surgical technicians and nurses participated in a curriculum complementary to the ATOM course, consisting of 8 individual 8-hour training sessions designed by and conducted at our institution. Didactic and practical sessions included educational content, hands-on instruction, and alternating role play during 5 system-specific injury scenarios in a simulated operating room environment. A pre- and postcourse examination was administered to participants to assess for improvements in team members' didactic knowledge. Course participants displayed a significant improvement in didactic knowledge after working in a team setting with trauma surgeons during the ATOM course, with a 9-point improvement on the postcourse examination (83%-92%, p = 0.0008). Most participants (90.5%) completing postcourse surveys reported being "highly satisfied" with course content and quality after working in our simulated team-training setting. Team training is critical to improving the knowledge base of surgical technicians and nurses in the trauma operative setting. Improved communication, efficiency, appropriate equipment use, and staff awareness are the desired outcomes when shifting the paradigm from individual to surgical team training so that improved patient outcomes, decreased risk, and cost savings can be achieved. Determine whether a pilot curriculum for surgical technicians and nurses, based on the American College of Surgeons' ATOM course, improves staff knowledge if conducted in a team-training environment. Surgical technicians and nurses participated in a curriculum complementary to the ATOM course. In all, 8 individual 8-hour training sessions were conducted at our institution and contained both didactic and practical content, as well as alternating role play during 5 system-specific injury scenarios. A pre- and postcourse examination was administered to assess for improvements in didactic knowledge. The course was conducted in a simulated team-training setting at the Legacy Institute for Surgical Education and Innovation (Portland, OR), an American College of Surgeons Accredited Educational Institute. In all, 22 surgical technicians and operating room nurses participated in 8 separate ATOM(s) courses and had at least 1 year of surgical scrubbing experience in general surgery with little or no exposure to Level I trauma surgical care. Of these participants, 16 completed the postcourse examination. Participants displayed a significant improvement in didactic knowledge (83%-92%, p = 0.0008) after the ATOM(s) course. Of the 14 participants who completed postcourse surveys, 90.5% were "highly satisfied" with the course content and quality. Team training is critical to improving the knowledge base of surgical technicians and nurses in the trauma operative setting and may contribute to improved patient outcomes, decreased risk, and hospital cost savings. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Prevalence and perpetrators of workplace violence by nursing unit and the relationship between violence and the perceived work environment.

PubMed

Park, Mihyun; Cho, Sung-Hyun; Hong, Hyun-Ja

2015-01-01

To identify the prevalence and perpetrators of workplace violence against nurses and to examine the relationship of work demands and trust and justice in the workplace with the occurrence of violence. This study employed cross-sectional data from a 2013 nurse survey conducted at a university hospital in Seoul, South Korea. The study sample included 970 female nurses from 47 nursing units, including general, oncology, intensive care units (ICUs), operating rooms, and outpatient departments. The second version of the medium-sized Copenhagen Psychosocial Questionnaire (COPSOQ II) was used to measure work demands (i.e., quantitative demands, work pace, and emotional demands), trust and justice, and violence. Relationships among those variables were examined by conducting multiple logistic regression analyses with multilevel modeling. The 12-month prevalence of verbal abuse (63.8%) was highest, followed by threats of violence (41.6%), physical violence (22.3%), and sexual harassment (19.7%), but bullying had the lowest prevalence (9.7%). Physical violence, threats of violence, and verbal abuse occurred most frequently in ICUs, whereas sexual harassment and bullying were highest in operating rooms. The main perpetrators were patients, followed by physicians and patients' families. Nurses perceiving greater work demands and less trust and justice were more likely to have been exposed to violence. The prevalence and perpetrators of violence varied considerably among nursing units. Greater work demands and less trust and justice were associated with nurses' experiences of violence. Adequate work demands and a trusted and just work environment may reduce violence against nurses. In return, reduction of violence will contribute to creating a better nursing work environment. © 2014 Sigma Theta Tau International.

An embedded checklist in the Anesthesia Information Management System improves pre-anaesthetic induction setup: a randomised controlled trial in a simulation setting.

PubMed

Wetmore, Douglas; Goldberg, Andrew; Gandhi, Nishant; Spivack, John; McCormick, Patrick; DeMaria, Samuel

2016-10-01

Anaesthesiologists work in a high stress, high consequence environment in which missed steps in preparation may lead to medical errors and potential patient harm. The pre-anaesthetic induction period has been identified as a time in which medical errors can occur. The Anesthesia Patient Safety Foundation has developed a Pre-Anesthetic Induction Patient Safety (PIPS) checklist. We conducted this study to test the effectiveness of this checklist, when embedded in our institutional Anesthesia Information Management System (AIMS), on resident performance in a simulated environment. Using a randomised, controlled, observer-blinded design, we compared performance of anaesthesiology residents in a simulated operating room under production pressure using a checklist in completing a thorough pre-anaesthetic induction evaluation and setup with that of residents with no checklist. The checklist was embedded in the simulated operating room's electronic medical record. Data for 38 anaesthesiology residents shows a statistically significant difference in performance in pre-anaesthetic setup and evaluation as scored by blinded raters (maximum score 22 points), with the checklist group performing better by 7.8 points (p<0.01). The effects of gender and year of residency on total score were not significant. Simulation duration (time to anaesthetic agent administration) was increased significantly by the use of the checklist. Required use of a pre-induction checklist improves anaesthesiology resident performance in a simulated environment. The PIPS checklist as an integrated part of a departmental AIMS warrant further investigation as a quality measure. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

[Virtual surgical education: experience with medicine and surgery students].

PubMed

Bonavina, Luigi; Mozzi, Enrico; Peracchia, Alberto

2003-01-01

The use of virtual reality simulation is currently being proposed within programs of postgraduate surgical education. The simple tasks that make up an operative procedure can be repeatedly performed until satisfactory execution is achieved, and the errors can be corrected by means of objective assessment. The aim of this study was to evaluate the applicability and the results of structured practice with the LapSim laparoscopic simulator used by undergraduate medical students. A significant reduction in operative time and errors was noted in several tasks (navigation, clipping, etc.). Although the transfer of technical skills to the operating room environment remains to be demonstrated, our research shows that this type of teaching is applicable to undergraduate medical students and in future may become a useful tool for selecting individuals for surgical residency programs.

Are we fully utilizing the functionalities of modern operating room ventilators?

PubMed

Liu, Shujie; Kacmarek, Robert M; Oto, Jun

2017-12-01

The modern operating room ventilators have become very sophisticated and many of their features are comparable with those of an ICU ventilator. To fully utilize the functionality of modern operating room ventilators, it is important for clinicians to understand in depth the working principle of these ventilators and their functionalities. Piston ventilators have the advantages of delivering accurate tidal volume and certain flow compensation functions. Turbine ventilators have great ability of flow compensation. Ventilation modes are mainly volume-based or pressure-based. Pressure-based ventilation modes provide better leak compensation than volume-based. The integration of advanced flow generation systems and ventilation modes of the modern operating room ventilators enables clinicians to provide both invasive and noninvasive ventilation in perioperative settings. Ventilator waveforms can be used for intraoperative neuromonitoring during cervical spine surgery. The increase in number of new features of modern operating room ventilators clearly creates the opportunity for clinicians to optimize ventilatory care. However, improving the quality of ventilator care relies on a complete understanding and correct use of these new features. VIDEO ABSTRACT: http://links.lww.com/COAN/A47.

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

PubMed

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

2012-08-01

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

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.

[Working conditions in operating rooms].

PubMed

Kułagowska, Ewa

2007-01-01

The aim of this study was to get acquainted with the opinions of the nursing staff on working conditions at their workplace. The study was carried out in a group of 398 nurses working in various kinds of operating rooms at 11 public hospitals. A questionnaire was used as a major tool of this study. The questionnaires were filled in by 259 operating room nurses (circulating nurses) and 139 nurse-anesthetists. The collected data show that working conditions in operating rooms do not ensure safety of the nursing staff at work. The main sources of problems are: work organization, technical factors, work equipment, work space, knowledge of hazards and strenuous factors among nurses, ways of preventing and/or limiting them. These elements are serious occupational risk factors influencing the work process and health status of nurses.

[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.

Effect of acclimation training on physiological changes in a randomized controlled trial in hot-humid environment.

PubMed

Zhang, Lei; Bao, Ying-chun

2014-11-01

This study was aimed to explore the physiological changes and the effect of heat acclimation training via a randomized control trial study. Forty healthy male volunteers were chosen and divided into experimental group and control group randomly. Those in experimental group received heat acclimation training including but not limited to meditation, unarmed run, yoga, and stepping in hot lab environment. And then, subjective feeling, rectal temperature, average skin temperature, and sweat electrolytes concentration were detected in order to describe their physiological changes. Before and after the training, both groups received some tests and their 3 000 m run-race time, nervous reaction time and subjective perception scores were recorded to evaluate the effect of acclimation training. (1) There was no difference in 3 000 m between the 2 groups in the same environment. Subjects' 3 000 m race time in experimental group was obviously shortened than that in control group in room temperature environment (t = 2.326, P < 0.05). And subjects' 3 000 m race time in experimental group was obviously shortened than that in control group in hot-humid environment (t = 4.518, P < 0.01). (2) Subjects' reaction time (RT) in experimental group was shortened than that in control group in room temperature environment (Z = 11.258, P < 0.05). And Subjects' RT in experimental group was sharply shortened than that in control group in hot-humid environment (Z = 6.519, P < 0.01). (3) No difference between the experimental and control groups was observed in subjective perception score (SPS) in room temperature environment. But subjects' SPS in experimental group was obviously lowered than that in control group and in hot-humid environment (t = 17.958, P < 0.01).(4) Anal temperature (AT) was lowered during training, while the change of mean skin temperature (MST) was not significant. Sweat sodium concentration (SSC) was lowered during training. SPS continued to decrease and entered plateau on the 13th day after training.(5) After acclimation training, the working capacity of the experimental group in hot-humid environment was over 85% of that in room temperature environment. While subjects' working capacity in control group in hot-humid environment was about 80% of that in room temperature environment. Hot-humid environment acclimation training improved the working capacity. After training, subjects' working capacity in hot-humid environment remained over 85% of that in room temperature environment, which was higher than that of those subjects who did not take part in training.

Orion Crew Module Move

NASA Image and Video Library

2017-11-17

Technicians in clean-room suits attach a crane to the Orion crew module for Exploration Mission-1 for its move to the thermal chamber in the Neil Armstrong Operations and Checkout Building high bay at NASA's Kennedy Space Center in Florida. Orion will be lifted out of a test stand and lowered onto another stand to for the move. The crew module will undergo a thermal cycle test to assess the workmanship of critical hardware and structural locations. The test also demonstrates crew module subsystem operations in a thermally stressing environment to confirm no damage or anomalous hardware conditions as a result of the test. The Orion spacecraft will launch atop NASA's Space Launch System rocket on its first uncrewed integrated flight.

Stress Testing of Organic Light- Emitting Diode Panels and Luminaires

DOE Office of Scientific and Technical Information (OSTI.GOV)

Davis, Lynn; Rountree, Kelley; Mills, Karmann

This report builds on previous DOE efforts with OLED technology by updating information on a previously benchmarked OLED product (the Chalina luminaire from Acuity Brands) and provides new benchmarks on the performance of Brite 2 and Brite Amber OLED panels from OLEDWorks. During the tests described here, samples of these devices were subjected to continuous operation in stress tests at elevated ambient temperature environments of 35°C or 45°C. In addition, samples were also operated continuously at room temperature in a room temperature operational life test (RTOL). One goal of this study was to investigate whether these test conditions can acceleratemore » failure of OLED panels, either through panel shorting or an open circuit in the panel. These stress tests are shown to provide meaningful acceleration of OLED failure modes, and an acceleration factor of 2.6 was calculated at 45°C for some test conditions. In addition, changes in the photometric properties of the emitted light (e.g., luminous flux and chromaticity maintenance) was also evaluated for insights into the long-term stability of these products compared to earlier generations. Because OLEDs are a lighting system, electrical testing was also performed on the panel-driver pairs to provide insights into the impact of the driver on long-term panel performance.« less

A procedure for rapid issue of red cells for emergency use.

PubMed

Weiskopf, Richard B; Webb, Mary; Stangle, Deena; Klinbergs, Gunter; Toy, Pearl

2005-04-01

A College of American Pathologists Q-Probe revealed that the median turnaround times for emergency requests for red blood cells from the operating room were 30 minutes to release of cells from the blood bank and 34 minutes to delivery to the operating room. These times may not be adequate to permit the red cells to provide sufficiently rapid delivery of oxygen in massively bleeding patients. To improve the time from emergency request for red cells to delivery to the operating room. A new emergency issue program was implemented for only the operating rooms; emergency issue to all other hospital locations remained unchanged. Six units of group O Rh-negative red blood cells (RBCs) are maintained in the blood bank in a separate basket with transfusion forms containing the unit numbers and expiration dates and a bag with one blood tubing segment from each unit. The times to issue and to delivery to the operating room suite were compared with time to issue of 2 group O Rh-negative RBCs for other hospital locations using the older system during the same time period and with the time to issue of 2 units to all other hospital locations during the preceding 2 years. A university hospital. Time between emergency request for red cells and delivery to the operating room. The time between blood bank notification and arrival in the operating room of the 6 units of RBCs was significantly shorter than the time required to just issue (not including delivery time) 2 units of RBCs to other hospital locations. With the new procedure, 82% of units issued reached the operating room within 2 minutes of request, 91% arrived within 3 minutes, and 100% arrived within 4 minutes. These percentages are significantly higher than those for only issue of blood (without delivery) using the older issuing procedure for all hospital locations during the previous 2 years (37%, 49%, and 66%, respectively; P = .007, .009, and .02, respectively) and for other locations during the same 7-month period (29%, 46%, and 73%, respectively; P = .004, .01, and .09, respectively). Time (mean [95% confidence interval]) from blood bank notification to delivery of RBCs to the operating room suite (2.1 [1.6-2.6] minutes, of which approximately 50-60 seconds is attributable to delivery time) was less than issue times (not including delivery times) using the older issuing procedure for other hospital locations during the same period (4.1 [3.1-5.0] minutes; P = .007). An emergency issue procedure can be used to issue several units of RBCs within 1 minute and have them delivered to the operating room within 2 minutes while maintaining sufficient controls and providing required information to satisfy patient and blood bank requirements.

Musical preference correlates closely to professional roles and specialties in operating room: A multicenter cross-sectional cohort study with 672 participants.

PubMed

Yamasaki, Alisa; Mise, Yoshihiro; Mise, Yoko; Lee, Jeffrey E; Aloia, Thomas A; Katz, Matthew H; Chang, George J; Lillemoe, Keith D; Raut, Chandrajit P; Conrad, Claudius

2016-05-01

It is unclear whether music preferences and perceptions in the operating room (OR) differ by demographic and professional factors and how an improved understanding of these potential differences can be leveraged to enhance team dynamics and the OR work environment. Currently, there is limited knowledge regarding the impact of music on OR team concentration and communication. This study was a multicenter, cross-sectional study of 282 preoperative patients and 390 providers-attending physicians, residents, and nurses in anesthesiology and surgery. Patient and provider responses were measured using a newly developed questionnaire. Patients who highly enjoyed music felt music alleviated stress and enhanced concentration and communication and favored use of music in the OR. The genres favored most by patients were rock music (32%), classical music (28%), and top 40 hits (26%). All providers reported a high frequency of use of music during the operation. Nurses and residents were more likely than attendings to report high enjoyment of music in the OR (P < .02). Surgeons and anesthesiologists had high median scores for enjoyment of music and low median scores for music as distraction. Anesthesiologists preferred classical and jazz/blues at lower volumes compared with surgeons, who favored top 40 music at higher noise pressure levels. Patients and providers perceived music to improve provider concentration and team communication; nurses held the most positive views. Musical preferences and perceptions of the effect of music in the OR differ by both professional status and specialty and provide insight into broader team dynamics that could be leveraged potentially to optimize the OR environment. Copyright © 2016 Elsevier Inc. All rights reserved.

[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.

Influenza-like symptoms in the college dormitory environment: a survey taken during the 1999-2000 influenza season.

PubMed

Tsuang, Wayne M; Bailar, John C; Englund, Janet A

2004-04-01

The effect of dormitory environments on the transmission of the influenza virus in college students is not well understood. During the 1999-2000 flu season, dormitory residents at a college campus in Chicago were surveyed about their living conditions and influenza-like symptoms (ILS). The survey had a 42 percent response ratio (721 of 1,704). Students who had > or = 50 percent carpeting in their room were at significantly lower risk for ILS (p = .02). Although the risk of ILS increased for roommates who shared sleeping quarters compared with those who slept in different rooms (RR = 4.3), the difference was not statistically significant. No evidence was found that ILS risk was affected by washroom, laundry, or dining settings, or by demographics, including gender or year in college. The survey instrument detected strong relations between ILS and the dormitory room environment, in contrast with other settings in the dormitory. Further research on transmission may focus on the room environment.

8. VIEW OF SLC3W CONTROL ROOM (ROOM 105) FROM ITS ...

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

8. VIEW OF SLC-3W CONTROL ROOM (ROOM 105) FROM ITS NORTHEAST CORNER. TELEMETRY ROOM VISIBLE THROUGH WINDOWS IN SOUTH WALL. - Vandenberg Air Force Base, Space Launch Complex 3, Launch Operations Building, Napa & Alden Roads, Lompoc, Santa Barbara County, CA

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

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

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

One Stop Post Op cardiac surgery recovery--a proven success.

PubMed

Joyce, L; Pandolph, P

2001-01-01

The One Stop Post Op model for open heart surgery recovery is an innovative approach to post op care utilized in only a few facilities in the country. This model calls for an integration of acute ICU and step-down phases of care, thus changing the paradigm for nursing care of the open heart surgery patient. Typically, hospitals incur inefficiencies transferring the patient through multiple levels of care, thus resulting in a "disconnect" as new caregivers relearn the patient's care requirements and special needs. The construction of a "one stop" unit allows the patient to remain stationary while the service level changes to accommodate changing care needs. The cardiac "one stop" model is similar to the LDRP concept for obstetrical care. The One Stop Post Op patient rooms are designed to accommodate every level of patient acuity. All rooms meet the regulations for critical care room design, however this is where the aesthetic similarity ends. The patient environment looks more like hotel rooms rather than the traditional ICU setting. Cabinets designed to cover medical gases, in the room's private bathrooms and comfortable furnishings help to create a patient focused environment conducive to recovery. This model has been utilized by several facilities and has demonstrated clear clinical and economic advantages for patients, families, and health care providers. Implementing an open heart surgery (OHS) program presents the opportunity for several community based hospitals to challenge the way they have been providing patient care and establish an innovative approach to post surgery patient care. The One Stop Post Op cardiovascular recovery unit is designed to receive the OHS patient directly from the operating room and to be the "care unit" for the patient's entire stay. Patient flow, quality monitoring and caregiver acceptance in this unit requires new paradigms from the traditional two or three step post OHS care delivery process. The One Stop Post Op model focuses the delivery of care on the patient. With proven success in clinical outcomes, patient, physician and caregiver satisfaction, it is anticipated that this innovative approach will drive hospitals to integrate clinical process with physical planning in the future.

Impact of surface disinfection and sterile draping of furniture on room air quality in a cardiac procedure room with a ventilation and air-conditioning system (extrusion airflow, cleanroom class 1b (DIN 1946-4)).

PubMed

Below, Harald; Ryll, Sylvia; Empen, Klaus; Dornquast, Tina; Felix, Stefan; Rosenau, Heike; Kramer, Sebastian; Kramer, Axel

2010-09-21

In a cardiac procedure room, ventilated by a ventilation and air-conditioning system with turbulent mixed airflow, a protection zone in the operating area could be defined through visualization of airflows. Within this protection zone, no turbulence was detectable in the room air.Under the given conditions, disinfection of all surfaces including all furniture and equipment after the last operation and subsequent draping of furniture and all equipment that could not be removed from the room with sterile surgical drapes improved the indoor room air quality from cleanroom class C to cleanroom class B. This also allows procedures with elevated requirements to be performed in room class 1b.

