Medical equipment is implemented in highly complex hospital environments, such as operating rooms, in hospitals around the world. In operating rooms (ORs), technological equipment is used for surgical activities and activities in support of surgeries. The implementation of government policies in hospitals has resulted in varying implementation activities for (medical) equipment. These result in varying lead times and success rates. An integral and holistic protocol for implementation does not yet exist. In this study, we introduce a protocol for the implementation of (medical) equipment in ORs that consists of implementation factors and implementation activities. Factors and activities are based on data from a systematic literature review and an explorative survey among surgical support staff on factors for the successful implementation of technological and (medical) equipment in ORs. The protocol consists of five factors and related implementation activities: the establishment of a project plan, organisational preparation, technological preparation, maintenance, and training.
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Thermal comfort in operating theatres is a less addressed research component of the in-door environment in operating theatres. The air quality naturally gets most attention when considering the risk of surgical site infections. However, the importance of thermal comfort must not be underestimated. In this research, the current thermal comfort situation of staff members is investigated. Results show that the thermal comfort for the members of a surgical team is perceived as not optimal. Application of the PMV and DR models needs further attention when applied for operating theatres. For the investigated ventilation systems, the differences in thermal comfort outcomes are small.
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Implementing new information systems and devices, in high-reliability organizations such as operating rooms (OR’s) in hospitals, is complex. To improve the success and efficiency of these implementations we constructed a protocol for implementation for digitization and devices in OR’s. This protocol consists of implementation factors, implementation activities, and implementation instructions. In this study, we evaluated this protocol. To gather data, we organized three focus group sessions with participants holding different job roles at different departments: a surgeon, a methodologist, anesthesiologists, a scrub nurse, a training officer, innovations officers, and OR-management. We gathered qualitative data regarding completeness, clearness, and the ability to execute. Sessions were video-recorded, transcribed, and coded in Nvivo for Windows according to Toulmins Argumentative Pattern. Based on this analysis, revisions to factors, activities, and instructions are presented for protocol enhancement; experts confirm that an implementation protocol is needed to increase implementation efficiency and adoption of new devices.
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Digitization of activities in hospitals receives more attention, due to Covid-19 related regulations. The use of e-health to support patient care is increasing and efficient ways to implement digitization of processes and other technological equipment are needed. We constructed a protocol for implementation and in this study, we evaluate this protocol based on a case to implement a device in the OR. We used various data sources to evaluate this protocol: semi-structured interviews, questionnaires, and project documents. Based on these findings, this protocol, including identified implementation activities and implementation instructions can be used for implementations of other devices. Implementation activities include setting up a project plan, organizational and technological preparation, maintenance, and training. In future research, these activities and instructions need to be evaluated in more complex projects and a flexible tool needs to be developed to select relevant activities and instructions for implementations of information systems or devices.
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from the Article: "Operating rooms (ORs) more and more evolve into high-tech environments with increasing pressure on finances, logistics, and a not be neglected impact on patient safety. Safe and cost-effective implementation of technological equipment in ORs is notoriously difficult to manage, specifically as generic implementation activities omit as hospitals have implemented local policies for implementations of technological equipment. )e purpose of this study is to identify success factors for effective implementations of new technologies and technological equipment in ORs, based on a systematic literature review. We accessed ten databases and reviewed included articles. )e search resulted in 1592 titles for review, and finally 37 articles were included in this review. We distinguish influencing factors and resulting factors based on the outcomes of this research. Six main categories of influencing factors on successful implementations of medical equipment in ORs were identified: “processes and activities,” “staff,” “communication,” “project management,” “technology,” and “training.” We identified a seventh category “performance” referring to resulting factors during implementations. We argue that aligning the identified influencing factors during implementation impacts the success, adaptation, and safe use of new technological equipment in the OR and thus the outcome of an implementation. The identified categories in literature are considered to be a baseline, to identify factors as elements of a generic holistic implementation model or protocol for new technological equipment in ORs."