Designing EvoRoom: An Immersive Simulation Environment for Collective Inquiry in Secondary Science

NASA Astrophysics Data System (ADS)

Lui, Michelle Mei Yee

This dissertation investigates the design of complex inquiry for co-located students to work as a knowledge community within a mixed-reality learning environment. It presents the design of an immersive simulation called EvoRoom and corresponding collective inquiry activities that allow students to explore concepts around topics of evolution and biodiversity in a Grade 11 Biology course. EvoRoom is a room-sized simulation of a rainforest, modeled after Borneo in Southeast Asia, where several projected displays are stitched together to form a large, animated simulation on each opposing wall of the room. This serves to create an immersive environment in which students work collaboratively as individuals, in small groups and a collective community to investigate science topics using the simulations as an evidentiary base. Researchers and a secondary science teacher co-designed a multi-week curriculum that prepared students with preliminary ideas and expertise, then provided them with guided activities within EvoRoom, supported by tablet-based software as well as larger visualizations of their collective progress. Designs encompassed the broader curriculum, as well as all EvoRoom materials (e.g., projected displays, student tablet interfaces, collective visualizations) and activity sequences. This thesis describes a series of three designs that were developed and enacted iteratively over two and a half years, presenting key features that enhanced students' experiences within the immersive environment, their interactions with peers, and their inquiry outcomes. Primary research questions are concerned with the nature of effective design for such activities and environments, and the kinds of interactions that are seen at the individual, collaborative and whole-class levels. The findings fall under one of three themes: 1) the physicality of the room, 2) the pedagogical script for student observation and reflection and collaboration, and 3) ways of including collective visualizations in the activity. Discrete findings demonstrate how the above variables, through their design as inquiry components (i.e., activity, room, scripts and scaffolds on devices, collective visualizations), can mediate the students' interactions with one another, with their teacher, and impact the outcomes of their inquiry. A set of design recommendations is drawn from the results of this research to guide future design or research efforts.

Impact of NICU design on environmental noise.

PubMed

Szymczak, Stacy E; Shellhaas, Renée A

2014-04-01

For neonates requiring intensive care, the optimal sound environment is uncertain. Minimal disruptions from medical staff create quieter environments for sleep, but limit language exposure necessary for proper language development. There are two models of neonatal intensive care units (NICUs): open-bay, in which 6-to-10 infants are cared for in a single large room; and single-room, in which neonates are housed in private, individual hospital rooms. We compared the acoustic environments in the two NICU models. We extracted the audio tracks from video-electroencephalography (EEG) monitoring studies from neonates in an open-bay NICU and compared the acoustic environment to that recorded from neonates in a new single-room NICU. From each NICU, 18 term infants were studied (total N=36; mean gestational age 39.3±1.9 weeks). Neither z-scores of the sound level variance (0.088±0.03 vs. 0.083±0.03, p=0.7), nor percent time with peak sound variance (above 2 standard deviations; 3.6% vs. 3.8%, p=0.6) were different. However, time below 0.05 standard deviations was higher in the single-room NICU (76% vs. 70%, p=0.02). We provide objective evidence that single-room NICUs have equal sound peaks and overall noise level variability compared with open-bay units, but the former may offer significantly more time at lower noise levels.

[Conflict matrix : Risk management tool in the operating room].

PubMed

Andel, D; Markstaller, K; Andel, H

2017-05-01

In business conflicts have long been known to have a negative effect on costs and team performance. In medicine this aspect has been widely neglected, especially when optimizing processes for operating room (OR) management. In the multidisciplinary setting of OR management, shortcomings in rules for decision making and lack of communication result in members perceiving themselves as competitors in the patient's environment rather than acting as art of a multiprofessional team. This inevitably leads to the emergence and escalation of conflicts. We developed a conflict matrix to provide an inexpensive and objective way for evaluating the level of escalation of conflicts in a multiprofessional working environment, such as an OR. The senior members of all involved disciplines were asked to estimate the level of conflict escalation between the individual professional groups on a scale of 0-9. By aggregating the response data, an overview of the conflict matrix within this OR section was created. No feedback was received from 1 of the 11 contacted occupational groups. By color coding the median, minimum and maximum values of the retrieved data, an intuitive overview of the escalation levels of conflict could be provided. The value range of all feedbacks was between 0 and 6. Estimation of the escalation levels differed widely within one category, showing a range of up to 6 (out of 6) levels. The presented assessment using a conflict matrix is a simple and cost-effective method to assess the conflict landscape, especially in multidisciplinary environments, such as OR management. The chance of conflict prevention or the early recognition of existing conflicts represents an enormous potential for cost and risk saving and might have positive long-term effects by building a culture of conflict prevention at the workplace and a positive influence on interdisciplinary cooperation in this working environment.

Factors involved in dental surgery fires: a review of the literature.

PubMed

VanCleave, Andrea M; Jones, James E; McGlothlin, James D; Saxen, Mark A; Sanders, Brian J; Walker, LaQuia A

2014-01-01

Surgical fires are well-characterized, readily preventable, potentially devastating operating room catastrophes that continue to occur from 20 to 100 times per year or, by one estimate, up to 600 times per year in US operating rooms, sometimes with fatal results. The most significant risk factors for surgical fires involve (a) the use of an ignition source, such as laser or electrocautery equipment, in or around an oxygen-enriched environment in the head, neck, and upper torso area and (b) the concurrent delivery of supplemental oxygen, especially via nasal cannula. Nonetheless, while these 2 conditions occur very commonly in dental surgery, especially in pediatric dental surgery where sedation and anesthesia are regularly indicated, there is a general absence of documented dental surgical fires in the literature. Barring the possibility of underreporting for fear of litigation, this may suggest that there is another mechanism or mechanisms present in dental or pediatric dental surgery that mitigates this worst-case risk of surgical fires. Some possible explanations for this include: greater fire safety awareness by dental practitioners, incidental ventilation of oxygen-enriched environments in patient oral cavities due to breathing, or suction used by dental practitioners during procedures. This review of the literature provides a background to suggest that the practice of using intraoral suction in conjunction with the use of supplemental oxygen during dental procedures may alter the conditions needed for the initiation of intraoral fires. To date, there appear to be no published studies describing the ability of intraoral suctioning devices to alter the ambient oxygen concentration in an intraoral environment. In vivo models that would allow examination of intraoral suction on the ambient oxygen concentration in a simulated intraoral environment may then provide a valuable foundation for evaluating the safety of current clinical dental surgical practices, particularly in regard to the treatment of children.

Environment of care: Is it time to reassess microbial contamination of the operating room air as a risk factor for surgical site infection in total joint arthroplasty?

PubMed

Parvizi, Javad; Barnes, Sue; Shohat, Noam; Edmiston, Charles E

2017-11-01

In the modern operating room (OR), traditional surgical mask, frequent air exchanges, and architectural barriers are viewed as effective in reducing airborne microbial populations. Intraoperative sampling of airborne particulates is rarely performed in the OR because of technical difficulties associated with sampling methodologies and a common belief that airborne contamination is infrequently associated with surgical site infections (SSIs). Recent studies suggest that viable airborne particulates are readily disseminated throughout the OR, placing patients at risk for postoperative SSI. In 2017, virtually all surgical disciplines are engaged in the implantation of selective biomedical devices, and these implants have been documented to be at high risk for intraoperative contamination. Approximately 1.2 million arthroplasties are performed annually in the United States, and that number is expected to increase to 3.8 million by the year 2030. The incidence of periprosthetic joint infection is perceived to be low (<2.5%); however, the personal and fiscal morbidity is significant. Although the pharmaceutic and computer industries enforce stringent air quality standards on their manufacturing processes, there is currently no U.S. standard for acceptable air quality within the OR environment. This review documents the contribution of air contamination to the etiology of periprosthetic joint infection, and evidence for selective innovative strategies to reduce the risk of intraoperative microbial aerosols. Copyright © 2017 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Teaching and learning in the operating room is a two-way street: resident perceptions.

PubMed

Vikis, Elena A; Mihalynuk, Tanis V; Pratt, Dan D; Sidhu, Ravi S

2008-05-01

The transformation of a trainee into a surgeon is influenced strongly by communication patterns in the operating room (OR). In the current era of limited educational opportunities, elucidation of teaching and learning strategies in this environment is critical. The aim of this study was to further understand the elements of an effective communicative instructional interaction (CII) as perceived by surgical residents. Qualitative research methodology was used to explore University of British Columbia surgery residents' perceptions of what constitutes an effective CII in the OR. Purposeful sampling was used to select participants from various years of training. Eighteen residents participated in semistructured interviews to facilitate reflection of their OR experiences. Interviews were transcribed, analyzed, and fed back to residents to confirm their accuracy. Independent coding and analysis led to the development of key emergent themes. Themes represented the interplay of ideals expressed by the residents. The primary emergent theme was that both teacher and learner play a major role in the creation of an effective CII. The ideal teacher had an instructional plan, facilitated surgical independence, and showed support and empathy for the surgical resident. The ideal resident was receptive, prepared, and acknowledged limitations. The contextual constraints of the OR played a central role in learning, and residents identified ways to maintain educational value despite primarily nonmodifiable contextual elements (ie, time constraints). In a unique environment such as the OR, both teacher and learner may benefit by an enhanced understanding of the elements of an effective CII.

KENNEDY SPACE CENTER, FLA. - In the high bay clean room at the Astrotech Space Operations processing facilities near KSC, workers prepare to attach an overhead crane to NASA’s MESSENGER spacecraft. The spacecraft will be moved to a work stand where employees of the Johns Hopkins University Applied Physics Laboratory, builders of the spacecraft, will perform an initial state-of-health check. Then processing for launch can begin, including checkout of the power systems, communications systems and control systems. The thermal blankets will also be attached for flight. MESSENGER - short for MErcury Surface, Space ENvironment, GEochemistry and Ranging - will be launched May 11 on a six-year mission aboard a Boeing Delta II rocket. Liftoff is targeted for 2:26 a.m. EDT on Tuesday, May 11.

NASA Image and Video Library

2004-03-10

KENNEDY SPACE CENTER, FLA. - In the high bay clean room at the Astrotech Space Operations processing facilities near KSC, workers prepare to attach an overhead crane to NASA’s MESSENGER spacecraft. The spacecraft will be moved to a work stand where employees of the Johns Hopkins University Applied Physics Laboratory, builders of the spacecraft, will perform an initial state-of-health check. Then processing for launch can begin, including checkout of the power systems, communications systems and control systems. The thermal blankets will also be attached for flight. MESSENGER - short for MErcury Surface, Space ENvironment, GEochemistry and Ranging - will be launched May 11 on a six-year mission aboard a Boeing Delta II rocket. Liftoff is targeted for 2:26 a.m. EDT on Tuesday, May 11.

KENNEDY SPACE CENTER, FLA. - At the Astrotech Space Operations processing facilities near KSC, NASA’s MESSENGER spacecraft from NASA’s Goddard Space Flight Center in Greenbelt, Md., is offloaded. MESSENGER - short for MErcury Surface, Space ENvironment, GEochemistry and Ranging - will be taken into a high bay clean room and employees of the Johns Hopkins University Applied Physics Laboratory, builders of the spacecraft, will perform an initial state-of-health check. Then processing for launch can begin, including checkout of the power systems, communications systems and control systems. The thermal blankets will also be attached for flight. MESSENGER will be launched May 11 on a six-year mission aboard a Boeing Delta II rocket. Liftoff is targeted for 2:26 a.m. EDT on Tuesday, May 11.

NASA Image and Video Library

2004-03-10

KENNEDY SPACE CENTER, FLA. - At the Astrotech Space Operations processing facilities near KSC, NASA’s MESSENGER spacecraft from NASA’s Goddard Space Flight Center in Greenbelt, Md., is offloaded. MESSENGER - short for MErcury Surface, Space ENvironment, GEochemistry and Ranging - will be taken into a high bay clean room and employees of the Johns Hopkins University Applied Physics Laboratory, builders of the spacecraft, will perform an initial state-of-health check. Then processing for launch can begin, including checkout of the power systems, communications systems and control systems. The thermal blankets will also be attached for flight. MESSENGER will be launched May 11 on a six-year mission aboard a Boeing Delta II rocket. Liftoff is targeted for 2:26 a.m. EDT on Tuesday, May 11.

KENNEDY SPACE CENTER, FLA. - In the high bay clean room at the Astrotech Space Operations processing facilities near KSC, workers attach an overhead crane to NASA’s MESSENGER spacecraft. The spacecraft will be moved to a work stand where employees of the Johns Hopkins University Applied Physics Laboratory, builders of the spacecraft, will perform an initial state-of-health check. Then processing for launch can begin, including checkout of the power systems, communications systems and control systems. The thermal blankets will also be attached for flight. MESSENGER - short for MErcury Surface, Space ENvironment, GEochemistry and Ranging - will be launched May 11 on a six-year mission aboard a Boeing Delta II rocket. Liftoff is targeted for 2:26 a.m. EDT on Tuesday, May 11.

NASA Image and Video Library

2004-03-10

KENNEDY SPACE CENTER, FLA. - In the high bay clean room at the Astrotech Space Operations processing facilities near KSC, workers attach an overhead crane to NASA’s MESSENGER spacecraft. The spacecraft will be moved to a work stand where employees of the Johns Hopkins University Applied Physics Laboratory, builders of the spacecraft, will perform an initial state-of-health check. Then processing for launch can begin, including checkout of the power systems, communications systems and control systems. The thermal blankets will also be attached for flight. MESSENGER - short for MErcury Surface, Space ENvironment, GEochemistry and Ranging - will be launched May 11 on a six-year mission aboard a Boeing Delta II rocket. Liftoff is targeted for 2:26 a.m. EDT on Tuesday, May 11.

KENNEDY SPACE CENTER, FLA. - At the Astrotech Space Operations processing facilities near KSC, a lift helps offload NASA’s MESSENGER spacecraft shipped from NASA’s Goddard Space Flight Center in Greenbelt, Md. MESSENGER - short for MErcury Surface, Space ENvironment, GEochemistry and Ranging - will be taken into a high bay clean room and employees of the Johns Hopkins University Applied Physics Laboratory, builders of the spacecraft, will perform an initial state-of-health check. Then processing for launch can begin, including checkout of the power systems, communications systems and control systems. The thermal blankets will also be attached for flight. MESSENGER will be launched May 11 on a six-year mission aboard a Boeing Delta II rocket. Liftoff is targeted for 2:26 a.m. EDT on Tuesday, May 11.

NASA Image and Video Library

2004-03-10

KENNEDY SPACE CENTER, FLA. - At the Astrotech Space Operations processing facilities near KSC, a lift helps offload NASA’s MESSENGER spacecraft shipped from NASA’s Goddard Space Flight Center in Greenbelt, Md. MESSENGER - short for MErcury Surface, Space ENvironment, GEochemistry and Ranging - will be taken into a high bay clean room and employees of the Johns Hopkins University Applied Physics Laboratory, builders of the spacecraft, will perform an initial state-of-health check. Then processing for launch can begin, including checkout of the power systems, communications systems and control systems. The thermal blankets will also be attached for flight. MESSENGER will be launched May 11 on a six-year mission aboard a Boeing Delta II rocket. Liftoff is targeted for 2:26 a.m. EDT on Tuesday, May 11.

Archaea in artificial environments: Their presence in global spacecraft clean rooms and impact on planetary protection

PubMed Central

Moissl-Eichinger, Christine

2011-01-01

The presence and role of Archaea in artificial, human-controlled environments is still unclear. The search for Archaea has been focused on natural biotopes where they have been found in overwhelming numbers, and with amazing properties. However, they are considered as one of the major group of microorganisms that might be able to survive a space flight, or even to thrive on other planets. Although still concentrating on aerobic, bacterial spores as a proxy for spacecraft cleanliness, space agencies are beginning to consider Archaea as a possible contamination source that could affect future searches for life on other planets. This study reports on the discovery of archaeal 16S rRNA gene signatures not only in US American spacecraft assembly clean rooms but also in facilities in Europe and South America. Molecular methods revealed the presence of Crenarchaeota in all clean rooms sampled, while signatures derived from methanogens and a halophile appeared only sporadically. Although no Archaeon was successfully enriched in our multiassay cultivation approach thus far, samples from a European clean room revealed positive archaeal fluorescence in situ hybridization (FISH) signals of rod-shaped microorganisms, representing the first visualization of Archaea in clean room environments. The molecular and visual detection of Archaea was supported by the first quantitative PCR studies of clean rooms, estimating the overall quantity of Archaea therein. The significant presence of Archaea in these extreme environments in distinct geographical locations suggests a larger role for these microorganisms not only in natural biotopes, but also in human controlled and rigorously cleaned environments. PMID:20703318

Archaea in artificial environments: their presence in global spacecraft clean rooms and impact on planetary protection.

PubMed

Moissl-Eichinger, Christine

2011-02-01

The presence and role of Archaea in artificial, human-controlled environments is still unclear. The search for Archaea has been focused on natural biotopes where they have been found in overwhelming numbers, and with amazing properties. However, they are considered as one of the major group of microorganisms that might be able to survive a space flight, or even to thrive on other planets. Although still concentrating on aerobic, bacterial spores as a proxy for spacecraft cleanliness, space agencies are beginning to consider Archaea as a possible contamination source that could affect future searches for life on other planets. This study reports on the discovery of archaeal 16S rRNA gene signatures not only in US American spacecraft assembly clean rooms but also in facilities in Europe and South America. Molecular methods revealed the presence of Crenarchaeota in all clean rooms sampled, while signatures derived from methanogens and a halophile appeared only sporadically. Although no Archaeon was successfully enriched in our multiassay cultivation approach thus far, samples from a European clean room revealed positive archaeal fluorescence in situ hybridization (FISH) signals of rod-shaped microorganisms, representing the first visualization of Archaea in clean room environments. The molecular and visual detection of Archaea was supported by the first quantitative PCR studies of clean rooms, estimating the overall quantity of Archaea therein. The significant presence of Archaea in these extreme environments in distinct geographical locations suggests a larger role for these microorganisms not only in natural biotopes, but also in human controlled and rigorously cleaned environments.

An Improved Indoor Positioning System Using RGB-D Cameras and Wireless Networks for Use in Complex Environments.

PubMed

Duque Domingo, Jaime; Cerrada, Carlos; Valero, Enrique; Cerrada, Jose A

2017-10-20

This work presents an Indoor Positioning System to estimate the location of people navigating in complex indoor environments. The developed technique combines WiFi Positioning Systems and depth maps , delivering promising results in complex inhabited environments, consisting of various connected rooms, where people are freely moving. This is a non-intrusive system in which personal information about subjects is not needed and, although RGB-D cameras are installed in the sensing area, users are only required to carry their smart-phones. In this article, the methods developed to combine the above-mentioned technologies and the experiments performed to test the system are detailed. The obtained results show a significant improvement in terms of accuracy and performance with respect to previous WiFi-based solutions as well as an extension in the range of operation.

31. Fourth floor attic, operating room with skylight, view to ...

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

31. Fourth floor attic, operating room with skylight, view to south - Portsmouth Naval Hospital, Hospital Building, Rixey Place, bounded by Williamson Drive, Holcomb Road, & The Circle, Portsmouth, Portsmouth, VA

Report: EPA’s Radiation and Indoor Environments National Laboratory Should Improve Its Computer Room Security Controls

EPA Pesticide Factsheets

Report #12-P-0847, September 21, 2012.Our review of the security posture and in-place environmental controls of EPA’s Radiation and Indoor Environments National Laboratory computer room disclosed an array of security and environmental control deficiencies.

Virtual Environment Training: Auxiliary Machinery Room (AMR) Watchstation Trainer.

ERIC Educational Resources Information Center

Hriber, Dennis C.; And Others

1993-01-01

Describes a project implemented at Newport News Shipbuilding that used Virtual Environment Training to improve the performance of submarine crewmen. Highlights include development of the Auxiliary Machine Room (AMR) Watchstation Trainer; Digital Video Interactive (DVI); screen layout; test design and evaluation; user reactions; authoring language;…

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

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

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

Installation of PMV Operation Program in DDC Controller and Air Conditioning Control Using PMV Directly as Set Point

NASA Astrophysics Data System (ADS)

Haramoto, Ken-Ichi

In general, air conditioning control in a building is operated mainly by indoor air temperature control. Although the operators of the machine in the building accepted a claim for indoor air temperature presented by the building inhabitants, the indoor conditions have been often too cool or warm. Therefore, in an attempt to create better thermal environments, the author paid attention to the PMV that is a thermal comfort index. And then, the possibility of air conditioning control using the PMV directly as the set point was verified by employing actual equipment in an air conditioning testing room and an office building. Prior to the execution of this control, the operation program of the PMV was installed in a DDC controller for the air conditioning control. And information from indoor sensors and so on was inputted to the controller, and the computed PMV was used as the feedback variable.

Computed intraoperative navigation guidance--a preliminary report on a new technique.

PubMed

Enislidis, G; Wagner, A; Ploder, O; Ewers, R

1997-08-01

To assess the value of a computer-assisted three-dimensional guidance system (Virtual Patient System) in maxillofacial operations. Laboratory and open clinical study. Teaching Hospital, Austria. 6 patients undergoing various procedures including removal of foreign body (n=3) and biopsy, maxillary advancement, and insertion of implants (n=1 each). Storage of computed tomographic (CT) pictures on an optical disc, and imposition of intraoperative video images on to these. The resulting display is shown to the surgeon on a micromonitor in his head-up display for guidance during the operations. To improve orientation during complex or minimally invasive maxillofacial procedures and to make such operations easier and less traumatic. Successful transferral of computed navigation technology into an operation room environment and positive evaluation of the method by the surgeons involved. Computer-assisted three-dimensional guidance systems have the potential for making complex or minimally invasive procedures easier to do, thereby reducing postoperative morbidity.

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.

Early Extubation in the Operating Room after Congenital Open-Heart Surgery.

PubMed

Fukunishi, Takuma; Oka, Norihiko; Yoshii, Takeshi; Kobayashi, Kensuke; Inoue, Nobuyuki; Horai, Tetsuya; Kitamura, Tadashi; Okamoto, Hirotsugu; Miyaji, Kagami

2018-01-27

Early extubation in the operating room after congenital open-heart surgery is feasible, but extubation in the intensive care unit after the operation remains common practice at many institutions. The purpose of this study was to evaluate retrospectively the adequacy of our early-extubation strategy and exclusion criteria through analysis based on the Risk Adjustment in Congenital Heart Surgery method (RACHS-1).This retrospective analysis included 359 cases requiring cardiopulmonary bypass (male, 195; female, 164; weight > 3.0 kg; aged 1 month to 18 years). Neonates and preoperatively intubated patients were excluded. Other exclusion criteria included severe preoperative pulmonary hypertension, high-dose catecholamine requirement after cardiopulmonary bypass, delayed sternal closure, laryngomalacia, serious bleeding, and delayed awakening. The early-extubation rates were compared between age groups and RACHS-1 classes.Overall, 83% of cases (298/359) were extubated in the operating room, classified by RACHS-1 categories as follows: 1, 59/59 (100%); 2, 164/200 (84%); 3, 61/78 (78%); and 4-6, 10/22 (45%). The early extubation rate in categories 1-3 (86%, 288/337) was significantly higher than for categories 4-6 (45.5%, 10/22) (P < 0.001). Because they met one of the exclusion criteria, 61 patients (17%) were not extubated in the operating room. Eight patients (2.7%) required re-intubation after early extubation in the operating room, and longer operation time was significantly associated with re-intubation (P < 0.001).Extubation in the operating room after congenital open-heart surgery was feasible based on our criteria, especially for patients in the low RACHS-1 categories, and involves a very low rate of re-intubation.

Maintaining reduced noise levels in a resource-constrained neonatal intensive care unit by operant conditioning.

PubMed

Ramesh, A; Denzil, S B; Linda, R; Josephine, P K; Nagapoornima, M; Suman Rao, P N; Swarna Rekha, A

2013-03-01

To evaluate the efficacy of operant conditioning in sustaining reduced noise levels in the neonatal intensive care unit (NICU). Quasi-experimental study on quality of care. Level III NICU of a teaching hospital in south India. 26 staff employed in the NICU. (7 Doctors, 13 Nursing staff and 6 Nursing assistants). Operant conditioning of staff activity for 6 months. This method involves positive and negative reinforcement to condition the staff to modify noise generating activities. Comparing noise levels in decibel: A weighted [dB (A)] before conditioning with levels at 18 and 24 months after conditioning. Decibel: A weighted accounts for noise that is audible to human ears. Operant conditioning for 6 months sustains the reduced noise levels to within 62 dB in ventilator room 95% CI: 60.4 - 62.2 and isolation room (95% CI: 55.8 - 61.5). In the preterm room, noise can be maintained within 52 dB (95% CI: 50.8 - 52.6). This effect is statistically significant in all the rooms at 18 months (P = 0.001). At 24 months post conditioning there is a significant rebound of noise levels by 8.6, 6.7 and 9.9 dB in the ventilator, isolation and preterm room, respectively (P =0.001). Operant conditioning for 6 months was effective in sustaining reduced noise levels. At 18 months post conditioning, the noise levels were maintained within 62 dB (A), 60 dB (A) and 52 dB (A) in the ventilator, isolation and pre-term room, respectively. Conditioning needs to be repeated at 12 months in the ventilator room and at 18 months in the other rooms.

Greening of orthopedic surgery.

PubMed

Lee, Rushyuan J; Mears, Simon C

2012-06-01

Every year, 4 billion pounds of waste are produced by health care facilities, and the amount continues to increase annually. In response, a movement toward greening health care has been building, with a particular focus on the operating room. Between 20% and 70% of health care waste originates from a hospital's operating room, and up to 90% of operating room waste is improperly sorted and sent for costly and unneeded hazardous waste processing. Recent successful changes include segregation of hospital waste, substitution of the ubiquitous polypropylene plastic wrap used for the sterilization and handling of surgical equipment with metal cases, and the reintroduction of reusable surgical gowns. Orthopedic-related changes include the successful reprocessing and reuse of external fixators, shavers, blades, burs, and tourniquets. These changes have been shown to be environmentally and economically beneficial. Early review indicates that these changes are feasible, but a need exists for further evaluation of the effect on the operating room and flow of the surgical procedure and of the risks to the surgeons and operating room staff. Other key considerations are the effects of reprocessed and reused equipment on patient care and outcome and the role of surgeons in helping patients make informed decisions regarding surgical care. The goals of this study were to summarize the amount and types of waste produced in hospitals and operating rooms, highlight the methods of disposal used, review disposal methods that have been developed to reduce waste and improve recycling, and explore future developments in greening health care. Copyright 2012, SLACK Incorporated.

Maximum performance synergy: A new approach to recording studio control room design

NASA Astrophysics Data System (ADS)

Szymanski, Jeff D.

2003-10-01

Popular recording studio control room designs include LEDE(tm), RFZ(tm), and nonenvironment rooms. The common goal of all of these is to create an accurate acoustical environment that does not distort or otherwise color audio reproduction. Also common to these designs is the frequent need to have multiple ancillary recording rooms, often adjacent to the main control room, where group members perform. This approach, where group members are physically separated from one another, can lead to lack of ensemble in the finished recordings. New twists on old acoustical treatment techniques have been implemented at a studio in Nashville, Tennessee, which minimize the need for multiple ancillary recording rooms, thus creating an environment where talent, producer and recording professionals can all occupy the same space for maximum performance synergy. Semi-separated performance areas are designed around a central, critical listening area. The techniques and equipment required to achieve this separation are reviewed, as are advantages and disadvantages to this new control room design approach.

EPRR

Science.gov Websites

Electronic Public Reading Room Operational Reading Room & Environmental Cleanup through April 2018 Los Alamos Legacy Cleanup Electronic Public Reading Room Environmental Cleanup from May 2018

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

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

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

A Comparison between Temperature-Controlled Laminar Airflow Device and a Room Air-Cleaner in Reducing Exposure to Particles While Asleep

PubMed Central

Spilak, Michal P.; Sigsgaard, Torben; Takai, Hisamitsu; Zhang, Guoqiang

2016-01-01

People spend approximately one third of their life sleeping. Exposure to pollutants in the sleep environment often leads to a variety of adverse health effects, such as development and exacerbation of asthma. Avoiding exposure to these pollutants by providing a sufficient air quality in the sleep environment might be a feasible method to alleviate these health symptoms. We performed full-scale laboratory measurements using a thermal manikin positioned on an experimental bed. Three ventilation settings were tested: with no filtration system operated, use of portable air cleaner and use of a temperature-controlled laminar airflow (TLA) device. The first part of the experiment investigated the air-flow characteristics in the breathing zone. In the second part, particle removal efficiency was estimated. Measured in the breathing zone, the room air cleaner demonstrated high turbulence intensity, high velocity and turbulence diffusivity level, with a particle reduction rate of 52% compared to baseline after 30 minutes. The TLA device delivered a laminar airflow to the breathing zone with a reduction rate of 99.5%. During a periodical duvet lifting mimicking a subject’s movement in bed, the particle concentration was significantly lower with the TLA device compared to the room air cleaner. The TLA device provided a barrier which significantly reduced the introduction of airborne particles into the breathing zone. Further studies should be conducted for the understanding of the transport of resuspended particles between the duvet and the laying body. PMID:27898693

A Comparison between Temperature-Controlled Laminar Airflow Device and a Room Air-Cleaner in Reducing Exposure to Particles While Asleep.

PubMed

Spilak, Michal P; Sigsgaard, Torben; Takai, Hisamitsu; Zhang, Guoqiang

2016-01-01

People spend approximately one third of their life sleeping. Exposure to pollutants in the sleep environment often leads to a variety of adverse health effects, such as development and exacerbation of asthma. Avoiding exposure to these pollutants by providing a sufficient air quality in the sleep environment might be a feasible method to alleviate these health symptoms. We performed full-scale laboratory measurements using a thermal manikin positioned on an experimental bed. Three ventilation settings were tested: with no filtration system operated, use of portable air cleaner and use of a temperature-controlled laminar airflow (TLA) device. The first part of the experiment investigated the air-flow characteristics in the breathing zone. In the second part, particle removal efficiency was estimated. Measured in the breathing zone, the room air cleaner demonstrated high turbulence intensity, high velocity and turbulence diffusivity level, with a particle reduction rate of 52% compared to baseline after 30 minutes. The TLA device delivered a laminar airflow to the breathing zone with a reduction rate of 99.5%. During a periodical duvet lifting mimicking a subject's movement in bed, the particle concentration was significantly lower with the TLA device compared to the room air cleaner. The TLA device provided a barrier which significantly reduced the introduction of airborne particles into the breathing zone. Further studies should be conducted for the understanding of the transport of resuspended particles between the duvet and the laying body.

Assessing team performance in the operating room: development and use of a "black-box" recorder and other tools for the intraoperative environment.

PubMed

Guerlain, Stephanie; Adams, Reid B; Turrentine, F Beth; Shin, Thomas; Guo, Hui; Collins, Stephen R; Calland, J Forrest

2005-01-01

The objective of this research was to develop a digital system to archive the complete operative environment along with the assessment tools for analysis of this data, allowing prospective studies of operative performance, intraoperative errors, team performance, and communication. Ability to study this environment will yield new insights, allowing design of systems to avoid preventable errors that contribute to perioperative complications. A multitrack, synchronized, digital audio-visual recording system (RATE tool) was developed to monitor intraoperative performance, including software to synchronize data and allow assignment of independent observational scores. Cases were scored for technical performance, participants' situational awareness (knowledge of critical information), and their comfort and satisfaction with the conduct of the procedure. Laparoscopic cholecystectomy (n = 10) was studied. Technical performance of the RATE tool was excellent. The RATE tool allowed real time, multitrack data collection of all aspects of the operative environment, while permitting digital recording of the objective assessment data in a time synchronized and annotated fashion during the procedure. The mean technical performance score was 73% +/- 28% of maximum (perfect) performance. Situational awareness varied widely among team members, with the attending surgeon typically the only team member having comprehensive knowledge of critical case information. The RATE tool allows prospective analysis of performance measures such as technical judgments, team performance, and communication patterns, offers the opportunity to conduct prospective intraoperative studies of human performance, and allows for postoperative discussion, review, and teaching. This study also suggests that gaps in situational awareness might be an underappreciated source of operative adverse events. Future uses of this system will aid teaching, failure or adverse event analysis, and intervention research.

The Effects of Altering Environmental and Instrumental Context on the Performance of Memorized Music

ERIC Educational Resources Information Center

Mishra, Jennifer; Backlin, William

2007-01-01

Three experiments investigated whether musical memory was context dependent. Instrumental musicians memorized music in one context and recalled in either the same or a different context. Contexts included atypical performing environments (Experiment 1: lobby/conference room) or commonly encountered environments (Experiment 2: practice room,…

Impact of surface disinfection and sterile draping of furniture on room air quality in a cardiac procedure room with a ventilation and air-conditioning system (extrusion airflow, cleanroom class 1b (DIN 1946-4))

PubMed Central

Below, Harald; Ryll, Sylvia; Empen, Klaus; Dornquast, Tina; Felix, Stefan; Rosenau, Heike; Kramer, Sebastian; Kramer, Axel

2010-01-01

In a cardiac procedure room, ventilated by a ventilation and air-conditioning system with turbulent mixed airflow, a protection zone in the operating area could be defined through visualization of airflows. Within this protection zone, no turbulence was detectable in the room air. Under the given conditions, disinfection of all surfaces including all furniture and equipment after the last operation and subsequent draping of furniture and all equipment that could not be removed from the room with sterile surgical drapes improved the indoor room air quality from cleanroom class C to cleanroom class B. This also allows procedures with elevated requirements to be performed in room class 1b. PMID:20941336

[Single-family rooms for neonatal intensive care units impacts on preterm newborns, families, and health-care staff. A systematic literature review].

PubMed

Servel, A-C; Rideau Batista Novais, A

2016-09-01

The quality of the environment is an essential point in the care of preterm newborns. The design of neonatal intensive care units (NICUs) (open-bay, single-patient room, single-family room) directly affects both the preterm newborns and their caregivers (parents, healthcare staff). The aim of this systematic review was to evaluate the impact of single-family rooms on the preterm newborn, its parents, and the staff. Single-family rooms improve outcome for the preterm newborn, with increasing parental involvement and better control of the environment (fewer inappropriate stimulations such as high levels of noise and illumination). This kind of NICU design also improves parental and staff satisfaction. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Evaluation of noise pollution level in the operating rooms of hospitals: A study in Iran.

PubMed

Giv, Masoumeh Dorri; Sani, Karim Ghazikhanlou; Alizadeh, Majid; Valinejadi, Ali; Majdabadi, Hesamedin Askari

2017-06-01

Noise pollution in the operating rooms is one of the remaining challenges. Both patients and physicians are exposed to different sound levels during the operative cases, many of which can last for hours. This study aims to evaluate the noise pollution in the operating rooms during different surgical procedures. In this cross-sectional study, sound level in the operating rooms of Hamadan University-affiliated hospitals (totally 10) in Iran during different surgical procedures was measured using B&K sound meter. The gathered data were compared with national and international standards. Statistical analysis was performed using descriptive statistics and one-way ANOVA, t -test, and Pearson's correlation test. Noise pollution level at majority of surgical procedures is higher than national and international documented standards. The highest level of noise pollution is related to orthopedic procedures, and the lowest one related to laparoscopic and heart surgery procedures. The highest and lowest registered sound level during the operation was 93 and 55 dB, respectively. Sound level generated by equipments (69 ± 4.1 dB), trolley movement (66 ± 2.3 dB), and personnel conversations (64 ± 3.9 dB) are the main sources of noise. The noise pollution of operating rooms are higher than available standards. The procedure needs to be corrected for achieving the proper conditions.

Ornamental indoor plants in hospital rooms enhanced health outcomes of patients recovering from surgery.

PubMed

Park, Seong-Hyun; Mattson, Richard H

2009-09-01

Clinical trials have not been reported concerning the health benefits of viewing indoor plants on stress and recovery of surgical patients within a hospital setting. Using various medical and psychologic measurements, this study performed a randomized clinical trial with surgical patients to evaluate whether plants in hospital rooms have therapeutic influences. Ninety (90) patients recovering from a hemorrhoidectomy were randomly assigned to either control or plant rooms. With half the patients, live plants were placed in their rooms during postoperative recovery periods. Data collected for each patient included length of hospitalization, analgesics used for postoperative pain control, vital signs, ratings of pain intensity, pain distress, anxiety and fatigue, the State-Trait Anxiety Inventory Form Y-1, the Environmental Assessment Scale, and the Patient's Room Satisfaction Questionnaire. Viewing plants during the recovery period had a positive influence linking directly to health outcomes of surgical patients. Patients in hospital rooms with plants and flowers had significantly more positive physiologic responses evidenced by lower systolic blood pressure, and lower ratings of pain, anxiety, and fatigue than patients in the control room. Patients with plants also felt more positively about their rooms and evaluated them with higher satisfaction when compared with patients in similar rooms without plants. Based on patients' comments, plants brightened up the room environment, reduced stress, and also conveyed positive impressions of hospital employees caring for patients. Findings of this study confirmed the therapeutic value of plants in the hospital environment as a noninvasive, inexpensive, and effective complementary medicine for surgical patients. Health care professionals and hospital administrators need to consider the use of plants and flowers to enhance healing environments for patients.

[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).

Noise disturbance in open-plan study environments: a field study on noise sources, student tasks and room acoustic parameters.

PubMed

Braat-Eggen, P Ella; van Heijst, Anne; Hornikx, Maarten; Kohlrausch, Armin

2017-09-01

The aim of this study is to gain more insight in the assessment of noise in open-plan study environments and to reveal correlations between noise disturbance experienced by students and the noise sources they perceive, the tasks they perform and the acoustic parameters of the open-plan study environment they work in. Data were collected in five open-plan study environments at universities in the Netherlands. A questionnaire was used to investigate student tasks, perceived sound sources and their perceived disturbance, and sound measurements were performed to determine the room acoustic parameters. This study shows that 38% of the surveyed students are disturbed by background noise in an open-plan study environment. Students are mostly disturbed by speech when performing complex cognitive tasks like studying for an exam, reading and writing. Significant but weak correlations were found between the room acoustic parameters and noise disturbance of students. Practitioner Summary: A field study was conducted to gain more insight in the assessment of noise in open-plan study environments at universities in the Netherlands. More than one third of the students was disturbed by noise. An interaction effect was found for task type, source type and room acoustic parameters.

Front view of bldg 30 which houses mission control

NASA Image and Video Library

1984-08-30

41D-3072 (30 Aug 1984) --- A 41-D shift change is taking place in the Johnson Space Center's Building 30. In its twenty years of operation, the mission control center has been the scene of many such changes. The windowless wing at left houses three floors, including rooms supporting flight control rooms 1 & 2 (formerly called mission operations control rooms 1 & 2).

Crew Field Notes: A New Tool for Planetary Surface Exploration

NASA Technical Reports Server (NTRS)

Horz, Friedrich; Evans, Cynthia; Eppler, Dean; Gernhardt, Michael; Bluethmann, William; Graf, Jodi; Bleisath, Scott

2011-01-01

The Desert Research and Technology Studies (DRATS) field tests of 2010 focused on the simultaneous operation of two rovers, a historical first. The complexity and data volume of two rovers operating simultaneously presented significant operational challenges for the on-site Mission Control Center, including the real time science support function. The latter was split into two "tactical" back rooms, one for each rover, that supported the real time traverse activities; in addition, a "strategic" science team convened overnight to synthesize the day's findings, and to conduct the strategic forward planning of the next day or days as detailed in [1, 2]. Current DRATS simulations and operations differ dramatically from those of Apollo, including the most evolved Apollo 15-17 missions, due to the advent of digital technologies. Modern digital still and video cameras, combined with the capability for real time transmission of large volumes of data, including multiple video streams, offer the prospect for the ground based science support room(s) in Mission Control to witness all crew activities in unprecedented detail and in real time. It was not uncommon during DRATS 2010 that each tactical science back room simultaneously received some 4-6 video streams from cameras mounted on the rover or the crews' backpacks. Some of the rover cameras are controllable PZT (pan, zoom, tilt) devices that can be operated by the crews (during extensive drives) or remotely by the back room (during EVAs). Typically, a dedicated "expert" and professional geologist in the tactical back room(s) controls, monitors and analyses a single video stream and provides the findings to the team, commonly supported by screen-saved images. It seems obvious, that the real time comprehension and synthesis of the verbal descriptions, extensive imagery, and other information (e.g. navigation data; time lines etc) flowing into the science support room(s) constitute a fundamental challenge to future mission operations: how can one analyze, comprehend and synthesize -in real time- the enormous data volume coming to the ground? Real time understanding of all data is needed for constructive interaction with the surface crews, and it becomes critical for the strategic forward planning process.