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In de Solution Rooms bespreken studenten, docenten, beleidsmakers en onderzoekers uitdagingen en oplossingsrichtingen voor het vervolgonderwijs van de toekomst. Eén van de thema's is 'Duurzaamheid', waar Rolien Blanken een wetenschappelijke reflectie over schreef. Twee problemen zijn geïdentificeerd bij doorvoeren van duurzaamheid binnen de instelling en het onderwijs: de complexiteit van het vraagstuk enerzijds en draagvlak en effecten op de studenten anderzijds. Dit bemoeilijkt het duurzaamheidsproces. Inzetten op het gebruik maken van meetinstrumenten voor verduurzaming van curricula, transdisciplinair- en sectoroverstijgend werken en duurzaam burgerschap als uitgangspunt voor studentontwikkeling kunnen helpen om tot een succesvolle verduurzaming te komen. Aandacht voor duurzaamheid in het onderwijs kent een hoge mate van urgentie. De student ervaart hierbij negatieve invloed op het welzijn. Tegelijkertijd is verduurzaming een complex proces. Het doorvoeren van regeneratief onderwijs kan helpen bij het aangaan van genoemde uitdagingen. Naast het meten van de duurzaamheid van het curriculum is aan te bevelen breder in de organisatie duurzaamheid te meten en door te voeren. Het werken met integrated reporting kan hierin bijdragen. Transdisciplinair en sectoroverstijgend werken is een goede oplossing om duurzaamheidstransities te bereiken. Dit kan men toepassen door te werken in labs. In deze omgevingen zijn diverse stakeholders betrokken en kan de student zijn rol als wereldburger hier in co-creatie vervullen.
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A local operating theater ventilation device to specifically ventilate the wound area has been developed and investigated. The ventilation device is combined with a blanket which lies over the patient during the operation. Two configurations were studied: Configuration 1 where HEPA-filtered air was supplied around and parallel to the wound area and Configuration 2 where HEPA-filtered air was supplied from the top surface of the blanket, perpendicular to the wound area. A similar approach is investigated in parallel for an instrument table. The objective of the study was to verify the effectiveness of the local device. Prototype solutions developed were studied experimentally (laboratory) and numerically (CFD) in a simplified setup, followed by experimental assessment in a full scale mock-up. Isothermal as well as non-isothermal conditions were analyzed. Particle concentrations obtained in proposed solutions were compared to the concentration without local ventilation. The analysis procedure followed current national guidelines for the assessment of operating theater ventilation systems, which focus on small particles (<10 mm). The results show that the local system can provide better air quality conditions near the wound area compared to a theoretical mixing situation (proof-of-principle). It cannot yet replace the standard unidirectional downflow systems as found for ultraclean operating theater conditions. It does, however, show potential for application in temporary and emergency operating theaters
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A substantial amount of studies have addressed the influence of sound on human performance. In many of these, however, the large acoustic differences between experimental conditions prevent a direct translation of the results to realistic effects of room acoustic interventions. This review identifies those studies which can be, in principle, translated to (changes in) room acoustic parameters and adds to the knowledge about the influence of the indoor sound environment on people. The review procedure is based on the effect room acoustics can have on the relevant quantifiers of the sound environment in a room or space. 272 papers containing empirical findings on the influence of sound or noise on some measure of human performance were found. Of these, only 12 papers complied with this review's criteria. A conceptual framework is suggested based on the analysis of results, positioning the role of room acoustics in the influence of sound on task performance. Furthermore, valuable insights are pre- sented that can be used in future studies on this topic. Whi le the influence of the sound environment on performance is clearly an issue in many situations, evidence regarding the effectiveness of strategies to control the sound environment by room acoustic design is lacking and should be a focus area in future studies.
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From the article: "A facile approach for the fabrication of large-scale interdigitated nanogap electrodes (nanogap IDEs) with a controllable gap was demonstrated with conventional micro-fabrication technology to develop chemocapacitors for gas sensing applications. In this work, interdigitated nanogap electrodes (nanogap IDEs) with gaps from 50–250 nm have been designed and processed at full wafer-scale. These nanogap IDEs were then coated with poly(4-vinyl phenol) as a sensitive layer to form gas sensors for acetone detection at low concentrations. These acetone sensors showed excellent sensing performance with a dynamic range from 1000 ppm to 10 ppm of acetone at room temperature and the observed results are compared with conventional interdigitated microelectrodes according to our previous work. Sensitivity and reproducibility of devices are discussed in detail. Our approach of fabrication of nanogap IDEs together with a simple coating method to apply the sensing layer opens up possibilities to create various nanogap devices in a cost-effective manner for gas sensing applications"
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The inefficiency of maintaining static and long-lasting safety zones in environments where actual risks are limited is likely to increase in the coming decades, as autonomous systems become more common and human workers fewer in numbers. Nevertheless, an uncompromising approach to safety remains paramount, requiring the introduction of novel methods that are simultaneously more flexible and capable of delivering the same level of protection against potentially hazardous situations. We present such a method to create dynamic safety zones, the boundaries of which can be redrawn in real-time, taking into account explicit positioning data when available and using conservative extrapolation from last known location when information is missing or unreliable. Simulation and statistical methods were used to investigate performance gains compared to static safety zones. The use of a more advanced probabilistic framework to further improve flexibility is also discussed, although its implementation would not offer the same level of protection and is currently not recommended.
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