Use of Video Analysis System for Working Posture Evaluations

NASA Technical Reports Server (NTRS)

McKay, Timothy D.; Whitmore, Mihriban

1994-01-01

In a work environment, it is important to identify and quantify the relationship among work activities, working posture, and workplace design. Working posture may impact the physical comfort and well-being of individuals, as well as performance. The Posture Video Analysis Tool (PVAT) is an interactive menu and button driven software prototype written in Supercard (trademark). Human Factors analysts are provided with a predefined set of options typically associated with postural assessments and human performance issues. Once options have been selected, the program is used to evaluate working posture and dynamic tasks from video footage. PVAT has been used to evaluate postures from Orbiter missions, as well as from experimental testing of prototype glove box designs. PVAT can be used for video analysis in a number of industries, with little or no modification. It can contribute to various aspects of workplace design such as training, task allocations, procedural analyses, and hardware usability evaluations. The major advantage of the video analysis approach is the ability to gather data, non-intrusively, in restricted-access environments, such as emergency and operation rooms, contaminated areas, and control rooms. Video analysis also provides the opportunity to conduct preliminary evaluations of existing work areas.

Absorption measurements of the second overtone band of NO in ambient and combustion gases with a 1.8-mum room-temperature diode laser.

PubMed

Sonnenfroh, D M; Allen, M G

1997-10-20

We describe the development of a room-temperature diode sensor for in situ monitoring of combustion-generated NO. The sensor is based on a near-IR diode laser operating near 1.8 mum, which probes isolated transitions in the second overtone (3, 0) absorption band of NO. Based on absorption cell data, the sensitivity for ambient atmospheric pressure conditions is of the order of 30 parts in 10(6) by volume for a meter path (ppmv-m), assuming a minimum measurable absorbance of 10(-5). Initial H(2) -air flame measurements are complicated by strong water vapor absorption features that constrain the available gain and dynamic range of the present detection system. Preliminary results suggest that detection limits in this environment of the order of 140 ppmv-m could be achieved with optimum baseline correction.

Absorption measurements of the second overtone band of NO in ambient and combustion gases with a 1.8- m room-temperature diode laser

NASA Astrophysics Data System (ADS)

Sonnenfroh, David M.; Allen, Mark G.

1997-10-01

We describe the development of a room-temperature diode sensor for in situ monitoring of combustion-generated NO. The sensor is based on a near-IR diode laser operating near 1.8 m, which probes isolated transitions in the second overtone (3,0) absorption band of NO. Based on absorption cell data, the sensitivity for ambient atmospheric pressure conditions is of the order of 30 parts in 10 6 by volume for a meter path (ppmv m), assuming a minimum measurable absorbance of 10 5 . Initial H 2 air flame measurements are complicated by strong water vapor absorption features that constrain the available gain and dynamic range of the present detection system. Preliminary results suggest that detection limits in this environment of the order of 140 ppmv m could be achieved with optimum baseline correction.

[Computerized monitoring system in the operating center with UNIX and X-window].

PubMed

Tanaka, Y; Hashimoto, S; Chihara, E; Kinoshita, T; Hirose, M; Nakagawa, M; Murakami, T

1992-01-01

We previously reported the fully automated data logging system in the operating center. Presently, we revised the system using a highly integrated operating system, UNIX instead of OS/9. With this multi-task and multi-window (X-window) system, we could monitor all 12 rooms in the operating center at a time. The system in the operating center consists of 2 computers, SONY NEWS1450 (UNIX workstation) and Sord M223 (CP/M, data logger). On the bitmapped display of the workstation, using X-window, the data of all the operating rooms can be visualized. Furthermore, 2 other minicomputers (Fujitsu A50 in the conference room, and A60 in the ICU) and a workstation (Sun3-80 in the ICU) were connected with ethernet. With the remote login function (NFS), we could easily obtain the data during the operation from outside the operating center. This system works automatically and needs no routine maintenance.

[Bioaerosol concentrations and the identification of aerosolized bacteria by 16S rDNA analysis in work environments].

PubMed

Ishimatsu, Sumiyo; Abe, Hiroki; Fukuda, Kazumasa; Ishidao, Toru; Taniguchi, Hatsumi; Hori, Hajime

2007-03-01

Bioaerosols cause sick building syndrome (SBS) and allergy. Many kinds of bioaerosol impactors are used for measurement of airborne microorganism concentrations in Japan. However, because the impactors are set on agar plates, some microorganisms cannot make colonies on the plates because of their lower viability or demands of nutrition. On the other hand, by double staining using ethidium bromide (EtBr) and carboxyfluorescein diacetate (CFDA), both total cells and cells with esterase activities can be detected without incubation. In this study, we calculated total cell concentrations and percentages of cells with esterase activities by the combination of filter sampling and double staining (EtBr and CFDA) from air of a laboratory, a conference room and outdoors. Temperature and humidity in the laboratory were constantly kept by an air conditioner, but in the conference room, an air conditioner was only operated sometimes because of its low frequency of use. There were no significant differences between total cell concentrations and humidity in both rooms, but increase of the percentages of cells with esterase activities depended on rainfall before the samplings (n=15, p<0.05 by Mann-Whitney test). The increase of active microorganisms by rainfall should be considered when we evaluate the risk of bioaerosols in the workplace. There were few differences in classifications of aerosolized bacteria by 16S rDNA sequence-based homology between the laboratory and the conference room. In both rooms, few pathogenic bacteria were observed.

Operating room-to-incision interval and neonatal outcome in emergency caesarean section: a retrospective 5-year cohort study.

PubMed

Palmer, E; Ciechanowicz, S; Reeve, A; Harris, S; Wong, D J N; Sultan, P

2018-07-01

We conducted a 5-year retrospective cohort study on women undergoing caesarean section to investigate factors influencing the operating room-to-incision interval. Time-to-event analysis was performed for category-1 caesarean section using a Cox proportional hazards regression model. Covariates included: anaesthetic technique; body mass index; age; parity; time of delivery; and gestational age. Binary logistic regression was performed for 5-min Apgar score ≥ 7. There were 677 women who underwent category-1 caesarean section and who met the entry criteria. Unadjusted median (IQR [range]) operating room-to-incision intervals were: epidural top-up 11 (7-17 [0-87]) min; general anaesthesia 6 (4-11 [0-69]) min; spinal 13 (10-20 [0-83]) min; and combined spinal-epidural 24 (13-35 [0-75]) min. Cox regression showed general anaesthesia to be the most rapid method with a hazard ratio (95%CI) of 1.97 (1.60-2.44; p < 0.0001), followed by epidural top-up (reference group), spinal anaesthesia 0.79 (0.65-0.96; p = 0.02) and combined spinal-epidural 0.48 (0.35-0.67; p < 0.0001). Underweight and overweight body mass indexes were associated with longer operating room-to-incision intervals. General anaesthesia was associated with fewer 5-min Apgar scores ≥ 7 with an odds ratio (95%CI) of 0.28 (0.11-0.68; p < 0.01). There was no difference in neonatal outcomes between the first and fifth quintiles for operating room-to-incision intervals. General anaesthesia is associated with the most rapid operating room-to-incision interval for category-1 caesarean section, but is also associated with worse short term neonatal outcomes. Longer operating room-to-incision intervals were not associated with worse neonatal outcomes. © 2018 The Association of Anaesthetists of Great Britain and Ireland.

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

Code of Federal Regulations, 2011 CFR

2011-04-01

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

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

Code of Federal Regulations, 2010 CFR

2010-04-01

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

Extreme Mapping: Looking for Water on the Moon

NASA Technical Reports Server (NTRS)

Cohen, Tamar

2016-01-01

There are many challenges when exploring extreme environments. Gathering accurate data to build maps about places that you cannot go is incredibly complex. NASA supports scientists by remotely operating robotic rovers to explore uncharted territories. One potential upcoming mission is to look for water near a lunar pole (the Resource Prospector mission). Learn about the technical hurdles and research steps that NASA takes before the mission. NASA practices on Earth with Mission Analogs which simulate the proposed mission. This includes going to lunar-type landscapes, building field networks, testing out rovers, instruments and operational procedures. NASA sets up remote science back rooms just as there are for actual missions. NASA develops custom Ground Data Systems software to support scientific mission planning and monitoring over variable time delays, and separate commanding software and infrastructure to operate the rovers.

Comparison of Dynamic Characteristics for an Inflatable Solar Concentrator in Atmospheric and Thermal Vacuum Conditions

NASA Technical Reports Server (NTRS)

Slade, Kara N.; Tinker, Michael L.; Lassiter, John O.; Engberg, Robert

2000-01-01

Dynamic testing of an inflatable solar concentrator structure in a thermal vacuum chamber as well as in ambient laboratory conditions is described in detail. Unique aspects of modal testing for the extremely lightweight inflatable are identified, including the use of a noncontacting laser vibrometer measurement system. For the thermal vacuum environment, mode shapes and frequency response functions are compared for three different test article inflation pressures at room temperature. Modes that persist through all the inflation pressure regimes are identified, as well as modes that are unique for each pressure. In atmospheric pressure and room temperature conditions, dynamic measurements were obtained for the expected operational inflation pressure of 0.5 psig. Experimental mode shapes and frequency response functions for ambient conditions are described and compared to the 0.5 psig results from the thermal vacuum tests. Only a few mode shapes were identified that occurred in both vacuum and atmospheric environments. This somewhat surprising result is discussed in detail, and attributed at least partly to 1.) large differences in modal damping, and 2.) significant differences in the mass of air contained by the structure, in the two environments. Results of this investigation point out the necessity of testing inflatable space structures in vacuum conditions before they can be launched. Ground testing in atmospheric pressure is not sufficient for predicting on-orbit dynamics of non-rigidized inflatable systems.

Testing of improved polyimide actuator rod seals at high temperature and under vacuum conditions for use in advanced aircraft hydraulic systems

NASA Technical Reports Server (NTRS)

Sellereite, B. K.; Waterman, A. W.; Nelson, W. G.

1974-01-01

Polyimide second-stage rod seals were evaluated to determine their suitability for applications in space station environments. The 6.35-cm (2.5-in.)K-section seal was verified for thermal cycling operation between room temperature and 478 K (400 F) and for operation in a 133 micron PA(0.000001 mm Hg) vacuum environment. The test seal completed the scheduled 96 thermal cycles and 1438 hr in vacuum with external rod seal leakage well within the maximum allowable of two drops per 25 actuation cycles. At program completion, the seals showed no signs of structural degradation. Posttest inspection showed the seals retained a snug fit against the shaft and housing walls, indicating additional wear life capability. Evaluation of a molecular flow section during vacuum testing, to inhibit fluid loss through vaporization, showed it to be beneficial with MIL-H-5606, a petroleum-base fluid, in comparison with MIL-H-83282, a synthetic hydrocarbon-base fluid.

A self-controlled trial to evaluate the use of active hearing defenders in the engine rooms of operational naval vessels.

PubMed

Ong, M; Choo, J T L; Low, E

2004-02-01

Active Hearing Defenders are established hearing protectors with in-built electro-acoustics that shut-off ambient noise while allowing effective communication between users. A blinded, self-controlled trial was conducted among naval servicemen to compare the effectiveness of two types of active hearing defenders (Howard-Leight Thunder TM and COM-55) in relation to passive hearing defenders in an operational environment. Subjects felt that the active hearing defenders were more comfortable, durable, and that the active hearing defenders helped them work better. When subjects were tested with a speech discrimination battery (Central Institute of the Deaf, Spondee Word lists), there was a significant difference (p value of 0.04, using the Kruskall-Wallis ANOVA test) between the two active and the passive defenders. However, no significant difference was found between the two types of active hearing defenders. Active hearing defenders are an acceptable and efficacious means of hearing protection in noisy environments.

KSC-2013-3100

NASA Image and Video Library

2013-07-24

CAPE CANAVERAL, Fla. – Linnea Applegate, right, of Grace Equine Rescue and Therapy for Humans, or GERTH, organizes her booth during the National Employee Health and Fitness Day event in the Operations and Checkout Building's Mission Briefing Room. GERTH is a nonprofit organization in Cocoa, Fla., that brings horses, children and adults together in a safe, nurturing and healing environment to promote therapeutic healing. Other vendors shown in the background include Bridget Griffin of the YMCA of Titusville, center, and Sunseed Co-op’s Marcia Cooney, in pink. Photo credit: NASA/Daniel Casper

The game theory in thoracic surgery: from the intuitions of Luca Pacioli to the operating rooms management.

PubMed

Ciocci, Argante; Viti, Andrea; Terzi, Alberto; Bertolaccini, Luca

2015-11-01

Game theory is a formal way to analyze the interactions among groups of subjects who behave each other. It has historically been of great interest in the economic fields in which decisions are made in a competitive environment. Game theory has fascinating potential if applied in the medical science. Few papers have been written about the application of game theory in surgery. The majority of scenarios of game theory in surgery fall into two main groups: cooperative and no cooperative games.

Normal-Mode Splitting in a Weakly Coupled Optomechanical System

NASA Astrophysics Data System (ADS)

Rossi, Massimiliano; Kralj, Nenad; Zippilli, Stefano; Natali, Riccardo; Borrielli, Antonio; Pandraud, Gregory; Serra, Enrico; Di Giuseppe, Giovanni; Vitali, David

2018-02-01

Normal-mode splitting is the most evident signature of strong coupling between two interacting subsystems. It occurs when two subsystems exchange energy between themselves faster than they dissipate it to the environment. Here we experimentally show that a weakly coupled optomechanical system at room temperature can manifest normal-mode splitting when the pump field fluctuations are antisquashed by a phase-sensitive feedback loop operating close to its instability threshold. Under these conditions the optical cavity exhibits an effectively reduced decay rate, so that the system is effectively promoted to the strong coupling regime.

The game theory in thoracic surgery: from the intuitions of Luca Pacioli to the operating rooms management

PubMed Central

Ciocci, Argante; Viti, Andrea; Terzi, Alberto

2015-01-01

Game theory is a formal way to analyze the interactions among groups of subjects who behave each other. It has historically been of great interest in the economic fields in which decisions are made in a competitive environment. Game theory has fascinating potential if applied in the medical science. Few papers have been written about the application of game theory in surgery. The majority of scenarios of game theory in surgery fall into two main groups: cooperative and no cooperative games. PMID:26716049

Low-temperature operation of a Buck DC/DC converter

NASA Technical Reports Server (NTRS)

Ray, Biswajit; Gerber, Scott S.; Patterson, Richard L.; Myers, Ira T.

1995-01-01

Low-temperature (77 K) operation of a 42/28 V, 175 W, 50 kHz PWM Buck DC/DC converter designed with commercially available components is reported. Overall, the converter losses decreased at 77 K compared to room temperature operation. A full-load efficiency of 97 percent was recorded at liquid-nitrogen temperature, compared to 95.8 percent at room temperature. Power MOSFET operation improved significantly where as the output rectifier operation deteriorated at low-temperature. The performance of the output filter inductor and capacitor did not change significantly at 77 K compared to room temperature performance. It is possible to achieve high-density and high efficiency power conversion at low-temperatures due to improved electronic, electrical and thermal properties of materials.

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

OR2020: The Operating Room of the Future

DTIC Science & Technology

2004-05-01

25 3.3 Technical Requirements: Standards and Tools for Improved Operating R oom Process Integration...Image processing and visualization tools must be made available to the operating room. 5. Communications issues must be addressed and aim toward...protocols for effectively performing advanced surgeries and using telecommunications-ready tools as needed. The following recommendations were made

76 FR 53714 - Notice of Request for the Approval of a New Information Collection

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-29

... Transportation, 1200 New Jersey Avenue, SE., Docket Operations, M-30, West Building, Ground Floor, Room W12- 140...., Docket Operations, M-30, West Building, Ground Floor, Room W12-140, Washington, DC 20590-0001 between 9 a... New Jersey Avenue, SE., Docket Operations, M-30, West Building, [[Page 53715

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…

Quantitative Investigation of Room-Temperature Breakdown Effects in Pixelated TlBr Detectors

NASA Astrophysics Data System (ADS)

Koehler, Will; He, Zhong; Thrall, Crystal; O'Neal, Sean; Kim, Hadong; Cirignano, Leonard; Shah, Kanai

2014-10-01

Due to favorable material properties such as high atomic number (Tl: 81, Br: 35), high density ( 7.56 g/cm3), and a wide band gap (2.68 eV), thallium-bromide (TlBr) is currently under investigation for use as an alternative room-temperature semiconductor gamma-ray spectrometer. TlBr detectors can achieve less than 1% FWHM energy resolution at 662 keV, but these results are limited to stable operation at - 20°C. After days to months of room-temperature operation, ionic conduction causes these devices to fail. This work correlates the varying leakage current with alpha-particle and gamma-ray spectroscopic performances at various operating temperatures. Depth-dependent photopeak centroids exhibit time-dependent transient behavior, which indicates trapping sites form near the anode surface during room-temperature operation. After refabrication, similar performance and functionality of failed detectors returned.

The Ethics of the Collegiate Locker Room

ERIC Educational Resources Information Center

Roper, Larry D.

2017-01-01

Locker rooms are a fixture in the athletic culture of colleges and universities. Given the important roles those spaces play in the learning, growth, and development of student-athletes, collegiate leaders should consider how to influence locker room environments in positive ways.

Evaluation of exposures of hospital employees to anesthetic gases

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lambeth, J.D.

1988-01-01

Hospital employees who work in hospital operating and recovery rooms are often exposed to a number of anesthetic gases. There is evidence to support the belief that such exposures have led to higher rates of miscarriages and spontaneous abortions of pregnancies among women directly exposed to these gases than among women not exposed. Most of the studies assessing exposure levels were conducted prior to the widespread use of scavenging systems. Air sampling was conducted in hospital operatories and recovery rooms of three large hospitals to assess the current exposure levels in these areas and determine the effectiveness of these systemsmore » in reducing exposures to fluoride-containing anesthetic gases. It was determined that recovery-room personnel are exposed to levels of anesthesia gases that often approach and exceed the recommended Threshold Limit Value-Time Weighted Average (TLV-TWA) of 2.0 ppm. Recovery-room personnel do not have the protection from exposure provided by scavenging systems in operating rooms. Operating-room personnel were exposed to anesthesia gas levels above the TLV-TWA only when patients were masked, or connected and disconnected from the scavenging systems. Recovery-room personnel also need to be protected from exposure to anesthesia gases by a scavenging system.« less

Impact of spinal anesthesia for open pyloromyotomy on operating room time.

PubMed

Kachko, Ludmyla; Simhi, Eliahu; Freud, Enrique; Dlugy, Elena; Katz, Jacob

2009-10-01

When pyloromyotomy for hypertrophic pyloric stenosis (HPS) is performed under general anesthesia, metabolic abnormalities and fluid deficits coupled with residual anesthetics may increase the risk of postoperative apnea, thereby, prolonging operating room time and delaying extubation. Spinal anesthesia has been found to reduce the rate of postoperative apnea in high-risk infants. The aim of the study was to evaluate the effect of spinal vs general anesthesia on operating room time in infants undergoing open pyloromyotomy. Data for 60 infants who underwent pyloromyotomy under spinal (n = 24) or general (n = 36) anesthesia at a tertiary pediatric medical center were derived from the computerized database. Primary outcome measures were total operating room time, procedure duration, anesthesia release time, wake-up time, and anesthesia control time (anesthesia release plus wake-up). Nonparametric Mann-Whitney test was used for statistical analysis, and Levene's test was used to assess the equality of variances in samples; P

Comparison of three distinct surgical clothing systems for protection from air-borne bacteria: A prospective observational study

PubMed Central

2012-01-01

Background To prevent surgical site infection it is desirable to keep bacterial counts low in the operating room air during orthopaedic surgery, especially prosthetic surgery. As the air-borne bacteria are mainly derived from the skin flora of the personnel present in the operating room a reduction could be achieved by using a clothing system for staff made from a material fulfilling the requirements in the standard EN 13795. The aim of this study was to compare the protective capacity between three clothing systems made of different materials – one mixed cotton/polyester and two polyesters - which all had passed the tests according to EN 13795. Methods Measuring of CFU/m3 air was performed during 21 orthopaedic procedures performed in four operating rooms with turbulent, mixing ventilation with air flows of 755 – 1,050 L/s. All staff in the operating room wore clothes made from the same material during each surgical procedure. Results The source strength (mean value of CFU emitted from one person per second) calculated for the three garments were 4.1, 2.4 and 0.6 respectively. In an operating room with an air flow of 755 L/s both clothing systems made of polyester reduced the amount of CFU/m3 significantly compared to the clothing system made from mixed material. In an operating room with air intake of 1,050 L/s a significant reduction was only achieved with the polyester that had the lowest source strength. Conclusions Polyester has a better protective capacity than cotton/polyester. There is need for more discriminating tests of the protective efficacy of textile materials intended to use for operating garment. PMID:23068884

Novel Hybrid Operating Table for Neuroendovascular Treatment.

PubMed

Jong-Hyun, Park; Jonghyeon, Mun; Dong-Seung, Shin; Bum-Tae, Kim

2017-03-25

The integration of interventional and surgical techniques is requiring the development of a new working environment equipped for the needs of an interdisciplinary neurovascular team. However, conventional surgical and interventional tables have only a limited ability to provide for these needs. We have developed a concept mobile hybrid operating table that provides the ability for such a team to conduct both endovascular and surgical procedures in a single session. We developed methods that provide surgeons with angiography-guided surgery techniques for use in a conventional operating room environment. In order to design a convenient device ideal for practical use, we consulted with mechanical engineers. The mobile hybrid operating table consists of two modules: a floating tabletop and a mobile module. In brief, the basic principle of the mobile hybrid operating table is as follows: firstly, the length of the mobile hybrid operating table is longer than that of a conventional surgical table and yet shorter than a conventional interventional table. It was designed with the goal of exhaustively meeting the intensive requirements of both endovascular and surgical procedures. Its mobile module allows for the floating tabletop to be moved quickly and precisely. It is important that during a procedure, a patient can be moved without being repositioned, particularly with a catheter in situ. Secondly, a slim-profile headrest facilitates the mounting of a radiolucent head cramp system for cranial stabilization and fixation. We have introduced a novel invention, a mobile hybrid operating table for use in an operating suite.

A collaborative working environment for small group meetings in Second Life.

PubMed

da Silva, Cintia Rc; Garcia, Ana Cristina B

2013-01-01

This paper presents the SLMeetingRoom, a virtual reality online environment to support group meetings of geographically dispersed participants. A prototype was developed to demonstrate the feasibility of the approach using the Second Life platform. Ten additional components had to be added to Second Life environment to support group work essential activities such as participants' communication, tasks' and participants' coordination, participants' collaboration and work evolution's perception. Empirical studies, both pilot and experiment, were developed comparing four different meeting settings: face-to-face, videoconference, stand Second Life and SLMeetingRoom. The study involved graduate students enrolled in the Interface and Multimedia discipline at the Fluminense Federal University (UFF) in Brazil. Results indicated that groups working within SLMeetingRoom environment presented similar results as face-to-face meeting as far as sense of presence is concerned and with low cognitive effort. Task completion and degree of participation were not affected by the meeting set up. It was concluded that Second Life, in conjunction with the SLMeetingRoom components, is a good tool for holding synchronous remote meetings and coexists with other electronic meeting technologies.

Intraoperative magnetic resonance imaging with the magnetom open scanner: concepts, neurosurgical indications, and procedures: a preliminary report.

PubMed

Steinmeier, R; Fahlbusch, R; Ganslandt, O; Nimsky, C; Buchfelder, M; Kaus, M; Heigl, T; Lenz, G; Kuth, R; Huk, W

1998-10-01

Intraoperative magnetic resonance imaging (MRI) is now available with the General Electric MRI system for dedicated intraoperative use. Alternatively, non-dedicated MRI systems require fewer specific adaptations of instrumentation and surgical techniques. In this report, clinical experiences with such a system are presented. All patients were surgically treated in a "twin operating theater," consisting of a conventional operating theater with complete neuronavigation equipment (StealthStation and MKM), which allowed surgery with magnetically incompatible instruments, conventional instrumentation and operating microscope, and a radiofrequency-shielded operating room designed for use with an intraoperative MRI scanner (Magnetom Open; Siemens AG, Erlangen, Germany). The Magnetom Open is a 0.2-T MRI scanner with a resistive magnet and specific adaptations that are necessary to integrate the scanner into the surgical environment. The operating theaters lie close together, and patients can be intraoperatively transported from one room to the other. This retrospective analysis includes 55 patients with cerebral lesions, all of whom were surgically treated between March 1996 and September 1997. Thirty-one patients with supratentorial tumors were surgically treated (with navigational guidance) in the conventional operating room, with intraoperative MRI for resection control. For 5 of these 31 patients, intraoperative resection control revealed significant tumor remnants, which led to further tumor resection guided by the information provided by intraoperative MRI. Intraoperative MRI resection control was performed in 18 transsphenoidal operations. In cases with suspected tumor remnants, the surgeon reexplored the sellar region; additional tumor tissue was removed in three of five cases. Follow-up scans were obtained for all patients 1 week and 2 to 3 months after surgery. For 14 of the 18 patients, the images obtained intraoperatively were comparable to those obtained after 2 to 3 months. Intraoperative MRI was also used for six patients undergoing temporal lobe resections for treatment of pharmacoresistant seizures. For these patients, the extent of neocortical and mesial resection was tailored to fit the preoperative findings of morphological and electrophysiological alterations, as well as intraoperative electrocorticographic findings. Intraoperative MRI with the Magnetom Open provides considerable additional information to optimize resection during surgical treatment of supratentorial tumors, pituitary adenomas, and epilepsy. The twin operating theater is a true alternative to a dedicated MRI system. Additional efforts are necessary to improve patient transportation time and instrument guidance within the scanner.

Practices and impacts post-exposure to blood and body fluid in operating room nurses: A cross-sectional study.

PubMed

Kasatpibal, Nongyao; Whitney, JoAnne D; Katechanok, Sadubporn; Ngamsakulrat, Sukanya; Malairungsakul, Benjawan; Sirikulsathean, Pinyo; Nuntawinit, Chutatip; Muangnart, Thanisara

2016-05-01

Improper or inadequate actions taken after blood and body fluid exposures place individuals at risk for infection with bloodborne pathogens. This has potential, significant impact for health and well-being. To evaluate the practices and the personal impact experienced following blood and body fluid exposures among operating room nurses. A cross-sectional, multi-center study. Government and private hospitals from all parts of Thailand. Operating room nurses from 247 hospitals. A questionnaire eliciting responses on characteristics, post-exposure practices, and impacts was sent to 2500 operating room nurses. Usable questionnaires were returned by 2031 operating room nurses (81.2%). Of these 1270 had experience with blood and body fluid exposures (62.5%). Most operating room nurses did not report blood and body fluid exposures (60.9%). The major reasons of underreporting were low risk source (40.2%) and belief that they were not important to report (16.3%). Improper post-exposure practices were identified, 9.8% did not clean exposure area immediately, 18.0% squeezed out the wound, and 71.1% used antiseptic solution for cleansing a puncture wound. Post-exposure, 58.5% of them sought counseling, 16.3% took antiretroviral prophylaxis, 23.8% had serologic testing for hepatitis B and 43.1% for hepatitis C. The main personal impacts were anxiety (57.7%), stress (24.2%), and insomnia (10.2%). High underreporting, inappropriate post-exposure practices and impacts of exposure were identified from this study. Comprehensive education and effective training of post-exposure management may be keys to resolving these important problems. Copyright © 2016 Elsevier Ltd. All rights reserved.

Situation-Dependent Medical Device Risk Estimation: Design and Evaluation of an Equipment Management Center For Vendor-Independent Integrated Operating Rooms.

PubMed

Maktabi, Marianne; Neumuth, Thomas

2017-12-22

The complexity of surgical interventions and the number of technologies involved are constantly rising. Hospital staff has to learn how to handle new medical devices efficiently. However, if medical device-related incidents occur, the patient treatment is delayed. Patient safety could therefore be supported by an optimized assistance system that helps improve the management of technical equipment by nonmedical hospital staff. We developed a system for the optimal monitoring of networked medical device activity and maintenance requirements, which works in conjunction with a vendor-independent integrated operating room and an accurate surgical intervention Time And Resource Management System. An integrated situation-dependent risk assessment system gives the medical engineers optimal awareness of the medical devices in the operating room. A qualitative and quantitative survey among ten medical engineers from three different hospitals was performed to evaluate the approach. A series of 25 questions was used to evaluate various aspects of our system as well as the system currently used. Moreover, the respondents were asked to perform five tasks related to system supervision and incident handling. Our system received a very positive feedback. The evaluation studies showed that the integration of information, the structured presentation of information, and the assistance modules provide valuable support to medical engineers. An automated operating room monitoring system with an integrated risk assessment and Time And Resource Management System module is a new way to assist the staff being outside of a vendor-independent integrated operating room, who are nevertheless involved in processes in the operating room.

Scheduling elective surgeries: the tradeoff among bed capacity, waiting patients and operating room utilization using goal programming.

PubMed

Li, Xiangyong; Rafaliya, N; Baki, M Fazle; Chaouch, Ben A

2017-03-01

Scheduling of surgeries in the operating rooms under limited competing resources such as surgical and nursing staff, anesthesiologist, medical equipment, and recovery beds in surgical wards is a complicated process. A well-designed schedule should be concerned with the welfare of the entire system by allocating the available resources in an efficient and effective manner. In this paper, we develop an integer linear programming model in a manner useful for multiple goals for optimally scheduling elective surgeries based on the availability of surgeons and operating rooms over a time horizon. In particular, the model is concerned with the minimization of the following important goals: (1) the anticipated number of patients waiting for service; (2) the underutilization of operating room time; (3) the maximum expected number of patients in the recovery unit; and (4) the expected range (the difference between maximum and minimum expected number) of patients in the recovery unit. We develop two goal programming (GP) models: lexicographic GP model and weighted GP model. The lexicographic GP model schedules operating rooms when various preemptive priority levels are given to these four goals. A numerical study is conducted to illustrate the optimal master-surgery schedule obtained from the models. The numerical results demonstrate that when the available number of surgeons and operating rooms is known without error over the planning horizon, the proposed models can produce good schedules and priority levels and preference weights of four goals affect the resulting schedules. The results quantify the tradeoffs that must take place as the preemptive-weights of the four goals are changed.

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

Live animals for preclinical medical student surgical training

PubMed Central

DeMasi, Stephanie C.; Katsuta, Eriko; Takabe, Kazuake

2016-01-01

Aims The use of live animals for surgical training is a well-known, deliberated topic. However, medical students who use live animals rate the experience high not only in improving their surgical techniques, but also positively influencing their confidence levels in the operating room later in their careers. Therefore, we hypothesized that the use of live animal models is a unique and influential component of preclinical medical education. Materials and Methods Medical student performed the following surgical procedures using mice; surgical orthotopic implantation of cancer cells into fat pad and subsequently a radical mastectomy. The improvement of skill was then analyzed. Results All cancer cell inoculations were performed successfully. Improvement of surgical skills during the radical mastectomy procedure was documented in all parameters. All wounds healed without breakdown or dehiscence. The appropriate interval between interrupted sutures was ascertained after fifth wound closure. The speed of interrupted sutures was doubled by last wound closure. The time required to complete a radical mastectomy decreased by almost half. A single animal died immediately following the operation due to inappropriate anesthesia, which was attributed to the lack of understanding of the overall operative management. Conclusion Surgical training using live animals for preclinical medical students provides a unique learning experience, not only in improving surgical skills but also and arguably most importantly, to introduce the student to the complexities of the perioperative environment in a way that most closely resembles the stress and responsibility that the operating room demands. PMID:28713875

Comparison of air exhausts for surgical body suits (space suits) and the potential for periprosthetic joint infection.

PubMed

Ling, F; Halabi, S; Jones, C

2018-07-01

Periprosthetic joint infection is a major complication of total joint replacement surgery and is associated with significant morbidity, mortality and financial burden. Surgical body suits (space suits), originally designed to reduce the incidence of infection, have paradoxically been implicated in increased periprosthetic joint infection rates recently. Air exhausted from space suits may contribute to this increased rate of periprosthetic joint infection. To investigate the flow of air exhausted from space suits commonly used in modern operating theatres. The exhaust airflow patterns of four commercially available space suit systems were compared using a fog machine and serial still photographs. The space suit systems tested all air exhausted into the operating room. The single fan systems with a standard surgical gown exhausted air laterally from the posterior gown fold at approximately the level of the surgical field. The single fan system with a dedicated zippered suit exhausted air at a level below the surgical field. The dual fan system exhausted air out of the top of the helmet at a level above the surgical field. Space suit systems currently in use in joint replacement surgery differ significantly from traditional body exhaust systems; rather than removing contaminated air from the operating environment, modern systems exhaust this air into the operating room, in some cases potentially towards the sterile instrument tray and the surgical field. Copyright © 2018 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

[The use of an opect optic system in neurosurgical practice].

PubMed

Kalinovskiy, A V; Rzaev, D A; Yoshimitsu, K

2018-01-01

Modern neurosurgical practice is impossible without access to various information sources. The use of MRI and MSCT data during surgery is an integral part of the neurosurgeon's daily practice. Devices capable of managing an image viewer system without direct contact with equipment simplify working in the operating room. To test operation of a non-contact MRI and MSCT image viewer system in the operating room and to evaluate the system effectiveness. An Opect non-contact image management system developed at the Tokyo Women's Medical University was installed in one of the operating rooms of the Novosibirsk Federal Center of Neurosurgery in 2014. In 2015, the Opect system was used by operating surgeons in 73 surgeries performed in the same operating room. The system effectiveness was analyzed based on a survey of surgeons. The non-contact image viewer system occurred to be easy-to-learn for the personnel to operate this system, easy-to-manage it, and easy-to-present visual information during surgery. Application of the Opect system simplifies work with neuroimaging data during surgery. The surgeon can independently view series of relevant MRI and MSCT scans without any assistance.

Reactivity to Cannabis Cues in Virtual Reality Environments†

PubMed Central

Bordnick, Patrick S.; Copp, Hilary L.; Traylor, Amy; Graap, Ken M.; Carter, Brian L.; Walton, Alicia; Ferrer, Mirtha

2014-01-01

Virtual reality (VR) cue environments have been developed and successfully tested in nicotine, cocaine, and alcohol abusers. Aims in the current article include the development and testing of a novel VR cannabis cue reactivity assessment system. It was hypothesized that subjective craving levels and attention to cannabis cues would be higher in VR environments merits with cannabis cues compared to VR neutral environments. Twenty nontreatment-seeking current cannabis smokers participated in the VR cue trial. During the VR cue trial, participants were exposed to four virtual environments that contained audio, visual, olfactory, and vibrotactile sensory stimuli. Two VR environments contained cannabis cues that consisted of a party room in which people were smoking cannabis and a room containing cannabis paraphernalia without people. Two VR neutral rooms without cannabis cues consisted of a digital art gallery with nature videos. Subjective craving and attention to cues were significantly higher in the VR cannabis environments compared to the VR neutral environments. These findings indicate that VR cannabis cue reactivity may offer a new technology-based method to advance addiction research and treatment. PMID:19705672

Human physiological responses to wooden indoor environment.

PubMed

Zhang, Xi; Lian, Zhiwei; Wu, Yong

2017-05-15

Previous studies are mainly focused on non-wooden environments, whereas few are concerned with wooden ones. How wooden indoor environments impact the physiology of the occupants is still unclear. The purpose of this study was to explore the distinct physiological responses to wooden and non-wooden indoor environments, assessed by physiological parameters tests including blood pressure, electrocardiogram measurements, electro-dermal activity, oxyhemoglobin saturation, skin temperature, and near distance vision. Twenty healthy adults participated in this experiment, and their physiological responses were evaluated in a 90minute investigation. The results illustrated that; less tension and fatigue were generated in the wooden rooms than in the non-wooden rooms when the participants did their work. In addition, the study also found that the wooden environments benefit the autonomic nervous system, respiratory system, and visual system. Moreover, wooden rooms play a valuable role in physiological regulation and ease function especially after a consecutive period of work. These results provide an experimental basis to support that wooden environment is beneficial to indoor occupants than the non-wooden indoor environment. Copyright © 2017 Elsevier Inc. All rights reserved.

The elephant in the room: collaboration and competition among relief organizations during high-profile disasters.

PubMed

Subbarao, Italo; Wynia, Matthew K; Burkle, Frederick M

2010-01-01

The non-governmental organizations (NGOs) that assume the bulk of emergency care during large-scale disasters in the developing world must expend considerable time and resources to ensure donations to sustain their field operations. This long-standing dilemma for the humanitarian community can create a competitive environment that: Compromises the delivery and quality of services, Allows the effectiveness of operations to be compromised by a lack of cooperation and collaboration, Disrupts the timely and accurate coordination and analysis of outcome measures that are crucial to successful response in the future, and Undermines the long-term capacity of indigenous aid organizations. This article addresses problems and potential solutions for improved coordination and long-term capacity-building of humanitarian aid.

Ultralow noise performance of an 8.4-GHz maser-feedhorn system

NASA Technical Reports Server (NTRS)

Johnson, D. L.; Petty, S. M.; Kovatch, J. J.; Glass, G. W.

1990-01-01

A total system noise temperature of 6.6 K was demonstrated with an 8.4-GHz traveling wave maser and feedhorn operating in a cryogenic environment. Both the maser and feedhorn were inserted in the helium cryostat, with the maser operating in the 1.6-K liquid bath and the feedhorn cooled in the helium gas, with a temperature gradient along the horn ranging from the liquid bath temperature at its lower end to room temperature at its top. The ruby maser exhibited 43 dB of gain with a bandwidth of 76 MHz(-3 dB) centered at 8400 MHz. Discussions of the maser, cooled feedhorn, and cryostat designs are presented along with a discussion of the noise temperature measurements.

Distribution of methicillin-resistant coagulase-positive staphylococci (MRCoPS) in a surgical unit and cystotomy operation sites in a veterinary teaching hospital

PubMed Central

FUNGWITHAYA, Punpichaya; BRIKSHAVANA, Pasakorn; CHANCHAITHONG, Pattrarat; PRAPASARAKUL, Nuvee

2016-01-01

This study aimed to investigate the spread of methicillin-resistant coagulase-positive staphylococci (MRCoPS) among veterinary staff, hand-touch sites and surgical tissue during cystotomy operations on cats and dogs that were patients, and to analyze the genetic relatedness and antimicrobial resistance profiles of the isolates. Human and environmental samples were obtained from the nasal passageways of 12 surgeons and veterinary assistants and from 29 hand-touch sites of instruments in operative units and subjected to bacterial isolation and enumeration. Swab samples were collected in triplicate from 29 dogs and three cats at the site of incision, from the incision area, from the peritoneum during surgery and from the peritoneum before suture. MRCoPS were identified by mecA gene detection and characterized by their antibiogram profile, SCCmec type and pulsed-field gel electrophoresis. Twenty-four staphylococci were isolated, derived from one veterinary assistant, 12 operating room floor areas and hand-touch sites, three dogs and one cat. Methicillin-resistant S. pseudintermedius (MRSP) was found on an electric clipper and rebreathing circuits in the operating room. Three dogs were positive for MRSP during surgery, and one methicillin-resistant S. aureus (MRSA) was detected in a cat. All MRCoPS were resistant to doxycycline, erythromycin, clindamycin and enrofloxacin, but no patients developed surgical site infections. According to their genotypic patterns, the clones obtained from the environment and human sources differed from the animal clones. Despite intensive hygienic management, a variety of MRCoPS clones were present within the surgical unit and during surgery. PMID:27990009

Distribution of methicillin-resistant coagulase-positive staphylococci (MRCoPS) in a surgical unit and cystotomy operation sites in a veterinary teaching hospital.

PubMed

Fungwithaya, Punpichaya; Brikshavana, Pasakorn; Chanchaithong, Pattrarat; Prapasarakul, Nuvee

2017-02-28

This study aimed to investigate the spread of methicillin-resistant coagulase-positive staphylococci (MRCoPS) among veterinary staff, hand-touch sites and surgical tissue during cystotomy operations on cats and dogs that were patients, and to analyze the genetic relatedness and antimicrobial resistance profiles of the isolates. Human and environmental samples were obtained from the nasal passageways of 12 surgeons and veterinary assistants and from 29 hand-touch sites of instruments in operative units and subjected to bacterial isolation and enumeration. Swab samples were collected in triplicate from 29 dogs and three cats at the site of incision, from the incision area, from the peritoneum during surgery and from the peritoneum before suture. MRCoPS were identified by mecA gene detection and characterized by their antibiogram profile, SCCmec type and pulsed-field gel electrophoresis. Twenty-four staphylococci were isolated, derived from one veterinary assistant, 12 operating room floor areas and hand-touch sites, three dogs and one cat. Methicillin-resistant S. pseudintermedius (MRSP) was found on an electric clipper and rebreathing circuits in the operating room. Three dogs were positive for MRSP during surgery, and one methicillin-resistant S. aureus (MRSA) was detected in a cat. All MRCoPS were resistant to doxycycline, erythromycin, clindamycin and enrofloxacin, but no patients developed surgical site infections. According to their genotypic patterns, the clones obtained from the environment and human sources differed from the animal clones. Despite intensive hygienic management, a variety of MRCoPS clones were present within the surgical unit and during surgery.

Comprehensive Training Curricula for Minimally Invasive Surgery

PubMed Central

Palter, Vanessa N

2011-01-01

Background The unique skill set required for minimally invasive surgery has in part contributed to a certain portion of surgical residency training transitioning from the operating room to the surgical skills laboratory. Simulation lends itself well as a method to shorten the learning curve for minimally invasive surgery by allowing trainees to practice the unique motor skills required for this type of surgery in a safe, structured environment. Although a significant amount of important work has been done to validate simulators as viable systems for teaching technical skills outside the operating room, the next step is to integrate simulation training into a comprehensive curriculum. Objectives This narrative review aims to synthesize the evidence and educational theories underlining curricula development for technical skills both in a broad context and specifically as it pertains to minimally invasive surgery. Findings The review highlights the critical aspects of simulation training, such as the effective provision of feedback, deliberate practice, training to proficiency, the opportunity to practice at varying levels of difficulty, and the inclusion of both cognitive teaching and hands-on training. In addition, frameworks for integrating simulation training into a comprehensive curriculum are described. Finally, existing curricula on both laparoscopic box trainers and virtual reality simulators are critically evaluated. PMID:22942951

Robotic digital subtraction angiography systems within the hybrid operating room.

PubMed

Murayama, Yuichi; Irie, Koreaki; Saguchi, Takayuki; Ishibashi, Toshihiro; Ebara, Masaki; Nagashima, Hiroyasu; Isoshima, Akira; Arakawa, Hideki; Takao, Hiroyuki; Ohashi, Hiroki; Joki, Tatsuhiro; Kato, Masataka; Tani, Satoshi; Ikeuchi, Satoshi; Abe, Toshiaki

2011-05-01

Fully equipped high-end digital subtraction angiography (DSA) within the operating room (OR) environment has emerged as a new trend in the fields of neurosurgery and vascular surgery. To describe initial clinical experience with a robotic DSA system in the hybrid OR. A newly designed robotic DSA system (Artis zeego; Siemens AG, Forchheim, Germany) was installed in the hybrid OR. The system consists of a multiaxis robotic C arm and surgical OR table. In addition to conventional neuroendovascular procedures, the system was used as an intraoperative imaging tool for various neurosurgical procedures such as aneurysm clipping and spine instrumentation. Five hundred one neurosurgical procedures were successfully conducted in the hybrid OR with the robotic DSA. During surgical procedures such as aneurysm clipping and arteriovenous fistula treatment, intraoperative 2-/3-dimensional angiography and C-arm-based computed tomographic images (DynaCT) were easily performed without moving the OR table. Newly developed virtual navigation software (syngo iGuide; Siemens AG) can be used in frameless navigation and in access to deep-seated intracranial lesions or needle placement. This newly developed robotic DSA system provides safe and precise treatment in the fields of endovascular treatment and neurosurgery.

High temperature superconductor dc SQUID micro-susceptometer for room temperature objects

NASA Astrophysics Data System (ADS)

Faley, M. I.; Pratt, K.; Reineman, R.; Schurig, D.; Gott, S.; Atwood, C. G.; Sarwinski, R. E.; Paulson, D. N.; Starr, T. N.; Fagaly, R. L.

2004-05-01

We have developed a scanning magnetic microscope (SMM) with 25 µm resolution in spatial position for the magnetic features of room temperature objects. The microscope consists of a high-temperature superconductor (HTS) dc SQUID sensor, suspended in vacuum with a self-adjusting standoff, close spaced liquid nitrogen Dewar, X-Y scanning stage and a computer control system. The HTS SQUIDs were optimized for better spatial and field resolutions for operation at liquid nitrogen temperature. Measured inside a magnetic shield, the 10 pT Hz-1/2 typical noise of the SQUIDs is white down to frequencies of about 10 Hz, increasing up to about 20 pT Hz-1/2 at 1 Hz. The microscope is mounted on actively damped platforms, which negate vibrations from the environment as well as damping internal stepper motor noises. A high-resolution video telescope and a 1 µm precision z-axis positioning system allow a close positioning of the sample under the sensor. The ability of the sensors to operate in unshielded environmental conditions with magnetic fields up to about 15 G allowed us to perform 2D mapping of the local ac and dc susceptibility of the objects.

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

PubMed Central

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

2015-01-01

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

Electronic Components and Circuits for Extreme Temperature Environments

NASA Technical Reports Server (NTRS)

Patterson, Richard L.; Hammoud, Ahmad; Dickman, John E.; Gerber, Scott

2003-01-01

Planetary exploration missions and deep space probes require electrical power management and control systems that are capable of efficient and reliable operation in very low temperature environments. Presently, spacecraft operating in the cold environment of deep space carry a large number of radioisotope heating units in order to maintain the surrounding temperature of the on-board electronics at approximately 20 C. Electronics capable of operation at cryogenic temperatures will not only tolerate the hostile environment of deep space but also reduce system size and weight by eliminating or reducing the radioisotope heating units and their associate structures; thereby reducing system development as well as launch costs. In addition, power electronic circuits designed for operation at low temperatures are expected to result in more efficient systems than those at room temperature. This improvement results from better behavior and tolerance in the electrical and thermal properties of semiconductor and dielectric materials at low temperatures. The Low Temperature Electronics Program at the NASA Glenn Research Center focuses on research and development of electrical components, circuits, and systems suitable for applications in the aerospace environment and deep space exploration missions. Research is being conducted on devices and systems for reliable use down to cryogenic temperatures. Some of the commercial-off-the-shelf as well as developed components that are being characterized include switching devices, resistors, magnetics, and capacitors. Semiconductor devices and integrated circuits including digital-to-analog and analog-to-digital converters, DC/DC converters, operational amplifiers, and oscillators are also being investigated for potential use in low temperature applications. An overview of the NASA Glenn Research Center Low Temperature Electronic Program will be presented in this paper. A description of the low temperature test facilities along with selected data obtained through in-house component and circuit testing will also be discussed. Ongoing research activities that are being performed in collaboration with various organizations will also be presented.

Using simulation to train orthopaedic trainees in non-technical skills: A pilot study.

PubMed

Heaton, Samuel R; Little, Zoe; Akhtar, Kash; Ramachandran, Manoj; Lee, Joshua

2016-08-18

To enhance non-technical skills and to analyse participant's experience of a course tailored for orthopaedic surgeons. A Delphi technique was used to develop a course in human factors specific to orthopaedic residents. Twenty-six residents (six per course) participated in total with seven course facilitators all trained in Crisis Resource Management providing structured feedback. Six scenarios recreated challenging real-life situations using high-fidelity mannequins and simulated patients. Environments included a simulated operating suite, clinic room and ward setting. All were undertaken in a purpose built simulation suite utilising actors, mock operating rooms, mock clinical rooms and a high fidelity adult patient simulator organised through a simulation control room. Participants completed a 5-point Likert scale questionnaire (strongly disagree to strongly agree) before and after the course. This assessed their understanding of non-technical skills, scenario validity, relevance to orthopaedic training and predicted impact of the course on future practice. A course evaluation questionnaire was also completed to assess participants' feedback on the value and quality of the course itself. Twenty-six orthopaedic residents participated (24 male, 2 female; post-graduation 5-10 years), mean year of residency program 2.6 out of 6 years required in the United Kingdom. Pre-course questionnaires showed that while the majority of candidates recognised the importance of non-technical (NT) skills in orthopaedic training they demonstrated poor understanding of non-technical skills and their role. This improved significantly after the course (Likert score 3.0-4.2) and the perceived importance of these skills was reported as good or very good in 100%. The course was reported as enjoyable and provided an unthreatening learning environment with the candidates placing particular value on the learning opportunity provided by reflecting on their performance. All agreed that the course achieved its intended aims with realistic simulation scenarios. Participants believed patient care, patient safety and team working would all improve with further human factors training (4.4-4.6). and felt that NT skills learnt through simulation-based training should become an integral component of their training program. Participants demonstrated improved understanding of non-technical performance, recognised its relevance to patient safety and expressed a desire for its integration in training.

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

NASA Technical Reports Server (NTRS)

Kressel, H.; Hawrylo, F. Z.

1976-01-01

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

A Protocol for a Prospective Study of Pregnancy Outcomes of Operating Room Nurses and Nurse Anesthetists Occupationally Exposed to Waste Anesthetic Gases as Compared to Psychiatric Nurses in the United States Air Force.

DTIC Science & Technology

1980-06-01

PROSPECTIVE STUDY OF PREGNANCY’ OUTCOMES OF OPERATING ROOM NURSES AND NURSE ANESTHETISTS OCCUPATIONALLY EXPOSED TO WASTE ANESTHETIC GASES AS COMPARED O TO...tionally Exposed to Waste Anesthetic Gases 6 Pt NFONMING 0 i REP"ORT NUMBER as Cor - p4~~ oP ciar~_Njssi Ruth L. Nancarrow 9 PERFONMtNG OI-GANIZATION...human factors involved in the control of waste anesthetic gases in the operating room; Lt. Colonel Phyllis Goins, Chief, Educa- tional Methodology

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

Optimizing Anesthesia-Related Waste Disposal in the Operating Room: A Brief Report.

PubMed

Hubbard, Richard M; Hayanga, Jeremiah A; Quinlan, Joseph J; Soltez, Anita K; Hayanga, Heather K

2017-10-01

Misappropriation of noncontaminated waste into regulated medical waste (RMW) containers is a source of added expense to health care facilities. The operating room is a significant contributor to RMW waste production. This study sought to determine whether disposing of anesthesia-related waste in standard waste receptacles before patient entry into the operating room would produce a reduction in RMW. A median of 0.35 kg of waste was collected from 51 cases sampled, with a potential annual reduction of 13,800 kg of RMW to the host institution, and a cost savings of $2200.

Determining high touch areas in the operating room with levels of contamination.

PubMed

Link, Terri; Kleiner, Catherine; Mancuso, Mary P; Dziadkowiec, Oliwier; Halverson-Carpenter, Katherine

2016-11-01

The Centers for Disease Control and Prevention put forth the recommendation to clean areas considered high touch more frequently than minimal touch surfaces. The operating room was not included in these recommendations. The purpose of this study was to determine the most frequently touched surfaces in the operating room and their level of contamination. Phase 1 was a descriptive study to identify high touch areas in the operating room. In phase 2, high touch areas determined in phase 1 were cultured to determine if high touch areas observed were also highly contaminated and if they were more contaminated than a low touch surface. The 5 primary high touch surfaces in order were the anesthesia computer mouse, OR bed, nurse computer mouse, OR door, and anesthesia medical cart. Using the OR light as a control, this study demonstrated that a low touch area was less contaminated than the high touch areas with the exception of the OR bed. Based on information and data collected in this study, it is recommended that an enhanced cleaning protocol be established based on the most frequently touched surfaces in the operating room. Copyright © 2016 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

The impact of intra-operative interruptions on surgeons' perceived workload: an observational study in elective general and orthopedic surgery.

PubMed

Weigl, Matthias; Antoniadis, Sophia; Chiapponi, Costanza; Bruns, Christiane; Sevdalis, Nick

2015-01-01

Surgeons' intra-operative workload is critical for effective and safe surgical performance. Detrimental conditions in the operating room (OR) environment may add to perceived workload and jeopardize surgical performance and outcomes. This study aims to evaluate the impact of different intra-operative workflow interruptions on surgeons' capacity to manage their workload safely and efficiently. This was an observational study of intra-operative interruptions and self-rated workload in two surgical specialties (general, orthopedic/trauma surgery). Intra-operative interruptions were assessed via expert observation using a well-validated observation tool. Surgeons, nurses, and anesthesiologists assessed their intra-operative workload directly after case completion based on three items of the validated Surgery Task Load Index (mental demand, situational stress, distraction). A total of 56 elective cases (35 open, 21 laparoscopic) with 94 workload ratings were included. Mean intra-operative duration was 1 h 37 min. Intra-operative interruptions were on average observed 9.78 times per hour. People who entered/exited the OR (30.6 %) as well as telephone-/beeper-related disruptions (23.6 %) occurred most often. Equipment and OR environment-related interruptions were associated with highest interference with team functioning particularly in laparoscopic procedures. After identifying task and procedural influences, partial correlational analyses revealed that case-irrelevant communications were negatively associated with surgeons' mental fatigue and situational stress, whereas surgeons' reported distraction was increased by case-irrelevant communication and procedural disruptions. OR nurses' and anesthesiologists' perceived workload was also related to intra-operative interruption events. Our study documents the unique contribution of different interruptions on surgeons' workload; whereas case-irrelevant communications may be beneficial for mental fatigue and stress in routine cases, procedural interruptions and case-irrelevant communication may contribute to surgeons' mental focus deteriorating. Well-designed OR environments, surgical leadership, and awareness can help to control unnecessary interruptions for effective and safe surgical care.

Concentrations of methoxyflurane and nitrous oxide in veterinary operating rooms

DOE Office of Scientific and Technical Information (OSTI.GOV)

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

1982-02-01

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

Coupling of Head and Body Movement with Motion of the Audible Environment

ERIC Educational Resources Information Center

Stoffregen, Thomas A.; Villard, Sebastien; Kim, ChungGon; Ito, Kiyohide; Bardy, Benoit G.

2009-01-01

The authors asked whether standing posture could be controlled relative to audible oscillation of the environment. Blindfolded sighted adults were exposed to acoustic flow in a moving room, and were asked to move so as to maintain a constant distance between their head and the room. Acoustic flow had direct (source) and indirect (reflected)…

Learner-Environment Fit: University Students in a Computer Room.

ERIC Educational Resources Information Center

Yeaman, Andrew R. J.

The purpose of this study was to apply the theory of person-environment fit in assessing student well-being in a university computer room. Subjects were 12 students enrolled in a computer literacy course. Their learning behavior and well-being were evaluated on the basis of three symptoms of video display terminal stress usually found in the…

Infrared transmission of electronic information via LAN in the operating room.

PubMed

Hagihira, S; Takashina, M; Mori, T; Taenaka, N; Mashimo, T; Yoshiya, I

2000-01-01

Recent advances in technology have brought many kinds of monitoring devices into the operating room (OR). The information gathered by monitors can be channeled to the operating ward information system via a local area network (LAN). Connecting patients to monitors and monitors to the LAN, however, requires a large number of cables. This wiring is generally inconvenient and particularly troublesome if the layout of the OR is rearranged. From this point of view, wireless transmission seems ideally suited to clinical settings. Currently, two modes of wireless connectivity are available: radio-frequency (RF) waves or infrared (IR) waves. Some reports suggest that RF transmission is likely to cause electromagnetic interference (EMI) in medical devices such as cardiac pacemakers or infusion pumps. The risk of malfunctioning life-sustaining devices and the catastrophic consequences this would have on seriously ill patients rules out the use of RF. Here, we report an IR system using IR modems for LAN connectivity in the OR. In this study, we focused on the possible detrimental effects of EMI during wireless connectivity. In our trial, we found no evidence of EMI of IR modems with any of the medical devices we tested. Furthermore, IR modems showed similar performance to a wired system even in an electrically noisy environment. We conclude that IR wireless connectivity can be safely and effectively used in ORs.

[Prevention of adverse effects in latex allergic patients: organizing a latex safe operating theatre].

PubMed

Bonalumi, Sabrina; Barbonaglia, Patrizia; Bertocchi, Carmen

2006-01-01

In 2001 the General Health Direction of Region Lombardia approved (decree n. 22303) a guideline for the prevention of latex allergic reactions in patients and health care workers. This document provides general recommendations in order to standardize behaviors in regional health care facilities. The reason is due to a rise in the incident of reactions to latex products in the last 20 years. Nowadays the prevalence is higher in certain risk groups (subjected to frequent and repeated exposures) rather than the general population. The aim of the project was to organize a latex safe operating theatre in the Ospedale Maggiore Policlinico, Mangiagalli e Regina Elena of Milan (Fondazione) and to standardize behaviors in order to prevent adverse effects in latex allergic patients. Thanks to the literature review and the creation of a multidisciplinar team, we produced a protocol. Therefore, we requested manufacturers the certification of the latex content of their products. Results and conclusion. When latex allergic patients need to undergone surgery in our hospital, a latex safe operating theatre is organized by personnel following a multidisciplinar protocol. No allergic reactions were experienced during surgical procedures after the creation of an environment as free as possible from latex contamination. The project will involve an emergency room, one room or more of a ward and of the outpatients department.

Threat and error management for anesthesiologists: a predictive risk taxonomy

PubMed Central

Ruskin, Keith J.; Stiegler, Marjorie P.; Park, Kellie; Guffey, Patrick; Kurup, Viji; Chidester, Thomas

2015-01-01

Purpose of review Patient care in the operating room is a dynamic interaction that requires cooperation among team members and reliance upon sophisticated technology. Most human factors research in medicine has been focused on analyzing errors and implementing system-wide changes to prevent them from recurring. We describe a set of techniques that has been used successfully by the aviation industry to analyze errors and adverse events and explain how these techniques can be applied to patient care. Recent findings Threat and error management (TEM) describes adverse events in terms of risks or challenges that are present in an operational environment (threats) and the actions of specific personnel that potentiate or exacerbate those threats (errors). TEM is a technique widely used in aviation, and can be adapted for the use in a medical setting to predict high-risk situations and prevent errors in the perioperative period. A threat taxonomy is a novel way of classifying and predicting the hazards that can occur in the operating room. TEM can be used to identify error-producing situations, analyze adverse events, and design training scenarios. Summary TEM offers a multifaceted strategy for identifying hazards, reducing errors, and training physicians. A threat taxonomy may improve analysis of critical events with subsequent development of specific interventions, and may also serve as a framework for training programs in risk mitigation. PMID:24113268

Smart active pilot-in-the-loop systems

NASA Astrophysics Data System (ADS)

Thomas, Segun

1995-04-01

Representation of on-orbit microgravity environment in a 1-g environment is a continuing problem in space engineering analysis, procedures development and crew training. A way of adequately depicting weightlessness in the performance of on-orbit tasks is by a realistic (or real-time) computer based representation that provides the look, touch, and feel of on-orbit operation. This paper describes how a facility, the Systems Engineering Simulator at the Johnson Space Center, is utilizing recent advances in computer processing power and multi- processing capability to intelligently represent all systems, sub-systems and environmental elements associated with space flight operations. It first describes the computer hardware and interconnection between processors; the computer software responsible for task scheduling, health monitoring, sub-system and environment representation; control room and crew station. It then describes, the mathematical models that represent the dynamics of contact between the Mir and the Space Shuttle during the upcoming US and Russian Shuttle/Mir space mission. Results are presented comparing the response of the smart, active pilot-in-the-loop system to non-time critical CRAY model. A final example of how these systems are utilized is given in the development that supported the highly successful Hubble Space Telescope repair mission.

Burner Rig in the Material and Stresses Building

NASA Image and Video Library

1969-11-21

A burner rig heats up a material sample in the Materials and Stresses Building at the National Aeronautics and Space Administration (NASA) Lewis Research Center. Materials technology is an important element in the successful development of advanced airbreathing and rocket propulsion systems. Different types of engines operate in different environments so an array of dependable materials is needed. NASA Lewis began investigating the characteristics of different materials shortly after World War II. In 1949 the materials group was expanded into its own division. The Lewis researchers sought to study and test materials in environments that simulate the environment in which they would operate. The Materials and Stresses Building, built in 1949, contained a number of laboratories to analyze the materials. They are subjected to high temperatures, high stresses, corrosion, irradiation, and hot gasses. The Physics of Solids Laboratory included a cyclotron, cloud chamber, helium cryostat, and metallurgy cave. The Metallographic Laboratory possessed six x-ray diffraction machines, two metalloscopes, and other equipment. The Furnace Room had two large induction machines, a 4500⁰ F graphite furnace, and heat treating equipment. The Powder Laboratory included 60-ton and 3000-ton presses. The Stresses Laboratory included stress rupture machines, fatigue machines, and tensile strength machines.

Mental and behavioral health environments: critical considerations for facility design.

PubMed

Shepley, Mardelle McCuskey; Watson, Angela; Pitts, Francis; Garrity, Anne; Spelman, Elizabeth; Kelkar, Janhawi; Fronsman, Andrea

2016-01-01

The purpose of the study was to identify features in the physical environment that are believed to positively impact staff and patients in psychiatric environments and use these features as the foundation for future research regarding the design of mental and behavioral health facilities. Pursuant to a broad literature review that produced an interview script, researchers conducted 19 interviews of psychiatric staff, facility administrators and architects. Interview data were analyzed using the highly structured qualitative data analysis process authored by Lincoln and Guba (1985). Seventeen topics were addressed ranging from the importance of a deinstitutionalized environment to social interaction and autonomy. The interviewees reinforced the controversy that exists around the implications of a deinstitutionalized environment, when the resulting setting diminishes patient and staff safety. Respondents tended to support open nurse stations vs. enclosed stations. Support for access to nature and the provision of an aesthetic environment was strong. Most interviewees asserted that private rooms were highly desirable because lower room density reduces the institutional character of a unit. However, a few interviewees adamantly opposed private rooms because they considered the increased supervision of one patient by another to be a deterrent to self-harm. The need to address smoking rooms in future research received the least support of all topics. Responses of interviews illustrate current opinion regarding best practice in the design of psychiatric facilities. The findings emphasize the need for more substantive research on appropriate physical environments in mental and behavioral health settings. Copyright © 2016 Elsevier Inc. All rights reserved.

Microbial Load in Septic and Aseptic Procedure Rooms.

PubMed

Harnoss, Julian-Camill; Assadian, Ojan; Diener, Markus Karl; Müller, Thomas; Baguhl, Romy; Dettenkofer, Markus; Scheerer, Lukas; Kohlmann, Thomas; Heidecke, Claus-Dieter; Gessner, Stephan; Büchler, Markus Wolfgang; Kramer, Axel

2017-07-10

Highly effective measures to prevent surgical wound infections have been established over the last two decades. We studied whether the strict separation of septic and aseptic procedure rooms is still necessary. In an exploratory, prospective observational study, the microbial concentration in an operating room without a room ventilating system (RVS) was analyzed during 16 septic and 14 aseptic operations with the aid of an air sampler (50 cm and 1 m from the operative field) and sedimentation plates (1 m from the operative field, and contact culture on the walls). The means and standard deviations of the microbial loads were compared with the aid of GEE models (generalized estimation equations). In the comparison of septic and aseptic operations, no relevant differences were found with respect to the overall microbial concentration in the room air (401.7 ± 176.3 versus 388.2 ± 178.3 CFU/m 3 ; p = 0.692 [CFU, colony-forming units]) or sedimentation 1 m from the operative field (45.3 ± 22.0 versus 48.7 ± 18.5 CFU/m 2 /min; p = 0.603) and on the walls (35.7 ± 43.7 versus 29.0 ± 49.4 CFU/m 2 /min; p = 0.685). The only relevant differences between the microbial spectra associated with the two types of procedure were a small amount of sedimentation of Escherichia coli and Enterococcus faecalis in septic operations, and of staphylococcus aureus and pseudomonas stutzeri in aseptic operations, up to 30 minutes after the end of the procedure. These data do not suggest that septic and aseptic procedure rooms need to be separated. In interpreting the findings, one should recall that the study was not planned as an equivalence or non-inferiority study. Wherever patient safety is concerned, high-level safety concepts should only be demoted to lower levels if new and convincing evidence becomes available.

Hacking the hospital environment: young adults designing youth-friendly hospital rooms together with young people with cancer experiences.

PubMed

Boisen, Kirsten A; Boisen, Anne; Thomsen, Stine Legarth; Matthiesen, Simon Meggers; Hjerming, Maiken; Hertz, Pernille Grarup

2015-12-09

There is a need for youth-friendly hospital environments as the ward environment may affect both patient satisfaction and health outcomes. To involve young people in designing youth-friendly ward environment. We arranged a design competition lasting 42 h (Hackathon). Students in architecture, design, engineering, communication and anthropology participated (27 young adults) - forming eight groups. Adolescents and young adults (AYA) with current or former cancer experience participated as sparring partners. We provided workspace and food during the weekend. The groups presented their products to a jury and relevant stakeholders. The groups created eight unique design concepts. The young designers were extremely flexible listening to ideas and experiences from the young patients, which led to common features including individual and flexible design, privacy in two-bed wardrooms and social contact with other hospitalized AYA. The winning project included an integrated concept for both wardrooms and the AYA day room, including logos and names for the rooms and an 'energy wall' in the day room. A hackathon event was an effective mode of youth participation. The design concepts and ideas were in line with current evidence regarding pleasing hospital environment and youth-friendly inpatient facilities and may be applicable to other young patients.

After-hour Versus Daytime Shifts in Non-Operating Room Anesthesia Environments: National Distribution of Case Volume, Patient Characteristics, and Procedures.

PubMed

Gabriel, Rodney A; Burton, Brittany N; Tsai, Mitchell H; Ehrenfeld, Jesse M; Dutton, Richard P; Urman, Richard D

2017-09-01

The objective of this study was to characterize workload during all hours of the day in the non-operating room anesthesia (NORA) environment and identify what type of patients and procedures were more likely to occur during after-hours. By investigating data from the National Anesthesia Clinical Outcomes Registry, we characterized the total number of ongoing NORA cases per hour of the day (0 - 23 h). Results were presented as the mean hour and standard error (SE). Multivariable logistic regression was applied to assess the association of various patient, procedural, and facility characteristics with time of day (after-hours = 17:01-06:59 local time versus day-time). Included in this analysis, there were a total of 4,948,634 cases performed on non-holiday weekdays. The mean hour for ongoing cases for gastroenterology, cardiac, radiology and "other" were: 10.8 with standard error (SE) of 0.002, 11.5 (SE of 0.005), 11.2 (SE of 0.005), and 10.8 (SE of 0.002), respectively. Pairwise differences between means for each NORA specialty were all statistically significant (p < 0.0001). During after-hour shifts (4.3% of cases), patients with higher American Society of Anesthesiologists physical status classification scores had increased odds for undergoing a NORA procedure, while procedures that were more physiologically complex had decreased odds. With the increasing demand for NORA services, it is prudent that we fully understand the challenges of providing safe and efficient anesthetic services particularly in locations where fewer resources are available.

KENNEDY SPACE CENTER, FLA. - Doors are open on the air-conditioned transportation van that carried NASA’s MESSENGER spacecraft from NASA’s Goddard Space Flight Center in Greenbelt, Md., to the Astrotech Space Operations processing facilities near KSC. After offloading, MESSENGER - short for MErcury Surface, Space ENvironment, GEochemistry and Ranging - will be taken into a high bay clean room and employees of the Johns Hopkins University Applied Physics Laboratory, builders of the spacecraft, will perform an initial state-of-health check. Then processing for launch can begin, including checkout of the power systems, communications systems and control systems. The thermal blankets will also be attached for flight. MESSENGER will be launched May 11 on a six-year mission aboard a Boeing Delta II rocket. Liftoff is targeted for 2:26 a.m. EDT on Tuesday, May 11.

NASA Image and Video Library

2004-03-10

KENNEDY SPACE CENTER, FLA. - Doors are open on the air-conditioned transportation van that carried NASA’s MESSENGER spacecraft from NASA’s Goddard Space Flight Center in Greenbelt, Md., to the Astrotech Space Operations processing facilities near KSC. After offloading, MESSENGER - short for MErcury Surface, Space ENvironment, GEochemistry and Ranging - will be taken into a high bay clean room and employees of the Johns Hopkins University Applied Physics Laboratory, builders of the spacecraft, will perform an initial state-of-health check. Then processing for launch can begin, including checkout of the power systems, communications systems and control systems. The thermal blankets will also be attached for flight. MESSENGER will be launched May 11 on a six-year mission aboard a Boeing Delta II rocket. Liftoff is targeted for 2:26 a.m. EDT on Tuesday, May 11.

Nontechnical skills training for the operating room: A prospective study using simulation and didactic workshop.

PubMed

Pena, Guilherme; Altree, Meryl; Field, John; Sainsbury, David; Babidge, Wendy; Hewett, Peter; Maddern, Guy

2015-07-01

The best surgeons demonstrate skills beyond those required for the performance of technically competent surgery. These skills are described under the term nontechnical skills. Failure in these domains has been associated with adverse events inside the operating room. These nontechnical skills are not learned commonly in a structured manner during surgery training. The main purpose of this study was to explore the effects of participation in simulation-based training, either as a sole strategy or as part of a combined approach on surgeons and surgical trainees nontechnical skills performance in simulation environment. The study consisted of a single-blinded, prospective comparative trial. Forty participants were enrolled, all participating in 2 simulation sessions challenging nontechnical skills comprising 3 surgical scenarios. Seventeen participants attended a 1-day, nontechnical skills workshop between simulation sessions. Scenarios were video-recorded for assessment and debriefing purposes. Assessment was made by 2 observers using the Non-Technical Skills for Surgeons (NOTSS) scoring system. There was a significant improvement in nontechnical skills performance of both groups from the first to the second simulation session, for 2 of the 3 scenarios. No difference in performance between the simulation and the simulation plus workshop groups was noted. This study provides evidence that formal training in nontechnical skills is feasible and can impact positively participants' nontechnical performance in a simulated environment. The addition of a 1-day didactic workshop does not seem to provide additional benefit over simulation-based training as a sole strategy for nontechnical skills training. Copyright © 2015 Elsevier Inc. All rights reserved.

49 CFR 195.446 - Control room management.

Code of Federal Regulations, 2010 CFR

2010-10-01

... written control room management procedures that implement the requirements of this section. The procedures... define the roles and responsibilities of a controller during normal, abnormal, and emergency operating... operator must define each of the following: (1) A controller's authority and responsibility to make...

An indicator device for monitoring of room illuminance level in the radiological image viewing environment.

PubMed

Azlan, C A; Ng, K H; Anandan, S; Nizam, M S

2006-09-01

Illuminance level in the softcopy image viewing room is a very important factor to optimize productivity in radiological diagnosis. In today's radiological environment, the illuminance measurements are normally done during the quality control procedure and performed annually. Although the room is equipped with dimmer switches, radiologists are not able to decide the level of illuminance according to the standards. The aim of this study is to develop a simple real-time illuminance detector system to assist the radiologists in deciding an adequate illuminance level during radiological image viewing. The system indicates illuminance in a very simple visual form by using light emitting diodes. By employing the device in the viewing room, illuminance level can be monitored and adjusted effectively.

Conditioned place preferences in humans using virtual reality.

PubMed

Astur, Robert S; Carew, Andrew W; Deaton, Bonnie E

2014-07-01

To extend a standard paradigm of conditioning in nonhumans to humans, we created a virtual reality (VR) conditioned place preference task, with real-life food rewards. Undergraduates were placed into a VR environment consisting of 2 visually distinct rooms. On Day 1, participants underwent 6 pairing sessions in which they were confined into one of the two rooms and explored the VR environment. Room A was paired with real-life M&Ms for 3 sessions, and Room B was paired with no food for 3 sessions. Day 2 was the test day, administered the next day, and participants were given free access to the entire VR environment for 5min. In experiment 1, participants were food restricted, and we observed that on the test day, participants display a significant conditioned place preference for the VR room previously paired with food (p<0.001). Additionally, they display a significant explicit preference for the M&M-paired room in a forced-choice of "Which room do you like best?". In experiment 2, when participants were not food restricted, there was no evidence of a place preference, either implicitly (e.g. dwell time) or explicitly. Hence, we show that we can reliably establish a place preference in humans, but that the preference is contingent on the participants' hunger state. Future research will examine the extent to which these preferences can be blocked or extinguished as well as whether these preferences are evident using other reinforcers. Copyright © 2014 Elsevier B.V. All rights reserved.

MOEMS deformable mirror testing in cryo for future optical instrumentation

NASA Astrophysics Data System (ADS)

Zamkotsian, Frederic; Lanzoni, Patrick; Barette, Rudy; Grassi, Emmanuel; Vors, Patrick; Helmbrecht, Michael; Marchis, Franck; Teichman, Alex

2017-02-01

MOEMS Deformable Mirrors (DM) are key components for next generation optical instruments implementing innovative adaptive optics systems, in existing telescopes as well as in the future ELTs. Due to the wide variety of applications, these DMs must perform at room temperature as well as in cryogenic and vacuum environment. Ideally, the MOEMS-DMs must be designed to operate in such environment. This is unfortunately usually not the case. We will present some major rules for designing / operating DMs in cryo and vacuum. Next step is to characterize with high accuracy the different DM candidates. We chose to use interferometry for the full characterization of these devices, including surface quality measurement in static and dynamical modes, at ambient and in vacuum/cryo. Thanks to our previous set-up developments, we are placing a compact cryo-vacuum chamber designed for reaching 10-6 mbar and 160K, in front of our custom Michelson interferometer, able to measure performances of the DM at actuator/segment level as well as whole mirror level, with a lateral resolution of 2μm and a sub-nanometric zresolution. Using this interferometric bench, we tested the PTT 111 DM from Iris AO: this unique and robust design uses an array of single crystalline silicon hexagonal mirrors with a pitch of 606μm, able to move in tip, tilt and piston with strokes from 5 to 7μm, and tilt angle in the range of +/- 5mrad. They exhibit typically an open-loop flat surface figure as good as < 20nm rms. A specific mount including electronic and opto-mechanical interfaces has been designed for fitting in the test chamber. Segment deformation, mirror shaping, open-loop operation are tested at room and cryo temperature and results are compared. The device could be operated successfully at 160K. An additional, mainly focus-like, 500 nm deformation is measured at 160K; we were able to recover the best flat in cryo by correcting the focus and local tip-tilts on some segments. Tests on DM with different mirror thicknesses (25μm and 50μm) and different coatings (silver and gold) are currently under way. Finally, the goal of these studies is to test DMs in cryo and vacuum conditions as well as to improve their architecture for staying efficient in harsh environment.

Factors influencing microbial colonies in the air of operating rooms.

PubMed

Fu Shaw, Ling; Chen, Ian Horng; Chen, Chii Shya; Wu, Hui Hsin; Lai, Li Shing; Chen, Yin Yin; Wang, Fu Der

2018-01-02

The operating room (OR) of the hospital is a special unit that requires a relatively clean environment. The microbial concentration of an indoor OR extrinsically influences surgical site infection rates. The aim of this study was to use active sampling methods to assess microbial colony counts in working ORs and to determine the factors affecting air contamination in a tertiary referral medical center. This study was conducted in 28 operating rooms located in a 3000-bed medical center in northern Taiwan. The microbiologic air counts were measured using an impactor air sampler from May to August 2015. Information about the procedure-related operative characteristics and surgical environment (environmental- and personnel-related factors) characteristics was collected. A total of 250 air samples were collected during surgical procedures. The overall mean number of bacterial colonies in the ORs was 78 ± 47 cfu/m 3 . The mean number of colonies was the highest for transplant surgery (123 ± 60 cfu/m 3 ), followed by pediatric surgery (115 ± 30.3 cfu/m 3 ). A total of 25 samples (10%) contained pathogens; Coagulase-negative staphylococcus (n = 12, 4.8%) was the most common pathogen. After controlling for potentially confounding factors by a multiple regression analysis, the surgical stage had the significantly highest correlation with bacterial counts (r = 0.346, p < 0.001). Otherwise, independent factors influencing bacterial counts were the type of surgery (29.85 cfu/m 3 , 95% CI 1.28-58.42, p = 0.041), site of procedure (20.19 cfu/m 3 , 95% CI 8.24-32.14, p = 0.001), number of indoor staff (4.93 cfu/m 3 , 95% CI 1.47-8.38, p = 0.005), surgical staging (36.5 cfu/m 3 , 95% CI 24.76-48.25, p < 0.001), and indoor air temperature (9.4 cfu/m 3 , 95% CI 1.61-17.18, p = 0.018). Under the well-controlled ventilation system, the mean microbial colony counts obtained by active sampling in different working ORs were low. The number of personnel and their activities critically influence the microbe concentration in the air of the OR. We suggest that ORs doing complex surgeries with more surgical personnel present should increase the frequency of air exchanges. A well-controlled ventilation system and infection control procedures related to environmental and surgical procedures are of paramount importance for reducing microbial colonies in the air.

Occupational exposure to nitrous oxide - the role of scavenging and ventilation systems in reducing the exposure level in operating rooms.

PubMed

Krajewski, Wojciech; Kucharska, Malgorzata; Wesolowski, Wiktor; Stetkiewicz, Jan; Wronska-Nofer, Teresa

2007-03-01

The aim of this study was to assess the level of occupational exposure to nitrous oxide (N(2)O) in operating rooms (ORs), as related to different ventilation and scavenging systems used to remove waste anaesthetic gases from the work environment. The monitoring of N(2)O in the air covered 35 ORs in 10 hospitals equipped with different systems for ventilation and anaesthetic scavenging. The examined systems included: natural ventilation with supplementary fresh air provided by a pressure ventilation system (up to 6 air changes/h); pressure and exhaust ventilation systems equipped with ventilation units supplying fresh air to and discharging contaminated air outside the working area (more than 10 air changes/h); complete air-conditioning system with laminar air flow (more than 15 air changes/h). The measurements were carried out during surgical procedures (general anaesthesia induced intravenously and maintained with inhaled N(2)O and sevofluran delivered through cuffed endotracheal tubes) with connected or disconnected air scavenging. Air was collected from the breathing zone of operating personnel continuously through the whole time of anaesthesia to Tedlar((R)) bags, and N(2)O concentrations in air samples were analyzed by adsorption gas chromatography/mass spectrometry. N(2)O levels in excess of the occupational exposure limit (OEL) value of 180mg/m(3) were registered in all ORs equipped with ventilation systems alone. The OEL value was exceeded several times in rooms with natural ventilation plus supplementary pressure ventilations and twice or less in those with pressure/exhaust ventilation systems or air conditioning. N(2)O levels below or within the OEL value were observed in rooms where the system of air conditioning or pressure/exhaust ventilation was combined with scavenging systems. Systems combining natural/pressure ventilation with scavenging were inadequate to maintain N(2)O concentration below the OEL value. Air conditioning and an efficient pressure/exhaust ventilation (above 12 air exchanges/h) together with efficient active scavenging systems are sufficient to sustain N(2)O exposure in ORs at levels below or within the OEL value of 180mg/m(3).

[Environmental hygiene of the surgery suites for the control of surgical wound infection: Italian legislation and international guidelines].

PubMed

Charrier, L; Castella, A; Di Legami, V; Pastorino, F; Farina, E C; Argentero, P A; Zotti, C M

2006-01-01

Aim of the study is to describe the application of surgical site infection (SSI) control procedures in general surgery operating rooms of Piedmont region hospitals. A specific data collection form was designed to record information. 54 questionnaires were compiled. Piedmont legislation related to operating rooms' equipment is obeyed in more than 90% of hospitals. Nevertheless, there are some critical aspects than could be risk factors for SSI or that are not useful in order to prevent them: use of UV radiation (11.3%), use of tacky mats at the entrance of the operating room (5.7%), special cleaning of operating rooms after contaminated or dirty operations (73.6%) and routine environmental sampling (10%) that is strongly recommended by ISPESL guideline in disagreement with international recommendations. Steam autoclave is used for surgical instruments sterilization by 100% of hospitals, but only 50% of them performs an annual validation of both autoclave performance and sterilization procedures. The study gave useful information in order to promote some structural modifications and personnel education for efficacious SSI prevention and control.

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

PubMed

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

2016-12-01

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

Engine Research Building’s Central Control Room

NASA Image and Video Library

1948-07-21

Operators in the Engine Research Building’s Central Control Room at the National Advisory Committee for Aeronautics (NACA) Lewis Flight Propulsion Laboratory. The massive 4.25-acre Engine Research Building contains dozens of test cells, test stands, and altitude chambers. A powerful collection of compressors and exhausters located in the central portion of the basement provided process air and exhaust for these test areas. This system is connected to similar process air systems in the laboratory’s other large test facilities. The Central Control Room coordinates this activity and communicates with the local utilities. This photograph was taken just after a major upgrade to the control room in 1948. The panels on the wall contain rudimentary floor plans of the different Engine Research Building sections with indicator lights and instrumentation for each test cell. The process air equipment included 12 exhausters, four compressors, a refrigeration system, cooling water, and an exhaust system. The operators in the control room kept in contact with engineers running the process air system and those conducting the tests in the test cells. The operators also coordinated with the local power companies to make sure enough electricity was available to operate the powerful compressors and exhausters.

Conceptual Inquiry of the Space Shuttle and International Space Station GNC Flight Controllers

NASA Technical Reports Server (NTRS)

Kranzusch, Kara

2007-01-01

The concept of Mission Control was envisioned by Christopher Columbus Kraft in the 1960's. Instructed to figure out how to operate human space flight safely, Kraft envisioned a room of sub-system experts troubleshooting problems and supporting nominal flight activities under the guidance of one Flight Director who is responsible for the success of the mission. To facilitate clear communication, MCC communicates with the crew through a Capsule Communicator (CAPCOM) who is an astronaut themselves. Gemini 4 was the first mission to be supported by such a MCC and successfully completed the first American EVA. The MCC seen on television is called the Flight Control Room (FCR, pronounced ficker) or otherwise known as the front room. While this room is the most visible aspect, it is a very small component of the entire control center. The Shuttle FCR is known as the White FCR (WFCR) and Station's as FCR-1. (FCR-1 was actually the first FCR built at JSC which was used through the Gemini, Apollo and Shuttle programs until the WFCR was completed in 1992. Afterwards FCR-1 was refurbished first for the Life Sciences Center and then for the ISS in 2006.) Along with supporting the Flight Director, each FCR operator is also the supervisor for usually two or three support personnel in a back room called the Multi-Purpose Support Room (MPSR, pronounced mipser). MPSR operators are more deeply focused on their specific subsystems and have the responsible to analyze patterns, and diagnose and assess consequences of faults. The White MPSR (WMPSR) operators are always present for Shuttle operations; however, ISS FCR controllers only have support from their Blue MPSR (BMPSR) while the Shuttle is docked and during critical operations. Since ISS operates 24-7, the FCR team reduces to a much smaller Gemini team of 4-5 operators for night and weekend shifts when the crew is off-duty. The FCR is also supported by the Mission Evaluation Room (MER) which is a collection of contractor engineers who provide analysis and long-term troubleshooting support. Each MER operator is an expert in a very small portion of a sub-system and each FCR console usually interfaces with several MER positions.

Utility of Recycled Bedding for Laboratory Rodents

PubMed Central

Miyamoto, Toru; Li, Zhixia; Kibushi, Tomomi; Okano, Shinya; Yamasaki, Nakamichi; Kasai, Noriyuki

2009-01-01

Animal facilities generate a large amount of used bedding containing excrement as medical waste. We developed a recycling system for used bedding that involves soft hydrothermal processing. In this study, we examined the effects of bedding type on growth, hematologic and serum biochemical values, and organ weights of female and male mice reared on either recycled or fresh bedding from 3 to 33 wk of age. Neither growth nor physiology differed between mice housed on recycled bedding compared with fresh bedding. When 14-wk-old mice were bred, litter size and total number of weaned pups showed no significant differences between animals raised on recycled or fresh bedding. Because bedding type influences the environment within cages and animal rooms, we evaluated particulate and ammonia data from cages and animal rooms. Values were significantly lower from cages and rooms that used recycled bedding than from those using fresh bedding, thus indicating that recycled bedding has the potential to improve the environment within both cages and animal rooms. Overall, this study revealed that recycled bedding is an excellent material for use in housing laboratory rodents. Specifically, recycled bedding may reduce medical waste and maintain healthy environments within cages and animal rooms. PMID:19653951

Differential responses of individuals with late-stage dementia to two novel environments: a multimedia room and an interior garden.

PubMed

Goto, Seiko; Kamal, Naveed; Puzio, Helene; Kobylarz, Fred; Herrup, Karl

2014-01-01

The purpose of this study was to determine the responses of individuals with advanced dementia to two novel sensory environments in a nursing home facility. The first was a multisensory Snoezelen room; the second was a temporary Japanese garden. Subjects viewed each environment twice a week for 15 minutes during the study. Stress was measured using heart rate and informant-based behavioral changes. By these criteria, the garden-viewing group showed positive behavioral changes while the responses of the subjects in the Snoezelen group were more negative. The response of the subjects' pulse rate was most dramatic. During the 15 minutes in the garden, the average rate (all subjects/all visits) was significantly less than in their residential room. In the Snoezelen room, we detected little or no change. The impact of the garden could also be seen in the negative behavioral signs elicited upon returning the subjects to the garden room after the installation had been replaced with plants and furniture arranged with no formal design. We propose that exposure to a small interior Japanese garden could be an effective intervention for individuals suffering from late stage Alzheimer's disease.

Working conditions in the engine department - A qualitative study among engine room personnel on board Swedish merchant ships.

PubMed

Lundh, Monica; Lützhöft, Margareta; Rydstedt, Leif; Dahlman, Joakim

2011-01-01

The specific problems associated with the work on board within the merchant fleet are well known and have over the years been a topic of discussion. The work conditions in the engine room (ER) are demanding due to, e.g. the thermal climate, noise and awkward working postures. The work in the engine control room (ECR) has over recent years undergone major changes, mainly due to the introduction of computers on board. In order to capture the impact these changes had implied, and also to investigate how the work situation has developed, a total of 20 engine officers and engine ratings were interviewed. The interviews were semi-structured and Grounded Theory was used for the data analysis. The aim of the present study was to describe how the engine crew perceive their work situation and working environment on board. Further, the aim was to identify areas for improvements which the engine crew consider especially important for a safe and effective work environment. The result of the study shows that the design of the ECR and ER is crucial for how different tasks are performed. Design which does not support operational procedures and how tasks are performed risk inducing inappropriate behaviour as the crew members' are compelled to find alternative ways to perform their tasks in order to get the job done. These types of behaviour can induce an increased risk of exposure to hazardous substances and the engine crew members becoming injured. Copyright © 2010 Elsevier Ltd and The Ergonomics Society. All rights reserved.

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. Copyright © 2015 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

Housing and testing in mixed-sex rooms increases motivation and accuracy during operant testing in both male and female mice.

PubMed

Lloyd, Kelsey R; Yaghoubi, Sarah K; Makinson, Ryan A; McKee, Sarah E; Reyes, Teresa M

2018-04-01

Operant behavior tasks are widely used in neuroscience research, but little is known about how variables such as housing and testing conditions affect rodent operant performance. We have previously observed differences in operant performance in male and female mice depending on whether mice were housed and tested in rooms containing only one sex versus rooms containing both sexes. Here, male and female mice in either single-sex or mixed sex housing rooms were trained on fixed ratio 1 (FR1) and progressive ratio (PR) tasks. For both sexes, animals in the mixed sex room had more accurate performance in FR1 and were more motivated in the PR task. We then moved the single sex housed animals to the mixed sex room and vice versa. Animals that started in mixed sex housing had no change to PR, but both sexes who started in single sex housing were more motivated after the switch. Additionally, the females that moved into single-sex housing performed less accurately in FR1. We conclude that housing and testing conditions can affect performance on FR1 and PR tasks. As these tasks are commonly used as training steps to more complex tasks, housing and testing conditions should be carefully considered during experiment design and reported in publications. Copyright © 2018 Elsevier Inc. All rights reserved.

Auger compositional depth profiling of the metal contact-TlBr interface

NASA Astrophysics Data System (ADS)

Nelson, A. J.; Swanberg, E. L.; Voss, L. F.; Graff, R. T.; Conway, A. M.; Nikolic, R. J.; Payne, S. A.; Kim, H.; Cirignano, L.; Shah, K.

2015-08-01

Degradation of room temperature operation of TlBr radiation detectors with time is thought to be due to electromigration of Tl and Br vacancies within the crystal as well as the metal contacts migrating into the TlBr crystal itself due to electrochemical reactions at the metal/TlBr interface. Scanning Auger electron spectroscopy (AES) in combination with sputter depth profiling was used to investigate the metal contact surface/interfacial structure on TlBr devices. Device-grade TlBr was polished and subjected to a 32% HCl etch to remove surface damage and create a TlBr1-xClx surface layer prior to metal contact deposition. Auger compositional depth profiling results reveal non-equilibrium interfacial diffusion after device operation in both air and N2 at ambient temperature. These results improve our understanding of contact/device degradation versus operating environment for further enhancing radiation detector performance.

Electronics for Deep Space Cryogenic Applications

NASA Technical Reports Server (NTRS)

Patterson, R. L.; Hammond, A.; Dickman, J. E.; Gerber, S. S.; Elbuluk, M. E.; Overton, E.

2002-01-01

Deep space probes and planetary exploration missions require electrical power management and control systems that are capable of efficient and reliable operation in very cold temperature environments. Typically, in deep space probes, heating elements are used to keep the spacecraft electronics near room temperature. The utilization of power electronics designed for and operated at low temperature will contribute to increasing efficiency and improving reliability of space power systems. At NASA Glenn Research Center, commercial-off-the-shelf devices as well as developed components are being investigated for potential use at low temperatures. These devices include semiconductor switching devices, magnetics, and capacitors. Integrated circuits such as digital-to-analog and analog-to-digital converters, DC/DC converters, operational amplifiers, and oscillators are also being evaluated. In this paper, results will be presented for selected analog-to-digital converters, oscillators, DC/DC converters, and pulse width modulation (PWM) controllers.

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.

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

PubMed Central

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

2013-01-01

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

Field evaluation and health assessment of air cleaners in removing radon decay products in domestic environments

DOE Office of Scientific and Technical Information (OSTI.GOV)

Li, Chih-Shan.

In this study, field evaluations of two types of air cleaners were conducted in three single-family houses. The measurements included radon concentration, particle number concentration, and concentration and size distribution of radon decay products. The influence on the behavior of radon decay products by various indoor particles both with and without the air cleaning systems was investigated. A room model was used to calculate the changes in the aerosol parameters caused by the operation of the air cleaners. Using the James dosimetric models (1989 and 1990), the changes in the hourly bronchial dose rate per Bq m{sup {minus}3} radon formore » men, women, and children can be estimated for various domestic environments. 94 refs., 60 figs., 28 tabs.« less

Montessori All Day, All Year

ERIC Educational Resources Information Center

Black, Connie; Davis, Liza

2015-01-01

Introducing real community into the Children's House goes back to the roots of Montessori education through all-day Montessori. The all-day environment is a house where children live with a "developmental room" of Montessori materials including a living room, kitchen, dining area, bedroom, bathroom, greeting rooms, and outdoor spaces.…

A novel interactive educational system in the operating room--the IE system.

PubMed

Nakayama, Takayuki; Numao, Noboru; Yoshida, Soichiro; Ishioka, Junichiro; Matsuoka, Yoh; Saito, Kazutaka; Fujii, Yasuhisa; Kihara, Kazunori

2016-02-02

The shortage of surgeon is one of the serious problems in Japan. To solve the problem, various efforts have been undertaken to improve surgical education and training. However, appropriate teaching methods in the operating room have not been well established. The aim of this study is to assess the utility of a novel interactive educational (IE) system for surgical education on urologic surgeries in the operating room. A total of 20 Japanese medical students were educated on urologic surgery using the IE system in the operating room. The IE system consists of two parts. The first is three-dimensional (3D) magnified vision of the operative field using a 3D head-mounted display and a 3D endoscope. The second is interactive educative communication between medical students and surgeons using a small-sized wireless communication device. The satisfaction level with the IE system and the physical burden on medical students was examined via questionnaire. All students utilized the IE system in urologic surgery and responded to the survey. Most students were satisfied with the IE system. They also felt more welcomed by the surgeon when using the IE system than when not using it. No major unpleasant symptoms were observed but five students (25 %) experienced mild eye fatigue as a result of viewing the medical images. The IE system has the potential to motivate students to become interested in surgery and could be an efficient method of surgical education in the operating room.

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 cleaned...

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 cleaned...

Clean room technology in surgery suites

NASA Technical Reports Server (NTRS)

1971-01-01

The principles of clean room technology and the criteria for their application to surgery are discussed. The basic types of surgical clean rooms are presented along with their advantages and disadvantages. Topics discussed include: microbiology of surgery suites; principles of laminar airflow systems, and their use in surgery; and asepsis and the operating room.

A Harsh Environment Wireless Pressure Sensing Solution Utilizing High Temperature Electronics

PubMed Central

Yang, Jie

2013-01-01

Pressure measurement under harsh environments, especially at high temperatures, is of great interest to many industries. The applicability of current pressure sensing technologies in extreme environments is limited by the embedded electronics which cannot survive beyond 300 °C ambient temperature as of today. In this paper, a pressure signal processing and wireless transmission module based on the cutting-edge Silicon Carbide (SiC) devices is designed and developed, for a commercial piezoresistive MEMS pressure sensor from Kulite Semiconductor Products, Inc. Equipped with this advanced high-temperature SiC electronics, not only the sensor head, but the entire pressure sensor suite is capable of operating at 450 °C. The addition of wireless functionality also makes the pressure sensor more flexible in harsh environments by eliminating the costly and fragile cable connections. The proposed approach was verified through prototype fabrication and high temperature bench testing from room temperature up to 450 °C. This novel high-temperature pressure sensing technology can be applied in real-time health monitoring of many systems involving harsh environments, such as military and commercial turbine engines. PMID:23447006

A harsh environment wireless pressure sensing solution utilizing high temperature electronics.

PubMed

Yang, Jie

2013-02-27

Pressure measurement under harsh environments, especially at high temperatures, is of great interest to many industries. The applicability of current pressure sensing technologies in extreme environments is limited by the embedded electronics which cannot survive beyond 300 °C ambient temperature as of today. In this paper, a pressure signal processing and wireless transmission module based on the cutting-edge Silicon Carbide (SiC) devices is designed and developed, for a commercial piezoresistive MEMS pressure sensor from Kulite Semiconductor Products, Inc. Equipped with this advanced high-temperature SiC electronics, not only the sensor head, but the entire pressure sensor suite is capable of operating at 450 °C. The addition of wireless functionality also makes the pressure sensor more flexible in harsh environments by eliminating the costly and fragile cable connections. The proposed approach was verified through prototype fabrication and high temperature bench testing from room temperature up to 450 °C. This novel high-temperature pressure sensing technology can be applied in real-time health monitoring of many systems involving harsh environments, such as military and commercial turbine engines.

Surgical team turnover and operative time: An evaluation of operating room efficiency during pulmonary resection.

PubMed

Azzi, Alain Joe; Shah, Karan; Seely, Andrew; Villeneuve, James Patrick; Sundaresan, Sudhir R; Shamji, Farid M; Maziak, Donna E; Gilbert, Sebastien

2016-05-01

Health care resources are costly and should be used judiciously and efficiently. Predicting the duration of surgical procedures is key to optimizing operating room resources. Our objective was to identify factors influencing operative time, particularly surgical team turnover. We performed a single-institution, retrospective review of lobectomy operations. Univariate and multivariate analyses were performed to evaluate the impact of different factors on surgical time (skin-to-skin) and total procedure time. Staff turnover within the nursing component of the surgical team was defined as the number of instances any nurse had to leave the operating room over the total number of nurses involved in the operation. A total of 235 lobectomies were performed by 5 surgeons, most commonly for lung cancer (95%). On multivariate analysis, percent forced expiratory volume in 1 second, surgical approach, and lesion size had a significant effect on surgical time. Nursing turnover was associated with a significant increase in surgical time (53.7 minutes; 95% confidence interval, 6.4-101; P = .026) and total procedure time (83.2 minutes; 95% confidence interval, 30.1-136.2; P = .002). Active management of surgical team turnover may be an opportunity to improve operating room efficiency when the surgical team is engaged in a major pulmonary resection. Copyright © 2016 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

Looking east along the operating deck above the intake toward ...

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

Looking east along the operating deck above the intake toward the Main Control Room. An evaporative-cooling system is to the left of the Control Room, and a motor-operated, geared trolly hoist and rake for removing debris from the trash rack is in the foreground - Wellton-Mohawk Irrigation System, Pumping Plant No. 1, Bounded by Gila River & Union Pacific Railroad, Wellton, Yuma County, AZ

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

PubMed

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

2008-03-01

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

Determinants, associations, and psychometric properties of resident assessments of anesthesiologist operating room supervision.

PubMed

Hindman, Bradley J; Dexter, Franklin; Kreiter, Clarence D; Wachtel, Ruth E

2013-06-01

A study by de Oliveira Filho et al. reported a validated set of 9 questions by which Brazilian anesthesia residents assessed faculty supervision in the operating room. The aim of this study was to use this question set to determine whether faculty operating room supervision scores were associated with residents' year of clinical anesthesia training and/or number of specific resident-faculty interactions. We also characterized associations between faculty operating room supervision scores and resident assessments of: (1) faculty supervision in settings other than operating rooms, (2) faculty clinical ability (family choice), and (3) faculty teaching effectiveness. Finally, we characterized the psychometric properties of the de Oliveira Filho etal. question set in an United States anesthesia residency program. All 39 residents in the Department of Anesthesia of the University of Iowa in their first (n = 14), second (n = 13), or third (n = 12) year of clinical anesthesia training evaluated the supervision provided by all anesthesia faculty who staffed in at least 1 of 3 clinical settings (operating room [n = 49], surgical intensive care unit [n = 10], pain clinic [n = 6]). For all resident-faculty pairs, departmental billing data were used to quantitate the number of resident-faculty interactions and the interval between the last interaction and the assessment. A generalizability study was performed to determine the minimum number of resident evaluations needed for high reliability and dependability. There were no significant associations between faculty mean operating room supervision scores and: (1) resident-faculty patient encounters (Kendall τb = 0.01; 95% confidence interval [CI], -0.02 to +0.04; P = 0.71), (2) resident-faculty days of interaction (τb = -0.01; 95% CI, -0.05 to +0.02; P = 0.46), and (3) days since last resident-faculty interaction (τb = 0.01; 95% CI, -0.02 to 0.05; P = 0.49). Supervision scores for the operating room and surgical intensive care unit were highly correlated (τb = 0.71; 95% CI, 0.63 to 0.78; P < 0.0001). Supervision scores for the operating room also were highly correlated with family choice scores (τb = 0.77; 95% CI, 0.70 to 0.84; P < 0.0001) and teaching scores (τb = 0.87; 95% CI, 0.82 to 0.92; P < 0.0001). High reliability and dependability (both G- and ϕ-coefficients > 0.80) occurred when individual faculty anesthesiologists received assessments from 15 or more different residents. Supervision scores provided by all residents can be given equal weight when calculating an individual faculty anesthesiologist's mean supervision score. Assessments of supervision, teaching, and quality of clinical care are highly correlated. When the de Oliveira Filho et al. question set is used in a United States anesthesia residency program, supervision scores are highly reliable and dependable when at least 15 residents assess each faculty.